Anna Żurada

The study techniques of Asian, American, and European medical students during gross anatomy and neuroanatomy courses in Poland

BackgroundPast research in medical education has addressed the study of gross anatomy, including the most effective learning techniques, comparing the use of cadavers, dissection, anatomy atlases, and multimedia tools. The aim of this study was to demonstrate similarities and differences among American, Asian, and European medical students (MS) regarding different study methods and to see how these methods affected their clinical skills.MethodsTo analyze the varying study methods of European, American, and Asian MS in our program and in order to elucidate any ethnic and cultural differences a survey was conducted. A total of 705 international MS, from the Polish (PD), American (AD), and Taiwanese (TD) divisions, were asked to voluntarily participate in the questionnaire. Students were asked the following questions: which methods they used to study anatomy, and which of the methods they believed were most efficient for comprehension, memorization, and review. The questions were based on a 5-point Likert scale, where 5 was ‘strongly agree’, and 1 was ‘strongly disagree’.ResultsThe PD and AD preferred the use of dissections and prosected specimens to study anatomy. The TD showed less interest in studying from prosected specimens, but did acknowledge that this method was more effective than using atlases, plastic models, or CD-ROMs. Multimedia tools were mainly used for radiological anatomy and review and also for correctly typing proper names of structures using exact anatomical terminology.ConclusionThe findings highlight the differences in study techniques among students from different ethnic backgrounds. The study approaches used in order to accomplish learning objectives was affected by cultural norms that influenced each student group. These differences may be rooted in technological, religious, and language barriers, which can shape the way MS approach learning.

Three-dimensional morphometry of the A1 segment of the anterior cerebral artery with neurosurgical relevance.

BACKGROUND: Despite research in the anatomical sciences for the last 200 years, some structures of the human body remain controversial or incompletely described. One of these structures is the A1 segment of the anterior cerebral artery (ACA). OBJECTIVE: To analyze the A1 segment of the ACA using novel stereoscopic methods because the 3-dimensional morphometry of the ACA is important to neurosurgeons. METHODS: A digital-image computer-based system was used to analyze the A1 segment of 230 ACAs derived from computed tomography. Data analysis included the inner diameter, length, and volume and calculation of A1 symmetry, hypoplasia, and deviation, and tortuosity indexes. RESULTS: Hypoplasia of the A1 segment was found in 0.87% and only on the right sides, whereas asymmetry was found in 42.6% and was more common in female patients. Right A1 segments tended to be longer in male patients, and this reached significance. Also of significance was the correlation of an increased length with age. Right A1 segments tended to have greater volumes, and this was significant in a comparison of male and female patients. Tortuosity indexes tended to be greater for left sides, but deviation indexes tended to be greater on the right sides. CONCLUSION: Morphometric data of the A1 segment of the ACA as analyzed in the present study may be of utility to the neurosurgeon. Right A1 segments tend to be more tortuous, more deviated, longer, and narrower than left A1 segments.BACKGROUND Despite research in the anatomical sciences for the last 200 years, some structures of the human body remain controversial or incompletely described. One of these structures is the A1 segment of the anterior cerebral artery (ACA). OBJECTIVE To analyze the A1 segment of the ACA using novel stereoscopic methods because the 3-dimensional morphometry of the ACA is important to neurosurgeons. METHODS A digital-image computer-based system was used to analyze the A1 segment of 230 ACAs derived from computed tomography. Data analysis included the inner diameter, length, and volume and calculation of A1 symmetry, hypoplasia, and deviation, and tortuosity indexes. RESULTS Hypoplasia of the A1 segment was found in 0.87% and only on the right sides, whereas asymmetry was found in 42.6% and was more common in female patients. Right A1 segments tended to be longer in male patients, and this reached significance. Also of significance was the correlation of an increased length with age. Right A1 segments tended to have greater volumes, and this was significant in a comparison of male and female patients. Tortuosity indexes tended to be greater for left sides, but deviation indexes tended to be greater on the right sides. CONCLUSION Morphometric data of the A1 segment of the ACA as analyzed in the present study may be of utility to the neurosurgeon. Right A1 segments tend to be more tortuous, more deviated, longer, and narrower than left A1 segments.

