我国大体解剖学科研近况

中国解剖学会本次年会大体解剖学专业委员会收到的论文,在较大的程度上,能反映我国两年来大体解剖学的科研动态。通过管中窥豹,可见一斑,若加以剖析,能从一个侧面了解这一领域的科研近况。在收到的500多篇论     

阑尾的应用解剖学探讨

目的 为临床应用提供更多的形态学资料。方法 在106具福尔马林固定的汉族成人尸体上对阑尾及其系膜进行了观测。结果 观察了阑尾的位置、形态、长度、开口形状,动脉分支及阑尾系膜的形态等指数。结论 阑尾位置以回肠前位最多,阑尾的形态以“S”形和扭曲形最多,阑尾开口呈漏斗形者最多,阑尾长度平均为(66.3±0.3)mm,阑尾系膜以三角形最多。     

举办大体解剖学新理论技术讲习班的通知(第一次)

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结合解剖学提高医学影像学教学质量

医学影像学是一门医学基础、临床实践与影像图像三者有机结合的综合性学科，具有知识结构复杂，信息量丰富，教学难度大的特点。它以人体解剖知识为基础，通过不同方式的人体成像发现病变，并对疾病的临床过程、转归预后和治疗效果进行互相印证、互相补充及综合评价。影像学技术高速发展使大体解剖结构和病理改变显示更加清楚、直观，大大提高了疾病的显示率。因此，为提高医学影像学教学质量，必须在教学中密切联系解剖学知识，将二者有效结合，同 时突出影像学诊断的自身特点。     

制作塑化标本的大体解剖技术

塑化标本不需用福尔马林液保存,无毒无味,且使用时间长。现在尸体材料来源越加困难,标本经塑化后使用和保存对教学和科研都非常有益,这也是人体解剖学标本发展的一个趋势。现有的技术资料对标本的塑化过程已有详尽介绍［１,２］。故本文重点介绍为制作塑化标本进行的...     

低温条件下大体标本生物塑化研究

目前我国以南京、重庆为代表采用常温条件和间断真空浸渗处理技术,而以大连、青岛为代表采用低温连续真空渗透技术;但制作技术的复杂性、关键技术未普及以及设备昂贵,使应用受限。生物塑化技术的研究国内报道颇多,但是对其详细制作方法、注意事项、塑化标本颜色加深的原因、影响塑化标本固化因素、低温真空技术与常温真空技术的比较等方面的相关研究,作者尚未见报道。为此作者依据自身经验进行相关文献分析和总结,以期为塑化技术实践者提供基础参考,也为解剖生物塑化技术的研究积累资料。     

顺应现代影像学发展创建断层解剖学课程

７０年代以来,超声（ＵＳ）、ＣＴ、ＭＲＩ、单光子发射断层扫描（ＳＰＥＣＴ）、正电子发射断层扫描（ＰＥＴ）和介入放射学相继崛起并迅速普及,已成为影像学诊治的主流。这些影像技术赖以诊断和介入治疗的形态学基础是断层解剖学,因此,在医药院校内开设断层解剖学课...     

生命文化视域下"大体老师"在人体解剖学教学中的伦理审度

本文探讨在阐述生命文化教育基本内涵的基础上,通过对"大体老师"在高校解剖学教学中多重价值的探讨,提升学生对生命伦理的认识,促进培养医学生人文价值观,努力提升医学生职业素养和综合素质.     

Vermiform Appendix During the Repackaging Process from Umbilical Herniation to Fixation onto the Right Posterior Abdomen

The anatomical position of the vermiform appendix varies among adults, and these variations are responsible for differences in the symptoms of appendicitis. However, to date no study has examined how and when these variations occur during fetal development. The present study examined horizontal sections of 27 midterm fetuses (crown rump length [CRL] 38–97 mm, gestational age approximately 8–15 weeks). There were 10 fetuses (CRL 56 mm or more) in which the cecum and appendix were in a posterosuperior site near the right kidney (postmigration phase), and 12 fetuses (CRL 39–72 mm) in which the ileocecal junction and appendix remained on the visceral surface of the liver in the anterior or anterolateral abdominal cavity (migration phase, after physiological umbilical herniation). Analysis of the 12 fetuses in the migration phase indicated that the appendix extended inferiorly in eight fetuses and superiorly in four fetuses. Likewise, a “preileal” appendix (a morphology in which the distal part of the appendix was in front of the terminal ileum) was present in eight of these fetuses. Extension of the appendix superiorly or inferiorly during the migration phase seems unrelated to the topographical relationship of the appendix with the terminal ileum at the postmigration phase in fetuses and in adults. Conversely, it seems likely that a retroileal appendix leads to a coiled appendix behind the ileocecal junction. “Guidance” by the liver surface seemed to be important for posterior migration, which ended with the ascent of the liver. Clin. Anat., 33:667–677, 2020. © 2019 Wiley Periodicals, Inc.     

