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Öğe A Case with Hereditary Neuropathy with Liability to Pressure Palsy(Derman Medical Publ, 2013) Dag, Ersel; Inal, Elem; Turkel, Yakup; Gokce, Nalan; Orkun, SevimHereditary neuropathy with liability to pressure palsy (HNPP) is an autosomal dominant disease which characterized by recurrent mononeuropathies with focal sensory or motor disturbance precipitated by minor trauma or compression. Clinically, it generally presents with painless pressure palsies, typically in the 2nd and 3rd decades of life, being a rare entity in childhood. We reported a case study of a 22 year-old female who presenting with low back pain, After detection of an Achilles reflex loss in her neurological examination and electrophysiological studies and genetic investigation was done than she diagnosed with HNPP. We want to emphasize that, the diagnosis of hereditary neuropathy with liability to pressure palsy is often delayed because it is rare in the practice of medicine and confused with polyneuropathy, careful neurological examination may be the most important factor in the diagnosis.Öğe Brucellar spondylodiscitis: a case report(Blackwell Publishing, 2006) Aydın, Gülten; Tosun, A.; Keleş, Işık; Ayaşlıoğlu, Ergin; Tosun, Özgür; Orkun, SevimBrucellosis is a common zoonosis which still remains as a major health problem in certain parts of the world. Osteoarticular involvement is the most frequent complication of brucellosis, in which the diagnosis of brucellar spondylodiscitis is often difficult since the clinical presentation may be obscured by many other conditions. Herein, we reported an uncommon case of spondylodiscitis due to brucella in an elderly male who had diabetes mellitus and degenerative spinal disease as underlying conditions. The diagnosis was established by using magnetic resonance imaging after the brucella-agglutination test was found to be positive. The diagnosis was also confirmed by positive blood culture. A high degree of suspicion in the diagnosis of brucellar spondylitis is essential to reduce the delay for the treatment. Thus, it should be essentially included in the differential diagnosis of longstanding back pain particularly in regions where brucellosis is endemic. Screening serologic tests for brucella should be used more widely in cases with low index of suspicion, especially in endemic areas.Öğe Case report: Lipoma arborescens in childhood(2004) Aydin, Gülümser; Keleş, Işık; Karagülle Kendi, A.Tuba; Yilmaz L., Özlem; Orkun, SevimLipoma arborescens (LA) is a rare intraarticular lesion of unknown etiology, mostly described in adult patients. Unilateral knee joint is the most frequent site of involvement. LA may be associated with osteoarthritis in some patients. Magnetic resonance (MR) imaging findings are extremely characteristic in the diagnosis. We report herein a 15-year-old female patient with LA; who has atrial septal defect, and who presented with pain and swelling of bilateral knee joints. MR imaging showed characteristic signs of LA and mild osteoarthritis. In childhood patients with mono/oligoarticular effusion and synovial hypertrophy without systemic involvement; LA should be considered in differential diagnosis. MR imaging is a sensitive modality in the diagnosis of LA.