Browsing by Author "Gulsen, Ismail"

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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
Chiari Iii Malformation With a Giant Encephalocele Sac: Case Report and a Review of the Literature
(Karger, 2013) Bulut, Mehmet Deniz; Yavuz, Alpaslan; Bora, Aydin; Gulsen, Ismail; Ozkacmaz, Sercan; Sosuncu, Enver
Co-Occurrence of Lumbar Spondylolysis and Lumbar Disc Herniation With Lumbosacral Nerve Root Anomaly
(Medknow Publications & Media Pvt Ltd, 2014) Yilmaz, Tevfik; Turan, Yahya; Gulsen, Ismail; Dalbayrak, Sedat
Lumbosacral nerve root anomalies are the leading cause of lumbar surgery failures. Although co-occurrence of lumbar spondylolysis and disc herniation is common, it is very rare to observe that a nerve root anomaly accompanies these lesions. A 49-year-old male patient presented with sudden-onset right leg pain. Examinations revealed L5/S1 lumbar spondylolysis and disc herniation. At preoperative period, he was also diagnosed with lumbosacral root anomaly. Following discectomy and root decompression, stabilization was performed. The complaints of the patient diagnosed with lumbosacral root anomaly at intraoperative period were improved at postoperative period. It should be remembered that in patients with lumbar disc herniation and spondylolysis, lumbar root anomalies may coexist when clinical and neurological picture is severe. Preoperative and perioperative assessments should be made meticulously to prevent neurological injury.
Decreased Vertebral Artery Hemodynamics in Patients With Loss of Cervical Lordosis
(int Scientific information, inc, 2016) Bulut, Mehmet Deniz; Alpayci, Mahmut; Senkoy, Emre; Bora, Aydin; Yazmalar, Levent; Yavuz, Alpaslan; Gulsen, Ismail
Background: Because loss of cervical lordosis leads to disrupted biomechanics, the natural lordotic curvature is considered to be an ideal posture for the cervical spine. The vertebral arteries proceed in the transverse foramen of each cervical vertebra. Considering that the vertebral arteries travel in close anatomical relationship to the cervical spine, we speculated that the loss of cervical lordosis may affect vertebral artery hemodynamics. The aim of this study was to compare the vertebral artery values between subjects with and without loss of cervical lordosis. Material/Methods: Thirty patients with loss of cervical lordosis and 30 controls matched for age, sex, and body mass index were included in the study. Sixty vertebral arteries in patients with loss of cervical lordosis and 60 in controls without loss of cervical lordosis were evaluated by Doppler ultrasonography. Vertebral artery hemodynamics, including lumen diameter, flow volume, peak systolic velocity, end-diastolic velocity, and resistive index, were measured, and determined values were statistically compared between the patient and the control groups. Results: The means of diameter (p=0.003), flow volume (p=0.002), and peak systolic velocity (p=0.014) in patients were significantly lower as compared to controls. However, there was no significant difference between the 2 groups in terms of the end-diastolic velocity (p=0.276) and resistive index (p=0.536) parameters. Conclusions: The present study revealed a significant association between loss of cervical lordosis and decreased vertebral artery hemodynamics, including diameter, flow volume, and peak systolic velocity. Further studies are required to confirm these findings and to investigate their possible clinical implications.
Delayed Traumatic Intracerebral Hemorrhage: for How Many Hours Should Patients With Mild Head Trauma Be Observed
(derman Medical Publ, 2015) Karadas, Sevdegul; Gonullu, Hayriye; Gulsen, Ismail; Baltacioglu, Huseyin
Delayed traumatic intracerebral hematoma is a rare complication of head injury. The etiopatogenesis of DTIH is not precisely known. We herein report a case of delayed traumatic intracerebral hematoma, with mild HT. This 25-year-old male fell down while playing in a footbal match. He had headache and vertigo. He was kept under observation for about 12 hours at the emergency department. At the 26th hour after the HT incident, he presented to our hospital again with the complaints of nausea, vomiting and headache. A control brain computed tomography was performed and a traumatic intracerebral hematoma was determined in the frontal region. As a result, DTIH may be fatal. Close observation and repeat CBT scanning may reduce complications and mortality.
