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.

Anatomical variations of foramen of the diaphragma sellae and neighboring structures: a cadaveric study.

The aim of our study was to examine the variations and types of foramen of diaphragma sellae (FDS) and their relationship with nearby surgical landmarks on cadavers.Twenty adult (9 male, 11 female) formalin-fixed cadaveric heads were bilaterally used to analyze the anatomical relationships around the supradiaphragmatic region of sella turcica. Lengths and distances of nearby surgical landmarks were measured by a digital microcaliper. SPSS version 25 was used to analyze the comparison between genders and body sides. Dorsum sellae distances to tuberculum sellae and the optic chiasm(OC) were higher in males than females (p < 0.05). Type 8 infundibulum passage was the most common variation with 50%. There was no finding related to types 1-4 of infundibulum passage. Thus, the present study has indicated that the infundibulum passes mostly from the posterior half of the foramen. The shape of the foramen was irregular in 45%, circular in 20%, sagittally oval in 20%, and horizontally oval in 15% of the cases. The OC was noted normal in 60%, prefixed in 35%, and postfixed in 5% of the cases. Comprehensive anatomical knowledge about the types of the FDS and their neighboring structures is crucial for preoperative planning of sellar region diseases in terms of navigating the region when accessing the foramen. Discrimination of variations of FDS, OC, and pituitary stalk, their relationships, and differences between genders is useful to minimize potential surgical complications.

Reappraisal of the types of hypoglossal canal: endocranial approach.

This study aims to classify the endocranial variations inside the Hypoglossal Canal (HC) and evaluate the elements of the HC region in terms of sizes, diameters, and distances to the nearby surgical landmarks. The present study was done on 18 adult human fixed cadaver heads bilaterally. The internal opening of HC was examined for the presence of dural or osseos septations in the canal and was classified into five types (Type 1-5). The dimensions of hypoglossal nerve (CN XII) and the distance of intracranial openings of HC from the jugular foramen and jugular tubercle were measured. The prevalence of endocranial HC types were determined on both sides as follows: type 1 (23.53% left, 6.25% right), type 2 (37.5% right, 5.88% left), type 3 (52.94% left, 25% right), type 4 (18.75% right, 17.65% left), type 5 (12.5% right). Understanding the endocranial HC types is crucial for neurosurgeons in the differential diagnosis of various intracranial pathologies for the posterior cranial fossa approach. Knowing the anatomical relationships between the adjacent structures and symmetrical organization of the HC according to the types is crucial in determining surgical strategies and preserving adjacent structures.

Trifurcation of the facial artery at the inferior border of the mandible: a case report.

PURPOSE: The facial artery is known to show variations in its origin, course, termination, and branching pattern. This study aimed to present a case with trifurcation of the facial artery at the inferior border of the mandible accompanied by variable branches. METHODS: During our routine head dissection, it was observed that a 67-year-old male cadaver had a trifurcation of the facial artery at the level of the lower border of the mandible on the left. The skin was reflected, and the subcutaneous fatty tissue and subcutaneous layers were dissected to reveal the triple facial artery. RESULTS: The left facial artery arising from the external carotid artery entered the face with three branches as it crossed the lower border of the mandible. The three branches are the anterior, intermediate, and posterior branches. The posterior branch passed in front of the anterior border of the masseter muscle along with the facial vein and gave off muscular branches with a straight course, whereas the anterior thickest curved branch terminated by the inferior labial artery, and a tortuous intermediate branch initially gave off the superior labial artery and then terminated by the angular artery. CONCLUSION: Understanding these variational branches of the triple facial artery and their relationships is crucial for avoiding complications in reconstructive and reparative maxillofacial, craniofacial and plastic surgery in order to mitigate the risk of damage to the facial artery during flap surgery.

Reappraisal of the types of trigeminal porus and importance in surgical applications.

