Il Museo anatomico “Luigi Rolando”

L’Istituto anatomico di Sassari, ora sezione di Anatomia e Istologia del Dipartimento di Scienze Biomediche della Facoltà di Medicina, come altre sedi universitarie italiane (Bologna, Cagliari, Ferrara, Firenze, Modena, Napoli, Parma, Pavia, Roma, ecc.) è dotato di un Museo anatomico, nato in primo luogo per provvedere alle esigenze didattiche dell’insegnamento dell’Anatomia umana. In questi ultimi anni l’interesse suscitato dai musei anatomici è andato via via crescendo, tanto è vero che nell’assemblea generale dei soci della Società Italiana di Anatomia, svoltasi a Torino nell’autunno del 1997, veniva affidata ufficialmente al prof. Vincenzo Mezzogiorno, direttore dell’Istituto di Anatomia umana della seconda Università di Napoli, quale massimo esperto in materia, l’incarico ufficiale di provvedere al censimento ed alla realizzazione di una guida ai musei anatomici italiani. A Sassari, nonostante l’insegnamento universitario dell’anatomia risalga a quasi quattro secoli fa, la costituzione ufficiale di un Museo anatomico, intitolato all'illustre Prof. Luigi Rolando, è relativamente recente (fine degli anni Ottanta); questo perché, facendo parte dell’Istituto anatomico, ne ha seguito, rimanendone condizionato, le vicende storiche e i diversi cambiamenti di sede

Apoptosis in spermatozoa of infertile men, clinical correlations

The methods for evaluation of male infertility include not only routine investigations, standardized by the WHO, but also complementary techniques, developed over the last years, in order to improve the predictive value of seminal analysis for natural conception and assisted reproduction. With reference to these new methods, studies suggest that sperm with certain levels of DNA fragmentation serve as a strong predictor of reduced male fertility. We studied subjects who underwent seminal fluid evaluation, because of an infertility condition, at the Department of Biomedical Sciences of the University of Sassari.The samples collected by masturbation were evaluated according to the World Health Organisation (1999).The samples was washed twice in PBS and cytocentrifuged for 10 min at 1800 rpm on polylysine-coated slides that were fixed in methanol at room temperature. The apoptosis was evaluated using the TUNEL (In Situ Cell Death Detection Kit, Fluorescein, Roche, Cat.No. 1 684 795). At fluorescent miscroscopy are counted at least 300 cells. Quantitative evaluation of apoptosis by the TUNEL method confirmed that apoptosis did not seem to be correlated with sperm concentration or morphology; however, we found a higher apoptotic rate in semen from patients affected by andrologic diseases, such as varicocele, than from those with alteration of semen characteristics. Apoptosis analysis might be used in infertile patients in order to understand the etiology of unexplained infertility and to improve therapeutic effectiveness

LPS-stimulated human macrophages displayed sex differences in estrogen receptors α and β

Macrophages play a key role in immunity, inflammation, and atherosclerosis. Moreover, several evidences demonstrate that 17-β-estradiol (E2) plays a key role in inflammation and atherosclerosis through estrogen receptors (ERs) ERα and ERβ, processes that display sex differences. It has been largely demonstrated that male tissues express active ERs, but there is still lack of knowledge on their role in inflammation in males. Macrophages, which have ERα and ERβ, are a good model to evaluate the role of ER levels and activation in inflammation. The aim of our work was to evaluate the ability of lipopolysaccharide (LPS) to modulate, in a sex-specific way, the expression and the activation status of ERα and ERβ in blood monocytes-derived macrophages (MDMs) from healthy men and women. MDMs were isolated from blood of 7 adult men and 7 adult and fertile women (aged 21 - 35 years), and cultured. After 10 days of culture, MDMs were incubated with 100 ng / ml LPS for 24 h and lysed for the analysis of ERα, ERβ, P- ERα, p38 and P-p38 expression by Western Blotting. We found that in basal conditions, the expression of ERα and ERβ was significantly higher in female MDMs than in male ones. Importantly, LPS stimulation up-regulated ERα and ERα phosphorylation in both sexes, but this regulation was more pronounced in male MDMs. Moreover, LPS down-regulated ERβ level only in female MDMs. The expression of p38 and P-p38 proteins, used as marker of ERβ activity, did not display any sex differences. Finally, the ratios between ERα / ERβ and P-ERα / ERα were significantly higher in male than in female MDMs. Our findings show, for the first time, that LPS can modulate the activation of ERα but not that of ERβ, identifying a critical role of the subtype ERα in inflammatory responses mediated by LPS, at least in human MDMs. These results represent a starting point in understanding the influence of sex in the relationship between LPS and ERα

Molecular technology and the recombinant TSH have changed diagnostics of thyroid carcinoma with positive I-131 whole body scan but low serum thyroglobulin.

