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Öğe Cerebro-spinal fluid shunt revisions, importance of the symptoms and shunt structure [Beyin-omurilik şant revizyonlari{dotless}, semptomlari{dotless}n ve şanti{dotless}n mekanik yapi{dotless}si{dotless}ni{dotless}n önemi](Turkish Neurosurgical Society, 2011) Turhan T.; Ersahin Y.; Dinc M.; Mutluer S.Aim: CSF shunt failure is still a frequent problem in children. This prospective study was designed for focusing symptoms and reasons of shunt failure. We also especially focused on the mechanical reasons of shunt failure. Material and Methods: We focused on the causes of shunt failures, and the symptoms and signs in patients who were operated for shunt malfunction between January 1, 2001 and December 31, 2005 in the neurosurgery department. All examination and operative data were collected prospectively. Evaluation of these data was with the chi-square and Fisher exact tests. RESULTS: After the evaluation of data on 111 patients and 153 revision procedures, the major symptoms in this group were vomiting (62.16%), somnolence (59.45%) and headache (48.64%). In the majority of the shunt revisions (115 operations, 75.2% of the all 153 procedures), one or more mechanical problems of the shunt systems were identified in surgery. Conclusion: Shunt failures in children sometimes appear with very unusual symptoms. Also, probable structural problems of the shunt systems seem very important for shunt failure according to patient characteristics and etiology of the hydrocephalus. A systematic approach including CT, shunt series and abdominal ultrasound is needed to rule out shunt malfunction.Öğe Characterizations of Riemannian maps between Kaehler manifolds by certain curves(Institute of Mathematics, University of Debrecen, 2024) Turhan T.; Tükel G.Ö.; Şahin B.Riemannian maps between Kaehler manifolds are studied with respect to certain curves. For this purpose, the geometric properties of the Riemannian maps themselves, the total manifold and the base manifold are investigated depending on the behavior of the geodesic, circle and Kaehler Frenet curves on the total manifold under Riemannian maps. © 2024 Institute of Mathematics, University of Debrecen. All rights reserved.Öğe Demographic and clinical features of child abuse and neglect cases: One-year experience of The Hospital-Based Child Protection Team of Ege University, Turkey [Çocuk istismari{dotless} ve ihmali olgulari{dotless}mi{dotless}zi{dotless}n demografik ve klinik özellikleri: Ege Üniversitesi Çocuk Koruma Birimi'nin bir yi{dotless}lli{dotless}k deneyimi](2012) Koç F.; Aksit S.; Tomba A.; Aydin C.; Koturoglu G.; Çetin S.K.; Aslan A.; Halicioglu O.; Erşahin Y.; Turhan T.; Çelik A.; Şenol E.; Kara S.; Solak U.Aim: Cases of child abuse and neglect (CAN) should be ideally managed by a multidisciplinary team. In the present study, our aim was to review the demographic and clinical features of cases of child abuse and neglect followed-up by the Child Protection Team of Ege University, Izmir, Turkey. Material and Method: The data of the cases of CAN referred to the multidisciplinary team of Ege University between August 2009 and 2010 were retrospectively reviewed. The demographic and clinical characteristics of the cases were summarized. Results: There were a total of 89 CAN cases evaluated by the team in our hospital during the last 12 months. The age of the cases ranged from 1 to 17 years, and 43 (48.3%) of them were male, while 46 (51.7%) were female. The sexual, physical and emotional abuse rates were 49%, 25% and 11% respectively, while 14% of them were diagnosed as pure neglect cases. The fathers were offenders in 67% of cases of physical abuse and in 9% of cases of sexual abuse. However, an extra-familial person was the perpetrator in 59% of the cases of sexual abuse. Conclusions: Recently, the number of reported CAN cases in our country has increased after the increase in the awareness of the public about this subject and multidisciplinary child protection teams have been established within hospitals. However, there is a long way to go, although remarkable improvements have been observed in the last decade.