Search

In the Visible Korean, serially sectioned images with real color and high resolution have been prepared from four cadaveric subjects: male whole body, female whole body, male head, and female pelvis. Recently, segmented images of the female whole body were manufactured, permitting the distribution of the complete four data sets. The purpose of this report was to promote the applications of sectioned and segmented images from the Visible Korean by announcing them. Reduced image data were loaded to self-developed browsing software; using the browsing software, the contents could be quickly grasped and evaluated by other investigators. The four data sets were compared to disclose the individual merits and demerits. The sectioned and segmented images showed the possibility to be used to reconstruct the stereoscopic volume and surface models of body structures. The Visible Korean is expected to contribute to the interactive simulation of medical learning and clinical practice.

Objective To provide an anatomical atlas made of serially sectioned images of a female cadaver that clearly demonstrated the pudendal nerve. Materials and Methods The courses of the pudendal nerve, internal pudendal artery, and internal pudendal vein were observed on the sectioned images of a female cadaver. The spatial relationship between the nerve and blood vessels was interpreted. Results Traces of the structures on the sectioned images showed that the sources of the sciatic and pudendal nerves were the fourth lumbar nerve to the second sacral nerve and the second to the fourth sacral nerves, respectively. As the borderline, the second sacral nerve showed a remarkable variation. The pudendal nerve gave off the internal rectal nerve proximal to the pudendal canal and it gave off the muscular branch to the urogenital triangle in the pudendal canal. It was divided into the posterior labial nerve and the dorsal nerve of clitoris distal to the pudendal canal. Inside the pudendal canal, the internal pudendal vein, internal pudendal artery, and pudendal nerve were arranged from superomedial to inferolateral order. In other words, the pudendal nerve was the farthest from the uterus. Conclusion The sorted sectioned images with labels, accompanied by the schematic drawings, could serve as references for interpreting clinical images and conducting procedures related to pudendal nerve conditions.

SUMMARY: In Southern Medical University, China, 1,200 medical students study neuroanatomy every year, whereas in Ajou University, Korea, only 45 medical students study neuroanatomy. The considerable difference of student numbers results in differences in educational situations. The purpose of this study was to investigate desirable neuroanatomy education methods for large and small numbers of students. The situations of neuroanatomy education in China and Korea were compared systematically. With a questionnaire survey, positive comments and recommendations for their counterparts were collected from the medical students (168 Chinese and 41 Koreans) and anatomists (6 Chinese and 3 Koreans). By reviewing the opinions, the Chinese and Korean anatomists could learn from each other to improve their strong points and make up for the weak points. The results also disclosed the common problems of neuroanatomy education, which could be relieved by developing the fitting book and the self-learning tools, such as lecture videos and stereoscopic computer models.

Background: In physical anthropology, bone landmarks are palpated in living humans for the identification of corresponding skin landmarks and exact biometry. The purpose of this study is to help comprehend the locations and depths of representative bone landmarks all over the body. Materials and methods: The sectioned images of a male cadaver’s whole body were used to build a volume model, which was continuously peeled at 1 mm thicknesses to disclose 27 selected landmarks in the anterior, lateral, or posterior views. Results: The captured views of peeled volume models along with the labels of the bone landmarks were loaded to browsing software that was distributed for free. The browsing software containing the peeled volume models will enhance convenient studying of the bone landmarks. Conclusions: With the knowledge of bone landmarks, investigators would be able to attain more accurate measurements between skin landmarks.

The sectioned images of a male’s whole body were used for making the four learning tools: the first tool to show the sectioned and color-filled images; the second tool to show surface models of individual structures; the third tool to show a volume model that was continuously peeled; the fourth tool to show a volume model that was freely sectioned. This study was intended to propose the possible learning effects of the four tools. The fourth tool that was recently developed to facilitate oblique sectioning and rotation of the volume model in real time. The four learning tools had their own characteristics, so that they could be separately used for specific achievements. Further, the combination of the tools based on the same raw data may result in a synergic effect. All the tools can be downloaded from the Visible Korean homepage (anatomy.co.kr) gratis. With the four learning tools, students may experience virtual dissection simulation regardless of the place, time, or economic status. Such free learning tools and commercial learning tools need to be improved to compensate and compete with each other.

Background The impact of coronavirus disease 2019 (COVID-19) has profoundly affected education, with most universities changing face-to-face classes to online formats. To adapt to the COVID-19 pandemic situation, we adopted a blended learning approach to anatomy instruction that included online lectures, pre-recorded laboratory dissection videos, and 3D anatomy applications, with condensed offline cadaver dissection. Methods We aimed to examine the learning outcomes of a newly adopted anatomy educational approach by 1) comparing academic achievement between the blended learning group (the 2020 class, 108 students) and the traditional classroom learning group (the 2019 class, 104 students), and 2) an online questionnaire survey on student preference on the learning method and reasons of preference. Results The average anatomy examination scores of the 2020 class, who took online lectures and blended dissection laboratories, were significantly higher than those of the 2019 class, who participated in an offline lecture and dissection laboratories. The questionnaire survey revealed that students preferred online lectures over traditional large group lecture-based teaching because it allowed them to acquire increased self-study time, study according to their individual learning styles, and repeatedly review lecture videos. Conclusion This study suggests that a blended learning approach is an effective method for anatomy learning, and the advantage may result from increased self-directed study through online learning., Graphical Abstract

