Numerical variations and localization of foramen spinosum in 3D-CT images

Objectives: The structures passing through the foramen spinosum and its neurovascular relationships are of great importance for surgical approches directed to middle cranial fossa. The aim of the present study was to examine the number and location of the foramen spinosum (FS) in 3D-CT images. Methods: The study was retrospectively conducted on 3D-CT images of 177 adults. Firstly, the transverse section passing through the upper edge of the orbit, extending parallel to the Frankfurt plane was chosen. Then, the x and y-axes were determined on that transverse section. The coordinates, number, and location of the FS with respect to the foramen ovale (FO) were identified accordingly on x and y-axes. Results: While 1 FS was present in 90.96% of a total of 354 sides of 177 heads, there were 2 FS and 3 FS in 8.76% and 0.28% of the sides, respectively. The FS was located posterolaterally in 97.68%, posteriorly in 2.06%, and laterally in 0.26% with respect to the FO. In terms of FS coordinates, there was no statistically significant difference between gender and sides in the distance of the FS to the x-axis, but there was a statistically significant difference between gender and sides in the distance of the FS to the y-axis. Conclusion: Evaluation of the number of the FS and its location would help identifying and preserving neighbouring neurovascular structures during surgical interventions directed to the middle cranial fossa.

Lungs and hypoxia: a review of the literature

Acute, intermittent or chronic hypoxia have negative effects on lung maturation during the embryological period which has been shown by many experimental models designed on animal studies. The receptors responsible from the development of lungs in fetal period are affected from hypoxia. Hypoxia also affects the morphometry, anatomy and microscopy of lung tissue in the adults. In acute phase of hypoxia; lung parenchyma showed destructive oxidative changes. However, in later phases repair and proliferative processes were observed in the lung tissue. Damage to the lining layer of alveoli, accumulation of alveolar macrophages, oedematous changes in the lung parenchyma, mild oedema, inflammatory cell infiltration, increased number of type II pneumocytes and pulmonary fibrosis are the main findings in cases of hypoxia. Chronic hypoxia accentuates lung growth by increasing the lung parenchyma. Decrease of capillary volume and suppression of elastin repair in lung fibroblasts are other clinically important microscopic findings in hypoxia. Many molecular studies found in the literature revealed micro-RNAs to be involved in modulation of hypoxia-induced pulmonary hypertension. In animal models submitted to acute hypobaric hypoxia; the researchers detected an increase in eNOS mRNA which is responsible of the immediate response, producing nitric oxide that caused vasodilation and bronchodilation in lung tissue. In other molecular studies; suppression of many immune molecules, major changes at the levels of various enzymes and growth factors were detected in the researches. Additionally; hypoxia causes to an increase in the amount of lung cancer cells and therefore; induces the metastases of lung cancer cells to brain tissues.

Protective role of sildenafil citrate in isoniazid-rifampicin induced histomorphological changes in liver of albino mice

Objectives: The objective of the study was to reveal the reversal of histo-morphological changes in mice liver induced by combined isoniazid-rifampicin (INH-RIF) therapy with sildenafil treatment. Methods: Twenty-one mice weighing between 25–35 g were enrolled in the study. Randomisation was carried out by simple balloting method. The selected mice were sorted into three groups with 7 mice, each group. In group C (n=7) control group, mice were administered 0.4ml of saline per kg body weight daily intra peritoneally for 21 days. In group R (n=7) INH-RIF group, rifampicin (50 mg/kg) and isoniazid (50 mg/kg), dissolved in 4 ml/kg isotonic saline, were administered intra-peritoneally (ip) daily for 21 days. In group S (n=7) sildenafil administered group, 10 mg/kg sildenafil was given orally by gastric gavage on daily basis along with the intraperitoneal injection of INH-RIF (50 mg/kg each) daily for 21 days. Results: Histopathology revealed hepatotoxicity in group R (INH-RIF), while significant improvement was observed in group C (INH-RIF-sildenafil). Conclusion: Sildenafil citrate possesses hepatoprotective role against INH-RIF induced hepatotoxicity.