OBJECTIVE: The detailed information regarding the types of trigeminal porus (TP) and related surgical approach is lacking in the literature. Therefore, we performed this study to elucidate further the types of TP and the relationships with critical surgical landmarks in the skull base. METHODS: The study was performed on 19 formalin-fixed cadavers of the cranial base (52.6% male, n = 10; 47.4% female, n = 9) on both sides. Calculations were made of the vertical dimension (VD), horizontal dimension (HD), and types of TP, the thickness of the TP, the HD and VD of the internal acoustic meatus, the distance between the TP-IAM, the thickness of the ossifying tissue that forms the TP, the trigeminal nerve (CN V) in both types and the distance between the CN V-VI. RESULTS: The elliptical (42.1% left, 36.8% right), oval (52.6% left, 36.8% right) and slit-like (5.3% right) types of TP were detected (X2 = 11.722). The HD of the TP was, on average, 8.02 mm (female) and 9.2 mm (male) on the right side, and 8.26 mm (female) and 8.81 mm (male) on the left side. The VD of the TP was, on average, 1.99 mm (female) and 2.65 mm (male) on the right side, and 2.42 mm (female) and 2.94 mm (male) on the left side. CONCLUSIONS: In our study, ellipse and slit-like types of TP are taken into account in order to plan the surgical approaches to remove or prevent the extension of tumors. A combined surgical technique is recommended to reach the TP easily without damaging the nearby surgical structures during surgery. The oval type of TP allows a wide range of movements, so it is more advantageous in skull base surgery.

Radical vulvectomy with right gluteal and left medial thigh V-Y advancement flap reconstruction

Vulvar cancer is rare. The vulva constitutes the external female genitalia and it is associated with the perineum with the intersection of urinary, sexual and anal systems. The deep anatomy of the perineum in the urogenital and anogenital triangle should be well-known to gynecological oncologists. Radical vulvectomy is the surgical treatment of choice in gross tumors expanding over the vulvar skin. After this type of excision, reconstruction is critically important because it is not always feasible to suture the vulvar defect in a primary manner. Thus, the reconstruction options should also be known to gynecological oncologists. Here, we present a video of radical vulvar cancer surgery, which was performed on a cadaver with gluteal and medial thigh V-Y advancement flap reconstruction.

Intraforaminal Dural Septations of the Jugular Foramen: A Cadaveric Study.

OBJECTIVE: The aim of this study was to define the types, prevalences, and diameters of dural septations (DSs) on the inner surface of the jugular foramen (JF) and to describe the distances between the JF, the glossopharyngeal nerve (cranial nerve [CN] IX), vagus nerve (CN X), and accessory nerve (CN XI), the internal acoustic meatus, and nearby surgical landmarks on cadaveric heads. METHODS: Seventeen adult (9 men and 8 women) formalin-fixed cadaveric heads were used to analyze the types and prevalence of DS bilaterally. Diameters and distances between the DS and the adjacent CNs (CN IX-XI) were measured by digital microcaliper. The multiple t test (SPSS version 25) was used to analyze the comparison between both sides via diameters, numbers, distance, length, and thickness of DS. RESULTS: The most frequent type of DS was type I (62.5%, right; 56.3%, left), followed by type II (18.8%, right; 25%, left), type III (12.5%, right; 6.3%, left), and type IV (6.3%, right; 12.5%, left). The mean diameter of the septum was 0.6-1 mm, and the mean length of the dural septa was 4.01 mm (right) and (3.83 mm) left. The difference in the length and thickness of the DS between the genders was statistically significant on both sides (P < 0.05). The DS-CN X and DS-JF distances of women were greater than those of men on the right side (P < 0.05). CONCLUSIONS: The significant differences between dural septum types on the 2 sides of the body may indicate asymmetric location or a variant emerging site of CNs in the same individual.

