Browsing by Author "Yilmaz, Nebi"

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Activity of Mannitol and Hypertonic Saline Therapy on the Oxidant and Antioxidant System During the Acute Term After Traumatic Brain Injury in the Rats
(Elsevier Science Bv, 2007) Yilmaz, Nebi; Dulger, Haluk; Kiymaz, Nejmi; Yilmaz, Cahide; Gudu, Burhan O.; Demir, Ismail
In this study, our objective is to investigate the effects of mannitol and 7.5% hypertonic saline (HS) therapy on the levels of malondialdehyde (MDA), catalase and glutathione peroxidase (GSH-Px) in the early stages of experimental head traumas in rats. Rats included in the study were divided into four groups: Group I Control, Group II Trauma, Group III Mannitol, and Group IV 7.5% Hypertonic Saline. Rats in Group 11 were subject to head trauma only. Mannitol was injected intraperitoneally to rats in Group III after head trauma and 7.5% HS was injected intraperitoneally to rats in Group IV after head trauma. Rats were sacrificed 4 h after administration of mannitol. or 7.5% HS, and the levels of MDA catalase and GSH-Px in brain tissues extracted from rats were determined. MDA levels in the trauma group were significantly increased compared with the control group (p<0.01), whereas there was a reduction in catalase and GSH-Px levels, although these differences were not significant. By contrast, in the mannitol group, MDA, catalase and GSH-Px levels were lower than the levels in the trauma group, and these reductions were statistically significant (p<0.05). The MDA, catalase and GSH-Px levels of the 7.5% HS group were lower than those of the trauma group; however, this reduction was not statistically significant. It was concluded that mannitol and 7.5% HS therapies that are used to reduce intracranial pressure and to increase the use of catalase, an antioxidant enzyme, and GSH-Px, are likely to reduce cellular damage by reducing the formation of MDA, the levels of which are known to be indicative of cellular level oxidant damage. (c) 2007 Elsevier B.V. All rights reserved.
Alstrom Syndrome Associated With Cerebral Involvement: an Unusual Presentation
(Modestum Ltd, 2006) Yilmaz, Cahide; Caksen, Huseyin; Yilmaz, Nebi; Guven, Ahmet Sami; Arslan, Derya; Cesur, Yasar
Alstrom syndrome (AS) is a rare autosomal recessive disorder, characterized by retinal degeneration, progressive hearing impairment, truncal obesity and non-insulin dependent diabetes mellitus. A 6-year-old girl was admitted with aphasia, deafness, strabismus, abdominal distention, and weakness on the right body side. The physical and laboratory examination revealed psychomotor retardation, right hemiparesis, sensorioneural hearing loss, aphasia, eye and teeth abnormalities, hyperpigmentation, truncal obesity, hepatosplenomegaly, severe iron deficiency anemia, delayed bone age, and cerebral hemiatrophy. Based on these abnormal findings she was diagnosed as AS. According to our knowledge this is the first case of AS with cerebral involvement. This last finding may be a component of the syndrome.
Cavernous Hemangioma Presenting as a Giant Cervical Mass: a Case Report
(Turkish Neurosurgical Soc, 2010) Kiymaz, Nejmi; Yilmaz, Nebi; Ozen, Suleyman; Demir, Ismail; Gudu, Burhan Oral; Kozan, Abdulbaki
Intramuscular hemangiomas of the head and, neck are rare congenital vascular tumors and are sparsely reported. Hemangiomas account for approximately 7% of benign tumors and usually present as a mass that suddenly enlarges. Hemangiomas are mostly seen on the trunk and extremities, but can also appear on the head and neck region. A 10-year-old boy was referred to our clinic for puffiness and swelling on the right side of his neck. Neurological examination was normal, but we observed an advanced degree of restriction in neck movement. An MRI study showed a soft tissue mass 9x8x5 in size. The mass was totally extracted by surgical intervention and pathological analysis revealed that it was a cavernous hemangioma. The patient's neck movement returned to normal after surgery. No relapse occurred during 1-year follow-up.
