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Öğe Aicardi Sendromuna Eşlik Eden Üçüncü Ventrikül Kolloid Kisti: Olgu Sunumu(2010) Cengiz, Şahika Liva; Erdi, Mehmet Fatih; Demir, Lütfi Saltuk; Beysefer, AlperAicardi sendromu koriyoretinal lakün, nöbet ve kallozal agenezi triadından oluşur. Üç aylık kız hasta anormal göz hareketleri ve nöbet şikayetleri ile kliniğimize getirildi. Fundus muayenesinde her iki gözde koriyoretinal lakün tespit edildi. Beyin manyetik rezonans görüntülemesinde korpus kallozum agenezisi ve üçüncü ventrikülü tıkayan kitle tespit edildi. Cerrahi olarak tedavi edilen hastanın histopatolojik incelemesi kolloid kist olarak geldi. Aicardi sendromunda intrakraniyal kistlere iyi tolerans olduğu bildirilmesine rağmen, üçüncü ventrikülü tıkamış kistik lezyona sahip olan bu olgu literatür ışığı altında tartışılmıştır.Öğe Alfa lipoik asidin deneysel subaraknoid kanama ve vazospazmda lipid peroksidasyonu, antioksidan durum ve endotelial apopitoz üzerine etkileri(Selçuk Üniversitesi Tıp Fakültesi, 2009) Erdi, Mehmet Fatih; Güney, Ahmet ÖnderBu çalışma ile ALA'nın tavşanlarda oluşturulan subaraknoid kanama modelinde vazospazm üzerine etkileri incelenmiştir. Gereç ve Yöntem: Yirmibir adet erkek, Yeni-Zelanda tipi tavşan randomize olarak her biri 7 tavşandan oluşan 3 gruba ayrılmıştır: grup 1 (kontrol), grup 2 (SAK), grup 3 (SAK+ALA). ALA tedavisi (100mg/kg/gün ip) olarak verilmiş ve tedaviye SAK oluşturulmadan hemen önce başlanarak tedavi 72 saat sürdürülmüştür. Yetmiş iki saatin sonunda denekler sakrifiye edilerek elde edilen beyin sapı dokularında doku MDA, SOD, GSH-Px düzeyleri ölçülmüş ayrıca elde edilen baziller arter kesitlerinde arter duvar kalınlığı, arter lümen alanı ve immünohistokimyasal olarak da endotelial apopitoz yüzdeleri tespit edilmiştir. Bulgular: Tavşanlarda oluşturulan vazospazm modelinde ALA tedavisi istatistiksel olarak anlamlı şekilde vazospazm gelişimini engellemiştir. SAK sonrasında artış gösteren MDA düzeyleri tedavi ile azalmış, SOD ve GSH-Px'de görülen azalma ise engellenmiştir. Histopatolojik olarak ALA, SAK sonrası ortaya çıkan arter duvar kalınlaşmasını ve arter lümen alanındaki daralmayı engellemiştir. İmmunohistokimyasal olarak ALA, SAK sonrasında görülen endotelial apopitozu azaltmaktadır. Sonuç: ALA tavşanlarda oluşturulan SAK modelinde vazospazm gelişimini engellemektedir. ALA'nın SAK sonrasında nöroprotektif ve apopitozu düzenleyici etkileri olduğu bu çalışma ile gösterilmiştir. ALA, SAK sonrası görülen serebral vazospazmda potansiyel bir tedavi edici ve engelleyici ajan olarak karşımıza çıkmaktadır. Klinik uygulamaya geçilebilmesine yönelik daha ileri çalışmalara ihtiyaç vardır.Öğe Beneficial Effects of Levosimendan on Cerebral Vasospasm Induced by Subarachnoid Haemorrhage: An Experimental Study(Taylor & Francis Ltd, 2010) Cengiz, Şahika Liva; Erdi, Mehmet Fatih; Tosun, Murat; Atalık, Esra; Avunduk, Mustafa Cihat; Sönmez, Fatma Cavide; Mehmetoğlu, İdris; Baysefer, AlperBackground: The aim of this study was to investigate the ability of levosimendan to prevent cerebral vasospasm in a rabbit model of subarachnoid haemorrhage (SAH). Animals and methods: Eighteen New Zealand white rabbits were allocated into three groups randomly. SAH was induced by injecting autologous blood into the cisterna magna. (Group 1 = control: sham surgery group, Group 2 = SAH alone group, Group 3 = SAH plus levosimendan group). Histopathological examination was performed on day 3 as described. Intravenous levosimendan dose (initially 12 mu g kg(-1) infusion, continuously for at least 10 minutes and then continued with a dose of 0.2 mu g kg(-1) min(-1)) treatment was started after the induction of SAH. Three days later, the animals were sacrificed. Results: In pathological investigation; there was statistically significant difference in luminal area and muscular wall thickness of the basilar artery between all groups (p < 0.005). Malondialdehyde level was also found significantly low in the levosimendan group compared with the SAH group. Conclusion: Intravenous levosimendan treatment was found effective by increasing the pathological luminal area and reducing muscular wall thickness measurements. This is the first study to show that intravenous administration of levosimendan is effective in preventing cerebral vasospasm induced by SAH in rabbits.Öğe The Effects of Alpha Lipoic Acid on Cerebral Vasospasm Following Experimental Subarachnoid Hemorrhage in the Rabbit(TURKISH NEUROSURGICAL SOC, 2011) Erdi, Mehmet Fatih; Guney, Onder; Kiyici, Aysel; Esen, HasanAIM: The aim of this study is to determine the effects of a strong dithiol antioxidant, alpha lipoic acid (ALA) on cerebral vasospasm following subarachnoid hemorrhage in a rabbit model. MATERIAL and METHODS: Twenty-one New Zealand white rabbits were assigned to one of three groups: group 1 (control), group 2 (SAH only), group 3 (SAH+ALA). ALA was administered (100 mg/kg/day, single dose, intraperitoneally). The rabbits were sacrificed 72 hours after SAH. The basilar artery lumen areas, arterial wall thickness and endothelial apoptosis in a cross section of basilar artery were measured in all groups. The tissue MDA, SOD, GSH-Px levels were also determined. RESULTS: The elevated tissue MDA levels after SAH were significantly reduced by ALA treatment. The reduced tissue SOD and GSH-Px levels after SAH were also elevated by ALA treatment. In the treatment group the average wall thickness and the mean percentages of apoptotic cells (apoptotic index) were reduced and the average cross-sectional areas of the basilar artery were increased statistically significantly. CONCLUSION: ALA treatment attenuates the severity of cerebral vasospasm by its strong antioxidant, antivasospastic and antiapoptotic properties. ALA may potentially serve as agents in the prevention of cerebral vasospasm after SAH.