Superior mesenteric artery revisited using magnetic resonance angiography.

PURPOSE: We aimed to examine the superior mesenteric artery in detail by magnetic resonance angiography to provide an alternative to other imaging methods, to reduce the exposure time of patients and physicians to X-rays and the time spent in catheter angiography, to determine the variations, positions, and locations of the celiac trunk, and to provide detailed information for surgeons and interventional radiologists using this method. METHODS: The procedures were approved by the Kocaeli University Medical School Non-Interventional Clinical Research Ethics Committee (10.04.2023, approval number: 2021/51). MR angiography images of 185 patients with abdominal imaging in PACS (Picture Archiving Communication Systems) were retrospectively registered. The level of origin of the superior mesenteric artery according to the vertebral column, angle of origin, distance between the superior mesenteric artery and branches of the abdominal aorta, and branching pattern of the superior mesenteric artery were evaluated. Parameters were evaluated according to gender and age using SPSS version 25. RESULTS: The distance between superior mesenteric artery-inferior mesenteric artery and superior mesenteric artery-aortic bifurcation in males was higher than in females, and the difference was statistically significant. In females and the whole study group, a low, positive and significant relationship was found between age and superior mesenteric artery-sagittal angle. The most common origin site for the superior mesenteric artery, according to the vertebral column was found to be at L1 middle for males and L1 upper for females. The most common superior mesenteric artery branching pattern was classical type in both genders. CONCLUSION: Individual evaluation of the superior mesenteric artery could reduce the risks during surgical interventions, considering the relationship of the superior mesenteric artery, especially with distally located vessels, and the gender differences for the angle of origin. Furthermore, considering that interventional radiologists choose the catheter according to the angle of origin of the artery during catheter angiography procedures, individual evaluation of patients taking into account gender and age is of utmost importance.

Evaluation of the celiac trunk and its branching pattern by magnetic resonance angiography.

OBJECTIVE: The study aimed to examine the celiac trunk (CT) in detail by magnetic resonance angiography, to determine the locations, positions and variations of the CT, to provide detailed information for surgeons and interventional radiologists, and to reduce the time spent in the catheter angiography. MATERIAL AND METHODS: MR angiography images of 185 patients with abdominal imaging in PACS (Picture Archiving Communication Systems) were retrospectively analyzed. The level of origin of CT, according to the vertebral column, angle of origin, distance between CT and branches of the abdominal aorta (AA), and the branching pattern of CT were evaluated. Parameters were evaluated according to gender and age. RESULTS: The most common origin site for CT, according to the vertebral column, was found to be at T12-L1 in both genders. There was a low, positive correlation between age and CT-Sagittal angle (SA) in the whole study group (p<0.05). The most common CT branching pattern was the hepatogastrosplenic trunk in both genders, according to Adachi and Uflkacker's classification. The distance between CT and the inferior mesenteric artery (IMA) and CT and the aortic bifurcation (AB) of males was greater than in females, and the differences were statistically significant (p<0.05). CONCLUSION: Knowledge of the locations, positions, and variations of CT is essential in the diagnosis, differential diagnosis and decision-making mechanisms regarding the type of intervention to be performed for this vessel and related structures. In addition, the fact that data on these vessels can be obtained by MR angiography due to the improved image quality will prevent patients and physicians from the problems caused by the ionizing radiation of computed tomography. The data presented will constitute a basis for detailed and individualized interpretation and evaluation of each patient, as they provide important details about the configuration of the CT concerning gender and age using MRA.

Morphological determination of glenohumeral joint and acromioclavicular joint with computed tomography / Determinación morfológica de la articulación glenohumeral y la articulación acromioclavicular con tomografía computarizada

SUMMARY: Although acute and chronic pathologies of the glenohumeral and acromioclavicular joints are frequently encountered in the population, the anatomy and morphometry are not fully known. The aim of this study is to determine the measurements of morphometric parameters according to age groups and sex in a large series of Turkish population. Nine hundred and forty-one shoulders computed tomography (CT) images were screened and those of subjects with healthy anatomical structure were included. Humeral head diameter (HDD) was measured on CT images. Measurements were made using 3D-CT images of: width (GW) and height (GH) of the glenoid cavity; width (CW) and height (CH) of the distal clavicular joint surface; and width (AW) and height (AH) of the acromial joint surface. Data were compared, stratified by age and sex. Images of 223 patients (118 men, 105 women) were analyzed. The following mean measurements were determined: HDD, 41.77±3.77 mm; GH, 34.66±3.26 mm; GW, 25.50±2.90 mm; CW, 14.85±3.51 mm; CH, 8.49±2.27 mm; AW, 12.97±2.94 mm; AH, 7.01±1.77 mm. When startified by sex, HDD (p<0.001), GH (p<0.001), GW (p<0.001), CW (p<0.001), CH (p=0.002), AW (p<0.001) and AH (p<0.001) measurements were significantly different and mean values were greater in men. Similarly for age, significant differences were found for GH (p=0.028), CW (p<0.001), AW (p<0.001), AH (p<0.001). The parametric values we have obtained in the Turkish population we measure differ from the measurements made in different populations according to age groups and sex. Knowing these features will contribute to treatment planning, implant and prosthesis applications.

