Central Retinal Artery: A Human Fetal Cadaveric Study with Histological Correlation

The optic nerve is the second cranial nerve. It is supplied by the central retinal artery. It is said that this artery starts getting incorporated within the optic nerve at around the sixth week of gestation, and by the ninth week it is entirely inside the optic nerve. However, the point of incorporation lies in the intraorbital course of the optic nerve. The present study aimed at identifying the location of the central retinal artery inside the optic nerve, i.e. the peripheral or central position. Human fetuses of second and third trimester were dissected to expose the optic nerve. Morphometric measurements were taken and sectioned in 3 regions. These transverse sections were subjected to histological procedures. The results showed that the central retinal artery, at its entry into the optic nerve, was peripheral and inferior in 3 of 25 optic nerves and peripheral and lateral in the remaining optic nerves. However, the arteries were all centrally placed, close to the posterior pole of the eyeball. These findings are important for the ophthalmologist in identifying certain congenital anomalies of the eyeball in neonates.

Devising focused strategies to improve organ donor registrations: A cross-sectional study among professional drivers in coastal South India

BACKGROUND

In India, annually, 500,000 people die due to non-availability of organs. Given the large proportion of brain death amongst road accident victims, any improvement in organ donation practices amongst this cohort could potentially address this deficit. In this study, we identify the potential areas for intervention to improve organ donation amongst professional drivers, a population more likely to suffer from road accidents.

METHODS

300 participants were surveyed using a structured, orally-administered questionnaire to assess knowledge, attitudes and practices regarding organ donation. Multivariate analysis was performed to identify key variables affecting intent to practice.

RESULTS

Nearly half our participants had unsatisfactory knowledge and attitude scores. Knowledge and attitude was positively correlated, rs (298) = .247, p < .001, with better scores associated with a higher likelihood of intent to practice organ donation [AOR: 2.23 (1.26-3.94), p = .006; AOR: 12.164 (6.85-21.59), p < .001 respectively]. Lack of family support and fear of donated organs going into medical research were the key barriers for the same [AOR: 0.43 (0.19-0.97), p = .04; AOR: 0.27 (0.09-0.85), p = .02 respectively].

CONCLUSION

Targeted health-education, behaviour change communication, and legal interventions, in conjunction, are key to improving organ donor registrations.

Left-Sided Persistent Superior Vena Cava with Superior Hemiazygos Arch

Persistent Left-side Superior Vena Cava (PLSVC) is the congenital central venous anomaly draining into the right atrium in 82-90% of cases via coronary sinus produce no haemodynamically significant consequences. In few cases it may drain into the left atrium directly or through the pulmonary veins resulting in right to left shunt. During routine undergraduate dissection, we found a PLSVC formed by the union of left subclavian and left internal jugular veins behind the left sternoclavicular joint was terminated into the right atrium through a larger coronary sinus ostium. Before its termination, PLSVC received a left hemiazygos vein formed by the continuation of the superior and inferior hemiazygos veins. A larger but thin communicating vein was noted between the right superior vena cava and PLSVC. Prior knowledge about such variations is essential in all the intervention procedures on right atrium through the left subclavian approach and also like in our case, the larger coronary sinus ostium if found during transthoracic echocardiography should be considered as an indication for the diagnosis of PLSVC.

Analysis of the Distribution of Mucins in Adult Human Gastric Mucosa and Its Functional Significance

INTRODUCTION

Mucins are complex composition of carbohydrates seen in the epithelial cells lining the gastrointestinal tract (GIT). Normal distribution of such mucins in different part of the GIT and its alteration in various inflammatory, benign and malignant lesions of GIT has aroused interest in the field of histochemistry.

AIM

By applying variety of histochemical techniques an attempt has been made to draw a map of mucin secretion by the different epithelial cell types in different parts of the stomach.

MATERIALS AND METHODS

Fifty samples were taken each from different parts of the stomach like fundus, body and pylorus, from dissected fresh specimens (total of 150 specimens). Tissue samples were subjected for routine process and studied for histological and different histochemical staining.

RESULTS

Mucin pattern in adult predominantly secretes neutral mucosubstances. Surface epithelium shows predominant neutral mucin while cardiac and gastric glands with foveolar cells show moderate amount. Sialomucin is present in a few cells of the surface epithelium, foveolar cells and in most of the mucous neck cells. Small amount of sialomucin and sulphomucin are found in surface epithelial foveolar cells while traces of sulphomucin are found in deep foveolar cells. Mucous neck cells secrete both sulphomucin and sialomucin.

CONCLUSION

Normal gastric mucosa adjacent to gastric ulcers and malignant tumours of stomach secretes mucins which differ histochemically and biochemically from that of normal. Early recognition of such changes could be useful in recognizing the different type of carcinomas and their prognosis.

Rare variations in the Origin, Branching Pattern and Course of the Celiac Trunk: Report of Two Cases

Multiple anomalies in the celiac arterial system presents as rare vascular malformations, depicting deviations of the normal vascular developmental pattern. We found a common left gastro-phrenic trunk and a hepato-spleno-mesenteric trunk arising separately from the abdominal aorta in one cadaver. We also found a common hepatic artery and a gastro-splenic trunk arising individually from the abdominal aorta in another cadaver. Even though many variations in the celiac trunk have been described earlier, the complex variations described here are not mentioned and classified by earlier literature. Knowledge of such variations has significance in the surgical and invasive arterial radiological procedures in the upper abdomen.

