Browsing by Author "Borman, Huseyin"

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Adipose-Derived Stem Cells Enhance Axonal Regeneration through Cross-Facial Nerve Grafting in a Rat Model of Facial Paralysis
(2016) Abbas, Ozan L.; Borman, Huseyin; Uysal, Cagri A.; Gonen, Zeynep B.; Aydin, Leyla; Helvacioglu, Fatma; Ilhan, Sebnem; Yazici, Ayse C.; https://orcid.org/0000-0001-6236-0050; https://orcid.org/0000-0002-6026-0045; https://orcid.org/0000-0002-3132-242X; 27465163; AAJ-2949-2021; AAH-8887-2021; AAS-6810-2021
Background: Cross-face nerve grafting combined with functional muscle transplantation has become the standard in reconstructing an emotionally controlled smile in complete irreversible facial palsy. However, the efficacy of this procedure depends on the ability of regenerating axons to breach two nerve coaptations and reinnervate endplates in denervated muscle. The current study tested the hypothesis that adipose-derived stem cells would enhance axonal regeneration through a cross-facial nerve graft and thereby enhance recovery of the facial nerve function. Methods: Twelve rats underwent transection of the right facial nerve, and cross-facial nerve grafting using the sciatic nerve as an interpositional graft, with coaptations to the ipsilateral and contralateral buccal branches, was carried out. Rats were divided equally into two groups: a grafted but nontreated control group and a grafted and adipose-derived stem cell-treated group. Three months after surgery, biometric and electrophysiologic assessments of vibrissae movements were performed. Histologically, the spectra of fiber density, myelin sheath thickness, fiber diameter, and g ratio of the nerve were analyzed. Immunohistochemical staining was performed for the evaluation of acetylcholine in the neuromuscular junctions. Results: The data from the biometric and electrophysiologic analysis of vibrissae movements, immunohistochemical analysis, and histologic assessment of the nerve showed that adipose-derived stem cells significantly enhanced axonal regeneration through the graft. Conclusion: These observations suggest that adipose-derived stem cells could be a clinically translatable route toward new methods to enhance recovery after cross-facial nerve grafting.
Asymmetric Z-plasty for Telephone Deformity in Prominent Ear Correction
(2014) Uysal, Afsin; Uysal, Cagri A.; Cologlu, Harun; Borman, Huseyin; https://orcid.org/0000-0001-6236-0050; https://orcid.org/0000-0002-8605-9032; 25098579; AAJ-2949-2021
There have been plenty of surgical techniques for the correction of prominent ears. "Telephone deformity" or "reverse telephone ear" has been described as the undesired result of the inappropriate correction of the prominent ear, mainly the deficient correction of the lobule. We have performed an asymmetric Z-plasty to the lobule to overcome this deformity not only by excision of the excess skin but also by transposition of the soft tissue. Between 2005 and 2011, the technique currently described was performed in 19 patients. Preoperative, intraoperative, and postoperative standardized photographs were taken, and measurements were done on postoperative first week, first month, and first year. The measurements include ear height at 3 different horizontal planes as follows: (1) the most cranial point of the ear, (2) the middle point of the ear, and (3) the most caudal point of the ear. The angle between the vertical plane of the head and the ear was measured at these previously defined 3 points. These measurements were used for indication and preoperative planning. There were statistically significant differences between preoperative and postoperative values (P < 0.05). The postoperative first year results indicated the effectiveness of this alternative technique for the long-term maintenance of the position of the lobule.
