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  • Küçük Resim
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    Effectiveness of Iloprost in the Treatment of Bone Marrow Edema
    (CUREUS INC, 2020) Tosun, Haci Bayram; Uludag, Abuzer; Demir, Sukru; Serbest, Sancar; Yasar, Mehmet Mete; Oznam, Kadir
    Background and objective Bone marrow edema (BME) is a rare condition caused by insufficient osseous blood supply and may result in severe pain that has adverse effects on patients' life. To date, various conservative treatments have been recommended for the treatment of BME, including analgesics, immobilization of the affected extremity, and iloprost infusion. The aim of this retrospective study was to investigate the effectiveness of parenteral iloprost therapy in the treatment of BME detected in different skeletal locations. Materials and methods This retrospective study included 23 patients (17 men and six women) with BME who were classified as stage I-III according to the Association Research Circulation Osseous (ARCO) classification. BME was localized to the proximal femur in 13 (56.5%), the distal femur in four (17.4%), tarsal bone in four (17.4%), and tibial plateau in two (8.7%) patients. The mean age of the patients was 46.7 years and all the patients were evaluated with the Visual Analog scale (VAS), Functional Mobility Scale (FMS), and MRI. Results A significant improvement was observed in the post-treatment VAS and FMS scores of all patients compared to their pre-treatment scores. Moreover, the edema regressed completely in 60.9% of the patients at three months of MRI control. No serious side effects were observed during the treatment in any of the patients. However, transient side effects including headache, arrhythmia, and flushing were observed in five patients. Conclusion The present study indicated that iloprost therapy is an effective and safe option in the treatment of BME patients, particularly in the reduction of severe pain that has adverse effects on patients' social life, regardless of ARCO staging. Moreover, this therapy could be particularly useful in reducing pain, improving functional recovery, and achieving complete regression of the edema on MRI in ARCO stage I-II patients.
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    Mechanical and Physical Properties of Autoclaved Aerated Concrete Reinforced Using Carbon Fibre of Different Lengths
    (Univ Osijek, Tech Fac, 2021) Demir, Ilhami; Sevim, Ozer; Ogdu, Mustafa Kagan; Dogan, Orhan; Demir, Sukru
    In this study, series of tests have been conducted to indicate the mechanical and physical properties (compressive strength, flexural strength, dry density, thermal conductivity and shrinkage) of autoclaved aerated concrete (AAC) reinforced with carbon fibres of different lengths. AG2/350 AAC block specimens without carbon fibre were prepared as a control specimen. The mixtures were prepared by replacing 0.5% weight of cement in the AAC with 4 mm, 6 mm, 12 mm length carbon fibres and these mixtures were poured into moulds and subjected to 58 degrees C for 4 hours to expand until reaching workable hardness. After preliminary curing, the produced AAC specimens were subjected to 180 degrees C and pressure of 11 bar for 6 hours in a steam cure until required hardness. The mechanical and physical properties of the reference and the fibre reinforced AAC specimens were determined and compared to each other. As a result, the use of 12 mm fibre reinforcement in AAC gave the best performance in comparison to the other fibre reinforcements of different lengths by increasing compressive strength for 10.63%, flexural strength of 31.48% and thermal conductivity up to 4.23% while reducing the shrinkage ratio to 51.47%. Herein for the specimen using 0.5% replacement of the AAC in weight with 12 mm carbon fibre is recommended.
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    MECHANICAL AND PHYSICAL PROPERTIES OF CEMENTITIOUS COMPOSITES CONTAINING FLY ASH OR SLAG CLASSIFIED WITH HELP OF PARTICLE SIZE DISTRIBUTION
    (Serban Solacolu Foundation, 2021) Sevim, Ozer; Baran, Mehmet; Demir, Sukru
    Fly ash (FA) and granulated blast furnace slag (GBFS) produced as waste materials from coal power plants and iron/steel sector are commonly used in the concrete industry for partial substitution of cement. As the production of cement releases a substantial amount of carbon dioxide, its replacement with FA or GBFS reduces carbon dioxide emissions. This study explores the effects of FA and GBFS fineness determined by particle size distribution (PSD) on the hydration rate and compactness of cementitious materials. Firstly, FA and GBFS were classified to have three different fineness ranges with the help of PSDs without any grinding process: FA and GBFS without PSD, FA and GBFS with 0-25 mu m PSD and FA and GBFS with 0-63 mu m PSD. Then, flexural strength, compressive strength, and water absorption properties of cementitious composites containing FA and GBFS with four different replacement levels up to 20% wt. of cement and with three different fineness were investigated at curing ages of 7, 28, and 90 days. Results revealed that cementitious composites that contain FA and GBFS with lower PSD yield better mechanical and physical properties.
