The neurochemistry of peripheral nerve regeneration

Peripheral nerve injuries (PNIs) can be most disabling, resulting in the loss of sensitivity, motor function and autonomic control in the involved anatomical segment. Although injured peripheral nerves are capable of regeneration, sub-optimal recovery of function is seen even with the best reconstruction. Distal axonal degeneration is an unavoidable consequence of PNI. There are currently few strategies aimed to maintain the distal pathway and/or target fidelity during regeneration across the zone of injury. The current state of the art approaches have been focussed on the site of nerve injury and not on their distal muscular targets or representative proximal cell bodies or central cortical regions. This is a comprehensive literature review of the neurochemistry of peripheral nerve regeneration and a state of the art analysis of experimental compounds (inorganic and organic agents) with demonstrated neurotherapeutic efficacy in improving cell body and neuron survival, reducing scar formation and maximising overall nerve regeneration

Spindle Cell Lipoma of the Dorsal Parts of the Foot

Spindle cell lipoma (SCL) is a tumor of the mature fat tissue that the collagen producing spindle cells take place in varying proportions. Most frequently, it settles on the back and neck and is located in the subcutaneous tissue. It is commonly seen in male patients in the 4th–5th decades. In addition to immunohistochemical examination, histopathological examination is necessary for the differential diagnosis. In this study, a spindle cell lipoma located on the dorsal foot was discussed along with the current literature review

A New Approach to Objective Evaluation of the Success of Nasal Septum Perforation

Background Perforations in the nasal septum (NSP) give rise not only to disintegration of the septum anatomy but also impairment in normal nasal physiology. The successes of these surgical techniques are usually equated to anatomical closure of the perforation. The goal of this study is to evaluate the subjective and objective results of our surgical technique for septal perforation surgery. Methods All NSPs in the six patients were closed by inferior turbinate flap. The Nasal Obstruction Symptom Evaluation (NOSE) instrument was used to evaluate the preoperative and postoperative subjective sensation of nasal obstruction. Measurement of preoperative and postoperative nasal airway resistance was performed using active anterior rhinomanometry which is an objective test. Wilcoxson signed rank test and Spearman correlation test were used to analyze correlation between NOSE scores and rhinomanometric measurements. Results The full closure of the septal perforations was noted in 100% of patients. The total NOSE score was 14 preoperatively and one postoperatively. The improvement in NOSE scores was statistically significant (P≤0.002). The mean preoperative total resistance (ResT150) value was 0.13 Pa/cm3s-1, which is below the normal range (0.16-0.31 Pa/cm3s-1), while the mean postoperative ResT150 value was 0.27 Pa/cm3s-1. The correlation between the improvement in NOSE scores and improvements in ResT150 values was statistically significant. Conclusions Surgical approaches should aim to solve both the anatomical and physiological problems of NSP. The application of subjective and objective tests in the postoperative period will help surgeons assess the applied techniques

Native extracellular matrix/fibroin hydrogels for adipose tissue engineering with enhanced vascularization

Adipose tissue engineering is a promising field for regeneration of soft tissue defects. However, vascularization is needed since nutrients and oxygen cannot reach cells in thick implants by diffusion. Obtaining a biocompatible scaffold with good mechanical properties is another problem. In this study, we aimed to develop thick and vascularized adipose tissue constructs supporting cell viability and adipose tissue regeneration. Hydrogels were prepared by mixing rat decellularized adipose tissue (DAT) and silk fibroin (Fib) at different v/v ratios (3:1, 1:1 and 1:3) and vortexing. Gelation times decreased with increasing fibroin ratio Among hydrogel groups 1:3-DAT: Fib ratio group showed similar mechanical properties with adipose tissue. Both pre-adipocytes and pre-endothelial cells, pre-differentiated from adipose derived stem cells (ASCs), were encapsulated in hydrogels at a 1:3 ratio. In vitro analyses showed that hydrogels with 1:3 (v/v) DAT: Fib ratio supported better cell viability. Pre-adipocytes had lipid vesicles, and pre-endothelial cells formed tubular structures inside hydrogels only after 3 days in vitro. When endothelial and adipogenic pre-differentiated ASCs (for 7 days before encapsulation) were encapsulated together into 1:3-DAT: Fib hydrogels both cell types continued to differentiate into the committed cell lineage. Vascularization process in the hydrogels implanted with adipogenic and endothelial pre-differentiated ASCs took place between the first and second week after implantation which was faster than observed in the empty hydrogels. ASCs pre-differentiated towards adipogenic lineage inside hydrogels had begun to accumulate lipid vesicles after 1 week of subcutaneous implantation Based on these results, we suggest that 1:3-DAT: Fib hydrogels with enhanced vascularization hold promise for adipose tissue engineering

