An alternative method for restoring opposition after median nerve injury: an anatomical feasibility study for the use of neurotisation

Opposition, one of the most important functions of the hand, is lost or impaired after median nerve injury. Complete recovery does not always occur after treatment, and various techniques of opponensplasty are used for restoring opposition. This study was performed in order to develop an alternative method for selective restoration of thenar muscle function. Ten arms from 5 cadavers were used. The median nerve with its thenar motor branch (Tb) and the anterior interosseous nerve with its motor branch to pronator quadratus (PQb) were prepared in the distal forearm. The mean widths and the number of myelinated fibres of these nerves were: PQb 1.3±0.10 mm, Tb 1.4±0.12 mm and PQb 912±88 mm, Tb 1020±93 mm. The minimum necessary distance from the distal flexor crease of the wrist for neurotisation of the Tb by the PQb was 60±5.41 mm. It was concluded that PQb-Tb neurotisation would be possible anatomically. The advantages are that motor function is reestablished with a motor nerve, the diameters and the number of myelinated fibres of both nerves are similar, the loss of function after denervation of the pronator quadratus is slight and opponensplasty still remains as a final option.     

The effects of thymostimulin on immunological function in patients with head and neck cancer

Patients with head and neck carcinoma show deficits of cellular immunity, probably due to low molecular mass factors (LMMFs) released by the tumour. Thymostimulin (TP1) restores the defective monocyte chemotaxis and dendritic cell clustering capability in the presence of the tumour when administered pre-operatively. In the present study we investigated these immune parameters in 39 patients treated with TP1 for 10 days pre- and 6 months post-operatively and in 22 patients who were not treated with TP1 for 6 months after operation. Removal of the tumour in non-TP1-treated patients also resulted in a restoration of monocyte and dendritic cell functions, while TP1 treatment gave no additional effect. LMMF levels in the blood of both TP1-treated and non-TP1-treated patients remained elevated even after removal of the tumour, and it is therefore concluded that it is unlikely that depression of cellular immunity is a direct effect of these LMMFS.     

An alternative method for restoring opposition after median nerve injury: an anatomical feasibility study for the use of neurotisation

Opposition, one of the most important functions of the hand, is lost or impaired after median nerve injury. Complete recovery does not always occur after treatment, and various techniques of opponensplasty are used for restoring opposition. This study was performed in order to develop an alternative method for selective restoration of thenar muscle function. Ten arms from 5 cadavers were used. The median nerve with its thenar motor branch (Tb) and the anterior interosseous nerve with its motor branch to pronator quadratus (PQb) were prepared in the distal forearm. The mean widths and the number of myelinated fibres of these nerves were: PQb 1.3±0.10 mm, Tb 1.4±0.12 mm and PQb 912±88 mm, Tb 1020±93 mm. The minimum necessary distance from the distal flexor crease of the wrist for neurotisation of the Tb by the PQb was 60±5.41 mm. It was concluded that PQb‐Tb neurotisation would be possible anatomically. The advantages are that motor function is reestablished with a motor nerve, the diameters and the number of myelinated fibres of both nerves are similar, the loss of function after denervation of the pronator quadratus is slight and opponensplasty still remains as a final option.     

Does acupuncture have a positive effect on school success in children？

OBJECTIVE：To evaluate school success in pediatric patients undergoing acupuncture treatment for variousindications.METHODS： The grades achieved during both school terms by children undergoing acupuncture treatment for various indications at the pediatric out patient clinic of Ulus State Hospital were analyzed. Exam grades in mathematics, social studies,and Turkish was compared between the first and the second terms. Forty children were included in thestudy,with 22 male and 18 female,and their average age was 11.1 years. These patients were undergoing acupuncture treatment for attention deficit-hyperactivity disorder（ADHD）, enuresis nocturna, migraine, obesity, atopic dermatitis, alopecia areata, and Tourette＇s syndrome. Treatments were done at the beginning of the second term. Four of the 25 patients with ADHD had borderline intelligence quotients.The report cards of all 40 patients were examined, and their grades in the first and these condschool term were compared.RESULTS： There was a statistically significant increase in the grades obtained in mathematics, social studies, and Turkish（P〈0.005） by the students from the first to the second school term. When 4 ADHD patients with borderline deficiency in intelligence were excluded, and the grades among the 21 patients with ADHD were compared for both terms, there was also a statistically significant increase in mathematics, social studies, and Turkish grades（P〈0.05）.CONCLUSION： Acupuncture contributed to the academic success of the children who under went acupuncture treatment for their primary symptoms.     

Prevention of renal ischemia/reperfusion-induced injury in rats by leflunomide

OBJECTIVE: There is increasing evidence to suggest that toxic oxygen radicals play an essential role in the pathogenesis of ischemia/reperfusion (I/R) injury in the kidney. This study was designed to investigate the effects of leflunomide, an isoxazole derivative and a unique immunomodulatory agent, in I/R-induced renal injury in rats. METHODS: Forty female Sprague-Dawley rats were divided equally into four groups: (I) control (only leflunomide 10 mg/kg, intragastrically treated); (II) sham operated (only unilateral nephrectomy); (III) I/R; and (IV) leflunomide (10 mg/kg for two doses prior to experiment) plus I/R groups. In groups III and IV, after unilateral nephrectomy, the rats were subjected to 60 min of left renal pedicle occlusion, followed by 6 h of reperfusion. At the end of the reperfusion period, rats were killed and kidneys and blood were removed. Catalase, myeloperoxidase and xanthine oxidase activities, and malondialdehyde, nitric oxide and protein carbonyl levels were determined in renal tissue. Serum creatinine, blood urea nitrogen and aspartate aminotransferase were measured for the evaluation of renal function. In histopathological examination, renal damage was scored 0-3. RESULTS: Group III animals demonstrated severe deterioration of renal function, renal morphology and a significant renal oxidative stress. Pretreatment of animals with leflunomide markedly attenuated renal dysfunction, morphological alterations, reduced elevated oxidative stress products levels and restored the depleted renal antioxidant enzyme. CONCLUSION: The findings imply that oxygen radicals play a causal role in I/R-induced renal injury, and leflunomide exerts renoprotective effects probably by the radical scavenging and antioxidant activities with immunomodulatory effect.