["Left hemicranium, the cranial nerves" by Tramond: An anatomical model in wax from the Delmas, Orfila and Rouvière's Museum in Paris: description and tri-dimensional photographic reconstruction (TDPR)]

An anatomical model in wax made by Tramond (middle of the 19th century) represented the cranial nerves of a left hemicranium. The aim of the study was to verify its anatomical veracity, to realize a tri-dimensional visualization by computer, and finally to numerize and to diffuse it to the general public in the purpose of culture on the internet. The model belonged to the Delmas, Orfila and Rouvière Museum (Paris Descartes university). It represented the cranial nerves especially the facial and the trigeminal nerves and their branches. To perform the photographic rotation every 5° along 360°, we used a special device made of two identical superimposed marble disks linked by a ball bearing. A digital camera and the Quick Time Virtual Reality software were used. Seventy-two pictures were shot. This wax was realized with a great morphological accuracy from a true cranium as a support for the cranial nerves. The work of numerization and its free diffusion on the Internet permitted to deliver to everybody the images of this sample of the collection of the Orfila Museum, the pieces of which were evacuated on December 2009 after its closure.

[An anatomical wax of the deep structures of the pelvic limb (by Tramond, 19th century): observation of the tridimensional photographic rotation]

Anatomical wax modelling was widely used during the 19(th) century, especially in France and Italy. In Paris, The Tramond house was specialized in the realization of this kind of samples.

MATERIAL AND METHODS

The sample was placed on two large horizontal marble disks, rotating every 5°. We could then describe the sample, verify its anatomical accuracy and also perform a virtual reconstruction with Quick Time Reality QTVR(®) software.

RESULTS

The muscular, nervous and arterial elements were represented. We divided the description in three parts: (1) lumbar, pelvic and femoral; (2) femoro-tibial; and (3) tibio-tarsian. We focused the anatomical description on the sciatic nerve; on the organization of the muscles of the gluteal region and the neurovascular organization; and on arterial segmentation. This sample was getting damaged with time, noticeably the representation of the nerves, which are very thin and so, very fragile. Nowadays, 3D representation of the dissected human body is more common, with new techniques such as plastination (Von Hagen's type), which allows one to preserve all the anatomical elements of the subject. This paper and the realization of the virtual museum also aim to participate in a work memory, which recognize the knowledge of the anatomist of wax makers, their teaching quality remained unequalled as their obvious artistical value.

[The nerves of the face: anatomical sample in wax in the Delmas-Orfila-Rouvière Museum in Paris]

The aim of the study was to check the anatomical veracity of the model of wax no. 262, from the Delmas, Orfila and Rouvière museums, 45, rue des Saints Pères, Paris 6th, made by Tramond M.D., entitled "nerves of the face". We successively took several numerical photographs with several view angles; anatomically described the nerves of the face as they were represented on this model; correlated the anatomical veracity of this representation with the classical, textbooks' data; approached the technical bases of fabrication; and collected successive photographs of the model every 5 degrees , all along 180 degrees , thus allowing an animated rotation on computer, using the QuickTime Virtual Reality program. The oversize of the model excluded a set on a real human skeleton. The building technique of the model was deduced from known data but could not be completely reported. The anatomical veracity of the sample was excellent. The difficulties of realization in wax of an oversized model of the nerves of the human face were solved in the late 19th century, in Paris by Tramond's factory. They remained unequalled.

[An enlarged dismantable anatomical model of the ear by Auzoux: observation and photographical tridimensional reconstruction]

