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Objective: Several canals and foramens in the human orbit are well known in the literature. However little is known about some minor canals or structures including metoptic canal and Warwick's foramen. The aim of the present study was to make morphometric measurements and to determine the incidence of the metoptic canal and Warwick's foramen in the Turkish population. Materials and Methods: Ninety-two dried human skulls were examined. All skulls were obtained from the Turkish population and collection of the Anatomy Department of the Akdeniz University. The metoptic canal and Warwick's foramen were identified in the skulls. Incidence of these structures and diameters were determined. Morphometric measurements were made using various reference points in the orbit. Results: Of the 92 dry human skulls, the metoptic canal was detected in 20 of them. This canal was detected unilaterally. The metoptic canal was observed in 11 (11.9%) dry skulls in the right side, whereas it was observed in 9 (9.7%) dry skulls in the left side. There were no statistically significant differences according to the side for any of the measurements recorded (p>0.05). The Warwick's foramen was observed in 12 (13.0%) skulls of all dry skulls. This foramen was also present unilaterally and was right sided in 7 (7.6%) skulls and left sided in 5 (5.4%) skulls. Conclusion: Determination of additional foramen in the orbit is contributed to the literature. The presence of the metoptic canal and Warwick's foramen and their relationship with other structures in the orbit may have clinical significance in surgical operations. [ABSTRACT FROM AUTHOR]

Variations of the branches of the external carotid artery have been well documented in the available literature. However, variation of the occipital artery arising from the internal carotid artery is extremely rare case. A 42-year-old man patient who suffered from subarachnoid hemorrhage with suspicious vascular anomalies was found to have this variation on the right side by angiography during selective catheterisation of main carotid artery for vascular mapping. Our literature searches revealed that there was rare case such variations. We think that this variation should contribute to literature and should be kept in mind during surgical, radiological and diagnostic procedures. [ABSTRACT FROM AUTHOR]

Objectives: Measurement of bone mineral density (BMD) is used frequently for assessment of bone strength and prediction of fracture risk in clinical settings. Among the bones in feet, fractures are seen often in second and third metatarsal of active sportsmen. This study was carried out to evaluate the reasons of increased risk of stress fractures in feet of active sportsmen by determining the BMD in overused regions. Methods: Two groups were examined in the present study. First group included males who were not sportsmen while the second and third groups were formed by professional male soccer and basketball players respectively. Areal bone density was measured by dual energy x-ray absorptiometry and the BMD values were calculated by using the rectangular region of interest in metatarsals. Results: The first metatarsal had the highest BMD in all groups (P<0.05). The fifth metatarsal had the second highest BMD value. Similarly subchondral measurement of the BMD revealed that the first tarsometatarsal joint were significantly denser than the first metatarsophalangeal joint (P<0.05). BMDs of all metatarsals in non-sportsmen group were significantly lower than BMDs of sportsmen groups and there were no noticable differences of BMD between soccer and basketball players. Conclusion: Because the degree of activity-induced enhancement of bone mineralization were similar in all metatarsals of active sportsmen, increased incidence of fractures in second and third metatarsals must be partly due to anatomical positioning of these bones. Hence appropriate shoe designs which have support for second and third metatarsals may decrease fracture incidence. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to evaluate the posterior and posterolateral approaches based on quantitative analysis of the foramen magnum and inferior clivus. Methods: The bony structures, distances and angles related to the foramen magnum area were measured in 25 cadaveric skulls. These measurements included the relationship of the foramen magnum to the occipital codyle, the hypoghossal canal, the jugular process of the occipital bone, the mastoid process and the sigmoid sinus. Results: The condylar length, width and thickness on the right side were 23.58±1.49 mm and 7.77±1.41 mm respectively. The lateral width of foramen magnum was 29.98±3.01 mm and anteroposterior width was 35.71±2.64 mm. The distance between the lateral edge of foramen magnum and the lateral edge of sigmoid sinus was found greater than the distance between the lateral edge of foramen magnum and the mastoid process. Conclusions: The findings showed that the anatomy of foramen magnum and its related structures is important for surgical approaches. These findings also demonstrate that the anatomical obstructions could be drilled to gain wide access to this region. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this cadaver study was to examine the surface morphology of the osteochondral grafts harvested from the femoral condyles using the free-hand graft harvesting technique. Materials and methods: One hundred osteochondral grafts were harvested with 6.5 mm chisels at ten different donor sites using the free-hand technique in five paired knee specimens (Mean age: 56.4 years). The cartilage and subchondral bone surface angles were measured through multiplanar reconstruction computerized tomography examination. The cartilage thickness was measured with a MicroScribe G2X digitizer with an accuracy of 0.02 mm. An acceptable congruity could be obtained when these plugs were transferred to a perpendicular socket (articular step-off of less than 1 mm and 0.5 mm) was evaluated. Results: Four plugs were damaged or broken during harvesting due to technical difficulties; thus remaining 96 plugs were analyzed. The cartilage thickness varied between 1.36 mm and 3.26 mm across the donor sites. The cartilage was the thinnest in the medial intercondylar notch and thickest in the lateral supracondylar notch. Twenty of ninety-six plugs (20.8%) had unacceptable cartilage surface inclination according to the > 0.5 mm protrusion criteria. Of these plugs, 14 were harvested from the lateral intercondylar notch, whereas five of 96 plugs (5.2%) had unacceptable cartilage surface inclination according to the > 1 mm protrusion criteria. Of these plugs, all were harvested from the lateral intercondylar notch. Conclusions: High rates of unacceptable plugs (up to 100%) might be harvested from the lateral intercondylar notch. In large chondral lesions that require multiple plugs, lateral and medial supracondylar ridges were the best donor sites for perpendicular plug harvesting, whereas lateral intercondylar notch should be avoided. [ABSTRACT FROM AUTHOR]

