Buffalo hump: spindle cell lipoma in posterior part of the neck.
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Head and Neck Neoplasms↗
Biomedical subjects
Bulent Erdogan
Publications and source records attributed to Bulent Erdogan.
Unusual dumbbell tumours of the mediastinum and thoracic spine.
Due to a lack of large clinical series in the literature of chondrosarcomas and hydatid disease presenting as mediastinal dumbbell tumours, clinicians have limited experience on this topic. We present three unusual cases of dumbbell tumour involving the spinal canal; two patients had chondrosarcoma originating from Th8-Th9 and Th10-Th12; one patient had a hydatid cyst at Th5-Th6. We performed a single-stage combined thoracic-neurosurgical approach in two patients, and a double-staged approach in one patient. During the intraspinal dissection, an operating microscope was used under electrophysiological monitoring. Spinal canal reconstruction was not required for any of the cases. Preoperative knowledge of neuroforaminal extension and the relations between the tumour and adjacent neural-vascular structures is essential to prevent spinal cord damage and plan the surgical approach. In chondrosarcomas, prognosis depends on patient age, histological grade, extent of surgery and response to radiotherapy and/or chemotherapy. In this article, the diagnostic and surgical difficulties of these unusual tumours and current treatment modalities are discussed with a review of the relevant literature.
Adult↗
Diphallus accompanied by anomaly of the urinary system.
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Abnormalities, Multiple↗
Open rhinoplasty without transcolumellar incision.
Traditional open rhinoplasty leaves a scar on the columella. No one can say that this scar is invisible. It is less noticeable in Caucasian patients but it is a problem in non-Caucasian patients like in our country. To avoid such a scar and still obtain a wide exposure of the nasal framework, the bilateral paramarginal incisions close to the columella were extended down to the nasal floors. The lower lateral cartilages forming the nasal tip could then be delivered out through one of the nostrils. An exposure similar to the traditional open rhinoplasty was then achieved. The technique has been used in 23 patients with satisfactory results. In conclusion, the open rhinoplasty without transcolumellar incision can replace the traditional transcolumellar open rhinoplasty technique in selected patients.
Humans↗
Various applications of chondrocutaneous composite grafts in secondary cleft lip nose patients.
Composite chondrocutaneous grafts were applied to 12 patients in various forms to repair the columellar deficit, to form the nasal tubercle and nostril sill in cleft lip nose patients. Cleft lip-nose deformity patients with alar cartilage hypoplasia, obtuse angulation of the medial and lateral crura and the resulting plica vestibularis, internal nasal valve problems associated with the weakness of upper lateral cartilages are included in this study and composite conchal cartilage grafts are utilized to achieve a symmetrical and functional result.
Adolescent↗
Panfacial squamous cell carcinoma.
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Aged↗
Multiple myeloma of the thoracic spine developed at the previous trauma site: case report.
The precise nature of the underlying plasma cell dyscrasias is not well understood. Even today, no causative factor has been found for this disease. It has been suggested that, several factors may act together in the development of this disease. This is a report of a 62-year-old man who initially had a T7 compression fracture and developed a multiple myeloma two years later at that site and at the adjacent vertebral level (T7-T8), respectively. Although the notion that trauma would initiate such a malignancy is speculative, the preceding trauma may be a causative factor in plasma cell dyscrasias.
Humans↗
An unusual case of ruptured distal anterior cerebral artery aneurysm associated with brucellosis.
Reports have noted aneurysmal dilatation of arteries in association with brucellosis, but involvement of intracranial vessels has not been documented to date. Sixty-one year old female patient who had been diagnosed with brucellosis 14 months earlier presented with symptoms of subarachnoid hemorrhage (SAH). Due to deterioration of the patient's clinical condition in spite of a two-drug antibiotic regimen, she was treated surgically and made a full recovery. It is important to identify this association promptly, as there are clinical implications for optimal management. The article also discusses the timing and duration of antibiotic therapy, indications for and considerations regarding surgery, and the use of other treatment modalities.
Aneurysm, Ruptured↗
Giant cell tumour of the sixth cervical vertebrae with close relationship to the vertebral artery.
Giant cell tumours of the vertebral column are rare and cervical vertebrae involvement is even less common. As these lesions may be closely related to the vertebral artery, therapeutic decision-making may be complex. Reviewing the literature, we found that there was no consensus on treatment or outcome assessment for these rare and difficult lesions. We present a case of a giant cell tumour of the sixth cervical vertebrae involving the posterior elements, neural foramina and transverse foramina and closely related to the vertebral artery. Radiological evaluation and therapeutic solutions are also discussed.
