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Die Augmentation des medialen patellofemoralen Ligamentes (MPFL) ist eine gangige Methode zur Therapie einer patellofemoralen Instabilitat. Diese kann selbst nach Amputation des Unterschenkels durchgefuhrt werden. Die Durchfuhrung einer Magnetresonanztomographie (MRT) ist jedoch zur praoperativen Diagnostik zwischenzeitlich obligat. Somit konnen potenziell unerkannte Begleitpathologien bei der praoperativen Planung berucksichtigt werden.

Bei der Behandlung komplexer Beckenverletzungen steht die Blutungskontrolle im Vordergrund. Untersuchungen bzgl. der Blutungslokalisation sind jedoch sehr widerspruchlich, sodass unterschiedliche Behandlungskonzepte empfohlen werden. Die im Schockraum angelegte externe Beckenkompression soll v. a. das Beckenvolumen verkleinern und durch eine Selbsttamponade dem Blutverlust entgegenwirken. Welchen Einfluss die externe Beckenkompression auf die Letalitat und das Outcome bei hamodynamisch instabilen Beckenverletzungen aufweist, soll anhand einer groseren Fallzahl untersucht werden. In der vorliegenden Studie wurden anhand des TraumaRegister DGU® (TR-DGU) 104 Datensatze uber den Zeitraum von 2002 bis 2011 retrospektiv ausgewertet. Alle Verletzten erlitten eine Verletzungsschwere von mindestens 16 ISS-Punkten (Injury Severity Score). Des Weiteren befanden sich die Patienten in einer hamodynamisch instabilen Kreislaufsituation bei nachgewiesener relevanter Monoverletzung des Beckens. Zur Beurteilung der Effektivitat der externen Beckenkompression wurden die Patienten mit und ohne externe Beckenstabilisierung miteinander verglichen. Von den untersuchten Patienten erlagen 26,9 % ihren Verletzungen. Dabei betrug die Letalitat in den ersten 6 h nach Aufnahme im Schockraum 78,8 %. Eine externe Beckenstabilisierung wurde bei 45,2 % der Patienten durchgefuhrt. In der Gruppe der Patienten mit externer Beckenstabilisierung verstarben 19,1 %. Dagegen lag die Sterblichkeit in der Gruppe der Patienten ohne externe Beckenstabilisierung bei 33,3 %. Im stationaren Verlauf entwickelten die uberlebenden Patienten mit externer Beckenstabilisierung deutlich haufiger eine Sepsis bzw. ein Multiorganversagen und waren langer intensivpflichtig. Die externe Beckenstabilisierung scheint ein wesentliches Instrument der Initialbehandlung bei hamodynamisch instabilen Beckenfrakturen zu sein und zeigt eine positive Wirkung auf die Letalitat der Verletzten.

In der Akutphase der Behandlung polytraumatisierter Patienten steht die Stabilisierung der Vitalparameter im Zentrum der Notfallbehandlung. Die Verletzungen des Gesichtsschadels werden daher haufig erst spater diagnostiziert. Jedoch steht der Gesichtsschadel eng benachbart zu neuronalen Strukturen und sensorischen Organen wie Auge, Nase und Ohr. Zudem druckt das Gesicht Emotionen aus und stellt wichtige Personlichkeitsmerkmale dar. Aus diesen Grunden durfen die Patienten nach der notfallmasigen Versorgung je nach Verletzungsmuster ein klar strukturiertes, interdisziplinare Versorgungskonzept erwarten, in das Neurochirurgen, HNO-Arzte, Mund-, Kiefer- und Gesichtschirurgen sowie Ophthalmologen einbezogen sind. Ziel der vorliegenden Analyse war es daher, neben epidemiologischen Daten das Verletzungsmuster am Gesicht bei polytraumatisierten Patienten darzustellen. In der vorliegenden Arbeit wurden anhand des TraumaRegister DGU® (TR-DGU) 37.398 Datensatze uber den Zeitraum von 2002 bis 2011 retrospektiv ausgewertet. Die Verletzungen im Gesicht wurden nach Augenverletzungen, Verletzungen knocherner periorbitaler Strukturen, Nasenverletzung, Kieferverletzung, Mundverletzung, Ohrverletzungen und komplexen Gesichtsschadelverletzungen unterschieden. Zur Evaluierung prognostisch relevanter Parameter, die fur das Vorliegen einer Gesichtsverletzung verantwortlich sein konnen, wurden Patienten mit und ohne Gesichtsverletzungen miteinander verglichen. Die Inzidenz der Gesichtsverletzungen lag bei 25,4 % und betraf jeden 4. schwerverletzten Patienten. Komplexe Gesichtsschadelverletzungen traten mit 35 % am haufigsten auf. Weichteilverletzungen am Auge, Mund und Ohr waren mit unter 2 % eher seltene Verletzungen. Polytraumatisierte Patienten mit Gesichtsverletzungen verunfallten haufiger als Autofahrer, Fahrradfahrer sowie Fusganger und erlitten relevante Schadel-Hirn-Verletzungen mit einem GCS