Evaluation of lacrimal gland dimensions with MR imaging in a Turkish population sample / Evaluación de las dimensiones de la glándula lagrimal con imágenes de RM en una muestra de población turca

SUMMARY: We aimed to evaluate the morphology of normal lacrimal gland in three different axes in a Turkish population sample by using magnetic resonance (MR) images in relation to sex, age, and side. Cranial MR images obtained by 3 Tesla MR unit of 85 individuals (40 female, 45 male; mean age 42.20±23.30 years; age range 2-83 years) performed in Göztepe Medical Park Hospital between December 2015 and July 2017 for non-orbital diseases were evaluated retrospectively. Anteroposterior, craniocaudal, and transverse dimensions of the lacrimal gland were measured on axial, coronal, and sagittal planes of MR images, and were evaluated in relation to side, age, and sex. Axial transverse and sagittal craniocaudal dimensions of lacrimal gland were significantly greater in the right side, as the coronal craniocaudal and sagittal anteroposterior dimensions were greater in the left side. Female and male individuals showed differences in terms of right-left sides in most of the parameters. In Spearman's correlation analysis, age of individuals was negatively correlated with left axial anteroposterior (r=-0.347, p=0.020), left axial transverse (r=-0.439, p=0.003), left coronal transverse (r=-0.429, p=0.003), and right coronal transverse (r=-0.436, p=0.003) dimensions of lacrimal gland. This is the first study determining certain morphometric parameters of the lacrimal gland in Turkish population sample. The side of lacrimal gland, and sex and age of individuals affect its dimensions. On the basis of reference measurements in the present study, orbital MR imaging can be used for the evaluation of lacrimal gland and its pathologies.

RESUMEN: El objetivo de este estudio fue evaluar la morfología de la glándula lagrimal normal en tres ejes diferentes en una muestra de población turca, mediante el uso de imágenes de resonancia magnética (RM) en relación con el sexo, la edad y lados izquierdos- derechos. Las imágenes RM obtenidas por RM 3 Tesla, en 85 individuos (40 mujeres y 45 hombres, edad media 42.20 ± 23.30 años, rango de edad entre 2 y 83 años) se realizaron en Göztepe Medical Park Hospital, entre diciembre de 2015 y julio de 2017. Considerando las enfermedades no orbitales, estas fueron evaluadas retrospectivamente. Se midieron las dimensiones anteroposterior, craneocaudal y transversal de la glándula lagrimal en los planos axial, coronal y sagital de las imágenes, y se evaluaron en relación con el lado, la edad y el sexo. Las dimensiones craneocaudal axiales transversales y sagitales de la glándula lagrimal fueron significativamente mayores en el lado derecho, y las dimensiones craneocaudal y anteroposterior sagital coronal fueron mayores en el lado izquierdo. Individuos femeninos y masculinos mostraron diferencias en términos de lados derecho-izquierdo en la mayoría de los parámetros. En el análisis de correlación de Spearman, la edad de los individuos se correlacionó negativamente con el anteroposterior axial izquierdo (r = -0.347, p = 0.020), transversal axial izquierdo (r = -0.439, p = 0.003), transversal coronal izquierdo (r = -0.429, p = 0.003), y las dimensiones transversales coronales derechas (r = -0.436, p = 0.003) de la glándula lagrimal. Este es el primer estudio que determina ciertos parámetros morfométricos de la glándula lagrimal en la muestra de la población turca. El lado de la glándula lagrimal, y el sexo y la edad de los individuos afectan sus dimensiones. En el presente estudio basado en las mediciones de referencia, la RM orbital se puede utilizar para la evaluación de la glándula lagrimal y sus patologías.

Sphenoid Sinus in Relation to Age, Gender, and Cephalometric Indices.

