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Öğe Analysis of the coracoid morphology with multiplanar 2D CT and its effects on the graft size in the Latarjet procedure(Sage Publications Ltd, 2020) Sari, Abdulkadir; Sasani, Hadi; Cetin, Mehmet Umit; Gunaydin, Burak; Kilinc, Seyran; Yildirim, Ilker; Dincel, Yasar MahsutPurpose: In this study, we aimed to reveal the individual differences regarding the size of the coracoid and their effects on the classical and modified Latarjet procedures. Methods: Computed tomography images of 120 patients (mean age: 41.18 +/- 12.01 years) without shoulder complaints or shoulder instability were evaluated retrospectively. The glenoid width, the surgical graft length, and the coracoid total length, width, and thickness were measured using the multiplanar reconstruction method on the Sectra Picture Archiving and Communications System (PACS) system. Age, gender, side, the dominant hand, and the height of the patients were recorded and the correlations between them were investigated. On the created hypothetical model, the current size of the coracoid was evaluated to determine what size of glenoid defects it could repair by employing the classical and the modified Latarjet techniques. Results: There was no significant difference between the right-hand-dominant group and the left-hand-dominant group in terms of coracoid measurement results (p > 0.05). Again, there was no statistically significant difference between the right and the left side regarding the coracoid size (p > 0.05). A positive correlation could be detected only between age and the coracoid width and thickness (p < 0.05). A positive correlation was also found between the glenoid width and the coracoid width and thickness in both shoulders (p < 0.001). Coracoid thickness could fill in the defects that amounted to 40% of the glenoid width, while the coracoid width could fill in for the defects that were 50% of the glenoid width in both genders. Conclusion: Our study showed that hand dominance and side were not effective on the coracoid dimensions. In addition, it has been shown that the coracoid dimensions did not have a significant effect in the choice of Latarjet technique in terms of defect repair and that repair rates of up to 40% could be achieved in glenoid defects with both techniques.Öğe Comparison of caspase-8, granzyme B and cytochrome C apoptosis biomarker levels in orthopedic trauma patients(Turkish Assoc Trauma Emergency Surgery, 2020) Pazarci, Ozhan; Aydin, Huseyin; Kilinc, SeyranBACKGROUND: The primary objective of this study was to investigate whether or not apoptosis is induced following bone fracture, and if so, to investigate whether the extrinsic or intrinsic pathway of cell death is stimulated. METHODS: A total of 30 patients who presented at our clinic and were diagnosed with bone fracture following trauma were included in the study group. A control group was formed of 37 age and gender-matched volunteers. On the day after the fracture, blood samples taken from the patients were examined for cytochrome C, granzyme B and caspase-8 with the ELISA method. RESULTS: A total of 67 individuals were evaluated (fracture group: 30, control group: 37) in this study. Caspase-8 was found to be statistically significantly high in the patient group (0.37 +/- 0.06 ng/mL, p=0.002). No significant difference was determined between the groups in respect to cytochrome C values (p=0. 173). The granzyme B values were determined to be significantly high in the patient group (52.56 +/- 8.51 pg/mL, p=0.007). CONCLUSION: These results obtained from patients with a long bone fracture demonstrated that serum caspase-8 and granzyme B levels were higher in patients than in the control group, thereby showing activation of the extrinsic pathway. However, no significant difference was determined between the groups concerning serum cytochrome C levels. This study may guide future studies designed for better understanding of the molecular pathways that govern the events during a fracture, which will be important for the future advancement of fracture treatment.