Annals of Anatomy-Anatomischer Anzeiger最新文献_第5页

Histological methods to quantify changes of white and brown adipose tissue in response to a high content fat diet in mice 用组织学方法量化小鼠高脂肪饮食后白色和棕色脂肪组织的变化

IF 1.7 3区医学 Q2 ANATOMY & MORPHOLOGY

Annals of Anatomy-Anatomischer Anzeiger

Pub Date : 2026-01-01 Epub Date: 2025-09-20 DOI: 10.1016/j.aanat.2025.152738

Giulia Lazzarini , Lorenzo Flori , Andrea Pirone , Elisabetta Giannessi , Lara Testai , Vincenzo Calderone , Vincenzo Miragliotta

Background

Obesity is a major global health challenge associated with increased risk of metabolic, cardiovascular, and inflammatory diseases. White (WAT) and brown adipose tissue (BAT) are highly dynamic tissues, capable of morphological and functional adaptation in response to nutritional and metabolic changes.

Methods

This study investigated histological alterations in WAT and BAT of Balb/c mice subjected to either a standard diet (STD) or high-fat diet (HFD) for 10 weeks. Adipocyte density, lipid vacuole size, macrophage infiltration and their immunophenotype were measured in WAT and BAT, while UCP1 expression was measured in BAT only. Four-µm thick sections obtained from FFPE samples were H&E stained or immunostained with anti-UCP1, anti-Iba1 and anti-CD163.

Results

In WAT from HFD-fed mice, a significant increase in adipocyte size and a decrease in cell density were observed, indicating hypertrophy without evident hyperplasia. BAT exhibited larger and more dispersed lipid droplets, reduced cell density, and decreased UCP1 immunoreactivity, consistent with a whitening process and impaired thermogenic function. Additionally, immunohistochemical analysis revealed changes in macrophage distribution in WAT, with a reduction in anti-inflammatory CD163 + cells and clustering of Iba1 + macrophages, suggesting a shift in macrophage polarization.

Conclusions

These findings highlight the histological adaptability of adipose tissue under different dietary conditions and reinforce the importance of morphological analysis in understanding obesity-related tissue remodeling.

背景：肥胖是一项主要的全球健康挑战，与代谢性、心血管和炎症性疾病的风险增加有关。白色脂肪组织（WAT）和棕色脂肪组织（BAT）是高度动态的组织，能够根据营养和代谢变化进行形态和功能适应。方法观察Balb/c小鼠标准饮食（STD）和高脂饮食（HFD） 10周后WAT和BAT的组织学变化。在WAT和BAT中检测脂肪细胞密度、脂质液泡大小、巨噬细胞浸润及其免疫表型，而仅在BAT中检测UCP1的表达。从FFPE样品中获得4µm厚的切片，进行H&；E染色或抗ucp1、抗iba1和抗cd163免疫染色。结果hfd喂养小鼠WAT脂肪细胞大小明显增加，细胞密度明显降低，呈肥大，但未见明显增生。BAT表现出更大、更分散的脂滴，细胞密度降低，UCP1免疫反应性降低，与增白过程一致，产热功能受损。此外，免疫组织化学分析显示WAT中巨噬细胞分布发生变化，抗炎CD163 + 细胞减少，Iba1 + 巨噬细胞聚集，提示巨噬细胞极化发生改变。结论这些发现突出了脂肪组织在不同饮食条件下的组织学适应性，并加强了形态学分析在理解肥胖相关组织重塑中的重要性。

{"title":"Histological methods to quantify changes of white and brown adipose tissue in response to a high content fat diet in mice","authors":"Giulia Lazzarini , Lorenzo Flori , Andrea Pirone , Elisabetta Giannessi , Lara Testai , Vincenzo Calderone , Vincenzo Miragliotta","doi":"10.1016/j.aanat.2025.152738","DOIUrl":"10.1016/j.aanat.2025.152738","url":null,"abstract":"<div><h3>Background</h3><div>Obesity is a major global health challenge associated with increased risk of metabolic, cardiovascular, and inflammatory diseases. White (WAT) and brown adipose tissue (BAT) are highly dynamic tissues, capable of morphological and functional adaptation in response to nutritional and metabolic changes.</div></div><div><h3>Methods</h3><div>This study investigated histological alterations in WAT and BAT of Balb/c mice subjected to either a standard diet (STD) or high-fat diet (HFD) for 10 weeks. Adipocyte density, lipid vacuole size, macrophage infiltration and their immunophenotype were measured in WAT and BAT, while UCP1 expression was measured in BAT only. Four-µm thick sections obtained from FFPE samples were H&E stained or immunostained with anti-UCP1, anti-Iba1 and anti-CD163.</div></div><div><h3>Results</h3><div>In WAT from HFD-fed mice, a significant increase in adipocyte size and a decrease in cell density were observed, indicating hypertrophy without evident hyperplasia. BAT exhibited larger and more dispersed lipid droplets, reduced cell density, and decreased UCP1 immunoreactivity, consistent with a whitening process and impaired thermogenic function. Additionally, immunohistochemical analysis revealed changes in macrophage distribution in WAT, with a reduction in anti-inflammatory CD163 + cells and clustering of Iba1 + macrophages, suggesting a shift in macrophage polarization.</div></div><div><h3>Conclusions</h3><div>These findings highlight the histological adaptability of adipose tissue under different dietary conditions and reinforce the importance of morphological analysis in understanding obesity-related tissue remodeling.</div></div>","PeriodicalId":50974,"journal":{"name":"Annals of Anatomy-Anatomischer Anzeiger","volume":"263 ","pages":"Article 152738"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145119359","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

Prevalence, symmetry and characterization of radicular concavities in human upper premolars 人类上前磨牙根状凹的普遍性、对称性和特征。

IF 1.7 3区医学 Q2 ANATOMY & MORPHOLOGY

Annals of Anatomy-Anatomischer Anzeiger

Pub Date : 2026-01-01 Epub Date: 2025-10-10 DOI: 10.1016/j.aanat.2025.152746

Lisann Mäder , James Deschner , Philipp Mildenberger , Pablo Cores Ziskoven , Jens Weusmann

Background

Radicular concavities, particularly in the maxillary premolar region, represent anatomical features that may significantly affect periodontal health. Therefore, the aim of this study was to evaluate the prevalence, dimensions and distribution patterns of radicular grooves in the maxillary premolar region using CBCT.

Methods

In total, 3492 CBCT image datasets from patients treated in all dentistry departments of the University Hospital of Mainz were screened. After applying strict inclusion criteria, a cohort of 836 patients with 1678 maxillary premolars could be included in this study. Horizontal depth, vertical extent, angulation, dentine wall thickness, and the distance from the cemento-enamel junction to the groove origin were analyzed.

