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Aneurysms of the basilar trunk represent an exceptional challenge to the neurosurgeon, due to high mortality and surgical morbidity. We present a 69-year-old man with a giant dolichoectatic thrombotic basilar trunk aneurysm (BTA), who underwent right orbitozygomatic craniotomy, posterior cerebral artery (PCA) to right middle cerebral artery (MCA) bypass and trapping of the BTA. Unfortunately, patient died after surgery due to multiple foci of intraparenchymal haemorrhage and thrombosis of a short segment proximal to aneurysm trapped and his body was donated to the hospital, giving us the unique opportunity to compare intraoperative details with anatomical dissection findings, according to our previously published cadaveric neurosurgical research. The great and unique opportunity of this reported case, to learn by watching and watching again what has been done during surgery, to observe small vessels and brainstem perforators and to look at stiches of the bypass, SVG and the position of the clips, permits to refine the theoretical and practical skills for the treatment of complex aneurysms such as that one reported. [ABSTRACT FROM AUTHOR]

Understanding physicians as actors who implemented the early modern ideal of collective empiricism into their practices within the local contexts of everyday life, the paper explores two cases from imperial cities in southern Germany in the 1720s and 1780s in which anatomical studies were contested. By analyzing the strategies and arguments that the two physicians used to justify and continue their anatomical dissections, it focuses on their references to different kinds of (local) community and relates these references to another type of collective: membership in a scientific academy. To examine references to community, it is proposed, offers an opportunity to better understand the spread and practice of the ideal of the study of nature as a collective project and how it was intertwined with concepts and structures of order and society in the Holy Roman Empire. [ABSTRACT FROM AUTHOR]

Purpose: Medical training has undergone many transformations to incorporate diagnostic imaging along side anatomical education. Post-mortem computed tomography (CT) scanning of body donors prior to dissection has been proposed. However, it poses challenges secondary to the embalming process and other post-mortem physiological changes that significantly alter the imaging quality. The purposes of this study were to compare the accuracy of pathology identification on pre- and post-mortem CT scans of body donors and to assess the integration of those scans in a dissection-based course, where these images were overlaid onto body donors using augmented reality (AR). Methods: Participants in this study included 35 fourth year medical students, 5 radiology residents and 3 radiologists. A convergent, parallel mixed methods design was employed with quantitative measures that included statistical analyses of a double-blinded comparison of pathological lesions recognition, on both image sets, the group responses to a study participant survey and the login access data from imaging repository. The study also included qualitative analysis of post-elective structured interviews. Results: The double-blinded comparison revealed that staff radiologists can only identify, on post-mortem images, 54.8% of the pathologies that they were able to detect on the pre-mortem scans. Analyses of the surveys and login access data reveal that 60% of radiology residents and 56% of students preferred pre-mortem scans and used those scans more often than post-mortem scans (67 access vs 36, respectively). However, post-mortem scans were significantly preferred when used to overlay onto body donors using AR (p = 0.0047). Conclusion: These results show that post-mortem imaging can be valuable alongside pre-mortem imaging, as they represent the most concordance between the anatomical structures and pathologies seen on the images and what is being dissected. [ABSTRACT FROM AUTHOR]

Coupling "know thyself" with anatomical illustrations produced a spatialized understanding of the self, providing preconditions for "brainhood," the view that "we are our brains." To picture oneself, whether in anatomical illustrations or neuroimaging, is to know thyself. This paper traces the historical development of the conflation of self-image and self-knowledge. First, I explore the Renaissance development of linear perspective. Second, I look at how the soul becomes spatialized in psychology as a science of the soul and its relationship to anatomical dissection. Third, I investigate the innovation of anatomical illustration and how it intersects with Renaissance visual culture. Finally, I show how these varied developments manifest "know thyself" in anatomical illustrations and its significance for how we see ourselves. I conclude that, according to the ideology of the neuro, we still "know thyself" through pictures of the body, but with neuroimaging as the new anatomical illustration. [ABSTRACT FROM AUTHOR]

This interview focuses on different aspects of the animal question in ancient Greek thought. Retracing the intellectual background of the interviewee, we show the emergence of a new historiographical and philosophical interest in animals in ancient societies from the 1970s onwards, questioning the theoretical perspectives of Marxism, historical epistemology and structuralism. The authors examine the transformation brought about by Aristotle’s thought in the scientific study of animals and the new techniques associated with it, in particular the anatomical dissection of their bodies. Finally, this relationship is questioned in its epistemological and political stakes in relation to modern breeding technologies.

