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THE IMPORTANCE OF RADIOLOGICAL AND SECTIONAL ANATOMY IN EDUCATIONAlthough the history of anatomystarts at the age before christ, history of radiology science is dating to 1895when Wilhelm Konrad Roentgen has discovered X-ray. The history of radiologicalanatomy is as old as the history of radiology. As in every branch of medicine,anatomy has an undeniable place in radiology.1970 was a revolution in terms ofradiology an also in radiological and sectional anatomy. Thanks to the ComputedTomography (CT) device discovered by Sir Godfred Newbold Hounsfield,cross-sectional imaging of human body has become possible and the concept of“sectional anatomy” has emerged. With the developing cross-sectional techniquesin radiology, the importance of sectional anatomy increased. For this purposequestionnaires were distributed with four questions for each radiological andsectional anatomy lecture modalities to volunteers in different classes at GaziUniversity, Faculty of medicine. The students considered that theirunderstanding and perception of anatomy was improved with these two modalities.They also stated that these two modalities should be given in both preclinicaland clinical classes. I think that these two modalities should be given notonly to undergraduate students but also to graduate students (both for radiologyand anatomy specialty training and PhD education). Because anatomy has a greatimportance in radiology education, it would be very useful to perform anatomyrotation for those whoreceive specialty training in radiology.

Background Palmoplantar pustulosis (PPP) is a rare, chronic, inflammatory skin disease characterized by sterile pustules on palmar or plantar areas. Data on PPP are scarce. Aim To investigate the clinical characteristics and risk factors for disease severity in a large cohort of Turkish patients with PPP. Methods We conducted a cross-sectional, multicentre study of patients with PPP recruited from 21 tertiary centres across Turkey. Results In total, 263 patients (165 women, 98 men) were evaluated. Most patients (75.6%) were former or current smokers. The mean Palmoplantar Pustulosis Area and Severity Index (PPPASI) was 8.70 +/- 8.06 and the mean Dermatology Life Quality Index (DLQI) score was 6.87 +/- 6.08, and these scores were significantly correlated (r = 0.52, P < 0.001). Regression analysis showed that current smoking was significantly associated with increased PPPASI (P = 0.03). Coexisting psoriasis vulgaris (PsV) was reported by 70 (26.6%) patients. Male sex prevalence, PPP onset incidence, disease duration, DLQI, and prevalence of nail involvement and psoriatic arthritis (PsA) were significantly increased among patients with PPP with PsV. Of the 263 patients, 18 (6.8%) had paradoxical PPP induced by biologic therapy, and these patients had significantly increased mean DLQI and prevalence of PsA (r = 0.03, P = 0.001). Conclusion Our data suggest that smoking is a risk factor for both PPP development and disease severity. Patients with PPP with PsV present distinct clinical features and patients with biologic therapy-induced paradoxical PPP have reduced quality of life and are more likely to have PsA.

Mycosis fungoides (MF) is a skin lymphoma characterised by atypical T lymphocyte infiltration, which may present with patches and tumors in advanced stages. Treatment options in MF aim to reduce symptoms, since patients usually do not achieve complete cure. Bexarotene is used for treatment-resistant early stage MF and advanced stages of the disease. It has been suggested that white blood cell (WBC)/absolute lymphocyte count, WBC, absolute lymphocyte and eosinophil counts might be prognostic factors in MF. Therefore, we investigated the changes in complete blood count (CBC) parameters and CBC-derived inflammatory biomarkers in patients with MF treated with bexarotene. The results revealed that neutrophil (NE)%, NE numbers, neutrophil/lymphocyte, derived neutrophil/lymphocyte, (neutrophil × monocytes)/lymphocyte and (neutrophils × monocytes × platelets)/lymphocyte counts decreased in all patients three months after bexarotene treatment. We suggest that these inflammatory biomarkers can be used in the follow-up of patients with MF receiving bexarotene treatment. Moreover, these results indicate that decrease in these inflammatory biomarkers may signify improvement of the disease. Key Words: Bexarotene, Inflammatory biomarkers, Mycosis fungoides.

