RESUMEN
Embryology and anatomy of the chest wall and breast will be developed in this chapter. The walls of the thorax will be described; the anatomical notions of thoracic deformities will be detailed. The anatomy of the mammary gland will be developed around the understanding of the means of fixity and vascularization. The anatomical descriptions come from the writings of ancient anatomists, notably Testut and Latarjet, as well as the iconographies taken from their various works.
Asunto(s)
Anatomía , Tórax , Mama/anatomía & histología , Humanos , Tórax/anatomía & histologíaRESUMEN
Bilateral absence of the superior vena cava (SVC) is an uncommon congenital vascular anomaly, mainly asymptomatic, usually undetected, and often associated with other cardiac anomalies. Though usually harmless and totally innocent, this vascular anomaly might complicate cardiovascular surgery, the insertion of a central venous catheter and the transvenous placement of a pacemaker. This SVC anomaly is still not well known, underdiagnosed and its incidence is much higher than described. A better understanding of this anomaly and its detection could play a key role in avoiding its potential complications. We are sharing a case of a female adult, with no medical history, who presented herself to the department of visceral surgery with a collateral venous circulation of the upper thorax, that was at first, mistaken for a portal hypertension syndrome, findings were pushed to finally conclude a bilateral absence of the SVC.
Asunto(s)
Malformaciones Vasculares , Vena Cava Superior/anomalías , Adulto , Circulación Colateral , Angiografía por Tomografía Computarizada , Errores Diagnósticos , Femenino , Humanos , Flebografía/métodos , Valor Predictivo de las Pruebas , Malformaciones Vasculares/diagnóstico por imagen , Malformaciones Vasculares/fisiopatología , Vena Cava Superior/diagnóstico por imagen , Vena Cava Superior/fisiopatologíaRESUMEN
BACKGROUND AND AIM: Difficulties are encountered in embryology learning such as imagining embryo modifications in three-dimensions and time. We provided an experimentation to evaluate if short videos during magisterial lecture could increase the quality and the efficiency of embryology teaching. METHODS: The study was conducted amongst students in first year of medical studies in France. It is an intense and highly competitive year at the end of which students can engage in medical or paramedical specialties depending on their rank. In a first step, pre-implantation embryo development and microscopic videos of in vitro Fertilization were presented during a course of medical ethics. Three months later, students gave their opinion on this presentation in a satisfaction survey using a Likert scale. In a second step (the two following years), similar videos were integrated in the regular embryology lectures and the results of the subsequent embryology test were analyzed. RESULTS: In the first step, students declared that movies could increase their interest in embryology and significantly help to the comprehension and memorization of embryologic processes. In the second step, we found that students answered better to the video-related questions of the test even if globally in the first year, results were weaker compared to previous years. DISCUSSION: The effects of movies in pedagogy are discussed, especially the accelerated rhythm imposed by this medium. Adverse consequences could be balanced by traditional drawing. CONCLUSIONS: The association of complementary pedagogic methods like movies and drawing could allow an optimization of embryo teaching.
Asunto(s)
Embriología/educación , Enseñanza , Grabación en Video , Curriculum , Educación en Odontología/métodos , Educación de Pregrado en Medicina/métodos , Educación en Farmacia/métodos , Evaluación Educacional/estadística & datos numéricos , Embrión de Mamíferos/diagnóstico por imagen , Embrión de Mamíferos/embriología , Francia , Humanos , Aprendizaje , Evaluación de Programas y Proyectos de Salud , Estudiantes de Medicina/psicología , Estudiantes de Medicina/estadística & datos numéricosRESUMEN
INTRODUCTION: Lacrimal cysts are rarely described and must be differentiated from diseases of the lacrimal gland. We present a rare case of lacrimal cyst developed from an accessory lacrimal gland. CASE REPORT: The management consisted of excision using a tarsoconjonctivale approach. DISCUSSION: Most cysts are diagnosed from the third decade, manifested by progressive exophthalmos. It is a benign disease. However, the differential diagnosis with malignancy is not excluded. Surgical resection is desirable if tumors become symptomatic.
