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Systematic review of the histological and functional effects of botulinum toxin A on masticatory muscles: Consideration in dentofacial orthopedics and orthognathic surgery A 型肉毒毒素对咀嚼肌的组织学和功能影响的系统回顾:牙颌面矫形和正颌外科手术中的考虑因素。
IF 2 3区 医学 Q2 ANATOMY & MORPHOLOGY Pub Date : 2024-07-20 DOI: 10.1016/j.aanat.2024.152302

Introduction

Botulinum toxin type A causes muscle paralysis and is widely used in the masticatory muscle for stomatognathic diseases, such as temporomandibular disorder, bruxism, or masseteric hypertrophy. Nonetheless, its muscular effect remains unclear. Better understanding could aid improved use and perhaps new indications, particularly in dentofacial orthopaedics and orthognathic surgery.

Methods

This systematic review explored the histologic and functional effects of botulinum toxin in animal and human masticatory muscles and was conducted in accordance with the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The MEDLINE, Web of Science, and Cochrane Library electronic databases were searched for relevant articles. The inclusion criteria were human or animal masticatory muscle analysis after botulinum toxin injection(s) AND histological structural/ultrastructural analysis by optical or electronic microscopy OR functional effect analysis by bite force evaluation (occlusal force analyzer) and muscle activity (electromyography).

Results

Of an initial 1578 articles, 44 studies were eventually included. Botulinum toxin injection in the masticatory muscle altered its histological structure and functional properties. The human and animal studies revealed ultrastructural change, atrophy, and fiber type modifications of the masticatory muscles after one injection. Botulinum toxin decreased bite force and muscle activity, but recovery was uncertain.

Conclusions

Muscle forces applied on the skeleton is a key feature of facial growth. Masticatory muscle paralysis changes mechanical stress on bones, which rebalances the force applied on facial bones. This new balance could benefit dental deformity or surgical relapse. Therefore, botulinum toxin could limit the orthognathic effect of the masticatory muscles in such patients. Given the uncertain recovery, multiple injections should be avoided, and usage should not deviate from established consensus.

简介A 型肉毒杆菌毒素可导致肌肉麻痹,被广泛用于咀嚼肌治疗颞下颌关节紊乱、磨牙症或咀嚼肌肥大等口腔疾病。然而,它对肌肉的作用仍不明确。更好地了解这种药物有助于改进其使用,或许还能增加新的适应症,尤其是在牙颌面矫形和正颌外科方面:本系统综述探讨了肉毒毒素对动物和人类咀嚼肌的组织学和功能影响,并根据《系统综述和荟萃分析首选报告项目》声明的建议进行。研究人员在 MEDLINE、Web of Science 和 Cochrane Library 电子数据库中检索了相关文章。纳入标准为肉毒毒素注射后的人类或动物咀嚼肌分析,以及通过光学或电子显微镜进行的组织结构/超微结构分析,或通过咬合力评估(咬合力分析仪)和肌肉活动(肌电图)进行的功能效果分析:在最初的 1578 篇文章中,最终纳入了 44 项研究。在咀嚼肌注射肉毒杆菌会改变其组织学结构和功能特性。人类和动物研究显示,注射一次肉毒杆菌毒素后,咀嚼肌的超微结构会发生变化、萎缩和纤维类型改变。肉毒杆菌毒素降低了咬合力和肌肉活动,但恢复情况并不确定:结论:施加在骨骼上的肌肉力量是面部生长的一个关键特征。咀嚼肌麻痹会改变骨骼上的机械应力,从而重新平衡施加在面部骨骼上的力量。这种新的平衡可能有利于牙齿畸形或手术复发。因此,肉毒杆菌毒素可限制此类患者咀嚼肌的正颌效应。鉴于恢复的不确定性,应避免多次注射,使用方法也不应偏离既定的共识。
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引用次数: 0
The dynamic progression of temporomandibular joint osteoarthritis-like lesions elicited by mandibular shift in a rat model 大鼠模型中下颌移位引起的颞下颌关节骨关节炎样病变的动态进展
IF 2 3区 医学 Q2 ANATOMY & MORPHOLOGY Pub Date : 2024-07-05 DOI: 10.1016/j.aanat.2024.152301
Yuchun Zou , Pengcheng Huang , Hanyu Lin , Zhenzhen Dai , Xiran Dai , Senxin Cai , Dali Zheng , You-Guang Lu , Linyu Xu

Background

Temporomandibular joint osteoarthritis (TMJ-OA) presents significant challenges due to its complex etiology, often insidious onset, high incidence, and progressive structural deterioration. While research has explored genetic and molecular factors, treatment outcomes remain suboptimal, emphasizing the need for a deeper understanding of disease progression.

