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    The Effects of Valproic Acid on Sciatic Nerve of Fetal Rats and Protective Effects of Folic Acid and Vitamin E
    (Soc Chilena Anatomia, 2009) Aluclu, Mehmet Ufuk; Tuncer, Mehmet Cudi; Guzel, Aslan; Aluclu, Mustafa Arif; Akkus, Murat
    We aimed to investigate the potential harmful effects of maternal valproic acid (VPA) on fetal sciatic nerve, and the protective effects of vitamin E (Vit E) and folic acid (FA) on fetal rats. Valproic acid (400 mg/kg), folic acid (400 mg/kg) and vitamin E (250 mg/kg) were administered to rats on each of gestation days 8-10. All fetuses were collected on gestation day 20. With thin sections of biopsies, sciatic nerve of fetuses were stained with uranyl acetat and were examined under transmission electron microscope. The fetuses (n:36) were divided into five groups: control, vpa, vpa+fa, vpa+vit e and vpa+fa+vit e groups. In each group; drug procedure, surgical procedure and histological methods were performed. Later, weights and lengths of fetuses in each group were compared and analyzed by One-Way Anova test. Administration of single doses of valproic acid (400 mg/kg) resulted in weight and length loss between control and vpa group. However, length and weight differences between the other groups were not significant. The histopathological findings of control group was normal. In vpa group, it showed extensive degenerative changes especially in myelin coat. In addition, most prominent finding in this group was condensation of collagen fibers in extensively demyelinated samples, while moderately effected areas were relatively normal. Both vpa+fa and vpa+vit e groups exhibited similar ultrastructural changes, reflecting minimal to moderate degenerative changes. In vpa+fa+vit e group had almost the normal structure. Administration of single doses of valproic acid (400 mg/kg) resulted in a deteriorative effect on sciatic nerve at ultrastructural level. Administration of FA and Vit E had a protective effect to prevent the degenerative changes to a certain degree. Combination of FA and Vit E together following VPA administration had a more potent protective effect. The objective of the present study is to analyze histopathologic changes which may occur in a high risk experimental model after the administration of valproic acid. In addition, protective roles of the administration of folic acid and vitamin E are assessed.
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    Electron Microscopic and Histological Evaluation of the Levator Muscle in Patients with Congenital Blepharoptosis
    (Sci Printers & Publ Inc, 2016) Soker, Sevda; Cakmak, Sevin; Nergiz, Yusuf; Deveci, Engin; Gul, Mehmet; Soker, Murat; Akkus, Murat
    OBJECTIVE: To examine the levator muscle in patients with congenital blepharoptosis and to investigate the relationship between those findings and age, gender, and degree of blepharoptosis. STUDY DESIGN: The levator muscles of 13 congenital ptosis patients who had undergone levator muscle resection were examined by light and electron microscopy. During the preoperative period the ptosis amount, levator function, tear function, Bell's phenomenon, and jaw-wink phenomenon were evaluated. RESULTS: There were 9 (69.2%) male and 4 (30.8%) female cases, with an average age of 10.61 +/- 4.77 years (range, 4-19). The quality and quantity of the levator muscle fibrils were assessed by histological examination. There was no relationship detected between histological features of levator palpebralis superior muscle and patients' age and gender (p < 0.05). Patients with a weak levator palpebralis superior muscle had fatty degeneration histologically. Higher levator palpebralis superior muscle function correlated with decreased fatty degeneration and increased skeletal muscle fibrils, but these findings were not statistically significant. There was a reduction in the diameter of muscle fibers and nucleus deformation when muscle function was examined in patients under low-magnification electron microscope. There were lipid droplets of various sizes in some sections, and the mitochondria were seen in mitochondrial crystalline structure depending on cytopathies. In some sections of this group there was large mitochondria and edema formation due to an increase in the mitochondrial matrix. CONCLUSION: More ultrastructural studies in larger populations are needed to support the relationship between structure and function of levator palpebralis superior muscle in patients with congenital blepharoptosis.
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    Importance of hair trace metal analysis after pectus bar implantation
    (2021) Akkus, Murat; Seyrek, Yunus; Yoruc Hazar, Afife Binnaz; Sahin, Fikrettin
    Aim: This study aimed to determine if there was a significant increase in scalp hair levels of trace metals in children with implanted pectus bars and investigate previously unreported hair metal levels after minimally invasive repair of pectus excavatum (MIRPE). Materials and Methods: Between November 2013 and December 2019, we prospectively collected scalp hair samples from patients before MIRPE and prior to pectus bar explantation (1 day before bar removal) to evaluate trace metal levels following the implantation of metal bars. Two study groups were involved: a group of consecutive patients who underwent pectus bar removal 2–5 years after MIRPE (study group, n = 97), and a group including the same patients (control group, n = 97) prior to MIRPE.Results: The mean patient age was 13.3 ± 2.7 years (range, 11–19 years) preoperative and 16.4 ± 2.3 years (range 14–23 years) postoperative; 64% of the patients were male (n = 62). Statistically significant increases in all studied trace metal levels (chrome, iron, nickel, and molybdenum) were identified in the intergroup comparison of hair trace metal analysis.Conclusion: The results of this prospective study show that hair is a good biological marker for the monitoring and study of trace metals released from pectus bars. This simple assessment may be useful for the screening of trace metal increase due to the pectus bar. When metal allergy is suspected during follow-up after MIRPE, the availability of preoperatively collected hair samples will be quite beneficial.