Attitudes of Turkish university employees and their relatives towards whole body and organ donation.

BACKGROUND: Dissection of human anatomic specimens still keeps its importance in medical curriculum. Experiences of medical students in the anatomy laboratory and the time they spent there makes them feel as doctors at the beginning of their education and helps them to get used to the notion of death. Unfortunately, the number of human body donors available for medical research and education as well as organ transplantation is limited. Obtaining human anatomic specimens continues being a great problem especially in middle-east countries. Religious factors, socioeconomic status, education, marital status or age are probably the main factors those effect body donations. The aim of the present study is to evaluate the attitudes of Turkish university employees and their relatives towards whole body donation and organ donation. METHODS: A total of 780 questionnaires taken from the participants were evaluated. All the participants were academic and administrative staff from four different universities based in Ankara, Eskisehir, Istanbul and Adana and their relatives. Participants were between the ages of 18-85. All the subjects were provided a questionnaire composed of 38 questions. FINDINGS: 26.2% of the individuals declared that they could donate their body for medical education while 73.8% of them did not. In contrast, 69.1% of the participants were willing for being organ donors. Of the ones who had accepted to donate their organs, 64.5% refused to donate their bodies. CONCLUSION: The results of this study indicate that not only whole body donation, but also organ donation continue being a problem in Turkey.

Localization of the carotid bifurcation according to hyoid bone and mandibular angle / Localización de la bifurcación carotídea según el hueso hióides y el ángulo mandibular

The aim of this study was to determine the carotid bifurcation level in relation with the hyoid bone and mandibular angle. Common carotid artery is the largest artery in the neck, and it gives off two terminal branches, namely external and internal carotid arteries. The bifurcation level of it shows variations, however it is usually situated at the level of C4 vertebra or at the upper border of thyroid cartilage. On the other hand, carotid bifurcation may be situated as low as T3 vertebra, or as high as the level of hyoid bone. In this study, conventional angiographic images of 112 patients were used. The distances of carotid bifurcation to hyoid bone and mandibular angle were measured on those images. In addition, right and left side difference was determined. The distance of carotid bifurcation level to the mandibular angle was measured as 21.26 ± 8.57 mm on the right and 20.25 ± 8.75 mm on the left side in males, and 19.72 ± 8.89 on the right, and 18.5 ± 9.25 mm on the left side in females. Distance between the carotid bifurcation level and hyoid bone ranged 1.94 ± 12.69 mm in female and 3.04 ± 9.00 mm in male on the left side. Having information about the level of carotid bifurcation is important in surgical and radiological procedures for determining the appropriate surgical procedure, and to prevent complications. We believe that the results of this study will shed light to planning of all interventions concerning common carotid artery.

El objetivo de este estudio fue determinar el nivel de bifurcación carotídea en relación con el hueso hioides y el ángulo de la mandíbula. La arteria carótida común es la arteria más grande del cuello, y tiene dos ramas terminales, las arterias carótidas externa e internas. El nivel de bifurcación muestra variaciones, sin embargo suele situarse a nivel de la cuarta vértebra cervical o en el margen superior del cartílago tiroideo. Por otro lado, la bifurcación carotídea puede estar situada tan baja como a nivel de la tercera vértebra torácica, o tan alta como a nivel del hueso hioides. En este estudio se utilizaron imágenes angiográficas convencionales de 112 pacientes. Se midieron las distancias de la bifurcación carotídea con el hueso hioides y el ángulo de la mandíbula en esas imágenes. Además, se determinó la diferencia entre los lados derecho e izquierdo. La distancia entre el nivel de bifurcación carotídea y el ángulo de la mandíbula se midió, siendo de 21,26 ± 8,57 mm a la derecha y 20,25 ± 8,75 mm en el lado izquierdo, en los hombres, y 19,72 ± 8,89 a la derecha y 18,5 ± 9,25 mm a la izquierda en mujeres. La distancia entre el nivel de bifurcación de la carótida y el hueso hioides osciló entre 1,94 ± 12,69 mm en mujeres y, 3,04 ± 9,00 mm en hombres, en el lado izquierdo. La información sobre el nivel de bifurcación carotídea es importante en los procedimientos quirúrgicos y radiológicos para determinar el procedimiento quirúrgico apropiado y prevenir complicaciones. Creemos que los resultados de este estudio arrojarán luz a la planificación de las intervenciones relacionadas con la arteria carótida común.

Perception of Symmetry in Aesthetic Rhinoplasty Patients: Anthropometric, Demographic, and Psychological Analysis.

