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    Anatomical parameters of percutaneous, minimally invasive, direct intralaminar pars screw fixation of spondylolysis
    (Elsevier Science Inc, 2024) Gudu, Burhan Oral; Aydin, Ahmet Levent; Mercan, Necip Engin; Dilbaz, Suna; Cirak, Musa; N/A; Özer, Ali Fahir; School of Medicine
    - OBJECTIVE: To investigate the anatomical parameters of the ideal screw trajectory for percutaneous intralaminar screw fixation of a pars defect in lumbar spondylolysis using computed tomography scans. - METHODS: Using advanced radiological software, the ideal intralaminar screw trajectory was determined. The anatomical parameters of this trajectory were analyzed using a total of 80 single-level lumbar tomography scans in patients with spondylolysis at the lumbar 4 vertebrae and lumbar 5 vertebrae levels. The ideal intralaminar screw trajectory started from the inferolateral edge of the lamina and was between the intralaminar region, pars defect, and defective pars neck and pedicle. Along this trajectory, the skin-lamina distance, intralaminar screw length, isthmic lamina length and width, defective pars neck width, lateral entry distance of the screw to the center of the spinous process, and sagittal and coronal screw application angles were analyzed. - RESULTS: When comparing the lumbar 4 vertebrae and lumbar 5 vertebrae parameters, the mean skin-to-lamina distances were 11-9 cm ( P = 0.000), intralaminar screw lengths 3.5-3.6 cm ( P = 0.067), isthmic lamina lengths 22 cm ( P = 0.698), mid-lamina widths 1-1 cm ( P = 0.941), defective pars neck widths 1-1 cm ( P = 0.674), screw lateral entry distances according to the spinous process 1-1.5 cm ( P = 0.000), sagittal screw angles 45 degrees-45 degrees ( P = 0.870), and coronal screw angles 10 degrees-20 degrees ( P = 0.000), respectively. There were no differences based on age and gender ( P < 0.05). - CONCLUSIONS: Percutaneous intralaminar rigid screw fixation of a pars defect in spondylolysis provides minimally invasive, low-profile instrumentation. In spondylolysis, a screw length of 3-4 cm and a screw diameter of 45 mm may be sufficient for pars fixation with intralaminar screws.
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    Association of TaqI (rs731236) polymorphism of vitamin D receptor gene with lumbar degenerative disc disease
    (Elsevier Science Inc, 2024) Serifoglu, Luay; Yilmaz, Seda Gulec; Karaaslanli, Abdulmutalip; Etli, Mustafa Umut; Ozdogan, Selcuk; N/A; Düzkalır, Ali Haluk; N/A; Koç University Hospital
    - BACKGROUND: Lumbar degenerative disc disease (LDDD) significantly contributes to low back pain, with a complicated etiology involving genetic and environmental facts. The aim of study was to investigate the association between the Taq I (rs731236) polymorphism of the vitamin D receptor ( VDR ) gene with LDDD. - METHODS: In total, 248 patients with symptomatic LDDD and 146 control subjects were examined. The evaluation of clinical features of patients with LDDD comprised radiodiagnostic magnetic resonance imaging, neurologic examinations, pain scores including the visual analog scale (VAS), and disability investigation with Oswestry Disability Index (ODI). Genotyping of the VDR gene polymorphism was conducted using polymerase chain reaction ebased methods.- RESULTS: Individuals of the LDDD group who were VDR TaqI AA genotype carriers were significantly greater than the other group ( P = 0.014), whereas those with GG genotype were significantly lower ( P = 0.028) in the patient group. In addition, VAS and ODI scores were significantly lower in the GG genotype carrier group, whereas AA genotype carriers had the greatest scores ( P = 0.004). Carrying the G allele decreased the risk of LDDD 1.7 times ( P = 0.014) and carrying the A allele enhanced the risk 1.8 times ( P = 0.028). Moreover, G-allele carriers had significantly lower VAS ( P = 0.002) and ODI scores ( P < 0.0001). - CONCLUSIONS: VDR Taq I (rs731236) GG genotype and G allele have protective potential, whereas the AA genotype and A allele are risk factors for LDDD. The findings reveal a statistically significant association of the Taq I (rs731236) polymorphism of VDR gene polymorphism with LDDD. This result highlights the potential role of genetic factors in developing LDDD and suggests avenues for future research in genetic screening and personalized treatment strategies.