Bilateral Propeller Flap Closure of Large Meningomyelocele Defects
(2014) Cologlu, Harun; Ozkan, Burak; Uysal, Ahmet Cagri; Cologlu, Ozlem; Borman, Huseyin; https://orcid.org/0000-0002-8605-9032; https://orcid.org/0000-0003-3093-8369; https://orcid.org/0000-0001-6236-0050; 24918736; AAO-4286-2020; AAI-5063-2020; AAJ-2949-2021
Background: Meningomyelocele is a defect of the spinal cord, vertebral spine, and overlying skin and is the most common form of spinal dysraphism. Multiple methods of soft tissue closure for larger myelomeningocele defects have been described, including skin grafting, random fasciocutaneous flaps, skin undermining with relaxing incisions, and musculocutaneous flaps. Most current methods for closure of defects of 8 cm and greater and kyphotic spines usually remains inadequate. In this study, we present our clinical experience with a new surgical procedure, bilateral propeller (BP) flaps based on dorsal intercostal and lumbar artery perforator, for the closure of large thoracolumbar meningomyelocele defects. Patients and Method: Between January 2011 and April 2012, 7 newborns (5 males and 2 females) with thoracolumbar large meningomyelocele were included in the study. Six patients had lumbar kyphosis. Myelomeningocele defects with a mean size of 89.3 cm(2) (range, 58.9-136.8) were closed with BP flaps. Results: All flaps survived; hematoma, seroma, wound dehiscence, flap necrosis, or infection was not observed. No patients required any surgical revisions. The patients had a follow-up of 4 to 16 months with a mean of 10 months, and no long-term complications, including necrosis of flap edges, wound breakdown, or instability, have been apparent in our series. Conclusions: We believe that the BP flaps represent a useful tool in the management of soft tissue defects associated with especially kyphotic large thoracolumbar and lumbosacral myelomeningoceles.
A Different Approach for Usage of the Implant Materials: The Composite Graft Prefabrication
(2016) Deniz, Lutfi Murat; Ataman, Murat Gorkem; Borman, Huseyin; Erinanc, Hilal; https://orcid.org/0000-0003-1401-6356; 27763981; AAL-1268-2021
With all implanted materials, a certain sequence of biological events occurs following the implantation. This process is destructive to the implant and peri-implant tissues. The aforementioned sequence of biological events may be responsible for the complications. In this study, the natural biologic process following implantation was completed in an area other than the final implantation area. The aim was to keep the peri-implant tissues in the final implantation area away from the process. In the control group, the porous polyethylene discs were implanted to subcutaneous area on the frontal bone of the rats. A month after the implantation, macroscopic and microscopic examinations were performed. In the study group, the discs were implanted primarily above the rectus abdominis muscle of the rats. It was named as the composite graft prefabrication. Twenty-one days after the first implantation, the discs were removed from the rectus muscle and implanted to subcutaneous area on the frontal bone of the rats. A month after the final implantation, macroscopic and microscopic examinations were performed. In macroscopic examination, all possible complications were evaluated. In microscopic examination, apoptosis, fibrosis, inflammation, and fibrovascular in-growing were evaluated. In the control group, implant exposure was observed in 3 of the rats. In the study group, no complications were observed. Although there was no statistical difference between 2 groups in the microscopic findings, at first glance, the inflammation seemed to be the factor responsible for the complication in the control group. According to the macroscopic results, the composite graft prefabrication seemed to be effective in preventing complications.
The Effect of Adipose Stromal Vascular Fraction on the Viability of Transverse Rectus Abdominis Myocutaneous Flap after Abdominoplasty: An Experimental Study
(2021) Coskun, Erhan; Ozkan, Burak; Terzi, Aysen; Ozer, Eda Ozturan; Uysal, Cagri Ahmet; Borman, Huseyin; Ertas, Nilgun Markal; 0000-0002-1225-1320; F-7546-2013
Introduction: A prior abdominoplasty is considered as an absolute contraindication to transverse rectus abdominis musculocutaneous (TRAM) flap surgery. The aim of this study is to investigate the effect of nonexpanded adipose stromal vascular fraction (ASVF) on the viability of TRAM flap after abdominoplasty. Materials and Methods: Thirty-five male Sprague Dawley rats were divided into five groups. Reverse abdominoplasty model was used in all groups except Group 1. TRAM flap was performed 2 weeks after abdominoplasty in Groups 2 and 4 and 4 weeks after in Groups 3 and 5. ASVF cells were injected during abdominoplasty in Groups 4 and 5. The viable flap area (VFA) percentage and newly formed perforators were assessed. Capillary density and fibrosis gradient and plasma vascular endothelial growth factor (VEGF) levels were measured. Results: The mean VFA to total flap area was measured as 82.90% +/- 7.59%, 3.31% +/- 3.29%, 9.40% +/- 6.18%, 31.92% +/- 9.29%, and 64.98% +/- 10.95% in Group 1, Group 2, Group 3, Group 4, and Group 5, respectively (P < 0.05). The number of newly formed musculocutaneous perforating arteries was 0.29 +/- 0.49, 1.14 +/- 0.69, and 2 +/- 0.82 for Groups 3, 4, and 5, respectively (P < 0.05). The mean capillary density was 6.86 +/- 0.50, 0.67 +/- 0.13, 2.79 +/- 0.53, 3.71 +/- 0.47, and 7.01 +/- 0.70 in Groups 1, 2, 3, 4, and 5, respectively (P < 0.05). There was a statistically significant increase between the baseline VEGF values and the second VEGF values in Groups 4 and 5. Conclusions: The study showed that local injection of ASVF increases the viability of TRAM flap after abdominoplasty.
