Functional outcomes and quality of life in patients with proximal row carpectomy

Objectives: This study aims to assess pain, functional status, patient satisfaction, and quality of life in patients with proximal row carpectomy. Patients and methods: Between December 2007 and November 2011, demographic, clinical, and operational data, and physical therapy program of 16 patients (11 males, 5 females; mean age 41.4±16.6 years; range 19 to 77 years) with proximal row carpectomy were recorded. Pain (0-no pain, 10-severe pain), and patient satisfaction (0-not satisfied, 10-very satisfied) were assessed with visual analog scale (VAS). Wrist range of motion, and hand grip strength were evaluated. The quick-disabilities of the arm, shoulder and hand (Q-DASH), and Mayo wrist score were used for functional evaluation of the upper limb. Short form-36 (SF-36) was used for the evaluation of quality of life. Results: Postsurgical duration was 20.6±16.4 (range; 6-56) months. Complex regional pain syndrome (CRPS) was detected in two patients (%12.5). The mean session numbers of physical therapy were 16.7±9.4 (range; 0-30), satisfaction VAS was 8.4±2.1, rest VAS 0.8±0.9, activity VAS was 2.3±2.2, grip strength of operated side 82% of nonoperated side, Q-DASH score was 13.4±16.5 (substantially good), and Mayo wrist score was 80.0±19.4 (good). Significant improvement was detected in postoperative flexion-extension arc compared to preoperative status (p=0.001). A correlation was detected between hand grip strength percentage and session numbers of physical therapy (p=0.025, r=0.558). Relationships between quality of life-pain subscore and activity pain (p=0.001, r= -0.819), Q-DASH (p=0.003, r= -0.698), and Mayo wrist score (p=0.037, r=0.525) were detected. The presence of complication was the only independent variable for prediction of functional status in multivariate linear regression analysis. Conclusion: Increased number of physical therapy session results in improved hand grip strength following the proximal row carpectomy, while CRPS complication which can be seen after surgery affects the functional status adversely

Evaluation of balance changings after arthroscopic anterior cruciate ligament reconstruction

Proprioseptif reseptörlerin, ön çapraz bağ (ÖÇB) içindeki varlığı bilinmektedir. ÖÇB koptuğunda, dizde bulunan bu ekanoreseptörlerden merkezi sinir sistemine gelen duyusal uyarılar yok olur. Böylece alt ekstremitenin uygun stabilizasyon yeteneğinde kayıp oluşur. Dizde oluşan instabiliteye ikincil olarak propriosepsiyonda da ve dolayısıyla postural stabilitede de önemli bir kayıp meydana gelmektedir. Postural stabilitenin kaybı düşme riskinde artışı beraberinde getirmektedir. Bu çalışmada ÖÇB yaralanması sonrası denge aktivitelerinin nasıl etkilendiğini ve cerrahi tamir sonrası nasıl değişiklikler gözlendiğini belirlemek amaçlanmıştır. Kemik-Patellar tendon-Kemik (K-Pt-K) otogrefti ile rekonstrüksiyon uygulanan 30 hasta preoperatif ve postoperatif takiplerde düşme riski, atrofi, endurans, yürüme hızı ve 6 dakika yürüme testi ile kontrol edilmiştir. Hastaların preoperatif düşme riskleri yüksek olup postoperatif 1. ayda tamamına yakını yüksek düşme riski taşır. Şikayet süresindeki artış düşme riskini arttırırken aynı zamanda düşme riskindeki düzelmeyi de azaltır. Yüksek enerjili travma öyküsü düşme riskindeki düzelme üzerine etki etmez. Lysholm skoru düşme riski ile ilişkisizken atrofi artışıyla düşme riski de artar. ostoperatif 3. ayda düşme riski preoperatif bazal değerlerin altına iner. Bu sonuçlar ışığında, düşme riskinin ÖÇB rüptürünün cerrahi tekonstrüksiyonu sonrası iyileştiği, ancak şikayet süresi uzadıkça bu iyileşmenin azaldığı sonucuna vardık.Proprioceptive receptors are known to be present at anterior cruciate ligament (ACL). When ACL is torn, the sensorial signals that are transmitted from these mechanoreceptors fade away. Secondary to instability of knee, proprioception and accordingly postural stability goes under serious deprivations. Loss of postural stability triggers increases at fall risk (fall index). In this study, we aimed to investigate how the balance activities are effected after ACL injury and which changes are seen after surgical procedures. 30 patients that have gone reconstruction with bone-patellar tendon-bone (B-Pt-B) autograft are investigated in terms of fall risk, atrophy, endurance, walking speed, and 6 minutes walking test preoperative and postoperatively. Whilst patients have high and medium preoperative fall risk, nearly all patients have high fall risk at postoperative first month. Since the increase in complaint duration increases fall risk, it also decreases the improvement at falling hazard. History of high energy traumas has no effect on improvement of fall risk. Whilst there is no relation between Lysholm knee score and fall risk, increases in fall risk is correlated with atrophy. At postoperative 3rd month, fall risk values goes below basal levels. In light of theese outcomes, we concluded that, fall risk improves after surgical reconstruction of ACL rupture, but as complaint duration elongates, this improvement decreases

