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Biomedical subjects

Cengiz Yilmaz

Publications and source records attributed to Cengiz Yilmaz.

16 recordsLinked to original sources
PubMed2006

Arthroscopic excision of the talar Stieda's process.

One of the causes of posterior ankle pain is posterior impingement syndrome. When the talar lateral process is long, in which case it is called Stieda's process, it may be impinged between the tibia and calcaneus. We report the case of a 19-year-old patient who complained of posterior ankle pain and was diagnosed with posterior impingement of Stieda's process. He failed to respond to conservative treatment and thus underwent arthroscopic excision. The ankle was approached through standard posterior lateral and trans-Achilles portals. A 4.5-mm diameter 30 degrees arthroscope was used. Soft tissues around the talus were cleared with the help of a motorized shaver; after this, the posterior aspect of the subtalar joint could be visualized. The Stieda's process was seen to impinge between the tibia and the calcaneus in forced plantar flexion. The talar process was removed with a burr until the impingement disappeared. The patient returned to contact sports 8 weeks after surgery. Arthroscopic excision of the lateral process of the talus can be accomplished easily and return to sports is achieved in a relatively short time.

Adult↗
PubMed2006

Cyanoacrylate adhesive provides efficient local drug delivery.

Biodegradable drug delivery systems have advanced treatment of a wide spectrum of musculoskeletal problems. However, their lack of availability and cost can restrict use. To find an easily available and inexpensive biodegradable implant, we tested a widely used tissue adhesive, n-butyl-2-cyanoacrylate, as a drug-trapping material. We tested vancomycin with commercially available absorbable gelatin-sponge pieces as the scaffold. We evaluated the in vitro and in vivo drug release profiles and in vivo inflammatory response. A mouse muscle pouch model was used for in vivo evaluations. The released vancomycin level was measured by fluorescence polarization immunoassay technique, and a leukocyte count-based grading system was used to evaluate inflammatory response. Our findings suggest the proposed implant provides effective drug release for as much as 42 days in vitro and 14 days in vivo. The presence of n-butyl-2-cyanoacrylate led to a local inflammatory response which decreased after 3 weeks in the group with less adhesive. These results showed that n-butyl-2-cyanoacrylate could efficiently trap and slowly release a drug when used in the structure of a biodegradable local drug delivery device.

Absorbable Implants↗
PubMed2005

Traumatic musculocutaneous neuropathy: a case report.

Isolated injury of the musculocutaneous nerve is a rare disorder. Reported cases are claimed to present with loss of biceps and brachialis power without a disturbing pain. The injury generally occurs after strenuous exercise and could be demonstrated by electrophysiological examination. We report a case of musculocutaneous nerve injury which occurred after a vigorous push and which presented with unusual symptoms and findings. The patient complained of episodic severe pain attacks which started from the axilla and radiated over the musculocutaneous nerve distribution including the lateral antebrachial cutaneous nerve area. He did not respond to 3 months of conservative treatment including multiple corticosteroid injections and finally required surgical release. Surgical epineurotomy resulted in immediate relief. This is the first reported case of acute musculocutaneous nerve injury presenting with unusual symptoms and findings. The operative release procedure performed was also not required in any of the other reported cases. An excellent result was obtained with epineurotomy.

Adrenal Cortex Hormones↗
PubMed2005

Total hip arthroplasty in developmental high dislocation of the hip.

In total hip arthroplasty for developmental high dislocations, placement of the implant cup in the true acetabulum and femoral-shortening osteotomy can produce satisfactory results. We performed total hip arthroplasties in 25 high dislocated hips (22 patients) between 1992 and 2000, placing all cups in the true acetabula and using noncemented components and performing a femoral-shortening osteotomy in 22 hips. The overall complication rate was 36%. At follow-up evaluation at an average of 5 years later, patients' mean scores had improved as follows: pain, from 2.3 to 5.7; function scores, from 2.3 to 4.5; mobility scores, from 2.3 to 4.4; Harris hip scores, from 37.8 to 95. We recommend both placing the cup in the true acetabulum to maximize host-bone contact with the implant and preserve as much host bone as possible and femoral-shortening osteotomy for a lower incidence of nerve injury than with aggressive soft-tissue release.

