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A new therapy modality for treatment-resistant depression: Vagal nerve stimulation
(Yerkure Tanitim & Yayincilik Hizmetleri A S, 2014) Buturak, Visal; Bakar, Bulent
Objective: Although new treatment modalities are recommended for the treatment resistant depression, it has been estimated that some depressive episodes treated for an adequate duration with recommended dose of an antidepressant exhibit treatment resistance. Direct evidence supporting a role for the vagal nerve stimulation (VNS) therapy in depression came from early observation of mood improvement in treatment resistant epileptic patients who were performed VNS. Results of the clinical and experimental studies recommended that VNS therapy could be a choice for long-term treatment of chronic or recurrent treatment resistant depression (TRD). The aim of this study was to review the literature which evaluates the affectivity and mechanism of the VNS which have been used as an alternative therapy modality in the treatment resistant major depressive disorders. Method: Medline/Index Medicus (PubMED) was searched and the reports which investigated the properties of the VNS (such as application procedures, mechanisms of effect, therapeutic affectivity and reliability of VNS in chronic or recurrent TRD episodes) were reviewed in a wide perspective in this article. Results: It has been reported in several studies that large number of patients receiving conventional treatment could not show full remission of depressive episodes, and the results of these studies support that new therapy modalities are needed. Numerous studies had been conducted regarding the effect mechanisms of VNS in treatment-resistant depressive episodes. However, in these studies which area of the brain - and how-was affected not fully understood. The effectiveness and the reliability of the VNS methods in intractable depressive episodes have been investigated by using different methods and study design. In some of these VNS studies for treatment of TRD episodes, showed an increase in the rate of treatment response and remission; however, some studies showed an increase only in the rate of treatment response. In these studies, the research group received a large portion of patints with unipolar disorder who had TRD episodes in general, and less portion of patients were bipolar disorders. And, the authors suggested future studies contained large sample size, because their study samples, which were conducted to investigate the effectiveness and reliability of VNS, consisted of relatively small number of the patients with bipolar disorder. In studies, the most commonly reported side effects in patients treated with VNS were incision side pain, hoarseness, neck pain, headache, cough, difficulty in swallowing, and shortness of breath. Conclusion: VNS in TRD episodes may seem an efficient and reliable treatment method to use, but this method more widely on this subject to be able to use more controlled studies are needed.
Analysis of biochemical laboratory values to determine etiology and prognosis in patients with subarachnoid hemorrhage: a clinical study
(Taylor & Francis Ltd, 2019) Ogden, Mustafa; Bakar, Bulent; Karagedik, Mustafa Ilker; Bulut, Ibrahim Umud; Cetin, Cansel; Aydin, Gulcin; Ozveren, Mehmet Faik
Objectives: The aim of this study was to establish prognostic and predictive markers in patients with subarachnoid hemorrhage (SAH) using simple laboratory methods. Methods: A retrospective examination was made of patients with SAH diagnosed secondary to isolated head trauma, isolated anterior communicating artery aneurysm rupture, and angiography-negative SAH. Age, gender, Glasgow Coma Scale (GCS) scores, and Fisher's grade scores, Glasgow Outcome Scale (GOS) scores, leukocyte count, neutrophil count, lymphocyte count, platelet count, neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio results (PLR) were evaluated. Results: NLR and PLR values, which were similar in patients with spontaneous SAH, were significantly high in patients with traumatic SAH. NLR and PLR values could be 80% sensitive and 75% specific for distinguishing traumatic SAH from spontaneous SAH. Eosinophil count was lower in patients with angiography-negative SAH and patients with aneurysmal SAH than in patients with traumatic SAH. Initially measured GCS score, Fisher's grade score, eosinophil, neutrophil and lymphocyte counts could be prognostic in all patients with SAH. Moreover, it was concluded that the initially measured number of eosinophils might be directly related to patient prognosis. The eosinophil count was generally found to be high in traumatic SAM patients and it was observed that this parameter could be predictive for these patients. Lymphocyte count and NLR values could be prognostic markers in patients with angiography-negative SAH. Conclusion: NLR, PLR and eosinophil count values could be predictive for etiological factors (traumatic SAH or spontaneous SAH) of patients who were admitted unconscious to the emergency room with SAH detected on radiological imaging.
