Bilateral simultaneous rupture of the quadriceps tendon in a patient with psoriasis: a case report and review of the literature

<p>Abstract</p> <p>Introduction</p> <p>Bilateral quadriceps tendon rupture is not common in the absence of systemic disease. Patients with chronic systemic diseases such as uremia and systemic lupus erythematosus and patients who are being treated with systemic steroids or local steroid injections are more prone to tendon rupture. The tendon can rupture spontaneously or as a result of trauma. We report an unusual case of simultaneous bilateral traumatic quadriceps tendon rupture in a patient with psoriasis who was being treated with topical steroid preparations.</p> <p>Case presentation</p> <p>A 57-year-old Caucasian man with a known history of psoriasis, for which he was being treated with topical steroid preparations, presented to our hospital with clinical signs of bilateral quadriceps tendon rupture after he fell while walking down stairs. The diagnosis was confirmed by bilateral ultrasound scans of the thighs. The patient underwent surgery to repair both quadriceps tendons. Post-operatively, the patient was immobilized first in bilateral cylinder casts for six weeks, then in knee braces for the next four weeks. His knees were actively mobilized during physiotherapy.</p> <p>Conclusion</p> <p>Bilateral quadriceps tendon rupture is a rare occurrence in patients with psoriasis who are being treated with topical steroids.</p

Comparison of plasma endothelin levels between osteoporotic, osteopenic and normal subjects

BACKGROUND: It has been demonstrated that endothelins (ET) have significant roles in bone remodeling, metabolism and physiopathology of several bone diseases. We aimed to investigate if there was any difference between the plasma ET levels of osteoporotic patients and normals. METHODS: 86 patients (70 women and 16 men) with a mean age of 62.6 (ranges: 51–90) years were included in this study. Patients were divided into groups of osteoporosis, osteopenia and normal regarding reported T scores of DEXA evaluation according to the suggestions of World Health Organization. According to these criteria 19, 43 and 24 were normal, osteopenic and osteoporotic respectively. Then total plasma level of ET was measured in all patients with monoclonal antibody based sandwich immunoassay (EIA) method. One-way analysis of variance test was used to compare endothelin values between normals, osteopenics and osteoporotics. RESULTS: Endothelin total plasma level in patients was a mean of 98.36 ± 63.96, 100.92 ± 47.2 and 99.56 ± 56.6 pg/ml in osteoporotic, osteopenic and normal groups respectively. The difference between groups was not significant (p > 0.05). CONCLUSION: No significant differences in plasma ET levels among three groups of study participants could be detected in this study

Tibiofibular syndesmosis in acute ankle fractures: additional value of an oblique MR image plane

Item does not contain fulltextOBJECTIVE: To evaluate the additional value of a 45� oblique MRI scan plane for assessing the anterior and posterior distal tibiofibular syndesmotic ligaments in patients with an acute ankle fracture. MATERIALS AND METHODS: Prospectively, data were collected for 44 consecutive patients with an acute ankle fracture who underwent a radiograph (AP, lateral, and mortise view) as well as an MRI in both the standard three orthogonal planes and in an additional 45� oblique plane. The fractures on the radiographs were classified according to Lauge-Hansen (LH). The anterior (ATIFL) and posterior (PTIFL) distal tibiofibular ligaments, as well as the presence of a bony avulsion in both the axial and oblique planes was evaluated on MRI. MRI findings regarding syndesmotic injury in the axial and oblique planes were compared to syndesmotic injury predicted by LH. Kappa and the agreement score were calculated to determine the interobserver agreement. The Wilcoxon signed rank test and McNemar's test were used to compare the two scan planes. RESULTS: The interobserver agreement (?) and agreement score [AS (\%)] regarding injury of the ATIFL and PTIFL and the presence of a fibular or tibial avulsion fracture were good to excellent in both the axial and oblique image planes (? 0.61-0.92, AS 84-95\%). For both ligaments the oblique image plane indicated significantly less injury than the axial plane (p?<?0.001). There was no significant difference in detection of an avulsion fracture in the axial or oblique plane, neither anteriorly (p?=?0.50) nor posteriorly (p?=?1.00). With syndesmotic injury as predicted by LH as comparison, the specificity in the oblique MR plane increased for both anterior (to 86\% from 7\%) and posterior (to 86\% from 48\%) syndesmotic injury when compared to the axial plane. CONCLUSION: Our results show the additional value of an 45� oblique MR image plane for detection of injury of the anterior and posterior distal tibiofibular syndesmoses in acute ankle fractures. Findings of syndesmotic injury in the oblique MRI plane were closer to the diagnosis as assumed by the Lauge-Hansen classification than in the axial plane. With more accurate information, the surgeon can better decide when to stabilize syndesmotic injury in acute ankle fractures

