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Background: There is no consensus regarding age-related facial anatomical changes. In this study, aging-related changes in soft and hard cheek tissues were quantitatively analyzed using computed tomography. Methods: We performed a retrospective study of 90 Asian females who underwent facial computed tomography. Three-dimensional model of soft tissue in apple zone was reconstructed, and age-related changes in fat volume and pyriform aperture area were quantified using Mimics software. Results: The apple zone is an aesthetic unit of the infraorbital cheek, with soft tissue located between the lateral wall of the pyriform aperture and the zygomatic major muscle. The superficial fat volume significantly decreased with age (P < 0.05). In contrast, a significant decrease in total fat volume was only observed between the young and old groups (P < 0.05). In linear regression modeling, age was a significant predictor of pyriform aperture area (R2 = 0.194, P < 0.001). Conclusions: These results suggest that superficial fat atrophy and bone remodeling in the cheek with age, and both of which combine to contribute to an aging facial appearance. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. [ABSTRACT FROM AUTHOR]

Objectives: A deep knowledge of the surgical anatomy of the target area is mandatory for a successful operative procedure. For this purpose, over the years, many teaching and learning methods have been described, from the most ancient cadaveric dissection to the most recent virtual reality, each with their respective pros and cons. Photogrammetry, an emergent technique, allows for the creation of three-dimensional (3D) models and reconstructions. Thanks to the spreading of photogrammetry nowadays it is possible to generate these models using professional software or even smartphone apps. This study aims to compare the neuroanatomical photogrammetric models generated by the two most utilized smartphone applications in this domain, Metascan and 3D-Scanner, through quantitative analysis. Methods: Two human head specimens (four sides) were examined. Anatomical dissection was segmented into five stages to systematically expose well-defined structures. After each stage, a photogrammetric model was generated using two prominent smartphone applications. These models were then subjected to both quantitative and qualitative analysis, with a specific focus on comparing the mesh density as a measure of model resolution and accuracy. Appropriate consent was obtained for the publication of the cadaver's image. Results: The quantitative analysis revealed that the models generated by Metascan app consistently demonstrated superior mesh density compared to those from 3D-Scanner, indicating a higher level of detail and potential for precise anatomical representation. Conclusion: Enabling depth perception, capturing high-quality images, offering flexibility in viewpoints: photogrammetry provides researchers with unprecedented opportunities to explore and understand the intricate and magnificent structure of the brain. However, it is of paramount importance to develop and apply rigorous quality control systems to ensure data integrity and reliability of findings in neurological research. This study has demonstrated the superiority of Metascan in processing photogrammetric models for neuroanatomical studies. [ABSTRACT FROM AUTHOR]

Withania (Solanaceae, Solanoideae) is a widespread genus. Comparative macro-, micro-morphological, anatomical, and molecular features of this genus in Egypt were examined using light and scanning electron microscopy to reassess the conflicted taxonomic relationships between the two studied species. The most significant morphological differences that have been found were: the shape of the lamina, apex, anther, and stigma, and the ratio of calyx tube/lobe; anatomical examination of taxonomic interest are as follows: number of vascular bundles, presence of ears and distribution of accessory vascular bundles in petiole and shape of spongy cells, and number of lower parenchyma in the midrib region of the leaf; trichomes of both species showed no significant differences; pollen, and seed characters are of taxonomic significance in differentiation and characterization between them. Protein profiling revealed that W. somnifera has only conserved proteins, while W. obtusifolia possessed both conserved and additional proteins in their SDS-PAGE banding patterns. Eleven starts codon-targeted (ScoT) primers were applied and produced 96 amplicons with an average of 70.83% polymorphism/primer. W. obtusifolia generated more polymorphic bands and maintained monomorphic ones. SDS-PAGE disclosed that both Withania species were 50% related. While Scot-Dendrogram revealed that both Withania species were poorly related. So, protein and molecular analyses showed considerable genetic variations between these two species. [ABSTRACT FROM AUTHOR]

Studies on the muscular-deep fascial system which connects the upper eyelid, brow, and glabella, are lacking. This study aimed to explore the fine anatomy of the muscular-deep fascial system in the region between the eyebrow and the superior orbital margin. We included eight formalin–phenol-embalmed cadavers (16 sides of specimens), and categorized them into anatomical dissections and histological sections. Five cadavers (10 sides) were dissected for gross anatomical observation, whereas all soft tissues of the other three cadavers (6 sides) were dissected for tissue sectioning and histological analysis. Three tissue blocks and 16 strips in each block were trimmed, numbered, and sliced into these specimens. Hematoxylin–Eosin and Masson's Trichrome staining were performed. In the region between the eyebrow and the superior orbital margin, the frontalis was covered by the orbicularis oculi. Fibers of the frontalis muscle penetrated into the orbicularis oculi muscle bundles, and crosslinked around the eyebrow level. Both the frontalis and the orbicularis oculi were attached to the thickened multilayered deep fascia in this region, which could be regarded as the muscular-deep fascial system. The muscular-deep fascial system connects the frontalis deep fascia and deep forehead compartments down to the orbicularis-supporting ligament. The precise anatomy of the muscular-deep fascial system in the region between the eyebrow and the superior orbital margin may provide a valuable reference for soft-tissue fixation and suspension in facial surgery. [ABSTRACT FROM AUTHOR]

We here describe abundant new fossil material of amphibians and reptiles from different late Neogene localities of northern Greece: the Early Pliocene (MN 14) of Spilia 0, Spilia 1, and Spilia 2; the Early Pliocene (MN 15) of Spilia 3, Spilia 4, Spilia 5, and Vevi; and the Late Miocene or Pliocene of Chalicorrema and Rema Marmara. These new late Neogene herpetofaunas are highly diverse, documenting a considerably rich herpetofauna allowing the identification of at least two salamander, seven frog, two turtle, seven lizard, and eight snake taxa. Salamanders are represented by the salamandrid genera Ommatotriton and Ichthyosaura. Frogs are represented by the bombinatorid Bombina, the discoglossids Latonia cf. ragei and Latonia sp., the pelobatid Pelobates aff. praefuscus and Pelobates sp., the ranids Pelophylax and Rana cf. dalmatina, the hylid Hyla gr. arborea, and the bufonid Bufotes gr. viridis. Turtles are represented by the emydid Emys and an indeterminate geoemydid. Lizards are represented by the scincid Ophiomorus, two lacertids (one of which potentially pertaining to Lacerta), amphisbaenians, agamids, the anguid Pseudopus, and a potential varanid. Snakes are represented by the erycid Eryx, the natricid Natrix aff. rudabanyaensis, a small-sized elapid, an "Oriental viper", the colubriforms Periergophis and Paraxenophis, as well as two further distinct but still indeterminate morphotypes of colubriforms. For the material from Spilia tentatively referred to Ommatotriton, this is only the third occurrence in the fossil record globally. The new material of Ichthyosaura and Bombina mark the first documentation of these genera in the Greek fossil record. Abundant cranial and postcranial material from Spilia is tentatively referred to Latonia ragei, a taxon previously known from the Early Miocene of Western Europe. The new record of Pelobates represents the oldest documented occurrences of the genus in the Greek fossil record. Interestingly, the Pelobates from Spilia bears much resemblance to an extinct taxon, Pelobates aff. praefuscus, which is otherwise known from the Late Miocene of the Caucasus, and not to the extant species that currently inhabits the area. The identification of Pelophylax and Rana adds to the rather poor Neogene record of ranids from Greece. Particularly for the case of Rana cf. dalmatina from Spilia 4, this corresponds to the only documented occurrence of this extant taxon in the Greek fossil record. Similarly, the identification of Hyla gr. arborea in Spilia 1, Spilia 3, and Spilia 4, marks only the third documented occurrence of this genus in the Greek fossil record. The Bufotes material from Spilia 1, Spilia 3, and Spilia 4 represents the first documented fossil occurrence of the extant Bufotes viridis complex in Greece. The material of Emys gr. orbicularis from Vevi marks the only known pre-Quaternary record of the genus in Greece and one of the only few Neogene members of the genus known from Europe. The scincid Ophiomorus is identified in Spilia 4, known from several cranial and postcranial remains, well outside the extant range of the genus. Practically, the Spilia Ophiomorus is only the fourth known fossil occurrence of this extant genus globally and also represents one of its oldest known occurrences. Material from Spilia 1 and Spilia 3 is tentatively referred to cf. Lacerta sp., and this would mark the first known occurrence of this emblematic extant genus in the Greek fossil record, denoting the presence of the genus since at least the Early Pliocene. The new amphisbaenian specimens from Spilia 4 add to the recently described single vertebra from the same locality, and represent the youngest occurrence of amphisbaenians from continental Eastern Europe. The new agamid material from Vevi and Chalicorrema add substantially to the record of this group, which was in Greece so far known exclusively from the latest Miocene/earliest Pliocene of Maramena. A similarly important addition is the record of Pseudopus from Spilia 4, as this genus had been known in the Greek fossil record only from a very few localities. The potential varanid from Spilia represents one of the few Pliocene occurrences of this group in Europe. We identify Natrix aff. rudabanyaensis among the material from Spilia 0, Spilia 4, and Vevi, adding to the previously known record of this taxon from Maramena, however, its precise species level assignment should await a revision of Neogene European Natrix spp. The find of a small elapid from Spilia 4 represents the youngest occurrence of a coral snake from Europe, extending their statigraphic range up to the Early Pliocene (MN 14). Periergophis and Paraxenophis, two bizarre snakes, so far exclusively known from their type locality in Maramena, could be also present here, even if tentatively identified. Most notably, the new material from these localities comprises forms that are now extinct (e.g., Periergophis and Paraxenophis) or extirpated from Europe (e.g., Latonia, Varanidae, Elapidae) but at the same time also loudly attests the emergence of the extant genera that dominate the extant herpetofaunas of Greece (Ichthyosaura, Bombina, Pelobates, Pelophylax, Rana, Hyla, Bufotes, Emys, Ophiomorus, Lacerta, Pseudopus, Eryx, and Natrix), for some of which their fossil record is documented here for the first time in the area. [ABSTRACT FROM AUTHOR]

