Eccentric Insertion Research Articles

Morphological Variations of the Umbilical Cord of Full-term Fetuses – Correlation with Maternal and Newborn Parameters

Introduction: Abnormalities in the development and site of insertion of the umbilical cord (UC) can cause problems which have the potential to affect maternal and fetal health. The aim of the present study was to evaluate the gross features of UC of singleton pregnancies and correlate it to the newborn parameters and maternal parameters at term. Materials and Methods: An observational, descriptive pilot study was carried out with 100 placentas. All ethical principles for human research were followed and ethical approval was obtained from the institutional ethics committee of the medical college from where data were collected. The inclusion criteria were the adequately preserved placenta with no gross abnormalities. Placenta belonging to hypertensive mothers and mothers with gestational diabetes were excluded. Results and Conclusion: The UC morphology was recorded and analyzed. Newborn parameters and maternal parameters were correlated to UC parameters. The present study statistics showed 53% placentas with central insertion, 36% eccentric insertion, 3% furcated and marginal insertions each, and 5% specimens with velamentous insertion. A correlation between the UC insertion site and birth weight was observed. Low birth weight was observed when the cord was inserted eccentrically. Further investigations are required among velamentous insertion to reach a conclusion for maternal blood group correlations.

Monochorionic – Monoamniotic Twins’ Placenta

A 33-year-old healthy primigravida with a body mass indexof 21 kg/m², unexplained infertility, pregnancy after IVF, and single embryo transfer, was referred to our department at 12 weeks. We diagnosed monochorionic – monoamniotic twin pregnancy with normal growth, anatomy, and dopplers in both fetuses, anterior normal appearing placenta with eccentric insertion of both umbilical cords, and cervical length of 40 mm. After extensive counseling on the risks and complications of monochorionic – monoamniotic twins, the parents decided to continue with the pregnancy. The course of the pregnancy was uneventful for the mother and fetuses with normal results on all biweekly performed ultrasound examinations. At 30 weeks she received corticosteroids for fetal lung maturation.

Влияние телескопического интрамедуллярного остеосинтеза большеберцовой кости на рост сегмента: пилотное экспериментальное исследование

Introduction Telescopic intramedullary osteosynthesis (TIO) is used in children with osteogenesis imperfecta and other diseases accompanied by frequent fractures and deformities of long bones due to pathological bone tissue featuring reduced strength properties. Purpose In an animal experiment to study the growth characteristics of an intact tibia under conditions of intramedullary reinforcement with a telescopic rod. Material and methods A non‑randomized controlled study was conducted on 4 animals (puppies, littermates) that underwent TIO of the right limb tibia with a telescopic titanium rod (outer diameter of 4.2 mm) at the age of 5 months. X-ray parameters (length of the tibia, angles of inclination of the articular surfaces, telescoping magnitude) were studied before surgery, on the day of rod placement, and after the end of spontaneous growth of the segment (7 months after surgery). The contralateral left tibia served as a control, and its X-ray parameters were studied at the same time-points. Results Transphyseal reinforcement with a telescopic rod caused growth retardation with loss of length in only one case out of four (8 mm or 4.8 % of residual growth). In other cases, no difference in the length of the tibias of the right and left lower extremities was found. Eccentric insertion of the transphyseal rods into the posterior third of the distal epiphysis (due to the natural anatomy of the canine tibial shaft) formed an angular deformity during growth: a significant increase in the distal anterior and lateral tibial angles of the operated limb compared to the intact limb. The amount of divergenceof the parts of the rods was, on average, 11.3 mm. There were no cases of migration of intramedullary rods or loss of fixation of threaded sections in the epiphyses. Conclusion Under experimental conditions, the slowing down of longitudinal bone growth is not a constantly observed effect. Titanium telescopic rods are not prone to blocking during the limb growth or to losing the position of the threaded parts in the epiphyses. The eccentric passage of the rods through the growth zones causes angular deformities in the course of growth of the segment.

