Newborn Cadavers Research Articles

An atypical anatomical variation of the petrosphenoidal ligament in a newborn cadaver.

To report an atypical anatomical variation of the petrosphenoidal ligament in a newborn cadaver and to discuss its clinical significance. During a study of ten newborn cadavers, the skull base was dissected to reveal the anatomy of the petrosphenoidal ligament and its relationship with the abducens nerve. An atypical anatomical variation was observed, and this is described. The length of the right and left ligaments to the point where it splits into two arms, the joint length of the two ligaments at the junction of the clivus, the length of the ligament proceeding to the posterior clinoid process, and the abducens nerve's diameter as it passes below the ligament were measured on ImageJ software. The petrosphenoidal ligaments were y-shaped, and the attachment of the proximal ligaments was bifid. In the midline above the clivus, some ligament bundles joined the contralateral petrosphenoidal ligament, whilst another group of bundles originated at the posterior clinoid process. At the entry to Dorello's canal, the abducens nerve had a diameter of 0.59mm on the left and 0.65mm on the right. The part of the ligaments converging on the clivus in the midline after dividing into two arms was 10.68mm. We think that this case report will provide useful information for surgical procedures to the petroclival region, transnasal surgical approaches, and surgical interventions involving the carotid artery.

Anatomy of the Petrosphenoidal Ligament and Its Relationship with the Abducens Nerve in Newborn Cadavers.

To examine the anatomy of the petrosphenoidal ligament (PSL), and its relationship with the abducens nerve (AN) in newborn cadavers. Using 10 formalin-fixed newborn cadavers, 20 PSLs and ANs on both sides were examined. The structure of each PSL, its morphometric features, and its relationship with the AN were evaluated. For the morphometric measurements, photographs were taken in macro mode and then the ImageJ program was used. The PSL was usually shaped like a butterfly. The structures of all the ligaments were complete. The PSL was attached to the petrous apex posteriorly and to the clivus or posterior clinoid process (PCP) anteriorly. The mean PSL length was 6.58 ± 1.4 mm. The mean width of the ligament's attachment to the petrous apex was 3.12 ± 0.63 mm. The mean width of the ligament's attachment to the PCP or clivus was 3.12 ± 0.5 mm. The AN was located below the PSL in all the samples. It was usually situated in the 1/3 lateral part under the PSL (70%). The mean diameter of the AN, as located under the ligament, was 0.8 ± 0.12 mm. The PSL serves as an important anatomical landmark in the petroclival region. In addition, AN is closely adjacent to many anatomical structures such as the trigeminal nerve and internal carotid artery. The increased knowledge obtained through this study on newborn cadavers concerning the anatomy of the PSL and its relationship with the AN will help increase the success of surgical procedures and reduce surgical complications.

FEATURES OF THE STRUCTURE OF THE LABYRINTH WALL OF THE TYMPANIC CAVITY IN THE THIRD TRIMESTER OF PREGNANCY

Acute otitis media is one of the most common diagnoses among young children, and prematurity is the most common risk factor for its occurrence. The immaturity of the organs and systems of these children often lead to the development of pathological symptom complexes, including from the organ of hearing, which may necessitate surgical intervention. Modern microsurgical technologies signifi cantly increase the quality of operations and reduce the risk of possible complications. The surgeon’s work on these structures requires accurate knowledge of the anatomical and topographic features of the structure of the temporal bone, including in prematurely born children. The syntopy and structure of the labyrinth wall of the tympanic cavity were studied in 35 human fetuses of the seventh to tenth months of intrauterine development and 11 newborn cadavers. It has been established that the dimensions of the structures of the labyrinthine wall of the tympanic cavity in prematurely born children do not have defi nitive dimensions and their location diff ers from that in those born at term. In prematurely born children, the bone wall of the facial nerve canal is absent, in those born on time it is partially present in 18.18% of cases, the angle of passage of the facial nerve canal decreases from 33° in fetuses of the seventh month of intrauterine development to 25° in newborns. The identifi ed features are important in improving technologies and the adequacy of surgical treatment in prematurely born children.

