In praise of tedious anatomy

Functional neuroimaging is fundamentally a tool for mapping function to structure, and its success consequently requires neuroanatomical precision and accuracy. Here we review the various means by which functional activation can be localised to neuroanatomy and suggest that the gold standard should be localisation to the individual's or group's own anatomy through the use of neuroanatomical knowledge and atlases of neuroanatomy. While automated means of localisation may be useful, they cannot provide the necessary accuracy, given variability between individuals. We also suggest that the field of functional neuroimaging needs to converge on a common set of methods for reporting functional localisation including a common "standard" space and criteria for what constitutes sufficient evidence to report activation in terms of Brodmann's areas.

Civility, comportment, and the anatomy theater: Girolamo Fabrici and his medical students in Renaissance Padua

Public anatomies have been characterized as carnivalesque events: like the Carnival, they took place in January and February and celebrated bodily existence. However, in late sixteenth-century Padua and its famous anatomy theater, the annual, public anatomy was a formal, ceremonial event. Girolamo Fabrici, the leading anatomist, gave a philosophical presentation of his research, a presentation organized by topic rather than by the gradual dissection of corpses. For medical students, the annual anatomy and the theater itself encouraged silence, obedience, and docility, reinforcing the virtues that permeated the late humanist environment of Renaissance Padua.

Anatomical investigations and their ethical dilemmas

The multi-faceted nature of modern anatomy comes as a surprise to many, especially when confronted by such seemingly different topics as cadavers and human embryo research. However, even these disparate facets of anatomy are linked by common underlying ethical considerations. This article traces historical views of anatomy and places them alongside the more contemporary dimensions of whole-body plastination, use of human material obtained under unethical circumstances, and human embryo research. These dimensions introduce issues of respect, human dignity, consent, scientific integrity, and societal expectations.

The future of interdisciplinary research and training: how to conquer the silo guardians

We have entered a new era in biomedical research in which large interdisciplinary teams are being established to answer important scientific questions. Scientists of multidisciplinary backgrounds within universities are combining forces and inter-institutional consortia that include alliances between academia and industry are springing up around the country to generate breakthrough advances. A number of driving forces are at work to establish these collaborative research approaches. By contrast, there also are barriers to be surmounted by institutions with silo mentalities for effective partnerships to be established. In order for this new era of research to reach maximal effectiveness, new approaches to education of the young and retraining of established administrators and scientists must take place. These issues were explored thoroughly at the 2006 annual meeting of the Association of Anatomy, Cell Biology and Neurobiology Chairpersons (AACBNC) that was held in Aruba from January 18 to 21. The theme of this historic meeting was the Future of Interdisciplinary Research and Training: Breaking Down the Barriers. In this introductory article, we discuss the formation of a trendsetting Institute of Biomedical Sciences and Technology, the concept of the AACBNC meeting, and the influence of the Institute on the content of the meeting. The proceedings of this meeting, including Nobel Laureate Papers and Nobel Round-Table Discussions on the future of interdisciplinary research and training, are contained in this special issue of Experimental Biology and Medicine, a journal dedicated to the publication of multidisciplinary and interdisciplinary research in the biomedical sciences.

A tale of two speeds: challenges for research universities

This manuscript represents a presentation to the Annual Conference of the Association of Anatomy, Cell Biology and Neurobiology Chairpersons. The author is responding to the question, "How can university administrations nurture both interdisciplinary and inter-institutional collaboration and cooperation?" The presentation makes the point that university administrators must be cognizant of the changing dynamics of interdisciplinary and inter-institutional collaboration and cooperation due to the speed of the Internet and the speed of travel today. Those institutional leaders, and their universities, that recognize that the world has become flat will flourish, while those locked in a silo mentality will perish.

Re-engineering Colles: form, function and fragility fractures

Of the twenty nine anatomy professors in the Royal College of Surgeons in Ireland, primus inter pares is Abraham Colles. In his 1811 book A Treatise on Surgical Anatomy he revolutionised the subject by teaching it topographically, seeking "to describe the relative position of the parts and to point out the subservience of anatomical knowledge to surgical practice". Today we have extended this to 'clinical practice' and, in the Anatomy Room, students are guided through each region by clinically trained staff, from surface anatomy via three-dimensional dissection to radiological images. This is augmented by online histology and radiology courses and DVDs in which dissection footage, edited by a content analysis engine, is used to preview and review practical classes. In the same book, Colles also wrote that 'the fixed and immutable laws of mathematics are little applicable to the science of medicine'. Computer-aided learning argues against this. So does research which links fatigue microdamage to bone remodelling and the development of algorithms to predict, and thus prevent, osteoporotic fractures. Mechanical principles are being used to develop scaffolds for tissue engineering and to optimise the mechanical environment of seeded mesenchymal stem cells. While Colles' teaching approach holds true, in biomechanics, tissue engineering and computing, mathematical laws are now being successfully applied to medical science.

