Department of Surgery, Section of Pediatric Surgery, University of Wisconsin SMPH, Madison, Wisconsin, USA.
Anat Rec (Hoboken). 2012 Dec;295(12):2129-40. doi: 10.1002/ar.22556. Epub 2012 Sep 14.
Human omphalocele is a congenital defect of the abdominal wall in which the secondary abdominal wall structures (muscle and connective tissue) in an area centered around the umbilicus are replaced by a translucent membranous layer of tissue. Histological examination of omphalocele development and moreover the staging of normal human abdominal wall development has never been described. We hypothesized that omphalocele is the result of an arrest in the secondary abdominal wall development and predicted that we would observe delays in myoblast maturation and an arrest in secondary abdominal wall development. To look for evidence in support of our hypothesis, we performed a histological analysis of normal human abdominal wall development and compared this to mouse. We also conducted the first histological analysis of two human specimens with omphalocele. In these two omphalocele specimens, secondary abdominal wall development appears to have undergone an arrest around Carnegie Stage 19. In both specimens disruptions in the unidirectional orientation of myofibers were observed in the external and internal obliques, and rectus abdominis but not in the transversus abdominis. These latter findings support a model of normal abdominal wall development in which positional information instructs the orientation of myoblasts as they organize into individual muscle groups.
人类脐膨出是一种腹壁先天性缺陷,其中以脐为中心区域的次级腹壁结构(肌肉和结缔组织)被一层半透明的膜状组织所取代。脐膨出的发生和正常人类腹壁发育的分期从未被描述过。我们假设脐膨出是次级腹壁发育停滞的结果,并预测我们会观察到成肌细胞成熟延迟和次级腹壁发育停滞。为了寻找支持我们假设的证据,我们对正常人类腹壁发育进行了组织学分析,并与小鼠进行了比较。我们还对两个脐膨出患者标本进行了首次组织学分析。在这两个脐膨出标本中,次级腹壁发育似乎在卡内基 19 期左右停滞。在两个标本中,在腹外斜肌、腹内斜肌和腹直肌中观察到肌纤维单向排列的中断,但在腹横肌中没有观察到。这些发现支持了一种正常腹壁发育的模型,其中位置信息指导成肌细胞在组织成单个肌肉群时的方向。