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WOS: 000457047700003, PubMed ID: 30686013, AIM: The objective of this study was to determine the neuroprotective effects of 2-aminoethyl diphenyl-borinate (2-APB) on the brains of rats with experimentally-induced severe acute pancreatitis. MATERIALS AND METHODS: Thirty Spraque-Dawley male rats with an average weight of 200-250 grams were randomly divided into three groups. Group 1: Sham group, Group 2: Severe acute pancreatitis group, Group 3: Treatment group with severe acute pancreatitis, given 2 mg/kg 2-APB before pancreatitis onset. In Groups 2 and 3, severe acute pancreatitis was induced by intraperitoneal administration of 1.5 g/kg L-arginine with a 1-hour interval. Tumor necrosis factor-a, interleukin 6, pancreatic amylase were all measured. Brain tissue samples were evaluated histopathologically. TUNEL staining method was used to visualize apoptotic cells. RESULTS: In Group 3, it was determined that the density of TUNEL-positive cells in the cerebral cortex has decreased, while the number of Bcl-2-positive cells had increased. In Group 3, it was observed that glial aggregation areas were diminished and histopathological changes were decreased as compared to Group 2. In Group 2, on the other hand, it was observed that in areas with glial cell aggregation, the density of TUNEL-positive glial cells had increased, while Bcl-2-positive cell reaction has been feeble. CONCLUSIONS: It was observed that 2-APB decreases neuronal apoptosis and glial cell aggregation.

WOS: 000451638900005, PubMed ID: 30345771, OBJECTIVE: This study aimed to investigate the therapeutic effect of ozone in combination with insulin on cranial and spinal neuropathy in rats with diabetes mellitus (DM). MATERIALS AND METHODS: Sixty adult male Sprague Dawley rats were randomly divided into the following six groups (n = 10): control (C), ozone (O), diabetic (D), ozone-treated diabetic (DO), insulin-treated diabetic (DI), and ozone, insulin-treated diabetic (DOI). DM was induced by a single intraperitoneal (ip) streptozotocin injection (60 mg/kg), followed by 3 IU (ip) insulin administration for 60 days. Next, 1.1 mg/kg (50 mu g/ml) ozone was administered to the O, DO, and DOI groups for 60 days. After inducing diabetes, the total oxidant status (TOS) and total antioxidant status (TAS) were measured; the oxidative stress index (OSI) was calculated. The brain and spinal cord tissues were obtained for histopathological evaluation. This cross sectional study was conducted in Dumlupinar University Laboratory Animals Research Center e.g 11.03.2015 - 15.05.2015. RESULTS: TAS was higher in the DO, DI, and DOI groups than in the D group. TOS and OSI were lower in the DO, DI, and DOI groups than in the D group. Little pathological alterations with degenerated axons and vascular congestion were observed in the DO, DI, and DOI groups compared with the D group. CONCLUSION: Ozone with insulin can stimulate the endogenous antioxidant defense mechanism in diabetic neuropathy, thereby preventing reactive oxygen species-induced damage and protecting against cranial and spinal neuropathies.

Eser, Olcay (Balikesir Author), BACKGROUND: Symptomatic lumbar intervertebral disc herniation (LDH) is rare in children and adolescents. To date, the treatments available for child and adolescent LDH, and the effect of each treatment, have not been fully reviewed. OBJECTIVE: The purpose of this retrospective study is to report the etiology, familial history, presenting symptoms, level of herniation, duration of symptoms, radiological findings, as well as treatment methods and outcome. METHODS: We retrospectively reviewed medical records of all patients with inclusion criteria of being younger than 20 years. (10'19 years); we used magnetic resonance imaging (MRI) to confirm lumbar disc herniations between 2013 and 2016. All patients were followed up for a minimum of 12 months and discharged if they remained almost asymptomatic for 6 months. All patients were treated conservatively and 6 patients they have progressive neurological deficit and persistent back pain, were treated with surgical procedures. The Visual Analogue Scale (VAS), as well as the Oswestry Disability Scale (ODS) and the modified Ashworth Scale (AS) were used to analyze physical examination findings both before and after treatment. To detect lumbar disc degeneration, we used the modified Pfirrmann grading system with MRI. All statistical analyses were performed with commercially available SPSS 15.0 software, while p ≤ 0.05 was considered statistically significant. RESULTS: A total of 70 cases with lumbar disc herniation have been treated. The mean age was 17.14 ± 2.15 years (range 9'19 years). The male to female ratio was 35:35. The mean duration of symptoms was 7.21 ± 1.69 months. The follow-up duration was 17.31 ± 4.17 months. The most common level was L4'5 in 38 (54%) patients and the second was L5-S1 in 24 (34%) patients. Subligamentous protruded discs were found in 42 (60%), extruded in 6 (9%), and disc bulge with intact annulus in 22 (31%) cases. VAS before treatment was 6.05 ± 0.83, while at 6 months after treatment it was 3.1 ± 0.6. However, at the first-year examination, VAS was 2.17 ± 0.76. The ODS was indexed before treatment 42.03 ± 3.75, at 6 months being 25.01 ± 2.75 and at the first year 9.92 ± 2.67. VAS and the OSD were both significantly decreased after treatment (p < 0.05). CONCLUSIONS:Either conservative or surgical methods can be performed comfortably for adolescent lumbar disc herniations. We proposed surgical treatment for patients with incapacitating persistent low back pain or radicular pain that lasted more than 6 weeks, despite rest and medication. We also pursued the development of neurological deficits, including recurrent pain that disturbed routine life activities.

This paper shows an investigation of the expressions of MMP-3,-13 and their polymorphisms in patients with lumbar spinal stenosis (LSS). Hypertrophied LF tissues and peripheral bloods were obtained...

Hydatid cyst (HC) disease is a zoonotic disease caused by the larvae of Echinococcus granulosus. We report our experience of treating HC manifesting aggressive characteristics. Between January, 2010 and December, 2013, 40 patients underwent surgery for HC disease in our department. The subjects of this study were six patients whose disease followed an aggressive and invasive clinical course. The HC disease in these patients involved the vertebrae, chest wall, mediastinum, diaphragm, and lung, with destruction of the lung. There were four men and two women, with a mean age of 47 years (range 12–81 years). Treatment consisted of cystectomy and additional procedures, such as corpectomy and resection of the chest wall, approaching the liver and spleen with phrenotomy and lobectomy. One patient suffered prolonged biliary drainage, and another had a bronchopleural fistula and atelectasis. One patient died of empyema 1 month postoperatively. The mean hospital stay was 9 days. In some patients, HCs can act as an aggressive tumor, involving the surrounding tissues, organs, and even bony structures. Aggressive HCs may cause various sequelae and require extended surgical interventions in addition to cystectomy.

