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Persistent sciatic artery PSA represents the persistence of the sciatic vessel in adult life that is responsible for the major blood supply to the lower limb in early embryologic development. The incidence of PSA has been estimated as low as 0.025-0.04%. We present 2 cases of PSA, one of which was complicated by an aneurysm that led to a life-threatening hemorrhage.

Transpedicular spinal fixation has recently been the focus of increased attention in several institutions throughout the world, but its safety and efficacy are still important questions for orthopedic surgeons. Accurate screwing through the pedicle will avoid neurologic complications and increase the stability of the instrumentation. In this study, it was aimed to analyze the anatomic relations quantitatively between the lumbar pedicle and the adjacent dural sac and nerve roots, to determine the risky areas for neural injury during transpedicular screw placement.Ten adult cadavers were used for observation of the lumbar pedicle and its relations. After removal of the laminas and facets, the lumbar pedicles, dural sac, and nerve roots were exposed. Interpedicular distance (IPD), pedicle-inferior nerve root distance (PIRD), pedicle-superior nerve root distance (PSRD), and pedicle-dural sac distance (PDSD) were measured.Average distance from the lumbar pedicle to the dural sac medially and to the adjacent nerve roots superiorly and inferiorly through the cranial to caudal lumbar levels ranged from 1.29 to 1.56, from 4.12 to 5.52, and from 1.10 to 1.06 mm, respectively. The mean IPD ranged from 32.77 to 41.24 mm. There were statistically significant differences between the L5 level and other lumbar levels for IPD, PSRD, and PDSD measurements.These results indicate that although L5 is safer than other lumbar levels for pedicle screw insertion, an improper medial and caudal placement of a pedicular screw will carry a great risk of injury to the dural sac and inferior nerve root.

Anastomosis between the pubic rami of the inferior epigastric and the obturator arteries has been referred to as the corona mortis. Because anomalous vessels in the retropubic region are at risk in groin or pelvic surgeries, they have an importance not only for general surgery but also for orthopaedics. Because it is hard to distinguish these vessels, they can be injured during ilioinguinal incision, which can lead to massive uncontrolled bleeding. For this purpose, 54 cadaver halves were dissected to determine the occurrence and location of the corona mortis anastomosis. We found venous corona mortis in 11 halves (20.37%). Additionally, in 8 halves (14.81%), the obturator artery originated from the inferior epigastric artery.

We aimed to determine the presence of median and ulnar nerve communication in the forearm by anatomical and electrophysiological examinations in the Anatolian population.30 forearms from 15 preserved cadavers (2 females, 13 males, 42-65 years of age) were carefully dissected to observe median and ulnar nerve communication. We also performed median and ulnar nerve motor conduction studies by recording the thenar, hypothenar and first dorsal interosseous (FDI) muscles, stimulating both nerves at distal and proximal points, and the recordings were compared in 60 forearms (30 subjects, 17 female, 13 male, 34-67 years of age).Martin-Gruber communication was observed in 2 of 30 forearms (15 cases) by anatomical examination, in 2 of 60 forearms (30 cases) by electrophysiological examination. No Marinacci communication was found in either anatomical or electrophysiological examinations.In this study group, the ratio of MGC was revealed as 3.3% and 6.6%, in the electrophysiological and anatomical examination, respectively. Knowledge of this crossover is of crucial importance in the clinical evaluation of nerve injuries of the median and ulnar nerves, as well as in accurate interpretation of nerve conduction velocity of these nerves, especially in association with carpal tunnel syndrome. Anatomical and electrophysiological classifications of Martin-Gruber communication are reviewed.

In acute appendicitis, although the relationship between the enteric nervous system (ENS) and mast cells (MCs) has been described in a few studies, neither the expression of nerve growth factor (NGF) nor its relation to mast cell density (MCD) and ENS has been delineated yet in this disease. The aim of this study was to immunohistochemically investigate the relationship between MCD, nervous system and NGF expression in the appendices of cases with clinically and histopathologically diagnosed acute appendicitis and of normal controls. Twenty-five patients with acute appendicitis and twelve normal controls were included in our study. Mast cell tryptase, PGP 9.5 and anti-NGF immunostained tissue sections were subjected to quantitative image analysis. Our results showed that MCD, the number of Schwann cells, the number and size of ganglia and NGF staining were significantly greater in acute appendicitis than in the control group (p0.01). A strong correlation between MCD and NGF staining was detected (r = 0.92) only in cases with acute appendicitis. Similarly MCD was also related to neuronal proliferation and hypertrophy in this group. We failed to detect any relationship between NGF staining and neural components either in the acute appendicitis or control groups. Our findings indicate that mast cells could be one of the important cell populations responsible for nerve proliferation and hypertrophy in acute appendicitis. The relationship between NGF staining and MCD and the lack of correlation between NGF staining and changes in neural components suggest that, in acute appendicitis, NGF might be responsible for the increased number of MCs, but not for neuronal proliferation and hypertrophy.

