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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 Decreased Tc-99m MDP uptake in myelonecrosis(Lippincott Williams & Wilkins, 2006) Kekilli, E; Yagmur, C; Kaya, E; Kuku, I; Ertem, K; Aydogdu, I[Abstract Not Available]Öğe Distal finger injuries(Medimond S R L, 2002) Ertem, K; Bora, A; Ayan, I; Karakaplan, M; Eskin, A; Bostan, H; Tas, F[Abstract Not Available]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 The effects of different skill training on neuromuscular electric activity of the limbs in amateur sportsmen(Ios Press, 2005) Kaygusuz, A; Meric, F; Ertem, K; Duzova, H; Karakoc, Y; Ozcan, CIn this study, we investigated the effects of different skills of sport on electromyography (EMG) of limb muscles in sportsmen. Two different skill groups of sport consisted of 10 soccer players who use extensively lower limb, and 10 handball, basketball and volleyball players with selectively high usage of the upper limb. Surface EMG (sEMG) were recorded from the abductor pollicis brevis and gastrocnemius muscles of subjects. In addition, Hoffmann reflex (H-reflex) were recorded from the lower limb of participants. EMG findings of two groups were compared with each other and age-sex matched sedentary controls. Amplitude and area of sEMG recorded from gastrocnemius muscle of handball -basketball-volleyball players were significantly higher than those of soccer players (p < 0.01 and p < 0.05), whereas not significantly different based on the abductor pollicis brevis (p > 0.05 in both). F-response of both muscles and H-reflex of handball-basketball-volleyball players were also significantly higher from those of soccer players and control group (p < 0.05 for all), whereas only F-response of gastrocnemius muscle of soccer player was significantly lower than that of control group (p < 0.05). We conclude that EMG amplitude of gastrocnemius muscle, F-response and H-reflex times of lower limbs increase in handball-basketball-volleyball players due to the nature of training skills. Volleyball, handball or basketball training contributes to neuromuscular differences in both upper and lower extremities more than football training because both extremities are extensively used in these sport categories.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 Evaluation of the gluteus medius muscle after a pelvic support osteotomy to treat congenital dislocation of the hip(Journal Bone Joint Surgery Inc, 2005) Inan, M; Alkan, A; Harma, A; Ertem, KBackground: Many authors have reported that the pelvic support osteotomy prevents a Trendelenburg gait by restoring the biomechanics of the abductor muscle in patients with congenital dislocation of the hip. However, we are not aware of any studies in which the hip abductor muscles were examined following pelvic support osteotomy. The purpose of this study was, first, to use magnetic resonance imaging to measure alterations in the length and volume of the gluteus medius muscle after pelvic support osteotomy and, second, to determine which factors influence the results of the Trendelenburg test. Methods: Eleven patients with a history of congenital hip dislocation who had been treated with a pelvic support osteotomy were examined clinically with the Harris hip score and the Trendelenburg test, radiographically to measure limb-length discrepancy and valgus angulation of the proximal part of the femur, and with magnetic resonance imaging to measure changes in the gluteus medius length and volume. Results: The pelvic support osteotomy achieved a functional and painless hip in all eleven patients. Five of the eleven patients had a persistently positive Trendelenburg gait at the time of the last follow-up visit, at an average of three years after the osteotomy. The muscle volumes were restored to 43% to 89% of the muscle volumes on the normal contralateral side, and the postoperative muscle volume correlated significantly with the result of the Trendelenburg test (r = -0.63; p = 0.03). There was a positive association between age and the result of the Trendelenburg test (p = 0.01): four of the five patients who had a positive test were at least thirty-one years of age at the time of the operation. There was no correlation between the Trendelenburg test and the change in the length of the gluteus medius muscle, which averaged 19.2 mm in the patients with a positive test and 19.3 mm in those with a negative test. Conclusions: Patient age at the time of the operation and the postoperative change in the volume of the gluteus medius muscle have a significant influence on the result of the Trendelenburg test after a pelvic support osteotomy. Moreover, our study demonstrated that restoration of the muscle volume after a pelvic support osteotomy is not sufficient to prevent a Trendelenburg gait in older patients with congenital dislocation of the hip.