Visualization of the dentogingival junction using micro-plastination technique.

Plastination has revolutionized the field of anatomy and research by providing biosecurity and enabling the long-term preservation of biological material, ranging from entire bodies to individual organs and even micron sections. The dentogingival junction (DGJ) consists of both epithelial and connective tissues that are closely related to the tooth's mineralized tissues. Cutting-grinding techniques are commonly used to visualize DGJ histology. These techniques exclude enamel from preparations and focus on visualizing hard or soft tissues. To improve the micro-anatomical and histological study of this region, we applied micro-plastination technique to obtain micro-thin slices below 150 µm thick from human and animal samples. The DGJ microanatomy was visualized by applying histological stains to the micro-plastinated slices, highlighting the technique's endogenous autofluorescence capacity identifying periodontal tissues, including dentin, enamel, cementoenamel junction, dentinal tubules, connective tissue, and collagen. Based on our results, we confirm that micro-plastination is a useful technique for visualizing anatomical regions that are difficult to access, such as the DGJ. Micro-plastination can be used as an alternative technique, providing a new approach for its application in anatomical and morphological research protocols.

Pituitary adenoma with oculomotor cistern extension: membranous anatomy and clinical application.

BACKGROUND: The anatomical basis of pituitary adenomas (PAs) with oculomotor cistern (OC) extension as a growth corridor is overlooked in the literature. In this paper, the authors use the technique of epoxy sheet plastination to study the membranous structure of the OC and validate the results by retrospective analysis of patients with OC extension. METHODS: Eighteen specimens were used to study the membranous anatomy surrounding the OC using the epoxy sheet plastination technique. Thirty-four patients with OC extension were retrospectively reviewed. RESULTS: The OC consisted of two thin membranous layers. The inner layer was extended by the arachnoid layer from the posterior fossa, and the lateral layer consisted of the dura mater sinking from the roof of the cavernous sinus. The oculomotor nerve is more likely to displace with a superolateral trajectory due to the weakness of the posterior dura and the relatively large space in the medial and posterior trajectories, which is consistent with the intraoperative observations. Among the anatomical factors that affect the PA by OC extension, we found that the relative position of the internal carotid artery (ICA) and posterior clinoid process may lead to the narrowing of the OC. Of 34 cases, 28 patients achieved total resection. Among 24 preoperative patients with oculomotor nerve palsy, 16 cases were relieved to varying degrees postoperatively. There was no ICA injury or severe intracranial infection found in any of the patients. CONCLUSIONS: Extension into the OC is influenced by two anatomical factors: a weak point in the dura in the posterior OC and a potential space beyond this region of the dura. Meticulous knowledge of the membranous anatomy in endoscopic endonasal surgery is required to safely and effectively resect PA with OC extension.

Creation of 21st century anatomy facilities: designing facilities for integrated preclinical education in the Middle East.

BACKGROUND: The establishment of new anatomy facilities needs to accommodate a combination of modern teaching modalities that best align with evidence-based best teaching practices. This article describes the process in which our state-of-the-art anatomy laboratories were designed and implemented, and how these facilities support aspects of modern anatomy education. METHODS: A list of best practices for anatomy education in a modern medical curriculum was summarized from the literature. To assess student satisfaction, a survey related to student perception of the anatomy facilities (5-point Likert scale) was conducted. RESULTS: Our educational modalities include a broad range of teaching approaches. The Instructional Studio houses prosected and plastinated specimens, and cadaveric dissections are performed. Each of our three Dry Laboratories allow for active learning and interaction between small student groups. The Webinar Room acts as a conference room for departmental and online meetings, discussions with students, and dialogues with affiliated hospitals via the internet. The Imaging Center is equipped with a Sectra® medical educational platform, CAE Vimedix® Virtual Medical Imaging Ultrasound Training System, and Philipps Lumify® Ultrasound devices to train students to conduct and interpret sonographic images. Moreover, the Complete Anatomy® program is made available to all our students. CONCLUSION: The layout of our newly created Anatomy Facilities allows for all aspects of modern medical education mentioned in the literature. These educational modalities and teaching approaches are highly appreciated by our faculty and students. Moreover, these technologies allowed for a smooth transition from on-site anatomy teaching to online education during the COVID pandemic.

The lateral ulnar collateral ligament: Anatomical and structural study for clinical application in the diagnosis and treatment of elbow lateral ligament injuries.

