Browsing by Author "Bekâr, Ahmet"
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Item Clinical and radiologic analysis of 3-level anterior cervical discectomy and fusion with interbody cages without plate fixation(Elsevier, 2008-02) Doǧan, Şeref; Türkkan, Alper; Kocaeli, Hasan; Korfali, Ender; Bekâr, Ahmet; Uludağ Üniversitesi/Tıp Fakültesi/Beyin Cerrahisi Anabilim Dalı.; AAI-6531-2021; 7102693077; 25029159600; 6603500567; 7004641343; 6603677218Objectives: The primary objective of this Study was to analyze the clinical and radiologic outcomes of 3-level anterior cervical discectomy and fusion procedures performed using interbody cages without plate fixation, Methods: Twenty-two patients with radiculomyelopathy were retrospectively evaluated. Functional Outcome of patients with radiculopathy was assessed using Odom's criteria, and myelopathic patients were rated according to Nurick's classification. Radiographs were used for evaluation of the cervical lordosis, fusion, foraminal height, and implant position. Results: An excellent or good functional result was found in all of the patients with radiculopathy. In addition, Nurick grades improved from a mean of 2.4 before surgery to a mean of 1.2 at follow-up (P = 0.007). These effects were accompanied by a significant increase in height of the foramina after surgery (P = 0.006). However, there was no statistically significant difference between cervical lordosis before Surgery and at final follow-Lip. Fusion was observed in 17 (77.3%) of the patients, whereas the remaining 5 patients (22.7%) had asymptomatic pseudarthrosis. Of the 66 total cages implanted, subsidence was present in 31 (46.9%). The mean follow-up was 26.1 months. Conclusions: The use of interbody cages Without plate fixation for 3-level anterior cervical discectomy increases cervical lordosis, increases foraminal height, assists fusion, and is associated with good clinical outcomes.Item A comparison of spinal anesthesia characteristics following intrathecal bupivacaine or levobupivacaine in lumbar disc surgery(Springer, 2013-10-26) Şahin, Ayça Sultan; Türker, Gürkan; Bekâr, Ahmet; Bilgin, Hülya; Korfalı, Gülsen; Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji ve Reanimasyon Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Beyin Cerrahisi Anabilim Dalı.; 0000-0002-3019-581X; 0000-0001-6639-5533; 0000-0002-7765-5297; AAI-6642-2021; A-7338-2016; B-3345-2015; 55914591300; 7003400116; 6603677218; 6701663354; 6701462594While bupivacaine is the most frequently used local anesthetic for spinal anesthesia, use of levobupivacaine in clinical practice has advanced recently. The aim of our study was to compare the clinical and anesthetic effects of isobaric bupivacaine and isobaric levobupivacaine when administered intrathecally in patients undergoing lumbar disc surgery. ASA I-III, 60 patients were enrolled in this study. Only patients with unilateral single-level (L4-5) lumbar disc hernia were selected and operated in each group and all were operated by the same surgeon. Patients were randomized into two groups, as group B (n = 30): 15 mg 0.5 % isobaric bupivacaine, or group L (n = 30): 15 mg 0.5 % isobaric levobupivacaine received intrathecally. The level of sensory block dermatome, degree of motor block, intraoperative sensory and motor block characteristics, and postoperative recovery times of spinal anesthesia were evaluated. The satisfaction scores of the surgeon and patients, intraoperative hemodynamic changes, intraoperative and postoperative complications were recorded. The maximum level of sensory blockade was significantly higher in the levobupivacaine group (group L 7 +/- A 1.63, group B 8.6 +/- A 1.76 thoracic dermatome, p < 0.05). There was no significant difference in the onset time of sensory (group L 6 +/- A 3 min, group B 9 +/- A 4 min) and motor (in group L 7 +/- A 3 min, in group B 10 +/- A 4 min) blockade (p > 0.05). There was no significant difference between the groups regarding duration of operation (group L 49 +/- A 7.3 min, group B 52 +/- A 8.1, p > 0.05). Recovery times of sensory (175 +/- A 57 min) and motor (216 +/- A 59 min) blockade were significantly shorter in the levobupivacaine group (p < 0.05). Mobilization was also earlier in the levobupivacaine group (339 +/- A 90 min, p < 0.05). Patients' satisfaction and intraoperative, postoperative