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    Combination hyperbaric oxygen and temozolomide therapy in c6 rat glioma model
    (Acta Cirurgica Brasileira, 2012) Dagistan, Yasar; Karaca, Ismail; Bozkurt, Erol Rustu; Ozar, Engin; Yagmurlu, Kaan; Toklu, Akin; Bilir, Ayhan
    PURPOSE: Temozolomide (TMZ) has anti-tumor activity in patients with malignant glioma. Hyperbaric oxygen (HBO) may enhance the efficacy of certain therapies that are limited because of the hypoxic tumor microenvironment. We examined the combined effects of TMZ-HBO in a rat glioma model. METHODS: After stereotactic injection of C6/LacZ rat glioma cells into the Wistar rats brain, the rats were randomly assigned to three treatment groups [group 1, control treatment; group 2, TMZ alone; group 3, a combination of TMZ and HBO]. Rats were sacrificed 18 days after treatment, and number of intra-/peri-tumoral vessels, microendothelial proliferations, immunohistochemistry and necrotic area were evaluated. RESULTS: Tumoral tissue was stained only sparsely with GFAP. Temozolomide treatment was significantly decreased in tumor tissue intratumoral vessel number / total tumor area level. The level of Ki67 was significantly decreased in the tumor tissue of the group 3. Additionally, the total necrotic area / total tumor volume (%) was decreased significantly in tumor tissue of the group 3 rats compared to group1 and 2. CONLUSION: The combination of hyperbaric oxygen with temozolomide produced an important reduction in glioma growth and effective approach to the treatment of glioblastoma.
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    Effects of Ibuprofen on Orthotopic Glioma Model in Rats
    (Coll Physicians & Surgeons Pakistan, 2012) Dagistan, Yasar; Karaca, Ismail; Bozkurt, Erol Rustu; Bilir, Ayhan
    Objective: To determine the effects of ibuprofen (Ibp) on the vessel proliferation and necrosis in a rat glioma model. Study Design: Experimental, randomized interventional trial. Place and Duration of Study: 1st Neurosurgery Clinic in Bakirkoy Mental Diseases Hospital, Bakirkoy, Istanbul, Turkey, in the year 2010. Methodology: After stereotactic injection of C6/LacZ rat glioma cells into the Wistar rats brain, the rats were randomly assigned to two treatment groups (group 1, control; group 2, Ibp treatment). Rats were sacrificed 18 days after treatment, and number of intra-/peri-tumoural vessels, microendothelial proliferations, immunohistochemistry and necrotic area were evaluated. Results: Ibp treatment significantly decreased tumour tissue, intratumoral vessel number and total tumour area level. The level of Ki67 was significantly decreased in the tumour tissue of group 2. Additionally, the total necrotic area / total tumour volume (%) was significantly less in the tumour tissue of the ibuprofen-treated rats compared to the controls. Conclusion: The data show that the Ibp produced an important reduction in glioma tumour cell proliferation in the rat model.
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    Extradural giant thoracic schwannoma in a pediatric patient; a case report
    (Springer, 2024) Cicek, Caner; Dagistan, Yasar; Akyuz, Yagiz
    IntroductionGiant extradural thoracic schwannomas are very rare tumors in the pediatric age group and often occur together with neurofibromatosis. Giant schwannomas span across more than two vertebral segments and have an extraspinal extension of over 2.5 cm. In this case, we report on a 5-year-old boy with a purely extradural giant schwannoma without accompanying neurofibromatosis.Clinical presentation.A 5-year-old male patient was admitted to the orthopedics and traumatology outpatient clinic with complaints of difficulty in walking following waist and left leg pain after falling from a chair. Contrast-enhanced spinal MRI and cranial MRI showed an extradural spinal lesion measuring 22 x 18 x 35 mm that pushed the spinal cord to the right at the T10-12 level and extended into the left foramen at the T11-12 level. The patient was operated. The tumor was removed completely by performing bilateral laminoplasty at the T10-11-12 levels. Histopathology result reported schwannoma.IntroductionGiant extradural thoracic schwannomas are very rare tumors in the pediatric age group and often occur together with neurofibromatosis. Giant schwannomas span across more than two vertebral segments and have an extraspinal extension of over 2.5 cm. In this case, we report on a 5-year-old boy with a purely extradural giant schwannoma without accompanying neurofibromatosis.Clinical presentation.A 5-year-old male patient was admitted to the orthopedics and traumatology outpatient clinic with complaints of difficulty in walking following waist and left leg pain after falling from a chair. Contrast-enhanced spinal MRI and cranial MRI showed an extradural spinal lesion measuring 22 x 18 x 35 mm that pushed the spinal cord to the right at the T10-12 level and extended into the left foramen at the T11-12 level. The patient was operated. The tumor was removed completely by performing bilateral laminoplasty at the T10-11-12 levels. Histopathology result reported schwannoma.IntroductionGiant extradural thoracic schwannomas are very rare tumors in the pediatric age group and often occur together with neurofibromatosis. Giant schwannomas span across more than two vertebral segments and have an extraspinal extension of over 2.5 cm. In this case, we report on a 5-year-old boy with a purely extradural giant schwannoma without accompanying neurofibromatosis.Clinical presentation.A 5-year-old male patient was admitted to the orthopedics and traumatology outpatient clinic with complaints of difficulty in walking following waist and left leg pain after falling from a chair. Contrast-enhanced spinal MRI and cranial MRI showed an extradural spinal lesion measuring 22 x 18 x 35 mm that pushed the spinal cord to the right at the T10-12 level and extended into the left foramen at the T11-12 level. The patient was operated. The tumor was removed completely by performing bilateral laminoplasty at the T10-11-12 levels. Histopathology result reported schwannoma.ConclusionGiant schwannomas are slow-growing tumors that rarely occur in childhood. In these patients, spinal traumas can lead to serious neurological deficits. Early diagnosis and successful surgery can prevent permanent neurological damage.
