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    Selected Abstracts

    Potential roles for BMP and Pax genes in the development of iris smooth muscle

    DEVELOPMENTAL DYNAMICS, Issue 2 2005
    Abbie M. Jensen
    Abstract The embryonic optic cup generates four types of tissue: neural retina, pigmented epithelium, ciliary epithelium, and iris smooth muscle. Remarkably little attention has focused on the development of the iris smooth muscle since Lewis ([1903] J. Am. Anat. 2:405,416) described its origins from the anterior rim of the optic cup neuroepithelium. As an initial step toward understanding iris smooth muscle development, I first determined the spatial and temporal pattern of the development of the iris smooth muscle in the chick by using the HNK1 antibody, which labels developing iris smooth muscle. HNK1 labeling shows that iris smooth muscle development is correlated in time and space with the development of the ciliary epithelial folds. Second, because neural crest is the only other neural tissue that has been shown to generate smooth muscle (Le Lievre and Le Douarin [1975] J. Embryo. Exp. Morphol. 34:125,154), I sought to determine whether iris smooth muscle development shares similarities with neural crest development. Two members of the BMP superfamily, BMP4 and BMP7, which may regulate neural crest development, are highly expressed by cells at the site of iris smooth muscle generation. Third, because humans and mice that are heterozygous for Pax6 mutations have no irides (Hill et al. [1991] Nature 354:522,525; Hanson et al. [1994] Nat. Genet. 6:168,173), I determined the expression of Pax6. I also examined the expression of Pax3 in the developing anterior optic cup. The developing iris smooth muscle coexpresses Pax6 and Pax3. I suggest that some of the eye defects caused by mutations in Pax6, BMP4, and BMP7 may be due to abnormal iris smooth muscle. Developmental Dynamics 232:385,392, 2005. © 2004 Wiley-Liss, Inc. [source]

    Early ontogeny and placentation of the grey short-tailed opossum, Monodelphis domestica (Didelphidae: Marsupialia): contribution to the reconstruction of the marsupial morphotype

    JOURNAL OF ZOOLOGICAL SYSTEMATICS AND EVOLUTIONARY RESEARCH, Issue 3 2001
    Zeller
    This study provides new findings on the placenta of Monodelphis domestica and a reconstruction of the marsupial morphotype. To achieve this, early ontogeny and placentation of the grey short-tailed opossum, M. domestica, from 3 h after copulation until birth (day 15), were studied and compared with other mammals. Both the ultrastructure and histochemistry of egg membranes, foetal membranes, oviduct and uterus were examined. The results of this study provide the first detailed ultrastructural description of a trophoblastic syncytium in a marsupial. In addition, this is the first original documentation of an invasive trophectoderm and an inflammatory reaction at parturition in M. domestica. These findings were compared with literature data and included into the reconstruction of the marsupial morphotype. Based on marsupial phylogeny as proposed by Luckett (J. Mammal. Evol. 2, 255,283, 1994), characters that are consistent at least within didelphids and dasyurids were determined to be characters of the marsupial morphotype. These characters are a central yolk separated from the peripheral yolk-poor cytoplasm in the unfertilized oocyte, the presence of a zona pellucida, a mucoid coat and a shell coat, the absence of a corona radiata, oviductal mucoid secretion, no shell secretion distal to the isthmus of the oviduct, uterine shell secretion, a short tubal passage (1 day at maximum), the apposition of blastomeres to the zona pellucida prior to intercellular association, the absence of a morula stage, the polarity of the zygotic yolk, the localized segmentation of deutoplasm (yolk) during the first cleavage and subsequent extrusion of yolk vesicles during the first two cleavage stages. With regard to the marsupial morphotype, the non-polarized yolk distribution in the zygote [Hartman (J. Morphol. 27, 1,84, 1916); McCrady (Am. Anat. Mem. 16, 1,233, 1938)] is a derived character of Didelphis virginiana. Didelphis virginiana [Hartman (J. Morphol. 27, 1,84, 1916); Hartman (J. Morphol. 32, 1,139, 1919); McCrady (Am. Anat. Mem. 16, 1,233, 1938)] and Didelphis marsupialis (Hill, Q. J. Micr. Sci. 63, 91,139, 1918) share the synapomorphous reduction of deutoplasmolysis to a generalized extrusion of vesicles. The absence of separated yolk and consequently a cleavage without yolk extrusion (Renfree and Lewis, Reprod. Fert. Dev. 8, 725,742, 1996) are apomorphies of macropodids. This is possibly correlated with the association of blastomeres in early cleavage stages (Renfree and Lewis, Reprod. Fert. Dev. 8, 725,742, 1996). A yolk sac placenta and a vascularized allantochorion can be assumed for part of the ontogeny in the marsupial morphotype, irrespective of the formation of an allantoic placenta at near term stages. The character polarization of the mode of placentation and parturition needs further investigation. Frühe Ontogenie und Plazentation der grauen Hausspitzmausbeutelratte, Monodelphis domestica (Didelphidae: Marsupialia): Ein Beitrag zur Rekonstruktion des Grundplans der Marsupialia Die vorliegende Arbeit beschreibt die frühe Ontogenese und Plazentation von 3 Stunden nach der Kopulation bis zur Geburt der Beutelratte Monodelphis domestica. Es wird die Ultrastruktur und Histochemie der Eihäute, der Fetalmembranen, des Oviductes und des Uterus beschrieben. Erstmalig wird die Ultrastruktur eines trophoblastischen Syncytiums bei einem Beuteltier beschrieben. Weiterhin wird ein invasives Trophektoderm und eine Entzündungsreaktion zum Zeitpunkt der Geburt bei M. domestica festgestellt. Die Befunde dieser Studie und Literaturdaten werden verglichen und in eine Grundplanrekonstruktion integriert. Merkmale, die mindestens zwischen Vertretern der Didelphidae und Dasyuridae übereinstimmen, werden basierend auf dem phylogenetischen System der Marsupialia nach Luckett, J. Mammal. Evol. 2, 255,283, 1994, für den Grundplan der Marsupialia angenommen. Diese Merkmale sind zentral separierter Dotter und peripheres dotterarmes Zytoplasma in der unbefruchteten Eizelle, das Vorhandensein von Zona pellucida, Mucoidschicht und Schalenhaut, das Fehlen einer Corona radiata, die Mucoidsekretion durch den Oviduct, die Schalensekretion durch den Uterus und nicht distal der Isthmusregion des Oviductes, eine kurze Tubenwanderung (maximal einen Tag), die Anlagerung der Blastomeren an die Zona pellucida vor der interzellulären Verbindung, das Fehlen eines Morulastadiums, die Dotterpolarität in der Zygote, die lokale Dotterabtrennung bei der ersten Teilung und die anschließende Dotterextrusion während der ersten beiden Teilungen. In Bezug auf den Grundplan der Marsupialia ist die unpolare Dotterverteilung in der Zygote ein abgeleitetes Merkmal von Didelphis virginiana. Didelphis virginiana und Didelphis marsupialis teilen als Synapomorphie die Reduktion der Deutoplasmolyse auf eine generelle Vesikelextrusion. Das Fehlen separierten Dotters in der Oocyte und die resultierende Furchung ohne Dotterextrusion [Renfree and Lewis, Reprod. Fert. Dev. 8, 725,742, 1996] ist eine Apomorphie der Macropodidae. Hiermit hängt möglicherweise die frühe Zusammenlagerung der Blastomeren zusammen [Renfree and Lewis, Reprod. Fert. Dev. 8, 725,742, 1996]. Ein vaskularisiertes Allantochorion und eine Dottersackplazenta können für einen Teil der Ontogenese im Grundplan der Marsupialia angenommen werden. Ob das Allantochorion neben der Respiration auch dem Stoffaustausch diente ist unklar. Die Lesrichtung für den Modus der Plazentation und der Geburt bedarf weiterer Untersuchungen. [source]