INTRODUCTION Pituitary surgery involving different techniques is often applied to the excision of benign adenomas. Operative interventions involved various approaches and techniques. Endoscopic transsphenoidal approach is the less traumatic route to the sella turcica, avoiding brain retraction, and also permitting good visualization, with lower rates of morbidity and mortality. Although mortality of pituitary surgery decreased by advances in surgical techniques morbidities such as synechiae formation, anosmia, bleeding, nasal septal perforations, drying, and incrustation due to traumatization of the nasal structures such as septum, nasal mucosa, and middle concha are the current problems in pituitary surgery. Here, the authors described an endoscopic transseptal subpericondrial hypophysectomy with minimal damage to normal anatomy and physiology and discussed advantages of this technique. METHODS The authors performed endoscopic transseptal subpericondrial hypophysectomy to 2 patients and evaluated intraoperative and postoperative results. RESULTS No complication was noted during surgery or postoperative period with endoscopic transseptal subpericondrial hypophysectomy technique. CONCLUSIONS Endoscopic transseptal subpericondrial hypophysectomy is a safe technique and, requires only a short surgery time and does not require the removal of any physiological tissue or cause any bleeding.

In our study, we evaluated the neuroprotective effects of dexmedetomidine on oxidant–antioxidant systems, pro-inflammatory cytokine TNF-α and number of apoptotic neurons on hippocampus and dentate gyrus after transient global cerebral I/R injury. Eighteen rats divided into 3 groups, equally. Group I rats were used as shams. For group II and III rats, they were prepared for transient global cerebral ischemia using a four-vessel-occlusion model. 5 mL/kg/h 0.9% sodium chloride was infused to the Group II and 3 µg/kg/h/5 ml dexmedetomidine was infused to the Group III for 2 h after I/R injury. The levels of MDA and NO and activities of SOD and CAT were measured in the left hippocampus tissue. The levels of TNF-α concentration were measured in the plasma . The number of apoptotic neurons was counted by TUNNEL method in histological samples of right hippocampus tissue. MDA and NO levels increased in Group II compared with Group I rats ( p = 0.002, p = 0.002, respectively). In group III, MDA and NO levels decreased as compared to Group II ( p = 0.015, p = 0.002, respectively). SOD and CAT activities increased in Group III as compared to Group II rats ( p = 0.002, p = 0.002, respectively). The decrease in TNF-α levels of group III was significant as compared to group II ( p = 0.016). The number of apoptotic neurons in group III was lower than Group II rats. Our study showed that dexmedetomidine has a neuroprotective effect on hippocampus and dentate gyrus of rats after transient global cerebral I/R injury.

Eser, Betül (Balikesir Author), "AIM: It has been proposed that apoptosis is effective on intervertebral disc degeneration. This study is the first study in which both polymorphisms and expressions of apoptotic genes in patients with intervertebral disc degeneration (IVDD) are evaluated together. The aim of our study is to determine whether polymorphisms and expressions of apoptotic genes involved in both pathways are related with grades of IVDD or not. MATERIAL and METHODS: Blood and tissue samples of 100 patients diagnosed with lumbar disc degeneration were collected. Patients were divided into 2 groups according to their radiological degeneration grades; grade 2 (mild), and grade 3 and 4 (severe). Polymorphisms in Fas (rs 2234767), Bcl-2 (rs 1801018) and Bax (rs 4645878) genes were determined with real-time PCR. Expressions of these genes were analyzed immunohistochemically following histological degeneration scoring.RESULTS: Whereas no relationship was found among polymorphisms of Fas and Bax genes and their expressions, we have determined a relationship among GG genotype of Bcl-2 and their expressions. Additionally, the ratio of Bax-positive cells was related with IVDD grades. Moreover, radiological degeneration grades were compatible with histological degeneration scores. CONCLUSION: GG genotype of Bcl-2 gene may influence the level of its expression and may be effective on the development of IVDD. Additionally, expression of Bax gene may be related with different grades of IVDD.", Research Fund of Balikesir University

A 29-year-old female presented with a brain abscess with subdural empyema in the left parafalcine region caused by Finegoldia magna. There was a partial clinical response to surgery and antibiotic therapy. An acute enfarctus developed after abscess drainage surgery in occipital lobe. We think that infarction developed due to transtentorial herniation and with the mass effect of brain abscess. F magna may be detected in many cases like soft tissue infections, septic arthritis, osteomyelitis, endocarditis and necrotizing pneumonia. Actually this is the first report of brain abscess in which F magna was found upon bacterial culture.

WOS: 000384881000005, PubMed: 27323133, The etiology underlying neural tube defects (NTDs) is not fully understood and is believed to involve a complex milieu of genetic and environmental factors. The A1298C polymorphism in the methylenetetrahydropholate reductase gene (MTHFR) has been associated with mild risk for NTDs. In this study, the genotype distribution of the MTHFR gene A1298C polymorphism and the levels of serum homocysteine, vitamin B12, and folate were evaluated in 33 children with NTDs, their mothers, and 46 healthy controls. Genotyping of the A1298C polymorphism was performed by real-time polymerase chain reaction. The A and C allele frequencies in children with NTDs and their mothers were similar to controls (P = 0.160). The 1298AA and 1298CC genotype frequencies (P = 0.551 and 0.062, respectively) in children with NTDs and their mothers did not differ from controls. On the other hand, the 1298AC genotype frequencies in children with NTDs and their mothers were significantly different from controls (P = 0.025). The genotype frequency of 1298AC was lower in children with NTDs than in controls. There was no significant association between clinical distribution of NTDs and 1298AA/AC/CC genotypes (P > 0.05). Serum vitamin B12 levels were higher in children with NTDs than their mothers and controls (P = 0.001). There were no differences among serum homocysteine and folate levels in all groups (P = 0.494 and 0.141, respectively). Both genetic and nutritional factors are important in the etiology of NTDs. Thus, the A1298C polymorphism cannot be regarded as a major risk factor for NTDs., Kocatepe University Scientific Research CommitteeAfyon Kocatepe University [051.TIP.40], Research supported by the Kocatepe University Scientific Research Committee as project number 051.TIP.40. The authors also wish to thank Afyon Kocatepe University's Foreign Language Support Unit for language editing.

Eser, Olcay (Balikesir Author), Femoral nerve palsy seconder to iliacus hematoma has been rarely reported in terms of blood coagulation abnormalities, either from anticoagulant medications or from hemophilia. The clinical symptoms vary from femoral neuropathy to fatal hypovolemic shock with increased used of anticoagulant agents; femoral nerve palsy subsequent to hemorrhage within the iliopsoas muscle has become a frequent clinical problem. In our case, a 73-year-old male patient presented to hospital with left leg pain and weakness. Lumbar magnetic resonance imaging (MRI) and abdomen computed tomography (CT) showed a left-sided iliopsoas hematoma. An extraperitoneal inguinal incision (Gibson incision) was made. The hematoma was superior of the external iliac artery in the iliopsoas muscle. It was nearly 8 cm deep and was drained and evacuated. After the operation, the left leg pain decreased, and the weakness of left leg improved (3/5).

