Wyniki leczenia uszkodzenia nerwu strzałkowego na wysokości kolana: doświadczenie oddziału szpitala wo¡skowego

Background and purpose We investigated the management outcome of common peroneal nerve decompression at the knee level between the years 2005 and 2009. Material and methods Thirty consecutive patients with knee-level peroneal nerve injury who underwent decompression surgery and external neurolysis at our institution were evaluated preoperatively and postoperatively by electrophysiological studies and motor examination (Medical Research Council grading). Results Twenty-eight of the cases were male and 2 were female. Mean age was 31.1 for males and 57.5 for females. Physical activity during military training (overstretch/contusion) was the cause of nerve lesion in the majority of the patients (n = 28, 93%). Mean time interval between the diagnosis and the surgery was 5 months. Follow-up time ranged from 3 to 48 months (mean: 14 months). Twenty-nine of 30 (97%) patients recovered totally or near totally in foot/toe dorsiflexion. Conclusions Early decompression and neurolysis of the common peroneal nerve (CPN) at knee level after strenuous physical activity offers excellent functional recovery. Additionally, for knee-level CPN injuries, in order to minimize the postoperative scar, pain and delay in wound healing, we strictly advocate short ‘lazy S-shaped incision’ around the fibular head in supine position unlike the classical extensive opening up to the superior border of the popliteal fossa in prone position.Wstęp i cel pracy Autorzy ocenili wyniki chirurgicznego odbarczenia nerwu strzałkowego wspólnego na wysokości kolana, wykonywanego w latach 2005–2009. Materiał i metody Przedoperacyjnej i pooperacyjnej ocenie klinicznej (w skali Medical Research Council) oraz elektrofizjologicznej poddano 30 kolejnych pacjentów z uszkodzeniem nerwu strzałkowego na wysokości kolana, u których wykonano odbarczenie chirurgiczne z zewnętrzną neurolizą. Wyniki Wśród leczonych było 28 mężczyzn (średnia wieku: 31,1 roku) i dwie kobiety (średnia wieku: 57,5 roku). U zdecydowanej większości pacjentów (n = 28, 93%) przyczyną uszkodzenia nerwu była aktywność fizyczna w czasie szkolenia wojskowego (nadmierne rozciągnięcie/stłuczenie). Średnia czasu od rozpoznania do operacji wyniosła 5 miesięcy. Obserwacja po zabiegu trwała od 3 do 48 miesięcy (średnia: 14 miesięcy). U 29 na 30 chorych (97%) uzyskano pełny lub prawie pełny powrót zgięcia grzbietowego stopy/palców. Wnioski Wczesne chirurgiczne odbarczenie i neuroliza nerwu strzałkowego wspólnego na wysokości kolana w leczeniu urazu powstałego wskutek nadmiernej aktywności fizycznej daje możliwość znakomitej poprawy czynnościowej. Ponadto w przypadku uszkodzeń nerwu strzałkowego wspólnego na wysokości kolana w celu zminimalizowania blizny pooperacyjnej, nasilenia bólu i opóźnienia w gojeniu się rany pooperacyjnej autorzy usilnie zalecają krótkie cięcie w kształcie wydłużonej litery „S” wokół głowy strzałki u chorego w pozycji leżącej na plecach zamiast klasycznego otwarcia aż do górnej granicy dołu podkolanowego w pozycji leżącej na brzuchu

Etiology, diagnosis, and treatment in childhood atelectasis

Introduction: Atelectasis is the loss of lung volume secondary to collapse. Narrow and collapsible airways and underlying chronic diseases facilitate the development of atelectasis in children. Since atelectasis is an important cause of morbidity and mortality in children, early diagnosis and treatment are of great importance. Methods: Thirty-six patients who were followed up in the pediatric service and pediatric intensive care unit of our clinic be - tween December 1, 2018, and June 1, 2019, and were diagnosed radiologically with atelectasis were evaluated retrospectively. Results: The median age was 1.85 years (1.0–7.37). The most common cause for hospitalization was pneumonia (n=30, 83%). Except for two patients, all patients had an underlying disease that increased the risk of atelectasis. Neurological diseases were the most common diseases among the underlying diseases (n=12, 36%). For the treatment, 4 (11.1%) patients received chest physiotherapy, 19 (52.7%) patients received nebulized medications, and chest physiotherapy, and 13 (36.1%) patients received positive end-expiratory pressure support in addition to these treatments. The frequency of atelectasis in more than one localization was higher in children with the neurological disease than in other patients (n=7, [54%] vs. n=3, [13%]; p=0.018). In patients with atelectasis in more than one localization, the duration of hospitalization was longer (median 12.5 days [9.5–16.75] vs. 19 days [13–22.75]; p=0.034). Discussion and Conclusion: Atelectasis is common in hospitalized children with an underlying disease. In the presence of pathological respiratory symptoms and signs, atelectasis should be kept in mind, and treatment should be started early

Europe, Turkey and the Mediterranean. Fostering Cooperation and Strengthening Relations. Europe in Dialogue 2012/03

Europeans can be proud as they look back on fifty years of peaceful integration. Nowadays many people worldwide see the European Union as a model of how states and their citizens can work together in peace and freedom. However, this achievement does not automatically mean that the EU has the ability to deal with the problems of the future in a rapidly changing world. The European Union must continue developing its unity in diversity dynamically, be it with regard to energy issues, the euro, climate change or new types of conflict. Indeed, self-assertion and solidarity are key to the debates shaping our future. “Europe in Dialogue“ wishes to make a contribution to these open debates. The analyses in this series subject political concepts, processes and institutions to critical scrutiny and suggest ways of reforming internal and external European policymaking so that it is fit for the future. However, “Europe in Dialogue“ is not merely trying to encourage an intra-European debate and makes a point of including authors from non-EU states. Looking at an issue from different angle or from afar creates a shift in perspective which, in turn, renders Europe‘s development more meaningful as it engages in critical dialogue with other societies

The partial oxidation of methane over Pd/Al2O3 catalyst nanoparticles studied in-situ by near ambient-pressure x-ray photoelectron spectroscopy

Near ambient-pressure X-ray photoelectron spectroscopy (NAP-XPS) is used to study the chemical state of methane oxidation catalysts in-situ. Al2O3{supported Pd catalysts are prepared with different particle sizes ranging from 4 nm to 10 nm. These catalysts were exposed to conditions similar to those used in the partial oxidation of methane (POM) to syn-gas and simultaneously monitored by NAP-XPS and mass spectrometry. NAP-XPS data show changes in the oxidation state of the palladium as the temperature in- creases, from metallic Pd0 to PdO, and back to Pd0. Mass spectrometry shows an increase in CO production whilst the Pd is in the oxide phase, and the metal is reduced back under presence of newly formed H2. A particle size effect is observed, such that CH4 conversion starts at lower temperatures with larger sized particles from 6 nm to 10 nm. We find that all nanoparticles begin CH4 conversion at lower temperatures than polycrystalline Pd foil

Mimarlık Doktora Eğitiminde Yapı Atölyesi: Alaçatı

Dokuz Eylül Üniversitesinde yürütülen "yapı atölyesi" dersi yıllardır doktora düzeyinde öğretilen derslerden biridir.</p