The incidence of pneumatised inferior turbinate and relation to close anatomic structures.

BACKGROUND: Pneumatisation of the inferior turbinate (PIT) is a rare abnormality of the paranasal sinus. It is very difficult to differentiate from the hypertrophia of the inferior turbinate clinically. Thus, it is important to be considered, especially in cases with no response to medical treatments. We aimed to investigate the presence and the frequency of PIT by computed tomography (CT). MATERIALS AND METHODS: A total of 2905 cases (1381 female, 1524 male) with an age range between 16 and 84 were included. RESULTS: The pneumatisation of the inferior turbinate was observed in 1.72% of the cases with a percentage of 1.88% in women and 1.57% in men. In PIT (+) cases the bilaterality was found in 54% of them. According to the subtypes, 70% was lamellar, 28% was bullous and 2% was extensive. No statistically significant difference was found for age distribution. The most commonly associated variations were the pneumatisation of the middle and upper turbinate and the septal deviation. CONCLUSIONS: The pneumatisation of the inferior turbinate is a rare variation with a similar frequency among men and women. It is diagnosed by CT and when symptomatic, the optimal treatment is surgery.

The effect of the functional asymmetry of the brain on face morphometry in the university students of mathematics and painting department.

BACKGROUND: The face is a complicated structure configurations of which are originated and components integrated during the developmental stages. Almost the whole of face is formed by neural crest cells migrating from the edge of the cranial neural folds to the pharyngeal arcus. Brain is an asymmetric organ both functionally and anatomically. While the left hemisphere is dominant in processing the verbal, mathematical and logical information, the right hemisphere is dominant in processing the perceptual, visible, spatial and artistic information. The functional differences in the left and right brain hemispheres might also cause differences in facial regions developing from the same centres as telencephalon during embryonic period. Therefore; we aimed to perform linear anthropometric measurements and determine whether functional asymmetry of brain creates any change in facial linear measurements, on the faces of students of painting and mathematics departments whose skills are different from each other. MATERIALS AND METHODS: This study was performed on 212 students. A total numer of 22 measurements from 17 anthropometric points for each student were done. Measurements were carried out between November 2011 and February 2012. RESULTS: Our findings revealed that there were statistically significant differences between two student groups in the face width, intercanthal distance, mandibular width, nose width, upper lip height and philtrum length. The comparison of genders revealed that there were statistically significant differences between all measured parameters. In addition, all students from both departments had euryprosopic face type when face type points were compared. CONCLUSIONS: Those differences might be related to the functional asymmetry of brain. Therefore it could be suggested that the functional asymmetry of brain could cause an asymmetry in the face as well as in the linear anthropometric measurements.

MRI-based detailed evaluation of the anatomy of the human coccyx among Turkish adults.

AIM: The human coccyx varies considerably in shape and size. The objective of this study was to investigate the morphology and morphometry of the coccyx on pelvic magnetic resonance imaging in asymptomatic individuals among Turkish adults. MATERIALS AND METHODS: This study was conducted retrospectively on the pelvic magnetic resonance images of 456 adult patients without a history of trauma in the coccyx region. The coccygeal vertebrae count, number of bone segments, and intercoccygeal and sacrococcygeal joint fusions were determined from the sagittal plane images. In addition, the length and angles (the sacrococcygeal angle, intercoccygeal joint angle, and sacrococcygeal joint angle) were measured. STATISTICAL ANALYSIS USED: Data were analyzed using the T-test or Mann-Whitney U-test, the ANOVA, or Kruskal-Wallis tests, and the chi-square test was used for the categorical variables. RESULTS: The coccyx is formed by four, five, or three vertebrae in a decreasing ratio. The coccyx is composed of one to five bone segments; one bone segment was found in 2.8% of the cases. Intercoccygeal joint fusions been observed predominantly in the last intercoccygeal joint, with or without sacrococcygeal joint fusion. The coccyx was found to be longer in adult males than in adult females. The sacrococcygeal angle might be anteverted or retroverted. CONCLUSION: The findings are contrary to the conventional knowledge in that the vertebrae shaping the coccyx were completely fused and consisting of a single bone in very few cases. Better understanding of the anatomical variation of the coccyx may be useful for clinicians evaluating patients presenting with conditions in the coccygeal region.

Central region morphometry in a child brain; age and gender differences.

BACKGROUND: Data on central region morphometry of a child brain is important not only in terms of providing us with information about central region anatomy of the brain but also in terms of the help of this information for the plans to be applied in neurosurgery. OBJECTIVE: In the present study, central region morphometry of a child brain in mid-sagittal MR images was analyzed in age and gender groups. MATERIALS AND METHODS: Different points determined previously, commissura posterior0 (PC) and the distances between cerebral cortex point (VCS) vertical to commissura anterior- commissura posterior line, sulcus centralis (CS), sulcus marginalis (MS), and the angle (α) between CS-PC-MS were determined and measured together with difference of gender in three different age groups (aged 6-9, 10-13, and 14-17). RESULTS: Central region measures of the brains of boys aged 6-17 are higher than girls except for MS-PC distance. While VCS-PC, CS-PC, and MS-PC measures display a significant difference in the girls aged 14-17 when compared to the other age groups of 6-9 and 10-13 (P < 0.05), angle α is not significantly different in age and gender groups (P > 0.05). However, while VCS-PC, CS-PC and MS-PC distances show a significant increase in girls beginning from the age of 14, this increase is limited in boys. CONCLUSION: Morphometric differences observed in different age groups in boys and girls shall contribute our evaluation of the alterations in brain development in both of genders and shall be useful in preparation of surgical operation plans to be applied to the central region.

