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Journal of the Anatomical Society of India

Abstracts of papers Presented in the 49th Annual Conference of the Anatomical Society of India, 2001, Held at Kasturba Medical College Manipal (KARNATAKA)

Author(s): Editors

Vol. 51, No. 1 (2002-01 - 2002-06)


KS Satyapal, AA Haffejee*, NG Naidoo*, B Singh &, JV Robbs*,

Discipline of Anatomy, School of Basic and Applied Medical Sciences, University of Durban - Westville, Durban, 4001. * *Department of Surgery, Unversity of Natal, Congella, 4013, South Africa

The use of donor kidneys in live related transplantation (LRT) with additional renal arteries (ARA) is controversial. Indeed, its use is contraindicated in some centres. In view of the dire shortage of organ procurement, it is necessary to review this position. The study aimed to assess the Immediate Graft Function (IGF) post-LRT using kdineys with ARA.

A retrospective study using donor kidneys with ARA in LRT over a period January 1985 to December 2000 in KZN was evaluated. Of the 250 LRT performed, 35 donor left kidneys with ARA were identified. Only Kidneys with upto 2ARA were chosen. All arteries were dilated with a 3mm Foggerty catheter before anastomosis. Four kidneys with single ARA (both vessels of equal size had bench-top side-to-side angioplasty; 1 kidney with single ARA (2 small vessels) was excised with an aortic cuff; 1 kidney with a singh ARA had the smaller (lower) artery anastomosed to the larger renal vessel. Nineteen kidneys with a single ARA and 10 kidneys with 2 ARA had each vessel anastomosed separately to recipient's external iliac artery. The parameters used to assess IGF included urine output, urea and electrolytes, perfusion scans and more recently duplex Doppler ultrasound. Results were compared with a similar cohort of donor kidneys that had a single renal artery.

Number of arteries
Cold perfusion mean time (min)
Vasculature anastomotic mean time : artery and vein (min)
Acute Tubular Necrosis
[Within 1 week & Acute rejection Biopsy confirmation]
A control (single artery)
35 10 20
1 (2.9%)
2 (5.7%)
B ARA x 1 25 14 281 (2.9%)2 (5.7%)ARA x 2 10 18 35 2(5.7%) 1(29%)

There was no graft loss in the immediate post-operative period in both groups.

The authors prefer the use of the donor left kidney despite higher incidence of ARA on that side Despite angiography remaining the gold standard in pre-operative donor work-up, the accuracy of ARA reporting (91%) remains a pitfall. The use of ARAs is technically demanding. IGF obtained with the use of ARAs versus single artery compared favourably with no graft loss in the immediate post-operative period. Donor kidneys with arterial variations with up to 2 ARA should not be a contraindication to LRT.


Lopa Mehta, Manu Kothari,

Department of Anatomy, Seth G.S. Medical College & K.E.M. Hospital, Parel, Mumbai.

Metastasis of cancer fools the clinician, frustrates the surgeon, and kills the patient. The all too commonness of cancer and its metastasis compels a review of its anatomy. The acceptance of cancer as superdifferentiated normal cell raises the possibility that metastasis of cancer cells relies on carrying forward into postnatal life the embryonic faculty of cellular migration. Such a view reduces metastasis to the status of normality.

The spread of cancer is largely in vein. The leptal nature of lymphatics, capillaries and venules combined with the sluggish movement of their contents comprise an arena of easy invasion and nidation. Th rest of the job is overseen by the universality of haemal and lymphatic circulation. Such a mechanism makes cancer "disease of the whole organism" which is enough to explain the fallacy of early diagnosis, treatment and prognosis. Researches have been afoot to prevent cancer cells from invading the vascular channels and to prevent vascular channels from proliferatinig within and around cancer by suppressing Tumour Angiogenesis Factor (TAF). Summary failure marks this effort.

A detailed physiology and anatomy of metastasis is integral to clinical anatomy. It creates within the mind of the student a wider perspective on health and disease.


N Lachman. * KS Satyapal, G Mathura and EA Vanker,

Department of Human Biology, Technikon Natal, *

Discipline of Anatomy, School of Basic and Applied Medical Sciences, University of Durban Westville, Durban, South Africa.

Although recognized as a distinct anatomical entity, the surgical significance of the intramural coronary artery and its branches has evoked much interest. With the trend towards minimal access cardiac surgery, pre-operative identification of such anatomical variants of coronary artery disposition becomes increasingly relevant if technical challenges that may be associated with its surgical presentation are to be abated. Whilst studies have been attempted, little has been achieved in terms of precise identification of the course of these arteries angiographically. This study presents findings of a correlative cadaveric and patient investigation aimed at recording the angiographic manifestation and anatomical presence of intramyocardial coronary artery branches. Twenty unembalmed hearts, free from surgical exploration were selected. The coronary systems were cannulated and injected with a barium solution. Images of the hearts were obtained, followed by detailed micro-dissection of the arteries. Twenty angiograms of patients presenting for cardiac surgery were compared with reports of surgical presentation of the coronaries. Results showed that when an intramural course was assumed coronary branches depicted a characteristic "straightness" on angiographs rather than the tortuous pattern typically observed. To date angiographers consider systolic arrowing of a coronary segment, indicative of myocardial bridging. Although this may be considered an indicative sign, there is uncertainty in it being confirmatory. The findings of this pilot study may contribute to a list of possible factors that suggest myocardial bridging. However, it is clear that stronger evidence is needed in order to establish a definitive diagnostic indicator for the presence of intramural coronary branches.


Manu Kothari, Lopa Mehta,
Department of Anatomy, Seth G.S. Medical College & K. E.M. Hospital, Parel, Mumbai

An endearing yet futile exercise in oncological research and practice is early diagnoses that presumably allowing early treatment offers the best results. Astronomical animal research and equally voluminous clinical and operative work have not provided any breakthrough. About the earliness obsession one could use Churchillian rhetoric to declare that never in the history of science has so much untruth been told by so few to so many for so long at such enormous physical and fiscal expense.

