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Öğe ACUTE TOXIC EFFECTS OF METHYL ALCOHOL ON THE RAT BRAIN: THE PROTECTIVE EFFECTS OF CAFFEIC ACID PHENETHYL ESTER(Carbone Editore, 2014) Cevik, Mehmet Ugur; Varol, Sefer; Yucel, Yavuz; Akil, Esref; Uzar, E.; Kaplan, I; Can, Yazgan UmitBackground: Efficiency of caffeic acid phenethyl ester (CAPE) in reducing free radicals generated by oxidative stress has been previously reported. In the present study, the protective effect of CAPE on methyl alcohol (MeOH) induced oxidative damages on rat brain were presented. Methods: The rats were randomly divided into four groups as follows: Control, methotrexate (MTX) alone, MTX+MeOH, and MTX+MeOH+CAPE (CAPE treatment). All animals except the control group were treated with MTX for 7 days. MTX was diluted in sterile saline and administered (0.3 mg/kg/day) intraperitoneally (ip). At the eighth day, MeOH was administered (3gm/Kg) (ip) in MeOH+MTX and CAPE treatment groups. Four hours after MeOH administration in the CAPE group rats were treated with 10 mu mol/kg CAPE (ip), serum physiologic (i.p.) in MeOH+MTX group. After eight hours, rats were anaesthetized and sacrificed. Malondialdehyde (MDA) levels, paraoxonase-1 (PON-1) activity were measured on the cerebral tissue. Results: MTX+MeOH group compared to the MTX alone group; a statistically significant increase in MDA levels (p = 0.042) were detected. In addition, MTX+MeOH group than MTX MTX alone group in led to a statistically significant decrease in PON-I activity (p = 0.018). CAPE treatment, significantly decrease in MDA levels was compared with MeOH+MTX (p = 0.001). However, CAPE treatment caused an increase on PON-I activity in MeOH group, which was statistically significant (p = 0.009). Conclusion: Consequently, it was demonstrated for the first time that CAPE prevents acute MeOH intoxication induced brain injury by reducing the increase in lipid peroxidation, and elevating the decrease in PON-1 activity.Öğe Changes in serum albumin levels and neutrophil-lymphocyte ratio in patients with convulsive status epilepticus(Taylor & Francis Ltd, 2017) Ozdemir, Hasan H.; Akil, Esref; Acar, Abdullah; Tamam, Yusuf; Varol, Sefer; Cevik, Mehmet Ugur; Arikanoglu, AdaletAim: Inflammation may be involved in the ictogenesis and development of some partial epilepsies. Serum albumin levels and the neutrophil-lymphocyte ratio (NLR) are markers of inflammation. The aim of this study was to investigate the ability of serum albumin levels and NLR to predict inflammation in patients with convulsive status epilepticus (CSE). Methods: This retrospective study was conducted on 58 patients who were diagnosed with CSE and control group comprised of 58 healthy individuals. Albumin levels and NLR were evaluated during both the acute and subacute periods of CSE. Results: The average serum albumin levels were 3.27 +/- 0.62 g/dL during the acute period and 3.4 +/- 0.67 g/dL in the subacute period in the patient group and 3.92 +/- 0.52 g/dL in the control group. Neutrophil counts were higher in patients in the acute phase of CSE, but lymphocyte counts were lower compared to the control group and the subacute phase. The average NLR values were 4.83 +/- 5.1 in the acute period, 3.07 +/- 3.02 during the subacute period and 1.98 +/- 0.42 in the control group. Serum albumin and NLR levels were significantly different between the patients in the subacute and acute periods of CSE and the control group (p < 0.05). There were significant negative correlational relationships between serum albumin and NLR levels (p < 0.05). Conclusion: We found serum albumin levels were significantly lower and the NLR was significantly higher in the acute period of CSE. Neutrophil-mediated inflammation may be important in the aetiopathogenesis of CSE.