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Öğe 6-Month Results of Transdiscal Biacuplasty on Patients with Discogenic Low Back Pain: Preliminary Findings(Ivyspring Int Publ, 2011) Karaman, Haktan; Tufek, Adnan; Kavak, Gonul Olmez; Kaya, Sedat; Yildirim, Zeynep Baysal; Uysal, Ersin; Celik, FeyziStudy Design: Prospective observational study. Objective: Our aim is to investigate the efficacy and safety of TransDiscal Biacuplasty. Summary of Background Data: Chronic discogenic pain is one of the leading causes of low back pain; however, the condition is not helped by most non-invasive methods. The results of major surgical operations for these patients are unsatisfactory. Recently, attention has shifted to disk heating methods for treatment. TransDiscal Biacuplasty is one of the minimally invasive treatment methods. The method was developed as an alternative to spinal surgical practices and Intradiscal Electrothermal Therapy for treatment of patients with chronic discogenic pain. Methods: The candidates for this study were patients with chronic discogenic pain that did not res pond to conservative treatment. The main criteria for inclusion were: the existence of axial low back pain present for 6 months; disc degeneration or internal disc disruption at a minimum of one level, and maximum of two levels, in MR imaging; and positive discography. Physical function was assessed using the Oswestry Disability Index when measuring the pain with VAS. Patient satisfaction was evaluated using a 4-grade scale. Follow-ups were made 1, 3, and 6 months after treatment. Results: 15 patients were treated at one or two levels. The mean patient age was 43.1 +/- 9.2 years. We found the mean symptom duration to be 40.5 +/- 45.7 months. At the sixth month, 57.1% of patients reported a 50% or more reduction in pain, while 78.6% of patients reported a reduction of at least two points in their VAS values. In the final check, 78.6% of patients reported a 10-point improvement in their Oswestry Disability scores compared to the initial values. No complications were observed in any of the patients. Conclusions: TransDiscal Biacuplasty is an effective and safe method.Öğe A Case of Pneumothorax after Phrenic Nerve Block with Guidance of a Nerve Stimulator(Korean Pain Soc, 2011) Beyaz, Serbulent Gokhan; Tufek, Adnan; Tokgoz, Orhan; Karaman, HaktanHiccups have more than 100 etiologies. The most common etiology has gastrointestinal origins, related mainly to gastric distention and gastroesophageal reflux disease. Intractable hiccups are rare but may present as a severe symptom of various diseases. Hiccups are mostly treated with non-invasive or pharmacological therapies. If these therapies fail, invasive methods should be used. Here, we present a patient on whom we performed a blockage of the phrenic nerve with the guidance of a nerve stimulator. The patient also had pneumothorax as a complication. Three hours after intervention, a tube thoracostomy was performed. One week later, the patient was cured and discharged from the hospital. In conclusion, a stimulator provides the benefit of localizing the phrenic nerve, which leads to diaphragmatic contractions. Patients with thin necks have more risk of pneumothorax during phrenic nerve location.Öğe Caudal epidural block in children and infants: retrospective analysis of 2088 cases(K Faisal Spec Hosp Res Centre, 2011) Beyaz, Serbulent Gokhan; Tokgoz, Orhan; Tufek, AdnanBACKGROUND AND OBJECTIVES: Regional anesthesia is usually preferred as caudal block via the epidural space. However, the number of large-scale studies including pediatric caudal blocks is small. The objective of this study was to evaluate complications and side effects of local anesthetics and adjuvant drugs. DESIGN AND SETTING: Retrospective, descriptive study of cases occurring during the period December 2007 to October 2009. METHODS: Of 4815 medical records were screened, 2088 pediatric cases were identified and included in this study. RESULTS: As a local anesthetic, we preferred mostly levobupivacaine in 1669 (79.9%) patients and bupivacaine in 419 (20.1%) patients. As adjuvant drug, we preferred mostly morphine (41 patients), fentanyl (7 patients) and adrenaline (6 patients) in 54 (2.5%) patients. For general anesthesia induction, we preferred mostly propofol (1996 patients, 94.2%); for maintenance, sevoflurane (1773 patients, 84.9%). For airway control, we preferred mostly the ProSeal laryngeal mask (PLMA), in 1008 (48.2%) patients. One thousand six hundred five (76.9%) patients were from outpatient clinics and 483 (23.1%) patients were from inpatient clinics. No permanent complication was encountered after caudal blocks. CONCLUSION: We conclude that caudal epidural blocks are a safe and effective method for subumbilical day-case pediatric surgeries when performed by anesthetists.