Nurzat Elmali

Inonu University, Malatia, Malatya, Turkey

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Publications (23)25.68 Total impact

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    ABSTRACT: Hyperlipidemia is a major risk factor for coronary heart disease. The most commonly used antihyperlipidemic drugs are 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase inhibitors (statins), of which atorvastatin is one of the most widely used. Little is known about the relationship between tendinopathy and HMG CoA reductase inhibitors (statins) or the effects of atorvastatin use on tendon healing following surgical repair of tendon rupture. We hypothesized that atorvastatin negatively affects this healing process. The Achilles tendons of 16 New Zealand rabbits were ruptured surgically and repaired with sutures. Eight of the rabbits were given oral atorvastatin. The other 8 served as a surgical control group. Six weeks postoperatively, all the rabbits were sacrificed, and the repaired tendons were removed. After standard histological preparation, fibroblastic activity, re-vascularization, collagenization, collagen construction, and inflammatory-cell infiltration were evaluated. On comparing the atorvastatin and surgical control groups, we observed no difference in fibroblastic activity. Although it did not reach statistical significance in our study, a difference was noted in revascularization, collagenization, and inflammatory cell infiltration; and a statistical difference was observed in collagen construction. Doubt remains about the adverse effect of atorvastatin use during tendon healing. Further investigations in animal and human models are needed on the effects of tendon healing when atorvastatin is administered for a longer time frame prior to the injury.
    Orthopedics 06/2010; 33(6):398. · 1.05 Impact Factor
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    ABSTRACT: Resveratrol, a polyphenol found in grape and red wine, was previously shown to have free radical scavenging and antioxidant properties in various tissues. In this study, the effects of resveratrol were investigated in muscle tissue concerning the ischemia reperfusion (I/R) injury of rat hindlimb. Arterial circulation of right hindlimbs of 24 Sprague-Dawley rats was ceased by a tourniquet applied for four hours (h). The tourniquet was released at the end of 4th hours and rats were divided into four groups of six rats. Then, extremity was reperfused for 4h in group I and for 8h in group II. Resveratrol in 0.5% ethyl alcohol was administered with a dose of 10 mg/kg in the treatment groups (group I and group II) intraperitoneally. Only 0.5% ethyl alcohol were administered in the control groups (group III and group IV) intraperitoneally. Gastrocnemius muscle was used for histological assessments and the anterior tibial muscle was used for measurement of malondialdehyde (MDA) levels. MN infiltration, edema, changes in diameters of muscle fibers and segmental necrosis were less prominent in rats treated with resveratrol compared with control groups (p<0.05). The MDA levels was significantly lower in treatment groups (p<0.05). The results suggest that resveratrol may protect the skeletal muscles against I/R injury with its potent antioxidant properties.
    Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery: TJTES 10/2007; 13(4):274-80. · 0.34 Impact Factor
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    ABSTRACT: The aim of this study was to investigate whether there is any significant bone loss of the ulna and radius following acute tendon-artery-nerve clean-cut injuries at the wrist level which were repaired and rehabilitated by early passive mobilisation. Fifty-eight patients who underwent such operation were enrolled in this study. Patients in Group I (n=28) had primary tendon repairs alone, in Group II (n=15) primary tendon and nerve repairs and in Group III (n=15) primary tendon, nerve and artery repairs. Bone mineral density (BMD) measurements of the ulna and radius were obtained during the first week, the sixth week, the third month and the 12th month after operation. The results demonstrated that BMD decrease in the ulna was more common than in the radius. When compared with the first week BMD measurements, the highest reduction was seen in the sixth week in Group I and during the third month, when bone loss of both the radius and ulna was considerable in Group II. The bone loss in all groups and subgroups were found to have recovered at the 12th month measurements, except in the distal region of the ulna in Group I. This study suggests that passive immobilisation is deleterious in respect of demineralisation of the forearm bones.
