Effects of chronic neck pain on grip strength and psychomotor skills in adults.

BACKGROUND: It can be challenging to perform activities of daily living in patients with chronic neck pain. As the severity of the pain increases, the quality of the movements decreases. Not only the neck, but also the shoulder, elbow, grip strength and psychomotor skills are affected by these pains. OBJECTIVE: In this study, it was aimed to investigate the effect of neck pain on grip strength and psychomotor skills in adults diagnosed with chronic neck pain. METHODS: A cross-sectional study was conducted to examine the effect of pain on grip strength and psychomotor skills in patients with chronic neck pain. This study was planned to be carried out between October 2019 and May 2020 at the Private Yasam Medical Center in Adana, with the official permission of the institution manager, but this period was carried out between October 2019 and November 2020 due to the fact that sufficient number of patients could not be reached due to the COVID-19 global epidemic. A total of 80 individuals, including 40 control and 40 patients, were included in the study. Forty adult patients who applied to the clinic with a diagnosis of chronic neck pain and 40 healthy adults without a diagnosis of chronic neck pain were included in the study. Conducted with 80 adults between the age of 19 and 74 years old. Individuals were divided into Group 1-control group (n = 40) and Group 2-patient group (n&#x02009;=&#x02009;40). Information such as age, height, body weight and occupation of the groups were noted. Visual analogue scale and Neck Disability Index were applied to both the groups; hand grip strength with a Jamar hydraulic hand dynamometer, finger lateral grip strength with a pinchmeter and psychomotor skills with the Purdue Pegboard test were evaluated. RESULTS: In the study, hand grip strength (p < .05), finger lateral grip strength (p < .05), psychomotor skills (p < .01) showed a statistically significant decrease in the patient group compared to the control group. CONCLUSION: It is thought that in addition to the routine treatments for neck pain in the treatment plan of patients with chronic neck pain, exercises to improve the functionality and psychomotor skills in daily living activities can be included in the direction of increasing the grip strength and will guide future studies.

Investigation of the morphometric characteristics of internal carotid artery between sexes and in patients with intracranial aneurysms.

PURPOSE: The purpose of this study is to investigate the morphometric properties of the internal carotid artery (ICA) by measuring the diameters and angles of its segments and exploring variations related to sex and the presence of aneurysms. METHODS: Digital subtraction angiography (DSA) images were utilized from 130 aneurysm patients and 75 non-aneurysm individuals to create 3D ICA models using 3D Slicer software. Segment diameters were measured via Autodesk Meshmixer 3.5.474 and angles were evaluated using ImageJ software. RESULTS: In total, DSA images of 130 aneurysm patients and 75 individuals with normally reported carotid systems were evaluated. It was found that the intracranial aneurysms (IAs) were predominantly formed on the anterior cerebral artery (ACA) in males (%43), whereas in females IAs were frequently localized in the C6 segment (31.7%) and middle cerebral artery (MCA) (30.2%). In the control group, the evaluation of gender differences in segment diameters and angles revealed that males had significantly larger C4 and C5 segment diameters (4.62 vs. 4.32 mm and 4.41 vs. 4.09 mm, respectively) and a greater C6 angle (146.9° vs. 139.7°) compared to females. Comparisons between patients with an aneurysm at the anterior cerebral artery (ACA) and the control group revealed that the ACA group had wider diameters in the C1 (4.88 vs. 4.53 mm), C3 (4.65 vs. 4.4 mm), C5 (4.51 vs. 4.25 mm), and ACA (2.36 vs. 2.06 mm) segments. Additionally, the ACA group had wider angles in the ACA (104.1° vs. 94.1°) and C6 segments (147.7° vs. 143.3°), whereas the control group exhibited wider angles in the middle cerebral artery (MCA) segment (141.5° vs. 135.5°) compared to the ACA aneurysm group. Patients with anterior cerebral artery (ACA) aneurysms exhibited larger diameters in C1, C3, C5, C6, and ACA segments compared to the control group. Additionally, while the control group had larger MCA angle, patients with ACA aneurysms had larger angles in C6 segment and ACA. CONCLUSION: Our results demonstrated that formation of aneurysms is affected by anatomical configuration of the ICA as well as sex characteristics, particularly regarding the ACA and MCA bifurcation angles, which showed associations with aneurysms in the respective branches.

Three-Dimensional (3D) Analysis of Orbital Morphometry in Healthy Anatolian Adults: Sex, Side Discrepancies, and Clinical Relevance.

