Browsing by Author "Mete, M"
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Item Constipation as a Rare Cause of Ventriculoperitoneal Shunt Dysfunction: A Case ReportMete, M; Selçuki, MVentriculoperitoneal shunt (VPS) insertion is a common neurosurgical procedure for the treatment of hydrocephalus. Constipation can play an important role in shunt failure either by mechanically blocking drainage from the peritoneal end of the VPS catheter or by increasing intra-abdominal pressure. The present report describes a 2-year-old boy with shunt-dependent hydrocephalus who presented with signs of shunt dysfunction. Medical history with detailed physical examination determined the constipation. Before shunt revision, a pediatric fleet enema was administered to possibly relieve the constipation and he had good evacuation of the bowel contents. Following the enema, his continuous crying resolved and ultimately disappeared within a few hours. Brain computed tomography scans performed 4 days later showed a reduction in ventricular size.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 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 Punicic Acid Inhibits Glioblastoma Migration and Proliferation via the PI3K/AKT1/mTOR Signaling PathwayMete, M; Unsal, UU; Aydemir, I; Sönmez, PK; Tuglu, MBackground: Punicic Acid (PA) is a polyunsaturated fatty acid that accounts for approximately 70%-80% of Pomegranate Seed Oil (PSO). PA possesses strong antioxidant, anti-inflammatory, anti-atherogenic effects, and anti-tumorigenic properties. Pomegranate extracts have been shown to have anticancer activity in many studies. However, there is no evidence for the effect of PSO on T98 glioblastoma cells. Therefore, the present study was the first to investigate the mechanisms induced by PA on T98 cells, which is one of the major compounds extracted from PSO. Methods: The effects of PA on cell viability; oxidative stress; and migration, proliferation, and apoptosis at the IC50 close were studied. Results: The proliferation and migration were inhibited in the treated group compared to the non-treated group by 9.85 mu l/ml PA. The difference was statistically significant (***p<0.001). Furthermore, PA-induced apoptosis in the T98 glioblastoma cells compared to non-treated group and the difference was statistically significant (***p<0.001). Apoptosis was determined via immunocytochemistry staining of caspase-3, caspase-9 and TUNEL methods. Apoptosis was checked by flow cytometry (using caspase 3 methods) and Scanning Electron Microscopy Analysis. We also investigated the potential signaling pathway underlying this apoptotic effect. The immunocytochemical stainings of PI3K/ Akt-1/ mTOR-1 demonstrated that Akt-1 staining was increased with PA treatment similar to mTOR-1 and PI3K staining (***p<0.001). These increases were statistically significant compared to the non-treated group. Conclusion: PA exhibited exceptional abilities as an anticancer agent against GBM cells. The use of punicic acid in combination with other drugs used in the treatment of glioblastoma may increase the efficacy of the treatment. This study provided a basis for future investigation of its use in preclinical and clinical studies.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 Hemorrhagic Risk in Vestibular Schwannoma Surgeries: Insights and ImplicationsTabanli, A; Yilmaz, H; Akçay, E; Benek, HB; Atci, IB; Mete, MBackground: Vestibular schwannoma is a slow-growing benign tumor arising from the 8th cranial nerve. It can originate in the cerebellopontine angle (CPA). This retrospective study aimed to investigate the factors associated with outcomes following surgical resection of vestibular schwannoma in the CPA in 30 patients at a single center in Turkey, focusing on postoperative intratumoral hemorrhage. Material/Methods: Thirty patients (mean age 42.8 years, range 17-81) underwent vestibular schwannoma surgery via a lateral suboccipital retrosigmoid approach. Patients were categorized as 'less bleeding' (n=15) or 'more bleeding' (n=15) based on the intraoperative nature of the tumor. Demographic characteristics, tumor size, extent of resection, postoperative intratumor bleeding rates, morbidity, and mortality were evaluated. Results: Mean tumor size was significantly larger in highly hemorrhagic tumors (3.8 cm, range 2.1-5 cm) compared with less hemorrhagic tumors (2.1 cm, range 1.8-3 cm) (P<0.001). Total resection was achieved in 60% of patients with highly hemorrhagic tumors >3 cm and chronic diseases, compared with 80% in less hemorrhagic tumors (P=0.02). Postoperative intratumoral hemorrhage occurred in 83.3% of subtotal resections in highly hemorrhagic tumors, versus 6.7% in less hemorrhagic tumors (P<0.001). Conclusions: Larger vestibular schwannoma size is associated with increased hemorrhagic nature, complicating total resection. Subtotal resection in hemorrhagic tumors significantly increases the risk of postoperative bleeding and edema. When possible, total removal should be attempted to minimize complications. In cases requiring subtotal excision, careful postoperative management of coagulation and blood pressure is crucial.Item Effects of alcohol during secondary neurulation in chick embryosMete, M; Aydemir, I; Ünsal, ÜÜ; Özbilgin, K; Tuglu, MI; Gürcü, BObjective: Alcohol continues to be consumed even though its harmful effecs are well established. One of the most common damage of alcohol consumption is fetal alcohol syndrome, characterized