Evaluation of an artificial intelligence system for the diagnosis of apical periodontitis on digital panoramic images.

Aims: The aim of the present study was to evaluate the effectiveness of an artificial intelligence (AI) system in the detection of roots with apical periodontitis (AP) on digital panoramic radiographs. Materials and Methods: Three hundred and six panoramic radiographs containing 400 roots with AP (an equal number for both jaws) were used to test the diagnostic performance of an AI system. Panoramic radiographs of the patients were selected with the terms 'apical lesion' and 'apical periodontitis' from the archive and then with the agreement of two oral and maxillofacial radiologists. The radiologists also carried out the grouping and determination of the lesion borders. A deep learning (DL) model was built and the diagnostic performance of the model was evaluated by using recall, precision, and F measure. Results: The recall, precision, and F-measure scores were 0.98, 0.56, and 0.71, respectively. While the number of roots with AP detected correctly in the mandible was 169 of 200 roots, it was only 56 of 200 roots in the maxilla. Only four roots without AP were incorrectly identified as those with AP. Conclusions: The DL method developed for the automatic detection of AP on digital panoramic radiographs showed high recall, precision, and F measure values for the mandible, but low values for the maxilla, especially for the widened periodontal ligament (PL)/uncertain AP.

Evaluation of the frequency and awareness of obesity among healthcare workers.

OBJECTIVE: The aim of this study is to determine the frequency of obesity in healthcare workers and to evaluate the awareness of obesity by using Obesity Awareness Scale. SUBJECTS AND METHODS: This descriptive frequency study was conducted between January 1 and March 31, 2021, in 17 Family Health Centers in the Health Training and Research Area. 119 health personnel working in Family Health Centers were included in the study. The Body Mass Index (BMI) classification accepted by the World Health Organization for adults was used to determine obesity. Obesity Awareness Scale adapted to the Turkish language was used to evaluate obesity awareness. RESULTS: The frequency of obesity among healthcare workers was 11.8% and overweight was 37.8%. 51.9% of physicians were overweight, 14.8% were obese; 38.5% of midwives were overweight, 15.4% were obese; 24.4% of the nurses were overweight and 9.8% were obese. The mean BMI of the participants was 18.00±0.52 for underweight, 22.65±1.35 for normal, 27.32±1.43 for overweight, and 31.53±1.68 for obese. The obesity awareness total score average of the participants was 63.97±7.47 (high level). According to the obesity awareness scale sub-dimension mean scores, obesity awareness was 28.7±3.9 (high), nutrition awareness was 20.0±3.1 (high), and physical activity was 15.3±1.8 (good). CONCLUSIONS: The frequency of obesity was found to be low, and the awareness of obesity was found to be high among HCWs in Family Health Centers. In addition, obesity was mostly detected in physicians, midwives, and nurses. Urgent act policies are needed to encourage both patients and HCWs to the awareness and prevention of obesity and to have a healthy lifestyle.

Evaluation of patient satisfaction with pharyngeal airway changes after orthognathic surgery in patients with Class III skeletal anomalies.

Purpose: The aims of our study were to determine the changes in the pharyngeal airway after treating patients with Class III malocclusion who received double jaw surgery, to determine the hard tissue and soft tissue parameters and the hyoid bone and tongue positions after surgery, to determine the changes to compare the pretreatment and post-treatment measurements of the patients in the double jaw group with the measurements of the control group patients, and to evaluate postoperative patient satisfaction. Materials and methods: The study included thirty-two Class III adult patients that received double jaw surgery and twenty-five Class I patients. Cephalometric records were taken before treatment (T1) and after treatment (T2). Results: After double jaw orthognathic surgery, there were statistically significant changes in all pharyngeal airway linear and areal parameters (p<0.001). There were significant superior and posterior movements of the tongue and hyoid bone post-surgery. The post-treatment analysis of the double jaw surgery group and control group were compared, with statistically significant differences in the mandibular dental parameters and pharyngeal airway measurements in patients in the double jaw surgery group. Conclusion: Despite the narrowings detected, high satisfaction scores were observed in the patient satisfaction questionnaire and the patients did not experience respiratory problems.

Identification of a HTT-specific binding motif in DNAJB1 essential for suppression and disaggregation of HTT.

