Clinical Anatomy最新文献

{"title":"The anatomical basis for surgical intervention in myositis ossificans-A systematic review.","authors":"Adam Stammer, Neil Ashwood, Veda Amara, Suraj Suryawanshi, Paul Wilson, Andrew Dekker","doi":"10.1002/ca.24238","DOIUrl":"https://doi.org/10.1002/ca.24238","url":null,"abstract":"<p><p>Myositis ossificans (MO) is a benign condition characterized by heterotrophic bone formation, most commonly within muscle tissue. Multiple types have been described, the most predominant being myositis ossificans circumscripta, which occurs in response to trauma. Myositis ossificans cases reported in the literature were reviewed systematically. The aim of the review was to examine how the condition and its management are influenced by the anatomical structures involved. The Medline and Ovid Embase online databases were searched for all papers relevant to MO between Jan 1972 and Dec 2020. Duplicate and unobtainable records were removed. The remaining records were manually assessed for relevance by three independent reviewers, initially by abstract and then by full-text screening, to ensure that all papers were suitable. Acceptance of articles was not limited by case features or study design. In total, 77 papers from the literature search were included. They contained information on 89 patients diagnosed with MO. The average age of the patients was 26.17 years (range 13 weeks to 72 years, a 71.75 year range) and 65.17% were male. The lower limb was affected more than the upper limb or spine, the most common site being the thigh. Muscle was the most commonly affected tissue, the quadricep femoris being most often involved. Diagnostic imaging varied widely among cases; X-ray alone was the most common method, followed by a combination of X-ray and MRI. Lesions in the lower limb had larger diameters than those in the upper limb or spine. More cases in the upper limb (47.83%) than in the lower limb (33.33%) required surgery. All instances of MO in the jaw, hand, and foot were symptomatic, and all required surgical management. The findings were consistent with previous research showing MO to be a predominantly male disease, with most patients being under 30 years of age. Trauma was involved in 52.81%, lower than previously reported. In this study, the vastus lateralis of the quadriceps was most often affected. MO lesions were less common and smaller in the upper limb but more required surgery. Anatomically confined sites such as the hand and foot always required surgery, probably because of earlier onset or more severe functional effects of symptoms. Further work is needed to review the anatomical predilection of MO to help identify patients who could benefit from earlier consideration of surgery. A national registry of MO cases could contribute to further research on this disease.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The ductal network in the human testis and epididymis: What belongs to which?","authors":"Andreas Gocht, Axel Stuart Merseburger, Süleyman Ergün, Marie Christine Roesch","doi":"10.1002/ca.24248","DOIUrl":"https://doi.org/10.1002/ca.24248","url":null,"abstract":"<p><p>The testes and epididymis are traversed by a system of tubules in which sperm cells are generated, matured, nourished, and transported. Among these are the efferent ductules, which connect the rete testis to the duct of the epididymis. In the Terminologia Anatomica (TA), the efferent ductules are assigned to the testicles, while numerous anatomy, pathology, and urology textbooks assign them to the epididymis. Developmentally, they are derivatives of the Wolffian duct; as is the epididymal duct, which unquestionably belongs to the epididymis. Allocation of the efferent ductules to the compartment of the epididymis has been established clinically. The precise identification of tissue components of the epididymis is essential for the prognostic assessment of testicular cancers. In primary germ cell tumors of the testis, tumor infiltration into the epididymis can influence the tumor stage and can be associated with a worse clinical prognosis than localized tumor disease. Thus, it is desirable to update the TA, assigning the efferent ductules to the epididymis.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“Practical Anatomy is to medical men what mathematics are to the physicist”","authors":"R. Shane Tubbs","doi":"10.1002/ca.24252","DOIUrl":"10.1002/ca.24252","url":null,"abstract":"<p>This first issue of <i>Clinical Anatomy</i> for 2025 includes articles of interest on the use of ultrasound to measure bone mineral density, neuroanatomy teaching in the flipped classroom, mechanisms of cerebrospinal fluid secretion by the choroid plexus epithelium, and the clinical anatomy of the coronary venous system in regard to retrograde cardioplegia and cardiac electrophysiological interventions. These and many other articles of interest await the reader of our Journal. As always, the editors are interested in any feedback/suggestions that will improve our quality.