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During the Covid-19 pandemic, one of the best means of personal protection was using face masks. In this context, the World Health Organization has declared the attempts to produce masks inactivating airborne virus species a welcome initiative. This preliminary study aimed to prove that airborne germs passing through a mask filter cartridge can be destroyed by the rays emitted from UVC LEDs placed in such cartridge. We therefore designed such a face mask and tested the efficiency of UVC LEDs placed in its cartridge against common contaminants, gram-positive Staphylococcus aureus, gram-negative Pseudomonas aeruginosa, and the influenza A/Puerto Rico/8/1934 virus because of its similarity with SARS CoV-2. Eight UVC LEDs with a total power of 75 mW provided sufficient germicidal effect for all three germs. In terms of safety, ozone production released during UVC LED emission was negligible. Our findings are promising, as they show that well-designed UVC-based face masks can be effective against airborne germs, but further research on a greater sample may help us learn more and optimise such face masks.

Introduction: The aim of the study was to investigate the presence of human papillomaviruses (HPV), mouse mammary tumour virus (MMTV), Epstein-Barr virus (EBV), and human polyomavirus BK in canine mammary tumours (CMTs) and to correlate the results of histopathological classification with the results of virological examination. Material and Methods: Eighty CMTs and ten normal canine mammary gland samples were evaluated using histopathological methods and TaqMan real-time PCR analysis. Results: The results indicated that all mammary tumours and normal mammary tissue samples were negative for HPV16 and other HPV, EBV, human polyomavirus, and human mammary tumour virus strains. Conclusion: Further studies should be performed to investigate the existence of other strains of HPV, EBV, and human polyomavirus in CMTs.

There is an emerging fluconazole resistance in Candida parapsilosis in recent years. The leading mechanism causing azole resistance in C. parapsilosis is the Y132F codon alteration in the ERG11 gene which encodes the target enzyme of azole drugs. In this study, we evaluated the sensitivity, compatibility, and specificity of a novel tetra-primer amplification refractory mutation system-polymerase chain reaction (T-ARMS-PCR) method for rapid detection of the Y132F mutation in fluconazole nonsusceptible C. parapsilosis. Antifungal susceptibility tests for detection of fluconazole resistance were performed by broth microdilution according to the CLSI guidelines. All susceptible and nonsusceptible C. parapsilosis isolates were analyzed for ERG11 mutations with Sanger sequencing. T-ARMS-PCR was fully concordant with the Sanger sequencing (100% of sensitivity and specificity) for detection of Y132F mutations. T-ARMS-PCR method could be a rapid, simple, accurate, and economical assay in the early detection of the most common cause of fluconazole resistance in C. parapsilosis isolates. In routine laboratories with high C. parapsilosis isolation rates, performing the T-ARMS-PCR for early detection of the most common reason of fluconazole resistance in C. parapsilo sis, could be a life-saving approach for directing antifungal therapy before obtaining the definitive antifungal susceptibility tests results.

The coronavirus disease 2019 (COVID-19) pandemic has affected the entire world, and has a variety of clinical presentations. The aim of this study is to determine the relationships of fecal cytokines and markers with the symptoms and prognosis of children with COVID-19 infection, and to identify noninvasive markers during follow-up. In a cohort of 40 COVID-19-positive children and 40 healthy controls, fecal cytokines and markers were examined in stool samples. A binary logistic model was used to assess the potential of cytokines as risk factors for hospitalization. Odds ratios (ORs) with 95% confidence intervals (CIs) were reported. A P -value <0.05 was accepted as statistically significant. Levels of fecal lysozyme, myeloperoxidase, hemoglobin, and interleukin-5 (IL-5) ( P  < 0.05) were significantly higher among the patients than controls. In a logistic regression analysis, fecal IL-2 (OR = 3.83; 95% CI: 1.44-15.92), IL-4 (OR = 2.96; 95% CI: 1.09-12.93), IL-5 (OR = 4.56; 95% CI: 1.18-27.88), IL-10 (OR = 2.71 95% CI: 1.19-7.94), interferon-gamma (IFN-γ) (OR = 4.03; 95% CI: 1.44-15.73), IFN-α (OR = 3.02; 95% CI: 1.08-11.65), calcium-binding protein B S100 (S100 B) (OR = 4.78; 95% CI: 1.31-27.82), neutrophil elastase (NE) 2 (OR = 4.07; 95% CI: 1.17-19.69), and matrix metalloproteinase 1 (MMP-1) (OR = 3.67; 95% CI: 1.1-18.82) levels were significantly higher in hospitalized patients with COVID-19 infection than outpatients. We demonstrated that various fecal cytokines and markers were increased in patients who had COVID-19. Fecal IL-2, IL-4, IL-5, IL-10, IFN-γ, IFN-α, S100 B, NE, and MMP-1 levels were significantly elevated in hospitalized patients. We suggest that the fecal and serum levels of cytokines could be used to predict the prognosis of COVID-19 disease, although more studies are needed to confirm this.

