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Öğe Alfa lipoik asidin deneysel subaraknoid kanama ve vazospazmda lipid peroksidasyonu, antioksidan durum ve endotelial apopitoz üzerine etkileri(Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi, 2009) Erdi, Mehmet Fatih; Güney, Ahmet ÖnderBu çalışma ile ALA'nın tavşanlarda oluşturulan subaraknoid kanama modelinde vazospazm üzerine etkileri incelenmiştir.Gereç ve Yöntem: Yirmibir adet erkek, Yeni-Zelanda tipi tavşan randomize olarak her biri 7 tavşandan oluşan 3 gruba ayrılmıştır: grup 1 (kontrol), grup 2 (SAK), grup 3 (SAK+ALA). ALA tedavisi (100mg/kg/gün ip) olarak verilmiş ve tedaviye SAK oluşturulmadan hemen önce başlanarak tedavi 72 saat sürdürülmüştür. Yetmiş iki saatin sonunda denekler sakrifiye edilerek elde edilen beyin sapı dokularında doku MDA, SOD, GSH-Px düzeyleri ölçülmüş ayrıca elde edilen baziller arter kesitlerinde arter duvar kalınlığı, arter lümen alanı ve immünohistokimyasal olarak da endotelial apopitoz yüzdeleri tespit edilmiştir.Bulgular: Tavşanlarda oluşturulan vazospazm modelinde ALA tedavisi istatistiksel olarak anlamlı şekilde vazospazm gelişimini engellemiştir. SAK sonrasında artış gösteren MDA düzeyleri tedavi ile azalmış, SOD ve GSH-Px'de görülen azalma ise engellenmiştir. Histopatolojik olarak ALA, SAK sonrası ortaya çıkan arter duvar kalınlaşmasını ve arter lümen alanındaki daralmayı engellemiştir. İmmunohistokimyasal olarak ALA, SAK sonrasında görülen endotelial apopitozu azaltmaktadır.Sonuç: ALA tavşanlarda oluşturulan SAK modelinde vazospazm gelişimini engellemektedir. ALA'nın SAK sonrasında nöroprotektif ve apopitozu düzenleyici etkileri olduğu bu çalışma ile gösterilmiştir. ALA, SAK sonrası görülen serebral vazospazmda potansiyel bir tedavi edici ve engelleyici ajan olarak karşımıza çıkmaktadır. Klinik uygulamaya geçilebilmesine yönelik daha ileri çalışmalara ihtiyaç vardır.Öğe Ameliorating the effects of Adalimumab on rabbits with experimental cerebral vasospasm after subarachnoid hemorrhage(Turkish Assoc Trauma Emergency Surgery, 2020) Toguslu, Gokhan; Erdi, Mehmet Fatih; Arac, Densel; Keskin, Fatih; Kilinc, Ibrahim; Cuce, GokhanBACKGROUND: Adalimumab (ADA), which is a new-generation recombinant human monoclonal antibody for tumor necrosis factor a (TNF alpha), has strong anti-inflammatory effects. The role of enhanced inflammation is well established for the development and progression of cerebral vasospasm. Investigated in the present study is the probable ameliorating and neuroprotective effects of ADA in rabbits using a cerebral vasospasm model with biochemical and histopathological methods. METHODS: Thirty male New-Zealand white rabbits were randomly divided into control, subarachnoid hemorrhage (SAH) only and SAH plus ADA treatment groups. SAH was established as a single cisterna magna autologous arterial blood injection. ADA treatment was started just after intracisternal blood injection and continued for 72 hours once a day. The animals were sacrificed 72 hours after the induction of SAH, serum and brainstem tissue obtained for investigations. RESULTS: Brainstem tissue and plasma levels of tumor necrosis factor-alpha and Interleukin-1 beta, brainstem tissue Matrix metalloproteinase-9 levels increased after SAH and partly decreased after treatment. Plasma levels of brain-derived neurotrophic factor decreased after SAH and partly restored after treatment. ADA treatment significantly increased the mean cross-sectional area of the vasospastic basilar arteries, reduced the basilar artery wall thickness and also ameliorates enhanced endothelial apoptosis. CONCLUSION: Findings obtained in this study suggest that ADA is an effective neuroprotective agent for ameliorating cerebral vasospasm in experimental rabbit vasospasm.