Search

Purpose Mesenteric circulation is provided by the celiac artery (CA), superior mesenteric artery (SMA), and inferior mesenteric artery (IMA). The collateral circulation between CA 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 CA and SMA stenosis rates in patients with CA and SMA stenosis from angiography images, the occurrence of the collateral variations, and the frequency of these variations. Methods A total of 408 nonselective or selective CA 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. Angiography images were analyzed in regards to CA and SMA stenosis rates, and the collateral variations between mesenteric vessels. Results Stenosis of CA 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 CA and SMA were found in 9 patients. The Rioalan arch was the most common type of collateral vessel in these patients. Conclusion It was observed that mesenteric circulation was mainly provided by gastroduodenal in patients with isolated CA or SMA stenosis or occlusion while in patients with stenosis or occlusion of both CA and SMA, mesenteric circulation was mainly provided by the Riolan arc. A significant increase was observed in the prominence of collateral vessels in patients with stenosis of more than 70%.

Objective: Osteoarthritis (OA) is the most common joint disease. In this study it was aimed to compare the general features of OA such as location, placement, severity and shape of the lesions in terms of radiological and morphological aspects and to determine their relationship with each other. Methods: In our study, the antero-posterior and lateral radiographies of knee talocrural and transverse tarsal joints of 20 cadavers by age between 30 and 50 years were taken. The results obtained from the radiological examination were graded according to the Kellgren and Lawrence scale. For each of the identified regions, the presence of degenerative changes was noted. Then samples were taken from these regions were examined by microscopic methods. The cartilage degeneration changes, presence of fibrillations, density, depth, chondrocyte aggregation, and necrotic changes were evaluated. Results: In the radiological examination OA was found in 35% in knee joint, 25% in the talocrural joint, 15% in the transverse tarsal joint. In the morphological examination OA was found in 31.5% knee joint, 25% ankle joint and 5% transverse tarsal joint. In the microscopic examination OA was found in 94.7% knee joint, in 94.7% ankle joint and in 100% transverse tarsal joint. Conclusion: Although radiological and macroscopic OA was detected in approximately 1/3 of cadavers aged between 30 and 50 years, degeneration of varying degrees was detected in all joints examined in microscopic examination. This shows that an advanced age disease OA, starts at a very early age. Key words: Osteoarthritis, Knee joint, Talocrural joint, Transverse tarsal joint

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.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.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.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.

Background: Melatonin exerts oncostatic effects on breast cancer via immunomodulation and antioxidation. 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 doxorubicin. 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 immunohistochemistry 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 melatonin 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 chemotherapeutics for breast cancer treatment.

Aim: Blooming is one of the color doppler artefacts which has unique importance for the tiny or slow-flow blood vessels of the fetus and is different and varies depending on the technique. The purpose of our study is to compare doppler techniques related to the flowering artefact so that the imaging method closest to the actual size of small vessels can be selected. Method: Twin-view mode was used for measurements in 100 patients, referred to our department for obstetric ultrasonography. The diameter of the intrahepatic umbilical vein was measured from the inner to the inner side of the vessels in both B mode side and each colorized lateral side of the vessels with all of the Doppler modes. Results: Diameters of the vessels measured by advanced dynamic flow were less than the ones measured by conventional color doppler and power doppler. Conclusion: Lowering the doppler gain will decrease the blooming artefact. However, this can cause flow information to be lost. Inversely, raising the gain will result overestimating the vessel diameter or over colorizing the tissue or mass with regard to vascularity. Vascular colorize is crucial for correct placement of PD sampling gate, which could be particularly useful in the small vessels of the fetus. ADF provides more accurate measurements of the diameters of the vessels due to less blooming. Because of that, we consider that ADF is a superior Doppler technique compared with CCD and PWD, for identifying a vessel and guiding the PD sample volume.

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.

