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Biomedical subjects

B Açikgöz

Publications and source records attributed to B Açikgöz.

At least 19 recordsLinked to original sources

Neurocutaneous melanosis associated with Dandy-Walker malformation.

Neurocutaneous melanosis is an uncommon congenital disorder consisting of benign or malignant melanocytic tumors of the leptomeninges with large or numerous cutaneous congenital melanocytic nevi. The Dandy-Walker malformation occurs as an enlarged posterior fossa with high insertion of the tentorium, hypoplasia or aplasia of the cerebellar vermis, and cystic dilatation of the fourth ventricle. To our knowledge, the association of these two conditions has been reported only 14 times. In this article, we present a newborn patient with neurocutaneous melanosis associated with Dandy-Walker malformation, which was diagnosed by magnetic resonance imaging.

Dandy-Walker Syndrome↗

Intramedullary spinal cord metastases: diagnosis and treatment - an illustrated review.

BACKGROUND: Intramedullary spinal cord metastases (ISCM) are rare but, with increasing use of magnetic resonance imaging (MRI) are being encountered with increasing frequency. Optimum treatment remains controversial. On the basis of a review of previous reports and experience with a patient with an ISCM from a large cell lung cancer, we propose practical diagnostic and therapeutic approaches. FINDINGS: We found 284 patients who had an Intramedullary spinal cord metastasis reported in English literature up to February 2004. 32 had been treated surgically. The mean survival in these patients was two times longer than in those treated by a conservative approach. Improvement and prolonged survival occurred in patient we treated by microsurgical dissection of the metastasis. CONCLUSION: Early diagnosis and early surgical resection can result in improvement in neurological deficits and in the quality of life of patients with a Intramedullary spinal cord metastasis.

Aged↗

Unilateral cervical facet fracture: presentation of two cases and literature review.

STUDY DESIGN: Two patients with diagnosis of unilateral cervical facet fracture due to motor vehicle accident (MVA) are presented, and the literature is reviewed. OBJECTIVE: To discuss the diagnostic difficulties and management strategies in two patients with post-traumatic cervical facet fracture. SETTING: Department of Neurosurgery, Zonguldak Karaelmas University, Faculty of Medicine, Turkey. SUBJECT: Nonoperative treatment with immobilization was preferred in two female cases (33-34 years old) with diagnosis of C6-7 facet fracture following MVA. Magnetic resonance imaging (MRI) could be performed in acute period in the first case, but not in the second because of inadequate technical condition. RESULT: The first case with a good compliance to immobilization recovered without any neurological complication. However, the second case mobilized earlier and used a collar irregularly. Instability developed in the second case on the second month and surgical intervention with anterior approach was performed. CONCLUSION: The diagnosis of unilateral facet fractures is often missed and the treatment is still controversial. The compliance of the patient to cervical immobilization in nonoperative treatment plays a very important role in the development of late complications. MRI in the acute period may be useful in determining instability.

Adult↗

External ventricular drainage for acute obstructive hydrocephalus developing following spontaneous intracerebral haemorrhages.

There is no consensus in the literature on the effects of the development of hydrocephalus on survival and disability after intracerebral haemorrhage (ICH) and the benefits of external ventricular drainage (EVD). In this open, prospective study, we investigated the clinical courses, radiological findings and outcome scores of 47 consecutive patients who were admitted to our clinic with spontaneous ICH. Hydrocephalus developed in 6 (12.8%) of the 47 patients, and EVD was applied in these 6 cases. In one of the 6 patients, the lesion was additionally excised due to the large cerebellar haematoma. Intraventricular haemorrhage was more common in patients developing hydrocephalus (83.3% vs. 29.3% in patients without hydrocephalus; p<0.05) and the lesions of all the patients were in the proximity of the ventricular system. Hospital mortality and functional outcome were not significantly different between patients with and without hydrocephalus. Our results shown that acute obstructive hydrocephalus should be anticipated if haematoma is near the ventricle or if it is opening to the ventricle. EVD is a life-saving and effective procedure that should be performed in patients who develop hydrocephalus following spontaneous intracerebral haemorrhage.

Adult↗

Giant aneurysm of the proximal (A1) anterior cerebral artery.

BACKGROUND: Aneurysms arising from the proximal (A1) segment of the anterior cerebral artery are quite rare. A giant aneurysm in this location is a true exception. METHOD-FINDINGS: A 66-year-old man who presented with drowsiness and confusion was diagnosed to harbor a giant ovoid (30 x 25 mm) aneurysm originating from the right A1. The aneurysm arose from the mid 3/5th of the artery and there was no neck. There was good cross-flow through the anterior communicating artery. Instead of trapping, the flow through the A1 was maintained by connecting the axis of inflowing A1 and outflowing A1 segments using a fenestrated clip. The sac was finally decompressed. The patient is alive and well 3 years postoperatively with complete resolution of the pre-operative hydrocephalus. INTERPRETATION: A review of the literature revealed 14 such cases. The presentation, management and the outcome of these rarities differ from routine A1 aneurysms or other paraclinoid giant aneurysms and are briefly reviewed.

