Mehmet Güney Şenol

Albumin, hemoglobin, body mass index, cognitive and functional performance in elderly persons living in nursing homes

The aim of this study is to produce the relation between cognitive and functional performance and some biochemical parameters in elderly population. So, we searched for the correlation between the activities of daily living (ADL), mini-mental state examination (MMSE) and body weight, age, hemoglobin, albumin, serum sodium level of 180 elderly people in five nursing homes. Face-to-face interviews and questionnaires were applied to evaluate ADL. To evaluate the cognitive function we used the MMSE. The average age of 180 people contacted was 71.5+/-5.1 (+/-S.D.), ranging 65-91 years; 112 of them were women (62.2%), 68 were men (37.8%). Of these elderly people, 25% had no medically diagnosed illnesses, whereas 17 of them (9.4%) were bedridden. There was a positive correlation between ADL and hemoglobin, albumin, body weight, cognitive function parameters and a negative one with age and serum sodium. There was a positive correlation between cognitive functions and hemoglobin, body weight, ADL and a negative one with serum sodium. Hemoglobin concentrations indicating anemia were observed in 30% of subjects, 3.9% of them had hyponatremia and 26.7% displayed a hypernatremia. There was a positive correlation between cognitive and physical function scores and hemoglobin, albumin levels in elderly patients. These results suggest that restoration of hemoglobin and albumin levels could improve cognitive and physical functional status in the elderly population.

The effect of obstructive sleep apnea on olfactory functions.

The aim of this study was to investigate the effect of obstructive sleep apnea (OSA) on the parameters of olfactory functions (odor threshold, odor discrimination, and odor identification tests) for orthonasal olfaction, retronasal olfactory testing, and olfactory bulb (OB) volumes.

Serum asymmetric dimethylarginine levels in diabetic patients with neuropathy

OBJECTIVE The goal of our study was to evaluate the role of asymmetric dimethylarginine (ADMA) in patients with diabetic neuropathy. MATERIALS AND METHODS In this study, 58 diabetic patients and 26 healthy volunteers were included. In both groups ADMA measurements were performed together with other biochemical examinations. Nerve conduction studies and Neuropathy Symptom Score (NSS) were administered to the diabetic patients. RESULTS ADMA levels were found significantly higher in diabetic patients compared to the control group (p = 0.0001). However, ADMA levels were not statistically significant between diabetic patients with neuropathy and without neuropathy (p = 0.86 and p = 0.47). CONCLUSION These results demonstrate that there is not any significant relationship between ADMA and diabetic neuropathy.

Role of anti-GQ1B antibody in differential diagnosis of acute ophthalmoparesis

Miller Fisher syndrome (MFS) is a triad of total external ophthalmoplegia, ataxia, and areflexia, while botulism has the usual clinical presentation of involvement of cranial muscles and palsies with blurred vision, diplopia, ptosis, dilated pupils, and facial paralysis, caused by a bacterial neurotoxin which attacks proteins involved in presynaptic vesicle release. In this report, we needed to make the differential diagnosis between MFS and botulism in a patient who presented with acute ophthalmoparesis and a history of diarrhea three days before, which started two days after consuming tinned food. Routine laboratory, neurophysiologic, and imaging investigations were normal. A clinical diagnosis of Miller Fisher syndrome was reached by anti-ganglioside GQ1B and GM1 Ig G and M antibody investigations which proved positive. The patient was treated with intravenous immunoglobulin two weeks after (in the late period) the symptoms started and he has recovered completely. Systemic autoimmune diseases should be considered in patients with bilateral ophthalmoparesis. As in the present patient, the evaluation of specific antibodies helps in the diagnosis and thus early effective treatment is possible.

Plasma apelin levels in diabetic patients with and without neuropathy

The aim of this study was to investigate the plasma apelin levels in diabetic patients with and without neuropathy. All consecutive diabetic patients who presented for routine follow-up at our outpatient clinic were invited to participate in this clinical study. Forty diabetic patients (20 female and 20 male) and twenty-two non-diabetic control subjects (9 female and 13 male) were included in the study. Neurological evaluations in diabetic subjects were done by nerve conduction studies and evaluated with the Neuropathy Symptom Score. Fasting plasma glucose, HbA1c, lipid and apelin levels were measured in each subject. The mean plasma apelin level was significantly higher in the diabetic patients than in the control subjects (p = 0.026). Apelin levels were statistically similar between diabetic patients with and without neuropathy (p = 0.43). Further, plasma apelin levels were found to be higher in diabetic patients with neuropathy when compared with those of healthy control subjects (p = 0.02). In diabetic patients with neuropathy, plasma apelin levels correlated significantly with diabetes duration (r = 0.5, p = 0.02). We propose that apelin levels in diabetic patients are higher in the presence of neuropathy and longer disease duration, although this might not solely suffice as an indicator for the presence of neuropathy in diabetic patients. Drawing attention to the possible association between the apelinergic system and diabetes mellitus, we believe that further studies with larger samples should be carried out also to investigate the presence of retinopathy and nephropathy.

