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Biomedical subjects

A Alkan

Publications and source records attributed to A Alkan.

At least 19 recordsLinked to original sources
PubMed2007

Mandibular symphyseal distraction osteogenesis: review of three techniques.

Mandibular symphyseal distraction osteogenesis (MSDO) is an alternative strategy to correct mandibular transverse deficiencies and dental crowding. Only a limited number of practitioners have reported their clinical experience and potential complications of this procedure to widen the mandible in a large case series. This study involved retrospective analysis of 40 patients who underwent mandibular symphyseal distraction osteogenesis. Three different types of distractor were used to widen the mandible: tooth-borne in 21 patients, bone-borne in 5 patients and hybrid (both bone and tooth-borne) in 14 patients. The distraction amount ranged from 7 to 11 mm (mean 7.31 mm). While 39 patients underwent successful mandibular symphyseal distraction, there was one failure. Most of the complications were experienced in bone-borne distractors, such as breakage of the distractor rod, gingival recession, secondary infection and ptosis of the chin. In the light of these findings, it is suggested that a lingually placed tooth-borne hyrax appliance is more suitable and reliable than the other distraction devices. Further larger studies are needed in order to better evaluate the effectiveness of bone-borne or hybrid devices.

Adolescent↗
PubMed2006

In vitro comparison of biomechanical characteristics of sagittal split osteotomy fixation techniques.

The aim of the present study was to compare the biomechanical stability of 10 different fixation methods used in sagittal split osteotomy. Twenty-five fresh sheep mandibles were stripped of all soft tissues and sectioned at the midline. A sagittal split osteotomy with 5mm advancement was performed on each hemimandible. The hemimandibles were randomly divided into 10 groups of 5, and then fixed with 5 different bicortical screws, 4 different miniplates with or without bicortical screws, and 1 resorbable screw configuration. All specimens were mounted on a specially designed 3-point biomechanical test model and compression loads were applied using the Lloyd LRX testing machine until 3mm displacement was reached. Load/displacement data were gathered and compared using the Mann-Whitney U-test with Bonferroni correction (P<0.01). The 3 bicortical screws in an inverted backward-L pattern provided the most biomechanical stability of the screw patterns tested. The miniplate fixed obliquely with 2 bicortical screws in the proximal segment provided the most biomechanical stability of the miniplate groups.

Animals↗
PubMed2006

Brucellar breast abscess.

Brucellosis is an endemic disease seen in many countries. It may affect different organ systems. Brucellar breast abscess is a rare entity. We report the radiological findings of breast abscess due to brucella. A 63-year-old female was investigated with mammography, ultrasonography, magnetic resonance imaging (MRI), and magnetic resonance spectroscopy (MRS). A mass measuring 25 x 20 x 15 mm was detected in the left breast on mammography and ultrasonography. The mass was homogenously hyperintense on T1- and T2-weighted MRI images. On contrast-enhanced T1-weighted images, peripheral capsular enhancement was found. MR spectroscopic analysis of the mass revealed elevated lipid and acetate peaks. The diagnosis was provided by fine needle aspiration biopsy and specimen culture. The lesion had diminished in size after 12 months' treatment with combined tetracycline and rifampicine.

Abscess↗
PubMed2006

Effects of postpartum uterine curettage on maternal well-being in severe preeclamptic patients.