Öğe The comparison of neuroprotective effects of intrathecal dexmedetomidine and metilprednisolone in spinal cord injury(Elsevier Science Bv, 2013) Celik, Feyzi; Gocmez, Cuneyt; Kamasak, Kagan; Tufek, Adnan; Guzel, Abdulmenap; Tokgoz, Orhan; Firat, UgurBackground: The purpose of this study is the investigation of the effects of intrathecally injected dexmedetomidine and methylprednisolone and their dominancy over one another in rats with generated Spinal Cord Injury (SCI). Methods: 40, female, adult Wistar Albino rats weighing 220-260 g were included in the study. The rats were fixed with Intrathecal catheter (IT) and divided into four groups. All subjects were applied T7-10 laminectomy after catheter. Group S (n:10) was injected with IT 10 mu L isotonic saline; Group C (n: 10) with IT 10 mu L isotonic saline after SCI; Group D (n:10) with IT one doze 10 mu L of dexmedetomidine after SCI; Group M (n:10) IT one dose 10 mu L of methylprednisolone. The subjects were sacrificed 72 h after this operation. The damaged area was removed biochemically and histopathologically examined. Results: Antioxidant and inflammatory parameters searched for in all damages tissue were statistically different in all groups from group S. They were different in group M and group D than group C (p < 0.001). After the comparison of group D and group M, PON and IL6 values were higher in group D (p = 0.003, p = 0.035) while the other two biochemical parameters were similar in both groups (Table 1). After histopathologic trials, edemas, bleeding and necrosis were found less in group S while at the most in group C (p < 0.001). In group M and group D, however, they were higher than group S and lower than group C (p < 0.001). After the comparison of group D and group M, while there was no difference in terms of edema necrosis, the amount of bleeding was lower in group D (p < 0.001) (Table 2). Conclusions: It has been discovered that intrathecal use of dexmedetomidine caused neuroprotective effects similar to methylprednisolone. (C) 2013 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.Öğe Comparison of the effectiveness of intrathecal bupivacaine and Levobupivacaine in hip surgery(Slovene Medical Soc, 2013) Celik, Feyzi; Karaman, Haktan; Tufek, Adnan; Kavak, Gonul Olmez; Yildirim, Zeynep Baysal; Tokgoz, Orhan; Guzel, AbdulmenapPurpose: We aimed to compare the anesthetic and hemodynamic effects of intrathecally administered levobupivacaine and bupivacaine in combination with fentanyl in hip surgery. Subjects and methods: Sixty patients categorized as class 1 or 2 according to the American Society of Anesthesiologists (ASA) Physical Status classification, aged between 18 and 65 years and scheduled for hip surgery were randomly assigned to two groups. Patients in Group I received spinal anesthesia with 0.5 % bupivacaine 12.5 mg + fentanyl 10 mu g (total 2.6 ml), and patients in Group II received 0.5 % levobupivacaine 12.5 mg + fentanyl 10 mu g (total 2.6 ml) intrathecally. The level of sensory block and motor block was evaluated, and hemodynamic data were recorded. Results: The onset of sensory block and the time to two-segment regression were similar between the two groups. In the levobupivacaine group, the time to motor block onset was longer and the motor block regression time was shorter than that of bupivacaine group. The groups were similar with respect to hemodynamic data. Conclusion: We consider that levobupivacaine may be a good alternative to bupivacaine, particularly in surgical procedures where less motor block development is desired.