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Origin of corpses received by the anatomical institute at the University of Jena during the Nazi regime.

During the Nazi regime (1933-1945), the anatomical institute at the University of Jena received 2,224 corpses, of which approximately 200 originated from executions. The available data clearly suggest that a large portion of these 200 executed persons must be considered victims of Nazi crimes. Approximately an equal number of bodies were delivered from state nursing homes and mental institutions in the state of Thuringia during the same time period. The available data suggest that it is highly likely that many of them were victims of decentralized "euthanasia" programs. The remains of many prisoners of nearby labor camps, mostly from Eastern Europe, are listed in the body register at the institute as well. A group of anatomists and historians has investigated the institute's association with Nazi crimes. Apart from documenting the association, the aim of the investigation is to clarify the whereabouts of the corpses. In particular, it must be ascertained that none of the specimens publicly displayed in the anatomical collection of the Friedrich Schiller University originated in the context of Nazi crimes.

Academies and Institutes↗

Sculpting the cardiac outflow tract.

The cardiac outflow tract is the site of anomalies that affect a substantial proportion of individuals with congenital heart defects. The morphogenesis of this site is complex, and requires coordinated development of many cell types and tissues. It is therefore not surprising that developmental mistakes arise here, and that the steps and mechanisms of morphogenesis are still controversial and poorly understood, despite advances in molecular techniques. Recent findings have provided new insight into mechanisms of outflow tract morphogenesis, including clarification of its origins and the fate of cardiomyocytes, as well as invading cell populations. Application of new and old techniques and a wide range of approaches to tackle the unanswered questions about the outflow tract calls for collaboration among investigators from different disciplines including anatomists, physiologists, and molecular biologists.

Animals↗

[Photography as a resource of microscopic research? Joseph von Gerlach (1820-1896) and the early anatomical microphotographers].

The Erlangen anatomist Joseph von Gerlach was one of the first medical researchers who used microphotography for their scientific aims in basic tissue research. Already in 1863, Gerlach published a famous handbook on the methodology of the microphotographic technique, entitled Die Photographie als Hülfsmittel mikroskopischer Forschung. Here, he discussed the technological, practical and epistemological standards and constraints of the newly introduced visualisation technique of scientific photography. The efforts and setbacks of Gerlachs' innovative approaches shall be characterised in the present paper. Furthermore, some of the most important arguments put forward by some of his peers are closely compared and thoroughly scrutinised. These anatomical and biological microscopists objected frequently to Gerlach's photographic approach as being "unscientific" or "insufficient" to support the growth of experimental morphology and neurohistological research. In his scientific self-defence, Gerlach developed important auxiliary arguments that display many facets of the epistemological discourse of 19th-century medical research, particularly on the question of how scientific objects should be visualised and identified in the experimental laboratory.

Germany↗

Re-inventing anatomy: the impact of plastination on how we see the human body.

Over the past 20 years the development of plastination has opened up new vistas for gross anatomy. In particular, it has led to a major expansion in the range of human anatomic specimens available for teaching and its potential value in research is increasingly being appreciated. More recently, it has burst into the public arena through what has become known as 'Anatomy Art,' as depicted in the von Hagens exhibition, Körperwelten (Bodyworlds). In this exhibition, the lifeless cadavers of the dissecting room have been transformed into standing, sitting, and jumping lifelike plastinated 'models' that demonstrate spinal cords, tumorous lungs, cirrhotic livers, joint prostheses, and sagittally sectioned whole bodies. Not surprisingly, the exhibition has raised considerable ethical debate about treating human cadavers in this way, an issue of particular relevance to anatomists. This article is an attempt to further this debate by considering the nature of plastinated human specimens, and the context within which they should be examined. The only rationale for displaying (plastinated) human material in the public domain is an educational one, with a basis in a museum ethos. The boundaries of this educational rationale are discussed, as are the opportunities and challenges presented by plastination to the anatomical community.

