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We investigated patients undergoing arthroscopic anterior cruciate ligament (ACL) reconstruction using otogenous hamstring tendons with a cross-pin technique to compare a post-operative home-based rehabilitation programme with a clinic-based programme. ACL reconstruction was performed on 104 patients (103 male) by the same surgeon. The mean age of the patients was 31.5 years (range 18 - 43 years) and the mean time interval between injury and operation was 34.3 months. Patients were randomly allocated to either a home-based (n = 52) or clinic-based rehabilitation programme (n = 52). Mean follow-up was 31.1 months (range 12 - 66 months). Patients underwent a series of examinations before and after surgery in order to evaluate functional recovery of their injured knee. The results demonstrated that using otogeneous hamstring tendons for ACL reconstruction was safe and produced satisfactory results. The study also demonstrated that a home-based rehabilitation programme was as effective as a clinic-based programme.

Introduction: This study aims to investigate the effectiveness of salicylate (Aspisol; Bayer AG, Leverkusen, Germany) and chloroquine on preventing cartilage damage in septic arthritis., Methods: A septic arthritis model was created by inoculating the knee joint of young rabbits (n=21) with Staphylococcus aureus. Some rabbits with inflicted septic arthritis did not undergo any treatment and served as the control group (n=7). The second group (n=7) was started on salicylate on day 2 to investigate the effects of salicylate on joint cartilage. The third group (n=7) was started on chloroquine on day 2 to investigate the effects of chloroquine on joint cartilage. All three groups underwent arthrotomy, drainage and synoviectomy on day 7 of the experiment. Animals were sacrificed on day 14 and the joint cartilages were extracted. Histopathology, determination of local prostaglandin (PGE)-like activity, and evaluation of hyaluronic acid loss were performed on all samples., Results: The control group and the salicylate group were similar in the extent of joint damage. Salicylate did not prevent joint cartilage damage despite inhibiting PGE synthesis. Chloroquine, despite not inhibiting PGE synthesis, did prevent cartilage destruction., Conclusion: If supported by larger-scale studies, chloroquine could be added to the antibiotic regimen in the treatment of septic arthritis to prevent cartilage damage.

The aim of this study was to evaluate the tunnel enlargement phenomenon after ACL reconstructions performed with hamstrings tendons fixed using the cross pin technique. Sixty-two knees in 62 patients were followed for two years to evaluate the possible clinical implications of the femoral and tibial tunnel enlargements noted after ACL reconstruction. The reconstructions were done with hamstring tendons using the cross-pin technique. Evaluation was based on calculated clinical scores (IKDC and Lysholm knee scores) and quantified by KT-1000 measurements. Sagittal and coronal plane computed tomography and conventional radiography were performed 3 days after operation and were repeated after 3 and 6 weeks, 6, 12 and 24 months, to assess early tunnel enlargement. Although it seems that tunnel enlargement after ACL reconstruction has no impact on the clinical results, long-term implications and potential need for revision surgery must be assessed. In this study, tunnel enlargement was noted fairly early after operation and was thought to be related with drilling of the tunnels. A possible solution to this problem may be drilling the tunnels to a diameter 1 mm smaller than the measured graft diameter, then to enlarge the tunnels to the graft diameter with the appropriate tunnel dilator.

Distraction osteogenesis is a well established clinical treatment for limb length discrepancy and skeletal deformities. Transforming growth factor beta 1 (TGF-beta1) is a multifunctional peptide which controls proliferation and expression of cells specific to bone like chondrocytes, osteoblasts, osteoclasts including mesenchymal precursor cells. To decrease the external fixation time with increasing the strength of regenerate (newly formed bone after distraction) we tested the effect of locally applied transforming growth factor beta 1 on distraction osteogenesis. A total of 28 mature female white New zealand rabbits weighing 3,5 kg-4,5 kg were studied. 10 animals were belonging to biomechanical testing group (5 for the study and 5 for the control subgroups), and the others were to histology group. In biomechanical group after tibial osteotomy TGF-beta1 was applied subperiosteally for 5 days just proximal to osteotomy site. Control group received only the solvent. Seven days after tibial osteotomy distraction was started at a rate of 0.25 mm/12 hours for 3 weeks with a unilateral fixator. Rabbits were sacrificed at the end of a consolidation period 8 week after tibial osteotomy. We assessed density of the elongation zone of rabbit tibial bones with the computed tomography. Then biomechanical parametres were assessed using the torsional testing using the material testing machine. In histology group rabbits were classified as control and study (rabbits that were given TGF-beta1). Rabbits were sacrificed at the end of first week, second week and fourth week also at the end of consolidation period 8 week after tibial osteotomy. Immunohistochemical and histologic parameters were examined. Biomechanical testing was applied as torsional testing. These values are used in determination of maximal loading, stiffness and energy absorbed during testing (brittleness). The histomorphometric examination looked for the differences between the study and control groups in terms of bone formation pattern, bone quality and quantity. The immunohistochemical studies investigated the mechanism of TGF-beta1, and its presence in different cell types. The results of this study suggest that locally applied TGF-beta1 improves the mineral density of distraction gap and load to failure(energy absorbed during testing). Though there is no significant histomorphometric difference between the study and control groups, there is an increased bone mineral density and an according maximum energy absorbance in the study group. This effect can be explained by the following mechanism: TGF-beta1 exerts its effect on two different receptor types (Type 1 and 2). Type 1 receptors are localized to bone matrix and type 2 receptors are localized to the intracellular space. The specific stains utilized in the current experiment are specific to type 2 receptors. They have been shown to be down-regulated by exogenous TGF-beta1 injections. Most probably, type 1 receptors are up-regulated by this exogenous administration, but unfortunately, there is currently no specific stain on tha market to display type 1 receptors and to prove this explanation.

