Biomedical subjects

Bülent Erol

Publications and source records attributed to Bülent Erol.

26 records · Page 2Linked to original sources

PubMed2004

[Transient osteoporosis of the hip in pregnancy: a report of three cases].

Transient osteoporosis of the hip is a rare disease of unknown etiology. It is usually seen in middle-aged men and women in the third trimester of pregnancy and is associated with hip pain. It typically runs a benign course with eventual resolution of symptoms. We report three patients who presented with unilateral hip pain that started in the third trimester of pregnancy. Diagnosis of transient osteoporosis of the hip was made with the help of clinical and radiologic studies. Treatment was comprised of pain control therapy with diclofenac sodium (100 mg/day) for three months, bed rest for a month followed by mobilization with a walking aid. The follow-up period was at least 24 months. Clinical improvement occurred in the third month in one patient, and at the end of six months in the remaining patients. Complete radiologic improvement was seen at the end of 12 months.

Adult↗

PubMed2004

[The mid-term results of minimal medial epicondylectomy and decompression for cubital tunnel syndrome].

OBJECTIVES: We evaluated the mid-term follow-up results of patients who were treated by minimal epicondylectomy and decompression for cubital tunnel syndrome. METHODS: The study included 17 elbows of 15 patients (9 females, 6 males; mean age 45 years; range 35 to 63 years) who underwent minimal medial epicondylectomy and in situ decompression for cubital tunnel syndrome, which was diagnosed through history, physical examination, and electrodiagnostic tests. Before surgery, all the patients received various conservative treatments for at least six months, with no beneficial effect. Thirteen patients had unilateral, two patients had bilateral involvement, with 11 elbows on the dominant side. The mean duration of symptoms was 14 months (range 3 to 36 months). Preoperative grading of nerve compression according to the McGowan system was as follows: three patients (20%) grade I, 11 patients (73.3%) grade II, and one patient (6.7%) grade III. The results of surgical treatment was evaluated according to the Wilson-Krout criteria. The mean follow-up was 32 months (range 25 to 64 months). RESULTS: Symptomatic improvement was achieved in all the patients. The results were excellent in 11 elbows (64.7%), good in five elbows (29.4%), and fair in one elbow (5.9%). None of the patients developed ulnar nerve palsy or subluxation, medial elbow instability, or weakness of the flexor-pronator origin. Pain and tenderness detected at the osteotomy site in four elbows disappeared after a mean of three months. CONCLUSION: Minimal medial epicondylectomy and decompression was found to be a safe and effective method with a low complication rate in the treatment of cubital tunnel syndrome.

Adult↗

PubMed2003

Penile hemodynamics in hypogonadal men with micropenis.

OBJECTIVES: To document the penile vascular and erectile response to intracavernous injection (ICI) of vasoactive agent in hypogonadal men with micropenis. METHODS: A total of 15, previously untreated, hypogonadal men with micropenis (stretched penis length less than 2.5 SD below the mean of the normal population) underwent a detailed urologic and endocrinologic evaluation. Their mean age was 21.2 +/- 4.2 years. Penile hemodynamics were assessed by color Doppler ultrasonography before and after ICI of 5 microg of prostaglandin E(1) combined with manual genital self-stimulation. RESULTS: Endocrinologic evaluation revealed that hypogonadism was hypogonadotropic in 10 (66.7%) and hypergonadotropic in 5 (33.3%). Karyotype analysis showed 46XY in all. Their mean stretched penile length was 6.2 +/- 1.4 cm (range 3 to 7.5) and increased to a mean of 6.96 +/- 1.5 cm (range 4 to 8.5) after ICI. The serum free testosterone levels ranged from 0.2 to 3.2 pg/mL (mean 1.9 +/- 0.92). None had had any previous sexual experience, and 14 (93.3%) reported a history of nocturnal erections. Penile color Doppler ultrasonography demonstrated a normal penile vascular system in 7 (46.7%) and penile arterial insufficiency in 4 (28.6%). All 11 of these patients (73.3%) achieved an adequate erectile response to ICI combined with manual stimulation. Mixed vascular disease was observed in the remaining 4 patients (28.8%), and they did not have a sufficient erectile response to ICI. Color Doppler ultrasonography revealed similar results in the hypogonadotropic and hypergonadotropic men. CONCLUSIONS: Our data suggest that the erectile response to ICI combined with manual genital self-stimulation is effective in most hypogonadal men having a micropenis with low serum androgen levels.

