Background: The value of radiological measurements of subcoracoid impingement such as the coracohumeral interval in predicting subscapularis tendon injuries is controversial. We aimed to assess the relationship between radiological measurements of subcoracoid impingement and subscapularis tendon lesions in young and middle-aged adults. Methods: This study was designed as a retrospective cohort study. Patients between the ages of 18–55 years without a history of shoulder surgery or major trauma were included and patients with arthritis, instability, or retracted rotator cuff tears were excluded from the study. Magnetic resonance images were evaluated and patients were grouped into two according to the subscapularis tendon condition: normal or pathologic. Glenoid version, axial coracohumeral distance, coracoglenoid angle, coracoid index, sagittal coracoid-glenoid tubercule distance, and axial coracoacromial inclination-glenoid version difference were measured for all patients. Measurement findings were compared between the groups. Correlation analysis was performed for age and radiologic measurements. A p < 0.05 was considered statistically significant for all tests. Results: A total of 298 patients, 107 women (35.1%) and 191 men (64.9%), with a mean age of 34.46 ± 10.10 years (range, 18–55 years) were examined in the study. Subscapularis tendon pathology was noted in 85 patients (28.5%). The diagnosed pathologies were tendinosis in 48 patients (56.5%), partial tears in 28 (32.9%), and full thickness tears in 9 (10.6%). A significant relationship was observed between increasing age and subscapularis tendon lesions (p = 0.001). There was no statistically significant relationship between subscapularis pathology and calculated measurements. Axial coracohumeral distance and coracoglenoid angle measurements showed a statistically significantly negative correlation with age. A positive correlation was found between axial coracohumeral distance and coracoglenoid angle measurements (p < 0.001) and also between glenoid version and coracoid index measurements (p = 0.004). Axial coracohumeral distance and coracoglenoid angle measurements showed a negative correlation with glenoid version and coracoid index measurements (p < 0.05). Conclusions In this study, the coracohumeral distance and coracoglenoid angle decreased and the incidence of subscapularis tendon lesions increased as the age progressed. However, no relationship was found between radiological measurements and subscapularis tendon lesions.

A 19-year-old man presented with long lasting significant back and bilateral leg pain, and hypoesthesia on the lateral side of both his thighs for which he had undergone several courses of medication and bouts of physical therapy treatment. His urodynamic parameters were normal and lumbar magnetic resonance imaging (MRI) revealed a low-lying conus at the L2-3 level with a thickened fatty filum, and he was diagnosed as having tethered cord syndrome (TCS). The patient underwent a fully endoscopic detethering through an interlaminar approach with intraoperative neurophysiological monitoring. The thickened filum terminale was located and then the filum was coagulated and cut. The patient showed a significant improvement in his preoperative symptoms, and reported no problems at 2-year follow-up. Detethering of the spinal cord in tethered cord syndrome using a fully endoscopic interlaminar approach provides the advantages of minimal damage to tissues, less postoperative discomfort, early postoperative recovery, and a shorter hospitalization.
Cauda Equina ; Conus Snail ; Follow-Up Studies ; Hospitalization ; Humans ; Hypesthesia ; Intraoperative Neurophysiological Monitoring ; Leg ; Magnetic Resonance Imaging ; Neural Tube Defects* ; Spinal Cord* ; Thigh ; Urodynamics ; Young Adult

PURPOSE: To evaluate whether alterations in plasma vitamin A and E levels in patients with psoriasis have an effect on tear film changes. METHODS: Sixty-two eyes of 31 patients with psoriasis vulgaris (Group A) and 74 eyes of 37 age- and gender-matched control subjects (Group B) were included in the study. Ocular and medical histories and dietary habits were obtained from each patient. The tear film break-up time (TBUT), the Schirmer 1 test results and plasma vitamin A and E levels were evaluated. RESULTS: The mean Schirmer 1 test score was 14.76 +/- 6.12 mm/5 min in Group A and 15.69 +/- 3.10 mm/5 min in Group B. The mean plasma levels of vitamins A and E in Groups A and B were 1.86 +/- 0.62 micromol/L and 1.88 +/- 0.65 micromol/L vs. 26.21 +/- 5.13 micromol/L and 27.19 +/- 8.89 micromol/L, respectively. The Schirmer 1 test results and plasma vitamin A and E levels were not found to be significantly different between the groups (p > 0.05). The mean TBUT was 9.94 +/- 6.18 seconds in Group A and 14.47 +/- 5.65 seconds in Group B, a significant difference (p < 0.05). No correlation existed between plasma vitamin A and E levels, TBUT or the severity and duration of the disease (p > 0.05). CONCLUSIONS: Plasma vitamin A and E levels do not seem to be related to tear film changes in patients with psoriasis vulgaris.
Adolescent ; Adult ; Female ; Humans ; Male ; Middle Aged ; Mucins/*metabolism ; Psoriasis/*metabolism ; Tears/*metabolism ; Vitamin A/*blood ; Vitamin E/*blood ; Young Adult

