Browsing by Author "Ak, Hakan"

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The Acute Effects of Thymoquinone on Acute Peripheral Nerve Injury: an Experimental Study
(Turkish Assoc Trauma Emergency Surgery, 2016) Gulsen, Ismail; Ak, Hakan; Kara, Mikail; Gokalp, Abdulsemat; Akyol, Veysel; Kocak, Omer Faruk; Ragbetli, Murat Cetin
BACKGROUND: The purpose of this study was to evaluate the acute effects of thymoquinone (TQ) on acute nerve injury. METHODS: A rat model of crush injury of the sciatic nerve was used. Animals were divided into 3 groups: control, trauma, and TQ treatment groups (n=6 per group). Seven days after injury, sciatic nerve specimens were obtained from the site of the injury and analyzed histologically and stereologically. Axon diameter, myelin thickness, and axon density were measured. RESULTS: There were no significant differences in axon diameter, myelin thickness, or axon density among groups. CONCLUSION: TQ has no acute therapeutic effect on acute nerve injury.
Are Blank Cartridge Guns Really Harmless
(Turkish Assoc Trauma Emergency Surgery, 2014) Gulsen, Ismail; Ak, Hakan; Sosuncu, Enver; Bulut, Mehmet Deniz
Blank cartridge guns are devices that discharge sound and gas, but no bullet or shot. These devices are very similar to real guns in the form of their external design and the sound generated during their firing. Although it is widely held in society that these devices are harmless, reports from Turkey and the world have shown that these guns are not entirely innocent. Herein, we present a 26-year-old male with a head injury due to gunshot from a blank cartridge. The purpose of this presentation is to emphasize that these devices are not harmless, contrary to common public opinion.
The Association of the Epidermoid Cyst of the Filum Terminale, Intradural Spinal Lipoma, Tethered Cord, Dermal Sinus Tract, and Type I Diastematomyelia in a Child
(Elsevier Science inc, 2014) Ak, Hakan; Atalay, Tugay; Gulsen, Ismail
The Effect of Povidone-Iodine on Peridural Fibrosis in Spinal Surgery
(Journal Neurological Sciences, 2014) Samancioglu, Halil; Yaycioglu, Soner; Ak, Hakan; Tataroglu, Canten; Gulsen, Ismail
Aim: The purpose of this study was to evaluate whether povidone-iodine has any incremental effect on peridural fibrosis in spinal surgery. Materials and methods: 24 albino rats were used for this experimental study. They were divided into three groups. In the first group (n= 8) only Th8-Th12 laminectomy was performed (control group). In the second group (n= 8), laminectomy area was irrigated with 2.5% concentrated povidone-iodine for 30s seconds. In the third group (n= 8), laminectomy area was irrigated with 10% concentrated povidone-iodine for 30 seconds. In pathological specimens, fibrosis length and fibrosis area was calculated and compared between groups. Results: Peridural fibrosis length and fibrosis area didn't show statistically significant difference between all groups. Conclusion: Povidone-iodine has not increasing effect on peridural fibrosis so it may be safely used in spinal surgery when it is needed.
The Effects of Caffeic Acid Phenethyl Ester on Inflammatory Cytokines After Acute Spinal Cord Injury
(Turkish Assoc Trauma Emergency Surgery, 2015) Ak, Hakan; Gulsen, Ismail; Karaaslan, Tamer; Alaca, Ilker; Candan, Aydin; Kocak, Havva; Yilmaz, Tevfik
BACKGROUND: The purpose of this study was to investigate the effects of Caffeic Acid Phenethyl Ester (CAPE) on proinflammatory cytokines, IL-1 beta and TNF-alpha, and explore its healing effect after acute spinal cord injury. METHODS: Forty-eight male Wistar-Albino rats were used in this study which was planned as three groups. All groups were divided into two sub-groups. Group la was the control group, in which only lower segment thoracic laminectomy was performed. In group lb, spinal cord trauma was performed with aneurysm clip. In the second group, serum physiologic was given systemically thirty minutes after trauma, and rats were sacrificed after the first and sixth hour. In the third group, CAPE was given systemically thirty minutes after trauma, and rats were sacrificed after the first and sixth hour. Serum IL-1 beta and TNF-alpha levels were analyzed by ELISA in the serum. Histopathological analysis was performed in damaged cord tissues. RESULTS: CAPE suppressed TNF-alpha and IL-1 beta levels in the serum. In histopathological evaluation, it was detected that CAPE decreased hemorrhage and necrosis. CONCLUSION: CAPE suppresses the levels of proinflammatory cytokines, TNF-alpha and IL-1 beta, after acute spinal cord injury in the early phase and contributes to the healing process.
