Search

Introduction: Mesial temporal lobe epilepsy (MTLE) is the most frequent form of partial epilepsy. Granule cell dispersion, resulting from aberrant neuronal migration in the hippocampus, is pathognomonic of MTLE. Reelin, a secreted neurodevelopmental glycoprotein has a crucial role in controlling the radial migration of neurons. Several animal studies have implicated Reelin in the MTLE pathogenesis Mesial temporal lobe epilepsy (MTLE) is the most frequent form of partial epilepsy. Granule cell dispersion, resulting from aberrant neuronal migration in the hippocampus, is pathognomonic of MTLE. Reelin, a secreted neurodevelopmental glycoprotein has a crucial role in controlling the radial migration of neurons. Several animal studies have implicated Reelin in the MTLE pathogenesis. Methods: The aim of this study was to investigate the Reelin signalling pathway in the MTLE patients. Therefore, we studied each step in the Reelin signalling pathway for the gene and protein expressions, in the hippocampal tissue obtained from patients undergoing surgery for MTLE and compared it with age matched normal autopsy cases. Results: We found statistically significant decrease (P

Core decompression supplemented by stem cell incorporation is an upcoming field of research in avascular necrosis of the femoral head. Plugging the canal to avoid loss of the concentrate injected has been recognized as a crucial step to improve the efficacy of the procedure. We describe a new surgical technique that results in native bone plug formation and eliminates the need for any additional blocker.This pilot study was performed on 4 cadaveric proximal femurs. The standard technique was used for core decompression and bone marrow aspirate concentrate (BMAC) injection. Additionally, two more tracts were drilled, superolateral, and inferomedial to the primary tract.No leakage of the radiopaque dye was observed from the entry point of the primary tract, ensuring its complete blockage in all 4 cadaveric proximal femurs. This was confirmed by sectioning the femur specimens which manifested bone plug formation at the confluence of the three tracts.Our technique is a unique and economical method of preventing leakage of BMAC through the entry point in the proximal femoral metaphysis. This may not only benefit patients but can also provide the groundwork for further research in this field.

The aims of this article are to detail the anatomy of the cystic duct in patients with and without gallstones as it relates to maneuvering of the duct during endoscopic transpapillary gallbladder cannulation, and to elucidate its role in the dynamics of bile flow during gallbladder contraction. One hundred MRCPs were retrieved from the prospectively maintained radiology data system to assess the configuration of the cystic duct and its confluence vis-a-vis the main biliary duct. The configuration of the cystic duct was broadly classified into four types: Angular (44%), Linear (40%), Spiral (11%), and Complex (5%). The level of emergence of the cystic duct from the bile duct was proximal in 29%, middle in 49% and distal in 20%. Its direction from the bile duct was to the right and angled upward in 69%, right and angled downward in 15%, left and angled upward in 13%, and left and angled downward in 1%. Its orifice was on the lateral surface of the bile duct in 50%, posterior in 19%, anterior in 15% and medial in 14%. In two cases, the cystic duct opened directly into the duodenum. Tortuous cystic ducts and non-lateral unions with the bile duct were significantly more prevalent in gallstone cases than the non-gallstone group (p = 0.02). The present study details the spatial anatomy of the cystic duct vis a vis the main biliary duct. This has not been well investigated to date but has become increasingly relevant with the advent of recent gallbladder interventions.

To report a rare variant muscle.Aberrant muscle was observed in the anterior chest wall musculature during routine cadaver prosection.Musculus sternalis consisting of two muscular bellies united at an angle by an intermediate tendon was observed anterior to the pectoral major of the left side. The muscle did not have any bony attachment.The present case represents a hybrid muscle with superior belly derived from the prepectoral mass and inferior belly from ventral longitudinal muscle column. Clinically, the musculus sternalis may be misinterpreted as a pathological mass or lesion thus its accurate knowledge is significant to radiologists, angiologists and surgeons for better interpretation of mammographic images, safer interventions and for reconstructive surgeries.

IntroductionThe atrial muscle sleeve (AMS) of the pulmonary vein is the most common source of the arrhythmogenic triggers in atrial fibrillation (AF). Anatomical substrate generating these ectopic currents is still elusive. The present study was designed to study the AMS of pulmonary veins with an emphasis on the structural basis which might govern AF initiation and perpetuation.Materials and MethodsThe study was conducted on longitudinal tissue section of pulmonary vein, taken from 15 human cadaveric non-diseased hearts. Tissue was studied histologically using H&E and Gömöri trichrome stain. The pacemaker channels were identified by immunohistochemistry using monoclonal HCN4 and HCN1 antibodies.ResultsThe AMS was identified in each pulmonary vein, located between the tunica adventitia and tunica media. A node like arrangement of myocytes was seen within the AMS in 30% of veins. It had a compact zone limited by a fibrous capsule and contained much smaller, paler and interconnected myocytes. Outside the capsule there was a zone of dispersed, singly placed myocytes separating the compact zone from the working myocytes of the AMS. HCN4 and HCN1 antibodies were expressed on the cell membrane of nodal myocytes, while the working myocytes demonstrated none to minimal staining.ConclusionPulmonary veins nodes are similar to the specialized cardiac conductive tissue in, histological arrangement of compact and transitional zones, cellular characteristics, and the presence of pacemaker channels. They might be the anatomical basis of ectopic arrhythmogenic foci. To our knowledge these nodes are being described for the first time in human.

