[Results of the surgical treatment for symptomatic mesoacromion]. / Semptomatik mezo-akromiyon cerrahi tedavisinin sonuçlari.

OBJECTIVES: Functional results of patients who were operated on for symptomatic meso os acromiale were retrospectively evaluated. METHODS: The study included six patients (5 females, 1 male; mean age 58.5 years; range 51 to 64 years) who underwent surgical treatment for symptomatic os acromiale following unsuccessful conservative treatment. Internal fixation and bone grafting were performed in all the patients. Evaluations were based on physical assessment, radiographic examination, and the UCLA (University of California at Los Angeles) score. All the patients had symptoms of subacromial impingement accompanied by various degrees of rotator cuff tears. Symptomatic os acromiale was diagnosed by imaging studies and tenderness over the acromion during palpation. In case of suspected stability of the acromion, arthroscopy was performed. Fixation was performed with cannulated screws (n=4) or K-wires (n=2) and a cerclage wire or nonabsorbable sutures. Bone graft was harvested locally. The mean follow-up period was 29 months (range 18 to 35 months). RESULTS: The mean UCLA score increased from a preoperative 11.8 to postoperative 28.2. Union was achieved in four patients in whom cannulated screws were used. Two patients who were fixed with K-wires remained ununited. CONCLUSION: It is possible to obtain satisfactory results with cannulated screws which probably enable a more rigid fixation in symptomatic os acromiale. Arthroscopic evaluation may be helpful in deciding whether or not os acromiale is symptomatic.

[Arthroscopic repair of combined superior labrum anterior posterior and Bankart lesions]. / Superior labrum anterior posterior ve Bankart kombine lezyonlarinin artroskopik tamiri.

OBJECTIVES: We retrospectively evaluated patients who underwent arthroscopic treatment for superior labrum anterior posterior (SLAP) lesions combined with antero-inferior labral detachment (Bankart lesion, Maffet type 5). METHODS: The study included eight male patients (mean age 31.8 years; range 23 to 50 years) who were treated with suture anchors for type 5 SLAP lesions. In all the patients the symptoms started after trauma, and all presented with shoulder instability findings. The range of motion was measured in the sitting position by a goniometer, and muscle force was assessed manually. In addition, Speed and O'Brien tests and Jobe relocation test were performed. All the patients were examined by standard shoulder magnetic resonance scans. Functional results were evaluated according to the UCLA (University of California at Los Angeles) shoulder score, and the Rowe rating scale for Bankart repairs. The mean follow-up was 37.8 months (range 24 to 52 months). RESULTS: Functional results were excellent-good in five patients, fair in two patients, and poor in one patient. The mean UCLA score increased from a preoperative 15 (range 14-17) to a postoperative 30 (range 20-35), with a corresponding increase in the mean Rowe score from 25 (range 15-45) to 81 (range 50-95) (p<0.05). CONCLUSION: Arthroscopic repair of combined Bankart and SLAP lesions may present technical difficulties. Nevertheless, it is possible to get good results in selected patients in whom intraarticular pathologies are diagnosed and treated appropriately.

[Early results of medial opening wedge osteotomy in varus gonarthrosis]. / Varus gonartrozunda medial açik kama osteotomisinin erken dönem sonuçlari.

OBJECTIVES: We evaluated the efficacy and short-term results of medial opening wedge high tibial osteotomy with the use of a Puddu plate in patients with medial compartment gonarthrosis. METHODS: The study included 15 knees of 12 female patients (mean age 50.6 years; range 45 to 63 years) who were treated with medial opening wedge high tibial osteotomy for varus knees with medial compartment gonarthrosis. The osteotomy sites were fixed with a Puddu plate followed by allograft application. The mean follow-up period was 30.7 months (range 19 to 40 months). RESULTS: The mean consolidation time was 7.1 weeks (range 6 to 9 weeks). The mean preoperative and postoperative Lysholm scores were 54.1 (range 30 to 60) and 82 (range 67 to 95), respectively. The mean preoperative femorotibial angle was 3.5 degrees in varus malalignment (range 3 degrees valgus to 9 degrees varus). It was 7.3 degrees valgus postoperatively. The mean correction of the mechanical axis was 10.7 degrees , with no loss of correction during the follow-up period. No adverse effects were observed associated with allograft use. The lateral cortex was broken in one patient (6.7%) who was then treated with an Ilizarov external fixator due to pseudoarthrosis. All but this patient were satisfied with the treatment. CONCLUSION: Compared with other osteotomy models, medial opening wedge osteotomy with the use of a Puddu plate offers advantages in terms of ease of application and maintenance of correction in the early follow-up period. With allograft application, consolidation is obtained without interfering with the rehabilitation period.

