Folia morphologica最新文献

Background: The left coronary artery (LCA) typically terminates by bifurcating into left anterior descending (LAD) and circumflex (Cx) branches, collectively forming a critical component of coronary circulation. Despite relevancy in coronary angiography interpretation and preoperative planning, description of standard and aberrant LCA branching pattern rates is often restricted to small-scale studies. Therefore, this study aimed to provide a comprehensive analysis of the prevalence of LCA branching patterns.

Materials and methods: A systematic review was conducted by searching major databases and relevant anatomical journals. Studies that provided quantitative data on LCA branching patterns were selected for inclusion. A total of 85 studies met the criteria, which encompassed a total of 23,421 LCAs. Data on LCA branching patterns rates, continent in which the study took place, and study methodology (imaging versus dissection) were extracted and analyzed via meta-analysis.

Results: The pooled prevalence of absent LCA was 0.40%, single LCA branch (aberrant Cx origin while LCA continued as LAD) was 0.03%, LCA bifurcation was 68.77%, trifurcation was 26.77%, tetrafurcation was 1.01%, and pentafurcation was < 0.01%. Subgrouping based on methodology revealed differing LCA bifurcation rates as seen in imaging studies (75.79%) versus dissection studies (64.22%) (Q = 15.91, p < 0.01). Subgrouping based on continent in which the study took place revealed significant heterogeneity (Q = 29.26, p < 0.01).

Conclusions: The LCA exhibits variable branching patterns, and understanding the prevalence of LCA branching patterns can support imaging interpretation and preoperative planning for coronary circulation interventions.

Background: The application of artificial intelligence (AI) in medicine has been a strong trend in recent years. Many generative tools have a model that processes a text command (so-called "prompt") and generates a response in the form of text (e.g. ChatGPT) or an image (e.g. Midjourney, DALL-E). Due to the wide availability, these tools are often used without proper supervision for educational purposes. The aim of this study was to assess the state-of-the-art use of AI-based generative tools in creating an image-based anatomical atlas using only images created by AI.

Materials and methods: The author's provided anatomical prompt into the Midjourney and individual images were made for each of the eight organ systems - digestive, facial, genitourinary, respiratory, skeletal, muscular, circulatory, and neurological. The systems were divided into two sections: a general sketch of body system (BS) and a detailed description of one of their representative structures (DS). The authors selected two of the highest images for each collection, correspondingly. The obtained data was assessed qualitatively depending on the presence of a specific structure, a physiological alteration, or the presence of an additional AI hallucination. Obtained results were compared with The Federative International Programme for Anatomical Terminology - Terminologia Anatomica 2nd version (TA2) and statistically analyzed using the chi-square test of independence (two-sided α = 0.05, β = 0.2) to evaluate the relationship of image complexity and the categories studied.

Results: A total of 12126 general BS and 2503 specific DS items according to TA2 were obtained and analyzed. As for the presence of structures, they were generally present in 17.3% (n = 2094), absent in 53.3% (n = 6462) and the generated scenery did not allow a clear assessment of the presence of a structure in 29.4% (n = 3570). Only 7.0% (n = 553) of the current structures were in physiological order. However, 6.0% (n = 471) of the particular items were classed as AI hallucinations. When comparing BS and DS findings, the tool significantly outperformed DS in all categories: structural presence (21.7% BS vs 40.3% DS; p < 0.001), physiological order (4.6% BS vs 15.5% DS; p < 0.001), and AI imagination (6.3% BS vs 4.9% DS; p = 0.034).

Conclusions: The current state-of-the-art of anatomy based on generative tools does not allow for the high-quality application of AI to generate anatomical atlases. Especially, inexperienced users may unknowingly cultivate inconsistent scientific understanding. The results obtained are expected to improve in the future due to the continuous addition of annotations to libraries and the improvement of algorithms, nevertheless more research is required.

Background: The brachial artery is a key vessel supplying the upper limb, and its anatomical variations can have significant clinical implications. One of the most common variations of this vessel is a high division of the brachial artery. This can occur at various levels of the arm and lead to the formation of a brachioradial artery, a brachioulnar artery, or their superficial variants.

Materials and methods: The study was based on the analysis of a case observed during a routine autopsy of a 64-year-old woman, conducted as part of the Normal Anatomy course for medical students at the Department of Normal and Radiological Anatomy of the Medical University of Lublin.

Results: The analysis revealed an atypical course of the arteries in the left upper limb. The brachial artery divided at the level of the upper third of the arm, 2 cm below the lower border of the teres major muscle, giving rise to the brachioradial artery and the brachioulnar artery. The common interosseous artery branched off from the brachioulnar artery in the cubital fossa. The vascular course in the right upper limb was confirmed as typical.

