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Amaç: SARS-CoV-2 tanısı ile takip Edilen, 2019-nCov testi için pozitif ve negatif sonuçlar alınan olgulara uygulanan ilaç tedavisinin literatür eşliğinde değerlendirilmesi amaçlandı. Materyal ve Metotlar: Elektronik ortamda; 2019-nCoV nedeni ile SARS-CoV-2 tanısı ile takip edilen olgulara ait verilerin, ülke ve dil kısıtlaması olmaksızın literatürde yerini alan araştırma sonuçları ile kıyaslanması gerçekleştirildi. Bulgular: Seftriakson, moksifloksasin, oseltamivir, hidroksiklorokin ve prognozu kötüye giden olgularda, gerektiğinde lopinavir/ritonavir etken maddeli farmasötikler ile 2019-nCoV’un tedavi edilebileceği gözlemlendi.Sonuç: SARS-CoV-2 tanısı için sadece rRT-qPCR testi ya da radyolojik olarak CT bulguları ile karar verilmemelidir. Her iki analiz sonuçlarına ek olarak klinik bulgular ile ortak paydada karar verilerek, tanı sonrası uygun tedavi modaliteleri düzenlenmelidir., Aim: The present article aimed to evaluate the drug therapy applied to patients who were followed up for SARS-CoV-2, and who were tested positive and negative 2019-nCov. Materials and Methods: A comprehensive and systematic literature search of numerous electronic databases regarding patients SARS-CoV-2 was performed. Results: Patients with 2019-nCoV can be treated with ceftriaxone, moxifloxacin, oseltamivir, hydroxychloroquine, and patients with poor prognosis can also be given lopinavir/ritonavir. Conclusion: Not only rRT-qPCR test results and CT findings but also clinical evidence should be considered for the diagnosis of SARS-CoV-2.

AIM: To investigate the supplementation of alpha-lipoic acid (ALA) at the molecular level to determine its effect on primary cell cultures prepared from human intervertebral disc (IVD) tissue in an in vitro environment. MATERIAL and METHODS: Human primary cell cultures were prepared from IVD tissue resected during surgery. While cell cultures without ALA supplementation formed the control group, those with ALA supplementation formed the study group. All cell groups were stained using acridine orange/propidium iodide (AO/PI), and the incidence of apoptotic cell death was determined under a fluorescent microscope. Cell surface morphology and extracellular matrix (ECM) structures were evaluated under an invert light microscope. Simultaneously, cell proliferation was evaluated by MTT–ELISA analysis, and the expressions of chondroadherin (CHAD), cartilage oligomeric protein (COMP), interleukin-1 beta (IL-1β), and matrix metalloproteinase (MMP)-7 and-19, which are genes associated with ECM regulation, were tested using qRT–PCR. The data obtained were evaluated statistically using Tukey’s honestly significant difference (HSD) test after analysis of variance (ANOVA) was performed. The alpha significance value was accepted as

IntroductionThe present study aimed to investigate the potential effects of rivaroxaban, an oral anticoagulant that inhibits the effects of factor Xa, on intact intervertebral disc tissue cells and the extracellular matrix (ECM).Material and methodsRivaroxaban was applied to primary human cell cultures prepared from tissues of the intervertebral disc. Comparative molecular analyses were performed on non-drug-treated control group samples. Descriptive statistics were presented as the mean ± standard deviation. An analysis of variance test was performed to determine whether there were significant differences in the mean across the groups. When differences across groups were observed, Tukey’s honestly significant difference post-hoc test was used for multiple pairwise comparisons. The significance of the obtained data was determined statistically. The α significance value was < 0.05.ResultsThe cells in the control group and in the rivaroxaban-treated group were viable, healthy, and proliferated (p < 0.05). However, the expression levels of the chondroadherin gene (CHAD), cartilage oligo matrix protein (COMP), matrix metalloproteinase (MMP)-13, and MMP-19 genes were changed (p < 0.05).ConclusionsAlthough rivaroxaban does not suppress cell proliferation due to morphological, biological, and biochemical changes in the intervertebral disc tissue, it may change the expression of genes that are related to ECM maintenance.

Objectives: Effectiveness of 0.5% bupivacaine administered onto dura, under lumbar superficial fascia and subcutaneous tissue on postoperative pain control was analyzed in patients undergoing lumbar microdiscectomy. Methods: Sixty adult patients scheduled to undergo elective, single-level lumbar discectomy were randomly divided into four groups: the control group (Control), the subcutaneous tissue group (Group C), which received 20 ml of 0.5% bupivacaine in the subcutaenous tissue, the superficial fascia group (Group F), which received 12 ml bupivacaine in the subcutaneous tissue and 8 ml in the space below the lumbar superficial fascia, and the dura group (Group D), which received a total of 20 ml (100 mg) of bupivacaine, consisting of 10 ml in the subcutaneous tissue, 8 ml in the space below the lumbar superficial fascia, and 2 ml on the dura. Visual Analog Scale Values (VAS) on postoperative 0, 15, 30, 45 minutes, at 1, 2, 4, 6, 12 and 24th hour and time of the first analgesic need were evaluated for all patients and recorded. Results: While mean VAS value measured at min 0 (as soon as the patient awakened) was 2.3 ± 1.2 in Group D; it was 2.7 ± 0.9 in Group C; 2.7 ± 1.0 in Group F and 3.1 ± 0.6 in control group (p = 0.232). At the end of 1th hour, mean VAS value was recorded as 2.8 ± 1.0 in Group D; 3.6 ± 1.5 in Group C; 3.6 ± 1.1 in Group F and 4.4 ± 1.1 in control group (p = 0.005). In Group D, 0.5% bupivacaine administered as 2, 8, 10 ml onto dura, fascia and subcutaneously was detected to provide significantly lower VAS values and significantly longer first analgesic need time. Conclusions: 0.5% bupivacaine administered onto dura, under lumbar superficial fascia and in subcutaneous tissue was detected to be a simple, effective and safe method in lumbar microdiscectomy operations.

