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PubMedDate not supplied

[Etienne Geoffroy Saint-Hilaire (1772-1844) and anencephaly: Contribution of one naturalist to medical knowledge].

Anencephaly, frequent and severe congenital malformation (around 1% childbirth) is know since highest antiquity, but often confused with acephaly. Its existence during Egyptian Antiquity is demonstrated by observation, by E. Geoffroy Saint-Hilaire, of an anencephalous foetus mummy. The first detailed anatomical observations are those of Morgagni, from 1742 to 1762, that is to E.G.S-H., as naturalist but as a doctor, we owe the crucial progress during the 19th century. As anatomist, by fine and meticulous observation of cranio-spinal skeleton, he shows persistency of all osseous pieces, distorted but preserving all their connexions: this brings him to create a fist nomenclature and a first classification. As embryologist, he establishes the principle of development arrest or delay at a given stage of embryonic life, and he affirms that the type of anomaly depends on her occurring date. Collecting his own observations and those of his predecessors, he describes several clinical characters. Observing amniotic flanges, he elaborates a physiopathological concept, identifies the accidental origin of this malformation, and tries to prove it by teratological experimentation.His works will be continued by his son, Isidore, doctor, who is considered as the Teratology science founder.

Anencephaly↗

PubMedDate not supplied

[The great omentum in surgical pathology].

The aim of the survey is to bring forward the relationship structure-function-pathology of the great omentum from the surgical point of view. The common origin (similar) with that of the spleen and the structural particularities give the great omentum distinct responding potentialities in pathology and these have challenged the anatomists, anatomo-pathologists and surgeons to a more careful and deep research for the last one hundred years. The study corroborates data from literature with the authors' experimental, clinical and microscopic research regarding the vascularization, the lymphoreticular component and the innervation, with the aim of emphasizing the functions of the great omentum in pathological conditions: plasticity, adherence to traumatized and swollen areas, neo-vascularization, absorption of fluids and phagocytosis. Concerning the innervation, by using special techniques, we have managed to emphasize neurofibres in interlobular spaces. By using clinical observation and microscopic study, we can notice dynamically the changes of the great omentum in the inflammatory pathology and in front of the malignant tumour invasion. Last but not least, this survey pays our respects to professor Ion Kiricuta, the first who used the great omentum in plastic surgery and whose studies stimulated the research concerning the great omentum that has been a subject for the international conferences for the last 20 years.

Humans↗

PubMedDate not supplied

Esophageal porto-caval anasthomosis. Critical view of the hypothesis of F.C. Carvalho.

The apparition and the breakage of esophageal varices et the level of cardioesophageal junction in the portal hypertension still represents a problem of pathological surgery. The presence of these varicose dilatations in this region is due to an important zone of porto-caval anastomoses. Angioarhitectonical study of lower abdominal esophagus represents a disputed problem in the specialty literature. The hypothesis of south American anatomist F. C. Carvalho (1966) looks to be the best model that could explain the appear of cardioesophageal varices. Studies realized in the past within the Anatomy Department of Medicine "Carol Davila" Bucharest tried to demonstrate the validity of Carvalho's theory, and the results of these researches are exposed in the present paper.

Autopsy↗

PubMed1992

Cooper's posterior lamina of transversalis fascia.

The original description of the transversalis fascia and the internal inguinal ring by Astley Cooper in 1804 is recounted along with the immediate recognition of its importance by other surgical anatomists. The description he made in 1807 of two laminae has been essentially ignored or denied. The deep posterior lamina has been confused with a membranous condensation in the preperitoneal fascia. However, Lytle and Fowler reported a secondary or deeper internal ring and Mackay described the inferior epigastric artery perforating the transversalis fascia at its origin and then coursing cephalad on it to enter the rectus sheath anterior to the arcuate line. My experience with preperitoneal exposure of groin herniae, from the anterior and posterior approach, has demonstrated a posterior lamina deep to the epigastric vasculature attached to the pubic ramus. Repair of inguinal herniae should begin in the preperitoneal layer internal to Astley Cooper's bilaminar transversalis fascia and the epigastric vessels. This will ensure ligation of any peritoneal sac within the iliac fossae, as recommended by Bassini, or internal to the false neck, as described by Henry. This is the avascular, fissile, envelope in which Stoppa has so successfully placed prostheses.

Anatomy↗

PubMed2004

Anatomical relationship between the superficial brachial arteries and the brachial plexus in humans, and their morphological significance.

