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Relationship between Coronal Alignment and Posterior Tibial Slope in the Lower Extremity  [PDF]
Serhat Mutlu, Harun Mutlu, Olcay Guler, Gokhan Ozkazanli, Atilla Parmaksizoglu
Open Journal of Orthopedics (OJO) , 2014, DOI: 10.4236/ojo.2014.44016
Abstract: Purpose: To restore the normal axial alignment of the lower extremity is important in reconstructive knee surgery. The aim of this study was to evaluate lower-limb alignment and posterior tibial slope. Methods: Thirty-two male and 32 female outpatients aged 22 to 46 were recruited. A full weight-bearing anteroposterior radiograph of the entire lower limb was obtained for each subject. The axial alignment was measured based on the centers of the femoral head, knee, and ankle. The tibiofemoral (TF), tibial joint (TJ), and posterior tibial slope (TS) angles were determined. Results: The mean TF angle was more varus in women (177.8°) than men (179.2°), and the mean TJ angle was more medially inclined in women than men. Women had a greater TJ angle than men (93.3° vs. 91.6°). The mean posterior TS was greater in men than women (16.0° vs. 12.5°, p < 0.05), while the mean TS angle was greater in women (14.8°) than men (12.3°). Conclusion: Knee alignment and geometry vary among populations. In our study, the TF angle was varus among all participants. The knee joint was more medially inclined in women than men. And also the posterior TS was greater in women than men.
Posterior Dislocation of the Hip in a 4-Year-Old Boy  [PDF]
Serhat Mutlu, Bulent Yucel, Tahir Mutlu Duymus, Baran K？mür, Ozgur Karaman, Harun Mutlu
Case Reports in Clinical Medicine (CRCM) , 2015, DOI: 10.4236/crcm.2015.41006
Abstract:
Traumatic hip dislocations occur in children below 15 years old. Just as in adults, posterior hip dislocations are 10 times more common than anterior hip dislocations. Traumatic hip dislocation in pediatric patients < 10 years of age requires much less force than that in an adult, while in children over 10 years old, We reported a 4-year-old boy with traumatic hip dislocation. Closed reduction with the Bigelow manoeuvre was applied without general anesthesia in the Emergency room. Patient was followed up for 4 weeks in a hip spica cast. There were no problems at the 6-month follow-up examination. Traumatic hip dislocation in children is not a common event and is generally caused by minor trauma.
Preliminary Results of Double-Bundle Anterior Cruciate Ligament Reconstruction and Technique-Specific Problems  [PDF]
Olcay Guler, Ferdi Donmez, Mahir Mahirogullari, Mehmet Isyar, Selami Cakmak, Serhat Mutlu
Open Journal of Orthopedics (OJO) , 2014, DOI: 10.4236/ojo.2014.48034
Abstract: Background: In this study, we determined the efficiency of anterior cruciate ligament (ACL) reconstruction using the double-bundle technique and addressed technique-specific problems. Patients and Methods: Twenty-nine patients who underwent ACL reconstruction due to ACL rupture with the arthroscopic double-bundle ENDOBUTTON CL method using autogenous hamstring tendons were evaluated. All patients were males and the mean age was 24.3 years (range 20 - 41 years). The mean follow-up period was 36.4 months (minimum 16 and maximum 53 months). Diagnosis was based on medical history and physical examination. Lachman, anterior drawer and pivot shift tests were performed. The patient diagnosis was verified with X-ray roentgenogram and magnetic resonance imaging (MRI). Tunnel mergence and graft hanging problems were discussed. Results: Pre- and postoperative clinical assessments of the patients showed the mean Lysholm score increased from 60.2 (48 - 72) preoperatively to 91.5 (85 - 98) at the final visit, whereas the mean Tegner score increased from 5.58 (3 - 9) preoperatively to 6.03 (4 - 9) at the final visit. According to the International Knee Documentation Committee (IKDC) knee ligament standard evaluation system, five patients were classified as B (17%); 11 patients were classified as C (38%); and 13 patients were classified as D (45%) before the surgery. At the postoperative evaluation, 17 (59%) patients were classified as A; 11 (38%) patients were classified as B; and 1 (3%) patient was classified as C. Conclusion: The double-bundle technique using hamstring tendons and femoral braces is an efficient and satisfactory method for ACL reconstruction.
