Sensitivities of conventional and new electrophysiological techniques in carpal tunnel syndrome and their relationship to body mass index

The purpose of this study is to evaluate prospectively the sensitivities of conventional and new electrophysiological techniques and to investigate their relationship with the body mass index (BMI) in a population of patients suspected of having carpal tunnel syndrome (CTS)

Arthroscopic treatment of focal osteochondral lesions of the first metatarsophalangeal joint

Abstract Background Although arthroscopic surgical treatment of the first metatarsophalangeal (MTP) joint involves painful sesamoid excision, synovectomy, debridement, and partial cheilectomy, no gold standard treatment technique has been defined in the literature for hallux rigidus and focal osteochondral lesions. This study aimed to assess the arthroscopic treatment for early grade focal osteochondral lesions of the first MTP joint and to determine the impact of arthroscopic microhole drill surgery on foot function and activities of daily living in a group of patients who failed conservative treatment. Methods This prospective study included 14 patients with hallux rigidus and focal osteochondral lesions of the first MTP joint who underwent surgery in 2014 and were followed on a regular basis thereafter. Results The patients had mean preoperative VPS (visual pain score) and AOFAS (American Orthopedic Foot and ankle Society)-Hallux scores of 8.14 ± 0.86 SD and 48.64 ± 4.27, respectively; the corresponding postoperative values of both scores were 1.86 ± 0.66 SD and 87.00 ± 3.70. Both VPS and AOFAS-Hallux scores changed significantly. Discussion In this prospective study, we explored the impact of arthroscopic microhole drill surgery on foot function and activities of daily living in patients with focal osteochondral lesions of the first MTP joint. Our results showed significant improvements in VPS and AOFAS scores with this treatment. Conclusions An arthroscopic microhole drill technique can be used with impressive functional scores and without any complications in patients who failed conservative therapy for hallux rigidus with focal chondral injury

Arthroscopic treatment of focal osteochondral lesions of the first metatarsophalangeal joint (vol 12, 68, 2017)

This article [2] was published twice [1] due to a production error. The original article [1] should be considered the version of record and used for citation purposes. The publisher apologizes to the authors and readers for the error and any inconvenience caused

Arthroscopic treatment of focal osteochondral lesions of the first metatarsophalangeal joint

Abstract Background Although arthroscopic surgical treatment of the first metatarsophalangeal (MTP) joint involves painful sesamoid excision, synovectomy, debridement, and partial cheilectomy, no gold standard treatment technique has been defined in the literature for hallux rigidus and focal osteochondral lesions. This study aimed to assess the arthroscopic treatment for early-grade focal osteochondral lesions of the first MTP joint and to determine the impact of arthroscopic microhole drill surgery on foot function and activities of daily living in a group of patients who failed conservative treatment. Methods This prospective study included 14 patients with hallux rigidus and focal osteochondral lesions of the first MTP joint who underwent surgery in 2014 and were followed on a regular basis thereafter. Results The patients had mean preoperative VPS (visual pain scale) and AOFAS (American Orthopedic Foot and Ankle Society)-Hallux scores of 8.14 ± 0.86 SD and 48.64 ± 4.27, respectively; the corresponding postoperative values of both scores were 1.86 ± 0.66 SD and 87.00 ± 3.70, respectively. Both VPS and AOFAS-Hallux scores changed significantly. Discussion In this prospective study, we explored the impact of arthroscopic microhole drill surgery on foot function and activities of daily living in patients with focal osteochondral lesions of the first MTP joint. Our results showed significant improvements in VPS and AOFAS scores with this treatment. Conclusions An arthroscopic microhole drill technique can be used with impressive functional scores and without any complications in patients who failed conservative therapy for hallux rigidus with focal chondral injury

Rapid eye movement dependent central apnea with periodic leg movements

Central sleep apnea is a period of at least 10 s without airflow, during which no ventilatory effort is present. Most of the central apneas occur in Non-Rapid eye movement (NREM) sleep. Central apnea occuring in Rapid eye movement (REM) sleep is extremely rare. We present our patient who had a diagnosis of obstructive sleep apnea in another sleep center since 2003. His Auto Continuous Positive Airway Pressure (CPAP) machine was disrupted so he admitted to our center to renew his machine and for daytime sleepiness while using his machine. The polysomnography revealed central apneas ending with respiratory arousals and periodic leg movements in rapid eye movement (REM) stage. We found no cause for central apneas. The patient benefited from servo ventilator therapy. We present this case as an unusual form of central apnea with the review of the literatures. Even the patients diagnosed as obstructive sleep apnea should be analyzed carefully. The diagnosis and the therapeutic approach may change in the favor of the patient