Anesthesia for a child with Walker-Warburg syndrome
(Elsevier Science Inc, 2014) Kose, Emine Arzu; Bakar, Bulent; Ates, Gokay; Aliefendioglu, Didem; Apan, Alpaslan
Background and objectives: Walker-Warburg Syndrome is a rare, autosomal recessive con-genital muscular dystrophy manifested by central nervous system, eye malformations andpossible multisystem involvement. The diagnosis is established by the presence of four crite-ria: congenital muscular dystrophy, type II lissencephaly, cerebellar malformation, and retinalmalformation. Most of the syndromic children die in the first three years of life because ofrespiratory failure, pneumonia, seizures, hyperthermia and ventricular fibrillation. Case Report : The anesthetic management of a two-months-old male child listed for electiveventriculo-peritoneal shunt operation was discussed. Conclusions : A careful anesthetic management is necessary due to the multisysteminvolvement. We reported anesthetic management of a two-months-old male child withWalker-Warburg Syndrome who was listed for elective ventriculo-peritoneal shunt operation. (C) 2013 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rightsreserved.
Bilateral Subdural Hematoma After Ventriculoperitoneal Shunt Surgery
(Emergency Medicine Physicians Assoc Turkey, 2019) Yuksel, Ulas; Akkurt, Ibrahim; Ogden, Mustafa; Bakar, Bulent; Keskil, Semih
Background: Bilateral subdural hematoma (SDH) following ventriculoperitoneal (V/P) shunt application was discussed in present case. Case Report: 8-year-old girl was operated due to thoracolumbar meningomyelocele immediately after birth. V/P shunt was inserted in right posterior parietal region due to hydrocephalus when she was 3 month-old. At age of 3 years, V/P shunt dysfunction was considered, and second V/P shunt was inserted in left posterior parietal region. One year after, patient was reevaluated, and CT images showed bilateral subacute SDH. Hematoma evacuation was not considered, but right ventricular catheter was ligated. At four years follow-up, no additional neurological impairment was observed in patient and CT scan revealed that SDHs were retracted greatly. Concusion: It should be kept in mind that SDH could develop after V/P shunt surgery. Additionally, it could be said that one of most important factor in determination of treatment of this complication was primarily neurological examination findings of patient.
Biochemical markers in the prognosis of intracranial hemorrhages
(Cukurova Univ, Fac Medicine, 2018) Yuksel, Ulas; Ogden, Mustafa; Akkurt, Ibrahim; Bakar, Bulent; Kisa, Ucler; Ozveren, Mehmet Faik
Purpose: The aim of this study was to determine prognosis of patients with intracranial hemorrhage by examining routine laboratory findings. Materials and Methods: Patients were divided into three groups according to hemorrhage type (subarachnoid hemorrhage, spontaneous intracerebral hematoma, subdural hematoma). Then serum sodium, potassium, C-reactive protein, blood leukocyte count and neutrophil percentage values were measured pre- and postoperatively. Results: Twenty-eight patients (10 female, 18 male) were included in study. There was no difference among groups in terms of all parameters. However, postoperative leukocyte counts were higher than preoperative values in intracerebral hematoma group; and postoperative sodium levels were higher than preoperative values in subarachnoid hemorrhage group. There was found negative correlation between Glasgow Outcome Scale scores and preoperative neutrophil, preoperative and postoperative sodium values in subarachnoid hemorrhage group. A negative correlation was found between Glasgow Outcome Scale scores and preoperative C-reactive protein values in subdural hematoma group. Conclusion: Study results suggested that pre-and postoperative serum sodium values in subarachnoid hemorrhage; age, Glasgow Coma Scale score, pre-and post-operative C-reactive protein values in spontaneous intracerebral hematoma; and preoperative C-reactive protein values in subdural hematoma were considered to be predictors of patient prognosis.
Can Routine Blood Biochemistry Parameters be Predictive Prognostic Marker(s) in Operated Patients with Meningioma WHO Grade 1?
