Article in PDF
How to Cite
Citation Manager
Readers' Comments (0)
Audio Visual Article Statistics
Link
to PUBMED
Print this Article
Send to a Friend
Advertisers
Access Statistics Resources
Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."
Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011
Dr. Shankar P.R.
"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."
Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011 Anuradha
Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.
Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020
Original article / research
Full Version
Morphology and Histogenesis of Thymus as a Tool for Estimating Foetal Age: A Cross-sectional Study
Correspondence Address :
Ashwini Balasaheb Nuchhi,
Aashirwad Nilaya, Malaprabhanagar, Ashram Road, Vijayapura-586103, Karnataka, India.
E-mail: ashwini.nuchhi@bldedu.ac.in
Introduction: The thymus is located in the superior mediastinum and anterior part of the inferior mediastinum. It plays a crucial role in the development, differentiation, and clonal expansion of T lymphocytes. In forensic cases involving foetal death, accurate estimation of foetal age is essential. When the foetus is extensively damaged, other organs can be used to estimate age. The thymus, being retrosternal and well-protected, is easily accessible during dissection. Therefore, studying the gross features and histogenesis of the thymus can be helpful in estimating gestational age in cases of severely mutilated foetal specimens.
Aim: To examine the morphological features and histogenesis of the thymus in aborted and stillborn foetuses from normal pregnancies.
Materials and Methods: A pilot study was conducted using a cross-sectional design at the Department of Anatomy, BLDEDU’s Shri BM Patil Medical College, Vijayapura, Karnataka, India, from May 2016 to April 2018. The dimensions and histogenesis of the thymus were studied in a total of 50 human foetal thymus specimens, collected from normal pregnancies across different gestational age groups ranging from 12 to 40 weeks. The specimens were obtained from the Department of Pathology and the Department of Obstetrics and Gynaecology. The dimensions and weight of the thymus were recorded during autopsy. Slides were prepared, stained with Haematoxylin and Eosin (H&E), and examined under a compound microscope. The histogenesis of the thymus was studied to observe its maturation.
Results: Foetal weight increased from 134.6±58.3 g at 12 weeks to 1942±598 g at 40 weeks. The weight of the thymus ranged from 0.2 g at 12 weeks to 5.9 g at 40 weeks. Crown rump length varied from 10.7 cm to 29.9 cm. The length of the thymus measured between 0.5 cm and 3.3 cm, breadth between 0.4 cm and 2.3 cm, and height between 0.2 cm and 0.9 cm from 12 to 40 weeks of gestation. Microscopic features observed in the present study at different gestational ages included a well-formed thick capsule at 17 weeks, lobulation starting at 19 weeks, cortico-medullary differentiation beginning at 17 weeks, appearance of epithelial cells around 19 weeks, and initial appearance of Hassal’s corpuscles at 17 weeks, with more numbers observed later on.
Conclusion: The thymus can be used in forensic investigations to estimate the gestational age of mutilated foetuses. It exhibits varying features at different gestational ages, which can aid in thymectomy procedures. Additionally, these findings can be considered during prenatal imaging studies.
Epithelial reticular cells, Gestational age, Hassall’s corpuscles, Medicolegal cases
The Greek word “warty excrescence” originates from the word thymus, which resembles the flowers of the thyme plant (1). The thymus is known as the primary lymphoid organ. It is located in the superior mediastinum and anterior part of the inferior mediastinum. Its function is to develop T lymphocytes, differentiate them, and assist in the clonal expansion of lymphocytes. The size of the thymus grows until puberty, reaching its maximum at puberty, and then degenerates. However, it may persist in old age as a fibrofatty organ (2). In cases of foetal death, accurate estimation of foetal age is crucial, especially when the foetus is extensively mutilated. In such cases, other organs can be used to estimate the age. The thymus, being a retrosternal and well-protected organ, can be utilised for foetal age determination, highlighting its importance in accurately estimating foetal age and its significance in legal, ethical, and clinical implications (3).
