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    Antinuclear, Cytoskeletal, Antineuronal Antibodies in the Serum Samples of Children with Tic Disorders and Obsessive Compulsive Disorders
    (Galenos Publ House, 2011) Gorker, Isik; Demir, Gulsen Akman; Polat, Nuray Gurel; Omeroglu, Rukiye Eker; Icoz, Sema; Serdaroglu, Piraye; Tuzun, Umran
    Objective: As environmental factors, the role of Group A beta hemolytic streptococcus infections in the development of tic and obsessive compulsive disorders (OCD) is controversial. The autoimmune hypothesis states that during infection, formation of autoantibodies leads to an autoimmune disorder, which in turn results in movement disorders, tic disorders and/or OCD. In order to test this hypothesis, we assayed these antibodies in children and adolescents diagnosed with tic disorders and/or OCD. Material and Methods: Children and adolescents who were diagnosed with either tic disorders or OCD according to DSM-IV criteria (n=28), were compared with healthy controls (n=15) having similar age and gender characteristics. Regardless of a streptococcus infection history, serum samples of all patients and controls underwent antinuclear, cytoskeletal, and antineuronal antibody assay using indirect immunofluorescence. Results: The rates of antinuclear antibody positivity were 21% and 20% in the patient and control groups respectively (p>0.05). Antineuronal antibody was positive in 2 (7%) of 28 patients versus in 1 (6%) of 15 controls (p>0.05). Conclusion: These results suggest that such antibodies may not be involved in the pathogenesis of tic disorders/OCD.
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    Evaluation of Cardiac Autonomic Dysfunction in Patients With Duchenne-type Muscular Dystrophy
    (Journal Neurological Sciences, 2010) Yilmazer, Murat Muhtar; Omeroglu, Rukiye Eker; Bornaun, Helen; Oner, Naci; Nisli, Kemal
    Objective: The aim of this study was to investigate the presence of cardiac autonomic dysfunction by time-domain heart rate variability analysis in patients with Duchenne Muscular Dystrophy (DMD). Methods: We evaluated cardiac autonomic function by time-domain heart rate variability analysis on 24-hour Holter ECG recordings in 43 patients with DMD and 34 healthy male controls. The variability of the heart rate and its circadian rhythm were assessed. The results of time-domain analyses were compared between study and control group. In addition left ventricular end-diastolic diameter, left ventricular ejection fraction and fractional shortening were measured by 2-dimensional echocardiography. Results: The mean age of study group was 8.79 +/- 3.0 years (range, 3 to 17 years), and control group was 9.52 +/- 3.1 years (range, 4 to 16 years). All of the time-domain parameters (NN, SDNN, SDANN, SDNN-i, RMSSD, pNN50) of the study group were significantly lower than control group. However no significant difference was found in left ventricular end-diastolic diameter on echocardiographic examination between study and control groups. Conclusion: The time-domain parameters were found to be decreased significantly in DMD patients. Our data showed a marked impairment of cardiac autonomic function in patinets with DMD, which reflect to mainly involve the parasympathetic activity. We concluded that autonomic dysfunction has developed in the earlier period in DMD before the development of mechanical cardiac dysfunction
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    Long term follow-up results of 139 Turkish children and adolescents with rheumatic heart disease
    (Springer, 2008) Yavuz, Taner; Nisli, Kemal; Oner, Naci; Dindar, Aygun; Aydogan, Umrah; Omeroglu, Rukiye Eker; Ertugrul, Turkan
    We aimed to evaluate the predictors of the severity of chronic rheumatic valvar disease. The long term follow-up records of 139 patients with chronic rheumatic carditis were reviewed. Children were followed-up on an outpatient basis for a period ranging from 1-16 years (5.0 +/- 3.7 years). Mitral regurgitation either isolated (51%, n=71) or combined with aortic regurgitation (AR) (49%, n = 68) was observed in all cases of the initial attack of rheumatic carditis. AR at initial attack of the rheumatic carditis was found to be affected by gender (AR was more associated with males, p = 0.032), combined mitral and aortic regurgitation (CMAR), and presence of MR at initial attack (p = 0.000 and p = 0.012, respectively) with univariate analysis. The effect of CMAR on AR at initial attack was also significant by multivariate analysis (p = 0.000). CMAR, MR, and AR at initial attack had significant effects on CMAR at final evaluation (p = 0.000, p = 0.020, and p = 0.000, respectively) in univariate analysis. Multivariate analysis revealed the significant effects of CMAR and MR at initial attack on CMAR at final evaluation (p = 0.000 and p = 0.005, respectively). Univariate analysis showed that MR and AR at initial attack, and CMAR at final evaluation, had significant effects on MR at final evaluation (p = 0.000, p = 0.029, and p = 0.000, respectively). MR at initial attack and CMAR at final evaluation had significant effects on MR at final evaluation with multivariate analysis (p = 0.001 and p = 0.003, respectively). AR at final evaluation was affected by CMAR and AR at initial attack (p = 0.000 and p = 0.000, respectively), and CMAR and MR at final evaluation (p = 0.000 and p = 0.000, respectively) with both univariate and multivariate analysis. Mitral valve prolapsus was more common in patients with a longer duration (37.5%, 6 out of 16) than those with a shorter duration (11%, 14 out of 123) and the difference was significant (p = 0.020). In conclusion, the initial severity of valve involvement and the presence of CMAR at initial attack were found to be the best predictors for the severity of chronic rheumatic valvar disease in this study.
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    Repolarization abnormalities in Duchenne-type muscular dystrophy
    (Turkish Soc Cardiology, 2009) Yilmazer, Murat Muhtar; Omeroglu, Rukiye Eker; Bornaun, Helen; Oner, Naci; Nisli, Kemal; Ertugrul, Turkan
    Objectives: Duchenne-type muscular dystrophy (DMD) is an X-linked recessive inherited disease affecting mainly the skeletal and cardiac muscles. We aimed to seek associations between the incidence of ventricular arrhythmias and corrected QT (QTc) dispersion and its component, corrected JT (JTc) dispersion in patients with DMD. Study design: The study included 43 consecutive male patients (mean age 8.8 +/- 3.0 years; range 3 to 17 years) with DMD. On standard 12-lead electrocardiograms (ECG) the QT and JT intervals and the corrected QT (QTc) and JTc dispersions were calculated. Ventricular extrasysto-les were assessed on 24-hour Holter ECG recordings. Ventricular dysrhythmic patterns were evaluated according to the Lown-Wolf classification. The results were compared with those of a control group of 34 healthy children (mean age 9.5 +/- 3.1 years). Results: The mean QTc and JTc dispersion values were significantly higher in DMD patients compared to controls (QTc: 78.0 +/- 20.6 msec vs. 50.9 +/- 16.5 msec; JTc: 77.6 +/- 20.5 msec vs. 50.8 +/- 17.7 msec; p<0.05). The results of Holter monitoring were evaluated in 36 patients and in 33 controls. Ventricular extrasystoles were found in six patients (16.7%) and in one (grade I) control subject (3%). The incidence of pathological findings was significantly higher in the study group (p<0.05), including grade I pathology in four patients, grade II pathology in one patient, and grade IV in one patient. QTc and JTc dispersion values of the patients with and without ventricular extrasystoles showed no statistically significant difference (p>0.05). Conclusion: Similar QTc and JTc dispersion values detected in patients with and without ventricular extrasystoles may suggest that ventricular repolarization abnormalities occur in early life and may predispose to the development of ventricular arrhythmias in the long-term.