The Effect of Disease Control on Mean Platelet Volume and Red Blood Cell Distribution in Patients With Acromegaly
(E-century Publishing Corp, 2015) Ucler, Rifki; Aslan, Mehmet; Atmaca, Murat; Alay, Murat; Ademoglu, Esra Nur; Candan, Zehra; Gulsen, Ismail
Objectives: Several studies have shown increased atherogenic risk factors and biomarkers of inflammation and atherosclerosis in association with growth hormone excess. Mean platelet volume (MPV) and red blood cell distribution (RDW) are currently gaining interest as new independent cardiovascular risk factors. The aim of this study was to evaluate the effect of disease control on MPV and RDW in acromegaly patients. Materials and methods: We retrospectively enrolled 36 acromegaly patients (23 males, 13 females; mean age 41.94 +/- 11.55). Patients were divided into two groups: disease controlled by surgical treatment alone (group A) or by somatostatin analog (SSA) therapy (group B). MPV and RDW measurements were evaluated during active and inactive disease periods in the two groups. Results: There were statistically significant increases in MPV and RDW in patients receiving SSA therapy (P = 0.012 and P = 0.020, respectively). The differences in MPV and RDW changes in patients receiving surgical treatment alone were not statistically significant (P=0.364 and P=0.339, respectively). Conclusions: This is the first report on the evaluated the effect of disease control on MPV and RDW in acromegaly patients. Our study results showed that MPV and RDW measurements are significantly increased in acromegaly patients with disease controlled by SSA therapy. Therefore, acromegalic patients treated with SSAs may have increased cardiovascular risk based on an increase in MPV and RDW.
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.
Effects of Low-Intensity Treadmill Exercise on Sciatic Nerve in Experimental Diabetic Neuropathy
(Sci Printers & Publ inc, 2016) Gulsen, Ismail; Demiroglu, Murat; Aycan, Abdurrahman; Uder, Rifki; Alaca, Ilker; Orhon, Zeynep Nur; Kanter, Mehmet
OBJECTIVE: To investigate the potential beneficial effects of low-intensity exercise on histopathological changes of sciatic nerves in streptozotocin (STZ)-induced diabetic rats. STUDY DESIGN: The rats were allotted randomly into 3 experimental groups: A (control), B (diabetic untreated), and C (diabetic treated with low-intensity exercise); each group contained 8 animals. Groups B and C received STZ. Diabetes was induced in 2 groups by a single intraperitoneal injection of STZ (40 mg/kg, freshly dissolved in 0.1 M citrate buffer, pH 4.2). Two days after STZ treatment, diabetes in 2 experimental groups was confirmed by measuring blood glucose levels. Rats with blood glucose levels >= 250 mg/dL were considered to be diabetic. Animals in the exercise group were made to run the treadmill once a day for 4 consecutive weeks. Exercise started 3 days prior to STZ administration. RESULTS: The treatment of low-intensity exercise caused a sharp decrease in the elevated serum glucose and an increase in the lowered serum insulin concentrations in STZ-induced diabetic rats. STZ induced a significant decrease in the area of insulin-immunoreactive beta cells. Low-intensity exercise treatment resulted in increased area of insulin-immunoreactive beta cells signficantly. Myelin breakdown decreased significantly after treatment with low intensity exercise. The ultrastructural features of degenerated axons also showed remarkable improvement. CONCLUSION: We believe that further preclinical research into low-intensity exercise may indicate its usefulness as a potential treatment for peripheral neuropathy in STZ-induced diabetic rats.
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.
