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    Myelomeningoceles and meningoceles: A clinicopathologic study of 43 cases [Miyelomeningosel ve meningosel: 43 olgulu kliniko-patolojik bir çali{dotless}şma]
    (Ege University Press, 2014) Karabagli P.; Gurcan T.; Celik Z.E.; Karabagli H.
    Objective: The purpose of the study both meningocele and myelomeningocele reviewing the clinical and pathological findings as well as to discuss the pathological diagnosis. Material and methods: Meningocel and myelomeningocele were retrived from the pathology files. Forty three cases with detailed clinical and radiological data were selected. Masson's trichrome performed on original sections from paraffin blocks. All sections from each case were reviewed. Results: There were 34 cases of myelomeningocele, 9 cases of meningocele. F/M ratio was 1.2 to 1. The age range of patients were from newborn to 4 months. 90% of cases were in the lumbosacral region. 31 cases of myelomeningoceles, and 3 cases of meningoceles were hydrocephalus. Chiari II malformation was seen in 88% of myelomeningocels and in 22% of meningoceles. Three patients had a clubfoot deformity. Microscopically, epithelial changes included ulceration, loss of appendages. Mesodermal findings included fibrosis (90% of cases), adipose tissue (62%), hypertrophic smooth muscle (18%), skeletal muscle (4%) and increased numbers of blood vessels (79%). Subepidermal calcification was noted in 2 cases. Neuroectodermal features, neuropil-like matrix and ependymal lining were noted in 34 and 15 cases respectively. Nerve fibers were identified varied from easily identifiable large myelinated nerve trunks to slightly increased numbers of fibers in 83% of the cases. Conclusion: Both clinical and pathological differences were seen among myelomeningoceles. These malformations involve ectoderm, neuroectoderm, and mesoderm. Definition of the pathological aspects of dysraphism will potentiate the understanding of these anomalies.
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    A novel nerve transfer: The first palmar interosseous motor branch of the ulnar nerve to the recurrent motor branch of the median nerve
    (Elsevier Ltd, 2020) Ozcelik I.B.; Yildiran G.; Mersa B.; Sutcu M.; Celik Z.E.; Ozalp T.
    Introduction: The recovery of recurrent motor branch of the median nerve might be delayed in high level median nerve injuries due to the long reinnervation distance. The aim of this study is to define a novel nerve transfer to restore the opposition and pinch. Methods: Two fresh frozen hand cadavers were used for the study. The motor branch of the first palmar interosseous muscle of the ulnar nerve was identified and dissected. Thenar branch of the median nerve was dissected from its insertion site. The motor branch of the first palmar interosseous muscle of the ulnar nerve was transferred to the thenar motor branch of the median nerve. Axon counts were examined histopathologically. Clinically this nerve transfer was performed for two female patients with a high-level median nerve injury. Mehta opposition scores were 21 and 20, respectively and the results were satisfactory six months after the surgery. Discussion: Although exploration and repair are recommended as the first treatment for median nerve injuries, the waiting time until the motor branch is reinnervated is critical in high level lesions. Nerve transfers become very important for fast recovery. Conclusions: This new nerve transfer proposal may be an important step in nerve transfer surgery. © 2020