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Hidradenitis suppurativa (HS) is characterized by deep-seated, highly inflamed, and painful lumps/abscesses, fistulae, and sinus tracts that grow extensively deep in the dermis and are highly immunogenic in nature. In about one-third of the HS patients there is strong evidence for the role of γ-secretase mutations along with dysregulated Notch signaling. However, the contribution of dysregulated Notch signaling in HS pathogenesis in relation to hair follicle alterations and hyper-activation of the immune system remains undefined. A genome-wide association study (GWAS), proteomic data and functional investigations of identified sequence variants in HS pathology are not fully revealing. The disease initiation or progression may involve bacterial infection besides intrinsic functional defects in keratinocytes, which may be key to further exacerbate immune cell infiltration and cytokine production in and around the lesional tissue. The absence of a suitable animal model that could fully recapitulate the pathogenesis of HS is a major impediment for proper understanding the underlying mechanisms and development of effective treatments. The presence of extracellular matrix (ECM) degradation products along with dysregulation in keratinocytes and, dermal fibroblasts ultimately affect immune regulation and are various components of HS pathogenesis. Bacterial infection further exacerbates the complexity of the disease progression. While anti-TNFα therapy shows partial efficacy, treatment to cure HS is absent. Multiple clinical trials targeting various cytokines, complement C5a and ECM products are in progress. This review provides state-of-the-art information on these aspects with a focus on dysregulated keratinocyte and immune cells; and role of ECM, and Keratin functions in this regard.

Background Aggressive angiomyxoma is an infrequent benign tumor that usually occurs in the pelvic region. Pelvic masses have variety of differential diagnosis but some featured findings should prompt the diagnosis of aggressive angiomyxoma by the radiologist. Case presentation A 40-year-old female patient presented with a two-year history of perineal swelling. Radiological examination including gray scale and color Doppler ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) was consistent with the diagnosis of aggressive angiomyxoma. The patient underwent surgical operation that ensures total resection of the tumor. Conclusion In the case of extensive pelvic soft tissue mass with characteristic imaging findings, the radiologists should take the diagnosis of aggressive angiomyxoma into consideration.

BACKGROUND: Autologous fat grafting is a popular technique for volume replacement in the breast and face. The efficacy, safety, and complication rate of this technique at the division of plastic surgery at the University of Alabama at Birmingham will be described in this review. METHODS: An institutional review board–approved retrospective review of patients undergoing fat grafting procedures from January 2015 to July 2018 was performed. Records were reviewed for fat graft recipient site, donor site, amount grafted, and complications. Continuous variables were compared using either a t test or one-way analysis of variance test. Categorical data were compared using χ(2) test. A P value of 0.05 or less was considered statistically significant for all comparisons. RESULTS: A total of 396 patients who underwent fat grafting procedures of the face and body from January 2015 through July 2018 met inclusion criteria. Average amount of fat grafted for all grafts was 124.4 +/− 6.74 grams. Two hundred fifty of the grafts (62.7%) involved the bilateral breasts with an average of 140.6 +/− 93.97 g used, 70 per side. Of the 396 patients, 110 (27.8%) experienced complications. Forty three of the complications (10.9%) were considered to be major, which included hematomas/seromas, fat necrosis, dermatitis/cellulitis, and infection. No statistical differences were seen among recipient site complication rate. Types of minor complications were statistically significant per recipient sites with bilateral breasts more likely to experience asymmetry than the other recipient sites (20% for bilateral breasts vs 16% overall, P < 0.05). Fifty nine of the 110 patients (53.6%) had the complications reported to be resolved. CONCLUSIONS: Fat grafting is a reliable method for volumization of the breasts and face. Minor complications were not infrequent in this case series; however, no life-threatening complications were observed. Continued work needs to be done to use fat grafting beyond traditional measures.

The present work reports an experimental study on the thermal and mechanical properties of hybrid composites obtained from Petiole Date Palm Fiber (PDPF)/Glass fiber (GF) as reinforcement and vinylester resin (VE). In order to improve the fiber/matrix adhesion, palm fibers were alkali treated with 5% NaOH solution for 24 h–72h. SEM and ATR-FTIR analysis revealed that the 48 h treatment of PDFP with NaOH solution led to rough fiber surface. Vacuum assisted resin transfer molding (VARTM) system was used to produce four hybrid composites (30PDPF/0GF, 20PDPF/10GF, 10PDPF/20GF and 0PDPF/30GF) where the weight ratio of total fiber reinforcement was kept 30%. The treated palm fibers were arranged as a nonwoven mat and placed between woven glass fabrics. Tensile, flexural, dynamic mechanical thermal analysis (DMTA), and thermogravimetric (TGA) were carried out to evaluate the performance of the hybrid composites. The flexural strength and modulus for pure PDPF composite were found to be 60 MPa and 3.87 GPa respectively. Addition of 20%wt glass fiber led an increase in the thermal stability and an enhancement in the tensile and flexural strength by 71.72% and 74.51%, respectively compared to pure PDPF composite. However, the incorporation of 10% of PDPF increases the damping factor from 0.2 for the composite glass/VE to 0.54 for the hybrid 10PDPF/20GF. According to findings of this study, PDPF based composites can be used as non-structural parts in automotive and boat industries.

