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Purpose: The aim of this study was to develop a positron emission tomography (PET) radiotracer for measuring pyruvate kinase M2 (PKM2) with improved physicochemical and pharmacokinetic properties compared to [ 18 F]DASA-23., Experimental Design: First, we synthesized [ 18 F]DASA-10 and tested its uptake and retention compared to [ 18 F]DASA-23 in human and mouse glioma cell lines. We then confirmed the specificity of [ 18 F]DASA-10 by transiently modulating the expression of PKM2 in DU145 and HeLa cells. Next, we determined [ 18 F]DASA-10 pharmacokinetics in healthy nude mice using PET imaging and subsequently assessed the ability of [ 18 F]DASA-10 versus [ 18 F]DASA-23 to enable in vivo detection of intracranial gliomas in syngeneic C6 rat models of glioma., Results: [ 18 F]DASA-10 demonstrated excellent cellular uptake and retention with values significantly higher than [ 18 F]DASA-23 in all cell lines and timepoints investigated. [ 18 F]DASA-10 showed a 73 % and 65 % reduced uptake respectively in DU145 and HeLa cells treated with PKM2 siRNA as compared to control siRNA treated cells. [ 18 F]DASA-10 showed favorable biodistribution and pharmacokinetic properties and a significantly improved tumor-to-brain ratio in rat C6 glioma models relative to [ 18 F]DASA-23 (3.2 ± 0.8 versus 1.6 ± 0.3, p = 0.01)., Conclusion: [ 18 F]DASA-10 is a new PET radiotracer for molecular imaging of PKM2 with potential to overcome the prior limitations observed with [ 18 F]DASA-23. [ 18 F]DASA-10 shows promise for clinical translation to enable imaging of brain malignancies owing to its low background signal in the healthy brain., Competing Interests: Declaration of competing interest CB and MLJ hold a patent (US20180043040A1) describing the use of radiopharmaceuticals to measure PKM2. The authors declare no other conflicts of interest., (Copyright © 2023 Elsevier Inc. All rights reserved.)

How a seizure spreads from a focal onset zone to other regions of the brain is not well understood, and animal studies suggest that there is a genetic influence. To understand how genetic factors may influence seizure spread, we examined whether the kindling resistance of WAG/Rij rats, which are slow to develop kindled motor seizures, is independent of the site of seizure induction and thus a global phenomenon, or whether it is circuit specific. We compared the kindling rates (number of stimulations to induce kindled motor seizures) of WAG/Rij rats to the rates of kindling in Sprague Dawley rats. Both groups underwent a standard hippocampal kindling protocol and a separate group was kindled from the medial dorsal nucleus of the thalamus, a site that has been previously demonstrated to result in the very rapid development of motor seizures. To examine whether there were differences in the interaction in a circuit involved with the motor seizures, evoked responses were obtained from the prefrontal cortex following stimulation of the subiculum or medial dorsal thalamic nucleus. The WAG/Rij rats once again demonstrated resistance to kindling in the hippocampus, but both strains kindled rapidly from the medial dorsal nucleus. In the WAG/Rij rats there was also a reduction in the duration of the afterdischarge in the frontal cortex during hippocampal stimulation, but there was no reduction during thalamic kindling. The prefrontal cortex evoked responses were reduced following stimulation of the subiculum in the WAG/Rij rats, but the evoked responses to thalamic stimulation were the same in both strains. These findings suggest that there are genetic influences in the strength of the input from the subiculum to the prefrontal cortex in WAG/Rij rats that could explain the resistance to limbic kindling because of reduced excitatory drive onto a key target region., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Background: In this study, we evaluated the microembolic signals (MES) frequency with transcranial Doppler ultrasound (TCD) in patients with atrial fibrillation (AF) under anticoagulant therapy, and we compared the treatment groups., Methods: Ninety-nine patients with nonvalvular AF with a history of stroke using warfarin (46%), 67 patients using rivaroxaban (31%), and 49 patients using dabigatran (23%), that is, a total of 215 patients, who have been referred to the stroke outpatient section of our department from May 2013 to November 2014, were included in the study. CHA(2)DS(2)VASc scoring was made for all patients, and International Normalized Ratio (INR) value was evaluated in patients using warfarin. All patients were monitored with TCD on the middle cerebral arteries bilaterally for 30 minutes. Embolic signals were evaluated according to their density and the mean number of signals in 2 consecutive recordings., Results: The incidence of emboli in the treatment group was 32 (32%) for warfarin, 24 (36%) for rivaroxaban, and 17 (35%) for dabigatran. The analysis of variance revealed that there was no statistically significant differences between the treatment groups in terms of patients' age (P = .145), CHA(2)DS(2)VASc scores (P = .968), and the number of emboli (P = .783). As CHA(2)DS(2)VASc score increases, number of emboli increase. A statistically significant negative correlation between the number of emboli and INR scores was found in the warfarin group. The number of emboli decreases as INR decreases., Conclusions: As we aim to reduce the risk of emboli to a minimum with anticoagulant therapy, this screening for MES can give us an idea for the risk of stroke., (Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.)