Öğe Conservative treatment of femoral neuropathy following retroperitoneal hemorrhage: a case report and review of literature(Lippincott Williams & Wilkins, 2014) Tosun, Aliye; Inal, Elem; Keles, Isik; Tulmac, Murat; Tosun, Ozgur; Aydin, Gulumser; Orkun, SevimAnticoagulant drugs are used to reduce the incidence thromboembolic events in patients at risk. However, minor and major bleeding complications may occur during anticoagulation therapy. Femoral neuropathy secondary to retroperitoneal hematoma is a well known complication of anticoagulant drugs. However, treatment of these patients is still controversial, both conservative and surgical treatments have been advocated. Herein, we report a male patient receiving warfarin for 7 years who developed femoral neuropathy due to retroperitoneal hematoma and was successfully treated with conservative methods. We suggest that conservative treatment and appropriate rehabilitation program should be given to the patients who do not demonstrate any signs of a continued bleeding and any progressive neurological deficits. Blood Coagul Fibrinolysis 25:769-772 2014 (C) Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.Öğe Correlations between autonomic dysfunction and circadian changes and arrhythmia prevalence in women with fibromyalgia syndrome(Turkish Soc Cardiology, 2009) Dogru, Mehmet Tolga; Aydin, Gueluemser; Tosun, Aliye; Keles, Isik; Gueneri, Mahmut; Arslan, Ayse; Orkun, SevimObjective: It is known that increased sympathetic activity and decreased parasympathetic activity are present in patients with fibromyalgia syndrome (FMS). This study aims to investigate the correlations of autonomic dysfunction and differences in autonomic circadian activity with arrhythmia prevalence in women with FMS. Methods: Fifty female patients with FMS and 30 healthy female controls were included in this cross-sectional, case-controlled study. A 12-lead electrocardiogram and 24-hour Holter monitoring were performed in all patients to evaluate arrhythmias and autonomic function tests. Heart rate variability (HRV) parameters were utilized to detect autonomic dysfunction in patients with FMS. HRV measurements were performed in total 24-hour, day time (06:00-22:59), night time (23:00-05:59) periods and during autonomic tests (stand - supine, inspiration-expiration and Valsalva tests) using 24-hour Holter monitoring recordings. Student t-test, Mann-Whitney U and Pearson Chi-square tests were used for comparisons of the data between groups. The correlation of data was tested by using Spearman correlation analysis. Results: The mean ages of the patient and control groups were 38 +/- 7.4 and 36 +/- 8.1 years, respectively. In HRV measurements, high frequency (HF) power, was significantly decreased in the patient group as compared with control group (167.4 msec(2) (107.0-312.0) vs.314.5 msec(2) (124.0-905.0), p=0.017). The low frequency/HF ratio (LF/HF) values for total 24 hours (2.22 +/- 0.18 vs. 1.22 +/- 0.12, p<0.001) and in the night time period (2.78 +/- 1.97 vs.1.15 +/- 0.77, p<0.001) were found to be significantly higher in the patient group than in control one. The ratio of LF/HFDay/LF/HFNight was markedly higher in the control group (2.67 (1.22-5.65) vs. 1.45 (0.83-2.05), p=0.004). The prevalence (p=0.028) and total number (127.1 +/- 21.4 vs. 187.3 +/- 62.3, p=0.019) of supraventricular extrasystoles in 24-hour period was higher in the patient group. Conclusion: The sympathetic activity was significantly increased and parasympathetic activity significantly decreased in FMS patients. Additionally, significant autonomic circadian activity changes were also detected in these patients. These autonomic changes might be linked to increased arrhythmia prevalence. (Anadolu Kardiyol Derg 2009, 9: 110-7)Öğe Diagnostic precision of ultrasonography in patients with carpal tunnel syndrome(Lippincott Williams & Wilkins, 2005) Keles, Işık; Kendi, A. Tuba Karagülle; Aydin, Gülümser; Zög, Ş. Gülfer; Orkun, SevimObjective: To evaluate the diagnostic value of ultrasonography in patients with electrophysiologically confirmed carpal tunnel syndrome. Design: A prospective ultrasonographic study of 35 wrists with electrophysiologically confirmed carpal tunnel syndrome and of 40 normal wrists. Receiver-operating-characteristics curves for the ultrasonographic measurements of median nerve were plotted to identify the most optimal cutoff values. Results: The ultrasonographic measurements of median nerves were found to be increased significantly in patients with carpal tunnel syndrome when compared with controls, particularly in terms of cross-sectional area (P < 0.001) and the bowing of the flexor retinaculum (P < 0.01) but not in the flattening ratio (P > 0.05). According to receiver-operating-characteristics curve results, the most optimal cutoff value for the cross-sectional area of the median nerve was obtained at the level of middle carpal tunnel, which was 9.3 mm(2), with a sensitivity of 80% and specificity of 77.5%. The optimal cutoff value for the bowing of the flexor retinaculum was 3.7 mm, with a sensitivity of 71.4% and specificity of 55%. No optimum cutoff value could be identified from the receiver-operating-characteristics curves for the flattening ratio of median nerve. Conclusion: Ultrasonographic examination of the median nerve seems to be a promising method in the diagnosis of carpal tunnel syndrome, evaluating the morphologic changes of the median nerve in patients with clinical signs and symptoms. Further studies with wider series are needed to confirm our preliminary results.Öğe Effects of ovariectomy and ascorbic acid supplement on oxidative stress parameters and bone mineral density in rats(Taylor & Francis Ltd, 2011) Arslan, Ayse; Orkun, Sevim; Aydin, Gulumser; Keles, Isik; Tosun, Aliye; Arslan, Mustafa; Caglayan, OsmanObjectives: The aim of this study is to investigate the effects of ovariectomy on bone mineral density (BMD) and oxidative state in rats, and the alterations in these effects that vitamin C supplementation may produce. Materials and methods: Twenty female Wistar albino rats were randomly divided into three groups: control (C, n = 6); ovariectomy (O, n = 7); and ovariectomy + vitamin C supplement (OV, n = 7). Oxidative stress (OS) was assessed 100 days postovariectomy by measuring the activity of several enzymes, including catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase, as well as the concentrations of malondialdehyde (MDA), nitric oxide (NO), and total sulfhydryl groups in plasma and bone homogenates. Results: A significant decrease in BMD was observed in O group compared with C group (p = 0.015), and a significant increase was observed in OV compared with O group (p = 0.003). When groups were compared with respect to parameters of OS, MDA and NO levels in bone tissue were significantly higher in O than in C (p = 0.032, p = 0.022) and were significantly lower in OV than in O (p = 0.025, p = 0.018). SOD activity was significantly higher in O than in C (p = 0.032). In plasma, MDA activity was significantly higher in O than in C (p = 0.022) and NO level was significantly higher in O than in C and OV (p = 0.017, p = 0.018). Conclusions: Our results suggest that ovariectomy may produce osteoporosis and OS in females, and vitamin C supplementation may provide alterations regarding improvement in OS and BMD values. We assume that studies including more subjects are needed to make a decisive conclusion about OS-BMD relation.Öğe Endogenous sex steroids and bone mineral density in healthy men(Elsevier France-Editions Scientifiques Medicales Elsevier, 2006) Keles, ışık; Aydin, Gülümser; Basar, M. Murad; Hayran, Mutlu; Atalar, Ebru; Orkun, Sevim; Batislam, ErtanObjective. - To evaluate the role of endogenous sex steroids on bone mineral density (BMD) in healthy Turkish men. Methods. - Serum total testosterone (TT), free testosterone (FT), dehydroepiandrosterone sulfate and estradiol levels were assayed in 174 healthy men of 240 volunteers, aged 22-76 years. Dual-energy X-ray absorptiometry was used to measure the BMD (g/cm(2)) of lumbar spine, femoral neck and non-dominant proximal and distal radius-ulna sites. Linear regressions were conducted using each BMD site as the dependent variable and each