About 30% of epileptic patients do not react to anti-epileptic drugs leading to refractory seizures. The pathogenesis of drug-resistance in Mesial Temporal Lobe Epilepsy (MTLE) is not completely understood. Increased activity of drug-efflux transporters might be involved, resulting in subclinical concentrations of the drug at the target site. The major drug-efflux transporters are permeability glycoprotein (P-gp) and multidrug-resistance associated protein-1 (MRP-1). The major drawback so far is the expressional analysis of transporters in equal numbers of drug-resistant epileptic tissue and age-matched non-epileptic tissue. We have studied these two transporters in the sclerotic hippocampal tissues resected from the epilepsy surgery (n=15) and compared their expression profile with the tissues resected from non-epileptic autopsy cases (n=15). Statistically significant over expression of both P-gp (p-value

The auditory tube (AT), an osteocartilaginous channel, connects the nasopharynx to the middle ear cavity. At the nasopharyngeal opening of the AT, there are dense collections of submucosal glands. In a recent article, Valstar et al. proposed these nasopharyngeal tubal glands conglomerate as salivary glands, which starkly contrasts with their previously known anatomy for being a component of the respiratory tract. This study examines the contesting views regarding the taxonomical categorization of the nasopharyngeal tubal glands.The AT glands in context were examined in human cadavers grossly, and microscopically using routine and special (Hematoxylin and Eosin [HE] and Periodic acid-Schiff [PAS] respectively), as well as immunohistochemical (for alpha-SMA and salivary amylase) staining methods and compared with the major and minor salivary glands and the submucosal glands in the trachea. Further, a biochemical analysis was performed to detect the presence of salivary amylase in the oral and nasopharyngeal secretions of the four living human subjects, representing major salivary glands and tubal glands, respectively.The submucosal seromucous glands with a surface lining of respiratory epithelium were observed at the nasopharyngeal end of AT. The cells in the tubal glands showed cytoplasmic positivity for alpha-SMA, which indicated the presence of the myoepithelial cells; however, this expression was significantly lower than in the seromucous submucosal glands within the trachea. Salivary alpha-amylase was undetectable in the cadaveric tissue samples. Moreover, the amylase level in the nasopharyngeal swabs was negligible compared to the oral swabs.The anatomical location along the respiratory tract, the presence of respiratory epithelium in the overlying mucosa, their morpho-functional resemblance to the seromucous glands in the trachea, and the absence of salivary amylase strongly indicate that the tubal glands are taxonomically different from the salivary glands. Given the available evidence, their existing recognition as a part of the respiratory tract and an integral component of the AT seems more appropriate.

Bone fracture is a severe health concern; therefore, understanding the causes of bone fracture are crucial. This paper investigates the microstructure and fracture behaviour of cadaveric cortical bone of two different groups (Young, n= 6; Aged, n=7). The microstructure is obtained from µ-CT images, and the material parameters are measured with nanoindentation. Fracture behaviour in transverse and longitudinal orientations is investigated experimentally and numerically. The results show that the Haversian canal (HC) size increases and the osteon wall thickness (OWT) decreases significantly in the aged group, whereas a nonsignificant difference is found in tissue properties. The crack initiation (Jic) and crack growth (Jgrow) toughness of the aged group are found to be significantly lower (p

Purpose Due to COVID-19 pandemic, Thanks giving ceremony to cadaver was different this year in two ways: the students were partially exposed to cadaveric dissections (for 7 months) and later learned Anatomy via online classes due to lockdown (for 5 months) and secondly it was not feasible to gather for the ceremony so virtual platform was preferred. The purpose of this study was to discern the gratitude for cadaver and to recognize the importance of cadaveric dissection from the reflection of students who experienced hybrid anatomy learning amidst COVID-19. Methods The study was conducted on 48 first year medical students who were admitted to the college in August 2019 and were willing to participate. An online invitation was sent to students to participate in virtual thanks giving to cadaver ceremony on the last day of their anatomy class (August 2020). Results Though the students partially studied gross anatomy with the aid of dissections on the cadaver; however, they expressed respect and gratitude to the silent mentor in the form of a card, poem, drawing or paragraph and shared it via google classroom platform. The students wished if they could continue their anatomy course in dissection hall as paused due to COVID-19 pandemic. Conclusions Reflection of these students may mark impact on future anatomy students who may or may not get the chance for dissections. The thanks-giving gesture will also help to bind medical science and humanity especially during the crisis of pandemic.