The reconstruction of the medial patellofemoral ligament has been an increasingly popular approach for patellar instability over the last ten years. It is a conglomeration of symptoms with varying degree of severity. For pinpointed surgery planning, magnetic resonance imaging is now the obligate diagnosic tool. Therefore, in the preoperative stage, collateral pathology can be observed.

Anamnese und klinischer Befund: Eine 66-jahrige Patientin mit morbider Adipositas (Grad III nach WHO, BMI 51 kg/m 2 ) wies eine klinisch manifeste viertgradige Gonarthrose rechts auf. Anamnestisch bestanden chronisch progrediente Schmerzen des rechten Kniegelenks mit einer auf wenige Meter reduzierten Gehstrecke und ausgeschopfter konservativer Therapie. Untersuchungen: Neben der eingeschrankten schmerzhaften Beweglichkeit des rechten Kniegelenks fiel eine ausgepragte Adipositas am Stamm sowie den Extremitaten mit Lip-/Lymphodem auf. Therapie und Verlauf: Nach der Implantation einer Kniegelenktotalendoprothese kam es zu einer fruhen Wundinfektion (Fruhinfekt) und einem komplizierten Behandlungsverlauf uber insgesamt 220 Tage. Schlieslich musste eine Arthrodese des rechten Kniegelenks mit Gastrocnemius-Lappenplastik durchgefuhrt werden. Folgerung: In Anbetracht der hohen Komplikationsraten bei Patienten mit morbider Adipositas sollte man sich bewusst sein, das der totalendoprothetische Gelenkersatz bei diesen Patienten durchaus, auch nach ausgiebiger Umfelddiagnostik, sehr schwerwiegende Folgen haben kann. Daher sollten in diesen Extremfallen eine auserst kritische Abwagung samtlicher Behandlungsoptionen erfolgen.

Die Lyme-Arthritis wird durch Zeckenstiche ubertragene Spirochaten, Borrelia burgdorferi sensu lato, hervorgerufen. Die Diagnose wird durch die klinische Symptomatik gestellt. Laborchemische Untersuchungen dienen zur Bestatigung der Verdachtsdiagnose. Die Erkrankung zeigt Fruh- und Spatmanifestationen. Die Therapie erfolgt stadien- und symptomorientiert mit antiphlogistischen Masnahmen und einer antibiotischen Behandlung.

Ein Schadel-Hirn-Trauma (SHT) stellt weltweit sowohl soziookonomisch als auch fur die Betroffenen selbst eine enorme Belastung dar. Daher ist es wichtig, v. a. die intrakranielle Blutung primar zu erkennen, damit eine fruhzeitigen Therapie begonnen und ein geeignetes Zielkrankenhaus anvisiert werden konnen. Ziel der vorliegenden Arbeit war es, das initiale Erkennen einer intrakraniellen Blutung durch den Notarzt zu untersuchen und prognostische Parameter fur ein erhohtes Risiko einer intrakraniellen Lasion bei polytraumatisierten Patienten zu erarbeiten. Aus dem TraumaRegister DGU® wurden retrospektiv insgesamt 8539 Datensatze von Patienten mit intrakranieller Blutung ausgewertet. Zur Analyse prognostischer Faktoren, die einen Einfluss auf das Erkennen einer solchen haben, wurden 2 Gruppen gebildet und miteinander verglichen. Patienten, deren intrakranielle Blutung am Unfallort vom Notarzt nicht erkannt wurde, wurden der Gruppe A zugeordnet (n = 929), Patienten mit erkannten intrakraniellen Blutungen der Gruppe B (n = 7610). Eine intrakranielle Blutung wird durch den Notarzt bei 10,9 % der polytraumatisierten Patienten ubersehen. Die Betreffenden wiesen haufig Schadelverletzungen mit einer Verletzungsschwere von AIS = 3–4 (AIS: „abbreviated injury scale“) und einen GCS („Glasgow Coma Scale“) zwischen 13 und 15 Punkten auf, zudem erlitten sie signifikant haufiger relevante Verletzungen an Extremitaten und Abdomen. Polytraumatisierte Patienten mit Verdacht eines leichten SHT, einem GCS-Wert ≤ 15 Punkten und relevanten Begleitverletzungen an den Extremitaten und Abdomen sollten als Hochrisikopatienten fur intrakranielle Blutungen angesehen werden.