Öğe Comparison of the efficacies of I-gel™ and LMA-ProSeal™ for airway management in pediatric patients(Tubitak Scientific & Technological Research Council Turkey, 2013) Tokgoz, Orhan; Tufek, Adnan; Beyaz, Serbulent Gokhan; Yuksel, Mustafa Ugur; Celik, Feyzi; Aycan, Ilker Onguc; Guzel, AbdulmenapAim: The present study was performed to compare the performance of I-gel (TM) with LMA-ProSeal (TM) in children undergoing anesthesia. Materials and methods: A total of 185 patients who were scheduled for elective surgery in Dicle University's hospital were randomly divided into 2 groups: the I-gel (TM) group (Group-I, n = 95) and the p-LMA (TM) group (Group-P, n = 90). Airway leakage pressure, insertion time, fiberoptic laryngeal image scores, ease of insertion, and possible complications were compared between these groups. Results: The airway leakage pressure of Group-I was significantly higher than that of Group-P (means +/- SD: 28 +/- 5 vs. 20 +/- 4 cmH(2)O, P < 0.01). The duration of supraglottic airway device insertion was shorter in Group-I than Group-P (19 +/- 4 vs. 28 +/- 5 s, P < 0.01). The overall success rate was 95% for Group-I and 94% for Group-P (P = 0.10). The I-gel provided a better view of the glottis than the p-LMA (93% of cases in Group-I and 68% of cases in Group-P, P = 0.03). There were no significant differences with regard to ease of insertion (P = 0.97). Conclusion: This study suggested that I-gel is an effective and safe alternative supraglottic airway device for use in children.Öğe The Complications of Transforaminal Lumbar Epidural Steroid Injections(Lippincott Williams & Wilkins, 2011) Karaman, Haktan; Kavak, Gonul Olmez; Tufek, Adnan; Yildirim, Zeynep BaysalStudy Design. A prospective observational study. Objective. In this study, we aimed to investigate the major and minor complications of transforaminal lumbar epidural steroid injections guided by fluoroscopy and the incidence of vascular penetration encountered during this procedure. Summary of Background Data. Epidural steroid administration is one of the treatment options for lumbar disc hernia accompanied by radiculopathy. This method, initially applied by blind interlaminar technique, has generally been performed by fluoroscopically guided transforaminal method now. The complications of this method cause to a serious concern. The complications of this intervention have been reported by either mostly retrospective studies or case reports until now. Prospective studies with large patient series are needed to determine the types and incidences of the complications. Methods. In this study carried out for more than 5 years, major and minor complications of transforaminal lumbar epidural steroid injections were investigated prospectively. All of the interventions were performed under fluoroscopic guidance by the same physician using a standardized method. A follow-up was made once in the third week. The complications encountered during the procedure and in the third week were prospectively recorded. In addition, the incidence of vascular penetration that is potentially hazardous is included in the study. Results. A total of 562 patients were performed 1305 times transforaminal lumbar epidural steroid. The overall incidence of vascular penetration encountered was 7.4%. Although major complications were not seen, the total rate of all minor complications was 11.5%. Whereas all of the minor complications were transient, the most frequent minor complication was vasovagal reaction (8.7%). Conclusion. On the basis of the results of this study in which only minor complications were encountered, it can be said that the frequency of major complications is pretty rare in transforaminal lumbar epidural steroid injections in expert hands and in the conditions in which safety precautions are taken.