Öğe Intradural Intramedullary Conus Medullaris Metastasis of Colorectal Adenocarcinoma: A Case Report(Ege University Press, 2012) Keskin, Fatih; Kalkan, Erdal; Erdi, Mehmet Fatih; Esen, HasanSpinal cord metastasis is rarely seen. Intramedullary spinal metastasis has been defined between the rates of 0,9 -2,1% in the autopsies performed on the cancerous cases. And also intramedullary spinal metastases are defined at a rate of 8,5% in the cases which have metastasis at central nervous system. The male patient, who was at the age of 62, was admitted to our clinic with the complaints of serious back and left leg pain and weakness at the left leg which had begun 15 days before. Low anterior resection + total mesorectal excision + ileostomy were applied to the patient five years ago due to colorectal adenocarcinoma. The carcinoma was reported as adenocarcinoma grade II. Chemotherapy and radiotherapy were applied after postoperative period. Left SLR was positive and 3/5 monoparesis at left leg was determined in the patients neurological examination. Conus medullaris located tumor was determined in the magnetic resonance imaging of the patient. Intradural intramedullary tumor which was infiltrated to the conus medullaris was totally removed with microneurosurgical technique via Th12-L1-2 total laminectomy. Th11-L3 posterior instrumentation and fusion were added because of expansive laminectomy and L1 corpus involvement of the tumor. The histopathological examination was reported as colorectal adenocarcinoma metastasis. In this manuscript we report a colorectal adenocarcinoma metastasis to the conus medullaris for the first time in the literature.Öğe Intradural Intramedullary Conus Medullaris Metastasis of Colorectal Adenocarcinoma: A Case Report(2012) Keskın, Fatıh; Kalkan, Erdal; Erdi, Mehmet Fatih; Esen, HasanOmurilik metastazları nadiren görülür. Kanserli olgularda yapılan otopsilerde %0.9 ile %2.1 arasında intramedüller spinal metastaz tanımlanmıştır ve de santral sinir sistemi metastazı olan olgularda %8.5 oranında intramedüller omurilik metastazı görülür. 62 yaşında erkek hasta 15 gün önce başlayan şiddetli bel ve sol bacak ağrısı, sol bacakta kuvvetsizlik şikayeti ile kliniğimize yatırıldı. Hastaya beş yıl önce alt anterior rezeksiyon, total mezorektal eksizyon, ileostomi uygulanmıştı. Patolojisi kolorektal adenokarsinom grade II idi. Nörolojik muayenesinde sol SLR (), solda 3/5 monoparezi tespit edildi. Hastanın manyetik rezonans görüntülemesinde konus medullarisde tümoral kitle tespit edildi. Th12-L1-L2 total laminektomi ile mikroskopik olarak konus medullarise infiltre olan kitle total çıkarıldı. L1 korpus tutulumu ve geniş laminektomi uygulandığı için Th11-L3 arası posterior enstrumantasyon ve füzyon uygulandı. Histopatolojisi kolorektal adenokarsinom metastazı olarak değerlendirildi. Konus medullarise metastaz yapmış kolorektal adenokarsinom olgusunu literatürde ilk kez rapor etmekteyiz.Öğe The role of intravenous immunoglobulin in the treatment of cerebral vasospasm induced by subarachnoid haemorrhage: An experimental study(TAYLOR & FRANCIS LTD, 2011) Cengiz, Sahika Liva; Erdi, Mehmet Fatih; Avunduk, Mustafa Cihat; Tosun, Murat; Ustun, Mehmet Erkan; Gokce, Recep; Yosunkaya, AlperObjectives: The aim of this study was to determine whether intravenous immunoglobulin (IVIG) prevents cerebral vasospasm in rabbits with induced subarachnoid haemorrhage (SAH). The effect of IVIG on apoptosis in the endothelial cells of the basilar artery was also evaluated. Methods: Eighteen New Zealand white rabbits were allocated randomly into three groups. SAH was induced by injecting autologous blood into the cisterna magna. Group 1, the control group, was subjected to sham surgery (no induction of SAH). Group 2 had SAH alone and Group 3 had SAH plus IVIG. Three days after treatment, the animals were sacrificed. The basilar artery tissues were analysed histologically and the malondialdehyde levels in the brain stem tissues were evaluated biochemically. Results: Differences in the histopathological luminal areas and full wall thicknesses in the SAH plus IVIG group and the SAH group were statically insignificant (p > 0.005). The malondialdehyde level was also found to be lower in the IVIG group than in the SAH group, although this difference was not significant (p > 0.005). Conclusion: Although the IVIG treatment was revealed to have no vasodilator effect on the SAH-induced spastic basilar artery, it was shown to have a beneficial effect on the apoptosis of endothelial cells, probably via anti-inflammatory mechanisms.