WOS:000476606000009 PubMed: 31258639 The aim of the present study was to investigate the effects of etanercept (ETA), a tumor necrosis factor (TNF) inhibitor, on human cell cultures prepared from intact intervertebral disc tissue. ETA is used as a treatment for cases of rheumatoid arthritis, psoriatic arthritis, axial spondyloarthritis and ankylosing spondylitis accompanied by moderate or severe joint pain. ETA was applied to primary cell cultures [annulus fibrosus and nucleus pulposus (NP) from intact intervertebral disc tissue]. Cell cultures without ETA treatment served as the control group. Morphological and quantitative molecular analyses of the two groups were performed. The number of viable cells and cell proliferation decreased in the ETA-treated cultures as compared with those in the control group. Furthermore, in the treatment group, the chondroadherin gene, an NP-specific marker, was not expressed after 24 h. By contrast, the cartilage oligo matrix protein was expressed 24, 48 and 72 h post-ETA treatment, while its expression was significantly lower than that in the control group. In addition, the expression of interleukin-1 beta, as well as matrix metallopeptidase-7 and -19, was markedly decreased. Overall, the cell proliferation and gene expression in the ETA-treated cells were significantly different from those in the control group (P

AIM The present study retrospectively evaluated the preoperative and postoperative clinical and radiological findings of patients (n = 32) treated surgically for cervical spondylosis (n = 32). The factors affecting early postoperative recovery rates and the preferred surgical approach's effects on early recovery rates and lordosis angles were examined in light of the literature. MATERIAL AND METHODS The patients included in the study (n = 32) were divided into three groups according to their preferred surgical approach. These surgical approaches are posterior cervical laminectomy, posterior cervical laminectomy plus fusion, and anterior approach. Then, pre-and postoperative modified Japanese Orthopaedic Association Myelopathy (mJOA) scores, Torg-Pavlov ratios measured on direct cervical radiography, and pre-and postoperative lordosis angles were recorded. The data obtained were evaluated statistically. RESULTS The radiological examinations revealed that the average preoperative Torg-Pavlov ratio was 1 in 29 patients. The average sagittal spinal canal diameter was 9 mm, and myelomalacia was detected in 25 patients. Postoperative mJOA scores in patients who underwent anterior corpectomy and fusion and posterior laminectomy were statistically significant (P 0.05). The highest symptomatic recovery rate was found in patients with preoperative neck pain. This finding was not statistically significant (P 0.05). Changes in the postoperative lordosis angles and recovery rates were also observed, depending on the preferred surgical approach. CONCLUSION If there is no kyphotic deformity or straightening of the cervical lordosis, a posterior laminectomy can be performed to avoid the long-term complications caused by an anterior corpectomy. It should be kept in mind that multi-segment and wide laminectomies may cause instability problems.

Aim: The present study aims to examine the effectiveness of the neutrophil-to-lymphocyte ratio in the treatment and diagnosis of patients with brain abscesses.Method: In this retrospective study, radiological, neurological, and surgical data obtained from the medical records of healthy volunteers (n = 10) who presented to the hospital for check-ups and patients with brain abscesses who were treated (n = 10) were evaluated statistically. Alpha significance value was accepted as 0.05). The preoperative neutrophil-to-lymphocyte ratio in cases diagnosed with brain abscesses showed statistical significance compared to that in the healthy volunteers (P, Amaç: Bu makalede; beyin apsesi tanısı alan olgularda, nötrofil-lenfosit oranı (NLO)’nın, tanı ve tedavide önemli olup olmadığının incelenmesi amaçlandı.Metod: Retrospektif dizayna sahip araştırmada, hastaneye kontrol için gelen sağlıklı bireyler (n=10) ile beyin apsesi olan ve tedavi edilen olgular (n=10)’dan elde edilen radyolojik, nörolojik ve cerrahi veriler istatistiksel olarak değerlendirmeye alındı. Alfa anlamlılık değeri 0,05). Sağlıklı bireylere oranla beyin apsesi tanısı alan olgulara ait preoperatif NLO değerlerinin istatistiksel olarak anlamlılık (P

The present study aimed to investigate the effects of paracetamol, an analgesic and antipyretic that is used in emergency departments and neurosurgery departments for postoperative pain management on intervertebral disc tissue. Paracetamol-treated human primary cell cultures and untreated cell cultures were compared using molecular analyses. Cell proliferation and gene expression were statistically analyzed. Cell proliferation was suppressed on days 10 (P=0.05) and 20 (P

Introduction: The aim of the present study is to investigate the effects of pregabalin (PGB) on chondrocyte proliferation and collagen type II (COL2A1), hypoxia-inducible factor 1-alpha (HIF-1 alpha), and chondroadherin (CHAD) gene expression in osteoarthritic chondrocytes. Material and methods: Standard primary chondrocyte cultures were prepared using osteochondral tissues that were surgically obtained from 6 patients with gonarthrosis. Cell morphology was evaluated using an inverted microscope, and cell death and proliferation were determined through MTT analysis, which was confirmed by AO/PI staining and statistically evaluated. The expression levels of CHAD, COL2A1, and HIF-1 alpha genes were assessed using gene-specific TaqMan Gene Expression Assays. Results: MTT analyses showed that PGB administration did not have a negative or toxic effect on cell viability and proliferation in cultured chondrocytes (p < 0.001), but in our morphological evaluation extracellular matrix development was observed to be weaker in cultures treated with PGB. After 24 h of treatment, COL2A1, HIF-1 alpha, and CHAD gene expression decreased in the groups to which PGB was applied compared to gene expression before the experiment (at 0 h); at 48 h, CHAD and HIF-1 alpha expression increased to the same level as the control group, but the expression of COL2A1 continued to decrease. Conclusions: Further studies need to be conducted with more participants to prove that there is a negative correlation between extracellular matrix formation and PGB administration. Our preliminary data show that even at low doses and over short-term administration, PGB may affect chondrocyte cells at the gene-expression level.