The sphenoid sinus is located in the center of the cranial base and is surrounded by numerous neurovascular structures. The aim of this study was to determine sphenoid sinus types and subtypes, dimensions of the sinus and cranium, and the relations of these to age and gender.Computed tomography data was obtained from 144 patients to determine right sphenoidal volume (sphVOLR), left sphenoidal volume (sphVOLL), total sphenoidal volume (sphVOLT), anteroposterior length of the sphenoid sinus (sphAP), laterolateral length of the sphenoid sinus (sphLL), head circumference (crHC), fronto-occipital length (crFO), and biparietal length (crBP), with OSIRIX software. The patients' ages ranged between 9 and 83 years (mean age 38 ±â€Š15.5 years). The study included 89 males (mean age 39 ±â€Š15.5 years) and 55 females (mean age 38 ±â€Š15.6 years).Conchal (1.4%), presellar (8.3%), sellar (23.6%), and postsellar (66.7%) type sphenoid sinuses were determined based on the extension of pneumatization around the sella turcica. Each type of sphenoid sinus was classified into the following 5 types based on the direction of pneumatization: body, full lateral, pterygoid, lesser wing, and greater wing subtypes. Mean sphAP was determined as 29.72 mm and mean sphLL as 37.73 mm. In 5 patients only (3.4%), the sphenoid sinus was not divided into right and left by the intersphenoidal septum.The variations in the extensions of pneumatization of the sphenoid sinus and its dimensions might be used to estimate the selection of a surgical approach to lesions bordering the sinus.

Evaluation of Eyeball and Orbit in Relation to Gender and Age.

The orbital aperture is the entrance to the orbit in which most important visual structures such as the eyeball and the optic nerve are found. It is vital not only for the visual system but also for the evaluation and recognition of the face. Eyeball volume is essential for diagnosing microphthalmos or buphthalmos in several eye disorders. Knowing the length of the optic nerve is necessary in selecting the right instruments for enucleation. Therefore, the aim of this study was to evaluate eyeball volume, orbital aperture, and optic nerve dimensions for a morphological description in a Turkish population sample according to gender and body side.Paranasal sinus computed tomography (CT) scans of 198 individuals (83 females, 115 males) aged between 5 and 74 years were evaluated retrospectively. The dimensions of orbital aperture, axial length and volume of eyeball, and diameter and length of the intraorbital part of the optic nerve were measured. Computed tomography examinations were performed on an Activion 16 CT Scanner (Toshiba Medical Systems, 2008 Japan). The CT measurements were calculated by using OsiriX software on a personal computer. All parameters were evaluated according to gender and right/left sides. A statistically significant difference between genders was found with respect to axial length of eyeball, optic nerve diameter, dimensions of orbital aperture on both sides, and right optic nerve length. Furthermore, certain statistically significant side differences were also found. There were statistically significant correlations between age and the axial length of the eyeball, optic nerve diameter, and the transverse length of the orbital aperture on both sides for the whole study group.In this study we determined certain morphometric parameters of the orbit. These outcomes may be helpful in developing a database to determine normal orbit values for the Turkish population so that quantitative assessment of orbital disease and orbital deformities will be evaluated both for preoperative planning and for assessing postoperative outcomes.

Anatomic variations of sphenoid sinus pneumatization in a sample of Turkish population: MRI study / Variaciones anatómicas de la neumatización del seno esfenoidal en una muestra de población turca: estudio por resonancia magnética

There are a number of variations regarding morphometric anatomy and degree of pneumatization of the sphenoid sinus. In our study, we planned to examine and show the differences of pneumatization of the sphenoid sinus particularly to guide the neurosurgeon during transsphenoidal surgery. Sagittal T1-weighed spin-echo Magnetic Resonance Images (MRIs) of 616 adult individuals (406 women and 210 men) were analyzed, retrospectively. According to the collected data from our study, the most common type of the sphenoid sinus was the sellar type (83%; n=511) for the whole study group. Of the 616 individuals 16.6% (n=102) had presellar type and 0.5% (n=3) had conchal type of sphenoid sinus. Preoperative detailed detection of the anatomical characteristics of sphenoid sinus is essential. A thorough information obtained from studies of the regional anatomy and awareness of its variability can provide a safe and accurate transsphenoidal and extended endoscopic skull base approaches.