Nitrogen-doped TiO2 fibers (N–TiO2 Fs) were successfully and efficiently fabricated using titanium diisopropoxide bis(acetylacetonate) and polyvinylpyrrolidone (PVP) as a carrier polymer and nitrogen source via centrifugal spinning and subsequent calcination methods. XRD analysis confirmed that N–TiO2 Fs contains only anatase and rutile phases. XPS analysis revealed that N-atoms (from PVP) were successfully incorporated into the lattice of TiO2 whereas DTA and FTIR analysis confirmed that calcination at 550 °C for 1 h is appropriate to remove all organic impurities from the N–TiO2 Fs. SEM images showed that the N–TiO2 Fs of diameter (0.65 μm–1.2 μm) were produced and controlled with the amount of Ti-precursor. BET analysis confirmed that the addition of commercial TiO2 nanoparticles increased the specific surface area of the N–TiO2 Fs. UV–Vis diffuse reflectance measurements showed that N–TiO2 Fs exhibited a stronger light absorption in the visible region and a red-shift which is responsible for narrow band gap energy owing to the presence of N-atoms in the TiO2 lattice. This results in enhanced photocatalytic activity of the synthesized N–TiO2 Fs for degradation of methylene blue under visible light irradiation.

Comorbidity trends after median sternectomy were studied at our institution by Vasconze et al (Comorbidity trends in patients requiring sternectomy and reconstruction. Ann Plast Surg. 2005;54:5). Although techniques for sternal reconstruction have remained unchanged, the patient population has become more complex in recent years. This study offers insight into changing trends in this patient population.A retrospective review was performed of patients who underwent median sternectomy followed by flap reconstruction at out institution between 2005 and 2020. Comorbidities, reconstruction method, average laboratory values, and complications were analyzed.A total of 105 patients were identified. Comorbidities noted were diabetes (27%), immunosuppression (16%), hypertension (58%), renal insufficiency (23%), chronic obstructive pulmonary disease (16%), and tobacco utilization (24%). The most common reconstruction methods were omentum (45%) or pectoralis major flaps (34%). Thirty-day mortality rates were 10%, and presence of at least 1 complication was 34% (hematoma, seroma, osteomyelitis, dehiscence, wound infection, flap failure, and graft exposure). Univariate analysis demonstrated that sex (P = 0.048), renal insufficiency, surgical site complication, wound dehiscence, and flap failure (P0.05) had statistically significant associations with mortality. In addition, body mass index, creatinine, and albumin had a significant univariate association with mortality (P0.05).Similar to the original study, there is an association between renal insufficiency and mortality. However, the mortality rate is decreased to 10%, likely because of improved medical management of patients with increasing comorbidities (80% with greater than one comorbidity). This has led to the increased use of omentum as a first-line option. Subsequent wound dehiscence and flap failure demonstrate an association with mortality, suggesting that increasingly complex patients are requiring a method of reconstruction once used a last resort as a first-line option.

Solution blow spinning (SBS) technique can produce nanofibers (NFs) mat in large-scale production. In this work, the SBS was used to fabricate piezoelectric polyvinylidene fluoride (PVDF) NF membranes that can be utilized for energy harvesting applications. The effect of operating air pressure from (2–5 bar) on the surface morphology of the NFs has been studied. The structural analysis for crystalline polymorph β-phase for PVDF powder, casted film, electrospinning and SBS NFs has also been presented with the aid of Fourier-transform infrared spectroscopy and X-ray diffraction (XRD). Piezoelectric characteristics of PVDF NFs mats were tested by applying impact impulse with different weights from different heights between 1 and 10 cm. The sensitivity of the voltage response increased from 1.71 mV/g to 8.98 mV/g, respectively. Besides, the SBS generated PVDF mat is found to be sensitive to pressure forces in a range of few Newtons with the generated voltage according to detected sensitivity of 80 mV/N based on the analysis of the impact of a few Hertz mechanical vibrations. In addition, the produced SBS NFs were applied as an acoustic signal detector within different acoustic frequencies. The results suggest that the β-phase PVDF nanofibrous membrane produced via the SBS technique has a great potential to be used as a piezoelectric sensor.

Introduction. Pyoderma gangrenosum (PG) is a multifactorial neutrophilic dermatosis of unknown etiology. It can occur in isolation; in association with different inflammatory, autoimmune, or malignant diseases; or as part of various syndromes. Because of its low incidence and the difficulty in distinguishing it from other possible lesions, PG is usually misdiagnosed. As a result, patients may be subjected to unnecessary treatments and surgical interventions that exacerbate the development of PG, as pathergy phenomenon is observed with this skin disorder. Surgical trauma can also lead to the formation of PG with the same mechanism. The occurrence of PG lesions has been reported after plastic surgery as well. In most cases, however, the diagnosis is delayed, resulting in disfigurement, additional surgeries, and extended hospital stay. Case Report. In this article, a case of early detected bilateral PG after reduction mammoplasty in a patient with no personal or family history of autoimmune disorders is presented. Careful examination of the wound and analysis of the clinical picture resulted in the diagnosis of PG. Conclusions. The authors believe that the description of the diagnostic clues considered in this case will aid the plastic surgeon in prompt recognition and management of postoperative PG, with the aim of decreasing patient morbidity and the duration of hospital stay while preventing additional complications.

