Neurological structures and mediators of pain sensation in anterior cruciate ligament reconstruction Publication date: September 2019 Source: Annals of Anatomy - Anatomischer Anzeiger, Volume 225 Author(s): Andrew J. Hong, Avinesh Agarwalla, Joseph N. Liu, Anirudh K. Gowd, Sean McMillan, Paul M. Sethi, Nirav H. Amin Abstract Anterior cruciate ligament (ACL) tears is a devastating injury and one of the most common knee injuries experienced by athletes in the United States. Although patients reach maximal subjective improvement by one-year following ACL reconstruction, many patients often experience moderate to severe post-operative pain. Opioids, intra-articular injections, and regional anesthesia have been previously implemented to mediate post-operative pain. However, chronic opioid usage has become an epidemic in the United States. Alternative analgesic modalities, such as nerve blocks, have been implemented in clinical practice to provide adequate pain relief and minimize opioid usage. Periarticular injections targeted towards local neurological structures performed concomitantly with nerve blocks provides superior pain relief and satisfaction than isolated nerve blocks. Therefore, it is imperative for physicians to understand local neurological anatomy around the knee joint in order to provide adequate analgesia while minimizing opioid consumption. This purpose of this investigation is to summarize (1) neurogenic origins of pain generators and mediators in sites affected by ACL reconstruction and autograft harvest sites and (2) analgesia utilized in ACL reconstruction.

Craniofacial abnormalities in a murine model of Saethre-Chotzen Syndrome Publication date: September 2019 Source: Annals of Anatomy - Anatomischer Anzeiger, Volume 225 Author(s): Sarah Lonsdale, Robin Yong, Alexander Khominsky, Suzanna Mihailidis, Grant Townsend, Sarbin Ranjitkar, Peter J. Anderson Abstract Background Saethre-Chotzen Syndrome (SCS) is an autosomal dominant syndrome that occurs due to a mutation or deletion of the Twist1 gene at chromosome 7p21. Our aim was to conduct a morphometric analysis of the craniofacial features in the mouse associated with a Twist1+/− mutation. Methods Micro-computed imaging was conducted for the skulls of forty skeletally mature mice, equally distributed by sex (male and female) and two genotypes (Twist1+/− or murine model of SCS; and Twist1+/+ or wild-type). A morphometric analysis was carried out for eight parameters for the maxillary-zygomatico-temporal region, 10 parameters for the mandible and three parameters for teeth from three-dimensional reconstructions. Results Compared with wild-type, the murine model of SCS showed these trends: (1) maxillary-zygomatico-temporal region, significantly shorter length and width posteriorly (p < 0.05), (2) mandible, significantly reduced height and width (p < 0.05), and (3) teeth, significantly shorter height, shorter mesio-distal width but longer bucco-lingual width (p < 0.05). In the murine model of SCS, the key morphological variations included incomplete ossification of the temporal bone and zygomatic arch, twisting and/or incomplete ossification of the palatal process of the maxilla, premaxilla and the ventral nasal concha, as well as bifid coronoid processes. Conclusions The skeletal and dental alterations in the height, length and width provide a foundation for large-scale phenomics studies, which will improve existing knowledge of the Twist1 signalling cascade. This is relevant given the predicted shift towards minimally invasive molecular medical treatment for craniosynostosis. Graphical abstract

Advantages and disadvantages of implant navigation surgery. A systematic review Publication date: September 2019 Source: Annals of Anatomy - Anatomischer Anzeiger, Volume 225 Author(s): Jordi Gargallo-Albiol, Shayan Barootchi, Oscar Salomó-Coll, Hom-lay Wang Abstract This review elucidates the advantages and disadvantages of the different implant navigation methods to assist the precise surgical placement of dental implants. Implant navigation surgery can be classified into: dynamic and static navigation, and static navigation can further be divided into full (FG)- and half-guided (HG) implant surgery. The HG implant placement includes the drilling-guided, pilot-drill guided, and the non-computed guided approaches. In dynamic navigation, the bone drilling and the implant placement are completely tracked with a specific software; while the static navigation refers to the use of static surgical templates. The FG associated with flapless surgery and teeth/crown supported guides has demonstrated the highest accuracy, followed by the drilling and pilot HG surgery that may provide comparable results, while the non-computer HG and FH implant placement provide the least accuracy in transmitting the implant positioning from the pre-surgical planning to the patient. Additionally, flapless implant surgery is related to reduced pain, less analgesic consumption, less swelling, shorter chair-time, and reduced risk of hemorrhage while achieving greater patient satisfaction. Nevertheless, other methods such as non-computer HG and FH implant surgery procedures require more surgical experience to overcome their limitations. There is still limited evidence to support dynamic surgery, and further investigations are needed.

