-
Journal of Clinical Medicine Nov 2023First described in 1760 by the anatomist Morgagni, coarctation of the aorta (CoA) is a congenital heart defect characterized by narrowing the aorta, typically distal to... (Review)
Review
First described in 1760 by the anatomist Morgagni, coarctation of the aorta (CoA) is a congenital heart defect characterized by narrowing the aorta, typically distal to the left subclavian artery. It accounts for approximately 5-8% of all congenital heart diseases, with an incidence estimated at 4 per 10,000 live births. In 1944, the Swedish surgeon Clarence Crafoord achieved the first successful surgical CoA repair by performing an aortic end-to-end anastomosis on two patients aged 12 and 27 years old. Presently, the most prevalent techniques for surgical repair, particularly in infants and neonates with isolated coarctation, involve resection with end-to-end anastomosis (EEA) and the modified Crafoord technique (extended resection with end-to-end anastomosis (EEEA)). Subclavian flap aortoplasty (SCAP) is an alternative surgical option for CoA repair in patients under two years of age. In cases where the stenosis extends beyond resection and end-to-end anastomosis feasibility, patch aortoplasty (PP) employing a prosthetic patch can augment the stenotic region, especially for older patients. Despite advances in pediatric cardiology and cardiac surgery, recoarctation remains a significant concern after surgical or interventional repair. This comprehensive review aims to provide a thorough analysis of coarctation management, covering the pioneering techniques introduced by Crafoord using end-to-end anastomosis and now extending to the contemporary era marked by percutaneous interventions as well as the recoarctation rate associated with each type.
PubMed: 38068402
DOI: 10.3390/jcm12237350 -
Annals of Anatomy = Anatomischer... Feb 2024The teaching and learning of human anatomy by dissection has existed for thousands of years. Over the centuries, evolving ethical considerations for the sourcing of... (Review)
Review
The teaching and learning of human anatomy by dissection has existed for thousands of years. Over the centuries, evolving ethical considerations for the sourcing of human bodies for dissection have resulted in a transition from the use of unconsented individuals to that of body donors and the institution of body donation programmes around the world. However, major challenges on the African continent have resulted in the continued use of unconsented or unclaimed bodies and the ethical dilemma for African anatomy departments regarding their use. Some of the key difficulties in sourcing donor bodies which exist on the African continent emanate from religious, cultural, societal trust and other confounding factors. This manuscript explores the challenges and suggests ways in which some of these constraints may be overcome.
Topics: Humans; Human Body; Cadaver; Dissection; Tissue Donors; Africa; Anatomy
PubMed: 38065269
DOI: 10.1016/j.aanat.2023.152196 -
Skin Research and Technology : Official... Nov 2023An intradermal injection is a medical procedure that involves administering a small amount of medication or substance into the dermal layer of the skin. This research...
BACKGROUND
An intradermal injection is a medical procedure that involves administering a small amount of medication or substance into the dermal layer of the skin. This research focused on identifying the most suitable injection needle for precise intradermal administration of skin boosters.
METHODS
The study involved conducting intradermal injections on four cadavers and participants using a 2 mm length, 34-gauge needle (N-Finders, Inc., South Korea). During the cadaveric study, the polynucleotide prefilled syringe was dyed green, and an anatomist performed dissections, removing only the skin layer. Ultrasonographic observations were carried out to ensure accurate intradermal injection placement.
RESULTS
In all four cadavers, the facial injections at the anterior cheek region were precisely administered intradermally at a 30-degree injection angle. However, the 90-degree injection was found just below the dermal layer upon skin layer removal.
DISCUSSION
The findings suggest that using a 2 mm needle length allows for easy and convenient intradermal injections.
Topics: Humans; Injections, Intradermal; Skin; Pharmaceutical Preparations; Needles; Ultrasonography
PubMed: 38009043
DOI: 10.1111/srt.13529 -
PeerJ 2023As a response to the COVID-19 pandemic, the faculty development program has partially shifted to online formats over the past two years, with a specific focus on...
BACKGROUND
As a response to the COVID-19 pandemic, the faculty development program has partially shifted to online formats over the past two years, with a specific focus on professional training related to blended learning. The effectiveness of this training is closely tied to the perceptions and acceptability of blended learning among the trainees. This study aims to evaluate the perspectives of educators on blended learning, thereby assessing the efficacy of faculty training programs.
METHODS
Anatomical teachers were chosen as a representative sample due to their significant presence among medical science educators. Chinese anatomists were invited to participate in a survey that gauges their attitudes and readiness for blended learning.
RESULTS
A total of 297 responses were collected, covering all provinces in mainland China. The findings from the survey demonstrate that Chinese anatomists hold learning flexibility in the highest regard among the various facets of blended learning. Meanwhile, the presence of a connected learning community emerged as a pivotal factor influencing anatomists' perceptions, explaining 14.77% of the total variance. Further analysis showed noteworthy disparities in anatomists' attitudes toward blending learning based on their job titles, mentorship guidance, and support from in-service institutions. Notably, lecturers showed a more pronounced engagement in the connected learning community than teachers with different job titles. Additionally, anatomists who received stronger institutional support showed higher proficiencies in learning management.