Öğe Determination of risk factors associated with colorectal cancer and compliance with fecal occult blood testing among patients aged 50 years and over in primary health care [Bi·ri·nci· basamakta 50 yaş ve üzeri· bi·reylerde kolorektal kanser i·le i·li·şki·li· olabi·lecek bazi faktörleri·n ve gai·tada gi·zli· kan tetki·ki·ne uyumun degerlendi·ri·lmesi·](2010) Acar-Vaizoglu S.; Turhan T.; Temel F.; Bolat Ö.; Baydar O.; Bacanli A.; Asarcikli F.; Güler Ç.Introduction: Our aim was to determine some risk factors for colorectal cancer, evaluate the knowledge about colorectal cancer among patients aged 50 years and over and their compliance with fecal occult blood test. Materials and Method: The study was conducted among 103 patients aged 50 years and over. Data were collected by a questionnaire form including 31 questions. Guaiac-based fecal occult blood test was used. Results: The mean age of participants was 58.5±7.3; 25.2% were males and 74.8% were females; 79.6% were married; 49.5% were graduates of primary school. Of the participants, 82.5% stated that none of their relatives were diagnosed with an intestinal disease. The mean colorectal cancer knowledge score was 7.3 ± 1.9. Six males and 13 females were diagnosed with anemia. 96.0% (71 patients) of the patients who brought their fecal specimen at least once, and 68.9% of the participants of the study completed the questionnaire form and brought fecal specimens on 3 consecutive days. Only one participant was positive for fecal occult blood test. Conclusion: Patients admitting to health centers should be informed on colorectal cancer, its risk factors and screening tests for early diagnosis. Compliance to fecal occult blood testing is relatively high in patients aged 50 and over, and it may be useful in primary care centers.Öğe The fourth case of Veillonella parvula meningoencephalitis diagnosed by stereotactic brain biopsy(Elsevier B.V., 2014) Guler A.; Kilic I.H.; Sirin H.; Turhan T.; Pullukcu H.Introduction: Veillonella parvula is a small, nonfermentative anaerobic gram-negative coccus. Meningitidis due to V. parvula seen extremely rare. Here we want to report the fourth case with meningoencephalitis due to V. parvula and emphasize the significance of brain biopsy in encephalitis cases with unknown ethiology. Case report: A 64-year-old male admitted to the emergency room with a frontal and bitemporal headache. On physical examination, the patient was concious and oriented, his reaction time was prolonged. There was no focal neurological deficit, fever and meningeal signs. The magnetic resonance imaging scan showed hyperintensity on the T2-FLAR weighted sequences and diffusion restriction at the same place, concordant with encephalitis. On the third day of admission, oromandibular focal motor seizures were observed. Wecould not define any microbiological agent by analysis of cerebrospinal fluid. Stereotactic brain biopsy performed and the bacterial culture of the biopsy material grew V. parvula. Discussion: We reported the fourth V. parvula encephalitis case in the literature. The aim of this case report is to emphasize that brain biopsy should be considered in patients with encephalitis of unknown etiology. © 2014 Elsevier GmbH. All rights reserved.Öğe Indirect bypass procedures for moyamoya disease in pediatric patients [Moyamoya hastaligi olan çocuklarda i·ndirekt bypass cerrahileri](Turkish Neurosurgical Society, 2011) Turhan T.; Ersahin Y.Aim: Many direct and indirect surgical intervention methods have been defined for the treatment of moyamoya disease. Indirect surgical procedures have been increasingly used. In this study, indirect surgical intervention methods especially used in combination with pial synangiosis were assessed together with other indirect methods. Material and Methods: 11 patients who were treated with an indirect bypass procedures at our clinic and followed for at least three years were retrospectively examined. 19 surgical interventions were performed for 18 patient hemispheres pertaining to these patients. 