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Öğe C2 transpedicular fixation technique in Hangman's Fracture(Sivas Cumhuriyet University, 2021) Küçükyıldız, Halil Can; Karademir, Mustafa; Güneş, Giray; Özüm, ÜnalObjective : Traumatic spondylolisthesis of the axis, also known as hangman fractures, all cervical it accounts for 4-7% of all traumas and is the second most common axis after odontoid fractures. trauma. There are unstable fractures and the treatment options are immobilization with halo or surgery.is stabilization. By most authors, it is primarily associated with halo in patients with Type 1 and Type 2 fractures.Although external fixation and immobilization are recommended, halon is a difficult orthosis to use.Because of this, segmental motion sparing surgery provides rapid recovery in suitable patients may be an option. In the case we presented, the treatment approach in Hangman's fractures was reviewed in the literature.has been reviewed and discussed.Clinical Presentation: Our case, after AITC, with Levin Edwards Type 1A Hangman fracture, A 40-year-old female patient with no neurological deficits. The patient does not prefer to use a halo orthosis C2 transpedicular surgery was performed with a lag screw for motion-sparing surgery to a young patient fixation is planned.Technique: C2 transpedicular lag screw was applied to the patient with intraoperative fluoroscopy.Conclusion: C2 transpedicular fixation with Lag screw, according to posterior segmental stabilization a more minimally invasive and motion-sparing surgery, faster recovery time may be preferred to traditional posterior stabilization methods in selected patient groups due to The patient who did not prefer the use of orthoses due to the social disadvantages of immobilization with Halo it is a quick and cost-effective surgical option in groups with a rapid recovery time.Öğe Co-existing Tumors On Suprasellar Region : A Rare Case and Re-view of Literature(Sivas Cumhuriyet University, 2022) Küçükyıldız, Halil Can; Güneş, Giray; Koç, Fatih; Özüm, ÜnalIntroduction: The co-existence of primary intracranial tumors originating from different cell types is rare. While the association of meningioma and glioma is frequently reported in the literature, the number of cases with meningiomas and epidermoid cysts is relatively low. We report a unique case because the association of suprasellar meningioma and the epidermoid cyst has not been reported before in the literature.Case Presentation: A 50-year-old female presented to the clinic with a headache and progressive vision loss. In cranial Magnetic Resonance (MR) images, a T1A hypointense, T2A iso-hyper intense heterogenous contrasting suprasellar mass lesion was observed. The patient was operated on with a diagnosis of suprasellar meningioma. At the suprasellar region, a mass that macroscopic view and consistency compatible with epidermoid cyst explored intraoperative incidentally. Two different pathological specimens were sent to pathology. The patient's pathology was reported as WHO 2021, Transitional type grade 1 Meningioma, and Epidermoid cyst content.Conclusion: The number of cases with meningiomas and epidermoid cysts is very low in the literature. Despite advanced MR imaging techniques, cystic lesions can be overlooked in the diagnosis. The occurrence of two different histopathological types of tumors in the same localization can be explained by the local paracrine effects of the tumors.Öğe Coronavirus-19 pandemic and its impact on elective neurosurgical operations(Selçuk BAŞAK, 2022) Küçükyıldız, Halil Can; Şimşek, Salih Kürşat; Söylemez, Burçak; Güneş, Giray; Koç, Fatih; Özüm, ÜnalBackground/Aim: The Coronavirus-19 (COVID-19) pandemic disrupted all planned, elective surgical procedures and appointment-based health services due to the decreased capacity of hospitals, healthcare professionals' focus on fighting the pandemic and efforts to protect patients, society and healthcare workers from the pandemic. The purpose of this study was to ascertain the perspective of patients on elective surgery, who applied to neurosurgery outpatient clinics at two different centers as clean and non-clean hospitals. Methods: This cross-sectional prospective study was performed between March 2021 and July 2021, during the COVID-19 pandemic. 