Anatomical Study Research Articles

Nasal Tip Vascularization and Its Application for Columellar Reconstruction.

Many studies have been published about the vascular anatomy of the nose and its utility for nasal reconstruction. Anatomic variations of the main arteries and their perforators are well described in the literature. A nasal tip perforator, not well described in the published studies, is analyzed in the present study and its utility for columellar reconstruction. This paper presents an anatomic study of the nasal tip artery and its clinical applications for columellar repair. This study investigated the nasal tip perforator artery during nasal tip flap surgery for columellar repair in patients with sequels after nasal continuous positive airway pressure use. A descriptive anatomic study was conducted using intraoperative vascular dissection of patients operated on for nasal columellar defects by the author between 2013 and 2018. An observational study of a group of patients operated on for columellar repair using the axial nasal tip flap is presented here. The nasal tip artery was found in all the intraoperative dissections. Location and trajectory are described. Observed columellar length and width in operated patients have been nonstatistical and significantly different than controls in this study. The presence and trajectory of the nasal tip artery have been consistent in all the studied cases. The nasal tip flap based on this perforator has been a useful method for columellar repair in the studied group of patients. The presence of this vessel may augment blood supply to the nasal tip skin. By confirming the preservation of this artery, the surgeon may elevate the nasal tip flap safely.

Morphometric characteristics of the abdominal surface of the diaphragm for various benefits

The dependence of the regional morphometric characteristics of the abdominal surface of the diaphragm on body shape was evaluated because the information available in the specialized literature on this issue differs significantly. The study was conducted on 30 corpses aged 50–70 years, who were embalmed using a special technology (preserving tissue elasticity, giving the diaphragm a physiological shape with deep exhalation by pumping air into the abdominal cavity). The objects were then frozen, abdominal organs were sequentially removed, and linear dimensions and areas of subdiaphragmatic, subhepatic, and splenic depressions, physiological openings (inferior vena cava, aorta, esophagus, and ligamentous apparatus of the upper floor of the peritoneal cavity), area nuda, diaphragm legs, and lumbar–rib triangles were examined. The results of the analysis of the morphometric parameters revealed significant statistically significant differences in the linear dimensions and areas of the right and left subdiaphragmatic, subhepatic, splenic depressions, and individual parts of the diaphragm in individuals with different body shapes. For these anatomical formations of the peritoneum, the highest values of morphometric parameters are characteristic of the brachymorphic form of the physique, except for the sizes of the lumbar–costal triangles, medial legs, and height of the diaphragm domes, which have the maximum dimensions with a dolichomorphic form. Attention was drawn to the significant differences in the area nuda between extreme forms of physique, which reached 59%. Statistically significant differences were found in the morphometric parameters of the abdominal surface of the diaphragm in mesomorphic and extreme forms of physique; however, they are characterized by smaller values, ranging from 8% to 42% for various parameters. Of particular importance is knowledge of the size of the studied parts of the diaphragm covered by the peritoneum during cytoreductive interventions. Anatomical studies performed on specially embalmed objects with preservation of tissue elasticity and the physiological shape of the diaphragm allow us to obtain its reliable morphometric characteristics.

Corona mortis: clinical evaluation of prevalence, anatomy, and relevance in anterior approaches to the pelvis and acetabulum

PurposeTo evaluate the clinical prevalence, characteristics, and relevance of the corona mortis (CM) in anterior approaches to the pelvis and acetabulum.MethodsRetrospective analysis of 185 theater reports from patients (73 females; mean age 62.8 ± 17.2 years) who underwent surgeries for pelvic ring injuries, acetabular fractures, or combined injuries using anterior approaches (Modified Stoppa or Pararectus) at our institution between 01/2008 to 12/2022. During procedures, the CM was routinely identified, evaluated, and occluded. Bilateral exposure of the superior pubic branch in 25 cases led to 210 hemipelvises analyzed. Exclusions: CM not mentioned in report and revisions via the initial approach.ResultsIn the 210 hemipelvises examined, the prevalence of any CM vessel was 81% (170/210). Venous anastomoses were found in 76% of hemipelvises (159/210), arterial in 22% (47/210). Sole venous anastomoses appeared in 59% (123/210), sole arterial in 5% (11/210). Both types coexisted in 17% (36/210), while 19% (40/210) had none. A single incidental CM injury occurred without significant bleeding. In ten cases, trauma had preoperatively ruptured the CM, but bleeding was readily managed. Females had a significantly higher CM prevalence than males (p = 0.001).ConclusionOur findings show a CM prevalence aligning more with anatomical studies than prior intraoperative series. Although we observed one incidental and ten trauma-related CM injuries, we did not encounter uncontrollable bleeding. Our data suggest that in anterior pelvic approaches, when the CM is actively identified and occluded, it is not associated with bleeding events, despite its high prevalence.

