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Öğe Comparison of stiffness, elasticity and resilience values of ACL with autografts used instead of ACL in terms of texture analysis(Cell Press, 2024) Mert, Ahmet; Cinaroglu, Selim; Aydin, Murat; Cicek, Fatih; Ceranoglu, Faruk GaziBackground: Anterior cruciate ligament (ACL) ruptures are one of the most extensively studied injuries in the field of orthopedics, but despite the extensive research, graft selection for ACL reconstruction remains a matter of debate. The present study aims to evaluate the stiffness and elasticity of native ACLs using texture profile analysis and compare results with those of autografts used in ACL reconstruction. Methods: Included in the study were dissected 12 cadavers from which grafts were recovered. The graft characteristics, such as stiffness, elasticity and resilience, were measured using a TA.XT Plus Texture Analyzer. Findings: Among the grafts studied, Achilles' tendon graft (0.70; 0.64) had the highest resilience in both males and females, while the greatest elasticity was identified in the patellar tendon graft (Male: 93 %; Female: 94 %) in all subjects. The highest stiffness value in males was recorded for the quadriceps tendon graft (2928.76 N), while the highest stiffness value in females was recorded for Achilles' tendon graft (2204.61 N). Interpretation: According to the study data, the autografts that may be considered as an alternative to ACL were, listed in order of strength from high to low, the quadriceps, Achilles', patella and hamstring tendons in men, and the Achilles', quadriceps, patellar and hamstring tendons in women. It is worthy of note that the hamstring tendon graft, which is the most frequently preferred autograft in ACL reconstruction, was found to be the lowest in all parameters in both groups.Öğe Evaluation of Autografts Used in Anterior Cruciate Ligament Reconstruction in Terms of Tensile Strength(Springernature, 2023) Mert, Ahmet; Cinaroglu, Selim; Keles, Haci; Aydin, Murat; cicek, FatihIntroduction Anterior cruciate ligament (ACL) injuries increase the likelihood of chronic knee problems in later years, including early onset osteoarthritis. Therefore, ACL treatment is important in preventing knee problems from developing. The treatment of choice for ACL tears is surgery (ACL reconstruction), and the most popular tendons for ACL reconstruction are the patellar tendon, hamstring tendon (semitendinosus and gracilis tendons), and bone-patellar tendon-bone. The present study compares the tensile strength of autografts used in ACL reconstruction to identify the optimum autograft for ACL in terms of mechanical properties. Methods Cadavers were dissected, and the Achilles tendons, quadriceps tendons, hamstring tendons (semitendinosus and gracilis tendons), patellar tendon grafts, and ACLs were harvested. Tensile tests of each tendon graft were performed using a Shimadzu Autograph AG-IS 100 kN tester (Shimadzu, Kyoto, Japan). Results The mean difference in tensile strength between ACL and other grafts was lowest for the quadriceps in both males and females (p < 0.001), meaning that ACL and quadriceps grafts are more compatible than other tendon grafts in terms of tensile strength. Conclusion The present study found the lowest mean difference in tensile strength to be between the ACL and the quadriceps tendon, suggesting that the use of the quadriceps tendon in ACL reconstruction will yield more positive outcomes.Öğe Evaluation of nerve innervation distribution of orbicularis oculi muscle for botulinum neurotoxin application using Sihler's method(Elsevier Gmbh, 2024) Cicek, Fatih; Cinaroglu, Selim; Ceranoglu, Faruk Gazi; Kucuk, Erkut; Zor, Kursad RamazanBackground: Blepharospasm is the involuntary and forced closure of the eyelids due to spasm-like contraction of the orbicularis oculi muscle around the eye. The study aimed to reveal the nerve innervation of the orbicularis oculi muscle for Botulinum neurotoxin (BoNT) treatment of blepharospasm by Sihler's staining technique.Methods: This study used six cephalus (12 orbicularis oculi muscles) with an average age of 69,6 (62-88) years. Then, the orbicularis oculi muscles were removed by