Sex determination from scapula by volume rendering technique in Turkish population / Determinación del sexo a partir de la escápula mediante la técnica de representación de volumen en la población turca

SUMMARY: The aim of this study is to measure the significant parameters on scapula at computed tomography images and to determine the effects of these parameters for sex determination. The second aim is to find the most effective single and combined parameters to use for sex determination using scapula in Turkish population. In this study, morphometric measurements of scapula on the computed tomography images of 60 male and 60 females were evaluated and their impacts on sex determination were examined via stepwise logistic regression analysis. 10 parameters and 6 indexes calculated via using these parameters were measured. Scapular breadth of the right scapulae (86.7%), maximum scapular length of the left scapulae (85%), scapular breadth of all scapulae (80%) were found to be the most effective single parameters. Combination of the scapular breadth and maximum scapular length were 85%, 90%, 86.7% effective in sex determination on the right scapulae, on the left scapulae and on all of the scapulae, respectively. We believe that the results of this study will contribute to sex determination studies using the scapula in Turkish population for anatomist, anthropologist and forensic scientists.

El objetivo de este estudio fue medir los parámetros significativos en la escápula en imágenes de tomografía computarizada y determinar los efectos de estos parámetros para la determinación del sexo. El segundo objetivo fue encontrar los parámetros individuales y combinados más efectivos para determinar el sexo utilizando la escápula en la población turca. Se evaluaron las medidas morfométricas de la escápula en las imágenes de tomografía computarizada de 60 hombres y 60 mujeres y se examinó su impacto en la determinación del sexo mediante un análisis de regresión logística paso a paso. Se midieron 10 parámetros y 6 índices calculados mediante el uso de estos parámetros. El ancho escapular de la escápula derecha (86,7 %), la longitud escapular máxima de la escápula izquierda (85 %), el ancho escapular de todas las escápulas (80 %) resultaron ser los parámetros individuales más efectivos. La combinación del ancho escapular y la longitud máxima escapular fueron 85%, 90%, 86,7% efectivas en la determinación del sexo en la escápula derecha, en la escápula izquierda y en todas las escápulas, respectivamente. Creemos que los resultados de este estudio contribuirán a los estudios de determinación de sexo utilizando la escápula en la población turca para anatomistas, antropólogos y científicos forenses.

Complications of endoscopic surgery of the pituitary adenomas: analysis of 570 patients and review of the literature.

Endoscopic transsphenoidal surgery is emerging as a minimally invasive and maximally effective procedure for pituitary adenomas. In this report we analyzed the complications in 624 procedures of endonasal transsphenoidal endoscopic surgery in the treatment of 570 patients with pituitary adenomas. The leading author (MB) operated pituitary adenomas via pure endoscopic endonasal transsphenoidal surgery between January 2006 and August 2011 at the Hacettepe University, Department of Neurosurgery in Ankara. Complications were assessed in 624 surgical procedures under five groups; rhinological, CSF leaks, infection, vascular and endocrinologic complications. We observed a total of 76 complications (12.1%). Rhinological complications occurred in 8 patients (1.3%): 4 epistaxis (0.6%) and 4 hyposmia (0.6%). Postoperative CSF leaks occurred in 8 patients (1.3%), and infectious complications occurred in 8 patients: 3 cases of sphenoidal sinusitis (0.4%), 5 cases of meningitis (0.8%). Only 1 case of internal carotid aneurysm rupture during the opening of sellar floor (0.16%) was observed. Endocrinologic complications occurred in 51 (8.1%) patients: Anterior pituitary deficiency in 12 (1.9%), transient diabetes insipidus (DI) in 29 (4.6%), permanent DI in 3 (0.4%) and inappropriate antidiuretic hormone secretion syndrome occurred in 7 (1.1%). There was no mortality directly related to the surgical procedure. The complication rates observed in our study suggests that the endoscopic pituitary surgery is at least as safe as microscopic transphenoidal surgery. These rates were obtained with due experience and well-coordinated teamwork. To further improve these rates, new technological developments will be helpful.

Comparison of the pretreatment effects of mixed vasodilators (3-D solution) on radial and internal thoracic arteries by using a 3-dimensional anaglyph electron microscope technique.