Three-dimensional Analysis of the Muscles Related to the So-Called "Pterygomandibular Raphe": An Anatomical and Histological Study.

The pterygomandibular raphe (PMR) is a tendinous bundle between the bucinator (BM) and the superior constrictor of pharynx (SC) and has been considered essential for swallowing. Despite its functional significance, previous studies reported that the PMR is not always present. Another study reported presence of theconnecting fascia between the BM and deep temporalis tendon (dTT). Therefore, the present study analyzed the three-dimensional relationship between the BM, SC, and dTT. We examined 13 halves of 11 heads from adult Japanese and Caucasian cadavers: eight halves macroscopically and five halves histologically. There was no clear border between the BM and SC in any specimens macroscopically. The BM attachment varied depending on its levels. At the level of the superior part of the internal oblique line, the BM fused with the SC with no clear border. At the level of the midpart of the internal oblique line of the mandible, the BM attached to the dTT directly, and the SC attached to the dTT via collagen fibers and the BM. Based on these results, these muscles should be described as the BM/dTT/SC (BTS) complex. The three-dimensional relationship of the BTS complex might result in the so-called "pterygomandibular raphe." The BTS complex could be important as a muscle coordination center in chewing and swallowing.

The Anatomy of the Mandibular Incisive Canal and Its Influence in Implant Therapy. A Scoping Review.

The interforaminal region is considered more favorable for implant placement than the posterior mandible in edentulous patients, mainly because of the interference of the inferior alveolar nerve with implant placement in the severely resorbed posterior mandible. However, complications in the interforaminal region may occur due to the presence of the mandibular incisive nerve. This scoping review aims to describe the mandibular incisive nerve anatomy related to the potential interference in implant therapy. A comprehensive literature search was conducted in the following databases: MEDLINE (via PubMed), Web of Science, and Scopus. This scoping review was structured according to the Joanna Briggs Institute method. Thirteen studies were included in the review. All the studies were observational cohort anatomical studies, carried out mainly by CBCT and on cadavers. A total of 1471 patients/cadavers were studied. The mandibular incisive nerve was presented in 87-100% of the cases, with an average length of 9.97 mm and an average diameter of 1.97 mm. The mandibular incisive nerve may be damaged during drilling and implant placement, especially using implant lengths larger than 12 mm. Damage to the mandibular incisive nerve due to implant placement could be present, however, it is necessary to conduct more studies focusing on assessing mandibular incisive nerve damage to understand the clinical relevance of this nerve and its associated morbidities such as neurosensorial alterations. Due to the different anatomical characteristics of this nerve, CBCT analysis is recommended for implant therapy in the anterior mandible to prevent the described complications.

Morphological features and anatomical structure of the leaves of Dagestan endemic species of <i>Allium</i>

Aim. To conduct a comparative analysis and assessment of the taxon specificity of the morphological and anatomical features of the leaves of endemic species of the genus Allium in Dagestan. Material and Methods. The research materials were samples of endemic species of the genus Allium from the natural populations of mountainous Dagestan: A. daghestanicum; A. gunibicum; A. charadzeae; A. mirzojevii and A. samurense. For the analysis of morphometric features, 10 generative individuals were collected in the full flowering phase. Processing of the collected material was carried out at the Laboratory of Introduction and Genetic Resources of the Mountain Botanical Garden, Dagestan Federal Research Centre, Russian Academy of Sciences. Fixation of the material and preparation of temporary micropreparations were carried out according to the generally accepted methods of anatomical studies. Anatomical studies were carried out on leaves of medium formation from the middle part of the leaf. Morphometric parameters of tissues and cells were measured using a Levenhuk D870T optical microscope with an eyepiece micrometer. Micropreparations were photographed using a Lomo‐AT 054 optical microscope and a DCM 510 SCOP video eyepiece. Results. A grouping of species according to leaf size was carried out: large‐leaved (A. daghestanicum, A. gunibicum, A charadze section Dagestanica. Tscholok. Friesen) and small‐leaved (A. mirzojevii, A. samurense section Oreiprason F. Herm.), according to the shape of the leaf cross section: grooved with smooth edges (A. daghestanicum), grooved with ribbed edges (A. gunibicum and A charadze) and rounded ribbed (A. mirzojevii and A. samurense), according to the number and size of vascular bundles. Descriptions of the anatomical structure of the leaves and an assessment of the species specificity of the studied traits of five species of Allium were carried out. Conclusions. It was determined that some features of the morphology and anatomy of the leaves of five endemic species of the genus Allium are species‐specific or due to environmental conditions of growth in the arid conditions of Inner Mountain Dagestan.

