Serdar Kabatas | Sağlık Bilimleri Üniversitesi (original) (raw)
Papers by Serdar Kabatas
Neurospine, 2021
Objective: To evaluate the quality and reliability of carpal tunnel syndrome surgery videos on Yo... more Objective: To evaluate the quality and reliability of carpal tunnel syndrome surgery videos on YouTube. Methods: A keyword set of "carpal tunnel syndrome surgery" was searched on YouTube. The DISCERN scoring system, Journal of the American Medical Association (JAMA) scoring system, and Health on the Net (HON) ranking systems were used to evaluate the quality and reliability of the first 50 videos appeared in the search results. The characteristics of each video, such as the number of likes, dislikes and views, upload days, video length, and the uploader, were collected retrospectively. The relationships between the video quality and these factors were investigated statistically. Results: All of the featured videos sorted were found to be of poor content (mean DISCERN score [n = 1.71 of 5], mean JAMA score [n = 1.76 of 4], mean HON score [n = 5.65 of 16]). Yet, DISCERN scores of the videos uploaded by medical centers were higher than that of the others (p = 0.022). No relationship was detected between the other variables and video quality. Conclusion: Healthcare professionals and organizations should be more cautious when recording and uploading a video to the online platforms. As those videos could reach a wide audience, their content should provide more information about possible complications of a treatment and other treatment modalities.
Sinir Sistemi Cerrahisi Dergisi, 2021
Spinal cord injuries cause psychological in humans and require expensive care and treatments. In ... more Spinal cord injuries cause psychological in humans and require expensive care and treatments. In recent years, various pharmacological agents have been tested in acute spinal cord injuries. Prospective randomized controlled clinical trials on a large scale have failed to demonstrate significant neurological progression, in contrast to their success in the laboratory. The search for an effective neuroprotective pharmacological agent to prevent secondary damage in acute spinal cord injuries remains primary goals for basic sciences and clinicians.
Turkish Journal of Agriculture - Food Science and Technology, 2020
Lumbar disc herniation (LDH) is a common cause of low back pain and radicular pain. The aim of ou... more Lumbar disc herniation (LDH) is a common cause of low back pain and radicular pain. The aim of our study was to evaluate the regression of LDH in patients who are considered to require surgical treatment but prefer conservative treatment. Patients who presented between January 2018 and June 2020 and who did not accept the recommended surgical treatment following a diagnosis of LDH based on clinical and radiological findings were retrospectively reviewed. All 12 of the patients included in the study showed spontaneous regression of LDH during outpatient clinical follow-up. Our study included 12 patients (seven male and five female). The mean age was 46.5 (the youngest was 30 years old; the oldest was 70 years old). Regression was observed at the L2-L3 level in two patients (10%), at the L4-L5 level in four patients (40%), and at the L5-S1 level in six patients (50%). On the follow-up examination of all patients, the severity of their pain was evaluated with the Visual Analogue Scale,...
Turkish Neurosurgery, 2020
AIM: To elucidate the characteristics of kyphoplasty in correlation with spinal metastasis. MATER... more AIM: To elucidate the characteristics of kyphoplasty in correlation with spinal metastasis. MATERIAL and METHODS: Data of patients treated by kyphoplasty between January 2017 and December 2019 were reviewed retrospectively. Preoperative prophylactic antibiotics and low-molecular-weight heparin injections were performed. Postoperative follow-up was conducted at least 24 hours after the procedure. All patients were treated under sedoanalgesia. Bone biopsies were collected from all patients. RESULTS: One hundred ninety-nine vertebra fractures were treated in 130 patients. The mean age of the patients was 65.27 ± 8.79 years (18-90 years) and 66 patients were male (50.7%). Forty-five patients had osteoporosis, six patients showed malignancy, and osteomyelitis was found in three patients, while the others' presentations were secondary to trauma. Most commonly, the L1 (n=59), Th12 (n=45), and L2 (n=34) levels were found to develop vertebral fractures. Forty patients had multiple levels of vertebral fracture, with a higher rate of osteoporosis (n=24; 60%). Three patients showed undiagnosed oncologic disease with an initial diagnosis of acute fracture following minor trauma, while the primary oncologic diagnosis was established by bone biopsy taken during the routine procedure in each procedure (e.g., plasmacytoma, lymphoma, adenocarcinoma of the lung). None of the patients developed an infection due to kyphoplasty, permanent neuromotor deficit, or mortality. The mean postoperative hospital length of stay was 1.6 days. CONCLUSION: Bone biopsy should be performed to diagnose early spinal metastases. Although an accurate bone biopsy may not be obtained from some patients, particularly from those with osteoporosis, performing bone biopsy during the procedure does not cause time loss or any other complications, and protects the surgeon from possible medicolegal problems.
