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Biomedical subjects

C Onal

Publications and source records attributed to C Onal.

17 recordsLinked to original sources

Effect of ticlopidine in the prevention of radiation enteropathy.

Impairment of vascular function is considered to play an important role in chronic radiation enteropathy. In this experimental study, the role of ticlopidine, an inhibitor of ADP-induced platelet aggregation, was investigated in radiation enteropathy. 80 male Wistar albino rats, each weighing 170-200 g, were divided into four groups: (a) radiation alone (n = 20); (b) radiotherapy plus ticlopidine (n = 20); (c) ticlopidine control (n = 20) and (d) control (n = 20). Both radiation groups received 19 Gy radiation to the exteriorized intestinal segments in a single fraction. Ticlopidine or vehicle was administered 12 h after radiotherapy and continued for 1 month. Rats from every group were euthanized randomly at intervals of 6 weeks from 2 weeks to 26 weeks. Histopathological radiation injury was assessed using radiation injury scoring (RIS). Radiation with ticlopidine or radiation alone groups showed significant RIS deterioration compared with controls in all time points studied. Comparison of median RIS of radiotherapy and radiotherapy+ticlopidine groups at the 2nd, 14th and 26th weeks yielded statistically significant RIS in favour of radiotherapy+ticlopidine group (p = 0.05). However, these differences were less pronounced at the 8th and 20th week (p = 0.07). Both radiation groups had poor weight gain when compared with control and ticlopidine groups. The weight gain in radiotherapy+ticlopidine group was significantly superior to only radiation group between 10th and 20th weeks (p = 0.05). This study showed that inhibition of platelet aggregation with ticlopidine might be useful in radiation enteropathy. However, the precise role of antiaggregant therapies on radiation enteropathy should be comprehensively studied before clinical consideration.

Animals↗

A case of frontal lobe abscess as a complication of frontal sinus ossifying fibroma.

Sinonasal ossifying fibroma is a rare, slow-growing, benign bony tumour, frequently involving the maxilla and mandible in the head and neck region. Although it is known to be the second most frequent fibro-osseous tumour of paranasal sinus, to the best of our knowledge, ossifying fibroma of frontal sinus causing brain abscess has not been presented yet in the relevant literature. We present the clinical, pathological and radiological findings of ossifying fibroma of the frontal sinus associated with brain abscess.

Brain Abscess↗

Importance of timing of antiaggregant treatment in the prevention of radiation induced enteropathy.

Chronic radiation enteropathy (CRE) is an undesirable radiation-induced toxicity and a common health problem in patients with pelvic or abdominal malignancies. Damage to microvascular endothelial cells and connective tissue is blamed to cause this adverse effect. It is shown that platelets are the first cellular elements that initiate the homeostatic and inflammatory responses and release of several proinflammatory and fibrinogenic mediators. Antiplatelet agents such as ticlopidine and clopidogrel were shown to prevent CRE and this effect is believed to be directed by their activities against thrombocytes. However, recent studies have shown that these drugs also induce apoptosis in endothelial cells and may lead to decreased expression of endothelial prostacyclin and thrombomodulin (TM) and increased release of von Willebrand factor which are shown to be major contributors of coagulation process. Assuming that radiation induced apoptosis occur 6-10h after irradiation, we think that timing of these antiaggregant drugs with irradiation is important and a 6-10h interval between these may be beneficial to avoid this adverse interaction.

Apoptosis↗

Haemophilus aphrophilus brain abscess in the first decade.

This report presents a case of brain abscess due to Haemophilus aphrophilus in a six-year old boy. He was admitted to our hospital suffering from left-sided weakness. The initial radiological diagnosis was an intracranial abscess. Purulent material was obtained by puncturing the subcortical lesion and the sample was cultured on conventional media. H. aphrophilus was isolated in pure culture, identified according to conventional methods and confirmed by Becton Dickinson Laboratory (BBL) crystal system. After surgical drainage and eight weeks of antibiotic therapy, the neurological findings improved. The presented case is an example of H. aphriphilus causing brain abscess in the first decade without cardiac predisposition and with good outcome.

Brain Abscess↗

An unusual presentation of occult spinal dysraphism.

Occult spinal dysraphism can lead to irreversible neurological complications, early diagnosis and treatment are necessary. It can be suspected from the presence of any cutaneous abnormality. We report a case with bony spur formation on the top of the 5th lumbar vertebra spinose process covered with skin mimicking a meningocel sac. By the help of this bony spur tethered cord could be diagnosed before any neurological deficit.

Bone Diseases↗

Supratentorial hydatid cyst with cerebellar signs: a rare case of diaschisis.

