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Biomedical subjects

Bülent Yalçin

Publications and source records attributed to Bülent Yalçin.

17 recordsLinked to original sources
PubMed2007

Variations of the nutrient artery of the fibula.

In this study the authors aimed to show variations of the nutrient artery of the fibula, which is important for more effective vascularized fibular grafts. Thirty intact legs were examined to determine the number, location, and diameter of the nutrient arteries in the shaft. In 27 of these specimens (90%) there was single nutrient artery; two legs (6.6%) had double nutrient artery. In one leg (3.3%) no nutrient artery was observed. The number of nutrient arteries found on each of the surfaces was summarized as follows. Most of the nutrient arteries pierced the fibula at its medial crest, while only one entered from the posterior surface. Most nutrient arteries were near the middle third of the fibula. The most frequent diameter of the nutrient artery was 0.9-1.5 mm. The authors think that their results about the variations of the nutrient artery supplying the fibula will contribute to the clinical and vascular anatomy knowledge.

Arteries↗
PubMed2006

Divided dose of cisplatin combined with gemcitabine in malignant mesothelioma.

Malignant mesothelioma is a rare but notoriously chemoresistant tumor. An impressive activity of gemcitabine and cisplatin combination in malignant mesothelioma has been shown. However, the hematological toxicity and nephrotoxicity related to this regimen affect the patient's life negatively. The aim of this study is to investigate the efficacy and toxicity of divided dose of cisplatin combined with gemcitabine in chemo-naïve patients with malignant mesothelioma. Twenty-six eligible patients with malignant mesothelioma were enrolled onto the study. Cisplatin 35 mg/m(2) and gemcitabine 800 mg/m(2) were administered on days 1 and 8 as intravenous infusion in a 3-week cycle, up to maximum 6 cycles. Response and toxicity evaluations were performed in 26 patients. Male-female ratio was 11/15 with a mean age of 50.5 years (37-70). Locations of tumor were pleura in 16 patients, and peritoneum in 10 patients. All patients had epitheloid subtype of malignant mesothelioma. The partial response and stable disease were observed in 6 patients (23.1%) and in 13 patients (50%), respectively, with an overall tumor control rate of 73.1%. Seven patients (26.9%) had progressive disease. Median time to disease progression and survival were 4 and 19.5 months, respectively. Grade 3 nausea and vomiting were observed in one patient (3.8%), grade 4 neutropenia developed in one patient (3.8%) and grades 3-4 thrombocytopenia and nephrotoxicity did not develop. There was no treatment related death. Divided dose of cisplatin combined with gemcitabine, at the current dosage and schedule, appears to be an active regimen in chemotherapy-naïve patients with malignant mesothelioma, and well-tolerated.

Adult↗
PubMed2006

Laryngeal branching pattern of the inferior laryngeal nerve, before entering the larynx.

The objective of the present work was to investigate the laryngeal branching pattern of the inferior laryngeal nerve (ILN) in detail before the branches entered the larynx. In 49 specimens 96 sides were examined for this project, including 27 males and 22 female cadavers. In 7 sides (7.3%, 5 on the left and 2 on the right) the ILN passed as a single trunk into the larynx below the inferior constrictor muscle. In 82 sides (85.4%, 40 on the left and 42 on the right) two laryngeal branches originated from the nerve. The nerve divided either just before entering the larynx (58.3%, 24 on the left and 32 on the right) or 15-32 mm below the inferior constrictor muscle (27.1%, 16 on the left and 10 on the right). In 69 sides (71.8%), the anterior and/or posterior laryngeal branches subdivided into one or two sub-branches. The anterior (observed in 49 sides, 51%) and posterior laryngeal branches supplied all intrinsic laryngeal muscles except the cricothyroid muscle and the mucosa below the vocal cords, respectively, while their sub-branches reached the cricopharyngeal part of the inferior constrictor muscle, esophagus and/or the thyroid gland. In 7 sides (7.3%, 4 on the left and 3 on the right) the nerve divided into three laryngeal branches. In conclusion, the branching pattern of the nerve may be important pitfalls of the thyroidal and laryngeal surgery. Owing to this the surgeon should keep in mind the risk of extra laryngeal division of the nerve and not confuse laryngeal and extra laryngeal branches.

Adult↗
PubMed2006

The extensor indicis et medii communis.

The aim of this study was to examine the existence of the extensor indicis et medii communis in detail. Thirty-one randomly selected adult cadavers (62 upper extremities) were examined for this project (22 males and 9 females between the ages 38 and 87). The muscle was observed in 3 of 62 hands, an incidence of 4.8%. One was in the right and the other two were in the left hands. Mean length and width of the muscle belly were 4.5 +/- 0.8 and 0.8 +/- 0.3 mm, respectively. Although the muscle did not have a junctura tendinum attachment between its two tendons, in one hand, the tendon to the index finger gave a thin slip to the tendon of the extensor digitorum communis for the same finger. Knowledge of variant muscle may be important when one is assessing the traumatized or diseased hand.

