Comparison of the effect of prolotherapy and paraffin wax for hand osteoarthritis.

OBJECTIVE: Hand osteoarthritis (OA) is associated with considerable disability, especially in the elderly patient population. Paraffin wax (PW) and prolotherapy (P) are non-pharmacological treatment methods used in this setting. This study aimed to compare the therapeutic efficacy of P and PW in hand osteoarthritis. PATIENTS AND METHODS: This study was designed as a single-center, randomized-controlled trial conducted at our Physical Medicine and Rehabilitation Clinic between February 2019 and July 2020. Patients with bilateral hand OA were divided into PW and P treatment groups. The PW group was treated 5 days per week for 2 weeks. The P group received an injection of dextrose solution into the ligaments of painful joints once weekly for three weeks. Visual analog scale (VAS), Duruoz Hand Index (DHI) scale, hand dynamometer for grip strength, and pinch meter for lateral pinch were used for baseline and post-treatment follow-up assessments. RESULTS: Overall, 42 patients were included. The VAS scores significantly decreased in both PW and P groups (p=0.024 and p=0.014). Baseline and third-month post-treatment VAS scores did not significantly differ (p=0.581). The DHI scores improved significantly in both groups (p<0.001 and p<0.001), being higher in the P than in the PW group (p=0.042). Right- and left-hand grip strength increased significantly in PW and P groups (p<0.001, p=0.001; p=0.013, p=0.002, respectively). CONCLUSIONS: Both treatment methods were effective regarding pain and grip strength; however, P improved the hand functions more significantly.

Gunshot bullet embolisation in the middle cerebral artery.

Bullet embolism (BE) is a rare phenomenon following a gunshot wound. A middle cerebral artery BE was detected in a 36-year-old male patient following a perforating left thoracic gunshot wound without obvious cranial injury. This paper discusses a case of BE in the cranial circulation in conjunction with a review of the relevant literature.

Yearly changes of insecticide susceptibility and possible insecticide resistance mechanisms of Anopheles maculipennis Meigen (Diptera: Culicidae) in Turkey.

To evaluate the adulticide susceptibility and yearly changes of Anopheles maculipennis Meigen (Diptera: Culicidae) in Thrace, five mosquito populations were evaluated against the resistance status of four different adulticides. Three biochemical resistance mechanisms and yearly changes of activities were investigated. All the strains were highly resistant to DDT, and all the strains were placed in the resistance surveillance category for malathion, permethrin and deltamethrin in 2007. Although DDT mortality rates had increased from 2007 to 2008 except in the Seremkoy strain, malathion, permethrin and deltamethrin mortality rates have decreased in all of the tested strains. High rates of increase were determined for nonspecific esterases (NSEs) activity by using the substrate p-NPA and these results showed correlation with malathion mortality rates. All the strains showed high level of glutathione S transferases (GSTs), and their activity level had significantly increased from 2007 to 2008. Different insecticide susceptibility statuses were observed between localities, and high DDT resistance was observed although DDT was banned in the 1980s. Biochemical assay results suggest that NSEs and GSTs could play a role insecticide resistance in all tested strains. Malathion susceptibility has decreased in all the tested strains and NSE's activity is possibly the main enzymatic mechanism related to the insecticide resistance. DDT resistance is at a high degree in all the strains and GST's activity is probably related to this situation. GST's activity could play an important role for permethrin and deltamethrin susceptibility but needs to be confirmed for molecular studies. Our results provide important data on insecticide susceptibility and change over time for the Anopheles maculipennis populations in Turkey.

Musca domestica L D.

Field strains of the house fly (Musca domestica L. Diptera: Muscidae) were collected in April and September 2002 from cow farms (Antalya, Izmir) and garbage dumps (Adana, Ankara, Istanbul, Sanliurfa) in Turkey. The resistance levels of first to fifth generation offspring were evaluated against six insecticides (cypermethrin, cyphenothrin, deltamethrin, permethrin, resmethrin, fenitrothion). Resistance levels for pyrethroid group insecticides ranged from 23.27 (permethrin-Istanbul fall strain) to 633.09 (cypermethrin-Izmir spring strain) and for fenitrothion ranged from 5.78 (Istanbul fall strain) to 51.04 (Antalya spring strain). Our results showed that pyrethroid resistance was high and changed from spring to fall in relation to usage and application frequencies of these compounds at the study sites. Although fenitrothion resistance levels were determined to be lower than pyrethroids, these levels were still high and led to control failure. Flies from cow farms were more resistant than those from garbage dumps, but resistance levels for Sanliurfa and Adana strains were also high in relation to usage of different insecticides for agricultural purposes. Although resistance levels against different pyrethroids decreased from spring to fall, these levels still indicated the presence of a strong selective pressure on the populations.

