The triticeous cartilage - redefining of morphology, prevalence and function.

BACKGROUND: Triticeous cartilage is a small cartilaginous component of the laryngeal skeleton. This cartilage, located in posterior end of the thyrohyoid ligament, presents in different shapes. Radiological studies indicate clinical and anatomical importance of the triticeous cartilage but these studies have limited information due to inadequate inspection method. Computed tomographic angiography is able to evaluate the triticeous cartilage with using three-dimensional images in more detail. The aim of this study is to describe prevalence and morphological properties of the triticeous cartilage. MATERIALS AND METHODS: We examined computed tomographic angiography images of 746 patients (368 women, 378 men) retrospectively. Shapes, calcification degrees, volumes, lengths and wideness of the triticeous cartilage were evaluated by OsiriX-Lite software. RESULTS: According to our results, triticeous cartilage presents common in the examined population (68.1%). The prevalence of the triticeous cartilage was higher in men than in women. We also found that the degree of calcification was not related with age and gender. CONCLUSIONS: Clinical importance of the triticeous cartilage is that it could be misdiagnosed with atherosclerosis in common carotid artery because the triticeous cartilage is located almost at same level as the bifurcation of the common carotid artery. Therefore, clinicians should be aware about the triticeous cartilage.

Revisiting the relationship between the submandibular duct, lingual nerve and hypoglossal nerve.

BACKGROUND: The aim of the study was to evaluate the relations between submandibular duct, lingual nerve and hypoglossal nerve for making a reassessment of this area in fresh frozen specimens. Also, the distance between the angle of the mandible and the vertical line drawn from the point where submandibular duct crossed lingual nerve to the base of the mandible was measured to determine a new landmark for neck surgeons. MATERIALS AND METHODS: Fourteen fresh frozen head and neck specimens were dissected and evaluated. A marginal mandibular incision was made from the mastoid process to the chin. RESULTS: In 8 cases, lingual nerve was crossing the submandibular duct superiorly; in 5 cases, lingual nerve was crossing the duct infero-medially and in 1 case it was parallel to the duct. In 1 case, lingual nerve subdivided into anterior and posterior branches. In 2 cases, 2 parallel submandibular ducts were found and the lingual nerve was crossing the upper duct from superior. In 1 case, lingual nerve was crossing the duct infero-medially and then it was subdividing into branches superior to mylohyoid. In 12 cases, the course of hypoglossal nerve was classical. In 1 case, hypoglossal nerve crossed the submandibular duct medially and coursed parallel to the tendon of posterior belly of digastric. And in another case, hypoglossal nerve crossed the inferior branch of submandibular duct medially. The other structures in this area were as usual. CONCLUSIONS: The main factor for reducing nerve damage during surgery is the understanding of the anatomy of this area.

Phosphorus defficiency and sludge bulking.

Separation by settling is one of the most troublesome stages of an activated sludge process. A decrease in the efficiency of separation of microbial biomass from the treated effluent causes a decrease in the overall efficiency of the treatment plant. One of the most common problems in activated sludge systems to negatively influence the settleability is sludge bulking which can be defined as non-settling situation of microbial mass. The main objective of this study is to find out the effect of phosphorus deficiency on bulking of activated sludge. In order to achieve this aim, the effects of a strictly phosphorus limited environment was investigated by running 6 semi-continuous activated sludge reactors. Since the specific aim of the study is to identify the effects of magnesium and calcium ions on sludge bulking in a phosphorus deficient medium, 3 different magnesium and calcium concentrations (5, 10, 20 meq l(-1)) were studied. Laboratory scale reactors were fed with synthetic wastewater and operated at a sludge age of 8 days. Results showed that, phosphorus deficiency caused sludge bulking. Sludge samples examined under microscope showed that the floc structures from reactors fed with different cations are significantly different. To identify the differences, a series of chemical analyses were conducted on the sludge samples. In addition to that, sludge volume index (SVI) values were monitored on a daily basis. Next, the concentration of phosphorus in the feed medium was increased in two separate steps and the possibility to cure the sludge bulking problem was investigated. It was found that bulking of activated sludges due to phosphorus deficiency could be cured by the addition of phosphorus. For phosphorus deficient bulking in relation to the cations present in the system some mechanisms are suggested.

Accidental use of the median nerve as an interposition material in first carpometacarpal joint arthroplasty.

Harvesting the median nerve accidentally as a tendon graft, is a major complication of upper extremity surgery which is noted only rarely in the literature. This article seems to be the first report of the median nerve being used as an interposition material in first carpometacarpal joint arthroplasty.

Ganglion cysts of the proximal tibiofibular joint review of literature with three case reports.

Proximal tibiofibular ganglion is a rare disorder. It may settle down in the subcutaneous tissue or may develop along the peroneal muscles and nerve. Common clinical findings are various sizes of mass, pain and hypoesthesis due to compression neuropathy. We report three cases of proximal tibiofibular ganglion and review the literature about the diagnostic tools, recurrence rates and treatment modalities.