16 research outputs found

    Electromyographic Evaluation of Early Stage Results of Exoscopic Microdecompressive Spinal Surgery in Dogs

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    Background: Spinal surgical interventions are generally used in the treatment of various spinal pathologies such as vertebral fracture, luxation-subluxation, congenital vertebral deformities, discal hernia, infection and tumor. Minimally invasive spinal surgery contributes to rapid recovery by reducing iatrogenic muscle damage and postoperative pain. In minimally invasive spinal surgery, a new hybrid imaging technique, the exoscope, has been developed in the last decade The purpose of this study was to report efficacy of the exoscopic microdecompressive spinal surgery (MDSS) and its early postoperative electromyography (EMG) results in dogs.Materials, Methods & Results:The material of this study consisted of the owned 10 dogs with spinal cord injury resulted from the different etiologies. On the basis of examinations, medical support (fluid therapy, corticosteroid, etc.) was applied to the required dogs. Exoscopic MDSS was performed under general anesthesia in dogs. The neurologic, radiologic and EMG examination were completed at pre- and postoperative periods. EMG results at postoperative 1st week showed increased conduction velocity and amplitudes in 3 cases. There was no significant change in a case. And, there was a slight slowdown in conduction velocity and significant decrease in amplitudes in a case. At postoperative 4th week, ther was increased conduction velocity and amplitudes in 8 cases and needle EMG showed that spontan muscle activity was normal in 5 cases, mild in 2 cases, moderate a case and severe in a case. But spontan muscle activity was unfollowed in a case. Postoperative outcomes were poor in 3 cases, fair in 3 cases, good in 3 cases and unfollowed in a case. Discussion: Spinal cord injuries encountered in veterinary medicine have significant morbidity and mortality. In spinal patients, in addition to neurological examination, lesion localization can be determined using imaging techniques such as radiology, computed tomography, and MRI. EMG and somatosensory evoked potentials examinations are used to evaluate quantitative functional recovery, especially in spinal cord injuries. EMG also provides an opportunity to evaluate muscle activation patterns during recovery. Exoscopic spinal surgery is the newest hybrid imaging technique. Exoscopic MDSS facilitated manipulation by providing adequate illumination and vision at the exploration site. Exoscopic MDSS has the advantages of microscopic surgery and is a new technique that can be applied in dogs with spinal pathology

    Comparison of clinical and molecular wnt and shh subgroups in medulloblastoma tumor cases

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    AIM: To determine the Wnt and SHH subtypes at the molecular level, and to compare them clinically by examining the changes in CTNNB1, AXIN, PTCH1, SMO, SUFU, and GLI1 mRNA expression in the medulloblastoma of a Turkish population determined according to patient selection criteria. In this context, the clinical distinction between Wnt and SHH groups are realized by considering the age, gender, survival time, location of the lesion, and radiological features of the patients.MATERIAL and METHODS: Molecular separation was performed by RT-PCR analysis of CTNNB1, AXIN, PTCH1, SMO, SUFU, and GLI1 mRNA expression changes.RESULTS: About 17.8% and 22.2% of the cases were included in the Wnt and the SHH group, respectively. When comparing group differences based on clinical and molecular data, 72.7% and 66.6% of matches were observed in the Wnt and the SHH group, respectively.CONCLUSION: It has been revealed that molecular analysis and grouping of patients with medulloblastoma can provide support for clinically determined subgroups

    Statistical shape analyses of the brainstem in chiari patients

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    AIM: To ascertain whether the brain stem's shape differs in patients with syrinx and without syrinx in cases with Chiari malformation Type I (CM-1), relative to healthy controls.MATERIAL and METHODS: Data on marked brainstem regions were obtained from 2D digital image files. Generalized Procrustes analysis was used to evaluate shape differences among patients with syrinx, patients without syrinx, and healthy controls. Shape deformations among groups were examined by Thin Plate Spline (TPS) analysis.RESULTS: According to the brain stem shape, there were differences between patients with syrinx and controls, and between patients without syrinx and controls. High-level deformations were also observed among the groups.CONCLUSION: In the present study, the presence of shape deformations in Chiari patients' brainstem was demonstrated. This is the first study using a landmark-based geometrical morphometric method to demonstrate the shape difference in Chiari patients' brainstem

    Surgery of Cranial Deformity Following Ventricular Shunting: A Multicenter Study

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    AIM: To review the cases of craniosynostosis secondary to ventricular shunting procedure.MATERIAL and METHODS: We retrospectively evaluated the medical records of all pediatric patients with hydrocephalus who were treated with ventriculoperitoneal shunt procedure between the years 2017 and 2021 at the Selcuk University, Ankara University, and Bursa Uludag University.RESULTS: Twenty-one patients were included in the study. The median age at the time of insertion of ventriculoperitoneal shunt for hydrocephalus was 8.1 (range, 1-22) months. Seven patients were shunted because of congenital hydrocephalus. The mean time to development of secondary synostosis was 8.8 (range, 1-36) months. Plagiocephaly was the most common type of secondary synostosis. While shunt revision was performed in 16 patients, cranial vault expansion surgery was performed in 5 patients.CONCLUSION: Slit ventricle syndrome is a frequent condition at shunted patients, but there is no consensus on identifying patients who require treatment. Using programmable or high-pressure valves, performing cranial vault modeling are possible treatment modalities. Increased awareness of this condition in follow-up may allow early diagnosis and intervention and prevent it from evolving into more serious deformities

