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The University of Bologna School of Medicine in 2003 adopted a near-peer teaching (NPT) program with senior medical students teaching and assisting younger students in human anatomy laboratories. This study aimed to evaluate the effectiveness and outcomes of this program—unique on the Italian academic panorama—from the tutors’ perspective. An anonymous online survey was administered to all those who acted as peer tutors in the period from 2003 to 2021; it evaluated tutors’ perceptions regarding the influence of the tutoring experience on their skillset gains, academic performance, and professional career. Furthermore, tutors were asked to express their views on the value of cadaver dissection in medical education and professional development. The overall perception of the NPT program was overwhelmingly positive and the main reported benefits were improved long-term knowledge retention and academic performance, improved communication, team-working and time management skills, and enhanced self-confidence and motivation. Most tutors strongly believed that cadaver dissection was an invaluable learning tool in medical education, helped them to develop professionalism and human values, and positively influenced the caring of their future patients. Nearly all the participants highlighted the importance of voluntary body donation for medical education and research. The present results supported the thesis that tutors themselves benefited from the act of teaching peers; this impactful experience equipped them with a wide range of transferable skills that they could draw on as future educators and healthcare professionals.

Most medical and health science schools adopt innovative tools to implement the teaching of anatomy to their undergraduate students. The increase in technological resources for educational purposes allows the use of virtual systems in the field of medicine, which can be considered decisive for improving anatomical knowledge, a requisite for safe and competent medical practice. Among these virtual tools, the Anatomage Table 7.0 represents, to date, a pivotal anatomical device for student education and training medical professionals. This review focuses attention on the potential of the Anatomage Table in the anatomical learning process and clinical practice by discussing these topics based on recent publication findings and describing their trends during the COVID-19 pandemic period. The reports documented a great interest in and a positive impact of the use of this technological table by medical students for teaching gross anatomy. Anatomage allows to describe, with accuracy and at high resolution, organ structure, vascularization, and innervation, as well as enables to familiarize with radiological images of real patients by improving knowledge in the radiological and surgical fields. Furthermore, its use can be considered strategic in a pandemic period, since it ensures, through an online platform, the continuation of anatomical and surgical training on dissecting cadavers.

Human body dissection is fundamental in medical education, as it allows future physicians to learn about the body's morphology in three dimensions, to recognize anatomical variations and to develop and increase the essential qualities of respect, compassion and empathy for patients. It is equally important in clinical training as it allows surgeons to improve their manual dexterity and practical skills and to test innovative surgical techniques and devices. In Italy prior to 2020, body acquisition and use for study and research purposes were regulated by a generic set of old directives and national decrees which dealt only marginally with these issues. However, in 2013, a whole body donation program was officially set up at the Institute of Human Anatomy of the University of Bologna. Completely free and voluntary informed consent has always been regarded as a core prerequisite and, since its inception, the program exclusively accepted bequeathed bodies. On February 10, 2020, a specific law governing the disposition of post mortem human body and tissues for study, training and scientific research purposes was definitively enacted. The present work traces the University of Bologna's experience leading to the whole body donation program and the brand new dissecting room. It describes the program of Bologna as an example of "good practice" in body donation, aimed at ensuring education and clinical training by means of both traditional gross anatomy and innovative technology. Moreover, it analyzes the results achieved in terms of increased donor enrollment and improved teaching/training quality and the strengths of this program in light of the provisions enshrined in the new law.