CONCLUSION
This survey revealed that Chinese anatomists attribute considerable value to aspects such as learning flexibility, a connected learning community, and effective learning management within the domain of online/blended learning. Positive attitudes toward blended learning are likely to be nurtured by mentorship and institutional support, subsequently correlating with improved training outcomes. The distinctive characteristics observed among Chinese anatomists in the context of blended learning offers insights to enhance the effectiveness of faculty training programs, thereby facilitating the evolution of future teaching strategies.
Topics: Humans; Anatomists; East Asian People; Pandemics; Faculty; Learning
PubMed: 37927785
DOI: 10.7717/peerj.16283 -
Cancers Oct 2023Male urethral injury during rectal cancer surgery is rare but significant. Scant information is available about the distances between the rectourethral space and...
Male urethral injury during rectal cancer surgery is rare but significant. Scant information is available about the distances between the rectourethral space and neighboring structures. The aim of this study is to describe the anatomical relations of the male urethra. This three-pronged study included cadaveric dissection, retrospective MRI analysis, and clinical cases. Measurements included the R-Mu distance (shortest distance between the rectum and the membranous urethra), R-Am distance (distance from the anterior rectal wall to anal margin nearest to the membranous urethra), and the anal canal-rectum axis angle. The clinical study analyzed the incidence of urethral injury and associated factors among 244 consecutive men from January 2016 to January 2023. The overall incidence of urethral injury in our series was low (0.73%), but in men with tumors < 10 cm from the anal margin, it was 4% in abdominoperineal resection and 3.2% in TaTME. On preoperative MRI, the median R-Mu distance was 1 cm (IQR, range, 0.2-2.3), the median R-Am distance was 4.3 cm (range, 2-7.3), and the median anorectal angle was 128° (range, 87-160). In the cadaveric study (nine adult male pelvises), the mean R-Mu distance was 1.18 cm (range 0.8-2), and the mean R-Am distance was 2.64 cm (range 2.1-3). Avoiding urethral injury is crucial. The critical point for injury lies 2-7.3 cm from the anal margin, with a 0.2-2.3 cm distance between the rectum and the membranous urethra. Collaborating with anatomists and radiologists improves surgeons' anatomy knowledge.
PubMed: 37894322
DOI: 10.3390/cancers15204955 -
Folia Morphologica Oct 2023Throughout the years, anatomic studies have demonstrated numerous variations in the course of the cephalic vein (CV). There are, however, very rare cases of uncommon...
Throughout the years, anatomic studies have demonstrated numerous variations in the course of the cephalic vein (CV). There are, however, very rare cases of uncommon formation, course or termination of the vein to which our attention should be drawn. During a routine dissections conducted in the Department of Anatomy and Neurobiology, in two formalin-fixed cadavers, the very rare anatomical variants were found. In 80 year-old Caucasian female the right cephalic vein, after crossing the clavipectoral triangle, ascended anterior and superior to the clavicle and drained into the lateral branch of the right external jugular vein, which in turn opened to the right subclavian vein. In the second case, the dissection of 83 year-old Caucasian male cadaver revealed that after passing through the deltopectoral groove, the left cephalic vein run between clavicle and subclavius muscle to terminate in the left subclavian vein. Understanding of the topography, morphology and anatomical variations of the cephalic vein is important not only for the anatomists but for the clinicians and nurses as well. Such knowledge can prevent multiple complications during many invasive procedures including implantation of Cardiac Implantable Electronic Devices, central venous access, arteriovenous fistula creation or even iatrogenic injuries during clavicle or glenohumeral joint surgery.
PubMed: 37889220
DOI: 10.5603/fm.96440 -
Anatomy & Cell Biology Dec 2023Understanding the anatomy of suprascapular area helps the clinicians and surgeons in management of any disability at the shoulder region. This work aimed to clear the...
Morphological types and morphometrical measurements of the suprascapular notch in both dry bones and human cadavers: anatomical study to improve the outcomes of the diagnostic and interventional procedures in the shoulder region.
Understanding the anatomy of suprascapular area helps the clinicians and surgeons in management of any disability at the shoulder region. This work aimed to clear the different morphological and morphometrical types of suprascapular notch (SSN). Unknown 120 dry human scapulae of both sides and 60 formalin-embalmed cadaveric upper limbs (40 males and 20 females) were used in the present study. Three main morphological forms of SSN were reported: J, U, and V-shaped. J-shaped notch showed the highest incidence followed by U-shaped then V-shaped one. Morphometrically, type (III) notch was the most prevalent in both dry bones and cadavers, while the incidence of type (II) was the lowest form. Also, the measurements of superior transverse diameter, middle transverse diameter and vertical dimension of the different types of the notch showed no side or sex significant difference. The suprascapular foramen with ossified superior transverse scapular ligament (STSL) was seen in 5.8% of dry bones and 10% of cadaveric specimens. Fan and band-shaped ossified transverse scapular ligaments were reported. Absence of SSN was seen in 10.8% of dry bones, 7.5% of male and 10% of female specimens with left side predominance. V-shaped, absence, and ossified STSL were considered as predisposing factors of suprascapular nerve entrapment syndrome. Knowledge of the morphology and morphometric parameters of SSN is of great clinical significance for anatomists, radiologists, physiotherapists, orthopedics and neurosurgeons to perform good diagnosis and best planning for surgical or arthroscopic interventions within the shoulder region.