(Georg Thieme Verlag Kg, 2021) Yuksel, Ulas; Ozdemir, Alemiddin; Kisa, Ucler; Ogden, Mustafa; Bakar, Bulent
Background Today, there is a need for new and independent additional advanced markers that can predict the prognosis of meningioma patients, postoperatively. The present study aimed to find out postoperative short-term prognostic markers in patients with meningioma using their demographic data and routine blood biochemistry findings evaluated preoperatively. Methods The Glasgow Coma Scale (GCS), and Glasgow Outcome Scale (GOS) scores of the patients were recorded. Additionally, preoperatively obtained serum glucose, C-reactive protein (CRP), sodium, potassium, creatinine, blood urea nitrogen, aspartate aminotransferase (AST), alanine aminotransferase, and hemoglobin level values, platelet, leukocyte, neutrophil, lymphocyte, eosinophil, basophil, and monocyte count results, erythrocyte sedimentation rate (ESR), neutrophil-lymphocyte ratio, platelet-lymphocyte ratio (PLR) and lymphocyte-monocyte ratio (LMR) values were evaluated. Results In the present study, 23 operated patients with meningioma World Health Organization (WHO) grade 1 (17 females, 6 males) were included. Correlation test results revealed that the GCS score, platelet count, and serum potassium level values could directly predict the short-term prognosis of these patients. Additionally, these test results suggested that the lymphocyte, monocyte, and eosinophil count values, PLR, LMR, ESR, serum glucose, CRP, and AST level values could be indirect markers in predicting the short-term prognosis. However, likelihood ratio test results revealed that only monocyte count value, LMR value, and serum CRP level value could be the markers for prediction of the short-term prognosis. Conclusion At the end of the present study, it was concluded that the monocyte count value, LMR value, and serum CRP level value could be the best markers in predicting the short-term prognosis of the operated meningioma patients.
Cerebral ischaemia/reperfusion injury could be managed by using tramadol
(Taylor & Francis Ltd, 2018) Akkurt, Ibrahim; Cetin, Cansel; Erdogan, Ahmet Melih; Dincel, Gungor Cagdas; Ceylan, Asli Fahriye; Kisa, Ucler; Bakar, Bulent
Objectives: No valid treatment modality that will repair stroke damage and provide neurological recovery has yet been identified in literature. Studies demonstrated that adequate quality of life could be provided if post-stroke pain could be treated sufficiently and timely. Besides its pain relief effects, tramadol has oedema-reducing and anti-inflammatory properties. With these in mind, this study investigated the influence of tramadol in acute and/or chronic ischaemia/reperfusion (I/R) injury. Methods: Putting aside the Control group, 23 Wistar albino rats were distributed to four groups to investigate the acute (Sham-A, TR-A) and chronic (Sham-C, TR-C) periods of I/R injury, and temporary aneurysm clips were applied to their internal carotid arteries for 30 min. Four hours after clippage, tramadol was administered to animals of TR-A and TR-C groups intraperitoneally. After sacrificing all animals, pyknotic and necrotic neuronal cells in hippocampal cornu ammonis (CA)1, CA2, CA3 and parietal cortical regions were counted, and perivascular oedema, intercellular organization disorder (IOD) and inflammatory cell infiltration were scaled histopathologically. Additionally, tissue interleukin (IL)-1 beta, IL-10, malondialdehyde, nitric oxide, tumour necrosis factor-alpha, caspase-3, beclin-1, Atg12, LC3II/LC3I levels were measured biochemically. Results: Tramadol could minimize perivascular oedema, IOD, parietal and hippocampal neuronal necrosis, inflammatory cell infiltration in both periods of I/R injury histopathologically. Apart from inhibiting apoptosis and enhancing autophagy, tramadol had no influence on any other biochemical result. Discussion: Tramadol can ameliorate the histopathological structure of ischaemic tissue in both periods of I/R injury in rat. We suggest further research investigating various dosages with different administration methods of tramadol in stroke should be conducted by adopting different explorative techniques.