Background: Hypospadias is a common urogenital system disorder. The frenulum, which is the most sensitive area of the glans penis, is not present in patients with hypospadias. This may lead to a failure in sexual and ejaculatory function, and cause emotional problems affecting cognitive processes., Aim: We aimed to study auditory Event Related Potentials (ERP) in patients with hypospadias to understand the status of cognitive function., Materials and Methods: Seventeen patients with hypospadias who presented to the Urology Outpatient Clinic of Çanakkale Military Hospital, and 11 healthy individuals of similar age were chosen. The auditory oddball paradigm with ERP from the Cz and Fz head regions were studied. The latency and amplitude of the P300 wave were measured., Results: Both, the study and control groups consisted of young males. Although the study group had a longer P300 latency and lower P300 amplitude when compared to control group, the results were not statistically significant (p: 0.059 and 0.346 respectively)., Conclusion: Although the results are not statistically significant, our findings indicate that there may be cognitive changes in patients with hypospadias. Further studies of larger sample size and older patient cohorts are needed.

Objective: Myasthenia gravis (MG) is commonly viewed as a muscle disorder. Less is known about neurosensory function and dysfunction in MG. We aim to evaluate olfactory and gustatory behavior in Turkish patients with MG, and compare these results with age and sex-matched healthy controls., Material/methods: 30 individuals with MG, and 30 healthy volunteers were studied. Olfactory function was studied with the Sniffin' sticks test. Taste strip test was used for studying taste function. The t-test was used for analyzing continuous variables, and the chi-square test for categorical data. Clinical staging and medication status were included in a model analyzed using analysis of variances., Results: MG patients showed significantly lower olfactory (p<0.001) and gustatory scores (p<0.001) than the healthy controls. In addition, olfactory loss correlated with the severity of the disease. Medications for MG did not influence these results., Conclusion: This study replicates the olfactory dysfunction found elsewhere in MG. Further, gustatory dysfunction, an activity unrelated to muscle strength, was also unveiled. Medications used for treating MG must not be blamed for the chemosensory dysfunction found in this neurological disorder., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Background: The University of Pennsylvania Smell Identification Test (UPSIT) is a well-developed and popular olfactory test, which has been validated in various populations. However, there was only one study in a Turkish population, and this study indicated that the North American version of the UPSIT was not enough to evaluate the olfactory functions of Turkish population. So, we developed a cross-cultural adaptation of the UPSIT, the UPSIT-Turkish (UPSIT-T). Thus, the goal of this study was to investigate the applicability of the UPSIT-T in healthy Turkish subjects., Material and Methods: The study included 51 healthy individuals who reported having normal olfactory function. The participants were administered the North American version of the UPSIT firstly, and then, after a day UPSIT-T was applied to the participants. The results of two smell tests were compared, and the applicability of UPSIT-T was evaluated., Results: The mean (standard deviation) value for correctly identified odors was 27.2 ± 5.7 (range, 14-38) with the UPSIT application, whereas the mean (standard deviation) value for correctly identified odors was 35.9 ± 3.1 for UPSIT-T. There was a statistically significant increase in the scores of the participants when UPSIT-T was performed (p < 0.001). The identification rates of 10 test odorants were <80% for our study group, and 2 of 10 were <70% for the UPSIT-T., Conclusion: The UPSIT-T modification is an adequate olfactory test for clinical use in a Turkish population.

