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Study of renal artery in adult North Indian population: A CT study
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Abstracts / Journal of the Anatomical Society of India 65S (2016) S1–S97
235 A computerized tomographic evaluative study of pneumatisation of paranasal air sinuses and association with mastoid air cells T.S. Gugapriya ∗ , S.D. Nalinakumari, E. Kamala, N.V. Kumar Chennai Medical College Hospital and Research Centre, Irungalur, Trichy, Tamilnadu, India Aims and objectives: Mammals have aeration systems in their skull for multitude of functions. The paranasal sinuses and mastoid cells are the best characterised structures for aeration in humans and they develop gradually by pneumatisation of the solid bones of the skull. The proximity of the opening of mastoid air system and paranasal sinuses in the nasopharynx had led to few studies on the influence of paranasal sinuses upon the mastoid pneumatisation post natally with contradicting claims. This study was done to evaluate pneumatisation of the paranasal sinuses and mastoid air cells in adults between genders and between sides in same individual. Material and methods: A retrospective analysis of 120 CT images from patients without paranasal sinuses and mastoid pathology were done. Axial and coronal computed tomography (CT) scans were obtained for both paranasal sinuses and temporal bones. In all scans, the volumes of each area (maxillary sinus, frontal sinus, sphenoid sinus and mastoid air cell) were calculated and analysed statistically. Results: The mean maximum volume of frontal, maxillary and sphenoid sinuses in males, females were (51.1 cm3 , 14.5 cm3 ), (40.9 cm3 , 28.4 cm3 ), (25.1 cm3 , 18.6 cm3 ) respectively. The mean mastoid volume in males, females was 23.1 cm3 , 39.4 cm3 respectively. There was correlation between maximum maxillary volume and maximum mastoid volume in the subjects studied. Women showed less mean volume for all the parameters studied when compared to males except the mastoid volume. Conclusion: The result of this study which showed correlation between maxillary sinus aeration and mastoid pneumatisation necessitates further studies regarding the factors that influence the variation in pneumatisation of the sinuses and mastoid air cells in adults. Conflicts of interest The authors have none to declare. http://dx.doi.org/10.1016/j.jasi.2016.08.243
etc. The specimens were than suspended in Kaiserling (I and II) preservative and stored in Perspex containers. Results: Institutional experience of handling specimen by preservation and imparting with readily available colors remain unchanged and displayed wet-specimen to their optimal elegance. Conclusion: Crafting a museum with brightly hued long-lasting specimen creates a visual orientation by its polychrome effect on observer and can be of great help in medical education. Conflicts of interest The authors have none to declare. http://dx.doi.org/10.1016/j.jasi.2016.08.244 237 Gender determination using clivus dimensions Massarat Jehan MGM Medical College, Indore, India Aims and objectives: The clivus is a bone region formed by the fusion of basi-sphenoid and basi-occiput situated between dorsum sella and foramen magnum, evaluated very clearly in routine CT scan due to its central location. Being a denser part of bony skull it can be recovered intact from scene of crime and therefore need to be researched as an alternate area for sex estimation. Material and methods: CT images of 276 subjects of MP region, in the age group of 13–70 years (140 male, 136 female) were chosen. The clivus length and width was measured using electronic caliper on DICOM viewing software. Results: The mean clivus length and width of male was 4.598 ± 0.3024 cm and 2.981 ± 0.3826 cm respectively which were significantly (p < 0.0001) larger than those of female with 4.391 ± 0.2475 cm and 2.647 ± 0.2388 cm respectively. Using analysis of variance 78.57% of male and 76.47% of female clivus length; and 74.29% of male and 79.41% of female clivus width were sexed correctly. The overall accuracy of correct diagnosis was 76.43% in male and 77.94% in females. Conclusion: CT measurement of the clivus dimensions can be used to differentiate male from female skull to some extent as an additional or only parameter when other parameters or measures were inconclusive in medico-legal cases. Conflicts of interest The author has none to declare.
