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1.
Surg Radiol Anat ; 46(7): 977-984, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38819487

RESUMO

PURPOSE: The anatomical position of the sphenoidal sinus (SS) is very important for neurosurgeons because of the transsphenoidal approach to the pituitary gland. Therefore, the aim of this study was to determine the volume and shape of the SS and its relationship with the morphometry of the sella turcica. METHODS: This study included CT images of 282 males and 258 females with a mean age of 50.52 years (range 18-75) who underwent head CT. The morphometric values of the sella turcica and the volume of the SS were measured on the included radiologic images. Measurements were made on the sagittal slice closest to the midline in T1 sequence. Morphometric measurements were made with Micro Dicom Viewers software program and volume measurements were made with ITK SNAP software program. RESULTS: In this study, 4 types of SS shapes were obtained in the whole population: amorphous, pentagonal, triangular and quadrilateral. The mean SS volume was 7055.88 mm3 in males and 5694.48 mm3 in females and a statistically significant difference was observed (p < 0.001). In addition, a statistically significant difference was found between the sexes in the width and surface area parameters of the sella turcica (p < 0.05). CONCLUSION: In this study, the morphometric relationship between the shape of the sinus sphenoidale and sella turcica was demonstrated between men and women. In particular, the shape of the sinus sphenoidale was found to be anthropometrically different between men and women in the Turkish population. It is hypothesised that the data obtained in our study will guide surgeons performing transsphenoidal approach.


Assuntos
Sela Túrcica , Seio Esfenoidal , Tomografia Computadorizada por Raios X , Humanos , Masculino , Feminino , Sela Túrcica/anatomia & histologia , Sela Túrcica/diagnóstico por imagem , Adulto , Seio Esfenoidal/anatomia & histologia , Seio Esfenoidal/diagnóstico por imagem , Pessoa de Meia-Idade , Estudos Retrospectivos , Idoso , Adolescente , Turquia , Adulto Jovem
2.
Rom J Morphol Embryol ; 65(1): 27-33, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38527981

RESUMO

Cyclophosphamide (CP) is an alkylating chemotherapeutic agent commonly used in cancer treatments. In this study, we aimed to investigate the effects of 4-Hydroperoxy cyclophosphamide (4-HC), which is active form of CP, on glucose-regulated protein 78 (GRP78), activating transcription factor 6 (ATF6), phospho-protein kinase R (PKR)-like endoplasmic reticulum (ER) kinase (p-PERK), phospho-inositol-requiring enzyme 1 alpha (p-IRE1α), eukaryotic translation initiation factor 2 alpha (eIF2α), and caspase-3 messenger ribonucleic acids (mRNAs) and proteins that play roles in the ER stress pathway and apoptosis in U87 and T98 human glioblastoma cell lines. U87 and T98 human glioblastoma cell lines were divided into control and 4-HC-treated groups. Cell viability assay was used to detect the half maximal inhibitory concentration (IC50) for 24 hours of 4-HC. Immunocytochemistry and quantitative polymerase chain reaction (qPCR) methods were used to evaluate the levels of proteins and their mRNAs. The IC50 values of U87 and T98 cells were calculated as 15.67±0.58 µM and 19.92±1 µM, respectively. The levels of GRP78, ATF6, p-PERK, p-IRE1α, eIF2α, and caspase-3 protein expressions in the 4-HC-treated group compared to that in the control group. These increased protein expressions also were correlated with the mRNA levels. The ER stress signal pathway could be active in 4-HC-induced cell death. Further studies of ER-related stress mechanisms in anticancer treatment would be important for effective therapeutic strategies.


Assuntos
Glioblastoma , Proteínas Serina-Treonina Quinases , Humanos , Proteínas Serina-Treonina Quinases/genética , Proteínas Serina-Treonina Quinases/metabolismo , Proteínas Serina-Treonina Quinases/farmacologia , Endorribonucleases/farmacologia , eIF-2 Quinase/genética , eIF-2 Quinase/metabolismo , eIF-2 Quinase/farmacologia , Caspase 3/farmacologia , Chaperona BiP do Retículo Endoplasmático , Estresse do Retículo Endoplasmático , Linhagem Celular , Apoptose , Ciclofosfamida/farmacologia
3.
Turk Neurosurg ; 34(2): 250-255, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38497177

