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PubMed2004

Immunocytochemical and stereological studies of the rat vestibular nucleus: optimal research methods using glucocorticoid receptors as an example.

Many anatomists agree that stereological procedures for counting neurons are superior to simple density measurements because the latter are biased by the way that sections are sampled and the likelihood of selectively sampling neurons of particular sizes and orientations. Despite this, few stereological studies of the vestibular nucleus complex (VNC) have been conducted and all of the published immunocytochemical studies have used densitometry to quantify receptor numbers. One possible reason for this is the difficulty of combining stereological methods with immunocytochemical techniques required to label specific types of receptors. In this paper we detail the optimal methods for combining stereological and immunocytochemical techniques for the unbiased quantification of neuronal number, using glucocorticoid receptors as an example. We report that the cryofixation method is more effective than perfusion with paraformaldehyde, in order to obtain sections to estimate neuronal number using the Cavalieri and physical disector methods. Thionin proved to be the optimal counterstain for identifying both neurons and the boundaries of the VNC. The combination of stereological and immunocytochemical techniques offers an effective means to ensure accurate estimates of the number of neurons expressing a receptor.

Animals↗

PubMedDate not supplied

[Anatomy of crucifixion].

Crucifixion was developed and abolished during the roman empire. The historical and pagan works are rare, and the story of Christianity gave us the firsts elements of knowledge of this punishment. Crucifixion of the upper limbs was represented a lot of time, because the importance of this theme in the art. The anatomical work of the artists was then widely used, but it is only during the twentieth century that anatomists and surgeons studied with precision the fixation of the upper limbs on the cross. Lastly the modem imagery with computerised reconstruction allowed a direct vision of the nail in the different structures of the wrist.

Art↗

PubMed2006

Eccles' perspective of the forebrain, its role in skilled movements, and the mind-brain problem.

Sir John Eccles' experimental life evolved from the "bottom" up: the synapse to the modular circuitry of the spinal cord, later the cerebellum and, less extensively, also the thalamus and hippocampus. He experimented quantitatively on basic properties of cell membranes, synapses, transmitters, cellular modules, reflexes, and plasticity. In parallel, he was also motivated to consider philosophical problems of mind-brain interactions. It was mostly during Eccles' "Swiss period" (1976-1997) that new experimental work advanced understanding of intentional motor actions and their preparation. For example, early brain imaging work suggested that the so-called "supplementary" motor area was rather a "supramotor" area, concerned with intentional preparation to move. Eccles also closely followed work on cortico-cerebellar integration and learning. His final contribution, in collaboration with the quantum physicist, Friedrich Beck, was a model of how specific neuronal modules interact with the mind. Being a declared dualist, Eccles encountered considerable resistance and skepticism among neuroscientists in accepting his experimentally untestable mind-brain theories. But one can only admire the remarkable continuity of effort in his search for modular operations of identified neurons in the central nervous system and their synaptic actions. This effort was facilitated by collaboration with the eminent anatomist, János Szentágothai, who had previously helped Eccles advance understanding of spinal and cerebellar circuitry. This review also includes some personal views on current understanding of the forebrain, with an emphasis on the multiplicity of cortical modules, all of which contribute in the mental preparation for forthcoming intentional actions.

Animals↗

PubMed1994

Instruction in surgical anatomy for gynecology residents using prosected human cadavers.

Prosected human cadavers were used by a team of anatomists and gynecologic surgeons to teach surgical anatomy to gynecology residents. The course was offered at the start of each 8-week gynecologic surgery rotation. Hemisections and other similar prosections were used to demonstrate anatomic relationships and surgical procedures from vantage points unobtainable at the operating table. The initial response from the faculty and residents was encouraging. The residents believed the program to be beneficial and were satisfied with it. Both the anatomy faculty and the gynecology faculty found new insights into teaching issues during the interdisciplinary process of course preparation and teaching.

Anatomy↗

PubMed1997

The conquest of Addison's disease.