Effects of vesicular-arbuscular mycorrhizal (VAM) fungi on the seedling growth of three Pistacia species.

The experiment was undertaken to test the efficiency of inoculation of vesicular-arbuscular mycorrhizal (VAM) fungi on the seedling growth of three Pistacia species used as rootstocks. The stratified Pistacia seeds were inoculated with VAM fungi. The highest rate of inoculated roots was 96.7% in P. khinjuck seedlings with G. clarum and G. etunicatum, 83.3% in P. vera seedlings with G. caledonium and 73.3% in P. terebinthus seedlings with G. caledonium. Mycorrhizal inoculations improved seedling height only in P. terebinthus. Certain mycorrhizal inoculations increased the leaf N, but not P and K contents. Seedlings inoculated with G. caledonium had higher reducing sugar contents. It was concluded that pre-inoculated Pistacia seedlings could have a better growth in the harsh field conditions.

The status and seasonal changes of organophosphate and pyrethroid resistance in Turkish populations of the house fly, Musca domestica L. (Diptera: Muscidae).

Field strains of the house fly (Musca domestica L. Diptera: Muscidae) were collected in April and September 2002 from cow farms (Antalya, Izmir) and garbage dumps (Adana, Ankara, Istanbul, Sanliurfa) in Turkey. The resistance levels of first to fifth generation offspring were evaluated against six insecticides (cypermethrin, cyphenothrin, deltamethrin, permethrin, resmethrin, fenitrothion). Resistance levels for pyrethroid group insecticides ranged from 23.27 (permethrin-Istanbul fall strain) to 633.09 (cypermethrin-Izmir spring strain) and for fenitrothion ranged from 5.78 (Istanbul fall strain) to 51.04 (Antalya spring strain). Our results showed that pyrethroid resistance was high and changed from spring to fall in relation to usage and application frequencies of these compounds at the study sites. Although fenitrothion resistance levels were determined to be lower than pyrethroids, these levels were still high and led to control failure. Flies from cow farms were more resistant than those from garbage dumps, but resistance levels for Sanliurfa and Adana strains were also high in relation to usage of different insecticides for agricultural purposes. Although resistance levels against different pyrethroids decreased from spring to fall, these levels still indicated the presence of a strong selective pressure on the populations.

The influence of growth regulators on shoot proliferation and rooting of in vitro propagated caper.

The objectives of this study were to examine the effect of TDZ and BAP on shoot proliferation and to develop a satisfactory rooting procedure for in vitro propagation of caper (Capparis spinosa L). TDZ was found to be more effective than BAP in shoot production. The highest shoot number per explant (45.7) was achieved on the media that contained 4.54 microM TDZ in the absence of IAA. TDZ at 4.54 microM alone or in combination with 0.57 microM IAA did not inhibit shoot elongation, although they produced the most shoots. Dipping the caper shoots in the solution of IBA at 24.6 microM for 10 minutes before planting on MS media, improved the rooting percentage up to 80.5% under a 16 hr photoperiod.

Microsurgical anatomy of the dorsal cervical rootlets and dorsal root entry zones.

BACKGROUND: Detailed anatomical knowledge of the dorsal cervical rootlets and dorsal root entry zones (DREZ) is important for the diagnosis and treatment of cervical myeloradiculopathy and surgical management of pain. There are far fewer micro-anatomical studies of this area than gross anatomical studies. This study presents several anatomical points regarding the dorsal cervical rootlets and dorsal root entry zones. METHOD: Fifteen adult formalin-fixed cadaveric spines from C1 to T1 were used to observe the posterior structures. They were studied under the surgical microscope following en bloc laminectomy and foraminotomy. The morphological features of the dorsal root entry zones and dorsal rootlets were determined. The distance from the midline to the DREZ, the longitudinal length of the DREZ in the spinal canal, the length of the dorsal rootlets, the number of dorsal rootlets and the intersegmental anastomoses between the dorsal rootlets were measured. FINDINGS: The distance from the midline to the DREZ ranged from 1.1 to 4.7 mm. Longitudinal length of the dorsal rootlets ranged 4.3-17.7 mm. The shortest length of the dorsal rootlets ranged between 5-28 mm, and longest lengths of the dorsal rootlets ranged 6.8-30.3 mm. The number of dorsal rootlets ranged from 2-13. Between the C2-T1 dorsal rootlets, 142 connections out of 30 intersegments were noted. CONCLUSIONS: The distance from the midline to the DREZ decreased in the lower cervical spine. The longest longitudinal length of the DREZ was at the C5 level. The length of the dorsal rootlets was increased in the lower cervical spine. The average number of dorsal rootlets tended to increase in the lower cervical spine. Anastomoses were most often found between C6-7 and C5-6 dorsal rootlets. Knowledge of the anatomical features of dorsal cervical rootlets and dorsal root entry zones is essential for a surgeon to avoid injuring the neural structures. This knowledge is a must not only to avoid complications but also for the success, safety and effectiveness of microsurgical operations of the pathological conditions like posterior myeloradiculopathy and pain treatment such as DREZ operations.

