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Öğe Akut i·skemi·k i·nme tedavi·si·nde hi·potermi·(Turkish Society of Cerebrovascular Diseases, 2010) Şirin H.[No abstract available]Öğe Aprotinin reduces injury of the spinal cord in transient ischemia(European Association for Cardio-Thoracic Surgery, 1997) Şirin B.H.; Yilik L.; Ortaç R.; Coşkun E.; Şirin H.; Çelebisoy N.Objective: The protective effect of aprotinin, which is a protease inhibitor, was assessed in a rabbit spinal cord ischemia model. Design: Randomized, controlled, prospective study. Setting: University research laboratory. Subjects: New Zealand white rabbits (36) of both sexes. Methods: In 24 animals, ischemia was induced with midline laparotomy and clamping the aorta just distal to left renal artery and proximal to aortic bifurcation for 20 min. Aprotinin was given 30 000 KIU as a short intravenous injection after anesthesia, and was followed by 10 000 KIU/h by continuous infusion in group 1 (n = 12). Similar volume of saline solution was used in control group of animals (group 2, n = 12). Group 3 of animals (sham group, n = 12) were anesthetized and subjected to laparotomy without aortic occlusion. Physiological parameters and somatosensory evoked-potentials (SEP) were monitored in animals before ischemia, during ischemia and in the first 60 min of reperfusion. Their neurological outcome was clinically evaluated up to 48 h postischemia. Their motor function was scored, and the intergroup differences were compared. The animals were sacrificed after two days of postischemia. Their spinal cord, abdominal aorta, and its branches were processed for histopathological examination. Results: In group 3, SEP amplitudes did not change during the procedures, and all animals recovered without neurologic deficits. At the end of ischemic period, the average amplitude was reduced to 53 ± 7% of the baseline in all ischemic animals. This was followed by a gradual return to 89 ± 8 and 81 ± 13% of the initial amplitude after 60 min of reperfusion in group 1 and group 2 correspondingly (P > 0.05). The average motor function score was significantly higher in group 1 than group 2 at 24 and 48 h after the ischemic insult (P < 0.05). Histological observations were dearly correlated with the neurological findings. Conclusion: The results suggest that aprotinin reduces spinal cord injury and preserves neurologic function in transient spinal cord ischemia in rabbits.Öğe Bombogor inscription: Tombstone of a Turkic quncuy ("princess")(Cambridge University Press, 2016) Şirin H.Turkic Runic inscriptions, discovered in Mongolia during the second half of the 20th century and especially in the last decade, are remarkable. The Bombogor, consisting of five-lines, is one of them. This article is an attempt to re-read the mentioned inscription which was first published by Ts. Battulga. According to my proposed reading, the text was written on a tombstone which was erected in honour of a Turkish qun?cuy ("princess") who might have been married into the Karluk tribe. © The Royal Asiatic Society 2015.Öğe A case of listeria rhombencephalitis mimicking vertebrobasilar stroke [Vertebrobaziller enfarktı taklit eden listeria rombensefaliti](Turkish Neurological Society, 2016) Kılıç İ.H.; Güler A.; Şirin H.[No abstract available]Öğe A case report of OGILVIE'S syndrome in an ischemic stroke patient [Iskemik serebral enfarktüs sonrasi gelişen OGILVIE sendromu olgusu](Turkish Society of Cerebrovascular Diseases, 2014) Kiliç I.H.; Dönmez I.; Uzunköprü C.; Güler A.; Şirin H.Acute colonic pseudo-obstruction (ACPO), also known as Ogilvie's Syndrome, is a clinical condition with acute dilatation of the colon without a provable cause. Early recognition and treatment of the condition is important in order to improve the outcome(1). An 86 year old right handed male patient, with an acute ischemic infarction in the area supplied by the right middle cerebral artery (MCA) anterior divison, was internalised to our intensive care unit of Neurology Department. Seventeen days after onset of the stroke, the patient, whose vitals, blood electrolite levels and oxygene saturation kept stabile developed an abdominal distention. He didn't have any fecal excretion for 2 days and his rectum was found to be empty on the rectal touche' examination. His lateral decubit abdominal x-rays were suspicious for sigmoid volvulus. His abdominal CT was