The effects of progressive neuromuscular exercise program and taping on muscle strength and pain in patellofemoral pain. A randomized controlled blind study.

PURPOSE: To investigate the effects of corrective kinesio taping applied on patellofemoral and foot joint in addition to a progressive neuromuscular exercise program in women with Patellofemoral Pain (PFP) on knee pain and muscle strength. METHODS: Thirty females (20-45 years), diagnosed with unilateral PFP were randomly divided into two groups: the exercise (n = 15) and the exercise and taping (n = 15). Both groups performed three-stage progressive neuromuscular exercises for 12 weeks as home exercises. Plantar and knee corrective taping was additionally applied to the exercise and taping group. The knee pain was measured using the Visual Analogue Scale (VAS) during stair ascending and descending. Isokinetic dynamometer was used to evaluate the isokinetic muscle strength of the hamstring and quadriceps femoris muscles. All assessments were conducted before the treatment, at the end of the 6th-week treatment, and at the end of the 12th week of the treatment. RESULTS: After intervention, pain, and muscles peak torque were improved in all groups (p ˂ 0.05). The decrease in pain and the increase in quadriceps and hamstring muscle peak tork were found to be significant for both groups (p < 0.05). In the taping group, the decrease in pain during stair descending and the increase in hamstring muscle tork were higher than that of the exercise group (p < 0.05). CONCLUSION: In order to reduce pain in a short time and control it in the long term, it will be beneficial to tape the knee and foot in addition to neuromuscular exercises.

The relationship between glycemic control and osteocalcin, type 1 collagen C-terminal telopeptide, bone-specific alkaline phosphatase and the effects of anti-diabetic regimens on circulating markers of bone turnover in newly diagnosed diabetic patients: Bone health in diabetics.

AIM: Bone mineral disorders are being increasingly seen among diabetic populations as the frequency of diabetes mellitus (DM) is rising at an alarming rate. Our aim is to examine the relationship between glycemic control and bone turnover markers like osteocalcin (OC), C-terminal carboxy telopeptide (CTX), and bone-specific alkaline phosphatase (ALP) in patients with type 2 diabetes, and the effects of anti-diabetic regimens on these markers. MATERIALS AND METHODS: A total of 80 newly diagnosed type 2 DM patients were enrolled into the study and divided into two groups according to glucose regulation (group 1 HbA1c < 7 and group 2 HbA1c ≥ 7). They were also classified into three groups according to antidiabetic regimen. Physical examination findings, demographic characteristics, and anti-diabetic regimens of the patients were recorded. Hemogram and biochemical parameters were studied after 12 hours of fasting. Serum levels OC and CTX were examined by ELISA method. Bone-specific ALP was examined by Chemiluminesence immuneassay (CLIA) method. Bone densitometry was performed on the 2016 model Stratos DR device of DMS brand, and T scores of the patients were recorded. All parameters were repeated at the 6th month of the study. RESULTS: Serum vitamin D and OC levels of group 1 were higher, while ALP was higher in group 2. However, we failed to determine a significant difference in CTX levels between the groups. OC levels were enhanced only in patients receiving metformin plus vildagliptin therapy. The CTX levels increased in all groups, whereas they decreased in the metformin plus DPP-4 group. CONCLUSION: Better glucose regulation is associated with better bone formation, and among three groups metformin plus vildagliptin therapy has a favorable effect on both bone formation and resorption.

The role of serum E-selectin level and E-selectin gene S128R polymorphism on the enlargement of renal cyst in patients with polycystic kidney disease: Genetic background of renal cyst growth
.

