Browsing by Author "Mavioglu, H"

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    Anaplastic Ependymoma and Atypical Refractory Longitudinal Expansive Transverse Myelitis Due to Immune Reaction After COVID-19-A Case Discussion That Raises Many Unknown Questions About Covid-19
    Gemici, YI; Çelik, F; Göz, ZZ; Isisag, A; Ovali, GY; Zileli, M; Barutçuoglu, M; Mavioglu, H
    Inflammatory neurologic manifestations, both infectious and noninfectious, have been reported secondary to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2/COVID-19). However, the relationship of spinal tumor and COVID-19 longitudinally extensive transverse myelitis (LETM) coexistence has never been reported in our knowledge. The clinical presentation and response to treatment of a 24-year-old female patient diagnosed with COVID-19 LETM and anaplastic ependymoma are described in this case report. The Patient's cerebrospinal fluid COVID-19 antibody level was higher than serum , she was resistant to immunosuppressive treatment. The interaction between COVID-19 and spinal tumor was discussed in the light of the literature. It is thought that COVID-19 infection could trigger tumor growth in this patient. Also, this is the first case of anaplastic ependymoma and COVID-19 myelitis coexistence in the literature.
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    Prognostic factors in patients with cerebral sinus venous thrombosis presenting with hemorrhage and papilledema
    Saritas, AS; Batum, M; Ataç, C; Öztürk, U; Yilmaz, H; Mavioglu, H; Selçuki, D; Ak, AK
    Objective: The thromboinflammatory process is considered to play a role in the pathogenesis and prognosis of cerebral sinus vein thrombosis (CSVT). The purpose of the study was to compare the thromboinflammatory parameters between individuals with CSVT and healty controls. Additionally, the study sought to compare these parameters among CSVT subgroups with and without haemorrhage, as well as with and without papilledema. Furthermore, the investigation also aimed to identify which parameters had a more significant impact on the risk of hemorrhage and the development of papilledema in CSVT.Methods: Thromboinflammatory parameters were compared retrospectively between the CSVT group of 88 patients and 80 age- and sex-matched healthy controls, and in the CSVT subgroups with (n = 35) /without hemorrhage (n = 53) and with (n = 52) /without papilledema (n = 36) after ethics committee approval. In both groups, parameters contributing to the risk of hemorrhage and papilledema development were determined by univariate and multivariate analyses.Results: Regarding the risk of hemorrhage in CSVT patients, the most significant factors included hematocrit of <30.2 (%), mean platelet volume of <= 8.9 fL, neutrophil count of >5600, and hsCRP of >9 mg/L. Regarding the risk of papilledema development, the most important risk factors were age of <= 49, presence of vomiting, presence of blurred vision, HDL of >47 mg/dL, and D-dimer of >178 ng/mL.Conclusion: It was suggested that evaluating serum thromboinflammatory parameters, as well as demographic characteristics and neurological examination findings, had a critical role regarding prognosis and predictive factors in CSVT.
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    Clinical and histological changes of intrathecally administered gadopentate dimeglumine (Gd-DTPA) in normal rats
    Mavioglu, H; Tuglu, I; Temiz, C; Ozbilgin, K; Cilaker, S; Selcuki, D; Selcuki, M
    Objectives: This study is carried out to explore clinical and histological changes induced in rats by intrathecal administration of Gd-DTPA via suboccipital spinal injection. 2.5, 5, 10 mu mol/g-brain of Gd-DTPA were injected intrathecally to 43 adult male rats and sucrose as control solution with same volume and osmolarity were injected to 18 rats. Animals were sacrificed on day 4 and 14. Sections from the cortex, brain stem, cerebellum and medulla spinalis were obtained to examine for cell loss and apoptosis. In this study, no clinical abnormalities were observed in 69.8 % of rats of Gd-DTPA group and in 83.3 % of rats of sucrose group. Transient neurological signs such as ataxia and paresis were seen in 11.6 % of rats in the Gd-DTPA group and in 5.5 % of rats in the sucrose group. They were seen more frequently in the Gd-DTPA group especially in the highest dose and volume. Histological examination did not revealed necrosis or apoptosis in both groups. This study suggests that intrathecally administered Gd-DTPA may be safe in humans when lower doses per gram of brain are used than rats.