Different Positions of Vermiform Appendix in Human Cadavers: A Cross-sectional Study

Introduction: The vermiform appendix is a wormlike tube situated in the right iliac fossa. It arises from the posteromedial cecal wall, 2 cm or less below the end of the ileum and suspended by a peritoneal fold known as meso appendix. Position of the appendix influences its mobility. Most common position of appendix has been reported to be retrocecal followed by pelvic position. But there are other variable positions also reported by many. Aim: To study the anatomical variations of the positions of vermiform appendix in human cadavers. Materials and Methods: This was a descriptive cross-sectional study which was carried out in the Department of Anatomy, Assam Medical College, Dibrugarh, Assam, India, from June 2020 to May 2021. Total 14 adult cadavers and 66 new born cadavers were included in the study. All the cadavers were dissected and abdominal cavity was explored. The position of the appendix was then noted in all specimens. Results: In most of the cases the position of vermiform appendix was found in retrocecal position followed by pelvic, pre-ileal and paracolic. In adults, retrocecal positions were more in males (88.9%) than females (40%) in contrast to newborns where retrocaecal positions were more in females (76.7%). As a whole, retrocecal position (66.25%) of appendix was the commonest finding in all cadavers. This was followed by pelvic (30%) position. Paracolic (2.5%) and pre-ilial (1.25%) positions were also noted in newborn cadaver. Conclusion: Knowing the variations in the position of appendix will guide the surgeons during intraoperative procedures. Since the positions of appendix vary considerably signs and symptoms also vary depending upon the different positions. Hence, the knowledge of its diverse anatomical positions is of utmost importance which helps the surgeons in proper management of appendicular pathology.

Yenidoğan kadavralarında karaciğer hacminin stereolojik olarak hesaplanması

Purpose: The aim of our study was to compare different techniques for the estimation of liver volume using cadaveric sample, magnetic resonance imaging (MRI) and ultrasonography (USG) images, and to measure errors associated with volume estimation techniques based on fluid displacement (the Archimedes' principle). Materials and Methods: Our study was formed of five newborn cadavers aged 39.7±1.5 weeks and weighted 2.220±1.056 g. We used three different methods for calculate the liver volume. Results: Liver volume (LV) measured by the Archimedes' principle was 70.00±49.96 cm3. There was no significant difference between the methods. Conclusion: MR and USG images provide easy, applicable and reproducible estimates in calculating volume of normal and anomalous liver with the Cavalieri’s principle. We think that our study may be a reference for similar studies to be done in the upcoming years.

Early Onset of Atherosclerosis of The Carotid Bifurcation in newborn cadavers

The anatomy of arterial bifurcations affects blood flow and has a significant role in the development of vascular disease. Therefore, it is important to know the structural characteristics of the Common Carotid Artery (CCA) and its branches for early onset of atherosclerosis in newborns. The present study was conducted to evaluate the characteristics of CCA in newborn cadavers. Eight carotid arteries obtained from newborn cadavers were used. The outflow to inflow area ratios was calculated to evaluate vessel diameters. Additionally, scanning electron and light microscopic investigations were conducted with tissue samples. The brachial artery of each cadaver was used as controls. Correlation between area ratios and atherosclerotic endothelial damage was determined. Light microscopic investigations demonstrated that control group sections showed no positivity for Oil red O staining, while carotid bifurcation regions depicted widespread occurrence of intimal lipid accumulations. Scanning electron microscopic examination of control group sections presented regular endothelial topography, while carotid bifurcation region topography exhibited numerous blood cells and separated endothelial cells. Fibrin accumulation on endothelial surface in low area ratios was another important finding in the examination of its endothelial surface degeneration. The above-mentioned morphological findings seemed to be quite parallel to outflow to inflow area ratio data favouring low area and degeneration. The correlation between area ratios and the histological characteristic of cerebral vessels of newborn cadavers indicate that early stages of atherosclerosis began in early embryologic life.

