The effect of vascular graft and human umbilical cord blood-derived CD34+ stem cell on peripheral nerve healing

AIM: There are many trials concerning peripheral nerve damage causes and treatment options. Unfortunately, nerve damage is still a major problem regarding health, social and economic issues. On this study, we used vascular graft and human cord blood derived stem cells to find an alternative treatment solution to this problem. MATERIAL AND METHODS: We used 21 female Wistar rats on our study. They were anesthetized with ketamine and we studied right hind limbs. On Group 1, we did a full layer cut on the right sciatic nerve. On Group 2, we did a full layer cut on the right sciatic nerve, and we covered synthetic vascular graft on cut area. On Group 3, we did a full layer cut on right sciatic nerve, and we covered the area with stem cell applied vascular graft. RESULTS: At the end of postoperative 8. weeks, we performed EMG on the rats. When we compared healthy and degenerated areas as a result of EMG, we found significant amplitude differences between the groups on healthy areas whereas there was no significant difference on degenerated areas between the groups. Then we re-opened the operated area again to reveal the sciatic nerve cut area, and we performed electron microscope evaluation. On the stem cell group, we observed that both the axon and the myelin sheet prevented degeneration. CONCLUSION: This study is a first on using synthetic vascular graft and cord blood derived CD34+ cells in peripheral nerve degeneration. On the tissues that were examined with electron microscope, we observed that CD34+ cells prevented both axonal and myelin sheath degeneration. Nerve tissue showed similar results to the control group, and the damage was minimal. © 2018 Ali Yilmaz, Abdullah Topcu, Cagdas Erdogan, Levent Sinan Bir, Barbaros Sahin, Gulcin Abban, Erdal Coskun, Ayca Ozkul

Fahr's syndrome presenting with epileptic seizure: Two case reports

Fahr's syndrome is a neuropsychiatric syndrome characterized by symmetrical and bilateral intracerebral calcifications located in the basal ganglia and usually associated with a phosphorus and calcium metabolism disorder. Clinical manifestations of Fahr's syndrome vary; it may start at different ages and have a variety of presentations. This article discusses rare presentation of Fahr's syndrome with epileptic seizure. These cases are important because they appear to be the first cases in the literature of Fahr's syndrome presenting with generalized tonic clonic seizure

Neurološki simptomi koji su česti u pacijenata s COVID-19: retrospektivna opservacijska studija

In December 2019, a novel coronavirus outbreak spread rapidly all over the world. The virus is known to be neuroinvasive, but much is still unknown. In this study, we aimed to present the main neurologic symptoms in patients who were diagnosed with coronavirus disease 2019 (COVID-19). The study was conducted retrospectively by phoning 156 patients in Turkey diagnosed with COVID-19 through real-time polymerase chain reaction; only 100 patients could be reached. Data about their demographics, initial symptoms, neurological symptoms, and sleeping habits were collected. During the disease process, 66% had at least one neurological symptom, 55% had central nervous system symptoms, 42% had peripheral nervous system symptoms, and 64% had sleep disturbances and myalgia. Impaired consciousness, smell and taste impairments, and sleep disturbances were significantly higher in patients with positive chest computed tomography imaging (p < 0.05). Neurological symptoms were observed in COVID-19, as in other coronaviruses. Headache in particular was the most common symptom in our population. In patients with respiratory system findings, the detection of certain neurological symptoms such as smell-taste impairments, impaired consciousness, and sleep disorders were more common. We concluded that COVID-19 patients should be approached in a more holistic way, taking the nervous system into account.U prosincu 2019. nova epidemija koronavirusa brzo se proširila cijelim svijetom. Poznato je da je virus neuroinvazivan, ali je pun nepoznanica. U ovoj studiji imali smo za cilj predstaviti glavne neurološke simptome kod pacijenata kojima je dijagnosticirana koronavirusna bolest 2019. (COVID-19). Studija je provedena retrospektivno telefoniranjem 156 pacijenata u Turskoj kojima je dijagnosticiran COVID-19 putem lančane reakcije polimeraze u stvarnom vremenu; moglo se doći do samo 100 bolesnika. Prikupljeni su podaci o njihovim demografskim podacima, početnim simptomima, neurološkim simptomima i navikama spavanja. U procesu bolesti, 66% je imalo barem jedan neurološki simptom, 55% je imalo simptome središnjeg živčanog sustava, 42% imalo je simptome perifernog živčanog sustava, a 64% imalo je poremećaje spavanja i mijalgiju. Poremećaji svijesti, mirisa i okusa te poremećaji spavanja bili su značajno veći u bolesnika s pozitivnim slikanjem računalne tomografije u prsima (p <0,05). Neurološki simptomi primijećeni su u COVID-19, kao što su ostali koronavirusi. Posebno je glavobolja najčešći simptom u našoj populaciji. U bolesnika s nalazima dišnog sustava češće je otkrivanje određenih neuroloških simptoma kao što su smetnje okusa mirisa, oslabljena svijest i spavanje. Zaključili smo da s pacijentima s COVID-19 treba postupati na cjelovitiji način, uzimajući u obzir živčani sustav