by craniofacial anomalies, cardiac anomalies and neural tube defects. Therefore, understanding the molecular mechanisms underlying the alcohol-induced toxicity that occur with time and dose dependent manner is very important., Most of the studies in order to understand the effects of alcohol have been carried out on early neurulation, however its effects on late neurulation are still unknown. Therefore in this study, effects of alcohol on secondary neurulation were investigated in chick embryos. Methods: Leghorn breed of embryonic chicken eggs were used. At 50 h of incubation, 100 mu L 50% ethanol solution was injected. Depending on the period of exposure to alcohol, varying degrees of pathological disorders were detected in E3, E7 and E10 days. Results: Developmental delay, structural abnormalities, morphological abnormalities in the heart and face and especially presence of two spinal cord cavities were found. In addition, we also detected delays in the closure of the neural tube, cellular deformities and the structural abnormalities in notochord. While eNOS, iNOS, and TUNEL levels increased, while laminin levels decreased. Conclusion: In this study during late development, significant alcohol-induced morphological and histopathological changes were observed. We also determined Increased level of oxidative stress caused by alcohol was accompanied with the changes in matrix composition. Better understanding of these mechanisms which affect the cell behavior is important and will allow learning of harmful effects of alcohol.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 Cutting filum terminale is very important in split cord malformation cases to achieve total releaseBarutcuoglu, M; Selcuki, M; Selcuki, D; Umur, S; Mete, M; Gurgen, SG; UmurSplit cord malformations (SCMs) are rare congenital anomalies of the vertebrae and the spinal cord. Tethered cord syndrome (TCS) is a clinical condition of various origins that arises from tension on the spinal cord. Radiographic findings may include and/or associate split cord malformations and the other neural tube defects. However, the spinal cord can even be tethered by a filum terminale with normal appearance and normal level conus medullaris in magnetic resonance imaging (MRI). The aim of our study is to show whether SMC patients with normal or abnormal MRI findings had all histological abnormal filum terminale and also to show that the standard SCM repairing operation without cutting filum will not achieve total release. We have reviewed 33 SCM patients between July 2005 and December 2013. They were operated by adding untethering procedure of filum terminale following standard surgical intervention, and a part of the filum was taken for histopathological examination even though MRI did not show the presence of abnormality of filum terminale. We found that abnormal filum terminale with a normal appearance may had dense collagen fibers, wide and numerous capillaries, and hyaline formation, while normal filum terminale is a mixture of collagen fibers and blood vessels. We did not obtain positive Verhoeff elastic fiber staining. The elastic fibers had disappeared in all fila terminalia, except control cadaver group. Our results showed that all fila of SCM patients had loss of elastic fibers and increased of hyalinization, which means loss of elasticity of filum terminale. Less severe traction may remain asymptomatic in childhood and present with neurological dysfunction later in life. For this reason, surgical procedure of SCM patients including releasing of filum terminale seems more beneficial for the patients and be better for long term.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 Are Herniated Cerebellar Tonsils the Main Culprit of Chiari Malformation Type I Symptoms? The Brainstem Compression Hypothesis seems to be Re-Elucidated and RevisedSelcuki, M; Mete, M; Selcuki, DAIM: The Chiari Malformation I (CM I) and the tethered cord syndrome (TCS) are both congenital abnormalities whose mechanisms are still not fully understood. The association of CM I and TCS has been reported only a few times previously. MATERIAL AND METHODS: This retrospective study included 7 patients who were diagnosed with CM I and TCS, managed by cutting of the filum terminale. RESULTS: The mean follow-up period was 21 months and 28 days. Although all patients underwent an untethering surgical procedure by cutting the filum terminale only, all patients reported significant early postsurgical resolution of CM I symptoms and symptoms related to TCS as well. CONCLUSION: Patients with symptomatic CM I, even if lumbar MRI is normal and the patient asymptomatic for TCS, may have tethered spinal cord at the same time. It seems it would be worthwhile to investigate CM I patients for occult TCS with spinal somatosensory evoked potentials.Item Scoliosis may be the first symptom of the tethered spinal cordBarutçuoglu, M; Selçuki, M; Umur, AS; Mete, M; Gurgen, SG; Selcuki, DBackground: Tethered cord syndrome (TCS) is a progressive clinical entity that arises from abnormal spinal cord tension. Scoliosis may be a unique symptom in TCS. The aim of this study is to investigate prognosis after releasing the filum terminale in scoliosis due to TCS with/without findings in magnetic resonance imaging (MRI) and to draw attention to the importance of somatosensorial evoked potentials (SSEP) on the differential diagnosis of idiopathic scoliosis versus scoliosis due to TCS with normal appearance