The lateral ulnar collateral ligament (LUCL) is considered one of the main stabilizers of the elbow. However, its anatomical description is not well established. Imaging techniques do not always have agreed upon parameters for the study of this ligament. Therefore, herein, we studied the macro and microanatomy of the LUCL to establish its morphological and morphometric characteristics more precisely. Fifty-five fresh-frozen human elbows underwent dissection of the lateral collateral ligament. Morphological characteristics were studied in detail. Ultrasound (US) and magnetic resonance (MR) were done before dissection. Two specimens were selected for PGP 9.5 S immunohistochemistry. Ten additional elbows were analyzed by E12 sheet plastination. LUCL was identified in all specimens and clearly defined by E12 semi-thin sections. It fused with the common extensor tendon and the radial ligament. The total length of the LUCL was 48.50 mm at 90°, 46.76 mm at maximum flexion and 44.10 mm at complete extension. Three morphological insertion variants were identified. Both US and MR identified the LUCL in all cases. It was hypoechoic in the middle and distal third in 85%. The LUCL was hypointense on MR in 95%. Free nerve endings were present on histology. The LUCL is closely related to the anular ligament. It is stretched during flexion and supination. US and MR can reliably identify its fibers. Anatomical data are relevant to the surgeon who repairs the ligaments of the elbow. Also, to the radiologist and pain physician who interpret imaging and treat patients with pain syndromes of the elbow.

The medial wall and medial compartment of the cavernous sinus: an anatomic study using plastinated histological sections.

The medial wall of the cavernous sinus (CS) has a significant role in evaluation and treatment of pituitary adenomas. This study was conducted to clarify the fine architecture of the medial wall and medial compartment of the CS at both macro- and micro-levels in twenty-one human cadaveric heads by using the epoxy sheet plastination technique. The sellar part medial wall is an intact dural layer that separates the CS from the pituitary gland. This dural wall adhered to the diaphragma sellae and the periosteum of the sella turcica to form fibrous triangles. Eight micro-protrusions of the pituitary gland were found at both sides of that wall. The thickness of the sellar part medial wall at its central portion was significantly thinner than that at the other surrounding portions. From the superior view, tortuous intracavernous carotid arteries can be divided into outward bending type and inward bending type. The inward bending intracavernous carotid was apt to bent towards the central part of the sellar part medial wall, where there were usually wide and short fibrous bands with more densely stained connective tissues between them. The micro-protrusion of the pituitary gland in the medial wall of the CS could provide an anatomical basis for the occult tumor invasion and the recurrence of residual tumor. Different bending facing states of tortuous intracavernous carotid arteries in the lateral direction may be a factor of the determination of the direction of growth of pituitary tumors.

A new concept of the fiber composition of cervical spinal dura mater: an investigation utilizing the P45 sheet plastination technique.

PURPOSE: Few reports have been published regarding the microanatomy of the dura mater located at the craniovertebral junction (CVJ). In clinic, the precise microanatomy of the CVJ dura mater would be taken into account, for reducing surgical complications and ineffective surgical outcomes. The main objective of the present investigation was to further elucidate the fiber composition and sources of the cervical spinal dura mater. METHODS: The formalin-fixed adult head and neck specimens (n = 21) were obtained and P45 plastinated section method was utilized for the present study. The fibers of the upper cervical spinal dura mater (SDM) were examined in the P45 sagittal sections in the CVJ area. All photographic documentation was performed via a Canon EOS 7D Mark camera. RESULTS: The posterior wall of the SDM sac at CVJ was found to be composed of stratified fibers, which are derived from three sources: the cerebral dura mater, the occipital periosteum, and the myodural bridge (MDB). The proper layer of the cerebral dura mater passes over the brim of the foramen magnum and enters the vertebral canal to form the inner layer of the SDM, and the fibers originating from the periosteum of the brim of the foramen magnum form the middle layer. The fibers of the MDB are inserted into the SDM and form its outer layer. It was found that the total number of fibers from each origin varied in humans. CONCLUSION: At the CVJ, the posterior wall of the SDM is a multi-layered structure composed of three different originated fibers. The cerebral dura mater, the periosteum located at the brim of the foramen magnum, and MDB contribute to the formation of the SDM. The present study would be beneficial to the choice of surgical approach at the CVJ and the protection of the SDB.

Architecture of the cancellous bone in human proximal tibia based on P45 sectional plastinated specimens.

