bluuebunny/crossref_metadata_2025 huggingface dataset:
Trochanteric branch of the lateral circumflex femoral artery and its possible role as a vascular pedicle bone graft
Authors: Bradnock B.
Published: February 2005

This paper discusses the trochanteric branch of the ascending branch of the lateral circumflex femoral artery which has been demonstrated in 42 cadavers, and the possible utilization of the greater trochanter as a vascularized bone graft.
A unique case of inguinal appendicitis?
Authors: Lanigan Dermot J. , Lee T. C.
Published: February 2005

An 81 year old man who had a reducible right inguinal hernia for 40 years presented with a 4 day history of irreducibility and a 2 day history of tenderness in his hernial sac. At operation a gangrenous appendix was found in the inguinal canal lateral to and outside the sac of an indirect hernia. This condition has not previously been described.
The development of the ligament of the head of the femur
Authors: Brewster S. F.
Published: February 2005

The hip joints of 30 human male and female fetuses and stillborns between 20 mm and 350 mm crown‐rump length were studied by light microscopy.

The ligament of the head of the femur developed in situ as a condensation of mesenchyme at the end of the second month of intra‐uterine life (IUL), and was vascularized by branches of acetabular vessels early in the fourth month. In the majority of fetuses older than 5.5 months IUL, vessels in the ligament passed a short way into the femoral head within cartilage canals, to supply a small region around the fovea capitis. The remainder of the head was supplied by vessels in canals from around the upper part of the neck.

The ligament changed from predominantly cellular to fibrous during the last 4 months of IUL. This increase in strength suggested significant mechanical functions in utero: limitation of adduction‐flexion and opposition to postero‐superior dislocation were the most likely.
Quantitative analysis of the intrinsic muscles of the hand
Authors: Linscheid Ronald L. , An Kai‐Nan , Gross R. Michael
Published: February 2005

As part of a study involving three‐dimensional modeling of the hand, the intrinsic muscles of the hand were evaluated quantitatively to estimate the range of muscular forces crossing the fingers. The Brand method of dissection allowed determination of muscle volume, fiber length, and physiologic cross section to estimate the maximal force. The intrinsic muscles were grouped by components on the basis of their origins in the trilaminar scheme of Cunningham as (1) dorsal abductors from the central ray, exemplified by the bipennate dorsal interossei; (2) the intermediate layer consisting of inter‐phalangeal joint extensors, exemplified by the unipennate palmar interossei with insertions into the extensor expansion; and (3) a superficial layer of adductors arising from the third metacarpal ridge, referred to as contrahentes.

The fiber lengths of either component of the dorsal interossei averaged 1.3 cm. The intermediate layer of muscle, numbered as flexores breves (FB), included the palmar interossei FB4,7,9; the superficial components of the dorsal interossei FB3,5,6,8; and the accessory adductor pollicis FB2. Fiber lengths averaged 1.7 cm. The superficial heads of the flexor pollicis brevis and abductor digiti quinti are possibly the border representations of the intermediate layer as FB1 and FB10. The thenar muscles made up 37%, dorsal interossei 24%, palmar interossei (flexores breves) of the fingers 16%, lumbricals 7%, and hypothenar muscles 16% of the total intrinsic muscle mass.

The ratio of muscle mass to fiber length, the physiologic cross‐sectional area, is useful in estimating available force.

This quantitative analysis of the intrinsic musculature may find application in the understanding of hand function and biomechanics.
Extraspinal course of the fifth lumbar spinal nerve: An update of its topographical relationships
Authors: Amonoo‐Kuofi H. S. , El‐Badawi M. G. , Fatani J. A. , Butt M. M.
Published: February 2005

The fifth lumbar spinal nerve traverses a highly mobile transitional junction of the vertebral column. Evidence suggests that it is often implicated in the etiology of low‐back pain, notably in entrapment syndromes. There appears to be a high incidence of unsuccessful attempts at surgical decompression in cases of suspected entrapment of the nerve, suggesting that perhaps the anatomical information on the topography of the nerve is incomplete. The present study examined the course and relations of the fifth lumbar spinal nerve by gross dissection of human cadaveric material. The results showed that the nerve and its subdivisions follow a complex, tortuous course as they cross the lumbosacral junction. The trunk and ventral and dorsal rami are all related to strong ligaments that are thought to be protective. The nearness of these nerves to ligaments in such an area of high mobility, however, predisposes them to impingement or entrapment in the event of joint or ligamentous pathology. It is suggested therefore that investigations of spondylogenic low‐back pain should include a detailed evaluation of the status of all parts of the fifth lumbar spinal nerve as they traverse their individual osteoligamentous compartments.
Topographic, microscopic, radiographic, and computerized morphometric studies of the human adult edentate mandible for oral implantologists
Authors: Maher William P.
Published: February 2005

Many edentate human mandibles obtained at random from cadaveric subjects of different ages were cleansed of their soft tissue coverings (macerated) and then divided into groups based upon alveolar process resorption differences. Each mandible was transected at five locations corresponding to prior sites of the molar and premolar teeth. The medial surface area of each section and its cortical and medullary components were accurately measured by computerized digital morphometry. Skeletomorphologic details were examined by gross, microscopic, and radiographic methods. Images made visible by the three methods were compared. Comparison clearly indicated that images of cortical thickness peripherally, trabecular bone density centrally, and the differences in density of canal borders and their locations in many edentate mandibles are very often inadequately portrayed by conventional oral radiographic methods. These inadequacies present a strong caveat to the unwary oral implantologist.
Longitudinal lymphatic plexuses of the teniae coli and their probable clinical significance
Authors: Parke Wesley W. , Settles Harry E. , Bunger Paul C. , Neufeld Daniel A.
Published: February 2005