Results

Patients with concavities in at least one premolar were identified in 637 of 836 cases (76.2 %). The analyzed first premolars exhibited one or more concavities in 83.7 % (right) and 80.7 % (left) of teeth; second premolars were affected in 37.4 % (right) and 30.0 % (left). Mesial concavities were the most prevalent (≈ 60 %), followed by distal (≈ 35 %) and buccal (≈ 4 %). Mean mesial depth reached 1.09 ± 0.39 mm and vertical extension frequently exceeded 6 mm. Three concavities in one premolar increased the risk ratio for the contralateral homologue up to 33.33 (p < 0.001).

Conclusions

The present study provides a detailed morphological characterization of radicular concavities in maxillary premolars using three‑dimensional imaging. These anatomical structures should be considered in clinical decision‑making, especially in patients with a predisposition to periodontal disease.

背景：根状凹，特别是上颌前磨牙区域的根状凹，是影响牙周健康的解剖学特征。因此，本研究的目的是利用CBCT评估上颌前磨牙区根状沟的患病率、大小和分布模式。方法：筛选美因茨大学医院所有牙科科室的3492例患者的CBCT图像数据集。经过严格的纳入标准，本研究纳入了836例患者，共1678颗上颌前磨牙。分析水平深度、垂直范围、角度、牙本质壁厚度、牙骨质-牙釉质交界处到沟原点的距离。结果：836例患者中637例（76.2%）发现至少一颗前磨牙有凹陷。83.7%（右）和80.7%（左）的第一前磨牙有一个或多个凹陷；右前磨牙占37.4%，左前磨牙占30.0%。中端凹陷最为常见（≈ 60%），其次是远端（≈ 35%）和颊部（≈ 4%）。平均中位深度达到1.09 ± 0.39mm，垂直延伸频繁超过6mm。结论：本研究利用三维成像技术对上颌前磨牙根状凹陷进行了详细的形态学表征。在临床决策时应考虑这些解剖结构，特别是对牙周病易感性的患者。

{"title":"Prevalence, symmetry and characterization of radicular concavities in human upper premolars","authors":"Lisann Mäder , James Deschner , Philipp Mildenberger , Pablo Cores Ziskoven , Jens Weusmann","doi":"10.1016/j.aanat.2025.152746","DOIUrl":"10.1016/j.aanat.2025.152746","url":null,"abstract":"<div><h3>Background</h3><div>Radicular concavities, particularly in the maxillary premolar region, represent anatomical features that may significantly affect periodontal health. Therefore, the aim of this study was to evaluate the prevalence, dimensions and distribution patterns of radicular grooves in the maxillary premolar region using CBCT.</div></div><div><h3>Methods</h3><div>In total, 3492 CBCT image datasets from patients treated in all dentistry departments of the University Hospital of Mainz were screened. After applying strict inclusion criteria, a cohort of 836 patients with 1678 maxillary premolars could be included in this study. Horizontal depth, vertical extent, angulation, dentine wall thickness, and the distance from the cemento-enamel junction to the groove origin were analyzed.</div></div><div><h3>Results</h3><div>Patients with concavities in at least one premolar were identified in 637 of 836 cases (76.2 %). The analyzed first premolars exhibited one or more concavities in 83.7 % (right) and 80.7 % (left) of teeth; second premolars were affected in 37.4 % (right) and 30.0 % (left). Mesial concavities were the most prevalent (≈ 60 %), followed by distal (≈ 35 %) and buccal (≈ 4 %). Mean mesial depth reached 1.09 ± 0.39 mm and vertical extension frequently exceeded 6 mm. Three concavities in one premolar increased the risk ratio for the contralateral homologue up to 33.33 (p < 0.001).</div></div><div><h3>Conclusions</h3><div>The present study provides a detailed morphological characterization of radicular concavities in maxillary premolars using three‑dimensional imaging. These anatomical structures should be considered in clinical decision‑making, especially in patients with a predisposition to periodontal disease.</div></div>","PeriodicalId":50974,"journal":{"name":"Annals of Anatomy-Anatomischer Anzeiger","volume":"263 ","pages":"Article 152746"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145282084","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

Dural penetration patterns of the suboccipital vertebral arteries 枕下椎动脉的硬脑膜穿透模式。

IF 1.7 3区医学 Q2 ANATOMY & MORPHOLOGY

Annals of Anatomy-Anatomischer Anzeiger

Pub Date : 2026-01-01 Epub Date: 2025-09-05 DOI: 10.1016/j.aanat.2025.152725

George Triantafyllou , Panagiotis Papadopoulos-Manolarakis , Nikolaos-Achilleas Arkoudis , Georgios Velonakis , Alexandros Samolis , Łukasz Olewnik , Maria Piagkou

Background

The vertebral artery (VA) undergoes a critical anatomical transition as it pierces the dura mater at the craniocervical junction. Precise knowledge of dural penetration patterns and angulation is essential for diagnostic imaging, neurosurgical planning, and minimizing iatrogenic risk in posterior fossa procedures.

Methods

This retrospective imaging study evaluated 100 adult patients who underwent 1.5 Tesla magnetic resonance angiography (MRA) with a time-of-flight protocol. The site of VA dural penetration was categorized on axial images as ventral, middle, or dorsal, and on coronal images as symmetrical (Type A) or asymmetrical (Types B or C). Angulations at the point of dural entry were quantified in axial and coronal planes. Documented vascular variants included extradural origins of the posterior inferior cerebellar artery (PICA) and aberrant VA trajectories.

Results

Middle axial penetration was the most frequent pattern (87 % of sides), while symmetrical coronal entry (Type A) predominated in 77 % of patients. Axial VA angulation differed significantly by sex (p = 0.034), with females exhibiting sharper angles. No side-related differences were observed for angulation or penetration type. Extradural PICA origin and aberrant VA course were identified in 16.5 % and 6 % of sides, respectively, but did not correlate with dural entry patterns.

Conclusions

The VA exhibits a highly consistent trajectory at the dura, most commonly entering at the middle axial zone with symmetrical coronal configuration. A sex-related difference in axial angulation may have biomechanical and hemodynamic implications. Although vascular variants are relatively common, they do not appear to influence penetration type yet remain relevant for surgical safety and diagnostic accuracy.

