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Biomedical subjects

B Atalay

Publications and source records attributed to B Atalay.

11 recordsLinked to original sources

Fusiform aneurysm of the superior cerebellar artery: short review article.

Fusiform superior cerebellar artery (SCA) aneurysms are quite rare and only 9 cases have been reported in the literature. Fusiform aneurysms are a small group of cerebral aneurysms among the most difficult to treat. The therapeutic approaches in the limited number cited in the literature include surgery and endovascular occlusion. Surgical techniques which have been used are parent artery occlusion, trapping or body clipping of the bleeding site, and wrapping for fusiform aneurysms. Neurological condition, presence of collateral circulation, type and configuration of the aneurysm, and type of the dissection are important factors that predict the course of fusiform SCA aneurysms. We reviewed the literature on fusiform aneurysm of the SCA and report a further case treated surgically.

Adult↗

Treatment of hydrocephalus with functionally isolated ventricles.

Rapid therapeutic drainage of one lateral ventricle may lead to ipsilateral slit ventricle, and the resultant functional obstruction of cerebrospinal fluid flow through the foramen of Monro may cause dilatation of the contralateral ventricle. Drainage of the lateral ventricle with a low-pressure shunt led to functionally isolated contralateral ventriculomegaly in this report. The patient's condition was complicated by a Candida albicans shunt infection. Following effective treatment of the infection by chemotherapy and removal of the shunt system, the patient was treated by bridging two lateral ventricles with ventricular catheters connected to an Ommaya reservoir. An occipital ventricular catheter was then inserted and connected to a programmable valve to drain the bridged lateral ventricles. Modern centers, caring for patients with infantile hydrocephalus, should have endoscopic facilities available but in cases with extensive ventricular adhesions and in asymmetric hydrocephalus where endoscopic septostomy between the ventricles is impossible our described technique may be used.

Candidiasis↗

Neurosurgical practice at Başkent University, Turkey: a new model.

BACKGROUND: The Turkish Organ Transplantation and Burn Foundation was established in 1980. This was followed by the founding of the Turkish Transplantation and Burn Foundation Hospital in 1985. Under the aegis of this foundation and the Haberal Educational Foundation, Baskent University (BU) was founded in 1993 by Professor Mehmet Haberal, general surgeon and pioneer of organ transplantation in Turkey, and the President of the university since then. METHODS AND FINDINGS: The BU Neurosurgery Department began functioning in January of 1995, with the advancement of the department and with contributions from the other hospitals in cities of Adana, Konya and Alanya. Just 13 years after its foundation, BU became one of the most prestigious universities of the country. While establishing new neurosurgery units within BU health care facilities, the neurosurgeons appointed to the new center spend few months in the neurosurgery department at the BU Ankara Hospital, central hospital, at first in order to get acquainted with the BU medical system. After the new neurosurgery unit begins to operate, senior neurosurgeons from Ankara are called to supervise junior colleagues during major surgical procedures. In addition to these exchanges, residents are sent routinely to these centers as part of the neurosurgical residency programme. As the system is very integrated, neurosurgeons from other centers of the BU also routinely come to Ankara Hospital and Research Center for educational purposes. CONCLUSION: BU as a whole and its health system model in particular are certainly unique in Turkey. The statistical data from all hospitals of the BU reveal growing patient demand and consumer satisfaction.

Academic Medical Centers↗

Sacral kyphoplasty for relieving pain caused by sacral hemangioma.

STUDY DESIGN: Case report describing sacral kyphoplasty in a patient with sacral hemangioma; the first account of this procedure in a sacral hemangioma. OBJECTIVES: To highlight the advantages of sacral kyphoplasty in the treatment of sacral tumors. SETTING: This study is made in Baskent University in Turkey. SUMMARY OF BACKGROUND DATA: Kyphoplasty and sacroplasty are new, minimally invasive techniques that are mostly used for treating osteoporotic vertebral body fractures. These techniques are very effective for achieving rapid pain relief and stabilizing the vertebra, and biopsy collection can be included in the procedure. The latter allows for informed treatment planning in patients with metastatic tumors. METHOD: A 74-year-old woman with known metastatic renal cell carcinoma was investigated for pain in the left sacral region. A tumoral lesion was detected, and sacroplasty was performed at S1. RESULTS: The sacral pain resolved completely after the procedure, and the patient was able to walk without assistance. The pathological diagnosis for the vertebral lesion was hemangioma. CONCLUSIONS: Sacral kyphoplasty is a very effective, minimally invasive surgical procedure. Patients with debilitating diseases such as primary sacral tumors or metastases can be treated by this technique with no significant complications.