BACKGROUND: A review of the understanding and treatment of adrenal insufficiency was undertaken to emphasize common themes in the history of endocrine disorders. METHODS: Literature survey. RESULTS: The presence of the adrenal glands, initially ignored by anatomists, was first described by Eustachius and later confirmed by Casserius. Bartholin identified the glands as ductless. In 1855, Thomas Addison described the clinical syndrome of adrenal insufficiency. Medullary hormonal effects were described by Oliver and Shäfer in 1895; epinephrine was isolated by Takamini, and the secretory patterns were characterized by Cannon. Cortical function was elucidated by Biedl and Stewart and Rogoff, and the first cortical hormones were synthesized by Reichenstein. Hormonal replacement therapy paved the way for the first bilateral adrenalectomy, which was performed in 1950. CONCLUSIONS: This review underscores the historical themes in endocrine diseases: discovery of the glands, identification of their hormonal products, use of the hormones for therapy, and biosynthesis for pharmacologic applications.

Addison Disease↗

PubMed2001

[Eugene Koebèrlé (1828-1915), founder of modern surgery].

Eugène Koeberlé, surgeon and anatomist gained international renown due to his outstanding ability in resection of ovary cysts and in hysterectomy. He was one of the first to perform these operations successfully. He was a pioneer in asepsis and pre- and postoperative care. He also invented many surgical instruments, among them an efficient hemostatic forceps.

Female↗

PubMed2001

[Paul Broca: 1824-1880].

Paul Broca was very gifted: a hospital surgeon and professor of surgery by the age of 29, anatomist, neurologist, anthropologist, he was interested in medicine as a whole. He remains famous for describing the first brain localisation.

Anthropology↗

PubMed1997

The women of Salerno: contribution to the origins of surgery from medieval Italy.

Medicine in medieval Europe benefited from Greek, Arabic, Hebrew, and Latin influences. Because of geographic and other favorable conditions, many of these cultural contributions synergized to form the Medical School at Salerno around 900 AD. Somewhat uncharacteristically, women physicians played a part in the advances that came from this school. Among the contributions associated with the School of Salerno were (1) textbooks of anatomy, obtained mainly from porcine dissections, (2) insistence on certification and training for physicians, (3) application of investigative thinking and deduction that led to important advances such as the use of healing by secondary intention, (4) the first textbook about women's medicine, and (5) the first recorded female medical school faculty member named Trotula de Ruggiero or Trocta Salernitana. The women physicians of Salerno contributed to a textbook that gained wide acceptance and distribution throughout Europe. The textbook, called De Passionibus Mulierium, was first published about 1100 AD and was a prominent text until a significant revision by Ambrose Paré's assistant in the early 1600s. Paré was the preeminent anatomist of his time, and many of his important anatomic and surgical considerations were directly and indirectly derived from the work of the women of Salerno. The advances first recorded, taught, and implemented by the women of Salerno are an interesting and important part of our surgical heritage.

Anatomy↗

PubMed2000

Congenital Heart Surgery Nomenclature and Database Project: single ventricle.

The extant nomenclature for single ventricle (SV) hearts is reviewed for the purpose of establishing a unified reporting system. The subject was debated and reviewed by members of the STS-Congenital Heart Surgery Database Committee and representatives from the European Association for Cardiothoracic Surgery. Efforts were made to include all relevant nomenclature categories using synonyms where appropriate. Although many issues regarding single ventricle or univentricular hearts remain unresolved among anatomists and pathologists, a classification is proposed that is relevant to surgical therapy. A comprehensive database set is presented, which is based on a hierarchical scheme. Data are entered at various levels of complexity and detail, which can be determined by the clinician. These data can lay the foundation for comprehensive risk stratification analyses. A minimum data set is also presented that will allow for data sharing and would lend itself to basic interpretation of trends. Outcome tables relating diagnoses, procedures, and various risk factors are presented.

Databases, Factual↗

PubMed2003

The accuracy of needle placement in lower-limb muscles: a blinded study.

OBJECTIVE: To assess the accuracy of common anatomic guides for electromyographic needle placement in muscles. DESIGN: Blinded study. The dissector identified different needle placements by a random number attached to a wire in the insertion site. SETTING: A university anatomy laboratory. CADAVERS: Ten cadaver lower limbs. INTERVENTIONS: By using techniques published in texts by Gieringer and Delagi and Perotto, clinical electromyographers palpated and measured appropriate locations for needle placement. A thin wire was inserted through the needle into 36 different muscles in 10 cadavers, resulting in 263 targeted muscles. An anatomist blinded to intended location dissected and recorded muscles and other tissues that the wire pierced or passed near. MAIN OUTCOME MEASURES: Targeted muscle penetration, final resting place of the wire tip, and proximity to vital structures. RESULTS: Fifty-seven percent of insertions penetrated the intended muscle. The wire tip was in the intended muscle 45% of the time. Seventeen percent of insertions penetrated or passed within 5mm of an important structure, including nerve (9.1%), tendon (3.0%), named artery (2.7%), vein (2.7%), or joint (0.8%). Specific muscle accuracy was highly variable, from 0% for 12 tries in various deep hip muscles to 100% of 10 tries in the vastus medialis. CONCLUSION: The accuracy of blind needle placement varied according to muscle. With the blind insertion technique, more accurate and safe needle placement strategies can be developed.