Turkish Neurosurgery, 2020
AIM: To reveal difficulties in differential diagnosis of some cases of cerebrovascular events (CV... more AIM: To reveal difficulties in differential diagnosis of some cases of cerebrovascular events (CVEs) and malignant primary brain tumors (MBTs) even a multidiciplinary evaluation in grand rounds. MATERIAL and METHODS: This study retrospectively analyzed the patient archives from January 2017-December 2019. The records of 572 patients discussed in these meetings were examined. A total of 8 patients having a challenge in differential diagnosis were detected. RESULTS: This study has included 8 cases in which neurology−neurosurgery−neuroradiology clinicians have difficulty in differentiating CVE and MBT. In the present study, three patients were evaluated with a preliminary diagnosis of hemorrhagic CVE in the emergency room. Since degradation products of hemoglobin have prevented advanced imaging methods to diagnose in two patients, these patients have been followed closely. The correct diagnosis could be made through the scan performed during control follow-ups The preliminary diagnosis of seven patients was CVE, but they received the MBT diagnosis during the follow-up. One patient was thought to have MBT initially; however, he/she was diagnosed with CVE after an advanced examination and close follow-up. CONCLUSION: Despite developing medical imaging methods and diagnostic studies, there are still some difficulties in making differential diagnosis of CVEs and MBTs. In some patients, further examination and imaging methods may be needed such as magnetic resonance imaging-spectroscopy (MRI-S), perfusion magnetic resonance imaging (Per-MRI), digital substratioangiography (DSA). Despite all these neuroradiological examinations and multidiciplinary evaluation, distinction between CVE and MBT may be difficult, and medicolegal problems may be encountered.
Bratislava Medical Journal, 2018
OBJECTIVE: This study aimed to analyze the effect of human Dental Pulp-Neural Crest Stem Cells (h... more OBJECTIVE: This study aimed to analyze the effect of human Dental Pulp-Neural Crest Stem Cells (hDP-NCSCs) delivery on lesion site after spinal cord injury (SCI), and to observe the functional recovery after transplantation. METHODS: Neural Crest Stem Cells (NCSCs) were isolated from human Dental Pulp (hDP). The experimental rat population was divided into four groups (n = 6/24). Their behavioral motility was scored regularly. After 4-weeks, rats were sacrifi ced, and their spinal cords were examined for Green Fluorescent Protein (GFP) labeled hDP-NCSCs by immunofl uorescence (IF) staining. RESULTS: In early post-injury (p.i) period, the ultrastructure of spinal cord tissue was preserved in Group 4. The majority of cells forming the ependymal region around the central canal were found to be hDP-NCSCs. While the grey-and-white-matter around the ependymal region was composed of e.g. GFP cells, with astrocytic-like appearance. The scores showed signifi cant motor recovery in hind limb functions in Group 4. However, no obvious change was observed in other groups. CONCLUSION: Cells e.g., mesenchymal (Vimentin+) which express GFP+ cells in the gray-and-white-matter around the ependymal region could indicate the potential to self-renewal and plasticity. Thus, transplantation of hDP-NCSCs might be an effective strategy to improve functional recovery following spinal cord trauma (Fig.
European Journal of General Medicine, 2010
Journal of Korean Neurosurgical Society, 2019
Objective : Spinal cord injury (SCI) is a very serious health problem, usually caused by a trauma... more Objective : Spinal cord injury (SCI) is a very serious health problem, usually caused by a trauma and accompanied by elevated levels of inflammation indicators. Stem cell-based therapy is promising some valuable strategies for its functional recovery. Nestinpositive progenitor and/or stem cells (SC) isolated from pancreatic islets (PI) show mesenchymal stem cell (MSC) characteristics. For this reason, we aimed to analyze the effects of rat pancreatic islet derived stem cell (rPI-SC) delivery on functional recovery, as well as the levels of inflammation factors following SCI. Methods : rPI-SCs were isolated, cultured and their MSC characteristics were determined through flow cytometry and immunofluorescence analysis. The experimental rat population was divided into three groups : 1) laminectomy & trauma, 2) laminectomy & trauma & phosphate-buffered saline (PBS), and 3) laminectomy+trauma+SCs. Green fluorescent protein (GFP) labelled rPI-SCs were transplanted into the injured rat spinal cord. Their motilities were evaluated with Basso, Beattie and Bresnahan (BBB) Score. After 4-weeks, spinal cord sections were analyzed for GFP labeled SCs and stained for vimentin, S100β, brain derived neurotrophic factor (BDNF), 2',3'-cyclic-nucleotide 3'-phosphodiesterase (CNPase), vascular endothelial growth factor (VEGF) and proinflammatory (interleukin [IL]-6, transforming growth factor [TGF]-β, macrophage inflammatory protein [MIP]-2, myeloperoxidase [MPO]) and anti-inflammatory (IL-1 receptor antagonis) factors. Results : rPI-SCs were revealed to display MSC characteristics and express neural and glial cell markers including BDNF, glial fibrillary acidic protein (GFAP), fibronectin, microtubule associated protein-2a,b (MAP2a,b), β3-tubulin and nestin as well as antiinflammatory prostaglandin E2 receptor, EP3. The BBB scores showed significant motor recovery in group 3. GFP-labelled cells were localized on the injury site. In addition, decreased proinflammatory factor levels and increased intensity of anti-inflammatory factors were determined. Conclusion : Transplantation of PI-SCs might be an effective strategy to improve functional recovery following spinal cord trauma.
