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Öğe A combination of methylprednisolone and quercetin is effective for the treatment of cardiac contusion following blunt chest trauma in rats(Assoc Bras Divulg Cientifica, 2014) Demir, F.; Guzel, A.; Kati, C.; Karadeniz, C.; Akdemir, U.; Okuyucu, A.; Gacar, A.Cardiac contusion is a potentially fatal complication of blunt chest trauma. The effects of a combination of quercetin and methylprednisolone against trauma-induced cardiac contusion were studied. Thirty-five female Sprague-Dawley rats were divided into five groups (n = 7) as follows: sham, cardiac contusion with no therapy, treated with methylprednisolone (30 mg/kg on the first day, and 3 mg/kg on the following days), treated with quercetin (50 mg.kg(-1).day(-1)), and treated with a combination of methylprednisolone and quercetin. Serum troponin I (Tn-I) and tumor necrosis factor-alpha (TNF-alpha) levels and cardiac histopathological findings were evaluated. Tn-I and TNF-alpha levels were elevated after contusion (P = 0.001 and P = 0.001). Seven days later, Tn-I and TNF-alpha levels decreased in the rats treated with methylprednisolone, quercetin, and the combination of methylprednisolone and quercetin compared to the rats without therapy, but a statistical significance was found only with the combination therapy (P = 0.001 and P = 0.011, respectively). Histopathological degeneration and necrosis scores were statistically lower in the methylprednisolone and quercetin combination group compared to the group treated only with methylprednisolone (P = 0.017 and P = 0.007, respectively). However, only degeneration scores were lower in the combination therapy group compared to the group treated only with quercetin (P = 0.017). Inducible nitric oxide synthase positivity scores were decreased in all treatment groups compared to the untreated groups (P = 0.097, P = 0.026, and P = 0.004, respectively). We conclude that a combination of quercetin and methylprednisolone can be used for the specific treatment of cardiac contusion.Öğe Complete L1-L2 lateral dislocation without fracture and neurologic deficit in a child(Karger, 2006) Guzel, A.; Belen, D.; Tatli, M.; Simsek, S.; Guzel, E.Spinal injuries in the infantile age group are relatively rare, mainly due to anatomical and biomechanical features of the pediatric spine. With its hypermobile character, pediatric spine can withstand trauma without fracture, and the elastic nature of the young spine allows easy slippage between segments, especially under the age of 8. Clinically, a few of the cases present with subluxation only, which seldom involve the lumbar level. We report an extremely rare case of traumatic complete upper lumbar lateral lystesis in a 3-year-old boy. The patient was treated conservatively and followed up for 2 years with some degree of correction. Copyright (c) 2006 S. Karger AG, Basel.Öğe The effects of nimopidine on platelet aggregation in severe head injury(Springer-Verlag Wien, 2008) Tatli, M.; Guzel, A.; Kilincer, C.; Batun, S.Background. Severe head injury (SHI) is often associated with traumatic subarachnoid haemorrhage (tSAH), vasospasm, and results in an unfavorable outcome. The aim of this study was to evaluate the effect of nimodipine on platelet aggregation in SHI. Method. This prospective study consisted of 80 patients (53 male, 27 female; ages ranging from 17 years to 65 years, mean: 36.2 years) with severe head injury (Glasgow Coma Score, GCS < 8). All patients received antioedema therapy and prophylactic anticonvulsant. The patients were randomly assigned to either the nimodipine group (2 mg/h continuous infusion for one week) (n = 45) or the control group (n = 35). There were 13 patients with tSAH in the nimodipine group and 10 patients with tSAH in the control group. The platelet aggregation ratio (PAR) was measured on the initial day and the 7(th) day. Higher PAR indicates lower circulating platelet aggregates. Findings. The two groups were well matched for age, sex, mode of injury, neurological status and CT scan findings. In fact, comparison of PAR and GCS in the two treatment groups revealed no difference on the first day. Compared to initial values, the nimodipine group showed a significantly higher PAR value (0.6 +/- 0.1 vs. 0.9 +/- 0.2, p < 0.001) and mean GCS value (7.4 +/- 0.7 vs. 13.7 +/- 1.0, p < 0.001) on the 7(th) day. As