Comparison of stiffness, elasticity and resilience values of ACL with autografts used instead of ACL in terms of texture analysis.

Background: Anterior cruciate ligament (ACL) ruptures are one of the most extensively studied injuries in the field of orthopedics, but despite the extensive research, graft selection for ACL reconstruction remains a matter of debate. The present study aims to evaluate the stiffness and elasticity of native ACLs using texture profile analysis and compare results with those of autografts used in ACL reconstruction. Methods: Included in the study were dissected 12 cadavers from which grafts were recovered. The graft characteristics, such as stiffness, elasticity and resilience, were measured using a TA.XT Plus Texture Analyzer. Findings: Among the grafts studied, Achilles' tendon graft (0.70; 0.64) had the highest resilience in both males and females, while the greatest elasticity was identified in the patellar tendon graft (Male: 93 %; Female: 94 %) in all subjects. The highest stiffness value in males was recorded for the quadriceps tendon graft (2928.76 N), while the highest stiffness value in females was recorded for Achilles' tendon graft (2204.61 N). Interpretation: According to the study data, the autografts that may be considered as an alternative to ACL were, listed in order of strength from high to low, the quadriceps, Achilles', patella and hamstring tendons in men, and the Achilles', quadriceps, patellar and hamstring tendons in women. It is worthy of note that the hamstring tendon graft, which is the most frequently preferred autograft in ACL reconstruction, was found to be the lowest in all parameters in both groups.

Investigation of Morphometric Characteristics of the Mesencephalon in a Healthy Turkish Population: An MRI-Based Morphometric Study.

INTRODUCTION: Due to the important functions of the mesencephalon, knowledge of its morphometric characteristics in a healthy population is important for any pathological diagnosis. The aim of this study was to determine the specific morphometric values of the mesencephalon in a healthy Turkish population. METHODS: Magnetic resonance (MR) images of 184 subjects (98 females, 86 males) with a mean age of 47.33 years (range 18 to 85 years) were included in the study. Then, parameter measurements were performed on 1.5 T MR images, and MicroDicom Digital Imaging and Communications in Medicine (DICOM) viewer 2022.1 (MicroDicom Ltd., Sofia, Bulgaria) software program was used for the measurements. RESULTS: The mean sagittal diameter of the right cerebral peduncle was 17.17±2.03 mm, the mean cross-sectional area of the right cerebral peduncle was 171.75±32.81 mm2, the mean transverse diameter of the left cerebral peduncle was 16.60±2.32 mm, sagittal diameter of tectum and tegmentum 17.01±1.57 mm, the cross-sectional area of tectum and tegmentum 223.40±27.37 mm2 and pontomesencephalic angle 52.03°±10.61°, while in males these values were 18.26±2.38 mm, 182.61±38.57 mm2, 17.39±2.57 mm, 17.76±1.90 mm, 237.20±35.94 mm2 and 56.77°±9.78°, respectively. Except for the mamillopontine distance, there was a statistically significant difference between genders in the other parameters (p<0.05). CONCLUSION: In conclusion, the findings related to the mesencephalon obtained in this study are presented for the first time in a healthy Turkish population. Especially, the cerebral peduncle cross-sectional area, tectum and tegmentum cross-sectional area, and cerebral peduncle transverse diameter can be evaluated clinically. We believe that knowledge of these values will guide specialists and radiologists in the diagnosis of any pathologic condition. Furthermore, the pontomesencephalic angle and mamillopontine distance have been identified as potentially useful landmarks in the diagnosis of intracranial hypotension and hydrocephalus. In particular, these angles can be measured in patient groups and may be a potential landmark in making an alternative diagnosis.

Evaluation of Autografts Used in Anterior Cruciate Ligament Reconstruction in Terms of Tensile Strength.