Adult↗
PubMed2005

Fixation of a talar osteochondral fracture with cyanoacrylate glue.

Cyanoacrylate glue was invented by Ardis in 1949 and was first used in surgery in 1959 by Coover. By further modifications, a nonhistotoxic form, butyl-2-cyanoacrylate, which had strong tissue binding properties even in nondry environments, was developed. Its use in the fixation of fractures and osteotomies is still under investigation and has had promising results in treatment of craniofacial and mandibular injuries. We fixed a talar osteochondral fracture with cyanoacrylate. After 3 months, magnetic resonance imaging showed an anatomically reduced and intact chondral surface. The clinical result was excellent. We believe cyanoacrylate glue may form an alternative means of fixation for osteochondral and, possibly, for chondral fractures.

Accidental Falls↗
PubMed2005

Topographic localization of the motor branch of the median nerve.

PURPOSE: To redefine the localization of the thenar branch (TB) of the median nerve in relation to the surface landmarks that are in routine use. METHODS: The study was performed in 37 hands of 34 patients who had carpal tunnel release. All of the patients were women and the mean age was 50 years (range, 35-67 y). A radiologic marking technique was used to determine the localization of the TB, the middle finger radial side line, and Kaplan's cardinal line. The TB was marked by circumscribing with a soft radiopaque yarn and the surface landmark lines were shown by taping a K-wire to the hand for each line. An image-intensifier-printed image was obtained for each case and the distances between the markers of the TB and the wires were measured. RESULTS: The TB had a mean ulnar offset of 12.6 mm (range, 4.0-19.7 mm) from the middle finger radial side line and was located 4.4 mm (range, 0-9.5 mm) proximal to the cardinal line. CONCLUSIONS: During carpal tunnel release surgery the surgeon must pay more attention to the localization of the TB of the median nerve because it was found to be 12.6 mm more ulnar than the location described in the literature.

Adult↗
PubMed2005

[The use of N-butyl-2-cyanoacrylate (Histoacryl) in primary tendon repair: a biomechanical study with sheep flexor tendons].

OBJECTIVES: In this study, the biomechanical properties of peripheral tendon repair with the use of epitendinous suture technique and N-butyl-2-cyanoacrylate (Histoacryl) (NBSA), a biodegradable glue, were compared. METHODS: Twenty-four flexor tendons were harvested from sheep hind limbs. Following transection of the tendons, 12 tendons (group 1) were repaired with modified Kessler core sutures using no 2 prolene and epitendinous running sutures with 3/0 prolene. In the other 12 tendons (group 2), NBSA was applied between the cut surfaces before placing modified Kessler core sutures. Placed on an hydrolic test machine, half of the tendons from each group were subjected to load to failure with a tensile force of 20 mm/min and the other half to cyclic loading with a tensile loading between 1-15 N at a rate of 20 cycles/min. Observation of a gap of 1 mm between the tendon ends in each test was regarded as repair failure. RESULTS: The mean load to failure was 27.3 N (range 25 to 32 N) for group 1 and 50.4 N (range 32 to 63 N) for group 2 (p=0.022). The mean number of cycles at failure was 140 (range 45 to 250) in group 1 and 350 (range 150 to 600) in group 2 (p=0.032). CONCLUSION: Our results showed that peripheral tendon repair with the use of NBSA has biomechanical advantages over repair with the epitendinous running suture technique.

Animals↗
PubMed2004

A case report of the unusual presence of hydatid disease in the pancreas and breast.

CONTEXT: Hydatid cyst disease can occur in all viscera and soft tissues although the liver and the lungs are the most commonly involved organs. Pancreatic and breast involvement with the disease are extremely rare and the presence of this disease in these organs without any other organ involvement has not been previously reported. CASE REPORT: We present herein a patient with isolated pancreatic cyst hydatid treated successfully with complete cyst excision. However, 18 months after the pancreatic surgery, hydatid disease was found in the breast and again the cyst was completely removed. No other organ involvement has been detected during a 2-year follow-up. CONCLUSIONS: Hydatid disease should be considered in the differential diagnosis of all cystic masses in all anatomic locations, especially in regions where the disease is endemic. The ideal treatment is the complete excision of the cyst without any spillage.

