Study Design: This was a retrospective study. Objection: Lumbar Spinal Stenosis (LSS) is a disease that causes chronic low back pain and can often be confused with herniated disk. In this study, a deep learning-based classification model is proposed to make LSS diagnosis quickly and automatically with an objective tool. Summary of Background Data: LSS is a disease that causes negative consequences such as low back pain, foot numbness, and pain. Diagnosis of this disease is difficult because it is confused with herniated disk and requires serious expertise. The shape and amount of this stenosis are very important in deciding the surgery and the surgical technique to be applied in these patients. When the spinal canal narrows, as a result of compression on these nerves and/or pressure on the vessels feeding the nerves, poor nutrition of the nerves causes loss of function and structure. Image processing techniques are applied in biomedical images such as MR and CT and high classification success is achieved. In this way, computer-aided diagnosis systems can be realized to help the specialist in the diagnosis of different diseases. Methods: To demonstrate the success of the proposed model, different deep learning methods and traditional machine learning techniques have been studied. Results: The highest classification success was obtained in the VGG16 method, with 87.70%. Conclusions: The proposed LSS-VGG16 model reveals that a computer-aided diagnosis system can be created for the diagnosis of spinal canal stenosis. In addition, it was observed that higher classification success was achieved compared with similar studies in the literature. This shows that the proposed LSS-VGG16 model will be an important resource for scientists who will work in this field.

The most important information to be noted about LSS not a hernia. While a hernia occurs with a rupture in the disc, LSS occurs as a result of calcification due to deformation of the bone in the following years. In addition, the correct interpretation and diagnosis of biomedical images requires serious expertise, making the diagnosis of LSS difficult. Looking at the literature, the U-Net method can perform semantic segmentation with high success. In recent years, it has been seen in the literature that the success of the classical U-Net has increased when the architecture of different deep learning methods has been applied. In order to segment the LSS region, semantic segmentation was performed on lumbar spine MR images with 3 different deep learning methods. The success of these methods was calculated by Dice and IoU scores. The highest segmentation success among 1560 images was obtained in the ResUNet model with 0.93 DICE score. LSS treatment, which negatively affects human life, is very important because of the difficulty of interpreting MR images and the confusion of LSS with lumbar hernia. Today, expert decision support systems have become essential for correct diagnosis, which is the most important feature of starting a treatment/surgical operation. Especially the high success of classification/segmentation obtained by deep learning methods has also been demonstrated in LSS segmentation, which is the subject of our study.

The aim of the study is to develop a noble biomaterial that can accelerate the healing process without the risk of infection by loading tetracycline hydrochloride and collagen hemostatic agent into the chitosan tissue scaffold. After the trials, a good tissue scaffold was obtained from chitosan and PVA by electro spinning. To increase the hemostatic features of this biomaterial, 10% (by weight) collagen hemostatic agent was added to the PVA chitosan blend. After the amount of collagen hemostatic agent in the chitosan tissue scaffold was set, various amounts of tetracycline were added and 5 different biomaterials were developed to augment the antibacterial and wound healing properties. Antibiotic concentration in the biomaterial was IV 10% in the first, 15% in the second, 20% in the third, 25% in the fourth and 30% in the fifth sample. Finally, the effects of the obtained biomaterials on the nosocomial bacteria (gram positive: Staphylococcus Aureus, gram negative: Pseudomonas Aeruginosa) were analyzed with in-vitro tests at Kahramanmaras Sutcu Imam University, School of Medicine Department of Microbiology laboratories. As a result of the examination, it was examined how much the biomaterial should be and how effective it was against bacterial growth on the first, third and fifth days. It is thought that biomaterial will be very effective in emergencies and surgical procedures.