PURPOSE: We assessed the effect of postpartum uterine curettage on maternal recovery time in severe preeclamptic patients. METHOD: Fifty-six pregnant women with the diagnosis of severe preeclampsia in their third trimester were enrolled in the study. Uterine curettage was performed in the early postpartum period on 31 randomly selected patients and curettage was not performed in the remaining 25 patients. Prepartum mean arterial pressure (MAP) values, quantitative platelet counts, presence of proteinuria tested semiquantatitively, lactic dehydrogenase (LDH), aspartate transferase (AST), alanine transferase (ALT), and uric acid levels were determined. FINDINGS: In the group that underwent curettage, we observed a faster drop in the mean arterial pressures monitored at two-hour intervals, especially after the sixth postpartum hour (p < 0.05). Average urine output recorded at four-hour intervals in the postpartum period was significantly higher in the curettage group compared to the non-curettage group (p < 0.05). The difference in the platelet counts of both groups was not significant at the 12th postpartum hour, however, at 24 hours, platelet counts in the curettage group were higher. In the postpartum period at the 12th and 24th hours there was no difference between the two groups with regard to LDH, AST, and ALT values (p > 0.05). RESULTS: In our study we have observed that uterine curettage performed in the postpartum period had favorable effects on blood pressure, platelet count, and urinary output and also helped in faster recovery from severe preeclampsia. We, therefore, consider that postpartum uterine curettage is useful for patients with severe preeclampsia that require faster recovery.

Adult↗
PubMed2005

Brain metabolite changes on proton magnetic resonance spectroscopy in children with poorly controlled type 1 diabetes mellitus.

The metabolite changes in the brains of children with poorly controlled type 1 diabetes mellitus (DM) were investigated by proton magnetic resonance spectroscopy (MRS). A total of 30 subjects and 14 age-matched healthy volunteers underwent single-voxel MRS (TE: 136). The duration of disease, medication, presence of hypoglycaemia episodes and the level of haemoglobin A1C (HbA1C) in the patients were noted. Voxels were placed in the pons, left basal ganglion (LBG) and left posterior parietal white matter (PPWM). N-acetylaspartate (NAA)/creatinine (Cr) and choline (Cho)/Cr ratios were calculated. The average HbA1c level was 11.9 +/- 3.4 (8.2-19.4). The average number of keto-acidosis episodes was 1.9 +/- 2.2 (0-9) and the average number of daily insulin injections was 2.8 +/- 0.97 (2-4). MRS revealed lower NAA/Cr and Cho/Cr ratios in the pons and lower NAA/Cr ratio in the PPWM of patients with DM than in control subjects. No significant correlation was observed between the number of hypoglycaemia episodes and metabolite ratios. Metabolic abnormalities have been observed by MRS in the brain of poorly controlled type 1 DM children. These metabolic changes, in particular in the pons region, include a decrease in NAA, indicating neuronal loss or functional impairment, and likely explanations for a decrease in Cho may be dynamic changes in membrane lipids and/or decreased membrane turnover.

Adolescent↗
PubMed2005

Evaluation and importance of asymptomatic bacteriuria in pregnancy.

OBJECTIVES: This study was undertaken to determine the incidence of asymptomatic bacteriuria (ASB) during pregnancy and its prevalance in the three trimesters. SUBJECTS AND METHODS: One hundred and ten pregnant women in their first trimester attending the antenatal outpatient clinic with no urinary tract complaints were included in the study. After perineal cleaning, urine samples were obtained from all patients for culture and microscopic evaluation. Approximately 1 ml urine was sampled using the mid-stream catch technique. Patients with bacterial counts over 100,000 with the mid-stream catch technique were considered to have asymptomatic bacteriuria. Patients fulfilling the criteria for bacteriuria were treated with either penicillin or cephalosporine for one week, depending on the in-vitro sensitivity test results. RESULTS: ASB rate in the study group was 8.1%. E. coli was isolated as the pathogenic organism in 77.77% of the cases with ASB. ASB was found to be more frequent in patients over age 25 and the average age of pregnant women with ASB was 29.89 +/- 5.80 (p < 0.05). Average duration of gestation in the group with ASB was 28.11 +/- 2.26 weeks. ASB rate in the group age 35 and over was 22.22% (p < 0.05). ASB was diagnosed in nine patients; one of these patients was in the first trimester, two were in the second trimester, and six in the third trimester. Clustering in the third trimester was found to be statistically significant (p < 0.05). CONCLUSION: ASB distribution in the first, second, and third trimesters was 0.9%, 1.83%, and 5.6%, respectively. There was a significant relationship between advanced maternal age and incidence of ASB. Women with no bacteriuria in their initial examination in the first trimester developed bacteriuria in the later trimesters. We, therefore, suggest that it would be prudent to screen pregnant women for bacteriuria in the second and third trimesters.