Sinir Sistemi Cerrahisi Dergisi, 2018
Periferik sinir hasarına özellikle ekstremite travmalarında sık karşılaşılmaktadır. Allogreft sin... more Periferik sinir hasarına özellikle ekstremite travmalarında sık karşılaşılmaktadır. Allogreft sinir transplantasyonu gerektirebileceği için çoğunlukla ihmal edilmektedir. Özellikle ekstremite düzeyinde gelişen sinir hasarında en sık kullanılan greft genellikle sural sinirdir. bulgular: Kesici alet ile altı ay önce sağ peroneal sinir hasarı gelişen 43 yaş erkek hastada 2/5 sağ ayak dorsifleksiyon ve total ayak eversion zaafiyeti mevcuttu. EMG sağ peroneal sinir total hasarı ile uyumluydu. 6. ayda sural sinir grefti ile peroneal sinir tamiri yapılan hasta ve cerrahi teknik sunulacaktır. Yöntem: Peroneal sinir kesisinin olduğu bölge eksplore edildi. Hasarın distal ve proksimal kısmı özenli diseke edilerek distalde tibial kasa uzanan yere kadar, proksimalde diz eklemine kadar peroneal sinir ortaya çıkarıldı ve hasarın iki ucunda kallus oluşan bölge eksize edildi. Yaklaşık 10 cm'lik sinir defekti saptanması sonrası sural sinir grefti alınması planlandı. Sağ ayak ekleminin lateralinde dış malleolun arkasında künt diseksiyon yapılarak sural sinir açığa çıkarıldı ve 10 cm kadar greft alınıp 8.0 sütür ile defekt alanına reimplante edildi. Sonuç: Hastanın altıncı ay poliklinik kontrolünde nörolojik muayenede minimal bir düzelme ve EMG de anlamlı bulgular saptandı. Periferik sinir transplantasyonu uygun şekilde yapıldığında hastanın hayat kalitesini iyileştiren bir yöntemdir.
Current protocols in stem cell biology, Jan 18, 2018
Human mesenchymal stromal stem cells (hMSCs) hold regenerative medicine potential due to their av... more Human mesenchymal stromal stem cells (hMSCs) hold regenerative medicine potential due to their availability, in vitro expansion readiness, and autologous feasibility. For neural repair, hMSCs show translational value in research on stroke, spinal cord injury (SCI), and traumatic brain injury. It is pivotal to establish multimodal in vitro systems to investigate molecular mechanisms underlying neural actions of hMSCs. Here, we describe a platform protocol on how to set up organotypic co-cultures of hMSCs (alone or polymer-scaffolded) with explanted adult rat dorsal root ganglia (DRGs) to determine neural injury and recovery events for designing implants to counteract neurotrauma sequelae. We emphasize in vitro hMSC propagation, polymer scaffolding, hMSC stemness maintenance, hMSC-DRG interaction profiling, and analytical formulas of neuroinflammation, trophic factor expression, DRG neurite outgrowth and tropic tracking, and in vivo verification of tailored implants in rodent models o...
Stem cells and development, Jan 9, 2018
Research endeavors originally generated stem cell definitions for the purpose of describing norma... more Research endeavors originally generated stem cell definitions for the purpose of describing normally sustainable developmental and tissue turnover processes in various species including humans. The notion of investigating cells that possess a vague capacity of "stamm (phylum)" can be traced back to the late 19th century, mainly concentrating on cells that could produce the germline or the entire blood system. Lately, such undertakings have been recapitulated for oncogenesis, tumor growth and cancer cell resistance to oncolytic therapies. However, due to the complexity and basic life-origin mechanisms comprising the genetic and epigenetic repertoire of the stemness in every developing or growing cell, presently there are ongoing debates regarding the biological essentials of the stem cell-like tumor initiation cells (i.e., cancer stem cells: CSCs). This conceptual analysis focuses on the potential pitfalls of extrapolating that CSCs bear major traits of stemness. We propose...
Joubert Syndrome (JS) in adult population is extremely rare. Here, we describe the first adult ca... more Joubert Syndrome (JS) in adult population is extremely rare. Here, we describe the first adult case seen in the Republic of Turkey. Our patient, a 19-year-old male, was diagnosed primarily by magnetic resonance imaging (MRI) finding of the typical “molar tooth sign”, in addition to JS clinical features such as mental retardation, hypotonia, dysarthria, nystagmus and ataxia. Detailed images of high resolution MRI, a review of the literature and a brief discussion are reported.
Cell transplantation, Jan 28, 2015
Intervertebral disk (IVD) degeneration is a common, chronic, and complex degeneration process tha... more Intervertebral disk (IVD) degeneration is a common, chronic, and complex degeneration process that frequently leads to back pain and disability, resulting in a major public health issue. In this review we describe biological therapies under preclinical or clinical development with an emphasis on stem cell-based multimodal approaches that target prevention and treatment of IVD degeneration. Systematical review of the basic science and clinical literature was performed to summarize the current status of devising biological approaches to treating IVD degeneration. Since the exact mechanisms underlying IVD degeneration have not yet been fully elucidated and conservative managements appear to be mostly ineffective, current surgical treatment focuses on removal of the pathological disk tissues combined with spinal fusion. The treatment options, however, often produce insufficient efficacy and even serious complications. Therefore, there have been growing demands and endeavors for developi...
Diagnostic and interventional radiology (Ankara, Turkey), 2007
The aim of this study was to determine the value of power Doppler ultrasonography in the differen... more The aim of this study was to determine the value of power Doppler ultrasonography in the differential diagnosis of intracranial extraaxial fluid collections in enlarged subarachnoid spaces. The study included 11 patients referred to our hospital's radiology department between April 2001 and February 2002 who were determined to have intracranial extraaxial effusion based on the results of cranial ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI). Transfontanel examinations of the enlarged subarachnoid spaces, including cortical vascular structures, with a 4-7 MHz linear probe were used to make differential diagnoses of extracerebral fluid collections. In 8 of the 11 patients, the diagnosis was an enlarged benign extraaxial subarachnoid space. In one case, the differentiation of mirror artifacts of an epidural hematoma from a cephalhematoma was constructed by the cortical vascular structure with power Doppler US. In 2 cases, subdural hematomas we...