HISTORY AND ADMISSION FINDINGS A 70-year-old deaf-mute women suffered from progressive chronic pain of the right hip joint caused by destructive osteoarthritis of the hip. INVESTIGATIONS In addition to painfully restricted range of motion of the right hip joint the clinical examination showed a bluish-black pigmentation of the ear-cartilage and the sclera. TREATMENT AND COURSE A total endoprosthetic replacement of the right hip joint was performed. During surgery, blackening of the hip joint capsule and cartilage was found. Histological, the diagnosis of an ochronosis was confirmed. Discoloration after exposure of urine to air supported the diagnosis. Based on extensive internal medical examination relevant cardiac changes were excluded. CONCLUSION Ochronosis (arthropathia ochronotica) is a rare entity which can be identified by a visual diagnosis. Early diagnosis can provide crucial information for the prognosis. Additionally, an interdisciplinary treatment concept should be established because of the early onset of degenerative changes at the skeletal system and pathological changes at internal organs. With suspicion on an ochronosis extended internal examinations are recommended in order to avoid complications.

Prehospital assessment of injury type and severity by emergency medical services physicians impacts treatment including appropriate destination hospital selection, especially in (potentially) life-threatening cases. Injuries which are underestimated or overlooked by the emergency physician can delay adequate therapy and thus significantly influence the overall outcome. The current study used data from the TraumaRegister DGU® to evaluate the reliability of prehospital injury assessments made by emergency physicians.Data of 30,777 patients from the TraumaRegister DGU® between 1993 and 2009 were retrospectively evaluated. Using the abbreviated injury scale (AIS), subjective prehospital assessments of injury severity by emergency physicians were correlated with objectively identified injuries diagnosed after admission to hospital. For this evaluation, prehospital injury assessments rated moderate or severe by the emergency physician as well as injuries diagnosed in hospital with an AIS score ≥3 points were deemed relevant.The 30,777 patients with an injury severity score (ISS) ≥ 9 suffered a total of 202,496 injuries and of these 26 % (51,839 out of 202,496) were considered relevant with an AIS ≥3 points. The most frequent relevant injuries were to the head (47 %) and chest (46 %). Of the 51,839 relevant injuries, the prehospital assessment by the emergency physician was accurate for 71 % and in 29 % of the cases relevant injuries were underestimated. Relevant injuries were unrecognized or underestimated in prehospital assessments for almost 1 out of every 7 cases of head trauma, almost 1 out of every 3 thoracic trauma and almost 1 out of every 2 abdominal and pelvic trauma.The assessment of injury severity by emergency medical services physicians based on physical examination at the scene of the trauma is not very reliable. Thus, mechanisms of injury and overall presentation as well as identifiable injuries and vital parameters should be recognized by the emergency physician when considering treatment strategies and choice of appropriate destination hospital. The patient should be re-evaluated in a priority-oriented manner at the latest on arrival in the trauma room to avoid the consequences of unrecognized or underestimated injuries.