a result, on the 7(th) day, the nimodipine group had a significantly higher PAR values (0.7 +/- 0.1 vs. 0.9 +/- 0.2, p < 0.001) and mean GCS (12.3 +/- 1.3 vs. 13.7 +/- 1.0, p < 0.001) as compared to the control group. When the analyses were repeated for the subgroups (the patients with tSAH or contusion) nimodipine showed the same effectiveness. Conclusions. Nimodipine effectively inhibits platelet hyperaggregability in severe head injury patients with or without traumatic subarachnoid haemorrhage. Thus, it may have a potential for use in these patients. However, its effect on long-term outcomes such as death and disability rates and quality of life is still to be determined.Öğe Is pregnancy over 45 with very high parity related with adverse maternal and fetal outcomes?(I R O G Canada, Inc, 2009) Kale, A.; Kuyumcuoglu, U.; Guzel, A.Objective: To examine whether very high parity and age over 45 years are related with adverse maternal and fetal outcomes. Study Design: This study was carried out at the Department of Obstetrics and Gynecology from January 1, 2007 to December 31, 2007. Sixty-one pregnant women were enrolled in this prospective study. Mothers were classified in two groups: the study group (n = 23) included women with very high parity over 45 years of age (age > 45 and >= 10 previous live births), and a control group (n = 38) included women with high parity between 40-45 years of age (between 40-45 years and 5-9 previous live births). Hypertensive disorders complicating pregnancy, preterm labor, breech presentation, cesarean section ratio, mean APGAR scores, birthweight, fetal sex, fetal macrosomia, and early neonatal death were compared within groups. Results: Six (26%) patients in the study group and 12 (31.5%) patients in the control group had hypertensive disorders of pregnancies (p > 0.05). Twelve (52.1%) patients in the study group and 22 (57.8%) patients in the control group had preterin labor (p > 0.05). One (4%) patient in the study group and two (5.2%) patients in the control group had breech presentation during delivery (p > 00.5). Twelve (52.1%) patients in the study group and 21 (55.2%) patients in the control group had cesarean operations (p > 0.05). Mean APGAR scores (at 1 min and 5 min), mean birthweight, fetal sex ratio, fetal macrosomia ratio, and early neonatal death ratio due to prematurity were not statistically significant in the study group as compared with the control group. Conclusion: It is generally assumed that women with advanced age have an increased risk for complications during pregnancy. However, prospective population-based studies do not exist and available publications give conflicting views. Based on our results, we hypothesized that cases aged 45 or over with very high parity are not always related with adverse maternal and fetal outcomes.Öğe Laparoscopic salvage for malfunctioning of peritoneal dialysis catheters(Edizioni Minerva Medica, 2012) Taskesen, F.; Arikanoglu, Z.; Uslukaya, O.; Aliosmanoglu, I.; Oguz, A.; Guzel, A.; Tas, I.Aim. The aim of this study was to emphasize the efficacy of the laparoscopic surgical method performed for elimination of catheter-induced mechanical complications developing in CAPD patients. Methods. Medical records of 31 patients who had undergone CAPD catheter implantation at the Dicle University Medical Faculty Hemodialysis Unit between January 2001 and June 2012 were examined retrospectively. Double-felted spiral Tenckhoff catheters were used in all patients for peritoneal access. Results. We performed a retrospective review of 31 patients who, over an 11-year period, underwent revision of a peritoneal dialysis catheter using laparoscopy. Chronic renal failure requiring dialysis occurred in 31 patients (12 males and 19 female). Ages ranged from 13 to 77 years (mean age 35.8 years). Conclusion. As a conclusion, CAPD is currently a choice to be frequently used in patients with ESRD. In the treatment of CAPD-associated mechanical catheter complications laparoscopic method may be preferred because of patient comfort, short hospital stay, and lesser postoperative complications.Öğe Malignant myoepithelioma of the external auditory canal: a case report(Wiley-Blackwell, 2009) Dirier, A.; Guzel, A.; Karadayi, B.; Ozekinci, S. O.; Tatli, M.