Morphometry of the hyoid bone: a radiological anatomy study

Objectives: The hyoid bone occupies a strategic position and participates in vital functions. The aim of this study was to examine the morphometry of the hyoid bone and define its location according to the vertebral level on 3D computed tomography (CT) images. Methods: This study was conducted using 3D–CT images of 216 patients (104 males, 112 females) aged between 10–98 years. The vertebral level of the hyoid bone was determined for each decade. Furthermore, the anterior-posterior length of the hyoid bone, the length and height of the greater horn, the height and width of the body, the distance between the posterior ends of the greater horn, and the distance of the hyoid bone to the vertebral column and the angle between right and left greater horn was measured. Results: The hyoid bone was most commonly located at C3 and C2–C3 vertebral level in females (35.7%) and C3 in males (38.5%). No statistically significant difference was found between right and left sides concerning the length and height of the greater horn. Conclusion: Knowing the radiological anatomy, morphometric properties and vertebral levels of the hyoid bone will contribute to the surgical planning of this region and the hyoid bone. In addition, our study will provide data on the morphometric properties of hyoid bone in forensic and anthropological research.

Three-dimensional muscle architecture of the infant and adult trapezius: a cadaveric study

Objectives: The elaborate morphometry of the human trapezius muscle facilitates its involvement in numerous active movements of the shoulder girdle and passive stabilization of the upper extremity. Despite its functional importance throughout the lifespan, little is known about the 3D architecture of trapezius at any post-natal timepoints. Accordingly, the aim of this preliminary cadaveric study was to digitize, quantify, model, and compare the 3D architecture of trapezius at two temporal extremes: infancy and adulthood. Methods: We examined trapezius in two female formalin-embalmed cadavers, aged 6 months and 72 years, respectively. We meticulously dissected each muscle, allowing us to digitize and model the comprehensive muscle architecture in situ at the fiber bundle level. We quantified standard architectural parameters to facilitate comparison between each functional partition of trapezius (i.e., descending, transverse, ascending) and proportionally between the infant and adult specimens. Results: We found markedly different patterns in fiber bundle length range, physiological cross-sectional area, and muscle volume within and between muscles. Notably, the proportional physiological cross-sectional area of the ascending and descending partitions was equal (1:1) in the infant, in contrast to 3:1 in the adult. The transverse partitions were proportionally similar, accounting for over half of the whole muscle physiological cross-sectional area in both specimens. Conclusion: This study provides preliminary insights into infant and adult trapezius architecture at an unparalleled level of detail and precision. The quantifiable architectural differences appear to coincide with functional development-a notion that warrants further investigation in larger samples and with longitudinal approaches.

Perforator flaps based on the deltoid branch of the thoracoacromial artery: anatomical study

Objectives: Tissue defects in the lateral triangle of the neck and the anterior cervical region represent a high demand for plastic and reconstructive surgery. Their management most often requires regional or free flaps. The perforator flap based on the deltoid branch of the thoracoacromial artery (TAA) may be a good solution for these indications. The objective of this work is to propose anatomical landmarks to raise perforator flaps pedicled on the deltoid branch of the TAA. Methods: We carried out dissection of 24 perforator flaps based on the deltoid branch of the TAA, in body donor specimens preserved in a glycerin-rich, formalin-free solution. The TAA was first injected with methylene blue. The vascular territory, location of perforators relative to known landmarks, along with the flap’s potential amplitude and arc of rotation were studied. Results: The main perforating arteries of the flap were located in the middle of the deltopectoral groove, often surrounded by adipose tissue in 18 out of 24 dissections. In 22 out of 24 dissections, there were at least 2 perforator arteries originating from the deltoid branch. The average diameter of the perforator arteries was 1 mm. The flap’s amplitude of movement made it possible to reach in all cases the lateral triangle of the neck and the anterolateral cervical region. Conclusion: The thoracoacromial artery has already been used for perforator flaps. However, the individualization of its deltoid branch offers to practitioners new surgical options. This anatomical study of the perforator flap based on the deltoid branch of the TAA made it possible to review the anatomical bases for the raising of this flap, and to fix useful landmarks for the surgeon in order to propose an easily feasible surgical technique.