Persistence of fetal communications between the carotid and vertebrobasilar systems is uncommon. Persistent proatlantal artery is an anastomosis between the carotid and vertebrobasilar systems, typically classified as Type I and II. In this case report, 600 angiographies are examined retrospectively and two persistent proatlantal arteries were observed - one with Type I (0.16%) and the other with Type II (0.16%) proatlantal artery. Existence of these arteries are associated with intracranial vascular anomalies, especially aneurysms. In both of our cases, an aneurysm was detected in the middle cerebral artery. Precise knowledge of these anastomoses is essential for intracranial operations and catheterizations performed in this region. [ABSTRACT FROM AUTHOR]

Purpose: Mesenteric circulation is provided by the celiac trunk (CT), superior mesenteric artery (SMA), and inferior mesenteric artery (IMA). The collateral circulation between CT and SMA and between SMA and IMA plays a protective role against intestinal ischemia in case of narrowing or occlusion of the mesenteric vessels. In our study, it is aimed to determine the CT and SMA stenosis rates in patients with CT and SMA stenosis from angiography images, the occurrence of the collateral variations, and the frequency of these variations. Methods: A total of 408 non-selective or selective CT and SMA angiographic images were taken of 215 patients (130 males, 85 females) who were admitted to Akdeniz University Hospital with symptoms of chronic mesenteric ischemia (CMI) were included. The angiography images were analyzed in regards to CT and SMA stenosis rates, and the collateral variations between mesenteric vessels. Results: Stenosis of CT was observed in 14 patients, whereas the stenosis of the SMA was observed in 12 patients. The most common collateral vessel in these patients was the gastroduodenal artery. Both stenoses of CT and SMA were found in 9 patients. The Riolan arch was the most common type of collateral vessel in these patients. Conclusion: It was observed that mesenteric circulation was mainly provided by gastroduodenal artery in patients with isolated CT or SMA stenosis or occlusion while in patients with stenosis or occlusion of both CT and SMA, mesenteric circulation was mainly provided by the Riolan arch. A significant increase was observed in the prominence of collateral vessels in patients with stenosis of more than 70%. [ABSTRACT FROM AUTHOR]

