Huseyin Selcuk Surucu

We carried out a study to assess the efficacy of tranexamic acid in preventing scar tissue in the craniectomy area in rats. Our study consisted of control and tranexamic acid groups with 10 subjects each. All subjects underwent bilateral frontoparietal craniectomy. After craniectomy, cotton pads were applied to the surgical sites. In the controls, the pads were soaked with saline and in the tranexamic acid group the pads were soaked with 30 mg/kg tranexamic acid. Rats were decapitated 30 days after surgery. The degree of scar formation was evaluated pathologically and by electron microscopy. In pathologic evaluation, dura mater thickness, scar tissue density, and arachnoid involvement were evaluated. The outcomes demonstrated that no adhesions were present in the rats of the Tranexamic acid group, whereas the control group exhibited severe scar tissue [eight of ten rats (80%)] with adhesions. Additionally, comparison between the two groups showed that the dura mater thickness of tranexamic acid animals was thinner than that of the control group animals. Similarly, the intensity of scar tissue density and the intensity of arachnoid involvement were much better than the control group. Scar tissue formation following craniectomies represents a significant adverse outcome that may lead to various complications. Intraoperative topical application of tranexamic acid has demonstrated potential efficacy in preventing scar formation in the craniectomy region in rat models.

Articulation of rostrum of sphenoid bone with alae of vomer forms a schindylesis type of joint. The circumference of this joint, called sphenovomerine suture (SVS), is very important in establishing a reliable surgical field in the endoscopic transsphenoidal pituitary surgery. Because of its vital role in endoscopic transsphenoidal pituitary surgery, this radio-anatomical study was designed to establish the morphological properties of SVS. In this study, the authors examined SVS in 235 patients (121 females and 114 males) on the computed tomography images of the paranasal sinus and made 4 measurements to describe SVS. The mean distance between superior margin of the upper labial philtrum and top of SVS was 6.66 ± 0.43 cm for females and 7.44 ± 0.54 cm for males. The distance between the top of SVS and dorsum sellae was 3.08 ± 0.33 cm for females and 3.19 ± 0.32 cm for males, the alae of vomer angle in the upper surface was 74.22 ± 20.06° for females and 74.23 ± 19.68° for males. The distance between the most lateral points of 2 alae of vomer was 0.99 ± 0.17 and 1.01 ± 0.19 cm for females and males, respectively. For an easy and successful operation, removal of the SVS is very important as it will provide a better view of the sellar base and make the management of the surgical instruments easier in the wider safe surgical field thus created.

To evaluate the radioprotective efficacy of amifostine on irradiated mature rat retina. A total of 108 Wistar albino rats were categorized into 3 groups, namely, apoptosis (n = 48), acute effects (n = 40), and late changes in retinal cell layers (n = 20). Each group was further subcategorized into 4 arms: control, amifostine (A), radiotherapy + placebo (RT), and RT + A arms, respectively. Intraperitoneal amifostine (260 mg/kg) was administrated to A and RT + A arms 30 minutes before irradiation. Control and A groups were sham-irradiated, whereas a single dose of 20 Gy whole-cranium irradiation was delivered to RT and RT + A arms. Apoptosis was assessed in 8, 12, and 18 hours after irradiation. Electron microscope was used 2 weeks after irradiation for evaluation and scoring of early morphologic changes in retina. Late effects were assessed and scored accordingly by using both the electron and the light microscope on Week 10. At acute phase, although no notable change was seen in 8 hours, significant increase in apoptosis was detected in 12 hours in RT arm (P = 0.029). Comparative analyses between the groups in 3 different time points displayed a higher apoptotic rate in RT group than the RT + A group (P = 0.008). Similarly, comparisons between groups for late effects on the basis of electron microscopic findings revealed lower scores in the RT + A than the RT arm (P < 0.001). This study suggested a potential radioprotective role for amifostine on mature rat retina by reducing radiation-induced apoptosis in retinal cells. These results form a basis for such preclinical investigations and call for future clinical studies.

Histopathological changes in septal and nasal mucosa of patients with nasal septum deviation are not well known. Biopsies of septal and lateral nasal mucosae from both sides of nose were obtained from 20 patients undergoing septoplasty and control group of 10 patients undergoing head and neck surgery. Histopathological changes including lymphocytic infiltration and squamous metaplasia were compared. This study determined significantly higher rate of squamous metaplasia and lymphocytic infiltration in septal mucosa opposite the deviation compared to control group. Furthermore, there was a significantly higher rate of lymphocytic infiltration in the lateral nasal wall mucosa opposite the deviation when compared to control group. Increased lymphocytic infiltration and squamous metaplasia are observed on both sides of nasal mucosa; however, they are more severe on the side opposite the deviation. Septal deviation predisposes to chronic mucosal inflammation and squamous metaplasia, both of which may render patients susceptible to chronic rhinosinusitis.

