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Karabay N, Odaman H, Vahaplar A, Kizmazoglu C, Kalemci O. MRI-based Texture Analysis in Differentiation of Benign and Malignant Vertebral Compression Fractures. Curr Med Imaging 2024; 20:CMIR-EPUB-138780. [PMID: 38415478 DOI: 10.2174/0115734056290762240209071656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 01/05/2024] [Accepted: 01/29/2024] [Indexed: 02/29/2024]
Abstract
INTRODUCTION The diagnosis and characterization of vertebral compression fractures are very important for clinical management. In this evaluation, which is usually performed with diagnostic (conventional) imaging, the findings are not always typical or diagnostic. Therefore, it is important to have new information to support imaging findings. Texture analysis is a method that can evaluate information contained in diagnostic images and is not visually noticeable. This study aimed to evaluate the magnetic resonance images of cases diagnosed with vertebral compression fractures by the texture analysis method, compare them with histopathological data, and investigate the effectiveness of this method in the differentiation of benign and malignant vertebral compression fractures. METHODS Fifty-five patients with a total of 56 vertebral compression fractures were included in the study. Magnetic resonance images were examined and segmented using Local Image Feature Extraction (LIFEx) software, which is an open-source program for texture analysis. The results were compared with the histopathological diagnosis. RESULTS The application of the Decision Tree algorithm to the dataset yielded impressively accurate predictions (≈95% in accuracy, precision, and recall). CONCLUSION Interpreting tissue analysis parameters together with conventional magnetic resonance imaging findings can improve the abilities of radiologists, lead to accurate diagnoses, and prevent unnecessary invasive procedures. Further prospective trials in larger populations are needed to verify the role and performance of texture analysis in patients with vertebral compression fractures.
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Affiliation(s)
- Nuri Karabay
- Department of Radiology, Dokuz Eylül University, Turkey
| | | | - Alper Vahaplar
- Department of Statistic, Software, NETAŞ Telecommunications, Turkey
| | | | - Orhan Kalemci
- Department of Neurosurgery, Dokuz Eylül University, Turkey
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Kizmazoglu D, Ince D, Cecen E, Kizmazoglu C, Guleryuz H, Ozer E, Demiral A, Olgun N. Pediatric paravertebral tumors: analysis of 96 patients. Childs Nerv Syst 2024; 40:123-133. [PMID: 37452862 DOI: 10.1007/s00381-023-06064-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 07/05/2023] [Indexed: 07/18/2023]
Abstract
PURPOSE The most important complication of paravertebral tumors is cord compression (CC), which is an oncologic emergency. Early and appropriate intervention is important in terms of reducing morbidity and mortality. Here, we report our clinical experience with paravertebral tumors. METHODS The files of patients who were followed up for benign/malignant paravertebral tumors between 1988 and 2022 were evaluated retrospectively. RESULTS There were 96 patients with paravertebral tumors. The median age at diagnosis was 5 years (1 month-17 years). The male/female ratio was 1.13. The median time to diagnosis was 4 weeks (0-28 weeks). The most common presenting complaint was pain (62.5%). The diagnosis distribution was as follows: sympathetic nervous system (SNS) tumors (n: 38), soft tissue sarcomas (STS) (n: 23), Langerhans cell histiocytosis (LCH) (n: 12), central nervous system (CNS) tumors (n: 9), germ cell tumor (n: 6), lymphomas (n: 4), and benign tumors (n: 4). Sixty-five patients (67.7%) had CC, 40% of whom received chemotherapy as first-line treatment. Decompression surgery was performed in 58.5% of the patients. For patients with CC, 26 patients had advanced disease at admission. Serious neurologic sequelae were observed in seventeen (17.7%) patients. CONCLUSION Pain and neurological findings in childhood are warning signs for paravertebral tumors and CC. A detailed neurologic examination and radiodiagnostic imaging should be performed, and a definitive diagnosis should be made quickly. Anticancer treatment should be planned multidisciplinary. Decompression surgery should be discussed for patients with severe neurological deficits. Childhood cancers are chemosensitive; if possible, treatment should be initiated with chemotherapy to avoid neurological sequelae.
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Affiliation(s)
- Deniz Kizmazoglu
- Department of Pediatric Oncology, Dokuz Eylul University Institute of Oncology, 35340, Balcova, Izmir, Turkey
| | - Dilek Ince
- Department of Pediatric Oncology, Dokuz Eylul University Institute of Oncology, 35340, Balcova, Izmir, Turkey.
| | - Emre Cecen
- Department of Pediatric Oncology, Dokuz Eylul University Institute of Oncology, 35340, Balcova, Izmir, Turkey
| | - Ceren Kizmazoglu
- Department of Neurosurgery, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Handan Guleryuz
- Department of Radiology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Erdener Ozer
- Department of Pathology, Dokuz Eylul University, Faculty of Medicine, Izmir, Turkey
| | - Ayse Demiral
- Department of Radiation Oncology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Nur Olgun
- Department of Pediatric Oncology, Dokuz Eylul University Institute of Oncology, 35340, Balcova, Izmir, Turkey
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Kalemci O, Kizmazoglu C, Karabay N, Ur K, Ozyoruk S, Coskun E, Ozer E, Erbayraktar S. Effects of Pterional and Osteoplastic Craniotomy on Temporalis Muscle and Calvarial Bone Graft Atrophy. J Craniofac Surg 2024; 35:147-149. [PMID: 37669471 DOI: 10.1097/scs.0000000000009728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 07/26/2023] [Indexed: 09/07/2023] Open
Abstract
This study aims to compare the effects of osteoplastic craniotomy on temporalis muscle and bone graft atrophy in patients operated on with a pterional approach to the standard technique. Patients operated on for an intracranial aneurysm with a pterional approach between 2014 and 2018 were studied. Following the exclusion criteria, 36 patients were included in this retrospective study. Temporalis muscle volume and bone graft volume were calculated. The volumes were compared from preoperative and postoperative computed tomography images for temporalis muscle and from early and late postoperative computed tomography images for the bone graft. The osteoplastic craniotomy group (group I) had 17 patients, and the standard craniotomy group had 19 patients (group II). Temporalis muscle volume and bone graft volume decreased statistically significantly in group II after surgery. However, no significant volume difference was found in group I measurements. When compared with the standard technique, osteoplastic craniotomy reduces the likelihood of postoperative temporalis muscle and bone graft atrophy in patients undergoing pterional craniotomy. As a result, the patients' cosmetic and functional well-being is improved.