Purpose: Fenestrations of posterior cerebral artery are exceedingly rare and, therefore, deserve being reported. Methods: During an educational dissection, a peculiar anatomical variant of the posterior cerebral artery (PCA) was found. Results: During an educational dissection targeting the right cerebellopontine angle, a peculiar variant of the right PCA was found. The respective posterior communicating artery inserted posteriorly into the junction of the P1 and P2 segments of the PCA. The P1 segment was thinner than the P2 segment. That junction was superior to the oculomotor nerve and was fenestrated, with a thin postero-medial arm facing the cerebral peduncle, and a larger antero-lateral arm formed by the distal end of the P1 segment and the proximal end of the P2 segment. Conclusions: To the authors' knowledge, fenestrated P1–P2 junctions of PCA were not found previously by dissection. The evidence presented here recommends such variations not to be ignored. [ABSTRACT FROM AUTHOR]

Background & Aims: Long course of the radial nerve and its proximity to the humerus makes Radial Nerve (RN) prone to injury in diaphyseal fractures. In an effort to maintain its integrity, soft tissue landmarks can be readily made use of to provide facile nerve identification, as osseous landmarks might get altered in fractures. The aim of this study was to provide an idea of safe zone for securing radial nerve in relation to soft tissue structures and thereby, preventing the concomitant iatrogenic injury. Materials & Methods: 40 Upper limb specimens from 20 cadavers were dissected. The radial nerve was identified proximal to the apex of Tricipital aponeurosis (TA) in posterior arm, at the level of entry into the lateral inter muscular septum and along the lateral border of TA. The mean distance between the radial nerve and aponeurosis was measured at all the three sites to find the safe zone for securing the radial nerve during surgeries. Results: The radial nerve was found proximally from the medial apex of tricipital aponeurosis at a distance of 43.49 ± 6.67 mm (range 30.34-55.72 mm) within the muscle belly of triceps. The minimal permissible distance for the triceps split was 3.03 cm from the medial apex for both right and left arms. The distance of above 15 mm (range from 15.56 to 47.47mm) from the lateral border of tricipital aponeurosis was considered as a safe zone and no branches of the radial nerve were found in this zone. Radial nerve was identified along its course in the range of 15.56 to 47.47 mm from the lateral border of TA and this should be taken into consideration by the operating surgeon. Conclusion: The Tricipital aponeurosis is a useful soft tissue landmark to secure the radial nerve safely throughout its course in the arm. Knowledge of safe and dangerous zones of the radial nerve would help the orthopedic surgeons to avoid the risk of iatrogenic nerve injury, which is not an uncommon phenomenon.

Macrodystrophia Lipomatosa (MDL) of the toe is a rare, congenital, disproportionate overgrowth involving one or more digits in the lower limb. Despite being a benign condition, when left untreated, it may cause physical impairment and interfere with daily activities. This form of localised gigantism is the result of excessive proliferation of fibroadipose tissue within the nerve along with associated macrodactyly. The mainstay of treatment is debulking or amputation to accommodate the patient’s daily activities, as well as for cosmesis. In this case report, the clinical and radiographic findings, anatomical descriptions, and histopathological findings are presented. The difference between MDL, fibrolipomatous hamartoma (FLH) and lipomatosis of the nerve (LON) are also discussed.

IntroductionNeurosurgery is one of the most complex surgical disciplines where psychomotor skills and deep anatomical and neurological knowledge find their maximum expression. A long period of preparation is necessary to acquire a solid theoretical background and technical skills, improve manual dexterity and visuospatial ability, and try and refine surgical techniques. Moreover, both studying and surgical practice are necessary to deeply understand neuroanatomy, the relationships between structures, and the three-dimensional (3D) orientation that is the core of neurosurgeons' preparation. For all these reasons, a microsurgical neuroanatomy laboratory with human cadaveric specimens results in a unique and irreplaceable training tool that allows the reproduction of patients' positions, 3D anatomy, tissues' consistencies, and step-by-step surgical procedures almost identical to the real ones.MethodsWe describe our experience in setting up a new microsurgical neuroanatomy lab (IRCCS Neuromed, Pozzilli, Italy), focusing on the development of training activity programs and microsurgical milestones useful to train the next generation of surgeons. All the required materials and instruments were listed.ResultsSix competency levels were designed according to the year of residency, with training exercises and procedures defined for each competency level: (1) soft tissue dissections, bone drilling, and microsurgical suturing; (2) basic craniotomies and neurovascular anatomy; (3) white matter dissection; (4) skull base transcranial approaches; (5) endoscopic approaches; and (6) microanastomosis. A checklist with the milestones was provided.DiscussionMicrosurgical dissection of human cadaveric specimens is the optimal way to learn and train on neuroanatomy and neurosurgical procedures before performing them safely in the operating room. We provided a “neurosurgery booklet” with progressive milestones for neurosurgical residents. This step-by-step program may improve the quality of training and guarantee equal skill acquisition across countries. We believe that more efforts should be made to create new microsurgical laboratories, popularize the importance of body donation, and establish a network between universities and laboratories to introduce a compulsory operative training program.