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":"38 1","pages":"1"},"PeriodicalIF":2.3,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ca.24252","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using large language models (ChatGPT, Copilot, PaLM, Bard, and Gemini) in Gross Anatomy course: Comparative analysis","authors":"Volodymyr Mavrych,&nbsp;Paul Ganguly,&nbsp;Olena Bolgova","doi":"10.1002/ca.24244","DOIUrl":"10.1002/ca.24244","url":null,"abstract":"<p>The increasing application of generative artificial intelligence large language models (LLMs) in various fields, including medical education, raises questions about their accuracy. The primary aim of our study was to undertake a detailed comparative analysis of the proficiencies and accuracies of six different LLMs (ChatGPT-4, ChatGPT-3.5-turbo, ChatGPT-3.5, Copilot, PaLM, Bard, and Gemini) in responding to medical multiple-choice questions (MCQs), and in generating clinical scenarios and MCQs for upper limb topics in a Gross Anatomy course for medical students. Selected chatbots were tested, answering 50 USMLE-style MCQs. The questions were randomly selected from the Gross Anatomy course exam database for medical students and reviewed by three independent experts. The results of five successive attempts to answer each set of questions by the chatbots were evaluated in terms of accuracy, relevance, and comprehensiveness. The best result was provided by ChatGPT-4, which answered 60.5% ± 1.9% of questions accurately, then Copilot (42.0% ± 0.0%) and ChatGPT-3.5 (41.0% ± 5.3%), followed by ChatGPT-3.5-turbo (38.5% ± 5.7%). Google PaLM 2 (34.5% ± 4.4%) and Bard (33.5% ± 3.0%) gave the poorest results. The overall performance of GPT-4 was statistically superior (<i>p</i> &lt; 0.05) to those of Copilot, GPT-3.5, GPT-Turbo, PaLM2, and Bard by 18.6%, 19.5%, 22%, 26%, and 27%, respectively. Each chatbot was then asked to generate a clinical scenario for each of the three randomly selected topics—anatomical snuffbox, supracondylar fracture of the humerus, and the cubital fossa—and three related anatomical MCQs with five options each, and to indicate the correct answers. Two independent experts analyzed and graded 216 records received (0–5 scale). The best results were recorded for ChatGPT-4, then for Gemini, ChatGPT-3.5, and ChatGPT-3.5-turbo, Copilot, followed by Google PaLM 2; Copilot had the lowest grade. Technological progress notwithstanding, LLMs have yet to mature sufficiently to take over the role of teacher or facilitator completely within a Gross Anatomy course; however, they can be valuable tools for medical educators.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":"38 2","pages":"200-210"},"PeriodicalIF":2.3,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is dissection or prosection equal in dental anatomy education?","authors":"Zekiye Karaca Bozdağ,&nbsp;Buse Naz Çandır,&nbsp;Aslı Ceren Macunluoğlu,&nbsp;İlke Ali Gürses","doi":"10.1002/ca.24239","DOIUrl":"10.1002/ca.24239","url":null,"abstract":"<p>This study aimed to investigate the learning outcomes and opinions about dissection and prosection methods among second-year dental students. Twenty-one dental students participated in the study. Two topographic subjects were selected from the head and neck region. Theoretical and practical pre-tests for the first subject were presented. After the theoretical lecture, the students were randomly divided into dissection and prosection groups and a practical lesson was presented. A post-test was then applied. On another day, the same steps were repeated for the second topographic topic, reversing the practice groups. A feedback questionnaire was supplied to the students at the end of the study. The questions in the first part of the feedback survey were scored using a 5-point Likert scale, and the open-ended questions in the second part were scored by creating a six-step latent thematic analysis — main themes and sub-themes. Post-test scores were higher in both subjects (<i>p</i> &lt; 0.001). While there was no difference between the pre- and post-test student scores on practical questions in the first subject, the post-test practical scores were higher in the second subject (<i>p</i> = 0.044). There was no significant difference between the dissection and prosection groups for either subject (<i>p</i> &gt; 0.05). Most of the students (<i>n</i> = 18, 85.71%) stated that both methods were necessary for anatomy education. Some of them (<i>n</i> = 12, 57.41%) found prosection more useful and some (<i>n</i> = 5, 23.81%) found dissection more useful. In response to the answers to the open-ended questions, four main themes were created and the results related to these main themes were collected in sub-themes. This study shows that the preferred method of cadaveric education, whether dissection or prosection, has a positive effect on both students' emotions and learning outcomes. Institutions can use both methods in a balanced way when designing anatomy curricula in dental schools.