Existen variaciones respecto a la anatomía morfométrica y el grado de neumatización del seno esfenoidal. En nuestro estudio, se examinaron las diferencias de neumatización del seno esfenoidal, especialmente para guiar al neurocirujano durante la cirugía transesfenoidal. Fueron analizadas las imágenes sagitales T1-spin de resonancia magnética (RM) de 616 individuos adultos (406 mujeres y 210 hombres). De acuerdo con los datos obtenidos a partir de nuestro estudio, el tipo más común de seno esfenoidal fue el de silla turca (83%, n=511) para todo el grupo de estudio, 16,6% (n=102) corresponden al tipo presellar y 0,5% (n=3) al tipo conchal. Una detección preoperatoria detallada de las características anatómicas del seno esfenoidal es esencial. Información exhaustiva obtenida de los estudios de la anatomía y el conocimiento de su variabilidad regional puede proporcionar un abordaje endoscópico transesfenoidal extenso, seguro y preciso, de la base de cráneo.

Evaluation of the lateral wall of the nasal cavity in relation to septal deviation / Evaluación de la pared lateral de la cavidad nasal en relación con la desviación septal

The objective of this study was to evaluate the relationship between variations of the lateral wall of the nasal cavity and septal deviation (SD). Coronal and axial paranasal sinus CT images of 115 individuals (65 females, 50 males) were reviewed and the presence of pneumatisation and hypertrophy of the conchae was evaluated. Pneumatisation of the concha was classified as lamellar concha bullosa (LCB), bulbous concha bullosa (BCB), or extensive concha bullosa (ECB). If bulbous and extensive conchae and hypertrophic conchae were bilateral the side on which it was greatest was accepted as the dominant concha. The relationship between these variations and nasal septum deviation was also taken into account. Eighty-six (74.8 percent) of the 115 subjects had SD. Of these, 20 were not affected by the size of the middle nasal concha (MNC) or inferior nasal concha (INC). Thirty-four cases had dominant MNC, 20 had dominant INC, and 11 had both dominant MNC and dominant INC, and all of which had SD towards the opposite side. In one case there was SD towards the side in which the MNC was dominant. Our data indicate that coexistence of pneumatisation or hypertrophy of the conchae and SD was more common in adults compared to the results of similar studies conducted with a wide range of age groups, including children. Thus the presence of SD together with a large concha increases with age. A prospective study, which will include infants, will elucidate the relationship between conchae and SD.

El objetivo del estudio fue evaluar la relación existente entre las variaciones de la pared lateral de la cavidad nasal y la desviación septal. Se revisaron los senos paranasales en imágenes de TC de 115 individuos (65 mujeres, 50 varones) coronales y axiales y se evaluó en ellas la presencia de neumatización e hipertrofia de los conchas nasales. La neumatización de la concha fue clasificada como concha laminar bulosa (CLB), concha bulbosa bulosa (CBB), o concha extensa bulosa (ECB). Conchas nasales bulbosa y extensa y conchas hipertróficas eran bilaterales siendo el lado en que esta era más grande como la concha dominante. También se tuvo en consideración la relación entre estas variacio nes y la desviación del tabique nasal. Ochenta y seis (74,8 por ciento) de los 115 sujetos tenían desviación septal. De éstos, 20 no se vieron afectados por el tamaño de la concha nasal media (CNM) o concha nasal inferior (CNI). Treinta y cuatro de los casos tenía CNM dominante, 20 tenían CNI dominante, y 11 tenían tanto CNM dominante y CNI dominante, todos los cuales tenían desviación septal hacia el lado opuesto. En un caso hubo desviación septal hacia el lado en el que el CNM era dominante. Nuestros datos indican que la coexistencia de neumatización o hipertrofia de conchas nasales y la desviación septal es más común en adultos en comparación con los resultados de estudios similares realizados con una amplia gama de grupos etarios, incluidos los niños. Así, la presencia de desviación septal, junto con una gran concha aumenta con la edad. Un estudio prospectivo, que incluirá los bebés, aclarará la relación entre concha nasal y desviación septal.

Advanced analysis of finger-tapping performance: a preliminary study.

