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Öğe Glutamate dehydrogenase gene mutation and hyperinsulinemia hyperammonemia syndrome: A case report [Glutamat dehidrogenaz gen mutasyonu ve hipoglisemi hiperamonemi sendromu: Bir vaka takdimi](2003) Çoker M.; Darcan S.; Gökşen D.; Orbak Z.; Yilmaz D.; Özkayin N.Congenital hyperinsulinism characterized by over-secretion of insulin is the most common cause of recurrent hypoglycemia in the neonatal period and can cause irreversible brain damage. In this case hyperinsulinemia was diagnosed by inappropriately elevated insulin levels during hypoglycemia, with negative ketone bodies in the urine and increased glucose levels to glucagon. Hyperammonemia persisted with sodium benzoate therapy and was not affected by protein restriction. Serum and urine amino acids and organic acid levels in urine were not consistent with urea cycle defects or with other hyperammonemia syndromes. A410T mutation was detected in the child and she was diagnosed as hyperinsulinemia hyperammonemia syndrome.Öğe Intertrochanteric femur fractures in the elderly treated with either proximal femur nailing or hemiarthroplasty: A prospective randomised clinical study(Elsevier Ltd, 2015) Özkayin N.; Okçu G.; Aktu?lu K.Introduction The purpose of this prospective randomised study is to compare in the elderly the functional results of intertrochanteric femur fractures treated either with closed reduction and internal fixation with proximal femoral nailing or cemented hemiarthroplasty. Materials and methods The study included patients above the age of 75 who were diagnosed with intertrochanteric femur fracture and admitted to the Department of Orthopaedics and Traumatology, Ege University Hospital between October 2006 and December 2012. After informed consent was obtained from the patients, they were randomised via sealed opaque envelops into two groups. Patients in Group 1 were internally fixated utilizing proximal femoral nail, whilst the patients in Group 2 were treated with a cemented hemiarthroplasty. Complications were recorded and functional results were evaluated using the Harris Hip score. The mean time of follow up was 31.72 months (min. 18-max. 47, std. dev. ±10.68). Results A total of 54 patients were included in the study. 21 of them (38.9%) received a proximal femoral nail whilst 33 (61.1%) were treated with hemiarthroplasty. Average age of the patients was 82.24 (min. 75-max. 97). Average age in Group 1 was 79.57 (min. 75-max. 91), whilst it was 83.94 in Group 2 (min. 75-max. 97). Harris Hip score analysis revealed that the difference between the patients treated with hemiarthroplasty and proximal femoral nailing was statistically significant in favour of the hemiarthroplasty group within the first 3 months. However, this difference diminished at the 6th month time point, and even reversed as of the 12th month postoperatively. Discussion and conclusions Although cases with hemiarthroplasty achieved a better level of activity in the beginning, cases with proximal femoral nailing reached a comparable level of activity within a short period of time, faster than those treated with hemiarthroplasty, displaying a better level of activity in the end. © 2015 Elsevier Ltd. All rights reserved.Öğe Should full threaded compression screws be used in adult femoral neck fractures?(Elsevier Ltd, 2015) Okcu G.; Özkayin N.; Erkan S.; Koray Tosyali H.; Aktu?lu K.Introduction Operative treatment consisting of fracture reduction and fixation, or arthroplasty to permit early patient mobilization, continues to be the treatment of choice for most femoral neck fractures. Options for internal fixation have included a variety of implants; however most recent reports and textbooks cite parallel multiple cancellous screws as the surgical technique of choice. Methods The study was prospective, randomized and IRB approved. Inclusion criteria included skeletal maturity, closed femoral neck fracture without concomitant fractures or injuries with complete charts and adequate radiographs obtained from the initial injury till the last follow-up. Forty-four patients were enrolled in this study during one-year period at two university centers. 22 were randomized to be treated with full threaded, cannulated compression screws (Acutrak 6/7, ACUMED) (Group 1) and the other 22 with 16 mm partial threaded, 6.5 mm or 7.3 mm cannulated screws (SYNTHES) (Group 2). Three or four screws were used in both groups according to fracture type and surgeon's preference. Data evaluated included surgical time, fluoroscopy time, fracture type, radiological outcome, complications and functional status using the Harris Hip Score. Results Both groups were comparable in terms of age and gender. There was not a significant difference in terms of surgical time, follow-up period, fracture type, or fluoroscopy time. There were eight complications in Group 1 and two in Group 2 (P = 0.049) Time to union was significantly longer in Group 1 (P = 0.001). However, Hip Scores were not significantly different in both groups (P = 0.20). Conclusion When compared with full threaded compression screws, partial-threaded cannulated screws provides a shorter union time and less complication rate while providing equivalent functional results in adult femoral neck fractures. © 2015 Elsevier Ltd. All rights reserved.Öğe Simultaneous pancreas - kidney transplantation in patients with type 1 diabetes mellitus and end stage renal disease [Tip 1 diabetes mellitus ve son dönem böbrek yetmezligi bulunan hastalarda eşzamanli pankreas - böbrek transplantasyonu](2003) Çoker A.; Zeytunlu M.; Sözbiyen M.; Firat Ö.; Töz H.; Seziş M.; Ertilav M.; Ulukaya S.; Acar L.; Mir S.; Özkayin N.; Hoşçoşkun C.; Yüzer Y.; Kaplan H.Diabetes Mellitus is the most common cause of end stage renal failure. Dialysis and renal transplantation offer improvements in the quality of life and long term survival for these group of patients. In the last decade, simultaneous pancreas - kidney transplantation became a worldwide accepted treatment modality for the patients with renal failure related to type 1 Diabetes Mellitus. In this paper, the first four simultaneous pancreas - kidney transplantation cases of Ege University Organ Transplantation and Research Center were reported with a review of the medical literature.Öğe Treatment of the four-part proxsimal humerus fractures in elderly patients with hemiarthroplasty [Yaşli{dotless} hastalardaki dört parça proksimal humerus ki{dotless}ri{dotless}klari{dotless}ni{dotless}n hemiartroplati ile tedavisi](2008) Özkayin N.; Aktuglu K.Objectives: In this study, elderly patients treated by hemiarthroplasty for the four-part proximal humerus fractures were retrospectively evaluated. Patients and methods: Twenty-eight patients 60 years of age and above who underwent hemiarthroplasty for the four-part humerus proximal shaft fractures between years 1991-2005 were evaluated. The mean age was 67.7 years (61-82). Nine patients were male and 19 patients were female. Cause of fracture in 11 cases was traffic accidents (39.3 %) and in 17 cases it was a simple fall (60.7 %). Results: The mean follow-up time was 54.5 (26-153) months. Rehabilitation started at the end of the first week of surgery. All the cases were evaluated according to the Neer Scoring System. The mean Neer score was 77.1 (32-92). Results were excellent in 14.3%, adequate in 46.4%, inadequate in 28.6% and unsuccessful in 10.7% of the cases. Conclusion: Primary shoulder hemiarthroplasty is a preferred treatment method in elderly patients having four-part humerus proximal fractures despite limited excellent results. Presence of osteoporosis, high osteonecrosis risk and difficulties in internal fixation amend the outcome.
