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    Progressive Multifocal Leukoencephalopathy in a Case Without Clear Evidence of Immunodeficiency
    (Journal Neurological Sciences, 2012) Guler, Ayse; Gokcay, Figen; Haznedaroglu, Damla; Gokcay, Ahmet; Zeytinoglu, Aysin; Sagduyu, Ayse Kocaman; Sirin, Hadiye
    Introduction: Progressive Multifocal Leukoencephalopathy(PML) is a rare demyelinating disease of the central nervous system due to reactivation of a latent infection with JC papovavirus. PML predominantly occurs in severely immunosupressed patients, mostly as a late complication of acquired immunodeficiency syndrome and lymphoproliferative disorders. Clinically it is manifested by motor and sensory deficits, ataxia, cognitive impairment and dementia, corresponding to central nervous system (CNS) lesions. It is difficult to distinguish PML clinically from immune-mediated diseases of the CNS, such as multiple sclerosis, neuropsychiatric sistemic lupus erythematosus and CNS vasculitis. Case Report: A 19-year-old woman presented with ataxia and slurred speech rapidly progressing to quadriparesis and confusion. The diagnosis of PML was made by detecting the JC virus in the cerebrospinal fluid by polymerase chain reaction. Discussion: PML predominantly occurs in severely immunosupressed patients. However, it must also be kept in mind in patients without an apparent immunodeficiency when the clinical and radiological features are typical.
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    Reduced left uncinate fasciculus fractional anisotropy in deficit schizophrenia but not in non-deficit schizophrenia
    (Wiley-Blackwell, 2012) Kitis, Omer; Ozalay, Ozgun; Zengin, E. Burcak; Haznedaroglu, Damla; Eker, M. Cagdas; Yalvac, Dilek; Oguz, Kaya; Coburn, Kerry; Gonul, Ali Saffet
    Aims: Schizophrenia is a psychiatric disorder manifesting with heterogeneous symptom clusters and clinical presentations. The deficit syndrome is the condition defined by the existence of primarily negative symptoms, and patients with the deficit syndrome differ from non-deficit patients on measures of brain structure and function. In the current study, by using diffusion tensor imaging (DTI), we investigated the frontotemporal connectivity that is hypothesized to differ between deficit and non-deficit schizophrenia. Methods: Twenty-nine patients and 17 healthy controls were included in the study. The patients had deficit (n = 11) or non-deficit (n = 18) schizophrenia and they were evaluated clinically with the Schedule for Deficit Syndrome (SDS) and Positive and Negative Syndrome Scale (PANSS). Diffusion-based images were obtained with a 1.5T Siemens Magnetic Resonance Imaging machine and analyses were carried out with Functional Magnetic Resonance Imaging of the Brain Library Software - Diffusion tool box software. Results: The fractional anisotropy values in the left uncinate fasciculus of schizophrenia patients with the deficit syndrome were lower than those of non-deficit patients and the controls. There were no differences between non-deficit schizophrenia patients and controls. Conclusion: These findings provide evidence of left uncinate fasciculus damage resulting in disrupted communication between orbitofrontal prefrontal areas and temporal areas in deficit schizophrenia patients.