Objective

This study employs a specific mandibular shift rat model to explore the dynamic progression of TMJ-OA-like lesions and evaluate the potential for self-repair at different stages, aiming to inform early diagnosis and preventative strategies.

Methods

Seventy-two female Sprague-Dawley rats were randomized into three groups: a control group (n=24; average weight: 157.23±1.63 g) receiving sham surgery. an experimental group (n=24; average weight: 157.78±1.88 g) subjected to mandibular shift induction, and a removal group (n=24; average weight: 158.11±2.20 g) experiencing mandibular shift for one, two, or four weeks followed by a one-month recovery period (designated as 1w Removal, 2w Removal and 4w Removal, respectively). Histomorphological and molecular analyses were conducted at designated time points.

Results

Rats in the 1-week removal group exhibited substantial recovery in condylar morphology, cartilage thickness, extracellular matrix composition, and expression of OA-related genes. Conversely, the 4-week removal group mirrored the experimental group, indicating limited self-repair capacity at later stages. The 2-week removal group presented with variable outcomes, with some animals showing signs of recovery and others resembling the experimental group, indicating a potential transitional phase in the disease process.

Conclusion

Recovery from early-stage TMJ-OA involves eliminating provoking factors such as occlusal interference or reducing joint loading. However, advanced stages exhibit diminished self-repair capabilities, necessitating additional therapeutic interventions. These findings emphasize the importance of early diagnosis and intervention in TMJ-OA management.

背景:颞下颌关节骨关节炎(TMJ-OA)病因复杂,通常起病隐匿,发病率高,结构逐渐恶化,因此给治疗带来了巨大挑战。虽然研究人员对遗传和分子因素进行了探索,但治疗效果仍不理想,因此需要对疾病的进展有更深入的了解:本研究采用一种特殊的下颌移位大鼠模型来探索颞下颌关节-OA 类似病变的动态发展过程,并评估不同阶段的自我修复潜力,旨在为早期诊断和预防策略提供依据:72只雌性Sprague-Dawley大鼠随机分为三组:对照组(n=24;平均体重:157.23±1.63g)接受假手术;实验组(n=24;平均体重:157.78±1.实验组(n=24;平均体重:157.78±1.88g)接受下颌骨移位诱导,移位组(n=24;平均体重:158.11±2.20g)接受为期一周、两周或四周的下颌骨移位诱导,然后经过一个月的恢复期(分别称为 1w 移位、2w 移位和 4w 移位)。在指定时间点进行组织形态学和分子分析:结果:1周移除组大鼠的髁状突形态、软骨厚度、细胞外基质组成和OA相关基因的表达均有显著恢复。相反,4 周移除组与实验组相同,表明后期的自我修复能力有限。2周移除组的结果各不相同,有些动物表现出恢复迹象,有些则与实验组相似,这表明疾病过程可能处于过渡阶段:结论:早期颞下颌关节-颌关节紊乱症的恢复需要消除诱发因素,如咬合干扰或减少关节负荷。然而,晚期患者的自我修复能力减弱,需要额外的治疗干预。这些发现强调了早期诊断和干预在颞下颌关节-OA 治疗中的重要性。
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引用次数: 0
Intracerebroventricular injection of spexin stimulates the hypothalamic-pituitary-testicular axis and increases the secretion of male reproductive hormones in rats 脑室内注射 spexin 可刺激大鼠的下丘脑-垂体-睾丸轴,并增加雄性生殖激素的分泌。
IF 2 3区 医学 Q2 ANATOMY & MORPHOLOGY Pub Date : 2024-07-04 DOI: 10.1016/j.aanat.2024.152300
Nesibe Yilmaz , Rida Zahiraldin Ibrahim Yasi̇n , Azibe Yildiz

Background

Male reproductive functions are regulated in the hypothalamic-pituitary-gonadal (HPG) axis. Any problem in this axis would lead to the deterioration of reproductive functions. The present study aimed to investigate the effects of intracerebroventricular (icv) Spexin (SPX) infusion on the HPG axis in detail.

Methods

40 Wistar albino rats were divided into four groups: control, sham, SPX 30 nmol and SPX 100 nmol (n=10). 30 nmol/1 µl/hour SPX was administered icv to the rats in the SPX 30 nmol group for 7 days, while rats in the SPX 100 nmol group were administered 100 nmol/1 µl/hour SPX. On the 7th day, the rats were decapitated, blood and tissue samples were collected. Serum LH, FSH and testosterone levels were determined with the ELISA method, GnRH mRNA expression level was determined in hypothalamus with the RT-PCR method. Seminiferous tubule diameter and epithelial thickness were determined with the hematoxylin-eosin staining method.

