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Airway management in patients with cleft lip and palate: Evaluation of intubation conditions with videolaryngoscopy
(2021) Mengu, Servet; Ganidagli, Suleyman; Emeli, Yusuf; Mendes, Ergun; Gocergil, Huseyin; Sevimli, Reşit
Cleft lip and palate are one of the most common congenital head and neck anomalies and are seen at a frequency of 11-15%. In this study we aimed to observe airway management and intubation conditions with videolaryngoscopy in patients with cleft lip and palate. 40 patients with cleft lip and palate (Group Y) and 40 normal patients (Group N) aged between 4 months and 10 years undergoing elective surgery were included in this prospective randomized study. Mallampati Classification (MMC), Cormack-Lehane Classification (CL-S), thyromental distance (TMM) and mouth opening were evaluated to predict difficult airway. Intubation times, number of intubation attempts, heart rate (HR), mean arterial pressure (MAP), peripheral oxygen saturation (SpO2) and end-tidal CO2 (Et-C02) values were also recorded. Intubation times was significantly higher in Group Y than Group N. HR and MAP values measured in Group Y were found to be significantly higher than Group N at the 5th and 10th minutes (p <0.05). Et-CO2 values in Group Y were found significantly higher than Group N at the 0 and 2 minutes of measurement times. It was observed that intubation was more difficult and the duration of intubation was longer in patients with cleft lip and palate compared to normal patients in the same age group. Because of this reasons hemodynamic and respiratory parameters were negatively affected in these patients.
Analysis of orthopedic surgery of patients with metastatic bone tumors and pathological fractures
(SAGE PUBLICATIONS LTD, 1 OLIVERS YARD, 55 CITY ROAD, LONDON EC1Y 1SP, ENGLAND, 2018) Sevimli, Reşit; Korkmaz, Mehmet Fatih
Objective This study was performed to determine the most common causes, locations, and treatments of metastasizing primary tumors through evaluation of patients with metastatic bone tumors who were admitted to our clinic. Methods In total, 96 patients with metastatic bone tumors who were admitted to our clinic from 2000 to 2016 were included in the study. Results The breast (30 patients, 31.3%) and lung (18 patients, 18.8%) were the most commonly metastasized primary organs. The femur was the most commonly metastasized bone. Conclusions Bone tumors in patients of advanced age are, unless otherwise proven, considered to be metastatic, and the development of specific diagnostic and treatment algorithms is needed. Clinicians should attempt to improve the general condition of patients with tumors exhibiting bone metastasis to increase the patients' quality of life by providing early mobilization. Thus, appropriate patient selection and proper internal fixation are essential.
Anatomic Anterior Cruciate Ligament Reconstruction by Using Quadriceps Tendon Autograft
(2015) Görmeli, Gökay; Görmeli, Cemile Ayşe; Sevimli, Reşit
[Abstract Not Available]
Bilateral humeral simple bone cyst coming with pathological fracture in mature individual: case report
(Turgut Özal Tıp Merkezi Dergisi, 2016) Sevimli, Reşit; Ertem, Kadir; Ayrancı, Barış; Canbay, Ali
Simple bone cysts are benign bone lesions commonly seen in childhood, and it is rare after the first two decades of life.Many factors are implicated in etiopathogenesis of bone cyst. Because etiologic factors are not certain, it is not possible to mention about a certain way of treatment either. In adolescence, once the bone maturation is complete, spontaneous regression of the cysts are expected. Many methods were applied in the treatment of these lesions. Mechanical treatment involving curettage and grafting, injectional treatment (steroids) especially applied in the 1st decade, decompression of the cyst (multi-drilling, pin, screw), decompression with structural support (intramedullary nails) can be mentioned among the methods.In this study, we have attempted to present diagnosis and treatment of case of 25 year old adult’s simple bone cyst with metaphyseal-diaphyseal complete involvement of both humerus which was identified in assessments after pathological fracture caused by a simple fall. Keywords: Bone Cyst; Pathological Fracture; Allograft.
