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Öğe Apelin-13: A Promising Biomarker for Multiple Sclerosis?(Wolters Kluwer Medknow Publications, 2018) Alpua, Murat; Turkel, Yakup; Dag, Ersel; Kisa, UclerObjectives: Recent studies have shown that Apelin 13 may have a neuroprotective property. Therefore it can be used as a biomarker for multiple sclerosis. Our purpose to assess serum apelin-13 levels in adult patients with multiple sclerosis and healthy controls. Patients and Methods: Subjects consisted of 42 relapsing remitting multiple sclerosis patients and 41 controls. Demographic characteristics including age, gender, duration of disease and Expanded Disability Symptom Scale (EDSS) were recorded. In serum samples obtained from the patients and controls, serum apelin-13 levels were measured with Enzyme Linked Immunosorbent Assay (ELISA) method. Results: Serum apelin-13 levels were significantly higher in the patients groups than the healthy controls (P = 0.003). Pearson analysis did not show any significant correlation between EDSS, disease duration and apelin-13 levels. Conclusion: The results of our study have been showed statistically significant higher levels of serum apelin-13 in multiple sclerosis patients compared to controls. Further studies with larger patients populations and healthy controls should be done to clarify to use serum apelin levels as a biomarker for multiple sclerosis.Öğe Autonomic dysfunction in patients with essential tremor(Springer-Verlag Italia Srl, 2017) Habipoglu, Yasin; Alpua, Murat; Bilkay, Cemil; Turkel, Yakup; Dag, ErselThe aim of this study was to evaluate the autonomic function in patients with essential tremor (ET). Thirty-one adult patients with ET and 26 healthy controls were enrolled in the study. The electrophysiological evaluations of the autonomic nervous system function were performed by sympathetic skin response (SSR) and R-R interval variation (RRIV) tests. The mean latency of SSR in ET patients was significantly delayed compared with the controls (P = 0.01). The mean amplitude of sympathetic skin response was significantly lower in ET patients in comparison to the controls (P = 0.001). No differences were found in mean RRIV values in both group subjects. Sympathetic dysfunction may occur in patients with ET. This may be easily demonstrated by SSR tests.Öğe Colchicine-Related Polyneuropathy and Multiple Organ Failure(Turkish Neurological Soc, 2013) Dag, Ersel; Turkel, Yakup; Gokce, BurcuColchicine arrests microtubule assembly and inhibits many cellular functions. This drug is used to treat gout and and Familial Mediterranean Fever. Its gastrointestinal side effects are frequent but more severe adverse effects such as neuropathy and multi-organ failure associated with colchicine are rare. The blood levels of colchicine are dependent on the liver and kidneys. Thus renal or liver failure can result in colchicine toxication. We presented a case of colchicine toxicity, which resulted in multi-organ failure and polyneuropathy.Öğe Compressive Optic Neuropathy Presenting With Psychiatric Symptoms(Lippincott Williams & Wilkins, 2014) Ornek, Nurgul; Buyuktortop-Gokcinar, Nesrin; Dag, Ersel; Ornek, KemalWe report a case of bilateral optic neuropathy presenting with psychiatric symptoms. A 50-year-old woman was admitted with blurry vision in both eyes. She had a 3 months' history of depressed mood. Both optic discs had mild temporal pallor with visible spontaneous venous pulsations. Magnetic resonance imaging of the brain showed a large frontal mass compressing the optic nerves. The tumor was surgically resected, and tissue pathology demonstrated an olfactory groove meningioma.Öğe Corneal Sensitivity and Tear Function in Neurodegenerative Diseases(Taylor & Francis Inc, 2015) Ornek, Nurgul; Dag, Ersel; Ornek, KemalPurpose: To measure corneal sensitivity and tear function in neurodegenerative diseases (NDs) and to compare them with age and sex-matched controls. Methods: Twenty patients with Alzheimer's disease (AD), 20 patients with multiple sclerosis (MS), 30 patients with Parkinson's disease (PD), 10 patients with Friedreich's ataxia (FA) and 21 patients with epilepsy (EP) who were recruited from the Kirikkale University Neurology Department during 2012 were included in this prospective study. Five groups of age and sex-matched subjects were selected as controls. Corneal sensitivity was measured using a Cochet-Bonnet esthesiometer. Tear function tests included tear break-up time (TBUT) and Schirmer's 1 tests. Results: