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    Neurotoxicity of chronic epidural somatostatin administration in rabbits
    (Vsp Bv, 2002) Tekin, I; Mirzai, H; Yentur, EA; Ates, U; Baka, M; Yurtseven, M
    The central administration of somatostatin (SMS) in humans became a subject of controversy on the issue of potential neurotoxicity on the spinal cord. The study was aimed at the assessment of the neurodegenerative effects of chronic epidural SMS administration in rabbits. Rabbits were randomly assigned to two groups: the SMS and the control group. The SMS group received 100 mug SMS and the control group received isotonic saline by epidural catheter for 15 consecutive days. Then, laminectomy was performed and the spinal cord was removed. Light and electron microscopic examinations were performed. In the control group, a mild dural inflammatory response and in the SMS group, loss of Nissl bodies at the pericarion, chromatolysis and shrinking at nucleus membranes were observed in all animals at different degrees in light microscopy. In electron microscopy, mitochondrial swellings, irregularities in both nucleus and cell membrane, splitting at myelin lamellae, degeneration at myelin sheath and shrinking of axolemma were found in the SMS group. Our results showed the neurotoxic effects of chronic administration of SMS in rabbits both in light and electron microscopy even in a quite low doses. However, there were no significant clinical findings for the neurological effects during long term follow up.
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    Repeated epidural injections of ketamine with preservative benzethonium chloride produce evidence for neurotoxicity in rabbits
    (Vsp Bv, 2003) Yentur, EA; Mirzai, IT; Mirzai, H; Ates, U; Baka, M; Yurtseven, M
    Background and objectives: In this study, we investigated whether repeated doses of 1% ketamine with preservative benzethonium chloride, administered into the epidural space of the rabbit, caused direct neurotoxicity. Methods: Twelve rabbits were randomly assigned to two groups (ketamine and control). After the animals were anesthetized, lumbar epidural catheters were placed for repeated epidural drug delivery. The ketamine group received 1% ketamine with preservative benzethonium chloride (0.5 ml) and the control group received isotonic saline (0.5 ml) once a day for 14 consecutive days. The day after the last injection, the animals were reanaesthetized, the left and right ventricles were cannulated and perfused with 2% glutaraldehyde, 1% formaldehyde mixture, in 0.1 mol/l phosphate buffer. Then, laminectomy was performed. A five centimetre segment of the spinal cord was removed and examined by light and electron microscopy to observe possible histological changes. Microscopic examinations were performed by coding each animal by a neuro-histologist who was blinded as to the source of each specimen. Results: Ketamine-treated rabbits showed significant histological changes at light and electron microscopy findings compared with the control group (p < 0.05). Conclusions: These changes suggested a neurotoxic effect of ketamine with preservative benzethonium chloride following chronic epidural administration.
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    The role of trigger point therapy in knee osteoarthritis
    (Vsp Bv, 2003) Yentur, EA; Okcu, G; Yegul, I
    Background and objectives: The purpose of this study was to investigate whether injection of trigger points with lidocaine combined with intra-articular hyaluronic acid injection would be more effective in pain reduction and assisting daily activities of patients with knee osteoarthritis then hyaluronic acid injection alone. Methods: Thirty-four, female, osteoarthritis patients were randomly assigned into two groups (hyaluronic acid group, n = 17; trigger point group, n = 17). Patients in the trigger point group received intraarticular 2 ml Na-hyaluronate injections and trigger point injections, three times with one-week intervals. The hyaluronic acid group received only hyaluronic acid injections. Before the treatment and 7 days after the third injection, the same physician who was blind to the treatment, assessed the intensity of pain at rest or during normal daily activities, activity restrictions, and joint range of motion. Results: A significant improvement of pain and reduction of activity restrictions was observed in the trigger point group (p < 0.001) while in the hyaluronic acid group, there were significant improvements only in squatting and walking (p = 0.03). A significant improvement in range of movement was observed only in the trigger point group.