Mortality due to K. pneumoniae bacteremia is on rise, particularly in regions with high rates of carbapenem and colistin resistance. We aimed to define risk factors for colistin resistance and its impact on mortality. Patients diagnosed with "carbapenem-resistant K. pneumoniae (CRKp)" bacteremia between 2014 and 2018 were divided into two groups as "colistin susceptible (ColS)" and "colistin resistant (ColR)" based on broth microdilution method. Retrospective case-control study was conducted to compare characteristics and outcomes. Multiple logistic regression model was used to define independent risk factors for acquired colistin resistance and Cox proportional hazard model for 28-day mortality. A total of 82 patients (39 ColS and 43 ColR) were included. Mean age was 61.5 years, and 50 (61%) were male. Colistin resistance was significantly increased with duration of hospital stay (p = 0.007) and prior colistin use (p = 0.007). Overall, the 28-day mortality rate was 66%. Age (p = 0.014) and colistin resistance significantly increased 28-day (p = 0.009) mortality. Microbiological response to treatment within 7 days favors survival. PFGE analysis revealed an outbreak with K. pneumoniae ST78 and ST45 clones. Patients treated with combined antimicrobials had significantly lower 28-day mortality (p = 0.045) in comparison to monotherapy. However, types of combinations did not show significant superiority on each other. Colistin resistance increases 28-day mortality in CRKp bacteremia. Although combined regimens are more effective than monotherapy, existing antibacterial combinations have no apparent superiority to each other. New treatment options are pivotal., (© 2020. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Cytokine release syndrome (CRS), characterized by overproduction of proinflammatory cytokines in the course of severe coronavirus disease 2019 (COVID-19), has been suggested as the major cause of mortality. Tocilizumab, a recombinant humanized monoclonal antibody against human IL-6 receptor, poses a therapeutic option for the treatment of CRS leading to severe acute respiratory syndrome in coronavirus-2 (SARS-CoV-2) infection., Methods: We performed a single-center retrospective study to reveal the outcome of COVID-19 patients on tocilizumab and proposed "the Cerrahpaşa-PREDICT score", a new clinical scoring system using clinical and laboratory parameters that would help predicting the 28-day mortality of COVID-19 patients receiving tocilizumab., Results: Eighty-seven patients (median age: 59 years) were included of whom 75.8% were male. Tocilizumab use significantly improved clinical and laboratory parameters. The 28-day mortality rate on tocilizumab was 16.1%. The Cerrahpaşa-PREDICT score, consisting of platelet counts, procalcitonin, D-dimer levels, SO 2 R and the time from symptom onset to tocilizumab administration had a positive predictive value of 94.5% and negative predictive value of 92.9% for anticipating 28-day mortality., Conclusions: Severe COVID-19 should closely be monitored for the signs of hyperinflammation. We showed that administration of tocilizumab early in the course of the disease (prior to ICU admission) resulted in a favorable outcome. Close monitoring usually aids identifying patients who would benefit from tocilizumab. In this regard, the Cerrahpaşa-PREDICT score might serve as a practical tool for estimating the 28-day mortality in COVID-19 patients who received tocilizumab and would facilitate timely recognition of fatal cases to be evaluated for other therapeutic options., (Copyright © 2021 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)

