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    Effects Of Folic Acid Versus Nicotine On Bone Development
    (Dergi Park, 2024) Doğan, Kadirhan; Nisari, Mehtap; Payas, Ahmet; Ertekin, Tolga; Güler, Hatice; Al, Özge
    Purpose: Nicotine exposure during pregnancy directly or indirectly harms not only the mother but also the fetal tissues. The aim of this study is to investigate the possible effects of folic acid given against nicotine used during pregnancy on bone development of fetuses. Materials and Methods: 18 adult female rats were divided into control, low-dose nicotine (LDN), high-dose nicotine (HDN), low-dose nicotine + folic acid (LDN + FA), high-dose nicotine + folic acid (HDN + FA), and folic acid (FA) group equally. During 20 days, 1 ml/kg serum physiologic (SP) solution to the control group, 3 mg/kg nicotine to LDN, 6 mg/kg nicotine to HDN, 3 mg/kg nicotine and 400 µg/kg FA to LDN+FA, 6 mg/kg nicotine and 400 µg/kg FA to HDN+FA, 400 µg/kg FA to the FA group was administered. Bones of fetuses taken by cesarean section on the 20th day of pregnancy were stained with the bilateral skeleton staining technique. The stained anterior and posterior extremity bones were photographed under a stereomicroscope. Bone length, extent of ossification and percentage of ossification were measured. Statistical data were evaluated using the R programming language (v. 3.2.3). Results: The bone development of LDN and HDN groups was significantly lower and LDN+FA and HDN+FA groups was close to the control group (p<0.05). Conclusion: While nicotine used during pregnancy decreases the bone development of fetuses, FA may decrease this effect and increase ossification.
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    The Effect of Pituitary Neuroendocrine Tumors on the Volumes of Intracranial Structures
    (Frontiers in Neurology, 2025) Gökoğlu, Abdulkerim; Yiğit, Hüseyin; Yolaçan, Ebru; Nisari, Mehtap; Unur, Erdoğan; Selçuklu, Ahmet
    Objective: Pituitary Neuroendocrine Tumors (PitNETs) can cause symptoms via mass effect or hormonal imbalances. This study investigated whether PitNETs induce volumetric changes in intracranial structures and assessed the diagnostic potential of these changes.Material and Methods: A retrospective analysis was conducted on 90 PitNET patients and 86 healthy controls. MRI data, acquired on a 1.5 Tesla scanner, were processed using the automated Vol2Brain system to calculate relative brain volumes.Results: PitNET patients exhibited significantly lower relative volumes across numerous brain structures compared to controls. This included reduced intracranial, cerebral, and cortical gray matter (GM), as well as temporal lobe, vermis, limbic lobe, hippocampus, and inferior lateral ventricle (ILV) volumes. Gyrus-level analysis also revealed significantly smaller volumes in key regions like the posterior orbital gyrus, supplementary motor cortex, and entorhinal area in PitNET patients. ROC analysis demonstrated good to very good diagnostic performance for ILV volume (AUC=0.863; p=0.002) and subcortical GM volume (AUC=0.725; p=0.049) in differentiating groups. Reduced volumes were also noted in basal ganglia structures.Conclusions: Our findings indicate significant volumetric reductions in various brain regions in PitNET patients, potentially explaining observed emotional and cognitive symptoms. The diagnostic utility of ILV and subcortical GM volumes is promising, suggesting their value as diagnostic adjuncts. These objective volumetric assessments may assist in surgical planning and patient stratification, though further prospective research is warranted to establish direct links with clinical outcomes.
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    The Impact of Multilevel Anterior Cervical Discectomy and Fusion on Cervical Sagittal Alignment: A Comparative Study of Single-, Two-, and Three-Level Procedures
    (Journal of Clinical Medicine, 2025) Gökoğlu, Abdulkerim; Yiğit, Hüseyin; Doğan, Kadirhan; Nisari, Mehtap; Unur, Erdoğan
    Objectives: Cervical degenerative disc disease (CDD) significantly compromises patients’ quality of life through the induction of radiculopathy and myelopathy. This study endeavored to compare the clinical and radiological outcomes of anterior cervical discectomy and fusion (ACDF) in patients presenting with single-, two-, and three-level CDD. Methods: A retrospective analysis was conducted on 94 patients who underwent ACDF between December 2018 and December 2023. Patients were categorized into single-level (n = 36), two-level (n = 40), and three-level (n = 18) CDD groups. Preoperative and postoperative radiological (X-ray, MRI) and clinical (Japanese Orthopedic Association [JOA], Visual Analog Scale [VAS]) data were rigorously analyzed. Results: Statistically significant improvements in postoperative JOA and VAS scores were observed across all cohorts. Notably, the three-level CDD group exhibited a significantly lower JOA improvement rate compared to the single-level group (p = 0.040). All groups demonstrated a marked increase in cervical lordosis and disc height postoperatively (p < 0.05). Patients undergoing three-level ACDF presented with lower JOA scores than those undergoing single- or two-level procedures. Logistic regression analysis identified that the preservation of the disc height significantly correlated with a higher likelihood of achieving a greater JOA improvement. Conclusions: ACDF is established as a safe and efficacious surgical intervention for patients with single-, two-, and three-level CDD. The implementation of hybrid prostheses appears to be instrumental in maintaining lordosis in multilevel ACDF. Three-level ACDF is associated with diminished JOA improvement rates compared to single-level ACDF. Further longitudinal, multicenter investigations are warranted to validate these findings.
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    The Impact of Multilevel Anterior Cervical Discectomy and Fusion on Cervical Sagittal Alignment: A Comparative Study of Single-, Two-, and Three-Level Procedures.
    (MDPI, 2025) Gökoğlu, Abdulkerim; Yiğit, Hüseyin; Doğan, Kadirhan; Nisari, Mehtap; Unur, Erdoğan
    Cervical degenerative disc disease (CDD) significantly compromises patients' quality of life through the induction of radiculopathy and myelopathy. This study endeavored to compare the clinical and radiological outcomes of anterior cervical discectomy and fusion (ACDF) in patients presenting with single-, two-, and three-level CDD. A retrospective analysis was conducted on 94 patients who underwent ACDF between December 2018 and December 2023. Patients were categorized into single-level ( = 36), two-level ( = 40), and three-level ( = 18) CDD groups. Preoperative and postoperative radiological (X-ray, MRI) and clinical (Japanese Orthopedic Association [JOA], Visual Analog Scale [VAS]) data were rigorously analyzed. Statistically significant improvements in postoperative JOA and VAS scores were observed across all cohorts. Notably, the three-level CDD group exhibited a significantly lower JOA improvement rate compared to the single-level group ( = 0.040). All groups demonstrated a marked increase in cervical lordosis and disc height postoperatively ( < 0.05). Patients undergoing three-level ACDF presented with lower JOA scores than those undergoing single- or two-level procedures. Logistic regression analysis identified that the preservation of the disc height significantly correlated with a higher likelihood of achieving a greater JOA improvement. ACDF is established as a safe and efficacious surgical intervention for patients with single-, two-, and three-level CDD. The implementation of hybrid prostheses appears to be instrumental in maintaining lordosis in multilevel ACDF. Three-level ACDF is associated with diminished JOA improvement rates compared to single-level ACDF. Further longitudinal, multicenter investigations are warranted to validate these findings.