Inan Gezgin

Multicentric Dentigerous Dermoid Cyst with an Unusual Location in the Central Nervous System

Dermoid cysts are benign and congenital ectodermal inclusions. Their occurrence in an intracranial location is quite rare. They constitute 0.1 to 0.7% of all intracranial tumors. Their occurrence in the fourth ventricle and their multicentric feature are extraordinary. A 12-year-old boy was admitted to our clinic with a dermoid cyst with sixth cranial nerve involvement. He had symptoms of increased intracranial pressure. This case is the first dermoid cyst in the literature at this unusual location; a mature tooth structure was found within the cyst, which extended over the cervical subsegments. There was a second dermoid cyst in the thoracic spine (multicentric). Our aim is to present an atypical dermoid cyst along with radiodiagnostic characteristics and macroscopic findings.

Evaluation of Long-term Clinical Results of Percutaneous Plasma Disk Coagulation Treatment in Lumbar and Cervical Disk Herniation

Objective:We report on late period results in 70 lumbar and cervical patients, who underwent percutaneous plasma disk coagulation treatment in our clinic, evaluated using a visual analogue scale (VAS). Methods:In our study, we evaluated 70 patients who had Macnab grade 1-2-3 lumbar and cervical disk herniation in the lumbar 4-5 and cervical 5-6 levels, without posterior longitudinal ligament tear but with radiculopathy. Data took the form of early-period and late-period VAS scores. Two groups of patients were evaluated: group 1 comprised 35 patients who had L4-L5 lumbar disk herniation with Pfirrmann grade 1-2-3 degeneration, whereas group 2 comprised 35 patients who had C5-C6 cervical disk herniation with Pfirrmann grade 1-2-3 degeneration. Results:A total of 70 patients presented to our clinic between January 2010 and April 2013, who had Macnab grade 1-2-3 disk herniation and radiculopathy, and had previously undergone conservative treatment and physical treatment methods, and those with no improvement were given percutaneous plasma disk coagulation treatment. The youngest patient was 19 years old, and the oldest was 50, yielding an average age of 28 years. The average preoperative VAS score of patients in the Pfirrmann grade 1-2-3 group was 7.1, whereas the postoperative scores were 3.8 in month 1; 4.1 in month 6; 4.3 in year 1; and 4.4 in year 2. The preoperative VAS score of group 2 was 7.2, whereas the postoperative scores were 3.5 in month 1; 2.5 in month 6; 2.1 in year 1; and 2.4 in year 2. Conclusions:It was found that percutaneous plasma disk coagulation (D30) treatment in patients with Macnab grade 1-2-3 and Pfirrmann grade 1-2-3 degeneration was useful in lumbar and cervical herniations, but the results were more significant in cervical disk herniations.

Sleeve Gastrectomy Ameliorates Mrna Expression of MatrixMetalloprotease I, III, V, IL-1a and IL-6 Genes in Substantia Nigra Tissuesof Obese Rats

Aim: To reveal metalloproteinase (MMP)-1, MMP-3, MMP-5, interleukin (IL)-1a and IL-6 gene expressions in substantia nigra region of brain in rats which undergone sleeve gastrectomy (SG) surgery. Methods: Rats were allocated into three groups in random, which were normal rats (Group I) (n=14), obese rats (Group II) (n=14), and obese rats subjected to SG (Group III) (n=14). MMP-1, MMP-3, MMP-5, IL-1a and IL-6 gene expressions were determined by polymerase chain reaction (PCR) and Real-time polymerase chain reaction (RTqPCR). Results: When normal (Group I), and obese (Group II) rats were compared, a decrease in expressions of MMP- 3 and IL-6 genes was observed in Group II. When obese rats (Group II) and obese rats subjected to SG (Group III) were compared, increases in the expressions of MMP-3 and IL-6 genes were observed in Group III. This phenomenon demonstrates that SG decreases obesity and consequently increases expressions of MMP-3 and IL-6 genes. Conclusion: These data show alterations of MMP-3 and IL-6 genes in the substantia nigra tissue of obese rats, consistent with the possibility that these changes may contribute to disease molecular background.