Umbilical Cord Changes in Anemia, Gestational Diabetes and Pregnancy Induced Hypertension

Background: The Umbilical cord (UC) structure is designed in such a way that it provides uninterrupted blood flow to the developing fetus even though it is influenced by uterine conditions and external forces throughout the pregnancy period. UC and placenta are the only structures, which nourish the fetus until term. Subjects and Methods: This cross-sectional study was carried out in the department of Obstetrics and Gynaecology, DVVPF’S Medical college and hospital. Results: In the GDM group without treatment, eccentric insertion is seen in 249 placentae and central insertion in 76 placentae. In the GDM group with treatment, central insertion is seen in 236 placentae and eccentric is seen in 89 patients. In the PIH group, without treatment, 22 central insertions and 68 eccentric insertions were observed. With treatment, PIH patients central insertions are seen in 76 and eccentric in 14. In the anemia group without treatment, 24 central insertions and 76 eccentric insertions are observed. Conclusion: On a concluding note, we observed in our study that, the pathological features observed in anemia, pregnancy induced hypertension and gestational diabetes mellitus are on a minimal note in treated patients after their onset, than in untreated patients. Various awareness programs constitutionalized by Governments and various NGO’s are bringing upon a desired change, but at the same time, intensity and frequency are to be increased.

Placental pathology and its correlation with immediate feto neonatal outcome

Background: Placenta plays a major role in growth and development of the fetus as it helps in both exchange of nutrients and removal of waste. Even though it yields a valuable information of prognostic significance for the newborn, majority of the time it will be discarded after the gross examination. Hence the present study was conducted to determine the placental pathology and its correlation with fetal outcome.Methods: The present study was carried out in Davangere for a period of 2 years. The placenta of 100 parturients, more than 28 weeks of gestation were included for the present study. The data was collected after detailed review of the obstetric case records. Placentas were examined soon after delivery. After the gross examination was complete, the placentas were put in a labelled plastic container. The placentas were re-examined macroscopically again by the pathologist. Cut-section examination was done. Then, at least 4 appropriate blocks were taken for each placenta. They were stained with hematoxylin-eosin stain and examined under the microscope. The histopathological examination was conducted as per proforma.Results: One hundred placentae belonging to one hundred babies were studied among which 80% of the maternal cases had anaemia, 68% were term infant, 37% had IUGR. Eccentric insertion of the cord was observed to be the commonest (51). Marginally inserted membranes were seen most frequently (97).Conclusions: In the present study we conclude that placental reserve is large and small alteration do not affect the pregnancy outcome. The placental changes are not specific to a particular condition affecting the pregnancy.