sex. steroid as the independent variable. Four models were run for each bone site and sex steroid; crude, age-adjusted, adjusted for age and body mass index (BMI), and adjusted for age, BMI and cigarette-smoking. Results. - The mean age and BMI of men enrolled in the study were 47.7 +/- 13.7 years and 26.9 +/- 3.6 kg/m(2). Log of FT was significantly associated with the BMD of distal forearm in all models analyzing the crude and adjusted effects. Dehydroepiandrosterone sulfate effect on BMD of proximal forearm came closer to the level of statistical significance when adjusted with age, BMI and cigarette-smoking. Estradiol and TT levels were not found to be associated with BMD of any sites measured. Conclusion. - Among the endogenous sex steroids in men, predominantly FT seems to be one of the determinants of BMD. Therefore a decrease in serum levels of testosterone in aging male or secondary causes may negatively affect BMD. (c) 2005 Published by Elsevier SAS.Öğe Evaluation of genitofemoral nerve motor conduction in inguinoscrotal pathologies(W B Saunders Co-Elsevier Inc, 2008) Soyer, Tutku; Tosun, Aliye; Aydin, Gueluemser; Kaya, Murat; Arslan, Ayse; Orkun, Sevim; Cakmak, MuratAim: Inguinoscrotal pathologies are commonly seen in childhood. The genitofemoral nerve (GFN) is responsible for sensitive innervations of scrotal region and the motor innervations of cremasteric muscle. GFN also innervates the afferent and efferent pathways of cremasteric reflex. A prospective study was performed to evaluate the possible relation between inguinoscrotal pathologies and GFN motor functions. Methods: Patients with inguinal hernia, hydrocele, undescended or retractile testicles, aged between 2-12 years were enrolled in the study. Bilateral latency and duration of GFN motor conductions (GFNMC) were obtained electrophysiologically by Surface electrodes. GFNMC recordings of non-pathological sides were assessed as control group. Latency and duration of each group were compared with control group (Mann-Whitney U test). P values lower than .05 were considered significant. Results: Seventy-three electrophysiologic evaluations were investigated in inguinal hernia (n:18), hydrocele (n:9). undescended testicle (n: 14), retractile testicle (n: 12) and control (n:20) groups. There was no age difference between groups and controls. Latency was significantly prolonged in inguinal hernia group when compared with control group (P = .028). Although the latencies were shortened in Undescended testicle group, no significant difference detected (P > .05). Conclusion: Prolonged latencies in inguinal hernia may be a result of nerve trap caused by hernia sac. GFN motor functions showed no causative role in other inguinoscrotal pathologies. It can be also suggested that clinical features of other inguinoscrotal pathologies were not affected by GFN motor functions. Electrophysiological studies in Younger age groups with large number of patients are needed to support our suggestions. (C) 2008 Elsevier Inc. All rights reserved.Öğe Evaluation of panoramic radiography measures for identifying reduced bone mineral density in elderly(Gunes Kitabevi Ltd Sti, 2010) Nalcaci, Rana; Baran, Ilgi; Orkun, Sevim; Tosun, Aliye; Misirlioglu, MeldaIntroduction: The purpose of this study was to assess the validity of panoramic based indices (Mandibular cortical index, cortical width, panoramic mandibular index, and mandibular ratio) and to determine whether they correlate with bone mineral density in elderly. Materials and Method: The participants of this study were 120 patients; 53 males (45-83 years old, mean: 61.6 +/- 10.02) and 67 females (42-81 years old, mean: 60.58 +/- 9.15). Mandibular indices and number of teeth were measured and evaluated from panoramic radiographs. Bone mineral density (BMD) at the lumbar spine was measured by dual energy X-ray