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The digital anatomist foundational model: principles for defining and structuring its concept domain.

We define a foundational model as an abstraction of a body of knowledge that explicitly declares the principles and concepts necessary for coherently and consistently modelling a knowledge domain. Principles for a foundational model of anatomy are defined and used to specify the components of such a model. These components include an anatomy ontology (Ao), an anatomical structural abstraction (ASA), an anatomical transformation abstraction (ATA) and metaknowledge (Mk), which comprises the rules for representing relationships in the other three components of the model. The foundational model Fm is therefore specified as the four-tuple Fm = (Ao,ASA,ATA,Mk). We hypothesize that this abstraction captures the information that is sufficient and necessary for describing the anatomy of any physical entity that constitutes the body, as well as that of the body itself.

Anatomy↗

Anatomy during the Third Reich--the Institute of Anatomy at the University of Marburg, as an example.

A complete documentation of German anatomical science and its representatives during the period of national socialism has not been published as yet--contrary to the situation in other medical disciplines. Instead of German anatomists, American anatomists have occasionally addressed this issue during their meetings and have reported on special aspects, such as the use of Nazi symbols in anatomical textbooks and atlases (Pernkopf 1952) and the use of corpses of justice victims for anatomical research and student education. Also, the genesis of the atrocious collection of "racial" skulls, initiated along with the SS-institution of the "Ahnenerbe" by the anatomist August Hirt of Strasbourg (who ordered more than 90 inmates from concentration camps to be murdered in the gas chamber built in the concentration camp of Natzweiler-Struthof close to Strasbourg, Alsace) has been described by Frederic Kasten and others. A broader view of the patterns of behaviour and political actions and fates of contemporary scientists, ranging from dismissal to clandestine opportunism, affirmative cooperation and fanatic activism can be obtained by the analysis of the activities in research, medical education and academic positions of the following members of the Institute of Anatomy at the Philipp-University in Marburg: Ernst Göppert, Eduard Jacobshagen, Ernst-Theodor Nauck, Adolf Dabelow, Helmut Becher and Alfred Benninghoff, whose activities and fates differ in several respects and allow more general deductions. Also, the individual fates of a number of prosecuted Jewish anatomists (Wassermann, München; Poll, Hamburg), of devoted and active members of the Nazi party (Clara, Leipzig; Blotevogel, Breslau) and of criminal fanatics (Hirt, Strasbourg; Kremer, Münster) are briefly discussed. The present contribution is an attempt to initiate a more detailed study of all German departments of anatomy during the Hitler regime and to generate a public discussion among the younger generation of German anatomists.

Anatomy↗

Thoracic outlet: an anatomical redefinition that makes clinical sense.

The diagnosis of thoracic outlet syndrome (TOS) is intrinsically difficult, and the literature about it is full of confusing terminology. Symptoms may arise due to compression of neural and/or vascular elements in one or more of three different locations. A number of tests were developed during the early part of this century, and a variety of syndromes have been described that relate to these tests, all of which are now considered to be subtypes of the thoracic outlet syndrome. Yet anatomists and clinicians fail to agree on even the definition of the thoracic outlet. It is proposed that anatomists not use the term thoracic inlet as a synonym for the superior thoracic aperture, nor thoracic outlet for the inferior thoracic aperture. What many clinicians call the thoracic outlet should be called the scalene triangle by both anatomists and clinicians, divisible into a lower portion to be called the thoracic outlet (for subclavian vessels and nerve roots C.8 and T.1) and an upper portion, the cervical outlet (for nerve roots C.5, C.6, and normally C.7). What is currently called thoracic outlet syndrome should be renamed the cervicoaxillary syndrome (CAS), divisible into three subtypes: thoracic outlet, costoclavicular, and pectoralis minor syndromes. Compression of the upper roots of the brachial plexus between the anterior and middle scalene muscles should be recognized as cervical outlet syndrome, and all terms containing the word scalenus should be discarded.

Humans↗

From Ars to Scientia: the revolution of anatomic illustration.