Adolescent↗
PubMed2004

A prospective randomised cross-over study of the effect of local haemostasis after third molar surgery on facial swelling: an exploratory trial.

OBJECTIVE: This study was undertaken in order to evaluate the effects of local haemostasis on the facial swelling induced in patients undergoing surgical removal of impacted mandibular third molar teeth. DESIGN: A prospective randomised cross-over study. SETTING: Department of Oral and Maxillofacial Surgery, Samsun, Turkey, 2002. MATERIALS AND METHODS: Twenty-five healthy patients who were having bilaterally symmetric, impacted third molar extraction were studied. The teeth were removed in two separate operations by two surgeons who had equal academic degrees. The patients were assigned to test and control groups by random selection. One side served as control and on the other local haemostasis was achieved by a haemostatic agent (oxidised regenerated cellulose). This was placed into the socket following gauze packing for 3 minutes (test). The operating time therefore significantly increased in the test group. Data was collected regarding the operating time, mouth opening and facial swelling. RESULTS: There were no statistically significant differences between the test and control groups for the mean values of the facial swelling and mouth opening at day 1 and 3 post-operatively (P > 0.05). Operating time was statistically longer for the test group than the control (P < 0.001). CONCLUSION: This study has shown that establishment of local haemostasis after removal of impacted mandibular third molars is not so effective in preventing facial swelling.

Adolescent↗
PubMed2004

Ultrasonographic assessment of mild and moderate idiopathic carpal tunnel syndrome.

AIM: To investigate the diagnostic value of ultrasonography in mild and moderate idiopathic carpal tunnel syndrome (CTS). MATERIALS AND METHODS: Cross-sectional areas (CSA), flattening ratios at three different levels, swelling ratio, and palmar displacement were analysed in 26 patients (14 with bilateral and 12 with unilateral disease, 40 wrists in total) for the presence and the severity of CTS. Twenty had normal nerve conduction studies (NCS) defined as "mild", and 20 of them had abnormal NCS defined as "moderate". The control group consisted of 20 healthy participants. RESULTS: All parameters were significantly different between patient and control groups. Palmar displacement, swelling ratio, CSA at all levels and distal flattening ratio had the highest significance (p < 0.0001). The criterion with the highest sensitivity was the swelling ratio > or = 1.3 (72.5%), followed by the middle CSA > 9 mm2 and the palmar displacement > 2.5 mm. All of these criteria had a higher sensitivity in diagnosing moderate cases (85-100%) than diagnosing mild cases (30-55%). There was a significant difference between normal and mild CTS groups regarding palmar displacement, distal flattening ratio, middle CSA and swelling ratio (p < 0.0001 for all) and between normal and moderate groups regarding all parameters (p < 0.01 - 0.0001) When combined middle CSA, palmar displacement and swelling ratio had an overall discriminatory accuracy of 83.8%. CONCLUSION: Additional diagnostic confirmation can be provided by ultrasonography and may be preferred as the initial step instead of electrophysiological studies. Detection of at least two of the three criteria (median nerve CSA > 9 mm2 at pisiform level, swelling ratio > or = 1.3, and palmar displacement > 2.5 mm) may be helpful for the verification of the diagnosis.

Adult↗
PubMed2004

Is there a clinical correlate to the histological and radiological evidence of inflammation in trans-ligamentous extruded and sequestered lumbar disc herniaton?

