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Background/aim: Syndesmophyte formation appears to be site-specific in ankylosing spondylitis (AS) and new bone formation seems to occur in regions of microtrauma that are prone to tensile forces. Pelvic and spinal parameters are unique for each individual. Pelvic tilt and sacral slope are important anatomical features that compensate in harmony in keeping the sagittal balance. After puberty, the sacral slope shapes the lumbar lordosis, whereas the pelvic incidence has an individual constant value. This study aimed to analyze the properties of pelvic parameters in AS patients with and without syndesmophyte formation in the spine after 15 years of disease duration. Materials and methods: Whole-spine radiographs and clinical data of 104 AS patients were analyzed according to radiographic damage in the spine. AS patients were grouped as those with and without syndesmophytes. Patients with complete bridging in at least one vertebral unit were excluded. Sacral slope, pelvic tilt, pelvic incidence, and lumbar lordosis were measured. Results: The mean disease duration was 14.5 years and 60% of the AS patients were male. The groups were similar in terms of age, sex distribution, and disease duration. Although numerically higher in patients with syndesmophytes, the mean pelvic incidence of AS patients was not significantly different between groups (55.2 ± 13.6 vs. 57.2 ± 15.4). The sacral slope was higher in patients with lumbar syndesmophytes (p < 0.005). Conclusion: The sacral slope was significantly higher in patients with syndesmophytes, which in turn resulted in increased lumbar lordosis. Our results imply that the individual shape of the spine affects the distribution of weight and tensile forces in AS, and some patients are possibly more prone to new bone formation due to altered repetitive microtrauma in the general genetic background of AS. Prospective studies addressing this cross-sectional observation may contribute to the development of new treatment strategies addressing mechanical load and may aid in decreasing the management costs of AS with the present biological therapies targeting new bone formation. [ABSTRACT FROM AUTHOR]

Objective: Temporal lobe epilepsy (TLE) accompanied by hippocampal sclerosis (HS) is the most common type of focal epilepsies. Hemispheric asymmetry is a feature of brain organization in both invertebrates and vertebrates and may be the key to some neurodegenerative diseases. In this context, we aimed to investigate the volumetric asymmetry difference in cerebral structures between TLE patients and the healthy control group, based on magnetic resonance imaging (MRI) data that may be used as a new neuroimaging marker for TLE cases. Patients and Methods: In this retrospective study the cranial MRIs of fourteen clinically manifesting, radiologically HS-identified, and diagnosed TLE patients and fourteen healthy individuals from the Radiology Department of Yeditepe University Hospital were evaluated. Volume measurements and asymmetry index (AI) calculations in the total brain, hippocampus, temporal lobe, amygdala, thalamus, nucleus accumbens (NAc), premotor cortex, primary and somatosensory cortices were performed using the medical NeuroQuant® software. A negative AI value represented asymmetry towards the right due to reduced left hemispheric volume; a positive AI value represented asymmetry towards the left due to reduced right hemispheric volume. Subsequently, differences in volume and asymmetric patterns were investigated among TLE subgroups (right and left-sided TLE) and controls. Results: The left-sided TLE patients showed significant bilateral total brain volume reduction compared to the control group. Significant ipsilateral volumetric declines were also detected in the premotor cortex, the temporal lobe, and NAc with remarkable asymmetry to the right side. No significant changes were detected in right-sided TLE patients compared to the other groups. Conclusion: Overall, findings suggest that TLE patients had volumetric alterations with symmetry changes beyond the mesial temporal structures. With further investigations, the asymmetry measures can provide additional knowledge for TLE diagnosis. [ABSTRACT FROM AUTHOR]

Byline: Gulten. Ozturk, Akif. Ayaz, Yasemin. Topcu, Gülcan. Akyuz, Olcay. Unver, Ismail. Akbeyaz, Gazanfer. Ekinci, Dilsad. Turkdogan Sir, Two patients with the same genetic mutation in ADPRHL2 gene, which takes [...]