Öğe COMPARISON OF CHANGES IN THE ANKLE AFTER UNICONDYLAR KNEE ARTHROPLASTY AND HIGH TIBIAL OSTEOTOMY(Atha Comunicacao & Editora, 2022) Sari, Abdulkadir; Dincel, Yasar Mahsut; Cetin, Mehmet Umit; Kilinc, Seyran; Gunaydin, Burak; Ozdemir, MikailObjectives: We aimed to compare the changes in the coronal alignment of the ankle joints and their clinical effects after high tibial osteotomy (HTO) and unicondylar knee arthroplasty (UKA). Methods: 50 HTO and 54 UKA patients who were operated on for medial knee osteoarthritis between 2013 and 2018 were retrospectively evaluated. The hip-knee-ankle angle (HKA), the medial proximal tibial angle (MPTA), the tibial plafond inclination (TPI) and the talar inclination (TI) angles were measured before and after operation. Visual analog scale (VAS), short form 36 (SF-36), and ankle-hindfoot scale (AHS) scores of both groups were evaluated and recorded. Results: Angular changes in the HKA, MPTA, TPI and TI values showed significantly greater values in the HTO group (p<0.001). When asymptomatic and symptomatic cases were compared, it was found that changes in the HKA, TPI and TI values were significantly greater in symptomatic cases in the HTO group (p<0.05). A significant decline was observed in the VAS, SF-36 and AHS scores in the HTO group in the postoperative period (p<0.05). In intergroup evaluations, a significant decline was detected in pain and functional scores of the HTO group when compared to the UKA group (p<0.05). Conclusion: Unicondylar knee arthroplasty can be a good alternative to HTO in selected cases for postoperative ankle complaints.Level of Evidence III; Therapeutic Studies Investigating the Results of Treatment.Öğe Delirium Awareness and Treatment Approach in Orthopedics Clinic(Aves, 2020) Pazarci, Ozhan; Kilinc, Seyran; Bekmez, Fatma; Cigdem, Burhanettin; Oztemur, ZekeriyaBACKGROUND/AIMS Orthopedic clinics are among the leading clinics in hospitals that request consultation for patients with delirium. However, delirium is often missed by nurses and physicians, resulting in an incorrect diagnosis. This study aimed to identify patients with delirium in the orthopedic clinics and describe our approach for these patients. MATERIAL and METHODS After forming a strategy for the diagnosis, treatment, and follow-up of patients with delirium, prospective follow-up was performed for patients hospitalized in the orthopedic ward. High-risk patients were screened using the Nursing Delirium Screening Scale, and patients diagnosed with delirium were evaluated using a prepared form. This approach was used to determine the risk factors for delirium, ensure patient safely, and treat the symptoms of delirium. RESULTS Total 988 patients were evaluated, and 34 (2.44%) were diagnosed with delirium. The mean age of the patients was 66.17 +/- 22.68 years. The mean duration of delirium was 2.88 +/- 0.84 days. An age group-based comparison showed that the duration of delirium in older patients was significantly longer than that in younger patients (3.08 +/- 0.9 vs. 2.45 +/- 0.52 d, p=0.042). Further, delirium duration was more among men than among women (3.0 vs. 2.2 d, p=0.031). CONCLUSION Rapid identification of delirium and determination of the etiological cause allows timely and appropriate correction of the condition Identification of delirium by the medical team and the use of a systemic approach are important in treatment. The duration of delirium is longer in men and the elderly; further, most delirious patients have more than one risk factor for delirium.Öğe Does mammalian target of rapamycin or sestrin 1 protein signaling have a role in bone fracture healing?(Tubitak Scientific & Technological Research Council Turkey, 2019) Pazarci, Ozhan; Dogan, Halef Okan; Kilinc, Seyran; Camurcu, Ismet YalkinBackground/aim: Fracture healing is a complex physiological process that involves a well-orchestrated series of biological events. The mammalian target of rapamycin (mTOR) and sestrin 1 (SESN 1) play a central role in cell metabolism, proliferation, and survival. The aim of our study is to present serum mTOR and SESN 1 levels by comparing patients with or without bone fractures. It is also a guide for further research on the roles of these proteins in fracture healing. Materials and methods: A total of 34 patients (10 females, 24 males) with bone fractures and 32 controls (10 females, 22 males) participated in this study. After collecting serum venous blood samples, the quantitative sandwich ELISA technique was used for the determination of serum mTOR and SESN 1 levels. Results: The mean serum mTOR level was significantly higher in the fracture group compared to the control group (P = 0.001). However, SESN 1 levels did not significantly differ between groups (p = 0.913). Conclusion: We found that serum mTOR levels increased on the first day after fracture compared to the control group. However, we obtained no significant difference between groups in terms of SESN 1 levels. This study may guide further clinical studies investigating the potential role of mTOR signaling in the bone healing process.Öğe Does the Addition of Poly(glycolide-co-lactide) to Teicoplanin-Containing Poly(methyl methacrylate) Beads Change the Elution Characteristics?