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Öğe The effect of risedronate on posterior lateral spinal fusion in a rat model(Korean Neurosurgical Society, 2009) Gezici, Ali Rıza; Ergün, Rüçhan; Gürel, Kamil; Yılmaz, Fahri; Okay, Önder; Bozdoğan, ÖmerObjective : To evaluate the potential effects of risedronate (RIS) which shows a higher anti-resorptive effect among bisphosphonates, after a posterolateral lumbar intertransverse process spinal fusion using both autograft and allograft in a rat model. Methods : A total of 28 Sprague-Dawley rats were randomized into 2 study groups. A posterolateral lumbar intertransverse process spinal fusion was performed using both autograft and allograft in a rat model. Group I (control) received 0.1 mL of steril saline (placebo) and Group II (treatment) received risedronate, equivalent to human dose (10 mu g/kg/week) for 10-weeks period. Results : The fusion rates as determined by manual palpation were 69% in the group I and 46% in the group II (p = 0.251). According to radiographic score, the spinal segment was considered to be fused radiographically in 7 (53%) of the 13 controls and 9 (69%) of the 13 rats treated with RIS (p = 0.851). The mean histological scores were 5.69 +/- 0.13 and 3.84 +/- 0.43 for the control and treatment groups, respectively. There was a significant difference between the both groups (p = 0.001). The mean bone density of the fusion masses was 86.9 +/- 2.34 in the control group and 106.0 +/- 3.54 in the RIS treatment group. There was a statistical difference in mean bone densities of the fusion masses comparing the two groups (p = 0.001). Conclusion : In this study, risedronate appears to delay bone fusion in a rat model. This occurs as a result of uncoupling the balanced osteoclastic and osteoblastic activity inherent to bone healing. These findings suggest that a discontinuation of risedronate postoperatively during acute fusion period may be warranted.Öğe Giant ossifying fibroma complicated by mucocele of sphenoid sinus - Case report(2008) Gezici, Ali Riza; Ergün, RüçhanOssifying fibroma is a benign tumour that rarely involves the skull. It is most commonly seen in the facial bones with a particular predilection for the mandible. It shares many pathological features with fibrous dysplasia. Ossifying fibroma is an expansive lesion and shows larger non-ossified areas of fibrous tissues. When the tumour is located deeply, encasing the optic-carotid complex, surgical removal becomes difficult because of its ossifying nature. Following surgical resection, the recurrence rate is very low. In the present study, a rare case of giant ossifying fibroma of sphenoid bone which had an intracranial extension with a coexistent mucocele is reported.Öğe Serum cortisol levels following acute experimental spinal cord injury(Elsevier Urban & Partner Sp Z O O, 2009) Gezici, Ali Rıza; Karakaş, Alper; Ergün, Rüçhan; Gündüz, BülentBackground and purpose: Cortisol has neuroprotective effects. We monitored the serum cortisol levels after cervical and thoracic spinal cord injury (SCI) in four groups of rats. Materials and methods: Forty male Sprague-Dawley rats were randomized to four groups. The control group received neither laminectomy nor SCI. The sham group received laminectomy without SCT. The cervical spinal trauma group received a C5-C6 laminectomy and spinal trauma at this level. The thoracic spinal trauma group received a T6-T7 laminectomy and spinal trauma. Blood samples were drawn 2, 6, 12 and 24 hours after surgeries and assayed immediately. Results: The level of cortisol in the cervical spinal trauma group was highest at the second hour of the experiment and the lowest in control and sham-operated groups at the same time. At the sixth hour, cortisol levels increased in control and sham operated groups decreased, but increased in thoracic and cervical groups decreased, but increased in thoracic and cervical groups. After the 24(th) hour, serum cortisol levels in thoracic and cervical groups decreased but did not change significantly in control and sham-operated animals. Conclusion: Activation of endogen cortisol secretion of the organism starts immediately after the SCI injury and throughout the experiment the serum cortisol levels in neurotrauma groups remained high compared with the control and sham-operated groups. At the beginning, the level of neurological lesion (cervical or thoracic) affected differently the level of serum cortisol at a statistically significant level but this difference disappeared at the 6(th) hour.