Discoidin domain receptor 1 as a promising biomarker for high-grade gliomas

Background: Two fundamental challenges in the current therapeutic approach for central nervous system tumors are the tumor heterogeneity and the absence of specific treatments and biomarkers that selectively target the tumor tissue. Therefore, we aimed to investigate the potential relationship between discoidin domain receptor 1 (DDR1) expression and the prognosis and characteristics of glioma patients. Materials and Methods: Tissue and serum samples from 34 brain tumor patients were evaluated for DDR1 messenger ribonucleic acid levels in comparison to 10 samples from the control group, and Kaplan-Meier survival analysis has performed. Results: DDR1 expression was observed in both tissue and serum samples of the patient and control groups. DDR1 expression levels in tissue and serum samples from patients were higher in comparison to the control group, although not statistically significant (P > 0.05). A significant correlation between tumor size and DDR1 serum measurements at the level of 0.370 was reported (r = 0.370; P = 0.034). The levels of DDR1 in serum showed a positive correlation with the increasing size of tumor. The results of the 5-year survival analysis depending on the DDR1 tissue levels showed a significantly higher survival rate (P = 0.041) for patients who have DDR1 tissue levels above cutoff value. Conclusions: DDR1 expression was significantly higher among brain tumor tissues and serum samples and its levels showed a positive correlation with the increased size of tumor. This study can be a starting point, since it investigated and indicated, for the first time, that DDR1 can be a novel therapeutic and prognostic target for aggressive high-grade gliomas

Incidence and Management of Delayed Epistaxis Following Endoscopic Skull Base Surgery

Objective:Among other complications of endoscopic skull base surgery, delayed epistaxis has not been given much importance. This report presents postoperative delayed nosebleed cases in a large number of patients who underwent an endoscopic endonasal transsphenoidal approach to the sellar region for resection of lesions.Methods:Three hundred and sixty three patients who were reached to the sellar region by endoscopic endonasal transsphenoidal route and operated was included in the study. Retrospective chart reviewing of these patients was performed. The correlation between the duration of nosebleeds, bleeding location, treatment methods and comorbidities of the patients were evaluated.Results:Ten patients (3.6%) reported delayed epistaxis in the postoperative period and were referred to the otolaryngology department. Postoperative epistaxis occurred between days 7th and 33th (mean 16.5) days. The treatment consisted of chemical silver nitrate cauterization in two patients, return to the operating room in three patients, nasal packing in five patients.Conclusion:Delayed postoperative epistaxis often has no obvious etiology, and intervention requires teamworking. Well-coordinated teamworking of the neurosurgeon with other specialities such as neuroradiology and otorhinolaryngology is needed to achieve better results

Langerhans cell histiocytosis involving temporal bone: A case report

Giriş: Langerhans hücreli histiositoz, langerhans tipi histiositlerin iyi huylu proliferatif bir hastalığıdır. Histiositoz X grubu hastalıkların lokalize şeklidir. Hastaların % 90'ı 5 ile 15 yaş arasındadır. Olgu Sunumu: Yirmi dokuz yaşında erkek hasta, başının sağ tarafında ağrı ve aynı bölgede küçük cilt altı şişlik yakınmaları ile beyin cerrahi polikliniğine başvurmuş. Sağ temporoparietal kemikte saptanan kitle, total çıkarılmış. Patolojisi histiositoz "X" olarak rapor edilen hasta, onkolojiye yönlendirilmiş. Sonuç: Direkt grafide osteolitik kemik lezyonu görülen genç hastalarda, langerhans hücreli histiositoz ayırıcı tanıda düşü- nülmeli ve ileri inceleme yapılmalıdır. Genellikle cerrahi eksizyon yeterlidir. Uygun tedavi hastanın prognozu açısından önemli bir faktördür. Bu nedenle, lezyonun yerleşimi ve klinik olarak alt tipinin doğru belirlenmesi, tedavi yaklaşımının doğ- ru planlanmasında çok önemlidir.Objective: Langerhans cell histiocytosis is a benign proliferative disease of langerhans type histiocytes. This type is the localized form of histiocytosis X group diseases. Ninety percent of patients are between 5 and 15 years of age. Case Presentation: A 29-year-old male patient consulted to neurosurgery clinic with symptoms of headache and swelling under skin of the right side of his head. The mass, which was detected in the right temporoparietal bone was excised totaly The patient, whose histopathology was reported as histiocytosis X was referred to medical oncology clinic. Conclussion: Langerhans-cell histiocytosis should be considered in the differential diagnosis of young patients, whose rontgenograms demonstrated osteolytic bone lessions, and advanced examinations should be performed.. Usually, surgical excision suffices. Appropriate therapy is important factor for the patient's prognosis. Therefore localisation of the lesion, and identification of its subtype is very important for accurate planning of therapy approach

