Efficacy of Kinesio® tapes in obstetrical brachial plexus injury: a randomized controlled trial.

OBJECTIVES: The purpose of this study was to investigate the effectiveness of Kinesio® tape application associated to exercise in patients with obstetric brachial plexus injury (OBPI). MATERIALS AND METHODS: Ninety patients with Erb-Duchenne palsy secondary to OBPI participated in a 3-month study, in 2 groups; study group (n = 50) and control group (n = 40). Both followed the same physical therapy program, while the study group also received Kinesio® taping over the scapula and forearm. The patients were evaluated, pre- and post-treatment, using the Modified Mallet Classification (MMC), Active Movement Scale (AMS), and active range of motion (ROM) of the plegic side. RESULTS: There were no statistically significant intergroup differences in age, gender, birth weight or plegic side (p > 0.05), or in pre-treatment MMC and AMS scores (p > 0.05). There were significant differences in favor of the study group for Mallet 2 (external rotation) (p = 0.012), Mallet 3 (hand on the back of the neck) (p < 0.001), Mallet 4 (hand on the back) (p = 0.001) and total Mallet score (p = 0.025), and for AMS shoulder flexion (p = 0.004) and elbow flexion (p < 0.001). ROM results before and after treatment (within groups) showed significant improvement in both groups (p < 0.001). CONCLUSION: Since this a was a preliminary study, the results should be interpreted with caution in terms of clinical efficacy. The results suggest that associating Kinesio® taping to conventional treatment helps functional development in patients with OBPI.'

¿Es posible la rediferenciación de NET tras la quimioterapia? Captación de imágenes de DOTA-péptidos marcados con 68Ga como cambio de estrategia en el tratamiento terapéutico / Is it possible NET-redifferentiation after chemotherapy? 68Ga DOTA-peptide imaging as a game-changer in therapy management

Se realizó una PET/TC con 68Ga DOTANOC a un varón de 64 años con tumor neuroendocrino de grado III, para estadificación. La lesión pancreática, múltiples ganglios peripancreáticos y diversas metástasis de gran tamaño en ambos lóbulos hepáticos, se mostraron con captación intensa. Tras 3 ciclos de quimioterapia con cisplatino y etopósido, el tumor primario y las metástasis disminuyeron de tamaño, aunque se reveló una mayor captación en la PET/TC con 68Ga DOTANOC de seguimiento. Otra biopsia hepática reflejó un descenso significativo del índice de proliferación de Ki-67, del 35 al 1%. El paciente recibió 2 ciclos de terapia con radionúclidos de receptores peptídicos con 177Lu DOTANOC

A 64-year-old man with pancreatic grade III neuroendocrine carcinoma underwent 68Ga DOTANOC PET/CT scan for staging. The pancreatic lesion, multiple peripancreatic lymph nodes and multiple gross metastases in both hepatic lobes were revealed with intense uptake. After 3 cycles of chemotherapy containing cisplatin and etoposide the primary and metastatic lesions were decreased in size, however showing higher uptake on follow-up 68Ga DOTANOC PET/CT scan. Another biopsy from liver demonstrated a significant decrease in Ki-67 proliferation index from 35 to 1%. The patient received 2 cycles of peptide receptor-targeted radionuclide therapy with 177Lu DOTANOC

Is it possible NET-redifferentiation after chemotherapy? 68Ga DOTA-peptide imaging as a game-changer in therapy management. / ¿Es posible la rediferenciación de NET tras la quimioterapia? Captación de imágenes de DOTA-péptidos marcados con 68Ga como cambio de estrategia en el tratamiento terapéutico.

A 64-year-old man with pancreatic grade III neuroendocrine carcinoma underwent 68Ga DOTANOC PET/CT scan for staging. The pancreatic lesion, multiple peripancreatic lymph nodes and multiple gross metastases in both hepatic lobes were revealed with intense uptake. After 3 cycles of chemotherapy containing cisplatin and etoposide the primary and metastatic lesions were decreased in size, however showing higher uptake on follow-up 68Ga DOTANOC PET/CT scan. Another biopsy from liver demonstrated a significant decrease in Ki-67 proliferation index from 35 to 1%. The patient received 2 cycles of peptide receptor-targeted radionuclide therapy with 177Lu DOTANOC.