also suspicious for mesoaxial volvulus, so the patient underwent a colonoscopy at the gastro enterology department. The colonoscope has reached the hepatic flexure but no volvulus has been observed. As the result of the colonoscopy the patient is diagnosed as acute colonic pseudoobstruction(Ogilvie's Syndrome). With conservative treatment, fecal excretion has been provided in 24 hours. Here, we want to take attention that, Ogilvie's syndrome, in which early diagnosis and treatment decreases mortality and morbidity rates, can also be seen in stroke patients and is one of the emergent situations which should be kept in mind for stroke patients who have abdominal distention and constipation.Öğe A comparative ID migraine™ screener study in ophthalmology, ENT and neurology out-patient clinics(SAGE Publications Ltd, 2009) Ertaş M.; Baykan B.; Tuncel D.; Gökçe M.; Gökçay F.; Şirin H.; Deniz O.; Öztürk V.; Idiman F.; Karli N.; Zarifoglu M.; Yildiz N.; Siva A.; Saip S.; Göksan B.; Ak F.; Aluçlu U.; Duman T.; Melek I.M.; Bulut S.; Berilgen S.; Ozdemir G.; Kilic M.A.; Cetin B.; Demir R.; Kocer I.; Aktan B.; Gurel G.; Boyacioglu F.; Cavdar C.; Aydin S.; Dogan N.; Beyazit T.; Gokdemir S.; Sayilir I.; Orhan G.; Akagunduz A.; Mustafa Kaymakçi; Yalman M.; Tamer C.; Oksuz H.; Dagli A.S.; Akoglu E.; Ulger M.A.Migraine is more likely to be misdiagnosed in patients with comorbid diseases. Not only primary care physicians, but also specialists might misdiagnose it due to the lack of diagnostic criteria awareness. The ID migraine test is a reliable screening instrument that may facilitate and accelerate migraine recognition. This study aimed to compare the prevalence and characteristics of migraine in a large sample of patients admitted to clinics of ophthalmology (OC), ear, nose and throat diseases (ENTC) and neurology (NC), as well as to validate the use of the ID migraine test in OC and ENTC settings. This was a multicentre (11 cites) study of out-patients admitting either to NC, ENTC or OC of the study sites during five consecutive working days within 1 week. From each of the clinics, 100 patients were planned to be recruited. All recruited patients were interviewed and those having a headache complaint received an ID migraine test and were examined for headache diagnosis by a neurologist, blinded to the ID migraine test result. A total of 2625 subjects were recruited. Only 1.3% of OC patients and 5.4% of ENTC patients have been admitted with a primary complaint of headache, whereas the percentage of NC patients suffering from headache was 37.6%. Whereas 138 patients (19.3%) in OC, 154 (17.3%) in ENTC and 347 (34%) in NC were found to be ID migraine test positive, 149 patients (20.8%) in OC, 142 (16%) in ENTC and 338 (33.1%) in NC were diagnosed with migraine. The sensitivity, specificity, and positive and negative predictive ratios of the ID migraine test were found to be similar in all clinics. An important fraction of the patients admitted to NC, as well as to OC and ENTC, for headache and/or other complaints were found out to have migraine by means of a simple screening test. This study validated the ID migraine test as a sensitive and specific tool in OC and ENTC, encouraging its use as a screening instrument. © Blackwell Publishing Ltd.Öğe Comparison of magnetic coil and needle-electrical stimulation in diagnosis of lumbosacral radiculopathy(1994) Ertekin C.; Nejat R.S.; Şirin H.; Selçuki D.; Araç N.; Ertaşs M.[No abstract available]Öğe Comparison of magnetic coil stimulation and needle electrical stimulation in the diagnosis of lumbosacral radiculopathy(1994) Ertekin C.; Nejat R.S.; Şirin H.; Selçuki D.; Ara¸c N.; Ertaş M.; Şolakoglu Z.Electrical stimulation (ES) of lumbosacral nerve roots using a needle electrode inserted to the laminar level at the midline of Th12-L1 or L1-2 intervertebral interspace, was compared with magnetic stimulation using a 9-cm diameter coil (MGS) at the L3-4 or L4-5 spine levels, Compound muscle action potentials (CMAP) were superficially recorded from homologous muscles in both sides in 15 normal control subjects and in 20 patients with lumbosacral radiculopathy. Soleus muscles were used for S1, tibialis anterior (TA) for L5, and rectus femoris (RF) muscles for L4 roots. According to the clinical or radiological diagnosis (CAT, MRI and/or myelography) conventional needle EMG was capable to localise the root lesion in 16 of 20 patients (80%) and ES localised the root involvement in 18 of 20 patients (90%); the diagnostic value of MCS was lower, about 65% (13 of 20 patients). Although ES is uncomfortable and invasive, it is superior to needle EMG in localising unilateral or multiple lumbosacral root involvement. At present, MCS is not suitable for the diagnosis of lumbar radiculopathy. © 1994.