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Pérez-Cruz JC, Macías-Duvignau MA, Reyes-Soto G, Gasca-González OO, Baldoncini M, Miranda-Solís F, Delgado-Reyes L, Ovalles C, Catillo-Rangel C, Goncharov E, Nurmukhametov R, Lawton MT, Montemurro N, Encarnacion Ramirez MDJ. Latex vascular injection as method for enhanced neurosurgical training and skills. Front Surg 2024; 11:1366190. [PMID: 38464665 PMCID: PMC10920354 DOI: 10.3389/fsurg.2024.1366190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 02/14/2024] [Indexed: 03/12/2024] Open
Abstract
Background Tridimensional medical knowledge of human anatomy is a key step in the undergraduate and postgraduate medical education, especially in surgical fields. Training simulation before real surgical procedures is necessary to develop clinical competences and to minimize surgical complications. Methods Latex injection of vascular system in brain and in head-neck segment is made after washing out of the vascular system and fixation of the specimen before and after latex injection. Results Using this latex injection technique, the vascular system of 90% of brains and 80% of head-neck segments are well-perfused. Latex-injected vessels maintain real appearance compared to silicone, and more flexible vessels compared to resins. Besides, latex makes possible a better perfusion of small vessels. Conclusions Latex vascular injection technique of the brain and head-neck segment is a simulation model for neurosurgical training based on real experiencing to improve surgical skills and surgical results.
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Affiliation(s)
- Julio C. Pérez-Cruz
- Laboratorio de Técnicas Anatómicas y Material Didactico, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City, Mexico
- Departamento de Anatomía, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Mario A. Macías-Duvignau
- Laboratorio de Técnicas Anatómicas y Material Didactico, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City, Mexico
| | - Gervith Reyes-Soto
- Department of Head and Neck, Unidad de Neurociencias, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Oscar O. Gasca-González
- Departamento de Anatomía, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
- Departamento de Anatomía, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Mexico City, Mexico
| | - Matias Baldoncini
- Laboratory of Microsurgical Neuroanatomy, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina
| | - Franklin Miranda-Solís
- Laboratorio de Neuroanatomía, Centro de Investigación de Anatomía y Fisiología Alto Andina, Universidad Andina del Cusco, Cusco, Peru
| | - Luis Delgado-Reyes
- Departamento de Anatomía, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Carlos Ovalles
- Department of Neurosurgery, General Hospital, Durango, Mexico
| | - Carlos Catillo-Rangel
- Department of Neurosurgery, Servicio of the 1ro de Octubre Hospital of the Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Mexico City, Mexico
| | - Evgeniy Goncharov
- Traumatology and Orthopedics Center, Central Clinical Hospital of the Russian Academy of Sciences, Moscow, Russia
| | - Renat Nurmukhametov
- Neurological Surgery, Peoples Friendship University of Russia, Moscow, Russia
| | - Michael T. Lawton
- Department of Neurosurgery, St. Joseph’s Hospital and Medical Center, Barrow Neurological Institute, Phoenix, AZ, United States
| | - Nicola Montemurro
- Department of Neurosurgery, Azienda Ospedaliero Universitaria Pisana (AOUP), Pisa, Italy
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Brenner E, Bleys RLAW, de Caro R, Catereniuc I, Chirculescu ARM, Destrieux C, Eppler E, Filgueira L, Kachlik D, Kiss P, Lee C, Matveeva N, Natsis K, Pais D, Paulsen F, Piagkou M, Quondamatteo F, Reglődi D, Şendemir E, Tranum-Jensen J, Tutkuviene J, Vázquez Osorio MT. The legal and ethical framework governing body donation in Europe - 2nd update on current practice. Ann Anat 2024; 252:152195. [PMID: 38042354 DOI: 10.1016/j.aanat.2023.152195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 11/28/2023] [Indexed: 12/04/2023]
Abstract
BACKGROUND In 2008, members of the TEPARG provided first insights into the legal and ethical framework governing body donation in Europe. In 2012, a first update followed. This paper is now the second update on this topic and tries to extend the available information to many more European countries. METHODS For this second update, we have asked authors from all European countries to contribute their national perspectives. By this enquiry, we got many contributions compiled in this paper. When we did not get a personal contribution, one of us (EB) searched the internet for relevant information. RESULTS Perspectives on the legal and ethical framework governing body donation in Europe. CONCLUSIONS We still see that a clear and rigorous legal framework is still unavailable in several countries. We found national regulations in 18 out of 39 countries; two others have at least federal laws. Several countries accept not only donated bodies but also utilise unclaimed bodies. These findings can guide policymakers in reviewing and updating existing laws and regulations related to body donation and anatomical studies.
