Relationship of Recurrent Laryngeal Nerve with Inferior Horn of Thyroid Cartilage, Berry's Ligament and Zuckerkandl's Tubercle.

During neck surgery; Zuckerkandl's tubercle, Berry's ligament, the inferior horn of thyroid cartilages have become crucial anatomical landmarks in order to protect the integrity of the recurrent laryngeal nerve. Forty-two male postmortem human cadavers were used. The proximal part of the recurrent laryngeal nerve, before the inferior thyroid artery arises from its source has been observed in 87% inside the tracheoesophageal groove and in 13% running laterally to the trachea. The recurrent laryngeal nerve was encountered passing behind and through the branches of the inferior thyroid artery in 92% and 8% respectively. At all sides; the nerve was piercing the larynx 0.6 ± 0.1 mm below the inferior horn of thyroid cartilage, passing next to the inner-lower side of Berry's ligament and running under the lower middle part of Zuckerkandl's tubercle. These landmarks and their upper mentioned distances to the laryngeal nerve can be taken into consideration as important surgical guides.

Importance of measurement methods and demographic characteristics in evaluating ulnar variance: A retrospective comparative study.

OBJECTIVE: This study aimed to compare 2 methods of ulnar variance (UV) measurement (the perpendicular method and the circular method) and to determine whether UV changed based on the demographic characteristics (sex and age). METHODS: UV was measured on bilateral wrist radiographs of 124 patients (62 men, 62 women; mean age=48.5 years; range=18-79 years) who had no history of trauma, congenital wrist anomaly, previous wrist surgery, and wrist osteoarthritis by a single radiologist with 4 years of experience. All measurements were made on standardized radiographic images using 2 methods: the perpendicular method and the circular method. All the patients were then divided into groups based on sex and age, and the study population was determined by selecting a similar number of patients for each sex and age group. RESULTS: The mean UV of the right and left wrists was measured as 0.33 (range=-4.3 to 5.7) mm by the perpendicular method and as 0.034 (range=-5 to 5.7) mm by the circular method. A significant difference was determined between the 2 measurement methods (p<0.001). There was a statistically significant difference between sex and UV values in the left wrist measurements by both methods (p<0.05). A significant correlation was found between the UV and age in both right and left side measurements, indicating a statistically significant difference between the methods (p<0.001). CONCLUSION: The results of our study demonstrated significant differences in the UV measurement between the 2 methods. Furthermore, UV measurement may change based on age and sex. These differences should be considered in the treatment planning of patients with wrist disorders. LEVEL OF EVIDENCE: Level IV, Therapeutic Study.

Prostaglandin F receptor expression in intrauterine tissues of pregnant rats.

In this investigation, we studied the expression and localization of rat prostaglandin F (FP) receptor in uterine tissues of rats on gestational Days 10, 15, 18, 20, 21, 21.5 and postpartal Days 1 and 3 using Western blotting analysis, real-time PCR, and immunohistochemistry. A high level of immunoreactivity was observed on gestational Days 20, 21, and 21.5 with the most significant signals found on Day 20. FP receptor protein was expressed starting on gestational Day 15, and a fluctuating unsteady increase was observed until delivery. Uterine FP receptor mRNA levels were low between Days 10 and 18 of gestation (p < 0.05). The transcript level increased significantly on Day 20 and peaked on Day 21.5 just before labor (p < 0.05). There was a positive correlation between FP receptor mRNA expression and serum estradiol levels (rs = 0.78; p < 0.01) along with serum estradiol/progesterone ratios (rs = 0.79; p < 0.01). In summary, we observed an increase FP receptor expression in rat uterus with advancing gestation, a marked elevation of expression at term, and a concominant decrease during the postpartum period. These findings indicate a role for uterine FP receptors in the mediation of uterine contractility at term.

Effects of green tea and vitamin E in the testicular tissue of streptozotocin-induced diabetic rats.

