Publications by authors named "Mustafa Gokce"

48 Publications

A. hierchuntica extract exacerbates genotoxic, cytotoxic, apoptotic and oxidant effects in B16F10 melanoma cells.

Toxicon 2021 Jul 7;198:73-79. Epub 2021 May 7.

Health Sciences University, School of Medicine, Department of Medical Biochemistry, Istanbul, Turkey; University of Health Sciences Turkey, Hamidiye Faculty of Medicine, Haydarpasa Numune Health Application and Research Center, Department of Medical Biochemistry, Istanbul, Turkey.

Melanoma is a highly malignant tumor caused by melanocytes. Even though melanoma represents just 3% of all skin malignancies, it represents 75% of deaths. Extracts of A. hierchuntica were reported to have anti-inflammatory, hepatoprotective, and anti-melanogenic activities. This study aims to investigate the dose-related relationship and selectivity of the toxic effects of A. hierchuntica extracts (AHE) on melanoma cells and provide a new option that can be used in the future treatment of melanoma. B16F10 Mus musculus malign melanoma cells and L929 Mus musculus healthy fibroblast cells were treated with root and leaf AHEs in a dose-dependent manner. Intracellular glutathione levels, mitochondrial membrane potential activity, apoptosis, genotoxicity, and cytotoxicity of AHE were evaluated. This study is probably the first study to show a significant apoptotic and genotoxic activity of AHE in selected B16F10 cancer cell lines. Mitochondrial membrane potential and glutathione activity of B16F10 and L929 melanoma cells decreased with increasing concentrations of both leaf and root AHEs. However, viability and reactive oxygen species levels showed selectivity especially the AHEs concentrations between 400 μg/mL and 500 μg/mL. This selectivity based on doses was also validated in apoptosis and genotoxicity between healthy and cancer cells (p < 0.001). The results showed that when looking at melanoma-specific, AHE could be a source of inspiration as an active ingredient in future treatment protocols. AHE can be recommended as potential nutraceuticals in the prevention of human melanoma cancer.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.toxicon.2021.04.026DOI Listing
July 2021

Time interval between E and E' waves can predict complicated clinical course in patients with acute pulmonary embolism.

J Clin Ultrasound 2021 Jul 3;49(6):580-585. Epub 2021 Mar 3.

Department of Cardiology, Kartal Koşuyolu Heart and Vascular Disease Research and Training Hospital, Istanbul, Turkey.

Purpose: Acute pulmonary embolism is a life-threatening cardiothoracic emergency leading to right ventricle systolic and diastolic dysfunction. In the present study, we investigated the right ventricle diastolic function and its predictive value in patients with acute pulmonary embolism.

Material And Methods: Were prospectively recruited in this study 621 patients diagnosed with acute pulmonary embolism between December 2015 and June 2019. Among them, 173 were excluded, leaving 448 patients for follow-up. Transthoracic echocardiography was performed for the evaluation of the right ventricle systolic and diastolic indices. At 30-day follow-up, the patients were allocated either into the benign or in the complicated clinical course group.

Results: The group with complicated clinical course had higher value of pulmonary artery systolic pressure (PASP), right/left ventricle diameter ratio, E-wave velocity, E/A ratio, A' wave velocity, E/E' ratio, and time interval between E and E' waves (P < .05), but lower values of tricuspid annular plane systolic excursion, A-wave velocity, isovolumetric relaxation time, deceleration time, E', and E'/A' (P < .05). Complicated clinical course was associated with shorter isovolumetric relaxation time (r = .564, P < .001), E/E' (r = .495, P < .001), and TE-E' (r = .596, P < .001). Receiver operator characteristic curve analysis showed that TE-E' had the largest area under curve (TE-E' 0.82, IVRT 0.77, E/E' 0.72). A cut-off value of TE-E' = 70 milliseconds had an 81.1% sensitivity and 71.4% specificity for the prediction of the complicated clinical course.

Conclusion: The assessment of the right ventricle diastolic function could predict the complicated clinical course in patients with acute pulmonary embolism.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/jcu.22995DOI Listing
July 2021

Urotensin-II, oxidative stress, and inflammation increase in hypertensive and resistant hypertensive patients.

Clin Exp Hypertens 2021 Apr 11;43(3):211-216. Epub 2020 Nov 11.

Department of Medical Biochemistry, Bezmialem Vakif University School of Medicine , Istanbul, Turkey.

: Hypertension is a multi-factorial process prevalent in developed as well as in developing countries. Urotensin-II, different antioxidants, free radicals, and inflammatory biomarkers play an essential role in the cardiovascular system. The aim of this study is to investigate Urotensin-II, oxidative stress, and inflammation markers in normotensive, hypertensive, and resistant hypertensive patients. : Fifty resistance hypertensive (rHT) patients, 50 hypertensive patients, and 50 age gender matched normotensive controls (NT-control) were enrolled. Urotensin-II (UII), total oxidant status (TOS), total antioxidant status (TAS), native thiol (NT), total thiol (TT), disulfide (DIS), interleukin 1 beta (IL1β), interleukin 6 (IL6), tumor necrosis factor-alpha (TNFα), high sensitive c reactive protein (hsCRP), high-density lipoprotein (HDL) low-density lipoprotein (LDL), and total cholesterol (TC) were evaluated. : Serum levels of UII, IL1β, IL6, TNFα, DIS, TOS, and OSI were found higher in rHT and HT as compared to NT-control ( < .001). On the contrary, serum levels of TT, TAS, and NT were lower in rHT and HT as compared to NT-control ( < .001). While TC, hsCRP, TOS, OSI, UII, IL1β, IL6, and TNFα levels increase from HT to rHT group ( < .001); TAS and NT levels decrease from HT to rHT group ( < .001). : UII levels, oxidative stress, and inflammation are higher in rHT and HT, while antioxidants and thiol levels are lower than the NT-control. Our study clearly showed that rHT and HT are more susceptible to impaired states of antioxidants, oxidative stress, and free radicals.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/10641963.2020.1847128DOI Listing
April 2021

