330 research outputs found

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

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    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

    Clinical results of carotid artery stenting versus carotid endarterectomy

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    Objective: To review our results of carotid artery stenting (CAS) and carotid endarterectomy (CEA). Methods: We evaluated the medical records of patients undergoing carotid artery revascularization procedure, between 2001 and 2013 in Baskent University Hospital, Ankara, Turkey. Carotid artery stenting or CEA procedures were performed in patients with asymptomatic carotid stenosis (=70%) or symptomatic stenosis (=50%). Demographic data, procedural details, and clinical outcomes were recorded. Primary outcome measures were in 30-day stroke/transient ischemic attacks (TIA)/amaurosis fugax or death. Secondary outcome measures were nerve injury, bleeding complications, length of stay in hospital, stroke, restenosis (ICA patency), and all-cause death during long-term follow-up. Results: One hundred ninety-four CEA and 115 CAS procedures were performed for symptomatic and/or asymptomatic carotid artery stenosis. There is no significant differences 30-day mortality and neurologic morbidity between CAS (13%) and CEA procedures (7.7%). Length of stay in hospital were significantly longer in CEA group (p=0.001). In the post-procedural follow up, only in symptomatic patients, restenosis rate was higher in the CEA group (p=.045). The other endpoints did not differ significantly. Conclusions: Endovascular stent treatment of carotid artery atherosclerotic disease is an alternative for vascular surgery, especially for patients that are high risk for standard CEA. The increasing experience, development of cerebral protection systems and new treatment protocols increases CAS feasibility

    Serum neurofilament light chain – A potential biomarker for polyneuropathy in type 2 diabetes?

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    AimsTo investigate the relationship between neurofilament light chain (NfL) and the presence and severity of diabetic polyneuropathy (DPN).MethodsWe performed cross-sectional analysis of data from 178 participants of the ADDITION-Denmark cohort of people with screen-detected type 2 diabetes and 32 healthy controls. Biobank serum samples were analyzed for NfL using single-molecule array. DPN was defined by Toronto criteria for confirmed DPN. Original and axonal nerve conduction study (NCS) sum z-scores were used as indicators of the severity of DPN and peripheral nerve damage.Results39 (21.9%) participants had DPN. Serum NfL (s-NfL) was significantly higher in participants with DPN (18.8 ng/L [IQR 14.4; 27.9]) than in participants without DPN (15.4 ng/L [IQR 11.7; 20.1]). There were no unadjusted s-NfL differences between controls (17.6 ng/L [IQR 12.7; 19.8]) and participants with or without DPN. Higher original and axonal NCS sum z-scores were associated with 10% higher s-NfL (10.2 and 12.1% [95% CI’s 4.0; 16.8 and 6.6; 17.9] per 1 SD). The AUC of s-NfL for DPN was 0.63 (95% CI 0.52; 0.73).ConclusionsS-NfL is unlikely to be a reliable biomarker for the presence of DPN. S-NfL is however associated to the severity of the nerve damage underlying DPN

    Bidirectional lipid droplet velocities are controlled by differential binding strengths of HCV Core DII protein

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    Host cell lipid droplets (LD) are essential in the hepatitis C virus (HCV) life cycle and are targeted by the viral capsid core protein. Core-coated LDs accumulate in the perinuclear region and facilitate viral particle assembly, but it is unclear how mobility of these LDs is directed by core. Herein we used two-photon fluorescence, differential interference contrast imaging, and coherent anti-Stokes Raman scattering microscopies, to reveal novel core-mediated changes to LD dynamics. Expression of core protein’s lipid binding domain II (DII-core) induced slower LD speeds, but did not affect directionality of movement on microtubules. Modulating the LD binding strength of DII-core further impacted LD mobility, revealing the temporal effects of LD-bound DII-core. These results for DII-core coated LDs support a model for core-mediated LD localization that involves core slowing down the rate of movement of LDs until localization at the perinuclear region is accomplished where LD movement ceases. The guided localization of LDs by HCV core protein not only is essential to the viral life cycle but also poses an interesting target for the development of antiviral strategies against HCV

    The effect of glutamate and aspartate on myocardial protection at cardiopulmonary bypass

