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Biomedical subjects

Akif Ince

Publications and source records attributed to Akif Ince.

3 recordsLinked to original sources

Gentamicin negatively influenced osteogenic function in vitro.

Local delivery of gentamicin is an accepted method of infection prophylaxis in the surgery of open fractures. However, the few reports of studies into the effect of locally applied gentamicin on osteoblasts used inadequate methods. In our study, we used the well-characterised C2C12 cell line with reproducible differentiation pathway into the osteoblast lineage. We investigated the viability, cell number, alkaline phosphatase activity, and the expression of osteogenic genes of C2C12 cells after exposure to gentamicin at concentrations of 12.5-800 microg/ml for 48 h. Exposure of C2C12 cells to gentamicin (12.5-800 mg/ml) for 48 h showed no significant changes in the cell number, but cell viability was decreased by one-third at the tested concentrations of 200-800 microg/ml. The alkaline phosphatase activity was significantly decreased by one-third to one-half at any tested concentration (12.5-800 microg/ml) of gentamicin. Any tested concentration of gentamicin up to 800 microg/ml for 48 h did not inhibit or decrease the osteogenic gene expression of osterix and alkaline phosphatase of the C2C12 cells. In conclusion, gentamicin at high concentrations as achieved by local application reduced cellular viability and alkaline phosphatase activity in vitro and therefore may be detrimental for bone healing and repair in vivo.

Alkaline Phosphatase↗

Component exchange in treatment of periprosthetic femoral fractures.

A retrospective analysis of 893 consecutive periprosthetic femoral fractures treated between 1976 and 2001 shows that component exchange with reimplantation of a cemented long-stem implant can be considered a reliable method of treatment with good functional results and low rates of complications (10%) and revision (7.5%). The possibility of increasing the degree of weight bearing postoperatively at an early stage or even immediate full weight bearing (25%) greatly facilitates mobilization of the mostly elderly and fragile patients. Evaluation according to the Harris Hip Score of the operation and rehabilitation results of a representative sample of 120 patients shows an average value of 85 after a mean period of 6.4 years. The patients' own rating is correspondingly high. In the authors' view, stem exchange is currently the method of choice in the majority of cases because of the rather high rate of stem loosening (77%) at the time of operation, the age-related frequently poor quality or loss of bone substance, and the possibility that the implant material may be damaged. The fact that more than one third of the fractures occurred without significant trauma underlines the importance of this injury as a possible sign of previously unrecognized osteolysis and weakening of the bone as a result of loosening of the prosthesis stem.

Adult↗

Synovial chondromatosis of the hip: a case report and clinicopathologic study.

Primary synovial chondromatosis (PSC) is a rare, usually monoarticular disorder of synovial joints. PSC is characterised by the formation of osteocartilaginous nodules in the synovial connective tissue. We report the case of a 32-year-old male with PSC of the left hip. At clinical examination abduction of the left hip was limited and rotation was painful. Ultrasound examination of the hip revealed joint effusion and multiple hyperechogenic foci due to distal acoustic shadowing. Plain radiographs showed a slight soft tissue swelling around the femoral neck and multiple round or ovoid calcifications of a uniform size. MRI revealed a large joint effusion with multiple small filling defects. Open total synovectomy was performed after dislocation of the femoral head. The diagnosis of PSC was confirmed by histological examination of the excised material. The majority of cells failed to exhibit any staining for cerb B-2 and ki-67. None of the sections showed more than 5% labelling for DNA-fragmentation proven by terminal deoxytransferase-mediated dUTD nick-end labeling (TUNEL), and all were completely non-reactive for p53 as well. In conclusion, immunohistochemical analysis suggests that in this case PSC originated from metaplasia and not from a proliferative process. After two years, the patient was free of symptoms and radiological control did not show evidence of recurrence or femoral head necrosis. Physical findings, diagnosis, histological features and management of PSC are discussed.

Adult↗