RESUMO

AIM: To compare the clinical and radiological outcomes of unilateral percutaneous kyphoplasty (PKP) surgeries performed using 3D printing technology in patients with osteoporotic compression fractures to conventional unilateral PKP surgeries. MATERIAL AND METHODS: Patients with acute painful single-level osteoporotic vertebral compression fracture (OVCF) who need surgical treatment were divided into two groups: group A (patients who had 3D template-guided PKP) and group B (patients who conventional PKP). To compare the two surgical procedures, Total Absorbed Radiation Dose (TARD), pre- and postoperative visual analog scale (VAS) scores, and Total Surgery Time (TST) were calculated and compared between groups in both surgical groups. RESULTS: A total of 44 patients with single-level OVCF who were experiencing acute pain were successfully operated on, with 22 patients in each group. TARD (2.6 ± 0.4 mGy vs. 6.1 ± 1.9 mGy, p < 0.05) and TST (12.4 ± 2.6 min vs. 20.2 ± 3.2 min, p < 0.05) differed significantly different between groups A and B. There was no statistically significant difference between the patient groups in preoperative and postoperative VAS values (p > 0.05). Cement leakage was lower in group A (3/22, 13.6%) than in group B (6/22, 27.3%) (p > 0.05). There were no neurological complications or infections in either group. CONCLUSION: When compared to the conventional procedure, the unilateral percutaneous kyphoplasty method was supported by a 3D printing guide template. By reducing operative time and radiation exposure, tt has resulted in a more effective surgical procedure for patients and a safer surgical procedure for surgeons and anaesthesiologists.


Assuntos
Fraturas por Compressão , Cifoplastia , Fraturas por Osteoporose , Fraturas da Coluna Vertebral , Vertebroplastia , Humanos , Cifoplastia/efeitos adversos , Fraturas por Compressão/diagnóstico por imagem , Fraturas por Compressão/cirurgia , Fraturas da Coluna Vertebral/diagnóstico por imagem , Fraturas da Coluna Vertebral/cirurgia , Coluna Vertebral , Vertebroplastia/métodos , Fraturas por Osteoporose/diagnóstico por imagem , Fraturas por Osteoporose/cirurgia
4.
Dalton Trans ; 53(3): 1253-1264, 2024 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-38112121

RESUMO

Herein, Cs2AgBiBr6 particles produced by the traditional super-saturation precipitation method were used as precursors to create Cs2AgBiBr6 films by the gas-quenching process under ambient atmospheric conditions. These films were utilized as a light-absorbing layer in hole-transporting free perovskite solar cells (PSCs) with carbon electrodes. Furthermore, the incorporation of the 1-butyl-3-methylimidazole hexafluorophosphate (BMIMPF6) ionic liquid (IL) at the metal oxide electron transporting layer/perovskite interface resulted in enhanced crystallinity of the perovskite, forming large perovskite grains of up to 800 nm. However, it was discovered that establishing the optimal concentration for passivating surface defects takes precedence over encouraging the growth of larger perovskite grains. The utilization of the optimized BMIMPF6 concentration led to a remarkable increase in the power conversion efficiency (PCE) of the cell, with a boost of over 31% to reach 1.67%, when compared to the cell produced without the inclusion of the IL. Our findings underscore that the passivation of surface defects between the TiO2 and perovskite layers holds more importance for enhancing the PCE of Cs2AgBiBr6-based perovskite solar cells than focusing solely on the perovskite morphology.

5.
Biomark Med ; 17(19): 787-798, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-38095984

RESUMO

Background: Autotaxin (ATX) is a nucleotide enzyme linked to cell growth, differentiation and migration. This study investigated serum levels of ATX in colorectal cancer (CRC). Methods: The study involved stage I-III CRC diagnosed between December 2020 and 2021, excluding those with neoadjuvant or adjuvant therapy, or metastasis. Healthy volunteers were controls. Serum ATX levels were measured by ELISA and compared. Results: This study included 129 patients (91 in the patient group and 38 in the control group). The optimal cutoff value of ATX for CRC was 169.98 ng/ml, and sensitivity, specificity, positive likelihood ratio and negative likelihood ratio were 91.2% (95% CI: 89.4-96.2), 78.9% (95% CI: 62.7-90.4), 4.33 and 0.11, respectively. Conclusion: The serum ATX level is a useful biomarker for CRC.


What is this summary about? Here, we summarize the results from 'The diagnostic value of serum autotaxin level in colorectal cancer' study, published in Biomarkers in Medicine. This study examined a biomarker that could enable the early diagnosis of colorectal cancer. Autotaxin (ATX) plays a key role in inflammatory and neoplastic processes. In our study, serum ATX levels were measured in patients with colorectal cancer. What are the results? Serum ATX levels were higher in patients with colorectal cancer than in healthy volunteers. ATX levels were not associated with tumor stage. However, ATX levels were lower in mucinous adenocarcinomas. The ATX levels were higher in females than males. Although our study sample was small, we observed that ATX was more sensitive and specific than carcinoembryonic antigen in detecting colorectal cancer. What do these results mean? Serum ATX levels are promising biomarkers for colorectal cancer diagnosis and patient surveillance.


