Semih Alay

A Sledgehammer on the Brachial Plexus: Thoracic Outlet Syndrome, Subclavius Posticus Muscle, and Traction in Aggregate

Reported here is a 30-year-old man who was seen because of pain and weakness in the upper extremities after a tractional injury. Physical examination revealed significant atrophy in the left deltoid and right intrinsic hand muscles, generalized hypoesthesia, decreased deep tendon reflexes bilaterally, and decreased strength in various muscle groups. Roos (right) and hyperabduction (bilateral) tests were positive. Electrodiagnostic studies were consistent with bilateral brachial plexopathy. Cervical radiographs showed long transverse process of C7 on the right side and a small rudimentary rib articulating with C7 on the left side. Brachial plexus magnetic resonance imaging demonstrated an aberrant muscle and compressive brachial plexus injury on the left side. Surgery via transaxillary approach was performed on the left side. The occurrence of traumatic brachial plexopathy in the presence of underlying thoracic outlet syndrome and subclavius posticus muscle is discussed for the first time in the literature.

Is Further Examination Necessary in Patients with Behçet's Disease Without Any Neurological Signs or Symptoms? -

Background and Purpose: A mean percentage of 5% was reported for neurological involvement in researches related to Behcets disease. The neurological involvement may be characterized by headache, neuropsychiatric symptoms, brain stem involvement, cerebral venous thrombosis or peripheral nervous system involvement. Sometimes neurological involvement may be seen without any neurological sign or symptom. In our study, we aimed to evaluate the cognitive, psychiatric and neurophysiological responses in Behcets disease without neurological sign and symptom. Methods: The study was performed on patients with Behcets disease without neurological signs and symptoms and healthy volunteers that would make the control group. The patients were assessed with Mini Mental State Examination, Hamilton Rating Scale for Depression, nerve conduction study and visually evoked potential. Results: A total of 27 male patients (age: 24.88±5.45 years) were enrolled in the study. Neurological examinations of all the patients were normal. Mean Mini Mental State Examination score of the patients was 29.62±0.79 (2 patients had loss of focus, 2 patients had disturbance in the copying function) and 2 patients had mild depression in Hamilton Rating Scale for Depression. In the nerve conduction study, 2 patients had right sensory-motor carpal tunnel syndrome, 1 patient had right sensory-motor carpal tunnel syndrome - bilateral ulnar nerve entrapment. In the visually evoked potential examination, 8 patients had prolonged P100 latency, decreased amplitude and disturbance of wave morphology. Conclusion: Visually evoked potential examination may be used as a conductive method to detect the subclinical neurological pathologies in Behcets disease. The possible silent neurological involvement should be evaluated with further neuro-screening methods.

Preservative solution for skeletal muscle biopsy samples

Context : Muscle biopsy samples must be frozen with liquid nitrogen immediately after excision and maintained at -80 o C until analysis. Because of this requirement for tissue processing, patients with neuromuscular diseases often have to travel to centers with on-site muscle pathology laboratories for muscle biopsy sample excision to ensure that samples are properly preserved. Aim: Here, we developed a preservative solution and examined its protectiveness on striated muscle tissues for a minimum of the length of time that would be required to reach a specific muscle pathology laboratory. Materials and Methods: A preservative solution called Kurt-Ozcan (KO) solution was prepared. Eight healthy Sprague-Dawley rats were sacrificed; striated muscle tissue samples were collected and divided into six different groups. Muscle tissue samples were separated into groups for morphological, enzyme histochemical, molecular, and biochemical analysis. Statistical method used: Chi-square and Kruskal Wallis tests. Results: Samples kept in the KO and University of Wisconsin (UW) solutions exhibited very good morphological scores at 3, 6, and 18 hours, but artificial changes were observed at 24 hours. Similar findings were observed for the evaluated enzyme activities. There were no differences between the control group and the samples kept in the KO or UW solution at 3, 6, and 18 hours for morphological, enzyme histochemical, and biochemical features. The messenger ribonucleic acid (mRNA) of β-actin gene was protected up to 6 hours in the KO and UW solutions. Conclusion: The KO solution protects the morphological, enzyme histochemical, and biochemical features of striated muscle tissue of healthy rats for 18 hours and preserves the mRNA for 6 hours.

Third molar tooth in the etiology of cluster type headache: A case report

WCN 2013 No: 2468 Topic: 8 — Headache Third molar tooth in the etiology of cluster type headache: A case report M. Yucel, O.M. Akgun, H. Akgun, S. Alay, E. Yasinoglu, Z. Odabasi, S. Demirkaya. Department of Neurology, Kasimpasa Military Hospital, Istanbul, Turkey; Department of Pediatric Dentistry, Gulhane Military Medical Academy, Turkey; Department of Neurology, Etimesgut Military Hospital, Turkey; Department of Neurology, Gulhane Military Medical Academy, Ankara, Turkey; Department of Dentistry, Kasimpasa Military Hospital,