Erdem Gumusburun

Frequency in the anomalous origin of the right coronary artery with angiography in a Turkish population

OBJECTIVE The estimate frequency of anatomic variations in origin of the right coronary artery in a Turkish population. MATERIAL AND METHOD The angiographic data of 5253 consecutive adults patients undergoing coronary angiography were analysed retrospectively for the diagnosis of anomalous origin of the right coronary artery. RESULTS Among 5253 adults patients, five (0.09%) patients had anomalous origin of the right coronary. They had an isolated anomalous origin of the right coronary artery. The right coronary arose from the left coronary sinus of Valsalva (there was separate orificium for the right coronary artery and the left coronary artery) in two (0.03%) patients, from above the left coronary sinus of Valsalva in three (0.05%) patients. In all patients, the anomalous origin of right coronary artery from the left sinus of Valsalva and from above the left coronary sinus of Valsalva coursed between the aorta and the pulmonary artery. CONCLUSION The anomalous origin of the right coronary artery is a rare congenital cardiac malformation. Most patients remain asymptomatic. However, there are cases of sudden cardiac death described in the literature, indicating a potentially malign course of the disease. The angiographic recognition of this vessel may be useful for physicians dealing with diagnosis and treatment of the anomaly of the right coronary artery.

A variation of the brachial plexus characterized by the absence of the musculocutaneous nerve a case report

A variation of the brachial plexus characterized by the absence of the musculocutaneous nerve on both sides was observed during the dissection of a 72 year-old female cadaver. The long thoracic nerve included only the fibers from C5 and C6 on the left side. The musculocutaneous nerve was absent and two branches from the lateral cord innervated the coracobrachialis muscle. The median nerve innervated the biceps brachii and brachialis muscles in the arm and also gave off the lateral antebrachial cutaneous nerve. Additionally, a communicating branch was found from the median nerve to the ulnar nerve in the forearm. The knowledge of the anatomical variations of the peripheral nerve system can help give explanation when encountering an incomprehensible clinical sign.

Double Right Coronary Artery: Review of Literature

Anomalies of the coronary artery are often asymptomatic and uncommon. We report an extremely rare coronary artery anomaly, a double right coronary artery. A 50-year-old male patient was hospitalized with the diagnosis of unstable angina pectoris. Right coronary artery (RCA) injection showed filling of two separately originating RCAs, coursing towards the right atrio-ventricular groove. Then they give a marginal branch and a septal artery, terminated by giving off the posterior descending artery (PDA) in posterior interventricular groove. Coronary anomalies should be recognized to avoid problems during coronary intervention and cardiac surgery.

Hippocampal Volume in Schizophrenia and Its Relationship with Risperidone Treatment: A Stereological Study

The purpose of this study was to assess the significance of the hippocampal volume differences and its relation with risperidone treatment in schizophrenia. In schizophrenic patients who were on risperidone treatment (n = 11) and in healthy volunteers (n = 11), volumes of the hippocampi were estimated using magnetic resonance images (MRIs). A detailed systematic series of coronal MRIs of the entire brain (3 mm thickness, T1-weighted, TR/TE 400/10 ms) was obtained for each subject. All estimations were done according to Cavalieri’s method by a modified point-counting grid placed on surface areas of hippocampal slices. The mean right and left hippocampal volumes in schizophrenics and control subjects were 1,059.4 and 1,003.2 mm3, and 1,780.1 and 1,589.1 mm3, respectively. The corresponding coefficients of errors were 0.05 and 0.068, and 0.059 and 0.081, respectively. The volumes of left and right hemispheres were not significantly different in both schizophrenic patients and controls (p > 0.05). However, a statistically significant difference (p < 0.05) was found between hippocampal volumes of the schizophrenic patients and controls. In conclusion, the hippocampal volume of the schizophrenic patients is significantly smaller than of the healthy controls. The patients who responded well to risperidone treatment had significantly greater hippocampal volumes than the patients who did not respond properly. Thus, hippocampal volume may be a predictor of the treatment response of schizophrenics to risperidone.

Evaluation of the fibular incisura of the tibia with magnetic resonance imaging.