Background and objective The complex structural integrity of the orbit is crucial for visual functions. Three-dimensional (3D) reconstructions from radiological images have revolutionized anatomical understanding, eliminating the limitations of two-dimensional (2D) imaging and offering intricate spatial details for complex structures. The aim of this study was to analyze the detailed morphometry of the orbit in healthy Anatolian adults, considering sex, side discrepancies, and clinical relevance using 3D models reconstructed from multidetector computed tomography (MDCT) images. Materials and methods Fifty-six (44.44%) males and 70 (55.56%) females (total: 126, mean age: 48.62) MDCT images were randomly selected and 3D skull models were reconstructed using 3D Slicer software. Measurements were conducted in millimeters (mm) for transverse and vertical diameters, circumference of the orbital opening, orbital wall lengths, as well as intraorbital and extraorbital distances. Results The method of measurements showed high reproducibility of results. The mean values for transverse and vertical diameters, circumference of the orbital opening, medial and lateral wall lengths, roof and floor lengths, and intraorbital and extraorbital distances were 40.23±2.12 mm (p<0.001), 34.94±2.16 mm (p=0.365), 44.74 ±3.02 mm (p<0.001), 46.30±2.69 mm (p<0.001), 51.26±2.91 mm (p<0.001), 49.01±3.22 mm (p<0.001), 126.10±5.71 mm (p<0.001), 19.63±2.35 mm (p=0.026), and 94.09±4.84 mm (p<0.001), respectively. Conclusion The study's high measurement reproducibility contributes significantly to the existing literature and clinical practice. These findings offer specific insights into Anatolian orbital morphometry, aiding in surgical planning, implant placement, and diagnostic assessments. The precise measurement values serve as a reliable reference for clinicians, facilitating the identification of normal and abnormal orbital anatomy and enhancing patient care. We believe this study provides valuable data for craniofacial and ophthalmological research, benefiting both clinical practice and future research endeavors in these fields.

Evaluation of lumbar lordosis in symptomatic individuals and comparative analysis of six different techniques: a retrospective radiologic study.

PURPOSE: The aim of this study; evaluate lumbar lordosis (LL) in symptomatic individuals with six different techniques and to examine the techniques comparatively. Thus, to provide an overview of lumbal lordosis and techniques. METHODS: Cobb L1-L5, Cobb L1-S1, Posterior Tangent, tangential radiologic assessment of lumbar lordosis (TRALL), vertebral centroid measurement of lumbar lordosis (CLL) and Risser Ferguson measurement techniques were used to assess LL from radiographs of 175 symptomatic adults. Correlations between techniques and relationship between the measurements obtained, gender and age were analyzed. Also interclass correlation (ICC) analyzed. Bland-Altman plots were performed to compare the techniques with Cobb. RESULTS: ICC for all methods were greater than 0.96. For each method, no difference in LL was observed with respect to gender or age (p > 0.05). High positive correlation was observed between the Risser Ferguson, Posterior Tangent, Cobb L1-L5, Cobb L1-S1 and CLL techniques (p < 0.001), and moderate positive correlation between TRALL and all other techniques (p < 0.001). CONCLUSION: In this study, it was found that the mean lumbar lordosis values of symptomatic participants were lower than most of the other asymptomatic studies in the literature and there was no significant difference in lumbar lordosis values in terms of gender and age in symptomatic individuals. Based on statistical findings, Risser Ferguson can be used to assess LL. These results and the data obtained as a result of the comparative examination of techniques according to age groups and gender will benefit clinicians and those working in the field by providing a better understanding LL.

Morphometric analysis of the infratemporal fossa using three-dimensional (3D) digital models.

PURPOSE: The infratemporal fossa contains important neurovascular components and is directly related to other anatomical regions and structures. The morphometric distances between the bones forming its borders have not been thoroughly investigated. The aim of this study was to determine the morphometry of the infratemporal fossa. METHODS: 3D models of the skull of 83 individuals were reconstructed from DICOM datasets, from which length, depth and width measurements were determined and compared between genders and the right and left sides. RESULTS: All measurements obtained were significantly different between males and females. There were also significant differences between the left and right sides for depth and width measurements. CONCLUSION: This is the first study to determine and investigate measurements of the infratemporal fossa; as such it provides a comprehensive view of the morphology of the fossa. It provides valuable information for surgical interventions and differential diagnoses of pathologies in this region, as well as enhancing its understanding in medical education.

Vitamin D3 Promotes Structural and Functional Recovery After Vincristine-Induced Peripheral Neuropathy in Rats: An Experimental Study.

Background Vincristine-induced peripheral neuropathy (VIPN) is a distal axonopathy characterized by the loss of distal myelinated axons. This study aimed to assess the potential neuroregenerative roles of vitamin D3 using functional and electron microscopic analyses in a rat model of VIPN. Methodology A total of 40 female Wistar rats were randomly divided into four main groups: Group 1 (control, n = 10), Group 2 (vincristine, n = 10), Group 3 (vincristine + vitamin D3, n = 10), and Group 4 (vincristine + vehicle, n = 10). Vincristine was administered intraperitoneally at a dose of 0.15 mg/kg, for two weeks, to induce peripheral neuropathy. Following successful induction, vitamin D3 (500 IU/kg/day) and vehicle treatments were applied weekly over four weeks. Structural (electron microscopic analysis) and functional analysis (von Frey test, pinch test, and electrophysiological analysis) were performed to assess functional recovery after peripheral nerve impairment. Results Withdrawal responses to mechanical allodynia and pinch tests were significantly higher in the vitamin D3-treated group (P < 0.05). The electrophysiological analysis also supported these results. Electron microscopic evaluation revealed that the remyelinated nerve fibers in the vitamin D3-treated group (Group 3) had thick myelin sheaths and normal axonal morphology. Conclusions Our study demonstrated that vitamin D3 could promote functional and structural recovery in a rat model of VIPN. Further studies should be conducted to elucidate the underlying mechanisms by which vitamin D3 exerts its regenerative effects in VIPN, using alternative administration protocols.

