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Öğe A Case of Upper Thoracic Intradural-Extramedullary Multiple Meningiomas(Lippincott Williams & Wilkins, 2013) Keskin, Fatih; Kalkan, Erdal; Karatas, YasarIntradural spinal tumors are classified into extramedullary and intramedullary tumors. The most frequent intradural-extramedullary tumors are meningiomas and neurinomas. Meningiomas mostly occur in thoracic region and are generally located at the dorsal aspect. Multiplicity is a rare condition for spinal meningiomas, and multiple spinal meningiomas are usually associated with neurofibromatosis. In this report, we present a case of thoracic spinal multiple meningiomas which was located at the ventral aspect and not associated with neurofibromatosis.Öğe Congenital Carotid-Jugular Fistula in a Child A Case Report(Sage Publications Inc, 2014) Erdi, Fatih; Kaya, Bulent; Keskin, Fatih; Koc, Osman; Karatas, Yasar; Kalkan, ErdalCongenital carotid-jugular (CJ) fistula of the neck is a very rare clinical entity that has various causes. The CJ fistulas are particularly prone to complications unlike other peripheral arteriovenous fistulas. The aim of this report is to present a case of a CJ fistula between the external carotid and the external jugular vein, which was successfully closed with detachable balloon by an endovascular approach. A 14-year-old child was admitted to our clinic with a pulsatile neck swelling. There was no previous history of trauma. A high-flow fistula between the external carotid and the external jugular vein was determined. The fistula was closed with detachable balloon by an endovascular approach. The postoperative angiogram demonstrated complete resolution of the fistula. Endovascular treatment of CJ fistulas with detachable balloons is a safe and less traumatic technique and may be an effective alternative to the open surgery in selected patients.Öğe The effects of steroids in traumatic thoracolumbar junction patients on neurological outcome(Turkish Assoc Trauma Emergency Surgery, 2019) Ilik, Mustafa Kemal; Keskin, Fatih; Erdi, Fatih; Kaya, Bulent; Karatas, Yasar; Kalkan, ErdalBACKGROUND: In this study, we aim to evaluate the potential effects of methylprednisolone on the neurological outcome of spinal cord injury (SCI) patients with thoracolumbar junction (T10-L1) spine fractures. METHODS: The data from 182 SCI patients who sustained a thoracolumbar junction spine fracture were operated by us between September 2008 to January 2015 were analysed retrospectively. The patients were divided into two groups: Group I underwent methylprednisolone treatment in conjunction with early surgical intervention, while group 2 underwent only early surgical intervention without methylprednisolone treatment. American Spinal Injury Association (ASIA) motor index scores of the patients were evaluated and compared with statistical methods at admission and at the first-year follow-up. RESULTS:The main follow-up period was 14.4 +/- 1.4 months in group 1 and 13.6 +/- 1.7 months in group 2. Initial and last follow-up ASIA scores of the patients were similar between groups (p>0.05), but the complication rate was significantly high in group 1 (p<0.05). CONCULSION: The findings showed that steroids have no significant beneficial effects on the neurological outcome but have significant side effects and leads to increased complication rate in SCI patients.Öğe Evaluation of nosocomial infections and related risk factors in a neurosurgery intensive care unit(E-Century Publishing Corp, 2016) Erayman, Ibrahim; Erdi, Fatih; Kalkan, Erdal; Karatas, Yasar; Kaya, Bulent; Keskin, Fatih; Izci, Emir K.Nosocomial infections (NIs) cause increased morbidity, mortality, and hospital costs, particularly in intensive care units. Neurosurgery intensive care units (NICUs) differ from other intensive care units in several respects. The aim of this study was to examine NIs and related risk factors in our NICU. NICU records and the database of our hospital's infection control team from January 2010 to December 2014 were reviewed retrospectively. Type of NI and associated risk factors were subjected to statistical analysis. Demographic data, risk factors for NI development, presentation, length of NICU stay, and Glasgow Coma Scale (GCS) score were recorded and reviewed. One hundred and eighteen NI episodes were detected in 115 of 820 patients. The mean age of the patient population was 42.4 years (range 16-74 years). Of the infected patients, 55 were female and 60 were male. The mean length of hospital stay of these patients was 38.4 +/- 21.8 days. The most common type of NI was ventilator-associated pneumonia, and the most frequently detected pathogen was Acinetobacter spp. GCS score, prior usage of broad-spectrum antibiotics, reoperation, mechanical ventilation, external lumbar or ventricular drainage, tracheostomy, and duration of NICU stay were significantly higher among infected patients. Univariate analysis identified low GCS score, longer NICU stay, use of mechanical ventilation, prior usage of broad-spectrum antibiotics, and reoperation as risk factors for NI.