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

OBJECTIVE: This study aimed to compare 2 methods of ulnar variance (UV) measurement (the perpendicular method and the circular method) and to determine whether UV changed based on the demographic characteristics (sex and age). METHODS: UV was measured on bilateral wrist radiographs of 124 patients (62 men, 62 women; mean age=48.5 years; range=18–79 years) who had no history of trauma, congenital wrist anomaly, previous wrist surgery, and wrist osteoarthritis by a single radiologist with 4 years of experience. All measurements were made on standardized radiographic images using 2 methods: the perpendicular method and the circular method. All the patients were then divided into groups based on sex and age, and the study population was determined by selecting a similar number of patients for each sex and age group. RESULTS: The mean UV of the right and left wrists was measured as 0.33 (range=−4.3 to 5.7) mm by the perpendicular method and as 0.034 (range=−5 to 5.7) mm by the circular method. A significant difference was determined between the 2 measurement methods (p

The aim of this study was to determine the course of marginal mandibular nerve (MMN) in relation to the inferior border of the mandible from the gonion until its terminal insertion to the depressor anguli oris, relating the position to a palpable anatomical landmark with emphasis on the depth of the nerve in relation to platysma and the deep cervical fascia. Twelve fresh adult cadavers were dissected and the mandibular base was contoured using needles with 5mm gaps, starting from the mandibular angle to the muscular termination point of the nerve bilaterally. The distance between the MMN and the mandibular base and total length of the nerve was measured bilaterally. The highest levels of MMN were measured 6.9mm and 6.5mm above, and the lowest levels were measured 4mm and 3mm below the mandibular base on right and left sides, respectively. The mean (SD) total length of the nerve until the muscular termination point was calculated 33.57 (3.41) mm on the right and 33.51 (4.88) mm on the left side. Previous publications that we had read all fell short of defining the schematic pathway of the nerve, as the described landmarks were of a combination of bone and soft tissue, which are not always clinically reliable. We have overcome this difficulty by standardising the inferior border of the mandible as a point in order to trace the marginal mandibular branch pathway. It originates along the gonion and ends at the second premolar tooth area.

Objectives Complex acetabular fractures involving the quadrilateral plate may necessitate infrapectineal buttress plating, which can be performed through the pararectus approach. The aim of this cadaveric study was to identify the anatomical guide points to protect neurovascular structures at risk of injury during the pararectus approach. Methods Six fresh frozen cadavers (12 hemipelves) were dissected in this study. Location of the inferior epigastric artery (IEA), obturator nerve (ON), and corona mortis (CM) was measured using common anatomic landmarks, namely anterior superior iliac spine (ASIS), symphysis pubis (SP), and sacroiliac (SI) joint. Results In the superficial dissection of the abdominal wall, the mean distance between the IEA and ASIS was 106.7±5.2 (range, 99.2 to 116.4) mm, and the mean distance between IEA and SP was 77.9±3.5 (range, 70.6 to 82.2) mm. In deep dissection, the mean distance between the SI joint to the SP was 133.1±5.7 (range, 126.0 to 142.0) mm. The mean distance between the SI joint and ON was 37.3±2.8 (range, 31.0 to 41.0) mm. The CM was unable to be detected in two cadavers, one on the right and one on the left hemipelvis. The mean distance between the CM and SP was 47.7±3.9 (range, 43.0 to 55.0) mm. Conclusions A pararectus approach is a useful approach which allows infrapectineal plating in the treatment of complex acetabular fractures; however, the preservation of critical neurovascular structures is essential during dissection. This study is helpful to identify the structures at risk according to commonly used anatomic landmarks. These data might be a necessary guideline for hip and trauma surgeons.

Objectives: This study aims to determine the secure location and angle of the most distal screw during posterior malleolar (PM) fracture fixation. Materials and methods: This prospective study was performed on September 15, 2019. Distal tibial concave articular depth and PM inclination angle were measured on 100 (50 male and 50 female) dry tibia bones using a digital caliper. A comparative analysis between male and female tibias was performed. Results: Anteroposterior width of male tibia (38.3±3.1 mm) was wider than female tibia (35.3±3.2 mm) (p

