Light microscopic analysis of the effects of gd-dtpa dimeglumine and iopromide on rabbit hyaline cartilage and synovial membrane

Bu çalişmanin amaci kontrastli maddelerin eklem kikirdaği ve sinoviyal membran üzerine olan etkilerini tavşan modelinde araştirmaktir. Çalişmada 60 tavşan dizi kullanildi. Kontrastli ajan olarak iopromid ve Gd-DTPA diz eklemlerine intraartiküler uygulanarak 1. saat, 1.gün, 1.hafta ve 2.hafta sonra sinoviyal membran ve hiyalin kikirdak üzerine olan histolojik etkileri işik mikroskobisi yardimi ile incelendi. Kontrol grubu olarak serum fizyolojik kullanildi. iopromid ve Gd-DTPAuygulanmasindan sonra sinoviyal membranda hiperemi, hemoraji ve yüzeyel stromada vakuollü hücre artişina rastlandi. Hiyalin kikirdakta ise proliferasyon, hipertrofi ve yoğun glikojen birikimi, piknoz ve GlikozAmino Glikan boyanma azliğina neden olduğu görüldü. Bu etkilerin 2. hafta sonunda azalarak devam ettiği saptandi. Çalişmamizda kullanilan maddelerin uygulama süreleri boyunca eklem kikirdağina ve sinoviyal membran üzerine olan etkilerinin istatistiksel olarak anlamli olduğu gösterilememiştir (p>0.05).The aim of this study is to assess the effects of contrast agents on hyaline cartilage and synovial membrane in a rabbit model. Light microscopic analysis of the effects of intraarticular Iopromide and Gd-DTPA on synovial membrane and hyaline cartilage at 1st hour, 1st day, 1st week and 2nd week was performed. NaCl%0.9 was used as control. Hyperemia, hemorhage and increase in the vacuolised cell number in the superficial stroma were observed in the synovial membrane. Proliferation, hypertrophy, dense glycogen storage, pycnosis and decrease in glycosaminoglycan (GAG) staining were observed in the hyaline cartilage. These effects lessened in two weeks. We were not able to demonstrate that contrast agents have any significant effect on hyaline cartilage and synovial membrane (p>0.05)

Mazabraud's Syndrome Coexisting with a Uterine Tumor Resembling an Ovarian Sex Cord Tumor (UTROSCT): a Case Report

The association of intramuscular myxoma and fibrous dysplasia is a rare disease known as Mazabraud's syndrome. We present a case of Mazabraud's syndrome coexisting with a uterine tumor and resembling an ovarian sex cord tumor (UTROSCT). This uterine tumor showed a high mitotic index and cytological atypia. To the best of our knowledge, the coexistence of the two different entities has not been reported in the literature

Legg-Calvé-Perthes disease; etiology and physiopathology

Legg-Calvé-Perthes disease is a childhood disorder in which specific clinical and radiological findings due to disruption in the arterial circulation of the capital femoral epiphysis are seen. It is most commonly seen in children between 4 and 8 years of age and is 4–5 times more common in boys than in girls. Hereditary influences, delay in bone matu-ration, blood coagulation abnormalities, type II collagen mutation, hyperactivity/attention deficit disorder, trauma, exposure to smoking are the main factors which are con-sidered to correlate with the origination of the disease. However, it is currently believed that the origin is probably multifactorial. Synovitis, necrosis in deep layers of the artic-ular cartilage, necrosis, resorption and new bone formation coupling (being the bone resorption more dominant) in the bone epiphysis, disruption in the physis and metaphyseal changes are the main histopathological findings.Legg-Calvé-Perthes hastalığı, femur başı epifizinin ar-teriyel kan akımının bozulması sonucu özgün klinik ve radyolojik bulguların görüldüğü bir çocukluk yaş grubu hastalığıdır. En sık 4–8 yaş arası çocuklarda görülür ve erkeklerde kızlara göre 4–5 misli daha fazladır. Kalıtsal nedenler, kemik gelişme gecikmesi, kanda pıhtılaşma bo-zuklukları, Tip II kollajen mutasyonu, hiperaktivite/dikkat eksikliği, travma, pasif sigara içiciliği, hastalığın ortaya çıkmasında rolü olduğuna inanılan başlıca etkenlerdir. Ancak, hastalığın günümüzde muhtemelen birden fazla etkenin varlığında ortaya çıktığına inanılmaktadır. Belli başlı histopatolojik bulgular; sinovit, eklem kıkırdağının derin tabakalarında nekroz, kemik epifizde nekroz, re-zorpsiyon ve yeni kemik oluşumu birlikteliği (rezorpsiyon daha baskın olmak üzere), büyüme plağında bozulma ve metafizyel değişikliklerdir