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http://dx.doi.org/10.1016/j.jasi.2016.08.245
A novel technique for augmenting the visual display of museum specimen
238
Pushpa Potaliya ∗ , S. Ghatak, D.S. Kataria, S. Dhuria, S.M. Nayeem All India Institute of Medical Sciences, Jodhpur, Rajasthan 34200, India Aims and objectives: To formulate a method of coloring wetspecimen for augmenting the visual display of anatomy museum. Material and methods: Various workers reported in literature have worked on numerous regimes for coloring and preservation of wet-specimen, using different varieties of colors. In our department we developed a technique using fabric colors to color various parts of viscera’s, arteries, veins, nerves, ligaments, tendons and muscles,
Study of renal artery in adult North Indian population: A CT study Archana Srivastava 1,∗ , J. Chopra 1 , Heeralal 2 , G. Sehgal 1 , P.K. Sharma 1 , A.K. Srivastava 1,2 1 Department of Anatomy, King George’s Medical University, Lucknow, UP, India 2 Department of Radiodiagnosis, SGPGIMS, Lucknow, UP, India
Aims and objectives: The kidneys are supplied by a single renal artery in 70–75% of normal persons. Renal arteries typically arise at the level of the upper margin of L2 vertebra. The left renal artery is shorter and wider than the right renal artery and arises at a lower
Abstracts / Journal of the Anatomical Society of India 65S (2016) S1–S97
level. The length of the renal artery and its diameter has not been described in standard anatomy textbooks. Renal transplantation has become the only curative option for end stage renal disease. A transplant surgeon requires at least 2 cm of renal artery length before hilar branching to ensure adequate anastomosis. A diameter of 3 mm is must, since anastomosis of arteries <3 mm is difficult and there is a high incidence of thrombosis. Therefore a prior knowledge of the length and diameter of renal artery is essential for renal transplant surgeons. Material and methods: CT scan of 100 normal adult (16 males and 84 females; mean age of 43.5 ± 10.42 years), who were voluntary prospective kidney donors, were analysed using a workstation (Extended Brilliance workspace, Philips Medical Systems). Axial, multi-planar reformatted image (MPR), volume rendered images (VRI) and maximum intensity projections (MIP) were reviewed. Number of renal arteries on either side, level of origin of renal arteries, diameter of renal artery, length of trunk of renal artery was observed and recorded. Prehilar branching of renal artery was defined as branching that occurred within 2 cm of origin of renal artery from aorta. Results: Single renal artery was present in 151 of the total 200 kidneys (75.5%). The prevalence of accessory renal artery (ARA) was 24.5% (49 of the 200 kidneys). In 61% cases the MRA originated at the level of L1 vertebra between its upper and lower margins. On the right side 63.0% of MRA originated at the level of L1 lower margin. The left renal artery originated at a lower level compared to the right MRA. In 47.0% cases the renal artery originated at the level of upper margin and middle of L2 vertebra. The mean length of left and right renal artery was 26.2 ± 10.6 mm was 29.6 ± 12.8 mm respectively. The difference in length was statistically significant (p = 0.040). In 22.5% the length of MRA was <20.0 mm (2.0 cm). The mean diameter of left MRA was 5.8 ± 1.2 mm and right MRA 5.2 ± 1.0 mm and difference was statistically significant (p < 0.001). The mean diameter of left and right MRA in males was more than in females and the difference was statistically significant (p = 0.002 and p < 0.001 respectively). Both in males and females the diameter of left MRA was more than that of right MRA and the difference was statistically significant (p = 0.002 and p < 0.001 respectively). In the present study early branching was seen in 22.5% cases. Early branching was seen in 26.2% females and 3.1% males. On the right side early branching was seen in 19.0% of renal arteries and on the left side it was present in 26.0% of renal arteries. Conclusion: In the present study it was observed that left renal artery was shorter and wider than right renal artery. In 22.5% cases the length was less than 2.0 cm. Conflicts of interest The authors have none to declare. http://dx.doi.org/10.1016/j.jasi.2016.08.246 239 Prevalence of supernumerary teeth in North Indian population: A radiological study Archana Rani 1,∗ , J.P. Gupta 2 , J. Chopra 1 , Rani Anita 1 , A. Pankaj 1 1
Department of Anatomy, King George’s Medical University UP, Lucknow, India 2 Sr. Dental Surgeon, PMHS, Faizabad, UP, India Aims and objectives: Supernumerary teeth are among the most significant dental anomalies affecting the primary and the perma-