(Springer Heidelberg, 2020) Kilinc, Seyran; Pazarci, Ozhan; Cakmak, Nese Keklikcioglu; Tas, AycaBackground The objective of our study was to measure and compare the elution characteristics of teicoplanin from poly(methyl methacrylate) PMMA beads with those of poly(glycolide-co-lactide) PGLA-added beads. Methods The study included two groups of PMMA + teicoplanin beads. PMMA was added to teicoplanin in Group 1 and PMMA + PGLA was added to teicoplanin in Group 2. A total of 16 beads of 1 cm(3) were created for each group. Samples were added individually to tubes containing 3 ml of phosphate-buffered saline (PBS). Antibiotic elution was measured by measuring absorbance values of 1-ml samples taken at regular intervals using a UV-Vis spectrophotometer and cumulative percentages of drug release were calculated. In addition, the spectra of teicoplanin were identified using a FTIR spectrophotometer in a wavelength range of 400-4000 cm(-1). Results Drug elution in the PBS medium was measured and compared for Groups 1 and 2. The cumulative percentage of drug release from the PGLA-added beads (Group 2) was significantly higher (p = 0.01). The molecular structure of teicoplanin was also confirmed using FTIR. Conclusion The in vitro results showed that the addition of biodegradable PGLA into bone cement functions as a water-soluble porogen which allows for significant increases in the elution of teicoplanin from cement. This increase in elution suggests that the PGLA would allow for further fluid contact and exchange with the previously entrapped drug. These results may have important clinical applications.Öğe Effect of Calcination on Microstructure Development and Properties of Hydroxyapatite Powders Extracted from Human and Bovine Bones(INDIAN CERAMIC SOC, 2019) Oksuz, Kerim Emre; Kilinc, Seyran; Ozer, AliThis study represents a comprehensive discussion of hydroxyapatite (HAp) formation from human and bovine bones. The phase formation and surface morphologies of prepared HAp powders were determined by XRD and SEM analyses, respectively. TEM was employed to understand the internal compositions with high magnifications and particle size. FT-IR characterizations provided information about molecular interactions and structures. In order to understand the effect of heat treatment at different temperatures and ultimately to get the desired morphology/particle size of the HAp powders derived from human and bovine, the powder samples were calcined at 700 degrees to 1100 degrees C with an interval of 100 degrees C. At 700 degrees C, the organic components were removed and finally, a carbonate apatite was obtained. The degree of crystallinity and crystallite size were noticed to increase progressively with calcination temperature. The overall results showed that the calcination temperature highly influenced the properties of HAp powders derived from human and bovine bone samples. As expected, higher temperatures led to more pure form of HAp with higher degree of crystallinity, larger crystallite size, and a less porous structure. Besides, the human bone structure, in contrary to the bovine bone, did not show temperature sensitivity by means of crystallite size increase.Öğe Effect on mortality of treatment method and surgery time for hip fracture patients aged over 65 years(Turkish Assoc Trauma Emergency Surgery, 2020) Ekici, Cihat; Pazarci, Ozhan; Kilinc, Seyran; Oztemur, Zekeriya; Ozturk, Hayati; Tezeren, Gunduz; Bulut, OkayBACKGROUND: This study aimed to evaluate the effects on mortality of implant selection used and time to surgery in patients aged over 65 years operated for hip fractures. METHODS: A total of 301 patients aged over 65 years were investigated in this study. Patients were divided into three groups as follows: Group 1 cemented hemiarthroplasty (CH), Group 2 cementless hemiarthroplasty (CLH), and Group 3 proximal femoral nail (PFN). Time of surgery, fracture and demographic information were retrospectively recorded. RESULTS: After removing 59 patients with missing information, this study included 242 patients. Mean age of patients was 80.5 years. When patient groups were examined according to treatment method, Group 1 (n=146) comprised 60.3%, Group 2 (n=54) comprised 22.3% and Group 3 (n=42) comprised 17.4% of the study group. There was no significant difference in survival between the patients operated in the first 48 hours and the patients operated later (p=0.834). There was an effect on the survival of treatment implant selection (p=0.016). Patients with CH were observed to survive longer than patients with CLH and PFN. CONCLUSION: Operation in the first 48 hours was not observed to affect mortality. Additionally, while sex and age were found to be effective on mortality, implant selection was also concluded to affect mortality.