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Öğe Autonomic dysfunction and cardiac repolarization abnormalities in patients with migraine attacks(Int Scientific Information, Inc, 2007) Melek, Ismet M.; Seyfeli, Ergun; Duru, Mehmet; Duman, Taskin; Akgul, Ferit; Yalcin, FatihThe clinical symptoms of migraine are widely accepted to be related to the involvement of the autonomic nervous system, and especially to dysfunction in the regulation of the circulatory system and autonomic balance. Disturbance of the autonomic nervous system is a primary characteristic of migraine Therefore, patients with migraine have a variety of symptoms, such as vasodilatation (flushing), pilo-erection, nausea, vomiting, diarrhea, cutaneous vasoconstriction (pallor), and diaphoresis. The electrocardiographic changes seen during a migraine attack compared with the pain-free period could be secondary to reversible disturbances of the state of autonomic innervation of the heart and coronary arteries. Dysfunction of ANS may affect atrial and ventricular repolarization. For instance, increased sympathetic activity causes sinus tachycardia, but increased parasympathetic activity causes sinus bradycardia, atrioventricular block, and ST-segment and T-wave abnormalities. Comprehensive electrocardiographic analyses have been providing more details in terms of the detection of abnormalities in atrial and ventricular repolarization which potentially may result in arrhythmias in patients with migraine. However, there is no information in literature reporting the frequency of cardiac arrhythmias in migraine patients who had cardiac repolarization abnormalities. In this review, detailed electrocardiographic findings and their relation with the autonomic nervous system, including recent observations, have been evaluated. However, further studies are needed to investigate the association between autonomic dysregulation and cardiac repolarization abnormalities in patients with migraine.Öğe Caffeic acid phenethyl ester protects rabbit brains against permanent focal ischemia by antioxidant action: A biochemical and planimetric study(Elsevier, 2008) Altug, Muhammed Enes; Serarslan, Yurdal; Bal, Ramazan; Kontas, Tuenay; Ekici, Fatih; Melek, Ismet M.; Aslan, HueseyinThe present study was conducted to investigate whether caffeic acid phenethyl ester (CAPE), an active component of propolis extract, has a protective effect on brain injury after focal permanent cerebral ischemia, and to determine the possible antioxidant mechanisms. Cerebral infarction in adult male New Zealand rabbits was induced by microsurgical procedures producing right focal permanent middle cerebral artery occlusion (pMCAO). CAPE was administered to the treatment group after pMCAO at a dose of 10 mu mol kg(-1) once a day intraperitoneally for 7 days. Neurological deficits were evaluated, using a modified six-point scale. Spectrophotometric assay was used to determine the contents of malondialdehyde (MDA), glutathione (GSH), catalase (CAT), nitric oxide (NO) and xanthine oxidase (XO). In the ipsilateral hemisphere, the infarct volume of the brain was assessed in brain slices stained with heamatoxylen and eosin. The results showed that treatment with CAPE significantly reduced the percentage of infarction in the ipsilateral hemisphere compared with the ischemia group. CAPE treatment significantly attenuated the elevation of plasma MDA, CAT and XO content (p < 0.05), whereas it significantly increased the levels of plasma GSH and NO (p < 0.05). Therefore, subacute CAPE administration plays a protective role in focal pMCAO due to attenuation of lipid peroxidation and its antioxidant activity. All of these findings suggest that CAPE provides neuroprotection against cerebral ischemia injury through its antioxidant action. (C) 2008 Elsevier B.V. All rights reserved.