Comparative morphometry of the human placenta at high altitude and at sea level. I. The shape of the placenta.
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Adaptation, Physiological↗
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Sciatic function index, nerve conduction tests, muscle contraction, and axon morphometry as indicators of regeneration.
The purpose of this study was to determine which parameters were the best measure of nerve regeneration, assuming that the sciatic functional index (SFI) represented the "gold standard." Three different sciatic functional indexes and 11 commonly used electrophysiologic and morphologic indicators of regeneration were all determined in 24 rats 12 weeks after one of three lesions was created in the sciatic nerve. With linear regression analysis, only fiber/axon diameter ratio (D/d) and myelin thickness/axon diameter ratio showed statistically significant correlations with sciatic functional index (r = 0.55 and 0.53, respectively). The other 11 parameters had poorer correlation. Therefore, if sciatic functional index is the best measure of comprehensive nerve function, then other parameters are not. It is probable that each parameter measures some different component of the regeneration process. A stepwise multiple linear regression analysis produced a model that included D/d, nerve conduction velocity, and nerve action potential amplitude that gave a slightly better correlation (r = 0.67). The relatively poor correlation between sciatic functional index and the other parameters of nerve function indicates that all nerve regeneration studies must be interpreted carefully before comparisons are made. Furthermore, the best measure of nerve function remains unproved or undiscovered in the experimental animal.
Animals↗
Morphometry of the orbital region: a soft-tissue study from adolescence to mid-adulthood.
The objective of this study was to gain information about normal sex-related linear and angular dimensions of the orbital region; left-right symmetry; and growth changes between adolescence and mid-adulthood. The three-dimensional coordinates of several soft-tissue landmarks on the orbits and face were obtained by an electromagnetic digitizer in 40 male and 33 female adolescents aged 12 to 15 years, 73 female and 89 male young adults aged 19 to 30 years, and 41 male and 38 female adults aged 31 to 56 years. From the landmarks-binocular and intercanthal widths; paired height and inclination of the orbit relative to both the true horizontal (head in natural head position) and Frankfurt plane; length and inclination of the eye fissure; and the orbital height to eye fissure length ratio were calculated and averaged for age and sex. Comparisons were performed by factorial analysis of variance. Both the linear dimensions and the angular values were significantly larger in male subjects than in female subjects of corresponding age (p < 0.05). A significant effect of age was found (p < 0.05): while the linear distances and the orbital height-to-length ratio were greater in older people of the same sex, the inclination of the eye fissure decreased as a function of age. Both orbital inclinations were larger in the young adult group than in the adolescent and middle-aged groups. On average, the paired measurements were symmetrical, with similar values within each sex and age group. Data collected in this investigation could serve as a database for the quantitative description of human orbital morphology during normal adolescent and adult growth.
Adolescent↗
Morphometry of the thoracic and lumbar spine related to transpedicular screw placement for surgical spinal fixation.
Vertebral transpedicular screws provide secure attachment for posterior spinal fixation devices. Screw design details, biomechanics, and implantation safety depend upon anatomic constraints, especially from the pedicle and body. Previous morphometric data were limited; thus, a retrospective study was undertaken using computerized axial tomograms (CT) of 91 vertebrae (T9-L5). In addition, eight cadaver vertebrae were CT scanned and then cut transversely to compare x-ray measurements with direct physical measurements. Measured parameters included pedicle width, pedicle length, angle of pedicle axis to sagittal plane, and transpedicular cortex-to-cortex chord length. Good correlation is shown to occur between CT scan and direct physical measurements of human vertebrae. Implications for spinal implant screw dimensions and safety of implantation are discussed. Comparison with previously available data is made.
Adolescent↗
Morphometry of the cervical spinal cord and its relation to pathology in cases with compression myelopathy.
The purpose of this study was to determine whether or not computerized tomography myelography (CTM) gave an actual size and shape of the cervical spinal cord, and whether such dimensions reflected pathology of the spinal cord in cases suffering from compression myelopathy. Spinal cord transverse area and compression ratio (sagittal diameter divided by transverse diameter) were measured as indicators of spinal cord morphology. As a basis for this study, we first performed CTM of cadaveric cervical columns and compared the actual dimensions of the spinal cord of the cadaveric specimens with the CTM image. Second, the correlations between these dimensions and pathology of the affected spinal cord were investigated. The results showed that CTM provided a precise image of the actual cross-section of the spinal cord. In 12 cadaveric specimens of cervical myelopathy examined, the transverse area and compression ratio were in good correlation with the severity of observed pathological changes.
