Person: DÜNDAR, TOLGA TURAN
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Publication Metadata only The Role of Staged Cryosurgery and Three-Dimensional Computed Tomography Integrated Navigation System in the Surgical Management of Severe Involvement of Craniofacial Polyostotic Fibrous Dysplasia(2020-01-01T00:00:00Z) Dündar, Tolga Turan; YILDIZ, KEMALETTİN; DÜNDAR, TOLGA TURAN; MEHDIZADE, TURAN; GÜNEREN, ETHEMFibrous dysplasia (FD) is a developmental bone disorder caused by the hamartamatous proliferation of bone-forming cells. A 29-year-old male patient with diagnosis of FD was admitted to our clinic with the symptoms of severe craniomaxillofacial involvement of FD beginning from last year. Neurological examination revealed diplopia, horizontal nystagmus, conductive hearing loss, and partial vision loss. In his medical history, it was reported that he had undergone intramedullary nailing operation in his left femur due to a pathological fracture approximately 8 years ago in the orthopedics clinic of our institution. The patient underwent 3 consecutive surgeries by our plastic and neurosurgical team. The patient was followed-up in the neuro-intensive care unit between the surgical sessions and 1 week after the last operation. Afterwards, he was transferred to the neurosurgical department. No postoperative complication was detected. The preoperative signs were recovered. During his 6th month follow-up control-visit, all his preoperative symptoms were improved. In addition, the patient was satisfied with his postoperative cosmetic improvement. In conclusion, virtual surgical planning and intraoperative surgical navigation systems can make the challenging cases possible to operate with increasingPublication Metadata only NÖROİNFLAMASYON(2022-08-01T00:00:00Z) Dündar, Tolga Turan; DÜNDAR, TOLGA TURANNÖROİNFLAMASYON VE İNTRASEREBRAL HEMATOMPublication Open Access Dexpanthenol and ascorbic acid ameliorate colistin-induced nephrotoxicity in rats.(2021-01-01T00:00:00Z) Aslan, T; Guler, E M; Dundar, T; Cakir, A; Gulgec, A S; Huseyinbas, O; Celikten, M; Coban, G; Hakyemez, I N; Kocyigit, ABDÜRRAHİM; Durdu, B; DÜNDAR, TOLGA TURAN; KOÇYİĞİT, ABDÜRRAHİMObjective: Colistin is a potent antibiotic which is mainly preferred in the treatment of multidrug-resistant (MDR) gram-negative bacilli. However, due to the increased risk of acute kidney injury following its use, the clinical application is limited. This nephrotoxicity is known to be induced by oxidative stress and related inflammation. In this study on rats, potent antioxidants Dexpanthenol (DEX) and Ascorbic acid (Vit C) have been administered in combination with Colistin to find out whether they would weaken Colistin's nephrotoxic effects. Materials and methods: Inflammation biomarkers were studied with enzyme-linked immunosorbent assay (ELISA) kits, and oxidative stress biomarkers were studied with different photometric methods in blood and tissue samples taken after treatment with DEX and Vit C in rats with colistin nephrotoxicity. In addition, inflammation and necrosis in the kidney tissues were examined pathologically. Results: It has been observed in the serum and tissue samples that DEX and Vit C decrease oxidative stress and inflammation biomarkers, therefore acting as nephroprotective agents. Conclusions: These compounds have been found to ameliorate the nephrotoxic effects of Colistin, which were demonstrated in the rats treated with Colistin, as well as the combinations.Publication Open Access Machine Learning-Based Surgical Planning for Neurosurgery: Artificial Intelligent Approaches to the Cranium(2022-04-01T00:00:00Z) Dündar, Tolga Turan; Yurtsever, İsmail; Kurt Pehlivanoğlu, Meltem; Yıldız, Uğur; Eker, Ayşegül; Demir, Mehmet Ali; Mutluer, Ahmet Serdar; Tektaş, Recep; Kazan, Mevlude Sila; Kitiş, Serkan; Gokoglu, Abdulkerim; Doğan, İhsan; Duru, Nevcihan; DÜNDAR, TOLGA TURAN; YURTSEVER, İSMAİL; KİTİŞ, SERKANObjectives: Artificial intelligence (AI) applications in neurosurgery have an increasing momentum as well as the growing number of implementations in the medical literature. In recent years, AI research define a link between neuroscience and AI. It is a connection between knowing and understanding the brain and how to simulate the brain. The machine learning algorithms, as a subset of AI, are able to learn with experiences, perform big data analysis, and fulfill human-like tasks. Intracranial surgical approaches that have been defined, disciplined, and developed in the last century have become more effective with technological developments. We aimed to define individual-safe, intracranial approaches by introducing functional anatomical structures and pathological areas to artificial intelligence. Methods: Preoperative MR images of patients with deeply located brain tumors were used for planning. Intracranial arteries, veins, and neural tracts are listed and numbered. Voxel values of these selected regions in cranial MR sequences were extracted and labeled. Tumor tissue was segmented as the target. Q-learning algorithm which is a model-free reinforcement learning algorithm was run on labeled voxel values (on optimal paths extracted from the new heuristic-based path planning algorithm), then the algorithm was assigned to list the