Search

Background: The aim of this study is to examine the effect of preoperative conservative treatment on the success of high-grade bursal/articular-sided partial rotator cuff repair. Methods: Patients who had undergone shoulder arthroscopy in institution for Ellman Stage 3 bursal-side or articular-side partial tears between January 2008 and April 2018 were investigated retrospectively. This study assessed 201 patients diagnosed with isolated partial rotator cuff tears with a history of failed conservative management and persistent shoulder pain who underwent arthroscopic surgery. The demographic data of patients and pre- and postoperative The American Shoulder and Elbow Surgeons Shoulder Scores (ASES) that were recorded in the archive were evaluated. Results: While 55 of the patients with Ellman grade 3 bursal-sided partial tears received preoperative conservative management for at least 6 months (Group 1), 62 of them could not tolerate conservative management and early arthroscopic repair was performed (Group 2). On the other hand, 42 of the patients with Ellman grade 3 articular-sided tears received preoperative conservative management (Group 3), 42 of them could not tolerate preoperative conservative management (Group 4). The mean ASES score improvement was 52.33 ± 8.55 for Group 1, 54.68 ± 11.29 for Group 2, 48.4 ± 7.77 for Group 3 and 49.33 ± 10.05 for Group 4. A statistically significant difference was found between the groups with one-way ANOVA test (p = 0.05). With the Tukey test, this difference was seen to be caused by Group 2. Conclusion: Although there are many factors affecting its success, conservative management should be the first option in the treatment of partial rotator cuff tears. However, we think that it should not be insisted especially in patients with bursal-sided tears (> 50% of the tendon thickness) that cannot tolerate conservative management due to severe pain since the results of early arthroscopic repair of bursal-sided tears were found to be better. Level of Evidence: Retrospective comparative study, Level III. [ABSTRACT FROM AUTHOR]

Background: Long head of biceps tendon (LHBT) instability is an important source of pain and disability for the shoulder. Supraspinatus and subscapularis tendons contribute to the formation of the biceps pulley system, which maintains biceps stability during shoulder movements. The aim of this study is to evaluate the effect of morphology of bicipital groove on the stability of LHBT. Also, to evaluate the relationship between bicipital groove morphology and subscapularis rupture and supraspinatus rupture.Material and Methods: Surgical images and magnetic resonance images of 200 patients who underwent shoulder arthroscopy surgery in our clinic between January 2016 and December 2017 were retrospectively analyzed. The depth of groove, medial wall angle and opening angle values of 200 patients were measured on MRI. The stability of the biceps long head tendon, rotator cuff tear and SLAP lesions was recorded by monitoring the shoulder arthroscopy records in each groups.Results: There were 200 patients, 131 male and 69 female, with an average age of 40.9 ± 14.2 (range: 17.0-79.0) years. In 69 (34.5%) patients, long head of the biceps tendon (LHBT) instability was detected. The patients were divided into two groups according to LHBT instability.The subscapularis rupture was significantly more frequent in the group with LHBT instability (52.2%) than the group without LHBT instability (4.6%) (p < 0.001). The supraspinatus tear was observed in 72.5% in the group with instability and 56.5% in the non-instability group, which shows a statistical difference between the two groups (p = 0.027). The presence of SLAP was observed in similar rates in both groups (p = 0.053). Mean depth of groove, medial wall angle, and opening angle measurements were similar in both groups (p = 0.568, p = 0.393 and p = 0.598, respectively).Conclusion: To conclude, the morphology of the bicipital groove is not related to the stability of LHBT, and the soft tissue factors above the bicipital groove rather than bone morphology are important in stability. In addition, subscapularis rupture is a pre-disposing factor for LHBT instability; therefore, we recommend a more careful examination of LHBT in patients with subscapularis rupture.Level Of Evidence: III. [ABSTRACT FROM AUTHOR]

