Statistical shape analysis of the lentiform nucleus of children of different age groups: a retrospective study

The basal nuclei are important during infancy because of the significant development of motor skills. The main aim of this study was to evaluate the shape differences of the lentiform nucleus between different age and gender groups. A total of 126 children's axial magnetic resonance image series were included in the presented study. These images were grouped between 1 and 5 yr old. Right and left lentiform nuclei are marked with selected landmarks using TPSDIG v2.04. Statistical shape analyses were examined by a Generalized Procrustes Analysis. Our results showed that there was no statistically significant difference in lentiform nucleus shape between genders. However, there was a difference between the shapes of the right and left lentiform nuclei between the 1-yr and 5-yr age groups. These results demonstrated the shape changes in the lentiform nucleus during the first 5 yr of life. Further clinical studies based on our results may be used to gather more detailed information about movement disorders and neuronal development.

Microcomputed tomographic analysis of bone microarchitecture after sinus augmentation with hyaluronic matrix: a case-control study

BACKGROUND

The aim of this study was to analyze trabecular microarchitecture of augmented sinuses with hyaluronic matrix and xenograft by microcomputed tomography, and to investigate whether hyaluronic matrix has an effect on the newly formed bone quality.

MATERIALS AND METHODS

Thirteen patients undergoing maxillary sinus augmentation were included in this split-mouth study. Right and left sinus sites were randomly assigned to test and control group. In test group, the sinus was grafted with hyaluronic matrix and xenograft; in control group, only with xenograft. Four months after augmentation, bone samples were harvested during implant placement and analyzed for the following trabecular microarchitecture parameters using microcomputed tomography: bone volume (BV), total volume (TV), bone volume fraction (BV/TV), bone surface (BS), specific bone surface (BS/BV), bone surface density (BS/TV), trabecular thickness (Tb.Th), trabecular separation (Tb.Sp), trabecular pattern factor (Tb.Pf), and fractal dimension (FD).

RESULTS

There was statistically significant difference only for BS/TV parameter between two groups. BS/TV was higher in hyaluronic matrix group compared with control group.

CONCLUSIONS

Addition of hyaluronic matrix to xenograft may enhance bone quality in terms of bone surface density. However, more research investigating the microstructural variation of augmented sinuses is needed with a greater sample.

Tendon of Flexor Carpi Radialis in carpal tunnel: a radiologic and cadaveric study

Background/aim

Carpal tunnel is an important anatomical passage that carries the flexor tendons into the hand. As there is still no consensus about its contents among the anatomy textbooks, the main purpose of this study was to identify the relations of the flexor carpi radialis tendon in the carpal tunnel.

Materials and methods

This retrospective study was completed in April 2018 at authors’ university’s hospital. Seventy-four female and 44 male patients’ wrists without any pathology were examined by using magnetic resonance images. The series of axial sections where the pisiform exist were evaluated by using T1 sequence and the structures in the carpal tunnel were identified.

Results

Results of this study showed that the tendon of the flexor carpi radialis was found above the flexor retinaculum within its own septal compartment in all patients.

Conclusion

According to the results, tendon of flexor carpi radialis crosses the wrist region superficial to the carpal tunnel. Thus, tendon of flexor carpi radialis doesn’t have any effect on the carpal tunnel syndrome. Further cadaveric studies would be useful for identifying the contents of the carpal tunnel and morphological organization of the wrist.

Morphometric analyses of clavicle's nutrient foramen

PURPOSE

Fractures of the clavicle, which has an important location and function in the upper extremity and shoulder joint, compose 10% of all fracture cases. During the osteosynthesis of clavicle fractures and in the post-operative period of patients, considering the detailed morphometric and topographic properties of the nutrient foramen of clavicle is important to avoid the disruption of arterial nutrition of the clavicle and prevent unexpected injuries. The aim of this study was to investigate the morphometric properties of the nutrient foramen of clavicle in more detail using computedtomography images.

METHODS

Computed tomography images of 116 healthy individuals (56 women/60 men) who had no pathology history were included in the presented study. Computed tomography images were reconstructed three-dimensionally using free-licensed Horos v3.3.3 software. Then, distances from clavicle's nutrient foramen to sternal end, anterior and posterior edges of the clavicle were measured. Statistical analyses were completed using SPSS v21 software.

