Laparoscopic anatomical liver resection has been increasingly reported worldwide,but how to demarcate the resection planes is technically challenging[1].Positive staining technique with intraoperative indocyanine gree...Laparoscopic anatomical liver resection has been increasingly reported worldwide,but how to demarcate the resection planes is technically challenging[1].Positive staining technique with intraoperative indocyanine green(ICG)-fluorescence imaging has been introduced as an effective tool for real-time intraoperative guidance[2].Liver anatomy is complex.Generally,liver is composed of 9 segments,each is composed of two to three subsegments,and each subsegment contains several hepatic cone units.A hepatic cone unit is dominated by a tertiary or quaternary hepatic pedicles[3].展开更多
The preservation of anatomical pieces in Veterinary Anatomy is essential since it is not possible to dissect all domestic species. Most techniques use reagents with high levels of toxicity such as formaldehyde. The ob...The preservation of anatomical pieces in Veterinary Anatomy is essential since it is not possible to dissect all domestic species. Most techniques use reagents with high levels of toxicity such as formaldehyde. The objective of this work was to develop a new preservation technique that uses reagents with zero toxicity and that allows obtaining preserved pieces suitable for anatomical studies. The alcohol propylene glycol technique was developed, the method of which uses a fixation step with alcohol, sodium chloride, commercial vinegar and subsequently the impregnation of the preservation solution made from propylene glycol and commercial vinegar, which are non-toxic. As a result of this work, adequately preserved sheep hearts were obtained that preserved their morphology with slight changes in size and weight, which did not affect their external and internal anatomical structure. Its coloration was not substantially affected, remaining a little lighter. The pieces obtained showed flexibility which allowed dissections to be carried out. The time to develop the technique was 20 days. A comparative study was carried out with the phenolated glycerin technique that uses toxic reagents (formaldehyde and phenol) and the pieces obtained with the alcohol propylene glycol technique were of better quality, observing that the pieces with phenolated glycerin tend to darken and are more rigid. And the time to develop the technique is 24 days. In conclusion, a preservation technique for anatomical pieces was developed that allowed the preservation of the organs under study, which allow their use for anatomical studies, and which have been preserved without changes until the time of this publication (8 months) and there are pieces preserved with this technique for 2 years.展开更多
Recent methodological advances in quantitative wood anatomy have provided new insights into the climatic responses of radial growth at the scale of cell structure of tree rings. This study considered long-term chronol...Recent methodological advances in quantitative wood anatomy have provided new insights into the climatic responses of radial growth at the scale of cell structure of tree rings. This study considered long-term chronologies of tracheid measurements, indexed by a novel approach to separate their specific climatic responses from signal recorded in cell production(closely reflected in tree-ring width). To fill gaps in understanding the impact of climate on conifer xylem structure, Scots pine(Pinus sylvestris L.)trees > 200 years old were selected within the forest-steppe zone in southern Siberia. Such habitats undergo mild moisture deficits and the resulting climatic regulation of growth processes. Mean and maximum values of cell radial diameter and cell wall thickness were recorded for each tree ring.Despite a low level of climatogenic stress, components of cell chronologies independent of cambial activity were separated to obtain significant climatic signals revealing the timing of the specific stages of tracheid differentiation. Cell expansion lasted from mid-April to July and was impacted similarly to tree-ring width(stimulated by precipitation and stressed by heat), maximum cell size formed late June. A switch in the climatic responses of mean anatomical traits indicated transition to latewood in mid-July. Secondary wall deposition lasted until mid-September, suppressed by end of season temperatures. Generally, anatomical climatic responses were modulated by a less dry May and September compared with summer months.展开更多
Objective: Study the contribution of the DIVA 3D dissection table in the teaching of anatomy at the Faculty of Medicine and Odontology of Bamako. Material and Methods: This was a qualitative study carried out from Nov...Objective: Study the contribution of the DIVA 3D dissection table in the teaching of anatomy at the Faculty of Medicine and Odontology of Bamako. Material and Methods: This was a qualitative study carried out from November 1 to December 30, 2023 at the clinical and morphological anatomy laboratory of the Faculty of Medicine and Odontostomatology of Bamako. Included in this study were students who participated in practical and tutorial sessions. The variables studied during this study were: the previous performance of dissection on a cadaver by the students, the opinion of the students on dissection on a cadaver, the replacement of dissection on a cadaver by virtual dissection in the absence of a body, the level student satisfaction. Results: We surveyed 130 participants. The average age was 22 ± 0.2 years with extremes of 17 and 29 years. 95.3% of participants were students. According to 66.7% of participants, virtual dissection is a good palliative in the absence of a corpse. 95.3% of participants found using the virtual dissection table easy with an average of 7.88 ± 1.4. The overall assessment was well rated by 99.3% of participants. Conclusion: According to the results of this study, the virtual dissection table should be improved by integrating commented videos. The use of the DIVA 3D virtual dissection table during practical and tutorial sessions is well appreciated by the students. We believe that the teaching of anatomy using 3D digital technology should be included in the study programs of the Faculty of Medicine and Odontostomatology.展开更多
BACKGROUND Gallstones are common lesions that often require surgical intervention.Laparo-scopic cholecystectomy is the treatment of choice for symptomatic gallstones.Preoperatively,the anatomical morphology of the cys...BACKGROUND Gallstones are common lesions that often require surgical intervention.Laparo-scopic cholecystectomy is the treatment of choice for symptomatic gallstones.Preoperatively,the anatomical morphology of the cystic duct(CD),needs to be accurately recognized,especially when anatomical variations occur in the CD,which is otherwise prone to bile duct injury.However,at present,there is no optimal classification system for CD morphology applicable in clinical practice,and the relationship between anatomical variations in CDs and gallstones remains to be explored.AIM To create a more comprehensive clinically applicable classification of the morphology of CD and to explore the correlations between anatomic variants of CD and gallstones.METHODS A total of 300 patients were retrospectively enrolled from October 2021 to January 2022.The patients were divided into two groups:The gallstone group and the nongallstone group.Relevant clinical data and anatomical data of the CD based on magnetic resonance cholangiopancreatography(MRCP)were collected and analyzed to propose a morphological classification system of the CD and to explore its relationship with gallstones.Multivariate analysis was performed using logistic regression analyses to identify the independent risk factors using variables that were significant in the univariate analysis.RESULTS Of the 300 patients enrolled in this study,200(66.7%)had gallstones.The mean age was 48.10±13.30 years,142(47.3%)were male,and 158(52.7%)were female.A total of 55.7%of the patients had a body mass index(BMI)≥24 kg/m2.Based on the MRCP,the CD anatomical typology is divided into four types:Type I:Linear,type II:n-shaped,type III:S-shaped,and type IV:W-shaped.Univariate analysis revealed differences between the gallstone and nongallstone groups in relation to sex,BMI,cholesterol,triglycerides,morphology of CD,site of CD insertion into the extrahepatic bile duct,length of CD,and angle between the common hepatic duct and CD.According to the multivariate analysis,female,BMI(≥24 kg/m2),and CD morphology[n-shaped:Odds ratio(OR)=10.97,95%confidence interval(95%CI):5.22-23.07,P<0.001;S-shaped:OR=4.43,95%CI:1.64-11.95,P=0.003;W-shaped:OR=7.74,95%CI:1.88-31.78,P=0.005]were significantly associated with gallstones.CONCLUSION The present study details the morphological variation in the CD and confirms that CD tortuosity is an independent risk factor for gallstones.展开更多
