Manners of terminology and description in Galen's anatomy in the ancient Rome and their historical consequences up to the modern time.

The oldest extant anatomy textbooks compiled in ancient Rome were by Galen who described in writing most of the various parts and organs of the body. History tells us that ever since the time of Galen, anatomical terminology would be a necessary and beneficial feature, but it also brought unexpected and annoying consequences into the field. The benefits are readily apparent in the case of muscle terminology. Galen identified more than 150 different kinds of skeletal muscles, most of which were unnamed, hence difficult to identify without professional knowledge of anatomy. Vesalius introduced detailed anatomical illustrations in Fabrica (1543), which made the identification of the muscles easier. Bauhin then introduced proper descriptive names for the muscles in Theatrum anatomicum (1605), which enabled the identification of the muscles without illustrations. After the terminology became complex and diverse, a logically consistent standard nomenclature was established by Nomina anatomica (1895). The unexpected consequences may be found in the terminology of bones and joints. Galen gave 39 proper names for individual bones, and classified and termed the types of bony joints. Many of these terms have survived in modern anatomy as literal translations of the bone terms, as well as the joint terms. The annoying consequences may be found in the terminology of intestines. Galen divided the small and large intestines into three portions, such that the major part of the small intestine suspended by the mesentery was divided into two without sufficient reason. The Latin translations of jejunum and ileum were, respectively assigned to them by Mondino in his Anatomia written in 1316.

The three layered structure of orbicularis oris and buccinator complex with partial connection at the modiolus and partial direct continuation.

PURPOSE: This study aimed to clarify the structural arrangement of the orbicularis oris (OOr), the buccinator, and the other perioral muscles around the modiolus. METHODS: The perioral muscles in seventeen cadavers fixed with formalin were dissected in situ and/or in isolated muscle specimens, and their layers were reconstructed schematically upon pantomographic view of the skeleton to evaluate their actions. RESULTS: The buccinator was composed of three parts including upper and lower oblique parts in its superficial layer and a middle transverse part in its deep layer. The superior and inferior OOr were composed of an inner marginal part (IM) and an outer labial part (OL) in each. The perioral muscles as a whole were arranged in three layers. The first layer consisted of the depressor anguli oris and the OL of superior OOr connected at the modiolus in a vertical direction. The second layer consisted of the upper and inner oblique part of buccinator and a part of the OL of inferior OOr connected at the modiolus in a horizontal direction. The third layer contained the middle transverse part of buccinator continuous with the IM of both OOr and a part of the OL of inferior OOr without connection to the modiolus. CONCLUSIONS: The different arrangement of the three layers of perioral muscles around the modiolus could serve as a good basis to predict the actions of the individual perioral muscles on the movement of lips in open/close of the oral fissure and widening/narrowing of the lip width.

Unique morphological architecture of the hamstring muscles and its functional relevance revealed by analysis of isolated muscle specimens and quantification of structural parameters.

The structural and functional differences of individual hamstrings have not been sufficiently evaluated. This study aimed to clarify the morphological architecture of the hamstrings including the superficial tendons in detail using isolated muscle specimens, together with quantification of structural parameters of the muscle. Sixteen lower limbs of human cadavers were used in this study. The semimembranosus (SM), semitendinosus (ST), biceps femoris long head (BFlh), and biceps femoris short head (BFsh) were dissected from cadavers to prepare isolated muscle specimens. Structural parameters, including muscle volume, muscle length, fiber length, sarcomere length, pennation angle, and physiological cross-sectional area (PCSA) were measured. In addition, the proximal and distal attachment areas of the muscle fibers were measured, and the proximal/distal area ratio was calculated. The SM, ST, and BFlh were spindle-shaped with the superficial origin and insertion tendons on the muscle surface, and the BFsh was quadrate with direct attachment to the skeleton and BFlh tendon. The muscle architecture was pennate in the four muscles. The four hamstrings possessed either of two types of structural parameters, one with shorter fiber length and larger PCSA, as in the SM and BFlh, and the other with longer fiber length and smaller PCSA, as in the ST and BFsh. Sarcomere length was unique in each of the four hamstrings, and thus the fiber length was suitably normalized using the average sarcomere length for each, instead of uniform length of 2.7 µm. The proximal/distal area ratio was even in the SM, large in the ST, and small in the BFsh and BFlh. This study clarified that the superficial origin and insertion tendons are critical determinants of the unique internal structure and structural parameters representing the functional properties of the hamstring muscles.