Bilateral Knee Osteonecrosis After Intraarticular Concomitant Local Anesthetic and Corticosteroid Injection: A Case Report
(2015) Görmeli, Gökay; Görmeli, Ayşe Cemile; Uçar, Muharrem; Sevimli, Reşit; Gürbüz, Şükrü
Abstract: Osteoartrit maluliyetin en önemli etkenlerinden biri olarak karşılaşabileceğimiz, en sık eklem hastalıkları formudur. Osteoartrit, eklem kıkırdağının dejenerasyonu, osteofit formasyonu ve subkondral kistler ile karakterizedir. Eklem kıkırdağının geniş olmadığı durumlarda konservatif tedavi tercih edilebilir. Klinisyenler tarafından tercih edilen konservatif tedavi yöntemlerden biri de lokal anestezik, kortikosteroid veya bunların her ikisinin birlikte kullanıldığı eklem içi enjeksiyonlardır. Mevcut literatür ve bizim deneyimlerimiz, eklem içi enjeksiyonların hasta memnuniyeti için olumlu etkilere sahip olduğunu göstermektedir. Eklem içi steroid uygulanımı osteoartritli hastalarda kısa dönemli ağrıyı giderir. Bu ilaçların ağrı ve maluliyeti azaltıcı etkisi olmasına rağmen kondrosit hasarına bağlı erken osteoartrit veya avasküler nekroz gibi yan etkileri de olmaktadır. Biz kortikosteroid ve lokal anestezik maddenin eklem içi enjeksiyonu sonrasında kısa dönem içerisine her iki dizde avasküler nekroz gözlenen bir olguyu sunmayı amaçladık.
The clinical and histopathological effects of perineural dexmedetomidine and in combination with sodium bicarbonate in sciatic nerve block in rabbits after sevoflurane anesthesia: A placebo controlled, randomized experimental study
(2019) Akbaş, Sedat; Özkan, Ahmet Selim; Sevimli, Reşit; Alan, Saadet
Abstract: Aim: Peripheral nerve blockade is a common regional anesthetic technique in surgical procedures in daily clinical practice. The aim of this experimental study was to compare perineural dexmedetomidine alone with perineural sodium bicarbonate added to dexmedetomidine for measurement of analgesia, sensorial and motor blockade and histopathologic evaluation. Material and Methods: Twenty-four rabbits were randomly allocated to 3 groups; Group S: sham, Group D: perineural dexmedetomidine (20 mcg/kg) and Group D+SB: perineural dexmedetomidine (20 mcg/kg) plus sodium bicarbonate. (8.4%, 0.125 mL). Analgesia measurement was evaluated by hotplate test, the paw withdrawal response was performed for sensorial and motor blockades, also were recorded at baseline, 30, 60, 90 and 120 min after drug administration. Dissected nerve tissue was also examined for histopathologic evaluation. Results: Latency times of Group D or Group D+SB were significantly longer when compared with Group S at 30, 60, 90 and 120 min. There was no significant difference between Group D and Group D+SB for the all scheduled times. Sensorial and motor blockade scores were similar in all groups. Group D or Group D+SB caused edema, inflammation with neutrophil leukocytes, and degeneration of myelin fibers, increased in vacuolization, granulation tissue and fibrosis. Conclusion: Perineural dexmedetomidine alone or in combination with sodium bicarbonate prolonged the duration of analgesia, but did not enhance the sensorial and motor blockade, when compared with placebo. Perineural dexmedetomidine combined with sodium bicarbonate didn’t enhance the blockage. Dexmedetomidine caused edema, inflammation and degeneration of myelin fibers, increased in granulation tissue and fibrosis.
