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Öğe Alterations in thyroid hormones in brain-dead patients are related to non-thyroidal illness syndrome(Via Medica, 2018) Akbaş, Türkay; Şahin, İbrahim Ethem; Öztürk, AyhanIntroduction: Alterations in thyroid hormone levels occur in patients with acute neurological disease states. The aim of this study is to study changes in thyroid hormones in patients with brain death (BD). Material and methods: Eleven brain-dead patients were studied prospectively. Thyroid hormones were measured on admission to the intensive care unit, the day before BD diagnosis (BD before), and the day after BD diagnosis (BD day). Results: Thyroid stimulating hormone (TSH) and free triiodothyronine (fT3) concentrations were found to be significantly low on admission, BD before, and BD day compared to age-matched healthy controls. TSH levels were shown to be increasing on BD day. Free thyroxine (fT4) levels were within normal limits in all cases except in one case having low fT4 levels with normal TSH levels. No statistically significant changes were encountered between admission thyroid hormone levels and BD-before and BD-day thyroid hormone levels. Six patients were on steroid therapy when BD-before blood samples were drawn, and no difference in thyroid hormone levels was encountered between steroid users and non-users. Correlation analysis showed a positive correlation between GCS and TSH, but a negative association between fT3 and APACHE II. Conclusion: We have shown that patients with BD have altered thyroid hormones days before BD diagnosis, and these alterations continue until the diagnosis of BD. The changes in thyroid hormones are compatible with non-thyroidal illness syndrome.Öğe Antenatal and delivery risk factors and prevalence of cerebral palsy in Duzce (Turkey)(Elsevier Science Bv, 2007) Öztürk, Ayhan; Demirci, Fuat; Yavuz, Taner; Yıldız, S.; Değirmenci, Yıldız; Döşoğlu, M.; Avşar, Y.This cross-sectional study aimed at investigating the prevalence and the etiological factors of cerebral palsy (CP) and comparing them with normal population within the rural and urban areas of Duzce province. Of the 102 children with cerebral palsy, 98 were associated with antenatal and delivery risk factors. The mean crude prevalence of cerebral palsy was 1.1 per 1000 live births. The children with CP were compared with 530 control subjects. The mothers of the children with cerebral palsy were significantly younger than the mothers of children in control group, and they had less parity and abortion. Preeclampsia, premature rupture of membranes, home births, prolonged labor, and twin pregnancies were significantly more common in the mothers of children with cerebral palsy, where no significant differences were found between the groups in terms of breech delivery, rate of cesarean births, gestational diabetes, and hemorrhage in late pregnancy. Birth asphyxia, liqueur with meconim stained, prolonged jaundice and neonatal seizure were also significantly more common in the group with cerebral palsy. Of the children with cerebral palsy, 78% were born at term, 20% were born with gestational ages of 32-36 weeks, 2% were born with gestational ages of 30-31 weeks. Nine percent of those children had a birth weight of >= 3000 g, 12.2% had a birth weight of 2500-2999 g, 33.7% had a birth weight of 1500-2499 g, and 5.1% had a birth weight of <= 1500 g. The causes of low prevalence of cerebral palsy were due to insufficient neonatal care, resulting in low survival in preterm and low birth weight children, and poor postnatal care of children with cerebral palsy. (c) 2006 Elsevier B.V. All rights reserved.Öğe A Case of Psychogenic Movement Disorder Mimicking Acute Cerebellar Syndrome(Yerkure Tanitim & Yayincilik Hizmetleri A S, 2016) Değirmenci, Yıldız; Öztürk, AyhanPsychogenic movement disorders (PMDs) are involuntary movements of various kinds without any underlying organic etiology. They can occur as tremor, spasm, dystonia, parkinsonism or myoclonus. A detailed history and neurological examination is essential to differentiate these disorders from organic neurological etiologies. Since PMDs are challenging entities in clinical practice, we presented this case of psychogenic tremor and gait disorder mimicking acute cerebellar syndrome in order to emphasize the importance of diagnostic clinical clues of PMDs in the differentiation of organic diseases, and to give accurate treatment.