BACKGROUND: The finger-tapping test is a commonly employed quantitative assessment tool used to measure motor performance in the upper extremities. This task is a complex motion that is affected by external stimuli, mood and health status. The complexity of this task is difficult to explain with a single average intertap-interval value (time difference between successive tappings) which only provides general information and neglects the temporal effects of the aforementioned factors. AIMS: This study evaluated the time course of average intertap-interval values and the patterns of variation in both the right and left hands of right-handed subjects using a computer-based finger-tapping system. STUDY DESIGN: Cross sectional study. METHODS: Thirty eight male individuals aged between 20 and 28 years (Mean±SD = 22.24±1.65) participated in the study. Participants were asked to perform single-finger-tapping test for 10 seconds of test period. Only the results of right-handed (RH) 35 participants were considered in this study. The test records the time of tapping and saves data as the time difference between successive tappings for further analysis. The average number of tappings and the temporal fluctuation patterns of the intertap-intervals were calculated and compared. The variations in the intertap-interval were evaluated with the best curve fit method. RESULTS: An average tapping speed or tapping rate can reliably be defined for a single-finger tapping test by analysing the graphically presented data of the number of tappings within the test period. However, a different presentation of the same data, namely the intertap-interval values, shows temporal variation as the number of tapping increases. Curve fitting applications indicate that the variation has a biphasic nature. CONCLUSION: The measures obtained in this study reflect the complex nature of the finger-tapping task and are suggested to provide reliable information regarding hand performance. Moreover, the equation reflects both the variations in and the general patterns associated with the task.

Guidelines for standard photography in gross and clinical anatomy.

Photography has a widespread usage in medicine and anatomy. In this review, authors focused on the usage of photography in gross and clinical anatomy. Photography in gross and clinical anatomy is not only essential for accurate documentation of morphological findings but also important in sharing knowledge and experience. Photographs of cadavers are supposed to demonstrate the required information clearly. Thus, photographs should be taken with certain techniques in order to obtain high quality and standardization. Camera, lens, lighting, background, and certain photographic techniques are among the factors to achieve precise images. A set of suggested guidelines for accomplishing these standards are given for anatomists.

Evaluation of Lingual Frenulum Using Geometric Morphometrics / Evaluación del Frenillo Lingual Utilizando Morfometría Geométrica

A fold of tissue, the lingual frenulum, extends onto the inferior surface of the tongue from near the base of the tongue on midline. The shape, length and alignment of lingual frenulum vary between individuals. The aim of this study is to evaluate morphology of lingual frenulum with respect to gender. Ninety seven volunteers who were students and employees of Zonguldak Karaelmas University, School of Medicine participated in the study. Two individuals with a history of hepatitis and 20 individuals with inadequate photographs were excluded from the study. Morphometric analyses were performed on the photographs of 75 volunteers (36 men, 39 women). Lingual frenulum photograph of each individual was taken using standard photographic techniques. The individual opened his/her mouth as much as possible with the tongue in contact with the interior surface of the two middle incisors. The morphology of the lingual frenulum was evaluated with linear measurements and geometric morphometrics methods. The length of lingual frenulum between the attachments of it, to the floor of the mouth and the inferior surface of the tongue were measured using Digimizer software. Four reference points determined previously were marked by tpsDig2 software on photographs. This process was repeated for each sample to create a txt file containing reference points of 75 individuals. Statistical analysis of txt files were carried out using Morpheus software. There were no statistically significant differences between the linear measurements of lingual frenulum according to gender (p>0.05). Lingual frenulum had no gender differences according to geometric morphometrics analysis as well (p>0.05). It can be suggested that lingual frenulum had similar architecture in both sexes.