Results

SPX infusion was increased GnRH mRNA expression in the hypothalamus tissue independent of the dose (p<0.05). Serum LH, FSH and testosterone levels in the SPX groups were increased when compared to the control and sham groups independent of the dose (p <0.05). Histological analysis revealed that SPX infusion did not lead to any changes in seminiferous epithelial thickness, while the tubule diameter increased in the SPX groups (p<0.05).

Conclusion

The study findings demonstrated that icv SPX infusion stimulated the HPG axis and increased the secretion of male reproductive hormones.

背景:男性生殖功能由下丘脑-垂体-性腺轴(HPG)调节。该轴的任何问题都会导致生殖功能的衰退。方法:40 只 Wistar 白化大鼠分为四组:对照组、假阳性组、SPX 30 nmol 组和 SPX 100 nmol 组(n=10)。SPX 30 nmol组大鼠每小时静脉注射30 nmol/1µl的SPX,连续7天;SPX 100 nmol组大鼠每小时静脉注射100 nmol/1µl的SPX,连续7天。第 7 天,将大鼠斩首,采集血液和组织样本。用ELISA法测定血清LH、FSH和睾酮水平,用RT-PCR法测定下丘脑中GnRH mRNA的表达水平。用苏木精-伊红染色法测定曲细精管直径和上皮厚度:结果:输注 SPX 增加了下丘脑组织中 GnRH mRNA 的表达,与剂量无关(p):研究结果表明,icv SPX输注可刺激HPG轴,增加男性生殖激素的分泌。
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引用次数: 0
Morphological differences between the lesser and the greater omenta in albino rats 白化大鼠小网膜和大网膜的形态差异。
IF 2 3区 医学 Q2 ANATOMY & MORPHOLOGY Pub Date : 2024-07-04 DOI: 10.1016/j.aanat.2024.152299

Background

Publications report that all mammals have two omenta, namely, lesser omentum and greater omentum. Basically, these organs, which share the same name except for the adjective “lesser” or “greater,” should not differ from each other. However, no clear description of the structure of the lesser omentum, as well as comparative morphological analysis between the lesser and greater omenta have been found in the literature, which necessitates a thorough investigation. Therefore, the aim of our study was to analyze the morphofunctional differences between the greater and lesser omenta in albino rats.

Method

The experiment involved 20 mature male albino rats, weighing 298,28±7,36 grams. The material for our study were preparations of lesser and greater omenta, fixed in 10 % of neutral buffered formalin. Paraffin sections were stained with hematoxylin-eosin and Van Gieson stain.

Results

The findings of the study showed that the greater omentum in albino rats, unlike other derivatives of the omentum (ligaments and mesenteries), represents a free extension (mostly from the greater curvature of the stomach), in the form of an “apron,” into a specific depth of the peritoneal cavity, duplicating the serous membrane. This duplication is characterized by the composition of two structurally interdependent formations. These include vascular-fatty arcades, associated with lymphoid nodules known as milky spots, and binding serous-reticular membranes. The findings of the study of the lesser omentum have established that in all cases it is located beneath the liver and becomes visualized only after hepatolifting. It is presented in the form of two ligaments: hepatoduodenal and hepatogastric, which contain two main structured formations, which we called vascular-fatty spurs, between these spurs, serous-reticular membranes are located.

Conclusion

despite having similar names, the lesser omentum, a derivative of the peritoneum, is fundamentally different. As it is well known, the lesser omentum is represented by ligaments that extend from the liver hilus to the lesser curvature of the stomach and the duodenum. Due to this arrangement, the lesser omentum lacks the mobile activity characteristic of the greater omentum, which plays a crucial role in rapid response to damage in the gastrointestinal tract. Despite sharing the same names, both formations differ in shape, morphological structure, development and function