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Affiliation(s)
- Erich Brenner
- Institute of Clinical and Functional Anatomy, Medical University of Innsbruck, Austria; Trans-European Pedagogic Anatomical Research Group (TEPARG).
| | - Ronald L A W Bleys
- Department of Anatomy, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Raffaele de Caro
- Section of Anatomy, Department of Human Anatomy and Physiology, University of Padova, Italy; Trans-European Pedagogic Anatomical Research Group (TEPARG)
| | - Ilia Catereniuc
- Department of Anatomy and Clinical Anatomy, Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Republic of Moldova
| | - Andy R M Chirculescu
- Department of Anatomy and Embryology, Faculty of Medicine, C Davila University, Bucharest, Romania; Trans-European Pedagogic Anatomical Research Group (TEPARG)
| | | | | | - Luis Filgueira
- Anatomy, Faculty of Science and Medicine, University of Fribourg, Switzerland
| | - David Kachlik
- Department of Anatomy, Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Péter Kiss
- Department of Anatomy, University of Pécs, Hungary
| | - Clive Lee
- Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Niki Matveeva
- Department of Anatomy, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, North Macedonia
| | - Konstantinos Natsis
- Laboratory of Anatomy and Anatomy of Surgery, Aristotele University School of Medicine, Thessaloniki, Greece
| | - Diogo Pais
- Departamento de Deontologia, Bioética e DireitoMédico, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Portugal; Trans-European Pedagogic Anatomical Research Group (TEPARG)
| | - Friedrich Paulsen
- Institute for Functional and Clinical Anatomy, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Maria Piagkou
- Department of Anatomy and Surgical Anatomy, National and Kapodistrian University of Athens, Greece
| | - Fabio Quondamatteo
- Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Dóra Reglődi
- Department of Anatomy, University of Pécs, Hungary
| | - Erdoğan Şendemir
- Anatomy Department, Medical Faculty, Uludağ University, Bursa, Turkey; Trans-European Pedagogic Anatomical Research Group (TEPARG)
| | - Jørgen Tranum-Jensen
- Department of Cellular and Molecular Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Janina Tutkuviene
- Department of Anatomy, Histology and Anthropology, Faculty of Medicine, Vilnius University, Lithuania
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Pettenuzzo S, Belluzzi E, Pozzuoli A, Macchi V, Porzionato A, Boscolo-Berto R, Ruggieri P, Berardo A, Carniel EL, Fontanella CG. Mechanical Behaviour of Plantar Adipose Tissue: From Experimental Tests to Constitutive Analysis. Bioengineering (Basel) 2023; 11:42. [PMID: 38247919 PMCID: PMC10813593 DOI: 10.3390/bioengineering11010042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 12/22/2023] [Accepted: 12/28/2023] [Indexed: 01/23/2024] Open
Abstract
Plantar adipose tissue is a connective tissue whose structural configuration changes according to the foot region (rare or forefoot) and is related to its mechanical role, providing a damping system able to adsorb foot impact and bear the body weight. Considering this, the present work aims at fully describing the plantar adipose tissue's behaviour and developing a proper constitutive formulation. Unconfined compression tests and indentation tests have been performed on samples harvested from human donors and cadavers. Experimental results provided the initial/final elastic modulus for each specimen and assessed the non-linear and time-dependent behaviour of the tissue. The different foot regions were investigated, and the main differences were observed when comparing the elastic moduli, especially the final elastic ones. It resulted in a higher level for the medial region (89 ± 77 MPa) compared to the others (from 51 ± 29 MPa for the heel pad to 11 ± 7 for the metatarsal). Finally, results have been used to define a visco-hyperelastic constitutive model, whose hyperelastic component, which describes tissue non-linear behaviour, was described using an Ogden formulation. The identified and validated tissue constitutive parameters could serve, in the early future, for the computational model of the healthy foot.
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Affiliation(s)
- Sofia Pettenuzzo
- Department of Civil, Environmental and Architectural Engineering, University of Padova, 35131 Padova, Italy; (S.P.); (A.B.)
| | - Elisa Belluzzi
- Musculoskeletal Pathology and Oncology Laboratory, Department of Surgery, Oncology and Gastroenterology, University of Padova (DiSCOG), Via Giustiniani 3, 35128 Padova, Italy; (E.B.); (A.P.)
- Orthopedics and Orthopedic Oncology, Department of Surgery, Oncology and Gastroenterology (DiSCOG), University of Padova, Via Giustiniani 3, 35128 Padova, Italy;
- Centre for Mechanics of Biological Materials, University of Padova, 35131 Padova, Italy; (V.M.); (A.P.); (R.B.-B.); (E.L.C.)
| | - Assunta Pozzuoli
- Musculoskeletal Pathology and Oncology Laboratory, Department of Surgery, Oncology and Gastroenterology, University of Padova (DiSCOG), Via Giustiniani 3, 35128 Padova, Italy; (E.B.); (A.P.)