Extracranial landmarks for surgical skull base approaches / Puntos de referencia extracraneales para abordajes quirúrgicos de la base del cráneo

SUMMARY: Surgical operations regarding to skull base are challenging and reliable anatomical landmarks are required. There is a lack of knowledge on anatomical variations in this region. The aim of this study was to determine the safe extracranial landmarks for surgical approach to the skull base. In this study, 23 adult dry skulls were evaluated: the age and sex of the specimens were unknown. All measurements were taken from external surface of inferior aspect of the skull by using digital calipers accurate to 0.01 mm. In right and left sides; the distances between the external acoustic meatus (EAM) and the following anatomical landmarks were measured: articular tubercle (AT); anterior margin of squamous suture (ASS); superior margin of squamous suture (SSS); posterior margin of squamous suture (PSS); end point of styloid process (SP); midpoints of pterygomaxillary fissure (PMF); foramen ovale (FO); foramen spinosum (FS); and of carotid canal (CC).The distances of the external acoustic meatus to the anatomical structures on the right and left sides were: EAM-SP; 24.24±3.19 mm, 23.16±3.17 mm; EAM-PMF; 46.56±4.51mm, 46.25±3.96 mm; EAM-FO; 27.57±2.87 mm, 28.70±2.85 mm; EAM-FS; 22.53±3.19 mm, 22.72±3.47 mm; EAM-CC; 17.35±3.56 mm, 17.19±3.39 mm; EAM-AT; 19.31±3.79 mm, 18.95±3.42 mm; EAM-ASS; 43.14±4.80 mm, 46.82±4.61 mm; EAM-SSS; 49.17±4.74 mm, 48.83±3.34 mm and EAM-PSS; 36.15±4.24 mm, 35.39±4.25 mm, respectively. We think that the findings obtained from this study related to external acoustic meatus can be an important reference for surgical anatomy and surgical procedures in skull base.

RESUMEN: Las cirugías relacionadas con la base del cráneo son un desafío, las cuales requieren puntos de referencia anatómicos confiables. Existe una falta de conocimiento sobre las variaciones anatómicas en esta región. El objetivo de este estudio fue determinar los puntos de referencia extracraneales seguros para el abordaje quirúrgico de la base del cráneo. En este estudio se evaluaron 23 cráneos secos adultos: se desconocía la edad y el sexo de los ejemplares. Las medidas se tomaron de la superficie externa de la cara inferior del cráneo utilizando calibradores digitales con una precisión de 0,01 mm. En lados derecho e izquierdo se midieron las distancias entre el meato acústico externo (MAE) y los siguientes puntos de referencia anatómicos: tubérculo articular (TA); margen anterior de la sutura escamosa (MASE); margen superior de sutura escamosa (MSSE); margen posterior de sutura escamosa (MPSE); punto final del proceso estiloides (PFPE); puntos medios de la fisura pterigomaxilar (PMFP); foramen oval (FO); foramen espinoso (FE); y del canal carotídeo (CC). Las distancias del meato acústico externo a las estructuras anatómicas de los lados derecho e izquierdo fue- ron: MAE-PFPE; 24,24 ± 3,19 mm, 23,16 ± 3,17 mm; MAE-PMFP; 46,56 ± 4,51 mm, 46,25 ± 3,96 mm; MAE-FO; 27,57 ± 2,87 mm, 28,70 ± 2,85 mm; MAE-FE; 22,53 ± 3,19 mm, 22,72 ± 3,47 mm; MAE-CC; 17,35 ± 3,56 mm, 17,19 ± 3,39 mm; MAE-TA; 19,31 ± 3,79 mm, 18,95 ± 3,42 mm; MAE-MASE; 43,14 ± 4,80 mm, 46,82 ± 4,61 mm; MAE-MSSE; 49,17 ± 4,74 mm, 48,83 ± 3,34 mm y MAE-MPSE; 36,15 ± 4,24 mm, 35,39 ± 4,25 mm, respectivamente. Creemos que los hallazgos obtenidos de este estudio relacionados con el meato acústico externo pueden ser una referencia importante para la anatomía quirúrgica y los procedimientos quirúrgicos en la base del cráneo.

Vitamin D as a Potential Agent for Ischemic Axonal Regeneration after Epineurial Devascularization of the Sciatic Nerve.

