Bulent Sabri Cigali

Measurement of tendon excursion velocity with colour Doppler imaging: a preliminary study on flexor pollicis longus muscle

PURPOSE To study the use of colour Doppler imaging (CDI) for the measurement of maximum and mean tendon velocity. Recent studies showed that CDI, normally used for blood flow examinations, can be used for the imaging of tendons at the hand and wrist region. Although other modalities are available for imaging of the muscle-skeletal system, in vivo measurements of the velocity of tendon excursion are not possible. METHODS The flexor pollicis longus (FPL) tendon of 16 healthy volunteers was measured bilaterally at two levels (wrist and thenar). A splint from the fingers along the proximal lower arm was applied. The thumb was fixed to the splint from the the first phalanx to allow flexion of the interphalangeal (IP) joint only. Pulsed CDI was used for the measurements. The maximum and mean velocities of the FPL tendon were measured at spectrum display mode during continuous voluntary contractions. At least 10 sequential Doppler peaks (cm/s) were recorded at every trial. The measurements were repeated three times. Paired t-test and correlation coefficients were calculated between levels on the same side and the opposite side. RESULTS No significant differences were found between two levels of the same hand and of the opposite hand. As expected, the data revealed variations in the inter-individual tendon velocities. CONCLUSIONS The velocity of the excursion of the FPL tendon can be measured with CDI with good reproducibility. It is expected that velocity measurements can be used in the future for the assessment of other tendons affected by various disorders.

Musculus Extensor Digiti Medii Proprius and Musculus Extensor Digitorum Brevis Manus – A Case Report of a Rare Variation

The musculus extensor digiti medii proprius and musculus extensor digitorum brevis manus are anomalous extensor muscles of the hand. During the routine dissection of a white male cadaver a musculus extensor digiti medii proprius was seen on both hands and a musculus extensor digitorum brevis manus was seen on the left hand. The extensor medii proprius has a belly originating from the distal third of the ulna near the extensor indicis proprius and its tendon is inserted into the dorsal aponeurosis of the middle finger on both hands. On the left hand there was another anomalous muscle (musculus extensor digitorum brevis manus) which originated from the distal end of the radius, carpal ligaments and carpal joint capsule and inserted on the tendon of the extensor digiti medii proprius. This case is a multivariation of the hand extensor muscles and a musculus extensor digitorum brevis manus inserting on the musculus extensor digiti medii proprius has not been reported previously.

Accessory inferior thyroid artery and internal thoracic artery originating from the thyrocervical trunk.

During the routine dissection of an 87-year-old Caucasian male cadaver, an accessory inferior thyroid artery originating from the left suprascapular artery was detected. In addition to the existence of inferior and superior thyroid arteries, a third thyroid artery arising from the left suprascapular artery was present at the left of these arteries; this artery was determined as the accessory inferior thyroid artery. Again, the left internal thoracic artery arose from the thyrocervical trunk. The internal thoracic artery originated near the thyrocervical trunk’s origin point and descended vertically. The thyrocervical trunk ended near the medial border of the anterior scalene muscle after giving rise to the inferior thyroid, transverse cervical and suprascapular arteries.