A previously undescribed lymphatic plexus was found coursing longitudinally in association with the teniae coli during a routine demonstration of the gastroenteric subserous lymphatics using the hydrogen peroxide method. Further investigation using sections of the colon from autopsy specimens and dogs showed this plexus to be a constant anatomic feature and suggested that deficiencies in the classic methods of lymph vessel demonstration were responsible for the lack of previous observations. As these lymphatics may course several centimeters in both anal and oral directions before draining into regional mesocolic lymphatics, they provide a route by which malignant cells may extend, or be forced by operative manipulation of a tumor, to more distant sites in the colon wall. With awareness of these plexuses, generous ranges of resection and prophylactic measures to reduce malignant cell transfer should help reduce their possible contribution to suture line recurrences of colon tumors.
Lymphatic anastomoses between the distal esophagus and gastric cardia in dogs
Authors: Natsugoe Shoji , Aikou Takashi , Shimazu Hisaaki , Tabata Masashi
Published: February 2005

The intramural lymphatic system draining the distal esophagus and gastric cardia was studied on 35 mongrel dogs, using a dye injection procedure. When the dye was injected into the esophageal or gastric mucosa within 2 cm of the esophago‐gastric junction (EGJ), a mesh of lympho‐capillary networks was observed advancing inferiorly or superiorly across the EGJ. The intramural lymphatics of the distal esophagus and gastric cardia anastomose, especially in the central part of the muscularis mucosae.

On transmission electron microscopy, lumina filled with dye were proved to be lymphatic capillaries by demonstrating open gaps and overlapping or inter‐digitating endothelial cell processes. Some lympho‐capillaries containing dye were also observed beneath the esophageal epithelium. If the situation be extrapolated to human anatomy, the results suggest that lymphatic neoplastic metastases may occur even in early cases of carcinoma of the distal esophagus or gastric cardia.
Anatomy of the lumbar spinal nerves in the intervertebral foramen
Authors: Kostelic John K. , Haughton Victor M. , Sether Lowell A.
Published: February 2005

The anatomic relationships between the dorsal and ventral roots, spinal nerve, and dorsal and ventral rami of the lumbar spinal nerves have been described previously primarily on the basis of gross dissection and not on sectional anatomic techniques. Therefore, we examined the proximal spinal nerves in 16 cadavers by gross dissection, cryomicrotomy, and histology. On opening the root sheath that had been exposed by gross dissection, multiple fascicles could be identified intervening between the spinal nerve and the spinal nerve roots. Anatomic sections in a sagittal plane immediately distal (lateral) to the dorsal root ganglion demonstrated a plexus of fascicles 6–15 in number and 2–6 mm in length. On histologic sections the 6–15 fascicles were identified interspersed with fat and numerous small blood vessels. The proximal spinal nerve is formed from the convergence of these fascicles.
A retroesophageal right subclavian artery with the right vertebral artery originating from the right common carotid artery
Authors: Roszel Adam J. , Kiely Michael L.
Published: February 2005

The right subclavian artery was found to be retroesophageal, and the right vertebral artery originated from the right common carotid artery in a 46‐year‐old female cadaver. The right subclavian artery stemmed from the upper portion of the thoracic aorta, posterior and inferior to the origin of the normal left subclavian artery. The right and left common carotid arteries originated from the aortic arch in close proximity. Compression of the trachea anteriorly could not be demonstrated. The right inferior laryngeal nerve was nonrecurrent. A brief review of the literature shows the importance of knowledge concerning the aberrant right subclavian artery for the roentgenologist and the surgeon in the treatment of patients with this vascular anomaly.
Vascular anatomy of the spinal epidural space: Considerations on the etiology of the spontaneous spinal epidural hematoma
Authors: Groen Rob J. M. , Ponssen Hans
Published: February 2005

The anatomy of the blood vessels in the spinal epidural space is an important basis for the understanding of the etiology of the spontaneous spinal epidural hemorrhage (SSEH). The structure of the internal vertebral venous plexus and epidural arteries, in particular the poorly recognised “cluster‐type” arteries, has been studied. The cluster arteries are easily mistaken for vascular anomalies. The literature is reviewed, and the different theories on the etiology of the SSEH are discussed.
Imaging the thoracic lymphatics: Experimental studies of swine
Authors: Collins James D. , Shaver Marla L. , Disher Anthony C. , Batra Poonam , Brown Kathleen , Miller Theodore Q.
Published: February 2005