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nent dentitions. Supernumerary teeth are defined as any teeth or tooth substance in excess of the usual configuration of 20 deciduous and 32 permanent teeth. The reported prevalence of supernumerary teeth in the permanent dentition ranges from 0.1% to 3.8% and from 0.3% to 0.6% in the deciduous dentition. Reports of this entity are rarely found in the literature. Therefore, a study was planned to evaluate its prevalence in North Indian population. Material and methods: Orthopentograms (OPGs) of 1025 subjects were collected from the Department of Oral Medicine & Radiology, King George’s Medical University, Lucknow. OPGs of permanent dentition were only considered for the study. OPGs of children, persons with fallen teeth, any pathology of teeth and surgical intervention were not included in the study. OPGs were studied carefully for various types of supernumerary teeth and prevalence was calculated. Results: The prevalence of supernumerary teeth was found to be 0.6% among which, unilateral (left) maxillary paramolar was present in 0.3% cases, bilateral maxillary paramolar in 0.1% subjects, 0.1% cases depicted two mesiodens in maxillary arch and 0.1% showed one mesiodens in maxillary arch. Conclusion: Supernumerary teeth may erupt or remain impacted and may lead to various complications. Clinicians should be aware of the various types of supernumerary teeth and their management after thorough clinical and radiographic investigations to meet the challenges. Conflicts of interest The authors have none to declare. http://dx.doi.org/10.1016/j.jasi.2016.08.247 240 Study of calcification of costal cartilages (1st to 7th) in different age groups and its effect on chest expansion in both sexes Koushik Ray 1,∗ , D. Mandal 1 , J. Bardhan 2 1 Department of Anatomy, Bankura Sammilani Medical College, Bankura, West Bengal, India 2 Department of Radiodiagnosis, Bankura Sammilani Medical College, Bankura, West Bengal, India
Aims and objectives: The hyaline costal cartilage is a flexible linkage connecting bony ribs to sternum which calcifies in human. Presence of this calcification has been correlated with increased ageing, usually starting in 2nd decade and described in literatures in limited detail using chest radiographs. It appears in women earlier than in men. Aim was to study the incidence of costal cartilage calcification in different age groups in both sexes and to evaluate the effect of costal cartilage calcification on chest expansion in the same population. Material and methods: Male and female (50 each) in the age group of 30–70 years attending OPD of Bankura Sammilani Medical College, who were not suffering from lung disease but undergone chest X-ray for some other disease at Department of Radiodiagnosis were examined for measurement of chest expansion at the level of xiphisternum after taking due informed consent and their chest X-ray films were examined for calcification. Persons with lung disease, history of chest injury, seriously ill were excluded. Study variables were age and sex. Statistical analysis was done in SPSS. Results: Incidence of costal cartilage calcification in male and female is 38% and 36% respectively and incidence increases with age. Chest expansion decreases with costal cartilage calcification in 87.5% case in males and 89.5% cases in females.
Abstracts / Journal of the Anatomical Society of India 65S (2016) S1–S97
235 A computerized tomographic evaluative study of pneumatisation of paranasal air sinuses and association with mastoid air cells T.S. Gugapriya ∗ , S.D. Nalinakumari, E. Kamala, N.V. Kumar Chennai Medical College Hospital and Research Centre, Irungalur, Trichy, Tamilnadu, India Aims and objectives: Mammals have aeration systems in their skull for multitude of functions. The paranasal sinuses and mastoid cells are the best characterised structures for aeration in humans and they develop gradually by pneumatisation of the solid bones of the skull. The proximity of the opening of mastoid air system and paranasal sinuses in the nasopharynx had led to few studies on the influence of paranasal sinuses upon the mastoid pneumatisation post natally with contradicting claims. This study was done to evaluate pneumatisation of the paranasal sinuses and mastoid air cells in adults between genders and between sides in same individual. Material and methods: A retrospective analysis of 120 CT images from patients without paranasal sinuses and mastoid pathology were done. Axial and coronal computed tomography (CT) scans were obtained for both paranasal sinuses and temporal bones. In all scans, the volumes of each area (maxillary sinus, frontal sinus, sphenoid sinus and mastoid air cell) were calculated and analysed statistically. Results: The mean maximum volume of frontal, maxillary and sphenoid sinuses in males, females were (51.1 cm3 , 14.5 cm3 ), (40.9 cm3 , 28.4 cm3 ), (25.1 cm3 , 18.6 cm3 ) respectively. The mean mastoid volume in males, females was 23.1 cm3 , 39.4 cm3 respectively. There was correlation between maximum maxillary volume and maximum mastoid volume in the subjects studied. Women showed less mean volume for all the parameters studied when compared to males except the mastoid volume. Conclusion: The result of this study which showed correlation between maxillary sinus aeration and mastoid pneumatisation necessitates further studies regarding the factors that influence the variation in pneumatisation of the sinuses and mastoid air cells in adults. Conflicts of interest The authors have none to declare. http://dx.doi.org/10.1016/j.jasi.2016.08.243
