Browsing by Author "Duransoy, YK"
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Item Differences in individual susceptibility affect the development 4 trigeminal neuralgiaDuransoy, YK; Mete, M; Akçay, E; Selçuki, MTrigeminal neuralgia is a syndrome due to dysfunctional hyperactivity of the trigeminal nerve, and is characterized by a sudden, usually unilateral, recurrent lancinating pain arising from one or more divisions of the nerve. The most accepted pathogenetic mechanism for trigeminal neuralgia is compression of the nerve at its dorsal root entry zone or in its distal course. In this paper, we report four cases with trigeminal neuralgia due to an unknown mechanism after an intracranial intervention. The onset of trigeminal neuralgia after surgical interventions that are unrelated to the trigeminal nerve suggests that in patients with greater individual susceptibility, nerve contact with the vascular structure due to postoperative pressure and changes in cerebrospinal fluid flow may cause the onset of pain.Item Prognostic Factors in Metastatic Brain Tumors: Study of 62 PatientsDuransoy, YK; Selçuki, M; Gökçe, T; Duransoy, ABackground: Brain metastases are the major cause of morbidity and mortality in patients with cancer. Variety of clinical and autopsy studies showed that brain metastases develop at 15%-45% of all cancer patients during the course of the disease and 1/2-2/3 of them were symptomatic. Average life expectancy of cancer patients with untreated metastatic brain tumors are approximately 1-2 months. Methods: We investigated the prognostic factors of removal of metastatic brain tumors in patients who admitted to neurosurgery department. Eighteen of 80 patients in the program excluded for various reasons and this study was completed with the remaining 62 cases. Results: Our study showed that neurological and general status, the extension of surgical resection, presence of the extra-cranial metastases at diagnosis and localization of the primary focus affect the prognosis. Conclusion: In the planning of treatment of patients with metastatic brain tumors, colleagues have to keep in mind level of neurological and general status, the extension of surgical resection, presence of the extra-cranial metastases at diagnosis and localization of the primary focus affect the prognosis. Surgical resection is beneficial for improving neurological status and survival of patients in brain metastases. Local control is essential and can be achieved with one of the adjunct therapies following the surgery.Item Comparison of Three Surgical Approaches for the Treatment of Lumbar Spinal Stenosis: Total Laminectomy, Unilateral Approach for Bilateral Decompression, and Total Laminectomy with Posterior Transpedicular Screw FixationBarutçuoglu, M; Mete, M; Unsal, UU; Gurgen, AI; Duransoy, YKIntroduction: Lumbar spinal stenosis (LSS) is one of the most common diseases for spinal surgery and many surgical techniques are used for treatment. Objective: The aim of this retrospective study was to observe the clinical and radiological results of total laminectomy (TL), unilateral approach for bilateral decompression, and posterior transpedicular fixation-interbody fusion with TL. Materials and Methods: The data of 112 patients who underwent surgical treatment for LSS with different surgical techniques were reviewed retrospectively. The patients were divided into 3 groups according to the surgical technique. In the first group, patients underwent TL, in the second group, patients underwent bilateral decompression via unilateral hemilaminectomy, and in the third group, patients underwent posterior transpedicular fixation-interbody fusion with TL. Preoperative and postoperative evaluations were done by visual analog scale (VAS) and functional back pain scales (FBPSs). Furthermore, three groups were compared in respect of operation time, bleeding, and complications. Results: The difference between preoperative and postoperative VAS and FBPS scores were statistically significant in all groups. Operation time, bleeding, and hospital stay were greater in fusion group than decompression-alone groups. The VAS improvement rate was 66%, 70%, and 62% in Group 1, Group 2, and Group 3, respectively. In addition, improvement of FBPS scores between preoperative and postoperative period was statistically significant for the three groups (P < 0.05). Conclusion: Decompression with fusion surgery had no significant