Visual perception of symmetry is a major determinant of satisfaction after aesthetic rhinoplasty. In this study, we sought to investigate the existence of any relationship between anthropometric characteristics of the face and visual perceptions of asymmetry among rhinoplasty patients and to evaluate tools that can shed light on patients who appear at high risk for exaggerating potential asymmetries. In the first part, 168 rhinoplasty patients were asked to fill out the demographic questionnaire, nasal shape evaluation scale, and the somatosensory amplification scale. In the second part, we examined the relationship between anthropometric characteristics of the face and visual perceptions of asymmetry using standardized photographs of 100 medical students. In the third part, patients answered the rhinoplasty outcome evaluation questionnaire 6 months after the surgery. Objectively, no symmetrical face was observed in the anthropometric evaluation. Subjectively, only 73% and 54% of the faces were considered asymmetrical by the rhinoplasty and the control groups, respectively. The rate of asymmetry perception was significantly greater in revision patients when compared with primary rhinoplasty patients. The relationship between the rate of subjective perception of asymmetry and the somatosensory amplification scale scores was statistically significant. We found a significant inverse relationship between the rate of asymmetry perception and the rhinoplasty outcome evaluation scores. Plastic surgeons should be aware of this high selectivity in asymmetry perception, which is associated with poor postoperative satisfaction. Somatosensory amplification scale may help identify rhinoplasty patients at a high risk for exaggerating potential asymmetries. LEVEL OF EVIDENCE: III.

Anatomic variations of the celiac trunk and hepatic arterial system with digital subtraction angiography.

BACKGROUND/AIMS: Anatomical variation of the abdominal arteries is important. Historic and modern anatomists, radiologists, as well as surgeons have reported and accumulated anatomical variations with a morphological and clinical interest. During graft procurement and reconstruction, accidental injury of the hepatic artery is more likely in the presence of hepatic arterial variation, which can be a common clinical entity. During cadaveric dissection and diagnostic radiological imaging, various types of vascular anomalies are frequently found in human abdominal viscera, especially the celiac trunk. The aim of the present study is to determine anatomical variations in the celiac trunk and hepatic arterial system. MATERIALS AND METHODS: Digital subtraction angiography data were collected from 152 consecutive donor patients (103 males and 49 females, aged between 6 and 77 years) who underwent orthotopic liver transplantation. RESULTS: We examined the anatomy of the celiac trunk in a total of 152 consecutive patients. In total, 62.5% (95/152) of patients showed the classical trifurcation of the celiac trunk. Variant right hepatic arteries arising from the superior mesenteric artery were observed in 17.8% (27/152), the hepatic arteries arising from the left gastric artery were found in 13.1% (20/152), and common hepatic arteries arising from the superior mesenteric artery were observed in 6.6% (10/152) of patients. CONCLUSION: These data are useful for planning and performing surgical and radiological procedures of the upper abdomen.

The Relationship between Balance, Muscles, and Anthropomorphic Features in Young Adults.

Posture can be defined as the form of the body when sitting, walking, or standing. There would be no problem if muscles interact in harmony with musculoskeletal system or nervous system. Posture analysis is crucial for clinical assessments in physical medicine and rehabilitation. However, studies into this issue are limited. In this study, the relationship between static standing balance and anthropomorphic features in healthy subjects was investigated. The study was carried out with a total of 240 students at Baskent University (116 females, 124 males) aged between 18 and 25 years. Type of balance of the subjects was determined with lateral posture analysis. Additionally, muscle shortness tests, subcutaneous fat thickness, and waist and thigh circumference were measured. As the results of lateral posture analysis, 107 subjects (71 males, 36 females) were detected to have anterior balance, 89 (41 males, 48 females) posterior balance, and 44 (12 males, 32 girls) neutral balance. Values of waist circumference, thigh circumference, and waist/thigh ratio were compared with all three balance types. A statistically significant difference was detected between these values in the subjects who had anterior balance (P < 0.05). In conclusion, a significant relationship was detected between muscle shortness, waist and thigh circumferences, and postural balance type.

Facial soft tissue thickness in individuals with different occlusion patterns in adult Turkish subjects.

Knowledge of variation in facial soft tissue thickness is important for forensic anthropologists, dentists, and plastic surgeons. Forensic anthropologists use such information as a guide in facial reconstruction and superimposition methods. The purpose of this study was to measure facial tissue thicknesses of adult males and females of Turkish origin across different types of occlusion, and to compare the results with each other and with values obtained for other populations. The study was conducted on 200 healthy individuals. The analysis of facial tissue thickness included 20 landmarks (10 dentoskeletal and 10 soft tissue) and 10 linear variables. Sex-based variation in facial tissue thickness was noted. The highest soft tissue thickness values were observed in the group with Class III occlusion type at Sn-A point for both the females (16.9, SD=2.4) and the males (17.8, SD=3.3). In the Class I group, the highest tissue depth was observed at Sn-A point (15.3, SD=2.1) in females, and at Li-Id point (17.1, SD=1.9) in males. In the Class II group, contrary to the findings for Class I, the highest soft tissue depth was at Li-Id point (16.0, SD=1.4) in females, and at Sn-A point (18.1, SD=2.6) in males. In conclusion, facial tissue thickness varied in adults depending on the sex and on the type of occlusion.