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":"38 3","pages":"324-333"},"PeriodicalIF":2.3,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative assessment of three AI platforms in answering USMLE Step 1 anatomy questions or identifying anatomical structures on radiographs","authors":"Khulood Mohammed Khalid Al-Khater","doi":"10.1002/ca.24243","DOIUrl":"10.1002/ca.24243","url":null,"abstract":"<p>The application of artificial intelligence (AI) in education has gained great attention recently. Integration of AI tools in anatomy teaching is currently engaging researchers and academics worldwide. Several AI chatbots have been generated, the most popular being ChatGPT (OpenAI: San Francisco, California, USA). Since its first public release in November 2022, several research papers have pointed to its potential role in anatomy education. However, it is not yet known whether it will prove superior to other available AI tools in this role. This article sheds some light on the current status of research concerning AI applications in anatomy education and compares the performances of three well-known chatbots (ChatGPT, Gemini, and Claude) in answering anatomy questions. A total of 23 questions were used as prompts for each chatbot. These questions comprised 10 knowledge-based, 10 analysis-based USMLE Step 1-type, and three radiographs. ChatGPT was the most accurate of the three, scoring 100% accuracy. However, in terms of comprehensiveness, Claude was the best; it gave very organized anatomical responses. Gemini performed less well than the other two, with a scored accuracy of 60% and less scientific explanations. On the basis of these findings, this study recommends the incorporation of Claude and ChatGPT in anatomy education, but not Gemini, at least in its current state.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":"38 2","pages":"186-199"},"PeriodicalIF":2.3,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of thoracic outlet syndrome to relieve chronic migraine","authors":"YH Cha,&nbsp;L. Randall,&nbsp;J. Weber,&nbsp;S. Ahn","doi":"10.1002/ca.24242","DOIUrl":"10.1002/ca.24242","url":null,"abstract":"<p>Prior case reports have suggested that treating thoracic outlet syndrome (TOS) may relieve intractable migraine headaches, but there has been no case series large enough to show when underlying TOS should be suspected as a contributor to migraine burden. This observational followed by questionnaire study was performed in an outpatient neurology practice to identify clinical features of patients with migraine in which TOS contributed to migraine burden. We report the clinical features of 50 consecutive patients (48 women, 2 men, age = 43.9+/12.7 years) who were treated for chronic migraine and TOS (20 migraine with aura, 28 migraine without aura, two hemiplegic migraines). Headaches had become chronic within 1 year of onset in 21 patients (42%) with characteristics as follows (percentages are based on known data): greater severity ipsilateral to TOS limb pain (38/50=76%), presence of limb swelling (32/48=67%), and worsened by recumbency (32/38=84%). Thirty-two patients eventually needed surgery, which included percutaneous transluminal venoplasty, 1st rib removal, scalenectomy, pectoralis minor tenotomy, and/or vein patching. The mean improvement of headaches on the treated side was 72 ± 26.7%; 12 patients experienced complete resolution of headaches after treatment of TOS (follow-up 7.2 ± 5.2 months). Questionnaire responders reported significant reductions in headache days (18.3 ± 8.6 to 11.1 ± 10.8 days/month, <i>p</i> &lt; 0.0016), severity (7.8+/2.5 to 5.4 ± 2.9, <i>p</i> &lt; 0.00079), and need for emergency care (3.6 ± 4.0 to 0.71 ± 1.3 visits/year, <i>p</i> &lt; 0.0029). Chronic migraines can be important manifestations of TOS. Early transition to a chronic state, lateralized limb pain, and headaches worsened by recumbency are clues to the contribution of TOS pathology. Addressing the TOS contribution to migraine can significantly reduce migraine headache burden.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":"38 3","pages":"314-323"},"PeriodicalIF":2.3,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11925132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomical description of malformations of the neck of the left atrial appendage","authors":"Jakub Batko,&nbsp;Rafał Jakiel,&nbsp;Agata Krawczyk–Ożóg,&nbsp;Kacper Jaśkiewicz,&nbsp;Radosław Litwinowicz,&nbsp;Marian Burysz,&nbsp;Marcin Jakiel,&nbsp;Krzysztof Bartuś,&nbsp;Filip Bolechała,&nbsp;Marcin Strona,&nbsp;Mateusz Krystian Hołda","doi":"10.1002/ca.24246","DOIUrl":"10.1002/ca.24246","url":null,"abstract":"<p>The recently-described left atrial appendage (LAA) neck is a truncated cone-shaped structure that connects the LAA orifice to its lobe. It shows malformations in some cases, but their exact description and clinical significance are unknown. Therefore, the aim of this study was to provide a detailed anatomical and morphometric analysis of LAA neck malformations in clinical context. A total of 250 autopsied human hearts (20.0% women, 46.7 ± 18.2 years old) were examined for mural malformations: spikes and bulges. Endocardial roughness of the LAA neck with a depth &lt;2 mm and no recognizable epicardial protrusion was defined as ectopic trabeculation. LAA neck malformations were found in 13.6%, bulges in 10.0% of the hearts examined, spikes in only 3.2%, and ectopic trabeculations in 24.8%. In one case, both a bulge and a spike were found in the LAA neck. Most LAA neck roughness was observed on the aortic and venous surfaces of the LAA neck. Those surfaces were the most common locations for malformations and ectopic trabeculations. The LAA wall was significantly thinner than the surrounding neck wall within the bulges and the ectopic trabeculations, but not in the spikes.