背景:文献报道,所有哺乳动物都有两个网膜,即小网膜和大网膜。从根本上说,除了 "小 "或 "大 "这两个形容词外,这两个器官的名称是相同的,它们之间应该没有区别。然而,文献中并未对小网膜的结构进行明确描述,也未对小网膜和大网膜进行形态学对比分析,因此有必要进行深入研究。因此,我们的研究旨在分析白化大鼠大网膜和小网膜的形态功能差异:实验对象为 20 只成熟雄性白化大鼠,体重为 298,28±7,36 克。研究材料为小网膜和大网膜的制备物,用 10%的中性缓冲福尔马林固定。石蜡切片经苏木精-伊红和范吉森染色:研究结果表明,白化大鼠的大网膜与网膜的其他衍生物(韧带和肠系膜)不同,它是以 "围裙 "的形式向腹腔特定深度的自由延伸(主要来自胃大弯),与浆膜重复。这种复制的特点是由两种结构上相互依存的形态组成。其中包括血管-脂肪弧,与被称为乳斑的淋巴结相关联,以及结合浆膜-网膜。对小网膜的研究结果表明,在所有病例中,小网膜都位于肝脏下方,只有在切除肝脏后才能看到。它以两条韧带的形式存在:肝十二指肠韧带和肝胃韧带,这两条韧带包含两种主要的结构形式,我们称之为血管脂肪刺,在这些刺之间是血清网状膜。众所周知,小网膜由韧带构成,韧带从肝门延伸至胃小弯和十二指肠。由于这种排列方式,小网膜缺乏大网膜特有的移动性,而大网膜在快速应对胃肠道损伤方面发挥着至关重要的作用。尽管名称相同,但这两种形态在形状、形态结构、发育和功能上都有所不同。
{"title":"Morphological differences between the lesser and the greater omenta in albino rats","authors":"","doi":"10.1016/j.aanat.2024.152299","DOIUrl":"10.1016/j.aanat.2024.152299","url":null,"abstract":"<div><h3>Background</h3><p>Publications report that all mammals have two omenta, namely, lesser omentum and greater omentum. Basically, these organs, which share the same name except for the adjective “lesser” or “greater,” should not differ from each other. However, no clear description of the structure of the lesser omentum, as well as comparative morphological analysis between the lesser and greater omenta have been found in the literature, which necessitates a thorough investigation. Therefore, the aim of our study was to analyze the morphofunctional differences between the greater and lesser omenta in albino rats.</p></div><div><h3>Method</h3><p>The experiment involved 20 mature male albino rats, weighing 298,28±7,36 grams. The material for our study were preparations of lesser and greater omenta, fixed in 10 % of neutral buffered formalin. Paraffin sections were stained with hematoxylin-eosin and Van Gieson stain.</p></div><div><h3>Results</h3><p>The findings of the study showed that the greater omentum in albino rats, unlike other derivatives of the omentum (ligaments and mesenteries), represents a free extension (mostly from the greater curvature of the stomach), in the form of an “apron,” into a specific depth of the peritoneal cavity, duplicating the serous membrane. This duplication is characterized by the composition of two structurally interdependent formations. These include vascular-fatty arcades, associated with lymphoid nodules known as milky spots, and binding serous-reticular membranes. The findings of the study of the lesser omentum have established that in all cases it is located beneath the liver and becomes visualized only after hepatolifting. It is presented in the form of two ligaments: hepatoduodenal and hepatogastric, which contain two main structured formations, which we called vascular-fatty spurs, between these spurs, serous-reticular membranes are located.</p></div><div><h3>Conclusion</h3><p>despite having similar names, the lesser omentum, a derivative of the peritoneum, is fundamentally different. As it is well known, the lesser omentum is represented by ligaments that extend from the liver hilus to the lesser curvature of the stomach and the duodenum. Due to this arrangement, the lesser omentum lacks the mobile activity characteristic of the greater omentum, which plays a crucial role in rapid response to damage in the gastrointestinal tract. Despite sharing the same names, both formations differ in shape, morphological structure, development and function</p></div>","PeriodicalId":50974,"journal":{"name":"Annals of Anatomy-Anatomischer Anzeiger","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141545690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
An easy-to-perform protocol for culturing primary murine lung tumor cells as organoids 将原代小鼠肺肿瘤细胞培养成器官组织的简便操作方案
IF 2 3区 医学 Q2 ANATOMY & MORPHOLOGY Pub Date : 2024-07-04 DOI: 10.1016/j.aanat.2024.152298
Jannis Ludwig , Felix Ritzmann , Andreas Kamyschnikow , Christian Herr , Robert Bals , Christoph Beisswenger

Cancer research involves significant animal consumption and suffering. Tumor cells can be differentiated in vitro into three-dimensional organoids that resemble the primary tumor. In basic cancer research, however, tumor organoids are usually only used alongside animal experiments. We have established an easy-to-perform protocol that allows to culture KRAS-driven lung tumor cells as organoids for extended periods of time. Like the corresponding tumors in mice, the organoids produce surfactant protein C but no markers of airway epithelial cells (e.g. SCGB1A1, KRT5). The organoids can be passaged as single cell suspensions. Our organoid model contributes to replace animal experiments with cell culture systems and can be used for drug testing or functional studies in cancer research.

