ABSTRACT
PURPOSE: The scar tissue that forms after lumbar dissection is a severe complication and a cause of lumbar and radicular pain. It was recently shown that radiotherapy could inhibit peridural fibrosis after laminectomy. In this study, the efficiency of external irradiation was compared with spinal membrane application. METHOD AND MATERIALS: Thirty male New Zealand rabbits underwent L5 laminectomy. Ten rabbits each received a single fraction of 900-cGy external irradiation administered by 9-MeV electron beam 24 h after the surgery. Ten other rabbits each had spinal membrane applied during laminectomy. The remaining 10 rabbits constituted the control group. All of the rabbits were killed 30 days after the laminectomy. Axial histologic sections through the laminectomy defect were evaluated. Each specimen was scored for the extent and density of fibrosis and arachnoidal adherence. RESULTS: The extent and density of fibrosis and arachnoidal adherence differed significantly between the control group and the treatment groups (p < 0.05). However, the extent and density of fibrosis and arachnoidal adherence did not differ significantly between the spinal membrane and irradiation groups (p > 0.05). CONCLUSION: This preliminary study showed that high-single-fraction/low-total-dose administered postoperatively can successfully inhibit postsurgical epidural fibrosis as effectively as applied spinal membrane.
Subject(s)
Cicatrix/prevention & control , Laminectomy/adverse effects , Postoperative Complications/prevention & control , Animals , Cell Count , Cicatrix/radiotherapy , Fibrosis/etiology , Fibrosis/prevention & control , Lumbosacral Region , Male , Membranes/transplantation , Postoperative Complications/pathology , Postoperative Complications/radiotherapy , Rabbits , Radiobiology , Random Allocation , Tissue Adhesions/pathologyABSTRACT
Oxygen free radicals may be implicated in the pathogenesis of ischemia-reperfusion damage. It is known that 2-chloroadenosine (2-CADO) has neuromodulatory effects and prevents the neuronal damage seen in the period of postischemia reperfusion. However, direct effects of 2-CADO on lipid peroxidation have not been investigated previously. The attack on the cell membrane by free radicals leads to lipid peroxidation, which can be assayed by the malondialdehyde (MDA) level. The aim of this study was to determine the effect of 2-CADO therapy on lipid peroxidation in experimental forebrain ischemia and postischemia reperfusion in Mongolian gerbils. Cerebral ischemia was induced by a bilateral 30-mm occlusion of the common carotid arteries. 2-Chloroadenosine (0.6 mg/kg, IV) was administered 5 min subsequent to ischemia. Ischemia was followed by reperfusion for 30 min. The MDA level was measured by the thiobarbituric acid (TBA) test. Bilateral carotid artery occlusion for 30 min in gerbils resulted in no significant change in MDA level in the brain. The MDA level was higher in postischemia reperfusion than in the ischemic group. 2-Chloroadenosine treatment did not change the MDA level in the ischemic period. However, the MDA level recovered significantly upon 2-CADO therapy during reperfusion following ischemia. These results suggest that 2-CADO may offer some degree of protection against oxidative stress in cerebral ischemia-reperfusion damage.
Subject(s)
2-Chloroadenosine/therapeutic use , Lipid Peroxidation/drug effects , Lipid Peroxides/metabolism , Neuroprotective Agents/therapeutic use , Prosencephalon/drug effects , Reperfusion Injury/prevention & control , Animals , Drug Evaluation, Preclinical , Female , Gerbillinae , Male , Malondialdehyde/metabolism , Prosencephalon/blood supply , Prosencephalon/pathology , Reperfusion Injury/metabolism , Thiobarbiturates/metabolismABSTRACT
The effect of 2-chloroadenosine, stable adenosine analog, and deoxycoformycin, adenosine deaminase inhibitor on brain ATP level and Na-K ATPase activity in ischemia were studied. The brain ATP level was increased after we administered both 2-chloroadenosine and deoxycoformycin, but Na-K ATPase activity did not change after deoxycoformycin. The results suggest that 2-chloroadenosine treatment influenced both the ATP production and membrane permeability due to cerebral ischemia. Deoxycoformycin did not protect the membrane permeability, although it increased the ATP production.