Conclusions: A high division of the brachial artery is a relatively common anatomical variation, occurring in 10.05% of the population, and therefore requires special attention during surgical and diagnostic procedures. Its most frequent variant is the division of the brachial artery into a brachioradial artery and a brachioulnar artery. The presence of this variation can affect the efficacy and safety of procedures such as angiography, vascular surgeries, or reconstructive surgeries. Further research should aim to standardize the descriptions of anatomical variations in upper limb arteries and establish a unified nomenclature system.

Background: A comprehensive anatomical understanding of the azygos venous system, and of the courses and branching patterns of major arteries and their possible variations, is essential for accurate diagnosis, effective management of vascular conditions, and for safe surgical or interventional procedures. Detailed preoperative assessment and recognition of such vascular morphologies and anomalies play a pivotal role in minimizing intraoperative risks and preventing postoperative complications.

Case report: Four concurrent variations of the vessels were identified in a ninety-eight-year-old Korean female cadaver during routine dissection for an anatomy class. The main trunk of the azygos vein (AV) bifurcated at the level of L1 and rejoined at the level of T10. During its ascent on the left side, the intercostal veins drained directly into the AV without forming the hemiazygos or accessory hemiazygos veins. The right common carotid artery exhibited severe kinking just inferior to the level of T1. The first branch of the right internal iliac artery was the obturator artery rather than the umbilical artery. Furthermore, the inferior gluteal artery (IGA) and the internal pudendal arose from a common trunk and bifurcated below the pelvic diaphragm. We observed a rare looped artery in the left internal iliac region connecting the posterior division of the internal iliac artery to the proximal portion of the IGA.

Conclusions: This case highlights that various rare vascular anomalies may coexist in a single individual; anatomist, surgeons, and other clinicians should be aware of this possibility during dissection and surgical procedures.

Introduction: The semimembranosus muscle (SM) is a key component of the posterior thigh and an integral part of the hamstring group. It plays a crucial role in lower limb movement, particularly in knee flexion, hip extension, and medial rotation of the tibia (with the knee flexed), in cooperation with other muscles of the hamstring complex. The aim of this study was to assess the anatomy and morphometry of the SM proximal tendon.

Materials and methods: The proximal tendon of the semimembranosus muscle was carefully dissected and examined in 60 cadaveric specimens (32 left and 28 right) obtained from 60 cadavers (27 females and 33 males).

Results: During dissection, one tendon variant was identified on the medial side, whereas two tendon variants (Type I and Type II) were distinguished on the lateral side. Type I was observed in 42 specimens, while Type II was identified in 18 specimens. Morphometric parameters, including the lateral and medial lengths of the superficial part of the SM tendon, the lateral and medial lengths of the deep part of the tendon, as well as tendon thickness and width, were measured in detail.

Conclusions: This study demonstrates that the proximal tendon of the semimembranosus muscle exhibits distinct anatomical variability. These findings may provide valuable reference data for clinicians, particularly orthopedic surgeons and radiologists, in the diagnosis and treatment of hamstring injuries.

Background: Accessory tendons of the extensor hallucis longus are well documented, whereas an extension of the extensor digitorum longus (EDL) to the great toe has only been briefly mentioned in Sarrafian's textbook, without detailed cadaveric documentation.

Case report: During routine dissection of a 78-year-old Korean male cadaver, the extensor and fibularis muscles of both lower limbs were examined. On both sides, an accessory tendinous slip of the EDL coursed medially to the great toe. The right accessory tendon arose from the posterior midportion of the EDL tendon above the talus, while the left originated from the dorsal fascia over the proximal part of the first metatarsal. Each accessory tendon inserted into the extensor apparatus of the great toe and corresponded to a notch on the medial-distal surface of the first metatarsal.

Conclusions: This case provides the first detailed cadaveric documentation of this variation in which an accessory tendon of the EDL extending to the great toe. The finding broadens the understanding of known EDL variations and provides a useful reference for anatomical description.

Introduction: Human anatomy is a key subject in medical education and the foundation of clinical practice. Learning anatomy can be challenging for medical and health science students, because they have to memorise a large number of anatomical terms. The structure of the hand is extremely complex due to the number of bones, ligaments, and tendons - structures that a physiotherapist must be able to recognise precisely. The aim of the study was to assess the knowledge of physiotherapy students on the location and names of the bones of the hand.

Materials and methods: The study was conducted among second-year physiotherapy students from three Polish universities who had completed an anatomy course. A total of 537 people (191 men and 346 women) took part in the study. Each participant had to correctly describe the bones of the hand in the illustration. The test was an extended version of the "Carpal Bone Test". The results were statistically analysed using Statistica 13.3 Tibco® software.

