Can Lateral Offset Be Used as a Predictive Marker for Proximal Femur Disorders?

Purpose: When the lateral offset (LO) changes, the forces acting on the head and neck of the femur change. Increase or decrease in LO can cause instability and possible dislocation of the implant. In addition, when the offset is reduced, more force is needed to balance the pelvis by the abductor muscles, and the force that occurs along the hip joint increases and causes wear and tear. In this study we aimed to investigate whether there is a correlation between LO and proximal femur morphology, and according to the results we aimed to investigate whether the LO can be used as a predictive marker for the risk of femoral neck fractures, osteoarthritis or femoroacetabular impingement. Methods: Femur length, femur neck length, femoral neck-shaft angle (NSA), anteroposterior (a-p) and superoinferior (s-i) diameters of femoral head and neck, and LO were measured on 82 dry adult femora of unknown age and gender from Turkish population. Results: There was no statistically significant correlation between the LO and a-p and s-i diameters of femoral head or neck. However, there was found statistically significant correlation between LO and femoral NSA (p < 0.01), femoral neck length (p < 0.05) and femur length (p < 0.01). Conclusion: High LO values can be used as an indicator for neck fractures, a negative marker for OA, but LO does not appear to be used as an indicator for FAI.

Radiological investigation and clinical evaluation of the morphometric development of the forearm in human fetuses / Investigación radiológica y evaluación clínica del desarrollo morfométrico del antebrazo en fetos humanos

Fetal period of time during which the fetus grows rapidly and the organs are formed. The prenatal and postnatal analyses of the fetal structure provide information as to fetal growth, growth retardation, gestational age and congenital malformations. The development of the skeletal system during the intrauterine period takes place in an orderly manner as it also does in other systems. It was aimed that the morphometric development of the forearm in human fetuses during the period between 20-40 gestational weeks be radiologically investigated and that its clinical importance be evaluated, as well. A total of 100 fetal forearms (50 fetuses: 23 male, 27 female), the ages of which varied between 20-40 gestational weeks, without having any external pathology or anomaly were incorporated into the study. The fetuses were separated into groups according to weeks, trimesters and months. After the general external measurements of the fetuses had been performed, the mammographies and forearm radiographies of the fetuses were shot in the way that the forearms would remain in a prone position. Morphometric measurements pertaining to forearm structures were taken from the forearm radiographies that were shot with the help of a digital compass. Later on, the morphometric measurements in question were statistically evaluated. The mean values and the standard deviations of the measured parameters were determined according to gestational weeks, trimesters and months. There was a significant correlation between the measured parameters and the gestational age (p<0.001). In the comparison of the measured parameters between trimesters and months, it was observed that there was a statistically significant difference between the groups (p<0.05). Separately, it was also determined that there was no statistically significant difference in the comparison of the parameters, which was made between genders and right-left forearms (p>0.05). As for the results obtained in our study, we are of the opinion that the data obtained during this study period will be beneficial for the involved clinicians, such as those in charge of gynecology, radiology, forensic medicine and perinatology, in terms of evaluating the clinical studies related to the morphometric development of the forearm throughout the fetal period, in determining the fetal age and sex, and also in determining the pathologies and variations regarding the development of fetal skeletal system.

El período fetal es el tiempo en el cual el feto crece rápidamente y se forman los órganos. Los análisis prenatal y postnatal de la estructura fetal proporcionan información sobre el crecimiento fetal, el retraso de crecimiento, la edad gestacional y las malformaciones congénitas. El desarrollo del sistema esquelético, como también el de otros sistemas durante el período intrauterino, avanza de manera ordenada. Se investigó radiológicamente el desarrollo morfométrico del antebrazo en fetos humanos durante el período comprendido entre 20-40 semanas gestacionales y se evaluó su importancia clínica. Un total de 100 antebrazos fetales (50 fetos: 23 de sexo masculino, 27 de sexo femenino), cuya edad varió entre 20-40 semanas de gestación, sin patología externa o anomalía, fueron incluidos en el estudio. Los fetos fueron separados en grupos de semanas, trimestres y meses. Después de realizar las mediciones externas generales de los fetos, las mamografías y las radiografías fueron realizadas de tal manera que los antebrazos permanecieran en pronación. Las radiografías de las medidas morfométricas correspondientes a las estructuras del antebrazo se tomaron con apoyo de una compás digital; posteriormente, las medidas fueron tratadas estadísticamente. Los valores medios y las desviaciones estándar de los parámetros medidos se determinaron de acuerdo con las semanas de gestación, los trimestres y los meses. Hubo una correlación significativa entre los parámetros medidos y la edad gestacional (p <0,001). En la comparación de los parámetros medidos entre los trimestres y los meses, se observó una diferencia estadísticamente significativa entre los grupos (p <0,05). Se determinó también que no hubo diferencias estadísticamente significativas en la comparación de los parámetros, que se realizó entre los sexos y los antebrazos derecho-izquierdo (p> 0,05). En cuanto a los resultados de nuestro estudio, los datos obtenidos durante este período de estudio serán beneficiosos para los clínicos, como también para profesionales de las áreas de ginecología, radiología, medicina forense y perinatología, en la evaluación de estudios clínicos relacionados con el desarrollo morfométrico del antebrazo durante todo el período fetal, determinación de la edad y el sexo fetal, así como en la determinación de variaciones en el desarrollo del sistema esquelético fetal.