Interactive 3D stereoscopic digital‐image analysis of the basilar artery bifurcation

The goal of this study was to analyze morphometrical variations of the basilar artery bifurcation (BAB), so that physicians could map out a patients anatomical structure prior to delicate neurosurgical procedures. The CT‐angio files of 98 patients ranging from 12 to 78 years of age were retrieved. These files were evaluated using Gradual Angiographic Image Data Analyzer (GAIDA) software, where a new interactive three‐dimensional (3D) stereoscopic visualization method was used to reconstruct computer images of the BAB complex. Subsequently the measurements of the BAB angles and BAB distances in relation to the dorsum sellae (DS), posterior clinoid processes (PCPs), and posterior biclinoid plane (PBP) were carried out. The average BAB angle was determined to be 117.7° (30.93°–172.2°). The three types of BAB were classified as type T with a BAB angle greater than 145° (mean 154.4°), type Y for an angle being equal or less than 145° but greater than 100° (mean 121.5°) and type V for angles less than 100° (mean 83.28°). The mean distances between BAB and DS (9.55 mm), BAB and left PCP (12.97 mm), and BAB and right PCP (13.01 mm), BAB and PBP (2.2 mm) were evaluated. Furthermore, the BAB is of great importance when examining basilar artery aneurysm development, particularly at the point of greatest hemodynamic stress, as well as the BAB distances in relation to the bony landmarks used for different approach methods in neurosurgical procedures. Clin. Anat. 21:127–137, 2008.

Three-dimensional morphometry of the A2 segment of the anterior cerebral artery with neurosurgical relevance

Most prior morphometry data regarding the A2 segment of the anterior cerebral artery (ACA) have been based on cadaveric measurements. With newer imaging modalities, surgical techniques, and minimally invasive procedures, new standards for the anatomy of this vessel are necessary. A novel computer‐based data system was used to analyze the three‐dimensional (3D) morphometry of 230 A2 segments. In addition, tortuosity (TI) and deviation indices (DI) for this segment were calculated. The mean internal diameter of the A2 segment was 1.86 mm, and segments tended to be larger in men and on left sides. A2 segments were asymmetrical in 43%, and this was more common in women. Lengths tended to be greater on right sides and in men. Volumes were greater in men and increased with age, which was statistically significant. These gender differences were found to be statistically significant (P < 0.05), for both volume and diameter. TI was equal among sides, but DI was more often greater on right sides. The correlation coefficient ratio for length and DI was statistically significant. It is important to understand various 3D morphometrical differences particularly between genders. By constructing blood flow simulation models and during revascularization procedures, surgeons are able to gain a better understanding of each patients vascular anatomy. These additional 3D data regarding the anatomy of the postcommunicating parts of the ACA may be useful to the neurosurgeon and interventional neuroradiologist. These data may assist with an earlier diagnosis of pathologies affecting the 3D morphology of the ACA. Clin. Anat. 23:759–769, 2010.

Three-dimensional morphometrical analysis of the M1 segment of the middle cerebral artery: potential clinical and neurosurgical implications.

With an increase in the understanding of the formation and treatment of cerebral aneurysms and an improvement in imaging technology, actual standardized measurement values for the cerebral arteries are necessary. Therefore, the aim of this study was to provide a detailed assessment of the three‐dimension (3D) morphology (vessels curvature and trajectory) and 3D‐morphometry of the M1 segment of the middle cerebral artery using computer tomography angiography (CTA) images. The DICOM files from CTA of 40 male and 75 female individuals with a mean age of 50.1 years were analyzed using an interactive postprocessing 3D volume‐rendering algorithm. Specifically, the M1 segment was evaluated. Calculations included the length, internal diameter, volume, deviation (DI) and tortuosity indices (TI). The M1 segment had a mean internal diameter of 2.23 mm and was greater in men. M1 asymmetry was identified in 23.4% of the individuals and was more common in women. The mean length was 15.62 mm and the left M1 segments were a little longer. The mean volume of the M1 segments was 63.92 mm3, and this was typically greater in men and on the left sides. The mean TI and DI for the M1 segment were 0.91 and 2.17 mm, respectively. Therefore, the M1 segments are only slightly curved or straight in their course. In addition, the longest vascular M1 segments are more deviated (curved) and more tortuous. Such standardized data as presented herein may be useful in the preprocedural evaluation of patients with intracranial vascular pathology of the M1 segment. Clin. Anat. 24:34–46, 2011.