Öğe The co-occurrence of Chiari type 1 malformation with syringomyelia and total situs inversus(Int Scientific Literature, Inc, 2007) Serarslan, Yurdal; Melek, Ismet M.; Duman, Taskin; Eraslan, Turali; Akdemir, Goekhan; Yalcin, FatihBackground: Total situs inversus (TSI) is a rare congenital anomaly that often occurs concomitantly with other disorders. TSI is the complete left-to-right inversion of the thoracic and abdominal organs. It develops due to an abnormal rotation of the cardiac tube during embryogenesis, the mechanism of which is of unknown mechanism. Syringomyelia (SM) is an uncommon disease of the spinal cord and is known as the occurrence of a cystic space in the middle of the spinal cord. SM occurs due to spinal cord injury, a primary tumor of the spinal cord, or an extramedullary lesion at the foramen magnum such as a Chiari type I malformation (CMI). In the literature there has been reported association of CMI and SM (CMI/SM) with known genetic syndromes. Case Report: We report a 33-year-old female with CMI/SM coexisting with TSI. Our patient presented with pain in the neck, arm, and upper back. She had no trsuma history. There was dysesthesia in the cervical-2 dermatomes. Radiological tools revealed that CMI/SM with TSI accompanied by no other abnormality. Conclusions: It can be suggested that the existence of this case indicates that genetic factors rnay influence the pathogenesis of some CMI/SM cases.Öğe The Consistency Between Clinical and Electrophysiological Diagnoses(Turkish Neurological Soc, 2009) Okuyucu, Esra E.; Turhanoglu, Ayse D.; Duman, Taskin; Savas, Nazan; Mengulluoglu, Necdet; Melek, Ismet M.Objective: The aim of this study was to provide information concerning the impact of electrophysiological tests in the clinical management and diagnosis of patients, and to evaluate the consistency between referring clinical diagnoses and electrophysiological diagnoses. Patients and Methods: The study included 957 patients referred to the electroneuromyography (ENMG) laboratory from different clinics with different clinical diagnoses in 2008. Demographic data, referring clinical diagnoses, the clinics where the requests wanted, and diagnoses after ENMG testing were recorded and statistically evaluated. Results: In all, 957 patients [ 644 (67.3%) female and 313 (32.7%) male] were included in the study. Mean age of the patients was 45.40 +/- 14.54 years. ENMG requests were made by different specialists; 578 (60.4%) patients were referred by neurologists, 122 (12.8%) by orthopedics, 140 (14.6%) by neurosurgeons, and 117 (12.2%) by physical treatment and rehabilitation departments. According to the results of ENMG testing, 513 (53.6%) patients' referrals were related to their referral diagnosis, whereas 397 (41.5%) patients had normal ENMG test results, and 47 (4.9%) patients had a diagnosis that differed from the referring diagnosis. Among the relation between the referral diagnosis and electrophysiological diagnosis according to the clinics where the requests were made, there was no statistical difference (p= 0.794), but there were statistically significant differences between the support of different clinical diagnoses, such as carpal tunnel syndrome, polyneuropathy, radiculopathy-plexopathy, entrapment neuropathy, and myopathy based on ENMG test results (p< 0.001). Conclusion: ENMG is a frequently used neurological examination. As such, referrals for ENMG can be made to either support the referring diagnosis or to exclude other diagnoses. This may explain the inconsistency between clinical referring diagnoses and diagnoses following ENMG.Öğe Correlation of sleep disorder and Parkinson's disease severity in Turkish patients(Riyadh Armed Forces Hospital, 2009) Okuyucu, Esra E.; Duman, Taskin; Melek, Ismet M.; Seydaoglu, Gulsah[Abstract Not Available]Öğe EEG abnormalities during treatment with tadalafil, a phosphodiesterase type 5 inhibitor(Taylor & Francis Ltd, 2009) Okuyucu, Esra E.; Guven, Oguz; Duman, Taskin; Gorur, Sadik; Melek, Ismet M.; Akcin, Soner; Yilmazer, SerkanObjective: Tadalafil is a selective phosphodiesterase type 5 (PDE-5) inhibitor approved for the treatment of erectile dysfunction. Less is known about the electroencephalography (EEG) effects of PDE-5 inhibitors, and the present study, therefore, examined the risk of EEG abnormalities associated with tadalafil. Method: EEG recordings from 35 erectile dysfunction patients taking tadalafil (20 mg) were graded for severity of EEG abnormalities (at admission, 2 and 48 hours after tadalafil administration). Results: At admission, there were no EEG abnormalities. At second EEG, abnormalities occurred in 12 (34.3%) of the 35 patients. Eight (22.9%) patients had mild and four (11.4%) patients had moderate EEG abnormalities. At third EEG, one (2.9%) patient had mild and one (2.9%) patient had moderate EEG abnormalities. Conclusion: PDE-5 inhibitors may produce EEG abnormalities. Although the exact role of PDE in altering susceptibility to seizure remains unclear, epileptic seizures may occur during treatment with PDE inhibitors. [Neurol Res 2009; 31: 313-315]Öğe Evaluation of oxidative stress and inflammation in long term Brucella melitensis infection(Springer, 2006) Melek, Ismet M.; Erdogan, Suat; Celik, Sefa; Aslantas, Ozkan; Duman, TaskinThe Brucella genus is able to cause chronic infection in a wide range of mammals including humans. Oxidative events, lipid peroxidation and inflammatory response against Brucella infection have not yet been well elucidated in vivo. We have investigated oxidative/antioxidative status and nitric oxide production in plasma, brain, liver and spleen during a 60 day period of B. melitensis infection in a rat model. In addition, inducible nitric oxide synthase (iNOS), IL-10, IL-12, IFN-gamma and TNF-alpha mRNA transcriptions were analyzed by semiquantitative reverse transcriptase PCR (RT-PCR) in brain samples. Animals were infected with B. melitensis and sacrificed at 7th, 15th, 30th, 45th and 60th day of post-inoculation. Malondialdehyde (MDA), as an indicator of lipid peroxidation, and nitric oxide (NO) concentrations were significantly increased after Brucella inoculation and began to decline to basal levels from 45th day in plasma, liver and spleen. However, iNOS transcription was not induced during the infection period in brains. In contrast, MDA level was increased in brain during the late phase of infection without any change in NO production. The infection did not alter the antioxidant enzyme activities in the tissues; although significantly increased catalase activity was observed between days 30 and 45 in the liver. Transcription analyses demonstrated that IL-10, IL-12 and IFN-gamma mRNA level were not induced in the brain. Only TNF-alpha mRNA was weakly up-regulated in brain 30 days after pathogen inoculation. The results obtained in this study demonstrate that B. melitensis induces lipid peroxidation and NO production in the liver and spleen in the early days of infection, but that these levels subsequently decline. Moreover, Brucella does not appear to induce antioxidant enzyme activities and inflammation during two months of infection. However, the pathogen does stimulate cerebral lipid peroxidation in the late phase of infection without causing significant inflammation.Öğe The frequency of slime, adhesin and methicillin resistance genes among staphylococci isolated from nasal samples of multiple sclerosis patients(Academic Journals, 2011) Melek, Ismet M.; Duran, Nizami; Duran, Gulay G.; Duman, Taskin; Okuyucu, EsraIt was aimed to determine the carriage rate of Staphylococcus aureus and the occurrence of methicillin resistance, slime and adhesin genes in staphylococcal strains isolated from the nasal cavities of multiple sclerosis (MS) patients. The presence of mecA and femA, and the genes implicated in adhesion were determined by multiplex PCR in all strains. The femA gene was detected in 46.6% of 105 MS patients. While 18.1% of isolates carried the mecA gene, 81.9% of isolates were negative for the mecA gene. The presence of icaA/icaD genes was determined in a total of 84.8% of all strains. While 85.7% of Staphylococcus epidermidis isolates were positive in terms of slime genes, this ratio was determined as 81.6% among the Staphylococcus aureus strains. The occurrence of clfA gene was determined in 29 of 49 (59.2%) S. aureus isolates. Also, 45 out of 49 (91.8%) S. aureus was found to carry the fnbA gene. The carriage rate of the cna gene was determined in 40 (81.6%) isolates among the 49 S. aureus strains. The rate of methicillin resistance gene, slime production and the frequency of adhesin genes in MS patients were also significantly higher than the healthy control population. Determination of the nasal S. aureus carriers and the virulence of these strains will be important for prediction of the MS prognosis in these patients. And treating these S. aureus carriers will be very useful in preventing MS relapses.