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Journal of the Anatomical Society of India

Abstracts (301 - 350)

Author(s): Members

Vol. 54, No. 1 (2005-01 - 2005-03)

302. Postnatal Weight of Rat Adrenal: Relationship with Body Weight in Normal and Stressed States

Mukherjee C,*, and Kavitha,S**

*Mahatma Gandhi Medical College and Research Institute,
Pondicherry
**PY Patil Medical College, Navi, Mumbai

Male albino rats were studied from birth to day (d) 100. Body weight (BW), weight of the adrenal gland (AW) were recorded.

Results in the study show that average BW of normal rat is 11.26 g on d 7. it increased 2.36 times by weaning day (d 21). It further increased 12.44 times by d 70 and 7.34 times by d 100. On the other hand, BW rats grownunder stress, increased 2.26 times up to weaning day, up to d 70 by 9.36 times and 16.49 times by d 100.

Average weight of adrenal gland of normal rats was 2.85 mg, by weaning day it increased 1.68 times. By d 70 itfurther increased 11.40 times and on d 100 it was 16.50 times of weight on d 7. Average weight of the adrenals of stressed animals was 2.58 times, 14.83 times and 16.1 times of the wt on days 21, 70 and 100.

On comparison of male rats adrenal weights with it body weight in normal rats it was 0.498% on d 7, 0.101% on d 70 and 0.99% on d 100. Grown under stressed condition, the adrenals were 0.5% on d 7, 0.167% on d 70 and 0.102 of BW on d 100.

303. Absence of Isthmus of Thyroid - A rare anomaly

N. Jayasree, TK. Rajasree, N. Ratnakar Rao, G. Ravindra Nath.

Kakatiya Medical College, Warangal

In routine cadaveric dissection, a rare congenital absence of Isthmus has been observed.

Congenital absence of lobes of thyroid has been observed by many observers, but total absence of isthmus is considered as very rare anomaly.

Various probabilities of Congenital anomalies will be discussed in detail.

304. The Fibrous Skeleton of the Heart - Steps in Dissection

KD Khushale, ML Kothari, LA Mehta

Seth. GS. Medical College, Parel, Mumbai.

Aim:

To make specimens of the fibrous skeleton of the heart and its dissection steps.

Material and Methods:

The fibrous skeleton of the heart was dissected in 60 cadavers and its morphological features, position, shape and extent were noted.

Conclusion and result:

The fibrous skeleton of the heart and its three-dimensional view can be very helpful for both undergraduate as well as postgraduate students of anatomy and cardiology.

It would also help cardio-thoracic surgeons with regard to annuloplasty operation.

305. Arch of Aorta - Vertebral level in Fetuses

Aswini S, Veena Kesi Reddy, Monica. E, Florence Tadi, BT Narayana Rao & S.Swayam Jothi

Katuri Medical College & Hospital, Guntur

In 55 full term still born fetuses, the level of the highest point of arch of aorta and its level of termination were studied.

The highest point of arch of aorta in adults corresponds to 2.5 cms below the upper border of manubrium sterni. This corresponds to the disc between 3rd and 4th thoracic vertebra.

In the fetuses, the highest point of arch of aorta varies between the inter vertebral disc between 1st and 2nd thoracic vertebra to 5th thoracic vertebra. The highest percentage of 25.45% is at the body of 2nd thoracic vertebrae and next highest percentage of 23.64% is at body of 3rd thoracic vertebrae and 20% is at the disc between 2nd and 3rd thoracic vertebrae.

The terminal part of arch of aorta crosses the left border of oesophagus to continue as descending thoracic aorta on the left side of the body of 4th thoracic vertebra or at its lower border in adults. In the fetuses, the terminal part of arch of aorta was crossing the oesophagus at a level varying from disc between 1st and 2nd thoracic vertebra to the body of the 5th thoracic vertebrae. In higher percentages it corresponds to 3rd thoracic vertebrae and 4th and 2nd thoracic vertebra in the order of percentages.

In sternal puncture, the position of arch of aorta is to be remembered and in correction of ductus arteriosus and coarctation of aorta, knowledge of the variation in its level will be of use.

306. Ultrasonographic Study of the Diameters of Liver in Adults

Vilas Khandare, LA Mehta

Seth. GS Medical College, Parel, Mumbai

Aim:

To evaluate the measurement of normal size of the liver by determining the longitudinal and anteroposterior diameters by ultrasound. These findings were correlated with age, sex, height \weight and body surface area.

Material and Methods:

One hundred and three cases (males 51, females 52) were included in this study. Patients were referred to examine the abdomen ultrasonically to establish or to rule out any pathology. The patient was included in the study group only when liver was found to be of normal echo texture and no other pathology was detected. The longitudinal and anteroposterior diameters of liver in mid clavicular line were measured. Thereafter height in meter and weight in kilogram was documented. The body surface area was calculated by using formula.

Result:

Ultrasonic measurements of longitudinal and anteroposterior diameters of liver estimated to be 12.44 cm +- 1.20 and 10.12cm +- 1.21. Both the diameters of liver area generally less in females as compared to males. The two diameters show positive correlation with parameters such as height, weight and body surface area.,

307. The Third Coronary Artery in the Human

K.Yoganarasimha*, Narga Nair & S. Nandha Kumar,

Kasturba Medical College, Manipal.

Autopsies of human bodies at Kasturba Medical College, Manipal revealed the presence of a third coronary ostium arising from the sinus of Valsalva in a human, female aged 48 years, who had succumbed to burn injuries. Examination of an otherwise normal heart, revealed the following findings: the right and left coronary arteries were seen arising from the anterior and left posterior aortic sinuses respectively. Closer examination of the aortic sinuses revealed an additional coronary ostium in the anterior aortic sinus, which was to the left of the right coronary artery ostium and was much smaller in size. The reported incidence of the above-mentioned findings, along with its clinical implications will be presented at the conference.