Aunque las patologías agudas y crónicas de las articulaciones glenohumeral y acromioclavicular son frecuentes en la población, la anatomía y morfometría no se conocen por completo. El objetivo de este estudio fue determinar las medidas de los parámetros morfométricos según grupos de edad y sexo en una serie de individuos de población turca. Se examinaron 941 imágenes de tomografía computarizada (TC) de hombro y se incluyeron las de sujetos con una estructura anatómica sana. El diámetro de la cabeza humeral (HDD) se midió en imágenes de TC. Las mediciones se realizaron utilizando imágenes 3D-CT de: ancho (GW) y altura (GH) de la cavidad glenoidea; anchura (CW) y altura (CH) de la superficie articular clavicular; y anchura (AW) y altura (AH) de la superficie articular acromial. Los datos fueron comparados, estratificados por edad y sexo. Se analizaron imágenes de 223 pacientes (118 hombres, 105 mujeres). Se determinaron las siguientes medidas medias: HDD, 41,77±3,77 mm; GH, 34,66 ± 3,26 mm; GW, 25,50±2,90 mm; CW, 14,85±3,51 mm; CH, 8,49±2,27 mm; AW, 12,97±2,94 mm; AH, 7,01±1,77 mm. Cuando se inicia por sexo, HDD (p<0,001), GH (p<0,001), GW (p<0,001), CW (p<0,001), CH (p=0,002), AW (p<0,001) y AH (p <0,001) las mediciones fueron significativamente diferentes y los valores medios fueron mayores en los hombres. De igual forma para la edad se encontraron diferencias significativas para GH (p=0,028), CW (p<0,001), AW (p<0,001), AH (p<0,001). Los valores paramétricos que hemos obtenido en la población turca difieren de las medidas realizadas en diferentes poblaciones según grupos de edad y sexo. El conocimiento de estas características contribuirá a la planificación del tratamiento, aplicaciones de implantes y prótesis.

Morphometric evaluation of second to fifth metacarpals for retrograde intramedullary headless screw fixation / Evaluación morfométrica del segundo al quinto metacarpianos para la fijación retrógrada con tornillos intramedulares sin cabeza

SUMMARY: Intramedullary headless screw fixation has come to the fore in the treatment of metacarpal fractures in recent years with its advantages. Our aim was to evaluate the metacarpal morphometry for retrograde intramedullary entrance and to determine the optimal entry point. Computed tomography images of 105 patients including 64 men and 41 women, were examined. Distal and proximal metacarpal widths, medullary cavity width, cortex thickness and the measurements of the optimal entry site in volar-dorsal and radio-ulnar directions were measured in both coronal and sagittal planes. In the sagittal plane, the second metacarpal had the widest proximal width (16.29 mm), distal width was greatest in the third metacarpal (14.34 mm) which was significantly different between the sexes (p<0.001). Third metacarpal had the widest medullary cavity width in the sagittal plane (4.12 mm). In the coronal plane, it was the second metarcarpal with the widest proximal (16.14 mm) and distal width (13.92 mm) and was also the longest (66.32 mm). Unlike the sagittal plane, the medullary cavity width in the coronal plane was at the widest (4.06 mm) in fifth metacarpal. The points determined for optimal entry were respectively (4.60 mm; 4.97 mm; 4.55 mm; 4.36 mm) in the dorsal-volar plane, close to the dorsal side. There was no significant difference between the sexes for optimal insertion point in the sagittal planes in all the measured metacarpals. Considering its three dimensional structure, metacarpal bones have irregular morphometric properties and these features differ in sagittal and coronal planes. The optimal entry site is located in the midline in the coronal plane, while it is located in the sagittal plane close to the dorsal part. Knowing these properties can reduce the complication rate by reducing entry attempts and help select the correct material.

