Double Filtration Plasmapheresis in the Treatment of a Case with Acute Disseminated Encephalomyelitis

Acute disseminated encephalomyelitis (ADEM), is a monophasic autoimmune demyelinating disease of the central nervous system. Although high-dose steroid management has been considered the mainstay of treatment for ADEM, some patients are unresponsive to steroid therapy. We report the case of a 44-year-old woman with ADEM who did not respond to steroid therapy, but who showed a noticeable improvement with double filtration plasmapheresis (DFPP). To the best of our knowledge, this is the first case report of ADEM in literature treated with DFP

The effect of macromolecule and growth factor combinations on in vitro development of bovine embryos

This study was conducted to determine the effects of diferent macromolecule sources added to synthetic oviduct fuid (SOF) culture medium supplemented with growth factors on the development of bovine embryos and blastocyst morphology. Zygotes were distributed into 5 treatment groups. Cleavage, morula, and blastocyst rates were evaluated under a stereomicroscope. Trophectoderm (TE) and inner cell mass (ICM) cells were determined by diferential staining method. It was found that bovine serum albumin (BSA), either alone or in combination with growth factors, as compared to the control or polyvinyl-alcohol (PVA) resulted in higher embryo yield and faster development during early bovine embryo culture. The quality of bovine embryos, based on the number of blastocyst cells and the ratio of ICM to total blastomeres, was afected by the sources of macromolecules and their combinations with growth factors. Growth factors supplemented to SOFaa media with BSA and PVA signifcantly increased the number of ICM cells and the ratio of ICM cells to total number of cells. In conclusion, replacing BSA with PVA depressed the blastocyst rate and cell numbers, and the number of blastomeres and ICM and TE cell numbers were afected by both the type of macromolecule and the growth factor supplements.This study was conducted to determine the effects of diferent macromolecule sources added to synthetic oviduct fuid (SOF) culture medium supplemented with growth factors on the development of bovine embryos and blastocyst morphology. Zygotes were distributed into 5 treatment groups. Cleavage, morula, and blastocyst rates were evaluated under a stereomicroscope. Trophectoderm (TE) and inner cell mass (ICM) cells were determined by diferential staining method. It was found that bovine serum albumin (BSA), either alone or in combination with growth factors, as compared to the control or polyvinyl-alcohol (PVA) resulted in higher embryo yield and faster development during early bovine embryo culture. The quality of bovine embryos, based on the number of blastocyst cells and the ratio of ICM to total blastomeres, was afected by the sources of macromolecules and their combinations with growth factors. Growth factors supplemented to SOFaa media with BSA and PVA signifcantly increased the number of ICM cells and the ratio of ICM cells to total number of cells. In conclusion, replacing BSA with PVA depressed the blastocyst rate and cell numbers, and the number of blastomeres and ICM and TE cell numbers were afected by both the type of macromolecule and the growth factor supplements

Níveis de sortilina-1, lipocalina-2, autotaxina, decorina e interleucina-33 no líquido cefalorraquidiano em pacientes com hipertensão intracraniana idiopática]

Background Idiopathic intracranial hypertension (IIH) is characterized by increased cerebrospinal fluid (CSF) pressure of unknown cause. It has been suggested that the inflammatory process plays a role in the pathophysiology of the disease. Sortilin-1, lipocalin-2, autotaxin, decorin, and interleukin-33 (IL-33) are among the factors involved in inflammatory processes. Objective To investigate the CSF levels of sortilin-1, lipocalin-2, autotaxin, decorin, and IL-33 in patients with IIH. Methods A total of 24 IIH patients and 21 healthy controls were included in the study. Demographic characteristics of the patients and of the control group as well as CSF pressures were evaluated. Sortilin-1, lipocalin-2, autotaxin, decorin and IL-33 levels in the CSF were measured. Results The CSF levels lipocalin-2, sortilin-1, autotaxin, IL-33 and CSF pressure were significantly higher in the patients group compared with the control group (p < 0.001). Decorin levels were reduced in patients (p < 0.05). There was no correlation between the autotaxin and IL-33 levels and age, gender, CSF pressure, and body mass index. The results of our study showed that inflammatory activation plays an important role in the development of the pathophysiology of IIH. In addition, the fact that the markers used in our study have never been studied in the etiopathogenesis of IIH is important in explaining the molecular mechanism of this disease. Conclusion Studies are needed to evaluate the role of these cytokines in the pathophysiology of the disease. It is necessary to evaluate the effects of these molecules on this process. © 2022. Academia Brasileira de Neurologia. All rights reserved

