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Öğe Adding intrathecal morphine to unilateral spinal anesthesia results in better pain relief following knee arthroscopy(Springer Tokyo, 2008) Demiraran, Yavuz; Yücel, İstemi; Akçalı, Gülgün Elif; Değirmenci, Erdem; Sezen, Gülbin; İskender, AbdülkadirIntrathecal morphine is administered to provide profound and prolonged analgesia, and to treat acute postoperative pain. We compared the effectiveness of hyperbaric bupivacaine alone and in combination with morphine for unilateral spinal anesthesia in patients undergoing knee arthroscopy. Sixty patients were randomly allocated to two groups to receive either 1.2 ml (6 mg) of 0.5% hyperbaric bupivacaine (group B; n = 30) or 1.2 ml of 0.5% hyperbaric bupivacaine containing 0.16 mg of morphine (group BM; n = 30). Spinal block was assessed by pinprick and a modified Bromage scale and compared between the operated and nonoperated sides. Visual analog scale (VAS) values, duration of analgesia, and total analgesic requirement of patients were recorded. Patients in group BM had significantly lower VAS values on movement at 30 min and at 2, 4, 6, and 12 h postoperatively (P < 0.05 and P < 0.001, P < 0.001, P < 0.001, and P < 0.05, respectively). The total analgesic requirement in the first 24 h after surgery was significantly higher in group B (P < 0.001). Patients in group BM had a significantly longer duration of analgesia in the first 24 h postoperatively (P < 0.001). Motor blockade of the operated limb in group BM was similar to that in group B (P > 0.05), and motor blockade of the nonoperated limb in group BM was also similar to that in group B (P > 0.05). We conclude that unilateral spinal anesthesia with hyperbaric bupivacaine plus 0.16 mg morphine is preferable to hyperbaric bupivacaine alone with respect to analgesic requirement, duration of analgesia, and VAS values.Öğe Autologous blood and corticosteroid injection and extracoporeal shock wave therapy in the treatment of lateral epicondylitis(2010) Özturan, Kutay Engin; Yücel, İstemi; Çakıcı, Hüsamettin; Güven, Melih; Sungur, İbrahimLateral epicondylitis is a common disorder characterized by pain and tenderness over the lateral epicondyle. It occurs most frequently as a result of minor, unrecognized trauma during sports activities and occupation-related physical activities. The goal of this study was to evaluate the short-, medium-, and long-term effects of corticosteroid injection, autologous blood injection, and extracorporeal shock wave therapy in the treatment of lateral epicondylitis. Sixty patients (32 women, 28 men) with lateral epicondylitis were randomly divided into 3 groups: group 1 received a corticosteroid injection; group 2, an autologous blood injection, and group 3, extracorporeal shock wave therapy. Thomsen provocative testing, upper extremity functional scores, and maximal grip strength were used for evaluation. Outcomes were assessed at 4, 12, 26, and 52 weeks. Corticosteroid injection gave significantly better results for all outcome measures at 4 weeks; success rates in the 3 groups were 90%, 16.6%, and 42.1%, respectively. Autologous blood injection and extracorporeal shock wave therapy gave significantly better Thomsen provocative test results and upper extremity functional scores at 52 weeks; the success rate of corticosteroid injection was 50%, which was significantly lower than the success rates for autologous blood injection (83.3%) and extracorporeal shock wave therapy (89.9%). Corticosteroid injection provided a high success rate in the short term. However, autologous blood injection and extracorporeal shock wave therapy gave better long-term results, especially considering the high recurrence rate with corticosteroid injection. We suggest that the treatment of choice for lateral epicondylitis be autologous blood injection.Öğe Bilateral clastonbroma dorsi: A ease report [Bilateral elastofibroma dorsi](2012) Yücel, İstemi; Solak, Kazım; Arıcan, Mehmet; Özturan, Kutay EnginElastofibroma dorsi, a rare sofi tissue tumor often seen in the subscapular chest wall, is unencapsulated with indistinguishable borders, and originates from fibrous tissue and tends to grow slowly. Iis etiology is not identified fully. It is commonly seen on the inferior corner o f the scapula adherent to the chest wall between latissimus dorsi and serratiis anterior muscles. In this study a case o f bilateral elastofibroma dorsi in a female patient which was treated surgically is presented.