The purpose of this work was to evaluate the arteries supplying the pancreaticoduodenal (PD) complex. The study was conducted on 15 fresh enbloc pancreatic specimens by latex injection method which enabled the visualization of the peripancreatic arteries and their minute branches. The gastroduodenal (GDA), anterior superior pancreaticoduodenal (ASPD), and anterior inferior pancreaticoduodenal (AIPD) artery was found in all the cases, whereas the posterior superior pancreaticoduodenal (PSPD) and posterior inferior pancreaticoduodenal (PIPD) artery was present in 93.34% cases. The ASPD artery originated from GDA in all the cases. Two types of variations were observed in the origin of PSPD artery and four types each in the origin of AIPD and PIPD artery. Anatomical and numerical variations were observed in both anterior and posterior arches, posterior arch being absent in 20% cases. In the present study, an attempt was made to systematically describe the individual arterial configurations of the PD complex. The information provided here has important implications for preoperative planning of technically challenging surgeries and interventions around the pancreatic head.

Better understanding of the surgical anatomy of the triangle of doom and the triangle of pain with fixed bony landmarks like the anterior superior iliac spine (ASIS) and the pubic symphysis (PS) can help in defining a safe location for trocar placement during laparoscopic surgeries and minimize neurovascular complications. Ten cadavers were dissected bilaterally to explore the surgical anatomy of both the triangles. ASIS and PS were evaluated in relation to the deep inguinal ring, external iliac artery, femoral nerve, and inferior epigastric artery. The deep inguinal ring was located at a depth of ~3 cm, about 4.9 ± 0.56 cm along the y-axis and 6.2 ± 0.94 cm along the x-axis, from the ASIS. The external iliac artery was located ~4.33 ± 0.6 cm along the y-axis and 7.29 ± 0.76 along the x-axis from the ASIS. The inferior epigastric artery was at ~4.31 ± 0.38 cm from the midline at the level of ASIS. This knowledge can help in the surface localization of both the triangles and prevent injury to the various neurovascular structures in relation to these triangles. In the current study, cranial to the ASIS lying at a distance of5 cm from the midline was observed to be a safe zone for accessory trocar placement. The umbilical port has been observed to be safe for trocar placement. The mean angle between ductus deferens and testicular vessels was observed to be 43.5° ± 4.79°, which could help in determining their relative locations during various surgical procedures.

Beyond the nutrient and suprascapular foramen, the other foramina, holes or osseous deficiencies, pockets has rarely been reported in scapula. If present, the bony holes or deficiencies may lead to radiolucent areas and may be mistaken for sites of osteolytic destruction related to skeletal metastases, multiple myeloma or others.In the present case of left scapula, unusual osseous deficiencies of different size and shape along with pockets were observed in the body of scapula. The maximum height and width of largest bony deficiency was 35.8 mm and 12.6 mm. There was abnormal osseous thickening beside the lateral border of scapula along with the presence of some spines. Five nutrient foramina, three on the costal and two on the dorsal surface were noticed.The present case reports the osseous deficiencies, pockets and extra osseous growth along the lateral border, multiple nutrient foramina altogether in one specimen. Thorough anatomical knowledge of these unusual osseous variations can provide the clinicians, radiologists and forensic experts with better clinical judgement and may add insight to the surgical planning by orthopaedic surgeons.

Internal bands of the basilar artery (BA) have been rarely studied. Because bands could have obvious consequences in patient diagnosis and care, the present multiinstitutional cadaveric study was performed.The intraluminal bands of BAs were studied in 80 cadaveric specimens derived from India (Group 1) and the United States (Group 2). Their orientation within the vessel was recorded. Measurements included the length of the BA, diameter of the BA, intraluminal band length and thickness, and distance of the band to the vertebrobasilar junction. Selected bands were submitted for histologic analysis.In Group 1, an intraluminal band (all vertically oriented) was identified in 16.6%. The mean length and thickness of the bands were 2.04 mm and 1.33 mm, respectively. These bands were located at a mean distance of 1.74 mm superior to the vertebrobasilar junction. In Group 2, an intraluminal band was identified in 6%. One band was vertically positioned, and 2 were horizontally positioned. The mean length and thickness of the bands were 2.5 mm and 0.9 mm, respectively. These latter bands were located at a mean distance of 2.23 mm superior to the vertebrobasilar junction. Histologically, the bands were essentially extensions of the tunica media and interna of the artery.To our knowledge, this study is the first multiethnic study of the prevalence and morphometry of the BA bands. A better understanding of these bands may help reveal their relationship to thrombus and aneurysmal formation and their impact on endovascular procedures.

