Anatomy Laboratory Research Articles

Neurosurgery Residency Training and Beyond in Turkey: A National Survey Study.

Training neurosurgery specialists is a challenging and demanding process. This national survey study was conducted to evaluate the infrastructure of neurosurgery residency programs and training clinics in Turkey and to assess how these factors impact specialist practice. A national survey consisting of 32 questions was distributed to neurosurgeons who had been practicing as specialists for at least two years. The survey was divided into four sections: demographic information, residency training process, hospital where they currently work as specialists, and microsurgical experience. Statistical analyses, including chi-square and logistic regression, were conducted to examine factors influencing surgical performance in specialist practice. Regression analyses indicated that performing skin-to-skin surgeries during residency significantly and most effectively increased the likelihood of performing these procedures as a specialist. Additionally, working in anatomy laboratories, attending hands-on cadaver courses, and increased years of practice were all positively associated with surgical performance. It was also found that participants who graduated within the last five years were statistically significantly less likely to have attended hands-on courses or visited another clinic for observerships/fellowships compared to those who graduated more than five years ago. Findings suggest that neurosurgical training in Turkey is affected by disparities in clinical infrastructure and hands-on experience. Standardizing residency experiences and ensuring access to necessary equipment and training resources could enhance neurosurgical competency and consistency in specialist practice.

A Missed Opportunity: Humanities in Anatomy Lab.

A first-year medical student's first patient is already dead. For decades, the cadaver, or body donor, has been the human body on which students first examine, cut, identify, and discover. That the student forms a detachment from the body and the person who once occupied the body, however, initiates a pedagogical series of events that is difficult to undo at best and may be harmful at worst. This process reveals gaps in the anatomical instruction process that present a missed opportunity to educate future physicians in a way that not only maintains their humanity and capacity for empathy but alsoenhances it. The anatomy lab should be a place where early medical students converse about death and begin to confront their own feelings of discomfort and hesitation. Relying on a metaphor of disappearance, as articulated by Jewson, this paper reframes this problem and offers new ways of improving human anatomy instruction through a brief examination of the history of anatomy in general, the history of the actual human being (body donor) in particular, and the response of the student through humanities-based interventions and content. In what follows, we consider the existing gaps, the possible curricular options for enhanced education, and the potential benefits of incorporating a more robust humanities curriculum in the anatomy laboratory for first-year medical students.

Accessory Mental Foramina in Dry Mandibles: An Observational Study Along with Systematic Review and Meta-Analysis

Background/Objectives: The mental foramen (MF) constitutes a passage for mental nerves and vessels, and it is a crucial anatomical landmark in the body of the mandible. The accessory mental foramen (AMF) is a small, addable foramen proximate to the MF, and it is mainly located posteriorly. The AMF is a rare anatomical variation in human mandibles that must be taken into consideration throughout dental and surgical operations. We aimed to assess the incidence and perform morphological and morphometric analyses of AMFs in the human dry mandibles of the Greek population, in addition to a relevant systematic review and meta-analysis of global data. Methods: We studied 114 human adult dry mandibles of unknown gender and age available from the Laboratory of Anatomy, Medical School, Democritus University of Thrace, Greece. We used the search term “accessory mental foramen” in the PubMed, Scopus, and Google Scholar databases to detect all publications of the last 50 years reporting the prevalence and morphology of AMFs in dry mandibles; the search ended on 13 January 2025. Quality assessments were performed using the relevant Joanna Briggs Institute tool. Data were synthesized with the random-effects REML model after Freeman–Tukey double arcsine transformationusing STATA 18. No external funding was received. The PROSPERO CRD is 42025638135. Results: According to our data, the MF was present in all observed mandibles, and it was bilateral. Nine AMFs (five right/four left; five round/four oval; six posterior/three anterior to the MF) were found in seven mandibles (five single and two double), and all were unilateral. AMFs presented a mean diameter of 0.96 ± 0.43 mm and mean distances of 4.12 ± 2.15 mm from the MF, 12.68 ± 4.10 mm from the alveolar ridge, and 11.92 ± 1.57 mm from the lower border of the mandible. Furthermore, 27 publications were included in the meta-analysis; the combined AMF prevalence was 6.1% (95% CI: 4.8–7.6%; I2 60%), the combined mean vertical axis was 1.18 ± 0.61 mm, and the combined mean distance from the MF was 3.64 ± 2.29 mm. Bilateral AMFs were detected in 2.1% of AMF cases. An oval shape was described in 37.3% of AMFs. No publication bias was detected. Conclusions: AMFs are not considered rare, and they are occasionally bilateral or even multiple in number. Moreover, they demonstrate considerable variation regarding their size, shape, anddistance from the MF, alveolar ridge, and lower border of the mandible. Dental surgeons must be aware of AMFs’ anatomical variations during surgical and anesthetic planning in order to effectively prevent or mitigate the risk of postoperative complications, such as pain, anesthesia, injury, and other adverse outcomes.

