Yazar "Kocak, Ayhan" seçeneğine göre listele
Listeleniyor 1 - 8 / 8
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe Acute Subdural Hematomas Caused by Ruptured Aneurysms: Experience from a Single Turkish Center(Turkish Neurosurgical Soc, 2009) Kocak, Ayhan; Ates, Ozkan; Durak, Akif; Alkan, Alpay; Cayli, Suleyman; Sarac, KayaAIM: Although an aneurysmal rupture typically presents on computed tomography (CT) imaging as only a subarachnoid hemorrhage (SAH), it may be associated with spontaneous (nontraumatic) subdural hemorrhage (sSDH). The purpose of this paper is to discuss the clinical and radiological characteristics, as well as a potentially dangerous situation in the diagnosis and the management of this life-threatening condition. MATERIAL and METHODS: The Department of Neurosurgery at Inonu University (Turgut Ozal Medical Center) (TOMC) maintains a prospective database of all patients treated for intracranial aneurysms since 1999. Using this database, we obtained patients with ruptured aneurysms who presented with sSDH on CT imaging. RESULTS: 687 patients with radiographically documented ruptured aneurysms were admitted from January 2000 through January 2009. Of these, eleven patients presented with sSDH. The incidence of aneurysmal rupture with sSDH is 1.6% in our series. CONCLUSION: Acute sSDH on cranial CT should be considered for an urgent workup of a ruptured aneurysm, even in the absence or presence of SAH finding. CT angiography has advantages over cerebral digital substraction angiography (DSA) and may be a reasonable alternative to latter modality in the diagnosis, triage, and treatment planning in patients with sSDH.Öğe The Antiedema Effect of Intracisternal Hyperosmolar Albumine on Experirnental Created Brain Edema(Derman Medical Publ, 2010) Tekiner, Ayhan; Onal, Cagatay; Kocak, Ayhan; Cayhli, Suleyman Rustu; Bayar, Mehmet Akif; Tektas, SevketAim The brain edema caused by central nervous system diseases and trauma is an important reason of morbidity and mortality currently. Although the most of physiopathology of traumatic brain edema has been elucidated through many clinical and laboratory studies, the treatment of edema couldn't been standardized. For this purpose, from past to the present although many treatment principles have been accepted, also different treatment agents are being used. Material and Methods In this experimental study thirty six New Zealander rabbits weighing between 2.2 and 2.8 kg were used. Craniectomi was applied to the subjects and gravity was dropped from high in order to develop traumatic brain edema. The subjects were divided into six groups and hyperosmolar albumine was given to each group on different time periods. It was aimed to resolve the edema by drawing the edema liquid to subarachnoid distance by giving human albumin a physiologic macromolecule through cysterna manga. The efficacy of tretment was evaluated through two parameters: the first cerebrospinal fluid osmolality and the second the rate of brain tissue fluid. Results Cerebrospinal fluid osmolality and brain tissue fluid ratio gained at the result of the study were statistical evaluated by Kruskal-Wallis nonparametric ANOVA test and Mann-Whitney U test. p value<0,05 was accepted statistical significant. Conclusion When compared the results of the study groups the difference was significant between trauma and control group and the difference was relatively close to the control group at the treatment group. The treatment was significantly efficient at the groups which were applied hyperosmolar albumine two or three times in the first 72 hours after trauma. According to these results we can declare this experimental study has reached to the purpose and can contribute to future studies about the same subject.