The Effects of Membranous Abnormalities on Mortality and Morbidity in Chronic Subdural Hematomas
(Journal Neurological Sciences, 2015) Ak, Hakan; Gulsen, Ismail; Yaycioglu, Soner; Atalay, Tugay; Demir, Ismail; Sosuncu, Enver; Arslan, Mehmet
Objective: Our aim was to evaluate the effects of membranous abnormalities on morbidity and mortality in chronic subdural hematomas (CSDH). Methodology: This retrospective study included 116 patients operated in three different hospitals during last three years. Patients were analyzed for the presence of trauma, operation type, recurrence, complication/s, presence of membranous abnormalities like thick outer membrane and septa formation, and mortality. Results: The mean age of the patients 62,06 +/- 11.4 ranging between 42 and 87. 78 (67.2%) of them were male and 38 (32.8%) were female The most common predisposing factor was the trauma especially in male gender. The presence of membranous abnormalities played significant effects on recurrence and complication rates. However, it didn't have significant effect on mortality. Conclusion: Trauma is still the most common etiological factor in chronic subdural hematomas. The presence of membranous abnormality in CSDH increases the recurrence and complication rates.
Effects of Resveratrol on Acute Sciatic Nerve Injury in a Rat Model
(Journal Neurological Sciences, 2015) Ak, Hakan; Gulsen, Ismail; Kara, Mikail; Atalay, Tugay; Akyol, Veysel; Ragbetli, Murat Cetin
Aim: This study evaluated the therapeutic efficacy of resveratrol (RVT), a naturally occurring polyphenol, during the management of acute nerve injury in a rat model. Materials and Methods: A total of 28 rats were divided into trauma, control and low-and high-dose RVT groups (all n = 7). In all three non-control groups, trauma was induced by a medium-pressure aneurysm clip, applied to the sciatic nerve for 30 s. After trauma, the animals were treated with RVT for 7 days, after which nerve tissue samples were obtained from the site of injury for use in histological and stereological analyses. Results: There was a significant group difference in myelin thickness. At 50 mg/kg, RVT treatment was associated with increased myelin thickness, but a decrease was observed at 100 mg/kg. Conclusion: RVT has a beneficial effect on acute crush injury of the sciatic nerve at a dose of 50 mg/kg.
Effects of Vitamin D and Memantine on Repetitive Mild Traumatic Brain Injury Via Mtor, Trpm2, and Gaba Expression Levels on Juvenile Rats
(Turkish Neurosurgical Soc, 2024) Gulsen, Ismail; Ak, Hakan; Akyol, Mehmet Edip; Ozmen, Ozlem; Alp, Hamit Hakan; Arabaci, Ozkan
AIM: To investigate the effects of vitamin D and memantine on the healing process in juvenile rats with repetitive brain injury (rTBI) and to elucidate the mechanisms underlying these potential therapeutic effects. MATERIAL and METHODS: Juvenile rats were randomly allocated into seven groups, with eight rats per group: sham-operated (Group I), trauma (Group II), memantine supplementation (10 mg/kg) pre-trauma (Group III), vitamin D supplementation (5 mu g/kg) pre-trauma (Group IV), vitamin D supplementation post-trauma (Group V), memantine and vitamin D supplementation post-trauma (Group VI), and vitamin D supplementation pre- and post-trauma with post-trauma memantine supplementation (Group VII). A modified repeated weight drop model was employed to induce rTBI. Brain tissues and blood samples were collected for analysis. Expressions of the mammalian target of rapamycin (mTOR), temporary receptor potential (TRPM2), and GABA receptors were assessed via immunohistochemistry. Levels of 8-hydroxy-2-deoxyguanine (8-OHdG) were determined using high-performance liquid chromatography (HPLC). Matrix metalloproteinases -2 and -9, tissue inhibitors of metalloproteinases-1 and-2, and NADPH oxidation-4 levels were determined using commercially available enzyme-linked immunosorbent Test kits. Immunohistochemistry analyses were performed on the brain cortex and hippocampus. RESULTS: The levels of 8OHdG/106dG, MMP-2, MMP-9, TIMP-1, -TIMP2, and NOX-4 were significantly higher in the trauma group than in the other groups. No difference was found between the control and Pre Vit D+Mem+Post Vit D groups regarding 8OHdG/106dG, MMP-2, -9 and NOX-4 levels. Normalized expressions of mTOR and TRPM2 were observed in Groups VI and VII. Conversely, GABA expression levels decreased in Group II, with the most pronounced therapeutic effects observed in Group VII. CONCLUSION: Memantine and vitamin D positively affected rTBI when used alone. Their combined use exhibited greater therapeutic outcomes. These effects are mediated by mTOR mRNA, TRPM2 mRNA, and GABA mRNA expressions.