Öğe Cooled radiofrequency application for treatment of sacroiliac joint pain(Springer Wien, 2011) Karaman, Haktan; Kavak, Gonul Olmez; Tufek, Adnan; Celik, Feyzi; Yildirim, Zeynep Baysal; Akdemir, Mehmet Salim; Tokgoz, OrhanBackground The unavailability of an effective and long-lasting treatment for sacroiliac-based pain has led researchers to study the efficacy of radiofrequency in denervation. In this study, we aimed to investigate the efficacy and safety of novel cooled radiofrequency application for sacral lateral-branch denervation. Methods Patients experiencing chronic sacroiliac pain were selected for our observational study. Fluoroscopy guidance cooled radiofrequency denervation was applied on the L5 dorsal ramus and the S1-3 lateral branches on patients who had twice undergone consecutive joint blockages to confirm the diagnosis and obtained at least 75% pain relief. At the 1st, 3rd and 6th month postoperatively, the patients' pain was evaluated using a visual analog scale (VAS), and their physical function was evaluated with the Oswestry Disability Index (ODI). Results Cooled radiofrequency was applied on a total of 15 patients. Prior to the procedures, the median VAS score (interquartile range) was 8 (7-9), but at the 1st, 3rd and 6th month, this had fallen to 3 (1-4), 2 (1-3) and 3 (2-4). The baseline median ODI score (interquartile range) was 36 (32-38), while at the 1st, 3rd and 6th month, it was 16 (820), 12 (9-18) and 14 (10-20), respectively. At the final control, while 80% of the patients reported at least a 50% decline in pain scores, 86.7% of those reported at least a ten-point reduction in ODI scores. Conclusion It was seen that the cooled radiofrequency used for sacroiliac denervation was an effective and safe method in the short to intermediate term.Öğe Current attitudes of Turkish anesthesiologists to radiation exposure(Springer Japan Kk, 2013) Tufek, Adnan; Tokgoz, Orhan; Aycan, Ilker Onguc; Celik, Feyzi; Gumus, AbdurrahmanPurpose The aim of this study was to investigate the attitudes of anesthesiologists to radiation exposure and current safety practice in Turkey. Methods The study enrolled anesthesiologists from all over Turkey, including all levels of academic degrees and all types of different institutions. Questionnaire forms were sent via e-mail to 505 anesthesiologists. The survey collected demographic data such as age, gender, position, and the institution at which the participant worked, and data about the frequency of radiation exposure during procedures and the participant's attitudes concerning radiation safety measures during these procedures. Results The questionnaire forms were delivered to 491 anesthesiologists, and 301 (61.3 %) of these were returned. Of these, 9 had not completed the questionnaire because of a lack of exposure to radiation. Among the remaining 292 personnel, the weekly frequencies of radiation exposure were more than five times (36.7 %), one to five times (50.3 %), and less than once (13 %) per week, respectively. Only a few anesthesiologists regularly wore a lead apron (30.11 %) and a thyroid shield (11.3 %) during procedures involving radiation exposure. Conclusions This study demonstrated that nearly all anesthesiologists are regularly exposed to radiation and that few anesthesiologists in Turkey wear protective clothing, which is essential for radiation protection. Therefore, if it is not, increasing awareness about radiation protection should be an integral part of medical training and education.Öğe Demographical Features of Patients with Suicidal Drug Intoxication, Glasgow Coma Scale and Revised Trauma Score Relationship with Mortality(Aves, 2012) Ozhasenekler, Rojsin A.; Karaman, Haktan; Kavak, Gonul O.; Tufek, Adnan; Yildirim, Zeynep; celik, Feyzi; Tokgoz, OrhanObjective: It is aimed in this study to analyze whether a relationship exists between mortality and demographical features, Glasgow coma scale (GCS) plus revised trauma scores (RTS) of inpatients diagnosed with suicidal drug intoxication. Material and Methods: Files of a total of 120 patients admitted in the reanimation unit because of suicidal drug intoxication whose data we could access were analyzed retrospectively. Results: 75.8% (n=91) of our patients were female while female/male ratio was 3.13/1. The average age of our patients was 25.18 +/- 10.26 years whereas mean arterial blood pressure, mean pulse rate and mean respiratory rate were 85.09 +/- 18.08 mmHg, 105.25 +/- 27.07 and 11.54 +/- 4.39, respectively. Mean GCS and RTS values of our patients on initial admission were 10.48 +/- 3.34 and 6.52 +/- 1.20, respectively. Mean duration of hospital stay of our patients was 6.43 +/- 14.2 days. 64 of our patients (53.3%) ingested a tricyclic antidepressant, while 22 (18.3%) took organic phosphorus. 