Atypical Leiomyomas of the Uterus: A Clinicopathologic Study of 54 Cases and an Immunohistochemical Analysis of Ki-67 and p53 / Leiomiomas atípicos del útero: un estudio clínico-patológico de 54 casos y un análisis inmunohistoquímico de Ki-67 y p53

ABSTRACT Objective: Uterine atypical leiomyomas (ALs) are extremely rare and occur in an age group almost one decade earlier than that for leiomyosarcomas. According to the literature, extensive clinicopathologic studies on ALs were limited to only two studies (2, 8). Atypical leiomyomas of the uterus are well-defined neoplasms with smooth muscle cells. The aim of this study was to investigate clinicopathologic findings in 54 cases diagnosed with ALs as well as Ki-67 and p53 expressions immunohistochemically. Methods: Fifty-four cases diagnosed between 2000 and 2013 were included. The histological and clinical features of the cases were reviewed, and their medical records were examined. Ki-67 and p53 were performed on all cases immunohistochemically. Results: The average age of the patients was 41.8 years. The average clinical follow-up period was 57 months. Hysterectomy was performed in 31 patients, and myomectomy in 21 patients, while resection of the mass was performed in two patients due to the intraligamentary mass. The average size of the neoplasms was 6.2 cm. Severe cellular atypia was noticed in 25 patients. While the number of mitoses was 1/10 high power field in 30 patients, it was 4/10 high power field in six patients. Ki67 was found to be positive in 50 patients at the rate of 1-5% immunohistochemically, while p53 demonstrated staining at the ratio of 10-15% staining in four patients. Conclusion: The differentiation of ALs from leiomyosarcomas is crucial. The recurrence rate after follow-up is 2%. In our opinion, the patients diagnosed with 'AL with limited experience' before should be correctly diagnosed as AL. We recommend that Ki-67 and p53 can be used as adjuvant markers immunohistochemically in the patients where a problem in differential diagnosis from leiomyosarcoma exists.

RESUMEN Objetivo: Los leiomiomas atípicos uterinos (LA) son extremadamente raros y se presentan en un grupo de edad casi una década antes que los leiomiosarcomas. De acuerdo con la literatura, los extensos estudios clínico-patológicos en los LA se limitaron a sólo dos estudios (2, 8). Los leiomiomas atípicos del útero son neoplasmas bien definidos con células de músculo liso. El objetivo de este estudio fue investigar los hallazgos clínico-patológicos en 54 casos diagnosticados con LA, así como las expresiones Ki-67 y p53, de forma inmunohistoquímica. Métodos: Se incluyeron cincuenta y cuatro casos diagnosticados entre 2000 y 2013. Se revisaron las características histológicas y clínicas de los casos y se examinaron sus historias clínicas. Ki-67 y p53 se realizaron en todos los casos de forma inmunohistoquímica. Resultados: La edad promedio de los pacientes fue de 41.8 años. El período promedio de seguimiento clínico fue de 57 meses. Se realizaron histerectomías a 31 pacientes, y miomectomías a 21 pacientes, en tanto que a dos pacientes se les realizó resección de la masa debido a la situación intraligamentosa. El tamaño promedio de los neoplasmas fue de 6.2 cm. Se observó atipia celular severa en 25 pacientes. El número de mitosis fue de 1/10 campos de gran aumento en 30 pacientes, en contraste con el número de mitosis de 4/10 campos de gran aumento en seis pacientes. Se encontró que Ki67 fue positivo en 50 pacientes a razón de 1-5% inmunohistoquímicamente, mientras que p53 mostró tinción a razón de 10-15% de tinción en cuatro pacientes. Conclusión: La diferenciación de LA entre los leiomiosarcomas es crucial. La tasa de recurrencia después del seguimiento es de 2%. En nuestra opinión, los pacientes diagnosticados con 'LA con experiencia limitada ' antes, deben ser diagnosticados correctamente como LA. Recomendamos que Ki-67 y p53 sean usados como marcadores adyuvantes inmunohistoquímicamente en los pacientes con un diagnóstico diferencial de leiomiosarcoma.