The incidence of facial palsy in parotid surgeries is up to 50% transient and 17% complete facial palsy. Locating facial nerve trunk during parotid surgery can be tricky despite using the standard landmarks. During a cadaveric dissection, we came across a simple technique to identify the trunk of facial nerve which we have also tried to use it in clinical setting and found it to be useful. Parotidectomy was done in 12 cadaveric hemi-faces. The distance between the mastoid tip and the tympanic segment of facial nerve was measured. The distance of the facial nerve and mastoid tip and tympanomastoid suture and facial nerve was measured. The trunk of facial nerve was found to cross the tympanomastoid sulcus-mastoid tip at around 8-10 mm from the mastoid tip in 70% of the cases. We extrapolated this information in 5 cases of parotidectomy in operative setting. We were able to identify facial nerve trunk accurately in 4/5 cases. Imaginary line connecting the mastoid tip and tympanomastoid suture can be used to locate the probable position of the facial nerve trunk reliably during parotidectomy.

Among all the cancer-related deaths globally, pancreatic ductal adenocarcinoma (PDAC) accounts for the seventh leading cause of mortality. A dysregulated immune system disrupts anti-tumor immunity by abnormal accumulation of myeloid-derived suppressor cells (MDSCs), but the underlying mechanisms are still inconclusive. To gain new insights into the role of MDSCs in tumor settings, we aimed to determine the mechanism of expansion of various subsets of MDSCs in PDAC patients and their role in promoting invasiveness. We assessed the load of MDSCs, chemokines responsible for the recruitment of MDSCs in PDAC patients by flow cytometry. We investigated the chemokine profile of tumor tissue using qRT-PCR and the status of epithelial-mesenchymal transition (EMT) related markers E-Cadherin, N-Cadherin, Snail, and ZEB1 by qRT-PCR and immunohistochemistry. We found a higher frequency of tumor infiltrated MDSCs in PDAC patients. Chemokine ligands CCL2 and the receptor CCR4 were markedly elevated in the PDAC tumor, while CCR4

The purpose of the study is to study the details of dimensions and shape of oval window in different age groups, sides and genders and their clinical implications. The oval window is a key structure while performing surgeries in relation to stapes. An intricate knowledge of the shape and size of the oval window is important for the reconstruction and fitting of cartilage compatible with the native shape of the oval window. Sixty normal wet cadaveric temporal bones of known age; gender and side were micro-dissected. The maximum height and width of the oval window was measured. The shape of the oval window was noticed. The mean value for maximum height and width of the oval window was 1.31 ± 0.28 mm and 2.67 ± 0.42 mm, respectively. The height and width of the oval window ranged between 1 mm and 1.5 mm and 2 mm and 3 mm in majority of the cases. he oval window was found to be oval shaped in 53.3% cases, other shapes such as kidney, D shape, rectangular or trapezoidal were also observed. The refined morphometric information of the oval window will help in preoperative assessment and surgical planning of various oval window-related surgical procedures. The knowledge may also help in designing and selecting proper cartilage shoe for the best outcome. Narrow oval window may cause procedural complications and surgeon discomfort in various stapes surgeries.

With expanding scope of interventions it becomes mandatory to have correct and evidence-based knowledge of surface anatomy of internal abdominal structures. Information available in text books is derived from work done on cadaveric studies. Current study was designed to provide data of key abdominal surface anatomical landmarks and their variations in living subjects using CT imaging of adult population. Cross-sectional study was conducted using 100 abdominopelvic CT scans of patients of Indian origin. Vertebral levels of origin of celiac trunk varied from T11 to L1/2 intervertebral disc, superior mesenteric artery from T12 to L2, inferior mesenteric artery from L2 to L4 and aortic bifurcation from L3 to L5. Origin of both renal arteries varied between T12 and L2 and the formation of inferior vena cava varied from L3 to L5. Vertebral levels of upper pole of both kidneys ranged from T11 to upper L3. Spleen was related to 9th to 11th ribs in 36% and 10th to 12th ribs in 34% scans. Most common vertebral levels of subcostal plane, planum supracristale and planum intertuberculare noticed were lower L2, L4 and lower L5, respectively. Data derived from imaging investigations of living subjects and variations from the conventional descriptions observed in the current study might be helpful for clinicians.

Breast carcinoma is a multifaceted-etiology malignancy. The presence of estrogen (ER), progesterone (PR), and HER2 (human epidermal growth factor receptor 2) receptors in breast carcinoma tissue has therapeutic implications. Recent studies indicate that pineal hormone melatonin by its receptor melatonin 1 (MT1) also influences the development and growth of breast cancer cells. The aim of this cross-sectional study was to elucidate the expression pattern of MT1 receptor in relation to estrogen, progesterone, and HER2 receptors in breast carcinoma. Two groups (receptor positive and triple negative) of breast carcinoma were taken. For comparison, normal mammary tissue was used as control. Immunohistochemistry was carried out using anti-melatonin receptor 1A antibody. Membranous/cytoplasmic expression was seen more than the nuclear expression in the cancerous tissue. Positive correlation of the MT1 expression was seen with ER, PR, and HER 2 receptor. Higher MT1 receptor expression was seen in the receptor-positive cases in comparison with triple-negative cases, which might signify melatonin deficiency in the former, leading to reactive increase in cell receptors. No correlation of MT1 expression with Ki67 index or lymph node status in both receptor-positive and triple-negative cases was found. Normal mammary tissue mainly showed cytoplasmic MT1 immunoreactivity of epithelial cells (ducts and acini), myoepithelial cells, and lining epithelium of blood vessels. Receptor-positive cases would, therefore, benefit from the use of melatonin as supporting therapy. This indicates that melatonin receptor status can be used as an independent pathologic indicator to evaluate breast carcinoma tissue, and melatonin receptor status may help to determine treatment protocols.

