Automatic segmentation of the cerebellum using volBrain software in normal paediatric population.

BACKGROUND: Morphological differences that can lead to cerebellar volume changes are associated with the pathogenesis of paediatric diseases. The aim of this study was to examine cerebellum volume in a healthy paediatric population. MATERIALS AND METHODS: To provide MRI-based volumetric measurements of the cerebellum, images from the years 2019 to 2021 were scanned retrospectively. A total of 100 images, including the paediatric population aged 0-15 years, were imported into the volBrain software. Volumetric segmentations were obtained automatically, and each lobular cerebellar volume was obtained. The samples were divided into groups of 0-2 years (n = 18), 3-5 years (n = 24), 6-11 years (n = 34) and 12-15 years (n = 24). Obtained cerebellar volumes, age groups, gender and bilateral side comparisons were made. RESULTS: In the comparative analyses performed for the total cerebellum and each of the 12 lobular segments, statistically significant differences were found between the age groups in all measurements except Crus II, lobules VIIB, VIIIA and VIIIB (p < 0.05). In multiple comparison tests, statistically significant differences were found between defined age groups, especially infants and toddlers and early adolescence groups (p < 0.05). There was a significant positive correlation between the ages of the subjects and their cerebellum volumes (p < 0.05). Statistically significant differences were found in lobules I-II, VI, VIIIB, IX and X in right and left side volumes (p < 0.05). CONCLUSION: There is a tendency to increase in cerebellar volume during the transition from childhood to adolescence. The cerebellum has volumetric differences in the first years of life and during adolescence. When the development of a healthy cerebellum is analysed based on volumetric segmentation, differences are observed. The findings of this study may be useful in confirming various theories attributed to the cerebellum in the clinic.

Use of AgNOR staining to determine the effect of metoclopramide on neural tube development in early chick embryos.

Nausea and vomiting during pregnancy are common problems and prolonged pharmacological treatment often is needed; however, the teratogenic effects of anti-emetic drugs on neural tube (NT) development are not clear. We investigated the effects of different doses of metoclopramide on NT development in 48 and 72 h chick embryos using an argyrophilic nucleolar organizing region (AgNOR) staining method. We used 150 fertile, specific pathogen-free eggs incubated for 28 h, then randomly divided into five equal groups: group A, sham control was administered 0.9% saline; groups B - E were administered 0.15 mg/egg, 0.3 mg/egg, 0.6 mg/egg and 1.2 mg/egg, respectively. Half of the eggs in each group were taken from the incubator at 48 h incubation and the other half at 72 h incubation. After incubation, eggs were opened, embryos were dissected from their membranes, fixed with 10% formalin and examined by light microscopy. The NT status, i.e., open or closed, and somite number, crown-rump length, morphological features and gross developmental abnormalities were recorded. Excised embryos were sectioned and stained using hematoxylin and eosin or the AgNOR procedure and examined for morphology and histopathology. Delayed NT closure was observed in all 48 h drug exposed embryos, but in the 72 h groups, this occurred only in high-dose groups. Somite number was reduced significantly in groups C - E compared to the control group. Crown-rump length was decreased in both 48 and 72 h embryos. We found a decreased total AgNOR area:nuclear area ratio in 48 and 72 h embryos of all experimental groups. We found that metoclopramide delayed NT closure in chick embryos in a dose-dependent manner.

Does Foramen Magnum Morphometry Influence the Development of Chiari Malformation?

AIM: To examine foramen magnum morphometry and shape of Chiari malformation in comparison with a control group, and to contribute to the literature on whether Chiari malformation affects foramen magnum morphometry. MATERIAL AND METHODS: In this study, cranial magnetic resonance images of 71 people with Chiari malformation and 61 people as controls were examined. The anteroposterior diameter, transverse diameter, and area of the foramen magnum were measured, and the shape of the foramen magnum was determined. RESULTS: In the Chiari malformation group, the anteroposterior diameter of the foramen magnum was 39.11 ± 4.29 mm, the transverse diameter was 34.25 ± 3.27 mm, and its area was 969.21 ± 199.57 mm < sup > 2 < /sup > . These results were statistically higher in female patients in the Chiari malformation group than in the control group. No significant difference was found between male patients in the Chiari malformation group and those in the control group. Round-shaped foramen magnum was predominant in both groups, but this was not statistically significant. CONCLUSION: In Chiari malformation, the foramen magnum is affected. This effect can be a factor that influences development of a malformation. As a result of a malformation, the foramen magnum may have expanded due to the pressure effect. More detailed and extensive research is needed to explain this phenomenon.

Interleukin-18 Binding Protein Pretreatment Attenuates Kidney Injury Induced by Hepatic Ischemia Reperfusion.