Morphometric development of sphincter of oddi in human fetuses during fetal period: microscopic study.

OBJECTIVE: In this study, morphometric developments of the sphincter of Oddi in human fetuses were observed. MATERIAL AND METHODS: We observed 113 human fetuses consisting of 67 male and 46 female subjects, whose ages varied between 14 to 40 weeks who showed no signs of any pathology or anomaly externally. The common external measurements of fetuses were carried out, followed by abdominal dissection to determine where the sphincters of Oddi were localized within the duodenum and pancreas. Histological specimens of tissue samples were gathered from the inner wall of the duodenum where it was assumed that the sphincters of Oddi had been localized. The parameters of total external diameters, lumen diameters, wall thickness, diameters of ductus choledochus and ductus pancreaticus, and the distance between these two structures, which are also known as the origins of the sphincter of Oddi, were measured by using a light microscope. The standard deviations of the measurements were calculated for each gestational week and trimester. RESULTS: The calculations suggested that there were statistically significant correlations between gestational age and all of the other parameters with the exception of the ductus choledochus (p<0.001). It was observed that the wall thickness of the ductus choledochus increased at the first half of the fetal stage and decreased at the second half, as the lumen diameter increased through the 40th week. The gender difference was not statistically significant (p>0.05). CONCLUSION: The data we collected in our study were considered as useful for the evaluation of the development of the sphincter of Oddi area and fetal stage.

The impact of prefertilization chronic mild stress on postnatal morphometric development.

OBJECTIVE: The aim of the present study was to examine the effects of chronic mild stress (CMS) induced before the fertilization on gestational maternal weight, length of gestation, and postnatal morphometric development. MATERIAL AND METHOD: Study is carried out on 18 Wistar albino rats; six females in the stress group, six females in the control group, and six males to be used for mating. CMS was induced in rats of the stress group for 4 weeks, followed by a post-CMS waiting period of 5-weeks. Rats were left for mating at the end of the post-CMS period. Weight gain in pregnant rats was monitored and length of gestation and litter size were recorded in the stress and control groups. Growth parameters of pups pertaining to the body, cranium, thorax, and limbs were measured until week 11. FINDINGS: Weight gained by pregnant rats in the stress group was less than the control group. Increases in mean morphometric parameters from day 0 to week 11 in the stress group were less than the control group (p < 0.05). Furthermore, when developmental parameters at weeks 7, 9, and 11 were compared between genders, females in the stress group were found more affected than males (p < 0.05). CONCLUSION: CMS sustained before fertilization has a negative effect on gestational maternal weight and postnatal morphometric development of pups, more prominently in females.

Anatomical development of the normal urachus during the fetal period.

OBJECTIVE: To evaluate the development of the normal urachus during the fetal period. METHODS: The study was carried out on 149 human fetuses (male 87, female 62) aged between 9-40 weeks, obtained with families' consent from Isparta Maternity and Children's Hospital, Isparta, Turkey, between 1997 and 2002. The study was carried out in the Department of Anatomy, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey during 2004. The type of the urachus was assessed and was classified. The length, antero-posterior depth, and the transverse width of the urachus were measured. Finally, the relationship between the urachus and umbilical arteries was evaluated during the fetal period, whether they ran parallel to each other. RESULTS: Two types of urachus were observed: the inverted funnel (84%) and tubular (16%). The length, depth, and width of the urachus increased with gestational ages in all cases. A 2% variation was observed in the neighborhood between urachus and umbilical artery. CONCLUSION: Comparing our results with previous studies, the development of the urachus can be different in neonates and children. The mean urachus length was 14.8 -/+ 7.7mm during this period. The inverted funnel type is the most common type in our study. Hence, there can be some differences in the relationship between the urachus and umbilical arteries. The data obtained in the present study can be used as base knowledge related to the development of the urachus, and for evaluating the urachus in utero pediatric urology, radiology, pediatric surgery, and fetopathology.