The profunda artery perforators: Anatomical study and radiological findings using computed tomography angiography in patients undergoing PAP flap breast reconstruction

The popularity of the profunda femoris artery perforator (PAP) flap is increasing; however, knowledge concerning the standardization of radiological findings and their clinical implications is limited. We evaluated the radiological architecture of posterior thigh perforators using Computed Tomography Angiography (CTA) to identify landmarks to facilitate flap dissection. A retrospective study was conducted on 35 patients who underwent unilateral breast reconstruction with a PAP flap. The preoperative CTA scans were analyzed, and the perforator characteristics were evaluated. The perforators were mapped using a Cartesian coordinate system. Data were normalized by anatomical landmarks and overlapped. Perioperative and postoperative results were analyzed. Radiological and intraoperative were compared. Two CTA scans were excluded; 66 thighs were examined. The mean perforator number was 3.2. The mean diameter of chosen perforators was 2.7mm (DS±0.6mm) at the origin, 2.2mm (DS±0.4mm) at the adductor space midpoint, and 1.7mm (DS±0.3mm) at the deep fascia. The mean adipose tissue thickness was 3.35cm (DS±0.94) at the deep fascia and 3.59cm (DS±1.19) at the adductor space midpoint. Intraoperatively, the perforator was located 3.22cm (DS±0.87) from the posterior border of the gracilis muscle and 8.98cm (DS±1.44) from the inferior gluteal crease. A radiological area located 9.33cm (DS±4.81) from the y-axis and 7.48cm (DS±1.88) from the x-axis was identified. CTA using the volume-rendering technique is a valuable method to study in vivo the radiological anatomy of the posterior thigh perforators.

Distal insertion of the clavicular portion of pectoralis major muscle: anatomical study.

Several descriptions of the anatomy of the pectoralis major (PM) have been published. However, the precise description of its distal humeral insertion, which is involved in traumatic tears, remains controversial. The distal tendon is classically described as being made of two layers, one anterior (ALPM) and one posterior (PLPM), which regroup at their distal edge. The clavicular head (CH) participates in the ALPM according to most authors. However, others describe a more superficial termination in a close relationship with the deltoid humeral insertion. The objective of this anatomical work is to precisely describe the anatomy of the CH and its relationship with the rest of the distal PM tendon and the distal deltoid tendon. Twenty-three fresh cadaveric specimens were dissected (41 shoulders). The entire PM as well as the deltoid were exposed. Several measurements were collected to establish the relationships between the distal tendon of the CH and the PM, the deltoid and the bony landmarks. In all cases, the CH muscular portion sits on the ALPM but does not participate in the connective structure of the PM distal tendon. The inferolateral part of its distal end gives a thin tendinous portion that inserts lower on the humerus in conjunction with the distal tendon of the deltoid. In 24.4%, this tendon was more difficult to isolate but was always observed. The distal tendon of the PM only comes from the muscle fibres of its sternal head. The CH fibres do not contribute to this tendon but appear to terminate in a separate tendon fusing with the humeral insertion of the deltoid: the deltopectoral tendon. This could explain the different patterns of tears observed in clinical practice.

History of research concerning the ependyma: a view from inside the human brain.