Aim: Acute respiratory tract infections are among the most common infectious diseases worldwide. Respiratory viruses are the leading cause of respiratory infections in children. Herein, we aimed to determine the epidemiologic and clinical feautures of viral agents among hospitalized children with lower respiratory tract infections., Material and Methods: Nasopharyngeal swab specimens were obtained from the 422 patients hospitalized with a diagnosis of lower respiratory tract infections between December 2012 and December 2016. Multiplex reverse-transcription polymerase chain reaction was performed for the detection of viruses., Results: Viral respiratory pathogens were detected in 311 patients (73.7%). In regard to respiratory virus subtypes, 103 patients (33.1%) had respiratory syncytial virus, 102 (32.7%) had human rhinovirus, 49 (15.7%) had multiple viruses, 15 (4.8%) had parainfluenzavirus, 13 (4.1%) had adenovirus, nine (2.8%) had human metapneumovirus, eight (2.5%) had human coronaviruses, six (1.9%) had bocavirus, five (1.6%) had influenza virus, and one patient (0.3%) had enterovirus. The median age was lower in patients with multiple viruses (p<0.001). The respiratory syncytial virus was more commonly detected in patients with a history of prematurity (p<0.001). Stridor was more common in other viruses including parainfluenza viruses (p<0.001)., Conclusion: Respiratory viruses are the main causative agents of respiratory tract infections in children. Timely and accurate detection of viruses is necessary in terms of public health. The detection of respiratory viruses also contributes to epidemiologic results and vaccine studies., Competing Interests: Conflict of Interest: The authors have no conflicts of interest to declare., (Copyright: © 2020 Turkish Archives of Pediatrics.)

Background: Macrolide resistance in Streptococcus pneumoniae (S. pneumoniae) is a worldwide problem., Aims: The aim of this work was to analyze the phenotypes, genotypes, and clonal relatedness among macrolide-resistant S. pneumoniae strains isolated from various clinical specimens in our hospital., Study Design: Cross-sectional study., Methods: 80 non-duplicate S. pneumoniae strains were analyzed by polymerase chain reaction for both the erm (B) and mef (A) genes., Results: Macrolide resistance was observed in 22.5% (18 strains) of strains. Two (11.2%) isolates possessed mef (A), eight possessed erm (B) (44.4%) and eight strains (44.4%) were positive for both erm (B) and mef (A) genes. Although BOX-PCR of 18 macrolide-resistant strains revealed 11 band patterns, they clustered as seven clones with a genetic distance >10% to each other. Eight isolates possessed both erm (B) and mef (A) genes and belonged to a single clone (44.44% of all macrolide-resistant strains)., Conclusion: Increased positivity rates for both resistance genes have also been reported from other hospitals in Turkey, but this is the first study from Turkey showing the clonal dissemination of both resistance genes.

Background: Blood stream infections (BSIs) due to carbapenem-resistant Enterobacteriaceae (CRE) are associated with high hospital mortality rates and present a tremendous challenge to clinicians. The optimal treatment remains undefined. We aimed to investigate the risk factors for mortality and the correlation between different treatment modalities and outcomes., Methods: The clinical characteristics and treatment outcomes of a cohort of 36 patients with BSIs due to CRE were investigated and a retrospective nested case-control study of surviving and non-surviving patients was conducted., Results: Fifty percent of the cases were male and the mean patient age was 54.9 ± 15.8 years. Klebsiella pneumoniae was the etiological agent in 26 cases (72.2%), Escherichia coli in eight (22.2%), and Enterobacter aerogenes in two (5.5%). All strains were phenotypically positive for carbapenemase activity and all except two (one E. coli and one K. pneumoniae) yielded both blaOXA-48 carbapenemases and blaCTX-M-type extended-spectrum beta-lactamases (ESBLs) in PCR products. The 14-day, 28-day, and all-cause in-hospital mortality rates were 41.6%, 50%, and 58.3%, respectively. The median time to death was 8 days (range 2-52 days). No significant differences were observed between survivors and non-survivors in terms of baseline characteristics, comorbid conditions, etiologies, or sources of bacteremia, however hematological malignancies (p=0.015) and prolonged neutropenia (p=0.044) were more common in non-survivors. Microbiological eradication and clinical response within 7 days were two major determinants of 28-day attributable mortality (p=0.001 and p=0.001, adjusted r(2)=0.845). Colistin-based dual combinations, and preferably triple combinations, were associated with significantly better outcomes when compared to non-colistin-based regimens (p<0.001). Time to active treatment had a significant effect on the course of infection (p=0.014)., Conclusion: Earlier active treatment with colistin based regimens and microbiological and clinical response within 7 days are major predictors of survival in cases of BSIs due to CRE. Rectal screening offers the advantage of earlier recognition and prompt empirical treatment., (Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objective: The ideal reduction method for anterior shoulder dislocation is defined as a practical technique applied without any assistance and minimizing patient interference. The aim of this study was to evaluate the outcomes of patients with shoulder dislocations reduced using the chair method in the emergency department and show that the chair method is one of the ideal methods., Methods: Seventy-four patients with anterior shoulder dislocation were treated using the chair method. Data from patients were recorded and analyzed., Results: All dislocated shoulders were successfully reduced using the chair method without any complication or difficulty. Thirty patients had first time dislocation and 44 patients had previous dislocation. Mean duration between dislocation and reduction was 3 (range: 1 to 6) hours. Mean duration of reduction was 13.9 (range: 3 to 45) seconds., Conclusion: The chair method is an effective and successful reduction method for shoulder dislocation. We believe that orthopedists and emergency department physicians should be familiar with this simple technique which does not have to be performed under general anesthesia.