The lungs and hearts of 15 swine were surgically harvested intact and studied in the fresh state. The lymphatics of the lung and mediastinum were cannulated and contrast medium was introduced by retrograde injection to identify the visceral pleural lymphatics and deep lymphatics of the lung. Radiographic x‐ray, CT, MR, and color photographic images were obtained. Collateralization, extravasation (bronchorrhea), perivascular stasis, and circumvention were demonstrated. Lymphatic communication with the contralateral lung, thoracic duct, heart, and the diaphragm was demonstrated. The findings correlate with the lymphangiographic display of lymphedema of the extremities, obstruction to lymph flow secondary to congenital abnormalities, trauma, tumor, and infections. Our results support the view that stents and/or large bore needles may be introduced into the superficial lymphatics of the lung. The lymphatics of the lung may be anastomosed post lung transplantation and thus possibly reduce passive congestion that occurs in the early postoperative period. The authors postulate that tumor cells and infectious agents may be spread from one lung to the other by the anatomical pathways demonstrated.
Subperitoneal layer of elastic fibers in the female pelvis
Authors: Pawlina Wojciech , Larkin Lynn H. , Masterson Byron J. , Ross Michael H.
Published: February 2005

A preliminary report from this group described a unique layer of subperitoneal elastic fibers in the female pelvis. The current study was undertaken to better characterize this elastic layer in the female and determine if it exists in the male pelvis. Thirty‐seven hemipelves were used in this study and were employed for one of two purposes: dissection and/or sampling for histologic study. The following histologic stains were employed: Verhoeff's hematoxylin for elastic fibers, Masson's trichrome for collagen, and hematoxylin and eosin for general morphology. In some areas (broad ligament) the subperitoneal elastic layer was very thin with dispersed fibers while in other areas (uterosacral fold) the layer was thick with tightly packed fibers. A subperitoneal layer of elastic fibers was not detected in samples from the greater omentum; however, a dense but poorly organized layer of elastic fibers was noted between the posterior layer of the rectus sheath and the peritoneum. While a similar layer of elastic fibers was found in the male pelvis, the layer was less dense and less well organized than in the female. These findings indicate that in addition to the well‐accepted pelvic ligaments, in the female there may be a layer of elastic fibers that assists in supporting pelvic viscera in a more dynamic manner than the ligaments. Proper alignment or manipulation of this layer during reconstructive surgery may enhance postoperative results.
Studies on scars
Authors: Reid William Henry
Published: February 2005

Over several years, pressure has been used to lessen disfigurement of postoperative and particularly post‐traumatic scars and latterly the application of silicone gel topical dressing has been used. Attempts have been made to quantify and elucidate why these forms of treatment are effective.
Anatomy of arm veins: Significance for vein valve transplantation
Authors: Purvis Edward S. , Hyde Gordon L. , Peck David
Published: February 2005

Vein valve transplantation is a recently described operation to treat the sequelae of lower extremity venous hypertension resulting from valvular dysfunction. The operation involves harvesting a segment of an arm vein contianing a competent valve and transplanting it into a lower extremity vein. To determine the optimal incisions for obtaining a suitable valve‐containing segment of vein, 20 cadaver arms were dissected. Cephalic, basilic, and brachial veins were examined for size, distribution of valves, and presence of tandem valves (defined as valves separated by 2 cm or less). Because patency rates are low in vascular grafts < 4 mm in diameter, only veins of this size or greater were considered adequate for transplantation. Cephalic veinswere found to have a consistently smaller diameter than basilic or brachial veins (P < 0.0001). Incisions for exposure of the basilic and brachial veins were evaluated. When exposure was limited to the middle third of the arm, an adequate vein, either the basilic or one of the brachial veins, was found in all cases. When either the distal or proximal third of the arm was exposed, however, an adequate vein was found in only 70% of the cases (P < 0.02). Tandem valves, although potentially useful, were present in only 5%, 25%, and 20%, respectively, of distal, middle, and proximal arm segments. Based on the results of this study, a medial incision along the middle third of the arm, exposing a basilic or brachial vein, is recommended as the optimal approach for vein harvesting in vein valve transplantation.
Cortical indices of the shaft of weight bearing and non‐weight bearing long bones in the adult human
Authors: Nwoha P. U.
Published: February 2005

This study was conducted on X‐ray films of the shaft of normal femur and second metacarpal bones of adult male and female Nigerians to compare the percentage cortical thickness relative to the subperiosteal diameter (cortical index) of these bones. Age was correlated with cortical index (CI) using Pearson's product of moment correlation coefficient. Confidence limits of CI were calculated for clinical use. Results obtained were analysed for each sex and compared at P<0.05 level of significane. CI of the second metacarpal is significantly greater than of the femur in both the male and female. Age maintained significant inverse correlation with CI of the femur and nonsignificant correlation with the second metacarpal in the female. In the male, age had nonsignificant correlation with the femur or with the second metacarpal bone.

It is concluded that (i) the amount of percentage relative cortical bone to subperiosteal diameter of the second metacarpal, a nonweight‐bearing bone, is greater than that of the femur, a weight‐bearing bone, (ii) age of the adult has significant effect on the amount of cortical bone of the femur in the female but not in the male, and (iii) age of the adult does not have significant effect on the amount of cortical bone of the second metacarpal in both sexes.
The influence of anesthesia of the ear on the sensory innervation of the soft palate
Authors: Williams Huw O. L. , Whittet Heikki B.
Published: February 2005

Following the application of a topical anesthetic agent to the tympanic membrane, a number of patients described a sensation of numbness in the mouth. On examination these patients were found to have a significant area of anesthesia on the inferior surface of the ipsilateral soft palate.

