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Biomedical subjects

I Ovül

Publications and source records attributed to I Ovül.

12 recordsLinked to original sources

Electrorhinomanometric evaluation of nasal functions in transseptal-transsphenoidal hypophysectomy.

OBJECTIVE: The prospective study in 23 patients, who were undergone transseptal-transsphenoidal hypophysectomy, underlines the rhinologic aspects of this technique. MATERIALS AND METHODS: Preoperative and postoperative subjective complaints were compared, postoperative nasal respiratory functions were evaluated by means of electrohinomanometry. RESULTS: Nasal respiratory functions were preserved postoperatively in the patients with normal preoperative nasal anatomy (no statistical difference); while, in patients with obstructive deviation of the nasal septum, an improvement in nasal respiratory functions were noted as a result of simultaneously performed septoplasty (p < 0.01). CONCLUSION: Our results emphasize the importance of the collaboration of otorhinolaryngology and neurosurgery teams for the sake of postoperative nasal functions.

Adult↗

Nasomaxillary osteotomy in lesions of the central compartment of the middle cranial base.

The pituitary fossa, sphenoid rostrum, sphenoid sinus, nasopharynx, pterygopalatine fossa and clivus are the components of the central compartment of the middle cranial base. It is a surgical challenge to gain access to this region. This fact has led to the development of a number of surgical procedures reported in the literature. However, none of these techniques can provide a wide and direct exposure to the middle cranial fossa without morbidity on its own. In this report, nasomaxillary osteotomy is described as a satisfactory alternative to reach the middle cranial fossa. With the nasomaxillary osteotomy technique, a wide access can be obtained to the central compartment of the skull base, caudally till the inferior clivus and upper cervical vertebrae (C1, C2). Since bilateral, internal carotid arteries are in sight laterally, the technique provides a secure resection of tumors with marked lateral extensions. Repositioning the translocated bone segment, surrounding the apertura piriformis, results in satisfactory cosmesis postoperatively. The technique is discussed on the basis of eight cases with the histopathological diagnosis of squamous cell carcinoma (1 case), olfactory neuroblastoma (2 cases), chordoma (2 cases) and juvenile nasopharyngeal angiofibroma (3 cases). No vascular complication has been encountered. One chordoma patient died of the disease in the follow-up period. All other cases, including one squamous cell carcinoma patient, are alive and disease-free without cosmetic deformity. In conclusion, nasomaxillary osteotomy provides a wide and direct exposure to the central compartment of the skull base in a relatively short period of time, securing the vascular and neural structures. Besides, it offers the advantage that it can be combined with other techniques in extensive tumors, while cosmesis and nasal functions are preserved.

Adolescent↗

Spinal hydatid disease.

Vertebral hydatid cysts are rare and found in less than 1% of all the cases of hydatidosis. Neural compression is common in vertebral hydatidosis. The prognosis is generally regarded as very poor. This paper examines the natural history and complications which may arise during the treatment of vertebral hydatid cyst, and discusses their treatment. Thirteen cases of hydatid disease affecting the vertebrae are presented. The patients were admitted with symptoms of spinal cord compression. Twelve were treated by laminectomy and one by costotransversectomy. Low back pain radiating to the legs and lower extremity weakness were the predominant symptoms. Different degrees of pareses were present in 12 patients. Nine patients had impaired sensation in lower extremities. In 13 patients, 27 operations were performed. The major complication of surgery was the death of one patient due to the formaline irrigation. The surgical goal should be an extensive removal of the cysts and affected bone. The surgical area needs to be irrigated with hypertonic saline. Mebendazole or albendazole therapy seems to retard the recurrences and control the disease.

Adolescent↗

Surgery of intramedullary spinal cord tumors.

The diagnosis and management of intramedullary spinal cord tumors have been significantly influenced by new diagnostic and surgical tools such as MRI, ultrasonic aspiration, intraoperative ultrasound, and evoked potential monitoring. In this study we compared the surgical results of our earlier cases using conventional methods with more recent cases using these new methods. We report our experience based on 44 adult cases. Histologic diagnosis revealed ependymoma (20 cases), astrocytoma (15 cases), glioblastoma multiforme (1 case), and other histologic diagnoses (8 cases). We performed 20 gross total resections, 19 partial resections, and 5 biopsies. The mean follow-up period was 25.8 months (3 months-10 years). Surgical results were improvement in 11 patients (25%), stabilization in 24 (54%), and deterioration in 9 (20%). The first 28 cases (group A) were diagnosed using conventional myelography and CT myelography. The more recent 16 cases (group B) were diagnosed with MRI and operated on using techniques such as ultrasonic aspiration, intraoperative monitoring and ultrasound imaging. Radical surgery (total excision) was performed in 36% (n = 10) of group A, while it was possible in 62% (n = 10) of group B. Deterioration after operation was noted in 28% (n = 8) of group A, but only 6.2% (n = 1) of group B. These results stress the importance of a preoperative MRI scan and the positive effects of intraoperative ultrasound imaging, ultrasonic aspiration, and evoked potential monitoring on surgical results. With the help of these tools, most intramedullary spinal cord tumors may be diagnosed and treated surgically with significantly decreased risk. Radical surgery was possible in as many as 62% of our more recent patients. Partial resection with radiotherapy should be confined to patients with high-grade astrocytomas.

Adult↗

Recurrence of meningiomas versus proliferating cell nuclear antigen (PCNA) positivity and AgNOR counting.

