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Öğe Acute patellar dislocation with multiple ligament injuries after knee dislocation and single session reconstruction(Pakistan Medical Assoc, 2016) Gormeli, Gokay; Gormeli, Cemile Ayse; Karakaplan, Mustafa; Gurbuz, Sukru; Ozdemir, Zeynep; Ozer, MustafaKnee dislocation is a relatively rare condition of all orthopaedic injuries. Accompanying multiple ligament injuries are common after knee dislocations. A 41-year-old male presented to the emergency department suffering from right knee dislocation in June 2013. The patient had anterior cruciate ligament, medial collateral ligament (MCL), medial patellofemoral ligament (MPFL) rupture, and lateral meniscal tear. A single-bundle anatomic reconstruction, medial collateral ligament reconstruction, medial patellofemoral ligament reconstruction and meniscus repair were performed in single session. At twelve months follow-up; there was 160 degrees flexion and 10 degrees extension knee range of motion. Lysholm knee score was 90. Extensive forces can cause both MCL and MPFL injury due to overload and the anatomical relationship between these two structures. Therefore, patients with valgus instability should be evaluated for both MPFL and MCL tears to facilitate successful treatment.Öğe Adsorbtif sıyırma voltametrisi ve diferansiyel puls polarografisi ile molibdenin çevre örneklerinde tayini(İnönü Üniversitesi, 1992) Karakaplan, Mustafa[Abtsract Not Available]Öğe Analysis of posttraumatic embitterment disorders by machine learning: Could sullenness be a predictor of posttraumatic embitterment disorder?(Kare Publ, 2022) Kilic, Bahar; Karakaplan, Mustafa; Unal, SuheylaObjective: This study aimed to determine some fundamental factors specific to posttraumatic embitterment disorder (PTED) using deep machine learning (ML) and network analysis techniques. Method: Sociodemographic data form, Buss-Perry Aggression Questionnaire, Brief Symptom Inventory (BSI), PTED Self-Rating Scale (PTED Scale), and list of stressful life events were administered to 557 people who applied to the outpatient anxiety clinic. ML method and network analysis were applied with the 33 most significant variables. Results: PIED was found in urban areas (p=0.006), individual health problems (p=0.029), early separation from their families (p=0.040), previous trauma (p=0.021), describing childhood sexual abuse (p<0.001), and those with the illness for more than 10 years (p<0.001) were detected at a higher rate than those without. The PIED score was higher in those with an anxiety disorder (p=0.043) and a personality disorder (p<0.001). Almost all life stressors were higher in the PIED group. There was a statistically significant difference between the groups in all subscales of the BSI. When the ML procedure was applied, sullenness was identified as the main symptom of PIED. The factors most associated with sullenness were well-being, hopelessness, and painful event experience. Conclusion: The higher rate of chronic trauma in the group with PTED and the detection of sullenness as the main symptom have been important data for understanding the psychopathological process.Öğe Arthroscopic limited intercarpal fusion without bone graft in patients with Kienbock's disease(Turkish Joint Diseases Foundation, 2016) Ertem, Kadir; Gormeli, Gokay; Karakaplan, Mustafa; Aslanturk, Okan; Karakoc, YunusObjectives: This study aims to present our clinical results obtained in arthroscopic limited intercarpal fusion performed without using bone graft in patients with Kienbock's disease. Patients and methods: The study included 11 patients with Kienbock's disease (6 males, 5 females; mean age 28.9 years; range 14 to 51 years) who were performed arthroscopic lunate excision and scaphocapitate fusion between November 2012 and December 2013. Bain and Begg Arthroscopic Classification was used for the staging of Kienbock's disease. Quick Disabilities of Arm, Shoulder and Hand and Mayo Wrist scorings were used for clinical evaluation. Results: Intercarpal fusion was achieved in approximately 7.2 weeks. There was a statistically significant difference in Mayo Wrist scores of postoperative third and sixth months and pre- and postoperative Quick Disabilities of Arm, Shoulder and Hand scores. There was no postoperative complication. Conclusion: According to our study findings, arthroscopic limited intercarpal fusion without using bone graft may be performed in patients with Kienbock's disease. Satisfactory clinical and functional results were obtained as a result of treatment with this method in stage 3 and 4 Kienbock's disease.