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    Comparison of the histologic changes in conchae induced by radiofrequency thermal ablation and submucosal diathermy
    (Springer, 2013) Kaplama, Mehmet Erkan; Kaygusuz, Irfan; Akpolat, Nusret; Karlidag, Turgut; Keles, Erol; Alpay, Hayrettin Cengiz; Yalcin, Sinasi
    Objective of study was to determine the histological change induced in the conchae by submucosal diathermy and radiofrequency thermal ablation, two techniques used in the treatment of lower conchal hypertrophy, and to compare the two methods to each other. The study was performed on 15 rabbits. Radiofrequency was applied to the study animals in Group I (n = 5) and submucosal diathermy to Group II (n = 5), while Group III (n = 5) was the untreated control. The animals were decapitated 21 days after treatment and their conchae nasales ventrales excised on both sides. Histology slides were prepared and evaluated by light microscopy for ciliary loss, increase in submucosal vascularity, loss of goblet cells, inflammatory cellular infiltration, fibrosis and epithelial damage. The differences between Groups I and III were not significant regarding ciliary loss, increase in submucosal vascularity, loss of goblet cells and epithelial damage (p > 0.05), while the inflammatory cellular infiltration and fibrosis were significantly different between these groups (p < 0.05). As for the differences between Groups II and III, they were significant for each of the compared parameters (p < 0.05), while among Groups I and II they were significant for ciliary loss (p < 0.05), increase in submucosal vascularity, loss of goblet cells, inflammatory cellular infiltration and epithelial damage but not fibrosis (p > 0.05). Based on these findings, we can state that the use of radiofrequency thermal ablation causes less change in the normal conchal histology than submucosal diathermy application.
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    The Effect of Methylprednisolone on Facial Nerve Paralysis With Different Etiologies
    (Lippincott Williams & Wilkins, 2015) Yildirim, Mehmet Akif; Karlidag, Turgut; Akpolat, Nusret; Kaygusuz, Irfan; Keles, Erol; Yalcin, Sinasi; Akyigit, Abdulvahap
    Objectives: The objective of this study was to evaluate the effectiveness of methylprednisolone (MP) in models of facial nerve paralysis obtained by nerve section, compression, or inoculation with herpes simplex virus (HSV). Study Design: Experimental controlled animal study. Setting: Tertiary referral center. Methods: A total of 30 female New Zealand rabbits weighing 1200-3000 g were used for the study. They were randomly assigned to one of 6 groups of 5 animals each. A nerve section injury was realized in Groups 1a (section and MP) and 1b (section, control) rabbits. A compression-type injury was inflicted to rabbits in Groups 2a (compression and MP) and 2b (compression, control). As for animals in Groups 3a (Type 1 HSV and MP) and 3b (Type 1 HSV, controls), facial nerve paralysis resulting from viral infection was obtained. Animals in the 3 treatment groups, designated with the letter a'', were administered MP, 1mg/kg/d, whereas those in control groups b'' received 1mL normal saline, both during 3 weeks. All subjects were followed up for 2 months. At the end of this period, all animals had the buccal branch of the facial nerve excised on the operated side. Semi-thin sections of these specimens were evaluated under light microscopy for the following: perineural fibrosis, increase in collagen fibers, myelin degeneration, axonal degeneration, Schwann cell proliferation, and edema. Results: No significant difference was observed (P> 0.05) between theMP treatment group and the control group with regard to perineural fibrosis, increase in collagen fibers, myelin degeneration, axonal degeneration, edema, or Schwann cell proliferation. In the group with a compressive lesion (Group 2), controls were no different from MP-treated animals as to perineural fibrosis, increase in collagen fibers, or Schwann cell proliferation, whereas axonal degeneration, myelin degeneration, and edema were significantly higher (P< 0.05) in the control group. When comparing the treatment and control groups among the animals inoculated with Type 1HSV, no significant difference was found with regard to perineural fibrosis, axonal degeneration, myelin degeneration, or Schwann cell proliferation. The only statistically significant advantage of the treatment group was in edema formation (P< 0.05). Conclusions: As a result of the evaluation of MP efficacy in different models of facial nerve palsy, we may say that this drug was without effect on nerve healing in paralysis due to nerve section and that it only reduced nervous edema in paralysis induced by Type 1 HSV, whereas it had positive effects on healing in the type of paralysis caused by nerve compression.