Decreased ocular pulse amplitude and retinal nerve fibre layer in multiple sclerosis

This study was conducted to assess ocular pulse amplitude and retinal nerve fibre layer in patients with multiple sclerosis and their correlation with disease duration and with severity. Retinal nerve fibre layer thickness was measured by Heidelberg Retinal Tomography II (HRT-II; Heidelberg Engineering, Dossenheim, Germany) and ocular pulse amplitude was measured by dynamic contour tonometry (Ziemer Ophthalmic Systems, Port, Switzerland) in 37 multiple sclerosis patients and 72 age- and gender-matched controls. Ocular pulse amplitude was significantly reduced and retinal nerve fibre layer was significantly thinner in temporal, superotemporal, and nasal sectors in patients with multiple sclerosis regardless of having an optic neuritis attack. The retinal nerve fibre layer was thinner in eyes with a previous optic neuritis attack compared with the eyes without an attack, but the difference was not significant. Ocular pulse amplitude showed a positive correlation with visual evoked potential amplitude and a negative correlation with visual evoked potential latency. Retinal nerve fibre layer thickness showed a significant negative correlation with the disease duration but not with visually evoked potential, disease severity, nor previous optic neuritis. These findings indicate that the process of degeneration starts in the early period of the disease, as our study group is composed of early-middle-stage multiple sclerosis patients, and is independent of relapses. © Informa Healthcare USA, Inc

İzole baş ağrısı bulgusu veren serebral ven trombozları

OBJECTIVE: The aim of this study is to demonstrate the demogrophical specialities and clinical features among patients with cerebral venous thrombosis (CVT), who had admitted to our department between 2006 and 2012 and who had headache as the only presenting symptom. MATERIAL and METHODS: Thirty-two patients who had diagnosed as CVT between 2006-2012 were evaluated and 12 of them who had headache as the only presenting symptom were included to the study. RESULTS: Headache was only symptom of CVT in 12 patients (10 Female, 2 Male). 8 of these 12 patients had papilledema. 4 patients had only headache without additional sign. The lateral sinus was the most frequently involved sinus. CONCLUSION: The headache is usually progressive over a few days, but a few patients have sudden onset or even a thunderclap headache. The outcome of CVT patients with isolated headache diagnosed was favourable

Akut allerjik rinitli hastalarda lokal sempatik sistem disfonksiyonunu gösteren lokal sempatik deri yanıtları testi’nin elektrofizyolojik çalışması

