Browsing by Author "Tüzün, Ç"

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    Effects of simvastatin on bone mineral density and remodeling parameters in postmenopausal osteopenic subjects
    Tikiz, C; Tikiz, H; Taneli, F; Gümüser, G; Tüzün, Ç
    Observational studies suggest that statin use may be associated with lower incidence of fracture. However, there are conflicting data for their effects on bone remodeling parameters and bone mineral density (BMD). In the present study, we aimed to investigate the effects of simvastatin on bone metabolism and BMD in subjects with hypercholesterolemia (> 240 mg/dl). For this purpose, 32 postmenopausal osteopenic subjects who were given simvastatin treatment (20 mg/day) and not on osteoporosis treatment were included in the study. During the 1-year follow-up period, the total cholesterol level decreased from 262.1 +/- 30.9 to 202.2 +/- 30.1 mg/dl (p < 0.0001). At a period as early as the 3rd month, levels of the anabolic markers, e.g., bone-specific alkaline phosphatase (BSAP) and osteocalcin (OCL), were found to be significantly increased (from 120.8 +/- 56.6 to 149.5 +/- 57.6 IU/l, p = 0.008, and from 20.8 +/- 12.6 to 34.7 +/- 118.4 mu g/l, p = 0.015, respectively) while no significant change was observed in the resorptive marker of serum N-telopeptide of type I collagen (CTX). At the 6th and 12th month, BSAP and OCL were both found to be decreased below the pretreatment values. While a significant reduction was found in BSAP levels (from 120.8 +/- 56.6 to 55.9 +/- 18.8 IU/l, p < 0.001), no significant change was observed in CTX levels after the 6-month treatment period. Parathyroid hormone showed a gradual profound increase during the follow-up period (from 62.7 +/- 41.5 to 108.4 +/- 51.7 pg/ml, p < 0.001). No significant change was found in BMD levels at the spine, femoral neck, Ward's triangle, and trochanter at the end of the 1-year follow-up period. In conclusion, simvastatin treatment showed a short-lasting anabolic effect on bone metabolism. However, this effect was lost by prolongation of therapy. The decrease in both anabolic and resorptive markers at the 6th and 12th month suggests that simvastatin affects bone metabolism mostly in favor of inhibition of the bone turnover in a long-term observation period although this inhibitory effect was not reflected in BMD.
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    Low-Level Laser Therapy is More Effective Than Pulse Ultrasound Treatment on Wound Healing: Comperative Experimental Study
    Tikiz, C; Angin, A; Demireli, P; Taneli, F; Özyurt, B; Tüzün, Ç
    Objective: To investigate and compare the effects of pulse ultrasound (US) and low-level laser therapy (LLLT) on wound healing. Material and Methods: Thirty-two rats were included in the study and two full-thickness skin wounds were made on dorsum area of the rats bilaterally, with a 17 mm hole-punch. The animals were divided into two groups. Pulsed US (with a power of 0.1 W/cm(2), a frequency of 1 MHz, 5 minutes daily) was applied to to the right sided wounds of Group A (n=16) and Ga-As laser (830 nm wavelength, 0.5 J/cm(2) dosage of 1 MHz frequency for 1 minute duration) was applied to right sided wounds of Group B (n=16). Left sided wound were considered as controls and same procedures were applied without any current (sham). Biochemical and histopathological evaluations were performed in each group on 7(th) and 15(th) days. Results: Inflammatory cells tended to decrease in both treatment groups on the 7(th) day, however, this finding did not reach a statistical significance (p>0.05). Fibroblasts and collagen were found to be significantly increased in the laser group when compared to the other group on the 7(th) day (p<0.05). Angiogenesis was found to be significantly increased only in the laser group when compared to the other group on the 15(th) day (p<0.05). There were no significant differences in tissue nitric oxide values between the groups although the values in the laser group tended to be higher on the 15th day (p=0.058) Conclusion: In this comparative study. LLLT was found to significantly accelerate mainly proliferative phase while pulse US had no effect on wound healing. Our results support the consideration that LLLT may constitute a beneficial treatment modality for wound healing.