The vasa vasorum reach deep into the human thoracic aorta Publication date: September 2019 Source: Annals of Anatomy - Anatomischer Anzeiger, Volume 225 Author(s): Jan Michael Federspiel, Thomas Tschernig, Matthias W. Laschke, Stefan Wagenpfeil, Philipp Schnabel, Hans-Joachim Schäfers Abstract Only limited data are available on the extent of the vasa vasorum of the human thoracic aorta, although this could be important with regard to certain pathophysiological states, i.e. aortic aneurysm or atherosclerosis. A preliminary investigation shows that the vascularization of the human thoracic aorta reaches deeper layers than generally believed.

Holding donated human bodies in conservation: A novel interactive safe-keeping system meeting high ethical and safety standards Publication date: September 2019 Source: Annals of Anatomy - Anatomischer Anzeiger, Volume 225 Author(s): Hans Schnittler, Uwe Ortmann, Stefan Washausen, Wolfgang Knabe, Frank Wesemann, Stefan Triphaus, Bettina Schöne-Seifert Abstract “Mortui vivos docent”. Learning from donated bodies is widely considered a corner stone in pre-clinical education, advanced clinical training, and scientific progress in medicine. Making such use of dead human bodies must, of course, accord with high ethical standards and legal constraints. Piety and respect towards donors require using their remains (i) for valuable purposes, (ii) with what we call ‘practical decency’, (iii) in an efficient way, and (iv) with the utmost safety for all parties involved. With regard to these goals, practical aspects of preservation, safekeeping procedures (for up to several years), and complete documentation become of great importance, but have so far only been realized unsatisfactorily. Here, we describe the new Safe-Keeping System-Münster (SKS-Münster) that has been developed and implemented in the Anatomy Department of the University of Münster. Integrated components of the system include a paternoster transport system, a removal station with ventilation and an air barrier, RFID transponder technology, and an easy to use software package allowing the system together to provide all required functions in an unprecedented way.

Early internationalization of students in a German medical school in the former German Democratic Republic Publication date: September 2019 Source: Annals of Anatomy - Anatomischer Anzeiger, Volume 225 Author(s): C. Gölkel, A. Wu, C. Chiuzan, J. Duong, P. Bernd, H. Kielstein Abstract The growing influence and importance of internationalization in higher education, especially in medical education, inspired anatomists at Columbia University New York, USA and at the Martin Luther University Halle-Wittenberg, Germany, to start a novel international preclinical collaboration project. As part of the anatomy dissection course a group of volunteer medical students from Halle dissected selected areas of the human body with the help of an English, illustrated, iPad-run dissection script (American Dissector). Meanwhile the rest of the students worked with a traditional German text-based dissector. Additionally, participating German students were matched with US students, with whom they connected via video-conferencing and discussed subjects like differences between their health care systems, structure and content of the anatomy course and the differences in their medical education systems. Questionnaires were sent for feedback and checklists confirmed dissection findings. Results indicated that the American Dissector was successfully shared internationally. The majority (62%) found it easier to find structures using the American Dissector compared to the standard dissector and also 62% needed the atlas two times less when using the American Dissector. Furthermore, students enjoyed their interaction with their international peers and the vast majority (77%) wished there were more interactions like this in the medical curriculum. This publication describes an approach to embed internationalization in the preclinical medical curriculum based in the gross anatomy course in a German Medical school, located in East Germany. Considering its history as a former German Democratic Republic faculty this is a meaningful step towardglobalization of medical education in this part of Germany.