Objective: The aim of this study was to evaluate the results of ACL reconstruction using a cross-pin femoral fixation system and hamstring autografts., Methods: The study included 49 men and one woman (mean age: 27.4 years; range: 15 to 44 years) with chronic ACL ruptures operatively treated between 2003 and 2006. Involvement was in the right knee in 27 patients, and the left knee in 23. There were no professional athletes included in the study. Patients with chondral lesions of the knee treated by microfracture or drilling or operated previously were excluded from the study. All patients had an ACL reconstruction with an autogenous four-strand hamstring graft. Thirty-five patients received treatment for other meniscal pathologies. All patients followed a similar accelerated rehabilitation program after surgery. Final evaluations were made using the Lysholm and International Knee Documentation Committee (IKDC) scoring systems and the Tegner activity rating system in the final follow-up., Results: Mean follow-up time was 43.9 (range: 29-57) months. Lysholm scores were good or excellent for 47 patients. IKDC scores were either Grade A or B for 48 patients. The mean Tegner activity score was 5.9 (range: 4-9) in the preoperative and 5.4 (range: 2-9) in the late postoperative period., Conclusion: Reconstruction of the ACL using four-strand hamstring tendons and cross-pin femoral fixation may be a safe and effective method, resulting in considerably high success rates.

Objectives: This study aims to point out the long-term results of fibrin sealant in the treatment of acute ruptures of the Achilles tendon., Patients and Methods: Between January 1998 and December 2007, 42 patients (42 males; mean age 37.8 years; range 27 to 56 years) admitted to our clinic for acute ruptures of the Achilles tendon were treated with a fibrin sealant. The average time to surgery from injury was 2.0 (range 1 to 4) days. The patients were divided into two groups; in the first 32 patients fibrin sealant was used which was heated for preparation. In the second group of 10 patients we used fibrin sealant which did not require heating for preparation., Results: The mean follow-up period was 51.5 (range 24 to 92) months. The Thermann scoring system was used to evaluate the patients postoperatively in both the early and the final follow-ups. We found that the Thermann scores of some patients slightly decreased in the advanced age group when compared to younger patients long-term, but the overall result remained unchanged by time. Only one patient needed to be re-operated for a re-rupture resulting from resumption of daily work and sports activities., Conclusion: Treatment of acute Achilles tendon ruptures with fibrin sealant can be one of the first choices selected because of its lower complication rate and equal results when compared to other treatment options.

