Investigation of changes in liver microanatomy in the steatosis model created by permanent canula in rats

Objective: The knowledge of nonalcoholic fatty liver disease (NAFLD) and Nonalcoholic Steatohepatitis (NASH) is limited to the findings from available suitable models for this disease. A number of rodent models have been described in which relevant liver pathology develops in an appropriate metabolic context. In this experimental study, it was aimed to create a new liver fat model by giving fat from the portal vein of rats and to visualize the changes in the liver with advanced microscopic techniques.Methods: 28 female rats were used in the study. Permanent intraabdominal cannulas were inserted into the portal vein of the rats. Rats were randomly divided four group. Intralipid 20% substance was injected through cannula to the experimental groups during the test period. Control group received saline at the same rate. At the end of the experiment, the animals were visualized with a laser speckle microscope and livers were divided into sections according to the stereological method. The sections were painted with Hematoxylin-Eosin, Oil red o, Masson trichoma, Bodipy, Nile red. Sections were evaluated under a microscope.Results: Ballooning, inflammation and fibrosis were observed in the 2 week intralipid group. In the 1 week intralipid group, the rate of parenchyma decreased while the sinusoid rate increased, and sinusoid rate increased significantly in the 2 week intralipid (p<0.05). Conclusion: According to the findings, steatohepatitis was detected in the 2 week intralipid, whereas only steatosis was observed in the 1 week intralipid. Thus, it was concluded that the newly formed rat model causes steatosis

Re-evaluation of the symptoms of Hirayama disease through anatomical perspective

Hirayama disease is a rare disease of the anterior horn motor neuron caused by compression of the cervical spinal cord when the neck is flexed. Cervical myelopathy may accompany the disease. It is characterized by symmetrical or asymmetrical muscle weakness and atrophy of muscles innervated by lower cervical and upper thoracic motor neurons. We recorded two male cases of Hirayama disease between the ages of 15 and 21 based on magnetic resonance imaging (MRI) features obtained from the cervical neutral state and from the flexion position which appeared in the right upper extremity. Loss of strength and atrophy in the right upper extremities was existent in clinical findings of these patients. When MRI was taken in the flexion position, there were dilated veins as hypointense signal void on T2 weighted series in posterior epidural area. The contrast enhancement was seen on these veins. It was observed that the posterior dura was displaced anteriorly and the anterior subarachnoid space was narrow. In cases which show clinical findings such as atrophy and loss of strength, having normal MRI results obtained in the neutral position makes it difficult to diagnose Hirayama Disease. In case of a suspicion of Hirayama disease the diagnosis can be made more easily by MRI taken in the flexion position. These case reports aim to bring Hirayama disease to mind and optimize the management of affected individuals

Serratus posterior superior intercostal plane block: A technical report on the description of a novel periparavertebral block for thoracic pain

Background and objectiveWe report a novel block technique aimed to provide thoracic analgesia: the serratus posterior superior intercostal plane (SPSIP) block.DesignA cadaveric evaluation along with a retrospective case series evaluating the potential analgesic effect of the SPSIP block. This study included one unembalmed cadaver and five patients. InterventionsBilateral ultrasound-guided SPSIP block was used on cadavers with 30 mL of methylene blue 0.5% on each side; single-injection SPSIP blocks were used in patients. To measure results, dye spread was used in the cadaver, and dermatomal/pain score evaluation was used in patients.Main resultsAnatomical investigation in one unembalmed cadaver shows that its mechanism of action covers the rhomboid major muscle, erector spinae muscle, the deep fascia of the subscapularis/serratus anterior muscles, and intercostal nerves. In our patients, SPSIP resulted in an almost complete sensory block in the back of the neck, shoulder, and hemithorax.ConclusionOur cadaveric study shows extensive dye spread from C7 to T7. Patients who were administrated SPSIP block reported consistent dermatomal blockade from C3 to T10 levels of the hemitorax. The SPSIP block seems to be a safe, simple, and effective technique for thoracic analgesia

Importance of sonographic paratracheal lymph node evaluation in early autoimmune thyroiditis

Background/aim: To review the sonographic views of paratracheal lymph nodes (PLNs) in the diagnosis and during different stages of autoimmune thyroiditis. Materials and methods: Features of the PLNs (left and right), thyroid sonography, and laboratory data were investigated in 126 cases. Patients were divided into three groups by using thyroid sonographic criteria in the literature (group 1: control, group 2: early-stage/ indeterminate, group 3: definite thyroiditis). Indeterminate patients were followed up for 1 year and included as indeterminate/earlystage thyroiditis patients. Results: Percentage of right and left PLN was 13.3% and 46.2% in control cases, 21.2% and 80% in early-stage/indeterminate cases, and 41.3% and 88.5% in definite thyroiditis cases. Significant among-group differences were evident in terms of right and left PLNs presence (Pearson chi-squared test, P = 0.011 and P = 0.001). Conclusion: Careful and thorough review of the PLNs can ensure diagnosis of autoimmune thyroiditis even in cases of early stage of the disease and prevent false-negative diagnoses

Evaluation of mandibular incisive canal and mental foramen in Turkish population by conical beam computed tomography