Assessment of Patients with Intracerebral Hemorrhage or Hemorrhagic Transformation in the VENOST Study.

Eur Neurol 2020 30;83(6):615-621. Epub 2020 Oct 30.

Department of Neurology, Yuzuncu Yıl University, Van, Turkey.

Introduction: Cerebral venous and sinus thrombosis (CVST) may lead to cerebral edema and increased intracranial pressure; besides, ischemic or hemorrhagic lesions may develop. Intracerebral hemorrhages occur in approximately one-third of CVST patients. We assessed and compared the findings of the cerebral hemorrhage (CH) group and the CVST group.

Materials And Methods: In the VENOST study, medical records of 1,193 patients with CVST, aged over 18 years, were obtained from 35 national stroke centers. Demographic characteristics, clinical symptoms, signs at the admission, radiological findings, etiologic factors, acute and maintenance treatment, and outcome results were reported. The number of involved sinuses or veins, localizations of thrombus, and lesions on CT and MRI scans were recorded.

Results: CH was detected in the brain imaging of 241 (21.1%) patients, as hemorrhagic infarction in 198 patients and intracerebral hemorrhage in 43 patients. Gynecologic causes comprised the largest percentage (41.7%) of etiology and risk factors in the CVST group. In the CH group, headache associated with other neurological symptoms was more frequent. These neurological symptoms were epileptic seizures (46.9%), nausea and/or vomiting (36.5%), altered consciousness (36.5%), and focal neurological deficits (33.6%). mRS was ≥3 in 23.1% of the patients in the CH group.

Discussion And Conclusion: CVST, an important cause of stroke in the young, should be monitored closely if the patients have additional symptoms of headache, multiple sinus involvement, and CH. Older age and parenchymal lesion, either hemorrhagic infarction or intracerebral hemorrhage, imply poor outcome.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1159/000510627DOI Listing
May 2021

Cerebral Venous Sinus Thrombosis in Women: Subgroup Analysis of the VENOST Study.

Stroke Res Treat 2020 1;2020:8610903. Epub 2020 Sep 1.

Antalya Research and Training Hospital, Clinic of Neurology, Antalya, Turkey.

Background: Early diagnosis of cerebral venous sinus thrombosis (CVST) associated with reproductive health-related risk factors (RHRF) including pregnancy, puerperium, and oral contraceptive (OC) use can prevent severe neurological sequelae; thus, the symptoms must be documented in detail for each group.

Methods: Out of 1144 patients with CVST, a total of 777 women were enrolled from a multicenter for the study of cerebral venous sinus thrombosis (VENOST). Demographic, biochemical, clinical, and radiological aspects were compared for 324 cases with RHRF and 453 cases without RHRF.

Results: The mean age of the RHRF (-) group (43.2 ± 13 years) was significantly higher than of the RHRF (+) group (34 ± 9 years). A previous history of deep venous thrombosis (3%), isolated cavernous sinus involvement (1%), cranial neuropathy (13%), comorbid malignancy (7%), and its disability scores after 12 months (9%) were significantly higher in the RHRF (-) group. The RHRF (+) group consisted of 44% cases of puerperium, 33% cases of OC users and 23% of pregnant women. The mean age was found to be higher in OC users (38 ± 9 years). A previous history of deep venous thrombosis was slightly higher in the pregnancy subgroup (4%). Epileptic seizures were more common in the puerperium group (44%).

Conclusion: The results of our study indicate that the risk of CSVT increases parallel to age, OC use, and puerperium period. In addition, when considering the frequency of findings and symptoms, epileptic seizures in the puerperium subgroup of the RHRF (+) group and malignancies in the RHRF (-) group may accompany the CSVT. In daily practice, predicting these risks for the CSVT and early recognition of the symptoms will provide significant benefits to patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1155/2020/8610903DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7481993PMC
September 2020

Epileptic seizures in cerebral venous sinus thrombosis: Subgroup analysis of VENOST study.

Seizure 2020 May 3;78:113-117. Epub 2020 Mar 3.

Clinic of Neurology, Saglik Bilimleri University, II. Sultan Abdulhamid Han Research and Training Hospital, Istanbul, Turkey; Clinic of Neurology, Sancaktepe Research and Training Hospital, Istanbul, Turkey.

Purpose: The aim of this study is to evaluate the presence and prognostic impact of early seizures in cerebral venous sinus thrombosis patients (CVST).

