Ozet Hastanemize kasik agrisi sikayeti ile basvuran 40 yasinda multipar hasta degerlendirilmis ve... more Ozet Hastanemize kasik agrisi sikayeti ile basvuran 40 yasinda multipar hasta degerlendirilmis ve tubaovaryen abse/malignadneksial kitle on tanilari ile tedaviye alinmistir. Olgunun klinik ve laboratuvar bulgularinin gerilememesi nedeniyle laparotomi karari verilerek sol salpingooferektomi yapilmistir. Malignensi kriterleri olan olgunun sonuclari benignolarak raporlanmis ve olgu sifa ile taburcu edilmistir.
Background This study aimed to investigate fetal cardiac functions by spectral tissue Doppler ima... more Background This study aimed to investigate fetal cardiac functions by spectral tissue Doppler imaging (s-TDI) in pregnancies complicated with late-onset fetal growth restriction (LO-FGR) and small-for-gestational age (SGA). Methods Forty pregnancies complicated with late-onset FGR and 40 pregnancies complicated with SGA between the 34th and 37th weeks of gestation were enrolled in this study. Forty gestational age-matched pregnant women with no obstetrics complication were randomly selected as a control group. Small fetuses were classified as fetal growth restriction or SGA according to estimated fetal weight (EFW), umbilical artery pulsatility index (PI), cerebroplacental ratio (CPR) and uterine artery PI. s-TDI measurements were obtained at the right atrioventricular valve annulus. Results SGA and LO-FGR fetuses had significantly lower A′ and S′ values, and higher E′/A′ ratio than the control group (P < 0.001). In comparison to controls, significantly prolonged isovolumetric co...
Annals of Otology, Rhinology & Laryngology, 2017
Objective: To determine whether intralabyrinthine hemorrhage affects vestibular hair cells, dark ... more Objective: To determine whether intralabyrinthine hemorrhage affects vestibular hair cells, dark cells, and transitional cells in human temporal bones. Methods: We examined 9 temporal bone specimens from 9 deceased donors with unilateral intralabyrinthine hemorrhage (the hemorrhage group) along with their 9 contralateral temporal bone specimens without hemorrhage (the control group). We estimated the density of type I and type II hair cells in all peripheral sensorial organs (including the cristae of the superior, lateral, and posterior semicircular canals, as well as the maculae of the saccule and utricle). We also estimated the density of dark and transitional cells in the lateral and posterior semicircular canals. Results: The loss of type I hair cells in the cristae of the superior, lateral, and posterior semicircular canals and in the maculae of the saccule and utricle was significantly higher in the hemorrhage group, as compared with the control group ( P < .05). The densit...
Kentler planli ve zaman icinde kendiliginden gelisim olmak uzere iki farkli evrim sureci izleyebi... more Kentler planli ve zaman icinde kendiliginden gelisim olmak uzere iki farkli evrim sureci izleyebilmektedir. Bu iki surecin fiziksel cevreye yansimasi farkli mekansalorganizasyonlarin olusumu seklinde olmaktadir. Bu farkliliklar, ayni olcekteki fiziksel cevre bilesenlerinin birbirleri ve farkli olceklerdeki bilesenlerle .etkilesimleri acisindan irdelendiginde, tumdengelim yontemi ile planlama yaklasiminda yerlesme butununde duzen saglanirken aIt olcekteki iliskilerin ihmal edildigi, veya farkli olceklerdeki sistemler arasinda olmasi gereken hiyerarsik sistemin yeterince kurulamadigi gorulmektedir. Diger yandan tamamen kendiliginden gelisen yerlesmelerde ise butunsel bir sistemden soz etmek mumkun olamamaktadir. Kentsel fiziksel cevreyi olusturan sistem ve alt sistemlerin birbirleri ile, kullanici ile ve kent butunu ile kurdugu iliskiler sonucu olusan karmasik sistemi bilesenlerine ayirarak ayri incelemek yerine mekansalorganizasyonun farkli olceklerde sahip oldugu karmasiklik duzeyini incelemek, sistemin anlasilmasi acisindan onemli katkilar sunmaktadir. Kentlerin kompleks ve yuksek derecede organize ohm yapisinin anlasilmasina yonelik calismalar incelendiginde, kentlerin kompleks yapisinin anlasilmasi ve matematiksel yontemlerle nesnel sonuclar alinmasi acisindan kaos teorisi ve fraktal geometrinin uygun bir taban olusturdugu gorulmektedir. Kaos teorisi kompleks, acik sistemlerin aciklanmasina yardimci olurken, fraktal geometri yontemihem bicimsel farkliliklardan bagimsiz olarak karmasiklik derecesini olcmekte hem de mekan ogeleri arasindaki etkilesimlerve olusum surecinin degerlendirilmesine olanak tanimaktadir. Kentlerin mekansal yapisi ile fraktal geometri yontemi uc acidan paralellik gostermektedir:
Objectives/Hypothesis: In this study, our objective was to histopathologically analyze the periph... more Objectives/Hypothesis: In this study, our objective was to histopathologically analyze the peripheral vestibular system in patients with Mondini dysplasia. Study Design: Comparative human temporal bone study. Methods: We assessed the sensory epithelium of the human vestibular system with a focus on the number of type I and type II hair cells, as well as the total number of hair cells. We compared those numbers in our Mondini dysplasia group versus our control group. Results: The loss of type I and type II hair cells in the cristae of the superior, lateral, and posterior semicircular canals, as well as in the saccular and utricular macula, was significantly higher in our Mondini dysplasia group than in our control group. The total number of hair cells significantly decreased in the cristae of the superior, lateral, and posterior semicircular canals, as well as in the saccular and utricular macula, in our Mondini dysplasia group. Conclusion: Loss of vestibular hair cells can lead to vestibular dysfunction in patients with Mondini dysplasia.
