The first extensor compartment of the wrist is a distinctly variable anatomical area. Anatomical variations in this region contribute to the pathophysiology and treatment failure of de Quervain’s disease, which is a kind of tenosynovitis that develops in the first extensor compartment of the wrist. We aim to describe the first extensor compartment morphology, to evaluate the septum frequency, location of the septum, and the number of tendons of abductor pollicis longus (APL) and extensor pollicis brevis muscles (EPB). First extensor compartment of 87 wrists of 45 cadavers were dissected. The presence or absence of septum and number of tendon slips of APL and EPB revealed. The proximal and distal widths of the compartments were measured. Septums were detected in 60.9% (n=53) of the wrists. Incomplete (distal) and complete (proximal) septa were present in 35.6% (n=31) and 25.3% (n=22) of the cases. Only 26.4% of the wrists had a single slip of APL tendon. The Remaining had multiple slips. The median inner width of the proximal and distal compartments in all wrists were calculated as in the order of 9.11±1.14 mm and 8.55±1.12 mm. We believe that understanding the anatomy of the first extensor compartment in the Turkish population would be helpful to surgeons, radiologists, and physiotherapists to diagnose and manage de Quervain’s disease.

OBJECTIVE: Findings about inflammatory processes in schizophrenia are increasing day by day. Inflammatory processes in schizophrenia are associated with both its etiology and clinical symptoms. Serum high-sensitivity C-reactive protein (hsCRP) is also one of these inflammatory processes. Particularly, it is thought to be closely related to clinical findings of patients with schizophrenia. METHODS: In this study, the relationship between clinical findings of hsCRP levels of patients with drug-naïve first-episode psychosis (FEP) and patients with schizophrenia in acute exacerbation phase is investigated. Clinical findings, psychometric properties (the Scale for the Assessment of Positive Symptoms, the Scale for the Assessment of Negative Symptoms, Brief Psychiatric Rating Scale), and hsCRP levels of patients were compared. RESULTS: Forty-eight patients with FEP, 74 patients with schizophrenia in acute exacerbation phase and 54 healthy controlled volunteers are included in the study. The most substantial finding in the study is that there is a positive correlation between hsCRP levels and severity of positive symptoms of both patient groups, with FEP and with schizophrenia. The second most substantial finding is there is no significant difference between patients with FEP and schizophrenia, in terms of hsCRP. CONCLUSION: The relationship between hsCRP and positive symptom severity in two groups of patients supports the inflammatory hypothesis in the etiopathogenesis of schizophrenia. This finding is supportive of close relation between inflammatory processes and clinical findings of patient with schizophrenia.
C-Reactive Protein ; Humans ; Polytetrafluoroethylene ; Psychometrics ; Psychotic Disorders ; Schizophrenia ; Volunteers

OBJECTIVE: To assess the prognosis of surgically-staged non-invasive uterine clear cell carcinoma (UCCC), and to determine the role of adjuvant therapy. METHODS: A multicenter, retrospective department database review was performed to identify patients with UCCC who underwent surgical treatment between 1997 and 2016 at 8 Gynecologic Oncology Centers. Demographic, clinicopathological, and survival data were collected. RESULTS: A total of 232 women with UCCC were identified. Of these, 53 (22.8%) had surgically-staged non-invasive UCCC. Twelve patients (22.6%) were upstaged at surgical assessment, including a 5.6% rate of lymphatic dissemination (3/53). Of those, 1 had stage IIIA, 1 had stage IIIC1, 1 had stage IIIC2, and 9 had stage IVB disease. Of the 9 women with stage IVB disease, 5 had isolated omental involvement indicating omentum as the most common metastatic site. UCCC limited only to the endometrium with no extra-uterine disease was confirmed in 41 women (73.3%) after surgical staging. Of those, 13 women (32%) were observed without adjuvant treatment whereas 28 patients (68%) underwent adjuvant therapy. The 5-year disease-free survival rates for patients with and without adjuvant treatment were 100.0% vs. 74.1%, respectively (p=0.060). CONCLUSION: Extra-uterine disease may occur in the absence of myometrial invasion (MMI), therefore comprehensive surgical staging including omentectomy should be the standard of care for women with UCCC regardless of the depth of MMI. Larger cohorts are needed in order to clarify the necessity of adjuvant treatment for women with UCCC truly confined to the endometrium.
Adenocarcinoma, Clear Cell ; Chemotherapy, Adjuvant ; Cohort Studies ; Disease-Free Survival ; Endometrium ; Female ; Humans ; Neoplasm Invasiveness ; Omentum ; Prognosis ; Retrospective Studies ; Standard of Care ; Uterine Diseases

OBJECTIVE: To determine factors influencing overall survival following recurrence (OSFR) in women with low-risk endometrial cancer (EC) treated with surgery alone. METHODS: A multicenter, retrospective department database review was performed to identify patients with recurrent “low-risk EC” (patients having less than 50% myometrial invasion [MMI] with grade 1 or 2 endometrioid EC) at 10 gynecologic oncology centers in Turkey. Demographic, clinicopathological, and survival data were collected. RESULTS: We identified 67 patients who developed recurrence of their EC after initially being diagnosed and treated for low-risk EC. For the entire study cohort, the median time to recurrence (TTR) was 23 months (95% confidence interval [CI]=11.5–34.5; standard error [SE]=5.8) and the median OSFR was 59 months (95% CI=12.7–105.2; SE=23.5). We observed 32 (47.8%) isolated vaginal recurrences, 6 (9%) nodal failures, 19 (28.4%) peritoneal failures, and 10 (14.9%) hematogenous disseminations. Overall, 45 relapses (67.2%) were loco-regional whereas 22 (32.8%) were extrapelvic. According to the Gynecologic Oncology Group (GOG) Trial-99, 7 (10.4%) out of 67 women with recurrent low-risk EC were qualified as high-intermediate risk (HIR). The 5-year OSFR rate was significantly higher for patients with TTR ≥36 months compared to those with TTR <36 months (74.3% compared to 33%, p=0.001). On multivariate analysis for OSFR, TTR <36 months (hazard ratio [HR]=8.46; 95% CI=1.65–43.36; p=0.010) and presence of HIR criteria (HR=4.62; 95% CI=1.69–12.58; p=0.003) were significant predictors. CONCLUSION: Low-risk EC patients recurring earlier than 36 months and those carrying HIR criteria seem more likely to succumb to their tumors after recurrence.
Cohort Studies ; Endometrial Neoplasms* ; Female ; Humans ; Multivariate Analysis ; Neoplasm Recurrence, Local ; Recurrence* ; Retrospective Studies ; Survival Analysis ; Turkey