difference compared with decompression alone in patient's clinical outcome and safety.Item Therapeutic effects of Lacosamide in a rat model of traumatic brain injury: A histological, biochemical and electroencephalography monitoring studyMete, M; Alpay, S; Aydemir, I; Unsal, UU; Collu, F; Özel, HF; Duransoy, YK; Kutlu, N; Tuglu, MIObjective: Traumatic Brain Injury (TBI) is a major cause of death and disability worldwide, especially in children and young adults. TBI can be classified based on severity, mechanism or other features. Inflammation, apoptosis, oxidative stress, and ischemia are some of the important pathophys-iological mechanisms underlying neuronal loss after TBI. Lacosamide (LCM) is an anticonvulsant compound approved for the adjunctive treatment of partial-onset seizures and neuropathic pain. This study aimed to investigate possible neuroprotective effects of LCM in a rat model of TBI. Material and methods: Twenty-eight adult male, Wistar albino rats were used. The rats were divided into 4 groups. Group 1 was the control group (n=7). Group 2 was the trauma group (n=7) where rats were treated with 100 mg/kg saline intraperitoneally (IP) twice a day. Groups 3 and 4, rats were treated with 6 (group 3, n=7) or 20 (group 4, n=7) mg/kg Lacosamide IP twice a day. For each group, brain samples were collected 72 hours after injury. Brain samples and blood were evaluated with histopathological and biochemical methods. In addition, electroencephalograpy monitoring results were compared. Results: The immunoreactivity of both iNOS and eNOS (oxidative stress markers) were decreased with LCM treatment compared to trauma group. The results were statistically significant (*** P<0.001). The treatments of low (56,17 +/- 9,69) and high-dose LCM (43,91 +/- 9,09) were decreased the distribution of HIF-1 alpha compared to trauma group (P<0.01). The number of apoptotic cells were decreased with LCM treatment the difference between the trauma group and 20mg/kg LCM treated group (9,55 +/- 1,02) was statistically significant (***P<0.001). Malondialdehyde level was reduced with LCM treatment. MDA level was significantly higher in trauma group compared to LCM treated groups (*** P<0.001). The level of Superoxide dismutase in the trauma group was 1,86 U/ml, whereas it was 36,85 U/ml in 20mg/kg LCM treated group (*** P<0.001). Delta strength of EEG in 20mg/kg LCM treated group were similar to control group values after LCM treatment. Conclusion: No existing study has produced results suggesting that different doses of LCM has therapeutic effect against TBI, using EEG recording in addition to histological and biochemical evaluations in rats. (C) 2021 Elsevier Ltd. All rights reserved.Item Inhibiting effect of oleocanthal on neuroblastoma cancer cell proliferation in cultureÜnsal, ÜÜ; Mete, M; Aydemir, I; Duransoy, YK; Umur, AS; Tuglu, MIWe investigated the potential anticancer effects of oleocanthal (OC) on neuroblastoma cells. Cells were divided into four groups: group 1, neuroblastoma cells were treated with OC; group 2, neurons that differentiated from neuroblastoma cells were treated with phosphate-buffered saline(PBS); group 3, bone marrow derived neuronal (BMDN) cells that were differentiated from bone marrow derived mesenchymal stem cells (BMSCs) were treated with OC; group 4, BMDN cells that were differentiated from BMSCs were treated with PBS. Groups 2 and 4 were control groups. The effects of OC on cell viability, oxidative stress, neurite inhibition and apoptosis at IC50 dose were investigated using MTT analysis, i-NOS and e-NOS measurement, neurotoxicity screening test (NST) and TUNEL staining, respectively. MTT analysis demonstrated that cells were significantly less viable in group 1 than in group 3. i-NOS and e-NOS staining intensity was significantly greater in group 1 than in group 3. NST revealed that OC inhibited neurite growth in both neuroblastoma and BMND cells; inhibition was significantly less in group 3 than in group 1. Significantly more TUNEL labeled cells were found in group 1 than in group 3. We found that OC prevented growth and proliferation of neuroblastoma cells in culture by increasing oxidative stress and apoptosis. We also found that the cytotoxicity of OC is negligible in BMDN cells.Item Intracranial hydatid cyst is a rare cause of midbrain herniation: A case report and literature reviewDuransoy, YK; Mete, M; Barutçuoglu, M; Ünsal, ÜÜ; Selcuki, MHydatid