bluuebunny/crossref_metadata_2025 huggingface dataset:
Fetal iliac angle measurements by three‐dimensional sonography
Authors: Lee W. , Blanckaert K. , Bronsteen R. A. , Huang R. , Romero R.
Published: March 2003

Objective

To determine the technical reliability of fetal iliac angle measurements by three‐dimensional sonography as a prenatal marker for Down syndrome.

Methods

Three‐dimensional multiplanar views of the fetal pelvis were used to standardize iliac angle measurements from 35 normal second‐trimester pregnancies. Measurement reliability for a single examiner and between two different examiners were analyzed by intraclass correlation. Normal iliac angle measurements were compared to those obtained from 16 fetuses with trisomy 21.

Results

The mean axial angle for normal fetuses was 79 ± 5.5 °, which was significantly less than that observed in fetuses with trisomy 21 (87.7 ± 4.9 °) (P < 0.001). Iliac angles did not correlate with gestational age. Axial angles were reproducible between two examiners who measured the same multiplanar view of the pelvis. Inter‐ and intraobserver reliability were also acceptable after a standardized multiplanar view was independently obtained by each examiner (intraclass correlation = 0.91 for both). Coronal angles were unreliable because of difficulties with finding a reproducible measurement plane. For a false‐positive rate of 5%, an axial angle threshold of 87 ° correctly identified 56% of fetuses with trisomy 21.

Conclusion

Axial iliac angle measurements are reliable by standardized three‐dimensional multiplanar views of the pelvis and can be used to identify some fetuses at increased risk for trisomy 21. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
Prenatal diagnosis of an epignathus: a case report and review of the literature
Authors: Clement K. , Chamberlain P. , Boyd P. , Molyneux A.
Published: March 2003

An epignathus is an extremely rare form of teratoma that arises from the oral cavity, most commonly from the palate. We describe a case identified sonographically at 17 weeks' gestation after a raised maternal serum alpha‐fetoprotein was recorded. This pregnancy was terminated but we review the literature over the last 10 years and describe the management options available in such cases. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
Screening for Down syndrome using first‐trimester ultrasound and second‐trimester maternal serum markers in a low‐risk population: a prospective longitudinal study
Authors: Audibert F. , Dommergues M. , Benattar C. , Taieb J. , Thalabard J.‐C. , Frydman R.
Published: March 2003

Objectives

To compare nuchal translucency and second‐trimester maternal serum measurements as alternative methods of antenatal screening for Down syndrome in a low‐risk population and to evaluate the consequence of combining the results in the estimation of risk.

Design

In a consecutive series of 4130 women aged less than 38 years with a singleton pregnancy, we examined both the detection rate of Down syndrome by nuchal translucency measurement at 10–14 weeks and maternal serum screening by human chorionic gonadotrophin and alpha‐fetoprotein at 14–18 weeks. Women with a nuchal translucency measurement of ≥ 3 mm and women with a maternal serum screening‐derived risk ≥ 1/250 were recommended to have amniocentesis. A second‐trimester detailed ultrasound scan was also performed in all women. The outcome of all pregnancies was recorded prospectively and the detection rate and false‐positive rate of different screening strategies were retrospectively analyzed.

Results

Out of the 4130 pregnancies that were followed (mean maternal age, 30.1 years), 12 cases of Down syndrome were observed (0.28%), all detected prenatally. Seven of 12 cases had a nuchal translucency measurement of ≥ 3 mm (58%), and six out of 10 cases with available maternal serum screening had a calculated risk of ≥ 1/250 (60%). Four of the five Down syndrome cases with a nuchal translucency measurement of < 3 mm were detected by subsequent maternal serum screening. At a threshold giving 5% of positive tests, the sensitivity of nuchal translucency, maternal serum screening and combined risk screening were 75%, 60% and 90%, respectively.

Conclusions

In screening for Down syndrome, an approach which combines the results from first‐trimester nuchal translucency and second‐trimester biochemistry is effective and increases the detection rate compared to the use of any single test. However, this strategy is likely to raise the false‐positive rate and the interpretation of maternal serum screening‐derived risk should be combined with the first‐trimester nuchal translucency measurement. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
Isolated echogenic foci in the fetal heart: do they increase the risk of trisomy 21 in a population previously screened by nuchal translucency?
Authors: Prefumo F. , Presti F. , Mavrides E. , Sanusi A. F. , Bland J. M. , Campbell S. , Carvalho J. S.
Published: March 2003

Objectives

To confirm the hypothesis that isolated cardiac echogenic foci at the second‐trimester anomaly scan do not influence our current calculation of risk of trisomy 21 in individual pregnancies, which is based on maternal age and nuchal translucency thickness at 11–14 weeks.

Design

Observational study in a fetal medicine unit.

Methods

In a general pregnant population undergoing first‐trimester nuchal translucency screening, data from 239 singleton pregnancies with isolated cardiac echogenic foci at the second‐trimester anomaly scan were compared with those of a control group of 7449 pregnancies with normal anomaly scans. Prevalence of trisomy 21 was determined in both groups. Following the anomaly scan, the individual risks of trisomy 21 were calculated by adjusting the previous risk based on maternal age and first‐trimester nuchal translucency. We assumed that echogenic foci did not alter each individual risk calculation. The expected number of cases of Down syndrome in both groups was then calculated from the sum of probabilities of each individual affected fetus. The observed number of cases was compared with the expected number in both study and control populations.

