InSafeLock humeral nail provides a safe application for proximal and distal locking screws with distal endopin - An anatomical study.

INTRODUCTION: Efforts to prevent iatrogenic neurovascular injuries with humeral intramedullary nailing lead to design new implants and inside to out distal locking technique using an endopin aims to provide a safer screw application. InSafeLock (TST, Istanbul, Turkey) humeral nail have been recently developed to minimize the possible screw related complications. The anatomical relationship between locking screws and neurovascular structures with the application time were compared between Trigen Humeral Nail (Smith and Nephew, Memphis, USA) and InSafeLock Humeral Nail. HYPOTHESIS: InSafeLock humeral nail would be safer than Trigen Humeral nail in terms of neurovascular injury. MATERIALS AND METHODS: Seven cadavers were used with both shoulders and surgical application of two nails was performed as the manufacturer guide. An Insafelock humeral nail was used for each right humerus and a Trigen humeral nail was used for each left humerus. Once the nails were placed, proximal and distal region of the nails were dissected to evaluate the relationship between screws and adjacent anatomical structures. The duration of the each screw was assessed via a stopwatch. RESULTS: No significant finding was noted for the relationship between the neurovascular structures and proximal screws in two groups (p<0.05). The distal locking of the InSafeLock humerus nail had a shorter application time and no neurovascular damage was recorded. DISCUSSION: The newly developed Insafelock humerus nails are at least as safe and effective as current humeral nails available on the market. Additional benefits include the preservation of neurovascular structures, as the Insafelock humerus nail does not require the use of an extra incision. Furthermore, surgical time is significantly shorter with using distal endopin. LEVEL OF STUDY: III, controlled laboratory study.

Morphometrical aspect on angular branch of facial artery.

Anatomic variability and anastomosis of the angular artery of the facial artery with the other arteries are important for both anatomists and surgeons. In particular, the angular artery is a significant landmark in dacryocystorhinostomy. Because of variations on anatomy of the angular artery, there are limited numbers of anatomic studies on the flaps of facial region. Hence, the aim of the cadaveric study was to evaluate the anatomic features of the angular artery in detail to help surgical procedures.The artery was represented under ×4 loop magnification in 32 sides of 16 formalin-fixed adult cadavers. The angular artery's position, diameter, and branch patterns relevant to the nose arterial supply were evaluated. The facial artery ended symmetrically in 10 (62.5%) of the cadavers. The facial artery was terminated as angular artery in all of the cases. The types of the angular artery were as follows: classical angular type in 8 cases (25.0%), nasal type in 15 cases (46.9%), alar type in 4 cases (12.5%), and labial type in 5 cases (15.6%) on the facial halves. We studied the topographic anatomic features of the angular artery for increasing reliability of the flaps on the region. The angular arterial anatomic details are critical and essential for surgical cosmetic and functional results.

Histamine induces the neuronal hypertrophy and increases the mast cell density in gastrointestinal tract.

Histamine is an endogenous biogenic amine that is synthesized from the basic amino acid histidine. Ability to mimic anaphylaxis is one of the first described functions of histamine and it has been demonstrated that histamine plays a significant role in the regulation of immune system and neuronal function, influences neuronal morphology and is involved in mast cells (MCs) chemotaxis. MCs as histamine releasers, may thus also interact with neuronal function. In the present study, we aimed to evaluate the role of histamine on mast cell density and neuronal morphology in the gastrointestinal tract of the mouse. Ten mice were daily injected intraperitoneally for 7 days with 20 mg/kg of histamine diluted in 0.5 ml physiological serum. After 7 days, mice were euthanised and samples from stomach, small bowel, colon and appendix were processed for histological examination. Immunohistochemistry was performed employing primary antibodies directed against triptase for mast cells and PGP 9.5 antigen for neuronal structures. The density of triptase and PGP 9.5 positive cells and the morphology of the ganglia were quantitatively evaluated by digital image analysis. The number of ganglia was higher in stomach, small bowel, colon and appendices of the histamine group when compared with the control group. Only in appendices and colon, the number of Schwann cells was significantly higher than that of the control group. The PGP 9.5 expression and the mean area of ganglia showed a significant increase only in appendices. In histamine group the MCs were clustered especially in the lamina propria. Mast cell density (MCD) was significantly higher than the control group in the small bowel, colon and appendices tissues. The intraperitoneally injection histamine increases the MCD and induces the neuronal hypertrophy and after the comparison of the organs in the gastrointestinal tract the results indicated the most effected organ as the appendices.

Relation of discoid lateral meniscus and cord-like anterior intermeniscal ligament: morphological and clinical study.

Discoid lateral meniscus is a rare disorder and its association with other variations in the knee joint has been reported. The anterior intermeniscal ligament has also been described as connecting the anterior convex margin of the lateral meniscus to the anterior horn of the medial meniscus. In the normal population, it was observed at 53-94%. Although the functional properties of the anterior intermeniscal ligament are not yet clarified, two distinct types of the ligament have been described according to their morphological characteristics as cord-like and membranous types. The purpose of this study was to evaluate any possible association between morphologic types of anterior intermeniscal ligament and discoid lateral meniscus. A retrospective study was designed; 20 discoid lateral menisci were operated using routine arthroscopic examination. Upon arthroscopic examination the thickness of the ligament and associated morphological changes were recorded systematically. The cord-like anterior intermeniscal ligament was an associated structure in 15 of the 20 knees with discoid lateral meniscus (75%). Patients with discoid lateral meniscus apparently have cord-like type anterior intermeniscal ligament, thus we conclude that cord-like type of anterior intermeniscal ligament is a frequent accompanying structure to discoid lateral meniscus and may have a potential stabilizing effect on its anterior stability.