Clinical and Laboratory Markers in Determination of Treatment Modalities and Short-Term Prognosis in Patients with Traumatic Acute Subdural Hematoma: Original Study
(Georg Thieme Verlag Kg, 2023) Bakar, Bulent; Yuksel, Ulas; Ozdemir, Alemiddin; Bulut, Ibrahim Umud; Ogden, Mustafa
Objective In patients with traumatic acute subdural hematoma (ASH), it has not been yet fully elucidated which patients can benefit from surgery or from clinical follow-up. This study was constructed to predict treatment modality and short-term prognosis in patients with ASH using their clinical, radiological, and biochemical laboratory findings during admission to hospital. Methods Findings of patients with ASH determined on their CT scan between 2015 and 2018 were evaluated. Patients were grouped in terms of ASH-FOL (patients followed-up without surgery, n =13), ASH-OP (patients treated surgically, n =10), and ASH-INOP (patients considered as inoperable, n = 5) groups. They also were divided into survived (n = 14) and nonsurvived (n = 14) groups. Results ASH developed as a result of fall from a height in 15 patients and traffic accidents in 13 patients. In deciding for surgery, it was determined that Glasgow coma scale (GCS) scores < 8, midline shift (MIS) level > 5 mm, MLS-hematoma thickness ratio > 0.22, leukocyte count > 12730 uL, and presence of anisocoria could be used as predictive markers. It was determined that GCS scores < 8, hematoma thickness value > 8 mm, and the presence of anisocoria could be considered as biomarkers in prediction of mortality likelihood. Conclusion It could be suggested that GCS scores, MLS level, MLS-hematoma thickness ratio, presence of anisocoria, and leukocyte count value could help in determination of the treatment modality in patients with ASH. Additionally, GCS scores, hematoma thickness value, and presence of anisocoria could each be used as a marker in the prediction of early-stage prognosis and mortality likelihood of these patients.
Current Ablation Type Surgical Treatment Modalities in Treatment-Resistant Major Depression: Review of The Recent Major Surgical Series
(Aves Press Ltd, 2019) Bakar, Bulent; Cetin, Cansel; Oppong, Jonathan; Erdogan, Ahmet Melih
Purpose: Major depression is currently a disease with high morbidity and mortality rates. About 20% of patients have treatment-resistant major depression (TRMD). This article which consisted of a recent large clinical case series reported in medical literature is constituted to screen ablative surgical treatment methods and their safety and efficacy in patients with TRMD. Methods: Four types of ablative surgical modality (i.e. anterior cingulotomy, anterior capsulotomy, subcaudate tractotomy, limbic leucotomy) in TRMD patients were evaluated and patients' data which was used to describe the basis of radiologic and operative procedures and findings, and outcome was obtained from PubMed/Medline database between years 2000-2018. Results: In literature, studies showed that about 40-60% of patients had complete remission and 35% of patients showed partial remission following anterior cingulotomy. It was reported that approximately 50% of patients were responsive and 40% of patients were remission following anterior capsulotomy. Studies demonstrated that about 55-75% of patients were responsive to treatment after performing subcaudate tractotomy. Long term clinical recovery was seen 36-76% of patients applied limbic leucotomy in literature. Conclusion: In conclusion, the long term therapeutic effects and mechanism of action of these surgical techniques that were used last two decades in the management of patients with TRMD are still under investigation and the need for research on the long-term benefits of these surgical modalities should be considered.
The effect of low-dose methotrexate on autologous fat graft survival
(Tubitak Scientific & Technical Research Council Turkey, 2016) Sari, Elif; Bakar, Bulent; Sarkarati, Bahram; Bozdogan, Onder; Cavusoglu, Tarik
Background/aim: The survival of autologous fat graft tissue is dependent on various factors such as vascularization and inflammation. The aim of the present study was to evaluate the possible beneficial effects of low-dose methotrexate (LD-MTX) on fat graft volume and survival. Materials and methods: A total of 13 male Wistar albino rats were divided into two groups, a control group and an LD-MTX group. An autologous fat graft obtained from the inguinal region of each rat was transferred to its back. LD-MTX was administered intraperitoneally in the LD-MTX group once a week for 4 weeks after the surgical procedure. The control group underwent surgery but was not administered MTX. Fat grafts were harvested for analyses. Results: The results showed that 2 months postoperatively the fat graft weights of the control and LD-MTX groups were not significantly different. In addition, the vascularity of the grafts was higher in the LD-MTX group than it was in the control group. The mean lipid peroxidation levels were essentially the same in the two groups, but myeloperoxidation was significantly lower in the LD-MTX group than it was in the other group. Conclusion: The results showed that LD-MTX administration may not preserve the quality and volume of transplanted fat tissue in rats.