We encountered some multiple vessel variations in the retropubic region of a 55-year-old male cadaver. The obturator artery had its origin from the external iliac artery, and inferior epigastric artery from the femoral artery. Additionally, an anastomosis between obturator and inferior epigastric veins (venous Crown of death) was observed.

The purpose was to compare the computed tomographic and plain film measurements with those of anatomical specimens to determine the antero-posterior diameter of the spinal canal in cervical region. Antero-posterior diameters of 75 cervical vertebral canals (15 sets of C3-C7) were measured anatomically at two different levels. Computed tomographic and plain film measurements were also obtained at the corresponding levels. Considering anatomical measurements as the gold standard, plain film and computed tomographic measurements were statistically compared. Interobserver and intraobserver differences were also evaluated. At the uppermost pedicle levels, there was no statistically significant difference between plain films and anatomical measurements, a good correlation. However, at lowermost pedicle level there was a statistically significant difference between plain films and anatomical measurements but not between tomographic and anatomical measurements. Our results suggest that plain films can accurately estimate cervical spinal canal mid-sagittal diameter at the uppermost pedicle level and be used as a first step examination for the evaluation of cervical spinal stenoses.

During our routine dissection studies we encountered an anomalous digastric muscle with three accessory bellies and one fibrous band in one embedded cadaver. All of these structures were attached to the mylohyoid raphe. This anomaly should be considered during surgical procedures involving this region.

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.

Objective: Heschl’s gyrus is the primary auditory cortex in humans. It is located in the posterior part of the area on the superior surface of the temporal lobe, or the planum temporale. The number and shape of this gyrus may differ. In this study, we aimed to investigate the number and shape variations of the Heschl gyrus in normal subjects by using MRI.Material and Methods: Eighty hemispheres in 40 subjects were evaluated. Of these subjects, 18 were patients with headache, evaluated in our MR imaging unit, and 22 were healthy volunteers. After the routine sequences, three dimensional transverse T1-weighted fast field echo images were obtained. The shape of the gyrus was classified as omega or heart shaped according to the images. The number of gyri in each hemisphere was noted. Number and shapes were analyzed according to right/left and dominant/non-dominant. Results: Of the 80 hemispheres, a single gyrus was present in 67 %84 and two gyri were present in 13 %16 . Three or more Heschl gyri were not seen. Of the total 93 Heschl gyri, 79 %85 were omega shaped and 14 %15 were heart shaped. With regard to dominance; thirty-six of the dominant hemispheres had one and 4 had two Heschl gyri. Thirty-one of the non-dominant hemispheres had one and 9 had two gyri. Conclusion: Our study shows that, among normal subjects, the number and shape of Heschl’s gyrus may show variations. In clinical investigations where the identification of this gyrus is needed, such as functional MRI studies, these variations should not be overlooked, Amaç: Heschl’in transvers girusları temporal lobun üst yüzününün arka kısmında yer alır. Primer işitme merkezi burada bulunur. Heschl’in transvers giruslarının morfolojisi işitme ile ilgili semptomları olan hastaların değerlendirilmesi sırasında önemli olabilmektedir. Çalışmamızın amacı Heschl’in transvers giruslarının morfolojik varyasyonlarını tanımlamak ve bu varyasyonların klinik önemini vurgulamaktır. Gereç ve Yöntemler: Çalışmaya, Radyoloji Anabilim Dalı MRG ünitesinde değerlendirilen ve başvuru yakınması başağrısı olan 18 hasta ve 22 sağlıklı gönüllü olmak üzere toplam 40 olgu dahil edilmiştir. Patolojisi bulunmayan ve çalışmaya alınan olgulara transvers düzlemde 3 boyutlu ince kesitli T1 ağırlıklı gradient eko görüntüler alındı. Girus, sagittal ve koronal reformat görüntülere göre omega ya da kalp şekilli olarak sınıflandı. Ayrıca girus sayı ve şekilleri hemisferik dominansa göre de analiz edildi. Bulgular: Kırk olgudaki 80 hemisferin 67’sinde %84 tek, 13’ünde %16 ise 2 adet Heschl girusu saptandı. Üç veya daha fazla Heschl girusu olan hemisfer yoktu. 93 Heschl girusunun 79’u omega, 14’ü ise kalp şeklinde idi. Hemisferik dominans açısından değerlendirildiğinde otuzaltı dominant hemisferde dört, otuzbir nondominant hemisferde 9 tanesinde iki Heschl girusu saptandı.Sonuç: Çalışmamızda Heschl giruslarının normal populasyondaki varyasyon gösterilmiştir. Fonksiyonel MRG gibi araştırmalarda bu girusların tanımlanması ve gözden kaçırılmaması önemlidir