Öğe Clinical and Demographic Features of Pseudotumor Cerebri Syndrome Diagnosed in a University Hospital(Turkish Neurological Soc, 2017) Arslan, Demet; Arikanoglu, Adalet; Akil, EsrefObjective: Pseudotumor cerebri syndrome (PTCS) is characterized by symptoms and signs of increased intracranial pressure without ventriculomegaly, intracranial tumor or mass. This study aimed to explore and analyze 34 patients with PTCS according to age, sex, symptoms of the disorder, cranial magnetic resonance images findings, etiology, and treatment. Materials and Methods: A total of 34 patients who were diagnosed as having PTCS and followed up between January 2011 and August 2016 by Dicle University Medical School Neurology Department were included in this study. PTCS was diagnosed in accordance with the modified Dandy criteria. Results: Thirty-four patients were identified as having PTCS. Twenty-one (91.2%) had headache, 19 (55.9%) had blurred vision, 6 (17.6%) had diplopia, 2 (5.9%) had vertigo, 1 (2.9%) had tinnitus, and 1 (2.9%) had numbness of the face. Twenty-seven patients were diagnosed as having idiopathic intracranial hypertension, 21 (61.8%) had no etiologic factors. Six (17.6%) patients were obese, one of whom had recently gained weight and another had polycystic ovary syndrome. Seven patients were thought to have secondary PTCS with the following etiologic factors: 2 (5.9%) patients had Hashimoto's thyroiditis, 1 (2.9%) had a history of all-trans retinoic acid intake due to a malignancy, 1 (2.9%) had choroid plexus granuloma, 2 (5.9%) had sinus venous thrombosis, and 1 (2.9%) had Familial Meditteranian Fever. Conclusion: Although PTCS was described many years ago, its physiopathology and exact treatment procedures are not clearly understood. The most important target of its treatment is to prevent loss of vision and improve symptoms. With a better understanding of its pathophysiology, effective treatment protocols will be developed.Öğe Double Filtration Plasmapheresis in the Treatment of a Case with Acute Disseminated Encephalomyelitis(Turkish Neurological Soc, 2013) Cevik, Mehmet Ugur; Cetincakmak, Mehmet Guli; Varol, Sefer; Akil, EsrefAcute disseminated encephalomyelitis (ADEM), is a monophasic autoimmune demyelinating disease of the central nervous system. Although high-dose steroid management has been considered the mainstay of treatment for ADEM, some patients are unresponsive to steroid therapy. We report the case of a 44-year-old woman with ADEM who did not respond to steroid therapy, but who showed a noticeable improvement with double filtration plasmapheresis (DFPP). To the best of our knowledge, this is the first case report of ADEM in literature treated with DFPP.Öğe Echocardiographic Epicardial Fat Thickness and Neutrophil to Lymphocyte Ratio Are Novel Inflammatory Predictors of Cerebral Ischemic Stroke(Elsevier Science Bv, 2014) Akil, Esref; Akil, Mehmet Ata; Varol, Sefer; Ozdemir, Hasan Huseyin; Yucel, Yavuz; Arslan, Demet; Akyuz, AbdurahmanBackground: The role of epicardial fat thickness (EFT) in ischemic stroke (IS) has not been previously investigated. The aim of the present study was to evaluate EFT and neutrophil/lymphocyte ratio (NLR) among patients with IS and to examine the relationship between these inflammatory markers and the incidence of IS. Methods: The cross-sectional design includes 38 patients with IS and 47 age- and sex-matched healthy controls. Echocardiographic measurement of EFT was conducted according to previously published methods. An automated hematology analyzer was used to generate total and differential leukocyte counts from patient blood samples. Results: Mean EFT was 4.86 +/- .68 mm in the control group and 5.95 +/- 1.14 mm in the IS group. EFTwas significantly greater in the IS patients in relation to the control group (P < .001). Mean NLR was significantly greater among IS patients in relation to the control group (2.5 +/- .6 vs. 1.8 +/- .4, P < .001). No significant confounding factors were identified in the data set. Spearman's correlation analysis revealed a mild, but highly significant correlation between EFT and NLR (r = 5.293, P =.006). Conclusions: This study demonstrates for the first time the association between EFT and cerebral IS. Echocardiographic EFT was significantly correlated with NLR. NLR and echocardiographic EFT represent inexpensive and readily available clinical markers that maybe useful in estimating risk of IS.