Cadaver↗

PubMed1980

Renal cancer invading the inferior vena cava: clinical review and anatomical approach.

Renal cell carcinoma invades the inferior vena cava in approximately 5 per cent of the patients. The only effective therapy for intravascular renal cell carcinoma is radical nephrectomy and complete removal of the tumor thrombus. To formulate a reasonable operative approach to intracaval renal cell carcinoma we have reviewed our experience with 6 cases as well as the experience of other investigators. In addition, we studied the collateral circulation of the renal veins as described by various anatomists, and to this information we have added our experience with inferior venacavography and with intraoperative and autopsy dissections. Herein we describe a new preoperative staging system for intravascular renal cell carcinoma. The operative approach to each stage is discussed in detail beneficial intraoperative maneuvers are described and illustrated.

Adenocarcinoma↗

PubMed1999

Laparoscopically assisted abdominal aortic aneurysm repair.

Since the first description of abdominal aortic aneurysms by sixteenth-century anatomist Vesalius, the history of this disease has reflected the remarkable progress of vascular surgery. From initial attempts of ligation and sclerosis to the recent advances of endovascular and laparoscopic repair, present-day vascular surgeons are supplied with a technically evolving choice of therapeutics. None of these procedures is mutually exclusive; currently, great interest lies in the use of laparoscopy to provide extraluminal control at the neck of aneurysms, to work with endoluminal grafts, and to control collateral vessel endoleaks. Laparoscopic vascular surgery must not be introduced into the clinical arena based only on the assumption that it is feasible. Clearly, it is a technically challenging procedure with a steep learning curve that requires specialized instrumentation and sophisticated laparoscopic suturing capability; however, with continued investigation, including prospective randomized trials, laparoscopic treatment of aortic aneurysms may become a standard option for high-risk patients.

Animals↗

PubMed2000

Transversalis fascia rediscovered.

The transversalis fascia is a layer in the make-up of the posterior inguinal wall. It is the deepest, thinnest, and least important layer in terms of the prevention of herniation. It is a segment of the wider endoabdominal fascia. The true posterior wall of the inguinal canal is formed, in varying degrees, by the muscles or aponeuroses of the internal oblique and transversus abdominis. Plainly, Daedalus was not needed to show surgeons and anatomists how to make a labyrinth out of a rabbit hole!

Animals↗

PubMedDate not supplied

Early descriptions of Horner's muscle and the lacrimal pump.

Horner's muscle (musculus orbicularis oculi pars lacrimalis or tensor tarsi) was first discovered by the French anatomist and surgeon, Jacques-François-Marie Duverney. In 1730 his student, Johann Caspar Schobinger, gave priority to Duverney and postulated muscular aid in an active drainage of tears. In 1745 Duverney first published his own anatomic description and the first illustration of this muscle. Credit for J.-F.-M. Duverney's discovery has often been erroneously given to his older brother, Joseph-Guichard Duverney. Subsequent anatomic descriptions by Johann Rosenmüller, William Horner, and others also included hypotheses about the physiology of a lacrimal pump. More recent theories about a lacrimal pump, such as those of Adler, Jones, Doane, and others, have their origins in these earlier writings.

England↗

PubMedDate not supplied

Witelo--Polish vision scientist of the middle ages: father of physiological optics.