Objective: The purpose of this study was to investigate the effect of transverse carpal ligament (TCL) thickness and the size of carpal tunnel area on clinical findings and electrophysiological changes through the wrist magnetic resonance imaging (MRI). Methods: In this prospective study, the thickness of the TCL and the carpal tunnel areas of preoperative cases diagnosed with carpal tunnel syndrome (CTS) were measured via wrist MRI results. The effect of TCL thickness and carpal tunnel area on endocrinopathies such as diabetes mellitus (DM) and hypothyroidism and the effect of these variables on clinical findings and electrophysiologic changes were evaluated in the light of the literature. Results: TCL thickness and carpal tunnel area were not statistically significant among DM, hypothyroidism and electrophysiological changes (p>0.05). Conclusion: This study include one of the limited researches comparing the carpal tunnel area and TKL thickness in cases with and without endocrinopathy CTS. However, there is a need for further researches that have a greater number of cases, including multi-centered, differentwinged people.

Aim This study discusses the management of patients with the syndrome of inappropriate antidiuretic hormone secretion (SIADH), developed after subarachnoid hemorrhage, in a comparative manner in light of the literature. Material and methods Without country or language restrictions, articles with high evidential value found in electronic databases were compared to our patients' data. Results After the literature review, three articles were included for systematic evaluation. Desmopressin was applied to the patients for the treatment of hyponatremia, volume contraction, and negative sodium balance caused by SIADH. However, it was not used for preventing re-bleeding. Conclusion To prevent the development of this complication (SIADH), the use of desmopressin, an analogue of vasopressin, is important in routine clinical practice.

Aim: This study aimed to examine the effects of tigecycline on primary cell cultures established using intervertebral disc tissues. Material and Methods: Primary Annulus Fibrosus and Nucleus Pulposus cultures were obtained from human intervertebral disc tissue. Untreated samples served as the control group, and treated samples served as the study group. Treated and untreated samples were statistically evaluated using an alpha signifiance value of < 0.05. Results: Proliferation and gene expression decreased in the tigecycline administered cultures when compared to the control group samples (P < 0.05). Conclusion: Drugs used in clinics may have side effects other than those indicated in their package insert.

AIM: To explain how to resect hippocampal tissue in rats used as live mammalian subjects for the resection of fresh cerebral tissue in laboratories. MATERIAL and METHODS: Adult male Wistar-Albino rats (n=50) were used for this purpose. RESULTS: The average bodyweight of the rats was 316.4 +/- 11.71 g, and the average weight of the resected hippocampal tissues was 1.01 +/- 0.03 g; however, there were no statistically significant differences between the body weights and the hippocampal tissue weights (p>0.05). The hippocampal tissues to be used in the study were excised practically by preserving the original anatomical configuration without injury to the tissue. CONCLUSION: This paper elucidates a simple, step-by-step methodology for performance in the laboratory in order to improve the standardization of hippocampal tissue dissection. IMU-HAYDEK, as the affiliates of the Regenerative and Restorative Medical Research Centre of Istanbul Medipol University We would like to extend our thanks to Specialist Veterinary Physician Ekrem Musa OZDEMIR, who works at the Medipol Medical Research Centre (MEDITAM), and IMU-HAYDEK, as the affiliates of the Regenerative and Restorative Medical Research Centre of Istanbul Medipol University.

Aim: A major cause of low back pain is disc degeneration. Nevertheless, no specific and reliable markers of the degeneration of the nucleus pulposus (NP) are available. This presented study aimed to examine changes in the expressions of genes in primary cell cultures isolated from intact and degenerated tissues to give insights into the biopathogenesis of intervertebral disc (IVD) tissue. Material and Methods: Tissues of eight patients (n = 8; average age: 41.74 ± 9.86 years) were resected through microdiscectomy, and primary cell cultures were prepared using degenerated disc tissue. The cultured degenerated tissues served as the study group. The samples in the control group comprised the intact tissues of patients (n = 8; average age: 38.68 ± 7.91 years) resected following a trauma. Morphology of the cell surface were evaluated using an inverted light/fluorescent microscopy at 0 and 24 h on days 10 and 21. The expressions of the chondroadherin (CHAD), cartilage oligomeric matrix protein (COMP), interleukin-1 beta (IL-1 beta), and matrix metalloproteinase (MMP)-7 and MMP-19 genes were evaluated using the reverse transcription-quantitative polymerase chain reaction (RT-qPCR). The data obtained were statistically analyzed. Results: The four genes investigated, except COMP (P > 0.05), changed significantly in primary cell cultures isolated from degenerative IVD tissues. This result was statistically significant (P < 0.05). The gene expressions in the samples derived from intact IVD tissues changed markedly and these changes were associated with proliferation (P < 0.05). Conclusion: Analyzing the changes in gene expression levels associated with IVD should contribute to future studies on the prevention and treatment of such pathologies. The data obtained from the present study will shed light on cellular-based personal targeted therapies through which genetic information can be transmitted to cells.