Evaluation of tympanic cavity volume by using computed tomography scan with the MATLAB and image J

The aim of this study is to calculate the tympanic cavity (TC) volume with manual tracing technique on computed tomography images of temporal bone with a software developed in house using MATLAB platform. Images with slice thickness of 0.25 mm were obtained from newborn cadavers and analyzed by two expert researchers independently using the software and the results were compared. The borders of TC were delineated manually and measurement of interested area was calculated on masked images. Then, the area measurements from all sections were added for the calculation of total volume. Dice similarity coefficient (DSC), Jaccard, sensitivity and specificity were used as a statistical validation metric to evaluate the performance of manual volume measurement. TC volumes were calculated as a 0.272±0.04 cm 3 and 0.286±0.03 cm 3 by the two researchers with MATLAB, 0.287±0.06 cm 3 with Image J. DSC values being above to 0.7 indicated that the software allows consistent and reliable volume measurements. This software can potentially be applied to measure other anatomical volumes from radiological images.

Estimation 0f the Total Brain Volume Using Semi-Automatic Segmentation and Stereology of the Newborns’ Brain MRI

Brain development begins in the early embryonic period and proceeds through the second decade of postnatal life. However information related to the development of the brain during this period is currently quite limited. The aim of the current study was to compare the total brain (cerebrum, cerebellum and brain stem, without the ventricular system) volumes in newborns using stereological (point-counting) and semi-automatic segmentation methods and Archimedes’ principle. Seven newborn cadavers, aged 39.9 (±1.2) weeks, were included in the present study. Firstly, the total brain (TB) volume was determined by the use of the fluid displacement technique and then magnetic resonance images were analyzed by using two methods. The mean (±SD) TB volumes by fluid displacement, Cavalieri principle (point-counting), and semi-automated segmentation methods were 288.70± 76.18, 270.12 ± 78.93 and 282.39 ± 73.17 cm3 respectively. We did not find any significant differences among the three methods (p>0.05). From these results, it can be concluded that the semi-automated segmentation method and stereological technique can be used for reliable volume estimation of total brains in neonates. Based on these techniques we compared here in, the clinician may evaluate the growth of the brain in a more efficient and precise manner. NeuroQuantology | June 2013 | Volume 11 | Issue 2 | Page 181-188

Stereological evaluation of the volume and volume fraction of newborns’ brain compartment and brain in magnetic resonance images

Brain development in early life is thought to be critical period in neurodevelopmental disorder. Knowledge relating to this period is currently quite limited. This study aimed to evaluate the volume relation of total brain (TB), cerebrum, cerebellum and bulbus+pons by the use of Archimedes' principle and stereological (point-counting) method and after that to compare these approaches with each other in newborns. This study was carried out on five newborn cadavers mean weighing 2.220 ± 1.056 g with no signs of neuropathology. The mean (±SD) age of the subjects was 39.7 (±1.5) weeks. The volume and volume fraction of the total brain, cerebrum, cerebellum and bulbus+pons were determined on magnetic resonance (MR) images using the point-counting approach of stereological methods and by the use of fluid displacement technique. The mean (±SD) TB, cerebrum, cerebellum and bulbus+pons volumes by fluid displacement were 271.48 ± 78.3, 256.6 ± 71.8, 12.16 ± 6.1 and 2.72 ± 1.6 cm3, respectively. By the Cavalieri principle (point-counting) using sagittal MRIs, they were 262.01 ± 74.9, 248.11 ± 68.03, 11.68 ± 6.1 and 2.21 ± 1.13 cm3, respectively. The mean (± SD) volumes by point-counting technique using axial MR images were 288.06 ± 88.5, 275.2 ± 83.1, 19.75 ± 5.3 and 2.11 ± 0.7 cm3, respectively. There were no differences between the fluid displacement and point-counting (using axial and sagittal images) for all structures (p > 0.05). This study presents the basic data for studies relative to newborn's brain volume fractions according to two methods. Stereological (point-counting) estimation may be accepted a beneficial and new tool for neurological evaluation in vivo research of the brain. Based on these techniques we introduce here, the clinician may evaluate the growth of the brain in a more efficient and precise manner.