Objective-To observe any changes in stria vascularis and cochlear hair cells in patients with syp... more Objective-To observe any changes in stria vascularis and cochlear hair cells in patients with syphilis Materials and Methods-We examined 13 human temporal bone samples from 8 patients with syphilis (our syphilis group), as well as 12 histopathologically normal samples from 9 agematched patients without syphilis (our control group). We compared, between the 2 groups, the mean area of the stria vascularis (measured with conventional light microscopy connected to a personal computer) and the mean percentage of cochlear hair cell loss (obtained from cytocochleograms). Results-In our syphilis group, only 1 (7.7%) of the 13 samples had precipitate in the endolymphatic or perilymphatic spaces; 8 (61.5%) of the samples revealed the presence of endolymphatic hydrops (4 cochlear, 4 saccular). The mean area of the stria vascularis area did not significantly differ, in any turn of the cochlea, between the 2 groups (P > 0.1). However, we did find significant differences between the 2 groups in the mean percentage of outer hair cells in the apical turn (P < 0.026) and in the mean percentage of inner hair cells in the basal (P = 0.001), middle (P = 0.004), and apical (P = 0.018) turns. In 7 samples in our syphilis group, we observed either complete loss of the organ of Corti or a flattened organ of Corti without any cells in addition to the absence of both outer and inner hair cells.
The spine journal : official journal of the North American Spine Society, Jan 18, 2016
Late presentation of missed aortacaval fistula as arteriovenous malformation following lumbar dis... more Late presentation of missed aortacaval fistula as arteriovenous malformation following lumbar disc surgery Arteriovenous malformation in the abdomen following excision of lumbar intervertebral disc is the nightmare of the spinal surgeons [1-3]. A 56-year-old man was admitted to the emergency service with heart failure and atrial fibrillation symptoms. Abdominal computerized tomography with contrast and magnetic resonance angiography images were obtained. An aortacaval fistula that later grew into a giant arteriovenous malformation was discovered (Figs. 1 and 2). Then, he underwent consecutive repair procedures at the cardiovascular surgery department [2,4,5]. The patient's medical history record shows he had a lumbar discectomy operation 4 months before the onset of his cardiac problems. This case emphasizes the importance of paying special attention to any overt hemorrhage that has originated from the disc space although it might have been controlled during surgery. Fig. 1. Magnetic resonance imaging (MRI) angiography shows two fistulas between the distal abdominal aorta and the inferior vena cava (IVC). White arrow points at the connection region between the distal abdominal aorta and the IVC.
To the best of our knowledge, histopathologic studies of syphilitic ears have generally focused o... more To the best of our knowledge, histopathologic studies of syphilitic ears have generally focused on hydropic changes; so far, no such studies have investigated peripheral vestibular otopathology using differential interference contrast microscopy, in patients with syphilis. For this study, we examined 13 human temporal bone samples from 8 patients with a history of syphilis. Using conventional light microscopy, we performed qualitative histopathologic assessment. In addition, using differential interference contrast microscopy, we performed type I and type II vestibular hair cell counts on each vestibular sense organ with minimal autolysis; in which the neuroepithelium was oriented perpendicular to the plane of section. We then compared vestibular hair cell densities (cells per 0.01 mm 2 surface area) in the syphilis group vs. the control group. In the syphilis group, we observed precipitate in the endolymphatic or perilymphatic spaces in 1 (7.7 %) of the samples and endolymphatic hydrops in eight (61.5 %) of the samples. Hydrops involved the cochlea (four samples) and/or saccule (four samples). In addition, the syphilis group experienced a significant loss of type II vestibular hair cells in the maculae of the utricle and saccule, and in the cristae of the lateral and posterior semicircular canals, as compared with the control group (P \ 0.05).
