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OBJECTIVE: To create a reusable and inexpensive training model with technological tools that simulates cerebral bypass surgery and a sensor system that provides tactile feedback to the surgeon. Furthermore, we aimed to evaluate the anastomotic stability and contribution to the surgeon's learning curve. METHODS: We created a superficial temporal artery (STA)-middle cerebral artery (MCA) bypass simulation model using chicken and turkey brachial arteries. A cranium model was printed with a three-dimensional printer for craniotomy and cerebral parenchyma was created by pouring silicone into the cranial mold. A blood flow simulation system was also prepared. Pressure-sensitive sensors were placed on parenchyma, and tactile conditioning was performed via audible warning from the sensors. 24 anastomosis were performed with different sutures and hand tools. Anastomosis completion times and durability and the number of touches and pressures applied to the parenchyma were recorded. The stability of the anastomoses was evaluated by increasing the pressure in the blood flow simulation system, so usefulness of the training model was evaluated. RESULTS: The time required for anastomosis completion decreased as the number of practices (p < 0.05). As the number of practices increased, the number of parenchymal touches decreased (p < 0.05). CONCLUSIONS: With practice, the time required for anastomosis completion and number of parenchymal touches decreased. Thus, the model is useful, inexpensive, reusable, easily accessible and contributes to the surgeon's learning curve. Our model with pressure-sensitive sensors can be used for microsurgery practice, enabling the surgeons to gain tactile conditioning and evaluate anastomotic stability and leakage.
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Depression is a mental disorder characterised by persistent low mood, anhedonia and cognitive impairment that affects an estimated 3.8% of the world's population, including 5% of adults. Peganum harmala L. (P. harmala) is a medicinal plant and has been reported to be effective against Alzheimer's disease, Parkinson's disease and depression. The present study was aimed to evaluate the behavioral and pharmacological effects of P. harmala seed extract in rats exposed to chronic unpredictable mild stress (CUMS) in vivo and to investigate the mechanism of action. CUMS-exposed rats were treated with P. harmala extract (75 and 150 mg/kg, i.p.) for 2 weeks. HPLC analysis was used to determine the concentration of harmaline and harmine alkaloids in the extract. Heavy metal analysis in seeds was performed by ICP-MS. Our results showed that P. harmala at the dose of 150 mg/kg significantly reduced the depressive-like behaviors in CUMS-exposed rats, as evidenced by increased sucrose consumption in the sucrose preference test (SPT), decreased immobility time in the forced swim test (FST) and plasma corticosterone levels, increased the time spent in open arms in the elevated plus maze (EPM), and improved memory and learning in the passive avoidance test (PAT). In addition, P. harmala decreased monoamine oxidase-A (MAO-A) levels, and increased serotonin (5-HT), dopamine (DA), and noradrenaline (NA) levels in the brains of rats exposed to CUMS. P. harmala decreased the expression of the pro-inflammatory transcription factor nuclear factor-κB (NF-κB), and increased the antioxidant nuclear factor erythroid 2-related factor 2 (Nrf2) in rat brain. Furthermore, P. harmala improved brain-derived neurotrophic factor (BDNF) and tropomyosin receptor kinase B (TrkB) protein expression in rat brain. In conclusion, P. harmala at a dose of 150 mg/kg is more effective in preventing depressive-like behavior in CUMS-exposed rats by improving neurotransmitter levels, reducing oxidative stress, suppressing neuroinflammation and activating the BDNF/TrkB pathway, all of which are important in the pathogenesis of depression.