The thymus develops as a bilobed structure from the endoderm of the third pharyngeal pouch during the 6th week of embryonic life. This endoderm interacts with neural crest cells, which become encapsulated within a capsule (4). While previous studies have focussed on the histogenesis of the thymus, less emphasis has been placed on its morphology along with histogenesis. Therefore, the gross features and histogenesis of the thymus can be used to estimate the gestational age of foetuses in cases of grossly mutilated foetal deaths. Several authors have conducted studies on the histogenesis of the thymus in various regions of Tamil Nadu, Andhra Pradesh, and North India, with only a few reported in Karnataka. Thus, the present study aimed to examine the morphological features and histogenesis of the thymus in aborted and stillborn foetuses from normal pregnant women.
A cross-sectional pilot study was conducted at the Department of Anatomy, BLDEDU’s Shri BM Patil Medical College, Vijayapura, Karnataka, India, from May 2016 to April 2018. The study received approval from the Ethical Committee of the Institution (IEC no:169/2016-17), and written consent was obtained from the parents. All foetuses that appeared grossly normal were included in the study. A total of 50 human aborted and stillborn foetuses were obtained from the study centre.
Inclusion criteria: All aborted and stillborn foetuses that appeared grossly normal and were aged between 12 to 40 weeks of normal pregnancy were included in the study (n=10 in each group) (Table/Fig 1). This time period was selected because organogenesis is completed by 12 weeks of gestation.
Exclusion criteria: Foetuses with anomalies were excluded from the study. The foetuses were obtained from the Department of Obstetrics and Gynaecology, immediately fixed in 10% formalin, and sent to the Department of Pathology for examination.
Study Procedure
The age of the foetus was determined by measuring the crown-rump length and foetal weight. The foetuses were dissected using the standard protocol described by Romanes GJ to obtain the thymus (5). The weight of the thymus was recorded using a weighing machine. The dimensions of the thymus, including length, breadth, and thickness, were measured using a measuring scale. Thin slices, as small as 5 mm, were cut from the entire thymus (Table/Fig 2)a-c. The tissue was processed, slides were prepared, and stained with H&E. The slides were observed under a compound microscope at magnifications of 40, 100, 400, and 1000 times for interpretation.
Statistical Analysis
Descriptive statistics, including the Number (N), mean, and Standard Deviation (SD), were used for summarising the characteristics. The statistical analysis was performed using Statistical Package for Social Sciences (SPSS) software version 20.0.
Foetal weight, thymus weight, crown-rump length, thymus length, breadth, and thickness increased from 12 weeks to 36 weeks (Table/Fig 3). In terms of histogenesis, the following parameters were included: formation of the capsule, lobulation and cortico-medullary differentiation, description of the stroma including blood vessels, epithelial reticular cells, and morphology of Hassall’s corpuscles.
As shown in (Table/Fig 4), the thymus exhibited the formation of a well-formed thick capsule (arrow 1) at 17 weeks of gestation. The capsule consisted of mucoid connective tissue with collagen fibres, abundant ground substance, and few fibroblasts. Interlobular septa were observed (arrow 2). Lobulation appeared at 19 weeks, and cortico-medullary differentiation started at 19 weeks, with well-formed trabeculae observed. The cortex of the thymus exhibited well-formed lymphocytes at 12 weeks (arrow 6), which were scattered at this gestational age.
These lymphocytes moved towards the periphery of the lobules at 17-19 weeks (as indicated by arrows 3 and 4). In later stages of gestation, such as 25-30 weeks onwards, fully formed lobules were observed (arrow 5). Blood vessels began to appear at 19 weeks. At 32 to 36 weeks, the connective tissue septa contained more blood vessels in the intralobular and interlobular regions.
As observed in (Table/Fig 5),(Table/Fig 6), the medulla was distinctly visible at 17 weeks. The medulla of adjacent lobules fused together. Hassall’s corpuscles (indicated by black arrows) appeared at 17 weeks at the cortico-medullary junction, and their numbers gradually increased with increasing gestational age, both in the medulla and at the cortico-medullary junction. Different types of Hassall’s corpuscles were observed. Epithelial cells were seen at 19 weeks. Blood vessels were also observed (yellow arrow) (Table/Fig 7). More epithelial reticular cells (black arrows) were seen at 33 weeks.