The history of research concerning ependymal cells is reviewed. Cilia were identified along the surface of the cerebral ventricles c1835. Numerous anatomical and histopathological studies in the late 1800's showed irregularities in the ependymal surface that were thought to be indicative of specific pathologies such as syphilis; this was subsequently disproven. The evolution of thoughts about functions of cilia, the possible role of ependyma in the brain-cerebrospinal fluid barrier, and the relationship of ependyma to the subventricular zone germinal cells is discussed. How advances in light and electron microscopy and cell culture contributed to our understanding of the ependyma is described. Discoveries of the supraependymal serotoninergic axon network and supraependymal macrophages are recounted. Finally, the consequences of loss of ependymal cells from different regions of the central nervous system are considered.

Anatomi Tumbuhan Pakan Gajah Sumatra (Elephas maximus sumatranus Temminck) di Taman Nasional Way Kambas

Forage plants are one of the main aspects in the conservation management of the Sumatran elephant. Anatomical studies of elephant food plants can provide reference data needed in identifying the diversity of elephant food plants, especially in the studies with faecal samples. This study aims to provide anatomical data of Sumatran elephant feed plants. The observed samples consisted of leaf samples from 24 species and stem samples from four species. Samples were prepared for microscopic paradermal section using the wholemount method. The results showed that rectangular epidermal cell shapes were found in samples of Poaceae leaves, Cyperaceae leaves and stems, and Arecaceae leaves. Stomata with dumbbell-shaped guard cells were only found in Poaceae leaf samples and Cyperaceae leaf and stem samples. The presence of silica cells and cork cells distinguished the Poaceae samples from Cyperaceae. Other leaf samples had qualitative anatomical characteristics that varied based on anticlinal walls of epidermal cells, type of stomata, and trichomes. Quantitative characterization of epidermal cell size; stomatal size, density, and index; and trichome density are used to complete the species description and distinguish species that have the same qualitative characteristics.
 
 Keywords: epidermis, paradermal leaf section, stomata, trichome, wholemount method

Micro-morphological study of three members of genus <i>Plectranthus</i> L. (Lamiaceae) in Nigeria

Micro-morphological studies of three members of the Genus Plectranthus L. (Lamiaceae) in Nigeria were conducted to investigate the anatomical characteristics of taxonomic importance. The following plant samples were collected from various locations in Southwestern Nigeria, namely Plectranthus aegyptiacus (Forssk.) C. Chr., Plectranthus esculentus N.E.Br. and Plectranthus monostachyus (P. Beauv.) B. J. Pollard. The anatomical study of the lamina epidermis, venation pattern and petiole were performed. The Single Linkage Cluster Analysis (SLCA) and one-way Analysis of Variance (ANOVA) with the Duncan Multiple Range Test (DMRT) were used to analyze the parameters, and photomicrographs were employed to document the observations. Foliar epidermal characteristics such as epidermal cell shape, anticlinal wall pattern, stomata types, trichome types and ergastic substances are essential in delimiting the species. The identification of numerous starch grains delimits P. monostachyus from the other species, a straight anticlinal wall pattern delimits P. esculentus, and the presence of abundant crystal sands delimits P. aegyptiacus. Quantitatively, stomata index (S.I.) and trichome length for both adaxial and abaxial surfaces were significantly different (P≤0.05) among the species. The venation pattern of the studied plant samples also revealed specific characteristics. Irregular vein spacing, eucamptodromous secondary vein category and polygonal areole shape delimit P. esculentus from the other species.

Hepatocellular Carcinoma with Right Atrial Metastasis

Cardiac tumours may be primary or secondary-metastatic (malignant). Secondary cardiac tumours are much more common than primary cardiac tumours. Their frequency on large anatomical studies varies between 3.4% and 13.9%. Though cardiac metastases may originate from any malignant tumor, melanomas have the greatest propensity for cardiac involvement, and also carcinomas of the thorax, including breast, lung, and esophageal [12,13]. The routes of metastasis include direct invasion, hematogenous, lymphatic, or transvenous, especially through the inferior vena cava [9,10]. Cardiac involvement should be suspected or sought in any patient with a known malignancy who develops new cardiovascular signs or symptoms. Imaging methods - echocardiography, computed tomography (CT) and MRI, are essential in establishing the diagnosis and the invasion of the tumour in the cardiac cavity. The severe evolution of secondary cardiac tumors depends on the extension of the primary tumour, but also on the severity of the clinical cardiac manifestations. Generally, the treatment is surgical. A correct diagnosis is important in the clinical setting since cardiac metastases are able to induce sudden cardiac death1. Primary hepatocellular carcinoma (HCC) is the sixth cause of cancer in the world and the second cause of cancer mortality worldwide, with more than 830,000 deaths recorded annually2. We present a case of HCC growth into the vena cava inferior (VCI) and invasion into the right atrium (RA).