308. A Study on Cardio Thoracic Ratio in 100 Cross Cultural Indian Population

WMS Johnson* pariscilla Johnson** S Kamalesh

*** P Saikumar ****Gunapriya Raghunath *****

Sree Balaji Medical College, Bharath Instiute of higher education & research, Deemed University, Chennai.

Sree Ramachandra Medical College and Research Institute, Deemed University, Chennai.
Sree Balaji Medical College, Bharath Institute of Higher Education and Research, Deemed university, Chennai.
Sree Balaji Medical College, Bharath Institute of Higher Education & Research, Deemed University, Chennai.
Sree Ramachandra Medical College and Research institute, Deemed university, Chennai.

Cardio thoracic ratio is the transverse cardiac diameter divided by the transverse chest diameter in chest skiagram. The ratio of 50% is considered normal in adults. Possible causes of ratio > 50% are cardiac failure, pericardial effusion, left ventricular hypertrophy etc., chest radiograph provides important predictive information of associated target organ damage in hypertensive patients. Cardiac size and shape helps to distinguish cardiogenic from noncardiogenic pulmonary edema. A significant relationship was found between cardiac measurement and the age. Cardiac c diameter increased with advancing age and thoracic diameter decreased with age., though a chamber hypertrophy is best determined in echocardiography, CXr can be used as a tool for follow up. Thus, standard chest skiagram remains a clinically relevant procedure.

310. Anatomy of Cardiomyopathies (II): Hypertrophic Cardiomyopathy

Pariplavi Mokkapati

Siddartha Medical College, Vijayawada. AP

Cardiomyopathy (CM) is a composite disease entity involving a primary and genetically transmitted disorder of the cardiac muscle resulting in altered structure and function of the heart. CMs are classified as hypertrophic (HCM), dilated (DCM) and restrictive (RCM). HCM is a fascinating disease that has intrigued and challenged cardiologists for decades. It is characterized by left ventricular and/or septal hypertrophy, with/without obstruction, diastolic dysfunction and histologic disorganization ultimately resulting in failure. Moreover, a large number of apparently normal /well-compensated patients undergo sudden cardiac deaths. The genetic factors contributing to the etiology and pathogenesis of the conditions are only recently being understood.

Diagnosis of HCM is based on patient and family history, physical examination and non invasive studies (roentgenography electrocardiography and echo cardiography). Echocardiography forms the backbone of clinical identification and quantification of morphological features. In combination with Doppler studies, even the haemodynamic features are assessed. Invasive procedures including biopsy may also be done.

The gross and microscopic features and clinical genetics of the disease shall be discussed.

The genetic link between the two forms of CMs will also be discussed.

Changing environments have led to changing lifestyles, which are also resulting in changing genetic pattern.

311. Metrical Study of Normal Cardiac Area and Other Parameters from Chest Roentgenogram

Dilipkumar Bhimrao.Kolekar, S.R. Mudholkar, Anil Joshi,

Govt. Medical College, Miraj.

Aims and objectives:

1) Calculate A) CT Ratio B) cardiac area c) Aortic knob d) width of right inferior pulmonary artery size
2) Prove reliability of cardiac area.
3) Provide normal values of cardiac parameter.

Material and Methods:

Cardiac area = II/4xLxB of heart (Ungerleider & Gubner Formula)
CT Ratio = TD. of heart/T.D. of chest.

Observation & Discussion
1) Cardiac Area Mean M - 99.14 sq.cm., F-88.8 sq.cm
2) T.D. of chest M - 26.26 cm, F-23.57 cm
3) Comparison byEdge M- 30.5 cm, F-26.0 cm.
4) Comparison by Edge M - 8.5 - 13.7 cm. F- 7.7 - 14.2 cm.
5) Comparison by Lennon 10-16 cm.Difference due to racial variation.
6) CT ratio M-0.46,F-0.43, study by Felson < 0.5.
7) Aortic knob M - 2.56 cm, F- 2.46 cm.
8) Rt. Inferior put. Art. Size M - 1.14 cm, F-1.06 cm.
All values more in males than females.

Conclusion:

1) CT Ratio & cardiac area value helps to avoid personal bias and cardio - myopathy, hypertrophy, emphysema etc. can be diagnosed.

2) With aortic knob, Pul. artery - aortic aneurysm, pul.art. stenosis.

3) These values are valuable in borderline cases.

4) Present study a pioneering attempt in western Maharashtra about aortic knob, right inferior pulmonary artery.

312. Ovarian Cyst

Namrata. S, Susmitha. D., D. Sree Lekha,

Nanda Kishore Bandlamudu, S. Swayam Jothi, Katuri Medical College & Hospital, Guntur

Ovarian cysts are the largest tumors found in human body. It develops during 30-60 years of age and generally unilateral and in 5% bilateral, essentially benign and in 5 to 10% become malignant.

We got 2 interesting cases of ovarian cyst from the nursing home. In both the cases, the patient had a large mass in the abdomen, which progressed in size and started giving pressure symptoms and pain.

Surgery was advised and the operated specimens were sent for histopathological study.

The cysts were weighting 5-6 kg. They had narrow pedicle with a glistening surface.

Cut section showed multiple cavities with viscid mucous secretion.

Histopathological study showed that they were pseudo mucinous cystadenomas.

Mucinous tumors account for approximately 10-20 % of all epithelial ovarian neoplasms and about 75-80% of them are benign.

313. An Attempt for Personal Identification by Means of Lip Prints in North Indian Subjects

Punita Manik, Anita Rani, AK Srivastav

Every human being has characteristic pattern and arrangement of lines on the lip, which is unique for every individual. Therefore, lip prints have been a helpful tool in forensic identification.

