When does the spheno-occipital synchondrosis close?

In forensic work, the spheno-occipital synchondrosis helps identify the deceased as a child or young adult. In the past, it was generally held that the synchondrosis closed between the late teens and 25 years, but recent studies have suggested closure in adolescence. There are also suggestions that the age at closure recorded might be influenced by ancestry and the technique used to study the joint. This comprehensive review of the literature of the past 60 years concludes that the age of closure of the spheno-occipital synchondrosis is very variable, from childhood to the mid-twenties, with no obvious association with the geographical location of the study population. We note that some studies on bony specimens indicated later closure than others using clinical images and draw attention to a possible misinterpretation of the so-called "fusion scar" which might explain this incongruity. Despite an increasing acceptance that the synchondrosis usually closes in adolescence, we are concerned that insufficient heed is being paid to reports of closure in childhood and in the early to mid-twenties. We conclude that, for forensic purposes, it is unwise to declare that the synchondrosis closes in adolescence. It would be safer to state that a closed synchondrosis indicates a person 6 years or over and that an open synchondrosis may be seen up to the mid-twenties. Clearly, for younger individuals, the dentition and, for all individuals in this age range, documentation of unfused postcranial epiphyses would be important in attempting to narrow this very broad estimation of age.

William Hunter's aristocratic post mortems.

William Hunter's writings, lectures and his collection of circa 1,400 pathological specimens at the University of Glasgow show that, within the scientific limitations of the 18th Century, he had a sound grasp of the significance of morbid anatomical appearances. Unlike John Hunter's collection at the Royal College of Surgeons of England, few of the Hunterian specimens at Glasgow have an accompanying case history. Within the Special Collections at the Glasgow University Library are a small number of post mortem reports, including four involving William Hunter's aristocratic patients. This article explores these patient cases, and also the only instance recorded by John Hunter of William working with him on a post mortem of an aristocrat, that of the Marquis of Rockingham, Prime Minister, who died in 1782. The study aims to better understand William Hunter's medical practice and his professional connections with other practitioners. The post mortem examinations were carried out by a surgeon/anatomist and observed by the patient's physician(s). For aristocratic post mortems, those attending were senior and well-established practitioners. The notes made were not particularly detailed. The reports show clearly that William Hunter's practice, in the 1760s at least, was not confined to midwifery.

Matthew baillie's specimens and engravings.

In 1799, Matthew Baillie, William Hunter's nephew, published his famous atlas of pathology. It was entitled A Series of Engravings Accompanied with Explanations which are Intended to Illustrate the Morbid Anatomy of Some of the Most Important Parts of the Human Body. The present study aims to match the illustrations to extant specimens in the collections of William and John Hunter, preserved at the University of Glasgow and at the Royal College of Surgeons of England respectively. Baillie's book contains 10 fasciculi, consisting of 73 plates and 206 figures. The specimens Baillie illustrated came from his own collection and those of ten others, including his uncles, William and John Hunter. The book was illustrated by William Clift and engraved by James Basire, William Skelton and James Heath. Excluding eight illustrations of intestinal worms where the provenance of the specimens is uncertain, a total of 98 specimens from William Hunter's collection were illustrated in 104 figures. Eight of the specimens were calculi impossible to identify specifically. Excluding worms and calculi, 72 of William Hunter's specimens illustrated by Baillie are extant in the Hunterian Collection at the University of Glasgow. All but one of the 20 specimens illustrated that had belonged to John Hunter were identified in the on-line catalog of the Royal College of Surgeons of England. Baillie's own collection was destroyed when the Royal College of Surgeons of England was bombed in 1941. Baillie is credited with being the first to produce an illustrated systematic textbook of morbid anatomy and probably the first to illustrate emphysema and transposition of the great vessels. His book, however, was not comprehensive. It did not cover a number of topics such as muscles and bones and there is little coverage of the nervous system. Baillie's book, however, was an original concept as an atlas of morbid anatomy and showed his deep insight into pathology. Clin. Anat. 31:622-631, 2018. © 2017 Wiley Periodicals, Inc.

William Cruikshank (1745-1800), anatomist and surgeon, and his illustrious patient, Samuel Johnson.

William Cumberland Cruikshank (1745-1800) was a Scot who from 1771 until his death taught anatomy at the famous school of anatomy in Great Windmill Street, London, founded by William Hunter (1718-1783). Arguably, his most famous patient was Samuel Johnson, the celebrated 18th Century man of letters and author of the first English dictionary. This article, largely drawn from Johnson's correspondence, documents the medical condition that caused Johnson to consult Cruikshank and some of the social links between Johnson, Hunter, and Cruikshank.

Sex determination from calcification of costal cartilages in a Scottish sample.

