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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.
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
3.
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
4.
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
5.
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
6.
Br J Neurosurg ; 35(2): 186-190, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32672074

RESUMO

Background: As an advanced imaging technique for the human brain, the importance of magnetic resonance imaging technique (MRI) is indisputable. The study aims to contribute to the literature by imaging post-mortem human brain hemispheres fixed with the Klinger method through the a 3.0 Tesla MRI Scanner and by defining the supratentorial major white matter tracts and central core anatomical structures.Methods: In our study, 10 post-mortem human brain hemisphere specimens were placed in 10% formalin solution for at least two months according to the Klingler method. The images were obtained using a 3.0 Tesla MRI Scanner. Anatomical structures were described on the T1-T2 axial, coronal, and sagittal MRI sections and compared with control images obtained from healthy humans.Results: Our examination revealed major association fibers, the basal cores and nuclei were denser, and the connections between them were clearly visible. The basal nuclei particularly were visualized more clearly compared with the normal MRI examinations. The claustrum, putamen, lateral and medial part of globus pallidus, and the caudolenticular bridges of the caudate nucleus could be clearly distinguished. The optic radiation line toward the occipital area as well as the forceps major and minor were distinct in the axial sections. Meanwhile, the imaging emphasized the importance of temporal stem, and the fibers it contained were clearly observed in the coronal sections.Conclusion: The use of hemispheres fixed using the Klinger method in post-mortem MRI examinations on brain hemispheres showed a clear separation of white matter fibers and nuclear structures.


Assuntos
Cérebro , Substância Branca , Autopsia , Encéfalo/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , Substância Branca/diagnóstico por imagem
7.
J Surg Res ; 252: 240-246, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32304930

RESUMO

BACKGROUND: To evaluate the correlation between intraabdominal pressure (IAP) measured via the bladder and renal resistive index (RRI) measured by Doppler ultrasonography (USG). METHODS: Eighty consecutive surgical patients were included into this study. Before Doppler USG evaluation, IAP was measured by a Foley catheter via the bladder. The left and right RRI, the diameters of the inferior vena cava and portal vein were measured by colored Doppler USG. Spearman correlation analysis was used to evaluate the correlation between different measurements. Intraabdominal hypertension (IAH) was defined as of IAP ≥ 12 mmHg. Significantly different variables from the univariate analysis between patients with and without IAH were entered into backward stepwise binary logistic regression analysis of IAH as the dependent variable. P values < 0.05 were accepted as statistically significant. RESULTS: In total, 80 patients were included into study. In 27 patients (34%) IAP was normal and in 53 patients (66%) IAH was diagnosed. The Spearman correlation analysis of IAP and the ultrasonographic measurements revealed a strong correlation between RRI and IAP (P < 0.001). Patients with IAH were more likely to be diabetic and had abdominal incisional hernia compared with patients with normal IAP (P < 0.05). The results of the multivariate logistic regression analysis revealed right RRI as the only independent predictor of IAH (B: 57.04, S. E.: 13.7, P < 0.001). CONCLUSIONS: There is a strong correlation between IAP and RRI. RRI can be an alternative, noninvasive technique for the diagnosis and follow-up of IAH after further evaluations in different patient groups.


Assuntos
Cavidade Abdominal/fisiopatologia , Hipertensão Intra-Abdominal/diagnóstico , Rim/diagnóstico por imagem , Circulação Renal/fisiologia , Resistência Vascular/fisiologia , Adulto , Idoso , Feminino , Humanos , Hipertensão Intra-Abdominal/fisiopatologia , Rim/irrigação sanguínea , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Ultrassonografia Doppler
8.
J Craniofac Surg ; 30(3): e218-e220, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30845079

RESUMO

The authors present a rare case of cavernous angioma mimicking a meningioma in a 58-year-old man who presented with a headache and dizziness. There were no neurological deficits or other neurological symptoms or signs. An extra-axial mass lesion thought to be associated with diffusely well-enhanced falx in the postcontrast sections was noted in the posterior interhemispheric fissure near the posterior part of the corpus callosum splenium. Extra-axial cavernous angiomas (cavernomas) are extremely rare lesions. They most commonly occur in the parenchyma but have been occasionally reported to arise from the dura matter. Dural cavernous angiomas arise from dural sinuses, falx cerebri, tentorium cerebelli, cranial base dura, or internal auditory canal dura and convexity. Parenchymal cavernous angiomas classically have a ring of hemosiderin surrounding the lesions observed on magnetic resonance imaging, but dural cavernous angiomas do not display the same magnetic resonance imaging characteristics and occasionally exhibit a dural tail sign due to which they can often be misdiagnosed as meningiomas.


