The nose anatomy is a functional and aesthetically important organ because of its three-dimensional structure, visible location in the face region, and its connection with the respiratory tract. Aesthetic and reconstructive nasal surgery requires correction of deformations in cartilage and bone structures as well as preservation of the natural connections between all subunits. The minimal mistake made can result in functional or aesthetically bad results. In this study, the authors aimed to create an experimental nose model that help aesthetic and reconstructive nose surgery operations.

Objective: Chronic kidney disease (CKD) patients have insulin secretion disorders and resistance to insulin effects, that is responsible for the development of cardiovascular events. Vaspin is an adipocytokine that regulates glucose and lipid metabolism. We aimed to determine the serum vaspin levels and its relationship with insulin resistance in CKD patients. Methods: In the study groups, serum vaspin levels, anthropometric parameters and routine blood tests were measured. The serum vaspin levels were examined by the enzyme-linked immunosorbent assay (ELISA) and insulin resistance was determined by the homeostasis model assessment of insulin resistance (HOMA-IR) formula. Results: The serum vaspin, HOMA-IR index and insulin levels were observed significantly high in the CKD group in comparison with the control group. No correlation was found between the serum vaspin level and the anthropometric and metabolic values. The serum vaspin level was positively correlated with the fasting plasma glucose and age but without statistical significance. Conclusion: Insulin resistance and hyperinsulinemia contribute to the development of cardiovascular complications in CKD. We consider that the increase in the serum vaspin level is a consequence of the reduced renal excretion in the CKD and increases in response to insulin resistance. How to cite this:Demir C, Dogantekin A, Gurel A, Aydin S, Celiker H. Is there a relationship between serum vaspin levels and insulin resistance in chronic renal failure? Pak J Med Sci. 2019;35(1):230-235. doi: https://doi.org/10.12669/pjms.35.1.96 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Background The palmaris longus (PL) is one of the most anatomically variable muscles in the body. Although these variations are often asymptomatic, symptoms related to nerve compression can sometimes be encountered. If treatment is indicated, correct diagnosis is important for successful management. In cases of upper extremity nerve compression, variations of the PL should be included in the differential diagnosis. We report a case of reversed PL (RPL) with symptoms of median nerve compression and review the literature, emphasizing the rare and challenging character of these lesions. Methods The literature review was performed using Google Scholar and PubMed databases. Keywords were “reversed palmaris longus,” “reversed palmaris longus median nerve compression,” “anomolous palmaris longus muscle,” and “symptomatic palmaris longus.” Only clinical RPL muscle cases with at least one of the symptoms of paresthesia and pain in the median nerve sensory area or swelling on the wrist were included. Results In the literature review, 21 publications including 30 patients, matched the search criteria between 1973 and 2018 and were evaluated. Conclusion In carpal tunnel syndrome, in cases with atypical presentation, RPL should be considered in the differential diagnosis.

fat and thin necks. This may have had an effect on our analysis of fat distribution between groups.We appreciate and agree with Dr. Liu's comments. Future studies should correct for these noted deficiencies.

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