Adolescent↗

PubMed2003

Metabolic risk factors in pediatric and adult calcium oxalate urinary stone formers: is there any difference?

OBJECTIVES: Urolithiasis in children is recognized with an increasing frequency, while exact etiological factors remain to be determined. The aim of this study is to compare the metabolic risk factors and saturation of urine in pediatric and adult calcium oxalate (Ca-Ox) stone formers. METHODS: A total of 33 pediatric (mean age: 6.8 +/- 3.1 years) and 120 adult patients (mean age: 39.7 +/- 5.7 years), with documented Ca-Ox urinary stone disease, underwent a comprehensive metabolic evaluation at our institution. Beside a broad serum analysis, concentrations of calcium, oxalate, magnesium, uric acid and citrate were measured in 24-hour collected urine. Saturation of urine was calculated by Marshall-Robertson's nomograms. RESULTS: Hypocitraturia, observed in 60.6%, and hypomagnesuria, detected in 39.4%, but not hypercalciuria, were the most common metabolic risk factors in the pediatric group. In adults, hypercalciuria still represented one of the major metabolic risk factors, detected in 44.1%, although hypocitraturia, observed in 45.8%, was the most prevalent metabolic risk factor, as it was in the pediatric group. Pediatric cases had significantly (p < 0.05) higher prevalence of hypocitraturia, hypomagnesuria and supersaturated urine when compared to adults. Metabolic abnormalities could be detected in a high percentage (82%) of primary and recurrent pediatric Ca-Ox stone formers, but not in primary adult stone formers. CONCLUSIONS: Metabolic risk factors significantly differ in pediatric and adult Ca-Ox stone formers. Hypocitraturia and hypomagnesuria seem to play a major role in stone formation, and metabolic abnormalities can be detected in a significant percentage of both primary and recurrent pediatric stone formers. Thus, a comprehensive metabolic evaluation is of utmost importance for all children with Ca-Ox stones.

Adult↗

PubMed2003

[The injection of acrylic bone cement prevents bone collapse in the intercalar bones lacking bony support: an experimental sheep semilunar bone model].

OBJECTIVES: In a sheep semilunar bone model, we investigated whether collapse in the intercalar bones lacking bony support could be prevented by the injection of acrylic bone cement. METHODS: The study included 16 limbs of eight sheep. Preoperatively, anteroposterior and lateral views of the carpal joints in the fore limbs were obtained. The animals were divided into four groups. In group 1 (n=3) no surgical procedure was performed in the right semilunar bones, whereas the periosteum on the contralateral side was elevated (group 2; n=3). The first two groups were left as controls. In Group 3 (n=5) the left semilunar bones were filled with acrylic bone cement following decancellation of the bone, while the right semilunar bones were left decancellated (group 4; n=5). The sheep were monitored for three months. Radiographs of the carpal joints were obtained to evaluate collapse occurrence in the semilunar bones. Thereafter, the animals were sacrificed and the semilunar bones were excised for biomechanical and histological examinations. Osteonecrosis and cartilage damage were sought and resistance to compressive forces was investigated. RESULTS: Radiologically, the extent of collapse was statistically significant in the semilunar bones in group 4 (p<0.05). The use of acrylic bone cement was found to prevent collapse in group 3, with no significant difference being noted between preoperative and postoperative semilunar bone heights (p>0.05). Biomechanically, the least resistance to compressive forces was measured in group 4 (p<0.05). Histologically, cartilage damage and osteonecrosis were only seen in group 4. CONCLUSION: Our data suggest that the use of acrylic bone cement prevents collapse in the semilunar bones, without inducing any cartilage damage or osteonecrosis.