Trigger toe is a rare entity, with only a few cases reported in the literature. It is usually seen in ballet dancers as a result of compression of the flexor hallucis longus tendon in the tarsal tunnel beneath the medial malleolus. We report a case of trigger toe due to a constricting lesion on the extensor hallucis longus tendon.

A 45-year-old male patient presented with paralysis of slow onset in the right forearm and hand muscles. Electromyographic assessment revealed severe denervation in the muscles innerved by the posterior interosseous nerve. Magnetic resonance imaging demonstrated a tumoral mass compressing the nerve. The patient underwent surgical excision with an initial diagnosis of lipoma. Surgical exploration and a biopsy confirmed the diagnosis. Active wrist movements and digital extension were possible after three weeks and the patient resumed full strength six weeks after the operation.

Objectives: We evaluated pediatric patients who underwent surgery for Langerhans cell histiocytosis with mono- or polyostatic involvement and an extensive soft tissue component and/or a high risk for pathologic fractures., Methods: The study included 13 children (6 boys, 7 girls; mean age 6 years; range 2 to 11 years) who were treated surgically for bone and soft tissue involvement of Langerhans cell histiocytosis with a high risk for fractures of the long bones and the pelvis. Eleven patients had only skeletal involvement while three patients had multisystem involvement. There were 17 bone lesions in the following localizations: acetabulum (n=7), femur neck and subtrochanteric region-proximal femur (n=5), and proximal (n=2) and distal (n=2) humerus. One patient had multifocal bone involvement. The risk for pathologic fractures was assessed using the scoring system of Mirels. Treatment consisted of surgery followed by chemotherapy. The results of treatment were evaluated according to the criteria by the Study Group of Langerhans Cell Histiocytosis. The mean follow-up after orthopedic surgery was 67 months (range 34 to 172 months)., Results: Only one patient developed recurrence, in which case bone marrow involvement responded well to chemotherapy. Radiographically, graft consolidation was observed in all the patients in the third postoperative month. No bone sequelae such as shortness and deformity were detected throughout the follow-up period., Conclusion: Surgical treatment combined with chemotherapy is effective in the treatment of aggressive histiocytic bone lesions associated with extensive soft tissue involvement and high risk for fractures.

The acetabular labrum is a fibrocartilaginous structure attached to the acetabular rim. It increases the surface area of acetabulum and stabilizes joint. Acetabular labral tears are an important cause of intractable hip pain in adults. We report a cause of an acetabular bucket handle tear of the right hip, caused by femoroacetabular impingement that was diagnosed and treated successfully with hip arthroscopy.

Two cases of acute pancreatitis with leptospirosis are reported in this article. CASE 1: A 68-year-old woman, presented initially with abdominal pain, nausea, vomiting, and jaundice. She was in poor general condition, and had acute abdominal signs and symptoms on physical examination. Emergency laparotomy was performed, acute pancreatitis and leptospirosis were diagnosed on the basis of surgical findings and serological tests. The patient died on postoperative d 6. CASE 2: A 62-year-old man, presented with fever, jaundice, nausea, vomiting, and malaise. Acute pancreatitis associated with leptospirosis was diagnosed, according to abdominal CT scanning and serological tests. The patient recovered fully with antibiotic treatment and nutritional support within 19 d.

