Morphology of the palmaris longus and plantaris muscles employed as flaps in reconstructive surgery

Tendons are frequently used for reconstructive surgery. This includes palmaris longus, plantaris, the long extensors of the toes and fingers as well as the flexors of the fingers. The surgeon must base his or her selection of the donor tendon for grafting on what is needed, for example tendon size, length, and width. The most desirable tendons in reconstructive surgery are the palmaris longus and plantaris tendons. These two muscles are also considered to be the easiest tendons to harvest, and therefore they remain the ideal choices for plantaris,or tendon grafts. Apart from what is mentioned in the literature, questions remain such as: which characteristics do the palmaris longus and plantaris muscles possess that make them suitable for use as flaps or grafts in reconstructive surgery and; how can knowledge of the characteristics of these muscles improve reconstructive surgery in South Africa? The palmaris longus and plantaris muscles are indeed subject to variation, whether in the general anatomy, form, attachment, actions and/or prevalence. A statistical significant difference was found between the male and female sample when considering the length of the palmaris longus muscle. When comparing the palmaris longus muscle to the plantaris muscles, it was found that there is a statistical significant difference between them as well. Therefore, although these muscles may look alike, when it comes to the surgical aspect it is suggested that the palmaris longus is used when a wider tendon is preferred and the plantaris muscle when a longer tendon is needed. The prevalence of the palmaris longus and plantaris muscles compared well with studies done on other population groups. No correlation was found between the sex of the cadaver and the prevalence of the palmaris longus and plantaris muscles. In addition it was established that there is no relationship between the prevalence of the palmaris longus and plantaris muscles in the same individual. A possible phylogenetic degenerative trend for the palmaris longus muscle was also examined. After studying various age groups, it was determined that such a trend could not be established for this sample. In conclusion, based on the morphology and prevalence of the palmaris longus and plantaris muscles in a South African population, they are ideal for the use of flaps and/or tendon graft in reconstructive surgery. But it is of utmost importance that the reconstructive surgeon, working on South African patients, remember that both these muscles are subject to variation and not only will it be beneficial to employ proper detection methods to determine the viability of either muscle before considering its suitability in reconstructive surgery but also a sound knowledge of the anatomy of these muscles must be known. AFRIKAANS : Tendons word dikwels gebruik vir rekonstruktiewe chirurgie. Dit sluit die M. palmaris longus en M. plantaris, die lang ekstensors van die tone en vingers, sowel as die fleksors van die vingers in. Die chirurg moet sy of haar keuse van die skenkertendon baseer op dit wat benodig word, byvoorbeeld tendongrootte, ~lengte en ~breedte. Die mees gesogte tendons in rekonstruktiewe chirurgie is dié van M. palmaris longus en M. plantaris. Hierdie twee spiere word ook geag as die maklikste spiere om te oes / bekom, en daarom bly hulle die ideale keuse vir weefselsnitte of tendon-oorplantings. Afgesien van wat in die literatuur beskryf word, bly die volgende vrae onbeantwoord: Watter eienskappe maak M. palmaris longus en M. plantaris geskik vir die gebruik as weefselsnitte of tendon-oorplantings in rekonstruktiewe chirurgie en, hoe kan kennis van hierdie eienskappe van dié spiere, rekonstruktiewe chirurgie in Suid-Afrika verbeter? M. palmaris longus en M. plantaris is inderdaad onderworpe aan variasie van die algemene anatomie, vorm, aanhegtings, aksies en / of aanwesigheid en/of afwesigheid. 'n Statistiese beduidende verskil is gevind tussen die manlike en vroulike steekproef ten opsigte van die lengte van M. palmaris longus. M. palmaris longus is met M. plantaris ook vergelyk en daar was gevind dat daar 'n statisties beduidende verskil tussen hierdie spiere is. Alhoewel hierdie spiere dieselfde lyk, is dit belangrik om in ag te neem dat as dit by die chirurgiese aspekte kom, word daar voorgestel dat M. palmaris longus eerder gebruik moet word wanneer 'n wyer tendon verkies word en M. plantaris gekies moet word wanneer ‘n langer tendon benodig word. Daar is goeie ooreenkoms tussen die aanwesigheid en/of afwesigheid van M. palmaris longus en M. plantaris wanneer hul met studies, wat op die ander bevolkingsgroepe gedoen was, vergelyk word. Geen ooreenkomste was tussen die geslag van die kadawer en die aanwesigheid en/of afwesigheid van M. palmaris longus en M. plantaris gevind nie. Daarbenewens was dit vasgestel dat daar geen verhouding tussen die aanwesigheid en/of afwesigheid van M. palmaris longus en M. plantaris in dieselfde individu is nie. 'n Moontlike filogenetiese degeneratiewe tendens vir M. palmaris longus is ook ondersoek. Na die bestudering van verskillende ouderdomsgroepe, is daar bepaal dat so 'n tendens nie bevestig kon word vir hierdie steekproef nie. Ter afsluiting, die morfologie en die aanwesigheid en/of afwesigheid van M. palmaris longus en M. plantaris, in 'n Suid-Afrikaanse bevolking, is ideaal vir die gebruik van weefselsnitte of tendon-oorplantings in rekonstruktiewe chirurgie. Maar dit is van uiterste belang dat die rekonstruktiewe chirurg, wie met Suid-Afrikaanse pasiënte werk, onthou dat beide hierdie spiere onderworpe is aan variasie. Dit sal dus voordelig wees om behoorlike opsporingsmetodes te gebruik om die vatbaarheid van hierdie spiere in rekonstruktiewe chirurgie vas te stel, maar hy of sy het ook kennis van die anatomie van hierdie spiere, nodig. CopyrightDissertation (MSc)--University of Pretoria, 2011.Anatomyunrestricte