BACKGROUND: To determine the role of E-selectin gene S128R polymorphism on the enlargement of renal cysts in patients with polycystic kidney disease (PKD). MATERIALS AND METHODS: 76 PKD patients with no comorbidity were enrolled in the study. Serum E-selectin levels were analyzed by enzyme-linked immunoabsorbent assay (ELISA). E-selectin gene S128R (561 A>C, rs: 5361) polymorphism was examined by polymerase chain reaction restriction fragment length (PCR-RFLP). Magnetic resonance imaging was performed at baseline evaluation and at the end of the 1st year to determine cyst enlargement and total kidney volume (TKV). RESULTS: No significant difference was identified between AA genotype and AC or CC variants of E-selectin gene S128R polymorphism in terms of age, disease duration, baseline cyst volume, cyst volume at the 12th month, baseline dominant cyst volume, and dominant cyst volume at the 12th month. In contrast, a significant difference was determined between the groups with regard to the change of TKV (2.9 ± 13.4 vs. 5.2 ± 16.3 mm3; respectively, p = 0.01). In the correlation analysis, the serum E-selectin level was significantly correlated to glucose, alanine transaminase, creatinine, calcium, phosphorus, total protein, albumin, and end diastolic volume (p = 0.0001, p = 0.001, p = 0.03, p = 0.021, p = 0.023, p = 0.002, p = 0.003, and p = 0.047, respectively). Multivariate logistic regression analysis demonstrated a 1.32-fold higher risk of cyst enlargement in patients with CC polymorphism when compared to AA genotype (p = 0.052), but not between AA and AC genotypes or CC and AC genotypes. CONCLUSION: PKD patients with CC variants of the E-selectin gene S128R polymorphism are at greater risk of cyst enlargement. The results of the present study should be confirmed with further studies with large sample size and longer duration of follow-up.

Serum ICAM-1 level and ICAM-1 gene 1462A>G (K469E) polimorphism on microalbuminuria in nondiabetic, nonhypertensive and normolipidemic obese patients: Genetical background of microalbuminuria in obesity / Polimorfismo 1462A>G (K469E) del gen ICAM-1 y nivel sérico de ICAM-1 en la oligoalbuminuria de pacientes obesos no diabéticos, no hipertensos y normolipidémicos: acervo genético de la oligoalbuminuria en la obesidad

Background: A growing body of evidence suggest that obese individuals are under risk of renal parenchymal disorders when compared to nonobese counterparts. Microalbuminuria is the early marker of renal involvement. Although most of obese patients carries multiple risk factors for microalbuminuria, some obese individuals without risk factor may progress to microalbuminuria. The present study was performed to examine the role of ICAM-1 gene 1462A>G (K469E) polymorphism on microalbuminuria in obese subjects without diabetes mellitus, hypertension, hiperlipidemia and older age. Methods: Ninety eight obese and 96 nonobese individuals without a comorbidity enrolled into the study. Serum ICAM-1 level was measured by enzyme linked immunoabsorbent assay (ELISA) method. ICAM-1 gene 1462A>G (K469E) polymorphism was examined by restriction fragment length polymorphism-polymerase chain reaction (RFLP-PCR). Nepholometric method was used to examine urinary albumin loss, and microalbuminuria was measured by albumin to creatinine ratio. Results: Obese individuals had significantly higher microalbuminuria and proteinuria level compared to nonobese subjects (p: 0.043 and p: 0.011; respectively). GG genotype of ICAM-1 carriers have significantly higher microalbuminuria compared to individuals with AA or AG genotype carriers (p: 0.042). Serum ICAM-1 level was significantly correlated with creatinine and microalbuminuria (p: 0.002 and p: 0.03; respectively). Logistic regression analysis indicated a 7.39 fold increased risk of microalbuminuria in individuals with GG genotype of ICAM-1 gene 1462A>G (K469E) polymorphism. Conclusions: GG genotype of ICAM-1 gene K469E polymorphism is associated with increased microalbuminuria in obese individuals without another metabolic risk factor (AU)

Introducción: Un conjunto de datos en aumento indica que los individuos obesos corren más riesgo de sufrir trastornos del parénquima renal si se los compara con sus homólogos no obesos. La oligoalbuminuria es un primer rasgo de afectación renal. Aunque la mayoría de los pacientes obesos presentan múltiples factores de riesgo de oligoalbuminuria, esta puede manifestarse en algunos individuos obesos sin factores de riesgo. El presente estudio se realizó para analizar el papel del polimorfismo 1462A>G (K469E) del gen ICAM-1 en la oligoalbuminuria de individuos obesos sin diabetes mellitus, hipertensión, hiperlipidemia ni vejez. Métodos: Para el estudio fueron reclutados 98 individuos obesos y 96 individuos no obesos sin comorbilidad. Se midió el nivel sérico de ICAM-1 mediante el ensayo de inmunoabsorción enzimática (ELISA). Se analizó el polimorfismo 1462A>G (K469E) del gen ICAM-1 por reacción en cadena de la polimerasay polimorfismo de longitud de los fragmentos de restricción (RFLP-PCR). El método nefolométrico se utilizó para analizar la pérdida urinaria de albúmina, y la oligoalbuminuria se midió con la tasa de albúmina/creatinina. Resultados: Los individuos obesos presentaron unos niveles de oligoalbuminuria y proteinuria considerablemente más elevados que los individuos no obesos (p: 0,043 y p: 0,011, respectivamente). La oligoalbuminuria en los portadores del genotipo GG de ICAM-1 fue bastante mayor que la de los portadores del genotipo AA o AG (p: 0,042). El nivel sérico de ICAM-1 se correlacionó notablemente con la creatinina y la oligoalbuminuria (p: 0,002 y p: 0,03, respectivamente). El análisis de regresión logística mostró un riesgo 7,39 veces mayor de oligoalbuminuria en los individuos con el genotipo GG del polimorfismo 1462A>G (K469E) del gen ICAM-1. Conclusiones: El genotipo GG del polimorfismo 1462A>G (K469E) del gen ICAM-1 se asocia con un aumento de la oligoalbuminuria en personas obesas sin otro factor de riesgo metabólico (AU)