complications were similar between the two groups. Our results showed that block recovery time was shorter in the levobupivacaine group, this may be a disadvantage for longer operative procedures. But with proper patient selection this can be eliminated. Recovery time was shorter in levobupivacaine group. Therefore, postoperative neurological examination can be done earlier. In addition, early mobilization can be an advantage for postoperative recovery.Item Dilatation of virchow-robin perivascular spaces: Report of 3 cases with different localizations(George Thieme, 2008-02) Aksoy, Kaya; Caner, Başak; Bekâr, Ahmet; Hakyemez, Bahattin; Taşkapılıoğlu, Özgür; Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Nöroşirürji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; 0000-0002-3425-0740; R-7501-2018; AAI-2318-2021; 25027089000; 6603677218; 6602527239; 6506852772We report on three different cases with Virchow-Robin spaces, including one with extreme widening causing hydrocephalus. In one patient we have performed neuroendoscopic cyst fenestration to resolve the problem.Item Effect of craniotomy without shaving on patient mood(Journal Neurological Sciences, 2013) Taşkapılıoğlu, Mevlüt Özgür; Eser, Pınar Ocak; Tunalı, Neslihan Zor; Korfali, Ender; Bekâr, Ahmet; Uludağ Üniversitesi/Tıp Fakültesi/Beyin ve Sinir Cerrahisi Anabilim Dalı.; 0000-0001-5472-9065; AAI-2073-2021; AAW-5254-2020; ABB-8161-2020; 25936798300; 55211742300; 55775646100; 7004641343; 6603677218Background: Shaving before cranial surgery has been a common practice for many decades. Most of the studies were about the infection rates, but there is a few data about the effect of shaving on patient mood. The aim of this study was to determine the effects of not shaving when performing a craniotomy on the mood of the patients. Methods: Patients who underwent a craniotomy between September 2010 and September 2011 and agreed to complete a questionnaire after the surgery were included in the study. Results: 207 patients included in the study. The mean age of the patients was 44.51 +/- 18.00 years. 114 patients (55.07%) did not think about shaving when they first learned they would undergo a craniotomy; 133 (64.2%) did not ask their surgeons about being shaved during the craniotomy. 30 patients (14.4%) pointed out that not being shaved was an important factor in choosing the surgeon. Nineteen (9.1%) patients complained about the wide scar tissue and alopecia. Conclusion: Not shaving is a strong factor that affects the time necessary to get back to one's routine and orientation to social life after craniotomy without increasing infection rates. However, it is not a factor that affects the patient's choice of doctors.Item Frontoethmoidal orbital osteoma as a cause of intraserebral abscess: Case report(Journal Neurological Sciences, 2011) Taşkapılıoğlu, Özgür; Kocaeli, Hasan; Caner, Başak; Bekâr, Ahmet; Yılmaz, Emel; Yalçınkaya, Ülviye; Uludağ Üniversitesi/Tıp Fakültesi/Beyin ve Sinir Cerrahisi Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Mikrobiyoloji ve Enfeksiyon Hastalıkları Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; ABB-8161-2020; AAH-8924-2021; 6506852772; 6603500567; 25027089000; 6603677218; 22037135100; 6508300295We report a case of a 33 year-old-man who presented with a left frontal intracerebral abscess which was associated with a frontoethmoidal orbital osteoma. Erosion of the frontobasal dura mater by the expanding osteoma caused this rare presentation. The patient underwent evacuation of the abscess followed by resection of the osteoma. Although osteomas tend to remain quiscent in most of the patients, they rarely become symptomatic to such an extent that, as in the present case, they deserve to be considered in the differential diagnosis of intracerebral abscesses.Item The immunohistochemical expression of c-Met is an independent predictor of survival in patients with glioblastoma multiforme(Elsevier, 2013-09) Ölmez, Ömer Fatih; Çubukçu, Erdem; Evrensel, Türkkan; Kurt, Mera; Avcı, Nilüfer; Tolunay, Şahsine; Bekâr, Ahmet; Deligönül, Adem; Hartavi, Mustafa; Alkis, Nihan; Manavoǧlu, Osman; Uludağ Üniversitesi/Tıp Fakültesi/Onkoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Nöropatoloji Bölümü.; Uludağ Üniversitesi/Tıp Fakültesi/Nöroşirürji Bölümü.; 0000-0003-1637-910X; 