Background/aims: End organ damage due to microcirculatory failure plays an important role in the pathogenesis of acute pancreatitis (AP). The aim of this study was to investigate whether dopamine, a vasoactive agent, is beneficial in the prevention of local and systemic injury in acute pancreatitis., Methodology: Pancreatitis was induced in rats with 5% Na-taurocolic acid infusion into the pancreatic duct. Rats were resuscitated for four hours with saline in the pancreatitis group (P), lactated ringer's (LR) solution in the LR group and low dose dopamine (5 microg/kg/min) + LR in the D-LR group. The sham group (S) underwent pancreatic duct cannulation only. Rectal temperature (RT) and meanarterial pressure (MAP) were monitored throughout the experiment. Blood samples for amylase, lipase, WBC and blood gas analysis were taken at baseline and at the end of the study. All rats were sacrificed at the 4th hour and pancreatic and lung tissues were removed for histopathological examination and tissue myeloperoxidase (MPO) activity., Results: MAP was lower in the P and LRgroups than the sham and the D-LR groups. RT was higher in P and LR groups than the sham and the D-LR groups. Base deficit was higher in the P group than the sham and the D-LR groups. The lung MPO activity was higher in the P group than all the others. Lung MPO activity that is closest to the sham was that of D-LR group's. The pancreatic MPO activity was found to be increased in the P and decreased in the LR groups., Conclusions: In this experimental model for AP, low dose dopamine + LR resuscitation attenuates the lung injury but not the local pancreatic injury.

Background: Despite its extensive application for the repair of inguinal hernias, the use of the Prolene Hernia System (PHS; Ethicon, West Somerville, NJ) for the repair of umbilical hernias has been sparse. The purpose of this prospective study was to assess, in comparison with currently available techniques, the effectiveness of the PHS in repairing umbilical hernias., Methods: Fifty consecutive patients diagnosed with a primary umbilical hernia were enrolled for the study. They were randomized and underwent elective repair of umbilical hernia using either the PHS (n = 17), Mayo repair (n = 18), or onlay repair with mesh (n = 15). Data for the time required for the surgical repair method, length of hospital stay, postoperative pain, analgesic necessity, and return to work, and early and late complications were recorded, and compared with respect to the repair procedure., Results: The mean operating time and the mean length of hospital stay were the longest in the onlay repair with mesh group (P < .05). Those patients operated on using the PHS described minimum pain on the postoperative first , second, and seventh days (P < .05) and also the necessity of analgesic was significantly lower in this group (P < .05). There were 2 recurrences in Mayo repair group. The mean follow-up duration was 22 months (range 6 to 44 months)., Conclusion: The PHS seemed to be useful for umbilical hernia repairs in selected patients as it caused minimal postoperative pain and less analgesic necessity.

Background: Gastric cancer is one of the most common types of cancer and one of the most frequent causes of cancer-related death. The majority of gastric cancers show distant metastasis at the time of diagnosis. At present, there is no general agreement over one standard chemotherapy regimen for metastatic gastric cancer., Aims: We evaluated the activity and toxicity of the combination of 5-Fluorouracil (5-FU), epirubicin and cisplatin (FEP) in previously untreated patients with metastatic gastric cancer., Setting and Design: Medical Oncology Department of Uludag University Faculty of Medicine, Bursa; retrospective study., Material and Methods: Sixty-eight patients received 5-FU 300 mg/m2 on Days 1-5, epirubicin 50 mg/m2 on Day 1 and cisplatin 60 mg/m2 on Day 1, every 4 weeks. A median of 3.5 cycles was administered. The response rate, time to disease progression, survival and toxic effects were analyzed., Statistical Analysis Used: Overall survival and time to progression were estimated using Kaplan-Meier method., Results: There were 4 partial responses and 1 complete response (overall response rate 7.3%); 16 patients had stable disease. Median progression-free and overall survival rates were 3.1 months (95% CI 1.9-4) and 6 months (95% CI 4.2-7), respectively. The principal toxicity was myelosupression. Grade 3-4 neutropenia occurred in 27.9%, anemia in 17.6%, and thrombocytopenia in 11.7% of patients. Non-hematological toxicity was mild and manageable., Conclusions: We concluded that FEP combination as used at the doses and schedules in this study has inferior activity against metastatic gastric cancer.