The benefits of regular physical activity are well known.Yet,few studies have examined the effectiveness of integrating physical activity(PA)into curricula within a post-secondary setting.To investigate the incorporat...The benefits of regular physical activity are well known.Yet,few studies have examined the effectiveness of integrating physical activity(PA)into curricula within a post-secondary setting.To investigate the incorporation of PA into medical curriculum,we developed a series of optional exercise-based review sessions designed to reinforce musculoskeletal(MSK)anatomy course material.These synchronous sessions were co-taught by a group fitness instructor and an anatomy instructor.The fitness instructor would lead students through both strength and yoga style exercises,while the anatomy instructor asked questions about relevant anatomical structures related to course material previously covered.After the sessions,participants were asked to evaluate the classes on their self-reported exam preparedness in improving MSK anatomy knowledge,PA levels,and mental wellbeing.Thirty participants completed surveys;a majority agreed that the classes increased understanding of MSK concepts(90.0%)and activity levels(97.7%).Many(70.0%)felt that the classes helped reduce stress.The majority of respondents(90.0%)agreed that the classes contributed to increased feelings of social connectedness.Overall,medical students saw benefit in PA based interventions to supplement MSK course concepts.Along with increasing activity levels and promoting health behaviours,integrating PA into medical curriculum may improve comprehension of learning material,alleviate stress and foster social connectivity among medical students.展开更多
Objective:To evaluate the basic appearance and variation of the venous sinuses and veins in healthy individuals.Methods:Prospectively-recruited healthy volunteers completed a questionnaire and underwent magnetic reson...Objective:To evaluate the basic appearance and variation of the venous sinuses and veins in healthy individuals.Methods:Prospectively-recruited healthy volunteers completed a questionnaire and underwent magnetic resonance imaging plus contrast-enhanced magnetic resonance venography(CE-MRV)to measure their sinus diameters.Anatomical variations of cerebral venous sinuses were evaluated.Results:Fifty-eight individuals were included.The mean diameter of the left transverse sinus(LTS)(5.37±1.35 mm)was significantly smaller than that of the right transverse sinus(RTS)(6.65±1.57 mm)(P<0.001),and the average discrepancy was 19.2%.RTS dominance was noted in 55.1%of cases.Four superior sagittal sinus(SSS)anatomical variations were found.Type A was the most common and was present in 43 participants(74.1%).The SSS preferentially drained into the RTS in 32 patients(55.2%),and arachnoid granulation was observed in the transverse sinus(TS)and SSS in patients.According to our reclassification combined with Osborn’s previous research,we found that the SSS commonly drained into the RTS and that the straight sinus(StS)branched into both TSs.Conclusions:A 19%difference between the LTS and RTS provides a threshold for TS lateral dominance instead of a TS abnormality.Clinicians and radiologists should not ignore the influence of acquired pathology when the SSS drains in a non-RTS-dominant manner.Anatomical variations of the torcular herophili are frequent;the most commonly observed was the StS branching into both TSs,with the SSS draining into the RTS.展开更多
Anatomy, a foremost basic medical science (BMS) has evolved in content and context, while remaining the most fundamental BMS subject. Stakeholders have continually made efforts especially in recent time to achieve an ...Anatomy, a foremost basic medical science (BMS) has evolved in content and context, while remaining the most fundamental BMS subject. Stakeholders have continually made efforts especially in recent time to achieve an evolution of this subject. The primary aim of this work was to study the perceptions and experiences of Anatomists towards contributing to programme and career advancements. Following ethical approval, structured questionnaire was administered to Nigerian anatomists using a Google form. It is a total population study. The questionnaire had 13 sections, with each section addressing a theme that was integral to the subject of research interest. The last section collected free responses as qualitative information. After indicating informed consent, 106 anatomists properly completed and returned the questionnaires. Statistical and quantitative analyses of results were done. The most popular field amongst respondents was Neuroscience (60.9%);followed by Histology or Microscopic Anatomy (53.6%), Embryology or developmental anatomy (35.5%), Gross anatomy (34.5%) and Histochemistry (30.9%). About half of Nigerian anatomists involved in the study had a PhD degree. Training emphasized the cognitive domains the most. Consequently, emphasis should be laid on the psychomotor (skills) and the affective domain (attitude) to improve capacity, competences, and the job prospects of trainees. The consensus was that the programme trained students and prepared graduates as medical educators, scientists, and researchers. Anatomy has significant potential to contribute to development with proper programme design, emphasis on research, teaching and applied services competencies, effective policy formulation and implementation and adherence to best practices.展开更多
Purpose: This study investigated the anatomical and histological characteristics of the rat Eustachian tube(E-tube)and the feasibility of Eustachian tubography in a rat model.Materials and methods: Fifteen male Wistar...Purpose: This study investigated the anatomical and histological characteristics of the rat Eustachian tube(E-tube)and the feasibility of Eustachian tubography in a rat model.Materials and methods: Fifteen male Wistar rats were used in this study, and the bilateral E-tubes of each rat were examined. Ten E-tubes were used for anatomical studies, another ten for histological analysis, and the other ten for Eustachian tubography. Five rats were euthanized and decapitated, and ten E-tubes were dissected to describe the anatomy of the E-tube. Ten E-tube specimens obtained from five other rats were sectioned to investigate Etube histology. Eustachian tubography was performed on the bilateral E-tubes of the other five rats using the trans-tympanic approach.Results: The rat E-tubes consisted of bony and membranous parts. Cartilage and bone tissue covered only the bony part. The E-tubes’ mean diameter and overall length were 2.97 mm and 4.96 mm, respectively. The tympanic orifices’ mean diameter was 1.21 mm. The epithelium of E-tubes was mainly composed of pseudostratified ciliated and goblet cells. Eustachian tubography was successfully performed on both sides of the E-tube for each rat.The technical success rate was 100%, the average running time was 4.9 min, and no procedure-related complications occurred. On tubography images, the E-tube, tympanic cavity, and nasopharynx could be identified because of the visualization of bony landmarks.Conclusion: In this study, we described the anatomical and histological features of rat E-tubes. With the aid of these findings, E-tube angiography was successfully performed using a transtympanic approach. These results will facilitate further investigation of E-tube dysfunction.展开更多