33 (27.5%) cases were multipledrug intoxication. 37 patients (30.8%) required mechanical ventilation support and mean duration of follow-up under mechanical ventilation support was found to be 2.39 +/- 9.08 days. 11 of our patients (9.1%) died. A statistically significant relationship was found not only between mortality and organic chlorine (p=0.002) plus TCA intoxication (p=0.003), but also between mortality and GCS (p<0.001) plus RTS (p=0.003). Conclusion: Since suicidal drug intoxications are among important issues faced in the emergency room and intensive care units, it was concluded that physiological scoring systems used for initial assessment and follow-up, as well as the kind of drug taken had impacts on mortality.Öğe The effect of I-gel™ airway on intraocular pressure in pediatric patients who received sevoflurane or desflurane during strabismus surgery(Wiley-Blackwell, 2012) Sahin, Alparslan; Tufek, Adnan; Cingu, Abdullah Kursat; Caca, Ihsan; Tokgoz, Orhan; Balsak, SelahattinObjectives: The aim of this study was to investigate the effect of I-gelTM laryngeal mask airway on intraocular pressure (IOP) in children with strabismus undergoing balanced anesthesia with sevoflurane or desflurane. Methods: Forty-seven children, ASA physical status I, were scheduled for elective strabismus surgery. Patients were randomly assigned to one of the two inhalation anesthetic groups. Sevoflurane group comprised of 27 children, and desflurane group comprised of 20 children. Anesthesia was induced and maintained with sevoflurane or desflurane. No muscle relaxant was used. IOPs were measured before anesthesia, at 2 and 5 min after insertion of I-gelTM and after removal of I-gelTM. IOP measurements were obtained by Tonopen (R). Results: Intraocular pressure significantly decreased 2 min after insertion of I-gelTM in both sevoflurane and desflurane groups (P < 0.001). Measurements 5 min after I-gelTM insertion were also significantly lower than those of before insertion in both groups (P < 0.01). However, no significant differences were found between the preoperative measurement and the measurement after removal of I-gelTM within two groups (P = 0.072 and P = 0.547, respectively). No significant differences were found in all IOP measurements between sevoflurane and desflurane groups. Conclusion: Insertion of I-gelTM laryngeal mask airway with giving sevoflurane or desflurane inhalation anesthetics seemed not to cause any increase in IOPs in pediatric ophthalmic surgery.Öğe Effectiveness of nucleoplasty applied for chronic radicular pain(Int Scientific Information, Inc, 2011) Karaman, Haktan; Tufek, Adnan; Kavak, Gonul Olmez; Yildirim, Zeynep Baysal; Temel, Vildan; Celik, Feyzi; Akdemir, Mehmet SalimBackground: Over the last several decades there has been a general trend toward reduction and minimalization in surgical treatment of chronic back pain, since open surgery brings complications in small and contained disc herniations instead of achieving expected success. Attention has been focussed on percutaneous nucleoplasty due to the limited success of other minimally invasive methods, as well due to their associated complications. However, there have been few studies in the English literature with a follow-up period of more than I year. Material/Methods: Patients with chronic disc herniations having more significant radicular leg pain, who did not respond to non-invasive treatment methods and for whom open surgery was not an option were selected for percutaneous nucleoplasty application. Upon intervention, patients were prospectively questioned by an independent physician regarding pain, physical improvement, and operation satisfaction at 1, 6, 12 and 24 months. Pain was evaluated with VAS, and physical improvement was evaluated based on the Oswestry Disability Index. Results: Mean VAS that was 8.7 +/- 1.1 before the procedure was determined to be 3.4 +/- 1.9 at 24 months follow-up. At the latest follow-up, 87.5% of the patients reported a 30% or higher decrease in their pain. While Oswestry scores were 76.1 +/- 10.2 in the beginning, they went down to 33.9 +/- 14.9 at the end of 2 years. The percent of those stating good and excellent satisfaction was 66% (23 persons) on the last follow-up. Conclusions: While it is once more shown that nucleoplasty is a safe method, it is also shown that its effectiveness continues at the end of 2 years.