4 indirect surgical revascularization methods were used for three patient hemispheres. On the other hand, indirect procedures combined with pial synangiosis were applied in 11 operations. In addition, the "multiple burr-hole surgery" method was used in 4 four operations performed for two patients. Results: The clinical success rate was 66.6% for patients where the techniques were applied with pial synangiosis. No new ischemic or hemorrhagic attack was observed during the follow-up period in any of these patients in this series. Conclusion: Pial synangiosis is a modification that Increases the success rate of indirect surgical methods. In addition, high success rates have been reported in recent publications related to multiple burr-hole surgery. This method is a candidate choice of surgical intervention for selected patients.Öğe ISOTROPIC RIEMANNIAN MAPS AND HELICES ALONG RIEMANNIAN MAPS(Politechnica University of Bucharest, 2022) Tükel G.Ö.; Şahin B.; Turhan T.This work has two main aims. The first aim is to study isotropic Riemannian maps as a generalization of isotropic immersions. The notion of isotropic Riemannian map is presented, an example is given and a characterization is obtained. The second aim is to study the helices along Riemannian map. By using the notion of isotropic Riemannian map and helices on the manifold, a characterization is obtained for the transportation of helices on the total manifold to the target manifold along a Riemannian map. © 2022, Politechnica University of Bucharest. All rights reserved.Öğe Moxifloxacin versus ampicillin + gentamicin in the therapy of experimental Listeria monocytogenes meningitis(2008) Sipahi O.R.; Turhan T.; Pullukcu H.; Calik S.; Tasbakan M.; Sipahi H.; Arda B.; Yamazhan T.; Ulusoy S.Objectives: This study aimed to compare the antibacterial activity of moxifloxacin and ampicillin + gentamicin in the treatment of Listeria monocytogenes meningitis in a rabbit meningitis model. Methods: Meningitis was induced by direct inoculation of a clinical strain isolated from an immunocompromised patient (107 cfu/mL) into the cisterna magna of New Zealand rabbits. After 16 h of incubation, rabbits were separated into four groups: moxifloxacin (M), ampicillin + gentamicin (A), ampicillin + gentamicin 2 (A2) and control (C). Group M received 20 mg/kg moxifloxacin at the end of the incubation time and 5 h later by intravenous (iv) route. Group A received ampicillin (30 mg/kg/h) and gentamicin (2.5 mg/kg/h) by iv route with continuous infusion for 8 h in 36 mL of 0.9% NaCl, group A2 received the same dosage of gentamicin and ampicillin in two different 36 mL 0.9% NaCl solutions and group C did not receive any treatment. Cerebrospinal fluid (CSF) samples (0.1-0.25 mL) were obtained 16 and 24 h after induction of meningitis. Results: At the end of the 16 h of incubation, CSF bacterial counts were similar in all groups (P > 0.05). At the final stage of the study (24 h after induction of meningitis), bacterial counts in all treatment groups were significantly lower than the control group (P < 0.05). When the three treatment groups were compared, bacterial counts were found to be similar (P > 0.05). Conclusions: These data suggest that antibacterial activity of moxifloxacin is similar to ampicillin + gentamicin in the treatment of experimental L. monocytogenes meningitis of rabbits. © The Author 2008. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.Öğe Near-infrared camera for intraventricular neuroendoscopic procedures: In vitro comparison of the efficiency of near-infrared camera and visual light camera during bleeding(2011) Turhan T.; Ersahin Y.Purpose: Bleeding is the most important problem in neuroendoscopic procedures. The visibility of the bleeding point for a long period of time is very crucial for the surgeon to stop the bleeding. In this study, the performances of a near-infrared camera (NIRC) and a visible light camera (VLC), which is widely used today, were compared in terms of the visibility duration of the bleeding point. Methods: A bleeding point was generated in vitro, and it was monitored with VLC and NIRC (sensitive to 850-nm infrared light), which were connected to two identical telescope systems. This trial was repeated for 40 times using different telescope systems (Clarus neurochannel endoscopy and Storz Hopkins). The images were merged and analyzed digitally. Results: Statistically, sharper brightness difference levels between bleeding point and background are achieved by NIRC than VLC. Analyses revealed that the bleeding point could be observed for a longer time with NIRC, when compared to VLC. Conclusion: NIRCs may provide very significant advantages against bleedings encountered during intraventricular operations. © 2010 Springer-Verlag.