- Orthopedics and Orthopedic Oncology, Department of Surgery, Oncology and Gastroenterology (DiSCOG), University of Padova, Via Giustiniani 3, 35128 Padova, Italy;
- Centre for Mechanics of Biological Materials, University of Padova, 35131 Padova, Italy; (V.M.); (A.P.); (R.B.-B.); (E.L.C.)
| | - Veronica Macchi
- Centre for Mechanics of Biological Materials, University of Padova, 35131 Padova, Italy; (V.M.); (A.P.); (R.B.-B.); (E.L.C.)
- Department of Neuroscience, Institute of Human Anatomy, University of Padova, 35121 Padova, Italy
- Veneto Region Reference Center for the Preservation and Use of Gifted Bodies, Veneto Region, 35100 Padua, Italy
| | - Andrea Porzionato
- Centre for Mechanics of Biological Materials, University of Padova, 35131 Padova, Italy; (V.M.); (A.P.); (R.B.-B.); (E.L.C.)
- Department of Neuroscience, Institute of Human Anatomy, University of Padova, 35121 Padova, Italy
- Veneto Region Reference Center for the Preservation and Use of Gifted Bodies, Veneto Region, 35100 Padua, Italy
| | - Rafael Boscolo-Berto
- Centre for Mechanics of Biological Materials, University of Padova, 35131 Padova, Italy; (V.M.); (A.P.); (R.B.-B.); (E.L.C.)
- Department of Neuroscience, Institute of Human Anatomy, University of Padova, 35121 Padova, Italy
- Veneto Region Reference Center for the Preservation and Use of Gifted Bodies, Veneto Region, 35100 Padua, Italy
| | - Pietro Ruggieri
- Orthopedics and Orthopedic Oncology, Department of Surgery, Oncology and Gastroenterology (DiSCOG), University of Padova, Via Giustiniani 3, 35128 Padova, Italy;
- Centre for Mechanics of Biological Materials, University of Padova, 35131 Padova, Italy; (V.M.); (A.P.); (R.B.-B.); (E.L.C.)
| | - Alice Berardo
- Department of Civil, Environmental and Architectural Engineering, University of Padova, 35131 Padova, Italy; (S.P.); (A.B.)
- Centre for Mechanics of Biological Materials, University of Padova, 35131 Padova, Italy; (V.M.); (A.P.); (R.B.-B.); (E.L.C.)
- Department of Biomedical Sciences, University of Padova, 35131 Padova, Italy
| | - Emanuele Luigi Carniel
- Centre for Mechanics of Biological Materials, University of Padova, 35131 Padova, Italy; (V.M.); (A.P.); (R.B.-B.); (E.L.C.)
- Department of Industrial Engineering, University of Padova, 35131 Padova, Italy
| | - Chiara Giulia Fontanella
- Centre for Mechanics of Biological Materials, University of Padova, 35131 Padova, Italy; (V.M.); (A.P.); (R.B.-B.); (E.L.C.)
- Department of Industrial Engineering, University of Padova, 35131 Padova, Italy
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Donatelli G, Emmi A, Costagli M, Cecchi P, Macchi V, Biagi L, Lancione M, Tosetti M, Porzionato A, De Caro R, Cosottini M. Brainstem anatomy with 7-T MRI: in vivo assessment and ex vivo comparison. Eur Radiol Exp 2023; 7:71. [PMID: 37968363 PMCID: PMC10651583 DOI: 10.1186/s41747-023-00389-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 09/01/2023] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND The brainstem contains grey matter nuclei and white matter tracts to be identified in clinical practice. The small size and the low contrast among them make their in vivo visualisation challenging using conventional magnetic resonance imaging (MRI) sequences at high magnetic field strengths. Combining higher spatial resolution, signal- and contrast-to-noise ratio and sensitivity to magnetic susceptibility (χ), susceptibility-weighted 7-T imaging could improve the assessment of brainstem anatomy. METHODS We acquired high-resolution 7-T MRI of the brainstem in a 46-year-old female healthy volunteer (using a three-dimensional multi-echo gradient-recalled-echo sequence; spatial resolution 0.3 × 0.3 × 1.2 mm3) and in a brainstem sample from a 48-year-old female body donor that was sectioned and stained. Images were visually assessed; nuclei and tracts were labelled and named according to the official nomenclature. RESULTS This in vivo imaging revealed structures usually evaluated through light microscopy, such as the accessory olivary nuclei, oculomotor nucleus and the medial longitudinal fasciculus. Some fibre tracts, such as the medial lemniscus, were visible for most of their course. Overall, in in vivo acquisitions, χ and frequency maps performed better than T2*-weighted imaging and allowed for the evaluation of a greater number of anatomical structures. All the structures identified in vivo were confirmed by the ex vivo imaging and histology. CONCLUSIONS The use of multi-echo GRE sequences at 7 T allowed the visualisation of brainstem structures that are not visible in detail at conventional magnetic field and opens new perspectives in the diagnostic and therapeutical approach to brain disorders. RELEVANCE STATEMENT In vivo MR imaging at UHF provides detailed anatomy of CNS substructures comparable to that obtained with histology. Anatomical details are fundamentals for diagnostic purposes but also to plan a direct targeting for a minimally invasive brain stimulation or ablation. KEY POINTS • The in vivo brainstem anatomy was explored with ultrahigh field MRI (7 T). • In vivo T2*-weighted magnitude, χ, and frequency images revealed many brainstem structures. • Ex vivo imaging and histology confirmed all the structures identified in vivo. • χ and frequency imaging revealed more brainstem structures than magnitude imaging.