Cervical Spinal Dysraphism
(Karger, 2010) Kiymaz, Nejmi; Yilmaz, Nebi; Gudu, Burhan Oral; Demir, Ismail; Kozan, Abdulbaki
Objective: Cervical spinal dysraphism is a rare congenital spinal pathology. The results obtained from our series are compared with the results obtained from other series of studies in the literature. Methods: Seven patients with cervical myelomeningocele and meningocele who underwent surgery between January 1996 and March 2009 at the YYU Faculty of Medicine in the Department of Neurosurgery were retrospectively studied. Results: The referral ages of the patients (6 females and 1 male) varied between 4 days and 4 months (median 1 month). A stalk lesion covered with a dysplastic skin formed as a sac and located at the cervical midline was demonstrated in all of the patients. Cervical myelomeningocele was present in 4 patients, while cervical meningocele was present in 3 patients; however, Chiari type II malformation and hydrocephaly were present in 3 patients with myelomeningoceles. Diastematomyelia and a filum terminal lipoma were present in 1 of the patients. Conclusion: In this series, in contrast to the literature, we noted that the number of girls with spinal dysraphism with a cervical myelomeningocele and meningocele was greater than the number of boys. Chiari type II malformation, hydrocephaly and motor weakness in patients with cervical spinal dysraphism are less frequent when compared to patients with caudal spinal dysraphism. The structure of the sac is also more durable and, accordingly, a cerebrospinal fluid leakage is uncommon. Copyright (C) 2011 S. Karger AG, Basel
Controversies in Chronic Subdural Hematoma
(int Scientific information, inc, 2007) Kiymaz, Nejmi; Yilmaz, Nebi; Mumcu, Cigdem
Background: Various surgical methods are recommended for the therapy of chronic subdural hematoma (CSH). In this study, burr-hole continuous drainage (CD) and burr-hole one-time drainage (OTD) methods for the treatment of CSH are retrospectively compared. Materials/Methods: Fifty patients with CSH referred to this clinic between July 1995 and December 2003 were selected for treatment. Twenty-one patients were treated by the burr-hole OTD method and 29 patients received burr-hole CD therapy. The recurrence rates and the extension of the hematoma were evaluated with respect to the period of postoperative hospitalization to evaluate the most effective method. Results: The postoperative hospitalization period was 7.9 days in the burr-hole continuous drainage group and 17 days in the burr-hole one-time drainage group. Recurrence developed in two cases (6.8%) in the CD group and in six cases (28.5%) in the OTD group. When the pre- and postoperative hematoma extension in the CD group were compared, a significant degree of decrease was observed on post-op day 1. Extension of the hematoma was found to be minimal in the days following the modification. The width of the hematoma in the OTD group was also reduced at post-op day 1; however, the degree of this decrease was not significant. Conclusions: Continuous drainage therapy for CSH is superior to the one-time drainage method due to the shorter time of post-op hospitalization and to the reduced rate of recurrence.
Evaluation of Lymphocyte Subgroups in Children With Down Syndrome
(Sage Publications inc, 2015) Yilmaz, Cahide; Dogan, Murat; Basarslan, Fatmagul; Yilmaz, Nebi; Yuca, Sevil; Bulan, Keziban; Caksen, Huseyin
In this study, lymphocyte subgroups including blood CD3, CD4, CD8, CD4/CD8, CD19, and CD16.56 values were analyzed in children with Down syndrome (DS). The study includes 85 children with DS, followed at Department of Pediatrics, Faculty of Medicine, Yuzuncu Yil University and 64 healthy age-matched control participants. Blood CD3, CD4, CD8, CD4/CD8, CD19, and CD16.56 values were examined in both the groups. Significantly decreased blood CD3, CD4, and CD19 values were found in the study group (P < .05) when compared with the control group. In conclusion, we would like to emphasize that blood CD3, CD4, and CD19 levels were found to be decreased in children with DS. Based on these finding, we think that these decreased lymphocyte subgroups might be responsible for increased susceptibility to infections in children with DS.