Migren hastalarında atak olmayan dönemde koku tanımlama testi ile koku fonksiyonunun değerlendirilmesi

Objective: Despite the fact that there are many studies about the osmo- phobia and migraine, we have very little knowledge about the olfactory abilities of migraineurs during the period between the attacks. So, the aim of this study was to evaluate the olfactory function of migraineurs during the period without headaches with odor identification test. Methods: Two hundred and ninety healthy people aged 16 to 65 years (152 female, 138 male) and 84 migraine patients aged 18 to 55 years (47 female, 37 male) were studied. The participants with migraine were selected from the patients who applied to headache outpatient clinic for assessment. Participants, appropriate to the study, were physically and neurologically examined in detail and then they were taken to the test room in order to be screened with Short Smell Test Battery of GATA Haydarpafla (GULTEST). Results: The mean GULTEST score of the migraine group was less than the healthy group and the difference was significant. The effect of gender, cigarette smoking and disease status (migraine) on GULTEST scores was evaluated by linear regression model. It was found that females had higher odor identification scores than males in both migraineurs and controls. On the other hand, cigarette smoking had a significant negative effect on GULTEST scores. Furthermore, migraine had a significant negative effect on GULTEST scores. Conclusion: Our study showed that even during the headache-free peri- od, migraineurs might have reduced olfactory abilities.

A Rare Case of Neurocysticercosis with an Isolated Central Nervous System Involvement in Turkey

Neurocysticercosis (NCC) is frequently seen in Latin America, South East Asia and Africa, it is rare in Western Europe and Muslim countries. This case report is found to be valuable for presentation due to isolated CNS involvement of NCC, high cystic lesion load and resistance to the antihelmintic agents. NCC is rare in Muslim countries, it should be considered in differential diagnosis of the patients with cystic lesions in CNS.

Segmental vitiligo in a patient with thoracic outlet syndrome

Reported here is a 35-year-old man with findings of thoracic outlet syndrome and bilateral segmental vitiligo on C8–T1 dermatomes. The possible causal relationship between the two disorders under the common denominator of cervical sympathetic involvement is discussed for the first time in the literature.

P187 Comparison of the effects of the antiepileptic drugs on peripheral nerve conduction

Purpose: There are mostly difficulties in the study of femoral sensory nerve transmission due to muscle artefacts. Moreover, as of today no orthodromic study related to anterior femoral cutaneous nerve (ACFN femoral intermediate cutaneous branch) has been made. In our study, saphenous nerve (SN) which was defined before, infrapatellar nerve (IPBSN) and the newly-defined orthodromic ACFN nerve transmissions have been examined. Method: The present study was undertaken in 50 normal, healthy control subjects. The IPBSN was stimulated medially with a surface electrode 1-2 cm below the patella. SN was stimulated in the side of index medial after saphenous vein. ACFN was conformed from almost 6 cm above the patella. The response was recorded with a needle electrode located close to the nerve 1cm lateral to the femoral artery in the inguinal region. Results: Sensory nerve action potentials were obtained. IPBSN: Mean latency of the first positive peak was found to be 8.1±0.9 ms and; conduction velocity was 54.1±4.4 m/s and response amplitude was 1.3±1.1 μV. SN: Mean latency of the first positive peak was found to be 7.1±0.8 ms and; conduction velocity was 59.2±4.8 m/s and response amplitude was 2.8±1.5 μV.ACFN: Mean latency of the first positive peak was found to be 4.1±1.0 ms and; conduction velocity was 57.4±5.2 m/s and response amplitude was 3.7±2.3 μV. Conclusion: The mostly-common case in the femoral and around the knee is the post traumatic injury. So,femoral sensory nerve transmissions become more important. In our study, the method used is both invasive anc usable in the selected cases.

MO44 Pudendal evoked potentials in adults before and after circumcision

Purpose: The electromyographic properties of the cremaster muscle are different from other skeletal muscles. Its motor units show excessive spontaneous decharges, and the motor unit firing frequency of the muscle during maximal voluntary effort resembles that observed in myopathic diseases of striated muscles. Methods: In this study, cremaster muscles of six adult cadavers and six orchioectomy specimens were used to reveal the detailed histology of the muscle and provide an anatomophysiological explanation for these unusual electromyographic properties. Histochemical stains (haematoxylin-eosin and Gomori’s stain) revealed the cremaster was composed of several distinct bundles of smooth and striated muscle fibers within collagen fibers and other of connective tissue components, together with distinct blood vessels and peripheral nerves. For visualization of axons, presynaptic nerve terminals and motor end-plates, Bielschowsky silver staining technique, anti-neurofilament and anti-synaptophysin immunostaining were performed. Multifocal motor end-plates of “en grappe’ type were observed as as a series of small dots or lines running along the muscle fibers. Results: Myosin (fast, slow) immunostaining showed the cremaster is a slow-twich muscle, and α-actin smooth muscle immunostaining confirmed the presence of a large number of smooth muscle fibers. Haematoxylineosin and Nissl stains and anti-neurofilament immunostaining showed small multipolar neurons forming plexuses and anti-glial fibrillary acidic protein immunostaining confirmed the presence of glial cells similar to astrocytes. Conclusion: The findings of this detailed anatomical study showed the cremaster muscle widely known as a striated muscle contains a large number of smooth muscle fibers, and the excessive electromyographic decharges are due to the presence of multifocal motor end-plates.