Anatomical variations: the true face of human anatomy

La studio dell’Anatomia umana presenta una varietà di sfaccettature, che sono alla base della reale comprensione del corpo umano; ovvero la vera anatomia non è quella rappresentata nei testi ma quella che appare durante la dissezione o nelle più sofisticate analisi di immagine. Lo scopo di questa tesi è stato quello di rivisitare alcune situazioni vascolari che possono andare incontro a variazioni e cercare di comprendere, anche con l’aiuto della bibliografia, se tali variazioni possono essere causa o epifenomeni di patologie a carico delle arterie affette dalle variazioni stesse o di territori da esse dipendenti per l’afflusso sanguigno. E’ stata condotta una analisi su preparati cadaverici in particolare in tre distretti: a) addome e tripode celiaco/mesenterica superiore; b) circolo cerebrale; d) orco aortico.The study Human Anatomy presents a variety of facets, which are the basis of the real understanding of the human body; i.e. the real anatomy that is not represented in the texts but one that appears during dissection or in the more sophisticated image analysis. The purpose of this thesis was to revisit some situations that are likely to experience vascular changes and try to understand, also with the help of the bibliography, if these changes can be cause or epiphenomena of pathologies of the arteries affected by the variations or of territories that they supply. It has been carried out an analysis on cadavers and namely in three districts: a) abdomen and celiac trunk/ superior mesenteric artery; b) cerebral circulation; d) aortic arch

Three-Dimensional Virtual Anatomy as a New Approach for Medical Student’s Learning

none8noMost medical and health science schools adopt innovative tools to implement the teaching of anatomy to their undergraduate students. The increase in technological resources for educational purposes allows the use of virtual systems in the field of medicine, which can be considered decisive for improving anatomical knowledge, a requisite for safe and competent medical practice. Among these virtual tools, the Anatomage Table 7.0 represents, to date, a pivotal anatomical device for student education and training medical professionals. This review focuses attention on the potential of the Anatomage Table in the anatomical learning process and clinical practice by discussing these topics based on recent publication findings and describing their trends during the COVID-19 pandemic period. The reports documented a great interest in and a positive impact of the use of this technological table by medical students for teaching gross anatomy. Anatomage allows to describe, with accuracy and at high resolution, organ structure, vascularization, and innervation, as well as enables to familiarize with radiological images of real patients by improving knowledge in the radiological and surgical fields. Furthermore, its use can be considered strategic in a pandemic period, since it ensures, through an online platform, the continuation of anatomical and surgical training on dissecting cadavers.openBartoletti-Stella, Anna; Gatta, Valentina; Mariani, Giulia Adalgisa; Gobbi, Pietro; Falconi, Mirella; Manzoli, Lucia; Faenza, Irene; Salucci, SaraBartoletti-Stella, Anna; Gatta, Valentina; Mariani, Giulia Adalgisa; Gobbi, Pietro; Falconi, Mirella; Manzoli, Lucia; Faenza, Irene; Salucci, Sar

Changes in the gene expression of co-cultured human fibroblast cells and osteosarcoma cells: the role of microenvironment