The existence of an independent nuclear inositide pathway distinct from the cytoplasmic one has been demonstrated in different physiological systems and in diseases. In this prospect we analyze the role of PI-PLCβ1 nuclear isoform in relation to the cell cycle regulation, the cell differentiation, and different physiopathological pathways focusing on the importance of the nuclear localization from both molecular and clinical point of view. PI-PLCβ1 is essential for G1/S transition through DAG and Cyclin D3 and plays also a central role in G2/M progression through Cyclin B1 and PKCα. In the differentiation process of C2C12 cells PI-PLCβ1 increases in both myogenic differentiation and osteogenic differentiation. PI-PLCβ1 and Cyclin D3 reduction has been observed in Myotonic Dystrophy (DM) suggesting a pivotal role of these enzymes in DM physiopathology. PI-PLCβ1 is also involved in adipogenesis through a double phase mechanism. Moreover, PI-PLCβ1 plays a key role in the normal hematopoietic differentiation where it seems to decrease in erythroid differentiation and increase in myeloid differentiation. In Myelodysplastic Syndromes (MDS) PI-PLCβ1 has a genetic and epigenetic relevance and it is related to MDS patients' risk of Acute Myeloid Leukemia (AML) evolution. In MDS patients PI-PLCβ1 seems to be also a therapeutic predictive outcome marker. In the central nervous system, PI-PLCβ1 seems to be involved in different pathways in both brain cortex development and synaptic plasticity related to different diseases. Another PI-PLC isozyme that could be related to nuclear activities is PI-PLCζ that is involved in infertility processes. J. Cell. Biochem. 118: 1969-1978, 2017. © 2017 Wiley Periodicals, Inc.

Con il termine variante anatomica si definisce una particolare struttura anatomica la cui morfologia si discosta da quella osservata nella maggior parte degli individui. Diversamente dalle anomalie congenite, che per definizione sono considerate patologiche, le varianti rientrano in un quadro di normalità. È però evidente che conformazioni anatomiche peculiari possono interferire con le procedure diagnostiche e aumentare il rischio di complicanze durante gli interventi chirurgici. La conoscenza dell’anatomia umana e lo studio delle sue varianti rappresentano perciò un requisito indispensabile per ogni pratica medica, e l’attività settoria, che consente di individuare e documentare eventuali varianti rispetto alla normale anatomia umana, costituisce un supporto fondamentale alla medicina e alla chirurgia. Il volume propone un excursus storico sulla pratica settoria, una introduzione alle attuali tecniche di dissezione e lo studio di alcune significative varianti anatomiche.

The hypo- and retrotympanum host a variety of crucial anatomical structures1, characterized by high variability, which are poorly been described. The aim of our study is to describe and classify the anatomical variants of the hypo- and retrotympanum by the means of transcanal endoscopy2. We hypothesize that the retro- and hypotympanum are subject to more anatomical variability than actually thought. Moreover, the configuration as bridge variants and variably shaped sinus interconnects the different subregions. A total of 125 middle ears (83 cadaveric dissections) were explored by the means of 3mm straight and angled scopes. The variants were documented photographically and tabularized. The bony crests ponticulus, subiculum and finiculus1 were most frequently represented as ridges. The ponticulus showed the highest variability with 38% ridge, 35% bridge and 27% incomplete presentation. The subiculum was bridge - shaped only in 8% of the cases, while the finiculus in 17%. The sinus tympani had a normal shape in 66% of the cases. A subcochlear canaliculus was observed in 50%. The retro- and hypotympanum were classified respectively to the present bony crests and sinus in chambers type I to IV. In our opinion, the retro- and hypotympanum have to be considered as a tightly coherent region of the middle ear. For this purpose, we propose a straightforward classification, according to the presence of the different bony crests and sinus forming the different chambers of the retro- and hypotympanum. The introduced classification may also serve as intraoperative assessment, to be aware of the different anatomical subregions. The hidden areas of the retro- and hypotampanum are difficult to access and therefore represent a region of risk for residual cholesteatomatous disease after surgical treatment. The extension below a bridge bony crest or into a deep sinus demands thorough exploration; therefore, exact anatomical knowledge and an effective technique to visualize the whole middle ear are required., Italian Journal of Anatomy and Embryology, Vol. 121, No. 1 (Supplement) 2016