Objectives: Psoriasis patients may be susceptible to malignancy due to chronic inflammation. Moreover, biological agents which are used in the treatment of psoriasis might increase the risk of malignancy due to their immunosuppressive effect. Within this study, we evaluated the mammography results of female patients with psoriasis aged over 40 before the initiation of biological agent treatment. We aimed to determine whether breast cancer screening with mammography should be a prerequisite before the initiation of biological agent treatment for psoriasis. Methods: Between April 2019 and March 2021, medical records of female psoriasis patients aged over 40 were reviewed retrospectively. Results: This study included 42 female psoriasis patients (mean age: 53.52±7.09). BI-RADS score was 2 in 18 (42.9%) patients, 1 in 13 (31%) patients, 3 in 9 (21.4%) patients and 4A in 1(2.4%) patient. Isodense masses were detected in 10 (23.8%) patients, while 6 (14.3%) patients had intramammary lymph nodes. Mammography revealed microcalcifications in 6 (14.3%) patients, macrocalcifications in 1 (2.4%) patient and a hamartoma in 1 (2.4%) patient. Isodense masses, calcifications and intramammary lymph nodes were associated with long disease duration (>10 years). Intramammary lymph nodes were more common in patients treated with biological agents previously compared to biologic-naive patients. Conclusions: We suggest that female patients over 40, especially who had a long disease duration, family history of breast cancer and previous history of treatment with biological agents should undergo mammography before the initiation of biological agents for the treatment of psoriasis.

Background: In the older population, tortuosity of the vertebral artery (VA), uncovertebral joint (UVJ) osteoarthritis, and abnormal vertebral alignment may alter the normal anatomy. Aim: We aimed to determine the anatomical variations and relationships between the cervical segment of the VA and the cervical spine with regard to ageing. Materials and methods: In this retrospective cross-sectional study, the computed tomography angiography scans of 110 subjects were reviewed. Any variations in the VA, UVJ degeneration were identified. The distance between the VA and uncinate process (UP) was measured electronically. The distance between the VA and UP were compared according to the age group (group A > 45, group B = 45-65, and group C > 65 years-old). Results: With regard to the transverse foramen, 7.2% of the cases had entering abnormalities of the VA, while in one case (0.83%), the right VA had an exiting abnormality (exiting from the C2 instead of the C1). UVJ degeneration was found to be significantly higher in the older age group (p > 0.05). Furthermore, at the C4-C7 levels, the distances between the VA and UP were significantly smaller in the older age group (p > 0.01). Conclusions: The VA-UP distance has been shown to decrease due to increasing UVJ osteoarthritis in the elderly. The convergence of the VA toward the spine occurs at the most mobile segment of the cervical spine, and this anatomical alteration may predispose temporary and/or permanent vertebral artery occlusion clinically, and be dangerous during cervical spine surgery.

Psoriasis is a chronic, inflammatory skin disease present in about 3% of the world’s population. The clinical symptoms manifest diversely, therefore one can distinguish several subtypes of psoriasis. The majority of patients with psoriasis experience pruritus, which is an unpleasant sensation that decreases patients’ quality of life. The knowledge on pruritus in different subtypes of psoriasis is limited. We have performed a cross-sectional, prospective, and multicenter study to evaluate the relationship between clinical subtypes of psoriasis (large-plaque, nummular, guttate, palmoplantar, inverse, erythrodermic, palmoplantar pustular, generalized pustular psoriasis, and psoriasis of the scalp) and the prevalence, intensity, and clinical manifestation of itch. We introduced a questionnaire assessing various aspects of pruritus to a total of 254 patients. Out of these, 42 were excluded. Pruritus was present in 92.9% of the remaining patients and its prevalence did not depend on the clinical subtype. A correlation between the severity of psoriasis and the intensity of itch was explicitly noticeable in palmoplantar pustular psoriasis and scalp psoriasis (p &lt, 0.05). The itch sensation was individual and differed among subtypes of psoriasis. In conclusion, pruritus is a frequent phenomenon, and its presentation is different in various subtypes of psoriasis.

Introduction Acne vulgaris is a multifactorial disease. One of the main factors that plays a role in acne pathogenesis is an increase in sebum secretion. For sebum secretion, sebocyte differentiation followed by sebogenesis is essential. Sebocyte differentiation and proliferation, and sebum synthesis are controlled by complex pathways. Studies have shown that perilipin 2 and melanocortin 5 receptors play a role in sebogenesis. This study sought to determine whether levels of perilipin 2 and melanocortin 5 receptors have an impact on the development of acne vulgaris. Methods A total of 65 patients diagnosed with acne and 43 healthy control subjects were included in the study. Perilipin 2 and melanocortin 5 receptor levels were analyzed using the enzyme-linked immunosorbent assay (ELISA) technique. Results No significant differences were observed between the acne group and the control group in serum perilipin 2 (p = 0.594) and melanocortin 5 receptor (p = 0.213) levels. In the moderate acne group, perilipin 2 and melanocortin 5 receptor levels were significantly higher than in the mild acne group (p = 0.0014, p = 0.003). The levels in the severe acne group were not higher compared to the moderate and mild acne groups. Conclusion This study failed to detect any association between acne pathogenesis and perilipin 2 and melanocortin 5 receptor serum levels. However, these proteins may have an influence on acne severity.