Adult↗
PubMed2003

[The reliability of somatosensory evoked potentials in the diagnosis of thoracic outlet syndrome].

OBJECTIVES: We assessed the role of somatosensory evoked potentials (SEP) in the diagnosis of thoracic outlet syndrome. METHODS: Somatosensory evoked potentials were recorded in provocative and decompressing positions in 30 patients (28 females, 2 males; mean age 32 years; range 20 to 52 years) with a diagnosis of thoracic outlet syndrome and in 30 healthy subjects showing a similar age and sex distribution. RESULTS: All recordings yielded normal ranges in both groups. No statistically significant differences were found between the positions in which SEPs were recorded and between the patient and control groups. CONCLUSION: Our data suggest that SEPs do not give diagnostic information in the identification of thoracic outlet syndrome.

Adult↗
PubMed2002

Comparison of nonsurgical treatment measures for de Quervain's disease of pregnancy and lactation.

de Quervain's disease of pregnancy and lactation is usually self-limited and responds well to nonsurgical treatment. We conducted a randomized prospective study on 19 wrists of 18 patients with de Quervain's disease who were either pregnant or breast-feeding. One group had a cortisone injection into the tendon sheath and the other group used thumb spica splints. All 9 patients with injections had complete pain relief with only one late recurrence. None of the patients with splints had complete pain relief; however, at the end of the lactation period, 8 had spontaneous resolution of symptoms and 1 received a cortisone injection. de Quervain's disease of pregnancy and lactation is self-limited and can be treated successfully with cortisone injection. Splinting does not provide satisfactory pain relief.

Adult↗
PubMed2001

Histopathologic assessment of healed osteochondral fractures.

PURPOSE: To assess the histopathologic features of healed tissue to define its biological and biomechanical properties after internal fixation of osteochondral fractures. Type of Study: Cohort study. METHODS: The general principle of management of detached acute osteochondral fractures is reattachment of the fragment by internal fixation, but the opinions on the quality and structure of the healed tissue that will be obtained after treatment is controversial. This study included 13 patients with acute osteochondral fractures who were treated arthroscopically and had surgical fixation providing joint-surface congruity. Patients with osteochondral fractures too small for fixation or with the overlying cartilage frayed, and patients with associated injuries were excluded from the study. The mean age of patients was 17 years (9 to 24 years). In 2 cases the fractures were localized at medial, in 7 at lateral femoral condyles, and in 4 at the patella. Internal fixation materials were K-wires for 1 case, Herbert screws for 3, and mini cancellous screws for 9 cases. The mean follow-up period was 6.3 years (3 to 13 years). On second-look arthroscopy, congruity of the joint surfaces and healed fractures was observed in all cases. Beside removal of the implant, punch biopsies were performed extending to the osteochondral junction; biopsy specimens were taken from the junction of the articular margin of the fragment and the edge of the remainder of the articular surface. RESULTS: On histologic examination of the specimens, scarce mature chondrocytes among regenerative stroma, which dyed more eosinophilic than the basophilic chondral stroma and which had a chondrocyte-like appearance, were seen. Maturation of histologic architecture to hyaline or articular cartilage was not recorded in any of these cases. CONCLUSIONS: The clinical results did not correlate with the histologic findings. Despite the protected joint surface congruence, restoration of the hyaline cartilage at the chondral junctions could not be obtained.

Journal Article↗
PubMedDate not supplied

Spinoglenoid septum: a new anatomic finding.

The spinoglenoid ligament has been implicated in compression of the suprascapular nerve in cases with isolated atrophy of the infraspinatus muscle. We dissected 32 shoulders of 16 embalmed cadavers. We could detect a spinoglenoid ligament in only 5 shoulders, and it was thin, loose, and weak. Instead of the spinoglenoid ligament, we observed a septum formed by the thickening of the fascial cover of the distal third of the supraspinatus and infraspinatus muscles. It originated from the spinoglenoid notch and extended into the posterior capsule. We named this structure the spinoglenoid septum. The suprascapular nerve passed between the bony margin of the spinoglenoid notch and the medial concave margin of the spinoglenoid septum. This septum may be a cause of dynamic compression of the suprascapular nerve.

Fascia↗