The pain of lumbar disc herniation is related to direct compression of the nerve root and to the foreign-body inflammatory response to the herniated disc material. In this study, we attempted to identify disc-related inflammation in trans-ligamentous extruded and sequestered lumbar disc herniation using gadolinium-DPTA-enhanced T1-weighted and short-time inversion recovery (STIR) magnetic resonance imaging. We assessed how these results related to each other, and to patients' clinical status, and to immunohistochemistry findings in disc specimens removed at surgery. Forty-one patients with trans-ligamentous extruded or sequestered disc herniation were investigated clinically and radiologically. Twenty-five patients who did not respond to initial medical treatment or who had progressive neurological deficits underwent discectomy. Specimens of disc material removed during surgery were studied immunohistochemically and inflammatory cell types were identified. The other 16 patients showed good response to treatment, and were given further medical therapy and monitored for a mean of 6.3 months of follow-up. All radiological diagnoses in the operated cases were confirmed at surgery. There were no significant differences among the rates of detection of inflammation by contrast MRI, STIR technique, and immunohistochemistry in the surgical treated cases. In the medically treated cases, the frequency of radiological evidence of inflammation on the initial contrast enhanced T1-weighted and STIR images was similar to the frequency observed on the most recent scans done during follow-up. The study showed that the radiological and immunohistochemical evidence of inflammation in these cases does not correspond with patients' clinical pain profiles over time. It also revealed that STIR and contrast T1W are equally reliable for detecting inflammation in trans-ligamentous extruded or sequestered lumbar disc herniation. In future, studies that focus on physical and chemical mechanisms of pain in lumbar disc herniation in larger series of conservatively and surgically treated patients may clarify the link between inflammation and radicular pain in these types of disc herniation.

Adult↗
PubMed2002

Early MRI findings in stab wound of the cervical spine: two case reports.

MR imaging was found to be the most sensitive modality for the detection of spinal cord abnormalities in the acutely injured spine. Although it is reported that traumatic pneumomyelogram indicates a base-of-skull or middle cranial fossa fracture and is almost certainly associated with intracranial subarachnoid air, early MR imaging may demonstrate subarachnoid air in penetrating trauma of the spinal cord without head injury. We report two cervical-spine stab-wound cases, one of which had subarachnoid air on early MR findings.

Adult↗
PubMed2001

AR spectral analysis of EEG signals by using maximum likelihood estimation.

In this study, EEG signals were analyzed using autoregressive (AR) method. Parameters in AR method were realized by using maximum likelihood estimation (MLE). Results were compared with fast Fourier transform (FFT) method. It is observed that AR method gives better results in the analysis of EEG signals. On the other hand, the results have also showed that AR method can also be used for some other researches and diagnosis of diseases.

Brain Diseases↗
PubMed2001

Peripheral glycerol injections in the treatment of idiopathic trigeminal neuralgia: retrospective analysis of 157 cases.

PURPOSE: This study presents the results of peripheral glycerol injections in patients with idiopathic trigeminal neuralgia. PATIENTS AND METHODS: The patients who either failed to respond to drug therapy or developed serious side effects were treated by means of glycerol injections. Medical records and questionnaires on 157 patients treated between 1983 and 1996 were evaluated. The minimum follow-up period for each patient was 4 years. RESULTS: The study population included 65 males and 92 females. The right side (112 patients, 71%) was affected more commonly than the left. The most common distribution was in the second and the third trigeminal divisions. The initial success rate was 98%. Pain recurred in 60 patients and was most frequently recorded between 25 and 36 months postinjection (28 of the 60 recurrences). These patients were successfully reinjected. At the end of 4 years, complete or almost complete pain relief was obtained in 154 patients. CONCLUSIONS: Peripheral glycerol injection is a minimally invasive and useful technique to manage trigeminal neuralgia, with a high success rate and low incidence of morbidity.

Adult↗
PubMed2001

The use of acrylic marbles for interposition arthroplasty in the treatment of temporomandibular joint ankylosis: follow-up of 47 cases.