Open reduction and internal fixation in AO type C distal humeral fractures using olecranon osteotomy: Functional and clinical results

BACKGROUND: To investigate the outcomes of patients undergoing open reduction and internal fixation with olecranon osteotomy due to AO type13C fractures of the distal humerus.METHODS: Data of 39 patients (mean age, 44.7 years; males, 56.4%) undergoing surgery with the diagnosis of AO type 13C distal humeral fractures were retrospectively evaluated. Patients’ demographic characteristics, medical history, and radiological and functional outcomes were recorded. The patients were evaluated at the final follow-up according to the Mayo Elbow Performance Index (MEPI).RESULTS: The mean degrees of flexion and extension loss were 102.2 degrees (range, 60–120 degrees) and 11.4 degrees (range, 0–25 degrees), respectively, at the final follow-up. According to the MEPI score, outcomes were excellent in seven, good in 12, fair in 13, and poor in seven patients. All patients achieved a radiological union of the fracture site within the first postoperative six months. It was found that the loss of extension was more severe, the range of flexion was decreased, and the mean MEPI score was lower in the patients with type C3 fractures than in those with type C1 and type C2 fractures. No significant difference was determined between fixation techniques (tension band vs. cannulated screw) regarding the functional outcomes.CONCLUSION: Our results revealed better prognosis in AO type C1 and type C2 fractures than in AO type C3 fractures and no different effects of two fixation techniques in olecranon osteotomy on the outcome

Eklem Hastalıkları ve Cerrahisi Joint Diseases and Related Surgery Original Article / Özgün Makale Treatment of mixed type femoroacetabular impingement using safe surgical hip dislocation in adults Erişkinlerde karışık tipteki femoroasetabüler sıkışmanın

ÖZ Amaç: Bu çalışmada tek bir merkezde güvenli cerrahi kalça dislokasyonu (GCKD) tekniği kullanılarak karışık tipteki femoroasetabüler sıkışma (FAS) tedavisinde edinilen deneyim değerlendirildi. Hastalar ve yöntemler: Çalışmada Ekim 2009 -Ekim 2014 tarihleri arasında kliniğimizde GCKD tekniği ile tedavi edilen 21 hastanın (7 erkek, 14 kadın; ort. yaş 33.8±10.6 yıl; dağılım 19-52 yıl) 22 kalçası geriye dönük olarak değerlendirildi. Ameliyat öncesi ve son Harris kalça skorları (HKS) ve alfa açıları karşılaştırıldı. Yaş, cinsiyet, taraf, sıkışma testleri, ameliyat öncesi HKS, tümsek ve kıskaç tip FAS radyografik göstergeleri ve ameliyat sırasındaki eklem bulguları en son işlevsel sonuçlar üzerindeki etkileri yönünden değerlendirildi. Bulgular: Semptomların ortalama süresi 29.5 aydı. Kalçanın fleksiyonu ve iç rotasyonu ile ortaya çıkan kasık ağrısı başlıca semptomdu. Tüm kalçalara radyografik olarak "karışık tipte FAS" tanısı konuldu. Yirmi iki kalçanın ortalama izlem süresi 48 aydı. Ameliyat öncesi ve en son ortalama HKS arasındaki farklılık istatistiksel olarak anlamlıydı (60.0'a karşın 87.6 puan, p<0.001). Yirmi iki kalçadan ortalama HKS'si 95.0 puan olan 17 kalçada (%77) tedavi yeterli olarak değerlendirildi. Ameliyat öncesi HKS'si 60 puanın altında olan kalçalar yetersiz sonuca biraz daha fazla yatkındı. Araştırılan hasta bağımlı, klinik, radyografik değişkenler ve ameliyat sırasındaki eklem bulguları içinde düz bir grafideki koksa profunda belirtisi daha yüksek bir yetersiz sonuç oranı ile ilişkili bulundu (p= 0.040). Sonuç: Güvenli cerrahi kalça dislokasyonu işlemi ortalama dört yıllık izlem sonrasında %77'lik bir başarı oranına sahiptir. Koksa profunda belirtisi yetersiz klinik sonuç ile bağlantılıdır. Ameliyat öncesi 60 puanın altındaki bir HKS klinik sonuç üzerinde negatif belirleyici bir değişken olarak görünmektedir. Anahtar sözcükler: Femoroasetabüler sıkışma; işlevsel sonuç; cerrahi kalça dislokasyonu; tedavi. ABSTRACT Objectives: This study aims to assess the experience gained in a single institution in the treatment of mixed type femoroacetabular impingement (FAI) using safe surgical hip dislocation (SSHD) technique. Patients and methods: In this study, 22 hips of 21 patients (7 males, 14 females; mean age 33.8±10.6 years; range 19-52 years) treated by SSHD technique in our clinic between October 2009 and October 2014 were retrospectively evaluated. Preoperative and final Harris hip scores (HHS) and alpha angles were compared. Age, gender, laterality, impingement tests, preoperative HHS, cam and pincer type FAI radiographic indicators and intraoperative articular findings were assessed in terms of their influence to the final functional outcomes. Results: Mean duration of the symptoms was 29.5 months. Groin pain, activated by flexion and internal rotation of the hip, was the main symptom. A radiographic diagnosis of "mixed type FAI" was made in all hips. Mean follow-up duration of 22 hips was 48 months. The difference between the mean preoperative and latest HHS was statistically significant (60.0 vs. 87.6 points, p<0.001). The treatment was considered satisfactory in 17 of 22 hips (77%) having a mean HHS of 95.0 points. Hips having a preoperative HHS of less than 60 points were more prone to unsatisfactory outcome. Among the investigated patient-dependent, clinical, radiographic variables and intraoperative articular findings, coxa profunda sign in a plain radiograph was found correlated with a higher rate of unsatisfactory outcome (p= 0.040). Conclusion: Safe surgical hip dislocation procedure has a success rate of 77% after a mean follow-up of four years. Coxa profunda sign is associated with the unsatisfactory clinical outcome. Preoperative HHS of less than 60 points seems to be a negative predictive variable on the clinical outcome

