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Despite the many benefits derived from the unique features and practicality of nanoparticles, the release of their toxic by-products or products from the synthesis stage into the environment could negatively impact natural resources and organisms. The physical and chemical methods for nanoparticle synthesis involve high energy consumption and the use of hazardous chemicals, respectively, going against the principles of green chemistry. Biological methods of synthesis that rely on extracts from a broad range of natural plants, and microorganisms, such as fungi, bacteria, algae, and yeast, have emerged as viable alternatives to the physical and chemical methods. Nanoparticles synthesized through biogenic pathways are particularly useful for biological applications that have high concerns about contamination. Herein, we review the physical and chemical methods of nanoparticle synthesis and present a detailed overview of the biogenic methods used for the synthesis of different nanoparticles. The major points discussed in this study are the following: (1) the fundamentals of the physical and chemical methods of nanoparticle syntheses, (2) the use of different biological precursors (microorganisms and plant extracts) to synthesize gold, silver, selenium, iron, and other metal nanoparticles, and (3) the applications of biogenic nanoparticles in diverse fields of study, including the environment, health, material science, and analytical chemistry.
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Nanopartículas del Metal , Nanoestructuras , Bacterias/química , Nanoestructuras/química , Hongos/química , Hongos/metabolismo , Plata/química , Hierro/metabolismo , Nanopartículas del Metal/química , Extractos Vegetales/química , Tecnología Química VerdeRESUMEN
OBJECTIVES: Skeletal muscle area (SMA) at T4 level on chest computed tomography (CT) is a newly available method that can be used as a surrogate sarcopenia marker. The objective of this study is to evaluate association of SMA with adverse COVID-19 outcomes in hospitalized patients. METHODS: Hospitalized COVID-19 patients were prospectively recorded in a database containing age, gender, date of admission, date of outcome (discharge, mortality, presence of intensive care unit (ICU) stay, additional coding information (comorbidities, superimposed conditions). Admission CT-scans were retrospectively evaluated for segmentation (bilateral pectoralis major/minor, erector spinae, levator scapulae, rhomboideus minor and major and transversospinalis muscles) and SMA calculation using 3-D slicer software. RESULTS: 167 cases were evaluated (68 male, 72 female, 140 survived, 27 dead). Muscle area was lower in patients with ICU stay (p=0.023, p=0.018, p=0.008) and mortality outcome (p=0.004, p=0.007, p=0.002) for pectoralis, back and SMA. In multivariate Cox-regression analysis, hazard ratio (HR) value for the pectoralis muscle area value below 2800 mm2 was found to be 3.138(95% CI: 1.171-8.413) for mortality and 2.361(95% CI: 1.012-5.505) for ICU. CONCLUSIONS: Pectoralis muscle area measured at T4 level with 3-D slicer was closely associated with adverse outcomes (mortality, ICU stay) in hospitalized COVID-19 patients. Since early treatment methods for COVID-19 are being evaluated, this method may be a useful adjunct to clinical decision making in regard to prioritization.
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COVID-19 , Sarcopenia , Humanos , Masculino , Femenino , Músculos Pectorales/fisiología , Estudios Retrospectivos , Músculo Esquelético/diagnóstico por imagen , Sarcopenia/diagnóstico por imagen , Sarcopenia/epidemiologíaRESUMEN
Herein we present a rare anatomic variation of unilateral accessory scapular ossicle in a trauma patient and its rare association with a common scapular anomaly, Sprengel deformity. Foci that appear near the inferior angle of the scapula due to failure of bony fusion during bone maturation are called accessory scapular ossicles. Sprengel deformity is defined as the congenitally high position of the scapula. The recognition of the normal variants of scapula is important, since they could be confused with other pathologies, such as fracture and pulmonary nodule in a trauma patient. Therefore, radiologists should be familiar to these entities even rarely seen.
