Determining anatomical localisations of cervical oesophagus, hiatal clamp and oesophagogastric junction with oesophagogastroduodenoscopy.

BACKGROUND: In this study, the purpose was to determine the anatomical localisations of the cervical oesophagus length, hiatal clamp, and oesophagogastric junction depending on age and gender in patients who undergo oesophagogastroduodenoscopy (EGD). MATERIALS AND METHODS: The images of the patients who underwent EGD between 2018 and 2020 were analysed retrospectively in this study. The distance of the anatomical localisations of the cervical oesophagus length, hiatal clamp, and oesophagogastric junction to the anterior incisors, and the relations of this distance with the demographic characteristics and clinical manifestations of the patients were investigated on the EGD data. RESULTS: A total of 298 patients (174 women, 124 men) were included in the study. The cervical oesophagus length and the distance of the oesophagogastric junction and hiatal clamp localisation of the patients were found to be 15.06 ± 0.57 cm, 37.51 ± 2.23 cm and 38.62 ± 2.23 cm, respectively. It was also found that the mean values of all lengths in males were higher at a statistically significant level than in females (p < 0.001; p < 0.01). CONCLUSIONS: Knowing these anatomical localisations may be important in predicting complications that may occur in this region in EGD and planning the precautions to be taken. We also believe that it will guide clinicians in determining hiatal hernia and related deficiencies.

Morphological variation of carotid artery bifurcation level in digital angiography.

Knowing of the level of carotid artery bifurcation (CB) is important for vascular surgery in the neck, radical neck dissections, carotid sinus baroreceptor stimulation, catheterisations, and aneurysms. The aim of this study was to determine the CB level in relation with the cervical vertebral levels, compare them on the right and the left sides, and investigate the relation of CB level with the length of neck. In this study, 100 conventional carotid angiographies were performed. The CB level was determined in relation with 10 different levels which were the levels of the cervical vertebrae and intervertebral disks, and the relation of CB level with the length of neck was investigated. The right and left CB levels of the patients were also determined, and compared. The highest level of CB was at the level of C2 vertebra, and the lowest level of CB was at the level of C6-C7 intervertebral disk in both male and female. When all patients were taken into consideration, CB level was most frequently seen at the level of C4-C5 (29%) on the right side, and at the level of C4 (26%) on the left side. The CB levels were not symmetrical in 10 female and 23 male. Knowing of the anatomical variations of CB level is important in surgical procedures. The anatomical differences must be taken into consideration since the neighbouring structures of CB change in case of variations. We believe that the results of this study will shed light to planning of all interventional methods concerning common carotid artery and its branches as well as surgery in the neck, and will help to minimise the complications.

Age-related immunohistochemical and ultrastructural changes in rat oculomotor nerve.

During ageing process, multiple changes occur on nervous tissue composed of cells and extracellular matrix. Changes on nervous tissues are usually known as degenerative changes on axon structure and connective tissue covering the nerve such as a decrease in the number of fibre or general structural changes. For this purpose, we have studied age-dependent ultrastructural changes in the rat oculomotor nerve with electron microscopy and also demonstrated collagen structure of the neural sheaths with immunohistochemical techniques. This study was conducted in Gazi University Faculty of Medicine, Department of Anatomy with a total of nine Wistar albino rats. We observed strong collagen type I immunoreactivity in endoneurium and slight to moderate reactivity in fibroblast cytoplasm in 3-month- and 12-month-old groups and mild reactivity in 24-month-old group. Collagen type IV immunoreactivity was stronger in endoneurium and perineurium in the 3-month- and 12-month-old groups compared with collagen type I and fibroblast cytoplasm showed a very strong reactivity. On the other hand, in the 24-month-old group, there was slight reactivity in endoneurium and a strong reactivity in perineurium. NGF staining showed moderate to strong reactivity on Schwann cells of the 3-month-old group. The immunoreactivity decreased in the 12-month- and 24-month-old groups. In the 3-month-old rat group, Schwann cell cytoplasm, mitochondrial structure and neurofilaments were normal. In the 12-month-old group, there were no changes in organelle distribution, mitochondrial structure and neurofilaments, but there was an increase in the connective tissue. An inconsiderable number of degenerated myelinated nerves were observed. We detected an important decrease in the collagen type I immunoreactivity, which could suggest that the endoneurium, perineurium and epineurium are less resistant to the age-related collagen loss and that the peripheral nerve is protected by a weaker barrier in the old group. The collagen type IV immunoreactivity was significantly decreased with age. NGF synthesis decreases with age because of Schwann cell structural degeneration or for different reasons. Thus, this could explain the diminished capacity of regeneration and damage of the myelination of the peripheral nerve.

[Cataract surgery by phacoemulsification in Werner's syndrome]. / La chirurgie de la cataracte par phakoéation dans le syndrome de Werner.

We report two cases of Werner's syndrome, a sister and a brother of 32 and 28 years, respectively, who were operated on for cataracts in both eyes. This hereditary syndrome, also called the adult progeria, is characterized by several manifestations of premature aging. Cataract surgery in this syndrome often predisposes to complications such as wound dehiscence and bullous keratopathy. The 4 eyes of the two patients were operated on using the phacoemulsification technique. The operations were successful, and we did not observe any serious complications during the 2-year follow-up period: cystoid macular edema in the brother's right eye was easily cured by topical indomethacin. This experience with these two patients showed that Werner's syndrome cataracts can be safely managed with the current phacoemulsification and small-incision surgery techniques.