disease is a parasitic infection affecting the brain in about 2% of the cases. Brain involvement is most commonly observed in children. Here, we report a 13-year-old male patient who presented with headache, nausea, and vomiting. Before cranial computed tomography (CT) was performed, the patient had generalized epileptic seizures. He was disoriented, and had anisocoria with dilatation of the right pupilla. CT showed a cystic lesion of 10-cm diameter in the right temporoparietal region that had caused a shift of the midline structures to the contralateral side; an urgent operation was performed as there were signs of midbrain herniation.Item Isolated Solitary Intramedullary Spinal Cord Metastasis Presenting as the First Manifestation of Small-Cell Lung Cancer: Report of a Rare CaseDuransoy, YK; Mete, M; Selçuki, M; Isisag, ABackground. Intramedullary spinal cord metastases presenting as the first manifestation of malignancies are extremely rare lesions. Case Description. The authors report a 74-year-old woman who presented with an isolated intramedullary spinal cord metastasis which presents as first manifestation of malignancy without central nervous system and/or other organ involvement. She went under surgery, and after histopathological evaluation, primary focus was determined in lung in positron emission tomography. She is still alive after 9 months since the first diagnosis of primary focus. Conclusion. In patients with solitary intramedullary lesion in the spinal magnetic resonance imaging, whole-body investigation might help for diagnosis of primary focus and approach to treatment.Item The Effects of Fibroblast Growth Factor-2 Blocking on Development of Chick Cervical Vertebra and Relationship with Oxidative Stress and ApoptosisDuransoy, YK; Simsek, T; Öztürk, F; Mete, M; Tuglu, MI; Selçuki, MFibroblast growth factor (FGF) plays a role in the development of bone and cartilage. FGF-2 is a member of this family and blocking of FGF-2 affects the bone development. In this study, effects of FGF-2 blocking on the formation of vertebrae in chick embryos before ossifications and orientation of cervical vertebrae were investigated with histological examinations. In this study, anti-FGF-2 was performed to chick embryos at E4th and E10th days. Samples were taken in E15th days and changes in the cervical spine were evaluated as histochemically (with hematoxylin-eosin, Alizarin red, Masson's trichrome staining) and immunohistochemically (with iNOS, eNOS and TUNEL). Also changings were evaluated by morphometric analysis. In macroscopic examination of the cervical vertebrae significant difference was not detected. But in histochemical staining, defects were observed in cartilage and ossification process. Increasing in oxidative stress was demonstrated by iNOS and eNOS. Also apoptosis which was represented by tunnel was found to be increased. FGF-2 blocking affects the ossification process in the cervical spine by inducing oxidative stress and apoptosis which results with cell death.Item Neuroprotective effects of bone marrow-derived mesenchymal stem cells and conditioned medium in mechanically injured neuroblastoma cellsMete, M; Aydemir, I; Ünlü Ünsal, Ü; Duransoy, YK; Tuglu, IM; Selçuki, MBackground/aim: Bone marrow-derived mesenchymal stem cells (BMSCs) possess self-renewal characteristics that distinguish them from other cell types. Recent studies have focused on the effects of conditioned medium (CM) that includes the extracellular matrix. Here we examined the neuroprotective effects of BMSCs and CM on damaged neuroblastoma cells. Materials and methods: The cells were divided into five groups: 1) healthy controls, 2) damaged cells alone, 3) damaged cells treated with BMSCs, 4) damaged cells treated with CM, and 5) damaged cells treated with both BMSCs and CM. Neuroprotective effects were then evaluated based upon the levels of oxidative stress, antitransforming growth factor beta 1 (anti-TGF beta 1) production, and apoptosis. Results: Significant differences were observed between healthy controls and damaged cells (P < 0.001), as well as between damaged cells and those treated with BMSCs alone (P < 0.05), CM alone (P < 0.05), and both BMSCs and CM in combination (P < 0.01). Among the treated groups, the strongest neuroprotective effects were seen in cells treated with both BMSCs and CM. Conclusion: These results show that both BMSCs and CM exhibit neuroprotective effects in damaged