Lateral lumbar interbody fusion (LLIF), developed by Dr. Luiz Pimenta in 2006, allows access to the spinal column through the psoas major muscle. The technique has many advantages, such as reduced bone and muscular tissue damage, indirect decompression, larger implants, and lordosis correction capabilities. However, this technique also has drawbacks, with the most notorious being the risk of spinal pathologies due to indirect injury of the lumbar plexus, but with low rates of persistent injuries. Therefore, several groups have proposed classifications to help identify patients at a greater risk of presenting with neurological deficits. The present work proposes a classification system that relies on simple observation of easily identifiable key structures to guide lateral L4-L5 LLIF decision-making. Patients aged > 18 years who underwent preoperative magnetic resonance imaging (MRI) between 2022 and 2023 were included until 50 high-quality images were acquired. And excluded as follow Anatomical changes in the vertebral body or major psoas muscles prevent the identification of key structures or poor-quality MRIs. Each anatomy was classified as type I, type II, or type III according to the consensus among the three observers. Fifty anatomical sites were included in this study. 70% of the L4-L5 anatomy were type I, 18% were type II, and 12% were type III. None of the type 3 L4-L5 anatomies were approached using a lateral technique. The proposed classification is an easy and simple method for evaluating the feasibility of a lateral approach to–L4-L5. [ABSTRACT FROM AUTHOR]

Purpose: Videos and images are becoming an educational tool in every domain. The objective was to assess the contribution of short educational endoscopic videos in learning the complex anatomy of the tympanic cavity. Methods: We conducted a prospective study amongst all the otolaryngology residents in 2021 in the greater Paris area (n = 74), from the first year to fifth year. We divided the residents into two groups who had the same 30-min anatomy class based on anatomical drawings. The second group had a 4-min endoscopic educational video at the end, whereas the first group did not. A video test of 10 surgical situations with each time 5 anatomic structures to identify was created. All the residents took the test just after the class, and 1 month later to assess long-term memory. The MERSQI score (design to assess the quality of educational studies) applied to our study was calculated. Results: The two groups were comparable in terms of training. The "video" group had significantly better results in the first test, mean score 24.40/50 (± 11.7) versus 16.74/50 (± 11.1) (p = 0.005) and also at 1 month, mean score 23.25/50 (± 12.3) versus 18.01/50 (± 11.3) (p = 0.035). The score in each group, and the difference between both groups, increased with resident seniority. The MERSQI score of our study was 14.5/18. Conclusion: This study highlights the educational value of videos to help memorise complex 3D anatomy such as in the tympanic cavity. [ABSTRACT FROM AUTHOR]

Fish biologists have long assumed a link between intestinal length and diet, and relative gut length or Zihler's index are often used to classify species into trophic groups. This has been done for specific fish taxa or specific ecosystems, but not for a global fish dataset. Here, we assess these relationships across a dataset of 468 fish species (254 marine, 191 freshwater, and 23 that occupy both habitats) in relation to body mass and fish length. Herbivores had significantly relatively stouter bodies and longer intestines than omni- and faunivores. Among faunivores, corallivores had longer intestines than invertivores, with piscivores having the shortest. There were no detectable differences between herbivore groups, possibly due to insufficient understanding of herbivorous fish diets. We propose that reasons for long intestines in fish include (i) difficult-to-digest items that require a symbiotic microbiome, and (ii) the dilution of easily digestible compounds with indigestible material (e.g., sand, wood, exoskeleton). Intestinal indices differed significantly between dietary groups, but there was substantial group overlap. Counter-intuitively, in the largest dataset, marine species had significantly shorter intestines than freshwater fish. These results put fish together with mammals as vertebrate taxa with clear convergence in intestine length in association with trophic level, in contrast to reptiles and birds, even if the peculiar feeding ecology of herbivorous fish is probably more varied than that of mammalian herbivores. [ABSTRACT FROM AUTHOR]

Purpose: The nasal foramen is located in the nasal bone and for vessels passage to supply the nasal area. This project aimed to establish reliable references for the nasal foramina for future clinical applications. Methods: The 72 dried skulls, 46 from the Division of Anatomy, University of Phayao, Thailand, and 26 from the Tulane University School of Medicine, USA, were collected and examined. The location, number, and sizes of nasal foramina were noted. The distances from each nasal foramen to the internasal suture, frontonasal suture, nasomaxillary suture, nasion, and rhinion were also recorded and used in the statistical analytical programs. Results: The most common type of nasal foramen in all skulls was type II (one external opening) at 65.97%, followed by type I (no foramen opening) at 20.83%, type III (two external openings) at 11.11% and type IV at 2.08% (three external openings). Nasal foramen subtypes in many of the Thai and American skulls were type IIb and type IIa. The diameter of a connecting nasal foramen was significantly larger than that of a non-connecting. Results from embalmed confirmed the passage of the external nasal artery through the nasal cavity. Conclusion: The study shows no significant difference in nasal foramen morphometry between Thai and American. It illustrates recent data on type and subtype classifications and the location of a vascular passage through the nasal foramen. This is the first study of NF variations and their respective classifications. [ABSTRACT FROM AUTHOR]

Introduction: The current study, which delves into proximal tibia morphometric parameters in a Greek sample, not only analyzes whether specific linear distance ratios are consistent but also paves the way for a potential novel metric system for knee arthroplasty imaging studies using constant ratios. These findings could have significant implications for future enlarged research and clinical practice. Methods: A total of 38 dried tibiae were evaluated by two independent investigators. The following distances were measured with a digital Vernier sliding caliper: (1) the mediolateral distance of the proximal surface (A), (2) the anteroposterior distance of the proximal surface (B), (3) The longitudinal length of the bone (C), (4) the line connecting the anterior margin of the proximal surface with the highest peak of the tibia tuberosity (D), (5) the depth of the proximal margin of the medial articular facet (AF) (medial plateau) (E) and (6) the depth of the proximal margin of the lateral AF (lateral plateau) (F). Results: The A, B, C, D, E, and F mean distances were 71.3 mm, 47.4 mm, 340.2 mm, 37.1 mm, 42 mm, and 35.9 mm. Reliability analysis for each observer on all measurements revealed an interclass correlation (ICC) score of 0.975 (observer 1) and 0.971 (observer 2). The ratio A/B was 1.5, A/C was a constant 0.2, and D/C was 0.1. The ratio E/F was 1.2. The six measurements (A-F) showed excellent inter-observer reliability (all ICC values > 0.990). Conclusions: The study established constant ratios of the studied linear distances around the proximal tibia. Considering these ratios, asymmetrical tibial components in knee arthroplasty seem to replicate the native anatomy more closely. Furthermore, the distance from the anterior margin of the proximal surface to the tibial tuberosity peak, constituting one-tenth of the longitudinal length of the tibia, shows promise as a metric system for imaging studies, especially in assessing lesions around tibial components. [ABSTRACT FROM AUTHOR]