Adult↗
Silent pituitary macroadenoma co-secreting growth hormone and thyroid stimulating hormone.
Silent pituitary adenomas are a group of tumors showing heterogenous morphological features with no hormonal function observed clinically. To date no explanation has been provided as to why these tumors remain "silent". We report a case of a silent macroadenoma with both growth hormone (GH) and thyroid stimulating hormone (TSH) staining and secretion but with no clinical manifestations, in particular, the absence of features of acromegaly or hyperthyroidism. The relevant literature is reviewed.
Adenoma↗
The relation between serum levels of osteoprotegerin and postoperative epidural fibrosis in patients who underwent surgery for lumbar disc herniation.
OBJECTIVES: Epidural fibrosis (EF) is a part of the normal physiological tissue response to laminectomy and it is an important cause of failed back surgery syndrome (FBSS). Osteoprotegerin (OPG) is a soluble member of the tumor necrosis factor receptor family, and is expressed in high concentrations by a variety of tissues and cell types. The objective of this study was to evaluate the relationship between serum OPG levels, and the existence of postoperative EF in patients with lumbar disc herniation. It has been suggested that cytokines and growth factors, which play a role in the wound healing, may enhance the expression of OPG. METHODS: Forty women who underwent surgery for lumbar disc herniation were included in this study. Postoperative MRI was performed to assess EF in all patients. RESULTS: The serum OPG levels of subjects with postoperative EF were significantly higher than those of subjects without postoperative EF (4.72 +/- 0.27 versus 3.25 +/-0.41 pmol/l; p=0.005) DISCUSSION: Although the role of OPG in the development of EF is poorly understood, our results suggest that elevated levels of serum OPG are associated with and may play a role in the pathogenesis of fibrotic process.
Absorptiometry, Photon↗
Hypothalamic hamartoma associated with a craniopharyngeal canal.
Hypothalamic hamartoma is a rare congenital lesion. We present the case of a 7-year-old girl who suffered from precocious puberty, the cause of which was diagnosed by using MR imaging and CT as pedunculated hypothalamic hamartoma associated with a large craniopharyngeal canal and sellar spine mimicking pituitary duplication.
Child↗
The role of closed-suction drainage in preventing epidural fibrosis and its correlation with a new grading system of epidural fibrosis on the basis of MRI.
In this study we aimed to evaluate the role of closed-suction drainage on the extent of epidural fibrosis (EF) after lumbar disc surgery and to define a new grading system of epidural fibrosis in these patients, based on magnetic resonance imaging. Seventy-nine patients (34 women, 45 men) with a unilateral, single-level lumbar disc herniation were included in this study. Forty-one patients in whom closed-suction drainage was implanted were compared with 38 patients in whom the drain was not implanted. We have used a new grading system for the extent of epidural fibrosis, on the basis of follow-up magnetic resonance imaging findings. Pain intensity was evaluated by visual analog scale (VAS), and the patients' function and working ability were measured according to the Prolo functional-economic scale. We conclude that, in patients operated on for unilateral, single-level lumbar disc hernias, implantation of closed-suction drainage into the operation site results in less formation of EF radiologically and yields better clinical outcome.
Adult↗
Lumbar meningeal hamartoma and epidermoid cyst associated with spinal dysraphism in an elderly patient.
Meningeal hamartoma associated with spinal dysraphism in an elderly patient is an extremely rare clinical presentation. A 62-year-old woman who progressively developed gait disturbance and urinary retention was admitted to our hospital. Magnetic resonance imaging (MRI) revealed a large cystic mass associated with a dermal sinus at the L4-L5 level. MRI was useful in the diagnosis and determination of this lesion. However, preoperative differential diagnosis of the tumor was not possible based on neuroimaging evidence. The diagnosis of meningeal hamartoma was based on the histological and immunohistological findings of the specimen obtained from the tumor. Meningeal hamartoma associated with spinal dysraphism should be kept in mind, even in adult cases. In this article, we also discuss the radiological and pathological appearance of this rare clinical entity.
Epidermal Cyst↗
Dual synergistic effect: the effect of dexamethasone plus carnitine on skin flap survival.
