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Öğe Anterior sacroiliac fusion - A new video-assisted endoscopic technique(Lippincott Williams & Wilkins, 1998) Guner, G; Gurer, S; Elmali, N; Ertem, KWe present a case of sacroiliac fusion performed for an intraarticular osteochondroma of the sacroiliac joint, which was the cause of severe pain and disability. Excision of the lesion and sacroiliac fusion were successfully performed by utilizing minimally invasive surgical techniques. Although the application of this technique requires a dedicated and highly experienced team, the encouraging result of our first case, with minimal morbidity and disability due to the operation, induces us to recommend this technique in sacroiliac fusion, especially when fusion is combined with additional procedures such as drainage, biopsy, or excision.Öğe Cervical myositis ossificans traumatica: a rare location(Springer Verlag, 1999) Baysal, T; Baysal, O; Sarac, K; Elmali, N; Kutlu, R; Ersoy, YAn unusual case of myositis:ossificans traumatica lesion located in the paraspinal region is reported. Despite the contiguity of the lesion with the cervical vertebrae and ominous appearance of the biopsy material, the history of antecedent trauma and computed tomography findings allowed preoperative accurate diagnosis. To our knowledge, myositis ossificans traumatica located in the cervical paraspinal region is very rare.Öğe The comparison of femoral curves and curves of contemporary intramedullary nails(Springer, 2005) Harma, A; Germen, B; Karakas, HM; Elmali, N; Inan, MThe aim of this study was to evaluate both the cortical and the medullary anterior bowing of the femur, and to compare these measurements with current intramedullary nails to assess the adequacy of their design. Methods: Lateral digital radiographic views of left femurs of 104 normal subjects (18-68 years old) were obtained. Radii of cortical and medullary curvatures of femurs were calculated using these images. The values obtained were compared to the radius of curvatures of ten different intramedullary nails. Results: Medullary bowing was between 114 and 1,389 mm (mean: 722 mm, SD: 230 mm) and the cortical bowing was between 109 and 1,666 mm (mean: 770 mm, SD: 267 mm). For males, these values were 114-1,389 mm (mean: 722 mm, SD: 230 mm) and 109-1,666 mm (mean: 770 mm, SD: 267 mm), respectively. For females, they were 114-1,389 mm (mean: 722 mm, SD: 230 mm) and 109-1,666 mm (mean: 770 mm, SD: 267 mm), respectively. The differences between genders were not significant. Cortical and medullar bowing was strongly correlated with age (r=-0.269, p < 0.006 and r=-0.234, p < 0.017, respectively). These significances were produced by females only. Radii of curvatures of intramedullary nails ranged between 150 and 300 cm and were higher than the mean cortical (77 cm) and medullary (72.2 cm) bowings. Conclusion: The difference between the curves of femur and the contemporary femoral nails implicates the inadequacy of the design of such nails for the Caucasian race living in Anatolia. Therefore, such nails should be revised accordingly to prevent the above-mentioned complications.Öğe Effect of caffeic acid phenethyl ester on cartilage in experimental osteoarthritis(Springer-Verlag, 2002) Elmali, N; Avan, I; Türköz, Y; Mizrak, B; Germen, B; Bora, AActivation of nuclear factor kappa B (NF-kappaB) in synovial cells is seen in RA and OA patients. Caffeic acid phenethyl ester (CAPE) is a specific and potent inhibitor of NF-kappaB. We aimed to determine the in vivo effects of intra-articular injections of CAPE on cartilage in an experimental rabbit osteoarthritis (OA) model. Two groups of six New Zealand white rabbits underwent unilateral anterior cruciate ligament transection (ACLT). Four weeks after ACLT, the test group was injected with 150 mug/kg CAPE in 0.5% ethanol once daily for 2 weeks and the control group was injected the same amount of 0.5% ethanol intra-articularly. All rabbits were killed 2 weeks after the last injection, and cartilage tissue was evaluated morphologically. A histological score totaling 7 points was determined for each knee. The CAPE group showed significantly decreased cartilage destruction and reduced loss of matrix proteoglycans. The histological score for cartilage tissue was significantly better in the CAPE group than in the control group (3.0 +/- 0.25 vs 5.3 +/- 0.55, P=0.005). This study suggests that intraarticular injection of CAPE may protect cartilage against the development of experimentally induced OA.Öğe Effect of resveratrol in experimental osteoarthritis in rabbits(Springer Basel Ag, 2005) Elmali, N; Esenkaya, I; Harma, A; Ertem, K; Turkoz, Y; Mizrak, BObjective: Resveratrol (trans-3,4',5-trihydroxystilbene) is a phytoalexin found in high concentration in the skins of grapes and red wines which has been shown to have antiinflammatory, anticancerogen and antioxidant properties. Resveratrol is a potent and specific inhibitor of nuclear factor kappa B ( NF-kappa B). Resveratrol also inhibits COX-2 gene expression and enzyme activity. We aimed to determine the in vivo effects of intra-articular injections of resveratrol on cartilage and synovium in an experimental osteoarthritis (OA) model in rabbits. Methods: As OA model, rabbits underwent unilateral anterior cruciate ligament transection (ACLT). Five weeks after test group was injected with 10 mu Mol/kg resveratrol in dimethylsulphoxide ( DMSO) in the knees once daily for two weeks and as the control group at the same time DMSO was injected into the knees. All rabbits were killed one week after the last injection. Cartilage tissue and synovium were evaluated with a histological scoring system. Results: Histological evaluation of cartilage tissue by H&E staining revealed a significantly reduced average cartilage tissue destruction score of 1.7 in the resveratrol group versus 2.8 in the control group ( p = 0.016). Loss of matrix proteoglycan content in cartilage was also much lower, as determined by safranin O staining. Scores of synovial inflammation didn't show difference between groups ( 1,3 vs 2,2; p = 0.057). Conclusion: A characteristic parameter in arthritis is the progressive loss of articular cartilage. This study suggests that intraarticular injections of resveratrol starting at the onset of disease may protect cartilage against the development of experimentally induced OA.