Anatomy, Artistic↗

Thoracoscopy: a new era for surgical anatomy.

In this new era of minimal access surgery, advances in optics and illumination have established thoracoscopic sympathectomy as a pre-eminent procedure, including a safe and efficient technique for upper limb sympathectomy. The success of thoracoscopy will doubtless ensure that a greater number of these procedures will be carried out and will put some of the daunting technical challenges posed by traditional open surgical procedures to rest. The thoracoscopic era affords the surgical anatomist a new challenge: to move the teaching of living anatomy to a higher level.

Anatomy↗

Fossa navicularis: anatomic variation at the skull base.

The fossa navicularis is a relatively rare anatomic variation of the skull base. Awareness of its existence will avoid misinterpretations of radiological images and unnecessary investigations. This study describes the appearance of the fossa navicularis, and investigates its incidence and whether it is related to pathology at the basiocciput. We studied 492 dry human skulls and 525 computer tomography (CT) images of patients. Dry skulls showing a fossa navicularis were investigated by CT scan, whereas patients identified as having a fossa navicularis were further examined with magnetic resonance imaging (MRI). To document the position of the fossa more precisely, measurements were made between the fossa navicularis and certain anatomic landmarks such as the foramen ovale, the pharyngeal tubercle, the posterior border of the vomer, the foramen lacerum, the carotid canal, and the occipital condyle. Upon examination, 26 of 492 skulls (5.3%) were found to have a fossa navicularis. Twelve were <2 mm in depth and the other 14 had a depth of >/=2 mm. Of the 525 patients, 16 (3.0%) were identified as having a fossa navicularis in CT images. Evaluation of MRIs showed no soft tissue lesions in any of these patients. Comprehensive anatomic details of the fossa navicularis have not been reported in the literature. The results of this study may be useful to radiologists, anatomists, and surgeons interested in the skull base.

Bone Cysts↗

Effects of an alternate dissection schedule on gross anatomy laboratory practical performance.

The current medical curricula reform that is taking place in many medical schools throughout the world has resulted in less time for gross anatomy laboratory instruction. In response, anatomists are using a variety of approaches (e.g., peer teaching, prosections, plastinated anatomical models, etc.) to adapt to these changes. To accommodate recent curricular reform at the University of Health Sciences College of Osteopathic Medicine, an alternating dissection schedule was implemented. The purpose of this study is to examine the effects of the alternating schedule on gross anatomy laboratory practical performance. Using a Mann-Whitney Rank Sum test, back and upper limb (back-upper limb), and lower extremity laboratory practical performance for students who dissected in every laboratory (EL group; n = 227) is compared to students who dissected in every other laboratory (EOL group; n = 254). For the back-upper limb part of the anatomy laboratory practical, the mean percentage scores for the EL and EOL groups were 74.5% and 68.1%, respectively (P < 0.001). The mean percentage scores for the EL and EOL groups on the lower limb portion of the anatomy lab practical were 75.9% and 75.6%, respectively (P = 0.994). These data suggest that the use of an alternating dissection schedule had an equivocal effect on the students' gross anatomy laboratory practical performance for these two sections. The reasons for these conflicting results may have been related to regional complexity or volume of information, and the sequence in which the regions were taught.

Anatomy↗

Cricothyroidotomy: a clinical anatomy review.

The safe and successful performance of a cricothyroidotomy demands a working and yet specific knowledge of anatomy. An ignorance or misunderstanding of anatomy may result in failure or complications. The Educational Affairs Committee of the American Association of Clinical Anatomists has highlighted the importance of clinical anatomy for several invasive procedures. This review is building on their work and contribute further to the understanding of the anatomical framework, particularly the pitfalls and complications related to performing a cricothyroidotomy.

Cricoid Cartilage↗

Median (third) occipital condyle.

