Clinical Anatomy最新文献

Effective anatomy education is critical for preparing medical students for clinical tasks such as surgical planning and radiological interpretation. Traditional chalkboard teaching and modern 3D printed models offer distinct approaches, yet their comparative pedagogical impact remains underexplored. This study evaluates chalkboard, 3D printed model, and hybrid teaching methods to optimize anatomy learning for clinical applications like coronary artery mapping and neurosurgery planning. A quasi-experimental study involved 120 undergraduate medical students randomly assigned to three groups (n = 40 each) for a 15-week intervention: chalkboard (lectures with 2D diagrams), 3D printed models (hands-on learning with patient-specific models, e.g., 3D printed heart for angioplasty), and hybrid (integrating both, model-first sequence). Outcomes were assessed via a 20-item anatomy quiz (skeletal, cardiovascular, neuroanatomy, muscular domains), a 30-item pre- and post-activity questionnaire (5-point Likert scale, knowledge, engagement, clarity), qualitative interviews (n = 28, hybrid group), and the Pedagogical Visualization Index (PVI). Data were analyzed using ANOVA, paired t-tests, and thematic analysis. The hybrid group outperforms others, with superior knowledge gain (81.8%, p < 0.001), engagement (4.4 ± 0.4), clarity (4.6 ± 0.3), and PVI (0.830) compared to 3D models (PVI: 0.720) and chalkboard (PVI: 0.543), excelling in cardiovascular (84%, e.g., coronary artery mapping) and neuroanatomy (85%, e.g., cranial nerve localization). Model-first sequencing enhances outcomes (PVI: 0.86, p = 0.03). Qualitative themes (78%) emphasize visualization for clinical reasoning (e.g., femoral artery mapping for vascular surgery). Additionally, the hybrid method demonstrates versatility across specialties, with students achieving high clarity (4.7 ± 0.2) in neurosurgery (e.g., optic nerve tracing for aneurysm clipping), precision (88%) in radiology (e.g., lung segmentation for pulmonary embolism), and engagement (4.6 ± 0.2) in orthopedics (e.g., ACL reconstruction), supported by tactile feedback from 3D models like the knee and congenital heart models for pediatric surgery (clarity 4.9 ± 0.1). The hybrid method, leveraging 3D printed models, optimizes anatomy learning for clinical tasks, supporting adoption in resource-limited curricula. Future research should validate findings with larger cohorts and objective clinical assessments.

Parkinson's disease is a multifactorial neurodegenerative disorder characterized by progressive dopaminergic neuronal loss in the substantia nigra pars compacta and widespread α-synuclein pathology. Despite extensive research, the precise molecular mechanisms underlying neuronal death remain incompletely defined. Emerging evidence indicates that multiple forms of programmed cell death (PCD), including apoptosis, autophagy failure, ferroptosis, and necroptosis, contribute to dopaminergic degeneration in distinct but overlapping contexts. This review synthesizes current insights from both post-mortem human studies and experimental models to delineate the biochemical and pathological signatures of these PCD pathways in Parkinson's disease. Post-mortem findings demonstrate heterogeneous and often coexisting PCD markers, suggesting that different neuronal subsets within the substantia nigra pars compacta may follow distinct death programs depending on their metabolic profile, iron load, and inflammatory milieu. In contrast, experimental models reveal more discrete pathway-specific activation patterns: apoptosis predominates in acute toxin paradigms, autophagy failure in genetic models, ferroptosis in iron-overload and oxidative stress conditions, and necroptosis in inflammation-augmented models. The apparent discrepancies between human and experimental evidence reflect differences in temporal resolution, pathogenic drivers, and neuronal heterogeneity but together support a unified model of multifactorial, context-dependent cell death. Finally, preclinical studies targeting these pathways, through caspase inhibition, autophagy enhancement, ferroptosis suppression, or necroptosis blockade, have provided proof-of-concept neuroprotection, although translation to clinical efficacy remains elusive. Understanding how these interconnected PCD pathways converge during Parkinson's disease progression is essential for developing multimodal therapeutic strategies that move beyond symptomatic relief toward accurate disease modification.