OBJECTIVE: Currently, internal thoracic arteries (ITA) and radial arteries (RA) are the first choice of conduits for coronary artery bypass grafts (CABG). Because the perioperative vasospasm continues to be a major problem, a number of pharmacologic agents such as papaverine, calcium receptor blockers, nitroglycerine, and phenoxybenzamine have been suggested as topical antispasmodics that may be used in the pre- and postoperative periods. In the present study, we investigated the quantitative efficacies of the mixed solution, which included verapamil, nitroglycerin, and papaverine, on RA and ITA using a scanning electron microscope with a 3-dimensional anaglyph technique. METHODS: Diameter changes of RA and ITA in response to clinically important vasodilators were measured on 40 RA and 40 ITA rings from patients who had been subjected to coronary artery bypass procedure after 20 minutes of ex vivo incubation with verapamil (45 microg/L), nitroglycerin (45 microg/L), papaverine solution (266 micromol/L or 0.1 micro/mL), and 30 mL autologous heparinized whole blood (individual patient's blood obtained before cardiopulmonary bypass contained 100 IU of heparin per kg of patient weight). The pretreatment action was assessed by measuring the response to vasodilators. RESULTS: In all cases, we did not observe graft vasospasm in any of the conduits during the intraoperative period between postanastomosis and sternal closure. In the postoperative period, we did not record any evidence of ischemic change in patients' electrocardiographic and myocardial enzyme analyses. None of the cases required inotropic support after the operation. The diameters of the pretreated RA and ITA were: minimum, 2.1 mm; maximum, 4.0 mm; and mean value, 2.80 +/- 0.46 mm. The diameters of the pretreated ITA were: minimum, 1.2 mm; maximum, 2.5 mm; and mean value, 1.76 +/- 0.35 mm. Incubated arterial segment diameters for the RA were: minimum, 2.8 mm; maximum, 5.2 mm; and mean value, 3.95 +/- 0.65 mm. These values for the ITA were: minimum, 1.5 mm; maximum, 3.9 mm; and mean value, 2.37 +/- 0.50 mm. These findings were statistically significant for both arterial grafts (P <.05). CONCLUSIONS: According to our study findings, the mixed solution demonstrates a broad range of efficacy. We conclude that the described vasodilator solution with heparinized autologous blood seems to be very effective and may be used as a pretreatment agent in CABG conduits. Although papaverine has the shortest duration of action, its efficiency is increased by verapamil and nitroglycerin, in our opinion. To the best of our knowledge, high-quality imaging of CABG conduits with the 3-D anaglyph technique using a scanning electron microscope was a first in the literature. This technical approach may be used for confirming the ultrastructural anatomy and the quantitative vasodilator effects of arterial conduits. We believe that valuable anatomo-pathologic details of the CABG conduit can be obtained by this technique.

Septum formation of the lateral ventricles.

In an MRI study examining anomalies of the septum pellucidum in 505 cases, we detected bilateral septum formation of the lateral ventricles in a 17-month-old baby. In this study, we evaluate 505 (242 males and 263 females) patients referred to the Emaray Imaging Center, Ankara, Turkey with various prediagnoses. We specially selected all the cases from a non-psychotic population. We obtained MRI scans on a 1-Tesla imager (Picker International, Highland Heights, Ohio, USA), with slices of 5 and 6 mm thickness. In axial and coronal sections, we observed septum formation laterally between the anterior horn and the ventricular body of the lateral ventricles. Radio opaque septum formations started from the caudate nucleus and stretched to the genu of the corpus callosum. There was a second septum formation between the posterior horn and the ventricular body of the right lateral ventricle. It started from the caudate nucleus and stretched to the cavum vergae.

Scanning electron microscopic observation of the brown tumor of the head of mandible.

Brown tumors are tumor-like, expansile osteolytic lesions of bone which are seen in both primary and secondary hyperparathyroidism. They generally resolve after surgical treatment of the parathyroid adenoma. Here, we report a case of brown tumor of the mandible of a cadaver with its scanning electron microscopic observation and review of literature.

Two cases of inferior vena cava duplication with their CT findings and a review of the literature.

Duplication of the inferior vena cava (IVC) is the most common anomaly to affect the vena cava. Variations in the IVC are diagnosed in routine dissection studies, in retroperitoneal surgeries, or in computerised tomography (CT) sections ordered for various reasons. In this paper we present two cases of a double IVC together with the CT findings. The duplication might have occurred during embryological development. Although venous anomalies are rare, they have particular importance with respect to the interruptions that may occur during retroperitoneal and thoracic surgery or in the treatment of thrombo-embolic disease.

Light and scanning electron microscopic examination of late changes in hair with hereditary trichodysplasia (Marie Unna hypotrichosis).

OBJECTIVE: Our aim was to investigate the microscopic surface structural alteration in hair with hereditary trichodysplasia. This article presents the results of light and scanning electron microscopy (SEM) examination of cases having hereditary trichodysplasia. METHODS: The biopsy specimens were obtained from 2 girls of ages 3 and 5-years, Department of Pediatrics, Faculty of Medicine, Hacettepe University in 2001. A large number of hair specimens were obtained from these 2 cases having hereditary trichodysplasia. Routine light microscopic and SEM procedure was performed on the tissue specimen, and then they were examined by light microscopy and SEM. RESULTS: Hair specimens taken from both patients had great similarities. Our results reveal that the atypical looking hair were flattened, twisted and partly scattered at the end. Moreover, these hairs had sheath structures with abnormal proliferation and these structures were damaged, the cuticles had fractures and were degenerative. CONCLUSION: There is only a small number of SEM studies in literature reporting the ultrastructural changes of hereditary trichodysplasia. Scanning electron microscopy is a 3 dimensional examination technique revealing easily comparable images and it is indispensable for diagnosis in various tissues which permit considerable magnification. As it is used in the hereditary trichodysplasia syndrome its routine usage in many dermatologic and hair diseases will result in valuable contributions to scientific literature.