Serdar Oruc

Neutrophil-to-lymphocyte ratio as a novel-potential marker for predicting prognosis of Bell palsy.

Bell palsy can be defined as an idiopathic, acute, facial nerve palsy. Although the pathogenesis of Bell palsy is not fully understood, inflammation seems to play important role. Neutrophil‐to‐lymphocyte (NLR) ratio was defined as a novel potential marker to determine inflammation and it is routinely measured in peripheral blood. Our goal was to investigate the relationship between Bell palsy and inflammation by using NLR.

The antioxidant and antiapoptotic effects of crocin pretreatment on global cerebral ischemia reperfusion injury induced by four vessels occlusion in rats

AIMS Cerebral ischemia reperfusion (IR) injury is a process in which oxidative and apoptotic mechanisms play a part. Neuroprotective agents to be found could work out well for the efficient and safe minimization of cerebral IR injury. Crocin is a strong antioxidant agent; however the influence of this agent on the experimental cerebral ischemia model has not been studied extensively and thus it is not well-known. The objective of our study was to investigate the antioxidant, antiapoptotic and protective effects of crocin on the global cerebral IR induced by four-vessel occlusion. MAIN METHODS A total of 30 adult female Sprague-Dawley rats were equally and randomly separated into three groups as follows: sham, IR and IR+crocin (40mg/kg/day orally for 10days). 24h after electrocauterization of bilateral vertebral arteries, bilateral common carotid arteries were occluded for 30min and reperfused for 30min. Oxidative stress parameters (TAS, TOS, OSI), haematoxylin and eosin staining, caspase-3 and hypoxia-inducible factor-1 alpha (HIF-1α) expressions and TUNEL methods were investigated. KEY FINDINGS There was a significant difference between the IR and sham groups by means of OSI level, histopathological scoring, caspase-3, HIF-1α and TUNEL-positive cell parameters. We have also observed that pre-treatment with crocin reduced these parameter levels back to the baseline. SIGNIFICANCE The data obtained from the present study suggest that crocin may exert antiapoptotic, antioxidant and protective effects in IR-mediated brain injury induced by four-vessel occlusion. To the best of our knowledge, this would be the first study to be conducted in this field.

Nerve enlargement after cold exposure: A pilot study with ultrasound imaging

Introduction: Changes of electrophysiogical parameters with regard to cold have been studied intensively but not the morphology of nerves. We explored the effects of cold exposure on median nerve morphology. Methods: Cross‐sectional area (CSA) and depth of the right median nerve were assessed at the carpal tunnel and mid‐forearm levels before and after 15 min ice‐pack application in 34 healthy volunteers. Results: After cooling, mean CSA measurements increased at the carpal tunnel and mid‐forearm levels (from 8.00 to 8.85 and 6.64 to 7.55, respectively, P < 0.05); however, the depth values were similar. Conclusions: These preliminary results revealed that cold exposure may cause acute nerve swelling. Further studies with larger samples will be necessary to confirm our findings, to correlate them with electrophysiological data, and to explore when/how the nerve edema resolves. Muscle Nerve 49:502–505, 2014

An evaluation of neuropsychiatric symptoms in Parkinson's disease patients

Objective: We aimed to examine neuropsychiatric symptoms of patients with early and advanced stage Parkinsons disease (PD). Materials and Methods: The study was performed at Kocatepe University Neurology Department in Turkey, comprised 46 PD patients and 46 controls. Hoehn-Yahr (HY) scale was used to evaluate the clinical stages of PD and Unified Parkinsons Disease Rating Scale (UPDRS) was used to evaluate the severity of clinical signs. Cognitive functions were evaluated by Mini-Mental State Examination (MMSE) and neuropsychiatric findings were evaluated by Beck Depression Inventory (BDI), Scale for the Assessment of Positive Symptoms (SAPS), and Scale for the Assessment of Negative Symptoms (SANS). Results: Significant difference was determined between BDI values of patients (13.28 ± 9.04) and control group (9.71 ± 5.19) (P = 0.02). Significant difference was determined with SANS (23.84 ± 15.42, 2.58 ± 3.13, P < 0.001) but not with SAPS (1.36 ± 4.16, 0.15 ± 0.43, P = 0.07). The patients were evaluated according to the HY stages and there was no significant difference between mild and severe symptom groups in respect of BDI, SAPS, and SANS values (P = 0.91, P = 0.31, and P = 0.29). According to gender, no significant difference was found between groups in respect of BDI, SAPS, and SANS values (P = 0.60, P = 0.54, and P = 0.67). No correlation was found between BDI, SAPS, SANS values, and HY stages. Conclusion: Higher rates of depression and negative symptoms were observed in patients with PD compared with healthy individuals. Results did not differ with different stages of PD. Therefore, it should be kept in mind that neuropsychiatric symptoms can be seen from the early stages of the disease and should be treated earlier.