Assuntos
Neoplasias Colorretais , Diester Fosfórico Hidrolases , Humanos , Biomarcadores , Proliferação de Células , Neoplasias Colorretais/diagnóstico , Ensaio de Imunoadsorção Enzimática
6.
Turk Neurosurg ; 33(5): 764-771, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37528716

RESUMO

AIM: To investigate the antiproliferative and apoptotic effects of S-allyl cysteine (SAC) on C6 glioblastoma cells using two- and three-dimensional (2D and 3D) cell culture systems. MATERIAL AND METHODS: Three groups of rat glioma cell line C6 were prepared: 2D-Control, 2D-SAC, 3D-CMC-Control, and 3D-CMC-SAC. The control cells were incubated under standard culture conditions, the SAC cells were incubated in a culture medium supplemented with the IC50 dose (50 ?M for both the 2D-SAC C6 and 3D-CMC-SAC groups) of SAC for 24 and 48 h. All experimental cells were stained with antibodies recognizing NOTCH1 and JAGGED1, and the mRNA expression levels of NOTCH1 and JAGGED1 were evaluated by qRT-PCR. RESULTS: Increasing doses of SAC were administered for 24 h to the C6 glioma cell line. The concentration of 50 ?M was selected as the most suitable dose for administration. The gene expression profiles differed between these two cell culture types. We found that the expression levels of NOTCH1 receptor mRNA were lower in cells exposed to 50-?M SAC for 24 h than those of control cells in both 2D and 3D cell cultures. The immunoreactivities of both the biomarkers JAGGED1 and NOTCH1 in the glioma cells decreased significantly in the SAC group. CONCLUSION: These findings indicate that SAC is a potential drug candidate for human use, as indicated by its nontoxic nature. In addition, SAC was found to exert an anticancer effect, which is associated with the modulation of JAGGED1 and NOTCH1 signaling pathways in glioma cancer cells.


Assuntos
Cisteína , Glioma , Ratos , Animais , Humanos , Linhagem Celular Tumoral , Glioma/tratamento farmacológico , Glioma/metabolismo , Técnicas de Cultura de Células , Técnicas de Cultura de Células em Três Dimensões , RNA Mensageiro
7.
Ulus Travma Acil Cerrahi Derg ; 29(8): 858-871, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37563894

RESUMO

BACKGROUND: The article was planned to make the first evaluation in terms of acute subdural hemorrhages, thinking that it can help in appropriate pathologies by tomography interpretation with the artificial intelligence (AI) method, at least in a way to quickly warn the responsible doctor. METHODS: A two-level AI-based hybrid method was developed. The proposed model uses the mask-region convolutional neural network (Mask R-CNN) technique, which is a deep learning model, in the hemorrhagic region's mask generation stage, and a problem-specific, optimized support vector machines (SVM) technique which is a machine learning model in the binary classification stage. Furthermore, the bee colony algorithm was used for the optimization of SVM algorithms' parameters. RESULTS: In the first stage, the mean average precision (mAP) value was obtained as 0.754 when the intercept over union (IOU) value was taken as 0.5 with the Mask R-CNN architecture used. At the same time, when a 5-fold cross-validation was applied, the mAP value was obtained 0.736. With the hyperparameter optimization for both Mask R-CNN and the SVM algorithm, the accuracy of the two-level classification process was obtained as 96.36%. Furthermore, final false-negative rate and false-positive rate values were obtained as 6.20%, and 2.57%, respectively. CONCLUSION: With the proposed model, both the detection of hemorrhage and the presentation of the suspicious area to the physician were performed more successfully on two dimensional (2D) images with low cost and high accuracy compared to similar studies and today's interpretations with telemedicine techniques.


Assuntos
Inteligência Artificial , Hematoma Subdural Agudo , Humanos , Redes Neurais de Computação , Algoritmos , Máquina de Vetores de Suporte
8.
World Neurosurg ; 175: e1197-e1209, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37121505

RESUMO

OBJECTIVE: The current study used polylactic acid molds [developed locally using three-dimensional printers and our software] and polymethyl methacrylate (PMMA) to perform cranioplasty of bone defects in technically demanding areas of the skull while ensuring ideal cosmetic results and functional recovery. The overall aim was to identify the ideal method for standard cranioplasty procedures METHODS: Polylactic acid duplicates of the skull defects were created for eligible patients, after which a two-part negative mold composed of plaster and silicone was used to form artificial bone with PMMA. Thereafter, cranioplasty was performed and the treatment success was assessed by evaluating the percentage of similarity objectively and the body image scale subjectively. RESULTS: No surgical complications were seen to occur in the 14 patients included in the current study. Furthermore, the subjective and objective evaluation revealed a significant improvement in outcomes (p < 0.05). No postoperative complications were observed over a follow-up period of 6 months, except in 1 patient who exhibited late infection. CONCLUSIONS: Cranioplasty operations were performed at an economical price of approximately US$50 dollars, suggesting that this method can be applied widely. Furthermore, preoperative preparation of the PMMA models can help reduce the duration of anesthesia and surgery which, in turn, will minimize the risk of surgical complications. Based on current knowledge in the field, we believe that this method represents the ideal technique.