Effectiveness of Dimethylsulfoxide on the Survival and Volume Preservation of Autologous Fat Graft Tissue: A Preliminary Study
(Oxford Univ Press Inc, 2016) Sari, Elif; Bakar, Bulent; Sarkarati, Bahram; Bozdogan, Onder; Cavusoglu, Tarik
Background: The survival of autologous fat graft tissue is dependent on various factors, such as vascularization and inflammation. Objective: This study aims to evaluate the possible beneficial effects of dimethylsulfoxide (DMSO) on fat graft volume and survival. Methods: Eighteen male Wistar albino rats were divided randomly into three groups. An autologous fat graft obtained from the inguinal region of each rat was transferred to its back. DMSO was administered intraperitoneally (IP) in the DMSO-IP group and cutaneously (C) in the DMSO-C group once daily for 15 days after the surgical procedure. The control group underwent surgery but was not administered with DMSO. Two months after surgery, the grafted fatty tissues were harvested for histopathological and biochemical analyses. Results: The results showed that 2 months postoperatively, fat grafts of the DMSO-C and DMSO-IP groups weighed significantly more than the grafts of the control group. Moreover, the vascularity of the grafts was higher in the DMSO-C group than in the control group, and no significant difference was found between the two DMSO groups. The mean lipid peroxidation levels were the same in the three groups, but myeloperoxidation was significantly lower in the DMSO-C group than in the other two groups. Conclusions: The study results showed that cutaneous rather than intraperitoneal DMSO administration could preserve the quality and volume of transplanted fat tissue in rats by enhancing vascularity and decreasing inflammation.
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, Mustafa
Purpose: 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.
Effectiveness of the Biophysical Barriers to the Peridural Fibrosis in Rat Laminectomy Model
(Taylor & Francis Inc, 2019) Akkurt, Ibrahim; Bakar, Bulent; Dincel, Gungor Cagdas; Yildiran, Fatma Azize Budak; Ogden, Mustafa; Nursoy, Egemen; Sari, Elif
Purpose: Peridural fibrosis which could occur after the spinal surgery could adhere neural tissue closely and may cause to neural entrapment symptoms and require surgical reintervention. Aim of the study: Present study was designed to reduce occurrence of peridural fibrosis in rat laminectomy model by using biophysical barriers called hyaluronic acid (HAS) dural barrier, activated polyethylene glycol and polyethylene imine (PEG) dural barrier, and platelet-rich plasma (PRP). Materials and methods: In this study, 2 of 26 male Wistar albino rats (325-350 g body weight), which were not included into study groups were sacrificed by removing their total blood and their blood was used for preparation of PRP, and remaining rats were randomly delivered into four groups called SHAM, HAS, PEG, and PRP groups. Then L3-4-5 laminectomy was performed to all animals and experimental agents were administered to the selected groups mentioned above. Spinal colons of all animals were removed gross total after 6-week period and investigated histopathologically. Additionally, real-time-polymerase chain reaction was used to obtain collagen type I and type III, transforming growth factor-1 beta, and tumor necrosis factor-alpha gene expressions. Results: All results demonstrated that polyethylene glycol and polyethylene imine dural barrier and PRP could decrease peridural fibrosis formation efficiently in rat. Conclusion: Present study results suggested that to reduce or block formation of peridural fibrosis, either polyethylene glycol and polyethylene imine dural barrier or PRP could be used effectively in human subjects after they will be closely investigated in future studies.