The pelvic bones and skull are not always available when human remains are discovered in a forensic setting. This study investigates the suitability to a Scottish sample of existing methods of sexing based on calcification patterns in the costal cartilages. Radiographs of chest plates of 41 cadavers, 22 male and 19 female aged 57-96 years were analyzed for their calcification patterns according to the methods of McCormick et al. (1985, Am. J. Phys. Anthropol. 68:173-195) and Rejtarova et al. (2004, Biomed. Pap. Med. Fac. Univ. Palacky. Olomouc. Czech. Repub. 148:241-243). With the method of Rejtarova et al. (2004, Biomed. Pap. Med. Fac. Univ. Palacky. Olomouc. Czech. Repub. 148:241-243) none of the male specimens was sexed correctly. Of the chest plates that were suitable for sexing, the method of McCormick et al. (1985, Am. J. Phys. Anthropol. 68:173-195) correctly sexed 82.4% of the female specimens but only 41.2% of the males. To improve the reliability, we suggest a new method of sex determination based on whether the calcified deposits in the second to seventh costal cartilages are predominantly trabecular bone or sclerotic calcified deposits. Specimens with minimal amounts or similar amounts of trabecular bone or sclerotic deposits in the costal cartilages are not appropriate for our method. When such specimens (10 specimens) were excluded, our method correctly sexed 16 of 17 (94%) males and 12 of 14 (86%) females. The authors acknowledge that their sample is small and that many of their subjects were elderly and that the method should be tested on a larger sample group before application in a forensic context.

Jejunal diverticulum with ectopic pancreatic mucosa: was it really a Meckel's diverticulum?

We report the case of a 72-year-old man who underwent surgery for a jejunal intussusception caused by an infarcted mass on the antimesenteric surface of the small bowel approximately 90 cm from the duodenojejunal flexure. The specimen was reported as an infarcted diverticulum containing heterotopic pancreatic mucosa in keeping with infarcted Meckel's diverticulum. We initially wished to establish when the term "Meckel's diverticulum" should be used. The anatomical site in the present case argues against this being a Meckel's diverticulum, a remnant from the mid-gut loop. Non-Meckelian diverticula are usually acquired and often multiple and generally occur on the mesenteric border of the bowel. It is rare for them to contain ectopic mucosa. The diverticulum in our patient thus has features which suggest it may have been congenital. We believe our patient had a rare occurrence of a congenital, but non-Meckelian, diverticulum with associated ectopic epithelium.

William Hunter and lymphatics.

William Hunter along with his brother, John, and their colleagues William Hewson, William Cruikshank and John Sheldon made a large contribution to understanding of lymphatic vessels. Hewson, Cruikshank and Sheldon all carried out mercury injections and made much progress in mapping the distribution of lymphatics in the human body. William Hunter appreciated that lymphatics absorbed fluid from the tissues of the body and that lacteals of the intestine and lymphatics are similar structures. John Hunter carried out an elegant series of experiments that proved that lacteals absorb products of digestion. The Hunters, however, were wrong in dismissing absorption by blood vessels and missed the importance of blood capillaries. William Hewson showed that lymphatics were not confined to mammals but that they are present in reptiles, birds and fish. Hewson also demonstrated that tracheobronchial glands are lymph nodes and not mucus-secreting glands as previously thought. Although William Hunter appreciated that tuberculosis and venereal diseases might involve the regional lymph nodes, he does not seem to have fully grasped that malignant disease might involve the local nodes or the concept that knowledge of lymph drainage could be used to define the likely site of a primary malignancy.

The anatomy of buccinator--insights from functional casts of the oral vestibule.

OBJECTIVE: When a dental elastomer is placed in the oral vestibule and the facial muscles contracted while it sets, the functional cast produced frequently shows a deep anteroposterior groove, and marked posterosuperior and smaller anteroinferior bulges. This study investigates whether these features have a structural or a physiological basis. DESIGN: Casts of the right side of the oral vestibule of dissecting room cadavers and living volunteers were made using a polyvinylsiloxane dental elastomer. The volunteers each produced two functional casts in each of the following situations: while the teeth were clenched but the facial muscles inactive, while grimacing, and while swallowing. RESULTS: Grooves and bulges were largely absent in casts from the dissecting room cadavers and of living volunteers with the teeth clenched but the facial muscles inactive. They were present when the elastomer set while the subjects grimaced but most marked when they had been swallowing their saliva. The depth of the grooves varied between individuals and generally was greatest alongside the second molar teeth. We found that the posterosuperior bulge did not coincide with the position of the parotid duct. CONCLUSIONS: The anteroposterior groove represents a well developed horizontal part of buccinator. The regions of the casts bulging superior and inferior to the groove probably represent weaker regions of buccinator towards its maxillary and mandibular attachments. The bulge superior to the groove was not explained by a weakness in buccinator where it is pierced by the parotid duct.

The medical collections at the University of Glasgow.