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Affiliation(s)
- Orhan Kalemci
- Department of Neurosurgery, Dokuz Eylul University Faculty of Medicine
| | - Ceren Kizmazoglu
- Department of Neurosurgery, Dokuz Eylul University Faculty of Medicine
| | - Nuri Karabay
- Department of Radiology, Dokuz Eylul University Faculty of Medicine, Izmir
| | - Koray Ur
- Department of Neurosurgery, Dokuz Eylul University Faculty of Medicine
| | - Safak Ozyoruk
- Department of Neurosurgery, Akdeniz Saglik Vakfi Yasam Hospital, Antalya, Turkey
| | - Ege Coskun
- Department of Neurosurgery, Dokuz Eylul University Faculty of Medicine
| | - Ercan Ozer
- Department of Neurosurgery, Dokuz Eylul University Faculty of Medicine
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Yurtal Z, Kulualp K, Ozkan H, Micili SC, Dogan H, Sisman AR, Ersoy N, Kizmazoglu C, Yakan A. Protective and Therapeutic Effects of Bovine Amniotic Fluids Collected in Different Trimesters on the Epidural Fibrosis After Experimental Laminectomy in Rats. World Neurosurg 2023; 171:e722-e730. [PMID: 36608801 DOI: 10.1016/j.wneu.2022.12.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND The aim of this study was to investigate the protective and therapeutic effects of bovine amniotic fluid (BAF) on the inhibition of epidural fibrosis (EF) after experimental laminectomy. METHODS Forty female Sprague Dawley rats were used. The amniotic fluids were collected from each trimester of a pregnant cow. The rats were divided into 5 groups. Whereas no laminectomy was applied to the control group, animals in the sham group underwent laminectomy. Laminectomy was performed in the animals in other groups and the operation area was closed by dripping 1 mL of BAF collected in 3 trimesters of pregnancy. Animals were killed 28 days after the operation. RESULTS Compared with control, VEGF gene expression levels were downregulated approximately 5-fold in BAF-2. Whereas IL-6 was upregulated approximately 8-fold in the sham, it was downregulated 5-fold and 3-fold in BAF-1 and BAF-2, respectively. There was downregulation in BAF-2 and BAF-3 in terms of CD105 gene expression levels. TGFβ1 was upregulated approximately 2-fold in the sham group and downregulated in BAF-1 and BAF-2. Although histopathologic alterations including EF grade and fibroblast cell density were found to increase in the sham group, all BAF treatment decreased those of alterations. The highest CD105 immunoreactivity was detected in the sham group. All BAF treatment markedly aggravated fibrosis via decreasing CD105 immunoreactivity. In terms of grading parameters, almost the closest grades to the control were determined in the BAF-2. BAF collected in the second trimester is most effective in healing of scar tissue and preventing fibrosis via decreasing microvessel and fibroblast densities. CONCLUSIONS The results indicate that BAF may be used as a potential protective agent to prevent EF.
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Affiliation(s)
- Ziya Yurtal
- Department of Surgery, Faculty of Veterinary Medicine, Hatay Mustafa Kemal University, Hatay, Turkey.
| | - Kadri Kulualp
- Department of Surgery, Faculty of Veterinary Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Huseyin Ozkan
- Department of Genetics, Faculty of Veterinary Medicine, Hatay Mustafa Kemal University, Hatay, Turkey
| | - Serap Cilaker Micili
- Department of Histology and Embryology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Halef Dogan
- Department of Obstetrics and Gynecology, Faculty of Veterinary Medicine, Tekirdag Namık Kemal University, Turkey
| | - Ali Riza Sisman
- Department of Biochemistry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Nevin Ersoy
- Department of Histology and Embryology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Ceren Kizmazoglu
- Department of Neurosurgery, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Akin Yakan
- Department of Genetics, Faculty of Veterinary Medicine, Hatay Mustafa Kemal University, Hatay, Turkey
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Kaya D, Micili SC, Kizmazoglu C, Mucuoglu AO, Buyukcoban S, Ersoy N, Yilmaz O, Isik AT. Allopurinol attenuates repeated traumatic brain injury in old rats: A preliminary report. Exp Neurol 2022; 357:114196. [PMID: 35931122 DOI: 10.1016/j.expneurol.2022.114196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 07/13/2022] [Accepted: 07/31/2022] [Indexed: 12/01/2022]
Abstract
Traumatic brain injury (TBI) is an overlooked cause of morbidity, which was shown to accelerate inflammation, oxidative stress, and neuronal cell loss and is associated with spatial learning and memory impairments and some psychiatric disturbances in older adults. However, there is no effective treatment in order to offer a favorable outcome encompassing a good recovery after TBI in older adults. Hence, the present study aimed to investigate the histological and neurobehavioral effects of Allopurinol (ALL) in older rats that received repeated TBI (rTBI). For this purpose, a weight-drop rTBI model was used on old male Wistar rats. Rats received 5 repeated TBI/sham injuries 24 h apart and were treated with saline or Allopurinol 100 mg/kg, i.p. each time. They were randomly assigned to three groups: control group (no injury); rTBI group (received 5 rTBI and treated with saline); rTBI+ALL group (received 5 rTBI and treated with Allopurinol). Then, half of the animals from each group were sacrificed on day 6 and the remaining animals were assessed with Open field, Elevated plus maze and Morris Water Maze test. Basic neurological tasks were evaluated with neurological assessment protocol every other day until after the 19th day from the last injury. Brain sections were processed for neuronal cell count in the hippocampus (CA1), dentate gyrus (DG), and prefrontal cortex (PC). Also, an immunohistochemical assay was performed to determine NeuN, iNOS, and TNFα levels in the brain regions. The number of neurons was markedly reduced in CA1, GD, and PC in rats receiving saline compared to those receiving allopurinol treatment. Immunohistochemical analysis showed marked induction of iNOS and TNFα expression in the brain tissues which were reduced after allopurinol at 6 and 19 days post-injury. Also, ALL-treated rats demonstrated a remarkable induce in NeuN expression, indicating a reduction in rTBI-induced neuronal cell death. In neurobehavioral analyses, time spent in closed arms, in the corner of the open field, swimming latency, and distance were impaired in injured rats; however, all of them were significantly improved by allopurinol therapy. To sum up, this study demonstrated that ALL may mitigate rTBI-induced damage in aged rats, which suggests ALL as a potential therapeutic strategy for the treatment of recurrent TBI.