Purpose: A deep knowledge of the variations of the posterior forearm musculature is crucial for assessing and diagnosing conditions in this region. Extensor indicis (EI) is one of the muscles in this region, which exhibits diverse anatomical variations. This report documents an extremely unusual form of the EI with an accessory head on the dorsum of the hand. Methods: During routine dissection, an extremely rare presentation of the EI was found in the left forearm of a 94-year-old female cadaver. Results: This unusual EI consisted of two muscle bellies. The traditional belly originated from the distal two-thirds of the ulna. The muscle became tendinous around the carpal area, distal to the extensor retinaculum. The tendon was subsequently joined by an accessory muscle belly originating from the distal radioulnar ligament. The EI tendon inserted onto the dorsal expansion of the index finger, ulnar to that of the extensor digitorum. The posterior interosseous nerve innervated the muscle. Conclusion: Herein, we report an extremely rare form of the EI. To our knowledge, EI with an accessory head has only been reported rarely over the past 200 years. Moreover, our report appears to be the first case with photographic details of this anatomical variation. Clinicians should be aware of this variation for proper diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study is to determine if ultrasound (US) allows a precise assessment of the paratenon (PT) of the Achilles calcaneal tendon (AT), and to anatomically describe the US-guided paratendinous injection technique. Methods: This study was initially conducted on eight cadaveric specimens using high-resolution ultrasound (HRUS) to examine the PT appearance, thickness, and its relationships with the AT, plantaris tendon (PLT), Kager's fat pad (KFP), sural nerve (SN), and fascia cruris (FC). US-guided paratendinous injection of China ink was performed in all specimens, followed by anatomical dissection to assess injectate distribution. Then, HRUS study of the PT was carried out bilaterally in twenty asymptomatic volunteers (40 legs). Two musculoskeletal radiologists recorded all data in consensus except PT thickness in volunteers which was recorded independently in order to calculate intra and inter-observer reliability. Results: The PT was consistently identified with HRUS along its entire course in both cadaveric specimens (8/8) and volunteers (40/40). The mean PT thickness was 0.54 mm in cadavers and 0.39 mm in vivo, without any correlation with the AT thickness. Intra- and inter observer reliability were respectively excellent and good for PT thickness. All eight (100%) ex vivo China ink injections were accurate, demonstrating a circumferential distribution of the injectate between the PT and the AT, associated with an anterior spread to the KFP. Conclusion: HRUS allows visualization of the PT along its entire length, and assessment of its relationships to adjacent structures. US-guided paratendinous injections can accurately and safely deliver injectates in the paratendinous sheath. [ABSTRACT FROM AUTHOR]

Purpose: The current systematic review with meta-analysis aimed to investigate the pooled prevalence of the superior thyroid artery (STA) pattern of origin (distinct or fused-common origin with adjacent arteries in the form of a common trunk). The standard and uncommon variants were also studied, considering the STA's exact surface of origin and the relationship with the upper border of the thyroid cartilage (TC, reference point), considering the laterality effect. Thus, the STA topographical anatomy was considered. Methods: An evidence-based systematic review with meta-analysis was performed according to the PRISMA 2020 guidelines. A literature search was conducted in four online databases using specific keywords, the pooled prevalence was calculated using statistical analysis in the R programming language, and multiple subgroup analyses were performed. Results: The most common distinct origin of the STA was from the external carotid artery (ECA) (56.94% pooled prevalence, 95%CI: 50.89–62.89), and the rarest one was from the internal carotid artery (ICA) (< 0.01%, 95%CI: 0.00–0.00). Common trunks were also investigated, with the thyrolingual trunk emanating from the ECA estimated at 0.61% (95%CI: 0.21–1.14), representing the most common. Subgroup analysis based on the nationality, type of study, and sample size, as well as a comparison between left and right sides and males and females, were investigated. Conclusions: The most common STA origin was estimated as the ECA, the medial surface of origin, and above the TC upper border. Adequate knowledge of STA origin is paramount for surgeons, especially during thyroidectomy, not to cause iatrogenic injury to the external branch of the superior laryngeal nerve. [ABSTRACT FROM AUTHOR]

The occipital artery (OA) typically originates from the external carotid artery (ECA). Variations of the ECA has been well described in the current literature, while the OA is a relatively stable vessel, and its variations are uncommon. In the current case report, an aberrant OA has been found coexisting with a linguofacial trunk (LFT) on the right hemineck of a 51-year-old male patient. The OA was identified originating from the cervical internal carotid artery (ICA) at the level of the second cervical vertebra (C2). On the ECA, the lingual and facial arteries were emanating in common, as LFT. The left hemineck of the patient was free of variations. The current coexistence of arterial variants has been reported only once previously; therefore, the current case corresponds to the second case in the English literature. The aberrant OA origin from the ICA has been estimated with a pooled prevalence of 0.37%, while the origin at the C2 level and from the anterior surface of the ICA corresponds to a very rare variation. Additionally, the LFT is one of the most common trunk that can be found on the ECA. Interventional radiologists and surgeons must be aware of common and uncommon variation to avoid iatrogenic lesion. [ABSTRACT FROM AUTHOR]

Introduction: The facial canal (FC) is an extensive bony canal that houses the facial nerve and occupies a central position in the petrous part of temporal bone. It is of utmost significance to otologists due to its dehiscence and relationship to the inner or middle ear components. The main objectives of current investigation are to detect variations in the reported values ​​of FC anatomy that may occur due to different methodology and to elucidate the influence of age and ethnic factors on the morphological features of FC. Methods: The methodology is adapted to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Pooled weighted estimation was performed to calculate the mean length, angle, and prevalence of dehiscence. Results: The cross-sectional shape of FC varied from circular to ellipsoid index and is 1.45 [95% CI, 0.86–2.6]. The mean length of the FC is 34.42 mm [95% CI, 27.62–40.13 mm] and the mean width or diameter is 1.35 mm [95% CI, 1.013–1.63 mm]. The length of the FC in fetuses and children is 21.79 mm [95% CI, 18.44–25.15 mm], and 26.92 mm [95% CI, 23.3–28.3 mm], respectively. In meta-regression, age is observed as a predictor and accounts for 36% of the heterogeneity. The prevalence of FC dehiscence in healthy temporal bones is 29% [95% CI, 20–40%]. Conclusion: The different segments of the FC exhibit significant variability and an unusually high incidence of dehiscence, which could potentially have clinical implications for the etiopathogenesis of facial nerve dysfunction. [ABSTRACT FROM AUTHOR]

Purpose: This study shows the danger zone and the safety corridor in the lateral approach with bridge plating by measuring the distance between the lateral side of the plate positioned on the lateral aspect of the humerus and the radial nerve after it pierces the lateral intermuscular septum, in the different forearm positions. Methods: Forty arms of 20 human cadavers were used, the radial nerve was identified and marked on the lateral surface the radial nerve at the exit of the lateral intermuscular septum and anteriorisation of the nerve in relation to the humeral shaft and the lateral epicondyle was also marked. The distances were measured with a digital caliper. A submuscular extraperiosteal corridor was created, proximally between the biceps brachialis and deltoid muscle and distally between the triceps and brachioradialis muscle, followed by the positioning of the low contact large fragments contoured plate with 14 combined holes (fixed and cortical angle), inserted from distal to proximal. Measurements were performed in four positions (elbow flexion with forearm pronation, elbow flexion with forearm supination, elbow extension with forearm pronation and elbow extension with forearm supination). Results: Significant statistical differences occurred with the different positions, and the elbow flexion with forearm supination was shown to be the position that provides the safest submuscular extraperiosteal corridor in a lateral approach of the humerus. Conclusion: The danger zone of radial nerve is an area that extends from 15 cm to 5 cm proximal to the lateral epicondyle and the safest way to create a submuscular and extraperiosteal corridor in the lateral region of the humerus is with the elbow in flexion and the forearm in supination. [ABSTRACT FROM AUTHOR]