Compared to their controls, mean corneal sensitivity was significantly reduced in AD, MS, PD and EP patients (all p<0.05), mean TBUT level was significantly shorter in patients with AD and MS (all p<0.05) and mean Schirmer's 1 test score was significantly lower in EP patients (p<0.05). When all groups were compared with each other, reduction of mean corneal sensitivity in AD and PD groups were significantly more than in FA and MS groups (overall p = 0.034). Mean TBUT levels in AD, MS and PD groups were significantly shorter than in FA and EP groups (overall p = 0.001). Mean Schirmer's 1 test scores in AD and PD groups were significantly lower than in MS, FA and EP groups (overall p = 0.040). Conclusions: Neurodegenerative diseases may be associated with reduced corneal sensitivity and abnormal tear function.Öğe Decreased plasma nesfatin-1 levels in patients with generalized anxiety disorder(Pergamon-Elsevier Science Ltd, 2012) Gunay, Huseyin; Tutuncu, Recep; Aydin, Suleyman; Dag, Ersel; Abasli, DilekNesfatin-1, a recently discovered satiety molecule, is localized in neurons of the hypothalamus and brain stem and colocalized with stress-related substances. However, the relation between nesfatin-1 and stressor related behaviors like anxiety and/or fear has not yet been investigated in human subjects. In the present study, our aim was to investigate whether there was a relationship between plasma nesfatin-1 levels and generalized anxiety disorder. The study group consisted of 40 patients (BMI, 22.98 +/- 0.56) with generalized anxiety disorder and 34 age-matched healthy male control subjects (23.05 +/- 0.4). Patients fully met the fourth Diagnostic and Statistical Manual of Mental Disorders, text revision. Blood samples for nesfatin-1 were drawn at the end of an overnight fasting period at least 10 h. Plasma nesfatin-1 levels were measured and found significantly lower in anxiety disorder group than in control group (0.35 +/- 0.037 ng/ml vs. 0.63 +/- 0.080 ng/ml, respectively, p < 0.05). Low nesfatin-1 levels may be related with generalized anxiety disorder. (C) 2012 Elsevier Ltd. All rights reserved.Öğe Effects of Lamotrigine and Topiramate on Brain Maturation and Cognitive Functions in Offspring of Pregnant Rats - Preliminary Study(Wroclaw Medical Univ, 2014) Dag, Ersel; Dag, Zeynep O.; Baydas, Giyasettin; Tuzcu, Mehmet; Yoldas, Tahir K.; Mungen, Bulent; Bal, RamazanBackground. Antiepileptic drugs (AED) which are used to treat seizures in pregnant women, infants, and young children may cause cognitive impairment or other uncertain injury. However, the precise mechanisms responsible for the negative effects of new AEDs like lamotrigine (LTG) and topiramate (TPM) in the developing brain are still unclear. Objectives. To investigate the GFAP, NCAM and S100B levels in the whole brain of newborn rats on postnatal 1 day and in the hippocampus of adult rats to find out the effect of TPM and LTG on cognitive impairment and brain maturation. Material and Methods. Twenty eight pregnant rats were randomly divided into 7 groups with 4 animals in each group. The first group, receiving no drugs, was assigned as the control group. The study groups received intraperitoneal TPM or LTG injections in each trimester. Western blot analysis of the GFAP, NCAM and S100B was performed in the offspring. Behavioral tests were performed at postnatal day 75. Results. The rats in the TPM-I and TPM-III groups had a significant impairment in escape latency on the 5th day as compared to the control rats in a Morris water maze test. In addition, in the expression of astrocyte derived markers, GFAP was upregulated, whereas S100 beta and NCAM were downregulated in the whole brain on postnatal day 1, in offspring exposed to LTG and TPM in utero. Conclusions. The detrimental effects of TPM and LTG appear to be confined particularly to the early stages of brain development. And TPM seems to have a partial role in the cognitive impairmentÖğe Effects of long-term low-level solvent exposure on cognitive function(Canadian Soc Clinical Investigation, 2012) Saygun, Meral; Ekici, Aydanur; Muluk, Nuray Bayar; Cakmak, Aytul; Pinar, Tevfik; Dag, Ersel; Ekici, MehmetPurpose: The effects of long-term low-level exposures to solvents on cognitive function were investigated. Methods: A total of 389 workers at a gun factory, those exposed to solvents (n = 193) and those that were not exposed to solvents during work (n = 196), were included. All the workers were given a questionnaire. Cognitive function was