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Öğe Acute stress disorder and post-traumatic stress disorder following traumatic amputation.(2010) Copuroglu C.; Ozcan M.; Yilmaz B.; Gorgulu Y.; Abay E.; Yalniz E.Traumatic amputations are important causes of acute stress disorder and post-traumatic stress disorder. In this study, we aimed to find out the occurrence rate of symptoms of acute and post-traumatic stress disorder after traumatic amputations and according to this, to assess the psychiatric status of the patients in the postoperative period. Twenty-two patients with traumatic limb amputation who were treated in our institution were retrospectively evaluated. During the early post-traumatic period, the patients were observed to determine whether they needed any psychiatric supportive treatment. During the follow-up period, after the sixth month from the trauma, the patients were referred to the psychiatry department and they were evaluated to determine whether they needed any psychiatric supportive treatment, by clinical psychiatric examination and use of the 'post-traumatic stress disorder scale' (Clinician Administered Post traumatic Scale, or CAPS). Twenty-one (95.5%) of 22 patients were male, one (4.5%) female. Mean age of the patients was 40.8 years (range: 15 to 69). During the early posttraumatic period, 8 (36.3%) of these patients consulted the psychiatry clinic following the orthopaedists' observations. Five (22.7%) of these patients needed psychiatric supportive treatment for acute stress disorder. After the 6th month (6 months to 5 years), 17 (77.2%) had chronic and delayed post-traumatic stress disorder and needed psychiatric supportive treatment. Patients who have sustained a traumatic amputation may need psychiatric supportive treatment in the late period after the trauma. As we orthopaedic surgeons treat these patients surgically, we should be aware of their psychiatric status.Öğe An analysis of genetic transmission in a father and son with osteosarcoma(2006) Tokatli F.; Alas R.C.; Altaner S.; Pala F.; Uygun K.; Uzal C.; Yalniz E.Familial osteosarcoma is a rare hereditary disease. We present a 37-year-old father and a 17-year-old son who developed osteosarcoma in the left and right distal femurs, respectively, at a three-year interval. They were treated with chemotherapy followed by surgery. Both had positive immunostaining for p53 tumor suppressor gene and HER-2/neu oncogene. The son also exhibited deletion of the retinoblastoma 1 gene. Pulmonary metastasis was detected in the father at the time of diagnosis and 13 months after primary treatment, whereas no distant metastasis was present in the child. The father died 39 months after the diagnosis from primary symptoms, but the son led a disease-free survival a year after completion of treatment. Genetic abnormalities documented in the father and son corroborate the presence of specific genetic alterations in the pathogenesis of osteosarcoma.Öğe A case of hydatid disease of the spine(1994) Yalniz E.; Er T.Hydatid disease of the spine is uncommon with a poor prognosis. We presented a patient who had a hydatid disease of twelfth thoracic vertebra without neurological finding. He was treated by multiple surgical drainage additing medical treatment with mebendazole.Öğe The comparison of the effects of bupivacaine+morphine and bupivacaine+clonidine in vertebral surgery(2000) Alagol A.; Evis M.; Memis D.; Yalniz E.; Pamukcu Z.In this study, for postoperative pain management of 40 patients who were operated for lumbal scoliosis, spondylolystesis and spondylolysis, a catheter was placed into the epidural space, during intraoperative period. By this way bupivacaine+morphine or bupivacaine+clonidine were administered and compared for analgesic, haemodynamic and side effects. In all patients premedication, induction and maintenence of anesthesia were similar. After awakening and neurologic examination, in group I, patients received bupivacaine % 0.125+morphine 2 mg; in group II; bupivacaine % 0.125+1 mcg/kg clonidine; in 10 ml volume of % 0.9 NaCl, via the catheter. Pain (NRS), haemodynamic, respiratory and side effects were noted at: the begining of the postoperative period (0. min.), 30. min. and 1., 2., 6., 12. and 24. hours respectively. 2 mg of morphine was applied from the catheter when needed and total morphine requirements were noted. Data were evaluated statistically; while NRS and haemodynamic results were lower in group II, respiratory values were equal. Analgesia time and side effects were higher in group I. In conclusion, as both combinations were effective and safe in postoperative pain management via an epidural catheter, bupivacaine+clonidine may be an alternative to morphine+bupivacaine.Öğe Fibrous dysplasia of the spine with sarcomatous transformation: a case report and review of the literature(Springer-Verlag, 1995) Yalniz E.; Er T.; Özyilmaz F.A fibrosarcoma is reported in the spine of a 53-year-old man with polyostotic fibrous dysplasia. There was no history of endocrine disturbances and no previous irradiation. Malignant transformation in fibrous dysplasia is rare. A review of the literature reveals 101 cases of malignant degeneration occurring in fibrous dysplasia. We believe that this is the first report of sarcomatous change arising in an area of fibrous dysplasia in the spine. © 1995 Springer-Verlag.Öğe Gorham-Stout disease of the humerus(2008) Yalniz E.; Alicioglu B.; Benlier E.; Yilmaz B.; Altaner S.Gorham-Stout disease is characterized by local proliferation of small vascular or lymphatic channels resulting in progressive destruction and resorption of bone. The etiology and pathogenesis of the disease remains mostly unknown, despite some 175 reported cases. A case of Gorham-Stout disease of the humerus in a 14-year-old boy is described. The patient presented with progressive pain and deformity of the right arm. Although the disease was described in different bones of the body its location in the humerus is rare. We report the natural history and clinical follow-up in a young patient. A fibular graft was performed but 10 months later, resorption and pathological fractures occurred again. This study presents the radiographic and MRI features of Gorham disease.Öğe Long-term changes in L5-S1 disks under the fusion region and the effect of sagittal balance on degeneration(Lippincott Williams and Wilkins, 2016) Yilmaz B.; Kömür B.; Alicio?lu B.; Çiftdemir M.; Özcan M.; Çopuro?lu C.; Yalniz E.Background: The aim of this study was to radiologically assess long-term degeneration in the L5-S1 disks under the fusion region and to research its association with clinical signs in patients with degeneration. Methods: This study evaluated 23 patients who underwent spinal fusion between January 1994 and July 2005. Degeneration in the L5-S1 disks was assessed radiologically over a long-term 10-year follow-up period, and those cases that showed degeneration were further assessed using the Japan Orthopedic Association score and visual analog scale (VAS). Results: Seven of the cases had mild osteophyte development according to radiographic findings. A statistically significant decrease was observed in the front and back disk heights between the preoperative and postoperative measurements (P=0.001 and 0.000). A statistically significant decrease was also observed in the anterior and posterior disk height between the preoperative and postoperative measurements (P=0.007 and 0.007). A significant difference was observed in disk degeneration and facet joint degeneration (P=0.000 and 0.000). On evaluation of radiologic assessments, degeneration was observed in 15 cases (65.3%). Clinical assessment of the cases revealed that 6 patients (26.0%) with radiologic degeneration had lumbar pain of varying degrees, 3 of whom also had pain that spread to the legs; 1 of these caused loss of sensation in the leg. Clinical assessment of pain levels using VAS scoring for all cases revealed an average preoperative score of 8.71, an average early postoperative VAS score of 2.14, and an average long-term follow-up score of 3.35. The recovery rate of the patients was found to be 37.5%, according to Japan Orthopedic Association scoring. The pain level of the patients decreased by almost 4-fold in the postoperative early period and 2.5-fold in the long term. Conclusions: Spinal fusion surgery is an effective treatment method in terms of its clinical results, despite the adjacent segment degeneration that may be identified radiologically in the long term. © 2014 Wolters Kluwer Health, Inc.