It is difficult for medical students and novice clinicians to interpret cardiac computed tomographs and echocardiographs. This study was intended to help familiarize them with the clinical images of the heart by providing software to browse the various planes of a heart’s volume model with real color and high resolution. On the sectioned images of a male cadaver, the heart and adjacent structures were segmented to obtain color-filled images. Volume models of the sectioned images and color-filled images were reconstructed and sectioned to obtain three orthogonal planes and five standard oblique planes. The planes were inputted into lab-made browsing software, which was then distributed free of charge. Users of the software would hopefully progress as follows. After experiencing the real color and high resolution, they would become familiar with the grayscale and low resolution. After experiencing the automatic annotation of the basic heart structures, they would become familiar with the detailed structures. After experiencing the designated planes, they would become familiar with the arbitrary planes. After experiencing the still heart, they would become familiar with the moving heart during echocardiography. The software, with a user-friendly interface and realistic features, is expected to properly orient medical novices to cardiac computed tomography and echocardiography images.

Background A book entitled “Visually Memorable Regional Anatomy (VMRA)” consists of extremely schematic figures as well as concise anatomic knowledge. On the other hand, in the Visible Korean (VK) project, three-dimensional surface models of 297 head structures have been reconstructed. The study's objective was to verify how the coexistence of the schematic figures and realistic surface models affected anatomy learning. Methods In the portable document format (PDF) file of VMRA, 19 pages of the surface models of the head from the PDF file of VK were embedded. The resultant PDF file was utilized as a learning tool of the medical students in two universities. Results The PDF file could be downloaded free of charge from anatomy.co.kr. The PDF file has been accessed by users from multiple countries including Korea, United States, and Hungary. In the PDF file, the surface models could be selected in any combinations, magnified, freely rotated, and compared to the corresponding schematics. The number of hours that the PDF file was used by medical students and the scores of written examination on the PDF file showed a low positive correlation in a university. The students replied that the combined PDF file was helpful for understanding anatomy and for doing cadaver dissection. They were also satisfied with the convenience of comparing the surface models and schematics. Conclusion The freely obtainable PDF file would be a beneficial tool to help students learn anatomy easily, interactively, and accurately., Graphical Abstract

This chapter explores the comprehensive functions of the brain, which are closely related not only to the morphology of the brain but also to the somatic and autonomic nerves of the cranial and spinal nerves. Details are the functions of the cerebral cortex, limbic system, basal nuclei, diencephalon, cerebellum, and brainstem. Readers can see drawings with consistent style of the brain shape and the neuronal connections. This chapter often refers to the general rule of afferent nerves having three neurons that is developed by the authors. The functions of the brain are explained within the boundary of neuroanatomy; the rest of the functions fall under neurophysiology.

The nervous system consists of four kinds of nerves: the somatic sensory nerve from receptor around the skeletal muscle (e.g., receptor in the skin), the somatic motor nerve to the skeletal muscle (voluntary muscle), the visceral sensory nerve from the receptor around the smooth or cardiac muscle (e.g., receptor in the gastrointestinal tract), and the visceral motor nerve (autonomic nerve) to the smooth or cardiac muscle (involuntary muscle). This chapter explores two pathways of the somatic sensory nerve (spinothalamic tract and medial lemniscus pathway), one pathway of the somatic motor nerve (corticospinal tract). Additional content is two components of the visceral motor nerve (sympathetic and parasympathetic nerves). Comprehension of the pathways is enhanced by practice with stained slices of the brainstem and spinal cord (or their photos).

Neuroanatomy and development of the central nervous system are like the result and its cause, respectively. Therefore, neuroanatomy can be well understood by knowing development. Reversely, development can be understood after knowing neuroanatomy, so this chapter is the book’s last part. The first form of the brain and spinal cord is the neural tube, which originates from the ectoderm. The five brain vesicles of the neural tube then develop and flex to become the cerebrum, diencephalon, midbrain, pons (and cerebellum), and medulla oblongata. Simultaneously, the inside neural canal becomes the ventricles and central canal. The sulcus limitans in the neural canal is the boundary between the sensory nerve and motor nerve, which provides great consistency of neuroanatomy.

The nervous system consists of the central nervous system (brain, spinal cord) and the peripheral nervous system (cranial nerve, spinal nerve). This chapter explores the gross morphology of the central nervous system, in preparation for further study of the neuronal connections. This chapter details the blood supply and cerebrospinal fluid flow of the central nervous system. Then it sequentially describes the morphology of the cerebral hemisphere, limbic system, basal nuclei, diencephalon, cerebellum, brainstem, and spinal cord. It is necessary to correlate external features of the structures to their sectional planes. It is suggested to review this chapter with other learning materials such as realistic neuroanatomy atlases, plastic specimens, three-dimensional computer models, and cadavers.

