The proximal humeral locking plate positioning to the pectoralis major tendon in achieving the proper calcar screw location: a cadaveric study

Background Proximal humeral fracture is the third most common of osteoporotic fracture. Most surgical cases were treated by fixation with anatomical locking plate system. The calcar screw plays a role in medial support and improving varus stability. Proximal humerus fracture in elderly patients are commonly seen with greater tuberosity (GT) fracture. The GT fragment is sometimes difficult to use as an anatomic landmark for proper plate and screw position. Therefore, the insertion of pectoralis major tendon (PMT) may be used as an alternative landmark for appropriate plate and calcar screw position. The purpose of study is going to identify the vertical distance from PMT to a definite point on the position of locking plate. Methods 30 cadaveric shoulders at the department of clinical anatomy were performed. Shoulders with osteoarthritic change (n = 5) were excluded. Finally, 25 soft cadaveric shoulders were recruited in this study. The PHILOS™ plate was placed 2 mm posterior to the bicipital groove. A humeral head (HH) was cut in the coronal plane at the level of the anterior border of the PHILOS plate with a saw. A calcar screw was inserted close to the inferior cortex of HH. Distance from the upper border of elongated combi-hole (UB-ECH) to the upper border of pectoralis major tendon (UB-PMT) was measured. The plate was then moved superiorly until the calcar screw was 12 mm superior to the inferior border of HH and the distance was repeatedly measured. Results The range of distance from UB-PMT to the UB-ECH was from − 4.50 ± 7.95 mm to 6.62 ± 7.53 mm, when calcar screw was close to inferior border of HH and when the calcar screw was 12 mm superior to the inferior border of HH, respectively. The highest probability of calcar screw in proper location was 72% when UB-ECH was 3 mm above UB-PMT. Discussion and conclusion The GT fragment is sometimes difficult to use as an anatomic landmark for proper plate and screw position. PMT can be used as an alternative anatomic reference. UB-PMT can serve as a guide for proper calcar screw insertion. UB-ECH should be 3 mm above UB-PMT and three-fourths of cases achieved proper calcar screw location.

Peculiarities of online training in the discipline of “Clinical anatomy and operative surgery” for the students of Ivano-Frankivsk national medical university

Background. Since mid-March 2020, the entire medical community of Ukraine has faced a new problem - the lack of experience and technical support for giving online classes. Purpose: to analyze the features of online training in the discipline of "Clinical Anatomy and Operative Surgery" for the second-year students of the medical faculty in IFNMU. Results. We have identified the benefits of online training. Thus, being at home, students can acquire knowledge under the conditions of constant mastering of educational material, so their theoretical basis will be quite thorough; online training also gives an opportunity to study the material anywhere with Internet access. In quiet home conditions online training provides mastering modern information and communication technologies. However, there are also the disadvantages of online training: the inability to form a consistent view and master practical skills in the discipline on their own, due to lack of necessary instruments, phantoms, models, etc., so it is difficult to obtain thorough knowledge, sometimes because of low capacity of the electronic network. Conclusion. In online training of the medical students, we outlined the following peculiarities of giving classes: remoteness, flexibility, mass, practicality, usability, economy, parallelism and modularity.

Eponyms in the human heart anatomy

The present time is characterized by an increase in the pace of life, and medicine is no exception. Often, when analyzing the medical literature, specialists are faced with the fact that in different publications almost the same structure has a different name, which causes misunderstanding among specialists in various medical fields. This is especially true for clinicians who use the convenient anatomical names of fundamental scientists such as morphologists. As these names, terms from the International Anatomical Nomenclature are used, along with which, especially in clinical anatomy and medicine, eponymous names are accepted. The use of the latter can also be misunderstood, because eponyms are absent in modern anatomical terminology. However, additional knowledge of eponyms, along with common terms, gives the opportunity to look into the past and honor the memory of those who first described the structures. The paper attempts to systematize the names - eponyms of human heart structures. The need for such work exists because many structures have several eponymous names. In addition, if you arrange the terms in the chronological order of their occurrence, you can trace the main stages in the history of the human heart study. Despite the large number of eponymous names for the same structure and the doubtful attribution of some authors, the work lists only the most common eponyms in domestic and foreign literature, about the origin and authors of which reliable information was found. In 1955, at the IV International Congress of Anatomists in Paris (Paris Anatomical Nomenclature, PNA), eponymous names were excluded from the terminology. There are a number of objective reasons for this, but at the same time, the main function of eponyms is lost - the preservation and transmission to descendants the memory of major figures of medical science who made a significant contribution to its development. Therefore, despite the exclusion of eponyms from the official terminology, these terms are widely used today both at the departments of universities in the world, and in clinical literature and practice.

