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Öğe Effectiveness of the biophysical barriers on the peridural fibrosis of a postlaminectomy rat model: An experimental research(Elsevier Sci Ltd, 2011) Kasimcan, Mustafa Omur; Bakar, Bulent; Aktas, Savas; Alhan, Aslihan; Yilmaz, MustafaPurpose: Long term results after surgical treatment of disc herniation have shown that epidural and/or peridural fibrosis formed during the healing process after surgical intervention. We conducted this experimental study to evaluation of the effectiveness of the bioresorbable barriers (ADCON-L and Seprafilm (R) Adhesion Barrier) on formation of the peridural fibrosis in rat model performed laminectomy. Methods: Thirty-two male Wistar albino rats 250-350 g body weight were distributed into three groups (CONTROL, AL group received ADCON-L; SAB group received Seprafilm (R) Adhesion Barrier). A dorsal laminectomy at L3, L4, L5 was performed, and then except those of the CONTROL group, the experimental material was left on the dura mater. Six weeks later spinal column of all rats was totally removed between the T10 and L5 levels, and peridural fibrosis, and dural adhesions were evaluated histologically and graded. The results were compared statistically by using the chi-square (chi(2)) test. Also three random regions were examined, and the fibroblast cells were counted. The fibroblast count results were statistically analysed by using the One-Way ANOVA test. Results: The variation of histopathological grades was statistically significant regarding the comparison of the all groups obtained from the chi(2) test (chi(2) = 16.40; p = 0.003). However, the variation in the mean values of the fibroblast count result was not statistically significant obtained from the One-Way ANOVA test (F = 2.114; p > 0.05). Conclusion: Our study results suggest that Seprafilm (R) Adhesion Barrier and ADCON-L can be effective in reducing the prevalence of the postoperative peridural adhesions in rat laminectomy model. On the other hand, the fibroblast densities of the experimental groups were not different between groups. So, we could say that these materials can act as a foreign body in long term period in rat. (C) 2010 Elsevier Ltd. All rights reserved.Öğe Evaluation of the neurotoxicity of DMSO infused into the carotid artery of rat(Elsevier Sci Ltd, 2012) Bakar, Bulent; Kose, Emine Arzu; Sonal, Sevilay; Alhan, Aslihan; Kilinc, Kamer; Keskil, Ismail SemihIntroduction: Despite the explanations put forth in many studies regarding histopathological evidence of the inflammatory stage related with the infusion of dimethyl sulfoxide (DMSO) in the vessel wall and its lumen, there has been no research to evaluate its neural toxicity when it is infused via the intracarotid route. This study was designed to evaluate the possible neurotoxic effects of DMSO on the closer and distant brain tissue and carotid artery when it was slowly infused into the internal carotid arteries of the rats. Methods: The right common carotid artery bifurcation was exposed through a midline neck incision, and then except those of the control group animals (n = 5), the experimental material (normal saline, n = 5 or anhydrous DMSO, n = 10) was infused into the internal carotid artery of the Wistar albino rats. After the experimental materials were administered intra-arterially, brain tissues were harvested for histopathological and biochemical studies at 72 h for investigation of the acute stage changes and on 10th day for investigation of the chronic stage changes. Internal carotid arteries of both sides were also removed for histopathological evaluation. During sacrification of the rats, whole body blood of them are collected for biochemical evaluation. Results: There was no statistically significant difference between the groups regarding comparison of the mean values of the hippocampal neuronal cell counts and the carotid artery diameters in both acute and chronic stages. Also, mean values of the lipid peroxidation levels of harvested brain tissues and serums of the collected bloods were similar in control, saline and DMSO groups. Conclusion: This experimental study suggested that DMSO has no toxic effect on the neural and arterial tissues of rats when it is slowly infused into the carotid artery. (C) 2011 Elsevier Ltd. All rights reserved.Öğe Evaluation of the Neurotoxicity of the Polyethylene Glycol Hydrogel Dural Sealant(Turkish Neurosurgical Soc, 2013) Bakar, Bulent; Kose, Emine Arzu; Balci, Mahi; Atasoy, Pinar; Sarkarati, Bahram; Alhan, Aslihan; Keskil, Ismail SemihAIM: Although polyethylene glycol (PEG) is a neutral, biocompatible hydrophilic polymer recognized for its lack of interaction with biological barrier, its neurotoxicity has not been clearly identified in neurosurgery. This study is constructed to evaluate the possible neurotoxicity of a PEG hydrogel dural sealant. MATERIAL and METHODS: After a burrhole was opened in the left parietal bone of the twenty five Wistar albino rats, the dura mater and cerebral cortex were incised and the experimental material (activated polyethylene glycol and polyethylene imine) was sprayed into the