Öğe Comparison of peripheral nerve repair using ethylcyanoacrylate and conventional suture technique in a rat sciatic nerve injury model(2020) Atam, Camettin; Orhan, Zafer; Toplu, Gaye; Serin, Merdan; Karaduman, Zekeriya Okan; Öztürk, AyhanObjective: The aim of this study was to compare the outcomes of primary nerve repair using either ethyl-cyanoacrylate orconventional microsuture technique in a rat peripheral nerve injury model.Methods: In this study, a total of 30 Wistar Albino rats weighing between 220 and 275 g were used. The rats were randomlydivided into three groups (10 in each), including one control (group 1) and two experimental groups (group 2, conventionalmicrosuture repair; group 3, cyanoacrylate repair). In each group, the sciatic nerve was identified and transected. No furtherintervention was performed in group 1. The nerve was repaired using the epineural technique with a 10/0 atraumaticnylon in group 2 and synthetic cyanoacrylate adhesive in group 3. At the fifth postoperative week, needle electromyography(EMG) was performed to measure distal latency, combined muscle action potential (CMAP), and motor nerve conductionvelocity (MNCV). Following the EMG recordings, animals were euthanized. Nerve samples were collected to evaluate vacuolardegeneration, fibrosis, and foreign body reaction histopathologically.Results: In the EMG analysis, mean distal latency was significantly shorter in group 1 (0.85±0.09 ms) than in groups 2(1.17±0.25 ms) (p=0.0052) and 3 (1.14±0.14 ms) (p=0.0026) while no significant differences existed between groups 2 and3 (p>0.9999). The mean CMAP was greater in group 1 (10.5±0.35 mV) than in groups 2 (2.86±1.28 mV) (p=0.011) and 3(2.16±1.34 mV) (p=0.0002), but there was no significant difference between groups 2 and 3 (p>0.9999). The mean MNCVwas 53.5±5.95, 39.62±7.31, and 39.84±4.73 mm/sec in groups 1, 2, and 3, respectively. There was a significant differencebetween groups 1 and 2 (p=0.0052) and between 1 and 3 (p=0.0026), but not between 2 and 3 (p>0.9999). In the histopathologicalevaluation, the mean vacuolar degeneration score was 0, 2.12, and 1.88 in groups 1, 2, and 3, respectively. No obviousdifference was observed between groups 2 and 3 (p=0.743). The mean fibrosis score was 0, 1.62, and 1.77 in groups 1, 2,and 3, respectively. There was no significant difference between groups 2 and 3 (p=0.888). The mean foreign body reactionscore was 0, 2.5, and 2.44 in groups 1, 2, and 3, respectively. No difference was present between groups 2 and 3 (p=0.743).Conclusion: Primary nerve repair using the cyanoacrylate adhesive may provide similar electrophysiological and histopathologicalresults as compared to the conventional microsuture repair.Öğe Frequency of migraine in patients with allergic rhinitis(Professional Medical Publications, 2013) Öztürk, Ayhan; Değirmenci, Yıldız; Tokmak, Burcu; Tokmak, AbdurrahmanObjectives: Allergic rhinitis (AR) is an IgE mediated disease which is released by activation of mast cells and basophils, and often leads to sinus headache. Histamine which is the key mediator in the pathogenesis of AR, also plays an important role in the pathogenesis of migraine with nitric oxide (NO). Aim of our study was to investigate the frequency of migraine in patients with AR. Methodology: Headache assessment and neurological examination was performed on patients diagnosed as AR in the outpatient ear nose and throat clinic with age-matched controls. Participants with headache were classified according to the International Headache Society criteria, and migraine frequency was investigated in the patients with AR and control groups. Results: Migraine headache was detected in 50% of the patients with