Background: Erector spinae plane block (ESPB) is a well-established method for managing postoperative and chronic pain. ESPB applications for the sacral area procedures are called sacral ESPBs (SESPBs). This cadaveric study aimed to determine the distribution of local anesthesia using the median and intermediate approaches to the SESPB.Methods: Four cadavers were categorized into the median and intermediate approach groups. Ultrasound-guided SESPBs were performed using a mixture of radiopaque agents and dye. Following confirmation of the solution distribution through computed tomography (CT), the cadavers were dissected to observe the solution distribution.Results: CT images of the median group demonstrated subcutaneous pooling of the radiopaque solution between the S1 and S5 horizontal planes. Radiopaque solution also passed from the sacral foramina to the anterior sacrum via the spinal nerves between S2 and S5. In the intermediate group, the solution distribution was observed along the bilateral erector spinae muscle between the L2 and S3 horizontal planes; no anterior transition was detected. Dissection in the median group revealed blue solution distribution in subcutaneous tissue between horizontal planes S1 and S5, but no distribution in superficial fascia or muscle. In the intermediate group, red solution was detected in the erector spinae muscle between the L2 and S3 intervertebral levels.Conclusions: Radiologic and anatomic findings revealed the presence of radiopaque dye in the superficial and erector spinae compartments in both the median and intermediate groups. However, anterior transition of the radiopaque dye was detected only in the median group.

We aimed to investigate the effects of central kisspeptin-10 and p234 administration on basal brain activity and epilepsy-like conditions induced by 4-aminopyridine (4-AP), as well as their roles in the electrocorticogram (ECoG) power spectrum and EEG waves. Thirty-five male Wistar rats were divided into five groups: sham,4-AP (2.5 mg/kg i.p.), kisspeptin-10 post-treatment (200 pmoli.c.v.), p234 post-treatment (1 nmol i.c.v.), and p234 pre-treatment (1 nmol i.c.v.). We performed 70 minutes of recordings (10 min baseline) for all groups under ketamine/xylazine (90/10 mg/kg) anesthesia. In the post-treatment groups, kisspeptin-10 or p234 injections were administered 20 minutes after epilepsy induction. In the pre-treatment group, p234 was injected after baseline recordings. Following a 20-minute pre-treatment period, 4-AP was administered. 4-AP alone induced epileptiform activity in all animals, reaching apeak after 30 minutes. Neither kisspeptin-10 nor p234 post-treatment affected 4-AP-induced epileptiform activity (p > 0.05). However, p234 pre-treatment reduced epileptiform activity (p < 0.05). Additionally, kisspeptin-10 did not alter the spectral analysis of the EEG bands or the power of the ECoG (p > 0.05). In contrast, p234 reduced the power of the ECoG and the slow bands (delta and theta) (p < 0.05). We conclude that p234 pre-treatment has an inhibitory effect on neuronal excitability and epileptiform activity in the neocortex.

Migraine is a recurrent headache syndrome with a wide spectrum of symptoms. The diagnosis of migraine is mostly made retrospectively, taking into account the characteristics of the headache and other symptoms. It is not known enough how migraine headache starts and in which brain regions it occurs. It is known that changes in the excitability of brainstem nuclei affect endogenous pain mechanisms and unilateral involvement of trigeminovascular structures are effective mechanisms in migraine development. Understanding the role of the cerebellum in migraine disease is a fairly new topic in neuroscience. 19 Mıgraıne Patıents (MP) and 14 Healthy Controllers (HC) partıcıpated ın our study. For the volumetric analysis of the cerebellum, the ceres method of volbrain, which is an automatic brain volume calculation method, was used and the volumes of the cerebellum structures were obtained. SPSS 22.0 program was used for the analysis of the data and the level of significance was accepted as p

Objective: Fetal development has been a subject of great interest from earliest times to the present day and can today easily be analyzed using ultrasound (US) and similar devices. The lengths or diameters of various fetal structures are measured, and intrauterine age and development can thus be monitored. Our study investigates the value of a series of lengths measured in the upper extremity in the monitoring of intrauterine age and development. Material and Methods: We measured the forearm length, hand length, wrist width and elbow widths of 21 fetuses (seven males, 14 females) estimated at 17.0-35.8 weeks intrauterine age according to foot length and with no visible abnormalities. These were compared to each other and analyzed with respect to gender. Measurements were taken using dividers and a vernier digital caliper. Results: No differences were determined between the groups statistically for the parameters measured and when they were compared for gender. Elbow and wrist widths and hand, forearm and foot lengths obtained from fetuses and the ratios of some of these measurements demonstrated considerable correlation (similarity) with measurements and proportions on the opposite side of the body and with intrauterine age. Conclusion: Measurable wrist and elbow widths and forearm, hand and foot length in whole or fragmented fetuses were determined to be individually valuable in diagnosing gestational age. It was also concluded that elbow and wrist width to forearm length ratios on the same side were important in monitoring intrauterine extremity development.

Introduction: Essential tremor (ET) and Parkinson's disease (PD) are the two most commonly encountered tremor disorders in movement disorders. Diffusion tensor imaging (DTI) is one of the best in vivo ways of mapping white matter pathways in the human brain. The aim of our study was to investigate diffusion variables and cerebellum volume in ET and PD using parcellation methods. Methods: Our study included 20 ET, 20 PD and 20 healthy controls. Fraction Anisotropy (FA) and Mean Diffusivity (MD) values were obtained with DTI, while the volume of each lobe of the cerebellum was obtained with T1 images. One-way ANOVA was used for intergroup analysis and Scheffe test was used for post-hoc analysis. Results: Significant differences were found in the diffusion values of the pedunculus cerebellaris, fornix stria, superior longitudinal fasciculus, sagittal stratum, cerebral pedunculus, tapatum and thalamus of ET and PD. Lobule V, Lobule IX, Lobule X volumes of the cerebellum showed significant differences between the groups. Conclusion: Stria thermialis shows involvement of mesolimbic dopaminergic system in PD and it is thought that disruption of strial networks leads to changes in the activity of cerebellar networks and reveals the role of the cerebellum in tremor. It is obvious that cerebellar thalamocortical pathways are affected in Parkinson's disease. In Parkinson's disease, patients should be evaluated for visual processing, conceptualisation, postural instability and gait disturbance to clarify the diagnosis or to differentiate from essential tremor.