Microsurgical Anatomy of Supraclinoid ICA in North West Indian Population: A Cadaveric Study.

Background: To study the microsurgical anatomy of supraclinoid ICA, the size and number of perforators, any anomalies in normal anatomy of ICA, its branches and surrounding structures in North West Indian population. Materials and Methods: Twenty cadaveric brain dissections were performed under operating microscope (Carl ZeissNC31). Sylvian fissure was meticulously dissected from distal to proximal. Anterior clinoid process (ACP) was drilled intradurally using M-80 pneumatic drill. Vessels, their branches and perforators were dissected with measurement of their length, diameter and number. Supraclinoid ICA was dissected till its bifurcation into anterior and middle cerebral arteries. The length of falciform ligament was also measured. Results: The length of ophthalmic segment was largest varying from 5.5 to 13.0 mm (average 9.75mm).The communicating segment was the shortest varying from 1.5 to 6.0 mm (average 3.2mm). The number of perforating arteries excluding the OphA, PComA and AChA arising from C4 varied from 3-10(average 6). The maximum perforators were from Cho Seg and least from Com Seg. Conclusion: The overall anatomical details of supraclinoid ICA in North West Indian population were comparable to existing literature.

Anatomy & distribution of coronary arteries in pig in comparison with man.

BACKGROUND & OBJECTIVE: The suitability of pig as an animal model for research in coronary artery disease is well established. As coronary arteries (CAs) of the pig are reportedly closely resemble those of man. We investigated the CAs of the pig (Sus scrofa) and study differences between the two, if any. METHODS: The origin and pattern of the coronary arteries were studied in the hearts of 30 fully grown pigs obtained from a slaughter house in Chandigarh (India). The openings of the CAs were identified at the commencement of the ascending aorta. The arteries were washed with acetone by introducing appropriate sized cannulae in their ostia. A 20 per cent solution of cellulose acetate butyrate (CAB), a plastic material, dissolved in acetone was injected in the CAs. The hearts were fixed in 10 per cent formalin solution for three to four days after which the CAs and their branches were dissected. RESULTS: Both coronary arteries arose from the aortic sinuses below the supravalvular ridge in all the cases. Sinuatrial nodal artery (SAN) arose from the RCA in 70 per cent and from the circumflex artery (CX) in 30 per cent of instances. There was RCA dominance in all hearts of the pig. The atrioventricular nodal artery (AVN) and the posterior interventricular artery (PIV) were branches of RCA. The coronary arterial circulation in the pig was found to be similar to that in human. INTERPRETATION & CONCLUSION: By and large the coronary arterial pattern of the pig was similar in that of the humans. We can conclude that the heart of a pig can be used for experiments but differences have to be kept in mind.

Gross anatomy of the retrohepatic segment of the inferior vena cava in northwest Indians.

BACKGROUND AND OBJECTIVES: Information regarding the size and position of the ostia of veins opening into the retrohepatic segment of inferior vena cava (HIVC) in northwest Indians is not available. Knowledge of gross anatomy of this segment is of importance in cases of segmental resection of the liver involving the groove for inferior vena cava (IVC) and when performing selective hepatic venography. We carried out this study to provide information on gross anatomy of HIVC in northwest Indians. METHODS: Livers were obtained from 500 adult autopsy subjects. The HIVC was opened posteriorly by a vertical cut and its circumference at the upper and lower cut ends was measured. To study the position of the ostia of the hepatic veins, HIVC was divided transversely into upper, middle and lower thirds. The anterior and anterolateral walls of HIVC were also divided into four equal parts longitudinally. The venous ostia were classified according to the size of their openings. In addition, in 100 livers the openings were injected with a 20 per cent solution of cellulose acetate butyrate (CAB) in acetone and veins were dissected. RESULTS: The HIVC extended upwards and to the left either obliquely (66.4%) or by describing a gentle curve (33.6%) in its upper half or upper third. Its average length was about 71 mm. Mean diameter at the upper cut end was about 19 mm. The posterior aspect of the upper half or upper one third of HIVC was covered by an extension of the caudate lobe completely (4%) or incompletely (7.4%). The ostia of the left, middle and right hepatic veins were large (>10 mm) and were located in the upper third segment of HIVC. In 87 per cent of specimens the left and middle hepatic veins had a common opening on the left anterior area. The ostium of the right hepatic vein was present in the right anterior area. INTERPRETATION AND CONCLUSION: In conclusion, our study provided gross measurements of HIVC in northwest Indians. A knowledge of the anatomy of HIVC and hepatic venous ostia will help the clinician interventional operator in planning the treatment by choosing a balloon of correct size and at correct site. The measurements helps in determining the fall in portal pressure with pharmacotherapy given for the prevention of variceal bleed.