Method: VENOST is a retrospective and prospective national multicenter observational study. CVST patients with or without epileptic seizures (ES) were analyzed and compared in terms of demographic and imaging data, causative factors, clinical variables, and prognosis in a total of 1126 patients.

Results: The mean age of the patients in the ES group was 39.73 ± 12.64 and 40.17 ± 14.02 years in the non-ES group (p > 0.05). Epileptic seizures were more common (76.6 %) in females (p < 0.001). Early ES occurred in 269 of 1126 patients (23.9 %). Epileptic seizures mainly presented in the acute phase (71.4 %) of the disease (p < 0.001). Majority of these (60.5 %) were in the first 24 h of the CVST. The most common neurological signs were focal neurologic deficits (29.9 %) and altered consciousness (31.4 %) in the ES group. Superior sagittal sinus (SSS) and cortical veins (CV) involvement were the most common sites of thrombosis and the mostly related etiology were found puerperium in seizure group (30.3 % vs 13.9 %). Patients with seizures had worse outcome in the first month of the disease (p < 0.001) but these did not have any influence thereafter.

Conclusions: In this largest CVST cohort (VENOST) reported female sex, presence of focal neurological deficits and altered consciousness, thrombosis of the SSS and CVs, hemorrhagic infarction were risk factors for ES occurrence in patients with CVST.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.seizure.2020.02.017DOI Listing
May 2020

Hepatic venous Doppler assessment can anticipate simplified pulmonary embolism severity index and right ventricle dysfunction in patients with acute pulmonary embolism.

J Clin Ultrasound 2020 Jun 1;48(5):254-262. Epub 2020 Apr 1.

Kartal Koşuyolu Heart and Vascular Disease Research and Training Hospital, Istanbul, Turkey.

Purpose: Acute pulmonary embolism (APE) is a life-threating cardiothoracic thromboembolic emergency in which right ventricle dysfunction (RVD) is a major concern. In the present study, we examined the hepatic veins (HVs) blood flow with pulsed-wave spectral Doppler ultrasonography to determine its relationship with the simplified pulmonary embolism severity index (sPESI) and the patient's RVD status.

Methods: We divided the 243 patients who met the inclusion criteria into two groups based on both their sPESI scores and their RVD status. Transthoracic echocardiography was performed to evaluate the RVD and the HVs within 1 hour after patient admission. The liver was evaluated using subcostal and intercostal echocardiographic windows in grayscale B-mode, and HVs were assessed using color and spectral Doppler assessment though the same echocardiographic windows.

Result: A cut-off value of the systolic reverse flow velocity-time integral (SrVTI) = 2.2 cm carried a sensitivity and specificity of 84.29% and 74.89%, respectively, for the prediction of sPESI ≥ 1. A SrVTI cut-off value of 2.1 cm yielded a sensitivity and specificity of 83.03% and 73.91%, respectively, for the prediction of RVD.

Conclusion: HV Doppler assessment could be a useful method for anticipating the sPESI and the presence of RVD in patients with APE. In addition, it may provide information regarding the hemodynamic impact of APE.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/jcu.22825DOI Listing
June 2020

Cerebral Venous Sinus Thrombosis as a Rare Complication of Systemic Lupus Erythematosus: Subgroup Analysis of the VENOST Study.

J Stroke Cerebrovasc Dis 2019 Dec 24;28(12):104372. Epub 2019 Sep 24.

Clinic of Neurology, Haydarpasa Sultan Abdulhamid Research and Training Hospital, İstanbul, Turkey.

Aim: Systemic lupus erythematosus (SLE) is an unusual risk factor for cerebral venous sinus thrombosis (CVST). As few CVST patients with SLE have been reported, little is known regarding its frequency as an underlying etiology, clinical characteristics, or long-term outcome. We evaluated a large cohort of CVST patients with SLE in a multicenter study of cerebral venous thrombosis, the VENOST study, and their clinical characteristics.

Material And Method: Among the 1144 CVST patients in the VENOST cohort, patients diagnosed with SLE were studied. Their demographic and clinical characteristics, etiological risk factors, venous involvement status, and outcomes were recorded.

Results: In total, 15 (1.31%) of 1144 CVST patients had SLE. The mean age of these patients was 39.9 ± 12.1 years and 13 (86.7%) were female. Presenting symptoms included headache (73.3%), visual field defects (40.0%), and altered consciousness (26.7%). The main sinuses involved were the transverse (60.0%), sagittal (40.0%), and sigmoid (20.0%) sinuses. Parenchymal involvement was not seen in 73.3% of the patients. On the modified Rankin scale, 92.9% of the patients scored 0-1 at the 1-month follow-up and 90.9% scored 0-1 at the 1-year follow-up.

Conclusions: SLE was found in 1.31% of the CVST patients, most frequently in young women. Headache was the most common symptom and the CVST onset was chronic in the majority of cases. The patient outcomes were favorable. CVST should be suspected in SLE patients, even in those with isolated chronic headache symptoms with or without other neurological findings.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2019.104372DOI Listing
December 2019

Cerebral hemodynamics in patients with ankylosing spondylitis.

J Back Musculoskelet Rehabil 2020 ;33(3):451-454

Department of Neurology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey.

Objective: The aim of this study was to assess the cerebral blood flow velocity as a marker by using transcranial Doppler (TCD) ultrasonography in patients with ankylosing spondylitis (AS).