Cytokinetics reveal that following inception, the fastest growing cancer takes 2 to 10 years before it is diagnosable by yhe most sensitive scan. Brooke has described this as a tumor's discrete silence. Taking breast tumor as an example, it takes 10 to 20 years before a breast tumor yields itself to palpatory or mammographic diagnosis. During the phase of discrete silence the tiniest to the largest mass has three thousands & six hundred seconds every hour for years together to leave the primary site to metastasize from head to foot. A gm of tumour cell reportedly releases 400 million cells into circulation every day.

Modern medicine's predicament is two fold: Cancer cells grow very slowly and for its cells number to croos a billion marks takes many years. This renders all attempts at early diagnosis, futile. We as anatomists need a clearer perspective on the cytokinetics and the temporality to understand the scope and limitations of modern medicine vis-a-vis the reserchability, diagnosability and/or treatability of cancer.


Shailaja Shetty and Balakrishna,*

Department of Anatomy, M.S. Ramaiah Medical College, Bangalore, * Bangalor Medical College, Bangalore.

Carrying angle is the angle due to the lateral deviation of forearm at the elbow as described by Potter (1895). The angle of deviation was measured using modified Steel and Tomlinson Method (1958) in this study. The materials include radiograph montages of both upper limbs of known sexes.

Results showed that :

(a) Carrying angle is more in the right upper limb compared to the left in the same sex.
(b) Females have less carrying angle than males in both the upper limbs.
There is no statistical significance in the mean carrying angle. Details will be discussed.


Kakar S, Choudhry R, Tuli A, Gupta V, Agarwal S,

Department of Anatomy, Lady Hardinge Medical College, New Delhi.

It is acknowledged that the magnitude and direction of funtional forces produce bone-remodelling effects during life and are reflected on them. The bone adapts itself to the mechanical needs by atrophy or hypertrophy in the form of grooves, ridges, spines, facets and other such features. These have fascinated the anatomists, anthropologists and research workers in allied fields for centuries and have inspired them to document such findings. Examination of coxal bones revealed one such variation in the form of facet on the non-articular part of pubic component of acetabulum just inferior to the anterior end of the lunate surface. Awareness of such a facet is important to differentiate variants from pathological conditions while performing hip arthroscopy and imaging procedures. The frequency of this feature and paucity of reports in literature warrants this study. A smooth facet was found antero inferior to lunate surface of 48 acetabula, in a study conducted on 315 dry adult coxal bones, 26 of which (13 pairs) were of articulated pelvis. Three different shapes of the facet were-oval (56.3%), piriform (22.9%) and elongated (20.8%). The prevalence of the oval facet was higher in both sexes. In 37.5% bones it extended to the superior ramus of pubis and in 62.5% it was limited within the acetabular margin. They were either discrete (58.3%) or continuous with the lunate surface (41.7%). The surface configuration was flat (29.2%), concave (43.7%) or grooved (27.1%). One male articulated pelvis showed a bilateral presentation. Measured along the long axis the size varied between 11 to 17.


Martin Lucas A, Manvikar Purushottam Rao, Srinivas, N, Sayee Rajangam,

Division of Human Genetics, Department of Anatomy, St. John's Medical College, Bangalore.

160 couples have been referred for karyotyping and counselling. 42 male partners (26.25%) had seminal causes as one of suspected etiological causes, among them 27 showed oligospermia, 5 asthenospermia and 20 had reduced motility. Mean age of these men was 33.5 ± 0.86 and the mean of abortions 3 ± 0.25. These men were referred to the urologist for further evaluation and treatment.


Anjali Dhamangaonkar,

Department of Anatomy, Seth G.S. Medical College & K.E.M. Hospital, Parel, Mumbai

Incidence of cranial chordoma in literature is only 0.1% of intracranial tumours. A case of cranial chordoma on left paraseller region compressing III, IV, VI cranial nerves, leading to ophthalmoplegia, is presented with review of literature. This type of tumour arising notochordal remnants is of rare occurrence.


Jyoti Mahajan, Manu Kathori, Lopa Mehta,

Department of Anatomy, Seth G.S. Medical College & K.E.M. Hospital, Parel, Mumbai.

Stenting of arteries specially coronaries, is a common feature globally. It is complementary to angioplasty. In USA 500,000 coronary stents are used per year. Regardless, NEJM concluded that there is no proof that stents save lives. This presentation is inspired by the enormous cost of stenting and doubtful returns thereof.

Stenting is named after British dentist Charles Stent (18451901) who originally used it for making dental moulds. Now it stands for any material or device used to hold tissue in place or to provide a support for a graft or an anastomosis while healing is taking place or to prevent collapse / closure of an artery after it has been angioplastically dilated. Material used is plastic or steel of which an amazingly wide variaty is in use.

While stenting is useful for slow flow area such as bile duct or the ureter, its rationale for a fast moving flow like in the coronary or any other blood vessel is debatable. Arterial flow is very rapid peristalsis in which the proximal segment must contract vigorously to forcefully dilate the immediate distal segment in quick succession. Stenting prevents collapse by preventing contraction thus denying peristaltic push to the entire post-stent segment. No wonder cardiac texts often mention "paradoxic" reduction of circulation after stenting. Stent is a deliberate permanent foreign body capable of irritating endothelium and inviting thrombosis. Restenosis following stenting can be vicious. In USA "The Commonest iatrogenic malignant disorder" is in-stent restenosis.


Manu Kothari, Lopa Mehta,

Department of Anatomy, Seth G.S. Medical College & K.E.M. Hospital, Parel, Mumbai

Municipality and Immunity are rooted in munis implying service, the former bounden to it the latter implying freedom therefrom. Immunity meaning freedom from service connotes at body level the freedom from fear of or having to fight with microbes or cancer. As of today immunity is undefined. Medicine knows poorly of its beneficial role but rather richly about all the autoimmune syndromes that immunity precipitates. If endocarditis, encephalomyelitis, thyroiditis and diabetes are frankly ascribable to immunity, we don't known if immunity is a friend or a foe!

Bumet in 1947 launched the idea of immunological surveillance of cancer. This suggested that whereas cancerous mutations of somatic cells occur every hour, immunocytes and antibodies devour them to keep four out of five humans free from cancer. This single idea spawned astronomical experiments to find the appropriate antibody, cell or vaccine to prevent or cure cancer. Soon it was realized that anticancer antibodies coat and pamper cancer cells whose food is immunocytes. Immunity has proved to be foe.