AR. Among these, 95% were migraine without aura, and 5% were migraine with aura. Migraine frequency in the control group was 18.75% in the control group, and all was migraine without aura. Migraine frequency in the patients with AR was four times higher when compared with the control group. Conclusion: While a histamine and IgE associated common mechanism is responsible in the pathogenesis of AR and migraine, not only sinus headache but also migraine headache should be kept in mind. Headache assessment of the patients with AR, and in case of headache existence, referral of these patients to neurology outpatient clinics for differential diagnosis and, to maintain appropriate therapy should not be forgotten.Öğe Intestinal parasitic infection in children in post-disaster situations years after earthquake(Wiley-Blackwell, 2004) Öztürk, Cihadiye Elif; Şahin, İdris; Yavuz, Taner; Öztürk, Ayhan; Akgünoğlu, Mustafa; Kaya, DemetBackround: Two earthquakes in the north-west region of Turkey destroyed 80% of the houses and schools in Duzce in 1999. This study was conducted to determine the parasitic infection rate associated with the post-earthquake unhealty living conditions and related epidemiological risk factors. Methods: Two populations living and studying in different socioeconomic conditions as a result of the earthquake were compared: Group 1 (study group) consisted of 326 children living and studying in transitory houses and classes. Group 2 (control) consisted of 127 children living in normal houses and studying in normal school classes. Fecal samples were obtained from both groups and examined for intestinal parasites' eggs and trofozoid forms. In addition, selotype procedure was applied to both populations. Epidemiological data determining the socioeconornic status of the populations were collected by questionnaire. Results: In group 1, Giardia lamblia (G. lamblia) cysts were observed in 10.4% of the fecal samples and Enterobius vermicularis (E. vermicularis) eggs were observed in 13.5% of selotype samples. In group 2, Giardia cysts were observed in 3.1% of the samples and E. vermicularis eggs were observed in 5.5% of selotype samples. The rate of Giardiasis and Enterobiasis was found to be significantly higher in children still living and studying in temporary houses and schools years after the earthquakes (P < 0.05). The following pidemiological and social factors arising after the earthquakes were associated with increased rate of G. lamblia and E. Vermicularis infections: number of communal toilets per child at school, socioeconomic level of the children, dimensions of the classrooms where the children are studying and living and frequency of hand-washing at school. These parameters are significantly different between the groups (P < 0.05). Conclusion: Giardiasis should be considered as an emerging disease in postdisaster situations and adequate prevention measures should be implemented in these circumstances. It should also be known that the rate of Enterobiasis is increased in populations living in crowded unhealthy conditions.Öğe Management of spontaneous intraparenchymatous hemorrhage: Retrospective analysis of 19 cases treated conservatively or surgery(Düzce Üniversitesi, 2005) İş, Merih; Can, Aytaç; Öztürk, Ayhan; Atakay, Selçuk; Gezen, FerruhObjective: The aim of this study was to assess the treatment modalities of spontaneous intraparenchymatous hematomas. Material and Method: The retrospective analysis of nineteen patients, who attended the neurology or neurosurgery department with spontaneous intraparenchymatous hematoma, was carried out. Results: Of the 9 patients in neurology department, 6 were male and 3 were female. Mean age was 64.5 . The Glasgow Coma Score (GCS) at presentation was 14-15 in four patients and ? 7 in 5 patients. Mean hematoma volume was 16.1cc ( 2.5-45.5cc). While 4 patients with GCS 14-15, were discharged with Glasgow Outcome Scale (GOS) 4 or 5, GOS was 1 in all of the patients with GCS ? 