Browsing by Author "Selcuki, M"
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Item Effects of lacosamide a novel antiepileptic drug in the early stages of chicken embryo developmentMete, M; Gurcu, B; Collu, F; Unsal, UU; Duransoy, YK; Tuglu, MI; Selcuki, MIn this study, three different doses of LCM (0.12, 0.5, and 1.60 mg in 0.18 mL) were applied under the embryonic disks of specific pathogen-free Leghorn chicken embryos after a 30-h incubation. Incubation was continued for 80 h, at which time all embryos were evaluated macroscopically and microscopically. There was growth retardation in all of the LCM-treated groups. Major malformations increased in a dose-dependent manner and were mostly observed in the supratherapeutic group. Based on our data, LCM may cause growth retardation or major congenital malformations. Nevertheless, more extensive investigations of its reliability are needed.Item Magnetic-stimulated motor evoked potentials in adult tethered cord syndrome pre-operative and post-operative evaluationSelcuki, D; Sari, US; Selcuki, M; Kisabay, AItem Clinical and histological changes of intrathecally administered gadopentate dimeglumine (Gd-DTPA) in normal ratsMavioglu, H; Tuglu, I; Temiz, C; Ozbilgin, K; Cilaker, S; Selcuki, D; Selcuki, MObjectives: This study is carried out to explore clinical and histological changes induced in rats by intrathecal administration of Gd-DTPA via suboccipital spinal injection. 2.5, 5, 10 mu mol/g-brain of Gd-DTPA were injected intrathecally to 43 adult male rats and sucrose as control solution with same volume and osmolarity were injected to 18 rats. Animals were sacrificed on day 4 and 14. Sections from the cortex, brain stem, cerebellum and medulla spinalis were obtained to examine for cell loss and apoptosis. In this study, no clinical abnormalities were observed in 69.8 % of rats of Gd-DTPA group and in 83.3 % of rats of sucrose group. Transient neurological signs such as ataxia and paresis were seen in 11.6 % of rats in the Gd-DTPA group and in 5.5 % of rats in the sucrose group. They were seen more frequently in the Gd-DTPA group especially in the highest dose and volume. Histological examination did not revealed necrosis or apoptosis in both groups. This study suggests that intrathecally administered Gd-DTPA may be safe in humans when lower doses per gram of brain are used than rats.Item Urinary Incontinence Triggered by Stretching ExercisesSelcuki, D; Selcuki, M; Erturk, ARA 47-year-old female patient who experienced urinary urgency after having stretching exercises of her legs is presented. Stretching of the legs are thought to be responsible for conus medullaris tethering which in turn causes urinary complaints. What is interesting in this case is that her complaints about urinary urgency stopped as she quit stretching exercise movements of her legs. There are some examples of such cases in the literature. The urinary urgency after stretching exercises warned us to investigate this patient in regard to tethered conus medullaris. Tethering of the conus medullaris can be temporary and can cause reversible functional disorders of the bladder. Incontinence at any age should be evaluated cautiously as it could be a sign of an underlying important developmental failure.Item Adult tethered cord syndrome mimicking lumbar disc diseaseUmur, AS; Selcuki, M; Selcuki, D; Bedük, A; Doganay, LObject This paper reports four tethered cord cases who initially applied with lumbar disk disease symptoms. Materials and methods All of them were investigated by magnetic resonance imaging (MRI) and somatosensory evoked potential (SSPE). In two patients, MRI revealed thick and fatty filum terminale, while in remaining two, the filum terminale appeared as normal in thickness. SSEP revealed pathological conduction values in all, and it was the main indicator for surgical sectioning in patients especially with normal MRI investigations. All patients had benefit from the surgical sectioning of the fila terminalia with either thick and fatty or normal appearance. Conclusion A particular patient with lumbar disc disease symptoms having normal MRI should also be investigated for tight filum terminale. If there is no pathological appearance in MRI investigation (both in regard to disc herniation and thick and fatty filum terminale), SSEP investigation should be done to check whether a conduction block or delay is present, indicating cord tethering.Item TGF-βs and SMADs Activities at the Site of Failed Neural Tube in the Human EmbryosBarutcuoglu, M; Umur, AS; Vatansever, HS; Umur, N; Ozbilgin, K; Sayhan, S; Selcuki, MAIM: Transforming growth factor beta (TGF-beta) and Smads control intracellular signaling pathways in neurulation. Although previously reported similar experimental animal studies, the aim of this human study is to investigate the