Purpose: For basic training in ultrasonography (US), medical students and residents must learn cross-sectional anatomy. However, the present educational material is not sufficient to learn the sectional anatomy for US. This study aimed to provide a criterion for reading ambiguous structures on US images of upper limb through the sectioned images of Visible Korean. Methods: US images of the right arm of a volunteer were scanned (28 planes). For comparison with US images, the sectioned images of the right upper limb (24 bits color, 0.5 mm intervals, 0.06 mm × 0.06 mm sized pixel) were used. After the volume model was constructed from the sectioned images using MRIcroGL, new sectioned images of 28 planes corresponding to the US images of 28 planes were created by adjusting the slope of the volume model. In all images, the anatomical terms of 59 structures from the shoulder to the fingers were annotated. Results: In the atlas, which consists of 28 sets of US images and sectioned images of various slope planes, 59 structures of the shoulder, arm, elbow, wrist, palm, and fingers were observed in detail. Conclusion: We were able to interpret the ambiguous structures on the US images using the sectioned images with high resolution and actual color. Therefore, to learn the cross-sectional anatomy for US, the sectioned images from the Visible Korean project were deemed to be the suitable data because they contained all human gross anatomical information. [ABSTRACT FROM AUTHOR]

Purpose: The meniscal vascularization remains poorly documented, particularly its origin. The aim of this cadaveric study was to describe the origin of the arterial vascularization of the menisci. Methods: This is an anatomical study on human specimens. Twenty knees were used. The average age of the subjects was 82.7 years old (56–97). Ten knees were injected with latex-neoprene and ten knees were injected with colored gelatin mixed with India ink. The same protocol for dissection was used in all cases. Results: The meniscal vascularization is provided by the genicular arteries of the knee originating from the popliteal artery. The superior medial, superior lateral, inferior medial, inferior lateral, and middle genicular arteries had constant pathways. A second middle genicular artery was found in 55% of cases. The inferior lateral genicular artery ran alongside the meniscal's periphery. The inferior medial genicular artery followed the proximal tibial metaphysis. In all dissections, a previously undocumented small artery originated from under the middle genicular arteries. This artery remained extracapsular and followed the medial meniscal periphery. This artery has been named the "medial capsulo-meniscal artery". The genicular arteries formed an extensive peri-articular anastomotic vascularization for the menisci and thus referred to the "peri-meniscal arterial archs". The lateral peri-meniscal arch was predominantly supplied by the inferior lateral genicular artery, while the medial peri-meniscal arch was mainly supplied by the medial capsulo-meniscal artery. Conclusion: The peri-meniscal arterial archs are a vascular complex formed by the genicular arteries of the knee and an artery not previously described: the "capsulo-meniscal artery". These archs have a constant presence but their formation and distribution is different between the medial and lateral menisci. [ABSTRACT FROM AUTHOR]

The presence of belowground organs with buds and carbohydrate storage is typical of perennial plants in fire-prone ecosystems. The bud-bearing storage organs allow regeneration after fire, and they may lose their regeneration capacity if the disturbance is excluded, because of the depletion in the bud bank. We assessed the morphology, anatomy, and storage of carbohydrates in the belowground organs of eight perennial species from open savannas and analyzed their bud banks at different fire frequencies (annual, biennial, and exclusion). Xylopodium was found in all the study species as bud-bearing organ, associated with proliferated storage parenchyma tissue, often in the tuberous roots. We found that bud bank size varied according to different fire frequencies for only half of the studied species (most forbs), and a tendency for lower bud bank sizes in fire-excluded areas was found for all shrub species. Our study highlights the significance of bud-bearing storage organs, particularly xylopodium, and that the species-specific responses of bud bank size to different fire frequencies underscore the need to consider individual plant strategies when analysing fire effects, emphasizing the critical role of belowground organs in sustaining these ecosystems. [ABSTRACT FROM AUTHOR]

While arguments have been made both for and against the value of anatomical eponyms, limited research exists regarding their use by anatomists. As the editors of the principal international anatomy journals have purview and control of terminology in anatomical journals, their perceptions regarding the relevance, ethics and inclusivity of eponym use in anatomy and in publishing in anatomical journals were investigated. A validated, confidential and anonymized self-administered questionnaire which included open-ended questions was distributed to the 22 Editor-in-Chiefs/Senior Editors of anatomical journals. Of the 16 (73%) editors who responded to the survey, only 56% were aware that eponyms had been censured since the time of the 1895 Nomina Anatomica. The majority of responding editors found the use of Latin- and Greek-derived terms more valuable when communicating with students and peers, but also thought eponyms were acceptable in manuscripts submitted to their journals. Thirteen (81%) of the responding editors agreed that eponyms play a vital role in the history of anatomy, and some thought they were important for discussing bioethics concepts. However, 62.5% felt that there were valid reasons for their discontinuation. Half of the respondents did not consider the continued use of eponyms an ethical concern. Responding editors of anatomical journals prefer the use of Latin- and Greek- derived terms when interacting with other anatomists and students. However, the continued use of eponyms was seen as an important opportunity for discussion on the history and ethics of anatomy. [ABSTRACT FROM AUTHOR]

The glans clitoris has a corona; however, unlike the corona of the glans penis, the corona of the glans clitoris is practically "nonexistent" as evidenced by the noteworthy absence of its mention and depiction in anatomical and clinical sciences. Accordingly, the corona of the glans clitoris has been neglected in anatomical education and clinical practice. This report details the history regarding the anatomical terminology of the glans and identifies that descriptions of the glans penis, corona of the glans penis, and other penile structures have preceded descriptions of the homologous anatomy of the clitoris by at least a century. Today, recognition of the corona of the glans clitoris, as well as the coronal sulcus and neck of the clitoris should be commonplace. Henceforth, the corona of the glans clitoris and its related anatomy including the sulcus of the glans clitoris and neck of the clitoris should be incorporated into anatomical and clinical language, illustrations, textbooks, education, and practice. Likewise, efforts should be made to propagate knowledge regarding the corona of the glans clitoris, coronal sulcus, and neck of the clitoris to the general public. Giving names to the anatomical structures of the clitoris will undoubtedly increase the awareness of their existence which, in turn, will encourage their clinical assessment and result in decreased morbidity and mortality. Likewise, improved self-awareness of clitoral anatomy will promote self-care which is important in the prevention of disease and the promotion of optimal sexual health. [ABSTRACT FROM AUTHOR]

Terminologia Anatomica (TA) is a unique collection of technical terms that allow communication in anatomy and medicine around the world. Considering this, we reviewed articles published by Latin American authors on Terminologia Anatomica and synthesized the main results found in this article. This study is a systematic review about Terminologia Anatomica that focuses on non-English-speaking countries in Latin America. The database used was Scopus via Elsevier. 207, and candidate articles were identified after applying the search strategy and with no restriction of year of publication. After the exclusion of articles whose authorship was not Latin American, 68 articles were filtered based on their titles and abstracts without the exclusion of any of them. These articles were fully evaluated resulting in 66 articles that met all the inclusion criteria of this review. We collected the following data: title of the article, year of publication, journal of publication, keywords of the study, country of origin, and aim of the article. Among the analyzed articles, 22 proposed changes to terms present in Terminologia Anatomica, 15 of them proposed the inclusion of terms for Terminologia Anatomica, and several articles sought to explain the existence of the existing terms. It is necessary to analyze the terms that are and their origins in the Latin America languages to evaluate their coherence and anatomical correspondence. A standard descriptor for Terminologia Anatomica was not obtained and it is a limitation since eventual articles may not have been obtained. As the study evaluates only articles that were published in journals indexed in Scopus, some articles published in non-indexed journals were not included. [ABSTRACT FROM AUTHOR]

Relatively more-apparent body parts are often used to name relatively less-apparent body parts. To explore this etymological phenomenon, this report assesses anatomical terminology derived from some of the most apparent structures of the human body—hairs. Hair-related anatomical terminology involves varied etymons, roots, and derivatives: calvus "bald," cilia "eyelashes," glaber "hairless," pilus "hair," pubes (historically referring to the developing beard), pudendum "modesty" (referring to hair growth that covers genitalia), tempus "time" (referring to the location where hair commonly grays, thus showing a person's age), and tragus "goat" (referring to the tuft of hair that resembles the beard of a goat). Also including lanugo, vibrissae, hirci, flocculus, and cauda equina, a systematic review of Terminologia Anatomica and Terminologia Neuroanatomica revealed 285 unique non-duplicate hair-related terms. Several anatomical terms allude to particular age groups or sexes, but are used indiscriminately (e.g., tragus alludes to the older male ear, though may describe the fetal female ear). Likewise, human-centric anatomical terminology influences non-human anatomical terminology— a turtle has a "temporal bone" only because some humans develop gray hair on the sides of their heads as they age. Accordingly, etymological recursion is common: The human ear has a tragus, named after the goat, and the goat ear has a tragus, named after the human tragus, that was named after the goat. The use of Latin as the foundation of anatomical and medical terminology may appear seriously supercilious; however, it is often simply super silly. After all, hundreds of body parts are formally named after hair. [ABSTRACT FROM AUTHOR]