Surface preparation and the effects on rock art deterioration

The Drakensberg is the highest part of a 1000-km long escarpment that also forms a natural border between South Africa and eastern Lesotho. The uKhahlamba-Drakensberg Park was declared a World Heritage site in 2000 and is globally significant, in particular due to the rock art painted by San hunter-gatherers who inhabited the area from about 8 000 years ago until the late 19th Century. Approximately 30 000 painted images can be found in nearly 600 rock shelters in the area. Rock art heritage in the Drakensberg is unfortunately being lost through a variety of processes, some natural and others resulting from human impacts. Previous research on the weathering of San paintings has focused largely on either monitoring processes causing weathering in rock shelters or investigating rock surfaces that are adjacent to the rock paintings. Recent findings indicate that some of the San art has been painted onto surfaces that were prepared by smoothing the rock surface with a “grinding stone” and coated with a clay (“ground”) layer prior to the application of pigments. This new information may have important implications for rock art conservation as smoothing of a rock surface could significantly modify the physical and chemical characteristics of the surface, thereby influencing the deterioration of the art. In this study two classification systems are developed from data collected in four rock shelters situated in the Park. The first, a Type of Surface Classification System, is developed for the purpose of identifying different types of rock surfaces within rock shelters. The second, a State of Deterioration Classification System, is developed with the purpose of establishing, through visual inspection, how deteriorated the rock art on different types of rock surfaces is. Linkages between the type of surface and the state of deterioration are also explored. Findings show that it is not only possible to determine which surface type a painting has been painted on, but that different rock surface types can deteriorate through different weathering mechanisms and to a different degree. One type of rock surface, acknowledged but not yet recorded, was found amongst the rock art paintings selected for the purpose of this study. More importantly, the alteration of rock surfaces through human action in the past is found to cause rock surfaces to deteriorate either at an accelerated or a retarded rate as opposed to rock paintings that were made on surfaces that have only been altered by natural weathering mechanisms. For example, if a rock surface has only been smoothed with a grinding stone, results show that weathering mechanisms did not deteriorate the surface as quickly as in the case where a clay ground layer has been applied to the rock surface. Different types of rock surfaces deteriorating through different weathering mechanisms (as a result of surface preparation) might have significant implications in terms of rock art conservation as the strategies implemented to conserve rock art should be adapted to consider surface type. In terms of rock art studies aiming to conserve this precious heritage, the two classification systems presented could, therefore, be useful non-destructive tools in assessing rock art deterioration. CopyrightDissertation (MA)--University of Pretoria, 2011.Geography, Geoinformatics and MeteorologyMAUnrestricte

An anatomical investigation of the suboccipital- and inferior suboccipital triangles

The suboccipital triangle (ST) is a clinically relevant landmark in the posterior aspect of the neck and is used to locate and mobilize the horizontal segment of the third part of the vertebral artery before it enters the cranium. Unfortunately, this space is not always a viable option for vertebral artery exposition, and consequently a novel triangle, the inferior suboccipital triangle (IST) has been defined. This alternative triangle will allow surgeons to locate the artery more proximally, where its course is more predictable. The purpose of this study was to better define the anatomy of both triangles by measuring their borders and calculating their areas. Ethical clearance was obtained from the University of Pretoria (reference number: 222/2021) and both triangles were subsequently dissected out on both the left and right sides of 33 formalin-fixed human adult cadavers. The borders of each triangle were measured using a digital calliper and the areas were calculated using Herons Formula. The average area of the ST is 969.82±153.15 mm2 , while the average area of the IST is 307.48±41.31 mm2 . No statistically significant differences in the findings were observed between the sides of the body, ancestry, or sex of the cadavers. Measurement and analysis of these triangles provided important anatomical information and speak to their clinical relevance as surgical landmarks with which to locate the vertebral artery. Of particular importance here is the IST, which allows for mobilisation of this artery more proximally, should the ST be occluded.http://www.acbjournal.orgAnatom

