School Of Anatomical Sciences Research Articles

Topographic and Structural Anatomy of the Suspensory Ligament of the Penis: Implications for Phalloplasty.

The suspensory ligamentous system of the penis supports the penis when erect and plays a key role during coitus. These ligaments, which are prone to injury during coitus, are clinically important in penile reconstruction procedures. The current study investigated the macro- and microanatomy of the suspensory ligamentous system of the penis to determine the origin, course, insertion, dimensions, and tissue composition of these ligaments, knowledge of which is vital for successful penile reconstruction procedures. The study utilized a total of 49 cadavers. Gross anatomy dissection, MRI, and histological staining were performed to elucidate the topography, dimensions, and tissue composition of the suspensory ligaments of the penis. Three ligaments were observed to form the suspensory ligamentous system of the penis. The most superficial is the fundiform ligament, which consists of superficial bundles and deep median bundles, with the former arising from the Scarpa's fascia and the latter arising from the linea alba of the anterior abdominal wall; both inserted into the superficial fascia of the penis. The suspensory ligament of the penis arose from the pubic symphysis and inserted into the deep fascia (Buck's fascia) of the penis. The arcuate ligament arose from the body of the pubis and pubic symphysis and inserted into the Buck's fascia. The ligaments were determined to consist of adipose tissue, collagen fibers, elastic fibers and reticular fibers, in varying proportions. The suspensory ligaments of the penis exhibit a fan-like structure on the penis that allows the forward movement of the penis as a result of engorgement of the erectile bodies while simultaneously offering support.

A cluster of dysmorphologies in a male human body: The value of anatomical variants in health sciences student training

The human body is known to contain many variations in its normal structure which, while of interest to teachers of anatomy, may be vexing to health sciences students when compared to the description of “normal” anatomy in their textbooks. However, these variations, and even dysmorphologies, pose interesting and sometimes challenging learning experiences to students during dissection of the body. Such an instance occurred for undergraduate medical students in the School of Anatomical Sciences, University of the Witwatersrand, South Africa, when three unrelated dysmorphologies were discovered while undertaking a full dissection of a donor’s body. An aberrant right subclavian artery was found in the thoracic cavity and two further dysmorphologies, a supernumerary kidney and accessory indentations on the diaphragmatic surface of the liver presented on dissection of the abdominal cavity. The aberrant right subclavian conformed with previous descriptions of the anomaly. However, the supernumerary kidney lacked a ureter, was lobulated and contained large blood-filled spaces, with histological evidence of urinary tubules in the intervening connective tissue. The accessory hepatic indentations varied in depth, with the deeper one forming a fissure and the less deep indentation, a sulcus. While the described dysmorphologies vary in their incidence, the occurrence of a cluster of three within one body provided a significant opportunity for the students to review the normal anatomy, and especially the complex development of the structures, as well as the clinical significance of each.

Making the Ethical Transition in South Africa: Acquiring Human Bodies for Training in Anatomy.

While dissection remains the method of choice for teaching human anatomy, ethical requirements for obtaining cadavers has made the process of acquiring human bodies more strenuous for institutions. In Africa and at the School of Anatomical Sciences in South Africa, dependence on unclaimed bodies has been prevalent. The aim of the present study was to determine whether more rigorous application of ethical consent has altered the provenance of the cadavers in the School of Anatomical Sciences, University of the Witwatersrand. The numbers of bequeathed/donated/unclaimed cadavers received over the period 2013-2017, as well as their sex and population affinity were analyzed. The majority (96.8%) of the cadavers dissected over the period were from bequests/donations. Marginally more females than males were available. In addition, the population affinity of the cadavers had changed from a majority of South African African (unclaimed) bodies to a majority of South African White (bequest/donated) bodies. The study shows that even with ethical constraints it is possible to transition from the use of mainly unclaimed bodies to the acquisition of bequeathed/donor bodies. However, there may be challenges in relation to anatomical collections in the School as few of the bequest/donated cadavers remain in the School to be added to the collections. These changes also affect the demographics of the Schools' collections.