Fibre-Optic Bronchoscopy-Assisted Percutaneous Dilatational Tracheostomy by Guidewire Dilating Forceps in Intensive Care Unit Patients
(B C decker inc, 2008) Yuca, Koeksal; Kati, Ismail; Tekin, Murat; Yilmaz, Nebi; Tomak, Yakup; Cankaya, Hakan
Objective: The purpose of this study was to prospectively analyze intensive care unit patients with fibre-optic bronchoscopy assisted percutaneous dilatational tracheostomy by guidewire dilating forceps (GWDF; Griggs percutaneous tracheostomy). Design: Prospective study. Setting: A tertiary care centre. Materials and Methods: Fifty-two critically ill patients (32 men and 20 women), aged 16 to 84 years (mean +/- 6 SD 42 +/- 1.6 years) who required endotracheal intubation for longer than 15 days were consecutively selected to undergo tracheostomy by the GWDF technique. The diagnoses of the patients and intraoperative and postoperative complications were recorded. Results: The patients were mechanically ventilated for an average of 14.8 +/- 1.2 days. The duration of the GWDF technique was 4.9 +/- 1.7/min. Intraoperative complications occurred in 10 (19.2%) patients: hemorrhage in 3 cases, puncture of the tracheal tube in 2 cases, difficult cannulation in 2 cases, difficult dilatation in 1 case, false passage in 1 case, and inadvertent extubation in 1 case. Postoperative complications occurred in three (5.7%) patients, stomal cellulitis in one case, subcutaneous emphysema in one case, and difficult recannulation in the remaining case. Conclusions: Fibre-optic bronchoscopy-assisted percutaneous dilatational tracheostomy by GWDF is a simple and fast technique for inserting a tracheal cannula.
Intracranial Foreign Bodies Causing Delayed Brain Abscesses: Intracranial Sewing Needles - Case Illustration
(Amer Assoc Neurological Surgeons, 2007) Yilmaz, Nebi; Kiymaz, Nejmi; Yilmaz, Cahide; Bay, Ali; Mumcu, Cigden
Intracranial Lipomas - a Clinical Study
(Elsevier, 2006) Yilmaz, Nebi; Unal, Ozkan; Kiymaz, Nejmi; Yilmaz, Cahide; Etlik, Omer
Objective: This study aimed to investigate the localization of the lipoma, as well as associated intracranial and extracranial lesions in 14 patients immediately following hospital admission. The pathological findings from the neurological examinations of these patients are also investigated. Methods: Fourteen patients who were admitted to our clinic with a variety of symptoms and diagnosed with intracranial lipoma were included in the study. Problems presented upon admission, neurological findings, and other existing system abnormalities were evaluated. Localization of the lipomas and accompanying pathologies were determined by using computerised tomography and magnetic resonance imaging. Results: The most frequent reasons for admission of patients with intracranial lipomas were: headache 7 (50%), trauma 3 (21.5%), epilepsy 3 (21.5%) and one with symptoms due to the local mass effect of tumor (7%). Although the pericallosal region is accepted as the region where lipomas commonly occur, this study found the most frequent occurrence in the quadrigeminal cistern. Intracranial lipoma calcification was only evident in 1 of the 14 patients. In addition, contrary to the expectations, intracranial and extracranial lesions accompanying lipomas were rare. All patients received systematic treatment. Conclusion: This study showed that intracranial lipomas are more frequent in the quadrigeminal region of the brain; most are asymptomatic, generally caught incidentally; and accompanying intracranial and extracranial pathologies are less common than expected. (c) 2005 Elsevier B.V. All rights reserved.
Intradural Disc Herniation a Case Report and Review of the Literature
(Modestum Ltd, 2005) Yilmaz, Nebi; Kiymaz, Nejmi; Etlik, Omer; Mumcu, Cigdem
Intradural disc herniation (IDH) is a rare pathology. Intradural disc herniations comprise 0.26-0.30% of all herniated discs. The preoperative knowledge of an intradural herniation is important because it has an influence on the operative strategy. A 55-year-old man suffered from decrease in the motor function of the lower extremities and urinary incontinence. Noncontrast MRI exam showed the intradural disc with caudal migration of an excluded fragment at the L3-4 level. At surgery, the L3 and L4 laminas were removed and after dura had been openned, a nucleus pulposus was seen which compressed the conus medullaris to the right and left of the spinal canal. Every neurosurgeuon involved in spinal surgery must be aware of this rare patology which, when overseen during the intervention, could have disastrous consequences for the patient.
