Age and gender related changes in bronchial tree: a morphometric study with multidedector CT.

OBJECTIVE: The aims of this study are the identification of differences in the diameter, length, area and branching angles of the trachea and bronchi with gender and age, and the identification of trachea types by using MDCT images. PATIENTS AND METHODS: The thoracic MDCT images of 253 patients (0-74 years old, 142 male and 111 female) were evaluated. Tracheal diameter, tracheal cross-sectional area, diameter and length of bronchi, and several angles of the bronchial tree [e.g. subcarinal angles (SCA), interbronchial angles (IBA)] were measured. RESULTS: Average anteroposterior and transverse diameter of the trachea in adult patients were measured as 15.8 ± 2.9 mm and 17.5 ± 3.7 mm respectively. Average tracheal cross-sectional areas in adult patients were calculated as 160.7 ± 41.3 mm² in females and as 275.7 ± 57.3 mm² in males. Four types of trachea were identified as circular (68% in adults, 73% in children), oval (13%, 15%), rectangular (11%, 5%) and horseshoe shaped (8%, 7%). The average right and left SCA were calculated as 34.5º ± 8.1º and 38.1º ± 8.9º respectively. The average right and left IBA were calculated as 32.4º ± 7.7º and 35.2º ± 8.1º respectively. CONCLUSIONS: The findings of this study may be helpful during bronchoscopy and tube and stent application procedures. MDCT seems to be a convenient technique for the evaluation of the bronchial tree.

Investigation of developmental toxicity and teratogenicity of antiemetics on rat embryos cultured in vitro.

In this study, we aimed to investigate and compare the direct toxic and teratogenic effects of dimenhydrinate, metoclopramide and trimethobenzamide HCl, antiemetic drugs on embryonic growth and development in cultured rat embryos. Embryos were explanted on day 9.5 of gestation and cultured. Whole rat serum was used as a culture medium for the control group while different concentrations of dimenhydrinate (2.5-20 µg/ml), metoclopramide (10-50 µg/ml) and trimethobenzamide HCl (25-100 µg/ml) were added to serum for the experimental groups. Effects of antiemetics on embryonic developmental parameters were compared, and embryos were evaluated for the presence of any malformations. Also, the total DNA was extracted from the cells to determine the fragmentation of nuclear DNA of embryonic cells. Compared with the control embryos, the antiemetics significantly decreased all growth and developmental parameters dose dependently. There was no difference regarding the fragmentation of nuclear DNA of the all used agents and controls. Amongst the agents, trimethobenzamide HCl was found to have more toxic and teratogenic potential, and metoclopramide appears to be the least toxic antiemetic and therefore could be more safely used and might be preferred for the treatment of nausea and vomiting in pregnancy.

Coronary artery variations and median artery in Turkish cadaver hearts.

INTRODUCTION: This study examined the routes and variations of the left coronary artery (LCA), the right coronary artery (RCA), and their branches, as well as the frequency of a median artery in cadaver hearts. METHODS: The hearts of 50 adult Turkish cadavers from various centres were dissected. RESULTS: The LCAs branched out of the aortic sinus and had an average diameter of 4.44 +/- 1.79 mm. They gave rise to two branches (bifurcation) in 46 percent, three branches (trifurcation) in 44 percent and four branches (quadrifurcation) in ten percent of the hearts. The median artery was identified in 27 hearts, with a mean diameter of 2.00 mm (standard deviation 0.67). The RCAs branched out from the right aortic sinus and had an average diameter of 3.32 +/- 0.79 mm. The conus branch, classically known as a branch of the RCA, branched out from the RCA in 32 percent of the hearts and from the right aortic sinus in 68 percent. Right dominance was observed in 42 percent, left dominance in 14 percent, and equal dominance in 44 percent of the hearts. Myocardial bridges were found on the LCA branches in 22 of the 27 hearts in which the median artery existed. CONCLUSION: There is a close relationship between the existence of the median artery and myocardial bridges. This suggests that the median artery might be important in myocardial bridges, which exist in embryos but do not result in any clinical symptoms for many years in a large number of people.

Multiple variations of the abdominal aorta in a single cadaver.

Numerous variations of the abdominal aorta were observed during a routine dissection of the abdominal region in a 60-year-old male cadaver in the Department of Anatomy, Meram Faculty of Medicine, Selcuk University, Turkey. In the present case, a common inferior phrenic trunk arose from the abdominal aorta and then divided into two branches. The left gastric artery arose from the front of the abdominal aorta, with an accessory right hepatic artery arising from the superior mesenteric artery. Although the single right renal artery originated from the abdominal aorta, double left renal arteries were found to originate from the abdominal aorta. Knowledge of these variations could help surgeons to identify and protect the abdominal aorta during surgery.

Investigation of developmental toxicity and teratogenicity of macrolide antibiotics in cultured rat embryos.