RESULTS

Our results demonstrated that the nutrient foramen of clavicle was located closer to the sternal end of the clavicle. The shortest distance to the sternal edge of clavicle was measured as 3.3 cm. Analyses of gender differences indicated that statistically significant differences were in favor of men. However, topographic properties of the clavicle's nutrient foramen were not affected by age.

CONCLUSION

Nutrient foramen is mostly located closer to the sternal end of clavicle. Especially during osteosynthesis of clavicle fractures at the sternal end, maintaining the arterial supply of clavicle is of great importance for increasing the post-operative life quality of patients.

The triticeous cartilage - redefining of morphology, prevalence and function

BACKGROUND

Triticeous cartilage is a small cartilaginous component of the laryngeal skeleton. This cartilage, located in posterior end of the thyrohyoid ligament, presents in different shapes. Radiological studies indicate clinical and anatomical importance of the triticeous cartilage but these studies have limited information due to inadequate inspection method. Computed tomographic angiography is able to evaluate the triticeous cartilage with using three-dimensional images in more detail. The aim of this study is to describe prevalence and morphological properties of the triticeous cartilage.

MATERIALS AND METHODS

We examined computed tomographic angiography images of 746 patients (368 women, 378 men) retrospectively. Shapes, calcification degrees, volumes, lengths and wideness of the triticeous cartilage were evaluated by OsiriX-Lite software.

RESULTS

According to our results, triticeous cartilage presents common in the examined population (68.1%). The prevalence of the triticeous cartilage was higher in men than in women. We also found that the degree of calcification was not related with age and gender.

CONCLUSIONS

Clinical importance of the triticeous cartilage is that it could be misdiagnosed with atherosclerosis in common carotid artery because the triticeous cartilage is located almost at same level as the bifurcation of the common carotid artery. Therefore, clinicians should be aware about the triticeous cartilage.

Revisiting the relationship between the submandibular duct, lingual nerve and hypoglossal nerve

BACKGROUND

The aim of the study was to evaluate the relations between submandibular duct, lingual nerve and hypoglossal nerve for making a reassessment of this area in fresh frozen specimens. Also, the distance between the angle of the mandible and the vertical line drawn from the point where submandibular duct crossed lingual nerve to the base of the mandible was measured to determine a new landmark for neck surgeons.

MATERIALS AND METHODS

Fourteen fresh frozen head and neck specimens were dissected and evaluated. A marginal mandibular incision was made from the mastoid process to the chin.

RESULTS

In 8 cases, lingual nerve was crossing the submandibular duct superiorly; in 5 cases, lingual nerve was crossing the duct infero-medially and in 1 case it was parallel to the duct. In 1 case, lingual nerve subdivided into anterior and posterior branches. In 2 cases, 2 parallel submandibular ducts were found and the lingual nerve was crossing the upper duct from superior. In 1 case, lingual nerve was crossing the duct infero-medially and then it was subdividing into branches superior to mylohyoid. In 12 cases, the course of hypoglossal nerve was classical. In 1 case, hypoglossal nerve crossed the submandibular duct medially and coursed parallel to the tendon of posterior belly of digastric. And in another case, hypoglossal nerve crossed the inferior branch of submandibular duct medially. The other structures in this area were as usual.

CONCLUSIONS

The main factor for reducing nerve damage during surgery is the understanding of the anatomy of this area.

Effects of local alendronate administration on bone defect healing. Histomorphometric and radiological evaluation in a rabbit model

PURPOSE

To performed a histomorphometric and radiological study to evaluate the effects of alendronate sodium administered locally in mandibular bone defects created in rabbits.

METHODS

Two circular defects 5 mm in diameter were created bilaterally in the mandibular corpus of 20 New Zealand rabbits (i.e., four defects per animal). Each defect received one of four treatments: no treatment (EC group), alendronate irrigation (AL group), autogenous bone grafting (AG group), or alendronate irrigation with autogenous bone grafting (AL+AG group). Histomorphometric and radiological assessments were conducted at 4 and 8 weeks after surgery.