![Research paper thumbnail of [Longitudinal clival fractures: a report of three cases]](https://attachments.academia-assets.com/88665102/thumbnails/1.jpg)
](Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES, 2006
Fractures of the clivus are often associated with severe head trauma and have high mortality rate... more Fractures of the clivus are often associated with severe head trauma and have high mortality rates due to coexisting injury of the adjacent vessels, brain stem and lower cranial nerves. An early diagnosis is often not possible because of adherent problems, high mortality rate and inadequacy of emergency imaging. Diagnosis has recently become easier with high resolution bone window computed tomography studies. In this study, radiological and clinical findings of three patients with longitudinal clival fractures and severe head trauma have been presented and associated injuries and prognostic issues are discussed with reference to the limited number of similar cases in the English literature.
Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES, 2004
Superior sagittal sinus thrombosis (SSST) is a rare entity, most often arising from infections, d... more Superior sagittal sinus thrombosis (SSST) is a rare entity, most often arising from infections, dehydration, and hematologic disorders. Development of this condition secondary to trauma is extremely rare. In this report, a 13-year-old boy who developed SSST following a closed head injury is presented. Imaging studies showed SSST caused by a depressed skull fracture. Neurologic examination of the patient was normal other than bilateral papillary stasis. He was treated with antiedematous and anticonvulsant drugs. Magnetic resonance venography obtained eight months after the diagnosis showed unoccluded superior sagittal sinus, neurologic examination findings were normal, as well.
Recent Patents on Regenerative Medicine, 2012
Surgical Science, 2011
The aim of this paper is to point out the growing clinical importance of Carpal tunnel syndrome i... more The aim of this paper is to point out the growing clinical importance of Carpal tunnel syndrome in patients on hemodialysis especially in aspect of the diagnosis, treatment and possible cause of the syndrome. Sixty patients with clinical diagnosis of Carpal Tunnel Syndrome was defined as the presence of two subjective symptoms (numbness, tingling in the median nerve distribution). The diagnosis was confirmed by electromyography. The patients with rheumatoid arthritis, thalasemia and thyroid dysfunction and the patients having pain due to arthritis or tenosynovitis were excluded. Fifty patients with clinical diagnosis of idiopathic CTS and seven hemodialysis patients having CTS were analyzed. Of 50 patients (47 female, 3 male) with clinical diagnosis of idiopathic CTS, 11 patients (22%) were involved bilaterally, 25 patients (50%) were affected only on the right and 14 patients (28%) were symptomatic only on the left. Of 7 hemodialysis patients (2 female, 5 male) with CTS, 1 patient (14%) was involved bilaterally (having two-sided A-V fistula), 4 patients (57%) were affected only on the right and 2 patients (28%) were symptomatic only on the left. There was significant correlation between the arteriovenous fistula and subsequent development of CTS. The all patients had fistulas in the affected side (5 of them were patent and 2 were occluded). In the relation between the duration of hemodialysis and development of CTS, 4 patients were over 10 years of hemodialysis, 2 patients were between 5 to 9 years and only 1 patient was below 4 years of duration. Amyloid deposit was demonstrated in 4 of 7 operated hands in the hemodialysis group. When we compared the presence of amyloid deposits in these groups, the difference between these two groups were found as statistically significant (p < 0.009). Although hemodialysis has no significant effect on development of fibrosis, the incidence of fibrosis was found as statistically significant in idiopathic carpal tunnel syndrome (p < 0.048). It is likely that there are numerous factors that may act either independently or in concert to potentiate the risk for developing CTS in patients on long-term hemodialysis.
Turkish Neurosurgery, 2011
AIm: This study aimed to analyze the effect of rat bone marrow-mesenchymal stem cells (rBM-MSCs) ... more AIm: This study aimed to analyze the effect of rat bone marrow-mesenchymal stem cells (rBM-MSCs) delivery on lesion site after spinal cord injury, and to observe the functional recovery after transplantation. mAterIAl and methOds: MSCs were isolated from rat femurs and tibias. The experimental rat population was divided into four groups: only laminectomy (1); laminectomy+trauma (2); laminectomy+trauma+PBS (3); laminectomy+trauma+MSCs (4). Their motility were scored regularly. After 4-weeks, rats were sacrificed, and their spinal cords were examined for GFP labeled rBM-MSCs by immunostainings. results: In the early posttraumatic period, the ultrastructures of spinal cord tissue were preserved in Group 4. The majority of cells forming the ependymal region around the central canal were found to be MSCs. The gray-and-white-matter around the ependymal region were composed of Nestin+/GFAP+ cells, with astrocytic-like appearance. The scores showed significant motor recovery in Group 4, especially in hind limb functions. However, no obvious change was observed in other groups. COnClusIOn: The increase Nestin+/GFAP+ cells in the gray-and-white-matter around the ependymal region could indicate the potential to self-renew and plasticity. Thus, transplantation of rBM-MSCs might be an effective strategy to improve functional recovery following spinal cord trauma. In conclusion, molecular factors in cell fate decisions could be manipulated to enhance reparative potential of cell-based therapy.
Turkish neurosurgery, 2008
The pyriformis syndrome is a rare entrapment neuropathy in which the sciatic nerve is compromised... more The pyriformis syndrome is a rare entrapment neuropathy in which the sciatic nerve is compromised by the pyriformis muscle or other local structures. It is an important cause of buttock pain that may often be accompanied by sciatica. The pain is usually increased by muscular contraction, palpation or prolonged sitting. The diagnosis relies on the clinical presentation and the electromyelography (EMG) findings. Other causes of symptoms should be excluded by careful examination and detailed neuroradiological studies of the lumbosacral spine, sacro-iliac and hip joints. A case of this syndrome seen in a 36-year-old man who recovered by CT-guided corticosteroid injection is reported.
