[FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Introduction: The fetal liver cells can differentiate into both hepatocytes and cholangiocytes based on the induction due to clonogenic properties with high growth potential. Understanding liver histogenesis might be helpful in liver and hepatocyte transplantation. Special histochemical and immunohistochemical stains provide better insight into the hepatic cellular architecture, although the literature regarding the same is relatively sparse. Methodology: This study's objective was to document the microscopic structure of the organization of hepatocytes, the appearance of central veins and sinusoids, the formation of the portal triad, and hematopoietic blasts of the liver at various weeks of gestation by using special histochemical and immunohistochemical stains and also to compare our observations with other regions of India and Western countries. Results: It was observed that the central vein and the arrangement of hepatocytes appeared at 14 weeks of gestation. The sinusoids and portal triads were formed at 15 weeks of gestation. The hemopoiesis level in the liver gradually increased from the 14^th to 26^th week of gestation, after which it decreased. Conclusion: A better understanding of human fetal liver histogenesis will help future research activities in liver transplantation and hepatocyte transplantation from the aborted/stillborn fetal liver from various weeks of gestation.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Background: The anterior cruciate ligament (ACL) is responsible for knee joint stability during all possible movements. The purpose of our present study was to estimate normal values of the position and dimensions of the tibial attachment of ACL for its successful reconstruction. Methodology: A sagittal magnetic resonance imaging (MRI) sample of the knee joint of 120 patients (58 men and 62 women) of 18–50 years of age was reviewed. Results: Anterior end of the tibial footprint was located at a mean of 14.92 mm ± 3.42 mm from the anterior end of the tibial plateau. The posterior end of the tibial footprint was located with a mean of 28.76 mm (±7.02) from the anterior end of the tibial plateau. The mean tibial footprint sagittal length was 14.56 mm ± 0.66 mm. The mean anterior cruciate sagittal center was located at 42.62% ±2.99% of the anteroposterior length of the tibial plateau. The present study will provide the baseline morphometric data for the position and size of the tibial footprint of the ACL on MRI in Punjab. Mean roof angle in the present study was 35.16° (±3.49°). Mean ACL-inclination angle was 50.13°(±4.56°). Mean ACL-Bluemensaat angle in the present study was 4.23°(±2.87°). Conclusion: Present study can help surgeons to ascertain the positioning of the tibial tunnel in routine ACL reconstruction as well as revised ACL reconstruction surgeries.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Background: Superior mesenteric artery (SMA) originates at L1 level as a ventral branch of abdominal aorta. It supplies the derivatives of midgut which extends below the opening of major duodenal papillae in the 2^nd part of the duodenum till the junction between the right 2/3^rd left 1/3^rd of the transverse colon. After its origin, it descends obliquely inside the mesentery up to the root of right iliac fossa. It is accompanied by superior mesenteric vein to its right side and is surrounded by a plexus of autonomic nerves. The SMA gives branches to jejunum, ileum and right colic, inferior pancreaticoduodenal (IPD), ileocolic, and middle colic artery. Variations in the course and branching pattern of SMA are of significant importance in gastrointestinal surgeries. Methodology: A prospective study was conducted with the convenient sample size of thirty cadavers. After opening the anterior abdominal wall, peritoneum and viscera were carefully separated and cleaned. The abdominal aorta with its branches was identified. SMA was identified at its origin. The course of the artery and its branches were traced and noted. The findings were tabulated and analyzed. The relation of superior mesenteric vein with the artery was identified and noted. Results: Variations in the branches of SMA were observed in 14 cadavers. We observed the absence of middle colic artery in four cadavers. Higher origin of ileocolic artery was found in two cadavers. One common trunk divides into middle colic artery and accessory right colic artery and another common trunk divides into right colic artery and ileocolic artery in a cadaver. The right colic artery and middle colic artery were found to take origin from a common trunk in a cadaver. The common trunk for IPD (artery and middle colic artery was found in one cadaver. The common trunk for right colic artery and ileocolic artery was observed in four cadavers. Accessory right colic artery was observed in four cadavers. The common trunk for accessory right colic artery and middle colic artery was found in two cadavers. Accessory right colic artery, right colic artery, ileocolic artery, and ileal branches had their origins from a common trunk in a cadaver. Variations in relation between SMA and superior mesenteric vein were found in two cadavers. Conclusion: Awareness and knowledge regarding the variations in SMA and its relation with vein are important for surgeons and radiologists to avoid both intraoperative and postoperative complications during surgical and diagnostic procedures involving intestines.