Öğe Arthroscopic limited intercarpal fusion without bone graft in patients with Kienböck’s disease(2016) Ertem, Kadir; Görmeli, Gökay; Karakaplan, Mustafa; Aslantürk, Okan; Karakoç, YunusAmaç: Bu çalışmada Kienböck hastalığı olan hastalarda kemik grefti kullanmadan uygulanan artroskopik kısmi interkarpal füzyonda elde edilen klinik sonuçlarımız sunuldu.Hastalar ve yöntemler: Kienböck hastalığı olan ve Kasım 2012-Aralık 2013 tarihleri arasında artroskopik lunat eksizyonu ve skafokapitat füzyon uygulanan 11 hasta (6 erkek, 5 kadın; ort. yaş 28.9 yıl; dağılım 14-51 yıl) çalışmaya dahil edildi. Kienböck hastalığının evrelendirilmesinde Bain ve Begg Artroskopik Sınıflaması kullanıldı. Klinik değerlendirme için Hızlı Kol Omuz El Disabiliteleri ve Mayo El Bilek puanlamaları kullanıldı.Bulgular: İnterkarpal füzyon yaklaşık 7.2 haftada sağlandı. Hastaların ameliyat sonrası üçüncü ve altıncı ay Mayo El Bilek puanları arasında ve ameliyat öncesi ve sonrası Hızlı Kol Omuz El Disabiliteleri puanları arasında istatistiksel olarak anlamlı farklılık vardı. Ameliyat sonrası komplikasyon yoktu.Sonuç: Çalışma bulgularımıza göre, Kienböck hastalığı olan hastalarda artroskopik kısmi interkarpal füzyon kemik grefti kullanmaksızın gerçekleştirilebilmektedir. Evre 3 ve 4 Kienböck hastalarında bu yöntemle tedavi sonucunda tatmin edici klinik ve fonksiyonel sonuçlar elde edildiÖğe Aşil tendon rüptürlerinin onarımı sonrası devamlı pasif hareketinin etkisi(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2001) Ertem, Kadir; Elmalı, Nurzat; İnan, Muharrem; Harma, Ahmet; Ayan, İrfan; Karakaplan, MustafaÖz: Bu kesitsel çabşma, Malatya kent merkezinde yaşayan kişilerin yıllık ortalama hekime başvuru sayısı ve bunu etkileyen gönenler ile son bir yılda yatarak tedavi görenlerin hastanelerden memnuniyetlerini belirlemek amacıyla yapılmıştır. Malatya'da mahallelerin sosyoekonomik düzeyine göre tabakalı örnekleme yöntemiyle saptanan adreslerde 1962 kişiye Ekim-Kasım 1998'de yüzyüze görüşme yöntemiyle anket uygulanmıştır. Kişi başına yılda ortalama hekime başvuru sayısı üçtür. Hekime başvuruyu etkileyen en önemli etken, kronik hastalık varlığıdır. Son 15 gün içinde hekime başvuranların sadece %3'ü Malatya dışındaki hekimlere başvurmuştur. Başvurulan kurumlar içinde Malatya SSK Hastanesi %33.2 ile en çok başvurulan kurumdur; bunu %20.3 ile özel hekimler ve %16.5 ile Malatya Devlet Hastanesi izlemektedir. Hekime muayene olabilmek için bekleme süresi 52 dakika (ortanca)dır ve başvuranların yarısı bu süreyi uzun bulmaktadır. Muayene süresi ise beş dakika (ortanca) olup, başvuranların %43'ü bu süreyi yetersiz bulmaktadır. Araştırmaya katılanların %4.4'ü son bir yıl içinde hastaneye yatırılmışlardır. Bunların %15'i Malatya'nın dışındaki şehirlerde yatırılmışlardır. Hastanelerden en çok şikayet edilen konular; hastalardan hastane dışından ilaç-malzeme getirmelerinin istenmesi, ücretlerin yüksekliği, yemekler ve temizliktir. Sağlık hizmetlerinin kullanımının artırılması için sağlık kuruluşlarının daha iyi organize olmaları ve hastaların memnuniyetine daha çok önem verilmesi önerilebilir. Başlık (İngilizce): The effect of continuous passive motion after repair of achilles tendon ruptures Öz (İngilizce): This cross-sectional study was performed to determine the annual average physician contacts number of people living in central Malatya with influencing factors and also to determine the patients' satisfaction who were hospitalized during last year. Stratified cluster sampling was used according to the socioeconomic