Results

There was no statistically significant difference between the prevalence of trisomy 21 in the study group (no cases) and in the control population (three cases). From individual risk calculations, observing no cases of trisomy 21 in the study group was the most likely event if echogenic foci did not increase the risk of this chromosomal abnormality (
P = 0.62).

Conclusion

The finding of isolated echogenic foci at the time of the 20 week‐scan does not significantly change the risks of trisomy 21 if background risk and previous nuchal translucency measurements are taken into account in the individual risk calculation. We suggest that no further adjustments to risk should be used. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
Platelet changes and subsequent development of pre‐eclampsia and fetal growth restriction in women with abnormal uterine artery Doppler screening
Authors: Missfelder‐Lobos H. , Teran E. , Lees C. , Albaiges G. , Nicolaides K. H.
Published: March 2003

Objectives

To investigate whether, in women with abnormal uterine artery Doppler, platelet volume and function will identify a subgroup of women at increased risk of pre‐eclampsia and intrauterine growth restriction and whether in‐vitro platelet aggregation precedes the onset of clinical disease.

Design

Platelet number, volume and aggregation induced by collagen or adenosine 5'‐diphosphate were evaluated in 16 non‐pregnant controls, 29 pregnant women with normal uterine artery Doppler and 31 pregnant women with abnormal Doppler, hence at risk of pre‐eclampsia and intrauterine growth restriction at 23 weeks. Outcome of pregnancy was recorded in each case.

Results

Twelve women in the group with abnormal uterine artery Doppler subsequently developed pre‐eclampsia and/or intrauterine growth restriction. All women with normal uterine artery Doppler had a normal pregnancy outcome. No differences in platelet count or in vitro platelet aggregation induced by collagen were observed between the groups. Mean platelet volume was greater in those with abnormal Doppler who had intrauterine growth restriction or normal pregnancy outcome compared with normal Doppler (10.3 and 10.3 vs. 9.4 fL, P = 0.004 and P = 0.01, respectively). Aggregation induced by adenosine diphosphate was higher in women with abnormal Doppler who developed pre‐eclampsia or intrauterine growth restriction compared with those with normal outcomes (66.5 and 66.5 vs. 21%, P = 0.02, P = 0.03, respectively).

Conclusions

Women with abnormal uterine artery Doppler at 23 weeks show alterations in mean platelet volume and platelet function that relate to subsequent adverse outcome. Copyright © 2002 ISUOG
Reference values for fetal limb biometry at 10–14 weeks of gestation
Authors: De Biasio P. , Prefumo F. , Lantieri P. B. , Venturini P. L.
Published: March 2003

Objectives

To calculate reference ranges for fetal limb measurements obtained by transabdominal ultrasound at 10–14 weeks of gestation.

Methods

Six hundred and six normal fetuses were examined transabdominally in a cross‐sectional study by a single observer. The crown–rump length of the fetuses ranged from 31 to 78 mm. Measurement of the length of the humerus, ulna, femur, tibia and foot was attempted from the longest section of each structure. To assess intraobserver repeatability, three sets of repeated measurements were obtained in 26 fetuses.

Results

An appropriate ultrasound measurement was obtained in a percentage of cases ranging from 93.2% to 97.9%. A significant correlation was found between crown–rump length measurements and humerus length (r = 0.74, P < 0.001), ulna length (r = 0.70, P < 0.001), femur length (r = 0.77, P < 0.001), tibia length (r = 0.69, P < 0.001) and foot length (r = 0.58, P < 0.001). Crown–rump length‐specific reference ranges for each measurement were calculated with the method of scaled absolute residuals. The study of intraobserver variability showed coefficients of variation ranging from 7.9 to 10.0% and intraclass correlation coefficients ranging from 0.89 to 0.94.

Conclusions

Fetal limb size is strongly correlated with crown–rump length. Despite a significant biological variability of the measurements, the availability of reference ranges could be of help in the early diagnosis of fetal skeletal dysplasias. Copyright © 2002 ISUOG
How successful is fetal echocardiographic examination in the first trimester of pregnancy?
Authors: Haak M. C. , Twisk J. W. R. , Van Vugt J. M. G.
Published: March 2003

Objective

Transvaginal echocardiography is still rarely incorporated into the first‐trimester ultrasound examination, despite the fact that heart defects are the most frequently encountered congenital malformation. This study was undertaken to explore the possibilities of fetal echocardiography in the late first trimester.

Methods

In 85 women with uncomplicated singleton pregnancies, three transvaginal ultrasound examinations between 11+0 and 13+6 weeks' gestation were performed. The examinations were carried out at weekly intervals and visualization of several echocardiographic planes was attempted (four‐chamber view, aortic root, long axis of the aorta, pulmonary trunk with three‐vessel view, cross‐over of the great arteries). The diameter of the aorta and pulmonary trunk were measured to establish reference ranges.

Results

The success rate of visualization of the different parameters increased with gestational age. The ability to perform a full cardiac examination increased from 20% in week 11 to 92% in week 13. Longitudinally derived growth curves of the aorta and the pulmonary trunk were constructed and both showed a linear increase with gestational age.