dissection, and Sihler's staining technique was applied to the muscles. The limit for dissection of the muscle is the orbital opening level, where the nerves enter the muscle, and the muscle attaches to the bone. Results: In the region above the palpebral fissure, the nerves entering the muscle were densely located in the superolateral quadrant between 9 and 12 o ' clock in the right eye and between 12 and 3 o ' clock in the left eye. In the region under the palpebral fissure, the nerves' density in the orbicularis oculi muscle was higher between 4 and 7 o ' clock in the right eye and between 5 and 8 o ' clock in the left eye.Conclusion: This study unveiled the nerve branches associated with the orbicularis oculi muscle. It pinpointed precise crossing points of these nerve branches, which can be targeted for applying BoNT in treating blepharospasm. Consequently, by utilizing minimal BoNT, it is anticipated that the quantity of toxin administered will decrease, leading to more efficient outcomes and reduced expenses. Furthermore, this approach can aid in averting potential undesired complications during BoNT administration.Öğe EVALUATION OF PATIENTS WITH COVID-19 IN THE EARLY HYPOXEMIC STAGE AND PATIENTS WITH VIRAL RESPIRATORY TRACT INFECTION IN TERMS OF PULMONARY HYPERTENSION(Sestre Milosrdnice Univ Hospital, 2023) Cinaroglu, Selim; Karakus, Kayhan; Keles, Haci; Kacmaz, MustafaArterial hypoxemia occurs in many COVID-19 patients. Hypoxemia is one of the causes of pulmonary hypertension (PH). Main pulmonary artery dilatation and the main pulmonary artery diameter (mPAD) to ascending aorta diameter (AAD) ratio of >= 1 are significant findings regarding PH. In this study, COVID-19 patients and non-COVID-19 patients with viral respiratory tract infection were evaluated retrospectively in terms of PH. A total of 124 patients (71 male and 53 female), age range 18-85 years, were included in the study as case group and control group. Thoracic computed tomography (CT) images, blood and biochemical parameters, and demographic information were compared between the case group and control group. The normality of numerical variables was examined with Kolmogorov-Smirnov test and homogeneity of the variances with Levene's test. This is the first study researching the effect of early hypoxemic stage COVID-19 infection on development of PH. As a result, it was specified that COVID-19 infection had no effects on mPAD, whereas it had a positive effect on AAD and thus led to a decrease in the mPAD/AAD ratio. Through these values, which could be easily calculated from thoracic CT images, the changes caused by COVID-19 infection on vessel diameters were put forward.Öğe Evolution of a traditional technique: Comparison of a 4-mm lag screw and Kirschner wire technique versus a 4-mm lag screw and Kirschner technique with anti-gliding miniplate fixation for the treatment of medial malleolar fractures(Turkish Assoc Trauma Emergency Surgery, 2022) Aydin, Murat; Cinaroglu, SelimBACKGROUND: In this study, we aimed to compare a 4-mm lag screw and Kirschner wire technique versus a 4-mm lag screw and Kirschner wire (K-wire) technique with additional miniplate fixation for the treatment of medial malleolar fractures. METHODS: A total of 23 patients who were diagnosed with isolated fractures of the medial malleolus and operated in our center were retrospectively analyzed. The patients were divided into two groups: Group A, medial malleolar fracture fixed with a 4-mm cannulated screw and a K-wire (n=11) and Group B, a 4-mm cannulated screw and K-wire used for fixation with miniplate fixation for extra stability (n=12). Clinical outcomes were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hind foot Score at 2, 6, 12, and 24 months postoperatively. At 12-24 months, the presence of pain and tenderness in the medial malleolus with palpation was evaluated using the visual analog scale (VAS) pain scores. RESULTS: The mean time to union was 2.23 +/- 0.56 (range, 1.8-2.9) months in Group A and 2.46 +/- 0.45 (range, 1.9-3.1) months in Group B, indicating no statistically significant difference between the two groups (p 0.01). However, there was no statistically significant difference in the mean AOFAS scores at 6 and 12 months between the groups (p 0.05). The mean VAS pain scores at 12-24 months postoperatively did not significantly differ between the groups (p>0.05). CONCLUSION: Our study results suggest that the treatment of medial malleolar fractures with a cannulated screw and K-wire with additional stabilization using a miniplate ensures favorable early outcomes with early return to daily living activities. However, both techniques have similar outcomes in the mid-term.