Subject(s)
2-Chloroadenosine/pharmacology , Adenosine Triphosphate/metabolism , Brain Ischemia/drug therapy , Nerve Tissue Proteins/metabolism , Neuroprotective Agents/pharmacology , Pentostatin/pharmacology , Sodium-Potassium-Exchanging ATPase/metabolism , 2-Chloroadenosine/therapeutic use , Adenosine Deaminase/physiology , Adenosine Deaminase Inhibitors , Animals , Brain Damage, Chronic/etiology , Brain Damage, Chronic/prevention & control , Brain Ischemia/complications , Brain Ischemia/metabolism , Cell Membrane Permeability/drug effects , Drug Evaluation, Preclinical , Enzyme Inhibitors/pharmacology , Enzyme Inhibitors/therapeutic use , Female , Gerbillinae , Male , Nerve Tissue Proteins/antagonists & inhibitors , Neuroprotective Agents/therapeutic use , Pentostatin/therapeutic useABSTRACT
T1. The effect of 2-chloroadenosine, an adenosine analogue, on brain ATP level and Na,K ATPase activity in ischemia and reperfusion was studied. 2. Na,K ATPase activity decreased in both ischemia and reperfusion. Although the ATP level decreased in ischemia, it increased with reperfusion (P < 0.05). 3. It is concluded that 2-chloroadenosine treatment influenced ATP production and Na,K ATPase activity in ischemia and reperfusion (P < 0.05).
Subject(s)
2-Chloroadenosine/pharmacology , Adenosine Triphosphate/metabolism , Brain Ischemia/drug therapy , Sodium-Potassium-Exchanging ATPase/metabolism , Animals , Brain/enzymology , Brain Ischemia/metabolism , Female , Gerbillinae , Male , Purinergic P1 Receptor Antagonists , ReperfusionABSTRACT
BACKGROUND: Fractures in the region of the sella turcica (ST) are usually associated with severe blunt head trauma and may produce many complications. The true incidence is difficult to assess since there have been only about 30 cases reported in the literature. METHODS: A total of 470 computed tomography (CT) sections--with optimum bone window images of skull bone--of 1600 head trauma patients who were admitted between 1979 and 1992, inclusive, to the Neurosurgery Department of Gazi University Medical School were analyzed retrospectively. RESULTS: There were a total of 17 patients with a fracture of the ST, constituting an incidence of 3.6%, and there was a preponderance of children. CONCLUSIONS: Computed tomography was very helpful in assessing the extent of ST fractures. In our cases, these fractures were not associated with a high complication or death rate, although a cerebrospinal fluid fistula was present in 53%.
Subject(s)
Sella Turcica/injuries , Skull Fractures/diagnosis , Adolescent , Adult , Female , Humans , Male , Middle Aged , Retrospective StudiesABSTRACT
We present 31 patients whose diagnoses were established by the aid of computed tomographic ventriculography. The indications for and diagnostic value of this method are reviewed.
Subject(s)
Brain/diagnostic imaging , Cerebral Ventriculography/methods , Adolescent , Adult , Child , Child, Preschool , Contrast Media , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Tomography, X-Ray ComputedABSTRACT
1. In the present study we have studied the effects of deferoxamine treatment on lipid peroxidation and Na-K ATPase activity after experimental induction of subarachnoid haemorrhage (SAH) in guinea pigs. 2. We assessed the extent of lipid peroxidation by measuring the level of malondialdehyde and Na-K ATPase activity in 3 different groups (sham-operated, SAH, SAH + deferoxamine). 3. There was no significant difference in lipid peroxide content between sham-operated and haemorrhagic animals, but Na-K ATPase activity decreased after SAH. 4. Deferoxamine treatment reduced the malondialdehyde content and induced the recovery of Na-K ATPase activity, exerting a brain protective role against the detrimental effects of the haemorrhage.