PURPOSE: To reveal differences in the pattern of trabecular architecture in the epiphysis and metaphysis of the proximal tibia. METHODS: The trabecular architecture of the proximal tibia was observed in 27 P45 plastinated knee specimens. RESULTS: In the medial and lateral condyles, under the articular cartilage surrounded by the medial or lateral meniscus, the cancellous bone is formed by thick and dense trabecular bands, which run longitudinally in the epiphysis and then pass through the epiphyseal line to terminate on the slanted cortex of the metaphysis. In the intercondylar eminence, the trabeculae are arranged basically in a network. In the central portion of the tibial metaphysis, cancellous bone consists of fine arcuate trabeculae, which extend to the anterior and posterior cortices, respectively. These trabeculae are intersected sparsely and form trusses over the medullary cavity. Near the areas of attachment of the iliotibial tract, tibial collateral ligament, anterior and posterior cruciate ligaments, and patellar ligament, the cancellous bone is locally reinforced with patchy trabeculae, dense radiating trabeculae, or two orthotropic trabecular bands. CONCLUSION: This study provides further accurate anatomical information on the trabeculae of the proximal tibia. The soft structures of knee joint, including the articular cartilage, menisci, and ligaments, and the slanted cortices of the metaphysis are important landmarks for the location of different arrangements of the cancellous architecture. The present results are beneficial for clinical diagnosis and treatment of pathologies of the knee joint, or the establishment of a finite element analysis model of the knee joint.

Environmental Durability Enhancement of Natural Fibres Using Plastination: A Feasibility Investigation on Bamboo.

Natural fibers are gaining wide attention due to their much lower carbon footprint and economic factors compared to synthetic fibers. The moisture affinity of these lignocellulosic fibres, however, is still one of the main challenges when using them, e.g., for outdoor applications, leading to fast degradation rates. Plastination is a technique originally used for the preservation of human and animal body organs for many years, by replacing the water and fat present in the tissues with a polymer. This article investigates the feasibility of adapting such plastination to bamboo natural fibres using the S-10 room-temperature technique in order to hinder their moisture absorption ability. The effect of plastination on the mechanical properties and residual moisture content of the bamboo natural fibre samples was evaluated. Energy dispersive x-ray spectroscopy (EDS) and X-ray micro-computed tomography (Micro-CT) were employed to characterize the chemical composition and 3-dimensional morphology of the plastinated specimens. The results clearly show that, as plastination lessens the hydrophilic tendency of the bamboo fibres, it also decreases the residual moisture content and increases the tensile strength and stiffness of the fibers.

Plastinated macroparasites, an alternative resource for use in practical lessons.

The plastination technique is a recently developed option to preserve biological tissues widely used in human and veterinary anatomy. This process allows one to obtain real, safe, clean, dry, resistant and permanently stable material without any additional treatment or maintenance. All these advantages are associated with the rapid expansion of plastination during recent decades in a high number of educational institutions. However, the studies of parasite conservation through plastination are scarce, although the material obtained has a high quality, as prior references have shown. In this study, 141 students of veterinary medicine and pharmacy university degrees used, in a blind study, plastinated specimens (experimental group) or wet specimens (control group) during three consecutive practical sessions. Afterwards all the students completed anonymous questionnaires on both knowledge and satisfaction. The results demonstrated that plastinated parasites are a valid and satisfactory alternative to be used as a teaching/learning tool during practical lessons. Moreover, with regard to the knowledge of morphological structures, the results from the questionnaire of assimilated knowledge showed no differences between the use of plastinated and formaldehyde-preserved parasites.