neuroblastoma cells. The strongest benefits were seen following treatment with both BMSCs and CM.Item Tethered Cord Syndrome in Adults: Experience of 56 PatientsSelcuki, M; Mete, M; Barutcuoglu, M; Duransoy, YK; Umur, AS; Selcuki, DAIM: The aim of this study was to describe the results of surgery performed in a group of adult patients with tethered cord syndrome with their outcomes. MATERIAL and METHODS: This retrospective study included 56 patients. There were 38 females and 18 males. All patients were older than 18 years. RESULTS: The mean age at referral was 36 years and 1 month. The mean follow-up period was 10 months 27 days. 95% of all patients with back and leg pains improved and 5% remained the same. Three patients with motor deficits remained the same in the postoperative period. Of the 16 patients with urological complaints, 10 improved, 5 unchanged and 1 patient died in the postoperative first day due to pulmonary embolism. CONCLUSION: The syndrome of tethered cord may be a situation to be treated even in the elderly in case of normal level conus medullaris and filum terminale with a normal appearance as well as a low-lying conus and thick filum. To prevent overlooking the diagnosis of tethered cord and/or unnecessary spinal surgeries, the tethered cord syndrome should be remembered in the differential diagnosis list in the presence of back and leg pains, neurological deficits or urological complaints.Item Congenital Dermal Sinus Tract of the Spine: Experience of 16 PatientsMete, M; Umur, AS; Duransoy, YK; Barutçuoglu, M; Umur, N; Gurgen, SG; Selçuki, MCongenital dermal sinus tract is a rare entity which lined by epithelial cells and can end anywhere between subcutaneous planes to thecal sac. These tracts may be accompanied with other pathologies such as lipomyelomeningocele, myelomeningocele, split cord malformation, tethered cord, filum abnormality and inclusion tumors and treatment includes resection of tract with intradural exploration. The authors review their experience with 16 cases. Clinical, radiological appearance and treatment of these lesions discussed with literature review.Item A giant hypertrophy of C5 spinous process in Klippel-Feil syndromeMete, M; Ünsal, ÜÜ; Duransoy, YK; Umur, AS; Selçuki, MCongenital cervical spinal anomalies are relatively common and can be seen in upper and lower cervical regions. However, hypertrophy of the lamina and spinous process of cervical vertebra is extremely rare. Here we reported an 11-year-old girl with unilateral hypertrophy of the lamina and spinous process of C5 vertebra coexistence with Klippel-Feil syndrome, occipitalization of atlas and atlantoaxial congenital fusion. Because of cosmetic anomaly patient underwent surgery and spinous process excised. To the best of our knowledge, this coexistence of congenital cervical bony anomalies in a child has not been reported previously in English literature.Item Inappropriate surgical interventions for midline fusion defects cause secondary tethered cord symptoms: implications for natural history report of four casesSelçuki, M; Umur, AS; Duransoy, YK; Ozdemir, S; Selcuki, DThe causes of tethered spinal cord are various. In order to release the tethering effect of these malformations, the surgical interventions must include removal of all tethering components, reconstruction of the neural tube and sectioning of tight filum terminale as well. The cases reported in this paper have had an operation many years before for various developmental defects. After a certain period of time (5-10 years) of the first operation, the patients reapplied to the hospital with various symptoms of spinal cord tethering, either vertical or horizontal. At surgical intervention, it was noted that inappropriate surgical procedures caused retethering of the spinal cord in all patients. Postoperative period of all patients were uneventful. All patients declared relief in their symptoms. We would like to draw attention that untreated (or inappropriately treated) midline developmental defects will invariably cause syndrome of tethered cord. Consequently, prophylactic surgical untethering must be applied to all patients with developmental midline defects as soon as possible. It looks that tethered cord symptoms invariably appear as enough negative influence accumulates as the time passes. Elapsed time may vary but unpleasant end result invariably arrives. While these cases with tethered spinal cord