Gas and seismicity within the Istanbul seismic gap.

Understanding micro-seismicity is a critical question for earthquake hazard assessment. Since the devastating earthquakes of Izmit and Duzce in 1999, the seismicity along the submerged section of North Anatolian Fault within the Sea of Marmara (comprising the "Istanbul seismic gap") has been extensively studied in order to infer its mechanical behaviour (creeping vs locked). So far, the seismicity has been interpreted only in terms of being tectonic-driven, although the Main Marmara Fault (MMF) is known to strike across multiple hydrocarbon gas sources. Here, we show that a large number of the aftershocks that followed the M 5.1 earthquake of July, 25th 2011 in the western Sea of Marmara, occurred within a zone of gas overpressuring in the 1.5-5 km depth range, from where pressurized gas is expected to migrate along the MMF, up to the surface sediment layers. Hence, gas-related processes should also be considered for a complete interpretation of the micro-seismicity (~M < 3) within the Istanbul offshore domain.

Temporomandibular disorders in patients with rheumatoid arthritis: A clinical study.

OBJECTIVES: The aim of this study is to evaluate the prevalence and type of temporomandibular disorders (TMD) in patients with rheumatoid arthritis (RA). MATERIALS AND METHODS: Fifty-four patients having RA treatment at Cukurova University in Rheumatology Clinic were enrolled to the study. Demographic and rheumatologic data were recorded. The patients were examined in Dental Faculty by using Research Diagnostic Criteria/TMD (RDC/TMD) axis I and answered RDC/TMD axis II Biobehavioral Questionnaire. Data were evaluated according instructions for scoring and assessment of RDC/TMD. Mann-Whitney test was performed to compare continuous variables between two groups and Kruskal-Wallis test was performed to compare continuous variables for more than two groups. RESULTS: Although their activity situations were 55.6% active and 44.4% inactive, the distribution of treatment modality was 31.5% for anti-tumor necrosis factor-α (TNF-α) and 68.5% for disease-modifying antirheumatic drugs (DMARD). The distribution of temporomandibular joint (TMJ) involvement was; 9.3% with no involvement, 7.4% with joint involvement, 64.8% with muscular involvement, 18.5% with both muscular and joint involvement. Rheumatologic functional scores were (0) 3.7%, (1) 50%, (2) 38.9%, (3) 7.4%. Patients' chronic pain was graded from 0 to 4 and the distribution was 3.7%, 24.1%, 20.4%, 31.5% and 20.4%, respectively. The mean duration of RA for anti-TNF-α (11.47 ± 7.67) was significantly higher compared with DMARD (7.09 ± 5.21) P = 0.040. CONCLUSION: There was a high prevalence of TMD in RA patients, and muscular involvement was the highest among the TMJ involvements. Thus, this study supports TMJ examination should be encouraged in the rheumatology settings.

Intermediate term outcomes associated with the surveillance of ureteropelvic junction obstruction in adults.

PURPOSE: We determined the outcome of minimally symptomatic adult ureteropelvic junction obstruction in a group of patients treated conservatively with an active surveillance regimen. MATERIALS AND METHODS: A total of 27 patients with asymptomatic or minimally symptomatic ureteropelvic junction obstruction were treated conservatively. All patients were evaluated with diuretic renograms. Ureteropelvic junction obstruction was defined by an obstructive pattern of the clearance curve and/or T1/2 greater than 20 minutes. Followup consisted of an office visit and renogram every 6 to 12 months. Cases of greater than 10% loss of relative renal function of the affected kidney, development of pyelonephritis and/or more than 1 episode of acute pain were considered active surveillance failures, and treatment was recommended. RESULTS: Of the 27 patients 6 were lost to followup, leaving 21 (median age 47 years) with sufficient followup for analysis. In the 4 patients (19%) who initially presented with mild pain that led to the diagnosis of ureteropelvic junction obstruction, the pain completely resolved. Ipsilateral relative renal function decreased significantly in 2 patients (9.5%, mean reduction 14%). Pain worsened in 3 patients (14.3%) and de novo pain occurred in 1 (4.7%). Surgical intervention for ureteropelvic junction obstruction was required in 6 patients (29%) at an average of 34 months. In total 15 patients (71%) remained on surveillance with a mean followup of 48 months. CONCLUSIONS: Active surveillance seems to be a reasonable initial option for asymptomatic or mildly symptomatic adult patients with ureteropelvic junction obstruction because only approximately 30% have progression to surgical intervention within 4 years of diagnosis. This strategy offers the advantage of individualizing therapy according to symptoms and renographic findings.

Venous free flaps for reconstruction of skin defects of the hand.

Twenty-one cases of skin defects of the hand were treated with venous flaps. According to type, nine flaps were arterialised flaps (A-A), five were (A-V), and seven were (V-V) type. Venous flaps can be used up to 8 x 3 cm in size or even bigger if the number of veins anastomosed is increased. The main advantage of venous flaps is that they can also be used for simultaneous reconstruction of circulation in digits.

Moving car-tire injuries of the foot: reconstruction with microvascular free flaps.

Moving car-tire injury of the foot is a condition that appears to be a new clinical entity in Istanbul, in which the non-weight-bearing surface of the foot is prone to be injured. Between 1992 and 1995, eight moving car-tire injuries of the foot were managed. Patient age averaged 10.25 years (range: 7 to 21 years). All patients presented with soft-tissue loss combined with extensor tendon and bone lesions. In 6 patients, immediate flap coverage after initial debridement and, in 2 patients, delayed coverage after multiple debridements, were performed. All the flaps survived. Although in all patients, the weight-bearing region was always intact, some had gait-pattern abnormalities due to the bone and soft-tissue injuries. Early removal of all devitalized tissues and closure of the wounds with transfer of healthy tissue have a higher rate of success, lower incidence of infection, require fewer operative procedures, and shorter hospitalizations.

Baluster entrapment avulsion of the little finger: a new clinical entity--case reports.

Five cases of avulsion injuries of the little finger are described. The mechanism of injury was identical in all cases. The little finger was entrapped by a baluster when the patient frantically attempted to grasp the handrail to avoid falling down stairs. To our knowledge, this type of injury has not been reported previously.