Mine Erbil

Variations in anatomy at the suprascapular notch possibly causing suprascapular nerve entrapment: an anatomical study

The purpose of the study was to determine anatomical variations at the suprascapular notch for better understanding of possible predisposing factors for suprascapular nerve entrapment. We dissected 32 shoulders of 16 cadavers between the ages of 39 and 74 years. We observed abnormally oriented superior fibers of the subscapularis muscle in five shoulders of the 16 cadavers, which were covering the entire anterior surface of the suprascapular notch and significantly reducing the available space for the suprascapular nerve. We also detected anterior coracoscapular ligament in six of the 32 shoulders, and calcified superior transverse scapular ligament in four of the shoulders. In this study, we classified the variations for the superior transverse scapular ligament. In conclusion, knowing the anatomical variations in detail along the course of the suprascapular nerve might be important for better understanding of location and source of the entrapment syndrome, especially for individuals who are involved in violent overhead sports activities such as volleyball and baseball. To our knowledge, close relationship of subscapularis muscle with the suprascapular nerve as a possible risk factor for suprascapular nerve entrapment has not been mentioned previously.

Effect of combined treatment with melatonin and methylprednisolone on neurological recovery after experimental spinal cord injury

Spinal cord injury (SCI) results in the loss of function below the lesion. Secondary injury following the primary impact includes a number of biochemical and cellular alterations leading to tissue necrosis and cell death. Methylprednisolone (MP), by reducing edema and protecting the cell membrane against peroxidation, is the only pharmacological agent with a proven clinically beneficial effect on SCI. Melatonin, known as a free radical scavenger, has been shown to have an effect on lipid peroxidation following experimental SCI. The purpose of this study was to examine the effect of MP and melatonin on neurological, ultrastructural, and electrophysiological recovery. Female albino rats weighing 200–250 g were randomized into five groups of 18 rats each and six rats for the control group. Weight-drop trauma was performed for each group and a 30-mg/kg single dose of MP for rats in group 1, a 10-mg/kg single dose of melatonin for rats in group 2, and MP and melatonin in the same doses for rats in group 3 were administered immediately after trauma. The rats in group 4 were the vehicle group (treated with ethanol) and group 5 was the trauma group. The motor and somatosensory evoked potentials were recorded at the 4th hour, the 24th hour, and on the 10th day of the study for six rats in each group. Posttraumatic neurological recovery was recorded for 10 days using “motor function score” and inclined plane test. After electrophysiological study the rats were terminated for an analysis of lipid peroxidation level of the injured site of the spinal cord. Electron microscopic studies were performed to determine the effects of melatonin, MP, and the combined treatment with MP and melatonin on axons, neurons, myelin, nucleus, and intracytoplasmic edema. The groups treated with MP, melatonin, and a combination of both had significantly enhanced electrophysiological, biochemical, and neurological recovery and also showed better ultrastructural findings than the trauma and vehicle groups. Although combined treatment was significantly more effective on lipid peroxidation than melatonin or MP treatments alone, at the 10th day, neurobehavioral, electrophysiological, and ultrastructural recovery were at the same level. In conclusion, MP, melatonin, and MP and melatonin combined treatment modalities improved functional recovery at the same level. Future studies involving different doses of melatonin and different dose combinations with MP could promise better results since each drug has a different antioxidative mechanism of action.