BACKGROUND: Intracranial hydatid disease has a distinct predominance in the pediatric age group and still causes serious problems in endemic areas. CASE REPORT: A 7-year-old girl admitted with a 3-month history of illness involving the main symptoms of ataxic gait, apraxia, headache, and tremor and with positive cerebellar signs and papilledema is presented. RESULTS: Cranial computerized tomography and magnetic resonance imaging revealed a right temporoparietal spherical lesion measuring 50 x 60 x 80 mm, which had a significant mass effect. A preoperative diagnosis of intracranial hydatid cyst was confirmed during the surgical procedure, which allowed removal of the cyst intact. The postoperative course was uneventful. CONCLUSIONS: The aim of this presentation is to emphasize the necessity for considering diaschisis--inhibition of function produced by a focal disturbance in a portion of the brain at some distance from the original site of injury, but anatomically connected with it through fiber tracts. We believe that this case, with a mass lesion in a temporoparietal location and definite clinical manifestations with plentiful cerebellar signs, is a good example of this rare phenomenon.

Atrophy↗

Long-term follow-up and results of thirty pediatric intracranial hydatid cysts: half a century of experience in the Department of Neurosurgery of the School of Medicine at the University of Istanbul (1952-2001).

A series of 30 documented cases of intracranial hydatid cyst out of 33 pediatric and 45 total patients admitted to the Department of Neurosurgery of the School of Medicine at Istanbul University within the years 1952-1996 is presented. The pediatric population consisted of 73% of the series. Twenty patients (66%) are alive and well after a follow-up period of 8-45 years (mean 21.5 years). Six patients (20%) died and 4 (13%) were lost to follow-up. There were 3 early postoperative deaths (10%), 2 being in the pre-CT era. In 4 cases (13%), brain involvement was secondary, and 2 cases (7%) had multiple intracranial hydatid cysts. Age ranged from 4 to 16 years, with a mean of 10.4. There were 5 intraventricular (17%) and 2 (7%) intracranial extradural settlements. No children with posterior fossa hydatid cyst, primary skull hydatidosis or concomitant spinal involvement were detected. One patient (3%) presented with "rhinorrhea" which in fact was a hydatid fluid leak. Preoperative pseudocerebellar syndrome, convulsion and extrapyramidal signs were seen in 6 patients each (20%). Five patients (17%) had permanent visual deficits, 3 being in pre-CT era. Out of 29 patients operated on, hydatid birth with intact cyst removal was achieved in 18 cases (62%), with no other manipulation needed. This rate has increased to 70% in the CT era. Intraoperative accidental rupture occurred in 8 cases (28%), of which 7 were localized frontally or had a frontal involvement (88% of the ruptured cases). Of the patients with intraoperative rupture, 5 are dead (63%) and they were all primary. In contrast, all 3 cases alive with intraoperative rupture are secondary. Three cases were punctured on purpose (10%). Four of the operated patients (14%) required long-term antiepileptic therapy, 3 having no preoperative seizures. Only 1 patient required a shunt (3%). Four cases had recurrence, all with intraoperative cyst rupture (14%). The long-term evaluation of the results yielded an overall mortality rate of 21%. Routine use of CT after the 80s decreased the rate to 14%. With the analysis of 50 years of data, it is strongly concluded that brain involvement in pediatric hydatid disease is a primary process if delayed diagnosis and insufficient treatment of extraneural hydatidosis are prevented.

Adolescent↗

Cavernous hemangioma in a child presenting with hemichorea: response to pimozide.

The case of a 9-year-old boy with hemichorea due to cavernous hemangioma in the left caudate nucleus is presented. To our knowledge, only two children have been reported with hemichorea associated with cavernous hemangioma. Hemichorea in our patient responded to pimozide, a neuroleptic that blocks central nervous system dopaminergic receptors.

Basal Ganglia Diseases↗

An unusual presentation of neurotuberculosis: subdural empyema. Case report.

Tuberculosis continues to be a major public health concern, especially in developing countries. Many types of neurotuberculosis have been described, but there is only one previously reported case of subdural empyema caused by tuberculous bacilli. A 1-year-old boy who had been treated for pulmonary tuberculosis was referred to the authors' institution with a diagnosis of right frontoparietal extraaxial abscess formation. Computerized tomography and magnetic resonance imaging revealed an extraaxial abscess with no evidence of calvarial infection. A craniotomy was performed to drain the pus, which was located subdurally. A polymerase chain reaction test yielded positive results, and histopathological examination revealed caseation. Antituberculous treatment was started after a diagnosis of subdural empyema with related neurotuberculosis had been made. At the end of a 12-month course of medical therapy, the patient was well with no evidence of tuberculosis.

Antitubercular Agents↗

Gliomatosis cerebri with neurofibromatosis: an autopsy-proven case.