Öğe Ameliorating the effects of Adalimumab on rabbits with experimental cerebral vasospasm after subarachnoid hemorrhage(Turkish Assoc Trauma Emergency Surgery, 2020) Toguslu, Gokhan; Erdi, Mehmet Fatih; Arac, Densel; Keskin, Fatih; Kilinc, Ibrahim; Cuce, GokhanBACKGROUND: Adalimumab (ADA), which is a new-generation recombinant human monoclonal antibody for tumor necrosis factor a (TNF alpha), has strong anti-inflammatory effects. The role of enhanced inflammation is well established for the development and progression of cerebral vasospasm. Investigated in the present study is the probable ameliorating and neuroprotective effects of ADA in rabbits using a cerebral vasospasm model with biochemical and histopathological methods. METHODS: Thirty male New-Zealand white rabbits were randomly divided into control, subarachnoid hemorrhage (SAH) only and SAH plus ADA treatment groups. SAH was established as a single cisterna magna autologous arterial blood injection. ADA treatment was started just after intracisternal blood injection and continued for 72 hours once a day. The animals were sacrificed 72 hours after the induction of SAH, serum and brainstem tissue obtained for investigations. RESULTS: Brainstem tissue and plasma levels of tumor necrosis factor-alpha and Interleukin-1 beta, brainstem tissue Matrix metalloproteinase-9 levels increased after SAH and partly decreased after treatment. Plasma levels of brain-derived neurotrophic factor decreased after SAH and partly restored after treatment. ADA treatment significantly increased the mean cross-sectional area of the vasospastic basilar arteries, reduced the basilar artery wall thickness and also ameliorates enhanced endothelial apoptosis. CONCLUSION: Findings obtained in this study suggest that ADA is an effective neuroprotective agent for ameliorating cerebral vasospasm in experimental rabbit vasospasm.Öğe Coronavirus Disease 2019-Related Fulminant Idiopathic Intracranial Hypertension(Georg Thieme Verlag Kg, 2023) Caliskan, Burcu; Canbal, Abdullah; Guven, Ahmet Sami; Bitirgen, Gulfidan; Erdi, Mehmet Fatih; Caksen, HuseyinIdiopathic intracranial hypertension or pseudotumor cerebri syndrome (PTCS) is defined as an increase in intracranial pressure (ICP) without an identifiable and/or structural cause or abnormal cerebrospinal fluid content. The most common symptoms of PTCS include headache, vomiting, pulsatile tinnitus, blurred vision, and diplopia. In 2 to 3% of PTCS patients, severe and rapidly progressive vision loss may develop within 1 month since symptoms begin; this clinical condition is usually defined as fulminant idiopathic intracranial hypertension (FIIH). This study presented a patient admitted to the hospital with headache and blurred vision, who also had high severe acute respiratory syndrome coronavirus 2 infections total antibody level and was treated with a lumboperitoneal shunt due to medical treatment-resistant increased ICP. We also reviewed similar cases previously reported in the literature. To the best of our knowledge, no children affected with coronavirus 2019 related to FIIH and requiring surgical treatment have been yet reported in the literature.