Objective: To investigate the presence of Chlamydophila pneumoniae and other bacterial pathogens in middle ear effusion samples obtained from children with otitis media with effusion (OME)., Materials and Methods: Twenty-eight children (mean age 7.03; standard deviation 2.18) with OME unresponsive to medical therapy were included in the study. All of the children underwent ventilation tube insertion under general anesthesia. Eighteen patients were bilaterally affected whereas 10 children had unilateral disease. The middle ear fluids (46 samples in total) were collected during ventilation tube insertion, and were evaluated subsequently for the presence of C. pneumoniae and other bacterial pathogens using polymerase chain reaction (PCR)., Results: Although all samples were negative for C. pneumoniae, bacterial DNA was detected in 21 of 46 samples. Overall 40% of the patients (4/10) with unilateral involvement, and 61% of the patients (11/18) with bilateral involvement were positive for bacterial DNA. In 6 patients with bilateral OME bilateral samples were positive, whereas 5 patients with bilateral OME showed only unilateral positivity. According to the results of DNA sequencing analysis, all of the positive samples harbored only one bacterial species. In 12 of 46 samples Alloiococcus otitidis DNA (26%), in 7 Haemophilus influenzae DNA (15%), in one Streptococcus pneumoniae DNA (2%) and in one Moraxella catarrhalis DNA (2%) were present., Conclusions: Our findings support that C. pneumoniae does not seem to have a role in OME in children whereas A. otitidis was found to be more frequent than the other common pathogens. Further studies are required to elucidate the exact pathogenetic role of these microorganisms in OME., (Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.)

Accounting for 20% to 50% of all benign forms, solitary osteochondroma is the most common bone tumor. The long bones of the lower extremity are most frequently affected, whereas the small bones of the hands, feet, pelvis, scapula, and spine are less common locations. Osteochondromas are benign osseous neoplasms with a distinct hyaline cartilage cap originating from the physis, and they cease to grow with skeletal maturity. Treatment of osteochondroma is usually conservative, unless symptoms, usually pain, are progressive or the lesion demonstrates rapid or new growth, or if enlargement after skeletal maturation is noted or malignant transformation is suspected. In this report, we describe the case of an adult with a giant, symptomatic osteochondroma localized to the fifth metatarsal. The lesion was treated with excision, and after more than 2 years of follow-up, no evidence of recurrence was noted. This case demonstrated that, despite the benign nature of the lesion, a large osteochondroma could localize to a metatarsal., (Copyright 2010 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.)

Objectives: Thirty-nine percent of the ankle and midfoot fractures in ankle distortions could be missed during initial evaluation in emergency department because of inadequate clinical and radiological evaluation in a limited time. We aimed to evaluate the follow-up and treatment outcomes of subjects with missed fractures, which were not diagnosed with plain radiographs obtained for ankle distortion, but with advanced imaging studies., Methods: Eight patients (4 females, 4 males) who were initially treated with a diagnosis of ankle distortion due to trauma between 2004 and 2008 were included in the study. Since there were no fractures in the initial radiographs reported by radiologists, conservative treatment was applied. However, the pain and swelling around the ankle were sustained and advanced imaging studies revealed talus fracture. All patients were evaluated with the scoring system of American Orthopedic Foot and Ankle Society (AOFAS)., Results: Mean age of the patients was 22.37 years (range 20-40 years) at the initial fracture diagnosis. The talar neck fracture was diagnosed with computed tomography (CT) in 1 patient and with magnetic resonance imaging (MRI) in the remaining 7 patients. Mean follow-up time was 6 months (range 3-8 months), and mean AOFAS score at last follow-up was 93.7 (range 80-100)., Conclusion: Talus fractures can lead to serious complications because of its anatomical localization. Areas with edema, tenderness or pain should be defined on physical examination, and deep palpation should be applied on the lateral aspect of the talar neck. If there is pain in this area at late examination and no fracture was reported with conventional radiographs, the possibility of missed talar fracture should be considered and the patient should be evaluated with CT or MRI.

The surgical procedures for unicameral solitary calcaneal bone cysts have ranged from simple curettage and grafting to subperiosteal resection with internal fixation and grafting. In this article, an endoscopically assisted technique is proposed for the curettage of a simple calcaneal cyst that takes advantage of direct visualization of the cyst wall and contents and permits accurate assessment of the extent of the lesion. After curettage, percutaneous filling of the defect with corticocancellous allograft makes the technique a complete, minimally invasive surgical approach for this condition. The technique uses 2 lateral portals, one for viewing and the other for manipulation, both of which are created under fluoroscopic control. Once the cyst has been located, the 30 degrees arthroscope is used to evacuate fluid, after which more solid cyst contents are fragmented and removed. Thereafter, curettage of the inner surface of the cavernous cyst wall is performed. Finally, complete packing of the previously cystic cavity with crushed corticocancellous allograft is performed under endoscopic visualization and confirmed radiographically., (Copyright 2010 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.)

