Ahmet Eroglu

Comparison of deferoxamine and methylprednisolone: protective effect of pharmacological agents on lipid peroxidation in spinal cord injury in rats.

Study Design. Experimental study. Objective. To investigate the protective effect of deferoxamine (DFO) administration in comparison with methylprednisolone (MP) on lipid peroxidation and antioxidants after spinal cord injury (SCI) in rats. Summary of Background Data. DFO is used for treating an iron-chelating agent, which is also used in the treatment of iron poisoning and thalassaemia. The neuroprotective effect of DFO was evaulated as a therapeutic agent for SCI. Methods. Forty Wistar rats were randomly divided into 5 groups as sham laminectomy (n = 8), laminectomy with SCI (n = 8), laminectomy with SCI and 0.9% saline intraperitoneal (i.p.) (n = 8), laminectomy with SCI and 30 mg/kg MP i.p. (n = 8), and laminectomy with SCI and 30 mg/kg DFO i.p. (n = 8). Neurological deficits were examined 24 hours after trauma, and all rats were killed. Spinal cord segments were harvested for both biochemical and histopathological evaluation. Results. At 24 hours post-SCI, whereas malondialdehyde levels were increased, superoxide dismutase, catalase, and glutathione peroxidase levels were decreased in groups I, II, and III. MP and DFO treatment decreased MDA levels and increased superoxide dismutase CAT, and glutathione peroxidase levels in control and study groups. There was no statistically significant difference between treatment with MP and DFO (P> 0.05). All rats were paraplegic after SCI, except in the sham group. Histopathological improvement was observed in control and study groups. Conclusion. This study indicates that beneficial effects may be provided and further studies need to investigate the dose-dependent beneficial and side effects of DFO in SCI. Level of Evidence: N/A

Demographical Aspects of Central Large Lumbar Disc Herniation.

AIM The purpose of this study was to investigate the risk factors for the development of the central large disc herniations and to compare the demographic data between central mass prolapse and broad-based central disc herniation. MATERIAL AND METHODS Between 2002 and 2007, 1630 patients underwent surgery and a large disc herniation was the main problem in 59 patients (3.6%). We performed a retrospective analysis of the demographic data of these patients. Magnetic resonance (MR) images were evaluated according to the disc type and level. Variables were evaluated both at baseline and follow-up, with special emphasis on physical job characteristics, sports activities, and MR - based morphologic findings. RESULTS Central large disc herniation was diagnosed in 59 patients consisting of 41 males and 18 females. The average age was 34.7 years. 36 patients had a central mass prolapse that occupied more than 50% of the spinal canal. Intraoperative observations confirmed that 29 out of 36 central disc prolapse patients (80.5%) had intact posterior longitudinal ligaments. Interestingly, the condition in these 29 patients was found to have a direct relation with age and occupation or other body training sports activities. CONCLUSION The size of the large central disc herniation, physical activity, age and gender are major factors in the development of disc herniation.

Basal cell adenocarcinoma of the parotid gland with rare scalp metastasis: a case report.

Salivary gland tumors constitute 3% of tumors in the body. Salivary gland tumors constitute 4% to 10.80% of all tumors in the head and neck tumors and most of them originate from the parotid gland. Most salivary gland tumors are benign. Basal cell adenocarcinoma is a rare salivary gland tumour. Most appear to be benign clinically. Metastases have occurred in less than 10% of patients. A 58-year-old female patient was admitted with the complaint of a growing mass at the top of her head. She was operated for parotid adenocarcinoma two years ago. Computed Tomography (CT) was performed to clarify the relationship between the mass with the calvarium and intracranial region. There is a risk of malignancy in scalp and calvarium lesions. Patients must be subjected to preoperative radiological evaluations.

Lumbar Disc Herniation in a Patient With Congenital Vertebral Body Anomaly: A Case Report

Lumbar disc herniation is characterized with low back and leg pain resulting from the degenerated lumbar disc compressing the spinal nerve root. The etiology of degenerative spine is related to age, smoking, microtrauma, obesity, disorders of familial collagen structure, occupational and sports-related physical activity. However, disc herniations induced by congenital lumbar vertebral anomalies are rarely seen. Vertebral fusion defect is one of the causes of congenital anomalies. The pathogenesis of embryological corpus vertebral fusion anomaly is not fully known. In this paper, a 30-year-old patient who had the complaints of low back and right leg pain after falling from a height is presented. She had right L5-S1 disc herniation that had developed on the basis of S1 vertebra corpus fusion anomaly in Lumbar computed tomography. This case has been discussed in the light of literature based on evaluations of Lumbar Computed Tomography (CT) and Magnetic Resonance Imaging (MRI). This case is unique in that it is the first case with development of lumbar disc herniation associated with S1 vertebral corpus fusion anomaly. Congenital malformations with unusual clinical presentation after trauma should be evaluated through advanced radiological imaging techniques.

Our Surgical Treatment Outcomes In Peripheral Nerve Lesions Depending On Gunshot Injuries: Assessment Of 28 Cases

BACKGROUND In this retrospective study, we present the results and outcomes in our clinic of 28 patients over 8 years who received surgical treatment for peripheral nerve lesions due to gunshot injury. METHODS The patients came to our clinic between January 2002 and February 2010. All came within 1-6 months after the initial gunshot injury and underwent surgery due to the diagnosis of peripheral nerve lesion. Preoperative and postoperative electromyographic analysis (EMG) and motor strength rating were performed on all patients. All patients were called for postoperative follow-up at 1, 6 and 12 months after surgery. RESULTS The mean time after initial injury before being seen at our clinic was 3.6 months (1 day - 6 months). The most commonly injured nerve was the sciatic nerve, in 14 cases (50%). Of the patients, 23 came due to a bullet injury (9 were civilian injury with a gun, 14 were military injury with a rifle) and 5 came due to shrapnel injury. Since in all cases integrity of the nervous tissue was fully intact, nerve grafting was not required during surgery. Relatively improved EMG findings, and recovery in motor functions were detected in cases who had undergone postoperative external epineurolysis plus decompression. CONCLUSION We recommend surgical treatment within the first six months in neural lesions, depending on gunshot injury, on the condition that surgical technique rules are obeyed (except infection, skin defect, vascular injury, and the presence of bone fracture).