Aged↗

Effect of pentoxifylline on endotoxin-induced haemostatic disturbances in rabbits.

Pentoxifylline (PTX, a methylxanthine derivative) has been found to interrupt early gene activation for tumour necrosis factor, interleukin-1, interleukin-6 and tissue factor production and to improve survival from experimental sepsis. During endotoxaemia, lipopolysaccharide (LPS, endotoxin) and proinflammatory cytokines trigger the development of disseminated intravascular coagulation (DIC) via the tissue factor-dependent pathway of coagulation. The present study was undertaken to determine whether pentoxifylline could prevent coagulation disturbances in LPS-treated rabbits. Endotoxaemia was induced with E. coli lipopolysaccharide in New Zealand White rabbits. Forty rabbits were used and divided into four equal groups. Group 1 served as a control group; Group 2: lipopolysaccharide was injected intravenously, Group 3: pentoxifylline was injected intraperitoneally, Group 4: lipopolysaccharide and pentoxifylline were injected simultaneously. Blood samples were collected 6 h after the treatments. In rabbits with endotoxin-induced DIC, platelet count, leukocyte count, percentage of differential leukocyte values, fibrinogen level, antithrombin III (AT-III) and protein C (PC) activity were decreased. Moreover, activated partial thromboplastin time (APTT) and prothrombin time (PT) were prolonged when compared to the control group. In conclusion, haemostatic disturbances associated with endotoxin-induced DIC were moderately suppressed by the administration of PTX.

Animals↗

Early effects of mild brain trauma on the cytoskeletal proteins neurofilament160 and MAP2, and the preventive effects of mexilitine.

OBJECTIVE: The aims were to investigate the early effects of graded, closed, mild head injury on neurofilament protein (NF160) and microtubule-associated protein-2 (MAP2) and to examine the levels of lipid peroxidation and the impact of mexilitine, inhibitor of lipid peroxidation, pretreatment on tissue damage. MATERIAL AND METHOD: One hundred and twenty-six rats were divided into groups as follows: Group 1 (n = 14) were controls; group 2 (n = 56) sustained trauma alone; and group 3 (n = 56) were pretreated with mexilitine (50 mg/kg). Groups 2 and 3 were subdivided into subgroups (n = 14 each), which were subjected to 100 g/cm2, 125 g/cm2, 150 g/cm2, and 175 g/cm2 trauma forces, respectively. Two hours after trauma, the frontal lobes from all groups were removed and processed for lipid peroxidation H&E staining, immunofluorescent labelling of neurofilaments and microtubules with anti-NF160 and anti-MAP2 antibodies. RESULTS: Compared to control findings, all the trauma-only animals showed increased lipid peroxidation levels and the elevations paralleled the amount of force applied. Administration of mexilitine significantly reduced the level of lipid peroxidation. In NF160 stainings, in group 2, the degree of impairment in axonal organization paralleled the different levels of force that were applied. Groups 3C and 3D (mexilitine pretreated) showed well-preserved axons and intact perikarya. In MAP2 stainings group 2 animals showed remarkably less MAP2 staining throughout the sections. There were no significant differences in MAP2 staining intensity or pattern among the group 2 subgroups. In contrast, in the sections from the group 3 animals, the level of MAP2 positivity was markedly preserved. CONCLUSION: In conclusion, our results show that the cytoskeletal proteins we investigated have different capacities for resisting injury, and that MAP2 is more vulnerable to injury than NF160. One of the reason for this cytoskeletal disruption may be increased lipid peroxidation. Inhibition of lipid peroxidation by pre-treatment with 50-mg/kg mexilitine significantly reduces the level of lipid peroxidation and may protect MAP2 and NF160 integrity in closed mild head injury. This protection is inversely proportional to the magnitude of the applied force.