Articulatio genu, Articulatio talocruralis ve Articulatio tarsi transversa'da osteoartritle (OA) ilgili makroskopik, mikroskopik ve radyolojik olmak üzere 3 yöntemin bir arada çalışıldığı literatür bilgisine rastlanılmamıştır. Bu çalışmada 30-50 yaş arasındaki kadavralarda Art. genu, Art. talocruralis ve Art. tarsi transversa'da OA sıklığı, makroskopik, mikroskopik olarak ve radyolojik açıdan incelendi. OA'nın yeri, yerleşimi, şiddeti ve lezyonların şekli gibi genel özelliklerinin radyolojik ve morfolojik açıdan karşılaştırılması ve birbirleri ile ilişkisinin belirlenmesi amaçlandı.Çalışmamızda, 20 adet % 10'luk formaldehit solusyonu ile fikse edilmiş ve yaş tesbitleri yapılmış, yaşları 30 ile 50 yaş arasında olan kadavraların Art. genu, Art. talocruralis ve Art. tarsi transversa eklemlerinin ön-arka ve lateral radyografileri çekilerek, radyolojik incelemede elde edilen sonuçlar Kellgren ve Lawrence skalasına göre her bir eklem için 0-4 arasında 5 derecede derecelendirildi.İncelediğimiz eklemlerin eklem yüzleri detaylı anatomik diseksiyon ile açıldı. Makroskopik olarak her bir eklem yüzeyi anterior, posterior, medial, lateral ve central olmak üzere beş bölgeye ayrılarak eklem yüzeyleri makroskopik olarak incelendi. Tanımlanan bölgelerin her biri için dejeneratif değişikliklerin varlığı not edilerek, 1-4 arasında derecelendirildi. Bu bölgelerden alınan örnekler mikroskobik yöntemlerle incelendi. Kıkırdaktaki dejenerasyon değişiklikleri, fibrilasyonların varlığı, yoğunluğu, derinliği, kıkırdak hücrelerinin kümelenmesi, nekrotik değişiklikler temel alınarak 1-4 değerleri arasında skorlama yapıldı.Çalışmada elde edilen bulgular SPSS [Statistical Package for Social Sciences] for Windows 15.0 programı kullanılarak istatistiksel olarak değerlendirildi. Makroskopik ve mikroskopik yöntemdeki bulguların sonuçlarının karşılaştırılması için kappa testi kullanıldı.Sonuçta makroskopik ve mikroskopik sonuçları her bir eklem yüzeyinin beş bölgesi için karşılaştırabilirken, radyografi değerlendirmelerinde sadece eklemin geneli için sonuç verilebildiğinden radyolojik bulgularımızı diğer bulgularla karşılaştıramadık.30 ile 50 yaş arası kadavraların yaklaşık 1/3'ünde radyolojik ve makroskobik OA belirlenmiş olmasına karşın, mikroskobik incelemede tetkik edilen tüm eklemlerde değişik derecelerde dejenerasyon olduğu saptanmıştır. Bu da bir ileri yaş hastalığı olan OA'nın çok erken yaşlarda başladığını göstermektedir.Anahtar Kelimeler: Osteoartrit, Art.genu, Art. talocruralis, Art. tarsitransversa There is not any literature available about osteoarthritis of the knee, talocrural and the tarsitransversal joints together studied by macroskobic, microskobic and radiological procedures. In the present study we investigated the insidence of osteoarthritis in the age of 30-50 years of cadaver by macroskobic, microskobic and radiological aspects. The comparison of the general features of the osteoarthritis such as localization, degree and the shape of the lesions by radiological and morphological aspect, and the relationship between them is aimed in this study.In our study we used 20 cadavers which were between 30-50 years old that are fixed in % 10 formaldehyde solutions. The antero-posterior and lateral radiographs of the knee, talocrural and tarsi transversal joints were taken and these results were evaluated by Kellgren and Lawrence scales by 5 degrees between 0 and 4 for each joint.The joint surfaces of the related joints were dissected anatomically. Each joint surface divided into 5 areas as anterior, posterior, medial, lateral and central. The degenerative changes of the determined joints were noted and degreed between 1-4. The specimens taken from these areas were evaluated by microscobic methods. The scoring between 1-4 was performed according to the alterations of the degeneration of the cartilage, fibrillation, intensity, deepness, the aggregation of the cartilage cells and the necrotic alterations. All these data were analized by SPSS 15.0 [Statistical Package for Social Sciences] for Windows. The Kappa test was used for comparing the results of macroskobic and microskobical procedures.As a result, we were able to compare the results of the macroscobic and microscobic procedures for 5 areas of each joints. We were only able to get the results for the whole joints radiologically so that we could not compare the results of the radiologic investigations with the morphologic results.Although, approximately in the 1/3 of the cadavers aged between 30 and 50, the OA was identified macroscobically and radiologically, there were different degrees of degeneration for each joints in the microscobic investigation. These results indicates that the OA as an elder disease can begin in the early ages.Keywords: Osteoarthritis, knee joint, talocrural joint, tarsitransversal join 57