    Anatomy of reflux: A growing health problem affecting structures of the head and neck

    THE ANATOMICAL RECORD : ADVANCES IN INTEGRATIVE ANATOMY AND EVOLUTIONARY BIOLOGY, Issue 6 2006
    Michael J. Lipan
    Abstract Gastroesophageal reflux disease (GERD) and laryngopharyngeal reflux (LPR) are sibling diseases that are a modern-day plague. Millions of Americans suffer from their sequelae, ranging from subtle annoyances to life-threatening illnesses such as asthma, sleep apnea, and cancer. Indeed, the recognized prevalence of GERD alone has increased threefold throughout the 1990s. Knowledge of the precise etiologies for GERD and LPR is becoming essential for proper treatment. This review focuses on the anatomical, physiological, neurobiological, and cellular aspects of these diseases. By definition, gastroesophageal reflux (GER) is the passage of gastric contents into the esophagus; when excessive and damaging to the esophageal mucosa, GERD results. Reflux that advances to the laryngopharynx and, subsequently, to other regions of the head and neck such as the larynx, oral cavity, nasopharynx, nasal cavity, paranasal sinuses, and even middle ear results in LPR. While GERD has long been identified as a source of esophageal disease, LPR has only recently been implicated in causing head and neck problems. Recent research has identified four anatomical/physiological "barriers" that serve as guardians to prevent the cranial incursion of reflux: the gastroesophageal junction, esophageal motor function and acid clearance, the upper esophageal sphincter, and pharyngeal and laryngeal mucosal resistance. Sequential failure of all four barriers is necessary to produce LPR. While it has become apparent that GER must precede both GERD and LPR, the head and neck distribution of the latter clearly separates these diseases as distinct entities warranting specialized focus and treatment. Anat Rec (Part B: New Anat) 289B:261,270, 2006. © 2006 Wiley-Liss, Inc. [source]

    Diffusion of innovations: Anatomical informatics and iPods

    THE ANATOMICAL RECORD : ADVANCES IN INTEGRATIVE ANATOMY AND EVOLUTIONARY BIOLOGY, Issue 5 2006
    Robert B. Trelease
    Abstract Over the course of many centuries, evolving scientific methods and technologies have advanced the study of anatomy. More recently, such dissemination of innovations has been formally studied in multidisciplinary psychosocial contexts, yielding useful knowledge about underlying principles and processes. We review these precepts and show how diffusion of innovations theory and principles apply to the development and dissemination of anatomical information methods and resources. We consider the factors affecting the late-20th-century dissemination of personal computers and World Wide Web hypermedia into widespread use in anatomical research and instruction. We report on the results of a small experiment in applied diffusion, the development and Internet-based distribution of learning resources for a popular, widely distributed personal media player. With these wearable microcomputer devices already in use by a variety of students, new opportunities exist for widespread dissemination of anatomical information. The continuing evolution of wearable computing devices underscores the need for maintaining anatomical information transportability via standardized data formats. Anat Rec (Part B: New Anat) 289B:160,168, 2006. © 2006 Wiley-Liss, Inc. [source]

