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Öğe Complication of epidural fat graft in lumbar spine disc surgery: Case report(Elsevier Science Inc, 1995) Cobanoglu, S; Imer, M; Ozylmaz, F; Memis, MA left-sided L5-S1 lumbar disc herniation operation was performed on a 36-year-old woman in 1987. After a 6-year period, the same patient came back to the clinic with the problem of severe sciatic pain on the same side as before. Upon diagnosis, it was seen that the left S1 radix was compressed with a piece of free autofat graft in the foramen, which was used in the first operation. As far as the writers are informed, this is the first report about a later complication of epidural autofat graft in lumbar spine disc surgery.Öğe The effect of aprotinin on extraneural scarring in peripheral nerve surgery(Springer-Verlag Wien, 1998) Görgülü, A; Imer, M; Simsek, O; Sencer, A; Kutlu, K; Cobanoglu, SExtraneural scarring is one of the factors negatively influencing the result of peripheral nerve surgery. Many organic materials have been used to prevent fibrosis. The effect of aprotinin on peripheral nerve scarring in rats was investigated in this study. Three types of surgical intervention were carried out; namely external neurolysis (I), abrasive injury (II), and anastomosis (III). The coded samples which consisted of pure collagen fibers soaked with aprotinin or phosphate-buffered saline were applied around the left sciatic nerves of rats whereas only sham operations were performed on the right sciatic nerves. Animals were sacrificed after 4 or 6 weeks. Neurological examination, gross evaluation of extraneural fibrosis, and histological study were undertaken. The results have demonstrated that aprotinin is a promising agent in the prevention of extraneural scarring.Öğe The effect of epidural free fat graft on the outcome of lumbar disc surgery(Springer, 2004) Görgülü, A; Simsek, O; Çobanoglu, S; Imer, M; Parsak, TNumerous materials have been used to prevent epidural scar tissue after lumbar disc surgery. Free fat grafts are common both experimentally and clinically, but there is some doubt about their protection against fibrosis, and some complications have been reported. In this prospective study, the usefulness of free fat grafts during lumbar disc surgery was evaluated. Ninety-nine patients who had undergone operation due to lumbar disc herniation were divided in two groups: those with implantation of free fat grafts (group A) and those without (group B). Outcome was evaluated at a mean of 2.6 years postoperatively according to the following criteria: visual analog scale for back and leg pain, Hannover Questionnaire on activities of daily living, reflex findings, sensory and motor deficits, consumption of analgesics, walking distance, straight leg raising test, and clinical examination. The outcome variables showed no significant differences between the two groups (P>0.05). This study suggests that the use of free fat grafts during lumbar disc surgery was clinically ineffective.Öğe The effect of low-dose external beam radiation on extraneural scarring after peripheral nerve surgery in rats(Lippincott Williams & Wilkins, 2003) Görgülü, A; Uzal, C; Doganay, L; Imer, M; Eliuz, K; Çobanoglu, SOBJECTIVE: Scar tissue is an inevitable result of peripheral nerve surgery. A variety of substances have been used to prevent epineurial scarring. In this study, the effect of low-dose radiation therapy on epineurial scarring was investigated. METHODS: Seventy-eight male Sprague-Dawley rats were studied. A total of 60 rats were subjected to one of three types of surgical procedure on the sciatic nerve, as follows: Procedure 1, external neurolysis (n = 20); Procedure 2, abrasive injury (n = 20); and Procedure 3, anastomosis (n = 20). On the left sciatic nerves, 700 cGy external beam radiation was administered 24 hours after surgery, and the right sciatic nerves served as a control group (surgery only). Eighteen animals without surgical intervention were used to establish the fibrotic effect of radiotherapy on normal nerves. A neurological examination was performed weekly. Six weeks after surgery, the extent of extraneural scarring was examined by gross microdissection by means of a numerical grading scheme and histological analysis. Cellular density and surface measurements of scar tissue were also evaluated. RESULTS: The dissection around the nerve was easier in rats treated with low-dose radiation compared with the control group. Furthermore, grading scores in both nerve adherence and nerve separability were significantly lower in treated nerves than in the control group (P less than or equal to 0.05). Low-dose radiotherapy decreased the scores of cellular density and surface measurement of scar tissue (P less than or equal to 0.05). In normal nerves, radio? therapy did not produce any fibrotic effects and the density of fibroblasts/fibrocytes was also very low. CONCLUSION: In the case of surgery or local trauma to peripheral nerve, the use of low-dose radiation therapy may be a safe method of limiting postoperative epineurial scar formation.Öğe The modification of the new type of end-to-side anastomosis between carotid arteries in rats: A technical and scanning electron microscopic study(Springer-Verlag Wien, 1996) Imer, M; Okar, T; Cobanoglu, S; Kayapinar, R; Memis, M; Hepgul, K; Kutlu, KModification of a type of end-to-side anastomosis that has been described before is studied. The recipient artery is occluded for only 3-4 minutes to complete the anastomosis by using only the running suture. The anastomotic site was studied by inspection and Scanning Electron Microscope (SEM) at different times after the operation on 30 rats.
