bluuebunny/crossref_metadata_2025 huggingface dataset:
Cervical C2 hemisection acutely induces swallow hyperreflexia
Authors: Huff Alyssa , Greene Clint , Cheffer Kimberly A , O'Steen Wilbur A , Howland Dena R , Pitts Teresa
Published: November 2023

The effects of cervical hemisection on swallow have not been determined. We hypothesized that cervical hemisection would increase swallow excitability and shift the pattern of swallow breathing coordination to maintain pharyngeal clearance. Electromyograms of the mylohyoid, geniohyoid, thyrohyoid, thyroarytenoid, thyropharyngeus, cricopharyngeus and diaphragm (costal and crural) muscles were recorded in anesthetized, spontaneously breathing anesthetized cats prior to and after a C2 hemisection. Swallow was elicited by infusion of 3ccs of water into the oropharynx. Acute C2 cervical hemisection significantly increased EMG amplitudes across all upper airway muscles during swallow, and swallow frequency increased from 3.3 ± 1.2 to 8 ± 1.4 per infusion. Significant changes in swallow‐breathing coordination were noted with all swallows occurring in E1 (as opposed to late E2), significantly increasing the risk for potential aspiration. These results support a theory of spinal cord inhibition/modulation of the swallow pattern generator and upper airway muscle excitability, as well as the importance of its role in swallow/breathing integration.

Support or Funding Information

Supported by R00‐HL 111215, The Kentucky Spinal Cord and Head injury Trust, The Commonwealth of Kentucky Challenge for Excellence, the Rebecca F Hammond Trust and RCS‐VA RR&D B9249S. The contents of this abstract do not represent the views of the DVA or US government.
Activation of esophageal mechanoreceptors alters the pharyngeal phase of swallow
Authors: Brown Alyssa , King Suzanne N , Poliacek Ivan , Pitts Teresa
Published: November 2023

The effects of esophageal mechanoreceptors on the pharyngeal phase of swallow have not been determined. We hypothesized that rapid activation of esophageal mechanoreceptors would increase swallow excitability to ensure successful movement of the bolus from the pharynx into the esophagus. Electromyograms of the mylohyoid, geniohyoid, thyrohyoid, thyroarytenoid, thyropharyngeus, cricopharyngeus and costal diaphragm were recorded in 8 spontaneously breathing cats. Swallow was elicited by infusion of water into the oropharynx and mechanoreceptor activation was produced by distension of a balloon in the upper third of the esophagus. Esophageal distension alone produced swallows in all animals in at least 1 trial. Trials in which the esophagus was distended while water was infused in the mouth had increased swallow‐related EMG recruitment of all recorded muscles compared to swallows produced by distension alone (p<.05). Water alone increased swallow‐related EMG recruitment on supra‐hyoid muscles (mylohyoid and geniohyoid) compared to esophageal distension alone (p<.05). Swallow duration was unchanged across all conditions. These results support a theory of esophageal afferent feedback modifying the excitability of the pharyngeal phase of swallow, and could be a novel therapeutic target in patients with dysphagia.

Support or Funding Information

Supported by R00‐HL111215, the Kentucky Spinal Cord and Head injury Trust, and The Commonwealth of Kentucky Challenge for Excellence.
Ovalbumin – Induced Airway Inflammation Enhances Hypoxic Ventilatory Response In Rats
Authors: Broytman Oleg , Brinkman Jacqueline , Pegelow David , Morgan Barbara , Teodorescu Mihaela
Published: November 2023

Rationale

Patients with asthma have an increased risk of developing obstructive sleep apnea (OSA). However, the underlying mechanisms are unknown. Allergen‐induced airway inflammation may affect control of breathing through cytokine signaling in the chemoreceptors or through mechanoreceptor feedback from lungs. We tested the effects of allergen induced lower airway inflammation on the hypoxic ventilatory response.

Methods

Brown‐Norway rats (n=4–6/group) were sensitized to ovalbumin (OVA) or saline (SAL) via subcutaneous injection. All animals were challenged with nebulized 1% OVA solution. Ventilation under room air, moderate hypoxia (12% FiO2) and severe hypoxia (9% FiO2) was measured by awake/behaving plethysmography 24 hours after OVA challenge. Ventilatory oxygen (V̇E/V̇O2) and carbon dioxide (V̇E/V̇CO2) equivalents were calculated. Measurements were repeated after 20 minutes exposure to nebulized formoterol. Negative Pressure Forced Expiration (NPFE) maneuvers, before and after formoterol, were performed on anesthetized animals, 48 hours after OVA challenge. Serum OVA‐specific IgE levels were measured using sandwich ELISA. Two‐way (± Repeated Measures) ANOVA was used to compare the groups.

Results

OVA‐sensitized animals had 1) elevated V̇E/V̇O2 during moderate hypoxia (p=0.003); 2) significantly higher slope of V̇E/V̇O2 response to moderate hypoxia (p=0.039), compared to SAL‐sensitized animals. These effects were augmented by formoterol. 3) After formoterol administration, OVA‐sensitized rats also mounted steeper V̇E/V̇CO2 responses to both moderate and severe hypoxia (p=0.012 and p=0.016, respectively), compared to SAL‐sensitized controls. 4) Formoterol significantly increased forced expiratory volume (FEV0.1/FVC) during NPFE measurements (p=0.04). 5) OVA‐specific IgE levels were significantly elevated in sera of OVA‐sensitized animals (p=0.036).