This paper focuses on the authors perspectives of the terminology developed by the Gross and Clinical Anatomy Working Group for Terminologica Anatomica2. Terminologica Anatomica2 represents a great deal of work by the Gross and Clinical Anatomy Working Group of the Federative International Program for Anatomical Terminology. Listing of synonyms and eponyms can be of great utility in terms of historical translation. However, the initial goal of achieving an international standard for anatomical terminology derived through a scholarly, consensus based process has been lost in Terminologica Anatomica2 as it provides a variety of choices that can be used to name a particular structure, in contrast to Terminologica Anatomica1 where preferred terminology is explicitly stated. [ABSTRACT FROM AUTHOR]

Anatomy was initially developed out of necessity to decrease surgery complications. Over time, anatomists and surgeons have sometimes used different terms for the same anatomical structures, thus resulting in numerous discrepancies in terminology between anatomy and surgery. To avoid any confusion or misunderstanding and to better elucidate the oral anatomy terms, the Federative International Programme for Anatomical Terminology (FIPAT) organized a group of specialists on oral anatomy, Terminologia Oroanatomica (ToA) working group, composed of dentists, anatomy researchers, anatomy educators, oral and maxillofacial surgeons, and oral and maxillofacial radiologists. Within the ToA working group, major anatomical structures in the mandible, such as the mandibular canal, were focused and discussed to determine the most appropriate term, i.e., inferior alveolar canal. Although yet to be approved by the International Federation of Associations of Anatomists (IFAA), this article will preview some changes suggested by the ToA. [ABSTRACT FROM AUTHOR]

Anatomy, the study of human structure, is foundational to medicine. Its language has a long history, with contributions from authors hailing from diverse cultures and countries, adhering to various scientific traditions, speaking different languages, and practicing medicine across a wide gamut of specialties. The resultant disparity in terms provides challenges both for students in learning and for interdisciplinary communication. We report here on a user-friendly look-up web site, "AnatomicalTerms.info" that links a Terminologica Anatomica term to alternative terms in usage: synonyms, polysemes, eponyms, homonyms, and terms in other languages. Accompanying open-source definitions are generated with the help of "Definition Machine" software, that supports creating the most concise and accessible definitions for anatomical terms, eschewing superfluous description, thus reducing cognitive load of learners of anatomy looking up terms. AnatomicalTerms.info is a readily accessible online source for both the authoritative and alternatively used terms that can accurately cross-reference and/or disambiguate anatomical structures across disciplinary and cultural divides. As such, it can serve as a useful educational and clinical resource that is also flexibly open to additions and expansion as anatomical and clinical needs dictate. [ABSTRACT FROM AUTHOR]

Until the mid-nineteenth century, "physiology" was a comprehensive theory of life, expounded and shaped by Johannes P. Müller (1801–1858). Biologists and medical doctors still refer to him today. In the summer term of 1851, Müller gave a lecture on the Comparative Anatomy of animals. This lecture was attended and recorded by Ernst Zeller (1830–1902), a future physician and zoologist, and has recently been published together with a German transcript. In this paper, we situate Johannes Müller within the intellectual history of his time. Through his "empirical idealism," we show how he opposed the speculative tendencies of the romantic understanding of nature, the emerging evolutionism, and the growing splits in the natural sciences. Müller focused on recognizing living nature as a whole and realizing ideal "phenomena" through his empirical research. He considered the notion of the soul of the world. Müller's lecture transcript serves as a poignant testament to German scientific culture in the mid-nineteenth century, a few years before the publication of Darwin's Origin of Species. It also provides valuable insights into the self-contained epistemological foundations of morphology. [ABSTRACT FROM AUTHOR]

Purpose: Virtual reality (VR) allows for an immersive and interactive analysis of imaging data such as computed tomography (CT) and magnetic resonance imaging (MRI). The aim of this study is to assess the comprehensibility of VR anatomy and its value in assessing resectability of pancreatic ductal adenocarcinoma (PDAC). Methods: This study assesses exposure to VR anatomy and evaluates the potential role of VR in assessing resectability of PDAC. Firstly, volumetric abdominal CT and MRI data were displayed in an immersive VR environment. Volunteering physicians were asked to identify anatomical landmarks in VR. In the second stage, experienced clinicians were asked to identify vascular involvement in a total of 12 CT and MRI scans displaying PDAC (2 resectable, 2 borderline resectable, and 2 locally advanced tumours per modality). Results were compared to 2D standard PACS viewing. Results: In VR visualisation of CT and MRI, the abdominal anatomical landmarks were recognised by all participants except the pancreas (30/34) in VR CT and the splenic (31/34) and common hepatic artery (18/34) in VR MRI, respectively. In VR CT, resectable, borderline resectable, and locally advanced PDAC were correctly identified in 22/24, 20/24 and 19/24 scans, respectively. Whereas, in VR MRI, resectable, borderline resectable, and locally advanced PDAC were correctly identified in 19/24, 19/24 and 21/24 scans, respectively. Interobserver agreement as measured by Fleiss κ was 0.7 for CT and 0.4 for MRI, respectively (p < 0.001). Scans were significantly assessed more accurately in VR CT than standard 2D PACS CT, with a median of 5.5 (IQR 4.75–6) and a median of 3 (IQR 2–3) correctly assessed out of 6 scans (p < 0.001). Conclusion: VR enhanced visualisation of abdominal CT and MRI scan data provides intuitive handling and understanding of anatomy and might allow for more accurate staging of PDAC and could thus become a valuable adjunct in PDAC resectability assessment in the future. [ABSTRACT FROM AUTHOR]

Electromagnetic tracking of endovascular instruments has the potential to substantially decrease radiation exposure of patients and personnel. In this study, we evaluated the in vivo accuracy of a vessel-based method to register preoperative computed tomography angiography (CTA) images to physical coordinates using an electromagnetically tracked guidewire. Centerlines of the aortoiliac arteries were extracted from preoperative CTA acquired from five swine. Intravascular positions were obtained from an electromagnetically tracked guidewire. An iterative-closest-point algorithm registered the position data to the preoperative image centerlines. To evaluate the registration accuracy, a guidewire was placed inside the superior mesenteric, left and right renal arteries under fluoroscopic guidance. Position data was acquired with electromagnetic tracking as the guidewire was pulled into the aorta. The resulting measured positions were compared to the corresponding ostia manually identified in the CTA images after applying the registration. The three-dimensional (3D) Euclidean distances were calculated between each corresponding ostial point, and the root mean square (RMS) was calculated for each registration. The median 3D RMS for all registrations was 4.82 mm, with an interquartile range of 3.53–6.14 mm. A vessel-based registration of CTA images to vascular anatomy is possible with acceptable accuracy and encourages further clinical testing. Relevance statement: This study shows that the centerline algorithm can be used to register preoperative CTA images to vascular anatomy, with the potential to further reduce ionizing radiation exposure during vascular procedures. Key Points: Preoperative images can be used to guide the procedure without ionizing intraoperative imaging. Preoperative imaging can be the only imaging modality used for guidance of vascular procedures. No need to use external fiducial markers to register/match images and spatial anatomy. Acceptable accuracy can be achieved for navigation in a preclinical setting. [ABSTRACT FROM AUTHOR]

