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Öğe Autonomic nervous system involvement in Behçet's disease: A pupillometric study(1998) Bayramlar H.; Hep?en I.F.; U?uralp M.; Bölük A.; Özcan C.The aim of this study was to elucidate whether autonomic nervous system dysfunction exists in patients with Behçet's disease by pupillometric tests. Thirty-one patients with Behçet's disease with a mean age of 41.3 years (range 21-64) and 41 control subjects with a mean age of 39.5 years (range 18-66) were selected for the study. To test the autonomic nervous system, four pupillometric techniques were used: pupil cycle time (PCT), dark-adapted pupil size (DAPS), 0.05% pilocarpine drop test, and 1% phenylephrine drop test. In all four tests, there were significant differences between the patients and controls. Mean PCTs were 1,156 ms (range 856-1,560 ms) and 919 ms (range 650-1,261 ms) in the patients and controls, respectively (p < 0.0001). The mean DAPS was 0.45 (range 0.31-0.66) in the patients, whereas it was 0.56 (range 0.42-0.67) in controls (p < 0.001). Iris sensitivity to both 0.05% pilocarpine and 1% phenylephrine showed significant differences between patients and controls, respectively (p < 0.05, p < 0.05). Among all four tests, only 0.05% pilocarpine sensitivity was correlated with the duration of Behçet's disease (p < 0.05). The results suggest that the autonomic nervous system innervating the iris is affected in Behçet's disease. This involvement may be due to the vasculitic nature of Behçet's disease. © 1998 Lippincott Williams & Wilkins,.Öğe Effect of risperidone on auditory event-related potentials in patients with chronic schizophrenia(2005) Özişik H.I.; Özcan Y.; Kizkin S.; Ünal S.; Özcan C.Objective: Cognitive deficits are major aspect and cause of disability in schizophrenia. Several neuropsychological studies have reported significant effects of atypical neuroleptics on cognitive functioning in patients with schizophrenia. Event-related potentials are objective assessments of human information processing, and provide a reliable method for evaluating the effects of psychotropic drugs. Methods: The study sample consisted of 7 subjects. They were outpatients at the Department of Psychiatry, İnönü University Hospital. The patients were diagnosed as having schizophrenia according to the DSM-IV on the basis of a structured psychiatric interview. The subjects were treated with risperidone. In order to examine the effects of risperidone on cognitive impairment in schizophrenia, event-related potentials (ERPs) were recorded before and after 6 weeks treatment ERPs were recorded using a standard oddball paradigm. The amplitudes and latencies of P300 component were measured in ERPs for target stimuli in the oddball task. Results: P300 latencies in Fz, Cz and Pz regions and amplitudes in Fz and Cz regions significantly decreased with risperidone treatment. Conclusion: These findings suggest that risperidone may speed up the information processing in schizophrenic patients.Öğe Epileptic seizures in patients with a posterior circulation infarct(Turkish Society of Cerebrovascular Diseases, 2014) Kaplan Y.; Kamişli Ö.; Kamişli S.; Özcan C.OBJECTIVE: The aim of this study was to investigate the frequency of seizures and the clinical features of patients with seizures related to a posterior circulation infarct (POCI). MATERIAL and METHODS: We reviewed all ischemic stroke patients admitted to our clinic between January 2011 and January 2012. The patients' database information was retrospectively analyzed. Fifty-five patients with a POCI were included in the study. We reviewed all patients with epileptic seizures related to a POCI. Age, gender, recurrent stroke, risk factors, etiology, radiographic localization, the seizure type and onset time, and the electroencephalographic findings of patients were evaluated. We excluded all patients who had precipitating conditions during seizures such as taking drugs, acid-base disturbances, electrolyte imbalance, and history of epilepsy. RESULTS: Seizures were observed in four patients (3 male, 1 female) with a POCI related epileptic seizures (7.2%). The etiology of strokes was cardiac-embolic in 3 patients and vertebral artery dissection in 1 patient. Seizures occurred in 2 patients as presenting finding, in 1 patient within 7 days, and 1 patient within 28 days. Primary generalized tonic-clonic seizures occurred in 3 patients and simple partial seizures with secondary generalization in 1 patient. Three patients had cerebellum infarction at the left hemisphere. One patient had lateral medullary infarction at the right side. The electroencephalographic findings of patients were normal. CONCLUSION: Studies involving patients with seizures related to a POCI are novel and few in number. Three patients with seizure had cerebellum infarction. The cerebellum in these patients may contribute via different mechanisms over seizure activity.Öğe The evaluation of serum uric acid levels in the ischemic stroke subtypes(Turkish Society of Cerebrovascular Diseases, 2013) Kamişli Ö.; Gönüllü S.; Kamişli S.; Kaplan Y.; Özcan C.OBJECTIVE: Uric acid is a water-soluble antioxidant which is the end-product of purine metabolism. Several studies indicated that high levels of serum uric acid increased the risk of cerebrovascular events and some of them reported poor prognosis with increased serum uric acid levels in stroke patients. Our aim was to analyse serum uric acid levels in the early phase of ischemic stroke and determine whether increased levels of uric acid are associated with ischemic stroke subtypes. MATERIAL and METHODS: 237 patients with ischemic stroke admitted to the study between January 2011 and December 2011. Ischemic stroke subtypes were classified according to Bamford classification. Patients admitted in the the beginning of the first 24 hour of disease were included the study. We compare the serum uric acid levels between stroke subgroups and controls. RESULTS: We found increased serum uric acid levels in all stroke patients but the most increased levels were in the posterior circulation infarct group. However this elevation was not statistically significant. CONCLUSION: Future researches should be focus on the pathogenetic mechanism of hyperuricemia as well as examining the role in stroke subtypes especially posterior circulation infarcts.