In the left upper limb of an adult male cadaver a triangular muscular slip, 3.5 cm long and 2.5 cm wide, arose from the lower border of latissimus dorsi just proximal to its tendon of insertion. It was inserted by a slender 6 cm long tendon mainly into the coracoid process of the scapula. Three short fibrous strands radiated from this slender tendon to gain attachments to pectoralis minor and the common tendon of origin of the short head of biceps brachii and coracobrachialis. In addition 2 flat tendinous bands attached the margin of this muscular slip to teres major. The thoracodorsal nerve entered the main bulk of latissimus dorsi close to the muscular slip but did not supply a separate branch to the latter. This is an axillary arch muscle in an unusually medial location.
During dissection an anomalous muscle was found on the medial aspect in the distal half of one left upper extremity. This muscle arose from the humerus between the m. coracobrachialis and the m. brachialis, passed obliquely across the front of the brachial artery and median nerve and blended with the common origin of the forearm flexor muscles. It does not appear to be an additional head of the biceps brachii or the brachialis muscles. The existence of this anomalous muscle should be kept in mind in a patient presenting with a high median nerve palsy together with symptoms of brachial artery compression.
Five anthroposcopic traits concerning the ear, namely ear lobe attachment, position of ears, shape of the helix, presence of Darwin's tubercle and hairy ears have been studied in a Malay population from Malaysia. The results of the present study are compared with similar reports in other ethnic groups.
The interalar width of the nose and the intercanine distance were measured in 266 Malay subjects (111 males and 155 females) randomly selected from the students of the School of Medical Sciences. University Sains Malaysia in Kota Bharu, Malaysia. The mean interalar width of the nose in male subjects was 39.8 +/- 2.3 mm (range 34-45 mm) and in female subjects 36.2 mm +/- 2.2 mm (range 30-41 mm). There is a statistically significant difference (t = 12.9: p < 0.05) in the nasal width between male and female Malay subjects. This agrees with the findings of other similar studies that males have wider noses than females. The mean maxillary intercanine distance in male subjects was 36.7 = 2.6 mm (range 30-42 mm) and in female subjects 36.2 = 2.3 mm (range 30-42 mm). The anterior maxillary arch is significantly wider in Malay subjects compared to Chinese from Singapore (Keng 1986) as p < 0.05 and to Caucasians (Sawiris 1977) as p < 0.05. There is a significant correlation (r = 0.312; p < 0.05) between the nasal width and the intercanine distance in female subjects but not in male subjects.
Early identification of a syndrome at birth is of paramount importance for genetic counselling and possible prevention. Often malformation of the hands and fingers are cardinal manifestations of recognizable syndromes. As there are no published standards for hand and finger size for Malay newborn infants, this study was undertaken to establish normal values for hand, middle finger and palmar lengths, and their indices. A cross-sectional study was done on 509 consecutive newborn Malay babies between 34 and 42 weeks of gestation. Measurements were made on the right hand according to the recommended guidelines of Bergsma & Feingold (1975). The mean values for the measurements did not differ significantly between boys and girls, or change with gestation. For the whole group the mean value for total hand length was 64.4 +/- 3.42 mm, middle finger length 37.1 +/- 2.91 mm, palmar length 27.4 +/- 2.15 mm, finger index 0.425 +/- 0.03 and palmar index 0.58 +/- 0.03. A comparison with published measurements for newborns of different racial origin shows significant differences for the total hand length, middle finger length and palm length from Indian and Jewish infants, but not from Japanese infants. The indices were similar in Malay, Indian, Jewish and Japanese newborn infants.
Dermatoglyphic patterns of fingers were studied in two hundred and fifty patients of various subtypes of schizophrenia and ninety normal control subjects. The difference between the males and female dermatoglyphic patterns in the schizophrenic and controls was found to be non significant. No difference was also found between the fingerprint patterns in patients of various subtypes of schizophrenia.
Patterns of superficial veins of the cubital fossa were studied in 170 male and 96 female Malays. Six venous patterns were observed. The less commonly known but clinically important patterns observed included absence of communication between basilic and cephalic veins (in 7.3% females and 8.8% males); an arched median cubital vein (in 2.0% females and 6.5% males); absence of the cephalic vein (in 1.0% females and 2.9% males) and two median cubital veins (in 1 male only). Awareness of these uncommon cubital venous patterns and their approximate incidence would be very useful for those performing venepuncture or venesection in Malays, especially under emergency conditions.
The upper eyelid crease height pretarsal skin and eyebrow height were studied in 305 Malay subjects (146 males and 159 females) varying in age from 2-80 years, who were randomly selected from the residents of Kota Bharu, Kelantan. In females, from the age of 11 years the mean pretarsal skin height increased progressively with age. In males, however, it decreased with age up to 60 years. In both sexes, subjects more than 60 years old showed highest values for pretarsal skin height. The mean eyelid crease height increased progressively with age from 11 years onwards in males but not in females. The mean eyebrow height increased with age in females but not in males. Eyebrow and eyelid measurements seem to show a definite racial variation. Besides establishing normal values for eyelid and eyebrow measurements in Malays, our findings indicate that age and sex should be taken into consideration to achieve satisfactory results in cosmetic eyelid surgery in Malays.