High-pressure drop and lower dust holding capacity reduce the performance of nanofibrous air filters. For that reason, this study was carried out to form filters with high-quality factor and high dust holding capacity, thanks to the glass particle additives. In this study, as an approach to such modifications, fluffy nanofiber webs were produced via solution blowing. Polyamide 6 (PA6) was chosen as the base for the nanofibrous mats, where glass microparticles were embedded as an additive to reduce web solidity. The effects of glass microparticle embedding on the filtration performance and pressure drop of the mats were investigated. SEM analysis was performed to analyze nanofiber diameter and morphology. Also, the barrier properties of samples were examined by air filtration and air permeability tests. Findings showed that the addition of glass particles did not alter fiber morphology significantly. However, lowering the pressure drop resulted in higher air permeability and better filtration performance in terms of the quality factor. Glass particles embedded composite samples exhibited a higher quality factor compared to the neat PA6 sample, and the PA6 + 5%GP sample has the highest quality factor value around 0.43. The filtration efficiency of this sample was 99.97% at an expense of 187.3 Pa pressure drop. The obtained enhancement was conducted to the lower solidity of composite webs which was 36% lower for the PA6 + 5%GP sample.

Malignant hand tumors are rarely observed in clinical practice which makes distinguishing them from benign soft tissue masses particularly challenging. A 41-year-old male presented with joint pain and swelling of his left index metacarpophalangeal joint. Radiological studies showed pronounced swelling around the affected joint with no bony abnormality, but incision and drainage of the site yielded negative cultures. Subsequent gross total resection confirmed the diagnosis of myxoid liposarcomas after cytogenetic pathology examination. Recurrence occurred after 1 year, followed by second resection and adjuvant radiotherapy. At 2 years follow-up, the patient was recurrence free. In conclusion, myxoid liposarcoma should be in the differential diagnosis of an older patient with erythema and swelling surrounding a subfascial mass of the hand. Keywords: Hand surgery, Hand tumor, Myxoid liposarcoma, Soft tissue mass

In this study, polyvinylpyrrolidone-based nanofibrous air filter media were produced via centrifugal spinning and subsequently stabilized by thermal cross-linking process. Samples were produced using solutions with three different polymer concentrations (5, 10 and 20 wt.%) and three different rotational speeds (4000, 6000 and 8000 r/min). After obtaining the optimum web structure with the lowest average fiber diameter and the most uniform distribution, the webs were later thermally cross-linked in order to stabilize polyvinylpyrrolidone against the degradative effects of water. In addition, the webs were subjected to dissolvability tests to see the efficacy of cross-linking treatment. Morphological, structural and chemical characterizations of the polyvinylpyrrolidone webs were performed by SEM, XRD and FTIR, respectively. Finally, filter efficiency and pressure drop were measured to assess filter performance. The results have shown that the lowest average fiber diameter is obtained at the highest rotational speeds. Subsequent thermal cross-linking treatment has been found to prevent fibers from dissolving in water. The produced water-resistant, environmentally friendly polyvinylpyrrolidone nanofibrous filter media has had a satisfactory filtration performance with a high filter efficiency of 99.995% and a high quality factor of 0.39 mm H2O−1.

Antibacterial wound dressing mats were produced via coating solution blown TPU nanofiber mats with Szygium aromaticum extract (clove oil). Soxhlet extraction was used to obtain clove oil (C...

In this study, silica-based nanofibers were produced via centrifugal spinning (C-spin) and subsequent calcination. The produced heat resistant media was challenged with NaCl nanoparticles to invest...

The performance of fibrous filter media relies on factors such as particle capture efficiency, pressure drop and clogging time. Fiber diameter, porosity and packing density are important web-based factors to improve final filtration performance. In this study, composite nonwoven webs were produced using spunbonded, meltblown and electroblown mats to obtain filter media with different fiber diameter, porosity and packing density. Such a layered composite approach caused huge differences in porosity and packing density, which resulted with improved clogging performance. The average fiber diameter was found to be 65 ± 19.4 nm for electroblown layer ( N), while that was 1.17 ± 0.38 μm for meltblown (M) and 17.64 ± 2.65 μm for spunbond (S) layers. NM (nanofiber+meltblown) configuration provided 12–13% lower mean flow pore size, which resulted in faster clogging compared to NS (nanofiber + spunbond) mats. The thicker nanofibrous layer resulted in lower pore size and quality factor. Additionally, the composite samples showed a faster-rising pressure drop than the thick microfibrous mats due to smaller pores that clogged quickly. It was also shown that nanofiber coating causes a linear increase in pressure drop with dust loading, while microfibrous samples exhibited smooth plateau and linear increase after clogging point. Nanofiber layer facilitates cake formation which causes more difficult airflow, and lower dust holding capacity. Among the layered composite mats, the NM configurations were found to be more advantageous due to higher initial filtration efficiency and almost similar dust loading performance.

