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Modern practical and theoretical instruction sessions need to be up-to-date, and nested with creativity and technology. Virtual reality (VR) is a state-of-the-art user interface interacting with multiple sensory channels and creating real-time simulations. In this study, we examined the effect of VR on the learning of the anatomy of the head and neck region. Seventeen students from 12 different medical schools in Turkey participated in this study. After one hour of theoretical training, the students were trained on cadavers for five hours. Then, a pre-test examination was given. After the pre-test, all students were given one-to-one virtual reality training and then a post-test. A statistically significant increase in the achievement of the students was found between the mean pre- and post-VR test scores (p=0.003). VR is considered as a rising trend in medicine when the skills and competencies of the generation Z on digital technologies are taken into consideration.

The initial interaction between medical students and their "Silent Teacher" in the dissection lab is an important experience in the process of establishing a professional ethos. However, COVID19 complicated this process and the optimal approach to achieve this introduction remains unclear. The purpose of this study was to develop an online case-based approach as the basis for donor introduction to medical students based on Magnetic resonance imaging (MRI) reports. MRI scans of 16 body donors were assessed by a radiologist and observations were uploaded to a web-based DICOM viewer (www.rad3d.com). A list of learning objectives were generated for each donor and radiology reports were constructed based on: chief complaints, medical history, radiology and pathology that were reviewed prior to the class. Within the lab and following COVID19 restriction policy, students read through the radiology reports and viewed the augmented reality (AR) visualizations of the MRI scans using z-space computers providing additional dissection team interactions. Finally, surface anatomy exercises were undertaken that corresponded to the primary pathology providing a direct interaction with the donor. This process included Sketchfab and other links to underscore anatomical correlations (Figure 1). A survey was conducted to assess student perceptions of the experience. The study design comprised a voluntary survey tool to assess student level of anxiety and whether the online approach was effective. Response scales were either bimodal or Likert-base (5 scale) and analyzed with Fisher's exact test. Follow up open ended questions were also presented to the students. The response rate was 33/80 (41.25%). Most students (82.7%) felt anxious first, but the anxiety decreased in time (60.7%). They mostly accomplished the tasks (surface exercises 97%; reviewing MRIs 87.9%) and found surface exercises useful in terms of reducing anxiety (90.6%), and initiating team work (100%). A total of 79.3% of t

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Background: Melatonin exerts oncostatic effects on breast cancer via immunomodulation and anti-oxidation. Doxorubicin is an effective chemotherapeutic agent, but parallel studies also provide ample evidence of an off-target effect of Doxorubicin in breast cancer patients. Objective: Combinatorial use of doxorubicin and melatonin has not been comprehensively analyzed in breast cancer models. We hypothesized that the anti-oxidative, anti-proliferative and anti-inflammatory effects of melatonin could ameliorate the off-target effects of doxorubicin in breast cancer patients and enhance the anti-tumoral effects of doxo-rubicin. The goal of the study is to test this hypothesis in cancer cell lines and xenografted mice. Methods: The effects of Melatonin and doxorubicin on the cell viability were evaluated in 4T1-Brain Metastatic Tumor (4TBM). Furthermore, the effects of melatonin and doxorubicin on the primary tumors and systemic metastasis were evaluated in the xenografted mice. Lung and liver tissues were removed and metastasis analyses were performed. The levels of p65, phospho-STAT3, CD11b+, GR1+, Ki67, and cleaved caspase-3 proteins were determined with im-munohistochemistry and western blot analysis. We examined the effects of melatonin and Melatonin+Doxorubicin combination therapy on 4TBM cells. Results: Our results showed that doxorubicin inhibited the proliferation of metastatic breast cancer cells while melato-nin did not affect cells. Tumor growth and metastasis were markedly suppressed in melatonin alone and in combination with doxorubicin. The expression of CD11b+ and GR1+ proteins, which are indicators of myeloid-derived suppressor cells (MDSCs), were noted to be reduced in both primary tumor and metastatic tissues in melatonin and doxorubicin groups. Conclusion: The combination of melatonin with doxorubicin reduced primary tumor growth and distant metastasis. Based on these results, melatonin is a promising candidate for combinatory use with conventional ch, This study was funded by TUBITAK 3001. The Scientific and Technological Research Council of Turkey (Project number 315S181)., The author acknowledge the financial support by TUBITAK 3001 The Scientific and Technological Research Council of Turkey., Türkiye Bilimsel ve Teknolojik Araştirma Kurumu, TÜBITAK: 3001

