The comparison of 1-year results for mini and wide-size cap grafts applied to nasal tips

OBJECTIVE

In the present study, we evaluated patient satisfaction with cap grafts by Rhinoplasty Outcomes Evaluation (ROE) scores. Mini cap and wide cap grafts were applied.

PATIENTS AND METHODS

A total of 80 patients who underwent a rhinoplasty operation with cap graft application to the tip region were included in the study. According to the cap graft size, there were two groups: Group 1 consisted of 40 patients with cap graft size ≤7 cm (mini cap group). Group 2 comprised 40 patients with cap grafts ≥8 cm (wide cap group). Patients in groups 1 and 2 underwent evaluations based on the following criteria at preoperative, postoperative-1st month, and postoperative-1st year intervals: (1) Rhinoplasty Outcomes Evaluation Questionnaire (ROE), (2) tip projection (cm), (3) nasal dorsum length (cm), (4) tip projection ratio (Goode), (5) nasofrontal angle, and (6) nasolabial angle.

RESULTS

Postoperative 1st-month and 1st-year ROE scores of the wide cap group were significantly higher than those in the mini cap group (p<0.05). Preoperative tip projection ratio (Goode) values of the wide cap group were considerably higher than those in the mini cap group (p<0.05). There were no significant differences between tip projection, nasal dorsum length, nasofrontal angle, and nasolabial angle values of the mini cap and wide cap groups (p>0.05). Correlation tests showed that as preoperative ROE scores decreased, postoperative-1st month and 1st-year ROE scores increased (p<0.05). Postoperative 1st-month and postoperative 1st-year's ROE scores increased together (p<0.05). In the wide cap group, postoperative 1st-month and postoperative 1st-year's ROE scores increased compared to the mini cap group (p<0.05). As postoperative 1st-year nasolabial angle values increased, postoperative 1st-year ROE scores also increased (p<0.05).

CONCLUSIONS

We found that patients who received wide-cap rhinoplasty had increased postoperative ROE scores and higher satisfaction rates during the first month and first year. Postoperative higher nasolabial angle values were related to higher ROE scores and patient satisfaction in the postoperative 1st year.

Low Density Polypropylene/Waste Cellulose Fiber Composites by High-Shear Thermo-Kinetic Mixer

Achieving an appreciable weight reduction in PP based composite materials, particularly the ones reinforced by glass fibers, is quite challenging while enhancing their mechanical properties and fullfilling other enviromental concerns. To address this issue, low density composites of Poly(propylene) (PP) and waste cellulose fibers (WCF) were produced by high-shear thermo-kinetic mixer. This technique facilitates the ease of processing for the mass production of such composite materials due to the availability of high shear rates and relatively short processing times during manufacturing. The structure-property behavior of the molded samples was investigated as a function of WCF content. Briefly, one-fold increase in elastic modulus, 18 % increase in tensile strength, 87 % increase in flexural modulus and 27 % increase in flexural strength of PP were achieved by the addition of 30 wt.% WCF. The significant enhancements in mechanical properties were mainly attributed to the homogeneous dispersion of intrinsically stiff WCF filler in the PP matrix as a direct result of the high-shear mixing. These results mainly suggest that waste cellulose fibers can be used as an effective reinforcing agent in PP matrix instead of highly dense, non-renewable and non-biodegradable fibers, such as glass fibers, that prevents further stresses on the environment. Along with this, the reuse of waste cellulose fiber in PP matrix, particularly at high concentrations like 30 wt.%, evenly corresponds to the reduction of total PP consumption for PP based composite production. The main conclusion of the study is that the extensive blending technology gives us the ability to produce high performance thermoplastic based composite materials as well as addressing the world-wide waste disposal problem by reusing of natural wastes, which is a great opportunity to ensure sustainability and reduce enviromental and economical costs for many industries.

The pterion in Turkish male skulls

This study was conducted to determine the location and type of pterion in Turkish males. The importance of the pterion is its relation to the middle meningeal artery, Broca's motor speech area on the left side, and surgical interventions relating to pathologies of the sphenoid ridge and optic canal. Specific measurements were taken on both sides of 26 Turkish human male skulls, none of which showed any obvious pathology or trauma. The sphenoparietal type of pterion was the most common (96% right side, 79% left side), followed by the frontotemporal (4% right side, 17% left side), and finally the epipteric type (4% left side only). The distances on the right and left sides respectively from the center of the pterion to the frontozygomatic suture were 3.30+/-0.40 cm and 3.44+/-0.39 cm, to the zygomatic arch 4.05+/-0.39 cm and 3.85+/-0.25 cm, to the optic canal 4.39+/-0.40 cm and 4.36+/-0.40 cm, and to the sphenoid ridge 1.40+/-0.33 cm and 1.48+/-0.32 cm. The thickness of the skull at the center of the pterion was 0.41+/-0.14 cm and 0.39+/-0.12 cm on the right and left sides respectively. These findings should be of use in surgical approaches and interventions via the pterion.

