Browsing by Author "FEDAKAR, RECEP"

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A neurosurgical assessment of the blood supply in the optochiasmatic system: A cadaveric-anatomic study
(Springer, 2021-01-05) Baykal, Duygu; Yılmazlar, Selçuk; Fedakar, Recep; Baykal, Duygu; YILMAZLAR, SELÇUK; FEDAKAR, RECEP; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Beyin Cerrahisi Anabilim Dalı; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Adli Tıp Anabilim Dalı; 0000-0003-3633-7919; AAH-5070-2021; AAH-6287-2021; GMD-4113-2022
The chiasmal and subchiasmal surfaces are of critical importance in connection with the performance of surgical procedures owing to the critical blood supply to these areas. Recently, the perforating arteries providing the blood to the optic nerves and chiasm have gained attention as they significantly affect the morbidity from surgical approaches. Intraoperative preservation of these perforating arteries is considered critical to prevent further visual loss. Thirty autopsy specimens, including the optic apparatus, were examined for their perforating arteries feeding the optic chiasm and optic nerves. The optic nerves and chiasmal surfaces were divided into four zones based on the presence and numbers of perforating arteries as anterior superior-posterior superior surfaces and anterior inferior-posterior inferior surfaces. The superior surface of the optic chiasm was supplied by the A1 segments of the bilateral anterior cerebral arteries and by the perforating arteries originating from the anterior communicating artery. On the other hand, the inferior surface of the optic chiasm was fed by the bilateral posterior communicating arteries and by the supraclinoidal segments of the bilateral carotid arteries. We demonstrated the anatomical involvement of a large number of nourishing arteries in feeding the optic apparatus related to the perforating arteries by classifying them into zones based on the surgical approaches, which has been rarely reported in the literature.
Death due to behcet's disease? Malpractice?
(Romanian Legal Medicine Society, 2015-12-01) Fedakar, Recep; Eren, Bülent; Gürses, Murat Serdar; Gök, Ertuğrul; Vojtisek, Tomas; GÜRSES, MURAT SERDAR; FEDAKAR, RECEP; 0000-0002-9982-0476; AAH-6287-2021; JAC-4250-2023
Behcet's syndrome (BS) is a chronic disease characterized by the presence oral and genital ulcers, skin, eye, gastrointestinal, vascular, and central nervous system involvement; the etiology of the disease is not fully understood. While it is known to be frequent in Mediterranean countries, the highest prevalence is in Turkey. In BS, various types of vascular involvement are identifiable. BS generally leads to venous thrombosis with more frequent involvement at lower extremities, and majority of cases are men. While thrombophlebitis is often observed, thromboembolic diseases are rarely found, because the venous thrombi adhere to the walls of the veins tightly.Our case is a 19-year-old male who developed massive hemoptysis in his sister's house where he was visiting for vacation and was brought to the hospital by emergency service. Despite aggressive cardiopulmonary resuscitation the patient deceased. His was classified as suspicious and the patient transferred to our service for autopsy. Upon reviewing the hospital documents we found that he was followed up for BS for about two years, and was treated with anticoagulants for pulmonary embolism in the last 5 months after being admitted in a chest clinic for hemoptysis. During external examination in bloody foams were detected in the mouth and nose. During the internal examination we found a pulmonary artery aneurism of 6 cm in diameter with a thrombus inside, a 20 cm long thrombus that was blocking almost the whole lumen of the popliteal vein and a macroscopic infarct and blood aspiration areas in the left lung.We discuss the autopsy findings of this case along with the literature in this field.
Glial fibrillary acidic protein (GFAP) and CD34 expression in the human optic nerve and brain in methanol toxicity
(Springer, 2008-02-01) Türkmen, Nursel; Eren, Bülent; Fedakar, Recep; Akgöz, Semra; Comunoglu, Nil; TÜRKMEN İNANIR, NURSEL; Eren, Bülent; FEDAKAR, RECEP; Akgöz, Semra; Uludağ Üniversitesi/Tıp Fakültesi/Adli Tıp Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; 0000-0002-2319-1757; JGZ-0807-2023; AAH-6287-2021; ACP-5545-2022; AAK-8096-2021
Introduction: The toxicity of methanol is as a result of its metabolites, formaldehyde and formic acid. Formic acid induces severe metabolic acidosis causing death, and is the primary agent responsible for ocular toxicity. Glial fibrillary acidic protein ( GFAP) immunostaining is the most commonly used method for examining astrocyte proliferation and hypertrophy after various central nervous system injuries. The antigen CD34 is expressed widely on vascular endothelium, including that of the central nervous system and high endothelial venules.Methods: In this study, GFAP and CD34 were immunohistochemically localised in the post-mortem optic nerve head, and brain tissue ( basal ganglia putamen) samples were collected from methanol-exposed and non-methanol-exposed ( control) subjects.Results: There was a positive correlation between the GFAP and CD34 intensity of staining scores in the methanol-exposed group ( P=0.711, P=0.010). Furthermore, there was also a positive correlation between the brain putamen and optic nerve head GFAP extent of staining in the methanol-exposed group ( P=0.720, P=0.008). A statistically significant difference was found between the methanol-exposed group and the control group optic nerve CD34 intensity scores ( P=0.014), but no significant difference was found between optic nerve CD34 and GFAP extent scores ( P=0.05).Conclusion: The study revealed that methanol affects brain putamen and the optic nerve selectively. We detected a positive significant correlation between brain and optic nerve GFAP expression. CD34 expression was markedly decreased by the toxic effects of methanol.