Introduction: In this study, we aimed to investigate sympathetic nervous system functions by local sympathetic skin responses of the nasal septum in patients with acute allergic rhinitis.Material and Methods: Eighty-five patients who were diagnosed as acute allergic rhinitis according to medical history and otorhinolaryngological examination with positive allergy evaluations via skin prick testing and 50 healthy subjects were included to the study. Sympathetic skin responses of the nasal septum were recorded in patients and in the control groups, and sympathetic skin response latencies and amplitudes were compared between groups.Results: The mean value of sympathetic skin response latencies was significantly longer in the patient group than that of the control group (p<0.001). In addition, mean value of sympathetic skin response amplitudes was significantly lower in the patient group than the control group (p<0.001).Conclusion: Our study is the first which electrophysiologically evaluated the local sympathetic nervous functions that shows objective evidence of local sympathetic nervous system dysfunction. This way to access local sympathetic nervous system dysfunction would be helpful in deciding patients' treatment

The association between central adiposity and autonomic dysfunction in obesity

Objective: To determine the relationship between central adiposity parameters and autonomic nervous system (ANS) dysfunction. Subjects and Methods: The study included 114 obese individuals without any cardiovascular risk factors. Weight (in kg), height (in m), and waist circumference (WC; in cm) were measured and body mass index was calculated. Echocardiographic examination was performed to measure left ventricular mass and epicardial fat thickness (EFT). All the participants underwent an exercise test and electrophysiological evaluation using electromyography. Heart rate recovery (HRR) at 1-5 min, R-R interval variation at rest and during hyperventilation, and sympathetic skin response were measured. Pearson's correlation analysis was used. Multiple linear regression analysis was used to identify the factors associated with autonomic dysfunction. Results: The HRR at 1-5 min was negatively correlated with WC and age (WC-HRR1: r = -0.32; WC-HRR2: r = -0.31; WC-HRR3: r = -0.26; WC-HRR4: r = -0.23; WC-HRR5: r = -0.21; age-HRR2: r = -0.32; age-HRR3: r = -0.28; age-HRR4: r = -0.41; age-HRR5: r = -0.42). Age was the only independent predictor of reduced HRR at 1-5 min. In addition, WC predicted a reduced HRR at 3 min. There were no significant associations between central obesity and electrophysiological parameters. EFT was not associated with ANS dysfunction. Conclusion: In this study, central adiposity and aging were associated with ANS dysfunction in obese individuals. The WC could be a marker of ANS dysfunction in obese individuals without any cardiovascular risk factors. The HRR assessment at a later decay phase could be more valuable for evaluating ANS function than during early recovery. © 2016 S. Karger AG, Basel

Turkish version of the paindetect questionnaire in the assessment of neuropathic pain: A validity and reliability study

Objectives: The aim of this study was to develop a Turkish version of the painDETECT questionnaire (PD-Q) and assess its reliability and validity. Methods: Two hundred and forty patients who were diagnosed by expert pain physicians in daily clinical practice and classified as having either neuropathic, nociceptive, or mixed pain for at least 3 months were enrolled in this study. After the usual translation process, the Turkish version of the PD-Q was administered to each participant twice with an interval of 48 hours. The Leeds Assessment of Neuropathic Symptoms and Signs (LANSS), Douleur Neuropathique en 4 questions (DN4) and a pain visual analog scale were assessed along with the PD-Q. Chronbach's α was calculated to evaluate internal consistency of the PD-Q. Intraclass correlation coefficient was calculated to examine test-retest reliability. Convergent validity was assessed by correlating the scale with LANSS and DN4. Discriminant statistics-sensitivity, specificity, Youden index, positive predictive value, negative predictive value-were also assessed. Results: A total of 240 patients with chronic pain, 80 patients in each neuropathic, nociceptive, and mixed pain group, were included in this study. Mean age of the patients was 54.1 years, and majority of the patients were female (52.9%). Chronbach's α of the Turkish version of the PD-Q was 0.81. The test-retest reliability of the Turkish version of the PD-Q was determined as 0.98 for the total score and ranged from 0.86 to 0.99 for individual items. The Turkish version of the PD-Q was possitively and significantly corralated with LANSS (r 0.89, P<0.001) and DN4 (r 0.82, P<0.001). When the two cutoff values in the original version were used, sensitivity was found 77.5% for a cutoff value ≤19, and specificity was 82.5%. Sensitivity and specificity were 90% and 67.5%, respectively, for the other cutoff value ≤12. Scores ≤12 represents a negative predictive value=87%, and scores 19≤ represents a positive predictive value=82%. When mixed pain patients were included in the neuropathic pain group, discriminant values were reduced as expected. Conclusions: The Turkish version of the PD-Q is a reliable and valid scale to be used to determine neuropathic component of chronic pain in Turkish patients. © 2013