Vertical and horizontal neoclassical facial canons in Turkish young adults

Four vertical and three horizontal measurements were taken to assess the validity of neoclassical facial canons in 500 (272 female, 228 male) healthy, young adults between the ages of 18 and 25 years from Turkey and to compare them with a different population. The measurements were made by a millimetric compass. The special head height was longer than the special face height in the majority of our group (women/men: 97.8%/91.7%). The three-section facial profile canon was equal in only one male subject (women/men: 0/0.4%). Faces with four equal profile sections were not seen in either of the sexes. The nose length was longer than the ear length in the minority of our population (women/men: 1.5%/1.3%). The intercanthal distance was shorter than the nose width and left eye fissure length in the majority of our subjects (women/men: 50.4%/78.9% and 50.0%/52.2% respectively). The mouth width was greater than 1.5 times the nose width in the majority of this study (women/men: 66.9% vs 49.1%).

Morphometric measurements from various reference points in the orbit of male Caucasians

The aim of this study was to determine the morphometric variations from various reference points to decrease risks in orbital surgery. Sixty-two orbits obtained from 31 skulls of male adult Caucasians were measured with a millimetric compass. On the medial orbital wall, the midpoint of the anterior lacrimal crest was the reference point; from this point we measured distances of 23.9+/-3.3 mm, 35.6+/-2.3 mm, 41.7+/-3.1 mm and 6.9+/-1.5 mm respectively to the anterior ethmoidal foramen, posterior ethmoidal foramen, midpoint of the medial aspect of the optic canal and posterior lacrimal crest. On the same wall, distances from the plane of the anterior and posterior ethmoidal foramina to the ethmoido-maxillary suture and distance from the posterior ethmoidal foramen to the anterior ethmoidal foramen and midpoint of the medial margin of the optic canal were 14.9+/-2.3 mm, 9.8+/-2.9 mm and 6.8+/-2.2 mm respectively. On the inferior orbital wall, the main reference point was the infraorbital foramen, and from this point to the midpoints of the lateral margin of the fossa for the lacrimal gland, inferior orbital fissure, inferior orbital rim and inferior aspect of the optic canal was 23.8+/-7.2 mm, 31.9+/-3.9 mm, 6.7+/-1.9 mm and 50.3+/-3.2 mm respectively. On the superior orbital wall, the distances from the supraorbital foramen to the midpoints of the superior orbital fissure, fossa for the lacrimal gland and superior aspect of the optic canal were 45.7+/-3.6 mm, 26.0+/-2.5 mm and 45.3+/-3.2 mm respectively. Furthermore, on the same wall, the distance from the posterior ethmoidal foramen to the midpoint of the superior orbital fissure was 14.6+/-2.8 mm. Finally, on the lateral orbital wall the frontozygomatic suture was the reference point. From this point distances to the midpoints of the fossa for the lacrimal gland, superior orbital fissure, lateral aspect of the optic canal and inferior orbital fissure were 17.5+/-2.1 mm, 37.7+/-3.6 mm, 44.9+/-2.5 mm and 33.4+/-3.1 mm respectively.

Evaluation of location of mandibular and mental foramina in dry, young, adult human male, dentulous mandibles

The present study was undertaken to determine the precise location of the mental and mandibular foramina and the surrounding anatomic landmarks. Measurements were made on both right and left sides of each of 34 dried young Turkish adult (30-40 years old) human male mandibles. The mandibles were moderately robust and were from dentulous subjects. The results obtained in the study showed that the distance of the mandibular foramen to the angle of the anterior ramus were 16.9 mm on the right and 16.78 mm on the left. The distance to the posterior side of the ramus was 14.09 mm on the right, and 14.37 mm on the left. The narrowest anteroposterior diameters were 32.8 mm on the right and 32.05 mm on the left. The mandibular foramen is 0.5 mm posterior to the centre of the ramus on the right and 0.75 mm on the left. The distance of the lowest point of mandibular notch to the foramen was 22.37 mm on the right and 22.17 mm on the left. The distance from the mandibular foramen to the inferior border of the ramus in the mid position of the ramus was 30.97 mm on the right and 29.75 mm on the left. The average angle of the mandible (gonial angle) was 120.17 degrees on both sides. The distance of the mental foramen to the inferior border of the mandible was 14.61 mm and 14.29 mm on the right and left, respectively. Its distance to the superior border was 13.62 mm on the right and 14.62 mm on the left. The horizontal dimensions of the mental foramen was 2.93 mm on the right, 3.14 mm on the left and its vertical dimension was 2.38 mm on the right and 2.64 mm on the left. The mental foramen was located below the root of the second premolar in 21 bones (61.76%) on the right and 17 bones (50%) on the left while in the remaining mandibles, the foramen was present between the roots of the first and second premolars in 13 bones (38.2%) on the right and in 17 (50%) on the left. The average angle of the mental foramen was 96.82 degrees.