Bone mineral density of human ear ossicles: An assessment of structure in relation to function.

Human ear ossicles are essential for normal sound conduction from the external environment to the inner ear. These bones are subjected to high biomechanical loads due to the sustained vibrations which occur with reception of sound. It is expected that the bones would undergo a significant amount of remodeling and change in bone mineral density during the lifespan of an individual. Therefore, the aim of the study was to evaluate the possible changes in bone mineral density of regions of the ossicular chain during postnatal life. Forty four left and 36 right sets of human ear ossicles, ranging from a sub-adult age group to a mature adult age group, were sourced from the School of Anatomical Sciences, University of Witwatersrand. The ear ossicles were scanned using a micro-focus CT X-ray. A three-dimensional reconstruction of each ossicle was created from the CT scan. Bone mineral density was then determined at specific sites on the ossicles. There was no statistically significant variation found in the bone mineral density in relation to the age of the specimens. However, the handle of the malleus, the incudo-stapedial joint and the insertion site for the tendon of stapedius had lower bone mineral densities when compared to adjacent articulation and nonattachment sites on the ossicular chain. This is possibly due to biomechanical stress in response to sound conduction rather than ageing. Lower bone mineral density may be indicative of regions that experience the highest biomechanical force, thus, resulting in increased remodeling. Clin. Anat. 31:1158-1166, 2018. © 2018 Wiley Periodicals, Inc.

Evidence of the sternalis muscle in two South African cadavers.

The sternalis muscle is an infrequent, non-pathological anatomical variant typically misrepresented in a clinical context. It presents with 3-8% prevalence, according to cadaveric studies. The muscles were identified during routine cadaver prosection at the School of Anatomical Sciences, University of the Witwatersrand. Here, we report two cases of the sternalis muscle in two South African White cadavers. Analysis of the sternalis muscles revealed unilaterally present, distinctly defined muscle masses on the right (case number 1, female) and left (case number 2, male) hemithorax, lateral to the sternum. The muscles occurred with a prevalence of 2.25% within the cadaveric population examined. The prevalence of the sternalis muscle is generally low, especially in the European population. Their presence represents the remnants of the cutaneous muscles in the ventral thorax of lower animals. Clinically, the sternalis muscle may be misinterpreted as a pathological mass or lesion, thus accurate knowledge regarding its variations and prevalence is of importance.

Three-dimensionally derived interlandmark distances for sex estimation in intact and fragmentary crania

The skull is the element most frequently presented to forensic anthropologists for analysis yet weathering, corpse maiming, and scavenger activity often result in damage and fragmentation. This fragmentation results in a reduction in the number of traditional calliper derived measurements that can be obtained and subjected to discriminant based analyses for sex estimation. In this investigation, we employed three-dimensional geometric morphometric methods to derive novel interlandmark distance measures across six regions of the cranium including the basicranium, basipalate, zygoma, orbits and the cranium globally to create functions to discriminate sex with high efficacy, even in the event of fragmentation. Forty-five homologous landmarks were digitised across each of 227 (114 males and 113 females) South African crania of European descent (white) sampled from the Raymond A Dart Collection of Human Skeletons, housed in the School of Anatomical Sciences, University of the Witwatersrand, South Africa. A total of 990 interlandmark distances (ILDs) were mathematically derived using Pythagorean geometry. These ILDs were then filtered by region and subjected to both direct and stepwise discriminant function analyses. Discriminant equations where derived for each region and achieved the following average cross-validated sex estimation accuracies: basicranium—74%; basipalate—80.2%; zygomatic—82.4; orbits—71.8%; nasomaxilla—83.7%; global cranium—88.2%. A large number of the ILDs used to derive the discriminant functions are novel, demonstrating the efficacy of geometric morphometric methods and illustrating the need to reassess old methods of data collection using modern methods to determine whether they best capture biological differences. The results of this study provide an invaluable contribution to forensic anthropology in South Africa as it provides an accurate, practical means of assessing sex using fragmentary material that may otherwise have been disregarded. These will undeniable aid in accurate sex estimation and ultimately, victim identification.