Öğe Serum leptin levels following acute experimental spinal cord injury(Taylor & Francis Ltd, 2009) Gezici, Ali Rıza; Ergün, Rüçhan; Karakaş, Alper; Gündüz, BülentBackground/Objective: Spinal cord injury influences many hormones that are known to be involved in the modulation of neurotrophic, neurogenic, and neuroprotective events. Recent studies showed that leptin could be neuroprotective, enhancing neuronal survival in vitro and in vivo. The objective of this study was to evaluate the pattern of the serum leptin levels in rats during acute traumatic SCI. Methods: Forty male Sprague-Dawley rats were divided randomly into 4 groups. In the control group, neither laminectomy nor SCI was performed; only laminectomy was performed without SCI in the sham group. In the cervical and thoracic spinal trauma groups, laminectomies were performed following the same trauma procedure. Blood samples were drawn 2, 6, 12, and 24 hours after the procedures and assayed immediately. Results: In the first 2 hours, levels of leptin were similar in control and sham-operated groups and higher in neurotrauma groups (P < 0.05). At the sixth hour, leptin levels increased in the sham-operated group, decreased in the neurotrauma groups (P < 0.05), and did not change in the control group (P > 0.05). At the 12th hour, the levels of leptin increased in all groups (P > 0.05). At the 24th hour, they decreased in the control, sham-operated, and cervical groups (P < 0.05); levels did not change in the thoracic group (P > 0.05). The decrease was higher in the control group than in the other groups (P < 0.05). Conclusions: Activation of endogenous leptin secretion started immediately after the SCI. The level of neurologic lesion (either cervical or thoracic regions) affected the levels of serum leptin differently, but with the exception of the first 12-hour period, this difference did not reach a statistically significant level.Öğe Serum neuron-specific enolase (NSE) and homocysteine levels in obtructive sleep apnea syndrome (OSAS)(Ortadogu Ad Pres & Publ Co, 2010) Ergün, Pınar; Çiftçi, Bülent; Ergün, Rüçhan; Erdoğan, Yurdanur; Turay, Ülkü Yılmaz; Gezici, Ali RızaObjective: Presence of a biochemical marker of cerebral injury would be of great benefit in obstructive sleep apnea syndrome (OSAS) to screen for even small brain damage and to monitor efficacy of therapy. The aim of this study was to evaluate whether two different parameters in serum, neuron-specific enolase (NSE) and homocysteine, can be used to detect even subtle levels of cerebral injury in OSAS patients. Material and Methods: We studied 38 patients with OSAS and 30 control subjects with an apnea-hypopnea index (AHI) less than five events per hour. All were evaluated by full-night polysomnography, and in the following morning, serum levels of NSE and homocysteine levels were measured using standard techniques. Results: The AHI in OSAS group was 39.2 +/- 13.8 (mean +/- SD) AH/h. Serum NSE levels were significantly higher in OSAS group (12.3 +/- 5.0 ng/ml) than in the control group (8.2 +/- 1.9 ng/ml; p< 0.01). No significant difference was detected between the groups with regard to serum homocysteine levels (14.1 +/- 6.3 v 14.6 +/- 4.8 mu mol/L; p> 0.05). Conclusion: Elevated serum NSE levels were much more correlated with the severity of OSAS, whereas homocysteine levels were in normal range in these OSAS cases who were otherwise healthy. We believe that there is a need for more sensitive biochemical markers and methods for detecting small cerebral injury in patients with sleep apnea syndrome.Öğe Spontaneous regression of a huge subligamentous extruded disc herniation: short report of an illustrative case(Springer Wien, 2009) Gezici, Ali Rıza; Ergün, RüçhanHerniated nucleus pulposus (HNP) is a common cause of radicular and low-back pain. Although some patients need surgical intervention because of prolonged intolerable leg pain, the majority heal with conservative treatment. Recently, with the advent of imaging diagnostic methods, there is an increasing interest in the phenomenon of spontaneous resorption of the HNP. We presented a case of lumbar HNP at the L4-L5 level in which clinical improvement was associated with a significant decrease in size of a huge subligamentous extruded disc herniation, documented on serial magnetic resonance imaging (MRI) scans.