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Affiliation(s)
- Graziella Donatelli
- Neuroradiology Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
- Imago7 Research Foundation, Pisa, Italy
| | - Aron Emmi
- Department of Neuroscience, Institute of Human Anatomy, University of Padua, Padua, Italy
- Center for Neurodegenerative Disease Research (CESNE), University of Padova, Padua, Italy
| | - Mauro Costagli
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Sciences (DINOGMI), University of Genoa, Genoa, Italy
- Laboratory of Medical Physics and Magnetic Resonance, IRCCS Stella Maris, Pisa, Italy
| | - Paolo Cecchi
- Neuroradiology Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
- Imago7 Research Foundation, Pisa, Italy
| | - Veronica Macchi
- Department of Neuroscience, Institute of Human Anatomy, University of Padua, Padua, Italy
- Center for Neurodegenerative Disease Research (CESNE), University of Padova, Padua, Italy
| | - Laura Biagi
- Laboratory of Medical Physics and Magnetic Resonance, IRCCS Stella Maris, Pisa, Italy
| | - Marta Lancione
- Laboratory of Medical Physics and Magnetic Resonance, IRCCS Stella Maris, Pisa, Italy
| | - Michela Tosetti
- Laboratory of Medical Physics and Magnetic Resonance, IRCCS Stella Maris, Pisa, Italy
| | - Andrea Porzionato
- Department of Neuroscience, Institute of Human Anatomy, University of Padua, Padua, Italy
- Center for Neurodegenerative Disease Research (CESNE), University of Padova, Padua, Italy
| | - Raffaele De Caro
- Department of Neuroscience, Institute of Human Anatomy, University of Padua, Padua, Italy
- Center for Neurodegenerative Disease Research (CESNE), University of Padova, Padua, Italy
| | - Mirco Cosottini
- Department of Translational Research On New Technologies in Medicine and Surgery, Neuroradiology Unit, University of Pisa, 56124, Pisa, Italy.
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Tsuge I, Mitsukawa N, Suzuki T, Akita S, Imai Y, Omori K, Morimoto N. Current ethical considerations of cadaver surgical training for Japanese plastic and reconstructive surgeons. J Plast Reconstr Aesthet Surg 2023; 84:276-278. [PMID: 37356304 DOI: 10.1016/j.bjps.2023.06.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 06/06/2023] [Accepted: 06/07/2023] [Indexed: 06/27/2023]
Affiliation(s)
- Itaru Tsuge
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
| | - Nobuyuki Mitsukawa
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Takane Suzuki
- Department of Bioenvironmental Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Shinsuke Akita
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yoshimichi Imai
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Koichi Omori
- Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Naoki Morimoto
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Bolino G, Fineschi V, Cecannecchia C, D'Antonio G, Frati P. The Practice of Teaching and Scientific Research on Cadaveric Material Remains Crucial for Medical Education. Clin Pract 2023; 13:1073-1081. [PMID: 37736931 PMCID: PMC10514866 DOI: 10.3390/clinpract13050095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 08/29/2023] [Accepted: 08/30/2023] [Indexed: 09/23/2023] Open
Abstract
The practice of teaching and scientific research on cadaveric material remains crucial for medical education, especially in surgical disciplines. However, in Italy, this practice has been neglected due to legislative insufficiency and financial constraints. Although innovative methods and tools like simulators and e-learning have been adopted, direct hands-on experience with human cadavers remains irreplaceable for medical and surgical education. The absence of clear legislation governing cadaveric dissection has limited availability for teaching and research, resulting in economic burdens for universities and individuals seeking proper surgical training. To address this issue, Law No. 10/2020 and the recent implementing decree were introduced in Italy, providing detailed legislation on the donation of bodies for educational and research purposes. The law emphasizes the importance of respecting the donor's specific choices and aligns with constitutional principles promoting culture, research, and health protection. However, some critical issues related to consent procedures, duration of body availability, and preservation of anatomical parts remain. Additionally, the law's dissemination among the population needs improvement. Future optimization could include allowing donors to choose the timing of body donation and considering different timeframes for body availability. Furthermore, the implementation of consent procedures could be simplified to increase donations. The law should also address the need for appropriate reception centers and allocate resources for effective dissemination. Despite these challenges, Law No. 10/2020 represents a significant step forward in enhancing medical-surgical training, scientific research, and the overall quality of patient care in Italy.