Introduction: Dermatologists see many patients with nail disorders requiring surgical interventions. However, nail surgery is often found to be difficult by dermatologists. The aim of this study was to evaluate the effectiveness of an integrated nail surgery course. Methods: A nail surgery course model, combining anatomy, pathology, and dermatology with theoretical lectures and hands-on training on fresh-frozen cadaver, was designed for dermatologists. Before and after the course, the participants were asked to complete a questionnaire in which they assessed their knowledge and competence levels. Results: Twenty-eight dermatologists completed the questionnaires. The majority of the dermatologists (79.6%) had limited nail surgery experience, previously. The most commonly cited reasons for lack of knowledge or low or moderate theoretical and/or practical level of knowledge of nail surgery were not having received theoretical and practical education during dermatology residency. The median scores of self-assessed knowledge and competency improved significantly after the course (p < 0.001). The majority (82.1%) of the participants were “quite” or “very” well satisfied. Conclusion: An integrative nail surgery course model seems beneficial and encouraging for dermatologists. Organizing this type of nail surgery course, especially in medical schools using fresh-frozen cadavers, may significantly improve dermatologists’ knowledge and skills.

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 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.

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.

Objectives This study aims to evaluate the effect of diabetes mellitus (DM) on intramuscular fatty degeneration after a full-thickness supraspinatus (SS) tendon tear in rats. Materials and methods The study included 24 adult male Wistar Albino rats (age, 18 to 24 weeks; weighing, 320-380 g) randomized into a sham group (n=6), control group (n=6) and experimental group (n=12). Rats with fasting blood glucose levels ≥250 mg/dL at each measurement after an injection of streptozotocin were accepted to have DM. On the seventh day of the study, the SS muscles of the rats in the experimental and control groups were cut from the insertion. All animals were performed euthanasia four weeks after the surgical procedure and SS muscles were excised completely. Fatty degeneration in the SS muscle was assessed histologically and immunohistochemically with oil red O and peroxisome proliferator-activated receptor gamma (PPAR-γ) staining using histological score (H-score) and quantitative methods. Results More intense oil red O and PPAR-γ staining was observed in all regions of the SS muscles of the experimental group compared to control and sham groups (p Conclusion The results of this study showed that DM accelerates intramuscular fatty degeneration after SS tendon tears. Fatty degeneration should be monitored closely in diabetic patients with rotator cuff tear who were selected for conservative treatment and early surgical treatment should be considered as an option.

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.

aytac, gunes/0000-0003-4902-2844 WOS:000522643800019 PubMed: 32130480 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.

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 surgeons in avoiding inferior alveolar nerve injury during mandibular osteotomies.

Introduction Civinini’s ligament is among the intrinsic ligaments of sphenoid bone that may occasionally ossify. The ossification may be complete or incomplete and unilateral or bilateral. It may lead entrapment of neighboring neurovascular structures and may cause difficulties during surgical procedures through infratemporal fossa. Therefore, the aim of the present study was to demonstrate the incidence and types of Civinini’s bar and discuss its clinical relevance. Methods Sixty-six adult human Anatolian dry skulls with unknown age and sex were obtained from the Department of Anatomy. All skulls were examined and classified with regard to presence or absence, side and ossification degree of Civinini’s bar. Results A total incidence of 31.81% of different types of Civinini’s bars was observed, out of which 1.51% were Type I, 18.18% Type II, 1.51% Type III, 0% Type IV and 10.60% were of Type V variety. Discussion Complete or incomplete ossification of Civinini’s ligament have significant relation with blockage and entrapment of important neurovascular structures. A thorough knowledge of the anatomy and incidence of Civinini’s bar and related clinical situations could be important for radiologists, neurosurgeons, maxillofacial surgeons, anaesthetists, anatomists and anthropologists.

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.

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.