Öğe Extradural spinal chondromyxoid fibroma mimicking intradural mass lesion: MR and MR myelographic images(Elsevier Science Inc, 2015) Keskin, Fatih; Erdi, M. Fatih; Kalkan, Havva; Karatas, Yasar; Koc, Osman[Abstract Not Availabe]Öğe Increased expression of ubiquitin C-terminal hydrolase L1 in astrocytomas of ascending grades(Lippincott Williams & Wilkins, 2023) Izci, Emir Kaan; Keskin, Fatih; Erdi, Fatih; Kaya, Bulent; Karatas, Yasar; Feyzioglu, Bahadir; Findik, SiddikaBackground:The ubiquitin-proteasome pathway controls the monitoring and degradation of important proteins and is involved in several cellular processes, such as development, differentiation, and transcriptional regulation. Recent evidence has shown that ubiquitin carboxy-terminal hydrolase-L1 (UCH-L1), a member of the deubiquitinating enzyme family that removes ubiquitin from protein substrates, is overexpressed in many types of cancer. Aim:This study thus examined the expression of UCH-L1 in human astrocytoma tissues. Material and methods:Formalin-fixed, paraffin-embedded astrocytoma samples were obtained from 40 patients, after which histopathological examination, typing, and grading were performed. The study group included 10 histologically normal brain tissues, which served as the control group, and 10 WHO grade II, 10 WHO grade III, and 10 WHO grade IV (glioblastoma) samples. Normal brain tissue samples were obtained from the histologically normal, non-tumoral portion of the pathology specimens. UCH-L1 expression was evaluated using quantitative reverse transcription-polymerase chain reaction and immunohistochemistry. Results:Astrocytoma tissues exhibited higher UCH-L1 expression compared to the control group. UCH-L1 overexpression increased significantly together with the increase in astrocytoma grades (from II to IV). Conclusion:UCH-L1 could be a good diagnostic and therapeutic marker for determining astrocytoma development and progression.Öğe Intratumoral hemorrhage-related differences in the expression of vascular endothelial growth factor, basic fibroblast growth factor and thioredoxin reductase 1 in human glioblastoma(Spandidos Publ Ltd, 2016) Kaya, Bulent; Cicek, Onur; Erdi, Fatih; Findik, Siddika; Karatas, Yasar; Esen, Hasan; Keskin, FatihThe present study was designed to evaluate the expression of vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF) and thioredoxin reductase 1 (TrxR1) in glioblastoma multiforme (GBM) with and without intratumoral hemorrhage. Surgically resected human GBM samples from 20 patients who underwent surgery at our institute were extracted from the histopathological specimens and divided into two groups. A total of 10 samples from each type of GBM (World Health Organization grade IV, intratumoral hemorrhage-positive or -negative) were included in each group. VEGF, bFGF and TrxR1 expression was analyzed using immunohistochemistry and the results were compared between groups. VEGF and bFGF immunoreactivity was significantly higher in GBMs containing intratumoral hemorrhage. Furthermore, VEGF, bFGF and TrxR1 immunointensity was significantly higher in GBMs containing intratumoral hemorrhage. Thus, the present study demonstrated a higher VEGF, bFGF and TrxR1 expression in GBMs contain intratumoral hemorrhage, indicatiogn a role of VEGF, bFGF and TrxR1 expression in the promotion of tumoral angiogenesis and tumoral growth by complex mechanisms that require further elucidation.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 Primary tumor of thoracic vertebra: chondrosarcoma(Elsevier Science Inc, 2016) Keskin, Fatih; Kalkan, Havva; Kaciran, Burkay K.; Erdi, M. Fatih; Karatas, Yasar; Kalkan, Erdal[Abstract Not Availabe]Öğe Ruptured spinal artery aneurysm associated with coarctation of the aorta(Elsevier Science Inc, 2016) Erdi, Fatih; Keskin, Fatih; Kalkan, Havva; Karatas, Yasar; Koc, Osman[Abstract Not Availabe]Öğe Telmisartan ameliorates oxidative stress and subarachnoid haemorrhage-induced cerebral vasospasm(Taylor & Francis Ltd, 2016) Erdi, Fatih; Keskin, Fatih; Esen, Hasan; Kaya, Bulent; Feyzioglu, Bahadir; Kilinc, Ibrahim; Karatas, YasarObjectives: Growing evidence suggests that oxidative stress is one of the factors contributing to subarachnoid haemorrhage (SAH)-induced cerebral vasospasm. SAH-induced cerebral vasospam alters thioredoxin (Trx) cycle enzymes and thioredoxin-interacting protein (TXNIP) as an important endogenous antioxidant system. In this study, we have explored the effects of telmisartan on the vascular morphological changes, endothelial apoptosis, tissue oxidative stress status and the level of Trx cycle enzymes/TXNIP in a rabbit SAH model. Methods: Forty male New Zealand rabbits were randomly divided into five groups of eight rabbits each: control group, sham group, SAH group, SAH + vehicle group and SAH + telmisartan group. SAH was created by a single cisterna magna blood injection. SAH + telmisartan group received telmisartan treatment (5 mg/kg intraperitoneal, once daily) for 72 h. The brainstem tissue Trx1, Trx2, Trx reductase (TrxR), TrxR1and TXNIP levels were investigated. Total oxidant status (TOS), total antioxidant status (TAS), malondialdehyde (MDA) levels and tumour necrosis factor alpha (TNF alpha) levels were investigated. Basilar artery segments were investigated for cross-sectional area, wall thickness measurements and endothelial apoptosis. Results: Telmisartan treatment restored the lowered level of Trx1, TrxR, TAS and the expression of TrxR1 seen in SAH. Telmisartan treatment also decreased TXNIP expression, TOS, MDA and TNF alpha levels. Morphological changes of cerebral vasospasm were attenuated after treatment. Endothelial apoptosis significantly reduced. Discussion: Treatment with telmisartan ameliorates oxidative stress and SAH-induced cerebral vasospasm in rabbits. These effects of telmisartan may be associated with downregulation of TXNIP and upregulation of Trx/TrxR.