Meningiomas have a wide range of biological potential and clinical behaviour. Histological findings are helpful in recognizing the malignant potential but often fail to correlate with clinical behaviour. This study attempts to correlate the silver nucleolar organizer regions (AgNORs) and proliferating cell nuclear antigen (PCNA) with clinicopathological features of biological activity. Thirty-four completely resected meningiomas were classified as benign [19], atypical [6] and malignant [9]. Forty-eight initial and recurrent tumour materials were investigated for staining of AgNORs and immunohistochemistry using monoclonal antibodies against PCNA (clone 19A2 and PC10). There were no difference between the recurrent and non-recurrent cases with regards to AgNOR, PC10 and 19A2 values. Also, no significant difference was found between the primary and recurrent tumours. Both PC10 and 19A2 labelling indices (LI) showed a significant difference between benign and malignant meningiomas. The 19A2 LI was 0.56 +/- 0.21 in benign and 2.45 +/- 16 in atypical meningiomas. The 19 A2 counts showed significant difference between benign and atypical tumours but PC10 values failed to show such a correlation AgNOR and PCNA indices were not found to be useful in predicting recurrences compared to the surgical procedure and histopathological criteria.

Adolescent↗

A prospective study on acute spinal injuries.

This work examines demographic and clinical characteristics of 163 consecutive cases of acute spinal injuries in a small area of Western Turkey, since 1982. These include all spinal injuries with or without neurological symptoms. Combined conservative and surgical methods were used for treatment. Age, sex, etiology, site of injury, radiologic findings, neurological status, and outcome are compared with the other studies. The results have been found to be parallel to those of the other studies except for some regional differences like an excess of tractor accidents.

Adolescent↗

Intracerebral hematoma after evacuation of chronic subdural hematoma.

A case of intracerebral hemorrhage occurring after evacuation of a chronic subdural hematoma is presented. The mechanism of this complication is not clear. However, hemorrhage into previously undetected areas of contusion, damage to cerebral vasculature secondary to rapid perioperative parenchymal shift, and sudden increase in cerebral blood flow with focal disruption of autoregulation have been postulated as causes. Although this is a rare complication after decompressive operation for chronic subdural hematoma, it should be suspected and investigated without delay in patients who deteriorate postoperatively.

Cerebral Hemorrhage↗

Effects of methyl prednisolone, dimethyl sulphoxide and naloxone in experimental spinal cord injuries in rats.

The effects of methyl prednisolone (MPD), dimethyl sulphoxide (DMSO), and naloxone were examined in 38 albino rats after making an impact spinal cord injury on the midthoracic segments with a modified Allen's weight dropping trauma method. Somatosensorial evoked potentials (SEPs) were recorded before and 12 h and 14 d after the injury from epidurally inserted electrodes on the parietal cortex with sciatic nerve stimulations. Lower extremity motor functions of the animals were also examined. It may be concluded that in this study model, DMSO has a moderate effect which can be demonstrated clinically and through SEPs. Naloxone has no effect on the clinical outcome but causes reasonable improvement electrophysiologically.

Action Potentials↗

A comparative study of brain-stem auditory evoked potentials and blink reflexes in posterior fossa tumor patients.

Brain-stem auditory evoked potentials (BAEP's) and blink reflexes (BR's) were recorded from 40 patients with clinical and radiological evidence of posterior fossa tumors. They were examined in three groups according to the anatomical location of the lesion: Group A included 15 patients with midline tumors; Group B included 14 patients with cerebellar hemispheric tumors; and Group C included 11 patients with cerebellopontine angle (CPA) tumors. More of the 40 patients had BAEP abnormalities (32) than BR abnormalities (24). All of the 11 patients with CPA tumors had some kind of BAEP and BR abnormalities. The 14 patients with cerebellar tumors showed the next most frequent abnormalities: 12 related to the BAEP's and seven to the BR's. The 15 patients with midline tumors showed the least number of abnormalities: nine related to BAEP's and six to the BR's. In the analysis of BAEP wave latencies and interpeak latencies, a wave III latency delay occurred in all groups; latencies of waves IV and V were more significantly delayed in patients with CPA and cerebellar hemispheric tumors, and the interpeak latencies of waves III-V and I-V were markedly prolonged only in patients with CPA tumors (p less than 0.01). In all tumor groups, early response (R1) of BR's was significantly delayed in comparison to a healthy volunteer control group (p less than 0.01), but R1 was more pronounced in cases of CPA tumors when compared with the other tumor groups. Although significant delays in direct and consensual late reflex components (R2) of BR's were noted in comparison to the control group, this delay could not differentiate one tumor group from another. In can be concluded that, while these tests reflect the functions of different cranial nerves and brain-stem tracts, BAEP monitoring is more sensitive than BR testing for the detection of brain-stem involvement in posterior fossa tumors. Cerebellopontine angle tumors almost always cause severe abnormalities in both tests. Cerebellar hemispheric tumors and midline tumors cause fewer changes in both BAEP's and BR's.

Adolescent↗

Unusual spinal cord injury by a speargun.

Penetrating injury of the upper cervical spinal cord is usually caused by missiles. An unusual case of injury to the upper cervical spinal cord by a speargun is reported. Surgical treatment was uneventful, and the patient made good neurological progress within 2 days after the operation. On the fifth day he became confused and had a temperature of 40 degrees C. A diagnosis of Branhamella catarhalis meningitis was made. The patient's condition continued to deteriorate despite parenteral broad-spectrum antibiotic therapy, and he died 15 days after the injury.

Adult↗

Orbito-cranial teratoma. A case report.

A case of congenital orbito-cranial teratoma is presented. Histological examination of this extremely rare tumour revealed unusual tissue elements derived from all three germinal layers.

Brain Neoplasms↗