etc. The specimens were than suspended in Kaiserling (I and II) preservative and stored in Perspex containers. Results: Institutional experience of handling specimen by preservation and imparting with readily available colors remain unchanged and displayed wet-specimen to their optimal elegance. Conclusion: Crafting a museum with brightly hued long-lasting specimen creates a visual orientation by its polychrome effect on observer and can be of great help in medical education. Conflicts of interest The authors have none to declare. http://dx.doi.org/10.1016/j.jasi.2016.08.244 237 Gender determination using clivus dimensions Massarat Jehan MGM Medical College, Indore, India Aims and objectives: The clivus is a bone region formed by the fusion of basi-sphenoid and basi-occiput situated between dorsum sella and foramen magnum, evaluated very clearly in routine CT scan due to its central location. Being a denser part of bony skull it can be recovered intact from scene of crime and therefore need to be researched as an alternate area for sex estimation. Material and methods: CT images of 276 subjects of MP region, in the age group of 13–70 years (140 male, 136 female) were chosen. The clivus length and width was measured using electronic caliper on DICOM viewing software. Results: The mean clivus length and width of male was 4.598 ± 0.3024 cm and 2.981 ± 0.3826 cm respectively which were significantly (p < 0.0001) larger than those of female with 4.391 ± 0.2475 cm and 2.647 ± 0.2388 cm respectively. Using analysis of variance 78.57% of male and 76.47% of female clivus length; and 74.29% of male and 79.41% of female clivus width were sexed correctly. The overall accuracy of correct diagnosis was 76.43% in male and 77.94% in females. Conclusion: CT measurement of the clivus dimensions can be used to differentiate male from female skull to some extent as an additional or only parameter when other parameters or measures were inconclusive in medico-legal cases. Conflicts of interest The author has none to declare.
236
http://dx.doi.org/10.1016/j.jasi.2016.08.245
A novel technique for augmenting the visual display of museum specimen
238
Pushpa Potaliya ∗ , S. Ghatak, D.S. Kataria, S. Dhuria, S.M. Nayeem All India Institute of Medical Sciences, Jodhpur, Rajasthan 34200, India Aims and objectives: To formulate a method of coloring wetspecimen for augmenting the visual display of anatomy museum. Material and methods: Various workers reported in literature have worked on numerous regimes for coloring and preservation of wet-specimen, using different varieties of colors. In our department we developed a technique using fabric colors to color various parts of viscera’s, arteries, veins, nerves, ligaments, tendons and muscles,
Study of renal artery in adult North Indian population: A CT study Archana Srivastava 1,∗ , J. Chopra 1 , Heeralal 2 , G. Sehgal 1 , P.K. Sharma 1 , A.K. Srivastava 1,2 1 Department of Anatomy, King George’s Medical University, Lucknow, UP, India 2 Department of Radiodiagnosis, SGPGIMS, Lucknow, UP, India
Aims and objectives: The kidneys are supplied by a single renal artery in 70–75% of normal persons. Renal arteries typically arise at the level of the upper margin of L2 vertebra. The left renal artery is shorter and wider than the right renal artery and arises at a lower
Abstracts / Journal of the Anatomical Society of India 65S (2016) S1–S97
level. The length of the renal artery and its diameter has not been described in standard anatomy textbooks. Renal transplantation has become the only curative option for end stage renal disease. A transplant surgeon requires at least 2 cm of renal artery length before hilar branching to ensure adequate anastomosis. A diameter of 3 mm is must, since anastomosis of arteries <3 mm is difficult and there is a high incidence of thrombosis. Therefore a prior knowledge of the length and diameter of renal artery is essential for renal transplant surgeons. Material and methods: CT scan of 100 normal adult (16 males and 84 females; mean age of 43.5 ± 10.42 years), who were voluntary prospective kidney donors, were analysed using a workstation (Extended Brilliance workspace, Philips Medical Systems). Axial, multi-planar reformatted image (MPR), volume rendered images (VRI) and maximum intensity projections (MIP) were reviewed. Number of renal arteries on either side, level of origin of renal arteries, diameter of renal artery, length of trunk of renal artery was observed and recorded. Prehilar branching of renal artery was defined as branching that occurred within 2 cm of origin of renal artery from aorta. Results: Single renal artery was present in 151 of the total 200 kidneys (75.5%). The prevalence of accessory renal artery (ARA) was 24.5% (49 of the 200 kidneys). In 61% cases the MRA originated at the level of L1 vertebra between its upper and lower margins. On the right side 63.0% of MRA originated at the level of L1 lower margin. The