Investigation of Neuroprotective Effect of Dexamethasone by Using Nitric Oxide and Leukocyte Levels in Experimental Head Trauma
(Taylor & Francis Ltd, 2007) Demir, Oezguer; Kiymaz, Nejmi; Ekin, Suat; Yilmaz, Nebi; Özbek, Hanefi
The objective of the present study was to determine the levels of nitric oxide (NO) and white blood cells (WBCs), which are assumed to play a role in secondary cerebral damage by increasing to pathological levels during cranial trauma, and to investigate the neuroprotective effect of dexamethasone on NO and WBC levels in experimental cranial trauma. For this purpose, adult Sprague-Dawley male rats were used. Blood NO and WBC levels were investigated in one group of non-trauma rats (control group, n = 10) after 6 h; in a group of rats with experimental post-cranial trauma (trauma group, n = 10) after 6 and 24 h; and in a third group of rats with experimental cranial trauma, intraperitoneally injected with 10 mg/kg dexamethasone after 1 and 12 h (trauma + dexamethasone group, n = 10), WBC and NO levels were measured after 6 and 24 h. Determination of NO levels was carried out by assaying serum nitrite and nitrate levels. The increases in post-trauma serum NO (nitrite and nitrate) and WBC levels were statistically significant for the trauma and trauma + dexamethasone groups compared to controls. There was no significant difference between serum NO and WBC levels in rats in the trauma + dexamethasone and those in the trauma group. The study demonstrated no significant inhibition of NO and WBC levels by dexamethasone, a drug used for its anti-edema and anti-inflammatory effects and its influence on membrane stabilization and in avoiding oscillation stress. In the present study, dexamethasone was found to be ineffective in decreasing NO and WBC levels to avoid secondary cerebral damage after cranial trauma.
Lipid Peroxidation in Patients With Brain Tumor
(Taylor & Francis Ltd, 2006) Yilmaz, Nebi; Dulger, Haluk; Kiymaz, Nejmi; Yilmaz, Cahide; Bayram, Irfan; Ragip, Balahoroglu; Oger, Muzaffer
Molecular and genetic signatures may predict brain tumor behavior and may soon guide tumor classification, diagnosis, and tumor-specific treatment strategies. Free oxygen radicals ( FOR) are thought to take part in oncogenesis and cellular differentiation. This article explored the state of FORs and antioxidant system in patients with cerebral tumor. The serum concentrations of malondialdehyde (MDA), catalase, and glutathione peroxidase (GSH-Px) enzyme activities were measured in the serum of 35 patients with cerebral tumors ( 21 glioma, 14 meningioma) and 11 controls. MDA measurement was done with fluorometric method and catalase and GSH-Px enzyme activities were done with photometric method. Mean serum MDA levels, catalase, and GSH-Px enzyme activities were significantly higher for both glial and meningiomal tumor cases when compared to controls (p < .05). There is no significant difference between glioma and meningioma groups in terms of the aforementioned parameters ( p > .05). In conclusion, lipid peroxidation and antioxidant enzymes as assessed by MDA, catalase, and GSH-Px were increased in patients with brain tumors, for this respect there is no difference between gliomas and meningiomas.
Metastatic Myxoid Liposarcoma of the Scalp: Case Report
(Ortadogu Ad Pres & Publ Co, 2012) Kiymaz, Nejmi; Yilmaz, Nebi; Gudu, Burhan Oral; Demir, Ismail; Gokalp, Abdulsemat
Liposarcomas are the second most frequent soft tissue sarcomas occurring in adults after malignant fibrous histiocytomas; however, liposarcomas rarely occur on the scalp. A mass was detected on the hairy skin of a 38-year-old male patient who had undergone surgery for a mass on the posterior aspect of the right thigh and had been diagnosed with a myxoid liposarcoma 3 years earlier. The patient had undergone total bulk excision and the histopathologic examination of the mass lesion revealed liposarcoma metastasis. Chemotherapy was initiated. Relapse or metastasis did not develop during 3 years of follow-up. Here we present a patient with a myxoid liposarcoma, which metastasized from the posterior side of the right thigh to the scalp.
