Talha Simsek - Academia.edu (original) (raw)

Papers by Talha Simsek

Research paper thumbnail of Ligamentum Flavumu İnvaze Eden Primer Servikal Osteosarkom: Olgu Sunumu

Namık Kemal Üniversitesi, 2017

Research paper thumbnail of Which pharmacological agents may be used to establish healthy, proliferating human primer nucleus pulposus / annulus fibrosus cell cultures? Systematic evaluation of our experience in the light of literature

Merit Research Journal of Medicine and Medical Sciences, Mar 1, 2018

Research paper thumbnail of Are the intervertebral disc tissue cells damaged when attempting to prevent thrombus formation with dabigatran which is amongst the new oral anticoagulants?

Turkish Neurosurgery, 2018

gatroban can be used in the prophylaxis or treatment of these diseases (21). Through pharmaceutic... more gatroban can be used in the prophylaxis or treatment of these diseases (21). Through pharmaceutical technology, these drugs, which are administered parenterally or subcutaneously, have been replaced with orally administered drugs (4). With the substitution of the hydroxyl in the fourth position of coumarin-derived molecules containing a 2-oxo-2H-1-█ INTRODUCTION V enous and arterial thrombosis are significant contributors to morbidity and mortality, and anticoagulant agents are a mainstay of venous thromboembolism treatment (11). Drugs such as heparin, low molecular weight heparins, fondaparinux, hirudin, bivalirudin, lepirudin, and ar-AIM: To investigate the effect of dabigatran, a new oral anticoagulant, on human primary cell cultures isolated from intact intervertebral disc tissue. MATERIAL and METHODS: Cell cultures were prepared from tissues obtained from six cases who had undergone surgery due to spinal trauma. Dabigatran, an active pharmacological agent, was applied to intact annulus fibrosus (AF)/nucleus pulposus (NP) primary cell cultures from the study group. After performing cell viability, toxicity, and proliferation tests on all cultures in the control and study groups, the surface morphologies of the samples were evaluated. Subsequently, chondroadherin (CHAD), cartilage oligomeric matrix protein (COMP), and matrix metalloproteinase (MMP)-13 and-19 expressions were measured via a real-time polymerase chain reaction (RT-PCR). Data were analyzed statistically. RESULTS: In the proliferation assays performed on the 20 th day of the study, cells in the dabigatran-supplemented group were reported to have lost 46.37% more viability than those in the control group. Expressions of all genes examined except MMP-13 were evaluated in the control group by time, but in contrast to the control group results, COMP and MMP-19 gene expressions decreased in the dabigatran-treated group. No CHAD or MMP-13 expression was noted in these cultures. CONCLUSION: The potential for a systemically applied drug to accumulate in tissue and negatively affect surrounding tissues and microstructures must be emphasized.

Research paper thumbnail of Do Endocrinopathies Cause Changes in Transverse Carpal Ligament Thickness and Carpal Tunnel Area in Carpal Tunnel Syndrome?

European Archives of Medical Research, 2020

The purpose of this study was to investigate the effect of transverse carpal ligament (TCL) thick... more The purpose of this study was to investigate the effect of transverse carpal ligament (TCL) thickness and the size of carpal tunnel area on clinical findings and electrophysiological changes through the wrist magnetic resonance imaging (MRI). Methods: In this prospective study, the thickness of the TCL and the carpal tunnel areas of preoperative cases diagnosed with carpal tunnel syndrome (CTS) were measured via wrist MRI results. The effect of TCL thickness and carpal tunnel area on endocrinopathies such as diabetes mellitus (DM) and hypothyroidism and the effect of these variables on clinical findings and electrophysiologic changes were evaluated in the light of the literature. Results: TCL thickness and carpal tunnel area were not statistically significant among DM, hypothyroidism and electrophysiological changes (p>0.05). Conclusion: This study include one of the limited researches comparing the carpal tunnel area and TKL thickness in cases with and without endocrinopathy CTS. However, there is a need for further researches that have a greater number of cases, including multi-centered, differentwinged people.

