Cerrahi yolla tedavi edilen el ve el bileği kitlelerinin değerlendirmesi

Amaç: El ve el bileği kökenli tümörler, Ortopedi ve Travmatoloji uzmanlarının sıkça karşılaştıkları durumlardır. Bu tümörler sıklıkla benign karakter taşımalarına karşın nadiren malign özellikte tümörlerle de karşılaşılabilir. Bu çalışmamızda; cerrahi tedavi için hastanemize yatan el ve el bileği tümörlü hastalar incelenmiştir. Gereç ve yöntem: 1985-2011 yılları arasında patolojik tanıları doğrulamış 379 hastanın 381 el ve el bileği kitlesi çalışmaya dahil edilmiştir. Hastaların; 213’ü kadın, 166’sı erkek ve yaş ortalamaları 30,8 olarak bulunmuştur. Sonuçlar: Tümörlerin 14 % 3,7 tanesi malign; 367 % 96,3 ’si ise benigndi. Malign tümörlerin görüldüğü ortalama yaş 42,3 ; benign tümörlerinki ise 30,6 olarak hesaplandı. Histopatolojik tetkik sonuçlarına göre en sık olarak görülen tümör, 117 olgu ile enkondrom olurken; ikinci sırayı 104 olgu ile ganglion, üçüncü sırayı 49 olgu ile osteokondrom almıştır. En sık görülen malign tümör 8 olgu ile kondrosarkom olmuştur. Yorum: El ve el bileği tümörlerinin sıklığı ve çeşitliliğine dair epidemiyolojik veriler oldukça kısıtlıdır. El ve el bileği yerleşimli kitleler, her Ortopedi ve Travmatoloji uzmanının karşılaşma ihtimali yüksek olan olgulardır. Bu tümörlerin çok büyük bir kısmı benign nitelikte olsa da; malign tümörlerin de görülebileceği unutulmamalıdır. Bu çalışmamızın; el ve el bileğinde görülen kitlesel lezyonların, tanı ve tedavisi açısından Ortopedi ve Travmatoloji ile uğraşan meslektaşlarımıza faydalı olacağına inanmaktayı

Reply to the Letter to the Editor Art in Science: Orthopaedics Through Philatelic Material

WOS: 000330976400046PubMed ID: 2444283

Erratum to: Art in Science: Orthopaedics Through Philatelic Material (vol 471, pg 3755, 2013)

WOS: 00033058500006

Two Column Bases from Mawan in the Hakkâri Province (Southeast corner of Turkey): A new Achaemenid Center?

Bell-shaped column bases are common finds from the Achaemenid Empire centers. These centers were governed either by Persians or local administrators who were dependent on Persia. Two bell-shaped column bases were found in the village of Mawan, 32 km from Şemdinli district of Hakkâri province in Turkey. These column bases are the first Achaemenid finds from the Hakkâri province. Mawan is situated at an important transit point between north-western Iran, eastern Anatolia and northern Iraq. At this point, it is necessary to draw attention to a widespread garrison network of the Achaemenid Empire in the region. Therefore, it is possible to consider the location of the Mawan column bases as the site of a garrison rather than an administrative center

Art in Science: Orthopaedics Through Philatelic Material

WOS: 000327083800007PubMed ID: 2407262

Pure elbow dislocation in the paediatric age group

WOS: 000371084600017PubMed: 26686496Purpose The main purpose of the present study was to evaluate the clinical results and prognosis of pure elbow dislocations in the paediatric age group following non-surgical treatment. Methods Acute traumatic pure elbow dislocations treated between January 2008 and January 2013 were evaluated. The median age was eight years. The mean follow-up time was 46 months. Active and passive range of motion (ROM), elbow stability, neurovascular status, functional status and any early or late complications were evaluated and recorded at the latest follow-up. Results The mean flexion-extension ROM was measured as 119.5 degrees. The mean pronation and supination were 67 and 79 degrees. Moderate instability was diagnosed in four cases. The mean Mayo Elbow Performance Score (MEPS) score was 91.6 points; the clinical outcome was excellent in nine patients, good in two and fair in one. Conclusions Acute traumatic pure elbow dislocation in childhood is a very rarely seen emergency that can be treated safely with closed reduction combined long-arm plaster splinting and physical rehabilitation

Isolated Subtalar Arthrodesis

The purposes of this study were to review the results of isolated subtalar arthrodesis in adults, to make a comparative analysis of the clinical outcomes between the patients with posttraumatic subtalar arthritis and the ones with other etiologic factors, and to evaluate the effects of grafting.The patients included 17 men and 10 women. The mean postoperative follow-up was 33.1 months. The mean AOFAS hindfoot score improved from a mean of 46.7 preoperatively to a mean of 78.4 postoperatively. Twenty-seven of 29 arthrodeses achieved bony union at a mean time of 15.5 weeks. The mean increase in the talocalcaneal height was m 3.7 mm in the feet without grafting, whereas it was 8 mm in the feet for which grafting was performed. Improvement in talocalcaneal angle was significantly worse in the feet with posttraumatic arthritis. The feet with posttraumatic subtalar arthritis were more prone to Reflex Sympathetic Dystrophy.