Öğe Evaluation of Serum Glucagon-Like Peptide 1 and Vitamin D Levels in Elderly Patients with Bone Fractures(Karger, 2020) Pazarci, Ozhan; Dogan, Halef Okan; Kilinc, Seyran; Camurcu, YalkinObjectives: To evaluate the correlation between levels of serum vitamin D and glucagon-like peptide-1 (GLP-1) in elderly patients with bone fractures. Materials and Methods: This study included 56 patients and 31 control subjects. The patients included were those aged >= 65 years who were admitted to our hospital with a diagnosis of bone fracture. The control group comprised age-matched, healthy individuals. Levels of serum vitamin D and GLP-1 were measured and compared between the 2 groups. Results: Significant differences were noted between the groups in terms of serum levels of vitamin D (p < 0.001) and serum levels of GLP-1 (p < 0.001). A positive correlation was observed between serum levels of vitamin D and GLP-1. Conclusion: Serum levels of GLP-1 were found to be significantly lower in elderly patients with bone fracture compared to healthy adults. In addition, a significant correlation was found between decreased vitamin D and GLP-1 levels. These results may therefore demonstrate the protective effects of GLP-1 on bone structure and metabolism, similar to those of vitamin D.Öğe Evaluation of the Effect of Gabapentin on Tendon Healing in an Experimental Rat Model(Aves, 2020) Kilinc, Seyran; Egilmez, Hatice Reyhan; Pazarci, Ozhan; Altunisik, Muhammed YasirBACKGROUND/AIMS To investigate the effect of gabapentin used in postoperative pain prophylaxis on tendon healing. MATERIAL and METHODS A total of 32 Wistar albino rats were randomly divided into 4 groups. Groups A and C were administered gabapentin by oral gavage, while Groups B and D were defined as the control groups. In all the rats, a transverse cut was made on the left Achilles tendon, approximately 0.5 cm proximal to the attachment point of the bone, then it was sutured using the Kessler method. Rats in Groups A and B were sacrificed on day 15 and those in Groups C and D on day 45. Differences between the groups were evaluated biomechanically using the tensile test, and immunohistochemically by examinations of collagen type 1 (COL1A), Proliferating Cell Nuclear Antigen (PCNA), and Transforming Growth Factor beta 1 (TGF-beta 1). RESULTS In the biomechanical evaluations, no significant difference was found between the study and control groups on days 15 and 45 in terms of the tensile test results (day 15, p=0.908; day 45, p=0.798). In the semi-quantitative comparisons of positive cell involvement in the immunohistochemical data evaluations, no statistically significant difference was also found. [TGF-beta 1, p(15)=0.328, p(45)=0.195; PCNA p(15)=0.645]. PCNA-positive cells were seen at a high rate in the first 15 days in both groups and the involvement of these cells was found to be similar on day 45. CONCLUSION In the immunohistochemical and biomechanical evaluations, gabapentin was not found to have any negative effect on tendon healing. It can be concluded that gabapentin can be used in cases with appropriate indications after tendon surgery. Nevertheless, there is a need for further studies in this area to investigate the mechanism of gabapentin's effect on the tendon.Öğe Evaluation of treatment results for proximal fibula and surrounding tumoral lesions(Bayrakol Medical Publisher, 2020) Pazarci, Ozhan; Kilinc, Seyran; Tuncer, KutsiAim: The proximal fibula has a specific anatomy and tumoral lesions are rarely observed in this region. The aim of this study was to present the diagnosis, treatment methods, and postoperative outcomes for tumoral lesions observed in and around the proximal fibula together. Materials and Methods: Data of 22 patients with tumor in or around the proximal fibula were retrospectively investigated. The preop, and postop findings, treatment administered and pathologic diagnosis data of the patients were collected. The postop Toronto Extremity Salvage Score (TESS), Musculoskeletal Tumor Society score (MSTS), Physical score (PCS-12), and Mental score (MCS-12) data for patients were recorded and analyzed with SPSS (ver. 23). Results: The mean age of patients was 28.45 years (min: 11, max: 60). The mean follow-up duration was 16.81 +/- 7.52 months. Of patients, 13 were male (59.1%) and 9 were female (40.9%). Lesions were present on the right side in 13 patients (59.1%) and on the left side in 9 patients (40.1%). Patients most commonly attended with complaints of pain and peroneal compression. Osteochondroma and giant cell tumor were the most commonly encountered pathological diagnoses. There was no significant difference observed between the form of the treatment and postop follow-up scores of the patients. Discussion: The strongest aspect of our study is that it contributes a 22-case series to the limited literature in this field. Additionally, the preop clinical presentation, postop follow-up outcomes and surgical treatment forms of the patients are presented together. In this case series including rarely-observed cases, eight different pathologic diagnoses are presented. Conclusion: Knee stability should definitely be evaluated during proximal fibula surgeries. The most commonly observed pathologic diagnoses in this region are presented in our study. When considering benign tumors in this region, the diagnoses in our series should be remembered. Additionally, it should not be forgotten that patients may apply with peroneal compression findings.