Unknown to the Western hemisphere, a Polish scientist, naturalist, anatomist, physiologist, philosopher and optician, Witelo, wrote an important ten volume manuscript, Peri-Optikes, usually cited in the literature as Perspectiva. This classic textbook was first published in 1535 in Nuremberg under the title: Vitellionis mathematici doctissimi ... vulgo Perspectivam vocant libri X, which is translated to English as Perspectiva. It was a vital source of information for such scientists as Leonardo da Vinci, Keppler and others in the next few centuries. Although many of his ideas were similar to Alhazan's, who earlier had written a significant optical manuscript De aspectibus, Witelo developed his own interpretation of many optical issues. He was one of the first scientists to discover spherical aberration of concave lenses and concave mirrors. He was also first to point out "that deflection of the light ray increases with the angle in which they approach two different optical substances and each increase is smaller than the previous one." Until recently, Witelo's achievements and contributions to the understanding of optical and anatomical aspects of the eye and visual function have remained unknown in western literature. Undoubtedly, Witelo should be recognized as the father of physiological optics.

History, Medieval↗

PubMed1990

Neurons, numbers and the hippocampal network.

Anatomists involved with studies of the hippocampal formation are being prodded by computational modelers and physiologists who demand detailed and quantitative information concerning hippocampal neurons and circuits. The beautiful camera lucida drawings of old, and the elegant descriptions of dendritic form that accompanied them are giving way to computer-reconstructed and three-dimensionally analyzed cells with rigorous determination of dendritic lengths and volumes, branching pattern and spine distribution. We will review certain quantitative aspects of hippocampal organization in the rat based on a survey of available literature and on our own intracellular labeling studies of granule cells of the dentate gyrus and pyramidal cells of the hippocampus. Some of the potential implications of these data for hippocampal information processing will be discussed.

Animals↗

PubMed2001

Todd, Hughlings Jackson, and the electrical basis of epilepsy.

John Hughlings Jackson is widely credited with the first electrical theory of epilepsy (1873), which was confirmed by the experimental studies of Hitzig and Ferrier. His views are summarised in his famous Lumleian lectures to the Royal College of Physicians in 1890. Robert Bentley Todd, however, had earlier developed an electrical theory of epilepsy, which he presented in his own brilliant Lumleian lectures to the Royal College of Physicians in 1849. Todd was influenced by the electrical discoveries of his contemporary, Michael Faraday, and thought of the brain as having battery like properties that led to the sudden discharge of electrical energy (nervous force) in epilepsy. Unlike Hughlings Jackson, Todd was an anatomist and physiologist as well as a physician, and he did his own electrical experiments in rabbits to prove his theory, something Hughlings Jackson, who relied on Ferrier for scientific and experimental support, could never have done. There is no mention of Todd's Lumleian lectures in Hughlings Jackson's later lectures and writings, nor in those of Hitzig or Ferrier. Todd's remarkable observations and lectures, and his electrical theory of epilepsy deserve to be drawn to the attention of the medical and scientific community.

Animals↗

PubMed2000

Problem-based anatomy for surgical residents.

Graduating medical students who enter surgery residencies frequently have limited anatomic experiences during their undergraduate training. Throughout the 5 years of surgical training residents are exposed to the anatomy as it relates to the operative procedures performed. Frequently, however, many of the complex anatomic areas of the body escape the experience of a surgery resident in training. The American Board of Surgery requires that surgeons have comprehensive experience with problems located in the head and neck, chest, abdomen, pelvis, and extremities. In an effort to provide an experience in the critical anatomic areas, the Michigan State University (MSU) Integrated General Surgery Residency developed a problem-based anatomy course that focuses on some of the most difficult anatomic areas in which surgeons are expected to provide lifesaving procedures.A program was developed that would present a series of clinical scenarios focusing on critical anatomic approaches and related structures in the head and neck, thorax, abdomen, pelvis, perineum, upper extremity, and lower extremity. The program involved 61 individual clinical scenarios, each requiring specific dissections. The course is directed by a surgeon and anatomist, with the discussion focused entirely on surgical approaches, related anatomic structures, and the options of therapy. The course has been taught for 4 years with great success. The program is now being extended to all affiliated general surgery residencies in the MSU system.A problem-based anatomy course has been developed that addresses many of the complex anatomic areas in which surgeons are expected to provide safe operative intervention. A problem-based approach has provided opportunities for surgical residents to consider operative approaches necessary to perform procedures in a safe, competent manner. The success of this approach would lend credence to expanding its utility to other specialties and even medical student training. (Curr Surg 57:377-380. Copyright 2000 by the Association of Program Directors in Surgery.)

Journal Article↗