The development of the aortic isthmus in human fetal life

Abstract Introduction The aortic isthmus is a specific feature of fetal circulation. It undergoes regression by becoming wider postpartum. Developmental abnormalities of an isthmus may lead to congenital defects. Aim The aim of this work was a morphometric study of the aortic isthmus in human fetuses aged between 4 and 8 months of fetal life. Materials and Methods We investigated 223 human fetuses, including 108 males and 115 females, aged between 4 and 8 months of fetal life. The entire material was obtained from the Department of Histology and Embryology at the Collegium Medicum, Nicolaus Copernicus University in Bydgoszcz, Poland. All fetal specimens had been conserved in a 9% formaldehyde solution for a period of more than 3 months. Only spontaneously aborted fetuses with a normal morphology and a normal karyotype were used in this study. We investigated the diameter of the aortic isthmus in human fetuses at different stages of prenatal life. We also analyzed the ratio of that diameter with regard to the diameters of other segments of the aorta and ductus arteriosus. We considered how these measurements varied depending on sex. Results, Discussion and Conclusions We found the growth of the aortic isthmus diameter to be linear in time. The measured diameters were similar in males and females. No significant differences with regard to sex were found between the ratios of that vessels diameter to the diameters of the ascending and descending aorta and the ductus arteriosus. The relative ratio of the aortic isthmus diameter to the diameters of the ascending and thoracic aorta decreased with time. On the contrary, the ratio of the aortic isthmus diameter to the ductus arteriosus diameter increased over time.

THE DEVELOPMENT OF THE AORTA IN PRENATAL HUMAN LIFE

Introduction. The anatomy and role of the aorta in prenatal life differ from those in postnatal life. Aim. We aimed at investigating the development of the aorta during a period between the 4 th and 8 th months of fetal life. We also analyzed the influence of sex on the values of the parameters examined. Materials and methods. We examined the diameters of aortas in 223 human fetuses, including 108 males and 115 females, aged between 4 and 8 months of prenatal life. The entire material was obtained from the Department of Histology and Embryology at the Collegium Medicum, Nicolaus Copernicus University in Bydgoszcz, Poland. All fetal specimens had been conserved in a 9% formaldehyde solution for a period of more than 3 months. Only spontaneously aborted fetuses of a normal morphology and a normal karyotype were used in this research. We measured the diameter of the proximal and distal ascending aorta, of the aortic arch, and of the proximal thoracic aorta. The measurements were taken in the following locations: the diameter of the proximal ascending aorta was taken at the level of the aortic valve; the diameter of the distal ascending aorta was taken at the ostium of the brachiocephalic trunk; the diameter of the aortic arch was taken between the ostium of the left common carotid artery and the left subclavian artery; the diameter of the proximal thoracic aorta was measured just beneath the arterial duct.

THE DEVELOPMENT OF THE PULMONARY TRUNK AND THE PULMONARY ARTERIES IN THE HUMAN FETUS

Abstract Introduction Up to date studies dealing with embryogenesis of the pulmonary trunk and arteries seldom analyze the anatomical variations between sexes and proportions of the pulmonary arteries dimensions. A large number of investigated subjects in our study enabled a detailed description of the growth of the pulmonary trunk and pulmonary arteries. Other studies involved fewer subjects. Aim We aimed at investigating the development of the pulmonary trunk and its branches, i.e., the left and the right pulmonary arteries, during a period between the 4th and 8th months of fetal life. Materials and Methods We investigated 223 human fetuses, including 108 males and 115 females, aged between 4 and 8 months of prenatal life. All fetuses had been conserved for a minimum period of 3 months in a 9% formaldehyde solution. All fetuses of a normal karyotype were obtained from spontaneous abortions and none of them revealed any external signs of malformations. We measured the diameters of the initial part of the pulmonary trunk and of the two main arteries: right and left pulmonary arteries. We determined the mean value of each assessed parameter for every age group, the rate of growth of particular vessels, the variations in these parameters with relation to sex, and the ratio between the left and the right pulmonary artery dimensions. For statistical analysis ANOVA, regression analysis, and Tukeys HSD post hoc test were used. Results, Discussion and Conclusions The growth of the diameters of pulmonary vessels (pulmonary trunk, left and right pulmonary arteries) is linear in time. The vessel dimensions do not differ with regard to sex. Only in the 5th month was the pulmonary trunk statistically significantly wider in female fetuses. The left pulmonary artery is smaller than the right one.

