-
World Journal of Gastroenterology Apr 2014Gastric cancer remains one of the most common causes of cancer death. However the proportion of early gastric cancer (EGC) at diagnosis is increasing. Endoscopic... (Review)
Review
Gastric cancer remains one of the most common causes of cancer death. However the proportion of early gastric cancer (EGC) at diagnosis is increasing. Endoscopic treatment for EGC is actively performed worldwide in cases meeting specific criteria. Endoscopic mucosal resection can treat EGC with comparable results to surgery for selected cases. Endoscopic submucosal dissection (ESD) increases the en bloc and complete resection rates and reduces the local recurrence rate. ESD has been performed with expanded indication and is expected to be more widely used in the treatment of EGC through the technological advances in the near future. This review will describe the techniques, indications and outcomes of endoscopic treatment for EGC.
Topics: Dissection; Early Detection of Cancer; Gastroscopy; Humans; Neoplasm Recurrence, Local; Neoplasm, Residual; Patient Selection; Predictive Value of Tests; Stomach Neoplasms; Treatment Outcome
PubMed: 24782609
DOI: 10.3748/wjg.v20.i16.4566 -
Anatomical Record (Hoboken, N.J. : 2007) Apr 2022Over the last four millennia, the discipline of anatomy and its relationships with medicine and society have evolved dramatically. Human dissection, the perennial tool...
Over the last four millennia, the discipline of anatomy and its relationships with medicine and society have evolved dramatically. Human dissection, the perennial tool for anatomical discovery and education, has both guided this evolution and matured alongside it. Soon after the first cadaveric dissections recorded in ancient Greece, China, India, and Persia, clear endorsements of its practice fell largely silent in the anatomical record for 1,500 years before reappearing in Europe at the dawn of the Renaissance. Between the 13th and 18th centuries CE, the performance of anatomical dissection became a popular form of education and public entertainment, and the demand for human cadavers steadily increased among European anatomical schools while supply remained limited by legal statute. This gave rise to an informal group of amateur and professional body snatchers called the Resurrectionists and, later, inspired the Anatomy Act of 1832 CE. In the 20th and 21st centuries CE, voluntary body bequeathal programs have enabled the practice of human dissection to continue in academic centers as a cornerstone of anatomical education, now with a newfound focus on the development of affective skills. This article provides an abridged account of anatomy's development, highlighting key moments in its growth, the valuable contributions of many different societies to the discipline, and the important roles of several luminary anatomists of antiquity. Within the broader context of this history, it offers an overview of anatomical dissection's evocative past, spanning from its inception to its present-day practice.
Topics: Anatomists; Anatomy; Cadaver; China; Dissection; Europe; History, 15th Century; History, 16th Century; History, 17th Century; History, 18th Century; History, 19th Century; History, 20th Century; History, 21st Century; History, Ancient; History, Medieval; Humans
PubMed: 34551186
DOI: 10.1002/ar.24764 -
Gut and Liver Mar 2020Therapeutic endoscopic resection has gained favor for its ability to achieve high en bloc and histologically complete resection rates via a minimally invasive approach.... (Review)
Review
Therapeutic endoscopic resection has gained favor for its ability to achieve high en bloc and histologically complete resection rates via a minimally invasive approach. The main technical difficulties faced by interventionists are first the lack of traction causing suboptimal visualization of the dissection field and second, the lack of triangulation using existing therapeutic apparatuses. These challenges can be overcome with the use of robots and the multiple degrees of freedom afforded by the robotic wrists. Nevertheless, complications such as bleeding and perforation can occur. It is hence beneficial for the robotic device to be equipped with additional abilities such as suturing. Once the robotic prototypes have been fully optimized and marketed, a structured program should be instituted to ensure proper and adequate training of the end-users. The future of robotics should then explore the possibility of developing a soft robot or a robot with more natural human-like movements. A robot with a force feedback mechanism would be superior and improve safety. Eventually, a supervised autonomous robot may perform interventions with greater precision and accuracy than an expert procedurist. This review describes the benefits of robot-assisted endoscopic resections, recent developments aimed at managing iatrogenic complications and future directions for robotic endoscopy.
