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Öğe Contralateral subdural effusion after aneurysm surgery and decompressive craniectomy: case report and review of the literature(Elsevier Science Bv, 2005) Kilincer, C; Simsek, O; Hamamcioglu, MK; Hicdonmez, T; Cobanoglu, SWe report a complication of decompressive craniectomy in the treatment of aneurismal subarachnoid hemorrhage (SAH) and accompanying middle cerebral artery (MCA) infarction. A 56-year-old man presented with subarachnoid hemorrhage and right sylvian hematoma. He was diagnosed with high-grade SAH and medical therapy was employed. He showed rapid clinical deterioration on day 9 of his admission. Computed tomographic scans showed right MCA infarction and prominent midline shift. Because of the patient's rapidly worsening condition, further evaluation to find origin of SAH could not be obtained, and decompressive right hemicraniectomy was performed. During sylvian dissection, right middle cerebral and posterior communicant artery aneurysms were detected and clipped. One week after operation, a contralateral frontoparietal subdural effusion and left to right midline shift was detected and drained through a burr-hole. Through successive percutaneous aspirations, effusion recurred and complete resolution was achieved after cranioplasty and subduroperitoneal shunt procedures. Decompressive craniectomy is generally accepted as a technically simple operation with a low incidence of complications. In the light of this current case, we hypothesize that a large craniectomy may facilitate the accumulation of recurrent effusion on contralateral side creating a resistance gradient between two hemispheres. This point may be especially true for subarachnoid hemorrhage cases requiring aneurysm surgery. We conclusively suggest that subdural effusions may be resistant to simple drainage techniques if a large contralateral craniectomy does exist, and early cranioplasty may be required for treatment in addition to drainage procedures. (c) 2004 Elsevier B.V. All rights reserved.Öğe The effect of aprotinin on extraneural scarring in peripheral nerve surgery(Springer-Verlag Wien, 1998) Görgülü, A; Imer, M; Simsek, O; Sencer, A; Kutlu, K; Cobanoglu, SExtraneural scarring is one of the factors negatively influencing the result of peripheral nerve surgery. Many organic materials have been used to prevent fibrosis. The effect of aprotinin on peripheral nerve scarring in rats was investigated in this study. Three types of surgical intervention were carried out; namely external neurolysis (I), abrasive injury (II), and anastomosis (III). The coded samples which consisted of pure collagen fibers soaked with aprotinin or phosphate-buffered saline were applied around the left sciatic nerves of rats whereas only sham operations were performed on the right sciatic nerves. Animals were sacrificed after 4 or 6 weeks. Neurological examination, gross evaluation of extraneural fibrosis, and histological study were undertaken. The results have demonstrated that aprotinin is a promising agent in the prevention of extraneural scarring.Öğe The effect of Brevibacterium linens on some physico-chemical properties and colour intensity of Kashar cheese(Volkswirtschaftlicher Verlag, 2001) Öksüz, O; Kurultay, S; Simsek, OIn this research Brevibacterium linens was inoculated to Kashar cheese with two different methods. Each group of fresh cheese was packed in plastic films (PA/PE) at 1 day intervals. During the storage period (1 month) changes in some physico-chemical, microbiological and sensory properties and colour intensities of the cheeses were examined. According to the results obtained, inoculation of Brevibacterum linens into the cheese milk or onto the cheese surface affected most of the physico-chemical properties such as dry matter, fat, water soluble nitrogen and titratable acidity significantly (p<0.01). Due to the high proteolytic and lipolytic activity of the Brevibacterium linens, the cheeses treated with this culture had the lowest organoleptic scores. At the end of the storage period a majority of the panellists noticed a fishy ammoniacal flavour in the cheeses inoculated with Brevibacterium linens. No significant changes in the development of the colour intensity of the cheeses were determined.Öğe The effect of environmental pollution on the heavy metal content of raw milk(Wiley-V C H Verlag Gmbh, 2000) Simsek, O; Gültekin, R; Öksuz, O; Kurultay, SThis investigation was conducted to determine the contents of some heavy metals in milk samples collected from three different regions, an industrial region, a rural and a heavy traffic intensity region around Bursa, a province of Turkey. A total of 75 raw milk samples were collected from these different regions, and the contents of lead, arsenic, copper, zinc, mercury and iron were determined. The average amounts in the samples from these three regions were for Pb 0.032, 0.049, 0.018 mg/kg; for As 0.05, 0.009, 0.0002 mg/kg; for Zu 4.49, 5.01, 3.77 mg/kg; for Cu 0.58, 0.96, 0.39 mg/kg; for Fe 1.78, 4.27, 1.01 mg/kg, while no mercury was detected in the samples. The highest heavy metal content was found in the milk samples collected from industrial region followed by traffic intensive region and rural region.