Umbilical cord abnormalities

Objective: Stillbirths and neonatal outcome after delivery has been associated with umbilical cord findings. Cord abnormalities may put the baby in higher risk of certain diseases or low birth weight. The etiology of the umbilical cord abnormalities are not clear diagnosis. Although the fetal mortality associated with umbilical cord abnormalities is very high, identification of the fetus at risk has remained a difficult problem. The aim of this academic work is to study the human umbilical cord (UC) congenital abnormalities including length, diameter, coiling pattern, and placental insertion site in full term Sudanese neonates. Materials and Methods: One thousand and twenty UC of full-term birth neonates of both sexes, single and twin, of normal vaginal delivery in 2013, were studied in the Department of Obstetrics and Gynecology, Omdurman Maternity Hospital. UC length was entirely measured in centimeters using flexible plastic meter and the diameter was measured by Vernier caliper. The number of UC coils, coils pattern, insertion site, knots, cysts, and the blood vessels were fully studied. Results: The average UC length was about 58 cm, with minimal difference between male to female, single to twin birth. In majority of the cases, true knots occur without any clinical significance, whereas the tight knot may impede the circulation and may lead to low birth or intrauterine death. Thin cord places fetus at risk during pregnancy and may result in restricted growth, low birth weight, and neonates which are small for gestational age. This appears to be a consequence of reduction in the area of Wharton's jelly or small cord diameter. Very helical designs may predispose the fetus to certain blood flow changes, and very straight designs may be susceptible to compression. In both these types of coils, the degree of coils vary depending on cord length, diameter, fetal gender, and number of pregnancy. Hypercoiled coils may predispose the fetus to certain blood flow changes and hypocoiled cords may lead to the fetus being susceptible to compression; however in both cases, the blood flow and fetal weight may be affected. These factors were considered regarding possible interactions and correlation to pregnancy and perinatal outcome. Conclusion: Average length of UC in Sudanese neonates about 55 cm, being long in males and single birth, and there is no big difference in the cord length measurement before and after birth, comparing the two methods (ultrasound and manual measurements). 20cm of the cord length is suitable for fetus to be delivered vaginally. Average UC diameter in Sudanese neonates about 1.5 cm, big in males and single birth, Maximum UC coils about 45 coils, more in males and single birth, eccentric insertion is more common than central or marginal false knots of the are also more common than true knots. Most of the cord true knots located near to the fetal end of the umbilical cord, and they were commonly coiled to the left side (anticlockwise direction) incidence of a SUA in Sudanese neonate about 1% more common in males

Novel pathological findings of placenta with fetal heart failure associated with congenital heart disease

Novel pathological findings of placenta with fetal heart failure associated with congenital heart disease

Intramedullary Elastic Transphyseal Tibial Osteosynthesis and Its Effect on Segmental Growth

Intramedullary transphyseal elastic osteosynthesis is used in children for the diseases accompanied by the reduced strength properties of bone tissue, and primarily for osteogenesis imperfecta. The purpose of the experimental study was to investigate tibial growth under the conditions of transphyseal counter-directed insertion of elastic rods without bone integrity breaking, under transverse fracture modeling, as well as under combining transphyseal reinforcement and subperiosteal positioning the titanium mesh with the elastic rods intervolved in it. Non-randomized controlled trial was performed. Three series of experiments performed in 18 puppies. Counter-directed transphyseal reinforcement of tibia performed in Series I, transphyseal reinforcement combined with transverse osteotomy of leg bones--in Series II, transphyseal elastic osteosynthesis and subperiosteal positioning the titanium nickelide mesh with intervolved in it elastic rods during transverse leg bone osteotomy performed in Series III. Transphyseal reinforcement resulted in growth retardation of the operated tibia. The loss of residual growth was 3.8 mm (p=0.078) in series I; 7.8 mm (p=0.032)--in series II; 7.7 mm (p=0.042)--in series III. Eccentric insertion of transphyseal rods formed an angular deformity (mean value 7°; p=0.023) of the distal tibial epiphysis in the process of residual growth. Periosteal and endosteal reactions contributed to enlargement of diaphyseal diameter of 3.9 mm (series II; p=0.037) and 3.8 mm (series III; p=0.041). Any difference of diameter between operated and intact tibia was not observed in series I. Intramedullary transphyseal reinforcement retards longitudinal bone growth. The positioning of the telescopic systems should be as close as possible to the center of growth plates in order to prevent angular deformities. Subperiosteal reinforcement doesn't retard consolidation of fragments, and it can be combined with intramedullary transnhyseal osteosynthesis.

Uncertainty analysis of criticality safety for the plate type fuel assembly storage rack

To evaluate the criticality safety of the fresh and the spent fuel storage racks in an open pool type research reactor designed by KAERI, the upper subcriticality limit (USL) analysis was carried out. First, the bias and its uncertainty of MCNP code system with ENDF/B-VII library were evaluated using the calculation results of the 183 benchmark experiments. The criticality calculations for the fuel storage rack are carried out under a normal state, an increased water temperature, a fuel assembly drop, and an eccentric insertion which can affect the criticality. Considering biases and uncertainties for the MCNP code system, abnormal conditions, and the manufacturing tolerance of the cell tube thickness, the USL value that can guarantee sufficient subcriticality is determined. It was found that the criticality of the fresh and the spent fuel storage racks currently designed satisfy the USL condition. Additionally, it was concluded that the pitch size of a fresh fuel storage rack can be reduced for efficient space availability, and even under a worst case in which the fresh storage rack is surrounded by a lower water density and the smallest pitch size satisfies the USL conditions.