OBJECTIVE: Acute kidney injury (AKI) is a serious condition that can be induced by liver transplantation, major hepatic resection or prolonged portal vein occlusion. AKI can increase the frequency of postoperative complications. In the current study, we aimed to investigate whether interleukin-18 binding protein (IL-18BP) pretreatment has a protective effect against possible kidney injury following liver ischemia-reperfusion (IR) achieved by Pringle maneuver in an experimental rat model. MATERIALS AND METHODS: A total of 24 male Wistar albino rats were included in this study. Animals were equally and randomly separated into 3 groups as follows: I, Sham group, II, IR group (1-hour ischemia and 4-hour reperfusion) and III, IR + IL-18BP group (50µg/kg IL-18BP was intraperitoneally administered 30 minutes before surgery). Blood, liver and kidney samples were collected for histopathological and biochemical (hepatic and renal function, nitric oxide, malondialdehyde and glutathione levels) analysis. In addition, proinflammatory cytokines including tumor necrosis factor α, IL-1ß and IL-6 levels were measured in kidney tissues. RESULTS: IL-18BP has improved kidney functions in acute kidney damage, restored structural changes, exhibited anti-inflammatory effects by decreasing proinflammatory cytokines and regulated the oxidative stress parameters by antioxidant effect. CONCLUSIONS: Current study would be the first to evaluate the protective, antioxidant and anti-inflammatory effects of IL-18BP on renal damage induced by liver ischemia (1 hour) and reperfusion (4 hours). As a result, we have demonstrated that AKI may develop after hepatic IR with Pringle maneuver and IL-18BP pretreatment can attenuate this damage. By this way, complications related to liver IR could be minimized and also postoperative hospitalization durations, treatment costs and healing periods could be decreased.

The effect of enoxaparin on seroma and mesh-tissue adhesion in a hernia model.

The aim of this study was to investigate whether enoxaparin (ENX) administration would increase seroma risk and worsen mesh tissue recovery in an experimental rat hernia repair model. Fifty-six adult male Wistar-Albino rats were included in the study. Rats were equally and randomly separated into seven groups: Group 1, Control, only subcutaneous dissection was performed; group 2, Sham, Hernia defect was primary sutured; Group 3, Prolene mesh; Group 4, Dual mesh; Group 5, ENX + Sham; Group 6, ENX + Prolene mesh; Group 7, ENX + Dual mesh. ENX was subcutaneously injected at a dose of 180 U/kg per day for 7 days. Rats were killed after the amount of subcutaneous seroma was determined by ultrasound on day 7 following the surgical procedure. Mesh-tissue healing was evaluated using histopathological and immunohistochemical (CD31) staining methods. The mean seroma amount significantly increased in Groups 5-7 compared to Groups 2-4. CD31 immunostaining showed a reduction in neovascularization in Groups 6 and 7, compared to Groups 3 and 4. Neovascularization decreased and hemorrhage, necrosis and oedema findings remarkably increased in Groups 6 and 7, when compared to Groups 3 and 4. Fibroblastic activity and inflammation were more prominent in Groups 3 and 4. It should be kept in mind that ENX interferes with inflammation, which is desired in the early period of healing and leads to an increase in overall seroma amount with anti-coagulant effects, which in turn may disrupt wound healing and mesh-tissue adhesions, as was indicated in our study.

Prognostic value of perihematomal edema area at the initial ED presentation in patients with intracranial hematoma.

OBJECTIVE: Intracerebral hemorrhage (ICH) is a potentially life-threatening condition. Interventions and treatments should be managed on time to reduce mortality. It has been put forth that perihematomal edema absolute volume (PHEAV) is related to mortality, however the effect of perihematomal edema absolute area (PHEAA) on mortality is unknown. The objective of this study was to evaluate the effect of PHEAA on 30-day mortality in patients with ICH. METHODS: Patients were screened with ICD-9, retrospectively. 106 patients were included in the study. Clinical data were obtained from the patient files. Computed tomography (CT) was acquired from the hospital imaging database. PHEAV and PHEAA were measured via CT by two clinicians blinded to the study protocol. The predictors of 30- day mortality were examined. RESULTS: Forty-three (40.6%) patients died within 30days. Older age, lack of trauma, low Glasgow coma scale and high blood glucose were associated with high mortality (P≤.001). PHEAV and PHEAA values were higher in nonsurvivors (P<.001). PHEAA was detected as an independent predictor of 30-day mortality. The cutoff value of PHEAA for mortality was 33.41cm(2) (sensitivity: 84.4%, specificity: 59.0%). There was no difference between receiver operating characteristic curves of PHEAA and PHEAV (P=.55). CONCLUSION: In contrast to PHEAV, PHEAA is a simple value which can be measured without the requirement of any additional techniques or extra costs which can be quickly applied and which is an independent indicator of 30-day mortality. PHEAA can accelerate physician interventions for patients with ICH within several hours of ED admission.

