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The aim of the current study was to observe the expression of cytokeratins in human fetal thymuses. Specific cytokeratin markers in adult humans and mice have been well described but there has been little similar work on human fetuses. We also aimed to see whether progenitor stem cells that could be harvested to treat various immunodeficiency disorders are present in fetal thymic tissue. Thymuses obtained from 30 aborted human fetuses (12 to 31 weeks) were examined immunohistochemically to investigate changes in cytokeratin expression in the epithelial cells (TEC) at various gestational ages. Before 16 weeks of gestation, cortical (cTEC) and medullary (mTEC) TEC exhibited homogenous staining for cytokeratins CK8 and CK5. After 16 weeks there was differential staining, with cTEC positive for CK8 and mTEC for CK5 and CK14. Interestingly, both CK5 + CK8+ progenitor stem cells were present in the fetal thymic cortex at all gestational ages, with a relatively high number from 12 to 16 weeks. Cytokeratin expression in fetal thymuses was quite different from that in the adult thymus owing to the presence of undifferentiated progenitor stem cells in fetal thymic stroma along with differentiated TEC. The best time to harvest these progenitor stem cells from fetal thymic stroma in order to treat various immune deficiency disorders appears to be 12-16 weeks. Clin. Anat. 29:711-717, 2016. © 2016 Wiley Periodicals, Inc.
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Feto/metabolismo , Queratinas/metabolismo , Células Madre/metabolismo , Timo/metabolismo , Células Epiteliales/metabolismo , Humanos , Timo/citologíaRESUMEN
Body donation is the act of giving one's body to science for study, practice, and research. This selfless act contributed to the education and training of professionals in the field of medicine. Body donation programs allow medical students to learn about the different aspects of human anatomy, perfect their dissection skills, and develop a better understanding of the relationship between structure and function in the human body. The purpose of article is to improve body donation programs which meet ethical standards and best practices. This article emphasizes the significance of body donation to teaching medical institutions by discussing various aspects of body donation to medical colleges in India and the procedural steps followed, sample proformas and the obstacles faced during the whole process. The process of body donation varies among different countries pertaining to their legal frameworks and the challenges faced. A description of the problems faced in the process of body donation has been discussed with suggestions for potential solutions in this section. The sample formats of the forms filled by donors and the certificates issued by concerned organizations are also provided to clearly understand the process of body donation. The information compiled will pave the way for medical teaching institutions that have yet to start a body donation program.
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BACKGROUND: Transpedicular stabilization of subaxial cervical spine is a very delicate procedure that requires thorough understanding of the pedicle anatomy to minimize the rate of neurovascular complications. The current study was conducted to investigate the morphometric details including dimensions and axis of typical cervical vertebrae (C3-C6) for transpedicular screw insertion surgery. METHODS: The current study was conducted on 100 sides of 50 dry and 160 sides of 80 vertebrae on computerized tomography scans of typical cervical vertebrae. Parameters that were studied bilaterally included distance between medial aspect of the pedicle and dural sac, pedicle height, pedicle width, interpedicular distance, lateral and medial cortical thickness, transverse pedicle angle and chord length. RESULTS: Distance between medial aspect of the pedicle and dural sac was found to be 2.2 ± 0.99 mm. Mean pedicle height (6.5 ± 1.1 mm) was found to be greater than pedicle width (4.9 ± 0.9 mm) in all the vertebrae. Mean transverse pedicle angle and chord length was observed to be 39.4° and 32.1 mm, respectively. Mean interpedicular distance, medial and lateral cortical thickness was observed to be 21.8 ± 1.6, 1.43 ± 0.4 and 0.79 ± 0.2 mm, respectively. CONCLUSIONS: The present study highlights a three-dimensional orientation of subaxial cervical pedicle anatomy, while emphasizing the risks involved in the view of comparatively smaller values of pedicle dimensions of subaxial cervical vertebrae. This knowledge about typical cervical vertebrae, its pedicle and their adjacent neurovascular structures may enhance the safety of transpedicular screw insertion.