Retrospective Analysis of a Mature Cystic Teratoma Discovered in the Anatomy Laboratory: Cross-Curricular Integration of Gross Anatomy, Histology, and Embryology

Retrospective Analysis of a Mature Cystic Teratoma Discovered in the Anatomy Laboratory: Cross-Curricular Integration of Gross Anatomy, Histology, and Embryology

Morphometric Evaluation of the Anterior Meniscofemoral Ligament in Human Cadaveric Knees: Anatomical Variations and Clinical Significance.

Introduction The anterior meniscofemoral ligament (aMFL) is an ancillary ligament within the knee. It has been noted for its rare occurrence and role in stabilizing the lateral menisci. Despite the perceived function, the prevalence of the aMFL is not entirely understood. Additionally, the aMFL holds clinical relevance for practicing physicians when evaluating lateral and posterior knee stability.Thus, this study aims to describe the prevalence of the aMFL and its variation in length and width across genders and knee laterality in all cadavers. Methods This cadaveric study evaluated 90 knees in the anatomy lab at Tilman J. Fertitta Family College of Medicine and Baylor College of Medicine. Unpaired T-tests were performed to compare mean variations in length and width between genders and knee laterality. Artificial knees and severely degenerated knees were excluded. Exclusion criteria pertained to samples with a history of osteoarthritis, total knee arthroplasty, or signs of severe tissue degeneration. Dissection was performed using a single transverse cut method with soft tissue extraction. This was done anteriorly with the knee at a 140° flexion angle. Calibrated digital calipers measured length and width. Results A total of 90 knees (45 cadavers; 28 women and 17 men) were carefully dissected. The aMFL in 61.76% of male knees (21 out of 34) and 62.5% of female knees (35 out of 56) for a total prevalence of 62.22% across both genders. Unpaired t-tests were conducted to analyze differences between the right and left knees and genders. In males, the right aMFL was found to be significantly wider than the left (p = 0.021). Conversely, in females, the left aMFL was significantly longer than the right (p = 0.0005). There was no significant difference in aMFL width between males and females (p = 0.1573); however, the length of the aMFL was significantly greater in males as compared to females (p = 0.0005). Conclusion In conclusion, our study found a high prevalence of aMFL in both sexes, with males having significantly longer aMFL ligaments than females. No significant difference in ligament width was observed between genders. Males had wider aMFL ligaments in the right kneewhile females had longer aMFL in the left knee. These gender and side-specific variations may impact knee biomechanics and clinical outcomes. Further research is needed to explore the functional implications of these findings.

Departing from standard practices: Strategic application of value engineering in the anatomy laboratory to enhance formaldehyde extraction using high-impact, low-cost, and low-maintenance solutions.