How Frequently External Ventricular Drainage Device Should Be Changed in Children With Ventriculoperitonel Shunt Infection
(Professional Medical Publications, 2015) Gulsen, Ismail; Ak, Hakan; Demir, Nihat; Sosuncu, Enver; Arslan, Mehmet
Objective: The purpose of the presenting study was to determine how frequently external ventricular drainage (EVD) device should be changed in children with ventriculopertienal shunt (VPS) infection during prolonged intravenous antimicrobial therapy. Methods: In this retrospective study, 25 children with VPS infection were evaluated between January 2012 and December 2013. In these children VPS was surgically removed and appropriate antimicrobial therapy was administered according to cerebrospinal culture results. Data noted about how frequently EVD device had been changed, the number of cells on direct observation of cerebrospinal fluid (CSF), glucose and protein levels of CSF, and CSF culture results were obtained from patients' records. Results: Total 25 children were included in the study. The median age was three months (1 and 65 months). In 44% of children, Staphylococcus epidermidis was isolated. During treatment period, EVD catheter has changed one to six times. A total of 68 EVD catheters were changed in these patients. When the duration of ventriculostomy catheter and leukocyte count in CSF were evaluated on daily basis, leukocyte count was decreased 5 units per day in children whose catheter remained less than 10 days. However, in children whose catheter remained more than 10 days leukocyte count was decreased 2.21 units per day. Conclusions: In children with VPS infection, EVD device should be changed at every 10 days for the rapid resolution of the infection.
Indications of Brain Computed Tomography Scan in Children Younger Than 3 Years of Age With Minor Head Trauma
(Hindawi Ltd, 2014) Gulsen, Ismail; Ak, Hakan; Karadas, Sevdegul; Demir, Ismail; Bulut, Mehmet Deniz; Yaycioglu, Soner
Objective. To investigate the indications to receive brain computed tomography (CT) scan and to define the pathological findings in children younger than three years of age with minor head trauma in emergency departments. Methods. In this study, hospital case notes of 1350 children attending the emergency department of Bitlis State Hospital between January 2011 and June 2013 were retrospectively reviewed. 508 children under 3 years of age with minor head trauma were included in this study. We also asked 37 physicians about the indications for requiring CT in these children. Results. This study included 508 children, 233 (45,9%) of whom were female and 275 were male. In 476 (93,7%) children, the brain CT was completely normal. 89,2% of physicians asked in the emergency department during that time interval reported that they requested CT scan to protect themselves against malpractice litigation. Conclusion. In infants and children with minor head trauma, most CT scans were unnecessary and the fear of malpractice litigation of physicians was the most common reason for requesting a CT.
