Treatment of symptomatic calcaneal lipoma with osseoscopy using a synthetic allograft

Objective: This study evaluated the results of symptomatic calcaneal lipoma patients treated with a recently introduced minimally invasive arthroscopic method. Materials and methods: Seven patients treated with osseoscopy in our clinic for calcaneal lipoma between 2013 and 2018 were evaluated. The median age of the patients was 37.7 years and five were male. The common compliant of the patients was pain that partially disrupted daily life. Surgery was utilized for patients who did not respond to conservative methods (sports restriction, partial weight bearing, and heel support) had persistent pain longer than 3 months and had a risk of impending fracture (>30% loss in trabecular bones). Results: The mean follow-up period after surgery was 21 (12–33) months. In all patients, the location of the ICL was in Ward’s triangle and the mean size was 28.8 (20-43) mm. According to Milgram’s classification, three ICLs were stage I, two were stage II, and two were stage III. The radiological result was evaluated using the classification system of Glutting and Chang. There was no persistent cyst and no recurrence. The radiological success rate was 100%. The mean ankle-hindfoot scale score (max. 100 pts) increased from a preoperative 74.7 ± 5.3 points (range: 69–83) to a postoperative 96.7 ± 2.62 points (range: 93-100). Conclusions: In the treatment of calcaneal lipoma, treatment with osseoscopy is easy and fast, has low complication rates, and is a cosmetically desirable alternative. The use of synthetic allografts to fill the cavity is a safe, inexpensive, and easy alternative

Comparative analysis of percutaneous excision and radiofrequency ablation for osteoid osteoma

BACKGROUND This retrospective study aims to compare the efficacy of computed tomography-guided percutaneous excision and radiofrequency ablation in the treatment of osteoid osteoma. MATERIAL AND METHODS We evaluated 40 patients with osteoid osteoma who underwent either percutaneous excision or radiofrequency ablation between 2012 and 2015. The cohort consisted of 10 female and 30 male patients, with a mean age of 15.1 years (range: 4-27 years) and a mean follow-up time of 19.02 months (range: 11-39 months). Percutaneous excision was performed in 20 patients, while radiofrequency ablation was performed in the remaining 20 patients. RESULTS The success rates of percutaneous excision and radiofrequency ablation were comparable, with unsuccessful outcomes observed in 10% and 5% of patients, respectively. The reasons for failure in the percutaneous excision group were attributed to a marking error and incomplete excision of the wide-based nidus. Complications were limited to pathological fracture (n=1) and deep infection (n=1) in the percutaneous excision group, while no complications were encountered in the radiofrequency ablation group. CONCLUSIONS Both percutaneous excision and radiofrequency ablation demonstrate high success rates in treating osteoid osteoma. However, radiofrequency ablation offers the advantage of a quicker return to daily activities without the need for activity restrictions or splints. While being a more cost-effective option, percutaneous excision should be considered cautiously to minimize potential complications

