Plantar heel pain, a chronic and disabling foot alignment, occurs in the adult population. Extracorporal shock wave therapy (ESWT) offers a nonsurgical option in addition to stretching exercises, heel cups, NSAI, and corticosteroid injections. This study aimed to investigate the effects of ESWT on calcaneal bone spurs and the correlation between clinical outcomes and radiologic changes. The study involved 108 patients with heel pain and radiologically diagnosed heel spurs. All patients underwent ESWT once a week for 5 weeks at the clinic. Each patient received 2,000 impulses of shock waves, starting with 0.05 mJ/mm2 (1.8 bar) and increasing to 0.4 mJ/mm2 (4.0 bar). Standard radiographies of the affected heels were obtained before and after the therapy. Clinical results demonstrated excellent (no pain) in 66.7% of the cases, good (50% of pain reduced) in 15.7% of the cases, and unsatisfactory (no reduction in pain) in 17.6%. After five ESWT treatments, no patients who received shock wave applications had significant spur reductions, but 19 patients (17.6%) had a decrease in the angle of the spur, 23 patients (21.3%) had a decrease in the dimensions of the spur, and one patient had a broken spur. Therefore, results showed no correlation between clinical outcome and radiologic changes. The present study supports the finding that even with no radiologic change after ESWT therapy, the therapy produces significant effects in reducing patients' complaints about heel spurs.

The aim of this study was to obtain the ultrasonographical reference values of ulnar nerve cross-sectional areas at the common areas of nerve entrapment as well as any differences related to age, sex, weight, height, dominant arm. Cross-sectional areas of the ulnar nerves of 72 healthy volunteers were measured bilaterally at the level of the epicondyle, 2 cm proximal to and 2 cm distal to the epicondyle, just at the entrance of cubital tunnel, at arterial split, at Guyon's canal. Age, sex, body weight, height, body mass index, and dominant extremity were recorded. The mean ulnar nerve cross-sectional area was 5.8 ± 1.1 mm(2) at 2 cm proximal to medial epicondyle, 6.2 ± 1.1 mm(2) at the medial epicondyle, 5.6 ± 0.9 mm(2) at the entrance of the cubital tunnel, 5.6 ± 1.0 mm(2) at 2 cm distal to medial epicondyle (inside the flexor carpi ulnaris), 5.0 ± 0.6 mm(2) at arterial split, and 4.9 ± 0.6 mm(2) at Guyon's canal. There was statistically no difference between the dominant and nondominant sides (p > 0.05). Females had statistically smaller nerves than males (p < 0.05). There was a significant correlation with height at all levels; also, weight was significantly correlated with cross-sectional areas except at two levels: tip of medial epicondyle and 2 cm distal. This study provides normative data of ulnar nerve ultrasonography and as well as any differences related to age, sex, height, weight, and dominant arm.

We aimed to evaluate the relation between the severity of carpal tunnel syndrome and metabolic syndrome. One hundred and fifty patients who had a clinical and electrophysiologically confirmed diagnosis of carpal tunnel syndrome (CTS), were included in this study. The patients were divided into two groups (with or without metabolic syndrome) according to the criteria of National Cholesterol Education Program. Eighty one (73.5 %) of the patients with CTS had metabolic syndrome. The patients with metabolic syndrome the severity of CTS was found 22.2 % had mild CTS, 56.8 % had moderate CTS, and 21 % had severe CTS. The patients without metabolic syndrome the severity of CTS was found 44.9 % had mild CTS, 40.6 % had moderate CTS, and 14.5 % had severe CTS. The severity of CTS between both groups was found to be statistically significant (p = 0.0009). While a correlation was found between the severity of CTS and high level of LDL with the presence of metabolic syndrome (correlation coefficient 0.209). In conclusion metabolic syndrome that appears to be a risk factor for CTS. At the same time, the presence of metabolic syndrome increases the severity of the disease.