absorptiometry. BMD values were categorized as normal (T-score greater than -1.0), and as indicative of osteopenia (T-score -1.0 to -2.5) or osteoporosis (T-score less than -2.5) according to the World Health Organization classification. Results: There were statistically significant correlations between bone mineral density and sex, cortical width, mandibular ratio and mandibular cortical index (p<0.05). However, there were no significant correlations between panoramic mandibular index and bone mineral density. Also, there were significant correlations between mandibular cortical index and panoramic mandibular index (p<0.01), cortical width (p<0.05), mandibular ratio (p<0.05) and the number of mandibular (p<0.01) and maxillary teeth (p<0.05). However, there was no statistical significant difference between the mandibular cortical index and age (p>0.05). Conclusion: Mandibular cortical index can be used for identifying subjects with low bone mass, allowing the dentists to have sufficient clinical and radiographic information to play a useful role in screening for individuals with osteoporosis.Öğe Factors affecting bone mineral density in men(Springer Heidelberg, 2009) Atalar, Ebru; Aydin, Gülümser; Keleş, Işık; İnal, Elem; Zog, Gulfer; Arslan, Ayşe; Orkun, SevimIn this study, in 131 men aged 20-75 years, we investigated correlations between bone mineral density (BMD) in the lumbar spine and femoral neck and endogenous factors (age, body mass index) as well as exogenous factors (calcium intake, physical activity, smoking, caffeine, socioeconomic and educational levels). The age had a negative effect on femoral neck BMD in patients overall, and on both lumbar spine and femoral neck BMD in patients under 50. Physical activity has effects on femoral neck BMD in men above 50. Lumbar vertebral BMD negatively correlated with smoking in patients overall, and this correlation persisted when patients aged 50 and older were analyzed separately. Femoral neck BMD was positively correlated with body mass index in men aged 50 and older. Given the variety of findings in the research literature regarding risk factors for low BMD, we suggest that genetic and geographic factors should be considered.Öğe Familial Mediterranean fever and ankylosing spondylitis in a patient with juvenile idiopathic arthritis: a case report and review of the literature(Springer Heidelberg, 2006) Keleş, Işık; Aydin, Gülümser; Tosun, Aliye; İnal, Elem; Keles, Hatice; Orkun, SevimThe association of familial Mediterranean fever (FMF) with juvenile idiopathic arthritis (JIA) or ankylosing spondylitis (AS), most commonly with negative HLA-B27 antigen, was described in several previous reports, although the pathogenic mechanism of this association still remains unknown. Herein we report an uncommon association of FMF with HLA-B27 positive AS as an occasional coincidence in a patient who had been diagnosed as having JIA 23 years previously.Öğe Kas-iskelet sistemi tutulumu olan brusellozisli hastalarda klinik ve laboratuvar özellikler(2005) Aydın, Gülümser; Keleş, Işık; Atalar, Ebru; Açıkgöz, Ergin Ayaşlıoğlu; Tosun, Aliye; Orkun, SevimAmaç: Kırıkkale ve kırsalında kas-iskelet sistemi tutulumu olan brusellozisli hastalarda demografik, klinik ve laboratuvar özellikleri incelemek. Gereç ve Yöntemler: Çalışmaya kas-iskelet sistemi tutulumu olan brusellozis tanısı konulmuş 28 hasta dahil edildi. Hastaların demografik özellikleri, yakınmasının süresi, şekli, olası enfeksiyon kaynağı sorgulandı. Ayrıntılı sistemik ve kas-iskelet sistemi muayene bulguları not edildi. Rutin biyokimya, tam kan sayımı, eritrosit sedimentasyon hızı, C-reaktif protein, romatoid faktör, antinükleer antikor, kan kültürü ve standart tüp aglütinasyon testleri yapıldı. Hastaların tümünde sakroiliak, lumbosakral ve gerekli görülen durumlarda periferik eklem radyografileri