癌症研究涉及大量的动物消耗和痛苦。肿瘤细胞可以在体外分化成与原发肿瘤相似的三维有机体。然而,在基础癌症研究中,肿瘤器官组织通常只用于动物实验。我们建立了一种易于操作的方案,可以将 KRAS 驱动的肺肿瘤细胞长期培养成器质体。与小鼠的相应肿瘤一样,器官组织也能产生表面活性蛋白 C,但没有气道上皮细胞的标记物(如 SCGB1A1、KRT5)。有机体可作为单细胞悬浮液进行传代。我们的类器官模型有助于用细胞培养系统取代动物实验,可用于癌症研究中的药物测试或功能研究。
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引用次数: 0
The median nerve´s system of connective tissue distal to the pronator teres to the carpal tunnel 正中神经的结缔组织系统,从前臂大肌远端到腕管。
IF 2 3区 医学 Q2 ANATOMY & MORPHOLOGY Pub Date : 2024-06-25 DOI: 10.1016/j.aanat.2024.152295
Dennis Aliev , Karsten Winter , Jeanette Henkelmann , Martin F. Langer , Hanno Steinke

Background

Connective tissue serves a role beyond mere spatial filling. Furthermore, there is increasing evidence that connective tissue plays an important role in the pathogenesis of conditions such as carpal tunnel syndrome (CTS). According to our hypothesis, the median nerve (MN) is surrounded by a system of connective tissue distal to the pronator teres and extending up to, and including, the carpal tunnel.

Methods

To visualize the connective tissue surrounding the median nerve, we dissected the forearms of 15 body donors from pronator teres to the carpal tunnel, created plastination slices stained with Periodic Acid-Schiff (PAS), and injected ink into the seen spaces. We verified our findings with a segmentational analysis of radiological data of 10 healthy individuals.

Results

We macroscopically describe the median nerve´s system of connective tissue (MC) distal to the pronator teres and up to and including the carpal tunnel. This system creates, connects, and separates spaces. At least from the pronator teres to the carpal tunnel it also creates subspaces from proximal to distal. For the MC, we established a mean cross-sectional area of 153.1 mm2 (SD=37.15) in the carpal tunnel. The median nerve consistently resides at the center of this MC, which further connects to flexor muscles of the forearm, and to the radius bone. In the carpal tunnel, the MC creates subspaces inside. There, it also acts as the outermost internal layer enveloping flexor tendons, and the MN.

Discussion

The term MC does not negate but orders the existence of other “connectives”, like subsynovial connective tissue, endo-, epi- or perineuria, epimysia, periostea, or peritendinea, to a hierarchy related to the median nerve. Diseases of the MN are common. Knowing the anatomy of the MC and how it relates to MN function may help clinicians recognize and understand conditions like CTS.

背景:结缔组织的作用不仅仅是填充空间。此外,越来越多的证据表明,结缔组织在腕管综合征(CTS)等疾病的发病机制中发挥着重要作用。根据我们的假说,正中神经(MN)被一个结缔组织系统所包围,该系统位于代趾远端,一直延伸至腕管,并包括腕管:为了观察正中神经周围的结缔组织,我们解剖了 15 名人体捐献者的前臂,从发音肌到腕管,制作了经酸周期-希夫(PAS)染色的塑化切片,并将墨水注入所见的空隙中。我们通过对 10 名健康人的放射学数据进行分割分析,验证了我们的研究结果:结果:我们从宏观上描述了正中神经的结缔组织(MC)系统,其远端位于代趾,一直到腕管(包括腕管)。该系统创造、连接和分离空间。至少从发音肌到腕管,它还创造了从近端到远端的子空间。对于正中神经,我们确定腕管的平均横截面积为 153.1 平方毫米(SD=37.15)。正中神经始终位于 MC 的中心,并进一步连接到前臂的屈肌和桡骨。在腕管中,正中神经在内部形成子空间。在那里,它也是包裹屈肌腱和 MN 的最外层内层:MC一词并不否定其他 "结缔组织 "的存在,如滑膜下结缔组织、内尿道、外尿道或尿道周围结缔组织、外膜、骨膜或腱膜周围结缔组织,而是将其归类为与正中神经相关的层次。正中神经疾病很常见。了解正中神经的解剖结构及其与正中神经功能的关系有助于临床医生识别和理解 CTS 等疾病。
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引用次数: 0
Newly revealed anatomy of the bucinator muscle: An anatomical and histological study 新发现的口角肌解剖结构:解剖学和组织学研究
IF 2 3区 医学 Q2 ANATOMY & MORPHOLOGY Pub Date : 2024-06-25 DOI: 10.1016/j.aanat.2024.152297
Joe Iwanaga , Keiko Fukino , Norio Kitagawa , Ana Carrera , Francisco Reina , Maria Cristina Manzanares-Cespedes , Mi-Sun Hur , Miguel A. Reina , R. Shane Tubbs

Background

Current anatomical knowledge of the origin of the bucinator muscle (BM), i.e., long thin attachments on the maxilla and mandible and the pterygomandibular raphe (PMR), is not supported by anatomical dissection of this muscle. The aim of this study was therefore to investigate the detailed morphology of the BM and associated structures and to discuss its function.