Tubercle and leprosy bacilli are too dull and toxin free to be pathogenic. Every one inhales them and yet we all cruise through life without problem. It is held that the over-reactivity of one's immune systems precipitates warfare inwhich the immune system in trying to attack bacilli thus wreaks havoc on body tissues to caseate them. In war, it isn't important who is right but who is left. The resurgence of all infections is proof positive that immunity is not a trustable friend.


Vilas Khandare, Aniruddha Chaphekar,

Department of Anatomy, Seth G.S. Medical College & K.E.M. Hospital, Parel, Mumbai.

Aim : To find the safe approach to drain abscess in the midpalmar space of the hand.

Materials and method : Dissections of twenty hands were carried out in the Department of Anatomy to explore the lumbricals canal. Transverse sections were taken at various levels and the relation of nerves and vessels were studied.

Midpalmar space abscesses in twenty patients were drained through the lumbrical canal in the Department of Surgery. Postoperatively it was observed that none of the patients had any neurological complications such as loss of sensation and movements of fingers.

Result : Thus we conclude that the lumbrical canal is the safe route to drain the abscess in midpalmar space of the hand.


Minnie Pillay, V.V. Pillay*, Urmilla Khadilkar,**

Department of Anatomy, *Department of Forensic Medicine, **Department of Pathology, Kasturba Medical College, Mangalore

In some forensic situations relating to homicide by strangulation, the services of an anatomist and pathologist may prove vital in elucidating the microscopic appearances of soft tissue of the neck, with particular reference to the thyroid gland. While a great deal of emphasis is often laid on the presence or absence of fractures of the hyoid bone and thyroid cartilage, it is not well recognized that damage to soft tissues, particularly the strap muscles and the thyroid gland may be a more consistent pointer to neck compression. One such case of alleged strangulation is discussed where a combined approach of a forensic expert, pathologist and anatomist proved of crucial importance in clarifying the microscopic picture of neck tissues.


Arun Kumar S. Bilodi, Niraj Jain* & Vibha Jain*,

Department of Anatomy, *Department of Paediatrics, Nepal Gunj Medical College Teaching Hospital, Nepalgunj, Nepal.

The present study has been done on some congenital anomalies that were seen in the Paediatric OPD at Nepalgunj Medical College Teaching Hospital, Nepalgunj, Nepal. The study has been done in absence and fusion of ribs, congenital diaphragmatic hernia, situs inversus with dextrocardia and lipomyelomeningocele. These anomalies were correlated with other workers and discussed.


R.N. Jadhav
Department of Anatomy, Padmashree Dr. D.Y. Patil Medical College for Women, Pimpri, Pune.

This paper is aimed to study wedging of lumbar interveretebral discs (LIVD) in males and females of different age groups from central region of Maharashtra State and to correlate wedging and prolapse of LIVDs in clinical conditions. The study was carried out by taking radiographs of lateral views of lumbar spine of different age groups ranging from twenty years to sixty (and above) years of age. Total 400 x-rays were taken in lateral recumbent position with knees and hip joints flexed at 45°. The x-ray beam was focused on L3 vertebra and anode film at a distance of 100 cm was maintained. all x-rays were taken on the same x-ray machine by same tachnician under the supervision of an experienced radiologist. Intervertebral disc (IVD) is recogniszed on x-rays by a translucent space between adjacent lumbar vertebra. Limits of upper and lower borders of IVDs are taken as anterior and posterior limits of vertebral end plates. Their margins are marked on radiographs. Anterior, posterior heights and average anterior and posterior depths of IVDs are measured. From these measurements index of wedging is calculated by using Amonoo's formula.

According to present study in males and females there is gradual increase in wedging of IVDs from L2-L3 to L5 S1. In females more wedging is seen in L5-S1 disc than in males. In this paper an attempt is made to discuss our results with help of graphic presentation and photographs.


L. Jayaraj. T.R. Kalavathy,

Institute of Anatomy, Madras Medical College, Chennai.

Fifty human brains were collected from Forensic Medicine Department of Govt. General Hospital, Chennai. They were preserved and studied under the following headings.

1. Age and Sex, 2. Normal and Abnormal patterns of Circle of Willis.
On the analysis of the individual components of the Circle of Willis we noticed the following variations

1. Regarding anterior cerebral artery - aneurysms, recurrent branch and super numery branch were noted.
2. Regarding anterior communicating artery - absence, aneurysms, different types and accessory number of communications were noted.
3. Regarding middle cerebral artery and stem of internal carotid Artery - No variations observed.
4. Regarding posterior communicating artery - Variation in number, hypoplasticity (single, multiple and capillary pattern) were noted.

This study is presented for its clinical implications in diagnostic and therapeutic procedures. More than this our observations in the above subject coincides much with the findings of Williams et al (1995), Bergman et al (2000) at virtual Hospitals (Australia, Taiwan and United states).


S. Shrivastava, A Bose, S.K. Wankhede,
Department of Anatomy, M.G.M. Medical College, Indore.

For safe and complication free operative procedures on extrahepatic biliary apparatus and surrounding organs, a comprehensive knowledge of the varied patterns of extrahepatic biliary duct, arterial supply and their three dimensional relationship is essential. Failure to recognize any unusal relationship may impair the result obtained by surgical interference. The present study was performed on 100 cadavers. The observation showed angular union of cystic duct with common hepatic duct in 80%, short parallel duct in 9%, and long parallel type in 11%. In case of long cystic duct, cholecystojejunostomy is bound to fail. Floating gall bladder was seen in 1%.

The normal arterial pattern was present in 70% cases, rest were having anomalous artery. Anomalies observed were common hepatic artery arising from superior mesenteric artery (2%), double right hepatic artery (5%). Accessory and replaced right hepatic arteries may be severed accidentally in pancreatoduodenal surgeries. The right hepatic artery crossing from right to left between right and left hepatic ducts (5%) is most likely to be injured during surgery in this region. Accessory left hepatic artery from left gastric artery was seen in 10% cases. A single cystic artery arising from right hepatic artery was observed in 92% cases. In rest it was replaced by cystic artery arising from replaced right heptic artery. In 18% cases gall bladder was supplied by double cystic artery arisinig from right hepatic artery either normal or accessory. The application of these abnormalities encountered in bille duct and arterial pedicle to surgery has been discussed.


