Regions of the human renal artery: histomorphometric analysis.

The renal artery is frequently involved in the pathogenesis of vasculorenal diseases, and it is a target in kidney surgery and therapeutic techniques for refractory hypertension. However, few detailed structural studies on the human renal artery have been conducted. Using histocytochemistry, immunohistochemistry, and quantitative image analysis, the wall thickness, structure, smooth muscle cells, extracellular matrix, and proportion of elastic tissue in the tunica media of main human renal arteries were used estimated. Ninety-six tissue samples were collected from sections of the right and left main renal arteries. The results showed that the renal artery changed from an elastic vessel in its proximal segment to a muscular artery in its distal part. A critical characteristic of the renal artery was the presence of longitudinal smooth muscle cell formations in the tunica adventitia of middle and distal segments but not in the proximal part of the artery. In addition, the tunica adventitia of the renal artery showed a rich vascularization and the presence of numerous nerves profiles. The artery's regional structural and morphometric features explain that a particular arterial pathology is more frequent in a specific vessel sector than in others. In addition, those characteristics could determine a different therapeutic response attending to the arterial sector.

Glial Cells and Retinal Nerve Fibers Morphology in the Optic Nerves of Streptozotocin-induced Hyperglycemic Rats.

PURPOSE: This study analyzes the structures of optic nerve elements, i.e., glial cells and nerve fibers, in an STZ-induced hyperglycemic animal model. Morphological changes in glial elements of the optic nerve in hyperglycemic and normoglycemic animals were compared. METHODS: Transmission electron microscopy, histochemistry, immunohistochemistry, and morphometry were used in this study. RESULTS: Hyperglycemia increased the numbers of inner mesaxons and axons with degenerative profiles. Furthermore, it led to both an increase in the amount of debris and in the numbers of secondary lysosomic vesicles in glial cytoplasm. Hyperglycemia also led to a decrease in glial fibrillary acidic protein expression and an increase in periodic acid-Schiff-positive deposits in the optic nerves of hyperglycemic animals. CONCLUSION: We conclude that the damage to the structural elements observed in our animal models contributes to the pathogenesis of optic neuropathy in the early stages of diabetes.

Competencias a desarrollar por los estudiantes de Medicina en la disciplina de Anatomía Humana en las universidades públicas españolas / ompetences that medical students should develop in the Human Anatomy course in Spanish public universities

OBJETIVO: El objetivo del estudio fue conocer las competencias generales y específicas del Grado en Medicina, definidas en la orden ECI/332/2008 por la que se establecen los requisitos para la verificación de los títulos universitarios oficiales que habiliten para el ejercicio de la profesión de médico, a cuyo desarrollo debería contribuir la materia «Anatomía Humana» en las universidades públicas españolas. MÉTODO: Se analizaron las memorias de verificación y la información disponible en las respectivas direcciones URL de los títulos de Grado en Medicina de 23 universidades públicas españolas que implementaron sus titulaciones de Grado en Medicina según la nueva ordenación de las enseñanzas (RD 1393/2007). RESULTADOS: Según las memorias de verificación registradas en el Registro de Universidades, Centros y Títulos (RUCT) en el segundo semestre de 2015, en la materia Anatomía Humana el estudiante deberá desarrollar competencias relacionadas con: valores profesionales, actitudes y comportamientos éticos en el 26,1% de las universidades seleccionadas; fundamentos científicos de la de la medicina en el 91,3%; habilidades clínicas en el 30,43%; habilidades de comunicación en el 34,78%; manejo de la información en el 8,69%; análisis crítico e investigación en el 34,78%, y salud pública y sistemas de salud en el 43,47%. Las competencias a las que se ha hecho referencia debían desarrollarse en los módulos especificados en la Orden ECI/332/2008 como sigue: a)morfología, estructura y función del cuerpo humano (82,6% de los casos); b)medicina social habilidades de comunicación e iniciación a la investigación (4,34%); c)formación clínica humana (4,34%), y d)procedimientos diagnósticos y terapéuticos (0%)