evaluated by Mini-mental Status Examination (MMSE) and psychological status was assessed by Hospital Anxiety and Depression (HAD) Scale. Results: No differences were found in the MMSE and HAD scores between solvent-exposed workers and control workers (p>0.05). In the workers who had used a mask for a longer time, orientation scores were lower. Daytime sleepiness was related to lower recall scores.. Left-handed workers had higher total HAD scores than right-handed workers. Conclusions: Long-term low-level exposure to solvents did not affect cognitive function in the workers, according to their MMSE scores. Duration of solvent exposure was also not related to MMSE Scores. Short sleep duration and daytime sleepiness may negatively affect cognitive function.Öğe Examination of the tissue ghrelin expression of rats with diet-induced obesity using radioimmunoassay and immunohistochemical methods(Springer, 2012) Aydin, Suleyman; Sahin, Ibrahim; Ozkan, Yusuf; Dag, Ersel; Gunay, Ahmet; Guzel, Saadet Pilten; Ozercan, Mehmet ResatCurrently, obesity is an important health problem in all countries, both developed and developing. Dietary habits and neurohormonal imbalances play a critical role in obesity. Circulating amounts of ghrelin, which is a neurohormonal hormone, decrease with obesity and increase with weight loss. Although it is known that both mRNA and peptide version of the ghrelin hormone are expressed in almost all tissues of both humans and animals, it is not known how obesity changes the expression of this hormone in the tissues, with the exception of the gastrointestinal system tissues. Therefore, the objective of the present study is to show how diet-induced obesity in rats changes ghrelin expression in all system tissues, and thus, to shed light on the etiopathology of obesity. The study included 12 male and 12 female 2-month-old Wistar albino species rats. The animals in the control group were fed on standard rat pellet, while those in the experiment group were fed ad libitum on a cafeteria-style diet for 2 months. When their body mass index reached 1 g/cm(2), diet-induced obese (DIO) rats were sacrificed in a sterile environment after one night fasting. Ghrelin localizations in the tissues were studied immunohistochemically using avidin-biotin-peroxidase complex (ABC) method, while tissue ghrelin amounts were analyzed using radioimmunoassay (RIA) method. When the ghrelin amounts in the urogenital system (with the exception of kidney tissues), sensory organs, respiratory system, immune system, skeletal muscle system, cardiovascular system, nervous system, and adipose tissue of rats analyzed by RIA method were compared to those in the control group, tissue ghrelin amounts in the DIO group were found lower. Immunohistochemical findings which showed a similar fall in ghrelin concentrations in the tissues were parallel to RIA results. In addition, ghrelin was shown to be synthesized in the cardiovascular system, heart muscle cells, tails of the sperms, hair follicles, lacrimal glands, tongue, and teeth of rats for the first time in this study and ghrelin syntheses in these tissues were found to decrease in obesity. Nutritional obesity is among the most common causes of obesity and the findings we have obtained through diet-induced obesity will contribute to the illumination of the etiopathology of obesity.Öğe Factors Influencing Cognitive Function in Subjects With COPD(Daedalus Enterprises Inc, 2016) Dag, Ersel; Bulcun, Emel; Turkel, Yakup; Ekici, Aydanur; Ekici, MehmetBACKGROUND: The aim of this study was to assess the association between cognitive function and age, pulmonary function, comorbidity index, and the 6-min walk distance in subjects with COPD as well as to compare the Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) in terms of their ability to identify cognitive dysfunction in subjects with COPD. METHODS: A total of 52 individuals with stable COPD were included in this study. Cognitive function was assessed using MMSE and MoCA. Age, body mass index, the Modified Cumulative Illness Rating Scale, 6-min walk distance, arterial blood gases, and pulmonary function tests were assessed and recorded. RESULTS: The range and SD of scores in subjects with COPD were larger with MoCA than with MMSE. MMSE and MoCA scores are associated with 6-min walk distance and comorbidity index in subjects with COPD. General cognitive function measured by MoCA was negatively correlated with the comorbidity index but was positively associated with 6-min walk distance in subjects with COPD after controlling for possible confounding factors in the multivariate model. However, general cognitive function measured by MMSE was not correlated with the comorbidity index and 6-min walk distance in subjects with COPD, after controlling for possible confounding factors in the multivariate model. CONCLUSIONS: MoCA may be a more reliable screening test than MMSE in detecting cognitive impairment in subjects with COPD. The addition of cognitive tests on assessment of subjects with COPD can provide further benefit.