Prediction of renal allograft function with early Doppler ultrasonography.

INTRODUCTION: Doppler ultrasonography (USG) is an useful, noninvasive diagnostic tool for the management and follow-up of the transplanted kidney. However, it is believed that the value of Doppler USG is limited to discrimination of acute rejection episodes. We tested whether early Doppler USG findings were predictive of 1-month and 1-year allograft functions in noncomplicated renal transplant recipients (RTRs). PATIENTS AND METHODS: Resistive index (RI) and pulsatile index (PI) values obtained by doppler USG within the first week of transplantation were correlated with allograft function at 1 month and 1 year in 45 (10 women, 35 men, mean age: 27 years) noncomplicated cases. Patients with complications during the first posttransplant year were not included. RESULTS: There was a negative correlation between both RI and PI with creatinine clearance values at 1 month and at 1 year posttransplant. There was a significant decline in allograft function among cases with either RI > or = 0.7 or PI > or = 1.1. Patients with impaired allograft function have higher RI and PI values. CONCLUSION: Renal allograft survival is influenced by many factors. However, no reliable simple parameter has been identified to predict long-term outcome. Doppler USG performed during the early transplantation period with calculation of RI and PI may have a predictive value to forecast early and long-term outcomes of noncomplicated kidney transplants.

Septic arthritis caused by Nocardia asteroides in a renal transplant recipient.

Although articular complications are common following renal transplantation, septic arthritis is not frequent. Previous bacterial infection in an another site is a consistent finding and the knee is the most often affected joint. We present a 30-year-old female renal transplant recipient with recurrent pulmonary infiltrates preceding septic arthritis of her left knee. Cultures of the aspirated synovial fluid yielded a gram-positive, rod-shaped bacterium later identified as Nocardia asteroides. The patient was treated with oral trimethoprim-sulfamethoxazole without any side effect. Nocardia is a rare but serious cause of infection in renal transplant recipients but there is no well-known predisposing factor. Recently mycophenolate mofetil has been implicated as a factor associated with Nocardia infections. Prolonged courses of treatment with sulphonamides are recommended.

Selective microsurgical vestibular neurectomy: an option in the treatment of intractable vertigo and related microsurgical landmarks.

Selective microsurgical vestibular neurectomy (SMVN) is an accepted and effective means of treating patients with intractable vertigo, a resistant component of Meniere's syndrome. Meniere's syndrome is a condition characterized by fluctuating hearing loss, tinnitus and serious vertigo attacks. Vertigo is the most disabling symptom of the disease. There may be permanent hearing loss in untreated cases and vertigo may continue after deafness. Selective microsurgical vestibular neurectomy is an elite surgical procedure providing exact relief from vertigo while protecting the preoperative hearing level. In this report, clinical results of nine patients with intractable vertigo operated in the University of Ankara Medical Faculty, Department of Neurosurgery between 1999 and 2001 are discussed. Accordingly, we aimed to represent the landmarks often required for microsurgical exposure. From this study we conclude that SMVN is an effective neurosurgical procedure for those patients who are resistant for medical treatment and require hearing preservation.

Comparison of nocturnal activities of mosquitoes (Diptera: Culicidae) sampled by New Jersey light traps and CO2 traps in Belek, Turkey.