Öğe Mortality-related factors in ischemic stroke patients 80 years of age and older(Turkish Society of Cerebrovascular Diseases, 2014) Kaplan Y.; Kamişli Ö.; Kamişli S.; Özcan C.OBJECTIVE: The aim of this study was to investigate mortality-related factors in ischemic stroke patients 80 years of age and older. MATERIAL and METHODS: We reviewed all ischemic stroke patients admitted to our clinic between January 2010 and January 2012. The patients' database information was retrospectively analyzed. One hundred and ten patients aged older than 80 years with ischemic stroke were included in the study. The patients were divided into two groups based on survival. Age, gender, recurrent stroke, risk factors, clinical syndrome, etiology, radiographic localization, duration of hospitalization, and presence of systemic complications were accepted as mortality-related prognostic factors. The groups were compared according to these prognostic factors. RESULTS: In the clinical follow-up, 58 (52.7%) patients died; 65.5% died of neurological causes, and 31% died of systemic complications. No significant differences existed between the two groups in age, gender, risk factors, recurrent stroke, or etiology. The frequency of total anterior circulation infarct syndrome was much higher in deceased than living patients (50% and 36.5% respectively;p<0.05). Deceased patients had a statistically significantly higher incidence of total MCA infarct and systemic complications than did living patients (p<0.05). CONCLUSION: To date, many variables that affect the early and late prognosis in stroke patients have been reported. Many of these factors cannot be changed, such as oldest age. It is important to determine the changeable and non-changeable factors related to disability and death in the oldest age groups. Starting appropriate treatment and care initiatives as soon as possible is also very necessary in the oldest stroke patients.Öğe The prognostic value of increased leukocyte and neutrophil counts in the early phase of cerebral venous sinus thrombosis(Turkish Society of Cerebrovascular Diseases, 2012) Kamişli S.; Kami?sli Ö.; Gön?ul?lu S.; Kaplan Y.; Özcan C.OBJECTIVE: Venous stasis, genetic and acquired factors and also inflamation are important in the formation and re- canalisation of cerebral venous thrombosis. In this study we aimed to investigate important indicators such as total white blood cell, neutrophil and lymphocyte counts and also neutrophil/lymphocyte ratio in the early phase of cerebral venous thrombosis. MATERIAL and METHODS: Thirty-five patients with evidence of CVT were included in this study. CVT patients were divided into two subgroups based on the presence or absence of parenchymal lesion. Count of blood cells (CBC) were compared with healthy control objects. RESULTS: Leukocyte and neutrophil counts and neutrophil / lymphocyte ratio were significantly higher in the CVT group who has parenchymal lesions than the control group in the early phase of CVT. CCONCLUSION: There may be a relationship between inflammation and the level of severity of illness in CVT patients on admission. This relationship may be guiding the determination of treatment and prognosis.Öğe Relationship between nitric oxide levels and delirium in patients with coronary bypass operation(2004) Sezer Ö.; Karlida? R.; Karabulut A.B.; Özcan C.; Nisano?lu V.; Türköz Y.; But A.Objective: Delirium is an acute brain failure which is related to various pathological conditions. Although there are some ideas about etiopathogenesis of delirium, some points have not been cleared yet. We aimed to investigate relationship between nitric oxide (NO) levels and delirium prospectively in patients with in coronary bypass operation. Methods: We included 50 (37 males, 13 females, ages: 37-75, mean±sd= 59.8±10.6) patients with coronary illnesses who will undergo bypass operation. Patients with dementia and any systemic disease, except hypertension and coronary artery disease, were excluded from study. Smoking was not allowed at least 7 days prior to operation. We diagnosed delirium using DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders) criteria. Delirium Rating Scale was used to estimate delirium severity. Blood samples were taken pre-operationally and post operationally. Patients were divided into two groups as delirium group and nondelirium group. We compared the two groups according to NO levels. Results: 12 of the 50 patients had delirium. While there was no significant difference among blood NO levels pre-operationally between two groups, the NO levels were statistically higher in the delirium group than the nondelirium group. Conclusion: Our study is important since it is first study that investigated the relationship between NO and delirium. Blood NO levels become higher in patients who developed post operationally delirium. These findings can be explained by increased NO production in brain tissue due to increased cerebral ischemia and/or increased response to oxidative stress during operation.Öğe Sinus thrombosis: Clinical assessment(Turkish Society of Cerebrovascular Diseases, 2009) Kamişli Ö.; Arslan D.; Altinayar S.; Kamişli S.; Kablan Y.; Özcan C.Cerebral venous sinus thrombosis is a challenging condition because of its variability of clinical symptoms and signs. Diagnosis is not easy at initial presentation. All age groups can be affected. Large sinuses such as the superior sagittal sinus are most frequently involved. Systemic inflammatory diseases, inherited and acquired coagulation disorders are frequent causes, although in up to 30% of cases no underlying cause can be identified. The oral contraceptive pills appears to be an important additional risk factor. The spectrum of clinical presentations ranges from headache with papil oedema to focal deficit, seizures and coma. Magnetic resonance imaging with venography is the investigation of choice; computed tomography alone will miss a significant number of cases. Intravenous heparin is the first-line treatment for cerebral venous sinus thrombosis.