status of the localities and 1962 individuals were administered a face to face questionnaire during October-November 1998. Annual average physician contact number was three. The main influencing factor related to contact with physician is the presence of a chronic disease. Within the last 15 days, only three percent of applicants had contacted with the physicians who work outside Malatya. The most applied health institution was SSK Hospital (33.2 %) followed by private physicians (20.3 %) and Malatya State Hospital (16.5%). Median waiting time to see the physician was 52 minutes and 50.0% of the applicants thought that this duration is too long. Median examination time was five minutes and 43.0% of applicants believe that examination time was not sufficient. 4.4% of the participitants were hospitalized during last year. 15.0% of the hospitalized patients were hospitilized in cities outside Malatya. Main complaints against hospitals are, patients' being asked to bring drug and other supply outside hospital, and high costs, meals and cleanliness. To increase the utilization of health services, a better organization of health institutions and taking patient satisfaction into consideration could be suggested.Öğe An attempt to understand the observed plateau of the magnetization in tetranuclear iron(II) complexes of thiacalixarene macrocycles(Indian Acad Sciences, 2010) Bayri, Ali; Bakir, H. Gokhan; Sulu, Mustafa; Karakaplan, MustafaThe next-nearest-neighbour (NNN) effect in tetranuclear iron(II) complexes of thiacalixarene macrocycles using the isotropic Heisenberg model has been investigated in order to understand its effects on the observed plateau of magnetization. Although NNN effect is generally very weak in these kinds of systems, it was calculated that its response is quite significant to the external perturbations in certain temperature regions. Using the isotropic Heisenberg exchange Hamiltonian, zero-field energy spectra have been calculated for this particular tetranuclear system. The average magnetic moments with and without next-nearest-neighbour interactions were also calculated. In order to verify the calculations, the results were compared with experimental data taken from the literature, whence, it is suggested that observed magnetic behaviour can be improved by taking into account the NNN effect.Öğe Axillary Artery Injury Following Inferior Dislocation of the Glenohumeral Joint(Derman Medical Publ, 2013) Korkmaz, Mehmet Fatih; Disli, Olcay Murat; Karakaplan, Mustafa; Akca, Baris; Erdem, Mehmet NuriIn this paper, we described a case of axillary artery injury following a primary traumatic inferior shoulder dislocation. It is aimed at raising the index of awareness for identifying this limb threatening injury based on its pathognomonic triad of findings during clinical examination, and to consolidate current thinking on its subsequent management and outcome. To our knowledge, this is the only report in the English literature describing vascular injury in primary traumatic inferior shoulder dislocation in a young man.Öğe Bilateral Achilles Tendon Xanthomas in a Patient with Cerebrotendinous Xanthomatosis A Case Report(Amer Podiatric Med Assoc, 2017) Karakaplan, Mustafa; Ergen, Emre; Gormeli, Gokay; Korkmaz, Mehmet Fatih; Elmali, NurzatCerebrotendinous xanthomatosis is a rare, autosomal recessive, lipid storage disease with accumulation of cholestanol in most tissues, particularly in the Achilles tendons. We described a 23-year-old female patient who had progressive painfull swelling of both Achilles tendons due to cerebrotendinous xanthomatosis. We performed surgery on both-side Achilles tendon tumors. Wide degenerative areas of the tendons were resected, and the flexor hallucis longus tendon was harvested and transferred to reconstruct motion function.