Tonnis triple pelvic osteotomy for Legg-Calve-Perthes disease

WOS: 000350369800017PubMed: 25417791Purpose The aim of this study is to evaluate the efficacy of Tonnis triple pelvic osteotomy in patients with LCP disease. Methods Between 2007 and 2011, Tonnis triple pelvic osteotomy was performed for 43 patients with LCP, in our institute. During the follow-ups of patients with LCP the indications for the surgery were lateralization of the femoral head, insufficient femoral head coverage and subluxation of the femoral head. The mean age of patients at the time of surgery was 9.4 years. Results Before surgical intervention, according to Waldenstrom classification, three patients were in the necrosis stage (7 %), six patients in the fragmentation stage (13.9 %), 16 patients in the re-ossification stage (37.2 %) and 18 patients in the remodeling stage (41.9 %). According to Herring classification, four patients were in group B (9.3 %), one patient in group B/C (2.3 %) and 38 patients in group C (88.4 %). After the operation, patients were evaluated with Stulberg classification, and good outcome (Stulberg I/II) was achieved in 23 patients (53, 5 %), fair outcome (Stulberg III) in 16 patients (37, 2 %) and poor outcome (Stulberg IV/V) was seen in only four patients (9.3 %). The mean value of CEA was 0.37 degrees pre-operatively and in the last follow-ups the mean value of CEA was 23.7 degrees. Conclusions We recommend triple pelvic osteotomy for patients with LCP when conservative methods are not successful. According to our results we believe that Waldenstrom classification is a better option than Herring classification to determine the prognosis of disease after containment surgery