Dexamethasone has well-known useful effects in dealing with the progression of necrosis. Carnitine is an endogenous cofactor, for having a regulatory action on the energy flow from different oxidative sources. The aim of this study was to determine whether combined local dexamethasone and systemic carnitine administration would result in an additive enhancement of skin flap survival in the rat model. A rectangular (3 cm x 11 cm) dorsal random skin flap was elevated on the rats and then sutured back into its original site with separate sutures. Overall, 40 rats were allocated randomly into 4 groups: Group 1 (control group, n = 10), group 2 (Dexamethasone group, n = 10, 2.5 mg/kg), group 3 (carnitine group, n = 10, 100 mg/kg), group 4 (dexamethasone plus carnitine group, n = 10).The mean flap survival area was 57.50 +/- 5.2% (mean survival area +/- SD) in control group (group 1), 71.5 +/- 4.8% in the dexamethasone group (group 2), 73.0 +/- 5.5% in the carnitine group (group 3), 85.30 +/- 6.1% in the dexamethasone plus carnitine group (group 4). In conclusion, based on the findings of this experimental study, the synergistic effect of carnitine and dexamethasone on skin flap viability is determined.
Animals↗
Intima-media thickness of the carotid arteries is related to serum osteoprotegerin levels in healthy postmenopausal women.
Osteoprotegerin (OPG) regulates bone mass by inhibiting osteoclast differentiation and activation, and also plays a role in vascular calcification. The objective of this study was to evaluate the relationship between serum OPG levels, and carotid artery intima-media thickness (IMT) and carotid plaque formation in healthy postmenopausal women. We recruited 68 healthy postmenopausal women for the study. Carotid plaque presence and IMT were evaluated by high resolution B-mode ultrasound. IMT was positively correlated with presence of plaque, age, menopause age and OPG, and inversely correlated with Apolipoprotein A1 (Apo A1). Serum OPG level was positively correlated with IMT (r = 0.366; p < 0.003) and age (r = 0.324; p < 0.008), and negatively correlated with Apo A1 (r = -0.481; p < 0.0001). We did not observe any significant relation between plaque occurrence and levels of serum OPG. In regression analysis OPG (p < 0.02) and menopause age (p < 0.05) were independent risk factors for IMT, and age (p < 0.05) and IMT (p < 0.05) were independent risk factors for plaque formation. Although the role of OPG in the vascular biology is poorly understood, our results suggest that elevated levels of serum OPG is associated with IMT and may play a role in the pathogenesis of atherosclerotic disease.
Carotid Arteries↗
Hemispheric cerebrovascular venous thrombosis due to closed head injury.
CASE REPORT: We present the case of an 8-month-old infant who was admitted to our Neurosurgery Department with venous infarction related to sagittal sinus thrombosis. The infarction was radiologically detected 5 days after the baby had undergone surgery for acute subdural hematoma due to a closed head injury. RESULTS AND CONCLUSIONS: Cerebrovascular venous thrombosis is a rare clinical entity that has multiple causes and variable presenting symptoms. There is no consensus on overall strategy concerning surgical, radiosurgical, or medical therapy (anti-coagulation, thrombolytic, and anti-edema treatment), and exactly how, when, or in which cases these should be applied. The treatment planning should be based on clinical findings, and should be modified according to the clinical course. In this case, the clinical and radiological findings regressed with symptomatic treatment alone.
Brain Edema↗
Effects of hyaluronic acid-carboxymethylcellulose membrane on extraneural adhesion formation and peripheral nerve regeneration.
The goal of nerve repair in the peripheral nervous system is to increase the number of axons passing from proximal to distal stump, and to enable the regenerated axons to reach the end organ as soon as possible. In the present study, the effect of the membrane formed by a mixture of hyaluronic acid and carboxymethylcellulose (HA-CMC) on nerve regeneration and perineurial scar formation was investigated. Eighteen New Zealand rabbits were allocated into control (n = 9) and experimental groups (n = 9). In the control group, conventional nerve repair was carried out following the transection of the sciatic nerve, while in the experimental group, following repair of the nerve, the repair line was covered by HA-CMC membrane extending 1 cm beyond the distal and proximal ends. Nerve regeneration and extraneurial adhesion formation were compared between the two groups 3 months later. It was observed that adhesion in the surrounding tissues was significantly less in the experimental group than in the control group. Furthermore, morphometric analysis of specimens obtained from the distal parts of nerves showed that the number of axons with myelin was higher in the experimental group than in the control group, with a statistically significant difference. Histologic sections obtained from the nerve repair line demonstrated that extraneural and intraneural fibrosis was significantly lower in the experimental group. It was concluded that HA-CMC membrane had a favorable effect on nerve regeneration, as well as extraneural scar formation, encouraging the clinical application of HA-CMC following nerve injuries.
Animals↗