Some structures of the human body still remain controversial or incompletely described.
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Brachial Plexus↗
Biomedical subjects
H Ozan
Publications and source records attributed to H Ozan.
Double superior vena cava.
Duplication of superior vena cava (SVC) is a rare anomaly. The incidence of double SVC in general population is 0.3% whereas in patients with congenital heart disease it varies between 10-11%. Double SVC cases have clinical importance if especially the one on the left side drains into the left atrium. Moreover, double SVC is surgically important in the presence of congenital heart disease. In this article, we presented adult patients who incidentally diagnosed with double SVC, one drained into the right atrium while the other into the left atrium and discussed the embryologic basis of these patent vessels.
Adult↗
Results of cisplatin, adriamycin and etoposide chemotherapy in patients with recurrent and metastatic endometrial cancer.
The efficacy of the combination treatment of cisplatin, adriamycin and etoposide were retrospectively evaluated in 26 recurrent or metastatic endometrial cancer patients. One hundred and twenty-three treatment courses were observed. Patients received 20 mg/m2 cisplatin and 80 mg/m2 etoposide by continuous i.v. infusion for three days and adriamycin 40 mg/m2 i.v. the second day. Treatment courses were repeated every four weeks. Megestrol acetate, 160 mg/day, was added in six patients who had positive progesterone receptors. Ten (38.5%) women had complete and three (11.5%) patients had partial response with an overall response rate of 50%. Median follow-up was 24 months. Surviving patients were alive for four months and six years. Toxicity was mainly hematological and gastrointestinal ulcerations and stomatitis were also observed.
Adult↗
Accessory suprarenal gland: report of a case.
The suprarenal glands are normally located at the superomedial aspect of the kidneys. Accessory cortical masses are seen in approximately half of the newborn but usually disappear later. Several cases with accessory cortical tissues located near the main suprarenal glands have been reported but their usual locations have been rarely described. Here we report a case with accessory cortical tissue located on the right in the retrocrural space with compression symptoms. Such a lesion may be confused with lymphadenopathy radiologically.
Adrenal Cortex↗
Misoprostol in labor induction.
The efficacy of a new dosing regimen of misoprostol, a recently introduced labor-inducing agent, was studied. Fifty-eight patients received 50 microg of misoprostol intravaginally and the dose was repeated every 3 hours until uterine contractions begin. Those who had an adequate contraction pattern, defined as three contractions in 10 minutes, were not given the repeat dose. Oxytocin augmentation, but not further misoprostol doses, was used in patients with an inadequate contraction pattern. The maximum total daily dose was 200 microg. The patients had the mean age of 28.9 +/- 5.4, the mean gestational age of 211.8 +/- 46.6 days, the mean gravidity of 2.5 +/- 1.2, the mean parity of 0.9 +/- 0.9 and the mean initial Bishop score of 1.6 +/- 1.8. The mean required dose of misoprostol was 120.5 +/- 54.7 microg and 10 of 58 patients required oxytocin augmentation. The mean induction of labor to delivery time was 701.5 +/- 404.0 minutes. When 3 cases who gave birth with caesarean section were excluded, the interval was 708.4 +/- 407.2 minutes. The mean 5th minute Apgar score of the newborns was 8.2 +/- 2.5. Two patients developed tachysystole after the second dose of misoprostol and were managed with vaginal irrigation and O2 supplementation successfully. Slight nausea and vomiting in 2 patients were the other adverse reactions. Our findings revealed that, 50 microg intravaginal misoprostol, combined with oxytocin augmentation when necessary, appears to be an effective and safe method of labor induction.
Administration, Intravaginal↗
Effect of prechemotherapy filgrastim on the bone marrow toxicity of topotecan.
PURPOSE: To investigate the efficacy and safety of single-dose filgrastim administered 24 hours prior to chemotherapy in the prevention of topotecan-related myeloid suppression. METHODS: No medication was given to 21 rats in group 1; 1.5 mg/m2/day topotecan was administered intraperitoneally for five days every three weeks to 21 rats in group II; a single dose of 5 microg/kg filgrastim was injected intraperitoneally 24 hours before the intraperitoneal administration of the same dose of topotecan to 21 rats in group III. After completion of six cycles of chemotherapy. the rats were decapitated and blood samples were immediately collected into citrated tubes for complete blood counts. RESULTS: White blood cell and lymphocyte counts in the control and the filgrastim + topotecan groups were similar (p > 0.05) and significantly higher than the counts in the topotecan group (p < 0.05). There was no difference in means of neutrophil, monocyte, eosinophil, basophil and erythrocyte counts among the groups (p > 0.05). CONCLUSION: Filgrastim administration prior to chemotherapy seems to be beneficial and further investigations are needed.