Assuntos
Neoplasias Encefálicas , Hemangioma Cavernoso , Encéfalo/diagnóstico por imagem , Neoplasias Encefálicas/complicações , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/fisiopatologia , Diagnóstico Diferencial , Tontura , Hemangioma Cavernoso/complicações , Hemangioma Cavernoso/diagnóstico por imagem , Hemangioma Cavernoso/fisiopatologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Meningioma , Pessoa de Meia-Idade
9.
J Craniofac Surg ; 30(3): 713-715, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30688810

RESUMO

Cranioplasty is a reconstruction operation made to protect intracranial structures. It is applied for the closure of bone defects occurring due to causes such as trauma, tumor, infection, and infarct. Many different products changing from autologous bone grafts to synthetic materials are used for cranioplasty. Three-dimensional printers that are among the popular innovations of today are used gradually more in medical area as in every field of life and they make the surgical operation easier. When customizable materials are combined with technology, the authors come across successful results and less complications. The aim of the authors' study was to show a 3-dimensional modeling method in 2 patients the authors applied cranioplasty and the advantages provided by this method for the surgeon and the patient.


Assuntos
Transplante Ósseo/métodos , Crânio/cirurgia , Humanos , Metilmetacrilatos/uso terapêutico , Modelos Anatômicos , Impressão Tridimensional , Procedimentos de Cirurgia Plástica/métodos , Tomografia Computadorizada por Raios X , Transplante Autólogo/métodos
10.
Turk J Med Sci ; 49(3): 922-927, 2019 06 18.
Artigo em Inglês | MEDLINE | ID: mdl-31121999

RESUMO

Background/aim: Application fields of bone tissue engineering studies continue to expand. New biocompatible materials aimed to improve bone repairment and regeneration of implants are being discovered everyday by scientists, engineers, and surgeons. Our objective in this study is to combine polylactic acid which is a polymer with hydroxyapatite in the repairment of bone defects considering the increased need by medical application fields. Materials and methods: After 750 g of PLA with a diameter of 2.85 mm was granulated into minimum particles, these particles were homogenously mixed with hydroxyapatite prepared in laboratory environment. Using this mixture, HA-PLA filament with a diameter of 2.85 mm was prepared in the extrusion device in Kütahya Medical Sciences University Innovative Technology Laboratory. The temperature was 250 °C and the gearmotor speed was 9 rpm during extrusion. X-ray diffraction (XRD) analysis was made for crystal phase analyses of the produced hydroxyapatite powder, to determine the produced main phase and examine whether a minor phase occurred. Vickers microhardness test was applied on both samples to measure the endurance levels of the samples prepared with HA-PLA filament. A loading force of 10 kg was applied on the samples for 10 s. Results: Hydroxyapatite peaks in XRD spectrum of the sample presented in figures are concordant with Joint Committee on Powder Diffraction Standards, JCPDS - File Card No. 01-075-9526 and no significant minor phase was observed. For both samples, hardness value was observed to increase between 3 and 5 mm. Conclusion: Surfacing hydroxyapatite on metallic materials is possible. By similar logic, to increase durability with low cost, characteristics of biomaterials can be improved with combinations such as hydroxyapatite PLA. Thus, we found that while these materials have usage limitations due to present disadvantages when used alone, it is possible to increase their efficiency and availability through different combinations.