Öğe Examination of the Tensile Strength of the Peroneus Longus Muscle(Springernature, 2024) Yagar, Hilal; Cinaroglu, Selim; Cicek, Fatih; Ceranoglu, Faruk; Karadag, HueseyinIntroduction: The peroneus longus tendon (PLT) is increasingly used as a tendon autograft in ligament and tendon reconstructions. The aim of this study is to evaluate the biomechanical properties of the PLT to assess its usability in frequently performed reconstructions. Methods: Six fresh-frozen, below-knee cadavers with a mean age of 65 years, no previous surgical operation, and no history of chronic disease were used. PLTs were harvested, freed from muscle tissue, and prepared for tensile strength testing at a tensile force rate of 2 mm/min using a Shimadzu Autograph AG-IS 100 kN instrument (Shimadzu Corporation, Kyoto, Japan). Results: The maximum tensile force varied between 600.7 N and 1131.313 N, with a median of 758.185 N. All tendons had diameters of 8 mm or more. The elongation at maximum force ranged from 9.0 mm to 16.0 mm, with a median of 14.0 mm. Conclusion: According to this study, PLT is a viable choice for surgeries involving autograft reconstruction. However, further clinical studies are needed to confirm its efficacy in reconstructive surgeries.Öğe Gender and Height Estimation from Hand and Handprint Sizes in the Turkish Population(Wolters Kluwer Medknow Publications, 2023) Keles, Haci; Cinaroglu, Selim; Cicek, Fatih; Ceranoglu, Faruk Gazi; Tekeli, MustafaIntroduction: In forensic medicine, it becomes impossible to identify corpses in events that affect a large part of the population, such as natural disasters, accidents, and wars. The aim of this study is to determine the height and gender of the Turkish population with hand and handprint morphometric measurements. Materials and Methods: The sample size of the study consists of 600 Turkish population aged between 18 and 58 years (mean +/- standard deviation: 22.18 +/- 5.43) living in Middle Anatolia. In the morphometric measurements of the hand, 21 anthropometric measurements were taken from each volunteer. Results: It was determined that men had higher values than women in all hand and handprint measurements and were statistically significant. When the correlation between hand and handprint measurements and statue was examined, it was determined that hand length and handprint length had the highest correlation with height in both genders (male: r: 0.57, r: 0.62; female: r: 0.49, r: 0.50). When comparing the bilateral asymmetry of the right and left hands of both sexes, it was observed that there was a statistically significant difference between the lengths of the thumb distal phalanx, little finger proximal, and middle phalanx in men and between the lengths of the index finger distal phalanx, middle finger middle and distal phalanx, and ring finger distal phalanx in women (P < 0.05). Conclusion: As a result, it was seen that the use of hand and handprint measurements to determine height and gender in the Turkish population gave high results.Öğe Investigation of Morphometric Characteristics of the Mesencephalon in a Healthy Turkish Population: An MRI-Based Morphometric Study(Springernature, 2023) Demir, Mehmet; Cinaroglu, Selim; Ceranoglu, Faruk G.; Cicek, Fatih; Koc, TuranIntroduction: Due to the important functions of the mesencephalon, knowledge of its morphometric characteristics in a healthy population is important for any pathological diagnosis. The aim of this study was to determine the specific morphometric values of the mesencephalon in a healthy Turkish population.Methods: Magnetic resonance (MR) images of 184 subjects (98 females, 86 males) with a mean age of 47.33 years (range 18 to 85 years) were included in the