Effectivity of the Radiological Imaging Methods in the Prediction of the Neurological Loss Risk in Patients with Blunt Chest Trauma
(2022) Yuksel, Ulas; Agababaoglu, İsmail; Yildiz, Ozgur Omer; Cinar, Eray; Özdemir, Adnan; Akın, Mustafa Emre; Bakar, Bulent
Objective: The study was aimed to investigate the diagnostic differences between X-ray\rand thorax computed tomography (CT) scan in patients with blunt chest trauma and to de-\rtermine which radiological method and/or radiological diagnostic criteria are more effective\rand predictive to diagnose the hemothorax, pneumothorax, and neurological deficit.\rMethods: The demographic and radiological imaging results of patients who had blunt chest\rtrauma between April 2011 and December 2018 were analyzed. A total of 869 patients\r(male=548, female=321) were included in the study. Of the patients, 756 (87%) were as-\rsessed by a traffic accident and 113 (13%) by falling from a height. The findings of rib, ster-\rnum, and spine fractures, hemothorax, and pneumothorax detected on X-ray and/or thorax\rCT were evaluated.\rResults: Rib fractures (p<0.001) and vertebra fractures (p<0.001) were detected much\rmore in CT scans than in chest X-rays. ROC curve test revealed that vertebra fracture,\rhemothorax, and pneumothorax could predict the development risk of the neurological\rdeficit. The logistic regression test results revealed that thorax CT imaging could be the\rbest radiological examination method to be used to diagnose hemothorax (p<0.001) and\rpneumothorax (p<0.001) and to predict the development risk of the neurological deficit\r(p<0.001).\rConclusion: In cases with a rib fracture, hemothorax, and/or pneumothorax, advanced\rvertebral radiological imaging should be performed in order not to overlook vertebral frac-\rtures and to predict the development of neurological deficits. Therefore, a thorax CT scan\rmay be the first choice to detect pathological findings in the thoracic vertebrae and other\rthoracic bone structures.
Effects of DMSO on a rabbit ear hypertrophic scar model: A controlled randomized experimental study
(Elsevier Sci Ltd, 2017) Sari, Elif; Bakar, Bulent; Dincel, Gungor Cagdas; Yildiran, Fatma Azize Budak
Dimethyl sulfoxide (DMSO) is an anti-inflammatory, antibacterial, analgesic drug widely used to treat several diseases as reported in the literature. It has a detractive effect on collagen deposition in the abnormal tissue. This study aimed to investigate the possible therapeutic effects of DMSO on hypertrophic scar formation in rabbits. Twenty-four New Zealand male albino rabbits were randomly divided into four groups: control, sham, DMSO, and TRA (triamcinolone acetonide). Except the control group, punch biopsy defects were created on each animal's right ear. Following the hypertrophic scar formation on day 28, intralesional DMSO and triamcinolone acetonide were administered once a week for 4 weeks into these scars of the DMSO and TRA groups, respectively. No therapeutic agent was administered to the control and sham groups. One week after the last injection, ear samples were collected for histopathological, immunohistochemical, and real-time polymerase chain reaction gene expression analyses. Histopathological examination revealed that the epithelium in the DMSO group was thicker than that in the control and TRA groups, but thinner than that in the sham group. Connective tissue thickness and vascularity level of the sham group were higher than those of the control, DMSO, and TRA groups. The collagen type I immunoreactivity level of the sham and TRA groups was higher than those of the control and DMSO groups. The collagen type III immunoreactivity level was higher in the sham group than in all other groups. Collagen type I/type III immunoreactivity ratios were lower in the DMSO group. The alignment of collagen fibers was normal in the DMSO group, but was irregular in the sham and TRA groups. The collagen type I gene expression levels of the DMSO and TRA groups were lower than that of the sham group. Collagen type III and IFN-gamma mRNA expression levels were almost similar among the groups. TGF-1 beta mRNA expression levels were higher in the DMSO and TRA groups than in the control and sham groups. On the basis of the results, it can be concluded that intralesional administration of DMSO decreases hypertrophic scar formation easily and safely. (C) 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
