Ahmet Piskin

The beneficial effects of Momordica charantia (bitter gourd) on wound healing of rabbit skin

Momordica charantia (MC; bitter gourd) is a traditional herbal commonly used for its antidiabetic, antioxidant, contraceptive and antibacterial properties. In the current study, the authors aim to observe the topical effect of MC cream on the wound-healing process in rabbits. Moreover, they compare the healing potential with conventional creams used therapeutically. Towards this aim, 28 New Zealand rabbits were divided into four groups and excision wounds (7 cm²) were made on their backs. Open wound dressing was carried out daily for 28 days among the experimental groups with the application of dekspanthenol (Bepanthen®; BP group, n = 7), nitrofurazon (Furacin®; FR group, n = 7) and olive oil extract of MC (MC group, n = 7). No application was made to the control group. At the end of day 28, areas of the skin with initial wound area were en bloc dissected and prepared for histopathological and stereological analysis. Inflammatory cells were abundant in the control group and cream application led to a decrease in the number of these cells, especially in the MC group. The highest number of fibroblasts was detected in the MC group. Furthermore, the MC group displayed the highest fractions of epidermis to papillary dermis, fibroblasts to reticular dermis and collagen fibres to reticular dermis. The MC group also presented a high density of blood vessels, moderate density of collagen fibres and mature fibroblasts. The BP group showed better epithelialisation compared with the FR group, but the latter provided more effective reorganisation of the dermis. Different cream supplements caused healthy and fast wound healing according to untreated controls and the results show that administration of the MC extract improves and accelerates the process of wound healing in rabbits in comparison with the BP and FR extracts.

Estrogen receptors in hip joint capsule and ligamentum capitis femoris of babies with developmental dysplasia of the hip.

OBJECTIVE The aim of this study was to detect the incidence of estrogen receptors in human hip joint capsule and ligamentum teres. METHODS The study included biopsies of the ligamentum capitis femoris (LCF) and hip joint capsule from 15 patients undergoing hip surgery for developmental dysplasia of the hip (DDH) and from the control hips of 15 cases of intrauterine fetal death. Mean age was 10.3 (range: 6 to 18) months at the time of surgery. Full-thickness 1x1 cm anterior capsule and LCF portions were taken as biopsy specimens. An immunohistochemical study using monoclonal antibody against estrogen receptors was performed to identify the rate of target estrogen cells in the hip joint capsule and LCF. RESULTS Estrogen receptor (ER) staining rates were 1.6±0.2% for the LCF and 1.3±0.2% for the hip joint capsule in the control groups, and 2.5±0.3% for the LCF and 2.0±0.3% for the hip joint capsule in the DDH groups. Estrogen receptor staining rates in the LCF and hip joint capsule control groups were significantly lower than that in the DDH groups (p<0.001). In both groups, ER rates were significantly lower in the hip joint capsule than in the LCF (p<0.01). CONCLUSION The high rate of ERs in the LCF and hip joint capsule appears to support the effect of estrogen in the etiology of the DDH.

Comparison of four different reduction methods for anterior dislocation of the shoulder

BackgroundShoulder dislocations account for almost 50 % of all major joint dislocations and are mainly anterior.ObjectiveThe aim is a comparative retrospective study of different reduction maneuvers without anesthesia to reduce the dislocated shoulder.MethodsPatients were treated with different reduction maneuvers, including various forms of traction and external rotation, in the emergency departments of four training hospitals between 2009 and 2012. Each of the four hospitals had different treatment protocols for reduction and applying one of four maneuvers: Spaso, Chair, Kocher, and Matsen methods. Thirty-nine patients were treated by the Spaso method, 47 by the Chair reduction method, 40 by the Kocher method, and 27 patients by Matsen’s traction-countertraction method. All patients’ demographic data were recorded. Dislocation number, reduction time, time interval between dislocation and reduction, and associated complications, pre- and post-reduction period, were recorded prospectively. No anesthetic method was used for the reduction.ResultsAll of the methods used included traction and some external rotation. The Chair method had the shortest reduction time. All surgeons involved in the study agreed that the Kocher and Matsen methods needed more force for the reduction. Patients could contract their muscles because of the pain in these two methods. The Spaso method includes flexion of the shoulder and blocks muscle contraction somewhat. The Chair method was found to be the easiest because the patients could not contract their muscles while sitting on a chair with the affected arm at their side.ConclusionsWe suggest that the Chair method is an effective and fast reduction maneuver that may be an alternative for the treatment of anterior shoulder dislocations. Further prospective studies with larger sample size are needed to compare safety of different reduction techniques.