Öğe The effect of epidural free fat graft on the outcome of lumbar disc surgery(Springer, 2004) Görgülü, A; Simsek, O; Çobanoglu, S; Imer, M; Parsak, TNumerous materials have been used to prevent epidural scar tissue after lumbar disc surgery. Free fat grafts are common both experimentally and clinically, but there is some doubt about their protection against fibrosis, and some complications have been reported. In this prospective study, the usefulness of free fat grafts during lumbar disc surgery was evaluated. Ninety-nine patients who had undergone operation due to lumbar disc herniation were divided in two groups: those with implantation of free fat grafts (group A) and those without (group B). Outcome was evaluated at a mean of 2.6 years postoperatively according to the following criteria: visual analog scale for back and leg pain, Hannover Questionnaire on activities of daily living, reflex findings, sensory and motor deficits, consumption of analgesics, walking distance, straight leg raising test, and clinical examination. The outcome variables showed no significant differences between the two groups (P>0.05). This study suggests that the use of free fat grafts during lumbar disc surgery was clinically ineffective.Öğe Effect of refining processes on the total and individual tocopherol content in sunflower oil(Blackwell Science Ltd, 2001) Alpaslan, M; Tepe, S; Simsek, OTotal and individual tocopherol contents of sunflower oil, processed either by chemical refining (CR), physical refining (PR) or soft column deodorization (SCD) methods were investigated. Total tocopherol content gradually decreased until the end of the refining process (the deodorization stage). Among the refining methods used CR and PR caused higher losses in the tocopherol content when compared with the SCD method. The content of alpha-, beta-, gamma- and delta -tocopherols also decreased as a result of the refining process. These significant losses in beta- and gamma -tocopherol contents were determined after the deodorization stage.Öğe The effects of hydrocolloids on some physico-chemical and sensory properties and on the yield of Kashar cheese(Wiley-V C H Verlag Gmbh, 2000) Kurultay, S; Öksüz, Ö; Simsek, O[Abstract Not Available]Öğe Factors affecting the outcome of decompressive craniectomy for large hemispheric infarctions: a prospective cohort study(Springer Wien, 2005) Kilincer, C; Asil, T; Utku, U; Hamamcioglu, MK; Turgut, N; Hicdonmez, T; Simsek, OBackground. Although surgical decompression of large hemispheric infarction is often a life-saving procedure, many patients remain functionally dependent. The aims of this study were to identify specific factors that can be used to predict functional outcome, thus establish predictive criteria to reduce poor surgical results. Method. In this non-randomized prospective study, we performed decompressive craniectomy in 32 patients (age range, 27 to 77 years) with large hemispheric infarctions. Based on their modified Rankin Score (RS), which was calculated 6 months postoperatively, patients were divided into two functional groups: good (RS 0-3, n = 7) and poor (RS 4-6, n = 25). The characteristics of the two groups were compared using statistical analysis. Findings. One-month mortality was 31%. However, most of the surviving patients were severely disabled (RS 4 or 5), and 6-month total mortality reached 50%. Increased age (>= 60 years) (P = 0.010), preoperative midline shift greater than 10 mm (P = 0.008), low preoperative Glasgow Coma Score (GCS <= 7) (P = 0.002), presence of preoperative anisocoria (P = 0.032), early (within the first three days of the stroke) clinical deterioration (P = 0.032), and an internal carotid artery infarct (P = 0.069) were the positive predictors of a poor outcome. Interpretation. We view decompressive craniectomy for space-occupying large hemispheric infarction as a life-sparing procedure that sometimes yields good functional outcomes. A dominant hemispheric infarction should not be an exclusion criterion when deciding to perform this operation. Early operation and careful patient selection based on the above-mentioned factors may improve the functional outcome of surgical management for large hemispheric infarction.Öğe Fatty acid composition and quality characteristics of low-fat cooked sausages made with beef and chicken meat, tomato juice and sunflower oil(Elsevier Sci Ltd, 2002) Yilmaz, I; Simsek, O; Isikli, MLow-fat (5.9-10.3% fat) cooked sausages were produced with seven different formulations. Sausages produced with total replacement of fat with sunflower oil had significantly lower oleic acid (C18:1) and higher linoleic (C18:2) and behenic (C22:0) fatty acid contents. Their ratio of TUFA/TS was 3.65 compared to 0.95-1.14 for the other sausages, Also these sausages had the lowest moisture content, highest overall palatability and were less firm. Sausages with tomato juice had the lowest pH value, total aerobic count and nitrite content. but were firmer. Sausages produced with reduced beef contents had lower fat contents, lower stearic (C18:0) and higher oleic (C18:1) fatty acid contents than sausages of high beef content, their texture was very soft and had the lowest score for juiciness. Finally the sausages with chicken meat had the lowest fat and highest salt contents, and lower stearic (C18:0) and higher linoleic (C18:3) fatty acid contents than those made with beef. Also their colour was lighter, less red and more yellow and they had the lowest flavor intensity and overall acceptability. (C) 2002 Elsevier Science Ltd. All rights reserved.