değerlendirildi. Klinik ve radyografik olarak derin eklemlerin tutulumundan şüphede kalındığı durumlarda magnetik rezonans görüntüleme yönteminden faydalanıldı. Bulgular: Hastaların yaş ortalaması 39.4 ± 14.4 yıl, hastalık süreleri 10.1 ± 12.7 aydı ve %64.3’ü erkekti. En sık izlenen semptom artralji (%85.7), bulgu ise splenomegaliydi (%32.1). Kan kültürü %39.3 hastada pozitifti. Eklem tutulumu olarak periferik artrit %71 oranı ile ilk sıradaydı ve en sık tutulan periferik eklemler %35 ile kalça ve dizdi. Sakroiliit %32 hastada tespit edildi ve %89’u unilateraldi. Spondilit %14 hastada ve en sık lomber segmentte (%75) izlendi. Her bir kas-iskelet sistemi tutulumunun tipi tüm parametreler açısından diğerleri ile kıyaslandığında sakroiliit grubunda sadece sakroiliak testleri pozitifliği, spondiliti olan grupta yaş, perküsyonla vertebra hassasiyeti ve spinal hareketlerle ağrının varlığı, diğerlerinden anlamlı düzeyde farklıydı (p< 0.05). Sonuç: Bölgemizde brusellozis saptanan ve aynı zamanda kas-iskelet sistemi tutulumu olan olgularda en sık tutulum periferik eklemlerde izlenmektedir. Sakroiliak ekleme yönelik özel testler sakroiliit için yol gösterici olabilir. Özellikle spinal hareketleri ağrılı ve perküsyonla hassasiyet saptanan brusellozisli yaşlı hastalarda omurga tutulumu olabileceği akılda tutulmalıdır. Spinal ya da periferik eklem ağrısı olan ve yumuşak doku romatizmasına bağlı şikayeti bulunan hastalarda brusellozis ayırıcı tanıda yer almalıdır.Öğe Laser Therapy in Knee Osteoarthritis: An Experimental Study(Gazi Univ, Fac Med, 2022) Ozbay, Kadri Koray; Atalar, Ebru; Karahan, Siyami; Orkun, Sevim; Ide, Tayfun; Tugcu, Ilknur; Sezer, RefiaAim: In this study, it is aimed to examine the effects of Infrared Gallium-Arsenic (Ga-Ar) laser therapy in rat osteoarthritis (OA) model that is formed chemically on the knee joint cartilage. Material and methods: Fifty-six female Wistar Albino rats having weights between 250 and 300 grams were used and the rats were divided in 3 groups. Group 1 and group 2 are the control (C) groups. In group 1 (C-1), 0.9% saline solution was aplied to the left knee joint of 32 rats and in group 2 (C-2), 1 mg monoiodoacetate (MIA) is applied to the right knee joint of the same 32 rats. Group 3 is the experimental (E) group and in this group, 1 mg MIA application to the right knees of 24 rats. Ga-Ar laser therapy was started after 24 hours for group 3 and it was applied for 15 days with 24-hour intervals. In all 3 groups, knee bending test was applied daily. Euthanasia was applied on 1st,7th and 15th days to 8 rats in C-1 and C-2 and on 7th, 15th and 30th days to 8 rats in group E. Their knee joints were removed, and they were histopathologically assessed under a light microscope. Results: As a result of the statistical assessment, in the assessment between the total scores between C-1 and C-2 groups, scores of the C-2 group were found higher at all the time points (p=0.001, p=0.002). Also when the E and C-2 groups were compared, no statistically significant difference was observed (p>0.05). There was no correlation between the pain assessment of knee bending test and the level of histopathological findings. Conclusions: We found no effect of laser therapy in the treatment of early knee osteoarthritis.Öğe Lipoma Arborescens in Childhood: A Report of Two Sisters(Turkish League Against Rheumatism, 2012) Aydin, Gulumser; Keles, Isik; Tosun, Ozgur; Tosun, Aliye; Yilmaz, Latife Ozlem; Karagulle, Tuba Kendi; Orkun, SevimLipoma arborescens (LA) is a rare benign lesion of synovial joints and bursae. The knee is the most common site of the involvement. Magnetic resonance imaging findings are typical in the diagnosis. The number of case reports of LA in children is significantly lower compared to the adults. In this article, two nine-year-old and 15-year-old sisters who were examined for the complaints of bilateral pain and swelling in knees were presented. Magnetic resonance imaging demonstrated typical features of LA in the right knees of both children. Pediatric patients with mono/oligoarticular effusion and synovial hypertrophy without systemic involvement, LA should be considered in differential diagnosis. Magnetic resonance imaging is a sensitive modality in the diagnosis of LA.