Öğe Device-associated nosocomial infection surveillance in the neurosurgery intensive care unit of the Inonu University Turgut Ozal Medical Center(Doc Design Informatics Co Ltd, 2008) Yetkin, Funda; Ersoy, Yasemin; Karaman, Perihan; Kayabas, Uner; Bayindir, Yaflar; Kocak, AyhanPatients in the intensive care units (ICUs) have a high risk of infection due to the severity of illness of the patients treated and the high number of medical devices used. For patients requiring neurosurgical intensive care there are certain risk factors (e.g. altered consciousness, impaired protective reflexes, head injury) of acquiring nosocomial infections (NIs). In this study, we prospectively investigated NIs, device utilization ratios and device-associated infection rates, isolated agents and their antimicrobial susceptibilities in the neurosurgery intensive care unit of the Inonu University Turgut Ozal Medical Center between May 2006-April 2007. 613 patients with a total of 3561 patient days were enrolled. The overall incidence of NIs was 13.9% per 100 patients and the incidence density 23.8 per 1,000 patient days. Pneumonia (65.8%), bloodstream infections (16.5%), and urinary tract infections (15.3%) were the most frequent NIs recorded. The rate of ventilator-associated pneumonia was 67.2 infections per 1,000 ventilator-days, the rate of catheter-associated bloodstream infection was 8.1 per 1,000 central line-days, and the rate of catheter-associated urinary tract infection was 3.9 infections per 1,000 urinary catheter-days. Of the bacteria determined 56.8% were Gram-negative. In this group Pseudomonas aeruginosa was the most frequently isolated (25%). Staphylococcus aureus (20.4%) was the most frequently found Gram-positive bacteria (38.6%). We aim to investigate the causes of ventilator-associated pneumonia and catheter-associated bloodstream infections and to determine necessary preventive measures in an observative and multidisciplinary studies.Öğe Effects of contrast material on the metabolite ratios in single-voxel MR Spectroscopy of intraaxial brain tumors(Churchill Livingstone, 2012) Alkan, Alpay; Burulday, Veysel; Oztanir, Namik; Dogan, Metin; Erbay, Mehmet Fatih; Kocak, Ayhan; Aralasmak, AyseAim: The purpose of our study was to determine whether the administration of contrast material affects the results of MR Spectroscopy (MRS) in different intraaxial brain tumors. Materials and methods: Thirty-three patients (median range 46.72 +/- 2.95, range 9-77) with intraaxial brain tumors underwent MRS before and 5 min after intravenous administration of gadolinium based contrast material at the standard dose of 0.1 mmol/kg (Gadodiamide or Gd-DOTA). Metabolite ratios (N-acetyl aspartate (NAA)/Creatine (Cr), Choline (Cho)/Cr. and NAA/Cho) were calculated. Results: There was no significant difference between the pre and postcontrast MRS spectra as regards to NAA/Cr (p:0.4), Cho/Cr (p:0.2), and NAA/Cho (p:0.2) ratios obtained from the intraaxial brain tumors. Conclusion: Contrast material administration did not change the metabolite ratios of MRS. Contrast administration would be useful in guiding voxel localization in MRS evaluation of intraaxial brain tumors. (C) 2012 Elsevier Ltd. All rights reserved.Öğe Isolated internal auditory artery aneurysm(Elsevier Sci Ltd, 2008) Kocak, Ayhan; Sarac, Kaya; Ates, Ozkan; Cayli, Suleyman Rustu; Kutlu, RamazanAnticoagulant therapy is effective and prevents death in more than 95% of patients with pulmonary embolism following deep vein thrombosis. We report a patient who developed deep vein thrombosis following rupture of a dissecting aneurysm of the internal auditory artery. The parent artery was occluded before anticoagulant therapy as a prophylactic measure to prevent intracranial haemorrhage. We discuss some of the clinical features, therapeutic difficulties, and pitfalls in the management of internal auditory artery aneurysm complicated by deep vein thrombosis. (C) 2007 Elsevier Ltd. All rights reserved.