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Vértebras Cervicales/anatomía & histología , Tornillos Óseos , Vértebras Cervicales/diagnóstico por imagen , Femenino , Humanos , Masculino , Procedimientos Ortopédicos , Valores de Referencia , Tomografía Computarizada por Rayos XRESUMEN
Objectives: The present study was performed to provide a normal reference range for humerus diaphysis length at the second trimester of pregnancy in an Indian population. Materials and Methods: This cross-sectional study was performed on 25 radiographs of aborted normal human fetuses of gestational age (GA) between 13th and 28th weeks. The radiographs were used to measure the maximum length of the humerus using a vernier calliper. Data were collected, tabulated, and statistically analyzed. Results: The mean diaphyseal length of humerus at the fourth lunar month was 22.18 ± 6.59 mm, and at the seventh lunar month, it was 41.39 ± 10.08 mm. Simple linear regression analysis shows a strongly significant linear relationship of humerus length with GA, biparietal diameter, head circumference, and abdomen circumference. Conclusion: We have provided a normal reference range for humerus diaphysis length at the second trimester of pregnancy in an Indian population.
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BACKGROUND: Online teaching has been practiced after lockdown due to Coronavirus Disease 2019 (COVID-19) pandemic which has replaced conventional classroom teaching. The aim of the present study was to know the perceptions regarding online learning as perceived by both teachers and students during COVID-19 pandemic. MATERIALS AND METHODS: The present study was cross-sectional and questionnaire-based. Web-based respondent-driven sampling technique was used to recruit participants for the present study. Three hundred and thirty-two students and 130 teachers of varying ages and gender participated in the study. The link of web-based questionnaire was sent to respondents through WhatsApp/Facebook. Responses from all the participants were tabulated and analyzed using univariate analysis (Chi-square test). RESULTS: Prerecorded lectures (38.9%) and Webinar apps (35/8%) were the most common modules of online teaching by students. One-third (34.3%) had the convenience to attend lectures from home whereas 44.3% had difficulty in concentration. Commonly cited disadvantage by students was inability to do practical work (37.9%). Regarding teaching faculty, 43.8% had no prior knowledge of online teaching. Sixty percent of teachers had 4 h/week of online teaching. No face-to-face interaction (67.7%) and internet issues (26.9%) were commonly stated barriers by faculty. CONCLUSION: The pandemic has pushed the teachers and students toward newer teaching avenues. However, more needs to be done to supplement the existent teaching pattern and preparedness of teaching faculty by incorporating online assignments and assessment methods, strengthening digital infrastructure in medical schools, and training support for teachers.
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Disintegrable inorganic nanoclusters (GIONs) with gold seed (GS) coating of an iron oxide core with a primary nanoparticle size less than 6 nm were prepared for theranostic applications. The GIONs possessed a broad near-infrared (NIR) absorbance at â¼750 nm because of plasmon coupling between closely positioned GSs on the iron oxide nanoclusters (ION) surface, in addition to the â¼513 nm peak corresponding to the isolated GS. The NIR laser-triggered photothermal response of GIONs was found to be concentration-dependent with a temperature rise of â¼8.5 and â¼4.5 °C from physiological temperature for 0.5 and 0.25 mg/mL, respectively. The nanoclusters were nonhemolytic and showed compatibility with human umbilical vein endothelial cells up to a concentration of 0.7 mg/mL under physiological conditions. The nanoclusters completely disintegrated at a lysosomal pH of 5.2 within 1 month. With an acute increase of over 400% intracellular reactive oxygen species soon after γ-irradiation and assistance from Fenton reaction-mediated supplemental oxidative stress, GION treatment in conjunction with radiation killed â¼50% of PLC/PRF/5 hepatoma cells. Confocal microscopy images of these cells showed significant cytoskeletal and nuclear damage from radiosensitization with GIONs. The cell viability further decreased to â¼10% when they were sequentially exposed to the NIR laser followed by γ-irradiation. The magnetic and optical properties of the nanoclusters enabled GIONs to possess a T2 relaxivity of â¼223 mM-1 s-1and a concentration-dependent strong photoacoustic signal toward magnetic resonance and optical imaging. GIONs did not incur any organ damage or evoke an acute inflammatory response in healthy C57BL/6 mice. Elemental analysis of various organs indicated differential clearance of gold and iron via both renal and hepatobiliary routes.