Research paper thumbnail of Evaluation of Biopathogenesis of Meningioma Cases in the Light of Literature

Medeniyet Medical Journal, 2018

In this study, it was aimed to investigate the bio pathogenesis of the cases diagnosed with menin... more In this study, it was aimed to investigate the bio pathogenesis of the cases diagnosed with meningioma in the light of the literature. The patients (n=79) operated due to the meningioma in neurosurgery department between 2005 and 2010 were retrospectively examined. Findings that may affect the biological behavior and prognosis of the tumours recorded in these reported data were evaluated. A total of 79 cases meeting the research criteria were included in the study. When the histopathological grade of the cases was examined, it was seen that 59 cases (74.7%) were grade I and 20 cases (25.3%) were grade II. When the relation between the localization and histological grade of the cases was examined, it was determined that the meningiomas were most frequently located in convexity and that most of grade II cases were localized at this site. Preoperative peritumoral oedema was found to be more prevalent, especially in the sphenoid wing and convexity meningiomas. A total of 9 cases of recurrence (11.4%) occurred during follow-up period. When carrying out evaluation between surgical resection grade and recurrent cases, it was detected that all cases where it was performed Simpson grade IV and Kobayashi grade IVA and IVB resection had a recurrence. When the localization of recurrent cases was examined, it was seen that 4 cases (%44.4) were sphenoid wing meningioma, 2 cases (%22.2) were parasagittal meningioma, 1 case (%11.1) was tuberculosis sellae meningioma and 1 case (%11.1) was intraventricular meningioma. In our study, histopathologic subtype and surgical resection grade were found to play a significant role in prognosis in meningiomas. It was also thought that the presence of peritumoral oedema and tumour localization could affect the biological behavior and prognosis of the meningioma. Findings obtained should be supported by multi-center studies that will include the cases of different races with more series.

Research paper thumbnail of Evaluation of the effect of apixaban on the primary intact intervertebral disc cell cultures

Annals of Medical Research, 2019

Apixaban is a frequently preferred pharmacological agent in clinics to prevent deep vein thrombos... more Apixaban is a frequently preferred pharmacological agent in clinics to prevent deep vein thrombosis and pulmonary embolism. Such new oral anticoagulants may cause hemorrhage's in tissues and/or organs or may cause gastrointestinal symptoms without bleeding. It is also reported in the literature that it may lead to mental disorders, unwanted disorders in the urinary tract and skeletalmuscle system. However, when the literature is examined, there are no studies, which are of high-evidential value, evaluating the efficacy of apixaban on healthy, intact intervertebral disc tissue, and matrix-like structures. In this pharmaco-molecular study, it was aimed to investigate the effects of a new oral anticoagulant agent containing the active ingredient apixaban on the intact intervertebral disc tissue cells, extracellular matrix (ECM) structure and to evaluate its positive and / or negative effects on gene expressions of cartilage oligo matrix protein (COMP), chondroadherin (CHAD), and Matrix Metalloproteinase (MMP)s. Material and Methods: The primary cell cultures were prepared from the intact tissues of the patients with the traumatic intervertebral disc herniation. Apixaban was administered to the cultures and molecular analyses were performed for 21 days. The data obtained from the apixaban-administered and non-apixaban-administered samples were evaluated statistically and the significance value was accepted as P <0.05. Results: The changes were observed in the cell proliferation and the expressions of the mentioned genes in the apixabanadministered group. The suppression of COMP value and the increase in MMP-13 value may be indicative of the development of matrix degeneration in the apixaban-administered group, compared to the non-drug-administered control group. Conclusion: The selectivity is one of the most important features of the drugs. However, it should not be forgotten that no drug will only produce the desired effect.

Research paper thumbnail of A study on side effects of antibiotics used in the treatment of patients with head trauma and legal responsibility of clinicians in terms of the right to health

Annals of Medical Research, 2019

Patients with head trauma are routinely, and commonly treated with prophylactic antibiotics, whic... more Patients with head trauma are routinely, and commonly treated with prophylactic antibiotics, which may also be used for the treatment of infection that may be developed during hospital stay. The relevant antibiotic may, however, some side effects and adverse event. The present study aimed to investigate whether the side effects and adverse events of the prophylactic antibiotics were considered as a complication or medical negligence. Material and Methods: Descriptive statistics were used for the evaluation of the data. Results: No studies were found in the literature. Ceftriaxone, ampicillin-sulbactam, and cefazolin sodium were preferred for antibiotherapy. Meropenem or vancomycin was solely administered to patients when observed active pathogens in cultureantibiogram. Clinicians should be cautioned the potential side effects and adverse events of some drugs frequently used in clinics. Conclusion: Otherwise, they may legally be held liable for medical negligence.