Serum ICAM-1 level and ICAM-1 gene 1462A>G (K469E) polimorphism on microalbuminuria in nondiabetic, nonhypertensive and normolipidemic obese patients: Genetical background of microalbuminuria in obesity.

BACKGROUND: A growing body of evidence suggest that obese individuals are under risk of renal parenchymal disorders when compared to nonobese counterparts. Microalbuminuria is the early marker of renal involvement. Although most of obese patients carries multiple risk factors for microalbuminuria, some obese individuals without risk factor may progress to microalbuminuria. The present study was performed to examine the role of ICAM-1 gene 1462A>G (K469E) polymorphism on microalbuminuria in obese subjects without diabetes mellitus, hypertension, hiperlipidemia and older age. METHODS: Ninety eight obese and 96 nonobese individuals without a comorbidity enrolled into the study. Serum ICAM-1 level was measured by enzyme linked immunoabsorbent assay (ELISA) method. ICAM-1 gene 1462A>G (K469E) polymorphism was examined by restriction fragment length polymorphism-polymerase chain reaction (RFLP-PCR). Nepholometric method was used to examine urinary albumin loss, and microalbuminuria was measured by albumin to creatinine ratio. RESULTS: Obese individuals had significantly higher microalbuminuria and proteinuria level compared to nonobese subjects (p: 0.043 and p: 0.011; respectively). GG genotype of ICAM-1 carriers have significantly higher microalbuminuria compared to individuals with AA or AG genotype carriers (p: 0.042). Serum ICAM-1 level was significantly correlated with creatinine and microalbuminuria (p: 0.002 and p: 0.03; respectively). Logistic regression analysis indicated a 7.39 fold increased risk of microalbuminuria in individuals with GG genotype of ICAM-1 gene 1462A>G (K469E) polymorphism. CONCLUSIONS: GG genotype of ICAM-1 gene K469E polymorphism is associated with increased microalbuminuria in obese individuals without another metabolic risk factor.

Decreased Serum 25-hydroxyvitamin D Level Causes Interventricular Septal Hypertrophy in Patients on Peritoneal Dialysis: Cardiovascular Aspects of Endogenous Vitamin D Deficiency.

Introduction. In the present study, we aimed to analyze the relation of vitamin D with echocardiographic indexes in patients with end stage renal disease (ESRD) receiving renal replacement therapy (RRT). Methods. A total of 98 patients, 64 patients on hemodialysis (HD) (29F/35M, mean age 56.75 ± 18.63 years) and 34 age matched patients on peritoneal dialysis (PD) (21F/13M, mean age 58.11 ± 10.63 years), with similar duration of ESRD and RRT were enrolled into this cross-sectional study. Echocardiographic examination was performed after dialysis session at normovolemic status. Fasting blood samples were obtained before dialysis session. Results. Patients on PD and female patients in both groups had significantly lower level of 25-OH-D3 level when compared to patients on HD or male patients (p: 0.0001 and p: 0.0001). When all participants were considered, there was no significant association between 25-OH-D3 and echocardiographic parameters; however, in patients on PD, a significant negative correlation was determined between 25-OH-D3 and diastolic blood pressure, interventricular septal hypertrophy (ISH), and left ventricular mass index (LVMI) (r: -0.424, p: 0.012; r: -0.508, p: 0.004; r: 0.489, p: 0.04, resp.). Conclusion. Low serum 25-hydroxyvitamin D levels is associated with ISH and LVMI in PD patients.

