The reversing effect of ondansetron on bupivacaine-induced sciatic nerve block.

Background and Aims: This experimental study was designed to test the hypothesis that ondansetron, a selective 5-HT3 receptor antagonist, would decrease the duration of motor, sensory, and proprioception blockade in a dose-dependent fashion in a bupivacaine-induced sciatic nerve blockade. Materials and Methods: Forty-nine male Wistar Albino rats who underwent unilateral sciatic nerve block were divided into seven groups with an equal number in each group. Group B: only perineural block (PB), Group BO200: PB and perineural 200 µg ondansetron, Group BO400: PB and perineural 400 µg ondansetron, Group BO800: PB and perineural 800 µg ondansetron, Group BO800IP: PB and intraperitoneal 800 µg ondansetron, Group O800: only perineural 800 µg ondansetron, Group S: sham-operated. The rats' motor, sensory, and proprioception functions were evaluated by a blinded investigator every 10 min until they returned to normal function. The recovery times of the motor, sensory, and proprioception functions were recorded and compared. All sciatic nerves were removed and examined by electron microscopy for neurotoxic signs. Results: In which sciatic nerve block was formed with bupivacaine, the duration of the motor, sensory, and proprioception functions blockade was decreased, and the duration to return to normal functions was significantly shortened at Group BO800 (p < 0.05). According to electron microscopy results, perineural 200 µg, 400 µg, and 800 µg ondansetron were not neurotoxic. Conclusion: This is the first study showing that perineural ondansetron administration (800 µg dose) reverses the effect of the local anesthetics and shortens the duration of the motor, sensory, and proprioception functions blockade.

A case of individual variation of the rhomboid muscles.

During the routine gross anatomic dissection of a Turkish male cadaver; a variation of rhomboid muscles was observed on the left side. There were two rhomboid minors and three rhomboid majors coursing under the trapezius muscle. The origins of the upper and lower rhomboid minor muscles were C5, C6 and C7 vertebrae, respectively. Their insertions were to medial border of scapula, to upper part and to lower part of the spine of scapula, respectively. The origins of the upper, middle and lower rhomboid majors were C7, T1-T3 and T4-T5 vertebrae, respectively. Their insertions were to the 2/3 most inferior part of the medial border of scapula, from superior to inferior in sequence. In the examination of the literature, we could not observe such a variation of these muscles. In surgical procedures these types of variations have a clinical importance for intrathoracic muscle flap transfers and in cases with the paralysis of trapezius muscle.

Evaluation of the anatomical measurements of the temporomandibular joint by cone-beam computed tomography.

BACKGROUND: To examine the detailed anatomy of the normal temporomandibular joint (TMJ) in a large series of patients divided into different age groups. MATERIALS AND METHODS: Cone-beam computed tomography images of 100 patients included in the study. Morphometric analysis regarding mandibular con- dyle and mandibular fossa, articular tubercle and the zygomatic arch was done. The volumetric and surface measurements of mandibular condyles (total tissue volume [TV], total bone volume [BV], bone surface area [BS] and percentage of bony tissue of the mandibular condyle [BV/TV]) were also measured. RESULTS: Statistical analysis was performed and statistically significant differences according to the side of the joint, sex, and age groups were reported. Additionally, correlations between aging and all of these parameters were also determined. CONCLUSIONS: TV, BV, BS and BV/TV parameters according to side, age, and sex groups were defined for normal TMJ which may help to understand the onset and progress of TMJ disorders.

Morphology of cranial sutures and radiologic evaluation of the variations of intersutural bones.