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Affiliation(s)
- Derya Kaya
- Dokuz Eylul University Faculty of Medicine, Department of Geriatric Medicine, Unit for Brain Aging and Dementia, Izmir, Turkey; Geriatric Science Association, Izmir, Turkey.
| | - Serap Cilaker Micili
- Dokuz Eylul University Faculty of Medicine, Department of Histology and Embryology, Izmir, Turkey
| | - Ceren Kizmazoglu
- Dokuz Eylul University Faculty of Medicine, Department of Neurosurgery, Izmir, Turkey
| | - Ali Osman Mucuoglu
- Dokuz Eylul University Faculty of Medicine, Department of Neurosurgery, Izmir, Turkey
| | - Sibel Buyukcoban
- Dokuz Eylul University Faculty of Medicine, Department of Anaesthesiology and Reanimation, İzmir, Turkey
| | - Nevin Ersoy
- Dokuz Eylul University Faculty of Medicine, Department of Histology and Embryology, Izmir, Turkey
| | - Osman Yilmaz
- Dokuz Eylul University Health Sciences Institute, Department of Laboratory Animal Science, Izmir, Turkey
| | - Ahmet Turan Isik
- Dokuz Eylul University Faculty of Medicine, Department of Geriatric Medicine, Unit for Brain Aging and Dementia, Izmir, Turkey; Geriatric Science Association, Izmir, Turkey
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Gurkan G, Erdogan MA, Karahan G, Kaya H, Yigitturk G, Kizmazoglu C, Erbas O. The Healing Effect Of Digoxin On Peripheral Nerve Damage and Its Relation to IL-17/IL-10. Turk Neurosurg 2022; 33:258-264. [PMID: 36622189 DOI: 10.5137/1019-5149.jtn.38233-22.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
AIM Peripheral nerve damage mainly develops after mechanical trauma, and microenvironment impairment after damage delays the healing process. Additionally, digoxin is a glycoside with proven anti-inflammatory activity. Thus, this study aimed to demonstrate the curative effect of digoxin on peripheral nerve damage with its anti-inflammatory role on interleukin (IL)-17. MATERIAL AND METHODS The study was conducted with 30 male Sprague Dawley albino mature rats, of which 10 formed the control group, 10 were surgically treated and administered saline (group S), and another 10 were surgically treated and administered digoxin (group D). Motor functions and immunohistochemical and biochemical variables of the rats were assessed after therapy. RESULTS The amplitude of the inclined plane test scores and the compound muscle action potential levels were greater in group D than in group S. Likewise, there were higher nerve growth factor percentages, higher axon counts, and lower fibrosis score percentages in group D than is group S. Lastly, lower tissue malondialdehyde and plasma IL-17 levels were determined in group D, while the IL-10 level was higher. CONCLUSION Digoxin contributes to nerve healing and neuroprotective effect by demonstrating its anti-inflammatory effect on IL-17. It can be considered an adjunctive therapy for peripheral nerve injury.
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Affiliation(s)
- Gokhan Gurkan
- Katip Celebi University, Atatürk Training and Research Hospital, Department of Neurosurgery, Izmir, Turkey
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Uzunoglu I, Gurkan G, Cingoz ID, Atar M, Kaya I, Coskun E, Sinci KA, Bayraktar ES, Ur K, Aydin HE, Kizmazoglu C, Kalemci O, Sayin M, Yuceer N. Preoperatively, Which Parameter Allows Us to Predict the C5 Palsy After Cervical Open-Door Laminoplasty? Turk Neurosurg 2022; 33:110-117. [PMID: 35713261 DOI: 10.5137/1019-5149.jtn.38560-22.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
AIM To uncover factors that can predict the development of C5 palsy before surgery by evaluating several different parameters. MATERIAL AND METHODS A total of 177 patients who underwent surgery between 2015 and 2020 were included in the study. In total, C5 palsy was observed in 22 (12.4%) of our patients. The radiological and clinical data of the patients were retrospectively analyzed and added to the data. RESULTS A total of 177 patients who satisfied the criteria were included in the study, among whom 117 (66.1%) and 60 (33.9%) were male and female, respectively. Patients with ossified posterior longitudinal ligament (OPLL) (92; 52.0%) needed surgery the most. C5 palsy developed in 16/92 (17.3%) patients who had surgery for OPLL. This result was statistically significant (p < 0.001). However, a significant difference in the postoperative Pavlov ratio was noted between both groups (p=0.027). The foraminal dimensions for the C5 palsy group were significantly lower than those for the non-C5 palsy group. CONCLUSION Smaller C5 root foramina diameter measurements were the most important predictive factor for the development of C5 palsy after open-door cervical laminoplasty. Although the pathophysiology remains to be fully understood, ischemia-reperfusion injury supposedly plays a role therein.
