Fibroblast Growth Faktör-2 Bloklamasının Tavuk Servikal Omurları Üzerindeki Etkisi ve Oksidatif Stres ve Apoptozis ile İlişkisi

Fibroblast büyüme faktörü (FGF) kemik, kıkırdak gelişiminde rol oynayan ve bu nedenle kemik oluşumunu yönlendiren bir etkendir. Bu ailenin bir üyesi olan FGF-2'nin bloklaması ile kemik gelişiminin etkilendiği gösterilmiştir. Bu çalışmada kemikleşme öncesi dönemde FGF- 2 bloklamasının tavuk embriyolarında vertebra oluşumuna etkisi ve servikal vertebraların bu etki altında nasıl yönlendiği histolojik açıdan incelenmesi amaçlanmıştır. Çalışmamızda E4 ve E10 günlerinde piliç embriyolarına anti FGF-2 uygulanarak E15 günü alınan örneklerde servikal vertebralarda oluşan değişiklikler histokimyasal olarak hematoksilen-eosin, Alizarin kırmızısı, Mason trikrom boyaları ile immünohistokimyasal olarak iNOS, eNOS ve TUNEL ile ayrıca oluşan değişiklikler morfometrik analizler ile değerlendirildi. Servikal vertebraların makroskobik incelemelerinde önemli bir farklılık saptanmazken, histokimyasal boyamalarda kıkırdaklaşma ve kemikleşme süreçlerinde bozukluklar, iNOS ve eNOS ile ortaya konan oksidatif stres artışı, ayrıca TUNEL ile gösterilen apoptoziste fazlalaşma olduğu bulundu. FGF ailesinin bir üyesi olarak FGF-2 bloklamasının servikal vertebralarda kemikleşme sürecini etkilediği ve bunun serbest oksijen radikallerinden kaynaklanan oksidatif stres ve ilişkili olabileceği apopitozu indükleyerek hücre ölümüne neden olduğunu göstermektedir.Fibroblast growth factor (FGF) plays a role in the development of bone and cartilage. FGF-2 is a member of this family and blocking of FGF-2 affects the bone development. In this study, effects of FGF-2 blocking on the formation of vertebrae in chick embryos before ossifications and orientation of cervical vertebrae were investigated with histological examinations. In this study, anti-FGF-2 was performed to chick embryos at E4th and E10th days. Samples were taken in E15th days and changes in the cervical spine were evaluated as histochemically (with hematoxylin-eosin, Alizarin red, Masson's trichrome staining) and immunohistochemically (with iNOS, eNOS and TUNEL). Also changings were evaluated by morphometric analysis. In macroscopic examination of the cervical vertebrae significant difference was not detected. But in histochemical staining, defects were observed in cartilage and ossification process. Increasing in oxidative stress was demonstrated by iNOS and eNOS. Also apoptosis which was represented by tunnel was found to be increased. FGF-2 blocking affects the ossification process in the cervical spine by inducing oxidative stress and apoptosis which results with cell death

Unstabil Odontoid Kırıklarda Odontoid Vida Fiksasyon için Yeni Kılavu Tüp: 6 Olguluk Seri

AMAÇ: Bu çalışmada, yeni bir kılavuz tüp ile geleneksel açık cerrahinin değiştirilmiş bir formu tanımlanmıştır. Bu kılavuz tüp geleneksel açık cerrahi, endoskopik cerrahi ve perkütan cerrahi ile karşılaştırıldığında daha basit bir teknik ile daha kısa sürede odontoid anterior vidalama sağlar. YÖNTEM ve GEREÇLER: Çalışmamız, unstabil odontoid kırık nedeniyle opere edilen 6 hastadan oluşmaktadır. Hastalarda anterior vida fiksasyonu için yeni kılavuz tüp kullandık. Bu kılavuz tüp, kanüllü yaklaştırma vidasını göndermek için, K-telinin yerleştirilmesini kolaylaştırmak amacıyla ilk yazar tarafından dizayn edilmiştir. BULGULAR: Tüm hastalara başarılı bir şekilde odontoid vidalaması yapılarak spinal stabilizasyon sağlanmıştır. Takip sürecinde tüm hastalarda solid füzyon geliştiği görüldü. SONUÇ: Odontoid vida fiksasyonu için kullandığımız bu teknik diğer cerrahi yaklaşımların aksine minimal invaziv, daha güvenli ve daha kolay cerrahi sağlamaktadırAIM: We describe a modified form of traditional open surgery with a new guide tube. This guide tube permits anterior screwing of odontoid in a shorter time with a more simple technique as compared to traditional open surgery, endoscopic and percutaneous surgeries. MATERIAL and METHODS: Our series includes 6 patients who were operated for unstable odontoid fracture. We used a new guide tube for anterior odontoid screw fixation. This guide tube was designed by the first author to facilitate the insertion of the K-wire for placement of a cannulated lag screw. Results: Successful placement of the odontoid screws and immediate spinal stabilization were achieved in all patients. Solid fusion was observed during follow-up time in all patients. CONCLUSION: This screw insertion technique for odontoid screw fixation provides a minimally invasive, safe and easy surgery in contrast to other surgical approaches

Isolated Solitary Intramedullary Spinal Cord Metastasis Presenting as the First Manifestation of Small-Cell Lung Cancer: Report of a Rare Case

Background. Intramedullary spinal cord metastases presenting as the first manifestation of malignancies are extremely rare lesions. Case Description. The authors report a 74-year-old woman who presented with an isolated intramedullary spinal cord metastasis which presents as first manifestation of malignancy without central nervous system and/or other organ involvement. She went under surgery, and after histopathological evaluation, primary focus was determined in lung in positron emission tomography. She is still alive after 9 months since the first diagnosis of primary focus. Conclusion. In patients with solitary intramedullary lesion in the spinal magnetic resonance imaging, whole-body investigation might help for diagnosis of primary focus and approach to treatment

Missing Screw as a Rare Complication of Anterior Cervical Instrumentation

Although anterior cervical arthrodesis is an effective procedure for the treatment of cervical disorders, the method has some complications. Here, we describe this rare complication of cervical instrumentation with a literature review. A 23-year-old male patient was operated for a C6-C7 dislocation. At postoperative month 10, he presented with hemoptysis and dysphagia. Cervical roentgenograms showed anterior migrations of one broken screw and a plate-locking screw at the C6 corpus. One screw was missing. We concluded that the missing screw had perforated the esophagus and had been eliminated spontaneously through the gastrointestinal tract. No screw should migrate. Even loose screws should be noted in follow-up X-ray studies. If such findings are detected, a second operation for revision should be considered as soon as possible to prevent potentially fatal complications