Geetha, Muddanna S Rao*, Geetha Krishnananda**, R. Kedlaya, D.M. Vasudevan***,

Departmet of Biochemistry, * Department of Anatomy, **Department of Pathology, KMC Manipal, ***MIMS Sikkim.

Atherosclerosis forms main causative factor for many cardiovascular diseases and cerebrovascular diseases. Present study was undertaken to see the effect of Ocimum Sanctum (Sacred Tulsi) extracts on Atherosclerosis of arch of aorta. Rabbits weighing about 1 kg were divided into three groups: (1) Normal: fed with normal Rabbit pellets. (2) Control: Fed with Cholesterol with 500 mg/ day for 45 days followed by normal Rabbit pellets. (3) Ocimum sanctum (OSE) treated: Rabbits fed with cholesterol for 45 days along with extract. Extract was continued for 4 months. There are two subgrounds: (i) Alcoholic extract treated group received 50mg/ day and 100mg/day OSE for 4 months. (ii) Aqueous extract treated group received 10mg. 30mg, 75mg and 150mg OSE for 4 months. Normal control and OSE treated groups were sacrificed and the arch of aorta were collected and processed with Haemotoxylin-Eosin staining. Results showed progressive atheroma formation in control group. But OSE treated group showed regression of atheroma.


M.N. Kulkarnai,

Department of Anatomy, Karnataka Medical College, Hubli.

In a routine dissection over 10 years, I have noticed 4 various forms of levator glandulae thyroidae, a remnant of thyroglossal duct of anatomical & surgical interest. It will be discussed with photograph at the Conference in presence of august audience.


Joshi S.D. and Joshi S.S.,

Department of Anatomy, Rural Mediacl College, Loni.

Tardy ulnar nerve palsy is known to occur when there are variations in the cubital tunnel. This may present as shallow ulnar groove on the posterior aspect of medial epicondyle of humerus; an inadequate fibrous arch over the ulnar nerve, may lead to recurrent subluxation or dislocation of the nerve. Occassionally there may be entrapment of ulnar by unusal fibrous band stretching between medial epicondyle and olecranon process or by Struthers arcade or encroachment of tunnel by fibres of neighbouring muscles. Because of the applied significance of these variations a detailed study of the cubital tunnel was carried out in 50 upper limbs in this department. The findings of the present work will be presented and discussed.


KS Satyapal, B Singh*, P Partab, L Ramsaroop, N Pather,

Discipline of Anatomy, School of Basic and Applied Medical Sciences, University of Durban- Westville, Durban, 4001. *Department of Surgery, University of Natal, Congella, 4013, South Africa.

Knowledge of groos anatomy and anatomic variations has long formed the bedrock of sound surgical endeavours. Understanding anatomy contributes to the adroitness of this technical exercise. Historically, surgeons have always had a strong anatomical association, either as life-long students, sometimes as teachers of anatomy. Anatomical arrangements have therefore inveigled surgical access and approach. A reversal of this tradition has been prompted by the minimal access surgical (MAS) explosion.

MAS may be defined as "surgery to the body done with the aid of a viewing scope and specially designed surgical instruments." "Scopic" anatomy reveals detailed and difficult to appreciate areas e.g. neuro-endoscopic, arthroscopic, thoracoscopic and ENT surgery. Advances in optics, illumination and magnification have established thoracoscopic sympathectomy as arguably the brightest strand in the MAS tapestry and is used as a benchmark. Currently, thoracoscopic descriptive anatomy appropriate to performing cervico-thoracic sympathectomies is sparse. Teachers of anatomy thus need to grasp the technical triumph offered by thoracoscopy that includes the contemporaneous recording of procedure to teach what is effective for this and future generations of surgeons, a "new" anatomy.

Due to limited view offered in "scopic" procedures, it is critical for teachers of anatomy to appreciate the approach and orientation of these procedures and be equipped with a broad understanding of anatomical variations. Although not a new approach, thorascoscopy is today standard practice. Surgical trainees are awating the nuances of this new anatomy. MAS affords an opportunity to make possible, "Anatomy Alive!" to step teaching of anatomy to a new paradigm.


Gunapriya Raghunath and T.R. Kalavathy,

Institute of Anatomy, Madras Medical College, Chennai.

Aim of Study : To analyse the morphology and vascular pattern of placenta and umbilical cord and clinically correlate this kowledge, to help in early diagnosis of foetal anomalies.

Materials and method : A total of 100 specimens of placentae with umibilical cords were utilized, an analysis of their morphology was made and corrosion technique and contrast study of their vascular pattern, were also done.

Results : The average placental weight in male and female babies was 519 gms and 526.6 gms respectively, which indicates an improvement in the antenatal care and nutritional status of the mother when compared to the previous studies. A case of sub chorionic placental cyst was observed, but was not associated with any foetal anomaly.

Placenta succenturiata was observed in 3% cases, but were not associated with any foetal anomaly. 3 cases of intra uterine death were observed, but were not associated with absent cord twist or anomaly of umbilical vessels. Rare phenomena such as velamentous cord insertion to amnioic band syndrome were not observed in this study. True knot was seen in one case (Cord Length -70cm) which was also associated with polyhydramnios. Histopathological examination of umbilical cord revealed the following features in the following cases: Pregnancy induced hypertension - rinning of umbilical arterial wall. Diabetes melliltus (under control) - normal architecture of umbilical vessels. Intrauterine death - marked thickening of arterial wall. Corrosion technique and contrast study done in two specimens each revealed a disperse type of placental vascular pattern, in all 4 specimens. Conclusion : An adequate knowledge of morphometric analysis and vascular pattern of placenta and umbilical cord with clinical correlations in -utero, proves to be useful in the early diagnosis of foetal malformations, by ultrasonogram.


PK Verma, S Roychoudhary, PL Jahagirdar,

Department of Anatomy, MIMER'S Medical College, Talegaon, Pune.

Gastroschisis is an enigmatic clinical entity (Skandalakis and Gray) as well as a rare developmental anomaly. The developmental basis of the anomaly is based on speculation (Schuster). It is more frequent in male infants and strangely, also found in domestic animals. A case of gastroschisis was detected in an aborted foetus of around 20 weeks gestation. The incidence, findings, embryological basis and clinical singificance, as also its comparison with an omphalococele are discussed.


