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    The Expression of MMP-11 In Benign Meningiomas
    (Journal Neurological Sciences, 2014) Ayan, Erdogan; Uyar, Suheyla Bozkurt; Cerci, Ajlan; Altas, Murat; Bolukbasi, Fatihhan; Elmaci, Ilhan; Sav, Aydin
    The WHO categorises tumours based on their histological properties; however, this classification falls short of understanding their biological behaviours. Recently, there has been an increase in the number of studies on extracellular matrix components with the aim of understanding the biological behaviours of tumours. MMP-11 is a metalloproteinase from the MMP family that has a different expression pattern, mechanism of action, and substrate range compared with the other members of this family. Of the 55 benign meningioma cases examined, 29 were transitional, 16 were meningothelial, and 8 were fibroblastic in nature. In the meningotheliomatous cases, the MMP-11 expression score was high (75%), whereas it was low in the fibrous cases (87.5%). The Ki-67 levels in the cases with high MMP-11 expression scores were significantly higher than those of cases with low MMP-11 expression scores. Although there was no statistically significant correlation between recurrence and the MMP-11 expression score, 5 out of 7 cases with recurrence were found to have high MMP-11 expression scores. According to our study, MMP-11 is expressed in Grade I meningiomas. The level of MMP-11 expression appears to be high in the meningotheliomatous tumours and low in the fibrous subtypes. The tumours with a high level of MMP-11 expression also demonstrated high Ki-67 values.
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    Investigation of ACE Genome Insertion/Deletion Correlation with Immunohistochemical Profile in Pituitary Adenomas
    (Turkish Neurosurgical Soc, 2013) Altas, Murat; Bayrak, Omer Faruk; Serefhan, Alpay; Silav, Gokalp; Coskun, Kerim Kenan; Cerci, Ajlan; Isik, Nejat
    AIM: The deletion polymorphism of the angiotensin-converting enzyme (ACE) genome causes neoplastic development in several organs by increasing the angiotensin 2 (A2) formation. In this study, we aimed to identify the ACE genome insertion/deletion polymorphism in pituitary adenomas and to compare it with the control group. MATERIAL and METHODS: Patients operated for pituitary adenomas were included in the study. Genomic DNA was extracted from tumoral tissues and peripheral blood samples of the patients by using the Miller method. Primary sequence was selected via targeting the polymorphic region of intron 16 of ACE genome 17q23. DNA samples were multiplied by PCR using HACE3s and HACE3as primers. RESULTS: Twenty-one operated cases were studied. In the study group; 44% of the patients were identified as DID, 33% of them as I/D and 23% of them as I/I. In 60%, D allele was identified. According to immunohistochemical investigation, we found that 100% of the patients with Cushing adenoma were D/D alleles. CONCLUSION: Presence of high rate of ACE genome deletion in patients with pituitary adenoma and grade 3-4 patients suggest that ACE genome polymorphism can be a risk factor for the development of pituitary adenomas.
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    Microsurgical management of non-neurofibromatosis spinal schwannoma
    (Elsevier Doyma Sl, 2013) Altas, Murat; Cerci, Ajlan; Silav, Gokalp; Sari, Ramazan; Coskun, Kenan; Balak, Naci; Isik, Nejat
    Introduction: The aim of this study is to assess the clinical properties and surgical results of patients diagnosed with spinal schwannomas without neurofibromatosis (NF) properties. Patients and methods: The data obtained from 35 patients who underwent resection of spinal schwannomas were analyzed. All cases with neurofibromas and those with a known diagnosis of NF Type 1 or 2 were excluded. 35 patients underwent surgery for spinal schwannoma at our institution between January 1997 and 2010. The data were gathered retrospectively from medical records and included clinical presentation, tumor location and post-operative complications. All cases were surgically excised, and they were confirmed to be schwannomas by pathologists with histopathological sections in paraffin stained with hematoxylin-eosin. Result: We treated 35 (20 males and 15 females) patients with spinal schwannomas. The mean age of the patients was 47.2 (between 13 and 76) years. Of the cases, six schwannomas were located in the cervical spine, four in the thoracic spine, two in cervico-thoracic area, 10 in the thoraco-lumbar area and 13 in the lumbar spine. Two patients had malignant schwannomas that were recurrent. Of the 35 cases, the schwannomas were intradural-extramedullary in 30 cases (86%), intradural-intramedullar in 2 cases (6%), and extradural in 3 cases (9%). Conclusion: Spinal schwannomas may occur at any level of the spinal axis and are most frequently intradural-extramedullary. The most common clinical presentation is pain. Most of the spinal schwannomas in non-NF patients can be resected completely without or with minor post-operative deficits. This knowledge may help us to create a strategy for total resection of a spinal schwannomas. (C) 2011 Sociedad Espanola de Neurocirugia. Published by Elsevier Espana, S.L. All rights reserved.
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    A New Molecule in Aneurysmal Subarachnoid Hemorrhage: Dendroaspis Natriuretic Peptide
    (Turkish Neurosurgical Soc, 2014) Serefhan, Alpay; Altas, Murat; Cerci, Ajlan; Isik, Nejat; Elmaci, Ilhan
    AIM: Dendroaspis natriuretic peptide (DNP) is the most recently identified member of the natriuretic peptide family. Although DNP has similar structure and function to other members, it is genetically different. The other members are known to cause vasorelaxation but the effects of DNP on vascular structure still remains unclear. In this study, we aimed to find out the role of DNP in the development of vasospasm following aneurysmal SAH (subarachnoid hemorrhage). MATERIAL and METHODS: DNP levels of 17 patients diagnosed with aneurysmal SAH and 25 volunteers as control were measured. All SAH patients were treated with aneurysm clip. Five ml of venous blood sample was obtained on postoperative 1,3 and 7th days from each patient. Additionally, DNP levels were determined by obtaining cerebrospinal fluid (CSF) postoperative 1,3 and 7th days. RESULTS: Statistically significant difference was observed between cerebrospinal fluid DNP levels on day 1 and day 3 (P<0.05). CONCLUSION:This study suggests that DNP can be anticipated among molecules leading development of vasospasm. The findings of present study are believed to encourage further studies regarding receptors and receptor specific drugs.