Gliomatosis cerebri is a glial neoplastic process that is diffusely distributed through neural structures, whose anatomical configuration remains intact. Among the more than 19,000 cases hospitalized in Istanbul University Istanbul School of Medicine Department of Neurosurgery throughout the past 45 years, only 2 cases were diagnosed as gliomatosis cerebri, 1 by stereotactic ante-mortem diagnosis and the other after autopsy. In this paper, the autopsy-proven case of this rare disease with coexistent neurofibromatosis--the sixth case reported in the literature--is presented.

Adolescent↗

The effect of intraventricular albumin in experimental brain oedema.

Therapy for vasogenic brain oedema (VBE) is still an unsolved problem. Experimental work with the aim of establishing an oncotherapeutic option is presented. VBE is performed by focal freeze injury in rats. Using a stereotactic head holder hypo- or hyperosmolar human serum albumin is administered via the intraventricular route. The goal is to enhance the migration of oedema fluid with the aid of oncotic pressures. Early and late results are obtained for each group respectively four and twenty-four hours after the infliction of cold injury. The efficacy of therapy is evaluated by cerebrospinal fluid (CSF) osmolality, cerebral water content, tissue specific gravity, and blood-brain barrier (BBB) permeability. Posttherapeutic values for CSF osmolality are obtained by cisterna magna puncture. Hyperosmolar CSF after performance of cold injury (p < 0.05) is thought to be a result of fluid accumulation in the traumatized region partially from the intraventricular space. Posttherapeutic values after hyperosmolar albumin administration have revealed iso-osmolar CSF, increase in specific gravity (p < 0.001), and decrease in BBB permeability (p < 0.05). These results are in accordance with withdrawal of oedema fluid into the ventricles which can be interpreted as a positive therapeutic effect. Late results in hyperosmolar group have disclosed a hypo-iso-osmolar CSF, persistent increase in specific gravity, and no regression. These values have shown that hyperosmolar albumin administration does not interfere with CSF circulation. Early results of hypoosmolar albumin application are discouraging. This preliminary work of a therapeutic trial on VBE may be a basis for future investigations with different dosages and time modalities.

Albumins↗

Three unusual cases of intracranial hydatid cyst in the pediatric age group.

Three unusual cases of hydatid disease with central nervous system involvement are reported in the pediatric age group: a 9-year-old boy with a total number of 12 intracranial secondary hydatid cysts; a 13-year-old girl admitted in areflexia who survived after cyst puncture and successive mass removal, and a 14-year-old boy with a huge intracranial hydatid cyst weighing 770 g which was extracted without rupture. The article discusses the surgical problems, and the related literature is reviewed.

Adolescent↗

A new ventriculocisternal shunt technique in treatment of noncommunicating hydrocephalus: a technical note with a brief discussion of the literature.

Ventriculo-cisternostomy is an established procedure for the treatment of noncommunicating hydrocephalus, if the underlying pathology cannot be removed. In cases in which the foramina of Monro and the proximal part of the third ventricle are obstructed, it is not possible to make a communication between the internal and external CSF-spaces by perforation of the floor of the third ventricle, the so-called third ventriculo-cisternostomy. For such cases the authors describe a new method of drainage of both lateral ventricles to the interpeduncular cistern. This new method has been used successfully in a case with obstructive hydrocephalus of both lateral ventricles, caused by a pilocytic astrocytoma of the optic chiasma and hypothalamus with obstruction of both foramina of Monro.

Astrocytoma↗

A serial CT scan and MRI verification of diffuse cerebrospinal gliomatosis: a case report with stereotactic diagnosis and radiological confirmation.

Gliomatosis cerebri is an infrequent tumor of neuroepithelial origin presenting with deterioration of cognitive functions, behavioral and mental changes, motor weakness, headache, and seizures. Laboratory data are unconclusive. MRI appears to be the imaging modality of choice and mainly reveals a bilateral and diffuse infiltration of midline adjacent brain structures whose anatomical configuration remain intact. MRI- or CT-guided stereotactic biopsy is advised as the diagnostic procedure in suspected cases. A 9-year-old girl with diffuse cerebrospinal gliomatosis, investigated with sequential cranial CT scans, and MRI-verified spinal cord involvement is reported, and the corresponding literature is reviewed.

Biopsy↗

Intracranial extradural hydatid cysts: report of three cases.

Intracranial extradural hydatid cysts are a rare occurrence with unclear pathogenesis. Three different cases are reported and the postoperative courses are discussed. Of the 11 cases found in the literature, all eight cases whose sex and age were reported are men, and seven of the eight are clustered in between the second and fourth decades.

Animals↗

A high-position basilar top aneurysm approached via third ventricle: case report.

The authors report a subfrontal transventricular approach to a high-position basilar top aneurysm considered to be inaccessible by conventional pterional or subtemporal techniques. This special technique may be preferred in the case where a megadolichobasilar artery coexists with such an aneurysm as it has the advantage of protecting the brain from the detrimental effects of strong retraction.

Adult↗