La technique de plastination est une méthode assez récente de préservation des tissus biologiques qui est désormais largement utilisée en anatomie humaine et vétérinaire. Ce procédé permet d'obtenir des préparations anatomiques réalistes, sûres, sèches, résistantes et stables qui ne nécessiteront pas de traitement ni d'entretien ultérieurs pour préserver leur durabilité. Ces avantages expliquent que le recours à la plastination se soit rapidement développé au cours des dernières décennies dans nombre d'institutions d'enseignement. Néanmoins, rares sont les études portant sur la préservation des parasites par plastination, bien que les spécimens obtenus lors de travaux antérieurs aient été jugés de très bonne qualité. Les auteurs présentent les résultats d'une enquête menée auprès de 141 étudiants préparant leur diplôme de médecine vétérinaire ou de pharmacie, à qui ont été distribués en aveugle des spécimens plastinés (groupe expérimental) et des spécimens conservés dans une solution liquide (groupe de contrôle) lors de trois séances consécutives de travaux pratiques. Il a ensuite été demandé aux étudiants de remplir anonymement un questionnaire portant sur les connaissances acquises lors de ces séances et sur leur degré de satisfaction. Les résultats ont montré que les parasites plastinés constituent une alternative valable et satisfaisante en tant que matériel pédagogique et d'entraînement pendant les leçons pratiques. Par ailleurs, s'agissant de l'étude des structures morphologiques, les résultats du questionnaire sur les connaissances acquises lors des travaux pratiques n'ont pas fait apparaître de différences entre les étudiants ayant travaillé sur des parasites plastinés et ceux ayant travaillé avec des parasites conservés dans le formol.

La técnica de la plastinación es un método de reciente aparición para conservar tejidos biológicos, utilizado con gran frecuencia en anatomía humana y veterinaria. Se trata de un proceso que permite obtener material real, inocuo, limpio, seco, resistente y con una estabilidad permanente sin necesidad de ninguna otra operación de tratamiento o mantenimiento. Todas estas ventajas explican que en los últimos decenios la técnica se haya extendido con rapidez por muy numerosas instituciones de enseñanza. Aun así, hay escasos estudios sobre la conservación de parásitos por plastinación, pese a que el material obtenido, como se desprende de referencias anteriores, es de gran calidad. Los autores describen un estudio ciego en el que 141 estudiantes universitarios en farmacia y medicina veterinaria emplearon muestras plastinadas (grupo experimental) o muestras húmedas (grupo de control) en tres clases prácticas consecutivas, tras lo cual todos los estudiantes respondieron anónimamente a un cuestionario que evaluaba tanto sus conocimientos como su nivel de satisfacción. Los resultados demostraron que los parásitos plastinados constituyen una alternativa válida y satisfactoria como herramienta para impartir y/o recibir clases prácticas. Además, desde el punto de vista del conocimiento de estructuras morfológicas, los resultados del cuestionario sobre conocimientos asimilados no pusieron de manifiesto diferencia alguna entre el uso de parásitos plastinados y el de parásitos conservados en formaldehído .

Outcomes of the use of plastination in anatomy education: current evidence.

PURPOSE: We aimed to evaluate the quantity and quality of current evidence concerning the outcomes of use of plastinated specimens in anatomy education. METHODS: We performed a narrative literature review, searching for papers dealing with the use of plastination in anatomy education. PubMed, Scopus, ERIC, Cochrane, Web of Science and CINAHL complete electronic databases were searched. The following data were extracted: author(s), year of publication, type of study (comparative or not), number of participants, evaluation of statistical significance, educational outcomes and their level according to Kirkpatrick hierarchy. RESULTS: Six studies were eligible for analysis. Five of them evaluated only students' reactions about plastination and one study also assessed their examinations results. There were four non-comparative and two comparative studies. Only a study evaluated statistical significance (p < 0.05) with higher score of perception in 2nd year undergraduate medical students, who were more familiar with plastination in comparison to 1st year students. Although the use of plastination was accompanied by positive outcomes in the majority of studies (five out of six), this method was not proved superior to traditional cadavers dissection. CONCLUSIONS: The existing evidence about the outcomes of the use of plastination in anatomy education is relatively limited and lacks comparative studies with statistical significant results. Positive students' reactions were generally noted, but further research is needed to clarify if plastination could be of benefit to students' attitude and anatomy knowledge.

Resin-embedded anatomical cross-sections as a teaching adjunct for medical curricula: is this technique an alternative to potting and plastination?