Un pliegue de tejido, el frenillo lingual, se extiende sobre la superficie inferior de la lengua cerca de su base en la línea mediana. La forma, la longitud y la alineación del frenillo lingual pueden variar entre los individuos. El objetivo de este estudio fue evaluar la morfología del frenillo lingual con respecto al sexo. Participaron en el estudio 97 voluntarios, estudiantes y empleados de la Facultad de Medicina de la Universidad Zonguldak Karaelmas. Dos individuos con antecedentes de hepatitis y 20 personas con fotografías inapropiadas fueron excluidas del estudio. El análisis morfométrico se llevó a cabo en las fotografías de 75 voluntarios (36 hombres y 39 mujeres). La fotografía del frenillo lingual de cada individuo fue tomada usando las técnicas fotográficas convencionales. Cada individuo abrió su boca tanto como fue posible con la lengua en contacto con la superficie interna de los dos incisivos centrales superiores. La morfología del frenillo lingual se evaluó con métodos de medidas lineales y morfometría geométrica. La longitud del frenillo lingual entre su origen e inserción del suelo de la boca a la superficie inferior de la lengua se midieron utilizando el software Digimizer. Cuatro puntos de referencia determinados previamente fueron marcados mediante el software tpsDig2 en cada fotografía. Este proceso se repitió en cada muestra para crear un archivo txt que contuviera los puntos de referencia de 75 personas. El análisis estadístico de los archivos txt se llevó a cabo utilizando el software Morpheus. No hubo diferencias estadísticamente significativas entre las mediciones lineales de frenillo lingual, en función del sexo (p>0,05). El frenillo lingual no tuvo diferencias de sexo según el análisis de morfometría geométrica (p>0,05). Se puede sugerir que el frenillo lingual tiene una arquitectura similar en ambos sexos.

Evaluation of hand asymmetry in relation to hand preference.

We evaluated the asymmetric hand measurements in right- and left-handed individuals. 343 men and 290 women aged 18-42 years (22.11 +/- 2.07) participated in the study. There were no statistically significant differences when right-left differences in hand length, third finger length, palmar length, and the digit index value were evaluated according to hand preference and sex. Statistically significant differences were found for right-left differences in hand width, hand-shape index, and the palmar length/width according to hand preference. The strong left-handers, weak left-handers, and ambidextrous individuals in the study group all exhibited asymmetry favoring the left and were considered together. Similarly, the strong and weak right-handers exhibited asymmetry favoring the right hand and were considered together. The difference between these two groups was significant. When the data were evaluated according to sex, significant differences were found between the subgroups. In particular, right-left differences in the hand-shape index and palmar length/width values of the strong left-handers, weak left-handers, and ambidextrous individuals were found to be statistically significant according to sex; in contrast, the strong and weak right-handers showed no significant differences according to sex. These results suggest a relation of hand asymmetry to hand preference in a Turkish population.

The thickness of the ligamentum flavum in relation to age and gender.

Hypertrophy of the ligamentum flavum (LF) can reduce the diameter of the spinal canal posteriorly. Such stenosis may significantly compress the dural sac and nerve roots, resulting in symptoms, even without a bulging anulus fibrosus or herniated nucleus pulposus. We conducted an anatomical study to determine the influence of age and gender on the thickness of the LF at the lower lumbar levels using magnetic resonance imaging (MRI). The thickness of 1,280 ligaments was determined at the L4-L5 and L5-S1 levels from MRIs. We screened 320 patients (152 males [47.5%] and 168 females [52.5%]) between 21 and 82 years of age. There were no significant differences in LF thickness with respect to gender (P > 0.05). Age was not correlated with the thicknesses of the LF. The left LF at the L4-L5 and L5-S1 levels was significantly thicker than on the right side (P < 0.05). Furthermore, the LF thicknesses at L5-S1 bilaterally were significantly greater than on the corresponding sides at L4-L5 (P < 0.05). The LF is an important anatomical structure, which might cause low back or leg pain. Therefore, the thickness of the LF should be measured and evaluated carefully in the case of spinal stenosis.

Association of height and weight with second to fourth digit ratio (2D:4D) and sex differences.

Sex difference in 2D:46 digit ratio was studied in 386 right-handed students. The lengths of index (2D) and ring (4D) fingers were measured using a caliper. Height and weight of participants were recorded. Body height correlated negatively with right- and left-hand digit ratios in the total sample (N = 386); correlations were significant for the left-hand digit ratio of men and for the right-hand digit ratio of women (no significant correlations with weight). Males had a significantly lower 2D:4D ratio than females. After controlling for height, sex differences in right- and left-hand digit ratios completely disappeared. The results suggest that height of adults reflecting prenatal hormone status may play a role in differences between men and women in 2D:4D digit ratio for right-handers.