Primary Sjögren’s Syndrome with Sensory Ganglionopathy and Painful Legs and Moving Toes Syndrome

Sjogren’s syndrome is characterized by the sicca syndrome, with dryness of the mouth (xerostomia) and the eyes (xerophthalmia). Sjogren's syndrome is the only connective tissue disease that has been associated with sensory neuronopathy. The syndrome of painful legs and moving toes consisting of pain in the lower limbs with spontaneous movements of the toes or feet. The association between Sjogren’s syndrome and painful legs and moving toes syndrome is a rare condition

Investigation of Mean Platelet Volume and Platelet Count in the Blood of Patients with Migraine

OBJECTIVE: Mean platelet volume (MVP) is an indicator for platelet function and activation. Studies researching MPV and platelet level on the patients with migraine are less. Our aim with this study is to search whether MPV and platelet count which are indicators for platelet activation in individuals with migraine when compared with healthy controls in a wide case series. METHODS: 193 patients (female/male: 128/65, average age: 31, 66±9.01) who have referred to Neurology Polyclinic of Dicle University, faculty of medicine between January 2010 and January 2012 and have been diagnosed with Migraine according to 2004 diagnosis criteria of International Headache Society (IHS) and 119 healthy individuals (female/male: 73/46, averge age: 32.27±9.88) who have referred to Family Practice Polyclinic and Blood Bank were involved into the study. MPV and platelet counts between the patients diagnosed with migraine and healthy control group who are similar for age and gender were compared. RESULTS: A statistically insignificant increase was found in MPV in patients with migraine (7.98±1.34 fL) when compared with the control group (7.85 ± 0.96 fL) (p=0.34). Platelet level was significantly lower in patients with migraine (367,6 ± 74.2) than the control group (286.9±68.3) (p=0.02). CONCLUSION: While we have found lower platelet levels in the patients with migraine than the healthy control group, we have found statistically insignificant increase in MPV in patients with migraine than the control group. These findings may indicate an insignificant platelet activation in patients with migraine.New prospective studies are necessary on this subjec

Serum paraoxonase-1 activities and malondialdehyde levels in patients with epilepsy

Objectives: We aimed to evaluate antioxidant paraoxonase-1 (PON-1) activity together with malondialdehyde(MDA) (an oxidative stress parameter) levels in patientswith epilepsy.Materials and methods: Forty-five epilepsy patientswere included in the study and compared with healthycontrols (n = 45). The levels of serum MDA and PON-1activities were measured by the Ohkawa method and theEckerson method, respectively.Results: Serum MDA level was significantly higher (P =0.015), whereas PON-1 activity was sigificantly lower (P =0.011) in the patient group than the controls.Conclusions: Increased reactive oxygen species levelsin epilepsy may result in a oxidative stress, which in turncould result in decreased antioxidant PON-1 activity andincreased MDA levels.Key words: Epilepsy, oxidative stress, malondialdehyde,paraoxonase-

Increased visinin-like protein-1, YKL-40, lipocalin-2, and IL-23 levels in patients with migraine