Radiology education is critical for medical students' anatomical competence and clinical readiness. However, it remains insufficiently integrated in medical curricula as residency program directors describe interns' basic image interpretation as unsatisfactory. This review aims to assess the efficacy of ultrasound, CT, MRI, and X-ray in facilitating the learning of anatomy among medical students. Following PRISMA guidelines, 983 articles were screened, and 52 studies published between 2000 and 2025 met the inclusion criteria by comparing radiology-integrated anatomy education with traditional methods such as cadaver and atlas use. Data extraction covered study design, radiology modalities, and effect sizes. Both integrated and traditional methods consisted of medical student cohorts assessed on objective knowledge and skills with recorded quantitative outcomes. Included studies showed knowledge gains on multiple choice assessments (pooled Cohen's d = 0.99, 95% CI: 0.34-1.65) but with high heterogeneity among studies (I² = 99.5%). Controlled designs were used in 21% of studies. Other investigations (68% of studies) used attitudinal surveys that revealed strong student preference for radiology-integrated learning. Of the modalities present, ultrasound was predominant (85% of studies), with other modalities (CT: 15%; MRI/X-ray: < 5%) substantially underrepresented despite clinical relevance. Radiology integration was shown to enhance anatomy education and clinical preparedness. The incorporation of radiology, specifically ultrasound, into anatomical education leads to a significant and substantial improvement in student learning outcomes. Future investigations can standardize assessments, expand multimodal research, and address global curricular disparities.

Paxton, a British surgeon, is best known for his influential anatomical textbook An Introduction to the Study of Human Anatomy (1831, 1844). Admitted as a Member of the Royal College of Surgeons in 1810 and later awarded an M.D. from the University of St Andrews in 1845, Paxton began his career as an army surgeon before establishing successful practices in Long Buckley, Oxford, and later Rugby. He also served as assistant-surgeon to the Oxfordshire militia. A skilled educator and writer, Paxton published several well-received medical works, including The Medical Friend (1843) and Living Streams (1855), and edited William Paley's Natural Theology. Known for combining anatomical precision with clear illustration and moral insight, Paxton was regarded as both a devoted physician and a man of deep religious conviction. He died at Ledwell House, Oxfordshire, in 1860 (Dictionary of National Biography 1895).

I believe both James Paxton and Matthew Baillie would have been avid readers of Clinical Anatomy. This first issue of 2026 contains interesting articles, including historical, educational, and original papers with relevance to the clinical anatomist. As always, we welcome comments from our readers on how to improve our Journal.

The greater omentum is a thin sheet-like abdominal organ sandwiched between the anterior abdominal wall and the intestines. It possesses adipose deposits, an epiploic vascular system, arcade-like vascular loops, and a significant number of omental milky spots, the name given to the immune/lymphatic cell clusters residing in its tissues. Observational and experimental evidence confirms that the omentum moves toward inflamed abdominal organs and surgical sites and invades via vascular and fibrous tissues, in order to isolate the area and launch an immune response. Correlated to this, direct evidence of omental growth in response to inflammatory chemokine stimuli has also been established. Further, it has been demonstrated that the metabolic activity of the milky spots, when engaged in such a response, increases 10-20 fold, along with increases in the number and size of the spots. A mechanism of chemotaxis has yet to be identified, but it is clear that the omentum is an important immunological organ that responds to inflammation and infection in the abdomen, both cellularly and physically. We propose that the blood vessels of the omentum act as a multi-pronged hydrostat system, engorging themselves and their capillaries with blood, responding to an inflammatory trigger like inflated fire hoses, and extending the organ across the abdomen. Thus, the omentum represents an unique mobile immune system that we believe warrants further focus in anatomical, clinical, immunological, and biomechanical research.

Whole-body dissection is a cornerstone of anatomy education. During and following the COVID-19 pandemic, exposure to infectious agents and other risks of dissection were highlighted. To identify potential risks, one must have the data outlining these risks in specific situations. However, information regarding the risks of encountering an infectious pathogen in donors is not readily available for educators and anatomical programs and there are presently no universal guidelines for lowering the risk of exposure to such pathogens. Therefore, this scoping review aims to provide information regarding infectious pathogens that one may encounter in the anatomy lab when engaging in dissection of both humans and animals, including zoonoses (e.g., rabies), blood-borne pathogens (e.g., HIV, HPV), and pathogens that pose a relatively less serious risk to the health of dissectors (e.g., fungal infections). A systematic and comprehensive search across PubMed/MEDLINE, Scopus, and ERIC databases without date restrictions was performed. When data were available, the prevalence of these pathogens within the worldwide population, viability in cadavers and the surrounding laboratory environment, and effects of formaldehyde fixation on pathogen infectivity are provided. This review also provides examples of mitigation methods and their effectiveness in reducing the risk of exposure to pathogens in the anatomy laboratory as published in the literature. A summary of potential toxicological hazards encountered in the lab is also included. Overall, this scoping review charts existing literature to provide information that anatomy programs worldwide can utilize to identify potential risks and identify mitigation methods to reduce such risks while dissecting.