Blood, sweat and plaster casts: Reviewing the history, composition, and scientific value of the Raymond A. Dart Collection of African Life and Death Masks

This paper addresses the history, composition and scientific value of one of the most comprehensive facemask collections in Africa, the Raymond A. Dart Collection of African Life and Death Masks. Housed within the School of Anatomical Sciences at the University of the Witwatersrand (South Africa), it comprises 1110 masks (397 life, 487 death, 226 unknown). Life masks represent populations throughout Africa; death masks predominately southern Africa. Males preponderate by 75%. Recorded ages are error prone, but suggest most life masks are those of <35 year-olds, death masks of 36+ year-olds. A total of 241 masks have associated skeletons, 209 presenting a complete skull.Life masks date between 1927 and c.1980s, death masks 1933 and 1963. This historical collection presents uncanny associations with outmoded typological and evolutionary theories. Once perceived an essential scientific resource, performed craniofacial superimpositions identify the nose as the only stable feature maintained, with the remaining face best preserved in young individuals with minimal body fat. The facemask collection is most viable for teaching and research within the history of science, specifically physical anthropology, and presents some value to craniofacial identification. Future research will have to be conducted with appropriate ethical considerations to science and medicine.

Unusual foramen in the middle cranial fossae of adult black South African skull specimens.

Variations of the skull base foramina are quite common and often cause surgical confusion during surgical intervention of the region. The unusual foramen was observed in five (0.98%) adult skulls of black South Africans obtained from the Raymond A Dart collection of human specimens housed in the School of Anatomical Sciences at the University of the Witwatersrand. Three of the five specimens were females while the remaining two were males. In four of the five skulls, the unusual foramen was located anterolateral to the foramen rotundum both on the left and right sides. In the fifth specimen, the foramen was located posterolateral to the foramen rotundum on the left half of the middle cranial fossa. On radiographs, two specimens with unusual foramen on the right showed that the foramen opened into a canal directed inferomedially towards the pterygopalatine fossa. In the remaining three specimens, the canals were blind and shallow. This information is vital during interpretation of CT scans at the base of the skull, as any less well-known foramen may be mistaken for abnormalities leading to surgical complications.

Transformation of a cadaver population: Analysis of a South African cadaver program, 1921-2013.

Anatomy has served as a cornerstone in the training of various allied and clinical disciplines and has traditionally been based on dissection of the human body. Thus, to pursue this method of teaching and learning, access to cadavers is of continuing importance. Over a significant period of time unclaimed cadavers have performed an essential role in the teaching of anatomy in South Africa and in Africa. As recent cadaver numbers were declining at the School of Anatomical Sciences, University of the Witwatersrand, Johannesburg and difficulty in procurement was being experienced, the purpose of this study was to critically evaluate the composition of our cadaver population over time so as to provide possible strategies to arrest the decline. A retrospective, quantitative analysis of cadaver records from the School of Anatomical Sciences between 1921 and 2013 was undertaken. Analysis included a comparison of Poisson counts and Fischer's exact test. A significant decrease in the number of cadavers received during the period 2000-2013 and a slow bequest program over the same period of time has led to concerns about the sustainability of teaching anatomy through dissection. Decreases in the numbers of males and cadavers of the black population group occurred between 1990 and 2013, and of bequests from 2000 to 2013. An influence on the cadaver population from a changing political climate and change in socioeconomic status of part of the population was perceived. Changes in sex and population group of the cadavers may have a long-term effect on teaching and research.