Background: Migraine is a type of primary headache caused by changes in the trigeminal system and has been reported to be associated with neurovascular inflammation of cerebral and extracerebral vessels. Objective: It is known that inflammation is an important process in the pathogenesis of migraine. It has been shown that the molecules of visinin-like protein 1 (Vilip-1), YKL-40, lipocalin-2 and interleukin (IL)-23 play a role in the inflammatory process. Our aim is to investigate the role of this molecule in the metabolic pathway of migraine disease. Methods: Fifty migraine patients with and without aura in the interictal period were included in the study. Vilip-1, YKL-40, lipocalin-2, and IL-23 levels were measured by ELISA method. Results: Serum vilip-1, YKL-40, lipocalin-2, and IL-23 levels were found to be significantly higher in migraine patients compared to the control group. We found that this molecule increased significantly in migraine subgroups compared to the control group (p < 0.001). A positive significant correlation was found between vilip-1 level and YKL-40 and lipocalin-2 levels in migraine patients. In addition, a positive correlation was observed between visual analogue scale score, number of days with pain and vilip-1 level (p < 0.01). The results of our study showed that activation of inflammatory mediators may play a role in the pathogenesis of migraine disease. In addition, our study is valuable in that inflammatory molecules are high in the interictal period and these biomarkers have never been analyzed in migraine patients. However, we still believe that larger studies are needed to explain the role of vilip-1, YKL-40, lipocalin-2, and IL-23 in the molecular mechanism of migraine disease

Investigation of Total Oxidants/Antioxidants in Patients with Intracerebral Haemorrhage

OBJECTIVE: There are numerous study about oxidant and antioxidant status in patients with ischemic stroke however there are few study about this subject in patients with intracerebral hemorrhage (ICH). Malondialdehyde (MDA) is an oxidant parameter which was investigated in patients with ICH, although total oxidant status (TOS) has not been investigated so far. We aimed to investigate in blood samples respectively oxidant and antioxidant parameters MDA and TOS, total antioxidant status (TAS) in patients with ICH. METHODS: Total of 30 patients with ICH, admitted and treated Neurology Clinic in Dicle University Medical Faculty Hospital and 30 control, had no stroke or any systemic disorder have been included. Peripheral vein blood samples taken from patients and controls were included in the first 24 hours after stroke. Serum TAS, TOS values measured to the original, fully automatic and colorimetric method of Erel. Serum level of MDA was measured according to the method of Ohkawa et al. RESULTS: According to the control group, the serum levels of TAS, TOS and MDA were significantly higher in patient with ICH (p 0.05). CONCLUSION: These findings support that oxidative stress may play a significant role in the pathogenesis of the ICH. However, the increase of these parameters not associated with hematoma volume and GCS in patients with IC

The Increase of The Mean Platelet Volume in Patients With Intracerebral Haemorrhage

OBJECTIVE: The mean platelet volume (MPV) is a biomarker of platelet function and activity. The influence of platelet function disorders on the aetiology of intracerebral haemorrhages (ICH) and mortality is not clear yet. The purpose of this study is to investigate the change in the MPV values in patients with ICH and to observe its influence on mortality in a retrospective manner. METHODS: Sixty-six patients with intracerebral haemorrhage (32 males, 34 females; mean age: 61.9± 16.9) were enrolled in the study. Patients with ICH were divided into two groups as those who died within the first 10 days and those who survived. The MPV values and the haematoma volumes were compared between the groups. Also, the MPV values and platelet counts of the patients with ICH were compared with the values of healthy volunteers from similar age and sex groups (27 males, 17 females; mean age: 59.9 ±3.2). RESULTS: The MPV values of the patients with ICH measured within 24 hours following the intracerebral haemorrhage (8.33 ± 1.27 fl/mL) were statistically significantly higher than the MPV values of the control group (7.76 ± 1.14 fl/mL) (p=0.018). The platelet counts of the patients with ICH also measured within the first 24 hours (235.8±94.9 x103/mL) were statistically significantly lower than the platelet counts of the control group (279.1 ± 94.9 x103/mL) (p=0.022). No statistically significant difference in terms of the MPV values and platelet counts was observed between the patients with ICH who died within the first 10 days and those who survived (p>0.05). However, the difference observed in the haematoma volume between the patients with ICH who died within the first 10 days (31.1 ±33.7 ml) and those who survived (8.7± 13.4 ml) was statistically significant (p<0.001). No correlation was found between the haematoma volume and the MPV value in the patients with ICH. CONCLUSION: The increase observed in the mean platelet volume in patients with ICH may point to a disorder in the platelet function. No relationship was found between the increase in the MPV and the mortality rates