Nurten Turhan-Haktanır

Evaluation of mental foramina in adult living crania with MDCT.

PurposeMulti-detector Computed Tomography (MDCT) is an exquisite technique in demonstrating the cranial foramina. This study aimed to assess the anatomic variations and locations of mental foramina in living adult mandible by MDCT.MethodsMDCT data of 100 dentulous adult subjects were collected from the high-resolution examinations that covered the mandible. Presence and number of foramina, their diameter and distance from the mid line that is mid sagittal plane and alveolar ridge were recorded.ResultsMental foramina was clearly identified, localized and characterized in all subjects. Duplication was observed in four patients. Among them, one subject had bilateral accessory foramina. Mid line distances were significantly higher in men than women. Distances and diameters of right foramina were insignificantly higher in the males. Also, left foramina was insignificantly wider in women. Positive correlations were noticed between the measurements of right and left foramina.ConclusionsThis is the first study on mental foramina in living mandible with MDCT. With its tremendous capabilities, MDCT may be established in anatomical studies and preoperative planning.

Variations of supraorbital foramina in living subjects evaluated with multidetector computed tomography

We aimed to evaluate the anatomic variations of supraorbital foramina/notches in living subjects using multidetector CT (MDCT) related to age, sex, and side.

The effect of scrotal reconstruction with skin flaps and skin grafts on testicular function.

Due to its unique composition, the reconstruction of scrotal skin defects is a major clinical challenge. This study was designed to evaluate the effects of scrotal reconstruction, using skin grafts and skin flaps, on spermatogenesis. In Group 1, the rats did not undergo surgery and were used as controls. In Group 2, after removal of all of the scrotal skin to expose the testicles, the defect was repaired using a skin flap from the right groin region. In Group 3, the reconstruction was achieved using skin grafts. All the rats were killed at 2 months postoperatively and evaluated. The mean wet weights of the testicles in the control group were significantly higher compared with that of the graft group. The mean height of the germinal epithelium was significantly greater in the control and flap groups compared with that of the graft group. The Johnsen score for spermatogenesis in the control group was higher than that in the graft group. The use of flaps resulted in testicular function that was comparable to that of the control group, whereas the use of grafts resulted in diminished testicular function. Therefore, we suggest that flaps may be the first choice for scrotal reconstruction.

Toe Leiomyoma A Case Report with Radiological Correlation

Abstract Only a limited number of case reports concerning the magnetic resonance imaging appearance of lower extremity leiomyoma have been published. To the best of our knowledge, there is not any instance of toe leiomyoma reported with MrI findings. We present MRI findings of a toe leiomyoma and discuss the literature.

Evaluation of amniotic fluid as a skin graft storage media compared with RPMI and saline

We aimed to assess and compare the histological changes of grafts stored in Roswell Park Memorial Institute-1640 solution (RPMI), amniotic fluid (AF), and saline. Amniotic fluid which has abundant nutrients, proteins, and growth factors, and antimicrobial features may be an easily achievable and cheap alternative for the short term preservation of skin grafts. Discarded surgical skin pieces obtained from 15 trauma patients were divided into three groups as RPMI, AF, and saline. The specimens were evaluated at days 7, 14, 21, and 28 for histological alterations by a 3-point scoring scale. Histological scores in the grafts stored in amniotic fluid and RPMI were found significantly lower than those stored in saline (p<0.01). No significant difference was detected between AF and RPMI stored grafts. AF may be a good alternative for skin graft preservation as demonstrated by histological changes. New studies with multiple AF donators and repeated experiments will be worthwhile. Besides, restrictions of some ethical and legal issues for AF use should be solved.

A case of eccrine spiradenoma arising in nevus sebaceous in an adolescent girl.

To the Editor: Eccrine spiradenoma is one of the rarest sweat gland tumors that was described by Kersting and Helwing in 1956 in detail. It is a benign neoplasm of the skin with a slow, indolent course that may arise anywhere in the body, though a predilection for the upper thorax and ventral side. Eccrine spiradenoma is seen in young to middle-aged adults of both sexes who are equally affected. The tumor is typically enclosed by normal or blue epidermis. It is often tender to palpation and painful. Malignant transformation has been described rarely, presenting as a rapidly enlarging nodule within a long-standing lesion. The nevus sebaceus (NS) is a hamartomatous disorder of the skin, which consists both epithelial and nonepithelial structures. Most frequently, it involves scalp, face, and neck. In 1965, Mehregan and Pinkus described the 3-stage life history of NS: At birth and in early childhood, it presents as a solitary, alopecic, slightly raised pinkish or yellow patch with a smooth surface. Overdevelopment of sebaceous glands, epidermal hyperplasia, and maturation of apocrine glands occur in puberty. In the last period, a wide variety of benign and, less commonly, malignant neoplasms from epidermal or adnexal origins develop. The estimated rate of neoplastic transformation was reported about 10%–30%, increasing with age. The most commonly described benign lesions arising in NS are syringocystadenoma papilliferum, syringoma, apocrinecystadenoma,hidradenoma, sebaceous epithelioma, trichoblastoma, and trichilemmoma. According to recent retrospective studies, less than 1% of NS is complicated by malignant tumors. To the best of our knowledge, Shapiro is the only and first author describing the first case of a benign spiradenoma arising in an NS on the scalp in an aged patient. In the present report, we describe such a case in an adolescent patient first in the literature. A 15-year-old female patient was referred for a painless lesion on the scalp. It was an asymptomatic, tender, skincolored, and nonulcerated nodule measuring 1.5 3 0.5 cm. The patient described it as existed since birth with slow progression. Excision of the lesion under local anesthesia was performed. Histopathological examination revealed hyperkeratosis and papillomatous hyperplasia of the epidermis (Fig. 1). There were buds of undifferentiated cells representing malformed hair structures. Numerous mature sebaceous glands in the upper dermis were noticed. Beneath the epidermis, away from the surgical margins, there were sharply demarcated lobules measuring totally 0.5 cm in diameter. On low magnification, the lobules appeared deeply basophilic because of the close aggregation of the nuclei. On higher magnification, the epithelial cells within the lobules were arranged in intertwining bands. Two types of cells were seen: cells with small dark nuclei lied at the periphery of the lobules and cells with large pale nuclei lied in the center of the lobule and around small lumina (Fig. 2). These findings led us to the diagnosis of eccrine spiradenoma that developed secondarily within an NS. Microscopically, eccrine spiradenoma locates in the cutis and subcutaneous tissue with clear margination. The tumor is highly cellular and composed of 2 cell types: small, dark, peripheral basaloid cells with hyperchromatic nuclei, and more frequent larger, central cells with pale nuclei. These cells, in sheets, cords or islands, or with a trabecular arrangement, make up the tumor nodules. The cells are periodic acid schiff

