The morphometry of the coracoid process--its aetiologic role in subacromial impingement syndrome.
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Humans↗
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The morphometry of the coracoid process - its aetiologic role in subcoracoid impingement syndrome.
Anatomical morphometric studies of the coracoid process and coraco-glenoid space were carried out on 204 dry scapulae. No statistically significant correlations were found between length, or thickness of the coracoid process, prominence of the coracoid tip, coracoid slope, coraco-glenoid distance, or position of the coracoid tip with respect to the uppermost point of the glenoid. These anatomical characteristics were independent of the dimensions of the scapulae. Three configurations of the coraco-glenoid space were identified. Type I configuration was found in 45% of scapulae and Type II and Type III, in 34% and 21% of specimens, respectively. The lowest value of the coraco-glenoid distance were seen in Type I scapulae. Morphometric characteristics which might predispose to subcoracoid impingement were found in 4% of Type I scapulae. A total of 27 scapulae, nine with each type of configuration were submitted to CT scanning. Scapulae with a Type I configuration were found to have low values for the coraco-glenoid angle and coracoid overlap, which are known to be associated with a short coraco-humeral distance. Subjects with a Type I configuration, and severe narrowing of the coraco-glenoid space, appear to be predisposed to coraco-humeral impingement. These morphometric characteristics may be easily evaluated on CT scans.
Adult↗
Morphometry of the external ear in our adult population.
This study aimed to determine the mean values of the different morphometric measurements from right and left ears. These measurements were taken from 341 healthy young adults (150 women and 191 men) ages 18 to 25 years using an electronic digital caliper. The results showed the mean values for total ear height, lobular height and width, distances from tragus to antihelix and to helix, and ear projection and width to be, respectively, 59.7 +/- 3 mm, 17.5 +/- 1.4 mm, 18.5 +/- 2.2 mm, 16.6 +/- 1.7 mm, 25.1 +/- 2 mm, 16.6 +/- 2 mm, and 31.3 +/- 2.2 mm for the left ear, and 59.5 +/- 3.1 mm, 17.9 +/- 1.5 mm, 18.9 +/- 2 mm, 16.5 +/- 1.8 mm, 25.2 +/- 1.9 mm, 17 +/- 1.9 mm, and 31.2 +/- 2.2 mm for the right ear in the young women. However, in the young men, these values were, respectively, 63.1 +/- 3.6 mm, 18.3 +/- 1.7 mm, 19.4 +/- 2 mm, 17.2 +/- 1.8 mm, 26.3 +/- 1.9 mm, 17 +/- 2.3 mm, and 33.3 +/- 2.2 mm for the left ear, and 62.9 +/- 3.5 mm, 18.4 +/- 1.7 mm, 19.8 +/- 1.9 mm, 17.2 +/- 1.8 mm, 26.6 +/- 1.9 mm, 17.6 +/- 2.1 mm, and 33.1 +/- 2.1 mm for the right ear.
Adolescent↗
Plagiocephaly: morphometry of skull base asymmetry.
The aim of this study was to perform a morphometric analysis of the skull base to understand the mechanism of asymmetry between malformational and deformational plagiocephaly. Since 1988, we have carried out 102 CT scans with three-dimensional reconstruction of the endocranial side of the skull base. There were 20 cases of malformational plagiocephaly, consisting of 18 unicoronal synostoses (UCS) and two unilambdoid synostoses (ULS), and 82 cases of plagiocephaly without synostosis, made up of 60 cases of frontal plagiocephaly (FP) and 22 of occipital plagiocephaly (OP). The skull base asymmetry was analyzed in three ways: (1) the hemibases and the cranial fossa angles were compared with each other; (2) the structural asymmetry of the chondrocranium was calculated; and (3) the architectural asymmetry was measured in relation to the medio-labyrinthine plane. The skull base asymmetry of malformational plagiocephaly was located in the anterior and middle cranial fossae for UCS and in the posterior and middle cranial fossae for ULS. The asymmetry was the result of a localized structural anomaly of the chondrocranium. The asymmetry of deformational plagiocephaly corresponded to a distortion in relation to the medio-labyrinthine plane while the chondrocranium remained symmetric. The skull base asymmetry of malformational plagiocephaly is secondary to a localized malformation of the chondrocranium, and that of the deformational plagiocephaly is secondary to an architectural deformation.