Should we continue teaching anatomy by dissection when …?

The central role that human dissection has long held in clinical education is being reevaluated in many institutions. Despite the impression that many institutions are abandoning dissection, very few have and most of those have reinstated dissection within a few years. What are the inherent qualities that lead institutions back to dissection? In our efforts to redesign a shortened dissection course, our consultations with a broad range of clinicians lead us to understand how the rhythms of clinical practice are modeled and developed in the small-group setting of the dissection laboratory. Following further consultation with colleagues who have experimented with different models of anatomy instruction, we discuss three themes in support of dissection. First, problem-solving in the dissection laboratory develops the habits-of-mind of clinical practice. Second, relating dissection to imaging modalities develops the spatial reasoning skills needed to understand computer simulations, interpret imaging data, and interact with surgeons, radiologists, and patients. Third, the human face of dissection fosters self-reflection and integration of the cognitive and affective skills required for medical practice. Through group process, the collaborative effort of dissection teams develops essential of attributes of clinical professionalism.

Anatomical ontologies: names and places in biology

Recently, ideas from the field of ontology have been picked up by computer scientists as a basis for encoding knowledge and with the hope of achieving interoperability and intelligent system behavior. The use of anatomy ontologies to represent space in biological organisms, specifically mouse and human are reviewed here.

Ontology has long been the preserve of philosophers and logicians. Recently, ideas from this field have been picked up by computer scientists as a basis for encoding knowledge and with the hope of achieving interoperability and intelligent system behavior. In bioinformatics, ontologies might allow hitherto impossible query and data-mining activities. We review the use of anatomy ontologies to represent space in biological organisms, specifically mouse and human.

Promoting graduate student interest and participation in human gross anatomy

For many years, graduate students at the University of North Texas Health Science Center (UNTHSC) were reluctant to enroll in dissection-based human gross anatomy courses. Furthermore, few graduate faculty mentors would allow their students to enroll in these courses. The significant amount of time allotted to courses such as anatomy and its effect on students' research programs have been identified by faculty as the primary reason for this lack of enthusiasm. For example, prior to 1999, graduate students taking human gross anatomy at UNTHSC registered for a 13-semester credit hour (SCH) course that was offered only in the fall semester. In the last 5 years, the anatomy teaching faculty in the Department of Cell Biology and Genetics (CGEN) restructured the human gross anatomy course for graduate students. A series of small, compact anatomy courses, ranging from 3-7 SCHs, are now offered throughout the school year to replace the single anatomy course. The CGEN faculty designed courses based on single or multiple body systems that varied in length from a few weeks to an entire semester. This change was initiated with the implementation of a system-based approach to anatomy instruction in our medical school curriculum and the elimination of our graduate anatomy course. With the development of six anatomy courses covering the entire human body, we have had a significant increase in graduate student participation. Moreover, the shorter duration of the courses has made them more appealing to graduate faculty mentors who want to keep graduate students focused on their research.

Provision of anatomical teaching in a new British medical school: Getting the right mix

In response to a government report, which recommended a substantial increase in the number of medical students in the United Kingdom by 2005, several new medical schools have been set up throughout the country. One such school, the Brighton and Sussex Medical School (BSMS), recently opened its doors to new students. BSMS offers a 5-year medical curriculum that uses an integrated systems-based approach to cultivate academic knowledge and clinical experience. Anatomy is one of the core elements of the program and, as such, features strongly within the modular curriculum. The challenge for the anatomy faculty has been to decide how best to integrate anatomy into the new curriculum and what teaching modalities should be used. A multidisciplinary approach has been taken using both traditional and contemporary teaching methods. Unlike most of the other new medical schools, BSMS uses cadaveric dissection as the cornerstone of its teaching, as the faculty believes that dissection still provides the most powerful technique for demonstrating anatomy as well as enhancing communication and teamwork skills. The dissection experience is handled using an understanding and professional way. However, to ensure that our students do not become detached from the process of patient-focused care, emphasis in the dissecting room environment is also placed on respect and compassion. To enhance conceptual understanding of structure and function and provide further clinical relevance, we are using imaging technology to demonstrate living anatomy. Unique to the BSMS curriculum is the teaching of the anatomy in the later years of the program. During specialist rotations, students will return to the dissecting room to study the anatomy relevant to that area. Such vertical integration ensures that core anatomical knowledge is gained at the most appropriate level relative to a student's clinical experience.