    Journal of Hand Surgery (European Volume) 07/2007; 32(3):320-5. · 1.22 Impact Factor
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    ABSTRACT: Nuclear factor kappa B (NF-kappaB), is a pivotal transcription factor involved in the activation of the TNF-alpha and IL-1beta genes. Activation of NF-kappaB in synovial cells is a feature seen in arthritis patients. Resveratrol, a polyphenolic, natural phytoalexin found with particularly high levels in grape skin and red wine is potent and specific inhibitor of TNF-alpha and IL-1beta induced NF-kappaB activation. We aimed to determine the in vivo effects of intra-articular injections of resveratrol on cartilage and synovium in an experimental rabbit inflammatory arthritis model. Arthritis was induced by intra-articular injection of three times of 50 mug lipopolysaccharide (LPS) at day 0, 4 and 8 at 4-day intervals into the knee joints of rabbits. To the test group, 10 muMol/kg resveratrol in the DMSO was injected in the knees at day 0 and then it was continued once daily for 2 weeks. To the control group the same time and amount of DMSO was injected the knees of rabbits. All rabbits were killed 1 week after the last injection and cartilage tissue and synovium were evaluated with semiquantitative scoring histologically. According to control group in the resveratrol group, significantly decreased cartilage destruction was determined by H&E staining (p = 0.04). Loss of matrix proteoglycan content in the cartilage was much lower, as determined by safranin O staining (p = 0.03). We also observed marked synovial inflammation after intra-articular injection to control knees, but not in the resveratrol treated group knees (p = 0.01). This study suggests that intra-articular injection of resveratrol may protect cartilage against the development of experimentally induced IA.
    Inflammation 05/2007; 30(1-2):1-6. · 2.46 Impact Factor
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    ABSTRACT: In this biomechanical study, 25 in vitro calf tibial models were used in order to compare the stability of the plates under axial compression loading. A 10-mm medial opening gap was stabilized in each of the five calf tibial models either with four or two-holed rectangular shaped plates with wedges, with four-holed reversed L-shaped plates with wedges, with the combination of these two types of plates, or with six-holed anatomical T-plates. The compression behavior of the model was tested by using a universal mechanical testing system. The specimens fixed with the combination of plates with the four-holed reversed L-shaped and with two-holed rectangular shaped; or with six-holed anatomical T-plates, showed significantly better stability than those of others. Four different kinds of failure (slippage of wedge, lateral cortex fracture, damage and/or loosening of screws, and bending of plates) were observed on the models. When the average value of force loading on the plates that were designed by the first author was considered, the plates were stable and the average force values at these points were higher than the loading force on a knee during the normal paced walking or running conditions.
    The Knee 02/2007; 14(1):46-50. · 2.01 Impact Factor
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    Irfan Esenkaya, Nurzat Elmali
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    ABSTRACT: Impaction fractures of the femoral head occurring after anterior or posterior hip dislocations are well described. However, locked posterior hip dislocation resulting in sinking of the posterior acetabular rim into the femoral head has hitherto been undescribed. A 26-year-old male patient presented with complaints of severe pain in the left thigh and marked limitation in the movements of the left hip two weeks after an in-car crash. He could only walk with crutches. Shortly after the accident, he was examined at another center with physical examination and plain radiographies and was given bed rest and medications for pain relief. Computed tomography demonstrated the locked posterior hip by the impact of the posterior acetabular rim against the femoral head. At surgery, the posterior acetabular rim was embedded in the anteromedial surface of the femoral head resulting in an osteochondral impaction fracture with a penetration depth of 12 mm. Due to wide destruction to the cartilage surface, an uncemented bipolar hemiarthroplasty was performed. After 28 months of follow-up, he had no complaints and hip movements were painless with full range of motion.
    acta orthopaedica et traumatologica turcica 02/2007; 41(2):155-8. · 0.60 Impact Factor
  • Irfan Esenkaya, Nurzat Elmali
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    ABSTRACT: We evaluated in this study indications, surgical technique, and results of wedge plates for fixation in proximal tibia medial opening wedge osteotomy. Fifty-eight knees in 56 consecutive patients (9 men, 47 women; mean age 52 years; ranging between 36 and 66 years) with medial compartment osteoarthrosis were treated with proximal tibia medial open-wedge osteotomy. For fixation, plates which were designed by the first author and which support the osteotomy surface with wedge-shaped projections were used. The plates were either rectangular in shape with two or four holes or had an inverse "L" shape with four holes, and had bearing metal wedges of varying heights from 5 to 15 mm. Tricortical (n=8) and bicortical (n=43) iliac bone autografts and allografts (n=7) were used. The average follow-up time was 21 months (ranging between 6 and 44 months). The mean preoperative tibiofemoral angle was 4.6 degrees varus (0 degrees -11 degrees ) while it was 5.6 degrees valgus (2 degrees -11 degrees ) postoperatively. The mean preoperative HSS score was 58 (range 51-75) and it was found 89 (range 79-96) postoperatively. As complications, lateral tibial plateau fracture in 5 knees (8.6%) and lateral cortex fracture in 15 knees (25.8%) were encountered during surgery. Deep vein thrombosis in two cases (3.4%) and nonfatal pulmonary embolism in one case (1.7%), delayed wound healing in two knees (3.4%), and delayed union as well as breakdown of a distal screw in one knee (1.7%) were encountered postoperatively. In conclusion, using wedge plates for fixation of proximal tibia medial opening wedge osteotomy in the treatment of medial osteoarthritis with unicompartmental involvement of the knee, provides adequate stabilization to allow early movement for functional rehabilitation and keeps the obtained correction level.
