Umbilical hernias and anterior fontanelle size in Jamaican children

This cross-sectional study documents the frequent occurrence of umbilical hernias among Jamaican children and suggests, for the first time, that the prescence of an umbilical hernia may be associated with larger anterior fontanelle dimensions. It also demonstrates that data about the people a community health officer serves can be recorded during a busy clinic schedule. (AU)

Head circumference and anterior fontanelle measurements of Jamaican children

This cross-sectional study documents, for the first time, head circumference measurements for normal children of Jamaica older than one year of age, and anterior fontanelle measurements for normal children of a developing nation. It demonstrates that medical data can be compiled by the community medical officer while attending to his clinical duties. (AU)

Roentgenographic skull volume in Jamaican children between the ages of one month and five years

Values for roentgenographic skull volume estimated with the help of McKinnon's formula in 331 black normocephalic children between the ages of one month and five years, using standard anteroposterior and lateral skull films, are presented. Mean skull volume was higher among boys at all ages after the first six months of life. Significant linear correlation was seen between log-age and skull volume for both sexes. The roentgenographic skull volume in Jamaican children was more or less similar to that of British and Indian children (AU)

Roentgenographic cranial-base and calvarial measurements of Jamaican children between one month and five years

Three hundred and thirty lateral skull films obtained from apparently healthy normocephalic Jamaican children between the age of one month and five years were studied, using bony reference points nasion (N), tuberculum sellae (Ts), internal occipital prominence (IOP), inion (I), bregma (B) and lambda (L). Cranial-base length was measured between N-Ts, Ts-IOP and N-I. Calvarial height was measured between Ts-B, N-Ts and Ts-L and N-I and Ts-L at all the ages and in both sexes. Ratios between lengths of anterior and posterior cranial-base, as well as between cranial-base lengths and anterior cranial heights, were nearly constant at all the ages and in both sexes. These observations support the view that there is definite proportionality between the growth of anterior calvarial height and cranial-base lengths. On the other hand, a significant increase with age was seen in the ratios N-Ts/Ts-L, N-I/Ts/L and Ts/B/Ts-L, suggesting a progressive decrease in growth of posterior calvarial height. A comparison of the data with previously published figures for Indian and Norwegian populations suggests a racial difference in the various cranial-base and calvarial ratios. (AU)

Sickle cell beta thalassaemia in Jamaica

An analysis of the radiological appearances in a skeletal survey of 48 patients in Jamaica with sickle cell beta thalassaemia is presented. The appearances are similar to those in homozygous sickle cell disease and SC disease and a confident distinction between the conditions on radiological grounds alone is likely. (AU)

The medico-legal aspects of the injuries of the skull

Points out the significance of noting the details of fractures of the skull in the living by Clinicians, and by the Pathologist in the dead, as it will throw much light on the nature of weapon used and the method of infliction of injury to the head. At the same time, the reasons for the variation encountered in the type of injury to skull and the related pertinent aspects are briefly discussed. For medico-legal purposes, to diagnose the presence of a fracture is not enough; accurate description is essential and this aspect is emphasized by appropriate illustrations. (AU)

Pleural mesothelioma associated with massive hepatic calcification and unusual metastases

A case of diffuse, malignant, pleural mesothelioma is reported in a 60-year-old Negro man. The clinical picture was most unusual; when the patient presented initially with chest pain, the radiographic appearances in the chest were normal, but extensive liver calcification was demonstrated. The latter was subsequently shown to be caused by metastases from the mesothelioma which took 2 more years to produce clinical and radiographic changes in the chest. There was microscopic evidence that the extensive liver calcification was dystrophic in nature and had resulted from marked degenerative changes and necrosis in the metastatic malignant pleural mesothelioma. Radiographs of the skeleton revealed focal, translucent lesions with sclerotic margins in the right seventh rib and the right iliac. Microscopic examination showed these bony lesions to be metastases. No previous report of secondary deposits in bone producing such radiographic appearances could be found in the literature (AU)

The teratogenicity of barbital sodium in mice

The teratogenic activity of sodium barital in pregnant mice of the Rockfeller strain was investigated. A high incidence of foetal resorption and congenital malformations were observed following the i.p. administration of the barbiturate. (Summary)