Analysis of Variance↗
Assessment of mastoid air cell size versus sigmoid sinus variables with a tomography-assisted digital image processing program and morphometry.
We assessed the mastoid air cell size and variables of the sigmoid sinus in healthy ears and ears with chronic otitis media (COM). Thirty-eight patients with unilateral COM [15 with cholesteatoma (COM/+) and 23 without cholesteatoma (COM/-)], and 20 subjects with healthy ears, were included in the study. Assessment was performed using a quantitative digital image processing computed tomography (CT) program, and the volume of the mastoid bone was measured using the morphometric method of Cavalieri. In both COM/+ and COM/- patients the sigmoid to suprameatal spine distance and mastoid size were greater on the healthy side than on the diseased side ( p<0.05). The distance and area were significantly greater in the healthy control subjects than in either the healthy or the diseased ears of the patients with COM ( p<0.05). In the healthy ears of COM patients, there was significant correlation between the sigmoid to suprameatal spine distance and air cell size and mastoid volume ( p<0.05). In the diseased ears of COM patients, this correlation was absent ( p>0.05). The sigmoid sinus shape was of the half-moon type (62%), protrusive type (22%) and saucer type (16%). The digital image processing CT program allowed us to estimate the individual area of the air and soft tissue filled mastoid air cells. The mastoid size in both intact and disease ears of COM patients was smaller than in the healthy controls. The mastoid size may be determined genetically. However, environmental factors such as infection may also affect the mastoid size. Therefore, both genetic and environmental factors may be related to COM as far as the size of the mastoid air cells is concerned.
Adult↗
Distal femur morphometry: a gender and bilateral comparative study using magnetic resonance imaging.
Among the anthropometric factors to be considered, anatomic differences in the distal femur and intercondylar notch have been implicated as a cause of the different rates of anterior cruciate ligament (ACL) rupture between men and women; therefore, in this study our aim was to evaluate a number of morphometric measurements in the distal part of the femur. Two hundred knee MRI examinations were analyzed: 56 male right, 44 male left, 42 female right and 58 female left. Measurements of the intercondylar height (ICH), intercondylar width (ICW), medial condylar width (MCW), lateral condylar width (LCW) and epicondylar width (EW) were obtained. The notch shape index (NSI) was also calculated. Statistical analysis for comparisons was done by Student's t-test. Correlations between the parameters studied were calculated by Pearson correlation coefficients. Significant bilateral differences were not found (p > 0.05). In all measurements, males showed significantly greater values than females (p < 0.001). No difference was seen in the NSI between males and females (p > 0.05). Conversely a significant association was obtained between age and all parameters. We conclude that the results of this study may be useful for anatomic evaluation of the distal femur region prior to orthopaedic operations.
Adolescent↗
Morphometry of the sacrum for clinical use.
Degenerative disease and instability in the lower lumbar spine may necessitate fusion and stabilization supplemented by instrumentation to the sacrum. However, screw placement in a reasonable position is more difficult to achieve because of the unique anatomy of the first sacral (S1) vertebra. Therefore, this study has been conducted to evaluate sacrum anatomy of the Western Anatolian population in terms of morphometric measurements and make a comparison with previous studies as well as giving a guidance to the surgeons. In this study, 60 dry adult sacrums (30 male and 30 female) were assessed for morphometric analysis. The measurement data for the sacrum and S1 vertebra revealed that there was no significant difference between both sexes except the sacral width and sacral canal width (p<0.05). In the present study, the ratio of S1 corpus' width to sacral width was lower in females compared with males. A detailed knowledge of the morphometric data about sacrum is very important for spinal surgery, as pedicle screw insertion is crucial in spinal instrumentation in order to prevent neurological injury and/or fixation failure.
Adult↗
Histochemistry and morphometry on bone marrow biopsies in chronic myeloproliferative disorders - aids to diagnosis and classification.