Conclusions

Our results suggest increased chemoreceptor loop gain in animals with OVA‐induced lung inflammation, which may involve the carotid body. Data suggest asthma patients may be prone to hyperventilation in response to hypoxia, which could lead to hyperventilation‐induced apneas during sleep. These effects appear mediated in part via pathways independent of alterations in lung mechanics. Further studies will be needed to understand these pathways and how to intervene to attenuate them.

Support or Funding Information

Supported by University of Wisconsin Department of Medicine Pilot Funding.
Isolated bullfrog rostral brainstems exhibit a DAMGO‐insensitive lung‐like episodic rhythm in the presence of bicuculline
Authors: Reed Mitchell , Iceman Kimberly , Harris Michael , Taylor Barbara
Published: November 2023

Respiratory behavior in terrestrial animals is primarily controlled via neural circuits in the medulla. A site in the amphibian rostral medulla at the level of the abducens nerve (CN VI) is believed to be homologous to the pre‐Bötzinger complex in mammals. The μ‐opioid agonist DAMGO has a suppressive effect, and the GABAA receptor antagonist bicuculline has an excitatory effect on lung activity in mammals and amphibians. However, the locations of action in amphibians are unknown. Therefore, we examined the effect of DAMGO and bicuculline on isolated rostral brainstem tissue.

We isolated brainstems from bullfrog tadpoles, placed them in a recording chamber, and allowed them to recover for 1 hour perfused with artificial cerebral spinal fluid (aCSF) equilibrated with 98.5% O2 and 1.5% CO2 (pH 7.8). During this time, neural activity from the facial (CN VII) and hypoglossal (CN XII) cranial nerves was recorded. Following recovery, brainstems were transected just rostral to the trigeminal (CN V) nerve, and at the level of the glossopharyngeal nerve (CN IX), removing the caudal medulla. Then activity from the trigeminal (CN V) and facial (CN VII) nerves was recorded. A cocktail containing either DAMGO (120 nM) and bicuculline methochloride (5 μM) or bicuculline alone was subsequently bath applied for 30 minutes.

The transection alone resulted in a loss of discernable respiratory rhythm. However, bicuculline application caused a lung‐like episodic rhythm to reappear. Contrary to the suppressive effect DAMGO has on lung activity in other preparations (including intact isolated amphibian brainstems), this rhythm was not affected by the addition of DAMGO in our transected preparation. This work informs the comparison of amphibian and mammalian respiratory oscillators and the consideration of their homology and differences.

Support or Funding Information

NIH under Award Numbers UL1GM118991, TL4GM118992, or RL5GM118990.
The Effect of Equilibriative Nucleoside Transporter 1 on Pseudomonas Aeruginosa‐Induced Acute Lung Injury
Authors: Chambers Eboni Delorse , Healy Abigail , Morrison Alan , Rounds Sharon , Lu Qing
Published: November 2023

Acute lung injury (ALI) is hallmarked by lung edema, excessive inflammation, and respiratory failure resulting in 40% mortality. Multidrug resistant Pseudomonas aeruginosa (P. aeruginosa) infections often cause ALI in patients with compromised immunity. It is well established that Adenosine, a signaling nucleoside increased upon tissue injury, has been shown to protect against ALI through activation of adenosine receptors (ARs). Extracellular and intracellular adenosine concentrations are regulated by equilibriative nucleoside transporters (ENTs). Whether altering adenosine signaling and uptake can prevent or treat bacterial P. aeruginosa‐induced ALI is unknown. We hypothesize that ENT1 inhibition will increase extracellular adenosine and protect against P. aeruginosa‐induced ALI via activation of ARs. ENT1 pharmacological inhibitors and null mice were used to determine the effects of ENT1 inhibition on P. aeruginosa‐induced ALI. We found that P. aeruginosa infections induced ALI in C57BL/6 mice in a dose dependent manner. Pharmacological inhibition of ENT1 via NBTI significantly attenuated P. aeruginosa‐induced ALI, as assessed by wet‐to‐dry lung weight, bronchoalveolar lavage (BAL) protein levels, BAL inflammatory cells, and pulmonary function determined by static lung compliance, tissue damping, and tissue elastance. NBTI also increased bacterial clearance in mice infected with P. aeruginosa. Additionally, NBTI attenuated P. aeruginosa‐induced IL‐1β levels in the BAL of mice. Consistent with ENT1 pharmacological inhibitor data, ENT1 null mice attenuated P. aeruginosa‐induced ALI as assessed by BAL protein and BAL cell counts. Finally, agonists of A2AR and A2BR mimicked NBTI blunting of P. aeruginosa‐induced ALI, whereas, antagonists against A2AR or A2BR diminished the protective effect of NBTI inhibition on P. aeruginosa‐induced ALI. These results suggest that inhibition of ENT1 protects against P. aeruginosa‐induced ALI via adenosine‐mediated activation of A2AR and A2BR. Inhibition of ENT1 may be a novel approach to prevent and treat P. aeruginosa‐ induced ALI.