As seen in (Table/Fig 8), Hassall’s corpuscles were observed. At 32 weeks (Table/Fig 9), arrow 1, primary cystic corpuscles were seen. They consisted of a hyalinised homogeneous acidophilic mass in the centre, surrounded by a cystic space encapsulated by flat epithelial cells. Arrow 2, large Hassall’s corpuscles consisted of a core of central hyalinised mass with layers of eosinophilic concentrates, resembling an onion peel. At 38 weeks, arrow 3, blood vessels were closely observed near Hassall’s corpuscles.
In (Table/Fig 10), at 40 weeks, one of the thymi showed a cylindrical type of Hassall’s corpuscle, which enclosed many cystic structures (arrow 1) and degenerating Hassall’s corpuscles (arrow 2).
The vasculature of the thymus, lymphoid cells, and arrangement of the cortex and medulla have been studied using light microscopy and electron microscopy since as early as 1974 by Harr JL (6). The interaction between the neural crest (capsule and connective tissue septa development) and endodermal components, specifically the 3rd pharyngeal pouch of the thymic primordia, plays a crucial role in the subsequent differentiation of thymic structure and function (7).
The findings of the present study, indicating a gradual increase in thymic weight (0.1 to 19 gm) with gestational age, are similar to the results of authors Lakshmi KV et al., 2012 (0.1-10 g) and Gouse HS et al., (0.12-14 g) [1,8]. The dimensions of the thymus also showed similar results. In the present study, the length ranged from 0.1-5 cm and breadth from 0.1-4.5 cm, which is consistent with the findings of Sophia MM et al., (length: 0.2-4 cm, breadth: 0.1-2.1 cm) and Lakshmi KV et al., (length: 0.2 cm-5.2 cm, breadth: 0.1 cm-4 cm at birth) (1),(7).
As seen in (Table/Fig 11), the present study was conducted on 50 thymi of aborted foetuses. Important microscopic features such as cortico-medullary differentiation, the appearance of Hassall’s corpuscles, and epithelial cells were observed at 17-19 weeks, which coincided with Group 1 and Group 2. These findings were consistent with other studies conducted by various authors (1),(6),(9),(10),(11),(12),(13). The present study focused on both morphology and histogenesis, making it unique and potentially useful in forensic investigations, such as age determination of grossly mutilated foetuses. Correlating both features can enhance the accuracy of the findings.
Future recommendations include increasing the sample size, conducting histometric analysis to validate the findings, and using special stains to demonstrate all the observed features. Immunohistochemistry using markers such as Foxn1 and CD205 (DEC205), which are specific for thymus organogenesis, can also be considered (14).
Limitation(s)
A limitation of the present study is that special stains were not used. Histometric analysis could be helpful in prenatal imaging as reference values.
In the present study, the morphology of the thymus was correlated with the histological changes occurring at different gestational ages. Events in histogenesis, such as the appearance of a thick capsule, lobulation, cortico-medullary differentiation, epithelial reticular cells, and Hassall’s corpuscles, mainly occurred from 17 weeks onwards. These findings have potential applications in forensic investigations for determining the gestational age of mutilated foetuses. The varying features of the thymus at different gestational ages can also be considered during thymectomy procedures and prenatal imaging studies.
Doi: 10.7860/JCDR/2023/66073.18443
Date of Submission: Jun 19, 2023
Date of Peer Review: Aug 01, 2023
Date of Acceptance: Aug 21, 2023
Date of Publishing: Sep 01, 2023
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Jun 20, 2023
• Manual Googling: Aug 14, 2023
• iThenticate Software: Aug 18, 2023 (5%)
ETYMOLOGY: Author Origin
EMENDATIONS: 6
- Emerging Sources Citation Index (Web of Science, thomsonreuters)
- Index Copernicus ICV 2017: 134.54
- Academic Search Complete Database
- Directory of Open Access Journals (DOAJ)
- Embase
- EBSCOhost
- Google Scholar
- HINARI Access to Research in Health Programme
- Indian Science Abstracts (ISA)
- Journal seek Database
- Popline (reproductive health literature)
- www.omnimedicalsearch.com