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    Melatonin's protective effect on the salivary gland against ionized radiation damage in rats
    (Wiley, 2016) Karaer, Isil Cakmak; Simsek, Gokce; Yildiz, Azibe; Vardi, Nigar; Polat, Alaadin; Tanbek, Kevser; Gurocak, Simay
    ObjectivesThe aim of this study was to examine the effects of melatonin on ionized radiation-induced salivary gland damage using an experimental model. Materials and MethodsThirty-two rats were randomized into four groups: (i) the control group (C, n = 8) that received intraperitoneal (i.p.) 0.9% NaCl; (ii) the melatonin group (M, n = 8) that received i.p. 5 mg/kg melatonin; (iii) the radiotherapy group (RT, n = 8) that underwent irradiation; (iv) the melatonin plus radiotherapy group (M+RT, n = 8) that received i.p. 5 mg/kg of melatonin, followed by irradiation 30 min later; and (v) the radiotherapy plus melatonin group (RT+M, n = 8) that received irradiation followed by i.p. 5 mg/kg of melatonin 30 min later. The medications and irradiation were administered for 5 days and the salivary glands of the rats were excised 10 days later; the histopathological changes in the salivary glands were assessed and biochemical analyses were conducted (tissue levels of malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), reduced glutathione (GSH), total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI)). ResultsRegardless of whether melatonin was administered before or after radiotherapy, melatonin decreased the radiation-induced parotid and submandibular histological damage. In addition, regardless of whether administration occurred before or after radiotherapy, melatonin decreased oxidative stress markers, such as MDA, TOS, and OSI. On the contrary, levels of antioxidative markers, such as CAT and GPx, were increased by melatonin. ConclusionsMelatonin may have a significant protective effect on salivary gland damage secondary to ionizing radiation.
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    Otolin-1 as a biomarker for the evaluation of the effectiveness of betahistine treatment for benign paroxysmal positional vertigo
    (Wolters Kluwer Medknow Publications, 2023) Karaer, Isil Cakmak; Urhan, Ayca; Akalin, Yahya
    ObjectiveBenign paroxysmal positional vertigo (BPPV) is the most common vertigo disorder. Betahistine is the most commonly used drug in the treatment of vertigo, however its effect on the inner ear is not fully known. Otolin-1 is an inner ear-specific glycoprotein that can be identified in peripheral blood. The aim of the study was to determine the effect of treatment of betahistine for BPPV on serum otolin-1 levels.MethodsThirty (30) patients with BPPV and 30 healthy controls were enrolled in the study. Serum otolin-1 levels were measured before and 14 days after perioral (po) betahistine treatment in the BPPV group, whereas otolin-1 level was examined once in controls. The efficacy of treatment was evaluated with Dizziness Handicap Index (DHI) and Visual Analog Scale (VAS) in the BPPV group.ResultsOtolin-1 levels were statistically significantly higher in patients with BPPV than controls. In the BPPV group, serum otolin-1 level was found to be statistically significantly lower after betahistine treatment. There was a statistically significantly difference between pre-treatment and posttreatment groups regarding to both DHI and VAS scores.ConclusionSerum otolin-1 can be used as a biomarker in monitoring the effectiveness of treatment of BPPV with betahistine as well as diagnosis of BPPV.
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    Treatment-related modulation of visuo-vestibular integration in post-earthquake dizziness syndrome: a longitudinal virtual reality-based study
    (Springer Heidelberg, 2026) Korkmaz, Hanifi; Karaer, Isil Cakmak; Orman, Kubra; Talu, Burcu; Inceoglu, Feyza
    BackgroundPost-earthquake dizziness syndrome (PEDS) is increasingly recognized as a condition marked by persistent dizziness and imbalance after major earthquakes, often without clear peripheral vestibular pathology. Despite proposed roles of visuo-vestibular dysfunction and sensory conflict, longitudinal objective evidence remains limited.ObjectiveTo examine the longitudinal effects of virtual reality-based vestibular rehabilitation (VR), cognitive behavioral therapy (CBT), and their integration (VR + CBT) on objective visuo-vestibular processing and symptom burden in adults with PEDS.MethodsIn a four-arm longitudinal study, 48 earthquake-exposed adults with PEDS were evaluated at baseline, post-intervention, and 3-month follow-up following an 8-week intervention. Objective visuo-vestibular outcomes were assessed using an immersive virtual reality-based system, including static and dynamic subjective visual vertical (SVV/DSVV), rod-and-frame test (RFT), and visual motion sensitivity (VMS) tests. Subjective outcomes included dizziness-related handicap (DHI) and post-traumatic stress symptoms (PCL-5).ResultsDizziness-related disability and trauma-related symptoms improved over time across groups, indicating clinical modifiability of PEDS. Objective measures demonstrated a domain-specific response profile: SVV and DSVV remained largely stable, whereas RFT showed improvement in active treatment arms, suggesting reduced visual frame dependence. VMS outcomes exhibited differential trajectories, with the integrated VR + CBT group showing the most consistent and durable modulation under visually provocative conditions.ConclusionsRecovery in PEDS appears to involve selective modulation of context-dependent visuo-vestibular processing rather than uniform changes across all spatial orientation measures. Integrated VR + CBT yields the most coherent and durable benefits in visually demanding domains, supporting multidisciplinary models that jointly address sensory conflict and cognitive-emotional mechanisms after major earthquakes.