Report of three cases. To describe a rare location of intervertebral disc migration. Migration of... more Report of three cases. To describe a rare location of intervertebral disc migration. Migration of sequestered disc fragments to the posterior extradural space is rare, and posterior migration of the free fragments causing cauda equina syndrome is exceptionally rare. Three patients with posteriorly migrated epidural disc fragments were evaluated with radiograph, computed tomography, and magnetic resonance imaging and underwent surgery. All of the patients responded well to operative therapy with complete relief of symptoms. Early surgery should be the first choice of therapy in patients with large posteriorly migrated sequestered disc fragments, to prevent severe neurologic deficits such as cauda equina and conus medullaris syndromes.
Background: The outcomes of coronary artery bypass surgery were evaluated, including mortality an... more Background: The outcomes of coronary artery bypass surgery were evaluated, including mortality and risk factors. Methods: A total of 1000 patients who had undergone coronary artery bypass grafting (CABG) in the Cardiovascular Surgery department of Atatürk University Faculty of Medicine, between January 2005 and April 2010, were evaluated retrospectively. Results: Preoperative factors affecting mortality included being over sixty years of age, having an ejection fraction below forty five, hypertension, and having a history of cerebrovascular disease. Intraoperative risk factors include having a cross-clamp time of over sixty nine minutes, and a cardiopulmonary bypass time of over one hundred and twenty minutes. Postoperative risk factors included: ventricular tachycardia with fibrillation, mediastinitis, mitral valve replacement, the necessity for extracorporeal membrane oxygenation (ECMO), or for an intra-aortic balloon pump, revision due to bleeding, or the necessity for MVR (Mitra...
Leiomyosarcomas are malignant tumors of smooth muscle origin. These tumors are very rare in the h... more Leiomyosarcomas are malignant tumors of smooth muscle origin. These tumors are very rare in the head and neck region. The majority of leiomyosarcomas of the head and neck arise in the paranasal sinuses, oral cavity, jaws and superficial soft tissues like the scalp. A mass was observed in the right temporoparietal region of the scalp of a 76-year-old female. Two years before presentation, the patient was operated for primary uterine leiomyosarcoma. Over the ensuing years, the mass substantially increased in size. Radiologic findings revealed a mixed density mass of the right temporalis muscle. Histologic and immunohistochemical examination of the tumor showed a malignant mesenchymal neoplasm consisting of spindle-shaped atypical mesenchymal cells with marked pleomorphism and central cigar shaped nuclei arranged in fascicles. We report a rare case of uterine leiomyosarcoma metastatic to the temporalis muscle, proven by histopathology.
We present a 29-year-old woman with a giant cell tumor of the temporal bone. The differential dia... more We present a 29-year-old woman with a giant cell tumor of the temporal bone. The differential diagnosis is discussed with reference to the literature regarding giant cell lesions, especially of the cranium.
Abstract Aim Our aim was to perform the Turkish-language adaptation of a practical ataxia rating ... more Abstract Aim Our aim was to perform the Turkish-language adaptation of a practical ataxia rating scale for children. Methods The Brief Ataxia Rating Scale was subjected to cultural adaptation following receipt of the requisite permissions. Thirty-six children aged 4–18 years followed-up with a diagnosis of ataxia were included in the study. Evaluation of each child was recorded on video. The video recordings were scored independently by nine observers (four physiotherapists, one pediatric neurologist, and four pediatricians). Intra-rater reliability was tested by the same video images being scored twice, at 15-day intervals, by a pediatric neurologist. Intraclass correlation coefficients were used for inter-rater and intra-rater reliability. The Scale for the Assessment and Rating of Ataxia was used for concurrent validity. Results Good to excellent reliability was determined among the nine observers in terms of total scores with the intraclass correlation coefficient among the nine observers (intraclass correlation coefficient = 0.926; 95% CI: 0.885–0.956). Intra-rater reliability analysis results exhibited strong reliability in terms of scores elicited at two-week intervals (intraclass correlation coefficient = 0.967; 95% CI: 0.890–0.987, r = 0.97, p < 0.001). At concurrent validity analysis, a strong relation was determined between total Scale of the Assessment and Rating of Ataxia score and total Brief Ataxia Rating Scale score (r = 0.942, p < 0.001). Conclusion The Turkish-language adaptation of the Brief Ataxia Rating Scale is reliable and valid for application in children. Implications for Rehabilitation This study shows the reliability and validity of the Turkish language adaptation of brief ataxia rating scale in children. The scale being both practical and easily applicable to ataxic children will contribute to broadening its use in the pediatric age group in particular.