Topics: Dissection; Endoscopy; Humans; Robotic Surgical Procedures
PubMed: 31158954
DOI: 10.5009/gnl19047 -
Pathobiology : Journal of... 2023Histopathology has historically been the critical technique for the diagnosis and treatment of human disease. Today, genomics, transcriptomics, and proteomics from... (Review)
Review
Histopathology has historically been the critical technique for the diagnosis and treatment of human disease. Today, genomics, transcriptomics, and proteomics from specific cells, rather than bulk tissue, have become key to understanding underlying disease mechanisms and rendering useful diagnostic information. Extraction of desired analytes, i.e., nucleic acids or proteins, from easily accessible formalin-fixed paraffin-embedded tissues allows for clinically relevant activities, such as sequencing biomarker mutations or typing amyloidogenic proteins. Genetic profiling has become routine for cancers as varied as non-small cell lung cancer and prostatic carcinoma. The five main tissue dissection techniques that have been developed thus far include: bulk scraping, manual macrodissection, manual microdissection, laser-capture microdissection, and expression microdissection. In this review, we discuss the importance of tissue dissection in clinical practice and research, the basic methods, applications, as well as some advantages and disadvantages for each modality.
Topics: Humans; Carcinoma, Non-Small-Cell Lung; Prognosis; Lung Neoplasms; Dissection; Microdissection; Tissue Fixation; Paraffin Embedding
PubMed: 35952628
DOI: 10.1159/000525979 -
Interactive Cardiovascular and Thoracic... Aug 2013A best evidence topic was written according to a structured protocol. The question addressed was whether dissection of the pulmonary ligament during an upper lobectomy... (Review)
Review
A best evidence topic was written according to a structured protocol. The question addressed was whether dissection of the pulmonary ligament during an upper lobectomy would result in improved outcomes. A total of 85 articles were found using the reported search, of which eight represented the best evidence to answer the clinical question. The authors, date, journal, study type, population, main outcome measures and results are tabulated. Reported measures were complications associated with dissection (atelectasis, bronchial stenosis, bronchial obstruction and bronchial deformation) and preservation (insufficient lung expansion, pooling of effusion and atelectasis) of the pulmonary ligament, ratio (%) of dead space in longitudinal axis (movement of nonoperated lobes), change in the angle (degrees) of main bronchus on the operated side, overall morbidity and mortality, overall survival and conversion rates. In a randomized control trial, the dissection of the pulmonary ligament revealed no significant difference in the dead space ratio or change in the angle of the main bronchus when compared with preservation. Dissection of the ligament, in theory, reduces the free space in the upper thorax by increasing the mobility of the residual lobes. Dissection of the ligament may lead to bronchial deformation, stenosis, obstruction or lobar torsion. Preservation of the ligament may prevent this complication by suppressing the upward movement of residual lobes. However, this may result in pleural effusion in the free thoracic space that may potentially become infected resulting in an empyema or bronchial fistula. Five large case series were analysed; three routinely dissected the pulmonary ligament and two did not. There was no observed difference in clinical outcomes between the two groups. There is no convincing evidence that dissection of the pulmonary ligament in an upper lobectomy significantly improves outcomes and reduces complications.
Topics: Benchmarking; Dissection; Evidence-Based Medicine; Female; Humans; Ligaments; Male; Middle Aged; Pneumonectomy; Postoperative Complications; Risk Factors; Treatment Outcome
PubMed: 23628653
DOI: 10.1093/icvts/ivt144 -
Scandinavian Journal of Surgery : SJS :... Jun 2021There are increasing reports on case series on spontaneous isolated mesenteric artery dissection, that is, dissections of the superior mesenteric artery and celiac...