Arrhythmia is not uncommon in the etiology of syncope which mimics epilepsy. Data about the epilepsy induced vagal tonus abnormalities have being increasingly reported. So we aimed to evaluate what a neurologist may gain by a simultaneous electrocardiogram (ECG) and electroencephalogram (EEG) recording in the patients who underwent EEG testing due to prediagnosis of epilepsy. We retrospectively evaluated and detected ECG abnormalities in 68 (18%) of 376 patients who underwent EEG testing. A minimum of 20 of minutes artifact-free recording were required for each patient. Standard 1-channel ECG was simultaneously recorded in conjunction with the EEG. In all, 28% of females and 14% of males had ECG abnormalities. Females (mean age 49 years, range 18-88 years) were older compared with the male group (mean age 28 years, range 16-83 years). Atrial fibrillation was more frequent in female group whereas bradycardia and respiratory sinus arrhythmia was higher in male group. One case had been detected a critical asystole indicating sick sinus syndrome in the female group and treated with a pacemaker implantation in the following period. Simultaneous ECG recording in conjunction with EEG testing is a clinical prerequisite to detect and to clarify the coexisting ECG and EEG abnormalities and their clinical relevance. Potentially rare lethal causes of syncope that mimic seizure or those that could cause resistance to antiepileptic therapy could effectively be distinguished by detecting ECG abnormalities coinciding with the signs and abnormalities during EEG recording., (© EEG and Clinical Neuroscience Society (ECNS) 2014.)

The aim of this study was to evaluate the effect of olfactory dysfunction on quality of life (QOL), and to investigate olfactory dysfunction related self-reported clinical features in Turkish population. The participants were questioned about the presence of any olfactory dysfunction. Participants with a complaint of olfactory dysfunction were asked to fill out a survey and then a validated olfactory test was performed. We asked 2,824 volunteers whether they had olfactory dysfunctions or not. A total of 199 (6.7 %) people mentioned that they had, and filled out the questions in our survey. The mean age of the surveyed population was 44 ± 15 years. The current investigation produced four major findings (1) the feeling of inadequacy due to olfactory dysfunction was more common among females than males (2) there was a significant correlation between subjective olfactory complaints and objective olfactory testing (3) problems in QOL issues are typically reported primarily in the areas of safety and nutrition (4) the possible reasons for the olfactory dysfunction according to the volunteers were upper respiratory infections including rhinosinusitis (46 %), allergic rhinitis (27 %), severe face and head trauma (6.5 %). The effect of subjective olfactory dysfunctions on QOL among the Turkish population was investigated for the first time. Problems in daily life issues are typically reported primarily in the areas of safety and nutrition.

Objective: Penetrating brain injury (PBI) has the highest risk for inducing posttraumatic epilepsy, and those PBIs with retained foreign materials such as bullet fragments carry the greatest risk. This study examines the potential contribution of copper, a major component of bullets, to the development of epilepsy following PBI., Methods: Anesthetized adult male rats received a penetrating injury from the dorsal cortex to the ventral hippocampus from a high speed small bit drill. In one group of animals, copper wire was inserted into the lesion. Control animals had only the lesion or the lesion plus stainless steel wire (biologically inert foreign body). From 6 to up to 11 months following the injury the rats were monitored intermittently for the development of epilepsy with video-electroencephalography (EEG). A separate set of animals was examined for possible acute seizures in the week following the injury., Results: Twenty-two of the 23 animals with copper wire developed chronic epilepsy, compared to three of the 20 control rats (lesion and lesion with stainless steel). Copper was associated with more extensive injury. The control rats with epilepsy had larger lesions. In the acute injury group, there was no difference in the incidence of seizures (83% lesion plus stainless steel, 70% lesion plus copper)., Significance: Copper increases the risk for epilepsy and may increase damage over time, but there were no differences between the groups in the incidence of acute postinjury seizures. Lesion size may contribute to epilepsy development in lesion-only animals. Copper may be an independent risk factor for the development of epilepsy and possible secondary injury, but lesion size also contributes to the development of epilepsy. The consequences of prolonged exposure of the brain to copper observed in these animals may have clinical implications that require further evaluation., (Wiley Periodicals, Inc. © 2014 International League Against Epilepsy.)