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Background: Cortical branches of the anterior cerebral artery (ACA) supply the medial surface and superior border of the cerebral hemisphere. Names of distinct cortical branches are according to the regions of the brain supplied by that particular branch. There can be variations in the number, origin, and distribution of these branches. There can also be variations of the ACA like azygous, bi hemispheric, median, aplasia, and fenestration of the ACA. This study aimed to evaluate the anatomical variation of the ACA and its cortical branches taking into consideration their number and site of origin. Methodology: Retrospective cross-sectional analysis of magnetic resonance angigraphs of 80 subjects (42 males and 38 females) without cerebrovascular diseases who was undertaken in the department of radiodiagnosis from July 2021 to August 2022. Results: The cortical branches were seen either being completely absent or present singly or in duplication. The callosomarginal artery (CmA) branch was found to be most commonly absent (51.25% on the right side), paracentral lobule artery most commonly duplicated (10% of cases on the right). CmA gave origin to the maximum number of cortical branches as compared to other cortical branches. The abnormal origin of anterior cortical branches was found to be more than posterior cortical branches. A few rare cases of variations (1.25% cases each) like azygous, bihemispheric, aplastic, and median ACA. Conclusion: In the present study different variations were observed in the cortical branches of ACA. These variations may also result in higher incidence of ischemic stroke in territory of ACA, involving the superior medial part of the parietal lobe and midline of the frontal lobe. Therefore, this study can be of clinical importance to neurosurgeons during cerebral surgeries.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Background: The talus is the second-largest tarsal bone. Morphometric analysis of both sides of the talus is necessary to know the right–left symmetry for implant design and for mechanical testing for surgeons and orthopedicians. Hence, this study was done to observe the facets of the inferior surface of the talus and to measure the morphometric parameters of the talus. Methodology: This cross-sectional study was carried out on a total of 66 dry adult human tali (33 of the right side and 33 of the left side). Morphologically, the types of articular facets on the head of the talus were assessed and classified as done by Boyan et al. as -Type A1, Type A2, Type A3, Type A4, Type B, and Type C. Morphometric evaluation of talus was done with the help of digital vernier caliper, and anteroposterior distance (length), maximum transverse width, vertical height of talus, length of sulcus tali, width of sulcus tali, depth of sulcus tali, and head–neck length (HNL) of talus were measures. Neck-body angle of the talus was also measured. Statistical analysis was performed, and data were expressed as mean, minimum, maximum values, and standard deviation. Results: In the present study, Type A1 facet was found in 51.5% of the talus, in 28.8% of Type A2, in 12.1% of Type A3, in 1.5% of Type A4, in 6.5% of Type B, and none of Type C facet found. The mean length, width, and height of the talus were 52.74 ± 4.39 mm, 31.45 ± 2.74 mm, and 25.93 ± 2.64 mm, respectively. The width, length, and depth of sulcus tali were 5.9 ± 1.02 mm, 21.88 ± 3.07 mm, and 5.52 ± 1.25 mm, respectively. HNL of talus was 15.72 ± 2.73 mm, and neck-body angle of the talus was 153.88° ±4.64°, respectively. No statistically significant difference was found on both sides except neck-body angle, where P = 0.031 (P < 0.05). Conclusion: The values of neck-body angle of the right side talus were higher than the left side, and the difference was statistically significant. Hence, the measurement of this study may help the surgeons to choose the appropriate size of the prosthesis for talus implantation surgeries.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Background: Complete or incomplete fissures divide the lung into lobes. Fissures can also be absent in the lung. Quantitative assessment of the completeness of fissures can be helpful for surgeons and radiologists during invasive procedures related to the lung. Hence, the present study was undertaken to record the extent of completeness of fissures, contour of the fissural surface of lobes, and accessory fissures. Methodology: The present study was done on 78 (right-40 and left-38) formalin-fixed random lung specimens obtained from adult cadavers. Results: Majority of oblique oblique fissures were incomplete (left-60.5% and right-60%). The absence of fissures was mainly seen in horizontal fissures (25%). Quantitative assessment for the degree of pulmonary fissure completeness showed that G0 and G3 were found more in the right oblique fissure (ROF) and horizontal fissure, G1 and G2 more in the left and ROF, respectively. Fissural surface of lower lobe was concave in the upper part and convex in the lower part, whereas fissural surface of middle lobe was convex in the majority of cases. Accessory fissures were found in 21.8%. Azygos fissure was present in two right lungs. A strong correlation was found between the depth of oblique fissure and the thickness of left lung. Conclusion: High frequency of incomplete fissures was found. Accessory fissures were commonly observed in the right lung. A wide range of variations in the completeness of fissures was noticed between the present and previous studies. Hence, surgeons and radiologists should be alert of these variations for surgical planning and interpretation of radiological images.