The application of casein phosphopeptide and amorphous calcium phosphate with fluoride (CPP-ACPF) for restoring mineral loss after dental bleaching with hydrogen or carbamide peroxide: An in vitro study Publication date: September 2019 Source: Annals of Anatomy - Anatomischer Anzeiger, Volume 225 Author(s): Carmen Llena, Irene Esteve, Francisco Javier Rodríguez-Lozano, Leopoldo Forner Abstract Objective To conduct an in vitro evaluation of the effect of casein-phosphopeptide and amorphous calcium phosphate with fluoride [CPP-ACPF] upon the calcium [Ca] and phosphorus [P] composition and morphology of dental enamel and dentin after the application of two bleaching agents: 37.5% hydrogen peroxide [HP]) and 35% carbamide peroxide [CP]. Materials and methods The crowns of 40 extracted human teeth were divided into four groups (n = 10 each). The crowns were sectioned along the cervical-incisal axis, and each half was embedded in acrylic resin, leaving a window 3 mm in diameter to explore the enamel or dentin (according to the study group involved). Groups 1a and 1b corresponded to the two halves belonging to the same tooth and were treated with HP applied to enamel three times for 10 min. Afterwards, CPP-ACPF was applied in group 1b for five minutes. The same procedure was carried out in groups 2a and 2b, but application was done on dentin. Groups 3a and 3b were treated with CP applied to enamel once for 30 min. Posteriorly, CPP-ACPF was applied in group 3b for five minutes. Groups 4a and 4b were treated in the same way as groups 3a and 3b, but application was done on dentin. The morphological changes were evaluated using confocal laser scanning microscopy (CLSM), and the changes in Ca and P composition were assessed by environmental scanning electron microscopy coupled to a microanalytical system (ESEM + EDX). Comparisons between groups were made using the Kruskal–Wallis test, and Duncan test was applied for two-by-two comparisons, with a significance level of p < 0.05. Results Both HP and CP produced similar changes in enamel morphology and produced no changes in dentin. Groups treated with CPP-ACPF after bleaching improved the percentage of Ca and P. Statistical significance was reached only in the case of the percentage of Ca in enamel (group 1b versus group 1a, p = 0.01) (group 3b versus group 3a, p = 0.03). Conclusions The application of CCP-ACPF for five minutes on the enamel surface after tooth bleaching is effective in restoring the Ca lost as a result of the bleaching process, while their effect in dentin could not be demonstrated.

Vascular access animal models used in research Publication date: September 2019 Source: Annals of Anatomy - Anatomischer Anzeiger, Volume 225 Author(s): Maria Kokozidou, Athanasios Katsargyris, Eric L.G. Verhoeven, Gundula Schulze-Tanzil Abstract Purpose To provide a systematic literature review on effectiveness of arteriovenous fistula (AVF) and Shunt (AVS) research animal models. Background Due to advancing human population age, there is increased incidence of patients suffering from vascular and renal diseases leading to dialysis access using AVF and/or AVS. During those interventions native venous or synthetic grafts are arterialized. Despite temporary good patency, complications are a consequence of neointimal hyperplasia (NIH) development that contributes to patients’ morbidity and mortality. Basic research attempts to elucidate the pathomechanisms, therefore the small and large animal models are becoming attractive. Methods Medline search (within 1966–2018) was performed on AVF/AVS animal models. Studies fulfilled following criteria: (1) reported complete material-methods-results section, (2) included statistically significant number of animals, (3) provided statistically significant results. 55 articles were identified encompassing six animal species used. Results Large animal models include creation of AVF and AVS in pig, sheep and dog. Porcine animal models use pelvic or femoral vessels, ovine use the common carotid artery (CCA) and jugular vein (JV). Canine animal models use the femoral vessels. Small animal models use rabbit (CCA/JV), rat (JV/CCA, abdominal aorta /Vena cava inferior and femoral artery/femoral vein) and mouse (aortocaval and supraortic AVF models). Conclusions Large animal models are best for haemodynamic shear stress studies and in vivo evaluation of new synthetic vascular grafts. Small animal models, especially the genetically manipulated ones, are ideal for analysis of molecular and cellular pathomechanisms. The selection of animal species to be used depends on the addressed research question.

The dentomaxillary apparatus from molecular biology to variational anatomy—Underpinning interdisciplinary research Publication date: September 2019 Source: Annals of Anatomy - Anatomischer Anzeiger, Volume 225 Author(s): Andreea Cristiana Didilescu, Elena Martinez-Sanz Abstract Over the past decades, the research environment in anatomy has dramatically changed. Studies have become more interdisciplinary and complex, with many components required, from basic to clinical research. Within this framework, this special issue was designed to create a link between fundamental fields such as developmental and molecular biology, dental materials, anatomy, histology, and their applications in the clinical research of the dentomaxillary apparatus.

Editorial Board Publication date: September 2019 Source: Annals of Anatomy - Anatomischer Anzeiger, Volume 225 Author(s):