The aim of this review is to evaluate morphological characteristics of the different subtypes of chronic myeloproliferative disorders (MPDs) derived by applying immunohistochemical and morphometric techniques to bone marrow biopsies and to combine these results with relevant clinical parameters. In comparison to control specimens, a significant decrease in erythroid precursors is determinable in chronic myeloid leukemia (CML), while this cell lineage is most prominent in polycythemia vera (PV) and moderately to markedly reduced in idiopathic myelofibrosis (IMF). On the other hand, neutrophilic granulopoiesis shows a predominance in CML and a relevant increase in PV, but no conspicuous changes are detectable in essential thrombocythemia (ET). CML is characterized by a prevalent growth of dwarflike micromegakaryocytes, occurring in particular in the so-called megakaryocyte-rich subtypes (about 30%). This finding differs significantly from the pleomorphous aspect, i.e. , clusters of small to giant-sized megakaryocytes in PV and the grossly abnormal (dysplastic) appearance of this cell lineage in patients with IMF. Similar cytological abnormalities of megakaryopoiesis consistent with maturation defects are never encountered in ET. The incidence of mature (resident) macrophages (phagocytic reticular cells) is significantly enhanced in IMF in comparison to the other MPDs and controls. Moreover, there is a striking difference in the density of reticulin-collagen fibers, ranging from normal (ET) to extreme values (IMF). In IMF more than 80% of the patients present with some degree of myelofibrosis-osteosclerosis at diagnosis, while the rest show an initial prefibrotic, hypercellular stage. This feature deserves special attention since, when accompanied by thrombocythemia, it may simulate ET. Sequential bone marrow biopsies in patients with IMF disclose that evolution of myelofibrosis is progressive, but occurs at a variable and unpredictable speed. A synoptical approach regarding clinical diagnosis and histological subtyping of MPDs is explicitly recommended and demonstrated by sets of diagnostic criteria. This rationale requires equal consideration of laboratory data and morphology by clinicians to include well-defined subtypes of MPDs into prospective management studies. Furthermore, it may even warrant follow-up studies and repeated bone marrow examinations in initially unclassifiable cases.
Bone Marrow↗
[Morphometry of megakaryocytes for supporting the histologic diagnosis of chronic myeloproliferative diseases].
Morphometric analysis of sections of biopsy specimens from patients with chronic myeloproliferative disorders (CMPD) can complement the individual histological diagnosis and help to distinguish the four groups of CMPD. A total of 130 diagnostic biopsies from 29 cases of chronic myelocytic leukemia (CML.CT), 26 cases of (CML.MI), 28 of essential thrombocythemia (PTH), 26 cases of chronic megakaryocytic granulocytic myelosis (CMGM), and 21 of polycythemia vera (P. vera), and 30 from healthy control persons were evaluated morphometrically in sections of undecalcified plastic-embedded core biopsies. Clear distinctions were revealed in size of megakaryocytes, nuclear lobulation, clustering, and the nuclear size and shape of megakaryocytes. Nuclear size and cellular size were significantly less in CML (range of means of cellular size: 220-360 microns2) than in the other three Ph1-negative groups (range of means: 480-750 microns2). Nuclear lobulation was more distinct in PTH than in P. vera, and especially in CMGM. Clustering of megakaryocytes was more than twice as frequent in CMGM (8.0-10.5%) as in any of the other three groups (0.1-7.0%). Naked nuclei were more numerous in all groups of CMPD. The main topic of the study is the different size of megakaryocytes in the four main groups of CMPE, allowing a distinction between small-megakaryocytic Ph1-positive CML and large-megakaryocytic Ph1-negative forms of CMPD.
Biopsy↗
Morphometry and estimated bulk oxygen diffusion in larvae of Xenopus laevis under chronic carbon monoxide exposure.
