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Item Effects of cross-linked high-molecular-weight hyaluronic acid on epidural fibrosis: Experimental study(American Association of Neurological Surgeons, 2015-01) Işık, Semra; Taskapılıoğlu, M. Özgür; Atalay, Fatma Öz; Doğan, Şeref; Uludağ Üniversitesi/Tıp Fakültesi/Beyin ve Sinir Cerrahisi Anabilim Dalı.; 0000-0001-5472-9065; K-6580-2015; AAW-5254-2020; JHC-4482-2023; AAI-6531-2021; 55972140700; 25936798300; 15623010600; 7102693077OBJECT: Epidural fibrosis is nonphysiological scar formation, usually at the site of neurosurgical access into the spinal canal, in the intimate vicinity of and around the origin of the radicular sheath. The formation of dense fibrous tissue causes lumbar and radicular pain. In addition to radicular symptoms, the formation of scar tissue may cause problems during reoperation. The authors aimed to investigate the effects of cross-linked high-molecular-weight hyaluronic acid (HA), an HA derivative known as HA gel, on the prevention of epidural fibrosis by using histopathological and biochemical parameters. METHODS: Fifty-six adult female Sprague-Dawley rats were evaluated. The rats were divided into 4 groups. Rats in the sham group (n = 14) underwent laminectomy and discectomy and received no treatment; rats in the control group (n = 14) underwent laminectomy and discectomy and received 0.9% NaCl treatment in the surgical area; rats in the HA group (n = 14) received HA treatment at the surgical area after laminectomy and discectomy; and rats in the HA gel group (n = 14) underwent laminectomy and discectomy in addition to receiving treatment with cross-linked high-molecular-weight HA in the surgical area. All rats were decapitated after 4 weeks, and the specimens were evaluated histopathologically and biochemically. The results were statistically compared using the Mann-Whitney U-test. RESULTS: Compared with the sham and control groups, the HA and HA gel groups showed significantly lower fibroblast cell density and tissue hydroxyproline concentrations (p < 0.05). There was statistically significant lower dural adhesion and foreign-body reaction between the control and HA gel groups (p < 0.05). Granulation tissue and epidural fibrosis were significantly lower in the HA and HA gel groups compared with the sham group (p < 0.05). There were no significant differences in any histopathological parameters or biochemical values between Groups 3 and 4 (p > 0.05). CONCLUSIONS: Cross-linked high-molecular-weight HA had positive effects on the prevention of epidural fibrosis and the reduction of fibrotic tissue density. The efficacy of this agent should also be verified in further experimental and clinical studies.Item Histologic and electromyographic evaluation of neuroregenerative effect of stromal vascular fraction following neuroanastomosis(Kafkas Üniversitesi, 2020-03-23) Acar, Hilal; Çerçi, Ece; Khezri, Marzieh Karimi; Çetin, Melike; Canatan, Uygur; Şen, Mehmet Metin; Aslan, Vildan; Sarıl, Canan Altıncı; Temiz, Elif Mekik; Taşkapılıoğlu, Mevlüt Özgür; Erdost, Hatice; Salcı, Hakan; Bursa Uludağ Üniversitesi/Veteriner Fakültesi/Cerrahi Anabilim Dalı.; Bursa Uludağ Üniversitesi/Veteriner Fakültesi/Histoloji ve Embriyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nöroşirürji Anabilim Dalı.; 0000-0001-5472-9065; 0000-0003-0154-9938; 0000-0001-9650-0891; 0000-0001-5323-6891; 000-0003-1547-7293; 0000-0001-6548-8754; AAH-9216-2021; AAI-6861-2021; AAW-5254-2020; ABB-8161-2020; 57209653860; 57212212053; 57216947212; 56393942900; 57189443508; 57216950078; 57200994296; 57216954758; 57216945905; 25936798300; 6505787570; 8680329000In this study, histologic and electromyographic (EMG) evaluation of neuroregenerative effect of stromal vascular fraction (SVF) following periferal nerve anastomosis was aimed. Totally, 31 Wistar Albino, male rats (weighing about 300 g) were studied, and these rats were grouped according to surgical techniques performed on the right sciatic nerve: group I (GRI) micro suture (n=7), group II (GRII) micro suture + SVF (n=7), group III (GRIII) fibrin glue (n=7) and group IV (GRIV) fibrin glue + SVF (n=7). Fat tissue was taken from 3 rats to prepare SVF, and