Background: Internalized stigma, adoption of negative attitudes and stereotypes of the society regarding persons' illness, has not been studied previously in pediatric psoriasis patients. Objective: We aimed to investigate the internalized stigma in pediatric psoriasis patients and to determine differences according to factors affecting internalized stigma compared to adult psoriasis patients. Methods: This multicenter, cross-sectional, comparative study included 125 pediatric (55 female, 70 male; mean age±standard deviation [SD], 14.59±2.87 years) and 1,235 adult psoriasis patients (577 female, 658 male; mean age±SD, 43.3±13.7 years). Psoriasis Internalized Stigma Scale (PISS), Dermatology Life Quality Index (DLQI), Perceived Health Status (PHS), and the General Health Questionnaire (GHQ)-12 were the scales used in the study. Results: The mean PISS was 58.48±14.9 in pediatric group. When PISS subscales of groups were compared, the pediatric group had significantly higher stigma resistance (p=0.01) whereas adult group had higher scores of alienation (p=0.01) and stereotype endorsement (p=0.04). There was a strong correlation between mean values of PISS and DLQI (r=0.423, p=0.001). High internalized stigma scores had no relation to either the severity or localization of disease in pediatric group. However, poor PHS (p=0.007) and low-income levels (p=0.03) in both groups, and body mass index (r=0.181, p=0.04) in the pediatric group were related to high PISS scores. Conclusion: Internalized stigma in pediatric patients is as high as adults and is related to poor quality of life, general health, and psychological illnesses. Unlike adults, internalized stigma was mainly determined by psoriasis per se, rather than disease severity or involvement of visible body parts, genitalia or folds. Copyright © The Korean Dermatological Association and The Korean Society for Investigative Dermatology.

The vagus nerve is the primary neural medium which enables gastrointestinal tract and brain communication. Hippocampus, a region of the brain commonly linked to memory function, is activated by vagus nerve-mediated gastrointestinal signals. Vagal afferent information is received by the medial solitary nucleus and is then transmitted via ascending neural pathways to different regions of the forebrain and hindbrain. Explanation of the exact mechanisms of microbiota and amygdala communication requires further research. By linking microbial activities to progressive structural and functional events in the brain in mice models and in humans, we can suggest that intestinal microbiota is an important contributor to neurodevelopment and neurodegeneration. Further researches revealing these relations may provide new approaches for understanding neurodegenerative, psychiatric and behavioral diseases.