Öğe Cerebrotendinous Xanthomatosis patients with late diagnosed in single orthopedic clinic: two novel variants in the CYP27A1 gene(Bmc, 2024) Koroglu, Muhammed; Karakaplan, Mustafa; Gunduz, Enes; Kesriklioglu, Betul; Ergen, Emre; Aslanturk, Okan; Ozdemir, Zeynep MarasBackground Cerebrotendinous Xanthomatosis (CTX) is a rare autosomal recessive lipid storage disorder caused by loss of function variants in the CYP27A1 gene which encodes sterol 27-hydroxylase, on chromosome 2q35. Although the symptoms begin commonly in infancy, CTX diagnosis is often delayed. The aim of this study is to review the orthopedic findings of the disease by providing an overview of the clinical features of the disease. It is to raise awareness of this condition for which early diagnosis and treatment are important. Methods We retrospectively evaluated the clinical, laboratory, radiological, and genetic findings of eight patients from four families who were admitted to our Orthopedics and Traumatology Department between 2017 and 2022 due to bilateral Achilles tendon xanthomas, were found to have high cholestanol and CYP27A1 gene mutations. Results The mean age of patients was 37, and five of them were male. The mean age at the onset of symptoms was 9.25 years. The mean age of initial diagnosis was 33.75 years. Between symptom onset and clinical diagnosis, an average delay of 24.5 years was observed. All patients had bilateral Achilles tendon xanthoma. Notably, a novel variant (c.670_671delAA) in CYP27A1 gene was identified in three patients who also presented with peripheral neuropathy and bilateral pes cavus. One patient had osteoporosis and four patients had osteopenia. Five patients had a history of bilateral cataracts. Furthermore, three of the patients had early-onset chronic diarrhea and three of the patients had ataxia. Two of the patients had epilepsy and seven of the patients had behavior-personality disorder. All patients had low intelligence, but none of them had cardiac disease. Conclusion We present the diagnostic process and clinical features which the largest CTX case series ever reported from single orthopedic clinic. We suggest that patients with normal cholesterol levels presenting with xanthoma being genetically analyzed by testing at their serum cholestanol level, and that all siblings of patients diagnosed with CTX be examined.Öğe Classification of some chemical drugs by genetic algorithm and deep neural network hybrid method(Wiley, 2021) Karakaplan, Mustafa; Avcu, Fatih MehmetDeep neural networks (DNN) and genetic algorithm (GA) are gaining importance quickly with many successful applications in the field of science and technology. They are indispensable tool for the numerical solution of difficult problems. It is possible to optimize DNNs using the GA and this combination can be used to classify data. In this article, some drugs are classified by Monte Carlo sampling with combination of GA and DNN due to stochastic nature of the domain, exponential number of variables and small number of chemical species. In addition to the values obtained from the databases of selected drugs, molecular dynamic and ab initio molecular mechanical calculation results were also used. The aim of this study is to generalize the molecular classification with the data obtained from chemical databases as well as molecular docking results by using the combination of deep learning and GA and its usability in drug design. The selected drugs are some agonist and antagonist drugs that bind to dopamine receptors, which are widely studied and well known in the literature. To train the DNN, input datasets were chosen by the GA framework written in pure Python named PyEvolve. Classification of drugs has been analyzed with the focus on orbital energies and docking results. It is possible to use this algorithm in many in silico calculations such as affinity and separation processes. The reliability of the algorithm was tested with the results given in the literature and the expected values were estimated at 93.8%.