STUDY DESIGN:This was a retrospective study.OBJECTION:Lumbar Spinal Stenosis (LSS) is a disease that causes chronic low back pain and can often be confused with herniated disk. In this study, a deep learning-based classification model is proposed to make LSS diagnosis quickly and automatically with an objective tool.SUMMARY OF BACKGROUND DATA:LSS is a disease that causes negative consequences such as low back pain, foot numbness, and pain. Diagnosis of this disease is difficult because it is confused with herniated disk and requires serious expertise. The shape and amount of this stenosis are very important in deciding the surgery and the surgical technique to be applied in these patients. When the spinal canal narrows, as a result of compression on these nerves and/or pressure on the vessels feeding the nerves, poor nutrition of the nerves causes loss of function and structure. Image processing techniques are applied in biomedical images such as MR and CT and high classification success is achieved. In this way, computer-aided diagnosis systems can be realized to help the specialist in the diagnosis of different diseases.METHODS:To demonstrate the success of the proposed model, different deep learning methods and traditional machine learning techniques have been studied.RESULTS:The highest classification success was obtained in the VGG16 method, with 87.70%.CONCLUSIONS:The proposed LSS-VGG16 model reveals that a computer-aided diagnosis system can be created for the diagnosis of spinal canal stenosis. In addition, it was observed that higher classification success was achieved compared with similar studies in the literature. This shows that the proposed LSS-VGG16 model will be an important resource for scientists who will work in this field.

In this study, it was investigated on the brain gray matter whether the effect of Nicotiana rustica, which is widely used in Kahramanmaraş and its environs and user age can be lower than secondary school, that harms are not clearly revealed, which can be bought quite cheaply and contains more nicotine than cigarettes. Segmentation of parts of the brain such as gray matter, white matter, and cerebrospinal fluid (CSF) with SPM and calculation of their volume were performed with the Voxel-Based Morphometry (VBM) interface. Segmentation of images in the study was carried out using the Gaussian Mixture Model. With these processes, gray matter volumes of users and non-users of Nicotiana rustica were calculated and classified using classical machine learning and deep learning techniques. A data set was created for those user of Nicotiana rustica and non users, with the volumes of gray and white matter, CSF volume and their ratios to each other obtained with VBM. This data set has been classified using classical machine learning methods (Naive Bayes, J48, kNN, Support Vector Machines, Random Forest), as well as deep learning methods (1D-CNN, CNN + LSTM). Methods classification success for classical methods, respectively: 70

Purpose: We aimed to present our experience within similar to laminoplasty with a simple method technique that allows stabilization of the spinal cord without instrumentation during tumor surgery.

Objective: We aimed to present our experience with a modified laminoplasty technique that allows stabilization of the spine without instrumentation during tumor surgery. Methods: This retrospective study was performed in the neurosurgery department of a university hospital and data were collected from the medical files who were treated surgically for spinal tumors. The same surgical team operated on the patients using the same procedure without any instrumentation for stabilization of the spine. Demographic and clinical data were collected. It was checked whether radiological and clinical instability developed at the 6th and 12th months postoperatively. Results: Our series comprised 41 patients (20 females, 21 males) with an average age of 47.122±20.33 (range: 11 to 86 years). The most common complaints detected in this series were diminution of motor power in lower extremities (20,47.62%), radicular pain (9,21.43%), and hypoesthesia (2,4.76%). The most frequent sites of involvement were L1-L2 (5,11.90%), L2 (4,9.52%), and T5-T6-T7 (2,4.76%), respectively. Histopathologically, schwannoma (8,19.94%), ependymoma (7,16.64%), meningioma (6,14.28%), and metastatic carcinoma (5,11.90%). The distribution of tumors was intradural and extramedullary (27,64.28%), intradural and intramedullary (13,30.95%), and extradural and extramedullary (2,4.77%), respectively. Conclusion: Our results imply that stability of the spinal cord can be preserved without fixation or instrumentation during surgical procedures for spinal tumors. However, longer periods of follow-up, as well as prospective, controlled, multi-centric trials on larger populations, are warranted to evaluate the safety and efficacy of the novel technique.

Alzheimer’s disease (AD) is a problematic disease that has shown a significant increase in patient numbers worldwide. AD is identified pathologically by the accumulation of the toxic amyloid beta (Aβ) protein, neurofibrillary tangles and neuropil threads in postmortem brains of AD patients. Women are more prone to AD either due to their increased life expectancy or the decline in Estrogen hormone levels around menopause. Estrogens play a physiologically important role in the brain, but there is debate about the association between estrogen and Ad. The neuroprotective effects of estrogens are possibly mediated by estrogen receptors (ERs), which include classical nuclear estrogen receptors (ERα and ERβ) and nonclassical ER (G protein-coupled estrogen receptor 1, GPER1(GPR30)). The effect of GPER1 on Aβ-induced neurotoxicity is unclear. Here we studied the effect of GPER1 receptor agonists G-1 on rat neuronal cells. Rat neuronal cells were incubated with Aβ1–42, either alone or in combination with GPER1 agonist G-1 (10−7, 10−8 and 10−9 M). Cell viability was determined by MTT assays and apoptotic effects induced by Aβ1–42 were measured by Cell Death Detection kit. Oxidative stress parameters, including nitric oxide (NO) levels and total oxidant status (TOS) were measured by spectrophotometry. Approximately half of the cell death was observed with 10−6 M Aβ1–42 incubation for 48 hours. This is the first study that explores the effect of activation of GPER1 by its agonist G-1 on neuroprotection against Aβ1–42-toxicity in rat neuronal cells. GPER1 activation significantly reduced on rat neuronal cells. Aβ1–42 induced cell death was significantly reduced by co-incubating with G-1. Our results suggest that G-1 treatment protects neurons from Aβ1–42 induced neurotoxicity by changing the oxidative parameters on rat neuronal cells.

