Zeliha Fazliogullari

The motor branches of median and ulnar nerves that innervate superficial flexor muscles: a study in human fetuses

PurposeWe aimed to describe the distribution of the motor branches of the median and ulnar nerves that innervate the superficial flexor muscles in detail, as well as to determine any communication between these two nerves in a series of 100 human fetuses.MethodsThis study was performed on 200 upper limbs from 100 fetuses. However, the motor branches of the median nerve were determined on 50 upper limbs because of the developmental properties of medial epicondylar muscles.ResultsThe motor branch, which innervates the pronator teres, is classified into two types and four subtypes. The flexor carpi radialis branch arose as a single branch in 30% of the cases. The innervation of the flexor digitorum superficialis was also performed by a single muscular branch in 88% of the cases and by two branches in 12% of the cases. The ulnar nerve was classified into two types according to the number of muscular branches in the forearm. Martin–Gruber anastomosis was observed in 7.5% of the cases.ConclusionsThese results show differences from classical definitions regarding the muscular branching patterns of the median and ulnar nerves. We suggest revisiting the classical descriptions of innervation patterns of pronator teres, palmaris longus and flexor carpi radialis muscles, since the variations observed in their innervation patterns are more diverse than has been described.

Investigation of Developmental Toxicity and Teratogenicity of Macrolide Antibiotics in Cultured Rat Embryos

Macrolides are considered to be one of the safest anti‐infective groups in clinical use, with severe adverse reactions being rare. However, there are limited data about their embryotoxicity and teratogenicity. We aimed to investigate and compare the effects of these agents on embryonic growth and development. Rat embryos were cultured in vitro for 48 h in rat serum. Whole rat serum was used as a culture medium for the control group while different concentrations of spiramycin and azithromycin (1.25–6.25 μg/ml), and clarithromycin (2.5–30 μg/ml) were added to rat serum for the experimental groups. Dose‐dependent effects of macrolides on embryonic developmental parameters were compared using morphological methods. Embryos were evaluated for the presence of any malformations. After morphological examination of the embryos, total DNA was extracted from the cells using standard procedures to determine fragmentation of nuclear DNA of embryonic cells. When compared with the control embryos, the macrolides significantly decreased all growth and developmental parameters dose dependently. While clarithromycin was found to cause more developmental toxicity than spiramycin and azithromycin, azitromycin was determined to have more teratogenicity potential. Compared with controls, there was no difference regarding the fragmentation of nuclear DNA of all the agents used. According to these results, when the toxic and teratogenic potential of the used agents compared, because of the lower toxic and teratogenic effects observed with spiramycin, this agent may be preferred for parturients.

The Levator Claviculae Muscle and Unilateral Third Head of the Sternocleidomastoid Muscle: Case Report

Durante una diseccion de rutina, se observo en un cadaver de sexo masculino de 70 anos de edad, la presencia de una tercera cabeza unilateral del musculo esternocleidomastoideo y de un musculo elevador clavicular accesorio. En el lado izquierdo del cuello, se observo que el musculo esternocleidomastoideo poseia una tercera cabeza, ademas de las cabezas esternal y clavicular . El musculo elevador de la clavicula, tenia su origen en el tuberculo posterior del proceso transverso de la tercera vertebra cervical y se insertaba en el margen posterior de la clavicula. El conocimiento de estas variaciones pueden ser importantes debido a su estrecha relacion con las estructuras neurovasculares del cuello durante las operaciones.

Unilateral Variations of Vessels and Nerves in the Neck

Durante una diseccion de rutina, fue obserada en el lado izquierdo del cuello de un cadaver de sexo masculino de 65 anos de edad variaciones anatomicas vasculares y nerviosas. Se observo que el tronco linguofacial se originaba de la arteria carotida externa y que la arteria faringea ascendente se origina en la arteria occipital. Se determino que los ramos laringofaringeos originadas desde el ganglio cervical superior, giraban en torno al origen de la arteria tiroidea superior. Como una variacion adicional, la vena jugular interna se encontro dividida. El asa cervical y el vientre inferior del musculo omohioideo pasaban a traves de las partes de la dividion de la vena. Creemos que este tipo de variaciones supone dificultades importantes durante procedimientos radiologicos y quirurgicos de la region del cuello, y por tanto, es importante que los cirujanos conozcan estas variaciones.

Anatomical Examination of the Foramens of the Middle Cranial Fossa

Tres foramenes pueden ser identificados en el ala mayor del esfenoides: El foramen redondo (FR), foramen oval (FO) y el foramen espinoso (FS). Puede ademas existir otro foramen llamado foramen oval accesorio o foramen de Vesalio (FV), que conecta la fosa craneal media a la fosa pterigoidea. Se describe como una abertura con paredes lisas por anterior y medial al foramen oval, que conduce a un canal oblicuo dirigido hacia la fosa pterigoidea. FV estuvo presente entre FO y FR en 14 (31,8%) de 44 craneos secos y 6 (33,3%), en 18 lados en la base de craneos de cadaveres (total 20 (32,3%) de 62). El diametro de los foramenes en los lados derecho e izquierdo se observo casi simetricos. Las distancias de FR desde la linea mediana en el lado izquierdo fue mayor que en el lado derecho. Ademas, la distancia entre FO y el vertice de la porcion petrosa y la distancia entre el FS y el vertice porcion petrosa fueron mayores en el lado izquierdo. En el lado derecho la distancia entre A y FR, asi como la distancia entre A y FS fueron mayores. Por otra parte, la distancia entre los FR y el vertice del porcion petrosa fue mayor en el lado derecho. Las variaciones anatomicas en el tamano de la apariencia y la distancia de FR, DE, FS y FV son de gran importancia quirurgica. Podemos inferir que la informacion proporcionada en este estudio puede ayudar al neurocirujano y anatomista para aumentar el conocimiento sobre la anatomia de la fosa craneal media.