The history and composition of the Raymond A. Dart Collection of Human Skeletons at the University of the Witwatersrand, Johannesburg, South Africa

The Raymond A. Dart Collection of Human Skeletons (Dart Collection) is housed in the School of Anatomical Sciences at the University of the Witwatersrand, Johannesburg, South Africa, and comprises one of the largest documented cadaver-derived human skeletal assemblages in the world. This collection originated in the early 1920s as a result of the efforts of Raymond Dart and continues to grow. The skeletons included represent varied indigenous and immigrant populations from southern Africa, Europe and Asia. This contribution documents the history of the collection and provides an updated inventory and demographic assessment of this valuable research collection. According to a recent inventory the Dart Collection currently comprises 2,605 skeletons representing individuals from regional SA African (76%), White (15%), Coloured (4%) and Indian (0.3%) populations. A large proportion of the skeletons (71%) represent males. The recorded ages at death range from the first year to over 100 years of age, but the majority of individuals died between the ages of 20 and 70. The Dart Collection has been affected by collection procedures based on availability. All of the cadavers collected before 1958, and large proportions subsequently, were derived from unclaimed bodies in regional South African hospitals. Some details of documentation (age at death, population group) are estimates and some aspects of the collection demographics (sex ratios) do not closely reflect any living South African population. Our inventory and analysis of the Dart Collection is aimed to assist researchers planning research on the materials from this collection.

The effect of hyperstimulation on transforming growth factor β 1 and β 2 in the rat uterus: possible consequences for embryo implantation

To investigate the effect of exogenous gonadotropins on the expression of transforming growth factor (TGF) beta(1) and beta(2) in the rat uterus and its consequences for successful embryo implantation. Controlled experimental research study. School of Anatomical Sciences, University of the Witwatersrand. Thirty-six adult, virgin, female Sprague-Dawley rats and two fertile males. Follicle-stimulating hormone (FSH) and human chorionic gonadotropin (hCG) were superimposed upon the normal hormonal milieu of normal, cycling female rats before mating. Uterine tissue was collected at peri-implantation stages (i.e., at 4.5, 5.5, and 6.5 days) after mating. Enzyme-linked immunosorbent assay (ELISA) was performed to estimate the blood estrogen and progesterone levels, and immunohistochemistry was performed to localize the TGF-beta(1) and TGF-beta(2) in the uterus. Hyperstimulation affecting the expression of both TGF-beta(1) and TGF-beta(2) during the peri-implantation period. The release of ovarian steroids was altered, causing a change in the endogenous hormonal environment. A marked increase in the expression of TGF-beta(2) was distinct in the glandular epithelium. Expression of both TGF-beta(1) and TGF-beta(2) was weaker in the subluminal stroma when compared with the deeper stromal region. Hyperstimulation with exogenous hormones affects the expression of both TGF-beta(1) and TGF-beta(2), which may contribute to the disruption of the endometrial environment required for successful embryo implantation.

The frequency and anatomical features of torus mandibularis in a Black South African population

Torus mandibularis is a rounded bony protuberance on the lingual surface of the mandible and usually found above the myolohyoid line, medial to the molar roots. This report describes the frequency and morphology of torus and also proffers the likely cause among black South Africans. A total of 284 modern skeletal specimens were obtained from the Raymond Dart Collection of Human Skeletons at the School of Anatomical Sciences, University of the Witwatersrand. The mandibles were classified into dentate and edentulous, while those with torus, especially in dentate mandibles, were reviewed for side location, type and shape. No measurements were made, consistent with the view that these characteristics are non-metrical and should be assessed by means of a standard observatory procedure. Out of 246 dentate mandibles, 60 (24.4%) were found to have torus and only 1 (4.3%) out of the 23 male edentulous mandibles; the difference is statistically significant ( P=2.8%). The torus distribution among males and females was 48 (80%) and 12 (20%), respectively, and again statistically significant ( P< 0.05). Prevalence of torus was highest in the 40–60 years age group. The morphology of the torus showed that 37 (61.7%) were bilateral in location, 42 (70%) were of the solitary type and 31 (51.7%) were round in shape. The formation of torus follows the threshold model which holds that this is primarily a genetic trait, but with environmental factors such as mechanical stress necessary for its development.