Polyethylene (PE) has high flammability and can be quickly burned under atmospheric conditions without leaving any residues. This study presents PE fibers produced by a novel modified melt spinning line to enhance mechanical and flame retardancy properties. Scanning electron microscopy equipped with energy dispersive X-ray, thermogravimetric analysis, limiting oxygen index, micro combustion calorimeter and tensile tests were performed to reveal morphological, thermal and mechanical characteristics of the fibers. An organic phosphorus additive was used to provide flame retardancy in addition to mechanical performance in one-step production. Subsequently, the produced fibers were subjected to the hot drawing, increasing modulus values from 135 MPa to 2.8 GPa. In addition, phosphorus-treated fibers exhibited a limiting oxygen index (LOI) value of 21.5, leaving some residue at 600°C. Furthermore, a decrease in the peak heat release rate (pHRR) was observed in all samples compared to the control sample for the micro combustion calorimeter (MCC) test. Looking at the decrease in heat release (HR), the best result belongs to zone II with 50 and 95°C produced at 1000 m/min take-up speed for the samples. Moreover, about 23%, 23%, and 18% decreases were observed in HR capacity, pHRR, and total HR values, respectively. The modified spinning system is capable of continuous production of flame retardant linear low-density polyethylene (LLDPE) fibers, which can find widespread applications in aviation, automotive, and defense industries.

Thermoresponsive films are favorable for the packaging of fresh fruits and vegetable products as their gas permeabilities increase to a greater extent than commercial films when temperature abuse occurs during refrigerated storage. Thermoresponsive polyurethane (PU) films were synthesized from polyethylene glycol (PEG) with three different molecular weights (400, 1000, and 1500 g mol(-1)), castor oil (CO) with two different proportions (30 and 50 %, CO/PEG ratio) and a constant level of 1,4-butanediol (BDO). The effects of these compositional factors on the thermal, mechanical, physical, structural, and gas barrier properties of the films were investigated. Melting temperatures (T-m) of the PU films varied from 25 to 29 degrees C and decreased with CO content. Glass transition temperatures (T-g) of the films were all below -32 degrees C and decreased by increased CO content. PU films with 1500 g mol(-1) PEG and 30 % CO/PEG ratio had better shape memory (R-r) and shape fixity (R-f) properties than others. O-2 permeabilities of the PU films were in the range of 1.99-7.25 barrer while their CO2 permeabilities were between 10.3 and 18.3 barrer. The temperature sensitivity of the gas permeabilities of the PU films was higher than that of a commercial LDPE film, which makes them more appropriate for fresh produce packaging. Nevertheless, PU films were mechanically weaker and they had higher water vapor permeability compared to the LDPE film. These properties of the PU films need further improvements for potential packaging applications.