    Development of the blood-brain barrier: A historical point of view

    THE ANATOMICAL RECORD : ADVANCES IN INTEGRATIVE ANATOMY AND EVOLUTIONARY BIOLOGY, Issue 1 2006
    Domenico Ribatti
    Abstract Although there has been considerable controversy since the observation by Ehrlich more than 100 years ago that the brain did not take up dyes from the vascular system, the concept of an endothelial blood-brain barrier (BBB) was confirmed by the unequivocal demonstration that the passage of molecules from blood to brain and vice versa was prevented by endothelial tight junctions (TJs). There are three major functions implicated in the term "BBB": protection of the brain from the blood milieu, selective transport, and metabolism or modification of blood- or brain-borne substances. The BBB phenotype develops under the influence of associated brain cells, especially astrocytic glia, and consists of complex TJs and a number of specific transport and enzyme systems that regulate molecular traffic across the endothelial cells. The development of the BBB is a complex process that leads to endothelial cells with unique permeability characteristics due to high electrical resistance and the expression of specific transporters and metabolic pathways. This review article summarizes the historical background underlying our current knowledge of the cellular and molecular mechanisms involved in the development and maintenance of the BBB. Anat Rec (Part B: New Anat) 289B:3,8, 2006. © 2006 Wiley-Liss, Inc. [source]

    A social biography of Carnegie embryo no. 836

    THE ANATOMICAL RECORD : ADVANCES IN INTEGRATIVE ANATOMY AND EVOLUTIONARY BIOLOGY, Issue 1 2004
    Lynn M. Morgan
    Abstract A tiny, sectioned embryo specimen known as Carnegie no. 836 has served as the prototype for Stage 13 (28-32 days) since the 1910s. Recently digitalized and reanimated for the 21st century, this singular specimen is now being used to develop 3D and 4D visualizations. Yet the social origins of the specimen have been largely forgotten. This essay traces the biography of 836 from its origins in a young woman's life, through sectioning and transformation into a scientific specimen, to its contemporary manifestations as a symbol of life. By reuniting the specimen with its story, we can appreciate how cultural attitudes toward embryo specimens have changed over the past century. Anat Rec (Part B: New Anat) 276B:3,7, 2004. © 2004 Wiley-Liss, Inc. [source]

    Common patterns of facial ontogeny in the hominid lineage

    THE ANATOMICAL RECORD : ADVANCES IN INTEGRATIVE ANATOMY AND EVOLUTIONARY BIOLOGY, Issue 3 2002
    Rebecca Rogers Ackermann
    Abstract Recent evaluation of Neanderthal and modern human ontogeny suggests that taxon-specific features arose very early in development in both lineages, with early, possibly prenatal, morphological divergence followed by parallel postnatal developmental patterns. Here we use morphometric techniques to compare hominoid facial growth patterns, and show that this developmental phenomenon is, in fact, not unique to comparisons between Neanderthals and modern humans but extends to Australopithecus africanus and to the hominoid lineage more broadly. This finding suggests that a common pattern of juvenile facial development may be more widespread and that the roots of ontogenetically early developmental differentiation are deep,perhaps predating the ape/human split of 6+ million years ago. Anat Rec (New Anat) 269:142,147, 2002. © 2002 Wiley-Liss, Inc. [source]

    Vascularization of the Fleshy Comb in the Domestic Chicken

    ANATOMIA, HISTOLOGIA, EMBRYOLOGIA, Issue 2005
    B. Vollmerhaus
    Up to now little is known about the vascularization of the chicken fleshy comb (crista carnosa). In order to evaluate the vascularization of the crista carnosa of the cook (breed White Leghorn), corrosion casts were created by injecting Plastoid into the internal carotid as described by Schummer (1951). Specimens were investigated by stereomicroscopy and scanning electron microscopy (SEM). Generally the dermis is highly vascularized by two capillary networks, which are localized beneath the epithelium and beneath the dermal papillas. The dense subepithelial network is characterized by the presence of sinusoid vessels. In the subcutaneous plexus numerous arteriovenous anastomoses of different types occur. Additionally there are arteriovenous anastomoses between the main vessels reaching the indentations of the comb. Our results show the presence of superficial and dense capillary networks and arteriovenous anastomoses are the anatomical basis for the functions of the chicken comb in mating behaviour and thermoregulation. Reference, Schummer, A. 1951: Simplified method for plastoid corrosion. Anat. Anaz. 98, 288,290. [source]

    Giovanni Filippo Ingrassia: A five-hundred year-long lesson

    CLINICAL ANATOMY, Issue 7 2010
    Francesco Cappello
    Abstract Giovanni Filippo Ingrassia was born five centuries ago in Regalbuto, a small town in the center of Sicily. After his medical course in Padua, under the guidance of Vesalius and Fallopius, he gained international fame as a physician and was recruited as a Professor of human anatomy in Naples and later in Palermo. He is remembered as "the new Galen" or "the Sicilian Hippocrates." He contributed to the knowledge of human anatomy through the description of single bones rather than the whole skeleton. In particular, he was the first to describe the "stapes," the "lesser wings of the sphenoid" and various other structures in the head (probably the pharyngotympanic tube) as well as in the reproductive system (corpora cavernosa and seminal vesicles). He was also a pioneer in the study of forensic medicine, hygiene, surgical pathology, and teratology. As Protomedicus of Sicily, he developed the scientific culture in this country. During those years, he faced the spread of malaria and plague with competence and authoritativeness. Indeed, he was one of the first physicians to suppose that certain diseases could be transmitted between individuals, therefore, introducing revolutionary measures of prevention. He is remembered for his intellectual authority and honesty. Five-hundred years after his birth, his teaching is still alive. In this article, we survey the life and contribution of this pioneer of early anatomical study. Clin. Anat. 23:743,749, 2010. © 2010 Wiley-Liss, Inc. [source]