Öğe Efficacy of transforaminal lumbar epidural steroid injections in patients with lumbar radiculopathy(Kare Publ, 2012) Cetin, Mehmet Fatih; Karaman, Haktan; Kavak, Gonul Olmez; Tufek, Adnan; Yildirim, Zeynep BaysalObjectives: This study looks into the efficacy and safety of the transforaminal lumbar epidural steroid injection (TLESI) applied to patients with radiculopathy due to lumbar disk herniation. Methods: The patients' files which were applied TLESI, were retrospectively scanned. Patients who did not respond to one-month conservative treatment and who were detected to have bulging or protruding lumbar disk herniation as a result of imaging methods were included in the study. All applications were performed with C-arm fluoroscopy under local anesthesia by outpatient method. In all cases, a mix of 80 mg triamsinolone and 0.25% bupivacaine, was transforaminally injected to the anterior epidural area. Initial VAS pain scores were compared with the values of the 1, 3 and 6th months after the application. Patient satisfaction was determined through scoring. Furthermore, early and late term complications were collected for evaluation. Results: A total of 222 patients were administered TLESI 460 times (average: 2.1, repeat interval: 1-6 times). The applications were carried out most frequently at the levels of L4-L5 and L5-S1. While the initial VAS score average was 8.2 +/- 0.7, after TLESI, it was 5.0 +/- 1.6, 4.8 +/- 1.5 and 5.1 +/- 1.5 in the 1, 3 and 6th months, respectively. 63.9% of the patients (n=142) defined the treatment as 'good and excellent'. No major complications were experienced and the overall minor complication rate was 11.1%. Conclusion: It was seen that TLESI was an efficient and safe method in the short and medium term.Öğe Ellagic acid attenuates oxidative stress on brain and sciatic nerve and improves histopathology of brain in streptozotocin-induced diabetic rats(Springer-Verlag Italia Srl, 2012) Uzar, Ertugrul; Alp, Harun; Cevik, Mehmet Ugur; Firat, Ugur; Evliyaoglu, Osman; Tufek, Adnan; Altun, YasarThe aim of this study was to investigate the possible effects of ellagic acid in brain and sciatic nerve tissues of diabetic rats. Also, the impact of ellagic acid on catalase and paraoxonase (PON-1) activities, total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI), malondialdehyde (MDA) and nitric oxide (NO) were examined. The rats were randomly divided into four groups, with eight rats each: Normal controls (not diabetic), only ellagic acid treated (ellagic acid controls, not diabetic), Diabetic controls (streptozotocin, diabetic), ellagic acid-treated diabetic (streptozotocin + ellagic acid). After a 4 week experiment, rats were sacrificed, and biomarkers for oxidative stress in the brain and sciatic nerve tissues of the rats were measured. There was significant depletion in the PON-1, catalase, and TAS levels in the brain and sciatic nerve tissues compared to the control groups (for both parameters, p < 0.05). The values of catalase, PON-1 and TAS reversed back to normal levels in ellagic acid-treated diabetic rats compared to untreated diabetic rats (for both parameters, p < 0.05). The levels of MDA, TOS, NO and, OSI in the brain and sciatic nerve tissues were higher in untreated diabetic rats compared to control group (for both parameters p < 0.05). However, MDA, TOS, OSI, and NO levels were found to be significantly reduced in the ellagic acid-treated diabetic group compared to the untreated diabetic group in these tissues (for both parameters, p < 0.05). In conclusion, the results of the present study suggested that ellagic acid exhibits neuroprotective effects against oxidative damage in diabetic rats.