Methods: A total of 30 AS patients aged 20 to 50 were enrolled in the AS group (male/female: 4/26, mean age: 34.7 ± 5.9) consecutively. The control group (non-AS group; male/female: 4/26, mean age: 32.3 ± 4.7) consisted of 30 age- and sex-matched, randomly selected patients without AS who had other diagnoses such as fibromyalgia and did not have risk factors for atherosclerosis. Bilateral middle cerebral artery (MCA) peak-systolic, end-diastolic, and mean blood flow velocities, Gosling's pulsatility index values, and Pourcelot's resistance index values were recorded with TCD by a neurosonologist blinded to the AS and control groups.

Results: The erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) levels and cerebral blood flow velocities of bilateral MCA were significantly higher in the AS group than in the control group.

Conclusions: This study highlights that the increased cerebral blood flow is indirectly associated with atherosclerosis regarding persistent inflammation in patients with AS.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3233/BMR-170947DOI Listing
October 2020

Investigation of the Effects of Biochemical Parameters on Alzheimer's Disease.

Am J Alzheimers Dis Other Demen 2019 Nov-Dec;34(7-8):464-468. Epub 2019 Jul 16.

Department of Neurology, Faculty of Medicine, Bezmialem Vakif University, Fatih, Istanbul, Turkey.

Background: The most common type of dementia is an Alzheimer's disease which is a major concern in growing chronic diseases in the geriatric society, and its connection with biochemistry has not been sufficiently understood.

Objective: This study aims to evaluate the effects of blood biochemistry on Alzheimer's disease.

Method: Eight participants aged 55+ with Alzheimer's disease were analyzed. A cross-sectional work has conducted. Eighty patients have been divided into 2 groups as group A and group B according to laboratory findings including glycosylated hemoglobin, high-density lipoprotein (HDL), low-density lipoprotein (LDL), total cholesterol (TC), triglycerides (TGA), vitamin D, folic acid, and vitamin B. Mean Mini-Mental State Examination scores between these different 2 groups have been compared.

Results: High levels of HDL, vitamin D, and folic acid correlate with cognitive scores, whereas high levels of total cholesterol, HbA1c, LDL show a negative effect on cognition scores.

Conclusion: High-density lipoprotein, vitamin D, folic acid, cholesterol, HgA1c, and LDL have an effect on dementia.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/1533317519862108DOI Listing
July 2020

Behçet's disease as a causative factor of cerebral venous sinus thrombosis: subgroup analysis of data from the VENOST study.

Rheumatology (Oxford) 2019 04;58(4):600-608

School of Medicine, Department of Neurology, Mersin University, Mersin.

Objective: This study was performed to determine the rate of cerebral venous sinus thrombosis (CVST) among cases of Behçet's disease (BD) included in a multicentre study of cerebral venous sinus thrombosis (VENOST).

Methods: VENOST was a retrospective and prospective national multicentre observational study that included 1144 patients with CVST. The patients were classified according to aetiologic factors, time of CVST symptom onset, sinus involvement, treatment approach and prognosis.

Results: BD was shown to be a causative factor of CVST in 108 (9.4%) of 1144 patients. The mean age of patients in the BD group was 35.27 years and 68.5% were men, whereas in the non-BD CVST group, the mean age was 40.57 years and 28.3% were men (P < 0.001). Among the aetiologic factors for patients aged 18-36 years, BD was predominant for men, and puerperium was predominant for women. The onset of symptoms in the BD group was consistent with the subacute form. The transverse sinuses were the most common sites of thrombosis, followed by the superior sagittal sinuses. The most common symptom was headache (96.2%), followed by visual field defects (38%).

Conclusions: BD was found in 9.4% of patients in our VENOST series. Patients with BD were younger and showed a male predominance. The functional outcome of CVST in patients with BD was good; only 12% of patients presenting with cranial nerve involvement and altered consciousness at the beginning had a poor outcome (modified Rankin Score ⩾2).
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/rheumatology/key153DOI Listing
April 2019

Clinical practices of the management of nonvalvular atrial fibrillation and outcome of treatment: A representative prospective survey in tertiary healthcare centers across Turkey.

Turk Kardiyol Dern Ars 2018 03;46(2):92-102

Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara.

Objective: The goal of this study was to define clinical practice patterns for assessing stroke and bleeding risks and thromboprophylaxis in nonvalvular atrial fibrillation (NVAF) and to evaluate treatment outcomes and patient quality of life.

Methods: A clinical surveillance study was conducted in 10 tertiary healthcare centers across Turkey. Therapeutic approaches and persistence with initial treatment were recorded at baseline, the 6th month, and the 12th month in NVAF patients.