The Canadian Journal of Neurological Sciences, 2000
Insight in the role played by the mesio-temporal structures in human epilepsy is derived from var... more Insight in the role played by the mesio-temporal structures in human epilepsy is derived from various sources. Hughlings Jackson 1 was the first to describe the autopsy findings showing a mesio-temporal lesion as the cause of psychomotor seizures. Echoing the original observations of Jackson, the many experimental studies of the 1950s such as those of Kaada, 2 Vigouroux, 3 Gastaut, 4 Green, 5 and the observations in the human by Feindel, 6,7 Penfield and Jasper, 8 and Morris 9 pointed to a very important role of the mesiobasal temporal structures in experimental and human epilepsies. There is a large collection of data describing striking neuropathological changes in the mesio-temporal area in patients with temporal epilepsy. The hippocampal sclerosis and mesiotemporal sclerosis, including changes in the amygdala, were reviewed in detail in a series of excellent studies. 10-12 More recent work has shed light on the basic physiopathological mechanisms responsible for mesio-temporal epilepsy. 13-20 Studies on mesio-temporal kindling have brought further ABSTRACT: Numerous studies of the electrophysiology and neuropathology of temporal lobe epilepsy have demonstrated the mesial temporal structures to be the site of seizure origin in the majority of cases. This is the rationale for a transcortical selective approach, first introduced by Niemeyer, for removal of the hippocampus and amygdala. Series from a number of centers have demonstrated the efficacy of selective amygdalohippocampectomy compared to a more traditional resection. The technique described here and used at the Montreal Neurological Institute (MNI) utilizes a strictly endopial resection of the hippocampal formation and amygdala in addition to computer image guidance to perform the procedure. Ninety-five percent of patients at the MNI who underwent selective amygdalohippocampectomy realized a cessation of seizures, or greater than 90% reduction, with minimal risk of complications. RÉSUMÉ: L'amygdalohippocampectomie sélective transcorticale dans l'épilepsie temporale. Plusieurs études électrophysiologiques et neuropathologiques de l'épilepsie temporale ont démontré que les structures temporales mésiales sont le site d'origine des crises dans la majorité des cas. C'est la justification de l'approche sélective transcorticale introduite par Niemeyer pour l'ablation de l'hippocampe et de l'amygdale. Des séries de cas de plusieurs centres ont démontré l'efficacité de l'amygdalohippocampectomie sélective comparée à une résection plus traditionnelle. La technique que nous décrivons ici et qui est utilisée à l'Institut neurologique de Montréal utilise une résection strictement endopiale de l'hippocampe et de l'amygdale sous guidage neuroradiologique pour effectuer l'intervention. Chez 90% des patients qui ont subi une amygdalohippocampectomie sélective à l'Institut neurologique de Montréal les crises ont disparu ou ont diminué de plus de 90% avec des risques de complications minimes.
To determine if peripheral vestibular otopathology is present in human temporal bones with otoscl... more To determine if peripheral vestibular otopathology is present in human temporal bones with otosclerosis. Comparative human temporal bone study. Seventy-four human temporal bones from 46 subjects with otosclerosis (mean age of 61 ± 18 years) and 20 within histologically normal limits from 17 subjects (mean age of 59 ± 14 years) were included in this study. Temporal bones with otosclerosis were divided into those with and without endosteal involvement. Using differential interference contrast microscopy at 1008× magnification, type I and type II vestibular hair cell counts were performed on each vestibular sense organ in which the neuroepithelia was oriented perpendicular to the plane of section. The organ-specific cell densities (cells/0.01 mm(2) surface area) were compared between the groups with and without endosteal involvement, and also compared to counts in the nonotosclerosis control group using Student's t-test. Mean type I and type II hair cell densities of all vestibular...
New techniques have minimized the incision length and thus required modifications of surgical ins... more New techniques have minimized the incision length and thus required modifications of surgical instruments. The Taylor retractor is one of these instruments. We therefore designed several modifications of the classical Taylor retractor. The following structural modifications were made on the classical Taylor retractor: First, we provided detachable blades with three different lengths (60, 70, 80 mm). Second, we breached a slit wide enough to let the intervertebral disc rongeurs to nestle down in it. Third, instead of a single sharp tip at the end of the blade, an arched blade that had two smooth tips was designed. Adjustable blades allowed placing the retractor just on the skin without any space between the retractor and skin by sliding the retractor over its blade downwards, thus providing a low-profile surgical retraction. The slit facilitated reaching the other side of the disc by leaning against the retractor. Pressing slightly and lowering the retractor subsided the skin and the...