Evaluation of the antioxidant effects of melatonin on the larynx mucosa of rats exposed to environmental tobacco smoke.

OBJECTIVES: This study's aim was to investigate the effect of melatonin in terms of mitigating the effects of smoking on the laryngeal mucosa of rats exposed to environmental tobacco smoke. DESIGN: Rats were divided into four groups: Melatonin + Smoking group exposed to smoke with melatonin; Smoking group exposed to smoke without melatonin; Saline group not exposed to smoke without melatonin; Melatonin group not exposed to smoke with melatonin. CuZn-superoxide dismutase (CuZn-SOD), catalase (CAT) and glutathione peroxidase (GSH-Px) activities were evaluated in plasma and tissues. Tissues were also examined the changes of squamous hyperplasia, keratosis, parakeratosis and epithelial hyperplasia by light microscope and the ultrastructural changes by electron microscope. RESULTS: Tissue SOD, CAT and GSH-Px activities were significantly higher in Saline and Melatonin groups than Melatonin + Smoking and Smoking groups. Plasma CuZn-SOD and CAT activities were significantly higher in Saline and Melatonin groups than Smoking group. Plasma GSH-Px showed no significant difference. The rate of epithelial hyperplasia was significantly higher in Smoking group than the other groups. The rate of parakeratosis was significantly higher in Smoking group than the other groups. The epithelial cells in Melatonin + Smoking group displayed, normal cell structure similar to those in Saline group under electron microscope. CONCLUSIONS: The study shows that smoking induces substantial pathological changes in the laryngeal mucosa and melatonin may have some beneficial effects in partially reversing smoking-induced laryngeal injury by inducing the expression of antioxidants; biochemical and histological outcomes also support these findings due to preventing tissue damage in laryngeal mucosa exposed to smoke.

Recovery of adriamycin induced mitochondrial dysfunction in liver by selenium.

Adriamycin (ADR) is a chemotherapeutic drug. Its toxicities may associate with mitochondriopathy. Selenium (Se) is a trace element for essential intracellular antioxidant enzymes. However, there is lack of data related to the effect of selenium on the liver tissue of ADR-induced mitochondrial dysfunction. The study was to investigate whether Se could restore mitochondrial dysfunction of liver-exposed ADR. Rats were divided into four groups as a control, ADR, Se, co-treated ADR with Se groups. The biochemical measurements of the liver were made in mitochondrial and cytosol. ATP level and mitochondria membrane potential (MMP) were measured. Total oxidant (TOS), total antioxidant (TAS) status were determined and oxidative stress index (OSI) was calculated by using TOS and TAS. ADR increased TOS in mitochondria and also oxidative stress in mitochondria. ADR sligtly decreased MMP, and ATP level. Partial recovery of MMP by Se was able to elevate the ATP production in cotreatment of ADR with Se. TOS in mitochondria and cytosol was diminished, as well as OSI. We concluded that selenium could potentially be used against oxidative stress induced by ADR in liver, resulting from the restoration of MMP and ATP production and prevention of mitochondrial damage in vivo.

Roles of matrix metalloproteinases in the etiology of inguinal hernia.

INTRODUCTION: The fascia transversalis is accepted as one of the anatomical structures that can prevent hernia formation. Degradation of collagen within the fascia transversalis is one of the known reasons for the development of inguinal hernia. In the present study, we investigated the roles of matrix metalloproteinases (MMPs), specifically MMP-1, MMP-2, and MMP-9 in the etiology of inguinal hernia. MATERIALS AND METHODS: This prospective study included 60 inguinal hernia patients: 30 patients had indirect inguinal hernia and 30 patients had direct inguinal hernia. An additional 30 patients operated for reasons other than hernia in the inguinal canal were included as a control group. All patients underwent operations at Istanbul Training and Research Hospital between 1 June 2009 and 1 December 2009. Tissue specimens were taken from the fascia transversalis from patient and control groups during the operation, and MMP-1, MMP-2, MMP-9 values were investigated using immunohistochemical methods. RESULTS: Significantly higher values of MMP-1, MMP-2, MMP-9, were found in inguinal hernia cases than in the control group (P = 0.0001, P = 0.007, P = 0.021, respectively). CONCLUSION: Increased MMP-1, MMP-2, MMP-9 values play a role in the etiology of inguinal hernia. Since weakening may also occur in other tissues in addition to the floor of inguinal canal in inguinal hernia patients, the association of arterial aneurisms and connective tissue diseases should also be investigated in these patients.