The incidence of ear lobe crease (ELC) was studied in 1576 healthy Malay subjects (566 males and 1010 females), randomly selected from the residents of Kota Bharu, Malaysia. ELC was present in 31.1% of males and in 3.6% of females; this difference in incidence between the two sexes is statistically significant (p > 0.05). In males the incidence of Type I crease was highest (10.1%) while that of Type III crease was lowest (2.3%). In females Type II crease showed the highest incidence (1.9%) and Type III the lowest. The incidence of bilateral presence of all three types of ELC showed an age-related increase in males. The ELC often starts unilaterally and later develops bilaterally and earlier in males than in females.
Hair distribution on the dorsum of phalanges of the hand was studied on 302 Chinese subjects (134 males and 168 females) randomly selected from the residents of Kota Bharu, Malaysia. Proximal phalangeal hair was seen on the dorsum of both hands in 99.3% of male subjects but in only 85.1% of female subjects. Chinese females showed a significantly lower (p < 0.05) incidence of proximal phalangeal hair on the hands than Chinese males. Comparison with other racial groups showed that Chinese females had significantly less (p < 0.05) hair on the proximal phalanges of the hands than Malay and African (Nigerian) females. The least common digital combination of proximal phalangeal hair in female subjects was the presence of proximal phalangeal hair only on the fourth digit (ring finger) and was noted in 0.6% of subjects. This has not been reported before. The frequency of middle phalangeal hair (MPH) distribution in Chinese falls between that in Malays and in Japanese which is probably explained by the fact that all these three racial groups originate from Asia. A study of digital combination of MPH in Chinese showed that the most common and the least common combinations in the Chinese differ considerably from those in other races. A total of 16 patterns of hair distribution was noted on the dorsum of the phalanges of the hands in Chinese subjects. Our study showed that though Chinese females had less digital hair on the hands than Chinese males, they showed a much larger variety of patterns of digital hair distribution than males.
In this study 200 Malay subjects (100 males and 100 females) were randomly selected from patients attending outpatient clinics of Hospital USM, Kelantan, Malaysia, to find out the incidence, density and direction of hair on the dorsum of phalanges of the hand. These features have not been studied so far in females nor has such a study been conducted in Malays. The probability of density of hair distribution among the digits of both hands showed significant correlation on proximal phalanges (p < 0.05) in both sexes. Significant correlation was not observed, however, in the middle phalangeal hair (MPH) of the hands. The direction of proximal phalangeal hair, from little finger to the thumb, showed significant changes from ulnar to radial in both sexes (p < 0.05). Identification of isolated digits, which is of medicolegal importance, would be more accurate if the direction and the density of hair on the digits are both considered together. MPH was present in 48% of males and in 33% of females studied. Comparisons with presence of MPH in other populations show that Malays are ethnically similar to other Asiatic populations.
Study site: utpatient clinics of Hospital USM, Kelantan, Malaysi
618 Malay subjects were selected randomly to find out the frequency and patterns of hair distribution on the phalanges of their hands. Hair on the proximal phalanx was absent in 2% of the males and in 3.3% of the females. The middle phalangeal hair (MPH) was absent in 78% of the females and in 64.9% of the males. The frequency in order of MPH was found to be 4 > 3 > 5 > 2. Fifteen patterns of hair distribution on the phalanges of the hand were found. Such a large number of patterns has not been reported yet. No subject had hair on the distal phalanges. These observations when compared with earlier studies show that the Malays are similar to other Asiatic populations such as the Japanese and Nepalis.
Religious patients with generalized anxiety disorder were given religious psychotherapy in addition to supportive psychotherapy anxiolytic drugs. Those receiving religious psychotherapy showed significantly more rapid improvement in anxiety symptoms than those who received supportive psychotherapy and drugs only. Thus, religious patients may require a different form of psychotherapy.
Schizophrenics (n = 250) and normal controls (n = 90) were studied to investigate and compare their dermatoglyphic patterns. Their fingerprint patterns were studied. The frequency of arches in the patient and control groups was similar. The frequency of loops in the control group was higher than in the patient group, and the trend was consistent in all the digits. The whorls in the patient group showed an increase over the control group in all the digits, although this finding was not statistically significant.
Eccrine cylindroma is a benign tumour arising from sweat glands in the skin. It favours the face, forehead and scalp involving the turban area and hence is called a turban tumour. Amongst a variety of tumours originating from adnexal skin structures, which may appear in the ear canal, eccrine cylindroma forms a very rare entity. We present such a case and discuss its pathological and clinical features.
Fourth branchial pouch anomalies are extremely rare and only a few such cases showing sinuses and cystic masses have been reported in the literature. We describe a patient who presented on the third day of life with cystic neck swelling of fourth branchial pouch origin giving rise to respiratory obstruction and stridor. Despite repeated aspiration of the cystic mass to relieve respiratory obstruction, rapid recurrence of the mass continued to cause stridor and ultimately required surgical excision. The clinical, radiological, and histopathological findings of this unusual condition are discussed with a review of the literature.