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    The anti-oxidant and anti-apoptotic effects of nebivolol and zofenopril in a model of cerebral ischemia/reperfusion in rats
    (Pergamon-Elsevier Science Ltd, 2012) Uzar, Ertugrul; Acar, Abdullah; Evliyaoglu, Osman; Firat, Ugur; Kamasak, Kagan; Gocmez, Cuneyt; Alp, Harun
    The aim of this experiment was to investigate whether nebivolol and zofenopril have protective effects against oxidative damage and apoptosis induced by cerebral ischemia/reperfusion (I/R). There were seven groups of rats, with each containing eight rats. The groups were: the control group, I/R group, I/R plus zofenopril, I/R plus nebivolol, I/R plus nebivolol and zofenopril. zofenopril only and nebivolol only. Cerebral I/R was induced by clamping the bilateral common carotid artery and through hypotension. The rats were sacrificed 1 h after ischemia, and histopathological and biochemical analyses were carried out on their brains. The total antioxidant capacity was evaluated by using an automated and colorimetric measurement method developed by Erel. I/R produced a significant increase in the levels of total oxidant status and malondialdehyde levels, the number of caspase-3 immunopositive cells and activities of prolidase and paraoxonase in brain when compared with the control group (p<0.05). A significant decrease in brain total antioxidant capacity and nitric oxide levels were found in I/R group when compared with the control group (p<0.05). Both nebivolol and zofenopril treatment prevented decreasing of the total antioxidant capacity and nitric oxide levels, produced by I/R in the brain (p<0.05). Both nebivolol and zofenopril treatment prevented the total oxidant status, malondialdehyde levels, activities of paraoxonase and prolidase from increasing in brains of rats exposed to I/R (p<0.05). In conclusion, both nebivolol and zofenopril protected rats from ischemia-induced brain injury. The protection may be due to the indirect prevention of oxidative stress and apoptosis. (C) 2011 Elsevier Inc. All rights reserved.
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    Assessment of Cases With Intracranial Hydatid Cyst: A 23-Year Experience
    (Journal Neurological Sciences, 2014) Turan, Yahya; Yilmaz, Tevfik; Gocmez, Cuneyt; Kamasak, Kagan; Kemaloglu, Serdar; Tekin, Recep; Hattapoglu, Salih
    Objective: Brain is involved in 1-2% of hydatid cyst infections. A cranial location is rare. In this study, we aimed to assess clinical findings, radiological investigations, and treatment modalities of cases with intracranial hydatid cyst. Materials and Method: The present study included 26 patients operated for cerebral hydatid cyst disease between January 1990 and October 2012. Results: Seventeen patients were male and 9 were female. The mean age of the study population was 20.3 years (range 7-50 years). Headache and nausea were the most common clinical symptoms. The lesions were demonstrated by computed tomography (CT) and magnetic resonance imaging (MRI) as large, smooth, thin walled, spherical-shaped, cystic homogenous lesions with the same density as cerebro spinal fluid, which showed no edema or contrast uptake. Two patients were complicated or infected cysts with perifocal edema and contrast uptake. In 20 patients, the cysts were removed completely with Dowlings technique, by rectifying cysts without rupturing. Eleven patients with ruptured cysts during operation, recurrent or systemic hydatid cyst were treated medically. Conclusion: Medical therapy appears effective in hydatid cyst disease. Cerebral hydatid cysts should be excised totally without rupturing them. Preoperative imaging techniques are central to surgical planning. Intracranial hydatid cyst should be remembered when CT or MRI shows a cystic lesion, especially in countries where hydatid cyst is endemic.