In the treatment of complex pelvic fractures hemorrhage control is of primary importance; however, studies regarding the localization of bleeding are contradictory so that various treatment approaches are recommended. The primary aim of external pelvic compression applied in the trauma room is to reduce the pelvic volume and counteract blood loss through self-induced tamponade. This study examined the influence of external pelvic compression on mortality and outcome in cases of hemodynamically unstable pelvic fractures in a larger number of cases.The current study used the TraumaRegister DGU® (TR-DGU) to retrospectively evaluate the records of 104 patients treated between 2002 and 2011. All patients suffered severe injury with an injury severity score (ISS) of at least 16 points. In addition, the patients were hemodynamically unstable with confirmed relevant isolated pelvic injuries. To evaluate the effectiveness of external pelvic compression, patients with and without external pelvic stabilization were compared.Of the investigated patients 26.9 % died of their injuries and of these the mortality was 78.6 % within the first 6 h of admission to the trauma room. External pelvic stabilization was performed in 45.2 % of patients. The mortality was 19.1 % in patients with external pelvic stabilization and in contrast, the mortality in the group of patients without external pelvic stabilization was 33.3 %. During the course of hospitalization, surviving patients with external pelvic stabilization were significantly more likely to develop sepsis or multiple organ failure and required longer periods of intensive care.External pelvic stabilization seems to be an important instrument for the initial treatment of hemodynamically unstable pelvic fractures and showed a positive effect on patient mortality.

Studienziel: Die proximale Humerusfraktur ist eine typische osteoporoseassoziierte Verletzung des alten Menschen. Mit dieser Arbeit sind wir der Frage nachgegangen, ob die Kooperationsfahigkeit das funktionelle Resultat operativ behandelter proximaler Oberarmfrakturen beeinflusst. Methode: Die Daten von 60 Patienten im Alter > 69 Jahre mit 2- und 3-Fragment-Frakturen, die mit einem proximalen Humerusnagel versorgt worden waren, wurden analysiert. Anhand zweier pflegerischer Assessments (Barthel-Index, Norton-Skala) wurden die Patienten in kooperationsfahige (K-Gruppe, n = 32) und nicht-kooperationsfahige (NK-Gruppe, n = 28) unterschieden. 6 Wochen, 6 Monate und 12 Monate postoperativ erfolgten klinische und radiologische Kontrollen, bei denen der Constant-Score ermittelt wurde. Ergebnisse: Das Durchschnittsalter lag bei 77,8 (70 - 93) Jahren, wobei sich die K-Gruppe mit 76,3 (71 - 93) Jahren und NK-Gruppe mit 78,2 (70 - 91) Jahren nicht wesentlich unterschieden. Im Rahmen der Nachuntersuchung wurden folgende Constant-Scores ermittelt: K-Gruppe 60,2/67,3/70,2 Punkte und NK-Gruppe 54,3/56,1/57,3 Punkte. Die Werte des Constant-Scores unterschieden sich zwischen den beiden Gruppen trotz ahnlicher Altersverteilung zu allen Nachuntersuchungszeitpunkten signifikant (p < 0,0001) voneinander. Ebenso zeigten die kooperationsfahigen Patienten im Verlauf eine signifikant (p < 0,0001) hohere Zunahme der Score-Werte. Schlussfolgerung: Neben der in der Literatur beschriebenen Altersabhangigkeit besteht nach unseren Ergebnissen eine Beeinflussung des funktionellen Resultates proximaler Humerusfrakturen im Senium durch die Kooperationsfahigkeit des Patienten, sodass diese zukunftig bei Untersuchungen an Patienten im hoheren Lebensalter Berucksichtigung finden sollte. Aim: Proximal humeral fracture is a common injury in elderly people suffering from osteoporosis. The purpose of this study was to examine whether the mental capability has influence on the functional outcome of proximal humeral fractures treated operatively. Method: We have studied datas of 60 patients older than 69 years with 2- and 3-part-fractures of the proximal humerus treated with antegrade intramedullary nailing. Patients were divided into a mental capable (C-group, n = 32) and non-capable group (NC-group, n = 28) using the Barthel-Index (Disability-Score) and the Norton-Scale (decubitus-risk-evaluation), which are used in nursing assessment. Clinical and radiological follow-up was performed at 6 weeks, 6 and 12 months after operation. Functional outcome was measured using the Constant-Score. Results: The mean age was 77.8 (70 - 93) years for all patients, 76.3 (71 - 93) for the C-group and with 78.2 (70 - 91) years similar for the NC-group. At the time of 6 weeks, 6 and 12 months Constant-Score was 60.2/67.3/70.2 points for the C-group and 54.3/56.1/57.3 points for the NC-group. Differences were significant (p < 0.0001) comparing both groups at every follow-up point as well as for the increase of the Constant-Score from 6 weeks to 12 months despite a comparable mean age. Conclusion: Age-depending functional outcome after proximal humeral fracture has been described in the literature before. Regarding to our results functional outcome is even markely influenced by the capability in elderly patients. Due to these results functional outcome after proximal humeral fractures in elderly treated operatively should be studied with respect to the mental capability of these patients.