As a result of auditory tube dysfunction many of the tympanic membranes were atrophic and retracted. In these cases the pars tensa was closely related to the medial wall of the tympanic cavity, and local anesthetic agents applied to the tympanic membrane could easily diffuse through to the promontory and related structures. If the bone over the tympanic plexus or that over the facial nerve were dehiscent these nerves would be exposed to the effect of the anesthetic. We feel that our observation suggests that in some individuals at least, the pathway of sensory innervation of the soft palate may involve either the facial nerve or the tympanic branch of the glossopharyngeal nerve.
Anatomic considerations in placement of central venous catheters
Authors: Mathers Lawrence H. , Smith David W. , Frankel Lorry
Published: February 2005

A knowledge of anatomy is essential for efficient and skillful placement of central venous catheters in seriously ill patients. The anatomy of the femoral, brachial, axillary, subclavian, external jugular, and internal jugular veins is described, and landmarks useful in achieving successful cannulation are discussed. Infectious and thrombotic complications of long‐term cannulation are reviewed. Catheterization of the umbilical vein in the newborn infant is a very useful alternative approach to central venous cannulation in this age group.
Tomographic abdominal anatomy with magnetic resonance color composites
Authors: Brown H. Keith , Hazelton Todd R. , Putnam Lisa M. , Silbger Martin L.
Published: February 2005

Magnetic resonance imaging (MRI) is an excellent modality for tomographically visualizing abdominal structures, particularly the liver, In an effort to simulate the natural color scheme of the living abdomen using MRI, we have generated color composites from sets of gray tone MR images obtained at corresponding anatomic slice positions from two healthy individuals. Pulse sequences used for our image sets included T1‐, T2‐, and proton density‐weighted spin echo sequences as well as an angiographic FISP gradient echo sequence. A PC/AT‐compatible computer with 24‐bit graphics display capbilites, along with commerical and customized image‐processing software, was used for composite generation. The applied colors were selected based on quantitative characteristics tissue intensity patterns so that tissue contrast could be optimized in the final image. The generated composites were correlated with cadaver sections to evaluate the color scheme of these false‐colored images. With our composite generation techniques, it was possible to generated near‐natural appearing color images of the abdomen. Color composites may be useful for teaching human cross‐sectional anatomy and may also have diagnostic applications in abdominal MRI studies. © 1992 Wiley‐Liss, Inc.
Computer‐generated three‐dimensional reconstruction of the mediastinm correlated with sectional and radiological anatomy
Authors: Conley David M. , Kastella Kenneth G. , Sundsten John W. , Rauschning Wolfgang , Rosse Cornelius
Published: February 2005

We describe a three‐dimensional computer‐generated model of the human mediastinum. Contours were manually traced from photographs of a serially sectioned, unfixed frozen cadaver block, Using software developed in‐house, the contours were digitized, automatically assembled and placed in registration, and displayed on a high performance graphics workstation as surfaced images. The model thus produced has advantages over traditional representations of anatomical structures; it is realistic, accurate, efficient, and flexible. Each anatomical component of the mediastinum is stored as a separate file in the computer and can be selectively accessed, displayed, and manipulated, allowing the model to be disassembled, reassembled, dissected, and viewed in any orientation. The model can be divided into a series of transversely cut “slabs,” the surfaces of which correlated with the anatomy displayed in the original cryosections and with radiological scans, thus permitting 2‐D sectional anatomy to be viewed in the context of the 3‐D model. Animation of the model can be accomplished by recording pre‐planned scripts onto videodiscs. The videodiscs serve as image archives that can be viewed in an interactive, self‐paced manner or accessed from a computer‐based multimedia system that is being developed by the Digital Anatomist Program. Anatomical reconstructions based on datasets of x‐, y‐, z‐coordinates have potential clinical applications as models that can be displayed to match the sectional planes of radiological images. The mediastinum model we describe is part of a large image database being developed by the Digital Anatomist Program that will form the spatial component of a knowledge base in structural biology. © 1992 Wiley‐Liss, Inc.
Anatomical concept for a selective anateromedial approach to the third cervical vertebra
Authors: Fasel J. , Gerber B. , Morscher E.
Published: February 2005

The present paper proposes a selective antermodial approach to the third cervical vertebra, based on the topographic and stratigraphic anatomy of the carotid regions. The study was performed on 12 subjects and involved 20 observations. The investigations showed the existence of an “access window” limited in one direction by the external carotid artery and pharynx, and in the other direction, by the superior thyroid artery and the hypoglossal nerve. The steps that precede the follows this crucial step of the approach are presented in a stratigraphic order from superficial to deep. © 1992 Wiley‐Liss, Inc.
The pulmonary arterial system, an anatomic/MRI study in sagittal planes
Authors: Cahill Donald R. , Breen Jerome F. , Myers Jay D.
Published: February 2005

This paper provides a decription and a mini‐atlas (with bold labeled anatomic drawings and magnetic resonance images) (MRIs) of the pulmonary arterial system and surrounding structures for the purpose of interpreint MRIs of heart patients examined in sagittal planes. The pulmonary arterial system (right outflow tract) was studied by examination of cadaver sections made in sagittal planes and by examination of corresponding MRIs from two living normal adult males. We propose a nontraditional format for describing the pulmonary arterial system by dividing in into four parts, rather than the customary three parts, adding a Pulmonary valve region between the ending of the conus arteriosus and the beginning of the pulmonary trunk. This region contains the entire pulmonary valve. It is approximately 1.5 cm long and is defined or outlined by the triple‐scalloped fibrous annulus of the pulmonary valve as decribed by Zimmerman (Ann R Coll Eng 39:348, 1966). Defining this region as a separate anatomic entity provides for a more precise description of the relationships of the left coronary and anteior interventricular arteries, the left sinus of the aortic valve, and left auricle to the outflow tract than that found in conventional descriptive anatomy. This paper also defines the ending of the pulmonary trunk, and the orifices of the left and right pulmonary arteries in relationship to the carina found in the upper posterior wall of the pulmonary trunk. An explanation for preferential enlargement of the left pulmonary artery in pulmonary valve stenosis is correlated to our study. © 1992 Wiley‐Liss, Inc.
Anatomy of the ulnar part of the lateral collateral ligament of the elbow
Authors: O'Driscoll Shawn W. , Horii Emiko , Morrey Bernard F. , Carmichael Stephen W.
Published: February 2005