Morphometric analysis of terminal villi and gross morphological changes in the placentae of term idiopathic intrauterine growth restriction

The aim of this study is to compare the gross morphology of the placentae and the morphometry of terminal villi and terminal villous capillaries in pregnancies complicated by idiopathic intrauterine growth restriction (IUGR) with those of normal pregnancies. 75 placentae were collected between April 2010 and March 2011. 50 placentae were associated with idiopathic IUGR and 25 were from controls. Insertion of cords, placental weights and diameters were noted. Hematoxylin and eosin-stained wax sections were analyzed stereologically. Growth of terminal villi and fetal capillaries was assessed by estimating total and mean surface areas. Villous capillarization was monitored using capillary:villus surface ratio. Measurements were done using image analysis system. In comparison with the control group, idiopathic IUGR placentae are significantly smaller (p=0.000) and lighter (p=0.000). In majority of IUGR (68%) and control (60%) cases, eccentric insertion of cord is noted. In idiopathic IUGR group, there is a significant decrease in the total areas of both terminal villi (p=0.048) and their capillaries (p=0.000) and a significant decrease in number of both terminal villi (p=0.000) and their capillaries (p=0.001), also, capillarization index is significantly smaller (p=0.038). Idiopathic IUGR is associated with reduced growth of placental terminal villi and fetal capillaries and this is accompanied by changes in measures of villous capillarization as compared with those of control placentae. Further investigations of idiopathic IUGR placentae are necessary, especially considering the histopathological changes that could affect the fetomaternal exchange, with a note that strict distinction should be made between idiopathic and nonidiopathic IUGR placentae.

Clinicopathology of maternal scleroderma

Women with scleroderma who become pregnant have an increased incidence of perinatal loss, premature birth, and growth restriction [1]. Placental abnormalities, including acute atherosis, infarcts, and other manifestations of reduced placental blood flow, are found in many cases of collagen vascular disease [2]. A 27-year-old woman (gravida 1) with scleroderma was admitted to hospital at 31 weeks of gestation with uterine contractions and intrauterine growth restriction (IUGR). Scleroderma was diagnosed 2 years previously and she was treated with penicillamine (250 mg per day). Antitopoisomerase I (anti-Scl-70) and anti-nuclear antibodies were positive. Doppler examination revealed IUGR and increased resistance index in the umbilical artery (pulsatility index (PI), 1.24). At 37 weeks of gestation she underwent a cesarean delivery; the 1860 g female infant developed necrotic enterocolitis after 4 days. Three days postpartum the patient developed elevated blood pressure (170/100 mm Hg), mild proteinuria (280 mg/ 24 h), with normal serum creatinine level and liver function tests, but reduced creatinine clearance (70 mL/min). Renal crisis episode and pre-eclampsia were included in the differential diagnosis. In order to control hypertension, an angiotensin-converting enzyme (ACE) inhibitor was used. On discharge from hospital the patient had normal blood pressure and normal renal function. At histopathology examination the placenta weighed 395 g and measured 16×9×4 cm. The umbilical cord presented eccentric insertion and was 38 cm in length and 1.2 cm in diameter. It contained 3 vessels. More than 5 placental infarcts were identified (measuring 1–3 cm). Histological examination of multiple sections (15) showed old placental infarcts and changes consistent with placental mesenchymal dysplasia (PMD, Fig. 1a), decidual vasculopathy (Fig. 1b), foci of decreased vascularity, foci of chorioangiosis, stromal fibrosis of villi, and extensive fibrinoid deposition on the villi. Focal

