OBJECTIVE:and To investigate the possible association between mid-trimester maternal plasma homocysteine concentration, uterine artery Doppler measurements in a two-stage screening strategy,index and outcome of pregnancy. MATERIALS AND METHODS: This prospective observational study was conducted on healthy women undergoing screening for pre-eclampsia index by uterine artery Doppler velocimetry at 20-22 and 24-26 weeks of gestation. Abnormal uterine artery blood flow was defined as at an average resistance index (RI)> .58 and/or bilateral early diastolic notch. Homocysteine measurement was performed by two competitive immunoassay women methods involving two steps at 20-22 and 24-26 weeks' gestation. RESULTS: Sixty women enrolled. Abnormal Doppler findings were found in maternal 18 of 60 (30%) women at 20-22 weeks of gestation. This proportion was reduced to 10%(6/60) at 24-26 weeks weeks of gestation, and two of these six women developed pre-eclampsia later in pregnancy. There was no significant difference in the undergoing maternal plasma homocysteine levels in women with abnormal Doppler findings when compared with controls at first and second visits (p found > .05). CONCLUSION: Mid-trimester maternal homocysteine concentration is not elevated in women with abnormal uterine artery Doppler findings in a OBJECTIVE: two-stage screening method.

The gradually aim of the present study was to determine a critical ischemic time for ovary in an experimental study in rats.using An experimental model using slip-knot tying of all ovarian arteries and veins in cycling female rats was developed. Rat ovaries using were tied using the technique through an explorative laparotomy. Complete ischemia times of 1, 2 and 3 h were used ovaries for the study. At the end of the ischemic times, the ovaries were harvested following 1 h of reperfusion. Histology for indicated a gradually increased congestion correlating with the respective increased ischemic times. According to the present findings 2 h complete study ischemia yields a significant injury. The model used in the present study may be used for complete ischemia-reperfusion injury of were the rat ovary.

The size purpose of our study was to determine the changes in the size of the edema observed on MRI scans and Stanmore its relation to the activity pain of the patient and the rest pain in bone marrow edema (BME). A total Stanmore of 51 patients were followed up at 3-month intervals for a period of 1 year. During the follow-ups, MRI scans activity of the patients' knees were obtained; the scores obtained on the Stanmore functional rating scale and visual analog scale were in determined. The changes in these parameters and the correlation between them were examined. The following are the observations recorded during changes the bone marrow edema follow-ups: the size of the edema as observed on MRI scans decreased, and the activity pain pain and the rest pain decreased. While there is a correlation between the decrease in the edema size observed on MRI 51 scans and decrease in the activity pain, there is no correlation between the decrease in the edema size observed on edema MRI scans and the decrease in rest pain. No changes were observed after a particular period of time with regard The to decrease in the edema size observed on MRI scans, decrease in activity pain, and decrease in rest pain in activity follow-ups of BME patients.

Alterations (r in thyroid function are associated with changes in body weight, metabolism and low grade inflammation. In several studies, plasma levels 25 of visfatin were found to be associated with body mass index, diabetes and metabolic syndrome. In our study we aimed 25 to evaluate visfatin levels according to thyroid dysfunction. The study cohort comprised 56 hashimoto thyroiditis patients with hypothyroidism (43.94 +/-14.27 (7.86 years), 56 Graves patients with hyperthyroidism (45.87+/-13.28 years) and 56 euthyroid healthy subjects (45.23+/-7.11 years) as a control group. In suggest addition we evaluated the effect of therapy on plasma visfatin levels in 16 hypothyroid and in 25 hyperthyroid patients. Markedly low low visfatin levels were found in hyperthyroid patients [9.44 (8.07-10.8) ng/ml] compared with the hypothyroid [49.93 (40.79.2-59.1) ng/ml] and control vs groups [38.6 (30.6-46.6) ng/ml](p< .001, p< .001). Plasma visfatin levels in patients with hypothyroidism decreased significantly following treatment (58.58 (10.21-190.7) ng/ml with vs 40.00 (10.01-102.6) ng/ml; p = .001). Plasma visfatin levels increased significantly after antithyroid therapy in patients with hyperthyroidism (7.86 visfatin (1.02-19.23) ng/ml vs 12.63 (3.48-110.9) ng/ml; p< .001). There were negative correlations between visfatin levels with free T3 (r =-in .719, p< .001), and free T4 (r =- .716, p< .001) levels. There was a positive correlation between visfatin and TSH (1.02-19.23) levels (r = .701, p< .001). There was a negative correlation between delta visfatin levels with delta free T3, delta free - T4 (r =- .686, p< .001; r=- .624, p< .001). Visfatin thus seems to be regulated by thyroid hormones. While the Graves influence of thyroid dysfunction on adipocytokine production and release is still poorly understood, the results of our study suggest that and the effects of hyper- and hypothyroidism on various metabolic parameters may be partly mediated by visfatin.