Aim: Bezoars (BZ) are the most common foreign bodies of gastrointestinal tract. Clinical manifestations vary depending on the location of BZ from no symptoms to acute abdominal syndrome. When located in small bowel, they frequently cause small bowel obstruction (SBO). We aimed to present our experience by reviewing literature., Methods: Thirty-four patients with gastrointestinal BZ were presented. The data were collected from hospital records and analyzed retrospectively. Morbidity and mortality rates were statistically analyzed between the subgroups according to SBO and endoscopic or surgical treatment modalities., Results: The 34 patients had phytobezoars (PBZ). Two patients with mental retardation and trichotillomania had trichobezoars (TBZ). More than half of them (55.88%) had previous gastric surgery. Also most of them had small bowel bezoars resulting in obstruction. Surgical and endoscopic morbidity rates were 32.14% and 14.28% respectively. The total morbidity rate of this study was 29.41%. Four patients in surgically treated group died. There was no death in endoscopically treated group. The total and surgical mortality rates were 11.76% and 14.28% respectively. The differences in morbidity and mortality rates between the subgroups were not statistically significant., Conclusion: BZ are commonly seen in stomach and small intestine. SBO is the most common complication. When uncomplicated, endoscopic or surgical removal can be applied easily.

Background/purpose: The aim of this study was to evaluate the effects of maternal nicotine exposure during gestation on injury severity of small intestine in the newborn rats subjected to hypoxia-reoxygenation and cold stress., Methods: A total of 21 Sprague-Dawley pregnant rats were divided into 3 equal groups. The groups were labeled as group 1, control group; group 2, hypoxia-reoxygenation group; and group 3, nicotine-hypoxia-reoxygenation group. The rats of group 3 were exposed to nicotine via subcuticular injection for the last week of gestation (2 mg/kg/d). Newborn rats were collected immediately after birth to prevent suckling of maternal milk (40 rat pups in group 1, 43 rat pups in group 2, and 41 rat pups in group 3). Litters in groups 2 and 3 were stressed twice daily with asphyxia followed by cold (4 degrees C for 10 minutes) stress to induce hypoxic intestinal injury which is relevant to human necrotizing enterocolitis. Breathing 100% CO2 for 10 minutes in a chamber followed by 10-minute 100% O2 breathing was the asphyxia model repeated twice daily. After hypoxia-reoxygenation and cold stress, newborn rats were returned to their mother's cages. This protocol was repeated for the following 2 days, and the rat pups were decapitated on the third day. Using this protocol of asphyxia and cold stress, all of neonatal rats developed clinical and pathological signs of hypoxia-induced intestinal injury. The entire gastrointestinal tract was removed and examined macroscopically. A 2-cm section of distal ileum from each animal was taken for histopathological and biochemical examinations. Histological changes in ileal architecture were scored and graded from 1 to 5. The remaining intestinal tissues of the animals were used for lipid peroxidation analysis., Results: Typical signs of hypoxia-induced intestinal injury were observed in the 2 experimental groups (groups 2 and 3) macroscopically. There were more grades 3 and 4 injuries in group 3 (P < .05). The malondialdehyde levels were elevated in groups 2 and 3 (P < .001). The malondialdehyde levels of the group 3 were also significantly higher than group 2 (P < .01)., Conclusions: Maternal nicotine exposure during gestation results in higher grade histological injury in newborn rats subjected to hypoxia-reoxygenation and cold stress.

Background: Nicotine is known to be associated with adverse effects in infants and children. It is concentrated in breast milk and is absorbed by the infant. The aim of this study was to investigate the effects on breast-fed rat pups of maternal nicotine exposure during lactation., Methods: In the experimental group (n = 6), nicotine was given to lactating dams (2 mg/kg/day) after delivery and continued for 10 days during lactation. Control animals (n = 4) received saline for the same duration. The suckling rats were weighed and killed on postnatal day 10, and samples were taken from the lung, liver, kidney, spleen and small intestine for histopathological examination. Superoxide dismutase (SOD), catalase (CAT) activities and malondialdehyde (MDA) levels were measured in the liver of the dam and the offspring., Results: Histopathological changes in the liver of the nicotine-exposed group showed portal inflammatory infiltrate, ballooning degeneration of hepatocytes, and focal necrosis in the parenchyma. Thickening of alveolar walls because of interstitial inflammation was noted in the lungs. Histopathological examination of kidney, spleen and small intestine tissue did not reveal any abnormality. In the experimental group, SOD and CAT activities were significantly decreased (p <0.001) but MDA levels were significantly increased (p <0.001) compared with the control group., Conclusion: These results indicate that maternal nicotine exposure induces oxidative stress and causes detrimental histopathological changes in the lung and liver of lactating offspring., (Copyright (c) 2005 S. Karger AG, Basel.)