Health education, research, and training rely on the altruistic act of body donation for the supply of cadavers. Organ transplantation and research rely on donated organs. Supply of both is limited, with further restrictions in Australia due to requirements for a next‐of‐kin agreement to donation, irrespective of the deceased's pre‐death consent. Research suggests health workers are less likely to support the donation of their own bodies and/or organs, despite recognizing the public good of donation, and that exposure to gross anatomy teaching may negatively affect support for donation. Attitudes to body and organ donation were examined in Australian students studying anatomy. Support for self‐body donation (26.5%) was much lower than support for self‐organ donation (82.5%). Ten percent of participants would not support the election of a family member or member of the public to donate their body, and just over 4% would not support the election of a family member to donate their organs, with one‐to‐two percent not supporting this election by a member of the public. Exposure to gross anatomy teaching was associated with an increased likelihood of consideration of issues about body and organ donation, whether for self, family, or the public, and registration as an organ donor. Exposure decreased participants' willingness to donate their own body, with those who practiced a religion least likely to support body donation. Gross anatomy courses provide an opportunity to inform future healthcare workers about altruistic donation, albeit with a recognition that religious or cultural beliefs may affect willingness to donate. [ABSTRACT FROM AUTHOR]

Augmented reality (AR) has recently been utilized as an integrative teaching tool in medical curricula given its ability to view virtual objects while interacting with the physical environment. The evidence for AR in medical training, however, is limited. For this reason, the purpose of this mixed method study was to evaluate the implementation of overlaying donor‐specific diagnostic imaging (DSDI) onto corresponding body donors in a fourth‐year, dissection‐based, medical elective course entitled anatomy for surgeons (AFS). Students registered in AFS course were separated into groups, receiving either DSDI displayed on Microsoft HoloLens AR head‐mounted display (n = 12) or DSDI displayed on iPad (n = 15). To test for the change in spatial ability, students completed an anatomical mental rotation test (AMRT) prior to and following the AFS course. Students also participated in a focus group discussion and completed a survey at the end of AFS, analyzed through thematic triangulation and an unpaired, Mann Whitney U test respectively, both addressing dissection experience, DSDI relevancy to dissection, and use of AR in anatomical education. Although statistically significant differences were not found when comparing student group AMRT scores, survey and discussion data suggest that the HoloLens had improved the students' understanding of, and their spatial orientation of, anatomical relationships. Trunk dissection quality grades were significantly higher with students using the HoloLens. Although students mentioned difficulties with HoloLens software, with faculty assistance, training, and enhanced software development, there is potential for this AR tool to contribute to improved dissection quality and an immersive learning experience. [ABSTRACT FROM AUTHOR]

Background: In the current literature, studies on the anatomy of the anteromedial region of the knee are scarce. However, the anteromedial structures, especially the longitudinal medial patellar retinaculum (MPR), may play an important role in restraining external tibial rotation. Purpose: To conduct a layer-by-layer dissection of the anteromedial side of the knee and describe qualitatively and quantitatively the MPR anatomy pertaining to surgically relevant landmarks. Study Design: Descriptive laboratory study. Methods: A total of 10 fresh-frozen human cadaveric knees (mean age 81 ± 16.3 years) without history of previous ligament injury were used in this study. A layer-by-layer dissection was performed, and measurements were obtained using a tactile 3-dimensional (3-D) measuring arm to define the anatomy of the MPR in relation to surgically relevant landmarks, such as the superficial medial collateral ligament (sMCL) and medial patellofemoral ligament (MPFL). The 3-D datasets were used for multiplanar reconstruction. Results: The tibial and femoral attachment of the MPR were identified in 100% of cases. Layer-by-layer dissection confirmed its close topography to the sMCL. The mean length of the MPR was 84.9 ± 9.1 mm. The average width of the tibial and femoral attachment was 23.8 ± 3.1 mm and 69.2 ± 8.2 mm, respectively. The distance from the midpoint of the MPR tibial attachment to the midpoint of the distal tibial attachment of the sMCL was 27.2 ± 5.8 mm. Femorally, the MPR attached at the anterior border of the MPFL over a mean distance of 52.3 ± 9.4 mm. Conclusion: The MPR is a distinct tibiofemoral structure with well-defined tibial and femoral attachments, which could be consistently identified. Layer-by-layer dissection confirmed its close topography to the sMCL and MPFL. Clinical Relevance: As injuries to the anteromedial side of the knee may contribute to anteromedial rotational rotatory instability (AMRI), precise knowledge of the underlying anatomy of the MPR may be necessary to perform an anatomic reconstruction of the anteromedial side of the knee. [ABSTRACT FROM AUTHOR]

