Suitability of foramen magnum measurements in sex determination and their clinical significance

Background: The foramen magnum provides a transition between fossa cranii posterior and canalis vertebralis. Medulla oblongata, arteria vertebralis and nervus accessorius spinal part pass through the foramen magnum. In this study, we aimed to make the morphometric measurements of the foramen magnum on computed tomography (CT) and to determine the feasibility of sex determination based on these measurements. Besides sex determination, from a clinical aspect, it is important to know the measurements of the foramen magnum in the normal population in terms of diseases characterised by displacement of the posterior fossa structures through foramen magnum to upper cervical spinal canal such as Chiari malformations and syringomyelia. Materials and methods: All the data for our study was obtained retrospectively from 100 patients (50 males, 50 females) who had a CT scan of the head and neck region in Adnan Menderes University Hospital, Department of Radiology. To examine the foramen magnum in each and every occipital bone, we measured the foramen magnum’s anteroposterior diameter, transverse diameter, the area of the foramen magnum and its circumference. Results: We found that men have a higher average value than women in our study. According to Student’s t-test results; in all measured parameters, there is significant difference between the genders (p < 0.05). When multivariate discriminant function test is performed for all four measurements, the discrimination rate is 64% for all women, 70% for all men and 67% for both genders. Conclusions: As a result of our study, the metric data we obtained will be useful in cases where the skeletons’ sex could not be determined by any other methods. We believe that, our study may be useful for other studies in determining of sex from foramen magnum. Our measurements could give some information of the normal ranges of the foramen magnum in normal population, so that this can contribute to the diagnosis process of some diseases by imaging. (Folia Morphol 2018; 77, 1: 99–104)  

Whale of a crowd: Quantifying the effectiveness of crowd-sourced serious games

Abstract—In this paper we analyze several Crowd-Sourced Serious Games (CSSGs), a new genre focused on advancing widely respected causes such as social equality and science. We observe that the general effectiveness of these games has remained largely unknown. Existing performance analyses have been limited to documenting experiences with individual systems. More importantly, existing game analytics approaches are designed for games that provide personal experience and entertainment. In contrast, CSSGs attract participants by evoking their sense of social responsibility and sympathy for others. Intuitively, social awareness and sympathy alone may not result in the same level of consistent participation as personal achievement, or fun. Consequently, the success of a CSSG may be more tightly linked to the contributions of few highly-dedicated players (whales)

Whale of a Crowd: Quantifying the Effectiveness of Crowd-Sourced Serious Games

19th International Conference on Computer Games: AI, Animation, InteractiveIn this paper we analyze several Crowd-Sourced Serious Games (CSSGs), a new genre focused on advancing widely respected causes such as social equality and science. We observe that the general effectiveness of these games has remained largely unknown. Existing performance analyses have been limited to documenting experiences with individual systems. More importantly, existing game analytics approaches are designed for games that provide personal experience and entertainment. In contrast, CSSGs attract participants by evoking their sense of social responsibility and sympathy for others. Intuitively, social awareness and sympathy alone may not result in the same level of consistent participation as personal achievement, or fun. Consequently, the success of a CSSG may be more tightly linked to the contributions of few highly-dedicated players (whales)

Prefabrication of a free peripheral nerve graft following implantation on an arteriovenous pedicle

WOS: 000175839800005PubMed: 12022033Extensive nerve injuries frequently necessitate the use of long autografts, and sources of expendable donor nerves are limited. It is for these cases that nerve transplantation would have its greatest potential. However, regeneration in the rejected allograft fails because of a lack of the positive neurotropic and neurotrophic influences physiologically, provided by, viable Schwann cells. This report aims to show the feasibility, of vascularization of the peripheral nerve by, prefabrication. The study, was designed to vascularize an autogenous nerve graft segment by, using an arteriovenous bundle in the rabbit. A 3.5-cm segment of sciatic nerve was harvested and implanted in between the femoral vessels, and was isolated from secondary, revascularization by, a custom-made tube. A peripheral nerve graft was prefabricated by implantation on the vascular pedicle, and neovascularization was evaluated by, microangiography and histology,. The graft exhibited early neovascularization on day 2, and numerous new capillaries were noted to restore primarily perineurial blood flow on day 7, then all along the graft on day, 14. The viability, of the Schwann cells was preserved, and the structural integrity of the graft was maintained. This is a preliminary, report on secondary, vascularization of a segment of an autogenous nerve to maintain the viability of Schwann cells and the integrity of the conduit. In the future, with the concomitant use of host immunosuppression or with more advanced pre-treatment methods, nerve allografts could be revascularized by vascular bundles. The current tempo of medical research will hopefully enable the use of fresh nerve allografts that are rendered less immunogenic by, more refined techniques