Aim: Colonic anastomotic strictures are usually caused by staple use, anastomotic leakage, intestinal or suture line ischemia and radiotherapy. Endoscopic treatments should be the first choice. Resection of the stricture line and re-anastomosis form the basis of surgical treatment. Compared to endoscopic approaches, the morbidity rate of surgical treatments for strictures are higher. In patients with stricture and history of multiple pelvic surgeries who don’t allow endoscopic treatments, magnetic compression strictureplasty (MCS) may be a good choice for lower morbidity. Methods: The study population included patients with colorectal anastomotic stricture who had failed endoscopic treatments and for whom a tertiary resection and anastomosis was also considered as having high morbidity. Firstly, the MCS technique was planned by colonoscopic approach. It was aimed to place the magnet proximal to the stenotic colon with the colonoscope, which has a ring-shaped magnet attached at the tip, through the ileostomy entrance. This endoscopic approach failed. Then, laparotomy was performed. A 1-cm colotomy was performed from the proximal site of the stricture, and the magnet was left inside the intestine. Another magnet was placed distally to stricture from the anus. The two magnets were observed to compress the stricture by magnetic attraction, and the operation was terminated. Patient demographics, surgical history, MRI results, colonoscopic examination results were recorded. The follow-up conditions of the patients were noted.Results: MCS was performed on two male patients mean aged 70 (14.14) years. All patients had multiple abdominal surgeries in their surgical history. Colonoscopy showed fully obstructing anastomotic stricture in patients. The mean distance from the anal verge to the stricture in colonoscopic examination was 7±1.41 cm. Mean stricture length in MRI was 12±2.82 mm. In follow up, control rectosigmoidoscopies revealed that the magnets had fallen into the rectum lumen and the stricture line was fully patent for all patients.Conclusion: MCS might be preferred as a safe surgical technique with low morbidity in patients with previous multiple colorectal surgeries and a full obstructive stricture in the colorectal anastomosis line., Amaç: Anastomoz kaçakları, anastomozun stapler ile yapılmış olması, anastomoz hattında oluşan iskemi ve radyoterapi uygulamaları kolonik anastomotik darlıkların en önemli sebepleridir. Striktür tedavisinde endoskopik girişimler ilk tercih olmalıdır. Striktür hattının rezeksiyonu ve yeniden anastomoz cerrahi tedavinin temelini oluşturur. Endoskopik yaklaşımlarla karşılaştırıldığında, darlıklara yönelik cerrahi tedavilerin morbidite oranı daha yüksektir. Endoskopik tedavilere izin vermeyen darlık ve çoklu pelvik cerrahi öyküsü olan hastalarda, manyetik kompresyon striküroplastisi (MCS) düşük morbidite için iyi bir seçim olabilir.Yöntemler: Çalışma popülasyonu kolorektal anastomotik darlığı olan ilave bir rezeksiyon-anastomoz girişiminin yüksek morbiditeye sahip olduğu ve endoskopik tedavilerin başarısız olduğu hastaları içermekteydi. İlk olarak MCS yöntemi kolonoskopik olarak planlandı. İleostomi açıklığından girerek ucunda halka şeklinde bir mıknatıs olan kolonoskop ile mıknatısın kolondaki darlığın proksimaline yerleştirilmesi hedeflendi. Bu endoskopik girişim başarısız oldu. Daha sonra hastalara laparotomi yapıldı. Striktürün proksimal bölgesinden yapılan 1 cm’lik kolotomiden sirküler yapıda 1,5 cm çaplı mıknatıs bağırsağın içine bırakıldı. Anüsten de striktürün distaline başka bir mıknatıs yerleştirildi ve iki mıknatısın, manyetik çekimle striktüre kısmı sıkıştırarak birbirine yapıştığı gözlendi ve ameliyat sonlandırıldı. Hastaların demografik bilgileri, cerrahi geçmişleri, MRG sonuçları, kolonoskopik muayene sonuçları kaydedildi. Hastaların postoperatif takip bilgileri kaydedildi. Bulgular: İki erkek hastaya MCS uygulandı. Yaş ortalaması 70 (14,14) saptandı. Tüm hastalar daha önce geçirilmiş multipl abdominal cerrahi öyküsüne sahipti. Kolonoskopide, hastalarda tamamen tıkanmış anastomotik darlık gözlendi. Kolonoskopik incelemede anal girimden striktüre olan ortalama mesafe 7±1,41 cm saptandı. Manyetik rezonans görüntülemede ortalama striktür uzunluğu 12±2,82 mm saptandı. Postoperatif takipte kontrol rektosigmoidoskopide mıknatısların rektum lümenine düştüğü ve darlık hattının tamamen açıldığı gözlendi. Sonuç: MCS, daha önce multipl kolorektal cerrahi geçirmiş olan ve kolorektal anastomoz hattında tam tıkayıcı striktüre sahip hastalarda güvenli ve düşük morbiditeli bir cerrahi teknik olarak tercih edilebilir.

Aim:Deciding on the type of fistula and deciding on the most appropriate type ofsurgery is still a challenge for anal fistula disease. In this study, we aimedto evaluate whether magnetic resonance imaging (MRI), endoscopic examinationand co-administration of both in preoperative preparations of anal fistulas arebeneficial in this respect. Methods:The study was retrospectively performed in patients treated surgically forperianal fistula between 2008 and 2017. The data of 307 patients operated foranal fistulas were reviewed with hospital records. Patients were grouped underthe headings of preoperative MRI and non-MRI, endoscopic and non-endoscopicexamination, and both performed and non-performed. The demographic data (age,sex), fistula type (simple or complicated), presence or absence of seton andthe type of surgery were recorded. These parameters were compared with the groups.Results:In the preoperative evaluation, 162 (53%) patients had MRI, 83 (27%) patientshad endoscopic examination and 60 (20%) patients had both. There was astatistically significant correlation between the presence of preoperative MRIand the need for seton placement (p 0.05 for all).Conclusion: Preoperative modalities such as MRI andendoscopy are not sufficient in determining the type of fistula in an analfistula and determining the surgical method to be applied. We believe thatcombining these studies with perioperative examination may be helpful inobtaining more effective results. Also, performing MRI preoperatively may helpsurgeons for decision of seton placement., Amaç:Anal fistül hastalığında fistül tipine karar vermek ve en uygun ameliyat tipinekarar vermek ileri tetkiklerin kullanılmasına karşın halen içerisinde zorluklarbarındırmaktadır. Bu çalışmada, anal fistül hastalarının ameliyat öncesi hazırlıklarındamanyetik rezonans görüntüleme (MRG), endoskopik inceleme ve her ikisinin birlikteuygulanmasının bu konuda yararlı olup olmadığını değerlendirmeyi amaçladık.Yöntemler:Çalışma 2008-2017 yılları arasında perianal fistül nedeniyle cerrahi tedavi uygulananhastalarda retrospektif olarak yapıldı. Anal fistül nedeniyle ameliyat edilen307 hastanın verileri hastane kayıtları ile gözden geçirildi. Hastalar ameliyatöncesi MRG yapılan ve yapılmayanlar, endoskopik inceleme yapılan ve yapılmayanlarve her ikisi yapılan ve yapılmayanlar başlıkları altında gruplandırıldı. Hastalarındemografik verileri (yaş, cinsiyet), fistül tipi (basit veya komplike), seton yerleşimininolup olmadığı ve uygulanan cerrahi tipi kaydedildi. Bu parametreler gruplarla karşılaştırıldı.Bulgular:Ameliyat öncesi değerlendirmede 162 (% 53) hastaya MRG, 83 (% 27) hastaya endoskopikinceleme ve 60 (% 20) hastaya da her ikisinin birden yapıldığı saptandı.Ameliyat öncesi MRG varlığı ile seton yerleştirilme gereksinimi arasında istatistikselolarak anlamlı korelasyon saptandı (p0,05). Sonuç:Anal fistül hastalığında fistül tipini saptamada ve uygulanacak cerrahi şeklinekarar vermede MRG, endoskopi gibi preoperatif modaliteler yeterli olamamaktadır,bu incelemelerin peroperatif muayene ile birleştirilerek değerlendirilmesinin dahaetkili sonuç elde etmede faydalı olacağı kanaatindeyiz. Ayrıca preoperatif MRGuygulamasının seton gereksinimi konusunda cerrahlara yardımcı olabileceğini düşünmekteyiz.