Purpose Methods Results Discussion Level of Evidence Kinematically aligned total knee arthroplasty (KA TKA), as a pure resurfacing procedure, is based on matching implant thickness with bone cut and kerf thickness, plus cartilage wear. However, the assumption of a consistent 2 mm femoral cartilage thickness remains unproven. This study aimed to systematically review the available literature concerning magnetic resonance imaging (MRI) assessment of femoral cartilage thickness in non‐arthritic patients. Our hypothesis was that cartilage thickness values would vary significantly among individuals, thereby challenging the established KA paradigm of ‘one‐cartilage‐fits‐all’.Systematic literature searches (Pubmed, Scopus and Cochrane Library) followed PRISMA guidelines. English‐language studies assessing distal and posterior femoral cartilage thickness using MRI in non‐arthritic adults were included. Studies lacking numerical cartilage thickness data, involving post‐operative MRI, considering total femoro‐tibial cartilage thickness, or failing to specify the compartment of the knee being studied were excluded.Overall, 27 studies comprising 8170 MRIs were analysed. Weighted mean femoral cartilage thicknesses were: 2.05 ± 0.62 mm (mean range 1.06–2.6) for the distal medial condyle, 1.95 ± 0.4 mm (mean range 1.15–2.5) for the distal lateral condyle, 2.44 ± 0.5 mm (mean range 1.37–2.6) for the posterior medial condyle and 2.27 ± 0.38 mm (mean range 1.48–2.5) for the posterior lateral condyle.Femoral cartilage thickness varies significantly across patients. In KA TKA, relying on a fixed thickness of 2 mm may jeopardize the accurate restoration of individual anatomy, leading to errors in implant coronal and rotational alignment. An intraoperative assessment of cartilage thickness may be advisable to express the KA philosophy at its full potential.Level IV. [ABSTRACT FROM AUTHOR]

The neuromuscular junction (NMJ) has an elaborate anatomy to ensure agile and accurate signal transmission. Based on our formerly obtained expressions of the thermal and conductance induced voltage fluctuations, in this paper, the mechanisms underlying the conductance-induced voltage fluctuation are characterized from two aspects: the scaling laws with respect to either of the two system-size factors, the number of receptors or the membrane area; and the "seesaw effect" with respect to the intensive parameter, the concentration of acetylcholine. According to these mechanisms, several aspects of the NMJ anatomy are explained from a denoising perspective. Finally, the power spectra of the two types of voltage fluctuations are characterized by their specific scaling laws, based on which we explain why the endplate noise has the low-frequency property that is described by the term "seashell sound". [ABSTRACT FROM AUTHOR]

The neurochemical anatomy underlying Cushing's syndrome is examined for regional brain metabolism as well as neurotransmitter levels and receptor binding of biogenic amines and amino acids. Preliminary studies generally indicate that glucose uptake, blood flow, and activation on fMRI scans decreased in neocortical areas and increased in subcortical areas of patients with Cushing's syndrome or disease. Glucocorticoid-mediated increases in hippocampal metabolism occurred despite in vitro evidence of glucocorticoid-induced decreases in glucose uptake or consumption, indicating that in vivo increases are the result of indirect, compensatory, or preliminary responses. In animal studies, glucocorticoid administration decreased 5HT levels and 5HT1A receptor binding in several brain regions while adrenalectomy increased such binding. Region-specific effects were also obtained in regard to the dopaminergic system, with predominant actions of glucocorticoid-induced potentiation of reuptake blockers and releasing agents. More in-depth neuroanatomical analyses are warranted of these and amino acid-related neurotransmission. [ABSTRACT FROM AUTHOR]

The aim of this study was to describe the origin and branches of the brachial plexus nerves in S. villosus, as well as the innervated musculature, contributing information to the field of comparative animal anatomy and providing insights for applied studies. Fifteen adult cadavers (eight males and seven females), previously identified, sexed, and fixed with a 10% aqueous formaldehyde solution were used. The patients underwent digital radiographic examinations of the cervical region to characterize the number of cervical vertebrae. The nerves were dissected to visualize the innervation of the intrinsic and extrinsic musculature of the thoracic limb. With the assistance of a costotome, the vertebrae were removed until visualization of the spinal cord and the roots, which gave rise to the nerve branches. The specimens presented seven cervical vertebrae, and the brachial plexus was characterized as postfixed, formed by connections between the last four cervical spinal nerves (C5, C6, C7, and C8) and the first two thoracic nerves (T1 and T2). The cranial, middle, and caudal trunks originate from the suprascapularis, subscapular, axillary, musculocutaneous, radial, median, and ulnar nerves for the intrinsic musculature and from the cranial pectoral, caudal pectoral, lateral thoracic, long thoracic, and thoracodorsal nerves for the extrinsic musculature. The ventral branches that contributed the most to plexus formation in the right antimer were C5 and C8, while in the left antimer, they were C7. The resulting nerves and the innervation for extrinsic and intrinsic musculature were similar to those observed in other rodents and representatives of the Mammalia class in general. [ABSTRACT FROM AUTHOR]

The present study aims to describe the anatomical bone, muscular, and nervous components of the capybara's pelvic limb, associating dissections with radiographic imaging findings. Four animals (two adult females, one adult male, and one young male) were used for macroscopic dissections, and one adult male for radiographic acquisitions. A specimen was prepared for bone descriptions using a maceration procedure. The results demonstrated an elongated thigh bone, the obturator foramen obturator, the ilial wing, and the iliac body straight. The anatomical variations of the pelvic limb of capybaras found were: in the femur, the third trochanter is absent; in the tarsal–metatarsal complex, the I tarsal and the I and V metatarsals are vestigial, and a single portion of the M. sartorius and M. gracilis muscles was demonstrated. Furthermore, variations were found in the origin and insertion of each muscle. Macroscopic musculoskeletal descriptions associated with radiographic analyses made it possible to establish a standard of comparative normality for knowledge of species examinations. The pelvic limb was innervated by nerves that emerge from the lumbosacral plexus, which gives rise to the following nerves: N.gluteus cranialis, N. gluteus caudalis, N. genitofemoralis, N. obturatorius, ischiadicus—rami musculares, N. cutaneus surae lateralis, N. cutaneus surae caudallis, N. pudendus, N. femoralis, N. saphenous, N. tibialis, and N.fibularis communis. In conclusion, the anatomy of the capybara's pelvic limb locomotor system presents particular characteristics related to its aquatic behavior and the absence of arboreal habits. [ABSTRACT FROM AUTHOR]

The study aimed to provide a detailed anatomical description of the forelimb of the capybara using gross anatomy, radiography images, and three-dimensional reconstruction. Four adult animals were used for macroscopic dissections, one for the acquisition of radiographic images and reconstructions, and one specimen for bone descriptions. The results showed the anatomical details of the scapula with a developed hamate process and the absence of a clavicle. Radius and ulna do not fuse. The hand has five metacarpal bones, and the first digit is rudimentary. The proximal row of the carpal comprises the intermedioradial, ulnar, and accessory carpal bones, and the distal row comprises four carpal bones. The muscles present a general pattern similar to other groups of domestic animals; however, the absence of the accessory head of the triceps brachii muscle has been demonstrated. The resulting images provided excellent detail of the main anatomical structures of the capybara's thoracic limb. The illustrations in the present study are a valuable reference for the interpretation of normal and pathological imaging studies in the species in the present study. [ABSTRACT FROM AUTHOR]

Introduction: It is estimated that up to 28% of global disease burden is surgical with hernias representing a unique challenge as the only definitive treatment is surgery. Surgical Outreach for the Americas (SOfA) is a nongovernmental organization focused primarily on alleviating the disease burden of inguinal and umbilical hernias in Central America. We present the experience of SOfA, a model focused on partnership and education. Methods: SOfA was established in 2009 to help individuals recover from ailments that are obstacles to working and independent living. Over the past 15 years, SOfA has partnered with local healthcare providers in the Dominican Republic, El Salvador, Honduras, and Belize. The SOfA team consists of surgeons, surgery residents, triage physicians, an anesthesiologist, anesthetists, operating room nurses, recovery nurses, a pediatric critical care physician, sterile processing technicians, interpreters, and a team coordinator. Critical partnerships required include the CMO, internal medicine, general surgery, nursing, rural health coordinators and surgical training programs at public hospitals. Results: SOfA has completed 24 trips, performing 2074 procedures on 1792 patients. 71.4% of procedures were hernia repairs. To enhance sustainability of healthcare delivery, SOfA has partnered with the local facilities through capital improvements to include OR tables, OR lights, anesthesia machines, monitors, hospital beds, stretchers, sterilizers, air conditioning units, and electrosurgical generators. A lecture series and curriculum on perioperative care, anesthesia, anatomy, and operative technique is delivered. Local surgery residents and medical students participated in patient care, learning alongside SOfA teammates. Recently, SOfA has partnered with SAGES Global Affairs Committee to implement a virtual Global Laparoscopic Advancement Program, a simulation-based laparoscopic training curriculum for surgeons in El Salvador. Conclusion: A sustainable partnership to facilitate surgical care in low resource settings requires longitudinal, collaborative relationships, and investments in capital improvements, education, and partnership with local healthcare providers, institutions, and training programs. [ABSTRACT FROM AUTHOR]