Art and anatomy have been closely related since the Renaissance, when artists studied the human body to gain more perfect perspectives, and anatomists began illustrating their texts. As the two fields became increasingly intertwined, the distinctions between artistic drawings and scientific illustrations of the human body's form and function became increasingly blurred. Early Renaissance anatomists were more artistic than scientific with their images, but Hieronymus Fabricius ab Acquapendente (1533-1619) provided a crucial turning point in the evolution of anatomic illustration. His new and strict focus upon scientific illustration developed in the context of previous anatomists' work and theories, but his is a critical and previously untold story in the history of medicine.

Anatomy, Artistic↗

["... that progress in anatomy is most likely to occur when its problems include the study of growth and function, as well as of structure". about the anatomy and physiology of Ernst Heinrich Weber (794-1878 and Wilhelm His (1831-1904) his successor in the department of anatomy at the University of Leipzig].

The Leipzig anatomist and physiologist Ernst Heinrich Weber had introduced physiological thinking in anatomy and exact methods of mathematical physics to the study of the functioning of the body making him the founder of a physically orientated physiology. But he would not have been that excellent physiologist without being a nonetheless distinguished anatomist since he solved his physiological problems usually following function in close relation to structure. Together with his brother Wilhelm Eduard Weber (1804-1891), who later was to become a famous physicist, in their theory of waves he laid the basis for an exact analysis of the movements of fluids in elastic tubes und was the first to apply the basic laws of hydrodynamics to the circulation of the blood. In collaboration with his youngest brother Eduard Friedrich Wilhelm Weber (1806-1871), who worked as a prosector at his institute and together with Wilhelm Weber had studied the mechanics of the walking apparatus, he demonstrated the inhibiting effect of the vagus nerve on the action of the heart. Ernst Heinrich Weber's approach to consider an organ as a whole not neglecting the study of its function set him apart from most of his contemporaries and has characterized the work of the Leipzig anatomists and physiologists since his time. Among those was Wilhelm His from Basle who succeeded him in the chair of anatomy in 1872. On the basis of a systematic analysis of human embryos by means of serial sections and plastic reconstruction His completely reformed the field of embryology and was the first to present a comprehensive treatise on human embryology. The making of modern human embryology was, above all, his achievement. He did not confine himself to mere description but wanted to gain deeper insight into the causal events by developmental-mechanical conceptions. With his detection of the neuroblasts and that they give rise to an axon and later to dendrites His provided the developmental foundations for the neuron-theory.

Anatomy↗

Facts and fiction surrounding the discovery of the venous valves.

Venous valves are delicate structures, the integrity of which is crucial for the normal function of the venous system. Their abnormalities lead to widespread disorders, ranging from chronic venous insufficiency to life-threatening thromboembolic phenomena. The discovery of the venous valves, however, has been the subject of hot controversy. Even though Fabricius ab Aquapendente is credited with the discovery by most historians, we demonstrate in this paper that other anatomists described them many years before Fabricius ab Aquapendente publicly demonstrated them in Padua in 1579. A thorough review of the historical literature surrounding the discovery of the venous valves was carried out from 1545 to the present under the supervision of the Medical History Department of our institution. Research was performed at the History of Medicine Division of the National Library of Medicine and through MEDLINE access to the medical literature. The Parisian Charles Estienne first mentioned the venous valves in his 1545 publication when he described "apophyses membranarum" in the veins of the liver. Lusitanus and Canano publicly demonstrated them in the azygos vein during cadaver dissections performed in Ferrera, Italy. The Parisian Jacques Sylvius described valves in the veins of the extremities in 1555. The work of these anatomists, however, could not achieve full recognition, because Andreas Vesalius, the leading anatomist at that time, was unable to confirm their findings and strongly denied the existence of venous valves. Vesalius's influence was so powerful that research on the subject was idle until 1579, when Fabricius ab Aquapendente "discovered" the venous valves. About the same time, the German Salomon Alberti published the first drawings of a venous valve (in 1585). William Harvey, a disciple of Fabricius ab Aquapendente, finally postulated the function of the venous valves, providing anatomical support for one of the greatest discoveries in medicine: the blood circulation. Therefore, our investigations revealed that Estienne and Canano discovered the venous valves in the 1530s. Fabricius ab Aquapendente's achievement was their full recognition 64 years later. However, it was not until 1628 that their function was fully understood, with the discovery of the blood circulation by William Harvey.

Anatomy↗

Genealogy of John and Charles Bell: their relationship with the children of Charles Shaw of Ayr.