Asunto(s)
Quistes/patología , Enfermedades del Aparato Lagrimal/patología , Aparato Lagrimal/anomalías , Quistes/cirugía , Femenino , Humanos , Enfermedades del Aparato Lagrimal/cirugía , Adulto JovenRESUMEN
A 64-year-old man complained of persistent dyspnea and bilateral basi-thoracic pain with shoulder irradiation. Chest computed tomography revealed a heterogeneous left diaphragmatic mass, while magnetic resonance imaging showed hypo-T1 and hyper-T2 signal. Positron-emission tomography did not show any hypermetabolism. Video-assisted thoracic surgery was decided. At inspection, tumour appeared within the posterior costal part of the diaphragmatic muscle. Tumour resection was extended to a 8-cm-long portion of the lumbar part of diaphragm. Diaphragm was repaired with non-absorbable interrupted sutures. Postoperative course was uneventful. Final pathology revealed an intra-diaphragmatic bronchogenic cyst, which is an exceptional condition. Primary diaphragmatic tumours are very rare and preoperative diagnosis cannot be affirmed. Embryologic hypotheses (migration along the oesophagus or envelopment within diaphragmatic precursors of an abnormal supernumerary lung bud) including recent molecular findings of deregulated pathways (fibroblast growth factor-10 and NOTCH) are discussed.
Asunto(s)
Quiste Broncogénico/diagnóstico , Diafragma/patología , Cirugía Torácica Asistida por Video/métodos , Quiste Broncogénico/cirugía , Diafragma/cirugía , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Tomografía de Emisión de Positrones , Tomografía Computarizada por Rayos XRESUMEN
Encephalocele is a congenital malformation caused by a neural tube defect during embryonic development. We report a case of posterior encephalocele in a 7-month-old infant with a painful occipital mass known since birth. Pathological examination of the mass showed different mature tissues derived from the brain and its coverings (e.g., neuroglia, ependymal canals and clusters of meningothelial cells). A diagnosis of encephalocele was made. The different forms of neural tube defect will be briefly discussed, especially the "aborted" forms (e.g., non-specific midline mass lesion or angioma) that the pathologist may encounter in his/her daily practice.
Asunto(s)
Encefalocele/diagnóstico , Encefalocele/diagnóstico por imagen , Encefalocele/patología , Encefalocele/cirugía , Eosinófilos/patología , Epidermis/patología , Femenino , Proteína Ácida Fibrilar de la Glía/análisis , Humanos , Lactante , Imagen por Resonancia Magnética , Defectos del Tubo Neural/clasificación , Neuroglía/química , Neuroglía/patología , UltrasonografíaRESUMEN
The "Université Libre de Bruxelles" was founded in 1834. Between this year and 1904, the teachers of human anatomy were essentially clinicians and surgeons. Their works were mainly practical. Until 1904 (arrival of Albert Brachet) since present, the researches of the anatomical laboratory were devoted to embryology, and included the beginning of causal embryology. More recently, biomechanics appeared in the field of activity of the laboratory.
Asunto(s)
Anatomía/historia , Docentes/historia , Universidades/historia , Anatomía/educación , Animales , Bélgica , Embriología/educación , Embriología/historia , Historia del Siglo XIX , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Investigación/historiaRESUMEN
INTRODUCTION: Nasal dermal sinus in children (NDSC) is a rare malformation (1/20,000 to 1/40,000). Apart from local infection, they present as median nasal lump or pit on the dorsum and their diagnosis and treatment are often delayed. Consequences of untreated NDSC are: local infection, meningitis, and empyema, due to their frequent intracranial extension. PATIENTS AND METHODS: Six cases of NDSC were retrospectively reviewed (5 boys and one girl), all treated between 2006 and 2012 in our institution (Nancy University Hospital). All patients underwent a brain and facial CT-scan and MR imaging to check any bony lesions, skull base extension by foramen cæcum, course of the sinus and the possible associated brain malformations. Evolution, treatment and follow-up (FU) were conducted by the same multidisciplinary team (neurosurgeon, ENT surgeon, and plastic surgeon). Children were operated on by a conjoined approach (cranial and facial) for removal of the sinus and its intracranial extension. RESULTS: Mean age at diagnosis was 12 months (birth-36 months). Initial presentation consisted of three local infections, one dorsum nasal lump, one CSF leakage, and one asymptomatic child. Five children presented with a skull base extension. There were no associated brain malformations. We observed only one surgical complication (bleeding from the anterior part of the superior sagittal sinus during dissection) leading to blood transfusion. Pathology results confirmed three dermoid cysts, one epidermoid cyst, one cyst with granulation tissue, and negative in one case. Average FU was 30.8 months (4-84 months). Two recurrences (same child) occurred, leading to two re-operations. There were no recurrences or complications at the end of FU. CONCLUSION: NDSC are rare malformations, mostly diagnosed before the age of three years, due to an infectious complication. The aim of the treatment is complete removal to avoid recurrence, and a multidisciplinary strategy is required.