Thermal-hydraulic Analysis Of Itu Triga Mark-ii Reaktör

Thesis (M.Sc.) -- İstanbul Technical University, Energy Institute, Yüksek LisansTez (Yüksek Lisans) -- İstanbul Teknik Üniversitesi, Enerji Enstitüsü, Yüksek Lisans In this study, a transient, one-dimensional thermal-hydraulic analysis for ITU TRIGA Mark-II Reactor was achieved. The cooling principle of TRIGA Mark-II is based on natural convection. However, mixed convection has been considered for the modeling of this study in order to have a general usage purpose. The parallel fuel rods in vertical position form a porous structure for the coolant fluid. The fluid, flowing among this porous media impels us to apply an approach so as to achieve the thermal-hydraulic analysis. We have employed a subchannel analysis in this study because the regular geometry of the fuel rings provides us simplicity during the application. By this way, several parameters of the fluid (i.e. flow area, hydraulic diameter, power density, etc.) can easily be determined and used safely during the thermal-hydraulic analysis. After the integration of the governing equations, the one dimensional conservation of energy equation, momentum balance equation in axial direction, and one dimensional heat conduction equation in radial direction have been discretized. by using the control volume approach to obtain a set of algebraic governing equations. Then, a pressure correction equation has been derived by the aid of the discretized continuity and momentum balance equations. Finally a FORTRAN programme has been developed to solve this set of algebraic equations by using SIMPLE algorithm. Hence, the temperature distribution of the cooling fluid and fuel rods have been determined. Additionally, the velocity and pressure distribution of the coolant has been designated.Bu çalışmada, İ.T.Ü. TRIGA Mark-II Reaktörü'nün termal-hidrolik analizi kontrol hacmi yaklaşımı yöntemi kullanılarak bir boyutlu olarak yapılmıştır. Reaktör havuzunun içinde düşey konumda bulunan silindirik yakıt çubuklarmm soğutulması, havuz içerisinde akışkanın ısınması sonucu oluşan yoğunluk farkına dayanan doğal konveksiyonla gerçekleştirilmektedir. Ancak, bu çalışmada reaktör içindeki akış modeli olarak en genel halde çözüm verebilecek bir model öngörülerek doğal ve zorlanmış taşınmam aynı anda dikkate alındığı birleşmiş taşınım esas alınmıştır. Soğutucu akışkana ait enerji korunumu ve momentum dengesi denklemlerinin çözümü eksenel doğrultuda yapılmıştır. Reaktör kalbinde düşey konumda birbirine paralel olarak bulunan yakıt çubukları, soğutucu akışkan için gözenekli bir yapı meydana getirirler. Bu yüzden akışkan akışının termal-hidrolik analizinin yapılması, bazı yaklaşımlar yapılmasını gerekli kılar. Bu çalışmada alt kanal analizi yöntemi kullanılarak, reaktör kalbi bölgesindeki akışkan akışı modellenmiştir. Reaktör kalbinin merkezi etrafında artarda dizili bulunan yakıt halkalarının düzgün geometrisi, bu çalışmada yakıt çubuğu merkezli alt kanal analizi yaklaşımında bulunulmasını sağlayan en önemli etken olmuştur. Bu sayede akış alam, hidrolik çap, yakıt çubuklanmn sürtünme yüzeyleri gibi termal-hidrolik analiz esnasında belirlenmesi gereken pek çok parametre kolayca tayin edilmiştir. Ayrıca, yakıt çubuğu halkalarının her konumunda basınç, hız gibi özeliklerin açısal doğrultuda değişmediği öngörüsü yapılmış ve böylece pek çok parametre kolayca belirlenmiştir. Soğutucu akışkanın modellenmesi, eksenel doğrultuda bir boyutlu olarak yapılmış, ayrıca seçilen alt kanallar arasmda çapsal doğrultudaki kütle, momentum ve enerji geçişinin etkisi ihmal edilmiştir. Soğutucu akışkana ait eksenel doğrultudaki enerji korunumu ve momentum dengesi denklemlerinin çözümlenmesi esnasında yakıt çubuklarından soğutma suyuna yapılan ısı transferi hesaplanarak dikkate alınmıştır. Yakıt çubuklarından soğutucu akışkana olan ısı transferinin hesaplanması ise bu yakıt çubuklanndaki hacimsel ısı kaynağı teriminin belirlenerek yakıt içerisinde radyal doğrultudaki ısı iletimi denkleminin çözümlenmesini gerektirir. Bu çalışmada yukarıda özetle açıklanan nedenlerle, incelenen akışkan için enerji korunumu ve momentum dengesi denklemlerinin eksenel doğrultuda; ayrıca yakıt çubukları için ısı iletimi denkleminin çapsal doğrultuda integralleri alındıktan sonra kontrol hacmi varsayımı altında sonra aynklaştınlmalan yapılmıştır. Aynklaştırma işlemleri tamamlanarak elde edilen cebirsel denklem seti SIMPLE Algoritması 'na göre çözümleme yapmak üzere geliştirilen bir FORTRAN programı vasıtası ile çözülmüştür. Böylece, hem daimi rejimde, hem de geçici rejimde yakıt çubuklarının ve soğutucu akışkanın sıcaklık dağılımı ve bunun yam sıra soğutucu akışkana ait hız, basınç ve sıcaklık dağılımları elde edilmiştir.M.Sc.Yüksek Lisan

A Research On The Relation Between The Broadcasting Policies of Turkish Radio-Television Institution For The Children and The Educational Policies of Ministry of National Education

