Biomedical subjects
Publications and source records attributed to Muzaffer Sindel.
Persistent sciatic artery PSA represents the persistence of the sciatic vessel in adult life that is responsible for the major blood supply to the lower limb in early embryologic development. The incidence of PSA has been estimated as low as 0.025-0.04%. We present 2 cases of PSA, one of which was complicated by an aneurysm that led to a life-threatening hemorrhage.
OBJECTIVE: To analyze the anatomical basis of the scapula, acromion, os acromiale, coracoid process, coraco-acromial arch, and glenoid cavity in Turkish adults. METHODS: We performed the study at the Faculty of Medicine, Akdeniz University, Turkey between January 2004 and December 2005. A total of 90 dry bones of the scapula from human cadavers were randomly selected. The length, width, and anterior thickness of the acromion and the acromial facet of the acromioclavicular joint were measured with an electronic caliber and was examined visually. For the radiological evaluation, the posterior anterior and the lateral shoulder radiographs of 90 consecutive adult patients with normal findings were used. These films were evaluated and grouped according to the acromial arch morphology. RESULTS: The distribution of the acromial morphologic types according to slope was type I (flat) 10%, type II (curved) 73%, type III (hooked) 17%. Type I was seen in 11%, type II 66%, type III 23% of the specimens. The morphological shape of the tip of the acromion was 31% cobra shaped, 13% square shaped, and 56% intermediate type. The scapulas, coracoid process and the coraco acromial arch were measured. In 72% of the specimen, the glenoid notch of the scapulas were absent and oval shaped, whereas in 28% the notch was well expressed and the glenoid cavity was pear shaped. The mean vertical length of the glenoid cavity was 36.3 +/- 3 mm, and the mean transverse length was 24.6 +/- 2.5 mm. Os acromiale is a rare anatomical condition. Its incidence has been documented in radiographic and anatomical studies to be between 1-15%. The presence of os acromiale was 1% in shoulder radiographs (os pre-acromiale), and in dry bones (os meta-acromiale) CONCLUSION: We reported the exact morphological measurements of the bone structures of the scapula in Turkish adult population. Our results present an instructive figures of anatomical preparations and radiological cases that can be used to make a more precise radiological and a differential diagnoses.
OBJECTIVE: Transpedicular spinal fixation has recently been the focus of increased attention in several institutions throughout the world, but its safety and efficacy are still important questions for orthopedic surgeons. Accurate screwing through the pedicle will avoid neurologic complications and increase the stability of the instrumentation. In this study, it was aimed to analyze the anatomic relations quantitatively between the lumbar pedicle and the adjacent dural sac and nerve roots, to determine the risky areas for neural injury during transpedicular screw placement. METHODS: Ten adult cadavers were used for observation of the lumbar pedicle and its relations. After removal of the laminas and facets, the lumbar pedicles, dural sac, and nerve roots were exposed. Interpedicular distance (IPD), pedicle-inferior nerve root distance (PIRD), pedicle-superior nerve root distance (PSRD), and pedicle-dural sac distance (PDSD) were measured. RESULTS: Average distance from the lumbar pedicle to the dural sac medially and to the adjacent nerve roots superiorly and inferiorly through the cranial to caudal lumbar levels ranged from 1.29 to 1.56, from 4.12 to 5.52, and from 1.10 to 1.06 mm, respectively. The mean IPD ranged from 32.77 to 41.24 mm. There were statistically significant differences between the L5 level and other lumbar levels for IPD, PSRD, and PDSD measurements. CONCLUSIONS: These results indicate that although L5 is safer than other lumbar levels for pedicle screw insertion, an improper medial and caudal placement of a pedicular screw will carry a great risk of injury to the dural sac and inferior nerve root.
BACKGROUND: We aimed to determine the presence of median and ulnar nerve communication in the forearm by anatomical and electrophysiological examinations in the Anatolian population. MATERIAL/METHODS: 30 forearms from 15 preserved cadavers (2 females, 13 males, 42-65 years of age) were carefully dissected to observe median and ulnar nerve communication. We also performed median and ulnar nerve motor conduction studies by recording the thenar, hypothenar and first dorsal interosseous (FDI) muscles, stimulating both nerves at distal and proximal points, and the recordings were compared in 60 forearms (30 subjects, 17 female, 13 male, 34-67 years of age). RESULTS: Martin-Gruber communication was observed in 2 of 30 forearms (15 cases) by anatomical examination, in 2 of 60 forearms (30 cases) by electrophysiological examination. No Marinacci communication was found in either anatomical or electrophysiological examinations. CONCLUSIONS: In this study group, the ratio of MGC was revealed as 3.3% and 6.6%, in the electrophysiological and anatomical examination, respectively. Knowledge of this crossover is of crucial importance in the clinical evaluation of nerve injuries of the median and ulnar nerves, as well as in accurate interpretation of nerve conduction velocity of these nerves, especially in association with carpal tunnel syndrome. Anatomical and electrophysiological classifications of Martin-Gruber communication are reviewed.
Anastomosis between the pubic rami of the inferior epigastric and the obturator arteries has been referred to as the corona mortis. Because anomalous vessels in the retropubic region are at risk in groin or pelvic surgeries, they have an importance not only for general surgery but also for orthopaedics. Because it is hard to distinguish these vessels, they can be injured during ilioinguinal incision, which can lead to massive uncontrolled bleeding. For this purpose, 54 cadaver halves were dissected to determine the occurrence and location of the corona mortis anastomosis. We found venous corona mortis in 11 halves (20.37%). Additionally, in 8 halves (14.81%), the obturator artery originated from the inferior epigastric artery.
We encountered some multiple vessel variations in the retropubic region of a 55-year-old male cadaver. The obturator artery had its origin from the external iliac artery, and inferior epigastric artery from the femoral artery. Additionally, an anastomosis between obturator and inferior epigastric veins (venous Crown of death) was observed.
In acute appendicitis, although the relationship between the enteric nervous system (ENS) and mast cells (MCs) has been described in a few studies, neither the expression of nerve growth factor (NGF) nor its relation to mast cell density (MCD) and ENS has been delineated yet in this disease. The aim of this study was to immunohistochemically investigate the relationship between MCD, nervous system and NGF expression in the appendices of cases with clinically and histopathologically diagnosed acute appendicitis and of normal controls. Twenty-five patients with acute appendicitis and twelve normal controls were included in our study. Mast cell tryptase, PGP 9.5 and anti-NGF immunostained tissue sections were subjected to quantitative image analysis. Our results showed that MCD, the number of Schwann cells, the number and size of ganglia and NGF staining were significantly greater in acute appendicitis than in the control group (p < 0.01). A strong correlation between MCD and NGF staining was detected (r = 0.92) only in cases with acute appendicitis. Similarly MCD was also related to neuronal proliferation and hypertrophy in this group. We failed to detect any relationship between NGF staining and neural components either in the acute appendicitis or control groups. Our findings indicate that mast cells could be one of the important cell populations responsible for nerve proliferation and hypertrophy in acute appendicitis. The relationship between NGF staining and MCD and the lack of correlation between NGF staining and changes in neural components suggest that, in acute appendicitis, NGF might be responsible for the increased number of MCs, but not for neuronal proliferation and hypertrophy.