Öğe Is there any association between microalbuminuria and multiple sclerosis?(Asean Neurological Assoc, 2016) Alpua, Murat; Turkel, Yakup; Dag, Ersel; Kisa, Ucler…Öğe Marked changes in olfactory perception during early pregnancy: a prospective case-control study(Springer, 2015) Simsek, Gokce; Muluk, Nuray Bayar; Arikan, Osman Kursat; Dag, Zeynep Ozcan; Simsek, Yavuz; Dag, ErselPregnancy seems to be related with a significant change in olfaction. Here, we investigate this theory by testing the odor identification abilities of uncomplicated pregnant women and compare the results with non-pregnant controls. The study included 31 healthy pregnant women in the first trimester (Group 1), 30 in the second trimester (Group 2), 31 in the third trimester, and 30 non-pregnant healthy controls (Group 4). In order to measure odor identification abilities, each subject completed the 12-item Brief Smell Identification Test (BSIT). Next, the demographic characteristics and BSIT scores of the groups were compared. The total BSIT scores of the subjects in Group 1 were found to be significantly lower than those of the other groups (p < 0.001). This reduction in odor identification abilities was particularly noticeable for leather, pine, and soot. Pregnant women in the second and third trimesters had similar odor identification abilities to the healthy controls (p > 0.05). Early pregnancy might be related to significant changes in olfactory performance. The distortion of odor identification in the first trimester might be a causative factor for the development of pregnancy-specific conditions, such as morning sickness and hyperemesis gravidarum, which are both common complaints during the early phase of parturition.Öğe Minnesota Multiphasic Personality Inventory profile in patients with restless legs syndrome(Wiley-Blackwell, 2015) Turkel, Yakup; Oguzturk, Omer; Dag, Ersel; Buturak, S. Visal; Ekici, Mehmet S.IntroductionRestless legs syndrome (RLS) is associated with psychiatric disorders. We aim to investigate the personality traits of RLS patients using the Minnesota Multiphasic Personality Inventory. MethodsTwenty adult patients with RLS (14 females and 6 males) and 20 healthy controls (14 females and 6 males) who were referred to university neurology were enrolled in the present study. Diagnosis of RLS was established using International Restless Legs Syndrome Study Group. Psychometric evaluation was made with the Turkish version of the Minnesota Multiphasic Personality Inventory. ResultsRLS patients have significantly higher absolute and clinical elevation scores on hypochondriasis and hysteria, and clinical elevation scores on psychasthenia, compared with the controls. Absolute scores on depression were higher at the border in RLS patients compared with the controls. DiscussionRLS patients have hypochondriac, hysterical, depressive, and anxious personality traits.Öğe Optical Coherence Tomography and Visual Field Findings in Patients With Friedreich Ataxia(Lippincott Williams & Wilkins, 2014) Dag, Ersel; Ornek, Nurgul; Ornek, Kemal; Erbahceci-Timur, Inci ElifBackground: To investigate the optical coherence tomography (OCT) and visual field findings in Friedreich ataxia (FRDA). Methods: Ten eyes of 10 patients with genetically confirmed FRDA were included in this study. Twenty-two eyes of 22 age- and sex-matched volunteers served as controls. All eyes were examined with spectral domain OCT (Retinascan Advanced RS-3000; NIDEK) and Humphrey Field Analyzer (HFA II 750; Zeiss-Humphrey Systems). Results: OCT measurements of the average peripapillary retinal nerve fiber layer (RNFL) thickness, average peripapillary retinal thickness (RT), and foveal RT showed a statistically significant reduction in patients with FRDA (P, 0.0001). There was no statistically significant difference in choroidal thickness. OCT measurements of horizontal cup-to-disc (C/D) ratio, vertical C/D ratio, and average cup area were significantly increased in patients with