Support or Funding Information

This work was in part supported by NIGMS P20GM103652 to S. Rounds and Q. Lu, RO1 HL130230 to Q. Lu, PULM‐019‐14F to S. Rounds, and NIEHS T32 ES007272 to E. Chambers.
Bioactive Fibrin Scaffolds for Use in Regenerative Medicine
Authors: Braga Sarah Felicio , Aquino Renata , Carvalho Antonio , Trovatti Eliane , Iemma Mônica , Amaral André Capaldo
Published: November 2023

Regenerative medicine has been shown to be a promising approach for treatment of musculoskeletal injuries, using as biological strategies scaffolds, cell therapy and biomolecules. The autologous fibrin matrix, derived from leukocyte (LEU) and platelet (PLA)‐rich plasma (L‐PRP) and LEU and PLA‐rich fibrin (L‐PRF) techniques, presents a great potential to act as a bioactive support in regenerative medicine, being able to contribute with the intrinsic maintenance of the cellular viability, stimulation of proliferation and the repopulation potential in the injury site. The aim of this research was to characterize the intrinsic cell viability maintenance potential of different bioactive fibrin scaffolds containing PLA and LEU. For such, blood samples from 3 male volunteers were collected and processed to obtain fibrin clots from the L‐PRP and L‐PRF techniques, using a fibrin matrix devoid of PLA and LEU as a control. In order, to characterize the in vitro viability potential, the human fibroblast cell line (MG07492) was used. After the sowing procedure (104cells), the scaffolds were maintained for 5 days in standard culture conditions in serum‐free Dulbecco's Modified Eagle Medium and subsequently submitted to analysis by scanning electron and fluorescence microscopy. The results demonstrated a distinct potential to promote intrinsic viability between L‐PRP and L‐PRF scaffolds, with L‐PRP responsible for the highest levels of viability. No cells were identified in the fibrin matrix used as control. These results allow the conclusion that fibrin scaffolds from the L‐PRP and L‐PRF techniques present intrinsic cell viability potential and represent promising alternatives for use as bioactive scaffold in musculoskeletal regenerative medicine.

Support or Funding Information

CNPq‐ Conselho Nacional de Desenvolvimento Científico e Tecnológico.
Student Performance in and Perception of Gross Anatomy in Varied Curricular Material Organization in Multiple Cohorts
Authors: Thompson Kristjan L
Published: November 2023

PURPOSE

The first and second year curriculum at Mercer University School of Medicine provides students an opportunity to learn the subject material in a Problem Based Learning case format. The Musculoskeletal Phase provides students with their first Gross Anatomy Laboratory dissection experience. This study looks at student performance when one group of students followed a case order that paralleled the laboratory dissection sequence (Dissection) compared to that of one which did not (Traditional). This study also evaluated student perception of their learning experiences in the Anatomy Laboratory.

RESULTS

Study participants were found in two different cohorts (2017 and 2018 graduating classes). Students in the Dissection group (n=132) scored a Gross Anatomy average of 78.15 and an overall phase average of 79.39. Students in the Traditional group (n= 81) had a Gross Anatomy average of 79.98 and an overall Phase average of 79.88. The results indicate that the case order presentation does not significantly alter the overall student performance within the discipline (p= 0.178) or the Phase (p= 0.566). One hundred thirty out of the 213 students participated in the survey assessing their perception of the learning experience within the Phase. Students felt laboratory was helpful in learning the phase material and that they would prefer to dissect in the same order as the PBL cases were presented. Those students within the Dissection group felt more prepared for laboratory experiences compared to their Traditional order counterparts.

CONCLUSIONS

Order of case presentation does not have an effect on student performance in the discipline or examination as a whole.
Correlation of Brief COPE and Academic Performance in First Year PA and Dental Students During Human Structure Course
Authors: Thiessen Amy S , Halliday Nancy
Published: November 2023

Purpose

The purpose of this study is to examine the relationship between items of the Brief COPE and exam grades. This correlation data can be used to help identify students that may lack key strategies needed for academic performance.

Methods

Students were administered the Brief COPE survey after exams. Participation was voluntary. The survey was administered online for convenience and anonymity. Data analysis included two‐tailed t test of individual survey items and exam score. Correlations between Brief COPE items was also done.

Results

Reports of high rates of self‐criticism had decreased exam scores. Reporting self‐criticism also has a correlation to disengagement and denial. Substance use as a coping strategy was correlated to disengagement.

Discussion

Students using poor coping and help strategies had reduced academic performance. Identification of these students can improve academic and social intervention and early identification of at risk students.