Intra-abdominal Content Movement in Prone Versus Lateral Decubitus Position Lateral Lumbar Interbody Fusion (LLIF).

A prospective, anatomical imaging study of healthy volunteer subjects in accurate surgical positions. To establish if there is a change in the position of the abdominal contents in the lateral decubitus (LD) versus prone position. Lateral transpsoas lumbar interbody fusion (LLIF) in the LD position has been validated anatomically and for procedural safety, specifically in relation to visceral risks. Recently, LLIF with the patient in the prone position has been suggested as an alternative to LLIF in the LD position. Subjects underwent magnetic resonance imaging of the lumbosacral region in the right LD position with the hips flexed and the prone position with the legs extended. Anatomical measurements were performed on axial magnetic resonance images at the L4-5 disc space. Thirty-four subjects were included. The distance from the skin to the lateral disc surface was 134.9mm in prone compared with 118.7mm in LD ( P <0.0001). The distance between the posterior aspect of the disc and the colon was 20.3mm in the prone compared with 41.1mm in LD ( P <0.0001). The colon migrated more posteriorly in relation to the anterior margin of the psoas in the prone compared with LD (21.7 vs . 5.5mm, respectively; P <0.0001). 100% of subjects had posterior migration of the colon in the prone compared with the LD position, as measured by the distance from the quadratum lumborum to the colon (44.4 vs . 20.5mm, respectively; P <0.001). There were profound changes in the position of visceral structures between the prone and LD patient positions in relation to the LLIF approach corridor. Compared with LD LLIF, the prone position results in a longer surgical corridor with a substantially smaller working window free of the colon, as evidenced by the significant and uniform posterior migration of the colon. Surgeons should be aware of the potential for increased visceral risks when performing LLIF in the prone position. Level II-prospective anatomical cohort study.

A cadaveric study and clinical application of the free superficial circumflex iliac artery perforator flap reconstruction of limb soft tissue defects

Introduction In recent decades the superficial circumflex iliac artery perforator (SCIP) flap technique has gradually overcome the previous disadvantages of its pedicle and donor site to be widely applied in treating tissue's defects. This article investigates the vascular anatomy of the SCIP flap and evaluates the result of using the flap to reconstruct limb defects. Materials and Methods The study was performed in two parts. Firstly a cross-sectional descriptive anatomical study comprising 49 groin dissections in 25 cadavers, with contrast radiographic demonstration of the vascular anatomy. Secondly a retrospective case series of 51 free SCIP flaps in 49 patients. Surgical outcomes were evaluated using the Vancouver Scar Scale on the regional function and the aesthetics of implanted flap and donor sites. Results The results of anatomical analysis on cadavers showed the superficial circumflex iliac arteries were detected in all specimens with an average diameter of 1.4 ± 0.3 mm. The superficial subcutaneous venous systems were also recorded, including two veins (superficial circumflex vein and superficial epigastric vein) in 79.5% with an average diameter of 2.3 ± 0.6 mm. The flap results showed the alive flap rate was 90.2%, partial-necrosis flap was 3.9% and total necrosis of the flap in 5.9%. In the aesthetic evaluation, fine line scars were seen in 13/51 cases (25.5%), stretch scars in 33/51 cases (64.7%) and hypertrophic scars in 5/51 patients (9.8%), with no cases of keloid scars. Conclusion The SCIP flap is a reliable free-tissue transfer for reconstructing limb soft tissue defects. Moreover, the SCIP flap is an ideal flap with pleasing aesthetics because the donor-site scar is situated in a well-hidden site. Care must be taken when vein grafts are used to lengthen the flap as flap necrosis rates increase.

Accessibility of osteochondral lesion at the capitellum during elbow arthroscopy: an anatomical study.