Sudeshna Majumda, Shyamalendru Choudhury,

University College of Medicine, Kolkata, West Bengal.

A study of fifty placentae was undertaken to find out morbid and histological changes of placentae belonging to hypertensive mothers in comparison to those of uncomplicated ones. Maternal hypertension is reflected in the placenta and foetuses are affected accordingly due to maternal vasoconstriction.

Mothers having blood pressure 140/90 mm of Hg or above were selected for the study along with the control group. After delivery, their placentae were collected for minute detection of gross anatomical and histological features. Newborn babies were examined and their birth weights were noted. It was found that in cases of mild pregnancy, induced hypertension or mild preeclampsia placentae were almost similar with control specimens. But in cases of severe preeclampsia or long standing cases of pregnancy aggravated hypertension placentae were grossly small in volume, irregular in shape with several clacified and infarcted points. Histologically, fibrin deposition, hyalinisation, calcification, syncytial knot formation, cytotrophoblastic cellular proliferation, fibromusucular sclerosis around stem arteries, endothelial proliferation of capillaries were found in much higher percentage than the findings of the control group. Babies were grossly small for date in such cases.

So, if we can control hypertension during gestation effectively, placentae will be of normal architecture (both morbid and histoligical) and newborn babies of these mothers will have normal birth weight and activities.


Kakar S., Choudhry R, Raheja S and Gupta V,

Department of Anatomy, Lady Hardinge Medical College, New Delhi.

The present study provides a detailed examination of brain weight in North Indian fetuses and its correlation with gestational age and sex. It was carried out on 40 fetal brains (23 males and 17 female), 15 to 37 weeks gestation and fixed in 10% formalin for 4-6 weeks. Whole brain, supratentorial, infratentorial, brain stem and cerebellar weights were recorded. The data was statistically analysed in terms of mean, standard deviation, correlation coefficient and p-value after grouping, the fetuses into 5 weeks/gestational periods. No significant sex difference was observed. Mean supratentorial weight showed maximum increase and cerebellar weight a least rise. Infratentorial part of brain stem weighed more than the cerebellum. All weights showed a maximum rise after 36 weeks.


Venkateshu, K.V.

Department of Anatomy, SDUMC, Tamaka, Kolar.

Meckel's Diverticulum presenting with symptoms simulating the various abdominal pathologies including appendicitis is well known. However Meckel's diverticulum associated with distinct functioning vitelline artery without covering band has so for not been detected/reported as we scan the literature. Our instant presentation is perhaps the first documentation of such occurrences. While operating on the patient with clinical diagnosis of chronic appendicitis a 'complete search' for "rare" Meckel's yielded this surprise. The anatomical/clinical implication of this event will be discussed in the detailed presentation.


Kum Kum Rana, Rewa Chaudhry,

Department of Anatomy, Maulana Azad Medical College. New Delhi.

The semen is not azospermic immediately after vasectomy. In our over populated country the early aspermia post vasectomy is very significant where little facilities are available for regular sperm counts. Also it is difficult to convey to illiterate patients the importance of contraception required immediately after surgery. Accidental conception after surgery can mar the popularity of sterilization programme and also marital relations.

Aspermia is reached after vasectomy in 3-6 months and after about 30-40 ejaculations.

In the present study sperm immobilization was studied on semen from 20 human adults of the age group 25 o 45 years and tissue toxicity was studied on twelve sexually mature male guinea pigs.

Furacin solution has the ability to immobilize sperm in certain critical concentrations. It is non toxic to the vas deferens of guinea pigs. An attempt has been made to recommend the use of Furacin as postoperative flush after vasectomy to ensure complete contraception.


Singh LK, Manhas V.B., Kumar R. and Roy T.S.,

Department of Anatomy, All India Institute of Medical Sciences, Ansari Nagar, New Delhi.

Congenitally malformed babies are born to mothers who consume alcohol during pregnancy. Foetal alcohol syndrome is one such condition in which growth retardation, craniofacial dysplasia, CNS dysfunctions and systemic abnormalities have been observed. The present study was done to study the effects of alcohol on cardiovascular system in chick embryos.

Fertilised white leghorn chick embryos were chosen for the study because they are precocial, develop in a self-contained environment and there is an ability to manipulate the precise number of eggs with the exact dose. The eggs were divided into control and experimental groups. The experimental group was injected with 0.02ml of 50% and 75% alcohol separately into the air space. Controls as well as experimental groups were then put into an incubator at temperature of 37°C and humidity of 50% - 60%. Embryos were sacrificed on day 20 and assessed for the total body weight, crown rump length, gross weight of heart, abnormalities of heart and its big blood vessels. It was observed that 30% embryos of experimental group showed abnormal origin of right subclavian artery, which originated directly from left ventricle instead of innominate artery. There was normal origin of other big blood vessels in experimental groups. Also the embryos of experimental group had increased mortality rate upto 20%. a decrease in the total body weight, C-R length and gross weight of heart when compared with control. Some of the embryos showed anterior abdominal wall and limb defects.

Thus alcohol when exposed to chick embryos during early stages of development can lead top CVS abnormalities, therefore alcohol consumption should be avoided during early gestational period.


Sudakshina Ghosh, B.T. Narayana Rao, S. Swayam Jothi,

Department of Anatomy, IMTU College of Medicine, Guntur.

The anatomy of the oesophagus in full term, stillborn foetuses were undertaken as this part of the gastro intestinal tract forms an important area for paediatric and plastic surgery.

While every aspect of oesophagus was observed, presence of meso-oesophagus was observed in 10 specimens out of 47 (21%). Usually there will be no true mesentery for the oesophagus. If it is present, it is the mediastinal pleura which is covering the sides of the oesophagus and then on the surface of the descending thoracic aorta and reflected on the vertebral column, covering the azygos vein, posterior intercostal arteries etc. The mesooesophagus is seen as translucent mesentery with blood vessels traversing it to reach the oesophagus.

Of the 10 specimens having meso-esophagus one showed an oesophageal recess at the upper limit of the meso-oesophgus.


Deepa H. Kamar, A.C. Manikar

Department of Anatomy, Goa Medical College, Bambolim, Goa.