Stereological evaluation of temporal lobe/telencephalon volume in temporal lobe epilepsy using the Cavalieri principle.

AIM: Epilepsy is a temporary electric discharge in the brain cells due to shortterm brain function disorder. Epileptic seizures mostly stem from the temporal lobe. The prevalence is the same for women and men. It is thought that there are both microscopic- and macroscopic-level localized changes in the temporal lobe epilepsy. This study aims to assess the volumetric changes that might occur in temporal lobe epilepsy and compare these with normal brains. MATERIAL AND METHODS: Volumetric assessment of temporal lobes and telencephalons was performed using the stereological method on the magnetic resonance images (MRI) of 30 female temporal lobe epilepsy patients and 30 healthy females (control group). The volume ratio of temporal lobe to the whole telencephalon was calculated by means of the Cavalieri principle over the coronal MR images of all participants. The section images were transformed into a series of images by Image j program and the measurements were performed by using a point grid. RESULTS: The patient group's temporal lobe/telencephalon volumetric ratios were found to be significantly lower than that of the normal participants. CONCLUSION: The pattern of temporal lobe volume decrease in TLE may be due to a combined effect of the electrical discharges during seizures and secondary damage due to disconnection.

Measurement of tympanic cavity volume by the Cavalieri principle in Turkish population.

OBJECTIVES: The aim of this study is to measure the tympanic cavity (TC) volumes with Cavalieri principle using computed tomography (CT) scanning of temporal bones, to investigate the difference between the right and the left ears with respect to sexes and to exemplify the TC volume measurements. PATIENTS AND METHODS: Clinical records of 91 patients (46 females 45 males; mean age 48.1 years; range 15 to 60 years) whose TCs were measured at ear nose throat clinic of Ankara Oncology Education and Research Hospital between January 2007 and March 2008, were retrospectively investigated. The CT scans which were obtained from two sides with a slice thickness of 1 mm were evaluated. Measurements of TC volumes were made with using the Cavalieri method. RESULTS: The mean TC volume in male subjects was 0.4721+/-0.0406 cm(3) on the left ears and 0.4883+/-0.0352 cm(3) on the right ears. In females the mean cavity volume was 0.4943+/-0.0501 cm(3) on the left ears and 0.4881+/-0.0485 cm(3) on the right ears. CONCLUSION: There was no statistically difference in between of the both sexes for the TC volume measurements and between both sites of the same individuals.

Body height estimation from head and face dimensions: a different method.

As there are cases brought for forensic examination where only the craniofacial region is available, estimation of stature from craniofacial dimensions is without doubt important in forensic cases. The study presented here attempts to estimate stature from craniofacial dimensions in the Turkish population. In the second phase of the study, the correlations between craniofacial dimensions and stature were also evaluated according to different head and face types. All measurements were taken from 286 healthy males with a mean age of 22.71 ± 4.86 years. The sample was then reclassified according to different head and face indexes. For the whole sample, correlation coefficients were low, changing only between 0.012 and 0.229. Thus, no significant increase in correlation coefficients was observed after the samples had been reevaluated according to different head and face types. As a conclusion, craniofacial dimensions are not good predictors for body height for the Turkish population.

Stereological evaluation of volumetric asymmetry in healthy human cerebellum.

OBJECTIVES: Age-related volumetric differences in brain anatomy or volumetric brain analyses in many disorders are of interest. Delineating the normal anatomical cerebellar volume is of importance for both the anatomists and clinicians. In the present study, we aimed to evaluate the cerebellar volume using a stereological technique and to determine the possible volumetric asymmetry depending on age and gender. MATERIALS AND METHODS: Volumetric asymmetry of cerebellar hemispheres was evaluated using stereological method on the magnetic resonance images (MRI) of healthy male and female subjects. Randomly selected individuals (27 males, 27 females) aged between 10-86 years who have normal brain MRI were enclosed in the study. All the subjects were right handed. The individuals were divided into three groups according to age as 18-34 (young), 35-60 (middle aged) and 60-84 (elder) and their MRI images were analyzed. The data set were analyzed by two factor repeated measure analysis. RESULTS: Although the cerebellum was smaller between young and middle aged groups and also middle aged and elder groups, there were no any statistically significant differences between compared groups' mean (P > 0.05). There were not statistically differences according to sex and age groups (P > 0.05). CONCLUSIONS: There was no cerebellar asymmetry between compared groups. The stereological evaluation of cerebellar asymmetry in humans correlate with both gender and age groups is of importance for both clinicians and anatomists. The technique is simple, reliable, unbiased and inexpensive.

