A Turkish Female Twin Sister Patient with Fibular Aplasia, Congenital Tibia Pseudoarthrosis, Oligosyndactyly, and Negative WNT7A Gene Mutation.

We report a rare limb defect named as fibular aplasia, tibial campomelia, and oligosyndactyly (FATCO) syndrome in a female monozygotic twin with a normal twin sister, presented with anterior tibia pseudarthrosis, oligosyndactyly, and pes equinovarus. Radiographic examination displayed the absence of left fibulae, anterolateral pseudarthrosis of left tibia, and the absence of some metatarsus and phalangeal bones. Our case report is the first to report that only one of the identical twins was affected by FATCO syndrome, which is a significant finding because the pathogenicity of FATCO syndrome is yet to be identified, and this clinical case may provide a new insight for discovering the etiology of FATCO syndrome.

Can Ureteral Jet Flow Measurement Predict Spontaneous Passage of Distal Ureteral Stones?

OBJECTIVES: The study aimed to investigate the relationship between the spontaneous passage of distal ureteral stones and ureteral jet flow measurement. METHODS: The study included 74 patients with acute renal colic between June 2015 and June 2016, and distal ureteral stones of 10 mm or less in a non-contrast CT were comprised in a prospective study. The ureteral jet was measured by Doppler ultrasonography. At the fourth week follow-up, kidney-ureter-bladder radiography was taken and the patients who no longer had a stone were considered to have spontaneously passed it. RESULTS: The average stone size of the patients was 5.6 ± 2.0 mm. After 4 weeks of follow-up, 55 patients (74.3%) had passed the stone spontaneously whereas 19 (25.6%) had not. The patients in the former group were found to have a higher peak flow velocity of ureteral jet on the stone side than those in the latter group. In regression analysis ureteral jet on the stone side was independently associated with spontaneous passage (p = 0.027). For the spontaneous passage, a ureteral jet flow peak velocity above 15.25 cm/s had an 85.4% sensitivity and 63.1% specificity. CONCLUSIONS: Measurement of the ureteral jet flow peak velocity can be beneficial in predicting the potential spontaneous passage of distal ureteral stones.

Effects of concentrated growth factors (CGF) on the quality of the induced membrane in Masquelet's technique - An experimental study in rabbits.

AIMS: The aim of the study was to test if the addition of CGF to the Masquelet technique contributes to the quality of the membrane formed surrounding the polymethylmethacrylate (PMMA), in terms of inflammation, proliferation and vasculazition in the Masquelet technique in the early and late phases in a rabbit model. MATERIALS AND METHODS: A critical bone defect of 15 mm was created in radius diaphysis, leaving 3 cm of intact bone to the joint. To mimic the Masquelet technique and to increase stability, a 6-hole 1.5 mm plate with two screws was applied, although it was initialy stable because of the inherently fixed ulna and radius both proximally and distally in the rabbits. Group 1 and Group 3, were soleley treated with the Masquelet technique as control groups, and were sacrificed at 3 and 6 weeks, respectively. Group 2 and Group 4, were treated with the Masquelet technique + CGF prepared from the rabbit blood groups, and were sacrificed at 3 and 6 weeks, respectively. The groups were compared histopathologically and immunohistochemically, in respect of the means of thickness of the membrane and ratio of elastic fibers, membrane vascularization (CD31), inflammation (MAC387), proliferation (Ki67), and presence of stem cells (STRO-1). RESULTS: Thickness of the membrane and CD31 values were significantly higher in Group 4 than Group 3 (p = 0.004 for both). MAC387 was statistically significantly higher in Group 2 compared to Group 1 and Group 4 compared to Group 3 (p = 0.04 for both). Ki67 was significantly higher in Group 2 compared to Group 1 and Group 4 compared to Group 3 (p = 0.05 and p = 0.006, respectively). Proliferation in the membrane was statistically significantly higher in Group 2 compared to Group 1 (p = 0.05). Likewise, the proliferation index of Group 4 was statistically significantly higher than Group 3 (p = 0.06). STRO-1 was significantly higher in Group 2 compared to Group 1 (p = 0036). CONCLUSION: The addition of CGF to the Masquelet technique contributes to the quality of the membrane formed, in respect of inducing inflammation and proliferation, maintaining vascularization on large diaphyseal bone defects, and increasing the number of stem cells.

Relationship Between Ureteral Jet Flow, Visual Analogue Scale, and Ureteral Stone Size.

OBJECTIVE: To contribute to the diagnosis and treatment of ureteral stones by investigating the relationship between the ureteral jet flow measurements of patients with ureteral stones and the size of the stones and the patients' pain scores. MATERIALS AND METHODS: The sample consisted of patients who presented acute renal colic between December 2014 and 2015 and from a noncontrast computed tomography were found to have a urinary stone. The ureteral jet flow velocities were determined using Doppler ultrasonography. The patients were all assessed in terms of stone size, localization and area, anteroposterior pelvis (AP) diameter, and visual analogue scale (VAS) scores. RESULTS: A total of 102 patients were included in the study. As the VAS score decreased, the peak jet flow velocity on the stone side increased, whereas the flow velocity on the other side, AP diameter, and stone area were reduced (P < .05). As the stone size increased, the peak jet flow velocity was reduced and the AP diameter increased significantly (P < .05). Ureteral jet flow was not observed in 17 patients on the stone side. A statistically significant difference was found between these patients and the remaining patients in terms of all parameters (P < .05). CONCLUSION: For patients, in whom the peak flow velocity of ureteral jet is low and with a severe level of pain or the peak flow velocity of ureteral jet cannot be measured, there is a low possibility of spontaneous passage and a high possibility of a large stone, and therefore the treatment should be started immediately.