B Manoharan

Atypical coeliomesenteric anastomosis: The presence of an anomalous fourth coeliac trunk branch.

The presence of more than three coeliac trunk branches is a commonly encountered variant. Literature occasionally describes cases of middle or left colic arteries originating from the celiac trunks or its branches; however, the presence of an anomalous arterial connection between the celiac trunk and both the superior and inferior mesenteric arteries (SMA and IMA, respectively) has yet to be reported. Routine abdominal dissection of a male Caucasian cadaver, revealed the presence of an anomalous fourth arterial branch on the 4‐cm long coeliac trunk. The course of this artery was traced, and it terminated by anastomosing with the marginal artery of the mesenteric circulation. The distal termination point of this anomalous fourth coeliac branch was the marginal artery, 5 cm medial of the splenic flexure, anastomosing almost perpendicularly. The diameter of this anomalous artery was comparable with the left gastric artery at their origins. The artery coursed inferiorlaterally toward the splenic flexure, passing immediately posterior to both the pancreas and the splenic vein. The anastomosis point of this artery, near Griffiths Point, is normally considered a watershed region with dual arterial supply from both the SMA and IMA, allowing collateral circulation. This region has a relatively higher susceptibility to irreversible damage in ischemic diseases because of lower perfusion, thus, the anastomosis of atypical coeliac branches represents a rare case for consideration. Awareness of the possibility of embryological variants will minimize the risk of complications in surgical or clinical procedures, and exploration of rare variants will benefit the understanding of vascular embryology. Clin. Anat., 2010.

Emergency appendicectomy in Australia: findings from a multicentre, prospective study

Emergency appendicectomy is the most common emergency surgical procedure performed in Australia. Despite this frequency, there is a relative paucity of contemporary, broad‐based, local data that examine how emergency appendicectomies are currently performed and what are the outcomes from these operations.

Quantification of medial thinning in human mesenteric arteries in relation to established morphometric parameters

This introductory paper gives an overview of Forensic Anthropology and its relationship to Anatomy. The role of the forensic anthropologist (FA) is to aid the investigating authorities by providing information on the identification of unknown individuals. A very brief account of the development of FA as a subject was given, from its tentative beginnings to its present status, both in the UK and in other countries. The aim of the FA is to establish a basic biological profile for an individual in terms of sex, age-at-death, stature and ethnic affinity but the success and accuracy of this will depend on many factors, not least of which is a thorough knowledge of human anatomy. The nature of the anatomical knowledge needed to determine each of these parameters is discussed. The different circumstances in which an FA is involved, the authorities consulting an FA and the skills needed, are outlined.

Subclassification of hepatocellular adenomas: practical considerations in the implementation of the Bordeaux criteria

Hepatocellular adenomas are benign liver lesions with a risk of rupture and malignant transformation. Various molecular subgroups have been identified which appear to have characteristic morphological and immunohistochemical features. We examined the morphology and immunohistochemical profile of a series of 121 HCA from 97 patients to identify the HCA subtypes present and determine the number at risk for malignant transformation according to the World Health Organization (WHO) criteria for hepatocellular adenomas. There were 34 HNF1α inactivated HCA (28%), 61 inflammatory HCA (50%), 15 β-catenin activated HCA (12%) and 11 unclassified adenomas (9%). This proportion of cases was similar to that seen in other series utilising molecular classification. The morphological features of the adenomas were suggestive but not definite indicators of the subtypes present. Morphological features that showed overlap between the subtypes included steatosis within the lesion, a ductular reaction and focal atypia, so that immunohistochemical typing was required for accurate classification. In conclusion, immunohistochemistry is a clinically useful surrogate for identifying underlying molecular changes in the HCA subtypes.

Age- and gender-associated changes in intima to media ratio (IMR) of mesenteric and coeliac arteries

Mutations in the gene encoding a nuclear intermediate filament protein, lamin A, cause a spectra of human age-related diseases and premature ageing syndromes, affecting a number of somatic tissues including muscle, heart, adipose, bone, neurons and skin. One disease mechanism for lamin diseases proposes that lamin A mutations impair the control of adult stem cell proliferation via retinoblastoma protein (Rb) pathway, which has a critical role in the maintenance of mammalian stem cell populations. Recently, we demonstrated the role of lamin A in Rb-dependent cell cycle regulation and maintenance of proliferation in adult skin cells. To further understand the role of lamin A in longevity and maintenance of proliferation we studied its role in ageing of human dermal fibroblasts (HDF) in vitro, which undergo a progressive loss of proliferative cells and an accumulation of irreversibly arrested senescent cells during ageing. Our results show that human fibroblasts aged in vitro acquire a range of aberrant nuclear phenotypes characteristic of progeroid human fibroblasts. Moreover, we show using three different biochemical techniques, including 2D-gel electrophoresis and mass spectrometry, glutathione blot assays and immunoprecipitation methods, that the C-terminal specific cysteine residues in lamin A undergo oxidative modifications (S-glutathiolation and other irreversible oxidative modifications) in senescent fibroblasts. These modifications inhibit the formation of higher-order disulphidelinked forms of lamin A in senescent fibroblasts as shown by cysteine cross-linking assays. In addition, during biochemical fractionation of senescent fibroblasts, these modifications led to a partial proteolysis of lamin A within its C-terminal domain. Consequently, lamin A fails to tether retinoblastoma protein (pRb) within the nuclei of senescent fibroblasts. Consistent with these findings, addition of extracts from senescent fibroblasts to a Xenopus in vitro nuclear assembly system caused oxidative modifications to C-terminal cysteine residues in Xenopus lamin LIII and inhibited nuclear lamina assembly and DNA replication. Our findings suggest that lamin A acts as an oxidative stress sensor and is a central component of senescence signalling. We propose a novel model for ageing of human fibroblasts in vitro whereby the accumulation of oxidative damage to lamin A contributes to senescence signalling by de-stabilising the nuclear architecture. This novel model of ageing by lamin A redox state may explain the impaired maintenance of cells and tissues and decreased longevity in patients with lamin A mutations and may help develop future drug treatments based on anti-oxidant therapy.