İmplant İlişkili Enfeksiyonların Önlenmesinde Titanium Oksit Kaplı Vidaların Etkinliği: Deneysel Bir Hayvan Çalışması

Amaç: İmplantla ilişkili spinal enfeksiyonlar, uzun süre antibiyotik kullanımı gerektirir ve hastanede yatış süresinin uzamasına neden olurlar; buna karşın bazı vakalarda tedavi amacına ulaşamayabilir. Bu çalışmada, sıçan omurgasında implantla ilişkili enfeksiyonların tedavisinde TiO2 kaplı vidaların etkinliği araştırılmaktadır. Yöntem ve Gereçler: 32 dişi beyaz Sprague Dawley sıçan, her biri 8 hayvandan oluşan 4 gruba randomize edildi. Anestezi altında, torasik omurgaya 3 mm.lik bir titanium mikrovida yerleştirildi. 4 grubun tümünde, aynı yoğunlukta (106 CFU/10?lt) Staphylococcus aureus ile inokülasyon yapıldı. Titanyum vida yerleştirilen gruplar grup 1 ve grup 2, TiO2 kaplı vida yerleştirilen gruplar grup 3 ve grup 4 olarak olarak belirlendi. Bulgular: Tüm hayvanlar 21 gün sonra sakrifiye edildi. Sonuçlar “Mann Whitney-U'' testi kullanılarak değerlendirildi. Gruplar karşılaştırıldığında, TiO2 kaplı vida grubu ve titanyum vida grubu arasında istatistiksel olarak anlamlı bir mikrobiyolojik farklılık görülmedi. Bununla birlikte, patolojik değerlendirmede TiO2 kaplı vidalar yerleştirilen hayvanlarda inflamatuar bulguların daha hafif olduğu görüldü. Sonuç: Bu çalışma, titanyum vidaların TiO2 ile kaplanmasının implanta bağlı enfeksiyonların engellenmesinde anlamlı bir farka neden olmadığını göstermiştir.Objective: The treatment of the implant related spinal infection requires long-term antibiotic use and causes prolonged hospital stay; even then in some cases the treatment goals cannot be achieved. This study aims to investigate the efficiency of TiO2-coated screws for the treatment of the implant-associated infections in rat spines. Methods: 32 female white Sprague Dawley rats were randomized into 4 groups, each consisting of 8 animals. Under anesthesia, a 3-mm titanium micro screw was implanted in the thoracic spine. All 4 groups were inoculated with the same concentration of Staphylococcus aureus (106 CFU/10μlt). Group 1 and 2 were assigned as titanium screw implanted groups and group 3 and 4 were assigned as TiO2-coated screw implanted groups. Results: All animals were sacrificed after 21 days. The results were analyzed using “Mann Whitney-U'' test. When the groups were compared, no statistically significant microbiological difference was found between the TiO2-coated screw groups and the titanium screw groups. However, the pathologic evaluation indicated that the inflammatory signs were milder in the animals implanted with TiO2-coated screws. Conclusions: This study has shown that coating the titanium screws with TiO2 has not resulted in a significant difference in the prevention of implant-related infections

Impact of sorafenib on epidural fibrosis: An immunohistochemical study

WOS: 000443886300003PubMed ID: 30211205AIM To determine if sorafenib, an antineoplastic agent, could prevent the development of spinal epidural fibrosis (EF). METHODS The study used CD105 and osteopontin antibodies in an immunohistochemical approach to quantify EF that occurred as a consequence of laminectomy in rats. Wistar albino rats (n = 16) were divided into two groups: control (L1-2 level laminectomy only) and sorafenib treatment (L1-2 level laminectomy + topical sorafenib). The animals were euthanatized after 6 wk, and the EF tissues were examined for histopathological changes after immunohistochemical staining. The EF grades were assigned to the tissues, and the treatment and control groups were compared. RESULTS The EF thickness, inflammatory cell density, and arachnoid adherences determined by light microscopy were significantly higher in the control group compared to the sorafenib-treated group. Based on fibrosis scores, the extent of EF in the treatment group was significantly lower than in the controls. Immunohistochemical staining for CD105 to identify microvessels revealed that the EF grades based on vessel count were significantly lower in the treatment group. Staining for osteopontin did not show any significant differences between the groups in terms of the extent of EF. The staging of EF based on vascular counts observed after immunohistochemical staining for CD105, but not for osteopontin, was compatible with conventional staging methods. Neither toxic effects on tissues nor systemic side effects were observed with the use of sorafenib. CONCLUSION Local administration of sorafenib significantly reduced post-laminectomy EF. Decreased neovascularization in spinal tissue may be due to the sorafenib-induced inhibition of vascular endothelial growth factor

