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De Fabrica Humani Corporis—Fascia as the Fabric of the Body
Published in David Lesondak, Angeli Maun Akey, Fascia, Function, and Medical Applications, 2020
In embryology the question “Where does it comes from?” usually leads to the so-called germ layers.18 In human development these three germ layers appear in approximately the third week after conception.19 In common embryology germ layers are regarded as morphological organ-forming units from which the various tissues and organs develop, resulting in a functioning organism. In most textbooks the three primary germ layers are referred to as ectoderm, mesoderm, and endoderm (sometimes mentioned as ectoblast (or epiblast), mesoblast, and endoblast (or hypoblast).
Structural Methods in the Study of Development of the Lung
Published in Joan Gil, Models of Lung Disease, 2020
Paul Davies, Daphne deMello, Lynne M. Reid
It is strange to realize that it is not for much more than 100 years that dissection combined with the microscope has been used to analyze cells and tissues in an organ. With this combination of techniques, the development of organs in the human embryo and fetus was established, and comparative embryology demonstrated what we now know; that ontogeny recapitulates phylogeny. At about the turn of the century, with the addition of experimental studies in animals, much else was discovered; how these changes came about was then explored. Chemical “organizer” substances were recognized, as well as special “zones” in which they operate. A signal must be delivered, but the cell or tissue must be prepared to receive it. This double requirement gives us the window to the perspectives we will mention at the end of this chapter.
Branching out: Specialties and subspecialties in medical genetics
Published in Peter S. Harper, The Evolution of Medical Genetics, 2019
Most of these early dysmorphologists were strongly clinical in their approach, but they were keenly aware that a detailed knowledge of embryology and teratology was essential for the understanding of congenital malformations and that the disorders resulting from environmental factors were intimately related to those caused by genetic defects. They also recognised the value of studying malformations in other species, which could provide homologues for human malformations and were more amenable to experimental approaches. In this they were greatly helped by experimental studies, largely on mice, notably the early work of Hans Grüneberg, based at University College London, part of the constellation of talent in genetics there represented by Penrose, RA Fisher, JBS Haldane and others (see Chapters 1 and 2). Grüneberg, like his American counterpart Josef Warkany, was a refugee from Nazi-controlled Europe, and his book Animal Genetics in Medicine (Grüneberg 1947) gave a firm foundation on which later more clinical workers could build. A number of these early workers, especially in America, were primarily pathologists and regarded themselves as ‘teratologists’, focusing more on the developmental basis of malformations than on their diagnosis during life.
Fetal Tethered Spinal Cord: Diagnostic Features and Its Association with Congenital Anomalies
Published in Fetal and Pediatric Pathology, 2023
Xiaomei Yang, Shiyu Sun, Yizheng Ji, Yasong Xu, Li Sun, Qichang Wu
The typical TCS is defined as a syndrome of neurological, motor, and urinary system disorders caused by a downward shift of the conus medullaris [4]. According to embryology, the spinal cord is of equal length with the spinal canal in early embryonic development and the position of the fetal conus medullaris gradually shifts upwards with the increase in gestational weeks until a certain position is attained [5]. Research shows that 95% of the fetal spinal cord conus positions have reached level L3.5 in mid-pregnancy (after 21 weeks of pregnancy) and level L3 in late pregnancy (after 28 weeks of pregnancy) [6]. The fetal TSC is characterized by congenital developmental abnormalities of the spinal cord and spine, which leads to the abnormal rise of the spinal cord at the end of the spinal canal. Its pathological changes, such as a thick and short terminal filament, spinal cord adhesion, and spinal cord lipoma are complex and occur in early embryonic development [7]. During the process of embryonic development, the lower end of the spinal cord cannot rise naturally, causing continuous stretch and compression on the lower end of the spinal cord and cauda equina, which results in ischemia and hypoxia of nerve tissue, and gradual degeneration, atrophy, and loss of nerve function.
‘Hybrid’ Bronchopulmonary Malformation – Lobar Emphysema and Extra Lobar Sequestration
Published in Fetal and Pediatric Pathology, 2022
Thattaruparambil Prakash Vinayak, Suravi Mohanty, Kanishka Das
Although rigid pathological criteria based on acinar dilatation, size of alveoli, bronchial abnormalities (atresia/stenosis of cartilage), and radial alveolar count are applied to differentiate between various congenital lung malformations like CCAM, ILE, and BPS, there is often an overlap in the histological findings between these apparently exclusive lesions [14]. The emphysematous lobe showed numerically normal alveoli but as in 50% cases, abnormalities of the cartilage were not evident. In addition to dilated alveolar ducts and normal acinar pattern of alveoli, the ELS showed dilated blood vessels. A combination of lesions may be present at surgery and/or histopathological examination [15]. Similarly, preoperative clinicoradiological diagnosis may be at variance with the postoperative histopathological diagnosis [15,16]. When a lesion has overlapping features and cannot be clearly labeled as a particular entity at histopathological evaluation, a diagnosis of ‘hybrid’ BPM is made. Such ‘hybrid lesions’ usually feature combination of CPAM (cystic/solid) and BPS (intralobar/extralobar). Sometimes both lesions occur in the same lobe [12,17,18]. An association of ILE and EL-BPS has not been described earlier. All these suggest a shared embryologic basis and analyzing the timing of embryologic development may explain the association. It has been recently suggested that in utero bronchial atresia is the primary basis for some of these malformations; the level, timing, and completeness of the obstruction acting cumulatively to create the final pattern of the malformation [4,19].
Doing More with Less: Surgical Training in the COVID-19 Era
Published in Journal of Investigative Surgery, 2022
Triantafyllos Doulias, Gaetano Gallo, Ines Rubio-Perez, Stephanie O. Breukink, Dieter Hahnloser
Mobile applications about surgical training or procedures are a growing field in surgical education. Using digital technology they can test the ability to digitally ‘perform’ a step-by-step surgical procedure aiming for patient safety. Platforms such as Touch Surgery are interactive surgical stimulators providing a realistic and detailed guide for the surgical trainee to perform a procedure. It is used in more than 230 counties and the user has the chance of performing 50 different procedures in 10 different specialties. Touch Surgery is also helping delivery of tailored training for residency programmes. A second mobile application with global presence is the iLappSurgery app which was created to educate trainees advanced techniques in laparoscopic surgery. For every procedure there is a detailed discussion on embryology, anatomy, step by step approach using 3 D animations and colorized videos.