The effect of autonomic nervous system dysfunction on oxygen consumption during daily living activities in patients with spinal cord injury.

STUDY DESIGN: Case-control study. OBJECTIVES: To investigate the level of autonomic nervous system dysfunction in patients with spinal cord injury and to determine its effect on the basal metabolic rate and oxygen consumption during daily living activities. SETTING: Turkish Armed Forces Rehabilitation Center, Ankara, Turkey. METHODS: Thirty-six patients with chronic spinal cord injury (SCI) were allocated into two groups according to the presence of autonomic nervous system dysfunction. Autonomic nervous system dysfunction was investigated with the measurements of blood pressure and heart rate during urodynamic examination and several provocative maneuvers (standing at tilt table, forcing deep respiration and Valsalva). Groups were compared in terms of the basal metabolic rate and oxygen consumption during daily living activities. Measurement of the basal metabolic rate was determined by indirect calorimetry under standardized conditions. Total body fat mass and lean tissue mass were measured in all participants using dual-energy X-ray absorptiometry by standard methods. Telemetric intrapulmonary gas exchange analyzer was used to measure oxygen consumption during daily living activities. RESULTS: There was no statistically significant difference between the groups in age, time since injury, body mass lean and fat rates, or sensory and motor scores (P>0.05). Basal metabolic rates and oxygen consumption during daily living activities were not different between the groups (P>0.05). CONCLUSIONS: These results suggest that the presence of autonomic dysfunction does not change oxygen consumption at rest and during daily living activities.

A histological study of toxic effects of aluminium sulfate on rat hippocampus.

Aluminium has toxic effects on many organ systems of the human body. Aluminium toxicity also is a factor in many neurodegenerative diseases. We investigated changes in numbers of hippocampal neurons in rats exposed to aluminium using an optical fractionator and we investigated aluminium-induced apoptosis using the transferase mediated dUTP nick end labeling (TUNEL) assay. Twenty-four female rats were divided equally into control, sham and aluminium-exposed groups. The control group received no treatment. The two treatment groups were injected intraperitoneally with 1 ml 0.9% saline without (sham) and with 3 mg/ml aluminium sulfate every day for two weeks. Following the treatments, the brains were removed, the left hemisphere was used for hippocampal neuron counting using an optical fractionator and the right hemisphere was investigated using hippocampal TUNEL assay to determine the apoptotic index. The number of neurons in the stratum pyramidale of the hippocampus was significantly less in the aluminium group than in the control and sham groups; there was no significant difference between the control and sham groups. The apoptotic index also was significantly higher in the aluminium group than in the other two groups. We quantified the toxic effects of aluminium on the rat hippocampus and determined that apoptosis was the mechanism of aluminium-induced neuron death in the hippocampus.

The left sternalis muscle variation detected during mastectomy.

The sternalis muscle variation is a well-known anatomical situation. It is present in 8.7% of women and 6.4% of men, although the incidence varies according to sex, race and ethnicity. During a left modified radical mastectomy operation on a 46-year-old female patient a sternalis muscle was detected on the pectoralis major muscle in the superficial fascia. It was in craniocaudal position and was parallel to the body of the sternum. The cylindrical muscle was approximately 8 cm in length and 2 cm in diameter. Such variations are considered to have their origin in embryological development. Awareness of muscular variations and their identification is important both for procedure through the proper dissection planes during breast surgery and in radiological examination and follow-up.

A variation of the brachial plexus characterized by the absence of the musculocutaneous nerve: a case report.

A variation of the brachial plexus characterized by the absence of the musculocutaneous nerve on both sides was observed during the dissection of a 72 year-old female cadaver. The long thoracic nerve included only the fibers from C5 and C6 on the left side. The musculocutaneous nerve was absent and two branches from the lateral cord innervated the coracobrachialis muscle. The median nerve innervated the biceps brachii and brachialis muscles in the arm and also gave off the lateral antebrachial cutaneous nerve. Additionally, a communicating branch was found from the median nerve to the ulnar nerve in the forearm. The knowledge of the anatomical variations of the peripheral nerve system can help give explanation when encountering an incomprehensible clinical sign.

The uncinate bulla.

In this study a total of 175 coronal CT scans of the nasal cavity and paranasal sinuses have been investigated. The uncinate bulla was detected in 21 (11 male and 10 female) cases of 175 patients. Out of 21, 17 were bilateral while 4 were unilateral. The incidence of the uncinate bulla was found as 12%.

A study of the nutrient foramina in the shaft of the fibula.

In this study a total of 305 adult fibulae were examined to determine the number and location of the nutrient foramina in the shafts of bones. Of 305 fibulae, 281 had one foramen, 12 had two and the remaining 12 had no foramen. The foramina were seen primarily on the posterior surface (48.36%) and in the middle third (98.00%) of the bone. The mean foraminal index of the fibula was found to be 48.14 +/- 0.46.

The secondary nasal middle concha.

In this study a total of 175 coronal CT scans of the nasal cavity and paranasal sinuses have been investigated. A secondary middle concha was detected bilaterally in 12 (6.8%) out of 175 patients. In all cases, the ethmoidal infundibulum was placed anteroinferior to the lateral origin of the secondary middle concha. This structure did not obstruct the osteo-meatal complex in any of the 12 cases.