Research paper thumbnail of Investigation of the effect of dipyrone on cells isolated from intervertebral disc tissue

Experimental and Therapeutic Medicine, 2019

The present study aimed to evaluate the effects of dipyrone, an indispensable analgesic, anti-pyr... more The present study aimed to evaluate the effects of dipyrone, an indispensable analgesic, anti-pyretic and anti-spasmodic used in emergency departments, on nucleus pulposus and annulus fibrosus cells in vitro. After surgical biopsy, primary cell cultures were prepared from intact intervertebral disc tissues. Dipyrone was administered to the cultures in the experimental groups except for the control group. The data obtained were statistically evaluated. The proliferation was identified to be suppressed via MTT analysis. The gene expression profile of the intervertebral disc cells in the dipyrone-treated groups was significantly changed. The expression of chondroadherin, cartilage oligo matrix protein, interleukin-1β and metalloproteinase (MMP)-19 genes were decreased, but MMP-13 and MMP-7 genes expressions were increased, as determined via reverse transcription-quantitative PCR. AO/PI staining revealed that no apoptotic or other type of cell death was detectable after administration of dipyrone does not mean that the drug is innocuous. The occurrence of cellular senescence and/or the halt of cell proliferation may also be important mechanisms underlying the adverse inhibitory effects of dipyrone. Therefore, prior to administering dipyrone in clinical practice, all possible adverse effects of this drug should be considered.

Research paper thumbnail of Effects of etanercept, a tumor necrosis factor receptor fusion protein, on primary cell cultures prepared from intact human intervertebral disc tissue

Experimental and Therapeutic Medicine, 2019

The aim of the present study was to investigate the effects of etanercept (ETA), a tumor necrosis... more The aim of the present study was to investigate the effects of etanercept (ETA), a tumor necrosis factor (TNF) inhibitor, on human cell cultures prepared from intact intervertebral disc tissue. ETA is used as a treatment for cases of rheumatoid arthritis, psoriatic arthritis, axial spondyloarthritis and ankylosing spondylitis accompanied by moderate or severe joint pain. ETA was applied to primary cell cultures [annulus fibrosus and nucleus pulposus (NP) from intact intervertebral disc tissue]. Cell cultures without ETA treatment served as the control group. Morphological and quantitative molecular analyses of the two groups were performed. The number of viable cells and cell proliferation decreased in the ETA-treated cultures as compared with those in the control group. Furthermore, in the treatment group, the chondroadherin gene, an NP-specific marker, was not expressed after 24 h. By contrast, the cartilage oligo matrix protein was expressed 24, 48 and 72 h post-ETA treatment, while its expression was significantly lower than that in the control group. In addition, the expression of interleukin-1β, as well as matrix metallopeptidase-7 and-19, was markedly decreased. Overall, the cell proliferation and gene expression in the ETA-treated cells were significantly different from those in the control group (P<0.05). These results suggest that the treatment duration and dosage of TNF inhibitors, which are used to suppress active inflammation, should be considered in the clinical setting. These biological agents may delay the healing of intervertebral disc tissue damage by slowing cell proliferation and altering gene expression via anabolic and catabolic pathways.

Research paper thumbnail of Evaluation of empirical antibiotic treatment in culture-negative pyogenic vertebral osteomyelitis

Turkish Neurosurgery, 2019

AIM: To investigate the efficacy of empirical antibiotic treatment in culture-negative pyogenic v... more AIM: To investigate the efficacy of empirical antibiotic treatment in culture-negative pyogenic vertebral osteomyelitis (PVO) cases. MATERIAL and METHODS: The records of patients with culture-negative PVO who were treated at infectious disease and neurosurgery outpatient clinics in the past four years were examined retrospectively. The control group comprised healthy subjects with similar age, gender, and body mass index but without pathology. In the statistical evaluation of the obtained data, the comparison of the groups was performed by analysis of variance. Statistical significance was accepted as p<0.05. RESULTS: No statistically significant difference in the white blood cell count and erythrocyte sedimentation rate was found between the spondylodiscitis and the healthy subject groups when the blood parameters obtained before and after the treatment (p>0.05). However, a statistical significance was assessed in the results of the comparison for C-reactive protein (p<0.05). CONCLUSION: In the context of evidence-based medicine and the rational use of antibiotics, it is clear that antibiotics should be preferred according to the culture antibiogram results in the treatment of infectious diseases.

