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

Lomber disk hernisi olan genç hastalarda faset eklem açı özelliklerinin lomber disk hernisi gelişimindeki rolünün araştırılması

Purpose:The aim of the current study was to investigate facet tropism in young patients with lumbar disc hernia (LDH) and the role of facet tropism in the development of LDH Materials and methods:The study included 57 patients aged 20-32 years with a diagnosis of LDH and bilateral facet joint angles at L3-4, L4-5 and L5-S1 levels measured on lumbar magnetic resonance imaging (MRI) tests. In the comparison of the two facet joint angles, a difference of 14° as severe tropism. A control group was formed of 46 age-matched healthy individuals with no lumbar disc hernia. Results:A total of 618 facet facet angles were measured, comprising 342 in the 57 patients in the LDH group and 276 in the 46 subjects of the control group. In the LDH group, at the L3-4 level, no tropism was determined in 46 (80.7%), moderate tropism in 9 (15.7%) and severe tropism in 2 (3.5%). At the L4-5 level, no tropism was determined in 36 (63.1%), moderate tropism in 17 (29.8%) and severe tropism in 4 (7%). At the L5-S1 level, no tropism was determined in 33 (57.9%), moderate tropism in 17 (29.8%) and severe tropism in 7 (12.2%).In the control group, at the L3-4 level, no tropism was determined in 40 (87%), moderate tropism in 5 (10.9%) and severe tropism in 1 (2.2%). At the L4-5 level, no tropism was determined in 37 (80.4%), moderate tropism in 8 (17.3%) and severe tropism in 1 (2.1%). At the L5-S1 level, no tropism was determined in 34 (73.9%), moderate tropism in 7 (15.2%) and severe tropism in 5 (10.9%). In the LDH group, the mean facet angle values were 40.4° at L3-4, 42.7° at L4-5 and 45.9° at L5-S1 levels. In the control group, the mean facet angle values were 39.2° at L3-4, 41.4° at L4-5 and 43.9° at L5-S1 levels. Conclusion: Although facet joint tropism was seen at a higher rate in the LDH patients than in the control group, the difference was not statistically significant (p>0.05). The results of the study did not suggest that facet tropism is a factor in the etiology of LDH.Amaç: Çalışmamızda lomber disk hernisi (LDH) olan genç hastalarda faset tropizmini ve faset tropizminin LDH gelişimindeki rolünü araştırmak amaçlanmıştır. Gereç ve yöntem:LDH’si olan 20- 32 yaş arasındaki 57 hasta ile lomber disk hernisi olmayan sağlam olarak kabul ettiğimiz 46 hastanın lomber Manyetik Rezonans Görüntüleme (MRG) tetkiklerinde L3-4, L4-5, L5-S1 mesafesinde bilateral faset eklem açıları aksiyal planda ölçüldü. Karşılıklı her iki faset eklem açısı arasında fark 14° ise ağır tropizm olarak sınıflandırıldı. Bulgular:LDH’li 57 hastada 342, kontrol grubu 46 hastada 276 olmak üzere toplam 618 faset açısı ölçüldü. LDH grubununda L3-4 seviyesinde, %80.7’sinde (n=46) tropizm olmadığı, %15,7’sinde (n=9) orta derecede tropizm olduğu, %2’sinde (n=3.5) ağır derecede tropizm olduğu görüldü. L4-5 seviyesinde, % 63.1’inde (n=36) tropizm olmadığı, %29.8’inde (n=17) orta derecede tropizm olduğu, %7sinde (n=4) ağır derecede tropizm olduğu görüldü. L5-S1 seviyesinde %57.9’unda (n=33) tropizm olmadığı, %29.8’inde (n=17) orta derece tropizm olduğu, %12.2’sinde (n=7) ağır tropizm olduğu tespit edildi. Kontrol grubunda ise L3-4 seviyesinde, %87’sinde (n=40) tropizm olmadığı, %10.9’unda (n=5) orta derecede tropizm olduğu, %2.2’sinde (n=1) ağır tropizm olduğu tespit edildi. L4-5 seviyesinde, %80.4’ünde (n=37) tropizm olmadığı, %17.3’ünde (n=8) orta derecede tropizm olduğu, %2.1’inde (n=1) ağır tropizm olduğu görüldü. L5-S1 seviyesinde %73.9’unda (n=34) tropizm olmadığı, %15.2’sinde (n=7) orta derece tropizm olduğu, %10.9’unda (n=5) ağır tropizm olduğu tespit edildi. LDH’li grupta faset açı ortalamaları L3-4’te 40.4; L4-5’t; 42.7; L5-S1’de 45.9 idi. Kontrol grubu faset açı ortalamaları L3-4’te 39.2; L4-5’te 41.4; L5-S1’de 43.9 derece idi. Sonuç: Çalışmamızda faset eklem tropizmi, LDH’li hastalarda kontrol grubuna göre bir miktar yüksek oranda görülüyor olmasına rağmen istatistiksel olarak anlamı olmadığını belirledik (p>0.05). LDH etiyolojisinde faset tropizminin predispozan bir faktör olarak rol oynamadığını düşünmekteyiz