The effect of adipose stromal vascular fraction on transverse rectus abdominis musculocutaneous flap: an experimental study
(2016) Ataman, Murat Gorkem; Uysal, Cagri A.; Ertas, Nilgun Markal; Bayraktar, Nilufer; Terzi, Aysen; Borman, Huseyin; 0000-0002-7886-3688; 0000-0001-6236-0050; 0000-0002-1225-1320; 27010192; Y-8758-2018; AAJ-2949-2021; F-7546-2013
An In Vivo Comparison of Commonly Used Topical Antimicrobials on Skin Graft Healing After Full-Thickness Burn Injury
(2015) Abbas, Ozan L.; Borman, Huseyin; Bahar, Taner; Ertas, Nilgun M.; Haberal, Mehmet; 0000-0002-3462-7632; 24823344; AAJ-8097-2021
Topical antimicrobials are frequently used for local control of infections in burn patients. It has been postulated that these agents retard wound healing. There are limited data about the effects of topical antimicrobial agents on skin graft healing. In this study, we aimed to evaluate the effects of nitrofurazone, 1% silver sulfadiazine, and povidone-iodine on skin graft healing. Forty male rats were used in this study. A meshed skin graft, placed on an excised burn wound, was used as a model to compare topical agents with a control group. Skin graft survival rates, closure of meshed graft interstices (based on physical parameters, namely epithelialization and wound contraction), and histological changes were analyzed. Graft take was more than 85% in all groups. There was no difference between the mean values of the percent graft survival for each group (P > .05). Epithelialization occurred significantly earlier in animals in the nitrofurazone group (P < .05). There was no significant difference between groups in wound contraction rates (P >.05). There was no histological difference between the biopsy specimens of skin grafts. In specimens obtained from the interstices of the meshed graft, no significant differences were found among the groups regarding the wound healing parameters (P > .05). We found that nitrofurazone, silver sulfadiazine, and povidone-iodine had no negative effect on graft healing and take in noncontaminated burn wounds.