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Hipertermia Inducida , Nanopartículas , Animales , Línea Celular Tumoral , Células Endoteliales , Oro/química , Oro/uso terapéutico , Hipertermia Inducida/métodos , Ratones , Ratones Endogámicos C57BL , Nanopartículas/química , Fototerapia/métodos , Medicina de PrecisiónRESUMEN
Gubernaculum testes is the most important parameter in testicular migration. At the end of migration, it is described as scrotal ligament, which has implications in testicular torsion. The present study aims to examine the structure of scrotal ligament and compare it with gubernaculum. Sixteen adult cadaveric testicular specimens and fourteen fetal testicular specimens of different age groups were examined after getting ethical clearance from the institute ethics committee and consent from the parents. Meticulous dissection was done. The length, site of proximal, and distal attachment of scrotal ligament and gubernaculum were noted and histologically evaluated. A separate scrotal ligament could not be delineated in any adult specimens. It merged with testicular coverings. Histological examination showed the presence of patchy areas of dense collagen fibres of variable density amidst loose areolar connective tissue. In contrast, fetal specimens showed the presence of a definitive gubernaculum testes and revealed the presence of mesenchymal tissue, collagen, elastic fibres, and myocytes which varied according to gestational age of fetuses. Structure of scrotal ligament and gubernaculum testes is highly variable. Description of scrotal ligament as a firm attachment from lower pole of testes to scrotum is controversial, questioning its role as protective factor in testicular torsion.
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Gubernáculo/anatomía & histología , Gubernáculo/embriología , Ligamentos/anatomía & histología , Ligamentos/embriología , Escroto/anatomía & histología , Escroto/embriología , Testículo/anatomía & histología , Testículo/embriología , Adulto , Cadáver , Edad Gestacional , Humanos , Ligamentos/fisiología , Masculino , Escroto/fisiología , Torsión del Cordón Espermático/etiología , Torsión del Cordón Espermático/prevención & controlRESUMEN
BACKGROUND: Atherosclerosis has been described as the most common cause of renal artery stenosis. The purpose of this autopsy study was to assess the preponderance and severity of atherosclerotic changes in renal artery in different age groups in normal population. METHODS: Ninety renal arteries from 45 cadavers above 30 years of age were obtained at autopsy. Fifty-four renal arteries were studied grossly after Sudan IV staining for extent and severity of fatty deposits in terms of Atherosclerotic index (AI). Another 36 renal arteries were studied microscopically for changes in different layers and at different sites of artery and luminal narrowing, if any with advancing age. RESULTS: In grossly stained specimens, incidence and AI which is the marker of extent and severity of lesions were found to increase gradually with advancement of age. Increased incidence of atherosclerotic changes with better nutritional status was recorded. In microscopically studied specimens, intimal thickness which is a marker of disease also showed upward rise with advancing age. Renal artery stenosis was prevalent in 13.8% cases. Lesions were most commonly detected at renal ostium and proximal segment. CONCLUSIONS: Fatty changes appear with advancing age. Advanced types of changes including fibrous plaques, calcification and ulceration were noticed first in fifth decade. The changes were usually bilateral. Proximal segment was the most affected part. Four cases had less than 50% and one case had 70% luminal narrowing. The changes were only moderately severe in most of the cases.