FPL tendon thickness, tremor and hand functions in Parkinson’s disease

Abstract Introduction In Parkinson’s disease (PD), a resting tremor of the thumb may affect the flexor pollicis longus (FPL) and influence hand functions. We investigated the relationship between FPL tendon thickness and hand function in PD patients and compared these characteristics with those in healthy controls. Methods The hand grip and pinch strengths were measured. The participants completed the Duruöz hand index, the Sollerman’s hand function test, and the Nine Hole Peg Test. The thickness of the FPL tendon was measured using ultrasonography Results The FPL tendon was thicker in PD patients but was not associated with tremor severity. In PD patients, despite functional performance of the hands are impaired and grip strength is decreased, pinch strengths are preserved. FPL thickness was not correlated with grip and pinch strengths. Conclusion The thicker FPL tendon may be associated with greater pinch and grip strengths and manual dexterity in healthy individuals. The presence of tremor is associated with a thicker FPL tendon.

Assessment of Pineal Gland Volume and Calcification in Healthy Subjects: Is it Related to Aging?

Purpose: The human pineal gland is a small neuroendocrine organ which produces melatonin. The main goal of this study was to provide a reference range for pineal volume in all age groups and to determine calcified and noncalcified tissue and their proportions, which may be a reflection of melatonin production in all age groups, by using very thin computerized tomography (CT) slices. Materials and methods: A total of 167 outpatients had undergone cranial CT. Each of the subject’s total pineal volume (TPV), calcified pineal volume (CPV) and noncalcified pineal volume (NPV) according to age groups were calculated in cubic millimeters. Also, proportion of calcification (POC) was noted. Results: The median values were 88.5 mm3 (12.3 mm3–411mm3) for TPV, 74.3 mm3 (12.3 mm3–298 mm3) for NPV, and 3.9 mm3 (0 mm3–141 mm3) for CPV. POC showed a gradual increase from 0–49 years. In the ≥70 group, when compared with the 60–69 age group, CPV and POC values were significantly lower (P: 0.036, P: 0.034, respectively). Conclusion: This study brings a radiological point of view to the distribution of pineal calcification according to age that has a link with melatonin secretion.

Babinski-Nageotte Syndrome Diagnosed in Postpartum Period

Babinski-Nageotte Syndrome (BNS) is one of the brainstem syndromes characterized by muscle weakness in the opposite half of the body with classic Wallenberg findings. According to our literature survey, only a few cases have been reported and none of them was in the postpartum period. We report a case of a typical BNS in a postpartum woman with an ischemic lesion in the medulla oblongata shown on magnetic resonance imaging.

The effect of zolmitriptan on cardiac autonomic modulation in patients with migraine: A double-blind, placebo-controlled, crossover study

BACKGROUND Triptans, which activate 5-hydroxytryptamine (5-HT)-1B/1D receptors in cerebral arteries, are very effective in aborting attacks of migraine. Although activation of 5-HT-1B/1D receptors diminishes the secretion of noradrenaline from cardiac sympathetic nerves, some studies report that they may cause chest discomfort, myocardial infarction and arrhythmias due to coronary vasospasm. The effect of zolmitriptan on cardiac autonomic modulation has not been evaluated in migraineurs. SUBJECTS AND METHODS Ten patients with migraine (nine women, mean age 33 ± 4 years) were crossover randomized to 2.5 mg zolmitriptan or identical placebo at least 5 days apart. Both time domain parameters (the mean R-R interval, the standard deviation of RR interval [SDNN], and the root mean square of successive R-R interval differences) and frequency domain parameters (low frequency [LF], high frequency [HF], and LF/HF ratio) of heart rate variability (HRV) were obtained during supine position, controlled respiration and handgrip exercise before and 2 h after zolmitriptan or placebo administration. RESULTS Baseline HRV parameters were similar for each occasion. Single dose zolmitriptan administration did not affect both time and frequency domain HRV parameters compared with the placebo. CONCLUSIONS A single dose, 2.5 mg oral zolmitriptan administration did not change sympathetic and parasympathetic reactivity and sympathovagal balance in migraineurs.