BACKGROUND: Although vitamin D has several noncalcemic functions particularly on nervous system, its neuroregenerative roles on ischemic peripheral nerve injury has not been reported. In this study, it was aimed to investigate the effect of vitamin D3 after epineurial devascularization of the sciatic nerve. METHODS: Forty adult female Wistar rats were randomly divided into four groups: Group 1 (Control), Group 2 (Sham-operated), Group 3 (Epineurial devascularization + vitamin D3 treatment), Group 4 (Epineurial devascularization + vehicle treatment). Recovery of the sciatic nerve was analyzed by functional (sciatic functional index, pinch test and biochemical analyses) and morphological (electron microscopic analysis and wet muscle weight analysis) methods. RESULTS: Comparison of the data revealed that vitamin D3 administration had a beneficial effect on regeneration after epineurial devascularization. CONCLUSION: We suggest that vitamin D3 is an effective agent in the prevention of ischemic peripheral nerve insults.

Assessment of scapular morphometry / Evaluación de la morfometría escapular

The current study was undertaken to assess the incidence of different types of suprascapular notch, acromion dimensions and the lower and upper scapular angles. The suprascapular notch and variations of the acromion are clinically important in suprascapular nerve compression and subacromial impingement. Measurements were taken from 73 Anatolian dry scapulae of unknown age or sex. The suprascapuar notch was classified according to that of Rengachary et al. (1979). Its width and depth, the distance between supraglenoid tubercle and the deepest point of notch, as well as the upper and lower scapular angles were also determine measured. The type of acromion was assessed according to shape (type I (cobra), type II (square), type III (intermediate)) and tilt (type I (flat), type II (curve). Acrmion length and the distance between acromion and coracoid process were also measured. The frequency of different types of suprascapular notch were type I (28.8 %), type II (23.3 %), type III (13.7 %), type IV (20.5 %), type V (2.7 %), type VI (5.5 %)and absence (5.5 %). Acromion type were type I (45.5 %), type II (7.5 %) and type III (47.0 %), acromion tilt type I (15.2 %), and type II (84.8 %). An understanding of the association between the anatomical structures of the scapula and morphometric measurements is clinically important.

En este trabajo se evaluó la incidencia de diferentes tipos de incisura supraescapular, dimensiones de acromion y los ángulos escapulares superior e inferior. La incisura supraescapular y las variaciones del acromion son clínicamente importantes en la compresión del nervio supraescapular y el pinzamiento subacromial. Las mediciones se tomaron de 73 escápulas secas de Anatolia, de edad y sexo desconocidos. La incisura supraescapular se clasificó según Rengachary et al. (1979). Se determinaron también el ancho y la profundidad, la distancia entre el tubérculo supraglenoide y el punto más profundo de la incisura, así como los ángulos escapulares superior e inferior. El tipo de acromion se evaluó de acuerdo con la forma [tipo I (cobra), tipo II (cuadrado), tipo III (intermedio)] y la inclinación [tipo I (plano), tipo II (curvo)]. También se midieron la longitud del elemento y la distancia entre el acromion, como así también el proceso coracoide. La frecuencia de los diferentes tipos de incisura supraescapular fueron: tipo I (28,8 %), tipo II (23,3 %), tipo III (13,7 %), tipo IV (20,5 %), tipo V (2,7 %), tipo VI (5,5 %) y ausencia (5,5 %). Los tipos de acromion fueron: tipo I (45,5 %), tipo II (7,5 %) y tipo III (47,0 %), tipo de inclinación de acromion I (15,2 %) y tipo II (84,8 %). En conclusión, el conocimiento de la asociación entre las estructuras anatómicas de la escápula y las mediciones morfométricas es clínicamente importante.

Anatomy and clinical importance of the extracranial clivus and surrounding structures / Anatomía e importancia clínica del clivus extracraneal y las estructuras circundantes

The aim of this study was to reveal the clinical importance of measurements taken from the pharyngeal tubercle (PT) to various anatomical structures around the extracranial clivus. Twenty-six adult dry Anatolian skulls were examined. The extracranial clivus and PT were used as landmarks from which various distances were measured using a digital caliper accurate to 0.01 mm. The following mean distances from the PT were observed; foramen lacerum (FL) (L: 17.15 mm, R: 17.4 mm) ; medial external margin of the carotid canal (CC) (L: 26.7 mm, R: 27.5 mm); anterior tip of occipital condyle (OC) (L: 16.4 mm, R: 16.3 mm); anterior margin of foramen magnum (FM) (10.8 mm); foramen ovale (FO) (L: 25.9 mm, R: 29.1); medial margin of the jugular fossa (JF) (L: 25.4 mm, R: 25.7 mm); medial external margin of the hypoglossal canal (HC) (L: 20.0 mm, R: 19.9 mm). Mean bilateral distances were: LFO-RFO: 45.34 mm; LFL-RFL: 20.1 mm; LCC-RCC: 52.1 mm; LOC-ROC: 17.6 mm; LJF-RJF: 45.2 mm; LHC-RHC: 33.5 mm. The following mean distances were observed from the FM: FM-OC (L: 8.3 mm, R: 9.3 mm); FM-HC (L: 17.8 mm, R: 17.4 mm). Also the mean distance of OC-HC were observed (L: 11.7 mm, R: 11.4 mm). Present measurements suggest that the PT can be used as an anatomical landmark during surgery involving clival pathology. However, the anatomy and variations of the extracranial clivus and surrounding structures must be taken into consideration.