Assuntos
Procedimentos de Cirurgia Plástica , Polimetil Metacrilato , Humanos , Polimetil Metacrilato/uso terapêutico , Crânio/cirurgia , Resultado do Tratamento , Complicações Pós-Operatórias/cirurgia , Próteses e Implantes
9.
Turk Neurosurg ; 33(2): 252-257, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36622188

RESUMO

AIM: To investigate the preoperative and postoperative differences in the upper-body and spinal shapes of patients with scoliosis. MATERIAL AND METHODS: Digitized two-dimensional X-ray images were used to obtain the shapes of the upper-body and spine. The preoperative and postoperative mean shapes were compared by using a Generalized Procrustes analysis. The thin plate spline (TPS) method was used to evaluate the spinal shape deformation between the preoperative and postoperative periods. RESULTS: The pre- and postoperative upper-body and spinal shape differences were significant. The TPS graphics showed highlevel deformations between the pre- and postoperative periods. The left superior border of the L4 spinous process showed the highest deformation. CONCLUSION: The preoperative and postoperative upper-body and spinal shape differences and structural deformations that correlated with scoliosis were shown to be significant.


Assuntos
Escoliose , Fusão Vertebral , Humanos , Criança , Escoliose/diagnóstico por imagem , Escoliose/cirurgia , Coluna Vertebral/diagnóstico por imagem , Coluna Vertebral/cirurgia , Placas Ósseas , Corpo Vertebral , Fusão Vertebral/métodos , Estudos Retrospectivos
10.
Turk Neurosurg ; 33(1): 110-117, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-35713261

RESUMO

AIM: To uncover factors that can predict the development of C5 palsy before surgery by evaluating several different parameters. MATERIAL AND METHODS: A total of 177 patients who underwent surgery between 2015 and 2020 were included in the study. In total, C5 palsy was observed in 22 (12.4%) of our patients. The radiological and clinical data of the patients were retrospectively analyzed and added to the data. RESULTS: A total of 177 patients who satisfied the criteria were included in the study, among whom 117 (66.1%) and 60 (33.9%) were male and female, respectively. Patients with ossified posterior longitudinal ligament (OPLL) (92; 52.0%) needed surgery the most. C5 palsy developed in 16/92 (17.3%) patients who had surgery for OPLL. This result was statistically significant (p < 0.001). However, a significant difference in the postoperative Pavlov ratio was noted between both groups (p=0.027). The foraminal dimensions for the C5 palsy group were significantly lower than those for the non-C5 palsy group. CONCLUSION: Smaller C5 root foramina diameter measurements were the most important predictive factor for the development of C5 palsy after open-door cervical laminoplasty. Although the pathophysiology remains to be fully understood, ischemia-reperfusion injury supposedly plays a role therein.


Assuntos
Laminoplastia , Humanos , Masculino , Feminino , Laminoplastia/efeitos adversos , Laminoplastia/métodos , Vértebras Cervicais/diagnóstico por imagem , Vértebras Cervicais/cirurgia , Estudos Retrospectivos , Paralisia/epidemiologia , Paralisia/etiologia , Paralisia/cirurgia , Radiografia
11.
Spinal Cord ; 61(2): 169-174, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-36575225

RESUMO

STUDY DESIGN: This was a retrospective, comparative 6-year study. OBJECTIVES: This study aimed to retrospectively analyze patients who were treated at Kilis State Hospital for spine and spinal cord injuries during the Syrian civil war and to compare the treatment results with the literature. SETTING: Kilis State Hospital, Kilis, Turkey. METHODS: In our study, 84 patients who were treated for spine and spinal cord injuries between December 2011 and May 2017 were examined. Patient age, sex, injury type, injury region, neurological status, time from injury to treatment, treatment methods, surgical methods applied, and complications were evaluated. RESULTS: Of the patients, 72 were male, and 12 were female. The mean age of the patients was 23.2 ± 7.3 years. Fifty-two patients were treated surgically. Surgical treatment was applied to 44 patients with neurological deficits. At least 1-grade neurological improvement was observed in 77.3% (n = 34) of patients with neurological deficits who underwent surgical treatment. Surgical treatment was performed on 18 (34.6%) patients in the first 24 h, 27 (51.9%) patients within 24-72 h, and 7 patients (13.5%) between 72 h and 5 days. Neurological improvement was observed in all patients with neurological deficits who underwent surgical treatment in the first 24 h. CONCLUSIONS: Early surgery (in the first 24 h) had a positive effect on the neurological recovery of the patients in our study. Thus, patients with spine and spinal cord injuries rendered a surgical-treatment decision should be operated on in a timely manner, particularly within the first 24 h.