With an ever-expanding use of cross-sectional imaging for diagnostic and therapeutic purposes, there has also been an increase in the need for exposure to such radiological and anatomical views at the undergraduate and postgraduate level to allow for early familiarisation with the relevant anatomy. Cadaveric cross-sections offer an excellent link between the two-dimensional radiological images and the three-dimensional anatomical structures. For such cross-sections to be useful and informative within educational settings, they need to be: (i) safe for students and trainees to handle and (ii) robust enough to withstand repeated handling; as well as (iii) displaying anatomy clearly and accurately. There are various ways in which cross-sections can be prepared and presented; plastinated, potted, vacuum-sealed or unmounted. Each of these approaches has advantages and disadvantages in terms of technical complexity, cost and quality. As an alternative to the above methods and their limitations, we propose the presentation of cadaveric cross-sections in a transparent polyester resin. This technique has been used extensively in craft and artistic industries, yet it is not publicised in anatomy teaching settings. The sections were layered in polyester resin contained within a mould. The set resin required finishing by sanding and polishing. The final cross-sections were safe to handle, durable and maintained excellent anatomical relationships of the contained structures. The transparency of the set resin was water-clear and did not obstruct the visibility of the anatomy. The cost of the process was found to be significantly lower, requiring less infrastructure when compared with alternative methods. The following trivial technical difficulties were noted during the resin-embedding process: trapped air causing organs to float; retained water in the anatomical specimens creating bubbles and discoloration; and microbubbles emerging from the solution affecting the finished surface. However, solutions to these minor limitations have been discussed within the paper with the aim of future proofing this technique. The sections have been used in undergraduate medical teaching for 4 years and they have shown no signs of degradation or discoloration. We believe that this method is a viable and cost-effective alternative to other approaches of displaying cross-sectional cadaveric material and will help students and trainees bridge the gap between the traditional three-dimensional anatomy and two-dimensional images.

E12 sheet plastination: Techniques and applications.

Plastination is an anatomical technique that consists of replacing the liquids and fat of specimens by reactive polymers through forced impregnation in a vacuum. These are then polymerized to achieve the final result. E12 sheet plastination involves epoxy resin impregnation of thin (2-4 mm) and ultra-thin (<2 mm) tissue sheets, producing dry, transparent, odorless, non-toxic and long-lasting sheets. E12 sheet plastination techniques were reviewed using MEDLINE, EMBASE and SciELO databases, and manual searches. After searching, 616 records were found using the online and manual searches (MEDLINE, n: 207; EMBASE, n: 346; SciELO, n: 44; Manual search: 23). Finally, 96 records were included in this review (after duplicates and articles unrelated to the subject were excluded). The aim of this work was to review the E12 sheet plastination technique, searching for articles concerning views of it, identifying the different variants implemented by researchers since its creation by Gunther von Hagens, and to identify its applications from teaching and research in anatomy to morphological sciences. Clin. Anat. 31:742-756, 2018. © 2017 Wiley Periodicals, Inc.

Use and perceptions of plastination among medical anatomy educators in the United States.

Traditionally, medical schools have maintained collections of tissues/organs to engage students in anatomy. Such collections are often stored in volatile and toxic preservatives. Plastination is an alternative tissue preservation technique in which polymers replace water and lipids resulting in benign, dry, and anatomically authentic specimens. Plastination is used in medical education internationally; however, its use within U.S. medical schools is not widely discussed in the anatomical literature. This study aimed to determine the knowledge, use, and perceptions of plastination as a teaching tool among U.S. anatomy medical educators. A total of 98 medical anatomy educators who fit inclusion criteria and teach allopathic (MD) students and/or osteopathic (DO) students in the United States completed a national survey, representing 77 medical schools across 37 states. Of these, 100% had heard of plastination, 57% correctly defined plastination, but only 39% currently utilize plastinates for anatomy education. The most frequent explanation for nonuse of plastinates was a preference for the dissection experience, followed by lack of resources and negative past experiences related to durability and quality. A majority (75%) of U.S. medical anatomy educators perceived plastination as a good supplement to, but not a replacement for, cadaveric dissection, 19% indicated no curiosity to use plastination or considered it not useful, and 14% expressed ethical concerns. These findings suggest plastinates are more widely used in the United States than reflected by the literature; however, perceptions regarding their utility indicate a dominant theme for their use to supplement, not replace, cadaveric dissection. Clin. Anat, 2017. © 2017 Wiley Periodicals, Inc.

A sectional anatomy learning tool for medical students: development and user-usage analytics.

