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Öğe The diagnostic role of pudental SEP in urinary incontinence due to multiple sclerosis(WILEY, 2018) Ekmekci, Hakan[Abstract not Available]Öğe Elevated Urinary Methylmalonic Acid/creatinine ratio and Serum Sterol levels in Patients with Acute Ischemic Stroke(UNIV PRESS, 2018) Sivrikaya, Abdullah; Öztürk, Şerefnur; Ekmekci, Hakan; Sağlam, Aslıhan; Abuşoğlu, Sedat; Ünlü, AliIntroduction: Sitosterolemia, defined as phytosterolemia, is a rare autosomal recessive disease characterized by elevated blood sterol levels. Our aim was to investigate serum plant sterols, methylmalonic acid, vitamin B12, oxidized-LDL and homocysteine levels in ischemic and hemorrhagic stroke patients and healthy subjects. Material and Methods: 50 healthy subjects (without a family history of coronary artery disease) and 89 patients hospitalized in the Selcuk University neurology clinic or intensive care unit with a diagnosis of stroke were included in this study. Serum plant sterols, homocysteine and methylmalonic acid, oxidized-LDL, total cholesterol, triglycerides, HDL-Cholesterol and vitamin B12 levels were analyzed by gas chromatography-mass spectrometry, liquid-chromatography tandem mass spectrometry, commercially available ELISA kit, spectrophotometry and chemiluminescence methods, respectively. Results: Urinary methylmalonic acid/creatinine ratio (p< 0.05), serum beta-sitosterol levels and beta-sitosterol/cholesterol ratio were significantly higher (p < 0.01) in patients compared to the control group. There was a significant positive correlation between the serum OxLDL-methylmalonic acid, serum homocysteine-urinary methylmalonic acid/creatinine ratio, serum methylmalonic acid-Urinary methylmalonic acid (p< 0.05), serum homocysteine-urinary methylmalonic acid, urinary methylmalonic acid-methylmalonic acid/creatinine ratio, serum methylmalonic acid-methylmalonic acid/creatinine ratio, serum beta-sitosterol-beta-sitosterol/cholesterol, total cholesterol-HDL, total cholesterol-LDL (p < 0.01) levels and negative correlation between vitamin B12-serum methylmalonic acid (p< 0.05), cholesterol-stigmasterol/cholesterol, LDL-stigmasterol/cholesterol (p < 0.01) levels in the patient group. Conclusion: Our findings presented that the serum sitosterol levels were significantly higher in stroke patients compared to controls.Öğe Idiopathic and unexplanable Thromboctopenia after Fingolimod Usage.(SAGE PUBLICATIONS LTD, 2016) Ekmekci, Hakan; Eren, Fettah; Ozturk, Serefnur[Abstract not Available]Öğe Language Disorders due to Posterior System Strokes - An Ignored Dysfunction(GALENOS YAYINCILIK, 2014) Ozturk, Serefnur; Ege, Fahrettin; Ekmekci, HakanThe anterior system is primarily responsible for the clinical picture in a patient that presents with clinical aphasia. However, recent reports have shown that injuries to posterior structures, the cerebellum in particular, may have a role in language processing. Herein, we will look first at the linguistic role of the cerebellum in light of the literature, then of the thalamus and some described clinical syndromes, and finally, specific syndromes resulting from occipital lobe lesions, all of which are supported by the posterior vascular system. The human brain is such a complex organization that in addition to the thalamus and occipital cortex, we can see the involvement of the cerebellum in high cognitive functions. Posterior system strokes may lead to clinical findings of cognitive deficits, including neurolinguistic components. Determining these defects in stroke patients may precipitate changes in current management strategies.