Subject(s)
Brain/drug effects , Deferoxamine/pharmacology , Lipid Peroxides/metabolism , Sodium-Potassium-Exchanging ATPase/drug effects , Subarachnoid Hemorrhage/drug therapy , Animals , Brain/metabolism , Disease Models, Animal , Female , Guinea Pigs , Male , Subarachnoid Hemorrhage/metabolismABSTRACT
A prospective analysis of 153 cases of head trauma was conducted with respect to their white blood cell counts. A white blood cell count exceeding 20 x 10(6)/l is associated with a poor clinical grade on admission and with a 96% mortality as opposed to that of a 23% mortality for those with slightly lower or slightly above normal white blood cell count. The sensitivity for this level is a mortality of 96% while the specificity is 77%.
Subject(s)
Brain Injuries/immunology , Leukocyte Count , Leukocytosis/immunology , Adolescent , Adult , Aged , Brain Injuries/mortality , Female , Glasgow Coma Scale , Humans , Leukocytosis/mortality , Male , Middle Aged , Prognosis , Prospective Studies , Survival Rate , Treatment OutcomeSubject(s)
Atlanto-Axial Joint/injuries , Head Injuries, Closed/diagnostic imaging , Joint Dislocations/diagnostic imaging , Tomography, X-Ray Computed , Accidents, Traffic , Atlanto-Axial Joint/surgery , Bone Wires , Child, Preschool , Female , Follow-Up Studies , Glasgow Coma Scale , Head Injuries, Closed/surgery , Humans , Joint Dislocations/surgery , Joint Instability/diagnostic imaging , Joint Instability/surgery , Neurologic Examination , Postoperative Complications/diagnostic imaging , Spinal FusionABSTRACT
Among the patients with a cervical injury admitted to our clinic between 1980 and 1988, 18 cases underwent a ventral fusion operation (Cloward) and 8 of them needed additional vertebrectomy. The injury in all of these cases was due to falls and presented with major compression fractures. In each case the vertebral body was resected and replaced by a "T" shaped iliac bone graft. The graft was fixated by a screw or wire when necessary, than the patients were immobilized by a bed rest for 2 weeks duration. During the follow-up period, cervical alignment was found to be stable in all patients. The radiological characteristics of the lesions, intraoperative surgical modifications for specific aspects of the lesion, other technical availabilities and the results are discussed.
Subject(s)
Bone Transplantation/methods , Cervical Vertebrae/injuries , Spinal Fractures/surgery , Spinal Fusion , Adolescent , Adult , Cervical Vertebrae/diagnostic imaging , Cervical Vertebrae/surgery , Female , Humans , Joint Instability/diagnosis , Joint Instability/etiology , Joint Instability/surgery , Male , Radiography , Retrospective Studies , Spinal Fractures/complications , Spinal Fractures/diagnostic imaging , Transplantation, AutologousABSTRACT
We describe a new computer-based, automated method for the assessment of in vivo cerebral vasospasm. Arterial diameter measurements were performed on post-processed digital substraction angiographic images, using "pixel" as the unit. Vasospasm which was difficult to detect by visual inspection could be measured by the "stenosis quantification" program. A computer-assisted method such as we describe might decrease the risk of subjective errors.
Subject(s)
Angiography, Digital Subtraction/instrumentation , Ischemic Attack, Transient/diagnostic imaging , Radiographic Image Interpretation, Computer-Assisted/instrumentation , Animals , Basilar Artery/diagnostic imaging , Endothelins/physiology , Female , Male , Rabbits , Software , Subarachnoid Hemorrhage/diagnostic imaging , Vertebrobasilar Insufficiency/physiopathologyABSTRACT
Fracture of the occipital condyle is a rare problem that can easily be overlooked. We report a patient with occipital condyle fracture who was neurologically intact on admission, and who developed hypoglossal nerve palsy in the late posttraumatic period. The diagnosis was facilitated by the aid of computed tomography.