The early detection of recurrent differentiated thyroid carcinoma (DTC) cells in the post surgery DTC patients relies on the sensitivity of measuring both the level of thyroglobulin (Tg) and 131-Iodine distribution by Whole Body Scan (WBS). Undetectable level of Tg associated with negative WBS or elevated levels of Tg associated with positive WBS ("concordant") is ordinarily indicative of either absence or presence of disease. At times, elevated level of Tg with negative WBS or low levels of Tg with positive WBS ("discordant") could also occur. In the present study, we retrospectively reviewed series of 573 patients with DTC followed in the Diagnostic Imaging and Radiotherapy of the University "Federico II" of Naples between 1993 and 1997. We focused on 9 out of 573 patients (1.56%) who had a discordant pattern with low level of Tg/positive WBS in the post-surgical follow-up. Four patients were metastatic at presentation while 5 patients with metastasis during follow-up still remained in persistently low levels of Tg (<5 ng/mL). This result does point to some flaw in the evaluation of "discordant" cases. Reviewing data previously described series by resetting cut-off values of Tg <1 ng/ml as undetectable changed the apparent "discordant" subgroup of patients into "concordant". Recent introduction of recombinant human TSH (rhTSH) to enhance the expression level of Tg brought significant increase in the sensitivity of diagnostic evaluation of thyroid cancer patients. The role of burdensome WBS in the follow up evaluation of DTC patients is significantly reduced over time especially in low-risk patients while the relevance of Tg assay is steadily increased. Sensitive Tg assays, significantly improved our ability to assess disease status in follow-up of DTC. Given the possibility of late disease relapses, the need for long-term follow-up, and reduced delay in treatment of persistent disease, there is still need for greater sensitive diagnostic tools for DTC

Educational methods in neuroanatomy: a review

Among the basic sciences providing relevant medical awareness, human anatomy, which includes gross and neuroanatomy, represents a crucial science in medical schools (Verhoeven et al., 2002). Although numerous changes have been performed in medical curricula worldwide, the anatomic background is deemed a cornerstone for approaching clinical medicine (McLachlan and Patten, 2006). In the last decades, several modifications in anatomy and, in particular, in neuroanatomy education have been done and numerous strategies have been identified to improve the skills of the students (Rizzolo et al, 2010). We carried out a non-systematic review focusing our interest on the transformation of traditional teaching methodology of neuroanatomy. Articles on neuroanatomy education were selected if the study described an approach for teaching/learning neuroanatomy and if the neuroanatomy course was aimed to all medical students but dental or healthcare students. PubMed database was used to select manuscripts with a predefined combined list of search terms: “neuroanatomy”, “anatomy”, “teaching”, “learning”, “methods and strategies”. Our search included only English language manuscripts published from December 1990 to January 2012. Abstracts and unpublished studies were excluded. References of all relevant retrieved articles, of relevant recent review articles, and abstracts published in proceedings were also evaluated manually in order to find additional articles. For data extraction an electronic form was prepared. Only eighteen of the fifty (36%) selected articles met the inclusion criteria. Two described the dissection as the primary educational method, whereas the majority used electronic tools providing three-dimensional information. Some authors highlighted that students could be more enthusiastic when they have the chance to study with cadavers deeming this approach near to clinical medicine (Zurada et al, 2011); however the comprehension of topography and spatial relationships of various structures is equally achieved with the use of electronic means. The post-mortem examination represents an opportunity to evaluate the variability of human anatomy; however, logistical, ethical, and safety issues hamper the implementation of this method in medical schools (Winkelmann, 2007). The method used for anatomy and neuroanatomy teaching is essential to augment the interest of the medical students towards medicine but several obstacles can hinder the implementation and scale-up of the best educational method