BACKGROUND: As far as our literature searches showed us, morphological characteristics of cranium such as sutures, sutural bones and fontanelles had been examined in the skulls in the museums and dry specimens until now. As a modern method, three-dimensional virtual reconstruction of cranial bones by using multidetector computed tomography-computed tomography angiography (MDCT-CTA) can display in vivo morphological characteristics. In our study, we aimed to determine the presence and incidence of these morphological characteristics that can be clinically significant in our population, by using radiologic methods. MATERIALS AND METHODS: We examined head and neck regions of 185 patients via MDCT-CTA. We evaluated radiologically detectable variations of the metopic sutures, lambda, bregma, asterion and pterion, which can be very easily confused with fractures. Additionally, the differences between the genders and incidence of coexistence of these variations were evaluated. RESULTS: According to our study, the incidence of persistent metopic suture was 8.1% and the incidence of lambda variations was 5.9%. Variations were most commonly encountered on the left asterion, and least commonly on the bregma and left pterion. In the evaluation of the coexistence of the parameters and combinations, the Wormian bones located at the right and left asterions were detected. There were no statistically significant differences between genders. CONCLUSIONS: Variations of the sutures and sutural bones can be easily misdiagnosed with the fractures of related bony regions in unconscious patients with multiple traumas. During surgical interventions in these patients, surgeons must take this fact into consideration in order to make differential diagnosis of fractures and intersutural bone variations.

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.

Hacettepe cartilage slicer: a novel cartilage slicer and its performance test results.

OBJECTIVE: This study investigated the performance of a cartilage slicer device referred to as the 'Hacettepe cartilage slicer'. METHODS: Forty-one cartilage pieces were harvested from eight fresh frozen human ears and measured in thickness with a digital micrometer. These pieces were randomly sliced using four different thickness settings and two different types of blades. The thicknesses of the slices and remaining pieces were measured also. Scanning electron microscopy was utilised to determine the surface smoothness of the slices. RESULTS: Thickness results showed a proportional increase with the increasing thickness setting, with a ±0.1 mm margin of error. The measurements showed that over 95 per cent of the slices' structural integrity was preserved. Although both blades provided satisfactory results, scanning electron microscopy revealed that the slices cut with a single bevel blade had superior surface smoothness. CONCLUSION: To our knowledge, the current study is the first to evaluate the performance of a cartilage slicer device. Based on the thickness results, the Hacettepe cartilage slicer fulfilled its design goals: to consistently produce slices at the intended thickness with a ±0.1 mm tolerance, and to preserve over 95.3 per cent of cartilage thickness thereby ensuring undamaged, strong cartilage slices.

Assessment of concomitant versus sequential trastuzumab on radiation-induced cardiovascular toxicity.

There are limited data regarding effect of trastuzumab on radiation-induced cardiovascular toxicity when used sequentially or concomitantly. This experimental study aims to investigate effect of trastuzumab on radiation-induced cardiovascular toxicity with respect to the treatment sequence. One hundred and eight female Wistar albino rats were divided into six groups (G): G1 was control, G2 was trastuzumab, and G3 was radiotherapy (RT); G4 and G6 were sequential RT and trastuzumab; and G5 was concomitant RT and trastuzumab groups, respectively. Rats were killed at 6th h, 21st and 70th days after RT; thoracic aorta and heart samples were obtained. Transthoracic echocardiography and functional studies evaluating relaxation of thoracic aorta were performed. Subendothelial edema scores of thoracic aorta samples at 21st and 70th days were higher in RT groups (G3, G4, G5, and G6) ( p < 0.001). There was a deterioration of relaxation responses of thoracic aorta samples in RT groups ( p < 0.001). Cardiac fibrosis (CF) scores revealed detrimental effect of RT beginning from 6th h and trastuzumab from 21st day. RT groups showed further deterioration of CF at 70th day. Ejection fraction, left ventricular mass, and fractional shortening were significantly decreased in G4, G5, and G6. Trastuzumab may increase pathological damage in cardiovascular structures when used with RT regardless of timing.

Amelioration of radiation-induced lung injury by halofuginone: An experimental study in Wistar-Albino rats.