BACKGROUND: A sound knowledge of cross-sectional anatomy is needed to interpret radiological images. Ultrathin E12-plastinated slices serve as good learning resources to begin with, but effective utilisation of these resources are often challenging due to their fragility and lack of adequate laboratory time. To enhance interpretation of E12 slices, and also to promote independent learning, we developed a web-based self learning resource. METHODS: An interactive online sectional anatomy learning tool (SALT) to learn the cross-sectional anatomy of the spinal levels, thorax, abdomen and pelvis was developed using Courselab software. SALT was piloted on third-year medical students learning regional and clinical anatomy of the human body. At the end of the academic year, student participation within the resource was analysed, and the resource usage was compared with the users' academic performance. RESULTS: Each aspect of SALT was accessed 338 times on average, by 51% of the class. The majority medical students accessed the resource after class hours. Continued research usage was observed on weekends and holidays, which peaked during exam periods. SALT usage also had a positive impact on the users' academic performance (p < 0.05). Students also used the resource after exams and during their subsequent years of study. CONCLUSION: SALT promoted independent learning, as well as enhanced students' learning experience and academic performance. Having the benefit of online access, the resource was used almost 24/7, both on and off-campus. Educators should be encouraged to develop and trial their own simple inexpensive online resources tailormade to meet student needs and supplement to the existing traditional teaching techniques.

The utility of plastinates in court: a case of firearm homicide.

Plastination is a technique renowned for its use in the preservation of human tissues or organs, and is mainly employed in anatomical training and in research regarding various scientific fields. The advantages of this method are related to the natural appearance, absence of odor, and easy-handling of the plastinated products. The use of plastinates in forensic sciences, their potential role in personal identification, and their usefulness in interpretation of post-mortem findings has been described, although literature on this topic is poor. The present paper is the first report of a firearm homicide where the brain of the victim was plastinated and presented in court as documentary evidence. Three dimensional examination of the brain during the trial allowed the judge to directly evaluate the pathway of the projectile and to compare it with the information that was presented based on depositions, post mortem data and police investigations, in a more straightforward manner. The important role played by plastination in the reported case in assisting with the final verdict could be a catalyst to extend the use of this technique to other criminal cases.

The oblique popliteal ligament: an anatomic and MRI investigation.

PURPOSE: Despite being the largest ligament on the posterior aspect of the knee, relatively little is known about the normal morphology of the oblique popliteal ligament (OPL). The aim of this study was to investigate the detailed anatomy of the OPL in cadavers and healthy volunteers. METHODS: The posterior knee was investigated in 25 cadaver lower limbs (mean age 76 ± 9.5 years; 7 men) by dissection, histology, and serial plastination and in 14 healthy individuals (mean age 23 ± 3.2 years; 11 men) using magnetic resonance (MR) imaging. OPL morphology, attachments sites, ligament length and width, relationship to surrounding structures and histological composition were recorded. Intraobserver reliability was assessed using intraclass correlation coefficients. RESULTS: The OPL is a distinct expansion of the semimembranosus (SM) tendon and sheath, which courses superolaterally to attach to the posterolateral joint capsule or fabella (when present), at the medial margin of the lateral femoral condyle. The ligament blends with the joint capsule medially and laterally, serves as an attachment site for plantaris, and has connections with popliteus. In 70% of dissections, the OPL divided into two bands, separated by small branches of the middle genicular neurovascular bundle that pierced the posterior joint capsule. Differences in mediolateral length were noted between dissection and MR imaging (43.6 ± 6.2 vs. 57.6 ± 4.4 mm; p < 0.001). At its medial and lateral attachments, the OPL was 23.2 ± 6.9 and 17.4 ± 8.7 mm wide (proximodistal), respectively. The OPL was predominantly composed of transverse collagen layers, with little elastin. While visible on axial MR scans, delineation of its most lateral extent was difficult. Repeatability of selected measurements ranged from good to almost perfect. CONCLUSIONS: The OPL is a distinct ligament with identifiable anatomical limits. Based on its morphological characteristics, it appears more tendinous than ligamentous in nature. A better understanding of the OPL may help define its importance in the assessment and treatment of posterior knee injuries.

The impact of Body Worlds on adult visitors' knowledge on human anatomy: A preliminary study.

Body Worlds is an anatomical exhibition that shows human remains to the public. It has been considered controversial since it raises ethical tensions and issues. However, organizers and supporters of Body Worlds have claimed the exhibition is intended to promote visitors' understanding over the human body. Despite these claims, no studies were found that support or refute the hypothesis that a visit to Body Worlds increases the public's objective knowledge on human anatomy. Consequently, the objective of this study was to determine the impact of Body Worlds on anatomical knowledge. We constructed and delivered a questionnaire to both a previsit random sample and a postvisit random sample of visitors of Body Worlds' event Facets of Life, in Berlin. The questionnaire was available in both English and German languages and contained (a) basic sociodemographic questions and (b) a valid and reliable anatomy quiz. The quiz consisted of 16 multiple-choice questions that assessed the ability to identify the location of major anatomical structures on the human body. Average scores achieved on the quiz by the postvisit sample (X¯= 9.08, s = 2.48, n = 164) were significantly higher (unpaired t = 3.3957, P = 0.0008) than those achieved by the previsit sample (X¯= 8.11, s = 2.69, n = 167). Our results suggest that a visit to Body Worlds' event Facets of Life may have a beneficial effect in anatomical knowledge. However, further studies with better empirical designs and fewer limitations are needed to confirm our results.