Conclusions

The best time in the first trimester to perform transvaginal echocardiography is at 13+0 to 13+6 weeks' gestation. In this period, a full cardiac examination is possible in 92% of cases. The increase of success rate compared to earlier studies is likely to result from the use of better resolution, high‐frequency transvaginal probes. First‐trimester echocardiography provides an opportunity to examine the fetal heart early in gestation, especially in patients at risk for cardiac malformations because of a positive family history or in fetuses with increased nuchal translucency. Copyright © 2002 International Society of Ultrasound in Obstetrics and Gynecology
Cardiac malformations in first‐trimester fetuses with increased nuchal translucency: ultrasound diagnosis and postmortem morphology
Authors: Haak M. C. , Bartelings M. M. , Gittenberger‐De Groot A. C. , Van Vugt J. M. G.
Published: March 2003

Objective

The aim of this study was to explore the diagnostic accuracy of first‐trimester transvaginal echocardiography in fetuses with increased nuchal translucency (NT) thickness, by comparing the ultrasound diagnosis with the findings on postmortem examination or mid‐gestational ultrasound and neonatal outcome.

Methods

Transvaginal echocardiography was performed in 45 fetuses with a NT > 95th centile. Karyotyping was performed in 43. In 20 of the 23 pregnancies in which termination of pregnancy was carried out, postmortem examination was performed to determine the presence and type of heart defect. Mid‐gestational echocardiography was performed in ongoing pregnancies and neonatal follow‐up information was obtained. Findings on first‐trimester transvaginal echocardiography were compared to those of second‐trimester echocardiography or the results of postmortem examination. The mean NT in the fetuses with and without heart defects was calculated.

Results

Of the 45 fetuses, heart malformations were suspected on first‐trimester ultrasound in 10 (22%), of which eight (80%) were found to have a chromosomal abnormality. Postmortem examination showed minor additional findings in some cases and major discrepancies occurred in none. Septal defects were the most common defects in trisomic fetuses. In three fetuses with a 45X karyotype, hypoplastic left heart syndrome was diagnosed. Heart defects were diagnosed in three euploid fetuses in which fetal demise occurred. The sensitivity and specificity for the detection of heart defects of transvaginal echocardiography were 88% and 97%, respectively. The mean NT in fetuses with a normal heart (4.3 mm) was significantly smaller than that of fetuses with heart defects (7.4 mm).

Conclusion

Transvaginal echocardiography can be performed reliably in first‐trimester fetuses with an increased NT. In this study, the proportion of chromosomally abnormal fetuses with a heart defect was not different from that found in newborns, except for cases of Turner syndrome. Fetal demise occurred in all three euploid fetuses with a heart malformation. The fetuses with a heart defect had a larger NT than did those without. Copyright © 2002 International Society of Ultrasound in Obstetrics and Gynecology
Effect of maternal position on cervical length measurement in twin pregnancies
Authors: Bernáth T. , Brizot M. L. , Liao A. W. , Cury L. , Banduki Neto J. D. , Zugaib M.
Published: March 2003

Objective

To compare cervical length measurements in twin pregnancies obtained from patients in the recumbent and standing positions.

Methods

Fifty women with uncomplicated twin pregnancies underwent monthly transvaginal ultrasound examinations for cervical length measurement in the recumbent and standing positions. The correlation between cervical length measurements obtained in the recumbent and standing positions, and between these measurements and gestational age, were examined. The significance of the differences between measurements obtained in the recumbent and standing positions was also analyzed.

Results

Based on data obtained at the first ultrasound examination, there was a significant correlation between cervical length measurements in the recumbent and standing positions (r = 0.77; t = 8.25; P < 0.0001) and both measurements showed a significant inverse correlation with gestational age (recumbent position: r = −0.60, P < 0.0001; standing position: r = −0.46; P = 0.0008). The mean of the differences (standing − recumbent) was −1.8 mm (95% confidence interval = −3.7–0.04; t = −1.96; P = 0.06) and the mean of percentage differences ((standing − recumbent)/recumbent × 100) was −2.9% (95% confidence interval = −8.6–2.7; t = −1.04; P = 0.3). When the data obtained at all examinations were examined by multiple regression analysis, cervical length measurement in the recumbent position was the only parameter that correlated significantly with the percentage difference between cervical length measurements (P < 0.0001).

Conclusions

Cervical length in twin pregnancies decreases with gestation and there is a good correlation between measurements obtained from women in the recumbent and standing positions. No significant changes in cervical length were observed comparing measurements obtained in the two maternal positions. Copyright © 2002 International Society of Ultrasound in Obstetrics and Gynecology
Fetal gender: antenatal discrepancy between phenotype and genotype
Authors: Bretelle F. , Salomon L. , Senat M.‐V. , Vialard F. , Albert M. , Roume J. , Ville Y.
Published: March 2003

Sexual discrepancy is reported in both 46,XY females and 46,XX males, and most diagnoses of sex reversal are made in the postpubertal period. We report three cases of sexual discrepancy, which were revealed by karyotyping following genetic amniocentesis, chorionic villus sampling and fetal blood sampling. The etiologies of 46,XX male, 45,X male and 46,XY female subjects are reviewed. When sexual discrepancy between fetal karyotype and ultrasonographic fetal phenotype is encountered, sample error and placental mosaicism should be excluded. A detailed fetal ultrasound examination should be performed to check for syndromic gender discrepancy. When repeat karyotyping is indicated, localization of the Sox related Y chromosome gene should be carried out. Copyright © 2002 International Society of Ultrasound in Obstetrics and Gynecology
Repeatability of echocardiographic measurements in the human fetus
Authors: Simpson J. M , Cook A
Published: March 2003

Objectives

To determine the repeatability of cross‐sectional, M‐mode and Doppler echocardiographic measurements in the human fetus.