Three-Dimensional Volumetric Assessment of the Effect of Decompression on Large Mandibular Odontogenic Cystic Lesions.

PURPOSE: The primary approach to treating large cystic lesions is controversial. The aims of the present study were to assess the effects of decompression before enucleation for the treatment of large cystic lesions and to compare the rate of decrease of keratocystic odontogenic tumor, ameloblastoma, and dentigerous cyst at specific times (preoperatively and at 6 months). PATIENTS AND METHODS: The study included 40 patients (mean age, 31.22 ± 8.78 yr) with large mandibular lesions (>3 cm). Decompression was used to release intraluminal pressure and decrease the volume of the lesion. Three-dimensional computed tomography was applied to all patients at the diagnosis stage and at 6 months after decompression. Volumetric analysis was performed using software designed for 3-dimensional measurement of volumes. Other variables, such as age, gender, and rate of decrease, were recorded. RESULTS: There were important differences in rates of decrease between preoperative and 6-month lesion volumes. Statistical analyses showed no significant differences among groups for age, gender, and histologic lesion type (P > .05). CONCLUSION: Decompression of large cystic lesions could be useful for surgical interventions without complications.

Assessment of Pineal Gland Volume and Calcification in Healthy Subjects: Is it Related to Aging?

PURPOSE: The human pineal gland is a small neuroendocrine organ which produces melatonin. The main goal of this study was to provide a reference range for pineal volume in all age groups and to determine calcified and noncalcified tissue and their proportions, which may be a reflection of melatonin production in all age groups, by using very thin computerized tomography (CT) slices. MATERIALS AND METHODS: A total of 167 outpatients had undergone cranial CT. Each of the subject's total pineal volume (TPV), calcified pineal volume (CPV) and noncalcified pineal volume (NPV) according to age groups were calculated in cubic millimeters. Also, proportion of calcification (POC) was noted. RESULTS: The median values were 88.5 mm3 (12.3 mm3-411mm3) for TPV, 74.3 mm3 (12.3 mm3-298 mm3) for NPV, and 3.9 mm3 (0 mm3-141 mm3) for CPV. POC showed a gradual increase from 0-49 years. In the ≥70 group, when compared with the 60-69 age group, CPV and POC values were significantly lower (P: 0.036, P: 0.034, respectively). CONCLUSION: This study brings a radiological point of view to the distribution of pineal calcification according to age that has a link with melatonin secretion.

Protective Effect of Alpha Lipoic Acid on Rat Sciatic Nerve Ischemia Reperfusion Damage.

BACKGROUND: Alpha lipoic acid is a potent antioxidant that plays numerous roles in human health. This study examined the effect of ALA on rat sciatic nerve ischemia reperfusion damage. AIMS: Protective effect of alpha lipoic acid (ALA) on sciatic nerve following ischemia-reperfusion in rats was investigated by using light microscopy and biochemical methods. Provided that the protective effect of ALA on sciatic nerve is proven, we think the damage to the sciatic nerve that has already occurred or might occur in patients for various reasons maybe prevented or stopped by giving ALA in convenient doses. STUDY DESIGN: Animal experiment. METHODS: Forty-two adult male Sprague-Dawley rats (250-300 grams) were used in this study. Rats were randomly divided into six groups including one control (Group 1), one sham (Group 2), two ischemia-reperfusion (Groups 3 and 4) and two treatment groups (Groups5 and 6). Doses of 60 and 100 mg/kg ALA were given (Group 5 and 6) intra peritoneally twice, 1 and 24 hours before the ischemia to each treatment group. Ischemia was carried out the abdominal aorta starting from the distal part of the renal vein for two hours followed by reperfusion for three hours. In immunohistochemical methods, fibronectin immunoreactivity was analyzed. For biochemical analyses, the tissues were taken in eppendorf microtubes and superoxide dismutase (SOD) and glutathione peroxidase (GSHPx) enzyme activities as well as malondialdehyde (MDA) and nitricoxide (NO) levels were measured. RESULTS: Fibronectin was observed to have increased significantly in the ischemia group; on the other hand, it was observed to have decreased in parallel to the doses in the ALA groups. Biochemical studies showed that SOD and GSHPx declined with ischemia-reperfusion, but the activities of these enzymes were increased in the treatment groups in parallel with the dose. It was found that increased MDA levels with ischemia-reperfusion were decreased in parallel with ALA dose. There were no statistically significant changes in NO. CONCLUSION: Increased fibronectin observed after ischemia/reperfusion of rat sciatic nerve is reduced after the administration of ALA. This indicates that the function of fibronectin, to reconnect cut nerve segments and regenerate nerves, is more prominent than its function in tissue healing after ischemia. ALA administered before ischemia decreases MDA and increases SOD and GSHPx. We think that ALA may protect against the pathological changes in ischemic nerve and may be used to devise more efficient treatments.

