Collagen and elastic fibers assessment of the human heart valves for age estimation in Thais using image analysis.

The study investigated the relationship between the histological compositions of the tricuspid, pulmonary, mitral, and aortic valves, and age. All 85 fresh human hearts were obtained with an age range between 20 and 90 years. The central area of the valves was conducted to analyze the density of collagen and elastic fibers by using an image analysis program. Neural network function in MATLAB was used for classification data and accuracy test of the age predictive model. Overall, a gradual increase in the density of collagen and elastic fibers was demonstrated with age in all valve types. The pulmonary valve cusps had the least density of collagen and elastic contents, whereas the most dense of collagen was found in the mitral leaflets. A similarity was noted for the elastic fibers in the tricuspid, mitral, and aortic valves. The highest correlation between the collagen (r = 0.629) and elastic fibers (r = 0.713) and age was found in the noncoronary cusp of the aortic valve. The established predictive equations using collagen and elastic fibers in the noncoronary cusp provided the standard error of ± 14.0 and 12.5 years, respectively. A 60.9% of accuracy was found in all age groups using collagen, while accuracy in elastic fibers showed 70.0% in the classification process using the neural networks. The current study provided additional data regarding age-associated changes of collagen and elastic fibers in the human heart valves in Thais and the benefits and application in age forensic identification.

Age estimation in the combined long bones and ribs by histomorphometry: Past, present, and future.

Numerous age estimation methods in unidentified bone have been a long time developing for application in forensic anthropology. The histomorphometric technique is one of the alternative methods that relied upon the evaluation of the cortical bone microstructure over the lifespan as a result of the remodeling process in bone. Remodeling is a sophisticated event occurring from the coupled function of bone formation and resorption cells for maintaining mineral homeostasis and repairment of microdamage in bone tissue. Products derived from remodeling are primary changes in the osteon or haversian system in various regions in the cortical bone, including periosteum, endosteum, and trabecular bone. Throughout life, bone remodeling rate with osteon alteration can be predictable. In the forensic field, histological methods are getting more attention due to the unavailability of macroscopic methods. Histomorphometry approach can be accomplished in fragmentary or incomplete bone remains indicating the limited use of gross morphological methods. In addition, the microscopic methods can aid to increase the more accuracy of analyses and diminish the biased subjective assessment for determining age. Most histomorphometry method utilizes a cross-section of the midshaft of the long bones including the mandible, rib, and clavicle. This review provides the basic knowledge of bone biology and anatomy, several age-estimating methods of histology, and crucial factors for age methods. Studies regarding overall age determination methods from the past until now contribute to obtaining more benefits for developing methods of histomorphometry using human bone in forensic identification.

Anatomical Study of Stabilizing Structures of the Extensor Carpi Ulnaris Tendon Around the Wrist.

PURPOSE: The sixth dorsal extensor compartment is a relatively common site of stenosing tenosynovitis in the upper extremity, but the exact location of stenosis is not fully understood. The objective of this study was to investigate the detailed anatomy of structures surrounding the extensor carpi ulnaris (ECU) tendon around the wrist. METHODS: Fifty fresh human cadaveric wrists were used for gross observation and morphology measurements of the sixth dorsal compartment and the ECU subsheath. An additional 13 wrists were used for histological examination. We evaluated the morphology of supporting structures in 3 regions: the ulnar groove (zone I), the ulnar styloid process (zone II), and the triquetrum (zone III). RESULTS: The fibro-osseous tunnel comprising the ulnar groove and the overlying subsheath (zone I) stabilized the ECU tendon, and the subsheath had thin membranous collagen fibers attached to the periosteum. We consistently found the distal extension of ECU subsheath (zone II), which connected the ulnar styloid process and the dorsal radioulnar ligament. Variations in the length of the distal extension increased with the forearm in pronation. Collagen fiber thickness around the ECU tendon in zone II was greater than that of zone I. In zone III, the overlying extensor retinaculum and septa, which were composed of thick circumferential collagen structures, supported the ECU tendon by attaching to the triquetrum on both sides of the ECU tendon. We found the presence of an ulnar septum of the sixth compartment attached to the triquetrum in 84% of dissected wrists. CONCLUSIONS: The ECU tendon was supported by the ECU subsheath, which had thin and elastic collagen fibers over the ulnar groove. Distal extension of the subsheath and surrounding radial and ulnar extensor retinaculum septa attached to the triquetrum provided thicker supporting structures. CLINICAL RELEVANCE: Stenosing ECU tenosynovitis may occur not only in the ulnar groove but also in the more distal ulnar styloid process and triquetrum areas.

Histological assessment of the human heart valves and its relationship with age.