To understand the mechanisms that allow tadpoles of the African clawed frog Xenopus laevis to develop under conditions of impaired convective transport (hemoglobin poisoning with carbon monoxide), whole animal surface area and volume were measured and bulk oxygen diffusion was modeled at four developmental stages (from initiation of heartbeat to pre-metamorphic climax). Surface area [8.5 mm2 at stages Nieuwkoop-Faber (NF) 33-34 to 70.2 mm2 at stages NF 50-51] and volume (1.8 mm3 at stages NF 33-34 to 35.7 mm3 at stages NF 50-51) measured from volumetric analysis from dual plane images of each animal were not significantly different between treatments. Bulk oxygen radial diffusion was estimated by modeling the larvae as a set of adjacent cylinders with different radii. The model was used to predict the oxygen tension at the water-skin interface at which the oxygen tension in the center of the animal is nil (0.7 kPa at stage NF 33-34 and 14.0 kPa at stage NF 50-51), suggesting that bulk oxygen diffusion is sufficient to meet the metabolic demand up to stages NF 46-47 irrespective of the oxygen tension at the water-skin interface. At NF 50-51 an anoxic core in the animal would appear if bulk oxygen diffusion were the only means of oxygen transport at oxygen tensions below 15 kPa. However, the relative volume of the anoxic core would only exceed 10% of the total volume of the animal only at oxygen tensions below 5 kPa. Therefore, the ten-fold increase in mass between NF 50-51 and metamorphosis would prove insufficient for embryonic oxygen requirements via simple diffusion, and therefore would require additional transport mechanisms.
Animals↗
Binswanger's encephalopathy: serial sections and morphometry of the cerebral arteries.
To identify arterial changes that are characteristic of Binswanger's encephalopathy (BE), we analyzed cerebral subarachnoid and medullary arteries of seven BE autopsy specimens by reconstruction of stained serial sections. We also noted the frequency of intimal fibrosis with or without atheroma of the subarachnoid arteries, and determined the medial thickness of the subarachnoid and medullary arteries. The results for the BE specimens were compared with those of six hypertensive brain hemorrhage (HH) specimens and six normotensive (NT) specimens from patients without cerebral abnormalities. In medullary arteries of BE in comparison with HH, we observed nonspecific but significantly more widespread intimal fibrosis with or without atheroma, as well as segmental loss of the medial smooth muscle cells (SMCs), which was sometimes associated with intimal plasma exudation or microaneurysm. A few medullary arteries in BE were completely occluded by fibrous connective tissue. Intimal fibrosis of the subarachnoid arteries was significantly more widespread in BE than in HH and NT. The media of the subarachnoid and medullary arteries was significantly thicker in BE and HH than in NT, and tended to be thicker in BE than in HH. In NT specimens the medullary arteries tended to be thinner in medial thickness than the subarachnoid arteries. These findings suggest that dysfunction of blood flow regulation due to increased arterial stiffness caused by hypertension-induced intimal fibrosis and loss of medial SMCs is an essential mechanism resulting in diffuse myelin loss of the cerebral white matter in BE, whereas luminal stenosis or occlusion and adventitial fibrosis are secondary. Moreover, selective and severe involvement of the cerebral medullary arteries compared with the subarachnoid arteries may be explained by the following two factors, (1) that many medullary arteries have normally dilated segments, and (2) that their media is thinner compared with that of the subarachnoid arteries of the corresponding diameter.
Aged↗
The use of nuclear morphometry for the prediction of survival in patients with advanced cancer of the larynx.
We examined retrospectively whether the quantitative morphometric analysis of nuclear shapes in patients with advanced cancer of the larynx could be used as a prognostic factor. In all, specimens were taken from 90 patients treated by surgery in the Department of Otolaryngology, Jagiellonian University, Cracow, Poland, between 1987 and 1988. The follow-up period was no shorter than 5 years. In the group examined there were 59 patients with T3 tumors and 31 with T4 tumors. A neck dissection was performed on one or both sides in each case. Metastases in regional lymph nodes were found in 26 patients. Histologic grading was assessed in all cases. Fourteen parameters of nuclear shape were studied using a computer-assisted system of image analysis. Morphometric data were compared with patients' survival rates. The worse survival rates were found to be linked with a nuclear area (NA) > or = 64.82 micron 2 and its standard deviation (SDNA) > or = 20.10 micron 2, a nuclear perimeter (NP) > or = 32.45 microns and its variation (SDNP) > or = 4.77 microns, nuclear density (ND) > or = 22,215.63 and its variation (SDND) > or = 6930.85 and nuclear roundness (NR) > or = 0.76. By using multivariate Cox regression analysis the SDND, presence of metastases in lymph nodes and low tumor differentiation were found to be independent prognostic factors. No statistically significant correlation was found between the parameters examined, lymph node status and tumor differentiation.