Total antioxidant capacity assay of human serum using copper(II)-neocuproine as chromogenic oxidant: the CUPRAC method.

BACKGROUND: Tests measuring the combined antioxidant effect of the nonenzymatic defenses in biological fluids may be useful in providing an index of the organism's capability to counteract reactive species known as prooxidants, resist oxidative damage and combat oxidative stress-related diseases. The selected chromogenic redox reagent for the assay of human serum should be easily accessible, stable, selective, respond to all types of biologically important antioxidants such as ascorbic acid, alpha-tocopherol, beta-carotene, reduced glutathione (GSH), uric acid and bilirubin, regardless of chemical type or hydrophilicity. Currently, there is no rapid method for total antioxidant assay of human serum meeting the above criteria. METHODS: Our recently developed cupric reducing antioxidant capacity (CUPRAC) spectrophotometric method for a number of polyphenols and flavonoids using the copper(II)-neocuproine reagent in ammonium acetate buffer was now applied to a complete series of plasma antioxidants for the assay of total antioxidant capacity (TAC) of serum, and the resulting absorbance at 450 nm was recorded either directly (e.g. for ascorbic acid, alpha-tocopherol and glutathione) or after incubation at 50 degrees C for 20 min (e.g. for uric acid, bilirubin and albumin), quantitation being made by means of a calibration curve. The lipophilic antioxidants, alpha-tocopherol and beta-carotene, were assayed in dichloromethane (DCM). Lipophilic antioxidants of serum were extracted with n-hexane from an ethanolic solution of serum subjected to centrifugation. Hydrophilic antioxidants of serum were assayed after perchloric acid precipitation of proteins in the centrifugate. RESULTS: The molar absorptivities, linear ranges and trolox equivalent antioxidant capacity (TEAC) coefficients of the serum antioxidants were established with respect to the CUPRAC spectrophotometric method, and the results (TEAC, or TEAC coefficients) were evaluated in comparison to the findings of the ABTS/TEAC reference method using persulfate as oxidant. As for hydrophilic phase, a linear correlation existed between the CUPRAC and ABTS findings (r=0.58), contrary to current literature reporting that either serum ORAC or serum ferric reducing antioxidant potency (FRAP) does not correlate at all with serum TEAC. The analytical responses of serum antioxidants were shown to be additive, enabling a TAC assay. The intra- and inter-assay CVs were 0.7 and 1.5%, respectively, for serum. CONCLUSIONS: The CUPRAC assay proved to be efficient for glutathione and thiol-type antioxidants, for which the FRAP test was nonresponsive. The findings of CUPRAC completely agreed with those of ABTS-persulfate for lipophilic phase. The additivity of absorbances of all the tested antioxidants confirmed that antioxidants in the CUPRAC test did not chemically interact among each other so as to cause an intensification or quenching of the theoretically expected absorbance. As a distinct advantage over other electron-transfer based assays (e.g. Folin, FRAP, ABTS, DPPH), CUPRAC is superior in regard to its realistic pH close to the physiological pH, favourable redox potential, accessibility and stability of reagents and applicability to lipophilic antioxidants as well as hydrophilic ones.

[Treatment of recurrent post-traumatic anterior-inferior glenohumeral instabilities with the selective capsular shift technique]. / Travma sonrasi tekrarlayan anterior-inferior glenohumeral instabilitelerin selektif kapsül kaydirma teknigi ile tamiri.

OBJECTIVES: We evaluated the functional results of treatment with the selective capsular shift technique in patients with recurrent post-traumatic anterior-inferior glenohumeral instability. METHODS: The study included 16 patients (15 males, 1 female; mean age 30 years; range 25 to 38 years) who underwent selective capsular shift operation for recurrent post-traumatic anterior-inferior glenohumeral instability. Dislocations occurred following severe (n=14) or mild (n=2) trauma. Preoperatively, the mean number of dislocations was 14 (range 4 to 45) and magnetic resonance imaging showed a Bankart lesion in all the patients and a Hill-Sachs lesion in 20%. The patients were evaluated according to the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) and Rowe's scoring for Bankart repair. Preoperative and postoperative anteroposterior and axillary x-rays were obtained from all the patients. Range of motion was measured with a goniometer and manual muscle strength tests were performed. The mean follow-up was 41 months (range 21 to 74 months). Statistical analysis was made using the t-test. RESULTS: The mean preoperative and postoperative ASES scores differed significantly (63.2 vs 95.8; p<0.05). The mean Rowe score was 92.5 (range 70 to 100). Strength of the infraspinatus, supraspinatus, and subscapularis muscles increased significantly (p<0.05). The results were excellent in 12 patients (75%), good in two patients (12.5%), and fair in two patients. Fifteen patients (93.8%) expressed satisfaction with the operation and results. CONCLUSION: Addition of the selective capsular shift technique to the Bankart repair procedure improves stability and preserves the range of motion of the glenohumeral joint in patients with anterior-inferior glenohumeral instability accompanied by a Bankart lesion and capsular injury or laxity.