Hintergrund Vertebroplastie und Kyphoplastie finden zunehmende Verbreitung in der Behandlung osteoporotischer Wirbelfrakturen. Die Vertebroplastie kann uber einen mono- oder bipedikularen Zugang durchgefuhrt werden, wobei Verkurzung von Operations- und Durchleuchtungszeit, Reduktion des Risikos punktionsbedingter Komplikationen und Senkung der Materialkosten als Vorteile der monopedikularen Technik dem moglichen Nachteil einer weniger homogenen Zementverteilung im Wirbelkorper gegenuber stehen. Experimentelle biomechanische Untersuchungen konnten keinen Nachteil des monopedikularen Vorgehens zeigen. Eine exakte Analyse der mit einem monopedikularen Zugang zu erreichenden Zementdistribution ist bislang nicht veroffentlicht worden.

Purpose/background Glomangiomas are perivascular tumours which, on the whole, are rare. They are most frequently located subungually on the fingers and toes. Diagnosis is difficult when they are atypically located at the knee joint. This may frequently result in a course of disease extending over many years. Material and methods The case of a 75-year-old male patient with a tumour which had existed for two years, located at the knee joint, is reported. Results Symptomatology, diagnostics, histology and therapy are presented and discussed in the context of the currently available literature relevant to this disease. In the case presented here, following removal of the tumour, the patient remained free of complaints and did not suffer a relapse. Conclusion Glomangiomas exhibit local, invasive growth, metastases have not been reported. The clinical picture is characterised by the classical trilogy of sensitivity to pain, pressure and temperature. In cases associated with the knee joint, misdiagnoses such as meniscus lesions or degenerative changes, are frequently made. Diagnostic procedures include sonography and magnetic resonance investigations. A resection of the tumour should be carried out well into the healthy tissue, as local relapse is a frequent occurrence in this disease.

In a 66-year-old obese woman (WHO stage III, BMI 51 kg/m2) pronounced osteoarthritis of the right knee was diagnosed. Because of progressive chronic pain of the right knee joint her walking distance was limited to a few meters. Conservative therapy was exhausted.Clinical examination showed a restricted and painful range of motion of the right knee and distinctive obeseness on the trunk and the extremities including a lipedema/lymphedema.After a complicated course of treatment lasting for 220 days the total knee replacement ended in an arthrodesis combined with a gastrocnemius muscle flap.With respect to this case the high complication-rates in obese patients should be taken into account: Total knee replacement can even lead to loss of the limb in the worst case. In addition to extended preoperative examination this indication should be critically scrutinized.

Playing-related musculoskeletal disorders (PRMD) in professional musicians are common. Existing literature demonstrates that up to 86 % of musicians are affected. The aim of the study was to evaluate the frequency of musculoskeletal pain in professional orchestral musicians with regard to their instrument affiliation. Of special interest were pain intensity and its association with predictors such as gender, instrument group, age or stage fright. Professional orchestra players completed a self-report questionnaire to assess playing-related musculoskeletal pain and its frequency and intensity in various body regions on a numeric rating scale (NRS). Relative frequencies and prevalence ratios for different instrument groups were estimated. Out of 720 approached musicians, 408 were included in the sample (response rate 57 %); overall, 89.5 % had been affected by current or past playing-related musculoskeletal pain, 62.7 % reported pain in the previous 3 months, and 8.6 % reported current pain. Pain distribution and frequency varied between instrument groups. For all instrument groups, the neck was the most common pain region. About 43 % of musicians presented more than five pain regions, in particular violin players. Approximately 40 % of musicians indicated frequent or permanent pain. Average pain intensities increased from NRS 3.8 up to a range of 5.9 and 7.4 for frequent and permanent pain, respectively. Female gender and stage fright were proven to be predictors for musculoskeletal pain. Professional orchestral musicians are greatly affected by PRMD, often experiencing frequent or permanent pain, high pain levels and pain in various body regions. As PRMD might contribute considerably to performance disability, sick leave and the possibility of premature termination of a musicians' career, this study highlights the necessity for tailored therapeutic and preventive strategies in performing arts medicine.