<strong>Aim:</strong> To carry out a 3D vector reconstruction of the typical cervical vertebra from anatomical sections of the “Korean Visible Human” for educational purposes. <strong>Material and ...<strong>Aim:</strong> To carry out a 3D vector reconstruction of the typical cervical vertebra from anatomical sections of the “Korean Visible Human” for educational purposes. <strong>Material and Methods:</strong> The anatomical subject was a 33-year-old Korean man who died of leukemia. He was 164 cm tall and weighed 55 kg. This man donated his body to science. Her body was frozen and cut into several anatomical sections after an MRI and CT scan. These anatomical sections were made using a special saw called a 0.2 mm thick cryomacrotome. Thus 8100 cuts were obtained. Only the sections numbered 940 to 1200 were used for our study. A segmentation by manual contouring of the different parts of the typical cervical vertebra was made using the software Winsurf version 3.5 on a laptop PC running Windows 7 equipped with a Ram of 8 gigas. <strong>Results:</strong> Our 3D vector model of the typical cervical vertebra is easily manipulated using the Acrobat 3DPDF interface. Each part of the vertebra accessible in a menu can be displayed, hidden or made transparent, and 3D labels are available as well as educational menus for learning anatomy. <strong>Conclusion: </strong>This original work constitutes a remarkable educational tool for the anatomical study of the typical cervical vertebra and can also be used as a 3D atlas for simulation purposes for training in therapeutic gestures.展开更多
characteristics,complex content,and it is difficult to understand.In view of the nature of the subject,many different models and specimens are required during teaching,increasing the difficulty of its teaching.Althoug...characteristics,complex content,and it is difficult to understand.In view of the nature of the subject,many different models and specimens are required during teaching,increasing the difficulty of its teaching.Although the mode of medical teaching is constantly updating,anatomical specimens are still important in the teaching of anatomy,as they help students to understand the organs,their positions,and structural forms as well as to better grasp the theoretical aspect.In addition,anatomical specimens and medical students contact condition can affect the teaching effect.Therefore,it is imperative to give full play to the role of anatomical specimens in anatomy teaching to improve the teaching effect.This paper summarizes the research on the use of anatomical specimens in the teaching of anatomy.展开更多
This present study includes twelve species that represent the Ficus genus,namely;aspera,carica,tinctoria subsp.gibbosa,hirta,hispida,neriifolia,palmata,pumila,racemosa,septica,sur,and sycomorus,belonging to the Morace...This present study includes twelve species that represent the Ficus genus,namely;aspera,carica,tinctoria subsp.gibbosa,hirta,hispida,neriifolia,palmata,pumila,racemosa,septica,sur,and sycomorus,belonging to the Moraceae family.The species samples were collected from various locations in Egypt.The study focused on the anatomical and molecular characteristics of mature foliage leaves.Since the identification and classification of taxa are highly dependent on the anatomical features of leaves,the anatomical characteristics were recorded in the form of a comparison between the examined plants in the data matrix.This study aims to contribute to the identification of the studied species based on the anatomical details of the matured leaves.Anatomical characterization includes the variations in upper and lower epidermal layers that are covered by a thin or thick cuticle;the number of palisade and spongy layers;crystals;secretory elements;lithocysts;the midrib zone has parenchyma associated with mechanical tissue,vascular system,and investigation of trichomes;on the other hand,in the current study,the phylogenetic analysis was conducted by using the ITS and 5.8 S sequences.From the analysis of all the available data,it could be stated that there is an overall agreement with the anatomical character dendrogram.展开更多
The visualization and evaluation of fruit vascular bundles in grape are indispensable for understanding the development and growth of the fruit. The vascular bundles in grape are as thin as human hair, and strongly ad...The visualization and evaluation of fruit vascular bundles in grape are indispensable for understanding the development and growth of the fruit. The vascular bundles in grape are as thin as human hair, and strongly adhere to flesh cells, making it difficult to isolate individual intact vessel elements. Currently there is little information about methods to characterize grape vascular tissue. In this study, we describe an easy and effective technique to visualize the xylem cell structure of the ‘Red Globe' grape(Vitis L.). The intact vascular bundles of the grape were isolated through enzymatic degradation of flesh cells by hydrolases which were effective in removing flesh cells from vascular bundles. This enabled the illustration of the fine surface structure of vessel elements and their arrangement in the vascular bundles of the grape. This modified method to separate the vascular bundles into individual vessel elements was more effective than former methods of manually shaking to isolate individual vessels. Clear images of xylem vessel arrangement and structural characteristics of individual vessel element were acquired by light microscopy(BX51, Olympus, Tokyo, Japan), transmission electron microscopy(Tecnai 12, Philips, Netherlands) and scanning electron microscopy(GeminiSEM 300, Carl Zeiss, Germany). In addition, the 3D structure of vessel elements was observed using confocal laser scanning microscopy(Zeiss: model: LSM-880, Oberkochen, Germany). The imaging techniques for visualizing and analyzing the structure of xylem vessels in grape described in this study are an improvement of past methods. An effective method to isolate grape vascular bundles from flesh cells was also developed, which enables the imaging of the fine surface structure of vessel elements and their arrangement in grape vascular bundles. By adjusting the process of maceration of vascular bundles, an easy and effective method was developed to gently disrupt the plant tissue and isolate individual vessel elements. These improved techniques are suitable to observe the intact morphology of vascular bundles in the grape, improve experimental efficiency and accelerate new discoveries on the anatomical structure of the grape.展开更多
Roughly quadrangular, the chiasma presents many morphological variations. The optical chiasm, odd and symmetrical structure of the optical pathways, is a required passage of the axons of neurons for the visual pathway...Roughly quadrangular, the chiasma presents many morphological variations. The optical chiasm, odd and symmetrical structure of the optical pathways, is a required passage of the axons of neurons for the visual pathways. Any modification of its morphology evokes a pathological process, generally tumoral. The quality of MRI images rivals that of anatomical slices. So the MRI is essential for the study of the chiasma. The aim of this work was to study the morphometry of the optic chiasm in patients addressed for cerebral MRI to the imaging department of the university hospital of the POINT-G, during the period from July 29, to November 30, 2016. All patients who had a normal examination of the optic chiasma, numbering 15, were included in this study. In 86.66% of cases the chiasma had a quadrilateral form. Its average length was 8.73 mm and its average width was 13 mm. The average thickness was 4.13 mm.展开更多