    Congenital absence of the portal vein,Case report and a review of literature

    CLINICAL ANATOMY, Issue 7 2010
    Jana Mistinova
    Abstract Congenital absence of the portal vein (CAPV) is a rare anomaly in which the intestinal and the splenic venous drainage bypass the liver and drain into systemic veins through various venous shunts. To our knowledge, we have reviewed all 83 cases of CAPV, since first described in 1793. This equates to a rate of almost 2.5 cases per year over the last 30 years. Morgan and Superina (1994, J. Pediatr. Surg. 29:1239,1241) proposed the following classification of portosystemic anomalies; either the liver is not perfused with portal blood because of a complete shunt (Type I) or the liver is perfused with portal blood due to the presence of a partial shunt (Type II). In our case, abdominal venous blood drained into the suprarenal inferior vena cava via the left renal vein and dilated left gastric veins. After analyzing all reported cases, we recognize that more than 65% of patients are females and more than 30% of all published cases had been diagnosed by the age of 5 years. Additional anomalies are common in CAPV. In the reported cases, more then 22% of patients had congenital heart disease. Other commonly found anomalies include abnormalities of the spleen, urinary and male genital tract, brain as well as skeletal anomalies. Hepatic changes such as focal nodular hyperplasia, hepatocellular carcinoma, and hepatoblastoma are diagnosed in more then 40% of patients. This article also illustrates the radiological findings of CAPV. Radiological evaluation by ultrasound, CT, and MRI is helpful to detect coexisting abnormalities. Clin. Anat. 23:750,758, 2010. © 2010 Wiley-Liss, Inc. [source]

    The subdural space of the spine: A lymphatic sink?

    CLINICAL ANATOMY, Issue 7 2010
    Myodil's last message
    Abstract Following the radiological study of a large number of myelograms, starting over 50 years ago when the only clinical contrast medium available to show the contents of the spinal canal was an iodized oil, the author has collected a number of examples where the oil was inadvertently injected into the subdural area, rather than the intended subarachnoid space. By taking follow-up films at various intervals following the inadvertent injection, it has been possible to study the extent to which the subdural space could become visualized from a lumbar injection, the contrast medium sometimes passing to the top of the cervical region and the lower part of the sacrum. Also, the contrast passed outward along the peri-neural lymphatic sheaths or spaces of the issuing spinal nerves, where it might remain for months, and under the influence of gravity it could extend for a considerable way. It also passed into abdominal and thoracic lymph vessels and nodes. Considering the morphology, predictability, and ease with which the demonstrated subdural space fills, the author concludes that the subdural region is a true and functionally significant "space," and an important conduit or functional part of the body's lymphatic system. He also considers that it has implications for the spread or dissemination of various organisms, substances or pathological conditions, as well as being part of the normal conduit for reabsorption of CSF with implications for hydrocephalus, and with potential for misplacement of spinal anaesthetic agents. Clin. Anat. 23:829,839, 2010. © 2010 Wiley-Liss, Inc. [source]

    Thoracic paravertebral spread using two different ultrasound-guided intercostal injection techniques in human cadavers

    CLINICAL ANATOMY, Issue 7 2010
    Tilemachos Paraskeuopoulos
    Abstract The continuity between the intercostal and paravertebral space has been established by several studies. In this study, the paravertebral spread of a colored dye was attempted with two different ultrasound-guided techniques. The posterior area of the trunk was scanned with a linear probe between the level of the fifth and the seventh thoracic vertebrae in eleven embalmed human cadavers. In the first technique, the probe was placed transversely below the inferior margin of the rib, and a needle was inserted between the internal intercostal membrane and the pleura. In the second technique, the probe was placed longitudinally at the intercostal space 5 cm lateral to the spinous processes, and the needle was inserted between the internal intercostal membrane and the pleura. In both techniques, 1 ml of methylene blue was injected, and both the intercostal and paravertebral spaces were prepared. In total, 33 injections were performed: 19 with the transverse technique and 14 with the longitudinal technique. Successful spread of the dye to the thoracic paravertebral space was recorded in 89.5% cases using the transverse technique and 92.8% cases using the longitudinal technique. No intrapleural spread of the dye was recorded in either technique. Ultrasound-guided injection into the intercostal space may offer an alternative approach to the thoracic paravertebral space. Clin. Anat. 23:840,847, 2010. © 2010 Wiley-Liss, Inc. [source]

    Pathoanatomy of posterior ankle impingement in ballet dancers,

    CLINICAL ANATOMY, Issue 6 2010
    Jeffrey A. Russell
    Abstract Dance is a high performance athletic activity that leads to great numbers of injuries, particularly in the ankle region. One reason for this is the extreme range of ankle motion required of dancers, especially females in classical ballet where the en pointe and demi-pointe positions are common. These positions of maximal plantar flexion produce excessive force on the posterior ankle and may result in impingement, pain, and disability. Os trigonum and protruding lateral talar process are two common and well-documented morphological variations associated with posterior ankle impingement in ballet dancers. Other less well-known conditions, of both bony and soft tissue origins, can also elicit symptoms. This article reviews the anatomical causes of posterior ankle impingement that commonly affect ballet dancers with a view to equipping healthcare professionals for improved effectiveness in diagnosing and treating this pathology in a unique type of athlete. Clin. Anat. 23:613,621, 2010. © 2010 Wiley-Liss, Inc. [source]

    Anatomic study of the prechiasmatic sulcus and its surgical implications

    CLINICAL ANATOMY, Issue 6 2010
    Bharat Guthikonda
    Abstract To address a lack of anatomical descriptions in the literature regarding the prechiasmatic sulcus, we conducted an anatomical study of this sulcal region and discuss its clinical relevance to cranial base surgery. Our systematic morphometric analysis includes the variable types of chiasmatic sulcus and a classification schema that has surgical implications. We examined the sulcal region in 100 dry skulls; bony relationships measured included the interoptic distance, sulcal length/width, planum sphenoidale length, and sulcal angle. The varied anatomy of the prechiasmatic sulcii was classified as four types in combinations of wide to narrow, steep to flat. Its anterior border is the limbus sphenoidale at the posterior aspect of the planum sphenoidale. The sulcus extends posteriorly to the tuberculum sellae and laterally to the posteromedial aspect of each optic strut. Averages included an interoptic distance (19.3 ± 2.4 mm), sulcal length (7.45 ± 1.27 mm), planum sphenoidale length (19 ± 2.35 mm), and sulcal angle (31 ± 14.2 degrees). Eighteen percent of skulls had a chiasmatic ridge, a bony projection over the chiasmatic sulcus. The four types of prechiasmatic sulcus in our classification hold potential surgical relevance. Near the chiasmatic ridge, meningiomas may be hidden from the surgeon's view during a subfrontal or pterional approach. Preoperative evaluation by thin-cut CT scans of this region can help detect this ridge. Clin. Anat. 23:622,628, 2010. © 2010 Wiley-Liss, Inc. [source]