Introduction: The cuprizone model is a well-established instance to study demyelination and remyelination in rodents. The primary aim of this study was to demonstrate the loss of function in motor activity. Second, it was evaluated together with the changes in the amount of myelin in the ongoing process. Materials and Methods: This study is based on the administration of the cuprizone model in male C57BL/6 mice by oral gavage. The advantage of the oral gavage model is that mice were subjected to the equal dose of cuprizone. For this reason, the nonequal in demyelination was minimized. We have designed four groups, including demyelination/control and remyelination/ control. Results: The results of the walking test and open field test showed that locomotor activity in the demyelination group deteriorated. Increased glial fibrillary acidic protein and decreased myelin basic protein expressions were shown in the corpus callosum of the demyelination group compared to the control and remyelination groups. The g-ratio of the demyelination group was calculated 0.86 ± 0.07, the g-ratio of the demyelination control group was calculated 0.66 ± 0.1, the g-ratio of the remyelination group was calculated 0.83 ± 0.06, and the g-ratio of the remyelination control group was calculated 0.76 ± 0.09. Discussion and Conclusion: In conclusion, in this demyelination model, which was applied differently from the literature, in our study, the behavioral effect on motor activity and to what extent it appeared histologically was evaluated. Thus, investigating the loss of function in motor activity as well as histological examination increased the reliability of the model we created in our study. [ABSTRACT FROM AUTHOR]

The article presents the life and works of French physician Pierre Mollaret. Mollaret was born in Auxerre, France in 1898. He started his education in medicine and science in 1916 and was interrupted by World War I. In 1920, Mollaret continued his education and received his degree in science in 1926. In 1931, Mollaret collaborated with his teacher Georges Charles Guillian in conducted scientific studies related to neurology and infectious diseases.

During neck surgery; Zuckerkandl's tubercle, Berry's ligament, the inferior horn of thyroid cartilages have become crucial anatomical landmarks in order to protect the integrity of the recurrent laryngeal nerve. Forty-two male postmortem human cadavers were used. The proximal part of the recurrent laryngeal nerve, before the inferior thyroid artery arises from its source has been observed in 87% inside the tracheoesophageal groove and in 13% running laterally to the trachea. The recurrent laryngeal nerve was encountered passing behind and through the branches of the inferior thyroid artery in 92% and 8% respectively. At all sides; the nerve was piercing the larynx 0.6 ± 0.1 mm below the inferior horn of thyroid cartilage, passing next to the inner-lower side of Berry's ligament and running under the lower middle part of Zuckerkandl's tubercle. These landmarks and their upper mentioned distances to the laryngeal nerve can be taken into consideration as important surgical guides. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the present study was to analyze the dimensions of the crista galli (CG) in preserved skulls, and to examine the role of the morphometry and morphology of the CG on the sex estimation. Methods: Anteroposterior, superoinferior, and laterolateral diameters of the CG were measured of 207 preserved adult skulls of Anatolia origin with known sex (108 males, 99 females) in the Anatolian population. CG were morphologically classified into three types according to the dimensions. The success of CG dimensions in sex determination was evaluated with ROC analysis, and univariate and multivariate binary logistic regression analysis. The relationship between morphological types of the CG and sex was analyzed with the Chi-square test. Results: The anteroposterior and superoinferior diameters of the CG significantly were longer in males than females while the laterolateral diameter of the CG was wider in females (p < 0.001). Superoposterior diameter (88.4%) of the CG showed higher sex classification accuracy for sex estimation compared to the laterolateral (82.6%) and anteroposterior diameters (80.6%). When all three parameters were used together, the sex classification accuracy rate was 94.2%. The presence of ossified and tubular types of CG identified the male sex with 85% and 74.6% accuracy rates, respectively while teardrop type CG identified female sex with a 72.2% accuracy rate. Conclusion: CG exhibits sexual dimorphism both morphometrically and morphologically. The height, length, and width measurements and the morphological types of CG can be used in sex determination directly from the skull with high accuracy rates. [ABSTRACT FROM AUTHOR]