Öğe Diagnostic value of electrical stimulation of lumbosacral roots in radiculopathies(1994) Ertekin C.; Şirin H.; Koyuncuoglu H.R.; Mungan B.; Nejat R.S.; Selçuki D.; Ertaş M.; Araç N.; Çolakoglu Z.Needle electrical stimulation of the lumbosacral roots at the laminar level of the Th12-L1 or L1-2 intervertebral spaces were performed in 24 normal subjects and 58 patients with various kinds of lumbar radiculopathy (unilateral L4, L5 and S1 herniated nucleus pulposus and lumber stenosis). The root stimulation method was compared with conventional needle EMG. Lumber electrical stimulation showed root abnormalities objectively in 80% of patients while the diagnostic value of needle EMG was 65%. Therefore, electrical root stimulation is superior to routine EMG for localizing lumbar root involvement. However, the only needle EMG demonstrated the root pathology in 7 cases (12%) and single electrophysiological abnormality was found by the root stimulation in 16 cases (27%). Thus, both electrophysiological methods should be complementary to each other in evaluation of the lumbar radiculopathy. Copyright © 1994, Wiley Blackwell. All rights reservedÖğe The Ege Stroke Registry: A hospital-based study in the Aegean Region, Izmir, Turkey(1998) Kumral E.; Özkaya B.; Sagduyu A.; Şirin H.; Vardarli E.; Pehliva M.We present the profile of risk factors, etiologic and clinical data of 2000 consecutive patients with first-ever-in-a-lifetime stroke (cerebral infarction, cerebral hemorrhage and subarachnoid hemorrhage), admitted to the Ege University Hospital between January 1, 1991, and September 31, 1995. This hospital-based registry is the first systematic epidemiologic report on the stroke profile of Turkish people. The Ege University Stroke Unit is the only tertiary medical care facility which is organized for patients with different stroke subtypes in Izmir, Turkey. A prospective hospital-based registry using systematic computer coding of data of all stroke patients has been used since January 1991. All patients were evaluated by clinical examination, CT and/or MRI, color duplex and specific cardiac investigations. They were followed up for at least 6 months. The mean age was 62.3 ± 12 years, and 44.4% were females. Ischemic stroke was found in 77%, primary intracerebral hemorrhage in 19% and subarachnoid hemorrhage in 4%. The major risk factor of ischemic stroke was hypertension (63%), followed by hypercholesterolemia (37%), diabetes mellitus (35%), ischemic heart disease (23%), atrial fibrillation (20%) and smoking (17%). The main cause of primary intracerebral hemorrhage was hypertension (88%), and the principal localization was the thalamus (38%), followed by putamen (28%), lobar (16%), pons (6%), cerebellar (4%), primary intraventricular hemorrhage (4%) and multiple hemorrhages (2%). The overall 30-day case-fatality rate was 19.7% and the higher mortality rate was found in patients with primary intracerebral hemorrhage (29%) than in those with ischemic stroke (17%). The Ege Stroke Registry allows to estimate the stroke-related problems in patients admitted to a stroke unit and to evaluate the risk factors, etiology and clinical manifestations of stroke in Turkey.Öğe Evaluation of viral etiology in central nervous system infections from a university hospital point of view in izmir based on seven years data [Santral Sinir Sistemi Enfeksiyonlarinda Viral Etiyolojinin izmir'de Bir Üniversite Hastanesinin Yedi Yillik Verileri Üzerinden Degerlendirilmesi](Ankara Microbiology Society, 2017) Zeytinoglu A.; Erensoy S.; Sertoz R.; Altuglu I.; Çiçek C.; Kayin M.; Şirin H.; Taner S.The serious diseases of the central nervous system (CNS); encephalitis and meningitis, have high mortality and morbidity rate especially not diagnosed and treated in time. Nucleic acid testing (NAT) is the tool of choice for viral diagnosis in CNS infections. In this study, viral etiological agents found in cerebrospinal fluid (CSF) samples sent to our university hospital virology laboratory for laboratory diagnosis