The difficulties experienced in accessing cadavers worldwide are increasing the demand for technology-supported solutions. Virtual cadavers can ensure continuity of education by providing students with the opportunity to explore and examine realistic anatomical structures in detail without any geographical or physical restrictions. In this context, the development of alternative methods such as augmented reality (AR) or virtual reality (VR) tools is of great importance for students to continue their education. In the current study, the effectiveness of a medical education model enriched through metaverse-supported virtual cadavers was examined in order to contribute to the seamless learning experience of students. Consistent with the aim of the study, the effects of this model on students' academic achievement, attitudes towards the course, and academic motivation were evaluated. The study adopted a mixed methodology incorporating qualitative and quantitative techniques. An achievement test, anatomy attitude scale, and academic motivation scale were employed as data collection instrument in the study. In addition, interviews were conducted with the students in the experimental group to examine their experiences with virtual cadavers in the metaverse environment in depth. This study was conducted with the participation of 110 first-year medical students studying at a state university in Türkiye. Within the scope of the study, the students were divided into two groups as experimental and control groups. Although the control group followed the traditional anatomy curriculum, the experimental group performed some activities on virtual cadaver models in the metaverse environment in addition to the curriculum. The research results revealed that the academic achievement, motivation and attitude levels of the students in the experimental group increased more than those in the control group. The students emphasized that metaverse-supported virtual cadaver activities have the potential to increase students' course success, attitudes towards the course and motivation. The findings show that more comprehensive and in-depth research is needed on the potential effects of metaverse-supported virtual cadaver applications in education. This is an important step to increase the efficiency of metaverse applications in education.

The use of human donor bodies for anatomical examination in the United Kingdom is regulated by the Human Tissue Authority (England, Wales, and Northern Ireland) and His Majesty's Inspector of Anatomy for Scotland. This study aimed to assess the variability of information provided to body donors and the associated consent forms across UK anatomy institutions. A total of 24 consent forms and information booklets were collected from all body donation programs across the UK. Building on previous research, each document was assessed against a checklist covering general information about the donation process, purposes and locations of body use, consent requirements, disposition of remains, and accessibility. The analysis revealed significant heterogeneity in the information provided. The findings suggest a need for standardization of body donation information and consent forms to ensure they meet ethical requirements for informed consent and to improve accessibility and inclusivity. Recommendations include ensuring consistency between information provided and consent forms, requiring confirmation of reading the information, standardizing age limits and medical condition statements, providing clear information for next of kin, and ensuring ethical oversight by institutional committees. Further research is needed on donors' perspectives regarding specific aspects of the donation process. These recommendations are proposed to provide a more consistent approach to sharing information about body donation, ultimately suggesting the development of a single, collaboratively produced form and information pack to minimize customization (and thus omissions).

Fractal geometry describes complex, self-similar patterns that repeat across spatial scales and is increasingly recognized as relevant in anatomical research. Indeed, the fractal organization is consistently observed in respiratory, cardiovascular, gastrointestinal, nervous, renal, hepatic, and dermatological systems. A comprehensive literature search was conducted on PubMed, Scopus, and Web of Science (1977 to March 2025) identifying peer-reviewed original articles, reviews, and conference proceedings addressing the fractal organization of human organs at macrostructural or microstructural levels, with structural–functional relationships and/or clinical applications. Studies were excluded if they lacked direct translational relevance to humans, were not peer-reviewed, or did not utilize explicit fractal methodology. Key findings highlight that bronchial tree fractal dimension (FD) correlates with airflow limitation in chronic obstructive pulmonary disease, while in the vascular system, retinal metrics reflect systemic microvascular health. Moreover, the fractal modeling of hepatic and renal hemodynamic models supports system-level interpretation. In the nervous system, cortical gyrification and neuronal dendritic FD are associated with cognitive capacity and disease progression. Gastrointestinal mucosal FD decreases in inflammatory and neoplastic conditions. Advances in multiscale imaging (e.g., micro-CT, MRI) and computational methods enable both in vivo and ex vivo assessment, although methodological heterogeneity remains a limiting factor. Overall, fractal analysis provides a quantitative and reproducible descriptor of anatomical complexity with demonstrated associations to functional performance and disease severity. Standardization of methodology, development of normative datasets, and validation in large prospective cohorts are essential for routine clinical practice.

Opinions on the meaning of the term fascia appear to have been diverging for the past quarter century. In 1998, the definition of fascia in the international standard anatomical nomenclature was narrowed by removing the term fascia superficialis. On the other hand, fascia researchers, who continue to widely accept the term superficial fascia, have progressively broadened their definition of fascia and proposed that fasciae constitute an anatomical system, the fascial system. Here we examine competing concepts from an anatomical perspective with the goal of finding a position that could lead to a consensus among anatomists, other biomedical scientists and health practitioners with an interest in fascia. We endorse a return to the traditional view that fasciae are fibrous membranes that compartmentalize and connect parts of the body, that they are primarily composed of sheets or sheaths of dense irregular connective tissue, and that they are not parts of well-defined organs. They are prominent components of the integument, musculature, lining of the body cavities, and extraperitoneal spaces. The proposal that fibrous membranous components of the skeleton and nervous system are also fasciae merits further study and discussion.