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Affiliation(s)
- Inan Uzunoglu
- Health Science University, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Neurosurgery, Ankara, Turkey
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Abstract
AIM To investigate the cytotoxic effects of boron application at different doses on U-87 MG glioblastoma cells. MATERIAL AND METHODS The T98G (ATCC® CRL-1690?) glioblastoma cell strain used in the study was acquired from the American Type Culture Collection (ATCC) (Manassas, USA). Boric acid solution was prepared by mechanical mixing in the medium. Afterwards, 2.5 mM, 25 mM and 50 mM boron were each added to U87-MG glioblastoma cells and incubated for 48 hours. The cytotoxic effects on the cells was determined using the MTT (Methylthiazole diphenyl tetrazolium) test 48 hours after boron application. RESULTS IC50 value was detected as 17 mM in the 48-hour boric acid application on U-87 MG glioblastoma cells. CONCLUSION Boron treatment might be an effective approach for glioblastoma.
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Affiliation(s)
- Hasan Emre Aydin
- Kutahya University of Health Sciences, Department of Neurosurgery, Kutahya, Turkey
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Kalemci O, Kizmazoglu C, Ozyoruk S, Uzunoglu I, Husemoglu B, Atar M, Aydin HE, Karakasli A. What is the effect of pedicle screw reinsertion through the same trajectory on pullout strength? Turk Neurosurg 2021; 32:635-640. [DOI: 10.5137/1019-5149.jtn.35526-21.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Atar M, Kizmazoglu C, Kaya I, Aydin N, Corumlu U, Sozer G, Aydin HE, Kalemci O, Karabay N, Yuceer N. 3.0 Tesla MRI scanner evaluation of supratentorial major white matter tracts and central core anatomical structures of postmortem human brain hemispheres fixed by Klingler method. Br J Neurosurg 2020; 35:186-190. [PMID: 32672074 DOI: 10.1080/02688697.2020.1779179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Background: As an advanced imaging technique for the human brain, the importance of magnetic resonance imaging technique (MRI) is indisputable. The study aims to contribute to the literature by imaging post-mortem human brain hemispheres fixed with the Klinger method through the a 3.0 Tesla MRI Scanner and by defining the supratentorial major white matter tracts and central core anatomical structures.Methods: In our study, 10 post-mortem human brain hemisphere specimens were placed in 10% formalin solution for at least two months according to the Klingler method. The images were obtained using a 3.0 Tesla MRI Scanner. Anatomical structures were described on the T1-T2 axial, coronal, and sagittal MRI sections and compared with control images obtained from healthy humans.Results: Our examination revealed major association fibers, the basal cores and nuclei were denser, and the connections between them were clearly visible. The basal nuclei particularly were visualized more clearly compared with the normal MRI examinations. The claustrum, putamen, lateral and medial part of globus pallidus, and the caudolenticular bridges of the caudate nucleus could be clearly distinguished. The optic radiation line toward the occipital area as well as the forceps major and minor were distinct in the axial sections. Meanwhile, the imaging emphasized the importance of temporal stem, and the fibers it contained were clearly observed in the coronal sections.Conclusion: The use of hemispheres fixed using the Klinger method in post-mortem MRI examinations on brain hemispheres showed a clear separation of white matter fibers and nuclear structures.
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Affiliation(s)
- Murat Atar
- Department of Neurosurgery, Sultan Abdülhamid Han Training and Research Hospital, Istanbul, Turkey
| | - Ceren Kizmazoglu
- Department of Neurosurgery, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Ismail Kaya
- Department of Neurosurgery, Kutahya Health Science University, Kutahya, Turkey
| | - Nevin Aydin
- Department of Radiology, Osmangazi University School of Medicine, Eskisehir, Turkey
| | - Ufuk Corumlu
- Department of anatomy, Kutahya Health Science University, Kutahya, Turkey
| | - Gulden Sozer
- Department of Pathology, Forensic Medicine Institution, Izmir, Turkey
| | - Hasan Emre Aydin
- Department of Neurosurgery, Kutahya Health Science University, Kutahya, Turkey
| | - Orhan Kalemci
- Department of Neurosurgery, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Nuri Karabay
- Department of Radiology, Dokuz Eylül University School of Medicine, Izmir, Turkey
| | - Nurullah Yuceer
- Department of Neurosurgery, Katip Celebi University Atatürk Training and Research Hospital, Izmir, Turkey
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Gürkan G, Sayin M, Kizmazoglu C, Erdogan MA, Yigitturk G, Erbak Yilmaz H, Uzunoglu I, Kaya I, Yuceer N. Evaluation of the neuroprotective effects of ozone in an experimental spine injury model. J Neurosurg Spine 2020; 33:1-9. [PMID: 32413852 DOI: 10.3171/2020.2.spine191439] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 02/20/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The pathophysiology of spine injury consists of primary and secondary damage mechanisms. The vast majority of treatments aim to prevent or at least stop the progression of secondary neurotoxic events during the acute period. Ozone has been found to have potent antiinflammatory effects, to activate the immune system, and to have a substantial impact on the antioxidant system. In this study the authors aimed to evaluate the neuroprotective effects of ozone and their possible roles in recovery from spine injury, assessed based on biochemical, histological, and neurological parameters using an experimental spine injury model in rats. METHODS The study included 31 female Wistar albino rats. The rats were divided randomly into 5 groups, with 7 rats in each group except the sham group, which contained 3 rats, as follows: group 1 (sham), laminectomy; group 2 (control), laminectomy and spinal trauma with no medical treatment (0.5 ml isotonic saline applied 1 hour postsurgery); group 3, single medical treatment with 30 mg/kg methylprednisolone applied intraperitoneally 1 hour after laminectomy and trauma; group 4, single medical treatment with 60 μg/ml ozone at 0.7 mg/kg applied intraperitoneally 1 hour after laminectomy and trauma; and group 5, double medical treatment with 30 mg/kg methylprednisolone and 60 μg/ml ozone at 0.7 mg/kg applied intraperitoneally 1 hour after laminectomy and trauma. After neurosurgery, neurobehavioral tests were performed in all groups. After 7 days of follow-up, all the rats were killed. Biopsy specimens obtained from trauma sites were examined using H & E, cresyl violet, immunohistochemical (anticonnexin-43), and TUNEL staining processes. Levels of interleukin (IL)-1β, IL-6, and tumor necrosis factor-α (TNF-α) and total oxidant status (TOS) and total antioxidant status (TAS) were measured in blood samples. RESULTS The level of neurobehavioral healing was the highest in the double-treatment group (group 5), and the difference between the groups was significant. The minimum IL-6 level was found in group 5, indicating that the antiinflammatory impact was the most significant in this group (p = 0.01). Additionally, ozone was found to reduce oxidant stress more effectively than methylprednisolone (p = 0.03). Although methylprednisolone was superior to ozone in terms of the antiinflammatory effect, this effect was greater in group 5. Nevertheless, the number of neurons in group 5 was close to that of the control group, and the number of apoptotic cells was the least in group 5 (p < 0.001). CONCLUSIONS In acute spinal injury, the combined application of methylprednisolone and ozone was found to have a greater antiinflammatory effect, hasten clinical recovery, and increase histological recovery compared with methylprednisolone therapy alone. This study showed that this combination therapy of methylprednisolone with the addition of ozone might have a more beneficial effect in the treatment of spinal injury than methylprednisolone therapy alone.