[Arthroscopic selective capsular release in the treatment of frozen shoulder]. / Donuk omuz hastaliginin tedavisinde artroskopik selektif kapsül gevsetmesi.

OBJECTIVES: We evaluated the results of arthroscopic selective capsular release in patients with frozen shoulder. METHODS: Sixteen patients (5 males, 11 females; mean age 51 years; range 25 to 73 years) underwent arthroscopic capsular release for frozen shoulder. The syndrome was due to trauma in two patients; nine patients had diabetes mellitus; no etiologic cause was found in three patients. Two patients had rotator cuff tendinitis. The mean duration of complaints was 14 months (range 3 to 36 months). The patients were treated conservatively for a mean of 9.5 months (range 3 to 12 months). The range of motion of the shoulder was measured with a goniometer. Functional evaluations were made according to the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES). Under general anesthesia, all the patients underwent arthroscopic capsular release, subacromial bursoscopy, and manipulation. Acromioplasty was performed in two patients with subacromial impingement. The mean follow-up was 14 months (range 4 to 25 months). RESULTS: Compared to the healthy side, postoperative increments in flexion, adduction-external rotation, abduction-internal and external rotations were 38%, 47%, 43%, and 30%, respectively. The strength of the infraspinatus, supraspinatus, and subscapularis muscles significantly increased (p<0.05). The mean postoperative ASES score improved by 50 (p<0.05). The mean visual analog scale score decreased significantly with significant improvements in daily activities (p<0.05). Complaints of pain and limitation disappeared in a mean of 3.5 months (range 15 days-12 months) in 14 patients (87.5%) who were fully satisfied with the operation. CONCLUSION: Patients with frozen shoulder unresponsive to conservative treatment can be effectively treated with arthroscopic selective capsular release and manipulation.

Fatty acid composition of seeds of Satureja thymbra and S. cuneifolia.

The chemical composition of fatty acid methyl esters (FAMEs) from seeds of S. thymbra and S. cuneifolia were analyzed by GC/MS. 7 FAMEs were identified from the seeds of S. thymbra mainly as 9-octadecenoic acid methyl ester (43.9%), hexadecanoic acid methyl ester (11.4%), 9,12,15-octadecatrienoic acid methyl ester (Z,Z,Z) (30.2%), and octadecanoic acid methyl ester (14.1%), while from the seed of S. cuneifolia 10 FAMEs were obtained with the main components, similar to S. thymbra. These were identified as 9-octadecenoic acid methyl ester (10.1%), hexadecanoic acid methyl ester (methyl palmitate, 34.6%), 9,12,15-octadecatrienoic acid methyl ester (Z,Z,Z) (6.3%) and octadecanoic acid methyl ester (1.8%).

Enzyme inhibitory and antioxidant activities of Viburnum tinus L. relevant to its neuroprotective potential.

In vitro neuroprotective activity of the extracts of Viburnum tinus L. was investigated via inhibition of acetylcholinesterase (AChE) and butyrylcholinesterase (BChE), and tyrosinase (TYRO) by microtitre plate assays. Their antioxidant activity was tested using 2,2-diphenyl-1-picrylhydrazyl (DPPH), N,N-dimethyl-p-phenylendiamine (DMPD), super oxide (SO), and nitric oxide (NO) radical-scavenging activities, ferric ion-chelation capacity, ferric- (FRAP), and phosphomolybdenum-reducing antioxidant power (PRAP) assays. Total phenol and flavonoid content of the extracts was determined spectrophotometrically. The branch-ethyl acetate and fruit-methanol extracts exerted potent anticholinesterase effects (66.4 ± 0.65% to 97.7 ± 0.47%), while the fruit-methanol extract had the highest TYRO inhibition (47.0 ± 0.68%). The methanol extracts showed higher activities in most of the antioxidant tests. All the extracts displayed notable NO-scavenging effects (47.5 ± 5.03% to 74.5 ± 1.80%). Only the fruit-ethyl acetate extract quenched SO radical (38.4 ± 1.01%) at 500 µg ml(-1). Our data indicate that the fruit and branch extracts of V. tinus may provide potential neuroprotection.