Öğe Mills' Syndrome - A Clinical Variant -Case Report(JOURNAL NEUROLOGICAL SCIENCES, 2013) Ekmekci, Hakan; Ozturk, Serefnur; Demir, AysegulThe Mills' syndrome was first described by Mills in 1900, the syndrome included progressive, ascending or descending hemiplegia, with no significant sensory impairment. Opposing to be a variant of primary lateral sclerosis, this syndrome is accepted as degeneration of the corticospinal tract unilaterally. Fifty six years old, right handed female patient was admitted to our clinic outpatient outpatient clinic with left spastic hemiparesis, dysphagia, dysarthria and bilaterally prominent lower extremity spasticity and behavioral disturbances, sudden loughing, spastic contractility of arms and legs, gait disturbance for the last three years. Following the dysartria, the loss of power belonging to left lower extremity was proceeded by spasticity prominently left side and cognitive impairment with slow progression. On neurological evaluation, she was concious and cooperative partially. The cranial nerves examination were yielded dysphagia and dysphonia, there were spastic plegia on upper and lower left sided extremities. Deep tendon reflexes were hyperactive with Babinski sign on the right. The cerebral MRI showed mild generalised atrophy prominently right sided, cervical MRI showed both spondylosis and significant spinal cord atrophy. EMG investigation revealed significant neurogenic motor unit changes on left sided extremities especially lower area. Our case is carrying a rare clinical specifications of hemiplegic ascending ALS type of Mills and also unilateral cerebral atrophy is discussed in the light of the literature.Öğe Mills' Syndrome A Clinical Variant -Case Report(2013) Ekmekci, Hakan; Ozturk, Serefnur; Demir, AysegulMills sendromu 1900 yılında Mills tarafından tanımlanan unilateral progresif assendan veya dessendan hemipleji ile duysal tutulum olmaksızın ortaya çıkan nadir bir motor nöron hastalığıdır. Primer lateral sklerozun bir varyantı olduğu da ileri sürülen bu sendromun kortikospinal yolun tek taraflı dejenerasyonuna bağlı olduğu düşünülmektedir. Sol spastik hemiparezi, yutma ve konuşma güçlüğü, bilateral alt ekstremitelerde belirgin spastisite ile kliniğimize başvuran 56 yaşında, sağ elli kadın hastanın yakınmalarının 3 yıldır davranış bozukluğu, ani gülme atakları, kol ve bacaklarda kasılmalar, yürüme bozukluğu, yutma güçlüğünü takiben, önce yavaş bir şekilde başlayan sol alt ekstremitede kuvvet kaybı, göz hareketlerinde beceriksizlik, solda belirgin spastisitesi ve kognitif yıkım süreci ile devam ettiği öğrenildi. Nörolojik muayenede, bilinç açık, kısmen koopere idi. Kranial sinir muayenesinde disfaji ve disfoni, motor muayenesinde sol alt ve üst ekstremite spastik plejik, sağ alt ve üst ekstremitede spastisite dışında motor kuvvet tamdı. Derin tendon refleksleri bütün odaklarda hiperaktifdi. Babinski sağda pozitifti. Duyu muayenesi normaldi. Kranial MRI sağ hemisferde belirgin atrofi dışında normal, torakal ve servikal MRI'da spondilozun yanısıra belirgin spinal kord atrofisi izlendi. EMG'de altda altta daha belirgin sol ekstremitelerde belirgin nörojenik motor ünit değişiklikleri, yer yer fasikülasyonlar dışında normal sınırlarda sinir ileti değerleri elde edildi. Mills sendromunun tanımlanan hemiplejik asendan ALS klinik özelliklerine sahip olmanın yanı sıra, literatürde tanımlanmamış ünilateral serebral atrofisi de bulunan vakamız literatür ışığında tartışıldı.Öğe Parathyroid Hormone Levels in the Prediction of Ischemic Stroke Risk(HINDAWI PUBLISHING CORP, 2017) Celik, Guner; Dogan, Ali; Dener, Sefik; Ozturk, Serefnur; Kulaksizoglu, Sevsen; Ekmekci, HakanObjective. It was examined whether PTH and 25-dihydroxyvitamin D(25(OH)D) levels, together or separately, are indicators of the risk of stroke. Materials and Methods. This prospective study was performed at two centers. In the study, 100 patients diagnosed with acute ischemic stroke and 100 control individuals in the same age range were examined. In addition to neurological examination, cranial imaging, extensive routine blood chemistry, PTH, and 25(OH) D levels were evaluated in all cases. Stroke risk factors were determined. Logistic regression was used for statistical analysis. Results. A total of 60 patients and 79 control individuals were included in the study. Different estimation models were designed in order to examine the relationship between PTH and 25(OH) D levels with stroke. According to modeling results, it was determined that the most effective predictor for risk of stroke was 25(OH) D levels, followed by hypertension and PTH levels, respectively. Conclusion. PTH and 25(OH) D levels together can make important contributions to determination of stroke risk, and further investigations are needed to understand this relationship more fully.