160 patients who were offered elective surgery for various indications in neurosurgery outpatient clinics were enrolled in the study. To this end, a questionnaire was administered to patients that included information about their demographics, pandemic processes and their anxiety levels during this process. Age, level of education, COVID -19 infection and vaccination status were all questioned in the survey. Univariate and multivariate analysis were used to determine the factors that might influence a patient's decision towards surgery. Results: In the univariate analysis of the factors, educational status, pandemic-induced anxiety and whether the hospital is a pandemic hospital or not were identified as statistically significant effective factors in patients' decision to accept surgery (PÖğe Deneysel serebral Vazospazm’da sürekli intrasisternal larginin İnfüzyonunun terapotik etkisi(Cumhuriyet Üniversitesi, 1999) Özüm, Ünal; Göksel, MuratVIII. ÖZET Subaraknoid kanama (SAK) sonrası gelişen serebral vazospazmın etyolojisi ve patogenezi hakkında son yıllardaki çalışmalarda; bu olayın vazokonstrüktör/vazodilatatör sistemler arasındaki dengenin bozulmasına bağlı olduğu varsayımı öne sürülmektedir. Bu dengede majör vazodilatatör etkenin nitrik oksid (NO) olduğu ve SAK sonrası serebral ortamda NO miktarının tam bilinmeyen bir biçimde azalması sonucu, serebral vazospazmın oluştuğu düşünülmektedir. Bu çalışmada tavşan deneysel SAK modeli kullanılmıştır. Deneklerde serebral vazospazm izlemi için Transkranial Doppler Ultrasound (TKD) yöntemi kullanılmıştır. SAK sonrası 4. günde tavşanlarda 1 saat süre ile, NO hammaddesi olan L-arginin'in intrasisternal infiizyonu yapılmış; ve bu sırada oluşan serebral arter çap değişimleri TKD ölçümleri ile izlenmiştir. Tüm deneklerde oluşmuş olan serebral vazospazmın, L-arginin infuzyonunun başlangıcıyla birlikte çözülmeye başladığı; ve tedavinin 20. dakikasından sonra oluşan vazodilatasyonun stabil olarak sürdüğü saptanmıştır. Elde ettiğimiz sonuçlar, SAK sonrası serebral vazospazmın patogenezinde NO eksikliğinin katkısı olabileceği varsayımını destekler niteliktedir. Sonuçlarımız, NO eksikliğinin, L-arginin substratının tükenmesine bağlı olduğunu düşündürmektedir. Bu durumda, SAK sonrası serebral vazospazmın proflaksi ve tedavisinde L-arginin kullanılabileceğini düşünüyoruz. Bu maddenin kısa etki süresi dezavantajı, sürekli intrasisternal iniuzyon yöntemi ile ortadan kaldırılabilir. 68Öğe Knowledge Status Related Concept of Pain of Seniors Who has been Educated in the Field of Health(Hemşirelikte Araştırma Geliştirme Derneği, 2010) Yılmaz, Meryem; Özüm, Ünal; Gürler, Hesna; Çifçi, Emine SeldaAim: Nursing, dentistry and midwifery professions, such as members of different health-related problems arise because of the “pain” and are frequently encountered. The study was carried out in health education at a university final year students to the concept of their own pain and pain characteristics to determine if the information. Method: In this descriptive study, data were collected by a questionnaire developed by researchers. Collected data were evaluated with SPSS-version 16 and frequency, Anova and Tukey tests were used as statistical analysis. Results: A total 246 senior students including 77 nursing, 64 medicine, 59 midwifery and 46 dentistry students were attended the study. We identified that most of students didn’t experience pain frequently, 73.2% of them experienced concentration difficulties when they experienced pain. Students viewed pain as a symptom of illness and recommended mostly nonpharmacological methods to people who experienced pain. Most of the students, except medicine faculty students, stated that education on pain that they received was sufficient. The most of midwifery seniors stated that their knowledge on pain concept, behaviors towards pain and their recommendations to patients with pain were all changed after they received education on pain. It was found that students’ general mean score on pain knowledge was 22.09 SD=3.35 in the study. Mean pain knowledge score of nursing students was 24.90 SD=2.02 and this mean score was higher than whole groups’mean score and specifically was higher than other groups’ mean scores. It was found that there is a statistically significant difference between groups F=10.294 P=0.001 . Conclusion: According to the results obtained from this study students’ overall concept of pain-related information as well as level of education among students but was not expected to change. Students are insufficient on pain knowledge, pain assessment, and pain control. For that reason, we recommended that curriculum should be reviewed by means of pain related subjects.