SUMMARY: This study was intended to evaluate the anatomy comics as learning material for adolescents. For that, both the learning comics and comic strips were shown to 341 junior high school students who subsequently completed a questionnaire. According to the students answers, the anatomy comics were greatly or somewhat helpful in understanding anatomy (learning comics: 87.7 %; comic strips: 86.2 %). The anatomy comics were greatly or somewhat entertaining (learning comics: 66.9 %; comic strips: 77.4 %). According to their free remarks, the anatomy comics enhanced the students’ understanding with the simple figures and easy explanations. The students regarded the anatomy comics as entertaining because of the related jokes and comparative daily lives. The students preferred the complimentary anatomy comics presented on the authors’ homepage (anatomy.co.kr). This investigation proves the possibility that the anatomy comics contribute to adolescents learning.

Background Working status is identified as a major risk factor of poor breastfeeding practices among workers. This study aimed to evaluate the knowledge, attitude, and factors associated with breastfeeding practice among white-collar and blue-collar workers in Indonesia. Methods A cross-sectional study was performed in two factories and three government offices in Jakarta from December 2015 to February 2016. Subjects were woman workers whose children were age 6 to 24 months old and actively working in the factory and/or office. The factors studied were selected socio-demographic and occupational characteristics, score on knowledge and attitude, and breastfeeding practice during working hours. Results From a total of 192 subjects, 73% of white-collar workers had good knowledge on breastfeeding, in contrast with 55% of blue-collar workers who had not good breastfeeding knowledge (P < 0.001). Most of the subjects were conducting breast pumping during working hours, however 15% of white-collar workers and 17% of blue-collar workers never breastfeed nor breast pumped at work. Working status (P = 0.005) and knowledge (P = 0.002) were factors associated with breastfeeding practice among workers. Conclusion White-collar workers have a better knowledge, attitude, and practice toward breastfeeding. Knowledge improvement related to breastfeeding benefits and supports to working mothers are a key priority, however advocacy to employers, managers, and supervisors in providing breastfeeding facilitation and program support were also critical to successful breastfeeding practice among workers., Graphical Abstract

Background We evaluated the effects of neurofeedback as an augmentation treatment on depressive symptoms and functional recovery in patients with treatment-resistant depression (TRD). Methods We included 24 adult patients with TRD and 12 healthy adults. 24 TRD patients were assigned to the neurofeedback augmentation group (n = 12) and the medication-only (treatment as usual [TAU]) group (n = 12). The neurofeedback augmentation group underwent combined therapy comprising medication and 12–24 sessions of neurofeedback training for 12 weeks. To assess the serum levels of brain-derived neurotrophic factor (BDNF) in both groups, pre- and post-treatment blood samples were obtained. Patients were evaluated using the Hamilton Depression Rating Scale (HAM-D), Beck Depression Inventory (BDI), Clinical Global Impression-Severity (CGI-S), 5-level version of European Quality of Life Questionnaire 5-Dimensional Classification (EQ-5D-5L), and Sheehan Disability Scale (SDS) at baseline, and at the 1-, 4-, and 12-week. Results From baseline to week 12, neurofeedback training reduced mean scores on HAM-D, BDI-II, CGI-S, and SDS, and increased mean EQ-5D-5L tariff score. In the neurofeedback augmentation group, the response and remission rates were 58.3% and 50.0%, respectively, at week 12. Changes in HAM-D, EQ-5D-5L tariff score, and SDS were significantly larger in the neurofeedback group than in the medication-only (TAU) group. No significant difference in BDNF level was found pre- vs. post-treatment in any of the groups. Conclusion Despite the small sample size, these results suggest that neurofeedback treatment may be effective as an augmentation treatment, not only for depressive symptoms, but also for functional recovery, in patients with TRD. Trial Registration Clinical Research Information Service Identifier: KCT0004183 ClinicalTrials.gov Identifier: NCT04078438, Graphical Abstract

SUMMARY: The sectional anatomy of a cat head is essential when interpreting CTs and MRIs of the region. In learning the sectional anatomy, sectioned images of a cat could be quite effective data. The main objective was to assist veterinary physicians who learn the sectional anatomy of a cat head by presenting high-quality sectioned images. A short-haired female cat was frozen and sectioned frontally using a cryomacrotome. Every sectioned surface in real body color was photographed with a digital camera. The frontal planes were stacked to produce dorsal and sagittal planes. High-quality sectioned images of a cat head allowed the identification of small, complicated structures. The notable structures were as follows: each bone of the cranium, structures of the brain, tympanic cavity (larger than human), oval window (larger than human), vestibular nerve, cochlear nerve, ear ossicles, six extraocular muscles, pupil (larger than human), retractor bulbi muscle (not found in human), optic nerve, olfactory bulb (considerably large), vomeronasal organ duct (not found in human), infraorbital gland (not found in human), masticatory muscles (larger than human), maxillary nerve (larger than human), and mandibular nerve. This pacesetting report describes the detailed head structures of a cat from the viewpoint of sectional anatomy. The sectioned images will be given to other interested researchers free of charge.