Royal Jel, Laminektomi Sonrası Epidural Fibrozis Gelişimini Önleyebilirmi? Deneysel Çalışma

Amaç: Başarısız bel cerrahisi sendromunun en önemli sebeplerinden biri epidural fibrosis gelişimidir. Bu çalışmada, yara iyileşmesine olumlu etkileri olduğu bilinen royal jelin deneysel olarak laminektomi sonrası epidural fibrosis gelişimine etkisi incelendi. Yöntem ve gereçler: Sıçanlar sekizerli iki gruba ayırıldı. Birinci gruba sadece laminektomi yapılırken, ikinci gruba laminektomi sonrası laminektomi bölgesine lokal olarak royal jel uygulandı. Vertebral kolonlar 6 hafta sonra blok olarak çıkarıldı. Bulgular: Parafin kesitler nöropatolog tarafından ışık mikroskobunda incelenerek fibrozis derecesi kaydedildi. Her iki grup, fibrozis derecesine göre karşılaştırıldı. Royal jel kullanılan grupta fibrozis derecesi, kontrol grubuna göre belirgin şekilde düşük bulundu. Sonuç: Royal jelin yara iyileşmesine olumlu etkileri bilinmesine rağmen, laminektomi sonrası epidural fibrozis gelişimine yönelik yaptığımız çalışma ilktir. Çalışmanın sonuçlarına göre royal jel, sıçanlarda laminektomi sonrası epidural fibrozis derecesini azaltmaktadır. Royal jelin insan vücuduna toksik etkilerinin olmaması nedeniyle, ilaç formunun faz çalışmalarının insanlarda yapılabileceği kanaatindeyiz.Objective: One of the most important causes of the failed back surgery syndrome is the development of epidural fibrosis. In this study, the effects on the development of epidural fibrosis following experimental laminectomy of royal jelly, of which the positive effects on wound healing are known, were investigated. Material and Methods: Rats were divided into two groups, with eight rats in each group. While only laminectomy was performed in the first group, royal jelly was applied locally in the second group following the laminectomy. Vertebral columns were removed 6 weeks later. Results: Paraffin sections were examined under the light microscope by the neuropathologist and the grade of fibrosis were recorded. Each group was compared with the other group according to the level of fibrosis. The fibrosis grade in the group that royal jelly was used was found as significantly lower as compared to the control group. Conclusions: Although the positive effects of royal jelly on wound healing are known, this study of ours about the effects on the epidural fibrosis development following laminectomy is a first. Based on the results of this study, royal jelly decreases the grade of epidural fibrosis in rats following laminectomy. Since the royal jelly has no toxic effects on human body, we believe that the phase studies on humans for the medicine form of royal jelly can be carried out