背景：椎动脉（VA）在颅颈交界处穿透硬脑膜时经历了一个关键的解剖转变。准确了解硬脑膜穿透模式和成角对诊断成像、神经外科计划和减少后窝手术的医源性风险至关重要。方法：本回顾性影像学研究评估了100例接受1.5特斯拉磁共振血管造影（MRA）和飞行时间协议的成年患者。硬脑膜穿透部位在轴位像上分为腹侧、正中或背侧，在冠状像上分为对称（A型）或不对称（B型或C型）。在轴位和冠状面上量化硬脑膜进入点的角度。记录的血管变异包括小脑后下动脉（PICA）的硬膜外起源和异常的VA轨迹。结果：中轴贯入是最常见的模式（87%），而对称冠状位进入（A型）占77%。轴向VA成角在性别上差异显著（p = 0.034），女性表现出更尖锐的角度。未观察到成角或穿透类型的侧面相关差异。硬脑膜外异位的起源和异常的静脉曲张路径分别在16.5%和6%的两侧被确定，但与硬脑膜进入模式无关。结论：VA在硬脑膜处表现出高度一致的轨迹，最常见的是在对称冠状位的中轴区进入。轴向成角的性别差异可能具有生物力学和血流动力学意义。虽然血管变异相对常见，但它们似乎并不影响穿透类型，但仍与手术安全性和诊断准确性相关。

{"title":"Dural penetration patterns of the suboccipital vertebral arteries","authors":"George Triantafyllou , Panagiotis Papadopoulos-Manolarakis , Nikolaos-Achilleas Arkoudis , Georgios Velonakis , Alexandros Samolis , Łukasz Olewnik , Maria Piagkou","doi":"10.1016/j.aanat.2025.152725","DOIUrl":"10.1016/j.aanat.2025.152725","url":null,"abstract":"<div><h3>Background</h3><div>The vertebral artery (VA) undergoes a critical anatomical transition as it pierces the dura mater at the craniocervical junction. Precise knowledge of dural penetration patterns and angulation is essential for diagnostic imaging, neurosurgical planning, and minimizing iatrogenic risk in posterior fossa procedures.</div></div><div><h3>Methods</h3><div>This retrospective imaging study evaluated 100 adult patients who underwent 1.5 Tesla magnetic resonance angiography (MRA) with a time-of-flight protocol. The site of VA dural penetration was categorized on axial images as ventral, middle, or dorsal, and on coronal images as symmetrical (Type A) or asymmetrical (Types B or C). Angulations at the point of dural entry were quantified in axial and coronal planes. Documented vascular variants included extradural origins of the posterior inferior cerebellar artery (PICA) and aberrant VA trajectories.</div></div><div><h3>Results</h3><div>Middle axial penetration was the most frequent pattern (87 % of sides), while symmetrical coronal entry (Type A) predominated in 77 % of patients. Axial VA angulation differed significantly by sex (p = 0.034), with females exhibiting sharper angles. No side-related differences were observed for angulation or penetration type. Extradural PICA origin and aberrant VA course were identified in 16.5 % and 6 % of sides, respectively, but did not correlate with dural entry patterns.</div></div><div><h3>Conclusions</h3><div>The VA exhibits a highly consistent trajectory at the dura, most commonly entering at the middle axial zone with symmetrical coronal configuration. A sex-related difference in axial angulation may have biomechanical and hemodynamic implications. Although vascular variants are relatively common, they do not appear to influence penetration type yet remain relevant for surgical safety and diagnostic accuracy.</div></div>","PeriodicalId":50974,"journal":{"name":"Annals of Anatomy-Anatomischer Anzeiger","volume":"263 ","pages":"Article 152725"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016955","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

Innervation pattern of the anterolateral ligament (ALL) of the knee: Indication of an active role in proprioception and autonomic modulation 膝关节前外侧韧带（ALL）的神经支配模式：在本体感觉和自主神经调节中起积极作用的指示。

IF 1.7 3区医学 Q2 ANATOMY & MORPHOLOGY

Annals of Anatomy-Anatomischer Anzeiger

Pub Date : 2026-01-01 Epub Date: 2025-09-11 DOI: 10.1016/j.aanat.2025.152732

P. Arviza-Lorenzo , P. Aragonés , F.J. Valderrama-Canales , M. Schicht , F. Paulsen , T. Tschernig , M. Brockmeyer , K. Ruzik , M.T. Vázquez Osorio

Background

The anterolateral ligament (ALL) of the knee is increasingly recognized as a key structure in rotational stability, yet its anatomical and functional properties remain incompletely understood. This study investigates the innervation of the ALL using immunohistochemistry and electron microscopy to characterize its neurochemical profile and structural organization.

Methods

Seventeen ALL samples from adult human body donors were analyzed. Thirteen were examined using immunohistochemical staining for PGP9.5 (ubiquitin carboxyl-terminal hydrolase L1 (UCH-L1)), VAChT (Vesicular acetylcholine transporter), TH (tyrosine hydroxylase), CGRP (calcitonin gene-related peptide), and NOS (nitric oxide synthase). Four additional samples underwent transmission electron microscopy to assess ultrastructural features. Six Fibular collateral ligaments (FCL) were used as controls.

Results

All ALL specimens displayed positive immunoreactivity for the markers evaluated, confirming the presence of neurochemically diverse peripheral nerve fibers. Both myelinated and unmyelinated fibers were identified, though no encapsulated mechanoreceptors were observed. The innervation pattern was comparable to that of the (FCL), used as a control.

Conclusion

The ALL is a richly innervated structure with sensory, autonomic, and potential for neuromodulation, suggesting an active role in proprioception and homeostasis. These findings challenge previous views of the ALL as a passive capsular thickening and underscore its functional relevance in knee joint physiology.

背景：膝关节前外侧韧带（ALL）越来越被认为是维持旋转稳定性的关键结构，但其解剖学和功能特性仍不完全清楚。本研究利用免疫组织化学和电子显微镜研究ALL的神经支配，以表征其神经化学特征和结构组织。方法：对17例成人供体ALL样本进行分析。13例采用免疫组化染色检测PGP9.5（泛素羧基末端水解酶L1 (UCH-L1)）、VAChT（囊泡乙酰胆碱转运蛋白）、TH（酪氨酸羟化酶）、CGRP（降钙素基因相关肽）和NOS（一氧化氮合酶）。另外四个样品通过透射电子显微镜观察其超微结构特征。6条腓骨副韧带（FCL）作为对照。结果：所有All标本对评估的标记物显示阳性免疫反应，证实存在神经化学多样性的周围神经纤维。髓鞘纤维和无髓鞘纤维均被鉴定，但未观察到包封的机械感受器。神经支配模式与作为对照的（FCL）相当。结论：ALL是一个神经支配丰富的结构，具有感觉、自主神经和神经调节的潜力，在本体感觉和体内平衡中起着积极的作用。这些发现挑战了以前认为ALL是一种被动囊增厚的观点，并强调了其在膝关节生理学中的功能相关性。