AmaçBu çalışmada, 2017-2018 eğitim-öğretim yılında, tıp fakültesinde uzmanlık eğitimi alan hekimlere, kendi uzmanlık alanlarında anatomi eğitiminin öneminin belirlenmesi amacıyla bir anket çalışması yapılmıştır.Gereç ve YöntemAkdeniz Üniversitesi tıp fakültesinde 6 farklı branşta (Radyoloji, Plastik Cerrahi, Genel Cerrahi, Göğüs Cerrahisi Ortopedive Anestezi) uzmanlık eğitimi alanı asistan hekimlere, araştırmacı tarafından 6 sorudan oluşan, uzmanlık alanına anatomi eğitimi entegrasyonunun yararı konulu bir anket çalışması yapılmıştır. Verilerin analizinde SPSS 7.4 programı kullanılarak ki kare uygulanmıştır.BulgularAnket sorularının cevapları değerlendirildiğinde uzmanlık eğitimi alan hekimlerin bir büyük çoğunluğu, Anatomi eğitimine uzmanlık alanında ihtiyaç duyduklarını (%97,23), almış oldukları uzmanlık eğitimine, anatomi eğitiminin katkısı olabileceğine inandıkları için anatomi entegrasyonunun olması gerektiğini (%94,6) ve sonraki hekimlik yaşantılarında anatomi eğitiminin faydalı olabileceğini (%97,2) vurgulamışlardır. Hekimlerin çoğu bu eğitimin 1. (%54,2) veya 2.(%45,8) yılda verilmesi gerektiğini belirtmişlerdir. Sonuç Anket sonuçları ışığında, mezuniyet sonrası tıp eğitiminde anatomi bilgisinin yeri ve önemi sorgulanmıştır ve uzmanlık eğitimi alan hekimler tarafından, eğitimleri sırasında, alabilecekleri anatomi bilgisinin önemli ve faydalı olabileceği vurgulanmıştır.

To compare the efficacy of the double- and single-needle arthrocentesis techniques in removing methylene blue from the temporomandibular joint (TMJ) space.This study was performed in 20 TMJs from 10 fresh cadavers. A total of 1 ml of 10 μM methylene blue solution was injected into the upper joint spaces, just prior to irrigation. Ten arthrocentesis procedures were carried out using the double-needle technique, and the remaining 10 were completed using the single-needle technique. The photo-absorbance values of methylene blue solution injected into and removed from the joint space were measured at a 665 nm wavelength. Statistical analysis was performed using Shapiro-Wilks test and t-test.The t-test analysis showed no statistically significant difference between the two methods in the removal of methylene blue.According to the results of the present study, the single-needle technique may be a good alternative with the advantages of easier application in cases where it is not possible to perform the double-needle technique.

Purpose The purpose of this study was to evaluate the clinical and radiological results of scaphotrapeziotrapezoid (STT) arthrodesis with a limited wrist fusion plate in patients with Stage IIIB Kienbock's disease (KD). Materials and methods A retrospective review was performed on nine patients with Stage IIIB KD who underwent STT arthrodesis between 2014 and 2017 at our institution. Clinical evaluations of the patients were made using the shortened quick version of the Disabilities of the Arm, Shoulder, and Hand (Q-DASH) Outcome Measure score (Institute for Work and Health, Toronto, ON, Canada) and grip strength measurements before surgery and at the final follow-up examination. All patients underwent computed tomography (CT) scan to confirm the union of the arthrodesis. Results A complete union was obtained in all patients. The Q-DASH score was changed from 57.8 ± 8.2 points (range: 47.7 - 70.5) to 32.3 ± 17.3 points (range: 13.6 - 54.5) (p = 0.008). Similarly, the grip strength was improved significantly (p = 0.007). Conclusions The use of limited wrist fusion plates for STT arthrodesis in KD is a safe and effective treatment method that provides a high rate union and acceptable functional results.

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.

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.

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.

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.