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Aterosclerosis/epidemiología , Obstrucción de la Arteria Renal/epidemiología , Arteria Renal/patología , Adulto , Factores de Edad , Anciano , Aterosclerosis/patología , Femenino , Humanos , Incidencia , India/epidemiología , Masculino , Persona de Mediana Edad , Prevalencia , Obstrucción de la Arteria Renal/patologíaRESUMEN
In recent years interest in the anatomy of corpus callosum (CC) has led to a number of studies on morphometric analysis of CC, either in vivo on magnetic resonance imaging (MRI) or on preserved (formalinfixed) cadaveric brain specimens. There are very few reports comparing the values obtained by both these methodologies, and to the authors' knowledge no study of CC morphometry in fresh (unfixed) autopsy brains has been done. Morphometric measurements of the CC were done on fresh autopsy brains (n = 15), preserved cadaveric brains (n = 44) and MRI scans (n = 30) in adults (age range: 20-60 years) of both sexes without any intracranial brain pathology, in north-west Indian subjects. Most of the CC measurements were found to be more in the fresh autopsy brain group as compared to the preserved cadaveric brain and MRI group. The distance between the splenium and superior colliculus in the fresh autopsy brain group was almost twice that in the other two groups. In addition, there was a similarity between the preserved cadaveric brain and MRI values for most of the parameters, but the distances between the genu and fornix and between the genu and anterior commissure were larger in the MRI group as compared to the other two groups. The present data may be of value in studying deviations from the normal in various disease processes as well in surgical planning of intraventricular and callosal pathologies.
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Cuerpo Calloso/anatomía & histología , Imagen por Resonancia Magnética , Preservación de Órganos , Adulto , Cuerpo Calloso/efectos de los fármacos , Cuerpo Calloso/patología , Femenino , Fijadores/farmacología , Humanos , India , Masculino , Persona de Mediana EdadRESUMEN
Brains were obtained from 1000 medicolegal autopsy subjects of varying ages. The circle of Wills was examined at the base of the brain. The cerebral vessels were observed with regards to their origin, caliber and typical configuration. Variations were noted and grouped into different categories. Out of 1000 specimens examined, 452 (45.2%) conformed to the typical pattern. In the rest of the specimens (54.8%) there were variations in the circulus arteriosus. The circle was deficient in 32 (3.2%). The anterior cerebral artery was absent in 0.4%; hypoplastic in 1.7%; duplicated in 2.6%; triple in 2.3% and single in 0.9%. The anterior communicating artery was absent in 1.8%, duplicate in 10%, triplicate in 1.2% and plexiform in 0.4%. Multiplication of posterior cerebral artery was observed in 2.4% cases while it was hypoplastic in 10.6% brains. Posterior communicating artery was absent in 1% and hypoplastic in 13.2%. Seventy-four brains (7.4%) had multiple variations. Intracranial saccular aneurysm was present in 10 (1%). These figures are compared with the available literature. Persistence of some embryonic vessel that normally disappear, disappearance of vessels that would normally persist or sprouting of new vessels due to hemodynamic and genetic factors are the usual causes for such anomalies. These variations are discussed with regard to development and other hemodynamic factors.
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Círculo Arterial Cerebral/anomalías , Círculo Arterial Cerebral/anatomía & histología , Adolescente , Adulto , Factores de Edad , Anciano , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Persona de Mediana EdadRESUMEN
A total of 260 male subjects between 1 and 80 years of age of north-west region of India were studied with regard to morphometry of the ear lobule. The purpose of the present study was to obtain average values and range of measurements of several parameters of the ear lobule and the differences between right and left lobules. Female subjects were excluded from the study due to piercing. Various measurements of lobule were taken with the help of Vernier and Lange's calipers. The results of the aforementioned measurements were analyzed statistically using Student's t-test. The maximum length of the lobule increased appreciably between 6-15 years and 41-80 years. The breadth of the ear lobule increased up to the age of 15 years and was almost static between the ages of 16 and 40 years and increased again from 41 years onwards. Length of the lobule showed significant growth from the age group of 6-10 to 11-15, 21-40 to 41-60 and 41-60 to 61-80 years on the right side and 6-10 to 11-15 and 21-40 to 41-60 years on the left side. Breadth and thickness of ear lobule also showed statistically significant growth pattern in some age groups. On comparing the ear lobe dimensions with the studies available in other populations of the world, it was observed that north-west Indians have smaller ear lobules as compared to Caucasian and Japanese populations. In the present study, the frequency of attached (square) type of lobules was the maximum, followed by free (pendulous) type and tapering lobules. These findings were similar to those found among the Onge tribe of Andhra (India) and Newars of Nepal.