This study describes the process of developing a high-impact, low-cost, and low-maintenance air ventilation system for anatomy facilities. It employed the strategic application of Value Engineering (VE), assuring that the air ventilation system meets contemporary threshold limit values (TLVs) for formaldehyde in the working zone of dissection tables. A creative-innovative construction methodology was used, combining the Theory of Inventive Problem Solving (TRIZ/TIPS) and VE for an anatomy laboratory air ventilation concept. The TRIZ/TIPS aimed to resolve conflicts that impeded progress toward higher ideality, while VE aimed to develop alternative approaches to fulfill required functions at a minimal cost. The findings were first trialed in a mockup while dissecting human tissues embalmed with two protocols. The experimental results were validated by computational fluid dynamics simulations, and then followed by a pilot and commissioning phase once the physical installation of the dissection laboratory concluded. The findings demonstrate the superiority of the combined TRIZ/TIPS and VE approach in terms of air distribution and efficient formaldehyde extraction within the breathing zone. A formaldehyde exposition below 0.1 ppm, lowered air exchange rates, and system usability proved that the given third-generation ventilation system complies with contemporary TLVs and potential changes in user requirements. The third-generation ventilation system offers a cost-effective, high-impact, and low-maintenance solution for state-of-the-art air ventilation systems in the anatomy dissection laboratory. The underlying design approach ensured that formaldehyde levels in the laboratory meet the TLV and indoor air guideline values for formaldehyde exposure, at which current knowledge indicates no increased risk of cancer.

Effect of Aflatoxin-Laced Diets on Ovarian Follicles of New Zealand White Rabbits

Contamination of crops by Aspergillus fungi can occur at any stage of food production, ranging from pre-harvest to storage. These toxins are generally found in the mycelium of filamentous fungi but may also exist in the spores of the Aspergillus genus. Their production is influenced by factors such as a favourable temperature range of 24–35°C and relative humidity levels between 7 and 10%, in conditions prevalent in tropical regions. Despite their harmful effects, the presence of aflatoxins in food and feed often goes unnoticed. This is due to a lack of public awareness, insufficient regulatory frameworks, the dumping of contaminated food products by importers and the introduction of tainted commodities into the food chain during periods of food scarcity caused by drought, conflict, political instability or economic crises. Aflatoxins are invisible and highly corrosive chemical toxins that damage the liver, and reproductive systems and are carcinogenic to various organs. The current study investigated the histopathological effects on the follicles of New Zealand White rabbits fed diets containing varying levels of aflatoxins. Over 45 days, 16 three-month-old rabbits were housed in well-ventilated cages with 12:12 hours of daily light: darkness exposure and fed diets containing four different levels of aflatoxins. At the end of the study period, one rabbit from each treatment group was humanely sacrificed, and its ovaries were removed and sent to the anatomy and pathology laboratory for histological analysis. The findings revealed a reduction in primordial follicles with increasing levels of aflatoxin in the diet. Part of the ovarian cytoplasm contained dark-red fluid resembling blood, indicating follicular infiltration. The inflammation likely obscured other follicles, and two follicles were observed to be necrotic. Examination of ovarian tissues in treatments 3 and 4 revealed mild histological changes, including desquamation of granulosa cells, congestion, and multifocal oedema between the congested blood vessels in the ovarian medulla. In conclusion, including aflatoxin in New Zealand White rabbit diets, even at the levels tested in this study, resulted in significant effects on the ovarian cytoplasm, reduced follicle number, and necrotic damage to the follicles. Based on these findings, it is recommended that aflatoxin levels in rabbit diets should not exceed 100 ppb to prevent adverse histological effects on the ovaries and reduce follicle numbers.

Tele-robot-assisted minimally invasive esophagectomy using a double-surgeon cockpit on a cadaver.

We conducted this study to evaluate the efficacy of robot-assisted minimally invasive esophagectomy (RAMIE) on cadavers in the prone position, utilizing telesurgical support through the double-surgeon cockpit (double SC) of the novel Japanese-made surgical robot system, hinotori™ (Medicaroid, Kobe, Japan). The Cadaveric Anatomy and Surgical Training Laboratory (CAST Lab) at Hokkaido University and Kushiro City General Hospital (KCGH) are interconnected by a dedicated 1 Gbps internet line, spanning 300km. An operation unit and double SC were installed at CAST Lab, whereas the double SC proctor was installed at KCGH. RAMIE was performed with telesurgical support on two adult cadavers. The onsite and proctor operation times were recorded as 88/79 min and 64/75min, respectively. Throughout the surgical procedures, communication remained stable, with an average communication delay of 13.1ms (range: 11.0-15.0ms). This study demonstrated the feasibility of performing RAMIE with the patient in the prone position, supported by telesurgical support using a double SC on the hinotori™ platform.