Öğe Bilateral elastofibroma dorsi(2012) Yücel, İstemi; Solak, Kazım; Arıcan, Mehmet; Özturan, Kutay EnginElastofibroma dorsi, sıklıkla göğüs duvarının subskapular bölgesinde görülen, kapsülsüz olduğu için sınırları iyi ayırt edilemeyen, nadir görülen, fibröz dokudan kaynaklanıp yavaş büyüme eğiliminde olan yumuşak doku tümörüdür. Etyolojisi tam olarak tanımlanamamıştır. Sıklıkla skapulanın alt köşesinde latissimus dorsi ile serratus anterior kasları arasında, toraks duvarının periostuna yapışık olarak bulunur. Bu çalışmada, klinik yakınmaları olan ve cerrahi tedavi uyguladığımız bilateral elastofibroma dorsi tanısı alan bir hasta sunulmuştur.Öğe Bilateral lipomaya bağlı bilateral Tarsal tünel sendromu: olgu sunumu(2010) Cansü, C. Eren; Yücel, İstemi; Özturan, KutayTarsal tünel sendromu posterior tibial sinir ve dallarının fleksör retinaculum altında sıkışma nöropatisidir. Ayağın plantar yüzünde, parmaklarda, baldır distalinde parestezik şikayetler meydana gelir. Tarsal tünel sendromuna yol açan nedenler arasında genellikle tünel içinde veya dışında sinire bası yapan yer kaplayan lezyonlar, ayak bileği deformiteleri, sistemik hastalıklar, travma veya sinirin kendisine ait sorunlar gelmektedir. Bu çalışmada bilateral lipomaya bağlı bilateral tarsal tünel sendromu olgusu sunulmuştur.Öğe Bilateral tarsal tunnel syndrome due to bilateral lipoma: A case report [Bilateral lipomaya ba?li bilateral tarsal tünel sendromu: Olgu sunumu](2010) Cansü, C. Eren; Yücel, İstemi; Özturan, KutayTarsal tunnel syndrome is an entrapment neuropathy of posterior tibial nerve under the flexor retinaculum. Patients generally present with paresthesias on the plantar side of foot and fingers and in the distal kruris. The causes of tarsal tunnel syndrome are space occupying lesions within or around the tunnel which exert pressure to the nerve, ankle deformities, systemic illnesses, trauma or lesions of the nerve itself. In this study a case of tarsal tunnel syndrome due to bilateral lipoma which was treated surgically is presented. © 2010 Düzce Medical Journal.Öğe Biomechanical and histological effects of intra-articular hyaluronic acid on anterior cruciate ligament in rats(Elsevier Sci Ltd, 2009) Yücel, İstemi; Karaca, Erkut; Özturan, Kutay; Yıldırım, Ümran; Duman, Seçkin; Değirmenci, ErdemBackground: The histologic and biomechanical effects of intra-articular hyaluronic acid on the anterior cruciate ligaments of rats were investigated. Methods: Thirty rats were divided into three groups, i.e., the hyaluronic acid group, saline group, and control group. The hyaluronic acid and saline groups received a total of four intra-articular injections, whereas no injection was administered to the control group. The hyaluronic acid group was injected with 50 mu g (0.05 cc) hyaluronic acid, and the saline group was injected with 50 mu l (0.05 cc) of 0.9% sodium chloride solution. All of the rats were sacrificed on day 29 and the femur-anterior cruciate ligament-tibia complexes from the right knees were prepared, tested mechanically, and evaluated histologically. Findings: The mode of failure involved the midsubstance of the anterior cruciate ligament in all the specimens. There were no statistically significant differences in the stiffness and ultimate load to failure values between the three groups (P > 0.05). The energy to failure values were evaluated and there was no statistically significant difference between the groups (P = 0.064, chi-square = 3.43). In the histologic analyses, there was a significant difference in the hyalinization values between the hyaluronic acid and saline groups (P = 0.029) and between the hyaluronic acid group and control groups (P = 0.029). Interpretation: The present study shows that intra-articularly delivered hyaluronic acid has no statistically significant effect on the tensile strength of the rat anterior cruciate ligament. Although hyalinization was increased, no difference was found on the other markers for degenerative changes. We conclude that intra-articular hyaluronic acid injections can be performed safely, although the use of a precise injection technique is recommended. (C) 2009 Elsevier Ltd. All rights reserved.