    Knee Surgery Sports Traumatology Arthroscopy 11/2006; 14(10):955-61. · 2.68 Impact Factor
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    ABSTRACT: Background: Studies in animal models for alcohol abuse have suggested that ethanol inhibits bone growth, decreases bone formation, and increases fracture risk.Methods: Experimental tibia fracture healing in rats fed a liquid diet containing 7.2% ethanol for 8 weeks was investigated with histological and osteodensitometric studies with respect to the control group. After 4 weeks of vitamin A– and sucrose-enriched milk containing 7.2% ethanol feeding, we created closed tibia fractures, which were then fixed with intramedullary nails, in 10 rats. After a follow-up time of 4 weeks, the rats were killed for examination. The same procedure was performed in another 10 rats, which were fed on the same diet (isocaloric modified liquid diet) but without ethanol and used as the control group. A histological scoring system was developed for fracture healing.Results: Histological evaluation of fracture region revealed an average fracture healing score of 1.9 in the ethanol-fed group versus 2.6 in the control group (p= 0.014). In the test group, dual-energy x-ray absorptiometry measurements in the fracture region showed a mean bone mineral density of 0.11 ± 0.03 g/cm2, whereas it was 0.130 ± 0.051 g/cm2 in the control group (p= 0.000). The mean bone mineral content in the fracture region was 0.103 ± 0.08 g/cm3 in the test group versus 0.128 ± 0.06 g/cm3 in the control group (p= 0.000). A significant correlation was found among histological scores, bone mineral density (r= 0.64, p= 0.04), and bone mineral content (r= 0.63, p= 0.04).Conclusions: This study showed that rats fed on a diet mixed with ethanol have a histologically delayed fracture healing associated with decreased bone density and mineral content. Besides the negative effects of ethanol on bone metabolism, it also interferes with the fracture-healing process.
    Alcoholism Clinical and Experimental Research 04/2006; 26(4):509 - 513. · 3.42 Impact Factor
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    ABSTRACT: Ochronotic spondylarthropathy, a long-term musculoskeletal manifestation of alkaptonuria and involvement of joints may lead to a radiographic appearance similar to that of degenerative joint disease. We report the cases of two siblings with progressive familial ochronotic arthropaty treated with total hip arthroplasty. La spondylarthropathie de l’ochronose, une manifestation musculo-squelettique à long terme d’alcaptonurie se traduit par des images radiologiques articulaires simulant une arthrose dégénérative. Nous rapportons ici deux cas d’enfants de mêmes parents, souffrant d’arthropathie ochronotique familiale progressive, traités par arthroplastie totale de hanches.
    European Journal of Orthopaedic Surgery & Traumatology 02/2006; 16(1):48-51. · 0.18 Impact Factor
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    ABSTRACT: We evaluated the dimensions and anatomic localization of the proximal tibiofibular joint (PTFJ) in human cadaver and amputated knees. In addition, we assessed the relation between the osteotomy line and the PTFJ and its vulnerability to injury on radiographs of patients after proximal tibial medial open wedge osteotomy (PT-MOWO). In the first phase, dimensions of the tibial part of the PTFJ lying between the lateral tibial condyle and the fibular head were measured by digital calipers in six human cadaver and six fresh amputed tibiae (4 females, 8 males; mean age 57 years) to evaluate the relation between the tibial surface of the PTFJ and the posterior part of the lateral tibial plateau. In the second phase, anteroposterior, lateral, and medial oblique radiographs were assessed with respect to the relation of the osteotomies with the PTFJ following PT-MOWO in 46 knees of 44 consecutive patients (38 females, 6 males; mean age 51 years). On cadaver and fresh amputation materials, the mean long and short axis dimensions of the ellipsoidal articular surface of the PTFJ in the posterolateral aspect of the tibial plateau measured 18.8 mm (range 13 mm to 20 mm) and 14.9 mm (13 mm-17 mm), respectively. The upper articular border lied at a mean of 6.3 mm (2 mm to 11 mm) distal to the posterior border of the articular surface of the lateral tibial plateau. Medial oblique radiographs showed that the osteotomy line extended to the PTFJ in cases in which it was proximally located, particularly in three cases (6.5%) where lateral cortex continuity was interrupted. The osteotomy line may encroach upon the PTFJ unless preoperative oblique radiographs are evaluated and a parallel course to the tibial slope of the lateral tibial plateau is followed. In addition, insufficient evaluation of PT-MOWO candidates may result in damage to the lateral cortex, which increases the risk for injury to the PTFJ.