El objetivo de este estudio fue revelar la importancia clínica de las mediciones tomadas desde el tubérculo faríngeo (TF) a diversas estructuras anatómicas alrededor del clivus extracraneal. Veintiséis cráneos, secos adultos, de Anatolia, fueron examinados. El clivus extracraneal y TF se utilizaron como puntos de referencia a partir de los cuales se midieron varias distancias con un calibrador digital con una precisión de 0,01 mm. Se observaron las siguientes distancias medias del TF: foramen lacerum (FL) (L: 17.15 mm, R: 17,4 mm); margen externo medial del canal carotídeo (CC) (L: 26,7 mm, R: 27,5 mm); parte anterior del cóndilo occipital (OC) (L: 16,4 mm, R: 16,3 mm); margen anterior del foramen magnum (FM) (10,8 mm); foramen oval (FO) (L: 25,9 mm, R: 29,1); margen medial de la fosa yugular (FY) (L: 25,4 mm, R: 25,7 mm); margen medial del canal hipogloso (CH) (L: 20,0 mm, R: 19,9 mm). Las distancias bilaterales medias fueron: LFO-RFO: 45,34 mm; LFLRFL: 20,1 mm; LCC-RCC: 52,1 mm; LOC-ROC: 17,6 mm; LJFRJF: 45,2 mm; LHC-RHC: 33,5 mm. Se observaron las siguientes distancias medias de la FM: FM-OC (L: 8,3 mm, R: 9,3 mm); FMCH (L: 17,8 mm, R: 17,4 mm). También se observó la distancia media de OC-CH (L: 11,7 mm, R: 11,4 mm). Las mediciones actuales sugieren que el TF puede ser utilizado como un hito anatómico durante la cirugía que involucra la patología clival. Sin embargo, se deben tener en cuenta la anatomía y las variaciones del clivus extracraneal y las estructuras circundantes.

Upper and lower lip soft tissue thicknesses differ in relation to age and sex / Grosores de los tejidos blandos de los labios superior e inferior difieren en relación con la edad y el sexo

This study was performed to determine age- and sex-related differences in lip thickness. Lateral cephalometric images of 220 healthy individuals were taken and the thicknesses of the upper and lower lips were measured. The measurements were performed in three different age groups. Our results indicate that the lower lip thickness, as well as the distance between the most anterior point of contact between the upper and lower lips and the most protruding point of the upper incisor teeth, differed between the two sexes. The lips of males were thicker than those of females. Receiver operating curve analysis was performed to determine the cutoff values to differentiate thickness between males and females. Our results showed that knowledge of upper and lower lips thickness in relation to age and sex may be beneficial to forensic anthropologists, to plastic and reconstructive surgeons, and to orthodontists for more detailed examination, effective treatment, and optimised outcomes.

Este estudio se realizó para determinar las diferencias en el grosor de los labios relacionadas con la edad y el sexo. Se tomaron imágenes cefalométricas laterales de 220 individuos sanos y se midió el grosor de los labios superior e inferior. Las mediciones se realizaron en tres grupos de edades diferentes. Nuestros resultados indicaron que el grosor del labio inferior, así como la distancia entre el punto más anterior de contacto, entre los labios superior e inferior y el punto más sobresaliente de los dientes incisivos superiores, difieren entre los dos sexos. Los labios de los hombres eran más gruesos que los de las mujeres. Se realizó un análisis de la curva de operación del receptor para determinar los valores de corte para diferenciar el espesor entre hombres y mujeres. Nuestros resultados demostraron que el conocimiento del grosor de los labios, superior e inferior, en relación con la edad y el sexo puede ser beneficioso para los antropólogos forenses, cirujanos plásticos y reconstructivos y para los ortodoncistas al momento de realizar un examen detallado, e implemantar un tratamiento más eficaz, alcanzando resultados optimizados.

The effect of alendronate sodium on trabecular bone structure in an osteoporotic rat model.

OBJECTIVES: TObjectives: This study aims to investigate the effect of alendronate sodium on trabecular bone structure in an osteoporotic rat model. MATERIALS AND METHODS: Between May 2006 and July 2006, 60 female Wistar Albino rats aged three months were randomly allocated to three groups: sham operated receiving no treatment (Shm); ovariectomized-alendronate receiving 1 mg/kg/day alendronate sodium (Ovx-A), and ovariectomized-vehicle receiving 1 mL/kg/day physiological saline (Ovx-PS). Both Ovx groups received treatment through gastric gavage for 56 days. RESULTS: Densitometric measurements showed that bone mineral density decreased in the Ovx-PS and increased in Ovx-A groups (p<0.05). Biomechanical measurements showed a decrease in the breaking force in the Ovx-PS group and an increase in the Ovx-A group (p<0.05). Histomorphometric measurements showed that the Shm group had normal trabecular structure, while the Ovx-PS group had a less well- formed trabecular structure with a loss in the trabecular number and thickness and a corresponding increase in the trabecular spacing (p<0.05). In the Ovx-A group, there was an improvement in the trabecular structure with an increase in the trabecular number and thickness and a loss in the trabecular space (p<0.05). CONCLUSION: Our study results suggest that alendronate sodium is a valuable treatment agent for osteoporosis in postmenopausal women.