Inhibition of the Notch Pathway Promotes Flap Survival by Inducing Functional Neoangiogenesis
(2015) Abbas, Ozan Luay; Borman, Huseyin; Terzi, Yunus K.; Terzi, Aysen; Bayraktar, Nilufer; Ozkan, Burak; Yazici, Ayse C.; 0000-0002-7886-3688; 0000-0003-3093-8369; 0000-0002-1225-1320; 0000-0002-3132-242X; 0000-0001-5612-9696; 25180956; Y-8758-2018; AAI-5063-2020; F-7546-2013; AAS-6810-2021; B-4372-2018
Objective The Notch pathway seems to function as an antiangiogenic factor, negatively regulating the sprouting effect of vascular endothelial growth factor (VEGF). This function is well defined in embryonic and tumor vasculature. However, little is known about its function in ischemia-induced angiogenesis. In the first part of this study, we investigated the role of Notch in reparative angiogenesis after ischemia. In the second part, we hypothesized that anti-Notch therapy will result in increased angiogenic sprouting. We analyzed the effect of Notch inhibition in the induction of angiogenic sprouting. Methods In the first part, we investigated the effect of ischemia on the Notch ligand delta-like ligand 4 (DLL4). Twenty rats were divided equally into 2 groups. In the surgery group, dorsal skin flap was used as model of ischemia. In the control group, no surgical procedure was performed. DLL4 and VEGF gene expressions were assessed. Immunohistochemical staining was used for detection of DLL4 in tissue materials. Plasma levels of VEGF and DLL4 were measured. In the second part, we investigated the effect of Notch inhibition using a gamma-secretase inhibitor (GSI) on inducing neoangiogenesis. Twenty rats were assigned to 2 equal groups. In all animals, dorsal skin flap was raised and sutured back into its bed. Animals in the GSI-treated group received GSI intravenously after surgery for 3 days. Saline was administered in the control group. Necrotic area measurements, microangiography, and histologic evaluations were performed to compare groups. Results In the first part, VEGF and DLL expressions increased in ischemic tissues (P < 0.01). Immunohistochemical analysis revealed that DLL4 expression was upregulated in capillary endothelial cells after ischemia. Plasma levels for VEGF and DLL4 were higher in the animals that underwent surgery (P < 0.01). In the second part, GSI treatment resulted in higher flap survival rates (P < 0.05). Microscopic analysis exhibited increase in the number of microvascular structures after GSI treatment (P < 0.05). Microangiographic evaluation showed that neovascularization increased in the GSI-applied flaps. Conclusions We present an evidence for the importance of the Notch pathway in the regulation of ischemia-induced angiogenesis. Notch inhibition promotes flap survival by creating a neovasculature that has an increase in vascular density.
The Notch Pathway Is A Critical Regulator of Angiogenesis in A Skin Model of Ischemia
(2015) Abbas, Ozan L.; Borman, Huseyin; Terzi, Yunus K.; Terzi, Aysen; Bayraktar, Nilufer; Yazici, Ayse C.; 0000-0002-1225-1320; 0000-0002-7886-3688; 0000-0001-5612-9696; 0000-0002-3132-242X; 25834117; F-7546-2013; Y-8758-2018; B-4372-2018; AAS-6810-2021
The Notch pathway is definitely required for normal vascular development. Although the contribution of Notch in postnatal angiogenesis is the focus of intense investigation, the implication of Notch in reparative neovascularization in the skin remains unexplored. In this study, we investigated Notch changes using a skin model of ischemia. Thirty Sprague-Dawley rats were divided into two groups. In the surgery group (n = 24), a caudally based dorsal skin flap was raised and sutured back into its initial position. In the control group, no surgical procedure was performed. Tissue biopsies were obtained at different time intervals. Tissue specimens were assessed for Delta-like ligand 4 (DLL4) and vascular endothelial growth factor (VEGF) gene expression by real-time polymerase chain reaction (PCR). Immunohistochemical staining was used for detection of DLL4 in tissue materials. Quantitative assessment of skin flap microvasculature was made. Compared with normoperfused tissue, VEGF and DLL4 expressions increased significantly (p < 0.01). Immunohistochemical analysis revealed weak and patchy expression of DLL4 in microvascular endothelial cells of normoperfused tissues. Conversely, DLL4 expression was upregulated in capillary endothelial cells after ischemia. In conclusion, in this study we have shown that the Notch ligand DLL4 is upregulated in skin tissue after ischemia. A deeper understanding of these fundamental principles will aid in the development of new avenues for the treatment of blood vessel-related skin pathologies.
Temporal Muscle Capillary Hemangioma: Case Report
(2014) Cologlu, Harun; Ozkan, Burak; Uysal, Ahmet Cagri; Kocer, Nazim Emrah; Borman, Huseyin; https://orcid.org/0000-0003-3093-8369; https://orcid.org/0000-0001-6236-0050; https://orcid.org/0000-0002-5943-9283; AAO-4286-2020; AAI-5063-2020; AAJ-2949-2021; AAM-5436-2021