The effects of amlodipine and platelet rich plasma on bone healing in rats.

AIM: The aim of this study was to evaluate the effects of calcium channel blocker (CCB) amlodipine (AML), platelet rich plasma (PRP), and a mixture of both materials on bone healing. MATERIALS AND METHODS: Fifty-six male Wistar rats were randomly divided into four groups: group A, tibia defect model with no treatment; group B, tibia defect model treated with AML, 0.04 mg daily by oral gavage; group C, tibia defect model treated with local PRP; group D, tibia defect model treated with local PRP and AML, 0.04 mg daily by oral gavage. RESULTS: At day 21, bone healing was significantly better in groups C and D compared to group A (P<0.05), but comparisons showed no statistically significant difference in group B (P>0.05). At day 30, groups B and C showed no statistically significant difference (P>0.05) compared to group A, but bone healing in group D was significantly better than in group A (P<0.05). Statistically, AML did not affect alkaline phosphatase (ALP) activity at 21 and 30 days (P>0.05), but PRP and AML + PRP increased ALP activity statistically (P<0.05). CONCLUSION: It can be concluded that AML had neither a positive nor a negative effect on bone healing, but when used in combination with PRP, it may be beneficial.

Alterations in pituitary gland volume in polycystic ovary syndrome: a structural magnetic resonance imaging study.

The purpose of this prospectively designed cross-sectional observational study was to evaluate the effect of polycystic ovary syndrome (PCOS) on pituitary gland volume (PGV) under the hypothesis that endocrinologic changes may lead to morphologic changes of the pituitary gland. Twenty-six PCOS patients and 31 control subjects underwent magnetic resonance imaging (MRI) of the pituitary. Informed consent was obtained from all subjects. PGV was significantly larger in PCOS patients than in control subjects. Luteinizing hormone/follicle-stimulating hormone ratio was the only predictor of PGV. The association between pituitary gland enlargement and PCOS should be kept in mind when pituitary hypertrophy is detected on MRI.

Evaluation of daily energy expenditure and health-related physical fitness parameters in patients with cholelithiasis.

OBJECTIVE: The aim of this study was to investigate the daily energy expenditure; resting metabolic rate (RMR); health-related physical fitness parameters such as maximal aerobic capacity, muscle strength, and flexibility; pulmonary function tests (PFTs); and body composition and body fat distribution changes in patients with cholelithiasis, and to compare them with healthy controls. MATERIALS AND METHODS: Thirty female patients with cholelithiasis and 30 controls were included in this study. Daily physical activity was monitored using a metabolic Holter and the maximal aerobic capacity was estimated using the Astrand submaximal exercise protocol. The body composition was established with a bioelectrical impedance analyzer. RMR, PFTs, strength, flexibility, circumference, and skinfold measurements were also carried out. RESULTS: Maximal aerobic capacity, trunk flexibility, daily moderate activity duration, daily vigorous activity duration, total energy expenditure, RMR, PFT, lean body mass, adiposity, and body fat distribution values were not significantly different between the patients and the controls. The cholelithiasis patients had lower daily step numbers, handgrip strength, and back-leg strength values, whereas their higher daily sleep duration values were comparable with those of the controls. CONCLUSION: Our results suggest that daily physical activity and muscle strength were impaired in female cholelithiasis patients when compared with the healthy controls. We suggest that using daily exercises, including not only aerobic but also strength training as lifestyle modifications in cholelithiasis patients, might be helpful for the development of more beneficial illness management strategies.

Absence of middle hepatic vein combined with retro-aortic left renal vein: a very rare case report.

The hepatic and renal veins drain into the inferior vena cava. The upper group of hepatic veins consists of three veins which extend to the posterior face of the liver to join the inferior cava. The left renal vein passes anterior to the aorta just below the origin of the superior mesenteric artery. We detected a variation in the hepatic and renal veins in a multislice CT angiogram of a nine-year-old male patient in the Radiology Department of Afyon Kocatepe University Medical School. The upper group hepatic veins normally drains into the inferior vena cava as three separate trunks, namely the right, left and middle. In our case, we found that only the right and left hepatic veins existed and the middle hepatic vein was absent. Furthermore, the left renal vein, which normally passes anterior to the abdominal aorta, was retro-aortic. Left renal vein variations are of great importance in planning retroperitoneal surgery and vascular interventions. Knowledge of a patient's hepatic vein and renovascular anatomy and determining their variations and anomalies are of critical importance to abdominal operations, transplantations and preoperative evaluation of endovascular interventions.