Assuntos
Traumatismos da Medula Espinal , Traumatismos da Coluna Vertebral , Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Traumatismos da Medula Espinal/epidemiologia , Traumatismos da Medula Espinal/cirurgia , Estudos Retrospectivos , Síria , Coluna Vertebral , Resultado do Tratamento , Traumatismos da Coluna Vertebral/cirurgia
12.
World J Transplant ; 12(12): 405-414, 2022 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-36570407

RESUMO

BACKGROUND: Over the last few years, the deceased donor organ donation rate was declined or remained stable, whereas the live donor organ donation rate has increased to compensate for the demand. Minimally invasive techniques for live donor nephrectomy (LDN) have also improved the live donor kidney donation rates. This increase has led to an interest in the surgical procedures used for LDN. AIM: To evaluate the LDN techniques performed in Turkey, the structure of surgical teams, and the training received. Additionally, the number of kidney transplantations at different centers, the surgeon experience level, differences in surgical approach during donor surgeries, and outcomes were assessed. METHODS: A questionnaire was sent to the Turkish Ministry of Health-accredited transplant centers. It inquired of the number of LDN surgeries, surgical techniques, complications, optimization protocols, the experience of surgeons, and the training. Descriptive statistics were outlined as follows: Discrete numeric variables were expressed as medians (minimum-maximum), while categorical variables were shown as numbers and percentages. As a result of the goodness-of-fit tests, if the significance of the differences between the groups in discrete numerical variables for which the parametric test statistical assumptions were not met, data were analyzed with the Mann Whitney U test and the χ 2 test. RESULTS: The questionnaire was sent to 72 transplant centers, all of which replied. Five centers that reported not performing LDN procedures were excluded. Responses from the remaining 67 centers were analyzed. In 2019, the median number of kidney transplants performed was 45, and the median number of kidney transplants from living donors was 28 (1-238). Eleven (16.5%) centers performed 5-10, while 34 (50.7%) centers performed more than 100 live donor kidney transplants in 2019. While 19 (28.4%) centers performed the LDN procedures using the open technique, 48 (71.6%) centers implemented minimally invasive techniques. Among the centers preferring minimally invasive techniques for LDN, eight (16.6%) used more than one surgical technique. The most and the least common surgical techniques were transperitoneal laparoscopic (43 centers, 89.6%) and single port laparoscopic LDN (1 center, 2.1%) techniques, respectively. A positive association was found between the performance of minimally invasive techniques and the case volume of a transplant center, both in the total number and live donor kidney transplants (15 vs 55, P = 0.001 and 9 vs 42, P ≤ 0001 respectively). The most frequently reported complication was postoperative atelectasis (n = 33, 49.2%). There was no difference between the techniques concerning complications except for the chyle leak. CONCLUSION: Turkish transplant centers performed LDN surgeries successfully through various techniques. Centers implementing minimally invasive techniques had a relatively higher number of live donor kidney transplants in 2019.

13.
Artigo em Inglês | MEDLINE | ID: mdl-35787227

RESUMO

BACKGROUND: Intervertebral disc degeneration (IDD) is a common and complex condition. Vascular endothelial growth factor (VEGF) is one of the key regulators of angiogenesis and vascular permeability. Nitric oxide (NO) plays a role in various physiological events. The endothelial nitric oxide synthase (eNOS) that catalyses NO generation are crucial for the regulation of NO level. This study aimed to evaluate the association between VEGF/ eNOS gene variants with IDD. MATERIALS AND METHODS: Two hundred ninety-one subjects (111 IDD patients and 180 controls) were included in the present case-control study. VEGF -2549 insertion/deletion (I/D) and eNOS VNTR variants were analysed by PCR method. The results of this analysis were evaluated for statistical significance. RESULTS: There were no statistically significant differences in genotype and allele distribution of VEGF -2549 I/D/ eNOS VNTR variants between IDD patients and control subjects. We then evaluated the association between the allele frequencies of these variants and clinical features of IDD. Lumber IDD was more common in patients carrying VEGF I/D variant D allele (p < 0.001). Also, patients with lumbar disc herniation, cervical disc herniation, lumbar stenosis, and lumbar IDD had more 4 b allele (p = 0.005, p < 0.001, p < 0.001, and p = 0.03, respectively). CONCLUSIONS: In conclusion, this study demonstrates first time that some clinical characteristics of IDD have been associated with allele frequencies of VEGF -2549 I/D/ eNOS VNTR variants.