Background: Implementing a robotic system for minimally invasive surgical procedures necessitates a comprehensive training regimen. This involves not only mastering the technological aspects of the robotic system but also enhancing surgical proficiency in manipulating robotic instruments. Furthermore, procedural expertise in specific surgeries is critical. Minimally invasive inguinal hernia repair is particularly suitable as an initial procedure for human application. The development of a comprehensive training model for this type of repair is a crucial element of such an educational pathway. Method: Anatomical dissections were carried out on pigs to assess both the similarities and differences between pig and human anatomy. A structured minimally invasive inguinal hernia repair was performed to determine the suitability of the porcine inguinal region for training purposes. Results: A detailed anatomical description of the porcine inguinal region is outlined, to provide a framework for assessing the critical view of the porcine myopectineal orifice. By integrating the human 'ten golden rules' for safe and effective minimally invasive inguinal hernia repair, the standardized porcine integrated robotic inguinal hernia training (SPIRIT) model describes a step-by-step approach to practice surgical techniques in a realistic setting. Conclusion: The SPIRIT model is designed to be a well-structured training model for minimally invasive inguinal hernia repair and incorporates the specific surgical steps as encountered in a human patient. [ABSTRACT FROM AUTHOR]

The thyroid surgeon should be familiar with the vascular anatomy and its possible variations to avoid damage to nerve structures. Here we report the case of the superior thyroid artery arising from the vertebral artery. This anatomic variation has not been described before. [ABSTRACT FROM AUTHOR]

Introduction: Ultrasonography (US) has become an essential tool for guiding botulinum neurotoxin (BoNT) injections in facial muscles, enhancing precision and safety. This narrative review explores the role of US in BoNT administration, particularly in complex anatomical regions, highlighting its impact on treatment customization, real-time visualization, and complication reduction. Materials and methods: A comprehensive literature search was conducted using PubMed, MEDLINE, Embase, and Cochrane Library for articles published from January 2018 to December 2023. Search terms included "Botulinum neurotoxin," "facial anatomy," "ultrasonography guided injection," and "facial muscle sonoanatomy." Studies focusing on US-guided BoNT injections in facial muscles were included. Data extraction and synthesis were performed independently by two reviewers, focusing on study design, ultrasonography techniques, outcomes, and conclusions. Results: The review found that US guidance significantly enhances the precision of BoNT injections by providing real-time visualization of facial muscles and blood vessels, thereby reducing the risk of adverse events. US enables tailored injection strategies, ensuring symmetrical facial expressions and minimizing over-treatment. The technique also offers immediate feedback, allowing for on-the-spot adjustments to improve treatment efficacy and safety. However, the review identified limitations, including potential selection bias and variability in US techniques across different studies. Conclusion: US guidance for BoNT injections into facial muscles offers substantial benefits in terms of precision, safety, and treatment customization. Despite the identified limitations, the integration of US into clinical practice is poised to enhance patient outcomes in aesthetic and therapeutic procedures. Further research is needed to standardize US techniques and broaden the inclusivity of studies to validate these findings comprehensively. [ABSTRACT FROM AUTHOR]

Purpose: Spread of disease in the retroperitoneum is dictated by the complex anatomy of retroperitoneal fasciae and is still incompletely understood. Conflicting reports have led to insufficient and incorrect anatomical concepts in radiological literature. Methods: This review will discuss previous concepts prevalent in radiological literature and their shortcomings will be highlighted. New insights from recent anatomical and embryological research, together with imaging examples, will be used to clarify patterns of disease spread in the retroperitoneum that remain unexplained by these concepts. Results: The fusion fascia and the renal fascia in particular give rise to planes and spaces that act as vectors for spread of disease in the retroperitoneum. Some of these planes and structures, such as the caudal extension of the renal fascia, have previously not been described in radiological literature. Conclusion: New insights, including the various fasciae, potential spaces and planes, are incorporated into an updated combined retroperitoneal fascial concept. [ABSTRACT FROM AUTHOR]

Purposes: The purpose of this study was to develop a new and more comprehensive classification system for portal vein (PV) variations using three-dimensional visualization and evaluation (3DVE) and to discuss the prevalence rates and clinical implications of the variants. Methods: The anatomies of PVs were tracked and analyzed by using three-dimensional visualization of CT images acquired between 2013 and 2022. Scans from 200 adults were evaluated and a total of 178 patients (N = 178) were included in the study. The new classification system, named BLB classification, was developed based on the level of the absent PV branch in each variant anatomy. Results: Using the BLB classification system, PVs were divided into thirteen subtypes. Only 82.6–84.8% of the portal veins of the 178 patients were depicted in Atri's, Cheng's or Covey's classification, compared with 100% identified by the BLB classification. The BLB classification was validated against external data sets from previous studies, with 97.0-98.9% of patients classified by the BLB system. Conclusion: Variant PV anatomies are more commonly seen based on 3DVE than in previous reports. The BLB classification covers almost all portal vein variants and may be used for planning liver surgery. Summary Box: What is already known on this topic: To date, the classification defined by Atri et al. and Covey et al. are mostly used, including four and six subtypes respectively. However, variants and patterns not defined in traditional classifications are frequently encountered during surgery. What this study adds: In this article, we have explored the development of a new classification system (BLB classification) for portal vein anatomies based on three-dimensional visualization and evaluation. The importance of the finding is that the BLB classification covers almost all portal vein variants, which should be much more comprehensive than other reported classification methods and may be used for planning liver surgery. How this study might affect research, practice or policy: The knowledge of variant portal vein subtypes is critically significant in performing safe and efficacious liver surgeries, such as portal vein embolization, liver resection, liver transplantation and TIPS creation. [ABSTRACT FROM AUTHOR]

Purpose: The current study proposes the comparison of the visualization and identification of anatomical details between natural human temporal bone, its respective copy from three-dimensional printing, and the virtual model obtained from CBCT. Methods: The sample consisted of undergraduate students in Dentistry (Group UE, n = 22), Postgraduate students in Radiology and Imaging (Group P-RI, n = 20), and Postgraduate students in Forensic Odontology (Group P-FO, n = 24). All participants attended a theoretical class on specialized anatomy of the temporal bone and subsequently performed the markings of 10 determined structures. Results: The number of correct identifications was similar in natural bone and printed three-dimensional models in all groups (p > 0.05). The virtual model showed a significantly lower number of correct structures (p < 0.05) in the 3 groups. In general, there were significantly higher percentages of accurate answers among postgraduate students compared to undergraduate students. Most graduate students believed that the printed three-dimensional model could be used to teach anatomy in place of natural bone, while undergraduate students disagreed or were unsure (p < 0.05). Regarding the virtual tomographic image, in all groups, students disagreed or were not sure that its use would be beneficial in replacing natural bone. Conclusion: Three-dimensional and virtual models can be used as auxiliary tools in teaching anatomy, complementing practical learning with natural bones. [ABSTRACT FROM AUTHOR]

Purpose: Ossification of the mamillo-accessory ligament (MAL) results in the formation of a mamillo-accessory foramen (MAF), which is associated with aging. The MAL tethers the medial branches of the lumbar dorsal rami to the lumbar vertebrae. A MAL ossified at the lumbar vertebrae can cause low back pain by compressing the medial branch of a dorsal ramus. Age ranges related to ossification of the MAL have not been reported in previous studies. The objective of the present study was to determine the prevalence of ossification of the MAL in the lumbar column and its relationship to aging, and to measure the newly formed MAF at each level of the lumbar vertebrae. Methods: This study examined 935 dried lumbar vertebrae from 187 donors at Khon Kaen University, Thailand, consisting of 93 females and 94 males. The research focused on ossification patterns of the MAL, categorizing them into three patterns. Results: We found that over 50% of ossified MAL occurred in the 30–45-year-old range and the frequency increased with age. The prevalence of ossified lumbar MAL was 72.73%, especially in L5 on the left side in females (76.92%). The width of the MAF did not differ significantly between the sexes, but it was greater on the left side (2.46 ± 1.08; n = 76) than the right (2.05 ± 0.95; n = 72) (p = 0.016). Conclusion: Ossification of the MAL into the MAF progresses with age, leading to low back pain from nerve compression. Physicians should be aware of the MAF during anesthesia block to treat low back pain. [ABSTRACT FROM AUTHOR]

