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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...

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.

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).

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 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.