Support or Funding Information

University of Oklahoma Health Sciences Center

College of Medicine

Oklahoma City, Oklahoma

University of Oklahoma Norman

College of Education
Introductory Anatomy Laboratory Teaching, Correlations Between Contact Hours and Student Success
Authors: Oh Alice Joowon , Georger Lesley , Rokitka Elizabeth M , Holz Jonathan , Olivieri Nina R , Stephen Frank , Olivieri Marion P
Published: November 2023

Anatomy is a critical subject for medical and health care education. Many colleges require minimum grades, only some schools allow repeating courses without penalty. The high stakes cause borderline students, often underclassmen, to withdraw to avoid low grades. Those that master the subject have better opportunity to earn admission into desired programs, while others have to face reassessment of career and life goals while potentially dealing with academic, scholarship and financial aid probations or dismissal from programs and/or college sometimes indefinitely. Repeating courses may impact student indebtedness, financial aid access, full‐time status, scholarships, and graduation conferral dates.

Effective teaching methods continue to be debated among educators. At D'Youville College, introductory anatomy laboratory classes have traditionally employed full‐time faculty utilizing models, slides, digital images and student cat dissection. During the fall semester of 2014, without adding material, an additional hour was added to the laboratory sessions. In 2015 peer‐tutor availability was increased during open laboratory sessions. In 2016, with addition of a new anatomy masters program, the masters candidates were employed as assistants in the teaching laboratories and to proctor open laboratory sessions often on the weekends. The objectives are to prepare better anatomy teachers as well as improve the success rate of our students. Each laboratory section includes a masters degree candidate to work alongside the faculty to assist students. In order to indicate relationships between the feline dissections and human anatomy, during class, the graduate students present a pro‐section of a human cadaver for comparison.

With the added contact time, z‐tests indicated a statistically significant difference (p< 0.0001) in the withdrawal rate that was reduced from 36% to 21%. Comparing the combined fall 2013 and 2014 withdrawal rate to the combined fall 2015 and 2016 it is shown that increasing the contact hours of the faculty and graduate students inside and outside the classroom is associated with an increase in student course completion.

Support or Funding Information

Work supported by the Department of Biology and Mathematics, D'Youville College.
Student Perception of the Value of Previous Anatomy Coursework on Medical Gross Anatomy
Authors: Robertson Ellen , Thompson Kenneth , Notebaert Andrew
Published: November 2023

Medical schools in the United States generally do not require the taking of Anatomy as a prerequisite course. Previous studies have shown that approximately half of incoming medical students have had some exposure to Gross Anatomy prior to beginning. In our previous look at medical students at the University of Mississippi Medical Center (UMMC) we found that the half of the students that do have anatomy prior to medical school perform better on the Medical Gross Anatomy course in the first semester. The purpose of this research is to better understand the relationship with pre‐requisite courses and their corresponding coursework in professional programs. From this we hope to determine what elements of this prior coursework contributes the most to student success.

An initial survey was given at the start of the UMMC Gross Anatomy course that collected both quantitative data (demographics and previous anatomy course grades) and qualitative data through questions regarding the students' perceptions of how their previous coursework would assist them in the course. Responses were analyzed using a constant comparative method which analyzed responses in one survey, proceeding to subsequent surveys looking for differences and revisiting prior surveys as necessary. Twenty‐nine Initial codes were created from student responses. These codes were then analyzed into predominant themes regarding each questions. Grade prediction data were analyzed with a Chi square test with previous anatomy exposure to examine any trends. The survey was completed by 143 students out of 148 enrolled, and 97 (66% of the class) reported having previous anatomy coursework. In response to questions about the value of previous anatomy, responses were coded into six main themes: content, learning strategies & time management, anatomical terminology & language, deeper understanding, dissection & techniques, and no perceived benefit. The previous anatomy experience for these students included high school level courses, undergraduate courses, graduate courses, and summer pre‐medical intensives. The predominant themes of the responses point to the importance of anatomy vocabulary, exposure to the content, and a strong feeling that many previous courses do not provide a benefit. Student responses for grade prediction illustrated that students who have previously had anatomy coursework predicted a grade of “A” 20% more often than those who had not had any experience. Looking forward, these responses can guide how educators design the initial class sessions in an anatomy course to facilitate meeting the students where they perceive they are in terms of preparation. Future directions for the research are to complete post course surveys and subsequent grade analysis to better understand the impact and perceived benefits of the previous coursework through comparison of responses after course completion and course grades.
PERCEPTION OF BODY DONATION AMONG AFRICAN AMERICANS
Authors: Werede Ayoda , Thompson Brent
Published: November 2023

INTRODUCTION

The use of cadavers for anatomical studies has long been an important component of medical education. To supply the needed cadavers, most medical schools rely on people donating their bodies upon death. Very few studies examining the demographics of body donors exist and they indicate that the majority of donors tend to be Caucasian males, leading to a lack of racial diversity among cadavers in the anatomy lab. The goal of this study is to understand why minorities, more specifically African Americans, do not participate in whole body donation programs. Understanding factors or obstacles that play a role in influencing willingness to partake in body donation may aid in developing interventions that facilitate involvement amongst this demographic.

METHODS

Ongoing studies are examining attitudes, knowledge and cultural beliefs that may influence willingness of African Americans to participate in whole body donation programs. Ten focus groups, each consisting of 5 to 7 people, will be conducted at local Optimist Clubs in the Metro Detroit Area. At each meeting, demographic data regarding gender, age group, education level, income level, marital status, and number of dependents will be gathered prior to researcher‐led discussions on views about body donation.