RESUMEN: En los últimos años, debido a sus ventajas la fijación intramedular con tornillos sin cabeza ha pasado a primer plano en el tratamiento de las fracturas de los huesos metacarpianos. Nuestro objetivo fue evaluar la morfometría del hueso metacarpiano para la entrada intramedular retrógrada y determinar el punto de entrada óptimo. Se examinaron imágenes de tomografía computarizada de 105 pacientes, incluidos 64 hombres y 41 mujeres. Los anchos de los huesos metacarpianos distal y proximal, el ancho de la cavidad medular, el grosor de la cortical y las medidas del sitio de entrada óptimo en las direcciones palmar-dorsal y radioulnar se midieron en los planos coronal y sagital. En el plano sagital, el segundo hueso metacarpiano presentó el mayor ancho proximal (16,29 mm), el ancho distal fue mayor en el tercer hueso metacarpiano (14,34 mm), lo que fue significativamente diferente entre individuos de ambos sexos (p<0,001). El tercer metacarpiano tenía la cavidad medular más ancha en el plano sagital (4,12 mm). En el plano coronal, era el segundo hueso metarcarpiano con mayor ancho proximal (16,14 mm) y distal (13,92 mm) y también era el más largo (66,32 mm). A diferencia del plano sagital, el ancho de la cavidad medular en el plano coronal era más ancho (4,06 mm) en el quinto hueso metacarpiano. Los puntos determinados para la entrada óptima fueron respectivamente (4,60 mm; 4,97 mm; 4,55 mm; 4,36 mm) en el plano dorsal-volar, próximo del lado dorsal. No hubo diferencia significativa entre ambos sexos para el punto de inserción óptimo en los planos sagitales en todos los huesos metacarpianos medidos. Teniendo en consideración su estructura tridimensional, los huesos metacarpianos tienen propiedades morfométricas irregulares, y estas características difieren en los planos sagital y coronal. El sitio de entrada óptimo se encuentra en la línea mediana en el plano coronal, mientras que se ubica en el plano sagital cerca de la parte dorsal. Conocer estas propiedades puede reducir la tasa de complicaciones al disminuir los intentos de entrada y ayudar a seleccionar el material correcto.

IInvestigation of possible oxidative damage caused by formaldehyde exposure in the rat's heart and aorta tissue / Investigación de posible daño oxidativo causado por la exposición al formaldehído en el corazón de la rata y tejido de la aorta

SUMMARY: Formaldehyde (FA) is a toxic substance used frequently in the field of medicine as well as in many industrial areas. Especially people working in the field of anatomy, histology, and pathology are in high risk group because of the use of the FA. Studies showing the effects of FA on the cardiovascular system are few in number. The purpose of the present study was to investigate the effects of FA exposure, which we believe can cause oxidative stress, on the heart and aorta with various biochemical analyses. A total of 24 Wistar Albino rats were used in our study. We divided the rats into 3 groups as the Control Group (CG), the group exposed to low-dose FA (avg. 1 ppm) (DDG) Group, and the group exposed to high-dose FA (avg. 10 ppm) (YDG). At the end of the subchronic FA exposure, the blood samples, heart and aorta tissues of the rats were taken and subjected to biochemical analyses. As a result of the analyses, statistically significant differences were detected between CG (2.96?0.85 ng/mg), and HDG (2.08?0.77 ng/mg) in aortic tissues in TXNIP analysis (p<0.05). In heart tissues, significant differences were detected between CG (0.73?0.27 ng/mg) and LDG (1.13?0.22 ng/mg) (p<0.05). Statistically significant differences were also detected between CG (1.98?0.31 mM/ml) and YDG (2.43?0.31 mM/ml) in serum MDA analyses (p<0.05). It was shown that subchronic application of FA to LDG rats through inhalation had no effects on apoptosis markers in heart tissues. More studies are required to show FA toxicity and the mechanism of action of pathology on the cardiovascular system. We believe that our study will contribute to clarifying the roles of mild and subchronic exposure of FA in heart and aortic tissues in terms of oxidative stress risk.