    Association of rudimentary sacral zygapophyseal facets and accessory and ligamentous articulations: Implications for load transmission at the L5-S1 junction

    CLINICAL ANATOMY, Issue 6 2010
    Niladri Kumar Mahato
    Abstract Weight transmitted from the fifth lumbar vertebrae to the sacrum is distributed as three separate components between (a) the vertebral bodies anteriorly, (b) the transverse elements intermediately, and (c) the lumbosacral facet joints, posteriorly. The posterior components of the fifth lumbar vertebra share greater proportion of load in comparison with the posterior elements of the upper lumbar vertebral levels. This study focuses on rudimentary lumbosacral facet articulations and their possible effects on load sharing at this region. Twenty sacra bearing rudimentary articulations were collected for analysis. Sixteen of these sacra presented unilateral rudimentary facets, and the remaining four had facets that were bilaterally rudimentary. Thirteen of the sacra with unilateral rudimentary facets showed an accessory articulating area on the upper surface of the ala on the same side as the rudimentary zygapophyseal facet. The remaining three sacra (out of the 16) showed evidence of strong ligamentous attachments between the L5 and S1 transverse elements on the sides of the rudimentary facets. All the sacra with bilateral rudimentary facets demonstrated bilateral accessory L5,S1 articulations. These observations indicated that load transmission at lumbosacral junctions bearing a rudimentary facet joint is not normal and that their associations with strong L5,S1 lumbosacral ligamentous attachments or accessory articulations at the transverse elements serve a compensatory mechanism for load sharing. Clin. Anat. 23:707,711, 2010. © 2010 Wiley-Liss, Inc. [source]

    Topographical anatomy of Spiegel's lobe and its adjacent organs in mid-term fetuses: Its implication on the development of the lesser sac and adult morphology of the upper abdomen

    CLINICAL ANATOMY, Issue 6 2010
    Si Eun Hwang
    Abstract At 8,16 weeks of gestation, Spiegel's lobe of the caudate lobe appears as a sac-like herniation of the liver parenchyma between the inferior vena cava and ductus venosus or Arantius' duct. In 5 of 11 fetuses at 20,30 weeks of gestation, we found that an external notch was formed into the posterior aspect of the caudate lobe by a peritoneal fold containing the left gastric artery. This notch appeared to correspond to that observed in adults, which is usually seen at the antero-inferior margin of the lobe after rotation of the lobe along the horizontal or transverse axis. However, the notch did not accompany two of the three fetuses in which the left hepatic artery originated from the left gastric artery. Notably, until 9,10 weeks of gestation, the inferior and left part of Spiegel's lobe rode over the hepatoduodenal ligament and protruded medially into the lesser sac (bursa omentalis) behind the stomach. Thus, the fetal Winslow's foramen was located at the "superior" side of the ligament. However, as seen in adults, the protruding Spiegel's lobe was located at the posterior side of the lesser omentum. Therefore, a hypothetical rotation along the transverse axis in the later stages of development seems necessary to explain this repositioning. Considering that Spiegel's lobe develops faster than surrounding structures, it is likely that the lesser sac resulting from the rotation of the gastrointestinal tract, which actively contributes to facilitate the growth of the Spiegel lobe. Clin. Anat. 23:712,719, 2010. © 2010 Wiley-Liss, Inc. [source]

    Magnetic resonance elastography: A review

    CLINICAL ANATOMY, Issue 5 2010
    Yogesh K. Mariappan
    Abstract Magnetic resonance elastography (MRE) is a rapidly developing technology for quantitatively assessing the mechanical properties of tissue. The technology can be considered to be an imaging-based counterpart to palpation, commonly used by physicians to diagnose and characterize diseases. The success of palpation as a diagnostic method is based on the fact that the mechanical properties of tissues are often dramatically affected by the presence of disease processes, such as cancer, inflammation, and fibrosis. MRE obtains information about the stiffness of tissue by assessing the propagation of mechanical waves through the tissue with a special magnetic resonance imaging technique. The technique essentially involves three steps: (1) generating shear waves in the tissue, (2) acquiring MR images depicting the propagation of the induced shear waves, and (3) processing the images of the shear waves to generate quantitative maps of tissue stiffness, called elastograms. MRE is already being used clinically for the assessment of patients with chronic liver diseases and is emerging as a safe, reliable, and noninvasive alternative to liver biopsy for staging hepatic fibrosis. MRE is also being investigated for application to pathologies of other organs including the brain, breast, blood vessels, heart, kidneys, lungs, and skeletal muscle. The purpose of this review article is to introduce this technology to clinical anatomists and to summarize some of the current clinical applications that are being pursued. Clin. Anat. 23:497,511, 2010. © 2010 Wiley-Liss, Inc. [source]

