Subungual osteochondroma: a diagnostic dilemma

Osteochondroma is the most common skeletal neoplasm of all benign bone tumors. However, it rarely occurs subungually. In this location, the lesion may penetrate the skin, causing nail deformity, and can easily be misdiagnosed. We report two cases of subungual osteochondroma of the distal phalanges of the first toes with cutaneous penetration and discuss the clinical, histologic, and radiographic features and the treatment options.     

Forces at single point attached commissures (SPAC) in pericardial aortic valve prosthesis.

OBJECTIVE: New pericardial aortic bioprostheses (3F Therapeutics and temporarily stented autologous pericardial valve prosthesis) were developed recently. These valves are designed with commissures connected to the aortic wall at only three single points (single point attached commissures (SPAC)). The aim of this study was to investigate the forces acting on SPAC during varying pressure load. METHODS: Aortic roots with diameters 19, 25, and 29 mm were made using silicone polymer. A bovine pericardial SPAC aortic valve prosthesis was constructed using a 3D-mold and was implanted in the silicone aortic root. The base of the valve was sutured onto the aortic annulus with 4-0 polypropylene running suture and each commissure was sutured to a miniaturized force transducer with only one 3-0 polypropylene U-stitch. Three silicon aortic roots of each size were pressurized up to 200 mmHg and forces on SPAC were measured. RESULTS: All valves remained competent at a pressure of 200 mmHg. Recordings showed a linear correlation between applied pressure and forces measured at SPAC. At a pressure of 80 mmHg (equivalent to diastolic pressure), the forces were 0.44+/-0.22N, 1.15+/-0.18N, and 2.00+/-0.35N in annular diameters 19 mm, 25 mm, and 29 mm, respectively. It was observed, that the main forces were acting along the axial direction and not along the radial direction. CONCLUSIONS: Forces on "single point attached commissures" in pericardial aortic valves were measured. These forces were acting mainly in axial direction and not in radial direction. This knowledge is important for the implantation technique of SPAC pericardial aortic valves.     

Urokinase plasminogen activator receptor levels in Behcet's disease

Purpose

To determine urokinase plasminogen activator receptor (uPAR) concentrations in Behcet patients with and without ocular involvement; and to investigate the associations between uPAR levels and clinical manifestations of Behcet's disease.

Methods

Sixty-four patients with Behcet's disease (31 patients with and 33 patients without ocular involvement) and 23 healthy control subjects were included in this study. A complete ophthalmologic examination was performed. Venous blood was collected from all patients and control subjects. Serum uPAR levels were determined by using human uPAR immunoassay (Quantikine) kits.

Results

There was no statistically significant difference in serum uPAR levels between the patients and the control subjects (p > 0.05). There were no statistically significant correlations between uPAR levels and age, gender, duration of the disease, clinical manifestations (genital ulcer, arthritis, skin lesions, ocular and vascular involvements) and activity of the disease.

Conclusion

This finding is important since this is the first study regarding uPAR levels in Behcet's disease.     

Dialysate CA125 levels after 5 years on continuous peritoneal dialysis

The aim of this study was to evaluate longitudinal changes in dialysate cancer antigen 125 (dCA125) levels over time and to analyze relationships between dCA125 and peritoneal glucose exposure (PGE) in children undergoing long-term peritoneal dialysis (PD). The study group included seven boys and four girls (mean age 13 ± 5.1 years) with a mean PD duration of 84.0 ± 1.1 months. A peritoneal equilibration test (PET) was performed, and dCA125 levels were measured in all patients. Peritoneal appearance rates (AR) of dCA125, the velocity of the decrease in dCA125AR values, and annual PGE levels were also calculated. The final tests were performed at a mean of 63.3 ± 3.5 months after the initial ones. Both dCA125 and dCA125AR levels showed statistically significant decrements during the follow-up period (p = 0.003), with the velocity of decrease in dCA125AR found to be 52.6 ± 19.4%. There were no significant differences in peritoneal transport parameters between the beginning and end of the study period. PGE values were significantly higher in the last year of the study than in the first year (p = 0.014), but the velocity of the decrease in dCA125AR levels was not related to total PGE. In conclusion, a significant decline was found in dCA125 and CA125 AR levels, reflecting mesothelial cell mass, in children undergoing long-term PD (>5 years), but these were not related to PGE.