Cervical Cancer: Activity Report at the Pathological Anatomy and Cytology Laboratory in Thies (Senegal)

Cervical Cancer: Activity Report at the Pathological Anatomy and Cytology Laboratory in Thies (Senegal)

BRCA1 Expression Profile in Breast Cancer Patients in West Nusa Tenggara

Abstract: Breast cancer is still the highest case in Indonesia. The mortality ratio: incidence of breast cancer in various countries can be influenced by differences in the clinical and biological profiles of tumors like BRCA1 expression status. In addition, several parameters that can be reviewed based on breast cancer incidence such as age and domicile can also be associated with BRCA1 expression. BRCA1 is tumor suppressor gene. This protein works as a cell cycle regulator. Germline mutations of BRCA1 are the main cause of inherited breast cancer. Breast cancer with BRCA1 mutations only contributes 20-40% to breast cancer incidence, but this condition have adverse tumor characteristics with poor prognosis. The aim of this study is to determine the BRCA1 expression profile in breast cancer patients in West Nusa Tenggara based on age and domicile status. A 50 paraffin blocks of breast cancer tissue were examined for BRCA1 expression status using immunohistochemistry techniques. Samples and clinicopathological data were obtained from Pathology Anatomy Laboratory collection in NTB Provincial Hospital and medical records. BRCA1 expression profile in breast cancer patients will be analyzed descriptively using the frequency distribution of BRCA1 expression based on age and domicile. The negative BRCA1 expression is high at age <40 (59.1%) in Central Lombok and East Lombok districts (40%). Negative BRCA1 expression was found at age <40 years, found in two districts in NTB.

From the Anatomy Lab to Clinical Practice: A Proposed Clinical Decision Making Flowchart for Symptomatic Accessory Soleus Muscle

From the Anatomy Lab to Clinical Practice: A Proposed Clinical Decision Making Flowchart for Symptomatic Accessory Soleus Muscle

Pathology discovered in the "first patient" can be the silent teacher of self-directed learning.

Pathology found during cadaveric dissection has been used to model integrative teaching methods for medical students at several institutions. Recent evidence has shown that pathology found during dissection can be used in the design of self-directed learning (SDL) activities with standards that are difficult to meet. This study presents a novel method for providing formative feedback, one of the most challenging aspects for LCME accreditation of SDL activities. Three practitioners (two board certified pathologists and one board certified family physician) reviewed and rated pathological findings during routine dissection by first year medical students in the gross anatomy laboratory in New Orleans, Louisiana. The students also rated the findings, and a comparative score was given that provided quick, individualized formative feedback with no additional faculty time burden. The inter-rater reliability (IRR) among the clinical expert panel (n = 3) was adequate (IRR = 0.85). The students' percentage agreement with the expert panel was just under 57%. There was no significant correlation between the score on the Gift formative feedback instrument (FFI) and the students' performances in their gross anatomy course (p > 0.05). This study describes a FFI that allows for the variety of clinical presentations in cadavers dissected in the gross anatomy laboratory, while protecting faculty time that would otherwise be used for scoring individuals in large cohorts of medical students. This instrument can be used to integrate pathology and gross anatomy and provide a practical way of implementing self-directed learning.

Battling time restrictions with collective discourse: collaborative quizzes in a condensed human anatomy course