left renal artery originated at a lower level compared to the right MRA. In 47.0% cases the renal artery originated at the level of upper margin and middle of L2 vertebra. The mean length of left and right renal artery was 26.2 ± 10.6 mm was 29.6 ± 12.8 mm respectively. The difference in length was statistically significant (p = 0.040). In 22.5% the length of MRA was <20.0 mm (2.0 cm). The mean diameter of left MRA was 5.8 ± 1.2 mm and right MRA 5.2 ± 1.0 mm and difference was statistically significant (p < 0.001). The mean diameter of left and right MRA in males was more than in females and the difference was statistically significant (p = 0.002 and p < 0.001 respectively). Both in males and females the diameter of left MRA was more than that of right MRA and the difference was statistically significant (p = 0.002 and p < 0.001 respectively). In the present study early branching was seen in 22.5% cases. Early branching was seen in 26.2% females and 3.1% males. On the right side early branching was seen in 19.0% of renal arteries and on the left side it was present in 26.0% of renal arteries. Conclusion: In the present study it was observed that left renal artery was shorter and wider than right renal artery. In 22.5% cases the length was less than 2.0 cm. Conflicts of interest The authors have none to declare. http://dx.doi.org/10.1016/j.jasi.2016.08.246 239 Prevalence of supernumerary teeth in North Indian population: A radiological study Archana Rani 1,∗ , J.P. Gupta 2 , J. Chopra 1 , Rani Anita 1 , A. Pankaj 1 1
Department of Anatomy, King George’s Medical University UP, Lucknow, India 2 Sr. Dental Surgeon, PMHS, Faizabad, UP, India Aims and objectives: Supernumerary teeth are among the most significant dental anomalies affecting the primary and the perma-
S77
nent dentitions. Supernumerary teeth are defined as any teeth or tooth substance in excess of the usual configuration of 20 deciduous and 32 permanent teeth. The reported prevalence of supernumerary teeth in the permanent dentition ranges from 0.1% to 3.8% and from 0.3% to 0.6% in the deciduous dentition. Reports of this entity are rarely found in the literature. Therefore, a study was planned to evaluate its prevalence in North Indian population. Material and methods: Orthopentograms (OPGs) of 1025 subjects were collected from the Department of Oral Medicine & Radiology, King George’s Medical University, Lucknow. OPGs of permanent dentition were only considered for the study. OPGs of children, persons with fallen teeth, any pathology of teeth and surgical intervention were not included in the study. OPGs were studied carefully for various types of supernumerary teeth and prevalence was calculated. Results: The prevalence of supernumerary teeth was found to be 0.6% among which, unilateral (left) maxillary paramolar was present in 0.3% cases, bilateral maxillary paramolar in 0.1% subjects, 0.1% cases depicted two mesiodens in maxillary arch and 0.1% showed one mesiodens in maxillary arch. Conclusion: Supernumerary teeth may erupt or remain impacted and may lead to various complications. Clinicians should be aware of the various types of supernumerary teeth and their management after thorough clinical and radiographic investigations to meet the challenges. Conflicts of interest The authors have none to declare. http://dx.doi.org/10.1016/j.jasi.2016.08.247 240 Study of calcification of costal cartilages (1st to 7th) in different age groups and its effect on chest expansion in both sexes Koushik Ray 1,∗ , D. Mandal 1 , J. Bardhan 2 1 Department of Anatomy, Bankura Sammilani Medical College, Bankura, West Bengal, India 2 Department of Radiodiagnosis, Bankura Sammilani Medical College, Bankura, West Bengal, India
Aims and objectives: The hyaline costal cartilage is a flexible linkage connecting bony ribs to sternum which calcifies in human. Presence of this calcification has been correlated with increased ageing, usually starting in 2nd decade and described in literatures in limited detail using chest radiographs. It appears in women earlier than in men. Aim was to study the incidence of costal cartilage calcification in different age groups in both sexes and to evaluate the effect of costal cartilage calcification on chest expansion in the same population. Material and methods: Male and female (50 each) in the age group of 30–70 years attending OPD of Bankura Sammilani Medical College, who were not suffering from lung disease but undergone chest X-ray for some other disease at Department of Radiodiagnosis were examined for measurement of chest expansion at the level of xiphisternum after taking due informed consent and their chest X-ray films were examined for calcification. Persons with lung disease, history of chest injury, seriously ill were excluded. Study variables were age and sex. Statistical analysis was done in SPSS. Results: Incidence of costal cartilage calcification in male and female is 38% and 36% respectively and incidence increases with age. Chest expansion decreases with costal cartilage calcification in 87.5% case in males and 89.5% cases in females.