The objective of the study is to note the lip pattern of an individual and correlate it with age, sex and blood group.

The subjects taken for the investigation of lip prints were 240 first year MBBS & BDS students admitted in the year 2004 at KG Medical University, Lucknow. Subjects with the deformity and scars of the lip were excluded. The lip prints were obtained by a method in which a dark colored frosted lipstick, a thin smooth paper and magnifying glass were used. Recording data is an important criterion for this study. Hence, the material was prepared for taking half size photograph for the lips with a Sony Digital camera and enlarging to the double size.

The observations and results will be discussed.

314. Footprint Study in Tree Climbing Communities: Arch Adaptation

Soubhagya Ranjan Nayak*, Shivarama Bhat** & Arunachalam Kumar***

KMC Mangalore. Kasturba Medical College, Mangalore, India

Bipedalism is a unique attribute evolution has conferred on man. Foot anatomy adaptation to weight bearing and hind limb locomotion is evidence bony the changes in the ostemyo-fascial components of human feet. Occupation stresses are also known to produce permanent morphological change.

This study compares the changes in foot anatomy, especially along the axis of the medial longitudinal arch through footprint pattern analysis in professional tree climbers.

Our observations reveal that all dimensions of the medial arch hollow, length, breadth, surface area and height are increase in climbers, the augmentation in metrical values being directly proportional to number of years in the occupation. Oddly, it was seen that there was an abrupt reversal of values after three decades in profession in all parameters, except arch height, which however continued to increase.

The possible causative factors for the changes in the metrical values of the medial edge of feet are discussed.

315. Dermatologlyphics in Congenital Talipus Equinovarus"

Kulkarni PR, Gaikwad

Govt. Medical College, Aurangabad. MH

The word "Dermatoglyphics" indicates study of epidermal ridge configuration on palms, soles & fingertips. These ridges are genetically determined & influenced by environmental, physical and topographical factors.

CTEV is one of the most common forms of congenital club foot, accounts for 95% of total club feet. So an attempt has been made in present study to see the dermatoglyphic patterns in CTEV patients at Government Medical College, Aurangabad.

In the present study, dermatoglyphic prints of 52 cases (44 males & 8 females) were taken with the help of drawing paper, Kore's duplicating ink, ink applicator. These prints were studied under magnifying lens & the prints were compared with dermatoglyphic prints of 48 controls (40 males & 8 females) matching with age group of CTEV patients ie., 5 months to 5 years. Parameters like fingertip pattern, triradial counts, a-t-d angle, a-b ridge count were studied.

Following conclusions are drawn in CTEV patterns in present study: 1 Ulnar loop frequency was significantly decreased in both hands in males and females. 2 Whorls showed significant rise in both hands in males & females. 3 Frequency of arches was loser in both hands of males, but female group did not show any variation. 4 Radial loop did not show any variation in both hands in males and females. 5 a-t-d angle did not show any variation in both hands in males and females. 6 a-b-ridge count was significantly decreased in both hands in male and females.

316. Left Handedness and Dermatoglyphic Pattern

Ingole I.V, J. Anbalagan, Ghosh SK

Department of Anatomy, Mahatma Gandhi Institute of Medical Sciences, Sevagram, MH

Abstract: A preference for the right or left hand is shown by humans and many other species including mammals, birds and amphibia. In case of human beings it appears in the early intrauterine life. This preference for the right or left hand has been correlated with the laterality, cerebral dominance and asymmetries in the brain. The presence of lateralized arm movements in early gestation was suggested to be a trigger for lateral asymmetries in the brain and has a genetic origin. Left handedness occurs in about 8% of the human population. It is more likely in a child if one or both parents are left handed. Since adopted children do not show similar links, this is taken as evidence of genetic rather than an environmental origin. The differentiation of dermal ridges also starts in early intrauterine life and is genetically determined. The present work is taken up to determine the prevalence if any of a particular type of pattern in the left handed individuals. For the study 30 left-handed individuals were selected 30 right-handed individuals were randomly taken. Prints of both the hands of each individual were taken. The prints were studied for the pattern on all the ten fingertips. The patterns of fingertips of right and left hand were compared for predilection of any particular pattern in either the right or left hand. It was interesting to note that there was increased incidence of whorls on the fingertips of both the hands of left handed persons when compared with the right handed individuals.

317. Study of Dermatoglyphic Patterns in Congenital Heart Disease

Deshmukh AG. Kulkarni A, Kulkarni P.R.

Govt. Medical College, Nanded.

The world "Dermatoglyphic's" indicates the study of epidermal ridge configuration on palms, soles and finger tips. It has long been recognized as a scientific and valuable method for medico legal, anthological and genetic studies. Present study was undertaken to study dermotoglyphic pattern in congenital heart diseased (CHD) patients.

Dermatoglyphic prints of hundred cases of CHD patients and hundred cases of normal individuals were taken as control group. The patients were diagnosed as CHD of age group ranging from 6 to 30 years. The incidence of CHD was found to be more in male (62%) than in females (38%).

In the present study ulnar loop, radial loop, whorl arch, whorl-loop index, triradial count, pattern intensity index and ATD angle were studied. Among these only ulnar loop and ATD angle were found to be statistically significant.

Frequency of ulnar loops in right hand in CHD group was 64.4% and in control group 57.15%. Frequency of ulnar loop in left hand in CHD group was 68.60 % and in control group 61.76%.

Mean ATD angle in right hand of CHD group was 49.31 and in control group was 42.28 while in left hand of CHD group it was 49.27 and in control group it was 42.28.

This indicates that there was statistically increase in ATD angle of CHD group.