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    An Adverse Event Associated with Antifungal Therapy: Clinic-Like Posterior Reversible Encephalopathy Syndrome
    Ak, AK; Erbüyün, S; Heppekcan, D; Batum, M; Boyaci, R; Mavioglu, H; Tok, DA
    Posterior reversible encephalopathy syndrome (PRES) is a diagnosis characterized by headache, changes in consciousness, epileptic seizures, visual symptoms (decreased visual acuity and blurred vision), vasospasm, and perfusion abnormalities in the posterior systemic vessels of the brain. The most common clinical findings of PRES include headache, epileptic seizure, altered consciousness, motor deficits, and loss of vision. In the patient who presented with symptoms similar to those in PRES after the use of anidulafungin and had a history of trauma, other causes of PRES (like carotid and/or vertebral artery dissection, intra-abdominal trauma, and head trauma etc.) were excluded. In our case, visual disturbance was assessed as being secondary to central nervous system pathology. There are no similar cases in the literature that presented with clinical features of PRES and normal imaging findings. The primary aim of this study was to draw attention to the fact that anidulafungin may cause symptoms similar to those in PRES.
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    Effects of oestrogen replacement therapy on pattern reversal visual evoked potentials
    Yilmaz, H; Erkin, E; Mavioglu, H; Laçin, S
    As a result of a regression in the ovarian functions, oestrogen level in circulation during the menopause drops to 1/50 of its value in the normal reproductive cycle. Excitatory oestrogen increases the sensitivity of the central nervous system to catecholamines by changing the opening frequency of voltage-related L-type calcium channels and augmenting the effect of glutamate; in addition it inhibits the formation of gamma-amino butyric acid (GABA) by the inhibition of glutamate decarboxylase enzyme. It is argued that oestrogen increases transmission in the optic pathways and that oestrogen is responsible for the shorter latency values and higher amplitudes of visual evoked potentials in women. We recorded the monocular pattern reversal visual evoked potentials (PRVEP) of both eyes of 54 post-menopausal women before treatment and of 30 of them after replacement therapy with Tibolon, and of 24 women receiving placebo treatment. The explicit values of P-100 latency of right and left eyes before treatment were 98.8 +/- 3.5 and 99.0 +/- 3.3 ms, respectively. The explicit values of P-100 latency of right and left eyes after placebo treatment were 98.6 +/- 3.7 and 98.8 +/- 4.0, respectively. The explicit values of P-100 latency of right and left eyes after replacement treatment were 94.6 +/- 3.7 and 94.8 +/- 4.0, respectively. We found a statistically significant decrease in the mean PRVEP latencies and a statistically significant increase in mean amplitudes after replacement treatment (P < 0.001) compared with those before treatment and those after placebo treatment, We attributed the changes in PRVEP values after replacement treatment to the action of Tibolon, which acted as a natural sex steroid and speeded the visual transmission time via the widespread receptors in the central nervous system. It is concluded that PRVEP is an objective electrophysiological assessment method in evaluating the efficiency of hormone replacement therapy in post-menopausal women.
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    Cross-facial nerve grafting as an adjunct to hypoglossal-facial nerve crossover in reanimation of early facial paralysis
    Yoleri, L; Songür, E; Mavioglu, H; Yoleri, Ö
    Reanimation of a spontaneous and synchronous smile, and sufficient depressor mechanism of the lower lip presents a surgical challenge in facial paralysis. Hypoglossal-facial nerve crossover and cross-facial nerve grafting are the best options if the mimetic muscles around the mouth are still viable in patients in whom the facial nerve was sacrificed at the brainstem, Although good muscle tone and facial motion have been obtained by hypoglossal-facial nerve crossover, smile is dependent on conscious tongue movement, Cross-facial nerve grafting provides a voluntary and emotion-driven smile, but requires two coaptation sites, which leads to substantial axonal loss and a long regeneration time. This method was not successful in activating the depressor mechanism. The first stage is the classic baby-sitting procedure, in which the bulk of the mimetic muscles was maintained by the rapid reinnervation of the hypoglossal-facial nerve crossover during the regeneration period of the cross-facial nerve graft, and temporalis muscle transfer to the eyelids is performed. During the second stage, the cross-facial nerve graft that used the thickest zygomaticobuccal branch on the healthy side was coapted with the corresponding branches on the paralyzed side. The hypoglossal-facial nerve crossover continued to innervate the depressor muscles. Good spontaneous smile and sufficient depressor mechanism were achieved by cross-facial nerve grafting and hypoglossal-facial nerve crossover respectively, and these techniques are demonstrated by the authors clinically and electrophysiologically.