The relation of anthropometric measurements and insulin resistance in patients with polycystic kidney disease.

OBJECTIVE: To examine the frequency of insulin resistance (IR) and its relation with anthropometric measurements in patients with autosomal dominant polycystic kidney disease (ADPKD). MATERIAL AND METHODS: Nonobese 82 patients with ADPKD and 58 age matched healthy controls were enrolled into the study. None of participants were diabetic or receiving renal replacement therapies (RRT). IR was determined by homeostasis model assessment of insulin resistance (HOMA-IR) formula. Tanita body composition analyzer was used for anthropometric measurements. Creatinine clearance of participant were assessed by the modification of diet in renal diseases (MDRD). RESULTS: Patients with ADPKD had significantly higher level of urea and creatinine, microalbuminuria, and lower level of MDRD. Body fat distribution and HOMA-IR in both the groups were similar. Systolic and diastolic blood pressure of patients were higher than those of controls. CONCLUSION: We failed to determine a higher frequency of IR among patients with ADPKD.

Relation of Complementary-Alternative Medicine use with glomerular filtration rate and depression in patients with chronic kidney disease at predialysis stage.

AIM: Complementary and alternative medicine is a broad field of health including all health care practices and methods, and their accompanying theories and beliefs. In the present study, we aimed to examine the frequency of complementary-alternative medicine use, and its relation with glomerular filtration rate and depression in patients with chronic kidney disease at predialysis stage. METHODS: A total of 1053 predialysis patients; 518 female and 535 male, that were followed up with chronic kidney disease for at least 3 months were enrolled into the study. Demographic features, biochemical parameters and findings of physical examination were recorded. Their compliance to diet, and knowledge about disease were questioned. Beck depression inventory and questionnaire regarding complementary-alternative medicine use were performed. RESULTS: The overall frequency of complementary-alternative medicine use was 40.3% . Total ratio of herbal products was 46%. Complementary-alternative medicine use was significantly more frequent in female or single patients, and patients that informed about chronic kidney disease or under strict diet (P = 0.007, P = 0.016, P = 0.02, P = 0.016, respectively). When glomerular filtration rate of participants were considered, complementary-alternative medicine use was similar in different stages of kidney disease. Depression was observed in 41.9% of patients and significantly frequent in patients with alternative method use (P = 0.002). Depression score was higher as creatinine increases and glomerular filtration rate decreases (P = 0.002; r = 0.093). CONCLUSION: We determined that complementary-alternative medicine use gradually increases at predialysis stage as glomerular filtration rate decreases and there is a strict relation between complementary-alternative medicine use and depression or female gender. Disorder related stressors may lead to seeking of alternative methods.

The effect of postural stabilization exercises on pain and function in females with patellofemoral pain syndrome.

OBJECTIVE: This study aimed to investigate the effect of postural stabilization exercises on pain, muscle strength and function in females with patellofemoral pain. METHODS: Forty-two volunteers with patellofemoral pain syndrome (PFPS) were included in this study. The subjects were randomly divided into two groups: Group 1 performed therapeutic knee and postural stabilization exercises (n=22); Group 2 performed therapeutic knee exercises only (n=20). All patients were evaluated for pain, hamstring flexibility, function, lower extremity strength and postural control before and after treatment and at the 12th week. A two-way ANOVA was done within each group before and after treatment and at the 12th week. The level of significance was set at p<0.05, and when this was observed, the Tukey test was used to determine which group had caused the significance. RESULTS: The results were statistically significant between the groups in terms of pain, flexibility, function, strength, endurance, postural control and the parameters of the Kujala patellofemoral pain scale (p<0.05). For all parameters, Group 1 achieved the greater success after treatment (p<0.05). CONCLUSION: The implementation of physiotherapy and rehabilitation programs including postural stabilization exercises may improve strength and function and reduce pain in patients with PFPS.

The relation of mean platelet volume with microalbuminuria and glomerular filtration rate in obese individuals without other metabolic risk factors: the role of platelets on renal functions.