Introduction: Helicobacter pylori (Hp) infection is the most common bacterial infection in the world. World Health Organization has classified this bacterium as a Class I carcinogen. The objective of this work is to s...Introduction: Helicobacter pylori (Hp) infection is the most common bacterial infection in the world. World Health Organization has classified this bacterium as a Class I carcinogen. The objective of this work is to study the epidemiological, clinical and pathological aspects of Helicobacter pylori infection among adults in a digestive endoscopy unit and the pathological anatomy service of Parakou. Patients and Methods: This was a descriptive and analytical cross-sectional study conducted from January 2020 to September 2020 in the digestive endoscopy unit and pathological anatomy service at the Departmental University Hospital Center of Borgou. Patients aged 18 years and older, who had undergone a gastroscopy with biopsies and who gave their oral consent were included. Three antral biopsies and two fundic biopsies were performed. The search for Hp was done under an optical microscope after staining with hematoxylin eosin. Results: A total of 151 patients were included and 51.66% were infected with Hp. Their average age was 40.63 ± 15.32 years and the sex ratio was 0.9. Epigastric pain was the most reported symptom (71.01%). Endoscopically, the prevalence of erythematous gastropathy was 98.72%. The study of chronic Hp gastritis according to Sydney system had shown signs of activity in 100% of patients with Hp and glandular atrophy in 83.33% of them. Intestinal metaplasia and dysplasia accounted for 24.35% and 29.48% of cases, respectively. Factors associated with Hp infection were: absence of proton pump inhibitor intake prior to examination, absence of handwashing with soap and water before eating, erythematous aspect of gastritis on gastroscopy, absence of intestinal metaplasia of the fundus, active and chronic aspects of gastritis on histology. Conclusion: The frequency of Hp infection in hospitals among adults admitted to the Digestive Endoscopy Unit of Parakou is high. To reduce this prevalence, it will be necessary to act on the factors identified.展开更多
Aim: This study aimed at describing the anatomical variations of the external branch of the superior laryngeal nerve and at estimating the frequency of nerves at risk during the thyroid surgery. Methodology: We realiz...Aim: This study aimed at describing the anatomical variations of the external branch of the superior laryngeal nerve and at estimating the frequency of nerves at risk during the thyroid surgery. Methodology: We realized a forward-looking study from September, 2016 in May 31st, 2018 in the laboratory of anatomy of the Faculty of Medicine and Odontostomatology of Bamako in Mali. All the fresh anatomical subjects not carrying trauma and or a scar at the level of the previous region of the neck were held. The anatomical subjects were not included presenting a traumatic lesion and\or a scar of the previous region of the neck. Results: We realized 34 dissections of the external branch of the superior laryngeal nerve to 17 deathly subjects (11 men and 6 women with a sex-ratio of 1.8). The average age of the subjects was of 42 years (extremes: 18 and 70 years). Our study allowed highlighting in 100% of the cases, the external branch of the superior laryngeal nerve and the superior thyroid artery so to the right as to the left. On 34 dissected external branch of the superior laryngeal nerve, none had a previous route. However we found 28 nerves (82.4%) having a later route, stuck to the external face of the lower constrictor of the pharynx. These were not mixed with the superior thyroid artery and its branch of division and were situated outside the thyroid capsule. In 17.6% of the cases (6 cases), the nerve had a route mixed in the branch of the superior thyroid artery. These were found inside of the capsule (11.8% adhered to the artery and 5.8% crossed its branch of division). Conclusion: The risk of injury of the external laryngeal nerve during thyroid surgery procedure is never zero. It is more important on the left side.展开更多
BACKGROUND Total mesorectal excision along the“holy plane”is the only radical surgery for rectal cancer,regardless of tumor size,localization or even tumor stage.However,according to the concept of membrane anatomy,...BACKGROUND Total mesorectal excision along the“holy plane”is the only radical surgery for rectal cancer,regardless of tumor size,localization or even tumor stage.However,according to the concept of membrane anatomy,multiple fascial spaces around the rectum could be used as the surgical plane to achieve radical resection.AIM To propose a new membrane anatomical and staging-oriented classification system for tailoring the radicality during rectal cancer surgery.METHODS A three-dimensional template of the member anatomy of the pelvis was established,and the existing anatomical nomenclatures were clarified by cadaveric dissection study and laparoscopic surgical observation.Then,we suggested a new and simple classification system for rectal cancer surgery.For simplification,the classification was based only on the lateral extent of resection.RESULTS The fascia propria of the rectum,urogenital fascia,vesicohypogastric fascia and parietal fascia lie side by side around the rectum and form three spaces(medial,middle and lateral),and blood vessels and nerves are precisely positioned in the fascia or space.Three types of radical surgery for rectal cancer are described,as are a few subtypes that consider nerve preservation.The surgical planes of the proposed radical surgeries(types A,B and C)correspond exactly to the medial,middle,and lateral spaces,respectively.CONCLUSION Three types of radical surgery can be precisely defined based on membrane anatomy,including nerve-sparing procedures.Our classification system may offer an optimal tool for tailoring rectal cancer surgery.展开更多
Endoscopic retrograde cholangiopancreatography(ERCP)is the preferred modality for drainage of the obstructed biliary tree.In patients with surgically altered anatomy,ERCP using standard techniques may not be feasible....Endoscopic retrograde cholangiopancreatography(ERCP)is the preferred modality for drainage of the obstructed biliary tree.In patients with surgically altered anatomy,ERCP using standard techniques may not be feasible.Enteroscope assisted ERCP is usually employed with variable success rate.With advent of endoscopic ultrasound(EUS),biliary drainage procedures in patients with biliary obstruction and surgically altered anatomy is safe and effective.In this narrative review,we discuss role of EUS guided biliary drainage in patients with altered anatomy and the various approaches used in patients with benign and malignant biliary obstruction.展开更多
BACKGROUND The sympathetic nervous system makes medium and large peripheral arteries smaller to slow the blood flowing through them.AIM To observe brachial artery sympathetic innervation.METHODS We developed a neuroph...BACKGROUND The sympathetic nervous system makes medium and large peripheral arteries smaller to slow the blood flowing through them.AIM To observe brachial artery sympathetic innervation.METHODS We developed a neurophysiological autonomous test that measured the effects of peripheral sympathetic fibres on peripheral arteries.Our specific objective was to find the sympathetic innervation of the brachial artery.To accomplish this purpose,the brachial artery baseline diameter and flow rate were measured in the right arm of the patients.Afterwards,electrical stimulus was applied to the medial nerve for 5 s.Through electrical sympathetic activation,the vessel diameter and overall flow rate will decrease.After 7 d,a similar experiment was repeated using the ulnar nerve.RESULTS The differences in diameter and flow rate of the brachial artery in response to median and ulnar nerve activation were compared.In the total group,no significant difference in diameter was seen between medial and ulnar nerve stimulation(P=0.648).The difference in absolute slowdown of flow rate between median nerve stimulation and ulnar nerve stimulation was not statistically significant for the entire group(P=0.733).CONCLUSION As a target organ,the brachial artery receives an equal amount of sympathetic innervation from the median and the ulnar nerves.展开更多
Henry Vandyke Carter(1831–1897),physician and illustrator from Saint George’s Hospital in London,England.He worked with Henry Williamson Gray(1827–1861)on anatomical dissections and Carter’s illustrations contribu...Henry Vandyke Carter(1831–1897),physician and illustrator from Saint George’s Hospital in London,England.He worked with Henry Williamson Gray(1827–1861)on anatomical dissections and Carter’s illustrations contributed significantly to the success of the Treaty of Anatomy,Descriptive and Surgical.Henry Carter never achieved any credit or royalty for his work.This book is currently regarded as one of the most influential human anatomy textbooks.The paper aims to present a brief review of Henry Carter’s contributions to the medical field.展开更多
基金from Health Commission of Zhejiang Province(JBZX-202004)the National Natural Science Foundation of China(82002925)the National Key Research and Development Program of China(2022YFC2407304).
