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    Controlled trial of efficacy of dexketoprofen in sciatic nerve crush injury in rats [Si{dotless}çanlarda siyatik sinir yaralanmasi{dotless}nda deksketoprofenin etkinli?inin kontrollü çali{dotless}şmasi{dotless}]
    (Ege University Press, 2014) Kaptan H.; Kasimcan O.; Ayaz M.; Bozdogan O.; Karabagli H.
    Object: Local applications of Dexketoprofen trometamol (dex) have been shown to increase in the sciatic nerve functional tests following the nerve injuries. The aim of the current study was to compare the efficacy of dex application for 1 and 5 days following nerve injury rat model. Possible effects of dex were checked by means of the Sciatic Function Index (SFI), Withdrawal of the Reflex Leg (WRL), number of axons, axon diameter, and nerve diameters. Material Methods: The animal crushed model was done through Aesculap -Yasargil aneurysm method on Wistar albino (N=21) right sciatic nerves. In order to achieve desired purpose 3 experimental groups were organized: Group 1: control (injured and no drug); Group2: dexketoprofen 1 days (injured and single dose of drug); Group3: dexketoprofen 5 days (injured and single dose of 5 times drug applications). Injections were done through the tissue expander's injection port with a connecting tube directed at the crush-injured site. Functional recovery of the sciatic nerves was evaluated with the improvement in the SFI values. Additionally, recovery of sensory function was assessed through WRL results and histopathological examination was performed 6 week following the injury. Results: At the end of the experimental periods there was no significant differences were found between the experimental group of animals on the bases of the number of axons, axon diameter, and nerve diameter. Moreover, up 30th day of the experimental period our functional test results have shown that there was no difference between the groups. But following the induction of the injury, the statistical significances were seen on the functional tests. This effect was seen only if the multi-dose application of the dex. Conclusions: This study suggests that; dexketoprofen trometamol of 5 consecutive days, has revealed positive significant changes in the sciatic nerve injury through analgesic effect of it.
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    Intercostal schwannoma developed after radiotherapy: Case report [Radyoterapi sonrasi gelişen i?nterkostal schwannoma: Olgu sunumu]
    (2013) Oncel M.; Sunam G.S.; Karabagli P.; Karabagli H.
    65 year old woman four years ago underwent mastectomy for left breast cancer patients received radiotherapy later. The patient was admitted our hospital due to complaint of pain in the left side of the surgical incision site. There was mass approximately 2cm in which left hemithorax. Surgical resection was performed and pathological investigation was resulted as schwannoma.
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    Intraventricular microcystic meningioma in a child: a case report
    (Springer, 2019) Sahinoglu M.; Karabagli P.; Karabagli H.; Koktekir E.
    Background: Microcystic meningiomas are extra axial masses that are extremely rare in the pediatric population. Intraventricular meningiomas are also rarely seen. Case Presentation: This case reports an 18-year-old boy who had an intraventricular mass on magnetic resonance imaging at the age of 12 years and had shown growth at a 6-year follow-up after subtotal resection. The mass was removed by total resection and pathological examination indicated microcystic meningioma. Conclusion: The present case is the first pediatric intraventricular microcystic meningioma in the literature. We believe that this unique case presented with its radiological, pathological and clinical features will contribute to the literature. © 2019, Springer-Verlag GmbH Germany, part of Springer Nature.
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    Myelomeningoceles and meningoceles: A clinicopathologic study of 43 cases [Miyelomeningosel ve meningosel: 43 olgulu kliniko-patolojik bir çali{dotless}şma]
    (Ege University Press, 2014) Karabagli P.; Gurcan T.; Celik Z.E.; Karabagli H.
    Objective: The purpose of the study both meningocele and myelomeningocele reviewing the clinical and pathological findings as well as to discuss the pathological diagnosis. Material and methods: Meningocel and myelomeningocele were retrived from the pathology files. Forty three cases with detailed clinical and radiological data were selected. Masson's trichrome performed on original sections from paraffin blocks. All sections from each case were reviewed. Results: There were 34 cases of myelomeningocele, 9 cases of meningocele. F/M ratio was 1.2 to 1. The age range of patients were from newborn to 4 months. 90% of cases were in the lumbosacral region. 31 cases of myelomeningoceles, and 3 cases of meningoceles were hydrocephalus. Chiari II malformation was seen in 88% of myelomeningocels and in 22% of meningoceles. Three patients had a clubfoot deformity. Microscopically, epithelial changes included ulceration, loss of appendages. Mesodermal findings included fibrosis (90% of cases), adipose tissue (62%), hypertrophic smooth muscle (18%), skeletal muscle (4%) and increased numbers of blood vessels (79%). Subepidermal calcification was noted in 2 cases. Neuroectodermal features, neuropil-like matrix and ependymal lining were noted in 34 and 15 cases respectively. Nerve fibers were identified varied from easily identifiable large myelinated nerve trunks to slightly increased numbers of fibers in 83% of the cases. Conclusion: Both clinical and pathological differences were seen among myelomeningoceles. These malformations involve ectoderm, neuroectoderm, and mesoderm. Definition of the pathological aspects of dysraphism will potentiate the understanding of these anomalies.
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    Palmar skin temperature importance during transthoracic endoscopic sympathectomy for palmar hyperhidrosis [Palmar hiperhidrozis i?çin yapılan transtorasik endoskopik sempatektomi sırasında palmar cilt sıcaklı?ının önemi]
    (Ege University Press, 2012) Oncel M.; Sudam G.S.; Karabagli H.; Kara I.; Celik J.B.
