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A temporary disc-like structure at the median atlanto-axial joint in human fetuses
Koichiro Sakanaka,Masahito Yamamoto,Hidetomo Hirouchi,Ji Hyun Kim,Gen Murakami,José Francisco Rodríguez Vázquez,Shin-ichi Abe 대한해부학회 2019 Anatomy & Cell Biology Vol.52 No.4
During observations of mid-term and late-stage fetuses, we found a joint disk-like structure at the anterior component of the median atlanto-axial joint. At mid-term, the disk-like structure was thick (0.1–0.15 mm) relative to the sizes of bones surrounding the joint. However, it did not completely separate the joint cavity, and was absent in the inferior and/or central part of the cavity. This morphology was similar to the so-called fibroadipose meniscoid of the lumbar zygapophysial joint that is usually seen in adults. In mid-term fetuses, there was evidence suggesting that a mesenchymal tissue plate was separated from a roof of the joint cavity. In late-stage fetuses, the thickness (less than 0.15 mm) was usually the same as, or less than that at mid-term, and the disk-like structure was often flexed, folded and fragmented. Therefore, in contrast to the zygapophysial meniscoid as a result of aging, the present disk-like structure was most likely a temporary product during the cavitation process. It seemed to be degenerated in late-stage fetuses and possibly also in newborns. Anomalies at the craniocervical junction such as Chiari malformations might accompany this disk-like structure at the median atlanto-axial joint even in childhood.
Ji Hyun Kim,Koichiro Sakanaka,Naomitsu Tomita,Gen Murakami,Hiroshi Abe,Shinichi Abe 대한해부학회 2017 Anatomy & Cell Biology Vol.50 No.1
Pacinian corpuscle-like structures were identified in the digital tendon sheaths and nail beds of hands obtained from eight of 12 human fetuses of gestational age 20–34 weeks (crown-rump length, 150–290 mm). The aberrant corpuscles were present in tight fibrous tissue connecting the flexor tendon sheath to the dorsal aponeurosis (138 corpuscles in the thumbs and all fingers of eight fetuses); loose fibrous tissue inside the sheath on the dorsal side of the tendon (37 corpuscles in the thumbs and all fingers of four fetuses); and the nail bed (10 clusters in the thumbs and second fingers of four smaller fetuses). The aberrant corpuscles in the tendon sheath were classified into two types: thin and short, with tightly packed lamellae, of diameter 20–40 μm and length 20–200 μm; and thick and long, with loosely packed lamellae, of diameter 70–150 μm and length 0.5–1.5 mm. The small corpuscles tended to form clusters, each containing 5–10 structures. Their similarity indicated that the tight and loose lamellae in these two types of corpuscles corresponded to typical immature and mature corpuscles, respectively, usually distributed along the palmar digital nerve. However, mature, large corpuscles were absent from the nail bed, and most aberrant corpuscles were smaller than typical corpuscles along the nerve. The aberrant corpuscles were apparently incorporated into the tendon sheath or nail bed during fetal vascular development, but they appeared to degenerate after birth due to mechanical stress from the tendon or nail.
Yosuke Miyachi,Rumi Nakabayashi,Minami Torai,Koichiro Mitsuoka,Gen Shimada,Toshimi Kaido 대한외상중환자외과학회 2023 Journal of Acute Care Surgery Vol.13 No.3
A male pedestrian in his 30’s was hit by a car and immediately taken to hospital by ambulance. On arrival, his blood pressure was 83/64 mmHg and his heart rate was 140 beats/min. Computed tomography showed extravasation of contrast medium from the lateral segment of the liver. Given the exacerbation caused by hypotension, an emergency laparotomy was performed. Temporary hemostasis was achieved by packing with gauze and a subsequent transcatheter arterial embolization. At the 2nd laparotomy, a small amount of active bleeding from the injury site was noted; therefore, an emergency lateral segmentectomy was performed. The postoperative course was uneventful and he was discharged home 8 days later. The pathology of the liver specimen revealed that a 2.5 cm hepatic hemangioma was the cause of bleeding. Traumatic rupture of hepatic hemangiomas is rare, and most reported cases are of giant hemangiomas. Our case demonstrated that even a small hemangioma can elicit life-threatening bleeding in blunt abdominal trauma.