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OBJECTIVE: Despite the relatively high success of surgical clipping of supraclinoid segment aneurysms of the internal carotid artery (ICA), flow diverter (FD) stent therapy is becoming increasingly used for these aneurysms. This study aims to evaluate the characteristics of FD placement for unruptured ICA supraclinoid segment aneurysms at 6 different centers with different experience levels in Türkiye. METHODS: In this retrospective, multicenter study, the authors reviewed the demographic information, aneurysm shape/dimensions (neck, aspect ratio, dome/neck ratio, and maximum diameter), preoperative antiplatelet regimen, FD stent brand, perioperative complications, intervention time, clinical (modified Rankin Scale) and radiological (O'Kelly-Marotta [OKM] grading scale) outcomes, and follow-up time of 54 patients. RESULTS: A total of 55 interventions for 61 aneurysms (58 supraclinoid ICA aneurysms) were performed in the 54 patients included in the study. The female/male ratio in this population was 44/10, and the mean age was 53.5 ± 13.6 (range 21-82) years. The most common form and location of the aneurysms were saccular 91.4% (53/58) and ophthalmic segment 69% (40/58), respectively. The preferred antiplatelet regimen was acetylsalicylic acid plus ticagrelor 50% (27/54). The overall complication rate was 25.5% (14/55), and the mean follow-up time was 25.76 ± 17.88 months. The successful radiological outcome (OKM grade C or D) rate at the 6-month follow-up was 92.6%. No perioperative complications led to any permanent or transient neurological deficit. CONCLUSIONS: The results of this first multicenter study evaluating FD stent use for unruptured ICA supraclinoid segment aneurysms showed that FD stent treatment is a feasible method for replacing clipping and coil embolization with manageable complications and a high success rate.
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Procedimientos Endovasculares , Aneurisma Intracraneal , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Enfermedades de las Arterias Carótidas , Arteria Carótida Interna/cirugía , Embolización Terapéutica/métodos , Procedimientos Endovasculares/métodos , Aneurisma Intracraneal/cirugía , Estudios Retrospectivos , Stents/efectos adversos , Resultado del TratamientoRESUMEN
AIM: To examine the effect of adiponectin administration on acute brain injury in an experimental model of cerebral ischemia/ reperfusion (I/R) in rats. MATERIAL AND METHODS: The study animals were divided into the following four groups: group I, sham (did not undergo surgical intervention and did not receive drugs); group II, the I/R model (received the intervention, but did not receive drugs); group III (I/Radiponectin) (the I/R model was used, and the animals were treated with 5 mg/kg adiponectin peritoneally 30 minutes after the ischemia); and group IV (I/R-tirofiban)( the I/R model was used, and the animals were treated with 0.5 mg/kg tirofiban peritoneally 30 minutes after the ischemia). RESULTS: Tumor necrosis factor-? (TNF-?) and interleukin (IL)-1? levels were statistically higher in the I/R group (group II) than in other groups. In the post-hoc (Tukey) test analysis, groups I, III, and IV had significantly lower TNF-? and IL-1? levels after treatment with both tirofiban and adiponectin than group II. No statistically significant difference was found between groups III and IV in terms of TNF-? levels. However, the decreased IL-1? level was more pronounced in group IV (tirofiban) than in other groups. The mean neurologic deficit scores were statistically significantly different among the groups. In the post-hoc (Tukey) test analysis, neurologic deficit scores were statistically significantly lower in groups III and IV than in group II. CONCLUSION: Adiponectin has anti-inflammatory and cerebral protective effects in experimental cerebral I/R injury.
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Isquemia Encefálica , Daño por Reperfusión , Ratas , Animales , Adiponectina/uso terapéutico , Tirofibán/uso terapéutico , Daño por Reperfusión/tratamiento farmacológico , Daño por Reperfusión/patología , Isquemia Encefálica/tratamiento farmacológico , Factor de Necrosis Tumoral alfa , Interleucina-1/uso terapéutico , IsquemiaRESUMEN
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.
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Laminoplastia , Humanos , Masculino , Femenino , Laminoplastia/efectos adversos , Laminoplastia/métodos , Vértebras Cervicales/diagnóstico por imagen , Vértebras Cervicales/cirugía , Estudios Retrospectivos , Parálisis/epidemiología , Parálisis/etiología , Parálisis/cirugía , RadiografíaRESUMEN
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.