Surgical complications may occur in the interforaminal area when course and morphological features of anatomical structures, which includes neurovascular structures in the mandible, cannot be defined correctly. The aim of this study is to determine the course and morphological characteristics of the mental foramen (MF) and the mandibular incisive canal (MIC) in Turkish society. Cone Beam Computed Tomography (CBCT) is considered the gold standard for dental imaging; therefore, in this study 96 CBCT images were examined retrospectively. The width and the length of the MF, distance from the MF to the alveolar bone crest, lower border of the mandible, angulation of mental canal to buccal bone surface, the length of the MIC, the angle among mental foramenincisive canal and a horizontal plane parallel to the inferior border of the mandible, and the height of the angle were measured. At the endmost point of the MIC, the distance between the canal and inferior, labial, and lingual borders of the mandible was measured. The most common locations of MF were along the second premolar (23.4%). MIC was absent in 24.4% of the cases. The most common locations of the endmost point of MIC were along the first incisive (35.8%), MIC length was significantly longer in males. Although the structures show variation among individuals, the mean values in Turkish society are similar to the mean values in the literature.Istanbul Medipol University Medical Research Counci

Evaluation of anatomoradiological findings on trigeminal neuralgia patients using computed tomography and cone-beam computed tomography

The study aimed to establish and evaluate anatomoradiological landmarks in trigeminal neuralgia patients using computed tomography (CT) and cone-beam CT. CT images of 40 trigeminal neuralgia (TN) and 40 healthy individuals were retrospectively analyzed and enrolled in the study. The width and length of the foramen rotundum (FR), foramen ovale (FO), foramen supraorbitale, and infraorbitale were measured. The distances between these foramen, between these foramen to the median plane, and between the superior orbital fissure, FO, and FR to clinoid processes were also measured bilaterally. Variations were evaluated according to groups. Significant differences were found for width and length of the foramen ovale, length of the foramen supraorbitale, and infraorbitale between TN and control subjects (p < 0.05). On both sides, FO gets narrower and the length of the infraorbital and supraorbital foramen shortens in the TN group. In most of the control patients, the plane which passes through the infraorbital and supraorbital foramen intersects with impression trigeminale; 70% on the right-side, and 67% in the left-side TN groups. This plane does not intersect with impression trigeminale and deviates in certain degrees. The determina-tion of specific landmarks allows customization to individual patient anatomy and may help the surgeon achieve a more selective effect with a variety of percutaneous procedures in trigeminal neuralgia patients

Evaluation of genial tubercle anatomy using cone beam computed tomography

WOS: 000356203400013PubMed ID: 26062865The purpose of this study was to characterize the anatomy of the genial tubercle using cone beam computed tomography (CBCT). The morphology and detailed anatomy of the genial tubercle were assessed retrospectively in 201 patients (101 females, 100 males) using CBCT images. The parameters examined were the height (GH) and width (GW) of the genial tubercle, the distance from the lower incisors to the superior border of the tubercle (I-SGT), the distance from the inferior margin of the tubercle to the inferior margin of the mandible (IGM-IBM), and the anterior mandible thickness (AMT). Statistical analysis was performed to assess relationships among these parameters, gender, and orthodontic malocclusion (P 0.05). However, IGM-IBM was larger for class III than for class I and class II male patients, and larger than for class I female patients. AMT in class III patients was greater than in class I and II patients (P < 0.05). The use of CBCT, which employs less radiation, is important for dental professionals, especially those performing surgery for obstructive sleep apnea (OSA), in order to avoid possible surgical complications

Does ESPB performed at the level of T4 cover axillary area? A cadaveric study

Erector spinae plane block (ESPB) has rapidly become popular following its first description by Forero et al. in 2016 [1,2]. Previous randomized controlled trials demonstrated the efficacy of ESPB for breast cancer surgery [3,4], however, still some issues such as the exact mechanism of action and spread of local anesthetic (LA) remain unclear [2]. In addition, none of the previous cadaveric studies have evaluated the axillary spread following

Is the deep supraspinatus muscle plane block and suprascapular nerve block the same approach? A cadaveric nomenclature study

Interfascial plane blocks have become popular in daily anesthesia practice in the field of acute and chronic pain management [1]. Owing to the use of ultrasound (US), novel plane blocks are increasingly being developed. To reduce controversy regarding the names and properties of these novel blocks, American Society of Regional Anesthesia and Pain Medicine (ASRA)-European Society of Regional Anaesthesia and Pain Therapy (ESRA) consensus published a nomenclature study [2]. Despite this, new descriptions of novel techniques continue to be defined. Kose et al. [3] has proposed that the deep supraspinatus muscle plane block (DSMPB), which involves the administration of local anesthetic (LA) into the plane between the supraspinatus muscles (SMs) and the posterior scapula, is a safer and easier novel technique. Recently, Teles et al. [4] called the DSMPB, a “new old technique” since the block is basically an indirect anatomical landmark-guided suprascapular nerve block (SNB) verified by US. In contrast, Ciftci et al. [5] emphasized the different injection points used for the two blocks, namely, the needle is inserted approximately 2.5 cm away from the suprascapular notch for an SNB, while the insertion point for a DSMPB is 4 cm away and therefore likely to act under the principles of interfacial plane blocks. Given this controversy, we performed a cadaveric study to directly test whether the US-guided DSMPB and landmark-guided (US-verified) SNB would result in a similar anatomical area of coverage

Gluteoperinealis muscle: A surgically important variation

Background Anatomical variations are common in gluteal region. This report presents two cases of gluteoperinealis muscles detected during radiological imaging. Case presentation Our study was conducted on two patients. This report describes an accessory muscle detected in the gluteal region on MRI examination of a patient who admitted to our clinic after a firearm injury and a second patient examined with CT imaging who had signs of pelvic infection. In the first case, this accessory muscle originated bilaterally from the fascia of the gluteus maximus throughout its posteromedial side and was attached to the perineal body. In the second case, it extended forward from the fascia of the gluteus maximus muscle and inserted to the cavernous body of penis on the left side and to the perineal body on the right. In the literature, this accessory muscle has been described as the gluteoperinealis muscle being a rare variation. Conclusion Considering the origin and insertion of the muscle, this variation may be important during the surgical operations of the gluteal and perineal regions