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    The relationship between inflammatory processes and apoptosis in lumbar disc degeneration
    (Elsevier Inc., 2024) Cetintas, Semih Can; Akyol, Sibel; Alizada, Orkhan; Tahmazoglu, Burak; Hanci, Murat; Isler, Cihan; N/A; Akgün, Mehmet Yiğit; N/A; Koç University Hospital
    Objective: Degenerative Disc Disease (DDD) is a common health problem in the population. There are recent studies focusing on relationship between DDD and immunological factors. However, there is still a lack of data on the role of apoptosis in DDD pathophysiology. Therefore, we aimed to investigate the relationship between Modic-type changes and the apoptosis in DDD. Materials and Methods: Ninety adult male patients who presented with low back and/or radicular pain and were operated on due to lumbar disc herniation were included. Three groups were formed based on Modic type degeneration observed on magnetic resonance imaging. Specific parameters involved in the intrinsic and extrinsic pathways of apoptosis were assessed in excised disc materials using the enzyme-linked immunosorbent assay method. Results: All three groups formed according to Modic degeneration types were homogenous in all variances. Cytochrome-C was significantly decreased only in the Modic type-3 group, whereas Tumor Necrosis Factor-Related Apoptosis-Inducing Ligand Receptor-1, B-Cell Lymphoma-2 (Bcl-2) Homologous Antagonist Killer-1, Direct Inhibitor of Apoptosis-Binding Protein with Low Pi, and Bcl-2 Associated X Apoptosis Regulator levels were significantly different in both Modic type-2 and -3 groups. However, BH3 interacting domain death agonist and Bcl-2 levels were similar across all groups. Conclusions: In conclusion, this study suggests that Direct Inhibitor of Apoptosis-Binding Protein with Low Pi, cytochrome - c, Bcl-2 Associated X Apoptosis Regulator, Bcl-2 Homologous Antagonist Killer-1, and Tumor Necrosis Factor-Related Apoptosis-Inducing Ligand Receptor-1proteins play important roles in the development and progression of DDD and are correlated with Modic types. Further studies are needed to explore the potential therapeutic role of inhibiting these apoptotic proteins in DDD. © 2024 Elsevier Inc.
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    Goodbye Hartmann trial: a prospective, international, multicenter, observational study on the current use of a surgical procedure developed a century ago
    (BMC, 2024) Perrone, Gennaro; Giuffrida, Mario; Abu-Zidan, Fikri; Kruger, Vitor F.; Livrini, Marco; Petracca, Gabriele Luciano; Rossi, Giorgio; Tarasconi, Antonio; Tian, Brian W. C. A.; Bonati, Elena; Mentz, Ricardo; Mazzini, Federico N.; Campana, Juan P.; Gasser, Elisabeth; Kafka-Ritsch, Reinhold; Felsenreich, Daniel M.; Dawoud, Christopher; Riss, Stefan; Gomes, Carlos Augusto; Gomes, Felipe Couto; Teixeira Gonzaga, Ricardo Alessandro; Brattig Canton, Cassio Alfred; Pereira, Bruno Monteiro; Fraga, Gustavo P.; Zem, Leticia Goncalves; Cordeiro-Fonseca, Vinicius; Tauil, Renato de Mesquita; Atanasov, Boyko; Belev, Nikolay; Kovachev, Nikola; Melendez, L. Juan