Effect of propolis aplication on postlaminectomy fibrosis: An experimental study

Geçmiş bilgiler: Başarısız bel cerrahisi sendromunun en önemli sebeplerinden biri epidural fibrosis gelişimidir. Laminektomi sonrası epidural fibrosis gelişimini engellemeye yönelik pek çok yöntem ve madde kullanılmıştır. İnsan sağlığına olumlu etkileri olduğu bilinen propolisin yara iyileşmesini hızlandırıcı ve düzenleyici özelliği vardır. Amaç: Bu çalışmada, propolisin deneysel olarak laminektomi sonrası epidural fibrosis derecesine etkisi sıçanlarda değerlendirildi. Materyal-metod: Denekler iki gruba ayırıldı: Grup-1 (n=8) (Kontrol grubu); L1 seviyesine sadece laminektomi yapıldı, grup 2 (n=8) (Tedavi grubu); L1 laminektomi yapılarak, laminektomi sahasına propolis uygulandı. İlgili vertebral kolonlar 6 hafta sonra blok olarak çıkarıldı. Parafin bloklardan 6 mm kalınlığında seviyeli kesitler alındı. Bulgular: Skar dokusunun derecesine göre yapılan evrelemede, grup 2’de grup 1’e göre EF’in daha düşük oranda geliştiği gösterildi. Aradaki farkın istatistiksel olarak anlamlı olduğu görüldü (p <0.05). Fibroblast sayısına göre yapılan evrelemede, grup 2’de grup 1’ye göre daha düşük derecede epidural fibrosis geliştiği ve aradaki farkın istatistiksel olarak anlamlı olduğu tespit edildi (p <0.05). Sonuçlar ve çıkarımlar: Omurga cerrahisi sonrası oluşan epidural fibrosisi önlemek amacıyla günümüze kadar birçok çalışma yapılmış ve bir çok madde kullanılmıştır. Propolisin, yara iyileşmesinde yararlı etkileri birçok çalışmada gösterilmiştir. Laminektomi sonrası epidural fibrosis gelişiminde ve diğer nöroşirüjik prosedürleri içeren çalışmalarda propolis hiç kullanılmamıştır. Çalışmamızın sonuçlarına göre propolis, sıçanlarda laminektomi sonrası epidural fibrosis gelişimini azaltmaktadır. Propolisin laminektomi sonrası insan çalışmalarında kullanılabilmesi için, standart jel formu oluşturulmalıdır.History: The development of epidural fibrosis is one of the most important reasons of failed back surgery syndrome. Many methods and substance have been used to prevent the development of post-laminectomy epidural fibrosis. Propolis is not only known to have positive effects on human health and regulatory properties, it also has accelerating eff ect on wound healing. Objective: This study evaluated experimentally the effect of propolis on the degree of epidural fibrosis after laminectomy in rats. Materials and Methods: The subjects were separated into two groups: Group 1 (n=8) (control group); L1 laminectomy was performed, group 2 (n=8) (treatment group); L1 laminectomy plus propolis in operation area was performed. Vertebral columns were removed on block after six weeks and six mm thick sections were cut in paraffin blocks. Results: In group two, lower rate of epidural fibrosis was developed according to the degree of scar tissue than in group one. The difference was statistically significant (<0.05). When the Staging was done according to the number of fibroblasts, in group two low grade of epidural fibrosis was determined and the difference was statistically significant (<0.05). Conclusion: Many methods and substance have been used to prevent the development of post-laminectomy epidural fibrosis. Although there are many studies have been pointed out the beneficial effects on wound healing, in neurosurgical practice propolis was never used. According to the results of this study propolis can be used for post-laminectomy epidural fibrosis in rats. The standard form of the gel must be formed in human studies

Deneysel İmplant İlişkili Spinal Enfeksiyon Modelinde Manuka Honeyin Antibakteriyel Etkisinin Değerlendirilmesi