This is a retrospective analysis of 47 patients (21 males, 26 females) with osseous or fibro-osseous temporomandibular joint ankylosis. who were referred to our clinic between 1981 and 1998. In all cases, an acrylic marble was used as the interpositional material to prevent recurrence after aggressive resection of the ankylotic mass. The mean mouth opening was 15.65 mm preoperatively and 32.48 mm postoperatively. Complications during the follow-up period, which ranged from 1 to 17 years, included reankylosis in three cases and extrusion and displacement of the acrylic marbles in two cases. The method produced good results and we believe that it is a simple alternative to other interposition arthroplasty procedures. Moreover, it has the advantages of reducing operating time and not requiring any personal skill.

Acrylic Resins↗
PubMed2001

Long-term results of Burch colposuspension.

The study included 220 women who had undergone Burch colposuspension. Group I (65 women) was studied prospectively and the mean follow-up was 1.5 years. Group II (155 women) was studied retrospectively and the mean follow-up was 4.5 years. The cure rate was 87.7% in group I and 77.4% in group II. The cure rate was significantly higher following the primary procedure than the secondary procedure. At follow-up, late complications in 220 women were: cystocele in 18; rectocele in 32; enterocele in 35; dyspareunia in 6, and groin or suprapubic pain in 15. In group I, of the 11 women with detrusor instability preoperatively, 10 were cured and in 1 detrusor instability persisted postoperatively. Two women had de novo detrusor instability. In conclusion, the cure rate of Burch colposuspension is satisfactory, although it declines a little with time. Women who had previous anti-incontinence surgery have a greater probability of recurrence. The procedure elevates the bladder neck into the abdominal cavity and stabilizes it. Surgical failure is related to inadequate elevation and stabilization of the bladder neck.

Adult↗
PubMed2001

Oral nodular fasciitis: a case report.

Nodular fasciitis of the cheek is an extremely rare lesion of the oral cavity. It should be considered in the differential diagnosis of swellings in the oral mucosa. We describe a case of nodular fasciitis and discuss the difficulties of histological and clinical diagnosis of this condition.

Adult↗
PubMed2001

Does temporary splinting before non-surgical therapy eliminate scaling and root planing-induced trauma to the mobile teeth?

The objective of this study was to determine whether temporary splinting of periodontitis-affected mobile teeth, prior to non-surgical mechanical therapy, affects treatment outcome by eliminating scaling and root planing-induced trauma to the teeth. Mandibular anterior teeth of 29 patients (15 females; 14 males; age range 30 to 48 years) with adult periodontitis were evaluated. Clinical measurements were performed at 4 sites per tooth including mesial, distal, buccal and lingual aspects at baseline, 3 and 6 months after treatment. The following clinical parameters were analyzed: plaque index (PI), gingival index (GI), bleeding on probing (BOP), pocket depth (PD), probing attachment level (PAL), gingival margin level (GML) and tooth mobility (TM). Patients were randomly divided into 3 groups: i) group 1 (n = 8) received scaling and root planing (SRP) only, ii) group 2 (n = 10) received scaling and root planing before splinting and iii) group 3 (n = 11) received scaling and root planing after splinting. Statistical analysis revealed that there were no significant differences among the groups for either bleeding on probing or probing attachment level values at any of the time intervals. At the end of the study, the greatest decrease in pocket depth was noted in group 2 (1.24+/-0.10 mm) which was thought to be the result of gingival recession (0.73+/-0.07 mm). Group 1 was the only group that showed reduction in tooth mobility at 3 months compared to baseline (1.67+/-0.55 PTV units). Group 3 displayed the least reduction in tooth mobility during the entire study period (0.26+/-0.44 PTV units). In conclusion, splinting of mobile teeth before SRP, and thereby elimination of potential SRP-induced trauma to the mobile teeth, did not show any adjunctive effect on healing when compared to splinting after SRP. Thorough debridement of root surfaces, even performed in the presence of increased mobility, resulted in improvements in clinical parameters, i.e. mechanical manipulation of mobile teeth during periodontal treatment did not affect clinical outcome negatively.

Adult↗