study. Then, parameter measurements were performed on 1.5 T MR images, and MicroDicom Digital Imaging and Communications in Medicine (DICOM) viewer 2022.1 (MicroDicom Ltd., Sofia, Bulgaria) software program was used for the measurements.Results: The mean sagittal diameter of the right cerebral peduncle was 17.17 +/- 2.03 mm, the mean crosssectional area of the right cerebral peduncle was 171.75 +/- 32.81 mm(2), the mean transverse diameter of the left cerebral peduncle was 16.60 +/- 2.32 mm, sagittal diameter of tectum and tegmentum 17.01 +/- 1.57 mm, the cross-sectional area of tectum and tegmentum 223.40 +/- 27.37 mm(2) and pontomesencephalic angle 52.03(degrees)+/- 10.61(degrees), while in males these values were 18.26 +/- 2.38 mm, 182.61 +/- 38.57 mm(2), 17.39 +/- 2.57 mm, 17.76 +/- 1.90 mm, 237.20 +/- 35.94 mm(2) and 56.77(degrees)+/- 9.78(degrees), respectively. Except for the mamillopontine distance, there was a statistically significant difference between genders in the other parameters (p<0.05).Conclusion: In conclusion, the findings related to the mesencephalon obtained in this study are presented for the first time in a healthy Turkish population. Especially, the cerebral peduncle cross-sectional area, tectum and tegmentum cross-sectional area, and cerebral peduncle transverse diameter can be evaluated clinically. We believe that knowledge of these values will guide specialists and radiologists in the diagnosis of any pathologic condition. Furthermore, the pontomesencephalic angle and mamillopontine distance have been identified as potentially useful landmarks in the diagnosis of intracranial hypotension and hydrocephalus. In particular, these angles can be measured in patient groups and may be a potential landmark in making an alternative diagnosis.Öğe Location of the Optic Foramen Relative to the Sphenoid Sinus and Orbital Apex Structures(Briefland, 2022) Cinaroglu, Selim; Zor, Kursad Ramazan; Guresci, Kursat; Keles, HaciBackground: Orbital decompression is performed to reduce intraorbital pressure by removing the fat tissue and bone around the orbit. Access to proper equipment, experienced personnel, and adequate anatomical knowledge are essential to perform this procedure. To achieve maximum decompression, surgeons need to open the orbit up to the apex, including the optic foramen and the annulus of Zinn. Objectives: This study aimed to determine the location of the sphenoid sinus relative to the optic foramen using computed tomog-raphy (CT) scan, which is essential for orbital decompression surgery, in the Central Anatolia Region, Turkey. Patients and Methods: This cross-sectional study was conducted on 64 patients from the Turkish population between March 15 and April 15, 2021 in the Central Anatolia Region. The patients were selected using the purposive sampling method. Based on the cranial CT scans, a total of 128 orbits were evaluated using the hospital's picture archiving and communication system. Patients included in this study were admitted to the hospital with headache. However, their CT images, evaluated by an experienced radiologist, were reported to be normal. The relationship between the optic foramen and the anterior surface of the sphenoid sinus was examined, and the location of the optic foramen was determined as anterior, posterior, or equal to the sphenoid sinus. Descriptive statistics were measured for statistical analysis. Results: The participants of this study included 32 men and 32 women in the age range of 20 -67 years. Based on the analyses, the optic foramen was mainly opposite to the anterior aspect of the sphenoid sinus in both females and males; this finding was more prominent in females. In the right orbit, the mean distance of the optic foramen to the anterior surface of the sphenoid sinus was +6.97 mm if the optic foramen was anterior to the anterior surface of the sphenoid sinus, while it was-4.1 mm if the optic foramen was located posteriorly to the anterior surface of the sphenoid sinus. Similarly, in the left orbit, the mean distance of the optic foramen to the anterior surface of the sphenoid sinus was +6.97 mm if the optic foramen was located anteriorly, while it was-4.15 mm if the optic foramen was located posteriorly to the anterior surface of the sphenoid sinus. The position of the optic foramen was symmetrical in 60.9% of cases in the two orbits. Conclusion: Based on the results of CT scan, the optic foramen was mainly located opposite to the anterior aspect of the sphenoid sinus; this finding was more frequently observed in females (59.4%) than in males (40.6%). The present results can provide further information for surgeons to perform orbital decompression or surgeries posterior to the orbit.