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Pabellón Auricular/anatomía & histología , Adolescente , Adulto , Factores de Edad , Anciano , Antropometría , Niño , Preescolar , Humanos , India , Lactante , Masculino , Persona de Mediana Edad , Tamaño de los ÓrganosRESUMEN
Split notochord syndrome represents an extremely rare and pleomorphic form of spinal dysraphism characterized by a persistent communication between the endoderm and the ectoderm, resulting in splitting or deviation of the notochord. It manifests as a cleft in the dorsal midline of the body through which intestinal loops are exteriorized and even myelomeningoceles or teratomas may occur at the site. A rare variant was diagnosed on autopsy of a 23+4-week-old fetus showing a similar dorsal enteric fistula and midline protruding intestinal loops in thoracolumbar region. The anteroposterior radiograph showed a complete midline cleft in the vertebral bodies from T11 to L5 region, and a split in the spinal cord was further confirmed by ultrasonography. Myelomeningocele was erroneously reported on antenatal ultrasound. Thus, awareness of this rare anomaly is necessary to thoroughly evaluate the cases of such spinal defects or suspected myelomeningoceles.
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INTRODUCTION: There is need to elucidate the histological developmental stages of various layers of retina, to understand the process better and provide clinically significant insights. AIM: To study the details and chronology of in utero development of different layers of retina. MATERIALS AND METHODS: To study time of appearance, differentiation and organization of all layers of central retina in different gestational age groups. Retina was studied histologically in 27 foetuses from18(th) to 34(th) weeks of gestation. RESULTS: We found the period of mid gestation (19(th) -21(st) week of gestation) to be the defining time for retinal layers: The bruch's membrane was fully formed at 20(th) week of gestation; the photoreceptor layer became well defined at 21(st) week of gestation; both the nuclear layers and both the plexiform layers and the ganglion cell layer became distinct at 19(th) week of gestation. Before the 19(th) week, outer and inner neuroblastic zones separated by the neuropil were seen. Well defined nerve fibre layer and inner limiting membrane was present at 18(th) week. The outer limiting membrane was first appreciated at 32(nd) week of gestation. Foetal retinal pigment epithelium was cuboidal and filled with melanin granules while no trace of lipofuscin pigment was found under fluorescent microscope. CONCLUSION: Detailed data on retinal histogenesis and its timeline might aid in directed differentiation of retinal cell types from stem cells for therapeutic purposes.
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AIM: The detection of foetal urinary abnormalities in the antenatal period will help in an adequate post natal management and it will also have a bearing on the decision of the termination of the pregnancy. The purpose of the present study was to detect urinary anomalies in the antenatal period by doing autopsies of the aborted foetuses. SETTINGS AND DESIGN: A cross-sectional study. METHODS AND MATERIAL: A total of 226 aborted foetuses were autopsied. The urinary anomalies which were related to the renal parenchyma, the pelvi-ureteral system and the urinary bladder were recorded. The associated anomalies of the other organ systems were also noted. The incidences of the different urinary anomalies among the aborted foetuses were calculated. The gestational ages at which the various anomalies were detected were also studied. RESULTS: Twenty nine of the 226 fetuses were detected to have 34 urinary anomalies. Renal agenesis was the single most common anomaly. Overall, the anomalies which were related to the renal parenchyma accounted for 67.65 % of all the urinary anomalies, while the anomalies of the pelvi-ureteral system and the bladder constituted 20.59% of the detected urinary anomalies. The anomalies of the renal parenchyma (renal agenesis and horse-shoe and polycystic kidneys) were more frequently seen in the foetuses with a shorter gestational age as compared to the gestational ages of the foetuses which showed pelvi-ureteral anomalies. The cumulative incidence of the foetuses with urinary anomalies by 30 weeks of gestation was 12.83%. CONCLUSIONS: A significant proportion of the aborted foetuses was detected to have urinary anomalies. An early antenatal detection of these and associated anomalies has significance, as this may help in an early postnatal diagnosis and management. The degree and the extent of the detected anomalies could also help in the decision making regarding the therapeutic abortions and the future pregnancies.
