Evaluation of apertura piriformis and related cranial anatomical structures through computed tomography: golden ratio.

BACKGROUND: The purpose of study was to evaluate normal morphometric measurements of piriform aperture (PA) by limiting the age range in genders to show the morphometry of the relevant and close proximal cranial structures; and also to investigate whether these are in compliance with the golden ratio. MATERIALS AND METHODS: Our study was performed on 83 (42 female, 41 male) multidetector computed tomography images obtained from patients. A total of 14 morphological measurements were performed including the height of PA, the width of PA and 12 cranial structures; and these measurements were evaluated for compliance with the golden ratio. The differences of 14 parameters between the genders and age groups, and also the interaction of these two factors were analysed. RESULTS: In our morphometric study, significant difference between the genders was found in all measurements except for the distance between vertex and rhinion (V~Rh), between rhinion and right foramen supraorbitalis (Rh~FSOR), between rhinion and left FSO (Rh~FSOL), and the width of PA on the level between the right and left foramen infraorbitalis (PAW~FIO) with the difference valid for both age subgroups (p < 0.05). When the differences between the age subgroups were evaluated, there was significant difference only at the widest distance of cranium (CW; p = 0.008); and it was observed that the average has increased with age in both genders. When the golden ratio was examined, the ratio of the distance between anterior nasal spine and nasion to the height of piriform aperture (NSA~N:PAH) was found to be within the limits of the golden ratio in males (p = 0.074). No golden ratio has been found in females. CONCLUSIONS: In our study, significant differences were detected between genders in all parameters of PA and in some parameters of the close cranial structures in the age group we examined. The effect of age was detected only in the CW parameter, and the PA and close cranial structures were not affected. In our study, the averages of the morphometric measurements of 13 parameters of young adults were determined. The PA and surrounding cranial structures are important for the area and related surgical procedures; however, gender differences must be considered in this respect. In addition to this, in the PA, which is the anterior limit of the skeletal nose in males, the NSA~N:PAH ratio having the ideal golden ratio limits is valuable in aesthetical terms and due to its position of the PA in the face.

Microarray-based gene expression analysis of an animal model for closed head injury.

OBJECTIVE: Traumatic brain injury (TBI) is a major cause of death and disability in both children and the elderly. Mortality from TBI is said account for 1-2% of all deaths. One-third to one-half of all traumatic deaths is due to head injury. Of those who survive, the majority is left with significant disabilities, including 3% who remain in a vegetative state and only approximately 30% who make a good recovery. Microarray studies and other genomic techniques facilitate the discovery of new targets for the treatment of diseases, which aids in drug development, immunotherapeutics and gene therapy. Gene expression profiling or microarray analysis enables the measurement of thousands of genes in a single RNA sample. METHODS: In this study, adult Wistar-albino rats underwent TBI using a trauma device. Brain tissues and blood samples were taken for gene expression at 1, 12 and 48 h post-trauma and were then analysed via microarray. Total RNA was isolated using an RNeasy Mini Kit (QIAGEN-Sample & Assay Technologies, Hilden, Germany) and tested using a 2100 Bioanalyzer (Agilent Technologies, Palo Alto, CA). Overall changes in gene expression were evaluated using Agilent Whole Rat Genome 4 × 44 K oligonucleotide arrays and analysed with GeneSpring (GeneSpring 6.1, Silicon Genetics, Redwood City, CA) software. Only genes with a signal-to-noise ratio of above 2 in the experiments were included in the statistical analysis. RESULTS: ANOVA (p<0.05) was performed to identify differentially expressed probe sets. Additional filtering (minimum 2-fold change) was applied to extract the most differentially expressed genes based on the study groups (Control vs. 1st hour, Control vs. 12th hour, Control vs. 48th hour). Differentially expressed genes were detected via microarray analysis. A gene interaction-based network investigation of the genes that were identified via traditional microarray data analysis describes a significantly relevant gene network that includes the C1ql2, Cbnl, Sdc1, Bdnf, MMP9, and Cd47 genes, which were differentially expressed compared with the controls. CONCLUSIONS: In this study, we will review the current understanding of the genetic susceptibility of TBI with microarrays. Our results highlight the importance of genes that control the response of the brain to injury as well as the suitability of microarrays for identifying specific targets for further study.

Nerve conduction studies of the axillary, musculocutaneous and radial nerves in elite ice hockey players.