    acta orthopaedica et traumatologica turcica 02/2006; 40(5):396-402. · 0.60 Impact Factor
  • European Journal of Orthopaedic Surgery and Traumatology - EUR J ORTHOP SURG TRAUMATOL. 01/2006; 16(1):48-51.
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    ABSTRACT: The aim of this study was to evaluate both the cortical and the medullary anterior bowing of the femur, and to compare these measurements with current intramedullary nails to assess the adequacy of their design. Lateral digital radiographic views of left femurs of 104 normal subjects (18-68 years old) were obtained. Radii of cortical and medullary curvatures of femurs were calculated using these images. The values obtained were compared to the radius of curvatures of ten different intramedullary nails. Medullary bowing was between 114 and 1,389 mm (mean: 722 mm, SD: 230 mm) and the cortical bowing was between 109 and 1,666 mm (mean: 770 mm, SD: 267 mm). For males, these values were 114-1,389 mm (mean: 722 mm, SD: 230 mm) and 109-1,666 mm (mean: 770 mm, SD: 267 mm), respectively. For females, they were 114-1,389 mm (mean: 722 mm, SD: 230 mm) and 109-1,666 mm (mean: 770 mm, SD: 267 mm), respectively. The differences between genders were not significant. Cortical and medullar bowing was strongly correlated with age (r=-0.269, p<0.006 and r=-0.234, p<0.017, respectively). These significances were produced by females only. Radii of curvatures of intramedullary nails ranged between 150 and 300 cm and were higher than the mean cortical (77 cm) and medullary (72.2 cm) bowings. The difference between the curves of femur and the contemporary femoral nails implicates the inadequacy of the design of such nails for the Caucasian race living in Anatolia. Therefore, such nails should be revised accordingly to prevent the above-mentioned complications.
    Surgical and Radiologic Anatomy 12/2005; 27(6):502-6. · 1.13 Impact Factor
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    ABSTRACT: Resveratrol (trans-3,4',5-trihydroxystilbene) is a phytoalexin found in high concentration in the skins of grapes and red wines which has been shown to have antiinflammatory, anticancerogen and antioxidant properties. Resveratrol is a potent and specific inhibitor of nuclear factor kappa B (NF-kappaB). Resveratrol also inhibits COX-2 gene expression and enzyme activity. We aimed to determine the in vivo effects of intra-articular injections of resveratrol on cartilage and synovium in an experimental osteoarthritis (OA) model in rabbits. As OA model, rabbits underwent unilateral anterior cruciate ligament transection (ACLT). Five weeks after test group was injected with 10 microMol/kg resveratrol in dimethylsulphoxide (DMSO) in the knees once daily for two weeks and as the control group at the same time DMSO was injected into the knees. All rabbits were killed one week after the last injection. Cartilage tissue and synovium were evaluated with a histological scoring system. Histological evaluation of cartilage tissue by H&E staining revealed a significantly reduced average cartilage tissue destruction score of 1.7 in the resveratrol group versus 2.8 in the control group (p = 0.016). Loss of matrix proteoglycan content in cartilage was also much lower, as determined by safranin O staining. Scores of synovial inflammation didn't show difference between groups (1.3 vs 2.2; p = 0.057). A characteristic parameter in arthritis is the progressive loss of articular cartilage. This study suggests that intraarticular injections of resveratrol starting at the onset of disease may protect cartilage against the development of experimentally induced OA.