INTRODUCTION: Mean platelet volume (MPV) is an indirect indicator of platelet activity that plays a major role in the pathogenesis of endothelial injury. Obese individuals have higher microalbuminuria which is the initial step of renal endothelial injury. We aimed to analyze the relation of microalbuminuria and MPV in obese individuals without metabolic risk factors. METHODS: A total of 290 obese individuals (body mass index (BMI)>30 kg/m2) without an accompanying chronic disorder, and 204 nonobese healthy subjects were enrolled into the study. All participants underwent physical examination. Biochemical, hemogram, and hormonal parameters along with urine albumin analysis were performed. Glomerular filtration rate (GFR) was measured by Cockcroft-Gault (GFRC&G), modification of diet in renal disease (MDRD). The BMI was calculated as weight/height2 (kg/m2). Logistic regression analysis was used to analyze relation of variables. RESULTS: The patient group consisted of 171 (59%) female (mean age: 37.15±8.05 years) and 119 (41%) male (mean age 38.98±10.68 years) obese individuals. 130 (63.7%) age matched female (mean age 36.18±8.26 years) and 74 (36.3%) age matched male (mean age 36.49±10.25 years) controls were assigned to the control group. There was a significant difference between groups with regard to BMI, spot microalbuminuria, spot urine microalbuminuria/creatinine ratio but not with to MPV and spot urine creatinine (p: 0.01, 0.004, 0.002; respectively). GFR measured by MDRD and Cockcroft-Gault formula were significantly higher in the obese group (p<0.001 for both). Correlation analysis revealed a significant correlation between BMI and spot urine microalbuminuria, spot urine microalbuminuria/creatinine ratio, GFR (Cockcroft-Gault Formula), Homeostasis Model Assessment of Insulin resistance (HOMA-IR), insulin, C-peptide, diastolic blood pressure, glucose, uric acid, total cholesterol, low density lipoprotein (LDL)-cholesterol, c-reactive protein (CRP), thyroid stimulating hormone (TSH), leukocyte count, platelet count. MPV was inversely and significantly correlated with spot urine creatinine, systolic blood pressure, triglyceride, C-peptide, and platelet count. Mean urea, creatinine, uric acid, triglyceride, total cholesterol, LDL-cholesterol, insulin, C-peptide, HOMA-IR were significantly higher in obese male individuals while obese female individuals had higher levels of mean high density lipoprotein (HDL), CRP, TSH, platelet count, spot urine microalbumin/creatinine rate, and GFR measured by MDRD. CONCLUSIONS: Obese individuals have higher microalbuminuria and nonsignificantly elevated MPV, however, urine albumin loss is independent of MPV.

Is hemodialysis a reason for unresponsiveness to hepatitis B vaccine? Hepatitis B virus and dialysis therapy.

Impaired renal function is associated with a high risk of chronicity of hepatitis B virus (HBV) infection. Patients on hemodialysis (HD) or peritoneal dialysis are at an increased risk of viral transmission due to frequent necessity of blood product transfer as well as use of contaminated dialysate or dialysis materials. Additionally, health professionals may cause viral spread via contaminated hands and carelessness against hygiene rules. The frequency of chronic HBV infection may be as high as 80% in patients on renal replacement therapies. This is because HBV vaccination is essential to eliminate chronic HBV infection. However, response rates of HD patients to HBV vaccination vary between 10%-50%. Dialysis adequacy and early vaccination before the onset of dialysis therapy seem to be major determinants of high seroconversion rates. Older age, male gender, duration of dialysis therapy and nutritional status are other well-known factors associated with seroconversion rate. There are controversial reports regarding the role of the presence of diabetes mellitus, HCV positivity, erythropoietin resistance, hyperparathyroidism, and vitamin D inadequacy. The role of genetic alteration in the functions or production of cytokines still needs to be elucidated.

Association of endothelial nitric oxide synthase gene G894T polymorphism and serum nitric oxide levels in patients with preeclampsia and gestational hypertension.