Research paper thumbnail of Evaluation of the effect of daptomycin, a glycopeptide agent, on intact intervertebral disc tissue

Turkish Neurosurgery, 2018

AIM: To evaluate the effects of pre-and intra-operatively administered daptomycin (DAP) on the in... more AIM: To evaluate the effects of pre-and intra-operatively administered daptomycin (DAP) on the intact human primary intervertebral disc tissue cells. MATERIAL and METHODS: Primary cell cultures were established using tissues obtained through decompressive laminectomy, traumatic intervertebral disc herniation excision, and posterior transpedicular stabilization. Non-drug-administered samples were used as a control group. The samples treated with DAP formed the study group. Molecular assays for proliferation and gene expression were performed. The obtained data were evaluated statistically, and results with a value of p<0.05 were accepted as significant. RESULTS: While no reduction was observed in the proliferation, the gene expression of intact intervertebral disc tissue cells was time-dependently decreased compared to the control group, and these results were reported to be statistically significant. CONCLUSION: This study observed the effect that a pharmaceutical preparation, which was used on intervertebral disc tissue before and after the operation, had on normal, healthy, and intact tissue. It concludes that alterations in the expression of genes involved in the anabolic and/or catabolic process, even in adjacent healthy tissue, may slow down the healing process of the damaged tissue or cause undesired cell differentiation.

Research paper thumbnail of Forestier syndrome presenting with dysphagia: case report of a rare presentation

Journal of spine surgery (Hong Kong), 2017

Diffuse idiopathic skeletal hyperostosis (DISH) (Forestier syndrome) is a rheumatologic disease, ... more Diffuse idiopathic skeletal hyperostosis (DISH) (Forestier syndrome) is a rheumatologic disease, the etiology of which is not exactly known. It is characterized by spinal osteophyte formations resulting from the ossification of the paravertebral ligaments and muscles. Anterior longitudinal ligament is the usual site of involvement and the frequency of the disease increases after the 5th decade. Lower cervical segments are the most frequently involved regions whereas the upper cervical involvement leading to dysphagia is very rare. In this report, a 77-year-old patient with Forestier syndrome in upper cervical region presenting with dysphagia was presented. Anterior cervical osteophyte resection was performed with no need for discectomy, fusion or stabilization. The patient showed a significant improvement in his all preoperative symptoms, and no recurrence was detected at 1-year follow-up.

Research paper thumbnail of Cauda Equina Syndrome Following Percutaneous Vertebroplasty

Sinir Sistemi Cerrahisi Dergisi, 2017

Perkütan vertebroplasti, vertebral kompresyon fraktürlerine eşlik eden ağrının tedavisinde kullan... more Perkütan vertebroplasti, vertebral kompresyon fraktürlerine eşlik eden ağrının tedavisinde kullanılan, etkin minimal invaziv bir yöntemdir. Bu çalışmada, perkütan vertebroplasti sonrası Kauda Equina sendromu gelişen bir olgu sunulmuştur. Olgu: Yetmiş iki yaşında kadın hasta polikliniğimize yaygın bel ağrısı yakınması ile başvurdu. Hastanın özgeçmişinde yaklaşık 2 yıl önce lomber spinal stenoz nedeniyle opere olduğu öğrenildi. Hastanın lomber spinal MRG ve BT tetkiklerinde, L1 osteoporotik kompresyon fraktürü saptanarak perkütan vertebroplasti yapıldı. Operasyon sonrası Kauda Equine sendromu saptanan hastanın yapılan lomber spinal BT tetkikinde Polimetilmetakrilat'ın (PMMA) anterior epidural mesafeye sızdığı görüldü. Hasta operasyona alınarak L1 total laminektomi yapıldı. Sonuç: Perkütan vertebroplasti, osteoporotik vertebral kompresyon fraktürlerinde etkin bir tedavi yöntemidir. PVP uygulanan hastalarda, PMM sızıntısı sık karşılaşılan bir durum olmasına ragmen, genellikle klinik bulguya neden olmadığından önemsenmemektedir. Fakat bu olguda göstermektedir ki, PVP sonrasında gelişen nörolojik defisitlerde, kesinlikle erken görüntüleme tetkiki yapılıp uygun olmayan PMMA sızıntısı tespit edilmeli ve gerekli durumunlarda hastaya erken cerrahi müdahale yapılmalıdır. anahtar kelimeler: Kauda Equina sendromu, komplikasyon, perkütan vertebroplasti

