Anatomical evaluation of nasopalatine canal on cone beam computed tomography images.

BACKGROUND: Nasopalatine canal (NPC) (incisive canal) morphology is important for oral surgery techniques carried out on the maxilla, in the treatment of naso- palatine cyst, palatal pathologies that require a surgical intervention. MATERIALS AND METHODS: The morphology of NPC was classified in sagittal, coronal and axial planes on the cone beam computed tomography (CBCT). The length of NPC was found by measuring the distance between the mid-points of nasopalatine foramen and incisive foramen. The numbers, shapes and diameters of incisive and nasopalatine foramina were examined. Nasopalatine angle present between the NPC and the palate and anterior to the NPC was measured. RESULTS: In the sagittal plane, the shape of NPC was classified in six groups: 26.7% hourglass, 14.7% cone, 13.3% funnel, 16.0% banana, 28.7% cylindrical and 0.7% reverse-cone-shaped. In the coronal plane, shape of NPC was classified in three groups: 63.3% Y-shaped, 36.0% single canal, 0.7% double canal and external border of NPC was classified in four groups: 26.7% U, 28.7% Y, 44.0% V and 0.7% reverse-V-shaped. In the axial plane, the shape of nasopalatine foramen, incisive foramen and NPC at the mid-level was evaluated. The shape of the canal was detected as four types at three evaluated levels: round, oval, heart- and triangle-shaped. It was seen in every three axial planes that the round group is more than the others. CONCLUSIONS: The morphological properties and variations of NPC should be con- sidered with a correct radiological evaluation so as to prevent the complications and improper practices in local anaesthesia, maxillary surgery and implant surgery practices. Especially dentists, otolaryngologist and plastic surgeons need to know the anatomy and variations of NPC.

Morphometric evaluation and surgical implications of the infraorbital groove, canal and foramen on cone-beam computed tomography and a review of literature.

BACKGROUND: The purpose of this study is to evaluate the anatomy, morphometry, and variations of infraorbital groove (IOG), infraorbital canal (IOC) and infraorbital foramen (IOF) on the cone-beam computed tomography (CBCT) images and to investigate their relations with surrounding structures. METHODS: IOG, IOC and IOF were evaluated retrospectively in CBCT images of 75 female (F) and 75 male (M) cases with a range of 18-65 years (F: 37.62 ± ± 13.55, M: 37.53 ± 15.87) by Planmeca Romexis programme. IOG, IOC and IOF were examined bilaterally (300 sides) in the cases. The 13 parameters were measured on these images in axial, sagittal and coronal planes. RESULTS: There was a very weak positive correlation between the age and the angle between IOC and IOG (p = 0.015, r = 0.198), there was a weak positive correlation between the age and skin thickness (p = 0.001, r = 0.281), and there was no correlation between the age and other parameters. A total of 21 (7%) IOCs were detected in maxillary sinus, bilaterally in 6 cases and unilaterally in 9 cases (5 on the left, 4 on the right). In 1 case, bilaterally, IOC was separated 2 canals while running anteriorly in the maxillary sinus. The larger one was directed to IOF in its normal course and the smaller one was directed to lateral wall of nasal cavity and opened to the inferior nasal meatus in front of the opening of nasolacrimal duct. CONCLUSIONS: We suggest that the parameters found in the present study may facilitate prediction of the location of the infraorbital nerve. Knowledge of this exact position in relation to easily measurable parameters may decrease the risk of infraorbital nerve injury during surgical approaches directed to this region and might serve as a guide during local anaesthetic interventions for dentistry, ophthalmology, plastic surgery, rhinology, neurosurgery and dermatology.

Massive upper gastrointestinal bleeding from an accessory splenic artery mimicking isolated gastric varices.

Knowledge of anatomical variations of coeliac trunk and its branches is important for surgeons and interventional radiologists planning surgical and radiological interventions. We describe a case of a 42-year-old male with an accessory splenic artery (ASA) originating from the left gastric artery (LGA) running in the wall of gastric fundus and mimicking isolated gastric varices, which was observed during endoscopy. Bleeding from this artery was massive and was managed with endovascular coil embolisation. Coeliac angiography of the patient with upper gastrointestinal bleeding showed that the coeliac trunk divided into 3 arteries: the LGA, the splenic artery, and the right hepatic artery. Additionally, the variations of ASA and the left hepatic artery arising from LGA, and the left and right inferior phrenic arteries arising from ASA were identified. This case is the first to be presented in the literature with ASA originating from LGA that was situated in the gastric wall where inferior phrenic arteries arose from the ASA.

Post-natal growth in the rat pineal gland: a stereological study.

The purpose was to observe the changes in a rat pineal gland using stereological techniques during lactation and post-weaning periods. Thirty Wistar albino rats were studied during different post-natal periods using light microscopy. Pineal gland volume was estimated using the Cavalieri Method. Additionally, the total number of pinealocytes was estimated using the optical fractionator technique. Pineal gland volume displayed statistically significant changes between lactation and after weaning periods. A significant increase in pineal gland volume was observed from post-natal day 10 to post-natal day 90. The numerical density of pinealocytes became stabilized during lactation and decreased rapidly after weaning. However, the total number of pinealocytes continuously increased during post-natal life of all rats in the study. However, this increment was not statistically significant when comparing the lactation and after weaning periods. The increase in post-natal pineal gland volume may depend on increment of immunoreactive fibres, capsule thickness or new synaptic bodies.