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    The effect of nimodipine and prednisolone on traumatic facial nerve injury treatment
    (Deomed Publ, Istanbul, 2017) Dolen, Tolga; Kaygusuz, Irfan; Akpolat, Nusret; Alpay, Hayrettin Cengiz; Keles, Erol; Karlidag, Turgut; Yalcin, Sinasi
    Objective: To investigate the histopathological effect of nimodipine and prednisolone treatment on an animal model with peripheral facial nerve paralysis generated by clamping. Methods: Twenty-eight New Zealand originated rabbits with facial nerve paralysis of the buccal branches generated by clamping were divided into four groups of seven each, administered with nimodipine, methylprednisolone and nimodipine-methylprednisolone combination throughout 21 days. The injured neural tissues were investigated histopathologically after treatment regarding perineural fibrosis, collagen degeneration, axonal degeneration, myelin degeneration, Schwann cell proliferation, normal myelin structure, and edema. The groups were compared with each other and with the control group. Results: Statistically significant difference was determined between nimodipine and control groups regarding increased number of collagen fibers, myelin degeneration, axonal degeneration and myelin structure; between nimodipine and methylprednisolone groups, and between nimodipine and nimodipine-methylprednisolone combination groups regarding edema (p< 0.05). Statistically significant data were also found between methylprednisolone and control groups in terms of increased number of collagen fibers, myelin degeneration, axonal degeneration and edema; between nimodipine-methylprednisolone combination and the control groups in terms of increased number of collagen fibers, myelin degeneration, axonal degeneration, normal myelin structure and edema (p< 0.05). Conclusion: Nimodipine and methylprednisolone both have positive effects on traumatic peripheral nerve paralysis with nerve integrity preserved whereas advantage of nimodipine over methylprednisolone cannot be suggested.
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    The effects of methylprednisolone and halofuginone on preventing esophageal and hypopharyngeal fibrosis in delivered radiotherapy
    (Springer, 2010) Dabak, Hakan; Karlidag, Turgut; Akpolat, Nusret; Keles, Erol; Alpay, Hayrettin Cengiz; Serin, Meltem; Kaygusuz, Irfan
    In this study, we assessed the effects of halofuginone and methylprednisolone on hypopharyngeal and esophageal stricture that can develop following radiation to the head and neck of rats. Rats were divided into four groups randomly and 18 Gy radiation was given to the head and neck regions of all rats except the control group. Group 1 (Control Group): No radiation or drugs were administered. Group 2 (Radiation Group): only radiation was applied without any drugs. Group 3 (Halofuginone Group): halofuginone 100 mu g/kg per day was given intraperitoneally. Group 4 (Methylprednisolone Group): methylprednisolone 1 mg/kg per day was administered intramuscularly. In all groups, 90 days after application of radiation, sections of the proximal esophagus and hypopharynx were examined for fibrosis, fibroblast proliferation, vascularization, epithelial atypia, necrosis, polymorphonuclear leukocytes, mononuclear cells, and stenosis index by light microscope and the hydroxyproline levels were assessed biochemically. Fibrosis, epithelial atypia and hydroxyproline levels were found to be significantly higher in the radiation group compared to the control group (P < 0.05). We did not observe fibrosis in either the halofuginone or the control groups. Fibrosis was also significantly lower in the methylprednisolone group than the radiation group (P < 0.05). The differences of the stenosis index scores between the groups were not statistically significant (P < 0.05). Vascularization was similar in all groups. We think that especially halofuginone is a drug that can be used safely to prevent fibrosis due to radiotherapy, but further studies are needed.