Osteochondrosis dissecans (OCD) at the capitellum is a common pathology in young patients. Although arthroscopic interventions are commonly used, there is a lack of information about the accessibility of the defects during elbow arthroscopy by using standard portals. An elbow arthroscopy using the standard portals was performed in seven fresh frozen specimens. At the capitellum, the most posterior and anterior cartilage surface reachable was marked with K-wires. Using a newly described measuring method, we constructed a circular sector around the rotational center of the capitellum. The intersection of K-wire "A" and "B" with the circular sector was marked, and the angles between the K-wires and the Rogers line, alpha angle for K-Wire "A" and beta angle for K-wire "B", and the corridor not accessible during arthroscopy was digitally measured. On average, we found an alpha angle of 53° and a beta angle of 104°. Leaving a sector of 51° which was not accessible via the standard portals during elbow arthroscopy. Non-accessible capitellar lesions during elbow arthroscopy should be considered preoperatively, and the informed consent discussion should always include the possibility of open procedures or the use of flexible instruments.

The Fulcrum of the Human Heart (Cardiac fulcrum)

Introduction: The functional anatomy of the myocardium allows envisioning that it initiates and ends at the origin of the great vessels. In our research, we have always considered that it should have a point of attachment to allow its helical rotation to fulfill the fundamental movements of shortening-torsion (systole) and lengthening-detorsion (suction), which once found, was called the cardiac fulcrum. Materials and methods: A total of 31 hearts, arising from the morgue and slaughterhouse were used: 17 corresponded to bovids and 14 were human. Anatomical and histological studies were performed. The heart was fixed in 10% buffered formalin. Hematoxylin-eosin, Masson’s trichrome staining technique, and 4-micron sections were used for the histological study, and 10 % formalin was used as a buffer. Results: The anatomical investigations have revealed that all the hearts (bovids and humans) have myocardial support whose histological structure in the analyzed specimens presents with an osseous or chondroid-tendinous character. In this structure, which we have called the cardiac fulcrum, are inserted the myocardial fibers at the origin and end of the band, which correspond to the continuous myocardium coiled as a helix. Conclusion: This description of the fulcrum would end the problem of lack of support of the myocardium to fulfill its function of suction/ejection.

Anatomic feasibility study of a sartorius myocutaneous flap with a distally based pedicle and proximal skin paddle

IntroductionWe conducted an anatomic feasibility study of a sartorius myocutaneous flap with a distally based pedicle and proximal skin paddle to cover soft tissue defects of the knee region. HypothesisA recent anatomic study by Mojalla showed that the sartorius muscle had 2 distinct pedicles, making it possible to isolate this muscle on its distal pedicle and harvest it with a skin paddle. Materials and methodsThis anatomic study was conducted on 10 lower limbs. The 2 criteria assessed were (1) the viability of our proximal skin paddle and (2) the arc of rotation and coverage obtained with this myocutaneous flap. ResultsWe identified 7 proximal skin paddles after the injection of India ink into the distal pedicle of the sartorius muscle. In all cases, the arc of rotation of the flap allowed coverage of the knee region. The mean distance between the inferior edge of the skin paddle and the proximal border of the patella (DBAP) was measured at 13cm, and the mean distance between the superior edge of the flap paddle and the anterior superior iliac spine (DASIS) at 16cm. The average skin paddle size was 14 by 7cm. DiscussionOur anatomic study demonstrated the feasibility of our sartorius flap with a distally based pedicle and proximal skin paddle. This technique may be a viable alternative when using gastrocnemius flaps is not feasible, or the surgeon lacks the microsurgical skills to perform free flaps. Level of evidenceIV; descriptive anatomic study.

Template-based target point localization for occlusion of the middle meningeal artery during evacuation of space-occupying chronic subdural hematoma.