Öğe Chondroprotective efficiencies of intra-articular treatment of glucosamine sulfate and hyaluronic acid(2019) Karaduman, Zekeriye Okan; Yücel, İstemi; Baş, Elif Gülşah; Solak, Kazım; Midi, AhmetObjectives: The main purpose of this study was to determine a comparison between the chondroprotective efficacy of intra-articular administrations of glucosamine sulphate (GS) and hyaluronic acid (HA) in the experimental knee osteoarthritis model in rats. Materials and Methods: Forty-five rats were assigned to the following three groups: GS group (Group 1), HA group (Group 2), control group (Group 3). The knee joints of the rats were seen macroscopically and the anterior cruciate ligaments were resected. Two weeks after surgery, an intra-articular injection was applied to each group for three weeks with 1 week interval. In the osteoarthritic rat knee joints, the histopathological effects of tissue regeneration of GS and HA applications were compared with the control group. Results: The total Mankin Scale was 2.64±2.56, 3.58±3.9, 8.12±2.80 for the GS group, HA group and control group respectively. According to these results, the GS and HA were superior to the control group. The values of the total Mankin Scale, cartilage structure, cellular abnormality, matrix staining and tidemark integrity of the GS group were lower than the values of the HA group but this difference was not statistically significant.Conclusion: According to the results of this study, intra-articular administration of GS for the management of osteoarthritis may be beneficial for patients with knee osteoarthritis.Öğe Comparison of High-Dose Extracorporeal Shockwave Therapy and Intralesional Corticosteroid Injection in the Treatment of Plantar Fasciitis(Amer Podiatric Med Assoc, 2010) Yücel, İstemi; Özturan, Kutay Engin; Demiraran, Yavuz; Değirmenci, Erdem; Kaynak, GürselBackground: The aim of this study was to evaluate the results of high-dose extracorporeal shockwave therapy applied with an ankle block and corticosteroid injection in patients with plantar fasciitis whose symptoms persisted for more than 6 months. Methods: Sixty patients were assessed clinically at presentation and at 3-month follow-up with a patient-assessed 100-mm visual analog scale of pain and a physician-assessed heel tenderness index. A therapeutic response rate was evaluated. A decrease of at least 50% from baseline to 3 months in visual analog scale or heel tenderness index scores was accepted as a successful result. Results: Extracorporeal shockwave therapy and corticosteroid injection provided significant improvements in visual analog scale and heel tenderness index scores, but between the two groups there was no significant difference in the visual analog scale score change 3 months after treatment (P > .05). Twenty-seven of 33 patients (82%) in the extracorporeal shockwave therapy group and 23 of 27 (85%) in the corticosteroid injection group had a successful therapeutic response after 3 months. Conclusions: Corticosteroid injection and extracorporeal shockwave therapy are successful treatment modalities for plantar fasciitis. Corticosteroid injection treatment is cost effective compared with extracorporeal shockwave therapy, and corticosteroid injection may be the first treatment choice according to these results. (J Am Podiatr Med Assoc 100(2): 105-110, 2010)Öğe Comparison of the effects of %0.5 bupivacaine and %0.5 levobupivacaine used for epidural anesthesia on QT dispersion and haemodynamy(2010) Özdemir, Yaşar; Sezen, Gülbin Yalçın; Demiraran, Yavuz; Yazıcı, Mehmet; İskender, Abdulkadir; Yücel, İstemiObjective: The aim of this study was to compare the hemodynamic variables and QT dispersion effects of 05% bupivacaine and 0.5% levobupivacaine using epidural via. Methods: Sixty patients scheduled for operation under epidural anesthesia were included to this study. The patients were randomized into two groups; 15 mL of 0.5% bupivacaine was given to Group B patients (n=30) and 15 mL of 0.5% levobupivacaine was given to Group L patients (n=30). Systolic blood pressure, diastolic blood pressure, mean blood pressure, heart rate, saturation of peripheral oxygen, respiratory rate and side-effects were recorded during perioperative period. Postoperatively, motor blockade recovery time was assessed at 30-minute inten'als and total motor blockade time was recorded. ECG was recorded at preoperatively, at 30 minutes after first epidural anesthetic and postoperatively 24-hour and was assessed by a cardiologist. Results: Motor blockade and total blockage time were found to be longer in Group B (p<0.05). Mean blood pressure at the 180th minute was found to be decreased in Group B (p<0.05). The longest corrected QT interval and the shortest corrected QT interval were increased in Group B (p<0.05). Incidence of hypotension was higher in Group B (p<0.05). Conclusion: Levobupivacaine can be preferred to bupivacaine in patients having cardiac problem and when less motor blockade is desired.