The History of Infectious Diseases and Medicine.

From ancient times to the present, mankind has experienced many infectious diseases, which have mutually affected the development of society and medicine. In this paper, we review various historical and current infectious diseases in a five-period scheme of medical history newly proposed in this paper: (1) Classical Western medicine pioneered by Hippocrates and Galen without the concept of infectious diseases (ancient times to 15th century); (2) traditional Western medicine expanded by the publication of printed medical books and organized medical education (16th to 18th century); (3) early modern medicine transformed by scientific research, including the discovery of pathogenic bacteria (19th century); (4) late modern medicine, suppressing bacterial infectious diseases by antibiotics and elucidating DNA structure as a basis of genetics and molecular biology (20th century, prior to the 1980s); and (5) exact medicine saving human life by in vivo visualization and scientifically verified measures (after the 1990s). The historical perspectives that these five periods provide help us to appreciate ongoing medical issues, such as the present COVID-19 pandemic in particular, and remind us of the tremendous development that medicine and medical treatment have undergone over the years.

Piezo2 expression and its alteration by mechanical forces in mouse mesangial cells and renin-producing cells.

The kidney plays a central role in body fluid homeostasis. Cells in the glomeruli and juxtaglomerular apparatus sense mechanical forces and modulate glomerular filtration and renin release. However, details of mechanosensory systems in these cells are unclear. Piezo2 is a recently identified mechanically activated ion channel found in various tissues, especially sensory neurons. Herein, we examined Piezo2 expression and regulation in mouse kidneys. RNAscope in situ hybridization revealed that Piezo2 expression was highly localized in mesangial cells and juxtaglomerular renin-producing cells. Immunofluorescence assays detected GFP signals in mesangial cells and juxtaglomerular renin-producing cells of Piezo2GFP reporter mice. Piezo2 transcripts were observed in the Foxd1-positive stromal progenitor cells of the metanephric mesenchyme in the developing mouse kidney, which are precursors of mesangial cells and renin-producing cells. In a mouse model of dehydration, Piezo2 expression was downregulated in mesangial cells and upregulated in juxtaglomerular renin-producing cells, along with the overproduction of renin and enlargement of the area of renin-producing cells. Furthermore, the expression of the renin coding gene Ren1 was reduced by Piezo2 knockdown in cultured juxtaglomerular As4.1 cells under static and stretched conditions. These data suggest pivotal roles for Piezo2 in the regulation of glomerular filtration and body fluid balance.

Relationship between the lumbosacral plexus deviation and 12th rib length in Japanese macaques (Macaca fuscata).

The relationship between the lumbosacral plexus (LSP) origin and the 12th rib length was recently determined in humans; cranial and caudal deviations of the plexus origin are related to shortening and elongation of the 12th rib, respectively. However, it remains unclear whether such anatomical correlations are also observed in non-human mammals. To address this issue, in the present study, we evaluated the LSP origin and the 12th rib length in Japanese macaques (Macaca fuscata). In typical cases, the femoral and obturator nerves were derived from both the 4th and 5th lumbar nerves, and the lumbosacral trunk was from the 5th to 7th lumbar nerves. Some of the LSPs exhibited a caudal deviation of their origins; the femoral and obturator nerves were also derived from the 6th lumbar nerve, in addition to the 4th and 5th lumbar nerves; the lumbosacral trunk lost the 5th lumbar nerve origin and arose from the 6th and 7th lumbar nerves. Individuals with the caudal deviation of LSP origin exhibited significant elongation of the 12th ribs, in comparison with individuals with the typical plexus. The present findings indicate that the caudal deviation of LSP origin was correlated to the 12th rib elongation in Japanese macaques, similar to humans. As a future studies, we need to clarify which mammalian groups exhibit such correlation between the deviation of the LSP origin and the lowest rib length, and further to provide evolutionary implications of this correlation.