Variations and morphometric features of the vermiform appendix: A systematic review and meta-analysis of 114,080 subjects with clinical implications

Determining the true and indisputable data regarding the vermiform appendix (VA) morphology is of a great clinical interest. The aim of this study was to provide the best evidence-based anatomical overview of the variations in location and size of VA using a systematic and meta-analytical approach. A systematic review with meta-analysis was performed of studies reporting variants of the location and morphometric data regarding the VA. The MEDLINE/PubMed, ScienceDirect, EMBASE, BIOSIS, SciELO, and Web of Science databases were thoroughly searched throughout June 2018. The reported locations of the body of the VA were re-classified into a new, standardized classification system divided into nine categories. The AQUA tool was used to assess the quality of included studies. The research was conducted following PRISMA guidelines and registered at PROPSERO database. Our meta-analysis included 242 studies (n = 114,080). Overall, the VA was most commonly found in the retrocecal location (32.1%, 95%CI: 29.2–35.1), followed by the pelvic (28.5%, 95%CI: 26.7–30.4) and ileal (14.5%, 95%CI: 11.8–17.7) locations. Subjects without known appendiceal pathologies had significantly smaller VA outer diameters (5.84 mm, 95%CI: 5.68–5.99) than patients diagnosed with acute appendicitis (10.64 mm, 95%CI: 10.14–11.15). The overall pooled mean length of the VA was 80.29 mm (95%CI: 76.68–83.89). Significant differences were found in size of the VA between imaging modalities. The results obtained from this evidence-based anatomy study will improve the clinical understanding of the VA anatomy, which in turn will have major implications for clinical practice. Clin. Anat. 32:85–98, 2019. © 2019 Wiley Periodicals, Inc.     

家猪心脏纤维支架的大体解剖

目的　观察猪心纤维支架 ,为猪心的研究和比较解剖学积累资料。方法　取甲醛固定后的猪心2 7例 ,液态塑料浸渍的塑化猪心 5例 ,解剖显示纤维支架后用游标卡尺进行观测。结果　猪心左纤维三角的三边分别平均为 17 4 1± 1 99mm、18.96± 3.2 6mm和 17.6 4± 2 .4 4mm ;右纤维三角三边分别为 15 .83± 2 .11mm、16 .19± 1.94mm和 2 0 .96± 2 .6 2mm ;二尖瓣环、三尖瓣环的周长平均为 73.0 0± 9.71mm ,6 8.89±7.2 4mm ;主动脉瓣环和肺动脉瓣环直径分别为 18.4 4± 2 .89mm和 16 .0 3± 2 .6 3mm ;猪Todaro腱呈扁带状 ,走行部位较深 ,且分支较人心多 ,长度为 2 0 98± 4 2 0mm。结论　猪心纤维支架与人类形态结构相似 ,但瓣环周长和Todaro腱形态有一定差别。     

Goblet Cell Carcinoid of the Vermiform Appendix with Ovarian Metastasis Mimicking Mucinous Cystadenocarcinoma

We describe a case of goblet cell carcinoid of the vermiform appendix, which metastasized to the bilateral ovaries, uterus, vagina and peritoneum three years and four months after appendectomy. The appendiceal tumor showed transmural infiltration of carcinoembryonic antigen-positive goblet cell-type tumor cells, intermingled with a small number of argyrophilic cells immunoreactive for serotonin and chromogranin A. The presence of neurosecretory-type granules was confirmed ultrastructurally in some mucin negative tumor cells. The pattern of proliferation was typical of carcinoid tumor originating from the lowermost part of the mucosa, and showed lymphatic permeation. The metastatic lesions in the pelvic organs showed either diffuse infiltration of goblet cell-type tumor cells or mucinous cystadenocarcinoma like features, the latter being evident in the right ovary. No neuroendocrine component was identified in the metastatic deposits. The kinship of appendiceal goblet cell carcinoid to adenocarcinoma is discussed. Acta Pathol Jpn 41: 455–460,1991.     

Gross anatomic evidence of partitioning in the human fibularis longus and brevis muscles

Evidence from a variety of studies suggests that many mammalian muscles are partitioned with respect to their architecture and innervation. Each of these specific muscle subvolumes is innervated by an individual muscle nerve branch, contains motor unit territories with a unique array of physiological attributes and has been known as a neuromuscular compartment or segment. This gross anatomic study investigated for evidence of neuromuscular segmentation in human fibularis (peroneus) longus and brevis muscles. Forty-three legs (24 left, 19 right) from embalmed adult cadavers were dissected. Any architectural segments within these muscles were identified. The specific innervation patterns of these muscles were also described. The fibularis longus muscle was consistently found to have connective tissue partitions that separated it into four parts: anterior superficial, anterior deep, posterior superficial, and posterior deep. The innervation pattern of this muscle was consistent with the segments defined by the connective tissue partitions. There were consistently four primary motor branches, each supplying a specific portion of the fibularis longus muscle. While a typical branching pattern was recognized, there was some variability as to the order of these branches as they originated. The fibularis brevis muscle was consistently found to have a central connective tissue partition that separated it into two portions: anterior and posterior. In 91% of the fibularis brevis muscles, there were two primary motor branches, one for each of the two segments of the muscle. In the other 9%, only one primary motor branch supplying the muscle could be identified. © 1996 Wiley-Liss, Inc.     