Öğe Girişimsel İşlemler İçin Sakral Kanal ve Hiatusun Çok Kesitli Bilgisayarlı Tomografi ile Morfometrik Analizi(2015) Kılıçaslan, Alper; Keskin, Fatih; Babaoğlu, Ozan; Gök, Funda; Erdi, Mehmet Fatih; Kaya, Bülent; Özbiner, Hüseyin; Özbek, Orhan; Koç, Osman; Kaçıra, Burkay KutluhanAmAÇ: Yakın zamanda sakral kanal, omurga hastalıklarının minimal invaziv tanı ve tedavi işlemleri için "bir koridor olarak" sıkça kullanılmaya başlanmıştır. Çalışmanın amacı sakral kanalın, hiatusun ve çevre yapıların farklı yaş gurupları ve cinsiyete göre morfometrik analizlerinin çok kesitli bilgisayarlı tomografi yöntemiyle incelenmesidir. yÖNTem ve GeReÇLeR: Üç farklı yaş grubuna (20-80 yaş arasında) ayrılan 300 yetişkin (150 kadın ve 150 erkek; 20-80 yaş) hastanın multiplanar rekonstrüksiyon görüntüleri kaydedildi ve geriye dönük olarak incelendi. Sakral hiatus ve çevre yapılar ile sakral kanala ait çeşitli anatomik ölçümler yapıldı. Sakral kurvatür açısı ve lumbosakral lordotik açı kaydedildi. BuLGuLAR: Bazı olgularda hiatus yokluğu (%0,3), komplet agenezis (%1) ve kemik septum (%2,6) gibi kemik anomalilerine rastlandı. Anteroposterior (AP) Hiatus çapı olguların %5'sinde 2 mm nin altındaydı. Tüm yaş gruplarında, hiatus AP çapı ve hiatus alan ve "sakral kanal AP çapının en kısa mesafesinin" ortalaması, 60-80 yaş grubunda, 20-40 yaş grubuna göre daha kısaydı (p0,01). Sakral kanal AP çapın en küçük olduğu lokalizasyon, en çok olguların %59,2'unda S2 ve %33,9'unda S3 seviyesinde idi. Maksimum kurvatür seviyesi olguların %63,3'ün de S3 ve %26,7'sin de S2 seviyesinde idi. Sakral kürvatur açı ve lumbosakral lordotik açı sırayla 164 and 134 olarak ölçüldü. soNuÇ: Sakral yapılarda anatomik varyasyonlar sık görünür. Anatominin ayrıntılı analizi, girişimsel işlemlerin başarısını ve güvenilirliğini artırabilir.Öğe Morphometric Analysis of the Sacral Canal and Hiatus Using Multidetector Computed Tomography for Interventional Procedures(Turkish Neurosurgical Soc, 2015) Kilicaslan, Alper; Keskin, Fatih; Babaoglu, Ozan; Gok, Funda; Erdi, Mehmet Fatih; Kaya, Bulent; Ozbiner, HuseyinAIM:The sacral canal has been frequently used asa passagefor minimally invasive diagnostic and therapeutic procedures for spinal diseases. The aim of the present study was to investigate morphometric analyses of the sacral canal, hiatus, and surrounding structures according to different age groups and gender by using themultidetector computed tomography method. MATERIAL and METHODS: Multiplanar-reconstructed images from 300 adult (150 females and 150 males, between 20 and 80 years old) were divided into three groups according to age and retrospectively examined. Various anatomic measurements of the sacral hiatus, surrounding structures, and sacral canal were performed. Sacral curvature angle and lumbosacral lordotic angle were noted. RESULTS: Bony anatomic abnormalities such as absent hiatus (0.3%), complete agenesis (1%), and bony septum (2.6%) were detected in some cases. The anteroposterior (AP) diameter of the hiatus was less than 2 mm in 5% of cases. In all groups, the mean values of the hiatus AP diameter and area, and the shortest distance of the sacral canal AP diameter were shorter in the 60-80 years age group when compared with those in 20-39 years age group (p=0.01). The shortest sacral canal AP diameter was commonly located at the S2 and S3 levels in 59.2% and 33.9% of cases, respectively. The levels of maximum curvature were at S3 and S2 in 63.3% and 26.7% of cases, respectively. Median sacral curvature angles and lumbosacral lordotic angles were measured as 164 degrees and 134 degrees, respectively. CONCLUSION: Sacral structures have morphometric variations. Understanding of the detailed anatomy may improve the reliability of interventional procedures.