Background: We aimed to demonstrate the positive effects of the serine protease inhibitor aprotinin on neural ischemia-reperfusion injury and apoptosis in a rat model. Methods: There were 18 rats divided into 3 groups: group A (sham, n = 6), group B (ischemia-reperfusion, n = 6), and group C (ischemia-reperfusion + aprotinin, n = 6). The systolic blood pressure of the group B and C rats was decreased to 40% to 50% of the normal level by taking blood from the femoral vein to develop hemorrhagic shock. The blood was retained and given to the remaining group B and C rats for reperfusion 20 minutes after the procedure. In group B, isotonic solution and, in group C, aprotinin was administered to the rats 5 minutes before reperfusion. After the rats were killed, the brain tissue samples were fixed for histopathologic examination. Brain tissue superoxide dismutase, malondialdehyde, and tissue myeloperoxidase level and apoptotic cell analyses were performed in all groups. Results: Superoxide dismutase level decreased from group A to group B and increased from group B to group C (p < 0.05). Malondialdehyde and myeloperoxidase levels and apoptotic cells increased from group A to group B and decreased from group B to group C (p < 0.05). Conclusion: The results suggest that the systemic use of aprotinin in ischemic neural tissue prevents reperfusion injury and also protects the morphologic, functional, and biochemical integrity of the neural tissue.

Background The beneficial effects of avocado/soybean unsaponifiables (ASU) are known as an antiarthritic agent. This experimental study presents the effects of ASU on oxidant/antioxidant systems and the number of apoptotic neurons of hippocampal formation after ischemia and reperfusion. Methods Eighteen rats were divided into three equal groups: group I rats were used as controls; group II rats were fed with standard diet and group III rats were fed with standard diet plus ASU pills for 10 days. One day after electrocauterization of bilateral vertebral arteries for groups II and III, bilateral common carotid arteries were occluded for 30 min and then reperfused for 30 min. After these procedures, rats of all groups were sacrificed. The levels of malondialdehyde (MDA) and nitric oxide (NO) and activities of superoxide dismutase (SOD) and catalase (CAT) were measured in the left hippocampus. The number of apoptotic neurons was counted by Tunel method in histological samples of right hippocampus. Results MDA and NO levels increased in group II compared with group I rats ( p = 0.002, p = 0.015). In group III, MDA and NO levels decreased as compared to group II ( p = 0.041, p = 0.002). SOD and CAT activities increased in group III as compared to group II rats ( p = 0.002, p = 0.002). The number of apoptotic neurons was lower in group III as compared to group II rats. Conclusions The present findings suggest that ASU could decrease oxidative stress and apoptotic changes in ischemic rat hippocampus. Dietary supplementation of ASU may be beneficial to prevent or ameliorate ischemic cerebral vascular disease.

In this study, we aimed to delineate the mode of neuroprotective action of FK-506, and demonstrated that FK-506 could decrease oxidative stress and apoptotic cell death in an in vivo rat model of neural ischemia-reperfusion after hemorrhagic shock. Thirty rats were used as experimental subjects and divided into five equal groups. Group A rats (sham group, n = 6) were anesthetized and craniotomies were performed for collecting brain tissue samples. In group B ischemia-reperfusion (I/R + 1 h, n = 6), group C (I/R + 24 h, n = 6), group D (I/ R + 1 h FK-506, n = 6) and group E (I/R + 24 h FK-506, n = 6), systolic blood pressure of the rats decreased to 40–50% of the normal level via bleeding from the femoral vein. Thus, a hemorrhagic shock and ischemic neural tissue model was formed. The bloodwas retained and given to the remaining animals in groups B, C,Dand E via femoral vein for reperfusion 20 min after the procedure. In group D and E, 1 mg/kg FK-506 in 0.5 ml isotonic solution was administered to the rats 5 min before reperfusion. Group B and D rats were sacrificed after 1 h and group Cand E rats were sacrificed 24 h after reperfusion; the rats were sacrificed via bleeding associated with intracardiac puncture. Craniotomy was also performed in groups B, C, D and E and brain tissue samples were fixed using neutral buffered 10% formaldehyde solution for immunohistopathological examination as in group A. Brain tissue superoxide dismutase (SOD) activities, malondialdehyde (MDA) levels, tissue myeloperoxydase (MPO) activities and apoptotic cell analyses with Apo 2.7 immunohistochemically were also performed in all groups. The result of the study revealed that the SOD activities were lower for groups B (I/R + 1 h) and C (I/ R + 24 h) than for group A (sham group) (p < 0.05). In addition, SOD activities were higher in groups D (I/ R + 1 h FK-506) and E (I/R + 24 h FK-506) than in groups B (I/R + 1 h) and C (I/R + 24 h) (p < 0.05). MDA levels, MPO activities and the number of apoptotic cells were lower in group A (sham group) than in groups B (I/R + 1 h) and C (I/R + 24 h) (p < 0.05). In addition to these MDA levels, MPO activities and the number of apoptotic cells were higher in groups B (I/R + 1 h) and C (I/R + 24 h) as compared to groups D (I/R + 1 h FK-506) and E (I/R + 24 h FK-506) (p < 0.05). The results suggest that the prophylactic use of FK-506 in an in situ ischemic neural tissue may prevent reperfusion injury.

Reactive oxygen species (ROS) have been implicated in the pathogenesis of cerebral injury after ischemia–reperfusion (I/R). Fish n-3 essential fatty acids (EFA), contain eicosapentaenoic acids (EPA) and docosahexoenoic acids (DHA), exhibit antioxidant properties. DHA is an important component of brain membrane phospholipids and is necessary for the continuity of neuronal functions. EPA prevents platelet aggregation and inhibits the conversion of arachidonic acid into thromboxane A 2 and prostaglandins. They have been suggested to be protective agents against neurological and neuropsychiatric disorders. In this study, the neuroprotective effects of fish n-3 EFA on oxidant–antioxidant systems and number of apoptotic neurons of the hippocampal formation (HF) subjected to cerebral I/R injury was investigated in Sprague–Dawley rats. Six rats were used as control (Group I). Cerebral ischemia was produced by occlusion of both the common carotid arteries combined with hypotension for 45 min, followed by reperfusion for 30 min, in rats either on a standard diet (Group II) or a standard diet plus fish n-3 EFA (Marincap ® , 0.4 g/kg/day, by gavage) for 14 days (Group III). At the end of procedures, the rats were sacrificed and their brains were removed immediately. The levels of malonedialdehyde (MDA) and nitric oxide (NO) and activities of superoxide dismutase (SOD) and catalase (CAT) were measured in left HF. In addition, the number of apoptotic neurons was counted by terminal transferase dUTP nick end labelling (TUNEL) assay in histological samples of the right HF. We found that SOD activities and MDA levels increased in Group III rats compared with Group II rats. On the other hand, CAT activities and NO levels were found to be decreased in Group III rats compared with Group II rats. Additionally, the number of apoptotic neurons was lower in Group III in comparison with Group II rats. The present findings suggest that fish n-3 EFA could decrease the oxidative status and apoptotic changes in ischemic rat hippocampal formation. Dietary supplementation of n-3 EFA may be beneficial to preserve or ameliorate ischemic cerebral vascular disease.