The Reverend William Bell had six children who survived infancy. Two of his sons entered the legal profession and two other sons became distinguished anatomists and surgeons--John Bell, said for 20 years to have been the leading operating surgeon in Britain and throughout the world--and Sir Charles Bell, possibly the most distinguished anatomist and physiologist of his day. Information is not known about the fifth son or their sister. Charles Shaw, a lawyer of Ayr, had four sons and two daughters who survived infancy. Two of his sons, John and Alexander, became anatomists and later surgeons at the Middlesex Hospital, and both worked closely with Charles Bell at the Great Windmill Street School of Anatomy. His third son entered the law and his fourth son became a distinguished soldier. The two daughters of Charles Shaw married into the Bell family: Barbara married George Joseph Bell and Marion married Mr (later Sir) Charles Bell.

Anatomy↗

[Jacques-Benigne Winsløw and his original research on the mobility and function of the spine].

It was not until the time of the anatomist Vesal (1514-64) that the function of the spinal facet-joints was understood. First with the effective anatomical studies of the Danish anatomist J.B. Winsløv (1669-1760) in Paris and of the German anatomist Josias Weitbrecht (17th and 18th century) in St. Petersburg, the building and function of the spinal disk were described. Texts and illustrations in the incunabels (last part of the 15th century) tells of the rather slow development of understanding of the spine's anatomy and movability. X-ray and MR scanning from the 20th century have produced far better methods for studying the normal and abnormal building and function of the spine - but Winsløw and Weitbrecht's investigations were really epoch-making.

Denmark↗

General Shrapnel and the "unfortunate" Dr. H. J. Shrapnell.

Several aspects of Shrapnell's career are still little known or erroneously typed. 1. Some historians of Medicine profess that Dr. Shrapnell was the inventor of a shell which bears his name. 2. Others neglect the negative points of Shrapnell's paper published in 1832 on the pars flaccida. To be able to comment on these different aspects of Shrapnell's life and work we compared the biographies of the anatomist and of the artillery officer. We noticed the positive and also the negative points of his paper. We conclude that: 1. Dr. Shrapnell was not an artillery officer, but the two men were present in the British Army; their surnames, their names and the period when they lived were about the same. 2. Errors in Shrapnell's paper were due to the philosophy and lack of anatomical and pathological knowledge of the time. 3. Otologists' reception was better than that of the Anatomists because for the Otologists, Shrapnell's membrane was recognized as an important original area of cholesteatoma, whereas for the Anatomists it was just a detail.

Anatomy↗

[Forbidden anatomy].

Since centuries anatomists have used any course of action in order to get hold of material for dissections, and at the same time avoid prosecution for grave robbery, at times the only way to get hold of cadavers. Stealing newly dead people from the churchyards and offering them for sale to anatomical institutions was not uncommon in the 19th century. "Resurrectionists"--as these thieves were called, as they made the dead "alive"--were seen as necessary for the teaching of anatomy in Victorian Britain. In the 1820s a scandal was revealed in Scotland, when it was discovered that some people even committed murder to make money from supplying anatomists with human cadavers. Two men, William Burke and William Hare, became particularly notorious because of their "business" with the celebrated anatomist Robert Knox in Edinburgh.

Anatomy↗

[The multinationality of the Anatomische Gesellschaft and the usage of the so-called congress languages in her meetings (author's transl)].

It is outlined the history of the Anatomische Gesellschaft - founded in 1886 by anatomists of the German-speaking area especially - with special consideration of the international colours and trends as well as the essential possibility to read the papers during the meetings not only in the German language but also in English, French, Italian, Latin and (since 1976) Russian. According the Herrlinger (1965) this history is divided in following parts: 1. from foundation to the world war I, 2. between the 2 world wars, and 3. after the world war II. Although the Anatomische Gesellschaft is resident in Germany (today in the Federal Republic of Germany and the German Democratic Republic) it never has been a German society. This important and most famous anatomists of all nations, countries and continents as well as representative scientists of other special branches interesting in morphology had been and now are members of this society. Hitherto the annual meetings of the Anatomische Gesellschaft are presided over by prominent American, Austrian, Dutch, French, German, Hungarian, Italian, Swedish and Swiss anatomists.

Anatomy↗

[Clinical anatomy in surgical education and graduate education].

