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Öğe Clinical Properties of Regional Thalamic Hemorrhages(Elsevier Science Bv, 2013) Tokgoz, Serhat; Demirkaya, Seref; Bek, Semai; Kasikci, Tayfun; Odabasi, Zeki; Genc, Gencer; Yucel, MehmetBackground: Thalamic hemorrhage constitutes 6% to 25% of intracerebral hemorrhages. Vascular lesions affecting the thalamus may cause a variety of clinical symptoms. This retrospective study aims to evaluate localization of hemorrhage and clinical symptoms in patients with thalamic hemorrhage. Methods: One hundred and one patients with thalamic hemorrhage were examined retrospectively in our department. Hemorrhages were classified into 5 groups according to computed tomography: medial (thalamoperforate), anterolateral (tuberothalamic), posterolateral (thalamogeniculate), dorsal (posterior choroidal), and global. The relation between volume, localization, and penetration to adjacent structures/ventricles of hemorrhage and risk factors, clinical features, and prognosis were evaluated. Results: The study group included 101 patients. Eighty-two percent of the patients had hypertension, 19.8% had diabetes mellitus, 14.9% had cardiac disease, and 5.9% had chronic renal failure. Mean blood pressure was 173/101 mm Hg. Decreased Glasgow coma scale was significantly higher in the global hemorrhage group than in all regional groups (Chi-square, 10.54; P = .002). Medial group hemorrhages had a significantly higher rate than anterolateral, posterolateral, and dorsal intraventricular expansion. Out of speech disorders, 49% of patients had a right thalamic lesion (especially dysarthria) and 51% of patients had a left thalamic lesion (mostly aphasia). Conclusions: In the study, we detected that the most important risk factor in thalamic hemorrhage is hypertension. The prognosis is worse in global and medial group hemorrhages, especially those which rupture to the ventricle, than the other groups. Thalamic lesions cause a variety of symptoms, including forms of aphasia, such as crossed dextral aphasia.Öğe Concomitant neuromyelitis optica and cytomegalovirus-associated retinitis in an immunocompetent female(Springer Heidelberg, 2014) Tokgoz, Serhat; Dogan, Ebru Apaydin; Gumus, Haluk; Ilhan, Nurhan; Ural, Onur[Abstract Not Availabe]Öğe Frequency, severity and risk factors for restless legs syndrome in healthcare personnel(Riyadh Armed Forces Hospital, 2012) Civi, Selma; Kutlu, Ruhusen; Tokgoz, SerhatObjective: To evaluate the frequency, severity, and risk factors for restless legs syndrome (RLS) in healthcare personnel. Methods: This cross-sectional study was performed at the Outpatient Family Medicine Clinic of Meram Medical Faculty in Konya, Turkey and included 354 healthcare personnel who were working at the Meram Medical Faculty Hospital between October 2010 and June 2011. The International RLS (IRLS) rating scale was used to calculate RLS severity. The RLS symptoms positive patients were investigated for neurological examination. Results: Of all the participants, 277 (78.2%) were female. The overall prevalence of RLS according to the 4 essential criteria in the participating healthcare personnel was 15% (n=53) (16.9% male, 14.4% female). Gender (p=0.726) and age (p=0.197) were not significantly related to RLS. According to the International Restless Legs Syndrome Study Group (IRLSSG) the severity scale for RLS, of the RLS positive patients, 16% were classified as mild (n=8), 40% as moderate (n=21), and 44% as severe (n=24). Approximately, 54.7% of 53 RLS patients had a positive family history of the disorder. Conclusions: Restless leg syndrome is a treatable disorder; however, it is still widely misdiagnosed by physicians. The history of the patient and family is very important in the diagnosis of RLS. Neurosciences 2012; Vol. 17 (3): 230-235Öğe Investigation of the relationship between ischemic stroke and endothelial nitric oxide synthase gene polymorphisms [G894T, intron 4 VNTR and T786C](Tubitak Scientific & Technological Research Council Turkey, 2019) Anliacik, Suleyman