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    Kyphoplasty for osteoporotic fractures: Experience of a single center
    (Ondokuz Mayis Universitesi, 2018) Dagistan, Yasar; Dagistan, Emine; Gezici, Ali Rıza; Sari, Kutlu; Aktas, Gulali
    Osteoporosis increases the risk of spontaneous fractures of skeleton by enhancing the microstructure of the bones. Kyphoplasty is preferred for decreasing the pain and disability in treatment of spinal fractures. We aimed to report our clinical experience in kyphoplasty for spinal fracture treatment and to express a brief literature review. We performed balloon kyphoplasty in 14 patients with osteoporotic spinal fractures between January 2012 and July 2015. Nine of the patients were women and 5 were men. Age of the patients ranged between 59 to 81 years. We think that spinal fractures should be initially treated with conventional methods, however, kyphoplasty should be done without a delay because it is very effective in pain and other complications of the fracture and a relatively safer method than other interventions. © 2018 OMU
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    Lumbar Microdiscectomy Under Spinal and General Anesthesia: A Comparative Study
    (Turkish Neurosurgical Soc, 2015) Dagistan, Yasar; Okmen, Korgun; Dagistan, Emine; Guler, Ali; Ozkan, Nezih
    AIM:To compare the safety and efficacy of spinal anesthesia (SA) in patients undergoing lumbar microdiscectomy (LM). MATERIAL and METHODS: We evaluated 180 patients who underwent LM between 1 January 2012 and 5 July 2013. Demographic, clinical, laboratory, and pre-, intra-, and postoperative information was determined from the patients' medical records. RESULTS: Total anesthetic times were longer in the general anesthesia (GA) group. There was less bleeding at the surgical site in the SA group. Intraoperative blood pressure was significantly also lower in the SA group. Meanwhile, tachycardia was significantly higher in the GA group. The analgesic requirement in post-anesthesia care unit (PACU) was higher in the general anesthesia group. At PACU admission, analgesic requirement, heart rate, and the mean arterial pressure were higher in the GA group. Postoperative nausea and vomiting was more frequent among patients recovering in general anesthesia group. SA patients had an increased incidence of urinary retention compared with GA patients. Pulmonary complications requiring specific treatment were insignificantly higher among GA patients. CONCLUSION: In patients who undergo lumbar disc surgery, SA is a good alternative for experienced surgeons because of a more comfortable healing process.
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    The therapeutic effects of cyclosporin-A on experimental spinal cord injury
    (Scientific Publishers of India, 2017) Gezici, Ali Riza; Kilic, Guven; Firat, Tulin; Cancan, Seckin Emre; Kukner, Aysel; Ozkan, Nezih; Dagistan, Yasar
    Background: According to the experiments, neutrophils and microglial cells are the first to attend the early phase of events in inflammatory response to SCI. Those pilot cells are seen in the first 12-24 hours and disappear about 3-5 days. The neutrophil accumulation and activation are steered by many cytokines such as TNF-?, IL-1 and IL-6. Neutrophils do accompany to the modulation of secondary injury mechanisms via neutrophil proteases and reactive oxygen molecules. When those processes are taken into account, depletion of neutrophils or depression of their functions may derive neuro-protection and neurological healing. Purpose: To investigate the therapeutic and neuroprotective effects of Cyclosporin-A (CSA) on recovery processes using clinical and histopathological tests, which has not been used very frequently in clip compression spinal cord injury (SCI) models. Material and methods: Twenty-four Spraque-Dawley rats were divided into three groups: group 1 [Sham-control, n=8], group 2 [SCI+2 mL saline intramuscular (i.m.), n=8], group 3 [SCI+5 mg/kg CSA (i.p.) 1 h after SCI and for the following three days, n=8]. Rats were evaluated 1st, 3rd, 5th and 10th days after SCI, clinically by Drummond and Moore scale and under light microscopy and by TUNEL test; after scarification on 10th day. Results: Clinical and histopathological results of treatment group were found significantly better than the results of the trauma group. Conclusion: CSA can depress apoptosis and necrosis rates in a statistically significant manner and carry out the statistical difference in clinical results. © 2017, Scientific Publishers of India. All rights reserved.