Assuntos
Substitutos Ósseos/química , Durapatita/química , Poliésteres/química , Impressão Tridimensional , Engenharia Tecidual/instrumentação , Teste de Materiais , Difração de Raios X
11.
J Craniofac Surg ; 27(4): 1015-20, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27213744

RESUMO

This retrospective study aimed to define outcomes and complications of endoscopic versus microscopic transsphenoidal surgery in pituitary adenoma. Data of 94 patients who underwent transsphenoidal endoscopic (n = 45) or microscopic surgery (n = 49) between June 2000 and June 2014 for pituitary adenoma, performed at Katip Çelebi University Hospital, were retrospectively analyzed. The patients' symptomatology, type of adenoma, radiologic findings, surgical outcomes, and preoperative and postoperative complications were investigated. The total subtotal resection rate was 73.4% (69 patients) and partial resection rate was 26.6% (25 patients). Total subtotal resection rate was 77.6% (38 patients) in the microscopic group and 68.9% (31 patients) in the endoscopic group. Total resection was seen more often in the endoscopic group than in the microscopic group, with no significant difference between the groups. Four patients (8.2%) in the microscopic group had postoperative cerebrospinal fluid leak compared with 3 patients (6.7%) in the endoscopic group. Two patients (2.1%) had hematoma, with 1 patient each in the endoscopic and microscopic group. Panhypopituitarism development rate was higher in the endoscopic group (no significant difference between the 2 groups). One patient (2%) developed blindness in the microscopic group and 1 (2.2%) had meningitis in the endoscopic group. Based on this study, the total resection rate was higher in the microscopic group than in the endoscopic group. However, outcomes and complication rate did not differ significantly between the 2 surgical techniques. Both techniques have advantages and disadvantages. Prospective randomized controlled trials should be conducted to compare the 2 surgical methods.


Assuntos
Adenoma/cirurgia , Endoscopia/métodos , Microscopia/métodos , Procedimentos Neurocirúrgicos/métodos , Neoplasias Hipofisárias/cirurgia , Complicações Pós-Operatórias , Seio Esfenoidal/cirurgia , Adenoma/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Neoplasias Hipofisárias/diagnóstico , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
12.
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.

13.
Neurocirugia (Astur : Engl Ed) ; 35(4): 205-209, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38964823

RESUMO

The anterior communicating artery (AcoA) aneurysms represent the most complex aneurysms of the anterior circulation. For years, surgical challenges including the intricate anatomy and narrow surgical corridor have been overcome using supplementary techniques including extended craniotomies, wide opening of the cisterns, gyrus rectus resection and special clips like fenestrated clips. However, imaginative solutions such as intraoperative clip modification may be inevitable in particular cases for safe clipping. We retrospectively analyzed clinical records of two patients who required clip modification intraoperatively. Case #1 underwent microsurgical clipping of a ruptured, 4-mm AcoA aneurysm. Unfortunately, given the short distance between the two A2s, it was not possible to clip the aneurysm without a compromise to the contralateral A2 with the available shortest 3mm-fenestrated clip. We then used the clip modification technique intraoperatively by shortening the clip tips with mesh-plaque cutter and smoothening the remaining sharp ends using cautery sanding. Eventually, the aneurysm was clipped successfully with the modified-fenestrated clip. Post-clipping imagings confirmed complete occlusion of the aneurysm and patency of parent arteries. Case 2# underwent microsurgical clipping for a ruptured, 1-mm AcoA aneurysm. Like Case 1#, the initial clipping attempt with the available shortest 4mm-fenestrated clip failed given the excessive length of the tips. The patient, thus, required clip modification as described above. The aneurysm was then clipped successfully using the modified-fenestrated clip, protecting bilateral A2s. Post-clipping imagings demonstrated patency of parent arteries with no residual aneurysm filling. Clip modification seems to be an effective option in clipping the AcoA aneurysms when available clips are too long to secure them safely.


Assuntos
Aneurisma Intracraniano , Instrumentos Cirúrgicos , Humanos , Aneurisma Intracraniano/cirurgia , Aneurisma Intracraniano/diagnóstico por imagem , Feminino , Pessoa de Meia-Idade , Masculino , Aneurisma Roto/cirurgia , Aneurisma Roto/diagnóstico por imagem , Estudos Retrospectivos , Microcirurgia/instrumentação , Microcirurgia/métodos , Desenho de Equipamento , Idoso , Procedimentos Neurocirúrgicos/métodos , Procedimentos Neurocirúrgicos/instrumentação
14.
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
15.
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
16.
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
17.
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
18.
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
19.
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
20.
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
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