Öğe Neuro-Behçet’s disease mimicking cerebral abscess complicated by metronidazole-induced encephalopathy(ASEAN Neurological Association, 2015) Guler A.; Cinar E.; Turhan T.; Pullukcu H.; Akalin T.; Gokcay F.; Celebisoy N.This is the report of a 32-year-old man with Behçet’s disease described dizziness, double vision and headache. The cranial MRI demonstrated a ring enhancing nodular lesion in left medial occipital lobe, and T2 hyperintense lesion in diencephalon mimicking abscesses. A stereotactic biopsy was performed. The histology showed features of neuro-Behçet’s disease and an abscess was ruled out. During the procedure till the histopathologic results were gathered he was given ceftriaxone and metronidazole when cerebellar signs appeared. Cranial MRI showed additional symmetrical hyperintensities in bilateral cerebellar dentate nuclei which was attributed to metronidazole toxicity. Repeat MRI performed forty days later showed complete resolution of both dentate hyperintensities and diencephalic and occipital ring enhancing lesions. This is the first case of neuro-Behcet’s disease complicated by metronidazoleinduced encephalopathy. This case also showed that nodular ring enhancing lesions can be seen in neuro-Behçet’s disease and can lead to difficulties in diagnosis and management. © 2015, ASEAN Neurological Association. All rights reserved.Öğe A rare cause of ischemic stroke: Intravascular B cell lymphoma [Nadi·r bi·r i·skemi·k i·nme nedeni·: İntravasküler B hücreli· lenfoma](Turkish Society of Cerebrovascular Diseases, 2014) Çiftçi Ş.; Güler A.; Akkoyun F.; Turhan T.; Çelebisoy N.; Şirin H.; Akalin T.; Hekimgil M.; Çalli C.Intravascular B cell lymphoma is rare and an agressive form of large B cell lymphoma which can affect central nervous system. Because of its varied clinical symptoms and the absence of lymphadenopathy, it is generally diagnosed postmortem. Cerebral infarction due to occlusion of arteries can be seen as a rare clinical form of central nervous system involvement. Large artery atherosclerosis, cardiyoembolism and small artery occlusion are the important causes of ischemic stroke but no any cause is detected in %15-40 of all cases. In this report, with the discussion of a case with ischemia like encephalopathy and multiple cerebral ischemic lesions at different stages in cranial MRI which was diagnosed by the help of brain biopsy as a intravascular B cell lymphoma, it is aimed to take attention intravascular lymphoma as a rare cause of ischemic stroke.Öğe Relationship between anterior inferior cerebellar artery and facial-vestibulocochlear nerve complex: An anatomical and magnetic resonance images correlation study(2004) Yurtseven T.; Savaş R.; Koçak A.; Turhan T.; Aktaş E.O.; Işlekel S.For the successful microneurosurgical treatment of CP angle located pathologies, an understanding of the relationship and variations between neural and vascular structures and a certain diagnosis are the most valuable factors for surgeons. CP angle lesions have now become a visible area by advances in magnetic resonance imaging (MRI) technology. An evaluation of this area and the decision for a neurosurgical decompression procedure are easier than before. Twenty unfixed adult human cadaver specimens, that have no sign of central nervous system pathology, were obtained and dissected bilaterally at routine autopsy. The facial-vestibulocochlear (VII-VIIIth) nerve complex and the anterior inferior cerebellar artery (AICA) were identified in all specimens. Thirteen of the 40 (32.5%) AICA were situated ventrally and fourteen (35%) were located dorsally to the VII-VIIIth nerve complex. Thirteen (32.5%) passed between the VIIth and the VIIIth nerve fibers. Five of the 40 (12.5%) AICA had a loop near the nerve complex and then passed the nerves ventrally or dorsally. In an MRI study 74 adult persons (148 sides) were investigated by using three-dimensional Fourier transformation constructive interference in the steady state technique (3D FT-CISS) on a 1.5 Tesla MRI system (Siemens Magnetom, Erlangen, Germany). The results were as follows; 48 AICA (32.4% of all 148 AICA) were situated ventrally to the VII-VIIIth nerve complex, 45 AICA (30.4%) were situated dorsally to the VII-VIIIth nerve complex, and the AICA passed between the VIIth and VIIIth nerves in 51 samples (34.5%). In four of the 148 CP angles (2.7%), the AICA was not identified. There was an AICA loop coursing to the internal acoustic meatus in 15 patients (10.1%). In this study, we examined the relations between VIIth and VIIIth nerve complex and the AICA in cadaver and MRI materials for an understanding of the value and reliability of the radiological data. This study also shows the anatomical variation between these structures.