Copyright C 2018 by Korean Society of Spine Surgery This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Asian Spine Journal • pISSN 1976-1902 eISSN 1976-7846 • www.asianspinejournal.org Received Jan 9, 2018; Accepted Jan 9, 2018 Corresponding author: Idiris Altun Department of Neurosurgery, Kahramanmaras Sutcu Imam University Medical Faculty, Kahramanmaras 46050, Turkey Tel: +90-3442803434, Fax: +90-3442803409, E-mail: idrisaltun46@hotmail.com

Objective: This study aims to examine the psychopathology, quality of life perception, eating behaviors and self-image of children and adolescents who are diagnosed with obesity; as well as their parents’ behaviour, coping skills and the relations between these conditions. Methods: In this study, 30 patients between the ages of 8 –18 who have consulted the University of Akdeniz Pediatric Endocrinology Department and had BMI standard deviation above 2 and had no mental retardation or received no previous psychiatric consultations on the obesity were enrolled. Our control group included 30 healthy children and adolescents who were matching on the same demographic information (gender and age) with the treatment (patient) group, and they had no previous medical or psychiatric illnesses. The Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version was administered to both groups, and the Rosenberg Self Image Scale was used to determine their self-images. The Quality of Life Scale for Children was administered to the children and adolescents as well as to their parents. To determine the methods of child rearing and coping strategies with stress, parents were administered the Family Life and Child Rearing Demeanours Scale and the Coping Strategies Scale. Results: There were no significant sociodemographic differences between the two groups except for parents’ educational level and socioeconomic status. As we found no differences on parenting styles and coping strategies, a higher percentage of psychiatric illnesses were detected in our study and the quality of life perception of parents was found lower in the obese group. Self-image scores were not varied between obese children and healthy controls. İt was observed that obese group children’s mother have more likley high obesity rates than the mothers in the control group children. Conclusions: As a result of this study, psychiatric disorders were observed more frequently in obese children and adolescents. The perception of quality of life for obese children and adolescents seem alike with control groups’ perception. However, the fact that obese children and adolescents’ parents claim that their children’s quality of life is not equal to other groups shows that obese children and adolescents are less aware of health condition and following problems they have and might possible attain in the future.

OBJECTIVE:To investigate the histopathological and biochemical effects of topical and systemic administrations of erythropoietin (EPO) on crush and transection type peripheral nerve injuries in an experimental rat model.METHODS:128 male Wistar-Albino rats were allocated to 8 groups according to the route of administration of EPO (local/systemic) and type of peripheral nerve injury (crush/transection). groups were compared with respect to histopathological examination and number of axons as well as levels of IL-1β, IL-6, and IL-10.RESULTS:Groups receiving EPO either locally or intraperitoneally revealed less scar tissue formation index, lower number of inflammatory cells, reduced number of perineural fibroblasts and increased number of axons (p < 0.001 for all). Levels of IL-1β and IL-6 were lower and IL-10 levels were higher in groups receiving EPO locally or intraperitoneally (p < 0.001).CONCLUSION:Iatrogenic nerve injury has remained an area with few therapeutic options. Our results indicated that local and systemic applications of EPO might have a promising potential therapeutic agent for crush or transection type of peripheral nerve injuries. Dose, route of administration and indications should be elucidated in further prospective, randomized, controlled trials (Tab. 3, Fig. 4, Ref. 32).