The clinical and histopathological effects of perineural dexmedetomidine and in combination with sodium bicarbonate in sciatic nerve block in rabbits after sevoflurane anesthesia: A placebo controlled, randomized experimental study
(2019) Akbas, Sedat; Ozkan, Ahmet Selim; Sevimli, Reşit; Alan, Saadet
Aim: Peripheral nerve blockade is a common regional anesthetic technique in surgical procedures in daily clinical practice. The aim of this experimental study was to compare perineural dexmedetomidine alone with perineural sodium bicarbonate added to dexmedetomidine for measurement of analgesia, sensorial and motor blockade and histopathologic evaluation. Material and Methods: Twenty-four rabbits were randomly allocated to 3 groups; Group S: sham, Group D: perineural dexmedetomidine (20 mcg/kg) and Group D+SB: perineural dexmedetomidine (20 mcg/kg) plus sodium bicarbonate. (8.4%, 0.125 mL). Analgesia measurement was evaluated by hotplate test, the paw withdrawal response was performed for sensorial and motor blockades, also were recorded at baseline, 30, 60, 90 and 120 min after drug administration. Dissected nerve tissue was also examined for histopathologic evaluation. Results: Latency times of Group D or Group D+SB were significantly longer when compared with Group S at 30, 60, 90 and 120 min. There was no significant difference between Group D and Group D+SB for the all scheduled times. Sensorial and motor blockade scores were similar in all groups. Group D or Group D+SB caused edema, inflammation with neutrophil leukocytes, and degeneration of myelin fibers, increased in vacuolization, granulation tissue and fibrosis. Conclusion: Perineural dexmedetomidine alone or in combination with sodium bicarbonate prolonged the duration of analgesia, but did not enhance the sensorial and motor blockade, when compared with placebo. Perineural dexmedetomidine combined with sodium bicarbonate didn’t enhance the blockage. Dexmedetomidine caused edema, inflammation and degeneration of myelin fibers, increased in granulation tissue and fibrosis.
The clinical and histopathological effects of perineural dexmedetomidine in combination with bupivacaine in sciatic nerve block in rabbits undergoing sevoflurane anesthesia
(2022) Sevimli, Reşit; Akbaş, Sedat; Karaaslan, Erol; Özkan, Ahmet Selim
Many drugs or additives have been tried as adjuvants in the blocking of nerve blocks with local anesthetics, and it is aimed to increase the duration of action and analgesia quality of local anesthetics in this way. In this study, we aimed to see the adjuvant efficacy of Dexmedetomidine [Dex] added to bupivacaine and its effect on analgesia and histopathological effects in rabbits by administering sevoflurane anesthesia. Twenty-four rabbits were randomly allocated to 3 groups; Group S: sham [0.5 ml saline], Group B: perineural bupivacaine [0.5 mg/kg] [0.5 ml] and Group BD: perineural bupivacaine [0.5 mg/kg] combined with Dex [20 µr/kg] [0.5 ml]. Analgesia measurement was evaluated by hotplate test, the paw withdrawal response was performed for sensorial and motor blockades also were recorded at baseline, 30, 60, 90, and 120 min after drug administration. Dissected nerve tissue was also examined for histopathologic evaluation. In the hot-plate test applied for the measurement of acute thermal pain; when compared to Group S, significant prolongation was found in Group B and Group BD at 0, 30, 60, 90, and 120 minutes [p<0.05]. When Group BD was compared with Group B, a significant prolongation was found at 60 minutes [p=0.012]. No significant difference was found in other times. No significant differences were found between the groups in sensory and motor block tests. In the BD group, compared to the B group, edema and inflammation in the epineurium and surrounding tissues were significantly reduced on the 1st day [p<0.05]. On the 14th day, there was no difference in terms of edema. In rabbits administered sevoflurane anesthesia, the mixture of bupivacaine and Dex applied to provide analgesia in the application of sciatic block prolongs the delay time and increases the quality of analgesia in the hot-plate test evaluating acute thermal pain. Dex added to bupivacaine contributed positively when the analyzed histopathological parameters were evaluated.
The clinical and histopathological effects of perineural dexmedetomidine in combinationwith bupivacaine in sciatic nerve block in rabbits undergoing sevoflurane anesthesia
(2022) Özkan, Ahmet Selim; Akbaş, Sedat; Sevimli, Reşit; Alan, Saadet; Karaaslan, Erol
Many drugs or additives have been tried as adjuvants in the blocking of nerve blocks with local anesthetics, and it is aimed to increase the duration of action and analgesia quality of local anesthetics in this way. In this study, we aimed to see the adjuvant efficacy of Dexmedetomidine [Dex] added to bupivacaine and its effect on analgesia and histopathological effects in rabbits by administering sevoflurane anesthesia. Twenty-four rabbits were randomly allocated to 3 groups; Group S: sham [0.5 ml saline], Group B: perineural bupivacaine [0.5 mg/kg] [0.5 ml] and Group BD: perineural bupivacaine [0.5 mg/kg] combined with Dex [20 µr/kg] [0.5 ml]. Analgesia measurement was evaluated by hotplate test, the paw withdrawal response was performed for sensorial and motor blockades also were recorded at baseline, 30, 60, 90, and 120 min after drug administration. Dissected nerve tissue was also examined for histopathologic evaluation. In the hot-plate test applied for the measurement of acute thermal pain; when compared to Group S, significant prolongation was found in Group B and Group BD at 0, 30, 60, 90, and 120 minutes [p<0.05]. When Group BD was compared with Group B, a significant prolongation was found at 60 minutes [p=0.012]. No significant difference was found in other times. No significant differences were found between the groups in sensory and motor block tests. In the BD group, compared to the B group, edema and inflammation in the epineurium and surrounding tissues were significantly reduced on the 1st day [p<0.05]. On the 14th day, there was no difference in terms of edema. In rabbits administered sevoflurane anesthesia, the mixture of bupivacaine and Dex applied to provide analgesia in the application of sciatic block prolongs the delay time and increases the quality of analgesia in the hot-plate test evaluating acute thermal pain. Dex added to bupivacaine contributed positively when the analyzed histopathological parameters were evaluated.