Jose; Dimova, Ana; Dimov, Stefan; Zelic, Zdravko; Augustin, Goran; Bogdanic, Branko; Moric, Trpimir; Chouillard, Elie; Bajul, Melinda; De Simone, Belinda; Panis, Yves; Esposito, Francesco; Notarnicola, Margherita; Lauka, Lelde; Fabbri, Anna; Hentati, Hassen; Fnaiech, Iskander; Aurelien, Venara; Bougard, Marie; Roulet, Maxime; Demetrashvili, Zaza; Pipia, Irakli; Merabishvili, Giorgi; Bouliaris, Konstantinos; Koukoulis, Georgios; Doudakmanis, Christos; Xenaki, Sofia; Chrysos, Emmanuel; Kokkinakis, Stamatios; Vassiliu, Panteleimon; Michalopoulos, Nikolaos; Margaris, Ioannis; Kechagias, Aristotelis; Avgerinos, Konstantinos; Katunin, Jevgeni; Lostoridis, Eftychios; Nagorni, Eleni-Aikaterini; Pujante, Antonio; Mulita, Francesk; Maroulis, Ioannis; Vailas, Michail; Marinis, Athanasios; Siannis, Ioannis; Bourbouteli, Eirini; Manatakis, Dimitrios K.; Tasis, Nikolaos; Acheimastos, Vasileios; Maria, Sotiropoulou; Stylianos, Kapiris; Kuzeridis, Harilaos; Korkolis, Dimitrios; Fradelos, Evangelos; Kavalieratos, George; Petropoulou, Thalia; Polydorou, Andreas; Papacostantinou, Ioannis; Triantafyllou, Tania; Kimpizi, Despina; Theodorou, Dimitrios; Toutouzas, Konstantinos; Chamzin, Alexandros; Frountzas, Maximos; Schizas, Dimitrios; Karavokyros, Ioannis; Syllaios, Athanasios; Charalabopoulos, Alexandros; Boura, Maria; Baili, Efstratia; Ioannidis, Orestis; Loutzidou, Lydia; Anestiadou, Elissavet; Tsouknidas, Ioannis; Petrakis, Georgios; Polenta, Eleni; Bains, Lovenish; Gupta, Rahul; Singh, Sudhir K.; Khanduri, Archana; Bala, Miklosh; Kedar, Asaf; Pisano, Marcello; Podda, Mauro; Pisanu, Adolfo; Martines, Gennaro; Trigiante, Giuseppe; Lantone, Giuliano; Agrusa, Antonino; Di Buono, Giuseppe; Buscemi, Salvatore; Veroux, Massimiliano; Gioco, Rossella; Veroux, Gastone; Oragano, Luigi; Zonta, Sandro; Lovisetto, Federico; Feo, Carlo V.; Pesce, Antonio; Fabbri, Nicolo; Lantone, Giulio; Marino, Fabio; Perrone, Fabrizio; Vincenti, Leonardo; Papagni, Vincenzo; Picciariello, Arcangelo; Rossi, Stefano; Picardi, Biagio; Del Monte, Simone Rossi; Visconti, Diego; Osella, Giulia; Petruzzelli, Luca; Pignata, Giusto; Andreuccetti, Jacopo; D'Alessio, Rossella; Buonfantino, Massimo; Guaitoli, Eleonora; Spinelli, Stefano; Sampietro, Gianluca Matteo; Corbellini, Carlo; Lorusso, Leonardo; Frontali, Alice; Pezzoli, Isabella; Bonomi, Alessandro; Chierici, Andrea; Cotsoglou, Christian; Manca, Giuseppe; Delvecchio, Antonella; Musa, Nicola; Casati, Massimiliano; Letizia, Laface; Abate, Emmanuele; Ercolani, Giorgio; D'Acapito, Fabrizio; Solaini, Leonardo; Guercioni, Gianluca; Cicconi, Simone; Sasia, Diego; Borghi, Felice; Giraudo, Giorgio; Sena, Giuseppe; Castaldo, Pasquale; Cardamone, Eugenia; Portale, Giuseppe; Zuin, Matteo; Spolverato, Ylenia; Esposito, Marialusia; Isernia, Roberta Maria; Di Salvo, Maria; Manunza, Romina; Esposito, Giuseppe; Agus, Marcello; Asti, Emanuele Luigi Giuseppe; Bernardi, Daniele Tiziano; Tonucci, Tommaso Panici; Luppi, Davide; Casadei, Massimiliano; Bonilauri, Stefano; Pezzolla, Angela; Panebianco, Annunziata; Laforgia, Rita; De Luca, Maurizio; Zese, Monica; Parini, Dario; Jovine, Elio; De