Abnormalities of the craniovertebral junction, most of which are associated with the occipital bone, are of interest not only to anatomists but also to clinicians because many of these deformities produce clinical symptoms. The occipital bone in humans is formed by the fusion of the sclerotomes corresponding to the roots of the hypoglossal nerve. In lower vertebrates, the cranial half of the first cervical sclerotome forms a separate bone between the atlas and occipital bone, the proatlas; in man it may contribute to anomalous structures around the foramen magnum. One such structure, a median occipital condyle, which exhibited an articular facet for the odontoid process, was observed in an adult male skull at the anterior margin of the foramen magnum. This anomaly is discussed in light of available literature.

Adult↗

Cystic duct and Heister's "valves".

The anatomy and physiology of the cystic duct have been relatively neglected by anatomists and the function of the spiral mucosal folds or "valves" of Heister, first described in 1732, remains obscure. The gross and microscopic anatomy of the cystic duct is reviewed together with results from laboratory investigations into the function of the cystic duct and its spirally arranged folds. The duct and spiral folds contain muscle fibers responsive to pharmacologic, hormonal, and neural stimuli. There is, however, no convincing evidence of a discrete muscular sphincter within the duct. Although the cystic duct is unlikely to play a major role in gallbladder filling and emptying, it appears to function as more than a passive conduit. Coordinated, graded muscular activity in the cystic duct in response to hormonal and neural stimuli may facilitate gallbladder emptying. The principal function of the internal spiral folds that are found in man and other animals may be to preserve patency of this narrow, tortuous tube rather than to regulate bile flow.

Animals↗

Artificial deformation of the human skull: a review.

Early examples of intentional human cranial deformation predate written history. Intentional cranial deformation as an extreme has seemingly not persisted into this century. However, mild forms of this manipulation are still practiced by various groups worldwide. Accidental cranial deformation or mild forms of intentional cranial deformation may be encountered by the clinician or anatomist. We review the literature regarding intentional manipulation of the human cranium.

History, 19th Century↗

Does the mendosal suture exist in the adult?

There is a paucity of information in the literature regarding the mendosal suture. Furthermore, reports of the closure of this presumed suture of childhood are variable. This study seeks to establish the presence or absence of this structure in the adult. Fifty adult skulls were evaluated for the presence or absence of the mendosal suture. Sixteen percent of specimens were found to have a mendosal suture. Six specimens were found to have these sutures bilaterally, and two had sutures on the right side only. Most sutures were linear in nature. The mendosal suture approximated the superior nuchal line in all specimens and more or less traveled medial and perpendicular to the lambdoidal suture. The length of these sutures ranged from 0.8 to 1.4 cm (1.1 cm). Our hopes are that these data will prove useful to both the anatomist and clinicians, so that, when present, misinterpretation of the mendosal suture will be avoided.

Adult↗

Mondino de' Liuzzi and his Anothomia: a milestone in the development of modern anatomy.

Mondino's Anothomia was written in Bologna around 1316. This book is the intellectual legacy of one of the fathers of human anatomy, and probably represents a collection of lessons given by the author at the Studium in Bologna. Mondino's Anothomia witnesses a profound renewal of the mode of understanding and teaching human anatomy through direct observation of dissected corpses. This book enjoyed an extraordinarily large dissemination in the whole of Europe, thanks to many extant manuscripts and printed editions. In this article, we present some selected passages from this remarkable book to let today's anatomists know how great was the descriptive skill of this medieval scientist, a pioneer in the anatomical discipline.

Anatomy↗

Patient confidentiality: implications for teaching in undergraduate medical education.

Respect for patient confidentiality is one of the core concepts of professionalism and should have high priority in medical education. Confidentiality should be introduced early in the curriculum so that students understand their ethical, professional, and legal obligations throughout their medical studies and later professional career. Anatomists have important opportunities for teaching professional values including confidentiality and should be major contributors to a multidisciplinary teaching on professionalism. Students should make a formal commitment to and be assessed on patient confidentiality in the context of professionalism. A Faculty development program on confidentiality and data protection will inform and support teachers in delivering these objectives. It is recommended that medical schools have a policy on patient confidentiality and a disciplinary procedure for the management of students who breach patient confidentiality.