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Affiliation(s)
- Gokhan Gürkan
- 1Department of Neurosurgery, Katip Celebi University Atatürk Training and Research Hospital, Izmir
| | - Murat Sayin
- 1Department of Neurosurgery, Katip Celebi University Atatürk Training and Research Hospital, Izmir
| | - Ceren Kizmazoglu
- 2Department of Neurosurgery, Dokuz Eylul University Hospital, Izmir
| | | | | | - Huriye Erbak Yilmaz
- 5Department of Medical Biochemistry, Katip Celebi University Atatürk Training and Research Hospital, Izmir; and
| | - Inan Uzunoglu
- 1Department of Neurosurgery, Katip Celebi University Atatürk Training and Research Hospital, Izmir
| | - Ismail Kaya
- 6Department of Neurosurgery, Dumlupinar University Kutahya Evliya Celebi Training and Research Hospital, Kutahya, Turkey
| | - Nurullah Yuceer
- 1Department of Neurosurgery, Katip Celebi University Atatürk Training and Research Hospital, Izmir
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Kizmazoglu C, Aydin HE, Kaya I, Atar M, Husemoglu B, Kalemci O, Sozer G, Havitcioglu H. Comparison of Biomechanical Properties of Dura Mater Substitutes and Cranial Human Dura Mater : An In Vitro Study. J Korean Neurosurg Soc 2019; 62:635-642. [PMID: 31679317 PMCID: PMC6835148 DOI: 10.3340/jkns.2019.0122] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 07/26/2019] [Indexed: 11/27/2022] Open
Abstract
Objective The aim of this study was to investigate the biomechanical differences between human dura mater and dura mater substitutes to optimize biomimetic materials.
Methods Four groups were investigated. Group I used cranial dura mater (n=10), group II used Gore-Tex® Expanded Cardiovascular Patch (W.L. Gore & Associates Inc., Flagstaff, AZ, USA) (n=6), group III used Durepair® (Medtronic Inc., Goleta, CA, USA) (n=6), and group IV used Tutopatch® (Tutogen Medical GmbH, Neunkirchen am Brand, Germany) (n=6). We used an axial compression machine to measure maximum tensile strength.
Results The mean tensile strengths were 7.01±0.77 MPa for group I, 22.03±0.60 MPa for group II, 19.59±0.65 MPa for group III, and 3.51±0.63 MPa for group IV. The materials in groups II and III were stronger than those in group I. However, the materials in group IV were weaker than those in group I.
Conclusion An important dura mater graft property is biomechanical similarity to cranial human dura mater. This biomechanical study contributed to the future development of artificial dura mater substitutes with biomechanical properties similar to those of human dura mater.
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Affiliation(s)
- Ceren Kizmazoglu
- Department of Neurosurgery, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Hasan Emre Aydin
- Department of Neurosurgery, Kutahya Health Science University Evliya Celebi Training and Research Hospital, Kutahya, Turkey
| | - Ismail Kaya
- Department of Neurosurgery, Kutahya Health Science University Evliya Celebi Training and Research Hospital, Kutahya, Turkey
| | - Murat Atar
- Department of Neurosurgery, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - Bugra Husemoglu
- Department of Biomechanics, Dokuz Eylul University School of Medicine Health Science Institute, Izmir, Turkey
| | - Orhan Kalemci
- Department of Neurosurgery, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Gulden Sozer
- Department of Pathology, Forensic Medicine Institution, Izmir, Turkey
| | - Hasan Havitcioglu
- Department of Biomechanics, Dokuz Eylul University School of Medicine Health Science Institute, Izmir, Turkey.,Department of Orthopedics and Traumatology, Dokuz Eylul University School of Medicine, Izmir, Turkey
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13
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Abstract
Introduction: Dural closure preference has been a topic of debate in contemporary neurosurgery. This study aims to compare different closure techniques using an in vitro model.Methods: Human cadaveric dura mater was attached to a cylindrical metal glass filled with blue dyed saline. A 1 cm dural incision was made. Dural closure was performed using three different techniques. Each group had six samples: Group I - interrupted simple 4-0 polyglactin suture (S) only, Group II - S plus on lay collagen graft, Group III - S plus fibrin sealant. In Group NS, a 1 cm × 1 cm dural window was made. An onlay collagen graft was used with no suturing for this group to serve as an overtly weak reconstruction reference. Primary and secondary leak pressures were recorded (PLP and SLP, respectively).Results: All groups (I-III) had significantly higher PLP and SLP than Group NS. PLP was significantly higher in Group III as compared to groups I and II. Groups I and II had similar PLP values. SLP was similar in all three groups.Conclusion: In this study, the use of fibrin sealant has proven to be the best option in preventing dural leak. However, no technique was superior in the case of SLP.