Objectives: The relationship between the mastoid triangle and the localization of the Asterion can be used in craniotomy and posterolateral surgical approaches. Therefore, we aimed to identify the relationship between the localization of the Asterion and mastoid triangle in dry skulls and its effect on surgery. Methods: Our study was performed on 93 adult skulls obtained from bone collections of the Anatomy Departments of Necmettin Erbakan University and Akdeniz University. The mastoid triangle, Asterion and linear distances between them were measured for to determine the localization of the Asterion. Results: The Asterion was located just above the Frankfurt horizontal plane on the left sides of the skulls in 54 (58.1%) specimens and on the right sides of the skulls in 71 (76.3%). It was located below the Frankfurt horizontal plane on the left sides of the skulls in 39 (41.9%) specimens; and on the right sides of the skulls in 19 (20.4%). There was a positive correlation between the distance of Asterion to apex of the mastoid process (r=0.832). Conclusion: The relationship between the mastoid process and the Asterion can be used for determination of the dural venous sinuses and neighboring neurovascular structures, in retrosigmoid posterolateral surgical approaches. [ABSTRACT FROM AUTHOR]

Objectives: Femoroacetabular impingement syndrome is a painful disorder of the hip formed by movements in the hip joint between the femoral head-neck junction and the acetabular edge. The aim of this study was to determine the prevalence of radiological femoroacetabular impingement syndrome findings in a young, asymptomatic Turkish population. Methods: A total of 1000 abdominal pelvic CT images were collected from patients aged between 18-40 years. Measurements were taken on the CT images of the alpha angle and femoral head offset as signs of cam-type deformity, and of the acetabular version angle and center-edge angle as signs of pincer-type deformity. Results: Femoroacetabular impingement syndrome was determined in 2.3% of the individuals. Pincer type deformity was determined in 56.5%, being 83.3% in females and 47.1% in males. The cam-type deformity was present in 43.5% of all cases, being in 16.7% of the females and in 52.9% of the males. No difference was determined between the genders in respect of alpha angle which is >55°. A head-neck offset which is <8 mm was at a higher rate in females (13.3%) than males. An acetabular anteversion angle which is <15° and centre-edge angle which is >40° was more in males than females at a rate of 11% and 25.2% respectively. Conclusion: The results of this study showed that the incidence of cam-type deformity in the adult males and the incidence of pincer-type deformity in the adult females were lower in the asymptomatic Turkish population than previously reported in literature. [ABSTRACT FROM AUTHOR]

Background/aim: The insula has attracted the attention of many neuroimaging studies because of its key role between brain structures. However, the number of studies investigating the effect of sex and laterality on insular volume is insufficient. The aim of this study was to investigate the differences in insular volume between sexes and hemispheres. Materials and methods: A total of 47 healthy participants [24 males (20.08 ± 1.44 years) and 23 females (19.57 ± 0.90 years)] underwent magnetic resonance imaging (MRI). Imaging was performed using the 3T MRI scanner. The insular volume was measured using the Individual Brain Atlases using Statistical Parametric Mapping (IBASPM); total intracranial, cerebral, grey and white matter volumes were measured using volBrain. Results: The right insular volume was significantly higher than the left insular volume in the participants, and the left cerebral volume was significantly higher than the right cerebral volume (p < 0.05). The total brain, total cerebral, left and right insular, and cerebral volumes were significantly larger in males than in females (p < 0.001). Also, the ratios of the insular volume to total brain and cerebral volume were significantly higher in males than in females (p < 0.05). Conclusion: This study shows that insular volume differs with laterality and sex. This outcome may be explained by the anatomical relationship between the insula and behavioural functions and emotional reactions and the fact that the right side of the brain is best at expressive and creative tasks. [ABSTRACT FROM AUTHOR]

