Topographic anatomy of the internal branch of the superior laryngeal nerve.

PURPOSE: The aim of this study was to investigate the surgical and topographical anatomy of the internal branch of the superior laryngeal nerve (ibSLN) in laryngectomy patients. METHODS: Patients aged 36-90 years old who underwent a total laryngectomy operation with a diagnosis of laryngeal carcinoma participated in the study. Fifteen patients who underwent a total laryngectomy operation between June 2015 and November 2016 were included in the study. A total of 29 superior laryngeal nerves (SLN) of 15 patients were studied. The position of the nerve was photographed before the thyrohyoid membrane (THM) was passed during dissection. The relationship and course of the ibSLN with respect to the superior laryngeal artery (SLA) were observed. The distance to adjacent formations and branching variants were examined along the course of the nerve. RESULTS: Of the total 29 ibSLN, 17 were divided into three branches and 12 into two branches. In all cases except for one, the ibSLN course after piercing the THM was determined. The ibSLN penetrated the THM at a mean of 12.0 ± 2.61 mm (6-16 mm) from the superior border of the thyroid cartilage. The ibSLN penetrated the THM with a mean distance of 9.34 ± 1.65 (6-12) mm from the inferior border of the hyoid bone. CONCLUSION: Our study demonstrated the surgical and topographical features of the ibSLN with respect to the THM, and provided a more precise knowledge of its anatomy in laryngectomy patients. It thus may help head and neck surgeons identify this nerve.

Evaluation of relationship between prevalence of palmaris longus muscle and handedness in Turkish population / Evaluación de la relación entre la prevalencia del músculo palmar largo en la población turca

Palmaris longus (PL) is a fusiform muscle with a short belly and a long tendon that crosses superficially over flexor retinaculum. It flexes wrist and tenses palmar aponeurosis. The absence of PL prevalence varies from 0.6 % to 63.91 % in the literature. The existence of PL on the right hand is more common compared to the left hand. Thus, we aimed to determine the prevalence of PL in the Turkish population and the relation of PL absence with sex and handedness in this study. We evaluated 1050 students of Sakarya University between ages 18-28 who participated in the study (525 males, 525 females). After completing a questionnaire including handedness, the volunteers were examined on both hands using some standard tests to find out PL absences. Pearson chi-square and Fischer's exact tests were used for statistics in SPSS 22 software. It was determined that 937 subjects were right-handed (89.2 %), 70 subjects were left-handed (6.6 %) and 43 subjects were ambidextrous (4.1 %). The presence of bilateral PL was found in 653 subjects, while the absence of bilateral PL was defined in 186 subjects. The absence of PL on right and left hand was detected respectively on 108 (10.3 %) and 103 (9.8 %) subjects. Left-handedness was more common in males (7.2 %) than females (6 %). PL was absent in 397 (37.8 %) subjects unilaterally and bilaterally. The study showed that our population has similar prevalence of PL absence with literature. Moreover, there was no correlation statistically between the absence of PL and sex or handedness.

El músculo palmar largo (PL) es un músculo fusiforme, con un vientre corto y un tendón largo que cruza superficialmente el retináculo flexor. Flexiona la muñeca y tensiona la aponeurosis palmar. La ausencia de prevalencia de PL varía de 0,6 % a 63,91 % en la literatura. La presencia de PL en la mano derecha es más común en comparación con la mano izquierda. Por lo tanto, nuestro objetivo en este estudio fue determinar la prevalencia de PL en la población turca y la relación de ausencia de PL con el sexo y la mano. Evaluamos a 1050 estudiantes de la Universidad de Sakarya entre 18-28 años de edad que participaron en el estudio (525 varones, 525 mujeres). Después de completar un cuestionario se examinaron ambas manos de los participantes usando algunas pruebas estándar para determinar la ausencia de PL. Se aplicaron las pruebas de Chi-cuadrado, Pearson y Fischer mediante el software SPSS 22. Se determinó que 937 sujetos eran diestros (89,2 %), 70 sujetos zurdos (6,6 %) y 43 sujetos ambidiestros (4,1 %). La presencia de PL bilateral se encontró en 653 sujetos, mientras que la ausencia de PL bilateral se definió en 186 sujetos. La ausencia de PL en los antebrazos derecho e izquierdo fue detectada en 108 casos (10,3 %) y 103 casos (9,8 %), respectivamente. La prevalencia de zurdos fue más común en los hombres (7,2 %) que en las mujeres (6 %). El PL estuvo ausente en 397 (37,8 %) sujetos unilateralmente y bilateralmente. El estudio mostró que nuestra población tiene similar prevalencia de ausencia de PL con respecto a lo hallado en la literatura. Por otra parte, no hubo correlación estadística entre la ausencia de PL y el sexo o la mano.