Neurospine, 2021
Objective: To evaluate the quality and reliability of carpal tunnel syndrome surgery videos on Yo... more Objective: To evaluate the quality and reliability of carpal tunnel syndrome surgery videos on YouTube. Methods: A keyword set of "carpal tunnel syndrome surgery" was searched on YouTube. The DISCERN scoring system, Journal of the American Medical Association (JAMA) scoring system, and Health on the Net (HON) ranking systems were used to evaluate the quality and reliability of the first 50 videos appeared in the search results. The characteristics of each video, such as the number of likes, dislikes and views, upload days, video length, and the uploader, were collected retrospectively. The relationships between the video quality and these factors were investigated statistically. Results: All of the featured videos sorted were found to be of poor content (mean DISCERN score [n = 1.71 of 5], mean JAMA score [n = 1.76 of 4], mean HON score [n = 5.65 of 16]). Yet, DISCERN scores of the videos uploaded by medical centers were higher than that of the others (p = 0.022). No relationship was detected between the other variables and video quality. Conclusion: Healthcare professionals and organizations should be more cautious when recording and uploading a video to the online platforms. As those videos could reach a wide audience, their content should provide more information about possible complications of a treatment and other treatment modalities.
Sinir Sistemi Cerrahisi Dergisi, 2021
Spinal cord injuries cause psychological in humans and require expensive care and treatments. In ... more Spinal cord injuries cause psychological in humans and require expensive care and treatments. In recent years, various pharmacological agents have been tested in acute spinal cord injuries. Prospective randomized controlled clinical trials on a large scale have failed to demonstrate significant neurological progression, in contrast to their success in the laboratory. The search for an effective neuroprotective pharmacological agent to prevent secondary damage in acute spinal cord injuries remains primary goals for basic sciences and clinicians.
Turkish Journal of Agriculture - Food Science and Technology, 2020
Lumbar disc herniation (LDH) is a common cause of low back pain and radicular pain. The aim of ou... more Lumbar disc herniation (LDH) is a common cause of low back pain and radicular pain. The aim of our study was to evaluate the regression of LDH in patients who are considered to require surgical treatment but prefer conservative treatment. Patients who presented between January 2018 and June 2020 and who did not accept the recommended surgical treatment following a diagnosis of LDH based on clinical and radiological findings were retrospectively reviewed. All 12 of the patients included in the study showed spontaneous regression of LDH during outpatient clinical follow-up. Our study included 12 patients (seven male and five female). The mean age was 46.5 (the youngest was 30 years old; the oldest was 70 years old). Regression was observed at the L2-L3 level in two patients (10%), at the L4-L5 level in four patients (40%), and at the L5-S1 level in six patients (50%). On the follow-up examination of all patients, the severity of their pain was evaluated with the Visual Analogue Scale,...
Turkish Neurosurgery, 2020
AIM: To elucidate the characteristics of kyphoplasty in correlation with spinal metastasis. MATER... more AIM: To elucidate the characteristics of kyphoplasty in correlation with spinal metastasis. MATERIAL and METHODS: Data of patients treated by kyphoplasty between January 2017 and December 2019 were reviewed retrospectively. Preoperative prophylactic antibiotics and low-molecular-weight heparin injections were performed. Postoperative follow-up was conducted at least 24 hours after the procedure. All patients were treated under sedoanalgesia. Bone biopsies were collected from all patients. RESULTS: One hundred ninety-nine vertebra fractures were treated in 130 patients. The mean age of the patients was 65.27 ± 8.79 years (18-90 years) and 66 patients were male (50.7%). Forty-five patients had osteoporosis, six patients showed malignancy, and osteomyelitis was found in three patients, while the others' presentations were secondary to trauma. Most commonly, the L1 (n=59), Th12 (n=45), and L2 (n=34) levels were found to develop vertebral fractures. Forty patients had multiple levels of vertebral fracture, with a higher rate of osteoporosis (n=24; 60%). Three patients showed undiagnosed oncologic disease with an initial diagnosis of acute fracture following minor trauma, while the primary oncologic diagnosis was established by bone biopsy taken during the routine procedure in each procedure (e.g., plasmacytoma, lymphoma, adenocarcinoma of the lung). None of the patients developed an infection due to kyphoplasty, permanent neuromotor deficit, or mortality. The mean postoperative hospital length of stay was 1.6 days. CONCLUSION: Bone biopsy should be performed to diagnose early spinal metastases. Although an accurate bone biopsy may not be obtained from some patients, particularly from those with osteoporosis, performing bone biopsy during the procedure does not cause time loss or any other complications, and protects the surgeon from possible medicolegal problems.