Objectives: The aim of this study was to compare the early postoperative results of open and arthroscopic Bankart repair for isolated traumatic anterior instability of the shoulder., Methods: The study included 64 male patients who underwent surgery for traumatic recurrent anterior shoulder instability. Of these, 30 patients (mean age 25.1 years) underwent open Bankart repair and 34 patients (mean age 25.8 years) underwent arthroscopic Bankart repair. All the patients had labral tears on preoperative magnetic resonance scans and had complaints of instability even during daily activities. Patients with at least six dislocations were included in the study; patients with multidirectional instability were excluded. The mean time from the first trauma to surgical intervention was 4.4 years (range 1 to 24 years) in the open surgery group, and 3.8 years (range 1 to 17 years) in the arthroscopy group. Decision for surgical treatment was made based on limitation of activities because of fear of having a dislocation and on positive results of instability tests. Repair was performed using metal anchors in both groups. The clinical results were evaluated using the Rowe scale. The severity of pain on the first postoperative day was assessed using a visual analog scale (VAS). The mean follow-up period was 26.1 months (range 12 to 52 months) in the open surgery group, and 26.6 months (range 12 to 51 months) in the arthroscopic repair group., Results: The mean duration of operation was 2 hours for open surgery, and 2.5 hours for arthroscopic repair. The size of the incision was approximately 8 cm in the open surgery group, and 3 cm in the arthroscopic repair group. The mean Rowe scores were 90.2 and 91.6, being higher in the arthroscopic repair group. Clinical results of open surgery were excellent in 21 patients (70%), good in eight patients (26.7%), and poor in one patient (3.3%). In the arthroscopic repair group, the results were excellent in 27 patients (79.4%), good in five patients (14.7%), and poor in two patients (5.9%). All the patients with a poor result experienced redislocations due to traumatic falls 5 to 18 months after surgery. The mean VAS score was 5.0 ± 1.3 in the open surgery group, and 4.4 ± 1.3 in the arthroscopic repair group. Loss of external rotation was observed in 15 patients (20° in 8 patients, 10° in 4 patients, 5° in 3 patients) in the open surgery group, and in nine patients (20° in 3 patients, 10° in 6 patients) in the arthroscopic repair group. There were no significant differences between the two groups with respect to Rowe scores, VAS scores, range of motion, apprehension test results, and the incidence of recurrent instability., Conclusion: Although, in the past, the results of arthroscopic repair were less satisfactory compared to open surgery, this condition has changed remarkably. The results of arthroscopic repair in our study were similar to those of open repair. We believe that, with enhanced experience and advances in arthroscopic repair techniques, arthroscopic treatment may outweigh open surgery.

Background: Femoral shaft fractures are usually seen in the young population as a result of high energy traumas and are often accompanied by major organ injuries. In this paper, we aimed to assess the clinical results of expandable femoral intramedullary nails in the treatment of 20 femoral shaft fractures., Methods: The average age was 34.7. One fracture was the result of a gunshot wound, type 3A open fracture, and the other 19 fractures were closed. Under fluoroscopic control, all patients underwent elective closed reduction and internal fixation with intramedullary expandable femoral nails (Fixion, Disc-O-Tech; Israel). In case of failed or unacceptable closed reduction, open reduction was achieved with a second incision over the fracture site. Average operation time was 26.3 minutes., Results: Full union was achieved in all patients. The shortest union time was 12 weeks and the longest 24 weeks, with an average of 15.2 weeks. Results in 15 patients (75%) were excellent, in 4 patients (20%) good and in 1 patient (5%) moderate according to Thorensen criteria., Conclusion: Use of expandable nails provides union without major complications and offers advantages such as less exposure to radiation as seen in distal locking of classical intramedullary nails. In conclusion, the good results of this study show that the expandable femoral intramedullary nail provides a successful option to classical intramedullary nails.