Öğe Effects of Ecballium elaterium on brain in a rat model of sepsis-associated encephalopathy(Taylor & Francis Ltd, 2017) Arslan, Demet; Ekinci, Aysun; Arici, Akgul; Bozdemir, Eda; Akil, Esref; Ozdemir, Hasan HuseyinDespite recent advances in antibiotic therapy, sepsis remains a major clinical challenge in intensive care units. Here we examined the anti-inflammatory and antioxidant effects of Ecballium elaterium (EE) on brain, and explored its therapeutic potential in an animal model of sepsis-associated encephalopathy (SAE) [induced by cecal ligation and puncture (CLP)]. Thirty rats were divided into three groups of 10 each: control, sepsis, and treatment. Rats were subjected to CLP except for the control group, which underwent laparatomy only. The treatment group received 2.5 mg/kg EE while the sepsis group was administered by saline. Twenty-four hours after laparotomy, animals were sacrificied and the brains were removed. Brain homogenates were prepared to assess interleukin 1beta (IL-1 beta), interleukin 6 (IL-6), tumor necrosis factor alpha (TNF-alpha), total antioxidant capacity (TAC), and total oxidant status (TOS). Brain tissue sections were stained by hematoxylin and eosin (H&E) to semi-quantitatively examine the histopathologic changes such as neuron degeneration, pericellular/perivascular edema and inflammatory cell infiltration in the cerebral cortex. We found a statistically significant reduction in brain tissue homogenate levels of TNF-a 59.5 +/- 8.4/50.2 +/- 6.2 (p = 0.007) and TOS 99.3 +/- 16.9/82.3 +/- 7.8 (p = 0.01) in rats treated with EE; although interleukin 6 levels were increased in the treatment group compared to the sepsis group, this was not statistically significant. Neuronal damage (p = 0.00), pericellular/perivascular edema and inflammatory cell infiltration (p = 0.001) were also significantly lower in the treatment group compared to those in the sepsis group. These data suggest that Ecballium elaterium contains some components that exert protective effects against SAE in part by attenuating accumulation of proinflammatory cytokines, which may be important contributors to its anti-inflammatory effects during sepsis.Öğe The effects of needle deformation during lumbar puncture(Wolters Kluwer Medknow Publications, 2015) Ozdemir, Hasan Huseyin; Demir, Caner F.; Varol, Sefer; Arslan, Demet; Yildiz, Mustafa; Akil, EsrefObjective: The aim of this study is to assess deformation of the tip and deflection from the axis of 22-gauge Quincke needles when they are used for diagnostic lumbar puncture (LP). Thus, it can be determined whether constructional alterations of needles are important for predicting clinical problems after diagnostic LP. Materials and Methods: The 22-gauge Quincke needles used for diagnostic LP were evaluated. A specially designed protractor was used for measurement and evaluation. Waist circumference was measured in each patient. Patients were questioned about headaches occurring after LP. Results: A total of 115 Quincke-type spinal needles used in 113 patients were evaluated. No deflection was detected in 38 (33.1%) of the needles. Deflection between 0.1 degrees and 5 degrees occurred in 43 (37.3%) of the needles and deflection >= 5.1 degrees occurred in 34 patients (29.6%). Forty-seven (41.5%) patients experienced post lumbar puncture headache (PLPH) and 13 (11.5%) patients experienced intracranial hypotension (IH). No statistically significant correlation between the degree of deflection and headache was found (P > 0.05). Epidural blood patch was performed for three patients. Deformity in the form of bending like a hook occurred in seven needles and IH occurred in six patients using these needles. Two of the needles used in three patients requiring blood patch were found to be bent. Conclusion: Deformation of needles may increase complications after LP. Needle deformation may lead to IH. In case of deterioration in the structure of the needle, termination of the puncture procedure and the use of a new needle could reduce undesirable clinical consequences, especially IH.