Background: Ischemic brain damage can be explained by the emergence of acute focal or global neur... more Background: Ischemic brain damage can be explained by the emergence of acute focal or global neurological findings caused by vascular occlusions or hemorrhages. Even in non-fatal cases, stroke is an important pathologic condition with a severe impact on the quality of life, and patients require considerable assistance in the daily lives. Objectives: The purpose of this study was to investigate the effect of rifampicin on malondialdehyde (MDA) levels and neurological examination of the hippocampal region in rats with transient cerebral ischemia. Methods: This experimental study has been performed in a university-affiliated animal lab, Trabzon, Turkey, in 2016. Thirty-eight Sprague Dawley rats weighing 220 - 280 g were used. In this two-vessel occlusion and hypotension ischemia-reperfusion model, the bilateral carotid arteries were temporarily clipped (30 minutes), and blood was withdrawn up to 3 mL of intracardiac volume before the induction of hypotension. After 30 minutes, the clips were removed, and a reperfusion medium was created. One group of 12 rats received intraperitoneal injections of 30 mg/kg of rifampicin every day, and after a 30-minute bilateral carotid artery clipping and hypotension (10 mL/kg). Another group of 12 rats underwent a 30-minute bilateral carotid artery clipping and hypotension (10 mL/kg). The third group consisting of 7 rats underwent skin laceration only. The final group of 7 rats received anesthesia for only 15 minutes. Neurological examinations were performed at the end of days 1, 4, 7, and 10 in all groups. At the end of the 10th day, the animals were euthanized, and their brain tissues were removed. The hippocampi were removed from the brains for biochemical analysis and stored at -76°C in a deep freeze. Ischemic changes in the brain were assessed biochemically by measuring MDA levels in both blood and brain tissue. Results: There was no statistically significant difference between the groups in terms of the mean tissue MDA levels (P = 0.112), but a significant difference was determined in the mean serum MDA values (P = 0.033). Serum MDA values significantly differed between the Group 1 and Group 2 (P = 0.030), but not between Group 1 and Group 3 (P = 0.58). Serum MDA values were also significantly different between Group 2 and Group 3 (P = 0.019), and between Group 2 and Group 4 (P = 0.035). Conclusions: Rifampicin could exhibit a neuroprotective effect on cerebral ischemia-reperfusion injury.
Report of three cases. To describe a rare location of intervertebral disc migration. Migration of... more Report of three cases. To describe a rare location of intervertebral disc migration. Migration of sequestered disc fragments to the posterior extradural space is rare, and posterior migration of the free fragments causing cauda equina syndrome is exceptionally rare. Three patients with posteriorly migrated epidural disc fragments were evaluated with radiograph, computed tomography, and magnetic resonance imaging and underwent surgery. All of the patients responded well to operative therapy with complete relief of symptoms. Early surgery should be the first choice of therapy in patients with large posteriorly migrated sequestered disc fragments, to prevent severe neurologic deficits such as cauda equina and conus medullaris syndromes.
Background: The outcomes of coronary artery bypass surgery were evaluated, including mortality an... more Background: The outcomes of coronary artery bypass surgery were evaluated, including mortality and risk factors. Methods: A total of 1000 patients who had undergone coronary artery bypass grafting (CABG) in the Cardiovascular Surgery department of Atatürk University Faculty of Medicine, between January 2005 and April 2010, were evaluated retrospectively. Results: Preoperative factors affecting mortality included being over sixty years of age, having an ejection fraction below forty five, hypertension, and having a history of cerebrovascular disease. Intraoperative risk factors include having a cross-clamp time of over sixty nine minutes, and a cardiopulmonary bypass time of over one hundred and twenty minutes. Postoperative risk factors included: ventricular tachycardia with fibrillation, mediastinitis, mitral valve replacement, the necessity for extracorporeal membrane oxygenation (ECMO), or for an intra-aortic balloon pump, revision due to bleeding, or the necessity for MVR (Mitra...
Leiomyosarcomas are malignant tumors of smooth muscle origin. These tumors are very rare in the h... more Leiomyosarcomas are malignant tumors of smooth muscle origin. These tumors are very rare in the head and neck region. The majority of leiomyosarcomas of the head and neck arise in the paranasal sinuses, oral cavity, jaws and superficial soft tissues like the scalp. A mass was observed in the right temporoparietal region of the scalp of a 76-year-old female. Two years before presentation, the patient was operated for primary uterine leiomyosarcoma. Over the ensuing years, the mass substantially increased in size. Radiologic findings revealed a mixed density mass of the right temporalis muscle. Histologic and immunohistochemical examination of the tumor showed a malignant mesenchymal neoplasm consisting of spindle-shaped atypical mesenchymal cells with marked pleomorphism and central cigar shaped nuclei arranged in fascicles. We report a rare case of uterine leiomyosarcoma metastatic to the temporalis muscle, proven by histopathology.