Variations of the superficial peroneal nerve and its terminal branches in the turkish newborn fetuses

The topography of the superficial peroneal nerve (SPN) and its terminal branches were studied, with the aim of providing further anatomical details for leg and foot in the Turkish newborn fetuses. Limbs from twenty newborn cadavers were dissected. The course of the SPN on the leg and its terminal branches on the foot were investigated. The SPN was lateral (75%), anterior (15%), or branched in both areas (10%) of the cases. The SPN in the dorsum of the feet branched further into medial dorsal cutaneous nerve (MDCn) and intermediate dorsal cutaneous nerve (IDCn). In 82.5% of the cases the MDCn and the IDCn split into three and two branches, respectively. In 10% of the cases, the MDCn gave off three, and the IDCn one terminal branches. In 7.5% of the cases, the MDCn had three while the IDCn had two branches that communicated with the lateral dorsal cutaneous nerve. The course of SPN on the anterolateral surface of the leg and its terminal branches on the dorsal surface of the foot were quite different. This unusual variant location will enable the surgeon to find and preserve the SPN and its terminal branches.

Localization of pterion in neonatal cadavers: a morphometric study

Pterion is defined as a junction of temporal, frontal, parietal, and sphenoid bones. In newborns, pterion may be defined as a region that shows variability in the exact location because of the lack of complete bony structure. The aim of this study is to define the topographic anatomy of this important surgical point, pterion, and the variability of its localization on craniums of newborn cadavers. Our study was performed using 35 term neonatal cadaver specimens. We measured the distances between the pterion and other critical points and used a scale diagram for the definition of pterional area. Our scale diagram showed that pterion is mostly localized in regions c, d, e, and f on the length and regions 2, 3, 4, and 5 on the width. Localization was not observed in regions a, b, g, and h, and in areas of squares 1 and 6. The most observed localization of pterion was the e4 (24.28%) area. This study provides a detailed knowledge on localization of this important point, pterion, which will be useful for the clinicians at operation planning and treatment stages, serving for the success in surgery in the presence of this variable topographic cranial anatomy.

Anatomic and arthroscopic study of the medial meniscal horns’ insertions

The insertions of the menisci to the tibia are the most important restraints to extrusion from the knee joint, and are vital for the functional integrity of the menisci. The aim of the present study was to determine variations of tibial insertions of the medial menisci (MM) in newborn cadavers macroscopically and in adults by arthroscopy. Neonatal part of this study was performed on 40 knee joints of 20 Caucasian neonatal cadavers. Adult part was performed on 41 Caucasian adults, whose ages were between 17 and 66 unilaterally by arthroscopy. In neonatal cadavers, according to its insertion, anterior horn of MM was classified in five groups and type 4, in which it was inserted to the transverse ligament, was determined the most frequent one (45%) and posterior horn of MM was classified in three groups and type 3, in which it was inserted to both the posterior intercondylar area of tibia and medial tubercle of intercondylar eminence was determined the most frequent one (50%). In adults, anterior end of MM was most frequently inserted to both anterior intercondylar area of tibia and transverse ligament (76%) and posterior horn of MM was inserted to the posterior intercondylar area of tibia in all of them. This study provides comparative information about insertion of the MM for neonatals and adults, not to evaluate the variants of the insertion of the MM as a tear of the anterior cruciate ligament or a meniscal tear and not to complicate arthroscopy.

C7 roots vulnerable to avulsion in newborns: histological and biomechanical basis for obstetric palsy of brachial plexus

Objective To investigate anatomical and biomechanical features of the semiconic pos-terosuperior ligaments at the brachial plexus roots in newborns in order to understand the specific mechanism of obstetric palsy of brachial plexus. Methods In 6 fresh newborn cadavers, the C5-7 nerve roots were histologically analyzed using hematoxylin and Mallory trichrome staining to observe the semiconic posterosu-perior ligaments. In 4 newborn cadavers, the complex of nerve roots-ligament-transverse process was bilaterally removed and a biomechanical test was performed to examine the failure load of the complex. Results The area of collagen fiber of the ligament around C7 nerve roots was significantly smaller than that of the ligaments around nerve roots of C5 and C6 (P<0.05). The semiconic posterosuperior ligament around the C5 and C6 nerve roots was reinforced by Sharpey fibers at its insertion to the transverse process. Sharpey fibers were hardly seen at the hgament around the C7 nerve roots. The failure loads of the attachments around the C5, C6 and C7 nerve roots were respectively (6.47±1.12), (6.23±1.21) and (5.03±1.05) N. The failure loads of the attachments around the C5 and C6 nerve roots were significantly larger than that around the C7 nerve roots (P=0.019 and 0. 046 respectively). Conclusion High incidence of C7 avulsion injury in ob-stetric palsy of brachial plexus may be attributed to the relatively weak semiconic posterosuperior ligament in newborns. Key words: Brachial plexus; Birth injuries; Ligament; Biomechanics; Histology