of CNS infections were retrospectively evaluated and results were compared with other reports from our country. Viral etiological agents found in cerebrospinal fluid (CSF) samples sent to Ege University Faculty of Medicine Department of Medical Microbiology Virology Laboratories for laboratory diagnosis of CNS infection between 01.01.2009-31.12.2015 were evaluated retrospectively. A total of 3778 CSF tests were performed for cell culture of enterovirus (EV) in 487 samples and 3291 tests for nucleic acid testing (NAT) by real time polymerase chain reaction (PCR) in herpes simplex virus 1 (HSV1), herpes simplex virus 2 (HSV2), varicella zoster virus (VZV), Epstein-Barr virus (EBV), cytomegalovirus (CMV), human herpes virus 6 (HHV6) and EV. VZV and EV NAPs were performed during the last one and five years period, respectively. NAT positive results for HSV1, HSV2, CMV, EBV, VZV, HHV6 and EV were 1.80% (24/1333), 0.08% (1/1333), 3.28% (19/580), 4.35% (22/506), 0.46% (1/216), 1.05% (5/478) and 3.37% (6/178), respectively. EV was isolated in 30 (6.20%) of 487 CSF samples by viral culture. Positive samples were mainly from pediatric, neurology and infectious diseases clinics as expected. The number of higher positive results were found in samples sentin December (35.3%), July (12.9%) and November (10.6%). Overall 80% of positive samples belonged to patients over 18 years old. When the results of other studies reported from Turkey are examined, although the positivity rates are generally similar, it is seen that the rates specific to certain factors are higher in selected smaller patient groups like HSV1 and EV. Rapid nucleic acid tests like multiplex PCR and microarray will provide more practical and effective laboratory diagnosis approach in CNS infections, since many more microorganisms may be causative agents.Öğe A fractional calculus approach to investigate the alpha decay processes(2013) Çalik A.E.; Ertik H.; Öder B.; Şirin H.In this study, the nuclear decay equation is taken under consideration by making use of fractional calculus. In this context, the first-order time derivative is changed to a Caputo fractional derivative hence, the resulting equation is the time fractional nuclear decay equation. The solution of this equation is obtained in terms of Mittag-Leffler function which plays an important role to study the non-Markovian feature of physical processes. As an application of this time fractional formalism, alpha decay half-life values have been calculated for Pb, Po, Rn, Ra, Th and U isotopes. Consequently, the theoretical half-life values have been obtained in consistent with the experimental data. The dependence of the order of fractional derivative µ being a measure of fractality of time, on the nuclear structure has been established. In the investigations carried out, we have arrived to the conclusion that for the µ values which are closed to one, where time becomes homogenous and continuous, the shell closure effects are predominant and that the fractional derivative order µ (i.e., fractality of time) and nuclear structure are closely related to each other. © 2013 World Scientific Publishing Company.Öğe Fractional mathematical investigation of bose-einstein condensation in dilute 87Rb, 23na and 7li atomic gases(2012) Ertik H.; Şirin H.; Demirhan D.; Büyükkiliç F.Although atomic Bose gases are experimentally investigated in the dilute regime, interparticle interactions play an important role on the transition temperatures of BoseEinstein condensation. In this study, BoseEinstein condensation is handled using fractional calculus for a Bose gas consisting of interacting bosons which are trapped in a three-dimensional harmonic oscillator. In this frame, in order to introduce the nonextensive effect, fractionally generalized BoseEinstein distribution function which features MittagLeffler function is adopted. The dependence of the transition temperature of BoseEinstein condensation on ? (a measure of fractality of space) has been established. The transition temperatures for the dilute 87Rb, 23Na and 7Li atomic gases have been obtained in consistent with experimental data and the nature of the interactions in the BoseEinstein condensate has been enlightened. In the course of our investigations, we have arrived to the conclusion that for ? < 1 attractive interactions and for ? > 1 repulsive interactions are predominant. © 2012 World Scientific Publishing Company.