[Abstract Not Available]Öğe Pediatric cerebral aneurysms: a report of 9 cases(Springer-Verlag Wien, 2008) Tatli, M.; Guzel, A.; Kilincer, C.; Goksel, H. M.Background. Intracranial aneurysms are rare in children, constituting less than 2% of all cerebral aneurysms. Relative to their adult Counterparts, published series are few and case numbers are small. Method. Nine children (5 males and 4 females, ages 13-18 years old) are reported. These patients constituted 6% of a total of 150 cerebral aneurysm cases treated at our institution over a 12-year period. Findings. Eight patients presented with subarachnoid haemorrhage; one patient's aneurysm was identified incidentally after head trauma. All but one of the patients were in good clinical grade (Hunt and Hess grades I to III). Aneurysm locations were: internal carotid artery (ICA) (5 cases), anterior communicating artery (2 cases), anterior cerebral artery (1 case) and vertebrobasilar junction (1 case). A giant (ICA bifurcation) aneurysm and bilateral ICA bifurcation aneurysms were each observed in one patient. Angiographic vasospasm was detected in three patients. Clinical deterioration attributable to vasospasm was observed in one of them. Seven patients underwent craniotomy, and aneurysms were clipped succesfully. One patient underwent endovascular coiling for a vertebrobasilar junction aneurysm. One patient died due to rebleeding before surgery on the second day of her initial haemorrhage. The 6-month Glasgow Outcome Score was 5 in seven patients and 4 in one patient. Conclusions. Our treatment regimen for pediatric aneurysms is similar to that used in adults, and consists of surgical clipping as the mainstay of treatment, with endovascular techniques reserved for selected cases. With the exception of one patient who died due to early rebleeding, this regimen resulted in good clinical outcomes.Öğe Spinal cord compression of primary extragonadal giant yolk sac tumor(Nature Publishing Group, 2007) Guzel, A.; Tatli, M.; Belen, D.; Seckin, H.Study design: Case report. Objective: To report an adult male patient witha primary extragonadal giant yolk sac tumor presenting with acute spinal cord compression. Setting: Faculty of Medicine, University of Dicle, Diyarbakir, Turkey. Method: A 31-year-old man was referred to our department witha diagnosis of Pott's disease, a complaint of back pain and gait difficulty for 2 weeks. Neurological examination showed spastic paraparesis and hypoesthesia below the L2 dermatome level. He also had urinary incontinence. Abdominal computed tomography and lumbar magnetic resonance imaging study revealed a giant cystic mass lesion located in the psoas muscle. Posteriorly, the third lumbar vertebral body was destructed and the tumor was compressing the dural sac. A combined anterior and posterior approach was performed. Pathological diagnosis was a yolk sac tumor. Result: His neurological status improved during the postoperative course. A chemotherapy protocol was given including bleomycin, etoposide and cisplatin. Five months after the last chemotherapy, he was brought to the emergency unit in sepsis and died despite antibiotherapy. Conclusion: Yolk sac tumor should be considered in young adult male patients presenting with acute paraparesis even without any signs or medical history of a testis tumor. These tumors may be unresectable; however, decompression of neural structures and stabilization of the spine with instrumentation may cause substantial improvement in neurological deficit and pain relief.Öğe Surgical Treatment of Cervical Arteriovenous Fistula in a Patient with Neurofibromatosis Type 1. A Case Report(Sage Publications Inc, 2007) Guzel, A.; Tatli, M.; Er, U.; Kazanci, A.; Ozturk, H. M.; Belen, D.Vasculopathies are frequently associated with neurofibromatosis type-1, and they are generally occlusive or stenotic type lesions. Vertebral arteriovenous fistula (AVF) is quite rare in neurofibromatosis type 1 patients. They can be treated with surgical excision or endovascular occlusion. We describe a surgically treated cervical AVF in a neurofibromatosis type 1 (NF-1) patient and discuss the selection of the patient for the surgery. Although endovascular occlusion is the first line treatment option for cervical AVFs, some selected cases can be successfully treated by surgery. Surgery should be considered as a treatment option in spite of its risks, especially for cervical AVF which is associated with fibromuscular system diseases like NF-1.