The progression of malignant tumors does not depend exclusively on the autonomous properties of cancer cells; it is also influenced by tumor stroma reactivity and is under strict microenvironmental control. By themselves, stromal cells are not malignant, and they maintain normal tissue structure and function. However, through intercellular interactions or by paracrine secretions from cancer cells, normal stromal cells acquire abnormal phenotypes that sustain cancer cell growth and tumor progression. In their dysfunctional state, fibroblast and immune cells produce chemokines and growth factors that stimulate cancer cell growth and invasion. In our previous work (1), we established an in vitro model based on a monolayer co-culture system of healthy human fibroblasts (HFs) and human osteosarcoma cells (the MG-63 cell line) that simulates the microenvironment of tumor cells and healthy cells. The coexistence between MG-63 cells and HFs allowed us to identify the YKL-40 protein as the main marker for verifying the influence of tumor cells grown in contact with healthy cells. In this study, we evaluated the interactions of HFs and MG-63 cells in a transwell co-culture system over 24 h, 48 h, 72 h, and 96 h. We analyzed the contributions of these populations to the tumor microenvironment during cancer progression, as measured by multiple markers. We examined the effect of siRNA knockdown of YKL- 40 by tracking the subsequent changes in gene expression within the co-culture. We validated the expression of several genes, focusing on those involved in cancer cell invasion, inflammatory responses, and angiogenesis: TNF alpha, IL-6, MMP-1, MMP- 9, and VEGF. We compared the results to those from a transwell co-culture without the YKL-40 knockdown. In a pro-inflammatory environment promoted by TNF alpha and IL-6, siRNA knock- down of YKL-40 caused a down-regulation of VEGF and MMP-1 expression in HFs. These results suggest that the tumor microenvironment has an influence on the protein expression of healthy surrounding tissues and on the process of tumorigenicity. The mechanisms of the microenvironment are emerging as attractive targets for therapeutic strategies

PEERS’ ANATOMY: teaching among students as an original approach to learning anatomy – a project made in Alma Mater

Anatomy is an ancient discipline which benefited greatly from technological improvements. Those very same technologies, along with a shift towards more clinically relevant topics, might be endangering anatomy’s central role as a cornerstone of medical education. A review of local realities showed anatomy to be quite uniformly taught by means of lectures alone. On the basis of our own experience, and comforted by references in literature (Day et al. [1]), we propose a revaluation of the teaching approach to anatomy, which includes an integration between different available resources and, above all, introduces peer-to-peer activity. Over the course of the last decade, based on a proposal from the Anatomy Department, more and more medical students took part to gross anatomy workshops abroad, thus consolidating what today is a large group of tutors. Working in parallel with the lectures, back home these students organize activities where notions are not a mere tool to pass the exam, but are aimed at giving younger students solid foundations on which to build their future competence. On the grounds of the experiences acquired in these years, we managed to divide the tutoring activities into six areas: surface and topographic anatomy, muscles and skeleton, heart and thorax, neuroanatomy, abdomen and pelvis, didactic coordination. Each group is based on the equal division of tasks and on respecting each tutor’s expertise, attitudes and skills. These workshops have proved to be highly effective both for students, as a chance to experience anatomy “hands-on”, and for tutors, as an opportunity of mastering the subject. Being appointed a tutor outlines a shift from a deductive learning method, typical of the pre-exam phase, to an inductive one, more useful in the future as medicine doctors. To sum up, the availability of adequate facilities for cadaveric dissection certainly enhances the teaching of anatomy; what our experience shows, however, is that only direct involvement of students as tutors brings out the full potential of these activities. We therefore propose abandoning a pure “learning-to-do” approach, in favour of a more effective “learning-by- doing” strategy

Protein kinase B/AKT isoform 2 drives migration of human mesenchymal stem cells.

This study was designed to investigate the migratory behavior of adult human mesenchymal stem cells (MSC) and the underlying mechanism. Cell migration was assessed by transwell, wound healing and time-lapse in vivo motility assays. Pharmacological inhibitors were used to determine the potential mechanism responsible for cell migration and invasion. The tests that were implemented revealed that MSC were fairly migratory. Protein kinase B (AKT) was strongly activated at the basal level. Through our analyses we demonstrated that pharmacological inactivation of AKT2 but not AKT1 significantly decreased cell migration and invasion. Although preliminary, collectively our results indicate that AKT2 activation plays a critical role in enabling MSC migration

The study of human anatomy represents the first fundamental step of an academic and clinical career: lesson learned from an experimental training program in Italy