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    The Effect of Fiber Type and Ratio on the Physical and Mechanical Properties of Marble Powder Added Fiber Concrete
    (Gazi Univ, 2022) Simsek, Osman; Demir, Sukru
    In this study, it is aimed to determine the effect of steel and macro synthetic fibers used in different ratios and types on the physical and mechanical properties of concrete. For this purpose; Macro synthetic fiber was used at 0.25%, 0.30% and 0.35% by volum4, steel fiber at 0.50%, 0.75% and 1.00% by volume. Chemical additives and marble powder were used in fixed proportions. In the study, the water / cement ratio was taken as 0.54 constant according to the fiber concrete TS 802 mixture. In this research, beams of 10 x 10 x 40 cm and 15 cm cube samples were produced for fresh and hardened concrete properties. The effect of fiber type and ratio was investigated by performing physical and mechanical tests on the produced samples. As a result of the study, as the fiber ratio of fiber mixes in fresh concrete increased, workability and unit volume weights decreased. As a result, as the fiber ratio in fresh concrete increases, the fiber ratio has negatively affected the workability and the unit volume weights decreased. In hardened concrete; In hardened concrete; As the fiber ratio increased, the initial crack stress and bending stress increased. The highest mechanical and physical properties were given by 1.00% steel fiber and 0.35% macro synthetic fiber concretes.
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    The effectiveness of fixation of hydroxyapatite-coated helical blade in preventing of the cut-out observed in treatment with proximal femoral nail of fractures of the femur intertrochanteric in elderly
    (Turkish Assoc Trauma Emergency Surgery, 2023) Tosun, Haci Bayram; Uludag, Abuzer; Serbest, Sancar; Cicek, Necati; Demir, Sukru
    BACKGROUND: This study aimed to retrospectively evaluate the effectiveness of hydroxyapatite-coated (HA-coated) implants and other caput-collum implants in preventing cut-out observed in treatment with proximal femoral nail (PFN) of intertrochanteric femur fractures in elderly patients.METHODS: A total of 98 consecutive patients (56 males and 42 females; mean age: 79.42 (61-115) years) treated with three differ-ent PFNs for intertrochanteric femoral fractures were retrospectively examined. The mean of the follow-up period was 7.87 (4-48) months. It was used a threaded lag screw in 40 patients, an HA-coated helical blade in 28 patients and a non-coated helical blade in 30 patients for PFN. The reduction quality, fracture type, and radiological outcomes among all groups were evaluated.RESULTS: Unstable type was seen in 50 (52.1%) patients according to AO Foundation/Orthopedic Trauma Association fracture classi-fication. An acceptable-good reduction quality was seen in 87 (88.8%) of all patients. The average of tip-apex distance (TAD) value was 27.61 mm, calcar-referenced TAD (CalTAD) value was 28.72 mm, caput-collum diaphyseal angle was 128,degrees Parker's anteroposterior ratio was 46.36%, and Parker's lateral ratio was 46.82%. The best suitable implant position was observed in 49 (50%) patients. Cut-out was observed in 7 (7.14%) patients, and secondary varus displacement of more than 10 degrees was observed in 12 (12.24%) patients. Correlation analysis and multivariate logistic regression analysis showed a significant difference between HA-coated and other implants in cut-out. Furthermore, implant type was the strongest predictive factor for cut-out complications in the multivariate logistic regression analysis.CONCLUSION: HA-coated implants may reduce the long-term cut-out risk due to increased osteointegration and bone ingrowth in elderly patients with intertrochanteric femoral fractures with poor bone quality. However, this alone is not enough; a suitable screw position, optimal TAD values, and excellent reduction quality are other important factors.