Öğe Multifocal osteoarticular tuberculosis: a case report(Springer Heidelberg, 2005) Keles, Işık; Aydin, Gülümser; Kendi, Tuba K.; Orkun, SevimOsteoarticular tuberculosis is a quite uncommon form of extrapulmonary tuberculosis. Difficulties in diagnosis often lead to delayed treatment, sometimes with devastating consequences for patients. We report herein a case of multifocal osteoarticular tuberculosis of insidious onset with no history of prior health problems or constitutional signs and symptoms. Despite widespread osteoarticular involvement, the outcome of the patient was favorable after the management. Osteoarticular tuberculosis must be considered in patients with insidious musculoskeletal symptomatology.Öğe Plasma leptin concentrations in postmenopausal women with osteoporosis(Taylor & Francis Inc, 2005) Yılmazı, Murat; Keleş, Işık; Aydın, Gülümser; Orkun, Sevim; Bayram, Merih; Sevinç, F. Ceylan; Yetkin, İlhan; Üçler, KısaOsteoporosis is less common in obese individuals with increased bone mineral density (BMD) and plasma leptin concentrations. The aim of this study was to determine the correlation between leptin levels and BMD in postmenopausal women. The study consisted of 90 postmenopausal women with a mean age of 53.45 +/- 0.87 years who visited our outpatient clinic for the evaluation of BMD. Thirty-six postmenopausal women with osteoporosis (mean age: 54.52 +/- 1.41 years and mean body mass index (BMI, kg/m 2 ) 29.33 +/- 0.66), 30 age- and BMI-matched postmenopausal women with normal BMD, and 24 postmenopausal women (mean age: 52.79 +/- 1.48 years and mean BMI: 29.45 +/- 0.89) with osteopenic BMD were included in the study. Plasma concentrations of leptin after an overnight fast were measured by radioimmunoassay. BMD values were measured by dual-energy X-ray absorptiometry (DEXA) at the L 2 -L 4 lumbar spine and femoral neck. The median spine BMD value in the patient group (0.67 +/- 0.08 g/cm(2) , mean +/- SEM) was significantly lower than that in the control group (1.02 +/- 0.25 g/cm 2 , mean + SEM) and osteopenic group (0.87 +/- 0.05 g/cm 2 , mean + SEM) (p < 0.150). Plasma leptin concentrations were correlated with BMI in three groups (r(s) = 0.450, p = 0.025 in normal BMD group and r(s) = 0.4254, P = 0.009 in the osteoporotic group, and r(s) = 395, p = 0.015 in the osteopenia group. There was no correlation between plasma leptin concentrations and BMD values in three groups (r(s) = -0.89 in normal BMD group, r(s) = -0.124 in osteopenia group, and r(s) = -0.195 in osteoporosis group). From this study we conclude that circulating plasma leptin does not have a significant direct influence on bone mass in postmenopausal women.Öğe Predictive value of grip strength for bone mineral density in males: site specific or systemic?(Springer Heidelberg, 2006) Aydın, Gülümser; Atalar, Ebru; Keleş, Işık; Tosun, Aliye; Zog, Gülfer; Keleş, Hatice; Orkun, SevimThis study aimed to investigate the predictive role of grip strength on bone mineral density (BMD) of different sites in males. Two hundred thirty-four male patients were included in the study. BMD of lumbar spine, femoral neck, proximal radius-ulna (PRU) and distal radius-ulna (DRU) sites were measured by dual-energy X-ray absorptiometry and grip strength by using a hand dynamometer. Grip strength and BMD values of PRU and DRU at forearms were significantly higher on the dominant sides (P = 0.001, P = 0.001, P = 0.001, respectively). Stepwise linear regression analysis revealed that only the grip strength of the same side was the best predictor of the BMD of the dominant and non-dominant PRU with a ratio of 8.5 and 10.2%, respectively, whereas grip strength of the same side, age and weight were the best predictors of the BMD of the dominant and non-dominant DRU with a ratio of 25 and 24.6%, respectively. There was no predictive value of grip strength for BMD of lumbar spine and femoral neck. In conclusion, grip strength appears to be predictive of site specific rather than systemic BMD.