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Öğe Azathioprine as a neuroprotective agent in experimental traumatic spinal cord injury(Turkish Neurosurgical Society, 2021) Bahadır, Sinan; Önal, Mehmet Bülent; Narin, Fırat; Başar, İbrahim; Yigitkanlı, Kazım; Bavbek, Murad; Ziyal, Mustafa İbrahimAIM: To evaluate the protective effects of azathioprine, a macrophage-inhibiting agent, on secondary injury in spinal cord trauma. MATERIAL and METHODS: A total of 40 Wistar rats were randomly divided into 4 groups. All the animals had undergone T8-10 laminectomy. Except in group I (control), all the animals were exposed to spinal cord trauma at the T9 level. Animals in group II (trauma) received no treatment following trauma. Animals in group 3 (treatment) and group IV (vehicle) were given intraperitoneal azathioprine 4 mg/kg and saline 2 ml, respectively, 30 minutes after the trauma. Half of the animals in each group were sacrificed 24 hours after injury and specimens were used for biochemical and immunohistochemical evaluations. The rest of the animals were followed-up for 4 weeks in terms of neurological functions and were also sacrificed to perform the histopathological analysis. RESULTS: Significant decrease in apoptotic cells and improved neurological function were observed in the animals treated with azathioprine. Biological and immunohistochemical analysis also showed less oxidative stress in this group compared to those without treatment. CONCLUSION: Azathioprine, a potent macrophage-inhibiting agent, has been shown to decrease the extent of secondary injury following spinal cord trauma.Öğe Comparison of ependymomas and medulloblastomas located in the posterior cranial fossa: An anatomical and histopathological study(Pisa University Press, 2020) Yılmaz, Tevfik; Öztürk, Pınar Aydın; Başar, İbrahim; Turan, Yahya; Aslanoğlu, Barış; Aydın, Kamuran; İbiloğlu, İbrahim; Tuncer, Mehmet CudiPURPOSE: Posterior fossa tumors (PFTs) include medulloblastomas, atypical teratoid/rhabdoid tumors, pilocytic astrocytomas, ependymomas, and brainstem gliomas. We evaluated patients with surgery at our clinic, comparing epidemiological, clinical, radiological, and pathological characteristics of medulloblastoma and ependymoma to identify factors that might assist preoperative diagnosis, help to develop treatment algorithms, and have prognostic value after surgery. METHODS: Pediatric patients from 0 to 16 and young adults from 16 to 29 years of age with surgery for pathologically confirmed ependymomas or medulloblastomas between January 2014 and January 2020 were eligible. The study included 19 patients, seven with ependymoma (37%) and 12 with medulloblastoma (63.2%). The ependymoma patients were 5.29 +/- 5.85 years of age, the medulloblastoma patients were 11.58 +/- 8.17 years of age, and 16 patients (84%) were children. RESULTS: Fifteen patients (79%) presented with signs of increased intracranial pressure and four (21%) presented with cerebellar findings. MRI found that 74% (14) of the PSTs were located in the midline, including six of the seven ependymomas (86%) and eight of the 12 medulloblastomas (67%). Enhancement was significantly greater in medulloblastomas compared with ependymomas (p = 0.022). In according to pathology results; synaptophysin, NSE, chromogranin and 50% GFAP positivity were observed in medulloblastoma. Ependymomas were S100 (43%) and vimentin (29%) positive. Ependymoma patients were younger than medulloblastoma patients and more were female. Conclusions: There were no significant differences in the clinical findings, but ependymomas were larger and had greater rates of enhancement and spinal metastasis compared with medulloblastomas.Öğe Hospital admissions of spontaneous subarachnoid hemorrhage during the COVID-19 pandemic: Southeastern Turkey experience(ASEAN Neurological Association, 2022) Başar, İbrahim; Bahadır, Sinan; Yılmaz, TevfikObjective: This study aimed to determine if the coronavirus disease 2019 (COVID-19) pandemic had any impact on admission patterns for subarachnoid hemorrhage (SAH) during 1st and 2nd waves and in-between in a tertiary institution in southeastern Turkey. Methods: Three periods were determined during the pandemic: First and second peaks (April 1-May 1, 2020 and November 18-December 18, 2020, respectively) and the slowdown period (July 5-August 4, 2020) where the daily new cases hit its lowest. We retrospectively collected data of the patients with SAH who were admitted to our institution within these periods during 2020 (the pandemic) and 2019 (the year before the pandemic). Demographic data, time between symptom onset and admission, Glasgow Coma Scale (GCS), Fisher score, World Federation of Neurosurgical Societies (WFNS), presence of intracerebral hemorrhage, intraventricular hemorrhage, hydrocephalus, type of SAH (aneurysmal vs non-aneurysmal) were recorded and compared between the pandemic and pre-pandemic periods. Results: The number of admissions in first peak, slowdown, and second peak during the pandemic was 11, 15, and 17, respectively. They did not differ significantly from corresponding periods in 2019 (17, 7, and 10, respectively) (all P>0.05). The mean time from onset to admission to hospital was similar between pandemic and 2019 (ranging between 0.40-2.00 days in 2020 compared to ranging between 1.12-2.29 days in 2019). The rate of cases with worse neurological condition on admission turned out to be lower during the first peak of the pandemic compared to previous year (9.1% vs 29.4%, P=0.029), but showed no difference in the remaining two periods. The incidence of accompanying pathologies (intracerebral hemorrhage, intraventricular hemorrhage, and hydrocephalus) was also similar between the periods in 2020 and their counterparts in 2019. Rate of non-aneurysmal cases ranged between 11.1%-45.5% in 2020 compared to 10.0%-57.1% in 2019 (all P>0.05). Conclusion: The study showed that hospital admission patterns for SAH was not affected by COVID-19 pandemic in the southeastern Turkey, unlike other reports. This may be due to different behavioral characteristics of the study population and capability of health care system to cope with high number of patient admissions.Öğe Long-term outcomes of pediatric meningioma surgery: Single center experience with 23 patients(Turkish Neurosurgical Society, 2020) Işıkay, İlkay; Hanalıoglu, Şahin; Narin, Fırat; Başar, İbrahim; Bilginer, BurçakAIM: To evaluate the long-term outcomes and prognostic variables in a surgical cohort of pediatric meningiomas treated in a single institution. MATERIAL and METHODS: Medical records and follow-up notes of 23 pediatric patients aged [removed] 3) during the last follow-up assessment. Ten patients (43.5%) had relapse. In univariate analysis, low histological grade (p=0.030) and gross total resection (p=0.024) were associated with favorable outcome. The 10-year overall survival rate was 86%. CONCLUSION: Meningiomas in the pediatric age group are surgically treatable tumors with fairly good outcomes. However, relapses are common even for low-grade tumors; therefore, long-term surveillance and aggressive treatment are needed.Öğe A study on neurosurgery specialty theses and their publication status in international journals(Galenos Publishing House, 2023) Bahadır, Sinan; Başar, İbrahimObjective: Bibliometric analysis of theses can provide information on the trends and shortcomings in the related scientific field. Several studies have evaluated the specialty theses in different medical disciplines. In this study, we investigated the publication rates of neurosurgery specialty theses in international scientific journals and associated factors. Methods: Neurosurgery specialty theses completed between 2015 and 2019 was searched in the National Thesis Center of Higher Education Council database. The author, mentor, institution, thesis title, study design, and study topic were extracted. Publications of authors were browsed in the Scopus database in terms of a paper derived from the thesis. Current publication parameters of the author and mentor were also recorded. The publication status of the theses was analyzed regarding author-related factors (publication count, h-index, first-author article), mentor-related factors (publication count, h-index), institution, study design, and study topic. Results: Two hundred and sixty-one theses were included in this study. The publication rate in a Scopus-indexed journal was 26.8%. Publication counts of author and mentor (p<0.001 and p=0.027, respectively), h-index of the author (p<0.001), first-author article by the author (p<0.001), study design (p=0.009), and study topic (p=0.013) were associated with the publication status of the theses. Conclusion: The publication rate of neurosurgical theses sits above average compared to other medical disciplines. The most important factor for the publication of a thesis appears to be the academic activity of the author. Regardless, still a high percentage of neurosurgery theses have not been published, and their contribution to cumulative scientific knowledge remains limited.