7. Of the ten patients in neurosurgery department, 6 were male and 4 were female. Mean age was 60.3 . Initial GCS was 9-12 in 4 patients and 3-7 in 6 patients. The hematoma volume varied from 56 cc to 248 cc (mean 96.5 cc). The GOS values at the time of hospital discharge were 5 in 3 patients and 4 in 1 patient in the subgroup of patients with GCS 9-12; while GOS values were 3 or 2 in 3 patients and 1 in 2 patients in group with initial GCS ? 7. However, the remaining 1 patient died because of pulmonary embolus at postoperative 7th month. Conclusion: The aim of the conservative treatment in intraparenchymatous hematoma should be the control of blood pressure, maintenance of normal intracranial pressure and cerebral perfusion, and prophylaxis of convulsions. The purpose of surgery is to lessen the mass effect of hematoma and minimize the potential brain damage. The patients can be treated better if collaborative evaluation of neurosurgery and neurology departments can be carried outÖğe MS AYIRICI TANISINDA NADİR GÖRÜLEN BİR HASTALIK: WEGENER GRANÜLOMATOZU POLİANJİTİS İLİŞKİLİ GRANÜLOMATOSİS)(2021) Ayaşlı, Alper; Öztürk, AyhanPolianjitis ilişkili Granülomatosis (GPA), Wegener Granülomatosis (WG), küçük ve orta boy arterleri etkileyen, nekrotizan granulomlar ile karekterize, etolojisi bilinmeyen, sistemik inflamatuar bir hastalıktır. Biz bu olgumuzda, MRI görüntülemeleri ve klinik olarak Multipl Skleroz (MS)’ten- şüphelenildiği için MS polikliniğimize- yönlendirilen, incelemeler neticesinde periferal ve santral sinir sistemi tutulumlu GPA tanısı konulan bir hastamızı sunuyoruz. 39 yaşında kadın hasta, görme ve işitme kaybı, sağ bacağında ve kolunda güç kaybı şikayetleriyle başvurdu. Öyküsünde nefes darlığı, idrar yaparken yanma ve kanlı işeme bulunmaktaydı. Muayenesinde görme düzeyi bilateral 0,4 düzeyinde, sağ üst ekstremite kas gücü 3/5, sağ alt ekstremite kas gücü 2/5 idi. Sağ ekstremitede hipoestezi mevcuttu. Biyokimya değerleri normaldi. Takiplerinde alt ekstremitede diffüz purpiritik lezyon geliştiği görüldü. Kranial MR’ ında, T2- FLAIR sekanslarında izlenen beyaz cevherde nonspesifik hiperintensiteler ve sağ optik sinirde “kink” görünümü izlendi. Multipl Skleroz (MS), santral sinir sistemini etkileyen, inflamasyon, demyelinizasyon ve akson hasarı ile uyumlu otoimmün bir hastalıktır. MS tanısı 2017 yılında revize edilen McDonald kriterlerine göre konur. Pek çok hastalık MS’ in ayırıcı tanısına girmektedir. GPA santral ve periferik sinir sistemini değişik oranlarda etkilemektedir (%10-45). Özellikle santral sinir sisteminin de etkilendiği atipik seyirli GPA nadir görülmesine rağmen MS in ayırıcı tanısında akılda tutulmalıdır.Öğe Neuroendocrine changes in brain dead patients(Elsevier Science Bv, 2017) Akbaş, Türkay; Öztürk, Ayhan…Öğe Pankreatik Nöroendokrin Karsinomda Paraneoplastik Ciddi Sensorimotor Aksonal Polinöropati: Vaka Sunumu ve Literatür Taraması(2022) Akbaş, Türkay; Kantarcıoğlu Coşkun, Sinem; Torun, Serkan; Öztürk, Ayhan; Eşbah, Onur; Onbas, OmerAmaç: Paraneoplastik nörolojik sendromlar (PNSs), kanser öncesi veya kanser sırasında gelişen, sinir sisteminin herhangi bir kısmını etkileyen çeşitli nörolojik hastalıkları içermektedir. Vaka: Yetmiş sekiz yaşında erkek hastanın üç yıl önce üst ekstremitelerde ağrı ve yanma hissi şikayetleri başlamış ve kısa süre sonra kas güçsüzlüğü eklenmiş. Bir yıl önce de alt ekstremitelerde benzer şikayetler ortaya çıkmış. Yoğun bakım ünitesine pnömoni tansıyla yatırılan hastanın yatış esnasında bilinci açık, fakat kuadriplejik ve modifiye Rankin skoru 5 idi. Abdomen bilgisayarlı tomografi karaciğer ve pankreasta kitle lezyonlarının olduğunu gösterdi. Lezyonyonlardan alınan biyopsiler pankreas orjinli küçük hücreli nöroendokrin karsinom olarak raporlandı. Elektrofizyolojik testler ciddi sensorimotor aksonal polinöropati ile uyumluluk gösteriyordu Diğer polinöropati nedenleri dışlandıktan sonra, hastaya paraneoplastik sensorimotor aksonal polinöropati tanısı konuldu. Hastanın fonksiyonel kapasitesi düşük olduğundan palyatif tedavi planlandı. Sonuç: PNS’li hastalarda uygun tedavinin başlanması için erken kanser tanısının konulması önem arz etmektedir.