Subcutaneous emphysema of the hand caused by the suction drain - A case report

PubMed: 15368154Subcutaneous emphysema of the hand can be related to non-infectious causes and most commonly high-pressure injection injuries. Surgical emphysema of the hand is rare. We report a case of surgical emphysema of the dorsum of the hand following the excision of a dorsal wrist ganglion when the inserted suction drain did not work properly, accompanied by the inadvertent compression of the patient's body. Conservative management was adequate; oedema and emphysema subsided in several days

Efficacy and safety of high dose intramuscular or oral cholecalciferol in vitamin D deficient/insufficient elderly

PubMedID: 22613271Objectives: To evaluate and compare the effects and safety of high dose intramuscular (IM) or oral cholecalciferol on 25-hydroxyvitamin D [25(OH)D] levels, muscle strength and physical performance in vitamin D deficient/insufficient elderly. Study design: Randomized prospective study. Main outcome measures: 116 ambulatory individuals aged 65 years or older living in a nursing home were evaluated. Eligible patients with 25(OH)D levels <30 ng/ml (n = 66) were randomized to IM or Oral groups according to the administration route of 600,000 IU cholecalciferol. Demographic and descriptive data were collected. Biochemical response was measured at baseline, 6th and 12th weeks. Muscle strength was measured from quadriceps by using a hand-held dynamometer and physical performance was evaluated by short physical performance battery (SPPB) at the beginning and 12th week. Results: Among the screened ambulatory elderly only 5.2% (n = 6) had adequate vitamin D levels. 37.1% (n = 43) were vitamin D deficient and 57.7% (n = 67) were insufficient. After administration of one megadose of vitamin D, mean serum 25(OH)D levels increased significantly at 6th week (32.72 ± 9.0 ng/ml) and at 12th week (52.34 ± 14.2 ng/ml) compared with baseline (11.76 ± 7.6 ng/ml) in IM group (p < 0.0001). In Oral group levels were 47.57 ± 12.7 ng/ml, 42.94 ± 13.4 ng/ml and 14.87 ± 6.9 ng/ml, respectively (p < 0.0001). At 12th week the increase in IM group was significantly higher than Oral group (p = 0.003). At the end of the study period, serum 25(OH)D levels were ?30 ng/ml in all patients in IM group and in 83.3% of the patients in the Oral group. Quadriceps muscle strength and SPPB total score increased significantly in both groups and SPPB balance subscale score increased only in IM group. Six patients (9.6%) developed hypercalciuria, no significant adverse events were observed. Conclusion: In vitamin D deficient/insufficient elderly, a single megadose of cholecalciferol increased vitamin D levels significantly and the majority of the patients reached optimal levels. Although both administration routes are effective and appear to be safe, IM application is more effective in increasing 25(OH)D levels and balance performance. © 2012 Elsevier Ireland Ltd. All rights reserved.The study was supported by the Research Fund of the Cukurova University. Project No. TF2009 LTP39

Temporoparietal fascia: An anatomic and histologic reinvestigation with new potential clinical applications