The lateral ulnar collateral ligament (LUCL) of the elbow has been illustrated variably in anatomy texts. The purpose of this investigations was to determine the percentage of specimens in which this structure is present, and to describe its anatomy and function. The LUCL was identified as part of the lateral capsulo‐ligamentous complex in 17 of 17 fresh frozen cadaver elbows (P <.0001). The LUCL originates on the lateral epicondyle, blends with the fibers of the annular ligament as it arches superficial to it, then curves to insert on the tubercle of the supinator crest of the ulna. It is distinct at its insertion, but not at its origin where its fibers blend with those of the common extensor origin. The insertion is exposed in the interval created between (the deep surface of) the fascia of the supinator and its muscle fibers. The insertion can be palpated by applying a varus stress to the elbow. Cutting the ulnar fibers permitted posterolateral rotatory subluxation of the ulno‐humeral joint and varus subluxation of the elbow. © 1992 Wiley‐Liss, Inc.
Anatomy of dorsalis pedis artery and its use in limb salvage surgery
Authors: Barman A. Addison , Chaudhry Saqib S. , Moideen Ahamed S. , Egozi Leon
Published: February 2005

The Dorsalis Pedis artery (DPA) is an often overlooked but important artery that can be utilized for limb salvage surgery. It is especially useful in the diabetic patient in whom disease at the level of the bifurcation of the popliteal artery is common. The unique anatomic location and communication with the pedal arch makes the DPA a good outflow vessel. Surg. Gynecol. Obstet. 105:401–405 (Verta, 1982, Ascer, 1988 J. Vasc. Surg., 8:434–441; Harris, 1989, Arch Surg., 124:1232–1235). © 1992 Wiley‐Liss, Inc.
Distribution of the extensor tendons on the dorsum of the hand
Authors: Godwin Yvette , Ellis Harold
Published: February 2005

The patterns of the tendons of extensor digiti minimi, extensor digitorum, and extensor indicis have been studied on the dorsum of the hands of 25 embalmed cadavers.

Each of the tendons of extensor digitorum (ED) is usually single, but those of the middle and ring fingers are occasionally multiple. Intertendinous connections are of variable pattern. The ED tendon of the little finger lies closely to that of the ring finger, with which it may be fused, or it may be absent. It is suggested that it may be undergoing evolutionary reduction.

Extensor digiti minimi (EDM) usually has two tendons, but may have three or four. In addition to EDM, the little finger also receives either a separate tendon, or a tendinous slip, from ED.

Extensor indicis (EI) varies in the number of its tendons, in its position relative to the ED tendon to index finger, and in its connection to extensor pollicis longus tendon.

Examples of supernumerary muscles (extensor digitorum brevis manus, extensor indicis brevis, and extensor pollicis et indicis communis) were also found. © 1992 Wiley‐Liss, Inc.
Skeletal maturity in normal children from Liverpool, United Kingdom
Authors: Dhar Sunil , Dangerfield P. H.
Published: February 2005

Previous studies have indicated a normal regional variation in skeletal maturity in the United Kingdom (Kristmundsdottir et al: Ann. Hum. Biol., 11:133–139, 1984). The purpose of this study was to assess the bone age of normal children from Liverpool by the TW2 method (Tanner et al.: Assessment of Skeletal Maturity and Prediction of Adult Height (TW2 Method). Second edition. London: Academic Press, 1983). Two hundred and seventy‐three children with appropriate hand and wrist radiographs for hand injuries were assessed. When compared with the TW2 standards, there was no significant difference in the skeletal maturity of these children. © 1992 Wiley‐Liss, Inc.
Vascular anatomy of the spleen: The basis for organ‐preserving surgery
Authors: Treutner Karl H. , Klosterhalfen Bernd , Winkeltau Gerd , Moench Sylvia , Schumpelick Volker
Published: February 2005

The increased susceptibility to infection following splenectomy calls for a partial organ‐preserving operative procedure. The basis for this conservative surgery depends on a thorough knowledge of the vascular anatomy of the organ. With this in mind 32 spleens were studied by angiographies and corrosion casts. The organs were classified into four groups according to their vascular pattern with special emphasis on the blood supply of the polar segments. Two, three, and four segments were found in 3.1%, 15.6%, and 81.3%, respectively. A bifurcation of the splenic artery was noted in 93.8%, and a trifurcation in 6.2%. A Y‐type of branching of the hilar vessels with easier access for surgical procedures was noticed in 84.4%, and a T‐type in 9.4%; in 6.2% a classification was not possible. Intersegmentary anastomoses, as a potential hazard for operations on the spleen, were present in 15.6%. Arteries and veins coincided. The exact diagnosis of the specific individual vascular anatomy and segmental organization of the spleen are necessary presuppositions for a successful partial spleen‐preserving technique. © 1993 Wiley‐Liss, Inc.
Fiber orientation of anterior cruciate ligament: An experimental morphological and functional study, part I
Authors: Inderster A. , Benedetto K. P. , Künzel K. H. , Gaber O. , Balyk R. A.
Published: February 2005

The anterior cruciate ligament (ACL) is divided morphologically as well as functionally into anteromedial and posterolateral bundles.