Omer; Tokgoz, Serhat; Zamani, Ayse Gul; Yildirim, Malunut Selman; Iyisoy, Mehmet SinanBackground/aim: We aimed to investigate the associations between endothelial nitric oxide synthase (eNOS) gene polymorphisms [G894T (rs1799983)], intron 4 (27-bpTR)variable number tandem repeat (VNTR) and T786C (rs2070744), and ischemic stroke in the Anatolian population. Materials and methods: This case-control study included 112 patients with stroke of undetermined etiology and 160 controls. Real-time polymerase chain reaction (RT-PCR) analysis was used to analyze these polymorphisms. Between-group frequencies of alleles and genotypes were compared using binary logistic regression analysis. Results: No significant difference was observed between the two groups in terms of the genotype and allele distributions of the eNOS G894T (rs1799983) polymorphism (P > 0.05). The a alleles and the 4b/a and 4a/a genotypes of the intron 4 (27-bpTR) VNTR polymorphism had significantly higher frequencies in the patient group than in the control group (OR: 2.715, P < 0.001; OR: 3.396, P < 0.001; OR: 10.631, P = 0.016, respectively). On the contrary, the TC genotype and C alleles of the T786C (rs2070744) polymorphism had a significantly lower frequency in the patient group than in the control group (OR: 0.244, P < 0.001, OR: 0.605, P = 0.006, respectively). Conclusion: Our findings indicate that the eNOS G894T and T786C [rs2070744] polymorphisms are not associated with the risk of ischemic stroke, whereas the intron 4 [27-bpTR] VNTR may be a risk factor in the Anatolian population.Öğe Is Neutrophil/Lymphocyte Ratio Predict to Short-term Mortality in Acute Cerebral Infarct Independently from Infarct Volume?(Elsevier, 2014) Tokgoz, Serhat; Keskin, Suat; Kayrak, Mehmet; Seyithanoglu, Abdullah; Ogmegul, AysegulBackground: Neutrophil/lymphocyte ratio (NLR) is related with increased mortality in both myocardial infarction and acute ischemic stroke. It remains unclear whether NLR is a simple marker of ischemic infarct volume or an independent marker of stroke mortality. The aim of this study is to investigate the relationship of NLR with infarct volume and short-term mortality in acute ischemic stroke (AIS). Methods: This retrospective study included 151 patients with first AIS that occurred within 24 hours of symptom onset. Patients were screened from the hospital's electronic record system by using International Classification of Diseases code (G 46.8). NLR was calculated as the ratio of neutrophils to lymphocytes. Short-term mortality was defined as 30-day mortality. Results: A total 20 of 151 patients died during follow-up. Both NLR and infarct volume of nonsurvived group were significantly higher than survived group (P < . 05). Infarct volume, NLR, and National Institutes of Health Stroke Scale (NIHSS) were independent predictors of the mortality in Cox regression analysis. The optimal cutoff value for NLR as a predictor for short-term mortality was determined as 4.81. NLR displayed a moderate correlation with both NIHSS and Glasgow Coma Scale (P < . 01). NLR values were significantly higher in the highest infarct volume tertile than both in the lowest volume tertile and midtertile of infarct volume (P = .001). Conclusions: NLR at the time of hospital admission maybe a predictor of short-term mortality independent from infarct volume in AIS patients. NLR should be investigated in future prospective trials investigating AIS.