Öğe Headache and Facial Pain Lasting Less Than Four Hours: Focus on Patients with Cranial Autonomic Features(Turkish Neurosurgical Society, 2022) Özdemir H.N.; Dere B.; Orujov A.; Baskan G.N.; Dorukoğlu M.M.; Şirin H.; Çelebisoy N.Objective: The aim of our research was to evaluate the demographic and clinical features, treatment characteristics, and responses of the patients who presented to the Ege University Neurology Headache Outpatient Clinic with headaches lasting less than 4 hours. Another primary goal was to compare the characteristics mentioned above of patients with and without cranial autonomic symptoms. Materials and Methods: Our study was retrospective and cross-sectional. The findings were based on the data collected at our tertiary headache center. Headache disorder diagnoses were made in accordance with the International Classification of Headache Disorders-3 guideline. We reviewed the patients’ charts and recorded the information on a standardized form. The patients’ clinical features, and treatment responses were noted. The patients were divided into two groups as those with and without autonomic findings, and the above-mentioned features were compared. Treatment responses of patients with trigeminal autonomic cephalgia (TAC) and patients with trigeminal neuralgia (TN) were analyzed via logistic regression analysis. Values of p<0.05 were considered statistically significant. Results: Sixty-eight patients were included. Twenty-five patients had TAC. Twenty-three patients had TN and 13 had tension type headache. Seven had other primary headaches. The patients’ clinical features and treatment responses were different in the subgroups. In patients with TAC, having a triggering factor [Odds ratio (OR): 0.059, 95% confidence interval (CI): (0.005-0.645); p=0.02] reduced the risk of need of attack treatment. In patients with TN, having a brainstem lesion on cranial magnetic resonance imaging sequences [OR: 24.776, 95% CI: (1.033-60.613); p=0.049] increased the risk of long-term treatment failure with carbamazepine, whereas having headache attacks more than once a day [OR: 0.58, 95% CI: (0.04-0.832); p=0.036] decreased the risk. Conclusion: The correct diagnosis of headache disorders is mainly based on the clinical features of the headache. For an effective treatment initiation, a correct diagnosis is mandatory, entirely dependent on adequate history taking. © 2022 by Turkish Neurological Society.Öğe Headache in primary Sjögren's syndrome: A prevalence study(2008) Gökçay F.; Öder G.; Çelebisoy N.; Gökçay A.; Şirin H.; Kabasakal Y.Objectives - To determine the prevalence of headache in patients with primary Sjögren's syndrome (pSS) and to examine the relationship between headache types and clinical, serologic features of the disease. Methods - The study enclosed 133 patients with the diagnoses of pSS and 97 healthy controls. A questionnaire designed to assess the presence of headache and if present to classify it according to the criteria of the International Headache Society was used. Results - In 133 of the pSS patients evaluated, 104 had headache. No association was present between types of headache and the clinical and laboratory manifestations of the disease. Both migraine and tension-type headache were more common in patients with pSS when compared with healthy controls (P < 0.001). Conclusions - The high prevalence of migraine in pSS patients might be explained by a vascular headache triggered by immuno-mediated disease activity without an obvious clinic or laboratory marker. Copyright © 2008 The Authors.Öğe Identification of enteroviruses from central nervous system infections by RT-PCR and cell culture methods [Santral sinir sistemi enfeksiyonu etkeni enteroviruslarin RT-PCR ve hücre kültür yöntemleri ile saptanmasi](2011) Kiliç I.; Altuglu I.; Çiçek C.; Pullukçu H.; Bayram N.; Şirin H.; Erensoy S.Viruses are the major causes of aseptic meningitis and encephalitis. Enteroviruses account for more than 80% of the aseptic meningitis cases for which an etiologic agent is identified. The aims of the present study were to identify agents of enteroviral meningitis by viral culture and reverse transcriptase polymerase chain reaction (RT-PCR) methods, to evaluate the appropriateness of a commercial RTPCR kit for its use in routine laboratory, and to obtain epidemiological data about enteroviral meningitis. Sixty