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    The validity and reliability of the Turkish version of Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) in patients with mild and moderate Alzheimer's disease and normal subjects
    Mavioglu, H; Gedizlioglu, M; Akyel, S; Aslaner, T; Eser, E
    Objectives The cognitive subscale of the Alzheimer's Disease Assesment Scale (ADAS-Cog) is the most widely used test in clinical trials dealing with Alzheimer's disease (AD). The aim of this study was to investigate the validity and reliability of the Turkish version of ADAS-Cog. Methods Twenty-nine patients with AD, fullfilling NINCDS-ADRDA criteria of probable AD, who were in stage 3-5 according to the Global Deterioration Scale (GDS), and 27 non-demented control subjects with similar age, gender and educational status were recruited for the study. The Turkish version of ADAS-Cog, Standardized Mini Mental Status Examination (MMSE) and Short Orientation-Memory-Concentration Test (SOMCT) were applied to both of the groups. Inter-rater reliability, internal consistency, test-retest reliability; face validity, differential validity and convergent validity were statistically analyzed. Results Both MMSE and ADAS-Cog have significantly differentiated patients with AD and control subjects (p < 0.001). A significant correlation was established between MMSE and ADAS-Cog scores in AD group (r: -0.739). ADAS-Cog was also highly significantly correlated with GDS (r: 0.720) and SOMCT (r: 0.738). For the group with AD, control and whole cohort coefficients of internal consistency, Cronbach's alpha: 0.800, 0.515, 0.873 were found respectively. Inter-rater reliability for total ADAS-Cog score was found as ICC: 0.99 and 0.98 and test-retest reliability was found as ICC: 0.91 and 0.95 for demented and nondemented subjects, respectively. Conclusion The Turkish version of ADAS-Cog has been found to be highly reliable and valid in differentiating patients with mild and moderate AD from nondemented subjects. Copyright (c) 2006 John Wiley & Sons, Ltd.
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    Adaptation to Turkish Community and Reliability-Validity of ADCS-ADL Scale
    Ince, A; Mavioglu, H; Eser, E
    Objectives: The aim of the present study is to assess the validity and reliability of Turkish adaptation of the Alzheimer Disease Cooperative Study-Activities of Daily Living (ADCS-ADL) scale and to enable the use of this scale in Turkey in Alzheimer Disease(AD) related studies. Material and Method: Thirty-two patients with AD, 10 suspicious demented patients (mild cognitive impairment) and 31 non-demented control subjects with similar age, gender and educational status were enrolled to the study. ADCS-ADL, Modified Older Americans Resources and Services Procedures Instrument(MOARSI), Mini Mental State Examination(MMSE), Clinical Dementia Rating (CDR) and Global Deterioration Scale(GDS) were applied to all subjects. Alzheimer Disease Assessment Scale-Cognitive Scale(ADAS-Cog) was also applied to the demented and suspicious demented subjects. Internal consistency, test-retest reliability, differential validity and concurrent validity were statistically analyzed. Findings: ADCS-ADL differentiated AD group from normal and suspicious demented groups significantly (p: 0.0001). Additionally, the scale was found sensitive to dementia stages (p: 0.01). A significant correlation between the ADCS-ADL scores of AD group and MMSE(r:0.736), CDR (r:0.758), CDR Total (r:0.828), GDS (r:0.743), basic section of MOARSI (r:0.826) and instrumental section of MOARSI (r: 0.826) groups were detected. The correlation with ADAS-Cog was weak (r:0.191). Internal consistency values were measured as alpha: 0.937, 0.719 and 0.758 for AH, suspicious demented and control groups respectively. Test-retest reliability was quite high (ICC: 0.998). Conclusion: The study showed that Turkish adaptation of ADCS-ADL is valid and reliable scale in assessing and monitoring the AD patients in Turkish society.
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    Total tongue reconstruction with free functional gracilis muscle transplantation: A technical note and review of the literature
    Yoleri, L; Mavioglu, H
    The tongue is one of the most difficult structures of the body to reconstruct if more than 85% to 90% of it has been resected, A functional neotongue requires both soft-tissue bulk and restoration of muscle function, The innervated gracilis muscle flap folded on itself was used to reconstruct a total glossectomy defect. The genioglossus muscle, which makes the greatest contribution to swallowing, and the mylohyoid muscle, which elevates the larynx to prevent aspiration, were simulated with the design and placement of the gracilis muscle, The muscle was placed and secured longitudinally from the remnant of the tongue base and pharynx to the mandible, and then folded on itself and attached to the hyoid bone. The obturator nerve to the gracilis was coapted with the hypoglossal nerve. The patient was able to resume oral feeding without aspiration, Electromyographic results demonstrated reinnervation of the flap with active elevation of the mouth base, The patient died 1 year postoperatively because of recurrence of her disease. This type of design and placement of gracilis muscle transplantation is recommended.
