Zülfü Karabulut

Bio: Zülfü Karabulut is an academic researcher. The author has contributed to research in topics: Femoral neck & Femoral head. The author has an hindex of 3, co-authored 3 publications receiving 13 citations.

Relationship between radiographic features and bone mineral density in elderly men.

Abstract: Lumbar disc degeneration is characterised radiologically by the presence of osteophytes, endplate sclerosis, and disc space narrowing. Our study was designed to assess anterior lumbar osteophytes, disc space narrowing, end plate sclerosis, and bone mineral density (BMD) in the lumbar vertebrae and femoral neck of elderly men. A total of 1000 men, aged between 71 and 90 years, were invited to participate in the study. BMD was assessed at the spine and femoral neck using dual energy X-ray absorptiometry (DXA). We examined the relationship with the degree of lumbar spinal and femoral neck deformity by using the Z-score. Lateral and anterioposterior spinal radiographs were evaluated for features of lumbar disc degeneration. The observers consisted of a consultant physical therapist, a radiologist, and anatomists who together studied the series of radiographs. Anterior lumbar osteophytes (grade 0-3), end-plate sclerosis, and disc space narrowing (grade 0-2) were evaluated. The Pearson correlation test was used to determine the association between radiographic features, the lumbar mineral density (LBMD), and femoral neck mineral density (FNBMD). In all, 90.6% of lumbar vertebral levels showed evidence of anterior osteophytes, 87.5% showed evidence of end plate sclerosis, and 68.2% of disc space narrowing. Additionally, there was a strong negative correlation in terms of age at the femoral neck, though not at the spine. On the other hand, there was a significant correlation between osteophyte grade and end plate sclerosis at the spine. In our study, the radiographic features of lumbar disc degeneration, anterior osteophytes, and end plate sclerosis were associated with an increase in BMD at the spine.

Analysis of MR Imaging of Wrists in Female Patients with Carpal Tunnel Syndrome and Healthy Controls

Abstract: El objetivo de este estudio fue evaluar los cambios morfologicos del nervio mediano en pacientes con sindrome del tunel carpiano (STC) y controles sanos, para correlacionar los hallazgos de las RM de muneca. Este estudio comparo no solo los cambios morfologicos del nervio mediano, tambien se muestran en forma descriptiva estructuras del tunel carpiano entre los pacientes diagnosticados con STC idiopatico y controles sanos. Nuestro estudio incluyo 60 manos, 30 manos fueron evaluados con diagnostico de STC idiopatico y 30 manos como controles sanos, bilateralmente. Dos pruebas de provocacion (prueba de Phalen y prueba de Tinel) se realizaron en cada mano para el grupo de pacientes (60 munecas) y el grupo control (60 munecas). En lo que respecta a los resultados de prueba de Phalen y prueba de Tinel, 24 y 26 munecas fueron excluidas del grupo paciente y grupo control respectivamente. En total 70 munecas fueron evaluadas, en terminos de la seccion transversal del area del nervio mediano a nivel de la articulacion radio-ulnar distal, el hueso pisiforme y el hamulus del hueso hamate por medio de resonancia magnetica en gruposs paciente y control. Ademas de la evaluacion de la seccion del area del nervio mediano, se determino la intensidad de la senal de la muneca y las diferentes localizaciones del nervio mediano en el tunel carpiano. La seccion transversal del area del nervio mediano medida por medio de resonancia magnetica de muneca a nivel de los huesos metacarpianos y la intensidad de la senal de las munecas pueden ser considerados como un valioso indicador al evaluar pacientes referidos con STC idiopatico.

Evaluation of the Singh index and Femur Geometry in Osteoporotic Women

Abstract: We aimed to compare the Singh index with bone mineral density (BMD) by dual-energy X-ray absorptiometry (DXA), body mass index (BMI) and femur geometry in the right proximal femur of osteoporotic women, using different statistical tests. Radiographs of each patient were assessed to determine the Singh index by five observers. The observers consisted of a consultant radiologist, physical therapist and anatomists who studied the series of radiographs. They were asked to apply the Singh index by comparing the trabecular bone pattern in the proximal right femur with the reference scale published by Singh et al. [1]. This has a six point scale from grade VI to grade I. We evaluated 47 osteoporotic women in this study. The subjects’ mean age, weigth, and height were 63,21 ± 10,106, 66,72 ± 12.523, 154,94 ± 7,026 respectively. We found a significant relationship between the Singh index and BMD. The Singh index correlated significantly with hip axis length, femoral neck diamater and trochanteric width. And, BMD correlated significantly with femoral head and neck diameter, femoral neck cortex width, medial calcar femoral cortex width and femoral shaft cortex width. The evaluation of the Singh index grades in its self, there was a significant relation among them.