Phenobarbitone Sodium, most frequently administered, cheap and safe amongst the anti-convulsant drugs, has produced developmental abnormalities in chick embryos when administered in single dose in the air sack of eggs on the 4th day of incubation. The teratogenic effect of phenobarbitone is noticed in a low dose of 2mg/ injection. The abnormalities increased with increasing dosage of the drug.

The deformities varied from generalised growth retardation to embryonic death. Besides gross physical deformities, internal organs like brain, liver and heart showed histological changes as generalised engorgement of blood vessels, perivascular oedema, separation and fragmentation of cardiac muscle and fatty degeneration of liver.

Epileptic mother receiving phenobarbitone requires close monitoring to arrive at minimum dosage of drug that will be safe yet effectively control seizures.


R.K. Rohatgi, K. Chopra*, VP. Pathak**, P. Gautam*, S.L. Jethani,
Department of Anatomy, *Pediatrics & ** Pathology, Himlayan Institute of Medical Sciences, Jolly Grant, Dehradun.

A female baby was delivered to a 2nd gravida mother at HIMS in January 2001. The mother was a known case of Fallot's Tetralogy. U/S at 26 weeks showed spinal dysraphism. At 28 weeks the child was delivered in this hospital.

The child was born alive but did not cry at birth so he was resuscitated. The baby weighed 1.25 kg at birth, length was 35cms, Head Circumference- 22.5 cms, Chest Circumference-23 cms & the Gestational Maturity was 28±2 weeks by Dubonitz criteria. The neck was short and retroflexed. There were occipital bone defects. Abduction of both shoulders was restricted, as the axillary skin fold was very short. The child died on the 3rd day.

On autopsy, transposition of the great vessels of the heart was found. There was agenesis of the Corpus Callosum, 3rd & 4th ventricles and the cerebellar hemispheres. The cavities of the lateral ventricles were continuous in the midline. The thalami were not properly developed. The Spinal Cord was extremely shortened. Spina Bifida extended from the lower thoracic to the lumbar vertebrae. There was associated meningomyelocele. The GIT revealed pyloric hypertrophy and partial atresias of the small intestine.


Singh Anurag and Haider S.J.,

J.N. Medical College, A.M.U., Aligarh.

The present study was carried out on 80 pregnant females in their 2nd & 3rd trimesters attending various OPDs and IPDs of J.N. Medical College and Hospital, AMU, Aligarh. USG scanning was performed at the level of thalami. In each case an axial scan passing through the frontal horn and atria of lateral ventricle was obtained. Measurements of Choroid Plexus (CP) width were performed directly on screen with electronic callipers of USG machine using an outer to inner technique. The BPD and the length of CP were also measured.

A gradual increase in the BPD was observed with increase in foetal age with maximum size being attained (92 mm) by the end of 3rd trimester. Similarly the length of CP increased steadily with increasing foetal age, reaching 22-22.8 mm by the end of gestation. On the other hand the width of CP was observed to reach its maximum size (5.5-8.1 mm) in the early part of 2nd trimester and subsequently the values were fairly constant in the latter half of 2nd and 3rd trimesters. The advantage of measurements of these modalities by USG emphasizes the relevance of USG as a tool for detection of congenital anomalies such as hydrocephalus and choroid cysts.


ND Jain and RK Zargar,

Department of Anatomy, Armed Forces Medical College, Pune.

A total of 540 pregnant women of Maharashtrian origin between 14-37 weeks of normal singleton pregnancy were examined by ultrasonography. All the women were between 20 to 35 years of age with average height and build. Studies were carried out on foetus and placenta. Foetal measurements such as BPD, HC, AC, FL & BL were taken and placental observations such as its location on uterine wall, thickness & grading as per classification were carried out.

The study revealed that all the foetal parameters increased progressively through the 2nd & 3rd trimester of pregnancy. All these parameters were reliable indicators of menstrual age. However placental observations were poor indicators of menstrual age. Placental classification in Maharashtrian women is found to be more as compared to the American women. The clasification of placenta was not significantly related to maternal age or parity.

A group of 10 IUGR (Intrauterine growth Retardation) foetuses were studied for their foetal parameters & placental observations Amongst all, AC was found to be most reliable indicator for identification of IUGR after 30 weeks of gestation.


Sushil Kumar, R.K. Zargar, R. Bhatnagar,

Department of Anatomy, Armed Forces Medical College, Pune.

Thyroid gland is the first endocrine gland to start developing in the embryo. Thyroid gland is well known for its developmental anomalies ranging from common and frequently seen to rare. Common anomalies include persistence of pyramidal lobe and thyroglossal duct cyst. Uncommon anomalies are failure of isthmus to fuse and absence of a significant part of lateral lobe while thyroid hemi-agenesis with or within isthmus is rare anomaly. An uncommon developmental anomaly of thyroid gland showing failure of fusion of thyroid isthmus in the midline resulting in two lateral lobes is reported and discussed.


T.R Kalavathy,
Institute of Anatomy, Madras Medical College, Chennai.

A headless monster was dissected which had trunk, lower limbs and well developed external genitals. Specimen showed no thoracic or upper abdominal viscera. But the intestines with a blind upper end, kidneys with ureters and not fully developed pelvic organs were seen. Spinal cord was present upto the thoracic region.

This presentation of the anomalous foetus will be presented with illustration.


T.R. Kalavathy, Instiute of Anatomy, Madras Medical College, Chennai.

Due to complexities of the development of the face anomalies of the face do occur and present in various forms. Clefts of the face are one such anomaly due to failure to fuse or delayed fusion of the maxillary, mandibular and palatine processes. At the same stage of development anomalies of the other parts of the skeleton like syndactyly, constriction rings occur and one such anomaly in a dead born fetus was dissected and presented.


R.Dada, N.P. Gupta*, K.Kucheria,

Department of Anatomy and *Urology, All India Institute of Medical Sciences, NEW DELHI.