Animals↗
Misoprostol in uterine atony: a report of 2 cases.
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Adolescent↗
Adjunctive use of the uterine artery resistance index in the preoperative prediction of myometrial invasion in endometrial carcinoma.
OBJECTIVE: The aim of this study was to evaluate the value of transvaginal ultrasonography (TVUS) and uterine artery flow velocimetry indices in the preoperative detection of deep myometrial invasion in endometrial carcinoma (EC). METHODS: Thirty-nine patients with EC underwent TVUS and Doppler flow velocimetry studies, during which endometrial, myometrial, and uterine measurements, presence and depth of myometrial invasion, and pulsatility and resistance indices (PI and RI, respectively) of uterine arteries were noted. TVUS and Doppler findings were correlated with pathological findings obtained by surgical staging. The respective diagnostic accuracies of these variables, and of age and grade, in detecting deep myometrial invasion were assessed with the use of histological findings as the standard. RESULTS: All patients with Grade 3 tumors had deep myometrial invasion, compared to 19% of patients with Grade 1 tumors. The mean age of patients with deep invasion was significantly higher, and their mean PI and RI were significantly lower, than patients with lesser degrees of invasion. While the sensitivity and specificity of TVUS in detecting deep invasion were 37 and 90%, respectively, the corresponding figures for age, grade, and uterine artery RI, found to be independent discriminators of deep invasion, were in the range of 58-84% and 60-70%. The combined use of the latter three parameters resulted in a sensitivity of 100% and specificity of 95%. CONCLUSIONS: Our findings indicate that TVUS is unreliable in diagnosing deep myometrial invasion. Detection rates of this pathological feature can be greatly improved, however, with the concomitant use of age, tumor grade, and uterine artery RI.
Adult↗
The neurovascular and muscular anomalies of the gluteal region: an atypical pudendal nerve.
In two cases, one male and one female, muscular anomalies together with neurovascular variations were encountered in the gluteal regions, in each cadaver on the same side. In the male cadaver, there was a double piriformis muscle and high division of the sciatic nerve. In the female cadaver, in addition to these anomalies, the superior and inferior gemelli and obturator internus muscles, and the internal pudendal vessels and pudendal nerve passed behind the sacrotuberous ligament. Although duplication of the piriformis and high division of the sciatic nerve have been reported previously, to the best of our knowledge the other anomalies have not yet been reported. The abnormal relationship of the internal pudendal vessels and the pudendal nerve with the sacrotuberal ligament, as in our case, may cause venous congestion, arterial obstruction, dysfunction of penile erection and perineal neuralgia. These anomalies of the gluteal region are not only of academic interest, but may be of practical importance for surgical intervention in the area.
Adult↗
Double gluteus maximus muscle with associated variations in the gluteal region.
We report bilateral muscular and neurovascular anomalies of the gluteal region in a cadaver. On the right side, the gluteus maximus muscle had two parts, one of which was fibrous and the other muscular. In addition, there were duplicated piriformis muscles and high division of the sciatic nerve. The common peroneal nerve passed between the two parts of the piriformis muscle, and the tibial nerve emerged from under the lower piriformis muscle (infrapiriform foramen). At the same time the internal pudendal vessels and pudendal nerve passed over the sacrotuberous ligament on the left side. The double piriformis muscles and high division of the nerve are known as an anomaly which is believed to cause a nerve compression syndrome called the syndrome of the piriformis muscle. To the best of our knowledge anomalies of the gluteus maximus muscle and pudendal structures have not yet been reported. This complex anomaly should be kept in mind in connection with intramuscular injections of the gluteal region, the piriformis syndrome, and the surgery of this region.
Adult↗
An unusual variation of the superficial ulnar artery.
Anomalous superficial ulnar arteries were found bilaterally during routine dissection of the upper limbs of a 60-year-old male cadaver. In the left arm, the superficial ulnar artery originated from the axillary artery. It crossed the median nerve anteriorly and ran anteromedial to this nerve and the brachial artery. The superficial ulnar artery was also rudimentary and gave rise to only a narrow muscular branch to the biceps brachii. In the hand, it anastomosed with the radial artery, completing the superficial palmar arch. The radial artery was larger than usual and the deep palmar arch was formed only by the radial artery. In the right arm, the superficial ulnar artery originated from the brachial artery at the level of the inter-epicondylar line. Additionally there were "inverse palmaris longus muscles" bilaterally. This was a rare case in which the superficially ulnar artery originated from a different source on each side accompanied by anomalies of the palmar arches on one side.