Animals↗

Spontaneous corynebacterium discitis in a patient with chronic renal failure.

STUDY DESIGN: Case report describing spontaneous Corynebacterium diptheria discitis in a patient with chronic renal failure. OBJECTIVES: To describe this very rare form of discitis and the results of surgical and antibiotic therapy. SETTING: University Department of Neurosurgery, Turkey. CASE REPORT: A 55-year-old man with chronic renal failure presented with acute low-back pain. Lumbar magnetic resonance imaging (MRI) suggested discitis and osteomyelitis at the L5-S1 level. The L5-S1 disc was operated upon and the discectomy material was sent for pathological and microbiological analysis. RESULTS: Pathological examination revealed infection and bacterial culture grew C. diptheria. The patient was prescribed combination antibiotic therapy with vancomycin, a third-generation cephalosporin, and rifampicin. Clinical status improved after 8 weeks of therapy. Lumbar MRI revealed remission of the discitis and osteomyelitis after 10 months of follow-up. CONCLUSION: Chronic renal failure patients with low-back pain should be investigated for spinal infection. These individuals are prone to low-grade infection in the form of discitis or osteomyelitis. Corynebacterium subspecies rarely cause spontaneous discitis. This case is interesting because of the unusual causal organism and the occurrence of discitis in the setting of chronic renal failure.

Anti-Bacterial Agents↗

Spontaneous resolution of lumbar vertebral eosinophilic granuloma.

Eosinophilic granuloma (EG) is a rare disease but is more common in adults than children. It's often self-limiting. Spinal involvement is rare. It is the localized and most benign form of Langerhans' cell histiocytosis (previously known as histiocytosis X), characterised by lytic lesions in one or more bones. Spontaneous resolution of vertebral body lesions is very rare. In this case, the patient had one EG in a cervical vertebra and a similar lesion in a lumbar vertebra. This case is important because it featured a symptomatic lesion in the cervical spine accompanied by an asymptomatic lesion in a lumbar vertebra. We treated the cervical lesion by surgical fusion and followed the lumbar lesion up conservatively, with the patient in a corset. After 8 years of follow-up, control MRI showed that the lumbar lesion had spontaneously resolved.

Cervical Vertebrae↗

Lumbar disc herniation and tight hamstrings syndrome in adolescence.

BACKGROUND: Lumbar intervertebral disc herniation is infrequently encountered in children and adolescents. Additional signs and symptoms such as postural deformities and abnormal gait accompany the classical findings of lumbar root irritation. These unusual signs have been described in the literature as "tight hamstrings syndrome". Waddling gait with flexed knees is considered as pathognomonic for this condition and may be masked by the signs of root irritation due to prolapsed intervertebral disc material. CASE REPORT AND DISCUSSION: We report an adolescent patient with lumbar disc herniation in whom gait abnormality and limitation of lumbar movements persisted after surgical intervention. A review of the literature on tight hamstrings is presented.

Adolescent↗

Cervical tuberculous spondylitis associated with systemic lupus erythematosus.

STUDY DESIGN: A case report of cervical tuberculous spondylitis associated with systemic lupus erythematosus (SLE). Infection is a frequent problem in SLE, especially in patients hospitalised with the complications of the disease. Tuberculous spondylitis very rarely occurs in SLE patients, and cervical involvement has not been previously reported. CASE REPORT: A 54-year-old female patient was admitted to our hospital with a complaint of neck pain radiating to her shoulder of 2 months' duration. The neurological examination was completely normal and radiological investigations revealed narrowing, angulation and destruction of the end plates of the 5th and 6th cervical vertebrae. She has received corticosteroid and colchicine treatment for the diagnosis of SLE during the last 10 years. The anterior cervical approach was used and pyogenic material was debrided from the C5-6 intervertebral space, and an otogenous bone graft with a Smith Robinson type fusion was performed. CONCLUSION: High doses of corticosteroids are implicated as a risk factor for infection in SLE patients. Early diagnosis and appropriate medical and surgical treatment, as well as increased awareness of higher susceptibility to opportunistic infections, such as tuberculous spondylitis, are keystones for decreasing morbidity and mortality in patients with SLE.

Adrenal Cortex Hormones↗