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Biomedical subjects

Gunhan Karakurum

Publications and source records attributed to Gunhan Karakurum.

10 recordsLinked to original sources
PubMed2006

Percutaneous release of the trigger thumb: is it safe, cheap and effective?

Percutaneous release of the trigger finger and trigger thumb has recently gained popularity. The aim of this study was to determine the clinical results and safety of percutaneous release in trigger thumbs. Twenty-five thumbs of 21 patients were released percutaneously in the polyclinic under local anaesthesia. Steroid injection was performed following the release procedure using the same needle. The thumb function was evaluated by a patient questionnaire, and functional thumb scores (VAS) were calculated in the preoperative and postoperative periods. At the 1 week follow-up, four patients had signs of discomfort and triggering because of incomplete release. These patients underwent open A1 pulley release. Three superficial tendon lacerations were seen during these open procedures. There were no wound complications or signs of digital nerve or artery injury in any of the patients. The preoperative mean VAS was 26.62 (18-36). This decreased to 2.57 (0-5) at the first postoperative month (P<0.001) and to 2.19 (0-3; P<0.001) at the sixth month. When the VAS scores at the first and sixth months were compared, the difference was statistically significant. We concluded that percutaneous release of trigger thumbs is a cheap, safe and effective procedure with a low rate of complications.

Adult↗
PubMed2006

Tuberculous spondylitis: abscess drainage after failure of anti-tuberculous therapy.

Spinal tuberculous abscesses usually respond to anti-tuberculous drugs. The purpose of this study was to evaluate the results of surgical drainage after failure of first-line anti-tuberculous drugs. Patients with spinal instability or vertebral collapse were excluded from the study. The authors retrospectively reviewed 11 patients. The operation was successful in all patients. Anterior/posterior spinal fusion or curettage was not performed. Drains were removed after two to three days. None of the patients required a second operation. Complications, such as spinal instability, vertebral collapse, or death did not occur.

Adult↗
PubMed2004

Tuberculous osteomyelitis of the lumbosacral region: a spinal epidural abscess with presacral extension.

INTRODUCTION: Tuberculous osteomyelitis in the lumbosacral region is an uncommon occurrence, and its treatment is not well-defined in the literature, particularly when it is associated with abscess formation. We present the outcome of a patient who had an epidural abscess with presacral extension. MATERIALS AND METHODS: A 30-year-old man had microbiologically confirmed tuberculous infection of the lumbosacral vertebrae complicated by extensive abscess formation. After a trial of chemotherapy, the infection proved refractory, and the treatment proceeded with abscess drainage through the anterior route. RESULTS: Approximately 1 year after surgery, the patient was symptom-free and did not show any significant radiologic changes. CONCLUSION: Antituberculous chemotherapy combined with anterior surgery seems to be beneficial in the setting of lumbosacral osteomyelitis complicated by epidural abscess formation with presacral extension.

Adult↗
PubMed2003

Seprafilm interposition for preventing adhesion formation after tenolysis. An experimental study on the chicken flexor tendons.

BACKGROUND: Hyaluronic acid and its derivatives have become increasingly popular for preventing adhesions in primary tendon repair. Their use in tenolysis, however, has not been established yet. The purpose of the current study was to evaluate the efficacy of Seprafilm, a combination of carboxymethylcellulose membrane and hyaluronate, in prevention of adhesion formation after tenolysis. MATERIALS AND METHODS: Thirty chickens were initially operated on their right central toes in order to constitute an experimental setting of postoperative flexor tendon adhesion. They were then randomly assigned to 3 groups at 6 weeks. Group 1 received no further procedure, group 2 underwent simple tenolysis with physiologic saline injection, and group 3 had tenolysis with Seprafilm interposition. RESULTS: Group 3 scored a significantly higher average gliding excursion value than the other groups. Histologic examination corroborated the biomechanical data. CONCLUSION: Seprafilm was effective in preventing adhesions after tenolysis.