Assuntos
Degeneração do Disco Intervertebral , Deslocamento do Disco Intervertebral , Humanos , Degeneração do Disco Intervertebral/genética , Deslocamento do Disco Intervertebral/genética , Óxido Nítrico/metabolismo , Óxido Nítrico Sintase Tipo III/genética , Fator A de Crescimento do Endotélio Vascular/análise , Fator A de Crescimento do Endotélio Vascular/genética , Fatores de Crescimento do Endotélio Vascular
14.
Turk Neurosurg ; 2022 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-35713259

RESUMO

AIM: Vertebral compression fractures (VCF) occur most commonly at the thoracolumbar junction (TLJ). Balloon kyphoplasty (BKP) is an effective method of bone remodeling in these cases. In this study, we evaluate the parameters that affect bone retropulsion and restoration in TLJ VCF without neurological deficits. MATERIAL AND METHODS: Thirty-one of Frankel E and AO A3-4 type VCFs fractures at the TLJ, with bone retropulsion into the spinal canal, from 2017 to 2020, were evaluated retrospectively. Data was gathered on patient demographics and medical histories. Measurements of anterior vertebral heights, posterior vertebral heights, local kyphotic angles, spinal cord area, and bone retropulsion into the spinal canal (BRC) were evaluated preoperatively, early postoperatively, and late postoperatively. RESULTS: In those patients who underwent early surgery ( 4 weeks postfracture), a significantly greater increase in anterior vertebral heights was seen between early postoperative and preoperative measurements than in patients who underwent late surgery ( 4 weeks postfracture) (p = 0.016). At the six-month follow-up, a significantly greater decrease in local kyphotic angle measurements was seen in patients over 65 years of age than those under 65 (p = 0.023). Comparison of local kyphotic angles between sexes revealed a significant decrease in measurements at follow-up in female patients (p = 0.029). Both early postoperative and late postoperative local kyphotic angle measurements of patients with a body mass index (BMI) ≥25 were significantly lower than those of patients with a BMI 25 (p = 0.012). CONCLUSION: The restoration of vertebral angles and heights with the maximum level of BKP can effectively reduce BRC.

15.
World Neurosurg ; 164: e899-e907, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35609726

RESUMO

OBJECTIVE: Although ventriculoperitoneal shunt surgery is the most common method for hydrocephalus treatment, it may lead to serious complications and require surgical interventions. Peritoneal catheter fracture is one of the common complications that may cause intermittent hydrocephalus. If patients with peritoneal catheter fracture have symptoms of hydrocephalus and ventricular dilatation, the treatment algorithm is clear. However, the diagnosis and treatment protocol remains unclear otherwise. In this article, the possible mechanisms of hydrocephalic symptoms, the diagnosis, as well as treatment algorithms are examined. METHODS: Eight patients with a ventriculoperitoneal shunt who had intermittent hydrocephalic symptoms due to peritoneal catheter fracture but without any radiologically significant ventricular dilatation at Nigde Ömer Halisdemir University from 2018 to 2021 were collected. A new diagnostic algorithm was created. Patient follow-up was performed in each patient as a procedure. RESULTS: The method that we determined was successful in all our patients. No complications were observed. We have followed the patients with a normal clinic for at least 6 months. CONCLUSIONS: The provocation test we have formulated always revealed the true cause of the clinic. Thus, on the one hand, with a positive provocation test we recommend revision surgery without waiting for the ventricular dilatation or hydrocephalic symptoms in patients with a fractured peritoneal catheter, considering the results of asymptomatic shunt revision surgery have been reported to be better than those with symptomatic shunt dysfunction; on the other hand, patients with negative provocation tests are saved from unnecessary surgical intervention as well as benefit from true etiologic fast treatment.


Assuntos
Anormalidades Cardiovasculares , Fraturas Ósseas , Hidrocefalia , Anormalidades Cardiovasculares/complicações , Anormalidades Cardiovasculares/cirurgia , Cateteres de Demora/efeitos adversos , Fraturas Ósseas/cirurgia , Humanos , Hidrocefalia/diagnóstico por imagem , Hidrocefalia/etiologia , Hidrocefalia/cirurgia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/cirurgia , Reoperação/efeitos adversos , Derivação Ventriculoperitoneal/efeitos adversos
16.
Childs Nerv Syst ; 38(9): 1743-1749, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35616724