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    Pattern reversal visual evoked potentials in different reproductive stages of females
    Yilmaz, H; Mavioglu, H; Erkin, EF; Oksel, F; Lacin, S
    Estrogens increase after puberty and remain at high levels in the reproductive period and decrease with menopause. These changes occuring in the level of estrogens affect dopamine metabolism indirectly by causing changes in cathecholamine sensitivity of the brain. To assess the role of estrogens on the formation of pattern reversal evoked potentials (PRVEPs), three groups of patients were considered: prepubertal group, reproductive age group and postmenopausal group. PRVEPs of all subjects were recorded. Mean latency was shortest in the reproductive age. While no statistical difference was present between the mean latencies of prepubertal and the reproductive period groups, the mean latencies of both of these groups were statistically significantly shorter than that of the postmenopausal group(p<0.005).
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    Visual evoked potentials in pregnancy
    Yilmaz, H; Erkin, EF; Mavioglu, H; Sungurtekin, Ü
    Pregnancy is a period when the estrogen/progesterone ratio rises considerably because of the passage of estrogen from the placenta. These changes in the level of estrogen during pregnancy increase the sensitivity of the central nervous system to cathecholamines. As a result, the sensitivity of the receptors in both the visual cortex and the inner plexiform layer of the retina to dopamine increases, and transmission in the optic pathways becomes faster. Inspired by this knowledge, we studied monocular pattern-reversal visual evoked potentials (PRVEPs) in both eyes of 30 pregnant women in the first trimester and 30 healthy nonpregnant women in the reproductive age. Mean P-100 latency of pregnant women was significantly shorter than mean P-100 latency of nonpregnant women (p<0.001). Mean P-100 amplitude values were higher in pregnant women, although not statistically significant (p>0.05). Plasma estrogen and progesterone levels of pregnant women showed a negative correlation with PRVEP latencies, but a positive correlation with PRVEP amplitudes. In conclusion, this study supports the impression that changes in the levels of sex steroids affect the formation of PRVEPs by their actions on the central nervous system. The increase in estrogen during pregnancy seems to facilitate neural transmission in the optic pathways. Rise in the estrogen-progesterone level might be responsible for the shorter PRVEPs latencies in pregnant women.
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    ASSESSMENT OF THE IMPACT OF DEMENTIA CARE AND SUPPORT PROGRAM IN BOTH PATIENT AND CAREGIVER OUTCOMES: AN INTERVENTION STUDY
    Uyar, F; Özmen, D; Mavioglu, H; Atalay, N
    Introduction: Dementia is one of the priority issues among the public health concerns. This study aims to assess the impact of the Dementia Care and Support Program in caregivers and patients with dementia. Materials and Methods: This study is an intervention study. Dementia Care and Support Program was a planned 16-week program. Sixty-one patient-caregiver pairs were randomized into two groups, the intervention (n=31) and control groups (n=30). Dementia Care and Support Program was applied to the intervention group, but the control group received routine hospital care. Data were collected between July and November 2016 from a dementia outpatient clinic. While data for patients were collected using the quality-of-life assessment in Alzheimer's disease and Neuropsychiatric Inventory, data for caregivers were collected using the quality of life SF-36, Beck Depression, Beck Anxiety, and Zarit Caregiver Burden Care Inventory. Results: Fifty-four patient-caregiver pairs completed the study. The mean age of the patients was 76.7 +/- 11.2 (46-96) years old. There was no statistically significant difference in the quality-of-life scores and neuropsychiatric symptom scores between the patient groups (p>0.05). The mean age of caregivers was 53.6 +/- 14.8 (22-81) years old. Statistically significant differences were found in NPI-D, quality-of-life mental health, quality-of-life physical health, depression, and anxiety scores between the caregiver groups (p<0.05), but there was no statistically significant difference in burden scores (p>0.05). Conclusion: This study established that Dementia Care and Support Program has positive effects on caregivers.
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    Review of Antiepileptic Therapy of a Case Associated With Eclampsia and PRESS
    Kisabay, A; Oktan, B; Sari, S; Mavioglu, H; Yilmaz, H
    Posterior reversible encephalopathy syndrome (PRES) is a syndrome characterized by headache, changes in mental status, epileptic seizure, visual disturbances, and typically alterations in posterior circulation of the brain. Ictal findings of this type of epileptic seizures and their response to the treatment vary. It is observed that single and/ or combined anti-epileptic drugs have been used in treatment of the seizures. Radiological involvement doesn't always correlate with clinical findings. The same also applies for the relationship between epileptic-seizure activity and distribution of radiological involvement. Simple partial seizures rapidly and well responding to the isolated treatment as well as course of status epilepticus may occur. The present study discussed how the current approach to epileptic seizures was associated with posterior reversible encephalopathy syndrome by presenting a report whose prognosis was good although the condition involved both basal ganglia and cerebral deep structures, and whose seizures ceased with magnesium replacement.