Effects of Intracisternal Dexmedetomidine on Cerebral Neuronal Cells in Rat: A Preliminary Study
(Turkish Neurosurgical Soc, 2013) Kose, Emine Arzu; Bakar, Bulent; Kasimcan, Omur; Atilla, Pergin; Kilinc, Kamer; Muftuoglu, Sevda; Apan, Alpaslan
AIM:The aim was to investigate whether dexmedetomidine had a toxic effect on cerebral neurons when it was administered centrally into the cerebrospinal fluid by the intracisternal route. MATERIAL and METHODS: Eighteen rats were anesthetized and the right femoral artery was cannulated. Mean arterial pressures, heart rates, arterial carbon dioxide tension, arterial oxygen tension, and blood pH were recorded. When the free cerebrospinal fluid flow was seen, 0.1 ml normal saline (Group SIC, n=6) or 9 mu g/kg diluted dexmedetomidine in 0.1 ml volume (Group DIC, n=6) was administered into the cisterna magna of rats. After 24 hours, the whole body blood was collected for measurement of plasma lipid peroxidation (LPO) levels. The hippocampal formations used for histopathological examination and measurement of tissue LPO levels. RESULTS: There was a statistically significant difference between the DIC/SIC groups and DIC/CONTROL groups regarding the brain LPO levels (p=0.002, p<0.001, respectively). Plasma LPO levels were statistically different between the CONTROL/DIC groups, CONTROL/SIC groups, DIC/ SIC groups (p=0.002, p=0.047, p=0.025, respectively),The picnotic neuron counts were different between the CONTROL/SIC groups, CONTROL/ DIC groups, DIC/SIC groups (p<0.001, p=0.001, p=0.024, respectively). CONCLUSION: In conclusion, dexmedetomidine had a toxic effect on cerebral neurons when it was administered centrally into the cerebrospinal fluid by the intracisternal route.
Effects of Low Dose Methotrexate in Cerebral Ischemia Reperfusion Injury in Rat
(Journal Neurological Sciences, 2015) Bakar, Bulent; Kose, Emine Arzu; Sari, Elif; Sarkarati, Bahram; Atasoy, Pinar
Background: During cerebral ischemia reperfusion injury, oxidative stress leads to excitotoxicity, blood brain barrier dysfunction and inflammation. This study was designed to evaluate possible protective effects of low dose methotrexate on cerebral transient ischemia reperfusion injury in rat. Methods: Except CONTROL group, temporary aneurysm clips were performed to both common carotid arteries of rats for duration of 30 minutes. Four hours later, except CONTROL and SHAM groups, methotrexate (1.25 mg/kg/day) was administered intraperitoneally. Seventy two hours later, animals of CONTROL, MTX-A and SHAM-A group; and ten days later animals of MTX-C and SHAM-C group were sacrificed and hippocampal pyknotic neuronal cell count results and tissue lipid peroxidation (LPO) values were analyzed statistically. Results: Pyknotic cell count values of CONTROL group were lower than SHAM-A, SHAM-C, MTX-A and MTX-C group values. Cell count values of SHAM-A and MTX-A group were higher than SHAM-C and MTX-C values, respectively. LPO values of CONTROL group were lower than SHAM-A and MTX-A values, but not different from MTX-C and SHAM-C values. LPO values of MTX-A group higher than MTX-C group values. Conclusion: Cell count values and LPO values demonstrated that low dose methotrexate could not prevent neuronal cells from destructive effects of transient ischemia reperfusion injury in rat.