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Degeneración del Disco Intervertebral , Desplazamiento del Disco Intervertebral , Humanos , Degeneración del Disco Intervertebral/genética , Desplazamiento del Disco Intervertebral/genética , Óxido Nítrico/metabolismo , Óxido Nítrico Sintasa de Tipo III/genética , Factor A de Crecimiento Endotelial Vascular/análisis , Factor A de Crecimiento Endotelial Vascular/genética , Factores de Crecimiento Endotelial VascularRESUMEN
AIM: To investigate the pullout strength of a pedicle screw reinserted through the same trajectory MATERIAL and METHODS: Fifty freshly frozen lamb L4 vertebrae were divided into the following five groups: Group 1, inserted with a 5-mm pedicle screw; Group 2, inserted with a 5-mm pedicle screw followed by the removal and reinsertion of the same screw after control; Group 3, inserted with a 5-mm pedicle screw followed by the removal and reinsertion of a 5.5-mm screw after control; Group 4, inserted with a 5.5-mm pedicle screw; and Group 5, inserted with a 5.5-mm pedicle screw followed by the removal and reinsertion of the same screw after control. Pedicle screws were inserted into the right pedicles, and axial pullout testing was performed at 5 mm/min. All data were recorded. A load-displacement curve was used to obtain the peak value of the pullout strength for all specimens. RESULTS: The mean pullout strengths were 1086.22 N, 1043.32 N, 1039.18, 1199.10, and 1131.68 N for Groups 1?5, respectively. No significant difference was observed among all groups (p > 0.05). CONCLUSION: Perioperative reinsertion of the same screw or (0.5 mm) larger in diameter through the same trajectory after the control of the screw trajectory did not affect the pullout strength of the screw.
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Tornillos Pediculares , Animales , Fenómenos Biomecánicos , Vértebras Lumbares/cirugía , Ensayo de Materiales , OvinosRESUMEN
OBJECTIVE: The aim of this study to investigate the benefits of patient-based 3-dimensional (3D) cerebral arteriovenous malformation (AVM) models for preoperative surgical planning and education. METHODS: Fifteen patients were operated on for AVMs between 2015 and 2019 with patient-based 3D models. Ten patients' preoperative cranial angiogram screenings were evaluated preoperatively or perioperatively via patient-based 3D models. Two patients needed emergent surgical intervention; their models were solely designed based on their AVMs and used during the operation. However, the other patients who underwent elective surgery had the modeling starting from the skull base. These models were used both preoperatively and perioperatively. The benefits of patients arising from treatment with these models were evaluated via patient files and radiological data. RESULTS: Fifteen patients (10 males and five females) between 16 and 66 years underwent surgery. The mean age of the patients was 40.0±14.72. The most frequent symptom patients observed were headaches. Four patients had intracranial bleeding; the symptom of admission was a loss of consciousness. Two patients (13.3%) belonged to Spetzler-Martin (SM) grade I, four (26.7%) belonged to SM grade II, eight (53.3%) belonged to SM grade III, and one (6.7%) belonged to SM grade IV. The mean operation duration was 3.44±0.47 hours. Three patients (20%) developed transient neurologic deficits postoperatively, whereas three other patients died (20%). CONCLUSION: Several technological innovations have emerged in recent years to reduce undesired outcomes and support the surgical team. For example, 3D models have been employed in various surgical procedures in the last decade. The routine usage of patient-based 3D models will not only support better surgical planning and practice, but it will also be useful in educating assistants and explaining the situation to the patient as well.
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OBJECTIVE: The aim of our study is to investigate the cytotoxic, antioxidant, and antimicrobial effects of newly synthesized boron compounds in U87MG glioblastoma cell treatment. METHODS: We synthesized boron glycine monoester (BGM) and boron glycine diester (BGD) structures containing boron atoms and determined their cytotoxic activities on glioblastoma by the MTT method. The inhibitory concentration 50 (IC50) value was calculated with GraphPad Prism 5.0 program. The IC50 values were administered 48 hours on U87MG glioblastoma cell. Catalase (CAT), acid phosphatase (ACP) and alkaline phosphatase (ALP) enzyme activity, malondialdehyde (MDA), total glutathione (GSH), and total protein levels were detected using spectrophotometric methods. We determined the antimicrobial activities of BGM and BGD with the disc diffusion method. RESULTS: After 48 hours of BGM and BGD application to U87MG glioblastoma cells, we found the IC50 value as 6.6 mM and 26 mM, respectively. CAT and ACP enzyme activities were decreased in BGM and BGD groups. MDA which is a metabolite of lipid peroxidation was increased in both boron compounds groups. GSH level was reduced especially in BGD group. BGM and BGD have been found to be antimicrobial effects. CONCLUSION: Boron compounds, especially the BGM, can provide a new therapeutic approach for the treatment of glioblastoma with their anticancer, antioxidant, and antimicrobial effects.