The study of human anatomy represents the starting point of the medical background. A good scholar of human anatomy summarises the theory and the practice on cadavers, in that the absence of one of the two impinges on a comprehensive knowl- edge of the human body, i.e. the road map for every physicians. We herby report the experience at the Department of Biomedical Sciences, Chair of Human Anatomy of the Alma Mater Studiorum University of Bologna, where exchanging programs with several International Academic Institutions worldwide have been established over the last dec- ade with the aim of providing a comprehensive knowledge in human anatomy, through both frontal lessons and dissection activities on cadavers. Students participating to these trainings were afterwards enrolled as “tutors” in the teaching laboratories for stu- dents of the 1st and 2nd year of the Medical School, sharing their knowledge with younger students and improving their teaching skills as well. These tutorial activities have been carried out even after the achievement of the Medical Degree, allowing an efficient interaction between the clinical knowledge of the young medical doctors and the teaching purposes of the anatomy courses. Finally, the International environment of the exchange programs represented the basis for further research and clinical ex- periences carried out by the tutors themselves, dramatically influencing the first steps of their careers. But the main issue of this presentation is the fact that in Italy and namely at the Department of Biomedical Sciences, Chair of Human Anatomy of Bolo- gna University, the gross anatomy in dissecting room is no longer a dream, but a solid reality that offers the possibility to undergraduate, postgraduate students, residents and specialists to renew constantly the knowledge of human anatomy, just carrying out dissections on cadavers

Identification of nuclear substrates of Akt/PKB by functional proteomics: prohibitin 2 is a target of Akt phosphorylation in human promyelocytic leukemia cells

The serine/threonine protein kinase Akt is a major signal transducer of the phosphoinositide 3-kinase (PI 3-K) pathway in all cells and tissues and plays a pivotal role in the maintenance of cellular processes including cell growth, proliferation, survival, metabolism and development of many malignancies including acute myeloid leukemia. The frequent aberrant activation of the PI 3-K/Akt pathway in human cancer has made it an attractive therapeutic target. Therefore, the study of effector proteins downstream of Akt could clarify the role of Akt in the development of myeloid leukemia. Although both localization and activity of Akt in the nuclear compartment are well documented, most Akt substrates identified so far are located in the cytoplasm, while nuclear substrates have remained elusive. In this study, we applied a proteomic approach to identify novel Akt substrates by using an antibody that recognized a consensus motif phosphorylated by Akt (K/RXK/RXXS/T) when phosphorylated on S/T (anti-phospho-Akt substrate antibody). NB4 cells were treated with ATRA, and the putative Akt substrate proteins were isolated by immunoprecipitation with the anti-phospho-Akt substrate antibody. The proteins were separated on SDS-PAGE and analyzed by ESI-Q-TOF mass spectrometry. This analysis indicated prohibitin 2, a potential tumor suppressor protein with potent transcriptional functions in the nucleus, as a putative substrate of Akt in the nucleus of NB4 cells. The putative Akt-Prohibitin 2 interaction was validated by reverse in vivo immunoprecipitation from nuclear protein of NB4 cells. In vitro phosphorylation of endogenous prohibitin 2 by recombinant Akt further validated this result. Vandermoere F, El Yazidi-Belkoura I, Demont Y, Slomianny C, Antol J, Lemoine J, Hondermarck H. Proteomics exploration reveals that actin is a signaling target of the kinase Akt. Mol Cell Proteomics. 2007 Jan;6(1):114-24. Kasashima K, Ohta E, Kagawa Y, Endo H. Mitochondrial functions and estrogen receptor-dependent nuclear translocation of pleiotropic human prohibitin 2. J Biol Chem. 2006 Nov 24;281(47):36401-10