To evaluate effects of halofuginone (H) on radiation-induced lung injury (RILI), 60 rats were divided into six groups: Group (G) 1 control, G2 radiotherapy (RT) only, G3 and G4 2. 5 and 5 µg H and G5 and G6 RT + 2.5 and 5 µg H groups, respectively. A single dose of 12 Gy RT was given to both lungs. H was applied intraperitoneally with daily doses, until animals were killed at 6 and 16 weeks after RT. At 6th and 16th weeks of RT, five rats from each group were killed. Lung tissues were dissected for light and electron microscopy. Chronic inflammation, fibrosis and transforming growth factor-beta (TGF)-ß scores of all study groups were significantly different at 6th and 16th week ( p < 0.001). Chronic inflammation, fibrosis and TGF-ß scores of G2 were higher than G5 and G6 at 6th and 16th weeks of RT. At 16th week, fibrosis and TGF-ß scores of G5 were higher than G6 ( p = 0.040 and 0.028, respectively). Electron microscopical findings also supported these results. Therefore, H may ameliorate RILI. The effect of the H was more prominent at higher dose and after long-term follow-up. These findings should be clarified with further studies.

Electron microscopic examination of effects of bogma raki and walnut on cochlea: an experimental study.

Illegal alcohol beverages known as bogma raki in our country are consumed widely in our region. The studies investigating the relationship between alcohol consumption and hearing ability report different results. In this study, we aimed to investigate the toxic effects of bogma raki that contains neurotoxic substances on cochlea by electron microscopy. To the best of our knowledge, this study is the first in the literature. A total of 48 Wistar male albino rats (aged 12-16 weeks and weighing 200-240 g) were used in the study. The rats were divided into 4 groups with 12 animals in each group. The groups include control, bogma raki, walnut, and walnut + bogma raki groups. Bogma raki (30% v/v, 9.2 ml kg(-1) day(-1)) is added to drinking water of rats in bogma raki group (n = 12) for 4 weeks. Walnut group rats (n = 12) are fed with standard rat food and walnut without limitation (10 g kg(-1) day(-1)). Bogma raki + walnut group rats (n = 12) are fed with standard rat food and walnut and bogma raki is added to drinking water. The cochleas were dissected and removed en bloc and examined by electron microscopy. Perineuronal oedema around neurons of spiral ganglion and hairy cells of organ of Corti were present in the bogma raki group, walnut group and bogma raki + walnut group under electron microscopic examination. Comparing these three groups, there were no differences in the ultrastructural pathological changes. In the ultrastructural examination of the myelinated axons forming cochlear nerve, no ultrastructural pathology was detected in all the groups.

Quantitative analysis of the terminal branches of facial nerve in fresh frozen head and neck specimens.

BACKGROUND: The first aim of this study was the quantification of nerve fibres found in terminal branches of facial nerve and the second aim was the ultrastructural analysis of these terminal branches in order to observe their ultrastructural differences, if present. In the examination of literature; we could not find any studies related to this subject. MATERIALS AND METHODS: Four fresh frozen head and neck specimens were used and the dissections were done bilaterally. Therefore; totally 8 samples were examined. The samples were prepared according to routine transmission electron microscopic tissue preparation technique. The semi-thin sections were examined under light microscope by camera lucida. In every sample, the quantitative analysis was performed in 5 different areas in an area of 0.01 mm2 and statistical analysis was done. Secondly; the ultrastructural appearance of these terminal branches were examined under transmission electron microscope. RESULTS: In the quantitative analysis of terminal branches of facial nerve in an area of 0.01 mm2; the least number of nerve fibres were found in temporal branches and the highest number were detected in cervical branches. In transmission electron microscopic examination, no significant difference was found in between these branches. In the statistical analysis; statistically significant differences were obtained in between the temporal and buccal, marginal mandibular, cervical branches; zygomatic and marginal mandibular, cervical branches; buccal and marginal mandibular, cervical branches; marginal mandibular and cervical branches. CONCLUSIONS: These numerical data will have an importance during the nerve repair process of terminal branches of facial nerve in various injuries.

Protective effect of dexamethasone on fetal rat skin in experimental intrauterine ischaemia/reperfusion injury.