Congenital femoral deficiencies have a wide spectrum ranging from simple hypoplasia to complete femoral aplasia. They are often associated with congenital shortening of the tibia and fibular hemimelia. This anomaly has no known genetic transmission. There are two main treatment modalities for congenital femoral deficiency: prosthetic replacement surgery (Syme amputation or Van Nes rotationplasty followed by prosthetic fitting) and lengthening reconstruction surgery. In this report, we presented two patients (male, 26 years; girl, 7 years) with congenital femoral deficiency treated with Van Nes rotationplasty. In both cases, the treatment took 1.5 months, after which the patients were mobilized with prosthesis. No complications were encountered within a follow-up period of five years and 1.5 years, respectively. Rotationplasty enables an improved functional gait in patients with a very short femoral segment or Paley type 3 femoral deficiency.

Diaphragmatic paralysis in newborns is related to brachial plexus palsy. It can be overlooked if thorough examination isn't done. We present a two-weeks-old baby with a birth weight of 3800 grams who had a left-sided brachial plexus palsy and torticollis with an undiagnosed left diaphragmatic paralysis even though he was examined by different physicians several times. The role of physical examination, the chest x-rays of patients with brachial paralysis and the treatment modalities of diaphragmatic paralysis due to obstetrical factors are discussed.

Introduction: There are various methods of long bone lengthening. The quality of the regenerated bone depends on stable external fixation, low energy corticotomy, latency period, optimum lengthening rate and rhythm, and functional use of the limb. Percutaneous corticotomy and ostetomy with multiple drill holes yield the best results for the quality of the regenerated bone. An alternative low energy osteotomy, which respects the periosteum, is the Afghan percutaneous osteotomy. The purpose of the current study was to compare a percutaneous multiple drill hole osteotomy with a Gigli saw osteotomy in terms of the healing index (HI)., Materials and Methods: Forty-four tibias of 41 patients were lengthened at our institution between 1995 and 2000. All patients underwent limb lengthening without any deformity correction by the Ilizarov device. The etiology of the limb length discrepancy was sequelae to poliomyelitis in 16 tibias, idiopathic hypoplasia in 17 tibias, posttraumatic discrepancy in 5 tibias, bilateral tibial lengthening in achondroplastic dwarfism in 3 patients. Patients with metabolic bone diseases were not included in this series., Results: The mean amount of length discrepancy was 5.7 cm (range 2-12 cm). The mean HI of the whole group was 1.65 month/cm (range 1.1-2.4 month/cm). When comparing the osteotomy methods without taking the etiology into consideration, the percutaneous, multiple drill hole group yielded a mean HI of 1.98 month/cm (range 1.4-2.4 month/cm), while the Gigli saw group yielded a mean HI of 1.37 month/cm (range 1.1-1.8 month/cm). There was a statistically significant difference between the two groups ( p=0.022). The Gigli saw patients with poliomyelitis had a significantly better HI compared with patients who underwent lengthening by the other form of osteotomy (1.1 vs 1.9 month/cm; p=0.027)., Conclusion: Our results confirm the biologic superiority of the Gigli saw technique.

Background/purpose: The aim of this study is to investigate the effect of zinc aspartate (ZA) pretreatment on ischemia-reperfusion (I/R) injury and blood and tissue antioxidant enzyme activity early after unilateral testicular torsion-detorsion (T/D)., Methods: Forty prepubertal male Sprague-Dawley rats (weight 160 to 220 g) were divided into 4 groups each containing 10 rats. Surgery was conducted under intraperitoneal 1-shot ketamine (50 mg/kg) anesthesia. The scrotum was entered through a midline incision. Rotating the left testis 720 degrees in a clockwise direction was the model of the testicular torsion. Group 1 was for the basal values. Group 2 had 4 hours T/D. Group 3 also had 4 hours T/D and pretreated with 50 mg/kg intraperitoneal ZA injection half an hour before detorsion. Group 4 was designed as a sham group. In the Group 2 and Group 3, the tunica vaginalis was opened, and left testicles were rotated clockwise 720 degrees and maintained in this torsion position by fixing with a silk suture to the scrotal wall. The scrotum was closed and 4 hours later reentered for testicular detorsion. After spermatic cord detorsion, the scrotum was closed. At the end of 4 hours detorsion period, bilateral orchiectomies were performed, and 5-mL intracardiac blood samples were taken. Blood and tissue superoxide dismutase (SOD), catalase (CAT) activities, and malondialdehyde (MDA) levels were measured, and histopathologic examination was performed., Results: Group 2 and group 3 had decreased blood SOD and CAT activities and elevated MDA levels indicating I/R injury. The 2 groups were also different from each other for these parameters reflecting the beneficial effect of ZA pretreatment (P <.05). The decreased ipsilateral tissue SOD and CAT activities in group 2 were different from the other groups including group 3 (P <.05). Ipsilateral tissue MDA levels of both group 2 and group 3 were elevated. Group 2 had higher values than group 3 (P <.05). In addition, specimens from group 2 had a significantly greater histologic injury than group 3 (P <.05). These findings were also supporting the beneficial effect of ZA pretreatment. All measurements of contralateral tests were similar to the basal values for all groups (P >.05)., Conclusions: ZA pretreatment reduces I/R injury by its antioxidant effects after unilateral testicular T/D and affects the antioxidant enzyme systems.