We present a 29-year-old woman with a giant cell tumor of the temporal bone. The differential dia... more We present a 29-year-old woman with a giant cell tumor of the temporal bone. The differential diagnosis is discussed with reference to the literature regarding giant cell lesions, especially of the cranium.
Abstract Aim Our aim was to perform the Turkish-language adaptation of a practical ataxia rating ... more Abstract Aim Our aim was to perform the Turkish-language adaptation of a practical ataxia rating scale for children. Methods The Brief Ataxia Rating Scale was subjected to cultural adaptation following receipt of the requisite permissions. Thirty-six children aged 4–18 years followed-up with a diagnosis of ataxia were included in the study. Evaluation of each child was recorded on video. The video recordings were scored independently by nine observers (four physiotherapists, one pediatric neurologist, and four pediatricians). Intra-rater reliability was tested by the same video images being scored twice, at 15-day intervals, by a pediatric neurologist. Intraclass correlation coefficients were used for inter-rater and intra-rater reliability. The Scale for the Assessment and Rating of Ataxia was used for concurrent validity. Results Good to excellent reliability was determined among the nine observers in terms of total scores with the intraclass correlation coefficient among the nine observers (intraclass correlation coefficient = 0.926; 95% CI: 0.885–0.956). Intra-rater reliability analysis results exhibited strong reliability in terms of scores elicited at two-week intervals (intraclass correlation coefficient = 0.967; 95% CI: 0.890–0.987, r = 0.97, p < 0.001). At concurrent validity analysis, a strong relation was determined between total Scale of the Assessment and Rating of Ataxia score and total Brief Ataxia Rating Scale score (r = 0.942, p < 0.001). Conclusion The Turkish-language adaptation of the Brief Ataxia Rating Scale is reliable and valid for application in children. Implications for Rehabilitation This study shows the reliability and validity of the Turkish language adaptation of brief ataxia rating scale in children. The scale being both practical and easily applicable to ataxic children will contribute to broadening its use in the pediatric age group in particular.
Background: Ischemic brain damage can be explained by the emergence of acute focal or global neur... more Background: Ischemic brain damage can be explained by the emergence of acute focal or global neurological findings caused by vascular occlusions or hemorrhages. Even in non-fatal cases, stroke is an important pathologic condition with a severe impact on the quality of life, and patients require considerable assistance in the daily lives. Objectives: The purpose of this study was to investigate the effect of rifampicin on malondialdehyde (MDA) levels and neurological examination of the hippocampal region in rats with transient cerebral ischemia. Methods: This experimental study has been performed in a university-affiliated animal lab, Trabzon, Turkey, in 2016. Thirty-eight Sprague Dawley rats weighing 220 - 280 g were used. In this two-vessel occlusion and hypotension ischemia-reperfusion model, the bilateral carotid arteries were temporarily clipped (30 minutes), and blood was withdrawn up to 3 mL of intracardiac volume before the induction of hypotension. After 30 minutes, the clips were removed, and a reperfusion medium was created. One group of 12 rats received intraperitoneal injections of 30 mg/kg of rifampicin every day, and after a 30-minute bilateral carotid artery clipping and hypotension (10 mL/kg). Another group of 12 rats underwent a 30-minute bilateral carotid artery clipping and hypotension (10 mL/kg). The third group consisting of 7 rats underwent skin laceration only. The final group of 7 rats received anesthesia for only 15 minutes. Neurological examinations were performed at the end of days 1, 4, 7, and 10 in all groups. At the end of the 10th day, the animals were euthanized, and their brain tissues were removed. The hippocampi were removed from the brains for biochemical analysis and stored at -76°C in a deep freeze. Ischemic changes in the brain were assessed biochemically by measuring MDA levels in both blood and brain tissue. Results: There was no statistically significant difference between the groups in terms of the mean tissue MDA levels (P = 0.112), but a significant difference was determined in the mean serum MDA values (P = 0.033). Serum MDA values significantly differed between the Group 1 and Group 2 (P = 0.030), but not between Group 1 and Group 3 (P = 0.58). Serum MDA values were also significantly different between Group 2 and Group 3 (P = 0.019), and between Group 2 and Group 4 (P = 0.035). Conclusions: Rifampicin could exhibit a neuroprotective effect on cerebral ischemia-reperfusion injury.
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