expression of TGF-beta (1,2,3) and Smads (1,2,3,6,7) in aborted human fetuses with myeloschisis. MATERIAL and METHODS: Twelve human fetuses with neural tube defect were obtained. They were stained with antibodies against TGF-beta 1, TGF-beta 2,TGF-beta 3, Smad (1,2,3), Smad 6 and Smad 7 using the indirect immunohistochemical technique. RESULTS: We noted mild immune reactivity of TGF-beta 1 and TGF-beta 2 in the open neural plate, motor neurons and surrounding tissue. Strong immune reactivity of TGF-beta 3 was shown in only open neural plate and surrounding tissue. Immunoreactivity of all Smads noted negative except Smad7. CONCLUSION: These results suggested at the site where the neural tube failed to close, TGF-beta 1,2 and Smads 1,2,3,6 do not continue their activity and decrease with internal timing of embryonic development. Additionally ectodermal layers are considered by embryo asnot closed wound and TGF-beta 3 activity may be an effort to repair the failed closure.Item The Effects of Meloxicam on Neural Tube Development in the Early Stage of Chick EmbryosCetinkal, A; Colak, A; Topuz, K; Demircan, MN; Simsek, H; Berber, U; Umur, AS; Selcuki, M; Vatansever, HSAIM: The aim of this study is to demonstrate the effect of meloxicam in early stage chick embryos on neural tube development. MATERIAL and METHODS: One hundred specific pathogen-free (SPF) chicken eggs were used to investigate the neurulation. SPF eggs were invastigated in four groups (n:25). All of the groups were incubated at 37.2 +/- 0.1 degrees C and 60 +/- 5% relative humidity for 30 hours, and an embryological development in the ninth stage as classified by Hamburger and Hamilton was obtained. In the end of the 30th hour, group A (control group) was administered 0.1 ml of saline (0.9% NaCl) in ovo and the other groups were administered meloxicam in increasing doses. At the end of 72 hours, all of the embryos were extracted from eggs and they underwent pathological examination with hematoxylin cosine and immuno-histopathological examinations with CD138 and tubulin beta II. RESULTS: While the groups A and B showed no neural tube defects, totally eight defective embryos were detected in the groups C and D (three in group C and five in group D. CONCLUSION: Our results suggested that meloxicam, a nonselective COX inhibitor, caused neural tube closure defects when injected at supratherapeutic doses. However, further studies with larger numbers of subjects are needed for its use in lower doses.Item Patients with urinary incontinence often benefit from surgical detethering of tight filum terminaleSelcuki, M; Ünlü, A; Ugur, HC; Soygür, T; Arikan, N; Selcuki, DWe retrospectively reviewed 77 patients with a tethered spinal cord syndrome to evaluate the results of neurosurgical treatment. The patients were divided into two groups: in group 1 there were 17 patients with primary tethered cord who had normal level conus medullaris (NLCM) and normal thickness filum terminale (NTFT) with urinary incontinence, and group was made up of 60 patients with secondary spinal cord tethering after a previous closure of a midline fusion defect who had a low-lying conus medullaris. Neurological examination, radiography, urodynamic tests and electrophysiological findings confirmed the diagnosis. Conventionally, tethered cord syndrome has been defined as a state in which the conus medullaris is located below the L1-2 disc space. However. in a patient with urinary incontinence and a hyper-reflexive type of neurogenic bladder, in whom the conus medullaris is found to be at the normal level, there may still be cord tethering that is causing the incontinence. In this study the comparison was based on evaluation of the response to treatment and general characteristics of the syndrome in both groups of patients to draw attention to the general approach to this incapacitating maldevelopment.Item Evaluation of the Effects of Mobile Phones on the Neural Tube Development of Chick EmbryosUmur, AS; Yaldiz, C; Bursali, A; Umur, N; Kara, B; Barutcuoglu, M; Vatansever, S; Selcuki, D; Selcuki, MAIM: The objective of this study is to examine the effects of radiation of mobile phones on developing neural tissue of chick embryos. MATERIAL and METHODS: There were 4 study groups. All Groups were placed in equal distance, from the mobile phones. Serial sections were taken from each Group to study the neural tube segments. RESULTS: The TUNEL results were statistically significant (p<0.001) at 30 and 48 hours in the third Group. We found low Bcl-2 levels partly in Group 4 and increased activity in Group 3. Caspase-3 was negative in the 48 and 72 hours in the Control Group, had moderate activity in the third Group 3, weak activity in the 48 hour, and was negative in the 72 hour in other groups. Caspase-9 immunoreactivity was weak in Group 1,2 and 3 at 30 hours and