AIM: To evaluate the effects of pre- and intra-operatively administered daptomycin (DAP) on the intact human primary intervertebral disc tissue cells. MATERIAL and METHODS: Primary cell cultures were established using tissues obtained through decompressive laminectomy, traumatic intervertebral disc herniation excision, and posterior transpedicular stabilization. Non-drug-administered samples were used as a control group. The samples treated with DAP formed the study group. Molecular assays for proliferation and gene expression were performed. The obtained data were evaluated statistically, and results with a value of p

Background: Subdural empyema is a rare form of intracranial infection. It is described as accumulation of purulent infective material between the inner layer of dura mater and outer layer of arachnoid membrane. Case Description: A 17-year-old girl was admitted to the emergency department with acute left hemiplegia and was diagnosed with interhemispheric subdural empyema that showed a three-fold increase in size within 12 hours. Complete recovery was achieved with emergency surgical evacuation and additional 3 weeks of antibiotic treatment. Conclusion: Subdural empyema should be diagnosed and managed early in time since it may progress very rapidly and can cause high morbidity and mortality. Complete recovery can be achieved if it is diagnosed early and treated in time.

Background: The study aimed to investigate the effects of the active ingredient, nimodipine, on chondrocyte proliferation and extracellular matrix (ECM) structures in cartilage tissue cells. Methods: Chondrocyte cultures were prepared from tissues resected via surgical operations. Nimodipine was then applied to these cultures and molecular analysis was performed. The data obtained were statistically calculated. Results: Both, the results of the (3-(4,5 dimethylthiazol2-yl)-2,5-diphenyltetrazolium (MTT) assay and the fluorescence microscope analysis [a membrane permeability test carried out with acridine orange/ propidium iodide staining (AO/PI)] confirmed that the active ingredient, nimodipine, negatively affects the cell cultures. Conclusion: Nimodipine was reported to suppress cellular proliferation; chondroadherin (CHAD) and hypoxia-inducible factor-1 alpha (HIF-1α) expression thus decreased by 2.4 and 1.7 times, respectively, at 24 hrs when compared to the control group (p < 0.05). Furthermore, type II collagen (COL2A1) expression was not detected (p

AIM: To investigate the effects of methylphenidate (MPH), on intervertebral disc tissue (IVD) cell cultures and extracellular matrix structures. Changes in the expression of some important marker genes involved in anabolic and catabolic mechanisms of IVD extracellular matrix formation were also evaluated. MATERIAL and METHODS: Primary cultures of nucleus pulposus cells (NPCs) and annulus fibrosus cells (AFCs) were isolated from tissues obtained from the operated patients. Cell viability and proliferation were tested, and the cell surface morphologies were evaluated by microscopy. The expressions of the chondroadherin (CHAD), cartilage oligomeric matrix protein (COMP), interleukin-1 beta (IL-1 beta) and matrix metalloproteinase (M MP) -7 and M MP-19 genes were evaluated using the quantitative real-time polymerase chain reaction (qRT-PCR). A value of p

WOS: 000454722700007 PubMed ID: 29484626 AIM: To determine the gene expression patterns of nucleus pulposus (NP) in cell cultures obtained from degenerated or intact tissues. MATERIAL and METHODS: Whereas 12 of the cases were diagnosed with lumbar disc herniation and had undergone lumbar microdiscectomy, 12 cases had undergone traumatic intervertebral discectomy and corpectomy, along with discectomy after spinal trauma. NP-specific markers and gene expressions of the reagents of the extracellular matrix in the experimental setup were tested at the 0th, 24th, and 48th hours by quantitative reverse transcriptase polymerase chain reaction (qRT-PCR). Visual evaluations were simultaneously made in all samples using invert and fluorescence microscopy. Vitality and proliferation analyses were evaluated by UV spectrophotometer. As a method of statistical evaluation, Spearman was used for categorical variants, and the Pearson correlation was used for variants with numerical and plain distribution. RESULTS: No association was found either between the tissue type and times (r=0.000; p=1.000) or between the region that the tissue was obtained from and hypoxia transcription factor-1 alpha (HIF-1 alpha) gene expression (r=0.098; p=0.245). There was no correlation between cell proliferation and chondroadherin (CHAD) expression or between type II collagen (COL2A1) and CHAD gene expressions. It was found that CHAD and HIF-1 alpha gene expressions and HIF-1 alpha and COL2A1 gene expressions affected cell proliferation. CONCLUSION: Cell culture setups are of paramount importance because they may influence the pattern of changes in the gene expressions of the cells used in these setups.

AIM: To investigate the efficacy of empirical antibiotic treatment in culture-negative pyogenic vertebral osteomyelitis (PVO) cases. MATERIAL and METHODS: The records of patients with culture-negative PVO who were treated at infectious diseases and neurosurgery outpatient clinics in the past four years were examined retrospectively. The control group comprised healthy subjects with similar age, gender, and body mass index but without pathology. The comparison of the groups was performed by analysis of variance. Statistical significance was accepted as p < 0.05. RESULTS: No statistically significant difference in the white blood cell count and erythrocyte sedimentation rate was found between the spondylodiscitis and the healthy subject groups when the blood parameters obtained before and after the treatment (p > 0.05). However, a statistical significance was assessed in the results of the comparison for C-reactive protein (p < 0.05). CONCLUSION: In the context of evidence-based medicine and the rational use of antibiotics, it is clear that antibiotics should be preferred according to the culture antibiogram results in the treatment of infectious diseases.