Surgery of the Peripheral Nerve

Abstract: The authors of this text are both plastic surgeons. Dr Dellon has studied sensory nerves extensively, sensibility testing and sensory reeducation in particular. Dr Mackinnon has had a long-term interest in nerve physiology as it relates to surgery on peripheral nerves and, particularly, grafting with autografts and allografts. Both authors are international authorities in their fields, and they also have a large experience with various peripheral nerve problems that are treated surgically. In order to be logical, comprehensive, and nonrepetitious, the authors have chosen to write this text themselves, and this appears to be a very good decision. The focus of this text is the surgery of peripheral nerve disorders, with which the authors have extensive, either clinical or research, experience. They have chosen a strict organization of the contents that starts with a macroscopic, microscopic, and ultrastructural description of the anatomy of peripheral nerves. The physiology of peripheral nerves

Aged-Related Changes in Body Composition and Association between Body Composition with Bone Mass Density by Body Mass Index in Chinese Han Men over 50-year-old

Abstract: Objectives Aging, body composition, and body mass index (BMI) are important factors in bone mineral density (BMD). Although several studies have investigated the various parameters and factors that differentially influence BMD, the results have been inconsistent. Thus, the primary goal of the present study was to further characterize the relationships of aging, body composition parameters, and BMI with BMD in Chinese Han males older than 50 years. Methods The present study was a retrospective analysis of the body composition, BMI, and BMD of 358 Chinese male outpatients between 50 and 89 years of age that were recruited from our hospital between 2009 and 2011. Qualified subjects were stratified according to age and BMI as follows: 50–59 (n = 35), 60–69 (n = 123), 70–79 (n = 93), and 80–89 (n = 107) years of age and low weight (BMI: < 20 kg/m2; n = 21), medium weight (20 ≤ BMI < 24 kg/m2; n = 118), overweight (24 ≤ BMI < 28 kg/m2; n = 178), and obese (BMI ≥ 28 kg/m2; n = 41). Dual-energy X-ray absorptiometry (DEXA) was used to assess bone mineral content (BMC), lean mass (LM), fat mass (FM), fat-free mass (FFM), lumbar spine (L1-L4) BMD, femoral neck BMD, and total hip BMD. Additionally, the FM index (FMI; FM/height2), LM index (LMI; LM/height2), FFM index (FFMI; [BMC+LM]/height2), percentage of BMC (%BMC; BMC/[BMC+FM+LM] × 100%), percentage of FM (%FM; FM/[BMC+FM+LM] × 100%), and percentage of LM (%LM; LM/(BMC+FM+LM) × 100%) were calculated. Osteopenia or osteoporosis was identified using the criteria and T-score of the World Health Organization. Results Although there were no significant differences in BMI among the age groups, there was a significant decline in height and weight according to age (p < 0.0001 and p = 0.0002, respectively). The LMI and FFMI also declined with age (both p < 0.0001) whereas the FMI exhibited a significant increase that peaked in the 80-89-years group (p = 0.0145). Although the absolute values of BMC and LM declined with age (p = 0.0031 and p < 0.0001, respectively), there was no significant difference in FM. In terms of body composition, there were no significant differences in %BMC but there was an increase in %FM (p < 0.0001) and a decrease in %LM (p < 0.0001) with age. The femoral neck and total hip BMD significantly declined with age (p < 0.0001 and p = 0.0027, respectively) but there were no differences in L1-L4. BMD increased at all sites (all p < 0.01) as BMI increased but there were declines in the detection rates of osteoporosis and osteopenia (both p < 0.001). A logistic regression revealed that when the medium weight group was given a BMI value of 1, a decline in BMI was an independent risk factor of osteoporosis or osteopenia, while an increase in BMI was a protective factor for BMD. At the same time, BMD in L1-L4 exhibited a significant positive association with FMI (p = 0.0003) and the femoral neck and total hip BMDs had significant positive associations with FFMI and LMI, respectively (both p < 0.0001). Conclusions These data indicate that LMI and FFMI exhibited significant negative associations with aging in Chinese Han males older than 50 years, whereas FMI had a positive association. BMD in the femoral neck and total hip declined with age but an increased BMI was protective for BMD. LMI and FFMI were protective for BMD in the femoral neck and total hip.