BackgroundUndergraduate medical education is currently undergoing a remarkable period of transformation. The exponential growth of medical knowledge, accompanied by societal changes and expectations for the upcoming generation of physicians, is placing immense pressure on academic institutions to reform their curricula, particularly foundational courses such as human anatomy. Consequently, instructors are grappling with the challenge of striking a balance between a new curriculum and maintaining the time-honored benchmarks of medical education.MethodsThis study proposes a 9,5-week medical gross anatomy course containing collaborative quizzes to improve the efficacy in a condensed pre-clerkship curriculum. It was hypothesized that the implementation of collaborative quizzes facilitates group learning while ultimately helping students to be better prepared for the NBME (National Board of Medical Examiners) unit examinations used as summative assessment within the course. During the four collaborative quizzes, medical and medical masters student groups rotated through twenty dissected donor stations, each containing a short clinical or anatomy-related multiple-choice question formatted in NBME style. Students individually answered the question first and then collaboratively discussed the question in their group. Success was measured by individual student outcomes of four collaborative quizzes, two NBME anatomy-focused unit examinations, and overall course evaluations.ResultsOverall, all students (n = 203) passed the course and performed well on collaborative quizzes and NBME anatomy-focused unit examinations. Analysis of the quizzes revealed that questions involving tagged structures, blood supply, and nerves resulted in the most answer changes after group discussion. Course evaluations proved the collaborative quizzes to be enjoyable and beneficial to identify lack of knowledge areas.ConclusionsTo address time constraints within the pre-clerkship curricula effectively, it is crucial for educators to explore smaller adjustments to core learning principles. Collaborative quizzes in the gross anatomy laboratory provided students with opportunities to assess their knowledge in a low-stakes setting while simultaneously benefiting from peer learning. The collection and analysis of quiz grades offered a method of identifying struggling students before their first summative examination, enabling timely academic support. In the future, the research team hopes to continue using this assessment and integrate content from various other pre-clerkship courses.

Back to the Anatomy Lab to Redefine the Pulley System of the Thumb: Is There an A0 Pulley?

There are various anatomical descriptions of the pulley system of the fingers and thumb. The A0 pulley, often referred to as palmar aponeurosis of the fingers, is of keen interest, especially regarding surgical release of the A1 pulley for trigger finger; however, there has been no anatomical description of the A0 pulley in the thumb. Twenty-four cadaveric thumbs were dissected to expose the entire pulley system. Each structure, including the A2, Aob, Av, A1 pulleys, and any proximal transverse elements, were cataloged. Three distinct transverse elements were identified proximal to the A1 pulley including: (1) the named ligament of Grapow; (2) the proximal commissural ligament and associated transverse fascial tissues; and (3) a definable A0, identified in 10/12 (83.3%) cadavers and 15/24 (62.5%) thumbs. Ten A0 pulleys occurred bilaterally, while 5 occurred unilaterally. The presence of an A0 pulley in greater than 80% of the studied thumbs serves as an important anatomic finding that should be considered in surgical treatment. An additional finding of importance is that the pulley system anatomy demonstrated variability in laterality. Based on these anatomic findings, not only can the A0 pulley be defined as a unique anatomic structure of the thumb, but its repair also has implications for successful surgical treatment of thumb pulley system pathologies.

A Mixed-Methods Investigation of First-Year Medical Students’ Professionalism Competency Development over the Gross Anatomy Course

Abstract Background While competency-based medical education (CBME) and competency assessment in clinical training are well documented, they are less commonly included in preclinical medical education. The gross anatomy laboratory is an opportune setting to incorporate competency assessment and reflection during preclinical medical education. This mixed-methods study determined how first-year medical student assessments of professionalism skills in the gross anatomy lab change over time and analyzed student reflections to contextualize the experiences they had developing the Professionalism competency. Methods First-year medical students at the University of Louisville completed self- and peer-assessments using the Professionalism Assessment Scale (PAS) at the beginning and end of their gross anatomy course (n = 83). The students also completed three competency development portfolio (CDP) entries throughout the course (n = 83). Qualitative thematic analysis with grounded theory was used to analyze comments related to professionalism skill development in the CDP reflections during the course. Results There was no statistical difference in PAS self-assessment scores from Time 1 (M = 4.81, SD = .209) to Time 2 (M = 4.85, SD = .217), p = .108. There was a statistically significant increase in PAS-peer-assessment scores from Time 1 (M = 4.89, SD = .165) to Time 2 (M = 4.93, SD = .127), p = .005. Thematic analysis of CDPs revealed that students believed they developed interpersonal relations/social skills, responsibility skills, and gross anatomy lab-specific skills over the gross anatomy course. Conclusions The Professionalism competency is inherently present and able to be assessed in the gross anatomy lab context for first-year medical students.