Öğe Lumbar gossypiboma(Turkish Soc Radiology, 2010) Erdem, Guelnur; Ates, Oezkan; Kocak, Ayhan; Alkan, AlpayGossypiboma is a mass formed by a retained surgical sponge and reactive tissue. The cases with gossypiboma are usually asymptomatic or with nonspecific symptoms, which delay diagnosis for months or years after surgery. We describe imaging findings in a 43-year-old woman with a symptomatic retained surgical sponge in a lumbar laminectomy site. Ultrasonography, computed tomography, magnetic resonance imaging (MRI), and diffusion-weighted MRI were performed. Gossypiboma should be considered in the differential diagnosis of a mass in a patient with a history of prior surgery. Diffusion-weighted Mill may provide important data for differential diagnosis of gossypiboma. With diffusion-weighted MRI, gossypiboma may be distinguished from an abscess by its low signal intensity and increased apparent diffusion coefficient (ADC) as compared to high signal intensity with low ADC in cases of abscess.Öğe Neuroprotective effect of etomidate on functional recovery in experimental spinal cord injury(Pergamon-Elsevier Science Ltd, 2006) Cayli, Suleyman R.; Ates, Ozkan; Karadag, Nese; Altinoz, Eyup; Yucel, Neslihan; Yologlu, Saim; Kocak, AyhanObjective: Primary impact to the spinal cord causes rapid oxidative stress after injury. To protect neural tissue, it is important to prevent secondary pathophysiological mechanisms. Etomidate, a strong antiexcitotoxic agent, stimulates the gamma aminobutyric acid (GABA) receptors. The purpose of this study was to investigate neurobehavioral and histological recovery and to evaluate the biochemical responses to treatment of experimental spinal cord injury (SCI) in rats with etomidate or methylprednisolone (MP) or both etomidate and MP. Material and methods: Seventy-two rats were randomly allocated into six groups: a control group (laminectomy alone), a trauma group (laminectomy + trauma), a methylprednisolone group (30 mg/kg MP), an etomidate group (2 mg/kg), a methylprednisolone, and etomidate combined treatment group (30 mg/kg MP and 2 mg/kg etomidate) and a vehicle group. Six rats from each group were killed at the 24th hour after the injury. Malondialdehyde, glutathione, nitric oxide and xanthine oxidase levels were measured. Neurological functions of the remaining rats were recorded weekly. Six weeks after injury, all of those rats were killed for histopathological assesssment. Conclusion: Etomidate treatment immediately after spinal cord injury has similar neuroprotection to MR In spite of different neuroprotection mechanisms, combined treatment with MP and etomidate does not provide extra protection. (c) 2006 ISDN. Published by Elsevier Ltd. All rights reserved.Öğe Neuroprotective effect of mexiletine in the central nervous system of diabetic rats(Springer, 2006) Ates, Ozkan; Cayli, Suleyman R.; Altinoz, Eyup; Yucel, Neslihan; Kocak, Ayhan; Tarim, Ozcan; Durak, AkifBoth experimental and clinical studies suggests that oxidative stress plays an important role in the pathogenesis of diabetes mellitus type I and type 2. Hyperglycaemia leads to free radical generation and causes neural degeneration. In the present study we investigated the possible neuroprotective effect of mexiletine against streptozotocin-induced hyperglycaemia in the rat brain and spinal cord. 30 adult male Wistar rats were divided into three groups: control, diabetic, and diabetic-mexiletine treated group. Diabetes mellitus was induced by a single injection of streptozotocin (60 mg/kg body weight). Mexiletine (50 mg/kg) was injected intraperitoneally every day for six weeks. After 6 weeks the brain, brain stem and cervical spinal cord of the rats were removed and the hippocampus, cortex, cerebellum, brain stem and spinal cord were dissected for biochemical analysis (the level of Malondialdehide [MDA], Nitric Oxide [NO], Reduced Glutathione [GSH], and Xanthine Oxidase [XO] activity). MDA, XO and NO levels in the hippocampus, cortex, cerebellum, brain stem and spinal cord of the diabetic group increased significantly, when compared with control and mexiletine groups (P < 0.05). GSH levels in the hippocampus, cortex, cerebellum, brain stem and spinal cord of the diabetic group decreased significantly when compared with control and mexiletine groups (P < 0.05). This study demonstrates that mexiletine protects the neuronal tissue against the diabetic oxidative damage.