Methods

This was a prospective echocardiographic study of 10 normal fetuses, involving measurement of 32 different echocardiographic variables in each. The intra‐ and interobserver error of measurements were quantified. The median (range) gestational age was 23 (17–34) weeks.

Results

Cross‐sectional echocardiography: for left ventricular end‐diastolic volume the intraobserver coefficient of variation was 13% and the interobserver limits of agreement were a ratio of 0.46–2.19. For left ventricular ejection fraction the repeatability was ± 8.8% and the interobserver limits of agreement were ± 20%. M‐mode echocardiography: the coefficient of variation for left ventricular end‐diastolic dimension was 10%, and the interobserver limits of agreement were a ratio of 0.74–1.70. The intraobserver repeatability of left ventricular fractional shortening was ± 8.8%, and interobserver limits of agreement ± 15%. Limits of agreement for M‐mode‐derived left ventricular end‐diastolic volume were wide, intraobserver coefficient of variation 32% and interobserver limits were a ratio of 0.44–4.36. Doppler echocardiography: the intra‐ and interobserver errors were high for Doppler variables such as acceleration time, acceleration slope, stroke volume, cardiac output and vessel dimension. There was less error associated with measurements such as maximum Doppler velocity, velocity time integral, ejection time and heart rate.

Conclusions

The repeatability of most echocardiographic measurements in the fetus is poor. This applies particularly to volumetric data such as ventricular volumes and volume flow estimations. Interobserver errors are consistently higher than intraobserver errors, confirming that when sequential measurements are clinically important, the same observer should be used. Copyright © 2002 International Society of Ultrasound in Obstetrics and Gynecology
Second‐trimester amniocentesis vs. chorionic villus sampling for prenatal diagnosis in multiple gestations
Authors: Antsaklis A. , Souka A. P. , Daskalakis G. , Kavalakis Y. , Michalas S.
Published: March 2003

Objective

To study the impact of invasive procedures for prenatal diagnosis on multiple pregnancies and compare first‐trimester chorionic villus sampling with second‐trimester amniocentesis.

Design

Retrospective study of 347 second‐trimester amniocenteses and 69 chorionic villus sampling procedures.

Results

Miscarriage occurred in 4.18% of women after amniocentesis and 4.54% of women after chorionic villus sampling. In the amniocentesis group the risk of miscarriage was higher in the cases with transplacental entry (4.54%) than in those with transamniotic entry (2.08%). The rates of preterm delivery ≤ 32 weeks and preterm delivery ≤ 35 weeks in the amniocentesis group were 11.8% and 32.4% and in the chorionic villus sampling group 16.66% and 23.8%, respectively. Total fetal loss rate was similar in the amniocentesis group (8.8%) and the chorionic villus sampling group (10.22%). In the 21 cases where selective feticide was carried out the total fetal loss rate was lower in the chorionic villus sampling group (8.3%) than in the amniocentesis group (11.1%), although the difference did not reach statistical significance.

Conclusion

Chorionic villus sampling appears to be a safe alternative to amniocentesis and should be considered as the method of choice particularly when there is a high risk of an affected fetus necessitating selective feticide. Copyright © 2002 International Society of Ultrasound in Obstetrics and Gynecology
Autosomal recessive type of Adams–Oliver syndrome: prenatal diagnosis
Authors: Becker R. , Kunze J. , Horn D. , Gasiorek‐Wiens A. , Entezami M. , Rossi R. , Guschmann M. , Sarioglu N.
Published: March 2003

We report on three pregnancies complicated by Adams–Oliver syndrome in a consanguineous Turkish couple. Two cases were correctly diagnosed prenatally at 22+3 and 13+0 weeks gestation following the first case of Adams–Oliver syndrome in which severe anomalies of the extremities were observed at 26+5 weeks' gestation. In this first case, the diagnosis of Adams–Oliver syndrome was made following termination of pregnancy at 27+2 weeks' gestation. In all three cases, autopsy was performed. All fetuses showed anomalies of the extremities, aplasia cutis and symmetric defects of the skull, with bone being replaced by collagenous tissue. Although there have been numerous cases of the postnatal diagnosis of Adams–Oliver syndrome following termination of pregnancy, this is the first description of the prenatal diagnosis of this disorder. Copyright © 2002 International Society of Ultrasound in Obstetrics and Gynecology
P1 Regionalisation of the brain as an evolutionarily conserved developmental mechanism.
Authors: GALE E. , ZILE M. , MADEN M.
Published: March 2003

Comparative studies of chordate neural connectivity and gene families have provided evidence for evolutionary conservation of the patterning mechanisms in brain development (review Holland & Holland, Curr. Opin. Neurobiol.9, 1999). Based on expression patterns of ascidian and amphioxus homologues of the Otx gene and the Hox1 gene and of the ascidian Pax‐2/5/8, the chordate brain has been suggested to have tripartite development (Wada et al., Development125, 1998; Kozmik et al., Development126, 1999). Primitively, the chordates have regions homologous to the vertebrate forebrain, anterior midbrain and posterior hindbrain while the posterior midbrain/anterior hindbrain region seems to be a vertebrate innovation. The extent of the homologies within each of these regions between the vertebrates and their ancestors is not fully determined but the similarity of Hox gene expression patterns suggests organisational constants over evolutionary time within the posterior hindbrain region.