Asunto(s)
Quiste Dermoide/cirugía , Recurrencia Local de Neoplasia/cirugía , Neoplasias Nasales/cirugía , Espina Bífida Oculta/cirugía , Femenino , Humanos , Masculino , Recurrencia Local de Neoplasia/diagnóstico , Neoplasias Nasales/diagnóstico , Estudios Retrospectivos , Espina Bífida Oculta/diagnóstico , Resultado del TratamientoRESUMEN
Naso-ethmoido-maxillary protrusion (NEMP) is a rare dental and facial dysmorphosis, with excessive growth of basicranium, ethmoid, maxillary, and nasal bones. The clinical presentation includes nasal and upper lip protrusion, telecanthus, a class 2 malocclusion with maxillary protrusion and exoclusion. The craniofacial field is increased in Delaire's analysis. Contrary to isolated maxillary protrusion secondary to membranous ossification dysfunction, NEMP is a constitutional anomaly resulting from an excessive primary growth of the chondrocranium. The therapeutic management of NEMP should take into account these specificities.
Asunto(s)
Hueso Etmoides/anomalías , Maloclusión/terapia , Maxilar/anomalías , Anomalías Maxilofaciales/terapia , Nariz/anomalías , Cefalometría , Hueso Etmoides/diagnóstico por imagen , Humanos , Maloclusión/diagnóstico por imagen , Maloclusión/epidemiología , Maloclusión de Angle Clase III/diagnóstico por imagen , Maloclusión de Angle Clase III/epidemiología , Maloclusión de Angle Clase III/terapia , Maxilar/diagnóstico por imagen , Anomalías Maxilofaciales/diagnóstico por imagen , Anomalías Maxilofaciales/epidemiología , Nariz/diagnóstico por imagen , Ortodoncia Correctiva/métodos , Radiografía , Cráneo/anomalías , Cráneo/diagnóstico por imagenRESUMEN
Accurate knowledge of normal cardiac development is essential for properly understanding the morphogenesis of congenital cardiac malformations that represent the most common congenital anomaly in newborns. The heart is the first organ to function during embryonic development and is fully formed at 8 weeks of gestation. Recent studies stemming from molecular genetics have allowed specification of the role of cellular precursors in the field of heart development. In this article we review the different steps of heart development, focusing on the processes of alignment and septation. We also show, as often as possible, the links between abnormalities of cardiac development and the main congenital heart defects. The development of animal models has permitted the unraveling of many mechanisms that potentially lead to cardiac malformations. A next step towards a better knowledge of cardiac development could be multiscale cardiac modelling.
Asunto(s)
Corazón/embriología , Animales , Linaje de la Célula , Regulación del Desarrollo de la Expresión Génica , Edad Gestacional , Cardiopatías Congénitas/embriología , Cardiopatías Congénitas/genética , Cardiopatías Congénitas/patología , Humanos , Modelos Animales , MorfogénesisRESUMEN
The subdiaphragmatic venous drainage of the embryo is provided by the two caudal cardinal veins to which is added the subcardinal vein system, draining the mesonephros, the perispinal supracardinal veins and the umbilical and vitelline venous system. The anastomosis of certain segments of the embryonic venous structures and the disappearance of others are at the origin of the inferior vena cava. Since the 19th century, three-dimensional reconstruction of solid models from histological sections were developed. At present, the development of computerized three-dimensional reconstruction techniques allowed to operate a multitude of techniques of image processing and modeling in space. Three-dimensional reconstruction is a tool for teaching and research very useful in embryological studies because of the obvious difficulty of dissection and the necessity of introducing time as the fourth dimension in the study of organogenesis. This method represents a promising alternative compared to previous three-dimensional reconstruction techniques including Born technique. The aim of our work was to create a three-dimensional computer reconstruction of the retrohepatic segment of the inferior vena cava of a 20mm embryo from the embryo collection of Saints-Pères institute of anatomy (Paris Descartes university, Paris, France) to specify the path relative to the liver and initiate a series of computerized three-dimensional reconstruction that will follow the evolution of this segment of the inferior vena cava and this in a pedagogical and morphological research introducing the time as the fourth dimension.