AIM: The aim of the study was to determine the general and specific competencies of the Degree in Medicine in Spanish public universities, as defined in the official Order ECI/332/2008, which establishes the requirements for verification of official degrees that qualify for the practice of the medical profession, and in particular should include the subject of Human Anatomy. METHOD: An analysis was carried out on the reports and information available in the respective URLs of the degree in Medicine of 23 Spanish public universities. These universities implemented their degrees in medicine according to the new education regulations (RD 1393/2007). RESULTS: According to the reports registered in the Register of Universities Centres and Degrees (RUCT) in the second half of 2015 on the subject of Human Anatomy, the students should develop related to: professional values, attitudes and ethical behaviour in 26.1% of the selected universities, scientific fundamentals of medicine in 91.3%, clinical skills in 30.43%, communication competences in 34.78%, information management in 8.69%, critical analysis and research in 34.78%, and public health and health systems in 43.47%. The competences should be developed in the modules as specified in the «Order ECI/332/2008» as follows: (I)morphology, structure and function of the human body (82.6% of cases); (II)social medicine, communication skills and introduction to research (4.34%); (III)human clinical training (4.34%), and (IV)diagnostic and therapeutic procedures (0%)

Segmentation of elastic fibres in images of vessel wall sections stained with Weigert's resorcin-fuchsin.

BACKGROUND AND OBJECTIVE: The elastic fibres are an essential component of the extracellular matrix in blood vessel walls that allows a long-range of deformability and passive recoil without energy input. The quantitative determination of elastic fibres will provide information on the state of the vascular wall and to determine the role and behaviour of this key structural element in different physiological and pathological vascular processes. METHODS: We present a segmentation method to identify and quantify elastic fibres based on a local threshold technique and some morphological characteristics measured on the segmented objects that facilitate the discrimination between elastic fibres and other image components. The morphological characteristics analysed are the thickness and the length of an object. RESULTS: The segmentation method was evaluated using an image database of vein sections stained with Weigert's resorcin-fuchsin. The performance results are based on a ground truth generated manually resulting in values of sensitivity greater than 80% with the exception in two samples, and specificity values above 90% for all samples. Medical specialists carried out a visual evaluation where the observations indicate a general agreement on the segmentation results' visual quality, and the consistency between the methodology proposed and the subjective observation of the doctors for the evaluation of pathological changes in vessel wall. CONCLUSIONS: The proposed methodology provides more objective measurements than the qualitative methods traditionally used in the histological analysis, with a significant potential for this method to be used as a diagnostic aid for many other vascular pathological conditions and in similar tissues such as skin and mucous membranes.

Quantification and Statistical Analysis Methods for Vessel Wall Components from Stained Images with Masson's Trichrome.

PURPOSE: To develop a digital image processing method to quantify structural components (smooth muscle fibers and extracellular matrix) in the vessel wall stained with Masson's trichrome, and a statistical method suitable for small sample sizes to analyze the results previously obtained. METHODS: The quantification method comprises two stages. The pre-processing stage improves tissue image appearance and the vessel wall area is delimited. In the feature extraction stage, the vessel wall components are segmented by grouping pixels with a similar color. The area of each component is calculated by normalizing the number of pixels of each group by the vessel wall area. Statistical analyses are implemented by permutation tests, based on resampling without replacement from the set of the observed data to obtain a sampling distribution of an estimator. The implementation can be parallelized on a multicore machine to reduce execution time. RESULTS: The methods have been tested on 48 vessel wall samples of the internal saphenous vein stained with Masson's trichrome. The results show that the segmented areas are consistent with the perception of a team of doctors and demonstrate good correlation between the expert judgments and the measured parameters for evaluating vessel wall changes. CONCLUSION: The proposed methodology offers a powerful tool to quantify some components of the vessel wall. It is more objective, sensitive and accurate than the biochemical and qualitative methods traditionally used. The permutation tests are suitable statistical techniques to analyze the numerical measurements obtained when the underlying assumptions of the other statistical techniques are not met.

Metodologías y materiales para el aprendizaje de la anatomía humana. Percepciones de los estudiantes de medicina 'nativos digitales' / Methodologies and materials in gross human anatomy learning. Perceptions by digital native medical students