Animals↗

PubMedDate not supplied

Superior excursion of the humeral head: a diagnostic tool in rotator cuff tear surgery.

Superior excursion of the humeral head on the face of the glenoid was investigated to determine whether a relationship exists between the degree of humeral head excursion and the identity of the injured tendon in a shoulder with a torn rotator cuff. Twenty-seven patients with unilateral full-thickness rotator cuff tears diagnosed by either positive arthrogram or magnetic resonance imaging were included in this study. Three groups were formed based on intraoperative findings: 10 patients had isolated supraspinatus tendon tears (group 1), 11 patients had supraspinatus and infraspinatus tears (group 2), and 6 patients had supraspinatus, infraspinatus, and subscapularis tendon tears (group 3). There was no statistically significant difference between the degree of humeral head excursion in groups 1 and 2. However, patients in group 3 had a statistically significantly higher degree of excursion of the humeral head (P < .05) when compared with groups 1 and 2. In addition, an inverse relationship between the degree of humeral head excursion and preoperative Constant scores was found. Superior excursion of the humeral head on the glenoid had a significantly higher incidence in patients with subscapularis tears, and a larger amount of excursion was present in patients who had lower preoperative Constant scores.

Adult↗

PubMedDate not supplied

Percutaneous intramedullary decompression, curettage, and grafting with medical-grade calcium sulfate pellets for unicameral bone cysts in children: a new minimally invasive technique.

Several treatment options exist for unicameral bone cysts (UBCs), including observation, steroid injection, bone marrow injection, and curettage and bone grafting. These are all associated with high recurrence rates, persistence, and occasional complications. Newer techniques have been described, most with variable success and only short follow-up reported. Because of these factors, a new minimally invasive percutaneous technique was developed for the treatment of UBCs in children. Twenty-eight children with UBCs who underwent percutaneous intramedullary decompression, curettage, and grafting with medical-grade calcium sulfate (MGCS) pellets by the senior author (J.P.D.) between April 2000 and April 2003 were analyzed as part of a pediatric musculoskeletal tumor registry at a large tertiary children's hospital. Four patients were lost to follow-up, and the remaining 24 patients had an average follow-up of 21.9 months (range 4-48 months). Twelve patients were followed for at least 24 months. Six of the 24 children had received previous treatment of their UBC, most often at an outside institution. Follow-up was performed through clinical evaluation and radiographic review. Postoperative radiographs at most recent follow-up showed complete healing, defined as more than 95% opacification, in 22 of 24 patients (91.7%). One patient (4.2%) demonstrated partial healing, defined as 80% to 95% opacification. One patient had less than 80% radiographic healing (4.2%). All 24 patients returned to full activities and were asymptomatic at most recent follow-up. The only complication noted was a superficial suture abscess that occurred in one patient; this resolved with local treatment measures. The new minimally invasive technique of percutaneous intramedullary decompression, curettage, and grafting with MGCS pellets demonstrates favorable results with low complication and recurrence rates compared with conventional techniques. The role of intramedullary decompression as a part of this percutaneous technique is discussed.

Administration, Cutaneous↗

PubMedDate not supplied

Congenital scoliosis and vertebral malformations: characterization of segmental defects for genetic analysis.

The developmental and genetic etiology of most congenital vertebral malformation disorders remains unknown. The objective of this study was to evaluate and classify congenital vertebral defect cases into groupings based on developmental etiology for clinical genetic studies. This classification is intended to be distinct from but complementary to traditional groupings based on spinal curvature or progression. In the first step of this analysis, the authors identified 84 cases of vertebral segmentation disorders by radiologic screening and prospectively recruited 39 of these patients into a clinical genetic study. Next, the authors quantified the extent of contiguous defects and organized cases by craniocaudal localization. Finally, the authors used available clinical association data to identify syndromic and nonsyndromic subcategories, and identified a high rate of orthopaedic and neurologic associations in nonsyndromic patients. This type of analysis has identified subgroups of patients with multiple, contiguous segmental defects and orthopaedic associations that are particularly suitable for further genetic analysis.

Humans↗