Identification of the posterior hindbrain region as a developmental unit in vertebrates is demonstrated in the retinoid‐deficient quail. Embryos laid by quails fed a retinoid‐deficient diet have no posterior hindbrain while the anterior hindbrain is specified normally. Through DiI cell lineage tracing and a temporal analysis of gene expression characteristic of this region (Krox‐20, Hoxb‐1, mafB, and fgf3), we have followed the development of this region of cells. From the initial formation of the neural plate phenotype in the retinoid‐deficient quail, there is no evidence of a posterior hindbrain. This region is never specified and all the cells of the hindbrain participate in an anterior hindbrain fate. A single retinoid injection in ovo during early development completely rescues the posterior hindbrain ensuring that the phenotype was the result of a single stimulus. Therefore cells from the posterior hindbrain respond in a coordinated regional manner to the presence or absence of a single gene inducer, retinoic acid.

We present evidence of regionalisation of the vertebrate head that is up stream of segment specification. In combination with data from amphioxus and ascidians, this may represent a common mechanism for head development throughout chordate evolution. Interestingly, regional deletion with enlargement of the adjacent region is very reminiscent of the gap gene phenotype in Drosophila. It would be disregarding millions of years of divergent evolution to suggest that vitamin A is identical to a Drosophila gap gene inducer; nevertheless this data supports the hypothesis of common underlying regulation of axial regionalisation and gene hierarchies.
Correspondence: Communication between the superior cervical sympathetic ganglion and the inferior laryngeal nerve
Authors: SATO IWAO , SATO TORU , SHIMADA KAZUYUKI
Published: March 2003

Complex arborisations occurs between the inferior ganglion of the vagus nerve and the superior cervical sympathetic ganglion (Braeucker, 1923; Fick, 1926; Siwe, 1931; Hoffman, 1957). The superior cervical sympathetic ganglion sends branches to the internal and the external carotid arteries, the inferior vagal ganglion, the superior laryngeal nerve and the cervical nerves, and provides superior cardiac and thyroid branches as well as the trunk that descends directly to the middle and inferior cervical sympathetic ganglia. There are communications between the vagus nerve (laryngeal branches) and the superior cervical sympathetic ganglion (SCSG). Cannizzaro et al. (1991) and Zerilli et al. (1994) reported abnormalities of sympathetic function among the effects of injury to the superior laryngeal nerve during thyroid surgery. The interconnections between these various nerves are therefore of clinical importance. We document here a rare example of complex communication between the vagus nerve and the SCSG in dissections of 113 adult (78 male, 35 female) Japanese cadavers. Both sides were examined in 88 cases, the right only in 18 and the left only in 7 (i.e. 201 sides in total).
Correspondence: Case report: congenital urethrocutaneous fistula
Authors: BARWELL J. , HARRIS D.
Published: March 2003

A 2‐year‐old boy presented with a suspected urethrocutaneous fistula. He had been born at 26 wk gestation and spent 14 wk in the special care baby unit with severe respiratory problems and an episode of meningitis. He had not had a urinary catheter in situ or urinary tract infections. Bilateral inguinal hernias had been repaired. At presentation he was below the 3rd centile for height and weight but had reached all other developmental milestones.
Obituary: PROFESSOR T. R. TREVOR‐JONES, OBE
Authors: KRAMER BEVERLEY
Published: March 2003

Professor T. R. Trevor‐Jones, former Professor and Head of the Department of General Anatomy, Faculty of Dentistry, University of the Witwatersrand, died in Gauteng on 19th September 1996.
Anatomical compartments of the parasellar region: adipose tissue bodies represent intracranial continuations of extracranial spaces
Authors: WENINGER WOLFGANG J. , STREICHER JOHANNES , MÜLLER GERD B.
Published: March 2003

The cavernous sinus is traditionally described as a single anatomical compartment that contains cranial nerves, blood vessels, and connective tissue. A detailed analysis of 45 infant and 4 fetal parasellar regions shows that this view must be modified. The spatial arrangement, the topographic relations, and the expansion of the adipose and connective tissue spaces were analysed and reconstructed 3‐dimensionally on a computer. It is shown that 3 different anatomical compartments, which are strictly demarcated by connective tissue, compose the parasellar region of infants. Two represent intracranial continuations of extracranial tissue spaces. The 3rd compartment corresponds to the so‐called ‘cavernous sinus’ of the adult. Each of the 3 compartments contains characteristic adipose tissue bodies. Because the cavernous sinus represents only one compartment of the area, we propose to use the term ‘parasellar region’ to designate the entire anatomical region on either side of the sella turcica.
Ultrastructural observation on ‘transitional tubules’ in human oviductal ciliogenic cells
Authors: HAGIWARA HARUO , AOKI TAKEO , FUJIMOTO TOYOSHI
Published: March 2003