Treatment of U-shaped Bone Ankylosis of the Knee with the Ilizarov Method: A Case Report

Osseous ankylosis following thermal burns is an uncommon but disabling problem1,2. There are two different types of bone ankylosis. The first type is due to extra-articular bridging heterotopic ossification with preservation of the underlying joint. This type typically responds to physical therapy and other treatment modalities, including surgical excision. The second type of bone ankylosis is intraarticular and occurs most commonly at the interphalangeal joints, resulting in serious functional and cosmetic problems2. There are several alternatives for treatment, including arthrodesis, osteotomy, arthroplasty, and amputation. However, treatment is always very difficult and the outcomes can be discouraging2,3. We present the case of a patient who had intra-articular bone ankylosis of the right knee joint in full flexion that was treated with the Ilizarov method4,5. To our knowledge, this is the first time that such a case, in terms of both the clinical presentation and the method with which it was treated, has been reported in the literature. Our patient was informed that data from the case would be submitted for publication. Aforty-seven-year-old woman presented with a 160° fixed flexion deformity of the right knee that was very disabling. She had sustained a third-degree thermal burn involving the right lower extremity when she was seven years old. There was circumferential scarring of the skin about the knee, and the right thigh appeared to be adhered to the leg. She required the use of crutches for mobility. A lateral radiograph showed that the right femur and tibia were almost parallel to each other and the knee was ankylosed (Fig. 1). We …

Immediate versus delayed primary nerve repair in the rabbit sciatic nerve

It is well known that peripheral nerve injury should be treated immediately in the clinic, but in some instances, repair can be delayed. This study investigated the effects of immediate versus delayed (3 days after injury) neurorrhaphy on repair of transected sciatic nerve in New Zealand rabbits using stereological, histomorphological and biomechanical methods. At 8 weeks after immediate and delayed neurorrhaphy, axon number and area in the sciatic nerve, myelin sheath and epineurium thickness, Schwann cell morphology, and the mechanical property of nerve fibers did not differ obviously. These results indicate that delayed neurorrhaphy do not produce any deleterious effect on sciatic nerve repair.

Subtrochanteric Derotation Osteotomy Using a Bent Dynamic Compression Plate in Children With Medial Femoral Torsion

Subtrochanteric osteotomy of the femur using a bent dynamic compression plate is a simple, safe, and stable technique for correction of severe medial femoral torsion.

Comparison between two mini incision techniques utilized in carpal tunnel release

OBJECTIVES We compared two mini skin incision techniques utilized in the treatment of carpal tunnel syndrome (CTS). METHODS Twenty-seven patients who underwent surgery for CTS were evaluated in two groups according to the site of the mini incision performed for surgical release. A single mini skin incision was performed over the transverse carpal ligament in 12 patients (group 1; 17 hands; 1 man, 11 women; mean age 55 years; range 38 to 66 years), and on the distal side of the ligament in 15 patients (group 2; 17 hands; all women; mean age 54 years; range 34 to 71 years). The two groups were compared with regard to improvement in pain and numbness, rigidity and sensitivity of the scar tissue, time to use the hands, and palmar pinch and grip strengths. The mean follow-up was 26.6 months in group 1, and 23.7 months in group 2. RESULTS Complete disappearance of symptoms was obtained in 14 wrists (82.4%) in group 1, and in 15 wrists (88.2%) in group 2, with no significant difference between the two groups (p>0.05). Rigidity and sensitivity of the scar tissue were seen in nine wrists (52.9%) in group 1, and in two wrists (11.8%) in group 2 (p<0.05), which lasted 3.5 months and 1.5 months, respectively. In group 2, time to use the affected hand for basic needs (9 days) and normal function (21 days) was significantly shorter, compared to 18 days and 35 days in group 1, respectively (p<0.05). The mean differences of grip and pinch strengths of the two hands were -2.78 kg and -0.60 kg in group 1, and -0.77 and -0.46 kg in group 2, respectively (p>0.05). CONCLUSION Although both methods of release yield satisfactory results in the mid- and long-term, mini skin incision performed on the distal side of the transverse carpal ligament is associated with less incision-related morbidity.

Controversies related to electromagnetic field exposure on peripheral nerves.