Filiform papillae in the mucosa of the human vaginal wall.

BACKGROUND & OBJECTIVE: While giving the gross anatomy of the mucosa of the vagina, textbooks of Anatomy and Obstetrics and Gynaecology describe the presence of a median longitudinal ridge on its anterior wall (columna rugarum anterior) and another similar ridge (columna rugarum posterior) on its posterior wall is described, and transverse rugae separated by sulci of variable depth, extend bilaterally from these ridges. While conducting autopsy of female cases the routine examination of vaginal mucosa did not show the presence of longitudinal ridges. In addition, some small areas bearing filiform papillae were seen in the lower third of the vagina in young subjects. As these papillae have not been described earlier, it was decided to study them in detail using scanning electron microscopy. METHODS: A total of 215 vaginal specimens were studied. At autopsy the vagina was slit open on the lateral sides up to the upper ends of the lateral fornices. The anterior vaginal wall was turned up over the uterus and mucosa of both walls examined macroscopically. In 16 subjects, small pieces of vaginal mucosa bearing filiform papillae were cut out and processed for examination under scanning electron microscope (SEM) and a light microscope. In addition, vaginae of 55 married women (20-40 yr age) with complain of lower abdominal pain or infertility were examined particularly for the median longitudinal ridges on the vaginal walls. RESULTS: At autopsy, the two median longitudinal ridges were not seen in any instance. Small variable areas of the lower third of the vagina showed the presence of filiform papillae on the two walls and at sides; they were prominent in the young individuals and tended to become absent in multipara and in old age. They were 2 to 3 in number on each wall. Histologically the papilla showed a core of highly vascular connective tissue covered by non-keratinized squamous epithelium. Immunoperoxidase staining with S-100 showed a large number of small nerve fibres in the subepithelial tissue which seemed to be more than in the surrounding areas not covered with papillae. INTERPRETATION & CONCLUSION: Anterior and posterior median longitudinal ridges were not seen on the vaginal mucosa in the autopsy specimens. In all autopsy specimens of young subjects between the ages of 15 and 40 yr, variable areas bearing filiform papillae were observed on the mucosa of the lower third of the vagina. Further studies need to be done to throw light on the role of these papillae.

Dimensions & weight of the cricoid cartilage in northwest Indians.

BACKGROUND & OBJECTIVES: Information on the diameters of the cricoid cartilage in northwest Indian children and adults is scanty. As injury to the mucous membrane of the larynx could occur when an endotracheal tube or a laryngoscope, selected on the basis of western data, is introduced into the larynx of patients. It was, therefore, considered necessary to study the diameters of the cartilage. METHODS: Cricoid cartilages were obtained from 100 male and 58 female adults, 25 male and 25 female children and adolescents on whom medico-legal postmortems were done. In addition, cartilages of 25 dead newborns were studied. Measurements taken included height and thickness of the lamina and anterior arch, anteroposterior and transverse diameters, circumference, length and breadth of the cricoarytenoid facets and angle between their long axes. RESULTS: With advancing age, there was an increase in the weight and in most of the measurements of the cartilage in the newborns, children and adolescents, and adults. Sexual dimorphism in weight and measurements became evident only after the age of 17 yr. INTERPRETATION & CONCLUSION: The weight and other measurements of the cricoid cartilage in northwest Indians are smaller than those recorded in the western populations. The tubes of appropriate size should therefore be used for intubation in different age groups particularly in children based on measurements taken in Indians. Use of the western measurements/standards for this purpose is not recommended. In case of a highly decomposed body, the measurements and weight of the cartilage may be useful in gender determination.