ANTICIPATED RESULTS

We hypothesize that the low participation rates of African Americans in whole body donation programs are due a combination of factors including a mistrust of the medical profession, lack of awareness of donation programs, and religious or cultural beliefs surrounding death and the disposition of the body.

CONCLUSION

The results are expected to help us understand African American beliefs surrounding whole body donation.

Support or Funding Information

Oakland University William Beaumont School of Medicine
Dissection Opportunity Affects Student Performance on Gross Anatomy Practical and Lecture Examination Questions
Authors: Marshall Aaron , Thompson Andrew R.
Published: November 2023

The University of Cincinnati College of Medicine offers a Special Master's Program (SMP) designed to strengthen the academic credentials of students preparing to apply to U.S. medical schools. In this program, approximately 32 students each year participate in a select portion of the first year medical school curriculum with the M1 medical students. The intention is to provide an identical educational experience for both groups; however, logistical challenges have resulted in small curricular differences. One notable example is that SMP students study gross anatomy by viewing dissections that the medical students have already completed. Because SMP and medical students take identical examinations, there is an opportunity to evaluate the potential affect this difference had on examination performance. To investigate this, two years of practical and lecture‐based written examination data were considered. Anatomy lecture examination questions were classified into the following categories: information covered only in lecture (not part of any dissection), information covered only in the laboratory, and information presented in both contexts. Aptitude was controlled by comparing medical and SMP students' examination scores using Analysis of Covariance with MCAT scores entered as a covariate. This was possible because MCAT scores are required for both the SMP and medical program. Results showed that medical students scored significantly higher on gross anatomy practical examinations (F(1, 402)= 36.9, P<0.01). This trend continued on anatomy lecture examination questions, where medical students performed significantly better on questions derived from information covered only in the laboratory (F(1, 402)= 51.9, P<0.01). However, performance between SMP and medical students was not significantly different among questions derived from information presented only in lecture (P=0.94) or in lecture and laboratory (P=0.14). While other potential factors are discussed, these results suggest that the dissection experience is important not only for learning cadaveric material, but also for understanding anatomical relationships tested conceptually during lecture‐based written examinations.
The Minute Clinic: Increasing Student Engagement in an Undergraduate Systems‐Based Anatomy Course
Authors: Hill Cheryl A. , Aldridge Kristina , Holliday Casey M , Middleton Kevin M , Ward Carol V , Maiolino Stephanie A , Jorgensen Michael E
Published: November 2023

The undergraduate anatomy courses at the University of Missouri provide anatomical training to a large cohort of pre‐professional students including future radiology technicians, physical and occupation therapists, nursing and dentistry providers. Historically, systems‐based anatomy was often taught in isolation, and the students struggled to connect course content with future clinical scenarios, leading to reduced student engagement. To improve student engagement and retention of course material, a new laboratory curriculum integrating clinical scenarios was developed in 2015. Named after the walk‐in primary care clinics which have recently gained popularity as a healthcare option, the in‐laboratory Minute Clinics are short presentations of common disorders correlated with the week's topic. The presentations incorporate descriptions of symptoms, relevant diagnostic imaging and brief discussion of treatment options. Other clinical applications within the curriculum included donor stations, clinical anatomy in‐lab worksheets and clinical stems on exam questions. Assessment of the curriculum included exam performance, student evaluations and instructor feedback. Results indicate that use of clinical stems in exam questions did not significantly change exam performance. However, the integration of clinical scenarios into the curriculum increased student engagement, leading to improved attendance, positive student evaluations and enriched instructor‐student relationships.
Inside Dinosaurs: A Broader Impacts Program for Research, Teaching and Public Education Through Dinosaur Biology, Physics and Evolution
Authors: Holliday Casey M , Hill Cheryl A , Davis Julian L , Witmer Lawrence M , Middleton Kevin M
Published: November 2023

Inside Dinosaurs is a NSF‐funded, multi‐pronged broader impacts program that immerses undergraduate research interns, secondary‐school science teachers, and the public in evolution, biomechanics and avian origins through a series of parallel and complementary activities. It incorporates STEM disciplines and offers opportunities for graduate and undergraduate lab members to interact with the local public and grade 6–12 teachers through science communication and outreach activities. Besides annual REU lines for University of Missouri undergraduates, we host two undergraduates from other institutions each summer to learn new experimental, modeling and anatomical techniques. Additionally, we recruit a local teacher each summer who, while embedded in the lab, conducts research and helps translate our discoveries into secondary school‐ level learning activities that fit within the Next Generation Science Standards. Together, the PIs, students, and teachers are developing and testing new classroom activities that are disseminated to interested Missouri teachers through a series of workshops. Besides these intense, lab‐based interactions, Inside Dinosaurs sponsors the Dinosaurs and Cavemen Science Expo, a pop‐up natural history museum exhibit that hosts two dozen activities put on by over thirty faculty and students and experiences crowds from 500–1000 people each year. These synergistic activities among faculty, teachers and visiting students help design and develop more specific learning activities to help bring paleontology, biomechanics, and anatomy to Central Missouri and the rest of the country.