Clinical features and follow-up results of the patients with methicillin-resistant Staphylococcus aureus (MRSA) in orthopedic practice
(2018) Erdemir, Nuri; Korkmaz, Mehmet Fatih; Duman, Yücel; Arslan, Aydın; Sevimli, Reşit
Abstract: Treatment of the infections caused by methicillin-resistant Staphylococcus aureus (MRSA) strains in orthopedic patients is a difficult and laborious process for both the patient and physician. Staphylococcus aureus(S. aureus) is one of the leading causes of community-acquired and nosocomial infections. In this study, we aimed to investigate the susceptibilityof the MRSA strainsisolated in orthopedic patients cultured for different reasons in our clinic to various antibiotics, and to evaluate clinical characteristics of the patients and factors affecting the prognosis. A total of 40 patients with MRSAisolated in our orthopedics clinic between December 2012 and November 2016 were retrospectively analyzed. Data including age, sex, comorbidities, previous surgeries, and previous antibiotic treatments were obtained from patients’ files and electronic information system. Of 40 patients, 60% were male, and 56% were over 60 years old. While 80% of the patients underwent an orthopedic surgery, 20% of them received no surgical intervention before the diagnosis. A total of 90% were in-patients, and the mean length of hospital stay was 22 days. The mean time from the date of hospitalization to the isolation of MRSA was 12 days. According to the consultation findings, in the clinical recovery process of the patients and in the treatment algorithm given to those patients, vancomycin and teicoplanin were found to be among the most important treatment options, in addition to significant debridement to be done, for MRSA strains. Our study results suggestthat, in addition to the surgical debridement, timely antibiotherapy is of utmost importance to reduce mortality and morbidity in MRSA-positive orthopedic patients.
Clinical results of endoprosthetic reconstructions in metastatic and primary bone tumors
(2022) Sevimli, Reşit; Karaman, Serdar
In this study, we aimed to compare the functional outcomes and survival of 38 patients with primary bone and metastatic bone tumors who were reconstructed with endoprosthesis. Thirty-eight patients who underwent endoprosthesis for malign bone tumors 2012- 2015 were included in the study. We retrospectively reviewed 38 patients, eight of whom underwent limb salvage with tumor resection prosthesis of tibia, 21 femur, and 9 humerus. When comparing functional outcomes, the revised Musculoskeletal Tumor Society (MSTS) scoring system was used for all surviving patients. The patients were evaluated in two groups as primary bone tumor and metastatic bone tumor. The mean follow-up period of 32 healthy and alive patients was 38 (12 to 98) months. While 12 patients were primary malign bone tumors, the other 26 patients had bone metastasis. All six patients who died during follow-up had a diagnosis of metastatic bone tumor. Periprosthetic infection was observed in two patients, recurrence tumor in one and prosthetic dislocation in one. It was found that the MSTS score in patients with primary bone tumors (22, 6) was statistically significantly higher than in patients with metastases (17, 6) (p<0.05). The score of the patients who had upper extremity (%22) reconstruction was found to be significantly higher than the lower extremity (%78) (p<0.05). It was determined that better functional results were obtained for patients with primary bone tumors than patients with bone metastasis. The low complication rates obtained because of this study, which had an average follow-up of 38 months, showed us that reconstruction with endoprosthesis is promising for tumors of the femur, tibia and humerus.