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Fracturas Óseas , Articulación del Hombro , Humanos , Escápula/diagnóstico por imagen , Escápula/anomalías , Articulación del Hombro/anomalíasRESUMEN
OBJECTIVE: To investigate the properties of paraspinal muscle structures in osteoporotic patients, lumbar computed tomography (CT) and their relationship with lumbar and femoral neck bone mineral density (BMD). STUDY DESIGN: A Descriptive study. PLACE AND DURATION OF STUDY: Department of Radiology and Physical Medicine, Istanbul Medeniyet University, Goztepe Prof Dr Suleyman Yalcin City Hospital, Istanbul, Turkey, between June 2020 and June 2021. METHODOLOGY: Ninety patients with osteoporosis, who received lumbar spine CT and dual-energy X-ray absorptiometry (DEXA) examinations, were retrospectively included. Cross-sectional areas (CSA), densities, index values, and Hounsfield unit average calculation(HUAC) values were measured for psoas, multifidus, erector spinae, and quadratus lumborum muscles at the L3 level, and their associations with BMD were investigated. RESULTS: A total of 90 patients including 71 females were evaluated. The mean age was 63.31±11.90 years. A moderate correlation of lumbar spine (r=0.32, p<0.01) and femur neck BMD (r=0.28, p<0.05) with erector spinae CSA was defined. Small correlation between psoas CSA (r=0.28, p<0.05) and psoas muscle index (PMI, r=0.24, p<0.05) with lumbar spine BMD was found. The CSA of all the paraspinal muscles (p<0.01) and densities, except psoas muscle (p<0.05), were higher in males. In non-obese osteoporotic patients, the density and HUAC values of the paraspinal muscles, except the psoas muscle, were found to be significantly higher (p<0.05). CONCLUSION: The properties of the paraspinal muscles measured by the lumbar CT scan are found to be related to BMD. The psoas and erector spinae CSA and index values are the most significantly associated parameters with the lumbar spine BMD. KEY WORDS: Bone mineral density, Computed tomography, Osteoporosis, Paraspinal muscles, Psoas.
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Osteoporosis , Músculos Paraespinales , Absorciometría de Fotón/métodos , Anciano , Densidad Ósea/fisiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Osteoporosis/diagnóstico por imagen , Estudios RetrospectivosRESUMEN
AIM: Sacroiliac joint (SJ) imaging is the key point in the diagnosis of ankylosing spondylitis (AS). The curved anatomy of the SJ makes the interpretation of imaging difficult. The aim of this study is to evaluate the interclass and intraclass reliability of specific lesions (bone marrow edema [BME], joint space narrowing, erosions, effusion, ankylosis, bridging, sclerosis, fat deposition, and other additional pathologies) on SJ magnetic resonance imaging (MRI). METHOD: In a total of 310 randomly chosen patients, 620 SJs were evaluated by three different radiologists with different radiology experiences of specialties other than musculoskeletal radiology. RESULTS: The agreement between readers for BME was fair to substantial, for active sacroiliitis was moderate to substantial, for sacroiliac narrowing was fair at best, for erosions was fair to moderate, for SJ sclerosis was none to slight, for chronic sacroiliitis was slight to fair, for degenerative sacroiliitis was none to slight, for normal SJ was slight, for SJ effusion was none to slight, and for fatty deposition was none. Intraclass correlation for readers 1 and 3 was usually good to excellent and for reader 2 was poor to fair. CONCLUSION: This study was designed to assess the agreement between radiologists who were not familiar with SJ MRI. The agreement between readers was usually fair to substantial and even intraclass correlation was poor to fair for reader 2. Future studies can be designed for standardization and validation of each MRI lesion for better interpretation of SJ MRI.
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Enfermedades de la Médula Ósea , Sacroileítis , Espondiloartritis , Edema/patología , Humanos , Imagen por Resonancia Magnética , Reproducibilidad de los Resultados , Articulación Sacroiliaca/diagnóstico por imagen , Articulación Sacroiliaca/patología , Sacroileítis/diagnóstico por imagen , Esclerosis/patologíaRESUMEN
OBJECTIVE: The aim of this study was to investigate the properties of psoas muscle in osteoporotic patients in lumbar magnetic resonance imaging (MRI) scan and their relationship with hip fracture. MATERIALS AND METHODS: One hundred seventy-seven patients with osteoporosis (63.69 ± 9.677, 105 female) who had received lumbar spine MRI and dual-energy X-ray absorptiometry (DXA) examinations were retrospectively included. Thickness (PMT), cross-sectional areas (CSA), and index (PMI) values were measured for psoas muscle at L3 level and psoas muscle characteristics were compared between hip fracture and control groups. RESULTS: PMT, CSA, and PMI values were statistically significantly different between hip fracture and control groups (respectively p < .001, p < .05, p < .01). The results showed that there was a significant association between being sarcopenic and having hip fracture (χ2 (1, n = 117) = 4.57, p < .05, phi = .20). CONCLUSION: PMT, CSA, and PMI might be associated with hip fracture in osteoporotic patients. However, this association is independent of bone mineral density (BMD). Psoas muscle features including PMT, CSA, and PMI should be used as significant predictors of falls and fractures in osteoporotic patients.