PubMed: 37853804
DOI: 10.5115/acb.23.167 -
Anatomy & Cell Biology Dec 2023Anterior cerebral arteries are paired and supply the major portion of the medial surface of the brain. They are branches of the intracranial part of the internal carotid...
Anterior cerebral arteries are paired and supply the major portion of the medial surface of the brain. They are branches of the intracranial part of the internal carotid artery and form the anterior portion of the circle of Willis (CW) which is situated in the interpeduncular fossa. During routine dissection in the department of anatomy, All India Institute of Medical Sciences, Bibinagar, Hyderabad, a rare variation had been observed in the CW, azygos anterior cerebral artery associated with hypoplastic A1 fragment of the right anterior cerebral artery in a 63-year-old female cadaver. It is important to identify and study this kind of rare variation for surgeons, anatomists, and radiologists during dissection, surgical, radiological, and diagnostic interventions.
PubMed: 37821394
DOI: 10.5115/acb.23.177 -
Diagnostics (Basel, Switzerland) Sep 2023Anatomic studies have traditionally relied on macroscopic, microscopic, and histological techniques to investigate the structure of tissues and organs. Anatomic studies... (Review)
Review
Anatomic studies have traditionally relied on macroscopic, microscopic, and histological techniques to investigate the structure of tissues and organs. Anatomic studies are essential in many fields, including medicine, biology, and veterinary science. Advances in technology, such as imaging techniques and molecular biology, continue to provide new insights into the anatomy of living organisms. Therefore, anatomy remains an active and important area in the scientific field. The consolidation in recent years of some omics technologies such as genomics, transcriptomics, proteomics, and metabolomics allows for a more complete and detailed understanding of the structure and function of cells, tissues, and organs. These have been joined more recently by "omics" such as radiomics, pathomics, and connectomics, supported by computer-assisted technologies such as neural networks, 3D bioprinting, and artificial intelligence. All these new tools, although some are still in the early stages of development, have the potential to strongly contribute to the macroscopic and microscopic characterization in medicine. For anatomists, it is time to hitch a ride and get on board omics technologies to sail to new frontiers and to explore novel scenarios in anatomy.
PubMed: 37761332
DOI: 10.3390/diagnostics13182963 -
International Journal of Surgery Case... Oct 2023The first clinical presentation of a hernia developing along the Spigelian line had been reported by Klinkosch. The Belgian anatomist Adriaan van der Spieghel (Adrianus...
INTRODUCTION & IMPORTANCE
The first clinical presentation of a hernia developing along the Spigelian line had been reported by Klinkosch. The Belgian anatomist Adriaan van der Spieghel (Adrianus Spigelius) was the first to describe the semilunar line now known as the linea Spigeli in 1645. Spigelian hernias are rare and account for 1 % to 2 % of all abdominal wall hernias. Most of these hernia occurs in the lower abdomen where posterior sheath is deficient. The hernia ring is well defined defect in the transverse aponeurosis.
CASE PRESENTATION
A 60 year old female, presented with a palpable lump at the right lower quadrant of the abdomen since 7 month before her presentation.
CLINICAL DISCUSSION
For the first time the swelling is small and painless then gradually increase in size and associated with dull aching pain. The swelling was reducible with a defect of size 4 × 4 cm palpable in right iliac fossa. There was a positive cough impulse. The swelling was non tender. Other hernial orifices were normal. No inguinal lymphadenopathy noted. Abdominal ultrasonography done revealed a defect in abdominal wall in right iliac fossa with reducible bowel content. Depending on basis of clinical and investigations, a diagnosis of Spigelian hernia was made. After preparation for surgery, exploration done. The defect measuring 4 cm in length was identified and anatomical repair was done with nylon- 0, by suturing medial border of internal oblique and transverse abdominus muscle to the lateral border of rectum abdominal wall followed by hernioplasty by mesh.
CONCLUSION
Spigelian hernias are rare multifactorial disorder leading to defect in the transversus abdominis muscle in anterior abdominal wall. Spigelian hernias carry a significant risk of incarceration and strangulation of sac content. The management of spigelian hernias is almost always surgical which can be done in a traditional open fashion or laparoscopically.
PubMed: 37757738
DOI: 10.1016/j.ijscr.2023.108785