Bone Cement Leakage in Transpedicular Percutaneous Vertebroplasty: Analysis of 20 Patients

Objective: Percutaneous vertebroplasty (PVP) is one of the frequently preferred interventional methods in spinal surgery. Although it is classified as minimally invasive, the most common complication of this procedure is bone cement leakage. Leakage of bone cement is often asymptomatic, but can lead to serious complications such as paraplegia and pulmonary embolism. In this study, we aimed to investigate the complications and consequences of cement leakage in the percutaneous vertebroplasty procedure. Methods: Between 2009 and 2015, 20 (14 female and 6 male, mean age 69.7) patients who underwent percutaneous vertebroplasty to 26 vertebrae were included in the study. 17 vertebrae were treated for osteoporotic compression (65.3%), 4 vertebrae for pathologic compression fractures (15.3%), 4 vertebrae for traumatic compression fractures (15.3%) and 1 vertebrae for painful hemangioma (3.8%). Leakage localizations of bone cement were classified as venous plexus, paravertebral soft tissue, spinal canal, intervertebral foramen, into the niddle channel and intervertebral disc space. Results: Twelve vertebrae showed no leakage (46.1%). 5 vertebrae had leakage into the niddle channel (19.2%), and 3 had leakage to vertebra disc space leakage (11.5%) and 2 vertebrae had to venous plexus and paravertebral tissue leakage (7.6%) Foraminal and spinal canal leakage (3.8%) was observed in one patient on single level. Radicular pain was seen in one patient. Partial pain control was observed in 20% of the patients while 80% of the patients had complete pain control on follow ups. Conclusion: Major complications following percutaneous vertebroplasty are mostly due to bone cement leaks. In order to prevent major complications, it is necessary to determine the possible causes of leakage. Performing the application with the correct technique with properly prepared bone cement is essential. Also usage of contast dye may be useful for pre-injection risk of leakage complications

Magnetic Resonance Guided Stereotactic Biopsy of Intracranial Lesions: Analysis of 310 Cases

Objective: Stereotaxic biopsy is an important surgical procedure that provides definite diagnosis in brain lesions. It is possible to obtain diagnosis with minimal invasive manner in deeply located and critical localized lesions. There are large case series in the literature. We aimed to present our experience of magnetic resonance (MR) guided 310 stereotaxic biopsies in this study. Method:We retrospectively evaluated age and gender distribution, locations of the lesions, histopathologic results, and complications of 310 cases which MR guided stereotactic biopsied was performed in our clinic between 2012 and 2018. In addition, technical information was also provided. Results:Stereotactic frame application was performed with local anesthesia and surgical procedure was performed by under general anesthesia. Of 310 patients 169 were male (55%) and were 141 female (45%). Mean age was 57.28 (3-87). 184 of the lesions were hemispheric (59%), and the most common diagnosis was glioblastoma multiforme (34.19%). 8 patients were not diagnosed (2%). Complications developed in 13 cases (4%) and 2 of cases were died in the early phase due to the procedure (0.6%). Histopathological diagnostic success was 99% Conclusion:The results of our study show that the stereotactic biopsy procedure applied in the MRI guideline is reliable and feasible with low complication rate and high effectiveness in cases where definitive histopathologic results are required for treatment planning

An in silico approach to the identification of diagnostic and prognostic markers in low-grade gliomas

Low-grade gliomas (LGG) are central nervous system Grade I tumors, and as they progress they are becoming one of the deadliest brain tumors. There is still great need for timely and accurate diagnosis and prognosis of LGG. Herein, we aimed to identify diagnostic and prognostic biomarkers associated with LGG, by employing diverse computational approaches. For this purpose, differential gene expression analysis on high-throughput transcriptomics data of LGG versus corresponding healthy brain tissue, derived from TCGA and GTEx, respectively, was performed. Weighted gene co-expression network analysis of the detected differentially expressed genes was carried out in order to identify modules of co-expressed genes significantly correlated with LGG clinical traits. The genes comprising these modules were further used to construct gene co-expression and protein-protein interaction networks. Based on the network analyses, we derived a consensus of eighteen hub genes, namely, CD74, CD86, CDC25A, CYBB, HLA-DMA, ITGB2, KIF11, KIFC1, LAPTM5, LMNB1, MKI67, NCKAP1L, NUSAP1, SLC7A7, TBXAS1, TOP2A, TYROBP, and WDFY4. All detected hub genes were up-regulated in LGG, and were also associated with unfavorable prognosis in LGG patients. The findings of this study could be applicable in the clinical setting for diagnosing and monitoring LGG