{"title":"Innervation pattern of the anterolateral ligament (ALL) of the knee: Indication of an active role in proprioception and autonomic modulation","authors":"P. Arviza-Lorenzo , P. Aragonés , F.J. Valderrama-Canales , M. Schicht , F. Paulsen , T. Tschernig , M. Brockmeyer , K. Ruzik , M.T. Vázquez Osorio","doi":"10.1016/j.aanat.2025.152732","DOIUrl":"10.1016/j.aanat.2025.152732","url":null,"abstract":"<div><h3>Background</h3><div>The anterolateral ligament (ALL) of the knee is increasingly recognized as a key structure in rotational stability, yet its anatomical and functional properties remain incompletely understood. This study investigates the innervation of the ALL using immunohistochemistry and electron microscopy to characterize its neurochemical profile and structural organization.</div></div><div><h3>Methods</h3><div>Seventeen ALL samples from adult human body donors were analyzed. Thirteen were examined using immunohistochemical staining for PGP9.5 (ubiquitin carboxyl-terminal hydrolase L1 (UCH-L1)), VAChT (Vesicular acetylcholine transporter), TH (tyrosine hydroxylase), CGRP (calcitonin gene-related peptide), and NOS (nitric oxide synthase). Four additional samples underwent transmission electron microscopy to assess ultrastructural features. Six Fibular collateral ligaments (FCL) were used as controls.</div></div><div><h3>Results</h3><div>All ALL specimens displayed positive immunoreactivity for the markers evaluated, confirming the presence of neurochemically diverse peripheral nerve fibers. Both myelinated and unmyelinated fibers were identified, though no encapsulated mechanoreceptors were observed. The innervation pattern was comparable to that of the (FCL), used as a control.</div></div><div><h3>Conclusion</h3><div>The ALL is a richly innervated structure with sensory, autonomic, and potential for neuromodulation, suggesting an active role in proprioception and homeostasis. These findings challenge previous views of the ALL as a passive capsular thickening and underscore its functional relevance in knee joint physiology.</div></div>","PeriodicalId":50974,"journal":{"name":"Annals of Anatomy-Anatomischer Anzeiger","volume":"263 ","pages":"Article 152732"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058777","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

Classification scheme for fifth metatarsal base fractures based on CT three-dimensional reconstruction 基于CT三维重建的第五跖骨基底骨折分类方案。

IF 1.7 3区医学 Q2 ANATOMY & MORPHOLOGY

Annals of Anatomy-Anatomischer Anzeiger

Pub Date : 2026-01-01 Epub Date: 2025-10-26 DOI: 10.1016/j.aanat.2025.152747

Haohang Shi , Wei Wang , Menglang Peng , Ruihan Wang , Guilin Ren , Lei Zhang

Background

Traditional classifications of fifth metatarsal base (MTB5) fractures often overlook injuries involving the fourth-fifth metatarsal and fifth metatarsal-cuboid joints, contributing to ongoing clinical debate. This study aimed to introduce a novel classification system based on articular involvement, validated through three-dimensional (3D) fracture line mapping and heatmap analysis.

Methods

Imaging data from 98 patients with MTB5 fractures were retrospectively analyzed. Fracture models were reconstructed using Mimics 21.0, and fracture lines were mapped onto a standard model in 3-matic 13.0. Heatmaps generated in E-3D illustrated fracture patterns. Three reference lines were established to quantify spatial relationships between high-risk fracture areas and joint margins.

Results

The cohort predominantly comprised patients aged 51–70 years (41.83 %), with a higher incidence among males (53.06 %). Fractures were classified into six types: non-articular (IA: tuberosity, 18.36 %; IB: metaphyseal, 23.46 %; IC: distal to metaphysis, 14.24 %) and articular (IIA: fifth metatarsal-cuboid joint, 36.73 %; IIB: fourth-fifth metatarsal joint, 3.06 %; IIC: both joints, 4.08 %). High-risk zones relative to joint boundaries were quantitatively delineated for each subtype.

Conclusion

A new six-type classification system for MTB5 fractures is proposed, differentiating non-articular (IA–IC) and articular (IIA–IIC) injuries. Supported by 3D heatmap analysis, this system integrates articular injury patterns, overcomes limitations of previous classifications, and may help guide treatment and improve outcomes.

背景：传统的第五跖骨基底骨折（MTB5）分类往往忽略了涉及第四-第五跖骨和第五跖骨-长方体关节的损伤，这导致了持续的临床争论。本研究旨在介绍一种基于关节受累的新型分类系统，通过三维（3D）骨折线测绘和热图分析进行验证。方法：回顾性分析98例MTB5骨折患者的影像学资料。使用Mimics 21.0重建裂缝模型，并将裂缝线映射到3-matic 13.0的标准模型上。E-3D生成的热图显示了裂缝模式。建立了三条参考线来量化高危骨折区域与关节边缘之间的空间关系。结果：该队列以51 ~ 70岁患者为主（41.83%），男性发病率较高（53.06%）。骨折分为非关节型（IA：结节，18.36%；IB：干骺端，23.46%；IC：干骺端远端，14.24%）和关节型（IIA：第五跖长方关节，36.73%；IIB：第四跖-第五跖关节，3.06%；IIC：双关节，4.08%）。相对于关节边界的高危区对每个亚型进行定量划定。结论：提出了一种新的MTB5骨折分型体系，可区分非关节型（IA-IC）和关节型（ia - iic）损伤。在3D热图分析的支持下，该系统整合了关节损伤模式，克服了以往分类的局限性，可能有助于指导治疗和改善结果。

{"title":"Classification scheme for fifth metatarsal base fractures based on CT three-dimensional reconstruction","authors":"Haohang Shi , Wei Wang , Menglang Peng , Ruihan Wang , Guilin Ren , Lei Zhang","doi":"10.1016/j.aanat.2025.152747","DOIUrl":"10.1016/j.aanat.2025.152747","url":null,"abstract":"<div><h3>Background</h3><div>Traditional classifications of fifth metatarsal base (MTB5) fractures often overlook injuries involving the fourth-fifth metatarsal and fifth metatarsal-cuboid joints, contributing to ongoing clinical debate. This study aimed to introduce a novel classification system based on articular involvement, validated through three-dimensional (3D) fracture line mapping and heatmap analysis.</div></div><div><h3>Methods</h3><div>Imaging data from 98 patients with MTB5 fractures were retrospectively analyzed. Fracture models were reconstructed using Mimics 21.0, and fracture lines were mapped onto a standard model in 3-matic 13.0. Heatmaps generated in E-3D illustrated fracture patterns. Three reference lines were established to quantify spatial relationships between high-risk fracture areas and joint margins.</div></div><div><h3>Results</h3><div>The cohort predominantly comprised patients aged 51–70 years (41.83 %), with a higher incidence among males (53.06 %). Fractures were classified into six types: non-articular (IA: tuberosity, 18.36 %; IB: metaphyseal, 23.46 %; IC: distal to metaphysis, 14.24 %) and articular (IIA: fifth metatarsal-cuboid joint, 36.73 %; IIB: fourth-fifth metatarsal joint, 3.06 %; IIC: both joints, 4.08 %). High-risk zones relative to joint boundaries were quantitatively delineated for each subtype.</div></div><div><h3>Conclusion</h3><div>A new six-type classification system for MTB5 fractures is proposed, differentiating non-articular (IA–IC) and articular (IIA–IIC) injuries. Supported by 3D heatmap analysis, this system integrates articular injury patterns, overcomes limitations of previous classifications, and may help guide treatment and improve outcomes.</div></div>","PeriodicalId":50974,"journal":{"name":"Annals of Anatomy-Anatomischer Anzeiger","volume":"263 ","pages":"Article 152747"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145395938","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