AIM: The peripheral nerves of the upper extremity are exposed to acute and chronic mechanical injuries in ice hockey players, because of the high repetition of motions, high muscular forces and extreme shoulder positions. This study was performed to evaluate the effect of ice hockey playing on the axillary, musculocutaneous and radial nerves crossing the upper arm region. METHODS: The ice hockey group consisted of 20 first-division male ice hockey players and the control group consisted of 20 non-active males. The neurophysiological study consisted of motor nerve conduction latency of the axillary, musculocutaneous and radial nerves. RESULTS: The values of distal motor latency (DML) of the axillary, radial and musculocutaneous nerves were significantly prolonged in the ice hockey players compared with the controls. Ice hockey can repetitively stress the upper extremity during shooting, because of forceful throwing to move the puck from the stick blade to the opponent's net. The mechanism of prolonged DML in the axillary nerve may both tract and compress as the axillary nerve stretches across the humerus during movement. From this study it emerged that using the biceps and coracobrachialis muscles can create notable muscle compartment pressure on the musculocutaneus nerve. The significant differences detected in the neurophysiologic study of the musculocutaneous nerve between the ice hockey players and controls may reflect the fact that the forces acting on the shoulder and the elbow during ice hockey matches can effectively influence DML. CONCLUSIONS: The authors suggest two plausible causes for prolonged radial nerve DML: direct compression by the hypertrophied triceps muscle and stretching of the arm. The study suggests it is likely that a combination of skeletal muscle hypertrophy and excessive biomechanical demands on neurological structures during ice hockey matches may be a major etiologic factor in compression of the axillary, musculocutaneous and radial nerves.

Nerve conduction study of ulnar nerve in volleyball players.

Ulnar neuropathy at the elbow is a common disorder seen in the throwing athlete. The purpose of our study was to determine whether asymptomatic physically active volleyball players and non-actives demonstrate distinct differences in nerve conduction of the ulnar nerve at the elbow. Nerve conduction studies were performed on both arms of 24 male volleyball players and 24 male non-actives. Nerve conduction velocity at the above to below elbow segment of the ulnar motor nerve were slower in the volleyball players compared with controls and their non-dominant arms. There were no statistical differences in latencies and conduction velocity of the ulnar nerve on the forearm, both in volleyball players and in the controls. In the evoked responses of the ulnar nerve, the amplitude was the same as corresponding normal values in both sensory nerve and muscle action potentials. We conclude that abnormal ulnar (motor) nerve conduction at the elbow segment may suggest a subclinical entrapment neuropathy as a result of strenuous elbow movements in volleyball players.

Comparison of nerve conduction velocities of lower extremities between runners and controls.

Peripheral nerve injuries can occur in runners, but large numbers of nerve injuries remain subclinical. Identification of nerve injuries needs an understanding of common sites of entrapment in running. Fourteen asymptomatic male middle-distance runners and 14 non-active subjects participated in this study. The neurophysiologic study consisted of motor and sensory nerve conduction of medial and lateral plantar nerves, sensory nerve conduction of sural and superficial peroneal nerves, and motor nerve conduction of common peroneal nerve. Active range of motion and muscle strength assessment (dorsi flexion/plantar flexion; inversion/eversion) as measured using a Biodex System3 Dynamometer were observed to be within normal limits for both groups. The medial plantar (sensory) nerve and sural nerve distal latencies were significantly prolonged and sensory conduction velocities were significantly delayed in the runners compared with the control subjects. Many of the asymptomatic runners with abnormal nerve conduction tests in this study may represent presymptomatic or asymptomatic neuropathy similar to the type of subclinical entrapment neuropathy.

Nerve conduction studies of upper extremities in tennis players.

OBJECTIVES: The influence of regular and intense practice of an asymmetric sport such as tennis on nerves in the elbow region was examined. METHODS: The study included 21 male elite tennis players with a mean (SD) age of 27.5 (1.7) years and 21 male non-active controls aged 26.4 (1.9) years. Anthropometric measurements (height, weight, limb length, and perimeters of arm and forearm) were determined for each subject, and range of motion assessment and radiographic examination carried out. Standard nerve conduction techniques using constant measured distances were applied to evaluate the median, ulnar, and radial nerves in the dominant and non-dominant limb of each individual. RESULTS: The sensory and motor conduction velocities of the radial nerve and the sensory conduction velocity of the ulnar nerve were significantly delayed in the dominant arms of tennis players compared with their non-dominant arms and normal subjects. There were no statistical differences in the latencies, conduction velocities, or amplitudes of the median motor and sensory nerves between controls and tennis players in either the dominant or non-dominant arms. However, the range of motion of the upper extremity was significantly increased in tennis players when compared with control subjects. Tennis players were taller and heavier than control subjects and their dominant upper limb lengths were longer, and arm and forearm circumferences greater, than those of the control subjects. CONCLUSIONS: Many of the asymptomatic tennis players with abnormal nerve conduction tests in the present study may have presymptomatic or asymptomatic neuropathy similar to subclinical entrapment nerve neuropathy.

Nerve conduction studies of lower extremities in pes planus subjects.

Pes planus is a condition in which the medial longitudinal arch is depressed. Pedoscop, eyeball visualization, ink mat and roentgenography were used in clinical evaluation. We performed nerve conduction studies on both feet of 28 pes planus subjects. Our results demonstrated mild prolongation distal latency of the medial and lateral plantar sensory nerves, and delayed sensory conduction velocity of the medial plantar sensory nerve. The presence of electrodiagnostic abnormalities in this study population helps to substantiate the presence of compression neuropathy of the medial or lateral plantar nerve in pes planus subjects.