Research paper thumbnail of Ligamentum Flavumu İnvaze Eden Primer Servikal Osteosarkom: Olgu Sunumu

Namık Kemal Üniversitesi, 2017

Research paper thumbnail of Which pharmacological agents may be used to establish healthy, proliferating human primer nucleus pulposus / annulus fibrosus cell cultures? Systematic evaluation of our experience in the light of literature

Merit Research Journal of Medicine and Medical Sciences, Mar 1, 2018

Research paper thumbnail of Are the intervertebral disc tissue cells damaged when attempting to prevent thrombus formation with dabigatran which is amongst the new oral anticoagulants?

Turkish Neurosurgery, 2018

gatroban can be used in the prophylaxis or treatment of these diseases (21). Through pharmaceutic... more gatroban can be used in the prophylaxis or treatment of these diseases (21). Through pharmaceutical technology, these drugs, which are administered parenterally or subcutaneously, have been replaced with orally administered drugs (4). With the substitution of the hydroxyl in the fourth position of coumarin-derived molecules containing a 2-oxo-2H-1-█ INTRODUCTION V enous and arterial thrombosis are significant contributors to morbidity and mortality, and anticoagulant agents are a mainstay of venous thromboembolism treatment (11). Drugs such as heparin, low molecular weight heparins, fondaparinux, hirudin, bivalirudin, lepirudin, and ar-AIM: To investigate the effect of dabigatran, a new oral anticoagulant, on human primary cell cultures isolated from intact intervertebral disc tissue. MATERIAL and METHODS: Cell cultures were prepared from tissues obtained from six cases who had undergone surgery due to spinal trauma. Dabigatran, an active pharmacological agent, was applied to intact annulus fibrosus (AF)/nucleus pulposus (NP) primary cell cultures from the study group. After performing cell viability, toxicity, and proliferation tests on all cultures in the control and study groups, the surface morphologies of the samples were evaluated. Subsequently, chondroadherin (CHAD), cartilage oligomeric matrix protein (COMP), and matrix metalloproteinase (MMP)-13 and-19 expressions were measured via a real-time polymerase chain reaction (RT-PCR). Data were analyzed statistically. RESULTS: In the proliferation assays performed on the 20 th day of the study, cells in the dabigatran-supplemented group were reported to have lost 46.37% more viability than those in the control group. Expressions of all genes examined except MMP-13 were evaluated in the control group by time, but in contrast to the control group results, COMP and MMP-19 gene expressions decreased in the dabigatran-treated group. No CHAD or MMP-13 expression was noted in these cultures. CONCLUSION: The potential for a systemically applied drug to accumulate in tissue and negatively affect surrounding tissues and microstructures must be emphasized.

Research paper thumbnail of Do Endocrinopathies Cause Changes in Transverse Carpal Ligament Thickness and Carpal Tunnel Area in Carpal Tunnel Syndrome?

European Archives of Medical Research, 2020

The purpose of this study was to investigate the effect of transverse carpal ligament (TCL) thick... more The purpose of this study was to investigate the effect of transverse carpal ligament (TCL) thickness and the size of carpal tunnel area on clinical findings and electrophysiological changes through the wrist magnetic resonance imaging (MRI). Methods: In this prospective study, the thickness of the TCL and the carpal tunnel areas of preoperative cases diagnosed with carpal tunnel syndrome (CTS) were measured via wrist MRI results. The effect of TCL thickness and carpal tunnel area on endocrinopathies such as diabetes mellitus (DM) and hypothyroidism and the effect of these variables on clinical findings and electrophysiologic changes were evaluated in the light of the literature. Results: TCL thickness and carpal tunnel area were not statistically significant among DM, hypothyroidism and electrophysiological changes (p>0.05). Conclusion: This study include one of the limited researches comparing the carpal tunnel area and TKL thickness in cases with and without endocrinopathy CTS. However, there is a need for further researches that have a greater number of cases, including multi-centered, differentwinged people.

