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Tuberous sclerosis complex (TSC) is an autosomal dominant, multisystem disorder that is characterized by cellular and tissue dysplasia in several organs. With the advent of genetic and molecular techniques, mutations in TSC1 or TSC2 genes were discovered to be responsible for mTOR overactivation, which is the underlying mechanism of pathogenesis. TSC is a highly heterogenous clinical entity with variable presentations and severity of disease. The brain, heart, skin, eyes, kidneys, and lungs are commonly involved in this syndrome, with the neurologic symptoms comprising a significant source of morbidity and mortality. In 2012, the diagnostic criteria were revised by the International Tuberous Sclerosis Complex Consensus panel, and genetic testing was incorporated to the guidelines. Early detection of cardiac rhabdomyomas or TSC-associated skin lesions can suggest the diagnosis and underlie the importance of clinical vigilance. Animal studies demonstrated the benefit of using mTOR inhibitors for various symptomtic condition. Ongoing research studies are providing promising leads for developing novel mechanistic strategies to address the pathophysiology of TSC.Background The management of the dura related complications, such as the repairment of dural tears and reconstruction of large dural defects, has still been the most challenging subjects of neurosurgery. Numerous surgical techniques and synthetic or autologous adjuvant materials have been emerged as an adjunct to primary dural closure, which may result in further complications or side effects. Therefore, subcutaneous autologous free adipose tissue graft has been recommended for the protection of the central nervous system and repair restore/reconstruct of the meninges. In addition, human adipose tissue is also a source of multipotent stem cells. However, epidural adipose tissue appears to be more promising than the subcutaneous tissue because of its proximal location and intercellular communications with the spinal cord. Here, we aimed to define and compare the differentiation capacity of adipose stem cells (ASC) derived from subcutaneous or epidural adipose tissue. Methods ASCs were isolated from human subcutaneous and epidural adipose tissue specimens which were harvested from the primary incisional site and the lumbar epidural space during lumbar spinal surgery. Results Our results indicated that both types of ASCs expressed the cell surface markers which are commonly expressed by stem cells; however, epidural ASCs had lower CD90 expression than subcutaneous ASCs. Moreover, we have demonstrated that osteogenic and neurogenic differentiation capacity of epidural adipose tissue-derived ASCs were more pronounced than subcutaneous adipose tissue-derived ASCs. Conclusion Consequently, characterization of epidural ASCs, will pave the way for new studies investigating their use in dural and also central nervous system healing and recovery after an injury.BACKGROUND/AIM Although ulnar neuropathy at the elbow (UNE) is the second most common entrapment mononeuropathy, there are few reports on its neurophysiological classification. In this study, we tried to find out the role of needle electromyography (EMG) in the neurophysiological classification of UNE. MATERIALS AND METHODS UNE patients who met the clinical and neurophysiological diagnostic criteria and healthy individuals were included in this study. Reference values of nerve conduction studies were obtained from healthy individuals. Needle EMG was performed to all UNE patients. According to the neurophysiological classification proposed by Padua, UNE patients were classified as mild, moderate and severe. RESULTS Thirty-one controls and thirty-five UNE patients were included in the study. There was mild UNE in 23 patients, moderate UNE in 8, and severe UNE in 4. Abnormal needle EMG findings were present in all patients with moderate and severe UNE and in 12 patients with mild UNE. Sodium succinate chemical structure CONCLUSION Abnormal needle EMG findings are seen in most of the UNE patients. Therefore, it is not practical to use needle EMG findings in the neurophysiological classification. Needle EMG abnormalities may also be present in patients with mild UNE due to axonal degeneration or motor conduction block.The success of treatment of bone fracture and defects are based on a proper contact and compression between the bone fracture fragments. Intraoperative manipulations such as bone compression or distractions are generally done in order to achieve this. However none of the bone plates currently in routine use allow these manipulations after fixation to the bone, requiring refixation and repeated drilling and screwing operations. Based on this shortcoming, we designed a novel adjustable bone plate system which allows bone shortening and lengthening even after fixation to the bone surface. This novel design allows for compression and distraction at the fracture ends post fixation; a property not present in any of the plate systems available today.Liver transplantation (LT) remainsas the only therapeutic option offering gold standard treatment for end-stage liver disease (ESLD) and acute liver failure (ALF), as well as for certain early-stage liver tumors. Currently, the greatest challenge facing LT is the simple fact that there are not adequate livers for all the potential patients that could benefit from LT. Despite efforts to expandthe donor pool to include the living and deceased donors, organ shortage is still a major problem in many countries. To solve this problem, the use of marginal liver grafts has become an inevitable choice. Although the definition of marginal grafts or criteria forexpanded donor selection has not clarified yet, they usually defined as grafts which may potentially cause primary nonfunction, impaired function or late loss of function. These include steatotic livers, older donors, donors with positive viral serology, split livers, and donation after cardiac death (DCD). Therefore, to get the best outcome from these liver grafts, donor-recipient selection should be vigilant. Alcohol-related liver disease (ALD) is one of the most common indications for LT in Europe and in North America. Traditionally, LT for alcoholic liver disease kept limited for patients who have achieved 6 months of abstinence, in part due to social and ethical concerns regarding the use of a limited resource. However, majority of patients with severe alcoholic hepatitis who fail medical therapy will not live long enough to meet this requirement. Besides, the initial results of early liver transplantation (ELT)without waiting for six months of abstinence period are satisfactory in Severe Alcoholic Hepatitis (SAH). It will be important to take care of these patients from a newer perspective.
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