To report rare and clinically significant anatomic variations in the biliary drainage of right hepatic lobe. Unique variations in the extra- and intrahepatic biliary drainage of right hepatic lobe were observed in 6 cadaveric livers during dissection on 100 formalin-fixed en bloc cadaveric livers. There was presence of aberrant drainage of right segmental and sectorial ducts in four cases and of accessory right posterior sectorial duct in two cases. We encountered some extensively complicated biliary drainage of right hepatic lobe, unsuccessful recognition of which can lead to serious biliary complications during hepatobiliary surgeries and biliary interventions.

The purpose of this work was to evaluate the sectorial and segmental arterial branching (second- and third-order branching) in the right and left hemilivers, as knowledge of this branching should lead to improved vascular mapping for various endovascular procedures in the liver. The study was conducted on 100 formalin-fixed adult cadaveric livers. The arterial anatomy of the liver was dissected from the origin of the hepatic arteries to their segmental branches. Conventional segmental branching of both the right and the left hepatic arteries was seen in only 25% of the livers. In the remaining livers, the segmental branching of one or both of the hepatic arteries was different from that given in anatomy texts. The branching of the right and left hepatic arteries was anatomically classified into seven and six patterns, respectively, mainly on the basis of their sectorial and segmental anatomy. The present study details the highly diverse segmental arterial anatomy of the liver. The information provided here has important implications for procedures that involve selective catheterization of segmental arteries.

Emerging evidence has shown that the Glucagon like peptide-1 (GLP-1) agonist can be used for treating Alzheimer’s disease, but knowledge of its neural targets is limited. To understand the neural substrates of GLP-1, we have done whole brain mapping for GLP-1 and its receptor (GLP-1R), in 30 human brains. GLP-1 expression was studied by immuno-histochemistry and confirmed by western blot method. GLP-1R gene expression was studied by RT-PCR. GLP-1 expression was seen in most of the cortical areas (maximum in frontal, prefrontal & parietal cortex), diencephalon and brainstem, but not in cerebellum. Protein expression studies validated these results. Highest expression of GLP-1R was found in the frontal cortex. The orbito-frontal cortex and cerebellum had negligible expression. Hippocampus demonstrated significant presence of GLP-1R but patchy immunoreactivity to GLP-1. GLP-1R presence in most of the human cortical regions and absence in cerebellum is the major deviation from the animal brain. Sites which might be of interest in Alzheimer’s have been identified. GLP-1 demonstrated age related decline in most of the areas after 5thdecade. At 60yrs GLP-1 was not found in any of the cortical areas except in the prefrontal cortex but it was present in the sub-cortical areas. Age related profiling of GLP-1 in various brain areas has been analysed, which can have important bearing on understanding the Alzheimer’s. This study provides detailed description of GLP-1 and GLP-1R locations by complete human brain mapping for the first time and may lead to novel treatment options targeting the GLP-1 receptors.

Pancreatic cancer has been identified as one of the deadliest malignancies because it remains asymptomatic and usually presents in the advanced stage. Tumor immune evasion is a well-known mechanism of tumorigenesis in various forms of human malignancies. Chronic inflammation via complex networking of various inflammatory cytokines in the local tissue microenvironment dysregulate the immune system and support tumor development. Pro-inflammatory mediators present in the tumor microenvironment increase the tumor burden by causing immune suppression through the generation of myeloid-derived suppressor cells and T regulatory cells. These cells, along-with myofibroblasts, create a highly immunosuppressive and resistant tumor microenvironment and are thus considered as one of the culprits for the failure of anti-cancer chemotherapies in pancreatic adenocarcinoma patients. Targeting these myeloid-derived suppressor cells using various combinatorial approaches might have the potential for abrogating the resistance and suppressive nature of the pancreatic tumor microenvironment. Therefore, there is more curiosity in studying the crosstalk of myeloid-derived suppressor cells with other immune cells during pathological conditions and the underlying mechanisms of immunosuppression in the current scenario. In this article, the possible role of myeloid-derived suppressor cells in inflammation-mediated tumor progression of pancreatic adenocarcinoma has been discussed.