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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.
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Cerebro , Sustancia Blanca , Autopsia , Encéfalo/diagnóstico por imagen , Humanos , Imagen por Resonancia Magnética , Sustancia Blanca/diagnóstico por imagenRESUMEN
AIM: To investigate the cytotoxic effects of boron application at different doses on U-87 MG glioblastoma cells. MATERIAL AND METHODS: The T98G (ATCC® CRL-1690?) glioblastoma cell strain used in the study was acquired from the American Type Culture Collection (ATCC) (Manassas, USA). Boric acid solution was prepared by mechanical mixing in the medium. Afterwards, 2.5 mM, 25 mM and 50 mM boron were each added to U87-MG glioblastoma cells and incubated for 48 hours. The cytotoxic effects on the cells was determined using the MTT (Methylthiazole diphenyl tetrazolium) test 48 hours after boron application. RESULTS: IC50 value was detected as 17 mM in the 48-hour boric acid application on U-87 MG glioblastoma cells. CONCLUSION: Boron treatment might be an effective approach for glioblastoma.
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Boro/toxicidad , Neoplasias Encefálicas/patología , Citotoxinas/toxicidad , Glioblastoma/patología , Ácidos Bóricos/metabolismo , Ácidos Bóricos/toxicidad , Boro/metabolismo , Terapia por Captura de Neutrón de Boro/métodos , Neoplasias Encefálicas/tratamiento farmacológico , Neoplasias Encefálicas/metabolismo , Línea Celular Tumoral , Citotoxinas/metabolismo , Relación Dosis-Respuesta a Droga , Glioblastoma/tratamiento farmacológico , Glioblastoma/metabolismo , HumanosRESUMEN
AIM: To investigate the acute effects of sildenafil citrate in an experimental model of severe head trauma, and to compare it with the efficacy of mannitol, which is an osmotically active agent frequently used in clinical treatment of traumatic brain injury (TBI). MATERIAL AND METHODS: Twenty-eight Wistar-derived albino strain female rats were randomized into four groups comprising seven rats each. These groups were designated as follows: Group I: sham; Group II: TBI; Group III: TBI + mannitol (20% 1 gr/ kg, intraperitoneal); and Group IV: TBI + sildenafil citrate (10 mg/kg, intraperitoneal). Sections prepared following the tissue processing of samples obtained from the right prefrontal cortex and right hippocampal regions of the brains of sacrificed rats were histopathologically evaluated. Fractionator method via the Stereo Investigator software program (Micro Bright Field) was used to count the neurons. Pyknotic neuron count and pyknotic / total neuron count were compared between the groups. RESULTS: In the comparison of Group II and IV, pyknotic neuron count (prefrontal; group II: 116.00 ± 30.50, group IV: 80.00 ± 19.47) and pyknotic/ total neuron count (prefrontal; group II: 0,30 ± 0.08, group IV: 0.21 ± 0.02) were significantly lower in Group IV in both regions (p < 0.05). Similarly, in the comparison of Group II and III, the values in Group III were lower in both regions (p < 0.05). CONCLUSION: Sildenafil citrate decreases neuronal death in the acute phase and produces similar results with mannitol. Therefore, we believe that sildenafil citrate can be a useful adjunct or alternative agent for the clinical treatment of patients with acute TBI.