Lomber Disk Cerrahisi Uygulanan Hastalarda Genel ve Spinal Anestezinin Maliyet Hesabı Yönünden Karşılaştırılması
(2015) Arslan, Mehmet; Sösuncu, Enver; Gulsen, İsmail; Çeğin, M. Bilal; Arslan, Ümit; Ak, Hakan
Bu çalışmada lomber diskektomi yapılan hastalarda genel anestezi ve spinal anestezi uygulamasının maliyet etkinliği üzerine etkisinin karşılaştırılması amaçlandı. Gereç ve Yöntem: Yüzüncü Yıl Üniversitesi Dursun Odabaş Tıp Merkezinde Nöroşirurji Kliniğinde, Haziran 2013 -Haziran 2014 tarihleri arasında lomber disk hernisi nedeniyle ameliyat edilen 58 hasta retrospektif olarak değerlendirildi. Hastane kayıtlarından hastaların demografik verileri, uygulanan anestezi şekli, fatura tutarları, ameliyat maliyeti, anestezi tutarları, ilaç bilgisi ve yatış gün sayıları incelendi. Bulgular: Genel anestezi uygulanan hastalarda toplam maliyet ve ilaç tutarları daha fazla iken spinal anestezide anestezi tutarı fazla çıkmaktadır (p<0.001). Hastanede yatış süresi anestezi tutarı hariç maliyeti etkilememiştir. Anestezi türüne göre hastanede kalış süresinin maliyeti etkilediği görüldü ancak istatiksel olarak anlamlı farklılık tespit edilmedi (p>0.05). Hasta yaşı ile maliyet arasında ilişki saptanmadı. Sonuç: Çalışmamızda lomber disk cerrahisinde spinal anestezi uygulamasının toplam maliyet ve ilaç tutarları üzerindeki etkinliği nedeniyle günümüz sağlık politikaları göz önüne alındığında maliyet giderlerini azaltmak amacıyla uygun hastalarda spinal anestezi, genel anesteziye tercih edilmelidir
Lumbar Suturing With Pack Needle in the Management of Low Back Pain: a False Non-Medical Manipulation
(Journal Neurological Sciences, 2013) Ak, Hakan; Gulsen, Ismail; Atalay, Tugay; Balbaloglu, Ozlem; Evcili, Gokhan
Low back pain is a common pathology in all societies and it has an important effect on health costs. Although low back pain is too often, problems are being still experienced in the management of it and these problems sometimes lead to seeking of non-medical methods. Herein, we present method of lumbar suturing with pack needle performed by a health merchant and results of this application.
Neuroprotective Effects of Thymoquinone on the Hippocampus in a Rat Model of Traumatic Brain Injury
(Elsevier Science inc, 2016) Gulsen, Ismail; Ak, Hakan; Colcimen, Nese; Alp, Hamit H.; Akyol, Mehmet E.; Demir, Ismail; Ragbetli, Murat C.
BACKGROUND: Traumatic brain injury is a leading cause of morbidity and mortality worldwide. We evaluated the neuroprotective effects of thymoquinone (TQ) in a rat model of traumatic brain injury by using biochemical and histopathologic methods for the first time. MATERIALS AND METHODS: Twenty-four rats were divided into sham (n = 8), trauma (n = 8), and TQ-treated (n = 8) groups. A moderate degree of head trauma was induced with the use of Feeney's falling weight technique, and TQ (5 mg/kg/day) was administered to the TQ-treated group for 7 days. All animals were killed after cardiac perfusion. Brain tissues were extracted immediately after perfusion without damaging the tissues. Biochemical procedures were performed with the serum, and a histopathologic evaluation was performed on the brain tissues. Biochemical experiments included malondialdehyde (MDA), reduced and oxidized coenzyme Q10 analysis, DNA isolation and hydroylazation, and glutathione peroxidase, and superoxide dismutase analyses. RESULTS: Neuron density in contralateral hippocampal regions (CA1, CA2-3, and CA4) 7 days after the trauma decreased significantly in the trauma and TQ-treated groups, compared with that in the control group. Neuron densities in contralateral hippocampal regions (CA1, CA2-3, and CA4) were greater in the TQ-treated group than in the trauma group. TQ did not increase superoxide dismutase or glutathione peroxidase antioxidant levels. However, TQ decreased the MDA levels. CONCLUSIONS: These results indicate that TQ has a healing effect on neural cells after head injury and this effect is mediated by decreasing MDA levels in the nuclei and mitochondrial membrane of neurons.