Effects of Borax and Sleeve Gastrectomy on mRNA Expression ofAntioxidant Genes in Substantia Nigra Tissue of Obese Rats

Aim: To evaluate the effects of borax and sleeve gastrectomy on mRNA expression of antioxidant genes in substantia nigra tissue of obese rats. Methods: Obese rats were fed with a high-fat diet containing 40% additional fat to the diet. Rats were allocated into four groups in random, which were normal rats (Group I) (n=14), obese rats subjected to SG (Group II) (n=14), obese rats subjected to borax (Group III) (n=14), and obese rats subjected to SG and borax (Group IV) (n=14). Catalase, superoxide dismutase (SOD) and glutathione S-transferase (GST) gene expressions were determined by polymerase chain reaction, real-time polymerase chain reaction (RT-qPCR) and western blotting. Results: When normal rats (Group I), and obese rats subjected to SG (Group II) were compared, a decrease in expressions of catalase, SOD and GST genes was observed in Group II. When obese rats subjected to borax (Group III) were compared with Group I and Group II, a decrease in expressions of catalase, SOD and GST genes was observed in Group III. This phenomenon demonstrates that borax and SG both decrease expressions of catalase, SOD and GST genes. Furthermore, the most significant decrease in expressions of catalase, SOD and GST genes was observed in obese rats subjected to SG and borax (Group IV) when compared to other three study groups. Conclusion: The borax decreases molecular obesity and consequently increases the expressions of Catalase, SOD and GST genes. These data show decrease of Catalase, SOD and GST genes in the substantia nigra tissue of obese rats, consistent with the possibility that these changes may contribute to disease pathogenesis.

Parieto-Occipital Interhemispheric Precuneal Approach to the Lesions of the Atrium: Experience with 66 patients.

AIM The atrium (trigone) is the most common site for intraventricular lesions. The parieto-occipital interhemispheric precuneal approach (POIPA) is one of the particular ways to reach these lesions. The aim of this study was to draw specific attention to the surgical difficulties of these lesions and to present our experience with this operative approach. MATERIAL AND METHODS Sixty-six patients with lesions located in the atrium of the lateral ventricles underwent surgical treatment in our institution using POIPA over a 13-year period. The clinical, radiological and surgical characteristics of these patients were retrieved and reviewed retrospectively. The histological diagnosis of the cases and postoperative complications were specifically focused on in this study. RESULTS Thirty-six (54.5%) patients were male and 30 patients were female with a mean age 37.9 years (range between 8 and 74 years). The lesion was in the right atrium in 25 cases and in the left in 41 (62.1%) patients. POIPA was used in all cases to remove the lesions. The most common tumor was glioblastoma (34.8%), followed by glial tumors grade I, II and III and meningiomas. The other lesions were metastases, ganglioglioma, epidermoid cysts and arteriovenous malformations. Gross total resection of the tumors was achieved in 59 patients (89.4%) while subtotal removal was performed in 7 cases. Five (7.5%) patients died within the first month after surgery. Conclusıon: POIPA provides a safe and effective way to reach lesions located in the atrium of the lateral ventricle. Knowledge of precise anatomy associated with the meticulous surgical techniques decreases the surgical morbidity and mortality of the patients.

Early cyclosporin A treatment retards axonal degeneration in an experimental peripheral nerve injection injury model

Injury to peripheral nerves during injections of therapeutic agents such as penicillin G potas-sium is common in developing countries. It has been shown that cyclosporin A, a powerful immunosuppressive agent, can retard Wallerian degeneration after peripheral nerve crush injury. However, few studies are reported on the effects of cyclosporin A on peripheral nerve drug in-jection injury. This study aimed to assess the time-dependent efficacy of cyclosporine-A as an immunosuppressant therapy in an experimental rat nerve injection injury model established by penicillin G potassium injection. The rats were randomly divided into three groups based on the length of time after nerve injury induced by cyclosporine-A administration (30 minutes, 8 or 24 hours). The compound muscle action potentials were recorded pre-injury, early post-injury (within 1 hour) and 4 weeks after injury and compared statistically. Tissue samples were taken from each animal for histological analysis. Compared to the control group, a significant im-provement of the compound muscle action potential amplitude value was observed only when cyclosporine-A was administered within 30 minutes of the injection injury (P < 0.05); at 8 or 24 hours after cyclosporine-A administration, compound muscle action potential amplitude was not changed compared with the control group. Thus, early immunosuppressant drug therapy may be a good alternative neuroprotective therapy option in experimental nerve injection injury induced by penicillin G potassium injection.