Gender differences in estrogenic compounds effect on human EPCs

Endothelial dysfunction has been defined as an “integrated risk factor”, and several gender difference have been reported in endothelial function. Several evidences suggest that endothelial progenitor cells (EPCs) are an important endogenous system that maintains integrity and vascular homeostasis. Their function is regulated by estrogens and estrogen receptors (ERs), but the effect of estrogenic compounds such as bisphenol A (BPA) and (R,R)-5,11-diethyl-5,6,11,12-tetrahydro-2,8-chrysenediol (THC) on human EPCs is unknown. BPA is used in plastic industry and BPA exposure is associated to abnormalities such as obesity, diabetes, disorders of the reproductive and immune systems, to endothelial dysfunction, and oxidative stress. This endocrine disruptor binds to ERα and ERβ with higher affinity for ERβ. THC is a specific agonist of ERα with a stronger ERβ antagonist activity. Therefore, the present work aimed to analyze if BPA and THC influence in a sex-specific manner the migration of human EPCs, an essential process in endothelial regeneration after vascular injury. EPCs were isolated from healthy adult men and women aged between 18 and 30 years, using a magnetic positive selection with the CD34 MicroBeads, a well-established marker of human progenitor cells. EPCs were also characterized for acetylated LDL Dil- (acLDL) and isothiocyanate (FITC)-conjugated with Ulex europaeus agglutinin I (lectin) uptake. The expression of ERα and ERβ was analysed by Western Blotting, while the migration assay was performed with the transwell chemotaxis assay. Male and female EPCs expressed both classical ERs: ERα was higher, but not significantly, in female cells, while ERβ was similarly expressed in both sexes. Male and female EPCs did not differ in basal migration. 17-β-estradiol (10-9 M e 10-10 M) significantly inhibited migration in female EPCs but not in male ones. Moreover, both 10-5 M THC and BPA (10-8 M) were able to bock migration only in female cells. Considering that BPA has a ERα and a prevalent ERβ agonist activity while THC has ERα agonistic activity and a prevalent ERβ antagonist activity, our data show that the effect on migration observed in female EPCs is mediated by ERα. Our data demonstrate that estrogenic compound have a sexual divergent effect on human EPCs, improving our knowledge on the gender differences observed in the pathophysiology of endothelial function

About the absence of musculocutaneous nerve

Introduction: Musculocutaneous nerve (C5-7) derives (90,5%) from the lateral cord of brachial plexus at the level of lateral border of pectoralis minor [1]. MC nerve pierces the coracobrachialis muscle and descends between the biceps brachii and brachialis to the lateral side of the elbow and terminates as the lateral cutaneous nerve of forearm. It supplies the biceps brachi, the coracobrachialis and the brachialis. Its terminal branch is purely sensory. Variations in the MC nerve course, distribution and termination have been reported and variably classified [2]. The most frequent variations are the presence of communicating branches with the median nerve [3] and the nerve not perforating the coracobrachialis muscle [4]. Total absence of MC nerve is less frequent (1.4 to 15%) [5]. Materials and Methods: 25 upper limbs from 13 cadavers were dissected. A skin incision was performed on deltopectoral groove and arm midline. Two fasciocutaneous flaps were raised, exposing brachial plexus and MC nerve. Results: In two specimens MC was not demonstrable. In these cases, the nerve branches to the coracobrachialis muscle and the lateral cutaneous forearm nerve originated directly from the median nerve. Conclusion: during embryogenesis MC nerve is derived relatively late, thus its absence may correspond to an incomplete differentiation of the brachial plexus. We believe this anatomical variation noteworthy because clinical procedures as plexus block or Latarjet’s procedure may be affected from MCN anomalies

Human The Distal Perforators Of Posterior Tibial Artery. A Study For The Correct Planning Of Medial Lower Leg Flaps

 The adipofascial flap, introduced by Lin in 1994 (1), has many advantages compared to fasciocutaneous or free flaps for lower limb reconstruction. Its dissection is relatively easy and fast with low donor site morbidity and it doesn’t alter the shape of the leg. The aim of this dissection study is to evaluate the anatomic localization of the most distal perforator of the posterior tibial vessels to provide an anatomical rationale for the safe harvesting of distally based medial adipofascial flaps of the leg. Thirty lower limbs from 15 cadavers were used for this study. In all the limbs, the femoral artery was cannulated. Different techniques of injection were employed. 26 specimens were injected with latex to fill the entire vascular network and ease dissection. 3 specimens were injected with a mixture of barium sulphate and gelatin and underwent a CT scan. CT scan dataset were used to make 3D reconstruction. They underwent anatomical dissection after the scan. 1 Specimen was injected with red epoxy resin mixed with barium sulphate (2). This technique is aimed to perform comparative anatomical vascular studies between CT three-dimensional reconstructions and traditional dissection techniques. A distal perforator was found in all specimens; the mean caliber was 0.77 mm. In all cases, the perforator artery passed in the septum between flexor hallucis longus m. and flexor digitorum longus m. and was accompanied by two veins. In our series, the distance between the lowest perforator and the medial malleolus ranged from 3.5 to 8.2 cm. The median was 6.75 cm, the 5th percentile 4 cm and the 95th percentile 8.1 cm. The mean distance of the perforator from the medial tibial border was 1.23 cm. The mean ratio between the distance of perforator from the medial malleolus and the total leg length was 21%. Compared to all previous researches (3), our study has found more distal perforators from posterior tibial perforator artery. This fact may have important clinical consequences because the anteromedial adipofascial flap would cover more distal soft tissue defects. Moreover, our data suggest some safety parameters to make the rising of a medial adipofascial leg flap safer in surgical practice