Informed consent is critical for maintaining the ethical standards associated with the utilization of human donor bodies by tertiary education institutions. Body donation programs undertake the responsibility for procuring human donor bodies for didactic and research purposes. However, its processes require scrutiny regarding best practice guidelines and the South African National Health Act (SA-NHA) (2013). Moreover, acknowledging and addressing the current perceptions of human body donation are indispensable in bridging the gap between academia and society. This study aimed to compare informed consent documentation and procedures across South African tertiary education institutions and their affiliated human body donation programs (HBDP) in accordance with international guidelines. The findings were used to create a human body donation form template aligned to current international best practices for consideration by the South African HBDP. A review of information and consent forms collected from South Africa's eight HBDP was conducted. The analyses consisted of a broad evaluation of information provided, ranging from the terms-of-use for human donor bodies to the commitments made by HBDP to body-donors. The results were considered in conjunction with the International Federation of Associations of Anatomists and other recent publications on informed consent in HBDP. Only two of the eight HBDP provided information and consent forms in more than one language. Most allowed donors to select how their bodies will be utilized – education, training and/or research. Some (6/8) made provisions for the next-of-kin to receive the cremains. Only one tertiary educational institution mentioned the occurrence of a memorial service in its documentation. An HBDF template was created aligned to current international best practices for presentation and possible adaption by SA HBDP. Human body donation forms (HBDF) requires thorough examination for the promotion and sustainability of HBDP. Effective communication by employing standardized non-technical terminology conveyed in language that is understandable and native to potential donors facilitates the deliverance of informed consent. Inconsistencies regarding the use and management of bodies catalyze the weakening perception of human body donation. Thus, this process of securing informed consent for body donation should be conducted in conjunction with public awareness campaigns and underpinned by the necessary policy and legislative reform. • Human body donation improves experiential learning and results in societally relevant research. • Human body donation must be autonomous and informed. • Body donors require a clear understanding of the implications and rights for doantion- legally & ethically. • A comprehensive review of donor forms in South Africa led to the creation of a recommended form template. [ABSTRACT FROM AUTHOR]

Surgeries for gastrointestinal tract malignancies are based on the paradigm that we should remove the tumour together with its lymphatic drainage in one block. This concept was initially proposed in rectal surgery and called a total mesorectal excision. This procedure gained much interest and has improved oncological results in rectal cancer surgery. The same idea for mesogastric and complete mesogastric excisions was proposed but, because of the complexity of the gastric mesentery, it has not become a standard technique. In this review, we analysed anatomical and embryological factors, proposed technical aspects of this operation and incorporated the available initial results of this concept. We also discussed analogies to other gastrointestinal organs, as well as challenges to this concept.

Anatomical dissection course relies much on cadavers. Body donation is a main source of cadavers used in anatomical dissection course in China. Since 1970s, body donation programs have been gradually established, supporting the anatomical dissection courses and the training of medical students. This article reviews the development of body donation programs in China and relevant researches from the following five aspects: very early stage, ethics and laws, data collection and questionnaire survey, humanistic care and humanistic education challenges and countermeasures. This article may pave a way for further development of body donation programs in China and for researches in the future.

Introduction and objective Common to the talocrural and subtalar joints, the calcaneofibular ligament forms with the anterior bundle a mechanical coupling factor for ankle stabilization. Adhering to the deep surface of the fibular sheath, doubled in depth by the lateral talocalcaneal ligament, it is solicited in isolated varus and its lesion is involved in subtalar instability. The therapeutic strategy for chronic ankle instability is currently based on the anatomical reconstruction of the ligaments, particularly by arthroscopy, hence the objective of this study, which aims to highlight the great variability of the calcaneofibular ligament. Material and methods Our work is based on the dissection of 24 ankles. The number of beams, the dimensions at the neutral point and after power-up, the relationships with the surrounding anatomical structures as well as the points of insertion of the CFL are studied. Results The calcaneofibular ligament was monofascicular in 91.6% of cases and bifascicular in 8.4%. Its average length in a neutral position was 26.85 ± 3.46 mm, and its width was 5.33 ± 1.45 mm. In dorsiflexion, the length was 27.10 ± 0.05 mm, and in forced inversion, it was 26.98 ± 0.07 mm. The distance between its fibular insertion and the apex of the lateral malleolus was 6.2 ± 0.9 mm. Conclusions Injuries of the calcaneofibular ligament are common in lateral ankle sprains, which can often get complicated by chronic instability. The macroscopic and morphometric knowledge of this ligament can allow a more accurate anatomical reconstruction and a more accurate choice of graft.