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Affiliation(s)
- Ceren Kizmazoglu
- Department of Neurosurgery, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Safak Ozyoruk
- Department of Neurosurgery, Ardahan State Hospital, Ardahan, Turkey
| | - Resit Bugra Husemoglu
- Department of Biomechanics, Dokuz Eylul University School of Medicine Health Science Institute, Izmir, Turkey
| | - Orhan Kalemci
- Department of Neurosurgery, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Gulden Sozer
- Department of Pathology, Forensic Medicine Institution, Izmir, Turkey
| | - Burak Sade
- Department of Neurosurgery, Dokuz Eylul University School of Medicine, Izmir, Turkey
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14
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Kilicarslan B, Kilicarslan E, Kizmazoglu C, Aydin HE, Kaya I, Danyeli AE, Karabekir HS. Evaluation of the Efficacy of Sildenafil Citrate Following Severe Head Trauma in an Experimental Rat Model. Turk Neurosurg 2019; 30:501-506. [PMID: 30829389 DOI: 10.5137/1019-5149.jtn.23864-18.3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
AIM To investigate the acute effects of sildenafil citrate in an experimental model of severe head trauma, and to compare it with the efficacy of mannitol, which is an osmotically active agent frequently used in clinical treatment of traumatic brain injury (TBI). MATERIAL AND METHODS Twenty-eight Wistar-derived albino strain female rats were randomized into four groups comprising seven rats each. These groups were designated as follows: Group I: sham; Group II: TBI; Group III: TBI + mannitol (20% 1 gr/ kg, intraperitoneal); and Group IV: TBI + sildenafil citrate (10 mg/kg, intraperitoneal). Sections prepared following the tissue processing of samples obtained from the right prefrontal cortex and right hippocampal regions of the brains of sacrificed rats were histopathologically evaluated. Fractionator method via the Stereo Investigator software program (Micro Bright Field) was used to count the neurons. Pyknotic neuron count and pyknotic / total neuron count were compared between the groups. RESULTS In the comparison of Group II and IV, pyknotic neuron count (prefrontal; group II: 116.00 ± 30.50, group IV: 80.00 ± 19.47) and pyknotic/ total neuron count (prefrontal; group II: 0,30 ± 0.08, group IV: 0.21 ± 0.02) were significantly lower in Group IV in both regions (p < 0.05). Similarly, in the comparison of Group II and III, the values in Group III were lower in both regions (p < 0.05). CONCLUSION Sildenafil citrate decreases neuronal death in the acute phase and produces similar results with mannitol. Therefore, we believe that sildenafil citrate can be a useful adjunct or alternative agent for the clinical treatment of patients with acute TBI.
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Affiliation(s)
- Bilal Kilicarslan
- Bitlis Tatvan State Hospital, Department of Neurosurgery, Bitlis, Turkey
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15
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Uzunoglu I, Kaya I, Sucu HK, Kizmazoglu C, Sevin IE, Aydin HE, Rezanko TA, Yuceer N. Evaluation of Incidentally Detected Pathology Results of Patients with Vertebral Fracture Treated by Vertebroplasty and Kyphoplasty: A Retrospective Study. World Neurosurg 2019; 122:e639-e646. [DOI: 10.1016/j.wneu.2018.10.116] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Revised: 10/16/2018] [Accepted: 10/19/2018] [Indexed: 01/09/2023]
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16
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Guvenc G, Kizmazoglu C, Aydin HE. Effect of Mannitol Infusion on Optic Nerve Injury After Acute Traumatic Subarachnoid Hemorrhage and Brain Injury. J Craniofac Surg 2018; 29:1772-1775. [PMID: 30106807 DOI: 10.1097/scs.0000000000004827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The primary aim of this paper is to investigate the neuroprotective and antiinflammatory effects of mannitol on optic nerve injury after acute traumatic subarachnoid hemorrhage and brain injury in rat models. Traumatic brain injury (TBI) and traumatic subarachnoid hemorrhage (tSAH) were produced by a custom-made weight-drop impact acceleration device. Thirty male Wistar rats were divided into 3 groups. Group I (n = 10) was the sham group, group II (n = 10) received TBI, and group III (n = 10) received TBI + mannitol (1 mg/kg intravenously). Optic nerve tissue glutathione peroxidase (GPx) and interleukin 1 beta (IL-1β) levels were measured 4 hours after the trauma. The authors used Kruskal-Wallis variance analysis and Mann-Whitney U tests for statistical analysis. Optic nerve tissue GPx levels were significantly higher in group III than in groups I and II (P < 0.05). Optic nerve tissue IL-1β levels were significantly lower in group III than in group II (P < 0.05) and higher than in group I (P < 0.05).Mannitol increased the antioxidant GPx levels and decreased the IL-1β levels, which can protect the optic nerve from secondary injury after severe acute trauma. Mannitol plays an important role in the treatment of acute severe indirect optic nerve injury after TBI and tSAH.
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Affiliation(s)
- Gonul Guvenc
- Department of Neurosurgery, Ataturk Training and Research Hospital, Katip Celebi University
| | - Ceren Kizmazoglu
- Department of Neurosurgery, School of Medicine Hospital, Dokuz Eylul University, Izmir
| | - Hasan Emre Aydin
- Department of Neurosurgery, Evliya Celebi Training and Research Hospital, Dumlupinar University, Kutahya, Turkey
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17
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Ur K, Demiroz S, Bengu AS, Ulucan A, Gergin OO, Kizmazoglu C, Ozer E. Serum endocan level and the severity of spinal cord injury. ACTA ACUST UNITED AC 2018; 119:298-301. [PMID: 29749245 DOI: 10.4149/bll_2018_056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To determine whether the endocan level may be related to the severity of spinal cord injury. BACKGROUND Several biomarkers were evaluated for this purpose, but endocan has never been studied before. It is correlated to endothelial dysfunction and ischemia, which are the characteristics of spinal cord injury in most cases. MATERIAL AND METHODS A total of 21 male Sprague-Dawley rats weighing 300-350 g were randomly divided into three groups. In Group I, only a laminectomy was performed; in Group II, a mild SCI was performed after laminectomy; and, in Group III, a severe SCI was performed after laminectomy. At 48 h after the injury, after neurological assessment by Tarlov method, all animals were euthanized. A 5 cc blood sample was drawn for biochemical analysis, and spinal cord tissues were removed for histopathological examination. RESULTS The difference between Groups I and III was statistically significant (p < 0.05). There was also a moderately positive correlation between the severity of SCI and the endocan level (r = 0.59, p < 0.05). CONCLUSION The endocan level may be used as an indicator to determine prognosis after SCI (Tab. 1, Fig. 2, Ref. 24). Text in PDF www.elis.sk.