OBJECTIVE: Pregnancy-induced hypertension is one of the most important cause of maternal-fetal morbidity and mortality. Pregnancy-related hypertensive disorders are usually associated with diminished nitric oxide (NO) levels. We aimed to evaluate the role of serum NO levels and eNOS gene G894T polymorphism on hypertensive disorders of pregnancy. METHODS: Eighty patients with gestational hypertension or preeclampsia, and 80 healthy pregnants were enrolled to analyze serum NO levels and G894T polymorphism of the eNOS gene. NO level was analyzed by high-performance liquid chromatography (HPLC) method. The G894T polymorphism of the eNOS gene was determined by polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP). RESULTS: There was no significant difference between groups in terms of G894T/eNOS genotype and allele frequencies (p > 0.05). Serum NO levels were significantly lower in the patients group. In the control group, subjects with thymine-thymine (TT) genotype had significantly lower NO levels when compared to subjects with guanine-guanine (GG) or guanine-thymine (GT) genotype (p < 0.05). CONCLUSIONS: We failed to demonstrate an association between eNOS gene G894T polymorphism and serum NO levels in patients with pregnancy-induced hypertensive disorders. We established a relation between pregnancy-induced hypertension and low NO levels.

Evaluation of relationship between sexual functions, depression and quality of life in patients with chronic kidney disease at predialysis stage.

AIM: The relation of chronic kidney disease (CKD) with metabolic, psychiatric and endocrinologic disorder is well-known. Depressive mood and sexual dysfunction are frequently observed as renal functions deteriorate. We aimed to analyze the relationship of sexual dysfunction, depressive mood and life quality in patients with CKD at predialysis stage. PATIENTS AND METHODS: Fifty-three patients; 27 female and 26 male with CKD who had estimated glomerular filtration rate (eGFR) between 15 and 90 mL/min and followed up in the Nephrology Department, Bursa Sevket Yilmaz Education and Research Hospital, were enrolled. Age- and sex-matched 20 female and 20 male healthy control subjects were assigned to the control group. Detailed medical and sexual history was obtained by using Female Sexual Function Index (FSFI), Erectile Function International Evaluation Form (IEFF), Short form (SF) 36 Form and Beck Depression Questionnaire (BDI). Biochemical and hormonal parameters including urea, creatinine, uric acid, sedimentation rate, c-reactive protein, total testosterone, DHEA-S, FSH, LH, TSH, estradiol and prolactin were analyzed. FINDINGS: Depression was observed in 12 male (46%) and 14 female (51%) patients. The frequency of depression among male patients and control subjects was similar, however, significantly higher in female patients than female controls (p=0.036). Physical function score, physical role score and pain score in SF 36 of entire patients were significantly lower than controls (p=0.0001, 0.0001, 0.001, respectively). The frequency of depression was similar between patients and controls (p>0.05). When SF 36 tests of male and female patients were compared, general health status, vitality and mental health status were significantly better in male patients (p=0.005, 0.016, 0.035, respectively). SF 36 scores of female patients were significantly lower than female controls (p=0.0001). The frequency of erectile dysfunction (ED) was similar between male patients (84%) and controls (75%) (p=0.62). On the other hand, sexual dysfunction was significantly higher in female patients when compared to female controls (92% vs. 30%; p=0.0001). CONCLUSION: We showed that sexual dysfunction and depression are more frequent among female patients with CKD at predialysis stage; however, it does not have significant impact on life quality. When life quality of female and male patients was compared, general health status, vitality and mental health status of female patients were poorer. We failed to demonstrate a relationship between sexual dysfunction and sex hormone level.

Surgical treatment of Achilles tendon ruptures: the comparison of open and percutaneous methods in a rabbit model.

BACKGROUND: This study was intended to investigate the healing properties of open and percutaneous techniques in a rabbit model and compare histological, electron microscopical, and biomechanical findings of the healed tendon between the groups. METHODS: Twenty-six rabbits were randomly assigned to two groups of thirteen rabbits each. Percutaneous tenotomy of the Achilles tendon (AT) was applied through a stab incision on the right side 1.5 cm above the calcaneal insertion in all animals. Using the same Bunnell suture, the first group was repaired with the open and the second group was repaired with the percutaneous method. ATs were harvested at the end of eight weeks for biomechanical and histological evaluation. RESULTS: When the sections were evaluated for fibrillar density under electron microscopy, it was noted that fibrils were more abundant in the percutaneous repair group. The tendon scores in the percutaneous group were less than the open group indicating closer histological morphology to normal. The difference was not significant (p=0.065). The mean force to rupture the tendon was 143.7± 9.5 N in percutaneous group and 139.2±8.2 N in the open group. The difference was not significant (p=0.33). CONCLUSION: Percutaneous techniques provide as good clinical results as the open techniques do. The healing tendon shows better findings in histological and electron microscopical level with percutaneous technique.