Knowledge of the distal tibiofibular syndesmosis should be helpful in determining the normal position of the fibula in the incisural notch. The purpose of this study was to determine the anatomic characteristics of the fibular incisura of the tibia on MR imaging. One hundred fifty lower limbs (43 male, 32 female volunteers) were examined with MRI. The length of the anterior facet was 10.4 mm in males and 8.9 mm in females, and the length of the posterior facet was 10.4 mm in males and 8.9 mm in females. The angle between anterior and posterior facets was 138.6° in males and 139.9° in females. The depth of the fibular incisura of the tibia was 3.6 mm in males and 2.9 mm in females. The vertical distance of tibiofibular overlapping was 7.9 mm in males and 7.0 mm in females. The distance between anterior margin of the tibia and anterior margin of the fibula was 14.3 mm in males and 12.5 mm in females. All of these parameters of men (except the angle between anterior and posterior facets) were significantly higher than the parameters of women (p < .001, p < .001, p < .05, p < .05, p < .01, respectively).

A magnetic resonance imaging study of the adhesio interthalamica in schizophrenia

Several recent studies have found a relationship between midline cerebral malformations (cavum septi pellucidum, absence of the adhesio interthalamica) and schizophrenia. In this study, we investigated whether the adhesio interthalamica is more often absent in patients with schizophrenia than healthy cases and whether the absence of the adhesio interthalamica may be related to the volume of the third ventricle. Twenty-six patients (11 male, 15 female) in the schizophrenia group and twenty-nine (11 male, 18 female) cases in the control group were examined by MRI. The adhesio interthalamica was found to be absent more often among patients with schizophrenia compared with control subjects and patients without adhesio interthalamica did not have significantly larger third ventricle volumes. The absence of the adhesio interthalamica may be important in explaining the association between the abnormalities of brain midline structures and schizophrenia.

Fracture of the ulnar sesamoid of the thumb in a handball player.

While playing handball, a 16-year-old girl was hit on her thumb by the ball. She complained of pain, swelling, and loss of motion. On examination of the injured hand, there was pain, tenderness, swelling, and a hematoma over the first metacarpophalangeal joint of the right hand. There was no disruption of the ulnar collateral ligament complex. Radiographs demonstrated a fracture of the ulnar sesamoid of the metacarpophalangeal joint of the right hand. The fracture was treated with a splint, and the splint was removed 3 weeks later. There was no pain and she resumed handball 8 weeks after the injury.

A study of sutural bones in Anatolian-Ottoman skulls

In this study, a total of 302 adult Anatolian-Ottoman skulls were classified into three morphological forms (dolichocephalic, mesocephalic, brachycephalic), and were examined in order to find the incidence of sutural bones in each forms. In addition, the cranial capacity was measured in the skulls with and without sutural bones. Comparison of the incidence of sutural bones in each form of the skulls, and cranial capacity in skulls with and without sutural bones showed no significant difference. In most populations, the average measure of difference between Anatolian-Ottoman and the others was statistically significant. In conclusion, the incidence of sutural bones is well suited for comperative studies as an anthropological marker or an indicator of population distance.

Körner's septum (petrosquamosal lamina) and chronic ear disease

To assess the clinical significance of Körner’s septum (KS) or petrosquamosal (PS) lamina in different chronic ear pathologies, a surgical and anatomic study was carried out, in which the significance of KS was assessed in various otologic diseases. Of 639 patients who underwent ear surgery between 1998 and 2001, 426 were included in the study. The diagnoses were chronic otitis media without cholesteatoma (COM), tympanosclerosis (TS), adhesive otitis media (AOM) and cholesteatoma (COL) in 160, 100, 70 and 96 patients respectively. The operative records of the patients were reviewed for the presence of KS. There was antral blockage by KS in all patients who also had Cog (the middle portion of the PS lamina). KS was mostly seen in cases of TS. The prevalence of KS was not significantly different when the result of the COM group was compared with that of the COL and AOM groups ( p >0.05). The prevalence of KS was significantly higher in patients with TS than in those with COM. Both antral and epitympanic blockages were more prevalent in cases of TS than in those of COM (χ2 =3.9, p =0.04 and χ2 =6.6, p =0.01 respectively). There is a significant association between the presence of KS and TS. Based on this finding, it is recommended that a mastoidectomy be performed in cases of severe tympanosclerosis in order to remove KS. How the removal of this anatomic impact will affect the natural course of the disease is still a question that needs further investigation.

Fracture of the ulnar sesamoid of the metacarpophalangeal joint of the thumb: A case report

Fracture of the thumb sesamoid bones is rare. We report here a fracture of the ulnar sesamoid in a 25‐year‐old man caused by a fall on his outstretched hand. He complained of pain and loss of thumb motion. Physical examination revealed tenderness, swelling, and a hematoma over the first metacarpal joint of the right thumb. Radiographs showed a fracture of the ulnar sesamoid which should not be confused with normal variants that occasionally arise from ossifications centers that fail to unite. Clin. Anat. 11:60–61, 1998.