Sario, Giuseppina; Lombardi, Raffaele; Aprea, Giovanni; Palomba, Giuseppe; Capuano, Marianna; Argenio, Giulio; Orio, Gianluca; Armellino, Mariano Fortunato; Troian, Marina; Guerra, Martina; Nagliati, Carlo; Biloslavo, Alan; Germani, Paola; Aizza, Giada; Monsellato, Igor; Chahrour, Ali Chaouki; Anania, Gabriele; Bombardini, Cristina; Bagolini, Francesco; Sganga, Gabriele; Fransvea, Pietro; Bianchi, Valentina; Boati, Paolo; Ferrara, Francesco; Palmieri, Francesco; Cianci, Pasquale; Gattulli, Domenico; Restini, Enrico; Cillara, Nicola; Cannavera, Alessandro; Nita, Gabriela Elisa; Sarnari, Jlenia; Roscio, Francesco; Clerici, Federico; Scandroglio, Ildo; Berti, Stefano; Cadeo, Alessandro; Filippelli, Alice; Conti, Luigi; Grassi, Carmine; Cattaneo, Gaetano Maria; Pighin, Marina; Papis, Davide; Gambino, Giovanni; Bertino, Vanessa; Schifano, Domenico; Prando, Daniela; Fogato, Luisella; Cavallo, Fabio; Ansaloni, Luca; Picheo, Roberto; Pontarolo, Nicholas; Depalma, Norma; Spampinato, Marcello; D'Ugo, Stefano; Lepre, Luca; Capponi, Michela Giulii; Campa, Rossella Domenica; Sarro, Giuliano; Dinuzzi, Vincenza Paola; Olmi, Stefano; Uccelli, Matteo; Ferrari, Davide; Inama, Marco; Moretto, Gianluigi; Fontana, Michele; Favi, Francesco; Picariello, Erika; Rampini, Alessia; Barberis, Andrea; Azzinnaro, Antonio; Oliva, Alba; Totaro, Luigi; Benzoni, Ilaria; Ranieri, Valerio; Capolupo, Gabriella Teresa; Carannante, Filippo; Caricato, Marco; Ronconi, Maurizio; Casiraghi, Silvia; Casole, Giovanni; Pantalone, Desire; Alemanno, Giovanni; Scheiterle, Maximilian; Ceresoli, Marco; Cereda, Marco; Fumagalli, Chiara; Zanzi, Federico; Bolzon, Stefano; Guerra, Enrico; Lecchi, Francesca; Cellerino, Paola; Ardito, Antonella; Scaramuzzo, Rosa; Balla, Andrea; Lepiane, Pasquale; Tartaglia, Nicola; Ambrosi, Antonio; Pavone, Giovanna; Palini, Gian Marco; Veneroni, Simone; Garulli, Gianluca; Ricci, Claudio; Torre, Beatrice; Russo, Iris Shari; Rottoli, Matteo; Tanzanu, Marta; Belvedere, Angela; Milone, Marco; Manigrasso, Michele; De Palma, Giovanni Domenico; Piccoli, Micaela; Pattacini, Gianmaria Casoni; Magnone, Stefano; Bertoli, Paolo; Pisano, Michele; Massucco, Paolo; Palisi, Marco; Luzzi, Andrea-Pierre; Fleres, Francesco; Clarizia, Guglielmo; Spolini, Alessandro; Kobe, Yoshiro; Toma, Takayuki; Shimamura, Fumihiko; Parker, Robert; Ranketi, Sinkeet; Mitei, Mercy; Svagzdys, Saulius; Pauzas, Henrikas; Zilinskas, Justas; Poskus, Tomas; Kryzauskas, Marius; Jakubauskas, Matas; Zakaria, Andee Dzulkarnaen; Zakaria, Zaidi; Wong, Michael Pak-Kai; Jusoh, Asri Che; Zakaria, Muhammad Nazreen; Cruz, Daniel Rios; Elizalde, Aurea Barbara Rodriguez; Reynaud, Alejandro Banon; Hernandez, Edgard Efren Lozada; Monroy, Jose Maria Victor Palomo; Hinojosa-Ugarte, Diego; Quiodettis, Martha; Du Bois, Maria Esther; Latorraca, Jose; Major, Piotr; Pedziwiatr, Michal; Pisarska-Adamczyk, Magdalena; Waledziak, Maciej; Kwiatkowski, Andrzej; Czyzykowski, Lukasz; da Costa, Silvia Dantas; Pereira, Bela; Ferreira, Ana Rita Oliveira; Almeida, Filipe; Rocha, Ricardo; Carneiro, Carla; Perez, Diego Pita; Carvas, Joao; Rocha, Catarina; Ferreira, Catia; Marques, Rita; Fernandes, Urania; Leao, Pedro; Goulart, Andre; Pereira, Rita