Objetivo: Conocer la opinión de los estudiantes de la primera generación que ha crecido bajo el imperio de las tecnologías de la información y comunicación sobre las metodologías utilizadas actualmente en el proceso de enseñanza-aprendizaje de la anatomía humana en los estudios de medicina. Sujetos y métodos: Se realiza un estudio a partir de los datos aportados por una encuesta contestada anónimamente por 74 estudiantes de segundo curso de la titulación de medicina en la Universidad de Las Palmas de Gran Canaria. Resultados y conclusiones: En general, las metodologías mejor consideradas para el aprendizaje de la anatomía humana fueron el estudio de casos y el reconocimiento de estructuras en material humano fijado (prosecciones y disección), siendo la principal ventaja de esta última el reconocimiento tridimensional de las estructuras anatómicas y la consecuente consolidación de los conocimientos anatómicos, y su principal desventaja es el olor desagradable, debido a los procesos de fijación. Para la adquisición de habilidades en anatomía clínica se consideraron como las metodologías más adecuadas el estudio de casos, el reconocimiento e identificación de estructuras en material humano fijado y las sesiones de anatomía de superficie, mientras que las que mejor se adaptaban a la adquisición de conocimientos de anatomía descriptiva y funcional eran las clases magistrales y el estudio del material humano fijado. Los métodos peor considerados para estudiar anatomía fueron la utilización de modelos anatómicos plásticos y los recursos informáticos

Aim: To know the opinion of the first students generation that has grown up under the information and communication technology about the methodologies currently used in the teaching-learning of gross human anatomy in medical studies. Subjects and methods: The study was based on the data provided by an anonymously answered survey. Seventy-four students of the second year medical students at the University of Las Palmas de Gran Canaria answered the survey. Results and conclusions: The methodologies better considered for learning gross human anatomy were the study of cases and the recognition of anatomic structures in fixed human material (prosections and dissection). The students considered the main advantage of the last, the recognition of tridimensional anatomical structures and the consolidation of anatomical knowledge, and the main disadvantage was the unpleasant odour due to the fixing process. Students considered the study of cases, the recognition and identification of structures in fixed human material and the surface anatomy sessions, the methodologies that better suited to acquire skills in clinical anatomy and the lectures and the study of fixed human material the most appropriate methodologies to obtain knowledge about descriptive and functional anatomy. Plastic anatomical models and computing resources were considered the worst methods to study gross human anatomy

The Chiari network: an anatomical variation or a risk factor? Case report

We report an association between a Chiari network and an abnormally long coronary sinus. The network, at the Eustachian valve and a morphologically similar network in the Thebesian valve, was also associated with a permeable foramen ovale. We review the embryological basis, associated anomalies, pathological conditions and clinical relevance (AU)

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Relevance of human anatomy in daily clinical practice.

AIM: the aim of this study has been to evaluate the relevance of gross human anatomy in daily clinical practice and to compare it to that of other basic sciences (biochemistry, bioethics, cytohistology, microbiology, pharmacology, physiology, psychology). MATERIALS AND METHODS: a total of 1250 questionnaires were distributed among 38 different medical speciality professionals. Answers were analyzed taking into account speciality (medical, surgery and others), professional status (training physician or staff member) and professional experience. RESULTS: the response rate was 42.9% (n=536). Gross human anatomy was considered the most relevant basic discipline for surgical specialists, while pharmacology and physiology were most relevant for medical specialists. Knowledge of anatomy was also considered fundamental for understanding neurological or musculoskeletal disorders. In undergraduate programmes, the most important focuses in teaching anatomy were radiological, topographical and functional anatomy followed by systematic anatomy. In daily medical practice anatomy was considered basic for physical examination, symptom interpretation and interpretation of radiological images. When professional status or professional experience was considered, small variations were shown and there were no significant differences related to gender or community. CONCLUSION: our results underline the relevance of basic sciences (gross anatomy, physiology, and pharmacology) in daily professional activity. Evidence-based studies such as ours, lend greater credibility and objectivity to the role of gross anatomy in the undergraduate training of health professionals and should help to establish a more appropriate curriculum for future professionals.

Anomalies associated with aberrant right subclavian arteries. A case report

Anomalies in the aortic arch are a consequence of disorders in the development of the double primitive aortic arch system. We report a case of variation in the great vessels of the aortic arch, with an aberrant right subclavian artery being observed during a routine dissection. This variation was associated with a tight trachea in its distal end and a right lung devoid of the horizontal fissure, with a lack of tissue in the anterior segment of the superior lobe and in the lateral and medial segments of the middle lobe. The two common carotid arteries arose from a common trunk and the right recurrent laryngeal nerve was absent. On the basis of the literature, we review the incidence of the anatomical variation, its embryological explanation, and its clinical consequences (AU)

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