Glacial to holocene watermass and continental weathering reconstructions from the Southeast Pacific

Sediments of the central Chile margin record changes in ocean circulation and continental erosion associated with large–scale climate change. Here Antarctic– influenced Southern Ocean currents flow equatorward, forming a link between the high– and low–latitude oceans. Part of this link, Antarctic Intermediate Water, is an important conduit that ventilates South Pacific subsurface and mid–depth waters. Differential weathering of the two parallel mountain ranges of Chile has been attributed to latitudinal shifts in the position of the southern westerly wind belt, with an equatorward shift increasing Coast Range rainfall and weathering rates. An increase in Coast Range weathering relative to Andean weathering has been proposed to reduce the delivery of iron to the marginal ocean, with implications for productivity in the Fe– limited Southern Ocean–derived waters. Sediments from three drill sites along the Chile margin (36°S–41°S, water depths ~500–1000 m) monitor changes in the extent and distribution of surface and subsurface ocean currents, as well as provenance of continental weathering products. Concentrations of the redox–sensitive metals Mn and Re in the sediments are controlled by bottom water oxygen. Decreasing concentrations of Mn and increased levels of Re relative to glacial–age concentrations suggest a deglacial poleward retreat of Antarctic Intermediate Water and subsequent expansion of low–oxygen water masses sourced from low latitudes. A suite of elements defines lithogenic contributions to the sediments, and a river sediment dataset provides a link to possible source regions on the continent. Rivers draining the Chilean Coast Range have similar Al concentrations to Andean rivers, but are poorer (relative to Al) in Ca, Mg, and Sr. Although Andean rocks have been hypothesized to be relatively iron–rich, levels of Fe/Al and Ti/Al are indistinguishable among river types. Marine sediments show reduced values of Mg/Al relative to glacial levels after deglaciation, suggesting a switch to a Coast Range source of material. This analysis implies that at latitudes south of 36°S ice sheet retreat after the glacial period caused an overall decrease in the rate of Andean weathering, which overwhelmed any signal of decreased Coast Range weathering driven by the poleward retreat of the westerly winds. In southern Chile (41°S) increased Holocene Ti/Al is interpreted as a switch after deglaciation to a Coast Range source rich in titanium. While weathering patterns, driven mainly by ice sheet changes, are not likely to change in a warming planet, recent observational trends in ocean circulation and intermediate water oxygen content suggest a future expansion of oxygen–minimum zones

HISTOPATHOLOGICAL CHANGES IN THE STOMACH MUCOSA OF RATS FED WITH GREAT SCALLOP (Pecten maximus)

Heavy metals, industrial and household wastes and pesticides are threats for the aquatic ecosystem. Polluted water sources are streaming into the seas and cause pollution in these systems. Dardanelles is exposed to pollution from the Marmara and Black Sea. Our previous studies demonstrated that the water and mollusc from certain regions of the Dardanelles contained heavy metal salts. The purpose of the study is to demonstrate the histopathologic changes in the gastric tissues of rats which are fed with great scallop (Pecten maximus) that are collected from the Çardak region of the Dardanelles. Four groups of rats are included in the study, group 1 (n=6), control group fed with standard rat food, group 2 (n=6), 75%&nbsp; great scallop and 25% standard rat food daily, group 3 (n=6), 75% great scallop and 25% standard rat food every two days, group 4 (n=6), 75%&nbsp; great scallop and 25% standard rat food every three days. After the routine histopathologic processing all gastric tissue samples are evaluated in terms of 8-hydroxy-2' -deoxyguanosine (8-OHdG) immunoreactivity with light microscopy and image analysis software. No histopathologic differences found in standard hematoxylin-eosin (H.E.) stained gastric tissue samples of the control group. Second group showed active chronic gastritis, third group showed less inflamation and chronic gastritis compared with the second group and fourth group showed less mononuclear inflammation compared to the second and third groups. In immunohistochemical staining, 8-OHdG immunoreactivity in gastric epithelial cells. 8-OHdG immunoreactivity was negative in stomach tissues in all groups. &nbsp;There was no statistically significant difference between the groups that were fed every day, every other day and every three days with great scallop (p&gt;0.05). The results of our studies showed that rats fed more with great scallops could produce gastritis in the stomac