Does the dominant hand factor have an effect on postoperative recovery in the surgical treatment of carpal tunnel syndrome?

Objective: Carpal Tunnel Syndrome (CTS) is the most frequently encountered entrapment neuropathy. Surgical treatment is usually suggested to patients with severe symptoms. In this study, we aimed to examine the effect of the dominant hand on the clinical results of CTS decompression surgery

Does the dominant hand factor have an effect on postoperative recovery in the surgical treatment of carpal tunnel syndrome?

Objective: Carpal Tunnel Syndrome (CTS) is the most frequently encountered entrapment neuropathy. Surgical treatment is usually suggested to patients with severe symptoms. In this study, we aimed to examine the effect of the dominant hand on the clinical results of CTS decompression surgery

Safety and Efficacy of Ventriculostomy Procedures under Dual Antiplatelet Therapy in Patients Treated with Stent Assisted Coiling in Subarachnoid Hemorrhage

AIM: Stent assisted coiling (SAC) is an alternative in the treatment of ruptured aneurysms. Stenting requires the use of dual antiplatelet agents. Hydrocephalus is a complication of subarachnoid hemorrhage (SAH) and may require ventriculostomy. Antiplatelet treatment carries a risk of hemorrhage in ventriculostomy. The anti-aggregant effect starts at least four hours after the initial doses of treatment. However, in many studies, ventriculostomy was performed before antiplatelet treatment and hemorrhagic complications were related to the procedure. The aim of this study was to determine the risk of ventriculostomy related hemorrhage in patients with impaired thrombocyte function and to contribute to the literature. MATERIAL and METHODS: Between 2011 and 2016, 53 patients treated with SAC due to SAH in our clinic were retrospectively evaluated. Hemorrhagic complication risks due to antiplatelet therapy related to ventriculostomy were also evaluated. RESULTS: All of the ventricular catheter procedures were performed at least 1 day after the dual therapy (in average 4.3 days after SAC). In 5 patients 1 ventriculostomy was performed, in 2 patients 2, and in 1 patient 6 ventriculostomies were performed. Although radiological hemorrhage was present on the catheter tract in 4 patients, no temporary or permanent neurological deficit was observed. CONCLUSION: Impaired thrombocyte functions pose a risk in ventriculostomy. Also, evaluating the risk of hemorrhage before the antiplatelet treatment reaches its full effect may lead to false results. Studies with small patient groups with anti-aggregant therapy and impaired thrombocyte functions also contribute to the literature. Larger studies regarding this subject are needed

Effects of Interactions among Gene Polymorphisms of the Renin-Angiotensin-Aldosterone System on Hypertension in Turkish People from Southeast Anatolia