The body donation program of Peking Union Medical College was established in May 1999. From May 1999 to December 2017, a total of 5,576 registrants registered and 1,459 donors donated their bodies. Demographic and medical characteristics of the donors were analyzed. The top four causes of death were neoplasms, heart diseases, respiratory diseases, and cerebrovascular diseases. Age at death among donors who died of neoplasms were significantly lower than other causes of death (all p <.05), and the interval between registration and donation among donors who died of neoplasms was significantly shorter than that among donors with other causes (all p <.001). The age of donors when they registered (p <.001) and donated (p <.001) was significantly older than that of general Beijing population. This study may provide a guide for medical colleges or research institutions to establish or enhance their own body donation programs. [ABSTRACT FROM AUTHOR]

To this day, autopsies and dissections have been essential in medical education, but declining autopsy numbers have endangered this long‐standing tradition. Students' perceptions of these teaching methods should be constantly updated to help educators understand how to achieve their teaching goals. The purpose of this study was to explore the state of autopsy‐ and dissection‐based teaching in two Finnish universities based on the experiences of the students, survey their perceptions of such teaching, and to compare the Finnish situation with students' perceptions in other countries as it emerges from medical literature. A questionnaire went to 859 second‐, fourth‐, and sixth‐year medical students. The questions concerned dissection and autopsy classes these students had attended, the views of the students in regard to the number of classes, and the benefits of and attitudes towards autopsy teaching. An open question of how to improve autopsy teaching was included. The response rate was 19.4%. Most respondents requested more autopsy and dissection classes, especially practical education. They found autopsies most beneficial in learning anatomy and dealing with one's own emotions related to death. Their experiences proved least beneficial for interaction with the relatives of a deceased patient and for people skills. Integrational methods and focusing on the main learning outcomes were suggested as improvements. Overall, students found dissection and autopsy teaching important, but felt concerned about the diminishing autopsy numbers. Focusing on main learning objectives and better integration of autopsies in the teaching of different specialties could help to utilize autopsies to a greater extent. [ABSTRACT FROM AUTHOR]

Surgeries for gastrointestinal tract malignancies are based on the paradigm that we should remove the tumour together with its lymphatic drainage in one block. This concept was initially proposed in rectal surgery and called a total mesorectal excision. This procedure gained much interest and has improved oncological results in rectal cancer surgery. The same idea for mesogastric and complete mesogastric excisions was proposed but, because of the complexity of the gastric mesentery, it has not become a standard technique. In this review, we analysed anatomical and embryological factors, proposed technical aspects of this operation and incorporated the available initial results of this concept. We also discussed analogies to other gastrointestinal organs, as well as challenges to this concept. [ABSTRACT FROM AUTHOR]

Abstract Background Medical faculties are currently embracing a modernistic approach to anatomical education that integrates diagnostic imaging largely through post-mortem computed tomography scanning of body donors. Post-mortem imaging, however, poses a multitude of challenges. The purpose of this study was to assess the implementation of pre-mortem donor-specific diagnostic imaging on student learning and dissection experience in addition to understanding the potential impact on students’ preparation for clinical practice. Methods Students in a fourth-year medicine elective course were divided into groups; group 1 received pre-mortem donor-specific diagnostic imaging, while group 2 received pathology-specific diagnostic imaging, a collection of images relating to the type(s) of pathologies the donors exhibited, though not specific to the donors themselves. Both groups also received a donor-specific case vignette. A convergent, parallel mixed methods design was employed. This included integrating data from group responses to a study participant survey and students’ academic assessment scores analyzed quantitatively through statistical analyses with data from focus group sessions investigating the psychosocial aspects of the student dissection experience and perceptions of the imaging use in the course analyzed qualitatively. Results As compared to students receiving pathology-specific diagnostic imaging, the quantitative results demonstrated that students receiving pre-mortem donor-specific diagnostic imaging more positively supported the relevancy of diagnostic imaging to their understanding of anatomy, valued the integration for future practice, and suggested an earlier integration within their medical curriculum. Qualitatively, two main themes were observed: the influence of diagnostic imaging integration on dissection experience and on professional mindset. Although both student groups received imaging corresponding to their body donor, consideration towards the humanistic nature of the body donor as a patient with a history was limited to student feedback from the donor- specific diagnostic imaging group. Conclusion Overall the integration of pre-mortem donor-specific diagnostic imaging into anatomical dissection provided students with practical skill development, an enhanced dissection experience, and reinforced personal qualities critical for future practice.

