Morphology of the groove of the inferior petrosal sinus: application to better understanding variations and surgery of the skull base.

Although adequate venous drainage from the cranium is imperative for maintaining normal intracranial pressure, the bony anatomy surrounding the inferior petrosal sinus and the potential for a compressive canal or tunnel has, to our knowledge, not been previously investigated. One hundred adult human skulls (200 sides) were observed and documented for the presence or absence of an inferior petrosal groove or canal. Measurements were made and a classification developed to help better understand their anatomy and discuss it in future reports. We identified an inferior petrosal sinus groove (IPSG) in the majority of specimens. The IPSG began anteriorly where the apex of the petrous part of the temporal bone articulated with the sphenoid part of the clivus, traveled posteriorly, in a slight medial to lateral course, primarily just medial to the petro-occipital fissure, and ended at the anteromedial aspect of the jugular foramen. When the IPSGs were grouped into five types. In type I specimens, no IPSG was identified (10.0%), in type II specimens, a partial IPSG was identified (6.5%), in type III specimens, a complete IPSG (80.0%) was identified, in type IV specimens, a partial IPS tunnel was identified (2.5%), and in type V specimens, a complete tunnel (1.0%) was identified. An improved knowledge of the bony pathways that the intracranial dural venous sinuses take as they exit the cranium is clinically useful. Radiological interpretation of such bony landmarks might improve patient diagnoses and surgically, such anatomy could decrease patient morbidity during approaches to the posterior cranial fossa.

Stiffness and echogenicity: Development of a stiffness-echogenicity matrix for clinical problem solving.

The assessment of soft tissue stiffness is important to evaluate many neuromusculoskeletal conditions. Several tools have been proposed for the assessment of stiffness, but ultrasonography appears to be most practical. The reflection of ultrasound waves as it travels through tissue enables assessment of tissue echogenicity, which is influenced by the characteristics of the sound wave as well as the characteristics of the tissue through which it passes, such as the amount of fat and fibrous tissue. However, tissue stiffness is not directly proportional to its echogenicity. Hence evaluation of echogenicity, as a stand-alone technique, is inadequate to describe its mechanical properties. The aim of this manuscript is to present a method of combining echogenicity evaluation by ultrasound and stiffness evaluation by palpation to better describe the mechanical properties of muscle using a stiffness-echogenicity matrix.

2019 Ejtm Special on Muscle Fascia.

For many years the fasciae have been considered by the anatomists only as a "white envelope for the muscles", that is generally removed in anatomical tables, to recognize muscle nerves and vessels. This is one of the reasons that different descriptions of the fasciae exist. On the other hand, in the last years the fasciae and their properties are becoming of central importance to clinicians practicing in various conventional and alternative therapies. The results from the worldwide research activities constitute a body of significant and important data, but this clinical interest is not supported by in-depth comprehension to how integrate the new knowledge about fasciae with the classical biomechanical models based on muscles, tendons and bones. To close this gap an Ejtm Special on "Muscle Fascia" will be published September 30, 2019, but the typescripts will be added to the Ejtm Early Release list as soon as all authors will approve their Epub papers. Deadline for original articles and reviews is June 1st, 2019, but the Editors hope that authors submit their typescripts much earlier.

Revisiting the peculiar regional distribution of muscle fiber types in rat Sternomastoid Muscle.

The sternomastoid (SM) muscle in rodents is known to have a peculiar distribution of fiber types with a steep gradient from surface to deep region. We here further characterize this peculiar regional distribution by quantitative histochemical morphometrys. In Hematoxylin-Eosin (H-E) stained transverse cryosections harvested in the medial portion of the muscle we counted around 10.000 myofibers with a mean diameter of 51.3±12.6 (µm). Cryisections of the SM stained by SDH reaction clearly show two distinct regions, toward the deep surface of the muscle a 40% area that contains packed SDH-positive myofibers, while the remaining area of the SM toward the external surface presents a more checker-board appearance. On the other hand, in the deep region of SM type 1 (slow contracting) muscle fibers, caracterized by positive acidic ATPase pH 4.35 reaction, are only the 24.5% of the fibers in the deep area of SM muscles, being restricted to the deepest region. The 75.5% of the myofibers in the deep region are of the fast contracting types (either 48.4% 2A, SDH -positive fibers or 27.1% 2B, SDH-negative fibers, respectively). As expected the 2B muscle fibers, acidic ATPase pH 4.3-negative and SDH-negative, present the largest size, while Type 1 fibers, acidic ATPase pH 4.3-positive and SDH-positive, present the smallest size in rat SM muscle. Based on present and previous observations, comparison of change in absolute number and/or percentage of the fiber types in any experimental model of muscle atrophy/hypertrophy/plasticity/pathology /recovery in the rat SM, and possibly of all mammals, will ask for morphometry of the whole muscle cross-sections, muscle sampling by bioptic approches will provide only comparable data on the size of the different types of muscle fibers.

Clinically-Orientated Anatomy: Five exemplars to portray the concept

It has become almost a truism that, as for many biomedical sciences courses, gross anatomy tuition for healthcare curricula (including medicine and dentistry) should be integrated with clinical components to improve vocational relevance. Nevertheless, many fundamental questions remain to be answered relating to the content to be taught, who teaches the discipline, how the students react, and whether the students are prepared to integrate the clinical and biomedical components. We additionally need evidence of how the delivery of clinical content is influenced by technical developments such as medical imaging. This article documents some examples, or case scenarios, showing how interactions between professional anatomists and clinicians can be fostered, as well as providing illustrations of different teaching styles. From a review of the literature, as well as from our own experiences, we conclude that, for many branches of medicine, it is essential to have access to human bodies for both anatomical and clinical education and training and that postgraduate anatomical teaching remains important for a variety of specialities. We therefore support the notion that a close relationship between professional anatomists and surgeons can reinforce core anatomical knowledge by deepening the understanding of its clinical importance. Paradoxically, however, there is evidence that medical students do not believe that the teachers of anatomy should necessarily be clinically qualified. Furthermore, while students appreciate the value of using clinical examples, scenarios or case histories in anatomy teaching, they remain ambivalent about their use in assessments or examinations. This article also emphasises that anatomy is important both as a scientific and a clinical, translational discipline and argues that the discipline is crucial for appreciation of the human body, not just in disease, but also in health

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The legal and ethical framework governing Body Donation in Europe - 1st update on current practice

Previously, we have reported on the legal and ethical aspects and current practice of body donation in several European countries, reflecting cultural and religious variations as well as different legal and constitutional frameworks. We have also established good practice in body donation. Here we shall further extend the legal and ethical frameworks in place and also focus on novelties in the law and different directives. Of particular interest are points that address the commercialization of human bodies and body parts and weaknesses in the legal directives. Therefore, it is important to define what is ethical and what needs to be considered unethical in body donation and the subsequent utilisation of human bodies for teaching and research (AU)

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