Biomedical subjects

Tamer Mungan

Publications and source records attributed to Tamer Mungan.

6 recordsLinked to original sources

PubMed2006

Observation of the relationship between the shape of skeletal muscles and their nerve distribution patterns: a transparent and microanatomic study.

BACKGROUND: There are many gaps in the understanding of the neuroanatomy of skeletal muscles with regards to the nerve distribution pattern and shape of the muscles. This study was designed to examine the entire intramuscular nerve-distribution patterns of various human skeletal muscles. METHODS: The relationships among nine skeletal muscles with various architecture (rhomboid major, biceps brachii, flexor pollicis longus, rectus femoris, sternohyoid, trapezius, masseter, digastric muscles) and their nerve-distribution patterns were investigated in four fetal cadavers using the Sihler staining method. The diameter and number of extramuscular (main) and major nerve branches, the number of minor nerve branches, and anastomoses were examined and evaluated statistically. RESULTS: With regards to the number of extramuscular (main) nerve branches, the rhomboid major muscle resembled the flexor pollicis longus, trapezius, masseter, and sternohyoid muscles, and the anterior belly of the digastricus muscle (p > 0.05), whereas it was significantly different from the rectus femoris, the posterior belly of digastricus, and the long and short heads of the biceps brachii (p < 0.05). Trapezius and masseter muscles were different from all of the skeletal muscles that were studied with regards to the diameter of main branches (p < 0.05). The masseter muscle had the largest diameter (p < 0.05). With regards to the number of minor nerve branches, the sternohyoid muscle was significantly different from all the skeletal muscles that were studied (p < 0.05) except the short head of the biceps brachii, rectus femoris, and the posterior belly of digastricus (p > 0.05). As for the number of neural anastomoses, the sternohyoid muscle was statistically different from all skeletal muscles that were studied (p < 0.05) except the masseter and trapezius muscles (p > 0.005). CONCLUSIONS: A surgeon's thorough knowledge of the relationship between the shape and nerve distribution pattern of skeletal muscles is important in successful reinnervation and regeneration of these muscles. It might also be useful in the field of muscle transplantation.

Arm↗

PubMed2005

Multiple repeat caesarean section: is it safe?

OBJECTIVE: We aimed to evaluate the obstetric outcome of patients without obstetric risks, who had two or more previous caesarean sections (C/S) prior to the current pregnancy, which was managed by caesarean section in our obstetric department. METHODS: We studied the case notes of 602 women who had a repeat caesarean section in our unit between May 2002-June 2003. We then compared the two groups: (1) those who had two or more previous caesarean sections and (2) those who had only one previous caesarean section. RESULTS: In the study group, while dense intraperitoneal adhesions were present in 3.6% of the patients, they were not found in control group. This difference was statistically significant (P < 0.05). Uterine wound separation rate was 1.9% in the study group and none of the patients in control group had uterine wound separation, which was statistically significant also (P < 0.05). There was no statistically significant association between Apgar scores and number of previous caesarean sections. Postoperative complication rates did not differ between the two groups (P > 0.05). CONCLUSION: Patients without any obstetric risks, with two or more previous caesarean sections had significantly more dense adhesions and uterine wound separations in the current caesarean section compared to patients with one previous caesarean section. But, maternal and fetal mortality and morbidity in women who have two or more previous caesarean sections did not differ from the patients with one previous caesarean section.

Adult↗

PubMed2005

Predictive value of maternal serum and vaginal interleukin-6 levels in preterm labor.

OBJECTIVE: The aim of the current study was to evaluate the predictive value of maternal serum and vaginal interleukin 6 (IL-6) levels for preterm delivery before 37 gestational weeks in patients with preterm labor and to determine the probable relationship between IL-6 concentrations and delivery interval. METHODS: In this prospective study, maternal serum and vaginal IL-6 levels were measured in 40 patients with the diagnosis of preterm labor between the 28th and 36th gestational weeks (study group) and in 20 pregnant women between the same gestational weeks attending the antenatal clinic with no complaints (control group). The gestational age at the time of admission and delivery, as well as the delivery interval, were evaluated and compared with the concentration of IL-6 on admission. RESULTS: There were no significant relationships between maternal serum concentrations of IL-6 and preterm delivery. Vaginal IL-6 levels were significantly higher in the study group as compared with the control group (P < .001). The optimal cut-off value for vaginal IL-6 (172 pg/mL) gave a sensitivity level of 73.9% (95% confidence interval [CI], 67-82%) at a specificity of 100% (95% CI, 91-100%) with positive and negative predictive values of 94.1% and 83.7%, respectively. In the study group, the interval from collection to delivery was significantly shortened when the maternal vaginal IL-6 levels increased. CONCLUSION: The ease of measurement, feasibility, cost-effectiveness, and success of identifying pregnancies at risk for preterm labor with vaginal IL-6 make this a useful biochemical marker for preterm labor and delivery.

