Ozgur Kardes

Effects of Melatonin on Ischemic Spinal Cord Injury Caused by Aortic Cross Clamping in Rabbits

Spinal cord injury remains a devastating complication of thoracic and thoracoabdominal aortic operations. We aimed to investigate neuro-protective role of melatonin administered to rabbits before ischemia against ischemia-reperfusion (IR) injury. Occlusion of the abdominal aorta was applied to adult rabbits, followed by removal of aortic clamp and reperfusion. The abdominal aortas of New Zealand White albino rabbits (n = 18) were occluded for 30 minutes. Experimental groups were as follows: control group (sham operation group, n =10), Ischemia/reperfusion group (I/R) (n = 10) undergoing occlusion but receiving no pharmacologic intervention, Melatonin-treated group (n = 8) receiving 10mg/kg melatonin intravenously 10 minutes before ischemia. Neurologic status was assessed at 6, 24, and 48 hours after the operation. Spinal cords were harvested for histopathologic and biochemical analyses. Melatonin-treated animals had better neurologic function than those of the I/R group. Decreased tissue and serum malondialdehyde (MDA) levels and increased tissue and serum glutathione (GSH) levels were observed in melatonin-treated group (p<0.05). In the same group tissue and serum nitrate levels were decreased (p<0.05). Histopathologic analyses demonstrated typical morphologic changes characteristic of necrosis in I/R group. Melatonin attenuated ischemia-induced necrosis. Melatonin administration may significantly reduce the incidence of spinal cord injury following temporary aortic occlusion.

Effects of vascular endothelial growth factor on ischemic spinal cord injury caused by aortic cross-clamping in rabbits.

BACKGROUND Spinal cord injury remains a devastating complication of thoracic and thoracoabdominal aortic operations. We aim to investigate neuro-protective role of vascular endothelial growth factor (VEGF) administered to rabbits after occlusion against ischemia-reperfusion (I/R) injury. MATERIALS AND METHODS Occlusion of the abdominal aorta was applied to adult rabbits, followed by removal of aortic clamp and reperfusion. The abdominal aortas of New Zealand White albino rabbits were occluded for 30 min. Experimental groups were as follows: control group (sham operation group, n = 7), I/R group (n = 9) undergoing occlusion but receiving no pharmacologic intervention, and VEGF-treated group (n = 7) receiving 0.8 microg/kg VEGF intravenously after occlusion. Neurological status was assessed at 6, 24, and 48 h after the operation. All animals were killed at 48 h after the operation. Spinal cords were harvested for histopathologic and biochemical analyses. RESULTS According to Tarlovs scale, neurological status of the rabbits at postoperative h 48 was better in the VEGF-treated group compared to the I/R group (P < 0.05). Decreased tissue and serum malondialdehyde levels and increased tissue and serum glutathione levels were observed in VEGF-treated group (P < 0.05). In the same group tissue and serum nitrate levels were decreased (P < 0.05). Histopathologic analyses demonstrated typical morphological changes characteristic of necrosis in the I/R group. VEGF attenuated ischemia-induced necrosis. CONCLUSIONS This is the first study that shows the effects of VEGF administered after occlusion on induced oxidative damage to injured spinal cords. VEGF administration may significantly reduce the incidence of spinal cord injury following temporary aortic occlusion.

Brain Metastasis Of Penile Angiosarcoma

Angiosarcoma is a rare malignancy originating from vascular endothelial cells. Brain metastasis of aniosarcomas are uncommon up to the literature. Penile angiosarcomas are also seldom among all anjiosarcomas. A case with penile angiosarcoma with confirmed brain metastasis is aimed to be reported and contribute to the literature for similar cases.

Effect of gabapentin on primary surgical treatment of experimental sciatic nerve injury in rats

BACKGROUND The aim of our study is to minimize the morbidity related to nerve injury by determining the protective effects of gabapentin in experimental sciatic nerve injury and end-to-end anastomosis model in rats and to guide clinical studies on this subject. METHODS In our study, 40 adult male Sprague-Dawley rats were randomly divided into the following five groups: I: Only surgical intervention was applied; II: The sciatic nerve was cut properly and was repaired by end-to-end anastomosis. No additional procedure was performed; III: A single dose of gabapentin at 30 mg/kg was given after anastomosis; IV: 30 mg/kg gabapentin was given for 3 days after anastomosis; and V: 30 mg/kg gabapentin was given for 7 days after anastomosis. The experiment was terminated with high-dose thiopental (50 mg/kg) 60 days after the surgical intervention. The right sciatic nerve was taken from all animals. The obtained sections were examined immunohistopathologically. RESULTS Immunohistochemical properties and Schwann cell proliferation were found to be statistically significantly lower in the control group than in the other groups. Schwann cell proliferation was higher in Group 3 than in Group 5. Immunohistochemical changes were significantly lower in Group 4 than in Group 3. Axonal degeneration was also higher in Group 4 than in Group 3. CONCLUSION Gabapentin promotes neurological recovery histopathologically in peripheral nerve injury due to its neuroprotective properties. Our study results show that gabapentin can be used as an adjunctive therapy to primary surgical treatment after peripheral nerve injury.