319. Congenital Inguinal Hernia - A case report

Valli Bramharamba Mallika, Madhusudana Rao, Suryanarayana, B, S. Swayam Jothi

Katuri Medical College & Hospital, Guntur

A female child, 4f years old came with fever and cough and with a swelling in the right inguinal region, which was present since birth. The complaints were pain after eating and drinking water and pain on urination and on exertion. There was fever and vomiting on and off.

On observation there was spherical swelling 2.5 cms x 2.5 cms at the medial part of the inguinal region extending on to the labia majora on the right side. On palpation, there was tenderness. Cough impulses was present. The mass was reducible. The soft mass of 3 cm x 2 cm was palpable in the superficial inguinal ring area extending into the labia majors.

The presence of cough impulse and reducibility shows that it is a hernia. Congenital inguinal hernia is quite uncommon in female.

320. Dermatoglyphic Study in Carcinoma of the Cervix

Inamdar VV, Vaidya SA.

BJ Medical College, Pune

Dermatoglyphic study of fingertip and palm region and its association with various diseases especially having genetic cause has been reported by various workers in past.

Carcinoma of cervix is second most common cancer among women worldwide and in developing countries it accounts for 80 percent of cases of cancer so the aim of present study was to determine an association between dermatoglyphic traits in carcinoma of cervix.

In present study, 90 histo pathologically established cases of cancer cervix whose age was above 25 yrs were taken, their prints were taken with the help of drawing paper, cotton pad, kore's duplicating ink and ink slab. These prints were studied under magnifying lens and are comparing with the prints of 90 normal healthy females above the age of 25 years. Different parameters like fingertip patterns, patterns in inter digital areas, TFRC, a-t-d<, a-b, b-c, c-d & t-d ridge counts were studied.

Statistical analysis of this data was done and following dermatoglyphic findings were observed in patients of carcinoma cervix as compared to controls.

Statistical analysis of this data was done and following dermatoglyphic findings were observed in patients of carcinoma cervix as compared to controls. 5 Increase in frequency of arches in left hand. 6 Decrease in frequency of ulnar loops in both hands. 7 Increase in frequency of whorls in both hands. 8 Increase in total finger ridge count in both hands. 9 Decrease in a-t-d angle in both hands. 10 Decrease in t-d ridge count in both hands.

322. Sympodia

Jayagandhi S, Rajan T, Kottiswari.P, Srinivasan KR

Aarupadi Veedu Medical College, Pondicherry

To study the limb abnormalities in fetuses, the fetuses from our obstetrics and gynecology department. The limb begin to appear towards the end of the fourth week as slight elevations of the ventrolateral body wall. The upper limb buds develop about 2 days before the lower limb buds. The tissues of the limb buds are derived from two main sources, mesoderm and ectoderm.

Initially the developing limbs are dissected caudally, later they project ventrally and finally they rotate on their longitudinal axis.

The majority of the limb anomalies are caused by genetic factors or from an interaction of genetic and environmental factors (multifunctional inheritance) or by specific teratogens. In our study, we observed a foetus with complete union of lower limbs producing the mermaid condition. Hence, presented for its rarity.

323. Dermatoglyphics in Thyrotoxicosis a Study in Females in Western Maharashtra

Kulkarni P* & Vaidya RB

Grant Medical College, Mumbai*, Government Medical College, Miraj.

Aims and Objectives:

1) to study the Dermatoglyphic pattern in 60 thyrotoxicosis patients and compare them with 60 control subjects from the same age group. 2) To find out whether these changes are statistically significant 3) To comment on the usefulness of the findings of the study in predicting changes of developing thyrotoxicosis in female from predisposed family.

Methodology:

Method used is standard - ink - method. The patients are taken from endocrine clinic and are confirmed by laboratory investigation of their T3, T4 and TSH levels.

Results:

1) Increase incidence of Sydney line (10%) in patients compared to normal.
2) Increase in 12-pattern incidence in patients in both palms.
3) Increase in mean right ab and bc counts in patients.
All the findings are statistically significant.

Conclusion:

Top the best of author's knowledge the study is first of its kind undertaken in India. It is also true that only 4 studies have been carried out abroad and the study done by Dimoftes and Negrea E (1980) is the only study available for comparison. It is felt that the findings of the present study will be meaningful if other workers carry out further research and their findings are reported authentically.

324. Meckel's Diverticulum - A case report

Bandlamudi Nanda Kishore, Madhusudana Rao , Soorya Narayana B., S Swayam Jothi.

Katuri Medical College, Guntur

The case is presented here to show how inflammation of the Meckel's diverticulum will mimic that of appendicitis.

A 28-year-old female patient came to the OP with pain in the lower part of the abdomen on the right side and vomiting.

On examination: There was tenderness in the right iliac fossa and in the right lumbar region.

Appendicitis was suspected and was operated. At operation, appendix was found to be normal. The terminal ileum was traced proximally startling from ileo-caecal junction. A diverticulum of about 3 cm in length was noticed about 48 cms from iliocaecal junction and was the cause for the pain in the right iliac fossa.

326. Anomalies in Morphology of Retina of an Anencephalic Foetus

BN Rao, V. Sunitha, NB. Devi

MIMS, Nellimarla

An anencephalic foetus of 5 weeks gestation has been obtained and after preservation, the eyeballs have been enucleated and subjected for histological study for any anomalies in the retina in the formative stage. The details of the anomalies found in retina along with other anomalies will be presented at the conference.

327. Evolving Concepts in Cryptorchidism

Ila, J Gujaria*, Navin Viswanath **

TN Medical College & BYL Nair Ch. Hospital, Mumbai.

Introduction

The mechanism of descent remained obscure until hunter dissected the human fetus and found the intra abdominal testis connected to the inguino abdominal wall by ligament called the gubernaculums testis because it appeared to guide the testis to the scrotum.