AIM: To investigate the effects of metformin, a drug used widely for the treatment of type 2 diabetes mellitus, on human primary cell cultures prepared from uninjured segment of disc material intervertebral disk tissues. MATERIAL and METHODS: Primary cell cultures were prepared using the tissues of six patients (three males and three females) who had undergone lumbar microdiscectomy and sequestrectomy. Untreated samples served as the control group, and metformintreated samples served as the experimental group. All the samples were evaluated using an inverted light microscope, acridine orange/propidium iodide staining (AO/PI), and a fluorescence microscope. The cytostatic and cytotoxic effects of metformin, which was administered to the samples using a commercial MTT assay kit, were also evaluated. The data obtained were statistically assessed, and the alpha significance value was accepted as less than 0.05. In addition, for the groups' changes in the expressions of chondroadherin (CHAD), cartilage oligomeric matrix protein (COMP), interleukin-1 beta (IL-1 beta) matrix metalloproteinase 7 (MMP-7), and matrix metalloproteinase 19 (MMP-19), genes related to the extracellular matrix synthesis and degradation were determined using gene-specific TaqMan Gene Expression Assays. RESULTS: The administration of the drug adversely affected nucleus pulposus (NP)/annulus fibrosus (AF) cells and extracellular matrix-like structures. This was statistically significant (p

WOS: 000456596400006 PubMed ID: 30120906 In the literature, there have been no studies showing clear results on how radio-contrast pharmaceuticals would affect intact disc tissue cells. In this context, it was aimed to evaluate the effects of iopromide and gadoxetic acid, frequently used in the discography, on intact lumbar disc tissue in pharmaco-molecular and histopathological level. Primary cell cultures were prepared from the healthy disc tissue of the patients operated in the neurosurgery clinic. Except for the control group, the cultures were incubated with the indicated radio-contrast agents. Cell viability, toxicity and proliferation indices were tested at specific time intervals. The cell viability was quantitatively analysed. It was also visually rechecked under a fluorescence microscope with acridine orange/propidium iodide staining. Simultaneously, cell surface morphology was analysed with an inverted light microscope, while haematoxylin and eosin (H&E) staining methodology was used in the histopathological evaluations. The obtained data were evaluated statistically. Unlike the literature, iopromide or gadoxetic acid did not have any adverse effects on the cell viability, proliferation and toxicity (P

WOS: 000466983900003, PubMed ID: 29694664, AIM: To systematically investigate the role of artificial small interfering RNA (SiRNA) molecules in glioblastoma treatment and to give a detailed overview of the literature concerning studies performed in this field worldwide in the last 31 years. MATERIAL and METHODS: Articles about clinical trials conducted between December 1, 1949 and November 8, 2017, were identified from the Cochrane Collaboration, the Cochrane Library, Ovid MEDLINE, ProQuest, the National Library of Medicine, and PubMed electronic databases, using the terms "post transcriptional gene silencing," "small interfering RNA," "siRNA," and "glioblastoma," either individually or combined ("OR" and "AND"), without language and country restrictions. Articles that met the examination criteria were included in the study. After descriptive statistical evaluation, the results were reported in frequency (%). RESULTS: After scanning 2.752 articles, five articles were found that met the research criteria. Examination of full texts of the five identified articles provided no sufficient evidence for research conducted with regard to the use of gene silencing via siRNAs in glioblastoma treatment. CONCLUSION: To be able to evaluate the clinical use of siRNAs, there is an urgent need for in vivo studies and for trials with randomized, controlled, and clinical designs that provide long-term functional outcomes.

WOS:000476606000026 PubMed: 31258656 The present study aimed to evaluate the effects of dipyrone, an indispensable analgesic, anti-pyretic and anti-spasmodic used in emergency departments, on nucleus pulposus and annulus fibrosus cells in vitro. After surgical biopsy, primary cell cultures were prepared from intact intervertebral disc tissues. Dipyrone was administered to the cultures in the experimental groups except for the control group. The data obtained were statistically evaluated. The proliferation was identified to be suppressed via MTT analysis. The gene expression profile of the intervertebral disc cells in the dipyrone-treated groups was significantly changed. The expression of chondroadherin, cartilage oligo matrix protein, interleukin-1 beta and metalloproteinase (MMP)-19 genes were decreased, but MMP-13 and MMP-7 genes expressions were increased, as determined via reverse transcription-quantitative PCR. AO/PI staining revealed that no apoptotic or other type of cell death was detectable after administration of dipyrone does not mean that the drug is innocuous. The occurrence of cellular senescence and/or the halt of cell proliferation may also be important mechanisms underlying the adverse inhibitory effects of dipyrone. Therefore, prior to administering dipyrone in clinical practice, all possible adverse effects of this drug should be considered.

Aim: The aim of this retrospective study was to evaluate the possible complications and the complication management of cervical anterior discectomies and fusions in light of the literature.Materials and Methods: The study population consisted of patients who presented to the clinic with neck pain and/or arm pain, loss of strength, and sensory disturbances who were operated on after a lack of response to conservative/medical treatment. This study included 200 cervical discopathy and/or cervical spondylosis cases. The literature review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta‑analyses guidelines without language or country restrictions.Results: The most common complication was dysphagia. The complications also included dural tears, cerebrospinal fluid leakage, graft extrusions, neurological deterioration, postoperative hematomas, and recurrent laryngeal nerve injuries. These were found to be consistent with the literature.Conclusion: In order to minimize the incidence of complications, the preoperative clinical examinations and radiological imaging of each patient should be examined carefully, and the appropriate surgical planning should be performed. It is also important to comply with the rules of asepsis and antisepsis, make sure the surgical time is as short as possible, and perform a dissection based on the patient’s anatomy with the appropriate surgical equipment. In addition, it is important to wash the surgical area frequently, drain the system at the end of the operation, close the tissues in accordance with anatomical integrity, and perform close clinical follow-ups.Keywords: Anterior cervical discectomy and fusion; cervical degenerative disc disease; complications; management of complications.