0000-0002-9732-5340; AAI-1612-2021; AAA-3961-2020; AAJ-1027-2021Item Investigation of mutations and expression of the FHIT gene in Turkish patients with brain metastases derived from non-small cell lung cancer(Sage Publications, 2007-11) Güler, Gülnür; Bekâr, Ahmet; Çeçener, Gülşah; Tunca, Berrin; Egeli, Ünal; Tolunay, Şahsine; Uludağ Üniversitesi/Tıp Fakültesi/Nöroşirürji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Biyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; 0000-0002-1619-6680; 0000-0001-7904-883X; 0000-0002-3820-424X; AAH-1420-2021; ABI-6078-2020; AAI-1612-2021; 6603677218; 6508156530; 6602965754; 55665145000; 6602604390Aims and background: Brain metastases occur in 20-40% of patients with cancer, and their frequency has increased over time. Lung, breast and skin (melanoma) are the most common sources of brain metastases. Recent studies show that several genes such as CD44 and PTEN have roles in the suppression of metastatic growth. Although it has been determined that there is a relationship between the FHIT gene and several primary tumors, its role in the initiation and progression of brain tumors has not yet been entirely explained. Furthermore, it is not known whether the FHIT gene has a role in the formation of brain metastases. Patients and methods: The present study investigated mutations of the FHIT gene in Turkish patients with brain metastases derived from non-small cell lung cancer (NSCLC). Single-strand conformational polymorphism and sequencing analysis of the coding exons (5-9) of the FHIT gene were performed on 26 tissues. Furthermore, the level of Fhit protein expression of 36 tumor tissues was identified by immunohistochemistry. Results: Using single-strand conformational polymorphism and sequencing analyses, no point mutations of the FHIT gene were detected in brain metastases derived from NSCLC. However, it was observed that Fhit protein expression was reduced in 88.9% of subjects. Conclusions: We suggest that the FHIT gene may be turned off in brain metastases via other genetic/epigenetic mechanisms rather than mutations.Item Multiple extracranial metastases from secondary glioblastoma: A case report and review of the literature(Türk Nöroloji Derneği, 2013) Taşkapılıoğlu, Mevlüt Özgür; Aktaş, Ulaş; Eser Ocak, Pınar; Tolunay, Şahsine; Bekâr, Ahmet; Uludağ Üniversitesi/Tıp Fakültesi/Nöroşirürji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; 0000-0001-5472-9065; 0000-0003-0132-9927; AAI-2073-2021; AAW-5254-2020; ABB-8161-2020; AAI-1612-2021; 25936798300; 55122917500; 55211742300; 6602604390; 6603677218Glioblastoma represents extreme anaplasia in astrocytic tumors. In spite of this aggressiveness, extracranial metastasis of glioblastoma is very rare and has been documented in only a few patients in the literature. In this article, a 30-year-old woman with secondary glioblastoma associated with extracranial distant metastasis was presented. In September 2008, an intracranial lesion in the left frontal region was diagnosed by magnetic resonance imaging (MRI) after admission to the hospital by headache and seizure and subsequently resected. The histology of the lesion revealed an anaplastic astrocytoma (grade III). Upon recurrence of the tumor 7 months later, the patient underwent a second craniotomy for recurrence tumor resection. The histological diagnosis was glioblastoma. After radiotherapy and chemotherapy, cranial computerized tomography (CT) and whole body scintigraphy revealed metastatic lesions in the right cervical lymph nodes and the left ischium. A neck dissection and parathyroidectomy on the right side was performed. The cytomorphological and histological features of the tumor supported the diagnosis of metastatic glioblastoma.Item Preemptive wound infiltration in lumbar laminectomy for postoperative pain: comparison of bupivacaine and levobupivacaine(Türk Beyin Cerrahi Derneği, 2014-01) Gurbet, Alp; Bekâr, Ahmet; Bilgin, Hulya; Özdemir, Nurdan; Kuytu, Turgut; Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Nöroşirürji Anabilim Dalı.; 0000-0001-6639-5533; 0000-0002-0505-3027; 0000-0002-6503-8232; A-7338-2016; CAI-2032-2022; A-7994-2018; 35618853300; 6603677218; 6701663354; 57212543974; 36548277700AIM: Patients usually suffer significant pain after lumbar laminectomy. Wound infiltration with local anesthetics is a useful method for postoperative pain