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    The comparison of neuroprotective effects of intrathecal dexmedetomidine and metilprednisolone in spinal cord injury
    (Elsevier Science Bv, 2013) Celik, Feyzi; Gocmez, Cuneyt; Kamasak, Kagan; Tufek, Adnan; Guzel, Abdulmenap; Tokgoz, Orhan; Firat, Ugur
    Background: The purpose of this study is the investigation of the effects of intrathecally injected dexmedetomidine and methylprednisolone and their dominancy over one another in rats with generated Spinal Cord Injury (SCI). Methods: 40, female, adult Wistar Albino rats weighing 220-260 g were included in the study. The rats were fixed with Intrathecal catheter (IT) and divided into four groups. All subjects were applied T7-10 laminectomy after catheter. Group S (n:10) was injected with IT 10 mu L isotonic saline; Group C (n: 10) with IT 10 mu L isotonic saline after SCI; Group D (n:10) with IT one doze 10 mu L of dexmedetomidine after SCI; Group M (n:10) IT one dose 10 mu L of methylprednisolone. The subjects were sacrificed 72 h after this operation. The damaged area was removed biochemically and histopathologically examined. Results: Antioxidant and inflammatory parameters searched for in all damages tissue were statistically different in all groups from group S. They were different in group M and group D than group C (p < 0.001). After the comparison of group D and group M, PON and IL6 values were higher in group D (p = 0.003, p = 0.035) while the other two biochemical parameters were similar in both groups (Table 1). After histopathologic trials, edemas, bleeding and necrosis were found less in group S while at the most in group C (p < 0.001). In group M and group D, however, they were higher than group S and lower than group C (p < 0.001). After the comparison of group D and group M, while there was no difference in terms of edema necrosis, the amount of bleeding was lower in group D (p < 0.001) (Table 2). Conclusions: It has been discovered that intrathecal use of dexmedetomidine caused neuroprotective effects similar to methylprednisolone. (C) 2013 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.
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    The effect of chloroquine treatment in malignant astrocytomas on prognosis
    (Tubitak Scientific & Technological Research Council Turkey, 2013) Bulut, Turgay; Ekici, Mehmet Ali; Tucer, Bulent; Basarslan, Seyit Kaan; Kamasak, Kagan; Kurtsoy, Ali
    Aim: To investigate the adjuvant role of the antimutagenic agent chloroquine in the treatment of patients with malignant astrocytomas (MAs). Materials and methods: Clinical research was conducted at the Neurosurgery Clinic of the Erciyes University School of Medicine, from September 2003 to April 2007, on 37 patients diagnosed with MA after tumor resection subsequent to craniotomy. Chloroquine treatment was started on a daily dose of 150 mg, additional to the patients' radiotherapy and chemotherapy protocol, and was continued throughout the 43-month surveillance period. A control group was formed of 81 patients with MA after the craniotomy. Results: While the mean survival time of the patients who were treated with chloroquine was found to be 15 months, during the observation period 7 of these patients (18.9%) were alive throughout. In the control group, 20 patients (35.1%) were alive throughout the observation period and their mean survival time was 17 months. There were no statistical differences between the control and chloroquine groups (P > 0.05). Conclusion: The chloroquine treatment was not been found to be effective for the medical treatment of MAs.
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    The effects of erythropoietin, dextran and saline on brain edema and lipid peroxidation in experimental head trauma
    (Turkish Assoc Trauma Emergency Surgery, 2015) Basarslan, Seyit Kagan; Gocmez, Cuneyt; Kamasak, Kagan; Ekici, Mehmet Ali; Ulutabanca, Halil; Dogu, Yurdaer; Menku, Ahmet
    BACKGROUND: The aim of this study was to investigate the protective effects of erythropoietin, dextran/saline and erythropoietin in combination with dextran/saline on brain edema and lipid peroxidation following traumatic brain injury in rats. METHODS: In the study, 40 male 3-month-old albino Wistar rats, weighing 250-340 g, were divided into four groups, each consisting of ten rats. Traumatic brain injury was induced in all rats by the weight drop method, and erythropoietin (5,000 U/kg) and/or dextran and saline (8 ml/kg) solutions were injected intraperitoneally ten minutes after trauma. Control animals received an equal volume of serum physiologic. All rats were sacrificed 24 hours later. Glutathione peroxidase activity and malondialdehyde levels were measured in the left hemisphere, and edema was quantitated by the wet dry method. RESULTS: Brain edema and the levels of malondialdehyde, the last product of lipid peroxidation in tissues, were decreased variably, and the activity of glutathione peroxidase, an antioxidant enzyme, was increased in others compared with the control group. CONCLUSION: In this study, it was concluded that the brain edema that developed in rats on which head trauma was induced and the secondary brain damage caused by oxidative stress could be deceased using a combination of erythropoietin, dextran, and saline.
