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Öğe Correlation between developmental stages of the human heart and gestational ages(SAUDI MED J, 2005) Uysal, II; Karabulut, AK; Salbacak, A; Buyukmumcu, M; Seker, MObjectives: In this study we aimed to investigate the normal developmental pattern of the human fetal heart in second and third trimester, and to evaluate the correlation of the values with the gestational age (GA). Methods: Seventy spontaneously aborted human fetuses with no external malformations were investigated and 11 parameters from each were assessed. The relationship of these parameters with the GA was evaluated by linear regression and correlation analyses using statistical methods. In addition, the values were compared to the gender and sides of the heart using Student t-test. This study was performed at the Department of Anatomy, Meram Medical Faculty, Selcuk University, Konya, Turkey, during the period from 2000 to 2004. Results: There was a statistically significant linear relationship between the heart wall thicknesses, the development of the valves of the heart and GA. The mean values of the right side of the heart were found to be higher than those of the left side, and differences were statistically significant (p < 0.05). Although, most of the parameters were found to be higher in females, only 2 of them were statistically significant. All parameters of the cardiac valves measured were significantly higher in the second trimester. There was no difference regarding the correlation ratio of the trimesters between the pulmonary valve diameter and GA. The measurement of the cardiac valves did not show any differences regarding the gender. Conclusion: This study presents the normal values of the development of the fetal heart in second and third trimester that may provide useful background information for clinical approaches.Öğe Distal femur morphometry: a gender and bilateral comparative study using magnetic resonance imaging(SPRINGER FRANCE, 2005) Murshed, KA; Cicekcibasi, AE; Karabacakoglu, A; Seker, M; Ziylan, TAmong the anthropometric factors to be considered, anatomic differences in the distal femur and intercondylar notch have been implicated as a cause of the different rates of anterior cruciate ligament (ACL) rupture between men and women; therefore, in this study our aim was to evaluate a number of morphometric measurements in the distal part of the femur. Two hundred knee MRI examinations were analyzed: 56 male right, 44 male left, 42 female right and 58 female left. Measurements of the intercondylar height (ICH), intercondylar width (ICW), medial condylar width (MCW), lateral condylar width (LCW) and epicondylar width (EW) were obtained. The notch shape index (NSI) was also calculated. Statistical analysis for comparisons was done by Students t-test. Correlations between the parameters studied were calculated by Pearson correlation coefficients. Significant bilateral differences were not found (p > 0.05). In all measurements, males showed significantly greater values than females (p < 0.001). No difference was seen in the NSI between males and females (p > 0.05). Conversely a significant association was obtained between age and all parameters. We conclude that the results of this study may be useful for anatomic evaluation of the distal femur region prior to orthopaedic operations.Öğe An ectopic parathyroid gland in the left axillary region: Case report(INT COLLEGE OF SURGEONS, 2004) Sahin, M; Er, C; Unlu, Y; Tekin, S; Seker, MThis is a review of ectopic localizations of the parathyroid gland in one case. A hard mobile mass (2 X 2.5 cm) was detected on the right side of the neck of a patient who had previously been given a diagnosis of hyperparathyroidism. Computed tomography showed an adenoma (25 X 35 mm) in the paratracheal region on the right side of the neck. Scintigraphy revealed an activity increase on the right side of the neck and in the left axillary region. Blood measurements were as follows: Ca, 12.7 mEq/l; parathyroid hormone (PTH), 235 U/l; and alkaline phosphatase (ALP), 776 U/l. The patient was operated on to remove the lesions located in the cervical and left axillary regions. Histopathological examination revealed that the lesion in the right cervical region was a parathyroid adenoma, whereas the lesion in the left axillary region was normal parathyroid gland tissue. Parathyroid glands may indicate ectopic locations in very different regions. We think the case presented here is the first case with this axillary location. Scintigraphy, alone or combined with other methods, may be used to determine ectopic localizations.