Ultrastructural and immunohistopathological evaluation of intravesical ureters via electron and light microscopy in children with vesicoureteral reflux

PubMedID: 24126283Purpose We used immunohistochemical methods and transmission electron microscopy to investigate the cytokine profiles and ultrastructural changes in the ureterovesical junction of children with primary vesicoureteral reflux. Materials and Methods A total of 39 distal intravesical ureters were obtained from 23 children who underwent ureteroneocystostomy for primary vesicoureteral reflux. Ureteral wall smooth muscle organization and transforming growth factor-ß1, vascular endothelial growth factor and CD34 were evaluated immunohistochemically and compared to controls, which consisted of 10 age matched autopsy specimens. Ultrastructural evaluations and morphological descriptions were performed semiquantitatively and compared to the published data. Results Of the patients 6 (26%) were male and 17 (74%) were female, and mean ± SD age was 73.2 ± 34.3 months (range 12 to 168). There was no correlation between reflux grade and age (p = 0.39). Smooth muscle disorganization score differed significantly between patients with intravesical ureters and controls (p = 0.01). Transforming growth factor-ß1 levels were significantly higher (p = 0.001) and vascular endothelial growth factor levels and microvessel densities were significantly lower in the patients with reflux compared to controls (both p <0.001). Vascular endothelial growth factor, CD34 and transforming growth factor-ß1 levels did not correlate with reflux grades (p = 0.84, p = 0.76 and p = 0.10, respectively). Urothelium, lamina propria and tunica adventitia appeared normal in the specimens for all grades of vesicoureteral reflux using transmission electron microscopy. Damage was observed in the muscular layers of the ureterovesical junction, especially in patients with grade IV or V reflux. Conclusions Primary refluxing ureters exhibit immunohistopathological abnormalities compared to normal ureters irrespective of reflux grade, and ultrastructural changes are especially severe in cases of high grade reflux. These abnormalities can hinder the normal ureteral valve mechanism, and may lead to reflux due to smooth muscle dysfunction and microvascular alterations. © 2014 by AMERICAN UROLOGICAL ASSOCIATION EDUCATION AND RESEARCH, INC

Primer Vezikoüretral Reflülü Çocuklarda Üreterovezikal Bileşkede Meydana Gelen Değişikliklerin Elektron Mikroskobik Olarak Değerlendirilmesi

AMAÇ: Vezikoüreteral reflü (VUR), çocukluk çağında %1 oranında görülen, hipertansiyon ve renal yetmezlik gibi ciddi komplikasyonlara yol açabilen ancak etiyopatogenezi tam olarak açıklanamamış bir anomalidir. Bu çalışmada, primer VUR’lu çocukların intravezikal üreter duvarında meydana gelen histopatolojik değişikliklerin ışık ve elektron mikroskopik olarak değerlendirilmesi amaçlanmıştır. GEREÇ VE YÖNTEM: Primer VUR nedeniyle üreteral reanastomoz yapılan 28 çocuk ve VUR nedeniyle daha önce STİNG (Submukozal transuretral ureterik implantasyon) prosedürü uygulanmış ancak sonrasında üreteral reanastomoz yapılan 7 çocuğun üreterovezikal bileşkelerinden elde edilen dokular ışık ve elektron mikroskobik incelemeler için uygun yöntemlerle hazırlandı. BULGULAR: Her iki gruba ait dokuların elektron mikroskobik olarak incelenmesinde intravezikal üretere ait yüzey epiteli ve lamina propriya normal olarak gözlendi. Her iki grupta da kas tabakasında histopatolojik değişikliklerin bulunduğu gözlendi. STİNG prosedürü uygulanmayan grupta yüksek grade'li VUR'lu olan intravezikal üreter dokularının kas tabakalarında intersellüler aralıkta ödem varlığı, kas hücrelerinin çekirdeğinde heterokromatin artışı, perinüklear sisternalar ve granüler endoplazmik retikülüm sisternalarında genişlemeler, ayrıca sitoplazma içerisinde yer yer membranöz yapılar içeren vakuollerin bulunduğu görüldü. Düşük grade VUR'lü üreterlerde ise kas hücrelerinin normal olduğu izlendi. STİNG prosedürü uygulanan tüm hastalara ait intravezikal üreter dokularında (Grade 1-4), STİNG prosedürü uygulanmayan yüksek derecede VUR'lu (Grade 4-5) grup ile benzer bulgular izlendi