Generally, reconstruction of knee defects with exposed bone, joint, tendon, and/or hardware requires a vascularized muscle flap for coverage. Although there are several surgical options for a knee defect reconstruction, the pedicled gastrocnemius muscle still remains the workhorse flap. Although this flap is commonly used for knee defect reconstruction and the technique is described very well, there is an absence of information in the literature detailing the technique of harvesting and insetting of the gastrocnemius flap step by step with illustrations. The purpose of this article is to describe in detail the technique to reconstruct defects of the knee with pedicled gastrocnemius muscle flap as well as to present demographics and surgical results of 21 patients who had knee reconstruction with a pedicled gastrocnemius muscle flap and split-thickness skin grafting.

Aim: Despite many treatment modalities, anal fistula disease remains an important problem. High recurrence rates have been reported in the surgical treatment of complicated anal fistulas. We hereby present complicated anal fistula patients treated with rectal advancement flaps.Methods: Patients who underwent rectal advancement flap surgery by a single surgeon between 2009 and 2019 were analyzed in this retrospective cohort study. Demographic data, number of previous operations, recurrence rate and complications were recorded.Results: Twenty patients (15 males and 5 females) underwent surgery with the rectal advancement flap technique. Nine patients had more than one previous operation. Seton, partial fistulectomy and curettage were the most performed operative techniques in their previous surgeries. The mean follow-up period was 31 months (3-74). Among 13 patients with follow up periods longer than 12 months, 3 patients had recurrences (23%), all of which had been previously operated twice or more. Conclusion: Although rectal advancement flap is not the first choice in the treatment of complicated and high transsphincteric fistulas, it still maintains its importance. Experienced surgeons prefer this method due to its sphincter-sparing nature. In our study we detected a recurrence rate of 23% and incontinence rate of 5%, which was thought to be related to previous surgeries., Giriş: Birçok tedavi yöntemine rağmen, anal fistül hastalığı önemli bir problemdir. Özellikle komplike anal fistüllerin cerrahi tedavisinde yüksek nüks oranları bildirilmiştir. Bu çalışmada rektal ilerletme flepleri ile tedavi edilen karmaşık anal fistül hastalarını analiz etmek amaçlandı. Yöntemler: 2009-2019 yılları arasında tek cerrah tarafından rektal ilerleme flep yapılan hastalar bu retrospektif kohort çalışmada incelendi. Demografik veriler, önceki operasyon sayısı, nüks oranı ve komplikasyonlar kaydedildi.Bulgular: Yirmi hastaya (15 erkek ve 5 kadın) rektal ilerleme flep tekniği uygulandı. Dokuz hasta önceden birden fazla ameliyat geçirmişti. Hastalara daha önce seton, parsiyel fistülektomi ve küretaj yapılmıştı. Ortalama takip süresi 31 aydı (3-74). 12 aydan daha uzun takip süreleri olan 13 hastanın 3'ünde nüks (%23) saptandı, bunların hepsi daha önce iki kez veya daha fazla ameliyat geçiren hastalardı. Sonuç: Rektal ilerletme flebi, komplike ve yüksek transsfinkterik fistüllerin tedavisinde ilk seçenek olarak kullanılmamasına rağmen, önemini korumaktadır. Deneyimli cerrahlar sfinkter koruyucu yapısı nedeniyle bu yöntemi tercih ediyorlar. Çalışmamızda, önceki ameliyatlara bağlı olarak düşünülebilecek %23'lük bir rekürrens oranı ve %5 inkontinans oranı analiz edildi.