Retrospective Analysis of Metastatic Bone Tumors

Aim: Bone tissue is the primary organ of hematopoiesis and osteogenesis in healthy individuals. Bone tissue is one of the most frequently metastasized organs. In addition, for all types of cancer, it is an indication that cancer has reached a level where it can no longer be cured and the patient's life expectancy is reduced. The aim of this study was to retrospectively evaluate the cases operated for bone metastasis. Material and Methods: A total of 67 patients who underwent a biopsy or operation due to bone tumors at Eskişehir Osmangazi University Medical Faculty Hospital between January 2020 and January 2022 were included in this study. Results: Of the metastatic cases, 49 (73.1%) were male and 18 (26.9%) were female. The mean age of the patients was 61.7±19.8 (range, 9-88) years. The most frequently metastasized tumors were lung carcinoma and tumor of unknown primary in males, while lung and breast in females. Tumors most frequently metastasize to the spine region. There were 6 (9.0%) cases, 1 (1.5%) of which was mesenchymal, in which the primary origin couldn’t be detected in metastatic tumors. Conclusion: Bone pain is always a symptom that is suspicious for metastasis in a patient followed up with a diagnosis of cancer and requires further investigation. Treatment is more palliative after bone metastasis. There is a need for targeted studies to prevent metastasis. It should be kept in mind that the primary focus may not be detected in all clinical and imaging methods in a group of patients

Evaluation of labral pathology and hip articular cartilage in patients with femoroacetabular impingement (FAI) : comparison of multidetector CT arthrography and MR arthrography

Background: To compare the multidetector computed tomography (MDCT) arthrography (CTa) and magnetic resonance (MR) arthrography (MRa) findings with surgical findings in patients with femoroacetabular impingement (FAI) and to evaluate the diagnostic performance of these methods. Material/Methods: Labral pathology and articular cartilage were prospectively evaluated with MRa and CTa in 14 hips of 14 patients. The findings were evaluated by two musculoskeletal radiologists with 10 and 20 years of experience, respectively. Sensitivity, specificity, accuracy, and positive predictive value were determined using surgical findings as the standard of reference. Results: While the disagreement between observers was recorded in two cases of labral tearing with MRa, there was a complete consensus with CTa. Disagreement between observers was found in four cases of femoral cartilage loss with both MRa and CTa. Disagreement was also recorded in only one case of acetabular cartilage loss with both methods. The percent sensitivity, specificity, and accuracy for correctly assessing the labral tearing were as follows for MRa/CTa, respectively: 100/100, 50/100, 86/100 (p0.05) and for femoral cartilage assessment were 100/75, 90/70, 86/71 (p>0.05). Inter-observer reliability value showed excellent agreement for labral tearing with CTa (k=1.0). Inter-observer agreement was substantial to excellent with regard to acetabular cartilage assessment with MRa and CTa (k=0.76 for MRa and k=0.86 for CTa) Conclusions: Inter-observer reliability with CTa is excellent for labral tearing assessment. CTa seems to have an equal sensitivity and a higher specificity than MRa for the detection of labral pathology. MRa is better, but not statistically significantly, in demonstrating acetabular and femoral cartilage pathology