Results: Of 210 patients (57.1% male; mean age: 64.86±12.87 years), follow-up data were collected for 146 patients through phone interviews at the 6th month and 140 patients at the 12th month. At baseline, most patients had high CHADS2 score (≥2: 48.3%) and CHA2DS2-VASc (≥2: 78.7%) risk scores but a low HAS-BLED (0-2: 83.1%) score. Approximately two-thirds of the patients surveyed were using oral anticoagulants as an antithrombotic and one-third were using antiplatelet agents. The rate of persistence with initial treatment was approximately 86%. Bleeding was reported by 22.6% and 25.0% of patients at the 6th and 12th month, respectively. The proportion of patients with an INR of 2.0-3.0 was 41.8% at baseline, 65.7% at the 6th month, and 65.9% at the 12th month. The time in therapeutic range was 61.0% during 1 year of follow-up. The median EuroQol 5-dimensional health questionnaire (EQ-5D) score of the patients at baseline and the 12th month was 0.827 and 0.778, respectively (p<0.001). The results indicated that patient quality of life declined over time.

Conclusion: In atrial fibrillation, despite a high rate of persistence with initial treatment, the outcomes of stroke prevention and patient quality of life are not at the desired level. National health policies should be developed and implemented to better integrate international guidelines for the management of NVAF into clinical practice.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5543/tkda.2017.79367DOI Listing
March 2018

Arterial Stiffness in Patients Taking Second-generation Antipsychotics.

Clin Psychopharmacol Neurosci 2016 Nov;14(4):365-370

Department of Psychiatry, Faculty of Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey.

Objective: That treatment with second-generation antipsychotics (SGAs) causes metabolic side effects and atherosclerosis in patients with schizophrenia and bipolar disorder (BD) is well-known. Increased arterial stiffness is an important marker of arteriosclerosis and has been identified as an independent risk factor for cardiovascular diseases. We measured pulse wave velocity (PWV) as a marker of arteriosclerosis in patients with schizophrenia and BD who use SGAs.

Methods: Patients and controls were collected from our psychiatry outpatient clinics or family medicine. Mental illness was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition. Mean age, gender, systolic and diastolic blood pressure, body mass index, Framingham risk score (FRS), etc. were determined. Simultaneous electrocardiography and pulse wave were recorded with an electromyography device. The photo-plethysmographic method was used to record the pulse wave. Inclusion criteria included use of SGAs for at least the last six months. Patients with diseases that are known to cause stiffness and the use of typical antipsychotics were excluded.

Results: Ninety-six subject (56 patients, 40 controls) were included in our study. There were 49 females, 47 males. Patients had schizophrenia (n=17) and BD (n=39). Their treatments were quetiapine (n=15), risperidone (n=13), olanzapine (n=15), and aripiprazole (n=13). Although differences in mean age, gender, and FRS in the patient and control groups were not statistically significant (=1), PWV was greater in patients in the antipsychotic group (=0.048).

Conclusion: This study supported the liability to stiffness in patients with schizophrenia and BD. Using SGAs may contribute to arterial stiffness in these patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.9758/cpn.2016.14.4.365DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5083947PMC
November 2016

Pineal gland volume in schizophrenia and mood disorders.

Psychiatr Danub 2015 Jun;27(2):153-8

Department of Psychiatry, Medical Faculty, Kahramanmaraş Sutcu Imam University, 46050 Kahramanmaras, Turkey,

Background: The majority of patients with schizophrenia and mood disorders have disruptions in sleep and circadian rhythm. Melatonin, which is secreted by the human pineal gland, plays an important role in sleep and circadian rhythm. The aim of the present study was to evaluate and compare pineal gland volumes in patients with schizophrenia and mood disorders.

Subjects And Methods: We retrospectively evaluated the pineal gland volumes of 80 cases, including 16 cases of unipolar depression, 17 cases of bipolar disorder, 17 cases of schizophrenia, and 30 controls. The total pineal gland volume of all cases was measured via magnetic resonance images, and the total mean pineal volume of each group was compared.

Results: The mean pineal volumes of patients with schizophrenia, bipolar disorder, unipolar depression, and the controls were 83.55±10.11 mm(3), 93.62±11.00 mm(3), 95.19±11.61 mm(3) and 99.73±12.03 mm(3), respectively. The mean pineal gland volume of the patients with schizophrenia was significantly smaller than those of the other groups.

Conclusions: Our data show that patients with schizophrenia have smaller pineal gland volumes, and this deviation in pineal gland morphology is not seen in those with mood disorders. We hypothesize that volumetric changes in the pineal gland of patients with schizophrenia may be involved in the pathophysiology of this illness.
View Article and Find Full Text PDF

Download full-text PDF

Source
June 2015

Clinical and radiological features in CADASIL and NOTCH3-negative patients: a multicenter study from Turkey.

Eur Neurol 2014 30;72(3-4):125-31. Epub 2014 Jul 30.

Department of Neurology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey.

Background: The diversity of clinical presentation and neuroimaging findings of CADASIL (cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy) from different regions of the world has not yet been studied in depth. Here we investigated the variability of clinical, radiological and genetic data of 48 patients analyzed for NOTCH3 mutation in Turkey.

Methods: Clinical evaluation was made according to a preformed questionnaire. Cranial neuroimaging findings were determined on the basis of T1, T2, FLAIR and proton-density magnetic resonance scans. For genetic analysis, polymerase chain reaction was performed with primers flanking exons 2-6 and 11 of NOTCH3 gene.

Results: Twenty-five patients (52.1%) were diagnosed as CADASIL with NOTCH3 mutation, while 23 patients (47.9%) had no mutation (NOTCH3-negative patients). The mean age and age at stroke onset were lower in male CADASIL patients (p < 0.03). A family history of migraine (p = 0.012), stroke (p < 0.001), recurrent strokes (p = 0.020) and dementia (p = 0.012) was more common in CADASIL patients. Temporal pole involvement was more common in CADASIL patients (p = 0.004).