Testicular descent into a low temperature environment of the scrotum in mammals is a complex multistage process and hence causative factors for nondescent are multifactorial.

Aims and objectives: 1) To study the embryogenesis of undescended testis. 2) To highlight the role of gubernaculum in the descent of the testis 3) To study if knowledge of anatomy has influenced the management of patients by laparoscopic surgery.

Material and methods

Study was conducted in TN Medical College and BYL Nair Ch. Hospital in collaboration with the pediatric surgery department during which 50 cases were studied along with the surgical treatment given.

Result:

Will be discussed during presentation.

Conclusion:

The knowledge of anatomy has immensely helped in the early surgical intervention of patients and thus improves this prognosis.

328. Kaufman Syndrome - A case report with multiple congenital abnormalities

SS Hattangdi*, Tanveer Akhtar**

TNMC & BYIL Nair Ch. Hospital, Mumbai.

In literature, very few cases are reported with distinct dismorphic group of congenital abnormalities mentioned as Kaufman syndrome. Phenotypically the case may be male of a female.

Such a case is discussed in this presentation with its clinical features, investigations, surgical intervention, prognosis, embryological basis and genetic etiology.

This two days old female baby weighting three kgs, full term normal delivery presented with distended abdomen-congenital hydrometrocolpos, congenital heart defects and postaxial polydactyly was brought to the pediatric surgery department, Nair Hospital, Mumbai. The Laparoscopic emergency treatment given and future corrective surgery is also discussed in the presentation.

329. Estimation of the Gestational Age of the Foetus in the First Trimester of Pregnancy by Measuring the Crown Rump Length by Ultrasound

Paliwal S*, Hattangdi SS. **

TNMC & BYL Nair Ch. Hospital, Mumbai.

Due to rapid growth of the foetus in the first trimester, with biological variation exists which may affect the size of the foetus. A direct and linear correlation exists between the crown rump length of the foetus and the gestational age, which relates with an accurate menstrual history.

Various studies in the past were carried on European population and European nomograms were prepared. In this study 50 Indian women in the first trimester who strictly met the selection criteria were scanned using linear array real time ultrasound, machines and the crowns rump length was measured up to 13 weeks of gestational age.

On regression analysis of the date collected, an equation was derived whereby in the absence of reliable menstrual history, the crown rump can be measured and used to calculate the gestational age.

The results of this study were compared with the studies in the past and it was found that they are in close agreement and the European nomograms can be used to estimate the age of the foetus in Asian and Indian population.

330. Evolving Concepts in the Etiology of Congenital Inguinal Hernia in Children

Ambiye*, Navin Vishwnath **

TN Medical College and BYL Nair. Ch. Hospital, Mumbai.

Introduction

A patent processus vaginalis is the principle factor in the development of a congenital inguinal hernia. The precise time of its obliteration postnatally is not known. It may remain patent in 25 percent of the boys at birth but only ten percent of them manifest as congenital inguinal hernia. The remaining 15% may have a patent processus vaginalis throughout life without clinically apparent inguinal hernia. This indicates that there are other factors involved in the etiology of congenital inguinal hernia. One of them could be the open internal inguinal ring.

Aims: To Study 1) The role of internal inguinal ring in the development of congenital inguinal hernia. 2) How the knowledge of anatomy has helped in the repair of inguinal hernia by laparoscopy.

Material and method:

A total of 167 patients with inguinal hernia, male: Female ratio being 129:38, age group from 6 weeks to 12 years over a period of four years were treated by laparoscopic technique at the Pediatric Surgery department, Nair Hospital, Mumbai.

Results:

a) Anatomical variations of the internal inguinal ring with respects to size, shape, openness noted.
b) The contra lateral processus vaginalis was patient in 16.8 percent in right and 48 per cent in left congenitalinguinal hernias.

Conclusion:

Laparoscopic repair of inguinal hernia gives an insight into:

1 a. The Anatomical variations of internal inguinal ring.

b. The issues of bilaterality

2. The openness of internal inguinal ring is an important determining factor in the occurrence of congenital inguinal hernia.

331. Acardius Acephalus Monster - A case Report

Usha Dhall. Kayalvizhi I& Sarita Magu *

Pt. BDS, PGIMS, Rohtek.

A case of an acardius acephalic monster is described. This case report is based on morphological and histological confirmation. Fetus acardius is a parasite for its vascular circulation from the donor twin. The twin reversed arterial perfusion syndrome is an extremely rare manifestation of feto fetal transfusion in twin pregnancy where the affected twin receives vascular supply retrogradely from the healthy twin. The present case, acardius acephalous presented with several malformations in association with absence of upper extremity. Placenta was monochorianic and diamnoitic. Umbilical vessels of the twins showed anastomosis on the surface of placenta. This case was diagnosed prenatally by ultra sound examination. The fetus acardius was covered with thick dark brown skin that was soft and oedematous. Both the lower limbs were near normal except for equinovarus deformity of the foot. There was no head, the top of the monster coming to a blunted end. External genitalia were ambiguous. In the upper pole of monster there were subcutaneous cysts containing clear yellow fluid. The heart and foregut derivatives were absent.

332. Sexual Dimorphism in Foot Print Ratio

Mohd. Anees Ur Rahman, A. Siddiqui, AA Mahajan, AG Shroff

Government Medical College, Aurangabad.

Aim: to find out differences in foot print ratio of male and female.

Material & Methods:

Footprints of 100 males and females were taken form the undergraduate students and staff members of Govt. Medical College, Aurangabad. The age group of these persons was in the range of 17 to 50 years. Footprints were taken by the ink method. Prints were analyzed statistically and standard footprint ratio was obtained by following formula.

Foot Print Ratio = Maximum width of the footprint in mm divided by maximum length of the footprint in mm.