AIm: Use of intraoperative MRI (iMRI) is the highest contemporary supportive means for brain tumo... more AIm: Use of intraoperative MRI (iMRI) is the highest contemporary supportive means for brain tumor surgery. In this article we describe the issues related to iMRI use in pediatric cranial operations. mAterIAl and methOds: Pediatric cases operated with the aid of Polestar N20 iMRI system are defined and the pros and cons of the system are emphasized. results: Patient positioning is easier and the obtained images are better in pediatric cases, particularly for posterior fossa tumors. COnClusIOn: iMRI should be used in all pediatric brain tumor operations when possible.
Silylated ethanolic extract of two propolis samples from Kazan and Marmaris regions in Turkey wer... more Silylated ethanolic extract of two propolis samples from Kazan and Marmaris regions in Turkey were investigated by capillary GC-MS. The compounds were characterized by comparison with library searches. Twenty four compounds from Kazan samples were identified, eight of them were new for propolis. Eighteen compounds from Marmaris samples were identified, two of them were new for propolis.
This study was undertaken to investigate the effect of betaglucan in ameliorating cisplatin ototo... more This study was undertaken to investigate the effect of betaglucan in ameliorating cisplatin ototoxicity. Rats were divided into four groups: cisplatin (C), cisplatin plus beta glucan (CB), beta glucan (B), and control (K). Distortion product otoacoustic emissions were elicited in 0th, 1st, and 5th days. For the group C differences were observed at 8,003 and 9,515 Hz between 0th and 5th days' measurements. In the group CB there were differences at frequencies of 3,996, 4,757, 5,660, and 6,726 Hz between 0th and 5th days' measurements. For the group B there were significant recovery in some frequencies. The observation of significant deterioration in terms of hearing in the group treated with cisplatin plus betaglucan may be suggested that depended on the increase of permeability and tissue conductance into the inner ear which may be caused by betaglucan. Further long-term follow-up studies by using different doses may clarify this matter.
AIm: Arachnoid cysts are benign intra-arachnoid cystic lesions filled with cerebrospinal fluid. W... more AIm: Arachnoid cysts are benign intra-arachnoid cystic lesions filled with cerebrospinal fluid. With advent of modern treatment techniques, debate continues regarding which surgical treatment is most effective. mATeRIAL and meTHods: A consecutive series of 75 patients with arachnoid cysts that were surgically treated between January 1992 and December 2009 are reported. Included in the study were 54 male and 21 female patients, ranging in age from 2 months to 45 years (mean age 20.02 years) at the time of surgery. Symptoms at presentation, location on the cysts, and treatment modalities were evaluated. ResuLTs: Headache was controlled in 92.5% of adult cases. Hydrocephalus, cognitive decline weakness and gait disturbances were controlled 100% after overall treatment methods. Follow-up CT scans showed significant reduction in cyst size in supratentorial arachnoid cysts. No significant changes in cyst size were found in infratentorial cysts but symptomatic improvements were noted. CoNCLusIoN: Patients with symptomatic arachnoid cysts regardless of age and cyst location should be treated. We think that avoiding shunt dependence should be one of the principle treatment goals. Proper patient selection results in good outcomes.
The anterior tarsal tunnel syndrome (ATTS) has first been described by Kopell and Thompson in 196... more The anterior tarsal tunnel syndrome (ATTS) has first been described by Kopell and Thompson in 1963. The anterior tarsal tunnel is formed by the fascia lining the inferior extensor retinaculum and talus as well as the navicular bone. Many ATTS cases with various etiologies have been reported since the first description. We report here an ATSS case resulting from a fibro-osseous structure that occurred after a missed talus fracture. The ATTS diagnosis can be made with a comprehensive clinical neurological examination and electrophysiological study. The treatment is based on the underlying etiology, while surgery is the most common treatment providing successful outcomes in the long term.
OBJECTIVE Different clival lesions have been reported in the literature previously. The lymphangi... more OBJECTIVE Different clival lesions have been reported in the literature previously. The lymphangioma reported in the present case seems to be the first lesion localized in the clivus. CLINICAL PRESENTATION The patient presented with a history of diplopia and headache. Imaging studies showed a lytic lesion at the cranial base. INTERVENTION Transsphenoidal excision of the lesion resulted in total resolution of the patient's complaints. CONCLUSION Lymphangioma must be kept in mind for the differential diagnosis of lytic lesions of the cranial base. Surgical removal leads to immediate improvement of the symptoms.
This article may be used for research, teaching, and private study purposes. Any substantial or s... more This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. The publisher does not give any warranty express or implied or make any representation that the contents will be complete or accurate or up to date. The accuracy of any instructions, formulae, and drug doses should be independently verified with primary sources. The publisher shall not be liable for any loss, actions, claims, proceedings, demand, or costs or damages whatsoever or howsoever caused arising directly or indirectly in connection with or arising out of the use of this material.