Kocatepe University, Faculty of Medicine, Departments of Neurosurgery1, Otorhinolaryngology2 and Pathology2, Afyonkarahisar, Turkey Paranasal sinus osteomas are benign slow growing tumors, occasionally known to cause complications for a long time. Frontobasal extension of paranasal sinus osteoma is an uncommon localization. We present a 20 year-old-man admitted to our clinic with a complaint of pus drainage and wound from forehead for 2 weeks. The radiological images of the patient revealed a mass mimicking osteoma and extending into the frontal sinus and frontobasal area with a chronic infection. The patient was initiated antibiotics for 2 weeks and the mass was extirped through the destructed anterior wall of frontal sinus. The histopathological diagnosis was osteoma and the patient was discharged uneventfully at the 7th day after the operation

It is important to define the dural sinuses during assessment of the clinical presentations in neurosurgery and neurology and especially before performing surgical interventions involving the brain. Variations of dural sinuses are frequently seen in confluence of the sinuses. In our case, cranial venous MRI angiography of a 49-year-old male patient demonstrated that the superior sagittal sinus bifurcated near sutura lambdoidea of the cranium. These coursed as two separate branches and drained into the transverse sinus without forming the confluence of the sinuses. Sinus rectus joined to the left transverse sinus. We think that this unusual variation which was not reported before will contribute to the assessment of the neurologic presentations and also to the surgical interventions, Nöroşirürji ve nöroloji ve özellikle beyin ile ilgili cerrahi müdahaleler öncesindeki klinik değerlendirmede, dural sinüsleri tanımlamak önemlidir. Dural sinüs varyasyonları, confluens sinuum içinde sık olarak görülür. Olgumuzda, 49 yaşındaki erkek hastanın çekilen kraniyal venöz MR anjiyografisinde süperior sagittal sinüs, kafatasındaki sutura lambdoidea hizasında çatallaştığı gösterilmektedir. Bunlar, iki ayrı dal şeklinde ve confluens sinuum’u oluşturmadan transvers sinüs’e drene olmaktadır. Sinüs rektus, sol transvers sinüs’e katılmaktadır. Biz, daha önce bildirilmemiş bu sıradışı varyasyonun, nörolojik prezentasyonlar ve de cerrahi müdahaleleri değerlendirmede katkı sağlayacağı düşüncesindeyiz

Objective: In this article our aim was to emphasize the possibility of development of epidural abscess after repeated injections in a patient into the spinal epidural space. Methods: Lumbar magnetic resonance imaging (MRI) was performed due to worsening of low back pain, inability to walk, fever and sweating. Surgical drainage of the abscess was carried out by bilateral L5 hemi-partial laminectomy. Antibiotic therapy was recommended for two months and neurological examination was normal after 6 months. Results: Two months after repeated injections, the patient was admitted to our clinic with the complaint of low back pain, inability to walk, fever and fatigue. T2-weighted magnetic resonance (MR) examination of the lumbosacral spine showed spinal epidural abscess at L5-S1 level and concomitant intervertebral discitis. Staphylococcus aureus grew on cultures. Conclusion: The frequent use of invasive procedures into the spinal cord such as epidural injections increases the incidence of abscesses whic...

Eser, Olcay (Balıkesir Author), Trauma is a common cause of pneumocephalus, or air in the cranial cavity, and of pneumorrhachis, or the presence of intraspinal air. After spinal surgery, occurrence of pneumocephalus, especially with pneumorrhachis, is extremely rare. We report the case of a patient who developed pneumocephalus and pneumorrhachis after lumbar disc surgery and pedicle screw fixation. There was no cerebrospinal fluid leakage during surgery. On postoperative day 1, the patient complained of headache, nausea, and dizziness. Brain and lumbar computed tomography scans revealed pneumocephalus and pneumorrhachis. With conservative treatment, the patient's complaints resolved within 10 days., yok

AMAC: Schwannoma 2. en sik periferik sinir tumorudur. Yavas buyuyen selim tumorlerdir. Tamamen spinal kanal icinde ya da kum saati seklinde intervertebral foramenden disari cikarak, nadiren de thorax veya posterior abdominal duvar kitlesi olarak kendini gosterir. Posterior abdominal duvar yerlesimli bir schwannoma olgusu sunuldu.OLGU: 49 yasinda bayan hasta bel ve her iki bacak agrisi sikayetiyle basvurdu. Norolojik muayenesinde laseque (30 degree) +/ -, sag basparmak dorsifleksiyonu 3/5 kas gucu olarak tespit edildi. Cekilen lomber MRI'da sol L5 vertebra korpusu anteriorunda 3x2.5 cm olculerinde duzgun kenarli, belirgin kontrast tutmayan kitle, sag L4-5 prodrude disk hernisi ve L3, L4 seviyesinde spinal dar kanal tespit edildi. Oncelikle kitleye yonelik cerrahi planlandi. GAA supine pozisyonunda, gobek alti median insizyonla katlar gecilerek batina girildi. Explorasyonda sol L5 korpusu anteriorunda, sol iliak arter ve iliak veni anteriora itmis retroperitoneal kitleye ulasildi. Iliak arter ve ven mediale ekarte edilerek kitleye ulasildi. Sinir kilifi acilarak lastik kivamindaki duzgun kenarli kitle total olarak cikarildi. Komplikasyon olmadi. Postoperatif ek bir defisit gozlenmedi. Patoloji sonucu schwannoma olarak rapor edildi. Spinal dar kanal ve lomber disk hernisine yonelik 2. bir operasyon planlanarak hasta taburcu edildi.SONUC: L5 korpusu anteriorunda yerlesmis noronal kaynakli tumorlerde gobek alti median yaklasimi kolay ve cevre anatomik yapilara hakimiyet acisindan guvenli bir yoldur.