Adult↗
PubMed2006

Anatomic configurations of the recurrent laryngeal nerve and inferior thyroid artery.

BACKGROUND: Although much attention has been given to the protection of the recurrent laryngeal nerve in thyroid surgery, cases of nerve injury are still reported occasionally in the literature. In the current study I aimed to describe variable relationships between the recurrent laryngeal nerve and inferior thyroid artery, and also document my findings in the form of high-resolution photographs. METHODS: Fifty specimens (100 sides) were examined for this project, including 36 male and 14 female cadavers between the ages of 38 and 87 years at death. RESULTS: A total of 100 sides were investigated, and 100 recurrent laryngeal nerves and 96 inferior thyroid arteries were encountered. I observed a highly variable relationship between the nerve and the artery. According to the location of the main trunk of the nerve and its branches entering to the larynx, I observed 20 types configurations. On the right, the nerve was frequently in front of the artery, and on the left the nerve was often behind the 2 branches of the artery. CONCLUSION: The relationship of the recurrent laryngeal nerve to the inferior thyroid artery is highly variable. Achieving a safe and effective operation on the thyroid gland is the goal of all surgeons. I imagine that to avoid any injury to the nerve in thyroid surgery demands a thorough knowledge of all types of relationships between them.

Adult↗
PubMed2006

Critical course of the anterior laryngeal branch of the inferior laryngeal nerve.

BACKGROUND: Although in the past few authors stated that the nerve penetrated the ligament of Berry, many new authors have not confirmed this assertion. Because of the clinical importance and indefiniteness of this subject, we aimed to present an anatomical study concerning the course of the inferior laryngeal nerve. METHOD: In 60 specimens, 102 sides were examined for this project, including 41 male and 19 female cadavers between the ages of 40 and 89 years at death. RESULTS: In two sides (one on the right and the other on the left), we found that the anterior (motor) laryngeal branch of the inferior laryngeal nerve penetrated the ligament unilaterally. The branch entered the ligament 5.6, 7.2 mm above its lower border and 3.3, 1.9 mm below its upper border. Distances from the entrance point of the branch to the trachea and thyroid were 9.5, 8.2 mm and 3.1, 2.2 mm, respectively. CONCLUSION: We found two anterior laryngeal branches penetrating the ligament of Berry. This subject is very important during the thyroid surgery, particularly during the division of the ligament for total lobectomy.

Adult↗
PubMed2006

Alpha fetoprotein producing gastric hepatoid adenocarcinoma.

Gastric carcinoma generally as presents adenocarcinoma and rarely shows a hepatoid pattern, it may or not produce alpha-fetoprotein. The interpretation of the lesion may be difficult in a patient with a hepatic mass and raised alpha-fetoprotein level. A 51 year old man with hepatoid adenocarcinoma in stomach, producing alpha-fetoprotein is presented.

Adenocarcinoma↗
PubMed2005

Detailed investigation of the relationship between the inferior laryngeal nerve including laryngeal branches and ligament of Berry.

BACKGROUND: Studies about the anatomic relationship between the inferior laryngeal nerve (ILN) and the ligament of Berry are insufficient, despite controversy in the literature. In addition, the relationship between the laryngeal branches of the ILN and the ligament of Berry has not been investigated. STUDY DESIGN: Sixty specimens (120 sides) were examined for this study, including 41 male and 19 female cadavers between the ages of 40 and 89 years at death. RESULTS: The nerve trunk or its anterior and posterior laryngeal branches run posterolateral to the ligament in 51 and 39 sides, respectively. The nerve trunk or both its laryngeal branches passed posteromedial to the ligament in 12 and 7 sides, respectively. In seven sides, the anterior branch of the ILN was located posterolateral and the posterior branch was posteromedial to the ligament. In three sides, the anterior (motor) branch of the ILN penetrated the ligament of Berry. In one right side, a nonrecurrent laryngeal nerve arose from the vagal nerve at the level of ligament of Berry. The nerve divided into the anterior and posterior laryngeal branches just above posterior surface of the ligament; both branches extended parallel to it. CONCLUSIONS: We have shown that the nerve was located not only posterolateral to the ligament but also posteromedial to it. Additionally, unlike other authors, we have shown that the anterior (motor) branch of the recurrent laryngeal nerve penetrated the ligament of Berry in 2.5% of 60 specimens.

Adult↗
PubMed2005

Insertional pattern of the inferior oblique muscle.

PURPOSE: We aimed to define the anatomy and anatomic variations of the inferior oblique muscle (IO) and classify its insertional pattern with photographs and drawings. DESIGN: Cohort study. METHODS: This study included 60 intact orbits of 30 (17 male and 13 female) embalmed adult cadavers. The inferior oblique muscle was dissected microanatomically from the origin to the insertion by using a dissection microscope. For each specimen, we photographed the insertional pattern of the muscle. A Vernier caliper was used to measure the width and length of the muscle at the insertion and from the division to the insertion, respectively. RESULTS: We classified the inferior oblique muscle into four groups according to the insertional pattern. In the first group, the muscle was formed of only one belly ("single," five eyes, 8.3%). In the second group, the muscle had a main and a secondary belly ("double," 30 eyes, 50%). In the third group, the muscle had three bellies ("triple," 16 eyes, 26.6%). In the fourth group, the muscle had more than three bellies ("multiple," 9 eyes, 15%). CONCLUSIONS: We found double, triple, and multiple muscle bellies in 91.7% of 60 cadaveric eyes. Ocular surgeons who do not frequently perform inferior oblique surgery should carefully examine the inferior temporal quadrant of the sclera to avoid missing portions of the inferior oblique muscle at the time of surgery.