Size and location of the fetal diaphragm during the fetal period in human fetuses.

AIM: The aim of this study was to determine the development and the size and localization of the diaphragm during the fetal period in human fetuses. MATERIALS AND METHODS: One hundred and eighty-four diaphragm obtained from human fetuses aged between 9 and 40 weeks of gestation was used in this study. The localization of the diaphragm with respect to abdominal cavity and the level of costodiaphragmatic recess with respect to the ribs were determined. The dimensions (height, width, and depth) of the diaphragm were measured. The diameter and localization of apertures on the diaphragm were determined. RESULTS: During the fetal period, the costodiaphragmatic recess was most commonly located at the level of the 9th rib. Means and standard deviations of the all parameters with respect to gestational weeks and months were calculated. No significant differences were observed between sexes for any of the parameters (P > 0.05). All parameters were increasing with age during fetal period. There was significant correlation between gestational age and all parameters (P < 0.001). The localizations of the diaphragmatic apertures did not change throughout the fetal period and aortic hiatus and oesophageal hiatus were most frequently situated to the left of the median plane. CONCLUSION: New data are derived for human fetuses to evaluate diaphragmatic development. Data acquired in this study are believed to contribute to studies of obstetrics, perinatology, forensic medicine and fetal pathology on fetal development of the diaphragm, and diagnosis of its anomalies, pathologies and variations.

The proportions of the white and red pulps of the human fetal spleen.

OBJECTIVE: To compare the proportions of white and red pulps of the human spleen during the fetal period. METHODS: We performed this study in the Department of Anatomy and Pathology of Suleyman Demirel University, Faculty of Medicine, Isparta, Turkey, from the period between 2002-2003. Spleens from 137 dead fetuses aged between 9 and 40 weeks were embedded into paraffin blocks following classical histological steps and stained with hematoxylin and eosin. White and red pulps could be differentiated only in 25 cases (13 males, 12 females). The proportions of the areas of white and red pulps (the trabeculae were included into the red pulp and the groups of lymphocytes were included into the white pulp) were estimated by point counting method on the sections taken from different parts of the spleens by systematic randomized sampling technique. RESULTS: It has been ascertained that the white pulp has been distinguished from 20th week onwards during the fetal period. The proportion of the white pulp area has been found to be 22.3% (of total white and red pulp areas) at the 20th week and has come to 37.6% at the 40th week. Concerning the trimesters, the proportion of the white pulp area has been found to be 30% (of total white and red pulp areas) at the 2nd trimester and has come to 36% at full term. While the white pulp area had a positive correlation with the gestational age (r: 0.34), the red pulp area had a negative one (r: -0.34). No difference has been found among gender. CONCLUSION: Reference values have been obtained about the proportions of white and red pulp areas of human fetal spleen.

Fetal development of the hand, digits and digit ratio (2D:4D).

OBJECTIVE: The purpose of this study was to investigate growth patterns in human hands, digits and digit ratio (2D:4D) during the fetal period. METHODS: The study is carried out on 161 human fetuses (83 males, 78 females) free from external pathology or malformation with ages ranging between 9 and 40 weeks of gestation. Following general external measurements, length and width of the hand, digit lengths separate for each hand was measured, hand index and the ratio of the lengths of the 2nd finger to the 4th finger (2D:4D index) was computed. RESULTS: Means and standard deviations of the parameters with respect to gestational weeks, months and trimesters were calculated. There was a significant correlation between all parameters and gestational age (p<0.001). No significant differences were observed between sexes or sides for any of the parameters (p>0.05). 2D:4D ratio was significantly higher in females compared to males (p<0.05) and mean 2D:4D did not change with gestational age. CONCLUSION: Detailed information of hand and digit parameters related to the fetal period will reveal the extent of biological variations of hand and digit parameters to be used in future studies. We hope that data acquired in this study will facilitate other studies on hand and digit anomalies, pathologies and variations as well as diagnoses and treatments of such conditions conducted in obstetrics, perinatology, forensic medicine and fetal pathology departments.