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    Oligoclonal Band Number Affect On Cognitive Function Of Multiple Sclerosis Patients
    Gemici, YI; Batum, M; Saritas, AS; Kisabay, A; Mavioglu, H
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    POSTERIOR REVERSIBLE ENCEPHALOPATHY SYNDROME (PRES): A CASE REPORT
    Yilmaz, H; Mavioglu, H; Kisabay, A; Oktan, B
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    Changes in pattern reversal evoked potentials during menstrual cycle
    Yilmaz, H; Erkin, EE; Mavioglu, H; Sungurtekin, Ü
    Hormonal changes that occur during the menstrual cycle of women influence the visual function of females. Estrogen is reported to cause a decrease in the visual transmission time by increasing the sensitivity of receptors in the optic pathways to dopamine. The aim of this study was to search if pattern reversal evoked potentials (PRVEPs) changed during the different phases of the menstrual cycle. PRVEPs of both eyes of 30 healthy women were recorded in 4 different phases of the menstrual cycle, namely, menstrual, follicular, ovulatory and luteal. The highest mean PRVEP latency and the lowest mean P-100 amplitude were recorded during the menstrual phase. The mean PRVEP latency recorded during the ovulatory phase (when estrogen level rises to 3-5 times that of other phases' without an increase in progesterone levels) was statistically significantly shorter than that of other phases' (p < 0.05). Although not statistically significant, the mean P-100 amplitude recorded during the ovulatory phase was higher than the ether phases. Looking at these results, sex steroids seemed to affect the generation of PRVEPs. The significant decrease in PRVEP latencies when estrogen levels peaked was thought to be due to facilitating effect of estrogen on the neural transmission of the visual pathways.
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    Miller Fisher Syndrome/Pharyngeal-Cervical-Brachial Variant of GBS Overlap and Human Herpes Virus-6 Reinfection: May There BE A Relationship?
    Mavioglu, H; Kisabay, A; Sari, S; Akçali, S; Oktan, B
    Miller Fisher Syndrome (MFS) is a rare variant of Gulliain Barre syndrome (GBS) characterized by external ophthalmoplegia, ataxia, areflexia, and usually by positive anti GQ1b antibody. It occurs through an autoimmune mechanism most frequently after Campylobacter jejuni, followed by Haemophilus influenzae infection. Although occurrence with other viruses and bacteria has been reported, the concurrence of MFS and Human Herpes Virus-6 (HHV-6) has not been reported so far. There are a few publications reporting association of GBS with HHV-6. In the present study, HHV-6 DNA with PCR was detected in the cerebrospinal fluid (CSF) of a 59 year-old female patient diagnosed with MFS/pharyngeal-cervical-brachial variant of GBS overlap from clinical findings and positive anti-GQ1b antibody in the serum. This article aims to create awareness of a possible relationship between MFS, GBS and HHV-6.
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    CIRCULATING MANGANESE SUPEROXIDE DISMUTASE (Mn-SOD, SOD2) LEVELS AND ITS Ala16Val POLYMORPHISM IN PATIENTS WITH ALZHEIMER'S DISEASE
    Kilinç, E; Var, A; Mavioglu, H; Dinç, G; Karaçam, M; Güvenç, Y
    Introduction: Amyloid beta protein, DNA damage, oxygen free radicals and mitochondrial dysfunction are propounded mechanisms for pathogenesis of Alzheimer's disease (AD). In this study, we have focused on manganese superoxide dismutase (MnSOD, SOD-2), the most important scavenger enzyme in mitochondria. Ala16Val polymorphism, the most common variation in the SOD-2 gene, is considered to participate in the pathogenesis of neurodegenerative diseases. Therefore, in this study, we aimed to explain whether the MnSOD levels and its Ala16Val polymorphism are associated with Alzheimer's disease. Materials and Method: We determined the protein SOD-2 levels and its Ala16Val polymorphism in patients with AD (n=55) and control samples (n=62) from age and sex matched healthy volunteers. Real time pcr and spectrophotometry were used for the analyses of Ala16Val polymorphism and SOD-2 levels respectively. Results: We found significantly increased MnSOD levels in patients with Alzheimer's when compared to the healthy volunteers (144 +/- 67U/gHb, 76 +/- 51 U/gHb respectively, p=0.001). But, there is no difference in Ala16Val polymorphism between the two groups. Conclusion: We consider that MnSOD is a critical antioxidant enzyme for mitochondrial vitality in Alzheimer patients, but its polymorphic structure does not contribute to pathophysiology of Alzheimer's.