文摘Laparoscopic anatomical liver resection has been increasingly reported worldwide,but how to demarcate the resection planes is technically challenging[1].Positive staining technique with intraoperative indocyanine green(ICG)-fluorescence imaging has been introduced as an effective tool for real-time intraoperative guidance[2].Liver anatomy is complex.Generally,liver is composed of 9 segments,each is composed of two to three subsegments,and each subsegment contains several hepatic cone units.A hepatic cone unit is dominated by a tertiary or quaternary hepatic pedicles[3].
文摘The preservation of anatomical pieces in Veterinary Anatomy is essential since it is not possible to dissect all domestic species. Most techniques use reagents with high levels of toxicity such as formaldehyde. The objective of this work was to develop a new preservation technique that uses reagents with zero toxicity and that allows obtaining preserved pieces suitable for anatomical studies. The alcohol propylene glycol technique was developed, the method of which uses a fixation step with alcohol, sodium chloride, commercial vinegar and subsequently the impregnation of the preservation solution made from propylene glycol and commercial vinegar, which are non-toxic. As a result of this work, adequately preserved sheep hearts were obtained that preserved their morphology with slight changes in size and weight, which did not affect their external and internal anatomical structure. Its coloration was not substantially affected, remaining a little lighter. The pieces obtained showed flexibility which allowed dissections to be carried out. The time to develop the technique was 20 days. A comparative study was carried out with the phenolated glycerin technique that uses toxic reagents (formaldehyde and phenol) and the pieces obtained with the alcohol propylene glycol technique were of better quality, observing that the pieces with phenolated glycerin tend to darken and are more rigid. And the time to develop the technique is 24 days. In conclusion, a preservation technique for anatomical pieces was developed that allowed the preservation of the organs under study, which allow their use for anatomical studies, and which have been preserved without changes until the time of this publication (8 months) and there are pieces preserved with this technique for 2 years.
基金supported by the Russian Science Foundation grant no. 23-44-00067the National Natural Science Foundation of China grant no.42261134537 in the framework of a joint Russian-Chinese project (fieldwork)by the Russian Ministry of Science and Higher Education,grant number FSRZ-2023-0007 (for data analysis)
文摘Recent methodological advances in quantitative wood anatomy have provided new insights into the climatic responses of radial growth at the scale of cell structure of tree rings. This study considered long-term chronologies of tracheid measurements, indexed by a novel approach to separate their specific climatic responses from signal recorded in cell production(closely reflected in tree-ring width). To fill gaps in understanding the impact of climate on conifer xylem structure, Scots pine(Pinus sylvestris L.)trees > 200 years old were selected within the forest-steppe zone in southern Siberia. Such habitats undergo mild moisture deficits and the resulting climatic regulation of growth processes. Mean and maximum values of cell radial diameter and cell wall thickness were recorded for each tree ring.Despite a low level of climatogenic stress, components of cell chronologies independent of cambial activity were separated to obtain significant climatic signals revealing the timing of the specific stages of tracheid differentiation. Cell expansion lasted from mid-April to July and was impacted similarly to tree-ring width(stimulated by precipitation and stressed by heat), maximum cell size formed late June. A switch in the climatic responses of mean anatomical traits indicated transition to latewood in mid-July. Secondary wall deposition lasted until mid-September, suppressed by end of season temperatures. Generally, anatomical climatic responses were modulated by a less dry May and September compared with summer months.
文摘Objective: Study the contribution of the DIVA 3D dissection table in the teaching of anatomy at the Faculty of Medicine and Odontology of Bamako. Material and Methods: This was a qualitative study carried out from November 1 to December 30, 2023 at the clinical and morphological anatomy laboratory of the Faculty of Medicine and Odontostomatology of Bamako. Included in this study were students who participated in practical and tutorial sessions. The variables studied during this study were: the previous performance of dissection on a cadaver by the students, the opinion of the students on dissection on a cadaver, the replacement of dissection on a cadaver by virtual dissection in the absence of a body, the level student satisfaction. Results: We surveyed 130 participants. The average age was 22 ± 0.2 years with extremes of 17 and 29 years. 95.3% of participants were students. According to 66.7% of participants, virtual dissection is a good palliative in the absence of a corpse. 95.3% of participants found using the virtual dissection table easy with an average of 7.88 ± 1.4. The overall assessment was well rated by 99.3% of participants. Conclusion: According to the results of this study, the virtual dissection table should be improved by integrating commented videos. The use of the DIVA 3D virtual dissection table during practical and tutorial sessions is well appreciated by the students. We believe that the teaching of anatomy using 3D digital technology should be included in the study programs of the Faculty of Medicine and Odontostomatology.
基金Supported by The Yunnan Medical Discipline Leader Training Program,No.D-2019012.
