Anatomists ; Anatomy, Cross-Sectional ; Europe ; Humans

Living donor liver transplantation has been associated with severe vascular complications like hepatic artery thrombosis, which commonly involves the hepatic segment 4. Most authors have defined the artery to this segment as the middle hepatic artery. The present study was undertaken to characterize the origin of middle hepatic artery and classify the variations observed in cadaveric livers, and also to analyze the significance (if any) of the findings in relation to living donor liver transplantation. The study was conducted on 125 adult livers, without macroscopic abnormalities, retrieved from human cadavers (age, 55-78 years; male, 77; female, 48) obtained from clinical wards. The hepatic arterial system was exposed, the origin of the middle hepatic artery was identified in each liver specimen and the variations observed in its origin were noted across all the specimen. Six types of hepatic arterial configurations were observed based on variations in the origin of middle hepatic artery, taking into consideration the presence of accessory hepatic arteries. It was noted in 19 (15.2%) livers that in the presence of an accessory left hepatic artery, the middle hepatic artery arose as a sub-branch of the right hepatic artery. Presence of the above hepatic arterial configuration in the donor could possibly be associated with an increased risk of intra-operative injury to the middle hepatic artery during right/left lobe living donor liver transplantation and this may subsequently lead to serious post-operative vascular complications like hepatic artery thrombosis.
Adult ; Arteries ; Cadaver* ; Female ; Hepatic Artery* ; Humans ; Liver ; Liver Transplantation* ; Living Donors* ; Male ; Thrombosis ; Tissue Donors

The review article attempts to focus on the practice of human cadaveric dissection during its inception in ancient Greece in 3rd century BC, revival in medieval Italy at the beginning of 14th century and subsequent evolution in Europe and the United States of America over the centuries. The article highlights on the gradual change in attitude of religious authorities towards human dissection, the shift in the practice of human dissection being performed by barber surgeons to the anatomist himself dissecting the human body and the enactment of prominent legislations which proved to be crucial milestones during the course of the history of human cadaveric dissection. It particularly emphasizes on the different means of procuring human bodies which changed over the centuries in accordance with the increasing demand due to the rise in popularity of human dissection as a tool for teaching anatomy. Finally, it documents the rise of body donation programs as the source of human cadavers for anatomical dissection from the second half of the 20th century. Presently innovative measures are being introduced within the body donation programs by medical schools across the world to sensitize medical students such that they maintain a respectful, compassionate and empathetic attitude towards the human cadaver while dissecting the same. Human dissection is indispensable for a sound knowledge in anatomy which can ensure safe as well as efficient clinical practice and the human dissection lab could possibly be the ideal place to cultivate humanistic qualities among future physicians in the 21st century.
Americas ; Anatomists ; Barber Surgeons ; Cadaver* ; Empathy ; Europe ; Grave Robbing ; Greece* ; Human Body ; Humans* ; Italy ; Schools, Medical ; Students, Medical ; United States

Johannes Nathanael Lieberkühn was a prodigious anatomist whose meticulous experiments and precise detailing helped in comprehending the microscopic anatomy of digestive system during early part of eighteenth century. Notably, his inventions in the field of microscopy aptly complemented his quest for anatomical knowledge at microscopic level. He designed a reflector (Lieberkühn reflector) which enhanced the amount of focussed light leading to bright illumination of tissue specimen. He invented the solar microscope which provided excellent resolution of minute anatomical details.Lieberkühn discovered the digestive juice secreting tubular glands (glands of Lieberkühn) present at the base of intestinal villi producing epithelial invaginations (crypts of Lieberkühn). He also described the intricate juxtaposition of blood vessels in relation to a single intestinal villi. Moreover, through empirically designed experimental set up, Lieberkühn was able to demonstrate the flow of lymph from intestinal villi to collecting lymphatic vessels. Also, his grandiose collection of laboratory specimens involving vascular anatomy are a testimony of his untiring efforts in academia. His contributions were seminal in comprehending the anatomy of digestive system and paved the way for future revelations. His work unveiled the enormous scope of microanatomy in medical science and catalysed the advent of histological staining methods a century later.