Introduction and objective. Common to the talocrural and subtalar joints, the calcaneofibular ligament forms with the anterior bundle a mechanical coupling factor for ankle stabilization. Adhering to the deep surface of the fibular sheath, doubled in depth by the lateral talocalcaneal ligament, it is solicited in isolated varus and its lesion is involved in subtalar instability. The therapeutic strategy for chronic ankle instability is currently based on the anatomical reconstruction of the ligaments, particularly by arthroscopy, hence the objective of this study, which aims to highlight the great variability of the calcaneofibular ligament. Materials and method. Our work is based on the dissection of 24 ankles. The number of beams, the dimensions at the neutral point and after power-up, the relationships with the surrounding anatomical structures as well as the points of insertion of the CFL are studied. Results. The calcaneofibular ligament was monofascicular in 91.6% of cases and bifascicular in 8.4%. Its average length in a neutral position was 26.85 ± 3.46 mm, and its width was 5.33 ± 1.45 mm. In dorsiflexion, the length was 27.10 ± 0.05 mm, and in forced inversion, it was 26.98 ± 0.07 mm. The distance between its fibular insertion and the apex of the lateral malleolus was 6.2 ± 0.9 mm. Conclusions. Injuries of the calcaneofibular ligament are common in lateral ankle sprains, which can often get complicated by chronic instability. The macroscopic and morphometric knowledge of this ligament can allow a more accurate anatomical reconstruction and a more accurate choice of graft. [ABSTRACT FROM AUTHOR]

William Hunter (1718–1783) was a Scottish anatomist and physician. He started his career as a man midwife and went on to become the leading obstetrician in London. He prepared anatomically dissected specimens depicting anatomy of gravid uterus and undelivered fetus with placenta in different stages of gestation. Hunter compiled illustrations prepared from these specimens with his clinical notes and published his treatise Anatomia uteri humani gravidi in 1774. This article is a tribute to William Hunter as we approach the 250th year of publication of his work which is a significant milestone in the history of obstetrics and its practice. [ABSTRACT FROM AUTHOR]

In Chile, the first teachings of anatomy were carried out in the XVI century, to develop the knowledge of health profesionals practicing in the country. In 1704, Pope Sixtus IV allowed the practice of dissection, led by city's mayor of the city and where doctors and surgeons were invited. Subsequently, the exclusively theoretical teaching of medicine at the Real Universidad de San Felipe encouraged teachers to teach anatomy in clinical and practical ways to complement the lectures. Independence of Chile, found that university careers suffer major curricular changes, although in medicine and anatomy, development was slow and tortuous. The aim of this study was to describe the practice of anatomical dissection in training doctors in Chile during the period between 1700 and 1889. A literature review was conducted in scientific articles related to the subject and books on the history of Chile and the history of Chilean medicine. This allowed us to des describe the beginnings, development and characteristics of the dissection practice used in the training of physicians in the period in question. The analysis of the results allowed us to identify 5 different stages, strongly influenced by their historical context and differentiated by the approach used by the teachers of each of these stages, who defined a bibliography, an orientation and a dissection practice. In turn, the focus of each teacher was based on the academic training of each of them. This work allowed ordering and exposing valuable information for the history of medicine in Chile, as well as understanding the educational practices that were carried out in the training of these professionals who had a critical role in the process of this developing nation. [ABSTRACT FROM AUTHOR]

Background: Recent decades have seen controversial discussions on the validity of dissection courses in medical education, with alternative programs tested for various reasons. On April 1, 2015 the classification of formaldehyde as a hazardous substance was upgraded by the EU, leding to some universities precluding the participation of pregnant and breastfeeding students in dissection course. However, the revision to the Maternity Protection Act, implemented in Germany on January 1, 2018, now protects student mothers from being disadvantaged in their studies as a consequence of their pregnancy or breastfeeding. Therefore, universities must offer alternatives to dissection courses using formaldehyde to these female students.Project description: As an alternative to regular dissection courses, which use the abovementioned chemical, the Centre for Anatomy at Charité has opted for developing dedicated courses for student mothers. These new courses use plastinated prosection material instead of formalin-treated cadavers of body donors. As the core of the anatomical education takes place during the third and fourth semester in the current curriculum of human medicine at Charité the alternative courses are limited to those two semesters. Additionally, alternative exams at the end of both semesters had to be developed. The alternative courses were designed to offer pregnant and breastfeeding students a study program as close as possible to the one in which their peers learn human anatomy.Results: For the new courses, plastinates had to be produced and further specimens are still needed. Additionally required sets of bones, models and radiological images were readily available at the Centre for Anatomy. The planning and conceptualization of the courses took half a year of intense preparation. The courses for the third and fourth semester were first running during summer semester 2017. There is a clear demand for courses among pregnant and breastfeeding students. At least 5 student participants per course were registered, corresponding to every fortieth female student in their semester cohorts. The highest number of student participants was 13 in one course so far. The performances of the participants in the anatomical examinations were matching that of students attending the regular courses.Discussion: The alternative macroscopic anatomy courses enable the implementation of the revised Maternity Protection Act. The targeted student group is highly satisfied with the offered alternative courses. Considering the number of participants and their examination performance so far, the Centre for Anatomy regards the efforts involved in planning and implementing the courses as justified. The courses allow pregnant and breastfeeding students to address the same anatomical themes at the same time as their fellow students. However, due to restricted flexibility of plastinates and because students cannot prepare specific anatomical structures independently the scope of topographic learning is limited. That being said, well-produced plastinates can display anatomical structures which often cannot be dissected in regular courses. The alternative macroscopic anatomy courses using plastinates constitute suitable alternatives to the regular dissection courses with formalin-treated cadavers for pregnant and breastfeeding students.