Evolution of microneurosurgical anatomy with special reference to the history of anatomy, surgical anatomy, and microsurgery: historical overview.

This article reviews the evolution of microneurosurgical anatomy (MNA) with special reference to the development of anatomy, surgical anatomy, and microsurgery. Anatomy can be said to have started in the ancient Greek era with the work of Hippocrates, Galen, and others as part of the pursuit of natural science. In the sixteenth century, Vesalius made a great contribution in reviving Galenian knowledge while adding new knowledge of human anatomy. Also in the sixteenth century, Ambroise Paré can be said to have started modern surgery. As surgery developed, more detailed anatomical knowledge became necessary for treating complicated diseases. Many noted surgeons at the time were also anatomists eager to spread anatomical knowledge in order to enhance surgical practice. Thus, surgery and anatomy developed together, with advances in each benefiting the other. The concept of surgical anatomy evolved in the eighteenth century and became especially popular in the nineteenth century. In the twentieth century, microsurgery was introduced in various surgical fields, starting with Carl O. Nylen in otology. It flourished and became popularized in the second half of the century, especially in the field of neurosurgery, following Jacobson and Suarez's success in microvascular anastomosis in animals and subsequent clinical application as developed by M.G. Yasargil and others. Knowledge of surgical anatomy as seen under the operating microscope became important for surgeons to perform microneurosurgical procedures accurately and safely, which led to the fuller development of MNA as conducted by many neurosurgeons, among whom A.L. Rhoton, Jr. might be mentioned as representative.

Localization of the Lumbar Plexus in the Psoas Muscle: Considerations for Avoiding Lumbar Plexus Injury during the Transpsoas Approach.

INTRODUCTION: Transpsoas lumbar spine surgery is minimally invasive and has very good corrective effects. However, approach-side nerve complications delay post-operative rehabilitation. We anatomically investigated the localization of the lumbar plexus running in the psoas muscle. METHODS: We examined 27 formalin-fixed cadavers. The left-sided psoas muscle was extracted and cut parallel to the intervertebral disc at the L2/3, L3/4, and L4/5 disc levels. Using digitized photographs, we calculated the ratio of the distance from the front edge of the psoas muscle to the center of the lumbar plexus in the anteroposterior diameter of the psoas muscle (%). Then, we calculated the ratio of the distance from the lateral edge of the psoas muscle to the center of the lumbar plexus in the lateral diameter of the psoas muscle (%). RESULTS: The anterior-posterior lumbar plexus localization was 74.5 at L2/3, 74.7 at L3/4, and 81.2 at L4/5. There was a significant difference between L2/3 and L4/5 and between L3/4 and L4/5, but not between L2/3 and L3/4 (P=0.02, 0.01, and 0.94, respectively). The lateral and medial lumbar plexus localization was 85.4 at L2/3, 83.9 at L3/4, and 77.7 at L4/5. There was a significant difference between L2/3 and L4/5 and between L3/4 and L4/5, but not between L2/3 and L3/4 (P=0.01, 0.04, and 0.41, respectively). CONCLUSIONS: The lumbar plexus was localized in the posterior one-third and medial one-third of the psoas muscle and moved to a posterolateral location at L4/5. To avoid neuropathy, consider the psoas muscle's position relative to that of the intervertebral disc. It is essential to understand lumbar plexus localization in the psoas muscle when looking directly at this muscle to enter the pricking point or route with a lower risk of nerve damage.

Three-Dimensional Architecture of Glomerular Endothelial Cells Revealed by FIB-SEM Tomography.