Öğe Management of aneurysmal subarachnoid hemorrhage with surgical clipping: A single center perspective(Selçuk BAŞAK, 2022) Küçükyıldız, Halil Can; Özüm, ÜnalBackground/Aim: There is no consensus on the optimal treatment for intracranial aneurysm rupture due to subarachnoid hemorrhage (SAH). In this study, we analyzed a series of ruptured intracranial aneurysms treated with the clipping method at our center. Methods: In this retrospective cohort study; we searched our patient database for patients who developed SAH due to ruptured intracranial aneurysm treated at the Neurosurgery Clinic of Sivas Cumhuriyet University. A total of 304 patients who underwent the clipping operation due to aneurysmal SAH between 2010 and 2020 were included in the study. Cases with aneurysmal SAH who underwent endovascular coiling which is consisted of 22 patients were excluded. Results: A significant inverse correlation was found between age and Glasgow coma scores (GCS) (r=−0.137, P=0.017). Hunt–Hess and Fisher grades increased significantly with increasing age (r=0.187, P0.05). Conversely, GCS scores were significantly lower and Hunt–Hess and Fisher grades were significantly higher in the surviving group than in the deceased group (PÖğe Patient With A Diagnosis Of Ochronosis After Lumbar Dyscectomy: Case Report(Sivas Cumhuriyet University, 2020) Yeldir, Neşe; Küçükyıldız, Halil Can; Başpınar, Nisa; Özüm, Ünal; Eğilmez, ReyhanOchronosis is the black discoloration of connective tissues seen with alkaptonuria, a metabolic disorder. Alkaptonuria is a rare autosomal recessive metabolic disorder caused by the lack of homogentisic acid oxidase enzyme. Alkaptonuria causes degenerative changes in cartilage, intervertebral disc and other tissues. The patients operated due to lumbar disc herniation in alkatonuria are very few. In this article a case of ochronosis in which the patient was determined after lumbar discectomy is presented.Öğe Prognosis in IDH-Mutant and IDH-wild type glioblastoma(Sivas Cumhuriyet University, 2021) Kılıç, Eren; Yeldir, Neşe; Özüm, Ünal; Yücel, Birsen; Yılmaz, Mukaddes; Özer, Hatice; Eğilmez, ReyhanGlioblastoma (GBM) is the most common brain tumor in adults with a poor prognosis and predominantly astrocytic differentiation. GBM is classified according to the isocitrate dehydrogenase (IDH) mutation according to the World Health Organization (WHO) Brain Tumors 2016 classification. IDH-1 gene mutations are evaluated immunohistochemically (IHC) and molecular methods in current pathology laboratory practice.The aim of this study was to determine the overall survival in GBM cases according to IDH-1 mutation status and Ki-67 proliferation index.Total of 53 patients diagnosed as GBM between 2007-2020 in Sivas Cumhuriyet University Faculty of Medicine, Department of Pathology were evaluated. Disease-free median survival of 7 (13%) GBM patients with IDH mutation was 2 months (2-year survival 14%), disease-free median survival 9 months (2-year survival 24 %) in GBM IDH-wild type cases. In cases with a higher Ki-67 proliferation index, the median disease-free survival were shorter.In conclusion statistically significant results could not be obtained between disease-free survival in GBM IDH-mutant type and GBM IDH-wild type. However, the mean Ki-67 proliferation index of GBM IDH-wild type cases was found to be much higher than GBM IDH-mutant cases. High Ki-67 proliferation index was found to be associated with a significantly shorter survival.Öğe RELATIONSHIP OF LUMBAR SPINAL ANATOMICAL STRUCTURES WITH LUMBAR DISC HERNIA AND SPINAL STENOSIS(Galenos Publishing House, 2024) Küçükyıldız, Halil Can; Koç, Fatih; Kıymaz, Eren; Özüm, ÜnalObjective: We aimed to radiologically evaluate the clinical and demographic features accompanying ligamentum flavum hypertrophy and possible accompanying differences in anatomical structures. Materials and Methods: We evaluated vertebral alignment, integrity of neural structures, diameter of the central canal, posterior longitudinal ligament, ligamentum flavum integrity, and position of the facet joints in patients with lumbar disk herniation and lumbar spinal canal stenosis using magnetic resonance imaging (MRI). Furthermore, we examined the age, body mass index (BMI), and employment status of the patients and the status of the vertebral and paravertebral anatomical structures using MRI. Age, BMI, employment