Öğe Repeated use of fibrin sealants kept at room temperature in conjunctival autografting: An animal study(Wolters Kluwer Medknow Publications, 2022) Zor, Kursad Ramazan; Cinaroglu, Selim; Kucuk, Erkut; Keles, Haci; Ozturk, AliPurpose: In this study, our aim was to investigate if fibrin adhesives used in conjunctival wound surgery with autologous conjunctival grafts could be used repeatedly at different times after surgical opening. Methods: 40 New Zealand rabbits were used in the study. These animals were divided into four groups, each consisting of 10 rabbits, and hence 20 eyes. In the first group (control group), Tisseel fibrin sealant was used on the day the eye was first opened surgically; in the second group, it was used on the seventh day; on the third group, it was used on the 14th day; and in the fourth group, it was used 28 days after surgical opening. The graft from the inferior bulbar conjunctiva was attached using Tisseel fibrin glue to the superior scleral bed at the location where the superior bulbar conjunctiva was excised in the same eye. Results: No microbial growth was detected in the cultures of the samples tested. There were two partial graft loss in group 2 and there was one partial graft loss in each group of the other groups, and further total graft loss was present in one rabbit in group 3. None of the rabbits had any complications like granuloma, Corneal dellen or infection. Conclusion: Based on these results, fibrin sealants can be used repeatedly by storing them at room temperature. Repeated use of fibrin adhesives will reduce the cost of ophthalmologic surgeries and non-ophthalmologic surgeries.Öğe Residual Symptoms After Carpal Tunnel Decompression and Treatment With Gabapentin: A Multicenter Study(Springernature, 2021) Aydin, Murat; Argun, Guldeniz; Acar, Baver; Arikan, Murat; Cinaroglu, Selim; Mert, Ahmet; Togral, GiirayObjectives To identify postoperative residual symptoms of carpal tunnel syndrome (CTS) and to investigate the effectiveness of gabapentin in the treatment of residual symptoms. Materials and methods Of a total of 412 patients who underwent surgery for CTS in four centers over a four-year period, 14 who had residual symptoms after CTS release and did not receive gabapentin (Group A) and 14 patients with postoperative residual symptoms and received gabapentin were included in this retrospective study. Postoperative residual symptoms were defined as persistent nocturnal numbness and tingling with or without occasional daytime pain. Tinel's and Phalen's tests were performed for the diagnosis of residual symptoms. Functional Severity Score (FSS), Symptom Severity Score (SSS), and Visual Analog Scale (VAS) were used to evaluate functional outcomes, severity of symptoms, and numbness and sleep quality, respectively at six and 12 weeks postoperatively. Results There was no statistically significant difference in the mean postoperative FSS (p=0.845) and VAS-numbness scores (p=0.367) between the groups. However, there was a statistically significant difference in the mean postoperative SSS (p=0.025) and VAS-sleep quality scores (p<0.001) between the groups. Conclusion Gabapentin treatment can be a treatment of choice for residual symptoms after CTS surgery and clinical improvement can be achieved owing to its relieving effect, particularly in nocturnal symptoms of patients having neuropathic pain.