Camillo Golgi was an extraordinary scientist whose contributions in the domain of neuroanatomy proved to be critical for emergence of neuroscience as a sovereign scientific discipline. Golgi’s invention of the Black Reaction (La reazione nera) was a watershed event as it allowed remarkable visualization of the organizational pattern of elements of nervous system among complex puzzle of close knit interconnections. Till this time thin filamentary extensions of neural cells (axon and dendrites) could not be visualized with available staining techniques because of their slender and transparent nature.However invention of Black Reaction and its subsequent application demystified the basic architecture of brain tissue which was now visible to the scholars in all its complexity in microscopic studies. Golgi is also credited with the discovery of two types of sensory receptors in muscle tendons: Golgi tendon organ and Golgi-Mazzoni corpuscles. Golgi was the first to be successful in staining myelin component of axon, which he used to discover the myelin annular apparatus. He identified the complete life cycle of Plasmodium (malarial parasite) in human erythrocytes. His research on histological details of human kidney highlighted the existence of juxtaglomerular apparatus. Later on Spanish scientist Santiago Ramón y Cajal, based on the use of Golgi’s Staining (Black Reaction) documented the morphologic details of nervous system in a more refined manner, which eventually led to the emergence of Neuron Doctrine. In recognition of their exemplary contributions in neuroscience Golgi and Cajal were jointly awarded the Nobel Prize for Physiology or Medicine in 1906.

Raymond de Vieussens was an exemplary anatomist who made seminal contributions in the field of cardiology. During initial part of his academic career, he adopted human dissection based experiments as medium of his research. This was in accordance with prevailing trend among anatomists during 17th century. He discovered the presence of tiny venous tributaries communicating between cardiac veins and chambers of heart (ducti carnosi/venae cordis minimae). He reported the existence of a collateral circulatory pathway between right and left coronary arterial systems (Vieussens arterial ring). He was the first to note the valve at the junction of great cardiac vein and coronary sinus (valve of Vieussens) and the prominent oval margin of the fossa ovalis (Vieussens Annulus). All his findings were associated with considerable clinical significance as evidenced in literature that followed. Vieussens accurately demonstrated the three-layered orientation of myocardium and gave a precise description of coronary arteries and their branches. At the onset of 18th century, buoyed by royal patronage from King Louis XIV of France, the second half of Vieussens illustrious career was defined by pathologic anatomy (autopsy based) and anatomo clinical correlations. This was a new trend initiated by Vieussens in anatomical research and was later adopted as a signature method by anatomists of 18th century. As a true connoisseur of cardiologic anatomy, Vieussens accurately charted the anatomo clinical correlations of cardiac tamponade, mitral stenosis and aortic regurgitation. His contributions were pivotal elements in metamorphosis of cardiology as a robust discipline of medicine in modern times.

The suprarenal arteries are arising from three sources: superior suprarenal artery, middle suprarenal artery, and inferior suprarenal artery. Variations in the arterial supply of the suprarenal glands in respect to origin and number are quite common and very frequently reported. The most common variation noted is in the inferior suprarenal artery followed by the middle suprarenal artery and the least common variations were observed in the superior suprarenal artery. Arteriogram of the inferior suprarenal artery is crucial in suprarenal tumour diagnosis but variation in the branching pattern and multiplicity of these arteries can cause hindrance in arteriography. The absence of middle suprarenal artery was seen to be associated with increased number of the inferior suprarenal artery. Variation in the multiplicity of arteries was observed more frequently in the inferior suprarenal artery and middle suprarenal artery which was more on the right side in most of the studies. Also, the variation in suprarenal arteries was often correlated to variations in inferior phrenic and gonadal arteries. The variations were observed to be more common on the left side therefore right adrenalectomy should be preferred over the left one. The loop formed by the inferior suprarenal artery around the right renal vein can cause venous obstruction. These variations of suprarenal vasculature are explained on the developmental basis, and prior knowledge of such variants is crucial for nephrologists to ensure minimum blood loss while performing laparoscopic adrenalectomy especially for large adrenal tumours and pheochromocytoma where the duration of surgery exceeds the usual.