Morphometric measurement and types of articular facets on the talus and calcaneus in an Anatolian population / Mediciones morfométricas y tipos de facetas articulares en el talus y calcáneo de una población Anatolia

Anatomical variations in terms of ligamentous attachments, articulations and bony morphology are common in the subtalar region. The shape of the articular facets of the talus and calcaneus and their relationship to each other are important for joint function and surgical procedures. In this study an assessment of the morphology of the articular facets of the talus and calcaneus, in an Anatolian population, was undertaken. 49 tali and 57 calcanei from Anatolian adults of unknown gender were examined. The types of articular facets on the talus and calcaneus were determined using the following classification: Type A1, the distance between the anterior and middle facets was less than 2 mm; Type A2, the distance between the anterior and middle facets was 2-5 mm; Type A3, the distance between the anterior and middle facets was more than 5 mm; Type A4, there was only one articular facet; Type B1, the separation between the anterior and middle facets was not complete; Type B2, separation of the anterior and middle facets was present; Type C, no separation between the anterior, middle and posterior facets was present, i.e. there was one articular facet. In addition, the anteroposterior length and width of the talus and calcaneus, together with the width, length and depth of sulcus tali and sulcus calcanei were determined. Left and right tali, respectively, displayed the folowing types of articular facet: A1, 0 %, 0 %; A2, 0 %, 3,4 %; A3, 0 %, 0 %; A4, 0 %, 0 %; B1, 60 %, 51,8 %; and B2, 40 %, 44.8 %. Articular facets on left and right calcanei, respectively, were: A1, 10 %, 7.4 %; A2, 10 %, 14.8 %; A3, 16.7 %, 11.1 %; A4, 3.3 %, 3.7 %; B1, 30 %, 22.2 %; B2, 30 %, 40.8 %. The length and width of left and right tali were 50.5±3.81 mm and 39.5±2.97 mm, and 53.1±4.38 mm and 39.3±3.66 mm, respectively. The width, length and depth of left and right sulcus tali were: 5.2±1.09 mm, 21.7±2.73 mm and 5.7±0.84 mm, and 6.1±2.05 mm, 21.1±3.66 mm and 5.7±1.52 mm, respectively. For left and right calcanei length and width were; 76.1±5.44 mm 44.0±3.97 mm, and 75.7±6.76 mm and 45.9±4.21 mm, respectively. The width, length and depth of left and right sulcus calcanei were: 6.4±1.19 mm, 31.9±2.76 mm and 4.0±0.81 mm, and 5.5±1.00 mm, 32.4±3.23 mm and 4.4±1.05 mm, respectively. The articular facets on both the talus and calcaneus in the Anatolian population studied was predominantly type B. This observations is similar to previous reports conducted in America, India and Africa, but differ from those undertaken in Europe. A knowledge of variations of the articular facets of the talus and calcaneus provides a valuable road map for orthopaedic surgeons, as well as others involved in foot rehabilitation.

Las variaciones anatómicas de ligamentos, articulaciones y morfología ósea son comunes en la región subtalar. La forma de las facetas articulares del talus y calcáneo y su relación mutua son importantes para la función articular y los procedimientos quirúrgicos. En este estudio se realizó una evaluación de la morfología de las facetas articulares del talus y del calcáneo en una población de Anatolia. Se examinaron 49 talus y 57 calcáneos de individuos adultos anatolios de sexo no conocido. Se clasificaron las facetas articulares del talus y el calcáneo de la siguiente manera: Tipo A1, la distancia entre las facetas anterior y media fue inferior a 2 mm; Tipo A2, la distancia entre las facetas anterior y media fue de 2-5 mm; Tipo A3, la distancia entre las facetas anterior y media fue de más de 5 mm; Tipo A4, sólo había una faceta articular; Tipo B1, la separación entre las facetas anterior y media no fue completa; Tipo B2, la separación de las facetas anterior y media estaba presente; Tipo C, no existía separación entre las facetas anterior, media y posterior, es decir, había una faceta articular. Además, se determinó la longitud anteroposterior y el ancho del talus y del calcáneo, junto con el ancho, la longitud y la profundidad del surco talar y del surco del calcáneo. Los talus izquierdo y derecho, respectivamente, mostraron los siguientes tipos de faceta articular: A1, 0 %, 0 %; A2, 0 %, 3,4 %; A3, 0 %, 0 %; A4, 0 %, 0 %; B1, 60 %, 51,8 %; B2, 40 %, 44,8 %. Las facetas articulares de los calcáneos izquierdo y derecho, respectivamente, fueron: A1, 10 %, 7,4 %; A2, 10 %, 14,8 %; A3, 16,7 %, 11,1 %; A4, 3,3 %, 3,7 %; B1, 30 %, 22,2 %; B2, 30 %, 40,8 %. La longitud y el ancho de talus izquierdo y derecho fueron 50,5±3,81 mm y 39,5±2,97 mm, y 53,1±4,38 mm y 39,3±3,66 mm, respectivamente. El ancho, la longitud y la profundidad del surco talar izquierdo y derecho fueron: 5,2±1,09 mm, 21,7 ± 2,73 mm y 5,7±0,84 mm, y 6,1±2,05 mm, 21,1±3,66 mm y 5,7±1,52 mm, respectivamente. Para el calcáneo izquierdo y derecho, la longitud y ancho fueron: 76,1±5,44 mm 44,0±3,97 mm y 75,7±6,76 mm y 45,9±4,21 mm, respectivamente. El ancho, longitud y profundidad del surco del calcáneo izquierdo y derecho fueron: 6,4±1,19 mm, 31,9±2,76 mm y 4,0±0,81 mm, y 5,5±1,00 mm, 32,4±3,23 mm y 4,4±1,05 mm, respectivamente. Las facetas articulares, tanto en el talus como en el calcáneo en la población de Anatolia estudiada, eran predominantemente de tipo B. Estas observaciones son similares a reportes previos realizados en América, India y África, pero difieren de los realizados en Europa. Un conocimiento de las variaciones de las facetas articulares del talus y del calcáneo proporciona una valiosa hoja de ruta para los cirujanos ortopédicos, así como otros involucrados en la rehabilitación de los pies.