Origin, course and distribution of the hypoglossal nerve in the New Zealand rabbit (Oryctolagus cuniculus L).

UNLABELLED: With 8 figures SUMMARY: This study aimed at revealing the origin, course and distribution of the hypoglossal nerve in 20 adult male New Zealand rabbits. In all the animals dissected, the hypoglossal nerve arose from the ventrolateral side of the medulla oblongata with two main roots and gave off a descending branch to the ansa cervicalis before reaching the division of the common carotid artery. This branch was not seen on the right side of only one case. At the lateral aspect of the hyoglossus muscle, the nerve then divided into the lateral and medial main branches, sent branches to the styloglossus, hyoglossus, genioglossus and geniohyoideus muscles and terminated in the intrinsic tongue muscles. A communicating branch was observed between the hypoglossal and accessory nerves in the right side of one animal and between the hypoglossal nerve and the ganglion nodosum in the right retropharyngeal area of another animal. An additional branch was observed innervating the stylohyoideus muscle in one animal only. A lateral lingual-hypoglossal communication was also seen between the lateral branch of the hypoglossal nerve and terminal branches of the lingual nerve.

The morphology of the cervico-thoracic sympathetic system in donkeys (Equus asinus L.).

Five adult donkeys of both sexes, used in applied anatomy classes, and perfused with formalin for teaching purposes, constituted the study material. Ganglion cervicale caudale of the examined materials has observed to exhibit individually variable situation as to extend on the left side of the median line, at the alignment of the first and second intercostal spaces and on the right side between the level of the first and third costa. The ganglion extended more caudally on the right side of median line. The lateral surface of the ganglion was determined to be covered with the m. scalenus medius. On the both sides of the median plane, the ganglion cervicale caudale was seen to be situated on the lateral surface of the m. longus colli. On the left side, the ganglion overlapped the oesophagus in two cadavers and on the right side it was situated within a groove between the m. longus colli and trachea in three cadavers. The rami communicantes received by the ganglion cervicale caudale originated from the eighth cervical and first thoracic spinal segments. The ganglion cervicale caudale was formed by the coalescence of the last cervical and first three thoracic sympathetic ganglia. The ganglion cervicale caudale gave off branches that formed the rami communicantes, plexus cardiacus, n. vertebralis and ansa subclavia. One branch extended from the ganglion to the plexus brachialis. in one specimen, two sympathetic-parasympathetic communicating branches were observed to extend from the ansa subclavia and near by the origin of the truncus sympathicus to the n. vagus. In one of the donkeys examined, a branch originating from the ganglion cervicale caudale on the left side of the median plane was determined to end on the ligamentum arteriosum. A microscopic ganglion structure suggesting the existence of the ganglion cervicale medium was determined in a donkey.

Constraint induced movement therapy: efficacy in a Turkish stroke patient population and evaluation by a new outcome measurement tool.

AIM: The purpose of this study was to show if constraint induced movement therapy (CIMT) is effective in a Turkish stroke patient population and whether the effectiveness could be measured by a different evaluation tool, i.e. Kocaeli Functional Evaluation Test (KFET). METHODS: Twenty-five patients with subacute or chronic stroke were included in the study. At the beginning, all the patients received a conventional rehabilitation programme for 3 weeks. Seventeen patients who had no improvement in upper extremity functioning with this conventional programme received CIMT for 3 weeks. Active range of motion (ROM) and modified Ashworth scale of the plegic upper extremity were noted; Wolf Motor Function Test (WMFT) and KFET were performed to each patient before and after CIMT. RESULTS: Active ROM of shoulder flexion (P<0.001), abduction (P<0.001), and external rotation (P=0.005), wrist flexion (P=0.025), and extension (P<0.01) of the plegic upper extremity improved significantly after CIMT. There were significant improvements in functional ability scale (P<0.05 for all parameters) and performance time results of 13 (P<0.05 for all parameters) out of 15 parameters of WMFT. Significant improvements were observed in quality-ability scores of every subunit of each activity (P<0.05 for all parameters) and performance time scores (P<0.05 for all parameters) of KFET. CONCLUSIONS: CIMT is found to be a noteworthy treatment for improving the function of the hemiplegic upper extremity in this Turkish patient population.