Support or Funding Information

NSF IOS 1457319
Anterior Components Separation (ACS) by Endoscopic Pathway: Alternative Pathway to Approach the Abdominal Wall
Authors: Barros Mirna Duarte , Roll Sergio , Nishio Ricardo Tadashi , Silva Rodrigo Altenfelder , Ayres Neto Daniel P. , Mendes Carlos José Lazzarini
Published: November 2023

Introduction

The abdominal wall hernias constitute a great challenge to the surgeon. The Giant, classified with a hernia orifice greater than or equal to 10cm, and the Complex, associated with diseases, infection, digestive or urinary ostomies present complications in the reconstruction of the abdominal wall. Primary closings with sutures, relaxing incisions in aponeuroses, positioning of supraponeurotic, bridge, subaponeurotic and intraperitoneal prosthetics, in addition to the shifting of the wall muscles, by open surgery or laporoscopy (robotic or not), are part of the alternatives for restitutio ad integrum of the wall. Knowledge of the stratigraphy of the wall allowed for the sectioning of muscles and aponeuroses, now called components. The Anterior Components Separation (ACS), described in 1990, is the sectioning of the aponeurosis of the external oblique muscle, parallel to the lateral border of the rectus abdominis muscle, in the craniocaudal direction, which is detached from the internal oblique muscle. For adequate execution of this technique, the lateral detachment of the skin and subcutaneous tissue is extensive, to the point of damaging the perforating vessels and paraumbilical branches of the lower epigastric artery, with ischemia and necrosis of the scar and umbilical region. The advent of video‐assisted procedures promoted access to these anatomical repairs. The objective of this study was to verify the viability of using a cadaver fixed in modified Larsen solution to perform ACS for teaching and training.

Method

The sectioning of the aponeurosis of the external oblique muscle was performed by means of a transverse incision of 12mm in the left iliac fossa, followed by divulsion by digitoclasy of the space between the internal oblique muscle and aponeurosis of the external, positioning the metal dilator, 10mm in diameter, in this space, promoting blunt dissection in the caudocranial direction to the left costal margin. Next came the insertion of 10‐mm optics at a 30‐degree angle, so as to visualize the aponeurosis and section it with Metzembaum scissors. To verify the efficacy of the procedure, two transversal flaps 25mm in depth were confectioned in order to demonstrate if the aponeurosis had been adequately sectioned or not (Figure 1).

Results

The external oblique muscle aponeurosis was adequately sectioned.

Discussion and conclusion

The ACS, perfectly performed by the video‐assisted method, diminished the quantity of detached and dissected tissue. We believe the procedure to be anatomically safe and that it effectively attends to the sectioning and shifting of the denominated components. The use of a cadaver fixed in modified Larsen solution presents a safe and reliable alternative for the teaching of video‐assisted anatomy and for the training of the resident surgeon.
To Model or Not to Model Embryonic Heart Development, that is the educational question
Authors: Blezinski Briauna , Richardson Alisa , Lee Lisa MJ
Published: November 2023

Embryology is one of the fundamental anatomical sciences subjects that integrates well with other basic sciences and seamlessly intersects with clinical domains. The topic of embryonic heart development is one such example. Knowledge in the 4‐dimensional complexity and molecular patterning involved in heart development can yield more competent management of congenital heart defects that affect approximately 1% of births each year. Unfortunately, contact hours for embryology education in medical and dental schools have remained at a minimal level for quite some time. Combined with the scant educational resources that effectively depict complex processes, embryology education faces critical challenges. To that end, a 3D virtual animation and 3D printed models were created to improve visualization and understanding of the heart developmental process. The goal of this study was to determine the educational value of the 3D virtual and printed models. Three different student populations (medical, dental and graduate) were recruited, each enrolled in anatomical science courses in the first year of their respective programs. Study participants completed a pre‐quiz prior to the interactive session with the 3D models followed by a post‐quiz and survey. Total of 61 students from the 3 cohorts completed the study. Quantitative analyses revealed a statistically significant increase in post‐quiz performance in all three cohorts (p<0.001). The increase in post‐quiz scores was not significantly different across the three cohorts (p = 0.64); suggesting that all participants improved approximately the same amount regardless of program affiliation. Qualitative analyses of the survey revealed more participants (79%) reporting that the 3D printed models enhanced their understanding of the heart development process, compared to the 3D virtual models (57.1%). Participants also reported that they would benefit from the use of 3D printed models (68.4%) and virtual animations (67.9%) depicting other embryonic processes. The results demonstrate that interacting with the 3D printed models and the 3D virtual animations can lead to learning in the absence of formal instruction. The survey results also demonstrate that there is a significant demand for visual and physical models in other embryonic developmental processes. Therefore, producing developmentally accurate embryonic models in both virtual and 3D printed platform will be an important next step in augmenting embryology education in health science programs.
3D Methods for Medical Education and Clinical Practice
Authors: Buynak Molly , Song Leonard K. , Dufeau David
Published: November 2023