Aged↗
Morphometry of the normal cadaveric cervical spinal cord.
STUDY DESIGN: The authors measured the transverse area and diameters of the cadaveric cervical spinal without evidence of nervous system pathology and also investigated factors related to spinal cord size. OBJECTIVES: This study attempted to provide basic data that affords an accurate morphometric analysis of the human cervical spinal cord. SUMMARY OF BACKGROUND DATA: Several postmortem morphometric studies of the spinal cord have been performed, but the measurements are different among the reports, and no authorized standard has been established. METHODS: The authors measured the transverse area and diameters of the C7 segment in 152 cadaveric specimens and investigated the cord size in relation to age, body height, body weight, and brain weight. Of these, 14 cases were selected and their segments from C2 to T1 were measured. RESULTS: There was a considerable individual variation in spinal cord size. The transverse area of the C7 segment varied from 33.3 mm2 to 74.0 mm2 (mean 49.6 +/- 7.4 mm2). The cord size showed a strong correlation with brain weight, and to a lesser degree with age and body height. Although the size of the spinal cord varied from case to case, the relative ratio of the transverse area of each segment to that of the C3 segment was almost the same among the cases examined. CONCLUSIONS: This large variation in cord size should be taken under consideration in morphometric analyses of the spinal cord. When the pathologic cord conditions such as compression or atrophy exist, the normally expected transverse area of the affected segment in each individual is calculable from measurement of a given single normal segment.
Age Factors↗
Morphometry of the supra sciatic notch intrailiac implant anchor passage.
STUDY DESIGN: Anatomic study of human ilia. OBJECTIVE: To determine the anatomic dimensions influencing intrailiac anchor placement and design. SUMMARY OF BACKGROUND DATA: The development of the Galveston intrailiac implant anchor markedly improved results of spinal instrumentation to the pelvis. Better quantification of the passage dimensions is needed for the design of anatomically specific implants. METHODS: The length and outer diameter of two intrailiac anchor passages were determined from randomly selected, disease-free pairs of ilia from 129 white skeletons belonging to the Hamann-Todd Osteological Collection (Cleveland, OH, Museum of Natural History). RESULTS: Path B, an anchor passage running from the posterior superior iliac spine to the anterior inferior iliac spine, was significantly longer than path A, proceeding from the posterior superior iliac spine to the superior rim of the acetabulum, in adult and teenage males and females. For example, in adult females path B measured 141.2 +/- 7.5 mm versus 124.9 +/- 7.1 mm, P = or < 0.0001. The absolute minimum path A length available for an intrailiac post or screw anchor, following the required posterior superior iliac spine removal, was 80 mm in adults and male teenagers and 70 mm in female teenagers. For path B the hip joint was not at risk, and a safe anchor passage of at least 90 mm in teenagers and 110 mm in adults was available. The minimum thickness of the paths occurred directly above the sciatic notch. It was significantly larger in path A than path B, 20.2 +/- 2.4 mm versus 14.4 +/- 3.2 mm, P < 0.0001. CONCLUSION: Of the two supra sciatic intrailiac paths studied, the path passing from the posterior superior iliac spine toward the anterior inferior iliac spine provided a longer and potentially safer anchor site. These studies suggest techniques for accessing longer anchor paths and the need for larger diameter anchors in order to achieve optimum intra iliac anchor stiffness and strength.
Adolescent↗
Pedicle morphometry in the upper thoracic spine: limits to safe screw placement in older patients.