Each copy of any part of a JSTOR transmission must contain the same copyright notice that appears... more Each copy of any part of a JSTOR transmission must contain the same copyright notice that appears on the screen or printed page of such transmission. JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range of content in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new forms of scholarship. For more information about JSTOR, please contact
Ozet Hastanemize kasik agrisi sikayeti ile basvuran 40 yasinda multipar hasta degerlendirilmis ve... more Ozet Hastanemize kasik agrisi sikayeti ile basvuran 40 yasinda multipar hasta degerlendirilmis ve tubaovaryen abse/malignadneksial kitle on tanilari ile tedaviye alinmistir. Olgunun klinik ve laboratuvar bulgularinin gerilememesi nedeniyle laparotomi karari verilerek sol salpingooferektomi yapilmistir. Malignensi kriterleri olan olgunun sonuclari benignolarak raporlanmis ve olgu sifa ile taburcu edilmistir.
Background This study aimed to investigate fetal cardiac functions by spectral tissue Doppler ima... more Background This study aimed to investigate fetal cardiac functions by spectral tissue Doppler imaging (s-TDI) in pregnancies complicated with late-onset fetal growth restriction (LO-FGR) and small-for-gestational age (SGA). Methods Forty pregnancies complicated with late-onset FGR and 40 pregnancies complicated with SGA between the 34th and 37th weeks of gestation were enrolled in this study. Forty gestational age-matched pregnant women with no obstetrics complication were randomly selected as a control group. Small fetuses were classified as fetal growth restriction or SGA according to estimated fetal weight (EFW), umbilical artery pulsatility index (PI), cerebroplacental ratio (CPR) and uterine artery PI. s-TDI measurements were obtained at the right atrioventricular valve annulus. Results SGA and LO-FGR fetuses had significantly lower A′ and S′ values, and higher E′/A′ ratio than the control group (P < 0.001). In comparison to controls, significantly prolonged isovolumetric co...
Annals of Otology, Rhinology & Laryngology, 2017
Objective: To determine whether intralabyrinthine hemorrhage affects vestibular hair cells, dark ... more Objective: To determine whether intralabyrinthine hemorrhage affects vestibular hair cells, dark cells, and transitional cells in human temporal bones. Methods: We examined 9 temporal bone specimens from 9 deceased donors with unilateral intralabyrinthine hemorrhage (the hemorrhage group) along with their 9 contralateral temporal bone specimens without hemorrhage (the control group). We estimated the density of type I and type II hair cells in all peripheral sensorial organs (including the cristae of the superior, lateral, and posterior semicircular canals, as well as the maculae of the saccule and utricle). We also estimated the density of dark and transitional cells in the lateral and posterior semicircular canals. Results: The loss of type I hair cells in the cristae of the superior, lateral, and posterior semicircular canals and in the maculae of the saccule and utricle was significantly higher in the hemorrhage group, as compared with the control group ( P < .05). The densit...
Kentler planli ve zaman icinde kendiliginden gelisim olmak uzere iki farkli evrim sureci izleyebi... more Kentler planli ve zaman icinde kendiliginden gelisim olmak uzere iki farkli evrim sureci izleyebilmektedir. Bu iki surecin fiziksel cevreye yansimasi farkli mekansalorganizasyonlarin olusumu seklinde olmaktadir. Bu farkliliklar, ayni olcekteki fiziksel cevre bilesenlerinin birbirleri ve farkli olceklerdeki bilesenlerle .etkilesimleri acisindan irdelendiginde, tumdengelim yontemi ile planlama yaklasiminda yerlesme butununde duzen saglanirken aIt olcekteki iliskilerin ihmal edildigi, veya farkli olceklerdeki sistemler arasinda olmasi gereken hiyerarsik sistemin yeterince kurulamadigi gorulmektedir. Diger yandan tamamen kendiliginden gelisen yerlesmelerde ise butunsel bir sistemden soz etmek mumkun olamamaktadir. Kentsel fiziksel cevreyi olusturan sistem ve alt sistemlerin birbirleri ile, kullanici ile ve kent butunu ile kurdugu iliskiler sonucu olusan karmasik sistemi bilesenlerine ayirarak ayri incelemek yerine mekansalorganizasyonun farkli olceklerde sahip oldugu karmasiklik duzeyini incelemek, sistemin anlasilmasi acisindan onemli katkilar sunmaktadir. Kentlerin kompleks ve yuksek derecede organize ohm yapisinin anlasilmasina yonelik calismalar incelendiginde, kentlerin kompleks yapisinin anlasilmasi ve matematiksel yontemlerle nesnel sonuclar alinmasi acisindan kaos teorisi ve fraktal geometrinin uygun bir taban olusturdugu gorulmektedir. Kaos teorisi kompleks, acik sistemlerin aciklanmasina yardimci olurken, fraktal geometri yontemihem bicimsel farkliliklardan bagimsiz olarak karmasiklik derecesini olcmekte hem de mekan ogeleri arasindaki etkilesimlerve olusum surecinin degerlendirilmesine olanak tanimaktadir. Kentlerin mekansal yapisi ile fraktal geometri yontemi uc acidan paralellik gostermektedir:
Objectives/Hypothesis: In this study, our objective was to histopathologically analyze the periph... more Objectives/Hypothesis: In this study, our objective was to histopathologically analyze the peripheral vestibular system in patients with Mondini dysplasia. Study Design: Comparative human temporal bone study. Methods: We assessed the sensory epithelium of the human vestibular system with a focus on the number of type I and type II hair cells, as well as the total number of hair cells. We compared those numbers in our Mondini dysplasia group versus our control group. Results: The loss of type I and type II hair cells in the cristae of the superior, lateral, and posterior semicircular canals, as well as in the saccular and utricular macula, was significantly higher in our Mondini dysplasia group than in our control group. The total number of hair cells significantly decreased in the cristae of the superior, lateral, and posterior semicircular canals, as well as in the saccular and utricular macula, in our Mondini dysplasia group. Conclusion: Loss of vestibular hair cells can lead to vestibular dysfunction in patients with Mondini dysplasia.
