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  • Küçük Resim
    Öğe
    Local Anesthetic Efficacy for Oral Surgery - Comparison of Diphenhydramine and Prilocaine
    (MOSBY-YEAR BOOK INC, 1998) Uçkan, Sina; Güler, Nurhan; Sümer, Mahmut; Üngör, Mete
    Objective. Diphenhydramine has been suggested as an alternative local anesthetic agent for patients claiming allergy to local anesthetics. The present study attempted to determine the local anesthetic efficacy of diphenhydramine for oral surgery. Study design. Seventeen patients claiming allergy to local anesthetics were given diphenhydramine as anesthetic alternative and compared with seven nonallergic control patients treated with prilocaine. After determining an average value of vitality score of neighboring and contralateral teeth by electrical pulp stimulation, molar and premolar teeth were extracted and postextraction vitality scores determined. Visual analogue scale, anesthesia onset times, and the incidence of pulpal and soft tissue anesthesia were analyzed nonparametrically by means of Mann-Whitney U tests. Results. The mean onset time of pulp anesthesia with diphenhydramine (range, 4 to 7.5 minutes), excluding one failure, was not significantly different from that of prilocaine; (range, 4 to 13 minutes). The duration of anesthesia was significantly longer and the visual analogue scale lower in the group receiving prilocaine in comparison with the group receiving diphenhydramine. Conclusion. In the small group studied, diphenhydramine administration provided adequate anesthesia before oral surgery; it may be useful as an anesthetic alternative in patients with histories of allergy to local anesthetics.
  • Küçük Resim Yok
    Öğe
    Squamous Cell Carcinomalı Hastalarda Normal ve Tümöral Dokudaki Zn ve Fe Seviyelerinin Karşılaştırılması
    (2000) Ataoğlu, Hanife; Güler, Nurhan; Öztürk, Kayhan; Uçkan, Sina
    Eser elementlerin enzimatik reaksiyonları inhi-be veya aktive ederek bir dizi biyolojik olayda rol oynadığı çok iyi bilinmektedir. Ancak malign hastalıklar veya teşhis ve prognozdaki klinik önemleri hala tartışmalıdır ve baş-boyun tümörleri üzerindeki etkileri tam olarak bilinmemektedir. Bu çalışma, %53'ü üçüncü evrede % 40 ise ikinci evrede olan 15 Squamous cell carcinomalı (SCC) hastada planlandı. Çinko ve demir seviyesinin belirlenmesi için hem tümör hem-de sağlıklı doku örnekleri SCC hastalardan elde edildi. Bu elementlerin seviyesi atomik ab-sorpsiyon spektrofotometre kullanarak belirlendi. Tumoral dokudaki çinko ve demir seviyeleri kontrol grubundaki çinko ve demir seviyeleri ile karşılaştırıldığında, her iki elementin seviyesinin tümör dokusunda kontrol grubundan yaklaşık 2 kat kadar fazla olduğu görüldü. Tümör dokusunda ortalama çinko ve demir seviyesi 141,8866,93 ug/g ve 868,76 461,92 ug/g olarak bulundu. Sağlıklı dokuda çinko 65,0324,24ug/g ve 430,84211,37 ug/g idi. Bu fark istatistiksel olarak anlamlı bulundu (p0.05). Tümör dokusundaki çinko ve demir seviyesi ile tümör evresi arasında anlamlı bir ilişki bulundu (p0.05). Bu çalışmadan elde edilen veriler, aşın çinko ve demir elementlerin seviyesinin baş-boyun SCC'lı hastaların karsinogenezisi üzerinde etkili olabileceğini göstermektedir.
  • Küçük Resim
    Öğe
    Temporomandibular joint internal derangement: relationship between joint pain and MR grading of effusion and total protein concentration in the joint fluid
    (BRITISH INST RADIOLOGY, 2005) Güler, Nurhan; Uçkan, S.; İmirzalioğlu, P.; Açıkgözoğlu, Saim
    Objectives: The objective of this study was to determine whether there is any association between the protein concentration in the synovial fluid and (i) the amount of articular hydrops, as graded in magnetic resonance (MR) images, and (ii) joint pain in temporomandibular joints (TMJs) with and without displacement of the disc. Patients and methods: This study involved 16 joints in 16 patients referred to our clinic with the complaint of pain and limited mouth opening. The control group consisted of 15 joints in 15 patients with unilaterally normal disc and condyle relationship and no pain while the opposite side had a non-painful joint with disc displacement without reduction (DDwoR). The subjects and controls were different individuals and only a single joint was used for each. Pain and dysfunction were evaluated by visual analogue scale. Bilateral proton density and T-2 weighted images of the TMJs of the 31 subjects were analysed for fluid and condyle bony changes as well as disc position. The amount of fluid, identified as an area of high signal intensity in the region of the upper and lower joint spaces, was characterized as none, minimal, moderate or marked. Arthrocentesis was performed both for synovial fluid analysis of total protein concentration and the treatment of the joints with DDwoR. Total protein concentration was measured by using protein dye binding on spectrophotometry. Results: All patients experienced a significant (P < 0.01) increase in maximal mouth opening immediately post-arthrocentesis. In the study group, the disc was displaced most frequently in an anteriormedial direction (75%) and deformation of disc form was seen in 13 joints. Condylar bony changes were seen in 27% of joints in the control group and in 81 % of joints in the study group. A statistically significant association was found between joints with disc displacement, disc form and condylar bony changes (P < 0.05). In the control group, only one joint, which had an osteophyte, showed joint effusion QE) with moderate fluid. In the study group, only four joints had no fluid (25%). JE was found in 10 (63%) joints with disc displacement on anteromedial direction, in 10 (63%) joints with disc deformation and in 10 (63%) joints with osteophytes and erosion. Mean total protein concentration was 16.87 +/- 7.9 (range 7.4 - 34.1 mg dl(-1)) in control joints, 55.08 +/- 35.16 (range 21.5- 153.9 mg dl(-1)) in study joints. There were significant differences in the mean total protein concentration between the control and study groups (P < 0.01). Significant positive correlation was found between the total protein concentration and JE (r = 0.65, P < 0.01). No significant correlation was found between the level of pain and dysfunction and JE and total protein concentration in either control or study groups (P > 0.05). Conclusion: Pain in the TMJ was not related to MR findings of effusion in internal derangement and synovial fluid aspirate findings of total protein concentration. However, total protein concentration was related to the amount of JE in DDwoR joints and painful joints were more likely to demonstrate the JE.