FRDA. Visual acuity was significantly correlated with age at onset (P = 0.021) and average RNFL value (P = 0.045). There was a significant correlation between foveal thickness and disease duration (P = 0.014). Mean RNFL thickness was significantly correlated with the severity of neurological involvement (P = 0.039). Visual field testing (VFT) revealed a generalized reduction of sensitivity in the patients. Conclusion: Patients with FRDA may have a measurable degree of retinal thinning as determined by OCT and a generalized reduction of sensitivity in VFT. Combining structural and functional findings may be used in the follow-up of patients with FRDA. (C) 2013 by North American Neuro-Ophthalmology SocietyÖğe The Pitfalls and Important Distances in Temporal Bone HRCT of the Subjects with High Jugular Bulbs - Preliminary Report(Wroclaw Medical Univ, 2015) Inal, Mikail; Muluk, Nuray B.; Dag, Ersel; Arikan, Osman K.; Kara, Simay A.Background. High jugular bulb (HJB) may be detected unilaterally or bilaterally in temporal bone high resolution computerized tomography (HRCT). Objectives. In this retrospective study, we investigated the pitfalls and important surgical distances in patients with unilateral and bilateral HJB via temporal bone HRCT. Material and Methods. In this preliminary report, the study group consisted of 20 adult patients (12 male, 8 female), or 40 ears, all of which underwent temporal bone HRCT. We divided them into groups that consisted of bilateral HJB (14 ears), unilateral HJB (13 ears), and control (No HJB, 13 ears). The anotomical relationships of the sigmoid sinus, jugular bulb, and carotid artery with several landmarks in the temporal bone were studied via temporal bone axial and coronal HRCT. The shortest distances between certain points were measured. These measurements were analyzed in respect to pneumatization. Dehiscence on the jugular bulb (JB) and internal carotid artery (ICA) and the dominance of JB were also evaluated for all of the groups. Results. In the axial sections of the temporal bone HRCTs, the sigmois sinus (SS)-external auditory canal (EAC) distance of the bilateral HJB group (14.00 +/- 1.17 mm) was significantly lower than that of the control group (16.46 +/- 2.14 mm). The JB-posteromedial points of the umbo on the ear drum (ED) distance of the bilateral HJB (6.28 +/- 1.72 mm) and the unilateral HJB groups (7.23 +/- 2.00 mm) were significantly lower than that of the control group (11.15 +/- 2.30 mm). In the coronal sections of the temporal bone HRCT, the JB-F distance of the bilateral HJB group (5.42 +/- 2.10 mm) was significantly lower than that of the control group (8.30 +/- 2.28 mm). As the mastoid pneumatisation and mastoid volume increased, the percentage of ICA-dehiscence and the percentage of JB-dehiscence increased. Conclusions. In subjects with well-pneumatised mastoids, the doctors should be aware of the increased risk of ICA-dehiscence and JB-dehiscence. These measurements should be done in greater series to yield more thorough knowledge.Öğe Psychological characteristics of patients with asthma(Wiley, 2018) Bulcun, Emel; Turkel, Yakup; Oguzturk, Omer; Dag, Ersel; Buturak, S. Visal; Ekici, Aydanur; Ekici, MehmetIntroduction: Psychological distress of patients with asthma may be reduced when they learned to live with their illness. Asthma can change the psychological and personality characteristics. We aim to investigate the psychological and personality characteristics of patients with asthma using MMPI (Minnesota Multiphasic Personality Inventory). Methods: Thirty-three adult patients with asthma (23 female and 10 male) and 20 healthy controls (14 females and 6 males) were enrolled in this study. Psychometric evaluation was made with the Turkish version of the MMPI. The patients were separated into two groups according to the duration of symptoms (recent-onset asthma<10 years, long-standing asthma >= 10 years). Results: Patients with asthma compared with control group had significantly higher the rate of clinical elevation on depression, hysteria, psychasthenia and social introversion. Patients with recent-onset asthma compared with long-standing asthma have significantly higher the rate of clinical elevation on depression, hysteria, psychopathic deviate, psychasthenia and social introversion. MMPI mean t score in patients with recent-onset asthma was higher than patients with long-standing asthma. MMPI mean t score in patients with asthma was negatively associated with the symptom duration in multivariate model. Conclusions: Patients with asthma have relatively more inactivity, anergia, guilt, pessimism, nonspecific physical complaints, irrational fears and introvert. Patients with long-standing asthma have less psychological distress, suggesting that learned to cope with his illness.