Neuroinflammation has an essential role in various neurodegenerative diseases including Parkinson's disease (PD). Microglial activation as a result of neuroinflammation exacerbates the pathological consequences of the disease. The toxic effect of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) causes alpha-synuclein (alpha-synuclein) accumulation, which leads to dopaminergic neuron death in the MPTP-induced mouse model. Toll-like receptor 4 (TLR4) stimulates release of cytokine through NF-kB by activating glial cells, thus resulting in the death of dopaminergic neurons. Melatonin has the ability to cross the blood-brain barrier and protect neurons through anti-inflammatory properties. We hypothesized that melatonin could suppress TLR4-mediated neuroinflammation, decrease cytokine release due to the inflammatory response, and reduce dopaminergic neuron loss in the MPTP-induced mouse model. In the MPTP-induced mouse model, we aimed to assess the neuroinflammatory responses caused by TLR4 activation as well as the effect of melatonin on these responses. Three-month-old male C57BL/6 mice were randomly divided into five groups; Control (Group-C), Sham (Group-S), Melatonin-treated (Group-M), MPTP-injected (Group-P), and MPTP + melatonin-injected (Group-P + M). MPTP toxin (20 mg/kg) was dissolved in saline and intraperitoneally (i.p.) injected to mice for two days with 12 h intervals. The total dose per mouse was 80 mg/kg. Melatonin was administered (20 mg/kg) intraperitoneally to Group-M and Group-P + M twice a day for five days. Eight days after starting the experiment, the motor activities of mice were evaluated by locomotor activity tests. The effects on dopamine neurons in the SNPc was determined by tyrosine hydroxylase (TH) immunohistochemistry. TLR4, alpha-synuclein, and p65 expression was evaluated by immunostaining as well. The amount of TNF-alpha in the total brain was evaluated by western blot analysis. In our results seen that locomotor activity was lower i, Akdeniz University Scientific Research ProjectsAkdeniz University [TYL-2018-3972], This study was supported by Akdeniz University Scientific Research Projects with project number TYL-2018-3972 and a Master of Science thesis of Sendegul YILDIRIM.

Objectives: The use of plastination can minimize health risks and cost in anatomy laboratories. Plastinates are easy to han- dle 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, p0.05). The test scores of both groups increased significantly after the lecture (p0.05). The post-test scores of group 2 wer e significantly higher than group 1 (p= 0.047, p0.05). The average test scores of those trained with formalin-fixed specimens increased from 23.78±1.94 to 48.22±3.19 (p0.05). 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 structure

The objectives of this study were to evaluate the manubriosternal joint (MSJ) to estimate the minimum chronological age of complete fusion, and how changes in this joint influence age estimation. The study also focused on investigating the calcification patterns of the second costal cartilage (SCC), as they may be related to age. Between January and September 2020, individuals between 30 and 80 years of age, who underwent chest tomography at our institution, were listed by sex and divided into five groups according to age with intervals of 10 years. Twenty patients from each age group and sex were randomly selected, and 200 patients were evaluated. The relationship between age and changes in MSJ and SCC was evaluated. The incidence of complete fusion did not differ significantly between the 30 and 80 age groups. A significant difference was found between the age groups and MSJ degeneration (p 0.001). The degree of MSJ degeneration and calcification in SCC significantly increased with age, but the range was wide. These values might be used to support traditionally accepted age-estimation methods but not as independent indicators of specific age ranges.