BACKGROUND: Perinatal asphyxia is an important cause of injury to fetal tissues such as the brain, heart, liver and gastrointestinal system. Fetal skin has also been shown to be vulnerable to intrauterine injury after intrauterine ischaemia/reperfusion (I/R) injury. AIM: To examine the effect of dexamethasone on fetal skin in intrauterine I/R injury in rats. METHODS: The response of rat fetal skin to I/R injury and maternal dexamethasone treatment were assessed by determining thiobarbituric acid reactive substances (TBARS), and myeloperoxidase (MPO) and nitric oxide (NO) metabolites. We also examined the ultrastructural changes of fetal skin. Bilateral utero-ovarian artery clamping was performed to produce ischaemia for 30 min in rats at day 19 of pregnancy, and reperfusion was achieved by removing the clamps for 60 min before fetal tissue was collected. The treatment group was given dexamethasone intraperitoneally 20 min before I/R was performed. RESULTS: TBARS, MPO and NO all increased significantly in fetal rat skin after I/R injury. Levels of TBARS, MPO and NO were significantly lower in the dexamethasone-treated group than in the I/R-only group. I/R injury produced ultrastructural damage in the epidermis. Oedema and mitochondrial damage were less severe in the dexamethasone-treated group. CONCLUSIONS: Maternal treatment with dexamethasone may have a protective effect on fetal skin in cases of I/R injury.

A combined anatomical variation of inferior epigastric vessels.

During the routine gross anatomical dissection of the right inguinal region of a 45-year-old male cadaver, a variation was observed both in the inferior epigastric artery and the inferior epigastric vein. In this case, the right inferior epigastric artery originated from the femoral artery 13 mm inferior to the inguinal ligament. Additionally, in this cadaver, the single right inferior epigastric vein drained into femoral vein 8 mm inferior to the inguinal ligament. The distal origin of the inferior epigastric artery from the femoral artery and the lower drainage of the single inferior epigastric vein to the femoral vein must be taken into consideration by surgeons.

Concomitant trastuzumab with thoracic radiotherapy: a morphological and functional study.

BACKGROUND: The purpose of this study is to elucidate if there is an additive or supra-additive toxic effects of radiotherapy (RT) and trastuzumab (T) on vascular structures when used concomitantly. METHODS: Female Wistar albino rats were treated with either 8 or 15 Gy of thoracic RT. T was applied i.p. with a dose of 6 mg/kg 2 h before RT. Four rats in each arm were killed at 6th h, 21st and 70th days after irradiation and thoracic aorta of each animal was dissected for electron microscopy. In addition, functional studies for evaluating the relaxation and contraction were carried out 21 days after RT. RESULTS: Only 15-Gy RT dose groups showed significant difference in terms of functional deterioration as more contraction than the others (P < 0.05) without any difference between RT and RT + T. However, T produced additional deficit in relaxation when added to RT, which was considered near significant (P: 0.0502). Electron microscopy showed endothelial and subendotelial damage signs in 15-Gy dose groups. T + 15-Gy arm showed more pronounced endothelial cell damage than 15-Gy RT-only arm, 70 days after RT. CONCLUSION: T and high-dose RT may lead to vascular damage that seems at least additive.

DEET-loaded solid lipid particles for skin delivery: in vitro release and skin permeation characteristics in different vehicles.

DEET (N,N-diethyl m-toluamide) is a lipophilic compound which has a common use as an insect repellent and causes not only skin irritation but also systemic side effects at high concentrations in long-term skin application. In this study, DEET is incorporated into solid lipid particles, a colloidal drug delivery system, in order to reduce the percutaneous permeation and avoid toxic effects and also maintain drug effectiveness on the skin surface for a long duration of insect repellence. Solid lipid particles were prepared based on emulsion systems at different concentrations and after the characterization studies, the formulation with 20% lipid phase and 1:1 drug:lipid ratio was carried to in vitro release and skin permeation studies. Solid lipid particles with DEET were compared to free DEET using cream and hydrophilic gel vehicles. Results showed that incorporation of DEET into solid lipid particles reduced the release rate and skin permeation of DEET. Imaging studies using scanning electron microscopy showed that there were still solid lipid particles on skin surface after 2 h indicating that DEET could be present for a longer time on the application site.