Introduction Anterior cruciate ligament (ACL) injuries increase the likelihood of chronic knee problems in later years, including early onset osteoarthritis. Therefore, ACL treatment is important in preventing knee problems from developing. The treatment of choice for ACL tears is surgery (ACL reconstruction), and the most popular tendons for ACL reconstruction are the patellar tendon, hamstring tendon (semitendinosus and gracilis tendons), and bone-patellar tendon-bone. The present study compares the tensile strength of autografts used in ACL reconstruction to identify the optimum autograft for ACL in terms of mechanical properties. Methods Cadavers were dissected, and the Achilles tendons, quadriceps tendons, hamstring tendons (semitendinosus and gracilis tendons), patellar tendon grafts, and ACLs were harvested. Tensile tests of each tendon graft were performed using a Shimadzu Autograph AG-IS 100 kN tester (Shimadzu, Kyoto, Japan). Results The mean difference in tensile strength between ACL and other grafts was lowest for the quadriceps in both males and females (p ˂ 0.001), meaning that ACL and quadriceps grafts are more compatible than other tendon grafts in terms of tensile strength. Conclusion The present study found the lowest mean difference in tensile strength to be between the ACL and the quadriceps tendon, suggesting that the use of the quadriceps tendon in ACL reconstruction will yield more positive outcomes.

Repeated use of fibrin sealants kept at room temperature in conjunctival autografting: An animal study.

Purpose: In this study, our aim was to investigate if fibrin adhesives used in conjunctival wound surgery with autologous conjunctival grafts could be used repeatedly at different times after surgical opening. Methods: 40 New Zealand rabbits were used in the study. These animals were divided into four groups, each consisting of 10 rabbits, and hence 20 eyes. In the first group (control group), Tisseel fibrin sealant was used on the day the eye was first opened surgically; in the second group, it was used on the seventh day; on the third group, it was used on the 14th day; and in the fourth group, it was used 28 days after surgical opening. The graft from the inferior bulbar conjunctiva was attached using Tisseel fibrin glue to the superior scleral bed at the location where the superior bulbar conjunctiva was excised in the same eye. Results: No microbial growth was detected in the cultures of the samples tested. There were two partial graft loss in group 2 and there was one partial graft loss in each group of the other groups, and further total graft loss was present in one rabbit in group 3. None of the rabbits had any complications like granuloma, Corneal dellen or infection. Conclusion: Based on these results, fibrin sealants can be used repeatedly by storing them at room temperature. Repeated use of fibrin adhesives will reduce the cost of ophthalmologic surgeries and non-ophthalmologic surgeries.

Evolution of a traditional technique: Comparison of a 4-mm lag screw and Kirschner wire technique versus a 4-mm lag screw and Kirschner technique with anti-gliding miniplate fixation for the treatment of medial malleolar fractures.

BACKGROUND: In this study, we aimed to compare a 4-mm lag screw and Kirschner wire technique versus a 4-mm lag screw and Kirschner wire (K-wire) technique with additional miniplate fixation for the treatment of medial malleolar fractures. METHODS: A total of 23 patients who were diagnosed with isolated fractures of the medial malleolus and operated in our center were retrospectively analyzed. The patients were divided into two groups: Group A, medial malleolar fracture fixed with a 4-mm cannulated screw and a K-wire (n=11) and Group B, a 4-mm cannulated screw and K-wire used for fixation with miniplate fixation for extra stability (n=12). Clinical outcomes were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score at 2, 6, 12, and 24 months postoperatively. At 12-24 months, the presence of pain and tenderness in the medial malleolus with palpation was evaluated using the visual analog scale (VAS) pain scores. RESULTS: The mean time to union was 2.23±0.56 (range, 1.8-2.9) months in Group A and 2.46±0.45 (range, 1.9-3.1) months in Group B, indicating no statistically significant difference between the two groups (p>0.05). The mean AOFAS score at 2 months postoperatively was 60.40±7.78 (range, 46-79) in Group A and 73.60±10.80 (range, 53-87) in Group B, indicating a statistically significant difference between the groups (p<0.01). However, there was no statistically significant difference in the mean AOFAS scores at 6 and 12 months between the groups (p>0.05). The mean VAS pain scores at 12-24 months postoperatively did not significantly differ between the groups (p>0.05). CONCLUSION: Our study results suggest that the treatment of medial malleolar fractures with a cannulated screw and K-wire with additional stabilization using a miniplate ensures favorable early outcomes with early return to daily living activities. However, both techniques have similar outcomes in the mid-term.