of filum terminale and conus medullaris. Materials and Methods: Eleven female and seven male patients with progressive scoliosis were included in the study. They were evaluated radiologically, SSEP and urodynamical studies. Preoperative and postoperative anteroposterior full spine X-rays were obtained for measuring the Cobb's angle. MRI was performed in all cases for probable additional spinal abnormalities. All patients underwent filum terminale sectioning through a L5 hemilaminectomy. The resected filum terminale were subjected to histopathological examination. Results: The mean Cobb angle was 31.6 degrees (range 18 degrees u45 degrees). Eight patients (44.45%) had a normal appearance of filum terminale and normal level conus medullaris in MRI, but conduction delay and/or block was seen on SSEP. In the histopathological examination of filum terminale dense collagen fibers, hyaline degeneration and loss of elastic fibers were observed. Postoperatively none of the patients showed worsening of the Cobb angle. Three patients showed improvement of scoliosis. Conclusion: In TCS presented with scoliosis, untethering must be performed prior to the corrective spinal surgery. Absence of MRI findings does not definitely exclude TCS. SSEP is an important additional guidance in the diagnosis of TCS. After untethering, a followup period of 6 months is essential to show it untethering helps in stopping the progress of the scoliotic curve. In spite of non progression (curve stopped lesser than 45 degrees) or even improvement of scoliosis, there may be no need for major orthopedic surgical intervention.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 Role of nitric oxide in the regulation of pain after nociceptive stimuli in rat spinal cordMete, M; Vural, K; Cezayirli, E; Varol, T; Tuglu, MIPurpose: In this study, we examined the responses of the neurons in the lumbar segments of the spinal cord to nociceptive stimuli induced by formalin using c-fos immunohistochemistry and NADPH-d histochemistry Materials and Methods: Thirteen male, Wistar albino rats were used. The rats were divided into 3 groups. Group 1: pain group (n=5). Group 2: sham group (n=5). Group 3: control group (n=3). In group 1, 50 mu l of 30% formalin solution was injected subcutaneously unilaterally on the dorsal surface of the right foot. In group 2, phosphate buffered saline was injected subcutaneously unilaterally on the dorsal surface of the right foot. In group 3, no treatment was given. For each group lumbar spinal cord (SC) samples were taken. Samples were stained with c-fos and NADPH-d histochemistry and c-fos/NADPH-d double-labeling methods and evaluated under light microscope. Results: We noted that cells on spinal cord sections stained with c-fos, NADPH-d and both became prominent with nociceptive stimuli. There were significant increases in the numbers of c-fos (+), NADPH-d (+) and double-labeled cells in pain group comparison to sham group. In group 1, NADPH was significantly increased in the Laminae I-IV of the lumbar segments of the SC on both sides and laminae VIII, IX and X on the same side. Conclusion: The findings suggest that NO is associated with formalin-induced FOS-ir in the spinal cord, that it may play an important role in the regulation of pain and that the nociceptive function is related to increased nitric oxide synthase (+) neurons in the spinal cord.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 Split Cord Malformation Type II Associated With Double Lipoma at The Same Level: Report of a Rare CaseMete, M; Gursoy, G; Umur, AS; Selçuki, MSplit cord malformations are classified as type I and type II and can be associated with lipomyelomeningocele. Although multiple lipoma in different levels at the same patient has been described, combination of SCM with double lipoma at the same level in literature is only once described previously. Herein, authors presented a 12 years old girl who had SCM type II associated with double lipoma at the same level.Item Neurotoxic effects of local anesthetics on the mouse neuroblastoma NB2a cell lineMete, M; Aydemir, I; Tuglu, IM; Selcuki, MLocal anesthetics are used clinically for peripheral nerve blocks, epidural anesthesia, spinal anesthesia and pain management; large concentrations, continuous application and long exposure time can cause neurotoxicity. The mechanism of neurotoxicity caused by local anesthetics is unclear. Neurite outgrowth and apoptosis can be used to evaluate neurotoxic effects. Mouse neuroblastoma cells were induced to differentiate and generate neurites in the presence of local anesthetics. The culture medium was removed and replaced with serum-free medium plus 20 mu l combinations of epidermal growth factor and fibroblast growth factor containing tetracaine, prilocaine, lidocaine or procaine at concentrations of 1, 10, 25, or 100 mu l prior to neurite measurement. Cell viability, iNOS, eNOS and apoptosis were evaluated. Local anesthetics produced toxic effects by neurite inhibition at low concentrations and by apoptosis at high concentrations. There was an inverse relation between local anesthetic concentrations and cell viability. Comparison of different local anesthetics showed toxicity, as assessed by cell viability and apoptotic potency, in the following order: tetracaine > prilocaine > lidocaine > procaine. Procaine was the least neurotoxic local anesthetic and because it is short-acting, may be preferred for pain prevention during short procedures.