RESULTS

Between-group comparisons of the new bone area, the value of the AL+AG group was significantly lower thanthe remaining three groups at 4 weeks postoperatively. In all groups, the new bone area was significantly larger at 8 weeks than at 4 weeks. The residual graft area at 4 and 8 weeks was significantly higher in the AL+AG group than in the AG group, although it was significantly smaller at 8 weeks than at 4 weeks in both these groups.

CONCLUSION

The use of alendronate sodium in conjunction with autogenous bone grafting improves the osteoconductive properties of the graft, enhances graft retention in the defect, and improves ossification.

Accidental Use of the Median Nerve as an Interposition Material in First Carpometacarpal Joint Arthroplasty

Harvesting the median nerve accidentally as a tendon graft, is a major complication of upper extremity surgery which is noted only rarely in the literature. This article seems to be the first report of the median nerve being used as an interposition material in first carpometacarpal joint arthroplasty.

The effect of infliximab on bone healing in osteoporotic rats

Purpose:

The aim of this study was to evaluate the effect of the infliximab on autogenous-mediated bone regeneration and resorption of autogenous graft in the ovariectomised rat model.

Materials and methods:

Forty rats underwent ovariectomy and 6 weeks later the animals were randomly assigned to four groups. Critical size defects were created in each rat calvarium. In the control group (C), the flap was closed without any further action. In the only infliximab group (In), the flap was closed without any further action. After the operation, intravenous infliximab was injected. In the autogenous graft group (Ag), autogenous bone was applied in to the defect. In autogenous graft + infliximab group (Ag+In), autogenous graft was placed on the defect. After the operation, intravenous infliximab was injected. The animals were sacrificed at 4 weeks. Bone formation was assessed by micro-computed tomography (micro-CT) scans and stereological analysis.

Results:

The mean new bone volume was the greatest in Ag+In group (1.76 ± 0.20), followed by the Ag group (1.51 ± 0.05) (statistically significant difference at P <0.05). The lowest new bone was found in the control group (1.05 ± 0.09), however no difference was observed from the In group (1.14 ± 0.08) ( P >0.05). Besides there was a statistically significant difference between the Ag+In group (1.00 ± 0.05) and Ag group (0.74 ± 0.04) in terms of the graft volume ( P <0.05).

Conclusion:

This study, despite its limitations, showed that infliximab has a beneficial effect for prevent graft resorption and bone regeneration in osteoporotic rats.

Ganglion cysts of the proximal tibiofibular joint review of literature with three case reports

Proximal tibiofibular ganglion is a rare disorder. It may settle down in the subcutaneous tissue or may develop along the peroneal muscles and nerve. Common clinical findings are various sizes of mass, pain and hypoesthesis due to compression neuropathy. We report three cases of proximal tibiofibular ganglion and review the literature about the diagnostic tools, recurrence rates and treatment modalities.

Phosphorus defficiency and sludge bulking

Separation by settling is one of the most troublesome stages of an activated sludge process. A decrease in the efficiency of separation of microbial biomass from the treated effluent causes a decrease in the overall efficiency of the treatment plant. One of the most common problems in activated sludge systems to negatively influence the settleability is sludge bulking which can be defined as non-settling situation of microbial mass. The main objective of this study is to find out the effect of phosphorus deficiency on bulking of activated sludge. In order to achieve this aim, the effects of a strictly phosphorus limited environment was investigated by running 6 semi-continuous activated sludge reactors. Since the specific aim of the study is to identify the effects of magnesium and calcium ions on sludge bulking in a phosphorus deficient medium, 3 different magnesium and calcium concentrations (5, 10, 20 meq l(-1)) were studied. Laboratory scale reactors were fed with synthetic wastewater and operated at a sludge age of 8 days. Results showed that, phosphorus deficiency caused sludge bulking. Sludge samples examined under microscope showed that the floc structures from reactors fed with different cations are significantly different. To identify the differences, a series of chemical analyses were conducted on the sludge samples. In addition to that, sludge volume index (SVI) values were monitored on a daily basis. Next, the concentration of phosphorus in the feed medium was increased in two separate steps and the possibility to cure the sludge bulking problem was investigated. It was found that bulking of activated sludges due to phosphorus deficiency could be cured by the addition of phosphorus. For phosphorus deficient bulking in relation to the cations present in the system some mechanisms are suggested.