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    Berberine Attenuates Cerebral Vasospasm After Experimental Subarachnoid Hemorrhage Via Modulating AMPK/Rho Pathway
    (Dokuz Eylul Univ Inst Health Sciences, 2020) Kadirhan, Ozge Altintas; Kumas, Meltem; Karatas, Ersin; Mutlu, Hasan Serdar; Kocyigit, Abdurrahim; Asil, Talip
    Purpose: Our goal is to clarify the effectiveness of berberine (BBR) on cerebral vasospasm induced by subarachnoid hemorrhage. Methods: Thirty male Sprague-Dawley rats (350-400 g) were randomly allocated to five groups (sham group, SAH, BBR, SAH+BBR1 or SAH+BBR2. Experimental SAH model was induced by applying autologous blood into the cisterna magna at interval of 48 hours. To evaluate early and late effects of BBR, we allocated BBR treated groups as SAH+BBR1 and SAH+BBR2 (respectively, received BBR at a dose of 20 mg/kg 15 minutes and 6 hours after first SAH induction). Rats were sacrificed on 72-hour after the study onset. Cross-sections of basilar artery was investigated by histologically. Total antioxidant status (TAS) and total oxidant status (TOS) of brain tissue were studied by spectrophotometric assay. Oxidative stress index (OSI) was calculated. NAPPH Oxidase 4 (NOX4) enzyme levels were measured by ELISA method. Endothelial nitric oxide synthase (e-NOS), phosphorylated e-NOS (pe-NOS), AMP-activated protein kinase (AMPK), phosphorylated AMPK (pAMPK), Rho kinase and cingulin protein expressions were detected by Western blot analysis. Results: SAH+BBR1 and SAH+BBR2 groups significantly demonstrated lower OSI values, increased basilar artery cross-sectional luminal area in comparison with the SAH group. Increased Phosho-eNOS, eNOS, P-AMPK levels and Cingulin expression, decreased Nox4 and Rho-kinase levels were shown in BRB treated SAH groups relative to the SAH group. Conclusion: Berberine might be a neuroprotective agent to improve impaired cerebrovascular spasm.
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    Determination of cerebral blood flow velocity and microembolic signals in essential thrombocytosis by transcranial doppler ultrasonography
    (Taylor & Francis Ltd, 2021) Cinar, Ahmet; Cetin, Guven; Altintas Kadirhan, Ozge; Turgut, Seda; Ekinci, Iskender; Asil, Talip
    Objectives The goal of treatment in essential thrombocytosis (ET) is to prevent vascular complications such as thrombosis and hemorrhage. This study aimed to evaluate the risk of cerebrovascular microembolism in ET patients due to detection of microembolic signals (MES) and measure cerebral blood flow velocity (CBFV) by Transcranial Doppler (TCD) ultrasonography. Material and Methods In this prospective case-control study, forty patients with diagnosed ET and age and sex-matched forty healthy controls were examined by the TCD sonography. Results The ET group had a higher rate of MES (8/40) in the right MCA than that in the control group (none), as measured by TCD. Five patients had MES at the left MCA compared to that in no subjects in the control group. The comparison of the ET and control groups in terms of CBFV parameters showed significantly lower end-diastolic FV at the right MCA in the ET group compared to that in the control group (p < 0.05). On the other hand; both pulsatility and resistance indices in the right and left MCA and the ratios of systolic to diastolic blood flow rates in the right and left MCA were significantly higher in the ET group than that in the control group. Discussion This study revealed that MES seems to be more common in patients with ET despite treatment. We could suggest that ET patients should be monitored more closely to address the potential risk of developing a cerebrovascular disease, which can be estimated by detection MES and raised CBFV, combine antiplatelet therapies to standard treatments.