Results: Statistical analysis showed that only 32.2% of physiotherapy students were able to correctly identify all 12 bones present in the diagram, while 84.4% identified 6 or more of them. An analysis of the correctness of the identification of individual bones of the hand showed that the lunate bone (85.1%) and the distal phalanx (87%) were most often correctly identified. The most errors were made in identifying the trapezium and proximal phalanx (30% of participants were unable to identify them). The average number of correctly identified carpal bones was 6.

Conclusions: When teaching students the anatomy of the hand bones, special attention should be paid to the shape and position of individual bones in relation to each other in order to avoid errors in their identification. The Hand Bone Test, extended to include the metacarpals and fingers, is a simple and easy-to-use tool that provides an objective picture of the level of knowledge of hand anatomy. In the case of Polish students, certain errors can be attributed to the similarity of anatomical names in the Polish language.

Background: Human cadavers form the foundation of anatomy education at medical universities. There is a shortage of bodies donated for scientific and educational purposes in relation to demand worldwide. Cadavers are used not only by medical students but also by resident physicians who train surgical skills on human bodies that most accurately reflect real operative conditions.

Materials and methods: The PubMed database was searched using the following keywords and terms: "body donation", "body donors." A total of 131 articles were included in this review. The literature review was planned and conducted in accordance with the PRISMA statement.

Results: The social readiness to donate one's body posthumously for educational and scientific purposes may have a multifactorial basis. Gender, age, education, religion, culture, or place of residence are only some of the variables that determine people's attitudes towards body donation. The attitudes of doctors, anatomists, and medical students - groups who regularly come into contact with human bodies - are also crucial for understanding this phenomenon.

Conclusions: In the context of body donation, it is essential to consider the posthumous commemoration of donors and to ensure due respect for human remains. Regardless of the country, actions should be taken to promote and increase public awareness of body donation for scientific and educational purposes. A thorough understanding and analysis of society's knowledge about body donation programs can lead to better dissemination of information and, consequently, greater overall awareness.

Background: The aim is to reveal the basic morphology of the infrahyoid muscles by proposing a new classification system.

Materials and methods: Data were analyzed from 67 sides from 34 Japanese cadavers. We propose a new classification system for the infrahyoid muscles, dividing them into 12 areas: superficial (S) and deep (D), cranial (1, 3, 5) and caudal (2, 4, 6), lateral (1, 2), intermediate (3, 4) and medial (5, 6). This system integrates morphology and innervation pattern of these muscles more accurately. In the superficial layer, top of the intermediate tendon of the omohyoid muscle serves as the boundary between the cranial and caudal parts. In the deep layer, the thyroid cartilage represents the boundary. Additionally, innervation by the cranial and caudal branches of the ansa cervicalis is a required criterion for classification.

Results: The incidences for six areas - S1, S2, S5, S6, D3, and D4 - exceeded 99%, with this pattern observed in 71.6% of cases, suggesting that these may represent standard anatomical patterns. In contrast, areas such as S3, S4, D1, D2, D5, and D6 showed lower incidences. Notably, three novel anatomical variations were observed and described in detail.

Conclusions: The proposed classification system allows for a more comprehensive understanding of the basic morphology of the infrahyoid muscle variation. Clinically, this is relevant for surgical procedures involving the infrahyoid area, such as flap reconstruction, where unexpected variations may occur surgical risks. Therefore, the proposed classification system offers anatomical and surgical framework of the infrahyoid muscles.

Background: Orthodontic tooth movement (OTM) is a complex biological process influenced by oxidative stress and inflammation. This study investigates the effects of resveratrol, a natural antioxidant and anti-inflammatory compound, on OTM in Wistar rats through biochemical, histological, and in silico analyses.

Materials and methods: Thirty female Wistar rats were divided into three groups: control, OTM, and OTM + resveratrol. OTM was induced using nickel-titanium closed-coil springs. The OTM + resveratrol group received 20 mg/kg resveratrol daily for 14 days. Total oxidant status (TOS) and total antioxidant status (TAS) levels were measured. Histopathological and immunohistochemical analyses were conducted to evaluate osteoblast/osteoclast activity and TNF-α expression. In silico analyses identified molecular pathways influenced by resveratrol.

Results: Resveratrol administration significantly reduced oxidative stress by increasing TAS and decreasing TOS levels. Histological findings showed enhanced osteoblast and osteoclast activity in the OTM + resveratrol group, indicating accelerated bone remodeling. Masson's trichrome staining demonstrated improved bone matrix integrity, while TNF-α immunostaining revealed decreased inflammatory response. In silico analyses identified 19 common proteins linked to TNF-α modulation by resveratrol, with key pathways involving interleukin and immune system signaling.

Conclusions: Resveratrol exhibits potent antioxidant and anti-inflammatory effects, enhancing bone remodeling and reducing TNF-α-mediated inflammation in OTM. These findings suggest its potential as a therapeutic adjunct in orthodontic treatments to mitigate adverse effects of mechanical forces on bone metabolism.