BACKGROUND AND AIMS
There are increasing reports on case series on spontaneous isolated mesenteric artery dissection, that is, dissections of the superior mesenteric artery and celiac artery, mainly due to improved diagnostic capacity of high-resolution computed tomography angiography performed around the clock. A few case-control studies are now available, while randomized controlled trials are awaited.
MATERIAL AND METHODS
The present systematic review based on 97 original studies offers a comprehensive overview on risk factors, management, conservative therapy, morphological modeling of dissection, and prognosis.
RESULTS AND CONCLUSIONS
Male gender, hypertension, and smoking are risk factors for isolated mesenteric artery dissection, while the frequency of diabetes mellitus is reported to be low. Large aortomesenteric angle has also been considered to be a factor for superior mesenteric artery dissection. The overwhelming majority of patients can be conservatively treated without the need of endovascular or open operations. Conservative therapy consists of blood pressure lowering therapy, analgesics, and initial bowel rest, whereas there is no support for antithrombotic agents. Complete remodeling of the dissection after conservative therapy was found in 43% at mid-term follow-up. One absolute indication for surgery and endovascular stenting of the superior mesenteric artery is development of peritonitis due to bowel infarction, which occurs in 2.1% of superior mesenteric artery dissections and none in celiac artery dissections. The most documented end-organ infarction in celiac artery dissections is splenic infarctions, which occurs in 11.2%, and is a condition that should be treated conservatively. The frequency of ruptured pseudoaneurysm in the superior mesenteric artery and celiac artery dissection is very rare, 0.4%, and none of these patients were in shock at presentation. Endovascular therapy with covered stents should be considered in these patients.
Topics: Dissection; Humans; Male; Mesenteric Arteries; Retrospective Studies; Time Factors; Treatment Outcome; Vascular Surgical Procedures
PubMed: 33724090
DOI: 10.1177/14574969211000546 -
MedEdPORTAL : the Journal of Teaching... Mar 2018For students beginning their medical education, the neuroscience curriculum is frequently seen as the most difficult, and many express an aversion to the topic. A major...
INTRODUCTION
For students beginning their medical education, the neuroscience curriculum is frequently seen as the most difficult, and many express an aversion to the topic. A major reason for this aversion amongst learners is the perceived complexity of neuroanatomy. By means of a video tutorial, this module aims to help students feel confident with the cadaveric dissection and identification of key anatomical structures as well as improve comprehension of associated clinical correlations presented for the scalp, meninges, and dural partitions.
METHODS
The authors expanded upon an established neuroscience curriculum, designed for first-year medical students, with the addition of a dissection video tutorial. A survey was provided to all students for feedback.
RESULTS
Of 36 students who participated in the survey, a majority (72%, = 26) rated the video tutorial 5 out of 5 for helpfulness, and 53% ( = 19) rated the video 4 out of 5 for perceived confidence after viewing prior to the dissection. Most students viewed the tutorial only once prior to the dissection.
DISCUSSION
This video tutorial focuses on the structures and clinical correlations related to the scalp, meninges, and dura; provides useful graphics for identification of checklisted structures for predissection preparation; and serves as a succinct step-by-step guide for the dissection and as a study aid for review. Its addition to the already established curriculum was well received by the student group, a majority of whom found it helpful and had a high level of perceived confidence prior to the start of the dissection.