Methods

The anatomy of the BM and related structures was investigated in 15 cadaveric heads using a surgical microscope and histological analysis.

Results

The inferior fibers of the BM originated from a small retromolar area (internal oblique line), which shared a common tendon with the deep tendon of the temporalis. The superior fibers of the BM originated from the maxillary tuberosity. The middle fibers originated the pterygoid hamulus. No PMR was identified in any of the specimens, but the border between the BM and superior pharyngeal constrictor muscle (SC) was clear because the muscle fibers followed different directions. Some horizontal fibers were continuous between the BM and SC.

Conclusions

Our results suggest the need to revise established accounts of the origins of the bucinator (the maxillary tuberosity, conjoint tendon of the temporalis, and pterygoid hamulus without a pterygomandibular raphe. It also needs to be noted that some of its fibers merge directly with the SC.

背景:目前对咬肌起源的解剖学知识,即上颌骨和下颌骨上的细长附着物以及翼颌下缘(PMR),并没有得到对该肌肉解剖学解剖的支持。因此,本研究旨在调查 BM 及其相关结构的详细形态,并讨论其功能:方法:使用手术显微镜和组织学分析方法对 15 具尸体头部的横纹肌和相关结构进行了解剖研究:BM的下部纤维起源于一个小的后摩尔区(内斜线),它与颞肌深部肌腱共享一条共同的肌腱。BM的上部纤维源自上颌结节。中间纤维起源于翼束肌。在所有标本中均未发现咽后肌,但咽后肌与咽上收缩肌(SC)之间的边界清晰可见,因为肌纤维的方向不同。一些水平纤维在 BM 和 SC 之间是连续的:我们的研究结果表明,有必要修改关于颊肌(上颌结节、颞肌联合肌腱和无翼下颌剑突的翼状肌)起源的既有说法。还需要注意的是,它的一些纤维直接与 SC 融合。
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引用次数: 0
A South African case study on anatomical embalming for human body donation programmes with toxicological considerations 南非人体捐献计划解剖防腐案例研究与毒理学考虑。
IF 2 3区 医学 Q2 ANATOMY & MORPHOLOGY Pub Date : 2024-06-24 DOI: 10.1016/j.aanat.2024.152296
Kirsten Alexandria van der Heyden , Victoria Elaine Gibbon , Kentse Sana Mpolokeng

Body embalming, a practice with deep historical roots across various cultures, forms the backbone of contemporary human body donation educational programmes. In this study, we explored current embalming practices within six South African human anatomical dissection programmes, focusing on the use and volumes of key chemicals—formalin, phenol, and alcohol—and their associated health risks and potential toxicity. We measured and compared aspects of embalming practices such as the duration of body preservation and the annual intake of bodies. Variations in embalming practices and chemical ratios across different South African universities were found. However, the consistent use of formalin, phenol and alcohol were observed across all six programmes. Formaldehyde concentrations used in South African dissection programmes were within the generally acceptable international range. Regarding arterial embalming, South African dissection programmes showed widespread adherence to international embalming practices, with one programme using a substantially lower concentration of formalin. The dual nature of formaldehyde as both an effective preservative and a recognised carcinogen was underscored in relation to human health regarding chemical toxicity. Phenol, like formaldehyde, was consistently used as it is important for the inhibition of bacterial and fungal growth. Alcohol was also consistently used, but there was much greater variation in its volume across South African institutions. Our data showed a slight positive relationship between storage duration and the volumes of formalin and phenol in human embalming fluid. South African regulators enforce stricter exposure limits than those set by the World Health Organisation and various European agencies. While South African institutions operate within internationally acceptable ranges of chemical use that both maximise preservation and minimise toxicity, we acknowledge that these data are preliminary. Further investigation is encouraged to ensure embalming practices effectively protect all those involved and support the educational goals of human anatomical dissection programmes in South Africa.