Adult↗
Relationship between exploratory eye movements and brain morphology in schizophrenia spectrum patients: voxel-based morphometry of three-dimensional magnetic resonance imaging.
The exploratory eye movements of schizophrenia patients and their relatives have been shown to differ from those of patients without schizophrenia and healthy controls. However the mechanism of exploratory eye movement disturbances in schizophrenia patients remains elusive. We investigated the relationship between the exploratory eye movements and brain morphology in 39 schizophrenia spectrum patients. Voxel-based morphometric analysis on three-dimensional magnetic resonance imaging was conducted by means of statistical parametric mapping 99. The decrease in the responsive search score, which is the total number of sections on which the eyes fixed in response to questioning in a comparison task, was significantly correlated with the decreased gray matter in the right frontal eye field (rFEF) including the right supplementary eye field (rSEF), right parietal eye field (rPEF), and right inferior frontal region. These results suggest that disturbance in exploratory eye movement in schizophrenia spectrum patients may be related to neural network dysfunction in FEF, SEF and PEF, which are the eye movement related areas, and in the inferior frontal region that may be related to information organization.
Adult↗
Morphology, immunohistochemistry and morphometry of pancreatic islets in cases of sudden infant death syndrome (SIDS).
The pancreatic islets from 112 infants (66 males and 46 females) who died of SIDS during the years 1990-1992 have been studied. The control group consisted of endocrine pancreas tissue from 19 infants who died of a clear cause of death (pneumonia, drowning, sepsis, etc.). The mean age of the SIDS group was 5.1 months. We found histologically normally developed organs in all the SIDS cases. By evaluating the relative endocrine cell area of the pancreas by immunohistochemical investigations, A-cells were found to make up 10-30%, B-cells 30-60%, D-cells 10-30% and pancreatic polypeptide cells less than 10% in the SIDS group and in the controls with a small increase in glucagon and insulin cells among SIDS cases. The morphometric evaluation revealed that cell enlargement and cytoplasm shrinking occurred slightly more often in the SIDS group than in the control group. The diameter of the islets was normal and the maximal volume was not enlarged. The results did not show significant differences so that a relationship between alterations of the endocrine pancreas and sudden infant death syndrome could not be demonstrated.
Cell Size↗
Endobronchial juvenile hemangioma--a case report of a neonate including immunohistochemical monitoring and nuclear, cellular, and vascular morphometry.
A 3-month-old female child suffered from tachypnea and dyspnea with abnormal blood gas values. Chest X-rays revealed an increased transparency of the left lung and a mediastinal shift to the right side. High resolution computed tomography (CT) documented a narrowing of the left upper stem bronchus. Ensuing endoscopy detected an occlusive endobronchial tumor mass that did not infiltrate the bronchial cartilage as confirmed with endobronchial ultrasonic monitoring. Based on gross histological examination of the surgical specimen obtained using sleeve resection, the highly vascularized tumor exhibited an adenomatoid growth pattern with a rather homogeneous population of nuclei. The light microscopical presentation was consistent with a juvenile (infantile) hemangioma, which was confirmed using immunohistochemical examinations despite the display of neuroendocrine features. Although endobronchial juvenile hemangiomas are an extremely rare event in early childhood, this case underscores the necessity to not neglect its occurrence in differential diagnosis.
Biomarkers, Tumor↗
Prenatal development of the human mandible. 3D reconstructions, morphometry and bone remodelling pattern, sizes 12-117 mm CRL.
Human embryos and fetuses ( n=25) ranging from 12 to 117 mm CRL (crown-rump-length) were serially sectioned and the mandibles were reconstructed in 3D. In addition, characteristic areas of apposition, resorption and resting zones were projected onto the surface of the mandibular reconstructions after histological evaluation of the remodeling processes. Furthermore, morphometric data were taken to describe growth processes in horizontal views. In this way the changing outlines as seen in 3D could be correlated with the remodeling patterns and with the changes in growth. In these stages the mandible showed a general appositional growth, but resorption areas were found at the posterior margins of the mental foramen and at the lateral and medial posterior bony planes at concave surfaces. The bulging of bone underneath and over Meckel's cartilage could be recognized as active appositional growth areas. Meckel's cartilage itself lay in a trough which could be characterized by less apposition and even resorption. Questions were raised in how much the gap between our present knowledge of genetic expression of signaling molecules and the precise morphologic description of the mandibles can be bridged.