Öğe Evaluation of retrograde intubation in patients with limited mouth opening(Springer Japan Kk, 2013) Tufek, Adnan; Ucan, Musa Can; Tokgoz, Orhan; Celik, Feyzi; Agacayak, Serkan[Abstract Not Available]Öğe Inhalation Anesthesia with Sevoflurane during Intravitreal Bevacizumab Injection in Infants with Retinopathy of Prematurity(Hindawi Ltd, 2013) Tokgoz, Orhan; Sahin, Alparslan; Tufek, Adnan; Cinar, Yasin; Guzel, Abdulmenap; Ciftci, Taner; Celik, FeyziBacground. To investigate the anesthetic management in premature infants with retinopathy of prematurity (ROP) treated with intravitreal bevacizumab (IVB) injections. Methods. A retrospective chart review was performed for the patients with ROP who had IVB injection. Clinical characteristics, demographic variables, anesthetic medications, operation techniques, time intervals, and complications were recorded. Results. Sixty-six eyes of 33 patients (23 males, 10 females) with type 1 ROP who were treated with IVB were included. A total of 66 anesthetic applications were performed. Mean gestational age at birth was 28.3 weeks (range 25-33). Mean birth weight was 1300 g (range 600-1850). Serious ocular and systemic complications were not observed in any infant. Conclusion. Inhalation anesthesia with sevoflurane during IVB treatment in premature infants with ROP may be appropriate for anesthetic management.Öğe Intra-articularly applied pulsed radiofrequency can reduce chronic knee pain in patients with osteoarthritis(Lippincott Williams & Wilkins, 2011) Karaman, Haktan; Tufek, Adnan; Kavak, Gonul Olmez; Yildirim, Zeynep Baysal; Uysal, Ersin; Celik, Feyzi; Kaya, SedatBackground: Osteoarthritis (OA) is the most widespread chronic joint disease worldwide. Symptomatic knee OA is observed in approximately 12% of individuals more than 60 years of age. Conservative treatments models may not be effective always, and that some of them have serious adverse effects that prompted the researchers to research different treatment methods. In this study, we investigated short- and mid-term effectiveness of intra-articular pulsed radiofrequency (PRF) applied in patients with chronic knee pain due to OA. Methods: This study was carried out in the pain management center of a university hospital between January 2009 and June 2009. The patient record files of 31 patients who received intra-articular PRF were retrospectively reviewed. The antero-lateral area of the knee, where the intervention would be applied, was anesthetized with 1% lidocaine. An introducer needle was placed intra-articularly. PRF was started as 42 degrees C at 2 Hz for 15 minutes. The pain of the patients was evaluated by 10 cm Visual Analog Scale (VAS). Furthermore, the ages, the gender, the symptom duration of the patients, the side of the knee on which the intervention was applied, and the complications were collected for statistical evaluation. Results: Although the mean initial VAS scores of the patients were 6.1 +/- 0.9 cm, it was found, respectively, to be 3.9 +/- 1.9 cm and 4.1 +/- 1.9 cm at the first- and sixth-month follow-ups. In general, a decrease of 32.8% in mean in the VAS scores was achieved in the last follow-up; whereas the rate of patients reporting a minimum decrease of 2 points in the VAS scores was 64.5% and the rate of patients reporting a decrease of >= 50% in their pain was calculated as 35.5%. Conclusion: PRF applied to the knee joint appears to be an effective and safe method. Copyright (C) 2011 Elsevier Taiwan LLC and the Chinese Medical Association. All rights reserved.Öğe Magnetic Resonance Imaging in Children under Anesthesia: The Relationship between the Degree of Information Provided to Parents and Parents' Anxiety Scores(Hindawi Ltd, 2014) Guzel, Abdulmenap; Atli, Abdullah; Dogan, Erdal; Celik, Feyzi; Tufek, Adnan; Dusak, Abdurrahim; Sen, VelatBackground. We aimed to investigate the correlation between the anxiety scores of parents whose children are administered anesthesia for magnetic resonance imaging (MRI) and the level of information provided to them before the MRI. The study included 146 children and their parents. The demographic information of the children and their parents was recorded. The parents were divided into two groups. In Group I, the patient's medical history and physical exam findings were recorded on a standard consultation form by an anesthesiologist. In Group II, the parents were additionally provided with more detailed information on how the anesthesia would be administered and the drugs to be used and their side effects and complications. The anxiety scores of the parents were found to be lower in Group II. A higher level of education was associated with higher anxiety scores. Intergroup comparison detected lower anxiety scores for Group II parents whose education levels were up to high school. However, no change upon receiving detailed information was detected in the anxiety scores of parents with higher education levels. In conclusion, this may lower the anxiety scores in parents informed about details of anesthesia administration and may raise parents' sense of confidence in the doctor.