STUDY DESIGN: An anatomic study of pedicle dimensions and orientation was performed for upper thoracic vertebrae from elderly human subjects. OBJECTIVES: To quantify dimensions of thoracic pedicles, and to determine the potential for safe transpedicular screw fixation in the upper thoracic spine. SUMMARY OF BACKGROUND DATA: Clinical and anatomic reports support thoracic pedicle fixation as a safe, effective alternative to hook fixation in both normal and osteoporotic bone. Much available data, however, pertains to young, robust patients, thoracolumbar segments, and mixed placement techniques. METHODS: For this study, T1-T6 vertebrae from 18 human cadavers were separated into individual vertebrae. Examiners measured each vertebra to determine medial-lateral pedicle width, cranial-caudal pedicle height, and coaxial depth from lamina to anterior vertebral cortex. Mean values were derived from repeated measures compared by level and side. RESULTS: Dimension a varied with individual and level, but not between the left and right pedicles. Pedicle diameter uniformly diminished as specimens proceeded caudally from T2. Findings showed that 25% of T1 pedicles, 17% of T2 pedicles, and 42% of T3 pedicles were narrower than 5.5 mm. At T4 61% of pedicles were too small, at T5 67% were too small, and at T6 75% were too small to accept a 5.5-mm screw. Dimension b remained relatively constant. Pedicles became increasingly narrow and oblong in the T4-T6 cross sections. Dimension c increased consistently from T1 to T6. Safe screw lengths ranged from 30 mm at T1 and T2, to 35 mm at T4 -T5, to 40 mm at T5 and T6. CONCLUSIONS: Even the largest patients had some pedicles that could not accommodate the smallest standard pedicle screw, and more than one half of the pedicles average patients were too small. Transpedicular screw placement is not safe in these patients. Proper placement must avoid penetration of the medial pedicle wall.
Aged↗
Vertebral morphometry by X-ray absorptiometry before and after liver transplant: a cross-sectional study.
OBJECTIVES: To evaluate bone density and fracture prevalence in patients with end-stage liver diseases (ESLD) awaiting liver transplant and in orthotopic liver-transplant (OLTx) recipients by using dual energy X-ray absorptiometry. DESIGN: In a cross-sectional study 27 patients (16 males and 11 females, mean age 49.9 +/- 1.7 years) with ESLD, and 36 subjects (26 males and 10 females, mean age 50.5 +/- 1.6 years) who had undergone OLTx 1-70 months before, were recruited. METHODS: All patients underwent biochemical assessment of mineral metabolism. Bone density measurement of the spine and femur and morphometric X-ray absorptiometry (MXA) of the vertebrae were also obtained. RESULTS: Bone density was decreased in both groups as compared to the expected normal values. Spinal density did not differ between the two groups, while femoral bone mass was lower in OLTx than in ESLD patients (T-scores of: femoral neck -1.91 +/- 0.16 vs -1.12 +/- 0.22, P < 0.01; total femur -1.62 +/- 0.16 vs -0.94 +/- 0.23, P < 0.02). Bone alkaline phosphatase was the only independent predictor of femoral density (R2 = -0.21, P < 0.05). Symptomatic fractures were reported by 25% of OLTx and 15% of ESLD patients. MXA vertebral fractures were present in 28% of OLTx and 7.5% of ESLD (P < 0.05) patients. Most of these fractures had been asymptomatic. Total methylprednisolone intake was higher in patients with MXA vertebral fractures than in non-fractured patients (P < 0.05). CONCLUSIONS: Fragility fractures, especially of the spine, occur more frequently after liver transplantation, with corticosteroid treatment being the most important risk factor. Morphometric X-ray absorptiometry represents a useful technique for identifying vertebral fractures even in liver transplanted patients.
Absorptiometry, Photon↗
Optic disc morphometry correlated with confocal laser scanning Doppler flowmetry measurements in normal-pressure glaucoma.
PURPOSE: To examine the relationship between morphologic optic disc parameters and hemodynamic parameters as measured by confocal laser scanning Doppler flowmetry in patients with normal-pressure glaucoma. METHODS: The study included 91 eyes of 54 patients with normal-pressure glaucoma (mean age: 57.7 +/- 9.8 years), and 136 eyes of 77 age-adjusted normal controls. Color stereo optic disc photographs were morphometrically examined, and confocal laser scanning flowmetry (Heidelberg Retinal Flowmeter) in the neuroretinal rim inside of the optic disc, and in the retina close to the temporal and nasal border of the optic nerve head was performed. RESULTS: Mean confocal laser scanning flowmetric measurements in the neuroretinal rim, temporal parapapillary retina, and nasal parapapillary retina were significantly (P<0.03) lower in the normal-pressure glaucoma group than in the age-adjusted control group. Correspondingly, mean confocal laser scanning flowmetric measurements within the neuroretinal rim decreased significantly, with relatively low correlation coefficients, decreasing neuroretinal rim area (P = 0.016; correlation coefficient r2 = 0.026), and increasing mean visual field defect (P = 0.011; r2 = 0.029). Measurements were statistically independent of alpha zone (P = 0.38; r2 = 0.004) and beta zone (P = 0.57; r2 = 0.002) of parapapillary atrophy. CONCLUSIONS: Confocal laser scanning flowmetric measurements within the neuroretinal rim were lower in eyes with normal-pressure glaucoma than in age-matched normal eyes. Confocal laser scanning flowmetric measurements decrease with increasing glaucomatous optic nerve damage. There is, however, a marked variability preventing a clear relationship between stage of glaucoma and decrease in confocal laser scanning flowmetric measurements. The correlation between parapapillary atrophy and confocal laser scanning flowmetric measurements is not statistically significant in normal-pressure glaucoma.
