Askin Gorgulu

Neuroprotective effects of tamoxifen on experimental spinal cord injury in rats

The aim of this study was to evaluate the effects of tamoxifen on tumor necrosis factor alpha (TNF-alpha) and interleukin 1beta (IL-1beta) levels and ultrastructural changes in rats with spinal cord injury. Rats were divided into four groups: control group (laminectomy only), trauma group (laminectomy+spinal trauma), tamoxifen group (laminectomy+spinal trauma+tamoxifen), and vehicle group (laminectomy+spinal trauma+vehicle). Spinal cords were extirpated at the T(7)-T(12) level and tissue samples from the spinal cords were gathered for TNF-alpha and IL-1beta measurements at 1 and 6hours. Spinal cords harvested at 6 hours were evaluated for ultrastructural changes. TNF-alpha and IL-1beta levels at 6 hours were significantly lower in the tamoxifen group than in the trauma group. Electron microscopic examination of tissue from the trauma group revealed gross cell deformities with widespread edema of all structures as well as severe edema in the neuropil. At 6 hours after trauma, these ultrastructural changes were less marked in the tamoxifen group. Our findings support a neuroprotective and restorative role for tamoxifen in the context of secondary pathological biochemical events after SCI.

Effect of Melatonin on Cerebral Edema in Rats

OBJECTIVE Melatonin (5-methoxy-N-acetyltrypamine), a chemical naturally produced in the pineal gland, has been suggested to be a free radical scavenger and an antioxidant. In the present study, the effect of melatonin on cold-induced brain edema was evaluated by determination of cerebral water content, blood-brain barrier permeability, and areas of infarct; the effects were also studied histopathologically. METHODS Brain edema was produced in rats by creating a lesion via cortical freezing. Animals were separated into four groups: sham-operated (craniectomy only); control (cold injury); sham-vehicle (cold injury plus saline); and melatonin treatment (cold injury plus melatonin). Melatonin was administered (50 mg/kg intraperitoneally) 15 minutes after the cold injury was induced. Twenty-four hours later, tissue samples from the core, from the periphery of the cold-injured hemisphere, and from the contralateral hemisphere symmetrical to the cold injury were obtained. RESULTS Melatonin treatment reduced edema (mean +/- standard deviation; 86.22 +/- 1.54% in the control group versus 80.78 +/- 2.76% in the melatonin treatment group, P < 0.001) and blood-brain barrier permeability (45.34 +/- 2.75% in the control group versus 38.26 +/- 3.40% in the melatonin treatment group, P < 0.001) at the periphery of cold injury. Area of infarct reduced from 5.84 +/- 0.58% in the control group to 3.30 +/- 0.89% in the melatonin treatment group (P < 0.001). The effect of melatonin was also confirmed histopathologically. CONCLUSION Melatonin was found to be neuroprotective in instances of cold-induced brain edema. Thus, melatonin may be a valuable therapeutic agent in the treatment of cerebral edema.

Doxorubicin for prevention of epineurial fibrosis in a rat sciatic nerve model: outcome based on gross postsurgical, histopathological, and ultrastructural findings.

OBJECT Epineural fibrosis may complicate peripheral nerve surgeries and currently is considered as one of the main factors responsible for failed surgeries. The authors investigated the postoperative antiscarring effects of topically applied doxorubicin (DXR) on rat sciatic nerves. METHODS The sciatic nerves were dissected from the surrounding tissue and exposed bilaterally in 20 Wistar albino adult male rats. Abrasion trauma was produced on the exposed surface of the biceps femoris muscle in the vicinity of the sciatic nerves and their main branches in all animals. In the DXR Group, cottonoid pads soaked with DXR (0.5 mg/ml) were placed around the nerves for 5 minutes, whereas cotton pads soaked with saline (0.9% NaCl) were applied to nerves of animals in the Control Group for the same duration. Twelve weeks after the procedure, all of the rats were killed and the sciatic nerves were examined. Epineural adhesions were evaluated histopathologically and ultrastructurally. Additionally, quantitative histological parameters, the scar tissue formation index and the scar density, were calculated in histological evaluation. RESULTS Gross postsurgical evaluation as well as histopathological and electron microscopic examination of involved nerve segments showed significantly less epineurial adhesions in the DXR Group than in the Control Group. Quantitative analysis of the epineurium revealed a statistically significant reduction in the density and amount of epineural scarring in specimens from the DXR Group than in those from the Control Group. CONCLUSIONS The results of gross postsurgical anatomical evaluation and histopathological and ultrastructural studies suggested that topical application of DXR effectively reduced epineural scar formation on rat sciatic nerves. These promising findings merit further experimental and clinical studies to determine the efficacy and safe applicability of DXR in human subjects.

