Πέμπτη 13 Ιουνίου 2019

Anatomy - Anatomischer Anzeiger

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 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.



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.



The ultrastructural anatomy of the nuclear envelope in the masseter muscle indicates its role in the metabolism of the intracellular Ca++

Publication date: July 2019

Source: Annals of Anatomy - Anatomischer Anzeiger, Volume 224

Author(s): M.C. Rusu, M.I. Nicolescu, A.M. Jianu, V.S. Mănoiu, A.C. Ilie, D. Dincă

Abstract

Specific ultrastructural anatomy of masticatory muscles is commonly referred to a general pattern assigned to striated muscles. Junctional feet consisting of calcium channels of the sarcoplasmic reticulum (i.e. the ryanodine receptors, RyRs) physically connected to the calcium channels of the t-tubules build triads within striated muscles. Functional RyRs were demonstrated in the nuclear envelopes of pancreas and of a skeletal muscle derived cell line, but not in muscle in situ. It was hypothesized that ryanodine receptors (RyRs) could also exist in the nuclear envelope in the masseter muscle, thus aiming at studying this by transmission electron microscopy. There were identified paired and consistent subsarcolemmal clusters of mitochondria, appearing as outpockets of the muscle fibers, usually flanking an endomysial microvessel. It was observed on grazing longitudinal cuts that the I-band-limited mitochondria were not strictly located in a single intermyofibrillar space but continued transversally over the I-band to the next intermyofibrillar space. It appeared that the I-band-limited transverse mitochondria participate with the column-forming mitochondria in building a rather incomplete mitochondrial reticulum of the masseter muscle. Subsarcolemmal nuclei presented nuclear envelope-associated RyRs. Moreover, t-tubules were contacting the nuclear envelope and they were seemingly filled from the perinuclear space. This could suggest that nucleoplasmic calcium could contribute to balance the cytosolic concentration via pre-built anatomical routes: (i) indirectly, via the RyRs of the nuclear envelope and (ii) directly via the communication of t-tubules and sarcoplasmic reticulum through the perinuclear space.



Punctal agenesis: Embryology, presentation, management modalities and outcomes

Publication date: July 2019

Source: Annals of Anatomy - Anatomischer Anzeiger, Volume 224

Author(s): Jenny C. Dohlman, Larissa A. Habib, Suzanne K. Freitag

Abstract

Punctal agenesis is defined as the absence of the punctum occurring secondary to a failure of embryogenesis. This review synthesizes existing data on the embryology, anatomy, clinical presentation, symptomatology, management options and treatment outcomes of punctal agenesis. A foundational knowledge of the underlying embryologic and anatomical abnormalities is fundamental to understanding its clinical presentation and assists in choosing an appropriate management strategy. Existing outcomes data is generally favorable and suggests management with a step-wise approach can alleviate symptoms in patients across a spectrum of disease.



A major review on disorders of the animal lacrimal drainage systems: Evolutionary perspectives and comparisons with humans

Publication date: July 2019

Source: Annals of Anatomy - Anatomischer Anzeiger, Volume 224

Author(s): Mohammad Javed Ali, Susan J. Rehorek, Friedrich Paulsen

Abstract
Purpose

To provide a systematic review of the literature on the disorders and management of the lacrimal drainage system (LDS) in few of the species of the animal kingdom.

Methods

The authors performed a PubMed search of all articles that were published in English with specific reference to lacrimal drainage disorders in animals. Data captured include demographics, presentations, investigation, diagnoses and management modalities. Emphasis was also on anatomical differences, evolutionary perspectives and addressing the lacunae and potential directions for future research.

Results

The lacrimal drainage system is a terrestrial adaptation in vertebrates. Evolutionary development of the LDS is closely linked to the Harderian gland and the vomeronasal organ. Variable differences in the clinical presentations and management of lacrimal drainage disorders (LDD) are noted in comparison to humans. These are secondary to unique structural and pathophysiological differences. Uniformity in usage and reporting of disease terminologies is required. Diagnostic challenges in clinical examination can be met with the development of customized lacrimal instruments. Contrast dacryocystorhinography is a very useful investigation in the diagnosis of LDD. Multiple bypass procedures like conjunctivorhinostomy, conjunctivobuccostomy and conjunctivomaxillosinosotomy have been described for nasolacrimal duct obstruction (NLDO). Advances of endoscopy and radiological techniques are paralleled by minimally invasive lacrimal interventions. The search for an ideal animal model for human LDS is far from over and the choice of the animal needs to be customized based on the research objectives.

Conclusion

The lacrimal drainage system is an ancestral feature in tetrapod vertebrates and it is present, in some form or another, in most descendant species. The lacrimal drainage system has evolved considerably, adapting to the needs of the species. It is essential to understand the lacrimal drainage disorders of domestic animals so that the animal and human lacrimal sciences contribute more meaningfully to each other.