SVF was produced by non-enzymatic method. The left sciatic nerve of all rats was evaluated for EMG as control. Under general anesthesia, after transversal incision of the sciatic nerve, microsurgical epineural repair technique was performed with 10/0 nonabsorbable suture. EMG examinations were performed in terms of conduction rate, amplitude, distal latency and spontaneous muscle activity at 0th day and postoperative (PO) 1st and 8th weeks. EMG results between and within the groups were statistically evaluated by one-way analysis of variance. Rats in all groups were sacrificed by decapitation at PO 8th week and histological examinations of the sciatic nerves were performed following preparation of the neural tissues. EMG examination results showed the highest nerve conduction in GRI, the highest amplitude in GRIII, normal latency in GRII and longer distal latency in GRIV at PO 8th week. Amplitude and conduction velocity increased gradually in all groups. In needle EMG, the best muscle membrane stabilization was achieved in GRII and GRIV at PO 8th week. Statistically, the values of amplitude, distal latency, conduction velocity, and spontaneous muscle activity were found to be at normal levels at PO 8th week in all groups (P>0.05). In the histological results, although fibroconnective tissue reactions in the anastomosis area had similar scores in GRII and GRIV, maximum fibroconnective tissue reaction and the best axonal regeneration was seen in GRI and GRIII, respectively. In addition, GRI and GRII had the most inflammatory cells accumulation in the suture region, and less inflammatory cells were seen in the anastomosis area of GRIII and GRIV. As a conclusion, fibrin glue presents good electrophysiological and histological results; however, it is clear that local SVF usage on the nerve anastomosis area can be a good choice to decrease fibroconnective tissue reaction and inflammation.Item Oleuropein modulates glioblastoma miRNA pattern different from Olea europaea leaf extract(Sage Publications, 2019-09) Tezcan, Gülçin; Aksoy, Seçil Ak; Tunca, Seçil Berrin; Bekar, Ahmet; Mutlu, Melis; Çeçener, Gülşah; Egeli, Ünal; Kocaeli, Hasan; Demirci, Hilal; Taşkapılıoğlu, Mevlüt Özgür; Uludağ Üniversitesi/Tıp Fakültesi; 0000-0002-3760-9755; 0000-0002-1619-6680; 0000-0002-3820-424X; 0000-0001-7904-883X; 0000-0001-5472-9065; AAH-8540-2021; ABI-6078-2020; CGB-7869-2022; FPB-0403-2022; AAP-9988-2020; AAH-1420-2021; FDK-3229-2022; CNW-1571-2022; AAW-5254-2020; 36668149100; 6602965754; 6603677218; 57212065763; 6508156530; 55665145000; 6603500567; 57193932262; 25936798300Glioblastoma (GBM) is the most prevalent and deadliest subtype of glioma. Despite current innovations in existing therapeutic modalities, GBM remains incurable, and alternative therapies are required. Previously, we demonstrated that Olea europaea leaf extract (OLE) kills GBM cells by modulating miR-181b, miR-137, miR-153 and Let-7d expression. However, although oleuropein (OL) is the main compound in OLE, its role in the antitumour effect of OLE remains unknown. This study determined the effect of OL on GBM cell line T98G and compared the results with our previous findings regarding the effect of OLE on the same cell line. The antiproliferative activity of OL and its effect on temozolomide (TMZ) response were tested inT98G cells using WST-1 assay. OL inhibition was evaluated using one-way analysis of variance with Tukey's post hoc test. The effect of OL on miR-181b, miR-137, miR-153 and Let-7d expression was assessed using quantitative reverse transcription polymerase chain reaction. Fold differences in expression between untreated, OL or OL + TMZ-treated samples were calculated using 2(-Delta Ct) method. Significance was evaluated using an independent sample t-test. Treatment with 277.5 and 555 mu M OL resulted in 39.51% and 75.40% reductions in T98G cells within 24 h. Coadministration of 325 mu M TMZ and 277.5 or 555 mu M, OL caused 2.08- and 2.83-fold increases, respectively, in the therapeutic effect of TMZ. OL + TMZ significantly increased microRNA expression, particularly Let-7d, than OLE. In conclusion, OL has an antitumour effect on GBM cells mainly via regulation of Let-7d expression. The