Huntington's disease is a neurodegenerative disease caused by an expanded polyQ stretch within Huntingtin (HTT) that renders the protein aggregation-prone, ultimately resulting in the formation of amyloid fibrils. A trimeric chaperone complex composed of Hsc70, DNAJB1 and Apg2 can suppress and reverse the aggregation of HTTExon1Q48. DNAJB1 is the rate-limiting chaperone and we have here identified and characterized the binding interface between DNAJB1 and HTTExon1Q48. DNAJB1 exhibits a HTT binding motif (HBM) in the hinge region between C-terminal domains (CTD) I and II and binds to the polyQ-adjacent proline rich domain (PRD) of soluble as well as aggregated HTT. The PRD of HTT represents an additional binding site for chaperones. Mutation of the highly conserved H244 of the HBM of DNAJB1 completely abrogates the suppression and disaggregation of HTT fibrils by the trimeric chaperone complex. Notably, this mutation does not affect the binding and remodeling of any other protein substrate, suggesting that the HBM of DNAJB1 is a specific interaction site for HTT. Overexpression of wt DNAJB1, but not of DNAJB1H244A can prevent the accumulation of HTTExon1Q97 aggregates in HEK293 cells, thus validating the biological significance of the HBM within DNAJB1.

Leptin/Melanocortin pathway hormones in obese patients after laparoscopic sleeve gastrectomy.

OBJECTIVE: The melanocortin system is an important neural system underlying the control of body weight and food intake. This system has recently received great attention as a potential target for obesity treatment. Therefore, the objective of this study was to find out the leptin-melanocortin pathway before and after Laparoscopic Sleeve Gastrectomy (LSG) in obese patients. PATIENTS AND METHODS: The study was carried out with a total of 144 individuals in 3 groups [control, obese group before LSG and obese group after LSG (who underwent LSG one year ago)]. The amount of leptin (LEP), leptin receptor (LEPR), tropomyosin receptor kinase receptor B (TrkB), brain-derived neurotrophic factor (BDNF), pro-opiomelanocortin (POMC) and melanocortin-4 receptors (MC4R) molecules were measured by using Enzyme-Linked Immunosorbent Assays. RESULTS: A statistically significant difference was found between the groups in terms of body mass index (BMI) values (p = 0.001). There was also statistically significant difference present between obese before LSG group and obese after LSG group regarding the levels of LEP, TrkB, BDNF and proteins (p < 0.05). A decline was determined in the LEP and BDNF levels one year follow-up after LSG. CONCLUSIONS: The evidence suggests that the leptin melanocortin pathway strictly regulates food intake and BMI before and after LSG surgery. This pathway should be kept under control for effectively reducing food intake and body weight in the treatment of obesity.

Effect of laser application on microtensile bond strength of an orthodontic adhesive to water-aged composite.

AIM: This study evaluated the microtensile bond strength (MTBS) of an orthodontic adhesive to water-aged composite surfaces using different surface treatments. SUBJECTS AND METHODS: Twelve composite blocks (10 mm × 10 mm × 5 mm) were fabricated and randomly divided into two groups. Half of the specimens were stored in distilled water for 1 day, and the other specimens were stored for 30 days. The specimens were randomly assigned to six groups according to surface treatments (n = 15): Group 1, control (no treatment); Group 2, phosphoric acid; Group 3, diamond bur; Group 4, diamond bur + phosphoric acid; Group 5, laser; and Group 6, laser + phosphoric acid. One coat of orthodontic adhesive was bonded to one surface of composite blocks, and a microhybrid composite resin was bonded to the surfaces via a Teflon mold. Bond strength was evaluated using an MTBS test. Surface topography was evaluated using scanning electron microscopy (SEM) analysis. The data were analyzed using one-way analysis of variance, Tamhane post-hoc test, and independent sample t-tests (P < 0.05). RESULTS: Bond strength values tended to decrease in all groups (with the exception of Group 2) after storage in water for 30 days (P < 0.05). Laser and diamond bur application (with or without phosphoric acid) enhanced the bond strength. CONCLUSIONS: An Er,Cr:YSGG laser application may be a feasible alternative to diamond bur for enhancing the bond strength of orthodontic adhesive to composite resin.

Serial Synapse Formation through Filopodial Competition for Synaptic Seeding Factors.