Investigation of Developmental Toxicity and Teratogenicity of Antiemetics on Rat Embryos Cultured In Vitro

In this study, we aimed to investigate and compare the direct toxic and teratogenic effects of dimenhydrinate, metoclopramide and trimethobenzamide HCl, antiemetic drugs on embryonic growth and development in cultured rat embryos. Embryos were explanted on day 9.5 of gestation and cultured. Whole rat serum was used as a culture medium for the control group while different concentrations of dimenhydrinate (2.5–20 μg/ml), metoclopramide (10–50 μg/ml) and trimethobenzamide HCl (25–100 μg/ml) were added to serum for the experimental groups. Effects of antiemetics on embryonic developmental parameters were compared, and embryos were evaluated for the presence of any malformations. Also, the total DNA was extracted from the cells to determine the fragmentation of nuclear DNA of embryonic cells. Compared with the control embryos, the antiemetics significantly decreased all growth and developmental parameters dose dependently. There was no difference regarding the fragmentation of nuclear DNA of the all used agents and controls. Amongst the agents, trimethobenzamide HCl was found to have more toxic and teratogenic potential, and metoclopramide appears to be the least toxic antiemetic and therefore could be more safely used and might be preferred for the treatment of nausea and vomiting in pregnancy.

A complex variation of the parietal and visceral branches of the abdominal aorta

SUMMARY: Variations in the branches of the abdominal aorta were determined during a routine abdominal region dissection ofa 70-year-old male cadaver. Left gastric artery arose as the first root from antero-lateral of aorta. Coeliacomesenteric trunk occurred as athick root. After 29.9mm, coeliacomesenteric trunk bifurcated as coeliac trunk and superior mesenteric artery. Coeliac trunk bifurcatedas splenic artery and common hepatic artery. These multiple variations which change the normal anatomic structure of the abdominalaorta have to be kept in mind by surgeons, radiologists and anatomists. KEY WORDS: Abdominal aorta; Coeliacomesenteric trunk; Anatomical variation. INTRODUCTION Aorta, the main artery of circulation, is divided intothree according to its course; ascending aorta, arch of aortaand descending aorta. Passing through aortic hiatus undersidethe face of Th 12, aorta lies as abdominal aorta which is 13cm long and ends underside of L 4. The branches of theabdominal aorta can be classified as single-double orvisceral-parietal. Double visceral branches are (middlesuprarenal artery, renal artery, testicular artery (ovarianartery), single visceral branches are (coeliac trunk, superiormesenteric artery, inferior mesenteric artery), double parietalbranches are (inferior phrenic artery, lumbar arteries), andsingle parietal branch is median sacral artery (Standring,2005).Knowledge of such case has important clinicalsignificance in an abdominal operation or invasive arterialprocedure, that is by procedure and liver transplantation,laparoscopic surgery, and radiological procedures in theupper abdomen.

Developmental Anomalies of Bronchial Tree: A Multidetector Computerized Tomography Study

Las anomalias del arbol bronquial pueden causar una infeccion pulmonar aguda recurrente y sintomas de obstruccion persistente. Las anomalias del desarrollo del arbol bronquial se presentan principalmente como informes de casos con una anomalia de acompanante. Sin embargo, en este estudio se detectaron estas anomalias en las imagenes de tomografia computarizada multidetector (TCMD), donde no se habian informado esta patologia. Se evaluaron las imagenes de TCMD toracica de 400 pacientes (0-74 anos, 224 hombres y 176 mujeres). Se detectaron cuatro bronquios traqueales (1%). Tres de ellos fueron de tipo desplazado, uno fue tipo bronquio de cerdo, y dos bronquio cardiaco accesorio (0,5%), originados de la pared medial del bronquio intermedio. De acuerdo con nuestros resultados, la incidencia de bronquio traqueal y bronquios cardiacos accesorios parecen ser mayor en la poblacion turca.

Evaluation of the facet joints with magnetic resonance images in the patients with disc degeneration and spondylolisthesis

PurposeWe aimed to research in detail the morphology of the facet orientation (FO) and tropism (FT) in degenerative diseases.MethodThis study consisted of patients with disc degeneration (DD) and with lumbar spondylolisthesis (LS) as well as a control group without these two diseases. The group of patients with DD was separated by DD grades. Vertebral body and intervertebral discs’ (IVDs) morphometric values, facet joint osteoarthritis (OA) grading, FO and FT were examined in all the groups. All measurements were applied to MRIs of 353 patients.ResultThere was a significant difference in facet angle values between the groups at L4–L5 (FO: p = 0.001). There was a significant negative correlation between FO at L4–L5 and L4 vertebral body anterior posterior diameter and L5 mid-vertebral body height, in 353 patients (p = 0.003; p = 0.010). Facet joint OA grading scores were lower in the control group than in the disc degeneration patient (DDP) and LS groups (p < 0.05). Sagittal FO was seen with the increase of facet joint OA scores at L4–L5 in the control and DDP groups (control: p = 0.001; DDP: p = 0.40).ConclusionFacet joints can show different orientation values in LS and DDP groups at L4–L5. The presence of FT is a risk factor for an LS patient at L4–L5. Sagittal FO is seen with vertebral slip at L5–S1. FO is affected by the morphometric changes of the vertebral body at L4–L5. Discussions in this regard need to be resolved through further research.