Öğe Comparison of ultrasound-, palpation-, and scintigraphy-guided steroid injections in the treatment of plantar fasciitis(Springer, 2009) Yücel, İstemi; Yazıcı, Burhan; Değirmenci, Erdem; Erdoğmuş, Beşir; Doğan, SemihThe aim of the study was to compare the efficacies of steroid injections guided by scintigraphy, ultrasonography, and palpation in plantar fasciitis. A total of 35 heels of 27 patients were randomly assigned to three steroid injection groups: palpation-guided (pg), ultrasound-guided (ug), and scintigraphy-guided (sg). Patients were evaluated for pain intensity before the injections and at the last follow-up of 25.3 months with a 100-mm visual analog scale (VAS). There were significant improvements in plantar fascia thickness, fat pad thickness, and VAS. Among the three groups of ug-pg, ug-sg, and pg-sg there were no statistically significant differences after treatment (P = 0.017, MWU = 36.5; P = 0.023, MWU = 29.5; and P = 0.006, MWU = 13, respectively). The ug, pg, and sg injections were effective in the conservative treatment of plantar fasciitis. We are of the opinion that steroid injections should be performed, preferably with palpation or ultrasonographic guidance.Öğe Complex regional pain syndrome type I: Efficacy of stellate ganglion blockade(2009) Yücel, İstemi; Demiraran, Yavuz; Özturan, Kutay; Değirmenci, ErdemBackground: This study was performed to evaluate the treatment of complex regional pain syndrome (CRPS) type I with stellate ganglion blockade. Materials and methods: We performed three blockades at weekly intervals in 22 patients with CRPS type I in one hand. The patients were divided into two groups depending on the time between symptom onset and treatment initiation. Group 1and 2 patients had short and long symptom-onset-to-treatment intervals, respectively. Pain intensity, using a visual analog score (VAS), and range of motion (ROM) for the wrist joint were assessed before and 2 weeks after treatment and were compared using nonparametric statistical analysis. Results: Treatment produced a statistically significant difference in wrist ROM for all patients (P < 0.001). VAS values showed an overall decrease from 8 ± 1 to 1 ± 1 following treatment, and there was a significant difference in VAS value between groups 1 and 2 (P < 0.05). Conclusions: We concluded that stellate ganglion blockade successfully decreased VAS and increased ROM of wrist joints in patients with CRPS type I. Further, the duration between symptom onset and therapy initiation was a major factor affecting blockade success. © 2009 Springer-Verlag.Öğe Dev Lipom: Olgu Sunumu(2017) Yücel, İstemi; Solak, Kazım; Karaduman, Zekeriya OkanLipom, insan vücudunun mezenkimal kaynaklı en sık görülen neoplazmı olarak karşımıza çıkmaktadır. Asemptomatik olmaları nedeniyle nadiren de olsa dev boyutlara ulaşabilirler. Ayırıcı tanıda birçok benign ve malign tümoral yapı ile karışabilmesine rağmen tedavide total cerrahi eksizyon yeterlidir. Görülme yaşı ortalama 5. dekaddır ve erkeklerde 5-10 kat daha sık ortaya çıkmaktadır. Bu olguda sırtta yaklaşık 18 cm boyutlarında dev kitle şikayeti ile başvuran ve eksizyon sonucu patolojik incelemede lipom olarak değerlendirilen 44 yaşında erkek hasta literatür e şliğinde sunulmuştur.Öğe Effect of insulin-like growth factor-1 and hyaluronic acid in experimentally produced osteochondral defects in rats(Medknow Publications & Media Pvt Ltd, 2016) Alemdar, Celil; Yücel, İstemi; Erbil, Barış; Erdem, Havva; Atiç, Ramazan; Özkul, EminBackground: 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.