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, Özgür
Öz: 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 kaçınılmazdır
Comparative analysis of the effects of combined spinal epidural anesthesia versus psoas compartment and sciatic nerve block for partial hip prosthesis in the geriatric population
(2020) Özden, Mehmet Mustafa; Cesur, Mehmet; Emeli, Yusuf; Sevimli, Reşit
Aim: We aimed to compare combined spinal-epidural anesthesia (CSE) and combined psoas compartment & sciatic nerve block (PCSNB) peripheral nerve blocks, in terms of intraoperative and postoperative pain, hemodynamics and side effects in geriatric population who underwent partial hip prosthesis.Material and Methods: A total of 50 patients who underwent elective partial hip prosthesis and PCSNB or CSE were included. The age range was between 60-99 years and ASA scores were ? 3. Twenty-five patients underwent CSE anesthesia with 1 mL plain bupivacaine, while PCSNB and iliac crest blocks were employed in 25 patients. Perioperative anesthetic efficacy, blood pressures, pulse rates, saturation values, need for postoperative analgesia and side effects were compared. Results: At the end of the operation, the mean arterial pressure was lower in both groups compared to the baseline (initial) values and the decline in the CSE group was statistically significant. Hypotension was detected in 11 patients (44%) in the CSE group and 2 patients (8%) in the PCSNB group. Effective analgesia was provided in all patients in the CSE group, while 5 patients (20%) required additional analgesic medications through the epidural catheter in the follow-up. The first postoperative analgesic hour was remarkably longer in the PCSNB group (4.84 ± 2.54 hours vs. 1.64 ± 0.9 hours).Conclusion: Our data demonstrated that the combination of the psoas compartment, parasacral, sciatic and iliac crest blocks provides effective analgesia and maintains hemodynamic stability after hip prosthesis operations in elderly patients.
Comparative analysis of the effects of combined spinal epidural anesthesia versus psoas compartment and sciatic nerve block for partial hip prosthesis in the geriatric population
(2020) Ozden, Mehmet Mustafa; Cesur, Mehmet; Emeli, Yusuf; Sevimli, Reşit
Aim: We aimed to compare combined spinal-epidural anesthesia (CSE) and combined psoas compartment & sciatic nerve block (PCSNB) peripheral nerve blocks, in terms of intraoperative and postoperative pain, hemodynamics and side effects in geriatric population who underwent partial hip prosthesis.Material and Methods: A total of 50 patients who underwent elective partial hip prosthesis and PCSNB or CSE were included. The age range was between 60-99 years and ASA scores were ≤ 3. Twenty-five patients underwent CSE anesthesia with 1 mL plain bupivacaine, while PCSNB and iliac crest blocks were employed in 25 patients. Perioperative anesthetic efficacy, blood pressures, pulse rates, saturation values, need for postoperative analgesia and side effects were compared. Results: At the end of the operation, the mean arterial pressure was lower in both groups compared to the baseline (initial) values and the decline in the CSE group was statistically significant. Hypotension was detected in 11 patients (44%) in the CSE group and 2 patients (8%) in the PCSNB group. Effective analgesia was provided in all patients in the CSE group, while 5 patients (20%) required additional analgesic medications through the epidural catheter in the follow-up. The first postoperative analgesic hour was remarkably longer in the PCSNB group (4.84 ± 2.54 hours vs. 1.64 ± 0.9 hours).Conclusion: Our data demonstrated that the combination of the psoas compartment, parasacral, sciatic and iliac crest blocks provides effective analgesia and maintains hemodynamic stability after hip prosthesis operations in elderly patients.
Comparison of medium-period outcomes of allografts and autografts used in repair of bone defects in patients who were treated in our department due to skeletal system tumors
(2017) Sevimli, Reşit
Objective: In orthopaedic oncology, reconstruction with autograft or allograft of bone defects which develop following tumor resection or curettage is a commonly used method. Bone generally has the ability to regenerate completely but requires a very small fracture space or some sort of scaffold to do so. Successful results of allografts or autograft in reconstruction of bone defect after tumor resection encouraged its utilization in post-traumatic defects. In this study, prospective representation of clinical and radiological medium-period outcomes of used autgrafts and allografts is aimed. Materials and Methods: 45 patients who were treated, for whom reconstruction was performed by using allograft or autograft following tumor excision or curettage between the years 2005-2015 in Inonu University Faculty of Medicine were included in the study. Patients were evaluated in regard to age, gender, tumor localization and union. Obtained data were analyzed by SPSS software version 15.0 Results: During follow-ups of the patients; union was radiologically observed in an average of 6.1 months in 43 (91%) patients (in 21 autografts it was 5.8 months, in 22 allografts it was 6.5 months). Nonunion occurred in 2 (9%) patients. No statistically significant difference was determined between groups with allografts and autografts (P>0.05). Conclusion: No difference was determined between use of either autogenous or allogenous grafts in segmental or cavitary bone defects, and reconstruction is a method with high success.