The changes in distance between femoral and tibial attachment sites of both bundles were measured throughout the full range of motion in ten formalin‐carbol preserved cadaveric knees.

The femoro‐tibial distance (and thus the length) of the anteromedial bundle remains nearly the same throughout the full range of motion. The femoro‐tibial distance for the posterolateral bundle decreases with flexion; thus it becomes increasingly slack from 0° to 90° of flexion.

For a truly functional replacement of the ACL, in which the roll‐glide motion of the knee joint is regained, isometric reconstruction of the anteromedial bundle is necessary. By utilizing the described method of intraoperative measurement, isometric positioning of the graft may be achieved. © 1993 Wiley‐Liss, Inc.
A morphologic study of interthalamic adhesions in Korean brains
Authors: Park Kyung Ah , Lee Hye Yun , Chung In Hyuk , Han Yong Pyo , Shin Tai Sun
Published: February 2005

The incidence, size and, configuration of interthalamic adhesions were investigated in 146 Korean human brains. The incidence of adhesions was 88.4% and they were located mainly in the center of the third ventricle and posterior‐superiorly in quadrant I. Average size was 6.7 ± 2.19 mm × 5.1 ± 1.89 mm, and the most common shape was oval. © 1993 Wiley‐Liss, Inc.
Comparison bilaterally of lingual and facial arterial rami in the mandibulo‐perimandibular complex: Arterioradiographic models for surgical consideration
Authors: Maher William P.
Published: February 2005

Anatomic illustrations and arterioradiograms of the facial, submental, lingual and sublingual arteries, and their primary branches in the mandibulo‐perimandibular complex are routinely demonstrated unilaterally; illustration and comparison bilaterally have not been documented. The unilateral illustration mode erroneously implies arterioanatomic similarity contralaterally. Mandibulo‐perimandibular arteries in 50 stillborn human fetuses and 50 human adult cadavera were assessed. Head and neck arteries of fetal subjects were perfused with a radiopaque perfusant via the ascending thoracic aorta. Then the entire mandibular complex and tongue of each fetus was excised en bloc and radiographed from above the tongue. The radiograms showed 1) that sublingual and submental arteries and their primary rami differ in size, number, arrangement, and distribution unilaterally, as well as bilaterally and 2) that the entire mandibular body complex (including periosteum, cortex, spongiosa, and dentoparadontal structures) receives substantial sources of supply via the facial, submental, and sublingual arteries (extrinsic sources). The facial and lingual arteries and their ramifications in the adult mandibular complex were demonstrated by gross dissection. Comparison between fetal and adult mandibular arterial anatomies showed remarkable similarity. Furthermore, the results of this arterio‐anatomic assessment and the results of concurrent, independent, experimental bone surgical studies (Hadidi, Doctoral dissertation, Medical College of Wisconsin, Milwaukee 1985) favor a growing opinion that rami from the facial, submental, and sublingual arteries (extrinsic sources) to the mandibular body are more essential to its need than is commonly believed. © 1993 Wiley‐Liss, Inc.
Characteristic features of the ultrastructure of choroid plexus capillaries of fetal lateral ventricles and their clinical significance for intraventricular hemorrhage
Authors: Wei Wang , Zhi‐Ming Qui , Ning‐Sheng Zhou , Ping Lian
Published: February 2005

The capillaries within the lateral ventricular choroid plexuses from 14 normal fetal brains and one 5‐year‐old child were studied with electron microscopy. Endothelial pores and simple tight junctions were not observed until a fetal age of 24 weeks. From 24 weeks through 30 weeks of fetal age, the protein particles of the tight junctions became progressively aligned into a continuous row. Only an intermittent basement‐membranelike material was found in the fetal tissues; however, a continuous basement membrane was found in tissues from a 5‐year‐old child. We suggest fluid in capillary lumina may enter the tissue space through “very leaky” endothelial tight junctions due to the fixed osmotic gradient, while the macromolecular substances pass into the tissue space by pinocytosis of the endothelial cells. The macromolecular substances may in turn be transferred into the ventricular cavities by epithelial cells. Although the pathogeny of fetal interventricular hemorrhage (IVH) is unclear, we suspect that the simple tight junctions found early in development may break down under certain abnormal vascular conditions and allow blood to leak out. Normal deficiencies in the fetal basement membrane and its weak extensibility are also factors which could contribute to fetal IVH. No relationship was demonstrated between the types and numbers of cell organelles present and fetal age. © 1993 Wiley‐Liss, Inc.
Lymphatico‐venous anastomosis after obstruction of abdominal lymphatics and lymphatic drainage of the prostate in canines
Authors: Suzuki Takanori , Kurokawa Kohei , Yamanaka Hidetoshi , Jimbo Hiroyuki
Published: February 2005