New imaging technologies and 3D rendering software, in addition to being useful diagnostic tools, allow us to augment patient education and further medical student and physician knowledge. 3D imaging modalities such as CT and MRI expedite the learning process for medical students, allow physicians to better visualize the anatomy and potential pathologies present, and aid in educating patients to help them better understand their conditions. We present here 3D interpretations from a sample of CT imaging studies of the cerebral vasculature, optic neural pathways, and paranasal sinuses. These data were obtained from the National Institutes of Health (NIH) Cancer Database, among other sources. The raw imaging data was imported into a third‐party image analysis software called Amira, which was used to primarily facilitate 3D renderings. From there, the project images were further manipulated and enhanced utilizing other third‐party programs, including Autodesk, MeshMixer, Adobe 3D Toolkit, and Softwarecasa Camtasia Studio, so that they could be exported as 3D prints, interactive 3D PDFs, and 3D animations. Analysis of data, 3D rendering, and construction of the final products all took place in the Marian University College of Osteopathic Medicine 3D Research Lab. Our intent for the first step in using these projects for medical education includes making these 3D models available to first‐year gross anatomy curricula, with the goal of helping students better visualize structures that may otherwise be problematic to view in a cadaver. Our ultimate goal is to have 3D visualization technology incorporated into various facets of medical practice and education: for instance, this technology may help physicians incorporate 3D visualizations of various pathologies (e.g. exact locations of berry aneurysms) into their everyday practice and patient interactions.
Imaging and 3D Reconstruction of Anatomical Specimens as an Alternative to Traditional Learning Models
Authors: Inglis Stuart Donald , Tomaszewski John E , Dannenhoffer Raymond P
Published: November 2023

The use of wet prosections, plastinations, and plastic models have all been extensively used to facilitate learning in the gross anatomy laboratory, each method offering advantages and limitations. Advances in the field of 3D printing now offers an additional economical method for developing anatomical learning resources. Organs of interest were identified at the University at Buffalo and prosected to remove unwanted tissue that may have interfered with specimen imaging. Specimens were then scanned using CT and MRI imaging to develop DICOM stacks, and 3D models were generated using the 3D Systems ProJet 660Pro Printer. The use of 3D printing results in the mass replication of anatomical models, interesting anatomical variations, and pathological specimens that retain the details of the original specimens, but without the concerns associated with the storage and handling of wet prosections or plastinations.
Educational Advantages to the Use of Soft Fixed Cadavers
Authors: Smith Gregory
Published: November 2023

Conventional embalming techniques routinely rely on the use of aldehyde fixatives. The aldehydes keep bacteria in check and also cross link proteins together producing a firm specimen. The resultant specimens are stabilized and can be kept and used a room temperature for extended periods of time. This type of specimen has formed the backbone of most anatomy classes involving dissection. These specimens, however, are less than ideal for teaching true anatomy or most forms of surgery. That is because tissues are often accidentally destroyed during dissection and often times render planes of anatomy unidentifiable. They are also not pliable. Alternative fixative techniques have evolved over the last 40 years and have led the production of soft fixed cadavers. These specimens are produced with an embalming solution that minimizes the concentration of aldehydes, At Saint Louis University School of Medicine we have adopted this form of fixation to create surgical models. In this abstract we report the use of soft fixed cadavers to teach cricothyrotomy, laparoscopic cholectystectomy, laparoscopic appendectomy, hand assisted laparoscopic nephrectomy, thoracostomy, open nephrectomy, skin closure techniques, etc. The advantages to this technique is that the cadaver more closely mimics the experience that the trainee would encounter in a living human being. Also since they are not crosslinked, the anatomical planes are intact and more identifiable leading to a more credible experience. They are ideal models to simulate real surgery and we have used them to produce a series of videos for training purposes. A sample video will be shown during this poster presentation
Classification of Vallate Papillae Based upon Morphology and Other Associated Anatomical Features
Authors: Holmes J. Scott , Rickards Allen A. , Russell Michelle L , Bliss Kaitlyn N , Lynch Hannah L , Ganoe Maria R , Zdilla Matthew J. , Lambert H. Wayne
Published: November 2023

The vallate papillae, commonly referred to as circumvallate papillae, are lingual papillae located at the posterior dorsum of the tongue, which form a V‐shaped row immediately anterior to the sulcus terminalis. As the name suggests, vallate papillae are normally surrounded by a vallum, a small mound of tissues, which creates a sulcus (or trench) around the papilla. The inner surface of the vallum houses approximately half of the taste buds located within the tongue. Therefore, vallate papillae are important anatomical structures in gustation; however, little data exists regarding the gross morphology of the vallate papillae. In this study, 103 human cadaveric tongues were dissected at West Virginia University, with approval of the West Virginia Anatomical Board, to identify and photograph individual vallate papillae. A total of 1,069 individual vallate papillae were identified and characterized into thirteen separate categories, based upon their morphology and associated anatomical features. Categorization was largely based upon the presence of a vallum (691 of 1069; 64.6%), and whether the vallum fully encompassed the papilla or partly encompassed the papilla. Other categorization included whether the papilla itself was fully formed or segmented. The results of this study demonstrate a wide variety of morphological categories of vallate papillae. Because vallate papillae are important in gustation, the anatomical differences may partly explain physiological differences in taste function.

