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Sanser Gül

Publications and source records attributed to Sanser Gül.

4 recordsLinked to original sources

Migration of a bullet in the spinal canal.

Migration of a bullet within the spinal canal after gunshot injury is rare. We report here the case of a penetrating gunshot injury of the lumbar spine at L3 with migration of the bullet within the spinal canal S2. The patient had marked paraparesis (proximal 1/5, distal 0/5 muscle strength) and anaesthesia at L3 and below, and had a hypocompliant, hyper-reflexive bladder with decreased capacity, and absent anal tonus. We removed osseous fragments in the canal with an L3 laminectomy and extracted the bullet by S2 laminectomy. After surgery, we observed an improvement in paraparesis, an increase in bladder capacity and urinary compliance, and improvement in anal tonus. The appropriate course of action in this type of injury remains unclear, because the number of cases described in the literature is not sufficient to provide a basis on which to make a definitive therapeutic decision. We herein review the literature describing cases in which a bullet in the spinal canal has migrated; we describe the treatment used and the outcomes in these cases.

Adult↗

Primary spinal extranodal Hodgkin's disease at two levels.

About 90% of Hodgkin's disease cases originate from lymph nodes whereas 10% from extranodal regions. Patients rarely present with spinal cord compression due to epidural Hodgkin's disease. Primary spinal extradural Hodgkin's disease which does not have any other organ involvement in the body is even rarer. A 39-year-old male patient who complained of lumbar pain had normal findings upon neurological examination. Radiological examination revealed a mass on the epidural space at level L3 and the involvement of the vertebral corpus accompanied by the involvement of C6 vertebral body. Primary focus could not be identified despite further investigation. The patient underwent L3 laminectomy and posterior decompression and biopsy was obtained from the lesion extending to epidural space. The pathological result was reported as lymphocyte dominant type Hodgkin's disease. Flow cytometry was performed to the lesion, also. The patient was evaluated as Stage 4A according to Ann Arbor classification. Postoperative radiotherapy was applied to lumbar and cervical region. In the literature we have not come across any case of primary spinal extranodal Hodgkin's disease with involvement at two levels. In conclusion, although it might be extremely rare, primary spinal extranodal Hodgkin's disease with involvement at two levels might be observed.

Adult↗

A training model for lumbar discectomy.

Training models are becoming increasingly important for gaining surgical skills. We present an easy to prepare and cheap model using cadaver sheep spine appropriate to learn and practice various discectomy procedures.

Diskectomy↗

Dose-dependent neuroprotective effects of melatonin on experimental spinal cord injury in rats.

BACKGROUND: This report examines the dose-dependent effects of melatonin on early lipid peroxidation levels, ultrastructural changes, and neurological function in experimental spinal cord injury (SCI) by comparing them with therapeutic levels of methylprednisone in rats. METHODS: SCI was performed by an aneurysm clip placed extradurally at the level of T10. Rats were randomly divided into six groups of 10 rats each. Group 1 (sham) received only laminectomy; group 2 (control) received SCI; group 3 (placebo) received SCI and physiological saline; group 4 received methylprednisone (30 mg/kg); groups 5 and 6 received melatonin at doses of 50 or 100 mg/kg, respectively, after SCI. Rats were neurologically tested 24 hours after trauma. Spinal cord samples were harvested for both lipid peroxidation levels and ultrastructural histopathological evaluation. RESULTS: Neurological scores of rats were not different in SCI groups. Lipid peroxidation levels are significantly restricted only in methylprednisone group at 24 hours. Melatonin-treated groups showed more ultrastructural improvement on electron microscope studies when compared with methylprednisone group. However, the therapeutic effects of melatonin were mainly observed on white matter of spinal cord in ultrastructural investigation. There was significant difference between melatonin dose groups increasing with dose. CONCLUSIONS: Results showed that melatonin has no significant dose-dependent effects on early lipid peroxidation bur rather some neuroprotective effects on both axons and myelin sheaths of white matter in ultrastructural observations when compared with methylprednisone. These effects significantly augmented with dose increase.

Animals↗