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    Cementless total hip arthroplasty for the management of tuberculosis coxitis
    (Springer, 2010) Öztürkmen, Yusuf; Karamehmetoğlu, Mahmut; Leblebici, Cem; Gökçe, Alper; Caniklioğlu, Mustafa
    Tuberculosis arthritis of the hip is a crippling disease and there is need for an effective and acceptable treatment for the hips with bone destruction. The aim of this report was to evaluate the efficacy of the diagnostic method for hip tuberculosis and clinical results of the patients to clarify the question of whether a total hip arthroplasty (THA) should be attempted on a patient with a current or previous infection. Nine patients with active tuberculosis of the hip, treated by cementless THA, were analyzed retrospectively. The mean age of the patients at diagnosis was 43.4 years (range 22-72 years). Laboratory tests of all the patients revealed high erthrocyte sedimentation rates (ESR) and C-reactive proteins. Plain radiographs showed bone destruction with joint space narrowing in all patients. Magnetic resonance imaging (MRI) scans showed fluid within the joint in five patients. Two patients had associated pulmonary tuberculosis. To confirm the clinico-radiological diagnosis, an open biopsy was performed for histopathological examinations of all the hips. Tuberculosis of the hips was treated with primary cementless THA, followed by postoperative antituberculous medication for 1 year. The inflamed soft tissues and the destroyed bones were completely resected and curetted out at the time of operation. At the final evaluation, the mean Harris Hip Score improved to 94.8 (range 90-98; P = 0.003). ESR became normal, less than 15 mm/h, with a mean time of 4 months (range 2-9 months). The C-reactive protein was normal, less than 0.8 mg/dl, after a mean time of 3 months (range 1-7 months). With an average follow-up of 5.6 years (range 2-8 years), no reactivation of tuberculosis infection was found in each patient. All of the femoral stems and acetabular cups were radiologically stable and demonstrated signs of bone ingrowth at the final follow-up. All histopathologic examinations showed granulomatous lesions including epitheloid histiocytes surrounded by lymphocytes. Cementless THA can be safely performed in advanced tuberculosis of the hip for providing symptomatic relief and functional improvement of the hips. Complete curettage and resection of the infected tissue and postoperative antituberculous chemotherapy with a minimum of 1-year duration are very important in preventing reactivations.
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    Goldston Syndrome; Diagnosis of Multiple Fetal Anomaliesaaa
    (Medimond S R L, 2008) Abalı, Remzi; Albayrak Kaya, Sinem; Bozkurt, Serpil; Leblebici, Cem; Yurtsever, Çiğdem Yavuz
    Goldston syndrome is a multisystemic disorder characterised by polycystic kidneys with Dandy Walker malformation. The aim of our study is to report this rare case. We diagnosed cleft palate, micrognatia, dilatation of the fourth ventricle, total agenesis of corpus callosum, multicystic kidneys, club foot by ultrasound in the 23(th) week of gestation. Based on the findings of neonatal autopsy, fetus is proposed to be diagnose as Goldston syndrome. The etiology of this kind of familial disorder remains unclear, but a genetic factor might be involved.