Clinical Competence↗

Wilhelm Erb and Erb's point.

Wilhelm Erb is well known for his early contributions to the field of neurology and was an eminent physician of his time. One area described by him and that still bears his name is Erb's point. This point located just superior to the clavicle was used by Erb to transcutaneously elicit contractions of various proximal arm muscles with electrical stimulation. Many have mistakenly interchanged the terms "Erb's point" and "nerve point" when describing the point of emergence of the cutaneous branches of the cervical plexus near the posterior border of the sternocleidomastoid muscle. We present a brief history of Erb's adult life and review his original description of his supraclavicular point and contrast this to the so called nerve point of the posterior cervical triangle. Clinicians and anatomists should be aware of the discrepancy often found in the literature between these two terms.

Anatomy↗

Cadaveric findings of persistent fetal trigeminal arteries.

Persistence of fetal intracranial arteries is rare. We review this anatomical literature regarding the persistence of the trigeminal artery and discuss the findings in two cadaveric cases both found to harbor this vessel. This anomaly should be considered by the clinician and anatomist who view imaging of the skull base. Additionally, the relationships between such an artery and other structures within the cavernous sinus should be understood by the neurosurgeon who operates in this region, e.g., transsphenoidal approaches to the skull base.

Aged↗

Perception of medical students towards the clinical relevance of anatomy.

Recent developments worldwide in medical curricula have often led to major cuts in the teaching of human anatomy. Indeed, it is perceived by some that gross (topographical) anatomy has an exaggerated importance in the initial training of doctors. The value of anatomy consequently has frequently been considerably diminished within medical curricula that have reduced factual content. To date, however, there have been no objective studies into the perceived relevance of anatomy to clinical medicine that have aimed to quantify the attitudes of medical students. On the basis of responses to an attitude analysis questionnaire devised according to the precepts of Thurstone and Chave (The Measurement of Attitude: A Psychophysical Method and Some Experiments with a Scale for Measuring Attitude Toward the Church. Chicago, IL: University of Chicago Press, 1951), we investigated the perception of medical students at Cardiff and Paris towards the importance of gross anatomy to clinical medicine. This was undertaken during the early stages of their studies (when they were newly-admitted to university and were about to commence anatomy courses), immediately after finishing their anatomy courses, and later in the final year of medical studies. The results suggest that, even where there might be geopolitical and cultural backgrounds, students at all stages of their medical course share with professional anatomists the view that anatomy is a very important subject for their clinical studies. Thus, contrary to the unquantified beliefs of those who are sceptical about the purpose and value of anatomy in an undergraduate medical curriculum, the students themselves do not appear to share such beliefs.

Anatomy↗

Accessory abducens nucleus and its relationship to the accessory facial and posterior trigeminal nuclei in cat.

Retrograde transport of HRP by the abducens nerve results in the labelling of its principal nucleus and, in addition, a second nucleus about 2.5 mm ventrolateral to the principal nucleus. The presence of this second or accessory nucleus of the abducens in a mammal confirms the observations of several Nineteenth Century anatomists and rebuts the conclusions of more recent investigators who argued that the nucleus was allied instead to the facial or trigeminal nerves. The same HRP technique applied to the facial or trigeminal nerves shows that the accessory nucleus of the abducens is in the same parasagittal plane as the accessory nucleus of the facial nerve and the most caudal cells of the motor trigeminal nucleus. The accessory abducens and accessory facial nuclei fall in a ventrocaudal to dorsorostral line between the principal nucleus of the facial and the motor nucleus of the trigeminal with the accessory abducens just caudal and ventral to the accessory facial.

Abducens Nerve↗