develop progressive neurological symptoms, prophylactic and appropriate surgical intervention should be considered as early as possible. There is no acceptable rationale to wait for the appearance of tethered cord syndrome symptoms to perform surgical untethering of the spinal cord because of the probability of irreversibility of the symptoms (incontinence of urine in particular) of tethered spinal cord syndrome.Item Simultaneous folate intake may prevent advers effect of valproic acid on neurulating nervous systemUmur, AS; Selcuki, M; Bursali, A; Umur, N; Kara, B; Vatansever, HS; Duransoy, YKThe aim of this study is to elucidate the preventive effect of folic acid (FA) on teratogenic effects of valporic acid (VA) in early stage chick embryos on neural tube development. One hundred and fifty specific pathogen-free (SPF) chick eggs were used to investigate the neurulation in five groups. Group A was the control group. Group B was injected 0.02 ml of saline (0.9% NaCl) and was used for sham group. VA (0.72 mg) in 0.02 ml saline was injected in Group C, and 0.342 mcg of FA in 0.02 ml NaCl were administered to the embryos in Group D. VA (0.72 mg) + 0.342 mcg of FA in 0.02 ml saline were administered simultaneously to the eggs in Group E. At the end of 72 h, all embryos were extracted from eggs and were fixed, and for histological analyses hematoxylin and eosine was used, for detection of apoptotic cells terminal deoxyribonucleotide transferase-mediated dUTP-X nick end labeling (TUNEL) was used and for distribution of P53, bcl-2 and caspase-3, caspase-6, caspase-8 and caspase-9 immunoperoxidase techniques were used. While there were no neural tube defects in the embryos of groups A, B and D, eight embryos died in group C and there were 12 embryos with retarded embryological development. In contrast to that, no death was observed in group E, but only eight embryos were detected with maldevelopmental delay stage. These results suggested that VA may induce apoptotic mechanisms but not through the p53 pathway. In addition, FA effectively prevents the teratogenic influence of VA on chick embryo at neurulation stages by stopping cascade of apoptosis before caspase 3 expression.Item Edaravone Leads To Increased Internal Luminal Vascular Circumference Following Subarachnoid Hemorrhage in An Animal Model of VasospasmMete, M; Özer, FD; Duransoy, YK; Kocaman, Ü; Oran, I; Demirtas, E; Selçuki, MPurpose: Cerebral vasospasm is the leading cause of morbidity and mortality following subarachnoid hemorrhage. Although a number of factors have been examined in clinical and experimental studies, the agent(s) responsible for developing and diminishing vasospasm remain poorly understood. Here, the role of edaravone, an antioxidant agent, was evaluated for its ability to diminish vasospasm in an animal model of subarachnoid hemorrhage. Materials and Methods: A rat basilar artery subarachnoid hemorrhage model was used. Rats were divided into three groups: sham (n=7; Group 1), subarachnoid hemorrhage (n=7 Group 2), and subarachnoid hemorrhage plus edaravone (4 mg/kg intraperitoneally, n=7; Group 3). At the end of the seventh day, the rats were sacrificed, their brains were removed, and sections were taken from the basilar artery. These were examined using a light microscope, comparing the internal luminal circumference of the basilar artery of each group. Results: The circumference was largest in Group 1, followed by Group 3 and then Group 2. That of Group 3 was 2% higher than that of Group 2, but this difference was not statistically significant. Conclusion: This animal model for vasospasm suggests that edaravone helps enlarge internal luminal circumference following vasospasm caused by subarachnoid hemorrhage. It may do this by blocking lipid peroxidation and thereby reducing the effects of oxyhemoglobin and reactive oxygen species.Item Neuroprotective Effects of Oleocanthal, a Compound in Virgin Olive Oil, in a Rat Model of Traumatic Brain InjuryMete, M; Aydemir, I; Unsal, UU; Collu, F; Vatandas, G; Gurcu, B; Duransoy, YK; Taneli, F; Tuglu, MI; Selcuki, MAIM: To evaluate the neuroprotective effects of deocanthal OC in a rat model of traumatic brain injury (TBI). MATERIAL and METHODS: Twenty-six adult male, Wistar albino rats were used. The rats were divided into 4 groups. Group 1 was the sham group (n=5). Group 2 was the trauma group (n=5) where rats were treated with 10 mg/kg saline intraperitoneally (IP) twice a day. Groups 3 and 4, rats were treated with 10 (group 3, n=8) or 30 (group 4, n=8) mg/kg OC IP twice a day. For each group, brain samples were collected 72 hours after injury. Brain samples and blood were evaluated with histopathological and biochemical methods. RESULTS: Histopathological evaluation revealed a significant difference between Group 2 and Group 4. Biochemical findings demonstrated that the oxidative stress index was highest in Group 2 and lowest in Group 4. CONCLUSION: OC has a protective effect on neural cells after TBI. This effect is achieved by reducing oxidative stress and apoptosis.Item Anterior odontoid screw fixation using Acutrak screw: Report of 19 patientsDuransoy, YK; Mete, M; Ünsal, ÜÜ; Aydin, M; Zileli, MBACKGROUND: This paper aims to present clinical and radiological results of patients who underwent anterior odontoid screw fixation (AOSF). METHODS: In this study, 19 consecutive patients with an unstable odontoid fracture were operated on using an Acutrak screw. RESULTS: The patients were followed for a mean duration of 12.5 months. Radiological fusion on CT scans was detected in 87.5% of the patients. CONCLUSION: Acutrak screws can be used for AOSF. This study contains the maximum number of patients using the Acutrak screw in the literature. However, larger prospective clinical studies can provide more accurate information about the effectiveness of the Acutrak screws for odontoid fractures.Item Neurotoxic effect of povidone-iodine on the rat spine using a laminectomy-durotomy modelAkcay, E; Ersahin, Y; Ozer, F; Duransoy, YK; Camlar, M; Atci, I; Yagci, A; Ozer, OObjective The efficacy and safety of povidone-iodine in wound dressing and irrigation of some operative cavities were established by many in vitro and in vivo experimental reports and clinical series. However, its use in defective tissue in neural structures has not been confirmed yet. The aim of the present study was to histopathologically investigate its effect on neural tissues when applied on the upper side of defective dura. Methods Wistar rats were randomly divided into two experimental groups: control and povidone-iodine groups. In the control group, durotomy was performed following laminectomy, and the spinal cord was covered with a dry sponge. In the study group, the same procedure was performed, but open duras were covered with a sponge that had been wetted with 0.1 % povidone-iodine solution. Three weeks after surgery, all experimental animals were sacrificed, and histopathological evaluations were conducted. Results Myelin changes were absent or minimal in all cases of the control group but were present as markedly increased myelin degeneration in nearly all cases in the study group. Axonal degeneration and hypoxic neuronal damage were absent in the control group, whereas they were marked in half of the study group. No statistically significant differences were established in Schwann cell proliferation, venous congestion, and lymphocytic proliferation between the two groups. Conclusions Based on the present study, 0.1 % povidone-iodine solution cannot be recommended for wound dressing for neural structures such as myelomeningocele cases because of possible damage to underlying neural tissues.Item Giant occipital aneurysmal bone cyst caused to hydrocephalus in a childMete, M; Duransoy, YK; Çinar, C; Ovali, G; Temiz, P; Selcuki, MItem A New Guide Tube for Odontoid Screw Fixation for Unstable Odontoid Fractures: Report of 6 Case SeriesDuransoy, YK; Mete, M; Zileli, M; Selcuki, MAIM: We describe a modified form of traditional open surgery with a new guide tube.This guide tube permits anterior screwing of odontoid in a shorter time with a more simple technique as compared to traditional open surgery, endoscopic and percutaneous surgeries. MATERIAL and METHODS: Our series includes 6 patients who were operated for unstable odontoid fracture. We used a new guide tube for anterior odontoid screw fixation. This guide tube was designed by the first author to facilitate the insertion of the K-wire for placement of a cannulated lag screw. RESULTS: Successful placement of the odontoid screws and immediate spinal stabilization were achieved in all patients. Solid fusion was observed during follow-up time in all patients. CONCLUSION: This screw insertion technique for odontoid screw fixation provides a minimally invasive, safe and easy surgery in contrast to other surgical approaches.