Byline: Tulin. Ergun, Dilek. Seckin, Andac. Salman, Esra. Ocak, Ayse. Yucelten, Haner. Direskeneli, Cuyan. Demirkesen, Gazanfer. Ekinci, Mahmut. Bayik Eosinophilic fasciitis is an uncommon connective tissue disease that may mimic [...]

Aim: The purpose of this study is to classify the malformations of cortical development in children according to the embryological formation, localization, and neurodevelopmental findings. Seizure/epilepsy and electrophysiological findings have also been compared. Material and Methods: Seventy-five children (age: 1 month-16.5 years; 56% male) followed with the diagnosis of malformation of cortical development, in Marmara University Pendik Research and Educational Hospital Department of Pediatric Neurology, were included in the study. Their epilepsy characteristics, electroencephalogram (EEG) findings, and prognosis were reported. Neurodevelopmental characteristics were evaluated by the Bayley Scales of Infant and Toddler Development (Bayley-III) for the ages of 0-42 months (n = 30); the Denver Developmental Screening Test-II (DDST-II) for ages 42 months-6 years (n = 11); and the Wechsler Intelligence Scales for Children (WISC-R), used for children 6 years and older (n = 34). Results: The patients were classified as 44% premigrational (14.6% microcephaly, 24% tuberous sclerosis, 2.7% focal cortical dysplasia, 1.3% hemimegalencephaly, and 1.3% diffuse cortical dysgenesis); 17.3% migrational (14.6% lissencephaly, 2.7% heterotopia); and 38.6% postmigrational (14.6% schizencephaly, 24% polymicrogyria) developmentally. According to involved area, the classification was 34.7% hemispheric/multilobar, 33.3% diffuse, and 32% focal. Seventy-five percent of the patients had a history of epilepsy, and 92% were resistant to treatment. The seizures started before the age of 12 months in diffuse malformations, and epileptic encephalopathy was more common in microcephaly with a rate of 80% and lissencephaly with a rate of 54.5% in the first EEGs. Ninety-five percent of patients had at least one level of neurodevelopmental delay detected by DDST/Bayley-III; this was more common in patients with accompanying epilepsy (P < .05). As seen more commonly in patients with diffuse pathologies and intractable frequent seizures, mental retardation was detected by WISC-R in 64.5% of patients (P < .05). Conclusion: In cases with cortical developmental malformation, epilepsy/EEG features and neurodevelopmental prognosis can be predicted depending on the developmental process and type and extent of involvement. Patients should be followed up closely with EEG. [ABSTRACT FROM AUTHOR]

Purpose: Malignant high-grade gliomas are the most common and aggressive type of primary brain tumor, and the prognosis is generally extremely poor. In this retrospective study, we analyzed the outcome of systemic treatment in recurrent high-grade glioma patients and the impact of prognostic factors on survivals. Methods: Data from 114 patients with recurrent high-grade glioma who received systemic treatment and followed in our clinic between 2012 and 2018 were retrospectively analyzed. Eastern Cooperative Oncology Group (ECOG) performance status, age, gender, histology, type of surgical resection, side effects after systemic treatment (deep vein thrombosis, hypertension, proteinuria), IDH1 and alpha thalassemia/mental retardation syndrome X-linked (ATRX) mutation status were investigated as prognostic factors for progression-free survival and overall survival. Results: At the time of diagnosis, the median age was 48 (17–77) and 68% of the patients were male. Most common pathologic subtype was glioblastoma multiforme (68%). Median follow-up duration was 9.1 months (1–68 months). Median progression-free survival and overall survival were 6.2 months and 8 months, respectively. In multivariate analysis, ECOG PS, deep venous thrombosis and the presence of ATRX and IDH1 mutation were found to be independent prognostic factors for progression-free survival (p < 0.05) and, ECOG PS, the presence of ATRX and IDH1 mutation for overall survival (p < 0.05). Conclusion: Our study is real life data and the median progression-free survival and overall survival rates are similar to the literature. We have found ECOG PS, presence of ATRX and IDH1 mutation to be independent prognostic factors for both progression-free survival and overall survival. [ABSTRACT FROM AUTHOR]

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