An isolated right ventricular myocardial infarction and severe tricuspid regurgitation due to occlusion of a non-dominant right coronary artery: role of delayed revascularization
Mutlu Vural,Ahmet Uslu,Serhat Bülbül
Anadolu Kardiyoloji Dergisi , 2010,
Abstract:
Complications during removal of stainless steel versus titanium nails used for intramedullary nailing of diaphyseal fractures of the tibia
Arel Gereli,Ferdi Donmez,Mahir Mahirogullari,Mustafa Seyhan,Serhat Mutlu
- , 2018, DOI: 10.1016/j.amsu.2017.12.012
Abstract: Intramedullary nailing is the treatment of choice for fractures of the tibial shaft, which might necessitate the nail removal due to complications in the long-term. Although considered as a low-risk procedure, intramedullary nail removal is also associated with certain complications. Here, we compared the most commonly used stainless steel and titanium nails with respect to the complications during removal and clinical outcome for intramedullary nailing of diaphyseal fractures of the tibia
Anterior Glenohumeral Instability: Classification of Pathologies of Anteroinferior Labroligamentous Structures Using MR Arthrography
Serhat Mutlu,Mahir Mah？ro？ullari,Olcay Güler,Bekir Yavuz U？ar,Harun Mutlu,Güner S？nmez,Hakan Mutlu
Advances in Orthopedics , 2013, DOI: 10.1155/2013/473194
Abstract: We examined labroligamentous structures in unstable anteroinferior glenohumeral joints using MR arthrography (MRA) to demonstrate that not all instabilities are Bankart lesions. We aimed to show that other surgical protocols besides classic Bankart repair are appropriate for labroligamentous lesions. The study included 35 patients (33 males and 2 females; mean age: 30.2; range: 18 to 57 years). MRA was performed in all patients. The lesions underlying patients’ instability such as Bankart, anterior labral periosteal sleeve avulsion (ALPSA), and Perthes lesions were diagnosed by two radiologists. MRA yielded 16 diagnoses of Bankart lesions, 5 of ALPSA lesions, and 14 of Perthes lesions. Albeit invasive, MRA seems to be a more reliable and accurate diagnostic imaging modality for the classification and treatment of instabilities compared to standard MRI. 1. Introduction Anterior shoulder instability is one of the most common orthopedic problems. Glenohumeral (GH) instability occurs mostly in young, active males and is usually caused by traumatic injury. Recurrent subluxations and dislocations of the GH joint occur as a result of changes in bone, cartilage, and soft tissues and are referred to as habitual dislocation of the shoulder [1, 2]. This problem, which causes severe morbidity that interferes with daily and sporting activities, is associated with many bone and soft tissue changes. The glenohumeral ligament, its inferior part in particular, is one of the most important passive stabilizers of the shoulder. The glenoid labrum contributes to stability of the shoulder by deepening the glenoid fossa with ligamentous attachments [3, 4]. A number of anterior instabilities can be associated with glenohumeral ligament lesions and with lesions of complex ligamentous structures that the glenohumeral ligament forms with neighboring tissues. The main instabilities are Bankart lesion (avulsion of the anterior glenoid labrum from the bone), glenoid edge fracture, Hill-Sachs lesion (osseous defect due to dislocation of the posterosuperior lateral humeral head), and loose body [1]. In addition, the Perthes lesion, a labroligamentous avulsion in which the scapular periosteum remains intact, and the ALPSA lesion, a medial displacement of the anteroinferior labral ligamentous complex with an intact scapular periosteum, should be considered potential causes of shoulder instability [5, 6]. The identification of anterior labral avulsion, capsular laxity, and other pathologies of the GH joint is of great significance in treatment planning. The methods used to identify these
Dynamic Arbitrageurs’ Long-Run Impacts on Convertible Bond Issuers’ Stock Prices  [PDF]
Serhat Yildiz
Theoretical Economics Letters (TEL) , 2018, DOI: 10.4236/tel.2018.89099
Abstract: I examine convertible bond arbitrageurs’ long-run impact on convertible bond issuers’ stock prices. I find a negative relation between arbitrage activity around convertible bond issues and convertible bond issuers’ long-run stock returns. Average three-year holding period return of convertible bond issuers with no-arbitrage activity around their convertible bond issues is two times larger than that of convertible bond issuers with arbitrage activity around their convertible bond issues. Overall, I show that convertible bond arbitrageurs’ price impact is not limited to short-term [1], but it also has a long-term component.