Since the significance of a superficial subscapular artery was reported by Yamada, macroscopic anatomical studies of axillary artery morphogenesis have been conducted by many authors. Notably, Japanese anatomists have reported important and groundbreaking theories on the morphogenesis of normal and aberrant axillary arteries. These include a description of the superficial brachial artery (BS) and Adachi's brachial plexus (AxC) by Chiba, the possible routes of the axillary artery by Aizawa et al. and the morphological significance of the inferior pectoral artery (Pi) by Kodama et al. and the deep axillary artery by Honma et al. We have also identified 11 BS among 322 sides of 161 adult human cadavers. We traced the BS with the AxC in 1 case, the development of a superficial subscapular artery in 3 cases, the development of a Pi in 3 cases, an unclear situation in 3 cases and a lateral median superficial brachial artery (BSML) in 1 case. Moreover, we carried out a fibre analysis of the BSML in order to understand the morphology more completely. Our findings are discussed herein. We have therefore described our cases and compare them with references, presenting gross anatomical data on their morphogenesis in an effort to unify experimental embryological data.

Adult↗

PubMed2005

Collaborative biomedical data exploration in distributed virtual environments.

Imaging techniques such as MRI, fMRI, CT and PET have provided doctors with a means to acquire high-resolution biomedical images that serve as the foundation for the diagnosis and treatment of diseases. Experts with a multitude of backgrounds, including radiologists, anatomists, psychiatrists and neuroscientists now collaboratively analyze the same images to extract a better understanding of the encoded information. Unfortunately, access to these specialists at the same physical location is not always possible and new tools and techniques are required to facilitate simultaneous and collaborative exploration of volumetric data between spatially separated domain experts. This paper presents CVMED, a collaborative visualization environment for volumetric biomedical data-sets, supporting heterogeneous hardware, rendering and display systems connected via heterogeneous networks. CVMED provides the user with the algorithms and tools for stereoscopic as well as monoscopic data visualization and annotation along with the middleware needed to exchange the resulting visuals between all participants in real-time.

Biomedical Technology↗

PubMed2004

[Clinical and radiological aspects of ageing of the respiratory tract].

The effects of ageing on the macroscopic appearance of the lung were recognized by Laennec, Andral suggesting that dyspnoea might be its clinical manifestation. At about the same time physiologists demonstrated the negative effects of ageing on the vital capacity, whereas anatomists defined its impact on the lung and thoracic cage structure. The prevalence of dyspnoea increases with ageing but co-morbid disease should always be sought. The prevalence of cough is strongly associated with active and passive smoking. With regard to physical signs, barrel chest and crepitations heard over the dependent lung zones do not necessarily have pathological significance. The usefulness of measuring the forced expiratory time remains to be established in the elderly. There is no characteristic radiological feature of a senile lung. If an X-ray abnormality is discovered during a routine examination, it should be regarded as pathological, but in most cases its detection will not alter management of the patient.

Aged↗

PubMedDate not supplied

[Inguinal hernia recurrence. Report of our personal experience].

In our previous studies, we reasserted the concept regarding the fundamental role of the transversalis fascia in securing and maintaining restraint on the abdominal wall in correspondence with the "inguinal fissure", which is considered a hiatus and a weak point. The role played by the transversalis fascia was first proposed by Edoardo Bassini and later reaffirmed by other authors, surgeons and anatomists. This concept led to the belief that the procedures deemed effective in treating inguinal hernia were those capable of strengthening or substituting the transversalis fascia. In a recent study we compared the immediate and long-term results of three techniques: Bassini, Lichtenstein and preperitoneal prosthesis by inguinal way. A lower number of recurrences was noted in the latter as compared to the others. Based on the aforementioned points, the same verification was carried out regarding recurrent inguinal hernia. The results concerning the incidence of relapse were similar, proving once again the effectiveness of the preperitoneal prosthesis (2.5% vs 6.6% for Lichtenstein). We have also attempted to identify the factors which were considered possible causes of recurrence in the previous cases we examined, allowing us to reach useful conclusions in the prevention of hernia recurrence.

Aged↗

PubMed2004

[Olaus Rudbeck as scientist and professor of medicine].