Öğe Relationship between sexual dysfunction and psychiatric status in premenopausal women with fibromyalgia(Elsevier Science Inc, 2006) Aydın, Gülümser; Basar, M. Murad; Keleş, Işık; Ergun, Gülbahar; Orkun, Sevim; Batislam, ErtanObjectives. To evaluate the possible relationship between the sexual and psychiatric status of premenopausal female patients with fibromyalgia compared with healthy controls. Methods. A total of 48 female patients with fibromyalgia and 38 age-matched healthy controls were enrolled in the study. All the subjects were asked to complete the Female Sexual Function Index (FSFI) for sexual status and the State-Trait Anxiety Inventory (STAI) and Beck Depression Inventory (BDI) for psychiatric assessment. Serum biochemical analysis was done, and the serum hormonal levels were analyzed. Results. The mean BDI score for patients was significantly greater than the score for the controls (P 0.017) and the mean FSFI score was significantly lower than the score for the controls (P = 0.001). According to the FSFI data, female sexual dysfunction was found in 26 patients (54.2%) with fibromyalgia and only 6 controls (15.8%), a significant difference (Pearson chi-square = 14.46, P = 0.000). When the subscores of each domain of FSFI were evaluated, the most common sexual problem was diminished desire in patients (n = 30, 62.5%) and controls (n = 11, 28.9%). In the correlation analysis, the FSFI score showed a significant negative correlation with the BDI (r = -0.337, P = 0.002) and STAI (r = -0.413, P = 0.004) scores. No significant correlation was revealed between the FSFI and BDI or FSFI and STAI scores in the controls. Conclusions. Depression is one of the emotional disorders commonly encountered in women with fibromyalgia, most possibly leading to sexual dysfunction. Thus, sexual dysfunction related to impaired psychiatric status should be considered a common problem in premenopausal women with fibromyalgia.Öğe Romatoid artritli olgularda krikoaritenoid eklem değişikliklerinin klinik ve bilgisayarlı tomografi bulgularının karşılaştırılması(2002) Kara, Simay Altan; Bayar, Nuray; Keleş, Işık; Altınok, Deniz; Koç, Can; Orkun, SevimRomatoid artrit etyolojisi bilinmeyen, simetrik erozif atini ve multisistem tutulumuyla giden otoimmün bir hastalıktır. Krikoaritenoid eklemler romatoid artritten etkilenen gerçek diartroidal eklemlerdir. Çalışmamızda, romatoid artritli olgularda bu eklemlerdeki değişikliklerin semptom, fizik muayene ve bilgisayarlı tomografi bulguları karşılaştırıldı. Romatoid artrit tanıtı 15 olguda, 30 krikoaritenoid eklemin üstüste binme tekniği ile elde edilen bilgisayarlı tomografi görüntüleri incelendi. Sonuçlar, semptom ve fizik muayene bulgularıyla karşılaştırıldı. Krikoaritenoid eklemde %66.7 olguda semptom, %13.3 olguda fizik muayene, %80 olguda bilgisayarlı tomografi pozitifti. Krikoaritenoid eklem incelemesinde, kıkırdaklarda volüm (%30), dansite artışı (%30), sublüksasyon (%20), eklemde belirginleşme (%16.7) ve eklem mesafesinde daralma (%6.7) saptandı. Bilgisayarlı tomografi romatoid artritli olgularda klinik bulgu vermeyen krikoaritenoid eklem değişikliklerini göstererek olguların olası risklere karşı korunmasını sağlar. Eklem değişikliklerinin gösterilmesi ve takibinde kullanılabilecek başarılı bir görüntüleme yöntemidir.