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Background: Surgeries such as discectomy, intervertebral fusion, anterior microforaminotomy, and anterior screw fixation can damage neurovascular content of foramen transversarium of cervical vertebrae. The aim of this study was to measure outer limit and strength of foramen transversarium with help of uncinate process, anterior tubercle, and anterior root thickness. Methodology: A total of 54 dried human cervical vertebrae collected from anatomy department. Only third to seventh cervical vertebrae were included. Digital vernier caliper was used to measure transverse length (TL) of body, bilateral distance of uncinate process, and anterior tubercle from mid of cervical vertebral body and thickness of mid of anterior root. Results: Mean TL of body of cervical vertebrae was 23.87 mm, mean distance of uncinate process from vertebral body was 9.14 mm on right and 8.49 mm on left (P < 0.0001), mean distance of anterior tubercle from vertebral body was 20.81 mm on right and 20.36 mm on left (P < 0.014), mean thickness of anterior root was 1.48 mm on right and 1.36 mm on left (P < 0.1003) whereas mean distance between uncinate process was 18.4 mm. Conclusion: Mean TL of cervical vertebrae was 23.8 mm, distance of uncinate process was 8.81 mm from the center, distance of anterior tubercle to uncinate process was 20.72 mm and thickness of anterior root was 1.43 mm. Uncinate process and anterior tubercle distance from mid of cervical vertebrae body can help surgeons to identify zone and avoid injury to contents.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Androgen receptor gene mutations on Xq12, which also have a 46XY karyotype abnormality, are the root cause of the X-linked uncommon recessive disorder of sex development known as androgen insensitivity syndrome (AIS). Complete AIS existed as a female, with normal breast, no uterus, ovaries, and fallopian tube with a blind-ending vagina but the presence of bilateral undescended testis either in the inguinal canal, abdomen, or labioscrotal junction and elevated testosterone levels. This was a rare case of a 22-year-old female patient who presented with primary amenorrhea. Ultrasonography showed gonads in the mid parts of inguinal canals on both sides, reaching up to the superficial ring. On investigation, increased in level of serum testosterone, follicle-stimulating hormone along with the luteinizing hormone was seen. AIS is actually very disturbing to individuals and families, so close collaboration between radiologist, pathologist, treating consultants, and psychiatrists are required for the proper management.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Background: The most often damaged ligament in the knee joint is the anterior cruciate ligament (ACL). Reconstruction surgery is the ideal option which requires morphometric understanding of ACL. The aim of the present study is to determine the length and width of ACL in the knee joint in the South Indian population. Methodology: The study was conducted from August 2020 to July 2021 during a 1-year period. We selected participants with no evident macroscopic abnormalities of the knee joints, between the ages of 27 years and 55 years of both genders. For the study, 50 knee joints from 29 cadavers that fulfilled the above requirements were dissected and the ACL was measured for its length and width in the center point in between bony attachments with digital vernier caliper. Results: The mean length of the ACL was found to be 29.73 mm with standard deviation of 2.32, and the mean width of the ACL was found to be 11.15 mm with standard deviation of 1.07. Conclusion: The present study will add to the existing knowledge on the morphometry of the ACL. This study would be helpful in selecting grafts for surgical reconstruction of the ACL.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

[FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Background: Uterine anomalies arise from abnormal fusion of paramesonephric ducts or failure of apoptosis of septum between two ducts leading to abnormal division of the uterine cavity. Initial dearth of universal standard diagnosis was the reason for the improper reporting of the data associated with prevalence of uterine developmental anomalies. But now various authors have reported the prevalence of uterine anomalies using standard diagnostic techniques. The objective of the study was to assess the prevalence of various uterine congenital anomalies among women of reproductive age (15–45 years) with no previous uterine pathology. Methodology: An ultrasound was utilized to take a transabdominal sonographs of both longitudinal and transverse planes from the supine position of participants who were made to consume 500–1000 mL of water to promote diuresis for the duration of the scan. Scans were then interpreted. Results: From a study of 200 participants whose mean age group fell around 30 ± 8 years, 140 of the women were parous and 60 were nulliparous. Twelve of the participants displayed anomalies that included bicornuate, arcuate, and septate. Five cases of the bicornuate uterus (2.5%), four arcuate uterus (2.0%), and three septate uterus (1.5%) were noted. Conclusion: From a sample size of 200, the occurrence of uterine anomalies is 6%, with no cases of uterine agenesis or a hypoplastic uterus.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]