Öğe Neuroprotective Effects of Milrinone on Experimental Acute Spinal Cord Injury: Rat Model(Elsevier Science Inc, 2021) Arac, Densel; Erdi, Mehmet Fatih; Keskin, Fatih; Kenan, Mehmet; Cuce, Gokhan; Aydemir, Fatma H. Y.; Guney, OnderOBJECTIVE: Spinal cord injury (SCI) disrupts nerve axons with devastating neurological consequences, but there is no effective clinical treatment. The secondary damage mechanism is a mainstay process, and it starts within a few minutes after trauma. We aim to investigate the neuroprotective effects of milrinone on the SCI model. MATERIALS AND METHODS: A total of 36 Wistar albino rats, each weighing 300-400 g, were randomly split into 4 groups that received different treatments: in group 1 (sham) (n = 9) control, only a laminectomy was performed; in group 2 (SCI) (n = 9), SCI was imitated after laminectomy; in group 3 (SCI + saline) (n = 9), physiological saline solution was injected intraperitoneally immediately after the SCI; and in group 4 (SCI + milrinone), milrinone was administered intraperitoneally on lateral decubitus position immediately after the SCI. Spinal cord contusion was established by the weight-drop technique after laminectomy. Neurological examination scores were recorded, and rats were killed 72 hours later. Serum and spinal cord tissue glutathione peroxidase, total antioxidant status, total oxidant status, 8-hydroxiguanosine, interleukin-6 and interleukin-10 levels, histopathological spinal cord damage score, and apoptotic index were examined and compared between groups. RESULTS: Neurological examination scores were significantly better in the milrinone-treated group compared with groups 2 and 3. SCI significantly increased serum and spinal cord tissue glutathione peroxidase, total oxidant status, 8- hydroxiguanosine, and interleukin-6 levels that were successfully reduced with milrinone treatment. Interleukin-10 and total antioxidant status levels decreased as a result of SCI increased with milrinone treatment. Increased histopathological spinal cord damage score and apoptotic index in groups 2 and 3 significantly decreased in group 4. CONCLUSIONS: Milrinone could reduce apoptosis and increase anti-inflammatory and antioxidative mediators, thus playing a protective role in secondary nerve injury after SCI in rats.Öğe Neuroprotective Effects of Tocilizumab on Experimentally-Induced Spinal Cord Ischemia-Reperfusion Injury(Elsevier Science Inc, 2019) Karatas, Yasar; Erdi, Mehmet Fatih; Kaya, Bulent; Keskin, Fatih; Cuce, Gokhan; Kilinc, Ibrahim; Uyar, MehmetOBJECTIVES: We aimed to evaluate neuroprotective effects of tocilizumab on spinal cord ischemia-reperfusion (I/R) injury. Our study design was an experimental rabbit spinal cord I/R injury model, and the setting was at the Animal Research Laboratory, Necmettin Erbakan University, Meram School of Medicine, Konya, Turkey. METHODS: Twenty-four adult New Zealand rabbits were randomly divided into 3 groups: Group 1, control group (n = 8); Group 2, I/R group, and Group 3 (n = 8) I/R injury D tocilizumab (4 mg/kg, ip) treatment group. Spinal cord I/R injury repair was performed by infrarenal aortic cross clamping. On neurologic evaluation, spinal cord tissue plasma tumor necrosis factor alpha (TNFa), total antioxidant status (TAS), total oxidant status (TOS), thiobarbituric acid reactive substances (TBARS), interleukin 6 (IL-6), interleukin 10 (IL-10) levels were analyzed. Spinal cord neuronal damage