Lomber Disk Herniasyonunda Ba��ar�S�Z Bel Cerrahisi; Epidural Fibrozis Ve N�Ks Olgular�N�N Reoperasyondaki Ba��ar� Skorlamas�N�N Retrospektif İNcelenmesi

Aim: In this work, failed back surgery syndrome(FBSS) which observed in Lomber disc herniation(DH) postoperatively is analysed; and especially epidural fibrosis and recurrent cases are retrospectively analysed through calculating the success scores. Method: Our work had been carried out between January/2000 – December/2006. In our clinic, 1268 cases in total were examined that were operated by reason of lomber disc herniation in our clinic. Among the cases that were included to the study, the 70 were evaluated as FBSS and the radiological evidences, surgical and clinical findings were analysed retrospectively. Result: Of all the patients 36 were women (51%), the 34 were male (48.6 %). Their ages changed between 22-74 and the age average was found as 49.9. Of all the reoperated cases; the 45 (64%) were reoperated by reason of recurrent DH, 9 (12.8%) epidural fibrosis and recurrent DH, 8 (11.4% ) paraspinal abse, 3 (4.2%) lomber stenosis, 3 (4.2%) foraminal stenosis, 1 (1.4%) postoperative discitis, 1(1.4%) Cerebro spinal fluid (CSF) fistule. While the success rate of the cases with epidural fibriosis was found as 37.2 % ; 75.9% success rate was recorded for the patients with recurrent DH. Statistical comparison was found as meaningful. (p< 0.05) Conclusion: The most frequent reoperation cause for the patients who were operated by reason of lomber DH is the recurrent herniations which occur at the same level; the same side or the opposite side. The cases with epidural fibriosis must be well-assessed radiologically and clinically and the most effective treatment plan should be aimed and formed.Amaç: Bu çalışmada Lomber DH cerrahisi sonrası görülen BBC, özellikle epidural fibrozis ve nüks olgularının reoperasyondaki başarı skorlamaları yapılarak retrospektif olarak incelenmiştir. Metod: Çalışmamız Ocak 2000- Aralık 2006 tarihleri arasında kliniğimizde lomber disk hernisi nedeniyle opere edilen toplam 1268 olguda yapıldı. Çalışmaya dahil edilen olgular arasında 70 olgu BBC olarak değerlendirilip radyolojik bulguları, ameliyat bulgularıve klinik bulguları retrospektif olarak analiz edildi. Bulgular: Olguların 36’sı kadın (%51.4), 34’ü erkek (%48.6), yaş sınırı 22-74 arasında olup, yaş ortalaması 49.9 bulundu. 45’i (%64) nüks DH, 9’u (%12.8) epidural fibrozis ve nüks DH, 8’i (%11.4) paraspinal abse, 1’i (%1.4) postoperatif diskitis, 3’ü (%4.2) darkanal, 3’ü (%4.2) foraminal stenoz, 1’i (%1.4) de BOS fistülü nedeni ile reopere edildi. Reopere edilen epidural fibrozisli vakalarda başarı oranı % 37.3 bulunurken, nüks DH lerde ise %75.9 olarak bulundu. İstatistiksel karşılaştırılması anlamlı bulundu (p<0.05). Sonuç: Lomber DH operasyonu geçiren hastalarda en sık (%64) reoperasyon sebebi aynı seviyede, aynı taraf veya karşı tarafta oluşan nüks disk hernileridir epidural fibrozis bulunan olgular radyolojik ve klinik olarak çok iyi değerlendirmeli en uygun tedavi planı amaçlanmalıdır