Following axon pathfinding, growth cones transition from stochastic filopodial exploration to the formation of a limited number of synapses. How the interplay of filopodia and synapse assembly ensures robust connectivity in the brain has remained a challenging problem. Here, we developed a new 4D analysis method for filopodial dynamics and a data-driven computational model of synapse formation for R7 photoreceptor axons in developing Drosophila brains. Our live data support a "serial synapse formation" model, where at any time point only 1-2 "synaptogenic" filopodia suppress the synaptic competence of other filopodia through competition for synaptic seeding factors. Loss of the synaptic seeding factors Syd-1 and Liprin-α leads to a loss of this suppression, filopodial destabilization, and reduced synapse formation. The failure to form synapses can cause the destabilization and secondary retraction of axon terminals. Our model provides a filopodial "winner-takes-all" mechanism that ensures the formation of an appropriate number of synapses.

Antimicrobial activity and volatile constituent analysis of three commercial herbal toothpastes containing Aloe vera L. and Fragaria vesca L. extracts.

AIMS: This work was designed to evaluate the antimicrobial activity of three different commercial herbal (Aloe vera L. and Fragaria vesca L. extracts) toothpastes [LR Aloe vera (HTP1), ESI Aloe fresh (HTP2) and ROCS Teens (HTP3)] against two microorganisms that cause tooth infections. MATERIALS AND METHODS: An agar disk diffusion method was used to test the antimicrobial activity of three herbal gel toothpastes in the amount of 100 µL against Streptococcus mutans and Staphylococcus aureus. In the second part of the work, the volatile organic compounds of three different commercial herbal toothpastes (HTP1-3) were determined by solid-phase microextraction/gas chromatography-mass spectrometry-flame ionization detection (SPME/GC-MS-FID). RESULTS: The sensitivity of the tested herbal toothpastes toward each microorganism was expressed as the mean of the clear zone within the range of 6-16 mm diameters. HTP1 and HTP2 were found to be more effective against both bacteria compared with HTP3. Oxygenated monoterpenes (99.34%, 91.44%, and 83.48%) were the most abundant groups in the SPME of HTP1-3, respectively. Menthol (25.41%, 35.82%, and 31.15%) and anethole (52.01%, 23.62%, and 38.79%) were the major compounds identified in the SPME analysis of HTP1-3, respectively. Carvone was found only in HTP3 (0.49%) in a small quantity. CONCLUSION: The commercial herbal toothpastes could have advantages in decreasing bacterial accumulation on teeth with protection of the oral cavity.

"Maternal Health and Family Planning Distance Education" experience among physicians: a three-phase study to determine the educational needs, develop education program, and evaluate efficacy of the education administered.

AIM: This study aims to assess the educational needs of family practitioners and evaluate the efficacy of the ongoing "Maternal Health and Family Planning Distance Education" program conducted by the General Directorate of Health Research (SAGEM) of the Turkish Ministry of Health. METHODS: This study consisted of three phases. In the first phase, an online survey on maternal health and family planning educational needs was sent to 20,611 physicians via e-mail. Of the 20,611 physicians, 4,729 completed the survey. In the second phase, of the 1,061 physicians registered to the education program, 632 physicians with active participation were included. In the third phase, the preeducation expectations of 287 physicians and posteducation satisfaction of 54 physicians were analyzed with a questionnaire. RESULTS: The majority of the physicians were employed in a family health center (97.4%) and practicing for 16-20 years (23.2%) without any prior in-service training (60.9%). High-to-very high educational need was expressed by 56.4% of physicians for pregnancy, delivery, and puerperality. Topics that the physicians, including both those with ≥16 years in practice and without prior in-service training, expressed need for more detailed content were pregnancy, delivery, and puerperality (37.5%); emergency obstetric approach in the primary care setting (33.1%); and gynecological infectious diseases and treatment approach (32.4%). Following the education program, the participants' expectations were fulfilled in terms of refreshing their knowledge, particularly in the field of Maternal Health and Family Planning (87.1% and 75.9%) and the percentage of participants who expressed that they had sufficient high level knowledge increased from 55% to 68.5%. CONCLUSION: The education on Maternal Health and Family Planning refreshed the knowledge of participants and highly met the preeducation expectations. Determining the educational needs and expectations of the target population prior to the education program seems to have an important role on determining its overall success.

The Effect of the iNOS Inhibitor S-Methylisothiourea and Hyperbaric Oxygen Treatment on Radiation Colitis in Rats.