The human heart valves are complex anatomical structures consisting of leaflets with many supporting structures. With advancing age, the microstructure of the components of the valves can change. Knowledge and understanding of the anatomical relationships between the different components of the heart valve structures and their relationship with age is crucial for the development and progression of treatment of valvular disease. The purpose of this study was to determine histological changes of the components of the heart valves and their relationship with age. Fifty hearts taken from cadavers were included to examine the histology of the tricuspid, mitral, pulmonary, and aortic valves. All specimens were stained with Elastic Van Gieson, and picrosirius red to enable the evaluation of elastic and collagen fibers, respectively. There was a gradual increase in elastic and collagen fibers with advancing age, particularly over 40 years, in all valve types. In the case of tricuspid and mitral valves increases in collagen and elastic fibers were observed starting in the fifth decade. Elastic fiber fragmentation was observed in specimens over 50 years. In the case of the pulmonary and the aortic valves, collagen fibers were denser and more irregular in the sixth to seventh decades when compared to younger ages while elastic fibers were significantly increased in the sixth decade. In addition, an increase in fat deposition had an association with aging. These findings provide additional basic knowledge in age-related morphological changes of the heart valves and will increase understanding concerning valvular heart diseases and treatment options.

Image analysis of morphometric evaluation from the heart valves for age estimation in Thai population / Análisis de la evaluación morfométrica de las valvas cardíacas para la estimación de la edad en la población tailandesa

Determination of age represents one of the most important aspects in forensic identification. Through aging, changes can occur in morphological structures of the heart valves. The objective is to examine the relationship between the dimensions of the rigth atrioventricular (tricuspid), pulmonary, left atrioventricular (mitral), and aortic valves and age at death. Sixty fresh human hearts were obtained from Department of Anatomy and Department of Forensic Medicine, Faculty of medicine, Chiang Mai University, Thailand. The age of individuals was between 20-90 years. We investigated the morphometric parameters of the valves were taken including: valve circumference, length, the height and area of each leaflet. All parameters were measured by using specific image analysis software. The correlation test and predictive equation were established. The positive correlation between the circumference, area of posterior leaflet, height of anterior leaflet, and area of anterior leaflet of the rigth atrioventricular valve were found. The left atrioventricular valve showed correlation with age in circumference, length and area of posterior leaflet. For the pulmonary and aortic valves, there were correlated between circumference at sinotubular junction and leaflet sizes in almost leaflets. The circumference at sinotubular junction of the pulmonary valve was highest significantly correlation with age (r=0.693). The predictive equation was age = -3.659+0.652(Circumference at sinotubular junction of the pulmonary valve) with standard error of ± 14.7 years. Additional knowledge of morphometric features in human heart valves and its relationship with age could be used as age indicator in forensic field.

La determinación de la edad representa uno de los aspectos más importantes en la identificación forense. Pueden ocurrir cambios a través del envejecimiento, en las estructuras morfológicas de las válvulas cardíacas. El objetivo de este estudio fue examinar la relación entre las dimensiones de las valvas atrioventricular derecha (tricúspide), pulmonar, atrioventricular izquierda (mitral) y aórtica, y la edad en relación a la muerte. Se obtuvieron sesenta corazones humanos frescos del Departamento de Anatomía y el Departamento de Medicina Forense de la Facultad de Medicina de la Universidad de Chiang Mai, Tailandia. La edad de las personas fluctuaba entre los 20 y 90 años. Investigamos los parámetros morfométricos de las valvas analizadas, incluyendo: circunferencia de la valva, longitud, altura y área de cada valva. Todos los parámetros se midieron utilizando un software de análisis de imagen específico. Se estableció la prueba de correlación y la ecuación predictiva. Se encontró la correlación positiva entre la circunferencia, el área de la valvula posterior, la altura de la valvula anterior y el área de la valvula anterior de la valva atrioventricular derecha. La valva atrioventricular izquierda mostró correlación con la edad en la circunferencia, longitud y área de la valvula posterior. Para las valvas pulmonar y aórtica, se correlacionó entre la circunferencia en la unión sinotubular y el tamaño de las válvulas. La circunferencia en la unión sinotubular de la valva pulmonar fue la mayor correlación significativa con la edad (r = 0,693). La ecuación predictiva fue edad = -3,659 + 0,652 (circunferencia en la unión sinotubular de la valva pulmonar) con error estándar de ± 14,7 años. El conocimiento adicional de las características morfométricas en las valvas cardíacas humanas y su relación con la edad podría usarse como indicador de edad en el campo forense.

Gross age-related changes and diseases in human heart valves.

Cardiac valves are highly complex structures optimizing their function during the cardiac cycle. They open and close directed by blood flow under different pressure conditions in the dynamic environment in the heart. It is acknowledged that the aging process affects the structure and functions of the heart valves. With regard to morphometry, age-related changes of the heart valve can be found in valve circumference, thickness of the leaflet, luminal area at the sinotubular junction, valve diameter, orifice area, and leaflet size in circumferential and radial direction. In addition, there are differences between male and female hearts in some features. Moreover, there are studies the qualitative and quantitative assessment of histological compositions, echocardiography study to investigate the annular circumference and diameter in the human heart valves related with age. Studies into the detailed anatomy of the changes in heart valves with age are important and the correlation between valve morphology and age may be used as an age indicator. This study reviews the basic anatomical structure of the heart valves, age-related changes of valve morphometry, heart valve diseases, and general treatment of valvular diseases in humans. Detailed knowledge of the anatomical features of the morphology of the human heart valve is useful for any treatments of valve pathology.