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    Effects of Intrathecal Caffeic Acid Phenethyl Ester and Methylprednisolone on Oxidant/Antioxidant Status in Traumatic Spinal Cord Injuries
    (Thieme Medical Publ Inc, 2015) Gocmez, Cuneyt; Celik, Feyzi; Kamasak, Kagan; Kaplan, Metin; Uzar, Ertugrul; Arikanoglu, Adalet; Evliyaoglu, Osman
    PurposeTo examine the effect of intrathecally given caffeic acid phenethyl ester (CAPE) on peroxidation and total oxidant and antioxidant systems, and the effect of intrathecally given methylprednisolone (MP) in spinal cord injury (SCI) models. Materials and MethodsFour groups of 10 rats were formed: (1) Laminectomy, intrathecal saline injection, no SCI (sham: S); (2) Laminectomy, intrathecal saline injection, SCI (control: SCI); (3) Laminectomy, intrathecally given single dose of 3 mg/kg MP, SCISCI (SCI+MP). 4) Laminectomy, intrathecally given single dose of 1 mu g/kg CAPE, SCI (SCI+CAPE). Malondialdehyde (MDA), total oxidant activity (TOA), total antioxidant capacity (TAC), superoxide dismutase (SOD), and glutathione peroxidase (GPx) values in the spinal cord tissue were evaluated. ResultsWhen group S and group SCI were compared, MDA, TOA, and SOD parameters increased post-SCI (p<0.01). When compared with group SCI, it was observed that CAPE and MP decreased the MDA, TOA, and SOD levels (p<0.01). This decrease was more pronounced in the SCI+CAPE group. When group S and group SCI were compared, a statistically substantial decrease was observed in the post-SCI TAC levels. When compared with group SCI, it was shown that CAPE and MP treatment substantially increased TAC levels (p<0.001). ConclusionIntrathecal injection of both CAPE and MP inhibits lipid peroxidation and increase of oxidants in SCIs.
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    Efficacy of dexamethasone on penicillin-induced epileptiform activity in rats: An electrophysiological study
    (Elsevier Science Bv, 2014) Yilmaz, Tevfik; Akca, Metehan; Turan, Yahya; Ocak, Hakan; Kamasak, Kagan; Yildirim, Mehmet
    Corticosteroids are extensively used in treatment of many diseases. In neurosurgery practice, dexamethasone (DEX) is commonly used particularly in cerebral edema secondary to brain tumors, head trauma, and central nervous system infections. There are some uncertainties surrounding the secure use of DEX in patients with epilepsy or seizures induced by diseases of the central nervous system such as head trauma and brain tumors. Despite its extensive use, the effect of DEX on epileptiform activity is unclear. In this study the effect of DEX on epileptiform activity was investigated in rats. The effects of 1, 3, and 10 mg/kg DEX on epileptiform activity was compared with effects of antiepileptic drugs commonly employed in treatment of epilepsy, namely phenytoin (PHT) 50 mg/kg and levetiracetam (LEV) 50 mg/kg that were administered intraperitoneally for 1 week. All groups were administered intracortical penicillin (500 IU) to induce epileptiform activity. DEX at the doses of 3 mg/kg and 10 mg/kg significantly reduced spike frequencies compared to the initial values. In conclusion, we think that DEX can effectively decrease the epileptiform activity. (C) 2014 Elsevier B.V. All rights reserved.