    A review of the thoracic splanchnic nerves and celiac ganglia

    CLINICAL ANATOMY, Issue 5 2010
    Marios Loukas
    Abstract Anatomical variation of the thoracic splanchnic nerves is as diverse as any structure in the body. Thoracic splanchnic nerves are derived from medial branches of the lower seven thoracic sympathetic ganglia, with the greater splanchnic nerve comprising the more cranial contributions, the lesser the middle branches, and the least splanchnic nerve usually T11 and/or T12. Much of the early anatomical research of the thoracic splanchnic nerves revolved around elucidating the nerve root level contributing to each of these nerves. The celiac plexus is a major interchange for autonomic fibers, receiving many of the thoracic splanchnic nerve fibers as they course toward the organs of the abdomen. The location of the celiac ganglia are usually described in relation to surrounding structures, and also show variation in size and general morphology. Clinically, the thoracic splanchnic nerves and celiac ganglia play a major role in pain management for upper abdominal disorders, particularly chronic pancreatitis and pancreatic cancer. Splanchnicectomy has been a treatment option since Mallet-Guy became a major proponent of the procedure in the 1940s. Splanchnic nerve dissection and thermocoagulation are two common derivatives of splanchnicectomy that are commonly used today. Celiac plexus block is also a treatment option to compliment splanchnicectomy in pain management. Endoscopic ultrasonography (EUS)-guided celiac injection and percutaneous methods of celiac plexus block have been heavily studied and are two important methods used today. For both splanchnicectomies and celiac plexus block, the innovation of ultrasonographic imaging technology has improved efficacy and accuracy of these procedures and continues to make pain management for these diseases more successful. Clin. Anat. 23:512,522, 2010. © 2010 Wiley-Liss, Inc. [source]

    Paresthesia and hypesthesia in the dorsum of the foot as the presenting complaints of a ganglion cyst of the foot

    CLINICAL ANATOMY, Issue 5 2010
    Diogo Casal
    Abstract Although ganglion cysts of the foot represent a substantial amount of lumps in this region, they rarely cause peripheral nerve symptoms. We describe the clinical case of a 43-year-old female with complaints in the previous three months of hypesthesia and paresthesia in the anterior portion of the medial half of the dorsum of her left foot that extended into the first interdigital cleft. She associated the start of her neurological symptoms to the appearance of a lump in the dorsum of the foot. A presumptive diagnosis of compression of the medial branch of the deep fibular nerve and of the medial dorsal cutaneous nerve in the dorsum of the foot by a ganglion cyst was made. Ultrasonography confirmed the cystic nature of the lesion and surgery allowed complete excision of a mass arising from the joint between the medial and intermediate cuneiform bones that was compressing the deep fibular nerve and the medial dorsal cutaneous nerve. Pathological examination confirmed that the lesion was a cystic ganglion. As far as the authors know, the simultaneous compression of the medial branch of the deep fibular nerve and of the medial dorsal cutaneous nerve in the dorsum of the foot by a ganglion cyst has not been described before. Clin. Anat. 23:606,610, 2010. © 2010 Wiley-Liss, Inc. [source]

    The contribution of the palmaris longus muscle to the strength of thumb abduction

    CLINICAL ANATOMY, Issue 4 2010
    Hope Gangata
    Abstract The palmaris longus muscle (PLM) is described as a weak flexor of the wrist and a tensor of the palmar aponeurosis, but not a thumb abductor. The PLM is believed to aid thumb abduction through its insertion onto the thenar eminence. Two groups, both right hand dominant, were selected from 1,200 sampled participants. The first group comprised of 38 subjects with unilateral presence of the PLM and was used to determine the strength of thumb abduction. The second group comprised of 30 subjects, with bilateral presence of the PLM, and it was used to calculate the effects of hand dominance. A significant number of subjects with bilateral absence of the PLM were observed and undocumented. Using a dynamometer in subjects with unilateral presence of the PLM, the force of thumb abduction was significantly greater on the hand with a PLM than the one without it (P = 0.014), irrespective of hand dominance. In the second sample with bilateral PLM, thumb abduction on the dominant hand was 10% stronger than on the nondominant hand and was similar to the universally accepted average of 10% increase in grip strength of the dominant hand. Thus, 10% was deducted from all the dominant hands, and the force of thumb abduction remained greater on the hand with PLM than the hand without it (P = 0.049). The results of this study demonstrated the PLM to be involved in thumb abduction, and the authors therefore recommend that this action of the muscle be universally accepted by anatomists and hand surgeons. Clin. Anat. 23:431,436, 2010. © 2010 Wiley-Liss, Inc. [source]

    The frequency of absence of palmaris longus in a South African population of mixed race

    CLINICAL ANATOMY, Issue 4 2010
    Robert Ndou
    Abstract The palmaris longus (PL) is a weak flexor of the wrist that may be harvested as a tendon graft and used in surgical procedures for reconstructive purposes. The PL is congenitally absent in 15% of the worldwide population. However, the frequency of absence varies considerably among different population groups, being as high as 63.9% in the Turkish population and as low as 3% in the black population in the Republic of Congo. In this study, South African persons of mixed race (n = 201) were assessed by two anatomists for the presence of the PL tendon using three clinical tests, namely the Traditional Test, Mishra's Test II, and the Gangata Test. The most reliable of the three tests used was determined using Kendall's coefficient of concordance. Of the total number of subjects used, 11.5% had absence (either bilaterally or unilaterally) of the PL tendon. There was a 5.5% bilateral absence of the PL. The study revealed that the PL tendon may present in six different patterns according to the clinical assessment tests applied, the presence or absence of the PL alongside the flexor capi radialis, and the degree of prominence of PL, if present. Using the Kendall's coefficient of concordance, the Mishra's Test II, and the Gangata Test, both involving abduction of the thumb, were found to be most effective in revealing the PL. The frequency of absence of the PL in South Africans of mixed race has been determined. Clin. Anat. 23:437,442, 2010. © 2010 Wiley-Liss, Inc. [source]