Adult↗

PubMed2004

Intrauterine structure of foot muscles in talipes equinovarus due to high-level myelomeningocele: a light microscopic study in fetal cadavers.

The purpose of this study was to investigate the light microscopic structure of extrinsic foot muscles in talipes equinovarus (TEV) deformity that developed during intrauterine life due to high-level myelomeningocele. Ten feet of five fetal cadavers ranging in age from 18 to 20 weeks were dissected. Five feet had typical TEV deformity and the other five feet did not have any deformity (control group). Under light microscopic examination quantitative measurement of both muscle fiber sizes and fibrosis in the muscle tissue were performed to investigate the denervation muscle atrophy. Mean muscle fiber size of the TEV group was found to be significantly lower than that of the control group in all foot muscles except the gastrocnemius muscle. The proportion of fibrosis due to denervation atrophy was significantly higher in the TEV group than in the control group in all muscles. This situation was most evident in the peroneus longus muscle. It was concluded that muscular imbalance due to significant muscular atrophy might be the cause of TEV deformity that developed during intrauterine life due to high-level myelomeningocele.

Aborted Fetus↗

PubMed2004

Significance of detecting insulin-like growth factor binding protein-1 in cervicovaginal secretions: comparison with nitrazine test and amniotic fluid volume assessment.

OBJECTIVES: The diagnosis of premature rupture of membranes (PROM) is sometimes challenging, and common diagnostic tests are of limited value in the diagnosis. We aimed to study the accuracy of detecting insulin-like growth factor binding protein-1 (IGFBP-1) in vaginal fluid by a rapid dipstick method in comparison with the nitrazine test and amniotic fluid index (AFI) and we studied the predictivity of these methods on the latency of pregnancy in patients with suspected PROM. MATERIAL AND METHOD: One hundred and fifty-one patients (36 definite PROM, 35 no PROM and 80 suspected PROM) at 20-42 weeks' gestation were included in the study. Patients with preterm labor and PROM, patients at <20 gestational weeks, and those with multiple pregnancies were excluded. IGFBP-1 in the cervicovaginal fluid was measured by a rapid dipstick method (PROM test). AFI was measured by the four-quadrant method and an AFI of <80 mm was considered as oligohydroamnios. RESULTS: The sensitivity, specificity and accuracy of the nitrazine test, the PROM test and AFI were 97, 16 and 56%, 97, 97 and 97% and 94, 91 and 92%, respectively. The nitrazine test results were affected by vaginal discharge but the PROM test results were not affected. Only a positive PROM test was associated with delivery within 7 days [odds ratio (OR) 12; 95% confidence interval (CI) 4.2-35, p < 0.001]. CONCLUSION: The dipstick method of detecting IGFBP-1 in the vaginal fluid is a rapid, reliable and noninvasive method. The PROM test is the most accurate diagnostic test and predictor of latency in patients with suspected PROM.

Adult↗

PubMed2003

Effect of inter-twin delivery time on Apgar scores of the second twin.

OBJECTIVE: The aim of the present study was to analyse the effect of inter-twin delivery time on the Apgar scores of the second twin. MATERIAL: Women attempting vaginal delivery of second twins were studied in 2000. Deliveries before 25 weeks' gestation, complicated pregnancies, operative deliveries, and deliveries by regional or general anaesthesia were all excluded. RESULTS: A total of 37 out of 126 twin pregnancies had the criteria to be included in the present study. The major factor identified to influence Apgar scores was gestational age (P < 0.01). There was a linear relationship between delivery interval and the Apgar scores of the second twin, and the addition of delivery interval significantly improved the predictivity of gestational age. There was no influence of presentation and delivery mode of the second twin. Interval was found to be the only significant predictive factor of the Apgar scores in second twins of >1900 g and where the second twin is in a breech presentation. Caesarean section did not improve the outcome of the second twins. CONCLUSION: Gestational age is the most important factor influencing the Apgar scores of second twins. The addition of delivery interval improves the predictivity of second twin Apgar score by gestational age. Inter-twin delivery time of >15 min is particularly important in the second twin which presents by the breech method and in the second twin of more than 1900 g.

Apgar Score↗