Öğe Effect of Strontium Ranelate on Fracture Healing in the Osteoporotic Rats(Wiley, 2011) Özturan, Kutay Engin; Demir, Berfu; Yücel, İstemi; Çakıcı, Hüsamettin; Yılmaz, Fahri; Haberal, AliThe aim of this study was to evaluate the effect of strontium ranelate (SrR) on fracture healing in the osteoporotic rat model. Forty female Sprague Dawley rats aged 3 months were enrolled in the study. Osteoporosis was induced by bilateral ovariectomy and subsequent daily heparin injection started 1 week after surgery and lasted for 4 weeks. Osteoporosis was confirmed by a reduction of bone mineral density (BMD). Twenty of the osteoporotic rats were assigned to the SrR group and the remaining 20 to the control group. An open right tibial midshaft transverse fracture was created and then an intramedullary fixation was performed. SrR group was treated by 450 mg/kg/day SrR per oral. Six weeks after surgical induction of fracture, all animals were sacrificed. One animal from each group died after ovariectomy. Two tibiae from the control group failed to unite. SrR-treated group showed higher mechanical strength and fracture stiffness when compared to the control group (p = 0.006, p = 0.001, respectively). SrR-treated group had mature woven bone or predominantly woven bone compared with osteoporotic control group (p = 0.038). SrR-treated group's callus maturity was significantly higher than control group (p = 0.001). SrR is associated with better fracture healing in the osteoporotic rat model. (C) 2010 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 29: 138-142, 2011Öğe Efficacy of Intramedullar Locking Plate in Mild to Moderate Hallux Valgus Deformity: Early Outcomes(2019) Değirmenci, Erdem; German, Ali Berat; Yücel, İstemiAim: Hallux valgus is a complex deformity of the first metatarsophalangeal joint characterizedby varus deformity of the first metatarsal bone, valgus deformity of the big toe, and lateraldeviation of the extensor tendons and sesamoid bones. Several surgical methods have beendescribed for correction of the deformity. Distal metatarsal osteotomy is a commonly usedprocedure in mild-to moderate hallux valgus. Different materials have been used for thefixation of osteotomy. The aim of this study was to evaluate radiological and clinical efficacyof intramedullar locking plate in hallux valgus surgery.Material and Methods: Postoperative 6th month data of patients with mild-to moderate halluxvalgus deformity who underwent distal metatarsal osteotomy using an intramedullary lockingplate between 2012 and 2014 were evaluated retrospectively. The surgical procedure wasapplied by Mitchell technique. Clinical and radiological features of the patients were analyzed.Results: Thirty-six (29 female, 7 male) patients whit a mean age of 51.00±12.96 years wereenrolled the study. Eight patients underwent bilateral surgery. There were statisticallysignificant improvement in hallux valgus angle, distal metatarsal articular angles, andAmerican Orthopaedic Foot and Ankle Society hallux valgus scores in the postoperative 6thmonth (all p values <0.001). No statistically significant difference were found between thepreoperative and postoperative 6th month inter-metatarsal angle values (p=0.058).Conclusion: The intramedullar locking plate usage in surgery of mild-to moderate halluxvalgus deformity is an effective method providing strong fixation and quick recovery that ledpatients to gain an early improvement in the daily life activities.Öğe Efficacy of Moxifloxacin Compared to Teicoplanin in the Treatment of Implant-Related Chronic Osteomyelitis in Rats(Wiley, 2010) Özturan, Kutay Engin; Yücel, İstemi; Kocoğlu, Esra; Çakıcı, Hüsamettin; Güven, MelihTreatment of implant-related chronic osteomyelitis is often difficult and usually consists of implant removal, extensive surgical debridement, and prolonged antibiotic use This study was performed to assess the efficacy of moxifloxacin compared to a glycopeptide, teicoplanin in chronic implant-related methicillin-sensitive Staphylococcus aureus (MSSA) osteomyelitis The left femoral medullar cavities of 60 Wistar male rats were contaminated with 100 mu l of 10(8) cfu/ml methicillin-sensitive S aureus (ATCC 29213) and Kirschner wires were placed into the medulla of the femur Alter 6 weeks, rats were randomly divided into five groups In two groups, the Kirschner wires were removed Experimental groups were as follows group 1 contaminated, Kirschner wire inside, received teicoplamn, group 2 contaminated, Kirschner wire removed, received teicoplanin, group 3 contaminated, Kirschner wire inside, received moxifloxacm; group 4 contaminated, Kirschner wire removed, received moxifloxacm, group 5 contaminated, Kirschner wire inside, no antibiotics (control group) Groups 1 and 2 received teicoplanin (20 mg/kg once daily), whereas groups 3 and 4 received moxifloxacin (10 mg/kg twice daily) intraperitoneally for 28 days At the end