Goncalves; Patrocinio, Sara Daniela Direito; de Mendonca, Nuno Goncalo Goncalves; Manso, Maria Isabel Cerqueira; Morais, Henrique Manuel Cardoso; Cardoso, Paulo Sebastiao; Calu, Valentin; Miron, Adrian; Toma, Elena Adelina; Gachabayov, Mahir; Abdullaev, Abakar; Litvin, Andrey; Nechay, Taras; Tyagunov, Alexander; Yuldashev, Anvar; Bradley, Alison; Wilson, Michael; Panyko, Arpad; Lateckova, Zuzana; Lacko, Vladimir; Lesko, Dusan; Soltes, Marek; Radonak, Jozef; Turrado-Rodriguez, Victor; Termes-Serra, Roser; Morales-Sevillano, Xavier; Lapolla, Pierfrancesco; Mingoli, Andrea; Brachini, Gioia; Degiuli, Maurizio; Sofia, Silvia; Reddavid, Rossella; Garberini, Andrea de Manzoni; Buffone, Angelica; del Pozo, Eduardo Perea; Aparicio-Sanchez, Daniel; Dos Barbeito, Sandra; Estaire-Gomez, Mercedes; Viton-Herrero, Rebeca; Gil Olarte-Marquez, Ma de los Angeles; Gil-Martinez, Jose; Alconchel, Felipe; Nicolas-Lopez, Tatiana; Rahy-Martin, Aida Cristina; Pelloni, Maria; Banolas-Suarez, Raquel; Mendoza-Moreno, Fernando; Nisa, Francisca Garcia-Moreno; Diez-Alonso, Manuel; Rodas, Maria Elisa Valle; Agundez, Maria Carmona; Perez Andres, Maria Inmaculada; Lopes Moreira, Claudia Cristina; Lizarazu Perez, Aintzane; Ponce, Inigo Augusto; Gonzalez-Castillo, Ana Maria; Membrilla-Fernandez, Estela; Salvans, Silvia; Serradilla-Martin, Mario; Pardo, Pablo Sancho; Rivera-Alonso, Daniel; Dziakova, Jana; Huguet, Jose Muguerza; Pages Valle, Naila; Colas Ruiz, Enrique; Rey Valcarcel, Cristina; Ruiz Moreno, Cristina; Moreno Salazar, Yeniffer Tatiana; Rubio Garcia, Juan Jesus; Mico, Silvia Sevila; Ruiz Lopez, Joaquin; Perez Farre, Silvia; Santamaria Gomez, Maite; Mestres Petit, Nuria; Titos-Garcia, Alberto; Aranda-Narvaez, Jose Manuel; Romacho-Lopez, Laura; Sanchez-Guillen, Luis; Aranaz-Ostariz, Veronica; Bosch-Ramirez, Marina; Martinez-Perez, Aleix; Martinez-Lopez, Elias; Sebastian-Tomas, Juan Carlos; Jimenez-Riera, Granada; Jimenez-Vega, Javier; Navas Cuellar, Jose Aurelio; Campos-Serra, Andrea; Munoz-Campana, Anna; Gracia-Roman, Raquel; Martinez Alegre, Javier; Lima Pinto, Francisca; O'Sullivan, Sara Nunez; Blanco Antona, Francisco; Munoz Jimenez, Beatriz; Lopez-Sanchez, Jaime; Gomez Carmona, Zahira; Torres Fernandez, Rocio; Blesa Sierra, Isabel; Roman Garcia de Leon, Laura; Polaino Moreno, Veronica; Iglesias, Eva; Lora Cumplido, Paola; Arango Bravo, Altea; Rey Simo, Ignacio; Lopez Dominguez, Carlota; Guerreiro Caamano, Aloia; Calleja Lozano, Rafael; Duran Martinez, Manuel; Naranjo Torres, Alvaro; Morales Bernaldo de Quiros, Javier Tomas; Pellino, Gianluca; Cloquell, Miriam Moratal; Garcia Moller, Elsa; Jalal-Eldin, Sami; Abdoun, Ahmed K.; Hamid, Hytham K. S.; Lohsiriwat, Varut; Mongkhonsupphawan, Aitsariya; Baraket, Oussama; Ayed, Karim; Abbassi, Imed; Ben Ali, Ali; Ammar, Houssem; Kchaou, Ali; Tlili, Ahmed; Zribi, Imen; Colak, Elif; Polat, Suleyman; Koylu, Zehra Alan; Guner, Ali; Usta, Mehmet Arif; Reis, Murat Emre; Mantoglu, Baris; Gonullu, Emre; Akin, Emrah; Altintoprak, Fatih; Bayhan, Zulfu; Firat, Necattin; Isik, Arda; Memis, Ufuk; Bayrak, Mehmet; Altintas, Yasemin; Kara, Yasin; Bozkurt, Mehmet