Anthropometric characteristics of young Turkish male athletes.

Comparative reports on the anthropometric characteristics of athletes are certainly important in modern sports and have long been studied by sports scientists. Studies on Turkish athletes however, are limited. In the present study physical characteristics of athletes active in various sports (American football, basketball, volleyball and football) were observed and compared to each other and to those of non-athlete individuals. 153 volunteer male subjects participated in the study. All of the athletes were licensed members of teams in inter-university leagues. All subjects were given information about the objectives of the study and were advised of the manner with which the anthropometric measurements would be obtained. In addition to 17 anthropometric values, body mass index (BMI) and somatotype components were calculated and evaluated. Length, breadth, and girth values were evaluated by ANCOVA and height and weight were used as co-variate factors. The other variables were evaluated by metric and non-metric ANOVA. The results of the study indicate that basketball and volleyball players were characteristic with their longer lower limb length; American football players were with their wider biiliac breadth and higher girth values; and football players with their small structure. It was also observed that Turkish athletes have higher endomorphy and lower mesomorphy values when compared to athletes from other countries.

Unusual Relation of the Median Nerve with the Accessory Head of the Biceps Brachii Muscle: An Original Case Report / Una Rara Relación del Nervio Mediano con la Cabeza Accesoria del Músculo Bíceps Braquial: Reporte de Caso

During the laboratory dissection of the brachial region and the arm, an abnormal relation of median nerve with the accessory head of biceps brachii muscle has been observed unilaterally on the right upper limb of a male cadaver. Whereas the short and long heads have their normal origin, additional-excess third head originated from the anteromedial surface of the superior part of the humerus. Some fibers of this accessory head on the medial side arise from the deep fascia surrounding the brachialis muscle. The fibers then cross the median nerve superficially before joining the third head which has inserted into a common tendon together with the long and short heads. To have information of such variations is of importance either for anatomists or clinicians especially for plastic surgeons in flap surgery.

Durante una disección de rutina de la región anterior del brazo, se observó una relación anormal del nervio mediano con una cabeza accesoria del músculo bíceps braquial, en un miembro superior derecho de un cadáver masculino. Mientras que las cabezas larga y corta tuvieron un origen normal, una tercera cabeza se originó de la superficie anteromedial de la parte superior del cuerpo humeral. Algunas fibras de esta cabeza accesorias, se originaron del lado medial de la fascia profunda que rodea al músculo braquial. Las fibras cruzaban al nervio mediano superficialmente, antes de unirse a la tercera cabeza, la cual se insertó a través de un tendón común con las cabezas larga y corta. El conocimiento de tales variaciones es de importancia tanto para anatomistas o clínicos, así como esencialmente para cirujanos plásticos en las cirugías, que se usan colgajos.

Body height estimation based on dimensions of sacral and coccygeal vertebrae.

This study is to evaluate whether it is possible to predict living stature from sacral and coccygeal vertebral dimensions. Individual vertebral body heights, sacral height (SH), and sacrococcygeal height (SCH) were recorded from the magnetic resonance images of 42 adult males. Sum of the heights of five sacral vertebrae (sigmaS), the first four coccygeal vertebrae (sigmaC), and the total height of the sacral and the first four coccygeal vertebrae together (sigmaSC) were also recorded. Linear regression equations for stature estimation were produced using the above mentioned variables. The regression equations were constructed and tested by using jack-knife procedure. Statistical analyses indicated that the combined variables (SH, SCH, sigmaS, sigmaC, sigmaSC) were more accurate predictors of stature than the heights of individual vertebrae. The results of the study pointed out that the equations derived from sacrococcygeal dimensions perform somewhat better than ones based on foot and head variables, but worse than those based on long-bone length. As a conclusion, the dimensions of sacral and coccygeal vertebrae could be used for stature estimation when long bones are not available.

Body height estimation based on tibia length in different stature groups.

Long bone length is one of the best-known indicators of human stature. Although the long bone length/height ratio differs in tall and short individuals, no detailed study has investigated whether specific formulae should be used to calculate height in different stature groups. This study proposes a new height estimation method. Body height and tibia length were measured in 121 male subjects aged 18.0-34.3 years. Three subgroups were established according to body height (short, medium, or tall), using the 15th and 85th percentiles as cutoff levels. The general formula and a group-specific regression formula were used to estimate height in each subgroup. A control group with the same properties as the study group was analyzed in the same manner. Particularly with "short" and "tall" subjects, the difference between true height and the height predicted by the group-specific formulae was smaller than the difference observed when the general formula was used. These discrepancies were statistically significant. When estimating height based on tibia length, the individual's general stature category should be taken into consideration, and group-specific formulae should be used for short and tall subjects.