Aspectos biométricos y morfológicos del pericardio fibroso y diafragma en el hombre / Biometric and morphological charachteristics of the fibrous pericardium and the diaphragm in man

El pericardio es una membrana fibro-serosa que envuelve al corazón y a la porción yuxtacardíaca de los grandes vasos. Realizamos un estudio del pericardio y del diafragma, registrando sus dimensiones, sus relaciones, así como también, establecer el tipo de conexiones existente entre ambas estructuras. Fueron disecadas 142 regiones mediastínicas de cadáveres sin fijación o con fijación en formaldehído al 10 por ciento, brasileños, adultos, de ambos sexos, de edades comprendidas entre los 18 y 70 años, fallecidos de diferentes causas. Para el estudio histológico, del conjunto pericardio y diafragma fueron retirados cinco fragmentos de diferentes regiones: anterior próxima al esternón (región 1), lateral izquierda próxima al ápice del corazón (región 2), posterior (región 3), lateral derecha próxima al paso de la vena cava inferior (región 4) y central (región 5). El promedio de los diámetros latero-lateral y antero-posterior del pericardio fueron de 103,3 +/- 6,7 y 66,0 +/- 2,3 mm, respectivamente y del diafragma de 309,4 +/- 27,4 y 152,5 +/- 24,9 mm, respectivamente. El área del diafragma fue en promedio de 37. 260 +/- 2.324 mm2. El área de la base del pericardio sobre el diafragma fue de 6.042 +/- 367 mm2. El espesor del diafragma fue en promedio: parte derecha, 2,42 +/- 0,34 mm; parte izquierda, 2,38 +/- 0,71 mm y la parte anterior, 2,52 +/- 0,66 mm. El promedio del espesor del pericardio separado del diafragma fue de 0,26 +/- 0,02 mm. En la región 2 ambas estructuras fueron separadas con facilidad en 47,2 mm; en la región 5 ambas estructuras se encuentran fusionadas. Los resultados obtenidos en este trabajo complementarán los conocimientos morfológicos sobre el pericardio fibroso y sus relaciones con el diafragma.

The pericardium is a fibrous and serous membrane that surround the heart and the juxta- cardiac portion of the great vessels. We studied the pericardium and diaphragm and we recorded different measurements, relations and connection between both. We dissected 142 mediastinal regions from 10 percent formaldehyde ¡ fixed or fresh individual cadavers, Brazilian adults, of both sexes, from 18-70 years of age. For the histology study from both structures were sectioned five fragments of different regions: anterior, next to sternum (region 1), left lateral, next to heart apex (region 2), posterior (region 3), right lateral, next to course of inferior vena cava (region 4) and central(region 5). The average of transversal and anterior-posterior diameters of pericardium were 103.3 +/- 6.7 mm and 66.0 +/- 2.3 mm, respectively; the same diameters of diaphragm were 309.4 +/- 27.4 mm and 152.5 +/- 24.9 mm, respectively. The diaphragm area was 37,260 +/- 2,324 mm² and the area of pericardium base over the diaphragm was 6,042 +/- 367 mm² . The thickness of diaphragm was 2.42 +/- 0.34 mm in right part, 2.38 +/- 0.71 mm in left part and 2.52 +/- 0.66 mm in anterior part. The thickness of pericardium was 0.26 +/- 0.02 mm. In region 2 both structures were easily separated in 47.2 mm; in the region 4 both structures are fused. The results of this study will complement the morphologic knowledges about fibrous pericardium and its relationships with the diaphragm.

Regional histomorphometry of the hepatic inferior vena cava; a possible sphincteric mechanism / Histomorfometría regional de la vena cava inferior hepática; un posible mecanismo de esfínter

This study was aimed at identifying the changes in diameter and structural composition of the Hepatic Inferior Vena Cava in its infrahepatic, intrahepatic and suprahepatic portions. Eighty adult liver specimens from the Chiromo and Nairobi City mortuaries were used for morphometry, while twenty of them were processed for light microscopy. A constriction was noted in the mid-portion of the HIVC, while structurally; the intrahepatic portion had thicker fibromuscular adventitia. It is plausible that these are sphincteric apparatus to prevent backflow of blood in the Hepatic Inferior Vena Cava.

Este estudio tiene por objetivo identificar los cambios en el diámetro y la composición estructural de la vena cava inferior hepática en sus porciones infrahepática, intrahepática y suprahepática. Ochenta hígados de especímenes adultos de los depósitos de cadáveres de la ciudad de Nairobi y Chiromo fueron usadas para morfometría, mientras que veinte de ellos fueron procesados para microscopía de luz. Se observó una constricción en el medio de la HIVC, mientras que estructuralmente, la porción intrahepática había una gruesa adventicia fibromuscular. Es posible que este sea un aparato esfinteriano para evitar el reflujo de sangre en la vena cava inferior hepática.

Pancreatico-biliary duct system in Jamaicans

The anatomy of the pancreatico-biliary duct system in Jamaicans was investigated with the following results: 1. The incidence of the different patterns of union of the cystic and common hepatic ducts showed marked differences from data derived other populations. 2. The cystic and common hepatic ducts may have a common wall. 3. The incidence and course of aberrant bile ducts correspond to those in the literature. 4. The upper limit of normality of the flattened width of the common bile duct is suggested to be 11 mm. 5. The presence or absence of smooth muscle tissue in the common bile duct wall is discussed in relation to: (a) the role of the duct as a passageway of bile, (b) problems encountered when grafting, and (c) causation of biliary pain. 6. In 8.1 percent of cases it was difficult to expose the pancreatic part of the common bile duct because it was surrounded by pancreatic tissue. 7. In 9.4 percent of specimens the pancreatic part of the common bile duct coursed for the whole or part of its lenght alongside the medial wall of the duodenum without pancreatic tissue intervening between them. 8. In 19.3 percent of cases the duct of Santorini was as big as or bigger than the duct of Wirsung, a higher incidence than that reported elsewhere. 9. It appeared that no real sphincter exists at the duodenal end of the duct of Santorini. 10. The incidence of a common channel/ampulla (44.4 percent) was low if compared with the data in the literature. 11. The mucosa folds in the intramural parts of the common bile duct and the duct of Wirsung might play a significant role in the prevention of duodenal reflux and the regulation of the flow of bile and pancreatic secretion into the duodenum. 12. The variability in the component parts of the sphincter of Oddi was investigated. A sphincter choledochus was present in all cases, a common hepatopancreatic sphincter (=sphincter "ampullae") was found in 45.9 percent of cases, but a clearly-defined sphincter pancreaticus was not observed. 13. It is postulated that the presence or absence of a common hepatopancreatic sphincter may be one of the important factors in determining the patency or non-patency of the duct of Santorini at the papilla minor. The clinical and functional implications of these findings are discussed (AU)