Aged↗

Angiotensin II receptor content within the circumventricular organs increases after experimental hydrocephalus in rats.

Hydrocephalus is known to cause various endocrinological abnormalities. These abnormalities are either though a direct effect on anterior hypothalamus or pituitary gland. However almost nothing is known about the effects of hydrocephalus on the intrinsic angiotensin system of the brain. The aim of this study is to investigate the effect of hydrocephalus on neurotransmitter-rich circumventricular organ systems. Such an effect was investigated by means of angiotensin receptor content in subfornical organ (SFO), organum vasculosum lamina terminalis (OVLT), area postrema (AP) and the median eminence (ME). Experimental hydrocephalus was created in rats by the intracisternal kaolin injection method as described by Shapiro et al. The receptor content was measured at 4-6 weeks by in-vitro autoradiography method as described by Israel et al. Angiotensin II receptor content in hydrocephalic animals was found to be statistically increased in SFO, OVLT and ME but not in AP when compared with the normal animals. Receptor content was found to have increased by 182.4% at SFO, 76.7% at ME, 7.7% at AP and 22.1% at OVLT after kaolin injection. These findings may indicate the possible role of CVO's on pathological conditions such as hydrocephalus.

Angiotensin II↗

Changes in end-plate vascularity after Nd: YAG laser application to the guinea pig intervertebral disc.

The authors previously have reported the effects of neodymiumyttrium-aluminum-garnet (Nd: YAG) laser on the cartilage end-plates (CEPs) in an animal model. However, there is no experimental study in the literature which specifically addresses the effects of the laser on CEP vascularity. The aim of our study is to investigate the vascular response of the CEP to Nd: YAG laser. In this study, sixteen guinea pigs were used. Experimental intervertebral disc (IVD) degeneration was induced in 12 animals by a ventral disc incision to study the effects of Nd: YAG laser on the CEP of the degenerated IVD from the aspects of pathology and radiology. At 2 months after the experimental annular lesion, the CEP vascular channel counts had increased significantly (p = 0.00) in the cranial CEP to 104%, and to 99% in the caudal CEP. In the early period after laser irradiation the vessel counts from both CEPs decreased due to the extensive damage of Nd: YAG laser on disc tissue (p = 0.00). Accordingly, the value of CEP index and MR signal intensity of the CEPs (cranial and caudal) had decreased one month after laser application. Thereafter, both the CEP vascular channel counts and the MR signal intensity remained relatively constant throughout the course of the experiment, but the value of CEP index had increased to 68% of the normal IVD. From the results of present study, it is evident that laser application had a significant negative influence on the CEP vascularization of the degenerated IVD.

Animals↗

Effect of Nd:YAG laser on experimental disc degeneration. Part I. Biochemical and radiographical analysis.

Intervertebral disc herniation is an important health problem from both the social and economic aspect. It is often accompanied by a decrease in the content of water and proteoglycan (PG). The present study was undertaken to elucidate the effect of neodymium-yttrium-aluminum-garnet (Nd:YAG) laser on degenerated disc tissue. In this study a ventral disc herniation model in guinea pigs was performed to study the effects of ND:YAG laser on degenerated disc with low water and PG content. Effect of ND:YAG laser on degenerated cervical disc tissue is examined from the aspects of biochemistry and radiology. In the acute period water, PG, and collagen content decreased due to the ablative effect of ND:YAG laser on disc tissue. When changes in the degenerated disc in the post-laser chronic period were compared with degenerated disc findings, statistically significant changes could not be be found. From the results of this study, there is no question that the Nd:YAG laser offers many potential benefits, it remains to be proven whether or not this is of real benefit in the treatment of patients with degenerated disc disease.

Analysis of Variance↗

Effect of CO2 laser on spinal epidural fibrosis.

In this study the effect of CO2 laser on spinal epidural fibrosis was examined in 24 guinea pigs which were divided into two groups. The first group was the control group, the second one the CO2 laser group. All animals had laminectomies at 3 levels. Re-exploration was performed three months after the laminectomy. In the second group the same procedure was performed but at the end of the re-exploration, CO2 laser irradiation of the epidural fibrotic tissue was done. The wounds in both groups were closed again. Four months later all animals were sacrificed. For verification and quantification of scar formation (postoperative fibrosis) light microscopic examinations and determination of hydroxyproline were done, using Bergman's spectrophotometric method. The differences which were observed between the two groups were statistically significant (U : 134, P < 0.05). This study demonstrates the reducing effect of CO2 laser irradiation on epidural scar formation. The findings encourage its use as an alternative method of prevention of epidural fibrosis after spinal surgery.

Animals↗

Angiotensin II receptor content within the subfornical organ and organum vasculosum lamina terminalis increases after experimental subarachnoid haemorrhage in rats.