RESUMO

OBJECTIVE: Kilis, Turkey, a city near Aleppo, Afrin and Azez, Syria, where conflicts are intense, is one of the cities that provides initial emergency treatment. The aim in this study was to analyze the clinical and radiological characteristics of and treatment methods and results in pediatric patients admitted to Kilis State Hospital with cranial gunshot wounds obtained during the Syrian war. MATERIALS AND METHODS: In this study, 62 pediatric patients treated for cranial gunshot wounds obtained during the civil war in Syria between December 2011 and May 2017 at the Neurosurgery Clinic of Kilis State Hospital on the Turkish side of the Turkey-Syria border were retrospectively analyzed. RESULTS: A total of 62 patients were evaluated. Forty-six (74.2%) patients were male and 16 (25.8%) were female. The mean age of the patients was 11.4 ± 6.3 (range: 1 month to 18 years) years. The mean Glasgow coma scale (GCS) score was 7.2 ± 3.8. Surgical treatment was performed in 36 patients (58.1%). Six (16.7%) of the surgically treated patients and 15 (57.7%) of the conservatively treated patients died (p < 0.001). While good clinical results (GOS4-5) were obtained in 24 (66.7%) patients who underwent surgical treatment, only 8 (30.8%) patients who underwent conservative treatment had good clinical results (GOS 4-5). The treatment results in patients with a GCS score of between 9 and 15 who were treated with both methods were significantly better (GOS score of 4-5) (p < 0.05) than those in patients with a GCS score of 8 or lower. The treatment results of the patients aged 10-18 years were significantly better than those of patients aged 0-9 years (GOS 4-5) (p < 0.05). CONCLUSION: In this study, the GCS score on admission was a significant predictive factor for survival in pediatric patients with cranial gunshot wounds. The outcomes of patients aged 0-9 years with severe neurological damage were worse than those in patients aged 10-18 years. On the basis of the analyses of the treatment methods and GCS and GOS scores of the patients in our study, we conclude that surgical treatment should be performed immediately in all patients with radiological indications and a GCS score higher than 3. Additionally, we conclude that child soldiers exist in Syria.


Assuntos
Ferimentos por Arma de Fogo , Criança , Feminino , Escala de Coma de Glasgow , Humanos , Lactente , Masculino , Estudos Retrospectivos , Síria , Resultado do Tratamento , Ferimentos por Arma de Fogo/diagnóstico por imagem , Ferimentos por Arma de Fogo/epidemiologia , Ferimentos por Arma de Fogo/terapia
17.
Ulus Travma Acil Cerrahi Derg ; 28(4): 418-427, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35485508

RESUMO

BACKGROUND: This study aims to evaluate the predictive level of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) risk calculator for post-appendectomy complications. METHODS: A total of 292 patients who were hospitalized for general appendectomy were included in the study. The age range of the patients was 18-76 years (mean: 35.3±13.6 years). The mean body mass index was 25.8±4.6. Twenty data points were entered into the ACS-NSQIP surgical risk calculator (SRC), which yielded the 17 most common complications and the average LOHS. Compli-cations encountered in 30-day follow-up were categorized according to the complications predicted by SRC. The actual and observed complication rates and LOHS were compared RESULTS: Post-operative complications developed in 13.4% of the patients, surgical site infection in 11.3%, serious complications in 3.1%, and readmission in 2.1%. Serious complications included pneumonia, sepsis, cardiac complications, and renal failure. The mean LOHS was 1.91±1.64 days (range: 1-14 days). No thromboembolism or mortality was observed. When the comparison of compli-cations using SRC was made with the ROC curve, the predictive value of SRC was 84.2% for any complication, 86.7% for serious complication, 47.6% for surgical site infection, 95.9% for renal failure, 99.0% for resurgery, and 88.3% for sepsis. CONCLUSION: Although it is rare to see complications after simple appendectomy, it is known that complication rates increase sig-nificantly in the elderly, the obese, and those with comorbidities. Tools such as SRC will be beneficial for patients with these risk factors.


Assuntos
Laparoscopia , Insuficiência Renal , Sepse , Cirurgiões , Adolescente , Adulto , Idoso , Apendicectomia/efeitos adversos , Feminino , Humanos , Laparoscopia/efeitos adversos , Masculino , Pessoa de Meia-Idade , Melhoria de Qualidade , Estudos Retrospectivos , Medição de Risco , Infecção da Ferida Cirúrgica , Estados Unidos , Adulto Jovem
18.
Int J Neurosci ; 132(7): 735-743, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33866943