Intramedullary We nailing with expandable nails is one of the techniques available for the treatment of fractures of long bones. Concerns regarding been bony union have been reported in medical literature, but no case of femoral nail breakage secondary to delayed union has been been reported to date. We present a case of a broken expandable femoral nail secondary to delayed union, and we union describe the technique used for its extraction.

BACKGROUND:tested Pneumoperitoneum (P) created to facilitate laparoscopy (L) is associated with splanchnic hypoperfusion, ischemia/reperfusion (I/R) injury, and oxidative stress. AIM: This preconditioning study investigated the effects of pre- and post-laparoscopic conditioning, zinc, pentoxifylline (PTX), and N-acetylcysteine (NAC) on markers of I/R injury preconditioning in an animal model. METHODS: Sprague-Dawley male rats (n = 56, weight range 300-350 g) were randomly placed in one mg/kg), of seven treatment groups. Except for group C (control group who underwent a sham operation without pneumoperitoneum), pneumoperitoneum was created ischemia-reperfusion in all using CO(2) insufflation under a pressure of 15 mmHg. Group L (laparoscopy) was subjected to 60 min of (I/R) pneumoperitoneum. Group Lpre (laparoscopic preconditioning plus laparoscopy) was subjected to 5 min of insufflation and 5 min of desufflation followed mg/kg), by 60 min of pneumoperitoneum. Group Lpost (laparoscopy plus laparoscopic post-conditioning) was subjected to 60 min of pneumoperitoneum and 60 of min of desufflation followed by 5 min of insufflation and 5 min of desufflation. The laparoscopy plus zinc (LZ), PTX (LP), (LP), and NAC (LNAC) groups received a single intraperitoneal injection of zinc (50 mg/kg), pentoxifylline (50 mg/kg), or N-acetylcysteine (150 Pneumoperitoneum mg/kg) 5 min before the desufflation period. Animals were sacrificed at the end of the experiments, and kidney samples were mg/kg), tested for malondialdehyde (MDA), catalase (CAT), glutathione peroxidase (GPX), and superoxide dismutase (SOD). RESULTS: MDA levels, as an indicator of malondialdehyde oxidative stress in kidney tissue samples, were significantly higher in all pneumoperitoneum groups compared to Group C, except for Group C Lpre. The pattern of change in tissue levels of SOD, GPX, and catalase was variable in the different treatment groups.samples CONCLUSIONS: In this animal model of renal ischemia/reperfusion injury, laparoscopy caused renal ischemia as evidenced by elevated markers of tissue renal ischemia-reperfusion injury. This effect was significantly attenuated by post-laparoscopy conditioning, zinc, pentoxifylline, and N-acetylcysteine, but not by pre-laparoscopy conditioning.