An anatomical study on the three-headed biceps brachii in human foetuses, and clinical relevance.

The biceps brachii (BB) is as one of the most variable muscles in the human body in terms of number and morphology of its heads. The most frequent variation is the presence of a third head, which has been reported by several authors in different populations. Our aim was to find the occurrence of the supernumerary head of BB in Turkish foetuses. Out of the 24 upper limbs of the foetuses, two (8.33%) arms were found to have a three-headed BB. The variations were present unilaterally in the right arm of one male foetus and one female foetus. In one of the cases, the third head of BB originated from the anteromedial aspect of the humerus just distal to the insertion of the coracobrachilais, medial to the brachialis, and in the other the third head was a thin muscle bundle, which arose on the lateral side of the insertion of coracobrachialis and over the origin of the brachialis. Both of them were extended distally and joined the common tendon. The occasional presence of the three-headed BB in the foetuses observed in the present study was similar to those of adults reported in previous studies. In conclusion, these variations are not rare and are interesting not only to anatomists but also to orthopaedic surgeons, plastic surgeons, traumatologists, physiotherapists, doctors dealing with sports medicine, and radiologists.

The effects of L-arginine on neurological function, histopathology, and expression of hypoxia-inducible factor-1 alpha following spinal cord ischemia in rats.

The aim of this study was to investigate the effects of L-arginine (L-Arg) on neurological function, histopathology, and expression of hypoxia-inducible factor-1 alpha (HIF-1alpha) following spinal cord ischemia in rats, and the interaction between therapy with the nitric oxide donor L-Arg and up-regulation of the expression of HIF-1alpha. Thirty Wistar rats weighing between 200 and 250 g were divided into three groups, each containing 10 rats: group 1, sham operation; group 2, untreated ischemia-reperfusion (I-R); group 3, I-R plus L-Arg treatment. Spinal cord ischemia was applied for 20 min. There were no significant differences in mean arterial pressures, temperatures, and blood gas levels among the groups. In group 2, malondialdehyde values were significantly increased compared with groups 1 and 3. The rats with aortic occlusion in group 2 had paraplegia or paraparesis. In group 3, all animals were neurologically intact. In group 3, spinal motor neurons did not decrease significantly, and little proliferation of microglia was observed compared with those in group 2. In group 2, spinal motor neurons in ventral gray matter decreased significantly compared with those in groups 1 and 3. HIF-1alpha-positive immunostaining was mildly detected in group 2 animals. The expression of immunoreactive cells was intensely increased in spinal cord tissue from I-R/L-Arg rats. In conclusion, our findings suggest that HIF-1alpha-positive immunostaining may be critical factors in the pathophysiology of inflammatory spinal cord injury induced by I-R. Nitric oxide may play an important role in the immunohistochemical expression of these molecules, and the neuroprotective benefit of L-Arg may be attributed to preventing neural cell necrosis.

The investigation of perivasculary space under the myocardial bridge in different species.

Our purpose in this study was to investigate the perivasculary space under the myocardial bridges (MB) in dog, sheep, goat and human hearts. A total of 160 hearts were studied, and perivasculary space under the myocardial bridges was examined under microscope. The specimens belonged to 25 dogs, 100 sheep, 25 goats and 10 humans. Special attention was paid to evaluate the distance between the MB and coronary arteries (CA), CA and underlying myocardium (UM) and to find the relation of concomitant vein number accompanying the CA and MB. 219 myocardial bridges were found in total of hearts, and specimens from these bridges were examined under microscope. There were large variations in distance between the MB and CA (0-714 microm) and distance between CA and UM (0-309 microm). The myocardial bridges were classified into three groups in terms of the number of veins accompanying CA, the bridges with no concomitant veins with one concomitant vein and with two concomitant veins. This suggests that the distance between the MB and CA is crucial to determine how much force is on the CA. The environment surrounding the CA may be a crucial factor in determining whether the MB influences the induction of heart disorders or not.

Echocardiographic and morphologic examination of left ventricular false tendons in human and animal hearts.

False tendons are thin, fibrous or fibromuscular structures that traverse the cavity of the left ventricle with no connection to the valvular cusps; they may be single or multiple. We retrospectively analyzed echocardiograms for the prevalence of false tendons in the hearts of 368 (231 male, 137 female) newborns, infants, and children (mean age = 6.28 +/- 4.32 years) who were referred for echocardiography because of suspected acquired or congenital heart disease, but in whom no cardiac pathology was found. In addition, we studied the prevalence of false tendons in 90 hearts from three species of animals (dog, sheep, goat) and eight cadaveric human hearts. In our echocardiographic study, false tendons were detected in 97 of 368 hearts (26.4%). In our gross morphologic studies, false tendons were observed in most of the animal and human hearts: they were present in 5 of 8 (62.5%) human hearts, 14 of 20 (70%) dog hearts, 41 of 50 (82%) sheep hearts, and 16 of 20 (80%) goat hearts. The overall prevalence in animal hearts was 71 of 90 (78.8%). Histologic examination showed the false tendons to be composed of cardiac muscle, blood vessels, fibrous tissue, and Purkinje cells. The possible role of false tendons in innocent murmurs, cardiac rhythm disorders, or left ventricular dysfunction is discussed.