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.

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.

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.

Development of the liver during the fetal period.

OBJECTIVE: To investigate the development of the liver in human fetuses aged between 9-40 weeks. METHODS: We studied 121 human fetuses (62 males, 59 females) with no external anomalies aged between 9-40 postmenstrual weeks during 2003-2004 in Suleyman Demirel University, Isparta, Turkey. The fetuses were divided into four groups as 1st, 2nd and 3rd trimesters and full term fetuses. We measured fetal weight, length, width, thickness, and volume of the liver. We established localization of the liver and its relation with the neighboring structures, its ligaments, and size of itself and its lobes, shapes of the liver and the localization of the porta hepatis on the visceral surface of the liver. RESULTS: We found significant correlations between the size, weight, volume of the liver, sizes of its lobe and gestational age (p<0.001). Group comparisons disclosed significant differences between groups in all parameters except between 3rd and 4th groups with respect to the heights of the liver and the caudate lobe (p<0.05). During the fetal period, the proportion of the distance between the porta hepatis and the right margin of the liver to the distance between the porta hepatis and the left margin of the liver did not change significantly (p>0.05). However, the proportion of the distance between the porta hepatis and the upper margin to the distance between the porta hepatis and the lower margin decreased significantly with gestational age (p<0.05). Type 3 liver (square) was the most commonly observed type of fetal liver (53%). CONCLUSION: Our opinion is that the parameters obtained can be useful to diagnose pathologies of liver development and anomalies concerning several branches of medicine such as anatomy, pathologic anatomy (fetopathology), forensic medicine, medical imaging, obstetrics and pediatrics.

Ovarian arteries with bilateral unusual courses.

Bilateral unusual coursed ovarian arteries were found in a 45-year-old female cadaver. The ovarian arteries arose from the abdominal aorta at a level inferior to the corpus of L1 vertebra bilaterally. The right ovarian artery was coursing behind the inferior vena cava. The left one was coursing between the left renal artery and vein upward to the level of the inferior part of the body of Th12 vertebra. At the level of Th12 vertebra, it turned caudally and proceeded downward between the anterior-inferior and posterior segmental renal veins. On both sides, ovarian arteries were on their normal routes below the L2 vertebra accompanying the ovarian veins. The variation determined by this study would reduce possible complications of nephrectomy operations that urologists, gynecologists and other related surgeons may encounter.

Uterine tube-ovary relationship and fimbrial development during the fetal period.

OBJECTIVE: We aimed to evaluate the position, localization and development of the uterine tubes and their relationships to the ovaries. METHODS: One hundred and fifty-four uterine tubes and ovaries taken from 77 human fetuses aged between 9-40 weeks of gestation have been included in this study. The study was performed in Department of Anatomy of Suleyman Demirel University Faculty of Medicine, Isparta, Turkey in 2004. The position and localization of the uterine tubes have been determined. Consequently, uterine tube - ovary relationship and fimbrial development has been investigated. RESULTS: It has been observed that the uterine tubes are transversely and obliquely positioned. The most commonly observed position was transverse position. When the relationship between the uterine tubes and ovaries was explored, it was observed that the ovaries were localized in the superior, anterior or posterior aspect of the uterine tubes. In addition, when relationship between the obliquely positioned uterine tubes and ovaries was assessed, we found that the ovaries are located at the middle, anterior, lateral or posterior of uterine tubes. Furthermore, it indicates that the fimbrial development begins only after the 20th week and the quantity of fimbriae increased by gestational age. CONCLUSION: We conclude that the uterine tubes are not positioned as in adults during the fetal period, some variants can be seen in the uterine tube - ovary relationship and fimbrial development begins after the 20th week of gestational age and continued after birth.