Objectives: The use of plastination can minimize health risks and cost in anatomy laboratories. Plastinates are easy to handle and can facilitate the learning of complex anatomical structures. Therefore, we aimed to evaluate the contribution of plastinates to teaching complex anatomy of the heart. Methods: Standard S10 technique was used for heart plastination by fixation, dehydration, impregnation and curing stages. Ninety volunteer first-year medicine students at Akdeniz University, who did not take cardiovascular system anatomy lectures yet, were included. Formalin-fixed heart specimens were used in the lecture of group 1; both formalin-fixed heart specimens and heart plastinates were used in the lecture of group 2. After the lecture, a 10-question exam was administered. Statistical significance between the scores of the two groups was tested with one sample t-test, and post hoc Tukey test was used for multiple comparisons. Results: The pre-test scores of the groups were compared with the scores obtained after the 2 hours of lecture (p=0.002, p<0.05). The test scores of both groups increased significantly after the lecture (p<0.05). The post-test scores of group 2 were significantly higher than group 1 (p= 0.047, p<0.05). The average test scores of those trained with formalin-fixed specimens increased from 23.78±1.94 to 48.22±3.19 (p<0.05). Students gave positive feedback about heart plastinates, and they stated that their rising interest in the anatomy lecture due to the odourless, disinfected and reusable materials. Conclusion: In conclusion, besides being cost-effective, healthy, long lasting and easy to maintain materials, plastinates are useful tools to teach complex anatomical structures. [ABSTRACT FROM AUTHOR]

Purpose: To compare five different repair techniques for extensor tendon zone III modified Kessler (MK), double-modified Kessler (DMK), modified Kessler epitendinous (MKE), double-modified Kessler epitendinous (DMKE), and running-interlocking horizontal mattress (RIHM) in terms of shortening, stiffness, gap formation, and ultimate load to failure.Methods: A total of 35 human cadaver fingers were randomly assigned to five suture techniques with 7 fingers each and were tested under dynamic and static loading conditions.Results: DMK was found to be superior over MK in terms of ultimate load to failure (36 N vs. 24 N, respectively), shortening (1.75 vs. 2.20 mm, respectively) and gap formation. However, these two methods had similar characteristics in terms of stiffness. The addition of epitendinous sutures to the repair methods resulted in approximately 40% increase in ultimate load to failure, whereas epitendinous sutures had no effect on shortening. DMKE was found to be superior over MKE in terms of shortening (1.77 vs. 2.22 mm, respectively). However, these two methods had similar characteristics in terms of mean ultimate load to failure and stiffness. RIHM was found to be superior over the other four methods in terms of ultimate load to failure (89 N), stiffness, and shortening (0.75 mm).Conclusion: RIHM was found to be stronger and more durable for extensor tendon zone III than the other techniques in terms of ultimate load to failure and stiffness. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to determine the morphology and location of mandibular lingula in relation to the surrounding structures in adult mandibles to provide data that can be used during oral and maxillofacial procedures. Methods: This study was performed on 50 dry adult mandibles of Turkish population. The shape of the lingula was examined bilaterally and classified into four types. Osteometric measurements were performed on both sides using a digital caliper. Statistical analysis was performed to determine the differences between right and left side measurements. Results: The most frequently encountered shape of lingula was triangular type (42%). The assimilated type was not observed among the mandibles studied. The mean distance between the lingula and the anterior border of the ramus of the mandible and between the lingula and the posterior border of the ramus of the mandible was measured as 16.86±2.73 mm and 14.7±1.6 mm, respectively. The mean height of the lingula was measured as 11.92±2.03 mm. No statistically significant differences were observed between the right and left side measurements for any parameters. Conclusion: The findings of present study may be used for various oral and maxillofacial surgical procedures and help sur- geons in avoiding inferior alveolar nerve injury during mandibular osteotomies. [ABSTRACT FROM AUTHOR]