present results also indicate other minor compounds in OLE play important anticancer roles.Item Prevention of epidural fibrosis in rats by local or systemic administration of citicoline(Turkish Neurosurgical Society, 2012-09) Ulus, İsmail Hakkı; Savran, Mehmet; Bekar, Ahmet; Cansev, Mehmet; Tolunay, Şahsene; Taşkapılıoğlu, Mevlüt Özgür; Uludağ Üniversitesi/Tıp Fakültesi/Nöroşirürji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Farmakoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; 0000-0001-5472-9065; 0000-0003-2918-5064; AAW-5254-2020; M-9071-2019; ABB-8161-2020; 6506735836; 6603677218; 8872816100; 6602604390; 25936798300AIM: The objective of this study was to investigate the effect of citicoline administration on epidural fibrosis which is a frequent complication of lumbar disc surgery with no effective treatment or preventive surgical technique. MATERIAL and METHODS: Sixty Sprague-Dawley female rats undergoing L4-5 right hemilaminotomy and annular fenestration were arranged in three groups: rats in Group 1 (control group) and Group 2 (topical citicoline group) were applied 0,9% saline and 100 mu M citicoline on surgical area, respectively, while rats in Group 3 (systemic citicoline group) received 600 mu mol/kg citicoline intraperitoneally. Rats were sacrificed four weeks later and their vertebral colons were removed en bloc. Groups were evaluated according to histological criteria and results were compared using statistical tools. RESULTS: Compared with control group, significantly less epidural fibrosis, dural adhesion, fibroblast cell density, foreign body reaction, and medulla spinalis retraction were observed in groups treated with topical and systemic citicoline (groups 2 and 3) (p < 0,001). No significant difference was found with regard to measured parameters between two treatment groups (p > 0,05). CONCLUSION: Our study demonstrates for the first time in the literature that citicoline may be effective for preventing postoperative epidural fibrosis. However, its mechanism of action and clinical effectiveness must be further investigated.Item Retrospective analysis of early- and late-operated meningomyelocele patients(Springer, 2020-08-06) Türedi, Bilge; Altunyuva, Oğuz; Taşkapılıoğlu, Mevlüt Özgür; Utangaç, Mehmet Mazhar; Balkan, Mehmet Emin; Kılıç, Nizamettin; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nöroşirürji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Ürolojisi Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Cerrahisi Anabilim Dalı.; 0000-0001-5472-9065; AAW-5254-2020; AAI-3656-2021; ABB-8161-2020; 25936798300; 56491004200; 41661142300; 7005266570Purpose Myelomeningocele (MMC) is one of the commonest congenital malformations. Hydrocephalus develops in 65-85% of cases with MMC. Only 3-10% of MMC patients have normal urinary continence. We aim to investigate the effects of early and late operation in MMC patients in terms of development of hydrocephalus, motor deficits, and bladder functions. Methods Medical records of MMC patients operated between January 2008 and December 2014 were reviewed retrospectively. Results We retrospectively investigated patients' records of 43 patients. Twenty of the patients were operated within the first 48 h after the delivery (early repair group), while 23 of the patients were operated after 48 h of delivery (late repair group). In the early repair group, 15 patients were operated due to hydrocephalus. Urodynamic problems were detected in 17 (85%) patients. In the late repair group, shunts were placed in 14 (61%) patients during follow-up period and urodynamic problems were detected in 19 (82.6%) patients. Mean operation time for the late group was 4.6 months. There was no statistical difference between the early and late group in terms of neurological and urodynamic deficits. The mean follow-up period was 45.5 months. Conclusion In the literature, surgery in the first 48 h of life is recommended for MMC patients. There was no difference between the early- and late-operated groups by means of hydrocephalus, urodynamic functions, and motor deficits in our study. Late surgery of intact sacs may avoid complications related to surgery in the neonatal period.