Multiple Brain Abscesses in a Child With Autoimmune Hemolytic Anemia
(Wiley-liss, 2007) Bay, Ali; Yilmaz, Nebi; Nalbantoglu, Ozlem; Yilmaz, Cahide; Etlik, Omer; Oner, Ahmet Faik
A 14-year-old female with autoimmune hemolytic anemia (AIHA) developed an acute hemolytic crisis with acute renal failure under conventional treatment with corticosteroids. Because of the life-threatening situation, we decided to start pulse dose methylprednisolone and also hemodialysis with a femoral catheter placement was performed. Fifteen days after initiating of dialysis subfebrile fever was developed, followed within 2 days with a left hemiparesis. Brain magnetic resonance imaging (MRI) revealed multiple intracerebral abscesses. The clinical picture worsened and the patient died before scheduled surgery for the abscesses.
Neurofibromatosis Type 1 With Subcutaneous Mass in Occipital Region, Bilateral Lisch Nodules of Iris and Cafe-Au Spots
(Modestum Ltd, 2005) Yuca, Koksal; Yilmaz, Nebi; Cinal, Adnan; Etlik, Omer; Kiris, Muzaffer
Penetrating Spinal Injury: Reports of Two Cases
(Turkish Assoc Trauma Emergency Surgery, 2009) Yilmaz, Nebi; Kiymaz, Nejmi; Mumcu, Cigdem; Demir, Ismail
Penetrating spinal cord injuries caused by stab wounds are rare. Such injuries may result from a direct lesion of the neural elements of the spinal cord, cord infarcts or, more rarely, intradural or epidural hematoma. In the present study, two cases with spinal cord and L4 root injuries caused by a knife are presented. The first case, a 22-year-old male, referred to our emergency outpatient clinic with a stab wound injury at the mid-section of his back. Neurological examination of this patient showed paraplegia, and spinal MRI displayed a total spinal cord lesion at the T7-T8 level. The wound was primarily sutured; however, during follow-up, CSF (cerebrospinal fluid) leakage continued and the patient was operated. The ruptured dura mater was primarily sutured in a surgical intervention that involved T7-T8 total laminectomy. The second patient referred to our emergency outpatient clinic with a torso injury caused by a sharp knife. The knife was embedded 2-3 cm deep at the wound site at the L3 level and the handle was broken. The patient was immediately operated and the broken and embedded metallic part of the knife was extracted.
Plasma Vitamin E and Selenium Levels in Rats With Head Trauma
(Elsevier Science inc, 2007) Kiymaz, Nejmi; Ekin, Suat; Yilmaz, Nebi
Background: Free radicals play an important role in brain damage induced by a head trauma. In this study, we examined the prevention of brain damage that occurs after oxidative stress in rats that had undergone an experimental head trauma and the determination of plasma levels of vitamin E and selenium, which are recognized as antioxidant agents. Methods: In this study, adult male Sprague-Dawley rats were used. Rats were divided into 2 groups. In the first group (control group, n = 10), pretraumatic plasma selenium and vitamin E levels were investigated and rats were not traumatized. In the second group (trauma group, n = 10), posttraumatic plasma selenium and vitamin E levels were investigated at the 6th and 24th hours in traumatized rats. Results: In the control group, the plasma selenium level was 107 8.113 mu g/L, whereas vitamin E level was 1.310 +/- 0.048 mg/dL. In the trauma group, the plasma selenium level was 79.93 +/- 3.130,mu g/L at the 6th hour and 74.74 2.947,mu g/L at the 24th hour, whereas the vitamin E level was 1.211 0.056 mg/dL at the 6th hour and 1.136 0.044 mg/dL at the 24th hour. Normal plasma selenium and vitamin E levels were significantly reduced in the early period after trauma. Conclusion: Because of oxidative stress that occurs directly after a head trauma, vitamin E and selenium depletion occurs in the early period. This condition supports the idea that brain damage can be reduced if decreased antioxidants are replaced when a head trauma occurs. We believe that these findings will guide and assist in future studies to develop clinical management strategies to prevent brain damage induced by head trauma. (c) 2007 Elsevier Inc. All rights reserved.