Olaus Rudbeck (1630-1702) was one of the pioneers in the study of lymphatic vessels. As a young student at Uppsala University he began dissecting small animals with great diligence and found the lymphatic connection between the intestines and the circulating blood, leading the prepared nutrients via the thoracic duct to the veins. By applying ligatures to the lymphatic vessels he could observe the direction of the flow. His observations confirmed William Harvey's newly advanced theory about the circulation of the blood and were in agreement with the then modern mechanistic view of body functions. Rudbeck demonstrated his findings for Queen Christina in the spring of 1652 and received from her money for a visit to the University of Leiden, Holland in the autumn of 1653. He had just before his departure published his own discoveries, but the Danish anatomist Thomas Bartholin had reported very similar results slightly before. During his stay in Holland (autumn 1653-summer 1654) where he was admired for his anatomical skillfullness, a priority dispute began between him and one of Bartholin's students, lasting for years. Back in Uppsala Rudbeck began and extensive activity, including the foundations of the botanical garden, the anatomical theatre and other university buildings. He became a professor of medicine in 1660 but soon left his anatomical studies for work in several disciplines and trades. He was a prominent master-builder and garden architect as well as an astronomer, botanist, musician and archaeologist. In the last mentioned capacity he published his ill-famed Atlantica, a gigantic reconstruction of the history of old Sweden from the times of the Flood, through the era of vast conquests including Russia and the Mediterranean region, supposed to have take place in the third and second millenium B.C. Rudbeck mingled philogical methods and mythological explanations with excavations and natural history to reach his phantastic conclusions. At the same time the Atlantica (in three volumes plus one unfinished) is a very personal document, demonstrating i.a. that he had a medical practices, including advanced anatomical surgery, as when helping at the birth of one of his children. The boy was christened "Johannes Caesar" in commemoration of the event, but apparently it was not a regular Caeserian section.

Anatomy↗

PubMed2005

[The history of neuro-ophthalmology in Edinburgh. Part I].

The Edinburgh Medical School occupies a unique position in the history of medicine. It gave the three famous clinicians and scientists who significantly developed the fundamentals of neuro-ophthalmology: Sir Charles Bell, Douglas Argyll Robertson and Harry Moss Traquair. Sir Charles Bell (1774-1842) was a Scottish anatomist, physiologist, neurologist and surgeon who enjoyed a distinguished career in London and Edinburgh during the first half of the nineteenth century. He was a prolific medical writer, a brilliant researcher and a skilled artist. Argyll Robertson (AR) (1837-1909) was the first surgeon in Scotland to practise entirely in the field of ophthalmology. In 1869 Robertson published the records of cases, which showed that disease of the spinal cord is sometimes associated with loss of the light reflex of the pupil but retention of its movement in accommodation. Harry Moss Traquair (1875-1954) was one of the founders of neuro-ophthalmology, being concentrated on bitemporal hemianopia, the course of the geniculo-calcarine visual pathway, pituitary tumours, optic nerve diseases (including acute retrobulbar neuritis), tobacco amblyopia and traumatic lesions of the optic tract. In his many publications, his most outstanding contribution to medical knowledge was the work which culminated in the publication, in 1927, of "An Introduction to Clinical Perimetry".

Eye Diseases↗

PubMed2005

[The urology in the anatomical plates of Andreas Vesalius (1514-1564)].

Perspicacious and methodical as much as genius, Vesalius was the greatest anatomist of all time. He created the anatomical nomenclature of organs used even today. He elaborated more than 300 remarkable anatomical illustrations, a part of which is dedicated to the male urogenital tract, providing in this way precious information about the knowledge on urology of his time.

Anatomy, Cross-Sectional↗

PubMed2005

[Application of the modified Sihler's stain technique to cadaveric peripheral nerves after medical students' dissection course].

The exact ramification and distribution pattern of the peripheral nerves is one of the most important information for anatomists and clinicians. However, it is very difficult to pursue perfectly all of the fine twigs of nerve branches even if we use a stereoscopic microscope. Recently, Liu et al. (Anat. Rec., 247: 137, 1997) applied a modified Sihler's stain technique to study the distribution of intramuscular nerve branches in mammalian skeletal muscles. Then, we attempted to apply this technique to plantar nerves of human foot removed from cadavers which were used for ordinary dissection practices at the School of Medicine. Intrinsic muscles of the foot with motor and sensory nerve branches were removed en bloc from bones of the foot. They were macerated and depigmented in 3% aqueous potassium hydroxide, decalcified in Sihler's solution 1. Then, after staining in Sihler's solution II, they were destained in Sihler's solution I, neutralized in 0.05% lithium carbonate, and cleared in increasing concentrations of glycerin. As a result, each nerve fascicle, which are bundles of nerve fibers invested by the perineurium, was very clearly visualized, since only nerve fibers were stained deep blue-purple, while muscles, the epineurium and the perineurium were made transparent in glycerin. We found an anastomosis between a deep branch of the lateral plantar nerve and the medial plantar nerve, composed of several nerve fascicles. Therefore, the modified Sihler's stain technique can be applied to cadaveric peripheral nerves after medical students' dissection course.

