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Öğe Atherosclerosis and peripheral neurological problems(Int Heart Journal Assoc, 2004) Canbaz, S; Turgut, N; Halici, U; Ege, T; Duran, E[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 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 Diagnosis of phrenic nerve injury after cardiac surgery(Elsevier Science Inc, 2004) Canbaz, S; Turgut, N; Halici, U; Duran, E[Abstract Not Available]Öğe Distal sensorimotor polyneuropathy affects skeletal muscle perfusion and metabolism by Tc-99m sestarnibi leg scintigraphy in patients with type 2 diabetes(Lippincott Williams & Wilkins, 2005) Ugur-Altun, B; Durmus-Altun, G; Ustun, F; Turgut, N; Altun, A; Tugrul, AWe evaluated the effects of distal symmetric sensorimotor polyneuropathy (DSP) on skeletal muscle perfusion and metabolism in patients with type 2 diabetes. Twenty-three patients with type 2 diabetes under-went electrophysiological and Tc-99m sesta-mibi leg scintigraphic studies. The study patients were divided into 2 groups: group I (n = 14) with DSP and group 11 (n = 9) without DSP. We found decreased Tc-99m sestamibi uptake ratios (UR) of both legs in patients with DSP (right UR 7.98 +/- 6.85, left UR 7.78 +/- 7.01 vs. right UR 8.91 +/- 7.98, left UR 8.67 +/- 8.23, respectively) than without DSP, although it did not reach statistical significance. The regression equation of right UR was (Tc-99m sestarnibi UR = [1.927 X velocity of tibial nerve] - [0.942 X amplitude of sural nerve] - 81.94). In conclusion, electrophysiological variables of tibial motor and sural sensory nerves predict Tc-99m sestarnibi UR at leg scintigraphy in patients with type 2 diabetes. Additionally, decreased Tc-99m sestarnibi UR in patients with type 2 diabetes with DSP was found.Öğe Dysphagia as a primary manifestation of hyperthyroidism: A case report(Taylor & Francis Ltd, 2006) Guldiken, B; Guldiken, S; Turgut, N; Yuce, M; Arikan, E; Tugrul, AMyopathy effecting mainly skeletal muscles of the limbs are frequently seen in hyperthyroidism. Rarely bulbar muscles may also be involved, causing dysphagia, nasal speech, and aspiration. We report a 70-year-old woman with severe dysphagia and aspiration pneumonia. Clinical examination and laboratory tests showed an underlying Graves' disease. Her dysphagia improved dramatically by antithyroid therapy. Considering its excellent response to medical therapy, hyperthyroidism being a very rare factor - is well-worth to remember for the unexplained dysphagia cases.Öğe Factors affecting the outcome of decompressive craniectomy for large hemispheric infarctions: a prospective cohort study(Springer Wien, 2005) Kilincer, C; Asil, T; Utku, U; Hamamcioglu, MK; Turgut, N; Hicdonmez, T; Simsek, OBackground. Although surgical decompression of large hemispheric infarction is often a life-saving procedure, many patients remain functionally dependent. The aims of this study were to identify specific factors that can be used to predict functional outcome, thus establish predictive criteria to reduce poor surgical results. Method. In this non-randomized prospective study, we performed decompressive craniectomy in 32 patients (age range, 27 to 77 years) with large hemispheric infarctions. Based on their modified Rankin Score (RS), which was calculated 6 months postoperatively, patients were divided into two functional groups: good (RS 0-3, n = 7) and poor (RS 4-6, n = 25). The characteristics of the two groups were compared using statistical analysis. Findings. One-month mortality was 31%. However, most of the surviving patients were severely disabled (RS 4 or 5), and 6-month total mortality reached 50%. Increased age (>= 60 years) (P = 0.010), preoperative midline shift greater than 10 mm (P = 0.008), low preoperative Glasgow Coma Score (GCS <= 7) (P = 0.002), presence of preoperative anisocoria (P = 0.032), early (within the first three days of the stroke) clinical deterioration (P = 0.032), and an internal carotid artery infarct (P = 0.069) were the positive predictors of a poor outcome. Interpretation. We view decompressive craniectomy for space-occupying large hemispheric infarction as a life-sparing procedure that sometimes yields good functional outcomes. A dominant hemispheric infarction should not be an exclusion criterion when deciding to perform this operation. Early operation and careful patient selection based on the above-mentioned factors may improve the functional outcome of surgical management for large hemispheric infarction.Öğe Hypercoagulopathy in stroke patients with nonvalvular atrial fibrillation(Westminster Publ Inc, 2006) Turgut, N; Akdemir, O; Turgut, B; Demir, M; Ekuklu, G; Vural, Ö; Özbay, GThe coagulation system is activated and coagulation activation markers are elevated in acute ischemic stroke with nonvalvular atrial fibrillation (NVAF). The etiology, severity, and prognosis of the ischemic stroke might be estimated with the level of the activation of the coagulation system. In this study, prothrombin F1+2 (F1+2), D-dimer, and fibrinogen levels were measured in patients with acute ischemic stroke with and without NVAF, and stroke severity was compared with these hemostatic parameters. Of 55 patients, 29 had sinus rhythm (group I), 26 had NVAF (group II); 20 healthy subjects (group III) were included in the study. Subtypes of cerebral infarction were classified. The patients underwent stroke severity, electrocardiography, echocardiography, cranial computed tomography, cervical duplex ultrasonography, and hemostatic parameter studies. In group II, F1+2 level (2.83 +/- 0.89) was significantly higher than in group I (2.33 +/- 0.80) and III (1.94 +/- 0.64) (p values: group I-II, 0.036; groups II-III, 0.001; groups I-III, 0.104). In group III, fibrinogen level (251.64 +/- 60.96) was significantly lower than that in groups I (347.97 +/- 111.49) and II (364.04 +/- 86.20) (p = 0.001). D-dimer was not significantly different between groups. In group I, lacunar syndrome (LACS), and in group II, partial and total anterior circulation syndrome (PACS + TAGS) were more common (p = 0.013, p = 0.001, respectively). In group II, Scandinavian Stroke Scale scores were lower than those in group I (group I = 45.2 +/- 14, group II = 35.4 +/- 18.9, p = 0.02). In conclusion, activation of coagulation, demonstrated by increment F1+2, is more abundant in the stroke patients with NVAF than in the stroke patients with sinus rhythm. Our results also showed that activation of the hemostatic system might be related to stroke subtype and stroke severity. It is suggested that the oral anticoagulation treatment as prophylaxis is important in the prevention of stroke in patients with NVAFÖğe Neuroapraxia - Reply(Elsevier Science Inc, 2005) Canbaz, S; Duran, E; Turgut, N[Abstract Not Available]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 Reversible postictal MRI change mimicking structural lesion(Elsevier, 2003) Hicdonmez, T; Utku, U; Turgut, N; Cobanoglu, S; Birgili, BA reversible change on magnetic resonance imaging (MRI) following generalised seizure mimicking a tumour-like structural lesion is reported in a 15-year-old patient. MRI revealed a left fronto-parietal cortico-subcortical lesion on T2 weighted images. The control MRI after 5 weeks from the onset revealed no pathological finding. The reversible MRI changes may be the result of a local brain swelling, and a defect of cerebral autoregulation during seizure at the site of activity. The transient nature of such neuroradiological findings have to be taken into consideration in the differential diagnosis because of their similar appearance on imaging to intrinsic brain tumours. (C) 2003 Elsevier B.V. All rights reserved.