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    A new described mechanisms of intestinal glandular atrophy induced by vagal nerve/Auerbach network degeneration following subarachnoid hemorrhage: The first experimental study
    (Elsevier Sci Ltd, 2019) Cakir, Murtaza; Ahiskalioglu, Ali; Karadeniz, Erdem; Aydin, Mehmet Dumlu; Malcok, Umit Ali; Soyalp, Celaleddin; Calikoglu, Cagatay
    Stress ulcers is a trouble complication of subarachnoid hemorrhage (SAH). Although gastrointestinal ulcerations may be attributed to increased HCL secretion in SAH; the exact mechanism of that complication has not been investigated definitively. We studied if vagal network degeneration may cause intestinal atrophy following SAH. Study was conducted on 25 rabbits, with 5 control group (Group-A), 5 SHAM group (Group-B), and 15 SAH group via injection of autologue blood to cisterna magna. Seven animals followed for seven days (Early Decapitated-Group-C) and eight animals followed 21 days (Late Decapitated-Group-D). The vagal nodosal ganglia (NGs), Auerbach plexuses and goblet cells of duodenums were examined by current stereological methods and compared statistically. The mean numbers of degenerated axon density/mm(2) of gastric branches of vagal nerves was 8 +/- 2, 34 +/- 11, 189 +/- 49 and 322 +/- 81 in the Group A, B, C, and D respectively. The mean numbers of degenerated neuron density/mm(3) of NGs was 5 +/- 2, 54 +/- 7, 691 +/- 87 and 2930 +/- 410 in the Group A, B, C, and D respectively. The mean numbers of degenerated Auerbach neurons 2 +/- 1, 4 +/- 1, 12 +/- 3 and 27 +/- 5/mm(3) in the Group A, B, C, and D respectively. The mean numbers of degenerated goblet cells/mm(3) were 4.3 +/- 1.02, 11.5 +/- 0.26, 143 +/- 26 and 937 +/- 65 Group A, B, C, and D respectively. Statistical analysis showed that vagal network ischemia could cause intestinal bleeding and so atrophy in SAH progression. Statistical analyses of groups were; Group-D/Group-A < 0.001, Group-D/Group-B < 0.005, Group-C/Group-A < 0.005. Undiscovered effect of ischemic vagal network injuries should be regarded as a major cause of stress ulcerations following SAH which has not been mentioned in the literature. (C) 2018 Elsevier Ltd. All rights reserved.
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    Growth rate of a giant Tarlov (perineural) cyst with intrapelvic extension
    (Springer, 2024) Kaptanoglu, Erkan; Malcok, Umit Ali; Kaptanoglu, Doga; Catav, Serdar
    Background and importanceGiant Tarlov cysts (GTCs) are perineural cysts and their presacral intrapelvic extension are extremely rare entities. We present a case of GTC with intrapelvic extension who has preoperative Magnetic Resonance Imaging (MRI) follow-ups of 12 years, and we demonstrate the annual growth rate and the time-size correlation of a GTC.MethodsCase report.Clinical presentationA 37-year-old woman was admitted with left gluteal pain radiating to left foot, left leg numbness, progressed over 12 years. On MRI, starting from the L5-S1 level, a giant Tarlov cyst with an atypical configuration, is observed. The patient had a known sacral Tarlov cyst, first discovered on MRI obtained 12 years before the surgery. She had 6 consecutive MRI follow-ups in 12 years preoperatively. The cysts diameters have been measured and the growth rate was estimated. We showed for the first time that presented GTC grows in in both Sagittal Diagonal (SD) and Sagittal Craniocaudal (SC) diameters over time with overall annual growth rates, 7.671% for RGR_SD and 6.237% for RGR_SC.ConclusionWhen the time-size correlation is observed, it becomes evident that the GTSs' growing speed increases over the years because of minimal resistance in the intrapelvic cavity. Early surgery may be considered to prevent rapid growth in the intrapelvic cavity and to reduce possible complications of the giant cyst.
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    Neuroprotective Effects of Piceatannol on Olfactory Bulb Injury after Subarachnoid Hemorrhage (Mar, 10.1007/s12035-023-03306-x, 2023)
    (Springer, 2023) Akar, Ali; Oztopuz, Rahime Ozlem; Buyuk, Basak; Ovali, Mehmet Akif; Aykora, Damla; Malcok, Umit Ali
    [Anstract Not Available]
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    The Relationship Between Breast Volume and Thoracic Kyphosis Angle
    (Pera Yayincilik Hizmetleri, 2024) Ertem, Senay Bengin; Malcok, Umit Ali
    Objective: It has been hypothesized that a disproportionate upper body weight caused by macromastia places abnormal stress on the spine, which may lead to skeletal abnormalities. To evaluate whether there is a relationship between breast volume and the thoracic kyphosis angle measured on thorax CT images. Methods: A total of 448 female patients who underwent thoracic CT examinations were included in this study. Breast volume (ml), by using the organ segmentation method; thoracic kyphosis angles by using Cobb's method were made manually on the workstation. Results: Mean right breast volume was 902.03 +/- 376.47 (154.21 - 2366.20 ml), left breast volume was 911.01 +/- 383.34 (167.93 - 2894.07 ml), total breast volume was 1810.09 +/- 750.82 (354.39 5100.68 ml). The total breast volume (p<0.001) and thoracic kyphosis angle (p=0.012) in patients aged 50-69 years were significantly higher than those aged 17-29 years. Larger total breast volume [p<0.001] and thoracic kyphosis angle (p<0.001) values were associated with larger BMI intervals. A significant positive correlation was observed between the total breast volume and thoracic kyphosis angle (r=0.771, p<0.001). Conclusion: Our results showed that the thoracic kyphosis angle significantly increased in parallel with a larger total breast volume, and that total breast volume was an independent risk factor for thoracic kyphosis angle. The manual organ segmentation method we used was found to be reliable and easy to apply, but time-consuming technique for calculating BV.
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    THE UTILITY OF HEMATOLOGICAL INDICES AT THE INITIAL ADMISSION TO THE NEUROSURGERY CLINIC IN CERVICAL DISC HERNIATION
    (Galenos Publ House, 2024) Cinpolat, Havva Yasemin; Akar, Ali; Malcok, Umit Ali; Alkan, Sevil
    Objective: This study aimed to investigate hematological indices to predict spontaneous regression in patients with cervical disc herniation (CDH) during the initial visit to outpatient clinics. Materials and Methods: This retrospective study was carried out at a single center by reviewing laboratory parameters to assess the outcomes of CDH patients. The cohort consisted of patients with CDH who had undergone surgery, those who had undergone conservative treatment and achieved spontaneous regression, and a control group without CDH. The laboratory data consisted of the neutrophil-tolymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and systemic immune-inflammatory index (SIII). Results: Differences in the NLR, MLR, and SIII were statistically significant across groups (p<0.001). Compared with the spontaneous regression and control groups, the surgical intervention group presented significantly greater NLR, MLR, and SIII values. According to the comparison of the patients with CDH in terms of the level of herniation, there were no significant differences at the C4-C5 and upper levels, whereas there was a statistically significant increase in the NLR, MLR, and SIII in the surgical intervention group compared with the spontaneous regression group at the C6-C7 level (p = 0.015, p<0.001, and p = 0.003, respectively). Conclusion: This study provides valuable insights into the use of hematological indices to predict the need for surgical intervention in CDH patients. The observed associations emphasize their practical use, providing a way for further research and their inclusion in routine diagnostic protocols for CDH management.