Conclusion: It is of clinical importance to identify the heterogeneity of CADASIL from different countries due to a low correlation of clinical and radiological data with respect to NOTCH3 mutation.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1159/000360530DOI Listing
June 2015

Angiographic characteristics of coronary artery fistulas.

Turk Kardiyol Dern Ars 2014 Jul;42(5):456-60

Department of Cardiology, Kahramanmaraş Sütçü İmam University Faculty of Medicine, Kahramanmaraş, Turkey.

Objectives: Coronary artery fistula (CAF) in adults is a rare form of coronary artery anomaly. It is often diagnosed incidentally during coronary angiography. The aim of this study was to evaluate the clinical and angiographic characteristics of adult patients with CAF.

Study Design: We retrospectively reviewed the database of 70,850 patients who had undergone coronary angiography in five different invasive cardiology centers in the southeastern region of Turkey. Among them, 56 patients had CAF (39 males, 17 females, mean age: 63.7±10.4 years). Demographic data, clinical evaluation and cardiac catheterization reports were reviewed from the medical records.

Results: A total of 58 fistulas were detected in 56 patients; two patients (3.6%) had bilateral fistulas originating from both the left and right coronary artery. In our angiographic series, CAF prevalence was 0.08%. Dyspnea on exertion and/or angina pectoris was the most common symptom (69%). Fifteen patients (26.8%) had concomitant obstructive coronary artery disease. Coronary artery fistulas originated mainly from the left anterior descending artery (n=30, 51.7%). Others originated from the right coronary artery (n=15, 25.9%), circumflex artery (n=6, 10.3%), and right sinus of Valsalva (n=3, 5.2%). In four patients (n=4, 7.1%), multiple micro fistula were draining into the left ventricle.

Conclusion: In our angiographic series, the prevalence of CAF was 0.08%, and the most common site of origin was the left anterior descending artery.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5543/tkda.2014.66281DOI Listing
July 2014

Intra-venous chlorpromazine with fluid treatment in status migrainosus.

Clin Neurol Neurosurg 2014 Apr 10;119:4-5. Epub 2014 Jan 10.

Department of Neurology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, 46050 Kahramanmaras, Turkey.

Objective: To present the results of the intra-venous chlorpromazine with fluid treatment in patients with status migrainosus.

Methods: Consecutive 21 patients with status migrainosus were received intra-venous chlorpromazine (maximum 25mg) with fluid treatment and their results were documented.

Results: Complete recovery of headache and nausea were seen in 20/21 and 17/21 of the patients respectively. 15/21 of patients were headache free following at 10mg chlorpromazine infusion. Most patients went on sleep after 10mg chlorpromazine infusion and when they wake already up headache free. Side effects such as tachycardia, palpitation, flushing and hypertension were seen only one of 21 patients following first dose 5mg injection.

Conclusions: This study showed that intra-venous chlorpromazine with fluid treatment for status migrainosus seems a good option.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.clineuro.2014.01.002DOI Listing
April 2014

An unusual clinical state: atrial fibrillation due to mad-honey intoxication.

Anadolu Kardiyol Derg 2012 Jun 13;12(4):365-6. Epub 2012 Apr 13.

Department of Emergency, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5152/akd.2012.105DOI Listing
June 2012

Cerebral venous sinus thrombosis associated with spontaneous intermittent cerebrospinal fluid rhinorrhea: a case report.

Med Princ Pract 2012 6;21(4):392-4. Epub 2012 Apr 6.

Department of Neurology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey.

Objectives: To present a rare case of cerebral venous sinus thrombosis (CVST).

Clinical Presentation And Intervention: A 43-year-old woman presented with coma and was diagnosed as a case of CVST. She recovered in a few days with heparin treatment. Many possible risk factors for CSVT were negative in the patient but intermittent cerebrospinal fluid (CSF) rhinorrhea was accidentally noticed. Cerebral computed tomography and magnetic resonance imaging were done. The patient was diagnosed as having spontaneous intermittent CSF rhinorrhea due to a defect in the base of the skull.

Conclusions: This case showed the importance of being aware that a defect in the base of the skull may lead to intermittent CSF rhinorrhea in patients with CVST.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1159/000336782DOI Listing
October 2012

Changes in cerebral blood flow velocity in patients with hypothyroidism.

Eur J Endocrinol 2011 Sep 6;165(3):465-8. Epub 2011 Jul 6.

Department of Neurology, Medical Faculty, Kahramanmaras Sutcu Imam University, 46050 Kahramanmaras, Turkey.

Background: At present, hypothyroidism is a well-known risk factor for cardiovascular disorders. The aim of this study was to assess the effects of hypothyroidism on cerebral blood flow velocity with transcranial Doppler (TCD) ultrasonography.

Design And Methods: In this study, 30 subjects were enrolled for clinical, subclinical, and healthy control groups. Bilateral middle cerebral artery (MCA) peak-systolic, end-diastolic, and mean blood flow velocities; Gosling's pulsatility index values; and Pourcelot's resistance index values were recorded and compared with each other. TCD was performed in clinical hypothyroid patients after they became euthyroid with thyroid hormone replacement therapy (HRT). The initial and post-HRT results for the clinical hypothyroid group were then compared and evaluated.