Öğe Clinical Effects of Platelet-Rich Plasma and Hyaluronic Acid as an Additional Therapy for Talar Osteochondral Lesions Treated with Microfracture Surgery: A Prospective Randomized Clinical Trial(Sage Publications Inc, 2015) Gormeli, Gokay; Karakaplan, Mustafa; Gormeli, Cemile Ayse; Sarikaya, Baran; Elmali, Nurzat; Ersoy, YukselBackground: Osteochondral ankle injuries commonly affect the dome of the talus, and these injuries are a common cause of athletic disability. Various treatment options are available for these injuries including intra-articular hyaluronic acid (HA) and platelet-rich plasma (PRP) injections. The purpose of this study was to compare the effects of HA and PRP as adjunct therapies after arthroscopic microfracture in osteochondral lesions (OCLs) of the talus. Methods: In this prospective, randomized blinded study, 40 patients with talar OCLs in their ankle joints were treated with arthroscopic debridement and a microfracture technique. Thirteen randomly selected patients received PRP, 14 patients received HA, and the remaining 13 patients received saline as a control group. The participants were assessed using the American Orthopaedic Foot & Ankle Society (AOFAS) and visual analog pain scale (VAS) scores after a 15.3-month (range, 11-25 months) follow-up. Results: Postoperatively, all the groups exhibited significantly increased AOFAS scores and decreased VAS scores compared with their preoperative results (P < .005). The AOFAS scores were significantly increased in the PRP group versus the HA and control groups (P < .005), although the increased AOFAS scores in the HA group versus the control group were also significant (P < .005). Similar to the AOFAS scores, the decrease in the VAS scores was significantly lower in the PRP group versus the HA and control groups (P < .005). In addition, the HA group had significantly lower VAS scores than the control group (P < .005). Conclusion: Both PRP and HA injections improved the clinical outcomes of patients who underwent operation for talar OCLs in the midterm period and can be used as adjunct therapies for these patients. Because a single dose of PRP provided better results, we recommend PRP as the primary adjunct treatment option in the talar OCL postoperative period. Level of Evidence: Level I, prospective randomized study.Öğe Clinical Results of Minor Upper Extremity Replantation and Revascularisation Patients in Comparison to the Literature: A Clinical Study(Turgut Özal Tıp Merkezi Dergisi, 2015) Doğan, Seyfullah; Ertem, Kadir; Karakaplan, Mustafa; Sevimli, Reşit; Arı, Bünyamin; Yılmaz, ÖzgürÖz: Amaç: Üst ekstremite minör replantasyon ve revaskülarizasyon uygulanan hastaların klinik sonuçlarının değerlendirilip literatür ile karşılaştırılması amaçlandı. Gereç ve Yöntem: Kliniğimizde 2008-2011 tarihleri arasında üst ekstremitelerin\'de travma sonucu total veya subtotal amputasyon oluşan 30 hastanın 35 parmağı ameliyat edildi. Total ampute 15 hastanın 15 parmağına replantasyon, ve subtotal ampute 15 hastanın 20 parmağına revaskülarizasyon yapıldı. Tedavi edilen tüm hastaların erken dönem sonuçları ile ortalama 17 ay (6 ay - 3.5 yıl) izlenen 28 hastanın 30 parmağı retrospektif olarak incelendi. Bulgular: Erken dönem sonuçlar incelendiğinde, yaşama oranları; replantasyon yapılan parmaklarda %93,3, revaskülarizasyon yapılan parmaklarda %80 olarak saptandı. Zon iki seviyesindeki yaralanmalarda yaşama oranı %66,6 iken zon 3 seviyesindeki yaralanmalarda %92,3 idi. Giyotin tipi yaralanmalarda ise %100 yaşama oranı mevcut iken, ezilme- avülsiyon tipi yaralanmalarda %68,8 olarak bulundu. Yaralanma şekillerine göre fonksiyonel sonuçlar Chen kriterlerine göre değerlendirildiğinde, giyotin tipi kesi ile yaralanan olguların %89.9\'unda çok iyiiyi, ezilme ve avulsiyon tipi kesi ile yaralanan olguların %33,3\'ünde çok iyi-iyi, %44.4\'ünde orta sonuç bulundu. Yapılan istatiksel değerlendirmede giyotin tipi kesilerle yaralanan olguların tedavi sonrası distal parçalarda yaşama oranları ve fonksiyonel sonuçlarının ezilme ve avulsiyon tipi yaralanmalara göre anlamlı olarak daha iyi olduğu bulundu. Sonuç: Minör replantasyon ve revaskülarizasyon uygulamaları teknik olarak zor ve donanımlı ekip gerektirmektedir. Replantasyon sonuçlarımız literatürle uyumlu olup daha geniş serili çalışmaların gerektiği kaçınılmazdırÖğe Clinical results of surgical