On the basis of the experience that knowledge of anatomy is not as sound in clinical education as it should be and with a view to the new licensing regulations for physicians, at the Westfälische Wilhelms-Universität Münster, Germany, we established an interdisciplinary anatomical education. Clinical practitioners from 14 different specialties together with anatomists give lessons in applied anatomy accompanying the dissection course, and clinical experienced anatomists guide senior medical students in parallel to the practical courses to refresh their anatomical knowledge. Conjointly clinical practitioners and anatomists initiate, organize and establish meetings in postgraduate surgical education and experimental surgery. All seminars are evaluated and have a very good compliance.

Anatomy↗

[Valsalva: much more than a simple maneuver. Antonio Maria Valsalva (1666-1723)].

Valsalva is a term commonly used to designate a special maneuver, consisting in a forced expiratory effort against a closed airway. We use Valsalva's maneuver many times in our clinical practice and we usually do not think about its origin. Most people do not know that this was originally described by an outstanding anatomist, surgeon and pathologist, Antonio Maria Valsalva, the mentor of another great anatomist, Giovanni Battista Morgagni. Valsalva's contribution was vast and description of Valsalva's maneuver was only a small fraction of the legacy that he left us, almost three hundreds years ago. We render a tribute to a great man, and learn about his life and work.

Anatomy↗

The human communicating nerve. An extension of the external superior laryngeal nerve that innervates the vocal cord.

OBJECTIVE: A second source of motor innervation for the thyroarytenoid (TA) muscle, other than the recurrent laryngeal nerve, has been suggested by clinical and experimental observations. Early anatomists noted what appeared to be small nerves connecting the cricothyroid and TA muscles; however, these observations were disputed by later anatomists and subsequently forgotten. METHOD: In this study, we processed 27 human hemilarynges with Sihler's stain, a technique that clears soft tissue and counterstains nerve. In addition, four communicating nerves (CNs) were frozen sectioned and stained for acetylcholinesterase, a marker for motor neurons. RESULTS: In 12 (44%) of the 27 specimens, a neural connection was found that exited the medial surface of the cricothyroid muscle and then entered into the lateral surface of the TA muscle. In general, this CN was composed of two parts: an intramuscular branch usually combined with the recurrent laryngeal nerve or terminated within the TA muscle directly and an extramuscular branch that passed through the TA muscle and terminated in the subglottic mucosa and around the cricoarytenoid joint. All four CNs tested positive for acetylcholinesterase. Specifically, the CNs contained an average of 2510 myelinated axons, of which 785 (31%) were motor neurons. CONCLUSION: The results suggest that when the CN is present, it supplies a second source of motor innervation to the TA muscle and extensive sensory innervation to the subglottic area and cricoarytenoid joint. In addition, the CN may be the nerve of the fifth branchial arch, a structure that has never been identified (to our knowledge).

Acetylcholinesterase↗

A review and meta-analysis of formaldehyde exposure and pancreatic cancer.

BACKGROUND: Most reviews on the carcinogenicity of formaldehyde have focused on cancers of the respiratory tract. Two recent studies have suggested that exposure to formaldehyde may increase the risk for pancreatic cancer. METHODS: We examine 14 epidemiology studies of workers exposed to formaldehyde where pancreatic cancer rates were reported and use meta-analytic techniques to summarize the findings. We also rank formaldehyde exposures for the industries in these studies. RESULTS: We found a small increase of pancreatic cancer risk in the studies overall (meta Relative Risk [mRR] 1.1, 95%CI 1.0-1.3); however, this increased risk was limited to embalmers (mRR 1.3, 95%CI 1.0-1.6) and pathologists and anatomists (mRR 1.3, 95%CI 1.0-1.7). There was no increased risk among industrial workers (mRR 0.9, 95%CI 0.8-1.1) who on average had the highest formaldehyde exposures. CONCLUSIONS: A small increased risk of pancreatic cancer from formaldehyde exposure cannot be ruled out from the studies examined. However, the null findings among industrial workers and the lack of biological plausibility would argue against formaldehyde as a cause. The increased risk of pancreatic cancer among embalmers, pathologists, and anatomists may be due to a diagnostic bias or to occupational exposures other than formaldehyde in these professions.

Formaldehyde↗