Influence of duration of total breast-feeding on bone mineral density in a Turkish population: does the priority of risk factors differ from society to society?

INTRODUCTION: Despite numerous studies on risk factors for osteoporosis the effect of breast-feeding on bone mineral density (BMD) is unclear. In this study our aim was to determine the influence of total duration of breast-feeding on BMD, and subsequent risk of osteoporosis. METHODS: A total of 1,486 postmenopausal women over the age of 40 were included in the study. Women with diseases or who were under drug treatments known to affect bone metabolism were excluded. The BMD of the lumbar spine and femoral neck were measured by dual-energy X-ray absorptiometry technique, using either the Norland XA-26 or Lunar DPX-IQ densitometers and were transferred to standard values. Patients were placed in groups of five with respect to the duration of their breast-feeding as never, 1-12 months, 12-24 months, 24-60 months, >60 months. RESULTS: One-way ANOVA test showed a significant difference between the lumbar spine and femoral neck BMD of these groups of women (p<0.001, p<0.001). Post hoc Bonferroni correction revealed that both the lumbar spine and femoral neck BMD results of women with longer duration of total breast-feeding were significantly lower than those of women with less duration of total breast-feeding. In subsequent analysis other potential risk factors were also considered in a multiple linear stepwise regression model. Years since menopause (p<0.001), weight (p<0.001), total duration of breast-feeding (p<0.001), and body mass index (p=0.001) were found to be the most important predictors for lumbar spine BMD; and age (p<0.001), weight (p<0.001), years since menopause (p<0.001), and total duration of breast-feeding (p<0.001) for femoral neck BMD. CONCLUSIONS: This study showed significant associations between total duration of breast-feeding and BMD. In conclusion, total duration of breast-feeding might be an important risk factor besides age, weight, and years since menopause in postmenopausal osteoporosis.

The arterial vascularization of septum interventriculare in donkeys (Equus asinus L.).

In this study, arteries that supply the septum interventriculare in donkeys, their course and variations, if present, were defined. Six hearts belonging to donkeys of varying age and sex constituted the material of the study. In order to expose the arteries, latex coloured with Rotring ink was injected into a. coronaria sinistra and a. coronaria dextra and dissection was performed. The arterial vascularization of the heart in donkeys is supplied by a. coronaria sinistra and a. coronoria dextra, which have their origin at the aorta. A. coronaria sinistra gives off two branches: one is ramus interventricularis paraconalis, which extends into the sulcus interventricularis paraconalis and the other is ramus circumflexus sinister, which lies within the sulcus coronarius. A. coronaria dextra is formed by the union of ramus interventricularis subsinuosus and ramus circumflexus dexter. Septum interventriculare is supplied by rr. septales, which originate from ramus interventricularis paraconalis, a branch of a. coronaria sinistra, as well as rami septales which have their origin in ramus interventricularis subsinuosus, a branch of a. coronaria dextra.

The macroanatomy of coronary arteries in donkeys (Equus asinus L.).

