Yedi yıl önce şizofreni tanısı almış, 34 yaşındaki erkek hastanın kendi kafasına 4 adet çivi çakmasıyla gelişen nadir bir penetran kafa travması olgusu sunuldu. Fiziksel incelemede kafasının sağ temporal ve paryetal bölgesinde saçlı deri içerisinde kraniyuma çakılı 4 adet çivi vardı. Beyin omurilik sıvısı fistülü yoktu. Hastanın nörolojik incelemesinde motor ve duyu defisiti yoktu. Glasgow koma skoru 15 idi. Direkt kafa grafisinde ve beyin bilgisayarlı tomografisinde (BT) çivilerin yaklaşık 10 cm uzunluğun-da olduğu ve değişik yönlere uzandığı görüldü. BT anjiyografisinde büyük vasküler yapılarda yaralanma yoktu. Genel anestezi altında sağ temporal bölgede olan 2 çivi direkt çekilerek, sağ paryetal bölgede olan 2 çivi ise mini kraniyotomiler ile çıkarıldı. Temporal bölge gibi kemiğin ince olduğu alanlarda çivi direkt çekilip çıkarılabilir. Ancak paryetal kemik gibi kemiğin kalın olduğu bölgelerde bu yöntemle çivilerin çıkarılması her zaman mümkün olmayabilir.Anahtar Sözcükler: Çivi; penetran kafa travması; şizofreni We present a rare case of self-inflicted penetrating head trauma by a 34-year-old male who hammered four nails into his own head; he had been diagnosed with schizophrenia seven years before. On the physical examination, four nails were observed in the hairy scalp that had been driven into the cranium in the right temporal and parietal areas of the head. No cerebrospinal fluid fistulas were present. On the neurological examination, no motor or sensory deficits were present. The Glasgow Coma Scale was 15. On direct skull X-ray and cranial computerized tomography (CT), the nails were seen to be approximately 10 cm long and extending in various directions. No injury was observed in the main vasculature on CT angiography. Under general anesthesia, two nails in the right temporal area were removed by extraction, and the other two nails in the right parietal area were removed through a mini craniotomy. In areas such as the temporal area where the bone is thin, nails can be removed by extraction. However, in areas like the parietal bone where the bone is thick, removal of the nails using this method may not always be possible.

Purpose We have discussed the importance of sacrococcygeal sinus angle (SSA), which is a new anatomical landmark in the surgery of presacral lesions. Because of its anatomical structure, the sacrum limits the surgical exposure like a compact barrier for the posterior surgical approach. The main aim of this paper is to explain the anatomical description and clinical importance of SSA in the surgery of presacral lesions.

In our in vitro study, antibiotic-impregnated DuraGen® material significantly inhibited microorganism growth. Our results show that antibiotic-impregnated DuraGen® has the potential to prevent infection.

No abstract

Objective: To investigate free fatty acid levels and histopathological changes in the brain of rats fed a high fructose diet (HFrD) and to evaluate the effects of Mucuna pruriens, known to have antidiabetic activity, on these changes. Materials and Methods: The study comprised 28 mature female Wistar rats. The rats were divided into 4 groups, each included 7 rats. Group 1: control; group 2: fed an HFrD; group 3: fed normal rat chow and M. pruriens; group 4: fed an HFrD and M. pruriens for 6 weeks. At the end of 6 weeks, the rats were decapitated, blood and brain tissues were obtained. Serum glucose and triglyceride levels were measured. Free fatty acid levels were measured in 1 cerebral hemisphere of each rat and histopathological changes in the other. The Mann-Whitney U test was used to compare quantitative continuous data between 2 independent groups, and the Kruskal-Wallis test was used to compare quantitative continuous data between more than 2 independent groups. Results: Arachidonic acid and docosahexaenoic acid levels were significantly higher in group 2 than in group 1 (p < 0.05). Free arachidonic acid and docosahexaenoic acid levels in group 4 were significantly less than in group 2 (p < 0.05). Histopathological examination of group 2 revealed extensive gliosis, neuronal hydropic degeneration, and edema. In group 4, gliosis was much lighter than in group 2, and edema was not observed. Neuronal structures in group 4 were similar to those in group 1. Conclusions: The HFrD increased the levels of free arachidonic acid and docosahexaenoic acid probably due to membrane degradation resulting from possible oxidative stress and inflammation in the brain. The HFrD also caused extensive gliosis, neuronal hydropic degeneration, and edema. Hence, M. pruriens could have therapeutic effects on free fatty acid metabolism and local inflammatory responses in the brains of rats fed an HFrD.