Support or Funding Information

Research by Holmes JS and Rickards AA funded by the WVU Initiation to Research Opportunities (INTRO) Summer Research program. Research by Russell ML, Bliss KN, Lynch HL, and Ganoe MR funded by WV Research Challenge Fund [HEPC.dsr.14.13].
FUNCTIONAL AND MORPHOLOGICAL CHARACTERISTICS OF EFFERENT BOUTON MITOCHONDRIA OF THE INNER EAR
Authors: Sobkiv Sofia , Kambalyal Anuj , Perkins Guy , Lysakowski Anna
Published: November 2023

Mitochondria are important organelles found in every cell of the body. The accepted structure of a mitochondrion consists of an outer and inner membrane (IM), the later folding in on itself forming structures known as cristae. The structure of the crista maximizes the membrane surface area over which cellular respiration occurs. Careful analysis of recent data gathered from electron microscopy has led to further investigation of structurally and functionally different subpopulations of mitochondria in the inner ear (Rabl et al., 2009; Zick et al., 2009). Further investigation suggests the presence of three different mitochondrial subpopulations: large mitochondria, medium‐sized mitochondria and small mitochondria, which are found in efferent boutons. The main focus of this study was the subpopulation in the efferent boutons, which are found contacting Type I and Type II hair cells of the inner ear. Utilizing IMOD software to obtain three‐dimensional (3D) reconstructions of efferent mitochondria in close proximity to high energy‐demanding structures, the morphological and functional characteristics of this subpopulation were studied. In a recent study (Perkins et al. 2010), it was discovered that cristae interact with the IM at specific points, termed cristae junctions (CJs). They also found that there were more CJs on the sides of mitochondria adjacent to synapses than on the opposite side, thus mitochondria appeared to be polarized. This suggests that Ca2+ and ATP are directed towards the synapse. Qualitative information gathered from our 3D reconstructions suggests that cristae are polarized towards similar high‐energy‐demanding structures such as the dense‐core vesicles, synapses and adjacent mitochondria found in efferent boutons contacting afferent calyces. In addition, the tubular form of cristae observed in efferent mitochondria are a lower‐energy form due to a lower capacity for dense ATP synthase molecule packing. Quantitative data included crista and IM surface areas, their respective volumes, and cristae junction counts. Key differences between efferent mitochondria and other subpopulations include the presence of tubular lower‐energy form of cristae, smaller average surface area and volume, and smaller quantities of ATP synthase molecular packing. The exact correlation between CJ count and the high‐energy‐demanding structures remains to be determined. Nonetheless, our 3D reconstructions suggest a unique relationship between such structures, as well as the CJs between neighboring mitochondria.

Support or Funding Information

Supported by NIH R21‐DC013181 (AL) and P41‐RR004050 (GP, ME)
MITOCHONDRIA NEAR RIBBON SYNAPSES IN INNER EAR HAIR CELLS
Authors: Ali Laila , Jayakumar Ashik , Perkins Guy , Lysakowski Anna
Published: November 2023

Mitochondria, generally referred to as the “powerhouses” of a cell, sustain life in eukaryotes by producing ATP. These structures, once thought to be bacterial symbionts, are now considered one of the most crucial organelles in the cell (van der Giezen, 2011). The mitochondrial inner compartment consists of two components, the inner membrane and the cristae. Recent EM tomography studies have shown us that these two membrane domains are connected by small tubular structures known as crista junctions (CJs). CJs “have been proposed to regulate the dynamic distribution of proteins, lipids, and soluble metabolites between mitochondrial subcompartments” (Zick et al. 2009). In our research, 3D models of mitochondria from vestibular hair cells were constructed from EM tomograms to understand the structural role of the cristae in neuronal activity at ribbon synapses. The cristae in the mitochondria serve as a site for a majority of the enzymes responsible for cellular respiration and ATP production, therefore playing an essential role in cellular activities, such as transmitting neuronal signals. A ribbon synapse is known to be a “‘high capacity docking site’ of synaptic vesicles that provide the fusion sites for ‘active zones’” (Schmitz et al. 1996). Synaptic ribbons are found in all hair cells. These synapses and the vesicles associated with them rapidly release neurotransmitters that carry messages between cells. These vesicles must be powered by an energy source such as ATP in order for them to transport and release neurotransmitters at the synaptic cleft. The objective of this study is to test the hypothesis that ribbon synapses require a large amount of energy to provide the power to transmit signals across synapses and that this energy is provided by mitochondria, which produce and contain large amounts of ATP. Cristae present in the mitochondrion, especially those in close proximity to synaptic ribbons, are oriented perpendicular to the ribbon and polarized towards the ribbon and its associated synaptic vesicles. By creating a 3D model of mitochondria near the synaptic ribbon, we have observed that multiple cristae in a single cell can provide the necessary energy. From our model, it is inconclusive about whether CJs are more prevalent on the side adjacent to the synaptic ribbon in vestibular hair cells.

Support or Funding Information

Supported by NIH R21‐DC01381 (AL) and P41‐RR004050 (GP, ME).