Abdussamet; Kocatas, Ali; Das, Koray; Seker, Ahmet; Ozer, Nazmi; Atici, Semra Demirli; Tuncer, Korhan; Kaya, Tayfun; Ozkan, Zeynep; Ilhan, Onur; Agackiran, Ibrahim; Uzunoglu, Mustafa Yener; Demirbas, Eren; Altinel, Yuksel; Meric, Serhat; Hacim, Nadir Adnan; Tebala, Giovanni D.; Khalil, Hany; Rana, Mridul; Khan, Mansoor; Florence, Charlotte; Swaminathan, Christie; Leo, Cosimo Alex; Liasis, Lampros; Watfah, Josef; Trostchansky, Ivan; Delgado, Edward; Pontillo, Marcelo; Latifi, Rifat; Coimbra, Raul; Edwards, Sara; Lopez, Ana; Velmahos, George; Dorken, Ander; Gebran, Anthony; Palmer, Amanda; Oury, Jeffrey; Bardes, James M.; Seng, Sirivan Suon; Coffua, Lauren S.; Ratnasekera, Asanthi; Egodage, Tanya; Echeverria-Rosario, Karla; Armento, Isabella; Napolitano, Lena M.; Sangji, Naveen F.; Hemmila, Mark; Quick, Jacob A.; Austin, Tyler R.; Hyman, Theodore S.; Curtiss, William; McClure, Amanda; Cairl, Nicholas; Biffl, Walter L.; Truong, Hung P.; Schaffer, Kathryn; Reames, Summer; Banchini, Filippo; Capelli, Patrizio; Coccolini, Federico; Sartelli, Massimo; Bravi, Francesca; Vallicelli, Carlo; Agnoletti, Vanni; Baiocchi, Gian Luca; Catena, Fausto; N/A; Uymaz, Derya Salim; Omarov, Nail; Balık, Emre; School of Medicine; Koç University Hospital
    Background: Literature suggests colonic resection and primary anastomosis (RPA) instead of Hartmann's procedure (HP) for the treatment of left-sided colonic emergencies. We aim to evaluate the surgical options globally used to treat patients with acute left-sided colonic emergencies and the factors that leading to the choice of treatment, comparing HP and RPA. Methods: This is a prospective, international, multicenter, observational study registered on ClinicalTrials.gov. A total 1215 patients with left-sided colonic emergencies who required surgery were included from 204 centers during the period of March 1, 2020, to May 31, 2020. with a 1-year follow-up. Results: 564 patients (43.1%) were females. The mean age was 65.9 +/- 15.6 years. HP was performed in 697 (57.3%) patients and RPA in 384 (31.6%) cases. Complicated acute diverticulitis was the most common cause of left-sided colonic emergencies (40.2%), followed by colorectal malignancy (36.6%). Severe complications (Clavien-Dindo >= 3b) were higher in the HP group (P < 0.001). 30-day mortality was higher in HP patients (13.7%), especially in case of bowel perforation and diffused peritonitis. 1-year follow-up showed no differences on ostomy reversal rate between HP and RPA. (P = 0.127). A backward likelihood logistic regression model showed that RPA was preferred in younger patients, having low ASA score (<= 3), in case of large bowel obstruction, absence of colonic ischemia, longer time from admission to surgery, operating early at the day working hours, by a surgeon who performed more than 50 colorectal resections. Conclusions: After 100 years since the first Hartmann's procedure, HP remains the most common treatment for left-sided colorectal emergencies. Treatment's choice depends on patient characteristics, the time of surgery and the experience of the surgeon. RPA should be considered as the gold standard for surgery, with HP being an exception.