Results: There were 30 subjects in each group. Men/women ratio and mean age in clinical hypothyroid, subclinical hypothyroid, and control groups were 3/27, 4/26, and 5/25, and 37.4, 34.4, and 36.7 respectively. Peak-systolic, end-diastolic, and mean blood flow velocities of bilateral MCA were similar in clinical and subclinical hypothyroid groups but significantly higher when compared with the control group. After adequate thyroid HRT in clinical hypothyroid group, the peak-systolic, end-diastolic, and mean blood flow velocities were significantly decreased.

Conclusions: Increased cerebral blood flow velocities were observed in clinical and subclinical patients with hypothyroidism. The normalization of increased blood flow velocity with thyroid HRT suggests a reversible condition.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1530/EJE-11-0254DOI Listing
September 2011

Intra-left ventricular systolic asynchrony in patients with overt hyperthyroidism.

Endocrine 2010 Oct 23;38(2):283-8. Epub 2010 Oct 23.

Department of Cardiology, Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, and Department of Internal Medicine, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.

Hyperthyroidism causes a variety of adverse effects on the cardiovascular system. Left ventricular (LV) asynchrony is defined as loss of the simultaneous peak contraction of corresponding cardiac segments. The aim of this study was to assess systolic asynchrony in patients with overt hyperthyroidism. Asynchrony was evaluated in 27 patients with overt hyperthyroidism and 21 controls. All the patients and controls were subjected to a tissue synchronization imaging (TSI). The time to regional peak systolic tissue velocity (Ts) in LV by the six-basal-six-mid-segmental model was measured on ejection phase TSI images and four TSI parameters of systolic asynchrony were computed. All TSI parameters of LV asynchrony increased in hyperthyroid patients compared to controls: the standard deviation (SD) of the 12 LV segments Ts (35.7±14.4 vs 20.1±10.1, P<0.0001); the maximal difference in Ts between any 2 of the 12 LV segments (111.9±40.7 vs 65.9±30.7, P<0.0001); the SD of the 6 basal LV segments (31.2±18.2 vs 16.8±9.7, P=0.01); and the maximal difference in Ts between any 2 of the 6 basal LV segments (76.6±42.0 vs 44.4±25.7, P=0.005). Patients with overt hyperthyroidism present evidence of LV asynchrony by TSI.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s12020-010-9385-6DOI Listing
October 2010

A patient with acute myeloblastic leukemia who presented with conus medullaris syndrome and review of the literature.

J Pediatr Hematol Oncol 2009 Jun;31(6):440-7

Division of Pediatric Hematology, Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, 06200, Demetevler, Ankara.

In childhood, the conus medullaris syndrome owing to leukemia is rare. Here, a 12-year-old boy with acute myeloblastic leukemia, maxillary mass, and conus medullaris syndrome is reported. A biopsy from the maxillary mass revealed "granulocytic sarcoma." Lumbosacral magnetic resonance imaging revealed clumped and thickened cauda equina nerve roots, epidural and periradicular diffuse soft tissue, which was enhanced with gadolinium. Cerebrospinal fluid revealed elevated protein but no cells. Chemotherapy and local radiotherapy for both the face and the spine, yielded bone marrow remission and abatement in neurologic and radiologic findings, but he developed bone marrow relapse and died because of sepsis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/MPH.0b013e31819ed24bDOI Listing
June 2009

An unusual Brugada syndrome case.

Anadolu Kardiyol Derg 2008 Oct;8(5):383-4

Department of Cardiology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.

View Article and Find Full Text PDF

Download full-text PDF

Source
October 2008

Isolated interrupted aortic arch: in a 40-year-old adult.

Int J Cardiol 2010 Feb 15;138(3):e39-41. Epub 2008 Aug 15.

Interrupted aortic arch (IAA) is a scarce and generally lethal congenital malformation. Patients with complete IAA scarcely reach adult age without previous surgical intervention. In this case, we presented a 40-year-old isolated IAA case with hypertension and angina pectoris. IAA just distal to left subclavian artery and markedly developed collateral circulation was demonstrated via cardiac catheterization (CC) and multi-slice computed tomography angiography (MSCT).
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ijcard.2008.06.059DOI Listing
February 2010

Oxidative stress in migraine with and without aura.

Biol Trace Elem Res 2008 9;126(1-3):92-7. Epub 2008 Aug 9.

Department of Neurology, Faculty of Medicine, Kahramanmaras Sutcu Imam University , Kahramanmaras, Turkey.

Migraine is the most common neurological disorder, but the molecular basis is still not completely understood. An impairment of mitochondrial oxidative metabolism might play a role in the pathophysiology. The goal of this study was to investigate the differences in oxidative stress status with the measurement of erythrocyte superoxide dismutase (SOD), catalase activity, and malondialdehyde (MDA) levels in the migraine patients with or without aura and attack. There were 56 patients (46 female, 10 male) in the migraine group and 25 matched healthy subjects in the control group. The patients comprised 37 with migraine without aura (MWoA], 19 with migraine with aura (MWA), and 22 with headache attack. The MDA levels of patients in the migraine group were significantly higher than that in the control group. The SOD activity was significantly higher in the MWA as compared to MWoA. There was no significant correlation between these levels and headache attack period. Conclusively, in this preliminary study, we had found increased oxidative stress in the migraine patients especially the patients with MWA. Further knowledge about this issue may contribute the cause and complications of migraine and may be essential for development of treatment approaches.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s12011-008-8193-9DOI Listing
April 2009

Isolated single coronary artery: a series of 10 cases.