Determination of the effect of diameter of the sac on prognosis in 64 cases operated for meningomyelocele

Objective: To examine the effect of meningomyelocele sac size on prognosis by retrospective review of 64 cases operated for meningomyelocele between January 2009 and December 2012.Methods: We evaluated newborn babies operated for meningomyelocele by retrospectively reviewing their files for head circumference, location and with of the defect, accompanying anomalies, treatments administered, drugs that mother used during pregnancy. Based on the defect size, 3 patient groups were created as 0-24 cm2 (group I), 25-39 cm2 (group II), and 40 cm2 and above (group III).Results: Throughout the study, 64 babies were evaluated. Mean head circumference was 37.4 cm (range, 30.7-50 cm). Based on their location, 49 of the defects (76.5%) were lumbar, 7 (10.9%) were thoracolumbar, 4 (6.2%) were thoracic, 3 (3.1%) were sacral, 1 (1.5%) was cervical. Mean size of the meningomyelocele sac was 4.7 cm×5.8 cm (range, 1 cm×1 cm-10 cm×8 cm), 13 of the babies (20.3%) had skin defect requiring flap. According to accompanying anomalies, 47 of the babies (73.4%) had hydrocephalus, 7 (10.9%) had club foot, 1 (1.5%) had diastematomyelia, 1 (1.5%) had tethered cord. Thirty-nine of the babies (60.9%) had paraplegia, 10 (15.6%) had paraparesis, 8 (12.5%) had monoplegia; neurological examination in the remaining 7 babies was normal.Conclusion: In our study, increased diameter of meningomyelocele sac was associated with greater amount of neural tissue within the sac, which worsens the prognosis. Sac localization was not changing prognosis but infection rates, hospitalization duration were increased in babies with bigger diameter of sacs

Rare cervical meningomyelocele in newborn

Nöral tüp defektleri (NTD), medulla spinalis ve kraniyumu kapsayan ve yenidoğan döneminde en sık saptanan konjenital malformasyonlardan birisidir. Nöral arkın kapanmasının tam gerçekleşememesi nedeni ile meningomyelosel, meningosel, spina bifida okülta, sirengomiyeli, dermal sinüs traktı ve tethered kord gelişebilmektedir. Yenidoğanda meningomyelosel yaygın görülebilmekte, genellikle folik asit eksikliği, genetik eğilim ve gebelik sürecinde alınan bazı ilaçlara bağlı oluşabilmektedir. Genellikle, lumbosakral bölgede görülür, servikal bölge lokalizasyonu nadirdir. Doğum sonrası, servikal bölgede kese görülmesi üzerine servikal magnetik rezonans (MR) görüntüleme ile değerlendirilen ve servikal meningomyelosel tesbit edilen yenidoğan kız bebek meningomyelosel lokalizasyonunun servikal bölgede olması ve nadir görülmesi nedeni ile sunmayı uygun gördük.Neural tube defects (NTD) are one of the most frequently seen congenital malformations covering the spinal cord and cranium in the neonatal period. Myelomeningocele, meningocele, spina bifida occulta, syringomyelia, dermal sinus tract and tethered cord can develop due to incomplete neural arch closure. Meningocele is commonly seen in newborns. It may occur usually due to folic acid deficiency, a genetic tendency and certain drugs taken during pregnancy. It is usually seen in the lumbosacral region but the cervical region is a rare localization. A newborn baby girl was evaluated by cervical magnetic resonance (MR) imaging. The MR findings show cervical myelomeningocele sac and she is diagnosed as having myelomeningocele. We present the case, due to localization of the meningomyelocele and its rarity

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