burrhole. Then brain tissues were harvested for histopathological and biochemical studies at 72 hours to investigate the acute stage changes and on 15th day to evaluate the chronic stage changes. RESULTS: There were statistically significant differences among the groups regarding the comparison of the values of the PMNL cell infiltration grades, gliosis and congestion in both acute and chronic stages. However, the values of the MNL cell infiltration grades, edema and fibrin formation, lipid peroxidation levels of harvested brain tissues were similar in all groups. CONCLUSION: Although this study did not present the detailed histopathological and biochemical evaluation results, it indicated that the application of the PEG-based hydrogel sealant was not associated with neurotoxicity, delayed healing, or degenerative changes.Öğe Possible predictive clinical and radiological markers in decision making for surgical intervention in patients with Chiari Malformation type 1(Taylor & Francis Ltd, 2022) Yuksel, Ulas; Burulday, Veysel; Akkaya, Suleyman; Baser, Selcuk; Ogden, Mustafa; Alhan, Aslihan; Bakar, BulentBackground The first aim of this study was to compare the clinical data and posterior fossa morphometry obtained during the admission to the hospital between control group individuals (who had not Chiari Malformation (CM) type 1) and CM type 1 patients treated surgically or not. The second aim was to create a valid and reliable scale that can predict the decision-making for surgical intervention simply and easily in these patients. Materials Medical data and radiological images of 70 CM type 1 patients during their admission to the hospital were compared with the data of 69 control group individuals. Results Conservative treatment and/or follow-up was applied to 58 (82.9%) patients, and 12 (17.1%) patients underwent surgery. ROC analysis showed that the presence of myelopathy, tonsillar herniation >8 mm, Chamberlain line >84 mm, McRae line >44.50 mm, and odontoid process-McRae line angle <10.50 degrees could be used as predictive markers in decision-making for surgical intervention (p < 0.05). Logistic Regression analysis revealed that symptoms severity, and McRae line value would be the 'best parameters' in decision-making for surgical intervention (p < 0.05). A scale named the CHIASURG scale developed using this study's parameters showed that the parameters of 'depth of tonsillar herniation', 'Chamberlain line', and 'McRae line' could predict the surgical intervention risk. Conclusion It was found that symptoms severity and McRae line value could be used as predictive markers in decision-making for surgical intervention. Additionally, it was concluded that a new scale called CHIASURG could predict surgical intervention risk validly and reliably.Öğe Quantative computerized tomography assessment of lung density as a predictor of postoperative pulmonary morbidity in patients with lung cancer(Ame Publ Co, 2015) Kaplan, Tevfik; Atac, Gokce Kaan; Gunal, Nesimi; Kocer, Bulent; Alhan, Aslihan; Cubuk, Sezai; Han, SerdarBackground: The aim of this study was to evaluate the pulmonary reserve of the patients via preoperative quantitative computerized tomography (CT) and to determine if these preoperative quantitative measurements could predict the postoperative pulmonary morbidity. Methods: Fifty patients with lung cancer who underwent lobectomy/segmentectomy were included in the study. Preoperative quantitative CT scans and pulmonary function tests data were evaluated retrospectively. We compare these measurements with postoperative morbidity. Results: There were 32 males and 18 females with a mean age of 54.4 +/- 13.9 years. Mean total density was -790.6 +/- 73.4 HU. The volume of emphysematous lung was (<-900 HU) 885.2 +/- 1,378.4 cm(3). Forced expiratory volume in one second (FEV1) (r=-0.494, P=0.02) and diffusion capacity of carbon monoxide (DLCO) (r=-0.643, P<0.001) were found to be correlate with the volume of emphysematous lung. Furthermore FEV1 (r=0.59, P<0.001) and DLCO (r=0.48, P<0.001) were also found to be correlate with mean lung density. Postoperative pulmonary morbidity was significantly higher in patients with lower lung density (P<0.001), larger volume of emphysema (P<0.001) and lower DLCO (P=0.039). A cut-off point of -787.5 HU for lung density showed 86.96% sensitivity and 81.48% specificity for predicting the pulmonary morbidity (kappa =-0.68, P<0.001). Additionally a cut-off point of 5.41% for emphysematous volume showed 84.00% sensitivity and 80.00% specificity for predicting the pulmonary morbidity (kappa = 0.64, P<0.001). According to logistic regression analyses emphysematous volume > 5.41% (P=0.014) and lung density <-787.5 HU (P=0.009) were independent prognostic factors associated with postoperative pulmonary morbidity. Conclusions: In this study, the patients with a lower lung density than -787.5 HU and a higher volume of emphysema than 5.41% were found to be at increased risk for developing postoperative pulmonary morbidity. More stringent precautions should be taken in those patients that were found to be at high risk to avoid pulmonary complications.