While our knowledge of fiber formation by using conventional nanofiber spinning techniques has increased to a considerable extent, there are still few studies on centrifugal spinning either in academia or in the industry. Centrifugal spinning is a comparatively new method of producing fibers having nano- or microscale diameters. In this study, three main parameters (nozzle orifice diameter, rotational speed, polymer concentration) of centrifugal spinning were optimized to produce air filter media from thermoplastic polyurethane nanofibers. The effect of concentration of polymer solution was found to be a major contributor in TPU fibers optimization estimating 77.5%. After the optimization studies, the average fiber diameter of nanofiber sample produced at optimum conditions (22G needle as an orifice, 4000rpm, and 10wt% concentration of polymer solution) was 205 84nm. Aerosol filtration performance of the produced webs was analyzed. Filtration efficiency of the optimized sample was found to be 99.4% for 0.3 mu m particle size at an expense of 98Pa pressure drop.Copyright (c) 2018 American Association for Aerosol Research

Ensete fiber is a natural material extracted from E. ventricosum plants which is widely cultivated for food. This study is the first attempt to develop its composite by improving its compatibility with high density polyethylene (HDPE). The premixed composite constituents were melt-compounded by twin-screw extrusion and granulated. Composite plates were molded using hot-press machine. The effect of grafting maleic anhydride to HDPE and varying fiber loading on composite properties were investigated. Increasing ensete fiber loading has resulted in the composites being stiffer and harder leading to a decrease in its elongation at break. The addition of 5 wt% compatibilizer into 25 wt% ensete fiber-filled HDPE improved the fiber-matrix adhesion. Its tensile strength, flexural strength and impact absorption energy increased by nearly 43%, 46%, and 56% respectively when compared to composites with the same fiber loading and without compatibilizer. Morphological analysis from microscopic images of tensile fracture surfaces enlightened the interfacial adhesion to support these test results. The composites density, water absorption and melt flow index were also compared. The results show that ensete fiber-HDPE composite could be used as construction and building materials, low-density furniture, and moldable structures in need of design flexibility.

Amac: Abdominal duvar hernilerinin tedavisinde temel prensip gerilimsiz onarimdir. Polipropilen mesh nedeniyle olusan adezyon riskini azaltmak icin antiadeziv bariyerli meshler kullanima girdi. Bu calismanin amaci, omega-3 yag asidi kapli polipropilen mesh kullanilarak ameliyat edilen hastalarin postoperatif takip sonuclarinin analiz edilmesi idi. Gerec ve Yontem: Bu calisma, kasim 2010 – temmuz 2015 yillari arasinda omega-3 yag asidi kapli polipropilen mesh kullanilarak opere edilen hastalarin, digital veri bankasinda taranmasi ile prospektif olarak yapildi. Uygulanan ameliyat teknigine gore hastalar iki gruba ayrildi (grub 1: laparoskopi, grub 2: acik cerrahi). Mesh olarak omega-3 yag asidi kapli polipropilen mesh kullanildi (C-QURTM Mesh, Atrium Medical Corporation, Hudson, NH, USA). Postoperatif komplikasyonlar irdelendi. Bulgular: Calismaya 30 hasta dahil edildi. Erkek- kadin orani esit olup yas ortalamasi 56.2±14.5 (aralik: 17-83) idi. Yirmi iki hastada (%73) primer sutur ile onarilamayan abdominal duvar hernisi (grub 2), 8 inde (%27) laparoskopik onarilan abdominal duvar hernisi (grub 1) vardi. Dokuz hastada (%30) komplikasyon gelisti. Yas, cinsiyet ve uygulanan cerrahi teknigin komplikasyon gelisimine etkisi istatistiksel olarak anlamli bulunmadi. Komplikasyon gelisen hastalarda defekt boyutu istatistiksel olarak anlamli derecede yuksekti. Sonuc: Antiadeziv bariyerli meshlerin uzun donem sonuclari bilinmemektedir. Bu tip meshlerin de komplikasyon, saglik problemi ve hatta olume bile neden olma potansiyeli oldugu unutulmamalidir.

In this work, an experimental investigation was proposed for the evaluation the wear resistance of hybrid polymer composite inter-layer of Petiole date palm fiber (PDPF) and glass fiber (GF). In order to enhance the interfacial of hydrophobic fibers (PDPF) and hydrophilic (Vinylester resin), chemical treatment was proposed based on 5% NaOH for 48 h. Besides, the glass fiber (woven) was used in order to increase the specific stiffness and the dimensional stability of specimens. The manufacturing of four hybrids specimens was done using a VARTM process [(30PDPF/0GF), (20PDPF/10GF), (10PDPF/20GF) and (0PDPF/30GF)]. The wear characteristics were evaluated at a sliding distance of (1000 m), sliding velocity (1.7 m/s) and applied loads (20 and 40 N). Scanning electron microscopy was performed on both treated alkali fiber and worn surfaces of hybrid specimens to evaluate the surface modification and wear mechanisms, respectively. The adding of glass fiber to PDP fibers was advantageous on the wear resistance, where it improved the wear resistance of 30PDPF/0GF around 190 and 310% as compared to (20PDPF/10GF) and (10PDPF/20GF), respectively. The adding of loads was disproportional to wear resistance. The SEM of worn surfaces showed debonding and bending of fibers, and fragmentation, fiber broken, and deformation on the resinous regions. In the end, the hybridization by 20% of glass fibers exhibits a high wear resistance relative to its nature (partially bio-friendly) and price.

