Calvarial defect in human anencephaly.

The calvarial defect in human anencephaly has been studied on 21 anencephalic skulls in all of which the defect extended into the vertebral column. Based on the boundaries of the defect, a nomenclature of the anomaly has been proposed that is simpler, more scientific, and more informative than previous ones because it expresses the precise extent of destruction of the cranial vault. In the present study, the defect was "fronto-occipito-vertebral" in in 71.4%, "occipito-vertebral" in 23.8%, and "parieto-occipito-vertebral" in 4.8% of cases. The morphologic details of the cranial bones bounding the calvarial defect have been described.

Helical structure of the human umbilical cord.

The helical structure of the human umbilical cord has been studied on 528 full-term cords from normal deliveries, 18 cords from aborted and developmentally normal fetuses with a CR length of 1.2-19.5 cm, 10 cords from monozygotic twins. In order to resolve the discrepancy in the nomenclature of the twist direction, a method has been suggested which takes into account the direction to which the fetus must have rotated to produce the twist. The incidence of the right helical pattern was 64.58%, of the left helical pattern 15.15%, and of the mixed patterns 17.43%; the twists were indeterminate in 1.89% and absent in 0.95% of the cords. Details of the mixed patterns are listed. The number of the uniform right twists ranged from 1 to 29 (7.5) and that of the left twists from 1 to 19 (6.7). There exists an exponential relation between the number of the twists and the ratio between length and thickness of the cords. The twists begin to appear during the early part of the 8th week, and their final number is possibly attained soon after the 9th week of development. In view of the absence of concordance in monozygotic twins, the helical nature of the cord is possibly controlled by factors which may be partly genetic and partly environmental.

Seven cases of branchial cyst and sinuses in four generations.

7 cases of isolated branchial anomalies distributed in four consecutive generations of a Central Indian family are described: 6 were males and 1 was female. 3 members had a left-sided branchial sinus, 1 had a right-sided sinus, 2 had bilateral sinuses, and 1 had a right-sided cyst. The family shows that branchial (lateral cervical) cysts and sinuses are inherited as autosomal dominant characters, and that the two anomalies are indistinguishable genetically.

Amniochorionic bands and adhesions with fetal deformities.

The amniochorionic bands and adhesions in 2 malformed human fetuses are described. The anencephaly, left harelip with grossly distorted face, and rudimentary right upper limb of case 1, and multiple pits and cavities in the liver of case 2, are directly attributable to membranous adhesions. The toughness of the bands is indicative of their mesoblastic (chorionic) origin. The histolytic effect on the liver of case 2 may suggest a contact with the trophoblastic cells. The exomphalos of case 1, and extroversion of cloaca with other caudal defects of case 2, are possibly due to vascular and mesodermal deficits imposed by single umbilical artery.

Hair patterns of the lower limb in Central Indian males.

The distribution of hair of the right lower limb has been studied in a random sample of 220 healthy Central Indian males 17 to 45 years of age. The common hair patterns observed are the proximal phalangeal hair in all toes in 55.45%, the middle phalangeal hair in the third toe in 8.18%, the tibial on the dorsum of foot in 69.55%, and the pedo-cruro-femoral in the lower limb in 70.00% subjects. Comparison of these findings with those of the right upper limb shows that hairiness of the two limbs is correlated, that the dorsum of foot is less hairy than the dorsum of hand, and that the third and second toes are comparable with the fourth and third fingers, respectively, as regards their middle phalangeal hair. Comparison with the available literature shows that the Central Indian males resemble the Whites in having greater frequency of middle phalangeal hair than those of the Negroes, that the dorsum of feet of this population is less hairy than the White and more hairy than the Negroes, and that the general hairiness of the lower limb is more or less equal in the three groups of persons.

Hair patterns of the pinna among the Central Indians.

The hair patterns of the pinna have been studied in a selected sample of 767 males and 5 females from Central India, all with hairy pinnae. The age of the males ranged from 21 to 85 years, and that of the females from 2.5 months to 32 years. All subjects were healthy and did not demonstrate any endocrine disturbance. The commonest hair pattern of the elevated areas of the pinna among the males was the helico-lobulo-antitragal, whereas in the females it was the helical. The hair pattern of the depressed areas of the pinna showing highest frequency was the conchal. The majority of the hairy pinnae are associated with bilateral tragal hair and the maximo-pilose distribution of the facial hair. The Central Indian males resemble the White males in their hair distribution of the pinna.

Cerebral hydatid cysts in central India.

Four cases of hydatid cysts of the brain are reported. All of the patients were under 18 years of age. One presented with a localized erosion of the skull and a characteristic cracked-pot sign. Angiographic findings were most useful in their diagnosis.

Forebrain in human anencephaly.