The communication between abdominal lymphatics and the vertebral venous system in canines was observed under conditions of lymphatic obstruction. After obstructing lymphatics of the lumbar trunks, lipiodol was injected into the pedal lymphatics and visualized to enter the inferior vena cava 10 days later, and the vertebral venous system 12 days later by fluoroscopy. Radiographs of the transverse sectioned vertebrae showed that the contrast medium flowed from the para‐aortic lymph nodes into the vertebral venous system and entered the vessels around the vertebrae and in the spinal canal, and the vertebral body at the ventral surface of lumbar vertebra. Histologically, the contrast medium was identified in the Haversian canal and peripheral region of the bone marrow. These results suggest that prostate cancer may metastasize the vertebral bone through the lymphatico‐venous anastomosis and vertebral venous system. © 1993 Wiley‐Liss, Inc.
The medial femoral circumflex artery: Its clinical anatomy and nomenclature
Authors: Clarke S. M. , Colborn G. L.
Published: February 2005

The medial femoral circumflex artery (MFC) is important in its supply to the head and neck of the femur and to the adductor and hamstring muscles, several of which, notably the gracilis and biceps femoris, are used commonly in reconstructive surgical procedures. Considering the clinical significance of this artery, it is somewhat surprising to note the present lack of clarity of description and inconsistency of the nomenclature for this vessel and its branches, as seen in respected sources. This project was undertaken 1) to reexamine the origin, course, and distribution of the MFC and 2) to reevaluate the nomenclature in the anatomic and clinical literature for this artery and its branches. In 30 cadaveric specimens the MFC arose most commonly from the deep femoral artery (53%) or the femoral artery (40%). The MFC typically gave origin to two major ventral muscular branches and a small trochanteric branch before passing from the adductor compartment into the flexor compartment of the thigh. Thereafter, the MFC divided into an ascending branch to the hip and a descending branch to the hamstrings and sciatic nerve. We recommend the use of the terms “ascending” and “descending,” which are listed in the 6th Edition of the Nomina Anatomica, and the deletion of “transverse,” “superficial,” and “deep” as named branches of the MFC. We question the description of the “crucial” or “cruciate anastomosis,” as usually taught to medical students. © 1993 Wiley‐Liss, Inc.
Age changes in the human laryngeal cartilages
Authors: Turk L. Munir , Hogg D. A.
Published: February 2005

Various changes in the human laryngeal cartilages have been studied by the naked eye, radiology, and histology in 28 dissecting room and 20 autopsy specimens (21 male and 27 female) ranging from 14 to 101 years. Except for one 14‐ and one 20‐year‐old specimen, radiographic signs of calcification occurred in all and were found in hyaline cartilaginous tissue of the thyroid, cricoid, arytenoid, and the variably occurring triticiate cartilages. A series of stages has been established indicating the pattern of spread of the process in the thyroid cricoid and arytenoid cartilages. Minor differences between the sexes were found in the thyroid and the cricoid, and some correlation was noted between sites of calcification with sites of muscle attachment and sites of greatest mass. The degree of involvement was not, however, found to be a reliable index of age, with wide variations occurring between individuals. Histology showed various degenerative processes, including calcification, but also revealed the occurrence of actual ossification even in some younger specimens. However, some foci of cartilage always persisted even when ossification was well advanced. Naked eye examination detected regions within the cartilages where ossification was well established, dark areas being produced by the presence of marrow. The remaining tissue was found histologically to be composed of cartilage, which might be calcified or might even contain small foci of bone. Radiology was an accurate method for detection of calcification and ossification, which were sometimes distinguishable, larger masses of calcified cartilage having a dense uniform radiographic appearance unlike the trabecular pattern of bone. © 1993 Wiley‐Liss, Inc.
Segment length and root orientation in normal and sacrally attached spinal cords: A morphometric study
Authors: Hynes P. J. , Fraher J. P. , O'Sullivan V. R.
Published: February 2005

This study compares human spinal cord segment length and spinal nerve root orientation in normal and sacrally attached cords. The proportion of the total length of the mature normal spinal cord made up by individual segments varies little between C1 and T1. Between T2 and T6 it increases gradually to a maximum and decreases steadily from T7 to the caudal termination of the cord. The C1 and C2 roots run superolaterally from the cord to their intervertebral foramina. C3 runs almost horizontally. From C4 to T2 roots run progressively more caudally. At T3 and lower levels each root runs caudally in contact with the lateral cord margin before turning laterally to its intervertebral foramen. The pattern of variation in segment length of a sacrally attached cord resembles that in normal cords between upper cervical and lower thoracic levels. In the sacrally attached cord, segment length remains relatively unchanged between mid‐thoracic and mid‐lumbar levels and decreases rapidly caudal to L3. © 1993 Wiley‐Liss, Inc.
Quantitative morphology of the normal human tricuspid valve: Autopsy study of 24 cases
Authors: Seccombe John F. , Cahill Donald R. , Edwards William D.
Published: February 2005