Evsel ve agro-endüstriyel atıklardan organik asit eldesi

TÜBİTAK ÇAYDAG15.10.2008Bu projede önemli bir çevre kirliliği kaynağı olan ve ülkemizde yüksek miktarlarda üretilen evsel ve agro-endüstriyel atıklar (peynir altı suyu, organik bazlı evsel katı aık, büyükbaş hayvan gübresi, şeker endüstrisi atıkları) organik asitlere dönüştürülmesi ve geri kazanımı çalışılmıştır. Peynir altı suyu ile yapılan deneylerde ilk etapta uçucu yağ asidi (UYA) eldesinin optimizasyonu kesikli reaktörler kullanılarak gerçekleştirilmiştir. pH değerinin 3 civarlarında seyretmesi ve tepe gazı ölçümlerinde metan bulunmaması metanojenik bakterilerin tamamen inhibe edildiğinin göstergesidir. Yapılan deneyler sonucunda, metanojenik aktivite başarılı bir biçimde durdurulmuş ve atıksudaki kimyasal oksijen ihtiyacı %7.6-27 aralığında uçucu yağ asidine dönüştürülebilmiştir. Organik bazlı evsel katı atık (OBEKA) ile yapılan deneylerin ilk bölümünde sızdırma yataklı reaktörlerde (SYR) çalışılmış, % 50-60’lara varan hidroliz verimi elde edilmiş ve 80 günlük işletim sonunda 7000-9000 mg tUYA üretilmiştir. Yapılan deneylerin ikinci bölümünde atık öncelikle pH’ ı kontrol edilen, optimum koşullarda günlük besleme- boşaltma prensibine göre işletilmiş olan sürekli karıştırılan reaktörlerde uçucu organik asitlere dönüştürülmüş; sonra da biyokimyasal metan potansiyeli (BMP) testine ait kesikli reaktörlerde gaz üretimi sağlanmıştır. Sonuç olarak yemek, sebze, meyve ve kağıttan oluşan organik atığın maksimum asidifikasyonunu sağlamak için gereken optimum işletim koşulları; organik yükleme hızı 15 g UK/L.gün, pH değeri 5.5 ve hidrolik bekletme süresi 2 gün olarak saptanmıştır. BMP deneylerinin sonuçları, anaerobik reaktörü iki faza ayırmanın ve asidifikasyon fazını optimum koşullarda işletmenin metan üreten reaktörde performansı artırdığını kanıtlamıştır. Projenin diğer bir bölümü kapsamında büyükbaş hayvan gübresi ile yapılan deneylerde hidrolik bekletme süresi (HBS), organik yükleme hızı (OYH) ve pH optimizasyonunu ile UYA üretim verimini maksimize etme amaçlanmıştır. Bu bölümde 2 günlük HBS (KBS) ve 15 g UKM/L.gun OYH değerleri gübrenin anaerobik asidifikasyonu için optimum değerler olarak belirlenmiştir. Son bölümde çalışılan şeker endüstrisi atıklarıyla ilk önce optimum asidifikasyon, dolayısıyla optimum UY A üretim, koşulları saptanmaya çalışılmış, daha sonra üretilen UY Aların elde edilen fermantasyon sıvısından ekstraksiyonu uygulanmıştır. Ekstraksiyon deneylerinde, fermentasyon sıvısından UYA’ların geri kazanım verimine, pH ve solvent konsantrasyonunun etkisi araştırılmıştır. Sonuç olarak optimum pH 2,5 olarak belirlenmiştir. Bu pH’da UYA’ların geri kazanım yüzdelerinin, ekstrakt edilen asitin tipine ve kerosen içerisindeki TOPO konsantrasyonuna bağlı olarak % 43,3 ve 97,6 arasında değiştiği gözlenmiştir.In this project, domestic and agro-industrial wastes (cheese whey, organic fraction of solid waste, dairy manure, sugar industry wastes), which are significant sources of environmental pollution and are produced in vast amounts in our country, were converted into organic acids and recovered. In the experiments conducted with cheese whey, the optimization of volatile fatty acids was performed by using bacth reactors. pH value of 3 and existance of no methane content in the reactors were the indications of complete inhibition of methanogenic bacteria. As a result of experiments conducted, the methanogenic activity was stopped succesfully and 7.6- 27% of the chemical oxygen demand could be converted into volatile fatty acids (VFA). In he first part of the experiments conducted with the organic fraction of municipal solid waste (OFMSW), leaching bed reactors (LBR) were operated and 50-60% of hydrolysis efficiencies were obtained, and 7000-9000 mg tVFA was produced at the end of the 80-day operation period. In the second part of the experiments, OFMSW were converted into organic acids in the fed-batch continously stirred tank reactors (CSTRs), then in the batch reactors of biochemical methane potential (BMP) test, gas production was achieved from these acids. As a result of BMP test, it was proved that separating the reactor into two parts and operating the acid reactor at optimum conditions enhanced the operation performance. In the experiments conducted by dairy manure, it was aimed to optimize the hydraulic retention time (HRT), organic loading rate (OLR) and pH for the maximum VFA production. At the end of this study, HRT and OLR of 2 days and 15 g VS/L.day were determined as the optimum conditions for anaerobic acidification. In the last part of the project, firstly, the optimization in the acidification conditions of sugar industry wastes was studied, and then the produced VFAs were extracted from the fermentation liquid. In the extraction experiments, effect of pH and solvent concentration on VFA recovery efficiency was examined. As a result, the optimum pH was determined as 2,5. At this pH value, it was observed that the recovery percentages varied between 43,3% to 97,6% depending on the type of acid and TOPO concentration in the kerosene

Eklem Hastalıkları ve Cerrahisi Use of quadriceps tendon versus hamstring tendon autograft for arthroscopic anterior cruciate ligament reconstruction: a comparative analysis of clinical results Artroskopik ön çapraz bağ onarımı için hamstring tendon otogr

Knee ligament injuries are among the most frequently encountered injuries. Anahtar sözcükler: Ön çapraz bağ onarımı; ön çapraz bağ; artroskopi; kuadriseps kası; tendon. Objectives: This study aims to evaluate midterm clinical results of the use of two autogenous graft types. Patients and methods: Between June 2005 and November 2010, clinical data of 44 patients who were operated were retrospectively analyzed. Quadriceps tendon-patellar bone autograft was used for reconstruction surgery in 23 patients (QT-PB group), while quadrupled hamstring tendon autograft was used in 21 patients (HT group). The Tegner's activity scale, Lysholm scoring system, single-leg-hop test and KT-2000 arthrometric measurements were used for data collection. Results: The mean length of follow-up was 37.6 months. Although the mean Lysholm score increased in both groups, excellent results in HT group were two-fold higher compared to QT-PB group. The mean laxity for the operated knee joint was 5.65 mm (3.5 to 8.0 mm) in QT-PB group and 3.67 mm (3.0 to 5.5 mm) in HT group. Head-to-head analysis using KT-2000 arthrometer demonstrated that 12 patients (52.1%) in QT-PB group and two patients (9.6%) in HT group had more than 3 mm of anterior laxity difference. Conclusion: Quadrupled hamstring tendon autograft is superior to central quadriceps tendon-patellar bone in arthroscopic anterior cruciate ligament reconstruction surgery