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Fracturas de Cadera , Osteoporosis , Fracturas Osteoporóticas , Absorciometría de Fotón/métodos , Densidad Ósea , Femenino , Fracturas de Cadera/diagnóstico por imagen , Humanos , Vértebras Lumbares/diagnóstico por imagen , Imagen por Resonancia Magnética , Masculino , Osteoporosis/diagnóstico por imagen , Fracturas Osteoporóticas/diagnóstico por imagen , Músculos Psoas/diagnóstico por imagen , Estudios RetrospectivosRESUMEN
This study reports an efficient, green, sensitive and simple analytical protocol for trace determination of methyl paraben, ethyl paraben, propyl paraben, butylparaben and benzyl paraben by high-performance liquid chromatography-ultraviolet detection (HPLC-UV). The analytes were preconcentrated using an ultrasonication supported (US) dispersive solid phase extraction (DSPE) method based on reduced graphene oxide (rGO) modified iron nanoparticles (US-Fe3O4@rGO-DSPE). A reversed-phase C18 column and an isocratic elution program comprising of 20 mM phosphate buffer (pH 4.50) and acetonitrile(58:42, v/v) were used to elute and separate the analytes for detection. The limits of detection determined for the analytes were very low and were in the range of 0.02 - 0.16 ng mL-1. The coefficients of determination obtained for the analytes ranged from 0.9973 to 0.9998, and this validated good linearity of the method.Percent relative standard deviations obtained in the range of 2.5 - 10.6% verified the method's high intraday repeatability. Accuracy of the proposed method was assessed with spiking experiments performed on complex sample matrices. Percent recoveries calculated for spiked soil, artificial seawater and seaweed samples were in acceptable ranges of 95 - 121%, 87 - 117% and 85 - 111%, respectively. These figures of merit suggest that HPLC-UV coupled with the US-Fe3O4@rGO-DSPEmethod is suitable for the determination of parabens in Antarctic samples.
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Nanocompuestos , Algas Marinas , Cromatografía Líquida de Alta Presión , Heces/química , Grafito , Islas , Parabenos/análisis , Suelo , Extracción en Fase Sólida , AguaRESUMEN
In this paper, a sensitive and simple zirconium nanoparticles (Zr-NPs) based vortex assisted ligandless dispersive solid phase extraction (VA-LDSPE) method was developed for the preconcentration of lead from wastewater samples for the determination by slotted quartz tube-flame atomic absorption spectrometry (SQT-FAAS). Zr-NPs were synthesized using zirconium (IV) chloride salt as a starting material through a simple reduction process with sodium borohydride, and used as selective adsorbent for the extraction of lead ions from aqueous medium. Single variant experiments were carried out for all optimizations of sorption/desorption steps including pH of solution, amount of nanoparticles, mixing type/period and eluent type. An SQT with five round slots was placed onto the burner of FAAS to increase the interaction between lead atoms and light from radiation source to enhance the absorbance signals. Under the determined optimum conditions, analytical figures of merit were evaluated and the limit of detection and quantification (LOD/LOQ) values were calculated as 5.2 and 17.3 µg L- 1, respectively. The developed method showed a linear calibration range between 25 and 250 µg L- 1 with a good regression coefficient value (0.9995). Recovery studies were also performed with domestic wastewater samples spiked at three concentrations and percent recovery values obtained in the range of 97%-102% validated the developed method's applicability and accuracy.