Macrolides are considered to be one of the safest anti-infective groups in clinical use, with severe adverse reactions being rare. However, there are limited data about their embryotoxicity and teratogenicity. We aimed to investigate and compare the effects of these agents on embryonic growth and development. Rat embryos were cultured in vitro for 48 h in rat serum. Whole rat serum was used as a culture medium for the control group while different concentrations of spiramycin and azithromycin (1.25-6.25 microg/ml), and clarithromycin (2.5-30 microg/ml) were added to rat serum for the experimental groups. Dose-dependent effects of macrolides on embryonic developmental parameters were compared using morphological methods. Embryos were evaluated for the presence of any malformations. After morphological examination of the embryos, total DNA was extracted from the cells using standard procedures to determine fragmentation of nuclear DNA of embryonic cells. When compared with the control embryos, the macrolides significantly decreased all growth and developmental parameters dose dependently. While clarithromycin was found to cause more developmental toxicity than spiramycin and azithromycin, azitromycin was determined to have more teratogenicity potential. Compared with controls, there was no difference regarding the fragmentation of nuclear DNA of all the agents used. According to these results, when the toxic and teratogenic potential of the used agents compared, because of the lower toxic and teratogenic effects observed with spiramycin, this agent may be preferred for parturients.

Investigation of direct toxic and teratogenic effects of anticoagulants on rat embryonic development using in vitro culture method and genotoxicity assay.

Heparin and low molecular weight heparins (LMWHs) are used to reduce the incidence of venous thromboembolism in pregnancy. Although, these agents have been shown to be safe when used during pregnancy, the studies about direct toxic and teratogenic effects of these drugs on embryonic development are limited. In this study, the effects of heparin and LMWHs on rat embryonic development were investigated by using in vitro embryo culture and micronucleus (MN) assay methods. Rat embryos were cultured in vitro in the presence of different concentrations of heparin (5-40 IU/ml), dalteparin (2.5-20 IU/ml), enoxaparin (25-100 microg/ml) and nadroparin (1-4 IU/ml). Effects of anticoagulants on embryonic developmental parameters were compared and embryos were evaluated for the presence of any malformations. After culturing the embryos, classic MN assay was performed. Anticoagulants significantly decreased all growth and developmental parameters dose-dependently. Dalteparin and enoxaparin were found to cause more developmental toxicity than heparin and nadroparin. Along with haematoma in general, heparin and nadroparin caused maxillary deformity, situs inversus and oedema most frequently, while neural tube defects were observed with dalteparin and enoxaparin. All agents also significantly induced MN formation in rat embryonic blood cells. These results indicate the possible genotoxic effects of anticoagulant agents on the developing rat embryo when applied directly.

An investigation of non-depolarizing muscle relaxants on embryonic development in cultured rat embryos.

BACKGROUND AND OBJECTIVE: We have investigated the toxic and teratogenic effects of certain non-depolarizing muscle relaxants on embryonic development in cultured rat embryos. METHODS: Rat embryos of 9.5 days were explanted and cultured in vitro for 48 h in rat serum. Whole rat serum was used as a culture medium for the control group while different concentrations of atracurium, cis-atracurium, rocuronium and mivacurium were added to rat serum for the experimental groups. Dose-dependent effects of these agents on embryonic developmental parameters were compared using morphological and biochemical methods. Each embryo was evaluated for the presence of any malformations. RESULTS: When compared to the control embryos, the muscle relaxants significantly decreased all growth and developmental parameters dose dependently with an increase in overall dismorphology. Among these malformations, maxillary deformity was most frequently observed. These effects were observed in much lower doses with atracurium and cis-atracurium compared to those with rocuronium and mivacurium. CONCLUSIONS: Our results suggest that non-depolarizing muscle relaxants cause dose-dependent toxicity on rat embryos at concentrations much greater than those in clinical practice. Although, these agents seems to have a low potential for causing developmental toxicity during organogenesis, because of the lower toxic effects observed with rocuronium and mivacurium, these agents may be preferred when recurrent administrations are necessary for parturients.

Saphenous vein graft for bypass of the maxillary to supraclinoid internal carotid artery: an anatomical short study.

The use of a saphenous vein graft for bypass of the maxillary artery (MA) to the supraclinoid internal carotid artery (ICA) in internal carotid occlusions is investigated. Five adult cadaver sides were used. Dissection required zygomatic arch osteotomy and a pterional craniotomy with extensive removal of the floor of the middle cranial fossa. The MA was found easily medial to infratemporal crest. The clinoidal segment of the ICA was exposed with the removal of the anterior clinoid process intradurally. The bypass graft was 4 to 5 cm long and was sutured end-to-end to the MA and end-to-side to the supraclinoid ICA. When high blood flow is needed in cases with ICA occlusion, such a bypass may be an alternative to superficial temporal (STA)-to-middle cerebral artery (MCA) bypass as well as to common carotid-to-MCA or-ICA bypass, which needs a long vein graft. This type of bypass will provide the opportunity to clip the ICA proximal to the origin of ophthalmic artery, which may inhibit distal embolization.