Use of ultrasonography in ulnar nerve entrapment surgery—a prospective study

The purpose of our study is to assess the usefulness of high-resolution ultrasonography in observing the morphology and dynamics of the ulnar nerve in the cubital tunnel and also the efficacy of ultrasonography in a more accurate diagnosis and appropriate surgical treatment decision. Cross-sectional area of the ulnar nerves of 40 healthy volunteers in the control group were measured bilaterally at the level of the epicondyle, 2 cm proximal to and 2 cm distal to the epicondyle. Measurements were obtained for elbows both in extension and flexion. Then, we prospectively obtained the cross-sectional area values of 18 patients at the same levels, elbows in extension and flexion position, and compared the data obtained from the patient group and the control group. The differences between the cross-sectional areas of the ulnar nerves in extension and flexion were statistically significant in the patient population (p < 0.001). Mean cross-sectional area of the ulnar nerve in the patient population was calculated as 0.16 cm², and we accepted the cut-off point as 0.1 cm². This value for cross-sectional area yielded a sensitivity of 90% and a specificity of 100% in diagnosis of ulnar nerve entrapment. Results substantiated conspicuous morphological changes in ulnar nerve during flexion and extension of the elbow. We also observed that as the degree of the nerve displacement by virtue of elbow flexion that is discerned by ultrasonography increased, a more aggressive decompressive surgery was needed for an appropriate treatment.     

Propagation of the uncertainties of sample position to the uncertainty of the counting efficiency in gamma-ray spectrometry.

The uncertainties generated by inaccurate positioning of homogeneous cylindrical samples are propagated into the uncertainty of the counting efficiency. In this work general expressions describing the uncertainty of the counting efficiency in terms of the sample and detector properties are derived. The uncertainty of the counting efficiency generated by the uncertainty of the sample-detector distance is evaluated using the point detector concept. The uncertainty generated by the displacement of the symmetry axes of the sample and the detector is evaluated using the empirical radial dependence of the efficiency for point sources. Results are presented for some counting geometries resembling counting conditions frequently used in actual measurements. The results of the evaluations are compared to experimentally measured results and are briefly discussed.     

Propagation of uncertainties in sample properties to the uncertainty of the counting efficiency in gamma-ray spectrometry.

Explicit expressions are derived describing the variance of the counting efficiency for a homogeneous cylindrical sample, placed coaxially on the detector's symmetry axis, in terms of the variances of the sample properties thickness, density and composition. In the derivation, the emission of gamma-rays parallel to the sample axis and the efficiency for an area source proportional to the solid angle subtended by the source from the effective point of interaction of the gamma-rays within the detector crystal are assumed. For the uncertainties of the mass attenuation coefficients, as well as for the uncertainties of concentrations of admixtures to the sample matrix, constant relative uncertainties are assumed.     

Preparation of sulfonated overoxidized polypyrrole film applicable as an SPME tool for cationic analytes

The use of a solid-phase microextraction (SPME) method with a new design of functionalized stable overoxidized sulfonated polypyrrole (OSPPy) film electrode to extract metal ions (Ni(II) and Cd(II)) without derivatization from water of high saline content is described. Different cation uptake behavior is obtained for OSPPy and overoxidized polypyrrole. The cation uptake and release properties of the OSPPy film electrode were examined under both open circuit and controlled potential conditions for prospective applications in electrochemically controlled solid-phase microextraction (EC-SPME). The cation uptake is enhanced if a positive potential is applied to the electrode. Accumulated cations are released rapidly from the film if the applied potential is switched to a negative value. The cation uptake and release mechanism is affected both by the cation exchange at the negative sulfonate and carboxylate groups on the film and by the altered solution pH occurring at the counter electrode caused by the applied potential. Scanning electron microscopy (SEM) and energy dispersive X-ray analysis (EDAX) measurements on the two films have confirmed the presence of a sulfur content in the films and shown that covalently bound sulfonate preferentially dopes the polymer even in the presence of a large excess of BF₄^? anions. Our preliminary fundamental results show that this new polymer offers a wide potential range for electroanalytical exploration from selective electrodes to separation and/or preconcentration sampling devices.     