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    Can TRIF/TICAM-1 dependent pathway be target pathway in lumbar intervertebral disc degeneration?
    (Turkish Neurosurgical Society, 2023) ALIZADA, Orkhan; AKYOL, Sibel; OZLEN, Fatma; CETINTAS, Semih Can; TURK, Okan; HANCI, Murat; N/A; Akgün, Mehmet Yiğit; N/A; Koç University Hospital
    AIM: To elucidate the role of the TIR-domain-containing adaptor-inducing interferon-β (TRIF) dependent pathway in intervertebral disc degeneration (IVD). MATERIAL and METHODS: A total of adult male patients with low back pain (LBP) (+/- radicular pain) were further evaluated by magnetic resonance imaging (MRI) with surgical indication for microscopic lumbar disc herniation (LDH). Preoperatively, patients were classified according to Modic Changes (MC), nonsteroidal anti-inflammatory drugs (NSAIDs) use, and the presence of radicular pain in addition to the LBP. RESULTS: The age of the 88 patients ranged from 19 to 75 years (mean: 47.3 ± 19.6 years). Twenty eight of the patients were evaluated as MC I (31.8%), 40 as MC II (45.4%), and 20 as MC III (22.7%). The majority of patients (81.8%) had radicular LBP, while 16 patients (18.1%) had only LBP. Predominantly, 55.6% of all patients were taking NSAIDs. Levels of all adaptor molecules were highest in the MC I group and lowest in the MC III group. The levels of IRF3, TICAM1, TICAM2, NF-kB p65, TRAF6, and TLR4 were significantly increased in the MC I group compared to the MC II and MC III groups. The variations of the individual adaptor molecules showed no statistically significant difference in the use of NSAIDs and radicular LBP. CONCLUSION: As a result of the impact assessment, the current study clearly demonstrated for the first time that the TRIF-dependent signalling pathway plays a crucial role in the degeneration process in human lumbar intervertebral disc specimens. © 2023. All Right Reserved.
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    Is the modular dynamic system as effective as classical dynamic systems in long segment dynamic thoracolumbar stabilization?
    (Turkish Neurosurgical Society, 2024) N/A; Günerbüyük, Caner; Akgün, Mehmet Yiğit; Özer, Ali Fahir; School of Medicine; Koç University Hospital
    AIM: To evaluate the outcomes of dynamic stabilization in the multilevel degenerative spondylotic spine, and to compare the two dynamic systems (Dynesys (R) and Orthrus (R)) to reveal the increasing role of dynamic systems in the management of the degenerative spine. MATERIAL and METHODS: A total of 74 patients who received dynamic stabilization for degenerative pathologies were retrospectively analyzed. Demographic details: preoperative data including neurological status, pain scores, and radiology; and intraoperative data including blood loss, duration of surgery, complications, and postoperative data including the neurologic status, duration of hospital stay, and pain scores were examined. RESULTS: Patients in both groups showed statistically significant improvements in their Visual Analog Scale and Oswestry Disability Index scores. Significant corrections of thoracic kyphosis (T2 -T12), the sagittal vertical axis, and T10 -L2 thoracolumbar kyphosis were obtained in our cohort (p<0.05). A total of 4 patients received revision surgery due to screw loosening. Patients were discharged after 3-4 days and mobilized on the first postoperative day. CONCLUSION: We did not experience any serious issues in terms of stabilization in the cases in which we employed both systems. Our patients' clinical results were satisfactory in both systems. Existing systems can be used safely even in long -segment stabilization surgeries.
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    Transient ageusia and dysgeusia following thalamic cyst drainage
    (Turkish Neurosurgical Society, 2024) N/A; Nokay, Aziz Emre; Erden, Mert Emre; Samancı, Mustafa Yavuz; Peker, Selçuk; School of Medicine
    Taste consists of sensation and perception. Specific neural structures transmit a stimulus from the taste buds to the gustatory cortex to generate taste sensation. Any disruption of this pathway, whether it affects sensation or perception, can result in taste disorders. Stereotactic procedures involving the thalamus may result in gustatory complications. A 41-year-old female patient who underwent stereotactic drainage of a thalamic cyst suffered transient ageusia. Subsequently, she developed metallic taste perception. When her stereotactic plan was re-evaluated, it was noted that the posteromedial ventral thalamus nucleus was in the path of the needle tract and the needle had passed through it. Follow-up was recommended and her symptoms completely resolved within 2 months following surgery. Modern imaging techniques allow for the visualization of neural structures related to the sense of taste. Additionally, care must be taken when planning stereotactic procedures for such lesions.