文摘BACKGROUND Gallstones are common lesions that often require surgical intervention.Laparo-scopic cholecystectomy is the treatment of choice for symptomatic gallstones.Preoperatively,the anatomical morphology of the cystic duct(CD),needs to be accurately recognized,especially when anatomical variations occur in the CD,which is otherwise prone to bile duct injury.However,at present,there is no optimal classification system for CD morphology applicable in clinical practice,and the relationship between anatomical variations in CDs and gallstones remains to be explored.AIM To create a more comprehensive clinically applicable classification of the morphology of CD and to explore the correlations between anatomic variants of CD and gallstones.METHODS A total of 300 patients were retrospectively enrolled from October 2021 to January 2022.The patients were divided into two groups:The gallstone group and the nongallstone group.Relevant clinical data and anatomical data of the CD based on magnetic resonance cholangiopancreatography(MRCP)were collected and analyzed to propose a morphological classification system of the CD and to explore its relationship with gallstones.Multivariate analysis was performed using logistic regression analyses to identify the independent risk factors using variables that were significant in the univariate analysis.RESULTS Of the 300 patients enrolled in this study,200(66.7%)had gallstones.The mean age was 48.10±13.30 years,142(47.3%)were male,and 158(52.7%)were female.A total of 55.7%of the patients had a body mass index(BMI)≥24 kg/m2.Based on the MRCP,the CD anatomical typology is divided into four types:Type I:Linear,type II:n-shaped,type III:S-shaped,and type IV:W-shaped.Univariate analysis revealed differences between the gallstone and nongallstone groups in relation to sex,BMI,cholesterol,triglycerides,morphology of CD,site of CD insertion into the extrahepatic bile duct,length of CD,and angle between the common hepatic duct and CD.According to the multivariate analysis,female,BMI(≥24 kg/m2),and CD morphology[n-shaped:Odds ratio(OR)=10.97,95%confidence interval(95%CI):5.22-23.07,P<0.001;S-shaped:OR=4.43,95%CI:1.64-11.95,P=0.003;W-shaped:OR=7.74,95%CI:1.88-31.78,P=0.005]were significantly associated with gallstones.CONCLUSION The present study details the morphological variation in the CD and confirms that CD tortuosity is an independent risk factor for gallstones.
文摘The benefits of regular physical activity are well known.Yet,few studies have examined the effectiveness of integrating physical activity(PA)into curricula within a post-secondary setting.To investigate the incorporation of PA into medical curriculum,we developed a series of optional exercise-based review sessions designed to reinforce musculoskeletal(MSK)anatomy course material.These synchronous sessions were co-taught by a group fitness instructor and an anatomy instructor.The fitness instructor would lead students through both strength and yoga style exercises,while the anatomy instructor asked questions about relevant anatomical structures related to course material previously covered.After the sessions,participants were asked to evaluate the classes on their self-reported exam preparedness in improving MSK anatomy knowledge,PA levels,and mental wellbeing.Thirty participants completed surveys;a majority agreed that the classes increased understanding of MSK concepts(90.0%)and activity levels(97.7%).Many(70.0%)felt that the classes helped reduce stress.The majority of respondents(90.0%)agreed that the classes contributed to increased feelings of social connectedness.Overall,medical students saw benefit in PA based interventions to supplement MSK course concepts.Along with increasing activity levels and promoting health behaviours,integrating PA into medical curriculum may improve comprehension of learning material,alleviate stress and foster social connectivity among medical students.
基金supported by the National Natural Science Foundation of China(82027802)the Pharmaceutical Collaboration Project of the Beijing Science and Technology Commission(Z181100001918026)the Talents Gathering Project of Xuanwu Hospital,Capital Medical University.
文摘Objective:To evaluate the basic appearance and variation of the venous sinuses and veins in healthy individuals.Methods:Prospectively-recruited healthy volunteers completed a questionnaire and underwent magnetic resonance imaging plus contrast-enhanced magnetic resonance venography(CE-MRV)to measure their sinus diameters.Anatomical variations of cerebral venous sinuses were evaluated.Results:Fifty-eight individuals were included.The mean diameter of the left transverse sinus(LTS)(5.37±1.35 mm)was significantly smaller than that of the right transverse sinus(RTS)(6.65±1.57 mm)(P<0.001),and the average discrepancy was 19.2%.RTS dominance was noted in 55.1%of cases.Four superior sagittal sinus(SSS)anatomical variations were found.Type A was the most common and was present in 43 participants(74.1%).The SSS preferentially drained into the RTS in 32 patients(55.2%),and arachnoid granulation was observed in the transverse sinus(TS)and SSS in patients.According to our reclassification combined with Osborn’s previous research,we found that the SSS commonly drained into the RTS and that the straight sinus(StS)branched into both TSs.Conclusions:A 19%difference between the LTS and RTS provides a threshold for TS lateral dominance instead of a TS abnormality.Clinicians and radiologists should not ignore the influence of acquired pathology when the SSS drains in a non-RTS-dominant manner.Anatomical variations of the torcular herophili are frequent;the most commonly observed was the StS branching into both TSs,with the SSS draining into the RTS.
文摘Anatomy, a foremost basic medical science (BMS) has evolved in content and context, while remaining the most fundamental BMS subject. Stakeholders have continually made efforts especially in recent time to achieve an evolution of this subject. The primary aim of this work was to study the perceptions and experiences of Anatomists towards contributing to programme and career advancements. Following ethical approval, structured questionnaire was administered to Nigerian anatomists using a Google form. It is a total population study. The questionnaire had 13 sections, with each section addressing a theme that was integral to the subject of research interest. The last section collected free responses as qualitative information. After indicating informed consent, 106 anatomists properly completed and returned the questionnaires. Statistical and quantitative analyses of results were done. The most popular field amongst respondents was Neuroscience (60.9%);followed by Histology or Microscopic Anatomy (53.6%), Embryology or developmental anatomy (35.5%), Gross anatomy (34.5%) and Histochemistry (30.9%). About half of Nigerian anatomists involved in the study had a PhD degree. Training emphasized the cognitive domains the most. Consequently, emphasis should be laid on the psychomotor (skills) and the affective domain (attitude) to improve capacity, competences, and the job prospects of trainees. The consensus was that the programme trained students and prepared graduates as medical educators, scientists, and researchers. Anatomy has significant potential to contribute to development with proper programme design, emphasis on research, teaching and applied services competencies, effective policy formulation and implementation and adherence to best practices.
基金funding from the Korea Health Technology R&D Project, Ministry for Health, Welfare and Family Affairs, Republic of Korea (HI17C0881)。
文摘Purpose: This study investigated the anatomical and histological characteristics of the rat Eustachian tube(E-tube)and the feasibility of Eustachian tubography in a rat model.Materials and methods: Fifteen male Wistar rats were used in this study, and the bilateral E-tubes of each rat were examined. Ten E-tubes were used for anatomical studies, another ten for histological analysis, and the other ten for Eustachian tubography. Five rats were euthanized and decapitated, and ten E-tubes were dissected to describe the anatomy of the E-tube. Ten E-tube specimens obtained from five other rats were sectioned to investigate Etube histology. Eustachian tubography was performed on the bilateral E-tubes of the other five rats using the trans-tympanic approach.Results: The rat E-tubes consisted of bony and membranous parts. Cartilage and bone tissue covered only the bony part. The E-tubes’ mean diameter and overall length were 2.97 mm and 4.96 mm, respectively. The tympanic orifices’ mean diameter was 1.21 mm. The epithelium of E-tubes was mainly composed of pseudostratified ciliated and goblet cells. Eustachian tubography was successfully performed on both sides of the E-tube for each rat.The technical success rate was 100%, the average running time was 4.9 min, and no procedure-related complications occurred. On tubography images, the E-tube, tympanic cavity, and nasopharynx could be identified because of the visualization of bony landmarks.Conclusion: In this study, we described the anatomical and histological features of rat E-tubes. With the aid of these findings, E-tube angiography was successfully performed using a transtympanic approach. These results will facilitate further investigation of E-tube dysfunction.