Aim: Apixaban is a frequently preferred pharmacological agent in clinics to prevent deep vein thrombosis and pulmonary embolism. Such new oral anticoagulants may cause hemorrhage’s in tissues and/or organs or may cause gastrointestinal symptoms without bleeding. It is also reported in the literature that it may lead to mental disorders, unwanted disorders in the urinary tract and skeletal-muscle system. However, when the literature is examined, there are no studies, which are of high-evidential value, evaluating the efficacy of apixaban on healthy, intact intervertebral disc tissue, and matrix-like structures. In this pharmaco-molecular study, it was aimed to investigate the effects of a new oral anticoagulant agent containing the active ingredient apixaban on the intact intervertebral disc tissue cells, extracellular matrix (ECM) structure and to evaluate its positive and / or negative effects on gene expressions of cartilage oligo matrix protein (COMP), chondroadherin (CHAD), and Matrix Metalloproteinase (MMP)s.Material and Methods: The primary cell cultures were prepared from the intact tissues of the patients with the traumatic intervertebral disc herniation. Apixaban was administered to the cultures and molecular analyses were performed for 21 days. The data obtained from the apixaban-administered and non-apixaban-administered samples were evaluated statistically and the significance value was accepted as P 0.05.Results: The changes were observed in the cell proliferation and the expressions of the mentioned genes in the apixaban-administered group. The suppression of COMP value and the increase in MMP-13 value may be indicative of the development of matrix degeneration in the apixaban-administered group, compared to the non-drug-administered control group. Conclusion: The selectivity is one of the most important features of the drugs. However, it should not be forgotten that no drug will only produce the desired effect.

WOS: 000442280500109 PubMed ID: 30112057 The aim of the present study was to determine whether pharmaceutical preparations with pregabalin (PGB) as an active ingredient, which are widely prescribed by clinicians, exert toxic effects on human primary nucleus pulposus (NP) and annulus fibrosis (AF). Primary human cell cultures were obtained from intact (n=6) and degenerated (n=6) tissues resected from the two groups of patients. Different doses of PGB were applied to these cultures and cells were subjected to molecular analyses at 0, 24 and 48 h. Cell vitality, toxicity and proliferation were assessed using a spectrophotometer. The expression of chondroadherin (CHAD), a (member of the NP-specific protein family), hypoxia-inducible factor-1 alpha (HIF-1 alpha) and type II collagen (COL2A1) was measured using reverse transcription-quantitative polymerase chain reaction. The results revealed that cell intensity increased in a time-dependent manner and cell vitality continued in the cultures without pharmaceuticals. Cell proliferation was suppressed in the PGB-treated cultures independent from the dose and duration of application. PGB was demonstrated to suppress the expression of CHAD and HIF-1 alpha. In contrast, COL2A1 gene expression was not revealed in any experimental group. The present study utilized an in vitro model and the PGB active ingredient used herein may not be representative of clinical applications; however, the results demonstrated that PGB has a toxic effect on NP/AF cell cultures containing primary human intervertebral disc tissue. In summary, the use of pharmacological agents containing PGB may suppress the proliferation and differentiation of NP/AF cells and/or tissues, which should be considered when deciding on an appropriate treatment regime.

WOS: 000443738300011 PubMed ID: 30186383 Non-steroidal anti-inflammatory drugs (NSAIDs) that are applied through oral, injectable or topical routes have been widely used in painful and inflammatory musculoskeletal diseases. The current study aimed to determine whether naproxen, an aryl acetic acid derivative with analgesic and anti-inflammatory effects, has a toxic effect on human chondrocytes. Samples containing monolayer primary chondrocyte cultures were prepared following resection from osteochondral tissues obtained from patients with gonarthrosis. Cell viability, toxicity and proliferation and levels of stage-specific embryonic antigen-1, a precursor to human prechondrocytes, were evaluated spectrophotometrically. The results from the untreated control group were compared with those of the study groups, where naproxen was administered in varying doses (1-1,000 mu M). Surface morphologies of the cells were compared using inverted light and environmental scanning electron microscopy. Treatment groups were compared by analysis of variance with Tukey's honest difference post hoc test. P

Stereotactic microsurgical techniques allow for the precise localization and resection of lesions in critical areas of cortex or deep within the brain and minimize operative exposure to the surrounding tissues. This study presents our experience with CT-guided stereotactic microsurgical resection of cerebral lesions using the Leksell frame. A total of 42 patients undergoing computerized tomography guided stereotactic microsurgical resection of cerebral lesions between June 2000 and September 2017 were included in the study. Clinical, radiological, histological and follow-up data were retrospectively evaluated. Pre-and post-operative general status of the patients was assessed by Karnofsky Performance Scale (KPS). Except for the subjects with high-grade gliomas, complete resection could be accomplished in all cases. Of the 24 cases with convulsions, a complete cessation of epileptic attacks was attained in 20 and a decrease in their number and frequency was noted in 4 cases. Overall, 20 patients had no change in the KPS score, while 28 patients had increased and two had decreased KPS scores. No postoperative mortality occurred. CT-guided stereotactic microsurgical craniotomy is a safe, reliable and effective technique, which is particularly useful for the surgical treatment of small, benign cranial lesions and cerebral metastases. © 2018, Logos Medical Publishing. All rights reserved.