About 25% of men in their reproductive age group have severe defect in sperm production. The aetiology cannot be defined in 40-50% of these cases. In the past decade there has been an yearly decline in sperm concentration (2.6%), sperms with normal motility (0.03%) and sperms with normal morpholoy (0.07%) which has led to a marked increase in the population of subfertile males. Therefore the present study was undertaken to analyse semen of infertile males and to correlate various parameters with aetiological factors. Sperm motility is the best predictor of fertility potential, which depends on an intact normal sperm morphology. Though it has been reported that high testiculo-epididymal temperatures adversely affect spermatogenesis but very few reports are available on the deterioration in semen quality in males exposed to high temperature. To achieve this aim the semen of 98 infertile & 25 fertile controls (control group) was analysed using the guidelines in WHO manual (1992). Eighty six males had no sperms in their ejaculate and were azoospermic. Twelve males had a total sperm count of less than 20 million sperms and were classified as oligozoospermic. Two of these twelve oligozoospermic males had normal sperm morphology and they were classified as group I. Remaining 10 oligozoospermic males were found to have a very high percentage of morphologically abnormal sperms predominantly coiled tails with impaired motality a picture characterstic of oligoasthenoteratozoospermia (OAT) and were classified as group II. These cases were analysed in detail and results were compared with the control group. The percentage of morphologically abnormal sperms with impaired motility were significantly higher in group II. Nine men with OAT and eleven azoospermic males had exposure to hgh temperatures at their workplace. The present study reports the presence of increased number of morphologically abnormal sperms and impaired motility in men with occupational exposure to high temperatures.


Prakask H.S., G.B. Rairam

Department of Anatomy, M.R. Medical College, Gulbarga.

A female foetus of about five months old was collected from district general hospital, Gulbarga The foetus with omphalocele has most of its organs outside the abdominal cavity. Other associated anomalies are (1) the cleft palate and cleft lip (b) anomalous hands and feet (c) a long tag of skin attached above and behind the left auricle. The case will be discussed.


Laksmi Rajgopal,

Department of Anatomy, Seth G.S. Medical College &

K.E.M. Hospital, Parel, Mumbai.
Aim : To analyse the incidence of Neural Tube Defects and correlate their embryological basis.

Materials and Methods : 29 cases of neural tube defects admitted to the Paediatric Surgery ward of our hospital were analysed to note down the site of the defect, the type of the defect, associated neurological deficit, incidence of hydrocephalus and other associated anomalies.

Results : Of the 29 cases, 16 were male children and 13 were female childen. The location of the lesion was lumbar in 11 cases and lumbosacral in 11. In seven cases it was occipital and it was frontal and sacral in one case each. 21 of the 29 cases were meningomyelocoele, five of them were encephalocoele while two were meningococle and one was a meningoencephalocele. Of the 20 cases, 13 did not show any neurological deficit nor did they have hydrocephalus. 14 showed neurological deficit in the form of paraparesis to paraplegia and bladder and bowel incontinence. These children also had hydrocephalus. The remaining two had paraparesis and bladder and bowel incontinence but did not have hydrocephalus.

Discussion : Associated anomalies included agenesis of corpus callosum, microcephaly and crossed renal ectopia. The embryological basis of neural tube defects is discussed.


Rani, Archana, Sahai, A., Srivastava, A.K., and Srivastava, A.N.

Department of Anatomy, King George's Medical College, Lucknow.

Of the potential health risks associated with exposure to chemical or physical agents,a prominent concern is that these agents may interfere with the ability of individuals to produce normal, healthy children. The susceptibility of the male reproductive system to pesticides has assumed increasing concern.

Isoproturon, a substituted phenylurea is a herbicide widely used in agriculture was taken to see its effect on sperm count and sperm motility of albino rats. Three groups of animals were used for the present study i.e. control group (8), isoproturon 400 mg/kg/day treated group (8) and isproturon 800 mg/kg/day treated group (8). The rats were anaesthetised by intraperitoneal administration of Nembutol (30 mg/kg body weight). The testis along with epididymis were taken out for obtaining sperms. Epididymal sperms were obtained by mincing the epididymis in normal saline and filtering through nylon mesh. The motility of epididymal sperms was assayed microscopically within 5 min following their isolation from epididymis at 37°C. Counting of sperms was done by using Neubauer chamber.

The present sperm motility in isoproturon treated rats after 60 days of experimental period with both low and high dose was found to be decreased as compared to control. The present sperm motility (mean±SD) of 8 aniamals in control group was 81.0 ± 4.8 while it was 64.2 ± 2.8 with low dose and 30.2 ± 10.8 with high dose.

The total sperm count (per ml) of 8 animals (mean ± SD) in control group was 100 x 106 ± 0.39 while 40x106 ± 0.21 with low dose and 10x106 ± 0.11 with high dose.

Therefore, this pesticide affects the fertility of human beings by adversely affecting the sperm motility and producing oligospermia.


T.R. Kalavathy,
Department of Anatomy, Madras Medical College, Chennai.

This premature dead born foetus shows the following features.

1. Defective development of left half of the abdominal diaphragmatic musculature and thereby the membranous part of the diaphragm balloon and forms a pouch into the left side of the thoracic cavity.
2. There is superior displacement of upper abdominal organs into this membranous sac.
3. External genitalia - (a) Hypertrophied clitoris, (b) Fusion of scrotal swellings- (Labia Majora), (c) Absence of openings of urogenital sinus - thereby absence of vestibule of the vagina.
4. On laparotomy a primitive gonadal tissue is seen on the left side and a non-specific mass of tissues on the right side (? Renal or > gonadal) has been subjected for histo pathological examinations. This case is presented for its uncommon incidence and interesting manifestations.


T.R. Kalavathy,
Institute of Anatomy, Madras Medical College, Chennai.

A full term dead female foetus with hyperextended neck, meningocoele & exomphalos with well developed limbs and face was dissected. The specimen showed absence of foramen magnum, complete spina bifida with a well developed brain and spinal cord. The Omphalocoele contained liver and coiled intestine. Other organs appeared normal. No arch of aorta was seen. This rare congenital anomaly is presented here.


Keerti Singh, Asha Singh*, Melani Rajendran,

Department of Anatomy, Sri Ramachandra Medical College & Research Institute [Deemed Unversity], Porur, Chennai, *Maulana Azad Medical College, New Delhi.

We have known the problem of infertility as far as the recorded history of mankind. Recognition of male factor as a cause of infertility has been steadily growing Hence an attempt has been made to study it with following aims and objectives.

1. To study the effects of mesterolone in oligospermic males.

2. To study the effects of combined therapy of mesterolone and clomiphene citrate in terms of semen parameters, effect on pituitary and liver.