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Nanopartículas , Aguas Residuales , Plomo , Extracción en Fase Sólida , Espectrofotometría Atómica , CirconioRESUMEN
PURPOSE: To identify the correlation of nonalcoholic pancreatic steatosis (NAPS) with nonalcoholic fatty liver disease (NAFLD) in an outpatient group. Based on its metabolic and imaging properties, NAPS has been increasingly recognized in recent years; however, its interaction with NAFLD is still not clear. PATIENTS AND METHODS: In this cross-sectional observational study, 345 consecutive patients without any chronic illness who were referred to the senior radiologist for abdominal ultrasound (US) were included. The US report showed hepatic and pancreatic echogenicity. The patients' demographic, anthropometric, and laboratory data were collected from medical records. RESULTS: Overall, NAPS and NAFLD were seen in 227 (65.8%) and 219 (63.5%) patients, respectively. Normal echogenicity was noted in 74 (21.4%) patients. Forty-four patients (12.8%) had steatotic liver without NAPS, 52 (15.1%) had steatotic pancreas without NAFLD, and 175 (50.7%) had steatosis in both organs. The discordance in steatosis grading between NAPS and NAFLD was 55.1%. Insulin resistance was present in 8.7, 26.7, 19, and 61.3% of patients with no steatosis, only NAFLD, only NAPS, and steatosis in both organs, respectively. Evident NAFLD and NAPS having grade 2 and 3 steatosis were present in 15.3% and 29.0% of the study group, respectively. Cholecystolithiasis was present in 6.8, 13.6, and 28.8% of patients with normal echogenic pancreas, only NAFLD, and only NAPS, respectively (p=0.01). CONCLUSION: Based on the ultrasonographic, clinical, demographic, and anthropometric features of the included patients, we found that NAPS did not fully accompany nonalcoholic fatty liver. Despite severe pancreatic steatosis, more than a quarter of cases had normal liver echogenicity. Insulin resistance frequency was insignificantly higher in NAFLD than NAPS (p=0.694). The significantly higher frequency of cholecystolithiasis in NAPS needs further large-scale studies. The inconsistency of steatosis degree in NAPS and NAFLD in >50% cases may reflect differences in the pathophysiology of these two clinical entities.
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Nowadays, it is well known that early diagnosis directly affects the success of treatment. Biomarkers play a crucial role in early diagnosis of diseases or explanation of pathological condition. The investigation of new biomarkers depends on the reliable quantification of analytes in biological matrices. Regarding to the critical roles of amino acids in metabolism, functions and nutrition of human body, the careful monitoring of their levels in biological samples is required to evaluate their potential in biomarker studies for clinical research. In this study, a reliable and accurate analytical strategy was developed for the simultaneous determination of glycine, methionine and homocysteine using LC-quadrupole-time of flight-tandem MS system. The method detection limit was found to be 0.73⯵g/mL, 0.017⯵g/mL and 0.019⯵g/mL for glycine, methionine and homocysteine, respectively. The calibration curves were obtained with great linearity (R2â¯≥â¯0.9993) and low relative standard deviation values showed the repeatability of proposed method. The method applicability was determined using human plasma and urine samples, and high percent recoveries demonstrated the accuracy of method developed. Each measurement was taken less than 4.0â¯min indicating a promising strategy for the fast and reliable quantification of target amino acids in clinical laboratories.
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Metionina , Espectrometría de Masas en Tándem , Cromatografía Liquida , Glicina , Homocisteína , Humanos , Límite de Detección , Reproducibilidad de los ResultadosRESUMEN
Tumors in the prevascular compartment of the mediastinum are rare and imaging plays a major role in their detection, (differential) diagnosis, staging, and follow-up. The prevascular compartment is bordered anteriorly by the posterior aspect of the sternum, posteriorly by the ventral aspect of the pericardium, cranially by the thoracic outlet, and caudally by the diaphragm. In many cases, the diagnosis of a lesion in the prevascular compartment is an incidental finding either on chest radiograph (CR) or on computed tomography (CT) scans. The differential diagnosis of masses in the pre-vascular mediastinum include primarily tumors arising from the thymus or the thyroid gland, lymphomas and germ cell tumors. The differential diagnosis of mediastinal masses is primarily based on the location of the mass, its tissue composition (i.e., fat content, calcifications) and the age of the patient. The imaging method of choice is CT, as it combines a high spatial and temporal resolution with the ability to determine tissue composition and detect fluid components, as well as areas of fat and calcifications. MRI is used as a more specific problem-solving tool to discriminate solid lesions from cystic lesions or to provide evidence of minimal fat content in teratoma and thymic rebound. The role of PET/CT in the evaluation of tumors other than lymphomas in the prevascular compartment is still under discussion.
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Preconcentration of cobalt was carried out with deep eutectic solvent based liquid phase microextraction (DES-LPME) for trace determination by a slotted quartz tube (SQT) attached flame atomic absorption spectrometry (FAAS) system. Choline chloride and phenol in a 1:2â¯M ratio was used as a green solvent to extract cobalt from the aqueous sample solution. Key parameters influencing the extraction efficiency of cobalt were examined and optimized. Under the conditions optimized, the linear dynamic range was found between 5.0 and 50⯵gâ¯L-1, and the limits of detection and quantification (LOD and LOQ) were calculated as 2.0 and 6.6⯵gâ¯L-1, respectively. The detection power of the conventional FAAS was improved upon by 67 folds using the optimized DES-LPME-SQT-FAAS method. The developed analytical method was successfully applied for the determination of cobalt in linden tea samples and the recovery results obtained for different spiked concentrations (20, 30 and 40⯵gâ¯L-1) were remarkable (≈100%).
