Browsing by Author "Ösün, A"

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    Histologic Changes At The Intervertebral Disc Tissue After Laser Nucleotomy
    Ösün, A; Samancioglu, A; Temiz, P; Temiz, C; Sayin, M
    Minimally invasive surgical techniques have become widely used for lumbar disc disease. Each of these techniques have a different physical effect in terms of retracting the prolapsed disc tissue and decompressing the adjacent nerve root by reducing the intradiscal pressure. Various types of laser generators with different wave lengths and electrode systems have been used for percutaneous laser disc decompression (PLDD). There are numerous studies regarding the clinical effectiveness of PLDD but histologic parameters which can prove the effectivity are few. Three patients with L4-5 disc prolapsus had undergone open microdiscectomy three months after PLDD because of the unsatisfactory results. The disc tissues were evaluated histologically. Fibrous fibrillary degeneration, integrity deformation of the fibres and chondrocyte proliferation were seen at the site of the microdiscectomy tissue. Previously laser irradiated disc materials had more severe fibrillary degeneration and the chondroid component degeneration was significant. In addition, degenerative calcification and massive necrosis of the chondrocytes were seen. Changes in fibronectin, tissue inhibitors of metalloproteinases (TIMP) and matrix metalloproteinases (MMPs) of the disc tissue were examined with immunohistochemical dyes. As a result, we found that PLDD causes a decrease in the water content of the disc tissue, hyaline degeneration, fibrillary destruction and chondrocyte depletion. Immunostaining showed that the extracellular matrix was effected, the metalloproteinase activity and protein compound of the extracellular matrix had changed. The findings were discussed in light of the literature.
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    Black colored intervertebral disc; ochronosis: A case report
    Ösün, A; Korkmaz, M; Temiz, P; Samancioglu, A; Atay, B
    Alkaptonuria is a rare inborn error of metabolism caused by mutations in the gene responsible for the production of homogentisate 1,2-dioxygenase, an enzyme that plays an important role in the normal degradation of the aromatic amino acids tyrosine and phenylalanine. Defective production of this enzyme results in the accumulation of homogentisic acid, a tyrosine degradation product, in the bloodstream. Accumulation of homogentisic acid and its metabolites in tissues cause ochronosis. The word ochronosis refers to the dark bluish black discoloration of connective tissues including the sclera, cornea, auricular cartilage, heart valves, articular cartilage, tendons, and ligaments. In this article, we present a 38-year-old male patient with alkaptonuria associated degenerative L4-5 disc hernia, in which the patient was diagnosed after lumbar discectomy.