Bone Mineral Density Correlation against Bone Radiograph Texture Analysis: An Alternative Approach

Abstract: Osteoporosis is the “Silent disease” in which the microarchitecture of bones becomes weak due to the low bone mass density. This common public health problem has lack of symptoms, and at the moment can only be diagnosed using a technique called dual-energy x-ray absorptiometry (DEXA). The DEXA scan of a bone provides bone mineral density (BMD), which is compared against the standard BMD values for diagnoses. The availability of DEXA machine in a third world country like Pakistan is an issue because of its high cost and the high percentage of population living in rural areas with limited health care facilities. The aim of this paper is to review the published work on this subject and suggest a solution that aids early diagnosis of osteoporosis using x-ray radiographs only. An associated problem is the use of T-score and Z-score reference values that are not based on the local population.

Association of low back pain, somatic dysfunction, and lumbar bone mineral density: reproducibility of findings.

Abstract: Context: Somatic dysfunction as diagnosed by palpation should be associated with an objective measure. Bone mineral density (BMD) has been shown to be elevated in lumbar vertebrae with somatic dysfunction and in the lumbar region of individuals with chronic low back pain (LBP). Objective: To investigate the association of lumbar somatic dysfunction and BMD T-score variability in participants with chronic LBP and without LBP (non-LBP) and to determine the reproducibility of previously published results. Methods: Two examiners, blinded to symptom history, evaluated participants for tissue texture abnormalities, rotational asymmetry, anterior motion restriction, and tenderness at vertebral levels L1 to L4. Participants also underwent dual-energy xray absorptiometry of vertebral levels L1 to L4 for the assessment of BMD T scores. Generalized linear models were used to compare the chronic LBP and non-LBP groups on the presence and severity of somatic dysfunction and to test whether group and the presence and severity of somatic dysfunction were related to BMD T scores. Results: Forty-three chronic LBP (54%) and 36 non-LBP participants (46%) completed the study. Although the presence of somatic dysfunction in the 2 groups was not significantly different, the presence of tenderness was significantly more common in the chronic LBP group (P<.001), as was the severity for tissue texture abnormalities (P=.03), motion restriction (P=.04), and tenderness (P<.001). Of the 316 vertebrae assessed, 31 (10%, all in the chronic LBP group) had moderate/ severe tenderness. The vertebral somatic dysfunction burden score, the total somatic dysfunction burden score, the vertebral somatic dysfunction severity score, and the total somatic dysfunction severity score were higher in the chronic LBP group (all P<.001). The vertebral BMD T score was significantly higher for vertebrae demon strating moderate/severe rotational asymmetry compared with those demonstrating mild or no rotational asymmetry (P=.01) and for vertebrae demonstrating moderate/ severe tenderness compared with those demonstrating no tenderness (P=.04). Conclusion: Study results suggest that somatic dysfunction was more significant in chronic LBP participants. Although the correlation between the presence of somatic dysfunction and segmental BMD T scores was not reproduced, BMD T scores were higher for vertebrae demonstrating moderate/severe rotational asymmetry and tenderness.

Role of diffusion tensor imaging in carpal tunnel syndrome: A case control comparative study to electrophysiological tests and clinical assessment

Abstract: Purpose To study the efficacy of diffusion tensor imaging (DTI) in the diagnosis of carpal tunnel syndrome (CTS). Materials and Methods Twenty-three wrists of healthy subjects (age between 29 and 71 with mean of 44 years) and 47 wrists of CTS patients (age between 19 and 84 with mean of 46 years) were evaluated with DTI and electrophysiological studies (EPS). The DTI was performed on a 1.5T scanner. Fraction anisotropy (FA) and apparent diffusion coefficient (ADC) of the median nerve were calculated. Electrophysiological tests were also performed. Paired student’s t-test, ANOVA, Mann-Whitney, Wilcoxon, Post Hoc, Kruskal-Wallis, Chi-Square, Spearman’s Rho and Pearson statistical tests were used. Results There was a significant difference between healthy individuals and patients with CTS (P Conclusion DTI can contribute to CTS diagnosis on the basis of FA and ADC measurements.