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    Should calcineurin inhibitors/sirolimus be ceased completely in posterior reversible encephalopathy syndrome?
    (Elsevier Science Inc, 2024) N/A; Karataş, Cihan; Akyollu, Başak; Arpalı, Emre; Koçak, Burak; School of Medicine; Koç University Hospital
    Background. To investigate the relationship between immunosuppressive treatments and posterior reversible encephalopathy syndrome (PRES) in transplant patients. Methods. We presented a retrospective study of 4 cases of PRES in transplant patients. Patient records were reviewed to identify potential risk factors, clinical presentations, radiological find- ings, and immunosuppressive treatments used. Results. Our analysis revealed a potential association between immunosuppressive treatments and the development of PRES in transplant patients. Specifically, we found that adjusting or switching immunosuppressive treatments can improve outcomes and prevent the recurrence of PRES. Conclusion. Our findings highlight the importance of recognizing PRES as a potential complication of immunosuppressive treatments in transplant patients. Early detection and management, including a review of immunosuppressive treatments, may improve patient outcomes and prevent further complications.
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    New tools for data harmonization and their potential applications in organ transplantation
    (Lippincott Williams and Wilkins, 2024) Foster, Bethany Joy; N/A; Tabatabaei Hosseini, Seyed Amir; Kazemzadeh, Reza; Arpalı, Emre; Süsal, Caner; Koç University Transplant Immunology Research Centre of Excellence (TIREX); School of Medicine; Graduate School of Sciences and Engineering; Koç University Hospital
    In organ transplantation, accurate analysis of clinical outcomes requires large, high-quality data sets. Not only are outcomes influenced by a multitude of factors such as donor, recipient, and transplant characteristics and posttransplant events but they may also change over time. Although large data sets already exist and are continually expanding in transplant registries and health institutions, these data are rarely combined for analysis because of a lack of harmonization. Promoted by the digitalization of the healthcare sector, effective data harmonization tools became available, with potential applications also for organ transplantation. We discuss herein the present problems in the harmonization of organ transplant data and offer solutions to enhance its accuracy through the use of emerging new tools. To overcome the problem of inadequate representation of transplantation-specific terms, ontologies and common data models particular to this field could be created and supported by a consortium of related stakeholders to ensure their broad acceptance. Adopting clear data-sharing policies can diminish administrative barriers that impede collaboration between organizations. Secure multiparty computation frameworks and the artificial intelligence (AI) approach federated learning can facilitate decentralized and harmonized analysis of data sets, without sharing sensitive data and compromising patient privacy. A common image data model built upon a standardized format would be beneficial to AI-based analysis of pathology images. Implementation of these promising new tools and measures, ideally with the involvement and support of transplant societies, is expected to produce improved integration and harmonization of transplant data and greater accuracy in clinical decision-making, enabling improved patient outcomes.
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    Corrigendum: thrombotic microangiopathy in the renal allograft: results of the tma banff working group consensus on pathologic diagnostic criteria
    (Frontiers Media Sa, 2023) Afrouzian, Marjan; Kozakowski, Nicolas; Liapis, Helen; Broecker, Verena; Truong, Luon; Avila-Casado, Carmen; Regele, Heinz; Seshan, Surya; Ambruzs, Josephine M.; Farris, Alton Brad; Buob, David; Chander, Praveen N.; Cheraghvandi, Lukman; Clahsen-van Groningen, Marian C.; Araujo, Stanley de Almeida; Formby, Mark; Ljubanovic, Danica Galesic; Hernandez, Loren Herrera; Honsova, Eva; Mohamed, Nasreen; Ozluk, Yasemin; Rabant, Marion; Royal, Virginie; Stevenson, Heather L.; Toniolo, Maria Fernanda; Taheri, Diana; N/A; Baydar, Dilek Ertoy; School of Medicine