Objective: The aim of this study was to compare the outcomes of primary nerve repair using either ethyl-cyanoacrylate or conventional microsuture technique in a rat peripheral nerve injury model. Methods: In this study, a total of 30 Wistar Albino rats weighing between 220 and 275 g were used. The rats were randomly divided into three groups (10 in each), including one control (group 1) and two experimental groups (group 2, conventional microsuture repair; group 3, cyanoacrylate repair). In each group, the sciatic nerve was identified and transected. No further intervention was performed in group 1. The nerve was repaired using the epineural technique with a 10/0 atraumatic nylon in group 2 and synthetic cyanoacrylate adhesive in group 3. At the fifth postoperative week, needle electromyography (EMG) was performed to measure distal latency, combined muscle action potential (CMAP), and motor nerve conduction velocity (MNCV). Following the EMG recordings, animals were euthanized. Nerve samples were collected to evaluate vacuolar degeneration, fibrosis, and foreign body reaction histopathologically. Results: In the EMG analysis, mean distal latency was significantly shorter in group 1 (0.85±0.09 ms) than in groups 2 (1.17±0.25 ms) (p=0.0052) and 3 (1.14±0.14 ms) (p=0.0026) while no significant differences existed between groups 2 and 3 (p>0.9999). The mean CMAP was greater in group 1 (10.5±0.35 mV) than in groups 2 (2.86±1.28 mV) (p=0.011) and 3 (2.16±1.34 mV) (p=0.0002), but there was no significant difference between groups 2 and 3 (p>0.9999). The mean MNCV was 53.5±5.95, 39.62±7.31, and 39.84±4.73 mm/sec in groups 1, 2, and 3, respectively. There was a significant difference between groups 1 and 2 (p=0.0052) and between 1 and 3 (p=0.0026), but not between 2 and 3 (p>0.9999). In the histopathological evaluation, the mean vacuolar degeneration score was 0, 2.12, and 1.88 in groups 1, 2, and 3, respectively. No obvious difference was observed between groups 2 and 3 (p=0.743). The mean fibrosis score was 0, 1.62, and 1.77 in groups 1, 2, and 3, respectively. There was no significant difference between groups 2 and 3 (p=0.888). The mean foreign body reaction score was 0, 2.5, and 2.44 in groups 1, 2, and 3, respectively. No difference was present between groups 2 and 3 (p=0.743). Conclusion: Primary nerve repair using the cyanoacrylate adhesive may provide similar electrophysiological and histopathological results as compared to the conventional microsuture repair. Cite this article as: Atam C, Orhan Z, Toplu G, Serin M, Karaduman ZO, Öztürk A. Comparison of peripheral nerve repair using ethyl-cyanoacrylate and conventional suture technique in a rat sciatic nerve injury model. Acta Orthop Traumatol Turc 2020; 54(3): 330-6. DOI: 10.5152/j.aott.2020.03.156.

Objective: Paraneoplastic neurological syndromes (PNSs) are a diverse group of neurological disorders affecting any part of the nervous system before or during cancer. Case: A 78-year-old patient had pain and burning sensation first in the upper extremity 3 years ago, and then, muscle weakness was added a short time later. The same symptoms developed in the lower extremities 1 year ago. He was admitted to the intensive care unit due to pneumonia and was conscious but quadriplegic with a modified Rankin score of 5. Abdominal computed tomography showed mass lesions in the liver and pancreas. The biopsies demonstrated pancreatic small cell neuroendocrine carcinoma. Electrophysiological studies disclosed severe sensorimotor axonal polyneuropathy. Since other polyneuropathy causes were excluded, the diagnosis was paraneoplastic sensorimotor axonal polyneuropathy. Palliative care was considered because the patient had a poor functional state. Conclusion: Early cancer diagnosis is paramount in patients with PNSs to have appropriate therapy.

Background: Multiple sclerosis (MS) is a chronic disease of the central nervous system characterized by autoimmune inflammation, demyelination, and axonal damage. MS has been linked to neuroinflammatory effects originating in the gut. Recently, research has focused on the gut microbiota composition and the differences in the abundance of specific taxa in patients with MS. We aim to determine the distribution of bacterial composition in the intestinal microbiota of patients with MS and to compare them with healthy controls. Methods: A total of 27 individuals were selected for the study, 18 of whom were in the MS group and nine in the healthy control group. Participants were surveyed to obtain some demographic and clinical information, body mass index, vitamin D use, and weekly consumption levels of prebiotics–probiotics, carbohydrates, fast‐food, and some other foods. Stool samples were also collected.16S rRNA gene sequencing was executed on the samples using the Illumina MiSeq platform. Bioinformatics (alpha and beta diversity indices) and statistical analyses (analysis of similarity, principal coordinate analysis, permutational multivariate analysis of variance, linear discriminant analysis effect size, Ward′s hierarchical clustering method, etc.) were applied to compare the gut microbiome composition of the groups. Results: In the bioinformatics analysis process, all samples were analyzed for 391 taxa. However, due to the complete absence of some taxa or the very low relative abundance of some taxa (n _{excluded−taxa} = 249), only 142 taxa were included in the analysis. No significant differences were provided between the groups for microbiota diversity indices ( p > 0.05). However, we found that 22 taxa were discriminatory in the gut microbiota compositions of groups. Actinomyces from the phylum Actinobacteria , unclassified some genera ( Barnesiellaceae_, Barnesiellaceae_g_ , and Desulfovibrionaceae_g ) from the families Barnesiellaceae , Desulfovibrionaceae, a genus classified as other ( Veillonellaceae_g_other ) from the family Veillonellaceae showed higher levels in the MS patients compared with the healthy controls ( p < 0.05). The control group showed significant increases in relative abundance of Blautia , Peptococcus from the phylum Firmicutes , Pseudomonas from the phylum Proteobacteria , unclassified genus ( Streptophyta_g_ ) from the order Streptophyta , unclassified genera ( Pseudomonadaceae_g_, Lachnospiraceae_g_ ) from the families Pseudomonadaceae and Lachnospiraceae ( p < 0.05). Conclusion: In our study, it was thought that the increase in the taxa Actinomycetaceae , Barnesiellaceae , Desulfovibrionaceae , and Veillonellaceae , which have been proven to be associated with inflammatory processes in the intestinal microbiota, and the decrease or loss of the taxa Blautia , Opitutae , and Lachnospiraceae , which are important parts of the eubiotic microbiota, may be effective in MS disease by causing inflammatory processes. We believe that our findings will make a crucial contribution to establishing a picture of the gut microbiota composition in MS patients.