RESUMEN: El formaldehído es una sustancia tóxica que se utiliza con frecuencia en el campo de la medicina, así como en muchas áreas industriales. Especialmente las personas que trabajan en el area de la anatomía, y patología se encuentran en el grupo de alto riesgo debido al uso de esta sustancia. Pocos son los estudios que muestran los efectos del formaldehído en el sistema cardiovascular. El propósito del presente estudio fue investigar a través de análisis bioquímicos, los efectos de la exposición a formaldehído, que podría causar estrés oxidativo, en el corazón y la aorta. Se utilizaron un total de 24 ratas Albinas Wistar. Dividimos a las ratas en 3 grupos: grupo control (GC), grupo expuesto a dosis bajas de AG (promedio 1 ppm) (DDG) y grupo expuesto a dosis altas de AG (promedio 10 ppm) (YDG). Al término de la exposición a FA subcrónica, se tomaron muestras de sangre, tejido cardíaco y aorta de las ratas y se sometieron a análisis bioquímicos. Como resultado de los análisis, se detec- taron diferencias estadísticamente significativas entre GC (2,96 ? 0,85 ng / mg) y HDG (2,08 ? 0,77 ng / mg) en los tejidos aórticos en el análisis TXNIP (p <0,05). En los tejidos cardíacos se detectaron diferencias significativas entre GC (0,73 ? 0,27 ng / mg) y LDG (1,13 ? 0,22 ng / mg) (p <0,05). También se detectaron diferencias estadísticamente significativas entre CG (1,98 ? 0,31 mM / ml) y YDG (2,43 ? 0,31 mM / ml) en los análisis de MDA en suero (p <0,05). Se demostró que la aplicación subcrónica de formaldehído a ratas LDG a través de la inhalación no tuvo efectos sobre los marcadores de apoptosis en los tejidos del corazón. Se requieren más estudios para demostrar la toxicidad de los AG y el mecanismo de acción de la patología en el sistema cardiovascular. Creemos que nuestro estudio contribuirá a aclarar las funciones de la exposición leve y subcrónica de formaldehído en los tejidos cardíacos y aórticos en términos de riesgo al estrés oxidativo.

Effect of surgical and natural menopause on proximal femur morphometry in obese women.

The purpose of this study is to determine whether there are differences in proximal femur parameters of women subjected to menopause surgically or naturally. In this study, 10 parameters belonging to proximal femur of a total of 60 women cases of whom 30 had a mean age of 55.53 ±â€¯4.57 years; body mass index, 33.06 ±â€¯4.21 kg/m2; menopause age, 48.10 ±â€¯5.92; and menopause years, 7.50 ±â€¯4.58; and who were subjected to natural menopause; and 30 women whose mean age was 56.10 ±â€¯6.87 years; body mass index, 33.33 ±â€¯3.76 kg/m2; menopause age, 48.00 ±â€¯4.64 years and menopause year, 8.10 ±â€¯7.29; who were subjected to surgical menopause, and who did not use hormone replacement, were examined by radiography. Their anthropometric measurements, body compositions, blood hormone analyses (FSH, LH, estradiol, progesterone) and bone mineral densities (femur neck, femur total, lumbar t-score) were evaluated. It was found that there was no difference between surgical and natural menopause with respect to proximal femur parameters (p > 0.05). It was also found that FSH levels were high in the surgical menopause group and there were significant differences between the groups (p < 0.040). No significant difference was found even though bone mineral density t-score tests were lower in the surgical menopause group (p > 0.05). It was found that the difference in low bone mineral density level and high FSH values in the surgical menopause group do not have a relationship with proximal femur morphometry. It was determined that even though the women did not have ovaries, there was no difference between surgical menopause women and natural menopause women with respect to proximal femur morphometry.

Influence of the long term use of a computer on median, ulnar and radial sensory nerves in the wrist region.

OBJECTIVES: Repetitive microtrauma or overuse injuries may often affect upper extremities of the long term computer users. The aim of this study was to compare sensory nerve conduction velocities (SNCV) for median, radial and ulnar nerves in the wrist of computer users with the same parameters in controls who do not use computers regularly. MATERIAL AND METHODS: Twenty one male computer users (age: mean (M) = 28.3 years ± standard deviation (SD) = 7.5 years) and 21 male control subjects (age: M±SD = 24.1±4.6 years) were recruited for the study. Limb length and the perimeters of the dominant arm and forearm were measured for each subject. The neurophysiological study consisted of measuring sensory nerve conduction of the median, ulnar and radial nerves. RESULTS: The sensory conduction velocities of both median and ulnar nerves were significantly delayed in the dominant arm of the computer users compared to the controls. In addition, sensory conduction velocity of the median nerve was significantly delayed in the dominant extremity of the computer users compared to their non-dominant extremity. CONCLUSIONS: This study shows that computer users have a tendency toward developing median and ulnar sensory nerve damage in the wrist region. Mechanism of delayed SNCV in the median and ulnar nerves may be due to sustained extension and ulnar deviation of the wrist during computer mouse use and typing. Reduced SNCV changes were more apparent on the dominant side of the median nerve. This may indicate the increased neural deficits related to an increased use of the dominant side. Further investigation is needed to determine how to reduce potential risk factors at this stage in order to prevent development of median or ulnar neuropathy in the long term computer users.