尸体防腐是一种在不同文化中有着深厚历史渊源的做法,是当代人体捐赠教育计划的支柱。在这项研究中,我们探讨了南非六项人体解剖计划中目前的防腐做法,重点关注福尔马林、苯酚和酒精等关键化学品的使用情况和用量,以及与之相关的健康风险和潜在毒性。我们测量并比较了尸体防腐做法的各个方面,如尸体保存时间和每年的尸体摄入量。我们发现,南非不同大学的防腐做法和化学配比存在差异。不过,在所有六项计划中,使用福尔马林、苯酚和酒精的情况一致。南非解剖课程使用的甲醛浓度在国际公认范围内。在动脉防腐方面,南非的解剖方案普遍遵守国际防腐做法,其中一项方案使用的福尔马林浓度大大降低。甲醛既是一种有效的防腐剂,又是一种公认的致癌物质,其化学毒性对人体健康的双重影响得到了强调。与甲醛一样,苯酚也一直被使用,因为它对抑制细菌和真菌生长非常重要。酒精也一直被使用,但在南非各机构中的使用量差异更大。我们的数据显示,储存时间与人体防腐液中福尔马林和苯酚的用量之间存在轻微的正相关关系。南非监管机构执行的接触限值比世界卫生组织和欧洲各机构规定的限值更为严格。虽然南非的防腐机构在国际公认的化学品使用范围内运作,既能最大限度地保存尸体,又能最大限度地降低毒性,但我们承认这些数据只是初步数据。我们鼓励开展进一步调查,以确保防腐操作有效保护所有相关人员,并支持南非人体解剖计划的教育目标。
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引用次数: 0
Anatomical human body donation in South Africa: Inconsistencies of informed consent 南非的人体解剖捐赠:知情同意的不一致。
IF 2 3区 医学 Q2 ANATOMY & MORPHOLOGY Pub Date : 2024-06-19 DOI: 10.1016/j.aanat.2024.152292
Keegan O. Meiring , Victoria E. Gibbon , Amanda Alblas

Introduction

Informed consent is critical for maintaining the ethical standards associated with the utilization of human donor bodies by tertiary education institutions. Body donation programs undertake the responsibility for procuring human donor bodies for didactic and research purposes. However, its processes require scrutiny regarding best practice guidelines and the South African National Health Act (SA-NHA) (2013). Moreover, acknowledging and addressing the current perceptions of human body donation are indispensable in bridging the gap between academia and society. This study aimed to compare informed consent documentation and procedures across South African tertiary education institutions and their affiliated human body donation programs (HBDP) in accordance with international guidelines. The findings were used to create a human body donation form template aligned to current international best practices for consideration by the South African HBDP.

Methodology

A review of information and consent forms collected from South Africa’s eight HBDP was conducted. The analyses consisted of a broad evaluation of information provided, ranging from the terms-of-use for human donor bodies to the commitments made by HBDP to body-donors. The results were considered in conjunction with the International Federation of Associations of Anatomists and other recent publications on informed consent in HBDP.

Results

Only two of the eight HBDP provided information and consent forms in more than one language. Most allowed donors to select how their bodies will be utilized – education, training and/or research. Some (6/8) made provisions for the next-of-kin to receive the cremains. Only one tertiary educational institution mentioned the occurrence of a memorial service in its documentation. An HBDF template was created aligned to current international best practices for presentation and possible adaption by SA HBDP.

Discussion & conclusions

Human body donation forms (HBDF) requires thorough examination for the promotion and sustainability of HBDP. Effective communication by employing standardized non-technical terminology conveyed in language that is understandable and native to potential donors facilitates the deliverance of informed consent. Inconsistencies regarding the use and management of bodies catalyze the weakening perception of human body donation. Thus, this process of securing informed consent for body donation should be conducted in conjunction with public awareness campaigns and underpinned by the necessary policy and legislative reform.

导言:知情同意对于维持高等教育机构使用人体捐献者遗体的相关道德标准至关重要。遗体捐献计划承担着为教学和研究目的采购人体捐献者遗体的责任。然而,其过程需要根据最佳实践指南和《南非国家卫生法》(SA-NHA)(2013 年)进行严格审查。此外,承认并解决当前对人体捐献的看法对于弥合学术界与社会之间的差距也是不可或缺的。本研究旨在根据国际准则,比较南非高等教育机构及其附属人体捐献项目(HBDP)的知情同意文件和程序。研究结果被用于创建符合当前国际最佳实践的人体捐献表格模板,供南非人体捐献项目考虑:方法:对从南非 8 个 HBDP 收集到的信息和同意书进行了审查。分析包括对所提供信息的广泛评估,从遗体的使用条款到 HBDP 对捐献者的承诺。分析结果与国际解剖学家协会联合会和其他近期出版的有关人体器官捐献者知情同意书的出版物一并考虑:结果:在 8 家人与生物数据中心中,只有 2 家以一种以上的语言提供信息和同意书。大多数都允许捐献者选择其遗体的使用方式--教育、培训和/或研究。一些机构(6/8)规定由近亲接收骨灰。只有一家高等教育机构在其文件中提到了追悼会。根据当前的国际最佳实践,创建了一个人体捐献表格模板,供南澳遗体捐献项目介绍和可能的改编:人体捐献表格(HBDF)需要彻底检查,以促进 HBDP 的发展和可持续性。通过使用标准化的非技术性术语,以潜在捐献者能够理解和使用的语言进行有效沟通,有助于获得知情同意。有关遗体使用和管理的不一致催化了人体捐献观念的弱化。因此,在征得遗体捐献知情同意的过程中,应结合公众宣传活动,并辅之以必要的政策和立法改革。
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引用次数: 0
The impact of orbital floor defect ratio on changes in the inferior rectus muscle and prediction of posttraumatic enophthalmos – A cadaver study 眶底缺损率对下直肌变化的影响以及创伤后眼球突出的预测 - 一项尸体研究。
IF 2 3区 医学 Q2 ANATOMY & MORPHOLOGY Pub Date : 2024-06-16 DOI: 10.1016/j.aanat.2024.152294
Ali Modabber , Philipp Winnand , Mark Ooms , Marius Heitzer , Nassim Ayoub , Felix Paulßen von Beck , Stefan Raith , Andreas Prescher , Frank Hölzle , Thomas Mücke