neurectomy of Morton’s neuroma(2024) Koroglu, Muhammed; Karakaplan, Mustafa; Turkmen, Ersen; Ozdes, Huseyin Utku; Acet, Omer; Ergen, Emre; Aslanturk, OkanAim: Morton’s neuroma (MN), specifically with its forefoot placement, sometimes significantly impacting patients’ quality of life. The aim of this study is to present the outcomes of neurectomy surgeries performed for MN disease. Investigating the impact of this surgery, which has a complication such as hypoesthesia, on postoperative patient satisfaction, is the targeted objective. Materials and Methods: Seventeen masses of 16 patients were studied. In patients diagnosed with MN mass through physical examination and imaging techniques, a 3 cm incision was made to excise the nerve mass either dorsally or plantar under spinal anesthesia. During routine outpatient follow-ups, the American Orthopedic Foot and Ankle Society (AOFAS) score, Visual Analog Scale (VAS) score, and Coughlin’s criteria were assessed both preoperatively and postoperatively. The effects of conservative treatments such as preoperative orthoses and steroid injections on pain scores were recorded and evaluated. Recurrence of mass development and wound issues were investigated to evaluate the outcomes. Results: The mean age at the time of surgery was 46.75 years (26-58 years). The mean follow-up period was 23.12 (6-75 weeks) weeks. After surgery, excellent results were achieved in 9 patients (64.3%), and good results were obtained in 4 patients (28.6%). Recurrent mass development occurred in two patients (12.5%). Two patients (12.5%) were operated on with a plantar approach, and one patient with recurrent massbelonged to this group. Hypoesthesia was described in 15 out of 16 patients. There were significant improvements between patients’ preoperative VAS and AOFAS scores and postoperative VAS and AOFAS scores, which were statistically significant (p <0.001). Conclusion: Numerous studies have been conducted on the diagnosis and treatment of MN disease, yet a common procedure has not been developed. Among existing treatments, excision of the mass with some healthy nerve tissue and a dorsal approach to the foot are commonly employed methods. Dorsal neurectomy surgeries demonstrate a success rate exceeding 80%. Informing patients about the possibility hypoesthesia before surgery and establishing realistic expectations can make this procedure safely applicable.Öğe A Clue Finding for to Detect the Localization of Pellet in Elbow Arthroscopy(2015) Ertem, Kadir; Görmeli, Gökay; Karakaplan, Mustafa; Aslantürk, Okan; Yılmaz, Özgür; Karakoç, YunusAbstract: In this case report, we aimed to share our experience of arthroscopic finding of chondral lesion can be helpful to detect the location of pellet that between brachial muscle and capsule in a 15 years male subject with left elbow gunshot injuryÖğe A Comparison of Dual-Energy CT with MRI in the Detection of Traumatic Bone Marrow Edema in Distal Extremity Bones(Erciyes Univ Sch Medicine, 2023) Kaya, Ahmet Turan; Ozdemir, Zeynep Maras; Erbay, Mehmet Fatih; Kahraman, Aysgul Sagir; Karaca, Leyla; Karakaplan, Mustafa; Gurbuz, SukruObjective: Our objective was to evaluate the performance of dual-energy computed tomography (DECT) in detecting post-traumatic bone marrow edema (BME) in distal extremities.Materials and Methods: We prospectively studied 31 consecutive patients (25 males) who presented within the first four weeks following distal extremity traumas (wrist, n=19; ankle, n=14) (protocol number: 2017/74). All patients underwent DECT and magnetic resonance imaging (MRI) within three days of presentation. Two independent radiologists analyzed DECT images for fractures and BME qualitatively. Computed tomography (CT) numbers on Virtual non-calcium (VNCa) images were obtained in both edematous and non-edematous areas for quantitative consensus assessment. We used MRI as a reference standard. Results: MRI identified BME in 56/71 bones (78.9%). The rates of BME detection on CT compared to MRI at the patient level were found to be statistically significantly