Evaluation of medial and lateral meniscus thicknesses in early osteoarthritis of the knee with magnetic resonance imaging.

OBJECTIVE: To evaluate early changes occurring in both medial and lateral meniscus thickness from the knees of patients with osteoarthritis (OA). METHODS: We conducted this study in the Department of Anatomy and Division of Radiology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey during the period 2004 to 2005. In this study, we measured the thickness of the medial and lateral meniscus in a group of 36 (50 knees) consecutive patients with chronic knee pain, and clinical findings of early OA, and 10 (20 knees) control subjects using MRI. RESULTS: The thickness of the posterior horn of the medial meniscus and anterior horn of the lateral meniscus were significantly higher in the OA patients compared with the control subjects. CONCLUSION: This study showed that meniscal degeneration in early stage OA is not evenly distributed in the knee. Thickening of the menisci in some areas may occur due to their own localization and biomechanics.

A rare case of distal one-third of the transverse colon supplied by a branch from splenic artery.

We observed a rare variation of splenic artery during the routine dissection in the Laboratory of the Anatomy Department. It arose from the splenic artery toward the distal part of transverse colon which typically supplied by the inferior mesenteric artery. Embryologically distal part of the transverse colon is a segment of hindgut. In this case, splenic artery which an artery of foregut supplies an area of hindgut. The knowledge of splenic artery variations has significant importance during surgery of the organs of the upper abdominal region. In this study, we discussed clinical significance and embryological aspects of this anomalous artery.

Comparative study on apoptosis in the testes of normal and alcoholic rats.

OBJECTIVES: To investigate the tissue injury associated with long-term alcohol consumption in male gonads. To this end, apoptotic testicle tissues of alcoholic rats were compared with the testicle tissues of the control rats. METHODS: This study was conducted in the Department of Anatomy and Division of Pathology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey during the period 2002 to 2003. We used Sprague-Dawley rats as the subject material in the investigation of apoptosis. We divided the rats into 2 groups: alcoholic rats and the control group, with 10 adult male rats in each group. We housed the subjects in each group under controlled temperature (22 +/- 3 degrees C) and humidity (62 +/- 7%) and lighting (12 hours darkness and 12 hours daylight per day). We fed the rats in the alcoholic group by ethanol in liquid diet for 12 weeks while the control rats received the normal isocaloric diet. We fixed the testicle tissues of both groups by perfusion of 10% formaldehyde through left ventricle and then removed. We further fixed the tissues in formaldehyde solution for at least 2 days. After dehydration by ethanol, we embedded the tissue in paraffin and used serial paraffin sections (5 micron thickness) for immunohistochemistry. We used Caspase-3 Ab-4 (CPP32) antibody to identify caspase reaction in apoptotic regions. Hence, we observed the stained sections and photographed the apoptotic seminiferous tubules (ST). For comparison of apoptosis in the alcoholic group and control group, we counted the apoptotic germ cells in x 400 magnification under light microscope. RESULTS: The diameters of seminiferous tubules were measured using light microscope with micrometre. The findings were compared by computer and significant differences in apoptosis between 2 groups (p<0.01) were detected. CONCLUSION: Apoptosis is significantly induced in ethanol treated rat related to the overuse of ethanol. The findings indicate the tissue injury of testicles associated with alcohol consumption.

Volumetric determination of medial epicondyle and lateral epicondyle of humerus in male and female volleyball players.

The aim of this study was to assess the volume of the medial epicondyle and lateral epicondyle in comparison with the distal end of humerus volume in male and female elite athletes participating in an impact loading sport (volleyball). The volleyball group consisted of 17 female, aged 20.47 +/- 2.47 years (mean +/- SD), 16 male aged 21.68 +/- 3.47 years (mean +/- SD); training for about 8 hours/week. The control group consisted of 15 nonactive females aged 21.73 +/- 2.68 years (mean +/- SD) and 14 nonactive males aged 23.35 +/- 4.16 years (mean +/- SD). Anthropometric determinations (height, weight, limb length, girth of arm and forearm) were made on each subjects. Range of motion was evaluated by standard goniometric technique. Comparative plain films of both elbows were obtained in an anteroposterior projection. The volumes of the medial epicondyle and lateral epicondyle were determined by the principle of Cavalieri which is an effective stereologic volume calculation method. In the volleyball players, increased medial epicondyle volume was recorded in the dominant and nondominant arms as compared with the control subjects (P < 0.05). Wrist flexors are highly involved in spiking, blocking and serving in volleyball. In this study we founded volume of medial epicondyle which is the connection point of flexor muscle was increased because of loading.