Hormones and growth factors involved in supplying offspring: Insights from fish to mammals 与提供后代有关的激素和生长因子：从鱼类到哺乳动物的见解。

IF 1.7 3区医学 Q2 ANATOMY & MORPHOLOGY

Annals of Anatomy-Anatomischer Anzeiger

Pub Date : 2026-01-01 Epub Date: 2025-10-04 DOI: 10.1016/j.aanat.2025.152745

Elisabeth Eppler , Alessandro Bilella , Karl Link , Helena D'Cotta , Jean-François Baroiller

A plethora of analogies to support energy provision and offspring nourishment have been posited between mammals and teleosts. This review provides a comprehensive overview of the intricate interactions between hormones and growth factors ranging from early egg development to feeding the newborn in mammals. The discussion encompasses hormones and growth factors in sexual development of male and female bony fish and then focuses on factors relevant during ovarian development and egg and yolk formation in female teleosts. The next chapter focuses on mechanisms to ensure calcium supply for embryo skeletal growth across vertebrate species and the respective maternal calcium mobilisation. Marine and freshwater fish possess divergent strategies for the acquisition of calcium, i.e., mineral homeostasis and osmoregulation. This review will focus primarily on actions of the growth hormone-insulin-like growth factor-system, the parathyroid hormone family, and other signalling factors and hormones. Prolactin is in the literature proposed as an evolutionary link between maternal nutrient supply in mammals, particularly calcium through lactation, and its ancestral role in regulating electrolyte and calcium uptake from the surrounding water in fish. The following section will present some hormones and growth factors in parental care in fish followed by signals in skeletal formation, lactation and calcium homeostasis in soil-egg-laying vertebrates, calcium metabolism in oviparous mammals and during embryonic and postnatal bone formation in placental mammals. Finally, hormones and factors relevant for the development of the mammalian breast are described.

在哺乳动物和硬骨鱼之间，有大量的类比来支持能量供应和后代的营养。这篇综述提供了从哺乳动物早期卵子发育到喂养新生儿的激素和生长因子之间复杂的相互作用的全面概述。讨论了雄性和雌性硬骨鱼性发育中的激素和生长因子，然后重点讨论了雌性硬骨鱼卵巢发育和卵黄形成的相关因素。下一章的重点是机制，以确保钙供应的胚胎骨骼生长跨脊椎动物物种和各自的母体钙动员。海洋鱼类和淡水鱼具有不同的钙获取策略，即矿物质稳态和渗透调节。本文将重点介绍生长激素-胰岛素样生长因子系统、甲状旁腺激素家族以及其他信号因子和激素的作用。在文献中，催乳素被认为是哺乳动物母体营养供应（特别是通过哺乳提供的钙）与调节鱼类从周围水中吸收电解质和钙的祖先作用之间的进化联系。下一节将介绍鱼类亲代抚育过程中的一些激素和生长因子，随后是土壤产蛋脊椎动物骨骼形成、哺乳和钙稳态中的信号，卵生哺乳动物的钙代谢以及胎盘哺乳动物的胚胎和出生后骨形成过程中的信号。最后，描述了哺乳动物乳房发育的相关激素和因素。

{"title":"Hormones and growth factors involved in supplying offspring: Insights from fish to mammals","authors":"Elisabeth Eppler , Alessandro Bilella , Karl Link , Helena D'Cotta , Jean-François Baroiller","doi":"10.1016/j.aanat.2025.152745","DOIUrl":"10.1016/j.aanat.2025.152745","url":null,"abstract":"<div><div>A plethora of analogies to support energy provision and offspring nourishment have been posited between mammals and teleosts. This review provides a comprehensive overview of the intricate interactions between hormones and growth factors ranging from early egg development to feeding the newborn in mammals. The discussion encompasses hormones and growth factors in sexual development of male and female bony fish and then focuses on factors relevant during ovarian development and egg and yolk formation in female teleosts. The next chapter focuses on mechanisms to ensure calcium supply for embryo skeletal growth across vertebrate species and the respective maternal calcium mobilisation. Marine and freshwater fish possess divergent strategies for the acquisition of calcium, i.e., mineral homeostasis and osmoregulation. This review will focus primarily on actions of the growth hormone-insulin-like growth factor-system, the parathyroid hormone family, and other signalling factors and hormones. Prolactin is in the literature proposed as an evolutionary link between maternal nutrient supply in mammals, particularly calcium through lactation, and its ancestral role in regulating electrolyte and calcium uptake from the surrounding water in fish. The following section will present some hormones and growth factors in parental care in fish followed by signals in skeletal formation, lactation and calcium homeostasis in soil-egg-laying vertebrates, calcium metabolism in oviparous mammals and during embryonic and postnatal bone formation in placental mammals. Finally, hormones and factors relevant for the development of the mammalian breast are described.</div></div>","PeriodicalId":50974,"journal":{"name":"Annals of Anatomy-Anatomischer Anzeiger","volume":"263 ","pages":"Article 152745"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240578","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

Beyond four heads: Should the quadriceps femoris be reclassified as multiceps muscle? 超越四个头：股四头肌应该被重新分类为多头肌吗？

IF 1.7 3区医学 Q2 ANATOMY & MORPHOLOGY

Annals of Anatomy-Anatomischer Anzeiger

Pub Date : 2026-01-01 Epub Date: 2025-09-19 DOI: 10.1016/j.aanat.2025.152737

Łukasz Olewnik , Ingrid C. Landfald , Kacper Ruzik , Judney Cley Cavalcante , Maria Piagkou , George Triantafyllou , Teresa Vázquez , Paloma Aragones , Fabrice Duparc

Background

The quadriceps femoris (QF) is classically described as a four-headed muscle. However, anatomical and radiological studies increasingly reveal supernumerary heads and tendon stratifications, challenging this concept.

Objective

This review synthesizes current cadaveric, imaging, and surgical evidence to propose a reclassification of QF as a multiceps femoris (MF). A five-type tendon-based classification system is introduced, reflecting distinct morphological variants and layering complexities.