Aged↗
Thoracic pedicle morphometry in vertebrae from scoliotic spines.
STUDY DESIGN: A morphometric analysis of thoracic pedicles in vertebrae from scoliotic specimens. OBJECTIVE: The objective of this study was to quantify the changes occurring in thoracic pedicles affected by a scoliotic deformity. SUMMARY OF BACKGROUND DATA: There exists a lot of controversy in the literature concerning the shape and size of thoracic pedicles in idiopathic scoliosis. In recent years, thoracic pedicle screws are being used more frequently in corrective spine surgery, but few studies have evaluated the morphology of scoliotic thoracic pedicles. MATERIAL AND METHOD: Thirty scoliotic specimens with curves presenting various degrees of severity were studied using a three-dimensional digitizing protocol developed to create a precise three-dimensional reconstruction of the vertebrae. Twenty-two parameters describing specifically the pedicles were then calculated for each vertebra from these reconstructions. Every scoliotic specimen was then matched with a normal specimen to provide for a representative control group and comparisons were made on pedicle width, length, height, surface, and orientation. RESULTS: A total of 683 thoracic vertebrae were measured (325 scoliotic and 358 normal vertebrae). Pedicles located on the concavity of typical right thoracic curves were found to be significantly thinner than their normal counterparts with a maximal mean difference of 1.37 mm at T8. The pedicles on the concavity of the high thoracic compensatory curve were also found to be significantly diminished with a maximal mean difference of 1.68 mm at T4. Mean left pedicle width at T8 (concavity) and mean right pedicle width at T4 (concavity) were found to be 4.08 mm and 2.60 mm, respectively. Pedicle length was found to be slightly increased, and pedicle height was found to be slightly decreased in pedicles from scoliotic spines with no preference for concavity or convexity. Pedicle orientation and inclination were unchanged with respect to each corresponding vertebral body. CONCLUSION: These results are of critical importance for clinicians performing spinal corrective surgery in patients with AIS. Pedicle width is significantly diminished on the concavity of scoliotic curves. Our results advocate caution in the use of pedicle screws in the thoracic spine especially on the concave side of the curve.
Adult↗
Exercise training alters skeletal muscle mitochondrial morphometry in heart failure patients.
BACKGROUND: Previous research has demonstrated that exercise intolerance in heart failure patients is associated with significant alterations in skeletal muscle ultrastructure and oxidative metabolism that may be more consequential than cardiac output. DESIGN: To examine the effect of exercise training on skeletal muscle mitochondrial size in chronic heart failure patients. METHODS: Six heart failure patients participated in 16-weeks of supervised upper and lower extremity exercise training. At the conclusion of training, percutaneous needle biopsies of the vastus lateralis were taken and electron microscopy was used to assess mitochondrial sizes. RESULTS: The exercise programme resulted in a significant increase in peak maximal oxygen consumption ( P< 0.05) and anaerobic threshold (P < 0.04). Knee extension muscle force increased following training ( P< 0.02). After exercise training, the average size of the mitochondria increased by 23.4% (0.036 to 0.046 mu(2), P< 0.015) and the average shape was unaltered. CONCLUSION: Exercise training with heart failure patients alters skeletal muscle morphology by increasing mitochondrial size, with no change in shape. This may enhance oxidative metabolism resulting in an increased exercise tolerance.
Aged↗
Morphometry of cells and guttae in subjects with normal or guttate endothelium with a contour detection algorithm.