Prevalence of hand x-ray abnormalities in female patients with osteoarthritis

OBJECTIVE

This study was to determine the patho-anatomical features of oseoarthritis by means of hand radiographs.

METHODS

Individual hand joint radiographs of 38 female patients (33 bilateral, 5 unilateral, aged 50-80 years) were utilized for grade, incidence and localization of osteophytes, joint space narrowing, subchondral sclerosis and erosion.

RESULTS

Our findings revealed that the most frequent osteophytes were in the distal interphalangeal of ring (38%), the least frequent ones in the proximal interphalangeal of little (1%). In addition, the joint space narrowing was most frequent found in the distal interphalangeal of little (93%), the least frequently in the metacarpophalangeal of ring (25%). Subchondral sclerosis was most frequently seen in the distal interphalangeal of index (70%), the least in the metacarpophalangeal of little 35%). Erosion was most prevalent in the distal interphalangeal of index (65%), and least in the metacarpophalangeal of thumb (1%).

CONCLUSION

This study was carried out to determine the radiographic characteristics of osteoarthritis by means of hand radiographs.

The effect of P-glycoprotein function inhibition with cyclosporine A on the biodistribution of Tc-99m sestamibi

PURPOSE

The failure to cure persons with cancer is caused primarily by the development of drug resistance by overexpression of p-glycoprotein. Diverse groups of drugs have been identified, including cyclosporine A, which can reverse drug resistance by inhibiting P-glycoprotein transport. Tc-99m sestamibi is a substrate for P-glycoprotein. P-glycoprotein is normally expressed in biliary canalicular surfaces of hepatocytes and is responsible for the excretion of cationic metabolites from the liver. The aim of the current study was to evaluate the effect of cyclosporine A on the biological distribution of Tc-99m sestamibi in vivo.

METHODS

Five patients with alopecia and two renal transplant patients who were treated with cyclosporine A were selected for the study. All patients were examined before and at least 2 weeks after administration of cyclosporine A. Tc-99m sestamibi scintigraphy was performed by obtaining planar abdominal images at 5, 30, 60, 120, and 180 minutes after injection, and the liver-heart ratios were calculated.

RESULTS

Plasma cyclosporine A, bilirubin levels, liver enzymes, and creatinine clearance values were obtained from all patients. In three, the plasma cyclosporine A level was increased to more than 400 pg/dl. The liver-heart ratio was increased significantly after cyclosporine A administration (P < 0.01). After cyclosporine A administration Tc-99m sestamibi excretion was delayed and the uptake in the liver was increased. The difference was 17% at 5 minutes and 38% at 180 minutes. Liver retention was greatest in patients with cyclosporine A toxicity.

CONCLUSIONS

With a limited number of patients, this study suggests that Tc-99m sestamibi excretion from the liver is mediated by P-glycoprotein, and inhibition of P-glycoprotein transport not only delays liver excretion but also increases the liver uptake of Tc-99m sestamibi. Because this observation deserves further investigation, the inhibition of P-glycoprotein function with nontoxic multidrug-resistance reversing agents may be used as an intervention to increase the tumor uptake of Tc-99m sestamibi and to increase the sensitivity of Tc-99m sestamibi tumor imaging.

Shape differences in the cervical and upper thoracic vertebrae in rats (Rattus norvegicus) and bats (Pteropus poiocephalus): can we see shape patterns derived from position in column and species membership?

The shapes of cervical (C1-C7) and upper thoracic (T1, T2) vertebrae from the rat and the grey-headed flying fox have been analysed by Fourier analysis to investigate the types of variation present and to try to isolate bones according to position along the vertebral column and species. It was found that the T2 vertebrae of the rat are very different from all others in the study, that C2 and C6 vertebrae are very similar and that the remaining vertebrae split according to species.