Ethics, transplantation, and the changing role of anatomists

Anatomists are regarded as custodians of cadaveric material donated to science. Almost every facet of medical science has experienced explosive advances. This has impacted directly on anatomists and their role. Increasingly, anatomists are raising concerns with regard to the treatment of human tissue (Jones,2002, Clin. Anat. 15:436-440). The Korperwelten (Bodyworlds) of Gunther von Hagens et al. (1987, Anat. Embryol. 175:411-421) has evoked considerable debate about the treatment of human cadavers. Thus far clinical anatomists have had little role to play in policy formulation, legislation, and ethical imperatives as applied to cadaveric donation for organ transplantation. Anatomists play an even more negligible role in the raging ethical controversy around live related/unrelated organ transplantation. Due to the critical international shortage of cadaveric donors, boundaries are being pushed to meet the needs of potential recipients (Ohler,2001, Prog. Transplant. 11:160-161). Constant reappraisal of these ethical and moral issues is therefore appropriate. Issues that relate to cultural and economic imperialism and pronouncements of international transplant societies may also require re-evaluation. The legislature governing the donation of human tissue in various countries is usually governed by a Human Tissue Act or its equivalent. In general, such acts are congruent with the Human Tissue Act (South Africa: Government Gazette 9, November 2001; No. 22824) that states "It is an offense to charge a fee in relation to the donation of human organs." In many countries, however, various lay press report that "the sale of body parts is now coming of age." Terms such as "rewarded gifting" and "donors" being transformed into "vendors" are opening a Pandora's Box (Nelson et al.,1993, "Financial incentives for organ donation: a report on the UNOS ethics committee payment subcommittee"). Cameron and Hoffenberg (1999, Kidney Int. 55:724-732) feel strongly that arguments in favour of the sale of organs are sufficiently cogent to warrant further discussion. Equally disturbing is the use of executed prisoners as organ donors. In the developing world there are additional socio-economic, indigenous and cultural, religious, and ethical issues to consider. In addition, strategies that are ethically sound and morally acceptable to expand the pool of living donors must keep pace with recent advances in medicine. A paradigm shift is required for anatomists to contribute to the international ethical debate, not only as custodians of the dead but also as protectors of the living. Their voices should be heard in transplantation and other forums, and contribute to the ethical debate as well as relevant evolving legislature.

Dissection as a teaching tool: Past, present, and future

Cultural changes, scientific progress, and new trends in medical education have modified the role of dissection in teaching anatomy in today's medical schools. We discuss in this article the role of dissection itself, the value of which has been under debate for the last 30 years. The importance of dissection is considered from different points of view: educational, bioethical, and human values. Included are different opinions from professors and students. Finally, the current practice of dissection is described for some universities in the United States and Europe, showing its use as a learning tool.

Attitudes of Turkish anatomists toward cadaver donation

There is an insufficient number of cadavers in anatomy education in Turkey. This is because of decreased number of unclaimed bodies and very few cadaver donations. Increasing the number of cadaver donation is one of the probable solutions. Although anatomists encourage people to donate bodies, the attitudes of anatomists toward donating their own bodies for dissection is not well known. In this study, the attitudes of Turkish anatomists toward cadaver donation were evaluated. The questionnaires were sent to the anatomists in Turkey by mail and E-mail. Eighty-three anatomists replied to the questionnaire. The main solutions proposed for cadaver insufficiency included increasing the supply of unclaimed bodies (77.1%) and increasing body donation (78.3%). Further, 51.8% of the respondents thought that increasing body donation was a long-term solution. The general belief (83.1%) was that a campaign would help to increase body donation and 47% of respondents were willing to participate in such a campaign. Of the 83 anatomists, 20.5% of the respondents donated their organs and 49.4% were planning to donate them. Further, 15.7% were planning to donate their bodies; however, 63.9% did not consider donating. The main reasons of the respondents to object the donation were: to be dissected by a colleague (15.7%), the unacceptability of donation by family (26.5%), psychological reasons (43.4%), the anxiety of disrespectful behavior to cadavers (26.5%), and religious beliefs (3.6%). Although the majority of the respondents objected to donating their bodies due to psychological reasons, body donation was proposed as the main solution of cadaver insufficiency.