Evaluation of face shape in Turkish individuals / Evaluacion de la forma de la cara en individuos turcos

The aim of this study was to determine the types of face shape in the Turkish population. Knowledge on face shape is important in anthropology and for planning medical procedures such as in aesthetic, maxillofacial and orthodontic surgery. The study group consisted of 1003 healthy subjects (470 male, 533 female) aged 18­68 years. Mean height, weight and body mass index (BMI) were 1.74 m, 78.65 Kg, 25.80±3.50 kg/m2 and 1.62 m, 60.55 kg, 22.87±3.49 kg/m2 in males and females, respectively. Face length (FL; the distance from nasion to gnathion) and face width (FW; bizygomatic breadth) were measured, from which a Prosopic Index (PI) was determined using the following formula: (PI= FL/FW x 100). The types of face shape were classified according to Banister's classification Type I (hypereuryprosopic), Type II (euryprosopic), Type III (mesoprosopic), Type IV (leptoprosopic), Type V (hyperleptoprosopic) in both males and females. PI was 84.31 (FL: 12.07 cm; FW: 14.34 cm) in males and 85.25 (FL: 11.30 cm; FW: 13.28 cm) in females. In males and females Type I face shape was observed in 18.1 % and 15.6 %; Type II in 35.3 % and 34.3 %; Type III in 33.2 % and 34.3 %; Type IV in 8.7 % and 11.8 %; and Type V in 4.7 % and 3.9 %, respectively. The determination of types of face shape as presented in this study may be useful for aesthetic surgical procedures as well as medical and anthropological investigations.

El objetivo fue determinar los tipos de forma de la cara en la población turca. El conocimiento de la forma de la cara es importante en antropología y para la planificación de los procedimientos médicos como la cirugía estética, maxilofacial y ortodoncia. Se analizó un grupo de 1003 sujetos sanos (470 hombres y 533 mujeres), con edades entre 18 a 68 años. La talla, peso e índice de masa corporal (IMC) fueron 1,74 m, 78,65 kg, 25,80±3,50 kg/m2 y 1,62 m, 60,55 kg, 22,87±3,49 kg/m2 en hombres y mujeres, respectivamente. Se midió el índice prosopo (IP) y se determinó la longitud de la cara (LC: la distancia desde Nasion a Gnathion) y el ancho de la cara (ancho bicigomático: AC) utilizando las siguientes fórmulas: (IP = [LC/AC] x 100). Los tipos de forma de la cara se clasificaron de acuerdo a la clasificación de Banister [Tipo I (hipereuriprosopo), Tipo II (euriprosopo), tipo III (mesoprosopo), Tipo IV (leptoprosopo) y Tipo V (hiperleptoprosopo)], tanto en hombres como en mujeres. El IP fue de 84,31 (LC: 12,07 cm; AC: 14,34 cm) en los hombres y 85,25 (LC: 11,30 cm; AC: 13,28 cm) en las mujeres. En hombres y mujeres se observó la forma Tipo I en 18,1 % y 15,6 %; Tipo II en 35,3 % y 34,3 %; Tipo III en 33,2 % y 34,3 %; Tipo IV en 8,7 % y 11,8 %; y Tipo V en 4,7 % y 3,9 %, respectivamente. La determinación de los tipos de forma de la cara presentados en este estudio pueden ser útiles para los procedimientos quirúrgicos estéticos, así como para las investigaciones médicas y antropológicas.

Location, number and clinical significance of nutrient foramina in human long bones.

