Sternoclavicularis - A variant of Pectoralis Major Muscle.

A rare muscle sternoclavicularis was found in a large triangular gap between the sternocostal and clavicular heads of Pectoralis Major muscle on the right side during routine cadaveric dissection. Sternoclavicularis was seen to arise from the anterior surface of manubrium sterni and the capsule of sternoclavicular joint and was inserted on the anterior surface of middle one third of the clavicle. It was supplied by the lateral pectoral nerve. Sternoclavicularis muscle may help in stabilizing the clavicle and may partially fill the triangular deficit in the origin of the Pectoralis Major. This variation may be of particular interest to plastic surgeons, orthopaedic surgeons, radiologists and neurologists. It may mimic a tumour at this site.

Feathered fibres of human soleus muscle / Fibras penniformes del músculo sóleo humano

The large size of superficial group of muscles of back of leg is a characteristic feature of the musculature of man being related directly to its erect posture and mode of progression. Triceps surae is one of the powerful muscles of the body after Gluteus maximus and Quadriceps femoris. To make the muscle more powerful nature has devised a unique method of packing the fibers in a small space by pennation. There exists a bipenniform mass as a peculiarly human feature. Its feathered fasciculi arise from the deep (anterior) surface of the soleus muscle. Most of the textbooks of Anatomy and the available literature on the triceps surae or the tendoachillis do not appreciate and describe this fascinating aspect of the muscle. It was Schafer et al. (1923) who gave a detailed account of this muscle. Standring et al. (2005) have also described this muscle in great detail. We have studied the unique features of this part of soleus muscle. Bipennate arrangement was seen in 86 percent (right-83 percent; left-89 percent); and its maximum width was found to be 3.63 cm (Rt-3.71cm; Lt-3.55cm). Median tendinous septum was directed backwards and medially. Thus this muscle will further increase the power of contraction of soleus, which is so very important for a bipedal gait.

El gran tamaño de los grupos musculares superficiales de la parte posterior de la pierna es un rasgo característico de la musculatura del hombre siendo relacionado directamente con su postura erguida y el modo de progresión. El músculo tríceps sural es uno de los músculos más potentes del cuerpo después de los músculos glúteo magno y cuadríceps femoral. Para hacer al músculo más potente, la naturaleza ha ideado un método único de empaquetamiento de las fibras en un pequeño espacio por pennación. Existe una masa bipenniforme como una característica peculiarmente humana. Los fascículos pennados surgen desde la superficie profunda (anterior) del músculo sóleo. La mayoría de los textos de Anatomía y la literatura disponible sobre el músculo tríceps sural o el tendón de Aquiles no se aprecia ni se describe este aspecto fascinante que tienen los músculos. Fue Schafer (1923) quien dió una detallada descripción del músculo sóleo y posteriormente, Standring et al. (2005) también describieron detalladamente al músculo. Estudiamos las características únicas de esta parte del músculo sóleo, observando una disposición bipenniforme en el 86 por ciento de los casos (derecha 83 por ciento; izquierda 89 por ciento). El ancho máximo del músculo fue de 3,63 cm (derecha 3,71cm; izquierda 3,55cm). El septo tendinoso mediano se dirigió hacia posterior y medial, aumentando así aún más el poder de contracción del músculo sóleo, el cual es muy importante para la bipedestación.

Anatomy of retrohepatic segment of inferior vena cava and termination of hepatic veins.

Background Information on anatomy of intrahepatic inferior vena cava (IVC) and hepatic vein openings in it is limited. Methods We studied the retrohepatic segment of IVC and hepatic vein openings in it in 69 livers obtained from cadavers. The retrohepatic portion of the IVC was opened posteriorly by a vertical cut, the exposed surface was divided into 12 quadrants and the position, size, and septation of ostia of hepatic veins and any accessory openings were charted; measurements were made using Vernier calipers. Results The median length of the intrahepatic IVC was 5.7 (range 3.3–8.2) cm and its median diameter was 2.3 (range 1.5–3.0) cm. The superior (major) set of hepatic veins comprised of two veins (right and left-middle) in 45 (65%) cases, three veins (right, middle, and left) in 23 (33%) and four veins in one (2%) case. Median diameter of the right hepatic vein was 1.5 (range 0.8–2.7) cm and that of left hepatic vein was 1.2 (0.7–2.6) cm. Middle hepatic vein, when separate, had a median diameter of 1.1 (range 0.5–1.5) cm. The inferior (minor) set of hepatic veins had two to 16 (median 7) veins. Conclusions Our data provide information on number, size, position, and septation of hepatic vein openings into the IVC. This information may be useful to hepatologists, hepatic surgeons while planning segmental resection of the liver, and to radiologists planning diagnostic and interventional procedures on hepatic venous system.

Investigation into the possible mechanisms involved in altered digoxin levels in diabetic patients.

The present study was undertaken to investigate the possible factors which may contribute to the altered digoxin levels in diabetic patients. The digoxin levels were found to be significantly higher in diabetics (1.74 +/- 0.09 ng/ml) as compared to non-diabetics (0.76 +/- 0.07 ng /ml). There was a positive correlation between digoxin levels and glycosylated haemoglobin levels. All diabetic patients had serum creatinine, urea and potassium levels within normal limits. However, serum TSH levels were found to be significantly higher in diabetics as compared to controls. Serum tri-iodo-1-thyronine (T3) levels were found to be lower in diabetics as compared to non-diabetics. Our data suggests that diabetes-mellitus causes alteration of digoxin levels. One of the causes of this increase in digoxin levels may be a tendency towards mild hypothyroidism associated with diabetes mellitus.

Nitrogen and sulphur elimination in 24 hours urine by elderly Indians.

Urinary output of N2-urea, creatinine, uric acid, ammonia and organic and inorganic SO3 were repeatedly examined in healthy vegetarian subjects in Bombay--35 elderly and 2 young. Their routine diet examined for a week indicated an average intake of 56 g proteins (15 g animal) and excretion of about 8 g N2, 0.75 g of SO3 both in young and old subjects. These are much lower than figures reported for Europeans taking protein rich diets. Two elderly subjects supplemented their protein intake to 95 g/day (50 g animal) for 3 weeks. A progressive rise in the outputs of N2 and SO3 with increasing protein intakes was seen. SO3 estimation like that of N2 (urea) is indicative of the protein consumption of a person, but the estimations of urea output per day being easier are to be preferred.

Urinary nitrogen in elderly Indians.

Urinary volumes, nitrogenous consituents eliminated in 24 hrs urine and diet taken by healthy elderly lactovegetarian Indian subjects in Bombay are reported. The average values where: diet = 1603 calories, 52.3 gms proteins intake per day; urinary volume 1568 cc, urea 11.27 +/- 3.59 gms/24 hrs, creatinine 1.09 +/- 0.8 gms, uric acid 0.56 +/- 0.21 gms and ammonia 0.38 +/- 0.25 gms per day. While the values of all N2 constituents-urea, creatinine, uric acid and ammonia are much lower, the total N2 as well as urea output in elderly Indians in less than half of that of the young Europeans on meat rich diet but greater than those on protein free diets.