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    The therapeutic effects of etanercept-methotrexate combination on experimental spinal cord injury
    (Scientific Publishers of India, 2017) Gezici, Ali Riza; Akar, Semih; Firat, Tulin; Dagistan, Yasar; Cancan, Seckin Emre; Kukner, Aysel; Ozkan, Nezih
    Background: Experimental studies have demonstrated that neurons keep dying in an unrecoverable and non-regenerative pattern in following hours after primary mechanical injury to spinal cord. The cascade of events which is called secondary injury is composed of vascular impairment, oedema, ischemia, inflammation, exotoxicity, electrolyte imbalance, lipid peroxidation, free radicals, necrosis and apoptotic cell death. Aims: With clinical and histopathological tests, this study investigated the therapeutic effects of etanercept-methotrexate combination which is an option in mono-therapy resistant rheumatological diseases; but this combination has not been used on recovery processes in clip compression Spinal Cord Injury (SCI) model yet. Study design: Forty Spraque-Dawley rats were divided into five groups: group 1 (Sham-control), group 2 (SCI+2 ml saline intramuscular), group 3 (SCI+1.25 mg/kg etanercept), group 4 (SCI+0.5 mg/kg methotrexate) and group 5 (SCI+1.25 mg/kg etanercept+0.5 mg/kg methotrexate). Methods: Rats were evaluated 1st, 3rd, 5th and 10th days after SCI, clinically by Drummond and Moore scale, under light microscopy and by Tunel test; after sacrification on 10th day. Results: Clinical and histopathological results of all treatment groups were found significantly better than the results of the trauma group; also no superiority in the monotherapy groups, over each other, was noted. Conclusion: Combined-treatment group had a statistically significant better outcome in preventing apoptosis, but there was no difference according to the clinical results. © 2017, Scientific Publishers of India. All rights reserved.
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    Traumatic Dissecting Aneurysm of Superficial Temporal Artery: A Case Report
    (Derman Medical Publ, 2014) Gezici, Ali Riza; Dagistan, Yasar; Guler, Kamil; Dagistan, Emine; Ozkan, Nezih
    Traumatic aneurysms of the superficial temporal artery (STA) are a rare occurrence. Here, we report a very rare case of dissecting aneurysm of superficial temporal artery caused by blunt trauma. 22 year man, admitted with a solitary painless, pulsatile swelling in the right temporal region. 8 mounts ago, he had closed head injury over right temporal region without a skull fracture. A traumatic aneurysm of the STA was diagnosed. Under anesthesia, the aneurysm was completely excised.
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    Upper cervical spinal injuries in elderly patients: Age-specific treatment
    (Scientific Publishers of India, 2017) Gezici, Ali Rıza; Dagistan, Yasar; Cancan, Seçkin Emre; Sarı, Kutlu; Kaya, Necdet Selim; Kılıç, Güven; Akar, Semih
    Incidence of upper cervical vertebra injuries in elder population augments in accordance with the increase in mean life expectancy of the general population. These injuries can be easily misdiagnosed since they can be caused by low-accelerated traumas due to the osteo-degenerative changes in elderly patients, and with generally no neurological findings. Odontoid fractures are the most common among these injuries. Treatment algorithms of odontoid fractures are not still well established because of preexisted co-morbidities and high rates of morbidity and mortality in older individuals. We have retrospectively evaluated 16 cases admitted to our clinic in last 3 years, which were older than 65 years of age and which have been diagnosed with C2 fractures. In 13 of these cases (81.3%) odontoid fractures (10 cases with type II and 3 cases with type III), in 2 cases (12.5%) lateral mass fractures and 1 pars interarticularis fracture were identified. 14 of the patients (87.5%) were treated with medical corsets (7 Halo vests, 7 Minerva braces) and 2 patients (12.5%) had undergone surgery. All patients who had rigid cervical immobilization (RCI) were discharged in cured conditions whereas 2 patients, who were treated with surgical intervention, had died in early post-operative period. In patients with RCI bone fusion rate was 63.6% and recovery with stable fibrosis rate was 36.4% for odontoid fractures. At the end of the medical corset application period, all patients were checked with dynamic X-ray imaging and in an unrelated manner to the bone fusion rates no instability, greater than 1 mm, was determined. In the mean follow-up period of 30 months, no complications were seen after the medical corset application for stabilizations. Therefore, we have the conclusion that in patients from the older population, with no certain indications for surgery, a suitable RCI should be tried at first, and recovery with a stable fibrosis can be adequate for this patient group. © 2017, Scientific Publishers of India. All rights reserved.