INTRODUCTION: External radiotherapy is one of the main treatment modalities for a variety of malignancies. However, the lower gastrointestinal tract is sensitive to the ionizing radiation. Hyperbaric oxygen treatment (HOT) has been suggested as a viable treatment for refractory radiation colitis, but the effect of S-Methylisothiourea (SMT) in the radiation colitis have not reported. To investigate the effect of SMT, HOT and the combination of both in an acute radiation-induced enterocolitis model. METHODS: Sixty Sprague-Dawley rats were divided randomly into five equal groups. A single dose of gamma irradiation (25 Gy) was administered through the colorectal region to anesthetized rats. In the control group, we applied 2 ml of saline solution intraperitoneally for five days. In the HOT group, 100-per-cent oxygen at 2.5 atm pressure was applied for five days. In the SMT group, 10 mg/kg/day of SMT was applied intraperitoneally for five days. In the HOT+SMT group, HOT and SMT were both applied in the same dosages as in the preceding two groups. At the end of five days, the rats were sacrificed and colon samples were collected for histological grading. Blood samples were collected to test for : tumor necrosis factor-α (TNF-α), interleukin-10 (IL-10), IL-1ß, transforming growth factor-ß (TGF-ß) and intercellular adhesion molecule-1 (ICAM-1) mRNA. RESULTS: The TNF-α, IL-1ß, IL-10 and TGF-ß levels were reduced by SMT, HOT and HOT+SMT applications (p < 0.05). However ICAM-1 mRNA levels were not significantly lower (p:0.19). The microscopic scores differed significantly between the SMT, HOT and HOT+SMT groups and the control group. There was significant improvement histologically, especially in the HOT+SMT group. When we compared the weight of the rats before and after the study, weight loss was significantly lower in the SMT, HOT and HOT+SMT groups compared with the control group (p < 0.05). CONCLUSION: HOT and SMT together were significantly more effective in preventing weight loss and in reducing inflammation and the severity of colitis histology when compared with HOT and SMT separately.

Comparison of p57, c-erbB-2, CD117, and Bcl-2 expression in the differential diagnosis of hydatidiform mole and hydropic abortion.

PURPOSE: To explore the utility of p57, c-erbB-2, CD 117, and Bel-2 immunostaining in the differential diagnosis of complete hydatidiform mole (CHM), partial hydatidiform mole (PHM), and hydropic abortion (HA). MATERIALS AND METHODS: Immunohistochemical expression of the p57, c-erbB-2, CD117, and Bel-2 proteins were investigated semi-quantitatively using paraffin-embedded tissue sections from histologically unequivocal cases of CHM (n = 20), PHM (n = 23), and HA (n = 17). RESULTS: All cases of CHM exhibited a striking absence of p57 expression. The percentage of positive p57 staining was similar between PHMs (73.9%) and HAs (76.5%) (p >0.05). The comparison of c-erbB-2 expression revealed a significantly higher percentage of positive c-erbB-2 staining in CHMs (45%) compared with that in PHMs (8.7%) and HAs (5.9%) (p = 0.006 and 0.01, respectively). The CD 117 expression pattern (immunoreactivity score, percentage of positive cells, and staining intensity) was significantly lower in HAs compared with that in PHMs and CHMs (p < 0.05 for all). A significantly increased Bel-2 expression pattern was observed in HAs compared with that in PHMs and CHMs (p < 0.05 for all). CONCLUSION: Immunohistochemical examination of p57, c-erbB-2, CD 117, and Bel-2 expression represents a relatively simple, reliable, and cost-efficient procedure to definitively distinguish among CHM, PHM, and HA.

Characteristic imaging findings of duodenal perforation.

Two patients were admitted to emergency room with complaint of abdominal pain with abrupt onset and retroperitoneal free air was detected in pararenal area on CT. In this paper, characteristic CT findings of patients diagnosed with duodenal perforation are presented under the light of literature data.

The determination of possible genetic damage to women undergoing in vitro fertilization due to infertility caused by the male factor.

In this study, we aimed at determining possible genetic damage to women who were exposed to in vitro fertilization (IVF) due to infertility with male factor. Four different genotoxicity tests were used in human lymphocytes in this study with regard to chromosomal aberration (CA), sister chromatid exchange (SCE), micronucleus (MN), and comet tests. There was a statistically significant increase in sister chromatid exchange (SCE) test in the study group compared with the control group. In addition, a higher rate of MN frequency was determined only in the 21­30 age range study group compared with the control group in the same age range. On the other hand, MN frequency did not differ significantly between the control and total study groups. In addition, there was no significant difference between the control group and the study group in terms of mitotic (MI), replication (RI), and nuclear division (NDI) indices. Furthermore, there was no statistically significant increase for chromosomal aberration and DNA damage to the study groups. Our results showed that in vitro fertilization treatments have a weak risk at the genetic level in cultured human lymphocytes.