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The study of the various morphometric parameters of the fetal femora carries significance because of its importance in the estimation of fetal gestational age, detection of skeletal growth anomalies including various congenital malformations, and also in certain cases of fetal demise associated with medico-legal implications. The present study was undertaken in the department of Anatomy, Government Medical College and Hospital, Chandigarh with the aim of collecting the morphometric parameters of the fetal femora. The material for the present study consisted of 45 fetuses from 12+1 to 28 weeks of gestation. Various morphometric parameters including CRL, lengths, widths and diameters were taken at different levels. The obtained data were statistically analysed using ANOVA, and Pearsons correlation coefficients were assessed. The average growth rate of medial and lateral lengths was calculated as 2.36 mm/wk and 2.30 mm/wk. It was assessed that fetal growth is seen to be more because of the increase in femur length as compared to increase in CRL after 20 weeks of gestation. Regression equations from femoral measurements are advised for age estimation from fetal remains in Indian population
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Humanos , Fémur/crecimiento & desarrollo , Desarrollo Fetal , Crecimiento , Antropometría/métodos , Edad Gestacional , Tamaño de los ÓrganosRESUMEN
The development of the long bones at various gestational ages in the fetus has always been a subject of interest for many clinicians. Some morphometric parameters such as length, etc., are considered standard parameters for evaluation of the gestational age of the fetus. However, not much emphasis is laid upon morphometric parameters to assess the histological changes in these age groups. Therefore, the present study was undertaken to determine the histological changes occurring in a developing bone. 30 fetuses sent to the Dept. of Anatomy for routine fetal autopsy by the Dept. of Obstetrics and Gynaecology were selected for the microscopic study of the femur. Left femora were extracted, and transverse and longitudinal sections were taken and stained with hematoxylin and eosin. The epiphysis of the growing bone exhibited the formation and proliferation of different zones in different age groups. The formation and distribution of distinct cartilage canals has been evidenced as early as 13+2 weeks of gestation in the growing epiphysis. The appearance of a secondary centre of ossification in the distal femoral epiphysis was observed as early as 28+4 weeks. The diaphysis showed the formation of a cancellous bone with increasing trabeculae proliferating more on one side of the shaft. The above observations are discussed in the light of available literature
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Humanos , Fémur/embriología , Cartílago/embriología , Desarrollo Óseo , Osteogénesis/fisiología , Condrocitos , Epífisis/embriología , Diáfisis/embriología , Feto/anatomía & histologíaRESUMEN
Better knowledge of unexpected fetal loss is the promise for better parental counseling and for prevention of recurrences. Fetal autopsy can provide a clue to ascertain cause of death in these cases. Variations in the incidence can be attributed to multiple factors. The present study was carried out to help us to develop a database concerning number of autopsies, incidence and types of congenital malformations (CMF) in the North-Western Indian population. The period of study was from January 2010 to November 2011. Autopsy was carried out on 150 fetuses following guidelines provided by a fetal autopsy protocol. Prior to autopsy, prenatal investigations such as ultrasound and radiographs were procured; a brief maternal and family history was noted. Out of a total of 150 autopsies, 87(58%) were induced abortions and 63(42%) spontaneous abortions. In total, the incidence of CMF was 104(69%) of fetal autopsies. The types of CMF were classified as central nervous system defects (CNS) in 49 (33%), gastrointestinal tract (GIT) disorders in 48 (32%), musuculoskeletal (MS) disorders in 31 (21%), genito-urinary (GU) in 25 (17%), and genetic disorders in 12 (8%). Multiple anomalies were present in 40 (27%) fetuses. Anencephaly (meroencephaly) turned out to be the most prevalent anomaly (29%). A few cases showed the occurrence of some uncommon syndromes. Major CMFs manifested very early in intra-uterine life, and could lead to termination of pregnancy (spontaneous or induced) in the 2nd trimester of gestation. Hence the presence of any CMF at the time of birth cannot provide the total percentage of CMF occurring in a given population. The above findings are discussed in the light of the available literature (AU)
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