Objective: To describe thoroughly and quantitatively the morphologic features of the human tricuspid valve, to define and classify classify certain prominent normal variations, and to offer a clear and concise terminology for describing its morphology. Background. In recent years there has been growing interest in the tricuspid valve. Noninvasive imaging is now commonplace and remarkably detailed. Surgical interventions involving the tricuspid valve have become increasingly common. These factors underscore the need variations. Methods. Quantitative and anatomic features of the tricuspid valve were studied in 24 normal hearts at autopsy from subject evenly distributed by age and sex. Leaflet length, surface area, chordal number, and leaflet morphology were recorded. Results. Valves demonstrated some degree of leaflet subdivision in 92% of cases. Mean tricuspid valve length was 11.3 ± 0.1 cm and the surface area was 21.0 ± 1.1 cm2. Mean lengths and surface areas were similar for the anterior, posterior, and septal leaflets (38–42 mm and 5.9–7.8 cm2, respectively). However, for a given valve, the longest leaflet could be twice the length and three times the area of the smallest. Calculated valvular diameter was 2.13 ± 0.03 cm/m2. The tricuspid valve was served by and average of 170 ± 36 chordae tendineae, 49% inserted on the free edge of the valve, 44% on the undersurface, and 7% on the basal regions. Chordal density (number of chordae/cm2) was greater in women than men (9.9 ± 0.5 vs. 7.3 ± 0.7 chordae/cm2, P < 0.02). The septal leaflet had the greatest chordal density and the anterior leaflet the lowest (12.7 ± 0.9 vs. 5.9 ± chordae/cm2). Conclusions. The concept of chordal density for the tricuspid valve has not been previously described and may be clinically relevant in the pathogensis of valvular prolapse. Modifications of existing tricuspid valve nomenclature are suggested. © 1993 Wiley‐Liss, Inc.
Variability of the arterial system of the human pancreas
Authors: Fiedor Piotr , Kaminski Pawel , Rowinski Wojciech , Nowak Mieczyslaw
Published: February 2005

The basic feature related to survival and the ultimate functioning of a transplanted segment or whole pancreas is the preservation and continuation of an adequate blood flow. The current study examined the anatomical variability of the arterial vascularization in 126 pancreases following their removal form cadavers by the technique routinely used for transplantation. Arteriography was conducted initially by the injection of either 75% uropolin or barium sulfate in 70 specimens following removal of the specimen. All 126 specimens were injected with latex, and corrosion casts were prepared through maceration with either sodium hydroxide or hydrochloric acid. The dorsal pancreatic artery showed the greatest variability with respect to the mode of origin and division into branches. Also 42.1% of the cases were found to have poor anastomoses between the body and tail segments. These observations suggest that it is necessary to carefully assess the origins of the vascular supply of the donor organ 1) as resection at the celiac rather than the splenic artery can increase preservation of the dorsal pancreatic artery; 2) whole organ transplantation may be indicated to ensure adequate vascularization; and 3) the presence of a separate arterial supply to the caudal segment in 42.1 % of the cases allows the consideration of its use as an independent transplant from a live donor. © 1993 Wiley‐Liss, Inc.
Microvasculature of the human esophagus: A study on 25 autopsy specimens
Authors: Treutner Karl H. , Ophoff Kerstin , Klosterhalfen Bernd , Winkeltau Gerd , Schumpelick Volker
Published: February 2005

The increasing number of esophagectomies coupled with the importance of microvasculature for anastomotic healing and a paucity of published data have prompted this study. Human esophagi were harvested from 12 male and 13 female cadavers with a mean age of 57.7 years (21–84) and an average length of 30.7 cm (22–40). Transverse sections (31) of each esophagus were made at equidistant intervals and prepared for microscopy. The number of intramural capillaries was counted in each section, the mean being 51.8 (45.4–61.3). Vascularization of the esophagus was best at the level of the cricoid cartilage (57. 12), proximal to the clavicles (57.44), and in its distal thoracic part (61.28), and worst cranial to the aortic arch (47.64) and above the diaphragm (45.36). The differences were significant (p < 0.05). The parts with the least number of capillaries correspond to the zones between the different origins of the main arterial sources. © 1993 Wiley‐Liss, Inc.
Variations of the middle meningeal artery: Significance for surgery and practice
Authors: Klisović Dino , Šikić Eleonora , Krmpotić‐Nemanić Jelena
Published: February 2005

The origin and branching of the middle meningeal artery (MMA), as well as the length and development of its three main branches, were analyzed by following the arterial sulci on skull bones. We examined 186 macerated skulls (128 male and 58 female). Variations were classified into nine types. Some of the previously ignored communications of the branches of MMA with other arteries of the external carotid systems such as the deep temporal a., deep auricular a., occipital a., and anterior tympanic a. are described. © 1993 Wiley‐Liss, Inc.
Lateral costal branch of the internal thoracic artery
Authors: Henriquez Jorge Aaron , Mandiola Eduardo Armando , Prates Jose Carlos
Published: February 2005

The lateral costal branch (LCB) of the internal thoracic artery (ITA) was studied because its presence sometimes may reduce the blood flow of the ITA when it is used for myocardial revascularization (Singh and Sosa, 1981). The ITA of 90 cadavers of adults of both sexes, whose ages ranged from 20 to 84 years, was studied after neoprene latex injection to determine its incidence, its relation to the phrenic nerve and first rib, its diameter, and the distance between the origin of the ITA and the origin of the LCB. We found the LCB in 16.6% of the cases, with bilateral presence in 5.5%. Unilateral rightside incidence was 11.1%, and left unilateral incidence was not observed. The LCB originated from the ITA in all cases, with a distance of origin along the ITA of 23.7 + 6.7 mm on the right side and 29.5 ± 6.4 mm on the left side. The mean diameter of the LCB was 1.7% ± 0.8 mm. © 1993 Wiley‐Liss, Inc.