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Cobalto/análisis , Análisis de los Alimentos/métodos , Microextracción en Fase Líquida/métodos , Espectrofotometría Atómica/métodos , Cobalto/aislamiento & purificación , Tecnología Química Verde , Límite de Detección , Cuarzo/química , Solventes/química , Espectrofotometría Atómica/instrumentación , Tés de Hierbas/análisis , Tilia/química , Agua/químicaRESUMEN
This paper proposed an accurate and sensitive analytical method based on the combination of Liquid Chromatography-Quadrupole Time of Flight-Tandem Mass Spectrometry (LC-QTOF-MS/MS) system with Quadruple Isotope Dilution-Mass Spectrometry (ID4MS) strategy for the determination of diuron at trace levels. In order to achieve accurate and reliable determination of the analyte, ID4MS strategy that uses stable isotopically labelled analogues was employed. Diuron-d6 was synthesized in the laboratory using a novel strategy and employed in ID4MS for the preparation of three calibration blends and seaweed sample blend. The analytical performance of the LC-QTOF-MS/MS method was evaluated and the respective detection and quantification limits obtained were 14.6⯵gâ¯kg-1 and 46.5⯵gâ¯kg-1. Good linearity was obtained with a correlation coefficient of 0.9995 over the dynamic range from 50 to 1000⯵g kg-1. The validity of the method was successfully tested by carrying out spiking experiments in seaweed samples. The percent recovery value showed superior enhancement for ID4MS strategy (99.97 ± 0.41%) confirming the applicability of the method to complex matrices with great accuracy and precision.
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Cromatografía Liquida/métodos , Diurona/análisis , Algas Marinas/química , Espectrometría de Masas en Tándem/métodos , Diurona/química , Técnicas de Dilución del Indicador , Marcaje IsotópicoRESUMEN
Isolated spermatic vein thrombosis is an uncommon pathology, mostly involving left side. These patients present with acute scrotal symptoms, and can be misdiagnosed as testicular torsion or incarcerated inguinal hernia. At this point, Doppler ultrasound (US) plays critical role for the prompt and correct diagnosis of this rare clinical entity. Herein, a 54- year-old man having left sided testicular enlargement and tenderness with an unremarkable etiology was reported as a rare case of isolated spermatic vein thrombosis which could easily be diagnosed by colour Doppler US.
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Escroto/irrigación sanguínea , Ultrasonografía Doppler en Color , Trombosis de la Vena/diagnóstico por imagen , Diagnóstico Diferencial , Humanos , Masculino , Persona de Mediana EdadRESUMEN
A switchable solvent based liquid phase microextraction (SS-LPME) has been proposed for the determination of cobalt in egg yolk and Vitamin B12 at trace levels. N,N-Dimethylbenzylamide (DMBA) was used as a switchable solvent and converted to protonated DMBA form by the addition of dry ice. Cobalt was complexed with 1,5-diphenylcarbazone (DPC) and extracted into the DMBA phase. After the extraction, HNO3 was added to increase nebulization efficiency of the DMBA phase. Slotted quartz tube (SQT) was combined with FAAS to enhance the detection power of the system when compared to the conventional FAAS. Under the optimum conditions, limit of detection values were recorded as 75⯵gâ¯L-1 for FAAS, 33⯵gâ¯L-1 for SQT-FAAS, 7.6⯵gâ¯L-1 for SS-LPME-FAAS, and 2.3⯵gâ¯L-1 for SS-LPME-SQT-FAAS. The developed method was applied for the determination of cobalt in egg yolk and Vitamin B12 and the recovery results were found in the range of 105-114% with 0.30-7.6 standard deviation values (nâ¯=â¯3).