What can Anthropometric Measurements Tell us About Mallampati Classification

Objective: Mallampati scoring is the most common examination method for predicting possible intubation problems. The purpose of this study is to investigate the relationship of facial anthropometric measurements with the modified Mallampati score (MMS). Material and Methods: The study population consisted of 153 male and 170 female volunteers (mean ages, 48,9p16,9 and 44,1p15,4 years, respectively). All participants were subjected to Mallampati scoring and facial anthropometric measurements during pre-operative visit. Anthropometric measurements included inter-incisor gap, lower face height, thyrogonial length, thyromental distance and bigonial distance. The relationship of anthropometric measurements with the MMS was investigated by statistical analysis. Results: Bigonial distance showed a positive correlation with the MMS (r=0.857; pl0.001), whereas inter-incisor gap, lower face height, and thyromental distance showed negative correlations (r=-0.809, r=-0.738, and r=-0.762 respectively pl0.001 for all). ROC and AUC analysis showed that the BGD level had the highest significant AUC (pl0.001). Optimal cut-off point for BGD was g113 mm, and at this cut-off point, the sensitivity rate was 94.8% and the specificity rate was 95.9%. BGD was the best predictor for discriminating MMS 3-4. Conclusion: We suggest that facial measurements such as bigonial distance may be used as alternatives for Mallampati evaluation when the patients condition is not suitable for Mallampati scoring. Turkish Baslik: Antropometrik Olcumler Mallampati Siniflamasi Hakkinda Ne Soyleyebilir? Anahtar Kelimeler: Antropometri, Bigonial mesafe, kesici disler arasi mesafe, Modifiye Mallampati skoru, Tiromental mesafe Giris: Mallampati skoru entubasyon ile ilgili olasi sorunlari tahmin etmek icin en yaygin kullanilan yontemidir. Bu calismanin amaci, modifiye Mallampati skoru (MMS) ile yuz antropometrik olcumler arasindaki iliskiyi arastirmaktir. Metod: Calisma 153 erkek ve 170 kadin gonullu ile (ortalama yas, 48,9 p 16,9 ve 44,1 p 15,4 yil, sirasiyla) yapildi. Tum katilimcilar pre-operatif ziyareti sirasinda Mallampati skoru degerlendirmesi ve yuz antropometrik olcumleri yapildi. Antropometrik olcumler arasinda kesici disler arasi mesafe, alt yuz yuksekligi, tirogonial uzunluk, tiromental mesafe ve bigonial mesafe vardi. MMS ile antropometrik olcumler arasindaki iliski istatistiksel analizi ile arastirildi. Sonuc: Bigonial mesafe MMS ile pozitif korelasyon oldugu gozlendi kesici disler arasi mesafe, alt yuz yuksekligi ve tiromental mesafe negatif korelasyon gostermekteydi (r = 0.857 p l0.001) (r = -0,809, r = -0,738, r = - 0.762 p l0.001). ROC ve AUC analizi bigonial mesafede yuksek duzeyde anlamli AUC (p l0.001) oldugu saptandi. Bigonial mesafe icin optimal cut-off noktasig 113 mm idi ve bunun duyarlilik orani % 94.8 ve ozgulluk orani % 95.9 idi. Bigonial mesafe MMS 3-4 icin en iyi tanimlayici oldugu saptandi. Tartisma: Bu calisma, hastanin genel durumunun Mallampati skorunun degerlendirmesi icin uygun olmadigi zamanlarda bigonial mesafe gibi antropometrik yuz olcumleri Mallampati degerlendirmesi icin alternatif olarak kullanilabilecegini gostermektedir.

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The articles about various pneumoconiosis in dental technicians who work in inconvenient conditions have been increasing in recent years. Exposure to dust and fume that occur during the dental procedure may play role in pneumoconiosis of dental technicians. A 53 years old male patient conveyed that he has worked in dental prosthesis procedures for 22 years (1968-1990).Environmental asbestosis was not established in the history of the case but there were calcified pleural plaques in the chest x-ray graphy.There were appearance of calcific asbest plaques in many section of thorax CT.A case of pneumoconiosis in dental technician who work in unadequate preventive conditions was reported in this paper. Probably ,exposure to the asbest fibers that occurs during the procedure of dental prosthesis were the main reason for developing calcific pleural lesions.The aim of this study was to investigate the efficacy of occlusion treatment on different age group patients with anisometropic amblyopia. Occlusion treatment was applied to 34 patients, 15 preschool children (age between 4-6 years), and 19 school age children (7-11 years). Daily duration of occlusion was minimum 6 hours. Best corrected visual acuity of patients was measured initially, at the end of 1st, 3rd and 6th months. Data belonging to amblyopia groups was compared with one another and with the controls. Initial visual acuity of two amblyopia groups were similar, however there was a significant difference between the amblyopia groups and the controls (PChest pain is a frequently encountered problem in childhood. In this study we aimed to asses the relationship between exertional chest pain and asthma by using the peek expiratory flow rate measurements. For this study, 64 otherwise healthy children with chest pain (chest pain group), 9-16 years of age (mean 11.9) and 58 healthy (control group), 8-11 years (mean 11.5) were compared with the use of peak flow-meter. Ages, weights, heights, systolic-diastolic blood pressures, pulses recorded. Preexertional and postexertional peak flow measurements (PEFR) at 2, 5 and 10 minutes determined. There was a decrease more than 15% in PEFR measures in 7 (10.9%) of chest pain group and in 1 (1.7%) of control group children (p