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18
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Guvenc G, Kizmazoglu C, Sayin M, Ture HS. Surgically Treated Status Epilepticus due to Large Cortical Tuber and Long-Term Follow-Up Results. Turk Neurosurg 2018; 30:458-461. [PMID: 29634076 DOI: 10.5137/1019-5149.jtn.21343-17.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
We present a case of invasive monitoring of a patient while he was being surgically treated in the status state. Our patient was a 27-year-old male who was hospitalized for frequent seizures, which began after a head trauma at the age of 3 years. Video electroencephalography was performed, and 25 clinical seizures were observed in 24 hours. Cranial magnetic resonance imaging (MRI) revealed a right frontal lesion which was hyperintense in T2-weighted and hypointense in T1-weighted images, and a subependymal nodule. For invasive monitoring, subdural electrodes were placed on the cortex surface via a right frontal craniotomy. The patient was re-operated, and the epileptic zone resection was performed. There was no sign of neurological deficit. Histopathological examination revealed cortical tuber, and the patient was scanned for tuberous sclerosis. There was no sign of tuberous sclerosis in other organs. The diagnosis of our patient was tuberous sclerosis, cortical tuber, subependymal nodule, epilepsy, and intermediate mental retardation. Radiological diagnosis should also be considered. Cortical tuber can be confused with focal cortical dysplasia. Finally, staged resection may be performed as a surgical treatment in some cases.
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Affiliation(s)
- Gonul Guvenc
- Izmir Katip Celebi University, Atatürk Training and Research Hospital, Department of Neurosurgery, Izmir, Turkey
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19
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Abstract
Although intraparenchymal meningiomas have rarely been reported in the literature, the papillary type has been reported only as infratentorial. Here we report the case of a 21-year-old female patient with intraparenchymal lesion. To our knowledge, this case describes the first report of a patient with a supratentorial intraparenchymal papillary meningioma.
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Affiliation(s)
- Inan Uzunoglu
- Department of Neurosurgery, Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey
| | - Ceren Kizmazoglu
- Department of Neurosurgery, Dokuz Eylül University School of Medicine, Izmir, Turkey
| | - Turkan Atasever Rezanko
- Department of Pathology, Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey
| | - Nurullah Yuceer
- Department of Neurosurgery, Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey
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20
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Kalemci O, Aydin HE, Kizmazoglu C, Kaya I, Yılmaz H, Arda NM. Effects of Quercetin and Mannitol on Erythropoietin Levels in Rats Following Acute Severe Traumatic Brain Injury. J Korean Neurosurg Soc 2017; 60:355-361. [PMID: 28490163 PMCID: PMC5426445 DOI: 10.3340/jkns.2016.0505.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 10/27/2016] [Accepted: 11/29/2016] [Indexed: 12/31/2022] Open
Abstract
Objective The aim of this study to investigate the normal values of erythropoietin (EPO) and neuroprotective effects of quercetin and mannitol on EPO and hematocrit levels after acute severe traumatic brain injury (TBI) in rat model. Methods A weight-drop impact acceleration model of TBI was used on 40 male Wistar rats. The animals were divided into sham (group I), TBI (group II), TBI+quercetin (50 mg/kg intravenously) (group III), and TBI+mannitol (1 mg/kg intravenously) (group IV) groups. The malondialdehyde, glutathione peroxidase, catalase, EPO, and hematocrit levels were measured 1 and 4 hour after injury. Two-way repeated measures analysis of variance and Tukey’s test were used for statistical analysis. Results The malondialdehyde levels decreased significantly after administration of quercetin and mannitol compared with those in group II. Catalase and glutathione peroxidase levels increased significantly in groups III and IV. Serum EPO levels decreased significantly after mannitol but not after quercetin administration. Serum hematocrit levels did not change significantly after quercetin and mannitol administration 1 hour after trauma. However, mannitol administration decreased serum hematocrit levels significantly after 4 hour. Conclusion This study suggests that quercetin may be a good alternative treatment for TBI, as it did not decrease the EPO levels.