Introduction: The aims of this study were to establish the prevalence of enuresis, to determine accompanying factors, and to identify common methods in the management of enuresis in Turkish children aged between 6 and 11 years living in eastern Anatolia., Methods: The parents of 3,527 schoolchildren aged between 6 and 11 years completed a self-administered questionnaire. The questionnaire asked about sociodemographic data, enuresis data, physical or psychological disorders, and family stressors. Descriptive statistics and chi2 test were used for data analysis., Results: The response rate was 88%. The overall prevalence of reported enuresis was 12.96%, and the prevalence of marked enuresis (at least weekly) was 9.8%. Enuresis was notably more common in boys (male:female ratio 1.6), and the prevalence rates decreased by age without gender bias. Of all enuretic children, 21% had also daytime bed-wetting. The rate of a positive family history was 42% for siblings only and 66% for the other family members. Significantly more of the dry children woke up spontaneously at night to void as compared with the enuretic children (p < 0.001). The parental concern level was not high, and only 15% of the children visited a physician for the management of enuresis. Low socioeconomic status, unfavorable perinatal or postnatal history, and unsatisfactory familial characteristics were significantly more frequent in the enuretic group (p < 0.05). The enuretic children had also higher rates of poor school performance and poor social adaptation as compared with nonenuretic children (p < 0.001)., Conclusions: These results suggest that the prevalence of enuresis in eastern Anatolia is similar to that reported from western Anatolia and from most other countries. Turkish families did not report a high-level concern about enuresis, and the problem was managed primarily within the family.

Intramural hematoma of the intestine is a rare complication of anticoagulant therapy. We evaluated 7 nontrauma patients with intramural hematoma of the intestine diagnosed at our institution between May 1998 and June 2001. All of the patients were receiving long-term anticoagulant therapy for previous diseases. All 7 patients had abdominal pain, 6 had additional symptoms of nausea and vomiting, and 4 had melanotic stools at admission. Six of the patients had abnormal coagulation parameters. Both abdominal ultrasonography (US) and computerized tomography (CT) showed the exact pathology in all patients. Five of the 7 patients were treated, nonoperatively, and the other patients underwent surgery. All of the patients were followed with abdominal US and CT (mean 12 = months), with complete resolution of their intramural hematomas. Abdominal US and CT evaluation performed together will help the accuracy of diagnosis of intramural hematoma, but nonoperative therapy is the treatment of choice, with surgery indicated if generalized peritonitis or intestinal obstruction develops.

1. The present study was conducted to determine if detrimental effects of high temperature on broiler performance could be overcome by short-term fasting and to examine the effect of food withdrawal on the responses of two commercial strains (S1 and S2). 2. An experimental design was used with three feeding groups and two strains. Birds in the control (C) group were fed ad libitum during the experimental period (0 to 6 weeks), while feed was withdrawn in the other groups between 10:00 and 16:00 h during weeks 5 and 6 (F1) or week 6 (F2), respectively. After standard brooding for the first 3 weeks temperature and humidity varied according to outside climate between 4 and 6 weeks of age. 3. Feeding strategy significantly affected body weight at week 6 (BW6) and daily weight gain during week 6 (DWG5-6). F2 gave the best results in BW6 and DWG5-6. Strain effect was significant on DWG4-5 and DWG5-6; S1 had higher DWG4-5 and S2 gained more at the last stage. S1C broilers had greater BW6 than S2C but the S2 strain gave a better response to short-term fasting compared with S1 and this resulted in significant strain by feeding interaction effect on BW6 and DWG5-6. 4. It was shown that short-term fasting was an effective method for controlling rectal temperature (RT) of broilers at 5 and 6 weeks of age. 5. Total food consumption (FCO-6), food conversion ratio (FCRO-6), mortality, and carcase characteristics were not affected by short-term fasting in the experimental conditions. 6. In conclusion, it can be recommended that broiler producers may practise 6 h of fasting during the hot period of the day without any adverse effect on slaughter weight and FCR when the birds are close to the average slaughter weight and a heat wave is expected. Strain differences in RT measurements also indicate the importance of choosing strains to be used in hot and warm climate conditions with attention to the thermoregulation ability of broilers.