Despite the presence of chondrogenic progenitor cells (CPCs) in knee osteoarthritis patients they are unable to repair the damaged cartilage. This study aimed to evaluate the oxidative stress, cellular senescence, and senescence-associated secretory phenotype (SASP) in the CPCs derived from osteoarthritic cartilage and compare with the CPCs of healthy articular cartilage.Isolated CPCs were characterized based on phenotypic expression of stem cell markers, clonogenicity, and tri-lineage differentiation assay. Production of ROS was measured using DCFDA assay. Cellular senescence in CPCs was assessed by senescence-associated beta-galactosidase assay and expression of senescence markers at the gene level using real-time PCR. Morphological features associated with senescent OA-CPCs were studied using scanning electron microscopy. To study SASP, the production of inflammatory cytokines was assessed in the culture supernatant using a flow-cytometer based cytometric bead array.OA-CPCs exhibited elevated ROS levels along with a relatively high percentage of senescent cells compared to non-OA CPCs, and a positive correlation exists between ROS production and senescence. The morphological assessment of senescent CPCs revealed increased cell size and multiple nuclei in senescent OA-CPCs. These results were further validated by elevated expression of senescence genes p16, p21, and p53. Additionally, culture supernatant of senescent OA-CPCs expressed IL-6 and IL-8 cytokines indicative of SASP.Despite exhibiting similar expression of stem cell markers and clonogenicity, CPCs undergo oxidative stress in diseased knee joint leading to increased production of intracellular ROS in chondrogenic progenitor cells that support cellular senescence. Further, senescence in OA-CPCs is mediated via the release of pro-inflammatory cytokines, IL-6 and IL-8.

Anatomy of the temporal region is complex with controversy over the relationship of fascial planes with the upper division of the facial nerve.This study aimed to identify the safe surgical landmarks to preserve the frontotemporal branch of the facial nerve during surgery and define the safest approach for surgical procedures in this region.The anatomical relationship of the frontal branch of the facial nerve, superficial temporal artery (STA), fascial planes, and fat pads was determined after dissection on 10 cadaveric heads, that is (20 sides) Dissection was performed layer by layer from skin to bone.The temporoparietal fascia was made up of multiple (3-4) layers above the zygomatic arch and these layers were integrated with thin fibrous septa. The frontotemporal branch of the facial nerve (FTFN) was observed in a deeper part of temporoparietal fascia and superficial fat pad. The frontotemporal branch of the facial nerve (FTFN) crossed the zygomatic arch as two branches in 25%, as three branches in 65% and as four branches in 10% of specimens.Interfascial dissection between two layers of deep temporal fascia through the intermediate fat pad is superior to other approaches because of the lack of facial nerve branches in this plane. The Intermediate fat could be easily separated from deep layer of deep temporal fascia.

Introduction Despite good surgical knowledge of the anatomy of parotid gland and meticulous surgical technique, the incidence of facial palsy in parotid surgeries is up to 26.7% transient and 1.7% complete facial palsy(1). The risk of facial palsy increases further in malignant and revision cases. Method Superficial parotidectomy was done in 14 cadaveric hemi faces in 10 cadavers. Posterior auricular artery and its stylomastoid branch was dissected and facial nerve trunk was identified in all cases. The relationship of posterior auricular artery along with its stylomastoid branch with the facial nerve trunk was studied and recorded. Result Posterior auricular artery was found running inferior to the facial nerve trunk in 12 cadaveric dissection while the posterior auricular artery was found crossing below the main trunk of facial in 2 cadaver dissection. The average distance between PAA and facial nerve trunk was 7 mm (2-14 mm) Stylomastoid artery was found arising from Posterior auricular artery in 12 of 14 and it was found running medial to the facial nerve trunk in all the 8 cadavers. Conclusion Post auricular artery can be used as another landmark for identification of the main trunk of facial nerve in parotid surgeries.

A three dimensional triangular space 'the Kambin's triangle (KT)' present on the dorsolateral aspect of the intervertebral disc, is considered to be a safe area for transforaminal approaches. It allows access to the exiting and traversing nerve roots, the thecal sac and to the intervertebral disc spaces. Our aim was to calculate the area of the triangle by measuring the height and base at all the intervertebral spaces bilaterally in the lumbar region in North West Indian cadavers and to assess the diameter of circle inscribed within this triangle which will correspond to the size of cannula inserted for the minimally invasive transforaminal approaches in this population. Five randomly chosen adult cadavers were used for this study. After clearing the area, the exiting nerve was identified. The height and base of the bony KTs (n=40) were measured with the help of digital Vernier's calliper (accuracy 0.02 mm) to calculate the area of the KT. There is a steady increase in the area of the bony KT reaching maximum at the level of L4-5 intervertebral space. Statistically there were no differences in the calculated areas between right and left side. The mean diameter of inscribed circle within the triangle also showed gradual increase from 5.82 mm at L1-2 level, reaching maximum value of 7.26 mm at L4-5 level on the right side while on the left side the values were 5.66 mm and 8.16 mm respectively. Careful anatomical consideration is of utmost importance in transforaminal approaches during surgical or interventional procedures in this region. Cannula having external diameter ranging 6-8 mm is recommended for any interventional approach through Kambin's space.