Objective: In this study we aimed to investigate the ef­ficacy, long term result and associated complications of Halo Vest treatment for patients with upper cervical spine fractures. Methods: This study included 13 patients (11 men and 2 women) who applied Halo Vest treatment for traumatic upper cervical vertebral fracture between 2006 and 2011. We reviewed the radiological and clinical findings of pa­tients before and after the treatment. Results: Six of 13 patients had odontoid type 3 fracture, 2 patients had odontoid type 2 fracture with C1 type 1 fracture, 2 patients had odontoid type 2 fracture with Jef­ferson fracture, one patient had type 2 hangman fracture and two patients had unclassified C2 corpus fractures. The mean follow-up time with Halo Vest was 14 weeks (10-21 weeks). Ten patients had bone fusion and the mean time of bone fusion was 12 weeks. Conclusions: Halo Vest treatment for upper cervical spine fracture is a safe and effective method but the pa­tients comfort and satisfaction are low. J Clin Exp Invest 2013; 4 (2): 171-174, Amaç: Bu çalışmada üst servikal vertebra fraktürü nede­niyle cerrahi uygulanmayan hastalarda Halo Vest uygu­lamasının etkinliğini, uzun dönem sonuçlarını, eşlik eden komplikasyonlarını ve hasta memnuniyetini araştırdık. Yöntemler: 2006-2011 yılları arasında travma sonrası üst servikal vertebra fraktürü nedeniyle kliniğimizde Halo Vest uygulanan 11\'i erkek 2\'si bayan toplam 13 hasta ça­lışmaya alınmıştır. Hastaların işlem öncesi ve sonrası kli­nik ve radyoljik bulguları da analiz edilmiştir. Bulgular: Halo Vest uygulanan 13 hastanın 6 tanesinde izole odontoid Tip 3 kırığı, 2 tanesinde odontoid Tip 2 ve C1 Tip 1 kırığı, 2 tanesinde odontoid Tip 2 ve Jefferson kırığı, 1 tanesinde Tip 2 asılmış adam kırığı ve 2 tane­sinde de sınıflandırılamayan C2 korpus kırığı mevcuttu. Hastalar Halo Vest immobilizasyon ile ortalama 14 hafta (10-21 hafta) takip edilmiştir. 10 hastada füzyon gelişmiş olup ortalama süre 12 haftaydı. Sonuç: Üst servikal vertebra fraktürlerinde Halo Vest uy­gulaması güvenilir ve etkili bir tedavi yöntemi olmakla bir­likte, hasta konforu ve memnuniyeti düşüktür.

Şimşek, Nejdet (Balikesir Author), PURPOSE: To evaluate the central nervous system toxicity of cisplatin and neuroprotective effect of selenium. METHODS: Twenty-one male Wistar albino rats were divided into three groups: control (C), cisplatin (CS), cisplatin and selenium (CSE, n=7 in each group). Cisplatin (12 mg/kg/day, i.p.) was administered to CS and CSE groups for three days. Furthermore, CSE group received 3mg/kg/day (twice-a-day as 1.5 mg/kg) selenium via oral gavage five days before cisplatin injection and continued for 11 consecutive days. The same volumes of saline were administered to C group intraperitoneally and orally at same time. RESULTS: Heterochromatic and vacuolated neurons and dilated capillary vessels in the brain were observed in the histochemical examinations of cisplatin treated group. Rats that were given a dose of 3mg/kg/day selenium decreased the cisplatin induced histopathological changes in the brain, indicating a protective effect. In addition, cytoplasmic staining of the cell for bcl-2, both cytoplasmic and nuclear staining for bax were determined to be positive in the all groups. Bax positive cells were increased in the CS group compared to C group, in contrast to decreased bcl-2 positivity. CONCLUSION: Selenium limited apototic activity and histological changes due to the cisplatin related central neurotoxicity.

Eser, Olcay (Balikesir Author), Objective : In this study, we aimed to investigate the underlying ethiological factors in chiari malformation (CM) type-I (CMI) via performing volumetric and morphometric length-angle measurements. Methods : A total of 66 individuals [33 patients (20-65 years) with CMI and 33 control subjects] were included in this study. In sagittal MR images, tonsillar herniation length and concurrent anomalies were evaluated. Supratentorial, infratentorial, and total intracranial volumes were measured using Cavalieri method. Various cranial distances and angles were used to evaluate the platybasia and posterior cranial fossa (PCF) development. Results : Tonsillar herniation length was measured 9.09 +/- 3.39 mm below foramen magnum in CM group. Tonsillar herniation/concurrent syringomyelia, concavity/defect of clivus, herniation of bulbus and fourth ventricle, basilar invagination and craniovertebral junction abnormality rates were 30.3, 27, 18, 2, 3, and 3 percent, respectively. Absence of cisterna magna was encountered in 87.9% of the patients. Total, IT and ST volumes and distance between Chamberlain line and tip of dens axis, Klaus index, clivus length, distance between internal occipital protuberance and opisthion were significantly decreased in patient group. Also in patient group, it was found that Welcher basal angle/Boogard angle increased and tentorial slope angle decreased. Conclusion : Mean cranial volume and length-angle measurement values significantly decreased and there was a congenital abnormality association in nearly 81.5 percent of the CM cases. As a result, it was concluded that CM ethiology can be attributed to multifactorial causes. Moreover, congenital defects can also give rise to this condition.

Araknoid kistler, araknoid ile piamater arasinda, araknoid membranin duplikasyonu ile olusan kistlerdir. Spinal ka­nalin ekstradural araknoid kistleri; konjenital veya edinsel olarak gorulen oldukca nadir patolojilerdir. Bu kistler idiyo­patik, posttravmatik ve araknoidit sonrasi gelisebilirler. 32 yasinda erkek hasta bir ay once baslayan idrar retansiyo­nu ve yurume bozuklugu nedeniyle poliklinige muracaat etti. Cekilen Torakal Magnetik Rezonans Goruntulemede Torakal 7-8 hizasinda ekstradural yerlesimli, beyin omuri­lik sivisi ile uyumlu goruntu veren kistik olusum goruldu. Hasta opere edildi. Histopatolojik inceleme sonucunda araknoid kist tanisi konuldu. Olgu cok nadir bir patoloji oldugu icin sunuldu.

The aim of this study is to investigate the putative neuroprotective effect of alpha-lipoic acid (LA) on spinal ischemia/reperfusion (I/R) injury in rabbits.Thirty-five adult female New Zeland rabbits, weighing 2,000-3,500 g (mean: 2,800), were divided randomly into five groups of seven rabbits each (n: 7) as Group 1: sham, only laparotomy; Group 2 (İ/R): I/R; Group 3 (LA): I/R and 100 mg/kg of LA; Group 4 (MP): I/R and 30 mg/kg of methylprednisolone (MP); and Group 5 (LA + MP): I/R and 100 mg/kg of LA plus 30 mg/kg of MP.A statically significant effect of LA, MP, and LA plus MP on lowering malondialdehyde levels both in the blood and in the cerebrospinal fluid (CSF) has been observed. Nitric oxide is significantly decreased in the blood and spinal cord tissues, and also in the CSF but it is not significant. Superoxide dismutase, catalase, and glutathione levels were increased by LA administration.LA exhibits antioxidant efficacy in spinal cord I/R injury, but it cannot decrease the oxidative stress. The histopathological result of the present study also demonstrated that LA has neuroprotective effect in spinal cord injury.

