Effect of vitamin E administration on histopathological changes in rat testes following torsion and detorsion.

INTRODUCTION: Testicular torsion is a medical emergency, especially in male neonates and adolescents. It is a common clinical outcome and a significant urological issue. From the literature, it is evident that the use of antioxidants in the prevention of testicular reperfusion injury following detorsion is conflicting. This study was conducted to investigate the role of vitamin E in testicular reperfusion injury following detorsion. METHODS: Male Wistar albino rats were divided into Groups I, II, III and IV. Only Group IV rats were pre-treated with vitamin E 100 mg/kg body weight for 30 days. Ischaemia was induced manually by rotating the rat testis to 720 degrees clockwise and counter rotating for reperfusion. The testes were fixed in Bouin's fluid and processed for histopathological examination. RESULTS: A significant decrease in the standard tubular diameter and epithelial height was observed in Group III rats compared to those in Groups I and II. However, the seminiferous tubules in Group IV rats showed recovery in the standard tubular diameter and epithelial height when compared with the untreated control groups. CONCLUSION: The results showed that vitamin E, when administered before torsion of the spermatic cord in rats, provided significant protection against acute testicular torsion and detorsion injury.

Anatomy of plantaris muscle: a study in adult Indians.

AIM: The plantaris muscle (PM) and its tendon is subject to considerable variation in both the points of origin and of insertion. The present study was carried out to fi nd the different types of origin, insertion and possible variations of the PM in the population of southern costal region of India. MATERIALS AND METHODS: 52 embalmed (Formalin fixed) cadaver lower limbs of 26 males (age ranged 48-79 years, mean age 68 years) were dissected, to study the origin and insertion of PM. Various dimensions (length and width) of plantaris muscle belly and its tendon were also measured. RESULTS: Three types of origin and equal number of insertion were noticed in the present study. The PM took origin from type I: Lateral Supracondylar ridge, Capsule of Knee joint and Lateral head of gastrocnemius in 73.07% cases; type II: Capsule of Knee joint and Lateral head of gastronemius in 5.76% cases; type III: Lateral Supracondylar ridge , Capsule of Knee joint , Lateral head of gastrocnemius and fibular collateral ligament in 13.46% cases. The plantaris tendon was inserted into type I: to the flexor retinaculum of foot in 28.84% cases; type II: independently to the os calcaneum in 36.53% cases; type III: to the tendocalcaneus at various levels in 26.92% cases. In four lower limbs (7.69%) the plantaris muscle was completely absent. Additionally the length and width of the plantaris muscle and its tendon were measured to know any side difference. There were no statistically significant differences between the measurements of left and right side (p>0.05). CONCLUSION: Present study will help the surgeons while attempting various surgical procedures in and around the posterior aspect of knee involving plantaris.

An anomalous left external jugular vein draining into right subclavian vein: a case report

Knowledge of the varying drainage patterns of superficial veins of head & neck, in particular, jugular veins are not only important for anatomists but also for the surgeons operating at this level and to clinicians in general. The variations are important for interventional radiologists too who perform transjugular procedures, such as port implantations and the transjugular intrahepatic portosystemic shunt or selective venous samplings. Results of recent studies report that the superficial veins, especially the external jugular vein (EJV), is been increasingly utilized for cannulation to conduct diagnostic and therapeutic procedures. We report a very unusual presentation of external jugular vein on left side of an embalmed male cadáver. Embryological evaluations of the anomaly was done and compared with available literature which showed that the observed variation is rare.

El conocimiento de los diferentes patrones de drenaje de las venas superficiales de la cabeza y cuello, en particular, las venas yugulares no sólo son importantes para anatomistas, sino también para los cirujanos que operan a este nivel y para los médicos en general. Las variaciones son importantes también para los radiólogos intervencionistas, quienes realizan procedimientos transyugulares, así como implantaciones portales y portosistémicas transyugulares intrahepáticas o derivación venosa selectiva. Resultados de estudios recientes informan que la venas superficiales, especialmente la vena yugular externa, es cada vez más utilizada para la canulación en diagnósticos y procedimientos terapéuticos. Se reporta una muy inusual variación anatómica de la vena yugular externa del lado izquierdo, presente en un cadáver embalsamado de sexo masculino. Fueron realizadas evaluaciones embriológicas de la anomalía y se compararon con la literatura mostrando que se trata de una variación rara.