status, ligamentum flavum thickness at the L4–L5 level, interspinous ligament thickness, facet joint diameter, posterior longitudinal ligament integrity, psoas muscle diameter, erector spina muscle diameter, and mean multifidus muscle diameter were also analyzed. Results: Significant differences were found in age, BMI, employment status, ligamentum flavum thickness, interspinous ligament thickness, mean facet diameter, mean multifidus muscle diameter, mean erector spina muscle diameter, and mean psoas muscle diameter. In addition, separate statistical analyses were conducted between sex, age, employment status, BMI, and lumbar anatomical parameters. Significant correlations were found between lumbar disk herniation and spinal stenosis pathologies based on radiological measurements of lumbar structures, such as the ligamentum flavum, interspinous ligament, and facet diameter, and demographic parameters, such as age, sex, employment status, and BMI. Conclusion: We examined changes in the anatomical structures accompanying the vertebral column and existing discal or stenotic pathologies. In addition to the demographic characteristics of the patients, changes in the accompanying lumbar spinal anatomical structures, such as degeneration, hypertrophy, and atrophy, may be important. These factors and changes will help plan the treatment process and guide the results. © Copyright 2024 The Author. Published by Galenos Publishing House on behalf of Turkish Spine Society.Öğe The usage of the laser doppler flowmetry in neurosurgery(Turkish Society of Cerebrovascular Diseases, 2003) Gürelik, Mustafa; Özüm, Ünal; Karada?, Özen; Gürelik, BilgeThe laser Doppler flowmetry is a method measuring continuously and real time blood flow in tissue. Laser Doppler flowmetry is used to measure the blood flow in both clinic and experimental applications in neurosurgery. In this technique is based on "Doppler principle", a part of the laser light delivered to tissue back reflects from the dynamic structures, mainly red blood cells and this back reflected light, frequency of which shifted is received by detector and analyzed. In this article, the physical principles of the laser Doppler flowmetry and its applications in neurosurgery are reviewed.Öğe Üst servikal spinal kordun manyetik uyarımının serebral kan akımı üzerine etkisi(Cumhuriyet Üniversitesi, 2006) Özüm, Ünal; Ünal, Ahmet1967 yılından bu yana elektriksel omurilik uyarımı, kronik ağrılı hastaların tedavisinde kullanılmaktadır. Omurilik uyarımı sırasında periferik vazodilatasyonun olduğu görüldükten sonra aynı etkisinin santralde da olabileceği düşünülmüştür. Üst servikalde omuriliğin dorsaline perkütan veya açık laminektomi ile yerleştirilen elektrotlar kullanılarak dorsal omurilik uyarımı sonucu beyin kan akımı anlamlı şekilde artmaktadır. Elde edilen bu yararlı etki kafa içi iskemik durumlarda kliniklerde kullanılmış ve hastalarda iyileşmeler görülmüştür. Sinir sisteminin manyetik uyarımı beyin, kortikospinal yollar, spinal sinirler ve periferik sinirlerin elektriksel uyarımı için geliştirilmiş invaziv olmayan bir yöntemdir. Bir manyetik uyarıcı aracılığı ile nöral dokular cilt üzerinden zahmetsizce uyarılabilir ve elde edilen etki elektriksel uyarımla elde edilene benzerdir. Omuriliğin elektriksel uyarımında, elektrotların yerleştirilmesi uygulaması invaziv ve komplikasyonlu bir yöntem olduğundan bu tip uyarım modelinin kafa içi iskemik olayların tedavisindeki kullanımının yaygınlaşmasına engel olmaktadır. Elektriksel uyarıma alternatif invaziv olmayan yeni bir yöntem ileri sürebilmek amacıyla, üst servikal omuriliğin manyetik uyarımının beyin kan akımı üzerine etkisi araştırılmıştır Bu çalışmada yaşları 17?40 arasında değişen sağlıklı erkek gönüllülerde üst servikal omurilik sırasıyla bir, ardışık iki ve ardışık üç kez manyetik olarak uyarılmış ve uyarımlar sırasında ve sonrasında beyin kan akımı transkranial Doppler ultrasonografi yöntemi ile değerlendirilmiştir. Üst servikal bölgeye verilen manyetik uyarımın beyin kan akımını artırıcı yönde etki gösterdiği tespit edilmiş ve uyarım sayısı artırıldıkça beyin kan akımındaki artmanın daha erken ortaya çıktığı ve elde edilen etkinin daha uzun sürdüğü tespit edilmiştir. Bulgularımıza dayanarak üst servikal omuriliğin elektriksel uyarımında olduğu gibi manyetik uyarımı ile beyin kan akımını artırılabildiğini söyleyebiliriz. Anahtar kelimeler: Transkranial Doppler ultrasonografi, manyetik uyarım, omurilik uyarımı, beyin kan akımı.