    Inflammation Research 05/2005; 54(4):158-62. · 1.96 Impact Factor
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    ABSTRACT: We investigated thermal changes associated with the application of the Ilizarov transosseous wires, the extent of necrosis, and the factors affecting necrosis. We used a pair of tibiae from a 1-year-old cow. After removal of metaphyseal areas, each of four equal diaphyseal zones marked on both tibiae was drilled at 600, 900, 1,200 and 1,800 rpm, each time with a new wire. Heat changes were recorded with heat electrodes during the application and the speed of the wire was calculated. For histopathological examination, specimens were obtained at the access and exit sites to assess the extent of necrosis. Thermal changes between the zones and immediate and remote cortices were compared. The most significant factor affecting the heat changes was analyzed by linear regression. Heat changes varied between 48.4 degrees C (at 1,200 rpm) and 151.9 degrees C (at 600 rpm). The thickness of the immediate cortex, the time and speed for the wire to pass the cortex were found as significant parameters in heat changes (p=0.003, p=0.01, and p=0.01, respectively). A negative correlation was found between the speed of the wire and the thickness of the necrotic area (r=-0.901, p=0.001). Regression analysis showed that the time for the wire to pass through the cortex was the most significant factor in inducing heat changes in both cortices (p=0.001, p=0.003, respectively). Histopathologically, the extent of necrosis and bone erosion was associated with lower drill speeds. Necrosis was significantly notable in the immediate cortex than that of the remote one (p=0.006). Transosseous wires should be passed at high drill speeds and with earliest time elapses to reduce thermal necrosis.
    acta orthopaedica et traumatologica turcica 02/2005; 39(1):70-5. · 0.60 Impact Factor
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    ABSTRACT: Traumatic knee dislocations are relatively rare and almost always respond to closed reduction; however, a small percentage of knee dislocations are irreducible and in these cases open reduction is frequently required. A 65-year-old man with an unreduced posterolateral knee dislocation with laterally dislocated patella was seen 3 weeks after a motor vehicle accident. Medial femoral condyle was found buttonholed through the medial capsule together with the medial collateral ligament and lying in the medial joint space that allowed posterior rotary dislocation of the joint. Both cruciate ligaments and medial meniscus were torn. There was no evidence of any vascular or nerve injury. Reduction was accomplished by removal of the capsuloligamentous structures which were incarcerated in the trochlea and intercondylar notch and by excision of meniscal tear. Following posterior cruciate ligament reconstruction with patellar tendon autograft, lateral patellar release, vastus medialis advancement, and gracilis transfer were done.
    European Journal of Trauma 01/2005; 31(6):586-589.
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    ABSTRACT: We evaluated the functional and radiologic results of surgical treatment in patients with displaced acetabular fractures. The study included 21 patients (13 males, 8 females; mean age 35 years; range 21 to 63 years). Before surgery, all the patients were evaluated with anteroposterior, iliac, and obturator oblique views and computed tomography scans. According to the Letournel-Judet classification, the fractures were simple in 10 patients and complex in 11 patients. Twelve patients had posterior wall and/or the posterior column fractures. Four patients underwent closed reduction under emergency settings for accompanying posterior dislocations. The mean time to surgery was 4.8 days (range 1 to 13 days). Surgery was performed by the Kocher-Langenbeck approach (n=12), a triradiate approach (n=5), and a modified extended iliofemoral approach (n=4). Functional results were assessed by the D'Aubigne-Postel's knee scoring system and radiologic results using anteroposterior, iliac, and obturator oblique views. The mean follow-up was 31 months (range 19 to 64 months). Functional results were excellent in eight patients (38.1%), good in seven (33.3%), satisfactory in four (19.1%), and poor in two patients (9.5%). Radiologic examination showed posttraumatic arthrosis in four patients (19.1%), heterotopic ossification in three patients (14.3%), and avascular necrosis in two patients (9.5%). Radiologic results were excellent and good in 16 patients (76.2%), satisfactory in three patients (14.3%), and poor in two patients (9.5%). Clinical and radiologic results showed concordance. The presence of dislocations and inadequate reduction were associated with poor functional results.
    acta orthopaedica et traumatologica turcica 02/2003; 37(2):97-101. · 0.60 Impact Factor
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    Nurzat Elmali, Irfan Esenkaya, Alpay Alkan
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    ABSTRACT: Four patients with three diverse localizations of synovial chondromatosis are presented. Three were men and one was a woman (mean age 32 years; range 21 to 55 years). The site of involvement was the shoulder joint in two patients, and the ankle and hip joints in the remaining two. Pain and restricted joint movement were common complaints. Other clinical complaints included locking, crepitus, loss of muscle strength, instability, and feeling of a mass lesion. Plain roentgenograms showed multiple radiopaque nodules/loose bodies, with the female patient additionally having osteoporosis and bone erosion. The patients underwent arthrotomy followed by synovectomy and the loose bodies were removed. Diagnoses were confirmed by histologic examination. All the patients became asymptomatic following surgical treatment and no evidence of recurrent disease was detected.
