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Öğe Bilateral ultrasound-guided erector spinae plane block for postoperative persistent low back pain in lumbar disc surgery(Springer, 2022) Akyuz, Mehmet Emin; Firidin, Mustafa NevzatBackground Persistent low back pain is an important disability after lumbar disc surgery. Erector spinae plane block (ESPB) is highly effective in providing post-surgical pain control, but its effectiveness in long-term persistent low back pain has not been investigated. The aim of this randomized controlled trial was to investigate the effect of ESPB on the reduction of persistent low back pain after surgery. Methods 162 patients who were operated for lumbar disc herniation under spinal anaesthesia were divided into two groups according to the following criteria; ESPB block group (Group A); applied before surgery and 1 month after surgery and non-ESPB block group (Group B). The preoperative and postoperative 6th month Visual Analogue Scale (VAS), Oswestry Low Back Pain Disability Questionnaire (ODI) and Japan Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) scores of the patients were evaluated, and it was examined whether there was a difference. Results In two groups with similar patient characteristics and no significant difference in preoperative pain scores, a significant improvement was observed in pain scores in Group A compared to Group B at the end of the 6th month. Conclusions ESPB, which has a low risk of complications and is simple to perform, has been found useful in the treatment of persistent low back pain after disc surgery.Öğe Effect of resveratrol on the changes in the cerebellum in traumatic brain injury(Science Printers and Publishers Inc., 2021) Firidin, Mustafa NevzatOBJECTIVE: To study the effects of resveratrol in neuronal structures in traumatic brain injury (TBI). STUDY DESIGN: Thirty rats were categorized as (1) control group (n=10), saline solution administered i.p. for 14 days, (2) TBI group (n=10), trauma induced by weight-drop model on brain, and (3) TBI+Resveratrol group (n=10), 15 minutes after injury the rats were given resveratrol (10 ?moL/kg/i.p.) for 14 days. At the end of the experiment the cerebellum was excised for routine paraffin tissue protocol. Blood samples were tested for serum biochemical markers (MDA, SOD, CAT, and GSH-x). RESULTS: SOD, GPx, and CAT values were lowest in the TBI group. MDA and histological scores of dilations in vessels, inflammation, degeneration in neurons, apoptosis in microglia, ADAMTS8, and GFAP expressions were highest in the TBI group. Sections of the control group showed normal cerebellar histology. The trauma group showed degenerated ganglion layer, pyknotic and apoptotic Purkinje cell nuclei. Vascular thrombus was seen in the substantia alba and substantia grisea. In the Trauma+Resveratrol group, most pathologies observed in the TBI group were improved. In the control group, GFAP protein was expressed in granular cells, axons, dendrites, Purkinje cells, and microglia cells. In the trauma group, increased GFAP expression was observed in glial processes, neurons, and Purkinje cells. In the Trauma+Resveratrol group, GFAP was expressed in molecular layer and glial processes. In the control group, ADAMTS-4 activity was observed in granulosa layer, glial cells, and Purkinje cells. In the trauma group, ADAMTS-4 expression was positive in Purkinje cells and glial cells. In the Trauma+ Resveratrol group, ADAMTS-4 was expressed in Purkinje cells, granular cells, and glial cells. CONCLUSION: GFAP and ADAMTS-4 proteins may be involved in regeneration of damaged astroglial cells and other glial cells, Purkinje cells, and synaptic extensions. We suggest that antioxidative drugs such as resveratrol may be alternative target agents in neurological disease. © Science Printers and Publishers, Inc.Öğe Effect of Resveratrol on the Changes in the Cerebellum in Traumatic Brain Injury(Sci Printers & Publ Inc, 2021) Firidin, Mustafa NevzatOBJECTIVE: To study the effects of resveratrol in neuronal structures in traumatic brain injury (TBI). STUDY DESIGN: Thirty rats were categorized as (1) control group (n=10), saline solution administered i.p. for 14 days, (2) TBI group (n=10), trauma induced by weight-drop model on brain, and (3) TBI+ Resveratrol group (n=10), 15 minutes after injury the rats were given resveratrol (10 mu moL/kg/i.p.) for 14 days. At the end of the experiment the cerebellum was excised for routine paraffin tissue protocol. Blood samples were tested for serum biochemical markers (MDA, SOD, CAT, and GSH-x). RESULTS: SOD, GPx, and CAT values were lowest in the TBI group. MDA and histological scores of dilations in vessels, inflammation, degeneration in neurons, apoptosis in microglia, ADAMTS8, and GFAP expressions were highest in the TBI group. Sections of the control group showed normal cerebellar histology. The trauma group showed degenerated ganglion layer, pyknotic and apoptotic Purkinje cell nuclei. Vascular thrombus was seen in the substantia alba and substantia grisea. In the Trauma+ Resveratrol group, most pathologies observed in the TBI group were improved. In the control group, GFAP protein was expressed in granular cells, axons, dendrites, Purkinje cells, and microglia cells. In the trauma group, increased GFAP expression was observed in glial processes, neurons, and Purkinje cells. In the Trauma+ Resveratrol group, GFAP was expressed in molecular layer and glial processes. In the control group, ADAMTS-4 activity was observed in granulosa layer, glial cells, and Purkinje cells. In the trauma group, ADAMTS-4 expression was positive in Purkinje cells and glial cells. In the Trauma+ Resveratrol group, ADAMTS-4 was expressed in Purkinje cells, granular cells, and glial cells. CONCLUSION: GFAP and ADAMTS-4 proteins may be involved in regeneration of damaged astroglial cells and other glial cells, Purkinje cells, and synaptic extensions. We suggest that antioxidative drugs such as resveratrol may be alternative target agents in neurological disease.Öğe Preoperative and postoperative diagnostic efficiency of multi-inflammatory index on pain scoring of degenerated intervertebral disc(Wroclaw Medical Univ, 2022) Firidin, Mustafa Nevzat; Akyuz, Mehmet EminBackground. The inflammatory index can be useful for neurosurgeons to understand and grade pain in degenerated intervertebral disc (DIVD). Objectives. The study focused on the value of the platelet-to-lymphocyte ratio (PLR), neutrophil-tolymphocyte ratio (NLR) and the inflammatory multiple indices (MIs), and aimed to compare its efficiency with the preoperative and postoperative pain scale and scoring algorithms. Materials and methods. A total of 88 DIVD patients were included in this retrospective clinical cohort study. Visual Analogue Scale Back (VASB) and Visual Analogue Scale Leg (VASL), Oswestry Disability Index (ODI), Roland-Morris Disability Questionnaire (RMDQ), and walking distance (WD) were used to assess pain. The multiple index (MI) was calculated as MI-1 = PLR x C-reactive protein (CRP) and MI-2 = NLR x CRP. Results. Comparing the MI with ODI, no correlation was found in preoperative values, while a positive correlation (MI-1: r = 0.398, p < 0.001; MI-2: r = 0.285; p = 0.007) was found between the postoperative measurements. A significant correlation was found for VASB and both MI-1 (preoperative: r = 0.373, p = 0.001; postoperative: r = 0.232, p = 0.041) and MI-2 (preoperative: r = 0.388, p < 0.001; postoperative: r = 0.206, p = 0.044). The MI-1 index showed 71.4% sensitivity and 73.3% specificity, while the MI-2 index exhibited 78.6% sensitivity and 68.9% specificity. Conclusions. MI-1 and MI-2 showed a positive correlation with pre- and post- operative VASB score and had strong potential to predict postoperative pain in DIVD. They are easy-to-use, noninvasive and low-cost indices; therefore, our results are promising for routine application.Öğe Prophylactic Effects of Honokiol on Spinal Cord in Rats(Sci Printers & Publ Inc, 2021) Firidin, Mustafa Nevzat; Akyuz, Mehmet EminOBJECTIVE: To investigate the prophylactic effect of the antioxidative honokiol on neuron and glial cells in the spinal cord after spinal cord injury biochemically and immunohistochemically. STUDY DESIGN: Twenty Wistar Albino rats were categorized as control and SCI groups. At T10-T11 vertebras, a steel rod was dropped from 10 cm to create a spinal cord injury under anesthesia. Spinal cord injury was created by dropping a 15-gram metal weight down the tube. Immediately after the trauma, 20 mg/kg hono-kiol was administered orally for 7 days. At the end of the experiment, blood samples were taken from the animals and analyzed with various biochemical markers. The spinal cord was excised for routine paraffin tissue protocol. Hematoxylin-eosin stain was used for histol-ogical examination, and caspase-3 and PSTAT-3 anti-bodies were used for immunohistochemistry. RESULTS: MDA, GSH, and MPO values in control, spinal cord injury, and spinal cord injury+ honokiol groups were compared. Both MDA and MPO values were increased in the SCI group as compared