The purpose of this investigation was to evaluate the relation of the basal turn of cochlea with middle cranial fossa and round window as pertaining to middle cranial fossa cochlear implant technique. Fifty-four formalin preserved temporal bones were micro-dissected to expose the basal turn. The point (f) was marked on the basal turn of cochlea where there was minimum distance of basal turn of cochlea from the floor of middle cranial fossa (f1). The f–f1 distance, the angle (∠smf) and distance of point “f” from the round window (s–f) was measured. The mean minimum distance between basal turn of cochlea and floor of middle cranial fossa (f–f1) was 2.0 ± 0.7 mm.The point f was at mean distance (s–f) and angle (∠smf) of 14.7 ± 1.6 mm and 217° ± 13.7° from round window, respectively. The information may be helpful for designing appropriate electrode array for middle fossa technique especially for deciding the length of electrode array towards round window, as otherwise electrode may extend into vestibule of inner ear. In the cases where bone thickness between superior part of basal turn of cochlea and middle cranial fossa is

The purpose of this article is to form a basic guide for beginning the cadaver dissection training programs focused on oculoplastic surgical procedures. Ours was a collaborative study between the departments of Ophthalmology and Anatomy in a tertiary care teaching institute. We formed a step-wise approach to begin the cadaver dissection focused on the oculoplastic surgical procedures. The basics of cadaver procurement, processing, and preparation for dissections were described. The operative requirements of trainees, surgical handling of cadavers, and basic oculoplastic surgical steps were discussed. The types of embalming (cadaver preservation process) and steps have been described in detail. We have emphasized the preoperative discussion about the proposed dissections using standard teachings and skull models for easier understanding. Additional helping tools like soft embalming and injectable substances for better intra-dissection understanding (intra-arterial, intravenous and orbital injections) have been described. Post-dissection cadaver handing and soft-tissue disposal protocols have also been described. Overall, the cadaver dissections provide holistic surgical learning for the residents, specialty trainees, and practitioners. This article may act as a basic step-wise guide for starting the cadaver-based oculoplastics lab dissection in various institutes and workshops.

Aim: The medial temporal lobe (MTL) is a highly complex neuroanatomical structure of tremendous neurosurgical importance. It is a common site for epilepsy, vascular lesions, and tumors. Owing to the critical location behind the sphenoid wing, it is more prone for traumatic contusion often with surgical implications. Hence, its microneurosurgical anatomy needs to be evaluated in detail. Materials and Methods: Twelve formalin-fixed human cadaveric brains from North-west Indian population were dissected under neurosurgical microscope and various dimensions of the MTL and their distance from important neurovascular structures were measured. Results: The MTL consists of important neural structures such as parahippocampal gyrus, uncus, hippocampus, temporal horn, and choroidal fissure. The average distance of tentorium from the uncus was 1.96 mm. The temporal horn and the inferior choroidal point were located from the anterior temporal pole at 22.9 mm and 30.9 mm, respectively. Important vessels that are intimately related to the MTL were anterior choroidal artery (AchA), posterior communicating artery, the P1 segment of posterior cerebral artery, and the M1 segment of middle cerebral artery. Conclusion: Complex anatomic and cytostructural organization makes the MTL unique. In this study, along with the descriptive anatomy, morphometric measurements of various structures were performed. The uncus and its relation to other neurovascular structures is well described in literature, but its exact distance from them as determined in this study is particularly helpful in guiding the surgeons while approaching in this area. Knowledge of the distance of the temporal horn from various surfaces is important while opening the temporal horn to avoid unnecessary damage to nearby structures.

Introduction Arthroscopic procedures like repair of subscapularis tendon tears pose a potential risk of injury to subscapular nerves. Damage to these nerves can be minimized by knowledge of relationship of subscapular nerve with nearby bony landmark such as coracoid process. Methods Gross anatomic dissection of thirty embalmed human cadaveric shoulder specimens was performed; variations in number and origin of subscapular nerves were noted. Distance of point of entry of upper and lower subscapular nerves into the subscapularis muscle from base and tip of coracoid process was measured in both neutral and external rotation with 30° abduction positions of arm. Length and angulation of coracoid process of 48 dry scapulae were also evaluated. Results Variability in terms of origin was more commonly observed in lower than upper subscapular nerve. Minimum safe distance of subscapular nerves was 39 mm medial to the base of a coracoid process with arm kept in neutral position and margin of safety reduced to 33 mm if the arm is in 30° abduction with external rotation position. Range of distance of nerve entry into muscle from tip was very wide as compared to the base of coracoid process. Length of coracoid process ranged from 28 to 45 mm, forward angulation of coracoid process ranged from 53°–86°. Discussion Greater margin of safety for upper and lower subscapular nerves was observed with the arm in neutral position in comparison to 30° abduction with external rotation position and base of coracoid could be more dependable landmark than its tip.

