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Öğe Acute disseminated encephalomyelitis presenting as conversion disorder(Amer Psychiatric Publishing, Inc, 2005) Abay, E; Balci, K; Ates, I[Abstract Not Available]Öğe Brachial plexus injury during open heart surgery - Controlled prospective study(Georg Thieme Verlag Kg, 2005) Canbaz, S; Turgut, N; Halici, U; Sunar, H; Balci, K; Duran, EBackground: Postoperative brachial plexus injury is often reported because the brachial plexus is stretched by sternotomy and the use of sternal retractors during open heart surgery. In many studies, brachial plexus injuries have been demonstrated by postoperative electrophysiological studies in susceptible patients. In this study, we estimated the incidence, severity, and type of brachial plexus injuries by routine preoperative and postoperative electrophysiological studies of patients undergoing open heart surgery. Methods: Patients undergoing coronary artery bypass grafting (CABG) surgery (Group 1), heart valve surgery (Group 2), or peripheral vascular surgery (Group 3) were included in the investigation. Electrophysiological studies of both upper extremities were performed five days before and three weeks after the operation. Results: Peripheral nerve problems were found preoperatively in 23 of the 112 patients (21 %). These problems persisted, but similar findings were obtained postoperatively from the left upper extremities of six of the 42 CABG (14%) and two of the 24 heart valve (8%) patients who had had normal preoperative evaluations. The patients with injured nerves were older and had undergone longer operation times. There were no differences between the patients with injured nerves and the others with respect to mammary artery harvesting or other operative variables. Conclusions: There are no reports in the literature of routine preoperative and postoperative electrophysiological studies in large patient groups to evaluate brachial plexus injury during open heart surgery. It is known that heart surgery sometimes causes partial brachial plexus injury, especially in the lower trunk. However, these peripheral nerve problems are usually not considered clinically important and are not investigated. Patients undergoing open heart surgery must be closely followed up for peripheral nerve injury during the postoperative period.Öğe A case of acquired stuttering resulting from left parietal infarction(Blackwell Munksgaard, 2002) Turgut, N; Utku, U; Balci, KObjective - Acquired stuttering is uncommon. and is reported anecdotally after head injury and cerebrovascular diseases. Although this entity is described to occur in lesions of dominant hemisphere, it is rarely shown to occur in non-dominant hemispheric and subcortical lesions, too. Therefore we described a case with this rare syndrome and we discussed the possible mechanisms, lesion locations and medical treatment of stuttering according to previous reports. Case report A 61-year-old right-handed man with sudden onset of right hemiparesia and stuttering without aphasia is reported. There was a circumscribed cortical infarction in the left parietal cortex on computerized tomography (CT) and magnetic resonance imaging (MRI) showed a recent infarct. Single photon emission computed tomography (SPECT) images evidenced perfusion abnormalities in the same region. He never Stuttered before and has no family history of stuttering. He has been maintained on antiaggregant and paroxetine treatment. Conclusion - A rare presentation of stroke associated with stuttering is reported and the treatment of stuttering with paroxetine is discussed.Öğe Clinical and neuroradiological predictors of mortality in patients with primary pontine hemorrhage(Elsevier Science Bv, 2005) Balci, K; Asil, T; Kerimoglu, M; Celik, Y; Utku, UBackground and purpose: Primary pontine hemorrhage (PPH) accounts aproximately for about 5-10% of intracranial hemorrhages, and PPHs are known to have a much less uniform prognosis. We aimed to evaluate the clinical and radiological predictors affecting the mortality in 32 patients with PPH. Material and methods: We retrospectively evaluated the data of 32 patients with PPH admitted to our clinic between 1994 and 2004. We divided the patients into two groups: (1) patients who survived (14 patients), and (2) patients who died (18 patients). The two groups were compared for age, gender, diabetes mellitus, hypertension, initial clinical status, initial GCS, pupillary abnormalities, ophthalmoparesis, volume and localisation of hemorrhage, intraventricular and extrapontine extension, necessity of mechanical ventilation and hydrocephalus. The hematoma volumes were measured with the formulation described by Broderick. Results: Eighteen patients (56%) died and 14 patients (44%) survived. The patients who died (61.3 +/- 8.8) were older than the survivors (56.4 +/- 11.0), but the difference was not statistically significant. The mean GCS was 4.4 +/- 0.2, the mean hematoma volume was 9.9 +/- 3.3 ml for patients who died and the mean GCS was 10.1 +/- 3.3, the mean hematoma volume was 3.3 +/- 1.2 ml for survivors (p < 0.001). Coma on admission (p = 0.001), extrapontine extension (p = 0.001), intraventricular extension (p = 0.019), necessity of mechanical ventilation (p = 0.007), hydrocephalus (p = 0.024), massive and bilateral tegmental localisation (p = 0.006) were found statistically significant predictors for mortality with univariate comparison, and coma on admission (p = 0.038) was the only significant predictor with multivariate regression analysis. Conclusion: In patients with PPH, it is important to know the prognostic factors for mortality for planning the treatment protocol, and coma and bad clinical status on admission was found the only significant prognostic predictor for mortality with multivariate regression analysis. (c) 2005 Elsevier B.V. All rights reserved.Öğe Clinical utility of dorsal sural nerve conduction studies in healthy and diabetic children(Elsevier Ireland Ltd, 2004) Turgut, N; Karasalihoglu, S; Kücükugurluoglu, Y; Balci, K; Ekuklu, G; Tütüncüler, FObjective: Monitoring of the dorsal sural sensory nerve action potential (SNAP) is a sensitive method for detection of peripheral neuropathies. We tried to determine the normal dorsal sural nerve conduction values of the childhood population and assessed the clinical utility of this method in diabetic children who have no clinical sign of peripheral neuropathy. Methods: In the study, 36 healthy and 27 diabetic children were included. In all subjects peripheral motor and sensory nerve studies were performed on the upper and lower limbs including dorsal sural nerve conduction studies. Results: The dorsal sural SNAP mean amplitude was 8.24 +/- 3.08 muV, mean latency was 2.47 +/- 0.48 ms, mean sensory conduction velocity was 41.63 +/- 5.43 m/s in healthy children. Dorsal sural SNAPs were absent bilaterally in one diabetic patient. In the other 26 diabetic patients, the mean dorsal sural nerve distal latency was longer (2.93 +/- 0.63 ms, P = 0.004), mean SCV was slower than in healthy subjects (36.68 +/- 7.66 m/s, P = 0.005). However, dorsal sural nerve amplitude was not different between the groups. A dorsal sural nerve latency of more than 2.9 ms had a sensitivity of 50% and a specificity of 75%. A dorsal sural nerve velocity of less than 36 m/s had a sensitivity of 54% and a specificity of 92%. Conclusions: We designated the reference values of the dorsal sural nerve in healthy children. In addition, our findings suggest that dorsal sural nerve conduction studies may have value to determine neuropathy in the early stages in children with diabetes. Significance: The dorsal sural nerve conduction studies in diabetic children may have value to determine the neuropathy in its early stages. (C) 2003 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.Öğe Factors affecting haemorrhagic transformation in middle cerebral artery infarctions(Churchill Livingstone, 2004) Çelik, Y; Utku, U; Asil, T; Balci, KObjective: Haemorrhagic transformation (HT) affects treatment and prognosis in patients with acute ischaemic stroke. The factors affecting haemorrhagic transformation in infarcts due to occlusion of middle cerebral artery (MCA) stem or branch were investigated. Materials and methods: Of 412 patients who were followed in our clinic between January 2001 and December 2001 with acute ischaemic stroke, 86 patients with occlusion in MCA stem or branch were enrolled in this study. These patients were divided into 2 groups, those with HT (n = 35) and without HT (n = 51). Age, sex, systemic arterial hypertension, diabetes mellitus, blood glucose