Results and conclusion:

Footprint ratio for male was obtained 0.370 & for female 0.364. Foot print ratio was slightly higher in males than females. This slight increase in foot print ratio was also found statistically significant. This method can be used as accessory tool for identification of sex in medicolegal cases.

333. Macrocephaly in Autism

Mini Kariappa*, Shobha Srinath**

Jubilee Mission Medical College, Thrissur, Kerala*, CAP Unit, Dept. of Psychiatry, NIMHANS, Bangalore.**

Autism is a neurodevelopment disorder, which is characterized by language delay, stereotyped behavior and social deficits. Macrocephaly (head circumference 2SD or more above the mean) correlate with clinically significant overgrowth of the brain.

According to previous literature, macrocephaly was considered one of the most common physical features seen in Autism.

Aim of the study was to find out the number of patients with macrocephaly and to compare them with date received from elsewhere in the world.

Materials and methods :

A hundred patients diagnosed to have Autism were subjected to measurements of occipitofrontal head circumference using an inch tape. The values obtained were recorded in centimeters and compared with standard Indian data. Assessment was made and then the data scrutinized statistically.

In our study, we have found that in Indian patients with Autism, macro cephaly was rare rather than the rule. Data will be presented during the conference.

334. Comparative Analysis of Localization of Placental Alkaline Phosphatase in Placenta of Normotensive and Hyeprtensive Mothers.

Preeti Shrivastava, Gyatri Rath and S. Salhan.*

Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi.

Placental alkaline phosphatase (PALP) has been reported to be secreted in second and third trimester of pregnancy by placental syncitiotrophoblasts. In this study, attempt has been made to find the difference in localization or intensity of PALP in placenta of normotensive and hypertensive mothers. Forty placenta were collected from normotensive and hypertensive mothers from the department of obstetrics and gynecology of our hospital. Fresh tissues from maternal side of placenta were collected and 4-micron thick cryostat sections were mounted on slide with help of glycerin jelly. PALP activity was noticed only in syncitiotrophoblastic membrane in all control and experimental cases. Cytotrophoblast, stroma and capillaries in placental villi did not show any PALP activity and presented a beached appearance. In all experimental groups, dense localization of PALP was present in the syncitiotrophoblastic membrane as compared to control ones. At higher magnification, at some places PALP was also localized in outer and inner cell membrane of syncitiotrophoblast. This bilaminar arrangement was discernible in the experimental group. the intensity of localization was proportional to the rise in the maternal blood pressure.This high intensity of PALP in syncitiotrophoblast of placenta of hypertensive mothers may be due to increased synthesis of this enzyme by syncitiotrophoblast. This could be a compensatory mechanism adapted by hypertensive placenta, to combat the hazardous effect on developing fetuses of these ailing mothers.

335. A Comparative Invitro Study of Human Amniotic Epithelial Cells in Different Growth Environment

*R Ramesh Kumar, KV Omprakash, P. Ravisankar, and R.Muthusamy.,

Dr. ALM Postgraduate Institute of Basic Medical Sciences, University of Madras, Chennai

The human amniotic epithelial (HAE) cells are multipotent embryonic stem cells and are immunologically naïve (Sakurugawa 1996). Kakishita K et al (2003) has shown that HAE cells secrete neurotrophins such as brain derived neurotrophic factor (BDNF) and neurotrophin - 3 (NT 3), both of which exhibit trophic activity on dopamine neurons in rats.

The multiplication of HAE cells in invitro and invivo and their growth curve need to be studied in order to maintain HAE cell line for research and possible clinical application.

HAE cells were cultured in two culture media RPMI 1640, MEM, substituted with different proportion of the Fetal Bovine serum and were maintained at 37 degrees C 5% CO2 incubator. The cultured cells were harvested at different time period and density count of the cells were done and recorded. For cell cycle study the HAE cells were treated with colcimide solution after 3 days of culture and the cell smears were stained with Geimsa stain.

336. Adherence of Umbilical Cord from the Umbilicus to the Forehead along the Anterior Midline - Associated anomalies

Narendra, K. Rajendra Babu, Sujatha Kiran

Kamineni Institute of Medical Sciences, Sreepuram, Narketpally, Nalgonda Dist., AP

A 26-week-old foetus was brought to department of Anatomy, Kamineni Institute of Medical Sciences, Narketpally for study. The umbilical cord was noted extending from the umbilicus along the midline superiorly up to forehead, showed thoracic, neck, face and brain anomalies with Talipes equinovarus. The details will be discussed.

337. Variation in Branches of Axillary Artery and Communication Between Musculocutaneous and Median nerves - A case report.

Mehra Bhoir,

TN Medical College & B.Y.L.N.CH. Hospital, Mumbai.

Variations in the branches of the axillary artery and the brachial plexus are of interest to the anatomist and surgeon both.

A routine dissection of the upper limbs of an adult male cadaver revealed the following:

1. The second part of the right axillary artery gave large common stem which gave the following branches: · Lateral thoracic · Thoracodorsal · Circumflex scapular · A branch, which runs posteriorly superior to the tendon of teres minor.
The other branches of the right axillary artery were normal; however, its third part did not give the subscapular artery. The branches of the left axillary artery were normal.

2. The musculocutaneous nerve gave a communicating branch to the median nerve in both arms. Branches and distribution of both these nerves were normal.

3. The medial cord was not medial to the 2nd part of the axillary artery, but posterior to it. The significance of these findings will be discussed during the presentation.

338. Division at the Origin of Abductor Pollicis Longus Muscle An Anomaly - A report.

Dr. D.A.V.S. Sesi, Prof C. Bhagya Lakshmi

Dept. of Anatomy, Rangaraya Medical College, Kakinada (East Godavari Dist. AP)

Abstract: During routine dissection of right upper limb, division of abductor pollicis longus muscle at its origin was observed. These parts united and formed a common tendon and inserted on radial aspect of first metacarpal base. Knowledge of this variation is useful for orthopedic surgeon while performing decompression in Dequervain's tenosynovitis and in placement of plate and screws in fracture fixation of radius and ulna and in dissecting the insertion of pronator teres without confusion while performing triple tendon transfer in radial nerve palsy.