Öğe Paraneoplastic Severe Sensorimotor Axonal Polyneuropathy in Pancreatic Neuroendocrine Carcinoma: A Case Report and Review of the Literature(Duzce Univ, Fac Medicine, 2022) Akbaş, Türkay; Coşkun, Sinem Kantarcıoğlu; Torun, Serkan; Öztürk, Ayhan; Esbah, Onur; Önbaş, ÖmerObjective: Paraneoplastic neurological syndromes (PNSs) are a diverse group of neurological disorders affecting any part of the nervous system before or during cancer. Case: A 78-year-old man first experienced pain and burning in the upper extremity three years previously, to which muscle weakness was added a short time later. The same symptoms developed in the lower extremities one year previously. He was admitted to the intensive care unit due to pneumonia and was conscious but quadriplegic with a modified Rankin score of 5. Abdominal computed tomography showed mass lesions in the liver and pancreas. Biopsies revealed pancreatic small cell neuroendocrine carcinoma. Electrophysiological studies revealed severe sensorimotor axonal polyneuropathy. Paraneoplastic sensorimotor axonal polyneuropathy was diagnosed since other causes of polyneuropathy had been excluded. Palliative care was considered due to the patient's poor functional state. Conclusions: Early diagnosis of cancer is of paramount importance in patients with PNSs if appropriate treatment is to be provided.Öğe Persistant hiccups due to the use of intravenous metilprednisolone in a patient wit relapsing remitting multiple sclerosis: a case report and literature review(2016) Değirmenci, Yıldız; Öztürk, Ayhan; Çamuşoğlu, BurçinHıçkırık, trakenin üzerinden glottisin kapanması ve ani inspirasyon ile takip edilen, diyaframın ani ve kontrol edilemeyen kasılmaları olarak tanımlanabilir. Bu refleks eylemden enstrümentasyon, gastrointestinal, kardiyovasküler, toksik-metabolik faktörler ve ilaçlar gibi çeşitli etiyolojiler sorumludur. Hıçkırığı sıklıkla tetikleyen ilaçlar opiatlar, barbitüratlar, bazı antibiyotikler, kemoterapötik ajanlar ve steroidlerdir. Steroidler nöroloji pratiğinde en sık kullanılan ilaçlardan biri olduğundan, intravenöz metilprednizolon sonrası inatçı hıçkırık ortaya çıkan, atak ve iyileşmelerle giden bir multiple skleroz hastasını, ilacın yan etkisini vurgulamak amacıyla sunduk.Öğe Subacute sclerosing panencephalitis (SSPE) associated with congenital measles infection(Turkish J Pediatrics, 2005) Şimşek, Enver; Öztürk, Ayhan; Yavuz, Cevdet; Kocabay, KenanA 13-month-old male presented with repetitive episodes of myoclonic jerks of the head and extremities for two months. His past medical history revealed that his non-immunized mother had measles at the time of delivery. Measles antibody titers in serum and cerebrospinal fluid (CSF) were 1/512 (hemagglutinin inhibition [HI]) and 1/128 HI, respectively. Immunofixation electrophoresis of CSF revealed an oligoclonal IgG band. The magnetic resonance imaging (MRI) of the brain on T2-weighted images showed lesions of high signal intensity in the subcortical white matter. Electroencephalography (EEG) revealed periodic high-amplitude slow waves. Diagnosis of subacute sclerosing panencephalitis (SSPE) was based upon clinical presentation, a characteristic EEG, and abnormal CSF studies. MRI findings supported the diagnosis. To the best of our knowledge, this is only the 3(rd) case to date, of SSPE-associated congenital measles in the literature.Öğe Susac's syndrome: A case of simultaneous development of all three components of the triad(Elsevier Science Bv, 2013) Öztürk, Ayhan; Değirmenci, Yıldız; Tunç, Murat; Keçeci, HulusiSusac's syndrome is characterized by the clinical triad of encephalopathy, branch retinal artery occlusions and sensorineural hearing loss. We here report a case of 46 year old woman with a sudden diminution in visual acuity at the left eye, headache and decreased hearing at the right ear with mild confusion considered as Susac's syndrome with complete triad. Although it's a relatively rare entity, it should be kept in mind in differential diagnosis of the neurological disorders, especially in women in 20- to 40-year of age presenting with acute hearing loss. (C) 2012 Elsevier B.V. All rights reserved.