Focused-ion beam-scanning electron microscopic (FIB-SEM) tomography enables easier acquisition of a series of ultrastructural, sectional images directly from resin-embedded biological samples. In this study, to clarify the three-dimensional (3D) architecture of glomerular endothelial cells (GEnCs) in adult rats, we manually extracted GEnCs from serial FIB-SEM images and reconstructed them on an Amira reconstruction software. The luminal and basal surface structures were clearly visualized in the reconstructed GEnCs, although only the luminal surface structures could be observed by conventional SEM. The luminal surface visualized via the reconstructed GEnCs was quite similar to that observed through conventional SEM, indicating that 3D reconstruction could be performed with high accuracy. Thus, we successfully described the 3D architecture of normal GEnCs in adult rats more clearly and precisely than ever before. The GEnCs were found to consist of three major subcellular compartments, namely, the cell body, cytoplasmic ridges, and sieve plates, in addition to two associated subcellular compartments, namely, the globular protrusions and reticular porous structures. Furthermore, most individual GEnCs made up a "seamless" tubular shape, and some of them formed an autocellular junction to make up a tubular shape. FIB-SEM tomography with reconstruction is a powerful approach to better understand the 3D architecture of GEnCs. Moreover, the morphological information revealed in this study will be valuable for the 3D pathologic evaluation of GEnCs in animal and human glomerular diseases and the structural analysis of developmental processes in the glomerular capillary system.

Anatomic characterization of the tibial and fibular nutrient arteries in humans.

The location of nutrient foramina has been extensively studied in long bones; however, accurate information on the origin and extra-osseous course of the nutrient artery remains clearly defined in some long bones, although it is crucial to protect the nutrient arteries during operative procedures. In this study, we elucidated the origin and extra-osseous course of tibial and fibular nutrient arteries based on the 54 cadaveric legs. The tibial nutrient artery typically arose from the posterior tibial artery. Some of the tibial nutrient arteries arose from the anterior tibial, popliteal, and fibular arteries. The tibial nutrient artery arose from these parent arteries as a long descending branch. It penetrated the most proximal portion of the tibialis posterior or flexor digitorum longus to enter the tibial nutrient foramen. The fibular nutrient artery arose from the fibular artery as a short descending branch in all the cases. The fibular nutrient artery penetrated the flexor hallucis longus to enter the fibular nutrient foramen. Our present and previous findings provide new insight into the anatomical characteristics for the nutrient arteries in the long bones of upper and lower extremities. Namely, the nutrient arteries of the long bones go away from the elbow or knee to enter the nutrient foramina.

Anatomical study of the soleus: Application to improved imaging diagnoses.

INTRODUCTION: Strains of the soleus are widely found both in amateur and professional athletes. For their accurate regional diagnoses, understanding the anatomy of the spatial relationship between muscular fibers and tendinous structures is important because their interfaces are susceptible sites to muscle strains. Therefore, this study evaluated the precise architecture of the soleus. MATERIALS AND METHODS: We evaluated the precise anatomical architecture of the soleus in 87 formaldehyde-fixed soleus muscles. To calculate mean relative physiological cross-sectional area of each muscular fiber compartment, we measured the fiber length, volume, and pennation angle in isolated compartments. RESULTS: The posterior soleus surface was covered by a broad aponeurotic posterior insertion tendon (PIT), which continued inferiorly to the insertion tendon. The anterior surface had three aponeurotic origin tendons, lateral origin tendon (LOT), medial origin tendon (MOT), and tendinous arch, which were arranged along the soleus margins. The anterior bipennate muscle portion (ABP), surrounded by the three origin structures, terminated as the sagittal insertion tendon (SIT), which continued inferiorly to PIT. The posterior main muscle portion behind LOT and MOT was separated into lateral and medial portions by the SIT. The soleus thus possessed a broad musculotendinous junction. Furthermore, ABP exhibited wide structural diversity in shape and size: in extreme cases, it was duplicated or absent. CONCLUSION: Systematic anatomical descriptions of the soleus will be useful for accurate regional diagnosis of its strains with magnetic resonance imaging and ultrasonography.