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Affiliation(s)
- Giorgio Bolino
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00161 Rome, Italy
| | - Vittorio Fineschi
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00161 Rome, Italy
| | - Camilla Cecannecchia
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00161 Rome, Italy
| | - Gianpiero D'Antonio
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00161 Rome, Italy
| | - Paola Frati
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00161 Rome, Italy
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Boscolo-Berto R, Macchi V, Tubbs RS, Emmi A, Stecco C, Loukas M, Porzionato A, De Caro R. The transversoclasiotome: a novel instrument for examining the vertebral artery. Forensic Sci Med Pathol 2023:10.1007/s12024-023-00638-x. [PMID: 37222901 DOI: 10.1007/s12024-023-00638-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2023] [Indexed: 05/25/2023]
Abstract
Opening the foramen transversarium of the cervical vertebrae is necessary for accessing the vertebral vessels. There are no specialist tools for cutting the anterior lamina of the transverse processes, and alternatives lead to questionable results. A novel tool, the transversoclasiotome, is described and tested. The literature and patent databases were systematically reviewed. A blueprint of the transversoclasiotome was created, and the prototype was tested through autopsy on ten fresh-frozen cadavers within our Body Donation Program. The transversoclasiotome consists of two delicate branches mounted as a scissor, one a cutting jaw and the other a knocker with a rounded tip, both angled 30° to the principal axis. The jaws shut, facing each other in parallel. The cutting jaw corresponds to a slit on the knocker profile without protruding beyond it even when entirely closed. It acts by cutting and wedging. The testing autopsies demonstrated its suitability for its purpose, with an adequate response to the pressure exerted on the bone lamina. The section cut cleanly, without sliding off while closing on the bone. The vertebral vessels were not injured either during instrument insertion or cutting. Their morphological features are described. The transversoclasiotome has been proven appropriate for sectioning the anterior lamina of transverse processes of the cervical vertebrae. It meets the needs of clinical anatomy in teaching and training clinicians or surgeons, forensic clinical anatomy during medico-legal investigation, and research.
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Affiliation(s)
- Rafael Boscolo-Berto
- Institute of Human Anatomy, Department of Neurosciences, University of Padova, Via A. Gabelli 65, 35127, Padua, Italy
- Veneto Region Reference Center for the Preservation and Use of Gifted Bodies, Veneto Region, Padua, Italy
- National Reference Center for the Preservation and Use of Gifted Bodies, Padua, Italy
| | - Veronica Macchi
- Institute of Human Anatomy, Department of Neurosciences, University of Padova, Via A. Gabelli 65, 35127, Padua, Italy
- Veneto Region Reference Center for the Preservation and Use of Gifted Bodies, Veneto Region, Padua, Italy
- National Reference Center for the Preservation and Use of Gifted Bodies, Padua, Italy
| | - R Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA
- Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA
- Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, LA, USA
- Department of Anatomical Sciences, St. George's University, St. George's, Grenada
| | - Aron Emmi
- Institute of Human Anatomy, Department of Neurosciences, University of Padova, Via A. Gabelli 65, 35127, Padua, Italy
- Veneto Region Reference Center for the Preservation and Use of Gifted Bodies, Veneto Region, Padua, Italy
- National Reference Center for the Preservation and Use of Gifted Bodies, Padua, Italy
| | - Carla Stecco
- Institute of Human Anatomy, Department of Neurosciences, University of Padova, Via A. Gabelli 65, 35127, Padua, Italy
- Veneto Region Reference Center for the Preservation and Use of Gifted Bodies, Veneto Region, Padua, Italy
- National Reference Center for the Preservation and Use of Gifted Bodies, Padua, Italy
| | - Marios Loukas
- Department of Anatomical Sciences, St. George's University, St. George's, Grenada
| | - Andrea Porzionato
- Institute of Human Anatomy, Department of Neurosciences, University of Padova, Via A. Gabelli 65, 35127, Padua, Italy
- Veneto Region Reference Center for the Preservation and Use of Gifted Bodies, Veneto Region, Padua, Italy
- National Reference Center for the Preservation and Use of Gifted Bodies, Padua, Italy
| | - Raffaele De Caro
- Institute of Human Anatomy, Department of Neurosciences, University of Padova, Via A. Gabelli 65, 35127, Padua, Italy.
- Veneto Region Reference Center for the Preservation and Use of Gifted Bodies, Veneto Region, Padua, Italy.