Öğe Sympathetic skin responses of the face and neck evoked by electrical stimulation(Elsevier Science Bv, 2007) Yıldız, Serpil Kuyucu; Türkoğlu, Şule Aydın; Yıldız, Nebil; Öztürk, Ayhan; Töre, FatmaThe sympathetic skin responses (SSRs) were recorded from different facial regions and neck in 25 subjects evoked by electrical stimulation of the median nerve at the wrist. Recordings from all regions were cross-compared with each other and within right and left sides individually. In one subject postauricular SSR, and in another subject upper lip SSR could not be elicited on both sides. Other responses could be obtained in all the remaining subjects. In I I subjects, the responses did not appear by the first stimulus, and began to appear by repeated stimuli. Mean latencies and the highest amplitudes of the responses were similar for both sides. Gradual amplitude increase was observed in the first three or four set of responses in 20 subjects, although the stimulus intensity was constant. In conclusion, face and neck SSRs are symmetric, can be evoked by electrical stimulation and can be used to investigate the sympathetic innervation of these areas. (C) 2007 Elsevier B.V. All rights reserved.Öğe Tekrarlayan Guillain-Barré sendromu ve idiyopatik trombositopenik purpura birlikteliği(2012) Dikici, Süber; Kocaman, Gülşen; Gümüş, Hatice; Öztürk, AyhanGuillain-Barré sendromu (GBS), genellikle hızlı ve ilerleyi- ci giden, asendan simetrik kuvvet kaybı ve arefleksi ile ka- rakterize akut enflamatuar polinradikülonöropatidir. Klinik tablonun gelişim mekanizması tam olarak bilinmemekle birlikte immun faktörler suçlanmaktadır. GBS geçiren has- taların %1-10’unda tekrarlama ihtimali vardır. İdiyopatik trombositopenik purpura (İTP), ortadan şiddetliye kadar değişebilen trombositopeninin eşlik ettiği edinsel sistemik bir hastalıktır. 12 yıldır İTP tanısıyla takip edilirken, 2 yıl arayla GBS geçiren olgu nadir gözlendiği için sunulacak- tır.Öğe Thyroid Hormone Levels in Brain Death Patients(Lippincott Williams & Wilkins, 2017) Akbaş, Türkay; Öztürk, Ayhan; Şahin, İbrahim Ethem…Öğe Unilateral linear verrucous epidermal nevus of the face and the oral mucosa(Lippincott Williams & Wilkins, 2005) Özçelik, Derya; Parlak, Ali Haydar; Öztürk, Ayhan; Kavak, Ayşe; Çelikel, Nuran…Öğe Visual evoked potential changes following Botox administration in patients with blepharospasm(Springer, 2023) Eski, Mehmet Tahir; Teberik, Kuddusi; Sezer, Taha; Ayasli, Aziz Hudai; Öztürk, AyhanPurposeTo examine visual evoked potential (VEP) changes following botulinum toxin type A (BTA) administration in patients with blepharospasm.MethodsPatients diagnosed with blepharospasm receiving BTA administration were included in the study. Three groups, a control group and two study groups (patients examined 14 days after BTA administration-Study Group 1, and patients examined 28 days after BTA administration-Study Group 2) were evaluated. Dilated fundus examinations were performed following detailed ophthalmological examinations and VEP tests. Keypoint (Dantec, Denmark) and ISCEV criteria were adopted for pattern VEP (PVEP) recording. BTA was applied in the form of local injections at a total 15-30 units, at 2.5-5 units per injection.ResultsA mean 19.4 +/- 3.2 units of BTA was used for each eye. N70 (ms), P100 (ms), and P100 (uV) values were statistically significantly lower in both study groups following drug administrations compared to the control group (p < 0.001 for all). Significant positive correlation was observed between increased P100 amplitudes and age in the control group (p = 0.008, r = 0.200). Significant negative correlation was observed between the BTA units used and decreased P100 amplitudes in both study groups 1 and 2 following drug administrations (p = 0.017, r = - 0.180 and p = 0.043, r = - 0.153, respectively).ConclusionVEP may be an important method in the diagnosis and follow-up of blepharospasm and in determining the success of drug administration and additional therapeutic requirements.