Methods

An extensive review of anatomical dissection studies, radiological investigations (MRI and ultrasound), and clinical reports were conducted to evaluate morphological variability and its implications for tendon harvesting and surgical access.

Results

Accessory heads such as the tensor vastus intermedius and caput tertium were present in over 60 % of cases, often contributing to distinct layers within the quadriceps femoris tendon (QFT). These configurations influence graft length, harvesting safety, and radiological interpretation. Misidentification of these structures may result in surgical complications or diagnostic errors. Functional and evolutionary analogies with other multiceps systems support the anatomical independence of these heads.

Conclusion

The MF model aligns with modular systems seen in the triceps surae and biceps femoris. Recognizing QF as MF offers a more anatomically accurate and clinically relevant framework. Adoption of updated terminology and imaging protocols may improve diagnosis, reduce surgical risk, and support personalized interventions.

背景：股四头肌（QF）被经典地描述为一个四头肌。然而，解剖学和放射学研究越来越多地揭示了多余的头部和肌腱分层，挑战了这一概念。目的：本文综合目前的尸体、影像学和外科证据，提出将QF重新分类为股多头肌（MF）。介绍了一种基于肌腱的五类分类系统，反映了不同的形态变异和分层复杂性。方法：广泛回顾解剖解剖研究、放射学调查（MRI和超声）和临床报告，以评估形态变异及其对肌腱收获和手术通路的影响。结果：超过60%的病例中存在股中间张肌和三角肌头等副头，通常导致股四头肌肌腱（QFT）内的不同层。这些结构影响接枝长度、收获安全性和放射学解释。这些结构的错误识别可能导致手术并发症或诊断错误。与其他多头肌系统的功能和进化相似性支持这些头部在解剖学上的独立性。结论：MF模型与三头肌表面和股二头肌的模块化系统一致。将QF识别为MF提供了一个解剖学上更准确和临床相关的框架。采用更新的术语和成像协议可以提高诊断，降低手术风险，并支持个性化干预。

{"title":"Beyond four heads: Should the quadriceps femoris be reclassified as multiceps muscle?","authors":"Łukasz Olewnik , Ingrid C. Landfald , Kacper Ruzik , Judney Cley Cavalcante , Maria Piagkou , George Triantafyllou , Teresa Vázquez , Paloma Aragones , Fabrice Duparc","doi":"10.1016/j.aanat.2025.152737","DOIUrl":"10.1016/j.aanat.2025.152737","url":null,"abstract":"<div><h3>Background</h3><div>The quadriceps femoris (QF) is classically described as a four-headed muscle. However, anatomical and radiological studies increasingly reveal supernumerary heads and tendon stratifications, challenging this concept.</div></div><div><h3>Objective</h3><div>This review synthesizes current cadaveric, imaging, and surgical evidence to propose a reclassification of QF as a multiceps femoris (MF). A five-type tendon-based classification system is introduced, reflecting distinct morphological variants and layering complexities.</div></div><div><h3>Methods</h3><div>An extensive review of anatomical dissection studies, radiological investigations (MRI and ultrasound), and clinical reports were conducted to evaluate morphological variability and its implications for tendon harvesting and surgical access.</div></div><div><h3>Results</h3><div>Accessory heads such as the tensor vastus intermedius and caput tertium were present in over 60 % of cases, often contributing to distinct layers within the quadriceps femoris tendon (QFT). These configurations influence graft length, harvesting safety, and radiological interpretation. Misidentification of these structures may result in surgical complications or diagnostic errors. Functional and evolutionary analogies with other multiceps systems support the anatomical independence of these heads.</div></div><div><h3>Conclusion</h3><div>The MF model aligns with modular systems seen in the triceps surae and biceps femoris. Recognizing QF as MF offers a more anatomically accurate and clinically relevant framework. Adoption of updated terminology and imaging protocols may improve diagnosis, reduce surgical risk, and support personalized interventions.</div></div>","PeriodicalId":50974,"journal":{"name":"Annals of Anatomy-Anatomischer Anzeiger","volume":"263 ","pages":"Article 152737"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115356","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

Exploring the interthalamic adhesion: A comprehensive review of its morphology, neuroconnectivity and history of research 探索丘脑间粘连：其形态学、神经连通性和研究历史的综合综述。

IF 1.7 3区医学 Q2 ANATOMY & MORPHOLOGY

Annals of Anatomy-Anatomischer Anzeiger

Pub Date : 2026-01-01 Epub Date: 2025-09-05 DOI: 10.1016/j.aanat.2025.152728

Kacper Abramek , Fryderyk Sobczak , Jerzy Walocha , Sanjib Ghosh , Apurba Patra , Krzysztof Balawender

The interthalamic adhesion, or massa intermedia, is a midline bridge of neural tissue connecting the thalami across the third ventricle and usually containing the nucleus reuniens. It is important radiologically and neurosurgically: accessing the third ventricle or structures through the third ventricle, endoscopic surgery at third ventricle. We aim to consolidate current knowledge on the interthalamic adhesion, focusing on its morphology, nomenclature, development, histology, connections and anatomical variations to clarify longstanding inconsistencies. The interthalamic adhesion develops around 13–14 weeks of gestation and contains neurons and commissural fibers that continue maturing postnatally. Fibers were mentioned to occur in a subset of individuals; however, this feature is not observed constantly. When present, these fibers project to the contralateral hemisphere, potentially indicating a role analogous – albeit significantly reduced – to that of the corpus callosum, anterior commissure, or posterior commissure. As the cortical evolution progresses, it may lose its functional relevance. Recent studies estimate the prevalence of the interthalamic adhesion at 87.3 %. It is more common in females, some authors suggest it is also larger. Its morphology varies widely – commonly single styloid or broad, but also bilobar, duplicated or even multiple. The interthalamic adhesion was most commonly located in the antero-superior quadrant of the third ventricle. Its morphology is associated with some psychiatric disorders such as schizophrenia, bipolar disease and depression. Histologically, the interthalamic adhesion is rich in glia, featuring a broad subependymal zone and contains various neuron types – oval, fusiform, triangular, and multipolar, some form unique circular arrangements.