Aim: Spondylodiscitis, if not diagnosed on time, can cause morbidity or mortality at high rates. This study was carried out with the aim of testing the hypothesis that “neutrophil-to-lymphocyte ratio can be used” especially in cases where it is difficult to diagnose spondylodiscitis. Material and Methods: This study involved 24 patients admitted to the State Hospital of Ministry of Health and Namik Kemal University for spondylodiscitis between January2014 and June2017. After excluding the cases that did not meet the inclusion criteria (n=6), the remaining cases (n=24) were referred to as the study group. A control group was created from healthy volunteers (n=24) who applied for routine physical checkups at the clinic between the same dates and who were similar in terms of age, sex, and body mass index to the study group. Hemogram parameters of the cases in both groups; white blood cell, C-reactive protein, erythrocyte sedimentation rate, and neutrophil-to-lymphocyte ratio were statistically compared. Results: Patients in the spondylodiscitis group, compared to healthy volunteers had statistically significant neutrophil-to-lymphocyte ratio value. Conclusion: Especially in cases where the diagnosis of spondylodiscitis is not assured, the neutrophil-to-lymphocyte ratio parameter, which is less costly than other diagnostic methods and the analysis results of which can be obtained in a shorter time, may be used to support clinical diagnosis.

Aim: Nimodipine is used to prevent cerebrovascular-originated ischemic neurological deficits, yet its effects on nucleus pulposus (NP) cells or annulus fibrosus (AF) cells weren’t studied. This study aimed to examine nimodipine’s effects on vitality and proliferation of chondroadherin (CHAD), type II collagen (COL2A1), and hypoxia-inducible factor 1 alpha (HIF 1α) gene expression in human primary NP/AF cells. Material and Methods: NP/AF cell cultures obtained from 6 patients who underwent microdiscectomy were treated with 100 µMolar nimodipine and analyzed at 0, 24, and 48 h. Data were evaluated using one-way ANOVA and post-hoc Tukey HSD with 95% confidence interval. Results: We observed suppressed cell proliferation and increased necrosis in nimodipine-treated NP/AF cell cultures, especially degenerated tissue. COL2A1 gene expression wasn’t detected in any experimental groups. CHAD and HIF 1α expression had time-dependent decreases in control. CHAD and HIF 1α expression were found to decrease at 24h, but increased at 48h in degenerated tissue. In nimodipine-applied intact tissues, CHAD expression was stable at 24h but 1.62 times higher than control at 48h. HIF 1α levels were lower than control. Conclusion: In nimodipine-treated degenerated AF/NP cultures, CHAD and HIF 1α expressions had time-dependent decreases. However, after complete RT-PCR data evaluation, no correlation between nimodipine application and gene expression occurred.

Aim To investigate the effect of dabigatran, a new oral anticoagulant, on human primary cell cultures isolated from intact intervertebral disc tissue. Material and methods Cell cultures were prepared from tissues obtained from six cases who had undergone surgery due to spinal trauma. Dabigatran, an active pharmacological agent, was applied to intact annulus fibrosus (AF)/nucleus pulposus (NP) primary cell cultures from the study group. After performing cell viability, toxicity, and proliferation tests on all cultures in the control and study groups, the surface morphologies of the samples were evaluated. Subsequently, chondroadherin (CHAD), cartilage oligomeric matrix protein (COMP), and matrix metalloproteinase (MMP)-13 and -19 expressions were measured via a real-time polymerase chain reaction (RT-PCR). Data were analyzed statistically. Results In the proliferation assays performed on the 20th day of the study, cells in the dabigatran-supplemented group were reported to have lost 46.37% more viability than those in the control group. Expressions of all genes examined except MMP-13 were evaluated in the control group by time, but in contrast to the control group results, COMP and MMP-19 gene expressions decreased in the dabigatran-treated group. No CHAD or MMP-13 expression was noted in these cultures. Conclusion The potential for a systemically applied drug to accumulate in tissue and negatively affect surrounding tissues and microstructures must be emphasized.

Diffuse idiopathic skeletal hyperostosis (DISH) (Forestier syndrome) is a rheumatologic disease, the etiology of which is not exactly known. It is characterized by spinal osteophyte formations resulting from the ossification of the paravertebral ligaments and muscles. Anterior longitudinal ligament is the usual site of involvement and the frequency of the disease increases after the 5th decade. Lower cervical segments are the most frequently involved regions whereas the upper cervical involvement leading to dysphagia is very rare. In this report, a 77-year-old patient with Forestier syndrome in upper cervical region presenting with dysphagia was presented. Anterior cervical osteophyte resection was performed with no need for discectomy, fusion or stabilization. The patient showed a significant improvement in his all preoperative symptoms, and no recurrence was detected at 1-year follow-up.