Objective: Posterior dynamic stabilization is an effective alternative to fusion in the treatment of chronic instability and degenerative disc disease (DDD) of the lumbar spine. This study was undertaken to investigate the efficacy of dynamic stabilization in chronic degenerative disc disease with Modic[for full text, please go to the a.m. URL], 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)

The aim of this study was to investigate whether enhanced stimulation voltage could be a predictor of the extent of injury in acute compressive peripheral nerve trauma.The femoral nerves were exposed on both sides, in 11 anesthetized rabbits. Supramaximal stimulation voltage was used to produce a maximal-amplitude compound muscle action potential (CMAP) from the quadriceps femoris muscle. Afterward, the left femoral nerve was clipped for 1 minute, and the right femoral nerve for 5 minutes to produce an acute compressive injury. Immediately after removal of the clip, the proximal and distal sides of the clippage site were stimulated by gradually increased voltage until CMAPs were obtained. The same procedure was repeated at the 30th and 60th minutes. The ratio of the CMAP amplitudes obtained from proximal and distal stimulation was measured to establish a classification.The stimulation voltages and amplitudes of the CMAPs before clippage were similar with the after-clippage values obtained from distal stimulation (p0.05), but the after-clippage values obtained from proximal stimulation were different in both sides (p0.05). Doubled stimulation voltage was enough to obtain CMAPs on the left side, but eightfold the initial level was required on the right side. The amplitude ratios recovered to preinjury levels in all of the subjects on the left side, but only two showed recovery on the right side (p0.001). Histopathologically, there was axonal compression without discontinuity on the left side, whereas the fibers were dispersed on the right side.Stimulation voltage was found to discriminate the severity of the lesion in experimental peripheral nerve injury. Proximal to distal amplitude ratio seems to be a prognostic factor when the injury is less severe.

Tuberculous osteomyelitis of the spine is most commonly seen in lower thoracic and lumbar vertebrae. Cervical spine tuberculosis is a very rare condition, and it represents a very small part of all patients with Pott's disease. We present a case with thoraco-cervical Pott's disease, with left-sided neck mass and left arm and hand weakness and numbness. The patient had a paraspinal abscess under the sternocleidomastoid muscle that was compressing the brachial plexus.

Vertebral arteries form the basilar artery at the pontobulbar junction. The vertebral artery may have dominancy in one of them. The branches of basilar arteries supply blood for the vestibular nuclei and its connections. Vertigo is seen generally in the upper middle aged patients. Vertigo can be observed in dolichoectasia of basilar artery such as angulation and elongation, because of the diminished blood supply and changed hemodynamic factors of vestibular nuclei and its connections. We hypothesized that angulation or elongation of basilar artery can be estimated according to the unilateral vertebral artery dominant hypertensive patients. The basilar artery can angulate from the dominant side of vertebral artery to the recessive side. These angulation and elongation can effect the hemodynamic factors in absence of growing collateral arteries. So, the vertigo attacks may occur in these patients.

A 45-day-old infant presented with a rare case of intracerebral hematoma complicated with brain abscess which developed after vitamin K deficiency. He was admitted to our emergency department with complaints of fever and confusion. Physical, neurological, and laboratory examinations and cranial computed tomography identified vitamin K deficiency and intracerebral hematoma. He started to suffer convulsions. The patient underwent surgery. A brain abscess was discovered with an intracerebral hematoma. The intracerebral hematoma and abscess were evacuated and antibiotic therapy was initiated. Convulsions became rare and were controlled with midozalam administration. Follow-up computed tomography after 6 months showed encephalomalacic changes in the temporoparietal area. If feeding depends only on human milk, the amount of vitamin K prophylaxis given to neonates should be increased to support vitamin K related factors.

We investigated the anti-inflammatory and antiapoptotic effects of interleukin-18 binding protein (IL-18BP) on spinal cord ischemia/reperfusion (I/R) injury in rats. Twenty-one adult male rats were divided into three groups: sham, I/R, and I/R+IL-18BP. Proinflammatory cytokines were determined in rat blood samples by using ELISA, while apoptosis was immunohistochemically evaluated in spinal cord tissue using caspase 3. Both IL-18 and TNF-? were significantly decreased in the IL-18BP group compared to that in the sham group. The highest caspase 3 levels were observed in the I/R group, while the lowest levels were found in the sham group. The mean Tarlov score of the I/R group was significantly lower than that of the sham group. However, the mean Tarlov score of the IL-18BP group was significantly higher than that of the I/R group. The results of the current study demonstrate that IL-18BP plays both anti-inflammatory and antiapoptotic roles in spinal cord I/R injury. © 2014 Springer Science+Business Media.

AIM: The aim of this study is to determine the structural changes of electromagnetic waves in the frontal cortex, brain stem and cerebellum. MATERIAL and METHODS: 24 Wistar Albino adult male rats were randomly divided into four groups: group I consisted of control rats, and groups II-IV comprised electromagnetically irradiated (EMR) with 900, 1800 and 2450 MHz. The heads of the rats were exposed to 900, 1800 and 2450 MHz microwaves irradiation for 1h per day for 2 months. RESULTS: While the histopathological changes in the frontal cortex and brain stem were normal in the control group, there were severe degenerative changes, shrunken cytoplasm and extensively dark pyknotic nuclei in the EMR groups. Biochemical analysis demonstrated that the Total Antioxidative Capacity level was significantly decreased in the EMR groups and also Total Oxidative Capacity and Oxidative Stress Index levels were significantly increased in the frontal cortex, brain stem and cerebellum. IL-1 beta level was significantly increased in the EMR groups in the brain stem. CONCLUSION: EMR causes to structural changes in the frontal cortex, brain stem and cerebellum and impair the oxidative stress and inflammatory cytokine system. This deterioration can cause to disease including loss of these areas function and cancer development. Turkish Neurosurgery Society Scientific Research Committee This study was supported by the Turkish Neurosurgery Society Scientific Research Committee. The authors alone are responsible for the content and writing of the paper.

Eser, Olcay (Balikesir Author), Kronik subdural hematom genellikle erişkin hastalığı olmakla birlikte çocuklarda nadirdir.Bu yazıda 9 yaşında erkek hastada futbol oynarken kafasına top çarpmasına bağlı gelişen araknoid kist ile ilişkili kronik subdural hematom olgusunu sunduk. Mental durum değişikliği veya nörolojik bozukluk gözlenmedi.Tek burr hole ile hematom drenajı yapıldı. Bir hafta sonra, hasta saçlı deride şişlik şikayetiyle kliniğimize başvurdu. Fizik muayenede verteksten başlayan subkütanöz fluktuasyon mevcuttu. Yazarlar kronik subdural hematomun ameliyat sonrası döneminde gelişen nadir bir komplikasyonunu ve araknoid kist ile ilişkili spora bağlı kronik subdural hematom olgusu bildirmektedir., Chronic subdural hematoma is predominantly a disease of the elderly and is rare in children. We report here a rare case of chronic subdural hematoma associated with arachnoid cyst in a 9-year-old child due to ball struck to his head while he was playing football. No altered mental state or focal neurological deficits were observed. The hematoma drainage was performed with one burr-hole. One week later, the patient was admitted to our clinic with complaint of scalp swelling. Physical examination revealed subcutaneous fluctuation beginning from the vertex. The authors reported a case of sports related chronic subdural hematoma in association with arachnoid cyst and a rare complication of subdural hematoma during postoperative period.