Öğe The Neuroprotective Effect of Caffeic Acid Phenethyl Ester on Global Ischemia-Reperfusion Injury in Rat Brains(Kafkas Univ, Veteriner Fakultesi Dergisi, 2014) Altug, Muhammed Enes; Melek, Ismet M.; Erdogan, Suat; Duzguner, Vesile; Ozturk, Atakan; Kucukgul, AltugThe aim of this study was to investigate the neuroprotective effects of caffeic acid phenethyl ester (CAPE) on phosphodiesterase 4 (PDE4) mRNA isoenzymes, oxidant and antioxidant defence in ischemia/reperfusion (I/R) injured rat brains. Twenty-one rats were randomly divided into three equal groups: sham-control, ischemia/reperfusion (I/R) and I/R+CAPE. Rats in sham-control group underwent only surgical intervention without bilateral common carotid artery occlusion. Ischemia/reperfusion was induced by bilateral common carotid artery occlusion with atraumatic clips for 30 min, followed by artery reopening. The I/R+CAPE group was subjected to the same surgical procedure as I/R group, but CAPE was administered intraperitoneally at the dose of 15 mu mol kg(-1) twice, 1 h before occlusion and at 12th h of reperfusion. The rats were sacrificed 24 h after I/R. The cAMP concentration was analyzed by ELISA and PDE4 isozyme mRNA transcriptions were evaluated by qRT-PCR methodology in the brain cortex. Ischemia-induced NO production was significantly attenuated by CAPE in the cerebral cortex. CAPE significantly enhanced GSH-Px activity, while SOD, CAT and XO activities non-significantly changed, as compared to the I/R group. CAPE significantly decreased PDE4A and PDE4B transcripts, without changing cAMP levels compared to I/R group. Ischemia-induced neurologic deficit scores were reduced by CAPE. These results suggest that CAPE slightly modulates the antioxidant defense system and NO release in rat brain during global cerebral ischemia/reperfusion injury. In addition, CAPE treatments produce the neuroprotective effect by reducing the levels of some PDE4 transcriptions.Öğe Probability of stroke in the couples of stroke patients; using Framingham Stroke Risk Profi?le(Turkish Society of Cerebrovascular Diseases, 2012) Duman, Taşkin; Okuyucu, Esra E.; Melek, Ismet M.; Yilmazer, Serkan; Inandi, Tacettin; Mengüllüo?lu, NecdetINTRODUCTION: Environmental and personal factors may be of importance for stroke risk. We determined the stroke risk factors among the stroke patients' couples and controls. MATERIAL AND METHODS: A prospective study was conducted on 221 participants (71 stroke patients, 71 stroke patients' couples, 79 controls) aged more than 54 years. Framingham Stroke Risk Profile was used to measure the stroke risk. RESULTS: In subjects aged 54 years and older, became a couple of stroke patient were not associated with an increased risk of stroke. CONCLUSION: In this study, environmental and personal factors were an independent risk factor for stroke in stroke patients' couples and controls older than 54 years.Öğe Stroke in children with sickle cell anemia(Turkish Society of Cerebrovascular Diseases, 2004) Melek, Ismet M.; Duman, Taşkin; Gali, EdipPatient groups at high risk with respect to cerebrovascular disease has a particular importance in terms of etiological and clinic evaluations. Sickle cell anemia has an important place in the etiology of patients who have had stroke before the age of 20. Among the risk factor of cerebrovascular diseases occurring during childhood, sickle cell anemia is the second important cause following the congenital heart diseases. The probability of a patient with sickle cell anemia to have cerebral infarction is 250 times higher when compared to those who don't have this disease at same age. Those who are born in Hatay forms the 17.49% of the all hemoglobinopathy cases reported in Turkey. In this study, the data on stroke obtained from 506 cases by hemoglobin electrophoresis since 1994 in Hatay, where 10.5% of the population is the carrier, was reported. Of the cases, 403 (79,6%), 99 (19,6%), 2 (0,4%) and 2 (0,4%) were HbSS, HbSS+Thalessemia, HbSD and HbSE, respectively. During a period of 10 year, 5 patients had stroke. Among them, the youngest one was 3 yr old while the oldest one was 15 yr old. The data on hemopatolgical parameters and on clinical and etiological were investigated. Being an autosomal recessive disease and arising from the mutation of hemoglobin beta gene, sickle cell anemia is considered to be a high risk factor for stroke besides the hematological features. In the regions where gene carriers are densely populated, studies on early diagnosis and monitoring appears to be highly important in the detection and prevention of childhood strokes.