The aim of this study was to define the arteries that supply the cardiac muscle in donkeys with regard to their course and possible variations. Six hearts belonging to donkeys of different age and sex constituted the material of the study. Following exposition of the arteries by means of injection of latex coloured with Rotring ink to a. coronaria sinistra and a. coronaria dextra, dissection was performed. The arterial vascularization of the heart in donkeys was determined to be supplied by a. coronaria sinistra and a. coronaria dextra which originate from the aorta. A. coronaria sinistra, measured to be larger than a. coronaria dextra, was determined to have its origin at the aorta, at the level of the free border of valvula semilunaris sinistra, and to extend between truncus pulmonalis and auricula sinistra. The mentioned artery was detected to give off two branches, namely, ramus interventricularis paraconalis and ramus circumflexus sinister which extend in sulcus interventricularis paraconalis and sulcus coronarius, respectively. However, a. coronaria dextra was determined to have its origin at the beginning of the aorta, at the level of valvula semilunaris dextra, and to extend to margo ventricularis dexter between truncus pulmonalis and auricula dexter. This study has revealed ramus interventricularis subsinuosus and ramus circumflexus dexter to intercommunicate by means of anastomosis and to form a. coronaria dexter. Examination of material revealed the absence of anastomosis between r. circumflexus sinister and r. circumflexus dexter. Branches named rami septales, originating from ramus interventricularis paraconalis and ramus interventricularis subsinuosus were determined to supply septum interventriculare. Ramus proximalis atrii sinistri was determined to have its origin at ramus circumflexus sinister whereas ramus proximalis venriculi dextri was determined to stem from the beginning of a. coronaria dextra in the material of this study. However, examination of the cranial and caudal branches of ramus coni arteriosi, revealed the cranial branch to be ramus proximalis ventriculi dextri in a cadaver.

On the gross anatomy of the cranial cervical ganglion of the donkey (Equus asinus) in Turkey.

The cranial cervical ganglion comprises neurons of especial functional importance for the head. Six specimens of heads of adult donkeys of both sexes, all of which had been exsanguinated and perfused with 10% neutral formalin for teaching purposes, were dissected to derive a gross description of the location, arrangement and branches of the cranial cervical ganglion (ganglion cervicale craniale) bilaterally. The ganglion was irregular fusiform-shaped or flattened, and reddish-grey in colour. It was 1.9-2.1 mm in length and 0.7-0.8 mm in thickness. The ganglion was located beneath the mandibular gland, caudal to the ramus of the mandible and diverticle of the guttural pouch, and ventral to the atlanto-axial joint. The branches of the ganglion were the internal and external carotid nerves, the jugular nerve, and a branch communicating with the ventral branch of the first cervical nerve fibres.

A detailed subgross morphometric study on the auditory ossicles of the New Zealand rabbit.

This study was designed to reveal, in detail, the features of the auditory ossicles of the New Zealand rabbit, one of the most frequently used animals in scientific researches. Heads of 10 dead adult New Zealand rabbits of both sexes weighing 2.5 +/- 0.2 kg were used in the study. The auditory ossicles were gently removed from their situs and observed. The auditory ossicles were three small bones: the malleus, the incus and the stapes. The lenticular bone seemed to be the lenticular process, as is in human beings. In general, macroanatomic features of the bones were similar to those reported in the literature. Findings in this study, however, differed greatly, especially in detail. There were statistically significant differences in the morphometric data of the features of the auditory ossicles between the right- and left-hand sides. Data from the right-hand side were significantly higher.

The origin and course of the greater, lesser and least thoracic splanchnic nerves in New Zealand rabbits.

In this study, the origin and course of the greater, lesser and least splanchnic nerves was investigated in 12 adult New Zealand rabbits with regard to sex and the side of the body. There were no significant differences between the female and male rabbits. The greater and lesser splanchnic nerves were present in all the cadavers examined. However, the least splanchnic nerve was found on the right side in 50% of the cadavers (nos. 2, 4, 6, 7, 11 and 12), and on the left side in 75% (1, 2, 4, 6, 7, 8, 9, 11 and 12). With regard to the origin and pattern of the greater, lesser and least splanchnic nerves, there were significant differences between the right and left sides of the body even in the same rabbit. No significant difference was observed between sexes.

Arterial vascularization of the pineal gland in the fetus of Zavot-bred cattle.