Comparison of medium-period outcomes of allografts and autografts used in repair of bone defects in patients who were treated in our department due to skeletal system tumors
(Turgut Özal Tıp Merkezi Dergisi, 2017) Sevimli, Reşit
Abstract Objective: In orthopaedic oncology, reconstruction with autograft or allograft of bone defects which develop following tumor resection or curettage is a commonly used method. Bone generally has the ability to regenerate completely but requires a very small fracture space or some sort of scaffold to do so. Successful results of allografts or autograft in reconstruction of bone defect after tumor resection encouraged its utilization in post-traumatic defects. In this study, prospective representation of clinical and radiological medium-period outcomes of used autgrafts and allografts is aimed. Materials and Methods: 45 patients who were treated, for whom reconstruction was performed by using allograft or autograft following tumor excision or curettage between the years 2005-2015 in Inonu University Faculty of Medicine were included in the study. Patients were evaluated in regard to age, gender, tumor localization and union. Obtained data were analyzed by SPSS software version 15.0 Results: During follow-ups of the patients; union was radiologically observed in an average of 6.1 months in 43 (91%) patients (in 21 autografts it was 5.8 months, in 22 allografts it was 6.5 months). Nonunion occurred in 2 (9%) patients. No statistically significant difference was determined between groups with allografts and autografts (P>0.05). Conclusion: No difference was determined between use of either autogenous or allogenous grafts in segmental or cavitary bone defects, and reconstruction is a method with high success. Keywords: Allograft; Autograft; Bone Tumors.
COMPREHENSIVE MANAGEMENT OF TRAUMATIC THORACOLUMBAR VERTEBRAL FRACTURE
(2014) Korkmaz, Mehmet Fatih; Karatas, Mehmet; Sevimli, Reşit; Erdem, Mehmet Nuri
Öz: Vertebral omurganın orta bölümü çubuk ve plakaların oluşan üç boyutlu trabeküler ağından oluşur. Bu trabeküler yapı özellikle bel omurları içinde basınç dayanımının % 90'ı sağlar. Ayrıca, trabeküler ağ içindeki kemik iliği basınç dayanımı ve enerji emilimini artırır. Belkemiğinin anterior bileşenleri (silindirik vertebral gövde ve disk) sıkıştırıcı kuvvetlere karşı direnç sağlarken, posterior ligamantöz elemanlar gerilme kuvvetlerine karşı direnç sağlar. Anterior ve posterior elemanlar diyagonal ve rotasyonel kuvvetlere ve eğilme momentinede direnç sağlar
Distribution and evaluation of primary bone and soft tissue tumors admitted from Malatya province and surrounding provinces
(2017) Sevimli, Reşit
Abstract: In this study characteristics and distribution of primary bone and soft tissue tumors which were operated in Inonu University Turgut Ozal Medical Center Department of Orthopaedics and Traumatology between January 2000 and December 2016 and comparison with the literature is aimed. Our study is retrospective and descriptive and 710 patients [275 M, 435 F, mean age: 30,67 ] who hospitalized with pre-diagnosis of a tumor were evaluated. Patients were analyzed according to age, gender, tumor frequency and localization. Of 710 cases which were taken into evaluation as primary bone and soft tissue tumors; 391 (55%) were determined to be bone tumors and 319 (45%) were determined to be soft tissue tumors. The most commonly seen benign bone tumor was determined to be osteochondroma (86; 25,59%) and then non-ossified fibroma (54; 16%), whereas the most commonly seen malignant bone tumor was determined to be chondrosarcoma (16, 29%) and then multiple myeloma (14; 25,45%) and osteosarcoma (8;15,54%). Among soft tissue tumors, the most commonly seen benign tumor was found to be ganglion cyst (cystic hygroma) (107; 36,1%), followed by lipoma (41; 13,99%) and tendon sheath giant cell tumor (33; 11,26%), whereas the most commonly seen malignant soft tissue tumor was found to be liposarcoma (6; 23,07) and malignant mesenchymal tumor (5; 19,23%), followed by pleomorphic undifferentiated sarcoma (5; 19,23%). In our country, statistical studies concerning distribution of bone and soft tissue tumors are progressively increasing. We suggest that larger series published by collecting from different centers are of particular importance in regard to epidemiological characteristics of bone and soft tissue tumors, as well as guiding in diagnosis and treatment
