Outcomes for core decompression with multiple drilling of the osteonecrosis of the femoral head in patients with solid organ transplantation

Objectives: This study aims to investigate the clinical and radiological outcomes of core decompression surgery performed with multiple drilling in solid organ transplantation patients with osteonecrosis of femoral head (ONFH) and evaluate the effectiveness of this procedure in regard to duration of corticosteroid use and stage of osteonecrosis. Patients and methods: A total of 22 solid organ transplantation (kidney, liver or heart) patients (14 males, 8 females; mean age 43.3 years; range. 23 to 67 years) who were scheduled to undergo core decompression surgery with multiple drilling for ONFH were evaluated. Patients' Harris hip scores (HHSs) and radiographic data including Association Research Circulation Osseous (ARCO) staging and Kerboul grading were retrospectively reviewed at pre- and postoperative controls. Results: Patients were followed-up for mean 34.3 months (range, 12 to 76 months). Two patients (9.09%) were performed total hip arthroplasty. These two patients' Kerboul grade was 3. There was no statistically significant relationship between preoperation and postoperative final control in terms of ARCO staging. There was no statistically significant difference between pre- and postoperative HHSs. Conclusion: Although multiple drilling is a safe and minimally invasive surgery, its effect is limited, particularly in solid organ transplantation patients with ONFH due to long-term corticosteroid use. Therefore, solid organ transplantation patients should be closely monitored in terms of ONFH development

Platelet-rich plasma decreases fibroblastic activity and woven bone formation with no significant immunohistochemical effect on long-bone healing: An experimental animal study with radiological outcomes

Purpose: This study aimed to analyze the immunohistochemical effect of platelet-rich plasma (PRP) on healing of long-bone fractures in terms of bone morphogenetic protein-2 (BMP-2), vascular endothelial growth factor (VEGF), the Ki-67 proliferation index, and radiological and histological analyses. Methods: Sixteen adult rabbits, whose right femoral diaphysis was fractured and fixed with Kirschner wires, were randomly divided into two groups, control and PRP (groups A and B, respectively). PRP was given to group B at 1 week postoperatively, and all animals were euthanized after 12 weeks. Radiographic evaluations were performed periodically. Cortical callus formation, chondroid and woven bone area percentages, osteoblastic and fibroblastic activities, and mature bone formation were examined. The depths of BMP-2 and VEGF staining were measured. The Ki-67 proliferation index was also calculated. Results: The mean radiological union score of group B was significantly higher than that of group A. There were also statistically significant differences between groups A and B in terms of cortical callus formation, woven bone area percentage, fibroblast proliferation, and mature bone formation. Group B had significantly more cortical callus and mature bone formation with less woven bone and fibroblast proliferation. Immunohistochemical analysis revealed no statistically significant difference between the groups in terms of BMP-2 and VEGF staining and the Ki-67 index. Conclusions: PRP had no effect on BMP-2 or VEGF levels with no increase in the Ki-67 proliferation index, although its application had a positive effect on bone healing by increasing callus and mature bone formation with decreased woven bone and fibroblast proliferation

New Age Data From The Tectonostratigraphic Units Of The Istranca "Massif" In Nw Turkey: A Correlation With Se Bulgaria

The Istranca Crystalline Complex in NW Anatolia and SE Bulgaria includes structural units that differ in lithostratigraphy, metamorphism, age and structural position. They are collectively named as the "Istranca nappes" comprising from bottom to top the Sarpdere, Mahyadag. and Dogankoy Nappes. The Sarpdere Nappe consists of Lower Triassic arkosic metasandstones with slate interlayers, followed by Middle to Upper Triassic carbonates and an alternation of Upper Triassic clastics and carbonates. The Mahyada. g Nappe comprises a low-grade metamorphic Late Paleozoic-Triassic carbonate-siliciclastic sedimentary succession. The Dogankoy Nappe includes Precambrian?-Paleozoic metasediments, intruded by Late Carboniferous-Early Permian calc-alkaline granitoids. Its Triassic cover comprises metaclastics and metacarbonates. The Istranca nappes were juxtaposed at the end of the Triassic and transgressively covered by Lower Jurassic coarse clastics, followed above by Middle to Late Jurassic carbonates, black shales and carbonate-siliciclastic sedimentary succession. The phosphate concretions in black shales yielded radiolarian assemblages indicating Late Bajocian-Early Bathonian, Early Bathonian and Early Kimmeridgian ages. These nappes and their Jurassic cover are unconformably overlain by the Cenomanian-Santonian volcano-sedimentary successions intruded by Santonian-Campanian Derekoy-Demirkoy intrusive suite. The preliminary data suggest that the Variscan basements of the Mahyadag and Sarpdere Nappes were juxtaposed prior to the Triassic and overridden by the Dogankoy Nappe of possible Rhodopean origin from S to N during the Cimmerian compressional events.WoSScopu

Biomechanical and histological comparison of the influence of oestrogen deficient state on tendon healing potential in rats

Thirty-six female Sprague-Dawley rats were divided into two groups: oophrectomised (oestrogen deficient) rats and sham operated (oestrogen maintained) rats. Rats were sacrificed at six, ten, and 14 weeks. The rats were randomly chosen to have biomechanical evaluation on one side and histological evaluation on the other. Biomechanical testing was performed on an Instron machine to measure peak load. Histological sections were evaluated for cell proliferation, collagen-fibre organisation, fibroblast density, angiogenesis, inflammatory cells, chondroid and osseous metaplasia. Compared with the sham operated group, the oophrectomised group showed a lesser average maximum stress (42.9 N/m2 versus 33.7 N/m2) at six weeks, which was significant (p < .05). Succeeding weeks showed no significant biomechanical differences between the two groups. The sham operated group showed greater inflammatory response, which was statistically significant (p < 0.05), and also revealed greater cell proliferation and density. The results of this study revealed that endogenous oestrogen may improve healing of the Achilles tendon in rats

Correlations of isokinetic measurements with tendon healing following open repair of rotator cuff tears

The aim of this study was to investigate the correlation of tendon integrity following open cuff repairs with functional and isokinetic strength measurements. Twenty-six shoulders of 25 patients were included in this study. At the final follow-up, 14 repairs (53.8%) were intact and 12 repairs (46.2%) had failed on magnetic resonance imaging (MRI). Mean UCLA score at latest follow-up was 28.5 and mean Constant score was 80.3. Constant scores were found to be significantly low for the failed group. Age was found to be significantly related to failed repair. Fatty infiltration stage in the failed repair group was significantly high, and a strong positive correlation for both groups existed pre and postoperatively. When both groups were compared, the failed group was found to have significantly low measurements at extension and internal rotation. Despite high failure rates, functional results were satisfactory. Increased age and fatty infiltration stage decrease success

Franchismo

We aimed to obtain information about the characteristics of the ICUs in our country via a point prevalence study

Current Statement of Intensive Care Units in Turkey: Data obtained from 67 Centers

OBJECTIVES: We aimed to obtain information about the characteristics of the ICUs in our country via a point prevalence study