Objectives/hypothesis: The aim of this study was to investigate the effect of obstructive sleep apnea (OSA) on the parameters of olfactory functions (odor threshold, odor discrimination, and odor identification tests) for orthonasal olfaction, retronasal olfactory testing, and olfactory bulb (OB) volumes., Study Design: Prospective clinical study., Methods: This study was carried out in 78 volunteers between the ages of 20 and 60 years. The mean age of the patients was 46 ± 10.1 years. Patients were divided into three groups according to polysomnography results: 1) a control group, 2) a mild to moderate OSA group, and 3) a severe OSA group. Clinical features of the participants were evaluated with the Epworth Sleepiness Scale. Orthonasal and retronasal olfactory testing were performed with Sniffin' Sticks olfactory testing and retronasal olfactory testing, respectively. Olfactory bulb volumes were measured by planimetric manual contouring on magnetic resonance imaging (MRI)., Results: The current investigation produced four major findings: 1) The apnea-hypopnea index had a significant and strong negative correlation with odor threshold scores and odor discrimination scores; 2) The apnea-hypopnea index was significantly negatively correlated with odor identification score and both right and left OB volumes; 3) retronasal olfactory scores were not significantly affected by OSA; and 4) continuous O2 saturation had a significant positive correlation on orthonasal olfactory functions, particularly the odor threshold and discrimination scores., Conclusions: This study demonstrated that OSA had significant negative effects on all orthonasal olfactory tasks, especially on threshold and discrimination. MRI also revealed volumetric shrinkage of OB volumes., (© 2014 The American Laryngological, Rhinological and Otological Society, Inc.)

Background: Olfactory assessment is often neglected in clinical practice, although olfactory loss can assist in diagnosis and may lead to significant morbidity. "Sniffin' Sticks" is a modern test of nasal chemosensory performance that was developed in Germany and validated in many countries. Our aim was to validate the applicability of "Sniffin' Sticks" in a Turkish population., Material and Methods: The study included 123 healthy volunteers with a reported normal sense of smell and 51 patients complaining of a reduction in their olfactory function presenting either at rhinology or neurology clinics. The mean age of the subjects tested was 30.2±12.5 years in 126 males and 48 females. The participants were divided into 2 groups according to subjective olfactory function - healthy or abnormal. Each subject's olfactory function was assessed using the "Sniffin' Sticks" test., Results: We found significant differences in "Sniffin' Sticks" test results between the abnormal and healthy groups. In healthy subjects, the 10th percentiles of odor threshold score, odor discrimination score, odor identification score, and TDI score were 7.25, 12, 11, and 32, respectively. Considering the 2 groups together, apple and turpentine were the least well-recognized odors from the 16 odors presented., Conclusions: Our study provides an update of normative values for routine clinical use of "Sniffin' Sticks" in a Turkish population. Also, the present study validates that "Sniffin' Sticks" olfactory test was applicable for clinical usage in a Turkish population.

Hydatid disease (Echinococcosis) is a common parasitic infection caused by Echinococcus granulosus mainly in sheep-raising areas of the world. Liver, lungs and brain are the predominantly involved organs. However, 0.5-1% of the hydatid disease involves the spine and in 90% of the cases it is confined to the bone and the epidural space. Although intramedullary involvement is extremely rare, in this report, we present a 55-year-old female patient who was diagnosed with a cervical intramedullary hydatid cyst during magnetic resonance imaging of the cervical vertebrae. Accordingly, we imply that particularly in endemic areas, hydatid cyst disease should be kept in mind for the differential diagnosis of spinal mass lesions.

Our purpose is to report a rare complication of an inferior vena cava (IVC) filter with vertebral bone penetration, interval fracture, subsequent endovascular management and outcome. We report a case of an IVC filter embedded within the second lumbar vertebral body and in which one of the primary struts fractured, which presented as chronic low back pain. The filter was retrieved percutaneously approximately 2 years after placement. A fractured small strut remained within the vertebral bone; patient's pain resolved. Symptomatic filter in situ should be retrieved even when fractured., (Published by Elsevier Inc.)