    Anatomical observations of the moderator band

    CLINICAL ANATOMY, Issue 4 2010
    Marios Loukas
    Abstract Apical ventricular septal defects are rare pathologies of the ventricular septum. The moderator band, or other large trabeculations, is the major obstacle for the repair of such defects. The aim of our study was to identify and describe variations in the size and anatomy of the moderator band. We studied the right ventricular apical trabeculations in 100 adult human cadavers. Overall, we identified the moderator band in 92% of hearts. In just over two-fifths (42%), the band was a short and thick trabeculation, whereas, in one-eighth (12%), it was long and thick. In just under one-quarter of the hearts (24%), the band was short and thin, whereas it was long and thin in 14% of the hearts. In the remaining eight hearts, we were unable to identify the moderator band. The mean thickness of the band was 4.5 ±1.8 mm, and its mean length was 16.23 ± 2.3 mm, ranging from 11.3 to 24.3 mm. According to these measurements, we were able to classify the band as originating less than 45% of the distance from the tricuspid valve to the apex (closer to tricuspid valve), seen in 12 hearts, between 45 and 55% of the distance from the valve to the apex, seen in 45 hearts, and greater than 55% of this distance (closer to the apex), seen in 39 specimens. We present these data that may prove useful in the setting of the surgical repair of apical ventricular septal defects through the right atrium. Clin. Anat. 23:443,450, 2010. © 2010 Wiley-Liss, Inc. [source]

    The celebrated écorchés of honoré Fragonard, part 1: The classical techniques of preparation of dry anatomical specimens in the 18th century

    CLINICAL ANATOMY, Issue 3 2010
    Christophe Degueurce
    Abstract The écorchés that Honoré Fragonard created between 1766 and 1771 have miraculously survived the ravages of time due to a technique of preparation which Fragonard never revealed. The present paper and a subsequent article aim to explain the classical methods used by anatomists of the 18th century (Part 1) and to throw light on the details of Fragonard's method (Part 2). Anatomists of the 18th century who wished to preserve their dissections used a method of mummification, which has now fallen into disuse: drying after immersion in alcohol. This article explains the stages of the classical method utilized by French anatomists of the Age of Enlightenment. The cadaver was selected with care before the vascular system was injected with a colored mixture of wax, animal fat, and plant resins. The body was then dehydrated by immersion in a bath of alcohol, after which it was removed and positioned by means of a wooden framework, which held the body in the desired pose while the alcohol evaporated. The vessels were painted, and finally the body was varnished. Clin. Anat. 23:249,257, 2010. © 2010 Wiley-Liss, Inc. [source]

    The celebrated écorchés of honoré Fragonard, part 2: The details of the technique used by Fragonard

    CLINICAL ANATOMY, Issue 3 2010
    Christophe Degueurce
    Abstract It is remarkable that the famous écorchés of Honoré Fragonard have survived the centuries to reach us today. Studies carried out by several teams have established details of the technique used by Fragonard that help to explain their longevity. The injection of the vessels was achieved by means of a mixture of mutton tallow and pine resin diluted in essence of turpentine and essential oils. This gave Fragonard a very high success rate. Above all, he did not add pigments to his mixture while injecting the veins, and this facilitated the procedure. The vessels were painted after preservation to give them the vivid colors that we can still see today. Another detail that explains their exceptional conservation is that the varnish used by Fragonard was composed of Venice turpentine, made from larch resin and known to repel insects. Clin. Anat. 23:258,264, 2010. © 2010 Wiley-Liss, Inc. [source]

    The historical Latin and etymology of selected anatomical terms of the larynx

    CLINICAL ANATOMY, Issue 2 2010
    Daniel D. Lydiatt
    Abstract The etymological evolution of the anatomical terms larynx, cricoid, glottis, epiglottis, and thyroid (cartilage) dates to antiquity. Human dissection replaced animal in the 16th and 17th centuries and terms evolved. This evolution was recorded in the literature largely in Latin. We translated key studies of laryngeal anatomy from the 16th century to better understand this evolution. We present the Latin with our translations, and historical commentary as essential to this understanding. Vesalius favored the Latin scutiform (shield) for the thyroid cartilage, but recognized peltalis (shield). The Basle Nomina Anatomica (BNA) chose the Greek thyroid (,,,,o,,, ) for modern convention. Vesalius used the name "innominate" for the cricoid cartilage, but described its resemblance to a ring, drawn in the margin of the Fabrica. Krikoid, the Greek for ring shaped, was adopted by the BNA. Although the term arytenoid was used for centuries, Vesalius argued the Greek name referred to the spout of a cup or ladle. He recognized the human arytenoids as two separate cartilages as opposed to single in certain animals. The glottis was defined by Vesalius as the vocal fold or rima glottidis of today, and he advanced its function by understanding the paired, mobile arytenoid cartilages. He defined the function of the epiglottis and first described the pre-epiglottic space. Vesalius' student at Padua, Italy, Columbo contributed to anatomical knowledge, but animosity between them clouded the record. Harvey, working 75 years later in England, offers an evolutionary window from Vesalius. Harvey's laryngeal studies preceded by a decade his groundbreaking studies on the circulation of blood. Clin. Anat. 23:131,144, 2010. © 2010 Wiley-Liss, Inc. [source]

    Acromioclavicular joint cyst formation

    CLINICAL ANATOMY, Issue 2 2010
    Andrew D. Hiller
    Abstract Acromioclavicular joint (ACJ) cysts are an uncommon and unusual sequela associated with shoulder pathophysiology. The majority of literature on ACJ cysts consists of individual case reports with no definitive literature review currently available. In addition to a comprehensive literature review, four clinical cases are presented in this report. First described by Craig (1984), a total of 41 cases have been previously reported in the literature. Of these cases, five occurred with the rotator cuff musculature intact. The remaining 36 cases of ACJ cysts occurred in patients with a complete tear/avulsion of the rotator cuff. Previous attempts at compiling a complete record of all reported cases have combined several distinct conditions into a single category. This article presents two distinct etiologies for the pathogenesis of ACJ cyst formation. In the presence of an intact rotator cuff, a Type 1 cyst can form superficially and be limited to the ACJ. Following a massive or traumatic tear of the rotator cuff, mechanical instability of the humeral head can cause a deterioration of the inferior acromioclavicular capsule (cuff tear arthropathy) and an overproduction of synovial fluid. Overtime, a "geyser" of fluid can form between the glenohumeral and the ACJ, forming a Type 2 cyst. This differentiation and categorization is essential for appropriate classification and treatment. Clin. Anat. 23:145,152, 2010. © 2010 Wiley-Liss, Inc. [source]