The medical and other collections in the University of Glasgow have at their core the generous bequest of Dr William Hunter (1718 - 1783), a local man who rose to become an internationally renowned anatomist and obstetrician. The University does not have a Medical Museum as such but an Anatomy Museum, a Zoology Museum, a Pathology Collection, medical displays in the main halls of the Hunterian Museum in the Gilbert Scott Building and a rich collection of antiquarian medical books and archives as well as contemporary libraries. The Hunterian Collection, since its inauguration at the University of Glasgow in 1807, has engendered a spirit of diversity and scholarship that embraces many disciplines across the campus. The Hunterian Museum was the first public museum in Scotland and service to the local, national and international communities and response to their academic needs is very much at heart of its function today.

The International Network on Public Health and Aging (INOPA): introducing a life course perspective to the public health agenda.

In this paper, we present an international network of researchers from projects examining the human aging process and its consequences. It is both vital and urgent to include aging and a life course perspective on the public health agenda, particularly in low-income countries. By announcing the network in a publication, we wish not just to position the network but, more importantly, to attract the attention of other potential collaborators either at the project, institutional, decision making, or applied level.

The meningo-orbital foramen in a Scottish population.

The meningo-orbital foramen is a small opening in the orbit lateral to the lateral end of the superior orbital fissure. It is widely reported to contain an orbital branch of the middle meningeal artery. The foramen may be single or multiple and may occur in the posterosuperior part of the lateral orbital wall or in the posterolateral part of the orbital roof. There is a lack of clarity in the literature as to whether foramina occurring in the orbital roof are the same entity as those occurring in the lateral wall. The disposition of the lesser wing of the sphenoid at the anterior limit of the middle cranial fossa makes it difficult to see how a foramen communicating with the anterior cranial fossa could transmit a branch of the middle meningeal artery. Our study contained 16 meningo-orbital foramina in the orbital roof that would transmit a fine probe. Fourteen of these passed into canals that tracked posteriorly in the bone to open into the middle cranial fossa close to the lateral extremity of the superior orbital fissure. The other two of these foramina communicated with the anterior cranial fossa and both were associated with a more posterior foramen that communicated with the middle cranial fossa. We hope this study clarifies an issue with relevance to surgery in the anterior cranial fossa.

The distribution of the radial and musculocutaneous nerves in the brachialis muscle.

Few have examined the distribution of the radial nerve branch to brachialis, generally believed to be motor, within the muscle. We examined the right brachialis muscles of six dissecting room cadavers and found that four received a supply from the radial nerve. The radial nerve branch(es) supplied the inferolateral region of the muscle and was overlapped proximodistally and mediolaterally by the intramuscular branches of the musculocutaneous nerve, which lay on a more superficial plane. The results have implications for the anterolateral approach to the humerus for orthopedic surgery. Anterior splitting of the muscle will almost certainly damage the most lateral branches of the musculocutaneous nerve.

What did William Hunter know about bone?

This article examines William Hunter's specimens on bone in the Anatomy Museum at the University of Glasgow. By referring to students' notes taken at Hunter's lectures and to the Manuscript Catalogue of his anatomical specimens, we attempt to answer the question, "What did William Hunter know about bone?" Hunter seems to have been particularly interested in the relationship between vascularisation and ossification and many of the specimens illustrate this. He provided his students with reasoned arguments on a number of issues: that the marrow serves as a fat store and not to produce synovial fluid or to keep bones supple; the periosteum serves as an attachment for tendons and ligaments; the rationale for the presence of epiphyses is not readily defined; that bones form by intramembranous and endochondral ossification and that, in the latter, cartilage is replaced by bone. William Hunter narrowly failed to realise that in long bones new bone is laid down by the periosteum and at the epiphysial plates, and is remodeled. These discoveries were to be made by his brother, John.

Changes in bone architecture in the femoral head and neck in osteoarthritis.

This study analyses changes in the bony architecture of the femoral head and neck in osteoarthritis. Five osteoarthritic hips were obtained from female patients undergoing total hip replacement and were compared to non-arthritic control specimens from the dissecting room. Analysis was carried out on a coronal bony slice of the femoral head and on a transverse section of the upper femoral neck. The results indicated that in the region of the compressive trabeculae the intertrabecular areas were generally smaller in the osteoarthritic specimens and that the inferior part of the cortex of the femoral neck had thickened. Our data thus quantified changes consistent with the thickening of compressive trabeculae reported by others and with thickening of the region of the femoral neck on which they converge. We found less trabecular bone in non-weight-bearing regions of the lower femoral head and in the medulla of the upper neck in the osteoarthritic specimens consistent with loss of tensile trabeculae. Scanning electron microscopy suggested that bone resorption activity was higher in the subchondral and non-weight-bearing regions of the osteoarthritic femoral heads than in the controls.