Objectives: Prevalence of flatfoot in healthy Turkish male adolescents was investigated., Patients and Methods: The present study was carried out in a high school in Istanbul in July 2006. Twenty-two subjects with flatfoot were diagnosed among 3169 male adolescent participants. Prevalence of flatfoot was evaluated statistically in this certain age and gender group. Correlation of flatfoot with weight and height were evaluated., Results: Prevalence of flatfoot was found to be 0.69%. Correlation of flatfoot with weight or height was not significant., Conclusion: Rigid and resistant flatfoot can cause severe disability. Therefore, the possibility of flatfoot should be kept in mind in symptomatic male adolescents.

Objective: In this study we aimed to investigate the presence of human herpesvirus 8 (HHV-8) and human papillomavirus (HPV) in laryngeal carcinoma., Materials and Methods: Fifty patients operated on because of laryngeal carcinoma were included in the study. Forty-seven had squamous cell carcinoma (SCC) whereas three had verrucous carcinoma. Fresh tumoral tissues, or tumoral tissues obtained from archival paraffin-embedded blocks, were examined. HHV-8 DNA and HPV DNA were detected using polymerase chain reaction (PCR) and viral genotypes of HPV were determined via the hybrid capture method. The presence of HHV-8 DNA and HPV DNA were also investigated in normal appearing laryngeal tissue collected from 50 cadavers at autopsy., Results: HPV DNA was detected in seven patients (7/50; 14%) (5 out of 47 patients with SCC (5/47; 10.6%) and two out of three patients with verrucous carcinoma). HHV-8 DNA was detected in five patients and they all had SCC (5/47; 10.6%). One case had both HHV-8 and HPV DNA. None of the control samples from cadavers harbored HHV-8 DNA, or HPV DNA. There was a statistically significant correlation between HHV-8 DNA and HPV DNA positivity and laryngeal SCC (Fisher exact test; p=0.023 for each). No statistically significant correlations were found between the presence of HHV-8 and/or HPV and age, gender, tumor stage, differentiation, the site of the tumor, smoking and alcohol use., Conclusions: The findings of the present study suggest that beside HPV, HHV-8 might have a role in laryngeal carcinogenesis. Further investigations are necessary to clarify the exact role of these viruses in laryngeal carcinoma.

Objectives: We evaluated the short-term results of reconstruction of anterior cruciate ligament (ACL) ruptures using a four-strand hamstring autograft and cross pin femoral fixation., Methods: The study included 62 male patients (mean age 24 years; range 21 to 44 years) with chronic ACL ruptures. Involvement was in the right knee in 32 patients, and in the left knee in 30 patients. All the patients were treated with a four-strand hamstring autograft, cross pin femoral fixation (Transfix, Arthrex and Sling Shot, Mitek), and an interference screw on the tibial side. Forty-one patients received treatment for other meniscal pathologies. Final evaluations were made at the end of postoperative 18 months using the Lysholm and IKDC (International Knee Documentation Committee) scoring systems, Telos stress testing, Tegner activity rating, and radiographs., Results: The Lysholm scores were good (n=23) or excellent (n=38) in 61 patients, and poor in one patient, the mean Lysholm score being 93.5. The IKDC scores were grade A (n=35) or B (n=26) in 61 patients, and grade D in one patient. Telos stress testing showed a significant difference between preoperative (mean 14.5 mm) and postoperative (mean 2.6 mm) laxity measurements (p<0.001). None of the patients had a graft rupture. One patient who developed grade III instability after postoperative six months underwent second-look arthroscopy followed by revision surgery., Conclusion: Reconstruction of the ACL using four-strand hamstring tendons and cross pin femoral fixation results in considerably high success rates in selected patients.

We evaluated eight patients after delayed treatment of nine metacarpal bone defects due to gunshot injuries. The mean length of the metacarpal defects was 3 cm and the average time between the gunshot injury and the reconstruction surgery was 10 months. Although all of the patients had been treated with wound irrigation and debridement immediately following injury, no attempt had been made to repair the metacarpal defect or to maintain metacarpal length. As a result, serious shortening had occurred. After the original length of the metacarpal had been restored by distraction of the soft tissues (1 mm/day), a tri-cortical iliac bone graft was inserted into the bone defect. The average follow-up time was 15 months. Clinical and radiological union was established in all cases after an average of 12 weeks. The mean grip strength of the hand and the mean range of motion of the metacarpophalangeal joint increased by 24% and 60%, respectively.