Research paper thumbnail of Evaluation of Biopathogenesis of Meningioma Cases in the Light of Literature

Medeniyet Medical Journal, 2018

In this study, it was aimed to investigate the bio pathogenesis of the cases diagnosed with menin... more In this study, it was aimed to investigate the bio pathogenesis of the cases diagnosed with meningioma in the light of the literature. The patients (n=79) operated due to the meningioma in neurosurgery department between 2005 and 2010 were retrospectively examined. Findings that may affect the biological behavior and prognosis of the tumours recorded in these reported data were evaluated. A total of 79 cases meeting the research criteria were included in the study. When the histopathological grade of the cases was examined, it was seen that 59 cases (74.7%) were grade I and 20 cases (25.3%) were grade II. When the relation between the localization and histological grade of the cases was examined, it was determined that the meningiomas were most frequently located in convexity and that most of grade II cases were localized at this site. Preoperative peritumoral oedema was found to be more prevalent, especially in the sphenoid wing and convexity meningiomas. A total of 9 cases of recurrence (11.4%) occurred during follow-up period. When carrying out evaluation between surgical resection grade and recurrent cases, it was detected that all cases where it was performed Simpson grade IV and Kobayashi grade IVA and IVB resection had a recurrence. When the localization of recurrent cases was examined, it was seen that 4 cases (%44.4) were sphenoid wing meningioma, 2 cases (%22.2) were parasagittal meningioma, 1 case (%11.1) was tuberculosis sellae meningioma and 1 case (%11.1) was intraventricular meningioma. In our study, histopathologic subtype and surgical resection grade were found to play a significant role in prognosis in meningiomas. It was also thought that the presence of peritumoral oedema and tumour localization could affect the biological behavior and prognosis of the meningioma. Findings obtained should be supported by multi-center studies that will include the cases of different races with more series.

Research paper thumbnail of Evaluation of the effect of apixaban on the primary intact intervertebral disc cell cultures

Annals of Medical Research, 2019

Apixaban is a frequently preferred pharmacological agent in clinics to prevent deep vein thrombos... more Apixaban is a frequently preferred pharmacological agent in clinics to prevent deep vein thrombosis and pulmonary embolism. Such new oral anticoagulants may cause hemorrhage's in tissues and/or organs or may cause gastrointestinal symptoms without bleeding. It is also reported in the literature that it may lead to mental disorders, unwanted disorders in the urinary tract and skeletalmuscle system. However, when the literature is examined, there are no studies, which are of high-evidential value, evaluating the efficacy of apixaban on healthy, intact intervertebral disc tissue, and matrix-like structures. In this pharmaco-molecular study, it was aimed to investigate the effects of a new oral anticoagulant agent containing the active ingredient apixaban on the intact intervertebral disc tissue cells, extracellular matrix (ECM) structure and to evaluate its positive and / or negative effects on gene expressions of cartilage oligo matrix protein (COMP), chondroadherin (CHAD), and Matrix Metalloproteinase (MMP)s. Material and Methods: The primary cell cultures were prepared from the intact tissues of the patients with the traumatic intervertebral disc herniation. Apixaban was administered to the cultures and molecular analyses were performed for 21 days. The data obtained from the apixaban-administered and non-apixaban-administered samples were evaluated statistically and the significance value was accepted as P <0.05. Results: The changes were observed in the cell proliferation and the expressions of the mentioned genes in the apixabanadministered group. The suppression of COMP value and the increase in MMP-13 value may be indicative of the development of matrix degeneration in the apixaban-administered group, compared to the non-drug-administered control group. Conclusion: The selectivity is one of the most important features of the drugs. However, it should not be forgotten that no drug will only produce the desired effect.

Research paper thumbnail of A study on side effects of antibiotics used in the treatment of patients with head trauma and legal responsibility of clinicians in terms of the right to health

Annals of Medical Research, 2019

Patients with head trauma are routinely, and commonly treated with prophylactic antibiotics, whic... more Patients with head trauma are routinely, and commonly treated with prophylactic antibiotics, which may also be used for the treatment of infection that may be developed during hospital stay. The relevant antibiotic may, however, some side effects and adverse event. The present study aimed to investigate whether the side effects and adverse events of the prophylactic antibiotics were considered as a complication or medical negligence. Material and Methods: Descriptive statistics were used for the evaluation of the data. Results: No studies were found in the literature. Ceftriaxone, ampicillin-sulbactam, and cefazolin sodium were preferred for antibiotherapy. Meropenem or vancomycin was solely administered to patients when observed active pathogens in cultureantibiogram. Clinicians should be cautioned the potential side effects and adverse events of some drugs frequently used in clinics. Conclusion: Otherwise, they may legally be held liable for medical negligence.