Aged, 80 and over↗

PubMed2005

Constructing clinical science.

Clinical practice became clinical science in the years 1720-1820. There were many reasons for this transformation. The discoveries by Santorio Santorio, William Harvey, Marcello Malpighi, Giovanni Alfonso Borelli, Lorenzo Bellini, Thomas Sydenham, Giovanni Maria Lancisi, were perceived by students who asked for changes in the medical curriculum. In 1761 Morgagni centered the study of diseases on morbid anatomy, a way to control at autopsy the validity of diagnosis. J.P. Frank who worked on public health and John Locke who supported a method of scientific reasoning based on asking questions were also instrumental for changes. Hospitals, formerly hospices for the poor, became places for curing and healing. Military hospitals represented models to be followed. In Vienna Marie Therese inaugurated the Allegemein Krankenhaus in 1785. In revolutionary France Fourcroy with the law Frimaire An III, 1794 gave a new rationale. Medicine and surgery were unified in the curriculum. Basic sciences were introduced. Dissection became compulsory, practical teaching became the rule. But it was with John Hunter, Domenico Cotugno and P. Joseph Desault that the great advancement was achieved. They were anatomists and therefore they made the knowledge of human body the core of medical curriculum. However experimentation on animals, as well as practical bedside teaching at the hospital also became important. Through their work hospitals and universities were associated in a common goal.

Anatomy↗

PubMed2005

The embalming, the scientific method and the paleopathology: the case of Gaetano Arrighi (1836).

Since the most ancient times the problem of the artificial preservation of dead bodies has been an important object of study. In ancient and classic times the reasons leading to this practice were essentially of a religious and esoteric type, but in the modern age, following the development of medical and biological studies, embalming has assumed a more practical trend which is both medicine and scientific. The discovery of blood circulation has marked the scientific method which, in its various forms, has circulated all over Europe bringing fame to eminent anatomists such as Federico Ruysch (1638-1731), William (1718-1783) and John Hunter (1728-1793), Jean Nicolas Gannal (1791-1852), Giuseppe Tranchina, Laskowky and Brosch, who affirmed the embalming by endoarterial injection of conservation fluids making evisceration useless and obsolete. The advent of formalin and the introduction of new surgical and autoptic methods have made this practice gradually fall into disuse. For this reason, the mummy found in Leghorn (Tuscany, Central Italy) is of particular importance since was obtained applying the intravascular injection following the method, described by the Italian medical Giuseppe Tranchina in 1835. The mummified body belongs to Gaetano Arrighi, a prisoner in the Leghorn fortress. He was born in Arezzo in 1789 and died on March 1836 at the age of 47 in the Civil Hospital of Leghorn following pleurisy, as results in an annexed document. The day after his death Dr. Raimondo Barsanti from Pisa and Superintendent at the Leghorn hospital made up the Tranchina's method, which consisted in the injection of an arsencial -mercury solution inside of the blood vessels, giving rigidity and dark red color to the dead body. The excellent outcome of the intervention has made it possible, more than 160 years later, to study not only the method by which Arrighi's body was embalmed but also to perform a careful paleopathological imaging study by traditional X-rays and by Computer Axial Tomography (CAT). The high percentage of mercury present in the conservation fluid conferred radiopacity, making it possible to evidence the diffusion of the liquid into the entire artery tree and in particular into the aorta as well as in all the right and left artery systems. The radiopacity showed an unusual thoracic picture suggesting a pathological situation. The CAT study enriched and ameliorated the results obtained by X-rays making it possible to reconstruct the embalming procedure and to confirm the diagnosis of wet pleurisy probably cause by a tubercular infection.

Embalming↗

PubMed2005

[Strategies of medical self-authorization in early modern medicine: the example of Volcher Coiter (1534-1576)].

Based on the example of Volcher Coiter--a town physician at Nuremberg and one of the leading anatomists in early modern medicine--, this essay points out that the authoritative status of contemporary physicians mainly was predicated on an interplay of self-fashioning and outside perception. It provides ample evidence that Coiter made use of several characteristic rhetorical and discourse-related strategies of self-authorisation such as the participation in social networks, a highly convincing technique of self-fashioning by emphasizing particular erudition, the presentation of academic medicine as a science authorised by god and the concurrent devaluation of non-academic healers. Furthermore, graphic and visual strategies of self-authorisation could be ascertained: Coiter took care for a premium typography of his books. He also used his talent as a graphic artist in his books to visualise his medical concepts. Moreover, the so-called 'Nuremberg Portrait' of Coiter served to illustrate his outstanding authority.