score and apoptotic cell count were also investigated. RESULTS: I/R injury significantly increases the plasma and spinal cord tissue TNFa, TOS, TBARS, and IL-6 levels and decreases the plasma and spinal cord tissue TAS and IL-10 levels. Tocilizumab treatment significantly reduces the plasma and spinal cord tissue TNF alpha, TOS, TBARS, IL-6 levels and increases plasma and tissue TAS and IL-10 levels. I/R injury significantly increases spinal cord neuronal damage score and apoptotic cell count. Tocilizumab treatment significantly reduces spinal cord neuronal damage score and apoptotic cell count. Neurologic examination scores at 24, 48, and 72 hours were significantly better in the treatment group when compared with the I/R group. CONCLUSIONS: This study shows significant neuroprotective effects of tocilizumab on rabbit spinal cord I/R injury.Öğe Periton Absorbsiyon Bozukluğu Olan Bir Hastada Ventriküloplevral Şant Operasyonu Sonrasında Gelişen Hidrotoraks(2014) Kalkan, Erdal; İlik, Mustafa Kemal; Erdi, Mehmet Fatih; Kaya, BülentHidrosefali yıllardan beri bilinen bir hastalık olmasına rağmen takip ve tedavisinde halen bilinmeyen noktalar bulunmaktadır.Hidrosefali tedavisinde alen ventriküloperitoneal şant cerrahisi en sık kullanılan tedavi yöntermidir. Ancak revizyon insidansı ve mortalitesi; enfeksiyon, fazla/az drenaj tıkanma nedeniyle oldukça yüksektir. 62 yaşında bayan hasta kliniğimizde opere edilerek ventriküloplevral şant uygulandı. Ameliyat sonrası beşinci günde hastada ilerleyici tipte nefes darlığı ve siyanoz şikayetleri ortaya çıktı. Hastanın çekilen akciğer grafisinde solda plevral effüzyon tespit edildi. Ventriküloplevral şant cerrahisi rekürren ventriküloperitoneal şant operasyonları ve revizyonları sonrası görülebilen peritoneal absorbsiyon bozuklukları nedeniyle tercih edilmektedir. Bu raporda ventriküloplevral şant sonrası gelişen tansiyon hidrotorakslı bir olgu sunulmuş ve literatür eşliğinde tartışılmıştır.Öğe Poor prognosis in paediatric haemorrhagic stroke(Via Medica, 2023) Çaksen, Hüseyin; Yılmaz, Saniye Yasemin; Güven, Ahmet Sami; Güldibi, Furkan; Erdi, Mehmet Fatih; Açıkgözoğlu, SaimStroke, increasingly recognised in children in recent years, is an important cause of long-term morbidity and disability. A wide range of conditions associated with paediatric stroke has been identified, which differ significantly from those in adults. Paediatric stroke can also present with a variety of symptoms and signs, both specific and non-specific [1, 2]. Paediatric haemorrhagic stroke (HS) is a rare but severe condition, with lifelong multifaceted adverse functional, psychosocial, and economic consequences [3]. In this study, we have evaluated the clinical, laboratory and neuroimaging findings in children with HS in order to draw attention to the high morbidity and mortality rates of paediatric HS. (...)Öğe Third Ventricular Epidermoid Tumor in a Pediatric Case(Georg Thieme Verlag Kg, 2023) Yuksek, Muhammed Erkam; Arac, Densel; Erdi, Mehmet FatihEpidermoid tumors, which constitute 0.2 to 1.8% of primary intracranial neoplasms, occur in the third and fifth weeks of fetal development. Epidermoid tumors, which are known to occur most frequently in the cerebellopontine angle, are rarely located intraventricularly. A third ventricular location can be seen in 0.7% of cases. Epidermoid tumors are more common between the ages of 19 and 69, and are very rare in the pediatric period. In this report, we present a third ventricular epidermoid tumor in an 11 years old pediatric patient.