Turkish Neurosurgery, 2020
AIM: To reveal difficulties in differential diagnosis of some cases of cerebrovascular events (CV... more AIM: To reveal difficulties in differential diagnosis of some cases of cerebrovascular events (CVEs) and malignant primary brain tumors (MBTs) even a multidiciplinary evaluation in grand rounds. MATERIAL and METHODS: This study retrospectively analyzed the patient archives from January 2017-December 2019. The records of 572 patients discussed in these meetings were examined. A total of 8 patients having a challenge in differential diagnosis were detected. RESULTS: This study has included 8 cases in which neurology−neurosurgery−neuroradiology clinicians have difficulty in differentiating CVE and MBT. In the present study, three patients were evaluated with a preliminary diagnosis of hemorrhagic CVE in the emergency room. Since degradation products of hemoglobin have prevented advanced imaging methods to diagnose in two patients, these patients have been followed closely. The correct diagnosis could be made through the scan performed during control follow-ups The preliminary diagnosis of seven patients was CVE, but they received the MBT diagnosis during the follow-up. One patient was thought to have MBT initially; however, he/she was diagnosed with CVE after an advanced examination and close follow-up. CONCLUSION: Despite developing medical imaging methods and diagnostic studies, there are still some difficulties in making differential diagnosis of CVEs and MBTs. In some patients, further examination and imaging methods may be needed such as magnetic resonance imaging-spectroscopy (MRI-S), perfusion magnetic resonance imaging (Per-MRI), digital substratioangiography (DSA). Despite all these neuroradiological examinations and multidiciplinary evaluation, distinction between CVE and MBT may be difficult, and medicolegal problems may be encountered.
Bratislava Medical Journal, 2018
OBJECTIVE: This study aimed to analyze the effect of human Dental Pulp-Neural Crest Stem Cells (h... more OBJECTIVE: This study aimed to analyze the effect of human Dental Pulp-Neural Crest Stem Cells (hDP-NCSCs) delivery on lesion site after spinal cord injury (SCI), and to observe the functional recovery after transplantation. METHODS: Neural Crest Stem Cells (NCSCs) were isolated from human Dental Pulp (hDP). The experimental rat population was divided into four groups (n = 6/24). Their behavioral motility was scored regularly. After 4-weeks, rats were sacrifi ced, and their spinal cords were examined for Green Fluorescent Protein (GFP) labeled hDP-NCSCs by immunofl uorescence (IF) staining. RESULTS: In early post-injury (p.i) period, the ultrastructure of spinal cord tissue was preserved in Group 4. The majority of cells forming the ependymal region around the central canal were found to be hDP-NCSCs. While the grey-and-white-matter around the ependymal region was composed of e.g. GFP cells, with astrocytic-like appearance. The scores showed signifi cant motor recovery in hind limb functions in Group 4. However, no obvious change was observed in other groups. CONCLUSION: Cells e.g., mesenchymal (Vimentin+) which express GFP+ cells in the gray-and-white-matter around the ependymal region could indicate the potential to self-renewal and plasticity. Thus, transplantation of hDP-NCSCs might be an effective strategy to improve functional recovery following spinal cord trauma (Fig.
European Journal of General Medicine, 2010
Journal of Korean Neurosurgical Society, 2019
Objective : Spinal cord injury (SCI) is a very serious health problem, usually caused by a trauma... more Objective : Spinal cord injury (SCI) is a very serious health problem, usually caused by a trauma and accompanied by elevated levels of inflammation indicators. Stem cell-based therapy is promising some valuable strategies for its functional recovery. Nestinpositive progenitor and/or stem cells (SC) isolated from pancreatic islets (PI) show mesenchymal stem cell (MSC) characteristics. For this reason, we aimed to analyze the effects of rat pancreatic islet derived stem cell (rPI-SC) delivery on functional recovery, as well as the levels of inflammation factors following SCI. Methods : rPI-SCs were isolated, cultured and their MSC characteristics were determined through flow cytometry and immunofluorescence analysis. The experimental rat population was divided into three groups : 1) laminectomy & trauma, 2) laminectomy & trauma & phosphate-buffered saline (PBS), and 3) laminectomy+trauma+SCs. Green fluorescent protein (GFP) labelled rPI-SCs were transplanted into the injured rat spinal cord. Their motilities were evaluated with Basso, Beattie and Bresnahan (BBB) Score. After 4-weeks, spinal cord sections were analyzed for GFP labeled SCs and stained for vimentin, S100β, brain derived neurotrophic factor (BDNF), 2',3'-cyclic-nucleotide 3'-phosphodiesterase (CNPase), vascular endothelial growth factor (VEGF) and proinflammatory (interleukin [IL]-6, transforming growth factor [TGF]-β, macrophage inflammatory protein [MIP]-2, myeloperoxidase [MPO]) and anti-inflammatory (IL-1 receptor antagonis) factors. Results : rPI-SCs were revealed to display MSC characteristics and express neural and glial cell markers including BDNF, glial fibrillary acidic protein (GFAP), fibronectin, microtubule associated protein-2a,b (MAP2a,b), β3-tubulin and nestin as well as antiinflammatory prostaglandin E2 receptor, EP3. The BBB scores showed significant motor recovery in group 3. GFP-labelled cells were localized on the injury site. In addition, decreased proinflammatory factor levels and increased intensity of anti-inflammatory factors were determined. Conclusion : Transplantation of PI-SCs might be an effective strategy to improve functional recovery following spinal cord trauma.