Bu çalışmamızda iskemi reperfüzyon hasarının ve denervasyonun böbrekfonksiyonları üzerindeki etkisini ve iskemi süresindeki farklılıkların bu hasarınderecesini ne kadar etkilediğini belirlemeye çalıştık. Nitrik oksit'in (NO) hasardansonraki serum düzeylerinin farklı iskemi süreleri ve denervasyondan nasıletkilendiğini araştırdık.Otuzaltı wistar türü sıçan altışarlı altı gruba ayrıldı. Bu sıçanlardan tamamınatek böbrek modeli oluşturmak için nefrektomi uygulandı. Denerve ve innerveböbreklere 30 dk ve 60 dk süreyle klemp takıldı. Grup I (n=6) sadece sağ nefrektomiyapıldı, grup II (n=6) sağ nefrektomi ve sol renal artere klemp takılarak 30 dk iskemiuygulandı, grup III (n=6) sağ nefrektomi ve sol renal artere klemp takılarak 60 dkiskemi uygulandı, grup IV (n=6) sadece sağ nefrektomi ve sol böbreğe denervasyonuygulandı, grup V (n=6) sağ nefrektomi ve sol böbreğe denervasyon ve sol renalartere klemp takılarak 30 dk iskemi uygulandı, grupVI (n=6) sağ nefrektomi ve solböbreğe denervasyon ve sol renal artere klemp takılarak 60 dk iskemi uygulandı. Kanakımının yeniden sağlanmasından sonra 24 saatlik idrar toplandı ve kan üre azotu(BUN), kreatinin, sodyum, klor, potasyum ve nitrik oksit anlizleri için kan alındı.Böbrek fonksiyonları glomerüler filtrasyon hızı (GFR) sodyumun fraksiyonel atılımı(FeNa) ile değerlendirildi.Serum kreatinin ve BUN değerleri G-I. BUN(26±3 mg/dl)-Creatinin(0,52±0,06 mg/dl) grubu ile karşılaştırıldığında, G-II BUN(52±25 mg/dl)-Creatinin(0,8±0,3 mg/dl), G-III BUN(77±30 mg/dl)-Creatinin(1,3±0,6 mg/dl), G-VBUN(78±31 mg/dl)-Creatinin(1,2±0,6 mg/dl) ve G-VI BUN(110±29 mg/dl)-Creatinin(1,8±1 mg/dl) gruplarında anlamlı olarak yüksekti. G-III (0,5±0,4 ml/dk),G-V(0,4±0,3 ml/dk), and G-VI (0,19±0,14 ml/dk) gruplarının GFR değerleri G-I(1,4±0,5 ml/dk) grubu ile karşılaştırıldığında anlamlı bir azalma gözlenirken G-II(0,8±0,3 ml/dk) grubunda anlamlı bir farka rastlanmadı. FeNa grupV (%1,09±1,01)ve grup G-VI (%1,4±0,9) de 1'in üzerindeydi. Serum NO seviyesi G-I (336±111mmol/L) grubuyla karşılaştırıldığında G- V (520±129 mmol/L) ve G-VI (539±129mmol/L) gruplarında anlamlı olarak yüksekti.Çalışmamız sonucunda tek başına denervasyonun böbrek fonksiyonları üzerineetkisi olmadığını ve böbrek sinirlerinin böbrek üzerindeki etkisinin denervasyonlaortadan kalkmasının iskeminin oluşturduğu hasarın etkisini arttırdığınıdüşünmekteyiz. İskemi reperfüzyon hasarının süresinin uzamasıyla serum NOseviyesinin hemen bazal seviyeye dönmesinin geciktiğini gözlemledik.