Arm↗
Determination of sex from the tibia of adult Turkish cadavers.
The aim of this research is to determine sex from the tibia. The tibia is an ideal bone because it resists erosive forces and keeps its anatomical shape for a long time even after being buried. Additionally, we tried to obtain a higher discrimination rate by using the biarticular breadth that was accepted as the most valid criterion in previous sex discrimination studies which were directed to the proximal part of the tibia. Right and left tibiae from 55 randomly selected adult Turkish cadavers (25 to 68 years) were measured to the nearest millimeter performed with a caliper; a total of six dimensions, one from the proximal and five from the distal ends, was measured. Canonical discriminant function test was performed to develop formulae and assess the accuracy of the technique. The results indicated that classification accuracy ranged from 89% in the right and 87% in the left for biarticular breadth. There was a minimal difference between the sides and the height of the medial malleolus. In conclusion, the distal and proximal dimensions of the tibia are highly discriminative as the sexual dimorphs in this Turkish sample. The study compares well with those on blacks and whites of North America and South Africa.
Adult↗
Anomalous insertional slip of latissimus dorsi muscle: arcus axillaris.
An anomalous muscular slip arising from the latissimus dorsi m. was encountered on the right side of a male cadaver during a dissection in our laboratory. The slip left the muscular part of the latissimus dorsi 8 cm distal to its insertion, coursed superolaterally anterior to the neurovascular structures and was inserted into the coracobrachialis fascia. The morphology of the additional slip and its possible clinical implications are discussed.
Aged↗
Left gastric artery originating directly from the aorta.
During the dissection of a 48-year-old male cadaver, the left gastric artery was observed directly originating from the abdominal aorta. An unusual embryologic development of the ventral splanchnic arteries may lead to considerable variations. The rare occurrence of this variation is stated to be 0.5%-15%. This case of the left gastric artery is described in detail, especially its point of emergence which may be important in operative procedures on the supracolic organs, in stomach resection, and during dissection of lymph nodes along this artery in gastric cancer.
Aorta, Abdominal↗
An unusual course of the right renal artery associated with an anomalous inferior vena cava.
In a 55-year-old male cadaver, the inferior vena cava bifurcated at a level midway between the hilus and inferior pole of the right kidney. The narrower branch, on the right side, drained the right renal and hepatic veins, ascended as the normal inferior vena cava, passed through the caval opening of the diaphragm and drained into the right atrium. The wider branch on the left side drained the left renal vein and penetrated the right crus of the diaphragm as the azygos vein. This vein ascended in the posterior mediastinum and drained into the superior vena cava. The hemiazygos and accessory hemiazygos veins were absent. In addition to these anomalies, the right renal artery entered the hilus after coursing through the above-mentioned two branches at the bifurcation. No congenital anomalies of the heart or abdominal viscera and main arteries were seen.
Adult↗
Comparison of four different antibiotics as prophylaxis in caesarean section.
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Journal Article↗
Acute Effects of Maternal Smoking on the Uterine and Umbilical Artery Blood Velocity Waveforms
> Objective: The acute effects of smoking during pregnancy on the uterine and umbilical blood flow velocity waveform were assessed. Methods: Twenty-two chronic women smokers at a mean gestational age of 194.17 +/- 58.02 days and 21 women non-smokers at a mean gestational age of 193.24 +/- 34.71 days were studied. Systolic-diastolic (S/D) ratio, resistance index, and pulsatility index of uterine and umbilical arteries were measured in the control group and before and after smoking a single standard 100-mm filtered cigarette in the study group. Results: There was no significant change in the uterine artery and umbilical artery blood velocity waveform indices that could be attributed to the acute effect of smoking in the study group, but all of the uterine artery indices and S/D ratio in the umbilical artery were statistically higher in the study group in comparison with the control group both before and after smoking. Conclusion: Our results suggest that smoking causes an increase in vascular resistance of the placenta and umbilical cord when used chronically.
Journal Article↗
Variant innervation of the coracobrachialis muscle and unusual course of the musculocutaneous nerve in man.
During the educational gross anatomy dissections of the upper extremities of 60 embalmed cadavers in our laboratory, the coracobrachialis muscle was found to be innervated by a nerve branch arising from the lateral root of the median nerve, but not from the musculocutaneous nerve nor from the lateral cord of the brachial plexus. Also the musculocutaneous nerve was found not to pierce the coracobrachialis muscle and to course downwards medial to it. The combination of two variations was seen in the right arm of a 64-year-old Turkish female cadaver. No other abnormality was observed in the branching pattern of the brachial plexus on both sides.
Brachial Plexus↗