bsbd@balikesir.edu.tr www.bau-sbdergisi.com OZET AMAC: Bu calisma yogun bakim unitesine yatarak tedavi goren hastalarin demografik ozelliklerinin ve yogun bakim unitesine kabul kriterlerinin Retrospektif olarak degerlendirilmesi amaciyla yapilmistir. YONTEMLER: Yogun bakim unitesinde Eylul 2009-Aralik 2010 yillari arasinda yatan 15 yas ve uzeri toplam 163 hastanin dosyalari retrospektif incelenerek calismaya alindi. Hastalar 2 gruba ayrildi. Bu 163 hastanin 36 tanesi postoperatif gozlem, 127 tanesi yakin izlem ve tedavi icin yatirilmistir. Yogun bakima kabul edilen hastalarin yas, cinsiyet gibi demografik ozellikleri, tanilari ve uniteye kabul edilis endikasyonlarina gore dagilimlari incelendi. Ayrica Glaskow Koma Skalalari ve mortalite hizlari da incelendi. BULGULAR: 163 hastanin %63,8 erkek, %36,2 kadin idi. 163 hastanin 36 tanesi postoperatif tedavi ve bakim olarak kabul edilen hastalardi. 127 hastanin tanilarina gore; intraserebral hematom %12,5, travmatik servikal fraktur %12,5, intrakranial kitle %11,8, kafa travmasi %32,2, serebellar hematom %2, torako-lomber fraktur %19,6 olarak degerlendirildi. Hastalarin %39,2 entube olarak takip edilirken, %60,8 ekstube olarak takip edildi. Hastalarin %73,6 opere edildi, %26,4 opere olmadi. Hastalarin ortalama Yogun Bakimda kalis suresi 10.5 gundur. SONUC: Yogun bakim unitelerine alinacak hastalarin seciminde belli kriterler olmalidir. Hasta kabulundeki sorunlarin YBU’nin sonuclarini etkileyen, mortaliteyi artiran ve kalis suresini uzatan onemli faktorlerden biri oldugu gorulmektedir.

Diffuse idiopathic skeletal hyperostosis (DISH) is characterized by anterior and lateral ossification of the vertebral body. We present a case report of central cord syndrome in a patient with DISH after minor trauma. The patient was treated surgically. We also discuss symptomatology and the common mechanism of cord injury in DISH.

Osteomlar membranöz kemiklerin yavaş büyüyen benign tümörleridir. Osteomlar kalvaryumun en sık primer benign tümörleridir. Kalvaryum osteomları genellikle dış tabuladan kaynaklanırlar. Asemptomatik lezyonlarda tedavi gerekmemektedir. Kozmetik nedenlerle cerrahi eksizyon yapılabilir. Çalışmamızda 51 yaşında bir erkek hasta temporoparyetal bölgede şişlik nedeniyle opere edildi. Histopatolojik inceleme sonucu osteom tanısı konuldu. Olgu literatür gözden geçirilerek sunuldu., Osteomas are slowly growing benign tumors of membranous bone. Osteomas are the most common primary benign tumors of the calvaria. Osteomas of the calvaria usually arise from the external table. No treatment is required for asymptomatic lesions. Surgical excision is possible for cosmetic reasons. In our study a 51 years-old male patient was operated for swelling in temporoparietal region. Osteoma was diagnosed by histopathological examination. Case was presented with literature review.

Intradural disc herniations, which comprise between 0.1% and .1% of all disc herniations, are very rare [1]. Intraradicular disc erniation was first described in 1984 and only 21 cases have een reported since then [1–6]. This is a rare condition that canot be diagnosed preoperatively and can cause failed back surgery. ntraradicular lumbar disc herniation is generally diagnosed during urgery. In this report, we present the case of a 43-year-old female atient who had severe lower back and left leg pain. Lumbar magetic resonance imaging (MRI) showed an extruded disc fragment ompromising the dural sac at the L1–L2 level. This is the first case f intraradicular lumbar disc herniation at the L1–L2 level to be escribed in the literature.

WOS: 000295823500062, PubMed: 21948754, We investigated a possible association between aggrecan gene polymorphism and lumbar degenerative disc disease in Turkish patients. One hundred 20-30-year-old patients with or without low back pain were selected for the study. Lumbar magnetic resonance imaging was performed on all patients. The patient group had low back pain clinically and degenerative disc disease radiographically. The control group included patients with and without low back pain: all were negative radiographically for degenerative disc disease. Genomic DNA was extracted from all participants. A PCR assay were used to evaluate variable number of tandem repeat polymorphism of aggrecan gene alleles to determine if there was any correlation with degenerative disc disease. Significant associations were found between short repeated alleles of the aggrecan gene and severe disc degeneration. A significant association was also found between short repeated alleles of the aggrecan gene and multilevel disc herniation as well as extrusion and sequestration types of disc herniation. In Turkish population, short repeated alleles of the aggrecan gene are associated with increased disc degeneration and disc herniation., Kocatepe University Scientific Research CommitteeAfyon Kocatepe University [051.TIP.44], The authors thank Murat Acar and Bumin Degirmenci for help with visual assessment of magnetic resonance images. Research supported by the Kocatepe University Scientific Research Committee (Project #051.TIP.44).

We investigated the protective effects of avocado/soybean unsaponifiables (ASU) on the prefrontal cortex (PFC) after global brain ischemia/reperfusion (I/R) injury in rats.Rats were randomly divided into three experimental groups as follows: Group I was control rats, Group II was ischemia rats, Group III was Isch + ASU rats. Brain ischemia was produced via four-vessel occlusion model. These processes followed by reperfusion for 30 min for both II and III groups. Rats were sacrificed and their brains were removed immediately. Malondialdehyde (MDA) and superoxide dismutase (SOD) were measured in left PFC, levels of TNF-α concentration were measured in the plasma. The number of apoptotic neurons was assayed in histological samples of the right PFC.MDA and TNF-α levels as well as the number of apoptotic neurons were observed to have decreased significantly in Group III compared to Group II, while SOD activities have been found to have increased significantly in Group III in comparison to Group II, significantly.We think that ASU might have an antioxidant and neuroprotective effects in brain I/R injured rats.

