MEDICAL LITERATURE has been deluged during the past few years with books and papers on penicillin; but a book which has been produced under the general editorship of Sir Alexander Fleming himself represents a complete and authoritative summary of penicillin therapy as it stands today.' The book contains a series of independent contributions by \"experienced and eminent men who have worked with penicillin in Great Britain\". Their opinions and practical methods differ slightly, and there is some overlapping; but these are not disadvantageous, comparison and contrast lending interest to the reading. In the first or general section of the book Fleming contributes two chapters, one on the history and development of penicillin, introducing some interesting sidelights in the romance of discovery, the other on the bacteriological control of penicillin therapy. In both chapters the information is set out in meticulous detail and with a clarity and simplicity which can be enjoyed by all readers. Fleming also gives the right perspective to the place of penicillin amongst the antibiotics and lays down the principles of treatment. Both chapters are well illustrated and are the most outstanding in the book. Included in this first section also are chapters on the chemistry and manufacture of penicillin and its pharmacy, pharmacology and methods of administration. The second section of the book is entirely clinical, giving each author's view on the use of penicillin therapy in a disease or an infection of some particular region of the body. The entire range of peniCillin-sensitive conditions is considered in twenty authoritative and clearly written chapters; these contain many references and illustrations. Dental and veterinary diseases are also given fairly full consideration. The final section is a condensed resume of much of the preceding chapters and is written for. the general practttioner. This chapter is superttuous: it does not contain enough detall to be of much practical value. The book as a Whole, however, will undoubtedly be considered a classical contribution to medical literature and is strongly recommended, not only because of the general interest of its topic, but as a reference book on penicillin therapy of hitherto unequalled excellence. The typography, although conforming to war economy standards, is clear and the paper is good. There is an excellent list of references and the index is satisfactory.

Gray's Anatomy

The aim of the study was to describe and analyze sciatic nerve variation especially the higher division within the lesser pelvis and its different routes of exit from pelvis. The sciatic nerve (SN) separates into its branches, the tibial and common peroneal nerves, outside the pelvis. However, it may rarely be separated within the pelvis. In such cases, the tibial nerve and the common peroneal nerve may leave the pelvis through different routes. These variations may cause nerve compressions under other anatomic structures, resulting in non-discogenic sciatica. 86 gluteal regions were examined in 43 formalin-fixed adult cadavers from different medical colleges of Gujarat region. From the study we found higher division of sciatic nerve bilaterally mainly in the female which is very rare and unilateral higher division of sciatic nerve which is also rare. The differences in the exit routes of these two nerves are important for surgeons, as this is the area of frequent surgical manipulation, nerve injury during deep intramuscular injections in gluteal region, failed sciatic nerve block in anesthesia and injury during posterior hip operations.

A variation in the high division of the sciatic nerve and its relation with piriformis muscle

The incidence of variations of falx cerebelli was studied in 52 adult cadavers of south Indian origin, at Kasturba Medical College Mangalore, after removal of calvaria. In eight (15.4%) cases, we observed duplicated falx cerebelli along with duplicated occipital sinus and internal occipital crest. The length and the distance between each of the falces were measured. The mean length of the right falces cerebelli was 38 mm and the left was 41 mm. The mean distance between these two falces was 20 mm. No marginal sinus was detected. Each of the falces cerebelli had distinct base and apex and possessed a distinct occipital venous sinus on each attached border. These sinuses were noted to drain into the left and right transverse sinus respectively. After detaching the dura mater from inner bony surface of the occipital bone, it was noted that there were two distinct internal occipital crests arising and diverging inferiorly near the posterolateral borders of foramen magnum. The brain from these cadavers appeared grossly normal with no defect of the vermis. Neurosurgeons and neuroradiologists should be aware of such variations, as these could be potential sources of hemorrhage during suboccipital approaches or may lead to erroneous interpretations of imaging of the posterior cranial fossa.

Duplication of falx cerebelli, occipital sinus, and internal occipital crest.