Topics: Dissection; Dura Mater; Education, Medical, Undergraduate; Humans; Meninges; Multimedia; Neuroanatomy; Scalp; Surveys and Questionnaires
PubMed: 30800895
DOI: 10.15766/mep_2374-8265.10695 -
Journal of Anatomy Apr 2020The structure of the human body and its parts is of obvious relevance in medicine, but it has also played a role in art. Accurate observation of surface or external... (Review)
Review
The structure of the human body and its parts is of obvious relevance in medicine, but it has also played a role in art. Accurate observation of surface or external anatomy is essential in both disciplines, and its understanding has been enhanced by knowledge of what is found beneath the skin, the internal anatomy, usually based on dissection. The role of anatomy in art in general, and in academies of art in particular, is the theme of this paper. The revival of dissection in 14th-century Italy was, if not causative, at least coincidental with the Renaissance. In 1563, Vasari founded the Accademia del Disegno in Florence, with una Anatomia included in its regulations. As a liberal art taught by university graduates, anatomy helped raise the status of painters and sculptors from artisans to artists and from guild to academy. Anatomy teaching was required in subsequent academies in Rome (1593) and Paris (1648), where the pattern of drawing from drawings, from casts, and from life was established and a Professor of Anatomy appointed in 1777. Anatomy was central to two of the Academy's most important genres, history painting and portraiture. The Academy system, with its emphasis on anatomy, spread to other European cities and to the Caribbean and the Americas from the 17th to the 19th centuries. This paper is concerned with the role of anatomy in the founding of art academies in general, while its companion paper, 'A Tale of Two Cities', considers the cases of the academies in London and Dublin in particular.
Topics: Anatomy; Dissection; History, 16th Century; History, 17th Century; History, 18th Century; Human Body; Humans; Italy; Medicine in the Arts
PubMed: 31813164
DOI: 10.1111/joa.13131 -
Puerto Rico Health Sciences Journal Sep 2022Our neurosurgical program did not have a cadaver laboratory. The need to create one arose following a decrease in elective cranial cases at our institution after...
OBJECTIVE
Our neurosurgical program did not have a cadaver laboratory. The need to create one arose following a decrease in elective cranial cases at our institution after Hurricane Maria. Many neurosurgical programs are in countries where financial support for projects such as developing a cadaver research laboratory cannot be expected from their parent institutions. This article describes how, despite limited resources, a neurosurgical cadaver dissection laboratory can be created and maintained to promote resident education and stimulate future research.
MATERIALS AND METHODS
The University of Puerto Rico Institutional Review Board evaluated and approved the proposal for creating a neurosurgical cadaver laboratory. The process to establish the laboratory was broken into steps. After obtaining the basic materials, the laboratory was created.
RESULTS
The creation of our neurosurgical cadaver laboratory was divided into discrete steps that can be undertaken by any institution with a similar goal. First, a suitable workspace was identified. Second, the surgical instruments and equipment required to perform dissections were obtained. Third, cadaveric specimens for dissection and for practicing surgical approaches were acquired. Last, documentation regarding the laboratory's development was maintained, and an expansion plan was created. We created a dissection laboratory by gathering decommissioned or donated operating room equipment, seeking out contributions from other institutions, and, sometimes, by monetary contribution from the faculty or residents.
CONCLUSION
Clear goals, interdepartmental collaboration, and a high degree of motivation were essential in creating, despite limited resources, a working neurosurgical cadaver laboratory to improve resident education.
Topics: Cadaver; Dissection; Humans; Neurosurgery; Surgical Instruments
PubMed: 36018744
DOI: No ID Found -
Molecular Pathology : MP Apr 2000Human tissues are composed of complex admixtures of different cell types and their biologically meaningful analysis necessitates the procurement of pure samples of the... (Review)
Review
Human tissues are composed of complex admixtures of different cell types and their biologically meaningful analysis necessitates the procurement of pure samples of the cells of interest. Many approaches have been used in attempts to overcome this difficulty, including a variety of microdissection methods. This review concerns a recent advance in microdissection techniques, namely laser capture microdissection (LCM). The principle underlying this technique is outlined, and practical issues pertaining to LCM are considered. In addition, the literature relating to LCM is reviewed, with examples of research applications of this technique being outlined.
Topics: Cell Separation; Cost-Benefit Analysis; Dissection; Humans; Microscopy, Confocal; Neoplasms; Specimen Handling
PubMed: 10889904
DOI: 10.1136/mp.53.2.64