Suggested Reading

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Bendich A, et al.: Influence of maternal nutrition on pregnancy outcome: public policy issues. Introduction to Part V. Ann N YAcadSci 678:284, 1993.

Boehm CE, Kazazian HH Jr: Prenatal diagnosis by DNA analysis. In Harrison MR, Golbus MS, Filly RA (eds): The Unborn Patient: Prenatal Diagnosis and Treatment. 2nd ed. Philadelphia, WB Saunders, 1991.

Brent RL, Beckman DA: Angiotensin-converting enzyme inhibitors, an embryopathic class of drugs with unique properties: information for clinical teratology counselors. Teratology 43:543, 1991.

Brent RL, Holmes LB: Clinical and basic science from the thalidomide tragedy: what have we learned about the causes of limb defects? Teratology 38:241, 1988.

Buehler BA, Rao V, Finnell RH: Biochemical and molecular teratology of fetal hydantoin syndrome. Ped Neuro Genet 12:741, 1994.

Centers for Disease Control. Contribution of birth defects to infant mortality—United States, 1986. MMWR Morb Mortal Wkly Rep 38(37):633, 1989.

Colborn T, Dumanoski D, Myers JP: Our Stolen Future. New York, Dutton, 1996.

Cooper RL, Kavlock RJ: Endocrine disrupters and reproductive development: a weight of evidence overview [review]. J Endocrinol 152(2):159, 1997.

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Special Embryology

Dermomyotome

of the neural tube, known as somitomeres in the head region and somites from the occipital region caudally. Somites differentiate into a ventromedial part, the sclerotome, and a dorsolateral part, the dermomyotome. At the end of the fourth week sclerotome cells become polymorphous and form a loosely woven tissue, the mesenchyme, or embryonic connective tissue (Fig. 8.1). It is characteristic for mesenchy-mal cells to migrate and to differentiate in many ways.

They may become fibroblasts, chondroblasts, or osteoblasts (bone-forming cells).

The bone-forming capacity of mesenchyme is not restricted to cells of the sclerotome, but occurs also in the somatic mesoderm layer of the body wall, which contributes mesoderm cells for formation of the pelvic and shoulder girdles and the long bones of the limbs. Neural crest cells in the head region also differentiate into mesenchyme and participate in formation of bones of the face and skull. Occipital somites and somitomeres also contribute to formation of the cranial vault and base of the skull. In some bones, such as the flat bones of the skull, mesenchyme in the dermis differentiates directly into bone, a process known as intramembranous ossification (Fig. 8.2). In most bones, however, mesenchymal cells first give rise to hyaline cartilage models, which in turn become ossified by endochondral ossification (see Figs. 8.5 and

Intramembranous Ossification Steps

Figure 8.1 Development of the somite. A. Paraxial mesoderm cells are arranged around a small cavity. B. As a result of further differentiation, cells in the ventromedial wall lose their epithelial arrangement and become mesenchymal. Collectively they are called the sclerotome. Cells in the dorsolateral wall of the somite form limb and body wall musculature, while cells at the dorsomedial portion migrate beneath the remaining dorsal epithelium (the dermatome) to form the myotome.

Figure 8.1 Development of the somite. A. Paraxial mesoderm cells are arranged around a small cavity. B. As a result of further differentiation, cells in the ventromedial wall lose their epithelial arrangement and become mesenchymal. Collectively they are called the sclerotome. Cells in the dorsolateral wall of the somite form limb and body wall musculature, while cells at the dorsomedial portion migrate beneath the remaining dorsal epithelium (the dermatome) to form the myotome.

Bone Spicules The Bones The Skull
Figure 8.2 Bones of the skull of a 3-month-old fetus showing the spread of bone spicules from primary ossification centers in the flat bones of the skull.

8.13). The following paragraphs discuss development of the most important bony structures and some of their abnormalities.

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