Accessory pancreatic duct patterns and their clinical implications

CONTEXT AND OBJECTIVE

Accessory pancreatic duct (APD) designed to reduce the pressure of major pancreatic duct by forming a secondary drainage channel. Few studies have mentioned the variant types of accessory ducts and their mode of formation, some of these have a clear clinical significance. Present study is aimed to evaluate the possible variations in the APD and its terminations.

MATERIALS AND METHODS

Forty formalin fixed adult human pancreas with duodenum in situ specimens were studied by injecting 1% aqueous eosin, followed by piece meal dissection of the head of the pancreas from posterior surface. Formation, tributaries, relations, and the termination of the accessory pancreatic duct were noted and photographed.

RESULTS

Accessory ducts revealed 50% belonged to long type, 22.5% were of short and ansa pancreatica type each, and embryonic type of duct pattern was seen in 5% specimens. 75% of long type ducts showed positive patency with eosin dye, followed by ansa type (44.4%), and least patency was found in short type (22.2%). With regard to the patency of the accessory pancreatic ducts towards their termination, we found 52.5% of the accessory ducts and 5% of the embryonic type pancreatic ducts were patent and in 42.5% of the specimen the ducts were obliterated. In 85% of specimens the minor duodenal papillae was anterosuperior to the major papilla and superior to the major papillae in 10% of the cases, and in 5% minor papillae was absent. The average distance between the two papillae was 2.35 cm.

CONCLUSION

The knowledge of the complex anatomical relations of the gland with its duct, duodenum and bile ducts are essential for the surgeons and sinologists to plan and perform both the diagnostic as well as therapeutic procedures effectively.

A study on the human pancreaticobiliary duct system and ampulla region with their clinical considerations

INTRODUCTION

The purpose of this study is to present the variations of the pancreatic duct system and hepatopancreatic ampulla so that an awareness of these variations may help in surgical planning and prevention of ductal injury.

METHODS

Forty human pancreatic specimens were used to study the duct pattern of the pancreas and the formation and mode of termination of the pancreatic ducts. Also, the patency of the main pancreatic ducts, length of the hepatopancreatic ampulla, and length of the main pancreatic duct were measured.

RESULTS

The main pancreatic duct was patent in 37 out of 40 specimens, 2 specimens showed the embryonic type of the duct system, and one had the duct obliterated at its duodenal end. The mode of termination of the main pancreatic and common pancreatic ducts was divided into four types. Seventy-five percent specimens belonged to type I, followed by type II in 22.5 % and type III in 2.5 % of specimens. The length of the main pancreatic duct ranged from 11 to 21.2 cm, the average being 17.3 cm, and the length of the hepatopancreatic ampulla varied from 1 to 10 mm (1 to 2 mm-5 %, 3 to 8 mm-55 %, and more than 8 mm in 15 % of specimens), and it was absent in 25 %.

CONCLUSION

Awareness of these anomalies may help in surgical planning and prevention of undue ductal injury.

A Cranio-Facial Dysmorphic Foetus; A New Syndrome?

Cranial Neural Crest (CNC) cells interact with and are consequently instructed by the pharyngeal endoderm, the branchial arch ectoderm, and the isthmic organizer at the midbrain– hindbrain boundary before giving rise to various types of tissues such as bone, cartilage, tooth, and cranial nerve ganglia in the craniofacial region. DOI: http://dx.doi.org/10.3126/jnps.v33i2.7672 J Nepal Paediatr Soc. 2013; 33(2):155-156

A rare case of craniofacial morphology with absent face and neck structures, with its review

The development of the head and the face requires an intimate interaction between two mesenchymal populations, a paraxial mesoderm and neural crest cells for the morphogenesis of the musculoskeletal components of the calvaria, the face and the branchial regions. The disruptions in these interactions can cause foetal fatalities or congenital craniofacial anomalies. We are describing a rarest case with a craniofacial malformation, who was born with complete absence of the facial skeleton and the neck structures, a set of well developed ears in their normal locations and eyelids at the junction between the head and the thorax.

Anatomical variations of the profunda femoris artery and its branches-a cadaveric study in South Indian population

The variations of the profunda and its branches are numerous, and, to a considerable extent, largely associated with one another. In occlusion of the Superficial femoral artery, the profunda femoris artery forms an effective collateral bed between the ileo-femoral segment and the popliteal artery and its branches. This study based on dissections performed on 40 properly embalmed human cadaver specimens. The position, source and the point of origin of the profunda and its circumflex branches were studied and compared with earlier literature. We found that profunda femoris was originated from the posterolateral surface of the common femoral artery with a mean distance of 3.56 cms from the midinguinal point. An absence of profunda femoris was noted in one (5 %) case. Medial circumflex femoral artery (in 40 % on right side and 60 % on left side) originated from the profunda femoris; whereas in 50 % on right and 35 % on left side, it begins from the femoral artery. On the otherhand, the lateral circumflex femoral in 80 % on right and 70 % on left sides sprungs from profunda femoris with 20 % and 25 % from common femoral arteries of right and left limb specimens respectively. Knowledge of variations in profunda femoris and its branches helps surgeons during preoperative clinical evaluation for surgical and interventional revascularization of the ileo-femoral and femoro-popliteal segments, in open canulation of femoral artery for cardiopulmonary bypasss, in radiological interventions for A-V malformations, and in salvage operations for traumatic limb ischemia.