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Cobalto/análisis , Yema de Huevo/química , Microextracción en Fase Líquida/métodos , Solventes/química , Espectrofotometría Atómica/métodos , Vitamina B 12/análisis , Límite de Detección , Cuarzo/química , Semicarbazonas/química , Contaminantes Químicos del Agua/análisisRESUMEN
OBJECTIVE: To evaluate the functional and radiological outcomes of anterograde headless cannulated screw fixation for medial malleolar fractures. SUBJECTS AND METHODS: This study included 12 patients (8 males, 4 females; age 27-55 years) with medial malleolar type B fractures according to the Herscovici fracture classification who had undergone anterograde headless cannulated screw fixation surgery between 2012 and 2014. Seven had an isolated medial malleolar fracture and 5 a bimalleolar fracture. All of the bimalleolar fractures were classified as 44-B2 based on the Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) classification. Postoperatively, bone union was evaluated on direct radiographs at the final follow-up examination. The American Orthopaedic Foot and Ankle Society (AOFAS) scoring system was used for clinical evaluation. RESULTS: The mean follow-up period was 17.2 ± 5.3 months (range 12-23). Full union was achieved in all fractures. The mean time to union was 3.4 ± 1.5 months (range 2-5). No instability, loss of reduction, non-union or infection was observed in any patient. The mean AOFAS score was 95.0 ± 5.4 (range 87-99). Based on the AOFAS score, 4 patients showed good results and 8 excellent results. The mean time to return to the previous level of activity was 4.0 ± 2.5 months (range 2-5). CONCLUSION: In this study, anterograde headless cannulated screw fixation yielded good clinical outcome in the surgical treatment of Herscovici type B fractures.
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Fracturas de Tobillo/cirugía , Tornillos Óseos , Fijación Interna de Fracturas/métodos , Adulto , Femenino , Curación de Fractura/fisiología , Humanos , Masculino , Persona de Mediana EdadRESUMEN
BACKGROUND: Soft tissue injuries may co-occur with tibial plateau fractures. These injuries may include medial or lateral ligament ruptures, peroneal nerve lesions, anterior cruciate ligament ruptures, and meniscus tears. OBJECTIVE: The aim of this study was to investigate the frequency of meniscus tears in lateral tibial plateau fractures and to evaluate the clinical and radiological results of meniscus repairs. MATERIALS AND METHOD: The study included 19 patients who underwent surgery for a closed lateral tibial plateau fracture. Anteroposterior and lateral radiographs of the knee, followed by magnetic resonance imaging (MRI) examinations, were undertaken for all cases. The clinical and radiological evaluation of the surgical treatment results was performed according to the Rasmussen criteria. RESULTS: Meniscus lesions were found in 10 (52.6%) patients. Nine meniscus tears were found in patients with type 2 fractures, and one meniscus tear was found in a patient with a type 3 fracture. All of the menisci were separated from the peripheral capsule adhesion point. On the MRI examination during follow-up, all of the repaired lateral menisci were determined to be in their original anatomic location. CONCLUSION: For successful outcomes in lateral plateau fractures, it is essential to determine whether there is a meniscus tear. In cases with meniscus tears, meniscus repair can be easily performed and should be considered because it has a positive impact on the treatment outcome.
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Fracturas de la Tibia/cirugía , Lesiones de Menisco Tibial/cirugía , Adulto , Femenino , Fijación Interna de Fracturas , Humanos , Masculino , Persona de Mediana Edad , Dimensión del Dolor , Rango del Movimiento Articular , Fracturas de la Tibia/clasificación , Fracturas de la Tibia/diagnóstico por imagen , Lesiones de Menisco Tibial/diagnóstico por imagen , Adulto JovenRESUMEN
BACKGROUND: The purpose of this study was to report the management and outcomes of ten patients with chronic Achilles tendon rupture treated with a turndown gastrocnemius-soleus fascial flap wrapped with a surgical mesh (Hyalonect). METHODS: Ten men with neglected Achilles tendon rupture were treated with a centrally based turndown gastrocnemius fascial flap wrapped with Hyalonect. Hyalonect is a knitted mesh composed of HYAFF, a benzyl ester of hyaluronic acid. The Achilles tendon ruptures were diagnosed more than 1 month after injury. The mean patient age was 41 years. All of the patients had weakness of active plantarflexion. The mean preoperative American Orthopaedic Foot and Ankle Society score was 64.8. RESULTS: The functional outcome was excellent. The mean American Orthopaedic Foot and Ankle Society score was 97.8 at the latest follow-up. There were significant differences between the preoperative and postoperative scores. Ankle range of motion was similar in both ankles. Neither rerupture nor major complication, particularly of wound healing, was observed. CONCLUSIONS: For patients with chronic Achilles tendon rupture with a rupture gap of at least 5 cm, surgical repair using a single turndown fascial flap covered with Hyalonect achieved excellent outcomes.