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    The effect of simvastatin on serum cytokine levels and bone metabolism in postmenopausal subjects
    Tikiz, C; Ünlü, Z; Tikiz, H; Ay, K; Angin, A; Onur, E; Var, A; Tüzün, Ç
    In this prospective study, we aimed to evaluate the effect of simvastatin on bone metabolism and the correlation between changes in bone turnover parameters and serum cytokine levels. For this purpose, 38 postmenopausal subjects with hypercholesterolemia (>240 mg/dl), not on osteoporosis treatment, were studied. Simvastatin was started at a dose of 20 mg daily and continued for 3 months. Six patients were excluded from the study during the follow-up period. Pre- and post-treatment samples were analyzed for bone alkaline phosphatase (BAP) and osteocalcin (OCL), as markers of bone formation; for carboxyterminal telopeptide of collagen I (CTX), as a marker of bone resorption; and for interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) cytokine levels. Total cholesterol level was decreased from 262.1 +/- 30.9 to 210.2 +/- 35.6 mg/dl after simvastatin treatment (P < 0.0001). While no significant change was observed in serum CTX level, BAP and OCL levels were significantly increased (from 120.8 +/- 56.6 to 149.5 +/- 57.6 IU/l [P = 0.008], and from 20.8 +/- 12.6 to 34.7 +/- 18.4 mug/l [P = 0.015], respectively). In the analysis of cytokines, while no significant change was observed in IL-6 levels, the TNF-alpha level was found to be significantly decreased after simvastatin treatment (from 77.9 +/- 31.6 pg/ml to 23.5 +/- 12.6 pg/ml [P = 0.021]). Individual changes in TNF-alpha levels showed a moderate negative correlation with the individual changes in BAP and OCL levels (r = -0.550 [P = 0.001], and r = -0.497 [P = 0.004], respectively). In conclusion; 20-mg daily simvastatin treatment for 3 months significantly increased BAP and OCL levels (markers of bone formation) in hypercholesterolemic postmenopausal subjects, without affecting bone resorption. These findings support the idea that simvastatin has an anabolic effect on bone formation. Additionally, the presence of a negative correlation between TNF-alpha levels and the anabolic bone parameters suggests that a cytokine-lowering effect of simvastatin may also be involved in the remodeling process and could exert some additive beneficial effect on bone metabolism.
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    Comparison of the efficacy of lower and higher molecular weight viscosupplementation in the treatment of hip osteoarthritis
    Tikiz, C; Ünlü, Z; Sener, A; Efe, M; Tüzün, Ç
    We aimed to compare the efficacy of intra-articular injections of a lower molecular weight hyaluronan (LMW HA) (Ostenil) with a higher molecular weight viscosupplement (hylan G-F 20, Synvisc) in hip osteoarthritis. For this purpose, 43 patients (56 hips) with hip osteoarthritis with a visual analogue scale (VAS) pain score higher than 50/100, a Lequesne index greater than 6, and persistence of the pain for longer than 3 months despite all conservative methods were enrolled in the study and randomly assigned to two groups: 25 (32 hips) received LMW HA and the remaining 18 patients (24 hips) received hylan G-F 20. Three injections were administered once weekly to each patient under fluoroscopic guidance. During the 6-month follow-up period, the primary outcomes were assessed at the 1st, 3rd, and 6th month by VAS, WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index), and Lequesne index. The intra-articular injections produced a significant reduction in VAS, WOMAC, and Lequesne index scores in both groups. After three injections, improvement was prominent at the 1st month and maintained for 6 months in both groups. The percentage reduction was 38 and 40% (p < 0.001) in VAS pain score, 43 and 40% in WOMAC (p < 0.001), and 47 and 49% in Lequesne index (p < 0.001) in the LMW HA and hylan G-F groups at the 6th month, respectively. However, there were no significant differences in outcomes between any of the measurements at the 1st, 3rd, and 6th month between the two groups (p > 0.05). No systemic adverse effect was recorded. Local adverse effects consisting of pain and/or swelling were noted in 3 of 32 hips (9%) injected with LMW HA and in 3 of 24 hips (12.5%) injected with hylan G-F 20. In conclusion, both types of viscosupplementation produced a significant clinical improvement during the 6-month follow-up period. However, no significant difference was found in outcomes between higher and lower molecular weight hyaluronan.