Anatomical variations of the thyroid gland: possible surgical implications.

INTRODUCTION: The organogenesis of the thyroid gland in humans is often disturbed, leading to a variety of morphological variations of the gland, such as hypoplasia, ectopy, hemiagenesis and agenesis. As the morphological variations are usually diagnosed incidentally during examination for other thyroid gland diseases, the true incidence is therefore uncertain. METHODS: This study was structured to investigate the gross anatomical features of the thyroid gland in 105 (88 male and 17 female) cadavers from the coastal belt of southern India, an endemic goitre region. RESULTS: The pyramidal lobe was present in 61 (58 percent) male cadavers, and 52 (49.5 percent) cadavers showed the presence of the levator glandulae thyroideae. 33 percent of the specimens studied showed agenesis of the isthmus. However, the accessory thyroid tissue was found in only one cadaver. CONCLUSION: This study highlights the various developmental anomalies of the thyroid gland, which forms a cornerstone to safe and effective surgery.

Relationship between the deep peroneal nerve and dorsalis pedis artery in the foot: a cadaveric study.

The aim of our work was to study the relationship between deep peroneal nerve (DPN) and dorsalis pedis artery (DPA) so that the frequency of these variations can be kept in mind by the angiographers and surgeons to ensure safe surgical approach during flap surgery. Ninety-two legs in 46 cadavers were dissected to study the relationship between DPN and DPA on the dorsum of the foot. The relationship of neurovascular bundle of the dorsum of the foot was classified into four types. Type I: division of the DPN distal to the midpoint between the two malleoli (observed in 26 limbs). In Type II, the division of the DPN was midway between the two malleoli (seen in 20 limbs). Both Type I and II are further divided into two subtypes (a and b) depending upon the crossing pattern of terminal branches of the DPN over DPA. In Type III, multiple branches of DPN were noted in two limbs. In Type IV, the looping pattern of DPN around the DPA was considered and was seen in eight limbs. Awareness of possible variations in the relationship of the DPA to DPN on the dorsum of the foot is important for vascular and reconstructive surgeons. Because it might help in decreasing confusion when considering treatment options like microvascular anastomosis in reconstruction of the leg.

Accessory brachialis muscle: a case report.

Variations of arm flexors are not uncommon with the exception of brachialis muscle. The role of brachialis is critical as it is the primary flexor of the elbow joint. Variations of brachialis are rare in literature. We present a case of an accessory-brachialis muscle (AcBr), found during routine cadaveric dissection. The AcBr originated from the lateral aspect of the brachialis muscle and lateral intermuscular septum. During its course towards the elbow, it crossed over the radial nerve and the distal tendon splits into two. The medial slip ran over the ulnar artery and merged with the deep fascia covering the pronator teres muscle, whereas lateral slip was inserted to the fascia covering the supinator. In the ipsilateral arm, an additional lateral cutaneous nerve of forearm (LCNF) was found coursing over the brachialis muscle medial to the LCNF. Clinical consideration of the present variations has been discussed. The present variation should be considered in the etiology of radial-tunnel syndrome (RTS).

Arched left gonadal artery over the left renal vein associated with double left renal artery.

Variations in the anatomical relationship of the gonadal arteries to the renal vessels are frequently reported. We present, on a male cadaver, an unusual origin and course of a left testicular artery arching over the left renal vein along with double renal arteries. The development of this anomaly is discussed in detail. Compression of the left renal vein between the abdominal aorta and the superior mesenteric artery usually induces left renal vein hypertension, resulting in varicocele. We propose that the arching of left testicular artery over the left renal vein could be an additional possible cause of the left renal vein compression. Therefore, knowledge of the possible existence of arching gonadal vessels in relation to the renal vein could be of paramount importance to vascular surgeons and urologists during surgery in the retroperitoneal region.

Third head of biceps brachii in an Indian population.