Permeability characteristics of pumice-bentonite mixtures in comparison with sand-bentonite mixtures

Environmental pollution is a significant concern around the landfill sites, waste repositories and other similar wastewater storage and treatment basin and ponds. Pumice is an abundant natural material in Kayseri, Turkey and therefore, permeability characteristics of pumice-bentonite mixtures were investigated in comparison with commonly used sand-bentonite mixtures. Four different bentonite contents (15, 20, 25 and 30%) and three grain size ranges (2.00 to 1.00; 1.00 to 0.50; 0.50 to 0.25 mm) of pumice and sand were used to determine the hydraulic conductivity of mixtures. Since it takes long time to determine the hydraulic conductivity of fine grained mixtures, empirical equations were developed between permeability and easily-determined geotechnical characteristics such as dry unit weight, moisture content, and swell potential of such mixtures. Pumice-based mixtures yielded identical permeability values for the same bentonite contents and size ranges. Overall evaluation of regression equations with regard to mean absolute error (MAE) and regression coefficients showed that while dry unit weight yielded the least MAE and the highest R2&nbsp;values for pumice-based mixtures, swelling potential yielded the best estimations for sand-based mixtures. Bentonite content of ≥ 30% is recommended for both pumice and sand-based mixtures with grain sizes between 2.00 and 0.50 mm and ≥25% for mixtures with grain sizes less than 0.50 mm.</p

Compaction and swelling characteristics of sand-bentonite and pumice-bentonite mixtures

Bentonite mixed with varying quantities of sand is currently of widespread interest as engineering liners for water containment and waste disposal. However, the alternative use of pumice, widespread in many volcanic regions, has been less studied and requires further characterization of geotechnical properties and performance prior to its extensive use. The objective of this study was to determine and compare the compaction and swelling characteristics of sand-bentonite and pumice-bentonite mixtures using available geo-materials from Turkey. Standard Proctor compaction tests and constant volume swell tests were carried out using mixtures with four different bentonite contents (15, 20, 25, 30%) and three different sand and pumice grain size ranges (2.00-1.00; 1.00-0.50; 0.50-0.25 mm). The results indicate that pumice-bentonite mixtures have lower maximum dry unit weights, higher optimum moisture contents and greater swelling potentials than equivalent sand-bentonite mixtures. Important differences occur in the swelling potentials of the sand and pumice mixtures with respect to grain size whereby sand-bentonite mixtures show increased swelling with coarsening grain size, in contrast to the pumice-bentonite mixtures which showed a decrease. These differences are attributed to the amount of grain-size-dependent connected pore space that can be filled during bentonite expansion and the presence of dissolvable salts in the pumice. It is concluded that locally available pumice material could be used to replace sand in engineering bentonite seals, despite some differences in their geotechnical properties

Common Failures of the Natural Wastewater Treatment Systems (Constructed Wetlands) of Kayseri, Turkey

Continuously polluted waters, decreasing water resources due to global warming and climate chance, and increasing labor and energy costs brought water and treatment technologies to first place on the world's agenda. Despite the continuously increasing environmental awareness and legal regulations against environmental pollution, domestic and industrial wastewaters arc discharged into the nearest receiving water bodies without any treatment. Haphazard disposal of wastes into the environment and untreated wastewater discharged into rivers and streams pollute air, water, and soil and create a danger for human, animal, and plant health. All these wastes should be treated before their disposal and discharge to leave a healthier and cleaner environment for future generations. The constructed wetlands, defined also as natural treatment systems, arc the systems emulating the natural wetland systems. They are commonly used for treatment of domestic and industrial wastewater in specially designed basins with aquatic plants and can easily be used for snull-to-medium sized communities. There are 51 constructed wetlands in the Kayseri Province of Turkey and more than three-fourths have some kind of structural failure and are not operating properly In this study, all of these constructed wetlands were investigated with regard to improper design aspects and possible failures. The common failures were identified as improper design, construction and site selection, substrate clogging and consequent (poundings), insufficient plantation, leakage through slopes, and lack of post-construction operation, monitoring, and maintenance activities. The reasons for such failures and possible corrective measures are also proposed in this study