    Effectiveness of multiple endoscopic fenestrations for the treatment of Sylvian fissure arachnoid cysts: a multicenter study

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    Purpose Arachnoid cysts are usually asymptomatic lesions. However, they can sometimes cause intracranial hypertension, headache, seizures, focal neurological deficits, and bleeding. The most commonly used surgical techniques are microsurgical cyst fenestration/excision/drainage, cyst shunting, and endoscopic procedures. We aimed to investigate the success of different surgical techniques. Methods Between 2000 and 2021, patients with Sylvan fissure arachnoid cysts who received treatment via an endoscopic approach chosen as the first-line treatment in three centers were enrolled. All case notes and radiological studies were evaluated retrospectively. Results The study included 131 (female, n=28; male, n=103) patients with a mean age of 87.04 +/- 66.76 (range, 0-216) months. Of the patients, 25 had Galassi type II left-sided arachnoid cysts, 33 had Galassi type II right-sided arachnoid cysts, 40 had Galassi type III left-sided arachnoid cysts, and 32 had Galassi type III right-sided arachnoid cysts. No difference was found between patients who underwent single and multiple fenestrations in terms of Galassi type, side, clinical outcome, and cyst size (p> 0.05). On the contrary, the rate of additional surgical intervention was lower in patients with multiple fenestrations than in those with single fenestration (36.10% vs. 5.30%; p <0.001). Conclusion Endoscopic fenestration of Sylvian fissure arachnoid cysts is a good alternative to open surgery or cystoperitoneal shunting, and the number of fenestrations made during this surgery decreases the need for a second surgical procedure

    Statistical Shape Analysis of Cerebellum in Patients With Chiari Malformation I

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    The surgical procedure is viewed as a typical treatment choice for patients with Chiari malformation (CM). Decompression is the preferred method for surgery, but it is not always possible to understand whether decompression has been successful especially in an early period. The present study focuses on investigating the shape differences in the cerebellums of Chiari patients compared with healthy controls, and to assess the clinical application of this situation whether if present. The MRI scans were reviewed retrospectively. Cerebellar data were obtained from the digital images and 9 anthropometric landmarks were marked on each image. Shape difference was assessed by performing Generalized Procrustes analysis. The cerebellar shape deformation from control to the patient was evaluated performing the Thin Plate Spline approach. There is a statistically significant cerebellar shape difference between groups. Highest deformation was determined at the cerebellar tonsillar inferior area, posterior of the uvula, and anterior of inferior medullary velum. The present study demonstrated cerebellar shape differences in CM I patients using a landmark-based geometric morphometric approach, considering the topographic distribution of cerebellum for the first time

    Does glioblastoma cyst fluid promote sciatic nerve regeneration?

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    Glioblastoma cyst fluid contains growth factors and extracellular matrix proteins which are known as neurotrophic and neurite-promoting agents. Therefore, we hypothesized that glioblastoma cyst fluid can promote the regeneration of injured peripheral nerves. To validate this hypothesis, we transected rat sciatic nerve, performed epineural anastomosis, and wrapped the injured sciatic nerve with glioblastoma cyst fluid- or saline-soaked gelatin sponges. Neurological function and histomorphological examinations showed that compared with the rats receiving local saline treatment, those receiving local glioblastoma cyst fluid treatment had better sciatic nerve function, fewer scars, greater axon area, counts and diameter as well as fiber diameter. These findings suggest that glioblastoma cyst fluid can promote the regeneration of injured sciatic nerve and has the potential for future clinical application in patients with peripheral nerve injury

    Long noncoding RNA MALAT1 may be a prognostic biomarker in IDH1/2 wild-type primary glioblastomas

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    Primary glioblastoma (GB) is the most aggressive type of brain tumors. While mutations in isocitrate dehydrogenase (IDH) genes are frequent in secondary GBs and correlate with a better prognosis, most primary GBs are IDH wild-type. Recent studies have shown that the long noncoding RNA metastasis associated lung adenocarcinoma transcript-1 (MALAT1) is associated with aggressive tumor phenotypes in different cancers. Our aim was to clarify the prognostic significance of MALAT1 in IDH1/2 wild-type primary GB tumors. We analyzed IDH1/2 mutation status in 75 patients with primary GB by DNA sequencing. The expression of MALAT1 was detected in the 75 primary GB tissues and 5 normal brain tissues using reverse transcription quantitative PCR (RT-qPCR). The associations between MALAT1 expression, IDH1/2 mutation status, and clinicopathological variables of patients were determined. IDH1 (R132H) mutation was observed in 5/75 primary GBs. IDH2 (R172H) mutation was not detected in any of our cases. MALAT1 expression was significantly upregulated in primary GB vs. normal brain tissues (p = 0.025). Increased MALAT1 expression in IDH1/2 wild-type primary GBs correlated with patient age and tumor localization (p = 0.032 and p = 0.025, respectively). A multivariate analysis showed that high MALAT1 expression was an unfavorable prognostic factor for overall survival (p = 0.034) in IDH1/2 wild-type primary GBs. High MALAT1 expression may have a prognostic role in primary GBs independent of IDH mutations
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