INTRODUCTION: The biceps brachii is one of the muscles of the anterior compartment of the upper arm. It is characteristically described as a two-headed muscle that originates proximally by a long head and a short head. The present study was carried out to find the occurrence of a third head of biceps brachii among a sample Indian population from the southern coastal part. METHODS: The arms of 42 cadavers were dissected and observed for variations in the origin and insertion of biceps brachii muscle bilaterally. The cadavers were embalmed and preserved in ten percent formalin. RESULTS: Among 42 arms studied, three had biceps brachii with three heads on the right side. The third head was of humeral origin, which inserted into the radial tuberosity by a common tendon with the long and short heads. The results of the present study compared with that of previous studies from medical literature shows that the occurrence of a third head of the biceps brachii muscle is relatively rare in Indians. CONCLUSION: Knowledge of the existence of the third head of biceps brachii may become significant in preoperative diagnosis and during surgery of the upper limb.

Vertebral body integrity: a review of various anatomical factors involved in the lumbar region.

UNLABELLED: The body of the vertebra can be affected in the majority of the conditions involving the lumbar spine. Multiple references, both books and periodicals, have been reviewed, and the anatomical factors responsible for the vertebral body integrity in the lumbar spine have been included under the following important areas, namely, morphology, development, genetics, microscopic examination using histology, structural architecture, blood supply, neuromuscular control, and biomechanics. INTRODUCTION: The anatomy provides a three-dimensional frame work to support the interaction between the physiological and pathological alterations. The body of the vertebra can be affected in a majority of acute or chronic conditions involving the lumbar spine. The etiology of these conditions is multifactorial, which has been dealt with in previous studies sporadically. This study aims to review and incorporate the important anatomical factors which can influence the integrity of vertebral bodies in the lumbar region and manifest as low back pain. METHODS: Multiple references, both books and periodicals, have been reviewed for the literature. Electronic databases, including Medline and PubMed, were used to collect the latest information. They were finally arranged in an anatomical framework for the article. An attempt has been made to cover these relevant issues in an integrated way in the article and have been structured into introduction, morphology, development, genetics, microscopic examination using histology, structural architecture, blood supply, neuromuscular control, biomechanics, and conclusion. The aforementioned anatomical aspects, some of which have received less attention in the literature, may be helpful to clinicians for restoring the mobility, stability, and load bearing capacity of the lumbar spine as well as planning better management strategies, especially for the chronic low back pain. RESULTS: In our article all the anatomical factors affecting the integrity of vertebral body, including the morphology, development, genetics, growth and ossification, blood supply, specifically in the lumbar region, have been described, which were not covered earlier. The limitations of this review is its wide dimensions; hence, there are fair scopes of missing many relevant facts, as all of them cannot be compiled in a single article. We have attempted to confine our views to different anatomical domains only, this is our second limitation. Additional studies are required to incorporate and discuss the uncovered relevant scientific details. CONCLUSIONS: The integrity of the body of the lumbar vertebra is multifactorial (Fig. 8). The vast spectrum of the anatomical domain influencing it has been summarized. The evolution of erect posture is a landmark in the morphology of human beings and the lumbar lordosis, which has also contributed to the gross design of the vertebral body, is one of the most important adaptations for axial loading and bipedal movements. The role of metamerism in the evolution of vertebrate morphology is repeated in the development of spine. The body of the vertebra is intersegmental in origin, which results in dual vascular and nerve supply, both from superior and inferior aspects of the body of the lumbar vertebrae. The vertebral body ossifies from three primary centers, one for centrum, which will form the major portion of body, and the other two for neural arches. The cartilaginous growth plate is mainly responsible for the longitudinal vertebral growth. Regional differentiation of the vertebral column, and the definite pattern of the structure of the different vertebra, is regulated by a large number of genetic factors, including the Hox genes. The vertebral body design therefore provides the requirements for optimal load transfer by maximal strength with minimal weight. Bone mineral density (BMD), bone quality, microarchitecture, and material properties are the important factors that contribute to bone strength. BMD is highly heritable; bone mineral distribution and architecture are also shown to be under strong genetic influence. All the aforementioned factors finally integrate to ensure mainly the mobility, stability, and load bearing capacity of the lumbar spine.