Serdar Ozturk

Measurement of orbital volume by a 3-dimensional software program: an experimental study.

PURPOSEnThis study reports a simple method with high accuracy for determining orbital volume from computed tomography (CT) scans.nnnMATERIALS AND METHODSnThe volume of 20 orbits was evaluated in 20 dry skulls by use of a 3-dimensional software program in General Electric High-Speed Advantage CT/I (Milwaukee, WI), and compared with the volume obtained by direct measurement using the water displacement method. Accuracy of volume measurement by this software program was assessed statistically by paired samples t-test.nnnRESULTSnThe mean volume was found to be 28.37 mL +/- 2.15 by direct impression and 28.41 mL +/- 2.09 by the software program. Volume difference between the 2 methods averaged 0.93 +/- 1.08 mL for each orbit (P < .01). The correlation between the techniques was found to be high (r = 0.887, P < .01). There was no significant volume discrepancy between the 2 methods.nnnCONCLUSIONnMeasurement by the technique described is an easy and accurate method of assessing the volume of the orbit.

Pain relief during dressing changes of major adult burns: Ideal analgesic combination with ketamine

Pain management during burn dressing changes is a critical part of treatment in acute burn injuries. Although several treatment options have been suggested, it is still a challenge in a clinical setting. This study is aimed at finding out an ideal analgesic, sedative and/or anxiolytic combination that would minimise the unwanted effects of ketamine. A total of 24 patients, with burns up to 20-50% of total body surface area (TBSA), were included in the study and randomly divided into three groups. In group I, 2 mg kg(-1) ketamine was administered. In group II, 1 mg kg(-1) tramadol was administered and 30 min later, 1 microg kg(-1) dexmedetomidine and 2 mg kg(-1) ketamine was administered. In group III, 1 mg kg(-1) tramadol was applied and 30 min later, 0.05 mg kg(-1) midazolam and 2 mg kg(-1) ketamine was administered. The evaluation was performed with cardiopulmonary monitoring, sedation and visual analogue pain scores and overall patient satisfaction. Any adverse effects of ketamine were recorded. The results showed that group II had better outcomes with respect to pain management during dressing changes. As a conclusion, the use of the combination of ketamine, tramadol and dexmedetomidine was found to be a good treatment option for the prevention of the procedural pain suffered by adult patients during dressing changes.

Accurate method for determining functional penile length in Turkish young men.

There are only a few reports that investigate the measurement of functional penile length and compare the methods used for this purpose. The aim of this study was to determine the correlation between the measurement techniques and to determine an appropriate method that correlates the erect state most closely. Measurements of penile length in 200 healthy men were made during three different states—flaccid, erect, and stretched—of the penis. The results were evaluated using descriptive statistics, paired t-test, correlation coefficients, and regression equations. The correlation between the flaccid and the erect lengths was 71.2%, and it was 80.2% between the stretched and the erect lengths (p < 0.01). Using regression equations, the degree of accuracy in estimating the erect length by using the stretched length was 65.3% (R2 = determination coefficient;p < 0.01) and was 50.8% by using the flaccid length (p < 0.01). When both the flaccid and the stretched lengths were considered together, the predictability of erect length was R2 = 65.5%. The results obtained using different statistical methods showed that the most accurate results can be obtained by considering stretched penile length, whereas flaccid length had little importance in determining erect penile length. In conclusion, the stretched penile length measurement technique is highly recommended for the accurate prediction of the erect penile length.

Evaluation of chitosan gel containing liposome-loaded epidermal growth factor on burn wound healing.

The objective of this study is to develop a chitosan gel formulation containing liposomes loaded with epidermal growth factor (EGF) and to evaluate their effects on the healing of second‐degree burn wounds in rats by immunohistochemical, histochemical and histological methods. EGF‐containing multilamellar liposomes which were carried in chitosan gel, EGF gel and EGF‐loaded liposome formulations were prepared. The in vivo experiments were performed on female Sprague Dawley rats. Second‐degree standard burn wounds were formed on rats and liposomes containing 10 µg/ml EGF in 2% chitosan gel, EGF‐chitosan gel and EGF‐loaded liposome formulations were applied daily to the burn wounds and biopsies were taken at the 3rd, 7th and 14th day of the treatment. When the results were evaluated immunohistochemically, there were significant increases in cell proliferation observed in the EGF‐containing liposome in chitosan gel (ELJ) formulation applied group (P < 0·001). The histochemical results showed that the epithelisation rate in the ELJ group was the highest compared with the other group results (P < 0·001). The histological results indicated and supported these findings and faster epithelisation was observed in the ELJ group compared with the other groups.

An unusual complication of a Medpor implant in nasal reconstruction: a case report.

There are few implant materials which have been successfully used for nasal reconstruction. Of these, the medpor implant is the most accepted alloplastic material for reconstruction of the nasal framework. Here, an unusual complication of a medpor implant in nasal reconstruction is presented. A 24-year-old medical student suffering from a saddle nose deformity after a primary rhino plasty was admitted to our department. The medpor nasal implant was used to restore the nasal dorsum. The surgical result was appreciated by the patient. No problem was encountered during two years after surgery. Recently, the patient suffered from an asymmetry of the nasal dorsum. The physical examination revealed a step on the nasal dorsum with caudal mobility of the implant. The nasal implant was suspected to be broken. Multislice CT scan and ultrasonographicimaging of the implant were obtained. The radiologicevaluation of the region confirmed the fracture of the medpor nasal implant. Nasal reconstruction with a medpor implant is a good choice with low complication rates. This is the first case in the literature reporting a broken medpor nasal implant. Moreover, in this study a new method is described for imaging the medpor implant material.