Evaluation of renal anomalies, inferior vena cava variations, and left renalvein variations by lumbar magnetic resonance imaging in 3000 patients

Background/aim: The variations and anomalies of the kidneys besides the variations of the inferior vena cava (IVC) and left renal vein (LRV) are mostly asymptomatic, but they carry potential risks particularly during retroperitoneal surgery and radiological interventions. Our aim was to find the frequencies, types, and sex distribution of renal anomalies and variations of the IVC and LRV utilizing magnetic resonance imaging (MRI). Materials and methods: Between November 2010 and April 2011, a retrospective study was conducted including lumbar spinal MRI of 3000 consecutive patients (1869 females and 1131 males) with a median age of 54 years (range: 9-78 years). Results: The percentages of renal anomalies and variations of the IVC and LRV were 0.9%, 0.07%, and 2.6%, respectively. Sex did not affect the distribution of renal anomalies (P = 0.2), IVC variations (P = 0.72), or LRV variations (P = 0.26).Conclusion: Lumbar spinal MRI is useful in detecting renal anomalies and variations of the IVC and LRV.

Altered Plasma MicroRNA Expression in Patients with Mitral Chordae Tendineae Rupture.

BACKGROUND: Mitral chordae tendineae rupture (MCTR) is a progressive disorder which leads to severe mitral regurgitation. Despite its importance, the precise pathogenetic mechanism of MCTR remains unclear. The study aim was to investigate the expression profile of circulating microRNAs (miRNAs) as being potentially involved in the development of MCTR. METHODS: Twenty-one patients with 'primary' MCTR, and 30 age- and gender-matched controls, were enrolled in the study. Comparisons were made between the expression levels of circulating miRNAs in MCTR patients and controls. Four target gene databases were used to predict target genes and pathways of differentially expressed miRNAs. RESULTS: Compared to controls, the expression of 22 miRNAs (hsa-miR-106b-5p, hsa-miR-126-3p, hsa-miR-150-5p, hsa-miR-17-5p, hsa-miR-195-5p, hsa-miR-19a-3p, hsa-miR-19b-3p, hsa-miR-20a-5p, hsa-miR-21-5p, hsa-miR-222-3p, hsa-miR-223-3p, hsa-miR-23a-3p, hsa-miR-25-3p, hsa-miR-92a-3p, hsa-miR-93-5p, hsa-miR-26b-5p, hsa-miR-30e-5p, hsa-miR-373-3p, hsa-miR-15b-5p, hsa-miR-16-5p, hsa-miR-191-5p, hsa-miR-26a-5p) were significantly down-regulated in the MCTR group. Bioinformatic analysis indicated that the following potential miRNA targets and pathways are commonly related to the development of MCTR: MMPs, TIMP-2,TGFBR2, VEGFA, PIK3R2, NRAS, PPP3CA, PPP3R1, PTGS 2 were predicted as putative targets of 13 of these miRNAs. CONCLUSIONS: The present study is the first to describe altered miRNA expression in patients with MCTR. Bioinformatic analysis has revealed that target genes involved in MCTR development were regulated by miRNAs.

DNA Repair Gene Polymorphism and the Risk of Mitral Chordae Tendineae Rupture.

Polymorphisms in Lys939Gln XPC gene may diminish DNA repair capacity, eventually increasing the risk of carcinogenesis. The aim of the present study was to evaluate the significance of polymorphism Lys939Gln in XPC gene in patients with mitral chordae tendinea rupture (MCTR). Twenty-one patients with MCTR and thirty-seven age and sex matched controls were enrolled in the study. Genotyping of XPC gene Lys939Gln polymorphism was carried out using polymerase chain reaction- (PCR-) restriction fragment length polymorphism (RFLP). The frequencies of the heterozygote genotype (Lys/Gln-AC) and homozygote genotype (Gln/Gln-CC) were significantly different in MCTR as compared to control group, respectively (52.4% versus 43.2%, p = 0.049; 38.15% versus 16.2%, p = 0.018). Homozygote variant (Gln/Gln) genotype was significantly associated with increased risk of MCTR (OR = 2.059; 95% CI: 1.097-3.863; p = 0.018). Heterozygote variant (Lys/Gln) genotype was also highly significantly associated with increased risk of MCTR (OR = 1.489; 95% CI: 1.041-2.129; p = 0.049). The variant allele C was found to be significantly associated with MCTR (OR = 1.481; 95% CI: 1.101-1.992; p = 0.011). This study has demonstrated the association of XPC gene Lys939Gln polymorphism with MCTR, which is significantly associated with increased risk of MCTR.

Anatomical variations of aortic arch branching: evaluation with computed tomographic angiography.