Key words: Abductor pollicis longus muscle, Dequervain's tenosynovitis, triple tendon transfer, radial nerve palsy.

339. Demonstration of the Effect of Prolonged Stress on Albino Rat

Mukerjee B. Prof, Sharbari Basu. Asst Prof.

Department of Anatomy & Biochemistry, Mahatma Gandhi Medical College & Research Institute, Pondicherry.

Abstract: Normal healthy male albino rats were subjected to intermittent (12-hourly) stress by inflection of electrical foot shock for 6 weeks (day 28 to day 70). Thereafter, for 3 weeks (day 70 to day 98) the same rats were observed for post stress effect. Blood glucose and adrenal ascorbic acid were recoded in both stress and post stress periods.

Results of the two parameters at weekly intervals will be presented to show that electrical foot-shock effects the elevation of blood glucose and depletion of adrenal ascorbic acid levels in the body but withdrawal of prolonged stress brings back the normal health.

340. Human Quadricuspid Pulmonary Valve

Dr. K. Yoganarasimha*, Dr. Narga Nair and Vanisri Prabhu,

Department of Forensic Medicine* and Anatomy, Kasturba Medical College, Manipal

Abstract: Autopsy of a human adult, male-aged 27 years revealed the following unusual congenital cardiac anomaly. The patient had succumbed to septicemia following 75 % burns. His heart showed a pulmonary valve consisting of 4 equal sized semi lunar cusps. Each cusp measured 1.5 cm transversely at its base, and 1.5 cm in depth. The endocardium was normal. The pulmonary trunk measured 6 cm in diameter, while the right ventricular wall measured 1 cm in thickness. The reported incidence of the above-mentioned observation, along with its clinical implications will be presented at the conference.

341. Computed Tomographic Study of Nasal Cavity

Dr. K. sudha Rani PG, Dr. SS. Sarada Devi, Prof. & HOD, Dr. TV Ramana Chary, Prof.

Department of Anatomy, Osmania Medical College, Hydeanbad

Abstract: Sinusitis is one of the most distressing agonies of makind. The cause for sinusitis is the anatomical variations of the nasal cavity. There are many anatomical variations, which cause sinusitis. Among these, deviated nasal septum is the commonest anatomical variation. One of the important and latest diagnostic tool is the computed tomographic scanning (CT), to find out the anatomical variations. CT imaging will highlight the variants and gives clue to the ENT surgeons prior to the surgery. Therefore, it is the important surgical road map for surgeons. A CT study was undertaken in 100 cases for normal variants in sinusitis patients and some of the results discussed.

342. Inferior Thyroid Artery and its Relation to Sympathetic Chain in Full term Fetuses

Md. Fazall Unnisa, Smitha Singh, Soveeta Souravee Rath, Dr. BT Narayana Rao & Dr. S. Swayam Jothi,

Katuri Medical College and Hospital, Guntur

Abstract: Inferior thyroid artery is a branch of thryo cervical trunk, and its relationship to sympathetic chain was observed in 55 dead born full term fetuses.

The relationship of the inferior thyroid artery to the sympathetic chain varies. The artery passes behind or in front of sympathetic trunk or through it in minor percentage of cases.

In 23 fetuses (41.82%), the inferior thyroid artery had a course behind the sympathetic chain on both the sides and in 8 fetuses in front of the sympathetic, chain on both the sides (4.55%).

In 6 of the fetuses (10.9%), on the right side the artery was anterior and on the left side posterior to the sympathetic chain. In 12 other (21.82%) the artery was anterior to the sympathetic chain on the left side and posterior to the sympathetic chain on the right side. In 3 of the fetuses (5.4%) the inferior thyroid was passing through sympathetic chain on the right side.

In 2 of the fetuses the left inferior thyroid artery was absent (3,.64%) and the right side artery passed behind the sympathetic chain. In 1 fetus (1.82%) the right inferior thyroid artery was absent and the left side inferior thyroid artery passed anterior to the sympathetic chain.

The knowledge about inferior thyroid artery is essential for thyroid surgery and while doing cervical sympathectomy.

343. Extensor Indicis Brevis Manus - A case report.

Dr.Mrudula (PG) , Dr. Sreelata(Prof.) , Dr. Anantha Kumari (Asst. Prof.)

Osmania Medical College, Hyderabad.

Abstract: The extensor group of muscles on the back of the forearm comprises of superficial and deep groups. Brachioradialis, extensor digiti minimi, extensor carpi radialis longus, extensor carpi radialis brevis,extensor digtorum, extensor carpi ulnaris anconeus are included in superficial group. Deep group includes supinator abductor pollicis longus, extensor pollicis longus, extensor pollicis brevis, and extensor indicis. Extensor indicis originates from the posterior surface of ulna and adjacent interosseous membrane. An extra muscle belly along with this muscle is observed in a male cadaver aged about 60 years. This extra belly arises from ulna just below the origin of extensor indicis. Its insertion, nerve supply, blood supply and importance are discussed

344. Venous Drainage of Foetal Oesophagus

Manasa Veena , Sowmya Sudha Kothapalle, Dr BT Narayana Rao & Dr.S Swayam Jyothi

Katuri Medical College & Hospital, Guntur.

Abstract: In a detailed study of oesophagus in 47 full term stillborn fetuses, the following observations regarding venous drainage of the oesophagus were made.