Fenestration of the vertebral artery: case presentation.

Fenestrations of vertebral arteries are considered to be rare abnormalities observed in angiographic and autopsy studies. They result from vascular abnormalities that occur during the embryological development of vertebral artery. Fenestrations of the vertebral artery are vascular structures having 2 different lumens and endothelium layers, sharing either the same or separate adventitia layers. As a result of the carotid Doppler ultrasonography performed on a 65-year-old woman applying to the Neurology Clinic of Cumhuriyet University Faculty of Medicine, Research and Practice Hospital with the complaints of vertigo and numbness in the head, a plaque leading to 60% stenosis in the right internal carotid artery, close to the place of initiation was seen. The patient, whose vertebral artery lumen structures and calibrations have found to be normal in the Doppler ultrasonography of vertebral artery, was scheduled for double-sided selective carotid and vertebral artery angiography. With the performed digital subtraction angiography imaging method, an atheroma plaque, extending to internal carotid artery proximal starting from sinus caroticus through the right internal carotid artery and leading to 50% stenosis, having the appearance of an ulcer, was observed. In the vertebral artery angiography of the case, while the right vertebral artery was found to be normal, fenestration in the upper cervical segment was observed in the left vertebral artery. This situation has been presented in this paper with radiological and embryological evaluation.

Left renal vein abnormalities detected during routine abdominal computed tomography imaging: clinico-radiological significance.

BACKGROUND: Preoperative knowledge of the presence of major venous anomalies facilitates the safe performance of aortic surgery. The purpose of the study was to estimate the incidence, as detected by abdominal computed tomography (CT), of major left renal vein anomalies related to the abdominal aorta in an adult population. MATERIAL AND METHODS: Seven hundred and fifty abdominal CT examinations were reviewed retrospectively for the presence of left renal vein anomalies. Eleven CT scans were excluded from the study because of technical or patient- -related factors. The course of the left renal vein was assessed on the CT slices to detect any anomalies. RESULTS: Left renal vein anomaly was detected in 23 (3.1%) of 739 cases. Seventeen (2.3%) of them were a retro-aortic, and six (0.8%) of them were a circumaortic left renal vein. CONCLUSIONS: It is important to detect left renal vein anomalies before retroperitoneal surgery or interventional procedures. These anomalies can be identified in routine abdominal CT examinations with a careful inspection.

Effects of methylene blue, pentoxyphylline and enoxaparin on postoperative adhesion formation and markers of angiogenesis in a rat uterine horn model.

OBJECTIVE: Postoperative adhesions still remain as a common and serious problem leading to morbidity, mortality and economic loss. Adhesions are the major cause of postoperative intestinal obstruction, infertility, and chronic pelvic pain. In this study, we aimed to compare adhesion prevention effects of pentoxyphylline, enoxaparin and methylene blue and to investigate the effects of these agents on angiogenesis, which is suggested as an important step in wound healing, in rat a uterine horn model. MATERIAL AND METHODS: Forty female Wistar albino rats were randomized into four subgroups and underwent laparotomy. Adhesions developed following cauterization at the anti-mesenteric surfaces of both uterine horns. After 14 days, adhesions were investigated by using macroscopic, histopathological and immunohistochemical [vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), transforming growth factor (TGF-beta), platelet-derived growth factor (PDGF)] methods. RESULTS: We found that enoxaparin significantly reduced adhesion formation. Pentoxyphylline had no significant effect on adhesion formation, whereas methylene blue had a significant decreasing effect on histopathologically determined adhesion markers and it may affect angiogenesis through PDGF. CONCLUSION: Among three agents, which were intraperitoneally given by a single dose manner in order to prevent postoperative adhesions, methylene blue and enoxaparin exhibited a positive effect, while no such effect was shown with pentoxyphylline.

Determination of cerebellar volume in children and adolescents with magnetic resonance images.

Recent studies show that the cerebellum contributes to higher cognitive functions as well as its role on motor system. It is thought that higher cognitive functions continue to develop during childhood and adolescence; therefore, cerebellum develops significantly during these periods. For that reason, this study was carried out in order to determine cerebellar volumes of 90 healthy individuals (40 males, 50 females) aged between 6 and 17 years according to their gender. The individuals were divided into three age groups of 6-9, 10- -13, and 14-17 years, and their cerebellar volumes were found by means of stereological methods using their magnetic resonance images. The cerebellar volumes found were compared among the groups without discriminating genders, among groups according to gender, and again according to gender within each age group. The general average cerebellar volume of the age group 10-13 years was significantly higher than the other two age groups(p 〈 0.05). When the groups were compared according to gender, there was no important difference between the groups in women (p 〉 0.05); as for men, cerebellar volume only in the age group 10-13 years was significantly higher than that in age group 6-9 (p 〈 0.05). When cerebellar volume for ages 6-17 years was compared according to gender (without dividing into age group) there was no significant difference between men and women (p 〉 0.05). It was seen that the cerebellum develops from childhood to adolescence, and reaches peak levels between the ages 10-13 years for both genders.