Reproductive characteristics of the african pygmy hedgehog, atelerix albiventris

To obtain further perspective on reproduction and particularly gamete function among so-called primitive mammals presently grouped in the Order Insectivora, we have examined the African hedgehog, Atelerix albiventris, in light of unusual features reported in shrews and moles. Atelerix proves to share many but not all of the characteristics seen in these other insectivores. The penis of Atelerix has a 'snail-like' form, but lacks the surface spines common in insectivores and a number of other mammals. Hedgehog spermatozoa display an eccentric insertion of the tail on the sperm head, and they manifest the barbs on the perforatorium that, in shrews, probably effect the initial binding of the sperm head to the zona pellucida. As a possible correlate, the structural matrix of the hedgehog acrosome comprises only two main components, as judged by immunoblotting, rather than the complex of peptides seen in the matrix of some higher mammals. The Fallopian tube of Atelerix is relatively simple; it displays only minor differences in width and in the arborized epithelium between the isthmus and ampulla, and shows no evidence of the unusual sperm crypts that characterize the isthmus or ampulla, depending on the species, in shrews and moles. In common with other insectivores, Atelerix appears to be an induced ovulator, as judged by the ovulation of some 6-8 eggs by about 23 h after injection of hCG. The dense cumulus oophorus appeared to have little matrix, in keeping with the modest dimensions of the tubal ampulla and, while it was not quite as discrete as that of soricids, it did show the same insensitivity to 0.5% (w/v) ovine or bovine hyaluronidase.

Reproductive characteristics of the african pygmy hedgehog, atelerix albiventris.

To obtain further perspective on reproduction and particularly gamete function among so-called primitive mammals presently grouped in the Order Insectivora, we have examined the African hedgehog, Atelerix albiventris, in light of unusual features reported in shrews and moles. Atelerix proves to share many but not all of the characteristics seen in these other insectivores. The penis of Atelerix has a 'snail-like' form, but lacks the surface spines common in insectivores and a number of other mammals. Hedgehog spermatozoa display an eccentric insertion of the tail on the sperm head, and they manifest the barbs on the perforatorium that, in shrews, probably effect the initial binding of the sperm head to the zona pellucida. As a possible correlate, the structural matrix of the hedgehog acrosome comprises only two main components, as judged by immunoblotting, rather than the complex of peptides seen in the matrix of some higher mammals. The Fallopian tube of Atelerix is relatively simple; it displays only minor differences in width and in the arborized epithelium between the isthmus and ampulla, and shows no evidence of the unusual sperm crypts that characterize the isthmus or ampulla, depending on the species, in shrews and moles. In common with other insectivores, Atelerix appears to be an induced ovulator, as judged by the ovulation of some 6-8 eggs by about 23 h after injection of hCG. The dense cumulus oophorus appeared to have little matrix, in keeping with the modest dimensions of the tubal ampulla and, while it was not quite as discrete as that of soricids, it did show the same insensitivity to 0.5% (w/v) ovine or bovine hyaluronidase.

Normal pituitary gland: coronal MR imaging of infundibular tilt.

To determine the prevalence of pituitary infundibular deviation or tilt as a normal variant, coronal magnetic resonance (MR) images of 50 patients who had been examined for reasons other than pituitary disease were evaluated retrospectively. Forty-six percent of the patients had a more or less pronounced tilt of the pituitary stalk. This tilt was due to developmental lateral eccentricity of the pituitary gland in relationship to the midline of the brain in 34% and to ontogenic eccentric insertion of the pituitary infundibulum off the midline of the gland in the other 12%. This high frequency of stalk deviation in patients without pituitary disease suggests that such displacement by itself should not be used to support the presence of pituitary microadenoma on MR images or computed tomograms.