PURPOSE: To develop a semiautomatic method to analyze morphology of cells and guttae in corneal endothelium. METHODS: Specular endothelial pictures from 42 and 21 subjects with healthy and guttate corneas, respectively, were analyzed independently by two observers with cell contour-extracting routines. One observer also analyzed healthy endothelia with the Corner method (Bambi). Differences between observers and between methods in mean cell area (MCA), coefficient of variation (CV), and percentage of cells with five, six, or seven sides were tested for significance with paired t tests. The Contour analysis of pictures with guttae included their mean area. RESULTS: There were no significant differences in MCA, CV, or the percentage of cells with five, six, or seven sides between the measurements obtained on repeated analysis by the same observer or on a second analysis performed by a different observer with the Contour method. However, the differences between the Contour and Bambi methods were statistically significant for MCA (337.5 +/- 37.7 vs. 327.7 +/- 36.5), CV (0.32 +/- 0.05 vs. 0.30 +/- 0.05), and percentage of cells with six and seven sides, but not for the percentage of five-sided cells. In subjects with guttata, the MCA was 561 +/- 170 microm, and the mean area of guttae was 1,538 +/- 849 microm. CONCLUSIONS: This detection algorithm is repeatable and reproducible, and it generates a cell border overlay useful in analyzing the morphology of cells and guttae. The analysis of corneal guttae could become a useful follow-up procedure to discriminate between patients with corneal guttata and Fuchs dystrophy.
Adult↗
Analysis of histological and immunohistochemical patterns of the liver in posthepatitic and alcoholic cirrhosis by computerized morphometry.
To assess the degree of fibrosis and the structural changes affecting parenchymal and extraparenchymal components in liver cirrhosis, a computerized morphometric model has been applied to liver specimens from patients with posthepatitic and alcoholic cirrhosis. All specimens have been stained with chromotrope-aniline blue method and monoclonal antibodies against cytokeratin 7, CD31, and VIII factor. Volume fractions of parenchymal compartment and fibrosis have been determined stereologically on CAB slices; moreover, volume fractions of portal bile ducts and proliferated bile ductules, hepatocytes with biliary metaplasia, capillary units, and vascular structures have been measured. Volume fraction of fibrosis was higher in alcoholic cirrhosis when compared with the case of posthepatitic cirrhosis. Volume fractions describing parenchymal compartment showed a similar trend in both viral groups. The main differences were related to immunohistochemical stainings. Volume fraction of hepatocytes with biliary metaplasia was higher in hepatitis C virus-related cirrhosis, whereas volume fractions of biliary structures were more prominent in hepatitis B virus-related cirrhosis. Capillary units were more prominent in posthepatitic cirrhosis than in alcoholic cirrhosis. Interestingly, both forms of posthepatitic cirrhosis show similar features when compared with alcoholic cirrhosis. Our computerized morphometric model well describes and quantifies the morphological alterations of the liver, and it could represent an adjunctive tool to evaluate the degree of dysplastic phenomena involving parenchymal and extraparenchymal components.
Adult↗
Effects of regular resistance training on muscle histopathology and morphometry in elderly patients with chronic kidney disease.
OBJECTIVE: To evaluate muscle histopathological outcomes, adaptation in muscle fiber area, and fiber type proportion after a resistance training program for patients with chronic kidney disease. DESIGN: Vastus lateralis muscle biopsies before and after the study period in seven patients and six healthy subjects performing the exercise program and in five patients in a nonexercising comparison group. RESULTS: The change in degree of histopathological abnormality did not differ between the groups after the exercise program. Muscle fiber type proportion and muscle fiber area was also the same after the observation period. CONCLUSIONS: Patients with chronic kidney disease have muscle histopathological abnormalities already in the predialysis phase. There was no indication that the exercise program had disadvantageous effects on muscle histopathology in these patients. There were no differences in muscle fiber area or in fiber type proportion after the exercise program within or between the groups. Thus, a workload of 60% of one repetition maximum was sufficient to increase muscular strength and endurance in patients with chronic kidney disease but not to increase muscle fiber area or to change muscle fiber type proportion.
Aged↗
Three-dimensional lip morphometry in adults operated on for cleft lip and palate.