Anti-acetylcholinesterase and antioxidant assets of the major components (salicin, amentoflavone, and chlorogenic acid) and the extracts of Viburnum opulus and Viburnum lantana and their total phenol and flavonoid contents.

Some Viburnum species are used for preparation of the traditional drink called gilaburu in Anatolia. In the current study, our goal was to evaluate acetylcholinesterase (AChE) inhibitory and antioxidant activities of the ethyl acetate, methanol, and water extracts prepared from the branches, leaves, and fruits of Viburnum opulus and Viburnum lantana along with salicin, amentoflavone, and chlorogenic acid, three major compounds abundantly found in these species. AChE enzyme inhibition was tested in vitro using an enzyme-linked immunosorbent assay microplate reader at 50, 100, and 200 µL/mL concentrations. Antioxidant activity was examined by ferrous ion chelating capacity, ferric reducing antioxidant power, and ß-carotene bleaching assay at 500, 1,000, and 2,000 µg/mL. Total phenol and flavonoid contents of the extracts were also established by Folin-Ciocalteau and AlCl(3) reagents, respectively. Our data revealed that the leaf methanol extract of V. opulus displayed a significantly high inhibitory effect against AChE (57.63 ± 1.23%, 87.41 ± 0.99%, and 93.19 ± 0.87% at 50, 100, and 200 µg/mL, respectively). The extracts of V. lantana exerted higher antioxidant activity.

The efficacy of magnetic resonance imaging and x-ray in the evaluation of response to radiosynovectomy in patients with hemophilic arthropathy.

OBJECTIVE: We aimed to assess the role of Magnetic Resonance Imaging (MRI) and X-Ray in the evaluation of response to radiosynovectomy (RS) in patients with hemophilic arthropathy. MATERIAL AND METHODS: Eleven patients who suffered from hemophilic arthropathy with a mean age of 11.7 (range between 7-15) were included in this study. 148-185 MBq Yttrium 90 silicate (Y-90) was administered intraarticularly to ten knee joints and one patient was treated with intraarticular 74 MBq Rhenium 186 (Re-186) injection into his ankle. Before radiosynovectomy, plain anteroposterior and lateral X-rays of the target joints were obtained by standard technique. The follow-up MRI and X-ray studies of the patients were done 6 months after RS. Pettersson hemophilic arthropathy scales were utilized to stage the condition of the joints on plain X-ray and classification of the investigated joints on MRI were done according to Denver score. The clinical assessment of the efficacy of the RS was made with the comparison of the average bleedings before and after the intervention. RESULTS: During the 6-month follow-up period after RS, an improvement in number of hemarthrosis 75% or greater compared with the prior six months occurred in six joints (54.5%). The Pettersson scores worsened in 1/11 (9%), remained unchanged in 9/11 (81.8%), and improved in 1/11 (9%) joints. At the 6-month follow-up, the MRI score worsened in one (9%) and was unchanged in 10/11 joints (90.9%). CONCLUSION: MRI is a more sensitive tool than plain radiography for evaluating and follow-up of joint disease in persons with hemophilia, but both methods don't show correlation with the therapeutic response Conflict of interest:None declared.

Antioxidant properties of Viburnum opulus and Viburnum lantana growing in Turkey.

In the present study, antioxidant properties of the water extracts of different parts of Viburnum opulus and Viburnum lantana (Caprifoliaceae) were investigated using the 2,2-diphenyl-1-picrylhydrazyl (DPPH) scavenging and superoxide anion scavenging methods. The extracts were prepared from the fruits, branches, and leaves of V lantana and V opulus species. The branch extracts of V lantana and V opulus inhibited superoxide anion in a concentration-dependent manner. Compared with t-tocopherol, the fruit extract of V lantana did not show any scavenging effect on superoxide anion formation. V lantana leaf extracts, however, showed a moderate scavenging effect on superoxide anion formation, whereas V lantana branch extracts showed a strong scavenging effect (IC50 = 3.1 mg/ml) on superoxide anion in higher concentration. On the other hand, all extracts exhibited a scavenging effect on the DPPH radical with various potencies. When compared with butylated hydroxytoluene, V opulus branch and V lantana leaf extracts, as well as V lantana branch, V opulus fruit and V lantana fruit extracts, showed strong DPPH radical scavenging activity with IC50 values of 0.014, 0.035, 0.052, 0.057 and 0.085 mg/ml, respectively.