Tętnica strzemiączkowa u szczura: morfologia i zakres unaczynienia

Summary Objective The thorough knowledge about anatomy and morphology of the stapedial artery is of such importance to the laryngologist. In rat this artery persists throughout life. The following study was performed to analyze the morphology and course of stapedial artery in rat. Methods 30 Wistar rats weighing 300–400 g were used to analyze the stapedial artery. After the anesthetic induction with ether, the lethal doses of thiopental were administered. The stapedial arteries were dissected after latex injection and an immersion and preservation in 9% formalin solution. Results The stapedial artery branches off internal carotid artery and course through the stapes. After that it gives middle meningeal artery and continues in a bony canal laterally to the tegmen tympani. In the orbit stapedial artery gives off ophtalmic artery to supply mainly the orbit structures (muscles, lacrimal gland and eyeball) and the infraorbital artery with palatine artery. Additionally, the ophtalmic artery gives off the central retinal artery. Conclusion Our study reveals that the stapedial artery and its distal branches are the only vessels supplying all tissues of the orbit, including the eyeball in rats.OBJECTIVE The thorough knowledge about anatomy and morphology of the stapedial artery is of such importance to the laryngologist. In rat this artery persists throughout life. The following study was performed to analyze the morphology and course of stapedial artery in rat. METHODS 30 Wistar rats weighing 300-400 g were used to analyze the stapedial artery. After the anesthetic induction with ether, the lethal doses of thiopental were administered. The stapedial arteries were dissected after latex injection and an immersion and preservation in 9% formalin solution. RESULTS The stapedial artery branches off internal carotid artery and course through the stapes. After that it gives middle meningeal artery and continues in a bony canal laterally to the tegmen tympani. In the orbit stapedial artery gives off ophtalmic artery to supply mainly the orbit structures (muscles, lacrimal gland and eyeball) and the infraorbital artery with palatine artery. Additionally, the ophtalmic artery gives off the central retinal artery. CONCLUSION Our study reveals that the stapedial artery and its distal branches are the only vessels supplying all tissues of the orbit, including the eyeball in rats.

Ludwik Maurycy Hirschfeld (1814–1876)

It is rare to encounter exceptional individuals such as Ludwik Maurycy Hirschfeld. He was born into poverty and early on discovered his passion for medicine, particularly anatomy. His life is a testament to what pure human determination can achieve. He overcame societal and financial obstacles, ultimately becoming a physician, anatomist, and scientist. In 1834, Hirshfeld left Poland for France. His first exposure to medical anatomy came while under the direction of the great anatomist Professor Bourgery at École Pratique de Médicine. In 1848, he earned his degree in medicine and published his work “Des injections capillaires.” He coupled his love of anatomy with teaching and research. Hirschfelds skills, as a dissector, enabled him to prepare specimens for illustration, which produced some of the anatomy atlases of modern times. “The Descriptive Anatomy of the Human Body” is one of his most influential works. Dr. Hirschfeld pioneered the initial illustrations of the meninges of brain. There are many anatomical structures named after him, including Hirschfelds nerves and anastomoses. Hirshfeld remained as a professor until 1875. His death in 1876 was a great loss to the scientific community. His scientific accomplishments were astounding but he should also be remembered as a great humanitarian, an individual who offered medical treatment to the poor, and who strived to instill in his students a passion for anatomy. Clin. Anat. 21: 225–232, 2008.