Measurements were taken from 18 patients operated on for cleft lip and palate, aged 19 to 27 years, and 162 control subjects matched for sex, age, and ethnic group. Nine soft-tissue landmarks on the lips were digitized by a three-dimensional electromagnetic instrument. From the landmarks, several linear distances (mouth width, philtrum width, vermilion height of upper and lower lip, total vermilion height, total lip height), the interlabial angle, and some areas (vermilion of upper lip, vermilion of lower lip, total vermilion) and volumes (upper lip volume, lower lip volume, total lip volume) were calculated. Patient and reference data were compared by t tests and Watson-Williams tests. In the men, significant differences (p < 0.05) were found in width of the philtrum, height and area of the vermilion part of the upper lip, and total vermilion height and area (all larger in male patients than in controls). In the women, significant differences were found in the height and area of the vermilion part of the upper lip (larger in female patients than in controls), and in the height and area of the vermilion part of the lower lip (smaller in patients than in controls). In both sexes, the interlabial angle was smaller than in the reference population. In conclusion, the upper lip of adult patients operated on for cleft lip and palate differed from that of healthy controls of the same age, sex, and ethnic group. Surgical correction of cleft lip and palate failed to provide a completely normal appearance. The analysis pointed out those parts of the lips and mouth (in particular, the vermilion part of the upper lip) that differed the most from the norm. The method may be used to indicate to the surgeon and patient where additional procedures might be performed to approximate the morphologic characteristics of a reference population.
Adult↗
Morphometry of the adult human earlobe: a study of 547 subjects and clinical application.
The purpose of this study was to define the factors that influence earlobe length and to establish a standard for adult earlobe length by sex and age. The study sample consisted of 547 adult subjects older than 20 years of age. A randomized, prospective design was used. Patients with malignancies, previous surgery or trauma to the earlobe, or congenital earlobe anomalies were excluded. The following variables were studied: sex; age; ethnic origin; skin complexion; height, weight, and body mass index; and piercing. Pearson's correlation, analysis of variance, t test, and multiple regression analysis were used for the statistical analysis. There were 383 women (70 percent) and 164 men (30 percent) aged 20 to 80 years. The average length of the left earlobe was 1.97 cm (SD, 0.42 cm), and that of the right earlobe, 2.01 cm (SD, 0.42 cm) (p < 0.0001). A post hoc test revealed a statistically significant difference among the three age groups (20 to 40 years, 40 to 60 years, and >60 years) in both men and women. Pendulous earlobes were significantly longer and less symmetrical than nonpendulous ones by t test. In men, nonpierced left earlobes were longer than pierced lobes; in women, there was no significant difference between pierced and nonpierced ears. Pearson's correlation tests for weight, height, and body mass index showed that only weight had a significant effect on earlobe length, and only in women. Analysis of variance for ethnic origin and skin color revealed a longer left earlobe in Ashkenazi and Sephardic Jews compared with Ethiopian, Asian, and American Jews and Arabs and a short earlobe in blacks compared with dark and fair-skinned people. On multiple regression analysis, sex and age were the only factors that contributed to earlobe length. A table of average earlobe length by age was formulated on the basis of the authors' findings. These data, together with the knowledge that earlobe length changes little in women over 40, that earlobes are not symmetrical, and that right and left nonpendulous earlobes are symmetrical in individual patients and shorter than pendulous earlobes, can assist the plastic surgeon in deciding on the proper time for loboplasty. The preferable technique is creating a nonpendulous earlobe to minimize the chances of further elongation with time.
Adult↗
Magnetic resonance imaging morphometry of the midbrain in patients with Wilson disease.
In this study, the focus is on midbrain magnetic resonance imaging morphometric measures (transverse diameter of the midbrain peduncle [Tp], transverse diameter of the tegmentum, anteroposterior diameter of the midbrain, interpeduncular distance [IPD], and interpeduncular angle [IPA]) in a group of 47 consecutive patients with neurologic (37 patients) and hepatic (10 patients) forms of Wilson disease (WD). Morphometric measures were significantly different between the group of patients with WD and healthy controls (51 subjects) as well as patients with Parkinson disease (15 patients) and multiple sclerosis (15 patients). Among the studied variables, IPA, Tp, and IPD were particularly useful in differentiating patients from healthy subjects (probability reaching 93%).
Adult↗