Folds of the meningeal layer of the dura mater, the falx cerebri and tentorium cerebelli, traverse the vertebrate intracranial cavity and thus compartmentalise the brain. The falx cerebelli, another dural fold, is found in the posterior cranial fossa and attaches to the inferior aspect of the tentorium cerebelli and to the internal occipital crest. We present a case of a duplicated falx cerebelli, occipital venous sinus and internal occipital crest that was detected upon routine dissection of a male cadaver. Since haemorrhage of a dural venous sinus can be a fatal complication of posterior cranial fossa surgery, knowledge of venous sinus variations in this region may prevent unpredictable complications during intracranial procedures.

/pdf/a-rare-variation-of-the-posterior-cranial-fossa-duplicated-1aet4of4l8.pdf

A rare variation of the posterior cranial fossa: Duplicated falx cerebelli, occipital venous sinus, and internal occipital crest

OBJECTIVE: The sciatic nerve (SN) separates into its branches, the tibial and common fibular nerves, outside the pelvis. However, it may rarely be separated within the pelvis. In such cases, the tibial nerve and the common fibular nerve may leave the pelvis through different routes. These variations may cause nerve compressions under other anatomic structures, resulting in non-discogenic sciatica. The aim of this study was to define the level of the SN exit and of the SN division. MATERIAL and METHOD: 50 gluteal regions were examined in 25 formalin-fixed adult male cadavers. RESULTS: In 52% of the cases, the SN exited the pelvis as a whole nerve without any division, whereas in 48% a high division was observed. Branches of the SN left the pelvis through the infrapiriform foramen (IP) as two separate nerves In 24%. One branch of the SN left the pelvis through the IP and other through a different route in another 24%. CONCLUSION: The differences in the exit routes of these two nerves are important in clarifying the clinical etiology of nondiscogenic sciatica. These variations require reviewing the piriformis syndrome.

Variations in the High Division of the Sciatic Nerve and Relationship Between the Sciatic Nerve and the Piriformis Siyatik Sinirin Yüksek Divizyon Varyasyonlar› ve Piriformis-Siyatik Sinir ‹liflkisi

In a 62-year-old male cadaver, high division of the sciatic nerve was observed bilaterally. Additionally, on the right side of the same cadaver, the common peroneal nerve passed just inferior to the piriformis muscle and the tibial nerve emerged inferior to the gemellus superior, between the gemellus superior and obturator internus muscles. Then, both of the nerves coursed posterior to the obturator internus, gemellus inferior and quadratus femoris muscles. The gemellus superior muscle, lying just posterior to the tibial nerve may cause to the symptoms of sciatica, because of the compression of the tibial nerve between the gemellus superior and obturator internus muscles. This pathology may lead to a new syndrome; the gemellus superior syndrome, just like the piriformis syndrome. As a conclusion, in the etiology and pathogenesis of sciatica, in addition to the priformis muscle, the abnormalities of the other gluteal external rotator muscles of the hip joint must also be taken into consideration by the clinicians. MR imaging of this region will be very helpful for the accurate diagnosis of this type of pathologies.

/pdf/a-case-of-bilateral-high-division-of-the-sciatic-nerves-au4n3imn5f.pdf

A case of bilateral high division of the sciatic nerves, together with a unilateral unusual course of the tibial nerve

During the removal of the brain in a 55-year-old male cadaver, a multiple layered duramater which was covering the left cerebral hemisphere was observed. In this cadaver, the endosteal layer of duramater was formed from 5 layers and there was a normal meningeal layer over the left cerebral hemisphere. Tissue specimens were taken for light microscopy from each of the endosteal layers and all of these 5 layers were found to be the endosteal layer of dura-mater. Following the mid-sagittal section of the brain, agenesis of the corpus callosum and septum pellucidum were also observed in this cadaver. In addition to all these findings, the gross anatomic appearance of the telencephalon was very abnormal, when compared with the normal brains. Agenesis of the corpus callosum and septum pellucidum are very rare abnormalities and they are usually associated with neurological disorders. However, a multiple layered duramater has not been reported previously. In conclusion, we believe that the combination of these three abnormalities is a unique entity and they might have been formed depending upon early embryological developmental abnormalities.

/pdf/agenesis-of-the-corpus-callosum-and-septum-pellucidum-1w4jhz2iwg.pdf

Agenesis of the corpus callosum and septum pellucidum together with a multiple layered duramater

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A case of bilateral high division of the sciatic nerves, together with a unilateral unusual course of the tibial nerve

Agenesis of the corpus callosum and septum pellucidum together with a multiple layered duramater