Purpose: The present knowledge about lymphatic drainage of the ovary is based on carcinological studies, but it has only rarely been studied under physiological conditions. However, it is one of the preferential routes of dissemination in ovarian cancer, and understanding it is therefore vital for optimal carcinological management.Our purpose was to evaluate the feasibility of an innovative technique to study the lymphatic drainage territories of the ovary using a recirculation module on the cadaveric model. Methods: We injected patent blue into the cortex of twenty "revascularised" cadaver ovaries with the Simlife recirculation model. We observed the migration of the dye live and described the drainage territories of each ovary. Results: We observed a staining of the lymphatic vessels and migration of the dye in all the subjects, systematically ipsilateral to the injected ovary. We identified a staining of the lumbo-aortic territory in 65% of cases, with a preferential lateral-caval involvement (60%) for the right ovary and lateral-aortic territory (40%) for the left ovary. A common iliac involvement was observed in only 10% of cases. In 57% of cases, the staining of the lumbo-aortic territory was associated with a staining of the suspensory ligament. The pelvic territory was involved in 50% of cases, with an external iliac staining in 25% of cases and internal in 20%. Conclusion: Our study provides for a better understanding of lymphatic drainage of the ovary using a new detection method, and allows the possibility of improving the teaching for operators with a realistic model. Continuation of this work could lead to considering more targeted and thus less morbid lymph node sampling for lymph node staging in early-stage ovarian cancer. [ABSTRACT FROM AUTHOR]

Purpose: The vertical level of carotid bifurcation (CB) is commonly indicated at the superior margin of the thyroid cartilage. Few studies observed the CB vertical topography. It was aimed at studying the vertical location of the CB as referred to vertebral and anterior cervical landmarks. Methods: An archived lot of 147 computed tomography angiograms was documented for the vertical level of CB referred to vertebral and anterior cervical landmarks. The topography of the CB in relation to anterior landmarks was classified into seven types: (1) at the superior margin of the thyroid cartilage; (2) between the hyoid and the thyroid cartilage; (3) at the hyoid level; (4) between the hyoid and mandible; (5) subgonial or supragonial CB; (6) lower cervical level; (7) intrathoracic. Results: The most common locations of CB were at C3 (27.21%), C3/C4 (26.19%) and C4 (25.51%). Bilateral symmetry of CB was found in 51.7%, except for C2 and C5/C6. Type 7 was not found, type 3 occurred in 39.12%, type 2 in 24.49%, type 1 in 13.95%, type 4 in 13.61%, type 5 in 6.12%, and type 6 in 2.72% (294 CBs). Bilateral symmetry of anterior types was found in 59.86%. Statistically significant correlations were found between sex and both left and right types and vertebral levels of CB. Conclusions: The vertical topography of the CB is highly variable and has sex-related specificity. This detail should be included in the teaching of anatomy. Surgeons and interventionists should better document the carotid anatomy on a case-by-case basis. [ABSTRACT FROM AUTHOR]

Introduction: We describe a first case of human congenital crico-thyroid dysplasia associated to a right sided aortic arch and an aberrant subclavian artery. Case presentation: Our patient presented with a two-weeks history of acute dyspnea, and reported hoarseness since his childhood. An urgent tracheotomy was performed, followed by direct laryngoscopy. Endoscopic examination showed a deviation of the dorsoventral axis of the larynx, with an obstructive submucosal swelling the area of the right false cord and aryepiglottic fold. Computed tomography conducted the following day confirmed the crico-thyroid dysplasia, an infected laryngocele, and the presence of a right sided aortic arch and an aberrant subclavian artery. Conclusion: The embryological basis of these anomalies is attributed to congenital defects of the development of the fourth and sixth pharyngeal arches. To our knowledge, the congenital crico-thyroid dysplasia has not been previously reported in human. This case underscores the importance of recognizing anatomical variations in laryngeal cartilages, understanding their embryological origins, and potential associated malformations. [ABSTRACT FROM AUTHOR]

In this section of Resonance, we invite readers to pose questions likely to be raised in a classroom situation. We may suggest strategies for dealing with them, or invite responses, or both. "Classroom" is equally a forum for raising broader issues and sharing personal experiences and viewpoints on matters related to teaching and learning science. [ABSTRACT FROM AUTHOR]

Drought stress severely restricts crop yields. Changes in root morphology and function are critical to rice performance under drought conditions, affecting water uptake efficiency, hormone regulation, and nutrient absorption. This study explores the responses of two rice lines, IZ036 with a small root system and IZ144 with a large root system, to drought stress (soil water potential of – 30 ± 5 kPa). The results showed that drought stress significantly inhibited the growth and yield of both rice lines by 35.6–58.1%. Under drought stress, the root-to-shoot ratio of IZ144 increased by 17.8–68.0%, while IZ036 decreased by 10.2–59.1%. While IZ036 experienced a significant reduction in leaf water potential under drought stress, no such impact was observed in IZ144. Both varieties exhibited altered tissue anatomy under drought stress, including, reduced leaf vascular size, increased proportion of vascular bundles in root cross-section, and changes in root thickness. Notably, IZ036 displayed cell and vessel shrinkage and leaf deformation. In response to drought stress, both rice lines exhibited elevated concentrations of auxin, salicylic acid and abscisic acid (ABA) in leaves and increased ethylene and gibberellin (GA) in roots. Notably, IZ144 had significantly higher ABA, cytokinin (CTK), GA, and auxin levels in leaves and CTK in roots than IZ036. Overall, our findings highlight the superior drought tolerance of IZ144 over IZ036, as evidenced by enhanced physiological and anatomical performances and more effective hormone distribution in leaves and roots, indicating the importance of root size in determining drought stress resilience in rice. [ABSTRACT FROM AUTHOR]

Background: The systematic status of sect. Tuberculata and its taxonomy have recently attracted considerable attention. However, the different bases for defining the characteristics of sect. Tuberculata has led to many disagreements among the plants in this group. Camellia neriifolia and Camellia ilicifolia have been the subject of taxonomic controversy and have been treated as different species or varieties of the same species. Therefore, it is important to use multiple methods, i.e., integrative taxonomy, to determine the taxonomic status of C. neriifolia and C. ilicifolia. This is the first study to systematically explore the taxonomic position of these two plants on the basis of Morphology, Anatomy, Palynology and Molecular Systematics. Results: Extensive specimen reviews and field surveys showed that many differences exist in C. neriifolia and C. ilicifolia, such as the number of trunk (heavily debarked vs. slightly peeling), leaf type (smooth thin leathery, shiny vs. smooth leathery, obscure or slightly shiny), leaf margin (entire vs. serrate), flower type (subsessile vs. sessile), number of styles (3–4 vs. 3), and sepal (ovate vs. round). Moreover, C. neriifolia has a more distinctive faint yellow flower color, and trunk molting was more severe in C. neriifolia than that in C. ilicifolia. In addition, micromorphological analysis of the leaf epidermis showed that the two species differed in the anticlinal wall, stomatal apparatus, and stomatal cluster, and pollen morphology analyses based on pollen size, germination furrow, and polar and equatorial axes showed that they are both distinct from each other. The results of the phylogenetic tree constructed based on the whole chloroplast genome, protein-coding genes, and ITS2 showed that both C. ilicifolia and C. neriifolia were clustered in different branches and gained high support. Conclusions: The results combine morphology, anatomy, palynology, and molecular systematics to treat both C. neriifolia and C. ilicifolia as separate species in the sect. Tuberculata, and the species names continue to be used as they were previously. In conclusion, clarifying the taxonomic status of C. neriifolia and C. ilicifolia deepens our understanding of the systematic classification of sect. Tuberculata. [ABSTRACT FROM AUTHOR]

Background: Resection of the medial wall of the cavernous sinus (MWCSR) is a growing surgical maneuver for the radical removal of pituitary adenomas. Method: We present a simple modification of the technique following the two dural layers of the floor of the sella turcica, allowing for early identification of the medial wall and simplifying dissection. We support this technique with an anatomical analysis on cadaveric specimens and clarifying dissection images. Conclusion: Recognition and dissection of the dural unfolding of the floor of the sella turcica are "key points" that lower the risk and facilitate the MWCSR. [ABSTRACT FROM AUTHOR]