OBJECTIVE: To investigate the possible therapeutic or protective effects of green tea in diabetic rat's testicular tissue, either as a single agent, or together with vitamin E. METHODS: The present study was carried out at the Faculty of Medicine, Gazi University, Ankara, Turkey from May to August 2011 for 10 weeks. Forty-eight adult male Wistar albino rats, weighting 250-300 g, were divided into 8 groups: control; nondiabetic vitamin E (0.4 mg/kg/NG); nondiabetic green tea (300 mg/kg/NG); nondiabetic vitamin E plus green tea administered groups; diabetic group (60 mg/kg/IV streptozotocin); diabetic vitamin E; diabetic green tea; and diabetic vitamin E plus green tea administered groups. Proliferative and apoptotic indexes were determined using anti-PCNA antibody immunohistochemistry and TUNEL assays respectively. Tubule degeneration was evaluated using the Johnson's score and also seminiferous tubules diameters, epithelial thickness were measured. RESULTS: Histopathological examination in diabetic group revealed degenerative changes in the seminiferous tubules together with a statistically significant decrease in PCNA positive cells, in epithelial thickness, diameter of the tubules and in Johnson's score, while exhibited an increase in the number of apoptotic cells. When all these findings are considered together, the most successful protective effects in diabetes were obtained in the combined antioxidant group. CONCLUSION: Combined therapy of vitamin E and green tea in diabetes was more effective than monotherapy. Therefore, these antioxidants may be use as a supporting therapy for reproductive dysfunction.

[Age-related changes in light microscopy with Sirius red technique in rat Achilles tendon]. / Siçan Asil tendonunda yasa bagli degisikliklerin isik mikroskobunda Sirius kirmizi teknigi ile incelenmesi.

OBJECTIVES: In this study, age-related morphological changes in intact rat Achilles tendon was investigated. MATERIALS AND METHODS: Thirty Wistar albino rats of 2-3 weeks, six months and 12 months old groups 10 animal in each group were examined with Sirius red light microscobic staining. RESULTS: The Sirius red light microscobic staining revealed that red stained collagen fibers have a decreased waviness with more rounded appearence of tenocyte nuclei, extracellular matrix along a increased vascularity and the number of tenocytes decreased with age was statistically meaningfull. CONCLUSION: The possible causes of the spontaneously Achilles tendon rupture in adult ages group was investigated with Sirius red light microscopic technique. In this age group, initiation of the degenerative changes are decreasing the elasticity thus function of this tendon.

Dose-related immunohistochemical and ultrastructural changes after oral methylphenidate administration in cerebrum and cerebellum of the rat.

Methylphenidate is a piperidine derivative and is the drug most often used to treat attention deficit/hyperactivity disorder of children and young adults. Our aim is to investigate dose-dependent dopamine-2 receptor and glial fibrillary acidic protein expression and ultrastructural changes of the rat brain, to demonstrate possible toxicity of the long-term and high dose use of the methylphenidate. In this study, 27 female prepubertal Wistar albino rats, divided into three different dose groups (5, 10 and 20 mg/kg) were treated orally with methylphenidate dissolved in saline solution for 5 days per week during 3 months. At the end of the third month, tissues were removed and sections were collected for immunohistochemical and ultrastructural studies. We believe that methylphenidate causes dose-related activation of the dopaminergic system in several brain regions especially in ventral tegmental area and also causing neuronal degeneration and capillary wall structural changes such as basal membrane thickness and augmentation of the pinostatic vesicle in the endothelial cells. Also, increased dose of Ritalin is inducing astrocytes hypertrophy especially astrogliosis in pia-glial membrane and this is the result of the degenerative changes in prefrontal cortex region due to high dose methylphenidate administration. The dose-related accumulation of the astrocytes in capillary wall might well be a consequence of the need for nutrition of the neuronal tissue, due to transport mechanism deficiency related to neuronal and vascular degeneration. Thus, we believe that the therapeutic dose of methylphenidate must be kept in minimum level to prevent ultrastructural changes.

Dose-dependent ultrastructural changes in rat cornea after oral methylphenidate administration.