In this study, nanostructured Mn3O4 (manganese oxide) thin films were successfully obtained by successive ionic layer adsorption and reaction (SILAR) method on the soda lime glass substrates using Manganese Nitrate (Mn(NO3)2) and Ammonium hydroxide (NH4(OH)) as cationic and anionic precursors respectively. Structural and morphological characterizations of the Mn3O4 films obtained at different cycles were determined using X-ray diffraction (XRD) and Scanning Electron Microscopy (SEM). The crystal structure of the thin films were also confirmed by RAMAN spectroscopy. Optical properties such as absorption, transmission, reflection, extinction coefficient and optical band gap of nanostructured Mn3O4 thin films were determined by UV-Vis spectroscopy. SEM images showed that the manganese oxide nanosheets formed uniformly on substrate surface. As the deposition cycles increased, nano-sheets structure deteriorated. The optical band gap of Mn3O4 thin films varied from 2.12 to 2.59 eV, depending on the increase in number of cycles. From contact angle measurements of thin films, it was determined that thin films had hydrophilic character. [ABSTRACT FROM AUTHOR]

The paper reports a study of the cause of defects in light structures and the toppling of a wall constructed on a fill material rich in Ankara clay. Laboratory tests were carried out on vertical and horizontal samples from boreholes and a trial pit was excavated near the damaged structures. The results showed that in the vicinity of the toppled wall, swelling pressures in the horizontal direction were greater than those measured in the vertical direction. The swelling properties of the fill material were higher than those of original Ankara clay as determined previously by other investigators, suggesting that breakdown of the cementing bonds and a change in the fabric are the main factors affecting the swelling pressure of disturbed and compacted expansive soils. The calculations to predict uplift showed a good agreement with the observations in the damaged structures. It is concluded that swelling was the main cause of the damage to the light structures at the study site and resulted from the highly expansive nature of the fill material, poor drainage, the semi-arid climate, poor construction methods and ineffective precautions. Some recommendations for minimizing the effects of swelling at the study site are briefly outlined. [ABSTRACT FROM AUTHOR]

Organizational culture is the term used to describe the shared beliefs, perceptions, and expectations of individuals in organizations. In the healthcare environment, organizational culture has been associated with several elements of organizational experience that contribute to quality, such as nursing care, job satisfaction, and patient safety. A range of tools have been designed to measure organizational culture and applied in industrial, educational, and health care settings. This study has been conducted to investigate the perceptions of military medical graduates on organizational culture at Gülhane Military Medical School. A measurement of organizational culture, which was developed by the researchers from Akdeniz University, was applied to all military medical graduates in 2004. This was a Likert type scale that included 31 items. Designers of the measurement grouped all these items into five main dimensions in their previous study. The items were scored on a five-point scale anchored by 1: strongly agree and 5: strongly disagree. Study participants included all military physicians who were in clerkship training period at Gulhane Military Medical Academy in 2004. A total of 106 graduates were accepted to response the questionnaire. The mean age of participants was 25.2 ± 1.1. At the time of study only 8 (7.5%) graduates were married. The study results have showed that the measurement tool with 31 items had a sufficient reliability with a Cronbach's alpha value of 0.91. Factor analysis has resulted a final measurement tool of 24 items with five factors. Total score and the scores of five subdimensions have been estimated and compared between groups based on living city and marital status. The study has shown the dimension of symbol received positive perceptions while the dimension of organizational structure and efficiency received the most negative perceptions. GMMS has a unique organizational culture with its weak and strong aspects. Conducting this kind of studies contribute to improve organizational culture in order to increase educational and research capability. [ABSTRACT FROM AUTHOR]

Residence at high altitude has been associated with elevation in systemic blood pressure (BP), but few studies have been done on the time course and the effects of a median altitude. Moreover, there exist population differences in the reactions given to altitude and the mechanism is unknown. This study was therefore designed to determine the effects of a median altitude on resting BP and heart rate (HR) in a group of 15 healthy, young, Turkish male subjects. After basic measurements were carried out in Bursa (155 m), subjects were transported to a mountain hotel (altitude 1,860 m), where the measurements were repeated once every 15 days during a 10-month period. Mean BP and diastolic BP increased on Day 4 and then remained above first values throughout the study. Compared with control measurements, high altitude increased systolic blood pressure (SBP) in all subjects, but in Month 4 and Month 6, SBP returned to control values, and remained elevated thereafter. HR continued to decrease in parallel with time and significant decrease occurred after Month 5. Our findings imply that moderate-altitude living results in a significantly greater BP and lower HR over equivalent low-altitude measurements and we conclude that chronic exposure to hypobaric hypoxia at a median altitude causes increased parasympathetic and sympathetic tone in healthy, young, Turkish males. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Risk factors for delayed bleeding after endoscopic submucosal dissection for colorectal neoplasms" by M. Terasaki et al. in the June 2014 issue.