Öğe Neutrophil Lymphocyte Ratio as a Predictor of Stroke(Elsevier Science Bv, 2013) Tokgoz, Serhat; Kayrak, Mehmet; Akpinar, Zehra; Seyithanoglu, Abdullah; Guney, Figen; Yuruten, BetigulBackground: The aim of this study is to investigate the relationship of the neutrophil to lymphocyte ratio (NLR) with short-term mortality in acute stroke. Methods: This retrospective study included 255 patients with acute cerebral infarction who presented within 24 hours of symptom onset. A hemogram from peripheral venous blood samples was taken at the time of admission. The NLR was calculated as the ratio of neutrophils to lymphocytes. Duration of follow-up was defined as 60 days. Results: Seventy-one of 255 patients died during the follow-up period. The median NLR was significantly increased among the mortality group compared with the survival group (median 11.50, interquartile ratio [IQR] 10.40 vs median 3.79, IQR 4.72; P = .001). In our multivariate Cox regression model, NLR >5.0 (hazard ratio [HR] 3.30; 95% confidence interval [CI] 1.35-8.07), National Institutes of Health Stroke Scale score (HR 1.11; 95% CI 1.07-1.16), glucose values at admission (HR 1.007; 95% CI 1.002-1.011), and history of coronary artery disease (HR 2.49; 95% CI 1.26-4.92) were predictors of short-term mortality. The sensitivity for short-term mortality when the NLR was >5 was 83.10%, and the specificity was 62.00%. The positive predictive value of a NLR >5 was 45.7%, and negative predictive value was 90.50%. A strong linear association between NLR and National Institutes of Health Stroke Scale score was also observed (r = 0.64; P = .001). In addition, the NLR was higher in both the atherosclerotic and cardioembolic stroke subgroups than the lacunar infarct subgroup (6.5 [IQR 7.2], 7.5 [IQR 8.9], and 3.20 [IQR 3.50], respectively; P = .001). Conclusions: The NLR at the time of hospital admission may be a predictor of short-term mortality in acute stroke patients. Because of the routine use and inexpensive nature of hemogram analysis, the NLR should be investigated in future prospective, randomized controlled trials investigating acute stroke.Öğe A New Therapeutic Approach to Obesity: Stroke?(Springer, 2017) Tokgoz, Serhat; Kozak, Hasan Huseyin[Abstract Not Availabe]Öğe Perfusion-weighted cranial MR imaging findings in a patient with hemophagocytic lymphohistiocytosis(Masson Editeur, 2013) Tokgoz, Serhat; Paksoy, Yahya; Tokgoz, Huseyin; Demir, Orhan; Mutluer, Muzaffer[Abstract Not Availabe]Öğe The Relationship Between Acute Ischemic Stroke and Acute Phase Reactants(Emergency Medicine Physicians Assoc Turkey, 2011) Gul, Mehmet; Cander, Basar; Girisgin, Sadik; Tokgoz, Serhat; Kocak, Sedat; Bircan, Metin; Kaya, HalilObjective: The role played by inflammation in the etiopathogenesis of stroke has been intensively investigated in recent years. In this clinical study, the relationship between acute phase reactants (APR) and acute ischemic stroke (AIS) was investigated. Material and Methods: 126 patients with AIS and 104 volunteer individuals as controls were included in the study. White blood count (WBC), C-reactive protein (CRP), fibrinogen, lipoprotein (a) (Lp a) and complementary fragments (C-3 and C-4) levels were investigated both in patients with AIS and the controls. Results: In patients with AIS, WBC and fibrinogen values were significantly higher than the controls (p < 0.001, p < 0.001, p < 0.001, respectively). There was no significant difference between Lp(a), C-3 and C-4 values in patients with AIS and controls (p=0.727, p=0.163, p=0.497, respectively). Conclusion: The most important goal in the prevention of primary stroke is that the risk factors leading to stroke are defined and changed.Öğe TAFI gene polymorphisms in patients with cerebral venous thrombosis(Springer Heidelberg, 2013) Tokgoz, Serhat; Zamani, Ayse Gul; Durakbasi-Dursun, Hatice Gul; Yilmaz, Osman; Ilhan, Nurhan; Demirel, Sennur; Tavli, MithatGene polymorphisms of thrombin activatable fibrinolysis inhibition (TAFI) factor have been investigated in various studies in terms of etiology (recurrence) and treatment (fibrinolytic effect) of thrombus formation. Cerebral venous thrombosis (CVT) is a life-threatening disease observed in young persons. Fifty-nine patients with CVT and 100 healthy control subjects were enrolled in the case/control study. The association between TAFI gene polymorphisms -438G > A, +505A > G and +1040C > T and cerebral venous thrombosis was investigated. It was found that frequencies of polymorphic genotype and allele were not different in patients than in control group and that they were not significant for cerebral venous thrombosis.