Öğe The role of thrombocyte activation on early brain injury in experimental subarachnoid hemorrhage model [Deneysel sak modelinde trombosit aktivasyonunun erken beyin hasari{dotless} gelişimindeki rolü](2012) Kocaman U.; Demirçivi Özer F.; Oran I.; Mete M.; Burak-Atci I.; Turhan T.; Demirtaş E.Aim: Thrombocyte activation is one of the mechanisms blamed for emerging of early brain injury(EBI) soon after subarachnoid hemorrhage(SAH). It is wondered by researching to what extend neuron injury is prevented by making thrombocyte inhibition in SAH model. It shows that the role of trombocyte activation on EBI. Material and Method: 21 rabbits weighting 3-5 kg are divided in 3 groups 7 each. After ether anesthesia, 0.2 cc arterial blood taking from group 1 and 2 was injected into cysterna magna and created SAH. After SAH, at regular intervals antithrombocyte drug (tirofiban) was given to group 2 intraperitoneally; no treatment was carried on group 1. 0.2 cc SF was injected into cysterna magna in group 3. Decapitation was done in 72nd hour and then ischemic brain map was done at hippocampus level. The amount of ischemic neuron was scored and statistically analyzed. Results: SAH was detected in all rabbits of group 1 and 2. There are meaningful difference between the group 1 and group 3 of scoring ischemic neuron of hippocampus's CA-3 and CA-4 areas. Whereas in group 2, which is a ischemic neuron treatment group, there is a decline in each area, this decline has reached to a statistical means only in CA-4 area. Conclusion: There can be neuronal loss due to EBI even in the area which is free from blood in experimental SAH. Decreasing the injury of neuron with an antithrombocyte medicine shows that thrombocyte activation plays a great role in pathogenesis of EBI.Öğe Shaken baby syndrome: Case report [Sarsi{dotless}lmi{dotless}ş bebek sendromu](Turkiye Klinikleri, 2012) Koç F.; Akşit S.; Turhan T.; Erşahin Y.; Tomba A.; Halicioglu O.; Aslan A.; Koturoglu G.; Aydin C.; Çetin S.; Şenol E.; Çelik A.; Kara S.Shaken baby syndrome (SBS) is a serious type of physical abuse characterized by subdural hematoma and retinal hemorrhage. This syndrome is frequently seen in children younger than 2 years of age. Most of the time it results in death or severe neurological damage. In these cases, external visible injuries are generally absent; often there no history of shaking or trauma. Clinical symptoms and findings are nonspecific. Therefore, most of the cases are missed when SBS is not considered in the differential diagnosis. In this article, we reported two SBS cases admitted to our hospital with a history of head trauma and convulsions, resulting in death in one case. © 2012 by Türkiye Klinikleri.Öğe Spinal meningeal melanocytoma: Report of two cases and review of the literature(2004) Turhan T.; Oner K.; Yurtseven T.; Akalin T.; Ovul I.The authors report on two patients with spinal meningeal melanocytoma and review the literature on this lesion. One case is particularly interesting because of the lesion's thoracic intramedullary localization. Meningeal melanocytoma is a benign but locally aggressive lesion and is very rarely associated with spinal localizations. This patient presented with paraparesis. Clinical and radiological examinations suggested the possibility of an intramedullary solid tumor. Thoracic laminectomy, posterior myelotomy, and tumor resection were performed; the mass was totally removed. The patient suffered no additional neurological deficit. During a 3-year follow-up period in which radiotherapy was not performed, the lesion did not recur. Total excision of the tumor is the best therapeutic option.