Temporal and seasonal variations in the nocturnal activities of adult females of six locally common mosquitoes, Aedes cretinus, Ochlerotatus caspius, Oc. dorsalis, Culex pipiens, Cx. tritaeniorhynchus and Culiseta annulata were studied at Belek, Turkey, using New Jersey light traps and CO2 charged olfactory traps. In addition to assessing the relative value of these traps as sampling devices capable of measuring activity at different periods of the night, these studies also examined the seasonal contribution of each species to the phenology of the overall mosquito population. While statistical results showed that differences in activation time preferences were found to be not significant for each species, the nocturnal activity profiles of Cx. tritaeniorhynchus, Ae. cretinus and Oc. caspius were definitely differed from those of other species. Ae. cretinus was a common species with a rate of 26.1% at 18:00-20:00, whereas the adult rate of Cx. tritaeniorhynchus was determined to be the lowest (11.4%) at that time interval. Significant differences were found at the time intervals 18:00-20:00, 22:00-24:00 and 02:00-04:00 in the general bias of mosquito populations among different months. While the nocturnal patterns of Cx. tritaeniorhynchus and Ae. cretinus were found to be bimodal, it was monomodal for Oc. caspius and Cu. annulata, unimodal for Cx. pipiens and Ae. dorsalis. While 69.6% of females captured by traps throughout the study period were found to be unfed, 24.8% were fed, 4.1% were half-gravid and 1.4% were gravid. Statistical results of trap preferences of Aedes species were found to be significant (P < 0.05). Oc. caspius and Ae. dorsalis preferred New Jersey light traps to CO2 traps. Light trap and CO2 trap collections can be influenced by design features including the amount of contrast between the light sources and surroundings. These features were found to be highly significant factors for the biting activity Cx. pipiens and Cx. tritaeniorhynchus.

Evaluation of protective efficacy of K-OTAB impregnated bednets for cutaneous leishmaniasis control in Southeast Anatolia-Turkey.

Large-scale field trials were performed in an endemic focus of cutaneous leishmaniasis in both urban and rural settlements of Sanliurfa City, SE Anatolia, Turkey, to evaluate the efficacy of insecticide impregnated bednets. An intervention field trial promoting the use of K-OTAB (deltamethrin-tablet formulation) impregnated bednets by the local inhabitants of five quarters for cutaneous leishmaniasis was performed between July 2000 and July 2001. The aim was to examine the monthly and annual efficacy of such bednets in controlling cutaneous leishmaniasis and to compare effect of impregnated bednets (IB) with non-impregnated bednets (NIB). Results showed significant (P < 0.05) reduction in cutaneous leishmaniasis incidence in the intervention areas from 1.87 % to 0.035% in Yenice and from 2.3% to 1.32% in Suruç B. In contrast, cutaneous leishmaniasis incidence increased in the untreated control areas from 1.03% to 1.38% in Suruç A. The annual incidence of the second control area for cutaneous leishmaniasis experiments showed almost no change at all(1.1% in July 2000; 1.02% in July 2001). Similar to results of control areas, cutaneous leishmaniasis incidence rates showed an increase despite the bednets in the Suruç C (1.22% to 1.47%) where NIBs were distributed.

Effect of insecticide-treated bednets for malaria control in Southeast Anatolia-Turkey.

Deltamethrin is one of the most effective insecticides for vector control, already widely used for bednet impregnation to control malaria. To evaluate the efficacy of deltamethrin-impregnated bednets in malaria control and in reducing the biting nuisance caused by Anopheles sacharovi, field trials were carried out in an endemic area of malaria in the surrounding rural settlements of Sanliurfa City, SE Anatolia, Turkey. Preliminary studies commenced in August 1999 with pre-intervention house-to-house surveys to identify villages outside of Sanliurfa City with high malaria incidence, to collect socio-economic, epidemiological and entomological data, and to determine physical properties of the study areas. An intervention field trial promoting the use of K-OTAB (deltamethrin-tablet formulation) impregnated bednets by local inhabitants of four villages was performed between July 2000 and July 2001. Its aim was to examine the monthly and annual efficacy of such bednets in controlling malaria and to compare the effect of impregnated bednets (IB) with non-impregnated bednets (NIB). The experimental design consisted of four villages. Gedik was selected as the intervention area using IBs, Orgulu served as the control area, and in Persiverek and Sandi NIBs were implemented. All 1,406 inhabitants of the 146 households were recruited for the study. Results showed significant (P < 0.05) reduction in malaria incidence in Gedik from 8.29% in the pre-treatment year to 1.57% in the post-treatment year. In contrast, malaria incidence slightly increased in Orgulu from 6.55% to 7.58%. Similar results were obtained from the other two villages where NIBs were used; malaria incidence rates increased from 2.16% to 6.77% (Persiverek) and from 1.9% to 9.8% (Sandi). Entomological surveys, employing different techniques, were carried out randomly at selected collection sites within the intervention and control settlements every month from June 2000 to June 2001 to determine the fluctuation of seasonal population sizes and compare the monthly density of malaria vectors between intervention and control areas.