Adult↗
PubMed2005

Vascular anatomy of normal and undescended testes: surgical assessment of anastomotic channels between testicular and deferential arteries.

OBJECTIVES: To demonstrate the vascular anatomy of the normal and undescended testes, emphasizing the surgical importance of the anastomotic channels between the testicular and deferential arteries in the undescended testis. METHODS: This study was performed on four normal testes obtained from adult cadavers and the undescended testes taken from men undergoing unilateral orchiectomy. To show the arteries and their connections, we used the injection-corrosion casting technique. RESULTS: The normal and undescended testes measured 36.3 +/- 9.2 mm x 21.2 +/- 4.3 mm x 14.3 +/- 5.4 mm and 19 x 16 x 9 mm, respectively. The testis and epididymis had an unusual shape in the undescended testes. The undescended testes were round, with a semilunar epididymis that was over the testis. All the testes, including the undescended testes, had testicular, deferential, and cremasteric arteries. The testicular, deferential, and cremasteric arterial diameter was 1.7 +/- 0.4, 1.1 +/- 0.3, and 0.5 +/- 0.3 mm in the normal testes and 1.5, 0.7, and 0.6 mm in the undescended testes, respectively. Communication among the three arteries was illustrated consistently by retrograde filling of the two noninjected arteries. Clearly visible anastomotic channels were present between the testicular and deferential arteries in the normal and undescended testes. CONCLUSIONS: We suggest that the original Fowler and Stephans concept (high ligation of the testicular artery) is valid to preserve vascularity to the testis when vascular transection orchiopexy is performed, although the number of our specimens was not enough to prove this definitively.

Adult↗
PubMed2005

Some variations of the musculus flexor digitorum brevis.

The aim of the present study was to investigate variations of the musculus flexor digitorum brevis. We examined 33 feet in total from 15 embalmed adult cadavers and three lower extremities. Of the 33 feet examined, 18 differed from the classical description given in anatomical textbooks. The muscle belly for the fifth toe was much smaller than the others in 12 feet and was missing in six feet. Two cases had extreme variations. In the left foot of one female cadaver, the flexor digitorum brevis was formed by a superficial and deep head, which had three muscle bellies and four tendons. In the right foot, a separated muscle belly for the fifth toe was very thin and originated from the intermuscular septum as a flat fascia under the flexor digitorum brevis. In another case (male), three heads (lateral, intermediate and medial) formed the quadratus plantae and the lateral and intermediate heads fused with the flexor digitorum brevis. Variation of the flexor digitorum brevis may be important clinically because of reconstruction of the heel pad by flexor digitorum brevis musculocutanous flap transfer.

Cadaver↗
PubMed2004

Muscular bridge between the inferior oblique and inferior rectus muscles.

PURPOSE: In this study, we aimed to investigate the muscular bridge between the inferior oblique (IO) and inferior rectus (IR) muscles of the eye. DESIGN: Cohort study. METHODS: The orbits of sixty intact cadavers with no history of eye muscle or orbital disorders during life were carefully dissected to expose the muscular bridge between the IO and IR muscles. Numbers of the bridges, their length and width were recorded. RESULTS: We observed muscular bridge between IO and IR muscles in 6.6% of 60 orbits. They originated from the lateral side of the IR muscle, and joined to posteromedial side of the IO muscle. Mean length and width were 14.2 +/- 6.3 and 1.3 +/- 0.2 mm, respectively. CONCLUSIONS: Muscular bridges were found in 6.6% of orbits dissected. We conclude that muscular bridges are important due to potential cause of failed IO or IR muscles surgery. In this respect, before surgery of the extraocular muscles, the muscular bridges should be kept in mind and demonstrated by computed tomography or magnetic resonance imaging in transverse, sagittal, and coronal planes.

Adult↗
PubMedDate not supplied

Overdose of lomustine: report of two cases.

Two male patients with high-grade gliomas were treated with subtotal or total resection and radiotherapy followed by a lomustine-containing chemotherapy regimen. Both patients took lomustine at an oral dose of 800 mg over five days instead of their regular doses of 200 and 240 mg. Grade 4 neutropenia and thrombocytopenia developed in both patients within two weeks of the last lomustine dose. One of them was admitted to hospital because of febrile neutropenia. Neutropenia and thrombocytopenia were detected in the other patient when he was examined in the emergency room following a generalized convulsion. Both patients recovered from the severe myelosuppression caused by lomustine. No other organ toxicities were observed.

Adult↗