A new technique for preparing cadavers using PMMA: Rat and mouse example.

BACKGROUND: Polymethyl methacrylate is a member of the acrylic polymer family with superior optical properties. It is used in dentistry, hospital incubators, lenses, and various surgical fields, especially orthopedics. In this preliminary study, we aimed to prepare cadavers using the industrial form of polymethyl methacrylate. METHODS: The new technique consists of fixation, washing, purification, impregnation, and polymerization. For the study, two whole rat bodies, two rat front legs and two rat hind legs, one half rat body, two whole mouse bodies, and all internal organs were used. Wistar albino rats and BALB/c mice were used. After the cadaver samples were fixed and washed, they were passed through an alcohol series starting from 50%, completing the purification process. In the next step, a solution was prepared by mixing 100 ml of Thinner into 1000 ml of a mixture containing styrene, methyl methacrylate, and Co(II)2-ethyl hexanoate. The samples were immersed in the solution under negative pressure (from 10 mmHg to 400 mmHg), allowing the samples to absorb the solution thoroughly. They were then treated with methyl ethyl ketone peroxide and the polymerization step was terminated. RESULTS: The cadaver samples obtained using polymer were hard, they maintained the given shape, and showed a relatively transparent quality. The production of these materials took 35 days, excluding fixation. The tissue samples were odorless in the process after polymerization. Also, there was no decay in the samples after the production stage and they could be stored under room conditions. CONCLUSION: This study determined that cadavers could be prepared using polymethyl methacrylate and methyl ethyl ketone peroxide. The polymer used here cost about $5. The cadavers can be safely exhibited in room conditions for five years without requiring special conditions like pools or cold storage. Further research should compare this technique with the plastination technique in terms of texture, color, weight, application time, and cost.

Residual Symptoms After Carpal Tunnel Decompression and Treatment With Gabapentin: A Multicenter Study.

Objectives To identify postoperative residual symptoms of carpal tunnel syndrome (CTS) and to investigate the effectiveness of gabapentin in the treatment of residual symptoms. Materials and methods Of a total of 412 patients who underwent surgery for CTS in four centers over a four-year period, 14 who had residual symptoms after CTS release and did not receive gabapentin (Group A) and 14 patients with postoperative residual symptoms and received gabapentin were included in this retrospective study. Postoperative residual symptoms were defined as persistent nocturnal numbness and tingling with or without occasional daytime pain. Tinel's and Phalen's tests were performed for the diagnosis of residual symptoms. Functional Severity Score (FSS), Symptom Severity Score (SSS), and Visual Analog Scale (VAS) were used to evaluate functional outcomes, severity of symptoms, and numbness and sleep quality, respectively at six and 12 weeks postoperatively. Level of Evidence: III, therapeutic study Results There was no statistically significant difference in the mean postoperative FSS (p=0.845) and VAS-numbness scores (p=0.367) between the groups. However, there was a statistically significant difference in the mean postoperative SSS (p=0.025) and VAS-sleep quality scores (p<0.001) between the groups. Conclusion Gabapentin treatment can be a treatment of choice for residual symptoms after CTS surgery and clinical improvement can be achieved owing to its relieving effect, particularly in nocturnal symptoms of patients having neuropathic pain.

The contribution of scholars to the anatomy of the eye and adnexa in islamic geography.

From the early period of Islam, Muslim scholars have translated the ancient Greek medical works, and they reached a much more advanced level. Blindness was a major cause of disability in all Islamic geography, so physicians from Islamic territory, particularly Yuhanna ibn Masawayh, Hunain Ibn Ishaq, Rhazes, Ali bin Isa, Ibn-i Sina, and Ibn Al-Haitam, were particularly focused on the anatomy of the eye and diagnosis and treatment of eye diseases. In this study, we aimed to report the contributions of the Muslim scholar on the anatomy of the eye and adnexa for the first time in the literature.