Primary Hydatid Cyst of the Brain During Pregnancy - Case Report
(Japan Neurosurgical Soc, 2006) Yilmaz, Nebi; Kiymaz, Nejmi; Etlik, Omer; Yazici, Taner
A 26-year-old woman in the 28th week of pregnancy presented with a primary cerebral hydatid cyst manifesting as deteriorating consciousness and weakness in the left arm and leg. Cranial computed tomography revealed an intracranial hydatid cyst. The cyst was surgically removed and albendazole was administered. The patient had a spontaneous vaginal term delivery and no problem was observed in the mother or child. No primary focus was found in the lungs, liver, and other organs. Hydatid cyst is still an important disease. Intracranial hydatid cyst without primary foci in organs such as the liver and lungs is very rare. Primary cerebral hydatid cyst during pregnancy can be successfully treated by surgical and medical intervention.
Prognostic Factors in Patients With Occipital Encephalocele
(Karger, 2010) Kiymaz, Nejmi; Yilmaz, Nebi; Demir, Ismail; Keskin, Siddik
Background: An encephalocele is a herniation of the brain and the meninges through a skull defect protruding towards the exterior. The condition is not rare when compared to spinal dysraphisms, but the worldwide incidence is not precisely known. The cases involving occipital encephaloceles which we have diagnosed in our clinic and the surgical approaches for this rare condition are presented herein. Methods: Thirty patients who were diagnosed with occipital encephaloceles and referred to our Neurosurgery Clinic at the Yuzuncu Yil University, Faculty of Medicine Research Hospital between 2000 and 2009 were enrolled in this study. The age of the patient, size of the sac, pathologies that accompanied the condition, and treatments applied were assessed. Results: In the present study, 30 patients (22 girls and 8 boys), whose ages varied between newborn and 14 months, were evaluated. The encephalocele sac was located in the occipital region in 27 patients (90%) and in the occipitocervical region in 3 patients (3%). Nine (30%) of the 30 patients died; 2 in the preoperative period, 2 in the postoperative early period (0-7 days) and 5 in the late postoperative period first week to 3 months). With the exception of the 2 patients who died preoperatively, surgery was performed on all of the patients. The mortality rate in our study was 29%. Conclusions: Our study demonstrated that factors which determine the prognosis of patients diagnosed with occipital encephaloceles include the size of the sac, the contents of the neural tissue, hydrocephaly, infections, and pathologies that accompany the condition. An occipital encephalocele is a congenital neurologic condition with an extremely high morbidity and mortality in spite of the treatments rendered pre- and postoperatively. Copyright (C) 2010 S. Karger AG, Basel
Protective Effect of Sildenafil (Viagra) in Transient Spinal Cord Ischemia
(Karger, 2008) Kiymaz, Nejmi; Yilmaz, Nebi; Mumcu, Cigdem; Anlar, Omer; Ozen, Suleyman; Kayaoglu, Cetin Refik
Prospective study of the neuroprotective activity of sildenafil in a rat spinal ischemia model. The present study involved 21 male Sprague-Dawley rats. The animals were divided into 3 groups. Physiological serum was administered intraperitoneally to the 8 rats in the control group at the beginning of reperfusion for a period of 20 min after abdominal aortal occlusion. Sildenafil (Viagra((R))) was administered as a single 10mg/kg/day intraperitoneal dose to the 8 rats in the sildenafil group at the beginning of reperfusion after 20 min of abdominal aortal occlusion. No occlusion was performed and no agent was administered to the 5 rats in the sham group, but the abdominal aorta was reached by means of surgical intervention. Before the animals were sacrificed, several physiological and biochemical parameters were investigated, preoperative and postoperative motor functions were also assessed, and somatosensory evoked potential (SEP) monitoring and histopathological examinations were carried out. No differences were found between the physiological and biochemical parameters in each of the 3 groups. Neurological scoring performed after reperfusion demonstrated a significant improvement in the neurological results relative to those of the control group over 48 h in subjects that received sildenafil. These animals also showed better 24-hour SEP results, measured in terms of extended latency and decreased amplitude, than the control animals. A histopathological study showed reduced ischemic symptoms in rats that received sildenafil compared with those in the control group. However, no anomalies were observed in the sham group with respect to the histopathological and neurological findings. These results indicate that neurological damage due to spinal-cord ischemia-reperfusion injury can be reduced by sildenafil.