Contributions of the Thiel's Method in teaching and researching anatomy.

INTRODUCTION: Knowledge of the human body is based on teaching and research. Anatomy remains an essential prerequisite for medical personnel to know the human body. The idea of Thiel's technique is to preserve the natural texture, volume, color and shape of the body. The objective of this study was to analyze a literature review of this technique from the perspective of anatomy teaching and biomechanical research. METHOD: We have taken up the process of Thiel's method from the original publication, stating the known applications of this technique in teaching and research. We have integrated into our study the specific advantages of using bodies preserved by this method in intertropical countries with a warm climate: the example of Gabon. DISCUSSION: Biomechanical research and teaching of medical and surgical sciences are regularly performed on human cadavers. Anatomical dissection therefore represents one of the main activities of anatomy laboratories. We have limited our analysis to aspects of anatomy teaching, research, and clinical and surgical practice. CONCLUSION: We have sought to popularize the Thiel body preservation technique. It offers many advantages. Teaching and research on human cadavers preserved by this method is an educational alternative. The simulation centre creates the conditions of a surgical block for the learners. We recommend this technique to anatomists and clinicians. This technique seems to be very interesting for structures with a limited number of bodies.

[Joseph-Guichard Duverney (1648-1730). Doctor, teacher and researcher in the 17th and 18th centuries]. / Joseph-Guichard Duverney (1648-1730). Médecin, anatomiste et chercheur aux xviie et xviiie siècles.

Duverney was a leader in the field of research and education, because he worked as a physician, as a surgeon and he led many scientific works. To Peltier, he was the first academic professor of surgery. His wonderful career was explained by his heavy interest in knowledge. He became one of the main actors of the scientific revolution of the 17th century, especially concerning the methods of investigation in the medical science. He had so much fear for imperfect purposes, that many scientists of his century called him the Master. The only work he published about the anatomy and physiology of the ear and audition, was a world success, and is still amazing today. During about 50 years, Duverney allowed many advances in the field of osteology, otology, embryology, respiratory and circulatory physiology, but also provided competent pupils as Winslow, Sénac, Petit, Dionis, Valsalva. Duverney is still frequently cited by veterinary and dentists for many descriptions in animal anatomy. He died at the age of 82 years, and worked for the service of science until his death. His legacy consists of many works, some have been used by his pupils to highlight all the benefits he gave to the scientific community.

[Long is the road...]. / "Du pain sur les planches"...

All our colleagues are unanimous: the anatomists were the most prestigious teachers of their preclinical curriculum. Our prestige, our durable impact on young students are partially based upon the fact that anatomy is the most "medical" discipline among all the lectures given in the first year(s) of medical curriculum. But the respect of our students is due in a large way to the quality of our educational methods based on lectures at the blackboard with pieces of chalk. A long preparation is required to achieve excellence and provide lectures melting science and art, inviting students to learn and understand with pleasure the human body on which they will practice up to date medicine. Training of anatomists requires long preparation in their own institutes as well as in common sessions organized at the Saints-Pères Institute of Anatomy of Paris, a mythic place of anatomy in France.

[Open chest cardiopulmonary resuscitation: is there an interest in France?]. / Intérêts des manoeuvres de réanimation à thorax ouvert en France ?

OBJECTIVE: To expose and clarify indications, techniques, results, complications and cost for open chest cardiopulmonary resuscitation manoeuvres (OCCRM) in traumatic or nontraumatic cardiac arrest. DATA SOURCES: References were obtained from Pubmed data bank using the following keywords: "emergency thoracotomy", "resuscitative thoracotomy". STUDY SELECTION: We focused on publications in English language, from 2000 to 2007. DATA SYNTHESIS: OCCRM are useful especially in case of traumatic cardiac arrest, penetrating trauma, but also in blunt trauma. Time between cardiac arrest and realisation of the thoracotomy seems to be the most important factor for the prognosis. CONCLUSION: According to the French "physician in ambulance" prehospital system, OCCRM might be promising in France, because this system favours the fastness of care and therefore would minimize the time factor.