Summary The aim of the present study was to investigate the detailed histological characteristics of membranous and cord-like anterior intermeniscal ligaments (AIMLs) by transmission electron microscopy (TEM) and light microscopy. Ten biopsies of AIMLs were sampled from 10 knees during total knee arthroplasty procedures. Three of them were membranous and 7 of them were cord-like. They were processed for light and TEM evaluations. Histologically, the findings in the membranous and cord-like ligaments were similar. They consisted of parallel bundles of collagen fibrils and their posterior surfaces were covered by a layer of loose well-vascularized synovial tissue. The subsynovial region consisted of loose connective tissue and was rich in blood vessels and nerve endings. Fibroblasts embedded between parallel-oriented collagen fibrils were the major cell type that we observed. Free nerve endings were squeezed between bundles of collagen fibers. Electron microscopic observations revealed the presence of Ruffini corpuscles. The presence of neural mechanoreceptors in the membranous and cord-like intermeniscal ligaments may contribute to structural and proprioceptional function of the knee. Protection of those ligaments may be valuable in planning and performing meniscal surgeries.

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

Purpose: To investigate the site of pudendal nerve compression and the relation between traction force and abduction angle regarding pressure levels at setup for hip arthroscopy. Methods: A total of 17 hips from 9 fresh-frozen cadavers (6 male and 3 female cadavers) were used. The pudendal nerves were dissected, and 3 FlexiForce force sensors (Tekscan, Boston, MA) were implanted on the pudendal nerve where the inferior rectal nerve, perineal nerve, and dorsal nerve of the clitoris/penis emerge. A custom-made traction table in a supine position was used with a padded perineal post of 9 cm. Recordings were made at 0, 10, 20, 30, and 40 kg of traction at varying hip abduction angles of 0 � ,1 5 � ,3 0 � , and 45 � . Results: The tuber ischiadicum (perineal nerve) and genital region (dorsal nerve of penis/clitoris) had statistically higher pressure values when compared with the pudendal canal (inferior rectal nerve) (P < .05). There was a significant increase in forces acting on the pudendal nerve with increasing application of 0 to 40 kg of traction in steps of 10 kg, with the exception of the pudendal canal sensor and reading of the perineal nerve sensor at 45 � of hip abduction (P < .004 with Bonferroni correction for significant values). On the contrary, hip abduction angle had no statistically significant effect on pudendal nerve compression. (All specific P values with Bonferroni correction were greater than .003.) Conclusions: To avoid nerve palsy completely, the etiopathogenesis of compressive neuropathy should be identified. The location for compression and relation between different traction positions and forces are clarified in this study. This information can be used for further research and prevention. Clinical Relevance: This study adds objective data on the etiopathogenesis of pudendal nerve compression, which potentially contributes to prevention of pudendal nerve palsy as a common complication of hip arthroscopy.

The canal of the posterior ampullar nerve is located between the inferior part of the internal acoustic meatus and ampulla of the posterior semicircular canal. It permits a more accurate localisation of the underlying labyrinth in inner-ear surgery. An anatomical and radiological study was undertaken to determine the importance the relationship between the canal and the labyrinth. Ten dry and 10 cadaveric temporal bone dissections, together with 20 high resolution CT scans of the same temporal bones were studied in an attempt to describe the anatomy of the canal of the posterior ampullar nerve. The length of the canal of the posterior ampullar nerve, the length of internal acoustic meatus, and distances from porus acusticus to the singular foramen and the transverse crest, and from the singular foramen to the vestibule and transverse crest, and from operculum to the sigmoid sinus and to the porus acusticus were measured. During the transmeatal posterior cranial fossa approach using the canal of the posterior ampullar nerve as a landmark enables more bone to be safely removed from the internal acoustic meatus thus preserving hearing.

Anatomical measurements were studied on 40 dry axis vertebrae to determine the suitability of the groove for the vertebral artery for atlanto-axial transarticular screw fixation technique. We measured 13 parameters including three angular and 10 linear dimensions related to the groove of the vertebral artery, pedicle, and pars interarticularis and evaluated 80 measurements for each parameter. All measurements were done after placing a Kischner guide wire through the pedicle. We found that differences between measurements on the left and right sides of each vertebra were nonsignificant. In spite of the variability in measurements such as height, width, and median angle of the pedicle, the decline angle for instrumentation, the depth of the groove for the vertebral artery, and the internal height of the pars interarticularis, all of these had good symmetry. However, there were statistically significant differences between the sides in measurements for both the width (P=0.05) and the angle (P