Öğe Investigation of the bifurcation level of the common carotid artery and variations of the branches of the external carotid artery in human fetuses(ELSEVIER GMBH, URBAN & FISCHER VERLAG, 2005) Zumre, O; Salbacak, A; Cicekcibasi, AE; Tuncer, I; Seker, MVariations in the position of the bifurcation of the common carotid artery (CCA) and the origin or branching pattern of the external. carotid artery (ECA) are well known and documented. In this study, the bifurcation levels of the CCA and origin variations of the branches of the ECA have been extensively investigated in human fetuses. Bilaterally, 40 carotid bifurcations and 40 ECA and their branches have been examined. A latex solution, which had been diluted with water at a ratio of 25% and colored with red India ink, was injected into the aortic arch. Fetuses were kept at room temperature for 24 h before the ECA and its branches were dissected under the microsurgery microscope. Cases of variation were determined and photographed. The bifurcation level of the CCA was determined to be 55% at the C-3 level, 35% at the C-4 level., 10% at the C-5 level on the right side and 60% at the C-3 Level., 40% at the C-4 level on left side. The distribution of the ECA trunks was determined as follows: A linguofacial trunk was present in 20% of the cases, a thyrolingual trunk in 2.5%, a thyrolinguofacial trunk in 2.5% and an occipitoauricular trunk in 12.5%. Beyond this the ascending pharyngeal artery (APA) was observed in one fetus to originate from the internal carotid artery (ICA). Knowledge of variations in the origin and course of the ECA and its branches is of great importance in surgery and radiological examinations. (c) 2005 Elsevier GmbH. All rights reserved.Öğe An investigation of the origin, location and variations of the renal arteries in human fetuses and their clinical relevance(URBAN & FISCHER VERLAG, 2005) Cicekcibasi, AE; Ziylan, T; Salbacak, A; Seker, M; Buyukmumcu, M; Tuncer, IWe investigated the origin, localizations and anatomic variations of the renal artery (RA) in human fetuses with the aim of determining the distribution of these variations according to lateralization and gender. In total, 90 fetuses of spontaneous abortion (45 mates, 45 females) with no congenital malformations were included to the study. The abdominal aorta and its branches were dissected after latex solution colored with red ink had been injected into the vessels from the thoracic aorta. In all., 180 RA dissections were performed bilaterally in 90 cases and the anatomic variations were photographed. Right and left RAs were found to originate from the following levels according to the columna vertebratis, respectively: 3.8% and 1.9% tower T-12, 67.3% and 25.0% upper L-1, 9.6% and 28.8% mid L-1, 15.3% and 40.3 lower L-1, 3.8% and 3.8% upper 1/3 part of L-2 vertebra. The right RA originated from the lateral part and anterolateral wall of the abdominal aorta in 73.0% and 26.9% of cases white the lateral. and anterolateral watt origin percentages of left RA were 90.3% and 9.6%, respectively. The origin site of the right RA from the abdominal aorta was superior to, at the same level with, and inferior to that of the left RA in 53.8%, 34.6% and 11.5% of the cases, respectively. There were no variations in 75% of the cases whereas the remaining 25% had several variation patterns. The presented morphological results are as follows: A single hilar artery in 75% of the cases, double hilar arteries in 11.1%, an inferior polar artery in 10.5%, and a superior polar artery in 3.3% of specimens studied. Anatomical variations were observed more frequently among mate fetuses and on the right side. Knowledge of RA variations is important for surgeons in performing many procedures and may help to avoid clinical. complications, especially, during radiological examination and/or surgical approaches in the abdominal. region. (c) 2005 Elsevier GmbH. All rights reserved.