OBJECTIVE: To investigate dose-dependent ultrastructural changes in rat cornea after oral methylphenidate Ritalin administration. METHODS: This study was conducted in the Department of Anatomy, Gazi University Faculty of Medicine, Ankara, Turkey between March and May 2005, with a total of 27 female prepubertal Wistar albino rats, divided into 3 different dose groups 5mg/kg, 10 mg/kg, 20 mg/kg, and their control groups. They were treated orally with methylphenidate, and eye tissue was removed to process for electron microscopic studies. RESULTS: We observed that all cells, and prominently basal cells of the corneal epithelium show dose-dependent degenerative changes such as apoptotic bodies, chromatin condensation, and ondulation in their nuclei and crystolysis of the mitochondrion. In the stroma, the most evident finding was the increase of the collagen fiber. In addition to dose-dependent changes related to the apoptotic process, which is chromatin condensation in their nuclei, electron dense material accumulation, and pericellular edema in the cytoplasm were also seen. In the endothelial cell lines, disruption of the junctional complexes, vacuolization in the cell cytoplasms, and crystolysis of the mitochondrion's with rough endoplasmic reticulum cisternae activity were observed. CONCLUSION: Ritalin is inducing an evident degeneration, especially in epithelium cells with increasing doses. Ultrastructural cell organelle composition degeneration with stromal fibrosis has a negative effect on cornea dehydration. In light of these findings, we believe that the Ritalin treatment doses need to be kept to a minimum to maintain healthy cornea ultrastructure and related physiology.

Morphometric study of a horseshoe kidney.

OBJECTIVE: To describe a horseshoe kidney, a congenital anomaly of the upper urinary tract. CLINICAL PRESENTATION: A case study of horseshoe kidney harvested from a 62-year-old cadaver at Gazi University Medical School is presented. RESULTS: The right and left kidneys were fused at their lower poles by a parenchymal isthmus located ventral to the abdominal aorta and formed a U-shape with two unequal arms. The isthmus of the ectopic kidney was placed obliquely to the left at the level of the fourth and fifth lumbar vertebra. The left kidney was larger and longer than the right one. The kidneys were supplied by three renal arteries arising from the abdominal aorta. Two arteries on the right side supplied blood of the two kidneys, while the third artery that directly originated from the aorta, above the origin of inferior mesenteric artery, supplied the isthmus. Venous drainage of the both kidneys and the isthmus were drained by three veins that opened independently into the inferior vena cava. The right ureter was duplicated in origin. CONCLUSION: This report shows that knowledge of anomalies such as this is very important in planning and conducting surgical procedures.

Effect of fresh and stored botulinum toxin a on muscle and nerve ultrastructure: an electron microscopic study.

The aim of this study was to compare the ultrastructural alterations of the muscle and nerve that appear following injection of freshly reconstituted and stored botulinum toxin A. Fifteen New Zealand white rabbits were assigned to 6 groups, and anterior auricular muscle was used for injections. Group 1 did not receive any injection and group 2 received saline injection. Groups 3 and 5 received fresh botulinum; muscles and motor nerves were harvested at 5 days and 12 weeks, respectively. Groups 4 and 6 received stored botulinum; muscles and motor nerves were harvested at 5 days and 12 weeks, respectively. Alterations in muscle and nerve ultrastructure were evaluated with electron microscopy. Degeneration findings in muscle after botulinum toxin injection revealed no significant difference between freshly reconstituted and stored toxin in the early period. When stored toxin was used, atrophic changes in the muscle were less severe than the fresh toxin at 3 months. On nerve evaluation, fresh toxin displays significant acute changes on nerve ultrastructure; however, fresh and stored toxin shows similar degeneration at 12 weeks.

Innervation of the rat anterior abdominal wall as shown by modified Sihler's stain.