Alanda televizyonun çocuk gelişimine etkilerine dair çalışmalar yapılmış olmasına rağmen, çocuğun bilişsel gelişimi, televizyonda çocuklara yönelik programlarda belirlenen hedefler ve eğitim politikaları arasındaki uyumluluğa ilişkin özel bir çalışma yapılmadığı görülmüş ve bu araştırmaya konu olarak seçilmiştir. Çalışmada belirlenen konuyu analiz etmek için televizyonun çocukların bilişsel gelişimine etkilerinden yola çıkılarak, Türkiye Radyo-Televizyon Kurumu'nun çocuklara yönelik yayın politikaları, planları ve uygulama programlarında yer alan ilke ve hedefler ile Millî Eğitim Bakanlığı'nın eğitim politikaları, planları ve programlarında yer alan ilke ve hedefler arasında nasıl bir ilişki olduğu ve bu ilişkinin televizyondaki çocuk programlarına nasıl yansıtıldığının incelenmesi amaçlanmıştır. Kuramsal bilgilerin gözden geçirilmesi ve literatür taramasına dayanan bu araştırma niteliksel bir tespit çalışmasıdır. Çalışmada üç bölümden oluşan bir analiz gerçekleştirilmektedir. İlk aşamada çocuğun bilişsel gelişimi ve televizyonun etkisi konusu ele alınmaktadır. Kuramsal bilgiler gözden geçirildiğinde, 7-12 yaş grubunda bulunan ve somut işlemler döneminden soyut işlemler dönemine ilerleyen çocukların bu dönemde, görsel ve işitsel tepkilere karşı duyarlılıklarının arttığı, bu yollarla iletilen bilgileri daha çabuk ve kalıcı bir şekilde aldıkları ve televizyondan kolayca etkilendikleri görülmektedir. İkinci aşamada TRT'nin ve MEB'in çocuklara yönelik eğitim politika, plan ve programları karşılaştırılmalı olarak analiz edilmekte ve ilgili kuramla karşılaştırılmaktadır. Karşılaştırma sonucunda her iki kurumun çocuklara yönelik olarak belirlediği ilke ve hedeflerin çocuğun bilişsel gelişimine uygunluğu dikkat çekmektedir. Çalışmanın son aşamasında TRT Çocuk kanalında 7-12 yaş arası çocuklara yönelik hazırlanan ve yapımı kurum tarafından gerçekleştirilen beş adet yerli program analiz edilmektedir. Yapılan analiz sonucunda incelenen programların hem çocuğun bilişsel gelişimine dair kuramsal bilgilere hem de TRT'nin ve MEB'in çocuklara yönelik ilke ve hedeflerine uygun olduğu görülmektedir. Çalışmada benimsenen amaç doğrultusunda yapılan analizlerle, TRT'nin çocuklara yönelik yayın politikaları, planları ve uygulama programlarında yer alan ilke ve hedefler ile MEB'in eğitim politikaları, planları ve programlarında yer alan ilke ve hedefler arasında paralelliğin sağlandığı ve bu paralelliğin televizyondaki uygulama programlarına yansıtılmasında gereken özenin gösterildiği sonucuna varılmaktadır.Despite studies were performed in the area concerning the effects of television for the child development, it has been understood that a special study wasn't carried out about the compatibility amongst the cognitive development of the child, the targets determined in the programs aimed at the children on television and the educational programs, and it has been chosen the topic for this research. In the study, it has been aimed, starting out the cognitive development of the children by television to analyze the subject determined, to investigate what sort of a relation exists amongst the broadcasting policies of Turkish Radio-Television Institution for the children, the principles and targets of it existing in its plans and application programs, and the educational policies, plans and programs of Ministry of National Education, and how these relations are shown in the child programs on television. This research depending on reviewing the institutional knowledge and literature review is a qualitative study of determination. In the study, an analysis consisting of three parts is performed. In the first stage, the subject about the cognitive development of the child and the effect of television is considered. When the institutional knowledge is reviewed, it is understood that the sensitivity of the children who are between the age group of 7-12 and going on from the concrete transactions to abstract transactions increase in this period against the visual and auditory reactions, that they get the knowledge delivered through these ways faster and in a permanent way, and that they are easily effected by television. In the second stage, the educational policy, plan and programs of TRT and MEB aimed at the children are comparatively analyzed, and it is compared by the concerned theory. As the result of the comparison, it is noticed that the principles and targets both of the institutions has determined for the children are suitable for the cognitive development of child. In the final stage of the study, the five native programs prepared in the child channel of TRT aiming at the children between 7-12 age group and the production of which was performed by the institution are analyzed. As the result of the analysis carried out, it has been understood that the programs investigated are available for both the theoretical knowledge about the cognitive development of the child and the principles and targets of TRT and MEB aiming at the children. In the study, with the analysis carried out according to the objective determined, it has been concluded that parallelism is shown between the principles and targets existing in the broadcasting policies of TRT for the children, its plans and application programs and the educational policies of MEB, its plans and programs, and that the necessary care is shown for this parallelism to reflect to the application programs on television

Comparison of iliac and femoral autograft practices in pemberton pelvic osteotomy