with the control and SCI+ honokiol groups, and the increase was statistically significant. GSH content was decreased in the SCI group as compared with the control and SCI+ honokiol groups, and the decrease was statistically sig-nificant. In spinal cord injury, degenerative changes in multipolar and bipolar neurons, dilation and thrombosis in the blood vessels, and increased inflammation were observed. Honokiol administration showed a significant increase in chromatin in canalis ependymalis cells and a decrease in degeneration in multipolar and bipolar neurons. Positive PSTAT-3 expression was observed in multipolar neurons in trauma and diffuse glial cells in the anterior horn and blood vessel endothelial cells. Pos-itive PSTAT-3 expression was observed in ependymal cells and solitary dispersed glial cells, weak PSTAT-3 expression in multipolar and bipolar neuron cells in the honokiol group. An increase in caspase-3 expression in multipolar cells and a positive caspase-3 reaction in solitary glial cells were observed in trauma. Negative caspase-3 activity was observed in canalis ependymalis cells and many glial cells in the honokiol group. CONCLUSION: After traumatic spinal cord injury, degenerative, apoptotic changes in neuron and glial cells developed with increased inflammation and thrombosis in blood vessels. Lipid peroxidation induced damage due to the increase in oxidative stress. Honokiol admin-istration stimulated the reduction of oxidative stress, inflammation, and angiogenetic effect in blood vessels. It is thought that it has a positive effect on the stimulation of apoptotic signals in neuron and glial cells in trauma injury.Öğe Prophylactic Effects of Honokiol on Spinal Cord Injury in Rats(Science Printers and Publishers Inc., 2021) Firidin, Mustafa Nevzat; Akyüz, Mehmet EminOBJECTIVE: To investigate the prophylactic effect of the antioxidative honokiol on neuron and glial cells in the spinal cord after spinal cord injury biochemically and immunohistochemically. STUDY DESIGN: Twenty Wistar Albino rats were categorized as control and SCI groups. At T10-T11 vertebras, a steel rod was dropped from 10 cm to create a spinal cord injury under anesthesia. Spinal cord injury was created by dropping a 15-gram metal weight down the tube. Immediately after the trauma, 20 mg/kg honokiol was administered orally for 7 days. At the end of the experiment, blood samples were taken from the animals and analyzed with various biochemical markers. The spinal cord was excised for routine paraffin tissue protocol. Hematoxylin-eosin stain was used for histological examination, and caspase-3 and PSTAT-3 antibodies were used for immunohistochemistry. RESULTS: MDA, GSH, and MPO values in control, spinal cord injury, and spinal cord injury+honokiol groups were compared. Both MDA and MPO values were increased in the SCI group as compared with the control and SCI+honokiol groups, and the increase was statistically significant. GSH content was decreased in the SCI group as compared with the control and SCI+ honokiol groups, and the decrease was statistically significant. In spinal cord injury, degenerative changes in multipolar and bipolar neurons, dilation and thrombosis in the blood vessels, and increased inflammation were observed. Honokiol administration showed a significant increase in chromatin in canalis ependymalis cells and a decrease in degeneration in multipolar and bipolar neurons. Positive PSTAT-3 expression was observed in; multipolar neurons in trauma and diffuse glial cells in the anterior horn and blood vessel endothelial cells. Positive PSTAT-3 expression was observed in ependymal cells and solitary dispersed glial cells, weak PSTAT-3 expression in multipolar and bipolar neuron cells in the honokiol group. An increase in caspase-3 expression in multipolar cells and a positive caspase-3 reaction in solitary glial cells were observed in trauma. Negative caspase-3 activity was observed in canalis ependymalis cells and many glial cells in the honokiol group. CONCLUSION: After traumatic spinal cord injury, degenerative, apoptotic changes in neuron and glial cells developed with increased inflammation and thrombosis in blood vessels. Lipid peroxidation induced damage due to the increase in oxidative stress. Honokiol administration stimulated the reduction of oxidative stress, inflammation, and angiogenetic effect in blood vessels. It is thought that it has a positive effect on the stimulation of apoptotic signals in neuron and glial cells in trauma injury © Science Printers and Publishers, Inc.