Cervical part: In all the fetuses, the inferior thyroid veins were draining the cervical part. Vertebral veins were receiving the veins in two foetuses and the right subclavian vein in six fetuses.

Thoracic Part: Oesophageal veins were draining into the azygos system in all the fetuses and into the right subclavian vein in five fetuses and into left vertebral vein into two fetuses.

Abdominal part: The oesophageal veins from the abdominal part drained into left gastric veins in all the fetuses and into the inferior phrenic veins in 31 foetuses.

345. Extrra Heads of Biceps Brachii

Jadhav. SD; Joshi. SD; Joshi SS and Athavale. SA.

Department of Anatomy, Rural Medical College, PIMS, Loni. Ahmednagar Dist.

Abstract: As a continuation of our earlier study on extra heads of biceps brachii we dissected 130 upper limbs over a period of 3 years. The level of origin, the number of heads and site of insertion of these extra heads were noted. In 10.76% cases biceps brachii showed additional heads. In majority, there were three heads of biceps brachii; only in two limbs, four heads of biceps brachii were seen.

346. Effect of Stress on the Rat Adrenals with Reference to Weight and Volume of Adrenals and its Cortical Zones

Mukerjee C, Professor* Kavitha S, Assitant Professor**

Department of Anatomy*Mahatma Gandhi Medical College and Research Institute, Pondicherry

** DY Patil Medical College, Navi, Mumbai

Abstract: Male albino rats were subjected to electrical foot-shock stress from end of four weeks to end of 10 weeks. Body weight and weight of adrenal gland and volumes of the zona glomerulosa, zona fasciculata and zona reticularis were recorded morphometrically.

After the prolonged intermittent regular stress period, the same parameters were observed for three weeks in the post-stress free period of the animal's life. The results and their significance will be presented and discussed.

347. Levator Glandulae thyroideae - A case report

T. Arun Kumar, D. Sree Lekha, Sravani Kolla, Dr. BT Narayana Rao, Dr. S. Swayam Jothi.

Katuri Medical College & Hospital, Guntur

Abstract: Any muscular reinforcement of thyroid fascia is regarded as a levator of the thyroid (Von Lang and Wachsmith 1962).

During routine dissection in 10 cadavers, we came across levator gandulae thyroideae in one male cadaver on the left side of the isthmus close to the left lobe of the thyroid gland. It was extending from the left end of the isthmus of the thyroid gland to the hyoid o\bone passing superficial to thyrohyoid and partly merging with thyrohyoid. Near the thyroid gland it appeared ligamentous, near the thyrohyoid became muscular, was appearing like one of the ribbon muscles, and received a twig from ansa cervicalis.

Based on its insertion and innervations, and according to the classification of Eisler (1900), this muscle may be considered as a longitudinal split from the thyrohyoid.

As reported by Faysal et al (1996) in our case also we saw a branch arising from ansa cervicalis supplying it and hence it belongs to infrahyoid musculature

Key words: Levator glandulae thyroideae, Ansa cervicalis, infrahyoid muscle.

348. Anterior Communicating Artery- Variations

Dr. M. Ranadheer Reddy, Dr. N. Jayasree, Dr. TK. Rajasree, Dr. N. Ratnakar Rao & Dr. G. Ravindranath

Kakatiya Medical College, Warangal.

Abstract: Fifty brains were studied in detail, out of which 40 were fresh specimens after removal from cranial cavities in mortuary, and 10 specimens after removal from cranial cavities in mortuary, and 10 specimens were fixed in formalin for routine dissection in Anatomy department.

Different patterns of formation of circle of Willis were observed, of which anterior communicating artery had variations. All the variations will be discussed in detail along with comparative study in other mammals.

349. Posterolateral Tunnel on Atlas: Possible Linkage with Barre Syndrome.

Mahdi Hasan, Sanjiv Shukla, Ashok Sahai

Department of Anatomy, King George's medical University, Lucknow

Abstract: A bridge or tunnel on the posterior arch of atlas may deflect and compress the vertebral artery and its accompanying sympathetic plexus. The condition is clinically significant. From the functional standpoint, interference with the important circulation to the hindbrain from pressure upon, or chronic irritation of the sympathetic plexus surrounding the vertebral artery is often manifested by dizziness, vertigo, tinnitus, many visual symptoms and nystagmus. Observations were made on 500 dried adult north Indian atlas vertebrae of either sex, prepared by maceration, from the collection of the department of anatomy, KGM University, Lucknow and 30 cadaver dissections. Photographs of specimens showing ponticuli or tunnels were obtained. Cross sectional areas of tunnels as well as the foramen transversaria of atlas, vertebrae were evaluated. Surrogate experiments were undertaken using a rubber tubing (diameter 4.3mm) representing the mean diameter of vertebral artery was passed through the foramina transversaria of axis and atlas vertebrae belonging to the same cadaver negotiating the lateral /posterior ponticuli or tunnels. The atlas was first rotated to the left and then to the right and resultant excursion of the vertebral artery and consequent change in diameter were noted. Rotation of atlas on axis by 30 degrees caused narrowing of the opposite vertebral artery. This kinking progressed up 45 degrees i.e. to the normal limit of rotation. The run through tunnel further compromises the caliber of the already stretched vertebral artery. Peri arterial sympathetic filaments traversing the posterolateral tunnel may be irritated during neck rotation causing vasospasm of vertebral artery and intermittent ischemia of the vertebro basilar territory. Impairment of vertebral artery flow caused by extrinsic lesion has been recently evaluated by Vaccaro et al. (1998) using magnetic resonance angiography (MRA). A chronic irritation of sympathetic filaments accompany vertebral artery has already considered cause of Barre syndrome (Nagasimha, 1979; J Neurosur. 32:512-521). Vaccro AR Klein, Gr,. Flanders AE et Al (1998) Spine 23: 789-795.

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