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Affiliation(s)
- Orhan Kalemci
- Department of Neurosurgery, School of Medicine and Hospital, Dokuz Eylul University, Izmir, Turkey
| | - Hasan Emre Aydin
- Department of Pharmacology, Eskisehir Osmangazi University, Eskisehir, Turkey.,Department of Neurosurgery, School of Medicine and Hospital, Dumlupınar University, Kutahya, Turkey
| | - Ceren Kizmazoglu
- Department of Neurosurgery, School of Medicine and Hospital, Dokuz Eylul University, Izmir, Turkey
| | - Ismail Kaya
- Department of Neurosurgery, Kilis State Hospital, Kilis, Turkey
| | - Hulya Yılmaz
- Department of Biostatistics and Medical Informatics, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Nuri M Arda
- Department of Neurosurgery, School of Medicine and Hospital, Dokuz Eylul University, Izmir, Turkey
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21
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Kizmazoglu C, Lee JH, Sade B. Dominant Occipital Sinus Complicating Surgery of a Fourth Ventricular Mass. World Neurosurg 2017; 97:753.e17-753.e19. [DOI: 10.1016/j.wneu.2016.10.048] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 10/05/2016] [Accepted: 10/07/2016] [Indexed: 11/26/2022]
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22
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Kizmazoglu C, Aydin HE, Sevin IE, Kalemci O, Yüceer N, Atasoy MA. Neuroprotective Effect of Resveratrol on Acute Brain Ischemia Reperfusion Injury by Measuring Annexin V, p53, Bcl-2 Levels in Rats. J Korean Neurosurg Soc 2015; 58:508-12. [PMID: 26819684 PMCID: PMC4728087 DOI: 10.3340/jkns.2015.58.6.508] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Revised: 06/14/2015] [Accepted: 07/15/2015] [Indexed: 12/28/2022] Open
Abstract
Background Cerebral ischemia is as a result of insufficient cerebral blood flow for cerebral metabolic functions. Resveratrol is a natural phytoalexin that can be extracted from grape's skin and had potent role in treating the cerebral ischemia. Apoptosis, a genetically programmed cellular event which occurs after ischemia and leads to biochemical and morphological changes in cells. There are some useful markers for apoptosis like Bcl-2, bax, and p53. The last reports, researchers verify the apoptosis with early markers like Annexin V. Methods We preferred in this experimental study a model of global cerebral infarction which was induced by bilateral common carotid artery occlusion method. Rats were randomly divided into 4 groups : sham, ischemia-reperfusion (I/R), I/R plus 20 mg/kg resveratrol and I/R plus 40 mg/kg resveratrol. Statistical analysis was performed using Sigmastat 3.5 ve IBM SPSS Statistics 20. We considered a result significant when p<0.001. Results After administration of resveratrol, Bcl-2 and Annexin levels were significantly increased (p<0.001). Depending on the dose of resveratrol, Bcl2 levels increased, p53 levels decreased but Annexin V did not effected. P53 levels were significantly increased in ishemia group, so apoptosis is higher compared to other groups. Conclusion In the acute period, Annexin V levels misleading us because the apoptotic cell counts could not reach a certain level. Therefore we should support our results with bcl-2 and p53.
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Affiliation(s)
- Ceren Kizmazoglu
- Department of Neurosurgery, Katip Celebi University Izmir Atatürk Training and Research Hospital, Izmir, Turkey
| | - Hasan Emre Aydin
- Department of Neurosurgery, Eskisehir State Hospital, Eskisehir, Turkey.; Department of Pharmacology, Eskişehir Osmangazi University, Eskisehir, Turkey
| | - Ismail Ertan Sevin
- Department of Neurosurgery, Katip Celebi University Izmir Atatürk Training and Research Hospital, Izmir, Turkey
| | - Orhan Kalemci
- Department of Neurosurgery, Dokuz Eylul University, School of Medicine Hospital, Izmir, Turkey
| | - Nurullah Yüceer
- Department of Neurosurgery, Katip Celebi University Izmir Atatürk Training and Research Hospital, Izmir, Turkey
| | - Metin Ant Atasoy
- Department of Neurosurgery, Eskişehir Osmangazi University School of Medicine Hospital, Eskisehir, Turkey
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23
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Yilmaz M, Karakasli A, Kalemci O, Kizmazoglu C, Yuksel ZK, Arda NM, Yucesoy K. Asymmetric Posterior Thoracolumbar Fixation following a Posterolateral Transpedicular Approach for Unilateral Vertebral Disease. Neurol Med Chir (Tokyo) 2015; 55:564-9. [PMID: 25797773 PMCID: PMC4628189 DOI: 10.2176/nmc.oa.2014-0085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The present study aimed to evaluate the clinical outcomes of patients who underwent asymmetrical posterior screw fixation for the treatment of unilateral posterior vertebral pathological entities. The study included 21 patients with a spinal tumor who underwent asymmetrical posterior spinal fusion surgery between April 2009 and March 2012. The American Spinal Injury Association (ASIA) motor score visual analog scale (VAS) score were used as the outcome measure at admission and follow-up. Among the 21 patients, 12 were male and 9 were female, and mean age was 50.71 (range, 24–78) years. Mean follow-up was 16.04 (range, 4–47) months. Postoperatively, neurological findings did not deteriorate in any of the patients. Among the ASIA grade C and D patients, eight (38%) of them exhibited clinical stability or recovery to ASIA E, whereas none of the ASIA B patients scores changed postoperatively. Perioperative complications were noted in six patients (28%). Spinal stability and fusion were achieved in 18 (85%) patients. The surgical asymmetrical fixation technique described reduced the duration of surgery, and the patients required less dissection of paraspinal muscles than bilateral symmetrical fixation. Asymmetrical fixation provides good stabilization for unilateral thoracolumbar vertebral pathological entities, and facilitates rapid rehabilitation of such patients, who are often elderly with comorbidities.
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Affiliation(s)
- Murat Yilmaz
- Department of Neurosurgery, Dokuz Eylül University
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24
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Sayhan S, Altinel D, Erguden C, Kizmazoglu C, Guray M, Acar U. Langerhans cell histiocytosis of the cervical spine in an adult: a case report. Turk Neurosurg 2010; 20:409-12. [PMID: 20669118 DOI: 10.5137/1019-5149.jtn.1625-08.2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
We present a case of a 47-year-old-woman with a complaint of cervical pain with paresthetic appearance on her left arm. She was treated with analgetics. Further radiological evaluation because of the persistent pain revealed an osteolytic destruction of the fourth cervical vertebra. The patient underwent anterior cervical corpectomy with total excision of the tumor. Stabilization of the cervical spine was performed. Histology confirmed the diagnosis of Langerhans cell histiocytosis (LCH) of the cervical spine. This case report presents the histopathological evaluation, diagnostic work-up and the treatment procedures because of rarity of cervical spinal LCH cases in the literature.
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Affiliation(s)
- Salih Sayhan
- Dokuz Eylul University, Faculty of Medicine, Department of Neurosurgery, and Izmir Tepecik Training Hospital, Department of Pathology, Izmir, Turkey
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