丘脑间粘连或间质是神经组织的中线桥，通过第三脑室连接丘脑，通常包含重连核。在放射学和神经外科上很重要：通过第三脑室进入第三脑室或结构，在第三脑室进行内窥镜手术。我们的目标是巩固目前对丘脑间粘连的知识，重点关注其形态、命名、发育、组织学、连接和解剖变异，以澄清长期存在的不一致性。丘脑间粘连在妊娠13-14周左右形成，含有神经元和互交纤维，在出生后继续成熟。据说纤维存在于一小部分个体中；然而，这个特性并不是经常观察到的。当存在时，这些纤维投射到对侧半球，可能表明其作用类似于胼胝体、前连合或后连合，尽管其作用明显减弱。随着皮质的进化，它可能失去其功能相关性。最近的研究估计丘脑间粘连的患病率为87.3%。它在女性中更常见，一些作者认为它也更大。其形态变化很大-通常是单茎或宽，但也双叶，重复或甚至多。丘脑间粘连最常见于第三脑室前上象限。其形态与精神分裂症、双相情感障碍和抑郁症等精神疾病有关。在组织学上，丘脑间粘连具有丰富的胶质细胞，具有广泛的室管膜下区，包含各种类型的神经元-卵圆形，梭状，三角形和多极，有些形成独特的圆形排列。

{"title":"Exploring the interthalamic adhesion: A comprehensive review of its morphology, neuroconnectivity and history of research","authors":"Kacper Abramek , Fryderyk Sobczak , Jerzy Walocha , Sanjib Ghosh , Apurba Patra , Krzysztof Balawender","doi":"10.1016/j.aanat.2025.152728","DOIUrl":"10.1016/j.aanat.2025.152728","url":null,"abstract":"<div><div>The interthalamic adhesion, or massa intermedia, is a midline bridge of neural tissue connecting the thalami across the third ventricle and usually containing the nucleus reuniens. It is important radiologically and neurosurgically: accessing the third ventricle or structures through the third ventricle, endoscopic surgery at third ventricle. We aim to consolidate current knowledge on the interthalamic adhesion, focusing on its morphology, nomenclature, development, histology, connections and anatomical variations to clarify longstanding inconsistencies. The interthalamic adhesion develops around 13–14 weeks of gestation and contains neurons and commissural fibers that continue maturing postnatally. Fibers were mentioned to occur in a subset of individuals; however, this feature is not observed constantly. When present, these fibers project to the contralateral hemisphere, potentially indicating a role analogous – albeit significantly reduced – to that of the corpus callosum, anterior commissure, or posterior commissure. As the cortical evolution progresses, it may lose its functional relevance. Recent studies estimate the prevalence of the interthalamic adhesion at 87.3 %. It is more common in females, some authors suggest it is also larger. Its morphology varies widely – commonly single styloid or broad, but also bilobar, duplicated or even multiple. The interthalamic adhesion was most commonly located in the antero-superior quadrant of the third ventricle. Its morphology is associated with some psychiatric disorders such as schizophrenia, bipolar disease and depression. Histologically, the interthalamic adhesion is rich in glia, featuring a broad subependymal zone and contains various neuron types – oval, fusiform, triangular, and multipolar, some form unique circular arrangements.</div></div>","PeriodicalId":50974,"journal":{"name":"Annals of Anatomy-Anatomischer Anzeiger","volume":"263 ","pages":"Article 152728"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016925","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

Peer-assisted uniform learning in musculoskeletal anatomy: Enhancing performance across cognitive domains in objective structured practical examination 肌肉骨骼解剖学的同侪协助统一学习：在客观结构化实践考试中提高跨认知领域的表现。

IF 1.7 3区医学 Q2 ANATOMY & MORPHOLOGY

Annals of Anatomy-Anatomischer Anzeiger

Pub Date : 2026-01-01 Epub Date: 2025-10-09 DOI: 10.1016/j.aanat.2025.152744

Sadia Qazi , Shahid Akhtar Akhund , Muhammad Atif Mazhar , Aftab Ahmed Shaikh , Eshal Atif , Samir Odeh , Mohammed Alged Elsheikh Musa , Hassan Shaibah , Paul Ganguly , Ahmed Yaqinuddin

Background

Peer-assisted learning enhances conceptual understanding in anatomy education; however, its impact on structured cognitive outcomes remains unclear. We evaluated the effect of the Peer-Assisted Uniform Learning (PAUL) program on musculoskeletal (MSK) anatomy objective structured practical examination (OSPE) performance.

Methods

We used a cross-sectional, controlled, observational design to analyse the OSPE scores of 304 students. Seventy-nine students who attended at least two PAUL sessions formed the exposure group, while 225 served as the control group. The PAUL participants alternated between tutor and tutee roles during the sessions. The OSPE items were divided into Cluster 1 (identification/recall) and Cluster 2 (application/analysis). A validated survey was used to assess the participants perceived learning outcomes and satisfaction.

Results

PAUL participants outperformed non-participants in Cluster 1 (78.4 vs. 73.7, p = 0.01) and Cluster 2 (87.2 vs. 82.8, p = 0.02). The relative gain was greater for application-based items (interaction effect: F = 8.37, p = 0.004), supporting the program’s effect on higher-order reasoning. Survey responses (91 % response rate) showed high satisfaction (mean 4.3 ± 0.6) and perceived learning gains (mean 4.1 ± 0.7); 85 % of students reported improved understanding of the subject.

Conclusion

The PAUL program, grounded in social constructivist principles and supported by faculty oversight, improved performance in both recall and application of MSK anatomy OSPE items, with the strongest impact on application-based learning.

背景：同伴辅助学习增强解剖学教育中的概念理解；然而，它对结构化认知结果的影响尚不清楚。我们评估了同伴辅助统一学习（PAUL）计划对肌肉骨骼（MSK）解剖客观结构化实践考试（OSPE）成绩的影响。方法：采用横断面、对照、观察设计对304名学生的OSPE成绩进行分析。79名参加了至少两次PAUL课程的学生组成了暴露组，而225名作为对照组。PAUL参与者在会议期间交替担任导师和学生的角色。OSPE项目分为第1类（识别/召回）和第2类（应用/分析）。采用一项有效的调查来评估参与者的学习成果和满意度。结果：PAUL参与者在第1组（78.4 vs. 73.7, p = 0.01）和第2组（87.2 vs. 82.8, p = 0.02）中的表现优于非参与者。基于应用程序的项目的相对增益更大（交互效应：F = 8.37, p = 0.004），支持程序对高阶推理的影响。调查反应（91%的回复率）显示满意度高（平均4.3±0.6）和感知学习收益（平均4.1±0.7）；85%的学生表示对这门学科的理解有所提高。结论：以社会建构主义原则为基础，在教师监督的支持下，PAUL计划提高了学生在MSK解剖OSPE项目的记忆和应用方面的表现，对基于应用的学习影响最大。