Factors Affecting Infection Development After Meningomyelocele Repair in Newborns and the Efficacy of Antibiotic Prophylaxis
(Springer, 2015) Demir, Nihat; Peker, Erdal; Gulsen, Ismail; Agengin, Kemal; Tuncer, Oguz
The purpose of this study was to evaluate the clinical and surgical variables that may be associated with wound infection and meningitis/ventriculoperitoneal (VP) shunt infection in newborns diagnosed with meningomyelocele (MMC), as well as the efficacy of antibiotic prophylaxis in reducing these complications. The data of 91 neonates diagnosed with MMC, who underwent surgical intervention between May 2012 and December 2014, were retrospectively evaluated. Multivariant logistic regression analysis was used to determine the possible clinical and neurosurgical variables associated with meningitis/VP shunt infection and surgical wound infection. Spearman's test was performed for the correlation analysis. Following MMC closure, of the 91 neonates, 18 (16.4 %) developed meningitis/shunt infection and 12 (11 %) developed surgical wound infection. The operation time was not a significant independent risk factor for the development of meningitis (RR 0.618 [0.199-1.922], p = 0.406). Open neural placodes that were not covered by any pseudomembrane (myeloschisis), external ventricular drainage (EVD) use, and flap transposition were determined as significant relative risk factors for the development of meningitis (RR 8.655 [2.329-32.157], p = 0.001; RR 9.404 [1.183-74.743], p = 0.034; RR 8.125 [2.496-26.448], p = 0.001; and RR 3.150 [1.963-10.308], p = 0.048, respectively). Deep surgical wound infection was not correlated with the operation time or wound surface area. However, there was an intermediate but very significant positive correlation between meningitis and cerebrospinal fluid (CSF) leakage, length of hospitalization, and flap transposition (r = 0.377, 0.420, 0.357, and 0.503, respectively; for all values, p < 0.001). There was no association between MMC closure and development of infection. Since it carries a high risk for the development of meningitis, the EVD system should be avoided unless necessary. Routine prophylactic antibiotic use did not reduce the infection risk in MMC repair surgery. Thus, antibiotics should not be used if there are no risk factors predisposing to infection.
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.
Imaging Findings for Bilateral Giant Vestibulocochlear Schwannoma
(Acad Medical Sciences I R Iran, 2016) Bulut, Mehmet Deniz; Yavuz, Alpaslan; Bora, Aydin; Gulsen, Ismail; Batur, Abdussamet
Neurofibromatosis type 2 mostly develops with multiple neoplasms of the central and penpheral nervous system and is associated with ocular abnormalities The presented case is a 19-year-old female patient with bilateral vestibulocochlear schwannomas in both pontocerebellar corners, intradural intra-e)dramedullary masses, and multiple neurofibromas in the spinal canal. The clinical picture for NF-2, also called central neurofibromatosis, is completely different from von Recklinghausen disease. Untreated Bilateral vestibulocochlear schwannoma may cause hydrocephalus in NF-2, and lead to death. Therefore, it is recommended to carefully monitor and treat Bilateral vestibulocochlear schwannonia in accordance with its stage.
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.
Intracranial Meningioma Diagnosed During Pregnancy Caused Maternal Death
(Hindawi Ltd, 2014) Kurdoglu, Zehra; Cetin, Orkun; Gulsen, Ismail; Dirik, Deniz; Bulut, M. Deniz
Brain tumors are rarely diagnosed during pregnancy. Accelerated growth of intracranialmeningiomas during pregnancy sometimes requires urgent surgical intervention. We describe a 41-year-old pregnant woman with severe neurological decompensation requiring immediate neurosurgery. Cesarean section resulted in maternal death. Meningioma diagnosed during a viable pregnancy should be managed according to the severity of maternal neurological symptoms and gestational age of pregnancy. Early intervention for intracranial tumors during pregnancy may save maternal and fetal lives.
Investigation of Regenerative Effect of Steroid Hormones on Peripheral Nerve Degeneration
(Wiley-blackwell, 2015) Ustun, Ramazan; Tombul, Temel; Gulsen, Ismail; Eren, Rabia; Oguz, Serife Bahtiyar; Erturk, Omer Berkay