Electromagnetic field (EMF) is a pervasive environmental presence in modern society. In recent years, mobile phone usage has increased rapidly throughout the world. As mobile phones are generally held close to the head while talking, studies have mostly focused on the central and peripheral nervous system. There is a need for further research to ascertain the real effect of EMF exposure on the nervous system. Several studies have clearly demonstrated that EMF emitted by cell phones could affect the systems of the body as well as functions. However, the adverse effects of EMF emitted by mobile phones on the peripheral nerves are still controversial. Therefore, this review summarizes current knowledge on the possible positive or negative effects of electromagnetic field on peripheral nerves.

Travmatik Anterior Omuz İnstabilitesinde Açık ve Artroskopik Bankart Tamiri Sonuçlarının Karşılaştırılması

Amac: Travmatik anterior omuz instabilitesi cerrahi tedavisinde acik ve artroskopik Bankart tamirinin klinik sonuclarinin karsilastirilmasi amaclandi. Materyal ve Metod: Ocak 2005 ile Ocak 2013 yillari arasinda tekrarlayan anterior omuz instabilitesi nedeniyle cerrahi tedavi uygulanan 23 hastadan son kontrolleri yapilan 20 hasta (17 erkek, 3 kadin) calismaya dahil edildi. Hastalarin 10’una (ort. yas 30, dagilim 17-43) acik Bankart tamiri, 10’una (ort. yas 21, dagilim 18-49) artroskopik Bankart tamiri uygulandi. Agri degerlendirmesi vizuel analog skalasina (VAS) gore yapilirken klinik sonuclar Rowe skalasi kullanilarak degerlendirildi. Ameliyat sonrasi ortalama takip suresi acik tamir grubunda 37.4±27.1 ay iken, artroskopik tamir grubunda 23±6.9 ay idi. Istatistiksel degerlendirmede Shapiro-Wilk testi ile Mann-Whitney U testi kullanildi. Bulgular: VAS skoru acik tamir grubunda 5.7±2.5, artroskopik tamir grubunda 4.1±1.9, Rowe skoru acik tamir grubunda 97.5 (dagilim 80-100), artroskopik tamir grubunda 95 (dagilim 50-100) olarak bulundu. Klinik sonuclar acik tamir grubunda 9 hastada (%90) mukemmel, bir hastada (10%) iyi iken, artroskopik tamir grubunda 8 hastada (80%) mukemmel, bir hastada (10%) iyi, bir hastada (10%) kotu olarak bulundu. Acik grupta 2 hastada, artroskopik grupta ise 5 hastada dis rotasyon kisitliligi gozlendi. Iki grup arasinda VAS skoru, Rowe skoru ve eklem hareket acikligi bakimindan istatistiksel olarak anlamli fark gorulmedi (p>0.05). Sonuc: Calismamizda artroskopik tamir ile acik tamir sonuclari, son yillardaki calismalarla paralel olarak esdeger bulundu. Ancak artroskopik tamirin cerrahi tecrube ve tamir yontemlerinin gelismesiyle, postoperatif hasta konforu ve rehabilitasyon kolayligi nedeniyle avantajli oldugu kanisindayiz.

Effects of patients' sex on postoperative analgesic use for shoulder surgery

Aim. Postoperative pain is a major problem in patients who have undergone surgery of the shoulder joint. We retrospectively evaluated 26 patients in whom a subacromial catheter had been placed for postoperative pain management following shoulder surgery. Method. Infusion of local anesthetics and/or opioids through a subacromial catheter, placed at the end of the procedure, was started after surgery. This catheter was kept in place for 24 hours. The patients’ pain was evaluated by using a visual analog scale (VAS). Patients with a VAS score greater than 7 were given meperidine, 0.5 mg/kg i.v., those with a score of 5-7 received tenoxicam, 20 mg i.v., and patients who continued to have a score of >5 at the end of 30 minutes were given paracetamol, 1 g i.v. as an additional analgesic injection. Results. None of the patients had a need for meperidine after 24 hours of surveillance. Seven patients with a VAS score of 5-7 were given tenoxicam, while seven patients, all female, who had continuing pain, received paracetamol. Conclusion. A subacromial catheter, which does not cause adverse effects or complications, is easy to apply and allows effective analgesia, can be used with confidence in the postoperative pain management of patients undergoing shoulder surgery. The need for supplementary analgesia in women only is significant, indicating the role of the patient’s sex in pain perception.