of the treatment, animals were sacrificed by inhalation anesthesia with ether and femora were retrieved and bacterial counts (cfu/g) were determined Bacterial counts in all study groups were significantly reduced relative to the control The decrease of bacterial counts was more prominent in group 4 compared to group 1 (p = 0 001) and group 2 = 0 003) Moxifloxacin therapy is an effective alternative to teicoplamn for chronic implant-related MSSA osteomyelitis (C) 2010 Orthopaedic Research Society Published by Wiley Periodicals, Inc J Orthop Res 28 1368-1372, 2010Öğe Epidural anestezide %0.5 bupivakain ve % 0.5 levobupivakain kullanımının QT dispersiyonu ve hemodinamik etkilerinin karşılaştırılması(2010) Özdemir, Yaşar; Sezen, Gülbin Yalçın; Demiraran, Yavuz; Yazıcı, Mehmet; İskender, Abdülkadir; Yücel, İstemiAmaç: Bu çalışmanın amacı, epidural yolla uygulanan %0.5 bupivakain ile %0.5 levobupivakainin; hemodinamik ve QT dispersiyonu etkilerinin değerlendirilmesidir. Yöntem: Epidural anestezi ile operasyon planlanan 60 hasta çalışmaya dahil edildi. Randomize olarak 2 gruba ayrıldı; Grup B'de (n30) 15 mL %0.5'lik bupivakain, Grup L'de (n30) 15 mL %0.5'lik levobupivakain epidural yoldan uygulandı. Peroperatif dönemde sistolik kan basıncı (SKB), diyastolik kan basıncı (DKB), ortalama kan basıncı (OKB), kalp atım hızı (KAH), periferik oksijen satürasyonu (Sp02), solunum sayısı ve yan etkiler kaydedildi. Postoperatif dönemde motor blok geri dönüş süreleri 30 dk.'lık periyotlarla değerlendirildi ve total blok süreleri kaydedildi. Preoperatif, ilk epidural anestezi uygulamasından 30 dk. sonra ve postoperatif 24. saatte EKG çekildi ve bir kardiyolog tarafından değerlendirildi. Bulgular: Motor blok gelişimi ve total blok süreleri Grup B'de yüksekti (p0.05) ve 180. dk. OKB Grup B'de azalmıştı (p0.05). En uzun düzeltilmiş QT zamanı ve en kısa düzeltilmiş QT zamanı Grup B'de uzamıştı (p0.05). Hipotansiyon görülme sıklığında ise Grup B'de artış saptandı (p0.05). Sonuç: Kardiyak problemleri olan, daha az motor blokaj istenen hastalarda levobupivakainin bupivakaine iyi bir alternatif olabileceğini düşünmekteyiz.Öğe Evaluation of the age and gender related changes in the Blumensaat line(Springer-Verlag France, 2019) Değirmenci, Erdem; Yücel, İstemi; Özturan, Kutay; Karaduman, Zekeriya Okan; Karaca, ErkutPurpose: The position of the patella according to the femur is very important in the evaluation of patella-femoral joint disorders. In 1938, Blumensaat (BS) described the BS line to evaluate the patella femoral congruence. This method is still valuable in clinical use. There is a limited number of studies demonstrating the accuracy of BS method as well as the affected variables. The aim of this study was to evaluate o the age and gender-related changes in the BS line. Methods: Standard lateral knee radiography was performed to all patients at 30° flexion. The relationship between the BS line and the patella inferior pole was examined and the variability of the measurements according to gender and age groups was investigated by statistical methods. Results: Ninety-five patients (43 men and 52 women) were enrolled in the study. Mean age of the patients were 43.7 ± 14.1 years (48.2 ± 11.7, 37.9 ± 14.8 in women and men, respectively). The BS line was passed through the inferior pole of the patella in only 2 (2.1%) of 95 patients. There was a statistically significant difference (p = 0.041) between BS measurement and gender which was found to be higher in females than males. There was no statistically significant correlation with this distance between the age groups (r = ? 0.216, p = 0.427). Conclusion: In our study, it was concluded that BS measurement differs according to gender but did not have any difference between different age groups. © 2019, Springer-Verlag France SAS, part of Springer Nature.Öğe Floating Forearm: Perilunar and Elbow Dislocation Without a Fracture(Coll Physicians & Surgeons Pakistan, 2010) Kandiş, Hayati; Yücel, İstemi; Sarıtaş, Ayhan; Güneş, HarunTraumatic perilunar and elbow dislocation is rarely seen together. There are only a few reported cases in the literature. Limitation of joint movement, deformity and pain are generally the presenting symptoms. A case of perilunar and elbow dislocation without fracture admitted to the emergency department due to a traffic accident and treated with closed reduction after sedoanalgesia and benefited from closed reduction
