[Effects of human amniotic fluid on posterolateral spinal fusion: an experimental preliminary study]

OBJECTIVES

In this study, the effects of human amniotic fluid on posterolateral spinal fusion were investigated in a rat model.

MATERIALS AND METHODS

Twenty-eight 20-week-old male Sprague Dawley rats were included in the study. The subjects were divided into two main groups as the control group and the amniotic fluid group. Posterolateral spinal fusion was performed by using autografts in all groups whereas 0.3 ml of centrifuged human amniotic fluid was added to the fusion area in amniotic fluid groups. Groups were further divided into subgroups each including seven rats and evaluated radiologically and histologically at the third and sixth weeks.

RESULTS

The radiological fusion observed in the amniotic fluid group was significant at the sixth week when compared to that in the control group. The histological fusion quality was significant in the amniotic fluid groups both at the third and sixth weeks when compared to the control groups.

CONCLUSION

We conclude that human amniotic fluid enhances posterolateral spinal fusion. We believe that the growth factors and hyaluronic acid present in the amniotic fluid played a role in this result.

Common peroneal and tibial nerve paralysis secondary to herpes zoster infection: a case report

BACKGROUND

The usual presentation of herpes zoster (HZ) is a self-limiting vesicular rash, often accompanied by post-herpetic neuralgia. However, HZ can give rise to other complications, that have unusual presentations and serious sequelae like segmental motor paralysis of the limbs that is a relatively rare complication.

CASE

A 68-year-old man presented with foot drop on the right side had a history of HZ infection on and around the knee and the popliteal fossa. He was treated with acyclovir by a dermatologist and 10 days after the inital symptoms he developed weakness on the right ankle and on the muscles distal to the knee. In a few days foot drop has developed and he was unable to walk without help. Three months later he was admitted to the neurology out patient clinic. On his electrophysiological examination common peroneal nerve could not be stimulated on the right side. The distal latency of the tibial nerve has prolonged, CMAP amplitude has diminished and the nerve conduction velocity has slowed down. Latency of the sural nerve has prolonged with a small SNAP amplitude and a slow nerve conduction velocity on the right side. Electromyography revealed denervation on the muscles inervated by tibialis anterior and common peroneal nerves distal to the knee.

CONCLUSION

The double mononeuropathy of the tibial and common peroneal nerves secondary to HZ was not found in the published data. HZ should be considered as a possible cause of the paralysis of peripheral nerves and more attention should be paid to it.

Effects of the antiepileptic drugs on peripheral nerve function

OBJECTIVE

We aimed to compare the effects of antiepileptic drugs and provide findings of peripheral nerve impairment using standard electrophysiological techniques.

MATERIALS AND METHODS

Young adult outpatients with epilepsy on monotherapy for no less than 6 months with carbamazepine (CBZ), valproic acid (VPA), oxcarbazepine (OXC) and topiramate (TPM) were examined. Patients who had any other disease that could effect nerve conduction studies and who had neuropathic symptoms were excluded.

RESULTS

Each group contained 15 patients and 20 healthy subjects were examined as the control group. Prolonged latency of median sensory nerve (P = 0.004), ulnar sensory nerve (P = 0.01) and sural nerve (P = 0.003) with a diminished nerve conduction velocity was observed in the CBZ group (P = 0.014, P = 0.002, P = 0.025, respectively). No correlation was found between VPA, OXC and TPM and the nerve conduction studies (P > 0.05).

CONCLUSIONS

Valproic acid, oxcarbazepine and topiramate don't have effects on nerve conduction studies. Mild electrophysiological changes contribute to carbamazepine therapy.

The sensitivity of sympathetic skin responses and standard electrophysiological methods in diagnosis of diabetic neuropathy

This study was planned to compare the sensitivity of standard electrophysiologic methods and sympathetic skin responses (SSRs) in the diagnosis of diabetic neuropathy. Randomly selected 49 patients, who were followed by Haydarpaşa Numune Hospital Diabetes Outpatient Department and age matched 26 healthy persons were included in the study. All of the patients and control subjects were assessed by standard electrophysiologic methods (nerve conduction velocities, H-reflex, F-waves) and SSRs parameters. The abnormality ratios were 85.8% for standard electrophysiological methods, and 76.2% for SSRs. The higher abnormality ratio for SSRs was found important. As a result, it was concluded that standard electrophysiologic methods (including F-wave latency) and SSRs investigations for the early diagnosis of diabetic neuropathy, could be very useful in the prevention of morbidity.

Squamous cell carcinoma of the scrotum

A patient complained of scrotal mass which was found to be a squamous cell carcinoma. There was no occupational exposure and nodal spread was not obtained. We present this rare case.