Purpose: This novel arthroscopic subscapular sling procedure stabilizes the shoulder using a semitendinosus graft to create a sling around the subscapular tendon, which provides both static and dynamic stability. The aim of the study was to evaluate the biomechanical stability of the subscapular sling procedure in human cadaveric shoulders. The hypothesis was that the sling offers an equal stabilizing effect and range of motion compared to an arthroscopic Bankart repair.Methods: Sixteen shoulders were investigated using an industrial robot-based testing platform and four different conditions: the physiologically intact shoulder, after creating a Bankart lesion, after arthroscopic Bankart repair, and finally after applying the subscapular sling procedure using a semitendinosus tendon graft. Joint translation and external rotation were evaluated for each condition.Results: The results show improved stability in the shoulders with the subscapular sling. The robot testing revealed a significant reduction in translation in anterior and anterior-inferior directions compared to the arthroscopic Bankart repair. None of the shoulders were dislocated by forced manual abduction and external rotation. No difficulties were encountered in performing the arthroscopic subscapular sling procedure. Thorough postoperative anatomical dissection showed no alterations to structures at risk.Conclusion: The biomechanical results show increased stability with the use of the subscapular sling method. [ABSTRACT FROM AUTHOR]

Background: Rectus abdominis is a muscle that is commonly used clinically as a muscle flap, especially in reconstructive surgery. Its intramuscular innervation, however, has rarely been examined in detail or accurately mapped. The purpose of this study was to use biopsied, histological specimens complemented with a staining technique to investigate intramuscular nerve connections and distribution of the rectus abdominis. Methods: Four fresh human cadavers were included in the study and rectus abdominis was dissected bilaterally. Nerve sections innervating the rectus abdominis were biopsied and histologically processed. Sections were viewed under the microscope, and axons within each fascicle were counted using imaging software. All specimens were stained with a modified Sihler's staining technique. Intramuscular innervation was observed and the number as well as distribution was recorded. Results: Macroscopically stained specimens showed that the eighth, ninth, 10th and 12th intercostal nerves innervated the eight muscle bellies of rectus abdominis. The greatest number of minor nerve branching as well as intramuscular nerve communications originated from nerve roots T9 and T10. Minor nerve branches crossed tendinous intersections to communicate with adjacent nerves and innervate adjacent muscle bellies. Nerves originating from T9 had the greatest number of nerve fascicles and the highest axon count in each cadaver. Conclusion: The rectus abdominis is divided into four compartments with each receiving its own independent nerve supply. Minor nerve branches crossed tendinous intersections to communicate with adjacent muscle bellies and nerves suggesting that rectus abdominis can be used as a whole in innervated free flap transfer procedures. [ABSTRACT FROM AUTHOR]

While cadaver dissection remains an unmatched learning tool for structural anatomy, recent shifts in medical culture and pedagogy indicate that developing humanistic practices and fostering empathic responses are crucial components of early medical education. The Donor Letter Project (DLP) was designed to accompany a traditional dissection curriculum, and the pilot, described here, tested its quality and efficacy. In 2017, family members of recently deceased donors to the Colorado State Anatomical Board were invited to submit letters about their loved ones, and forty-seven first-year medical students at the University of Colorado School of Medicine volunteered to read the letters after their human anatomy course. The students then completed a survey about their experience. Because student and donor family responses to the DLP were overwhelmingly positive, the DLP will be repeated with incoming medical school classes, and an addendum to the State Anatomical Board donation application will invite donors to submit letters along with their enrollment materials that may be read by students at the time of donation. [ABSTRACT FROM AUTHOR]