OBJECTIVE: The purpose of this study was to use the modified Sihler's staining technique to demonstrate detailed distribution of the rat anterior abdominal wall nerves and test the value of Sihler's technique in demonstrating such a complex muscle-nerve relationship. MATERIALS AND METHODS: The anterior abdominal walls of 5 Wistar rats were isolated by making a deep incision from the costal arches on each side down to the inguinal region and processed using a modified Sihler's stain technique. RESULTS: This technique was successfully applied to visualize the innervation of the anterior abdominal wall muscles of the rat. The segmental nerves of T6-L1 and their terminal branches were shown and possible motor and sensory fibers identified. CONCLUSIONS: This technique is valuable in understanding the complex nature of final branching of the nerve endings, and it may be useful for studying experimental nerve models.

The immunohistochemical approach to determine the origin and possible function of the juxtaoral organ in dogs.

OBJECTIVE: In this study, we applied immuno- histochemical techniques on the functionally little known organ of Chievitz (juxtaoral organ [JOO]) in dogs to determine its origin and possible function. METHODS: The term abortive materials of 6 Doberman dogs were used for experimental procedures in July 2002 to June 2003 at Gazi University Faculty of Medicine, Ankara, Turkey, after routine light microscopic tissue preparation, the sections were stained with Masson's trichrome stain. In order to elucidate the function-related origin of the organ, we used epidermal growth factor (EGF-r), transforming growth factor (TGF-alpha) and nerve growth factor (NGF-beta) immunohistochemical stains. RESULTS: We observed a very strong and widespread immunoreactivity of EGF-r and TGF-alpha on simple squamous capsular cells. We detected nerve growth factor-beta positivity in granular form both in simple squamous capsular cells and in neighboring connective tissue. However, we did not detect EGF-r reactivity on parenchymal cells except a weak immunoreactivity on central ones. We noticed transforming growth factor-alpha in most of the parenchymal cells while we observed NGF-beta strongly in all the parenchymal cells. CONCLUSION: These results may point out that the JOO may be of mesothelial or epithelial origin. Having NGF-alpha positive granules and close relationship with blood vessels may imply a neurosecretory function. We believe that our study may add new perspectives to the function of the JOO.

Common surgical pitfalls in the skull.

BACKGROUND: A detailed knowledge of the morphologic variations in the ossicles, foramina, and ridges of the skull vault and skull base is vital to performing safe radical surgery. METHODS: A surgical reminder of possible pitfalls was composed based on the incidences of most of the minor variations such as the supraorbital notch, frontal foramen, metopism, foramen caecum, parietal foramina, bony defects in the fossa occipitalis cerebellaris, Inca bone, foramen lacerum anterius, incomplete posterolateral wall of the foramen ovale, absence of the medial or posterior wall of the foramen spinosum, foramen innominatus, foramen meningoorbitale, bony dehiscence of the internal carotid canal, bony ridge or torus in the floor of the external auditory meatus, foramen of Huschke, precondylar tubercle, foramen hypoglossi, anterior condylar canal, hypoglossal bridging, divided articular surface of the occipital condyle, high jugular bulb, paramastoid process, atlanto-occipital assimilation, ossicle of Kerkring, delta or keyhole shaped bony defects in the anterior border of foramen magnum, foramen of Vesalius, posterior condylar canal, mastoid emissary foramen and occipital foramen in 200 skulls. CONCLUSION: Recognition of these structures and their possible variations will help in distinguishing normal from potentially abnormal structures during computed tomography and magnetic resonance imaging examinations, and in avoiding misinterpretations that lead to confusion during surgical interventions. Instrumentation near potential bone gaps may traumatize important neural or vascular structures.

Effects of vasoconstriction on the acute anterior pituitary hormonal response to head injury.

Since cerebral vasoconstriction alone may impair the hypothalamic and pituitary circulation, we planned to investigate whether the hormonal response to the vasoconstriction that may be induced by the head injury is a significant component of the general acute hormonal response to head injury. Although diffuse adrenocorticotropic hormone immunohistochemical staining of the adenohypophysis of rabbits was observed in the head trauma administered group, only mild positive staining was present in the Endothelin-1 administered group. However, decreased prolactin staining was found in both of the groups. It is postulated that trauma induced vasoconstriction may not be an important manipulating factor in the corticotrophic hormone response to injury, while it may be responsible for the decreased prolactin response.