lower, ex-cept for individuals over 40 years of age, women, those with 7-30 days between trauma and admission, and those with CT-detected fractures (p<0.05). The rates of BME detection on CT at the bone level, compared to MRI, were found to be statistically significantly lower (p<0.01), except for women and those with fractures detected on CT. The interobserver agreement for the qualitative analysis of BME was fair (kappa=0.407 and p<0.001). DECT's diagnostic accuracy rates in predicting BME were significantly higher in patients with fractures (p=0.028). CT numbers in edematous areas were significantly higher than in non-edematous areas (p<0.001).Conclusion: DECT may serve as an alternative for detecting post-traumatic BME in distal extremity bones. However, in our heterogeneous bone sample group, it exhibited low sensitivity and a low negative predictive value.Öğe Comparison of lateral deltoid splitting and deltopectoral approaches in the treatment of proximal humerus fractures(Turkish Assoc Trauma Emergency Surgery, 2015) Korkmaz, Mehmet Fatih; Erdem, Mehmet Nuri; Karakaplan, Mustafa; Gormeli, Gokay; Selcuk, Engin Burak; Maras, Zeynep; Karatas, TurgayBACKGROUND: Fractures of the proximal humerus that limit function are quite common. The objective of this retrospective study was to compare deltoid splitting and deltopectoral approaches by using the same fixation method. METHODS: Eighty-six patients who underwent surgical treatment between September 2005 and July 2011 were included into the study group. Deltoid splitting approach was used by exploring the axillary nerve on Group A patients as described by Codman, and deltopectoral approach was used on Group B patients. Group A consisted of a total of fifty-six patients of whom twenty-two were male and thirty-four were female patients, with a mean age of 62.5 years (range, 26 to 90 years). Group B consisted of a total of thirty patients of whom fourteen were male and sixteen were female patients, with a mean age of 54.8 years (range, 24 to 84 years). PHILOS plate system was utilized as an internal fixation tool in all patients. Functional results and complications of the two groups were compared using Constant scores. RESULTS: It was observed that humeral head and tubercular fragment reduction were better with lateral deltoid splitting approach, and Constant shoulder scores were higher in the early stages (66.8-57.4 consecutively; p0.05). DISCUSSION: Deltoid splitting approach, especially with AO/ASIF B and C type fractures, enables reduction and plate fixing under 270 degree control of the proximal humerus without forceful retraction and soft tissue damage, providing easy access to posterior tubercular fragment. Compared to deltopectoral approach, patients treated with deltoid splitting approach achieved higher Constant scores at an earlier stage. Lateral deltoid splitting approach, by exploring the axillary nerve, is a useful surgical technique which provides an expansive and multi-dimensional control without risking the deltoid muscle function and the axillary nerve.Öğe Deconvolution of Gaussian peaks with mixed real and discrete-integer optimization based on evolutionary computing(Wiley, 2020) Karakaplan, Mustafa; Avcu, Fatih MehmetThis study describes an alternative method for deconvolution of overlapping characteristic Gauss peaks with the help of optimization of a mixed variable genetic algorithm. Continuous and discrete variables and nonlinear discrete variables in optimization problems cause solution complexity. The processing and analysis of complex analytical signals is important not only in analytical chemistry but also in other fields of science. As the amount of data increases and linearity decreases, high-performance computations are needed to solve analytical signals. It takes a long time to perform these calculations with traditional processor systems and algorithms. We have used NVIDIA graphical processing units (GPUs) to shorten the duration of these calculations. Solving such analytical signals with genetic algorithms is widely used in computational sciences. In this study, we present a new curve-fitting method using a genetic algorithm based on Gauss functions used to deconvolve overlapping peaks and find the exact peak number in absorption spectroscopy. The deconvolution of individual bands in the UV-VIS region is a complex task, because the absorption bands are broad and often strongly overlap. Useful information about the molecular structure and environment can only be obtained by appropriate and truthful separation of these peaks.