Öğe Klippel-Feil syndrome associated with persistent trigeminal artery(LIPPINCOTT WILLIAMS & WILKINS, 2004) Paksoy, Y; Seker, M; Kalkan, EStudy Design. In the present report, radiologic findings of the patient with the Klippel-Feil syndrome associated with persistent trigeminal artery are reviewed. In same case, there was also spina bifida occulta, cervical spondylosis, atlanto-occipital assimilation, bilateral cervical ribs, and lack of flow signal in the C4 segment of contralateral vertebral artery. The persistent trigeminal artery and Klippel-Feil syndrome can be seen together and with the other anomalies. It should be considered that they might be related with the insufficiency or dysfunction of the embryologic developmental process. Objectives. To draw attention to this rare presentation of Klippel-Feil syndrome associated with persistent trigeminal artery. Summary of Background Data. Klippel-Feil syndrome is a congenital spinal malformation characterized by the failure in segmentation of 2 or more cervical vertebrae. Although the anomaly is defined by its skeletal component, Klippel-Feil Syndrome may also be associated with developmental defects in many other organ systems including the inner ear, spinal cord, heart, and genitourinary tract. The primitive trigeminal, otic, hypoglossal, and proatlantal intersegmental arteries are persistent fetal anastomoses between the carotid and vertebrobasilar circulations. The authors report the association of a persistent trigeminal artery with the Klippel-Feil syndrome. Methods. Radiologic findings of a case of Klippel-Feil syndrome associated with persistent trigeminal artery are described. Results. There was vertebral fusion, spina bifida occulta, bilateral cervical ribs, atlanto-occipital assimilation, and cervical spondylosis. Magnetic resonance angiography showed the persistent trigeminal artery between the left internal carotid and basilar artery, but there was no sign of flow in the C4 segment of right vertebral artery. Conclusions. It should be kept in mind that a persistent trigeminal artery and Klippel-Feil syndrome can be seen together and with the other anomalies. Because of this reason, this type of case should prompt a search for the other related anomalies, and magnetic resonance angiography can be used as a noninvasive diagnostic technique in the persistent trigeminal artery determination.Öğe Maxillary-to-petrous Internal Carotid Artery Bypass: an Anatomical Feasibility Study(SPRINGER-VERLAG, 2003) Büyükmumcu, Mustafa; Üstün, ME; Seker, M; Karabulut, Ahmet Kağan; Uysal, YYThe possibility for maxillary artery (MA) to petrous internal carotid artery (ICA) bypass was investigated. Five adult cadavers were dissected bilaterally. After zygomatic arch osteotomy, the coronoid process was sectioned at its base. An extensive infratemporal craniotomy was performed at the level of foramina ovale, rotundum and spinosum. The petrous portion of the ICA was exposed by drilling away the floor of the middle fossa, posterior to the foramen ovale and medial to the foramen spinosum. The MA was identified medial to the infratemporal crest and was followed in the pterygopalatine fossa, then transected at the origin of the infraorbital artery. The MA graft was brought posteromedially to reach the petrous ICA. The mean caliber of the MA before the origin of the infraorbital artery was 2.54 +/- 0.31 mm, 2.76 +/- 0.14 mm at the site of anastomosis, and 3.46 +/- 0.32 mm after giving off the middle meningeal artery. The average length of the MA between the middle meningeal artery and the infraorbital artery was 43.4 +/- 2.35 mm, and up to the site of anastomosis was 37.64 +/- 1.68 mm. We conclude that the length and diameter of the MA are sufficient for a tension-free anastomosis between MA and petrous ICA, and such a procedure could be used in the treatment of patients with tumors of the infratemporal fossa invading the high cervical ICA.Öğe A morphometric study and variations on the lumbar arteries of human fetuses(ELSEVIER GMBH, 2005) Seker, M; Cicekcibasi, AE; Salbacak, A; Buyukmumcu, MLumbar arteries are in series with the posterior intercostal. arteries. The aim of this study has been to investigate the morphometric data on the abdominal aorta of the human fetus and define different types of origin variations of the Lumbar artery. Initially, the latex solution colored with red ink was injected into the thoracic aorta. The abdominal. aorta and its branches were dissected and examined bilaterally in 120 fetuses (ranging between 16 and 32 post-menstrual. weeks) and the anatomic variations recorded. Fourteen fetuses with variations were studied and photographed. The origins and morphologic variations of the lumbar arteries were defined and classified. The