Sunflower oil in the treatment of hot tar burns

Hot tar burns compose a unique class of thermal injury, because removal of this highly sticky compound may be very difficult without inflicting additional tissue damage. Early removal of tar facilitates assessment of the burn and improves patient comfort. Although the use of many substances for the painless removal of tar has been described, we used sunflower oil effectively in the treatment of four tar burn patients. This first report describes the practical and successful use of sunflower oil which was easily obtained from the hospital kitchen.

Biomechanical analysis of the effect of mesenchymal stem cells on mandibular distraction osteogenesis.

BackgroundThe purpose of this study was to investigate the effects of bone marrow–derived stem cells on consolidation period by using a new biomechanical testing method on sheep mandible model. MethodsEight sheep underwent bilateral mandibular osteotomies. After latency period, bone distraction was activated. Mesenchymal stem cells were transplanted into the gap of the left mandibular distracted callus on the first day of consolidation period. The sheep were then randomly divided into 2 groups (group A = 4, group B = 4). Group A and group B animals were killed on the third and sixth weeks of consolidation, respectively. Fracture pattern and localization, bone regeneration ratio and density, and stress distribution of 16 distracted hemimandibles were evaluated by computed tomography and biomechanical analysis. ResultsTwo different fracture patterns were observed in the 2 groups. The left halves of mandibles exhibited horizontal fracture out of the distraction zone, and the cross-sectional area was compact bone [H (−) C], whereas the fracture patterns of control sides were oblique, which passed through the distraction zone with a propensity of trabecular bone [O (+) T]. Stress distribution at the critical cross-section of distraction region was not different in halves of mandibles. However, bone regeneration ratios and regenerated bone densities were significantly higher in left sides (P < 0.05). ConclusionsTransplantation of mesenchymal stem cells promotes maturity of the distracted callus. The new experimental model, which allowed to test the mandible as a system by simulating in vivo loading conditions, revealed differences in the mechanical behavior of the halves of mandible.

Squamous cell carcinoma arising in the giant cutaneous horns accompanied with renal cell carcinoma

An 85-year-old man who presented with two giant cutaneous horns on his lower lip underwent an explorative laparotomy because of a left renal tumor and gall bladder stones. The cutaneous horns on the lower lip were excised at the same session. Histology revealed a renal cell carcinoma and minimally invasive squamous cell carcinoma at the base of the giant cutaneous horns. We present this case showing the simultaneous occurrence of squamous cell carcinoma at the base of a giant lower lip cutaneous horn and a renal cell carcinoma of the L kidney.

Evaluation of Breast Reduction Surgery Effect on Body Posture and Gait Pattern Using Three-Dimensional Gait Analysis

Breast hypertrophy is a significant health burden with symptoms of back and shoulder pain, intertrigo, and shoulder grooving from the bra straps. Women often rely on surgery to relieve these symptoms, and they are mostly satisfied with the results. The satisfaction from surgery usually is evaluated by subjective measures. Objective evidence testing of the surgical outcomes is lacking. In this study, 10 women with breast hypertrophy underwent reduction mammaplasty. Their surgical outcomes were evaluated using three-dimensional gait analysis before surgery and 2xa0months afterward. A statistical difference was sought between the kinematic data of the spine, hip, knee, and ankle joints. The average maximum anterior pelvic tilt angles decreased 41xa0%, and the average maximum spine anterior flexion angles decreased 30xa0%. The difference between the pre- and postoperative values was statistically significant. The analysis of the kinematic data showed no significant difference in the hip, knee, or ankle joint angles postoperatively. The outcomes of breast reduction surgery have been evaluated mostly by subjective means until recently. As an objective evidence for surgical gain in the current study, reduction mammaplasty resulted in the patients’ improved body posture when walking.Level of Evidence IVThis journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Effect of hyaluronan on adult and fetal fibroblast proliferation and collagen synthesis: in vitro study

Abstract In this study, we hypothesized that there is a significant difference between the proliferation rate and collagen and elastic fiber content of the fetal and adult type of cultured fibroblast due to higher hyaluronan (HA) content in fetal tissues. To address this issue, we examined the difference in the proliferation rate of fetal and adult cultured fibroblasts by evaluating the time for being confluent and the morphology of the cells; in addition, granular (rough) endoplasmic reticulum and the Golgi apparatus were also observed by both light microscopy and transmission (TEM) and scanning electron microscopy (SEM) in subgroups that were treated with HA or left untreated. Addition of HA to the culture medium was started at day 3. The average time difference for confluence of the cells between the treated and untreated adult fibroblast groups was statistically significant (P<0.001). In the untreated adult fibroblast group, cells showed less granular endoplasmic reticulum and Golgi apparatus, whereas large and dilated endoplasmic reticulum was seen in treated adult and untreated fetal fibroblasts. Our study showed that adult fibroblasts can show similar changes to the fetal fibroblasts in response to elevated levels of HA in vitro. It is likely that HA may play important roles in fibroblast morphology, proliferation, and differentiation.