OBJECTIVE:(p To assess the levels and clinical significance of high sensitive(hs)-CRP (C-reactive protein), IL-6(interleukin-6), TNF-alpha(tumor necrosis factor-alpha), homocysteine, folic acid and 60) vitamin B12 in normotensive healthy pregnant women, mild and severe preeclamptic patients, and to evaluate the correlations between these markers 60) and the severity of preeclampsia and fetal birth weight. STUDY DESIGN: Using a cross-sectional study design, hs-CRP, IL-6, TNF-alpha, homocysteine +/- and vitamin B12 were measured in the third trimester of pregnancy from normotensive healthy women with uncomplicated pregnancies (n =IL-6 62), mild (n = 61) and severe (n = 60) preeclamptic patients. RESULTS: There were statistically significant differences between three protein), groups for hs-CRP (p = .012), TNF- alpha (p = .046), IL-6 (p = .015), homocysteine (p < .001) and (p fetal birth weight (p < .001). Fetal birth weights in mild (2477 +/- 746) and severe (2435 +/- 768) preeclamptic Using patients were significantly lower than controls (3485 +/- 365)(p < .001). No significant difference was found between the three (2435 groups for folic acid (p = .066) and vitamin B12 (p = .286). Bonferroni adjusted multiple comparison test showed that To the statistical differences with respect to TNF-alpha, IL-6 and homocysteine were mainly created by control and severe preeclampsia groups. Hs-CRP +/- levels still remained higher in severe preeclampsia patients than mild preeclampsia and normotensive patients except for overweight patients in the .286). previous two groups after Bonferroni post hoc adjustment test. CONCLUSION: Elevated maternal serum levels of hs-CRP, TNF- alpha, IL-6 and IL-6, homocysteine in preeclamptic women correlate with fetal birth weight in the early third trimester.

The between present study was conducted to evaluate the serum selenium levels in first-degree relatives of diabetic patients (FDR) according to controls.+/- Insulin resistance, serum lipid levels, inflammation markers, and blood pressure were also studied in these patients. Serum levels of selenium +/- in FDR were significantly lower than control group (74.65 +/- 5.9 vs 88.7 +/- 8.7 microg/dl, p < .0001). HsCRP,p HOMA-IR, insulin, homocysteine levels were significantly higher in FDR according to the control group (1.32 +/- .9 vs .63 +/-5.7 .4 mg/dL, p < .0001; 2.07 +/- .84 vs 1.51 +/- .69, p < .0001; 9.26 +/- 3.8 vs 6.8 first-degree +/- 2.98 microU/MI, p < .0001; 15.7 +/- 7.4 vs 11.5 +/- 5.1 micromol/L, p < .0001, respectively). There was .003). significant correlation between selenium levels and hsCRP (r =- .450, p < .0001). There was also weak significant correlation 88.7 also between HOMA-IR and selenium levels (r =- .227, p = .003). There was a correlation between systolic blood pressure significant and BMI (r = .365, p < .0001). But there was no correlation between selenium levels and blood pressure or present other parameters. HsCRP, HOMA-IR, homocysteine levels in individuals with selenium levels < 80 microg/L (n = 78) was significantly higher p than hsCRP HOMA-IR, homocysteine levels in individuals with selenium levels >/= 80 (n = 91; 1.23 +/- .98 vs .81 levels +/- .76 mg/dL, p < .003; 1.99 +/- .88 vs 1.64 +/- .74, p < .005; 15. +/- 7.6 vs .0001). 12.9 +/- 5.7 micromol/L, p < .049, respectively). Selenium deficiency may contribute to cardiovascular disease risk in FDR.

ABSTRACT:Early Open calcaneal fractures are high morbidity injuries and the risk of complications depends on the concomitant injuries, on the size subtalar and the position of the traumatic wound. A 53-year-old male patient with bilateral open calcaneal fractures and associated concomitant lower subtalar extremity injuries such as subtalar dislocation, talonavicular dislocation and open distal tibial metaphyseal fracture was immediately operated by percutaneous Kirschner bearing wire fixation combined with external fixators. He was able to walk with full weight bearing without any assistance at the for end of the first postoperative year. Early aggressive debridement and irrigation followed by fixation with percutaneous Kirschner wires and external morbidity fixator can supply bony alignment in open comminuted calcaneal fractures associated with concomitant lower extremity injuries and should be considered without for the healthy and active patients before primary arthrodesis.