WOS: 000467103000005Introduction: Hypertension (HT) is characterized by high blood pressure. The reninangiotensin-aldosterone system (RAAS) plays a crucial role in blood pressure (BP) regulation by maintaining vascular tone and the water-sodium balance. We aimed to investigate whether there is any relation between AGT (M235T), ACE (I/D), and AGTR1 (A1166C) genetic polymorphisms and hypertension among Turkish people from Southeast Anatolia. Method and Results: A total of 210 individuals, consisting of 102 healthy controls and 108 patients with essential hypertension admitted to the Cardiology Department of the Adiyaman University Research and Application Hospital were included the study. DNA isolation was performed from the blood samples via commercial kit. Genotype determination was determined using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. Statistically significant differences were found between the control and patient groups in terms of genotype distribution and allelic frequencies of ACE I/D polymorphisms. Significant differences were found in the frequencies of ICM, DCM, DCT, DAT between the patient and control groups. Conclusions: In this study, we found a significant association of ACE I/D polymorphism with HT, and we showed that the I allele can increase the risk of HT in Turkish people from Southeast Anatolia. Although we did not find any association between independent AGT M235T and AGT1R A1166C polymorphisms and HT, we observed that the DCM, DCT, and DAT haplotypes of ACE/AGT1R/AGT polymorphisms reduced the risk of hypertension, while the ICM haplotype increased it.Research Foundation of Adiyaman UniversityAdiyaman University [TIPFBAP/2013-0004]This study was supported by a grant from the Research Foundation of Adiyaman University (TIPFBAP/2013-0004), Turkey

Effects of Interactions among Gene Polymorphisms of the Renin–Angiotensin-Aldosterone System on Hypertension in Turkish People from Southeast Anatolia

Introduction: Hypertension (HT) is characterized by high blood pressure. The reninangiotensin-aldosterone system (RAAS) plays a crucial role in blood pressure (BP) regulation by maintaining vascular tone and the water-sodium balance. We aimed to investigate whether there is any relation between AGT (M235T), ACE (I/D), and AGTR1 (A1166C) genetic polymorphisms and hypertension among Turkish people from Southeast Anatolia

Effect of gabapentin on primary surgical treatment of experimental sciatic nerve injury in rats

BACKGROUND: The aim of our study is to minimize the morbidity related to nerve injury by determining the protective effects of gabapentin in experimental sciatic nerve injury and end-to-end anastomosis model in rats and to guide clinical studies on this subject. METHOD: In our study, 40 adult male Sprague-Dawley rats were randomly divided into the following five groups: I: Only surgical intervention was applied; II: The sciatic nerve was cut properly and was repaired by end-to-end anastomosis. No additional procedure was performed; III: A single dose of gabapentin at 30 mg/kg was given after anastomosis; IV: 30 mg/kg gabapentin was given for 3 days after anastomosis; and V: 30 mg/kg gabapentin was given for 7 days after anastomosis. The experiment was terminated with high-dose thiopental (50 mg/kg) 60 days after the surgical intervention. The right sciatic nerve was taken from all animals. The obtained sections were examined immunohistopathologically. RESULT: Immunohistochemical properties and Schwann cell proliferation were found to be statistically significantly lower in the control group than in the other groups. Schwann cell proliferation was higher in Group 3 than in Group 5. Immunohistochemical changes were significantly lower in Group 4 than in Group 3. Axonal degeneration was also higher in Group 4 than in Group 3. CONCLUSION: Gabapentin promotes neurological recovery histopathologically in peripheral nerve injury due to its neuroprotective properties. Our study results show that gabapentin can be used as an adjunctive therapy to primary surgical treatment after peripheral nerve injury

Effect of decompressive hemicraniectomy in patients with acute middle cerebral artery infarction 2050

Background/aim: We aimed to determine in which cases this procedure may be more effective based on the data of patients who underwent decompressive hemicraniectomy (DHC). Material and methods: Overall, 47 patients who underwent DHC due to acute middle cerebral artery (MCA) infarction between January 2014 and january 2019 were retrospectively investigated. These patients were divided into two groups: those who died after DHC (Group A) and those who survived DHC (Group B). The groups were compared in terms of various parameters. We investigated whether the patient's modified Rankin scale (mRS) status changed depending on age (> 60 and 60 years who underwent DHC for MCA infraction was 61.5% and 26.5%, respectively (p = 0,041). The median mRS of patients 60 years were 4 (1-6) and 6 (1-6), respectively (p = 0.018). Conclusion: Age, DHC timing, and elapsed time until hospitalization or access to treatment directly affect the functional outcome and survival in MCA-infarcted patients who underwent DHC. In patients in whom the medical treatment fails, early DHC administration will increase survival without waiting for neurological worsening once herniation is detected radiologically