    Background: The primary goal of this study is to identity and analysis age, diagnosis, sympathic chain levels, complications and results associated with successful endoscopic surgical treatment for hyperhydrosis and also this study was to investigate of palmar temperature changes during the operation and to prove the successful surgical procedures and beneficial of the bilateral sympathectomy during the peroperative case. Methods: Fifty one patients with severe primary palmar hyperhidrosis received bilateral endoscopic thoracic sympathectomy. Different levels of transection from T4 to T2 were performed step by step until the successful extirpation was implied by the recorded unilateral right palmar temperature intraoperative monitoring. The results of the operations were studied. All patients were followed up and evaluated for symptom resolution, postoperative complication, levels of satisfaction, and severity of compensatory sweating. Effective extirpation ganglia occurred with the intraoperative increasing palmar temperature. Results: Of a total of 102 lateral procedures, 76 laterals (76%) ended the procedure at the T4 level, 23 laterals (23%) ended the procedure at the T3-T5 level, and 1 lateral (1%) ended the procedure at the T2 level. The postoperative complication was minor, and no Horner's syndrome was detected. The rate of symptom resolution was 100% and no recurrence was found. The satisfaction rate was 92%, and the incidence of mild, moderate, and severe compensatory sweating were 12%, 8%, and 6%, respectively. Conclusions: Concerning the sympathectomy for palmar hyperhidrosis, there is a possibility that the level of the transection varies and should be adjusted for each individual patient. Intraoperative monitoring of temperature may be a useful tool in establishing a kind of standardized reference for finding the correct target level.
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    Rarely encountered spinal tanycytic ependymoma and concominant syringomyelia [Nadir görülen spinal tansitik ependimoma ve buna eşlik eden siringomiyeli olgusu]
    (2010) Karabagli H.; Karabagli P.; Hakan T.
    Objective: To present a rare case of the tanycytic variant of intramedullary ependymoma associated with syringomyelia. Case Report: A 51-year-old-woman developed gradual sensory disturbance and weakness of bilateral hands over ten months prior to admission. Magnetic resonance imaging (MRI) demonstrated an enhancing tumor throughout C-2 to C-4 levels of the spinal cord from and syringomyelia extending from C-1 to C-2 and C-4 to C-5. The tumor was totally resected. Histological findings indicated a diagnosis of tanycytic ependymoma. The tumor was characterized by poor cellularity, markedly elongated spindle shaped cells, which were immunopositive for S-100 protein and glial fibrillary acidic protein. Since a complete resection was performed at surgery, no further treatment was proposed. One year later, MRI imaging demonstrated collapse of the cervical syringomyelia. The patient has no recurrence during a 2-year follow up period. Conclusion: Tanycytic ependymoma may occur frequently in spinal cord, especially in the cervical region. It histologically resembles pilocytic astrocytoma and schwannoma; and so other benign spindle cell tumors of the central nervous system should be takes into account in the differential diagnosis. Tanycytic ependymomas should be managed in the same way as ordinary ependymomas, since there is no current evidence suggesting that these morphologic distinct tumors differ in terms of biological behavior. Intramedullary spinal tumors with associated syrinx are not rare, which may be due to the expanding of tumor along the central canal of the spinal cord. The surgical treatment of primary pathology could improve both the tumor and the secondary syringomyelia.
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    Thoracic neurogenic tumours [Torakal nörojenik tümörler]
    (2013) Öncel M.; Sunam G.S.; Karabagli P.; Karabagli H.
    Intrathoracic neurogenic tumours are neoplasms arising from any of the neurogenic elements of the mediastinum. Schwannomas and neurofibromas develop from nerve sheath, ganglioneuromas and neuroblastomas from autonomic ganglions. The aim of in this study we present the clinical and pathological details of these patients and to determine only extending the mediastinum. Materials and methods: We reached retrospective clinical data of 16 patients (10 males and 6 females) with neurogenic tumours of the mediastinum undergoing surgical treatment 2008 to 2012. Age of the patients ranged from 5 to 66 years (mean 46 years). When the patients admitted our clinic to surgery. All patients had detailed history and physical examination, routine chest radiography, electrocardiography and standard laboratory blood tests. For localizations and to define the nature of the tumour whole the patients were performed computed tomographic (CT). Especially when we suspected involvement of intervertebral space and vascular space magnetic resonance imaging. Results: Preoperative symptoms were observed in 13 cases (%81), as follows: back and thoracic pain in 10 (%63), short of breathness in 3 (%19) patient.The preoperative CT showed the tumour as a solid lesion in 16 cases. The tumour was located on the posterior mediastinum in 10 (%63) patients and cases.2 (%13) patients upper mediastinum and 4 (%25) patients from thoracic wall. The histological type of the tumours was in 3 (%19) cases, ganglioneuroma, in 3 (%19) cases benign neurofibroma, in 9 (%56) cases schwannomas. 1 (%6) case originated from malignant peripheral nerve sheet tumour (MPNST). Complete surgical excision was achieved in all patients, with no postoperative mortality. There was no significant intraoperative and postoperative blood loss and no major surgical complications occurred. Conclusions: After the surgical indications may be carefully determined in cases. There is a good result in these tumours. MRI would facilitate therapeutic determination by distinguishing nature, spread and invasion of the neurogenic tumour. Patient with benign neurogenic tumours have a good survival prospect following operations.