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Background Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy. Studies have shown that results of CTS surgery are poorer in patients with diabetes. In this study, the effect of platelet-rich plasma (PRP) on nerve regeneration was investigated through clinical and electromyographic findings in patients with diabetes who underwent CTS surgery. Methods A retrospective analysis of 20 patients with diabetes who had surgically decompressed CTS was conducted. Patients were divided into two groups. The study group received PRP treatment following surgery. The control group did not receive any treatment. Patients were assessed using electromyography and the Boston Carpal Tunnel Syndrome Questionnaire preoperatively as well as postoperatively at 3-month, 6-month, and 1-year follow-ups visits. Results There was a decrease in complaints and an improvement in sensory and motor examinations in both groups. The Boston Carpal Tunnel Syndrome Questionnaire scores did not show any statistically significant differences between the two groups. However, electromyographic findings showed that there were statistical differences between preoperative and postoperative (3 months, 6 months, and 1 year) results in both groups. When the two groups were compared using preoperative and postoperative (3 months, 6 months, and 1 year) electromyographic values, no statistically significant differences were seen. Conclusion Single injections of PRP did not have a significant impact on median nerve regeneration following CTS surgery in patients with diabetes. The effectiveness of multiple PRP injections can be investigated in patients with diabetes in future studies.

Mart 2011’de Suriye’de meydana gelen savaş neticesinde ülkelerini terk edip komşu ülkelere sığınan Suriyelilerin en çok tercih ettiği ülkelerden biri de Türkiye’dir. Savaşın uzun süre devam etmesinin de etkisiyle ülkemizde hızla artan Suriyeli sayısı sosyal, siyasal, ekonomik ve kültürel olarak birçok açıdan ülkemizi etkilemiştir. Bu çalışmamızda tekstil şehri olarak bilinen Denizli iline sığınan geçici koruma altındaki Suriyelilerin Denizli’ye etkileri ekonomik yönden analiz edilmiştir. Çalışmamızın sonucunda, Suriyelilerin olumsuz vergi algısına neden olduğu ortaya çıkmıştır. Bununla beraber kamu harcamalarını, kayıt dışılığı ve işsizliği artırdığı sonucuna ulaşılmıştır. Ayrıca kadınların ve eğitim seviyesi yüksek olan katılımcıların Geçici Koruma Altındaki Suriyelilerin çalışma hayatına katılımlarını daha çok destekledikleri tespit edilmiştir.

Aim: Necrosis in composite grafts used for the repair of tissue defects in the nasal wings, columella, and nasal sidewalls after tumor resection or trauma is an important problem related to the size of the graft. Success in the surgical or medical interventions on the recipient field or graft in order to enhance composite graft survival is clinically limited. The aim of this study is to research the effect of platelet-rich plasma (PRP) on composite graft viability during graft operation. Materials and Methods: One of the eight adults New Zealand white rabbits was used isogenically to obtain PRP. Circular full-thickness chondrocutaneous composite grafts in 2 cm diameter were excised from the both ears of each remaining seven rabbits. Right ears were separated as experimental group and left ears were selected as control group. In the experimental group, PRP was applied subcutaneously to the four different points on inner and outer surfaces at the graft donor and topically to the graft sides. The composite graft was turned 180°, and it is sutured back to the donor area. PRP was also applied on suture lines. Composite grafts formed in control group were turned for 180° and sutured without any application. At the end of the 21st day, histological evaluation was performed following measurement and photodocumentation of living and necrosis areas. Results: In the control group, except one total necrosis, partial necrosis and viable areas were identified at the other composite grafts. Mean viable area measurements in the experimental group were 33.62% and 21.15% in the control group (P < 0.05). Histological evaluation was based on the appearance of chondrocyte nuclei in the lacuna in cartilage tissue and the living areas were confirmed histologically. Angiogenesis, fibroblast proliferation, and inflammatory cell proliferation were not significantly different between the groups. Conclusion: Although the viability ratio in the experiment group was found significantly higher than that of the control group, 100% of viability ratio was not identified in any of the composite grafts. However, our findings support that PRP is positively effective on the enhancement of the composite graft viability as well.