morphological. relationship of the Lumbar arteries to the abdominal. aorta and the Length and width (diameter) of the vessels were investigated by performing measurements using a digital calliper (mm). The frequency and the types of the different variations determined in the present study have been Listed. Abdominal aortic branches and lumbar artery aneurysms are rare lesions with potentially life-threatening consequences and they are difficult to access anatomically and formidable to manage operatively. During the performance of conventional or open surgical. replacement of an abdominal aortic aneurysm with prosthetic grafts, the surgeon needs precise knowledge of the anatomy of the abdominal. aortic branches and immediate retroperitoneal. structures. The variations on the lumbar arteries may have clinical importance. When this region is under diagnostic and/or surgical investigation using computed tomography scan or diagnostic angiography, the possibility of these variations should be take into consideration to avoid complications. (c) 2005 Elsevier GmbH. All rights reserved.Öğe Possibility of middle meningeal artery-to-petrous internal carotid artery bypass: An anatomic study(THIEME MEDICAL PUBL INC, 2004) Ustun, ME; Buyukmumcu, M; Seker, M; Karabulut, AK; Uysal, II; Ziylan, TThe possibility of creating a middle meningeal. artery (MMA)-to-petrous internal carotid artery (ICA) bypass was investigated in si cadavers (bilaterally). Such a procedure could be used to treat patients with high cervical vascular lesions and those with tumors of the infratemporal fossa invading the high cervical ICA. After a frontotemporal craniotomy, the foramen spinosum and foramen ovale were exposed extradurally. Immediately posterior to the foramen ovale and medial to the foramen spinosum, the petrous portion of the ICA was exposed with a diamond-tipped drill. The MMA was lifted from its groove, and a sufficient length was transected to perform a bypass with the petrous ICA medially. The mean width of the MMA at the site of anastomosis was 2.3 +/- 0.35 mm. The mean length of MMA from the foramen spinosum to the site of the anastomosis was 9.6 +/- 1.7 mm. Based on these measurements, width and length of MMA appear to be sufficient for a bypass with petrous ICA.Öğe Proximal superficial temporal artery to proximal middle cerebral artery bypass using a radial artery graft: an anatomic approach(SPRINGER, 2004) Buyukmumcu, M; Guney, O; Ustun, ME; Uysal, IK; Seker, MWe present the use of radial artery graft for bypass of the proximal superficial temporal artery to the proximal middle cerebral artery. Six adult cadaver sites were used bilaterally. After apterional incision, 2x2-cm minicraniectomy was performed which began 2 cm behind the zygomatic process of the frontal bone. The superficial temporal artery was transsected before exposing the zygomatico-orbital artery branch. The proximal side of the radial artery graft was anastomosed end-to-end to the proximal superficial temporal artery and the distal side end-to-side to the proximal middle cerebral artery. The mean calibers of the proximal superficial temporal artery and largest trunk of the middle cerebral artery were 2.25+/-0.35 mm and 2.3+/-0.3 mm, respectively. The average graft length was 85+/-5.5 mm. We conclude that such bypasses are simpler than proximal middle cerebral artery revascularization using long vein grafts. This method proves that the caliber of the proximal superficial temporal artery is more suited to providing sufficient flow than the distal superficial temporal artery, and the graft is short. Such bypasses to the middle cerebral artery may be an alternative to those from the distal superficial temporal artery or extracranial carotid artery.Öğe A rare variation of the coeliac trunk(URBAN & FISCHER VERLAG, 2005) Cicekcibasi, AE; Uysal, II; Seker, M; Tuncer, I; Buyukmumcu, M; Salbacak, AThe hepatic, splenic and left gastric arteries are considered as the "main classic branches" of the coeliac trunk. During the routine dissections in the laboratory of the Anatomy Department in a 62-year-old mate cadaver, a rare variation, a coeliacomesenteric trunk was observed. This trunk gave rise to the left gastric, the common hepatic, the splenic, the left gastro-epiploic, the right and Left inferior phrenic arteries. The developmental and clinical significance of this anomalous vessel is discussed. (c) 2005 Elsevier GmbH. All rights reserved.
