Morphology and morphometric analysis of stromal capillaries in full term human placental villi of smoking mothers: an electron microscopic study.

OBJECTIVES: The capillaries of placental villi play a very important role in the feto-maternal exchange of gases and nutrients. A morphological change in their structure may lead to the impairment of placental function. In this study an attempt has been made to find out the morphological and morphometric features of the capillaries in full term placental villi of non smoking mothers as well as active and passive smoking mothers under an electron microscope. MATERIALS AND METHODS: A total number of 163 placentae from active, passive and nonsmoking mother (n = 61+42+60) were processed for electron microscopic study. The ultrathin sections were examined under electron microscope and images were recorded. Morphometry and statistical analysis were carried out with the help of software. RESULTS: The study revealed that the endothelial cells of stromal capillaries of the placental villi were oedematous and the cytoplasm was rich in dilated endoplasmic reticulum, mitochondria, fibrils and fine filaments in both groups of the smokers' placenta in comparison to control. Morphometric analysis showed a significant reduction in the perimeter of the stromal capillary of the tertiary villi of placenta in both active and passive smokers from mean value of 71.65 ± 47.82 µ to mean value of 59.77 ± 29.72 µ (p = 0.07) and 49.49 ± 20.94 µ (p = 0.0005) respectively. In case of passive smoker, area of the capillary (µm²) reduced significantly (p = 0.00004) from mean value of 266.29 ± 331.86 µm² to 116.64 ± 83.62 µm² whereas the number of capillary per villus increased significantly (p = 0.046) from mean value 2.42 ± 1.84 to 4.2 ± 3.16. The thickness of basement membrane of the endothelial cells of stromal capillaries of the placenta increased significantly in active as well as passive smokers (p = 0.00001). CONCLUSIONS: The ultrastructural changes noticed in the endothelial cells of placental villi may be due to hypoxia resulting from tobacco consumption either in active or passive form by the pregnant mothers. Thus, targeted therapy may be implicated for hypoxia, which is one of the major cause of the life threatening disorders of pregnancy.

Unusual grooved styloid process in a human skull: morphological details and clinical implications.

The temporal Styloid Process is an important anatomical landmark for surgeons while performing skull based surgery, for anaesthetists while injecting local anaesthetic solution and for radiologists during interpretation of CT and MRI scans. Knowledge of morphological variations of the styloid process such as a unique groove on its posterior aspect as seen in the present case not only has great clinical implications but is also of academic interest. The present article describes in detail an unusual groove in the styloid process with an additional anterior angulation at its tip. The morphological features, embryological basis and clinical relevance is discussed in details.

Clinico-anatomical report of a rare anomalous disposition of brachioradialis: a possible site for compressing superficial branch of radial nerve.

The topography of the neurovascular structures in the antebrachium assumes relevance during surgical approaches in this region. The aim of the present case report was to describe the clinical importance of a bifid brachioradialis with the superficial branch of radial nerve entrapped between the two slips. The insertion of the two slips was unusual and merits a special documentation in anatomy literature. We propose that the superficial branch of radial nerve could possibly be subjected to compression resulting in the neurological symptoms of varying magnitude. A precise working knowledge of the nerves and muscles of the antebrachium and elbow region is vital for the operating surgeons to avoid post-operative complications.

An accessory venous channel of abdomen: an anatomical insight.

Variations in the venous architecture of the retro peritoneum is not uncommon, mostly those of Inferior Vena Cava (IVC). In this report we describe an extremely rare anatomical entity, where the IVC is formed by the union of the right common iliac vein and the left internal iliac vein. This is associated with a parallel venous channel which is the upward continuation of the left external iliac vein, which finally drains into the IVC at the level of renal veins. Awareness of such unusual variation of abdominal venous channels is helpful during retroperitoneal and laparoscopic surgeries of the abdomen, in staging of abdominal neoplasm, in radiological interpretation as well as therapeutic intervention in cases of recurrent pulmonary embolism.

An unusual bifid origin of 1st lumbrical muscle of hand: anatomical and clinical perspectives.

Lumbrical muscles are pivotal in execution of fine skillful movements of the hand. Anomalies in their morphology are not uncommon. We report an exceptional bifid origin of first lumbrical muscle of the left upper limb, discovered incidentally in gross anatomy dissection class. The 1st lumbrical was observed to comprise of two heads, the accessory one arising from the tendon of flexor digitorum superficialis of the index finger and the other main belly taking origin as usual from flexor digitorum profundus. The two heads joined to form a common muscle belly and were inserted normally in the dorsal digital expansion. The report highlights the surgical and phylogenetic significance of such variation. Additionally, notification of such muscular variants assumes importance in the event of surgical interventions in this region. Moreover, the anomalous origin, length and volume of the first lumbrical are important parameters for the outcome of operations on the carpal tunnel.

Bitendinous insertion of abductor pollicis longus coexistent with a rare accessory antebrachial muscle: clinico-anatomical considerations.

Reports of the anomalous orientation of the musculature of the fi rst osseofi brous extensor compartment of the wrist are not uncommon; especially that of Abductor Pollicis Longus (APL) muscle. Such variations can be explained phylogenetically; owing to a synonymous occurrence in primates. In this report, we highlight a unique variation in the APL muscle of the left side in an adult male cadaver. The present anomaly consisted of a bitendinous insertion of APL on the base of the fi rst metacarpal, complemented by an additional muscle belly arising from the fascia covering Extensor Carpi Radialis Longus (ECRL). Such an accessory muscle is speculated to greatly alter kinematics at the wrist and thumb, thus affecting the daily activities of the hand. Such multiple tendons of APL are benefi cial clinically in providing additive support to the fi rst carpo-metacarpal joint and act as effective aids in tendon transfers and reconstructive procedures of the hand. In contrast, they can pose as surgical hazards in post-operative cases of De Quervain's disease. Thus, it is imperative for surgeons and clinicians to acquire a prior substantial knowledge of such anatomical variants of APL before attempting any treatment of this region.