was negative in Group 1 and 4 at 48 and 72 hours. Caspase-9 activity in the third Group was weak in all three stages. CONCLUSION: Electromagnetic radiation emitted by mobile phones caused developmental delay in chick embryos in early period. This finding suggests that the use of mobile phones by pregnant women may pose risks.Item The spontaneous umbilical perforation of the distal end of ventriculoperitoneal shunt - A rare shunt complicationSilav, G; Tun, K; Dolgun, H; Unlu, A; Selcuki, MWe present a case of umbilical perforation of the distal end of ventriculoperitoneal shunt as a rare complication of ventriculoperitoneal shunts including an umbilical abscess and an infection related with ventriculoperitoneal shunt. The ventriculoperitoneal catheter was removed, the umbilical abscess was drained and appropriate medication was employed for infection with successful outcome. Possible factors that might predispose to these complications of ventriculoperitoneal shunting are suggested.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 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 Apoptosis seems to be the major process while surface and neural ectodermal layers detach during neurulationSelcuki, M; Vatansever, S; Umur, AS; Temiz, C; Sayin, MObjective The aim of this study is to demonstrate the process of detaching neural and surface ectodermal layers soon after the neurulation completes. Materials and methods Specific pathogen-free chicken egg embryos were used to investigate the neurulation procedure. Ten eggs were saved as controls. The other ten eggs were opened at the 30th hour of embryo development and cultured with Z-VAD-FMK (peptide caspase inhibitor) to investigate the results of the apoptosis inhibition. Embryos were placed and developed up to 48 h in the culture medium. To detect apoptotic cells between neural and surface dermal layers, immunoreactivity of p53 and terminal uridine deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay were used. Results While the control group shows positive immunoreactivity of p53 and TUNEL-positive apoptotic cells at the site where the neural folds detach from the surface ectoderm, no TUNEL activity and no detachment were detected in the apoptosis-inhibited group. Conclusion As inhibition of apoptosis prevented the detachment of the neural and surface ectodermal layers from each other at the end of the neurulation, inhibition of apoptosis seemed to cause a considerable embryological error accounted for congenital dermal sinus tractus maldevelopment.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 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.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 Surgical outcomes of tethered cord syndrome in patients with normal conus medullaris and filum terminale without urologic symptomsTabanli, A; Akcay, E; Yilmaz, H; Ozdemir, S; Mete, M; Selcuki, MPurposeTethered cord syndrome (TCS) typically presents with urologic symptoms and abnormal imaging findings. However, some patients present with normal conus medullaris level and filum terminale appearance on MRI. This research seeks to assess the intended surgical results in this particular group of TCS patients who do not present with urologic complaints, under the premise that the surgical approach goes a long way in preventing the onset of urologic abnormalities.MethodsThis retrospective study included 59 operated patients with tethered cord syndrome who had a normal level terminating conus medullaris and a normal looking filum terminale without urologic symptoms. Of these patients, 38 were female and 21 were male. All patients underwent somatosensory-evoked potentials (SSEPs), and magnetic resonance imaging (MRI). The surgical technique used was flavotomy, which involves cutting the filum terminale without performing a laminectomy.ResultsThe study population had a mean age of 22.5 years (SD = 13.2). During the mean postoperative follow-up period of 2.5 years, none of the patients developed urinary incontinence. Preoperative SSEP abnormalities included conduction block in 39 patients (66.1%), low amplitude in 12 patients (20.3%), and delayed N22 wave latency in 8 patients (13.5%). The surgical procedures were completed without morbidity or mortality, and all patients showed significant postoperative improvement in SSEP parameters.ConclusionOur results indicate that even though the filum terminale might have a normal looking MRI, TCS can also occur due to some potential microscopic or structural abnormality. The study proves SSEP to be useful in TCS diagnosis and it also proposes that if surgery is done early before any urologic complaints arise, chances of their onset will be minimized. Such findings support the view that surgical measures should be entertained in symptomatic patients with abnormal SSEP but normal MRI.