Tezcan Caliskan

Intraabdominal Pseudocyst Developed after Ventriculoperitoneal Shunt: A Case Report

Abdominal pseudocyst is a rare complication developing after ventriculoperitoneal shunt treatment. It is more commonly seen particularly in children. The underlying pathogenesis may be associated with repeat revisions or infections. Morphologically, it has no complete cyst wall, presenting only with a pseudocapsule among the intestinal loops, around the lower shunt tip. The principal problem appears to be the reduced peritoneal absorption capacity. The treatment is complicated and difficult. In this report, we present an 8-year-old abdominal pseudocyst case with a history of many shunt revisions.

Effect of naproxen on proliferation and differentiation of primary cell cultures isolated from human cartilage tissue

Non-steroidal anti-inflammatory drugs (NSAIDs) that are applied through oral, injectable or topical routes have been widely used in painful and inflammatory musculoskeletal diseases. The current study aimed to determine whether naproxen, an aryl acetic acid derivative with analgesic and anti-inflammatory effects, has a toxic effect on human chondrocytes. Samples containing monolayer primary chondrocyte cultures were prepared following resection from osteochondral tissues obtained from patients with gonarthrosis. Cell viability, toxicity and proliferation and levels of stage-specific embryonic antigen-1, a precursor to human prechondrocytes, were evaluated spectrophotometrically. The results from the untreated control group were compared with those of the study groups, where naproxen was administered in varying doses (1–1,000 µM). Surface morphologies of the cells were compared using inverted light and environmental scanning electron microscopy. Treatment groups were compared by analysis of variance with Tukeys honest difference post hoc test. P<0.01 was considered to indicate a statistically significant difference. The research revealed significant changes to proliferation and differentiation of chondrocytes in all treatment groups (P<0.01). Naproxen was demonstrated to suppress chondrocyte proliferation and differentiation, which may be an important factor to consider when prescribing this medication to patients.

Are radio-contrast agents commonly used in discography toxic to the intact intervertebral disc tissue cells?

In the literature, there have been no studies showing clear results on how radio‐contrast pharmaceuticals would affect intact disc tissue cells. In this context, it was aimed to evaluate the effects of iopromide and gadoxetic acid, frequently used in the discography, on intact lumbar disc tissue in pharmaco‐molecular and histopathological level. Primary cell cultures were prepared from the healthy disc tissue of the patients operated in the neurosurgery clinic. Except for the control group, the cultures were incubated with the indicated radio‐contrast agents. Cell viability, toxicity and proliferation indices were tested at specific time intervals. The cell viability was quantitatively analysed. It was also visually rechecked under a fluorescence microscope with acridine orange/propidium iodide staining. Simultaneously, cell surface morphology was analysed with an inverted light microscope, while haematoxylin and eosin (H&E) staining methodology was used in the histopathological evaluations. The obtained data were evaluated statistically. Unlike the literature, iopromide or gadoxetic acid did not have any adverse effects on the cell viability, proliferation and toxicity (P < 0.05). Although this study reveals that radio‐contrast pharmaceuticals used in the discography, often used in neurosurgical practice, can be safely used, it should be remembered that this study was performed in an in vitro environment.

Forestier syndrome presenting with dysphagia: case report of a rare presentation

Diffuse idiopathic skeletal hyperostosis (DISH) (Forestier syndrome) is a rheumatologic disease, the etiology of which is not exactly known. It is characterized by spinal osteophyte formations resulting from the ossification of the paravertebral ligaments and muscles. Anterior longitudinal ligament is the usual site of involvement and the frequency of the disease increases after the 5th decade. Lower cervical segments are the most frequently involved regions whereas the upper cervical involvement leading to dysphagia is very rare. In this report, a 77-year-old patient with Forestier syndrome in upper cervical region presenting with dysphagia was presented. Anterior cervical osteophyte resection was performed with no need for discectomy, fusion or stabilization. The patient showed a significant improvement in his all preoperative symptoms, and no recurrence was detected at 1-year follow-up.

Rapidly progressing interhemispheric subdural empyema showing a three-fold increase in size within 12 hours: Case report.

Background: Subdural empyema is a rare form of intracranial infection. It is described as accumulation of purulent infective material between the inner layer of dura mater and outer layer of arachnoid membrane. Case Description: A 17-year-old girl was admitted to the emergency department with acute left hemiplegia and was diagnosed with interhemispheric subdural empyema that showed a three-fold increase in size within 12 hours. Complete recovery was achieved with emergency surgical evacuation and additional 3 weeks of antibiotic treatment. Conclusion: Subdural empyema should be diagnosed and managed early in time since it may progress very rapidly and can cause high morbidity and mortality. Complete recovery can be achieved if it is diagnosed early and treated in time.

The Effect of Matrix Metalloproteinase-3 on the Prognosis and Biological Behaviour of Meningiomas.

AIM To analyse the effect of MMP-3 (Matrix Metalloproteinase Enzyme-3)-one of the extracellular matrix proteins- on the prognosis and biological behaviour of meningiomas. MATERIAL AND METHODS 79 cases of meningioma that were operated in our clinic between 2005 and 2010 were retrospectively analysed. Age, sex, preoperative peritumoral edema, histological subtype, grade, Ki-67 expression, MMP-3 staining pattern and recurrence rate were analysed. Pathological preparations were graded according to the WHO (World Health Organisation) 2007 grading system. RESULTS Of the MMP-III positive cases; 24 cases (60%) were grade I, 16 cases were grade II. The MMP-3 staining pattern was significantly positive (80%) in grade II meningioma. 14 of the MMP-3 positive cases were atypical meningiomas. Of the 20 cases with high Ki-67 proliferation index (PI), 12 cases (60%) were MMP-3 positive and 8 cases (40%) were MMP-3 negative. Rates of recurrence and preoperative peritumoral edema were high in cases with MMP-3 positivity. CONCLUSION In this study it was determined that MMP-3 positivity has a strong relationship with meningiomas having an aggressive character. MMP-3 may be used as a proliferation marker for biological behaviour, recurrence rate and prognosis of meningiomas.