Purpose: Extended reality (XR) technology enhances learning in medical education. The purpose of this study was to develop and apply a case-based approach for teaching radiological anatomy utilizing XR technology for improved student exploration and engagement. Methods: The workflow consisted of MRI scanning cadavers followed by radiological, pathological, and anatomical assessment, and finally case presentation based on XR visualizations and student interaction. Case information (Subject, History, and Physical Exam) was presented to student groups who generated and recorded hypotheses using Google Forms. Results: Use of all components of the system was voluntary and a total of 74 students responded to the survey request (response rate = 95%). Assessment of the experience was conducted through a qualitative survey comprising four Likert scale questions (1-5, 1 lowest), three binary questions, and open-ended comments. Mean, standard deviation, and overall agreement (mean +/- SD, OA) showed that students found MRI scans of cadavers to be helpful for dissections (4.14 +/- 1.1, 74.3%) and provided an understanding of relevant anatomy (4.32 +/- 0.9, 79.7%), while 78.4% of students used the DICOM viewer to visualize scans of cadavers. The difficulty of use was found to be average (2.90 +/- 1.0, 23%). zSpace visualizations were used by 40.5% of students, generally agreeing that an understanding of spatial relationships improved as a result (3.60 +/- 1.0, 43.2%). More case-based sessions were favored by 97.3% of students. Conclusions: Results suggest that cadaveric MRI radiological visualization and XR technology enhance understanding of case-based anatomical dissections and encourage student exploration and engagement., The authors wish to thank the altruistic donors of the JABSOM, Willed Body Program for their generous contributions in providing unique educational and research opportunities for the next generation of health care providers. We would also like to thank the JABSOM class of 2022 for completing the educational activity and post-survey. Thank you to Dr. Marcus Keep for the narration of the hematoma and pupillary response videos. This study was institutionally reviewed and approved (IRB 2018-00120). This study is funded by `XLR8UH, Quake Capitol'., XLR8UH, Quake Capitol

Neuroinflammation has an essential role in various neurodegenerative diseases including Parkinson's disease (PD). Microglial activation as a result of neuroinflammation exacerbates the pathological consequences of the disease. The toxic effect of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) causes alpha-synuclein (alpha-synuclein) accumulation, which leads to dopaminergic neuron death in the MPTP-induced mouse model. Toll-like receptor 4 (TLR4) stimulates release of cytokine through NF-kB by activating glial cells, thus resulting in the death of dopaminergic neurons. Melatonin has the ability to cross the blood-brain barrier and protect neurons through anti-inflammatory properties. We hypothesized that melatonin could suppress TLR4-mediated neuroinflammation, decrease cytokine release due to the inflammatory response, and reduce dopaminergic neuron loss in the MPTP-induced mouse model. In the MPTP-induced mouse model, we aimed to assess the neuroinflammatory responses caused by TLR4 activation as well as the effect of melatonin on these responses. Three-month-old male C57BL/6 mice were randomly divided into five groups; Control (Group-C), Sham (Group-S), Melatonin-treated (Group-M), MPTP-injected (Group-P), and MPTP + melatonin-injected (Group-P + M). MPTP toxin (20 mg/kg) was dissolved in saline and intraperitoneally (i.p.) injected to mice for two days with 12 h intervals. The total dose per mouse was 80 mg/kg. Melatonin was administered (20 mg/kg) intraperitoneally to Group-M and Group-P + M twice a day for five days. Eight days after starting the experiment, the motor activities of mice were evaluated by locomotor activity tests. The effects on dopamine neurons in the SNPc was determined by tyrosine hydroxylase (TH) immunohistochemistry. TLR4, alpha-synuclein, and p65 expression was evaluated by immunostaining as well. The amount of TNF-alpha in the total brain was evaluated by western blot analysis. In our results seen that locomotor activity was lower i, Akdeniz University Scientific Research ProjectsAkdeniz University [TYL-2018-3972], This study was supported by Akdeniz University Scientific Research Projects with project number TYL-2018-3972 and a Master of Science thesis of Sendegul YILDIRIM.

Objectives: The use of plastination can minimize health risks and cost in anatomy laboratories. Plastinates are easy to han- dle 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, p0.05). The test scores of both groups increased significantly after the lecture (p0.05). The post-test scores of group 2 wer e significantly higher than group 1 (p= 0.047, p0.05). The average test scores of those trained with formalin-fixed specimens increased from 23.78±1.94 to 48.22±3.19 (p0.05). 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 structure

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., In this study, images of a PhD thesis which has been supported by Akdeniz University Scientific Research Projects Coordination Unit under the grant number TDK-2015-703, were used. This study was presented at 11th International Symposium of Clinical and Applied Anatomy (ISCAA) on 24-26 June 2019, Madrid, Spain., Akdeniz University Scientific Research Projects Coordination UnitAkdeniz University [TDK-2015-703]

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., In this study, images of a PhD thesis which has been supported by Akdeniz University Scientific Research Projects Coordination Unit under the grant number TDK-2015-703, were used. This study was presented at 11th International Symposium of Clinical and Applied Anatomy (ISCAA) on 24-26 June 2019, Madrid, Spain., Akdeniz University Scientific Research Projects Coordination UnitAkdeniz University [TDK-2015-703]

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.

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.