WOS: 000431850300018 PubMed ID: 29849772 The aim of the present study was to investigate the effects of three different formulations of hyaluronic acid (HA): Low molecular weight (MW) Sinovial One((R)), medium MW Viscoplus((R)) and high MW Durolane((R)), on chondrocyte proliferation and collagen type II (COL2A1), hypoxia-inducible factor 1 alpha (HIF-1 alpha) and chondroadherin (CHAD) expression in primary chondrocyte cultures. Standard primary chondrocyte cultures were established from osteochondral tissues surgically obtained from 6 patients with gonarthrosis. Cell morphology was evaluated using an inverted light microscope; cell proliferation was determined with a MTT assay and confirmed with acridine orange/propidium iodide staining. Levels of CHAD, COL2A1 and HIF-1 alpha expression were assessed using specific TaqMan gene expression assays. The results demonstrated the positive effect of HA treatment on cell proliferation, which was independent from the MW. COL2A1 expression increased in the medium and high MW HA treated groups. It was observed that HIF-1 alpha expression increased in the high MW treated group alone. CHAD expression increased only in the medium MW HA treated group. Evaluation of gene expression revealed that levels of expression increased as the duration of HA application increased, in the medium and high MW HA treated groups. In terms of increased viability and proliferation, a longer duration of HA application was more effective. Taken together, it may be concluded that the administration of medium and high MW HA may be a successful way of treating diseases affecting chondrocytes in a clinical setting.

Post supratentorial and spinal surgeries, in rare cases, Remote Cerebellar Haemorrhage (RCH) develops as a complication. Although the exact aetiology of RCH remains uncertain, excessive drainage of the Cerebrospinal Fluid (CSF) is accepted as the most possible cause. It has been suggested that overdrainage of CSF leads to stretching and resultantly tearing of the cerebellar veins. Early diagnosis and appropriate management decrease mortality and morbidity significantly. In this report, we present a case of RCH encountered on the third postoperative day of transcranial pituitary surgery and discuss the possible causative factors. Excessive loss of CSF is considered to be the major cause of RCH. To our knowledge this is the first case of RCH seen after transcranial macroadenoma surgery reported in the literature so far.

Aim: Although antibiotics are generally well-tolerated, they may have cytotoxic effects. The present randomized, double-blind, in vitro study aimed to investigate the effects of tigecycline on cartilage tissue cells and the extracellular matrix. Material and Methods: Cartilage tissues of patients (n = 8) were used for the preparation of primary cell cultures. Tigecycline-treated cell cultures served as the study group. Non-treated cell cultures served as the control group. Analyses were performed at 0, 24, 48, and 72 h in both groups. The results obtained were statistically evaluated. The alpha significance value was determined to be 0.05. Results: Proliferation remained unchanged in the tigecycline-treated cell cultures. The gene expressions of the markers involved in anabolic pathways increased in the tigecycline-treated cell cultures. The results obtained were statistically significant (P < 0.05). Conclusion: Although tigecycline had no toxic effect on the chondrocyte cell cultures and caused no damage to the extracellular matrix, the present study was performed in an in vitro environment.

Aim: Our aim was to determine whether a combination of sagittal index (SI), canal compromise (CC), and loss of vertebral body height (LVBH) is associated with the severity of neurological injury in patients with thoracolumbar burst fractures. Materials and Methods: Seventy-four patients with thoracolumbar burst fracture undergoing instrumentation between 2010 and 2015 were analyzed retrospectively. The degree of neurological injury was determined using the American Spinal Injury Association (ASIA) scoring system. The association between the morphology of the fracture and the severity of neurological injury was analyzed. Results: There was a strong association between fracture morphology and the severity of neurological injury. Of the patients, 77.5% with SI ≥20°, 81.6% with CC ≥40%, and 100% with LVBH ≥50% had lesion according to ASIA. All of 7 patients with ASIA A had SI ≥20°, CC ≥40%, and LVBH ≥50%. On the other hand, 79% of the patients with ASIA E had SI 25°, the patients with CC >40%, and the patients with LVBH >50% are likely to have a more severe neurological injury.

AIM To analyse the effect of MMP-3 (Matrix Metalloproteinase Enzyme-3)-one of the extracellular matrix proteins- on the prognosis and biological behaviour of meningiomas. MATERIAL AND METHODS 79 cases of meningioma that were operated in our clinic between 2005 and 2010 were retrospectively analysed. Age, sex, preoperative peritumoral edema, histological subtype, grade, Ki-67 expression, MMP-3 staining pattern and recurrence rate were analysed. Pathological preparations were graded according to the WHO (World Health Organisation) 2007 grading system. RESULTS Of the MMP-III positive cases; 24 cases (60%) were grade I, 16 cases were grade II. The MMP-3 staining pattern was significantly positive (80%) in grade II meningioma. 14 of the MMP-3 positive cases were atypical meningiomas. Of the 20 cases with high Ki-67 proliferation index (PI), 12 cases (60%) were MMP-3 positive and 8 cases (40%) were MMP-3 negative. Rates of recurrence and preoperative peritumoral edema were high in cases with MMP-3 positivity. CONCLUSION In this study it was determined that MMP-3 positivity has a strong relationship with meningiomas having an aggressive character. MMP-3 may be used as a proliferation marker for biological behaviour, recurrence rate and prognosis of meningiomas.

Aim: Patients with head trauma are routinely, and commonly treated with prophylactic antibiotics, which may also be used for the treatment of infection that may be developed during hospital stay. The relevant antibiotic may, however, some side effects and adverse event. The present study aimed to investigate whether the side effects and adverse events of the prophylactic antibiotics were considered as a complication or medical negligence.Material and Methods: Descriptive statistics were used for the evaluation of the data.Results: No studies were found in the literature. Ceftriaxone, ampicillin-sulbactam, and cefazolin sodium were preferred for antibiotherapy. Meropenem or vancomycin was solely administered to patients when observed active pathogens in culture-antibiogram. Clinicians should be cautioned the potential side effects and adverse events of some drugs frequently used in clinics. Conclusion: Otherwise, they may legally be held liable for medical negligence.Keywords: Adverse effect; head trauma; human rights; malpractice; negligence; rational antibiotic use; right to health; side effect; professional liability.