Öğe Examining the Relationship Between Preventable Psychiatric Problems and Child Extremity Fractures(Pera Yayincilik Hizmetleri, 2022) Sari, Seda Aybuke; Pazarci, Ozhan; Kilinc, Seyran; Cicek, Ayla UzunObjective: Extremity fractures (EF) are among the most common causes of admission to hospitals in children. We aimed to evaluate children treated for EFs by comparing them with the control group from a psychiatric perspective. Method: Thirty-six children aged between 3 and 17 years who administered to the Orthopedics and Traumatology clinic due to EF were included in the study. 36 children of similar age and gender with the study group were included as the control group. A child psychiatrist evaluated all children included in the study. A psychiatric diagnosis interview was conducted. The parents filled out the Conner's Parent Rating Scale-Revised Short Form (CPRS-R:S). Results: Of the cases in the patient group, 66.7% were male. The ratio of rural residents in the patient group was higher compared to the control group. The most common fracture location was lower extremity (55.6%). The most common cause of the fracture was falling (52.8%). In the patient group, the ratio of the children who had previously experienced fracture was 36.1%. Psychopathology was detected to be at a higher level in the patient group. The most common was Attention Deficiency and Hyperactivity Disorder (ADHD). Children in the patient group scored higher on the CPRS-R:S than the control group. Conclusion: Children with EF exhibited more impulsive and hyperactive behaviours than controls and had more psychopathology. For this reason, it is essential to evaluate children who apply due to fracture in terms of psychopathology.Öğe Hemiarthroplasty with cementless intramedullary stem versus proximal femoral nail in the treatment of unstable intertrochanteric fractures in elderly patients(Acta Medica Belgica, 2021) Kilinc, Seyran; Pazarci, OzhanSeveral methods are used in the treatment of unstable intertrochanteric hip fractures in elderly patients with high mortality and morbidity. The aim of this study was to compare and present the clinical and radiological results of two alternative methods : cementless distal intramedullary stems and proximal femoral nail (PFN). One hundred and seventeen patients who were over 70 years of age and operated on in our clinic for unstable intertrochanteric fractures between January 2014 and January 2018 were included in this study. In addition to the sociodemographics, patients' Singh index, type of fracture, time to surgery, duration of surgery, blood need, blood loss, length of hospital stay, concomitant diseases, complications, ASA scores, time to mortality and mobilization statuses were recorded. The data collected was evaluated using the SPSS v.23 software. The duration of surgery, intraoperative bleeding amount, postoperative drainage and blood requirement amounts, and the use of fluoroscopy in HA were significantly higher than PFN (p<0.001). There was no significant difference between the groups in terms of one-year mortality rate. Similarly, no significant difference was detected between the groups in terms of the latest mobilization status of the patients. Patients who underwent HA were found to be associated with high bleeding amount and long duration of surgery. The groups exhibited similar results in terms of one-year mortality rate and functional results. Neither type of the implants is superior to the other, therefore both can be effectively used in the treatment of unstable hip fractures in the elderly. On the other hand, the femoral stem design in the study is a alternative treatment method for uIT fractures but the surgery is technically challenging and should be undertaken by an experienced arthroplasty surgeon.