文摘<strong>Aim:</strong> To carry out a 3D vector reconstruction of the typical cervical vertebra from anatomical sections of the “Korean Visible Human” for educational purposes. <strong>Material and Methods:</strong> The anatomical subject was a 33-year-old Korean man who died of leukemia. He was 164 cm tall and weighed 55 kg. This man donated his body to science. Her body was frozen and cut into several anatomical sections after an MRI and CT scan. These anatomical sections were made using a special saw called a 0.2 mm thick cryomacrotome. Thus 8100 cuts were obtained. Only the sections numbered 940 to 1200 were used for our study. A segmentation by manual contouring of the different parts of the typical cervical vertebra was made using the software Winsurf version 3.5 on a laptop PC running Windows 7 equipped with a Ram of 8 gigas. <strong>Results:</strong> Our 3D vector model of the typical cervical vertebra is easily manipulated using the Acrobat 3DPDF interface. Each part of the vertebra accessible in a menu can be displayed, hidden or made transparent, and 3D labels are available as well as educational menus for learning anatomy. <strong>Conclusion: </strong>This original work constitutes a remarkable educational tool for the anatomical study of the typical cervical vertebra and can also be used as a 3D atlas for simulation purposes for training in therapeutic gestures.
文摘characteristics,complex content,and it is difficult to understand.In view of the nature of the subject,many different models and specimens are required during teaching,increasing the difficulty of its teaching.Although the mode of medical teaching is constantly updating,anatomical specimens are still important in the teaching of anatomy,as they help students to understand the organs,their positions,and structural forms as well as to better grasp the theoretical aspect.In addition,anatomical specimens and medical students contact condition can affect the teaching effect.Therefore,it is imperative to give full play to the role of anatomical specimens in anatomy teaching to improve the teaching effect.This paper summarizes the research on the use of anatomical specimens in the teaching of anatomy.
文摘This present study includes twelve species that represent the Ficus genus,namely;aspera,carica,tinctoria subsp.gibbosa,hirta,hispida,neriifolia,palmata,pumila,racemosa,septica,sur,and sycomorus,belonging to the Moraceae family.The species samples were collected from various locations in Egypt.The study focused on the anatomical and molecular characteristics of mature foliage leaves.Since the identification and classification of taxa are highly dependent on the anatomical features of leaves,the anatomical characteristics were recorded in the form of a comparison between the examined plants in the data matrix.This study aims to contribute to the identification of the studied species based on the anatomical details of the matured leaves.Anatomical characterization includes the variations in upper and lower epidermal layers that are covered by a thin or thick cuticle;the number of palisade and spongy layers;crystals;secretory elements;lithocysts;the midrib zone has parenchyma associated with mechanical tissue,vascular system,and investigation of trichomes;on the other hand,in the current study,the phylogenetic analysis was conducted by using the ITS and 5.8 S sequences.From the analysis of all the available data,it could be stated that there is an overall agreement with the anatomical character dendrogram.
基金supported by the National Natural Science Foundation of China (Grant Nos. 31872050 and 32102348)。
文摘The visualization and evaluation of fruit vascular bundles in grape are indispensable for understanding the development and growth of the fruit. The vascular bundles in grape are as thin as human hair, and strongly adhere to flesh cells, making it difficult to isolate individual intact vessel elements. Currently there is little information about methods to characterize grape vascular tissue. In this study, we describe an easy and effective technique to visualize the xylem cell structure of the ‘Red Globe' grape(Vitis L.). The intact vascular bundles of the grape were isolated through enzymatic degradation of flesh cells by hydrolases which were effective in removing flesh cells from vascular bundles. This enabled the illustration of the fine surface structure of vessel elements and their arrangement in the vascular bundles of the grape. This modified method to separate the vascular bundles into individual vessel elements was more effective than former methods of manually shaking to isolate individual vessels. Clear images of xylem vessel arrangement and structural characteristics of individual vessel element were acquired by light microscopy(BX51, Olympus, Tokyo, Japan), transmission electron microscopy(Tecnai 12, Philips, Netherlands) and scanning electron microscopy(GeminiSEM 300, Carl Zeiss, Germany). In addition, the 3D structure of vessel elements was observed using confocal laser scanning microscopy(Zeiss: model: LSM-880, Oberkochen, Germany). The imaging techniques for visualizing and analyzing the structure of xylem vessels in grape described in this study are an improvement of past methods. An effective method to isolate grape vascular bundles from flesh cells was also developed, which enables the imaging of the fine surface structure of vessel elements and their arrangement in grape vascular bundles. By adjusting the process of maceration of vascular bundles, an easy and effective method was developed to gently disrupt the plant tissue and isolate individual vessel elements. These improved techniques are suitable to observe the intact morphology of vascular bundles in the grape, improve experimental efficiency and accelerate new discoveries on the anatomical structure of the grape.
文摘Roughly quadrangular, the chiasma presents many morphological variations. The optical chiasm, odd and symmetrical structure of the optical pathways, is a required passage of the axons of neurons for the visual pathways. Any modification of its morphology evokes a pathological process, generally tumoral. The quality of MRI images rivals that of anatomical slices. So the MRI is essential for the study of the chiasma. The aim of this work was to study the morphometry of the optic chiasm in patients addressed for cerebral MRI to the imaging department of the university hospital of the POINT-G, during the period from July 29, to November 30, 2016. All patients who had a normal examination of the optic chiasma, numbering 15, were included in this study. In 86.66% of cases the chiasma had a quadrilateral form. Its average length was 8.73 mm and its average width was 13 mm. The average thickness was 4.13 mm.