Öğe Evaluation of cerebral venous thrombosis secondary to oral contraceptive use in adolescents(Springer-Verlag Italia Srl, 2015) Ozdemir, Hasan H.; Varol, Sefer; Akil, Esref; Acar, Abdullah; Demir, Caner F.Our goal was to evaluate the clinical patterns, additional risk factors, treatment and outcome of cerebral venous thrombosis (CVT) related to adolescent oral contraceptive pill (OCP) usage. We evaluated 22 patients with CVT related to OCPs admitted to Firat and Dicle University Hospitals from January 2008 to January 2013. We assessed the clinical features, risk factors, imaging results and prognosis. Magnetic resonance imaging (MRI) and magnetic resonance were the preferred procedures for the diagnosis of CVT. MRI revealed parenchymal lesions in 11 (50 %) patients, and the remaining patients had normal MRIs. The sinuses most frequently affected by thrombosis were the superior sagittal sinus and the transverse sinus. The additional risk factors identified for CVT were antiphospholipid syndrome, protein C deficiency, protein C and S deficiency, factor V Leiden associated with heterozygous antithrombin III deficiency, methylenetetrahydrofolate reductase and prothrombin gene mutations. CVT may be overlooked in adolescents because it is more common among middle-aged and elderly adults. CVT should be suspected in the presence of neurological symptoms in adolescents, especially in those using OCPs.Öğe Facial diplegia: etiology, clinical manifestations, and diagnostic evaluation(Assoc Arquivos Neuro- Psiquiatria, 2015) Varol, Sefer; Ozdemir, Hasan Huseyin; Akil, Esref; Arslan, Demet; Aluclu, M. Ufuk; Demir, Caner F.; Yucel, YavuzObjective: Facial diplegia (FD) is a rare neurological manifestation with diverse causes. This article aims to systematically evaluate the etiology, diagnostic evaluation and treatment of FD. Method: The study was performed retrospectively and included 17 patients with a diagnosis of FD. Results: Patients were diagnosed with Guillain-Barre syndrome (GBS) (11), Bickerstaff's brainstem encephalitis (1), neurosarcoidosis (1), non-Hodgkin's Lymphoma (1), tuberculous meningitis (1) herpes simplex reactivation (1) and idiopathic (1). In addition, two patients had developed FD during pregnancy. Conclusion: Facial diplegia is an ominous symptom with widely varying causes that requires careful investigation.Öğe High-sensitivity C-reactive protein and high mobility group box-1 levels in Parkinson's disease(Springer-Verlag Italia Srl, 2019) Baran, Aslihan; Bulut, Mahmut; Kaya, Mehmet Cemal; Demirpence, Ozlem; Sevim, Bunyamin; Akil, Esref; Varol, SeferVarious immunologic and inflammatory factors are contributed to pathogenesis of Parkinson's disease (PD). High mobility group box-1 (HMGB1) is a protein that plays certain roles in inflammation, DNA repair, transcription, somatic recombination, cell differentiation, cell migration, neuronal development, and neurodegeneration. The aim of the present study was to evaluate the serum levels of HMGB1 and high-sensitivity C-reactive protein (hs-CRP) among patients with Parkinson's disease and healthy controls. This study includes 30 patients with PD and 30 healthy controls, matched sex, age, body mass index, and smoking status. HMGB1 and hs-CRP serum levels were compared between the groups. The diagnostic performance of HMGB1 and hs-CRP was evaluated with receiver operating characteristic (ROC) curve analysis. HMGB1 levels were significantly higher in PD patients than in controls. Hs-CRP levels were significantly higher in PD patients than in controls There was a moderate correlation between hs-CRP and HMGB1 levels in the patient group. The cut-off value of HMGB1 level for the prediction of PD was determined as 32.8ng/mL with 80% sensitivity and 60% specificity (p=0.006). The cut-off value of hs-CRP level for the prediction of PD was determined as 0.63mg/L with 66.7% sensitivity and 77.7% specificity (p=0.007). This study demonstrates for the first time the association between HMGB1, hs-CRP, and PD. We found that HMGB1 and hs-CRP levels to be significantly higher in the PD patients than in the normal controls. As a result of the ROC curve analysis, HMGB1 and hs-CRP levels may be fair markers in the diagnosis of PD.Öğe Identifying autonomic nervous system dysfunction in acute cerebrovascular attack by assessments of heart rate variability and catecholamine levels(Georg Thieme Verlag Kg, 2015) Akil, Esref; Tamam, Yusuf; Akil, Mehmet Ata; Kaplan, Ibrahim; Bilik, Mehmet Zihni; Acar, Abdullah; Tamam, BanuObjective: This study aimed to evaluate changes in the autonomic nervous system caused by cerebral lesions due to acute stroke. We assessed heart rate variability and catecholamine levels in lieu of stroke lesion localization. Materials and Methods: A total of 60 stroke patients and 31 healthy controls were enrolled in the study. Plasma epinephrine and norepinephrine