Amaç: Spinal cerrahi prosedürlerde implant ilişkili enfeksiyonlar, tüm önlemlere rağmen hala önemli problemlerden biridir. İmplant ilişkili enfeksiyonları önlemeye yönelik bir çok ilaç ve yöntem uygulanmıştır. Manuka honey, ilaç formu FDA tarafından onaylanmış bal türüdür. Manuka honeyin, implant ilişkili enfeksiyonlarda en sık izole edilen bakteri olan metisilin rezistan stafilokokus aureusa karşı bakterisit ve bakteriostatik etkileri vardır. Bu çalışmadaki amacımız, implant ilişkili spinal enfeksiyon modelinde, ucuz ve doğal bir ürün olan balın sıçanlarda enfeksiyon gelişimini önleyici etkisinin olup olmadığını değerlendirmektir. Yöntem: Sıçanlar sekizerli 3 gruba ayrıldı. 1. grup (kontrol grubu); sadece spinal implant uygulanan grup, 2. grup (enfeksiyon grubu): spinal implantla beraber bakteri ekilen grup. 3. grup (tedavi grubu): spinal implant ve enfeksiyona ilave manuka honey uygulanan grup. Grup 1'deki sıçanların hiç birinde doku, implant ve kan kültürlerinde bakteriyel üreme olmadı. Grup 2 ve 3'teki sıçanların tamamında ekimi yapılan standart MRSA suşu üredi. Gruplar birbirleri arasında enfeksiyon yoğunluğu açısından karşılaştırıldı. Grup 2'deki vertebral kolon ve implantlar üzerinde üreyen bakteri sayısının grup 3'e kıyasla daha şiddetli olduğu, üreyen bakteri koloni sayısının kantitatif olarak daha fazla olduğu tespit edildi. Bu fark, implant üzerinde istatistiksel olarak anlamlı bulunurken, vertebral kolonda anlamlı bulunmadı. Sonuç: Manuka honey bu modelde, MRSA enfeksiyonunu tam olarak önleyememiş ancak, enfeksiyonun şiddetini belirgin olarak azaltmıştır. Manuka honeyin implant ilişkili enfeksiyonlarda farklı bir model oluşturularak, düzenli aralıklarla kullanılabilmesi durumunda, daha objektif ve umut verici sonuçlar ortaya konabilir. Ayrıca Manuka honeyin, farklı modeller oluşturularak, farklı bakterilerde ve diğer stp aureus suşlarında da denenmesinin uygun olacağı kanaatindeyiz.Aim: Implant-related infections in spinal surgical procedures are still an important problem despite all the precautions. Various methods and medicinal products have been applied in order to prevent implant-related infections. “Manuka honey” is a type of honey which has been approved by FDA as a medicinal product. “Manuka honey” has bactericidal and bacteriostatic effects on “methicillin resistant Staphylococcus aureus” which is the most frequently isolated bacteria. The purpose of this study is to evaluate whether as an inexpensive and natural product, honey would prevent infection growth on rats in the implant related infection model. Method: Rats were divided into 3 groups, each of which containing 8 rats:namely, the control, infection and treatment groups. In the 1st group, there was no bacterial proliferation. Planted standard MRSA strain has been detected on rats belonging to the groups 2 and 3. On the vertebral column and implants, bacterial growth was greater in the 2nd group than the 3rd group. Also more bacterial colony growth has been detected in 2nd group as compared to 3rd group. While this difference was deemed significant in implant, the same did not apply to vertebral column. Result: Manuka honey could not completely eradicate the MRSA infection; however, it did decrease the intensity of the infection. If manuka honey, through constituting a different model, could be used in infections regularly, more objective and promising results would be revealed. Moreover, we consider that experimenting “manuka honey” on different bacteria including other Staph. aureus strains would be appropriate through constituting different models

The role of sympathectomy on the regulation of basilar artery volume changes in stenoocclusive carotid artery modeling after bilateral common carotid artery ligation: an animal model

Gundogdu, Cemal/0000-0003-2857-923XWOS: 000334426000017PubMed: 24557449Stenoocclusive carotid artery disease causes important histomorphologic changes in all craniocervical vasculatures, such as luminal enlargement, vascular wall thinning, elongation, convolutions, and aneurysm formation in the posterior circulation. Although increased pressure, retrograde blood flow, and biochemical factors are described in the pathogenesis of vascular remodelisation, the vasoregulatory role of the autonomic nervous system has not been investigated thus far. We investigated the relationship between the sympathetic nervous system and the severity of histomorphologic alterations of basilar arteries after bilateral common carotid artery ligation (BCCAL). This study was conducted on 21 rabbits. the rabbits were randomly divided into three groups: baseline group (n = 5), sympathectomy non-applied group (SHAM; n = 8), and sympathectomy applied group (n = 8) before bilateral common carotid artery ligation. Permanent ligation of the prebifurcations of the common carotid arteries was performed to replicate stenoocclusive caroid artery disease. Basilar artery volumes were measured after ligation. Volumes of the basilar arteries were estimated by stereologic methods and compared between groups. Luminal enlargement, wall thinning, elongation, convolutions, and doligoectatic configurations were detected in the majority of basilar arteries. the mean basilar arterial volume was 4.27 +/- 0.22 mm3 in the baseline group; 5.28 +/- 0.67 mm(3) in the SHAM group, and 8.84 +/- 0.78 mm3 in the study group. the severity of basilar enlargement was significantly higher in the study group compared with the SHAM (p < 0.005) and baseline groups (p < 0.001). Sympathectomy causes basilar artery enlargment, which is beneficial for maintaining cerebral blood flow; however, it also causes wall thinning, elongation, convolution, and aneurysm formation, which may be hazardous in stenoocclusive carotid artery disease. Sympathectomy can prevent new vessel formation and hyperthyrophic changes at the posterior circulation. Neovascularisation is not detected adequately in sympathectomised animals