Background: The purpose of this study was to investigate the effects of temperature on oxidative stress in brain stem tissue induced by hemorrhagic shock. We researched the hemorrhagic oxidative stress at various core temperatures using reduced glutathione (GSH) levels and thiobarbituric acid-reactive substances (TBARS) as markers of lipid peroxidation in brain stem homogenate., Methods: Forty rats were divided into four groups, of which one constituted the nonbleeding normothermia control group. In all of the three study groups, 40% of estimated blood volume was removed while they were being held at normothermia, mild hypothermia (32 degrees C), or moderate hypothermia (28 degrees C). Parameters including mean arterial pressure, rectal temperature, and heart and breathing rates were monitored and recorded during the procedures. After an hour at shock state, tissue samples were removed by craniectomy., Results: The tissue levels of TBARS increased significantly in normothermic and mild hypothermic hemorrhagic shock groups (10.74 nmol/g and 8.26 nmol/g) as compared with the control group (3.50 nmol/g) (p < 0.001). However, the tissue TBARS level in the moderate hypothermia group was only minimally increased (4.53 nmol/g). GSH showed a slight decrease in normothermic and mild hypothermic bleeding rats, and were unchanged in the moderate hypothermic rats., Conclusion: Moderate systemic hypothermia (28 degrees C) appears to protect brain stem tissue from oxidative stress during severe hemorrhagic shock in rats, as indicated by insignificant change in tissue TBARS and GSH concentrations. These results suggest antioxidant protective effects of moderate systemic hypothermia in metabolically active brain stem tissue during hemorrhagic shock. Similar effects in humans remain to be studied.

Background/purpose: It is still controversial whether unilateral testicular torsion (TT) affects contralateral testis. The authors wanted to evaluate contralateral testicular damage in a rat model by the serum inhibin B levels, which is suggested as a marker of Sertoli cell function and spermatogenesis., Methods: Fifty peripubertal male Wistar Albino rats were divided into 5 groups each containing 10 rats. Surgery was conducted under intraperitoneal 1-shot ketamine (50 mg/kg) anesthesia. Torsion-detorsion, torsion-detorsion-orchiectomies, orchiectomies, and sham operations were performed on the right testicle through a midline incision. Torsions were created by rotating the right testes 720 degrees in a clockwise direction and maintained by fixing the testes to the scrotum with a silk suture. Torsion duration was 4 hours. After each surgical intervention the incisions were closed. In group 1, 3-mL blood samples were taken to determine basal values of inhibin B in serum, and bilateral orchiectomies were performed. In group 2, 4 hours of torsion and detorsion was created and 1 month later, 3-mL blood samples were taken, and bilateral orchiectomies were performed. In group 3, 4 hours of torsion-4 hours of detorsion was created, and right orchiectomies were performed and 1 month later, 3-mL blood samples were taken and contralateral orchiectomies were added. In group 4, unilateral orchiectomies were performed, and 1 month later, 3-mL blood samples were taken, and contralateral orchiectomies were added. After the measurement of the serum inhibin B levels and histopathologic examinations, results are expressed as mean +/- SD., Results: Serum inhibin B levels expressed as mean +/- SD were 108.233 +/- 21.296 pg/mL for group 1, 54.065 +/- 16.910 pg/mL for group 2, 74.195 +/- 2.779 pg/mL for group 3, 108.335 +/- 26.078 pg/mL for group 4, and 107.645 +/- 4.705 pg/mL for group 5. Inhibin B levels in group 2 and group 3 were different from group 1, group 4, and group 5 (P <.05). In histologic examination, Johnsen's scores expressed as mean +/- SD of right testes were 9.74 +/- 0.08 for group 1, 3.64 +/- 3.36 for group 2, and 9.86 +/- 0.05 for group 5. Histologic findings in group 2 were different from group 1 and group 5 (P <.05). Johnsen's scores expressed as mean +/- SD of left testes were 9.78 +/- 0.09 for group 1, 9.75 +/- 0.14 for group 2, 9.76 +/- 0.15 for group 3, 9.79 +/- 0.07 for group 4, and 9.82 +/- 0.08 for group 5, and there was no difference between groups (P >.05)., Conclusions: The serum inhibin B levels decrease after unilateral TT reflecting contralateral testicular damage. Orchiectomy to prevent contralateral testicular damage after TT may not be effective after critical period. Measurement of inhibin B levels to evaluate contralateral testicular damage after unilateral TT is more effective than histopathologic examination., (Copyright 2001 by W.B. Saunders Company.)