The effect of perineural application of bupivacaine combined with sodium bicarbonate on the synatic nerve block in rabbits after sevofluran anesthesia
(2020) Sevimli, Reşit; Türkmen, Ersen; Özkan, Ahmet Selim; Akbaş, Sedat; Alan, Saadet
Abstract: Aim: The aim of this study was to investigate the effect of combining sodium bicarbonate with bupivacaine on prolonging peripheral nerve block time. Material and Method: Following the approval of the required Ethics Committee, 24 male New Zealand rabbit (4250-5350 g) were randomized and divided into three groups. Group 1 sham n: 8; Group 2 (bupivacaine): 0.5 mL of 0.5% bupivacaine (0.5 mg / kg) injected into the perineural area. n: 8; and Group 3 (bupivacaine + sodium bicarbonate): 0.5 ml of 0.5% bupivacaine + sodium bicarbonate (125 ml of 8.4% injected into the perineural area. n: 8. After the skin was closed in all groups, the paw pull response was monitored and recorded every 30 minutes until the sensory block of the experimental animal returned back. Hot-plate test was used for analgesia evaluation. In addition, tissue histopathology was examined for histopathological evaluation of the injection site. Sensory block was evaluated with claw tightening test and claw pull test (hot-plate) response. The measurements were carried out every 30 minutes for 120 minutes or until the block was completely resolved. Results: 30., 60. and 90.min paw pull response in Group 2 and Group 3 showed statistically significant elongation when compared to Group 1, this difference disappeared in 120 minutes. Compared to the sham group, the 30 min hot plate and claw pull response was significantly longer in group 3 (sodium bicarbonate and bupivacaine), this difference disappeared in 60 minutes (p = 0.018). Conclusion: When sodium bicarbonate and bupivacaine are combined, it was seen in this study that the sensory block was prolonged. We believe that the current results can be used as a guide for future studies
The effect of perineural application of bupivacaine combined with sodium bicarbonate on the synatic nerve block in rabbits after sevofluran anesthesia
(2020) Sevimli, Reşit; Ozkan, Ahmet Selim; Akbas, Sedat; Alan, Saadet; Turkmen, Ersen
Aim: The aim of this study was to investigate the effect of combining sodium bicarbonate with bupivacaine on prolonging peripheral nerve block time.Material and Method: Following the approval of the required Ethics Committee, 24 male New Zealand rabbit (4250-5350 g) were randomized and divided into three groups. Group 1 sham n:8; Group 2 (bupivacaine): 0.5 mL of 0.5% bupivacaine (0.5 mg / kg) injected into the perineural area. n:8; and Group 3 (bupivacaine + sodium bicarbonate): 0.5 ml of 0.5% bupivacaine + sodium bicarbonate (125 ml of 8.4% injected into the perineural area. n: 8. After the skin was closed in all groups, the paw pull response was monitored and recorded every 30 minutes until the sensory block of the experimental animal returned back. Hot-plate test was used for analgesia evaluation. In addition, tissue histopathology was examined for histopathological evaluation of the injection site. Sensory block was evaluated with claw tightening test and claw pull test (hot-plate) response. The measurements were carried out every 30 minutes for 120 minutes or until the block was completely resolved.Results: 30., 60. and 90.min paw pull response in Group 2 and Group 3 showed statistically significant elongation when compared to Group 1, this difference disappeared in 120 minutes. Compared to the sham group, the 30 min hot plate and claw pull response was significantly longer in group 3 (sodium bicarbonate and bupivacaine), this difference disappeared in 60 minutes (p = 0.018).Conclusion: When sodium bicarbonate and bupivacaine are combined, it was seen in this study that the sensory block was prolonged. We believe that the current results can be used as a guide for future studies.

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