Postnatal lethality and cardiac anomalies in the Ts65Dn Down Syndrome mouse model

The Ts65Dn mouse is a well-studied model for Down syndrome (DS). The presence of the translocation chromosome T17 16 (referred to as T65Dn) produces a trisomic dosage imbalance for over 100 genes on the distal region of mouse Chromosome 16. This dosage imbalance, with more than half of the orthologs of human Chromosome 21 (Hsa21), causes several phenotypes in the trisomic mice that are reminiscent of DS. Careful examination of neonates in a newly established Ts65Dn colony indicated high rates of postnatal lethality. Although the transmission rate for the T65Dn chromosome has been previously reported as 20%-40%, genotyping of all progeny indicates transmission at birth is near the 50% expected with Mendelian transmission and survival. Remarkably, in litters with maternal care that allowed survival of some pups, postnatal lethality occurred primarily in pups that inherited the T65Dn marker chromosome. This selective loss within 48 h of birth reduced the transmission of the marker chromosome from 49% at birth to 34% at weaning. Gross morphologic examination revealed cardiovascular anomalies, i.e., right aortic arch accompanied by septal defects, in 8.3% of the trisomic newborn cadavers examined. This is an intriguing finding because the orthologs of the DiGeorge region of HSA22, which are posited to contribute to the aortic arch abnormalities seen in trisomy 16 mice, are not triplicated in Ts65Dn mice. These new observations suggest that the Ts65Dn mouse models DS not only in its previously described phenotypes but also with elevated postnatal lethality and congenital heart malformations that may contribute to mortality.

Tomographic physical phantom of the newborn child with real-time dosimetry I. Methods and techniques for construction

A tomographic phantom representing a newborn female patient was constructed using tissue-equivalent materials previously developed at the University of Florida. This phantom was constructed using contoured images from an actual patient data set, a whole-body computed tomography of a newborn cadaver previously described by Nipper et al. [Phys. Med. Biol. 47, 3143-1364 (2002)]. Four types of material are incorporated in the phantom: soft tissue, bone tissue, lung tissue, and air. The phantom was constructed on a slice-by-slice basis with a z-axis resolution of 5 mm, channels for dosimeters (thermoluminescent dosimeter (TLD), metal-oxide-semiconductor field-effect transistor, or gated fiber-optic-coupled dosimeter (GFOC)) were machined into slices prior to assembly, and the slices were then fixed together to form the complete phantom. The phantom will be used in conjunction with an incorporated dosimetry system to calculate individual organ and effective doses delivered to newborn patients during various diagnostic procedures, including, but not limited to, projection radiography and computed tomography. Included in this paper are images detailing the construction process, and images of the completed phantom.

Sensitivity of autopsy and radiological examination in detecting bone fractures in an animal model: Implications for the assessment of fatal child physical abuse

Skeletal injuries are often strong indicators of child abuse and their detection is therefore crucial. The aim of this study was to compare the sensitivity of three diagnostic approaches, namely autopsy, traditional (conventional) radiology, and computed tomography on “battered” piglets, in order to verify the sensitivity of each method, with respect to the true number of bone fractures assessed once the piglet was skeletonised (osteological control). Four newborn cadaver piglets who had died from natural causes were severely beaten post-mortem in every district of the body. Traditional radiography, computed tomography (CT) and autopsy were performed. The piglet was then macerated until skeletonised and the number of all fractures present recorded (osteological control). On the cranium, traditional radiology revealed only 35% circa of actual fractures, autopsy detected only 31% ( P < 0.01 for both comparisons versus osteological control), whereas CT imaging detected all fractures actually present. For ribs, radiology detected only 47% of all fractures present, and autopsy 65% circa ( P > 0.05 for both comparisons versus osteological control), while CT scans detected 34% ( P < 0.01). In suspected cases of fatal child abuse, we suggest that the bones of specific districts be directly analysed either at autopsy or by collecting specific diagnostic sites, such as parts of the rib cage, and subjecting them to maceration. The removed areas could be replaced with artificial material for cosmetic purposes. The authors stress the importance of combined radiological, CT scan, autopsy and osteological survey in the detection of perimortem bone fractures.