30 males with foliopathic oligospermia were included for this study. Out of them, 10 males were used as controls. 10 males were given 50 mg of tab mesterolone 1 b.d and 25 mg of clomiphene citrate 1 o.d. and another 10 males were given only tab mesterolene 50 mg b.d for 4 months. A follow up study was conducted at the end of 100 days, 150 days and 200 days respectively in all the groups. Following parameters were used semen volume (ml), viscosity, sperm concentration in million/ml, % of grade III motility, % sperms with normal morphology, % of living sperms, % immature sperms and differential count of sperms.

The study revealed only mestorolone was not effective in comparision of the combination of mesterolene and clomiphene citrate which was much effective and showed 40% increase in sperm concentration.


Kanak Iyer, Rathi Sudhakaran,

Department of Anatomy, Lokmanya Tilak Municipal Medical College, Sion, Mumbai.

Lungs are essential organs of respiration. The basic structure of the airways is already present at birth. The state of maturity of lung is the critical feature in determining viability of the preterm infant. Few infants survive at gestations below 24 weeks - the time at which the critical maturation to the saccular phase normally occurs. So it was decided to study stages of maturation in foetuses of various stages of gestation obtained from medical termination of pregnancies and spontaneous abortions. The fetuses were dissected and external lung features were studied. Histology slides of lungs were prepared and stained by Hematoxylin & Eosin. It was observed that a linear relation existed between body weight and lung weight initially. The study showed all periods of lung development as recorded in text books. Cilia, goblet cells and bronchial glands first appeared in 18 to 19 weeks. Primitive cartilage is seen first in 13-15 weeks and smooth muscle was seen in 16-17 weeks. Density of cellular parenchyma progressively reduced and it was invaded by more and more capillaries The epithelium lining bronchioles and wide air spaces progressively became flatter and thinner. The study postulates that the necessary histological changes required for the lung to function immediately after birth are already present at the time of birth and even at an earlier stage from 30-32 weeks.


Anjali Dhamangaonkar,

Department of Anatomy, Seth G.S. Medical College &

K.E.M. Hospital, Parel, Mumbai. Most primates including Homo sapiens are mono-ovulatory and birth of a single foetus is a rule. Twinning and multiple births are accidental and sporadic in these species and are influenced by genetic and environmental factors.

Two separate organising centres appearing simultaneously in single germ disc having overlaping differentiating influence to such an extent, that two embryos are incompletely separated from each other and result into conjoint twin or double monsters, equal in sizes and receive proper blood supply and can be completely separated by appropriate surgery.

This is a rare conjoint twins, separated in all aspects except urinary system, humerus and radius, ulna with ten fingers, is discussed.


M. Natarajan, Manu Kathori, Lopa Mehta
Department of Anatomy, Seth G.S. Medical College & K.E.M. Hospital, Parel, Mumbai.

This interesting term and concept comprises homoios(G) meaning like, similar and Maltese root bux meaning tree. The term box implies a case made from tree. Homeobox then means unchanging constant trigerminal case (polyunit) from which the feather winged beetle measuring <0.25mm and a blue whale measuring >30,000mm arise embryologically the same way, the ratio being 1:120,000. The tiniest metazoan in the human body is the male thread worm (a member of polybiosis) measuring 2mm. It is chastising to accept that a microinsect, man a mammoth are related to a single developmental plan that provides closely related animal bodies, the basic plan being summed as the homeobox. Interestingly, against 1000 muscles of man, a caterpillar has 4061 muscles.

Pander in 1817 gave the description of the three germ layers in chick and later the concept was extended by von Baer to include all vertebrates. As a phylogenic reversal Kowalevysky in 1867 extended the same concept to invertebrates thus establishing embryological unity in the whole animal kingdom.

The homeobox should be seen as Nature's conservatism; divine simplicity. Similarity of developmental signals for limb and face permit an operational concept of homoebox as starfish giving rise to a typical vertebrate.

Embryogenesis as a homeobox generalisation is universally simple. In details, embryogenesis defies understanding. The homeobox concept has the merit of being comprehensible to the lay and the learned, children and adults alike.


S.D. Desai.
Department of Anatomy, Shri. B.M. Patil Medical College, Bijapur.

Growth is the natural process, which takes place in all living organisms. At the same time no two persons are alike in their measurable characters. It is desirable to have some means of giving qunatitative expression to the variations that are often found for proper interpretation of the data and evaluation of development of a child. It is an essential to have an accepted standard reflecting normal growth for purpose of comparison. Till now the standards established by the U.S.A. have been employed. Since the growth and development depends on genetic potential, nutrition and other factors, this U.S.A. standard do not suit Indian children. There are very few studies regarding growth of the children. Therefore this study was undertaken. To collect the data regarding pattern of growth cross sectional study was done on 456 school going male children between 8 to 16 years of age in Bijapur District of North Interior Karnataka. The study was done during 1st Jan to 28th Feb 2001. Certain age group showed maximum spurt of growth for a majority of measurements. All length measurements of the body showed 2 growth spurt one between 9 and 19 years and another between 14 to 16 years. Width measurements showed high rate of growth between 14 to 15 years. The Karnataka boys are found to be shorter in all the measurements when compared to other Indian and non-Indian standards except South Indian boys.


Govind Hoskeri,

Departmet of Anatomy, Seth G.S. Medical College & K.E.M. Hospital, Parel, Mumbai.

The first quarter of the last century was a very critical period in the history of our subcontinent. The nation was rediscovering and redefining its heritage and tradition of one of the oldest civilizations in terms of unshackling itself from slavery imposed on it by history. The British imperialism had not spared the medical profession also. The article traces the birth and contribution of the twin institutions of Seth G.S. Medical College and the K.E.M. Hospital against the backdrop of the Indian freedom struggle.

50. PRIONS :

Manu Kothari, Lopa Mehta,

Department of Anatomy, Seth G.S. Medical College & K.E.M. Hospital, Parel, Mumbai.

In mankind's losing battle against microbes prions are the latest set of pathogens that have already provided a Nobel prize to its proposer and discoverer. The abbreviation PRION stands for Proteinaceous Infectious Particles (PR + I + ON). Prions are rapidly infective, very very slow in developing and there

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