Anatomi temel ders kitabıdır

Enterik sinir sistemi, gastrointestinal sistemde “bağırsakların beynini” oluşturan vemerkezi sinir sisteminden bağımsız olarak işlev gören nöronların bir araya gelmesiyleoluşmuş bir sistemdir. Enterik sinir sistemi içerisinde sinir hücreleri (enterik nöronlar) vedestekleyici (glial) hücreler, küçük kümeler halinde, sinir lifi demetleriyle birbirinebağlanan enterik ganglionlarda gruplandırılır. Enterik ganglionlar, iki ana pleksus olanplexus myentericus ve plexus submucosus ile bazı küçük pleksuslarda toplanmışlardır.Nöroksin, presinaptik nöronal hücre adezyon proteinidir ve postsinaptik nöroligin proteiniile bağlanırlar. Nöroliginlere bağlı olan nöroksin izoformları, örneğin sinapsspesifikasyonu, oluşumu, olgunlaşması ve plastisitesinde rol oynayan eksitatör ve inhibitörsinapslarda trans-sinaptik kompleksler oluşturabilirler. ‘Stres’, vücut öz dengesini tehditeden veya vücudun bu şekilde algılandığı bir durum olarak tanımlanır. Enterik sinir sistemimotilite, viseral duyu, sekresyon, absorpsiyon, immün ve epitel bariyer fonksiyonunuiçeren çok sayıda gastrointestinal fonksiyon üzerinde düzenleyici kontrol sağlar. Bunedenle, ESS fonksiyonundaki değişiklikler, stresle ilişkili gastrointestinal bozukluklarındamerkezi bir patofizyolojik süreci temsil eden, derin klinik semptomlarına yol açabilir.Çalışmamızda, perinatal stresin, farklı embriyonik günlerdeki ratların enterik sinirsisteminde (ESS) nöroligin-1 ve nöroksin IIα üzerine olan etkilerin araştırılmasıamaçlanmıştır. Genel bir değerlendirme ile, prenatal stresin duodenum, jejenum, ileum,kolon duvar kalınlığını, epitel yüksekliğini, kript derinliğini arttırdığı, postnatal stresin ise,duvar kalınlıkları, epitel yükseklikleri ve kript derinliklerinde negatif yönde etki göstererekazalttığı görülmüştür. Stres gruplarında kontrol gruplarına göre immunreaktivite yoğunlukyüzdeleri ve pozitif hücre sayılarında düşüş dikkat çekicidir. Bu düşüşte prenatal ve/veyapostnatal stresin bir etkisinin olduğu sonucuna varılmıştır.Anahtar Kelimeler : Perinatal Sistem, Enterik Sinir Sistemi, Rat The enteric nervous system is a system formed by the combination of neurons that formthe "brain of the intestines" in the gastrointestinal tract and function independently of thecentral nervous system. In the enteric nervous system, nerve cells (enteric neurons) andsupporting cells (glial cells) are grouped into small clusters in enteric ganglia that areconnected by bundles of nerve fibers. Enteric ganglia are collected in the two mainplexuses, myenteric (Auerbach) and submucosal (Meissner) plexus. Neurexin is apresynaptic neuronal cell adhesion protein, and they bind with neuroligin, the postsynapticprotein. Neurexin isoforms that are linked to neuroligins may form trans synapticcomplexes in excitatory and inhibitory synapses that play a role in, for example, synapsespecification, formation, maturation, and plasticity. 'Stress' is defined as a condition thatthreatens body self-balance. The enteric nervous system provides regulatory control over alarge number of gastrointestinal functions, including motility, visceral sensation, secretion,absorption, immune and epithelial barrier function. Therefore, changes in ESS function canlead to deep clinical symptoms, representing a central pathophysiological process in stressrelatedgastrointestinal disorders. In our study, we aimed to investigate the effects ofperinatal stress on neuroligin-1 and neurexin IIα in the enteric nervous system (ESS) ofrats on different embryonic days. With a general evaluation, it was observed that prenatalstress increased duodenum, jejunum, ileum, colon wall thickness, epithelial height, cryptdepth, and postnatal stress negatively decreased by wall thicknesses, epithelial heights, andcrypt depths. It is noteworthy that the stress reactivity density percentages and positive cellnumbers decreased in the stress groups compared to the control groups. It was concludedthat prenatal and/or postnatal stress had an effect on this decrease.Key Words : Perinatal Stress, Enteric Nervous System, Rat

Amac: Tip Fakultesinde preklinik siniflarda okutulan Anatomi temelde ders kitaplari, dersler ve kadavra diseksiyonlarina dayandirilmaktadir.icerisinde Radyolojik ve Klinik anatomik bilgiler verilmesinin ogrencinin anatomi dersini ogrenmesini ve anlamasini nasil etkiledigi ve klinik siniflara yonelik olarak da verilmesinin gerekliligi konusunda nasil daha faydali olunabilecegi sorusuna cevap aranmistir. Yontem: Gazi Universitesi Tip Fakultesinde egitim alan degisik siniflardaki toplam 943 ogrenciyeRadyolojik ve Klinik anatomi dersleri ile ilgili olarak 4’er sorudan olusan anket yapilmistir. Bulgular: Ogrenciler genelde anatomi egitimi icerisinde radyolojik bilgilerin verilmesini isteyenlerin orani 2. sinifta %64.76 iken, bu oran 4. sinifta %79.91, 5. Sinifta %90.91 ve 6. sinifta %95.08 saptanmistir. Klinik anatomik bilgiler icin oranlar sirasiyla %88.85, %91.38, %97.47 ve %94.08 bulunmustur. Ogrenciler bu derslerin motivasyonlarini arttirdigini ve anatomiyi daha iyi anlamalarina neden olduklarini ve hem temel egitim doneminde, hem de klinik siniflarda bu derslerin faydali olacagini belirtmislerdir. Sonuc: Sinif buyudukce, ogrencilerin anilan derslerin suresinin artmasini ve klinik donemlerde de anlatilmasini istedikleri gorulmustur.