Management of Osteoid Osteoma in Unusual Locations.

PURPOSE OF THE STUDY Osteoid osteoma is a benign tumor that forms in bone, which accounts for 3% of all primary bone tumors. The classical clinical finding is substantial nocturnal pain and imaging findings. The management of osteoid osteomas include open surgical excision or minimally invasive percutaneous interventions. Why and which treatment modality should be considered between CT-guided radiofrequency ablation and open surgical excision for osteoid osteomas in unusual locations? MATERIAL AND METHODS We retrospectively reviewed 17 patients with osteoid osteomas in unusual locations included cuboid, triquetrum, coronoid process, and proximal phalanx. We evaluated the duration from symptoms to diagnosis, activity related pain, clinical findings, and possible recurrence or complications. The minimum clinical follow-up was 51 ± 34.8 months. RESULTS CT-guided radiofrequency ablation was applied to 3 patients and open surgical excision procedures to 14. All the complaints of patients gone after treatment. No major complications were observed following CT-guided radiofrequency ablation or surgical excision. Transient weakness/paresthesia was determined in 1 patient in the treated shoulder after CT-guided radiofrequency ablation, which resolved spontaneously in the 6th week. There was only recurrence seen in 1 patient, who had 2nd proximal phalangeal osteoid osteoma. Proximal interphalangeal joint arthrodesis was performed after recurred lesion. DISCUSSION The main challenge in management of the osteoid osteomas of the unusual locations are the diagnosis. When we examined the literature, the interval from the beginning of the symptoms to accurate diagnosis did not change over the past decades. Techniques for management of these lesions should be chosen with consideration of the location of the lesion. CONCLUSIONS If there is long-term complaint of undiagnosed limb pain, the physician should suspect osteoid osteoma. However, the selection of treatment modality should be considered according to the location of the lesion. Which management modality is superior may change depending on the location of the lesion between CT-guided radiofrequency ablation and surgical excision. Key words: osteoid osteoma, unusual locations, CT guided, radiofrequency ablation, benign bone tumor.

Chondrocyte proliferation, viability and differentiation is declined following administration of methylphenidate utilized for the treatment of attention-deficit/hyperactivity disorder.

PURPOSE: Methylphenidate (MPH) derivative drugs are used because of psychostimulants effects on attention-deficit hyperactivity disorder in children and adults. As far as we know, toxic or anti-proliferative effects of MPH against cartilage tissue were not studied in the literature. The present study was carried out to investigate the possible effects of MPH on the proliferation, viability and differentiation of primary human chondrocytes, in vitro. METHODS: Monolayer primary chondrocyte cultures were prepared using osteochondral tissue obtained from patients who underwent a total knee prosthesis operation. Stock solution of MPH was prepared and aliquots having 1-1000 µM concentrations of the drug was composed. These solutions were applied to the wells containing cultured chondrocyte samples within the well plates. Control groups were composed of pure chondrocyte culture and no solution was added into them. All groups were evaluated at 24, 48 and 72 h in order to determine the possible negative effects of the drug on the chondrocytes. The data were evaluated by Tukey's honestly significantly different test following analysis of variance. RESULTS: In the group where MPH was applied, it was found that viability, proliferation and stage-specific embryonic antigen-1 protein expression were decreased in comparison to the control group. CONCLUSIONS: It was emphasized that clinicians should not disregard the fact that this drug might suppress chondrocyte cell proliferation and chondrogenic differentiation.

Association of apelin, endoglin and endocan with diabetic peripheral neuropathy in type 2 diabetic patients.

OBJECTIVE: Diabetic peripheral neuropathy is a common complication of type-2 diabetes mellitus. Endocan, apelin and endoglin are thought to be associated with endothelial dysfunction, angiogenesis and inflammation. In this study, we planned to evaluate these markers in diabetic peripheral neuropathy patients. PATIENTS AND METHODS: This single-blind, controlled clinical study was conducted on 99 type 2 diabetic patients with or without diabetic peripheral neuropathy and 53 healthy volunteer controls. Physical and laboratory examinations were done in all groups. In these groups, Endoglin, apelin and endocan levels were measured with ELISA method. RESULTS: Endoglin, apelin and endocan concentrations in diabetic peripheral neuropathy patients were higher than other diabetes mellitus patients and healthy controls. Similarly, diabetes mellitus patient's endoglin, apelin and endocan levels were higher than healthy controls. The differences were statistically significant. We detected a significant positive correlation between endoglin, apelin and endocan levels in all groups. CONCLUSIONS: Endoglin, apelin and endocan may reflect angiogenesis and endothelial dysfunction in diabetic peripheral neuropathy and they may be used as a marker in the future.

Is prematurity a risk factor for developmental dysplasia of the hip? : a prospective study.

The aim of this prospective study was to investigate prematurity as a risk factor for developmental dysplasia of the hip (DDH). The hips of 221 infants (88 female, 133 male, mean age 31.11 weeks; standard deviation (sd) 2.51) who were born in the 34th week of gestation or earlier, and those of 246 infants (118 female, 128 male, mean age 40.22 weeks; sd 0.36) who were born in the 40th week of gestation, none of whom had risk factors for DDH, were compared using physical examination and ultrasound according to the technique of Graf, within one week, after the correction of gestational age to the 40th week after birth or one week since birth, respectively. Both hips of all infants were included in the study. Ortolani's and Barlow's tests and restricted abduction were accepted as positive findings on examination. There was a statistically significant difference between pre- and full-term infants, according to the incidence of mature and immature hips (p < 0.001). The difference in the proportion of infants with an α angle < 60° between the two groups was statistically significant (p < 0.001). The incidence of pathological dysplasia (α angle < 50 º) was not significantly different in the two groups (p = 1.000). The Barlow sign was present in two (0.5%) pre-term infants and in 14 (2.8%) full-term infants. These results suggests that prematurity is not a predisposing factor for DDH.