In Group 1, 19 cases underwent a preoperative EMG examination and in 35 cases, EMG examination was obtained postoperatively. Pre- and postoperative EMG results were normal in all cases in Group 1 on both the operational and non-operational sides. In Group 2, 15 preoperative and 25 postoperative EMG examinations were obtained. In Group 2, only one case with a right inguinal hernia who had normal preoperative EMG results showed no IIN response in a postoperative EMG evaluation obtained in the third postoperative week, with a normal left-side response. The EMG was repeated at the three-month postoperative third mark and revealed the same result. In a six-year-old female case, there was a negative EMG response on the non-operative side both pre- and postoperatively.

Alzheimer's disease (AD) is a progressive disorder that manifests itself with characteristic pathological changes in the brain, such as cognitive dysfunction, memory loss, senile plaques, and neurofibrillary tangles. 1 Although a clinical diagnosis of AD may be made after other causes of dementia have been excluded, a definite diagnosis may only be possible following postmortem evaluation of brain tissue for typical neuropathological findings. 2 With the aim of early initiation of treatment, the role of several biomarkers for the definite antemortem diagnosis of AD has been evaluated in recent years. The diagnostic criteria for AD were revised in 2007 and medial temporal lobe atrophy as a magnetic resonance imaging finding, as well as the novel cerebrospinal fluid (CSF) biomarkers, were considered supportive of diagnosis. 3 To date, three CSF biomarkers have been described; beta-amyloid 1-42 (Aβ 1-42), total tau (t-tau), and phospho-tau-181 (p-tau). However, obtaining a CSF sample may be challenging, which highlights the need for the determination of biomarkers from peripheral blood. 4 Apelin is a neuropeptide that was first segregated from bovine stomach tissue in 1998. It is an endogenous ligand for the APJ receptor. 5 The human preproapelin gene is located on chromosome Xq25-26.1. The apelin preproproteins consist of 77 amino acid residues that are cleaved into biologically active C-terminal fragments of various sizes. The apelin peptides, including 13 (65-77), 17 (61-77), and 36 (42-77) amino acids, are all capable of binding to APJ.

With the exploration of penicillin, incidents of syphilis, which swept the Europe during the 16th century, decreased after 1940. Neurogen bladder arising from neurosyphilis was seen frequently before the penicillin period. We aimed to share a patient who has this rarely seen association. A 46-year-old male patient was admitted to a neurology clinic because of convulsion, dementia, and incontinence. No lesion determined in brain at magnetic resonance study. In the cerebrospinal fluid investigation, an increase in the number of leukocytes with lymphocytes and amount of protein was determined. Based on high positive treponema palladium hemagglutination assay (TPHA) test in the cerebrospinal fluid and blood, the presence of suspect sexual intercourse history, and occurrence of eruption on hands and feet that cleared up 10 years ago, a neurosyphilis diagnosis was made, and 6x4 M IU/d units iv penicillin treatment was applied for 21 days. After the completion of the patient's treatment in the neurology clinic, further examination was decided, because it was thought that neurogen bladder arising from neurosyphilis might develop because of the presence of urinary incontinence and pollakiuria complaints. At the beginning, uroflowmetry was worked to be done; however, the patient could not make enough (at least 150 mL) micturation. Thereupon, we decided to do filling cystometry and pressure-flow study. It was seen in the ultrasonography that bladder volume was 500 mL, thickness of the bladder wall was at normal level, prostate volume was 20 cc, and kidneys were bilaterally normal. It was seen that residual urine was approximately 400 cc after micturition. In filling cystometry, it was seen that maximum bladder capacity before the overflow incontinence was 490 mL. It was seen that the first urinary feeling occurred at 350 mL of volume and 26 cm H 2 O of pressure; first urge to void feeling occurred at 460 mL volume and 35 cm pressure. It was seen that sense of bladder started to get damaged; however, the sense was not completely gone yet. It was seen that intra-vesicular pressure increased at 300 mL of volume and was more than 40 cm H 2 O of pressure at end of study. It was decided that the bladder compliance was 12.4 mL/cm H 2 O and that there was a medium-level loss of compliance. It was seen at the pressure-flow study that the patient who was encouraged to micturate for 2 minutes could only micturate by increasing intra-abdominal pressure, and detrusor pressure did not increase. As is, a hyposensitive and acontractile bladder diagnosis was made. It was thought that aseptic intermittent catheterization (AIC) and oral anticholinergic treatment were appropriate for the patient. Neurosyphilis is a rarely seen disease nowadays. Neurogen bladder arising from neurosyphilis is much rare in urology practices. When encountering a patient with this disease, urodynamic assessment should be done in order to have an idea about bladder functions; a choice should be made among bladder neck resection, urinary diversion and AIC. (...

Amaç: Epileptik nöbet geçiren hastalarda interlökin-6 (IL-6) düzeyinin nöbet türü, etiyolojisi ile infeksiyon parametreleri olan ateş, lökosit ve c-reaktif protein (CRP) ile ilişkisinin incelenmesi amaçlandı. Gereç ve Yöntem: Çalışmaya 24 kişiden oluşan hasta grubu ve 24 kişiden oluşan kontrol grubu olmak üzere toplam 48 kişi dahil edildi. Hastaların IL-6, ateş, lökosit ve CRP değerleri ölçülerek kaydedildi. Hastalar nöbet türüne ve etiyolojisine göre sınıflandırıldı. IL-6 düzeylerindeki yüksekliğin, infeksiyon parametreleri, nöbet türü ve etiyolojisiyle olan ilişkisi değerlendirildi. Bulgular: IL-6 düzeyi nöbet hastalarında kontrol grubuna göre yüksek bulundu. Epilepsi hastalarında IL-6 düzeylerindeki yükselmenin ateş, lökosit ve CRP düzeylerindeki yükselme ile arasında korelasyon bulunmadı. Hastalar nöbet türüne göre değerlendirildi. Hasta grubu ve kontrol grubunun IL-6 düzeyleri karşılaştırıldığında kontrol grubu ile parsiyel nöbet geçiren hastalarla arasında anlamlı fark bulunmazken (p=0,270), primer jeneralize, sekonder jeneralize ve jeneralize status ile arasında anlamlı fark belirlendi (sırasıyla p=0,012, p=0,011, p=0,040). Nöbet etiyolojisi ile IL-6 düzeyleri arasında ilişki saptanmadı. Sonuç: Epileptik nöbet geçiren hastalarda IL-6 düzeyi diğer infeksiyöz parametrelerden ve etiyolojiden bağımsız olarak yüksek saptanabilmektedir. IL-6 düzeyi, primer jeneralize, sekonder jeneralize nöbetlerde ve jeneralize statusta, parsiyel nöbetlere göre anlamlı olarak yüksek bulunabilir.

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