The aim of the study was to determine the accuracy of a 19th century anatomical model of an ear by Auzoux (a French manufacturer). It measured 63 cm in length; 43 cm in width; 37 cm in height. The disassembled parts were studied on the morphological aspect in its whole and after removing of its components: external ear (43 cm x 23 cm x 15 cm), tympanic drum and middle ear ossicles; cochleo-vestibular apparatus. The main dimensions of each part were recorded. The arterial vascularisation of the three components of the ear and its sensitive and sensorial nervous system were established on the model which represented the external carotid artery with its terminal bifurcation, several collateral branches specially the posterior auricular artery and the middle meningeal artery; the internal carotid artery at the two extremities of the carotid canal. The cochleo-vestibular and facial nerve as well as other elements of small calibre were exactly figured and labelled by a number. The middle ear components were disassembled. The ossicles of the middle ear and a dried peritoneal tympanic membrane were dismountable as a whole. Only a few minor modification from the admitted data of anatomy as well as the cutaneous muscles of the external ear were observed on this sample, the anatomical aspects of which were very precisely represented. The material was typical of the Auzoux manner: a special papier-mâché whose conception and realization remains unequalled. This kind of very rare model can be dated at the earliest 1835 (Lemire, 1990).

[Constant Duméril (1774-1860) anatomist doctor and naturalist, about a portrait by G. Devers]

André, Marie, Constant Duméril (1774-1860) served as a professor in the << faculté de médecine de Paris >> from 1801 to 1855. He was also chairman of herpetology and ichthyology of the << Muséum national d'histoire naturelle >> in Paris. The Paris-Descartes University (department of anatomy) owns a great, framed portrait which is an oil painting by Giuseppe Devers, 1855, representing C. Duméril sat on a chair. The study of his portrait, biography and bibliography brings precisions on a noticeable scholar of the anatomical and naturalistic field in Paris in the first half of the 19th century.

[The Vitruvian Man: an anatomical drawing for proportions by Leonardo Da Vinci]

The aim of the study was to find out and to analyse the text by Vitruvius which inspired the famous drawing by Leonardo da Vinci (circa 1490) kept in the Galleria dell'Accademia, in Venezia, Italy: the man inscribed in one circle and in one square. The book "de Architectura" by Vitruvius Marcus Pollio was printed several times since the Renaissance when both the roman architecture of antiquity and this text became very popular. From a French translation by Claude Perrault in 1864, it became easy to find a French translation with the original text in Latin (Paris, 2003, Les Belles Lettres, French text by Pierre Gros). The drawing by Leonardo da Vinci illustrates with great accuracy and fidelity the quotation of Vitruvius (with the exception of two of the 12 main relationships). The genius of Leonardo da Vinci was to keep only one trunk, head and neck for two pairs of limbs: scapular and pelvic; to make the circle tangent to the lower edge of the square; to adjust a few features of the quotation for the equilibrium of the whole figure; and of course to bring his incredible skill as a drawer (one of the best of his century). The drawing was made on a sheet of paper 344x245mm, in black ink which became dark brown with time; several lines complete the figure above and below; a short caption and a horizontal scale appear just under the drawing. The celebrity of the drawing, a symbol of the Renaissance, of the equilibrium of man and mankind, of the universality of the artists and intellectuals of the time (Humanism) made it iconic and it has been constantly reproduced and adapted especially for advertisement and logos, not only in the medical field.

Intertubercular sulcus of the humerus: biometry and morphology of 100 dry bones

The dimensions and morphology of a critical zone of the intertubercular sulcus (ITS) of the humerus were specified for 100 dry bones. The upper part of the ITS was narrow and at an angle with the lower part. The tendon of the long head of the biceps brachii muscle (TLBB) was particularly worn down during its course through this critical zone. The critical zone extended from the first perceptible proximal depression to the distal extremity of the lesser tubercle. It showed a proximal part of 12.4 mm (standard deviation = 2.23) and a distal part of 15.1 mm (s.d. = 3.37). The two parts made an angle of 142 degrees (s.d. = 7.87). Its total length was 28.5 mm (s.d. = 4.74), depth 2.44 mm (s.d. = 0.49), width 6.33 mm (s.d. = 0.84). The supratubercular ridge was the only bony variation, found in 45% of the bones of this series. Bony abnormalities were of three types: (1) calcifications in 39% of the bones, (2) lateral spurs in 32% and medial spurs in 23%, (3) degenerative changes in 9% of the bones. Biometric considerations showed that the TLBB inside the ITS was unstable. The supratubercular ridge could increase this instability and thus favor disease of the tendon. Bony abnormalities which may be associated with TLBB lesions, can be seen in radiographs.