Problem: Epidemiological studies in humans implicate maternal expression of different combinations of KIRs, which are a family of cell surface receptors that tune cellular activation status, as being predictive in pregnancy complication onset (e.g., preeclampsia) and fetal health. This receptor family is expressed in both innate and adaptive immune cell populations, including the most abundant cell types found in the pregnant uterus. Due to limitations in studying human samples, a mouse model was generated in which the functionally homologous receptor family, Ly49s, has been globally deleted. The deletion of this gene complex leads to impaired vasculature formation and remodeling in mid-pregnancy, ultimately driving pregnancy defects, mirroring the correlations seen in the human population. However, the problem is that the mechanisms by which the lack of Ly49 receptors change immune cell function and leads to deleterious pregnancy outcomes remains unknown. Method of Study: To investigate the contributions of Ly49 receptors in pregnancy associated angiogenesis, we mated wildtype (WT) and Ly49−/− dams with WT sires and analyzed the implantation sites at gestational day 9.5. We performed a proteomic screen for expression of proteins known to be involved in angiogenesis, followed by verification via flow cytometry and western blot. Additionally, cultured WT and Ly49−/− uterine single cell suspensions were analyzed by flow cytometry and conditionedmedia was utilized an in-vitro angiogenesis assayusingamurineendothelial cell line, SVEC4-10, onaGeltrexextracellular matrix bed. Endothelial tube formation was imaged by light microscopy and quantified using ImageJ. Results: Ly49−/− dams at gestational day 9.5 display a skewed expression of angiogenesis related proteins, as compared to WT dams, with several proteins having significantly decreased abundance. VEGF expression in particular is 2–3-fold lower in Ly49−/− implantation sites, with this decrease coming from a non-immune cell population. Cultured Ly49−/− uterine cells display an increased production of pro-inflammatory cytokines compared to WT, including TNFa and IFNg, whose cellular source is from a monocyte/macrophage lineage. Conditioned media from Ly49−/− uterine cells leads to a significant anti-angiogenic effect, with a substantial decrease in endothelial tube branching and pronouncedmorphological changes. Conclusion: Together, these data indicate that loss of Ly49 receptors is leading to dysregulated immune cell function and production of

To investigate whether there is an association between mild head injury (MHI) and attention deficit hyperactivity disorder (ADHD) symptoms in preschool children.

yetiştiriciliğinin yaygın olduğu ülkelerde

Objective: To present our clinical outcomes with anterior approach microdiscectomy and artificial disc replacement in patients with C5-6 disc hernias. Material and Methods: This cohort study is based on data collected during follow-up of a total of 53 patients (23 women, 30 men; mean age: 40.6±4.4 years) operated in the neurosurgery departments of 3 institutions between February 2010 and February 2013. Pain and neck disability were evaluated preoperatively and at postoperative 6th, 12th and 24th months by means of visual analogue scale (VAS) and neck disability index (NDI), respectively. Alterations in VAS and NDI scores were compared during the follow-up period. Results: Scores in VAS and NDI were improved significantly at postoperative 6th, 12th and 24th months (p<0.001 for all). Furthermore, VAS and NDI scores at 12th and 24th months were better than those at 6th month (p=0.021 and p=0.006 for VAS; p<0.001 for NDI). However, no differences were observed between VAS (p=0.192) and NDI scores (p=0.258) at postoperative 12th and 24th months. Conclusion: We suggest that microdiscectomy and implantation of the artificial cervical disc prosthesis is a safe and effective procedure for reduction of pain and improvement of neck disability in patients with disc herniation at the level of C5-C6. Long- term follow-up in larger series and controlled trials are required for documentation of the safety and efficacy of the procedure more accurately.

Low back is a very frequently seen disease which can be an indicator of many diseases with heterogenous distribution. Mechanical causes are responsible for 90%-95% of cases with chronic low back pain and the most common reasons are degenerative disc pathologies and facet joint problems. The 5%-10% of non-mechanical causes of low back pain include neoplastic primary or metastatic problems, infection, fibromyalgia, somatoform disorders, inflammatory arthritis, Paget’s disease and Scheuermann kyphosis. In rheumatoid arthritis patients, low back pain has been reported at the rate of 33-40%, but this low back pain has been reported not as a symptom of RA but as a development associated with inflammation, flare-up of disease, or the use of insufficient or ineffective drugs. Herein, we have reported a patient who presented with complaints of low back and leg pain without any additional complaint and diagnosed as rheumatoid arthritis. Patients may not always present with clinical symptoms of RA and it should be kept in mind that the first symptoms of RA can be low back and leg pain.