The aim of the present study was to perform clinical, biochemical, and radiological evaluation of the efficacy of mesenchymal stem cells derived from Wharton jelly (WJ) present within the human umbilical cord in the treatment of knee osteoarthritis. Between 2018 and 2019, 10 patients with knee osteoarthritis for whom the conservative treatment was not beneficial were included in the study. Patients were clinically, radiologically, and biochemically evaluated before treatment initiation. Thereafter, the patients were intra-articularly injected using a solution containing 1 × 10⁸ WJ-derived MSCs. Evaluations were performed on day 21 (V1) and 42 (V2) and month 3 (V3), 6 (V4), and 12 (V5) after the procedure. At 1-year post-injection, visual analogue scale, Western Ontario and McMaster Universities Osteoarthritis Index, and Lequesne scores of patients were lower than those observed during the initial evaluation, whereas the mean 36-Item Short Form Health Survey score was higher. Cartilage thicknesses were found to be increased in all regions except in the medial femur, medial posterior femur, lateral posterior femur, and lateral posterior tibia regions in magnetic resonance imaging. A significant increase was observed in tumor necrosis factor-alpha, interleukin-1β, adiponectin, resistin, and interleukin-6 levels compared with pre-injection values. The leptin levels at 6-month and 1-year controls were lower than the pre-injection levels, and the decrease observed at 6 months was significant. In patients with knee osteoarthritis, intra-articular WJ-derived MSC injection causes significant pain reduction, satisfactory functional improvement, and increased patient satisfaction following a 1-year follow-up. These clinical improvements were supported by magnetic resonance images, along with changes in adiponectin and leptin levels in synovial fluid. Level of evidence: IV.

Aim: To determine the early effects of excess weight on renal cortical stiffness in children and adolescents using point shear wave elastography (pSWE). Materials and methods: One hundred and forty-six overweight and obese children (43.2% male; mean age, 12.6±2.9 years: range 4.3-18) and 48 lean children (27.1% male: mean age, 12.4±3.4: range 4.8-18.9) were included in the study and control group, respectively. pSWE measurements of the two kidneys were performed. The mean value of shear wave velocity was compared between groups. Results: The mean shear wave velocity was 2.79±0.53 m/s for the control subjects and 3.09±0.59 m/s for the overweight-obese subjects. The differences between the two groups were sta-tistically significant (p=0.001). There was no correlation between shear wave velocity and age or depth. A positive correlation was found between shear wave velocity and body mass index, body mass index-standard deviation score. Conclusion: Renal cortical stiffness was higher in children with excess weight than in lean children. This study is the first attempt at applying pSWE to investigate the early adverse effects of excess weight.

Background. Metabolic syndrome (MetS) and insulin resistance (IR) are known predictors of nonalcoholic fatty liver disease (NAFLD) which is one of the significant comorbidities of obesity. Obese children with MetS and IR are reported to be more likely to have advanced liver fibrosis compared to those without MetS or IR. The aim of this study is to determine the effects of excess weight, MetS and IR on liver fibrosis assessing liver stiffness in children using ultrasound elastography and compare gray scale ultrasonographic findings of hepatic steatosis (HS) with liver fibrosis.Methods. The study group involved 131 overweight/obese children. The control group involved 50 healthy lean children. Groups were adjusted according to body mass index (BMI) and BMI-standard deviation scores (SDS). Liver stiffness measurements which are expressed by shear wave velocity (SWV) were performed for each individual. The study group was further subgrouped as children with MetS and without MetS, with IR and without IR.Results. The mean SWV of liver was 1,07 +/- 0,12 m/s in the control group and 1,15 +/- 0,51 m/s in the study group. The difference was significant (p=0,047). SWV of liver was weakly correlated with age, BMI, BMI-SDS, Homeostatic Model Assessment-Insulin Resistance and high-density lipoprotein cholesterol. The mean SWV of the liver in the study group for children without MetS was 1,1 +/- 0,44 m/s, with MetS was 1,23 +/- 0,70 m/s. The difference was not significant (p=0,719). The mean SWV of the liver in the study group for children without IR was 1,02 +/- 0,29 m/s, with IR was 1,24 +/- 0,61 m/s. The difference was not significant (p=0,101). In multivariate regression analysis, the only independent factor affecting liver stiffness was BMI-SDS (OR:2,584, 95% CI: 1,255-5,318, p=0,010).Conclusions. Obesity itself, regardless of MetS or IR seems to be the major problem affecting liver stiffness in this study. However, large scale longitudinal studies might clarify this issue.

Objective: Tuberculosis (TB) is still a global health concern. Although thoracic TB is the most common manifestation, TB can also affect extrathoracic sites, including the central nervous system, musculoskeletal system, and abdomen. The incidence of extrathoracic TB in children is higher compared to adults. This study aimed to examine the radiological findings of pediatric extrathoracic TB involvement in the central nervous system, musculoskeletal system, and abdomen. Materials and Methods: The radiological features of 19 patients diagnosed with extrathoracic TB in childhood at Erciyes University Medical School between 2011 and 2024 were examined retrospectively. Patient gender, age, medical history, and laboratory data were reviewed from the hospital archiving systems. Results: Nineteen patients diagnosed with extrathoracic TB were evaluated. Ten patients (52.9%) were female, and nine (47.1%) were male. The mean age was 97.5±20.8 months (ranging from 2 to 300 months). Three patients (15.8%) were immunocompromised, and nine patients (47.1%) had coexisting pulmonary TB. Central nervous system involvement was observed in six patients (31.6%), musculoskeletal system involvement in ten patients (52.6%), and abdominal involvement in three patients (15.8%). Conclusion: Recognizing the classic radiological findings of pediatric extrathoracic pulmonary TB is crucial for prompt diagnosis, initiation of appropriate treatment, and prevention of long-term morbidity.