Tıp Fakültesi / Faculty of Medicine

Permanent URI for this collectionhttps://hdl.handle.net/11727/1403

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    Management of Isolated Infraorbital Neuralgia by Ultrasound-Guided Infraorbital Nerve Block with Combination of Steroid and Local Anesthetic
    (2017) Cok, Oya Y.; Deniz, Sinan; Eker, H. Evren; Oguzkurt, Levent; Aribogan, Anis; https://orcid.org/0000-0003-3004-2626; https://orcid.org/0000-0002-9887-2864; https://orcid.org/0000-0002-7901-0185; https://orcid.org/0000-0002-4419-5693; 28235509; AAI-7998-2021; AAA-1269-2022; AAI-8769-2021
    Patients with isolated peripheral branch neuralgia of trigeminal nerve usually receive traditional treatment such as medical therapy and interventional procedures targeting the entire trigeminal nerve or related ganglions. However, if the intractable pain is limited to a certain branch, the patient may also benefit from a peripheral and nerve-targeted interventional approach. Here, we report the management of a patient with isolated infraorbital neuralgia by ultrasound-guided infraorbital nerve block with steroid and local anesthetic combination. 48 years-old male patient diagnosed with trigeminal neuralgia was resistant to medical therapy for 3 years. The pain site was isolated to the area of the right nasal wing, right lateral incisor, the upper right canine and the first premolar teeth. His pain was an electric shock-like, throbbing and stabbing with a pain score of 8-9 according to numeric rating scale (NRS) and 18 according to the Leeds Assessment of Neuropathic Symptoms and Signs Pain Scale (LANSS). Following a diagnostic ultrasound-guided infraorbital nerve block with 1% lidocaine, the block was repeated twice with 15 mg lidocaine and 1.5 mg dexamethasone in a total volume of 1.5 mL in a month. The patient's NRS and LANSS scores decreased to 2 and 8, for approximately 21 months until this report was written. We suggest that ultrasound-guided infraorbital nerve block with dexamethasone and lidocaine combination may present as an initial interventional treatment option in patients with isolated infraorbital neuralgia. (C) 2016 Elsevier Inc. All rights reserved.
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    The Notch Signaling System Is Involved in the Regulation of Reparative Angiogenesis in the Zone of Stasis
    (2017) Abbas, Ozan Luay; Ozatik, Orhan; Terzi, Yunus Kasim; Ozatik, Fikriye Yasemin; Nar, Rukiye; Turna, Gamze; https://orcid.org/0000-0001-5612-9696; 28319529; B-4372-2018
    The Notch pathway ligand Delta-like 4 (Dll4) functions as an antiangiogenic factor, inhibiting vascular endothelial growth factor (VEGF)-induced angiogenesis. This function is documented in tumor and embryonic vasculature. However, its implication in burn wounds remains unexplored. Our objective was to explore the involvement of the Notch in the healing of zone of stasis burns. We hypothesized that anti-Dll4 therapy would prevent progressive necrosis in the stasis zone by promoting angiogenesis. Burns were created in 21 rats using the comb burn model. The Notch inhibitor N-[N-(3,5-difluorophenacetyl)1- alanyl]-S-phenylglycine-t-butyl-ester was administered in the treatment group. Controls were given the same amount of solvent. Seven days after the burn, skin samples were evaluated for VEGF and Dll4 gene expressions. Immunohistochemical analysis was used for the assessment of vascular density, endothelial Dll4 expression, and apoptosis count. Histologic grading of tissue damage was performed. Circulating levels of VEGF and Dll4 were determined. VEGF and Dll4 mRNA levels were found to be simultaneously induced after the burn. In the treatment group, a significant increase in the number of vessels was observed. However, gross evaluation documented an expansion of necrosis to the zone of stasis with marked activation of apoptosis. Histologic assessment showed that the resultant vascular overgrowth was accompanied by extensive edema and abundant infiltration of leukocytes. We provide evidence for the involvement of Notch in the regulation of angiogenesis in zone of stasis burns.
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    Efficacy of Acupuncture on Pain Mechanisms, Inflammatory Responses, and Wound Healing in the Acute Phase of Major Burns: An Experimental Study on Rats
    (2021) Abali, Ayse Ebru; Cabioglu, Tugrul; Bayraktar, Nilufer; Ozdemir, Binnaz Handan; Moray, Gokhan; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0002-1298-7944; 34309681; AAJ-8097-2021; AAE-8704-2021
    We investigated acupuncture, a potential contributor for burn care, on physiological and pathological pain mechanisms and systemic and local inflammatory responses in a rat experimental burn model. Forty male Sprague-Dawley rats were divided into two groups. One-hour groups (five rats/group) were observed for 1 hour and included Sh1 (sham/observation), ShA1 (sham + acupuncture/observation), Brn1 (burn/observation), and BrnA1 (burn + acupuncture/ observation). Seven-day groups (five rats/group) were observed for 7 days and included Sh7 (sham/observation), ShA7 (sham + acupuncture/observation), Brn7 (burn/observation), and BrnA7 (burn + acupuncture/observation). "Pain-distress scores" were noted daily, and acupuncture was repeated within every wound-dressing change on alternate days. After observation periods, blood samples for interleukin 6 and beta-endorphin and skin biopsies for inflammatory changes and immunohistochemical staining of interleukin 6 were collected for analysis(P <.05). In 1-hour groups, interleukin 6 accumulation in burn wounds of BrnA1 was less than Brn1, with Brn1 having the highest mean blood level (P <.05). Mean beta-endorphin levels were higher in ShA1, Brn1, and BrnA1 than in Sh1 (P <.05). In all 7-day groups, the agonizing period was 48 to 72 hours after burn, with Brn7 most affected (P <.05). Microvessels were multiplied in the Brn7 group, with significantly higher numbers in burn wounds of BrnA7 (P<.05). Burn wounds of BrnA7 had less accumulation of interleukin 6 than Brn7 with the Brn7 group having the highest mean blood level and Sh7, ShA7, and BrnA7 having similarly low levels (P>.05). Beta-endorphin levels in ShA7, Brn7, and BrnA7 were lower than in Sh7 (P <.05). Acupuncture contributed to the management of physiological and pathological pain, modulation of inflammatory responses, and associated enhancement of angiogenesis in the acute phase of burn injury in rats.