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Öğe Comparative preventive efficacy of recombinant tissue plasminogen activator (rt-PA), urokinase, hyaluronic acid and enoxaparin in post laminectomy epidural fibrosis in rats(TIP ARASTIRMALARI DERNEGI, 2011) Kemaloğlu S.; Gür A.; Yilmaz F.; Acemoğlu H.; Özkan U.Aim: We aimed to determine the effects of rt-PA and enoxaparin on post laminectomy epidural fibrosis and to compare the effects of these two medications with hyaluronic acid and urokinase in an experimental model of spinal epidural fibrosis. Method: Forty Spraque-Dawley rats were anaesthetized by intraperitoneal anesthesia (ketamin 8 mg/100 g) and randomly allocated to five groups. All groups were underwent L1-2 total laminectomies. Topical medications were applied to group 2-5 right after the laminectomy space. Hence, in group 1 (G1=control) only laminectomy was constituted, in group 2 (G2) laminectomy + topical Urokinase, in group 3 (G3) laminectomy + topical rt-PA, in group 4 (G4) laminectomy + topical enoxaparin and in group 5 laminectomy + topical Hyaluronic acid (G5) application were performed. The potentials of local urokinase, rt-PA, hyaluronic acid and enoxaparin in preventing the production of epidural fibrosis were assessed. Result: In inter group comparison, G1-G2, G1-G3, G1-G4, G1-G5 groups differed from each other for total scar score, middle scar score and deep scar score (p<0.05). However, G2-G3, G2-G4, G2-G5, G3-G4, G3-G5 and G4-G5 were not different from each other. Conclusion: In rats, the topical thrombolysis with fibrinolitic agents is safe and efficacious in preventing of post laminectomy epidural fibrosis. Thrombolytic therapy with topical hyaluronic acid, rt-PA, urokinase and enoxaparin may come to play an important role in the prevention of post operative spinal epidural fibrosis and arachnoiditis. Based on the results we found that rt-PA and enoxaparine inhibit the formation of epidural scar adhesions and arachnoiditis compared with control group.Öğe Crescentic glomerulonephritis requiring hemodialysis and elevated MPO-ANCA level and vasculitis allergica cutis in a 21-year-old girl.(2002) Kara I.H.; Yilmaz M.E.; Sari Y.; Gür A.; Büyükbayram H.Microscopic polyangiitis (mPA) is a systemic necrotizing nongranulomatous vasculitis that affects small blood vessels. Clinical features include constitutional symptoms such as fever, anorexia, fatigue, and weight loss. Skin lesions include purpura and splinter hemorrhages, which occur in 50% of patients. Another characteristic feature is rapidly progressive glomerulonephritis, which often affects the kidneys in the early stages of the condition. Diagnosis is based on typical clinical features, biopsy, and presence of antineutrophil cytoplasmic antibodies (ANCA). This disorder tends to involve middle-aged and older persons, with a predilection for males; it is very rare in children. A 21-year-old female patient with mPA who did not respond well to treatment, required hemodialysis, developed vasculitis allergica cutis (VAC) later, and had a relatively short-term survival is reported herein.Öğe Effects of cervical degenerative changes on vertebral artery blood flow in patients with and without vertigo(2003) Çevik R.; Bilici A.; Can A.; Kocamaz S.; Gür A.; Nas K.Vertigo is an important clinical finding of vertebrobasiller insufficiency syndrome which occurs as a result of cervical spondylosis. The aim of present study was to investigate blood flow velocity of vertebral artery in patients having cervical spondylosis with and without vertigo by color Doppler ultrasonography, and its relation with degenerative changes of cervical spine. Thirty patients with vertigo due to spondylosis (I group), 20 patients with spondylosis and without vertigo (II group), and 20 healthy controls were included to the study. Maximum systolic velocity and end diastolic velocity of vertebral arteries were measured bilaterally in all subjects by color Doppler ultrasonography. Mean ages of study groups were 49.2 ± 8.5, 47.35 ± 8.23 and 45.63 ± 4.75, respectively There were significant differentiations among three groups in all VA blood flow velocities (p<0.01 and p<0.001). There were significant correlations between stage of cervical degenerative changes and all VA blood flow velocities (p<0,001). In conclusion, color Doppler ultrasonography, which is non-invasive and uncomplicated tecnique, is a useful method to evaluate vertebral artery blood flow velocity in patients having cervical spondylosis with vertigo.