文摘Introduction: Helicobacter pylori (Hp) infection is the most common bacterial infection in the world. World Health Organization has classified this bacterium as a Class I carcinogen. The objective of this work is to study the epidemiological, clinical and pathological aspects of Helicobacter pylori infection among adults in a digestive endoscopy unit and the pathological anatomy service of Parakou. Patients and Methods: This was a descriptive and analytical cross-sectional study conducted from January 2020 to September 2020 in the digestive endoscopy unit and pathological anatomy service at the Departmental University Hospital Center of Borgou. Patients aged 18 years and older, who had undergone a gastroscopy with biopsies and who gave their oral consent were included. Three antral biopsies and two fundic biopsies were performed. The search for Hp was done under an optical microscope after staining with hematoxylin eosin. Results: A total of 151 patients were included and 51.66% were infected with Hp. Their average age was 40.63 ± 15.32 years and the sex ratio was 0.9. Epigastric pain was the most reported symptom (71.01%). Endoscopically, the prevalence of erythematous gastropathy was 98.72%. The study of chronic Hp gastritis according to Sydney system had shown signs of activity in 100% of patients with Hp and glandular atrophy in 83.33% of them. Intestinal metaplasia and dysplasia accounted for 24.35% and 29.48% of cases, respectively. Factors associated with Hp infection were: absence of proton pump inhibitor intake prior to examination, absence of handwashing with soap and water before eating, erythematous aspect of gastritis on gastroscopy, absence of intestinal metaplasia of the fundus, active and chronic aspects of gastritis on histology. Conclusion: The frequency of Hp infection in hospitals among adults admitted to the Digestive Endoscopy Unit of Parakou is high. To reduce this prevalence, it will be necessary to act on the factors identified.
文摘Aim: This study aimed at describing the anatomical variations of the external branch of the superior laryngeal nerve and at estimating the frequency of nerves at risk during the thyroid surgery. Methodology: We realized a forward-looking study from September, 2016 in May 31st, 2018 in the laboratory of anatomy of the Faculty of Medicine and Odontostomatology of Bamako in Mali. All the fresh anatomical subjects not carrying trauma and or a scar at the level of the previous region of the neck were held. The anatomical subjects were not included presenting a traumatic lesion and\or a scar of the previous region of the neck. Results: We realized 34 dissections of the external branch of the superior laryngeal nerve to 17 deathly subjects (11 men and 6 women with a sex-ratio of 1.8). The average age of the subjects was of 42 years (extremes: 18 and 70 years). Our study allowed highlighting in 100% of the cases, the external branch of the superior laryngeal nerve and the superior thyroid artery so to the right as to the left. On 34 dissected external branch of the superior laryngeal nerve, none had a previous route. However we found 28 nerves (82.4%) having a later route, stuck to the external face of the lower constrictor of the pharynx. These were not mixed with the superior thyroid artery and its branch of division and were situated outside the thyroid capsule. In 17.6% of the cases (6 cases), the nerve had a route mixed in the branch of the superior thyroid artery. These were found inside of the capsule (11.8% adhered to the artery and 5.8% crossed its branch of division). Conclusion: The risk of injury of the external laryngeal nerve during thyroid surgery procedure is never zero. It is more important on the left side.
基金the National Natural Science Foundation of China,No.81874201Technology Plan Project,No.20Y11908300+2 种基金Shanghai Medical Key Specialty Construction Plan,No.ZK2019A19Shanghai Municipal Commission of Health and Family Planning,No.202040122and Shanghai Pujiang Program,No.21PJD066.
文摘BACKGROUND Total mesorectal excision along the“holy plane”is the only radical surgery for rectal cancer,regardless of tumor size,localization or even tumor stage.However,according to the concept of membrane anatomy,multiple fascial spaces around the rectum could be used as the surgical plane to achieve radical resection.AIM To propose a new membrane anatomical and staging-oriented classification system for tailoring the radicality during rectal cancer surgery.METHODS A three-dimensional template of the member anatomy of the pelvis was established,and the existing anatomical nomenclatures were clarified by cadaveric dissection study and laparoscopic surgical observation.Then,we suggested a new and simple classification system for rectal cancer surgery.For simplification,the classification was based only on the lateral extent of resection.RESULTS The fascia propria of the rectum,urogenital fascia,vesicohypogastric fascia and parietal fascia lie side by side around the rectum and form three spaces(medial,middle and lateral),and blood vessels and nerves are precisely positioned in the fascia or space.Three types of radical surgery for rectal cancer are described,as are a few subtypes that consider nerve preservation.The surgical planes of the proposed radical surgeries(types A,B and C)correspond exactly to the medial,middle,and lateral spaces,respectively.CONCLUSION Three types of radical surgery can be precisely defined based on membrane anatomy,including nerve-sparing procedures.Our classification system may offer an optimal tool for tailoring rectal cancer surgery.
文摘Endoscopic retrograde cholangiopancreatography(ERCP)is the preferred modality for drainage of the obstructed biliary tree.In patients with surgically altered anatomy,ERCP using standard techniques may not be feasible.Enteroscope assisted ERCP is usually employed with variable success rate.With advent of endoscopic ultrasound(EUS),biliary drainage procedures in patients with biliary obstruction and surgically altered anatomy is safe and effective.In this narrative review,we discuss role of EUS guided biliary drainage in patients with altered anatomy and the various approaches used in patients with benign and malignant biliary obstruction.
文摘BACKGROUND The sympathetic nervous system makes medium and large peripheral arteries smaller to slow the blood flowing through them.AIM To observe brachial artery sympathetic innervation.METHODS We developed a neurophysiological autonomous test that measured the effects of peripheral sympathetic fibres on peripheral arteries.Our specific objective was to find the sympathetic innervation of the brachial artery.To accomplish this purpose,the brachial artery baseline diameter and flow rate were measured in the right arm of the patients.Afterwards,electrical stimulus was applied to the medial nerve for 5 s.Through electrical sympathetic activation,the vessel diameter and overall flow rate will decrease.After 7 d,a similar experiment was repeated using the ulnar nerve.RESULTS The differences in diameter and flow rate of the brachial artery in response to median and ulnar nerve activation were compared.In the total group,no significant difference in diameter was seen between medial and ulnar nerve stimulation(P=0.648).The difference in absolute slowdown of flow rate between median nerve stimulation and ulnar nerve stimulation was not statistically significant for the entire group(P=0.733).CONCLUSION As a target organ,the brachial artery receives an equal amount of sympathetic innervation from the median and the ulnar nerves.
文摘Henry Vandyke Carter(1831–1897),physician and illustrator from Saint George’s Hospital in London,England.He worked with Henry Williamson Gray(1827–1861)on anatomical dissections and Carter’s illustrations contributed significantly to the success of the Treaty of Anatomy,Descriptive and Surgical.Henry Carter never achieved any credit or royalty for his work.This book is currently regarded as one of the most influential human anatomy textbooks.The paper aims to present a brief review of Henry Carter’s contributions to the medical field.