The diameters of common carotid artery and its branches in newborns

The common carotid artery (CCA) bifurcation is of clinical importance due to its vascular access site for intravascular intervention. Additionally, it is also one of the most common sites of atherosclerotic plaque formation. There are numerous studies on the diameters of CCA, internal carotid artery (ICA), and external carotid artery (ECA) in adults, but few studies on newborns. Cadaver and angiographic studies have shown dimensional variations in the carotid arteries within/between individuals and also between different sexes. It is well known that the initial lesions of atherosclerosis begin very early in fetal life. Therefore, it is important to know the anatomical details of the CCA and its branches. In the present study, the neck regions of 20 (11 males and 9 females) fixed newborn cadavers were dissected. The CCAs were cut below the bulb of the carotid bifurcation further; ICA and ECA were cut above the bulb of the carotid bifurcation. The internal diameters of the CCA, ICA, and ECA were measured using a light microscopy. ECA/CCA, ICA/CCA, ICA/ECA ratios, and outflow to inflow area ratio were calculated. The mean outflow to inflow area ratio was 1.14+/-0.28. Our results highly correlated with the defined optimal ratio (1.15). The ECA/CCA, ICA/CCA, and ICA/ECA ratios were 0.78+/-0.12, 0.71+/-0.13, and 0.93+/-0.16, respectively. There were no statistically significant differences between male and female and also between right and left sides. These findings are of importance in understanding the anatomy of carotid artery during newborn period.

Synovial knee plica in newborn cadaver knee: a comparison between Anatomy and Arthro-TC

Fifty-two newborn knees were used to verify the validity of the arthro-TC of double contrast for the diagnosis of normal synovial plicas, aiming at classifying and verifying their quantitative incidence and ethnic distribution. The plica synovialis mediopatellaris was identified in brown (60%), white (40%) and black races (9%) in this study. The incidence in black people was quite low as compared to white and brown people. The most commonly found folds were the plica synovialis infrapatellaris (69%) followed by the plica synovialis suprapatellaris (44%) and plica synovialis mediopatellaris (31%). Plicas were not found in 6% of the knees. The communication of bursa patellares with the articulation of the knee is present at birth in 85% of newborns. Identification of plica synovialis infrapatellaris was difficult because it is covered by abundant fat tissue. Arthro-TC was studied and analyzed by six observers, three radiologists and three orthopedic surgeons. The results showed a medium sensibility of 72% and a medium specificity of 60% for radiologist versus 89% and 61% for orthopedist surgeons, respectively.

Formation and location of the sural nerve in the newborn

In this study, the location and formation of the sural nerve were examined in 40 legs of new-born cadavers. The sural nerve was formed by the peroneal communicating branch from the common peroneal nerve joining the medial sural cutaneous nerve in 27 of 40 legs (67.5%). It was formed by the peroneal communicating branch from the lateral sural cutaneous nerve joining the medial sural cutaneous nerve in 4 (10%). It was formed by the peroneal communicating branch from the common peroneal nerve and fibers from the posterior femoral cutaneous nerve joining the medial sural cutaneous nerve in 2 (5%). In 5 of 40 legs (12.5%), the medial sural cutaneous nerve was in the place of the sural nerve without joining any other nerve. In one case (5%), the sural nerve was not formed bilaterally.

Variations of nerves located in deep gluteal region.

The relation of the nerves with the piriformis muscle in the deep gluteal region examined in 50 buttock from 18 male and 7 male newborn cadavers. The nerves were found in usual position in 74% of sides, while one or more nerves perforated the piriformis in 16% and, unusual location of the nerves with intact piriformis was in 10% of sides. Abnormal located nerves are utilised in view of whether originating from dorsal or ventral part of the sacral plexus.