Research paper thumbnail of Investigation of the effect of dipyrone on cells isolated from intervertebral disc tissue

Experimental and Therapeutic Medicine, 2019

The present study aimed to evaluate the effects of dipyrone, an indispensable analgesic, anti-pyr... more The present study aimed to evaluate the effects of dipyrone, an indispensable analgesic, anti-pyretic and anti-spasmodic used in emergency departments, on nucleus pulposus and annulus fibrosus cells in vitro. After surgical biopsy, primary cell cultures were prepared from intact intervertebral disc tissues. Dipyrone was administered to the cultures in the experimental groups except for the control group. The data obtained were statistically evaluated. The proliferation was identified to be suppressed via MTT analysis. The gene expression profile of the intervertebral disc cells in the dipyrone-treated groups was significantly changed. The expression of chondroadherin, cartilage oligo matrix protein, interleukin-1β and metalloproteinase (MMP)-19 genes were decreased, but MMP-13 and MMP-7 genes expressions were increased, as determined via reverse transcription-quantitative PCR. AO/PI staining revealed that no apoptotic or other type of cell death was detectable after administration of dipyrone does not mean that the drug is innocuous. The occurrence of cellular senescence and/or the halt of cell proliferation may also be important mechanisms underlying the adverse inhibitory effects of dipyrone. Therefore, prior to administering dipyrone in clinical practice, all possible adverse effects of this drug should be considered.

Research paper thumbnail of Effects of etanercept, a tumor necrosis factor receptor fusion protein, on primary cell cultures prepared from intact human intervertebral disc tissue

Experimental and Therapeutic Medicine, 2019

The aim of the present study was to investigate the effects of etanercept (ETA), a tumor necrosis... more The aim of the present study was to investigate the effects of etanercept (ETA), a tumor necrosis factor (TNF) inhibitor, on human cell cultures prepared from intact intervertebral disc tissue. ETA is used as a treatment for cases of rheumatoid arthritis, psoriatic arthritis, axial spondyloarthritis and ankylosing spondylitis accompanied by moderate or severe joint pain. ETA was applied to primary cell cultures [annulus fibrosus and nucleus pulposus (NP) from intact intervertebral disc tissue]. Cell cultures without ETA treatment served as the control group. Morphological and quantitative molecular analyses of the two groups were performed. The number of viable cells and cell proliferation decreased in the ETA-treated cultures as compared with those in the control group. Furthermore, in the treatment group, the chondroadherin gene, an NP-specific marker, was not expressed after 24 h. By contrast, the cartilage oligo matrix protein was expressed 24, 48 and 72 h post-ETA treatment, while its expression was significantly lower than that in the control group. In addition, the expression of interleukin-1β, as well as matrix metallopeptidase-7 and-19, was markedly decreased. Overall, the cell proliferation and gene expression in the ETA-treated cells were significantly different from those in the control group (P<0.05). These results suggest that the treatment duration and dosage of TNF inhibitors, which are used to suppress active inflammation, should be considered in the clinical setting. These biological agents may delay the healing of intervertebral disc tissue damage by slowing cell proliferation and altering gene expression via anabolic and catabolic pathways.

Research paper thumbnail of Evaluation of empirical antibiotic treatment in culture-negative pyogenic vertebral osteomyelitis

Turkish Neurosurgery, 2019

AIM: To investigate the efficacy of empirical antibiotic treatment in culture-negative pyogenic v... more AIM: To investigate the efficacy of empirical antibiotic treatment in culture-negative pyogenic vertebral osteomyelitis (PVO) cases. MATERIAL and METHODS: The records of patients with culture-negative PVO who were treated at infectious disease and neurosurgery outpatient clinics in the past four years were examined retrospectively. The control group comprised healthy subjects with similar age, gender, and body mass index but without pathology. In the statistical evaluation of the obtained data, the comparison of the groups was performed by analysis of variance. Statistical significance was accepted as p<0.05. RESULTS: No statistically significant difference in the white blood cell count and erythrocyte sedimentation rate was found between the spondylodiscitis and the healthy subject groups when the blood parameters obtained before and after the treatment (p>0.05). However, a statistical significance was assessed in the results of the comparison for C-reactive protein (p<0.05). CONCLUSION: In the context of evidence-based medicine and the rational use of antibiotics, it is clear that antibiotics should be preferred according to the culture antibiogram results in the treatment of infectious diseases.