Discriminant function sexing of fragmentary femur of South African blacks

When fragmentary and incomplete bones are all that are available to the forensic anthropologist for use in sex determination, non-metric and metric sex discriminating parameters that have been derived from complete bones may be of little use. In such circumstances, sex discriminating metric methods that are of specific application to fragmentary bones will be more useful. Since such studies have not been systematically carried out in bones of South African blacks, the aim of this study was to begin to provide such data. Two hundred and twenty left femurs of black South Africans were obtained from the Raymond A. Dart Collection of African Skeleton, School of Anatomical Sciences, University of the Witwatersrand, South Africa. Five variables from the upper end of the femur and three variables from the lower end of the femur were measured and subjected to univariate and multivariate discriminant function analyses. The vertical head diameter and the medial condylar length were most successful in sex identification from the upper and lower ends of the femur respectively. The combined variables were more useful than the use of variables individually. Discriminant function score equations were derived for individual and combined variables from the upper and lower ends of the femur of the South African blacks.

Sexual Dimorphism of the Calcaneus of South African Blacks

Forensic anthropology is a rapidly growing field in South Africa and skeletal biologists are often called upon by the police to assist in personal identification from skeletal remains, which are recovered in suspected cases of homicide and suicide and in mass disaster. Measurements of the calcaneus have been shown to be sexually dimorphic in South African whites. Since the validity of discriminant function equations in sex determination is population specific, the aim of the present study was to derive similar equations for the calcanei of the South African blacks. The bones that were used in this study were obtained from the Raymond A. Dart Collection of Human Skeletons, School of Anatomical Sciences, University of the Witwatersrand, Johannesburg. One hundred and sixteen (116) intact and non-pathological calcanei, consisting of 58 males and 58 females and belonging to individuals whose age at death ranged between 22 and 75 years, were selected by the simple random sampling technique. The measured variables included the maximum length, the load arm length, the dorsal articular facet length, the body height, the maximum height, the cuboidal facet height, the middle breadth, the dorsal articular facet breadth and the maximum breadth. Discriminant function analyses were done using the Statistical Product and Service Solutions (SPSS) program. All measured parameters of the calcaneus showed significant sexual differences. Length measurements were found to be the most sexually dimorphic. Combinations of variables provided better estimate of sex (79%-86%) than individual variables (64%-79%).

Discriminant Function Sexing of the Calcaneus of the South African Whites

The skull and some postcranial elements, such as the humerus, femur, and tibia, have been used in their intact states for sex determination in forensic and archaeological cases. But, in practice, these bones are often recovered in fragmented states, which render them unsuitable for use in sex determination. The calcaneus is a compact bone that is able to withstand high tensile forces. Some of its parameters have been used for sex determination in American whites and blacks (1) and Italians (2). This bone has not been used for sex determination in the South African white population. Therefore, the aim of this study was to assess the degree of sexual dimorphism of the calcaneus of the South African white population sample, derive discriminant function score equations for use in sex determination, and determine the level of accuracy of its sex-determining ability. Nine parameters were measured on each pair of 53 male and 60 female calcanei of known South African white skeletons, obtained by a random sampling technique from the Raymond A. Dart Collection of Human Skeletons, School of Anatomical Sciences, University of the Witwatersrand, Johannesburg. Basic statistic and discriminant function analysis was performed on the acquired data. The basic statistics showed that all measured parameters were sexually dimorphic. Discriminant function score equations were generated for use in sex determination. The average accuracy of sex classification ranged from 73 to 86% for the univariate method, 81 to 91% for the stepwise method, and 82 to 92% for the direct method. It is concluded that the calcaneus is useful for sex determination in the South African white population.