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Lesiones Traumáticas del Encéfalo/patología , Encéfalo/efectos de los fármacos , Neuronas/efectos de los fármacos , Neuronas/patología , Fármacos Neuroprotectores/farmacología , Citrato de Sildenafil/farmacología , Animales , Encéfalo/patología , Muerte Celular/efectos de los fármacos , Modelos Animales de Enfermedad , Femenino , Manitol/farmacología , Inhibidores de Fosfodiesterasa 5/farmacología , Ratas , Ratas WistarRESUMEN
OBJECTIVE: The aim of this study was to investigate the biomechanical differences between human dura mater and dura mater substitutes to optimize biomimetic materials. METHODS: Four groups were investigated. Group I used cranial dura mater (n=10), group II used Gore-Tex® Expanded Cardiovascular Patch (W.L. Gore & Associates Inc., Flagstaff, AZ, USA) (n=6), group III used Durepair® (Medtronic Inc., Goleta, CA, USA) (n=6), and group IV used Tutopatch® (Tutogen Medical GmbH, Neunkirchen am Brand, Germany) (n=6). We used an axial compression machine to measure maximum tensile strength. RESULTS: The mean tensile strengths were 7.01±0.77 MPa for group I, 22.03±0.60 MPa for group II, 19.59±0.65 MPa for group III, and 3.51±0.63 MPa for group IV. The materials in groups II and III were stronger than those in group I. However, the materials in group IV were weaker than those in group I. CONCLUSION: An important dura mater graft property is biomechanical similarity to cranial human dura mater. This biomechanical study contributed to the future development of artificial dura mater substitutes with biomechanical properties similar to those of human dura mater.
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OBJECTIVE: The primary aim of this investigation was to explore the nature of dura mater biomechanics following the introduction of puncture defect(s). METHODS: Twenty-eight dura mater specimens were collected during autopsy from the department of forensic medicine of the authors' institution. Specimens were divided randomly into one of four groups : group I (cranial dura mater; n=7), group II (cranial dura mater with one puncture defect; n=7); group III (cranial dura mater with two puncture defects; n=7), and group IV (cranial dura mater with three puncture defects; n=7). RESULTS: The mean±standard deviation tensile strengths of the dura mater were 8.35±3.16, 8.22±3.32, 7.13±1.77, and 6.94±1.93 MPa for groups I, II, III, and IV, respectively. There was no statistical difference between all groups. A single, two or more punctures of the dura mater using a 20-gauge Quincke needle did not affect cranial dura tensile strength. CONCLUSION: This biomechanical study may contribute to the future development of artificial dura mater substitutes and medical needles that have a lower negative impact on the biomechanical properties of dura mater.
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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.
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Sustitutos de Huesos/química , Durapatita/química , Poliésteres/química , Impresión Tridimensional , Ingeniería de Tejidos/instrumentación , Ensayo de Materiales , Difracción de Rayos XRESUMEN
BACKGROUND: Vertebroplasty and kyphoplasty are minimally invasive techniques used to treat vertebral compression fractures. The etiology of vertebral compression fractures varies among patients. Although osteoporosis and trauma are major etiologic factors in patients with a vertebral compression fracture, unexpected results were found in 11 patients in the present study. The aim of the present retrospective study was to determine the incidentally detected pathology results of patients with vertebral fracture treated by vertebroplasty and kyphoplasty. METHODS: From February 2010 to November 2015, 616 patients with a vertebral compression fracture were treated by kyphoplasty and vertebroplasty at our institution. Vertebral biopsies were obtained from 533 patients during a vertebral augmentation technique. The average patient age was 62.4 years. Of the 616 patients, 388 were female and 228 were male. Histological evaluation of the biopsy specimens from the vertebral compression fractures was performed. RESULTS: The biopsy results of 505 patients showed various stages of bone healing. Among these patients, malignancy was identified in 23 patients, and 43 patients had a history of malignancy. In 6 patients, an unsuspected malignancy was found, and 1 patient had Paget's disease. Infection was detected in 4 patients. In our study, the rate of unsuspected malignancy was 1.1%. CONCLUSIONS: Tissue examination is useful and could reveal pathologic fractures. An incidentally detected biopsy result could change the treatment of patients; however, bone biopsy should be reserved for those patients whose preoperative radiological diagnosis raises suspicion of a nonosteoporotic etiology.