Os vesalianum pedis is a rare accessory ossicle located at the 5th metatarsal base. This anatomic variation is typically asymptomatic and usually detected incidentally on routine foot radiographs. However, it may be a source of lateral foot pain and rarely become symptomatic following traumatic ankle injuries such as an inversion ankle sprain. To date, seven symptomatic os vesalianum pedis cases that required surgical treatment have been reported in the current literature. Herein, a 17-year-old professional football player with a symptomatic os vesalianum pedis was presented. The ossicle was surgically removed upon failure of conservative treatment. At the sixth month, the patient returned to sport without any restriction or pain. Clinical presentation, diagnosis, and treatment options of symptomatic os vesalianum pedis were discussed with an extensive literature review. [ABSTRACT FROM AUTHOR]

Objective: To analyze the effects of melatonin on vascular endothelial growth factor A (VEGF-A) expression and follicle reserve in rat ovary. Materials and Methods: A total of 45 female Wistar rats were used in the present study. Rats were divided into three groups: group 1 (control), group 2 (vehicle), and group 3 (melatonin). Rats in the melatonin group were treated with an intraperitoneal injection of melatonin at a dose of 50 mg/kg/day for 56 days. We investigated VEGF-A expression in rat ovary in all the groups using Western blot and reverse transcriptionpolymerase chain reaction. Histopathological parameters were evaluated using light microscopy. Results: The number of atretic follicles was significantly lower in the melatonin treatment rats than in the control rats (p<0.05); however, the number of antral follicles was significantly higher in the former (p<0.05). Additionally, we observed a weak immunoblot stain in the melatonin group for VEGF-A protein. Interestingly, melatonin treatment induced a significant decrease in VEGF-A expression in the ovary of group 3 rats (p<0.05), whereas no such difference was observed between group 1 and group 2 rats (p>0.05). Conclusion: The present study demonstrates that the protective effect of melatonin on the degeneration of follicles in rat ovary is reduced by decreasing the VEGF-A expression. These results suggest that melatonin is effective against follicular atresia and preserves antral follicles, thus, offering a therapeutic advantage in clinical use. [ABSTRACT FROM AUTHOR]

Abstract Aim The purpose of this study was to investigate the role of anatomic variations in distal radius radiographic indices in patients with or without scaphoid fractures. Materials and methods Radial inclination (RI), volar tilt (VT), radial height (RH) and ulnar variance (UV) were measured on wrist radiographs of 320 patients with (Group I, n = 167) or without (Group II, n = 153) scaphoid fracture, fall on outstretched hand (FOOSH). Receiver operating characteristics (ROC) curve analysis was used to assess the diagnostic performance for each variable. Sensitivity (Sn), specificity (Sp), cutoff value, and area under the ROC curve were analyzed. Odds ratio was calculated for defined cutoff values. Results The mean age of the groups was similar (29.3 ± 10.2 vs 31.1 ± 9.9 years, p = 0.060). RI (30.0 ± 2.9 vs 26.8 ± 2.3°) VT (11.4 ± 2.4 vs 10.5 ± 2.2°), RH (14.8 ± 2.1 vs 13.2 ± 1.9 mm), UV (−0.46 ± 1.7 vs 0.00 ± 1.5 mm) were higher in scaphoid fracture group (Gr I vs Gr II, p = 0.000, p = 0.000, p = 0.001, p = 0.012 respectively). Ulna minus variant was more prevalent in fracture group (p = 0.001). Optimal cutoff points for RI, VT, RH and UV in differentiating fractured and intact scaphoid were 28.6° (Sn = 81.0%, Sp = 26.3%), 12.2° (Sn = 80.4%, Sp = 67.1%), 14.85 mm (Sn = 80.4%, Sp = 52.1%) and 0 mm (Sn = 88.6%, Sp = 75.8%), respectively. Odds ratios for defined cutoff points for RI, VT, RH and UV were 10.4 (95% CI, 6.2–17.4), 1.8 (95% CI, 1.1–3.0), 3.7 (95% CI, 2.3–6.2) and 2.2 (95% CI, 1.3–3.7) respectively. Conclusion Increased RI, VT, RH and negative UV were found to be predisposing anatomical risk factors for scaphoid fracture when FOOSH. Highlights • Scaphoid fractures may remain occult in the initial radiographic examination. • Identification of anatomic risk factors may help to detect scaphoid fractures. • Increased radiographic indices of distal radius are risk factors for scaphoid fractures. • Negative ulnar variance is an anatomic risk factor for scaphoid fractures. [ABSTRACT FROM AUTHOR]

