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    Comparison of Bone Dust With Other Types of Bone Grafts for Cranioplasty
    (Lippincott Williams & Wilkins, 2014) Karamese, Mehtap; Toksoz, Mustafa Rasid; Selimoglu, Muhammed Nebil; Akdag, Osman; Toy, Hatice; Tosun, Zekeriya
    Purpose: Split calvarial bone graft is preferred in the reconstruction of calvarial defects. However, it is not feasible for use in some challenging cases and in children. Particulate bone graft containing viable osteoblasts could be an attractive alternative. Materials and Methods: A total of 32 female rats were randomly separated into 4 groups. Full-thickness bone graft from rat calvaria was harvested in diameters of 8 x 8 mm. In group 1, the periosteum and skin were closed without any bone graft; bone dust particles were placed in group 2; bone fragments were placed in group 3; and full-thickness cranial bone graft was placed in group 4. After 12 weeks, all rats were killed. Degrees of resorption, foreign body reaction, and bone spicule length were assessed histologically, and an immunohistochemical study was used to show bone graft viability. Results: In graft viability, osteogenesis, and osteoblastic differentiation, groups 3 and 4 were similar and superior to groups 1 and 2. No osteoblastic activity and no viable bone dust were detected in groups 1 and 2. Resorption was observed in every preparate that contains bone tissue, and foreign body reaction was prominent in small bone groups, such as in group 2. Conclusions: In the full-thickness cranial bone graft group and the bone fragment group, the preservation of bone viability was obviously superior to the bone dust group and the periosteum-only group. In conclusion, bone dust behaved like the periosteum and could not create new bone, whereas bone particles behaved like the full-thickness cranial bone graft and were capable of preserving viability.
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    The Effects of Adipose-Derived Mesenchymal Stem Cells and Adipose-Derived Mesenchymal Stem Cell-Originating Exosomes on Nerve Allograft Regeneration An Experimental Study in Rats
    (Lippincott Williams & Wilkins, 2023) Koplay, Tugba Gun; Yildiran, Gokce; Dursunoglu, Duygu; Aktan, Murad; Duman, Selcuk; Akdag, Osman; Karamese, Mehtap
    IntroductionNerve regeneration has been the subject of many studies because of its complex mechanism and functional outcome. Mesenchymal stem cells and exosomes are promising factors in regeneration in many areas. Reconstruction of nerve defects is a controversial issue, and nerve allografts are promising alternatives with many advantages. In this study, it is aimed to evaluate the nerve regeneration in cellularized and decellularized nerve allografts and whether it is possible to accelerate this process with adipose-derived mesenchymal stem cells (ad MSC) or ad MSC-originating exosomes.MethodThis study was performed with 36 Lewis and 18 Brown Norway isogenic male rats aged 10 to 12 weeks and weighing 300 to 350 g. The Lewis rats were divided into 6 groups. Nerve allografts at a length of 12 mm that were obtained from the Brown Norway rats' proximal portion of both sciatic nerve branching points were coapted as cellularized in group A and decellularized in group B to the sciatic nerve defects of the Lewis rats. Group A received oral tacrolimus (0.2 mg/kg) for 30 days. Perineural saline (A1-B1), ad MSC (A2-B2), or ad MSC-originating exosomes (A3-B3) were applied to these groups. Walking track analysis, pinch-prick test and electromyelography were applied at the 8th and 16th weeks following surgery. Nerves were examined histopathologically at the 16th week.ResultsBetween cellularized groups, better results were shown in A3 about axon-myelin regeneration/organization (P = 0.001), endoneural connective tissue (P = 0.005), and inflammation (P = 0.004). Better results were shown in the B2 and B3 groups electromyelographicaly about latency period (P = 0.033) and action potential (P = 0.008) at late period, and histomorphologicaly at vascularization (P = 0.012).DiscussionIt is argued that regeneration is accelerated with decellularization of nerve allografts by removing the chondroidin sulfate proteoglycans. The positive effects of stem cells are derived by exosomes without the cell-related disadvantages. In this study, better results were obtained by decellularization and perineural application of ad MSC and/or ad MSC exosome.
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    VACUUM THERAPY AND PECTORALIS MAJOR MUSCLE FLAP COMBINATION IN TREATMENT OF STERNAL INFECTIONS: A CASE REPORT
    (Medknow Publications & Media Pvt Ltd, 2014) Karamese, Mehtap; Akdag, Osman; Yildiran, Gokce Unal; Selimoglu, Muhammed Nebil; Gormus, Niyazi; Tosun, Zekeriya
    Wound infections subsequent to cardiac surgery are challenging surgeons because of being life-threatening situations and these infections are among conditions that require multidisciplinary approach. Antibiotherapy, surgical debride-ments, regional or free flap surgeries are used by multidisciplinary approach in the treatment of sternal wound infections. Beside these known alternatives, some other methods are advanced for wound care. However; sternal instability, ventricular rupture and pneumonia may be mortal in many patient as the course of the disease. In this article, a negative pressure wound therapy and reconstruction with pectoralis major muscle flap was introduced for postoperative mediastinitis occurred in a diabetic, coronary bypass patient. A wound therapy, that controls infection and supplies wound care as an effective treatment alternative for highly mortal mediastinis cases.