control. Our aim was to compare the efficacies of preemptive wound infiltration with bupivacaine and levobupivacaine. MATERIAL and METHODS: 60 patients were randomized three groups as follows: Group L wound infiltration with 20 mL 0.25% levobupivacaine and 40 mg methylprednisolone just before wound closure; Group B wound infiltration with 20 mL 0.25% bupivacaine and 40 mg methylprednisolone before closure; Group C had this region infiltrated with 20 ml physiological saline. Demographic data, vital signs, postoperative pain scores and morphine usage were recorded. RESULTS: First analgesic requirement time was significantly shorter in the control group compared to other two groups (p<0.001). Group B had the lowest cumulative morphine consumption at the end of 24 hours within 0-4, 4-12 and 12-24 hours time intervals and the values were not significant when compared with Group L, however the consumption of both groups was significantly lower compared to the control group (p<0.001). CONCLUSION: Our data suggest that preoperative infiltration of the wound site with bupivacaine or levobupivacaine provides similarly effective pain control with reduced opiate dose after unilateral lumbar laminectomy.Item Stab injury of the thoracic spinal cord: Case report(Turkish Neurosurgical, 2008-06-02) Doǧan, Şeref; Kocaelı, Hasan; Taşkapılıoğlu, Mevlüt Özgür; Bekâr, Ahmet; Uludağ Üniversitesi/Tıp Fakültesi/Beyin Cerrahisi Anabilim Dalı.; AAI-6531-2021; ABX-9081-2022; FDK-3229-2022; CEJ-0661-2022; 7102693077; 6603500567; 25936798300; 6603677218Stab injuries of the spinal cord are rare. We report a case of a 22-year-old male who was hospitalized because of a spinal cord injury resulting from a stab wound in the posterior thoracolumbar area. On admission, the patient had 2/5 muscle strength of the right leg (monoparesis) and hypoethesia below the L1 level. Radiological investigation revealed the retained tip of a knife that penetrated the spinal canal at the T12 An urgent right T12 hemilaminotomy was performed and retained knife fragment was removed. Six months after operation, the motor deficit had completely improved although hypoethesia was still present. Surgery should be considered as the first-line treatment in cases of incomplete injuries of the spinal cord with retained metallic object.Item Unusual complications and presentations of intracranial abscess: Experience of a single institution(Elsevier, 2008-04) Kocaeli, Hasan; Hakyemez, Bahattin; Yılmaz, Emel; Korfalı, Ender; Bekâr, Ahmet; Yılmazlar, Selçuk; Abaş, Faruk; Uludağ Üniversitesi/Tıp Fakültesi/Beyin Cerrahisi Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Nöroradyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Mikrobiyoloji Anabilim Dalı.; 0000-0003-3633-7919; 0000-0002-3425-0740; AAI-2318-2021; AAH-5070-2021; 6602527239; 6603500567; 6603677218; 6603059483; 8546184300; 22037135100; 7004641343Background: Complicating events and unusual presentations associated with intracranial abscess are rare but potentially fatal conditions. This study was undertaken to shed light on the unusual complications and presentations of intracranial abscess treated at a single institution. Methods: We retrospectively reviewed 116 cases of intracranial abscesses that were treated at our institution over the last 10 years and identified 11 (9.4%) cases with unusual complications. Results: These complications consisted of (1) rupture within the abscess, (2) hemorrhage into the abscess, (3) hemispheric infarction due to ICA thrombosis, (4) acute visual loss due to pituitary abscess, (5) acute neurologic deterioration due to rapid gas fori-nation within the abscess, (6) acute hydrocephalus, (7) trigeminal neuralgia, (8) fungal abscess developing secondary to intracranial extension of a temporal bone tumor, (9) Cryptococcus abscess with different morphology, (10) pontine infarction, and (11) sigmoid sinus thrombosis. Sinusitis accompanied 8 (72.7%) of the cases, and there were 5 (45.4%) mortalities. Culture results were unyielding in 4 patients, whereas Streptococcus species were identified in 4 and fungi in the rest. Conclusion: Intracranial abscesses and their complications still continue to be challenging entities in the neurosurgical practice. Our experience may provide an informational source for those who are taking care of patients with intracranial abscess.