Protective and antigenotoxic effect of Ulva rigida C. Agardh in experimental hypothyroid.

The presence of chromosomal damage in bone marrow cells affected by several diseases such as thyroid, cancer etc., was detected by the micronucleus (MN) assay. The present study was designed to evaluate: i) volatile components of Ulva rigida, ii) effects of hypothyroidism on bone marrow MN frequency, iii) effects of oral administration of Ulva rigida ethanolic extract (URE) on MN frequency produced by hypothyroidism, and iv) thyroid hormone levels in normal and 6-n-Propylthiouracil (PTU)-induced hypothyroid rats. The volatile components of Ulva rigida was studied using a direct thermal desorption (DTD) technique with comprehensive two-dimensional gas chromatography time-of-flight mass spectrometry (GCxGC-TOF/MS). URE administration was of no significant impact on thyroid hormone levels in control group, while PTU administration decreased thyroid hormone levels compared to control group (p < 0.001). Moreover, URE supplementation resulted in a significant decrease in MN frequency in each thyroid group (p < 0.0001). This is the first in vivo study that shows the strong antigenotoxic and protective effect of URE against the genotoxicity produced by hypothyroidism.

Calculation of pediatric femoral fracture rotation from direct roentgenograms.

BACKGROUND: Radiologic determination of pediatric femoral fracture rotation has been debated. Measuring the antetorsion angle of the fractured femur by computed tomography and comparing it with the opposite side has been the method of choice for this purpose. However, no simple method for direct measurement of femoral fracture rotation exists in the literature. In this study, our aim was to test a mathematical method of measuring the axial plane malrotation from direct roentgenograms. MATERIALS AND METHODS: A pediatric femoral shaft fracture model was produced. The bone was secured to a wooden frame that allowed the distal part of the fracture to rotate around an axis. Radiographs were taken at known intervals of rotation ranging from the neutral position to 60° external rotation and to 60° internal rotation in 5° increments of rotation. Five independent, blinded observers measured the radiographs and calculated the fracture rotation according to a standard formula. Calculated rotation values were compared with known rotation values. RESULTS: Calculated rotation values were close to actual rotation values throughout the arc of rotation. The mean absolute error of five observers for all measurements of external and internal rotation was 3.97° (±0.83). The correlation coefficient between calculated and actual rotation values was 0.9927. The interobserver intraclass correlation coefficient for calculated rotation was 0.997. CONCLUSIONS: Absolute error and correlation coefficient values indicate that this method is accurate and reliable in determining the fracture rotation.

Determination of volatile nitrosamines in grilled lamb and vegetables using comprehensive gas chromatography - nitrogen chemiluminescence detection.

The grilling of meat may generate dangerous levels of mutagenic and carcinogenic nitrosamines (NAs). Meat and vegetable samples underwent a two-step solid-phase extraction before analysis by comprehensive gas chromatography with a nitrogen chemiluminescence detection system (GCxGC-NCD). The GCxGC-NCD method showed high selectivity, sensitivity and equimolarity in its response to six specific NAs. NA contamination of charcoal-grilled lamb at various stages of cooking and with various fat contents and also charcoal-grilled vegetables were investigated. The grilling of lamb on unready charcoal resulted in the formation of considerable quantities of NAs. Grilling lamb on properly prepared, ready charcoal resulted in an increase in total concentrations of six NAs from 0 to 4.51 µg kg(-1) over a period of 16 min. Increasing the fat content of the grilled lamb from 5% to 20% caused a modest increase in total concentrations of the six investigated NAs from 4.51 to 5.30 µg kg(-1).

Effect of autoclave postpolymerization treatments on the fracture toughness of autopolymerizing dental acrylic resins.