Öğe Etiopathogenesis in fibromyalgia(2008) Gür A.Fibromyalgia (FM) is a form of non-articular rheumatism characterized by long term (>3 months) and widespread musculoskeletal pain. Research performed in the past decade has shown that patients with FM frequently have dysfunction of the stress response system. Furthermore, emerginq clues propose that such dysfunction may be important in the pathogenesis of the syndrome. The biophysiology of FM, however, has remained elusive and the treatment remains mainly empirical. There are numerous hypotheses about the pathophysiology of chronic widespread pain and FM. Pain, stiffness and depression in FM could be associated with some signs of inflammatory response system activation. Illumination of the pathophysiologic secrets of FM will sign the most effective treatment regims. This article reviews pain mechanisms and new developments in pathopysiology of fibromyalgia.Öğe Musculoskeletal involvement in brucellosis in different age groups: A study of 195 cases(SMW supporting association, 2002) Geyik M.F.; Gür A.; Nas K.; Çevik R.; Saraç J.; Dikici, Bünyamin; Ayaz C.Objective: The aim of the present study was to determine the distribution and characteristics of arthritis in 195 patients with musculoskeletal involvement due to brucellosis in different age groups in the southeastern region of Turkey. Patients and methods: We carried out a retrospective analysis of 283 patients with brucellosis records and identified 195 with musculoskeletal involvement. Patients were classified into acute-subacute (<12 months) and chronic (>12 months) brucellosis. Patients were also classified into three age groups: <15 years old (group A), 15-45 years (group B), and over 45 years (group C). In addition, patients were classified into five subgroups according to type of arthritis: peripheral arthritis, polyarthritis, spondylitis, sacroiliitis, and spondylitis/sacroiliitis. Results: 195 (69%) of the 283 patients [138 female (49%), 145 male (51%)] had musculoskeletal involvement. Of the patients with musculoskeletal involvement 113 (58%) were female and 82 (42 %) were male, ranging in age from 3 to 71 years (mean age 33.14 ± 15.03). Of 195 patients studied, 39 (14%) were <15 years old (group A), 122 (43%) were aged 15-45 (group B), and 34 (12%) were over 45 (group C). The most commonly affected joints were the sacroiliac joint in 108 patients (55%), peripheral joints in 106 (54%), and spondylitis in 60 (31%). Of 108 patients with sacroiliitis, 19 were in group A, 76 in group B, and 13 in group C. Bilateral sacroiliitis was less common in group B (23 patients) than in groups A (3) and C (3) (p <0.05). Spondylitis was more common in group B (18%). Sacroiliitis and polyarthritis were more common than other types of musculoskeletal involvement in females, whereas in males the distribution of all types was similar. In patients aged under 15 and 15-45, sacroiliitis and polyarthritis were common compared with other types of arthritis, but the distribution was similar in patients over 45. Conclusion: In southeastern Anatolia musculoskeletal involvement in brucellosis is frequent. The series presented suggests that musculoskeletal involvement in group A is higher than groups A and C. The prevalence of musculoskeletal involvement appears to differ according to age, sex and clinical type.Öğe Prevalence of disability in Diyarbakir(2000) Nas K.; Çevik R.; Gür A.; Erdo?an F.; Saraç A.J.; Atli Turhano?lu A.D.While the ideal vision for everyone may be to lead a physically and mentally healthy life well into old age, every year many millions die prematurely or are disabled by diseases and condition that are to a large extent preventable. In our study, the prevalence of disabilities was investigated at four zones of Diyarbakir which determinant by socioeconomic situation. The epidemiological survey was carried out from a total of 38685 persons and questionnaires formed by World Health Organization (WHO) were used. The prevalence of disabilities was found to be 14.84% (5742 persons). The prevalence of visceral disabilities was found to be 6.8% (2629 persons) and locomotor disabilities was found to be 2.66%(1013 persons). The relationships between disabilities and factors such as age, educational status, economic status, and marriages among relatives were found to be significant (p<0.001).