Absence of the arteria profunda femoris / Ausencia de la arteria femoral profunda

At arteria femoralis, arteria profunda femoris is the main branch feeding the thigh. After iliofemoral embryological evolution many variations can be seen in this vessel. The absence of a. profunda femoris is one of the rare seen variation among these variations. Knowing the anatomy and variations of a. profunda femoris well, is important in low extremity ischemia, vessel surgery and angiography applications. In this study, 1036 films belonging to low extremity found in the Radiology department of School of Medicine of Cumhuriyet University were examined as retrospective. Among these films at four of them of male cases, absence of a. profunda femoris was detected. In cases at ages of 32, 37, 47 and 53 respectively, in the first and second case at the right low extremity there was no a. profunda femoris and at the left low extremity it was seen that a. circumflexus femoris medialis and a. circumflexus femoris lateralis emerged from a. profunda femoris. In the third case it was detected that at left low extremity a. profunda femoris did not exist, and at right low extremity a. circumflexus femoris lateralis emerged from a. profunda femoris, and a. circumflexus femoris medialis emerged from a. femoralis. In the fourth case at left low extremity there was no a. profunda femoris and at right low extremity it was seen that at a. profunda femoris and a. femoralis were in unsteady course. The absence of a. profunda femoris had 0,4 percent. The results were discussed by comparing with literature data.

La arteria femoral profunda, se origina de la arteria femoral, siendo la rama principal que alimenta al muslo. Después de la evolución embriológica de las aa. iliofemorales, muchas variaciones pueden verse en este vaso. La ausencia de una a. femoral profunda es una rara variación observada dentro de estas variaciones. Conocer la anatomía y las variaciones de la a. femoral profunda, es importante para la isquemia de los miembros inferiores, cirugía vascular y aplicaciones en angiografía. En este estudio, fueron examinadas retrospectivamente 1036 placas imagenológicas del miembro inferior, pertenecientes al departamento de Radiología de la Facultad de Medicina de la Cumhuriyet University. Entre estas placas, en cuatro casos pertenecientes a hombres, se detectó la ausencia de la a. femoral profunda. Los casos comprendieron a individuos cuyas edades eran 32, 37, 47 y 53 años, respectivamente. En el primer y segundo caso en el miembro inferior derecho no había una a. femoral profunda y en el miembro inferior izquierdo, se vio que la aa. circunflejas femorales medial y lateral se originaban de la a. femoral profunda. En el tercer caso se observó ausencia de la a. femoral profunda en el miembro inferior izquierdo, y en el miembro inferior derecho, la a. circunfleja femorale lateral se originaba desde la a. femoral profunda, y la a. circunfleja femoral medial se originaba desde la a. femoral. En el cuarto caso en el miembro inferior izquierdo, no existía la a. femoral profunda y en el miembro inferior derecho se observó que tanto la a. femoral como la a. femoral profunda tenían un curso variable. La ausencia de la a. femoral profunda fue del 0,4 por ciento. Los resultados fueron analizados y comparados con la literatura.

Evaluation of the length and angulation of the styloid process in the patient with pre-diagnosis of Eagle syndrome.

Clinical symptoms caused by the elongated styloid process (SP) or calcified stylohyoid ligament were first described by W. Eagle and they are now known as Eagle syndrome (ES). Normal length of SP was stated by Eagle as 2.5 cm. The objective of this study was to determine and discuss the length of SP and medial angulation degree with computed tomography (CT), which is an affective modality in the identification of ES, and a comparison with related studies. Three-dimensional (3D) images obtained from the axial CT scans of 22 cases (11 males and 11 females) aged between 24 and 80 years, who referred to Cumhuriyet University Hospital, Department of Radiology for multi slice CT with the pre-diagnosis of ES, were used. Lengths of the SP and medial angulations were measured on the obtained images. Inter- and intra-group comparisons were carried out using Wilcoxan and Mann-Whitney U tests. The mean length of the SP was found as 4.1 ± 1.1 cm. When inter- and intra-group lengths of the right and left SP were compared, the difference was not significant (p 〉 0.05). The mean medial angulation of the SP was found as 67.5 ± 5.1°. There was a significant difference found between the right side medial angulation and left side medial angulation in all persons (p 〈 0.05). Lengths of the right and left SP of the patients with pre-diagnosis of ES were close to each other. However, the right-side angulation was observed to be smaller than the left medial angulation in all the patients. Similarly, right side medial angulation of the females was smaller than the left side medial angulation, but this difference was absent in the males. Eagle syndrome should be kept in mind in patients with a sore throat radiating to the ears with swallowing and an observed non-compliance between the complaints such as feeling a foreign body in the throat and facial pain, and physical examination of those who do not have a response to long-term medical therapy should be performed.