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    Cricopharyngeal muscle electromyography in laryngopharyngeal reflux
    (2005) Celik M.; Alkan Z.; Ercan I.; Ertasoglu H.; Alkim C.; Erdem L.; Turgut S.; Ertekin C.
    Objectives/Hypothesis: The objective was to determine whether laryngopharyngeal reflux was associated with an electrophysiological abnormality of the main part of the upper esophageal sphincter, namely, the cricopharyngeal muscle, which could be related to laryngopharyngeal reflux symptoms. Study Design: A prospective study of 20 patients with symptoms of laryngopharyngeal reflux. Methods: The diagnosis was based on clinical, laryngoscopic, and ambulatory 24-hour pH monitoring findings. Double-probe pH monitoring was performed with placement of the distal and proximal probes 5 cm above the proximal border of the lower esophageal sphincter and 15 cm proximal to the distal probe, in or just beneath the upper esophageal sphincter. Electromyographic recordings were obtained simultaneously on submental and cricopharyngeal muscles during water swallowing. The peak of the submental electromyographic amplitude and its duration was measured using bipolar surface electrodes placed under the chin. The electromyographic features of the cricopharyngeal muscle were investigated by means of concentric needle electrodes inserted percutaneously both in 20 normal subjects and in 20 patients with laryngopharyngeal reflux. Results: All electrophysiological parameters were normal in all of the patients. The durations of foreburst revealed significant correlation with the number of reflux episodes and acid exposure time (P = .026 and P = .044, respectively). Conclusion: The duration of the foreburst correlating with acid exposure time and number of reflux episodes suggested that foreburst duration was extended because of the irritation caused by the acid reflux.
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    Oculopharyngodistal myopathy is a distinct entity: Clinical and genetic features of 47 patients
    (2011) Durmus H.; Laval S.H.; Deymeer F.; Parman Y.; Kiyan E.; Gokyigiti M.; Ertekin C.; Ercan I.; Solakoglu S.; Karcagi V.; Straub V.; Bushby K.; Lochmüller H.; Serdaroglu-Oflazer P.
    Background: Oculopharyngodistal myopathy (OPDM) has been reported as a rare, adult-onset hereditary muscle disease with putative autosomal dominant and autosomal recessive inheritance. Patients with OPDM present with progressive ocular, pharyngeal, and distal limb muscle involvement. The genetic defect causing OPDM has not been elucidated. Methods: Clinical and genetic findings of 47 patients from 9 unrelated Turkish families diagnosed with OPDM at the Department of Neurology, Istanbul Faculty of Medicine, between 1982 and 2009 were evaluated. Results: The mean age at onset was around 22 years. Both autosomal dominant and autosomal recessive traits were observed, without any clear difference in clinical phenotype or severity. The most common initial symptom was ptosis, followed by oropharyngeal symptoms and distal weakness, which started after the fifth disease year. Intrafamilial variability of disease phenotype and severity was notable in the largest autosomal dominant family. Atypical presentations, such as absence of limb weakness in long-term follow-up in 9, proximal predominant weakness in 4, and asymmetric ptosis in 3 patients, were observed. Swallowing difficulty was due to oropharyngeal dysphagia with myopathic origin. Serum creatine kinase levels were slightly increased and EMG revealed myopathic pattern with occasional myotonic discharges. Myopathologic findings included rimmed and autophagic vacuoles and chronic myopathic changes. Importantly, a considerable proportion of patients developed respiratory muscle weakness while still ambulant. Linkage to the genetic loci for all known muscular dystrophies, and for distal and myofibrillar myopathies, was excluded in the largest autosomal dominant and autosomal recessive OPDM families. Conclusions: We suggest that OPDM is a clinically and genetically distinct myopathy. Copyright © 2011 by AAN Enterprises, Inc. All rights reserved.
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    Peripheral component of laryngeal and pharyngeal motor evoked potentials [Composante périphérique des potentiels évoqués moteurs laryngés et pharyngés]
    (Elsevier Masson SAS, 2016) Celik Gokyigit M.; Ercan I.; Seker S.; Gundogdu Celebi L.; Ertekin C.
    In this study, the responses of thyroarytenoid (TA) and cricopharyngeus (CP) muscles were simultaneously recorded to peripheral magnetic stimulation of the vagus nerve. Recordings were performed in 13 subjects by means of concentric needle EMG electrodes inserted in the TA and CP. Magnetic shocks were delivered to the vagus nerve with a round coil placed occipitally, while EMG was silent in the TA. In all subjects, clear-cut responses were obtained simultaneously in both muscles. In TA compared to CP, the maximum amplitude of the responses were higher, whereas the onset latency was shorter. Our results revealed that simultaneous recordings of TA and CP motor responses to occipital magnetic stimulation enabled a reliable evaluation of their peripheral innervation by the vagus nerve. © 2016 Elsevier Masson SAS