Degenerative trends of the palmaris longus muscle in a South African population

The literature reports that the palmaris longus muscle (PL) is only found in mammals in which the forelimbs are weight-bearing extremities. It is suggested that the function of this muscle has been taken over by the other flexors in the forearm. Terms used in the literature to describe the diminishing of this muscle include retrogressive or phylogenetic degenerative trends. The aims of this study were to determine the prevalence of PL in a South African population and whether a phylogenetic degenerative trend for the PL exists. To determine the prevalence of the PL, five groups, representing different age intervals (Years 0–20, 21–40, 41–60, 61–80, and 81–99) were used. A sample of 706 participants of various ages was randomly selected. Statistical analysis included comparisons of the prevalence of the muscle between males and females and left and right sides, using a student t-test. A Chi-squared test was used to determine a possible phylogenetic degenerative trend of PL within the five groups. The sample yielded a bilateral absence of the PL in 11.9% of the cases. The muscle was unilaterally absent on the left side in 7.65% and 6.94% on the right side. The Chi-squared tests revealed a P-value of 0.27 for the left arm and 0.39 for the right arm. No obvious trend could be established for the phylogenetic degeneration of the PL in this study. It would appear that the PL muscle should not be considered as a phylogenetically degenerating muscle in a South African population.http://onlinelibrary.wiley.com/journal/10.1002/(ISSN)1098-2353hb201

A morphological study of the shape of the corpus callosum in normal, schizophrenic and bipolar patients

Abnormalities in the morphology of the corpus callosum have been found to be involved in cognitive impairments or abnormal behaviour in patients with mental disorders such as schizophrenia and bipolar disorder. The present study investigated morphological shape differences of the corpus callosum in a large cohort of 223 participants between normal, schizophrenic and bipolar patients on MRI scans, CT scans and cadaver samples. Healthy samples were compared to a mental disorder population sample to determine morphological shapes variations associated with schizophrenia and bipolar disorder. Landmark-based methodology was used to contour the corpus callosum shape that served as standard positions to allow for radial and thickness partitioning in order to determine shape variations within the specific localised anatomical sections of the corpus callosum. Shape analysis was performed using Ordinary Procrustes averaging and superimposing landmarks to define an average landmark position for the specific regions of the corpus callosum. No significant global shape differences were found between the different mental disorders. Schizophrenia and bipolar shapes differed mostly in the genu-rostrum, posterior body, isthmus and splenium. Sample group comparisons yielded significant differences between all groups and global measurement parameters and in various sub-regions. The findings of the present study suggest that the corpus callosum in schizophrenia and bipolar differs significantly compared to healthy controls, specifically in the anterior body and isthmus for schizophrenia and only in the isthmus for bipolar disorder. Shape changes in these regions may possibly, in part, be responsible for the symptoms and cognitive impairments observed in schizophrenia and bipolar disorder.http://wileyonlinelibrary.com/journal/joahj2023AnatomyPhysiolog

Evaluation of the inion and asterion as neurosurgical landmarks for dural venous sinuses: osteological study on a sample of South African skull specimens

BACKGROUND : Sub-Saharan neurosurgeons most likely need to perform invasive procedures without the latest imaging and navigation technology in the operating room. Therefore, these surgeons need to utilize other methods such as superficial surface landmarks for neuro-navigation. Bony landmarks, including the inion and asterion, are commonly used during invasive procedures to pinpoint the location of the confluence of sinuses and transverse-sigmoid sinus junction, respectively. The purpose of this study was to investigate whether the inion and asterion can be used as superficial landmarks for the confluence of sinuses and the transverse-sigmoid sinus junction, respectively, in a South African population. METHODS : Fifty South African human skulls were used (25 male, 25 female). The micro-focus X-ray radiography and tomography facility (MIXRAD) at Necsa scanned and created three-dimensional virtual images of the skull specimens. Reference points were then inserted on the images and the relation between bony landmarks and venous sinuses was documented. RESULTS : The inion was directly related to the confluence of sinuses in 4% of the sample, whereas the asterion was directly related to the transverse-sigmoid sinus junction in 28% of the cases, on both the right and left sides. CONCLUSIONS : This study confirmed that neither the inion, nor the asterion, are directly related the confluence of sinuses and transverse-sigmoid sinus junction, respectively. These bony landmarks are more likely to be located either inferior, or not related at all, to the investigated dural venous sinuses.https://www.minervamedica.it/en/journals/neurosurgical-sciences2022-04-01hj2022Anatom