Background: The endoscopic endonasal opening of the optic canal has been recently proposed for tumors with medial invasion of this canal, such as tuberculum sellae meningiomas. Injury of the ophthalmic artery represents a dramatic risk during this maneuver. Therefore, the aim of this study was to analyze the endoscopic endonasal anatomy of the precanalicular and canalicular portion of this vessel, discussing its clinical implication. Methods: The course of the ophthalmic artery was analyzed through five endoscopic endonasal dissections, and 40 nonpathological consecutive MRAs were reviewed. Results: The ophthalmic artery arises from the intradural portion of the supraclinoid internal carotid artery, in 93 % of cases about 1.9 mm (range: 1–3) posterior to the falciform ligament. At the entrance into the optic canal, the ophthalmic artery is located infero-medially to the optic nerve in 13 % of cases. In 50 % of these cases the artery moves infero-laterally along its course, remaining in a medial position in the others. In cases with an non medial entrance of the ophthalmic artery, it runs infero-lateral to the optic nerve for its entire canalicular portion, with just one exception. Conclusion: The endoscopic endonasal approach gives a direct, extensive and panoramic view of the course of the precanalicular and canalicular portion of the ophthalmic artery. Dedicated high-field neuroimaging studies are of paramount importance in preoperative planning to evaluate the anatomy of the ophthalmic artery, reducing the risk of jeopardizing the vessel, particularly for those uncommon cases with an infero-medial course of the artery.

Polyphosphoinositides (PPIns) are a family of seven lipid messengers that regulate a vast array of signalling pathways to control cell proliferation, migration, survival and differentiation. PPIns are differentially present in various sub-cellular compartments and, through the recruitment and regulation of specific proteins, are key regulators of compartment identity and function. Phosphoinositides and the enzymes that synthesise and degrade them are also present in the nuclear membrane and in nuclear membraneless compartments such as nuclear speckles. Here we discuss how PPIns in the nucleus are modulated in response to external cues and how they function to control downstream signalling. Finally we suggest a role for nuclear PPIns in liquid phase separations that are involved in the formation of membraneless compartments within the nucleus.

STUDY OBJECTIVE: To clarify the relationship of hypogastric nerves (HNs) with several pelvic anatomic landmarks and to assess any anatomic differences between the 2 sides of the pelvis, both in cadaveric and in vivo dissections. DESIGN: Prospective observational study. SETTING: An anatomic theater for cadaveric dissections and a university hospital for in vivo laparoscopy. PATIENTS: Five nulliparous female cadavers underwent laparotomic dissection; 10 nulliparous patients underwent laparoscopic surgery for rectosigmoid endometriosis without posterolateral parametrial infiltration. INTERVENTIONS: Measurements of the closest distance between HNs and ureters, the midsagittal plane, the midcervical plane, and uterosacral ligaments on both hemipelvises. A comparison of anatomic data of the 2 hemipelvises was conducted. MEASUREMENTS AND MAIN RESULTS: The right and left HNs were identified in all specimens, both on cadavers and in vivo dissections. A wide anatomic variability was reported. Regarding the differences between the 2 hemipelvises, we found that the right HN was significantly (p .05). CONCLUSIONS: Despite a wide anatomic variability of position and appearance, the HNs are reproducibly identifiable using an "interfascial" technique and considering the ureters and uterosacral ligaments as anatomic landmarks.

The anatomical variations of the brachial plexus are important to be reported, in order to avoid their damage during the upper-limb surgical procedures. Despite of the frequent documented abnormalities in the pathway of the musculocutaneous and the median nerves, the anatomical variation accurately described in the present case is unusual to see: it does not perfectly come under any of the classifications proposed in literature. During the dissection of the right brachial plexus in an old male Caucasian cadaver a communicating branch between the musculocutaneous nerve and the median nerve was observed. Proximally It originated by the musculocutaneous nerve, after its perforation of the coracobrachialis muscle; distally it joined the median nerve only at the level of the cubital fossa. The musculocutaneous nerve and the median nerve maintained their normal courses, supplying all the collateral and terminal branches. In the same limb an atrophied short head of the biceps brachii muscle was also seen. Keywords: Median nerve, Musculocutaneous nerve, Communicating branch, Brachial plexus, Variation