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":"38 4","pages":"471-479"},"PeriodicalIF":2.3,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ca.24246","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relating normal human cardiac development to the anatomical findings in the congenitally malformed heart","authors":"Jill P. J. M. Hikspoors,&nbsp;Wouter H. Lamers,&nbsp;Janet Kerwin,&nbsp;Zihan Hu,&nbsp;Deborah J. Henderson,&nbsp;Robert H. Anderson","doi":"10.1002/ca.24240","DOIUrl":"10.1002/ca.24240","url":null,"abstract":"<p>A proper appreciation of cardiac development can now provide the necessary background to understand the anatomical findings in the congenitally malformed heart. We recently presented an account of human cardiac development based on reconstructions of histological datasets from human embryos aged between 3.5 and 8 weeks subsequent to conception. In this review, we summarize the changes observed relative to the findings when the heart is congenitally malformed. Beginning at the stage when it is first possible to recognize the primary heart tube, we describe the looping of its ventricular component, which occurs in the 5th week. We proceed with discussion of the formation of the atrial and ventricular chambers in the 6th week. The phases are successive, albeit partially overlapping. Separation of the circulations at the venous pole is completed at stage 17, equivalent to almost 6 weeks of development. During stages representing the 7th week of development, we concentrate on the remodeling of the outflow tract. This involves initially septation, but then separation of the developing circulations. The changes involve incorporation of the proximal outflow tract into the ventricles, with formation of the arterial roots in its middle part, and addition of a distal non-myocardial component to produce the intrapericardial arterial trunks. We pay particular attention to the changes occurring during remodeling of the interventricular foramen. We show that an understanding of this process provides the basis for understanding the functionally univentricular heart, as well as the arrangement found in double outlet right ventricle.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":"38 3","pages":"296-313"},"PeriodicalIF":2.3,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11925143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of augmented reality with other teaching methods in learning anatomy: A systematic review","authors":"Ally Williams,&nbsp;Zhonghua Sun,&nbsp;Mauro Vaccarezza","doi":"10.1002/ca.24234","DOIUrl":"10.1002/ca.24234","url":null,"abstract":"<p>Augmented reality (AR) has been investigated as an engaging educational tool that motivates undergraduate health science students to learn human anatomy. AR technology is developing rapidly, supporting medical education by presenting models of human anatomy as digital objects overlaid in the real world via mobile or head-mounted display (HMD). The purpose of this systematic review is to provide a post-pandemic analysis of AR compared with other methods for teaching anatomy and to determine the effects of AR on learning outcomes (LOs). Original research published between January 2020 and April 2024 was obtained from the WOS, Scopus, MEDLINE(Ovid), EMBASE, and PubMed databases, following PRISMA 2020 protocols. Articles included for analysis compared AR with alternative pedagogical methods of teaching undergraduate human anatomy. Studies that described AR as “mixed reality” (MR) were included, while those describing “virtual reality” (VR) were not considered. Risk of bias and limitations in individual studies were assessed using the Quality Assessment with Diverse Studies (QuADS) tool. Data were synthesized using a convergent integrated approach with LOs tabulated for visual analysis. A total of 17 articles were eligible for review: nine studies comparing AR via HMD hardware, and eight comparing mobile AR. The LOs of 12 studies were overwhelmingly reported as non-significant. Insufficient data precluded an accurate meta-analysis of LOs, and critical analysis revealed a considerable risk of bias and lack of justified methodology. While AR holds potential for supporting undergraduate students in learning anatomy, definitive outcomes from the current literature are limited by the heterogeneous nature of the studies and inconsistent use of terminology. It is recommended that future research employs professional AR technologies and incorporates the perspectives of university educators to ensure reliable outcomes that can direct the further development of AR technology in medical education.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":"38 2","pages":"168-185"},"PeriodicalIF":2.3,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}