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Öğe Anesthetic and analgesic effects in patients undergoing a lumbar laminectomy of spinal, epidural or a combined spinal-epidural block with the addition of morphine(ELSEVIER SCI LTD, 2012) Duger, Cevdet; Gursoy, Sinan; Karadag, Ozen; Kol, Iclal Ozdemir; Kaygusuz, Kenan; Ozal, Hasan; Mimaroglu, CanerThis study was designed to evaluate the anesthetic, analgesic and side effects of spinal, epidural and combined spinal-epidural anesthesia with the addition of morphine for lumbar laminectomy. A total of 66 patients undergoing lumbar laminectomy were included in the present study of whom 64 completed the study. Patients were randomly divided into three groups: (i) spinal anesthesia - the SA group; (ii) epidural anesthesia - the EA group; and (iii) combined spinal-epidural anesthesia - the CA group. Demographical data, surgical times and peak sensory levels of groups were similar. Heart rate, mean arterial pressure, and peripheral oxygen saturation did not differ between the three groups. No differences were observed intraoperatively in Ramsey sedation scale (RSS) scores between the groups, but postoperatively, although RSS scores were similar for the EA and CA groups, they were significantly lower for the SA group. The postoperative visual analogue scale pain scores were higher in the SA group compared to the EA and the CA groups except for the second postoperative hour. Time-to-use of the first patient controlled analgesia was similar for all groups. The total consumption of morphine over the 24-hour study period was significantly higher in the SA group compared to the EA and the CA groups. Postoperative nausea and vomiting frequencies were higher in SA group, but pruritus frequency was lower than the EA and the CA groups. In conclusion, although spinal, epidural, and combined spinal-epidural anesthesia are adequate and effective for lumbar laminectomies, epidural and combined spinal-epidural anesthesia techniques are more effective than spinal anesthesia for postoperative analgesia and sedation with lesser side effects. (C) 2011 Elsevier Ltd. All rights reserved.Öğe CD44, membrane type 1-matrix metalloproteinase (MTI-MMP) and KI-67 expression in astrocytic tumors(SPRINGER, 2007) Kivanc, Fugen; Egilmez, H. Reyhan; Tuncer, Ersin; Ozer, Hatice; Karadag, Ozen; Goze, O. Fahrettin…Öğe Characteristics and outcomes of patients with primary central nervous system lymphoma: A single center experience and review of the literature(2012) Korkmaz, Serdal; Sencan, Mehmet; Ozum, Unal; Karadag, OzenThis retrospective study was designed to review the clinicopathological characteristics and outcomes of primary central nervous system lymphoma (PCNSL) cases at our institute. Patients diagnosed with PCNSL at our institute from August 2010 to December 2011 were evaluated. During this period, a total of 5 cases have been diagnosed with PCNSL. Parieto-occipital lobe was the most common site of involvement. Diffuse large B-cell lymphoma (DLBCL) was the most common histological pattern. 4 patients were treated with 3.0 g/m2 methotrexate (MTX) intravenously concomitant with intraventricular 15 mg MTX and 1 patient was treated with radiotherapy (RT). The median overall survival (OS) was 8 months (minimum: 1 months, maximum: 15 months) and mean OS was 8.4 ± 5.41 months. As mentioned previous studies, MTX-based chemotherapy regimens are still the most effective treatment option in this patient population.Öğe A safe and effective method for treatment of chronic subdural haematoma(CANADIAN J NEUROL SCI INC, 2007) Gurelik, Mustafa; Aslan, Adem; Gurelik, Bilge; Ozum, Unal; Karadag, Ozen; Kars, H. ZaferObjective: Burr-hole irrigation and burr-hole drainage without irrigation are the most popular methods for treatment of chronic subdural haematoma. It is not well known if irrigation is necessary or which method has a higher recurrence rate. We compared the recurrence rates of those two methods. Materials and Methods: Forty-two patients were treated by burr-hole irrigation (irrigation group), whereas 38 patients were treated by burr-hole drainage (drainage group). Recurrence rate and its relation with sex, age, haematoma localization and aetiology were investigated in both groups. Results: There was no significant difference between recurrence rates of the two groups. There was also no correlation between recurrence rate and age, sex, haematoma localization, or aetiology. Conclusions: There was no significant difference between recurrence rates of the two groups. Since the burr-hole drainage method is simpler to carry out, its use may be preferable.Öğe Unilateral laminotomy for decompression of lumbar stenosis is effective and safe: A prospective randomized comparative study(2012) Gurelik, Mustafa; Bozkina, Cemal; Kars, Zafer; Karadag, Ozen; Unal, Ozum; Bayrakli, FatihObjective: The purpose of this study is to determine the efficacy and safety of unilateral laminotomy for decompression of lumbar stenosis (LS). Although minimally invasive procedures are gaining increasing popularity in the treatment of spinal disorders, minimally invasive techniques are not standard in the surgical treatment of lumbar stenosis yet. Methods: Fifty-two consecutive patients with lumbar stenosis were randomized to two treatment groups (unilateral laminotomy for decompression-Group 1, decompressive laminectomy-Group 2). Maximum walking distance (MWD), Oswestry Disability Index (ODI), spinal MRI and CT, and flexion-extension radiography were used to assess clinical outcome, adequacy of decompression and postoperative instability. Results: Excellent-good clinical outcome was obtained in 88% of patients in Group 1 and in 69% of patients in Group 2. Increase in MWD and dural sac area after surgery were adequate in both groups. Postoperative spinal instability occurred in five patients in Group 2, none in Group 1. There was no surgical complication in the groups. Conclusions: Unilateral laminotomy for decompression is an effective and safe technique for treatment of LS. This technique ensures adequate decompression and good clinical outcome. It does not cause spinal instability.
