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Öğe Lumbar Microdiscectomy Under Spinal and General Anesthesia: A Comparative Study(Turkish Neurosurgical Soc, 2015) Dagistan, Yasar; Okmen, Korgun; Dagistan, Emine; Guler, Ali; Ozkan, NezihAIM: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.Öğe 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, YasarBackground: 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.Öğe 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, NezihBackground: 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.Öğe Traumatic Dissecting Aneurysm of Superficial Temporal Artery: A Case Report(Derman Medical Publ, 2014) Gezici, Ali Riza; Dagistan, Yasar; Guler, Kamil; Dagistan, Emine; Ozkan, NezihTraumatic 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.