- National Reference Center for the Preservation and Use of Gifted Bodies, Padua, Italy.
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8
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Boscolo-Berto R, Porzionato A, Stecco C, Macchi V, De Caro R. Reference centers for tissue and body donations: Compulsory requirements in Italy. Clin Anat 2023; 36:465-470. [PMID: 36514860 DOI: 10.1002/ca.23990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 12/05/2022] [Accepted: 12/07/2022] [Indexed: 12/15/2022]
Abstract
Recent Italian legislation (Law No. 10/2020) establishes the legal, ethical and technical requirements governing how individuals can donate their bodies or tissues post-mortem for study, training, and scientific research purposes. A ministerial working group has recently approved some of the law's implementing rules relating to technical issues. The rules for implementing the new legislation, retrieved from the legal databases and translated into English, are discussed. For the first time in Italy, the law establishes compulsory requirements and minimum characteristics-in terms of logistics, safety, availability of staff, space, and equipment-for institutions to be recognized as reference centers for the conservation and use of bodies and tissues donated post-mortem for study, training and scientific research purposes. This makes it possible to standardize the features of such reference centers nationwide, and to coordinate their activities and potential future development, while ensuring basic operational efficiency and workplace safety, the provision of adequate facilities, buildings and equipment, and staff training. The law and its implementing rules discussed here are the first to establish criteria and compulsory requirements for centers receiving body and tissue donations in Italy. This is a step forward for the whole anatomy community, providing practical guidelines for body donation programs and related facilities in other countries too.
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Affiliation(s)
- Rafael Boscolo-Berto
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy.,Veneto Region Reference Center for the Preservation and Use of Gifted Bodies, Padova, Veneto Region, Italy.,National Reference Center for the Preservation and Use of Gifted Bodies, Padova, Italy
| | - Andrea Porzionato
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy.,Veneto Region Reference Center for the Preservation and Use of Gifted Bodies, Padova, Veneto Region, Italy.,National Reference Center for the Preservation and Use of Gifted Bodies, Padova, Italy
| | - Carla Stecco
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy.,Veneto Region Reference Center for the Preservation and Use of Gifted Bodies, Padova, Veneto Region, Italy.,National Reference Center for the Preservation and Use of Gifted Bodies, Padova, Italy
| | - Veronica Macchi
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy.,Veneto Region Reference Center for the Preservation and Use of Gifted Bodies, Padova, Veneto Region, Italy.,National Reference Center for the Preservation and Use of Gifted Bodies, Padova, Italy
| | - Raffaele De Caro
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy.,Veneto Region Reference Center for the Preservation and Use of Gifted Bodies, Padova, Veneto Region, Italy.,National Reference Center for the Preservation and Use of Gifted Bodies, Padova, Italy
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Fava A, Gorgoglione N, De Angelis M, Esposito V, di Russo P. Key role of microsurgical dissections on cadaveric specimens in neurosurgical training: Setting up a new research anatomical laboratory and defining neuroanatomical milestones. Front Surg 2023; 10:1145881. [PMID: 36969758 PMCID: PMC10033783 DOI: 10.3389/fsurg.2023.1145881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 02/13/2023] [Indexed: 03/12/2023] Open
Abstract
IntroductionNeurosurgery is one of the most complex surgical disciplines where psychomotor skills and deep anatomical and neurological knowledge find their maximum expression. A long period of preparation is necessary to acquire a solid theoretical background and technical skills, improve manual dexterity and visuospatial ability, and try and refine surgical techniques. Moreover, both studying and surgical practice are necessary to deeply understand neuroanatomy, the relationships between structures, and the three-dimensional (3D) orientation that is the core of neurosurgeons' preparation. For all these reasons, a microsurgical neuroanatomy laboratory with human cadaveric specimens results in a unique and irreplaceable training tool that allows the reproduction of patients' positions, 3D anatomy, tissues' consistencies, and step-by-step surgical procedures almost identical to the real ones.MethodsWe describe our experience in setting up a new microsurgical neuroanatomy lab (IRCCS Neuromed, Pozzilli, Italy), focusing on the development of training activity programs and microsurgical milestones useful to train the next generation of surgeons. All the required materials and instruments were listed.ResultsSix competency levels were designed according to the year of residency, with training exercises and procedures defined for each competency level: (1) soft tissue dissections, bone drilling, and microsurgical suturing; (2) basic craniotomies and neurovascular anatomy; (3) white matter dissection; (4) skull base transcranial approaches; (5) endoscopic approaches; and (6) microanastomosis. A checklist with the milestones was provided.DiscussionMicrosurgical dissection of human cadaveric specimens is the optimal way to learn and train on neuroanatomy and neurosurgical procedures before performing them safely in the operating room. We provided a “neurosurgery booklet” with progressive milestones for neurosurgical residents. This step-by-step program may improve the quality of training and guarantee equal skill acquisition across countries. We believe that more efforts should be made to create new microsurgical laboratories, popularize the importance of body donation, and establish a network between universities and laboratories to introduce a compulsory operative training program.