Endovascular middle meningeal artery (MMA) occlusion may help reduce the risk of recurrence after burr hole evacuation of chronic subdural hematoma (cSDH) but carries an additional periprocedural risk and remains hampered by logistical and financial requirements. In this study, the authors aimed to describe a simple and fast technique for preoperative MMA localization to permit burr hole cSDH evacuation and MMA occlusion through the same burr hole. The authors performed a preclinical anatomical and prospective clinical study, followed by a retrospective feasibility analysis. An anatomical cadaver study with 33 adult human skulls (66 hemispheres) was used to localize a suitable frontal target point above the pterion, where the MMA can be accessed via burr hole trephination. Based on anatomical landmark measurements, the authors designed a template for projected localization of this target point onto the skin. Next, the validity of the template was tested using image guidance in 10 consecutive patients undergoing elective pterional craniotomy, and the feasibility of the target point localization for cSDH accessibility was determined based on hematoma localization in 237 patients who were treated for a space-occupying cSDH in the authors' department between 2014 and 2018. In the anatomical study, the mean perpendicular distance from the zygomatic process to the target point in the frontoparietal bone was 4.1 cm (95% CI 4-4.2 cm). The mean length along the upper margin of the zygomatic process from the middle of the external auditory canal to the point of the perpendicular distance was 2.3 cm (95% CI 2.2-2.4 cm). The template designed according to these measurements yielded high agreement between the template-based target point and the proximal MMA groove inside the frontoparietal bone (right 90.9%; left 93.6%). In the clinical validation, we noted a mean distance of 4 mm (95% CI 2.1-5.9 mm) from the template-based target point to the actual MMA localization. The feasibility analysis yielded that 95% of all cSDHs in this cohort would have been accessible by the new frontal burr hole localization. A template-based target point approach for MMA localization may serve as a simple, fast, reliable, and cost-effective technique for surgical evacuation of space-occupying cSDHs with MMA obliteration through the same burr hole in a single setting.

„Mortui vivos docent” – badania anatomiczne w starożytnej medycynie greckiej

„Mortui vivos docent” – anatomical studies in Ancient Greek medicine Systematic dissection of human corpses only began to be practised in modern times. In the ancient world, the dead body was burdened with impurity and had to be buried with dignity so that the relatives of the deceased would not be affected by the taint. For this reason, anatomical studies were mainly based on observation of the wounded on the battlefield or on autopsies of animal bodies. On this basis, conclusions were drawn about human anatomy and bodily functions. The exception was Alexandria during the Hellenistic period, which became the dominant scientific centre, especially during the reign of the first three Ptolemies. It was there that Herophilos and Erasistratos, physicians who, would dissect human cadavers, were active. Their writings have survived only in small fragments, but from later sources we learn of their significant achievements in anatomical research. Particularly relevant here is the testimony of the Latin encyclopaedist Celsus, who, while understanding the necessity of dissecting examinations, disapproved of the vivisections allegedly performed by Alexandrian scholars. In the Roman period, dissection of human cadavers was no longer practised, not only because of the impurity of the human body, but also because the new trend in medicine, empiricism, abandoned the search for the causes of disease, focusing mainly on the treatment of visible symptoms.

Anatomical Study and Determination of the Animal Bones and Teeth Samples of the Excavation of Qareh Tape Sagzabad (Qazvin Province, Iran) in 2018 (Iron Age II and III) and Making 3D Models

Background: Zooarchaeology shares close ties with Comparative Anatomy of Veterinary Medicine. This scientific discipline involves the study of the bones of various animals, using anatomical information to explore the place and role of these animal species in life and human survival, thereby enriching our knowledge about the interaction of humans and their ecosystems. Objectives: Using available anatomical information, this study investigated the typology of bone remains and animal teeth in the area of Qareh Tepe, Segzabad (Qazvin Province, Iran). Another goal was to detect the abnormal effects created by humans or animals in bones, such as cuts, burns, or chewing effects by carnivorous animals. By extracting this information, it is possible to analyze the livelihood economy of that historical site correctly. Methods: A total of 1110 bone and teeth samples excavated in 2017 were analyzed. The samples were transferred to the Osteology Lab of the Anatomy Department of the Faculty of Veterinary Medicine, University of Tehran, Tehran City, Iran. Anatomical studies were conducted in several stages based on the excavated samples. Results: Among the detected animal samples, the highest percentage (30.09%) was related to sheep samples, and then the samples of small ruminants (26.94%) (which could not be separated). The percentages of gazelle, Asian water buffalo, wild boar, and chicken were trivial and less than 1%. In this study, abnormal symptoms were detected in the phalanges of the Caspian horse. Conclusion: One of the remarkable points about the small ruminant samples separated at the species level in this study is that the number of sheep samples detected surpassed that of goats. It seems that the conditions for keeping sheep were more suitable. The number of Perissodactyla, especially horses, shows a significant increase compared to the Neolithic periods and the beginning of the complexity of Iron Age I technology. This finding indicates the use of horses and donkeys in agriculture and transportation activities.