levels were measured on the first, third, and seventh days following the stroke event. Heart rate variability was evaluated with time-domain and frequency-domain analyses via 24-hour Holter monitor recordings. Results: On the first and third day following the stroke, norepinephrine levels were significantly higher in all patient groups as compared to controls. Epinephrine levels on the first, third and seventh days after the stroke were significantly higher in patients with lesions in the right middle cerebral artery territory than controls. In frequency-domain analysis, patients with right middle cerebral artery territory lesions had greater low frequency and low frequency to high frequency ratio values than controls. Time-domain analysis revealed significant decreases in the standard deviation from the mean for 5-minute 288 R-R intervals in patients with lesions in the right middle cerebral artery and posterior cerebral artery territory when contrasted with controls. Patients with lesions in the right middle cerebral artery territory demonstrated the highest increase in the percentage of consecutive R-R intervals differing by more than 50 ms (pNN50) as compared to the control group. Conclusion: These findings indicate that autonomic dysfunction favoring an increase in sympathetic activity occurs in acute stroke patients.Öğe The increase of carcinoembryonic antigen (CEA), high-sensitivity C-reactive protein, and neutrophil/lymphocyte ratio in Parkinson's disease(Springer-Verlag Italia Srl, 2015) Akil, Esref; Bulut, Aslihan; Kaplan, Ibrahim; Ozdemir, Hasan Huseyin; Arslan, Demet; Aluclu, Mehmet UfukThe role of carcinoembryonic antigen (CEA) in Parkinson's disease (PD) has not been previously investigated. The aim of the present study was to evaluate the serum level of carcinoembryonic antigen, high-sensitivity C-reactive protein (hs-CRP), and Neutrophil/lymphocyte ratio (NLR) among patients with Parkinson's disease and to examine the relationship between these inflammatory markers. The cross-sectional design includes 51 patients with Parkinson's disease and 50 age- and sex-matched healthy controls. We investigated the differences in hs-CRP, CEA, and NLR levels between these two groups. CEA was significantly higher in PD patients relative to the control group (mean 2.40 +/- A 1.51 vs. 1.72 +/- A 0.87 (ng/mL), respectively; p = 0.015). Mean NLR was significantly higher in PD patients relative to the control group (mean 3.1 +/- A 1.3 vs. 2.1 +/- A 0.32, respectively; p < 0.001). Serum level of hs-CRP was higher in PD patients than in control group (mean 1.04 +/- A 0.62 and 0.54 +/- A 0.31, respectively; p < 0.01). Correlation analysis revealed significant correlation between hs-CRP, CEA, and Neutrophil/lymphocyte ratio (p < 0.05). This study demonstrates for the first time the association between CEA, hs-CRP, NLR, and PD. We found CEA, hs-CRP, and NLR levels to be significantly higher in the PD patients than in the normal controls.Öğe The Increase of The Mean Platelet Volume in Patients With Intracerebral Haemorrhage(Galenos Publ House, 2012) Arikanoglu, Adalet; Cevik, Mehmet Ugur; Uzar, Ertugrul; Acar, Abdullah; Akil, Esref; Ekici, Faysal; Tasdemir, NebahatObjective: The mean platelet volume (MPV) is a biomarker of platelet function and activity. The influence of platelet function disorders on the aetiology of intracerebral haemorrhages (ICH) and mortality is not clear yet. The purpose of this study is to investigate the change in the MPV values in patients with ICH and to observe its influence on mortality in a retrospective manner. Material and Method: Sixty-six patients with intracerebral haemorrhage (32 males, 34 females; mean age: 61.9 +/- 16.9) were enrolled in the study. Patients with ICH were divided into two groups as those who died within the first 10 days and those who survived. The MPV values and the haematoma volumes were compared between the groups. Also, the MPV values and platelet counts of the patients with ICH were compared with the values of healthy volunteers from similar age and sex groups (27 males, 17 females; mean age: 59.9 +/- 3.2). Results: The MPV values of the patients with ICH measured within 24 hours following the intracerebral haemorrhage (8.33 +/- 1.27 fl) were statistically significantly higher than