Öğe If the Airway Opens with Finger During Epileptics Attack: A Case Report(DERMAN MEDICAL PUBL, 2015) Kilinc, Seyran; Ortucu, Abdulrahman; Bulut, Okay; Tezeren, Gunduz; Oztemur, ZekeriyaThe human bites generally have been came across after the situation as fighting, aggression, murder, sports competitions and child abuse. Hands and wrists are the most common areas that human bites have seen. Our case was seen first time when 65 aged woman treating for diabetes mellitus in our endocrinology service consultated us with a neglected open wound that occurred after she put on her hands second finger's proximal phalanx to her relative's mouth to keep open duration of epileptic attack before 45 days. In this case we try to explain that the wrong intervention in epileptic attack and delaying treatment of infections of human bites can be resulted with limb missing.Öğe Investigating the risk factors that affect mortality after cemented hemiarthroplasty in advanced age patients(Elsevier, 2020) Kilinc, Seyran; Pazarci, OzhanBackground & aims: The number of hip fracture surgeries exhibit an increasing trend due to the aging of the world's population and it is expected to become a serious public health problem in the future. This study aimed to investigate the relationship between mortality and morbidity in patients aged 65 years or older who underwent partial hip prosthesis due to hip fracture. Methods: Four-hundred and forty-three patients aged 65 and above who underwent partial hip prosthesis for fractured hips between 2007 and 2014 were retrospectively investigated. The age before surgery, gender, type of fracture, additional diseases, ASA scores of the patients and time to mortality were investigated in addition to the factors that affect mortality. Results: Of the 443 patients in the study, 167 were males and 276 were females, with an average age of 80.5 +/- 7.2 and 81.1 +/- 7.0 years, respectively. One hundred and sixty-two (36.57%) of these patients died within the first year. When the patients were investigated according to age groups, there was a significant relationship between mortality after surgery and patients aged 80 years and above. No statistically significant relationship was found between the time to surgery and mortality. When compared in terms of ASA scores, it was concluded mortality in ASA 3 and 4 groups was significantly higher than ASA 1 and 2 groups (p < 0.001). When hospital stay and one-year mortality rates were compared, it was seen that the length of hospital stay of the patients who died in the first year was significantly higher. Conclusions: In patients who underwent partial hip replacement after hip fracture, there was a significant relationship between mortality, long hospital stay, patients with an ASA score of 3-4, and patients aged 80 years and above, whereas no relationship was detected with time to surgery.Öğe Investigation of the Antibiofilm Effects of Mentha longifolia Essential Oil on Titanium and Stainless Steel Orthopedic Implant Surfaces(AVES, 2019) Pazarci, Ozhan; Tutar, Ugur; Kilinc, SeyranObjective: This study aimed to determine the antibiofilm activity of Mentha longifolia essential oil (EO) against biofilms forming on in-vitro implant surfaces. Materials and Methods: Enterococcus faecalis, Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Candida albicans biofilms were used. Stainless steel and titanium samples were grouped as control, water diluted, no EO addition, and reducing amounts of EO doses. The six microorganisms included in the study were investigated to examine if there were differences between the doses on the implant surfaces. The eradication effect of the EO in samples investigated with electron microscope was classified as 0: none, 1: mild, 2: moderate, and 3: severe. The chemical composition of the EO was determined with gas chromatography. Results: In terms of biofilm formation, no difference was observed between implant surfaces. While S. aureus and C. albicans were observed to be the most susceptible, P. aeruginosa was identified as the most resistant. According to gas chromatography, M. longifolia EO comprised 61.40% carvacrol and 0.28% thymol. Conclusion: In vitro, M. longifolia EO was shown to be effective against gram negative/positive and fungal biofilms forming on the surface of stainless steel and titanium implants.Öğe Isolated Gluteus Maximus Muscle Hydatid Cyst: A Case Report(DERMAN MEDICAL PUBL, 2015) Kilinc, Seyran; Golge, Umut Hatay; Bulut, Okay; Tezeren, Gunduz; Ozturk, HayatiHydatid cyst disease is a parasitic infection caused by Echinococcus granulosus. Hydatid cyst disease is endemic in our country. This disease is most commonly detected in the liver and lung. Primary soft tissue involvement is very rare, causing a diagnostic challenge. Turkey is an endemic area for hydatid cyst disease and we should bear this disease in mind as a differential diagnosis in all cystic lesions. In this study, we mentioned a hydatid cyst case in gluteus maximus muscle without any primary lesion.