RESUMO

AIM: Brain arteriovenous malformations (AVMs) are congenital anomalies that present as intracranial hemorrhage or epilepsy. AVMs often remain clinically silent for extended periods. Although AVM treatment methods are controversial, three treatment strategies are usually combined or applied alone: surgical removal, embolization and stereotactic radiosurgery. We compared clinical and radiological outcomes in intracranial AVM patients treated via surgical resection with and without prior embolization. MATERIALS AND METHODS: Patients who did (30 patients) and did not (30 patients) undergo endovascular embolization before surgical resection at the Izmir Katip Çelebi University Atatürk Training and Research Hospital Neurosurgery Clinic from 2011 to 2019 were included in this retrospective, cohort study. Symptoms at diagnosis, comorbidities and clinical (AVM and Spetzler-Martin grade) and morphological characteristics were assessed. RESULTS: A mean one-year follow-up assessed outcomes using the modified Rankin score, and imaging studies assessed AVM obliteration post-procedure. Mean operation times for surgical resection with and without embolization were 166.50 ± 32.02 and 204.47 ± 26.66 min, respectively. Mean patient hospitalization periods for surgical resection with and without embolization were 8.43 ± 3.60 and 12.00 ± 5.51 days, respectively. CONCLUSION: Among patients who underwent surgical resection, significant operation time and hospitalization time differences were observed in favor of patients who underwent embolization, indicating that preoperative embolization is a safe and beneficial method for treating ruptured and non-ruptured AVMs.


Assuntos
Embolização Terapêutica , Malformações Arteriovenosas Intracranianas , Radiocirurgia , Estudos de Coortes , Embolização Terapêutica/métodos , Seguimentos , Humanos , Malformações Arteriovenosas Intracranianas/diagnóstico por imagem , Malformações Arteriovenosas Intracranianas/cirurgia , Radiocirurgia/métodos , Estudos Retrospectivos , Resultado do Tratamento
19.
J Craniofac Surg ; 33(4): 1013-1017, 2022 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-34538790

RESUMO

ABSTRACT: Studies on cranial gunshot injuries in the Syrian war are present in the literature. However, the effect of surgical timing on the clinical outcomes of patients undergoing surgical treatment has not been discussed extensively. In this study, the time from injury to surgery is called "time to surgery." Kilis, a city close to Aleppo, Afrin, and Azez, where the conflicts in Syria are intense, is one of the cities where the first emergency treatments were administered. This study aimed to evaluate patients who underwent surgery in Kilis State Hospital due to cranial gunshot injury in the Syrian war and to investigate the effect of surgical timing on mortality and Glasgow Outcome Score.Surgical treatment was applied to 42 (32.8%) patients in the first 4 hours, 64 (50%) patients within 4 to 24 hours, and 22 (17.2%) patients between 24 hours and 3 days. As the time to surgery decreased, the good Glasgow Outcome Score (GOS) (4-5) outcome rates increased. The differences in surgical timing and GOS results of patients with Glasgow Coma Score (GCS) <8 and >8 were found to be significant for good GOS results. As the time to surgery decreased for patients with a GCS <8 and >8, mortality rates decreased equally. This result was statistically significant.Our study showed that surgical timing is as important as early intubation, aggressive resuscitation, and admission GCS for both survey and GOS.


Assuntos
Traumatismos Cranianos Penetrantes , Ferimentos por Arma de Fogo , Escala de Coma de Glasgow , Traumatismos Cranianos Penetrantes/cirurgia , Humanos , Prognóstico , Estudos Retrospectivos , Síria , Ferimentos por Arma de Fogo/cirurgia
20.
Turk J Phys Med Rehabil ; 67(3): 328-335, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34870120

RESUMO

OBJECTIVES: This study aims to investigate the postoperative short-term effectiveness of preoperative pain neurophysiology education on pain severity, kinesiophobia, and disability in patients undergoing lumbar surgery for radiculopathy. PATIENTS AND METHODS: Between April 2019 and August 2019, a total of 41 patients (22 males, 19 females; mean age 52.1±9.5 years; range, 37 to 64 years) scheduled for lumbar radiculopathy surgery were randomized to receive either preoperative routine education only (control group, n=20) or a 70-min pain neurophysiology education in addition to preoperative routine education (intervention group, n=21). The patients were evaluated for the following outcomes prior to surgery (baseline) and at 12 weeks after surgery: low back pain and leg pain using Numeric Pain Rating Scale, disability using Oswestry Disability Index), and kinesiophobia using Tampa Scale for Kinesiophobia. RESULTS: There were no statistically significant differences in low back pain (p=0.121), leg pain (p=0.142), and the length of stay hospital (p=0.110) between the groups. However, the interaction effects of intervention group were superior to control group regarding disability (p=0.042) and kinesiophobia (p<0.001). CONCLUSION: The addition of pain neurophysiology education to routine education following lumbar radiculopathy surgery yields significant improvements for disability and kinesiophobia, although no additional benefits is seen regarding the pain severity and length of stay in hospital in the short-term.

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