Histological assessment of skin grafts stored in amniotic fluid and saline

Abstract We investigated the efficacy of amniotic fluid as a substance in which to store grafts; it is rich in nutrients, proteins, and growth factors, and has well-known antimicrobial features. We compared it with the widely-used and practical saline. Split-thickness grafts 4 × 4 cm were prepared from the back of 20 rats and divided into four groups (n = 5 each). The rolled grafts were wrapped in gauze dampened with saline or amniotic fluid and placed into refrigerators in sterile containers for storage. On days 7, 14, 21, and 28, histological examinations were made. A semiquantitative evaluation of the histological damage to the skin was made by scoring its degree of severity. Compared with saline, histological scores in the grafts stored in amniotic fluid were found to be significantly lower on the 14th, 21st, and 28th days (p values on days 14, 21, and 28; cell swelling: 0.014, 0.006, and 0.005, respectively; nuclear swelling: 0.003, 0.006, and 0.007, respectively; nuclear pleomorphism: 0.004, 0.005, and 0.003, respectively; nuclear haloes: 0.015, 0.005, and 0.005, respectively; nuclear pyknosis: 0.003, 0.005, and 0.003, respectively; dermo-epidermal clefting: 0.005, 0.003, and 0.003, respectively; eosinophilia and mitosis: 0.003, 0.006, and 0.004, respectively; dermal collagen: 0.003, 0.003, and 0.003, respectively). Amniotic fluid maintained preservation better for skin grafts than saline. Comparison with other modern storage media would be beneficial.

Radiologic and Histologic Assessment of Diced Cartilage Grafts for Cranial Bone Defects of Rabbits: An Experimental Study

This study was performed to experimentally evaluate the viability and coverage of diced cartilage grafts for cranial defects. Biparietal bone defects were prepared in each of 20 rabbits. Otogenous bone grafts were fixed to one side, whereas cartilage grafts taken from the right ear, diced, and wrapped with oxidized regenerated cellulose (Surgicel) were placed on other side. Parenchymal impression, contour, and ossification of all grafts in the 16 rabbits surviving after 8 weeks were evaluated with computed tomography and magnetic resonance imaging. The existence of ossification was examined pathologically. Parenchymal impression was significantly more frequent in bone grafts than in cartilage grafts (p < 0.05). This difference probably is attributable to the application technique. There was no significant radiographic difference in other parameters between the two groups. No significant difference in ossification was found. In conclusion, ossification was seen radiologically and pathologically in diced cartilage grafts. Because of autogenicity, ease of shaping, absence of postoperative warping, reduced resorption rates, and inherent viability and ossification properties, the authors suggest that diced cartilage grafts may be an alternative material for cranial defects, especially for frontal cranial reconstruction in which deformities may cause aesthetic and functional disabilities. The authors believe that further long-term studies also are needed.

Presence of interferon regulatory factor-1 in aggressive and nonaggressive histological variants of Basal cell carcinoma specimens.

Background: Expression of Interferon regulatory factor-1 (IRF-1) has been demonstrated in a variety of cancers previously. To the best of our knowledge, there is only one report about the IRF-1 expression in basal cell carcinoma (BCC) specimens, which has demonstrated increased expression of the IRF-1 gene in BCC versus normal skin. Furthermore, IRF-1 expression has not been compared between aggressive and nonaggressive subtypes of BCC before. Aims: Our aim is to examine the relation between IRF-1 staining patterns of aggressive and nonaggressive histological subtypes of BCC. Materials and Methods: Thirty-seven archival tissue specimens from 33 BCC patients were stained for cytoplasmic and nuclear IRF-1. Twenty-five tumors were grouped as nonaggressive and 12 were grouped as aggressive histological variants, according to the established criteria. Results: IRF-1 was not only expressed in tumor cells, but also in some surrounding inflammatory cells. There was no significant difference between the groups for cytoplasmic or nuclear IRF-1 staining. Aggressive or nonaggressive histological subtypes did not show any statistical difference for gender, relapse, treatment method, or localization. When staining was compared with gender, relapse, treatment method, localization, and tumor grades, no significant difference was found. Conclusions: Interferon seems to be expressed in BCCs with both aggressive and non aggressive histology. Further studies are needed to elaborate the precise diagnostic and prognostic roles and utility of interferon in the treatment of BCC.