PURPOSE: The aim of this study was to investigate the frequency and gender distribution of variations in the aortic arch branching pattern using 64-slice computed tomograhic angiography. MATERIALS AND METHODS: A total of 1000 patients with a normal left-sided aortic arch who underwent computed tomographic angiography for various reasons were analysed retrospectively for the frequency of variation of aortic arch branching; the variations were categorised into seven types. RESULTS: Of the 1000 patients, 79.2% had a normal aortic arch branching pattern - type 1 - and 20.8% had variations. The frequency of type 2 variation - brachiocephalic and left common carotid arteries arising from the aortic arch in a common trunk - was 14.1%, that of type 3 - left vertebral artery originating from the aortic arch - was 4.1%, that of type 4 - coexistence of type 2 and type 3 - was 1.2%, that of type 5 - aberrant right subclavian artery - was 0.6%, that of type 6 - coexistence of aberrant right subclavian artery and bicarotid trunk - was 0.7%, and that for type 7 - thyroidea ima artery arising from the aortic arch - was 0.1%. The incidences of the variations of aortic arch branching were similar among males and females (20% versus 22.1%). The incidence of an aberrant right subclavian artery - type 5 and type 6 - was higher among females compared with males (2.5% versus 0.5), whereas the frequencies of the other variations were either equal or similar in both genders. CONCLUSION: Recognition of variations of aortic arch branching is important because they may cause symptoms due to tracheoesophageal compression or complications during surgical or endovascular interventional procedures of the aorta and its branches.

Determination of lateral ventricle and brain volume in children with stereological method using MRI / Determinación del volumen del ventrículo lateral y del cerebro en niños utilizando el método estereológico mediante RNM

Although brain development is most active during the intrauterina period of life, the processes of myelination and arborization affect the structure of the brain throughout childhood and adolescence. Brain development is also very active in the early years of a child's life, and continues to be so for approximately 15 years after gestation. Volumetric changes in the brain are effected by sex. Understanding the variability of human brain volume during development is important for the interpretation of childhood neuroimaging studies. Hence the aim of this study is to determine the effects of sex difference on brain volume (BV), lateral ventricle volume (LV) and the ratio of brain volume and lateral ventricle volumes as a percentage (RLBV%) of 90 healthy children between the ages of 6-17 according to their sex with MRI. These children were divided into three age groups of 6-9, 10-13 and 14-17 also BV, LV were calculated using the Cavalieri principle, which is classified as a stereological method and than RLBV% were calculated. Results: The BV of age group 6-9 was significantly smaller than the other two age groups (P < 0.05). General average BV of the age group 10-13 was higher than the other two age groups but this difference is insignificant. When the groups were compared according to sex, there was no important difference between girls and boys (P > 0.05). General average LV of the age group 6-9 was higher than the other two age groups but this difference insignificant. Moreover there was no sex difference. This study was presented that BV was continued to increase until the ages 10-13 for both of the genders. While LV was increased until the ages 10-13 for boys, it was had a negative relationship with changes of BV for girls.

Aunque el desarrollo del cerebro es más activo durante el período de la vida intrauterina, los procesos de mielinización y arborización afectan a la estructura del cerebro durante la infancia y la adolescencia. El desarrollo del cerebro es activo en los primeros años de la vida, y sigue siendo así durante unos 15 años después de la gestación. Cambios volumétricos en el cerebro son afectados según el sexo. La comprensión de la variabilidad del volumen del cerebro humano durante el desarrollo es importante para la interpretación de los estudios de neuroimagen en la infancia. Por lo tanto, el objetivo de este estudio fue determinar, a través de resonancia nuclear magnética, los efectos de las diferencias de sexo en el volumen cerebral (VC), en el volumen del ventrículo lateral (VL) y la relación porcentual de los volúmenes del cerebro y del ventrículo lateral (% VLVC) de 90 niños sanos entre 6-17 años de edad, en ambos sexos. Los niños fueron divididos en tres grupos de edad: 6-9, 10-13 y 14-17. El VC y el VL se calcularon utilizando el principio de Cavalieri, además de la relación porcentual RLBV. El VC del grupo 6-9 años fue significativamente menor que el de los otros dos grupos (p <0,05). El promedio del BC del grupo 10-13 años fue superior a los otros dos grupos de edad, pero esta diferencia fue mínima. Cuando se compararon los grupos en cuanto al sexo, no hubo diferencia entre niños y niñas (P> 0,05). El promedio general del grupo VL de 6-9 años fue mayor que los otros dos, sin diferencia significativa entre ambos sexos. El VC siguió aumentando hasta los 10-13 años en ambos sexos. Mientras LV aumentó hasta los 10-13 años de edad en los niños, se observó en las niñas una relación negativa con cambios de BV.