Infection-related atlantoaxial subluxation in two adults: Grisel syndrome or not?

Grisel's syndrome involves the subluxation of the atlanto-axial joint from inflammatory ligamantous laxity following an infectious process in the head or neck. It is a rare disease usually affecting children, but infrequent adult cases do occur. Today, due to the widened use of antibiotics and availability of MR imaging, some cases presenting with neck pain, resulting from the infectious inflammation of C1 and C2 but without pronounced subluxation, can be a challenging problem for most neurosurgeons. Several theories have been proposed to explain the pathogenesis of inflammatory subluxation. The primary treatment of Grisel's syndrome is medical. The underlying infectious organism must be isolated and appropriate antibiotics must be prescribed. The subluxation is reduced in holter or skeletal traction. This paper reports two cases of infection-related atlanto-axial subluxation in two adults. The literature on this subject is briefly reviewed.

Effects of farmyard manure and chemical fertilizers on the nutritional status of the loquat trees.

The nutritional status of the loquat trees was investigated using cattle manure and commercial fertilizers for three years. The farmyard manure increased N, P, K, Mg, Fe and Zn contents of the leaves. No significant difference was found between the fertilizer types for trunk growth. Yield efficiency was nearly doubled by application of farmyard manure. Fertilizers did not affect the weight and shape of the fruits; however, commercial fertilizers led the lower total acidity in fruits. It was concluded that the loquat trees grown in sandy soils could fulfill their principal nutrient requirements for growth and commercial yield with application of farmyard manure.

Pure red cell aplasia preceding malignant lymphoma in a renal transplant patient.

Malignant disorders are one of the major causes of morbidity and mortality in transplant patients. We present herein a renal transplant recipient with malignant lymphoma which preceded by pure red cell aplasia (PRCA). Acquired PRCA is a rare hematologic disorder in renal transplant recipients. It has been associated with a variety of disorders of immunologic dysfunction and neoplasms, exposure to drugs and toxins, infectious diseases, pregnancy and severe nutritional deficiency. This is the first case with PRCA preceding the malign lymphoma in a renal transplant patient. Treatment of lymphoma and lymphoma-related humoral and cellular changes or other undefined effects that may be related to therapy may be responsible of the resolving of PRCA in this patient. In this regard, renal transplant patients with acquired PRCA, must be closely followed for an underlying neoplastic disorder.

Finding the self? An event-related fMRI study.

Researchers have long debated whether knowledge about the self is unique in terms of its functional anatomic representation within the human brain. In the context of memory function, knowledge about the self is typically remembered better than other types of semantic information. But why does this memorial effect emerge? Extending previous research on this topic (see Craik et al., 1999), the present study used event-related functional magnetic resonance imaging to investigate potential neural substrates of self-referential processing. Participants were imaged while making judgments about trait adjectives under three experimental conditions (self-relevance, other-relevance, or case judgment). Relevance judgments, when compared to case judgments, were accompanied by activation of the left inferior frontal cortex and the anterior cingulate. A separate region of the medial prefrontal cortex was selectively engaged during self-referential processing. Collectively, these findings suggest that self-referential processing is functionally dissociable from other forms of semantic processing within the human brain.

Multiple spinal intramedullary cavernous angioma: case report.

Spinal cavernous angiomas frequently accompany to cranial cavernous angiomas. Multiple spinal cord cavernous angiomas are very rare and to authors knowledge, only one case has been described having multiple intramedullary cavernous angiomas without cranial involvement until now. In this report, we present a case with acute paraplegia who had thoracic and cervical intramedullary cavernous angiomas and normal cranial magnetic resonance imaging.

Post-traumatic intradiploic epidermoid cyst. A case report.

A patient with an intradiploic epidermoid cyst of calvarium was presented. Head injury that may cause the inclusion of epidermal cells into the diploe of the bone was present in his medical history. Skull radiographs and cranial magnetic resonance imaging (MRI) demonstrated the tumor. The tumor was totally removed and the patient was discharged free of symptoms.