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There is still no consensus on a normal value for the cross-sectional area of the ulnar nerve at the elbow. Such data would be valuable for the ultrasound diagnosis of ulnar neuropathy. Comparison of the symptomatic and contralateral asymptomatic sides has been recommended. The aim of this study was to investigate whether or not the asymptomatic ulnar nerve could be a reference value. High-resolution ultrasonic measurements of the cross-sectional areas of the ulnar nerves at the elbow were compared with 38 contralateral asymptomatic elbows of patients with unilateral ulnar neuropathy and 38 healthy controls. There were significant differences in the cross-sectional areas at all levels between the healthy control subjects and asymptomatic side of the ulnar neuropathy patients (p < 0.05). The findings of this study suggest that there is a limitation in using the asymptomatic side for obtaining reference values in ultrasonographic studies. Each ultrasonographic laboratory should determine its own reference values.

Oxidative stress may produce high level of reactive oxygen species (ROS) following cell exposure to endogenous and exogenous factors. Recent experiments implicate oxidative stress as playing an essential role in cytotoxicity of many materials. The aim of this study was to measure intracellular malondialdehyde (MDA), advanced oxidation protein product (AOPP) levels, and superoxide dismutase (SOD) activities of L929 fibroblasts cultured on PDLLA, polyethylene glycol (PEG), or ethylenediamine (EDA) grafted PDLLA by plasma polymerization method. Cell proliferation on these scaffolds was studied by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide assay. The study showed that MDA, AOPP levels, and SOD activities in L929 fibroblast cells cultured on all scaffolds were significantly different compared to the control group and each other. The highest MDA (0.42 ± 0.76 nmol/mg protein), AOPP (14.99 ± 4.67 nmol/mg protein) levels, and SOD activities (7.49 ± 3.74 U/mg protein) were observed in cells cultured on non-modified scaffolds; meanwhile, the most cell proliferation was obtained in EDA-modified scaffolds (MDA 0.15 ± 0.14 nmol/mg protein, AOPP 13.12 ± 3.86 nmol/mg protein, SOD 4.82 ± 2.64 U/mg protein). According to our finding, EDA- or PEG-modified scaffolds are potentially useful as suitable biomaterials in tissue engineering.

Recently, the incorporation of magnetic nanoparticles into standard scaffolds has emerged as a promising approach for tissue engineering applications. This strategy can promote not only tissue regeneration but also reloading of scaffolds through an external supervising center that adsorbs growth factors, preserving their stability and biological activity. In this study, novel magnetic silk fibroin e-gel scaffolds were prepared by the electrogelation process of concentrated Bombyx mori silk fibroin (8 wt%) aqueous solution. In addition, basic fibroblast growth factor was conjugated physically to human serum albumin = Fe3O4 nanoparticles (71.52 ± 2.3 nm in size) with 97.5% binding yield. Scanning electron microscopy images of the prepared human serum albumin = Fe3O4-basic fibroblast growth factor-loaded silk fibroin e-gel scaffolds showed a three-dimensional porous morphology. In terms of water uptake, basic fibroblast growth factor-conjugated scaffolds had the highest water absorbability among all groups. In vitro cell culture studies showed that both the human serum albumin coating of Fe3O4 nanoparticle surface and basic fibroblast growth factor conjugation had an inductive effect on cell viability. One of the most used markers of bone formation and osteoblast differentiation is alkaline phosphatase activity; human serum albumin = Fe3O4-basic fibroblast growth factor-loaded silk fibroin e-gels showed significantly enhanced alkaline phosphatase activity (p < 0.05). SaOS-2 cells cultured on human serum albumin = Fe3O4-basic fibroblast growth factor-loaded silk fibroin e-gels deposited more calcium compared with those cultured on bare silk fibroin e-gels. These results indicated that the proposed e-gel scaffolds are valuable candidates for magnetic guiding in bone tissue regeneration, and they will present new perspectives for magnetic field application in regenerative medicine.

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