The clinical and sonographic effects of kinesiotaping and exercise in comparison with manual therapy and exercise for patients with subacromial impingement syndrome: a preliminary trial.

OBJECTIVE: The purpose of this study was to compare the effects of manual therapy with exercise to kinesiotaping with exercise for patients with subacromial impingement syndrome. METHODS: Randomized clinical before and after trial was used. Fifty-four patients diagnosed as having subacromial impingement syndrome who were referred for outpatient treatment were included. Eligible patients (between 30 and 60 years old, with unilateral shoulder pain) were randomly allocated to 2 study groups: kinesiotaping with exercise (n = 28) or manual therapy with exercise (n = 26). In addition, patients were advised to use cold packs 5 times per day to control for pain. Visual analog scale for pain, Disability of Arm and Shoulder Questionnaire for function, and diagnostic ultrasound assessment for supraspinatus tendon thickness were used as main outcome measures. Assessments were applied at the baseline and after completing 6 weeks of related interventions. RESULTS: At the baseline, there was no difference between the 2 group characteristics (P > .05). There were significant differences in both groups before and after treatment in terms of pain decrease and improvement of Disability of Arm and Shoulder Questionnaire scores (P < .05). No difference was observed on ultrasound for tendon thickness after treatment in both groups (P > .05). The only difference between the groups was at night pain, resulting in favor of the kinesiotaping with exercise group (P < .05). CONCLUSION: For the group of subjects studied, no differences were found between kinesiotaping with exercise and manual therapy with exercise. Both treatments may have similar results in reducing pain and disability in subacromial impingement in 6 weeks.

Lack of Association between PTPN22 Gene +1858 C>T Polymorphism and Susceptibility to Generalized Vitiligo in a Turkish Population.

BACKGROUND: Vitiligo is an autoimmune polygenic disorder characterized by loss of pigmentation due to melanocyte destruction. The PTPN22 gene +1858 C>T single nucleotide polymorphism (rs2476601) has been shown to be associated with various autoimmune disorders. OBJECTIVE: The aim of this study was to investigate whether the PTPN22 gene +1858 C>T single nucleotide polymorphism is associated with susceptibility to generalized vitiligo in a Turkish population. METHODS: One hundred and seven patients with generalized vitiligo, and one hundred and twelve gender-, age-, and ethnic-matched controls were enrolled in the study. Genotyping was done by polymerase chain reaction-restriction fragment length polymorphism. RESULTS: The PTPN22 +1858 C>T genotype and allele frequencies of the generalized vitiligo patients did not differ significantly from those of healthy controls. CONCLUSION: We found no association between the PTPN22 +1858 C>T gene polymorphism and vitiligo susceptibility in Turkish generalized-vitiligo patients.

The association of endothelial nitric oxide synthase gene G894T polymorphism and serum nitric oxide concentration with microalbuminuria in patients with gestational diabetes.

AIM: Gestational diabetes mellitus (GDM) is a glucose intolerant condition that affects 14% of all pregnancies. Diabetes mellitus (DM) occurs in 30 - 70% of patients with GDM after delivery. DM and GDM are associated with structural and functional deterioration of the renovascular system. Our aim is to investigate the association Glu- 298Asp polymorphism of the endothelial nitric oxide synthase (eNOS) gene with serum nitric oxide levels and microalbuminuria in patients with GDM and healthy pregnancies. MATERIAL AND METHODS: Serum nitric oxide (NO) levels, urinary excretion of albumin and Glu298Asp polymorphism of the eNOS gene were analyzed in 68 patients with GDM and 73 healthy controls. High performance liquid chromatography (HPLC-Griess) method was used to analyze serum NO levels. Microalbuminuria was evaluated by rate nephelometry method. The Glu298Asp polymorphism of the eNOS gene was determined by polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP). RESULTS: Nitric oxide, glucose, creatinine, and microalbuminuria were significantly different between the patients and the control subjects (p = 0.001, p = 0.001, p = 0.002, and p = 0.005, respectively). There was a significant difference between groups in terms of the ratio of GG/GT+TT of eNOS gene Glu- 298Asp (p = 0.02). The patients with GT+TT genotype had significantly higher microalbuminuria levels and lower NO concentrations (22.16 vs. 9.51, p = 0.005, and 10.56 vs. 12.73, p = 0.021, respectively). The presence of T allele of eNOS gene is an independent predictor of microalbuminuria (OR: 2.346, 95% confidence interval: 1.247 - 5.238, p = 0.02) as well as serum glucose and NO concentration. CONCLUSION: The G894T polymorphism of eNOS gene and decreased NO concentration seem to be independent predictors of increased urinary excretion of albumin in patients with GDM. Determining the frequency of eNOS gene G894T polymorphism may help to identify pregnancies at increased risk of microalbuminuria.