Objective-To observe any changes in stria vascularis and cochlear hair cells in patients with syp... more Objective-To observe any changes in stria vascularis and cochlear hair cells in patients with syphilis Materials and Methods-We examined 13 human temporal bone samples from 8 patients with syphilis (our syphilis group), as well as 12 histopathologically normal samples from 9 agematched patients without syphilis (our control group). We compared, between the 2 groups, the mean area of the stria vascularis (measured with conventional light microscopy connected to a personal computer) and the mean percentage of cochlear hair cell loss (obtained from cytocochleograms). Results-In our syphilis group, only 1 (7.7%) of the 13 samples had precipitate in the endolymphatic or perilymphatic spaces; 8 (61.5%) of the samples revealed the presence of endolymphatic hydrops (4 cochlear, 4 saccular). The mean area of the stria vascularis area did not significantly differ, in any turn of the cochlea, between the 2 groups (P > 0.1). However, we did find significant differences between the 2 groups in the mean percentage of outer hair cells in the apical turn (P < 0.026) and in the mean percentage of inner hair cells in the basal (P = 0.001), middle (P = 0.004), and apical (P = 0.018) turns. In 7 samples in our syphilis group, we observed either complete loss of the organ of Corti or a flattened organ of Corti without any cells in addition to the absence of both outer and inner hair cells.
The spine journal : official journal of the North American Spine Society, Jan 18, 2016
Late presentation of missed aortacaval fistula as arteriovenous malformation following lumbar dis... more Late presentation of missed aortacaval fistula as arteriovenous malformation following lumbar disc surgery Arteriovenous malformation in the abdomen following excision of lumbar intervertebral disc is the nightmare of the spinal surgeons [1-3]. A 56-year-old man was admitted to the emergency service with heart failure and atrial fibrillation symptoms. Abdominal computerized tomography with contrast and magnetic resonance angiography images were obtained. An aortacaval fistula that later grew into a giant arteriovenous malformation was discovered (Figs. 1 and 2). Then, he underwent consecutive repair procedures at the cardiovascular surgery department [2,4,5]. The patient's medical history record shows he had a lumbar discectomy operation 4 months before the onset of his cardiac problems. This case emphasizes the importance of paying special attention to any overt hemorrhage that has originated from the disc space although it might have been controlled during surgery. Fig. 1. Magnetic resonance imaging (MRI) angiography shows two fistulas between the distal abdominal aorta and the inferior vena cava (IVC). White arrow points at the connection region between the distal abdominal aorta and the IVC.
To the best of our knowledge, histopathologic studies of syphilitic ears have generally focused o... more To the best of our knowledge, histopathologic studies of syphilitic ears have generally focused on hydropic changes; so far, no such studies have investigated peripheral vestibular otopathology using differential interference contrast microscopy, in patients with syphilis. For this study, we examined 13 human temporal bone samples from 8 patients with a history of syphilis. Using conventional light microscopy, we performed qualitative histopathologic assessment. In addition, using differential interference contrast microscopy, we performed type I and type II vestibular hair cell counts on each vestibular sense organ with minimal autolysis; in which the neuroepithelium was oriented perpendicular to the plane of section. We then compared vestibular hair cell densities (cells per 0.01 mm 2 surface area) in the syphilis group vs. the control group. In the syphilis group, we observed precipitate in the endolymphatic or perilymphatic spaces in 1 (7.7 %) of the samples and endolymphatic hydrops in eight (61.5 %) of the samples. Hydrops involved the cochlea (four samples) and/or saccule (four samples). In addition, the syphilis group experienced a significant loss of type II vestibular hair cells in the maculae of the utricle and saccule, and in the cristae of the lateral and posterior semicircular canals, as compared with the control group (P \ 0.05).