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Affiliation(s)
- Arianna Fava
- Department of Neurosurgery, IRCCS Neuromed, Pozzilli, Italy
- Department of Neuroscience, Sapienza University, Rome, Italy
- Correspondence: Arianna Fava
| | | | | | - Vincenzo Esposito
- Department of Neurosurgery, IRCCS Neuromed, Pozzilli, Italy
- Department of Neuroscience, Sapienza University, Rome, Italy
| | - Paolo di Russo
- Department of Neurosurgery, IRCCS Neuromed, Pozzilli, Italy
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De Stefano A, Rusciano I, Moretti V, Scavarda A, Green MJ, Wall S, Ratti S. Graphic medicine meets human anatomy: The potential role of comics in raising whole body donation awareness in Italy and beyond. A pilot study. Anat Sci Educ 2023; 16:209-223. [PMID: 36346170 DOI: 10.1002/ase.2232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 08/22/2022] [Accepted: 10/03/2022] [Indexed: 06/16/2023]
Abstract
Cadaver dissection has always played a fundamental role in medical education. However, especially in Italy, the topic of body donation has remained partially unknown for years. The current study analyses graphic medicine as a new possible communication tool, evaluating and reflecting, with second-year students enrolled in the International School of Medicine and Surgery at the University of Bologna, about its potentialities for body donation awareness-raising in both the scientific community and the general population. For the first time in an Italian University, two graphic medicine workshops were organized focusing on human anatomy and body donation. Seminars were positively evaluated by students using a four items Likert-scale question: mean 3.54 (± SD 0.73) for the Likert question about the experiences of the workshops; 3.88 (± 0.33) for the Likert question regarding the use of graphic medicine in body donation awareness campaigns among the general population; 3.59 (± 0.65) for the Likert question regarding the use of graphic medicine in body donation awareness campaigns among the scientific community. Furthermore, the open-ended questions included in the anonymous questionnaire were analyzed using the constructivist grounded qualitative analysis, whence various themes emerged. Finally, five graphic medicine projects about body donation were created by students, proving their interest in testing this method to promote body donation, focusing the attention on different communicative aspects. Considering the results of this pilot study, the co-creative collaborative use of graphic medicine could be evaluated as an additional strategy to increase body donation awareness-raising in Italy and beyond, especially in the non-experts' community.
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Affiliation(s)
- Alessia De Stefano
- Cellular Signalling Laboratory, Anatomy Centre, Department of Biomedical and NeuroMotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | - Isabella Rusciano
- Cellular Signalling Laboratory, Anatomy Centre, Department of Biomedical and NeuroMotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | - Veronica Moretti
- Department of Sociology and Business Law, University of Bologna, Bologna, Italy
| | - Alice Scavarda
- Department of Culture, Politics and Society, University of Torino, Torino, Italy
| | - Michael J Green
- Department of Humanities, Penn State College of Medicine, Hershey, Pennsylvania, USA
- Department of Internal Medicine, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Shelley Wall
- Biomedical Communications Graduate Program, Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Biology, University of Toronto Mississauga, Mississauga, Ontario, Canada
| | - Stefano Ratti
- Cellular Signalling Laboratory, Anatomy Centre, Department of Biomedical and NeuroMotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
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Suzuki T, Shichinohe T, Kobayashi E. Cadaver surgical training of orthopedic surgery during the SARS-CoV-2 pandemic in Japan. J Orthop Sci 2023; 28:280-281. [PMID: 36437151 PMCID: PMC9659510 DOI: 10.1016/j.jos.2022.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/27/2022] [Accepted: 11/02/2022] [Indexed: 11/16/2022]
Affiliation(s)
- Takane Suzuki
- Department of Bioenvironmental Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670 Japan
| | - Toshiaki Shichinohe
- Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Eiji Kobayashi
- Department of Kidney Regenerative Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan,Corresponding author. Department of Kidney Regenerative Medicine, Industry-Academia Collaborative Department, The Jikei University School of Medicine. 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
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Boulos AN. Evaluation of the effectiveness of online education in anatomy for medical students during the COVID-19 pandemic. Ann Anat 2022; 244:151973. [PMID: 35738314 PMCID: PMC9212768 DOI: 10.1016/j.aanat.2022.151973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 05/21/2022] [Accepted: 06/08/2022] [Indexed: 11/05/2022]
Abstract