level in the acute period, renal and liver function tests, systolic and diastolic arterial blood pressure in the acute period, previous cerebrovascular disease, leukoaraiosis, modified Rankin Disability Score (mRDS) and stroke subtype were evaluated. Results: High blood glucose level in the acute period and presence of leukoaraiosis on cranial computerized (CCT) tomography were detected as risk factors in development of HT. HT was seen more frequently in MCA stem infarction than branch infarction. mRDS were worse in the group with HT. In multivariate analysis, there were independent relationships between mean blood glucose level on admission, mRDS, presence of diabetes mellitus, and MCA stem infarction and development of haemorrhagic transformation in patients with MCA territorial infarction. (C) 2003 Elsevier Ltd. All rights reserved.Öğe Hepatic myelopathy with spastic paraparesis(Elsevier, 2005) Utku, U; Asil, T; Balci, K; Uzunca, I; Çelik, YProgressive myelopathy is a rare neurological complication of chronic liver disease with portal hypertension and there is no special diagnostic tool for hepatic myelopathy. Neuropathological studies of the patients with hepatic myelopathy have demonstrated demyelination of the lateral corticospinal tracts with various degree of axonal loss. Transcranial magnetic stimulation (TMS) is widely utilized as an indicator of changes in exitability and conductivity of the motor pathways. TMS studies are also used for the diagnosis of hereditary spastic paraparesis in the literature. In this study, we described two patients who presented with spastic paraparesis; TMS studies suggested that they had myelopathy and diagnosed as hepatic myelopathy when all the other possible diagnoses were ruled out. (c) 2004 Elsevier B.V. All rights reserved.Öğe Normal values for single fiber EMG parameters of frontalis muscle in healthy subjects older than 70 years(Elsevier Ireland Ltd, 2005) Balci, K; Turgut, N; Nurlu, GObjective: Single fiber EMG (SFEMG) is a potent electrophysiological method to evaluate impaired neuromuscular transmission, and allows sensitive diagnosis of neuromuscular transmission abnormalities such as myasthenia gravis. The jitter and fiber density values are different for various muscles and age groups and the reference values increase with age. In this study, we evaluated the reference values of jitter and fiber density of frontalis muscle in healthy subjects older than 70 years. Methods: We evaluated the jitter and fiber density of frontalis muscle in 32 healthy subjects. Twenty-two of them were between 70 and 79 years old (mean +/- SD, 73.9 +/- 1.7), and 10 of them were older than 80 years (mean +/- SD, 82.2 +/- 1.2). Results: Normal limit of jitter (95% confidence limit) was calculated as 40.4 mu s for healthy subjects between 70 and 79 years old and 43.7 mu s for healthy subjects older than 80 years and normal limit of fiber density (95% confidence limit) were calculated as 1.90 for subjects between 70 and 79 years old and 2.14 for subjects older than 80 years. Conclusions: We designated the reference values of jitter and fiber density for frontalis muscle in healthy subjects older than 70 years. Our reference values may have value to diagnose neuromuscular transmission abnormalities in elderly patients. Significance: SFEMG is sensitive for neuromuscular transmission abnormalities and it is important to know the reference values of frontalis muscle in healthy subjects older than 70 years. (c) 2005 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.Öğe Proximal myotonic dystrophy associated with parkinsonism(Elsevier Sci Ltd, 2006) Celik, Y; Turgut, N; Balci, K; Kabayel, LAlthough mental changes and cognitive disorders are seen frequently in myotonic dystrophy (MD) there are only three cases of MD associated with parkinsonism reported in the literature. We report another case of this extremely rare combination. (c) 2006 Elsevier Ltd. All rights reserved.Öğe Recovery from aphasia after decompressive surgery in patients with dominant hemispheric infarction(Lippincott Williams & Wilkins, 2005) Asil, T; Utku, U; Balci, K; Kilincer, C[Abstract Not Available]Öğe Utility of dorsal sural nerve in early determination of diabetic polyneuropathy(Blackwell Publishing, 2005) Balci, K; Karacayir, S; Varol, G; Utku, U[Abstract Not Available]