Bilateral distal tibio-fibular synostosis: a case of morphological deformity in cadaveric remains of black ethnicity at the department of anatomy, equator University of Science and Technology

Tibial fibular synostosis is a rare congenital or acquired abnormality with most cases identified coincidentally upon clinical presentation. Distal tibio-fibular synostosis are reported to be secondary to traumatic events; and whereas Unilateral distal Tibial fibular synostosis have been widely documented, bilateral occurrences are rare among persons of black ethnicity. The objective of this report is to elaborate a rare occurrence of bilateral distal tibial fibular synostosis incidentally found during a bone preparation procedure in a gross anatomy laboratory. This was a distally located bone fusion with exostoses, involving the anterior, medial and posterior surfaces of the tibial-fibular bones. The causative factor of this deformity in our case couldn’t be ascertained since this was a cadaveric incidental finding with no life or clinical history to relate to. However with distal fusions and visible exostoses, we probably infer that this was synostosis of osteochondromatic origin. Permission to access the case specimens and present this report was sought and granted by the University Research and Ethics committee of Equator University of science and technology.

Virtual reality in medical education: Effectiveness of Immersive Virtual Anatomy Laboratory (IVAL) compared to traditional learning approaches

Virtual reality in medical education: Effectiveness of Immersive Virtual Anatomy Laboratory (IVAL) compared to traditional learning approaches

Perception and Effectiveness of Online Anatomy Lab Exercise on Undergraduate Students of BPKIHS During COVID-19 Pandemic

Introduction: Online mode of teaching learning activities were started for medical students of Nepal to reduce the risk of spreading virus during COVID-19 pandemic. BPKIHS started the modified online lab exercise (LABEX) for the undergraduate students after six months of pandemic. Objective: The main objective of study was to evaluate the student’s perception and effectiveness of modified online LABEX (prior content video uploading) during pandemic. Methods: The mixed method cross-sectional study design using semi-structured questionnaire was conducted. The questionnaire had sub-sections such as questions regarding students’ means of study, students’ perception on modified online lab exercise during pandemic and reflective writing. We collected the responses from 129 students after institutional ethical clearance and informed consent. Student’s paired test for analysis of effectiveness of modified online LABEX was done by using pre-test/post-test score. Thematic analysis was performed for reflective writing. A p<0.05 was considered as statistically significant. Results: The mean age was calculated as 20.84 year. The modified online LABEX increase the scoring of students for three consecutive sessions with an average score of 1.71; 1.55 & 1.09 respectively (p<0.001). We formulated 15 codes and 3 themes from reflective writing such as strength, weakness and recommendation of modified online LABEX. We found that “Accessibility of recorded Labex” (n=54) was major strength and “less efficient of online LABEX” (n=57) was major weakness. Conclusions: Although physical form of anatomy education is best way of learning but modified online LABEX can be used as alternative during pandemic like situations in future

T1- and T2-weighted MRI signal and histology findings in suboptimally fixed human brains

T1- and T2-weighted MRI signal and histology findings in suboptimally fixed human brains

Profiles, tissue and microbial integrity of cadavers used in medical faculties in South-western Uganda: implication in anatomical education.

Cadaveric dissection has remained an integral part of anatomical education globally; hence, the profiles of cadavers, their gross tissue and microbial integrity has great implication in anatomical education. This study determined the profiles, gross tissue and microbial integrity of cadavers used in South-western Uganda (SWU) medical schools. A cross-sectional study was carried out for three months in anatomy and microbiology laboratories of SWU medical teaching institutions. Ethical approval was obtained, cadavers were proportionately selected and examined grossly, and surface swabs taken for microbial analysis. Data collected was entered into Microsoft Excel, cleaned, and exported to Stata version 17 for analysis. Majority of cadavers were male (68%), adult (96%), blacks (100%), unknown cause of death (96%), obtained as unclaimed bodies (100%) and with no cadaver record tag (96%). Nearly a half (48%) cadavers had disrupted dentition, 68% had poor muscle integrity and 80% with abnormal fat. About 27% cadavers had poor surface microbial integrity among which 62.5% had a mixture of both bacteria and fungi, 25.0% had only fungi while 12.5% had only bacteria. A high number of cadavers had micro-organisms on their surfaces with majority having a mixture of bacteria and fungi. Majority of cadavers had poor gross tissue integrity. Better cadaver preservation methods should be adopted. To advocate for the establishment of cadaver donation policy and programs through which good quality cadavers can be obtained.