Browsing by Author "Cirak, B."

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Catamenial Mononeuropathy and Radiculopathy [3] (Multiple Letters)
(1999) Cirak, B.; Guven, M.B.; Zager, E.L.; Brown, M.J.
Epidural Analgesia After Lumbar Disc Surgery With Ropivacaine Plus Fentanyl or Bupivacaine Plus Fentanyl
(2005) Kati, I.; Demirel, C.B.; Cirak, B.; Huseyinoglu, U.A.
We compared the efficacy and safety of continuous epidural infusion of ropivacaine plus fentanyl versus bupivacaine plus fentanyl in the management of postoperative pain after lumbar laminectomy. Twenty-two patients who underwent elective lumbar laminectomy were randomly allocated to one of two groups. The patients were treated with ropivacaine 0.1% plus fentanyl 2 μg/ml in group 1, and with bupivacaine 0.1% plus fentanyl 2 μg/ml in group 2 via bolus epidural infusion (6-10 ml/h). General anesthesia was standardized. Postoperative pain was evaluated using VAS at 0, 1, 2, 3, 8, 20, 32, 48 hours after surgery. The amount of ropivacaine plus fentanyl or bupivacaine plus fentanyl used over the 48-h postoperative period was documented. The postoperative pain and sedation scores were not significantly different between groups throughout the study period. The total consumption of ropivacaine plus fentanyl over the 48-h period was significantly lower (p < 0.05) than that of bupivacaine plus fentanyl. There was no difference in the incidence of side effects. No patient developed respiratory depression or wound infection. We conclude that the use of ropivacaine-fentanyl mixture for patient epidural analgesia after lumbal disc surgery provides similar succesful pain relief as bupivacaine plus fentanyl, but patients receiving bupivacaine-fentanyl need a higer dose. © 2005 VSP.
Intracranial Plasmacytomas
(1999) Cirak, B.; Inci, S.; Palaoglu, S.
Background: Solitary plasmacytoma of the central nervous system is a rarely reported pathology in the literature, and mostly are in the form of case reports. We retrospectively evaluated six cases of intracranial plasmacytoma. Method: Six patients' files were evaluated retrospectively. Their presenting symtomps and signs, laboratory and radiological findings, surgical intervention, adjuvant treatment protocols and outcomes were analysed. Results: All six patients were diagnosed clinically, radiologically and histologically as solitary intracranial plasmacytoma. All of the patients underwent radiotherapy regardless of the extensivity of the surgical resection. Two patients whose tumors were resected subtotally were put on chemotherapy postoperatively. Of these six patients, three died in the follow up period with the diagnosis of dissemination into the multiple myeloma, three patients had a good outcome. Conclusion: Intracranial solitary plasmacytoma, eventhough, is a rare pathology, may be mortal if it is not properly handled. Total resection it must be the aim of surgery. Radiotherapy, and in partially resected cases, chemotherapy as adjuvant are helpful. Although everykind of treatment regiment has been applied, change into multiple myeloma may occur in follow up period.
Regarding "acute Ecg Changes and Chest Pain Induced by Neck Motion in Patients With Cervical Hernia" -: in Response
(Westminster Publ inc, 2001) Güler, N; Bilge, M; Eryonucu, B; Cirak, B; Cirak, B.
Trigeminal Neuralgia Caused by Intracranial Epidermoid Tumor: Report of a Case and Review of the Different Therapeutic Modalities
(American Society of Interventional Pain Physicians, 2004) Cirak, B.; Kiymaz, N.; Arslanoglu, A.
Trigeminal neuralgia (TGN) is characterized by recurrent paroxysms of unilateral facial pain that typically is severe, lancinating, and activated with cutaneous stimulation. Paroxysms typically last for 1 to 2 seconds. Etiology includes compression of the trigeminal nerve by vascular structures, tumors and multiple sclerosis plaques in the medulla spinalis. TGN is rather rare as a presenting symptom with intracranial tumors. Epidermoid tumors comprise 1% of all intracranial tumors. The majority of epidermoid tumors are located at the pontocerebellar angle, the third ventricle, and the suprasellar region. Symptomatology is not different from other tumors located at the same sites. Trigeminal neuralgia may be caused by tumor compressing the nerve itself, an inflammatory response to the epidermoid tumor or vascular compression of the nerve. We describe the case of a 30-year-old female presenting with right-sided facial pain. Her past history revealed multiple teeth extractions done to relieve facial pain. Radiological evaluation, including magnetic resonance imaging (MRI), showed a pontocerebellar angle (PCA) epidermoid tumor. TGN resolved completely after total tumor resection. A temporary facial paralysis consequent to surgical removal of the tumor improved 6 months postoperatively, and she remained pain-free, without medications.