Torsion problem for elastic cylinder with inserts and holes

Abstract An integral equation method to solve the classical torsion problem for an elastic cylinder with inserts and holes is treated. The bounded region outside the inserts and the holes will be termed a matrix . As is well-known the solution depends on finding plane harmonic functions in the matrix and inserts such that (a) on the outer boundary of the matrix and the boundaries of the holes the harmonic function in the matrix takes the values 1 2 (x 2 +y 2 )+c j , and (b) on the interfaces of the matrix and the inserts relations exist between the harmonic functions and between their normal derivatives. Here ( x , y ) are the coordinates of the point on the boundary and c j , are unknown constants. The usual methods are cumbersome and lengthy. In this paper a straightforward method is presented which is easily programmable. The numerical solution is obtained by evaluating a few integrals either analytically or numerically and solving a system of linear simultaneous equations. An example of a cylinder with an eccentric insert is given which substantiates the theory developed in this paper and is found to agree with known results. However, the method is general and may be applied to a variety of problems.

The fine structure of distal receptors on the labium of the aphid, Brevicoryne brassicae L. (homoptera). Implications for current theories of sensory transduction.

Short peg receptors located at the distal tip of the aphid labium have the structure of mechanoreceptors. Each peg is innervated by a single sensory nerve which is anchored eccentrically to a basal cuticular tube and terminates in electron-dense material in the base of the peg. The arrangement and eccentric insertion of the eight pegs in the labial wall on one side of the stylet groove, with the eccentric insertions of their innervating neurones, provide a mirror image of the receptors on the opposite side. On the basis of a comparison of the structure of these receptors with that of tactile receptors for which electrophysiological data on sensitivity are available, it is possible to predict that the receptors detect both surface contact (pressure) and surface profile; and that the bilateral symmetry in the receptor arrangement facilitates the detection of vein contours which are preferred settling sites on the leaf. The structure of the dendritic terminal and its insertion is that of a well reinforced cytoskeleton designed to transmit tension to the cell membrane, in agreement with the concept that transduction is a membrane related phenomenon. The distal microtubules, fifty per-cent of which originate as well as terminate in the "tubular body", are packed in electron-dense material which binds to the cell membrane. The membrane in turn is attached to cuticular components of the receptor. Abrupt changes in dimension of the dendritic outer segment may be designed to modulate the conduction of a membrane potential. On the other hand, lack of continuity in the microtubules makes these organelles poor candidates for the transduction of excitation from a distal site of stimulation to a proximal region.

The housefly interfacetal hair: ultrastructure of a presumed mechanoreceptor.

The external and internal fine structure of the housefly interfacetal hair and its sensory dendrite was studied with the scanning and transmission (high and low voltage) electron microscopes. The hair shaft contains no dendrites, and is usually situated within a socket on the lens surface. Immediately beneath and directly connected to the base of each hair is a bipolar neuron whose dendrite tip is enveloped in a shealth cell which, in turn, is surrounded by a second sheath cell. Septate junctions are seen between all these cells and contiguous portions of a large pigment cell. At the hair base, the dendrite of the neuron terminates in a tubular body only 1.5 mum in diameter which is filled with about 400 microtubules in highly ordered (in parallel pentagonal and hexagonal) arrays and whose sides are fused to neurofilaments in parallel. Another filament (ca. 70 A diameter) is in the center of each microtubule-neurofilament polygon. Structures proximal to the tubular body are typical for a scolopoid sensillum, i.e., connecting cilium (9 times 2 + 0 microtubules) with rootlet and basal bodies, unmodified dendrite, perikaryon and axon. The axon has not been traced to its synapse. The high degree of internal organization and shortness of the tubular body, as well as its eccentric insertion into the hair shaft lead to the hypothesis that this hair may be a highly sensitive mechanoreceptor. On the basis of their single innervation, these hairs could monitor flight speed from the degree of hair deflection caused by wind in general or particular laminar air currents flowing past the eyes during flight.