Road traffic collisions in Bursa, Turkey, during 2003, 2004 and 2005
(Elsevier Sci Ltd, 2008-05-01) Durak, Dilek; Fedakar, Recep; Türkmen, Nursel; Akgöz, Semra; Baduroğlu, Erol; DURAK, DİLEK; FEDAKAR, RECEP; TÜRKMEN İNANIR, NURSEL; Akgöz, Semra; Baduroğlu, Erol; Uludağ Üniversitesi/Tıp Fakültesi/Adli Tıp Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; 0000-0003-3469-340X; AAH-6587-2021; AAH-6287-2021; ACP-5545-2022; JGZ-0807-2023; ENO-6380-2022
Aim: To highlight the demographic pattern of road traffic injuries in Bursa and to improve emergency care and health facility-based treatment.Methods: Records of all registered road traffic collisions maintained by the Uludag University Emergency Department in Bursa for the period 2003 to 2005 and trauma files of 1307 road traffic collision victims were examined in this study. A form was designed to document patients' age, gender, type of trauma, time of trauma (hour, day, month and year), type and time to hospital of transport, presence of safety devices, presence of alcohol and blood alcohol concentration, localisations of wounds, trauma scores and outcomes.Results: Of the 1307 cases, 418 (32%) were female and 889 (68%) were mate. Ages ranged from 3 months to 87 years; mean age (+/-S.D.) was 34.8 (+/-17.3) years. The mean (+/-S.D.) ages of women and men were 35 +/- 17.6 and 34.7 +/- 17.2 years, respectively. Trauma was most commonly sustained within the motor vehicle (72.2%), followed by pedestrian injuries (21.7%), motorcycle injuries (5.5%) and bicycle injuries (0.6%). Collisions were most frequent in summer (34.7%) and on Fridays and weekends (48.5%). Seat belts were used in only 1.8% of incidents. In 90 cases (6.9%) alcohol was found in the blood; mean blood alcohol concentration was 139.2 +/- 88.3 mg/dl.Conclusions: The identification of RTC characteristics may contribute to the development of injury prevention measures. Road travel requires extra attentiveness at peak accident times. Seat-belt use should increase, as well as use of other safety equipment such as collision helmets. Shorter transportation time of casualties to hospital would improve outcome. (C) 2007 Elsevier Ltd. All rights reserved.
The anatomic variations and surgical windows among optic chiasm/nerves and carotid arteries in the sellar region play a role in choosing the best surgical approaches: A Cadaveric study
(Elsevier Espana, 2020-05-01) Baykal, Duygu; Yılmazlar, Selçuk; Fedakar, Recep; Baykal, Duygu; YILMAZLAR, SELÇUK; FEDAKAR, RECEP; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Beyin Cerrahi Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Adli Tıp Anabilim Dalı.; 0000-0001-9833-9392; 0000-0003-3633-7919; AAH-5070-2021; AAH-6287-2021; GMD-4113-2022
Objective: Understanding the relationship between the carotid artery, optic nerve and the anterior clinoid process is the basis of surgical approaches performed in the subchiasmal region. The location of the optic chiasm, the length of the optic nerves, and the distance and angle between the optic nerves determine the route of surgical approaches. We have determined the types of optic chiasm to study the relationship between vascular and neural structures in this region.Materials and methods: Thirty autopsy specimens were investigated at the Bursa Forensic Medicine Institute for optic chiasm types and the relationship between the neural and vascular anatomical structures of the sellar-parasellar and subchiasmal region was examined between June 2016 and November 2016.Results: In this study, 4 prefix types (13%), 6 postfix types (20%), and 20 central types (67%) of chiasm were defined. Furthermore, we measured this angle between two optic nerves, which indirectly shows the location of chiasm according to the diaphragma sellae, and then detected the mean value of this angle as 87.1 +/- 11.6 degrees. The "limit" value to designate a chiasm as prefix was measured in the current study as >= 101.1 degrees. T.he angle between optic nerves ranged from a mean value of 69.9 +/- 3.7 degrees in 6 cases with postfix chiasm, to a mean value of 104.0 +/- 2.1 degrees in 4 cases with prefix chiasm and a mean value of 88.8 +/- 6.7 degrees in 20 cases with central chiasm.Conclusion: In this study, we showed that the relationship among optic chiasma types, optic nerves and bony and vascular structures around the sellar area was effective at determining the surgical approach to this region. (C) 2019 Sociedad Espanola de Neurocirugia. Published by Elsevier Espana, S.L.U. All rights reserved.
Two accidental hanging cases of children
(Pakistan Medical Assoc, 2015-07-01) Gök, Ertuğrul; Çetin, Selçuk; Baduroğlu, Erol; Fedakar, Recep; Akan, Okan; Saka, Naile Esra; Gök, Ertuğrul; FEDAKAR, RECEP; Uludağ Üniversitesi/Tıp Fakültesi; 0000-0003-1573-283X; JJF-8712-2023; AAH-6287-2021
The cases emphasise the implementation of safety measurements which may prevent the occurrence of accidental hanging in children. Two accidental hanging cases were autopsied at The Council of Forensic Medicine, Bursa Group Chairmanship, Morgue Department. The inquest papers written by police were examined and the scenes and autopsy findings are presented. The first case was a four year old girl and the second case was a five year old boy. Their manners of death were determined as an accident. The first accident occurred out of home, but the second accidental hanging occurred at home. It was seen that childhood deaths due to hanging are preventable. Detailed medico-legal investigation in order to elucidate the manner of death is required in similar cases.
Usability of dental pulp visibility and tooth coronal index in digital panoramic radiography in age estimation in the forensic medicine (vol 134, pg 381, 2020)
(Springer, 2020-05-01) Gök, Ertuğrul; Fedakar, Recep; Mustafa Kafa, İlker; FEDAKAR, RECEP; KAFA, İLKER MUSTAFA; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Adli Tıp Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Anatomi Anabilim Dalı.; 0000-0001-8309-0934; AAH-6287-2021; AAG-7125-2021