The Canadian Journal of Neurological Sciences, 2000
Insight in the role played by the mesio-temporal structures in human epilepsy is derived from var... more Insight in the role played by the mesio-temporal structures in human epilepsy is derived from various sources. Hughlings Jackson 1 was the first to describe the autopsy findings showing a mesio-temporal lesion as the cause of psychomotor seizures. Echoing the original observations of Jackson, the many experimental studies of the 1950s such as those of Kaada, 2 Vigouroux, 3 Gastaut, 4 Green, 5 and the observations in the human by Feindel, 6,7 Penfield and Jasper, 8 and Morris 9 pointed to a very important role of the mesiobasal temporal structures in experimental and human epilepsies. There is a large collection of data describing striking neuropathological changes in the mesio-temporal area in patients with temporal epilepsy. The hippocampal sclerosis and mesiotemporal sclerosis, including changes in the amygdala, were reviewed in detail in a series of excellent studies. 10-12 More recent work has shed light on the basic physiopathological mechanisms responsible for mesio-temporal epilepsy. 13-20 Studies on mesio-temporal kindling have brought further ABSTRACT: Numerous studies of the electrophysiology and neuropathology of temporal lobe epilepsy have demonstrated the mesial temporal structures to be the site of seizure origin in the majority of cases. This is the rationale for a transcortical selective approach, first introduced by Niemeyer, for removal of the hippocampus and amygdala. Series from a number of centers have demonstrated the efficacy of selective amygdalohippocampectomy compared to a more traditional resection. The technique described here and used at the Montreal Neurological Institute (MNI) utilizes a strictly endopial resection of the hippocampal formation and amygdala in addition to computer image guidance to perform the procedure. Ninety-five percent of patients at the MNI who underwent selective amygdalohippocampectomy realized a cessation of seizures, or greater than 90% reduction, with minimal risk of complications. RÉSUMÉ: L'amygdalohippocampectomie sélective transcorticale dans l'épilepsie temporale. Plusieurs études électrophysiologiques et neuropathologiques de l'épilepsie temporale ont démontré que les structures temporales mésiales sont le site d'origine des crises dans la majorité des cas. C'est la justification de l'approche sélective transcorticale introduite par Niemeyer pour l'ablation de l'hippocampe et de l'amygdale. Des séries de cas de plusieurs centres ont démontré l'efficacité de l'amygdalohippocampectomie sélective comparée à une résection plus traditionnelle. La technique que nous décrivons ici et qui est utilisée à l'Institut neurologique de Montréal utilise une résection strictement endopiale de l'hippocampe et de l'amygdale sous guidage neuroradiologique pour effectuer l'intervention. Chez 90% des patients qui ont subi une amygdalohippocampectomie sélective à l'Institut neurologique de Montréal les crises ont disparu ou ont diminué de plus de 90% avec des risques de complications minimes.
To determine if peripheral vestibular otopathology is present in human temporal bones with otoscl... more To determine if peripheral vestibular otopathology is present in human temporal bones with otosclerosis. Comparative human temporal bone study. Seventy-four human temporal bones from 46 subjects with otosclerosis (mean age of 61 ± 18 years) and 20 within histologically normal limits from 17 subjects (mean age of 59 ± 14 years) were included in this study. Temporal bones with otosclerosis were divided into those with and without endosteal involvement. Using differential interference contrast microscopy at 1008× magnification, type I and type II vestibular hair cell counts were performed on each vestibular sense organ in which the neuroepithelia was oriented perpendicular to the plane of section. The organ-specific cell densities (cells/0.01 mm(2) surface area) were compared between the groups with and without endosteal involvement, and also compared to counts in the nonotosclerosis control group using Student's t-test. Mean type I and type II hair cell densities of all vestibular...
New techniques have minimized the incision length and thus required modifications of surgical ins... more New techniques have minimized the incision length and thus required modifications of surgical instruments. The Taylor retractor is one of these instruments. We therefore designed several modifications of the classical Taylor retractor. The following structural modifications were made on the classical Taylor retractor: First, we provided detachable blades with three different lengths (60, 70, 80 mm). Second, we breached a slit wide enough to let the intervertebral disc rongeurs to nestle down in it. Third, instead of a single sharp tip at the end of the blade, an arched blade that had two smooth tips was designed. Adjustable blades allowed placing the retractor just on the skin without any space between the retractor and skin by sliding the retractor over its blade downwards, thus providing a low-profile surgical retraction. The slit facilitated reaching the other side of the disc by leaning against the retractor. Pressing slightly and lowering the retractor subsided the skin and the...