Aim: Numerous flaps have been described for the reconstruction of complicated defects of the fingertip. The aim of this study was to evaluate our experience on flaps that can be used in emergency settings, and analyze the outcomes of these procedures. Materials and Methods: A retrospective analysis of 81 patients, who presented to the emergency unit with complicated fingertip defects between 2009 and 2014 and in whom replantation was deemed unsuitable due to various reasons including crush or avulsion type of injury mechanism, absence of the amputated part, or unrepairable vascular injury in the amputate, was carried out. Results: Eighty-nine flaps were performed in 81 patients. The defects were repaired with V-Y advancement flaps in 57% (45 patients – 51 fingers) of the defects, kite flap in 15% (13 patients – 13 fingers), cross-finger flap in 12% (11 patients – 11 fingers), Kutler flap in 6% (4 patients – 5 fingers), digital artery perforator flap in 6% (4 patients – 5 fingers), and thenar flap in 4% (4 patients – 4 fingers) of the injuries. One patient operated with the digital artery perforator flap, and one other operated with the kite flap, developed partial flap necroses. There were no other complications. Conclusion: Functional and esthetic restoration of soft tissues in the fingers is possible with the use of appropriate flaps and meticulous surgical technique.

The aim of the present study was to analyze the alterations in the, antioxidant enzyme activities (such as superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px) and level of glutathione (GSH) and lipid peroxidation (LPO) of wheat acutely treated with CP and DM treatments at low, high doses and their combination. CP and DM were administered to wheat in different doses of 1, 1.5, 5 and 35 mg kg–1 given alone and combination. After 3 weeks, antioxidant enzyme activities, and the level of GSH and LPO were recorded and analyzed. Antioxidative defense mechanisms and LPO in wheat display different responses depending on different pesticide treatments and doses. Biochemical analysis showed that exposure of the CP and DM cause plant tissue damage. It is suggested that appropriate ecotoxicological risk assessment should be made in the areas where DM is proposed to be used in pest control when compared to CP. In the present study, we also concluded that the effect of the combined of CP and DM on the oxidative stress may be synergistic.

Swellings of the hand are commonly encountered in a general practice setting and include a multitude of diagnoses. Although majority of these lesions are benign, a specific diagnosis should be achieved for an appropriate treatment. We present a case of a very unusual rheumatoid nodule on the palmar aspect of the hand, but without any rheumatological disease, which was initially misdiagnosed as a tendon sheath tumor. The nodule was successfully treated by surgical excision. The patient made an uneventful recovery, did not experience progression to rheumatoid arthritis (RA), and showed no recurrence during the one-year follow-up. We suggest that when dealing with patients with a hand mass, a rheumatoid nodule should be considered as a differential diagnosis. Understanding the cutaneous expressions of RA can enable early diagnosis, prompt treatment, and lower morbidity and mortality for the affected persons.

Granular cell tumor (GCT) is a rare soft tissue neoplasm. It was first named as “granular cell myoblastoma” in 1926 by Abrikossof. GCT often manifests as a single, painless nodule that shows a slow enlargement in the cutaneous, subcutaneous, or submucosal tissues. It mostly affects adults between ages 30 and 60 years, and is very rare in children. We herein report two children with GCT; the first patient with a tumor in the neck is presented due to the rare occurrence of the tumor in children. The other patient with a tumor in the leg is presented both due to the rare occurrence of the tumor in children and the relatively less common site of occurrence. Both of the patients were female. The mean tumor size was 2.5 × 2 cm. Histopathological examination of the specimens revealed benign granular cell tumor. One of the patients who had positive margin did not follow-up after the first excision of the tumor and she presented with a local recurrence in a year. Then a wide excision was performed and the defect was closed primarily. The second patient had negative margin and had no recurrence during the follow-up period. Granular cell tumor is rare in children. Although it is mostly benign, it may be malignant in approximately 2% of the cases and metastasize. The local recurrence in a year is characteristic for malignant GCT before metastasis. Positive surgical margins are associated with high recurrence rates, therefore total excision of the tumor is crucial for local recurrence. GCT should be included in the differential diagnosis of head and neck masses. It should be remembered that the tumor may arise in atypical locations and there is a possibility of malignancy.

Aim. The classic inguinal lymph node dissection is the main step for the regional control of the lower extremity melanoma, but this surgical procedure is associated with significant postoperative morbidity. The permanent lymphedema is the most devastating long-term complication leading to a significant decrease in the patient’s quality of life. In this study we present our experience with modified, saphenous vein sparing, inguinal lymph node dissections for patients with melanoma of the lower extremity. Methods. Twenty one patients (10 women, 11 men) who underwent saphenous vein sparing superficial inguinal lymph node dissection for the melanoma of lower extremity were included in this study. The effects of saphenous vein sparing on postoperative complications were evaluated. Results. We have observed the decreased rate of long-term lymphedema in patients undergoing inguinal lymphadenectomy for the lower extremity melanoma. Conclusion. The inguinal lymphadenectomy with saphenous vein preservation in lower extremity melanoma patients seems to be an oncologically safe procedure and it may offer reduced long-term morbidity.