The Importance of Prostate-Specific Membrane Antigen Expression in Carotid Body Paragangliomas

Objective:Prostate-specific membrane antigen (PSMA) is a transmembrane protein expressed in prostate cancer. It is, however, also expressed in the neovasculature of some non-prostatic solid tumors. Carotid body paragangliomas (CBPs) are highly vascular neoplasms. In this study, we aimed to investigate the possible role of PSMA expression in CBPs. There are no studies in the literature that report to have investigated the relationship between PSMA and CBPs.Methods:This study is a retrospective analysis of cases diagnosed with CBP based on their demographic, clinical, radiological, surgical and immunohistochemical findings. Immunohistochemical examination results of Ki-67, S100, synaptophysin, chromogranin were retrieved from patient files. Then, the paraffin blocks of CBPs specimens, stained by PSMA-antibody by immunohistochemical methods were examined histopathologically.Results:The number of patients operated on for CBP was 12 (four men and eight women). Ten out of 12 specimens were suitable for staining and histopathological examination. Capsular and/or vascular invasions of tumors were seen in complicated cases. Intratumoral vascular PSMA expression was seen in all specimens except one. Extratumoral vascular PSMA expression was not detected in any of the cases. Tumoral cell PSMA staining was seen in six of ten cases.Conclusion:We found higher intratumoral vascular expressions of PSMA nearly in all CBPs, but we could not assess the statistical significance because of the small number of specimens. These data might be a guide for future studies that are planned for either diagnostic or therapeutic approaches to CBPs

Protective effect of insulin and glucose at different concentrations on penicillin-induced astrocyte death on the primer astroglial cell line

Astrocytes perform many functions in the brain and spinal cord. Glucose metabolism is important for astroglial cells and astrocytes are the only cells with insulin receptors in the brain. The common antibiotic penicillin is also a chemical agent that causes degenerative effect on neuronal cell. The aim of this study is to show the effect of insulin and glucose at different concentrations on the astrocyte death induced by penicillin on primer astroglial cell line. It is well known that intracranial penicillin treatment causes neuronal cell death and it is used for experimental epilepsy model commonly. Previous studies showed that insulin and glucose might protect neuronal cell in case of proper concentrations. But, the present study is about the effect of insulin and glucose against astrocyte death induced by penicillin. For this purpose, newborn rat brain was extracted and then mechanically dissociated to astroglial cell suspension and finally grown in culture medium. Clutters were maintained for 2 weeks prior to being used in these experiments. Different concentrations of insulin (0, 1, 3 nM) and glucose (0, 3, 30 mM) were used in media without penicillin and with 2 500 μM penicillin. Penicillin decreased the viability of astroglial cell seriously. The highest cell viability appeared in medium with 3 nM insulin and 3 mM glucose but without penicillin. However, in medium with penicillin, the best cell survival was in medium with 1 nM insulin but without glucose. We concluded that insulin and glucose show protective effects on the damage induced by penicillin to primer astroglial cell line. Interestingly, cell survival depends on concentrations of insulin and glucose strongly. The results of this study will help to explain cerebrovascular pathologies parallel to insulin and glucose conditions of patient after intracranial injuries. © 2012, Editorial Board of Neural Regeneration Research. All rights reserved