six cerebrospinal fluid (CSF) samples from patients with suspected viral central nervous system (CNS) infection by clinical and CSF biochemical findings, sent to Ege University Faculty of Medicine, Department of Medical Microbiology were included in the study. The CSF samples were all negative for tested bacteria, mycobacteria, fungi, herpes simplex virus and cytomegalovirus. Thirty-four (51.5%) of the samples were from female and 32 (48.5%) were from male patients. Twenty-three (34.8%) patients were children (5 months-18 years) and 43 (65.2%) were adults (19-86 years). Shell vial rapid cell culture method by using Vero, HEp-2 and RD cell lines was performed for virus isolation and the results were evaluated on 48 th hours after staining the cells with fluorescein labeled polyclonal antibodies (Pan-Enterovirus Blend, Light Diagnostics, USA). Enteroviral RNA in the samples was detected by a commercial RT-PCR kit (Enterovirus Consensus Kit, Argene, France). Sixty-one (92.4%) of 66 samples from patients with suspected viral CNS infection were found to be negative for enterovirus both with RT-PCR and shell vial cell culture methods. Three samples (4.5%) were positive by shell vial culture method. In one CSF sample that was culture positive, RT-PCR was also positive. However, the remaining two culture positive samples yielded negative result by RT-PCR. Intermediate results with RT-PCR were obtained in two samples (3%) that were identified as negative by cell culture. Two of the three positive samples in cell culture were identified as echovirus, however, the remaining sample could not be identified due to small sample amount. As a result, the commercial assay was found non-practical and labor intensive, giving indeterminant results in some cases and missing two culture positive samples. Since it didn't have an advantage over the cell culture method used, it was found inappropriate for routine diagnosis in our laboratory. On the other hand, it has been known that nucleic acid amplification tests (NAT) have markedly improved the diagnosis of enterovirus infections by increasing the sensitivity compared with cell culture methods. An alternative NAT method should be evaluated in parallel with cell culture method especially in CSF samples of children with suspected viral central nervous system infections.Öğe Mechanical thrombectomy with solitaire stent in acute ischemic stroke patients: Our first experiences [Akut iskemik i·nmeli olgularda solitaire stent ile mekanik trombektomi: İlk deneyimlerimiz](Ege University Press, 2014) Güler A.; Çinar C.; Oran I.; Şirin H.; Çelebisoy N.; Akarca F.K.; Kiyan G.S.Introduction: Intravenous thrombolysis or endovascular treatment for occluded vessel in acute ischemic stroke patients reduces mortality and effects prognosis. Mechanical thrombectomy shows better results than intravenous thrombolytic treatment on proximal vessel occlusions. In this study, we aimed to evaluate efficiency of Solitaire stent based mechanical thrombectomy for acute ischemic stroke patients who has proximal vessel occlusion, and its impact on prognosis of these patients. Material and Method: Data of eleven patients, who applied to Ege University Medical School Emergency Department between March 2012 -May 2013 with acute ischemic stroke diagnosis due to proximal vessel occlusion and treated with mechanical thrombectomy collected retrospectively. İnclusion criterias were: 1)Age between 18-80, 2)NIHSS ?10 at admission, 3)ICA or ASM occlusion found on cranial and neck CT angio, 4)symptom duration? 6 hours, 5) no contrindication for reperfusion theraphy. Results: Eleven patients treated with mechanical thrombectomy(8female/3male), and mean age of these patients were 59(min34, max 75). The mean symptom to door time was 98 minutes(30-180 minutes). Demographic data, application time, time to treatment, additional treatments, complications, NIHSS at 0 and 24 hour and mRS at discharge were evaluated. Conclusion: The main aim of acute stroke treatment is revascularizaion of occluded vessel as quickly as possible. Intravenous thrombolytic treatment is the standard treatment procedure for acute ischemic stroke. Intraarterial treatment options must be inside of our treatment strategies for the patients with acute ischemic stroke diagnosis and who had proximal vessel occlusion.