Can standing knee radiographs predict chondral lesions in young- and middle-aged population?

PURPOSE: The aim of the study is to investigate the correlation between arthroscopic findings and joint space width on the standing knee radiographs at various flexion degrees in the young- and middle-aged patients with complaints of knee pain. METHODS: Middle-aged patients with complaint of knee pain ongoing more than 6 months and failure in conservative treatment methods were included. Weight-bearing full extension, 30 and 45° of flexion radiographs were obtained. Joint space width was calculated on radiograms. Arthroscopy was performed to evaluate the chondral pathologies. Correlation analysis was performed. RESULTS: Fourty-three patients (18 female, 25 male) with a mean age of 44.6 (20-63) were included. Mean joint space width was 4.87 mm ± 1.45 (2-10) mm in medial and 5.43 mm ± 1.47 (1-9) in lateral on standing extension radiographs. In 30° flexion radiographs, mean joint space width was 4.33 mm ± 1.25 (1.5-7.5) in medial and 5.36 mm ± 1.69 (1-9) in lateral. In 45° flexion radiographs, medial joint space was 4.28 mm ± 1.59 (2-9) in medial and 5.15 mm ± 1.59 (1.5-9) in lateral. In arthroscopic evaluation, one knee had grade 1 (2.3%), three knees had grade 2 (7%), nine knees had grade 3 (20.9%), and twelve knees had grade 4 (27.9%) lesions in the medial compartment. In the lateral compartment, two knees had grade 3 (4.7%) and one knee had grade 4 lesion (2.3%). Radiological data did not correlate with the arthroscopic findings. CONCLUSION: Standing knee radiographs do not correlate with the arthroscopic findings in the middle-aged population with chondral lesions in knee joint. LEVEL OF EVIDENCE: Case series with no comparison group, Level IV.

An unusual case of cavernous hemangioma of the rib in a young man with lung tuberculosis: a brief review and case report.

Hemangiomas are benign vascular tumors that usually involve the liver, skin, eyes and central nervous system. Hemangioma of the bone is unusual and is generally observed in the vertebrae or skull while hemangioma of the costae is extremely rare. Hemangioma of the rib and chest wall tuberculosis may be misdiagnosed as chest wall tumors. We herein report a case of hemangioma of the rib with a tuberculosis infection of the pleura.

Predictive role of acute phase reactants in the response to therapy in patients with chronic hepatitis C virus infection.

BACKGROUND/AIMS: Biochemical parameters and acute-phase proteins (APPs) may provide complementary data in patients with chronic hepatitis C (CHC). We aimed to evaluate the predictive role of APPs in the response to antiviral therapy. METHODS: Forty-five patients underwent antiviral therapy. Serum ferritin, C-reactive protein (CRP), transferrin, albumin, alpha-1 acid glycoprotein (A1AG), and alpha-2 macroglobulin (A2MG) levels were examined at the initial evaluation and at the 4th, 12th, and 48th weeks. HCV RNA levels were examined at the initial evaluation and at the 12th and 48th weeks. RESULTS: Ferritin, transferrin, A1AG, and A2MG levels were significantly higher in the patient group (p<0.05). CRP, ferritin, A1AG, and A2MG levels were significantly increased from baseline to the 4th week (p<0.05). The responders and nonresponders to antiviral therapy had insignificantly but remarkably different levels of CRP, ferritin, transferrin, A1AG, A2MG, and alanine aminotransferase (ALT) both at the initial evaluation and at the 12th week. CONCLUSIONS: Variations in ferritin, A1AG, A2MG, albumin, CRP, and transferrin levels are not alternatives to virological and biochemical parameters for predicting an early response to therapy in patients with CHC. However, the investigation of ALT levels and hepatitis C virus RNA in combination with acute-phase reactants may provide supplementary data for evaluating responses to antiviral therapy.