Objective: Endoscopy is now being used for diagnosis and surgical treatment of disorders of the nose and paranasal sinuses. Direct observations of mucociliary clearance patterns have shown that there are clear cut pathways in the sinuses, with secretions always trying to leave through the natural ostia.' Maxillar ostia is exists behind the upper part of the medial wall and often at intersection region of the rear lower infindubulum and lower front surface of the ethmoid bulla. Accessory ostium exists at the 25-30% of the general population instead of the natural ostium. There are some features that differentiate the accessory ostium and natural ostium. Methods: To determine the incidence and location of the accessory ostium 29 fromaldehyde fixed adult cadaver was examined with endoscope. Results: The accessory ostium is encountered at 8 cases (13.8%). These are located at rare-middle, front-middle and rear in 2 (0.03%), 3 (0.05%), 3 (0.05%) cases respectively. Recognition of the maxillary ostia is tedious while performing endoscopic procedures which accounts for a high rate of orbital complications for a novice performing surgery in this region. Conclusion: It is therefore imperative to know the landmarks in this regions which may be obliterated by disease. Radiologist should be aware of this entity as it can appear as communication between the maxillary sinus and nasal cavity on sinus imaging examinations. [ABSTRACT FROM AUTHOR]

Scientific Background: One of the matters in clinical neurophysiology is evaluation of the proximal conduction time along the lumbar plexus. Objectives: Instead of investigating only distal segment of the nerve from the groin as is generally done we aimed to investigate both proximal and distal parts of the nerves originating from the lumbar plexus. Material and Methods: In this paper different proximal conduction methods were studied in 109 healthy adult human subjects by measuring proximal motor conduction time of femoral, obturator and genitofemoral nerve along the lumbar plexus using both by using lumbar magnetic and peripheral electrical stimulation and by using the H-reflex methods in adductor and quadriceps muscle group. The anatomical parts of the study were applied on 20 human adult cadavers, dissecting femoral, obturator genitofemoral nerve and roots proximally. Results: The total distance from ligamentum inguinale to spinal level was 392.4±13.3mm in femoral nerve. The total distance was approximately 382.8±11.1mm in obturator nerve and the total distance was approximately 353.1±12.5 mm in genitofemoral nerve. With the H reflex method, using the distance obtained from the cadaver, femoral and obturator nerve proximal conduction velocity were determined to be 62.5±6.1 m/sec and 53.6±7.4 m/sec, respectively. Using lumbar magnetic stimulation and the peripheral electrical stimulation, proximal conduction velocities in femoral, obturator and genitofemoral nerves were determined to be 59.1±13.3m/sec, 52.7±14.9 and 58.7±0.8 m/sec, respectively. Conclusions: No statistical differences were found between the proximal conduction velocities elicited by both methods. Either approach is preferable to evaluate proximal conduction time. [ABSTRACT FROM AUTHOR]