cortico-tumoral pathways that aim to remove the maximum tumor tissue and in the meantime that functional anatomical tissues will be least affected. Results: The most suitable cranial entry areas were found with the artificial intelligence algorithm. Cortico-tumoral pathways were revealed using Q-learning from these optimal points. Conclusions: AI will make a significant contribution to the positive outcomes as its use in both preoperative surgical planning and intraoperative technique equipment assisted neurosurgery, its use increasedPublication Metadata only Nöroinflamasyon(Pelikan Tıp & Teknik Kitapçılık, 2022-08-01) Dündar T. T. (Editör); DÜNDAR, TOLGA TURANher yönü ile nöroinflamasyonPublication Metadata only A Rare Presentation of Neurobrucellosis in a 6-Year-Old Pediatric Patient with Sagittal Sinus Thrombosis(2020-10-01T00:00:00Z) TÜREL, Özden; KUTLU, NURETTİN ONUR; YEŞİLBAŞ, Osman; Yozgat, Can Yilmaz; DÜNDAR, TOLGA TURAN; BURSAL DURAMAZ, BURCU; UZUNER, SELÇUK; ABDİLLAHİ, FATOUMA KHALİF; TÜREL, ÖZDEN; UZUNER, SELÇUK; BURSAL DURAMAZ, BURCU; DÜNDAR, TOLGA TURAN; SEYİTHANOĞLU, MEHMET HAKAN; YEŞİLBAŞ, OSMAN; KUTLU, NURETTİN ONURBrucellosis is one of the most common zoonosis worldwide. It is still endemic in many regions of the world. A 6-year-old female was admitted to the emergency department (ED) due to a sudden change in consciousness, urinary incontinence, vomiting, and difficulty in walking. Neurological examination demonstrated abducens nerve paralysis, mild-to-moderate motor deficit in hemiparesis in the left arm. Brain magnetic resonance imaging showed a hemorrhagic focus at the right frontal lobe and thrombosis in the superior sagittal sinus of the brain. The diagnosis of neurobrucellosis was confirmed by identifying Brucella spp. in the blood culture on the day 6 of pediatric intensive care unit admission; thus, trimethoprim-sulfamethoxazole and rifampicin, and ceftriaxone were promptly initiated. Despite neuroprotective management and acetazolamide, the patient-s neurological problems and high intracranial pressure (ICP) persisted. An external ventricular drainage tube and a Codman ICP monitor were placed to be on the consent vigilance of the patient-s neurological condition. The patient-s ICP continued to increase despite the current treatment regimen; therefore, a decompressive bitemporal craniectomy was performed. The ICP level of the patient returned to its normal range immediately after the craniectomy. The patient did not have any notable neurologic sequelae at the first-year follow-up. Neurobrucellosis is a rare complication of systemic brucellosis and may present as meningitis, encephalitis, myelitis, radiculitis, and/or neuritis. Herein, we describe a six-year-old girl with brucellosis complicated with cerebral vein thrombosis. This case illustrates the need for close monitoring of patients with unexplained neurological signs or symptoms for brucellosis in endemic areas.Publication Metadata only Oxidative Stress Level in Patients with Subarachnoid Hemorrhage.(2021-12-12T00:00:00Z) Abdallah, Anas; Guler, Eray Metin; Çınar, İrfan; Papaker, Meliha Gündağ; Dündar, Tolga Turan; Yurtsever, İSMAİL; GUNDAG, MELİHA; ÖZER, ÖMER FARUK; YURTSEVER, İSMAİL; DÜNDAR, TOLGA TURANPublication Open Access Follow-Up of High-Grade Glial Tumor; Differentiation of Posttreatment Enhancement and Tumoral Enhancement by DCE-MR Perfusion(2022-01-01T00:00:00Z) DÜNDAR, TOLGA TURAN; Cetinkaya, Ezra; YURTSEVER, İSMAİL; Uysal, Ömer; Aralaşmak, Ayşe; DÜNDAR, TOLGA TURAN; ÇETİNKAYA, EZRA; YURTSEVER, İSMAİL; UYSAL, ÖMERPurpose: To search for the utility of DCE-MRP to differentiate between posttreatment enhancement (PT) and tumoral enhancement (TM) in high-grade glial tumors. Materials and methods: Thirty-four patients with glioma (11 grade 3; 23 grade 4) were enrolled. Enhancement in the vicinity of the resection cavity demonstrated by DCE-MRP was taken into consideration. Based on the follow-up scans, reoperation or biopsy results, the enhancement type was categorized as PT or TM. Measurements were performed at the enhancing area near the resection cavity (ERC), nearby (NNA) and contralateral nonenhancing areas (CLNA). Perfusion parameters of the ERC were also subtracted from NNA and CLNA. Intragroup comparison (paired sample t-test) and intergroup comparison (Student's t-test) were made. Results: There were 7 PTs and 27 TMs. In the PT, the subtracted values of Ve and IAUC from the CLNA and NNA and the subtracted value of Kep from NNA were statistically different. In TM, all metrics were significantly different comparing the CLNA and NNA. Comparing PT with TM, Ktrans, IAUC, Kep, and subtracted values of Ktrans and IAUC from both NNA and CLNA were significantly different. Conclusions: In PT, only Ktrans values did not reveal any difference comparing NNA and CLNA. To differentiate PT from TM, Ktrans, Kep, IAUC, and subtracted values of Ktrans and IAUC from NNA and CLNA can be used. These findings are in concordance with literature.Publication Metadata only McFARLANE RAT DORSAL CİLT FLEP MODELİNDE AMNİOMAX’IN NEKROZ ÖNLEYİCİ ETKİSİNİN ARAŞTIRILMASI(2020-07-01T00:00:00Z) Dündar, Tolga Turan; Yıldız, Kemalettin; Tosuner, Zeynep; Mihrapoğlu, Semih Lütfi; Kitiş, Serkan; DÜNDAR, TOLGA TURAN; YILDIZ, KEMALETTİN; KİTİŞ, SERKAN