Bone Remodeling↗
In vivo morphometry and functional analysis of human articular cartilage with quantitative magnetic resonance imaging--from image to data, from data to theory.
Analyses of form-function relationships and disease processes in human articular cartilage necessitate in vivo assessment of cartilage morphology and deformational behavior. MR imaging and advanced digital post-processing techniques have opened novel possibilities for quantitative analysis of cartilage morphology, structure, and function in health and disease. This article reviews work on three-dimensional post-processing of MR image data of articular cartilage, summarizing studies on the accuracy and precision of quantitative analyses in human joints. It presents normative values on cartilage volume, thickness, and joint surface areas in the human knee, and describes the correlation between different joints and joint surfaces as well as their association with gender, body dimensions, and age. The article summarizes ongoing work on functional adaptation of articular cartilage to mechanical loading, analyses of in situ cartilage deformation in intact joints in vivo and in vitro, and the quantitative evaluation of cartilage tissue loss in osteoarthritis. We describe evolving techniques for assessment of the structural/biochemical composition of articular cartilage, and discuss future perspectives of quantitative cartilage imaging in the context of joint mechanics, mechano-adaptation, epidemiology, and osteoarthritis research. Specifically, we show that fat-suppressed gradient echo sequences permit valid analysis of cartilage morphology, both in healthy and severely osteoarthritic joints, as well as highly reproducible measurements (CV%=1 to 3% in the knee, and 2 to 10% in the ankle). Relatively small differences in cartilage morphology exist between both limbs of the same person (approximately 5%), but large differences between individuals (CV% approximately 20%). Men display only slightly thicker cartilage then women (approximately 10%), but significantly larger joint surface areas (approximately 25%), even when accounting for differences in body weight and height. Weight and height represent relatively poor predictors of cartilage thickness (r2 <15%), but muscle cross section areas display more promising correlations (r2 >40%). The level of physical exercise (sportive activity) does not account for interindividual differences in cartilage thickness. The thickness appears to decrease slightly in the elderly--in particular in women, even in the absence of osteoarthritic cartilage lesions. Strenuous physical exercises (e.g., knee bends) cause a 6% patellar cartilage deformation in young individuals, but significantly less deformation in elderly men and women (<3%). The time required for full recovery after exercise (fluid flow back into the matrix) is relatively long (approximately 90 min). Static in situ compression of femoropatellar cartilage with 150% body weight produces large deformations after 4 h (approximately 30% volume change), but only very little deformation during the first minutes of loading. Quantitative analyses of magnetization transfer and proton density hold promise for biochemical evaluation of articular cartilage, and are shown to be related to the deformational behavior of the cartilage. Application of these techniques to larger cohorts of patients in epidemiological and clinical studies will establish the role of quantitative cartilage imaging not only in basic research on form-function relationships of articular cartilage, but also in clinical research and management of osteoarthritis.
Cartilage, Articular↗
Molecular bone morphometry.
Quantitative histomorphometric assessment of bone biopsies represents a powerful and informative method for the study of metabolic bone diseases. It is the gold standard against which the noninvasive "diagnostic" markers of bone metabolism as well as newly available therapeutic modalities are tested. With the rapid progress in technology of molecular biology, identification of systemic and local biomolecules known to regulate bone metabolism can now be achieved. The study of localization, levels of expression, and synthesis of these factors in bone and its microenvironment is possible through applications of in situ hybridization histochemistry (ISHH) and immunohistochemistry (IHC). Application of ISHH allows study of specific mRNA expression. IHC determines the presence and distribution of target protein in cells. These two methodologies provide the link between the cellular processes of mRNA transcription and translation to the working protein. Combining the established bone histomorphometric techniques with ISHH and IHC elevates the study of bone to new heights, i.e., cellular and molecular mechanistic issues can now be studied.
Bone and Bones↗