the MPV values of the control group (7.76 +/- 1.14 fl) (p=0.018). The platelet counts of the patients with ICH also measured with in the first 24 hours (235.8 +/- 94.9 x 10(3)/mL) were statistically significantly lower than the platelet counts of the control group (279.1 +/- 94.9 x 10(3)/mL) (p=0.022). No statistically significant difference in terms of the MPV values and platelet counts was observed between the patients with ICH who died within the first 10 days and those who survived (p>0.05). However, the difference observed in the haematoma volume between the patients with ICH who died within the first 10 days (31.1 +/- 33.7 ml) and those who survived (8.7 +/- 13.4 ml) was statistically significant (p<0.001). No correlation was found between the haematoma volume and the MPV value in the patients with ICH. Discussion: The increase, observed in the mean platelet volume in patients with ICH, may point to a disorder in the platelet function. No relationship was found between the increase in the MPV and the mortality rates.Öğe Increased fibrinogen, D-dimer and galectin-3 levels in patients with migraine(Springer-Verlag Italia Srl, 2014) Yucel, Yavuz; Tanriverdi, Halis; Arikanoglu, Adalet; Varol, Sefer; Kaplan, Ibrahim; Akil, Esref; Celepkolu, TahsinThere are limited studies evaluating the fibrinogen levels in patients with migraine. It remains unknown whether the levels of the haematological marker of thromboembolism, d-dimer, and the levels of galectin-3, which plays an important role in inflammation as a proinflammatory mediator, change during the attacks in patients with migraine. The present study aims to compare galectin-3, fibrinogen and d-dimer levels in patients with migraine during the attacks and interictal periods, and to compare galectin-3, fibrinogen and d-dimer levels between patients with migraine and healthy controls to investigate the role of these parameters in the pathogenesis of migraine. Fifty-nine patients with migraine and 30 age-gender matched healthy control subjects were enrolled in the study. Blood galectin-3, fibrinogen and d-dimer levels were measured in patients with migraine. Patients with migraine had higher levels of galectin-3, fibrinogen and d-dimer compared to the healthy controls (p < 0.05). No statistically significant difference was found between galectin-3 and fibrinogen levels during the attacks and interictal period in the migraine group (p > 0.05). Migraine patients had higher d-dimer levels during the attacks compared to the patients in the interictal period in the migraine group (p = 0.05). In conclusion, we found increased levels of fibrinogen, d-dimer and galectin-3 in patients with migraine compared to the healthy control group. Furthermore, we showed increased galectin-3 levels in patients with migraine, and higher d-dimer levels during migraine attacks compared to the interictal periods for the first time. These findings may be associated with the hypercoagulability and neurogenic inflammation during migraine headaches.Öğe Investigation of Mean Platelet Volume and Platelet Count in the Blood of Patients with Migraine(Turkish Neurological Soc, 2013) Varol, Sefer; Akil, Esref; Cevik, Mehmet Ugur; Celepkolu, Tahsin; Yucel, Yavuz; Tanriverdi, Mehmet Halis; Aluclu, Mehmet UfukObjective: Mean platelet volume (MPV) is an indicator for platelet function and activation. Studies researching MPV and platelet level on the patients with migraine are insufficient. In this study, we aimed to find a difference in MPV and platelet count in individuals with migraine compared to healthy controls, which are indicators for platelet activation. Material and Method: We recruited 193 patients (female/male: 128/65, average age: 31.66 +/- 9.01) who are referred to the Neurology Clinic of Dicle University, Faculty of Medicine between January 2010 and January 2012 and have been diagnosed with migraine according to 2004 diagnostic criteria of International Headache Society (IHS) and 119 healthy individuals (female/male: 73/46, averge age: 32.27 +/- 9.88) who are referred to the Family Practice Clinic and Blood Bank. We compared MPV and platelet counts between the patients with migraine and healthy controls. Both groups were similar in terms of age and gender. Results: A statistically insignificant increase was found in MPV in patients with migraine (7.98 +/- 1.34 fL) when compared to the control group (7.85 +/- 0.96 fL) (p=0.34). Platelet levels were significantly lower in patients with migraine (367.6 +/- 74.2) than the platelet levels of the control group (286.9 +/- 68.3) (p=0.02). Discussion: We found lower platelet levels in the patients with migraine compared to the control group. There was also statistically insignificant increase in MPV in patients with migraine, suggesting that these findings may indicate an insignificant platelet activation in patients with migraine. New prospective studies are needed on this subject.