[Contribution of the posterior auricular artery in the vascularization of the facial nerve in prestylian space: anatomical study and surgical applications]. / Contribution de l'artère auriculaire postérieure à la vascularisation du nerf facial dans l'espace préstylien : étude anatomique et conséquences chirurgicales.

INTRODUCTION: The aim of our study was to establish a systematization of collateral branches originating from posterior auricular artery to facial nerve in prestylian space. MATERIALS AND METHODS: Thirty posterior auricular arteries were studied on 15 fresh cadavers after selective patent blue injection. We observed subsequent colouration of facial nerve. Number and topography of collateral branches were highlighted. RESULTS: Posterior auricular artery supplied facial nerve in 67%. Collateral branches dedicated to facial nerve could be classified into three types: type 1 corresponded to one artery in prestylian space, type 2 to several branches in prestylian space; finally type 3 featured several branches originating from posterior auricular artery in prestylian space on the one hand, in superficial retroauricular area on the other hand. CONCLUSION: Posterior auricular artery is the main blood supply to facial nerve in prestylian space. In most of the cases, branches to facial nerve originate deeply in parotid space. Nevertheless nervous branches may originate from superficial retroauricular segment of posterior auricular artery. Their damage during surgical procedures as bat ear surgery can cause definitive facial nerve palsy.

[François Chaussier (1746-1828). A vision of the anatomic nomenclature based on education]. / François Chaussier (1746-1828). Une vision de la nomenclature anatomique fondée sur la pédagogie.

François Chaussier (1746-1828) developed an original point of view concerning the anatomic nomenclature teaching and learning. The myology nomenclature proposed by Chaussier was based on a very simple concept: the name of a muscle is composed by its two attachment points. He wanted to make science learning easier for the students; that we can see in his myology nomenclature, his publications and anatomical drawings. His experience is still interesting nowadays.

[Trapezio second metacarpal joint: anatomical study and clinical matters]. / Articulation du trapèze avec le second métacarpien: étude anatomique et intérêts cliniques.

INTRODUCTION: An unusual dislocation of the column of the thumb associated with a fracture of the base of the second metacarpal inspired an anatomical study of the trapeziosecond metacarpal joint. MATERIALS AND METHODS: Forty-five dissections of the palmar aspect of trapeziometacarpal joint aimed at focusing on palmar ligaments and tendons reinforcing the joints. RESULTS: Trapeziosecond metacarpal joint is a constant little diarthrosis reinforced by a palmar ligament stressed between the crest of the trapezium and the base of the second metacarpal. The tendon of flexor radialis carpi muscle is an active link due to strong vinculae to trapezium bone and distal attachment to the bases of both second and third metacarpals. CONCLUSION: The connections between the trapezium and the base of the second metacarpal bone play a role in the treatment of thumb instability and their mechanical importance is illustrated in our original clinical observation.

[Evaluation of a training method for transtracheal punction for emergency oxygenation]. / Ponction de la membrane intercricothyroïdienne pour l'oxygénation en urgence: évaluation d'une formation.

INTRODUCTION: Transtracheal oxygenation is a lifesaving technique in a cannot-ventilate, cannot-intubate situation, in setting percutaneous transtracheal catheter. OBJECTIVE: To assess training for cricoid membrane puncture performed with a Ravussin needle. METHOD: Ten residents in anaesthesiology nearing completion of their training participated in the study. Following a didactic session and a video demonstration, participants performed percutaneous transtracheal punctures on fresh cadavers. Success rate and time to perform the puncture were measured. Results are expressed as mean+/-SD. RESULTS: By the third attempt, all procedures were successful. Mean performance time at the first attempt was 31.2+/-21.8 s, progressively decreasing with the following attempts to reach a plateau by the third attempt (20.6+/-19.3s). Performance time varies with the cadaver's morphology and the ability to recognize anatomic landmarks. However, whatever the difficulty, performance time is 40 s or less by the third attempt. CONCLUSION: Percutaneous transtracheal catheter setting is a life saving technique with which every anaesthesiologist should be familiar. Viewing a pedagogic videotape and training on cadavers provides a rapid and effective training method for cricoid membrane puncture. Four attempts seem necessary to obtain an optimal success rate.