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    Evaluation of risk factors affecting hospital-acquired infections in the neurosurgery intensive care unit
    (Informa Healthcare, 2014) Gocmez, Cuneyt; Celik, Feyzi; Tekin, Recep; Kamasak, Kagan; Turan, Yahya; Palanci, Yilmaz; Bozkurt, Fatma
    The aim of the present study was to identify nosocomial infections (NIs), and their associated risk factors, in patients treated in the neurosurgery intensive care unit (NICU) of our hospital. Patients determined to have NIs between January 2008 and December 2012 were included in the study. Each patient's age, gender, microbiological culture results, underlying conditions, type of NIs, device utilization, total parenteral nutrition, reason for hospitalization, Glasgow score, and treatment were recorded and evaluated using statistical analysis. Risk factors for NIs were analyzed with a logistic regression model. During the five-year period, 60 NI episodes were detected in 56 out of 1643 patients. The mean age of the patient population was 33.3 (1-79) years. Of the patients, 22 were female and 34 were male. The overall incidence rate (NIs/100) and incidence density (NIs /1000 days of stay) of NIs were 3.65% and 6.5/1000 patient days, respectively. Regardless of the year of surveillance, the three most commonly detected NIs were bloodstream infection, shunt infection, and ventilator-associated pneumonia. No statistically significant difference was detected between infected and uninfected patients in terms of sex, age, blood transfusions, or mannitol and steroid use (p >= 0.05). In the present study, Glasgow scores, the frequency of prior usage of broad-spectrum antibiotics, and NICU stay durations were significantly higher among patients with infections (p < 0.001). Univariate analysis demonstrated that a low Glasgow score, re-operation, and use of mechanical ventilation were risk factors for NIs. We identified low Glasgow coma scores, long hospital stay duration, use of wide spectrum antibiotics, mechanical ventilation, total parenteral nutrition, and re-operation as risk factors for NIs.
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    Three-Dimensional Analysis of Foramen Magnum and its Adjacent Structures
    (Lippincott Williams & Wilkins, 2014) Gocmez, Cuneyt; Goya, Cemil; Hamidi, Cihad; Kamasak, Kagan; Yilmaz, Tevfik; Turan, Yahya; Uzar, Ertugrul
    The goal of this effort is to evaluate the anatomy of the foramen magnum (FM) using 3-dimensional computed tomography (3D CT), and determine whether or not the anatomical features of vascular structures and condylar foramen (CF) affect the types of FM. The CT angiography records of 101 patients (44 men and 57 women) were retrospectively examined in this study. Details of the FM, CF, and the vertebral and basilar arteries were examined using maximum intensity projection and 3D rendering images. The average age of the 101 patients was 45.28 +/- 16.3 years. The 8 types of FM, in order of their frequency of occurrence, are as follows: round (19 cases; 18.8%), 2 semicircles (18; 17.8%), egg-shaped (15; 14.9%), hexagonal (14; 13.9%), tetragonal (11; 10.9%), oval (11; 10.9%), pentagonal (9; 8.9%), and irregular (4; 4%). There was no statistically significant relationship between the anatomical features of the vertebral and basilar arteries and the CF with the different types of FM (P >= 0.05). In our study, the diameter of the anteroposterior (AP) FMwas 34.7 +/- 3.6 mm, and the transverse (T) diameter was 29.5 +/- 2.5 mm. The AP and T diameters were significantly higher in men than in women (P = 0.006 and P <= 0.001, respectively). Our study revealed that 3D CT is a safe and easy method for visualizing the anatomical structure of the FM and neighboring structures. Furthermore, this study was the first to demonstrate that there is no correlation between the 8 types of FM and the vertebral artery, basilar artery, and CF.