Öğe Isolated bone metastasis in testicular germ cell tumors: A case report and review of the literature(Karger, 2006) Uygun, K; Karagol, H; Kocak, Z; Cicin, I; Yalcin, O; Caloglu, M; Simsek, OBackground: In testicular germ cell tumors ( GCT), bone metastases are usually seen late in the disease progress and are almost always associated with involvement of other sites. However, isolated bone metastasis is an extremely rare finding in these patients. Case Report: A 43-year-old man was admitted to the neurosurgery department of our hospital suffering from dysarthria, ataxia, headaches and a progressive swelling above the parietooccipital region of the skull. Radiological, biochemical and pathologic tests showed that the lesion of the skull was an isolated skull metastasis as an initial manifestation of nonseminomatous GCT of the testis. Discussion: When a young patient presents with bone pain or painless swelling, even if it is an unusual site and isolated, testicular GCT should be considered as a differential diagnosis, as these lesions could be the first evidence of metastatic GCT.Öğe Mycoflora of hazelnut (Corylus avellana L.) and aflatoxin content in hazelnut kernels artificially infected with Aspergillus parasiticus(Wiley-V C H Verlag Gmbh, 2002) Simsek, O; Arici, M; Demir, CIn this research, 30 hazelnut samples were used to determine their internal mould populations and their aflatoxin contents. The results showed that Aspergillus was the most common genus in the experimental samples (96.6% of all samples). Thirty-one % of isolates were classified as Aspergillus flavus and none of the samples contained aflatoxins. In the second part of the experiment, the kernels were inoculated with conidia of Aspergillus parasiticus and incubated at three different humidified conditions and two different temperatures for 45 days. Aflatoxin contents of the samples kept in 98% relative humidity and at 28degreesC were higher (904.6 mug/kg) than that of the other samples. On the other hand, no aflatoxin was detected in the control samples that were not inoculated but kept at the same conditions.Öğe Selection of starters for a traditional Turkish yayik butter made from yoghurt(Academic Press Ltd- Elsevier Science Ltd, 2002) Sagdic, O; Arici, M; Simsek, OButter is produced from two different materials in Turkey, cream and yoghurt. The butter produced from fresh yoghurt or 'tulum yoghurt' (a strained yoghurt produced from cow, goat or sheep milk) is called 'yayik butter' and has been traditionally produced in Turkey for centuries. In this research, we attempted to isolate and identify the natural lactic acid bacteria (LAB) of yayik butter and to select the best LAB combination for butter production. Twenty samples of yayik butter were collected from Afyon-Antalya, Isparta and Konya regions in Turkey and determined to have a mean pH of 4.78 +/- 0.33, a mean titratable acidity (lactic acid) of 0.23 +/- 0.07% and a mean NaCl of 0.55 +/- 1.22%. The mean counts of LAB (log(10) cfu g(-1)) were 2.66 +/- 0.84 and 1.72 +/- 0.82 on MRS agar at 30 and 42degreesC, 2.44 +/- 0.93 and 1.78 +/- 0.24 on M17 agar at 30 and 42degreesC, and 1.64 +/- 1.196 on Sodium Azide Leuconostoc agar at 21degreesC, respectively Eighty-five different LAB isolates were obtained from 20 yayik butters and identified as Streptococcus salivarius ssp. thermophilus (21.2%), Streptococcus sp. (4.7%), Lactobacillus delbrueckii ssp. bulgaricus (20%), Lactobacillus casei ssp. casei(15.3%), Lactobacillus paracasei ssp. paracasei (2.3%), Enterococcus faecium (18.8%). Leuconostoc pseudomesenteroides (Leuconostoc mesenteroides ssp. dextranicum) (7.1%), Leuconostoc gelidum (Leuconostoc mesenteroides ssp. mesenteroides) (4.7%) and Weissella paramesenteroides (Leuconostoc paramesenteroides) (5.9%). Combinations of S. salivarius ssp. thermophilus S51 Lb. delbrueckii ssp. bulgaricus A42, Lb. casei ssp. casei K64, Lb. paracasei ssp. paracasei A27 and Leu. pseudomesenteroides E83 were used as starter bacteria for experimental butter production from cream. Six different groups of butters were produced using different combinations of these bacteria (B, C, D and E samples), commercial culture (F sample), and without culture (A sample). Sensory evaluations showed that the experimentally produced butter sample of group B was more acceptable than the other butters. In addition, the buttermilk of sample B had lowest fact content. LAB counts of experimental butters produced with combined cultures and commercial culture were similar (6.66 +/- 1.87-6.83 +/- 0.040 and 6.81 +/- 0.13 log(10) cfu g(-1) on MRS agar respectively). (C) 2002 Elsevier Science Ltd. All rights reserved.Öğe Surgical management of combined stab injury of the spinal cord and the aorta -: Case report(Japan Neurosurgical Soc, 2004) Simsek, O; Kilincer, C; Sunar, H; Hamamcioglu, MK; Canbaz, S; Çobanoglu, S; Duran, EA 32-year-old man presented with a combined penetrating stab injury of the spinal cord and the aorta caused by a knife wound in his back at the low thoracic level. The knife had broken, and part of the blade had been retained in the wound, passing through the spinal canal and into the aortic lumen. The patient was treated in two steps: the aorta was repaired by a thoracotomy, then spinal exploration was carried out through a laminectomy. Because of the tamponade effect of the foreign body, it was necessary to delay removal of the blade until vascular control had been achieved. Any sign of a penetrating body passing through the spine should suggest careful evaluation to detect any visceral injury, and multidisciplinary treatment should be planned.