    acta orthopaedica et traumatologica turcica 02/2003; 37(2):173-7. · 0.60 Impact Factor
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    ABSTRACT: Activation of nuclear factor kappa B (NF-kappaBeta) in synovial cells is seen in RA and OA patients. Caffeic acid phenethyl ester (CAPE) is a specific and potent inhibitor of NF-kappaBeta. We aimed to determine the in vivo effects of intra-articular injections of CAPE on cartilage in an experimental rabbit osteoarthritis (OA) model. Two groups of six New Zealand white rabbits underwent unilateral anterior cruciate ligament transection (ACLT). Four weeks after ACLT, the test group was injected with 150 micro g/kg CAPE in 0.5% ethanol once daily for 2 weeks and the control group was injected the same amount of 0.5% ethanol intra-articularly. All rabbits were killed 2 weeks after the last injection, and cartilage tissue was evaluated morphologically. A histological score totaling 7 points was determined for each knee. The CAPE group showed significantly decreased cartilage destruction and reduced loss of matrix proteoglycans. The histological score for cartilage tissue was significantly better in the CAPE group than in the control group (3.0+/-0.25 vs 5.3+/-0.55, P=0.005). This study suggests that intra-articular injection of CAPE may protect cartilage against the development of experimentally induced OA.
    Rheumatology International 12/2002; 22(6):222-6. · 2.21 Impact Factor
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    ABSTRACT: Studies in animal models for alcohol abuse have suggested that ethanol inhibits bone growth, decreases bone formation, and increases fracture risk. Experimental tibia fracture healing in rats fed a liquid diet containing 7.2% ethanol for 8 weeks was investigated with histological and osteodensitometric studies with respect to the control group. After 4 weeks of vitamin A- and sucrose-enriched milk containing 7.2% ethanol feeding, we created closed tibia fractures, which were then fixed with intramedullary nails, in 10 rats. After a follow-up time of 4 weeks, the rats were killed for examination. The same procedure was performed in another 10 rats, which were fed on the same diet (isocaloric modified liquid diet) but without ethanol and used as the control group. A histological scoring system was developed for fracture healing. Histological evaluation of fracture region revealed an average fracture healing score of 1.9 in the ethanol-fed group versus 2.6 in the control group (p = 0.014). In the test group, dual-energy x-ray absorptiometry measurements in the fracture region showed a mean bone mineral density of 0.11 +/- 0.03 g/cm(2), whereas it was 0.130 +/- 0.051 g/cm(2) in the control group (p = 0.000). The mean bone mineral content in the fracture region was 0.103 +/- 0.08 g/cm(3) in the test group versus 0.128 +/- 0.06 g/cm(3) in the control group (p = 0.000). A significant correlation was found among histological scores, bone mineral density (r = 0.64, p = 0.04), and bone mineral content (r = 0.63, p = 0.04). This study showed that rats fed on a diet mixed with ethanol have a histologically delayed fracture healing associated with decreased bone density and mineral content. Besides the negative effects of ethanol on bone metabolism, it also interferes with the fracture-healing process.
    Alcoholism Clinical and Experimental Research 05/2002; 26(4):509-13. · 3.42 Impact Factor
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    ABSTRACT: The effect of continuous early passive motion on morphologic and histologic healing following repair of Achilles tendon rupture was evaluated in comparison with cast immobilization. Achilles tendons of 20 adult rabbits were repaired with the use of modified Kessler technique after surgical transection. Throughout the postoperative six weeks, the rabbits were randomly assigned to cast immobilization (n=10) and to continuous early passive motion four hours a day (n=10). All the rabbits were sacrificed at the end of six weeks and their tendon tissues were removed for macroscopic and histologic examinations. On macroscopic evaluation, findings on adhesions at the operation site, periarticular atrophy, and the ROM of the ankle joint were found significantly more favorable with continuous early passive motion than those of the control group (p<0.001, p<0.05, and p<0.001, respectively). On histologic evaluation, regular collagen bundle alignment was 70% and 20% in the study and control groups, respectively (p<0.05), whereas findings on hyalinization and inflammatory infiltration were not significantly different. The utilization of continuous controlled passive motion following repair of Achilles tendon rupture was shown to have beneficial effects on tendon healing and ankle range of movement, without leading to eventual ruptures.
    acta orthopaedica et traumatologica turcica 02/2002; 36(2):141-6. · 0.60 Impact Factor