Circ J 2008 Aug;72(8):1254-8

Cardiology Department, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey.

Background: Isolated single coronary artery (SCA) is an extremely rare congenital coronary anomaly. Some subgroups of SCA can lead to angina pectoris, acute myocardial infarction or even sudden death in the absence of atherosclerosis. Young patients, especially, have the risk of serious clinical events, but middle-aged-to elderly patients have a variable clinical course.

Methods And Results: The aim of this study was to present the clinical and angiographic properties, relatively long-term follow-up (54+/-14 months) and management of adult patients (mean age 57+/-12 years) with SCA. The records of 70,850 patients undergoing coronary angiography between 1999 and 2005 were reviewed. Ten patients (0.024%) were found to have SCA, originating from the left sinus of Valsalva in 3 (30%) patients and from the right sinus of Valsalva in 7 patients (70%). No atherosclerotic involvement was seen in 7 (70%) patients. One patient was also treated by stent implantation to the SCA. Other patients were followed medically. All patients have been followed uneventfully.

Conclusion: Medical treatment is usually adequate for middle-aged to elderly patients with SCA in the absence of ischemia and/or acute coronary syndrome.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1253/circj.72.1254DOI Listing
August 2008

Hoffmann's syndrome: a case report.

Med Princ Pract 2008 3;17(4):346-8. Epub 2008 Jun 3.

Department of Neurology, Faculty of Medicine, University of Kahramanmaras Sutcu Imam, Kahramanmaras, Turkey.

Objective: We report a very rare case of Hoffmann's syndrome with musclehypertrophy complicating hypothyroidism.

Clinical Presentation: A 24-year-old man presented with a 2-year history of forgetfulness, swelling in his face, shoulder and calf, and motor weakness in his lower extremities. His calf and shoulder muscles were hypertrophic. Neurological examination revealed hoarseness of the voice, proximal muscle weakness, reduced deep tendon reflexes and a mildly ataxic gait. Laboratory tests indicated markedly elevated serum muscle enzymes and lipids, a high thyroid-stimulating hormone level and low free triiodothyronine and free thyroxine levels. Electromyographic evaluation showed myopathy.

Intervention: Oral L-thyroxine treatment was started and at a 1-month follow-up examination, mental status and physical performance were improved.

Conclusion: This report shows that in the differential diagnosis of myopathy with pseudohypertrophy, Hoffmann's syndrome should be considered.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1159/000129619DOI Listing
September 2008

Nontraumatic scalp arteriovenous fistula in an adult: technical report on an illustrative case.

Surg Neurol 2008 Aug 4;70(2):194-7. Epub 2008 Mar 4.

KSU Medical School Department of Neurosurgery, 46050 Kahramanmaras, Turkey.

Background: The treatment of sAVF is difficult, and many therapeutic approaches have been proposed. General approaches for the treatment of sAVF include ligation of the feeding arteries, surgical removal, electrothrombosis, embolization, and a combination of these approaches.

Case Description: A 35-year-old man presented with occipital subcutaneous pulsatile thrill. We discussed and illustrated a rare sAVF, which was a high-flow sAVF fed by the occipital branch of the right ACE draining intraosseously into the SS. The case was treated by surgical origin ligation.

Conclusion: This case was unusual in the sense that it was apparently spontaneous, and the major venous drainage was through the bone into the SS. Arterial supply pattern of sAVF is very important in therapeutic decision-making. We suggest that surgical origin ligation for sAVF be considered if the case has 1 feeding artery.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.surneu.2007.04.018DOI Listing
August 2008

Metastatic adenocarcinoma in the right atrium and secondary Budd-Chiari syndrome (a case report).

Int J Cardiol 2009 Feb 19;132(1):e1-4. Epub 2007 Nov 19.

Budd-Chiari syndrome is a rare clinical syndrome which is characterized by the occlusion of the major hepatic veins or the inferior vena cava at the suprahepatic level. Metastatic cardiac tumors (MCT) are much more common than the primary cardiac tumors. Although MCT are frequently clinically silent, rarely pericardial tamponade or effusion may be the first clinical sign of MCT. Budd-Chiari syndrome rarely developed secondary to MCT. We report an unusual case of Budd-Chiari syndrome which was associated with metastatic right atrial adenocarcinoma with unknown origin in a 60-year-old woman. This combination in Budd-Chiari syndrome has been never published before.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ijcard.2007.07.086DOI Listing
February 2009

Paradoxical embolism involving 4 organ systems (pulmonary, renal, splenic, and hepatic artery).

Am J Emerg Med 2007 Jul;25(6):737.e1-3

Department of Emergency Medicine, Karadeniz Technical University Faculty of Medicine, 61080 Trabzon, Turkey.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ajem.2007.01.006DOI Listing
July 2007