Effects of low-dose methotrexate in spinal cord injury in rats
(Turkish Assoc Trauma Emergency Surgery, 2013) Bakar, Bulent; Kose, Emine Arzu; Kupana Ayva, Sebnem; Sarkarati, Bahram; Kasimcan, Mustafa Omur; Kilinc, Kamer
BACKGROUND This study was designed to evaluate the possible protective effects of low-dose methotrexate in the spinal cord injury (SCI) in rats. METHODS Thirty-seven Wistar albino rats were used in the present study. Except for the animals of the Sham group, all animals were divided into two main groups, which were used in acute and subacute stage investigations. Then, thoracal laminectomy was performed, and except for the Sham group, SCI was induced using a temporary aneurysm clip. After clip compression, the experimental material (methotrexate or methylprednisolone) was administered intraperitoneally, except in the Sham and Control groups. Then, the spinal cords were removed to evaluate the SCI histopathologically and biochemically at the scheduled date. RESULTS Neither experimental material was shown to reduce the histopathological grade in either stage of SCI. Low-dose methotrexate was shown to decrease lipid peroxidation levels only in the subacute stage of SCI. However, methylprednisolone and low-dose methotrexate could not decrease or block myeloperoxidase enzyme activation in either stage of SCI. CONCLUSION Low-dose methotrexate was effective in reducing the lipid peroxidation levels in the subacute stage of SCI, although histopathological evaluation results and myeloperoxidase levels of all groups did not support this finding at either stage.
Effects of Sulphasalazine in Cerebral Ischemia Reperfusion Injury in Rat
(Elsevier Science Inc, 2017) Cetin, Cansel; Erdogan, Ahmet Melih; Dincel, Gungor Cagdas; Bakar, Bulent; Kisa, Ucler
Background. Management of cerebral ischemia/reperfusion (I/R) injury is still difficult process today. Aims of the Study. Aim of present study was to investigate therapeutic properties of sulfasalazine in cerebral transient I/R injury in rat. Methods. Except Control group (n = 5), 20 Wistar albino rats were allocated for acute and chronic stage investigation of I/R injury, and temporary aneurysm clips were attempted to both internal carotid arteries for thirty min. Four hours later, 40 mg/kg once a day sulfasalazine was administered to animals of SL-A and SL-C groups, orally. Animals were decapitated, following which pyknotic and necrotic neuronal cells, perivascular edema, irregularities of intercellular organization (IIO) of hippocampal regions, and cortical necrotic neurons of parietal lobe were counted or scaled histopathologically. Tissue malonyldialdehyde (MDA), myeloperoxidation (MPO), total nitrite/nitrate (NO), interleukin 1-beta (IL-1 beta), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha) level values were evaluated biochemically. Results. Sulfasalazine could reduce perivascular edema, 110, cortical and hippocampal neuronal cell death in both stages. It could decrease MDA in acute stage, but not reduce IL-1 beta, IL-6, MPO, NO, and TNF alpha levels. It could increase IL-1 beta levels in chronic stage but not affect to IL-6, MPO, MDA, NO, TNF-alpha levels. Conclusion. Sulfasalazine could improve histopathological architecture of hypoxic tissue in both stages of FR injury in rat. It could inhibit lipid peroxidation cascades just in acute stage. These results suggested that therapeutic mechanisms of sulfasalazine in cerebral I/R injury should be investigated by using more specific laboratory methods in future studies. (C) 2017 IMSS. Published by Elsevier Inc.
Estimated beginning time of local anesthesia effectiveness in forced cold air application: A preliminary study
(Taylor & Francis Inc, 2016) Sari, Elif; Sandikci, Mert Muhittin; Bakar, Bulent; Tellioglu, Ali Teoman
Background: The literature has reported that forced cold air anesthesia decreases the discomfort effect of various laser therapies. The aim of this preliminary study was to determine the average beginning time of the local anesthetic effect of the forced cold air application when it is applied to all body surfaces except the face. Materials and methods: A total of 52 participants (26 females and 26 males) were included in this study. During application of the forced cold air, the beginning time of local anesthesia effectiveness for each volunteer was determined by giving painful stimuli. The results were then analyzed statistically. Results: The mean beginning time value of the local anesthesia was 52.88 (ranging between 30 and 60) seconds in the female group and 56.34 (ranging between 30 and 60) seconds in the male group. The mean beginning time value of the local anesthesia was 54.61 (ranging between 30 and 60) seconds in both genders. There was no statistical difference between the two groups (Z = - 0.834, p = 0.404). Conclusion: Forced cold air anesthesia-which is a quick, safe, cost-effective, and practical local anesthesia method-seems to be useful and effective when used alone in laser treatment.

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