The retro- and hypotympanum are hidden areas of the middle ear, only poorly recognized. Nevertheless, this region is of relevant clinical significance, since it is regularly affected by disease such as cholesteatoma. The aim of this study is to explore and describe the anatomical variants of the hypo- and retrotympanum by the means of transcanal endoscopy. We hypothesize a significant variability of this hidden region of the middle ear. Moreover, we believe that the minimal invasive, endoscopic access is suitable since angled scopes may be used to explore the region. To this end a total of 125 middle ears (83 cadaveric dissections, 42 surgical cases) were explored by the means of 3 mm straight and angled scopes. The variants were documented photographically and tabularized. The bony crests ponticulus, subiculum and finiculus were most frequently represented as ridges. The ponticulus showed the highest variability with 38% ridge, 35% bridge and 27% incomplete presentation. The subiculum was bridge-shaped only in 8% of the cases, the finiculus in 17%. The sinus tympani had a normal configuration in 66%. A subcochlear canaliculus was detectable in 50%. The retro- and hypotympanum were classified, respectively, to the present bony crests and sinus in a novel classification type I-IV. In conclusion, we found abundant variability of the bony structures in the retro- and hypotympanum. The endoscopic access is suitable and offers thorough understanding and panoramic views of these hidden areas.

Background Tripping over a raised surface is considered to be the most common cause of falls in the elderly. The aim of this study was to detect alterations of the motor pattern of elderly subjects while climbing a single step (“one step negotiation”) which may account for tripping and risk of falling. Methods We tested a sample of 32 “healthy” elderly subjects with a mean age of 72.4 years (SD 4.81; range 65–86). The control group consisted of 18 young subjects with a mean age of 26.5 years (SD 2.12; range 24–33). An experimental set-up for kinematic assessment while climbing a single step was provided. The elderly population was characterized clinically and functionally by a comprehensive geriatric assessment including information about comorbidity, disability, depression, motor, and muscular function. Findings Despite the high level of motor ability measured clinically, biomechanical analysis enabled us to demonstrate precise changes in step-climbing strategy in the elderly. A prolonged double stance phase duration, a greater anterior flexion of the trunk, a greater flexion of the hip, and a reduced dorsiflexion of the ankle were detected with respect to controls. All these factors and especially the latter could be determinants in the possible risk of tripping. Interpretation The biomechanical analysis performed on a population of healthy elderly subject has shown precise abnormalities of the trunk, hip and ankle kinematic during the motor task execution. This information can be of relevance in planning physical activity programs adapted for elderly and aimed at reducing the risk of tripping and falling.

This study tested the hypothesis that PI-PLCβ1 is associated with myeloid differentiation and that its expression could be useful for predicting the response of MDS patients to azacitidine, as the clinical effect of epigenetic treatments is often detectable only after several cycles of therapy. To this end, PI-PLCβ1 was quantified on 70 MDS patients (IPSS risk: 13 Low, 20 Int-1, 31 Int-2, 6 High) at baseline and during the first 3 cycles of azacitidine. Results were then compared with the hematologic response, as assessed after the sixth cycle of azacitidine therapy. Overall, 60 patients completed 6 cycles of azacitidine, and for them, a clinical and molecular evaluation was possible: 37 of these patients (62%) showed a specific increase of PI-PLCβ1 mRNA within the first 3 cycles, which was associated with a longer duration of response and with an increased myeloid differentiation, as evidenced by PI-PLCγ2 induction and the recruitment of specific myeloid-associated transcription factors to the PI-PLCβ1 promoter during azacitidine response. Moreover, the increase of cyclin D3 gene expression throughout all of the therapy showed that PI-PLCβ1-dependent signaling is indeed activated in azacitidine responder patients. Taken together, our results show that PI-PLCβ1 quantification in MDS predicts the response to azacitidine and is associated with an increased myeloid differentiation.