Endometriosis of the Appendix

Endometriosis is a well known cause of infertility. Endometriosis of the appendix is a very rare condition. To highlight this rare entity, we are reporting a case of a young lady who was admitted with recurrent attacks of lower abdominal pain associated with primary infertility. Preoperative diagnosis was acute appendicitis. Histopathological examination of the appendix revealed endometriosis. Endometriosis should be considered in the differential diagnosis of recurrent lower abdominal pain in young females especially with history of infertility.     

Gross anatomical study of the human palatopharyngeus muscle throughout its entire course from origin to insertion

The palatopharyngeus (PP) extends throughout the entire length of the pharynx and probably plays an important role in deglutition, but its spatial distribution remains undefined in some respects. This study was designed to clarify the exact distribution of the PP indispensable for understanding its functions. Using 50 cadavers, the PP and its neighboring muscles were bilaterally exposed in both surfaces of the pharynx. The PP was composed of two divisions: longitudinal and transverse. It is already known that the longitudinal PP is divided into two fasciculi sandwiching the levator veli palatini (LVP) immediately after originating from the palatine aponeurosis. However, we newly discovered a fasciculus originating from the uvula, and further regarded the salpingopharyngeus as another fasciculus of origin. The four fasciculi united to descend through the palatopharyngeal arch and inserted into the thyroid cartilage and beneath the mucosa of the hypopharynx. The transverse PP occupied a location transitional between the PP and superior constrictor (SC), where it originated from the palatine aponeurosis and passed dorsally to encircle the pharyngeal isthmus and reach the pharyngeal raphe. Although whether it belongs to the PP or SC has remained controversial, we regarded it as a portion of the PP from the evolutionary perspective and proposed anatomical criteria for differentiating it from the SC. The wide distribution of the PP suggests that it acts not only to elevate the pharynx or depress the soft palate, but also as a nasopharyngeal sphincter when closing the pharyngeal isthmus.     

成人及儿童阑尾的应用解剖学研究

本文解剖60具尸体标本，对阑尾的位置、形态、长度和外径及其系膜作观察测量，并对此作了统计学分析，供临床阑尾炎诊治和尿道修补术应用参考。     

Gross anatomy dissections and self-directed learning in medicine

The Medical School of the University of Castilla-La Mancha (UCLM, Albacete Spain) was launched in 1998 and is the most recent one in Spain. Teaching is based on small groups of students (20-25 students/group). An objective-oriented self-learning approach provides maximal autonomy and independence in the achievement of objectives by the students in close association with academic staff. Gross Anatomy courses take place in the first and second years. The one in the first year is a single 10-credit course, where one credit equals 10 hr of teaching activity. In the second year, Anatomy and Embryology are integrated with Physiology and Histology, and comprise 70 credits altogether. In addition, all students carry out two mandatory gross anatomical dissections per year, in groups of three students, to allow direct handling of human anatomical material. Students are provided with handouts containing general instructions on how to perform the dissection and the structures (items) that they must expose in a given period of time (4 hr). Afterward, a Faculty member checks the number of items demonstrated and the quality of the dissection. Each group submits a written report that contributes to the final score. We evaluated the number of items shown in each of two consecutive dissections for first and second year medical students. The data obtained indicate that students engaged in self-directed learning through small groups working with Faculty staff are able to self-improve their anatomical skills.     

Negative correlation between age of subjects and length of the appendix in Bangladeshi males

Introduction

The anatomy of the vermiform appendix shows variations in its macroscopic dimensions some of which have potential to influence the clinical aspects of the appendix. Anatomical studies on the appendix using people in Bangladesh as a sample are limited and fall short of producing any standardized anthropometric data. This study is predominantly a cross-sectional observational study which also uses some statistical analysis to understand the relationships amongst variables.

Material and methods

Fifty-six adult male postmortem appendices and adnexa were examined for macroscopic features. Possible interrelationships among the variables were assessed through statistical analysis. The age of the samples ranged from 18 to 67 years. The most common position of the appendix was retrocolic (53.57%) followed by pelvic (30.35%), postileal (12.5%), and subcaecal (3.5%).

Results

In most cases (62.5%) the mesoappendix did not reach the tip of the appendix. The appendicular length varied from 6.00 cm to 16.30 cm with mean (± SD) and median value of 10.21 ±2.50 cm and 10.00 cm respectively. The base of the appendix was 1.90 to 3.80 cm away from the ileocaecal junction. The other macroscopic measurements of the appendix were taken at the base, at the midzone and at the tip of the appendix and the mean of the three measurements was considered as the overall value. Thus, the overall external diameter varied between 0.32 cm and 0.83 cm. Assessment of possible correlations amongst different variables revealed a significant negative correlation between the age of the subjects and the length of the appendix.

Conclusions

The data of the present study may provide a baseline along with some previous data in the standardization of the anthropometric information regarding the vermiform appendix of Bangladeshi males.