Nephrocytes are part of the spectrum of filtration epithelial diversity.

The excretory system produces urine by ultrafiltration via a filtration epithelium. Podocytes are widely found as filtration epithelial cells in eucoelomates. In some animal taxa, including insects and crustaceans, nephrocytes serve to separate toxic substances from the body fluid, in addition to podocytes. Drosophila nephrocytes have been recently utilized as a model system to study podocyte function and disease. However, functionality and cellular architecture are strikingly different between Drosophila nephrocytes and eucoelomate podocytes, and the phylogenetic relationship between these cells remains enigmatic. In this study, using focused-ion beam-scanning electron microscopy (FIB-SEM) tomography, we revealed three-dimensional architecture of decapod nephrocytes with unprecedented accuracy-they filled an enormous gap, which can be called "missing link," in the evolutionary diversity of podocytes and nephrocytes. Thus, we concluded that nephrocytes are part of the spectrum of filtration epithelial diversity in animal phylogeny.

Anatomic Analysis of the Attachment of the Posteroinferior Labrum and Capsule to the Glenoid: A Cadaveric Study.

PURPOSE: To measure the height of the posteroinferior glenohumeral ligament (PIGHL) attachment to the labrum and the depth of the posteroinferior labrum to the glenoid, macroscopically, and to investigate the morphology of the attachment of the posteroinferior labrum to the glenoid, histologically. METHODS: Fifty cadaveric shoulders without exposed subchondral bone on the glenoid and detached posterior labrum were used. We examined the frequency of the heights of the PIGHL attachments to the labrum and the length of the labral attachment on the glenoid rim at the 7, 8, 9, and 10 o'clock positions, macroscopically. According to morphology of the histological labral attachments, it was divided into 3 groups. Labra attached on the articular surface and the glenoid neck were defined as the SN type, while labra attached only to the glenoid neck constituted labra attached to the bone and side of the articular cartilage (Nc type) and labra attached only to bone (Nb type). RESULTS: The PIGHL attached from 7 o'clock to 9 o'clock in 48 shoulders (96%). The mean labral attachment at the 7 o'clock position was 6.3 ± 1.0 mm (range, 4.6-9.4 mm), which was significantly longer than at the other positions (P < .05). Histologically, the frequency of SN type attachment was 49 (98%) shoulders at the 7 o'clock position. CONCLUSIONS: The PIGHL attached between 7 and 9 o'clock in 96% of the shoulders. In 98% of the shoulders, the labrum did not attach to the articular surface, but attached to both the articular cartilage and the bone of the glenoid neck at 7 o'clock. CLINICAL RELEVANCE: The posteroinferior labrum should be repaired widely at the 7 o'clock position and not on the articular surface because the labrum attached anatomically to the glenoid neck.

Anatomic characterization of the femoral nutrient artery: Application to fracture and surgery of the femur.

The localization of nutrient foramina and direction of nutrient canals have been studied. However, information about the origin and extraosseous course of nutrient arteries is lacking in some types of long tubular and irregular bones. Thus, we aimed to reexamine the origin and course of the femoral nutrient artery (FNA) through cadaveric dissection to clarify its anatomic characteristics. Sixty thighs were collected from 57 cadavers. To fix the cadavers and visualize the small arterial branches, 10% formalin was injected from the femoral artery, followed by an injection of acrylic ink. The arterial tree in the posterior part of the thigh was recorded by line drawings. The femur received single or double FNAs via the femoral nutrient foramina, which were on and along the linea aspera. In cases with single FNA (41 of the 60 thighs), it typically arose from the four parts of the profunda femoris system: profunda femoris artery between the origins of the third and fourth perforating arteries; second perforating artery; third perforating artery; and terminal branch. In cases with double FNAs (remaining 19 thighs), the superior FNA typically arose from the second perforating artery, and the inferior FNA arose from the terminal branch of the profunda femoris artery and popliteal system. FNAs are described as branches of the perforating arteries in Terminologia Anatomica and anatomy textbooks. However, we found that FNAs also frequently arose from the profunda femoris artery and popliteal system, in addition to the perforating arteries. Clin. Anat. 33:479-487, 2020. © 2019 Wiley Periodicals, Inc.