Deregulation of signal transduction pathways frequently confers selective biological advantages to tumors. Phosphoinositides play an essential role in numerous cellular functions and, among the enzymes implicated in these processes, phosphoinositide-specific phospholipase C β1 (PI-PLCβ1) is one of the key regulators. In the present study, a fluorescence in situ hybridization (FISH) approach was used to investigate PI-PLCβ1 gene copy number alterations in various types of breast cancer differing in their invasiveness and proliferative activity, according to their mitotic index. At the molecular level, we also performed both real-time PCR and immunohistochemical analyses on PI-PLCβ1 to further investigate its expression in primary breast cancers. Finally, we analyzed the correlation between PI-PLCβ1 gene copy number and clinicopathological parameters. Our results show that most of our cases had aneusomies on the PI-PLCβ1 locus (20p12) and amplification of this specific region was the most frequent alteration observed. Our findings also indicate that the amplification of the region containing the PI-PLC β1 gene was mostly related to the mitotic index, rather than to the invasion status. Finally, even though our case series is limited, PI-PLCβ1 gene amplification seems to be correlated to clini - copathological parameters. cular markers to better characterize this tumor. A number of different factors are involved in breast carcinoma pathogenesis, making a correct biopathological characterization essential to determine tumor aggressiveness and to identify the most appro- priate therapy. Moreover, as numerous genetic alterations are preserved throughout the evolution of breast cancer and a strong correlation exists between the presence of precursor lesions and the risk of developing invasive carcinoma (2-5), the discovery of new molecular targets could play an important role in the early diagnosis and monitoring of this disease. In breast cancer, as well as in other tumors, the deregulation

Knowledge of the anatomy of renal vessels and their anatomical variations (diverse branching from abdominal aorta) represents an indispensable moment for planning and performing surgical operations in this area. Renal arteries originate from abdominal aorta at L1-L2 level. Normally the right renal artery passes behind inferior vena cava and right renal vein, the left one is shorter and passes behind left renal vein. Each renal artery gives inferior adrenal gland arteries and divides in four or five branches close to the hilum. Usually, shortly below the right renal artery, right gonadic artery arises and runs in front of the inferior vena cava. In our Department, during a routine gross anatomy dissection of a 98-year-old Caucasian male cadaver for undergraduated, postgraduated students and residents, we observed that right renal artery exhibit an early bifurcation. The two arteries have a peculiar running, in spite of the more frequent behavior. They cross each other at the middle of the path between abdominal aorta and renal hilum forming a sort of knot. The lower branch goes up looking like a superior polar artery, from which stems a short retropielic artery. Right gonadic artery originates from right renal artery in spite of its more frequent origin from abdominal aorta at L3 level. These monolateral variations are of course unusual but not responsible for any hemodynamic impairment. Probably as concerning the right renal artery variation it looks like that it is due to a non complete fusion of the primitive segmental arteries at the first steps of formation of right dorsalis aorta. This impinges on the fact that also the right gonadic artery stays close to the upper part of dorsalis aorta and therefore originates eventually from the right renal artery., Italian Journal of Anatomy and Embryology, Vol 117, No 2 (Supplement) 2012