AIm: Use of intraoperative MRI (iMRI) is the highest contemporary supportive means for brain tumo... more AIm: Use of intraoperative MRI (iMRI) is the highest contemporary supportive means for brain tumor surgery. In this article we describe the issues related to iMRI use in pediatric cranial operations. mAterIAl and methOds: Pediatric cases operated with the aid of Polestar N20 iMRI system are defined and the pros and cons of the system are emphasized. results: Patient positioning is easier and the obtained images are better in pediatric cases, particularly for posterior fossa tumors. COnClusIOn: iMRI should be used in all pediatric brain tumor operations when possible.
Silylated ethanolic extract of two propolis samples from Kazan and Marmaris regions in Turkey wer... more Silylated ethanolic extract of two propolis samples from Kazan and Marmaris regions in Turkey were investigated by capillary GC-MS. The compounds were characterized by comparison with library searches. Twenty four compounds from Kazan samples were identified, eight of them were new for propolis. Eighteen compounds from Marmaris samples were identified, two of them were new for propolis.
This study was undertaken to investigate the effect of betaglucan in ameliorating cisplatin ototo... more This study was undertaken to investigate the effect of betaglucan in ameliorating cisplatin ototoxicity. Rats were divided into four groups: cisplatin (C), cisplatin plus beta glucan (CB), beta glucan (B), and control (K). Distortion product otoacoustic emissions were elicited in 0th, 1st, and 5th days. For the group C differences were observed at 8,003 and 9,515 Hz between 0th and 5th days' measurements. In the group CB there were differences at frequencies of 3,996, 4,757, 5,660, and 6,726 Hz between 0th and 5th days' measurements. For the group B there were significant recovery in some frequencies. The observation of significant deterioration in terms of hearing in the group treated with cisplatin plus betaglucan may be suggested that depended on the increase of permeability and tissue conductance into the inner ear which may be caused by betaglucan. Further long-term follow-up studies by using different doses may clarify this matter.
AIm: Arachnoid cysts are benign intra-arachnoid cystic lesions filled with cerebrospinal fluid. W... more AIm: Arachnoid cysts are benign intra-arachnoid cystic lesions filled with cerebrospinal fluid. With advent of modern treatment techniques, debate continues regarding which surgical treatment is most effective. mATeRIAL and meTHods: A consecutive series of 75 patients with arachnoid cysts that were surgically treated between January 1992 and December 2009 are reported. Included in the study were 54 male and 21 female patients, ranging in age from 2 months to 45 years (mean age 20.02 years) at the time of surgery. Symptoms at presentation, location on the cysts, and treatment modalities were evaluated. ResuLTs: Headache was controlled in 92.5% of adult cases. Hydrocephalus, cognitive decline weakness and gait disturbances were controlled 100% after overall treatment methods. Follow-up CT scans showed significant reduction in cyst size in supratentorial arachnoid cysts. No significant changes in cyst size were found in infratentorial cysts but symptomatic improvements were noted. CoNCLusIoN: Patients with symptomatic arachnoid cysts regardless of age and cyst location should be treated. We think that avoiding shunt dependence should be one of the principle treatment goals. Proper patient selection results in good outcomes.
The anterior tarsal tunnel syndrome (ATTS) has first been described by Kopell and Thompson in 196... more The anterior tarsal tunnel syndrome (ATTS) has first been described by Kopell and Thompson in 1963. The anterior tarsal tunnel is formed by the fascia lining the inferior extensor retinaculum and talus as well as the navicular bone. Many ATTS cases with various etiologies have been reported since the first description. We report here an ATSS case resulting from a fibro-osseous structure that occurred after a missed talus fracture. The ATTS diagnosis can be made with a comprehensive clinical neurological examination and electrophysiological study. The treatment is based on the underlying etiology, while surgery is the most common treatment providing successful outcomes in the long term.
OBJECTIVE Different clival lesions have been reported in the literature previously. The lymphangi... more OBJECTIVE Different clival lesions have been reported in the literature previously. The lymphangioma reported in the present case seems to be the first lesion localized in the clivus. CLINICAL PRESENTATION The patient presented with a history of diplopia and headache. Imaging studies showed a lytic lesion at the cranial base. INTERVENTION Transsphenoidal excision of the lesion resulted in total resolution of the patient's complaints. CONCLUSION Lymphangioma must be kept in mind for the differential diagnosis of lytic lesions of the cranial base. Surgical removal leads to immediate improvement of the symptoms.
This article may be used for research, teaching, and private study purposes. Any substantial or s... more This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. The publisher does not give any warranty express or implied or make any representation that the contents will be complete or accurate or up to date. The accuracy of any instructions, formulae, and drug doses should be independently verified with primary sources. The publisher shall not be liable for any loss, actions, claims, proceedings, demand, or costs or damages whatsoever or howsoever caused arising directly or indirectly in connection with or arising out of the use of this material.
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