Three-dimensional imaging of podocyte ultrastructure using FE-SEM and FIB-SEM tomography.

Podocytes are specialized epithelial cells used for glomerular filtration in the kidney. They can be divided into the cell body, primary process and foot process. Here, we describe two useful methods for the three-dimensional(3D) visualization of these subcellular compartments in rodent podocytes. The first method, field-emission scanning electron microscopy (FE-SEM) with conductive staining, is used to visualize the luminal surface of numerous podocytes simultaneously. The second method, focused-ion beam SEM (FIB-SEM) tomography, allows the user to obtain serial images from different depths of field, or Z-stacks, of the glomerulus. This allows for the 3D reconstruction of podocyte ultrastructure, which can be viewed from all angles, from a single image set. This is not possible with conventional FE-SEM. The different advantages and disadvantages of FE-SEM and FIB-SEM tomography compensate for the weaknesses of the other. The combination renders a powerful approach for the 3D analysis of podocyte ultrastructure. As a result, we were able to identify a new subcellular compartment of podocytes, "ridge-like prominences" (RLPs).

Three-dimensional architecture of pericardial nephrocytes in Drosophila melanogaster revealed by FIB/SEM tomography.

Nephrocytes are similar in structure to podocytes and play a role in the isolation of toxic substances from hemolymph in insects. Drosophila melanogaster nephrocytes have recently been used to study podocyte function and disease. However, the three-dimensional ultrastructure of nephrocytes is not clearly understood because their surrounding basement membrane makes it difficult to observe using conventional scanning electron microscopy. We reconstructed the three-dimensional ultrastructure of Drosophila pericardial nephrocytes using serial focused-ion beam/scanning electron microscopy (FIB/SEM) images. The basal surfaces were occupied by foot processes and slit-like spaces between them. The slit-like spaces corresponded to the podocyte filtration slits and were formed by longitudinal infolding/invagination of the basal plasma membrane. The basal surface between the slit-like spaces became the foot processes, which ran almost linearly, and had a "washboard-like" appearance. Both ends of the foot processes were usually anastomosed to neighboring foot processes and thus free ends were rarely observed. We demonstrated that FIB/SEM is a powerful tool to better understand the three-dimensional architecture of nephrocytes.

Morphological Processes of Foot Process Effacement in Puromycin Aminonucleoside Nephrosis Revealed by FIB/SEM Tomography.

BACKGROUND: Foot process effacement is one of the pathologic indicators of podocyte injury. However, the morphologic changes associated with it remain unclear. METHODS: To clarify the developmental process, we analyzed puromycin nephrotic podocytes reconstructed from serial focused-ion beam/scanning electron microscopy (FIB/SEM) images. RESULTS: Intact podocytes consisted of four subcellular compartments: cell body, primary process, ridge-like prominence (RLP), and foot process. The RLP, a longitudinal protrusion from the basal surface of the cell body and primary process, served as an adhesive apparatus for the cell body and primary process to attach to the glomerular basement membrane. Foot processes protruded from both sides of the RLP. In puromycin nephrotic podocytes, foot process effacement occurred in two ways: by type-1 retraction, where the foot processes retracted while maintaining their rounded tips; or type-2 retraction, where they narrowed across their entire lengths, tapering toward the tips. Puromycin nephrotic podocytes also exhibited several alterations associated with foot process effacement, such as deformation of the cell body, retraction of RLPs, and cytoplasmic fragmentation. Finally, podocytes were reorganized into a broad, flattened shape. CONCLUSIONS: The three-dimensional reconstruction of podocytes by serial FIB/SEM images revealed the morphologic changes involved in foot process effacement in greater detail than previously described.