Research paper thumbnail of Evaluation of the effect of daptomycin, a glycopeptide agent, on intact intervertebral disc tissue

Turkish Neurosurgery, 2018

AIM: To evaluate the effects of pre-and intra-operatively administered daptomycin (DAP) on the in... more AIM: To evaluate the effects of pre-and intra-operatively administered daptomycin (DAP) on the intact human primary intervertebral disc tissue cells. MATERIAL and METHODS: Primary cell cultures were established using tissues obtained through decompressive laminectomy, traumatic intervertebral disc herniation excision, and posterior transpedicular stabilization. Non-drug-administered samples were used as a control group. The samples treated with DAP formed the study group. Molecular assays for proliferation and gene expression were performed. The obtained data were evaluated statistically, and results with a value of p<0.05 were accepted as significant. RESULTS: While no reduction was observed in the proliferation, the gene expression of intact intervertebral disc tissue cells was time-dependently decreased compared to the control group, and these results were reported to be statistically significant. CONCLUSION: This study observed the effect that a pharmaceutical preparation, which was used on intervertebral disc tissue before and after the operation, had on normal, healthy, and intact tissue. It concludes that alterations in the expression of genes involved in the anabolic and/or catabolic process, even in adjacent healthy tissue, may slow down the healing process of the damaged tissue or cause undesired cell differentiation.

Research paper thumbnail of Forestier syndrome presenting with dysphagia: case report of a rare presentation

Journal of spine surgery (Hong Kong), 2017

Diffuse idiopathic skeletal hyperostosis (DISH) (Forestier syndrome) is a rheumatologic disease, ... more Diffuse idiopathic skeletal hyperostosis (DISH) (Forestier syndrome) is a rheumatologic disease, the etiology of which is not exactly known. It is characterized by spinal osteophyte formations resulting from the ossification of the paravertebral ligaments and muscles. Anterior longitudinal ligament is the usual site of involvement and the frequency of the disease increases after the 5th decade. Lower cervical segments are the most frequently involved regions whereas the upper cervical involvement leading to dysphagia is very rare. In this report, a 77-year-old patient with Forestier syndrome in upper cervical region presenting with dysphagia was presented. Anterior cervical osteophyte resection was performed with no need for discectomy, fusion or stabilization. The patient showed a significant improvement in his all preoperative symptoms, and no recurrence was detected at 1-year follow-up.

Research paper thumbnail of Cauda Equina Syndrome Following Percutaneous Vertebroplasty

Sinir Sistemi Cerrahisi Dergisi, 2017

Perkütan vertebroplasti, vertebral kompresyon fraktürlerine eşlik eden ağrının tedavisinde kullan... more Perkütan vertebroplasti, vertebral kompresyon fraktürlerine eşlik eden ağrının tedavisinde kullanılan, etkin minimal invaziv bir yöntemdir. Bu çalışmada, perkütan vertebroplasti sonrası Kauda Equina sendromu gelişen bir olgu sunulmuştur. Olgu: Yetmiş iki yaşında kadın hasta polikliniğimize yaygın bel ağrısı yakınması ile başvurdu. Hastanın özgeçmişinde yaklaşık 2 yıl önce lomber spinal stenoz nedeniyle opere olduğu öğrenildi. Hastanın lomber spinal MRG ve BT tetkiklerinde, L1 osteoporotik kompresyon fraktürü saptanarak perkütan vertebroplasti yapıldı. Operasyon sonrası Kauda Equine sendromu saptanan hastanın yapılan lomber spinal BT tetkikinde Polimetilmetakrilat'ın (PMMA) anterior epidural mesafeye sızdığı görüldü. Hasta operasyona alınarak L1 total laminektomi yapıldı. Sonuç: Perkütan vertebroplasti, osteoporotik vertebral kompresyon fraktürlerinde etkin bir tedavi yöntemidir. PVP uygulanan hastalarda, PMM sızıntısı sık karşılaşılan bir durum olmasına ragmen, genellikle klinik bulguya neden olmadığından önemsenmemektedir. Fakat bu olguda göstermektedir ki, PVP sonrasında gelişen nörolojik defisitlerde, kesinlikle erken görüntüleme tetkiki yapılıp uygun olmayan PMMA sızıntısı tespit edilmeli ve gerekli durumunlarda hastaya erken cerrahi müdahale yapılmalıdır. anahtar kelimeler: Kauda Equina sendromu, komplikasyon, perkütan vertebroplasti