    Communications between the palmar digital branches of the median and ulnar nerves: A study in human fetuses and a review of the literature,

    CLINICAL ANATOMY, Issue 2 2010
    Nadire Unver Dogan
    Abstract In this study, median nerves (MNs) and ulnar nerves (UNs) were dissected in 200 palmar sides of hands (left and right) of 100 (50 male, 50 female) spontaneously aborted fetuses with no detectable malformations. The fetuses, whose gestational ages ranged from 13 to 40 weeks, were dissected under an operating microscope. The MN divided first into a lateral ramus and a medial ramus and then formed a common digital nerve. The first common digital nerve trifurcated in all of the studied cases. The branching patterns were classified into two types (Type 1 and Type 2) based on the relationship with the flexor retinaculum (behind/distal of it). A communication branch between the UNs and MNs in the palmar surface of the hand was found in 59 hands (29.5%). The proper palmar digital nerves were numbered from p1 to p10, starting from the radial half of the thumb to the ulnar half of the little finger, and these nerves exhibited six types of variations. The present data obtained from human fetuses will aid in elucidating the developmental anatomy of the nervous system and provide hand surgeons with a more complete anatomical picture to help them to avoid iatrogenic injuries. Clin. Anat. 23:234,241, 2010. © 2009 Wiley-Liss, Inc. [source]

    John Browne (1642,1702): Anatomist and plagiarist

    CLINICAL ANATOMY, Issue 1 2010
    Marios Loukas
    Abstract In contrast to many other physicians of his age, John Browne (1642,1702), an English anatomist and surgeon, managed to strike a balance in his career that spanned relative obscurity, prestige, and notoriety. Among his more prestigious credits, Browne was Surgeon in Ordinary to King Charles II and William III. He also had numerous publications to his name, some of which are credited as great innovations. His career, however, was tempered by his most important book, which has been critiqued by his contemporaries as well as modern historians as plagiarism. Although Browne undeniably copied the works of others and published them under his name, he was not alone in this practice. Various forms of intellectual thievery were common in Browne's day, and there were many perpetrators. The life of this overlooked figure in the history of anatomy and the stigma attached to him will be examined. Clin. Anat. 23:1,7, 2010. © 2009 Wiley-Liss, Inc. [source]

    Locating the arcuate line of Douglas: Is it of surgical relevance?

    CLINICAL ANATOMY, Issue 1 2010
    P.M. Mwachaka
    Abstract Ventral hernia formation is a common complication of rectus abdominis musculocutaneous flap harvest. The site and extent of harvest of the flap are known contributing factors. Therefore, an accurate location of the arcuate line of Douglas, which marks the lower extent of the posterior wall of the rectus sheath, may be relevant before harvesting the flap. This study is aimed at determining the position of the arcuate line in relation to anatomical landmarks of the anterior abdominal wall. Arcuate lines were examined in 80 (44 male, 36 female) subjects, aged between 18 and 70 years, during autopsies and dissection. The position of the arcuate line was determined in relation to the umbilicus, pubic symphysis, and intersections of rectus abdominis muscle. Sixty four (80.4%) cases had the arcuate line. In most cases (52), this line was located in the upper half of a line between the umbilicus and the pubic symphysis. Most males (93%) had the arcuate line, while more than a third of females did not have it. In all these cases, the line occurred bilaterally as a single arcade, constantly at the most distal intersection of the rectus abdominis muscle. Consequently, the arcuate line is most reliably marked superficially by the distal tendinous intersection of the rectus abdominis muscle. Harvesting of the muscle cranial to this point will minimize defects in the anterior abdominal wall that may lead to hernia formation. Clin. Anat. 23:84,86, 2010. © 2009 Wiley-Liss, Inc. [source]

    The branching pattern of the deep inferior epigastric artery revisited in-vivo: A new classification based on CT angiography

    CLINICAL ANATOMY, Issue 1 2010
    Warren M. Rozen
    Abstract The deep inferior epigastric artery (DIEA) is a reliable pedicle in the design of DIEA perforator flaps, with variations in its anatomy infrequent. Previous studies describing its branching pattern have all been based on cadaveric anatomy and described the following three branching patterns: Type 1 (single trunk), Type 2 (bifurcating trunk), and Type 3 (trifurcating trunk). The increased use of preoperative imaging, particularly with computed tomographic angiography (CTA), has enabled visualization of the DIEA and its branches in vivo, providing a functional view of this anatomy. We undertook a study of 250 patients (500 hemiabdominal walls) undergoing preoperative CTA before DIEA perforator flaps for breast reconstruction. The branching pattern of the DIEA and correlation to the contralateral hemiabdominal wall were assessed. The branching patterns of the DIEA were found to be different in vivo compared with cadaveric studies, with a higher than previously reported incidence of Type 1 patterns and lower than reported incidence of Type 3 patterns, and that some patterns exist which were not included within the previous nomenclature (namely, Type 0 or absent DIEA and Type 4 or four-trunk DIEA). There was also shown to be no overall concordance in the branching patterns of the DIEA between contralateral sides of the same abdominal wall; however, there was shown to be a statistically significant concordance in cases of a Type 1 DIEA (51% concordance, P = 0.04). As such, a new modification to the classification system for the branching pattern of the DIEA is presented based on imaging findings. Clin. Anat. 23:87,92, 2010. © 2009 Wiley-Liss, Inc. [source]