V–Y advancement flap closures for complicated pilonidal sinus disease

Background and aims Hair entry into the midline is the generally accepted theory in pilonidal sinus formation. This theory is also involved in the pathogenesis of the recurrence after different types of operations for pilonidal sinus disease. The relationship of the suture lines and the midline was evaluated in this study.Patient and methods Thirty-four patients with stage 4 or recurrent pilonidal sinus disease who underwent V–Y advancement flap closure were randomized into two groups: vertical suture line unrelated to midline (VLUM, n=18) and vertical suture line related to midline (VLRM, n=16).Results None of the patients with or without a suction drain developed flap necrosis, local haematomas or seromas. The median length of the postoperative hospital stay was 3 days for theVLRM group and the VLUM group (p>0.05). The median follow-up period was 32 months. During the follow-up period, two recurrences were determined 22 and 15 months after operation in the VLRM group. Recurrences were situated in the scar tissue over the midline.Interpretation and conclusion Routine application of suction drains is not recommended after V–Y advancement flap closure. Avoidance of the relationship of the postoperative suture line and the midline, if possible, offers a safe method of definitive reconstruction.     

Two siblings with fulminant viral hepatitis A: case report

Fulminant hepatitis is a rare complication of acute hepatitis A infection. Nevertheless, the seroepidemiology of the infection is rapidly changing with the developing world, rendering more adults susceptible to the infection, in particular with more severe course. We report here fulminant hepatitis A infection with a mortal course during an epidemic period in two siblings. Although it causes a self-limited mild disease, hepatitis A virus may have a severe course including fulminant hepatitis and may lead to mortality, especially in older ages. Hence, the risk of hepatitis A virus infection and its complications should be reduced with measures of immunization and sanitation.     

Assessment of atrial conduction time by tissue Doppler echocardiography and P-wave dispersion in smokers

Introduction

The aim of this study was to evaluate the relationship between cigarette smoking and atrial rhythm disorders with the use of noninvasive methods.

Methods

The study population consisted of 50 healthy volunteer smokers and 40 healthy volunteer non-smokers who had normal echocardiographic parameters and similar sex and age profiles. P-wave dispersion (PWD) was calculated from the 12-lead surface ECG. Left ventricle (LV) end-systolic and end-diastolic diameters, LV ejection fraction, and interatrial and intraatrial electromechanical delay were measured by tissue Doppler imaging and conventional echocardiography.

Results

Isovolumetric relaxation time and deceleration time were significantly higher (91.5?±?11 vs. 82.35?±?8.6, p?p?p?=?0.003). There were no significant differences between the groups with respect to Sm and Em values, Am value, and E/A and E/Em ratios. However, the Em/Am ratio was significantly lower in smokers (1.28?±?0.21 vs. 1.44?±?0.33, p?p?p?r?=?0.567, p?r?=?0.653, p?=?0.001).

Conclusion

We have demonstrated the relationship between inter- and intraatrial electromechanical delay and PWD. These parameters may be useful predictive markers for the development of AF in the asymptomatic period before cardiac rhythm disturbances occur. This finding may indicate that smokers have an increased risk of developing atrial rhythm disturbances.     

Ghrelin expression in normal kidney tissue and renal carcinomas

Ghrelin expression in cancers is either reduced/absent or increased depending on the organs involved. The aims of this study were to investigate: (i) whether there are differences in ghrelin peptide expression between kidney tissues from a series of renal cell carcinoma cases, oncocytomas, and normal controls; (ii) whether there are correlations between tissue ghrelin levels in a series of renal carcinoma cases and normal controls; and (iii) how normal is kidney ghrelin expression per mg tissue as compared with the normal stomach tissue ghrelin level. We studied 7 normal stomach and 7 normal kidney samples, 21 clear cell renal carcinomas, 7 chromophobe type renal cell carcinomas (RCC), 7 papillary type RCC, and 7 oncocytoma samples. Tissue ghrelin expression was measured by RIA and immunohistochemistry. Grades 1–3 clear renal cell carcinomas, chromophobe type RCC, papillary type RCC, and oncocytomas expressed 88%, 94%, 95%, 51%, 75%, and 48% less ghrelin than the normal kidney, respectively. Overall, we concluded that ghrelin expression in renal cell carcinoma tissues is always lower than that in normal kidney or is absent. This low level or lack of ghrelin may play a role in the etiopathogenesis and progression of cancer.