Credentialing↗

PubMedDate not supplied

Anatomic characteristics of foramen vesalius.

OBJECTIVES: Foramen Vesalius is an inconstant foramen that gives passage to an emissary vein that connects pterygoid venous plexus with cavernous sinus, the importance of which lies in the fact that an infected thrombus from an extracranial source may reach cavernous sinus. This study presents some data on characteristics of foramen vesalius. METHODS: We studied 70 sides of 35 dried adult human skulls available in the Department of Anatomy, Manipal College of Medical Sciences, Pokhara, Nepal. Variation in number and incidence of foramen Vesalius were noted. Differences between the right and the left side and between the male and the female sex are discussed. MAIN FINDINGS: Foramen Vesalius was present in 23 sides (14 right, 9 left) out of the 70 sides observed, the incidence being 32.85% (20.0% right side, 12.85% left side) of all the sides observed. Incidence of bilateral and unilateral foramen vesalius was 22.85% (8 out of 35 skulls) and 20% (7 out of 35 skulls) respectively. Foramen vesalius was found in 10 sides in males and in 13 sides in females. No remarkable differences were observed in the incidence of foramen vesalius between the sides within same sex but the incidence was more in females compared to male skulls. SIGNIFICANCE OF FINDINGS: Anatomic variations of the foramen vesalius could be explained by developmental reasons. Knowledge about characteristics of foramen vesalius and its incidence is not only important for anatomists but equally essential for an operating surgeon.

Cadaver↗

PubMed2005

A new morphometric method for the sella turcica and the hypophyseal fossa and its clinical relevance.

The sella turcica and the hypophyseal fossa should be considered different entities, the latter being part of the former. Their morphology and dimensions correlate to some extent with those of the contained pituitary gland and have, for this reason, attracted the interest of anatomists and radiologists. With the application of MRI, however, these data are of limited use in the diagnosis of pituitary disorders, although they remain valuable with regard to a microsurgical approach to the hypophysis. The proposed morphometric method was applied to 20 dry skulls. We first made casts of the corresponding sellae. Their volumes were then measured by immersion. The frontal section of each hypophyseal fossa was obtained through its deepest point and magnified. The Cartesian co-ordinates of the contour of the section were used to evaluate the corresponding area and centroid. The volume of each fossa was finally obtained by the use of Pappus' theorem applied to solids of rotation. The volumes of the sellae obtained as above ranged from 460 mm3 to 1570 mm3 with a mean value of 835 mm3. These figures are comparable to those reported from previous authors. To our knowledge the method described has enabled a close approximation of the volumes of the hypophyseal fossae to be made for the first time. These volumes ranged from 24 mm3 to 300 mm3, with a mean value of 157 mm3. Similar numerical methods might be applicable in vivo by the use of MR imaging.

Anthropometry↗

PubMed2006

[Topic on clinical anthropology in scientific activity of docent Antanas Adomaitis].

The present paper is dedicated to docent Antanas Adomaitis, anatomist and anthropologist, former member of editorial board of journal "Medicina", on the occasion of his 65th birthday and 40 years of scientific activity. First publications of Antanas Adomatis appeared in the 1960s, and now the list of his scientific publications exceeds 140 in number. The research field of docent Antanas Adomaitis is wide and covers problems from growth and development to physical status of adult people and its changes associated with a particular period. However, his most important scientific works are in the field of clinical anthropology. Antanas Adomaitis investigated growth and maturation under pathological circumstances, body composition of adult people, prevalence of obesity, growth diversity and secular trend: in 1975 he defended his thesis entitled "Physical development and sexual maturation of children with congenital heart defects" for the degree of Doctor of Medicine, later focused on growth and development of children with congenital facial anomalies, also blind and weak-sighted children. Recently docent together with the other scientists of our Department investigates growth variety of children from different towns and rural areas of Lithuania. Antanas Adomaitis collected probably most anthropological data on Lithuanians (children and adults)--this is ponderable contribution to Lithuanian auxology and clinical anthropology, valuable material for the future researches of growth and maturation, also physical status of adult people and secular trend.

Adolescent↗