An Empirical Multi-Output Production Decision Model for the Profit Maximizing Multiproduct Firm  [PDF]
Ekaterina Vorotnikova, Serhat Asci
Theoretical Economics Letters (TEL) , 2015, DOI: 10.4236/tel.2015.54065
Abstract: Empirical estimation of a theoretical multi-output production model that uses multiple inputs is difficult because of the complexities of its functional form. By using proper parameterization to linearize theoretical model’s functional form, this paper develops an empirical estimation for multi-output production decision using multiple inputs in the profit maximizing firm, namely, multi-output production decision model. The model aligns with the dual approach of cost minimization and revenue maximization for the profit maximizing multi-product firm while keeping jointness in production structurally intact.
A Study of the Chinese Retaliatory Tariffs on Tree Nuts Industry of California  [PDF]
Srini Konduru, Serhat Asci
Theoretical Economics Letters (TEL) , 2019, DOI: 10.4236/tel.2019.98172
Abstract: The objective of this study is to analyze the economic impact of Chinese retaliatory tariffs on California’s economy using the Input-Output model. Our model uses state level Impact Analysis for Planning (IMPLAN) dataset along with data from the United States Department of Agriculture-Foreign Agricultural Service (USDA-FAS), California Department of Food and Agriculture, and County Ag Commissioner’s reports. The analysis focuses on the implications of the retaliatory tariffs by China in a scenario where the demand from other alternate export markets does not change. The results show that the tree nut industry’s total output decreases by about 14% and 10% in the short-run and long run period respectively when compared to the baseline scenario. The tree nut sector would be employing about three thousand people lesser than the baseline scenario in the short-run period and about two thousand people in long-run period, which is equivalent to 7% in the short-run and 5% in the long-run period. The study concludes that it is very important for the US and China to resolve their trade disputes as quickly as possible in order to bring confidence not only to the tree nut industry in California, but hundreds of other industries that have been impacted by this trade war.
Retrospective Cohort Study of the Prevalence of Lumbosacral Transitional Vertebra in a Wide and Well-Represented Population
Demet U？ar,Bekir Yavuz U？ar,Yahya Co？ar,Kurtulu？ Emrem,Gürkan Gümü？suyu,Serhat Mutlu,Burcu Mutlu,Mehmet Akif ？a？an,Y？lmaz Mertsoy,Hatice Gümü？
Arthritis , 2013, DOI: 10.1155/2013/461425
Abstract: Purpose. The aim of this study is to determine the prevalence of lumbosacral transitional vertebra (LSTV) in a well-represented general population. Methods. For a retrospective cohort study, abdominal radiographs of adult subjects were queried with clear visibility of the vertebral body articulation of the last rib, all lumbar transverse processes, and complete sacral wings. Exclusion criteria included any radiologic evidence of previous lumbosacral surgery that would block our view. A total of 6200 abdominal films were reviewed, and 3607 were identified as being suitable for the measurement of the desired parameters. Results. A total of 3607 subjects were identified as eligible for the study, and 683 (18.9%) were classified as positive for a lumbosacral transitional vertebra. The prevalence of sacralization and lumbarization was found as 17.2% and 1.7%, respectively. The average age at the time of the study was years (18–86 years). Conclusions. As a result of different opinions, LSTV retains its controversial status. Our prevalence study of the general population will provide assistance for resolution of the controversy. Prevalence studies of the general population with a wide participation will shed light on comparative studies. 1. Introduction Lumbosacral transitional vertebra (LSTV) is a congenital vertebral anomaly of the L5-S1 junction in the spine [1]. LSTV occurs because of sacralization in which one or both of the transverse processes of the fifth lumbar vertebra exhibits fusion with the first sacral segment or as a result of lumbarization in which the first sacral segment exhibits an abnormal transverse process similar to that of the lumbar vertebra. This modification may contribute to incorrect determination of a vertebral segment, which can lead to surgery at the wrong level and unresolved symptoms [1]. LSTV is evaluated with lumbosacral anteroposterior radiographs, and abdominal radiographs may also show this anomaly. Abdominal radiographs, as radiographic examinations for abdominal indications, have many clinical uses and are most often indicated for patients who exhibit signs of intestinal obstruction or visceral perforation. In this study, a different purpose was pursued. We used abdominal radiographs which were with clear visibility of the last rib’s vertebral body articulation, all lumbar transverse processes, and the complete sacral wing to provide radiographic images of the lumbar spine. For a study evaluating LSTV cases, the use of these radiographs was desirable as they are likely to be representative of the general population. The
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