Safety and efficacy of ventriculostomy procedures under dual antiplatelet therapy in patients treated with stent assisted coiling in subarachnoid hemorrhage

AIM Stent assisted coilling (SAC) is an alternative in the treatment of ruptured aneurysms. Stenting requires the use of dual antiplatelet agents. Hydrocephaly is a complication of subarachnoid hemorrhage (SAH) requiring ventriculostomy. Antiplatelet treatment reveal a risk of hemorrhage in ventriculostomy. Anti-aggregant effect starts at least four hours after the initial doses of treatment. However, in many studies, ventriculostomy was performed before antiplatelet treatment and the hemorrhagic complications were related to the procedure. The aim of this study was to determine the risk of ventriculostomy related hemorrhage in patients with impaired thrombocyte function and to contribute to the literature. MATERIAL AND METHODS Between 2011 and 2016, 53 patients treated with SAC due to SAH in our clinic were retrospectively evaluated. Hemorrhagic complication risks due to antiplatelet therapy related to ventriculostomy were retrospectively evaluated Results: All of the ventricular catheter procedures were performed at least 1 day after the dual therapy (in average 4,3 days after SAC). On 5 patients 1 ventriculostomy was performed, on 2 patients 2, and on 1 patient 6 ventriculostomies were performed. Although radiological hemorrhage was present on the catheter tract in 4 patients, no temporary or permanent neruologic deficit was observed. CONCLUSION Impaired thrombocyte functions pose a risk in ventriculostomy. Also, evaluating the risk of hemorrhage before the antiplatelet treatment reaches its full effect may lead to false results. Studies with small patient groups with antiagregant therapy and impaired thrombocyte functions also contribute to the literature. Larger studies regarding this subject are needed.

Rapid Spontaneous Resolution of Acute Epidural Hematoma: A Case Report and Review of the Literature.

BACKGROUND Epidural hematomas (EDH) are pathologies in which the early diagnosis and treatment are important. Resolution under 24 hours is very rare. CASE REPORT An 11-month-old male patient was brought to the emergency department with head trauma from falling out of bed onto his back. There were no neurological deficits, except for the patient being somnolent. Computed tomography (CT) of the patient revealed subgaleal edema in the right parietal region, linear fracture and image consistent with EDH with a thickness of about 9 mm underneath fracture. A control CT was performed after 3 hours as somnolence continued in follow-up of the patient. Hematoma in the epidural region was observed to completely resolve and edema in the subgaleal region was observed to gain hemorrhagic characteristics. CONCLUSION In total, 15 cases have been reported, including our case, in the literature with resolution less than 24 hours. Our case has the fourth fastest resolution ever reported in the English literature. We think that the most important factor in the rapid spontaneous resolution is the presence of a connection between the epidural and epicranial space, either through a fracture or cranial sutures.

The Role of the Nitric Oxide Pathway by Angiographic Demonstration of the Acute Phase of Arterial Spasm. An Experimental Study

The present study examined the benefits of computerized quantitation methods for analysis of digital angiograms to quantify vasospasm. Methods currently used to quantify vasospasm in such experimental settings have several shortcomings. The present method provides quantitative data that none of the others provided. An endothelin-1 (ET-1) induced vasospasm model of the rabbit basilar artery was employed for the study. L-nitro arginine methyl ester (L-NAME) and dexamethasone were applied intra-arterially. Basilar artery diameters were measured by angiography using special software. L-NAME and dexamethasone inhibited the vasospasm caused by ET-1 that was quantified by computerized quantitation methods for analysis of digital angiograms. Computerized quantitation for analysis of digital angiograms is an accurate technique for the measurement of vasospasm. The non-selective nitric oxide synthases (NOS) inhibitor, L-NAME, inhibits the vasoconstriction induced by ET-1 as does the selective immunological NOS (iNOS) inhibitor, dexamethasone, in the proposed doses.