Improving properties of polymeric and non-polymeric fibers, for example mechanical, dimensional stability, thermal degradation, and etc. with understanding a recent theoretical investigation on the solid mechanism of single crystal growth leads to obtain fiber-based products with unusual characteristics. Similarly, high performance fibers are important engineering products and widely used due to their outstanding mechanical property along with dimensional stability. They have found extensive use as fiber reinforcement and can be utilized in many applications such as cords, ropes, performance fabrics, electronic packaging, sports equipment and fiber optics (Hearle, 2001; Kerr, Chawla and Chawla, 2005). It is well known that the highest tenacity and elastic moduli reported for such fibers are still much lower than their theoretical values. An extensive open gap between theoretical values and practical results encourage scientists to workand improve the mechanical properties. On the other hand, due to their nonconventional chemistry and instrumentation, many researches have been concentrated on reducing its production costs. Additionally, there is no single fiber chemistry that can withstand all sort of end-use conditions. The objective of this review paper is to provide a critical andconstructive analysis on current state of art high performance fiber production and modification techniques. Current problems and novel solutions were emphasized separately.

Aims: Retrorectal tumors are rare, mostly benign tumors and named due to their localization. Diagnoses of these tumors are usually delayed because of nonspecific complaints and symptoms. Magnetic resonance imaging has beneficial uses both for diagnosis and treatment. In this study, we reviewed a case series of retrorectal tumors. Subjects and Methods: The patients who were diagnosed with retrorectal tumors between 2008 and 2015 were analyzed. This investigation was conducted at a Tertiary Education and Research Hospital. Sixteen patients were included in this study. Patients' demographic data, imaging workups, surgical operation reports, pathologic examination results, postoperative complications, and follow-up results were examined. Descriptive statistics, median, and standard deviation for continuous variables were used. The primary outcomes measured were diagnostic conflict, knowledge, and preference for surgery. Statistical Analysis Used: Definitive statistical methods (mean, standard deviation, median, frequency, and percentage) were used to evaluate the study data. Results: One patient refused operation and one was in preoperative preparation period. Fourteen of sixteen patients were operated. Two (14.3%) of operated patients have malignant histopathological result (one gastrointestinal stromal tumor, one ganglioneuroblastoma). Rest of the operated patients' histopathological reports was as follows: Four schwannomas, three epidermoid cysts, two tailgut cyst, one dermoid cyst, one teratoma, and one angiomyolipoma. Eight patients were operated by posterior incision, five patients with transabdominal approach, and one patient with combined approach. Conclusions: Retrorectal tumors are rare cases, and treatment of retrorectal tumors is surgery and should be operated in referenced hospitals to avoid diagnostic and therapeutic problems.

This study aimed to identify the effects of the stacking sequences on mechanical and dynamic mechanical properties of ensete/glass hybrid composites. The composites were fabricated by using 4 layers of carded ensete web and woven glass fabric by Vacuum-assisted resin transfer molding method. Mechanical and dynamic mechanical properties of hybrid composites were characterized. The test results showed that hybridization of ensete web with glass woven fabrics enhanced the mechanical properties of ensete composites. The morphology of fractured samples reveals that higher glass fibers pullout than ensete fibers in hybrid composites. The flexural properties also increased when glass fiber hybridized with ensete fiber and the optimum values obtained when it is used as the skin of the composite.The composites stacked as glass-ensete-glass (GEEG) showed higher storage modulus as compared to glass-ensete (GGEE) ensete composites whereas loss modulus of the composites reinforced with glass fiber exhibited the maximum value of 407 MPa and the height of the damping curve decreased in GEEG composite. Experimental studies showed that the ensete/glass fiber hybrid polyester composites can be used as load-bearing structures and components where high resistance to deformations and thermal stability is necessary.

In the present work, effect of annealing on charging and surface morphology of isotactic polypropylene (PP) filaments was reported. To enhance the surface crystallinity of the filaments, samples were annealed at 70 and 110 °C for 12 h. As expected, fiber surface crystallinity increased upon annealing which led more stable electret fibers. However, the change in the initial surface potential was not so remarkable. The same trend was also observed in filaments containing a commercial nucleating agent, NA11 (sodium 2,2′-methylene-bis(4,6-di-tertbutylphenyl)-phosphate). Surface crystallinity was analyzed using the intensity of specific peaks obtained from attenuated total reflection infrared spectroscopy analysis. The surface charge characteristics of fibers were determined using a modified surface potential decay test.