In this study, we evaluated 70 limbs in 42 women with anterior knee pain. We investigated tibial tubercle position and patellar height indices as indicators of malalignment. Tibial tubercle rotation angles were determined by computed tomography, and patellar height indicators, Insall-Salvati, modified Insall-Salvati, Caton, and Blackburne indices were calculated on lateral knee roentgenograms. The results were compared to values obtained from 80 limbs in 40 healthy female volunteers. Tibial tubercle rotation angle was 68.1° (±3.6) in the study group and 70.3° (±3.8) in the control group. The difference was statistically significant (P< 0.01). Patellar height indicators were not statistically different between the two groups. These results suggested that patellar height is not a malalignment indicator in female patients with anterior knee pain. These patients should be investigated by computed tomography to determine tibial tubercle position. Clin. Anat. 13:199–203, 2000. © 2000 Wiley-Liss, Inc.

We describe a new instrument and a percutaneous technique for closed anterior fixation of odontoid fracture. The instrument which we developed consists of a telescopic tube system. This new instrument and closed fixation technique was used in six cadavers with type II odontoid fractures and to two cadavers with an intact odontoid process. Each cadaver underwent satisfactory placement of the screw to the odontoid with this technique under biplanar scopy control. After this procedure, no serious injury was found in the parapharyngeal and neurovascular areas of the necks of the cadavers, in which anatomical dissection along the track of this instrument was performed. The instrumentation and the technique as a whole is seen as reliably applicable for odontoid fracture fixation. Also, we expect to reduce operating time and hospital costs because this system is simple, easily applicable and minimally invasive.

The dorsolateral, suboccipital, transcondylar technique was used in this cadaveric study. The angle and distance measurements in the corridors were taken intradurally both superior and inferior of the foramen magnum level. In the first stage of this study, the findings which were gained from the standard lateral suboccipital approach were compared with the findings after condyle and lateral atlantal mass removal. After condylectomy, the approach to anterior foramen magnum via both corridors was found to be shorter and the lateral angle of the exposure of the anterior foramen magnum was found to be wider. The considerable shortening of the distances to the anterior foramen magnum, especially in the superior corridor, emphasises the necessity of combining standard approaches with condylectomy. In addition, it was found that after condylectomy, considerable widening of both transverse and longitudinal planes in the inferior corridor allows the surgeon greater access to work on lesions. Furthermore, the freed space between the superior corridor and the interior corridor, which was gained by condylectomy, shows that condylectomy provides a combined approach to the inferior and superior parts of the foramen magnum anteriorly.

Lomber pleksus'un proksimal iletim zamanının değerlendirilmesi, klinik nörofizyolojinin önemli sorunlarından birisidir. Bu çalışmada, genellikle yapıldığı gibi, lomber pleksusun sadece distal parçasını araştırmak yerine, hem distal hem proksimal parçasını araştırmayı amaçladık. Bu çalışmada 109 sağlıklı erişkin olguda, periferik elektrik uyarım ve lomber manyetik uyarımla genitofemoral, obturator ve femoral sinirin motor iletim zamanı ölçülerek, ayrıca adduktor ve kuadriseps kas grubunda H refleksi metodu kullanarak farklı proksimal ileti metotları çalışıldı. Çalışmanın anatomik kısmı 20 yetişkin kadavrada femoral, obturator, genitofemoral sinir ve proksimal kökler diseke edilerek uygulandı. Ligamentum inguinale'den spinal seviyeye ortalama toplam mesafe femoral sinirde 392.4±13.3mm, obturator sinirde yaklaşık olarak 382.8±11.1, genitofemoral sinirde ise 353.1±12.5mm olarak ölçüldü. H- refleksi metodu ile, kadavradan elde edilen mesafe kullanılarak femoral ve obturator sinirin proksimal iletim zamanı 62.5±6.1 ve 53.6±7.4 m/sn olarak saptandı. Periferik elektrik uyarım ve lomber manyetik uyarım ile femoral, obturator ve genitofemoral sinirin proksimal ileti hızı sırası ile 59.1±13.3, 52.7±14.9, 58.7±0.8 m/sn olarak ölçüldü. Her iki metotla da proksimal ileti hızları arasında istatistiksel olarak farklılık gözlenmedi. Her iki yaklaşım da olgulara göre proksimal ileti hızını değerlendirmek için tercih edilebilir., 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.