Sesquiterpene lactones from Geigeria aspera Harv. and their cytotoxicity

Geigeria poisoning, referred to as ‘vermeersiekte’ is an important plant poisoning in southern Africa. Three sesquiterpene lactones, isogeigerin acetate (1) ivalin (2) and geigerin (3) were isolated and purified from Geigeria aspera Harv. (Asteraceae). Structures were deduced using 1 and 2D NMR spectroscopy and mass spectrometry, while the absolute configurations of compounds 1 and 3 were determined for the first time by X-ray crystal diffraction analyses. Cytotoxicity of isogeigerin acetate, ivalin and geigerin were compared by exposing a murine skeletal myoblast (C2C12) cell line to varying concentrations of the three sesquiterpene lactones isolated. Cell viability was assessed using the methyl-thiazolyl-tetrazolium (MTT) assay. The EC50s were 3.746, 0.0029 and 3.792 mM for isogeigerin acetate (1), ivalin (2) and geigerin (3), respectively. The results indicate that ivalin is much more toxic, approximately 1000 times, in vitro compared to isogeigerin acetate and geigerin.http://www.tandfonline.com/loi/gnpl202020-10-16hj2020ChemistryParaclinical Science

Ecodomy - Life in its fullness

This book provides a coherent and conceptual portrayal of aspects of the theological research theme, entitled Ecodomy (literally meaning to ‘build a house’). In its figurative meaning the term Ecodomy addresses the theme, ‘life in its fullness’. This fullness of life entails a polarity which is inherently part of life, namely its brokenness and its wholeness. From various theological disciplines, namely Old Testament Studies, New Testament Studies, Systematic Theology, Church History and Practical Theology, both the brokenness and wholeness are addressed theologically. Every chapter focuses on a specific theological discipline, while the combination of theological disciplines, addresses the brokenness and wholeness of life as coherent concept. One pole does not exclude the other. Brokenness is visible in current or recent very relevant societal challenges, such as racism and xenophobia, apartheid, foreignness and exclusivism, leadership crises and violence. In contrast, wholeness is embedded in themes such as the African concept of ubuntu, a life of faith and wisdom, reconciling leadership, or transforming space and community. Ultimately, a Greek term ἀναίδεια (persistence) is connected to the meaning of Ecodomy and ‘life in its fullness’. Several methodologies have been used in the different contributions of the book. Every theological discipline applies a different methodology for the purpose of exposing a specific topic or research theme. In general, the contributions in this book follow a combination of a literature study with the further application of diachronic and synchronic exegetical methods. In addition, single contributions follow an own hermeneutical approach. Not one single contribution, but a combination of different theological disciplines, which form the concepts of brokenness and wholeness (life in its fullness), which expose the polarity of life, are included in this book. In its exposed interdisciplinary interwovenness, the book provides a tapestry of how different theological disciplines are combined into a single theme and how they contribute together by means of theological analyses and attempted building blocks to build the broken ‘houses’ of societal structures or human life. The book contributes to selected aspects of broken life in society and the healing experiences of human life. Several themes touch on recent and relevant challenges which have contributed to the brokenness of life. Not only in South Africa, but globally these are currently relevant themes. They include realities of racism and xenophobia, apartheid, foreignness and exclusivism, leadership crises and violence. With the focus on wholeness, specific attention is given to the African concept of ubuntu, a life of faith and wisdom, reconciling leadership, and transforming space and society. A Greek term ἀναίδεια (insolence as ‘in keeping on asking’ – Lk 11:8) illuminates the theme of Ecodomy from the perspective of a parable. The target audience of the book is academic scholars and theologians, who specialise in the different fields of Theology, the Humanities and other Social Sciences. Furthermore, the book is also accessible to scholars of other academic disciplines outside these disciplines. The book contains original research and contributions have not been plagiarised from publications elsewhere

