Efficacy of multimodal anticancer therapy in the course of pancreatic neuroendocrine carcinoma.

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Iulius Casserius: revolutionary anatomist, teacher and pioneer of the sixteenth and seventeenth century.

The demand for anatomical illustrations in the early modern period coincided with a scientific revolution. Starting out as a servant, Iulius Casserius became a great anatomist, who challenged the Galenic doctrine. The aim of this paper is to honor his memory and recreate the stylism of his anatomical illustrations. Online databases were searched for articles and original works. A medical graphic designer then recreated the figures presented in the article. Casserius was born around 1552. After moving to Padua, he served Fabricius in performing dissections. Obtaining his medical degree, he began working as an anatomical dissector and surgeon, later giving private anatomy lectures to students. He published De Vocis Auditusque and Pentaestheseion, and then became the lecturer of Surgery. In 1616, Casserius started his first Anatomy course and then died suddenly, at the height of his career. From the sixteenth century, illustrative techniques began focusing less upon artistry in favor of precise depictions of anatomical structures. Fabricius is considered to have used a strict scientific approach to illustrations for the first time. Anatomists of subsequent generations would still frequently use artistry in illustrations. Despite Casserius' mixed accuracy and artistry, his plates mark a new epoch in anatomic representation. Casserius left numerous eponyms and depicted, for the first time, many anatomical structures. Reprints in textbooks in the centuries following show convincing evidence of his success. Casserius contributed to medical education by taking the theatricality out of anatomy. Our article is a tribute to Casserius's achievements and depicts the revolution brought forth by a pioneer of his times.

The Prevalence of Anatomical Variations of the Median Nerve in the Carpal Tunnel: A Systematic Review and Meta-Analysis.

BACKGROUND AND OBJECTIVE: The course and branches of the median nerve (MN) in the wrist vary widely among the population. Due to significant differences in the reported prevalence of such variations, extensive knowledge on the anatomy of the MN is essential to avoid iatrogenic nerve injury. Our aim was to determine the prevalence rates of anatomical variations of the MN in the carpal tunnel and the most common course patterns and variations in its thenar motor branch (TMB). STUDY DESIGN: A systematic search of all major databases was performed to identify articles that studied the prevalence of MN variations in the carpal tunnel and the TMB. No date or language restrictions were set. Extracted data was classified according to Lanz's classification system: variations in the course of the single TMB--extraligamentous, subligamentous, and transligamentous (type 1); accessory branches of the MN at the distal carpal tunnel (type 2); high division of the MN (type 3); and the MN and its accessory branches proximal to the carpal tunnel (type 4). Pooled prevalence rates were calculated using MetaXL 2.0. RESULTS: Thirty-one studies (n = 3918 hands) were included in the meta-analysis. The pooled prevalence rates of the extraligamentous, subligamentous, and transligamentous courses were 75.2% (95%CI:55.4%-84.7%), 13.5% (95%CI:3.6%-25.7%), and 11.3% (95%CI:2.4%-23.0%), respectively. The prevalence of Lanz group 2, 3, and 4 were 4.6% (95%CI:1.6%-9.1%), 2.6% (95%CI:0.1%-2.8%), and 2.3% (95%CI:0.3%-5.6%), respectively. Ulnar side of branching of the TMB was found in 2.1% (95%CI:0.9%-3.6%) of hands. The prevalence of hypertrophic thenar muscles over the transverse carpal ligament was 18.2% (95%CI:6.8%-33.0%). A transligamentous course of the TMB was more commonly found in hands with hypertrophic thenar muscles (23.4%, 95%CI:5.0%-43.4%) compared to those without hypertrophic musculature (1.7%, 95%CI:0%-100%). In four studies (n = 423 hands), identical bilateral course of the TMB was found in 72.3% (95%CI:58.4%-84.4%) of patients. CONCLUSIONS: Anatomical variations in the course of the TMB and the MN in the carpal tunnel are common in the population. Thus, we recommend an ulnar side approach to carpal tunnel release, with a careful layer by layer dissection, to avoid iatrogenic damage to the TMB.

Knowledge on the subject of human physiology among Polish high school students--a cross-sectional study.

BACKGROUND: In most cases the only knowledge an individual will receive with regards to their own body and its proper functioning is during their high school education. The aim of this study was to evaluate high school students' knowledge about basic physiology. MATERIAL AND METHODS: The research was carried out in five, randomly chosen high schools in Krakow, Poland. Young people in the age of 17-19 years were asked to fill in the questionnaire designed by the authors. The first part of the survey included personal data. The second part contained 20 close-ended questions assessing students' knowledge about the basics of human physiology. Question difficulty varied from easy through average, and up to difficult. The maximum number of points to achieve was 20. RESULTS: One-thousand-and eighty-three (out of 1179 invited--91.86%) Polish high school students (63.25% female) filled in a 20-item questionnaire constructed by the authors regarding basic human physiology. The mean age of the group was 17.66 ± 0.80 years. The mean score among the surveyed was 10.15 ± 3.48 (range 0-20). Only 26.04% of students achieved a grade of 60% or more, and only one person obtained the highest possible score. Females achieved significantly better scores than males (10.49 ± 3.38 vs. 9.56 ± 3.56; p < 0.0001). Pupils in their second year who were in the process of studying physiology, obtained better results than those in their third year who had already finished the biology course (10.70 ± 3.27 vs. 9.81 ± 3.74 respectively; p < 0.0001) and those in their first year who did not yet study human physiology (10.70 ± 3.27 vs. 9.63 ± 2.74 respectively; p = 0.003). Over 23% of students did not know that mature red blood cells do not have cell nuclei and a similar number of them answered that humans have 500,000 erythrocytes in 1 mm3 of blood. Over 32% believed that plasma does not participate in the transport of respiratory gases, and 31% believed that endocrine glands secrete hormones within their immediate vicinity and into the blood. CONCLUSIONS: Our research has shown that young people, especially men, often lack basic physiological knowledge needed to make conscious and responsible decisions regarding their health. Our results suggest that more emphasis should be put on properly teaching human physiology in high school, especially to those students who do not plan a career in medicine-related fields. This study brings to light the disturbing fact that about a year after a student finishes his basic physiology course his knowledge of the subject returns to a pre high school level.

Topography of ulnar nerve and its variations with special respect to carpal region.

Ulnar nerve supplies small muscles of the hand and apart from the median nerve is the main coordinator of precise movements performed both in the medical and dental practice. Based on their anatomical and clinical experience, authors revised a knowledge on this nerve with special respect to its topography, variation in the wrist.