The public display of plastinates as a challenge to the integrity of anatomy.

Anatomy has been thrust into the public domain by the highly successful public displays of dissected and plastinated human bodies. This is anatomy in modern guise, anatomy as perceived by the general public. If this is the case, the message it is giving the public about the nature of anatomy is that it is an impersonal analysis of the human body of value within a medical and health care environment. While this is in part true, and while it reflects important aspects of anatomy's history, it fails to reflect the humanistic strands within an increasing swathe of contemporary anatomy. These are manifested in growing recognition of the centrality of informed consent in the practice of anatomy, awareness of the personal dimensions and relationships of those whose bodies are being dissected, and manifested in thanksgiving ceremonies involving staff and students. The notion that the bodies undergoing dissection can be students' first teachers and/or patients is gaining ground, another indication of the human dimensions of the anatomical enterprise. Exhibitions such as Body Worlds ignore these dimensions within anatomy by dislocating it from its clinical and relational base. The significance of this is that loss of these dimensions leads to a loss of the human face of anatomy by isolating it from the people whose body bequests made this knowledge possible. What is required is greater transparency and openness in the practices of all who deal with the dead human body, trends that owe much to the writings of scholars from within a range of humanities disciplines as they have responded to the public displays of dissected plastinated bodies. Anatomists have much to learn from these debates.

Body donations today and tomorrow: What is best practice and why?

There is considerable agreement that the use of human bodies for teaching and research remains important, yet not all universities use dissection to teach human gross anatomy. The concept of body donation has evolved over centuries and there are still considerable discrepancies among countries regarding the means by which human bodies are acquired and used for education and research. Many countries have well-established donation programs and use body dissection to teach most if not all human gross anatomy. In contrast, there are countries without donation programs that use unclaimed bodies or perhaps a few donated bodies instead. In several countries, use of cadavers for dissection is unthinkable for cultural or religious reasons. Against this background, successful donation programs are highlighted in the present review, emphasizing those aspects of the programs that make them successful. Looking to the future, we consider what best practice could look like and how the use of unclaimed bodies for anatomy teaching could be replaced. From an ethical point of view, countries that depend upon unclaimed bodies of dubious provenance are encouraged to use these reports and adopt strategies for developing successful donation programs. In many countries, the act of body donation has been guided by laws and ethical frameworks and has evolved alongside the needs for medical knowledge and for improved teaching of human anatomy. There will also be a future need for human bodies to ensure optimal pre- and post-graduate training and for use in biomedical research. Good body donation practice should be adopted wherever possible, moving away from the use of unclaimed bodies of dubious provenance and adopting strategies to favor the establishment of successful donation programs.

Cone beam computed tomography of plastinated hearts for instruction of radiological anatomy.

Radiological anatomy education is an important aspect of the medical curriculum. The purpose of this study was to establish and demonstrate the use of plastinated anatomical specimens, specifically human hearts, for use in radiological anatomy education. Four human hearts were processed with routine plastination procedures at room temperature. Specimens were subjected to cone beam computed tomography and a graphics program (ER3D) was applied to generate 3D cardiac models. A comparison was conducted between plastinated hearts and their corresponding computer models based on a list of morphological cardiac features commonly studied in the gross anatomy laboratory. Results showed significant correspondence between plastinations and CBCT-generated 3D models (98 %; p < .01) for external structures and 100 % for internal cardiac features, while 85 % correspondence was achieved between plastinations and 2D CBCT slices. Complete correspondence (100 %) was achieved between key observations on the plastinations and internal radiological findings typically required of medical student. All pathologic features seen on the plastinated hearts were also visualized internally with the CBCT-generated models and 2D slices. These results suggest that CBCT-derived slices and models can be successfully generated from plastinated material and provide accurate representations for radiological anatomy education.