Acute pancreatitis and hyperlipidemia during pregnancy is a rare but life-threatening condition for both mother and fetus. In this article, we reported two cases suffered from acute pancreatitis and hyperlipidemia; 24-year old pregnant women and 40 year old non-pregnant women. The risks of the pregnancy in this situation were also discussed.

1. An experiment was conducted to determine the effect of different dietary protein contents on the performance of naked neck (Na/na) and normally feathered (na/na) broilers. 2. Chicks from the two genotypes were reared in wire-floored cages and divided at random into 3 groups. Birds were fed on high protein (HP, 12.99 MJ ME, 238 g crude protein/kg and 12.94 MJ ME, 216 g crude protein/kg from 0 to 3 and 3 to 7 weeks, respectively), medium protein (MP, 12.99 MJ ME, 219 g crude protein/kg and 12.87 MJ ME, 201 g crude protein/kg from 0 to 3 and 3 to 7 weeks), and low protein (LP, 12.94 MJ ME, 205 g crude protein/kg and 12.75 MJ ME, 184 g protein/kg from 0 to 3 and 3 to 7 weeks) diets. 3. The LP diets resulted in a significantly lower daily body weight gain of males from 0 to 3 weeks. Dietary protein content had no effect on body weight gain from 3 to 7 weeks, body weight at 7 weeks, and the food intake of birds. Carcase composition of birds from both genotypes was unaffected by dietary protein. 4. Naked neck birds had significantly higher body weights at 7 weeks. Yields of carcase and breast of Na/na males were significantly higher than those of na/na males. There were no significant differences between females from the two genotypes as regards carcase yield. 5. It was concluded that the dietary protein requirements of naked neck birds were similar to those for normally feathered birds.

This study was planned to investigate the effects of copper (Cu) deficiency on liver and bone metabolism in malnourished children. Serum total calcium (Ca), inorganic phosphorus (P), Ca/P, Cu/Ca, Cu/P ratios and alkaline phosphatase (ALP) activity values were analyzed. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma glutamyltransferase (GGT) enzyme activities and the ALT/AST (De Ritis) ratio as well as their correlations with Cu were tested to determine liver function. The results of the study showed that Cu deficiency directly affects the organic matrix formation, and by the suppression of ALP activity, indirectly causes decalcification. In the liver, however, no direct effect of Cu deficiency was seen. Deterioration in liver function and Cu deficiency increased parallel with the severity of malnutrition. Thus we concluded that a correlation exists between Cu and the parameters that indicate liver function.

From 1979 to 1986 seven patients were studied in whom bezoars had been diagnosed. The history of five patients revealed that they had eaten a fruit called prunus lauricerasus, grown in the east Black Sea region. This is quite different from persimmons which are well-known as an aetiological agent of phytobezoars. Trichobezoars were present in one case, and phytobezoars in five cases. In one case, trichophytobezoar was removed surgically from the stomach. Our five cases were operated on to treat small bowel obstruction. Surgery was performed in all our cases and prunus lauricerasus should be kept in mind as an aetiological factor besides persimmons.

There is still uncertainty about the etiology and pathogenesis of abomasal displacement. Changes in total and ionized calcium are considered to be important pieces in the mosaic of causative factors. The present study on pre- and postoperative clinical chemical changes revealed a preoperative reduction in ionized calcium values. The reduction seemed mainly to be due to changes in the pH of blood.

A clinical study of 42 patients with hydatid disease was carried out using a real-time gray scale B-scanner. All cases were confirmed surgically. The ultrasound characteristics of the hydatid cysts were classified into three groups: Type I, simple hydatid cyst (19 of the 42 cases), type II, hydatid cyst with a disrupted wall and septa (14 cases), and type III, hydatid cyst with a heterogeneous echo pattern (9 cases). It was concluded that ultrasound classification of the cysts increases diagnostic accuracy. However, if a hydatid cyst becomes secondarily infected these typical changes are lost and the ultrasound diagnosis may then become more difficult. Periodic examinations should be performed with ultrasound after surgery.