Öğe Neutrophil to Lymphocyte Ratio May Be a Diagnostic Marker for Prosthetic Joint Infection(DERMAN MEDICAL PUBL, 2016) Golge, Umut Hatay; Kaymaz, Burak; Pazarci, Ozhan; Kilinc, Seyran; Oztemur, Zekeriya; Bulut, OkayAim: Total knee arthroplasty (TKA) is an effective and successful procedure but the outcome may occasionally be compromised by complications such as periprosthetic joint infection (PJI). Blood neutrophil to lymphocyte ratio (NLR) is a simple marker of subclinical inflammation that can be easily obtained from the differential White Blood Cell count. This study aims to to analyze the predictive ability of NLR for the diagnosis of PJI. Material and Method: Patients who were diagnosed as grade 4 gonartrosis and operated for total knee arthroplasty between years 2007-2014 were evaluated. Thirty patients with PJI were included in the study as Group I and hematological tests including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), white blood cell count (WBC) and neutrophil to lymphocyte ratio (NLR) of the patients were evaluated retrospectively. Preoperative and postoperative 6th month NLR values of the patients were compared. Also 103 age matched patients operated for total knee arthroplasty with no sign of infection were included in the study as controls (Group II). Patients in Group I and Group II were also compared in terms of NLR. Results: Thirty patients (17 female, 13 male) were present in Group I (patients with PJI and treated with two staged revision surgery) and 103 patients (94 female, 9 male) were present in Group II (patients operated for total knee arthroplasty and had no sign of infection during the follow up period). NLR has been found to decrease from 3.2+/-0.7 to 2.2+/-0.5 when compared between the preoperative and postoperative 6th month period (p=< 0,001). NLR has been found to be 2.1+/-0.7 in Group II and 3.2+/-0.7 in Group I at preoperative period. (p=< 0,001). The value of 2.45 was found to be cut-off point for infection. Discussion: NLR can be used as marker for PJI together with the other markers as ESR and CRP to increase the accuracy of the diagnosis.Öğe Research into biocompatibility and cytotoxicity of daptomycin, gentamicin, vancomycin and teicoplanin antibiotics at common doses added to bone cement(Turkish Joint Diseases Foundation, 2020) Kilinc, Seyran; Tunc, Tutku; Pazarci, Ozhan; Sumer, ZeynepObjectives: This study aims to investigate the biocompatibility and cytotoxicity of daptomycin, gentamicin, vancomycin and teicoplanin at commonly-used dose intervals added to polymethylmethacrylate (PMMA) in vitro . Materials and methods: This prospective study was conducted between February 2016 and June 2016. Antibiotics were added to PMMA at doses frequently used in clinical practice. The antibiotic doses added were teicoplanin (2 g, 3 g, 4 g), gentamicin (0.5 g, 0.75 g, 1 g), daptomycin (0.5 g.) and vancomycin (2 g, 3 g, 4 g). Standard cement balls (10 mm) were created. Activated L929 mouse fibroblast cell culture was used for incubation. Agar diffusion, Cell Proliferation Kit II (XTT) test and electron microscope investigations were performed to examine biocompatibility and cytotoxicity. Results: In the cytotoxicity test, teicoplanin at 4 g and daptomycin at 0.5 g doses were observed to cause reductions in viability percentages. The same doses caused 20% and 20-40% cell lysis indices during the agar diffusion test. On electron microscope images, cytotoxic effects in fibroblast cells and involvement with the surface of cement balls were observed. Conclusion: Gentamicin, vancomycin and teicoplanin were observed to be non-toxic and biocompatible at commonly-used dose intervals. Teicoplanin at 4 g and daptomycin at 0.5 g doses were identified to be cytotoxic and not biocompatible. When selecting antibiotics to be added to bone cement, care should be taken that the antibiotic is non-toxic and biocompatible.Öğe A serious case of anthrax associated with compartment syndrome(TAYLOR & FRANCIS LTD, 2017) Kilinc, Seyran; Keskinbicki, Mehmet Vakif; Sengul, Murat; Nergiz, Semra; Ortucu, Abdurrahman; Bulut, OkayCompartment syndrome linked to skin anthrax is a rare complication that may develop and it should be noted that the disease may progress in spite of medical drug treatment. Our case was a farmer who was exposed after slaughtering a dead animal, a time delay for treatment hided this history and then developed compartment syndrome. In anthrax cases with delayed treatment and aggressive progression, circulation in the extremities should be carefully noted. We believe that the cases with compartment syndrome progressing in spite of medical drug treatment may be assessed for fasciotomy as a treatment approach.