Background In the field of medicine, anatomy is considered one of the most important subjects to be studied in college, even for clinicians. Learning from cadaveric specimens is considered an important part of the medical experience. The current study consisted of a questionnaire given to Year 1 and Year 2 medical students. This study was performed to assess using a questionnaire whether students were capable of continuing studying Anatomy during the COVID-19 period. Methods The study consisted of 102 students in Years 1 and 2 of the Faculty of Medicine of Alexandria University in Egypt. It included Year 1 Students (mean age 18.6 ± 1.1 years old; 21 males and 36 females), and Year 2 Students (mean age 20.4 ± 1.0 years old; 22 males and 23 females). The survey consisted of three sections. The first section consisted of four questions on the demographic data of the participating students. The second section consisted of 10 questions concerning their satisfaction with the tutorials and presented by the Department of Anatomy. Answers to the questionnaire were in the form of a Likert scale (with 1 = strongly disagree to 5 = strongly agree). Results The students disagreed with the fact that they found difficulty in time management, represented by a mean score of 2.23 ± 1.14. That is to say, the students were capable of managing their time well. Here also, the difference between Year 1 and Year 2 students was significant (p = 0.028), which is an indicator that Year 2 students found more difficulty in time management. Most students agreed (mean score of 3.48 ± 1.07) that they were able to handle online learning and the transition between the systems was acceptable. Students were also convinced and agreed that the methods used by the college limited the spread of COVID-19 (mean score of 3.81 ± 1.04). Allowing assignments and projects increased the interaction between the students and the staff members. Conclusions Education must continue during the COVID-19 period, based on their responses and opinions in the questionnaire. Online learning proved to be effective in teaching medical students during the COVID-19 pandemic.
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Affiliation(s)
- Atef N Boulos
- Department of Anatomy and Embryology, Faculty of Medicine, University of Alexandria, Egypt.
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Suzuki T, Suzuki-Narita M, Kubota K, Mori C. Updates on cadaver surgical training in Japan: a systematic facility at Chiba University. Anat Sci Int 2022; 97:251-263. [PMID: 35522373 PMCID: PMC9073481 DOI: 10.1007/s12565-022-00667-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 04/11/2022] [Indexed: 11/21/2022]
Abstract
Cadaver surgical training (CST), which ensures medical safety by improving the skills of surgeons, is popular overseas. However, training involves ethical issues given the use of cadavers. In 2012, the Japan Surgical Society and the Japanese Association of Anatomists compiled and opened the “Guidelines for Cadaver Dissection in Education and Research of Clinical Medicine (Guideline 2012)” to the public. This has allowed Japan to conduct CST or research under the regulations of Postmortem Examination and Corpse Preservation Act and the Body Donation Act. However, its dissemination has been sluggish. The Clinical Anatomy Lab (CAL), established in 2010 at Chiba University, is a facility for conducting CST and research. In the 11 years since its inception, 250 programs have been implemented. Orthopedics had the most implemented in the clinical field, with 120 (48%), followed by emergency and critical care medicine with 27 (10.8%), and neurological surgery with 27 (10. 8%). Based on the purpose of the training, the most common objective for the programs (approximately 83%) was education. Further, the highest number of programs was recorded in 2018 (34) and participants in 2017 (631). The implementation of CST requires more than just guiding surgeons to a dissection practice room. There are several methods of preserving cadavers to make them suitable for CST. For various surgical simulations, an operating table is more suitable than a dissection table. The current paper provides information on how to implement CST in universities that have so far only worked on anatomy education for medical students.
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Affiliation(s)
- Takane Suzuki
- Department of Bioenvironmental Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.
| | - Miyako Suzuki-Narita
- Department of Bioenvironmental Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Kenji Kubota
- Department of Bioenvironmental Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Chisato Mori
- Department of Bioenvironmental Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
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Pistilli R, Bonifazi L, Barausse C, Ruggeri A, Covelli M, Karaban M, Felice P. An Ancient Science to Improve Today's Clinical Practice: Oral Surgery Meets Human Anatomy. Int J Environ Res Public Health 2021; 18:11915. [PMID: 34831673 DOI: 10.3390/ijerph182211915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/09/2021] [Accepted: 11/09/2021] [Indexed: 11/28/2022]
Abstract
Human body dissection was a ubiquitous practice in the past, to better understand anatomy and to develop medicine. Today, its role could still be important to answer everyday clinical queries and help surgeons. The example of the possible lack of anesthesia during symphysis surgeries can emphasize the usefulness of dissection. The mandibular symphysis usually receives innervation from inferior alveolar nerve terminations, but, in some rare cases, a particular anastomosis involves the lingual nerve and the nerve to the mylohyoid. The anatomical knowledge resulting from body dissections could help oral surgeons to understand the reason why the patient could feel pain during the surgery, and ensure performance of the right lingual nerve block to obtain complete anesthesia. This clinical situation shows the educational role of an ancient, yet still valid, practice, human dissection, and the importance of anatomical studies to improve surgical skills, to provide better treatment for the patient.
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