The proportion of the face in younger adults using the thumb rule of Leonardo da Vinci

The present study was conducted to examine whether the thumb rule of Leonardo da Vinci could be an objective method in the determination of the natural and artistic proportions of human face. In this study, a sample of 400 subjects (200 male and 200 female, 22-25 years old) was used. Measurements were made of the length of thumb, the length of ear, the approximate distances between the hair line and the glabella or eyebrows, between the glabella or eyebrows and the tip of the nose and the distance between the nose and the chin, and the distance between the ear and the lateral aspect of the eye. The results obtained in the males and females showed significant (p < 0.01) correlations between the length of thumb and the proportions of the face examined in the study. Additionally, the height of the face was found to be almost three times the length of the thumb. However, the measurements obtained from female subjects were on average smaller than those taken from males. The results obtained in this experiment could be of value in understanding of the evaluation of the face for the people working in plastic surgery or art.

Measurement and relationship of the inclination angle, Alsberg angle and the angle between the anatomical and mechanical axes of the femur in males

The present study was undertaken to determine whether there is a constant difference between the angle of inclination and the Alsberg angle and to evaluate statistical relationships between the inclination angle, Alsberg angle and the angle between the anatomical and mechanical axes of the femur. Measurements were taken from 50 male femurs (25 right and 25 left, aged 30-40 years) from the Anatomy Department, Cukurova University: inclination angle was determined between the neck and the shaft of the femur; Alsberg angle, between a line drawn through the base of the epiphyseal plate and shaft of the femur, and the angle between the anatomical and mechanical axes. The results showed that, for the right and left femurs respectively, the average inclination angle was 123.72 degrees and 125.96 degrees; the angle between the anatomical and mechanical axes was 6.24 degrees and 5.96 degrees; and the average Alsberg angle was 39.92 degrees and 40.61 degrees. The difference between the angle of inclination and the Alsberg angle in this study was 83.80 degrees and 85.36 degrees for the right and left femurs respectively. The correlation, coefficient between the angle of inclination and Alsberg angle was 0.96 and 0.93 for the right and left femurs respectively, while those between the angle between the anatomical and mechanical axes and inclination angle were -0.89 and -0.91 for the right and left femurs respectively. Furthermore, the correlation coefficient between the angle between the anatomical and mechanical axes and Alsberg angle were -0.88 and -0.90 for the right and left femurs respectively.

Terbinafine: efficacy and safety in the treatment of dermatophytosis

A double-blind study with terbinafine was performed in 39 patients with dermatophyte infection, between 1987 and 1989, to compare the safety and efficacy of two dosage schedules of 125 mg twice daily versus 250 mg once daily. Mycologic assessments were negative by microscopic examination and Sabouraud's culture in 59% and 100% of patients in the first and the fourth weeks of treatment, respectively. There was no statistically significant difference between the two groups of patients receiving 125 mg b.i.d. and 250 mg q.d. with respect to the safety and efficacy of the treatment; however, the differences between the sums of clinical scores before and after the treatment were statistically significant. There were no adverse effects, and the drug was well tolerated.

Rapid fixation of whole organ specimens and attendant problems

Gross specimens are valuable sources in morphology education. In this study, we investigated how the fixation of gross specimens may be accelerated. For this purpose, whole organ specimens from freshly killed rabbits: extremities, kidney, heart, liver, stomach and uterus were fixed in a mercaptoethanol-formaldehyde mixture for 3-3.5h under the following conditions: 1, at room temperature; 2, at gradually increasing temperatures up to 45 degrees C; and 3, at a gradually increasing vacuum ranging from 20 kPa to 40 kPa. The results were compared with those of formaldehyde-fixed controls, and the mercaptoethanol-formaldehyde mixture was found to be useful in shortening the fixation time and providing good fixation. Both heat and vacuum enhanced these phenomena.

Scanning electron microscopic (SEM) examination of structures which supply subcapsular and midcortical region postglomerular microcirculation in sheep kidney

Sheep kidneys were injected with polyester crystic (Dewilux 511-0196) and three dimensional forms of the structure forming the postglomerular microcirculation were examined by scanning electron microscope. During the examination of the afferent and efferent arterioles, a glomerulus with double efferent arterioles were examined and microdiverticular structures were observed in the terminal end of peritubular capillary plexus. It is concluded that these structures widen the surface area of the capillaries as a result of which diffusion across the capillary bed is facilitated.

Examination of microvascular structures of midcortical region in sheep kidneys: a three dimensional approach

Polyester-crystic cast was observed to reach the peritubular capillary plexus following injection in sheep kidneys. Microvascular structures in this region are also reported in this study. Glomeruli were found to vary in size and shape. Diameters of afferent arterioles were larger than those of efferent arterioles. The glomerulus is supplied by more than one afferent arteriole, and in some regions, the blood in afferent arterioles joins collateral circulation via the intercapillary plexus. Morphological properties at the end of the peritubular capillary plexus were found to be remarkably significant.