Öğe Investigation of Total Oxidants/Antioxidants in Patients with Intracerebral Haemorrhage(Turkish Neurological Soc, 2013) Cevik, Mehmet Ugur; Acar, Abdullah; Yucel, Yavuz; Varol, Sefer; Akil, Esref; Arikanoglu, Adalet; Yuksel, HaticeObjective: Although there are numerous studies about oxidants and antioxidants in patients with ischemic stroke, the number of studies on this subject in patients with intracerebral hemorrhage (ICH) is limited. Malondialdehyde (MDA) is an oxidant parameter investigated in patients with ICH, and total oxidant status (TOS) has not been investigated so far. We aimed to investigate in blood samples the oxidant parameters MDA and TOS, and the total antioxidant status (TAS) in patients with ICH. Material and Method: A total of 30 patients with ICH, admitted and treated at the Neurology Clinic in the Faculty of Medicine, University of Dicle and 30 control who had no stroke or any systemic disorders were included in the study. Peripheral vein blood samples taken from patients and controls were included in the first 24 hours after stroke. Serum TAS, TOS values were measured with the Erel method, a specific, fully automatic and colorimetric method, and serum level of MDA was measured with method of Ohkawa. Results: Compared to the control group, the serum levels of TAS, TOS and MDA were significantly higher in the ICH patients (p < 0.05). However, there was no correlation between serum TOS, TAS and MDA levels and Glasgow Coma Scale (GCS) total scores and hematoma volumes (p> 0.05). Discussion: The increase in the serum levels of MDA, TOS, and TAS in ICH patients may demonstrate that there is an increase in oxidative stress and this supports the fact that that oxidative stress may play a significant role in the pathogenesis of the ICH. However, the increase of these parameters was not found to be associated with hematoma volume and GCS in patients with ICH.Öğe Just Get Headache... Isolated Transverse Sinus Venous Thrombosis(Aves, 2013) Ozhasenekler, Ayhan; Durgun, Hasan Mansur; Kacmaz, Omer; Tunc, Ibrahim; Akil, Esref; oner, HakanCerebral venous thrombosis is a rare condition than arterial oclusive disease of brain. While sagittal and cavernous sinus thrombosis are frequently seen, transverse sinus thrombosis is rare. Clinically, headache is the most common and the initial symptom. The first diagnostic tool of cerebral venous thrombosis is non-contrast brain tomography. Non-contrast brain tomography, one of the imaging methods commonly used in patients with a headache in the emergency room, should be evaluated well.Öğe Low fetuin-A level in migraine: a case-control study(Springer-Verlag Italia Srl, 2014) Tanriverdi, Mehmet Halis; Varol, Sefer; Arikanoglu, Adalet; Bucaktepe, Pakize Gamze Erten; Celepkolu, Tahsin; Akil, Esref; Yuksel, HaticeMigraine is a type of primary headache which is caused by the alterations in trigeminovascular system. Migraine attacks are associated with neurovascular inflammation of the cerebral and extracerebral vessels, but its pathophysiological mechanisms have not still been fully delineated. Also, migraine has been found to be associated with higher risks for various metabolic disorders. Thus, we aimed to investigate the matrix metalloproteinases (MMP), fetuin-A, ghrelin, and omentin levels which have important roles in metabolic disorders and inflammation, and to examine their relationship with migraine subtypes and attack frequency. Forty-nine migraine patients and 30 age- and sex-matched healthy control subjects were enrolled. Migraine diagnosis was confirmed according to the International Classification of Headache Disorders-II diagnostic criteria. Analyses of