According to 1756 Haller description, coeliac trunk presents usually his typical trifurcation in left gastric, splenic and common hepatic arteries [1]. In 1928 Adachi first classified anatomical variations of the coeliac trunk2. Then Adachi and Michels classified the coeliac trunk into six different types [2,3]. The types are: 1, normal branching; 2, hepatosplenic trunk and left gastric artery from aorta; 3, hepatosplenomesenteric trunk and left gastric artery from aorta; 4, hepatogastric trunk and splenic artery from superior mesenteric artery; 5, splenogastric type (splenic and left gastric from the coeliac trunk and common hepatic artery from superior mesenteric artery); 6, coeliacomesenteric trunk (splenic, left gastric, common hepatic and superior mesenteric arteries arise from a common trunk). It appears that only 87.6% of the coeliac trunk shows the classical trifurcation, while an incomplete coeliac trunk can be observed in 12.4% of cases [4]. In our Department, during a routine gross anatomy dissection of a 98-year-old Caucasian male cadaver for undergraduated, postgraduated students and residents, it was noted that the coeliac trunk divided just into two vessels (left gastric and common hepatic arteries). The length of this trunk was 3.0 cm and it had diameter of 0.6 cm. A second trunk, divided into two branches (superior mesenteric and splenic arteries), arose from abdominal aorta 0.7 cm below the coeliac trunk. This anatomical variation corresponds to type 4 according to Michels. In the reported variation, because of this low origin, splenic artery resulted very long and particularly tortuous, and was located below and anteriorly to both body and tail of the pancreas. This is highlighted by the fact that dorsal pancreatic artery originates from splenic artery inferiorly to pancreatic body, with an ascending course. The presence of variations of coeliac and superior mesenteric arteries is due to variable ways of fusion of right and left primitive yolk arteries when they localize in the dorsalis meso root. Probably the hepatogastric trunk originates from right yolk artery, and the splenomesenteric trunk from the left one. The small distance between the two origins (0.7 cm versus 2.5 cm, i.e. the common distance) supports this organogenetic explanation. It is worthwhile mentioning that the reported findings are interesting given that this variation is quite rare [5] and is not responsible for any hemodynamic problems, as reported by clinical history of the patient., Italian Journal of Anatomy and Embryology, Vol 117, No 2 (Supplement) 2012

The serine/threonine protein kinase Akt is a major signal transducer of the phosphoinositide 3-kinase (PI 3-K) pathway in all cells and tissues and plays a pivotal role in the maintenance of cellular processes including cell growth, proliferation, survival, metabolism and development of many malignancies including acute myeloid leukemia. The frequent aberrant activation of the PI 3-K/Akt pathway in human cancer has made it an attractive therapeutic target. Therefore, the study of effector proteins downstream of Akt could clarify the role of Akt in the development of myeloid leukemia. Although both localization and activity of Akt in the nuclear compartment are well documented, most Akt substrates identified so far are located in the cytoplasm, while nuclear substrates have remained elusive. In this study, we applied a proteomic approach to identify novel Akt substrates by using an antibody that recognized a consensus motif phosphorylated by Akt (K/RXK/RXXS/T) when phosphorylated on S/T (anti-phospho-Akt substrate antibody). NB4 cells were treated with ATRA, and the putative Akt substrate proteins were isolated by immunoprecipitation with the anti-phospho-Akt substrate antibody. The proteins were separated on SDS-PAGE and analyzed by ESI-Q-TOF mass spectrometry. This analysis indicated prohibitin 2, a potential tumor suppressor protein with potent transcriptional functions in the nucleus, as a putative substrate of Akt in the nucleus of NB4 cells. The putative Akt-Prohibitin 2 interaction was validated by reverse in vivo immunoprecipitation from nuclear protein of NB4 cells. In vitro phosphorylation of endogenous prohibitin 2 by recombinant Akt further validated this result. Vandermoere F, El Yazidi-Belkoura I, Demont Y, Slomianny C, Antol J, Lemoine J, Hondermarck H. Proteomics exploration reveals that actin is a signaling target of the kinase Akt. Mol Cell Proteomics. 2007 Jan;6(1):114-24. Kasashima K, Ohta E, Kagawa Y, Endo H. Mitochondrial functions and estrogen receptor-dependent nuclear translocation of pleiotropic human prohibitin 2. J Biol Chem. 2006 Nov 24;281(47):36401-10., Italian Journal of Anatomy and Embryology, Vol 116, No 1 (Supplement) 2011