Heparin Hedeflemesinde Manyetik Polimerik Nanoparçacık Sistemlerin Geliştirilmesi

Heparin, yüksek düzeyde sülfatlanmış bir glikosaminoglikan olup, yaygın bir şekilde pıhtılaşma önleyici olarak kullanılmaktadır. Heparin, bilinen biyolojik moleküller arasında en yüksek negatif yük yoğunluğuna sahip bir moleküldür. Önerilen projede, heparin, manyetik özellikli PAMAM dendrimerlere yüklenerek nanoparçacıkların karakterizasyonu yapılacaktır. Projede yalnızca nanoparçacıkların ameliyat edilecek bölgeye yönlendirilmesi ve nekrozlu dokunun daha etkin bir biçimde iyileştirilmesi amaçlanmaktadır. Böylece heparinin sağlıklı dokular üzerindeki olası yan etkilerinin azaltılması hedeflenmektedir. Bu amaçla projede heparin yüklü manyetik nanoparçacıkların sentezlenmesi, karakterizasyonu ve fibroblast hücreleri üzerindeki sitotoksik etkileri ODTÜ Biyolojik Bilimler Bölümü tarafından; in vivo sitotoksisite, doku hedeflemesi ve doku canlılığı üzerindeki etkileri ise GATA Plastik ve Rekonstrüktif Cerrahi Anabilim Dalı tarafından yürütülecek çalışmalar ile belirlenecektir

0-15 Yaş Arası Çocukluk Çağı Yanık Olgularının Değerlendirilmesi

Çocukluk çağında en sık görülen yanıklar, sıcak bir obje veya sıcak sıvı ile temas sonucu meydana gelmektedir. Çocukluk çağı yanık olgularında etiyoloji genellikle kaza olup, ihmale bağlı yanık olguları %6-20 oranında görülmektedir. İhmale bağlı yanıkların en sık nedeni haşlanma yanıklarıdır. Haşlanma yanıkları vücudun sıcak sıvıya dalması veya sıcak sıvının vücuda sıçraması ile oluşmaktadır. Bu çalışmada, Gülhane Askeri Tıp Akademisi Yanık Merkezinde, 2002-2006 yılları arasında yatırılarak tedavi edilen, 0-15 yaş arası, 82 olgunun hasta dosyaları retrospektif olarak incelendi. Olguların yaş, cinsiyet, yanık nedeni, yanık derecesi, yanık yüzdesi, hastanede yatış süresi, mortalité ve morbidité özellikleri değerlendirildi. Olguların, %72’sinin haşlanma yanığı, %19’unun alev ve aleve bağlı inhalasyon yanığı, %5’inin elektrik yanığı ve %4’ünün temas yanığı olduğu saptandı. Olguların vücut yanık yüzde oranının %20.71, mortalité oranının ise %17.1 olduğu tespit edildi. Sözlü olarak ifade etme becerileri tam gelişmemiş, küçük yaştaki çocuklarda ihmalin saptanması zordur ve bu olgular kolaylıkla kaza şeklinde yorumlanabilmektedir. Yanığın loka-lizasyonu, biçimi, yaralanmanın oluş şekli ile yanığın karakteristiği arasındaki ilişki değerlendirilerek, yaralanmanın kaza veya ihmal sonucu meydana gelip gelmediği saptanabilir. Çocuk ihmaline ait kanıtların fark edilmesi ile sağlık personelinin sorumluluğu artmakta ve olguların adli makamlara bildiriminin yapılması gerekmektedir. Anahtar kelimeler: Çocuk, yanık, ihma