A 70-year-old deaf-mute women suffered from progressive chronic pain of the right hip joint caused by destructive osteoarthritis of the hip.In addition to painfully restricted range of motion of the right hip joint the clinical examination showed a bluish-black pigmentation of the ear-cartilage and the sclera.A total endoprosthetic replacement of the right hip joint was performed. During surgery, blackening of the hip joint capsule and cartilage was found. Histological, the diagnosis of an ochronosis was confirmed. Discoloration after exposure of urine to air supported the diagnosis. Based on extensive internal medical examination relevant cardiac changes were excluded.Ochronosis (arthropathia ochronotica) is a rare entity which can be identified by a visual diagnosis. Early diagnosis can provide crucial information for the prognosis. Additionally, an interdisciplinary treatment concept should be established because of the early onset of degenerative changes at the skeletal system and pathological changes at internal organs. With suspicion on an ochronosis extended internal examinations are recommended in order to avoid complications.

Vertebroplasty and kyphoplasty are being increasingly used in the treatment of osteoporotic vertebral body fractures. Shortening the duration of operative time and radiation exposure as well as reduction of cannulation-related risks and costs are advantages of the unipedicular technique in contrast to less homogeneous cement distribution as a possible disadvantage. Biomechanical investigations have shown similar results with respect to strength and stiffness both for uni- and bipedicular vertebroplasty. Studies evaluating cement distribution with CT scans using a unipedicular approach have not been published yet.We present a prospective study on 92 vertebral body fractures (Th8-L5) in 60 patients, aged 76.8 (60-95) years, which were treated by unipedicular vertebroplasty using a para-/transpedicular approach. We evaluated needle position, injected cement volume, and cement deposition based on CT scans. The vertebral body was divided into nine segments in a frontal plane view. The needle was placed in the middle third in 85.9% (79/92), in the right in 11.9% (11/92), and in the left third in 2.2% (2/92). Complications associated with cannulation were not observed. The injectable cement volume was 4.5 (1.5-9.0) ml.With respect to superior, middle, and inferior parts, filling of the middle third was achieved in 94.9%, of the right third in 76.1%, and of the left third in 80.4%. Only the right- and left-sided inferior segments showed a filling rate below 75%. Positioning the needle into the right or left third resulted in comparably high filling rates of the middle third (100/83.3%) but only 50.0/54.5% of the contralateral third of the vertebral body.Unipedicular vertebroplasty using a modified approach permits a reliable placement of the needle into the middle third of the vertebral body, which is the optimal position regarding cement distribution. Unipedicular vertebroplasty allows homogeneous filling and augmentation of vertebral bodies without need for a second cannulation.

Glomangiomas are perivascular tumours which, on the whole, are rare. They are most frequently located subungually on the fingers and toes. Diagnosis is difficult when they are atypically located at the knee joint. This may frequently result in a course of disease extending over many years.The case of a 75-year-old male patient with a tumour which had existed for two years, located at the knee joint, is reported.Symptomatology, diagnostics, histology and therapy are presented and discussed in the context of the currently available literature relevant to this disease. In the case presented here, following removal of the tumour, the patient remained free of complaints and did not suffer a relapse.Glomangiomas exhibit local, invasive growth, metastases have not been reported. The clinical picture is characterised by the classical trilogy of sensitivity to pain, pressure and temperature. In cases associated with the knee joint, misdiagnoses such as meniscus lesions or degenerative changes, are frequently made. Diagnostic procedures include sonography and magnetic resonance investigations. A resection of the tumour should be carried out well into the healthy tissue, as local relapse is a frequent occurrence in this disease.

We describe a method of removing a posteriorly dislocated lens involving the use of a Machemer lens to visualize displaced lens remnants. Following core vitrectomy, the lens remnants are brought anteriorly and then removed by phacoemulsification. Lens implantation may then be performed with sulcus fixation. Eight of 10 patients in which this technique was used achieved 20/40 or better visual acuity.