In the human oviduct epithelium during ciliogenesis, short tubular structures were found in the transitional zone between the basal body and cilium. The tubules, termed transitional tubules from their location, were 34–36 nm in diameter and 0.13±0.06 μm in length; the number around a basal body was variable, but usually 4–6. The cytoplasmic leaflets of the tubule membranes were coated by electron‐dense material and appeared to be connected to alar sheets. The transitional tubules existed transiently during ciliogenesis. The exact role of transitional tubules is unknown, but considering their location, they may fix the basal body in the apical cytoplasm during ciliary elongation and/or may be related to formation of alar sheets.
The ulnar tunnel: a rare disposition of its contents
Authors: OLAVE ENRIQUE , DEL SOL MARIANO , GABRIELLI CARLA , PRATES JOSÉ CARLOS , RODRIGUES CELIO F. S.
Published: March 2003

The ulnar tunnel is located at the proximal part of the hand radial to the pisiform bone and to the proximal part of the carpal tunnel. Inside it lie the ulnar nerve and artery. Compression of the ulnar nerve in this tunnel is often reported. Cysts, occupational trauma, fractures and muscle variations are among the main causes (Schjelderup, 1964; Kleinert & Hayes, 1971). Damage to the ulnar nerve and artery during the endoscopic decompression of the carpal tunnel has been reported recently (Agee et al. 1992; Nath et al. 1993; De Smets & Fabry, 1995). The structures within the ulnar tunnel are closely related to the medial part of the flexor retinaculum, in particular the ulnar artery which is located lateral to the ulnar nerve. During a study of this region we found a rare disposition of the contents of this tunnel. We believe that knowledge of this variation is important for the surgical anatomy of this region.
Cartilaginous development of the human craniovertebral junction as visualised by a new three‐dimensional computer reconstruction technique
Authors: DAVID KAROLY M. , McLACHLAN JOHN C. , AITON JAMES F. , WHITEN SUSAN C. , SMART STEVE D. , THOROGOOD PETER V. , CROCKARD H. ALAN
Published: March 2003

Serial transverse histological sections of the human craniovertebral junction (CVJ) of 4 normal human embryos (aged 45 to 58 d) and of a fetus (77 d) were used to create 3‐dimensional computer models of the CVJ. The main components modelled included the chondrified basioccipital, atlas and axis, notochord, the vertebrobasilar complex and the spinal cord. Chondrification of the component parts of CVJ had already begun at 45 d (Stage 18). The odontoid process appeared to develop from a short eminence of the axis forming a third occipital condyle with the caudal end of the basioccipital. The cartilaginous anterior arch of C1 appeared at 50–53 d (Stages 20–21). Neural arches of C1 and C2 showed gradual closure, but there was still a wide posterior spina bifida in the oldest reconstructed specimen (77 d fetus). The position of the notochord was constant throughout. The normal course of the vertebral arteries was already established and the chondrified vertebral foramina showed progressive closure. The findings confirm that the odontoid process is not derived solely from the centrum of C1 and that there is a ‘natural basilar invagination’ of C2 during normal embryonic development. On the basis of the observed shape and developmental pattern of structures of the cartilaginous human CVJ, we suggest that certain pathologies are likely to originate during the chondrification phase of development.
JOHN ZACHARY YOUNG, F.R.S., Hon. F.B.A., M.A. (1907–1997)
Authors: THOMAS P. K.
Published: March 2003

John Zachary Young, universally known as JZ, was born in Bristol on 18 March 1907 and died on 4 July 1997. The Zachary in his name was said to be of Cornish origin. His ancestor Thomas Young achieved fame through his modulus and through the Young–Helmholtz theory of colour vision. JZ was educated at Marlborough, which school also produced another notable scientist, student of and early collaborator with JZ, Peter Medawar. Having acquired an interest in zoology at school, JZ read zoology at Magdalen College, Oxford, and then obtained a scholarship to work at the Zoological Section in Naples. There he began to investigate the autonomic innervation of the gut of fish. While in Naples he rediscovered the giant axons of the squid but, unlike L. W. Williams in 1909, he immediately recognised their importance. His observations led to the fundamental studies on the generation of the membrane potential and conduction of the action potential of axons by Hodgkin and Huxley. During his time in Naples before the War, JZ began his lifelong interest in the brain and behaviour of cephalopods.
Surface ectodermal wound healing in the chick embryo
Authors: LAWSON AARON , ENGLAND MARJORIE A.
Published: March 2003

Wound healing has been studied in the surface ectoderm overlying the midbrain region of stages 16–20 chick embryos by light microscopy, scanning and transmission electron microscopy, and immunofluorescent techniques. The embryos were divided into 6 groups, i.e. stages 16–17 for groups I, V and VI, and stages 19–20 for groups II, III and IV. For groups I and II embryos, a longitudinal incision about 0.6 mm was made close to the dorsal midline and the embryos incubated for varying periods of time up to 24 h. To determine the role of actin in the process of healing, selected groups I and II embryos were stained with FITC phalloidin and the wound margins examined using a confocal microscope. Wounds of all embryos in group I and about 20% in group II healed completely within 24 h of reincubation. The process of healing involved a change in the shapes of the ectodermal cells at the wound ends. This appeared as a zipping‐up of the wound from both ends. In about 80% of group II embryos where healing did not occur, wound gaping was marked. Intense actin staining (actin cable) was observed at the wound margins of groups I and II embryos suggesting that the actin purse‐string mechanism may play a role during wound healing in this epithelial model. The role of tension in wound healing was also determined by placing 2 secondary wounds about 0.5–0.7 mm long close to, and at right angles to the ends of the primary wound in groups III and V embryos. The procedure decreased the tension within the ectodermal cells at the wound ends. Groups IV and VI embryos served as controls for groups III and V embryos, respectively. Healing of both primary and secondary wounds after reduction of tension was rapid. Most primary wounds in group V embryos healed completely within 3 h of reincubation and the rate of reepithelialisation after the reduction of tension was about 160% more than that in group VI (control) embryos. Similarly, most primary wounds in group III embryos were almost closed within 6 h of reincubation. Here, the rate of reepithelialisation was 80% more than that in group IV (controls). Thus tension is an important factor in wound healing in this model.
Spatial distribution of nerve processes and β‐adrenoreceptors in the rat atrioventricular node
Authors: PETRECCA KEVIN , SHRIER ALVIN
Published: March 2003