Öğe Neurocritical care in turkey [Türkiye'de nörolojik yog baki{dotless}m](2011) Topcuoglu M.A.; Kocaman A.S.; Öztürk S.; Nazliel B.; Şirin H.Over the last 20 years, emergence of neurointensive care units has provided a significant increase in the survival rate and quality of post-intensive care unit life of patients with life-threatening neurological and neurosurgical catastrophes. Therefore, the neurointensive care unit has become a fundamental part of contemporary third-level hospitals or referral centers. Due to the extensiveness of a specific examination, monitoring and treatment techniques and the methods unique to neurology, it is impossible to manage critical neurological patients in "general" intensive care units. As a result, there has been a progressive increase in the number of proponents stating that national health authorities "should" not only establish more and improve the existing neurointensive care units in all reference hospitals, but also (re)organize a transport and referral system to ensure that patients in need of neurointensive care units care are taken to these hospitals. As mandated by the modern critical care paradigm, the proposed plan and strategy can be suggested as a "sine qua non" for avoiding ethico-legal problems.Öğe Neuroprotective effects of preischemia subcutaneous magnesium sulfate in transient cerebral ischemia(1998) Şirin B.H.; Coşkun E.; Yilik L.; Ortaç R.; Şirin H.; Tetik C.Objective: Neurological injury due to transient cerebral ischemia is a potential complication of cardiovascular surgery. The neuroprotective effect of magnesium, when given subcutaneously before the ischemia, was assessed in a rat model of transient global cerebral ischemia. Methods: Thirty-six male Wistar albino rats were included to this randomized, controlled, prospective study. In 24 animals, ischemia was induced with four-vessel occlusion technique with the duration of 15 min. MgSO4 was given 600 mg/kg subcutaneously 48 h before the procedure in group 1 (n = 12). Similar volume of saline solution was used in animals of control group (group 2, n = 12). The animals in group 3 (sham group, n = 12) were anesthetized and subjected to operative dissections without vascular occlusion. Physiological parameters and somatosensory evoked-potentials (SEP) were monitored in animals before ischemia, during ischemia and in the first 30 min of reperfusion. Their neurological outcome had been clinically evaluated and scored up to 4 days postischemia. The intergroup differences were compared. Then the animals were sacrificed and their brains were processed for histopathological examination. Results: In group 3, SEP amplitudes did not change during the procedures, and all animals recovered without neurologic deficits. At the end of ischemic period, the average amplitude was reduced to 5 ± 3% of the baseline in all ischemic animals. This was followed by a gradual return to 87 ± 10% and 83 ± 8% of the initial amplitude after 30 min of reperfusion in group 1 and group 2, respectively (P > 0.05). The average neurological score was significantly higher in group 1 than in group 2 at 48, 72 and 96 h after the ischemic insult (P < 0.05). Histological observations were clearly correlated with the neurological findings. Conclusion: The results suggest that subcutaneous MgSO4 reduces cerebral injury and preserves neurologic function when given two days before the transient global ischemia in rats.Öğe Nonlocal Phenomena in Quantum Mechanics with Fractional Calculus(Elsevier Ltd, 2020) Atman K.G.; Şirin H.In this study, nonlocal phenomena in quantum mechanics are investigated by making use of fractional calculus. in this context, fractional creation and annihilation operators are introduced and quantum mechanical harmonic oscillator has been generalized as an important tool in quantum field theory. Therefore wave functions and energy eigenvalues of harmonic oscillator are obtained with respect to the order of fractional derivative which corresponds to influence of nonlocal effects. In order to investigate nonlocality in quantum field theory, Einstein's coefficients are taken into consideration in the framework of fractional calculus. For this purpose, all energy modes of photons are considered as fractional quantized harmonic oscillators and thus Einstein's coefficients are obtained. In the case ? = 1, where space becomes continuous, results of conventional physical models are recovered. © 2020 Polish Scientific Publishers