Focused practice of lacrimal drainage disorders

Publication date: July 2019

Source: Annals of Anatomy - Anatomischer Anzeiger, Volume 224

Author(s): Mohammad Javed Ali, Friedrich Paulsen



Dacryocystography: From theory to current practice

Publication date: July 2019

Source: Annals of Anatomy - Anatomischer Anzeiger, Volume 224

Author(s): Swati Singh, Mohammad Javed Ali, Friedrich Paulsen

Abstract
Purpose

To provide a review and an update on dacryocystography (DCG) and its relevance in the current era.

Methods

The authors performed a PubMed search of all articles published in English on DCG, digital subtraction-DCG (DS-DCG), computed tomographic DCG (CT-DCG) and magnetic resonance-DCG (MR-DCG). Data analyzed include the indications, techniques, interpretations, complication and limitations.

Results

Dacryocystography has been used for illustrating the morphological and functional aspects of the lacrimal drainage system (LDS). Subtraction DCG provides the precise location of the alterations and acceptably delineates stenosis or an obstruction. Transit time for contrast into the nose varies widely across the studies. Low osmolality iodinated contrast media are tolerated well for DS-DCG and CT-DCG. However, normal saline either mixed with lidocaine or alone provided similar image quality as obtained with gadolinium for MR-DCG. CT-DCG provides useful information in complex orbitofacial trauma and lacrimal tumors. MR-DCG allows better 3D visualization of the LDS and dynamic functional evaluation. Sensitivity of CT-DCG and MR-DCG are mostly similar in identifying an LDS obstruction.

Conclusion

Various forms of DCGs can provide additional information to evaluate patients with maxillo-facial trauma, functional epiphora, suspected lacrimal sac diverticula, partial nasolacrimal duct obstruction, and lacrimal drainage tumors. Canaliculi and the membranous part of the nasolacrimal duct are not yet visualized in detail and further focused studies with advanced techniques are required.



The large intestine from fetal period to adulthood and its impact on the course of colonoscopy

Publication date: July 2019

Source: Annals of Anatomy - Anatomischer Anzeiger, Volume 224

Author(s): Slawomir Wozniak, Tomasz Pytrus, Christopher Kobierzycki, Krzysztof Grabowski, Friedrich Paulsen

Abstract

The human large intestine in the living adult has a total length of about 1300 mm, ranging from 1100 to 2108 mm. The development of the gut continues after birth, up to the age 4–5. The large intestine ascends at the beginning in the right abdominal quadrant, then it traverses the abdominal cavity, and finally it descends to the anus. The left and right colic flexures are the basic flexions between the transverse, ascending and descending colon, respectively. Additionally, there are secondary bendings between intestinal segments. The angles between the neighbouring parts can vary between examined subjects. Most of the angulations can be found in the transverse (range 2–9) and sigmoid colon (range 1–9), making them the most troublesome parts to pass with a colonoscope.

Colonoscopy (usually performed in the left lateral or supine position) is one of the most important examination of the large intestine mucus membrane. During this procedure the endoscope is passed through the colon into the cecum or terminal ilium. The individual anatomical features (tortuosity, supernumerary loops and elongation) may slow down or interfere with the progress of the scope.

We summarize current knowledge on the human large intestine from the fetal period to adulthood and carve out some aspects that are currently less known to colonoscopists.



Ultrastructure of the lacrimal drainage system in health and disease: A major review

Publication date: July 2019

Source: Annals of Anatomy - Anatomischer Anzeiger, Volume 224

Author(s): Mohammad Javed Ali, Friedrich Paulsen

Abstract
Purpose

To provide a systematic review of the literature on the ultrastructural findings of the lacrimal drainage system in healthy state and in few of the disorders studied so far.

Methods

The authors performed a PubMed search of all articles published with reference to electron microscopic features of the lacrimal drainage pathways. Data captured include demographics, study techniques, scanning or transmission electron microscopic features, presumed or confirmed interpretations and their implications. Specific emphasis was laid on addressing the lacunae and potential directions for future research.

Results

Ultrastructural studies have led to better understanding of the lacrimal drainage anatomy-physiology correlations. Cellular interactions between fibroblasts and lymphocytes could form a basis for pathogenesis of punctal stenosis. Ultrastructural characterization of peri-lacrimal cavernous bodies and changes in primary acquired nasolacrimal duct obstruction (PANDO) led to them being partly implicated in its etiopathogenesis. Electron microscopic characterization of the dacryolith core promises insights into their evolution. Ultrastructural tissue effects of mitomycin-C during a DCR surgery has provided potential evidence of its role in cases with high-risk of failure. Lacrimal stent biofilms are common but their clinical implications are currently uncertain.

Conclusion

Ultrastructural exploration of lacrimal drainage system so far has been limited and sparsely explored. The list of unexplored areas is exhaustive. There is a need for the lacrimal Clinician-Scientist to make themselves familiar with techniques and interpretation of electron microscopy to advance the ultrastructural frontier of this science.



Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
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