Öğe Restless legs syndrome in a bipolar disorder patient treated with olanzapine: is there an association?(Cumhuriyet Univ Tip Fak Psikiyatri Anabilim Dali, 2015) Buturak, Sadiye Visal; Tiryaki, Duygu; Dag, Ersel; Turkel, YakupThe aim of this case report is to report a case of restless legs syndrome (RLS) in a patient with bipolar disorder (BD) caused by olanzapine and to draw attention to possible relationship between BD and RLS. A female patient was diagnosed with mixed episode of BD. Olanzapine 10 mg/day was added to the extended release valproic acid 1000 mg/d treatment that the patient was using. In the next day after the beginning of olanzapine, itching, aching and tingling sensations begun in her legs at rest. She was diagnosed as RLS caused by olanzapine. Then the dose of olanzapine gradually reduced. But the symptoms were continuing at the dose of 2.5 mg/day. RLS symptoms disappeared in the next day after discontinuation of olanzapine. RLS has comorbidity with some psychiatric and neurologic disorders such as attention deficit/hyperactivity disorder (ADHD), depressive disorders, migraine. There are studies that showed genetic relationship between BD and both migraine and ADHD. As a result there might be an association between BD and RLS. These may account for the appearance of RLS with low dose olanzapine in this case. To our knowledge there are no studies about the association between BD and RLS and further research are needed on this subject.Öğe Time-dependent changes in the serum levels of prolactin, nesfatin-1 and ghrelin as a marker of epileptic attacks young male patients(Elsevier Science Inc, 2011) Aydin, Suleyman; Dag, Ersel; Ozkan, Yusuf; Arslan, Ozgur; Koc, Guray; Bek, Semai; Catak, ZekiyeA relationship between hormones and seizures has been reported in animals and humans. Therefore, the purpose of this study was to investigate the association between serum levels of prolactin, nesfatin-1 and ghrelin measured different times after a seizure or non-epileptic event and compared with controls. The study included a total of 70 subjects, and of whom 18 patients had secondary generalized epilepsy (SGE), 16 patients had primary generalized epilepsy (PGE), 16 patients exhibited paroxysmal event (psychogenic) and 20 healthy males were control subjects. The first sample was taken within 5 min of a seizure, with further samples taken after 1, 24, and 48 h so long as the patient did not exhibit further clinically observable seizures; blood samples were taken once from control subjects. Prolactin was measured immediately using TOSOH Bioscience hormone assays. Nesfatin-1 and ghrelin peptides were measured using a commercial immunoassay kit. Patients suffering from focal epilepsy with secondary generalization and primary generalized epilepsy presented with significantly higher levels of serum prolactin and nesfatin-1 and lower ghrelin levels 5 min, 1 and 24 h after a seizure than patients presenting with paroxysmal events (psychogenic) and control subjects; the data were sirnilar but not statistically significant after 48 h. The present study suggests that increased serum prolactin and nesfatin-1 concentrations, decreased ghrelin concentrations could be used as markers to identify patients that have suffered a recent epileptic seizure or other paroxysmal event (psychogenic). (C) 2011 Elsevier Inc. All rights reserved.Öğe Topiramate Induced Excessive Sialorrhea(Derman Medical Publ, 2015) Dag, Ersel; Habipoglu, Yasin; Erdemoglu, Ali KemalIt is well-known that drugs such as clozapine and lithium can cause sialorrhea. On the other hand, topiramate has not been reported to induce sialorrhea. We report a case of a patient aged 26 who was given antiepileptic and antipsychotic drugs due to severe mental retardation and intractable epilepsy and developed excessive sialorrhea complaint after the addition of topiramate for the control of seizures. His complaints continued for 1,5 years and ended after giving up topiramate. We presented this case since it was a rare sialorrhea case induced by topiramate. Clinicians should be aware of the possibility of sialorrhea development which causes serious hygiene and social problems when they want to give topiramate to the patients using multiple drugs.