Recurrent Gliosarcoma in Pregnancy
(Hindawi Ltd, 2014) Gulsen, Ismail; Ak, Hakan; Yilmaz, Tevfik; Bulut, Mehmet Deniz; Alkis, Ismet; Bayram, Irfan
Gliosarcoma is a rare tumor of the central nervous system and it constitutes about 1 to 8% of all malignant gliomas. In this report we are presenting a recurrent gliosarcoma case during a pregnancy in a 30-year-old woman. This is the first report presenting gliosarcoma in the pregnancy.
Risk Factors Associated With Mortality and Survival of Acute Subdural Hematoma: a Retrospective Study
(Wolters Kluwer Medknow Publications, 2019) Atalay, Tugay; Ak, Hakan; Gulsen, Ismail; Karacabey, Sinan
Background: Acute subdural hematoma (ASDH) is mostly seen after head injury and is a major cause of morbidity and mortality. We studied the risk factors for ASDH and the effects of these factors on mortality as well as on survival with 100 cases from the rural area of Anatolia region. Materials and Methods: One-hundred cases of the ASDH that had been treated surgically between 2011 and 2014, at three different health-care centers from the rural area of Anatolia region, were retrospectively reviewed. Demographic data of patients, etiology, Glasgow Coma Scale (GCS) on admission, survival, presence of comorbid disease, unilaterality or bilaterality of the hematoma, and length of stay in the Intensive Care Unit (ICU) and/or neurosurgery clinic were recorded from the patients' files. Results: The total mortality rate was 34%. Age, etiology, GCS on admission, and laterality of the hematoma (unilateral or bilateral) affected the mortality rates (P = 0.005, P = 0.001, P = 0.001, and P = 0.001, respectively). Advanced age, low GCS on admission, and bilaterality of the hematoma were related with high mortality rates (P = 0.005, P = 0.001, and P = 0.001, respectively). The presence of comorbid disease and gender had no effect on patient survival (P = 0.299 and P = 0.861). Conclusion: The most important factors affecting the mortality rate were GCS on admission, etiology, age, and laterality of the hematoma in this study. Advanced age, low GCS on admission, and bilaterality of the hematoma were related with high mortality rates. Etiology had an important role in mortality rates, especially in the pedestrian injury group.
Spontaneous Rapid Resolution of Acute Epidural Hematoma in Childhood
(Hindawi Ltd, 2013) Gulsen, Ismail; Ak, Hakan; Sosuncu, Enver; Yavuz, Alpaslan; Kiymaz, Nejmi
Acute epidural hematoma is a critical emergency all around the world, and its aggressive diagnosis and treatment are of vital importance. Emergent surgical evacuation of the hematoma is known as standard management; however, conservative procedures are also used for small ones. Spontaneous rapid resolution of these hematomas has also been reported in eight pediatric cases. Various theories have been proposed to explain the underlying pathophysiology of this resolution. Herein, we are reporting a new pediatric case with spontaneously resolving acute epidural hematoma 12 hours after admission to the emergency room.
Timokinonun Akut Periferik Sinir Hasarı Üzerine Akut Etkisi: Deneysel Bir Çalışma
(2016) Ak, Hakan; Gulsen, İsmail; Koçak, Ömer Faruk; Gökalp, Abdülsemat; Akyol, Veysel; Rağbetli, Murat Çetin; Kara, Mikail
AMAÇ: Bu çalışmanın amacı akut sinir hasarında timokinonun akut dönem etkilerini değerlendirmektir.GEREÇ VE YÖNTEM: Çalışma sıçan sinirinde siyatik sinirde ezilme modeli geliştirilerek yapıldı. Sıçanlar kontrol, travma ve timokinon tedavi grubuolmak üzere üç gruba ayrıldı (n=6). Sinir hasarından yedi gün sonra hasar yerinden siyatik sinir doku örnekleri alındı. Bu doku örneklerinde histolojikve steryolojik çalışma yapıldı. Akson çapı, myelin kalınlığı ve akson yoğunluk ölçümleri yapıldı.BULGULAR: Gruplar arasında akson çapı, miyelin kalınlığı ve akson yoğunluğu bakımından anlamlı bir farklılık görülmedi.TARTIŞMA: Timokinon akut sinir hasarı üzerinde akut dönemde iyileştirici etkiye sahip değildir.