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Fracturas por Compresión/cirugía , Hallazgos Incidentales , Cifoplastia , Fracturas de la Columna Vertebral/cirugía , Vertebroplastia , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Fracturas por Compresión/patología , Humanos , Masculino , Persona de Mediana Edad , Osteítis Deformante/diagnóstico , Osteítis Deformante/patología , Estudios Retrospectivos , Fracturas de la Columna Vertebral/patología , Neoplasias de la Columna Vertebral/diagnóstico , Neoplasias de la Columna Vertebral/patología , Columna Vertebral/diagnóstico por imagen , Columna Vertebral/patología , Columna Vertebral/cirugía , Adulto JovenRESUMEN
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.
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Neoplasias Encefálicas , Hemangioma Cavernoso , Encéfalo/diagnóstico por imagen , Neoplasias Encefálicas/complicaciones , Neoplasias Encefálicas/diagnóstico por imagen , Neoplasias Encefálicas/fisiopatología , Diagnóstico Diferencial , Mareo , Hemangioma Cavernoso/complicaciones , Hemangioma Cavernoso/diagnóstico por imagen , Hemangioma Cavernoso/fisiopatología , Humanos , Imagen por Resonancia Magnética , Masculino , Meningioma , Persona de Mediana EdadRESUMEN
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.
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Trasplante Óseo/métodos , Cráneo/cirugía , Humanos , Metilmetacrilatos/uso terapéutico , Modelos Anatómicos , Impresión Tridimensional , Procedimientos de Cirugía Plástica/métodos , Tomografía Computarizada por Rayos X , Trasplante Autólogo/métodosRESUMEN
Background/aim: The aim of this study was to investigate the effects of valproic acid (VPA) and a new-generation antiepileptic drug called brivaracetam (BRV) on the brain damage occurring after status epilepticus (SE) in rats. Materials and methods: In our study, an experimental animal model of SE, generated by stereotaxically injecting 0.42 µg of kainic acid into the rat hippocampus, was used. The laboratory animals were divided into 4 groups: the first group was a sham group that was subjected to anesthesia and SE was not induced; the second group was a SE group, in which SE was induced using kainic acid but subjects were not treated; the third group was the VPA group, in which SE was induced using kainic acid and subjects were treated with VPA; and the fourth group was the BRV group, in which SE was induced using kainic acid and subjects were treated with BRV. Results: Annexin V and p53 levels were statistically higher in the SE group than in the sham group (P < 0.001). Following the treatment with VPA and BRV, a substantial decrease was observed in the annexin V and p53 levels compared to those of the SE group (P < 0.001). There was a statistically significant increase in Bcl-2 levels after VPA and BRV treatment compared to the SE group (P < 0.001). Conclusion: Our study showed that VPA and BRV are protective against neuronal damage occurring after SE in rats due to the increase in Bcl-2.
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The objective of our study is to detect the patient group that will most benefit from intravenous (IV) thrombolytic therapy by showing predictive factors of good functional outcomes. The present study covers 88 patients who were admitted to our clinic within the first 4.5 hours from the onset of stroke symptoms, diagnosed with acute ischemic stroke and who received IV thrombolytic therapy between May 2014 and June 2017 as a result of a retrospective analysis of a database prospectively collected. The patients with a score of ≤2 on modified Rankin scale within 3 months were accepted as good functional outcome and those with a score of >2 were accepted as poor functional outcome. As a result, within the period of 3 months posttreatment, good functional outcomes were obtained in 45 (51.1%) patients and poor functional outcomes were obtained in 43 (48.9%) patients. In comparisons, cardioembolic stroke group was statistically significantly higher in the good functional outcome group (P = .03). Pretreatment National Institute of Health Stroke Scale (NIHSS) scores (P < .001), presence of proximal hyperintense middle cerebral artery sign in noncontrast computed brain tomography (P = .03), and being aged ≥80 and older (P = .04) were markedly higher in the group with poor functional outcomes. In conclusion, our study demonstrated that cardioembolic strokes may have an impact on good functional outcomes and being aged 80 and older, presence of proximal HMCAS in computed brain tomography, and pretreatment NIHSS scores may have an impact on poor functional outcomes.