Background

Orbital floor fractures result in critical changes in the shape and inferior rectus muscle (IRM) position. Radiological imaging of IRM changes can be used for surgical decision making or prediction of ocular symptoms. Studies with a systematic consideration of the orbital floor defect ratio in this context are missing in the literature. Accordingly, this study on human cadavers aimed to systematically investigate the impact of the orbital floor defect ratio on changes in the IRM and the prediction of posttraumatic enophthalmos.

Methods

Seventy-two orbital floor defects were placed in cadaver specimens using piezosurgical removal. The orbital defect area (ODA), orbital floor area (OFA), position and IRM shape, and enophthalmos were measured using computed tomography (CT) scans.

Results

The ODA/OFA ratio correlated significantly (p < 0.001) with the shape (Spearman’s rho: 0.558) and position (Spearman’s rho: 0.511) of the IRM, and with enophthalmos (Spearman’s rho: 0.673). Increases in the ODA/OFA ratio significantly rounded the shape of the IRM (ß: 0.667; p < 0.001) and made a lower position of the IRM more likely (OR: 1.093; p = 0.003). In addition, increases in the ODA/OFA ratio were significantly associated with the development of relevant enophthalmos (OR: 1.159; p = 0.008), adjusted for the defect localization and shape of the IRM. According to receiver operating characteristics analysis (AUC: 0.876; p < 0.001), a threshold of ODA/OFA ratio ≥ 32.691 for prediction of the risk of development of enophthalmos yielded a sensitivity of 0.809 and a specificity of 0.842.

Conclusion

The ODA/OFA ratio is a relevant parameter in the radiological evaluation of orbital floor fractures, as it increases the risk of relevant enophthalmos, regardless of fracture localization and shape of the IRM. Therefore, changes in the shape and position of the IRM should be considered in surgical treatment planning. A better understanding of the correlates of isolated orbital floor fractures may help to develop diagnostic scores and standardize therapeutic algorithms in the future.

背景:眼眶底骨折会导致眼眶形状和下直肌(IRM)位置发生严重变化。IRM 变化的放射成像可用于手术决策或预测眼部症状。在这种情况下,系统考虑眶底缺损率的研究在文献中尚属空白。因此,本研究以人体尸体为对象,旨在系统研究眶底缺损率对 IRM 变化的影响以及对创伤后眼球突出的预测:方法:使用压电手术切除法在尸体标本上放置了 72 个眶底缺损。使用计算机断层扫描(CT)测量眶缺损面积(ODA)、眶底面积(OFA)、位置和 IRM 形状以及眼球突出情况:ODA/OFA比率与IRM的形状(Spearman's rho:0.558)和位置(Spearman's rho:0.511)以及眼球突出(Spearman's rho:0.673)显著相关(p < 0.001)。ODA/OFA比值的增加会使IRM的形状明显变圆(ß:0.667;p < 0.001),并使IRM的位置更有可能变低(OR:1.093;p = 0.003)。此外,ODA/OFA 比值的增加与相关眼球后凸的发生显著相关(OR:1.159;p = 0.008),并根据缺损位置和 IRM 的形状进行了调整。根据接收器操作特征分析(AUC:0.876;p < 0.001),ODA/OFA 比值≥ 32.691 的阈值用于预测眼球突出的风险,其灵敏度为 0.809,特异性为 0.842:ODA/OFA比值是眼眶底骨折放射学评估中的一个相关参数,因为无论骨折定位和IRM的形状如何,ODA/OFA比值都会增加眼球突出的风险。因此,在制定手术治疗计划时应考虑到 IRM 形状和位置的变化。更好地了解孤立性眶底骨折的相关因素有助于将来制定诊断评分标准和标准化治疗算法。
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