{"title":"Peer-assisted uniform learning in musculoskeletal anatomy: Enhancing performance across cognitive domains in objective structured practical examination","authors":"Sadia Qazi , Shahid Akhtar Akhund , Muhammad Atif Mazhar , Aftab Ahmed Shaikh , Eshal Atif , Samir Odeh , Mohammed Alged Elsheikh Musa , Hassan Shaibah , Paul Ganguly , Ahmed Yaqinuddin","doi":"10.1016/j.aanat.2025.152744","DOIUrl":"10.1016/j.aanat.2025.152744","url":null,"abstract":"<div><h3>Background</h3><div>Peer-assisted learning enhances conceptual understanding in anatomy education; however, its impact on structured cognitive outcomes remains unclear. We evaluated the effect of the Peer-Assisted Uniform Learning (PAUL) program on musculoskeletal (MSK) anatomy objective structured practical examination (OSPE) performance.</div></div><div><h3>Methods</h3><div>We used a cross-sectional, controlled, observational design to analyse the OSPE scores of 304 students. Seventy-nine students who attended at least two PAUL sessions formed the exposure group, while 225 served as the control group. The PAUL participants alternated between tutor and tutee roles during the sessions. The OSPE items were divided into Cluster 1 (identification/recall) and Cluster 2 (application/analysis). A validated survey was used to assess the participants perceived learning outcomes and satisfaction.</div></div><div><h3>Results</h3><div>PAUL participants outperformed non-participants in Cluster 1 (78.4 vs. 73.7, <em>p</em> = 0.01) and Cluster 2 (87.2 vs. 82.8, <em>p</em> = 0.02). The relative gain was greater for application-based items (interaction effect: <em>F</em> = 8.37, <em>p</em> = 0.004), supporting the program’s effect on higher-order reasoning. Survey responses (91 % response rate) showed high satisfaction (mean 4.3 ± 0.6) and perceived learning gains (mean 4.1 ± 0.7); 85 % of students reported improved understanding of the subject.</div></div><div><h3>Conclusion</h3><div>The PAUL program, grounded in social constructivist principles and supported by faculty oversight, improved performance in both recall and application of MSK anatomy OSPE items, with the strongest impact on application-based learning.</div></div>","PeriodicalId":50974,"journal":{"name":"Annals of Anatomy-Anatomischer Anzeiger","volume":"263 ","pages":"Article 152744"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260203","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

Modified free functional split gracilis flap design for periorbital and perioral smile reanimation in patients with total flaccid facial paralysis: A cadaveric study 改良的自由功能性薄股肌瓣设计用于全弛缓性面瘫患者的眶周和口周微笑恢复：一项尸体研究。

IF 1.7 3区医学 Q2 ANATOMY & MORPHOLOGY

Annals of Anatomy-Anatomischer Anzeiger

Pub Date : 2026-01-01 Epub Date: 2025-09-09 DOI: 10.1016/j.aanat.2025.152727

Murat Enes Saglam , Ayhan Comert , Mehmet Yilmaz , Mehmet Aydin , Necati Salman , R. Shane Tubbs , Murat Igde

Background

Facial reanimation after total flaccid facial paralysis requires natural smile animation with participation of both periorbital and perioral compartments.

Objective

To define detailed anatomy of gracilis muscle flap and investigate anatomical feasibility of split muscle flap transfer for periorbital and perioral smile reanimation.

Materials and methods

Flap transfer was evaluated on 20 gracilis muscles, was adapted between temporal area and oral and eyelid regions. Morphological measurements were obtained. Vascular pedicle of flap was examined. Distal vessel distribution was visualized on radiography.

Results

Width of gracilis was 55.94 ± 6.83 mm. Number of distal branches of major pedicle was minimum four and maximum six. There was no correlation between number of vessels and muscle width. Appropriate length of distal muscle was cut from hilum. Vessels within sagittal sections at the distal edge of the flap were examined under an operating microscope. Uppermost(1st) part had a weak vascular network (1.70 ± 0.45). All neurovascular morphological measurements indicated suitability for anastomosis sites.

Conclusion

Results showed that distal part of gracilis muscle flap in all cadavers could be split into four equal parts, each having vessels. Anatomically, modified free functional split gracilis flap design is suitable and transferable for periorbital and perioral smile reanimation.

背景：完全弛缓性面瘫后的面部恢复需要眶周和口周隔参与的自然微笑。目的：明确股薄肌瓣的详细解剖结构，探讨分离肌瓣移植用于眶周、口周微笑恢复的解剖学可行性。材料和方法：对20块薄股肌进行皮瓣转移，在颞区和口腔、眼睑区之间进行移植。形态学测量得到。检查皮瓣血管蒂。x线片显示远端血管分布。结果：股薄肌宽度为55.94±6.83mm。主蒂远端支数最少4支，最多6支。血管数量与肌肉宽度无相关性。从门部切取适当长度的远端肌肉。在手术显微镜下检查皮瓣远端矢状面血管。上(1)部血管网较弱（1.70±0.45）。所有神经血管形态学测量显示吻合部位的适宜性。结论：所有尸体的股薄肌远端皮瓣均可均匀地分成四等份，每一等份均有血管。解剖学上，改良的自由功能性薄股肌瓣设计适合于眶周和口周的微笑恢复。

{"title":"Modified free functional split gracilis flap design for periorbital and perioral smile reanimation in patients with total flaccid facial paralysis: A cadaveric study","authors":"Murat Enes Saglam , Ayhan Comert , Mehmet Yilmaz , Mehmet Aydin , Necati Salman , R. Shane Tubbs , Murat Igde","doi":"10.1016/j.aanat.2025.152727","DOIUrl":"10.1016/j.aanat.2025.152727","url":null,"abstract":"<div><h3>Background</h3><div>Facial reanimation after total flaccid facial paralysis requires natural smile animation with participation of both periorbital and perioral compartments.</div></div><div><h3>Objective</h3><div>To define detailed anatomy of gracilis muscle flap and investigate anatomical feasibility of split muscle flap transfer for periorbital and perioral smile reanimation.</div></div><div><h3>Materials and methods</h3><div>Flap transfer was evaluated on 20 gracilis muscles, was adapted between temporal area and oral and eyelid regions. Morphological measurements were obtained. Vascular pedicle of flap was examined. Distal vessel distribution was visualized on radiography.</div></div><div><h3>Results</h3><div>Width of gracilis was 55.94 ± 6.83 mm. Number of distal branches of major pedicle was minimum four and maximum six. There was no correlation between number of vessels and muscle width. Appropriate length of distal muscle was cut from hilum. Vessels within sagittal sections at the distal edge of the flap were examined under an operating microscope. Uppermost(1st) part had a weak vascular network (1.70 ± 0.45). All neurovascular morphological measurements indicated suitability for anastomosis sites.</div></div><div><h3>Conclusion</h3><div>Results showed that distal part of gracilis muscle flap in all cadavers could be split into four equal parts, each having vessels. Anatomically, modified free functional split gracilis flap design is suitable and transferable for periorbital and perioral smile reanimation.</div></div>","PeriodicalId":50974,"journal":{"name":"Annals of Anatomy-Anatomischer Anzeiger","volume":"263 ","pages":"Article 152727"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042520","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