This study aimed at revealing arterial vascularization of the pineal gland of the Zavot-bred foetus. Twenty foetuses, regardless of their sex, at the age of 2-7 months were used. Coloured-latex was injected by way of both the right and left common carotid arteries. Then, dissection was performed and vessels nourishing the pineal gland were documented. The pineal gland is vascularized by a number of 2-5 central rami. A small vessel arising from each of the central rami in two foetuses (10%) was shown anastomosing with a branch of the cranial cerebral artery, which advances in cranio-caudal direction in the callosal groove. Hence, anastomoses were observed between several sub-branches of each caudal cerebral and cranial cerebellar arteries.

Arterial supply of the penis in the New Zealand rabbit (Oryctolagus cuniculus L.).

In the present study, the distributional pattern of the penile artery and the vessels joining the blood supply of the penis were investigated in the New Zealand rabbit. Eight adult rabbits were used in the study. In order to exhibit the vascular network by dissection, latex was injected via the abdominal aorta. The main vessel which supplies blood to the penis, the penile artery, is a branch of the internal pudendal artery. It divides into two branches which form the deep and dorsal penile arteries at the level of the ischiadic arch. The deep penile artery penetrates the tunica albuginea, and forms the arterial network of corpus cavernosum penis. On the other hand, the dorsal penile artery gives off three small branches for the subischiocavernosus muscle and at the level of the attachment of this muscle sends two small branches for the preputium. The course of both arteries follows the dorsolateral surface of the penis to the glans and ends in an anastomosis. Hence, a caudal branch of the prostatic artery which originates from the umbilical artery joins the blood supply of the penis in the rabbit. After vascularizing the prostate complex, it ends by entering the corpus spongiosus penis at the dorsolateral surface at the level of the ischiadic arch.

The role of botulinum toxin a in the management of lower limb spasticity in patients with cerebral palsy.

This study aimed to determine the effects of botulinum toxin-A (btA) on spasticity in children with cerebral palsy (CP). Thirty-five children with spastic CP were evaluated. The injection group consisted of 25 patients who were injected with btA and received conventional physical therapy. The control group consisted of 10 patients who were treated with conventional physical therapy only. In the injection group, btA was applied to the lower extremity spastic muscles at a total dose of 8-10 lU/kg. Spasticity was measured by the Ashworth scale. Gait function was evaluated by clinical gait assessment in all patients and temporal distance factors in 16 patients. All the parameters were recorded before treatment, after three days and after one month of therapy. Following injection of btA, significant improvement in all parameters was observed. No statistically significant progression was noted in the control group except clinical gait analysis scores. Comparing the three-day and one-month measurements of spasticity of the two groups, statistically significant results were obtained in favour of the injection group in all parameters except for clinical gait analysis scores. The findings of this study showed btA injection to be an effective treatment for reducing spasticity and improving gait function in patients with spastic CP

Electromyographic biofeedback-controlled exercise versus conservative care for patellofemoral pain syndrome.

OBJECTIVE: To determine the effects of electromyographic biofeedback treatment in patients with patellofemoral pain syndrome. DESIGN: Randomized controlled trial. SETTING: A physical medicine and rehabilitation department in a research hospital of a university referral center. PATIENTS: Sixty patients with patellofemoral pain syndrome. Patients were randomly placed into 2 groups: biofeedback group (n = 30) and a control group (n = 30). INTERVENTION: The biofeedback group received electromyographic biofeedback training and a conventional exercise program, whereas the control group received a conventional exercise program only. MAIN OUTCOME MEASURES: Maximum and mean contraction values of the vastus medialis and the vastus lateralis muscles were assessed with the biofeedback device. Pain and functional status of the patients were measured by a visual analog scale (VAS) and the Functional Index Questionnaire (FIQ), respectively. RESULTS: Contraction values improved significantly at the end of the first month, compared with the pretreatment values in both groups. Mean contraction values in the biofeedback group of the vastus medialis muscles in all 3 monthly measurements, and the vastus lateralis muscles at the end of the first month, were significantly higher than those of the control group. Significant improvements were shown for both the VAS and the FIQ in both groups. Monthly follow-ups showed no VAS and FIQ differences between the groups. CONCLUSION: Electromyographic biofeedback treatment did not result in further clinical improvement when compared with a conventional exercise program in patients with patellofemoral pain syndrome.