Carpal tunnel decompression is one of the most common surgical procedures in hand surgery. Cutaneous innervation of the palm by median and ulnar nerves was evaluated to find a suitable incision preserving cutaneous nerves. A morphometric study was designed to define the safe-zone for mini-open carpal tunnel release. Sixteen fresh-frozen (8 right, 8 left) and 14 formalin-fixed (8 right, 6 left) cadaveric hands were dissected. Anatomy of the palmar cutaneous branch of the median and the ulnar nerve, motor branch of the median nerve, superficial palmar arch were evaluated relative to the surgical incision. We also identified the motor branch of the median nerve. Detailed measurements of the whole palmar region are reported in this study. The motor branch of the median nerve was extraligamentous as 60%, subligamentous as 34%, transligamentous as 6%. The palmar cutaneous branches of the median and the ulnar nerves in the palmar region were classified as Type A (34%), Type B (13%), Type C (13%), Type D (none), Type E (40%) according to forms of palmar cutaneous innervation originating from the ulnar and median nerves. Injury to the palmar cutaneous branch of the median nerve (PCBMN) is the most common complication of the carpal tunnel surgery. Various techniques were described to decrease post-operative morbidity. Based on these anatomic findings mini incision between the superficial palmar arch and the most distal part of the PCBMN in the palmar region is the safe-zone for carpal tunnel surgery. [ABSTRACT FROM AUTHOR]

Most accessory ossicles and sesamoid bones of the ankle and the foot remain asymptomatic; however, they have increasingly been examined in the radiology literature, because they can cause painful syndromes or degenerative changes in response to overuse and trauma. Our aim was to document a detailed investigation on the accessory ossicles and sesamoid bones of Turkish subjects in both the feet according to the sex, frequency and division of the bones, coexistence and bilaterality by radiography. A double-centered study was performed retrospectively to determine the incidence of the accessory ossicles and sesamoid bones in the ankle and foot. Accessory ossicles (21.2%) and sesamoid bones (9.6%) were detected by Radiographs of 984 subjects. The most common accessory ossicles were accessory navicular (11.7%), os peroneum (4.7%), os trigonum (2.3%), os supranaviculare (1.6%), os vesalianum (0.4%), os supratalare (0.2%), os intermetatarseum (0.2%). We observed bipartite hallux sesamoid in 2.7% of radiographs. Interphalangeal sesamoid bone of the hallux was seen in 2% of radiographs. Incidences of metatarsophalangeal sesamoid bones were found as 0.4% in the second digit, 0.2% third digit, 0.1% fourth digit and 4.3% fifth digit. We also identified the coexistencies of two different accessory ossicles as 6%, accessory ossicles and sesamoid bones as 7%, and bipartite sesamoid bones and sesamoid bones as 1.9%. Distribution of the most common accessory ossicles in male and female subjects was similar. We reported the incidence of accessory ossicles and sesamoid bones of the feet in Turkish adult population. [ABSTRACT FROM AUTHOR]

Objective: Multiple sclerosis (MS) is a T-cell mediated autoimmune central nervous system (CNS) disease. Although the etiopathogenetic factors of multiple sclerosis remain unclear, autoimmune mechanisms that associated with genetic predisposition and environmental triggers are suspected. Tolllike receptors (TLRs) mediate immune response to autologous components. It has been shown that microglia are the highest TLR4 expressing cell in the CNS. Several studies have shown that certain TLRs are over-expressed in MS. However, to our knowledge, the expression of TLR4 in cuprizone-induced demyelination has not been demonstrated previously. In the light of the information mentioned above, we aimed to evaluate the expression of TLR4 in glial cells in a mouse model of cuprizone-induced demyelination. Methods: In this study, we used the cuprizone model in mice to investigate the expression of TLR4. Forty male C57BL/6 type mice were used. Four groups were designed as demyelination/control and remyelination/control. 0,2% cuprizone was used to induce demyelination. TLR4 expressions in glial cells were evaluated with immunohistochemistry. Results: We show a significantly increased expression of TLR4 in the glial cells of the demyelination group. The expression of TLR4 was significantly higher in the demyelination group than the remyelination group. Besides, TLR4 expression in demyelinated mice glial cells was higher than the control groups. Conclusion: We showed that TLR4 expressions were significantly higher in demyelinated mice. High expressions of TLR4 may indicate that it could be one of the underlying mechanisms of immune activation in MS. We believe that histopathological and molecular studies are necessary to obtain further information on the background of the disease. [ABSTRACT FROM AUTHOR]