Erdemli, Esra/0000-0002-9737-269X; Tuccar, Eray/0000-0002-1137-1961WOS: 000084513700007PubMed: 10626968Temporoparietal fascia constitutes a very important structural unit from both an aesthetic and a reconstructive surgical point of view. A histologically supported anatomic study was conducted for the reappraisal of the anatomic relationships and clinical application potentials of the data obtained. Anatomy of the temporoparietal fascia was investigated on 20 sides from 10 cadavers. After dissections, necropsies were obtained to demonstrate histologic features of the temporoparietal fascia. The outer part of the temporoparietal fascia is continuous with the superficial musculoaponeurotic system (SMAS) in the inferior border and with orbicularis oculi and frontalis muscles in the anterior border. Therefore, plication of the temporoparietal fascia call increase tightness of the SMAS, orbicularis oculi, and frontalis muscle in rhytidectomy. The frontal branches of facial nerve were noted to course parallel to the frontal branch of the superficial temporal artery, lying deeper to the temporoparietal fascia within the innominate fascia. In the view of these findings, conventional subfascial dissection, which is performed to protect frontal branches of the facial nerve, is not reasonable during the temporal part of rhytidectomy. Careful subcutaneous dissection just under the hair follicles is more appropriate to avoid nerve injury and also provides excellent exposure of the temporoparietal fascia for plication in rhytidectomy with protection of the auriculotemporal nerve and the superficial temporal vessels. Furthermore, two layered structures of the temporoparietal fascia ar-e very suitable to insert a framework into the temporoparietal fascia for ear reconstruction to eliminate some of the shortcomings of Brent's technique. A thin muscle layer was also noted within the outer part of the temporoparietal fascia below the temporal line; the term "temporoparietal myofascial flap" would, therefore, be more accurate than "temporoparietal fascial flap." Finally, the innominate fascia and the deep temporal fascia call be elevated with the two layers of the temporoparietal myofascial flap to obtain a well-vascularized, four-layered myofascial flap based on die superficial temporal vessels. This multilayered flap can be used to reconstruct all defects when fine, pliable, thin, multilayered flaps are required

Ankylosing spondylitis and multiple sclerosis in an HLA-B27 negative patient

WOS: 000227237800006PubMed: 15742608A 41-year-old man presented with vertigo and gait disturbance. He gave a 10-year history of definite ankylosing spodylitis with low back pain, limitation of spinal mobility, decreased chest expansion and radiological evidence of bilateral sacroiliitis. The vertigo attacks started 3 years before and he had insidious evolution of bilateral leg weakness, increased muscle tension and walking disability during the past 2 years. The HLA haplotypes of the patient were A2, A33, B14, B49, Bw4, Bw6, Cw7 and he was HLA-B27 negative. The axial and sagittal cranial magnetic resonance imaging(MRI) showed multiple foci of increased signal intensity in the periventricular white matter and cerebellar hemispheres, suggesting a demyelinating disease process. The MRI of the spine showed centromedullar high intensity lesions at C7,Th7-8, Th 9-10 levels. The diagnosis was definite MS (primary progressive MS) as the patient had insidious neurological progression, CSF evidence of inthrathecal production of oligoclonal bands, conduction defects at VEP multiple brain and additional spinal cord lesions on MRI and continued progression for more than 1 year

Surgical aspects and the outcomes of kidney transplants with multiple renal arteries

Introduction: The effect of multiple arterial anastomosis and different reconstruction techniques on the outcome of renal transplant recipients is not clearly defined. In this retrospective study, we report our experience of living donor kidney transplantation using allografts with multiple renal arteries, regarding the patient and graft survival, as well as surgical complications. Materials and Methods: Patients were divided into two groups according to the arterial anatomy of the renal allograft. While group I consisted of patients with single renal artery grafts, group II included patients with multiple renal artery grafts. Results were compared between single and multiple artery groups and further analyzed between the groups, which were constituted according to vascular reconstruction technique. Results: Forty-five patients (15.7%) had grafts with multiple renal arteries. The mean total ischemia time was longer in multiple renal artery group (90.8±17.3 vs. 71.9±16.6 minutes, p0.001). The mean serum creatinine level at posttransplant one year was significantly higher in multiple artery group than in single renal artery group (1.74±0.45 vs.1.46±44 mg/dl), but it was similar at fifth year. There was no significant difference between the groups with regard to mean systolic blood pressure, the incidence of acute tubular necrosis and acute rejection, vascular and urological complications, graft and patient survival rates. Similar findings were obtained in patients with multiple arteries whose anastomosis were performed with different reconstruction techniques. Conclusion: Our data shows that transplantation of the kidney with multiple arteries is safe. Any reconstruction technique can be chosen according to the vascular anatomy of the graft and the recipient