Nutrient arteries, the main blood supply to long bones, are particularly important during the active growth period, as well as during the early phases of ossification. In the present study, 569 adult human long bones of the upper (101 humeri, 93 radii, 102 ulnae) and lower (100 femora, 100 tibiae, 73 fibulae) limbs were investigated to determine the number and location of their nutrient foramina. For each bone, a foraminal index was calculated giving the location of the nutrient foramen in relation to its proximal end. In the upper limb, foramina were located on the diaphysis 15-69% of the overall length of the humerus, 22-46% for the radius and 27-54% for the ulna. In the lower limb, foramina were located on the diaphysis 29-69% of the overall length of the femur, 27-63% for the tibia and 26-83% for the fibula. In addition, the number and the distribution of the foramina in relation to specific regions/surfaces of the diaphysis were identified. This study provides additional and important information on the location and number of nutrient foramina in the long bones of the upper and lower limbs in the Turkish Caucasian population.

Stature estimation based on hand length and foot length.

This study was carried out to estimate the relationship between hand length, foot length and stature using multiple linear regression analyses based on a sample of male and female adult Turks residing in Adana. Measurements of hand length, foot length and stature were taken from 155 adult Turks (80 male, 75 female) aged 17-23 years. The participants were students of the Medical Faculty of Cukurova University. A multiple linear regression model was fitted to the observed data. Stature was taken as the response or dependent variable, hand length and foot length were taken as explanatory variables or regressors. All possible (simple and multiple) linear regression models for each of males, females and both genders together were tested for the best model. The multiple linear regression model for both genders together was found to be the best model with the highest values for the coefficients of determination R2 = 0.861 and R2adjusted = 0.859, and multiple correlation coefficient R = 0.928.

Evaluation of location of mandibular and mental foramina in dry, young, adult human male, dentulous mandibles

The present study was undertaken to determine the precise location of the mental and mandibular foramina and the surrounding anatomic landmarks. Measurements were made on both right and left sides of each of 34 dried young Turkish adult (30-40 years old) human male mandibles. The mandibles were moderately robust and were from dentulous subjects. The results obtained in the study showed that the distance of the mandible foramen to the angle of the anterior ramus were 16.9 mm on the right and 16.78 mm on the left. The distance to the posterior side of the ramus was 14.09 mm on the right, and 14.37 mm on the left. The narrowest anteroposterior diameters were 32.8 mm on the right and 32.05 on the left. The mandibular foramen is 0.5 mm posterior to the centre of the ramus on the right and 0.75 mm on the left. The distance of the lowest point of mandibular notch to the foramen was 22.37 mm on the right and 22.17 mm on the left. The distance from the mandibular foramen to the inferior border of the ramus in the mid position of the ramus was 30.97 mm on the right and 29.75 mm on the left. The average angle of the mandible (gonial angle) was 120.17 on both sides. The distance of the mental foramen to inferior border of the mandible was 14.61 mm and 14.29 mm on the right and left, respectively. Its distance to the superior border was 13.62 mm on the right and 14.62 mm on the left. The horizontal dimensions of the mental foramen was 2.93 mm on the right, 3.14 mm on the left and its vertical dimension was 2.38 mm on the right and 2.64 mm on the left. The mental foramen was located below the root of the second premolar in 21 bones (61.76 percent) on the right and 17 bones (50 percent) on the left while in the remaning mandibles, the foramen was present between the roots of the first and second premolars in 13 bones (38.2 percent) on the right and 17 (50 percent) on the left. The average angle of the mental foramen was 96.82 degrees. (AU)

Diagnostic approach to prostate cancer using total prostate specific antigen-based parameters together.

This prospective study investigated the value of serum total prostate specific antigen (tPSA)-based parameters in the diagnosis of prostate cancer (PCa). Serum tPSA, free to tPSA ratio (f/tPSA), PSA density (PSAD), and PSA transition zone (PSAT) were evaluated in 110 patients with histologically confirmed benign prostate hyperplasia (BPH) and 98 patients with PCa. Once the serum tPSA was elevated (greater than 4 ng/ml) or digital rectal examination (DRE) was suspicious, transrectal ultrasound-guided biopsies were recommended. The tPSA, f/tPSA, PSAD, and PSAT levels were significantly different between the BPH and PCa groups. In patients with a tPSA level of 4.1-9.9 ng/ml or an abnormal DRE finding, only PSAT was found to have discriminating power. The cut-off values were 0.15 for f/tPSA, 0.30 for PSAT, and 0.15 for PSAD. The diagnostic sensitivity of a positive result for one of these parameters in the whole group was 84%, but 75% in patients with a tPSA of 4.1-9.9 ng/ml or an abnormal DRE finding. The diagnostic specificity of positive results for 3 parameters was 92% in the whole group and 93% in patients with a tPSA of 4.1-9.9 ng/ml or an abnormal DRE finding. All parameters were influenced by the histological grades. Histological grades showed a negative correlation (r = -0.56) with f/t PSA and a positive correlation (r = 0.44) with PSAT. No diagnostic marker investigated heretofore was able to rule out or detect early PCa in patients with a PSA level of 4.1-9.9 ng/ml. Using the PSA-based parameters together can be helpful in management of these patients. If all of the PSA-based parameters are negative, biopsy might be postponed; patients who have three positive PSA-based parameters should be biopsied. In case of one or two of the parameters, the patient's age and race should be considered in clinical decision-making.