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 Isolated zone III vertical fracture of first sacral vertebra - a case report(Taylor & Francis Inc, 2005) Harma, A; Inan, M; Ertem, K[Abstract Not Available]Öğe Magnetic resonance spectroscopy study of proton metabolite level changes in sensorimotor cortex after upper limb replantation-revascularization(Elsevier Science Inc, 2005) Ertem, K; Alkan, A; Sarac, K; Onal, C; Bostan, H; Yologlu, S; Bora, AWe aimed to investigate the changes in proton metabolite levels at the motor and somatosensory cortex by magnetic resonance spectroscopy (MRS) after upper extremity replantation or revascularization. Nine patients who referred to our clinic suffering from major total (two) and subtotal (seven) amputation of the upper extremity were enrolled in this study. Mean time value between the injury and operation was 5.1 h. Mean follow-up period or mean time between the injury and MRS analysis was 26.2 months (ranging from 7 to 41 months). Voxels JR: 2000; TE: 136 ms) were placed onto locations in the bilateral precentral and postcentral cortex area of the cerebral hemispheres that represent the upper extremity. Contralateral sides of the brain hemisphere that represent the injured extremity were accounted as control groups. Metabolite ratios [NAA (N-acetyl aspartate)/Cr (creatine) and Cho (choline)/Cr] of the motor and somatosensory cortex were calculated. The NAA/Cr and Cho/Cr metabolite ratios between the two groups were found to be insignificant, and these results may indicate that there is no remarkable somatosensorial cortex disruption or demyelination in these patients. Fifty-six percent of patients were found as functional according to Chen's scale. (C) 2005 Elsevier Inc. All rights reserved.Öğe Pathologic hepatic Tc-99m-MDP uptake in polyostotic fibrous dysplasia(Springer, 2004) Kekilli, E; Yagmur, C; Kuzucu, A; Soysal, O; Cikim, AS; Ertem, KFibrous dysplasia of bone is a congenital, sporadic developmental disorder characterized by immature fibrous connective tissue and bone deformities. Hepatic Tc-99m-MDP uptake is a rare, serendipitous finding during bone scanning studies. The present patient was a 25-year-old male who had severe polyostotic fibrous dysplasia. On Tc-99m-MDP (methylene diphosphonate) bone scintigraphy, increased activity accumulations were seen on multiple ribs, vertebrae and base of the cranium. In addition, diffuse increased pathologic uptake of Tc-99m-MDP in the liver was shown. Intravenous pamidronate was administered monthly for two months. In the third week of the last administration Tc-99m-MDP bone scintigraphy was performed again, but despite sustained bone involvement, pathologic hepatic uptake was not seen on the scan. We thought that pathologic hepatic Tc-99m-MDP accumulation, may be related to the formation and aggregation of calcium oxalate and phosphate crystals which improved with pamidromat treatment.Öğe Successful treatment of high congenital dislocated hips in older children by open reduction, pelvic and femoral osteotomy with external fixator stabilization (average 8.2 years of age)(Lippincott Williams & Wilkins, 2005) Inan, M; Harma, A; Ertem, K; Germen, B; Bowen, RJA new technique using a hinged external fixator to stabilize an open reduction with pelvic and femoral osteotomies has been developed for treating high-dislocated hips in older children with developmental dislocated hip (DDH). This technique was performed in 11 patients (12 hips) at a mean age of 8.2 years. At follow up, radiographic results showed no redislocation/subluxation and clinical results demonstrated 11 hips as excellent/good and only one hip as poor from persistent stiffness. In conclusion, this new technique produces acceptable results in the treatment of older children with high dislocation of the hip from DDH.