Ganglioglioma mimicking the cerebral abscess in advanced age: a case report.

Ganglioglioma is one of the rare mixed neuronal glial tumors of the central nerve system. It is responsible for 0.4 - 2% of the intracranial tumors observed in infants and young matures. Its most common localization is the supratentorial region. Typically, the first symptom is epilepsy. Due to the glial structure, that rare tumor can exhibit a malign transformation. Growing slowly through several months or years, it forms neurological dysfunction. The standard treatment of that supratentorial tumor is usually total resection. If an anaplastic quality is observed, the patient undergoes radiotherapy after the surgical intervention. In this article, we presented a 53-year-old patient who presented with headache and dysphasia. The patient was operated for the cystic mass in the left parietal lobe reported as an abscess. The pathology was reported as ganglioglioma and we discussed the case according to the literature.

Recurrent carpal tunnel syndrome: Evaluation and treatment of the possible causes

AIM To investigate the causes of the recurrent carpal tunnel syndrome (CTS) and implemented surgical interventions. METHODS Four hundred and eighty-seven patients, who were diagnosed with CTS and underwent surgical intervention between October 2016 and September 2007, were evaluated in this retrospective study. The age, gender, physical evaluation findings, electrophysiological examination reports and implemented surgical treatment methods were analyzed. RESULTS Thirty-nine of the cases were operated due to recurrent CTS. Further examination of the patients with recurrent CTS revealed that ten cases had diabetic polyneuropathy, three cases had hypothyroidism, two cases had rheumatoid arthritis and one case had systemic amyloidosis. Postoperative electromyography confirmed the neuropathy was due to systemic diseases. The remaining 23 patients with recurrent CTS did not have any systemic disease and all of them had applied previously to another health center. CONCLUSION We concluded that the recurrence rates in CTS might be decreased with exploration and incision of the entire transverse ligament. Damage to the motor and sensory branches of the median nerve could be avoided with an incision on the ulnar side.

Clinical results after surgical treatment in young male patients with low grade isthmic spondylolisthesis

Gönderilme tarihi: 13.01.2017 Kabul tarihi: 24.05.2017 Abstract Purpose:The aim of this study is to evaluate the long term results of surgical treatment in young patients with low grade isthmic spondylolisthesis (IS). Materials and methods:Postoperative clinical results of 42 patients ageing between 20-29 were retrospectively analized in this study. Oswestry Disability Index (ODI) and Visual Analog Scales (VAS) scores were used to compare patients’ preoperative and postoperative pain levels. Results: All patients were male and the mean age of patients was 23.4 (between 20-29). Mean duration of symphtoms was 1.8 years (between 1-4 years). All patients had physical therapy before surgery and 24 patients (%57.1) used lumbosacral brace. Isthmic spndylolisthesis was present in L5-S1 level in 78.5% (n=33) and in L4-5 level in 21.4% (n=9) of the patients. Mean preoperative ODI and VAS scores were 76.68 (between 43-100) and 5.98 (between 3-10), respectively (p<0.05). Mean postoperative ODI and VAS scores were 26.65 (between 0-66) and 2.49 (between 0-5), respectively (p<0.05). Conclusion:Posterolateral in stu fusion and transpedicular instrumentation in young well-selected patients with low grade IS reduce pain, improve function and result good clinical outcome. Prospective and multicenter studies with 10-20 years follow-up are needed for further data.

Determination of the Effect of Diameter of the Sac on Prognosis in 64 Cases Operated for Meningomyelocele

Objective To examine the effect of meningomyelocele sac size on prognosis by retrospective review of 64 cases operated for meningomyelocele between January 2009 and December 2012. Methods We evaluated newborn babies operated for meningomyelocele by retrospectively reviewing their files for head circumference, location and with of the defect, accompanying anomalies, treatments administered, drugs that mother used during pregnancy. Based on the defect size, 3 patient groups were created as 0–24 cm2 (group I), 25–39 cm2 (group II), and 40 cm2 and above (group III). Results Throughout the study, 64 babies were evaluated. Mean head circumference was 37.4 cm (range, 30.7–50 cm). Based on their location, 49 of the defects (76.5%) were lumbar, 7 (10.9%) were thoracolumbar, 4 (6.2%) were thoracic, 3 (3.1%) were sacral, 1 (1.5%) was cervical. Mean size of the meningomyelocele sac was 4.7 cm×5.8 cm (range, 1 cm×1 cm—10 cm×8 cm), 13 of the babies (20.3%) had skin defect requiring flap. According to accompanying anomalies, 47 of the babies (73.4%) had hydrocephalus, 7 (10.9%) had club foot, 1 (1.5%) had diastematomyelia, 1 (1.5%) had tethered cord. Thirty-nine of the babies (60.9%) had paraplegia, 10 (15.6%) had paraparesis, 8 (12.5%) had monoplegia; neurological examination in the remaining 7 babies was normal. Conclusion In our study, increased diameter of meningomyelocele sac was associated with greater amount of neural tissue within the sac, which worsens the prognosis. Sac localization was not changing prognosis but infection rates, hospitalization duration were increased in babies with bigger diameter of sacs.