Nests of cells within the central nervous system, namely the circumventricular organs (CVOs) which include the subfornical organ (SFO), organum vasculosum lamina terminalis (OVLT), area postrema (AP) and the median eminence (ME) are known to contain not only receptors for angiotensin II (ANG II) but also ANG II itself. Though the significance of this central ANG II network in the pathophysiology of certain conditions like hypertension is well established, there appears to be a lack of knowledge as to how this system might be involved after subarachnoid haemorrhage (SAH). In this study, we have investigated ANG II receptor content change at various circumventricular organs after experimental subarachnoid haemorrhage in rats using a transcervical transclival model. ANG II receptor content was detected by in vivo autoradiography using intracisternal ANG II Sar 1, Ile 8 labelled with iodine (I) 125 both at 30 minutes and 48 hours after the SAH. Serum angiotensin converting enzyme activity was also detected during the time course reflecting the involvement of the peripheral angiotensin system and showed an early rise and a fall after two days. Immunohistochemistry was utilized to show the ANG II-containing cells within the circumventricular organs. SFO and OVLT were found to have a statistically significant increase in ANG II receptor content persisting over two days after the SAH. These alterations in the receptor content of CVOs may indicate their possible role in delayed ischaemic deficits seen after SAH.

Animals↗

Endoscopic evacuation of sacral hydatid cysts: case report.

A case of hydatid disease of the intra and parasacral area is reported. This rare localization was probably due to previous abdominal hydatid cyst surgery. The patient underwent surgery, with a small opening in the SI lamina and the cysts were removed totally with the aid of a rigid endoscope. The surgical technique used and MRI findings are discussed.

Adolescent↗

Efficacy of high dose amino acid solution on spinal cord injury induced by focal Nd:YAG laser irradiation.

In this experimental study, a neodymium:yttrium-aluminium-garnet (Nd:YAG) laser was used to induce highly reproducible focal spinal cord lesions in anaesthetized guinea pigs. The efficacy of high dose amino acid solution (HDAAS) on this injury is investigated. Experiments were performed on 36 animals divided into three groups; sham operated controls, laser irradiated surgical controls, and amino acid groups. Acute responses to injury were evaluated with somatosensory (SSEP) and motor evoked potentials (MEP) and functional recovery was assessed for 8 weeks using the inclined plane technique. In the laser irradiated surgical control group, MEP disappeared one hour after the laser injury, but SSEP revealed changes of amplitude and latency. In this group, the average value of the inclined plane at 24 hours after the laser application was 45.3 +/- 1.4 degrees. In the amino acid group, at the sixth hour of injury, MEP and SSEP changes improved with infusion of HDAAS for 4 hours. This improvement was statistically significant (for latency of SSEP U = 140 p < 0.05). Inclined plane value at 24 hours after the laser application was 65.5 +/- 1.2 degrees in this group. This study showed that application of Nd:YAG laser irradiation on the spinal cord induced spinal cord injury which presented as paraparesis, HDAAS may provide significant therapeutic protection in secondary damage following this injury and may have a potential role in the treatment of acute spinal cord injury.

Amino Acids↗

The effect of topical CCNU(1-(2-chloroethyl)-3 cyclohexyl 1 nitrosurea) treatment on lipid peroxidation of glial tumours transplanted on rat brain.

1. The effect of topical CCNU treatment on lipid peroxidation of glial tumors transplanted on rat brain has been investigated in 22 rats. 2. Four groups have been selected as normal brain tissue, normal brain tissue+CCNU, tumour tissue, tumour tissue+CCNU. In these groups malondialdehyde (MDA) levels have been measured as a marker of lipid peroxidation. 3. Lipid peroxidation was high in tumour tissue in respect to controls (P < 0.05). In normal tissues topical CCNU treatment caused increase in lipid peroxidation (P < 0.05). In tumor tissues, topical CCNU decreased lipid peroxidation (P < 0.05). It is concluded that further studies have to be performed in order to determine whether increases in lipid peroxidation on CCNU treated normal brain tissues is a result of the inhibitory effect on cellular defence systems or promotion of free radical production.

Administration, Topical↗

A new experimental model: for further investigation of the secondary changes following spinal cord injury.

To investigate the pathophysiology of spinal trauma, several experimental models have been used. In this study, the authors present a new experimental model for further investigation of secondary damage following spinal injury. Nd:YAG laser irradiation was applied to the spinal cord of guinea pigs to produce an injury. A 30 Watt (20 Joule) laser produced paraparesis. The injury was evaluated with evoked potentials, lipid peroxidation values, and histopathological examination.

Animals↗

Topical effect of bromocriptine on rat-transplanted human prolactinomas.

In prolactinoma surgery, especially in macro-adenomas, it is not always possible to remove the tumour totally. Cell remnants may cause a regrowth and continue hypersecretion. In order to find out whether tumour remnants could be destroyed by local application of bromocriptine, a research model has been designed. First, prolactin secreting pituitary tumours, removed during surgery, were implanted bilaterally into the brain tissue of rats. In eight rats, the viability of tumour transplants was proven histopathologically and their prolactin secretion was shown immunocytochemically. In a second step, on eight rats, sterile bromocriptine solution was applied topically to the tumour transplants on one side. The other side served as control. Histopathological examination of these treated tissues revealed fibrosis. Immunocytochemical analysis showed no secretory activity. Ultrastructural investigations also revealed evidence of degeneration of the treated cells. The natural course of the transplanted tumour tissues of the other side, as a control group, was also observed during the same 55-day period.

Animals↗