Öğe Diz Dejeneratif Artritinin Artroskopik Tedavisi(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2002) Elmalı, Nurzat; Ertem, Kadir; İnan, Muharrem; Ayan, İrfan; Esenkaya, İrfan; Karakaplan, MustafaŞubat 1993-Haziran 1998 yılları arasında kliniğimizde, diz eklemi dejeneratif osteoartriti nedeniyle artroskopik tedavi uygulanıp yeterli takibini yaptığımız 78 olgunun 86 diz eklemini değerlendirdik. Hastaların 46 sı kadın 32 si erkek olup yaş ortalaması 44.8 (28-65)’dir. İşlem 8 hastada her iki dize olmak üzere 52 sağ, 34 sol diz eklemine uygulandı. Tedavi öncesi radyolojik olarak Ahlback kriterlerine göre evre 1-4 arası olan olguların dahil edildiği çalışmada artroskopik bulgular Outerbridge sınıflandırmasına göre değerlendirildi. Ortalama 20.8 ay süre ile takip edilen olgularda artroskopik tedavi sonrası klınik değerlendirme Patel-Aichroth kriterlerine göre yapıldı. 6. aydaki izlemde %80.1 dizde çok iyi ve iyi sonuçlar alırken ortalama 20.8 aylık izlemde çok iyi ve iyi sonuçların %50’ye düştüğü görüldü (p<0.05). Sonuç olarak diz eklemi dejeneratif artritinin erken dönemlerinde uygulanacak artroskopik tedavi, hastaların şikayetlerini geçici de olsa iyileştirmede yararlı, minimal invazif ve erken harekete imkan veren biyolojik bir yöntemdir.Öğe Diz osteoartritinin artroskopik debridman ve intraartiküler hyaluronik asit ile tedavisi(İnönü Üniversitesi, Tıp Fakültesi, Ortopedi ve Travmatoloji Anabilim Dalı, Malatya., 2002) Elmalı, Nurzat; İnan, Muharrem; Ertem, Kadir; Esenkaya, İrfan; Ayan, İrfan; Karakaplan, MustafaÖz: Giriş: Diz osteoartritinin artroskopik debridmanla tedavisine genellikle nonsteroidal antienflamatuar ilaçlar, eklem içi kortikosteroid enjeksiyonları ve fizyoterapi gibi yardımcı tedaviler eklenir. Bunun yanısıra diz osteoartritli hastalarda eklem içi hyalüronik asit enjeksiyonlarının ağrıda azalma ve fonksiyonda iyileşme sağladığı bildirilmektedir. Bu çalışmada diz osteoartriti bulunan hastalarda artroskopik debridmanla birlikte eklem içi hyalüronik asit (HA) uygulanmasının sonuçlarını değerlendirmeyi amaçladık. Gereç ve Yöntem: Nisan 1998-Aralık 1999 tarihleri arasında diz osteoartriti saptanan 23 hastanın 29 dizine artroskopik debridmanı takiben birer hafta aralarla ve toplam 3 enjeksiyon olmak üzere eklem içi sodyum hyaluronat (30 mg/2ml) uyguladık. Hastaların 14'ü kadın, 9'u erkek ve ortalama yaş 53.8 (39-63) idi. İşlem 19 sağ, 10 sol dize uygulandı. Klinik değerlendirme, Hospital for Special Surgery (HSS) ve Knee Society (KS) diz skorlama sistemleri kullanılarak tedaviden önce, ilk yılın sonunda ve ortalama 20.3 ayda (12-32 ay) yapıldı. Artroskopik muayenede saptanan kıkırdak lezyonlan Outerbridge sınıflamasına göre değerlendirildi. Bulgular: Yirmialtı dizde (%90) medial femoral kondil (MFK) de, 12 dizde (%41) lateral femoral kondil (LFK) de ve 11 dizde (%38) patellada evre 1-4 kondromalazi mevcuttu. Tedavi sonrası ilk yılın sonunda 19 hastanın 23 dizinde (%79.3) mükemmel ve iyi sonuç elde edilirken 20.3 aylık izlemde 17 hastanın 20 dizinde (%69) mükemmel ve iyi sonuçlar devam etmekteydi. Artroskopik olarak MFK de evre 1-3 kıkırdak lezyonu saptanan hastaların son izlemlerinde, klinik yileşme devam etmekteyken, evre 4 kıkırdak lezyonu bulunan hastalarda tedavi öncesine göre fark yoktu.Sonuç: Diz osteoartriti bulunan hastalarda her iki tedavinin kombine edilmesi ile kısa süreli de olsa başarılı sonuçlar alınabilir. Ancak bu tedavinin sonuçlarını artroskopik debridmanla ya da eklem içi HA uygulamaları ile karşılaştırmak için iyi kontrollü, uzun süreli ve geniş klinik çalışmalara ihtiyaç vardır.