Hypo and retrotympanum: the importance of anatomical variants

The hypo- and retrotympanum host a variety of crucial anatomical structures1, characterized by high variability, which are poorly been described. The aim of our study is to describe and classify the anatomical variants of the hypo- and retrotympanum by the means of transcanal endoscopy2. We hypothesize that the retro- and hypotympanum are subject to more anatomical variability than actually thought. Moreover, the configuration as bridge variants and variably shaped sinus interconnects the different subregions. A total of 125 middle ears (83 cadaveric dissections) were explored by the means of 3mm straight and angled scopes. The variants were documented photographically and tabularized. The bony crests ponticulus, subiculum and finiculus1 were most frequently represented as ridges. The ponticulus showed the highest variability with 38% ridge, 35% bridge and 27% incomplete presentation. The subiculum was bridge - shaped only in 8% of the cases, while the finiculus in 17%. The sinus tympani had a normal shape in 66% of the cases. A subcochlear canaliculus was observed in 50%. The retro- and hypotympanum were classified respectively to the present bony crests and sinus in chambers type I to IV. In our opinion, the retro- and hypotympanum have to be considered as a tightly coherent region of the middle ear. For this purpose, we propose a straightforward classification, according to the presence of the different bony crests and sinus forming the different chambers of the retro- and hypotympanum. The introduced classification may also serve as intraoperative assessment, to be aware of the different anatomical subregions. The hidden areas of the retro- and hypotampanum are difficult to access and therefore represent a region of risk for residual cholesteatomatous disease after surgical treatment. The extension below a bridge bony crest or into a deep sinus demands thorough exploration; therefore, exact anatomical knowledge and an effective technique to visualize the whole middle ear are required

Varianti anatomiche

illustrator"Con il termine variante anatomica si definisce una particolare struttura anatomica la cui morfologia si discosta da quella osservata nella maggior parte degli individui. Diversamente dalle anomalie congenite, che per definizione sono considerate patologiche, le varianti rientrano in un quadro di normalità. È però evidente che conformazioni anatomiche peculiari possono interferire con le procedure diagnostiche e aumentare il rischio di complicanze durante gli interventi chirurgici. La conoscenza dell’anatomia umana e lo studio delle sue varianti rappresentano perciò un requisito indispensabile per ogni pratica medica, e l’attività settoria, che consente di individuare e documentare eventuali varianti rispetto alla normale anatomia umana, costituisce un supporto fondamentale alla medicina e alla chirurgia. Il volume propone un excursus storico sulla pratica settoria, una introduzione alle attuali tecniche di dissezione e lo studio di alcune significative varianti anatomiche. Giulia Adalgisa Mariani, laureata in Scienze Biologiche, ha conseguito il dottorato di ricerca in Scienze Biomediche sotto la guida del Professor Lucio Cocco presso l’Università di Bologna, ove attualmente lavora al Dipartimento di Scienze Biomediche e Neuromotorie, sezione di Anatomia Umana.

The variants of the retro- and hypotympanum: an endoscopic anatomical study

The retro- and hypotympanum are hidden areas of the middle ear, only poorly recognized. Nevertheless, this region is of relevant clinical significance, since it is regularly affected by disease such as cholesteatoma. The aim of this study is to explore and describe the anatomical variants of the hypo- and retrotympanum by the means of transcanal endoscopy. We hypothesize a significant variability of this hidden region of the middle ear. Moreover, we believe that the minimal invasive, endoscopic access is suitable since angled scopes may be used to explore the region. To this end a total of 125 middle ears (83 cadaveric dissections, 42 surgical cases) were explored by the means of 3 mm straight and angled scopes. The variants were documented photographically and tabularized. The bony crests ponticulus, subiculum and finiculus were most frequently represented as ridges. The ponticulus showed the highest variability with 38% ridge, 35% bridge and 27% incomplete presentation. The subiculum was bridge-shaped only in 8% of the cases, the finiculus in 17%. The sinus tympani had a normal configuration in 66%. A subcochlear canaliculus was detectable in 50%. The retro- and hypotympanum were classified, respectively, to the present bony crests and sinus in a novel classification type IâIV. In conclusion, we found abundant variability of the bony structures in the retro- and hypotympanum. The endoscopic access is suitable and offers thorough understanding and panoramic views of these hidden areas