Sinir Sistemi Cerrahisi Dergisi, 2018
Periferik sinir hasarına özellikle ekstremite travmalarında sık karşılaşılmaktadır. Allogreft sin... more Periferik sinir hasarına özellikle ekstremite travmalarında sık karşılaşılmaktadır. Allogreft sinir transplantasyonu gerektirebileceği için çoğunlukla ihmal edilmektedir. Özellikle ekstremite düzeyinde gelişen sinir hasarında en sık kullanılan greft genellikle sural sinirdir. bulgular: Kesici alet ile altı ay önce sağ peroneal sinir hasarı gelişen 43 yaş erkek hastada 2/5 sağ ayak dorsifleksiyon ve total ayak eversion zaafiyeti mevcuttu. EMG sağ peroneal sinir total hasarı ile uyumluydu. 6. ayda sural sinir grefti ile peroneal sinir tamiri yapılan hasta ve cerrahi teknik sunulacaktır. Yöntem: Peroneal sinir kesisinin olduğu bölge eksplore edildi. Hasarın distal ve proksimal kısmı özenli diseke edilerek distalde tibial kasa uzanan yere kadar, proksimalde diz eklemine kadar peroneal sinir ortaya çıkarıldı ve hasarın iki ucunda kallus oluşan bölge eksize edildi. Yaklaşık 10 cm'lik sinir defekti saptanması sonrası sural sinir grefti alınması planlandı. Sağ ayak ekleminin lateralinde dış malleolun arkasında künt diseksiyon yapılarak sural sinir açığa çıkarıldı ve 10 cm kadar greft alınıp 8.0 sütür ile defekt alanına reimplante edildi. Sonuç: Hastanın altıncı ay poliklinik kontrolünde nörolojik muayenede minimal bir düzelme ve EMG de anlamlı bulgular saptandı. Periferik sinir transplantasyonu uygun şekilde yapıldığında hastanın hayat kalitesini iyileştiren bir yöntemdir.
Current protocols in stem cell biology, Jan 18, 2018
Human mesenchymal stromal stem cells (hMSCs) hold regenerative medicine potential due to their av... more Human mesenchymal stromal stem cells (hMSCs) hold regenerative medicine potential due to their availability, in vitro expansion readiness, and autologous feasibility. For neural repair, hMSCs show translational value in research on stroke, spinal cord injury (SCI), and traumatic brain injury. It is pivotal to establish multimodal in vitro systems to investigate molecular mechanisms underlying neural actions of hMSCs. Here, we describe a platform protocol on how to set up organotypic co-cultures of hMSCs (alone or polymer-scaffolded) with explanted adult rat dorsal root ganglia (DRGs) to determine neural injury and recovery events for designing implants to counteract neurotrauma sequelae. We emphasize in vitro hMSC propagation, polymer scaffolding, hMSC stemness maintenance, hMSC-DRG interaction profiling, and analytical formulas of neuroinflammation, trophic factor expression, DRG neurite outgrowth and tropic tracking, and in vivo verification of tailored implants in rodent models o...
Stem cells and development, Jan 9, 2018
Research endeavors originally generated stem cell definitions for the purpose of describing norma... more Research endeavors originally generated stem cell definitions for the purpose of describing normally sustainable developmental and tissue turnover processes in various species including humans. The notion of investigating cells that possess a vague capacity of "stamm (phylum)" can be traced back to the late 19th century, mainly concentrating on cells that could produce the germline or the entire blood system. Lately, such undertakings have been recapitulated for oncogenesis, tumor growth and cancer cell resistance to oncolytic therapies. However, due to the complexity and basic life-origin mechanisms comprising the genetic and epigenetic repertoire of the stemness in every developing or growing cell, presently there are ongoing debates regarding the biological essentials of the stem cell-like tumor initiation cells (i.e., cancer stem cells: CSCs). This conceptual analysis focuses on the potential pitfalls of extrapolating that CSCs bear major traits of stemness. We propose...
Joubert Syndrome (JS) in adult population is extremely rare. Here, we describe the first adult ca... more Joubert Syndrome (JS) in adult population is extremely rare. Here, we describe the first adult case seen in the Republic of Turkey. Our patient, a 19-year-old male, was diagnosed primarily by magnetic resonance imaging (MRI) finding of the typical “molar tooth sign”, in addition to JS clinical features such as mental retardation, hypotonia, dysarthria, nystagmus and ataxia. Detailed images of high resolution MRI, a review of the literature and a brief discussion are reported.
Cell transplantation, Jan 28, 2015
Intervertebral disk (IVD) degeneration is a common, chronic, and complex degeneration process tha... more Intervertebral disk (IVD) degeneration is a common, chronic, and complex degeneration process that frequently leads to back pain and disability, resulting in a major public health issue. In this review we describe biological therapies under preclinical or clinical development with an emphasis on stem cell-based multimodal approaches that target prevention and treatment of IVD degeneration. Systematical review of the basic science and clinical literature was performed to summarize the current status of devising biological approaches to treating IVD degeneration. Since the exact mechanisms underlying IVD degeneration have not yet been fully elucidated and conservative managements appear to be mostly ineffective, current surgical treatment focuses on removal of the pathological disk tissues combined with spinal fusion. The treatment options, however, often produce insufficient efficacy and even serious complications. Therefore, there have been growing demands and endeavors for developi...
Diagnostic and interventional radiology (Ankara, Turkey), 2007
The aim of this study was to determine the value of power Doppler ultrasonography in the differen... more The aim of this study was to determine the value of power Doppler ultrasonography in the differential diagnosis of intracranial extraaxial fluid collections in enlarged subarachnoid spaces. The study included 11 patients referred to our hospital's radiology department between April 2001 and February 2002 who were determined to have intracranial extraaxial effusion based on the results of cranial ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI). Transfontanel examinations of the enlarged subarachnoid spaces, including cortical vascular structures, with a 4-7 MHz linear probe were used to make differential diagnoses of extracerebral fluid collections. In 8 of the 11 patients, the diagnosis was an enlarged benign extraaxial subarachnoid space. In one case, the differentiation of mirror artifacts of an epidural hematoma from a cephalhematoma was constructed by the cortical vascular structure with power Doppler US. In 2 cases, subdural hematomas we...
Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES, 2006
Fractures of the clivus are often associated with severe head trauma and have high mortality rate... more Fractures of the clivus are often associated with severe head trauma and have high mortality rates due to coexisting injury of the adjacent vessels, brain stem and lower cranial nerves. An early diagnosis is often not possible because of adherent problems, high mortality rate and inadequacy of emergency imaging. Diagnosis has recently become easier with high resolution bone window computed tomography studies. In this study, radiological and clinical findings of three patients with longitudinal clival fractures and severe head trauma have been presented and associated injuries and prognostic issues are discussed with reference to the limited number of similar cases in the English literature.
Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES, 2004
Superior sagittal sinus thrombosis (SSST) is a rare entity, most often arising from infections, d... more Superior sagittal sinus thrombosis (SSST) is a rare entity, most often arising from infections, dehydration, and hematologic disorders. Development of this condition secondary to trauma is extremely rare. In this report, a 13-year-old boy who developed SSST following a closed head injury is presented. Imaging studies showed SSST caused by a depressed skull fracture. Neurologic examination of the patient was normal other than bilateral papillary stasis. He was treated with antiedematous and anticonvulsant drugs. Magnetic resonance venography obtained eight months after the diagnosis showed unoccluded superior sagittal sinus, neurologic examination findings were normal, as well.
Recent Patents on Regenerative Medicine, 2012
Surgical Science, 2011
The aim of this paper is to point out the growing clinical importance of Carpal tunnel syndrome i... more The aim of this paper is to point out the growing clinical importance of Carpal tunnel syndrome in patients on hemodialysis especially in aspect of the diagnosis, treatment and possible cause of the syndrome. Sixty patients with clinical diagnosis of Carpal Tunnel Syndrome was defined as the presence of two subjective symptoms (numbness, tingling in the median nerve distribution). The diagnosis was confirmed by electromyography. The patients with rheumatoid arthritis, thalasemia and thyroid dysfunction and the patients having pain due to arthritis or tenosynovitis were excluded. Fifty patients with clinical diagnosis of idiopathic CTS and seven hemodialysis patients having CTS were analyzed. Of 50 patients (47 female, 3 male) with clinical diagnosis of idiopathic CTS, 11 patients (22%) were involved bilaterally, 25 patients (50%) were affected only on the right and 14 patients (28%) were symptomatic only on the left. Of 7 hemodialysis patients (2 female, 5 male) with CTS, 1 patient (14%) was involved bilaterally (having two-sided A-V fistula), 4 patients (57%) were affected only on the right and 2 patients (28%) were symptomatic only on the left. There was significant correlation between the arteriovenous fistula and subsequent development of CTS. The all patients had fistulas in the affected side (5 of them were patent and 2 were occluded). In the relation between the duration of hemodialysis and development of CTS, 4 patients were over 10 years of hemodialysis, 2 patients were between 5 to 9 years and only 1 patient was below 4 years of duration. Amyloid deposit was demonstrated in 4 of 7 operated hands in the hemodialysis group. When we compared the presence of amyloid deposits in these groups, the difference between these two groups were found as statistically significant (p < 0.009). Although hemodialysis has no significant effect on development of fibrosis, the incidence of fibrosis was found as statistically significant in idiopathic carpal tunnel syndrome (p < 0.048). It is likely that there are numerous factors that may act either independently or in concert to potentiate the risk for developing CTS in patients on long-term hemodialysis.
Turkish Neurosurgery, 2011
AIm: This study aimed to analyze the effect of rat bone marrow-mesenchymal stem cells (rBM-MSCs) ... more AIm: This study aimed to analyze the effect of rat bone marrow-mesenchymal stem cells (rBM-MSCs) delivery on lesion site after spinal cord injury, and to observe the functional recovery after transplantation. mAterIAl and methOds: MSCs were isolated from rat femurs and tibias. The experimental rat population was divided into four groups: only laminectomy (1); laminectomy+trauma (2); laminectomy+trauma+PBS (3); laminectomy+trauma+MSCs (4). Their motility were scored regularly. After 4-weeks, rats were sacrificed, and their spinal cords were examined for GFP labeled rBM-MSCs by immunostainings. results: In the early posttraumatic period, the ultrastructures of spinal cord tissue were preserved in Group 4. The majority of cells forming the ependymal region around the central canal were found to be MSCs. The gray-and-white-matter around the ependymal region were composed of Nestin+/GFAP+ cells, with astrocytic-like appearance. The scores showed significant motor recovery in Group 4, especially in hind limb functions. However, no obvious change was observed in other groups. COnClusIOn: The increase Nestin+/GFAP+ cells in the gray-and-white-matter around the ependymal region could indicate the potential to self-renew and plasticity. Thus, transplantation of rBM-MSCs might be an effective strategy to improve functional recovery following spinal cord trauma. In conclusion, molecular factors in cell fate decisions could be manipulated to enhance reparative potential of cell-based therapy.
Turkish neurosurgery, 2008
The pyriformis syndrome is a rare entrapment neuropathy in which the sciatic nerve is compromised... more The pyriformis syndrome is a rare entrapment neuropathy in which the sciatic nerve is compromised by the pyriformis muscle or other local structures. It is an important cause of buttock pain that may often be accompanied by sciatica. The pain is usually increased by muscular contraction, palpation or prolonged sitting. The diagnosis relies on the clinical presentation and the electromyelography (EMG) findings. Other causes of symptoms should be excluded by careful examination and detailed neuroradiological studies of the lumbosacral spine, sacro-iliac and hip joints. A case of this syndrome seen in a 36-year-old man who recovered by CT-guided corticosteroid injection is reported.