WOS: 000280396600061, PubMed: 20589617, Association between neural tube defects (NTDs) and C677T polymorphism of the methylenetetrahydrofolate reductase (MTHFR) gene was suspected, because the MTHFR gene codes for a key enzyme in folate metabolism. Its deficiency usually leads to significant reductions in plasma concentrations of folate, vitamin B-12 and methionine, whereas homocysteine levels are increased. We examined folate, vitamin B-12 and homocysteine serum concentrations and polymorphism of the C677T MTHFR gene in Turkish children with neural tube defects. Thirty-three children with NTDs, 26 mothers and 48 healthy individuals were studied. C677T MTHFR polymorphism was determined by melting curve analyses (LightCycler (R)). The levels of folate, vitamin B-12 and homocysteine serum concentrations in NTDs were evaluated and compared, along with information concerning alleles of the MTHFR gene. C677T allele frequencies in NTD children and their mothers were similar to those found in controls. Serum folate and vitamin B-12 concentrations were significantly higher in NTD children than that of controls. Serum homocysteine concentrations were not significantly higher in NTD children and mothers. We concluded that C677T MTHFR gene polymorphism does not affect folic acid, vitamin B-12 and homocysteine metabolism in Turkish children with NTDs. C677T polymorphism of the MTHFR gene cannot be regarded as a major risk factor for NTDs in Turkish children., Afyon Kocatepe University Scientific Research Projects CommissionAfyon Kocatepe University [051.TIP.40], Research supported by the Afyon Kocatepe University Scientific Research Projects Commission (#051.TIP.40).

The aim of this study was to investigate the association between the polymorphisms of the vitamin D receptor (VDR) and aggrecan genes and degenerative disc disease in young Turkish patients. Aggrecan and VDR proteins are the main components of bone and cartilage. In our study, the polymorphisms of the VDR and aggrecan genes were investigated in a total of 300 individuals regarding disc degeneration and herniation. An association was found in the patients having VDR gene TT, Tt, FF, and Ff genotypes with the protrusion type of disc herniation, whereas the patients having tt and ff genotypes were associated with extrusion/sequestration types of the disease. Also, an association was observed between TT and FF genotypes of the VDR gene and mild forms of disc degeneration; and tt, ff, and Ff genotypes and severe forms of the disease. There was also an association between shorter, normal, and longer alleles of the aggrecan gene and a protrusion type of disc herniation. An association was found between short alleles and multilevel and severe disc degeneration, as well as normal and long alleles and mild disc degeneration. This study revealed that the polymorphisms of the VDR and aggrecan genes are associated with disc degeneration and herniation.

The aim of the kyphoplasty method for the treatment of traumatic osteoporotic vertebral compression fractures in geriatric patients is to improve the patient's quality of life. In this report we present two elderly patients who were suffering of traumatic osteoporotic vertebral compression fractures and underwent successful kyphoplasties. Percutaneous kyphoplasty method for the surgical treatment of these fractures decreases the hospitalization, morbidity and mortality in these patients.

This study aimed to investigate the 677CT and 1298AC MTHFR gene polymorphisms and their metabolic effects on the levels of folate, vitamin B12 and homocysteine in the serum of Turkish spina bifida occulta (SBO) patients and healthy individuals in disease.A case-control study was performed to detect 677CT and 1298AC MTHFR gene polymorphisms in 39 SBO patients and 34 healthy individuals. The folate, vitamin B12 and homocysteine concentrations in the serum of SBO and healthy individuals were evaluated and compared with MTHFR gene polymorphisms.677 CC/CT/TT MTHFR genotype frequency differences between the SBO patients and controls were not significant (x(2)=3.325, P=0.068; x(2)=1.479, P=0.224; x(2)=0.275, P=0.600; respectively). 1298AC MTHFR genotype frequency differences between the SBO patients and controls were significant (x(2)=8.477, P=0.004). The frequencies of the Aand C alleles of the 1298AC polymorphism did not differ in a statistically significant manner between the groups (x(2)=0.576, P=0.448). The biochemical parameters were not significantly different between SBO patients and healthy individuals (P0.05).The 677CT and 1298AC polymorphisms of the MTHFR gene cannot be regarded as major risk factors for SBO in the Turkish patients 677TT homozygosity may affect the metabolism of homocysteine.

The aim of this experimental study was to investigate the possible protective effect of dexmedetomidine (DEX) on traumatic spinal cord injury (SCI). Twenty-two New Zealand rabbits were divided into three groups: sham (no drug or operation, n = 6), Control [SCI + single dose of 1 mL saline intraperitoneally (i.p), after trauma; n = 8] and DEX (SCI + 1 microg/kg dexmedetomidine in 1 mL, i.p, after trauma, n = 8). Laminectomy was performed at T10 and balloon angioplasty catheter was applied extradurally. Four and 24 h after surgery, rabbits were evaluated by an independent observer according to the Tarlov scoring system. Blood, cerebrospinal fluid (CSF), tissue samples from spinal cord were taken for biochemical and histopathological evaluations. After 4 h of SCI, all animals in control or DEX treated groups became paraparesic. On the other hand, 24 h after SCI, partial improvements were observed in both control and DEX treated groups. Traumatic SCI leads to increase in the lipid peroxidation and decreases enzymatic or nonenzymatic endogenous antioxidative defense systems. Again, SCI leads to apoptosis in spinal cord. DEX treatment slightly prevented lipid peroxidation and augmented endogenous antioxidative defense systems in CSF or spinal cord tissue, but failed to prevent apoptosis or neurodeficit after traumatic SCI. Therefore, it could be suggested that treatment with dexmedetomidine does not produce beneficial results in SCI.

The aim of this study was to produce an internal carotid artery (ICA) occlusion model in dogs that can be used for studying the effects of surgical revascularization procedures.After left frontoparietal craniectomy, the ICA and arterial circle of the brain were coagulated and transected, letting the middle cerebral artery be perfused by the contralateral ICA by way of the rostral cerebral artery in five mongrel dogs. Magnetic resonance imaging (MRI) and brain single-photon emission computed tomography (SPECT) were performed during the first 24 to 48 hours and 7 to 10 days after the operation. Paired t and Wilcoxon matched pair tests were used for statistics (p0.05).All the dogs had postoperative hemiparesis that returned to normal after 7 to 10 days. Early MRI showed cerebral ischemia in the left parietal cortical area extending to the subcortical white matter, sparing the basal ganglion and the internal capsule. Early brain SPECT demonstrated hypoperfusion corresponding to the same area. This area became significantly restricted to a small cortical area in late MRI and SPECT images (p0.05).It is concluded that, as symptoms resolved spontaneously, this model can be used as a "reversible ischemic neurological deficit" model for diagnostic imaging and pharmacological studies.

Five large myelomeningocele defects repaired by bilateral fasciocutaneous flaps are presented in this article.After the neurological repair, bilateral fasciocutaneous flaps were raised, transposed over the midline, and sutured to each other.All operations lasted shorter than one hour and no major complication was noted in the follow-up. Three of the defects were in the thoracolumbar and two in the lumbosacral regions. The areas of the defects were between 5x6 cm (30 cm2) and 8x10 cm (80 cm2).The bilateral fasciocutaneous flap technique offers a shorter operation duration and lower bleeding rate; it is simple to learn and practice and does not abolish alternative operation techniques.