Reevaluation of the superior radial collateral artery in the human upper arm.

The superior radial collateral artery (SRCA) was described in well-established anatomy textbooks published in the 1800s. According to those textbooks, the SRCA originates from the brachial artery, passes transversely between the coracobrachialis and the humerus, and distributes to the most distal portion of the deltoid. The SRCA is not listed in the international standard on anatomical terminology, Terminologia Anatomica, or in modern anatomy textbooks. In the present study, we reevaluated the anatomical features of the SRCA by cadaveric dissection. We found that two kinds of SRCAs were consistently present in the upper arm. One was similar to the previous descriptions of the SRCA in terms of origin and course, but the distribution was somewhat different. The other was similar to the previous descriptions in terms of the distribution, although it differed in origin and course. The discrepancy between the description of the SRCA in classical textbooks and the actual morphologies of the SRCA presumably prompted previous anatomists to question the existence of the SRCA, resulting in its absence from anatomical textbooks after a particular time point.

Anatomic characterization of the radial and ulnar nutrient arteries in humans.

BACKGROUND: The localization of nutrient foramens has been extensively studied in humans and other vertebrate animals. However, accurate information on the origin and extraosseous course of the nutrient arteries in some types of long tubular bones is lacking. Terminologia Anatomica, the international standard on human anatomic terminology, lists the radial nutrient artery (RNA) and the ulnar nutrient artery (UNA) as branches of the radial and ulnar arteries, respectively. Anatomy textbooks published in both German- and English-speaking countries regard both the RNA and UNA as branches of the anterior interosseous artery. METHODS: To clarify the anatomic characteristics of the RNA and UNA in humans, we reexamined the origin and course of these arteries by cadaveric dissection. RESULTS: Almost all RNAs and UNAs branched from the ulnar artery or its tributaries. In typical cases, the RNA branched from the anterior interosseous artery and the UNA branched from the proximal part of the ulnar artery or the anterior interosseous artery. These findings are reasonable from the perspective of regional anatomy, since the ulnar artery passes more deeply than the radial artery in the proximal forearm and thus the proximal part of the ulnar artery and its major branches are situated more closely to the radial and ulnar nutrient foramens. CONCLUSIONS: Based on our findings, it is necessary to correct the position of the RNA and UNA in the arterial hierarchy of T. Anatomica for accurate morphological description.

A new technique of surgical planning for anterior cruciate ligament reconstruction: Feasibility Assessment of Shear Wave Elastography to Tendon of Semitendinosus Muscle.

There is currently no method to quantify the quality of the harvested graft before anterior cruciate ligament (ACL) reconstruction. The purpose of this study was to explore a method for measuring stiffness of the normal tendon of the semitendinosus muscle using shear wave elastography (SWE). Our investigation comprised two steps. First, we determined orientation of the semitendinosus tendon fibers in 20 lower legs of embalmed cadavers. Second, we investigated the feasibility of quantifying stiffness of the normal semitendinosus tendon by SWE in 24 subjects (48 legs: 24 male and 24 female subjects) in vivo. Measured values were compared between male and female subjects. The point at the intersection of the semitendinosus tendon with the axial section through the center of the patella mostly was the middle of the semitendinosus tendon in the cadavers. The SWE modulus in all of the subjects could be measured on this point in vivo. The SWE modulus of males and females were 474.0 ± 71.9 kPa and 396.9 ± 104.5 kPa, respectively. The SWE modulus of males was significantly larger than that of females (P < 0.01). This study demonstrates that stiffness of the tendon of the semitendinosus muscle can be measured by SWE. It also shows that tendon of the semitendinosus muscle in males is stiffer than in females. Clin. Anat. 31:404-408, 2018. © 2017 Wiley Periodicals, Inc.