Current MRI Methods for the Assessment of Pathologic Prostate: A Brief Review for Clinician

: The application of magnetic resonance imaging (MRI) have helped in different modalities for prostate cancer management, from early detection to treatment planning and follow-up, the evolution of MRI techniques allows to obtain not only anatomical but also functional information to take advantage of prostate cancer detection and staging while supplying prognostic and predictive biomarkers. This review presents conventional and advanced MRI techniques (known as multiparametric MRI) that allow functional and quantitative assessment of the normal prostate gland and its correlation with prostate cancer. Additional topics include the epidemiology of prostate cancer following the Global Burden Diseases Cancer Collaboration 2018, the clinical anatomy of the prostate gland, and the lower urinary tract; we also mention some aspects of the diagnosis performance in ultrasound. We end the review with a brief explanation about the anatomical foundation of external-beam planning radiotherapy.

Teaching cadaveric laparoscopic anatomy in medical curriculum – An essential learning option

Teaching anatomy to the medical students is shifting from learning the traditional gross anatomy with didactic lectures to learning anatomy by laparoscopic dissection on the cadavers. The open dissection hall teaching is loosing relevance to learning clinical anatomy with laparoscopic dissection live by the medical students. Laparoscopic demonstrations can generate interest in surgery in the students that would otherwise not be possible in the preclinical years. Additional advantages of laparoscopic anatomy learning are improved three-dimensional orientation, increased dexterity and development of team working skills among students. The magnified laparoscopic views and the ability to deeply explore anatomical features to demonstrate the basic anatomy better with full clarity does makes an impression on the young medical students. The major disadvantage is student may feel the lack of pleasure of tactile sensation, of touching the anatomical organs during laparoscopic demonstration.

Morphology, morphometry and some aspects of clinical anatomy in the skull and mandible of Sharri sheep

The aim of this study was to investigate and record data on the morphometrical parameters of the skull and mandible in Sharri sheep. We have evaluated 34 skulls (24 females and 10 males) of Sharri sheep (Ovis aries), a local breed of sheep from Northern Macedonia. Fifty-one measurements were evaluated in total: 37 parameters on the skull and 14 parameters on the mandible. The results of the study show that, in general, the morphology and morphometric parameters of the skull and mandible, of Sharri sheep are similar to those of other sheep breeds with few differences. The mean skull length (SL), skull height (SH), distance between two supraorbital foramina (DBTSF), orbital length (OL), mandible length (ML) and Sharri sheep diastema (D) were 247.47 ± 13.12 mm, 104.71 ± 6.21 mm, 50.73 ± 3.44 mm, 41.21 ± 1.99 mm, 185.91 ± 13.33 mm and 45.81 ± 3.73 mm, respectively. The results also show that out of 51 parameters, only 13 show a statistically significant difference between females and males, particularly the distance of akrokranion to opisthion (AO), articular surface length of mandibular condyle (ASL) and anterior limit of the mandibular foramen to cranial border of ramus mandible (RBMFRMRM). The findings of this study are important in many aspects: morphologically, morphometrically and especially clinically, during surgical interventions in the head region. With a lack of information in current literature on the investigated parameters in this sheep breed, the present data are a solid basis for further studies in comparative anatomy with other ruminants and in other areas such as zooarchaeology and animal welfare.

Use of Advanced Artificial Intelligence in Forensic Medicine, Forensic Anthropology and Clinical Anatomy

Three-dimensional convolutional neural networks (3D CNN) of artificial intelligence (AI) are potent in image processing and recognition using deep learning to perform generative and descriptive tasks. Compared to its predecessor, the advantage of CNN is that it automatically detects the important features without any human supervision. 3D CNN is used to extract features in three dimensions where input is a 3D volume or a sequence of 2D pictures, e.g., slices in a cone-beam computer tomography scan (CBCT). The main aim was to bridge interdisciplinary cooperation between forensic medical experts and deep learning engineers, emphasizing activating clinical forensic experts in the field with possibly basic knowledge of advanced artificial intelligence techniques with interest in its implementation in their efforts to advance forensic research further. This paper introduces a novel workflow of 3D CNN analysis of full-head CBCT scans. Authors explore the current and design customized 3D CNN application methods for particular forensic research in five perspectives: (1) sex determination, (2) biological age estimation, (3) 3D cephalometric landmark annotation, (4) growth vectors prediction, (5) facial soft-tissue estimation from the skull and vice versa. In conclusion, 3D CNN application can be a watershed moment in forensic medicine, leading to unprecedented improvement of forensic analysis workflows based on 3D neural networks.