Öğe Opioids Inhibit Angiogenesis in a Chorioallantoic Membrane Model(Am Soc Interventional Pain Physicians, 2017) Karaman, Haktan; Tufek, Adnan; Karaman, Evren; Tokgoz, OrhanBackground: Angiogenesis is an important characteristic of cancer. Switching from the avascular phase to the vascular phase is a necessary process for tumor growth. Therefore, research in cancer treatment has focused on angiogenesis as a drug target. Despite the widespread use of opioids to treat pain in patients with cancer, little is known about the effect of these drugs on vascular endothelium and angiogenesis. Objectives: We aimed to investigate the efficacies of morphine, codeine, and tramadol in 3 different concentrations on angiogenesis in hens' eggs. Study Design: This is a prospective, observational, controlled, in-vivo animal study. Setting: Single academic medical center. Methods: This study was conducted on the chorioallantoic membrane (CAM) of fertilized hens' eggs. The efficacies of morphine, codeine, and tramadol in 3 different concentrations were evaluated on angiogenesis in a total of 165 hens' eggs. Results: Statistically significant differences were found between drug-free agarose used as a negative control and concentrations of morphine of 10 mu M and 1 mu M, a concentration of tramadol of 10 mu M, and concentrations of codeine of 10 mu M and 1 mu M. Concentrations of morphine of 10 mu M and 1 mu M showed strong antiangiogenic effects. While codeine had strong antiangiogenic effects at high concentrations, at 0.1 mu M it was shown to have weak antiangiogenic effects. However, tramadol at a concentration of 10 mu M had only weak antiangiogenic effects. Limitations: This is just a CAM model study. Conclusion: In this study, we tested the effects of 3 different opioid drugs on angiogenesis in 3 different concentrations, and we observed that morphine was a good anti-angiogenic agent, but tramadol and codeine only had anti-angiogenic effects at high doses.Öğe Our percutaneous vertebroplasty applications in vertebral compression fractures(Kare Publ, 2012) Karaman, Haktan; Kaya, Sedat; Tufek, Adnan; Olmez Kavak, Gonul; Baysal Yildirim, Zeynep; Celik, Feyzi; Akdemir, Mehmet SalimObjectives: We aimed to investigate the effectiveness and complications of the percutaneous vertebroplasty (PVP) applications in vertebral compression fractures. Methods: Our study was carried out as a retrospective study in which PVP was conducted on patients with vertebral compression fractures due to benign or malignant causes between October 2006 and December 2009. The patients' pain was evaluated on a visual analog scale ( VAS). In addition, the amount of cement injected, whether or not any leakage from the vertebrae corpus was seen, and any complications resulting from the application during or after the operation were recorded. The age and gender of the patients, duration of pain, number and location of fractured vertebrae, and the duration of follow-up were also collected for evaluation. Results: A total of 15 patients were included in the assessment. Of the patients, 13 were female, and the mean age was 69.5 +/- 8.5 years. A total of 19 PVPs were applied to the 15 patients. While initial VAS scores were 7.9 +/- 1.6, at the end of an average of 10.3 +/- 3.8 ( range: 4-18) months of follow-up, VAS scores had fallen to 2.6 +/- 2.7. 80% of the patients reported at least a 50% reduction in pain scores compared to initial scores, and 86.7% of them reported at least a 2-point decrease in VAS scores. In three patients, leakage of cement into the intervertebral disc occurred. Conclusion: PVP may be used successfully in symptomatic vertebral compression fractures not responding to medical treatment, with a low rate of complications.