To evaluate the effect of renal denervation and serum nitric oxide level with a different time course of renal ischemia-reperfusion injury.Thirty-six male Wistar rats were randomized into 6 groups. All rats underwent right nephrectomy to create a single kidney model. Renal denervated and innerved rats were subjected to renal clamping for 30-60 minutes. The study was performed in the Department of Anatomy, Akdeniz University, Antalya, Turkey, between June and November 2005.Combined effect of denervation and ischemia may caused significant increase in serum nitric oxide levels and decrease in glomerular filtration rates.Our results indicate that kidney denervation did not cause any changes in renal functions, but with ischemia it worsens the deleterious effect of ischemia-reperfusion injury, and causes a significant increase in serum nitric oxide levels.

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.

Pierre Mollaret was a French physician who made various significant contributions to neurology and infectious diseases. He was born in Auxerre, France in 1898. In 1916, he began to study medicine and science but his education was interrupted by World War I. During 1917 and 1918, he served as an assistant physician and was decorated with the Croix de Guerre when the war ended. He resumed his medical studies in 1920 and received his degree in science in 1926. During his education, one of his teachers was Professor Georges Charles Guillian (1876–1961; Guillian of the Guillian–Barre syndrome), with whom Mollaret worked …

During the routine dissection studies on the right side of a 56-year-old female cadaver we encountered co-existence of the pectoralis quartus and pectoralis intermedius muscles. The pectoralis quartus originated from the costochondral junction of the fifth and sixth ribs, and then extended laterally under the border of pectoralis major muscle, but it was entirely separate from it. The pectoralis quartus formed a long flat band with an average width of 1.5 cm. It then inserted as an aponeurosis to the both of lateral lip of the intertubercular groove of the humerus and tendon of the short head of the biceps brachii muscle. Furthermore, the pectoralis intermedius muscle was a fleshy slip between the pectoralis minor and pectoralis quartus muscles and arose from the third and fourth ribs. It then united to the tendon of the short head of the biceps brachii muscle two cm below the coracoid process.

To analyze the anatomical basis of the scapula, acromion, os acromiale, coracoid process, coraco-acromial arch, and glenoid cavity in Turkish adults.We performed the study at the Faculty of Medicine, Akdeniz University, Turkey between January 2004 and December 2005. A total of 90 dry bones of the scapula from human cadavers were randomly selected. The length, width, and anterior thickness of the acromion and the acromial facet of the acromioclavicular joint were measured with an electronic caliber and was examined visually. For the radiological evaluation, the posterior anterior and the lateral shoulder radiographs of 90 consecutive adult patients with normal findings were used. These films were evaluated and grouped according to the acromial arch morphology.The distribution of the acromial morphologic types according to slope was type I (flat) 10%, type II (curved) 73%, type III (hooked) 17%. Type I was seen in 11%, type II 66%, type III 23% of the specimens. The morphological shape of the tip of the acromion was 31% cobra shaped, 13% square shaped, and 56% intermediate type. The scapulas, coracoid process and the coraco acromial arch were measured. In 72% of the specimen, the glenoid notch of the scapulas were absent and oval shaped, whereas in 28% the notch was well expressed and the glenoid cavity was pear shaped. The mean vertical length of the glenoid cavity was 36.3 +/- 3 mm, and the mean transverse length was 24.6 +/- 2.5 mm. Os acromiale is a rare anatomical condition. Its incidence has been documented in radiographic and anatomical studies to be between 1-15%. The presence of os acromiale was 1% in shoulder radiographs (os pre-acromiale), and in dry bones (os meta-acromiale)We reported the exact morphological measurements of the bone structures of the scapula in Turkish adult population. Our results present an instructive figures of anatomical preparations and radiological cases that can be used to make a more precise radiological and a differential diagnoses.