Through the historical portrait of Galen, I argue that even an enchanted nature does not prevent the performance of violence against nature. Galen (129-c. 216 CE), the great physician-philosopher of antiquity, is best known for his systematization and innovation of the Hippocratic medical tradition, whose thought was the reigning medical orthodoxy from the medieval period into the Renaissance. His works on anatomy were the standard that Vesalius' works on anatomy overturned. What is less known about Galen's study of anatomy, however, is its philosophical and theological edge. In this paper, I show that it is precisely because nature is enchanted that Galen undertakes the grisly practices of anatomical dissection and vivisection, which entail violence against nature. First, I illustrate the violent character of Galen's anatomical experiments. Second, I elucidate Galen's anatomical methodology as a form of philosophizing and theologizing with a scalpel. Third, I explicate the importance of the demonstration of divine teleology that anatomical dissection reveals. Fourth, I sketch how anatomical dissection as a way of knowing nature and God becomes a kind of anatomical, liturgical theology. I conclude that, at least for Galen, an enchanted nature is not in itself exempt from violence. [ABSTRACT FROM AUTHOR]

We encountered a case of a double inferior vena cava with major predominance of the left inferior vena cava during an anatomical dissection course for medical students in 2015. The right inferior vena cava (normal inferior vena cava) was 2.0 mm wide, and the left inferior vena cava was 23.2 mm wide. The fine right inferior vena cava began at the right common iliac vein, ascended along the right side of the abdominal aorta, and then joined the left inferior vena cava at the level of the lower margin of the first lumbar vertebra. The dominant left inferior vena cava started from the left common iliac vein and ascended along the left side of the abdominal aorta. Most patients with a double inferior vena cava are asymptomatic, and these variants are incidentally detected by computed tomography or magnetic resonance imaging. Their presence may have significant implications for surgery, particularly abdominal surgery in patients with paraaortic lymphadenopathy and in those undergoing laparoscopic radical nephrectomy or inferior vena cava filter placement. We herein discuss the embryology of a double inferior vena cava based on detailed anatomical data of the variations of a double inferior vena cava, including those that require clinical attention.

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In the last years, there is an increase in the number of complex surgical procedures on the spleen. This process couldn’t have gone unnoticed and eventually caused a growth of interest toward this abdominal cavity organ. Acessory spleen represents one of the crucial anatomical variations of the spleen and has major clinical significance. During the anatomical dissection of 35 organ complexes, we encountered 3 cases of accessory spleen, which represents 8.6% of the total number of cases. In this article, we present the three accessory spleen cases with a review of their clinical significance.

Colon cancer continues to be a real public health problem despite recent advances. Surgery in colon cancer patients remains the only curative treatment, hence the importance of an adequate techniqual approach. Heald introduced, in 1982, the total mesorectum excision technique for rectal cancer patients, with susequent improvement in oncologic results and reduced recurrence rates. Thus, total mesorectum excision technique represents today the gold standard in surgical resection of rectal malignancies. Based on this results, Hohenbergen first applied in 2007 the total mesorectum excision principle in colon cancer surgery as complete mesocolon excision (ECM) and central vascular ligation (CVL). Complete mesocolic excision is based on a correct identification of the dissection plan between the mesofascial plane and the retroperitoneal fascia, central vascular ligation of the vessels to remove vertical lymph nodes and resection of the affected colonic segment. This paper aims to follow the principle of ECM and LVC in classic surgery and to correctly identify the anatomical dissection plans. In conclusion, applying the principles of CME and CVL in colon cancer surgery can improve cancer outcomes without increasing the incidence of postoperative complications. [ABSTRACT FROM AUTHOR]

The preponderance of men in the narrative of anatomical education during the 1800s has skewed the historical perception of medical cadavers in favour of adult men, and stifled the conversation about the less portrayed individuals, especially children. Although underrepresented in both the historical literature and skeletal remains from archaeological contexts dated to the 1800s, these sources nevertheless illustrate that foetal and infant cadavers were a prized source of knowledge. In the late 1700s and 1800s foetal and infant cadavers were acquired by anatomists following body snatching from graveyards, from the child's death in a charitable hospital, death from infectious disease in large poor families, or following infanticide by desperate unwed mothers. Study of foetal and infant remains from the 1800s in the anatomical collection at the University of Cambridge shows that their bodies were treated differently to adults by anatomists. In contrast to adults it was extremely rare for foetal and infant cadavers to undergo craniotomy, and thoracotomy seems to have been performed through costal cartilages of the chest rather than the ribs themselves. However, many infants and foetuses do show evidence for knife marks on the cranium indicating surgical removal of the scalp by anatomists. These bodies were much more likely to be curated long term in anatomical collections and museums than were adult males who had undergone dissection. They were prized both for demonstrating normal anatomical development, but also congenital abnormalities that led to an early death. The current findings show that the dissection of foetal and infant cadavers was more widespread than previous research on anatomical education suggests. This research details the important role of the youngest members of society in anatomical education during the long 19th century, and how the social identity of individuals in this subgroup affected their acquisition, treatment and disposal by elite medical men of the time. [ABSTRACT FROM AUTHOR]