Variations in collateral contributions to the blood supply to the sternum.

The blood supply of the sternum plays a major role in healing of the sternum after sternotomy. The sternal blood supply is derived mainly from the medial horizontal branches of the internal thoracic artery (ITA). The ITA is usually described as giving off sternal, anterior intercostal and perforating branches supplying their respective areas. The aim of the present study was to describe variations in the arterial branching pattern of collateral contributions to the sternum. The study was conducted on 30 fresh specimens of anterior thoracic wall in which cellulose acetate butyrate was injected into the ITA. The branches of the ITA in the first to sixth intercostal spaces were dissected and any additional artery supplying the sternum in each intercostal space was observed. In the present study, the ITA gave off non-collateral branches - sternal, anterior intercostal and perforating. The ITA was also found to have branches which divided into two to supply two destinations which could establish collateral flow to the sternum: (1). A sterno-intercostal branch (1-12 mm in length) divided and diverged in a Y or T shape. The medial limb supplied the sternum and the lateral limb supplied the adjoining thoracic wall, anastomosing with the terminal part of the posterior intercostal artery. (2). A sterno-perforating branch supplied the sternum either anteriorly or posteriorly before perforating and supplying the pectoral region and anastomosing with the thoracoacromial artery. This study reinforces the practice of ligating branches of the ITA close to its trunk as they have the potential to develop collateral blood supply. In the present study the posterior intercostal artery was at times found to supply the sternum directly or via its collateral branch and was named the persistent posterior intercostal artery.

Weight and measurements of kidneys in northwest Indian adults.

Weights and measurements of paired kidneys obtained from medicolegal autopsies of northwest Indian adults, 155 males and 84 females, were compared. The right and left kidneys weighed 108.7 +/- 22.6 g and 111.8 +/- 23.3 g (P > 0.05), respectively, in males. Corresponding weights in females were 96.6 +/- 19.3 g and 99.4 +/- 25.3 g (P > 0.05) for the right and left kidneys, respectively. Sex differences in the weights of both right and left kidneys were statistically significant (P < 0.001). Other measurements of the right kidney in males were as follows: length, 99.5 +/- 9.4 mm; width at the middle of the hilum, 45.8 +/- 6.2 mm; and the thickness 33.3 +/- 5.2 mm, which did not differ from corresponding measurements of the left kidney (99.7 +/- 10.9 mm, 46.4 +/- 7.1 mm, and 34.0 +/- 6.4 mm, respectively). Other measurements of the right kidney in females were as follows: length, 91.3 +/- 8.7 mm; width at the middle of the hilum, 44.6 +/- 4.6 mm; and thickness 31.2 +/- 4.7 mm, which did not differ from those of the left kidney (92.1 +/- 11.0 mm, 43.5 +/- 6.5 mm, and 31.1 +/- 6.1 mm, respectively). Sex differences in measurements of both right and left kidneys were significant except for the width of the kidney at the middle and below the hilum.

Liver span and weight in health and disease.

BACKGROUND: The liver mass, made up of independent functional units called acini, correlates with liver functions. Hepatic morphological changes causing alteration in its size and volume occur in various hepatic disorders. METHODS: Antemortem clinical liver span and postmortem liver weight was studied in 23 critically ill patients. Out of these, 8 had fulminant hepatic failure, 7 had chronic liver disease with encephalopathy and 8 had other serious illnesses (chronic renal failure 3; ischaemic heart disease 3; cerebrovascular accidents 2). We also studied postmortem liver span and liver weight in 173 healthy individuals dying of accident/terrorist attacks. RESULTS: Antemortem liver span in 23 critically ill patients was 9.9 +/- 4.7 cm (mean +/- S.D.) and postmortem liver weight was 1536.9 +/- 704.7 g (mean +/- S.D.). Antemortem liver span correlated well with the postmortem liver weight (r = 0.9635). Postmortem liver span in 173 healthy individuals was 16.3 +/- 2.7 cm (mean +/- S.D.) and liver weight was 1301.5 +/- 358.8 g (mean +/- S.D.). There was very good correlation between the postmortem liver span and liver weight (r = 0.516), height (r = 0.410) and body weight (r = 0.340) in these individuals. CONCLUSION: Liver span fortells the liver weight, hence, the functional liver mass in diseased and healthy individuals.

Burn mortality in Chandigarh zone: 25 years autopsy experience from a tertiary care hospital of India.

An analysis of autopsy records of burn victims revealed that most burn deaths occurred in the age group 21-40 years (67 per cent) with female preponderance (61 per cent) in all age groups except in the extreme age groups. 62 per cent of burn cases originated in urban areas. The majority of subjects (99 per cent females and 76 per cent males) died as a result of flame burns. Kerosene was the most common factor (76 per cent) in burn deaths. 11 per cent of deaths were due to the stove bursting and 27 per cent of victims died due to leakage of oil from the stove. 39 per cent of subjects sustained burns when their clothes caught fire. Scalds (3.3 per cent), electrical (4.7 per cent) and chemical (2.3 per cent) burns were more commonly seen in males, mainly sustained at their working place. Accidental burns were observed in 80 per cent of subjects followed by suicidal (16.2 per cent) and homicidal burn assaults (4.1 per cent). Peak incidence of burns in females was observed between 5.01 a.m. and 11 a.m. (38 per cent), which was the time of least incidence in males (10.3 per cent). The opposite trend was seen between 11.01 p.m. and 5 a.m. Among males, burn deaths were more common (85 per cent) in those who were living alone, away from their families; whereas in women the incidence of burn deaths was higher (74 per cent) in those living with their families. The majority of deaths due to burns occurred within one week (77 per cent) of the incident. Septicaemia was the major cause of death (55 per cent).