Animals↗
PubMed2003

Multidisciplinary evaluation of occult spinal dysraphism in 47 children.

OBJECTIVE: To present the clinical (urologic, orthopedic and neurologic) and urodynamic findings of 47 children suffering from occult spinal dysraphism, together with the long-term follow-up results obtained with various treatment modalities. MATERIAL AND METHODS: Between 1997 and 2000 a total of 47 children (27 girls, 20 boys; male:female ratio 1.3) referred to the Urology and/or Pediatrics Departments with symptoms and signs of closed spina bifida were enrolled in the study program. All patients underwent routine assessment of the urinary tract, including detailed anamnesis, physical examination and radiologic evaluation (X-ray, renal bladder ultrasonography and sacral MRI). In addition to video-urodynamic evaluation of the lower urinary tract, all patients were also evaluated by the Orthopedic Department with respect to possible lower extremity deformities. RESULTS: The age range of the children was 2 months to 16 years (mean 6.9 years). At first referral, 23 children were found to have normal urinary and fecal continence after toilet training; among the other presenting symptoms and signs, 34% of patients demonstrated recurrent urinary tract infections and 38.2% had abnormal findings on urinary tract investigations. Evaluation of urodynamic parameters before and after conservative treatment demonstrated an increase in age-related bladder capacity in 34 patients and detrussor instability had been cured in 23/30 patients (p < 0.05). Overall, bladder capacity was found to be normal in 40 children following conservative management (p < 0.05). The conservative approach proved to be effective in 40 children (85.1%), and intravesical instillation therapy with oxybutynine hydrochloride was successful in one of the remaining seven children (14.2%). Bladder augmentation was performed in six children (12.7%) in whom conservative measures were ineffective. CONCLUSIONS: In the light of our findings and the literature data it is obvious that a multidisciplinary approach together with early urologic evaluation to determine the extent of neurologic involvement of the lower urinary tract is essential to ensure a successful treatment outcome and to prevent the occurrence of serious functional and structural complications. Clinical, radiologic and video-urodynamic assessments should be performed to define the neuro-urologic pathophysiology and to provide management guidelines and a baseline for future comparison.

Adolescent↗
PubMed2003

Comparative effect of intra-articular administration of hyaluronan and/or cortisone with evaluation of malondialdehyde on degenerative osteoarthritis of the rabbit's knee.

Hyaluronan and cortisone have controversial and an important role in the healing of degenerative osteoarthritis. The purpose of the research was to compare individual and combined effects of hyaluronan and cortisone on the healing of degenerative osteoarthritis and to determine the serum malondialdehyde level as a lipid peroxidation marker. A rabbit model was used in which a degenerative osteoarthritis was created in the articular cartilage by resection of anterior cruciate ligament. The rabbits divided into three groups namely were injected with hyaluronan (group A) and cortisone (group B) at days 31, 38 and 45. Cortisone at day 31 and hyaluronan at days 38 and 45 were injected to the third group (group C). We obtained blood samples from each rabbit to determine the malondialdehyde levels at days 1, 30, and 52. At day 52, 21 rabbits were sacrificed. In biopsies obtained from treated and untreated knees articular cartilage degeneration was examined by light microscopy. Histopathologically the healing rate was significantly higher in group C than the other groups. Degeneration decreased 72% in group A, 52% in group B and 88% in group C at day 22. Malondialdehyde levels were 2.056 +/- 0.37 in the control group, 1.94 +/- 0.54 in group A, 1.98 +/- 0.37 in group B and 1.55 +/- 0.41 in goup C. The malondialdehyde levels of group A and B were less than the control group (statistically insignificant, p > 0.05). But, there were statistically significant values between control group and group C (p < 0.05). The results showed that the combination of cortisone and hyaluronan is the most effective in the treatment of cartilage degeneration in the course of the ostearthritis and the malondialdehyde levels are correlated with the severity of degeneration.

Adjuvants, Immunologic↗