Öğe Effects of dominance, body mass index and age on grip and pinch strength(Ios Press, 2003) Ertem, K; Inan, M; Yologlu, S; Elmali, N; Harma, A; Sahin, S; Bora, AMeasurement of grip and pinch strength is an important component in hand evaluation. It assesses the patient's initial limitations and provides a quick reassessment of patient's progress throughout the treatment. This investigation was conducted to examine the effects of hand dominance, body mass index (BMI) and age on grip strength (GS) and pinch strength (PS) tasks. Subjects were 365 apparently healthy young male adults (19-33 years). No correlation was found between the BMI hand strength measures. Grip and pinch strength were measured instrumentally. The rule dominant hand (DH) is approximately 10% stronger than the nondominant hand (NDH) was found to be valid for left handed persons only (11.2%), otherwise these measures should be considered equivalent in both hands in clinical practice.Öğe Fracture healing and bone mass in rats fed on liquid diet containing ethanol(Lippincott Williams & Wilkins, 2002) Elmali, N; Ertem, K; Ozen, S; Inan, M; Baysal, T; Güner, G; Bora, ABackground: Studies in animal models for alcohol abuse have suggested that ethanol inhibits bone growth, decreases bone formation, and increases fracture risk. Methods: Experimental tibia fracture healing in rats fed a liquid diet containing 7.2% ethanol for 8 weeks was investigated with histological and osteodensitometric studies with respect to the control group. After 4 weeks of vitamin A- and sucrose-enriched milk containing 7.2% ethanol feeding, we created closed tibia fractures, which were then fixed with intramedullary nails, in 10 rats. After a follow-up time of 4 weeks, the rats were killed for examination. The same procedure was performed in another 10 rats, which were fed on the same diet (isocaloric modified liquid diet) but without ethanol and used as the control group. A histological scoring system was developed for fracture healing. Results: Histological evaluation of fracture region revealed an average fracture healing score of 1.9 in the ethanol-fed group versus 2.6 in the control group (p = 0.014). In the test group, dual-energy x-ray absorptiometry measurements in the fracture region showed a mean bone mineral density of 0.11 +/- 0.03 g/cm(2), whereas it was 0.130 +/- 0.051 g/cm(2) in the control group (p = 0.000). The mean bone mineral content in the fracture region was 0.103 +/- 0.08 g/cm(3) in the test group versus 0.128 +/- 0.06 g/cm(3) in the control group (p = 0.000). A significant correlation was found among histological scores, bone mineral density (r = 0.64, p = 0.04), and bone mineral content (r = 0,63, p = 0.04). Conclusions: This study showed that rats fed on a diet mixed with ethanol have a histologically delayed fracture healing associated with decreased bone density and mineral content. Besides the negative effects of ethanol on bone metabolism, it also interferes with the fracture-healing process.Öğe An investigation of hand dominance, average versus maximum grip strength, body mass index and ages as determinants for hand evaluation(Ios Press, 2005) Ertem, K; Harma, A; Cetin, A; Elmali, N; Yologlu, S; Bostan, H; Sakarya, BMeasurement of grip strength is an important component in hand evaluation. It assesses the patient's initial limitations and provides a quick reassessment of patient's progress throughout the treatment. This investigation was conducted to examine the determinants of hand dominance of average versus maximum grip strength, body mass index (BMI) and age for hand evaluation. Subjects were 877 apparently healthy male adult volunteers from the Inonu University - students and personnel; average age 21.14 +/- 2.09 (19-40 years). A good correlation was found between the BMI hand strength measures. Grip strength was measured instrumentally. The rule dominant hand (DH) is approximately 10% stronger than the non-dominant hand (NDH) was found to be valid for left handed persons only (7%), otherwise these measures should be considered equivalent in both hands. The difference between maximum and average of three consecutive measurement of grip strength was found significant for both hands. As the significant difference was found between RGSmax (Maximum Grip Strength of Right Hand) and RGSav (Average Grip Strength of Right Hand); LGSmax (Maximum Grip Strength of Left Hand)[LGSav (Average Grip Strength of Left Hand) measures for RDH. RGSmax and LGSmax where correlated only for LDH, Therefore, average of three consecutive measurement of grip strength is more consistent for standard hand evaluation.Öğe The stone man: myositis (fibrodysplasia) ossificans progressiva(Springer Verlag, 1998) Baysal, T; Elmali, N; Kutlu, R; Baysal, OMyositis ossificans progressiva (MOP) is a rare hereditary connective tissue disorder characterized by progressive ossification of striated muscle and connective tissue associated with pain and disability. It is presumably transmitted as an autosomal dominant defect. Congenital anomalies of the hands and feet are early signs of this disease. Involvement of the spine, hips and extremities lead to the development of the stone man with only less than 600 cases reported in the literature. We present a case of MOP with typical muscle ossifications and skeletal malformations.