Background: There is no consensus in regard to grafts used after pelvic osteotomy in developmental dysplasia of the hip in the literature. The aim of this study was to compare iliac and femoral autografts used after Pemberton pelvic osteotomy (PPO). Methods: In this prospective, randomized study, 60 hips with dysplasia of the hip were included. All patients underwent open reduction, PPO, and femoral shortening osteotomy. Iliac autograft (group I; n=30 hips; mean age, 39.07; range, 18 to 72 mo) and femoral autograft (group II; n=30 hips; mean age, 42.53; range, 19 to 70 mo) were used to fill the iliac osteotomy. The height and width of the iliac and femoral autografts were measured intraoperatively. Anteroposterior pelvic radiographs were obtained on the 45th day, and in the 2nd, 3rd, 6th, and 12th months postoperatively. Acetabular index angle, height of the graft, loss of graft position, graft resorption, operative time, blood loss, and union time were compared between the groups. Results: There was a significant difference in each group in terms of loss of graft height between the intraoperative measurement and the postoperative measurement at the 6th week and 3rd month. The intraoperative width of the grafts was significantly greater, loss of graft height was significantly less, and the amount of bleeding was significantly lower in group II (P<0.001 for all 3). However, time to union was significantly shorter in group I (P<0.001). There was no significant difference between the groups in terms of acetabular index angle at the last controls. There were loss of graft position in 2 cases and graft resorption in 1 case for group I, but no such cases occurred for group II. Conclusions: Graft height and position loss, donor site morbidity, and graft resorption were less in the femoral autografts group compared with the iliac autografts group in the treatment PPO with femoral shortening osteotomy

Big and deep seated lipomatous tumours in children : Results of surgical treatment

The objective of the study is to evaluate results of our pediatric patients with big and deep-seated lipomatous tumors Results of 32 children who underwent resection for 5 cm or larger and deep-seated lipomas were evaluated. The mean age of the patients was 9.1 years (range, 0-16 ; 11 female/21 male), and median follow-up period was 3.21 years (range, 1-10 years). The median size of the excised tumour was 11 cm (range, 6-28 cm) in maximal dimension. Big lipomas in children can be treated with marginal resection procedures without biopsy with lower complication and local recurrence ratio compared to adult patients with similar tumours in similar size and location

Depression, social phobia and quality of life after major lower limb amputation

Introduction: In this study, we aimed to compare the social phobia, depression and quality of life in patients with major lower limb amputation to non-amputated.Methods: Patients who were underwent above or below the knee amputation in the past were evaluated retrospectively by examining the hospital records. All the participants were administered Liebowitz Social Anxiety Scale (LSAS), Hospital Anxiety and Depression Scale (HADS), and Short-Form 36 (SF-36).Results: The number of patients was 30 (21 males, nine females) in the amputated group and 30 (22 males, eight females) in the control group. The mean age was 41.8±14.09 years in the amputated group and 43.3±18.68 years in the control group. All LSAS and HADS scores were higher, and SF-36 scores were lower in the amputation group compared to the control group (p<0.05). The patients who were amputated more than five years ago had higher LSAS social fear scores, and lower HAD depression scores compared to patients less than five years (p=0.035, p=0.024, respectively). The employed patients had lower HAD depression and HAD total scores compared to unemployed patients (p=0.008, p=0,049, respectively). The patients amputated due to medical complications had higher scores in anxiety compared to the patients with traumatic amputation (p=0.005, p=0.016, respectively).Discussion and Conclusion: Social phobia, depression and poor quality of life are common problems in patients with major lower limb amputation. After five years, it should not be forgotten that social phobia will increase; depression will decrease along with its seriousness. Therefore, amputated patients should be psychiatrically counseled and treated. It is important to provide permanent employment opportunities to improve the quality of life

Effect of insulin-like growth factor-1 and hyaluronic acid in experimentally produced osteochondral defects in rats

OZKUL, EMIN/0000-0003-2149-8154WOS: 000381289600012PubMed: 27512224Background: The common purpose of almost all methods used to treat the osteochondral injuries is to produce a normal cartilage matrix. However current methods are not sufficient to provide a normal cartilage matrix. For that reason, researchers have studied to increase the effectiveness of this methods using chondrogenic and chondroprotective molecules in recent experimental studies. Insulin-like growth factor-1 (IGF-1) and hyaluronic acid (HA) are two important agents used in this field. This study compared the effects of IGF-1 and HA in an experimental osteochondral defect in rat femora. Materials and Methods: The rats were divided into three groups ( n = 15 per group) as follows: The IGF-1 group, HA group, and control group. An osteochondral defect of a diameter of 1.5 mm and a depth of 2 mm was created on the patellar joint side of femoral condyles. The IGF-1 group received an absorbable gelatin sponge soaked with 15 g/15 l of IGF-1, and the HA group received an absorbable gelatin sponge soaked with 80 g HA. The control group received only an absorbable gelatin sponge. Rats were sacrificed at the 6 (th) week, and the femur condyles were evaluated histologically. Results: According to the total Mankin scale, there was a statistically significant difference between IGF-1 and HA groups and between IGF-1 and control groups. There was also a significant statistical difference between HA and control groups. Conclusion: It was shown histopathologically that IGF-1 is an effective molecule for osteochondral lesions. Although it is weaker than IGF-1, HA also strengthened the repair tissue