Spatial analysis of some physical soil properties in a saline and alkaline grassland soil of Kayseri, Turkey

In this study, geostatistical analysis of electrical conductivity (EC) and soil pH values, soil clay (C), silt (Si), and sand (S) content, permanent wilting point (PWP), organic matter (OM), field capacity (FC) and water stable aggregates (WSA) were investigated in 1500 ha degraded grassland of Kayseri, Turkey. Coefficients of variations (CVs) of EC (125 - 103 dS m(-1)) were higher than the other soil properties while the lowest CV was found for pH (5 - 5) in 0 - 30 (D1) and 30 - 60 cm (D2) depths. To summarize the relationships among examined soil properties, Pearson Correlation analysis was performed and significant correlations were found between LnEC-LnpH and selected physical soil properties for D1 and D2 (p<0.01 and p<0.05). Independent sample t-test indicated that the means of EC and organic matter content of soil (OM) were statistically different while there were no differences for the others (p<0.05). In geostatistical analysis, exponential model was fitted to experimental variograms for LnEC, LnC, SqSi, and LnS of D1 and LnEC of D2, while spherical model was used for LnpH, SqOM, PWP, SqFC, and SqWSA of D1 and LnpH, LnC, SqSi, LnS, SqOM, PWP, FC, and SqWSA of D2. Selected soil variables showed different degree of spatial correlation. Kriging maps showed environmentally risky areas of the study site

HEAVY METAL, NITROGEN AND PHOSPHORUS ADSORPTION OF COMPACTED LINER MIXTURES

Nitrate, phosphorus and heavy metals are among the most common pollutants and create potential dangers for groundwater contamination. In this research, a liner design was proposed for waste repository sites, constructed wetland basins and manure management lagoons to prevent groundwater contamination by seepages from the bottom of these facilities. For this purpose, sand-bentonite and pumice-bentonite mixtures with pre-defined grain size range (1.00-0.50 mm) and bentonite content (30%) was used. The mixtures were compacted at optimum moisture content and maximum dry weight and then permeability tests were carried out over compacted mixtures. Various concentrations of nitrate, phosphorus (25, 50, 100, 150 and 200 ppm) and heavy metal (Cd, Ni, Pb, Cr and Cu) solutions (10, 20, 30, 40 and 50 ppm) were used to saturate the permeability test samples. Extracts of permeability tests were used to investigate the adsorption characteristics of proposed mixtures for liner design. With regard to heavy metal adsorption, bentonite had the best performance because it is a clay mineral. Sand and pumice exhibited similar performances in lead and cadmium adsorption, but pumice had much better performance than sand in chrome, copper and nickel adsorption. Although sand-bentonite and pumice-bentonite mixtures exhibited similar performance in nitrate adsorption, again pumice-bentonite mixtures had much better performance than sand-bentonite mixtures in phosphorus adsorption. Current results revealed that pumice with macro-micro pore structure and resultant adsorptive surface characteristics could be used as an alternative of sand in liner design

A Novel Liner Desing to Prevent Groundwater Pollution

In this research, study, a novel liner design was proposed for waste repository sites, constructed wetlandbasins and manure management lagoons to prevent the groundwater contamination by seepages from the bottom ofthese facilities. For this purpose, sand-bentonite and pumice-bentonite mixtures with pre-defined grain size range(1.00-0.50 mm) and bentonite content (30%) was used in experiments. Various concentrations of nitrate,phosphorus (25, 50, 100, 150 and 200 ppm) and heavy metals (Cd, Ni, Pb, Cr and Cu) solutions (10, 20, 30, 40 and50 ppm) were used to saturate the permeability test samples. Extracts of permeability test were used to investigatethe adsorption and desorption characteristics of proposed mixtures for liner design. With regard to heavy metaladsorption, bentonite had the best performance. Sand and pumice exhibited similar performances in lead andcadmium adsorption, but pumice had much better performance than sand in chrome, copper and nickel adsorption.Although sand-bentonite and pumice-bentonite mixtures exhibited similar performance in nitrate adsorption, againpumice-bentonite mixtures had much better performance than sand-bentonite mixtures in phosphorus adsorption.Current results revealed that pumice with macro-micro pore structure and resultant adsorption surfacecharacteristics could be used as an alternative of sand in liner design.&nbsp;</p