OBJECTIVES: Evaluation of a new material, high-density porous polyethylene (HDPP), which is covered with fascia lata, for experimental nasal septal perforation closure. METHODS: Twenty New Zealand albino rabbits were included and divided into study and control groups. A lateral incision was made from the lateral aspect of the left nares to the incisura nasomaxillaris. After exposure of the cavum nasi, the nasal mucoperichondrium was elevated bilaterally. A full-thickness 0.5x0.5-cm perforation was created over the septum nasi with a No. 11 surgical blade. A fascia lata graft was used for the study group. The HDPP was covered with fascia lata and placed under the elevated mucosa. HDPP without a fascial covering was used in the control group. Four months after the procedure, magnetic resonance imaging was performed to evaluate resorption of the material. The animals were sacrificed, and the nasal septum was completely removed. Macroscopic and histopathological examinations were performed on the nasal septum. RESULTS: All rabbits had survived after the 4-month period. Macroscopically, nine of 10 (90%) perforations were closed in the fascia lata-covered HDPP group. Histopathological examination of these nine rabbits revealed that the continuity of cartilage was disturbed in the perforation areas. Granulation tissue was inverted in areas in which the cartilage continuity was disturbed. The HDPP had remained intact at the edge of the perforation. In the HDPP group, six of 10 implants were still perforated (60%) and four (40%) were closed. The fascia lata-covered HDPP implant had a significantly higher perforation closure rate than that of the HDPP implant alone (P<0.05). CONCLUSION: In cases of septal perforation, it is better to cover the HDPP implant with fascia lata. This covered implant can be used for the repair of nasal septal perforations. HDPP implants are easy to work with and avoid the increased operative time and morbidity associated with harvesting autografts.
Animals ; Cartilage ; Fascia ; Fascia Lata ; Granulation Tissue ; Magnetic Resonance Imaging ; Mucous Membrane ; Nasal Septal Perforation ; Nasal Septum ; New Zealand ; Operative Time ; Polyethylene ; Polyethylenes ; Pyridones ; Rabbits ; Transplants

PURPOSE: Pelvic organ prolapse is a multifactorial disorder in which extracellular matrix defects are implicated. Fibrillin-1 level is reduced in stress urinary incontinence. In Marfan syndrome, which is associated with mutations in Fibrillin-1, pelvic floor disorders are commonly observed. We hypothesize that Fibrillin-1 gene expression is altered in pelvic organ prolapse. METHODS: Thirty women undergoing colporrhaphy or hysterectomy because of cystocele, rectocele, cystorectocele, or uterine prolapse were assigned to a pelvic prolapse study group, and thirty women undergone hysterectomy for nonpelvic prolapse conditions were assigned to a control group. Real-time polymerase chain reaction was conducted on vaginal tissue samples to measure the expression of Fibrillin-1. Expression levels were compared between study and control groups by Mann-Whitney U test with Bonferroni revision. RESULTS: Fibrillin-1 gene expression was not significantly lower in the study group than in the control group. Similarly, no significant correlation between Fibrillin-1 levels and grade of pelvic prolapse was found. Age over 40 years (P=0.018) and menopause (P=0.027) were both associated with reduced Fibrillin-1 levels in the pelvic prolapse group, whereas the delivery of babies weighing over 3,500 g at birth was associated with increased Fibrillin-1 expression (P=0.006). CONCLUSIONS: The results did not indicate a significant reduction in Fibrillin-1 gene expression in pelvic prolapse disorders; however, reduced Fibrillin-1 may contribute to increased pelvic organ prolapse risk with age and menopause. Increased Fibrillin-1 gene expression may be a compensatory mechanism in cases of delivery of babies with high birth weight. Further studies are needed for a better understanding of these observations.
Birth Weight ; Cystocele ; Extracellular Matrix ; Female ; Gene Expression ; Humans ; Hysterectomy ; Marfan Syndrome ; Menopause ; Parturition ; Pelvic Floor Disorders ; Pelvic Organ Prolapse* ; Prolapse ; Real-Time Polymerase Chain Reaction ; Rectocele ; Urinary Incontinence ; Uterine Prolapse