The effects of medroxy progesterone acetate on the pro-inflammatory cytokines, TNF-alpha and IL-1beta in the early phase of the spinal cord injury

Abstract Objectives: Spinal cord injuries (SCIs) have high morbidity and mortality rates and currently the definitive treatment of complete SCIs are still not possible. We investigated the effects of the medroxy progesterone acetate on the pro-inflammatory cytokines, TNF-alpha and IL-1beta in the early phase of the SCI. Methods: Forty-eight Wistar albino male rats were divided equally into four groups each consisting of 12 rats. All animals underwent T10-T12 laminectomy. We administered placebo, and 8 mg/kg medroxy progesterone acetate (MPA) intra-peritoneally into control and progesterone group at 30 minutes after the clip-compression trauma in spinal cord. We performed only T10-T12 laminectomy and clip-compression trauma in laminectomy and trauma group, respectively. Half of the rats from each group were killed at 1 hour and the other half were killed at 6 hours after the trauma. Spinal cord segments were then removed and stored at −80°C in phosphate buffer. TNF-alpha and IL-1beta levels were determined using ELISA kit. Results: We have found that there was an increase only in the TNF-alpha level at 6 hours after the trauma comparing to control group. MPA appeared to lower the TNF-alpha level significantly in the trauma group. Discussion: This experimentally proven anti-inflammatory effect of MPA via acting upon TNF-alpha may offer new therapeutic options in human subjects with SCIs.

Cervical leptomeningeal and intramedullary metastasis of a cerebral PNET in an adult.

The term ‘primitive neuroectodermal tumor’ (PNET) was first introduced by Hart and Earle [1] as an important fraction of pediatric brain tumors that are clinically defined by their aggressive behaviour in 1973. The term ‘PNET’ was then used to refer all small cell embryonal neoplasms of neuroectodermal origin. Leptomeningeal spread of cerebral PNETs to the spinal cord via cerebrospinal fluid may also be detected during the course of the malignancy.

Postoperative cerebral abscess formation caused by Toxocara canis in a meningioma cavity

Joseph M. Piepmeier Yale University School of Medicine, New Haven, CT, USA Dear Editor, We report a patient who was operated with the diagnosis of a convexity meningioma and in whom we subsequently detected abscess caused by Toxocara canis in the tumor cavity. We think that this case is original both from the point of causative agent, Toxocara canis, causing parasitic infestation in humans and from the point of the formation of abscess in the tumor cavity postoperatively. Both authors contributed the paper effectively. We extensively changed the format and reduced the size of the paper considerably as you suggested. We also added a specialist of Infectious Disease as an author. Thank you very much for your consideration. Askin Gorgulu MD, Associated Professor Department of Neurosurgery, Suleyman Demirel University, Medical Faculty Hospital Cunur-Isparta, Turkey E-mail: askingorgulu@hotmail.com Phone: +90-532-224-1541 Fax: +90-246-2371165 Toxocara canis is a worldwide known intestinal dog borne parasite responsible for parasitic infestations, chronic urticaria and bronchial hyperreactivity in humans. A-56-years old female patient from a rural area admitted to our outpatient clinic with the complaint of headache and mild weakness on her left side. Upon detection of left-sided hemiparesis (3/5 motor strength), we ordered a cranial MRI which revealed right parietal parasagittal mass enhanced homogenously with contrast agent (Figure 1). We removed the tumoral mass totally using standard microsurgical techniques. Gross pathological appearance of the mass was in the favor of meningioma and the histopathological diagnosis was also reported as meningotheliomatous meningoma subsequently. Postsurgical followup was uneventful and the patient discharged as being neurologically intact 5 days after surgery. One month after discharge, patient readmitted with severe headache and left-sided hemiparesis (2/5 motor strength). Cranial MRI revealed a mass enhanced in ring pattern with perilesional edema (abscess?) in the tumor cavity (Figure 2). We decided reoperation. Peroperatively, we did not observe any purulent abscess material to drain;

Sudden Cessation of Respiration in a Patient with a Solitary Metastatic Focus of Renal Cell Carcinoma in Medulla Oblongata

Renal cell carcinoma (RCC) is a highly malignant tumor arising from renal parenchyma. It has a poor prognosis and metastasizes to almost all organ systems mainly to bones and lung and it may involve cerebrum and spinal cord lately in its course [1]. Case series in the literature show that locations of brain metastasis of RCC are generally distributed evenly with no predilection. Although multiple metastatic foci of RCC in the cerebrum are encountered during the course of the disease, solitary metastasis in brain is a very rare occurrence [2].