Cognitive Profile of Inpatients

Amac: Bilissel bozulma hastalarin hastanede yatis surelerini olumsuz etkilemektedir. Hastalarin bilissel ozelliklerinin onceden taninmasi, tedavi ba- sarisini etkiler. Biz hastanemizde yatan hastalarin kognitif profillerini ortaya koymak istedik. Gerec ve Yontemler: 1-15 Şubat 2009 tarihleri arasinda hastanemizde yatan 50 yas ve uzeri 106 hasta bilissel acidan degerlendirildi. Koopere olamayacak kadar bilinc kaybi olanlar ve primer kognitif bozukluk nedeniyle hastanede yatan hastalar calismaya dahil edilmedi. Ilk degerlendirmede bilissel yikim tespit edilen hastalar demans polikliniginde tekrar degerlendirilerek hastalarin kognitif profilleri saptandi. Kognitif yikim olan ve olmayan gruplar demografik ozellikleri acisindan karsilastirildi. Bulgular: Yuz alti hastanin 57’si (%53.7) MMSE’den 24 ve alti puan aldi. 106 hastanin 30’unda (%28.3) kognitif bozukluk oldugu saptandi. Bunlarin 22’si (%20.8) hafif kognitif bozukluk, 8’i (%7.5) ise primer demans sendromu idi. Kognitif yikim olan ve olmayan gruplar incelendiginde; cinsiyet ve soygecmis acisindan fark saptanmadi (p=0.48 ve p=0.58). Kognitif yikim olan grubun yas ortalamasi daha yuksek ve egitim duzeyi daha dusuktu (p=0.008 ve p=0.006). Gruplarin MMSE puanlari sirasiyla 18.7±2.3 ve 25.5±2.2 idi (p < 0.001). Ilginc olarak unutkanlik yakinmasi, demans bulunmayan grupta daha fazlaydi (%33 ve %67). Ankete katilan hastalarin %71’i unutkanligin hastalik olmadigina ve tedavi edilemeyecegine inaniyordu. Sonuc: Yatarak tedavi goren hastalarda kognitif yetmezlik daha sik gorulmektedir. Hastanin bakimindan sorumlu yakinlari ve saglik personeli bu yetmezligin farkinda degildir.

Kronik Gerilim Tipi Basagrısının Proflaktik Tedavisinde Amitriptilin ile Venlafaksinin Karsılastırılması

Bilimsel Zemin: Kronik gerilim tipi basagrisi tedavisinde kullanilan Trisiklik antidepresanlarin istenme— yen yan etkileri, bu ilaclarin kullanimlarini sinirlamaktadir. Selektif serotonin-noradrenalin geri alim inhibitoru olan Venlafaksin degisik tipteki kronik agrilarda kullanilan ve yan etkileri gorece daha az olan bir ilactir. Amac: Bu calismada kronik gerilim tipi basagrilarinin prosaktik tedavisinde Venlafaksin ve Amitriptilin’in et— kinlikleri karsilastirilmistir. Gerec ve Yontem: Prospektif olarak yapilan bu calismaya 41 hasta alindi. 20 hasta Amitriptilin, 21 hasta Venlafaksin kullandi. Hamilton Depresyon skalasiyla depresyon tanisi dislanan hastalarin tedavi oncesi aylik agri sikligi, agri suresi ve agri siddeti kaydedildi. Hastalar 3 ay boyunca ayda bir kez kontrole cagrilarak tedavi sirasindaki degisimler ve yan etkiler belirlendi. Bulgular: Calisma tamamlandiginda Amitriptilin grubunda ortalama ilac dozu 25751847 mg/gun, Venlafaksin grubunda 101.62i33.9 mg/gun olarak saptandi. Her iki tedavi grubunda 3. ay sonunda baslangic degerlerine gore bas agrisinin siklik, siddet ve surelerinde istatistiksel 01a— rak cok anlamli azalma saptandi (p:0.000). %50’nin uzerinde iyilesme temel alindiginda agri sikligi, suresi ve siddeti Amitriptilin grubunda sirasiyla %100. %95 ve %25, Venlafaksin grubunda %95, %90 ve %20 hastada azalma gosterdi. Yan etki profilinde ise Venlafaksin’in Amitriptilin’e gore daha guvenilir oldugu goruldu. Sonuc: Bu calisma Venlafaksin’in kronik gerilim tipi basagrisi tedavisinde dusuk yan etki profili ve etkin agri kontrolu ile iyi bir alternatif ilac oldugunu gostermektedir