Bu çalışmanın amacı, tiazolidin’in (Tiazolidin-4-karboksilik asit (4S)-2- (4- hidroksi-3-metoksifenil) zebra balığı (Danio rerio) solungaç ve karaciğer dokusunda asetilkolinesteraz enzim (AChE) aktivitesi ve total protein (TP) düzeyleri üzerindeki etkilerinin araştırılmasıdır. Zebra balıkları tiazolidin’in 0,2 ppm, 0,4 ppm ve 0,6 ppm farklı dozlarına 96 saat süreyle maruz bırakılmıştır. AChE enzim aktivitesi karaciğer dokusunda, tiazolidin’in 0,2 ppm, 0,4 ppm ve 0,6 ppm doz gruplarında, kontrol grubuna oranla artmıştır. Solungaç dokusunda ise, tiazolidin’in 0,2 ppm, 0,4 ppm ve 0,6 ppm doz gruplarında, kontrol grubuna oranla AChE enzim aktivitesinin azaldığı görülmüştür. Total protein seviyesi karaciğer dokusunda, tiazolidin’in 0,2 ppm, 0,4 ppm ve 0,6 ppm doz gruplarında, kontrol grubuna oranla azalmıştır. Solungaç dokusunda ise, tiazolidin’in 0,2 ppm, 0,4 ppm ve 0,6 ppm doz gruplarında, kontrol grubuna oranla total protein seviyelerinin önemli sayılabilecek oranda arttığı görülmüştür. Sonuç olarak, bu araştırmada tiazolidinin zebra balığı solungaç ve karaciğer dokuları üzerinde az da olsa zararlı etkilere neden olabileceği görülmüştür The aim of this study was to investigate the effects of thiazolidine (4S)-2-(4- hydroxy-3-methoxyphenyl) thiazolidine-4-carboxylic acid) on acetylcholinesterase enzyme (AChE) activity and total protein (TP) levels in zebrafish (Danio rerio) gill and liver tissue. Zebrafish were exposed to 0.2 ppm, 0.4 ppm and 0.6 ppm different doses of thiazolidine for 96 hours. AChE enzyme activity increased in liver tissue in 0.2 ppm, 0.4 ppm and 0.6 ppm dose groups of thiazolidine compared to the control group. In the gill tissue, AChE enzyme activity was decreased in 0.2 ppm, 0.4 ppm and 0.6 ppm dose groups of thiazolidine compared to the control group. Total protein level in liver tissue decreased in 0.2 ppm, 0.4 ppm and 0.6 ppm dose groups of thiazolidine compared to the control group. In the gill tissue, total protein levels were significantly increased in the 0.2 ppm, 0.4 ppm and 0.6 ppm dose groups of thiazolidine compared to the control group. In conclusion, it was seen that thiazolidine may cause some harmful effects on zebrafish gill and liver tissues in this study.

Accurate assessment of stiffness distribution is essential due to the critical role of single cell mechanobiology in the regulation of many vital cellular processes such as proliferation, adhesion, migration, and motility. Cell stiffness is one of the fundamental mechanical properties of the cell and is greatly affected by the intracellular tensional forces, cytoskeletal prestress, and cytoskeleton structure. Herein, we propose a novel holographic single-cell stiffness measurement technique that can obtain the stiffness distribution over a cell membrane at high resolution and in real-time. The proposed imaging method coupled with acoustic signals allows us to assess the cell stiffness distribution with a low error margin and label-free manner. We demonstrate the proposed technique on HCT116 (Human Colorectal Carcinoma) cells and CTC-mimicked HCT116 cells by induction with transforming growth factor-beta (TGF-\b{eta}). Validation studies of the proposed approach were carried out on certified polystyrene microbeads with known stiffness levels. Its performance was evaluated in comparison with the AFM results obtained for the relevant cells. When the experimental results were examined, the proposed methodology shows utmost performance over average cell stiffness values for HCT116, and CTC-mimicked HCT116 cells were found as 1.08 kPa, and 0.88 kPa, respectively. The results confirm that CTC-mimicked HCT116 cells lose their adhesion ability to enter the vascular circulation and metastasize. They also exhibit a softer stiffness profile compared to adherent forms of the cancer cells. Hence, the proposed technique is a significant, reliable, and faster alternative for in-vitro cell stiffness characterization tools. It can be utilized for various applications where single-cell analysis is required, such as disease modeling, drug testing, diagnostics, and many more.