Effect of Melatonin on Cerebral Edema in Rats

OBJECTIVE Melatonin (5-methoxy-N-acetyltrypamine), a chemical naturally produced in the pineal gland, has been suggested to be a free radical scavenger and an antioxidant. In the present study, the effect of melatonin on cold-induced brain edema was evaluated by determination of cerebral water content, blood-brain barrier permeability, and areas of infarct; the effects were also studied histopathologically. METHODS Brain edema was produced in rats by creating a lesion via cortical freezing. Animals were separated into four groups: sham-operated (craniectomy only); control (cold injury); sham-vehicle (cold injury plus saline); and melatonin treatment (cold injury plus melatonin). Melatonin was administered (50 mg/kg intraperitoneally) 15 minutes after the cold injury was induced. Twenty-four hours later, tissue samples from the core, from the periphery of the cold-injured hemisphere, and from the contralateral hemisphere symmetrical to the cold injury were obtained. RESULTS Melatonin treatment reduced edema (mean +/- standard deviation; 86.22 +/- 1.54% in the control group versus 80.78 +/- 2.76% in the melatonin treatment group, P < 0.001) and blood-brain barrier permeability (45.34 +/- 2.75% in the control group versus 38.26 +/- 3.40% in the melatonin treatment group, P < 0.001) at the periphery of cold injury. Area of infarct reduced from 5.84 +/- 0.58% in the control group to 3.30 +/- 0.89% in the melatonin treatment group (P < 0.001). The effect of melatonin was also confirmed histopathologically. CONCLUSION Melatonin was found to be neuroprotective in instances of cold-induced brain edema. Thus, melatonin may be a valuable therapeutic agent in the treatment of cerebral edema.

Early effects of extracorporeal shock‐wave lithotripsy exposure on testicular sperm morphology

Objective: To investigate the effects of extracorporeal shock‐wave lithotripsy (ESWL) applied to the pelvic region on testicular histology and spermatogenesis. Material and Methods: ESWL (2000 shock waves over a 20‐min period at 18 kV) was applied to 12 adult New Zealand male rabbits. The rabbits were divided into three equal groups: those in Group 1 were sacrificed 1 h after the intervention, those in Group 2 were sacrificed on the 3rd day and those in Group 3 were sacrificed on the 7th day. Both testicles were removed for histopathological examination to investigate the effects of ESWL. Transmission electron microscopy (TEM) was used to detect ultrastructural changes. Epididymal and testicular touch‐print preparations were stained with SperMac ® stain in order to evaluate the morphology of the spermatozoa. Results: There were no significant differences between the groups in terms of sperm morphology (p = 0.386). TEM revealed only huge vacuolation of Sertoli cells and diffuse edema in the mitochondria of Sertoli cells. Conclusion: No detrimental effect of ESWL on sperm morphology was detected in this study. We conclude that shock waves do not cause severe permanent effects but only transient disorders in testes.

Arteries of the thumb originating from the superficial palmar arch: five cases

Five cases are described where the first web space of the hand received arteries only from the superficial palmar arch. None of these branches was large enough to deserve the name “princeps pollicis artery”. These variations must be taken into account during surgical dissections of the hand.

Ultrastructural changes on sperm after extracorporeal shock wave lithotripsy in patients with distal ureteral stone.

Theoretically, ESWL can cause several side effects on the male reproductive system. We determined here the long-term effects of ESWL on sperm with transmission electron microscopy (TEM) in patients with distal ureteral stone. Fifteen men with stones in the distal ureter applied to our clinic formed the group of study. The other 15 men with renal or upper ureter stones formed the group of control. The ESWL sessions, including maximum 19 kW energy level and 3000 shock waves, were performed with Siemens Lithostar (electromagnetic; Siemens Medical Systems, Erlangen, Germany) lithotriptor. We examined the semen samples from all patients on the day before and 90 days after ESWL. The semen samples were examined with transmission electron microscopy (TEM) to detect ultrastructural changes on the day before and 90 days after ESWL. All the statistical analyses were realized with SPSS 10.0 (SPSS Inc., Chicago, USA) statistical package program. When the control and study groups were compared for initial and day 90 sperm concentration and motility, a significant decrease was found in the study group. Although there was no important anomaly in the control group, we determined some damage on sperm structure in 5 patients (33.3%) who are in the study group 3 months after ESWL. It can reduce sperm concentration and motility permanently. It can also cause severe ultrastructural defects on sperm after a long term period in patients with lower ureteral stone. Therefore, we suggest other treatment modalities for young men with distal ureteral stones to prevent the development of male infertility.