Accurate course and relationships of the transverse facial artery in human cadavers.

Both the course and localization of the transverse facial artery are described, based upon the bilateral dissection of heads from 20 human cadavers. Its anatomical relationships with the mandibular fossa, the articular tubercle, the zygomatic arch, the parotid duct and the maxillary artery are studied and morphometric features are calculated. Furthermore, the transverse facial territory was examined. This territory was supplied by a single perforating branch in 28 cases, by two perforating branches in 10 and by three perforating branches in 2. Knowledge of the course and relationships of the transverse facial artery should help to protect this artery from the risk for transection. However, the variable course of the transverse facial artery must always be taken into consideration by the clinicians during surgical procedures.

Quantitative analysis of myelinated axons of commissural fibers in the rat brain.

In this study, the myelinated axons of the rostrum, genu, truncus and splenium parts of the corpus callosum and of the anterior, posterior and habenular commissures were counted in the rat brain by using a camera lucida. The numerical densities of these axons were compared with each other by means of quantitative analytical statistical methods. In parts of the corpus callosum, a statistically significant difference was found between the rostrum and genu, rostrum and truncus, rostrum and the splenium, genu and truncus, and the genu and splenium. However, no statistically significant difference was found between the truncus and splenium. When comparing the number of myelinated axons of the anterior, posterior and habenular commissures, statistically significant differences were found between the anterior and posterior commissures, and between the anterior and habenular commissures. No statistically significant difference was found between the posterior and habenular commissures. Small sized myelinated axons were present in all parts of the corpus callosum and in the anterior commissure. However, a heterogeneous distribution of myelinated axons was present in the posterior and habenular commissures.

A very rare anatomic variation of the left brachiocephalic vein: left retro-aortic brachiocephalic vein with tetralogy of Fallot.

An anomalous course of the left brachiocephalic vein behind the aortic arch was identified in a patient with tetralogy of Fallot. A 6-year-old male patient had been admitted to the hospital with a diagnosis of tetralogy of Fallot and patent foramen ovale. At the beginning of the operation the left brachiocephalic vein could not be found. The pericardium was opened longitudinally and there was no persistent left superior vena cava. After careful examination, the left brachiocephalic vein was found behind the aorta. Especially during open heart surgery this pathology is very important. We conclude that when the left brachiocephalic vein can not be found, the possibility of persistent left superior vena cava and retro-aortic left brachiocephalic vein should be borne in mind.

Three-dimensional (3-D) reconstruction of the human coccygeal body.

The three-dimensional reconstructions of the human coccygeal bodies were undertaken using semi-thin serial sections which were cut from the tissue specimens taken from the ventral parts of the tip of the coccyges of four patients. The coccygeal bodies were observed in the form of convoluted, irregular helical tubes. The diameters of the coccygeal bodies in serial sections were measured and a statistical analysis performed. The lumens of the coccygeal bodies were not observed in the twisted parts of the tissue specimens. Depending upon to the irregular courses of the lumens and their lack of appearances in the twisted areas, we are unable to show the three-dimensional reconstructions of the lumens of the coccygeal bodies. In conclusion, this is the first study reporting the three-dimensional reconstruction of the contours of the coccygeal body. These type of studies, which were done by using serial sections will be very helpful for the understanding of the little known organs of the human body.

A study of variations of transverse foramens of cervical vertebras in human: accessory foramina in shape and number.

Transverse foramens of 250 cervical vertebras were examined. There were accessory foramina and variations in shape and number in 10 out of 250 cervical vertebras. Since such a variation of foramens, through which the vertebral artery passes, has not been detected in the literature, these ten cases are to be considered.