Resveratrol has been shown to have vasoprotective effects by upregulating oxidative defense mechanisms in a variety of pathophysiological conditions. However, the effect of resveratrol on diabetic oxidative stress and vascular and metabolic abnormalities is not completely understood. Therefore, this study was designed to evaluate whether long-term resveratrol supplementation has a protective effect on vascular function and integrity in association with metabolic parameters and oxidative stress in insulin-dependent diabetes. Diabetes was induced in rabbits with alloxan and maintained for 8 weeks. We used a resveratrol dose of 5 mg/L (10 weeks, starting 14 days before alloxan injection) and 50 mg/L (8 or 10 weeks, starting concomitantly or 14 days before alloxan injection) in the drinking water of rabbits. Relaxation to acetylcholine was impaired (control 75.6 ± 3.59%, versus diabetic 42.23 ± 2.53%) and contractions to phenylephrine increased (control 136.89 ± 2.27%, versus diabetic 159.37 ± 6.27%) in aortas from diabetic animals. These changes were associated with increased basal or NAD(P)H-induced superoxide production, as well as lipid peroxide and superoxide dismutase (SOD) levels in the aortic samples. The maximal relaxation to acetylcholine improved by 75.74 ± 9.04% in diabetic rabbits treated with resveratrol. The increased contractions to phenylephrine were not restored to control values after resveratrol treatments, but sensitivity to the contractions tended to decrease. Resveratrol increased nitrite/nitrate levels and suppressed basal or NAD(P)H-induced superoxide production and lipid peroxide levels in the aortas. Importantly, resveratrol increased serum insulin levels without affecting blood glucose and the lipid profile in diabetic rabbits. Using electron microscopic examinations, resveratrol was found to markedly protect the endothelial integrity from diabetes. Overall, there was no noticeable difference between resveratrol treatment groups on the recovery from diabetes. Our results indicate that resveratrol alleviates type 1 diabetes-induced vasculopathy by decreasing vascular oxidative stress and thereby increasing the bioavailability of nitric oxide without changing metabolic abnormalities.

Vitamin D has a selective radio and chemosensitizing effect on tumor cells. In vitro and in vivo studies have shown that vitamin D inhibits collagen

The aim of this study was to translate the questionnaire into Turkish and to investigate the test-retest reliability, construct validity and its sensitivity to change following physical therapy. The questionnaire was translated into Turkish using the forward and backward translation technique. Test-retest reliability was assessed with the correlation coefficients. Scale analysis for internal validity, the Cronbach's alpha score was calculated. Construct validity was tested with principal components analysis and was also tested with divergent validity. Following three weeks of treatment, sensitivity to change and responsiveness of the questionnaire was assessed. The questionnaire was applied on 55 patients and high correlations were found on the repeated items 48 hours later. In the scale analysis, the Cronbach's alpha score was found as 0.911 for the total questionnaire. Two factors were found compatible with the original questionnaire with principal components analysis. These two factors explain 61.647% of the total variance in the questionnaire performed on 150 patients. In divergent validity, the fear avoidance beliefs were found in low correlation with the clinical variables. Sensitivity to change and responsiveness of the FABQ was found to be low. FABQ has sufficient psychometric features for its applicability in the Turkish population with subacute and chronic low back pain.

Peripheral nerves with defective segments can only be repaired using nerve grafts. Among the various nerve graft options, the outcome of vascularized grafts has been shown to be better, especially when used in the hypovascular and scarred recipient bed. The purpose of this study was to compare the regeneration capacities of various types of venous nerve grafts in a rat model. Forty adult male Wistar albino rats were divided into four groups. A 2-cm-long segment of femoral sheath was isolated from the surrounding tissue without disturbing the unity of the femoral sheath contents. Four different nerve graft models were applied: flow-through venous, arterialized venous, prefabricated venous, and conventional nerve graft (control). All nerve grafts were closed with silicone sheets. These neurovascular segments were reopened in postoperative week 10 to determine the viability of the grafted nerves and to assess the degree of nerve healing. Histopathologic examinations, morphometric analysis, and electrophysiological measurements were performed. The degree of nerve healing in the flow-through venous nerve grafts was similar to that observed in the arterialized nerve grafts. Prefabricated flow-through venous grafts were not as successful as flow-through venous grafts or arterialized nerve grafts. All of the vascularized nerve grafts showed better results than the conventional nerve grafts.

Application of acupuncture methods goes back centuries. Today, there is much scientific research and many approaches to explain the mechanism of acupuncture. Among these approaches, the most popular one is the neurophysiologic approach. In this paper, we explain the series of events that follow the insertion of acupuncture needles under the headings of local reactions; regional reflexes related with viscero-cutaneous and cutaneo-visceral reflexes; increased levels of β-endorphin, enkephalin, and serotonin in the central nervous system and plasma; and effects of these neurotransmitters in the nervous system and many other systems. We then address the clinical application of this neurophysiologic approach.