Introduction To evaluate the hepatic arterial, bile duct and portal venous anatomy as applicable to major liver resections. Methods The study was conducted on 100 formalin fixed adult cadaveric livers. The hepatic arterial, bile ductal and portal venous anatomy of the liver was dissected from their origin up to their segmental branching. Left and right hemilivers were compared with regard to the single and multiple vascular or biliary pedicles entering their respective hemilivers. Results The anatomy of all the three structures, ie., hepatic artery, bile duct and portal vein were conventional in 39% and variant, i.e., “triple” anomaly in 4% of liver specimens. In 57% liver specimens, the anatomy of one or two structures was variant and individual variation of hepatic artery, bile duct and portal vein anatomy was observed in 34%, 42% and 14% of livers respectively. The anatomy of hepatic artery was classified according to the Michels classification. In 9% of livers, rare variations not included in Michels classification was found. The drainage pattern of bile ducts was grouped according to Blumgart’s classification. In 11% of livers, rare variations not included in Blumgart’s classification were found. The branching pattern of main portal vein was classified according to the Akgul’s classification. In 1% of livers, rare variations in the right portal vein were found. Discussion In the present study, the vasculobiliary anatomies of liver were highly complex with the existence of many anatomic variations. The increasing complexity of hepatic surgical procedures necessitates appropriate knowledge of these anatomic variations.

The purpose of this investigation was to evaluate the distances and angles on basal turn of cochlea in relation to round window at which the jugular bulb, internal carotid artery and facial nerve are at maximal risk and their implications in cochlear implantation (CI). Fifty-four cadaveric temporal bones were microdissected to expose the basal turn of cochlea, the carotid canal, the facial canal and the jugular fossa. The points were marked on the basal turn of cochlea, where there was minimum distance of basal turn of cochlea from the roof of the jugular fossa (point a), carotid canal (point b) and facial canal (point c). The distances and angles of these points from the round window were measured. The points a, b and c were at mean (range) distances of 2.8 mm (1.3–4.1 mm), 8.4 mm (6.5–10.4 mm) and 16.4 mm (12.5–20.5 mm) and at mean angles of 30° (15°–45°), 111° (71°–136°) and 284° (255°–315°), respectively, from the round window. This study highlights that 2.8 ± 0.5 mm (30 ± 5.40), 8.4 ± 1 mm (111 ± 12.70) and 16.4 ± 1.7 mm (284 ± 13.5) from the round window are the high-risk points on the basal turn of the cochlea for the jugular bulb, internal carotid artery and facial nerve, respectively. A wide range found for each parameter indicates that it is mandatory to evaluate these distances in each CI patient on preoperative radiographs to avoid intraoperative injury to these vital structures.

Introduction There is increasing evidence implicating the active role of melatonin beyond regulation of the human biological clock and reproduction. Its therapeutic use has been extended to neurodegenerative disorders, psychiatric disturbances, memory as well as a host of other neurological manifestations. This study was thus designed to identify regions of brain and retina for the expression of different types of melatonin receptors. Method Six unfixed brains and 10 retinae were studied. Tissue samples were taken from 14 sites in the brain. Immuno-histochemical staining was done using antibody against Melatonin 1and Melatonin 2 receptors. Result In the cerebral cortex, MT 1 receptor presence was mostly detected in layers 4 and 5 while MT2 receptors were mapped in all the layers. The frontal and occipital poles were devoid of both the receptors. The suprachiasmatic nuclei of the hypothalamus had immunoreactivity for both MT1 and MT2 while the larger cells of the supraoptic nuclei showed positivity for MT1 receptors. The pyramidal and granule cells of the cerebellar cortex showed the presence of MT2 receptors while the pons and the medullary reticular formation stained positive for MT1 and MT2. Discussion Differential and comparative characterization of MT1 and MT 2 receptors in different regions of brain and retina has led to virtual creation of a neuroanatomical map localizing potential areas susceptible to interventions specifically targeting melatonergic pathways.

The congenital anomalies of kidney are not uncommon. The incidence of renal anomalies varies from 1:400 for horseshoe kidney to 1:10,000 for bilateral renal agenesis. The most of this available data is from western populations. Little or no data is available on incidence of renal anomalies in Indian population. Our objective was to determine the incidence of congenital renal anomalies in Indian population. A retrospective analysis of observations made from 1,900 consecutive autopsies for presence of congenital renal anomalies was done. In 1,900 autopsies, there were nine cases of congenitally anomalous kidneys (42%). These anomalies included three cases of horseshoe kidney (16%), two cases of extrarenal calyces (12%), and one each of renal ectopia with fusion, trilobar kidney, polycystic kidney and unilateral renal agenesis. The incidence of renal anomalies in Indian population is relatively less as compared to their western counterparts. How to cite this article Gupta T, Goyal SK, Aggarwal A, Chawla K, Kaur H, Sahni D. Congenital Renal Anomalies in Indian Population. J Postgrad Med Edu Res 2017;51(1):12-16.