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    Objective: To determine whether glutamat and aspartat enriched cold crystalloid cardioplegia which was given in antegrade way has any effect on the myocardial protection during cardiopulmonary bypass. Material and Methods: Thirty-four patients who were electively undergone open heart surgery at Osmangazi University Faculty of Medicine, thoracic and cardiovascular surgery department, between March 2001 and May 2001 were included in this study. The patients were divided in two groups, each consisting of 17 patients. In group 1 coronary artery bypass surgery (CABG) was performed in 11 patients, mitral valve replacement (MVR) in 3 patients, aortic valve replacement (AVR) in 1 patient and AVR and MVR in 2 patients. While in group 2 CABG was performed in 13 patients and MVR was done in 4 patients. Group 1 patients received antegrade glutamat and aspartat (15 mmol/L) enriched cold crystalloid cardioplegia and group 2 patients were given cold crystalloid cardioplegia by antegrade route. Age, gender, diabetes mellitus, hypertension, preoperative myocardial infarction, smoking, ejection fraction, aortic cross-clamp time, need to defibrillation, inotropic support, and intraaortic balloon pump were recorded. The levels of cardiac troponin I (cTI) and creatine kinase myocardial band fraction (CK-MB) were measured in arterial blood samples at five different times. Statistical analysis was performed using Student's t-test and Chi-square test. Results: There were no statistically significant differences in cTI and CK-MB values in blood samples taken at 5 different times pre and postoperatively between group 1 and group 2. Conclusion: It is concluded that glutamat and aspartat enriched cold crystalloid cardioplegia does not have any effect on myocardial protection

    The effect of glutamate and aspartate on myocardial protection at cardiopulmonary bypass

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    Objective: To determine whether glutamat and aspartat enriched cold crystalloid cardioplegia which was given in antegrade way has any effect on the myocardial protection during cardiopulmonary bypass. Material and Methods: Thirty-four patients who were electively undergone open heart surgery at Osmangazi University Faculty of Medicine, thoracic and cardiovascular surgery department, between March 2001 and May 2001 were included in this study. The patients were divided in two groups, each consisting of 17 patients. In group 1 coronary artery bypass surgery (CABG) was performed in 11 patients, mitral valve replacement (MVR) in 3 patients, aortic valve replacement (AVR) in 1 patient and AVR and MVR in 2 patients. While in group 2 CABG was performed in 13 patients and MVR was done in 4 patients. Group 1 patients received antegrade glutamat and aspartat (15 mmol/L) enriched cold crystalloid cardioplegia and group 2 patients were given cold crystalloid cardioplegia by antegrade route. Age, gender, diabetes mellitus, hypertension, preoperative myocardial infarction, smoking, ejection fraction, aortic cross-clamp time, need to defibrillation, inotropic support, and intraaortic balloon pump were recorded. The levels of cardiac troponin I (cTI) and creatine kinase myocardial band fraction (CK-MB) were measured in arterial blood samples at five different times. Statistical analysis was performed using Student's t-test and Chi-square test. Results: There were no statistically significant differences in cTI and CK-MB values in blood samples taken at 5 different times pre and postoperatively between group 1 and group 2. Conclusion: It is concluded that glutamat and aspartat enriched cold crystalloid cardioplegia does not have any effect on myocardial protection

    Pathological femoral neck fracture caused by an echinococcus cyst of the vastus lateralis - case report

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    <p>Abstract</p> <p>Background</p> <p>Musculoskeletal hydatid cysts are rare, but being locally invasive, can potentially cause significant deformity or pathological fracture.</p> <p>Case presentation</p> <p>A 39 y.o. male presented to our orthopaedic outpatient clinic complaining of severe right hip pain, and inability to ambulate. Symptoms were not preceded by trauma. Subsequent imaging confirmed a large, 17 × 3 × 5 cm echinococcus cyst in the vastus lateralis, causing erosion of the proximal metaphysis of the femur. As a consequence the patient suffered a non-traumatic pathological intertrochanteric femur fracture. The patient was treated with an en-bloc excision of the lesion - the affected soft tissue envelope containing the large cyst - and as a second surgical step a cemented total hip replacement (THR) was implanted under the same anaesthetic.</p> <p>The manuscript reviews the literature regarding musculoskeletal hydatid disease.</p
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