Although intra-articular knee injection is not a complicated procedure, it could be difficult to assess whether the tip of the needle lies free in the joint or is embedded in synovium or other intra-articular soft tissues. The purpose of this study was to evaluate the accuracy rate of intra-articular injection using anteromedial (AM), anterolateral (AL), lateral midpatellar (LMP), and medial midpatellar (MMP) portals in cadavers. In this study 156 knees of 78 fresh cadavers were included. Anterolateral and AM injection to both knees of 39 cadavers (78 knees) were performed. MMP and LMP injection to both knees of other 39 cadavers were also performed. Accuracy rate was the highest (85%) in the AL injection portal and lowest in the MMP portal (56%). In conclusion, the accuracy obtained with use of the MMP portal was significantly lower than that obtained with the use of either the AM (P < 0.05), AL (P < 0.0001), or LMP (P < 0.05) portal. Although AL injection site resulted in good intra-articular delivery with 85% accuracy rate and with a lower incidence of soft tissue infiltration, the results were not statistically significant when compared to AM and LMP portals. Therefore, any of these three portals might be preferred depending on the experience of the physician. On the other hand, 100% accuracy could not be obtained through any portals in the study, which should be kept in mind when treating knee problems with intra-articular medications.

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Eosinophils are associated with various disorders, such as allergic or hypersensitivity reactions, parasitic diseases, connective tissue diseases, certain neoplastic diseases (Hodgkin's disease, lymphomas, and carcinomas), and various immune deficiency states. Eosinophils can infiltrate any tissue and can cause tissue damage. Heart, has been demonstrated to be the most extensively involved and toxicity of eosinophils is well-established on cardiac tissue. We describe 3 cases with extensive eosinophilic infiltration without endomyocardial fibrosis. All patients died after a short clinical course with rapidly progressive heart failure. Bronchial asthma, hydatid disease and drug reaction were considered as possible etiologies of eosinophilia in case 1 and case 2. Case 3 was considered to fall into the "idiopathic hypereosinophilic syndrome" in which no underlying causes for eosinophilia could be identified.

Objective: In this study, we aimed to identify the difficulties encountered by the health teams and personnel working as volunteers or on assignment in the earthquake area, and to identify their experiences and recommendations regarding the disaster. Material and Methods: This study was conducted in October and November 2011 in Van,Turkey and the surrounding region with Individuals, mainly health personnel, who arrived in the city as volunteers or on assignment to assist the relief efforts. The study was conducted as these individuals carried out their duties. Face-to-face interviews were conducted with volunteers and personnel who agreed to complete the questionnaires as required. Results: A total of 168 persons were included in the study. The mean age of these individuals was calculated as 31+8 (age range 17 to 56). Of the participants, 74 (44%) arrived in the city or the surrounding area as part of their official assignment, and 94 (56%) arrived as volunteers. During the study, 77 (46%) of the individuals experienced a health problem on at least one occasion. A job definition could be identified for 74% of the participants. Conclusion: The job definitions and required materials should be pre-determined and work hours rotated according to a shift system. We believe that this would allow relief efforts to be conducted more effectively. (JAEM 2013; 12:66-70)