Atrioventricular (AV) nodal conduction time is known to be modulated by the autonomic nervous system. The presence of numerous parasympathetic and sympathetic nerve fibres in association with conduction tissue in the heart is well authenticated. In this study, confocal microscopy was used to image the distribution of antibodies directed against the general neuronal marker PGP 9.5, tyrosine hydroxylase (TH), vasoactive intestinal peptide (VIP), calcitonin gene‐related peptide (CGRP) and β1 and β2‐adrenoreceptors. Serial 12 μm sections of fresh frozen tissue taken from the frontal plane of the rat atrioventricular node, His bundle and bundle branches were processed for histology, acetylcholinesterase (AChE) activity and immunohistochemistry. It was found that the AV and ventricular conduction systems were more densely innervated than the atrial and ventricular myocardium as revealed by PGP 9.5 immunoreactivity. Furthermore, the transitional cell region was more densely innervated than the midnodal cell region, while spatial distribution of total innervation was uniform throughout all AV nodal regions. AChE‐reactive nerve processes were found throughout the AV and ventricular conduction systems, the spatial distribution of which was nonuniform exhibiting a paucity of AChE‐reactive nerve processes in the central midnodal cell region and a preponderance in the circumferential transitional cell region. TH‐immunoreactivity was uniformly distributed throughout the AV and ventricular conduction systems including the central midnodal and circumferential transitional cell regions. β1‐adrenoreceptors were found throughout the AV and ventricular conduction systems with a preponderance in the circumferential transitional cell region. β2‐adrenoreceptors were localised predominantly in AV and ventricular conduction systems with a paucity of expression in the circumferential transitional cell region. These results demonstrate that the overall uniform distribution of total nerve processes is comprised of nonuniformly distributed subpopulations of parasympathetic and sympathetic nerve processes. The observation that the midnodal cell region exhibits a differential spatial pattern of parasympathetic and sympathetic innervation suggests multiple sites for modulation of impulse conduction within this region. Moreover, the localisation of β2‐ARs in the AV conduction system, with an absence of expression in the circumferential transitional cell layer, suggests that subtype‐specific pharmacological agents may have distinct effects upon AV nodal conduction.
Os zygomaticum bipartitum: frequency distribution in major human populations
Authors: HANIHARA TSUNEHIKO , ISHIDA HAJIME , DODO YUKIO
Published: March 2003

The frequency of the Os zygomaticum bipartitum was examined in major human populations around the world. Eastern Asians have a higher frequency of the bipartite zygomatic bone than any other geographical groups. The arctic peoples, Amerindians and the Oceanians, who all may have derived from eastern Asian population stocks, have a considerably low frequency of this trait. The frequency distribution from East/Southeast Asia to Africa and Europe through South/Central/West Asia suggests some clinality for the bipartite zygomatic bone. The second peak in the frequency is seen in Subsaharan Africa. The clinal variation with no identifiable regulation by subsistence patterns and environmental factors suggested a genetic background for the occurrence of the Os zygomaticum bipartitum.
Case report: bilateral sternalis muscles with a bilateral pectoralis major anomaly
Authors: O'NEILL M. N. , FOLAN‐CURRAN J.
Published: March 2003

The importance of continuing to record and discuss anatomical anomalies was addressed recently by Hicks & Newell (1997) in the light of technical advances and interventional methods of diagnosis and treatment. Two recent radiological reports (Bradley et al. 1996; Murphy & Nokes, 1996) highlighted the diagnostic dilemma posed by a sternalis muscle in the detection of breast cancer.
Skin morphology and its role in thermoregulation in mole‐rats, Heterocephalus glaber and Cryptomys hottentotus
Authors: DALY T. JOSEPH M. , BUFFENSTEIN ROCHELLE
Published: March 2003