Öğe The contribution of scholars to the anatomy of the eye and adnexa in islamic geography(Wolters Kluwer Medknow Publications, 2020) Zor, Kursad R.; Cinaroglu, Selim; Kucuk, ErkutFrom the early period of Islam, Muslim scholars have translated the ancient Greek medical works, and they reached a much more advanced level. Blindness was a major cause of disability in all Islamic geography, so physicians from Islamic territory, particularly Yuhanna ibn Masawayh, Hunain Ibn Ishaq, Rhazes, Ali bin Isa, Ibn-i Sina, and Ibn Al-Haitam, were particularly focused on the anatomy of the eye and diagnosis and treatment of eye diseases. In this study, we aimed to report the contributions of the Muslim scholar on the anatomy of the eye and adnexa for the first time in the literature.Öğe The Effects of an Absorbable Hemostat Produced From Oxidized Regenerated Cellulose on Adhesion Formation in a Rat Mode(Galenos Yayincilik, 2021) Yavuz, Adem; Oner, Gokalp; Tas, Mustafa; Cinaroglu, SelimObjective: This study aimed to analyze the effect of an absorbable hemostat produced from oxidized regenerated cellulose (ORC) on pelvic adhesion formation in a rat model using an adhesion scoring system and immunohistochemical staining. Methods: This randomized, controlled experimental study included 20 female Wistar-Albino rats that were equally divided into the following groups: control and absorbable hemostat groups. The uterine horns of all the rats were exposed by laparotomy and using 10 W bipolar cautery. Five standard lesions were applied to the antimesenteric areas of each uterine horn. The experimental group received an absorbable hemostat to the traumatized uterine surfaces, whereas the control group did not. After a 28-day follow-up period, a relaparotomy was performed, and adhesions were evaluated based on an adhesion scoring system, and histological sections from areas with adhesion were obtained for immunohistochemical staining. Immunohistochemical staining included analysis of Ki-67 (proliferation index), CD-31 (neovascularization index), and Masson Trichrome [(MTC) fibrosis and collagen formation index]. Additionally, acute and chronic inflammation indices were determined via polymorphonuclear leukocytes (PMNL) and mononuclear leukocytes (MNL), respectively. Results: The intensity and scope of adhesion and overall adhesion ratings were substantially higher in the absorbable hemostat group than the control group (2.8 +/- 0.85 vs. 2.2 +/- 0.53, 0.92 +/- 0.26 vs. 0.61 +/- 0.25, and 3.72 +/- 0.96 vs. 2.81 +/- 0.75, respectively). Staining results for Ki-67, CD-31, MTC, PMNL, and MNL were also significantly higher in the absorbable hemostat group than in the control group (p<0.05 for all). Conclusion: The obtained results suggest that the use of ORC-based absorbable hemostats in pelvic surgery may increase adhesion formation on peritoneal surfaces by increasing inflammation, vascularity, and collagen formation.Öğe The Use of Alkyd Resin Method in Wistar Rats for the Preparation of Teaching Materials and Museum Exhibits(Kafkas Univ, Veteriner Fakultesi Dergisi, 2020) Cinaroglu, Selim; Keles, HaciAlkyd Resin method, patented by the Turkish Patent Institute, is a cadaver preparation and preservation technique. This study examines whether exhibition-museum materials can be produced from rat cadavers processed with alkyd resin method in different postures and whether dissection and suturing can be performed on the samples. Besides, samples prepared with alkyd resin and samples prepared freshly were compared in terms of dissection and suturing. 14 Wistar Albino Rats were used in the study. Seven were prepared with alkyd resin method and the others were freshly prepared for comparison in terms of suturing and dissection. The alkyd resin method was applied to two cadavers as a pretrial and to five cadavers for them to be museum-exhibition and educational materials. Alopecia was detected in two cadavers. In some of the exhibition samples processed with the method mentioned, shrinkage and hardening of the skin was noticed. All the samples prepared with this method became products suitable for suturing and dissection. The exhibition-museum materials prepared with the alkyd resin method have maintained their first body postures. We believe that alkyd resin method can be applied to the entire body, and the products can be used for exhibition and educational purposes. Furthermore, the method should be further popularized, and it should be applied to cadavers of different species so that its applicability increases.