First fungal genome sequence from Africa : a preliminary analysis

Some of the most significant breakthroughs in the biological sciences this century will emerge from the development of next generation sequencing technologies. The ease of availability of DNA sequence made possible through these new technologies has given researchers opportunities to study organisms in a manner that was not possible with Sanger sequencing. Scientists will, therefore, need to embrace genomics, as well as develop and nurture the human capacity to sequence genomes and utilise the ’tsunami‘ of data that emerge from genome sequencing. In response to these challenges, we sequenced the genome of Fusarium circinatum, a fungal pathogen of pine that causes pitch canker, a disease of great concern to the South African forestry industry. The sequencing work was conducted in South Africa, making F. circinatum the first eukaryotic organism for which the complete genome has been sequenced locally. Here we report on the process that was followed to sequence, assemble and perform a preliminary characterisation of the genome. Furthermore, details of the computer annotation and manual curation of this genome are presented. The F. circinatum genome was found to be nearly 44 million bases in size, which is similar to that of four other Fusarium genomes that have been sequenced elsewhere. The genome contains just over 15 000 open reading frames, which is less than that of the related species, Fusarium oxysporum, but more than that for Fusarium verticillioides. Amongst the various putative gene clusters identified in F. circinatum, those encoding the secondary metabolites fumosin and fusarin appeared to harbour evidence of gene translocation. It is anticipated that similar comparisons of other loci will provide insights into the genetic basis for pathogenicity of the pitch canker pathogen. Perhaps more importantly, this project has engaged a relatively large group of scientists including students in a significant genome project that is certain to provide a platform for growth in this important area of research in the future.We thank the National Research Foundation (NRF) of South Africa, members of the Tree Protection Co-operative Programme, the THRIP initiative of the Department of Trade and Industry and the Department of Science and Technology (DST)/NRF Centre of Excellence in Tree Health Biotechnology and the Oppenheimer Foundation for funding.http://www.sajs.co.zanf201

A multi-method study to explore perceptions and attitudes towards neuroanatomy in an undergraduate medical curriculum

Human anatomy is a core module of the medical curriculum. Anatomy lecturers are expected to teach clinically-relevant content, while utilising interactive and student- centred teaching methods and approaches. This teaching and facilitation must happen in the context of decreased curriculum hours while credits remain mostly unchanged. Therefore, a dire need exists to explore the various teaching modalities currently used in medical education, to improve the teaching and facilitation of anatomy, and more specifically, neuroanatomy. Neuroanatomy tends to be challenging for students. Their inability to integrate the basic concepts with the clinical environment could lead to the development of a negative attitude or fear towards neuroanatomy (neurophobia). Neuroanatomy provides exceptional opportunities for the integration of basic- and applied concepts, however, the teaching approaches and time allocated to this subject has a large influence on how staff and students perceive neuroanatomy and the teaching thereof. A multi-method research study was conducted to explore the attitudes of anatomy lecturers, undergraduate- and postgraduate students towards the teaching and learning of neuroanatomy in the medical curriculum. This study further explored the perception of students on the importance of neuroanatomy as it relates to their future careers. The sample constituted four groups: Nineteen neuroanatomy lecturers from various medical schools in South Africa, five postgraduate neuroscience students and 299 undergraduate medical students from the University of Pretoria, as well as two international key-opinion leaders in the field of neuroanatomy education and neurophobia. Various methods were used for data collection which included online questionnaires, focus-group discussions, round-table discussions and semi-structured interviews. All the neuroanatomy lecturers acknowledged that neuroanatomy is important in their students’ medical training. However, only a few deem it necessary to modernize their teaching approaches to be more suitable for the 21st century student. Information of the medical neuroanatomy curriculum and teaching practices at the institutions were gathered, which was then benchmarked against various international medical schools’ curricula. One-directional didactic lectures and guided dissection are mainly used for undergraduate neuroanatomy teaching. This indicated a need for more innovative, technology-supported teaching methods better suited for the 21st century medical student in South Africa. Undergraduate medical students preferred lecture notes to other literature types while their most favourite topic was cranial nerves. The postgraduate students shared their undergraduate neuroanatomy experiences and provided constructive feedback and suggestions to undergraduate students and lecturing staff. These students perceive neuroanatomy as an interesting and important subject in their medical degree stating, however, that changes are needed to modernize neuroanatomy and make it more accessible and student-friendly. The interviews with the experts yielded three themes namely the teaching practices in neuroanatomy, perceived relevance of neuroanatomy within the medical curriculum and the perception of neurophobia. The participants had opposing views on teaching approaches and the relevance of neuroanatomy in the undergraduate medical curriculum. However, they had similar opinions on neurophobia, its impact on the undergraduate medical students and possible preventative measures. This study highlighted that there is neither a single best teaching method for neuroanatomy, nor does it need to be a modern teaching approach, but rather student- centred. Therefore, by reflecting on our own perceptions, attitudes and teaching approaches for neuroanatomy, and by making the necessary changes, we can help our students overcome this fear for the neurosciences.Thesis (PhD)--University of Pretoria, 2020.AnatomyPhDUnrestricte