Alizarin red in the study of the apposition and resorption of bone

Alizarin red is given intraperitoneally in dosages of 50-200 mg per kg. It stains visibly only one generation of bone. Its deposition is studied in gross specimens and in undecalcified sections, and is controlled by comparison with serial decalcified sections. Apposition of white bone can be followed in relation to red bone on periosteal surfaces (where it presents appearances corresponding to different growth rates), on endosteal surfaces, in osteons, and in the interstitial compaction of cancellous bone. Red surfaces may be sites of deposition, stasis, or resorption. Measurements may be made from red lines, provided microscopic control is available. Removal of red bone implies resorption. It is closely correlated with the presence of osteoclaasts in control sections and with areas of surface pitting grossly. Resorbing surfaces may be precicely delimited by studing a graded series of animals. Whole surfaces or zones of stained bone are seen to drift to other situations, undergoing resorptive dissolution or consolidating anew as they move relative to the newer layers. The usefullness of the dye lies in its simplicity of administration, its ready visibility, and the fact that its persistence in bone enables the fate of areas of bone to be followed over long periods. The preparation of undecalcified sections is a problem common to many other techniques

The role of mitosis in the post-natal morphogenesis of the basal synchondroses of the skull

In the study factors which influence the growth of any tissue, a distinction must be made between determination, the decision as to which of the inherent genetic potentialities a given tissue will realize, and differentiation, the realization of expression of a specific potentiality. In the two tissue systems that are involved in the morphogenesis of the skull namely, synchondroses and syndesmoses, mitosis seems to have an essential place in between the act of determination and the process of differentiation. Mitosis is the first visible sign that a determination has occurred, and it precedes the final differentiation which results in deposition of bone or hypertrophy of cartilage. We have been using tritiated thymidine autoradiography to label pre-mitotic cells in the periodontal ligament (a syndesmosis) and in the spheno-occipital synchondrosis in the rat. In the case of the synchondrosis, growth of the adjacent basal bones can be directly related to mitosis within the cartilage between 40 and 80 days of age by calculations comparable to those of Kember. However, between 1 and 40 days, there is more growth than can be accounted for on the basis of mitoses detected within the cartilage. On the other hand, if one calculates the portion of growth due to endochondral replacement alone, interstitial mitoses in the cartilage are found to be adequate. Perichondral apposition of cartilage cells need not be postulated. The remaining portion of the total growth of the bones is accounted for by apposition of bone from the periosteum (AU)

The role of soft tissues in skull growth in rabbits

The vault is said to expand centrifugally, following expansion of the brain or of an equivalent fluid mass. The bones are carried passively outwards. However, the frontal bone shows, simultaneously, sutural growth: resorption in parasutural areas endocranially and in the olfactory fossa: stasis or slow erosion ectocranially over the eminence, differential endocranial and estocranial deposition, and differential deposition and resorption on the orbital plate; and a pronounced postolfactory ridge of endocranial deposition. Cartilage is said to act as "pacemaker", its interstitial growth and turgidity enabling it to thrust bones in particular directions. Pressure on bone familarly leads to resorption. Two areas on the frontal bone in contact with the enlarging cartilaginous ethmoid show, respectively, resorption and deposition. The response to thrust is not simple. Can muscular pressure affect the form of the braincase? The squamosal bone forms a bed for muscles: (1) the temporalis (a) attached to its postzygomatic surface above, fibres nearly horizontal: (b) attached to its orbital surface, fibres vertical; (c) its tendon related to the upper aspect of the zygomatic process root; and (2) the lateral pterygoid related to the paracondylax fossa and inferior margin. Surface (1) (a) shows deposition; (1) (b) marked resorption; (1) (c) shows stasis early, slow deposition later - a rate of deposition increased by temporalis section. Surface (2) shows resorption above, with continuous osseous drift inwards, and below, deposition. Further experiments are needed to elucidate the cause-effect relationships between muscle and bone. The contribution of the sense capsules to the overall form of the cranium has been neglected. The cribriform plate is displaced endocranially, as is the posterior part of the orbit, where it forms neurocranial wall. The circumferential growth of the ear capsule causes periotic encroachment upon the cranial cavity. Thus brain growth must be compensated for at areas other than these (AU)

Vacuum extractor: experimental demonstration of distortion of the fetal skull

Using a mature stillborn fetus, various sizes of caps and different degrees of traction of the Malmstrom vacuum extractor were employed and radiographs taken in order to demonstrate distortion of parietal bones. The danger of tearing the injunction of the falx and tentorium or rupture of the sagittal sinus were discussed. Further x-rays were taken with a Neville-Barnes forceps instead of the vacuum extractor (AU)