INTRODUCTION: Microwave and water bath postpolymerization have been suggested as methods to improve the mechanical properties of heat and autopolymerizing acrylic resins. However, the effects of autoclave heating on the fracture properties of autopolymerizing acrylic resins have not been investigated. PURPOSE: The aim of this study was to assess the effectiveness of various autoclave postpolymerization methods on the fracture properties of 3 different autopolymerizing acrylic resins. METHODS: Forty-two specimens of 3 different autopolymerizing acrylic resins (Orthocryl, Paladent RR and Futurajet) were fabricated (40x8x4mm), and each group was further divided into 6 subgroups (n=7). Control group specimens remained as processed (Group 1). The first test group was postpolymerized in a cassette autoclave at 135°C for 6 minutes and the other groups were postpolymerized in a conventional autoclave at 130°C using different time settings (5, 10, 20 or 30 minutes). Fracture toughness was then measured with a three-point bending test. Data were analyzed by ANOVA followed by the Duncan test (α=0.05). RESULTS: The fracture toughness of Orthocryl and Paladent-RR acrylic resins significantly increased following conventional autoclave postpolymerization at 130°C for 10 minutes (P<.05). However, the fracture toughness of autoclave postpolymerized Futurajet was not significantly different than its control specimens (P<.05). The fracture toughness of Futurajet was significantly less than Paladent RR and Orthocryl specimens when autoclaved at 130°C for 10 minutes. CONCLUSIONS: Within the limitations of this study, it can be suggested that autoclave postpolymerization is an effective method for increasing the fracture toughness of tested autoploymerized acrylic resins.

Risk factors for osteoporosis after renal transplantation and effect of vitamin D receptor Bsm I polymorphism.

OBJECTIVE: Rapid loss of vertebral or hip mineral density after renal transplantation is a major complication which occurs within 6-12 months. The aim of this study was to evaluate risk factors contributing to bone disease in the early stage after renal transplantation and the effect of vitamin D receptor (VDR) gene polymorphisms. METHODS: We prospectively followed for up to 12 months 44 patients (29 men and 15 women) with end-stage renal disease who underwent kidney transplantation. All patients received prednisone with either cyclosporine (CsA)/mycophenolate mofetil (MMF) or tacrolimus (Tac)/MMF therapy. Spine, hip, and whole body bone mineral density (BMD) was measured at 12 months after transplantation. According to World Health Organization recommendations, our patients were categorized as normal, osteopenic, or osteoporotic BMD levels. VDR alleles were genotyped as BB, Bb, or bb by polymerase chain reactions based on polymorphism at the Bsm I restriction site. RESULTS: Forty-six percent of patients were normal, 43% osteopenic, and 11% osteoporotic. Significant risk factors for osteoporosis among renal transplant recipients were younger age and pretransplant high intact parathyroid hormone (iPTH) levels. (P values .045 and .027, respectively). According to polymorphic group categorization, posttransplant serum Ca was significantly higher in patients with BB or Bb genotype than in those with bb genotype (P = .012). Although there was no statistical significance regarding iPTH levels, it was higher among Bb+BB than the bb genotype group. Also, first-year BMD analysis after transplantation according to Bsm I polymorphism showed significant differences in femur BMD levels according to the dual classification of polymorphism (P < .05). The BMD levels in the bb group was higher than in the Bb+BB group. CONCLUSIONS: Although high pretransplant iPTH levels and younger age enhanced posttransplant bone loss, functionally different alleles of the VDR gene may modulate bone turnover during the first year after renal transplantation.

Denervation point for neuromuscular blockade on lateral pectoral nerves: a cadaver study.

PURPOSE: The objective of our study was to clarify the topography of the medial and lateral pectoral nerves (LPNs) and the vascularity in the infraclavicular fossa and to propose an ideal injection point for neuromuscular blockade of the pectoralis major (PM) muscle. METHODS: The pectoral muscles and their nerves were examined bilaterally on 10 formalin-fixed cadavers. The PM muscle was dissected from its clavicular origin and sternocostal attachments. It was reflected superolaterally to expose the pectoralis minor muscle and neurovascular bundle at the infraclavicular fossa. We took the measurements to identify a landmark point and reach the neurovascular bundle from an overlying point on the skin. RESULTS: The LPN was closely related to the thoracoacromial artery and veins on the lower surface of the PM muscle and was visible under the muscle fascia as a neurovascular bundle. The point where the pM line (perpendicular to midsternal line beginning from the inferior border of the jugular notch) transects the neurovascular bundle was sufficiently close to the point at which the neurovascular bundle enters the PM muscle. Hence, this point was determined as the denervation point in all cadaveric dissections. This denervation point is 2.81 ± 0.33 cm distant vertically from the 1/3 medial part of the clavicle and 8.12 ± 1.09 cm distant horizontally from the midsternal line. CONCLUSIONS: We have identified an injection point which may be and suitable and safe location to administer neuromuscular motor blockade of the pectoralis muscles with a percutaneous local anesthetic agent in some clinical pathologies requiring elective denervation.