The skin structure of 2 Bathyergid rodents, the naked mole‐rat (Heterocephalus glaber) and the common mole‐rat (Cryptomys hottentotus) is compared, to investigate whether thermoregulatory differences may be attributed to different skin features. Histological and ultrastructural studies of the dorsal skin of these closely related species show morphological and structural similarities but differences in the degree of skin folding, thickness of the integument and dermal infrastructure were evident. The skin of the common mole‐rat conforms with expected morphological/histological arrangements that are commonly found in mammalian skin. Many features of the skin of the naked mole‐rat, such as the lack of an insulating layer and the loosely folded morphological arrangement contribute to poikilothermic responses to changing temperatures of this mammal. Further evidence for poikilothermy in the naked mole‐rat is indicated by the presence of pigment containing cells in the dermis, rather than the epidermis, as commonly occurs in homeotherms. Lack of fur is compensated by a thicker epidermal layer and a marked reduction in sweat glands. Differences in skin morphology thus contribute substantially to the different thermoregulatory abilities of the 2 Bathyergids. The skin morphology is related to the poor thermoinsulatory ability of the animals while simultaneously facilitating heat transfer from the environment to the animal by thigmothermy and/or other behavioural means.
The timing between skeletal muscle myoblast replication and fusion into myotubes, and the stability of regenerated dystrophic myofibres: an autoradiographic study in mdx mice
Authors: McGEACHIE JOHN K. , GROUNDS MIRANDA D.
Published: March 2003

In mdx mice, a model for Duchenne muscular dystrophy, the timing between the replication of myoblasts and their incorporation into myotubes was determined autoradiographically. Thirty‐eight mdx mice aged 23 d were injected with tritiated thymidine to label myoblasts replicating early in the dystrophic process. At intervals from 8 h to 30 d after injection the tibialis anterior muscles were removed, processed for autoradiography and analysed for labelled central myonuclei (derived from the progeny of myoblasts which had been labelled at 23 d). At 8 h after injection there were no labelled central myonuclei, showing that the labelled myoblasts had not fused within this time. At 1 d, 2% of central myonuclei were labelled, at 2 d, up to 32% were labelled, at 3 d ∼60% were labelled, and at 4 d the labelling peaked at 74%. In the 27 mice sampled from 5–30 d after injection, the levels of central myonuclear labelling varied enormously: from 1–63%. However, there was a consistent decrease in the numbers of labelled central myonuclei with time. This may have been due to dilution of the relative numbers of labelled myonuclei due to other, nonlabelled, myoblasts replicating after the availability of tritiated thymidine, and fusing. It was also possible that labelled myofibres underwent subsequent necrosis and were eliminated from the muscle. The proposal that a regenerated myofibre can undergo a subsequent cycle of necrosis and regeneration was supported by evidence of some necrotic myofibres with labelled and unlabelled central nuclei. These results have implications for understanding the cellular biology and pathology of dystrophic muscle, particularly in relation to myoblast transfer therapy as a potential treatment of Duchenne muscular dystrophy.
Scoring of nonmetric cranial traits: a methodological approach
Authors: GUALDI‐RUSSO E. , TASCA M. A. , BRASILI P.
Published: March 2003

The purpose of the present study was to analyse the replicability of the scoring of discontinuous traits. This was assessed on a sample of 100 skulls from the Frassetto collection (Dipartimento di Biologia Evoluzionistica Sperimentale of Bologna University) analysed through intraobserver comparisons: the discontinuous traits were determined on the same skulls and by the same observer on 3 separate occasions. The scoring was also assessed through interobserver comparisons: 3 different observers performed an independent survey on the same skulls. The results show that there were no significant differences in the discontinuous trait frequencies between the 3 different scorings by the same observer, but there were sometimes significant differences between different observers. Caution should thus be taken in applying the frequencies of these traits to population research. After an indispensable control of material conditions (subject age included), consideration must be given to standardisation procedures between observers, otherwise this may be an additional source of variability in cranial discontinuous trait scoring.
Effects of ageing on the insertion zones of the human vocal fold
Authors: PAULSEN FRIEDRICH , KIMPEL MARTIN , LOCKEMANN UTE , TILLMANN BERNHARD
Published: March 2003

The vocal ligaments insert at the anterior and posterior commissures of the larynx. These structures fulfil biomechanical functions, balancing the different elastic moduli of tendon, cartilage or bone and undergo age‐related changes that may be responsible for voice changes with increasing age. The aim of this study was to analyse the insertion structures of the vocal ligaments by means of macroscopic, histological, immunohistochemical and electron‐microscopic methods and to draw conclusions from age‐related structural changes on a functional basis. Investigations were carried out on the larynges of 22 males and 15 females (aged 1–95 y). In adolescence, the insertion zone of the vocal ligament tendon, a dense network of connective tissue rich in sulphated glycosaminoglycans at the thyroid cartilage, is characterised by a layer between tendon and cartilage comparable to fibrocartilage. The insertion zone lacks a perichondrium. Collagen fibrils of the vocal ligament tendon penetrate directly into the thyroid cartilage. In the insertion area, the chondrocytes are surrounded by collagen fibrils, which show positive reactivity to antibodies against type I and type III collagen. Sulphated glycosaminoglycans are integrated between the collagen fibrils. In the area of the posterior glottis, elastic cartilage rests like a cap on the hyaline base of the arytenoid cartilage. There is no distinctive border between the structures. With increasing age, ossification of the laryngeal skeleton occurs, involving hyaline cartilage at the posterior glottis and hyaline and fibrocartilage at the anterior commissure. At the same time, a loss of sulphated glycosaminoglycans is observed inside the vocal ligament tendon. Advanced ossification of the laryngeal skeleton, particularly in the area of the commissures, an increasing loss of glycosaminoglycans in the vocal ligament tendon and changes in the elastic tissue reduce the elastic modulus between tendon, cartilage and bone, thus ‘stiffening’ the insertion zones, which could be one factor among others favouring voice changes with advancing age.