Gross and microscopic study of twelve human anencephalics revealed existence of the forebrain with variable growth in all specimens, meaning thereby closure of the neural tube at its cephalic extremity. This is supported by the findings of choroid plexus, pineal tissue and rudimentary pallium within the anterosuperior margin of a median dorsal opening situated behind the forebrain mass. The opening bears an intimate relation to the undue dorsal convexity of the sphenooccipital junction, and leads cranially to a cavity representing the third and lateral ventricles. This opening is situated in the posterior part of the roof of diencephalon, and seems to be the primary site of disturbance causing anencephaly. Weakness of the diencephalic roof is indicated by its epithelial nature and its ballooning in cyclopia and cebocephaly. A corresponding potential weakness in the overlying tissues is evidenced by the sagittal fontanelle of early fetal life and by congenital scalp and skull defects of the parietooccipital region.

Ectopic lungs in a human fetus with Klippel-Feil syndrome.

The hyperplastic lungs protruding out of the thoracic cavity are described in a full term still-born male cotwin having Klippel-Feil syndrome, single umbilical artery, dextrocardia and a right sided aorta. Both lungs herniated into the abdomen through bilateral defects in the diaphragm. The righ lung, in addition, herniated superiorly toward the base of the skull. The pulmonary herniation appears to be due to spinal retroflexion which reduces the capacity of the thoracic cage. The various anomalies observed can be attributed to the disturbances caused by single umbilical artery.

Lactate dehydrogenase and aspartete transaminase of the cerebrospinal fluid in patients with brain tumours, congenital hydrocephalus, and brain abscess.

The diagnostic value of CSF lactate dehydrogenase and aspartate transaminase in cases of brain tumours (except for CSF AST in the benign tumours), congenital hydrocephalus, and brain abscess is established. Tumour cyst fluids show a higher enzymatic activity than does the CSF. The two enzyme estimations do not help in differentiating the supratentorial from the infratentorial tumours. CSF AST is superior to CSF LD in discriminating the malignant and benign tumours, in so far as the AST is increases selectively in malignancy. Estimates of CSF LD are slightly superior to those of CSF AST, both in incidence of abnormality and the degree of their rise.

Spinal retroflexion in craniorhachischisis: its classification and limitations.

Spinal retroflexion has been studied in five stillborn human fetuses having craniorhachischisis. The findings show that retroflexion in this variant of anencephaly can be classified into severe, moderate and mild forms. The three grades can be differentiated from one another by the direction of the face, shape of the mentothoracic junction, extension of hairline on back, radiographic abnormalities of the spine, and the diaphragmatic defects. It is discussed that, though the anencephalies with severe or moderate degree of cervical retroflexion resemble iniencephaly in their features of spinal retroflexion, those having mild retroflexion are contrasted and should not be categorised with iniencephaly. It is suggested that for precision the term "spinal retroflexion" should be used after duly prefixing it by an appropriate word (severe, moderate or mild) indicating the degree of retroflexion observed.

Cebo-anancephaly.

A case of cebocephaly associated with anencephaly, preauricular appendages and single umbilical artery in a stillborn full term female fetus is described. The changing nomenclature of the median faciocerebral defects, which has led to an apparent confusion, is discussed. It is felt that paucity of literature on cebocephaly is partly due to missed diagnosis of these cases in the absence of a competent teratologist.

Aplasia of the trachea in a malformed human foetus with single umbilical artery.

Aplasia of the trachea associated with multiple congenital anomalies is described in a stillborn male foetus with single umbilical artery. The tracheal anomaly conformed to the usual anatomic pattern consisting of absence of the trachea from the cricoid to slightly above the main stem bronchi where lay a fistula with the oesophagus. The larynx was normal externally but had a deformed cricoid and a narrow, blind lumen. The single umbilical artery was possibly responsible for causing the cardiovascular and tracheo-oesophageal anomalies by disturbing the haemodynamics, and the remaining caudal defects of the body by replacing the abdominal aorta below the origin of the inferior mesenteric artery.

Eyedness.

The so-called 'eyedness' with regard to fixation of the gaze on a particular point has been investigated on 283 right-handed and 30 left-handed healthy persons of Central India. The results show that the majority (65.81%) of them are right-eyed, and that the eyedness is not influenced by sex or handedness. Though the left cerebral hemisphere seems to play a dominant role in gaze fixation in the greater proportion of the population, consideration of the joint of the two cerebral hemispheres for individual functions of the body has been advocated.

A study of "palthi" posture among Indians.

"Palthi" (leg-folding) posture has been studied in a random survey of 864 right handed and 37 left handed persons, ranging from 5 to 66 years of age and belonging to the Gwalior district of Madhya Pradesh (Central India). The results show that the frequency of L-type "Palthi" (i.e. left leg crossed above the right leg) is significantly greater than that of R-type, and that it is not correlated either with age, sex, or handedness. Since "Palthi" is fairly under voluntary control, the cerebral dominance may be an important factor in the genesis of this posture pattern. This is well in keeping with the revised concept of cerebral dominance.