MMP9,MMP3, ghrelin, omentin, and fetuin-A were performed by the ELISA method. Fetuin-A, MMP-9, and MMP-3 levels were significantly lower in migraine than controls (p < 0.05). There were no significant differences between groups with respect to omentin and ghrelin (p > 0.05). In migraine patients, serum fetuin-A levels were positively correlated with MMP-9 and negatively correlated with MMP-3. MMP-3, MMP-9, fetuin-A, omentin and ghrelin levels did not correlate with age, disease duration, or frequency of migraine headache (p > 0.05). Migraine patients have lower fetuin-A, MMP-3 and MMP-9 levels than healthy individuals. Migraine patients have low fetuin-A levels, which may be related to the pathogenesis of migraine. The importance and impact of our findings on the pathogenesis, characteristics, and treatment of migraine needs to be investigated in further detailed studies.Öğe Oxidative Damage is Ameliorated by Curcumin Treatment in Brain and Sciatic Nerve of Diabetic Rats(Taylor & Francis Ltd, 2012) Acar, Abdullah; Akil, Esref; Alp, Harun; Evliyaoglu, Osman; Kibrisli, Erkan; Inal, Ali; Unan, FatmaTo date, there have not been enough studies about the effects of curcumin against oxidative stress on sciatic nerves caused by streptozotocin (STZ) in diabetic rats. Therefore, this study was undertaken to determine whether curcumin, by virtue of its antioxidant properties, could affect the oxidant/antioxidant balance in the sciatic nerve and brain tissues of streptozotocin (STZ)-induced diabetic rats. A total of 28 rats were randomly divided into four groups of seven rats each: normal controls, only curcumin treated, diabetic controls, and diabetics treated with curcumin. Biomarkers-malondialdehyde (MDA), total oxidant status (TOS), total antioxidant status (TAS), oxidative stress index (OSI), and NO levels-for oxidative stress in the brain and sciatic nerve tissues of the rats were measured. We found a significant increase in MDA, NO, TOS, and OSI, along with a reduction in TAS levels in the brains and sciatic nerves of the STZ-induced diabetic rats (for both parameters p < 0.05). The MDA, TOS, OSI, and NO levels in these tissues were significantly reduced in the curcumin-treated diabetic group compared to the untreated diabetic group. In conclusion, the results of this study suggested that curcumin exhibits neuroprotective effects against oxidative damage in the brain and sciatic tissues of diabetic rats.Öğe THE PLASMA LEVEL OF PARATHORMON AND HOMOCYSTEINE IN MIGRAINE PATIENTS; ANOTHER ASPECT ON MIGRAINE-STROKE ASSOCIATON(Carbone Editore, 2015) Varol, Sefer; Akil, Esref; Yunce, Muharrem; Kaplan, Brahim; Ozdemir, Hasan Huseyin; Arslan, Demet; Yilmaz, AhmetThe pathogenesis of migraine has been well studied and it is associated with oxidative stress, neurogenic inflammation, and endothelial dysfunction. To the best of our knowledge, no studies have focused on the impact of the parathormone (PTH) and homocysteine levels in migrane patients. To determine migraine-stroke association, our study focused on the levels of PTH and homocysteine in the blood of migraine patients. Fifty five migraine patients in the presence or absence of aura were included. The patients in the migraine group were divided into subgroups: (I) migraine in the attack period (with and without aura) (n = 23), and (II) migraine in the interictal period (with and without aura) (n = 32). As a control, 30 healthy volunteers were also enrolled in the study. As a result, we found that PTH and homocysteine levels of the migraine patients were increased significantly when compared with healthy volunteers (p = 0.001). The PTH and homocysteine levels of the patients with aura were higher than patients without aura in the migraine group (p < 0.05). There were no statistically significant differences between PTHIhomocysteine levels and migraine duration or migraine attack frequency (p > 0.05). There was a positive correlation between PTH and homocysteine levels in the migraine patients (p = 0.001, r = 0.49). To summarize, we found statistically significant increases in PTH and homocysteine blood levels of migraine patients versus healthy volunteers. These results may help to understand the pathogenesis of migraine ischemia, and potentially identify new prognostic markers for this condition.