[THe Laumonier wax model of the ear (Collections of the Museums of the Anatomy Laboratory of Saints Pères, Paris)]

Authentified by the name of Laumonier (fecit), written on the zygomatic process of the temporal bone, a model in wax of the medial, middle and lateral ears, belongs to the collection of the "Musées Delmas, Orfila et Rouvière" in Paris. This model presents large dimensions with a great anatomical rightness. The entire temporal bone is represented with the upper part of the endocranial petrous bone removed in order to demonstrate the main elements of the internal ear (cochlea and semi-circular canals) and of the middle ear (malleus and incus). Also were represented the temporal muscle and temporal vessels, the emergency of right cranial nerves, the superior orbital fissura and its elements; the internal carotid artery and the internal jugular vein, the upper part of the sterno-cleido-mastoidal muscle and of the styloïd muscles; the middle internal part of the basis of the cranium with the trunk of the trigeminal nerve, the Gasser's ganglion with its trifurcation, the sigmoïd sinus. The dimensions are greater than the real size: total highness: 22 cm; total length: 46.5 cm; maximal highness of the ear cartilage: 16.5 cm; hemicranium width: about 22 cm. Thus the magnification of size is 2 or 3 if calculated on the basis of the external ear and 3 or 4 with reference to the half width of the cranium. The sample is fixed by two screws on a single wood board measuring 46.5 cm on 29.2 cm with two supplementary boards of 2.4 cm width under the two extreme of width, with a thickness of 1 cm.

Stereology of the myocardium in human foetuses

The rate of cellular proliferation and hypertrophy of the cardiac myocytes in the human perinatal period is still controversial. This work uses stereology to evaluate the prenatal quantitative changes of the myocardium. The hearts of 36 human foetuses, ranging from the 2nd trimester to the 3rd trimester, were studied. Fifteen random microscopic fields were analyzed in each heart. The following stereological parameters were determined: Vv[myocyte] and Vv[interstitium] (the volume densities of the cardiac myocyte and interstitium, respectively) and the Nv[myocyte] (the numerical density of the cardiac myocytes). The total number of myocytes (N[myocyte]) and the mean myocyte volume (V[myocyte]) were also determined. All differences between the second and the third trimester of gestation, tested with the Mann-Whitney test, were statistically significant (P < 0.05). The Vv[myocyte] decreased 8.69% and the Vv[interstitium] increased 49.83% in this period. Simultaneously, the Nv[myocyte] decreased 16.64%, the V[myocyte] increased 16.39%, the cardiac weight increased 366.67% and the N[myocyte] increased 272.06%. In conclusion, during the last two gestational trimesters the human heart increases in weight more than 4.5 times, the volume density of myocytes decreases while the volume density of the cardiac interstitium increases. The numerical density of myocytes per myocardium volume decreases but the myocytes became greater in mean volume (more than 16%).

[Biometry of the inferior vena cava (subrenal segment): dissection of 100 recently deceased subjects]

The vena cava inferior in its infra-renal part is a selective place to set on anti-thrombosis devices. The biometry of 100 fresh, adult cadavers interested the useful and real lengths, the diameters on several levels and on the corresponding part of the aorta, the end of the iliac venae and the origin of the iliac arteriae . The useful length of the vena cava inferior is 96 mm in mean, and its real diameter is 17 mm, on the middle of the infra-renal part.

[Computer-assisted reconstruction of the distal end of the humerus]

Horizontal cross-sections of the distal humerus were introduced into a computer of assisted conception with one high resolution graphism. Images were reconstituted with several noticeable angles. Architectural characteristics of this complex osseous structure were noticed and the superimposition of the cross-sections by transparency could got the spindle shape of the medial pillar, more horizontal than the quadrangular and massive column of the lateral pillar. Informatic apparatus was a high technology one, anatomical applications are promising if the reconstructions are realized from precise and thinly systematically seriated cross-sections with a good knowledge of their morphological aspect. Informatic introduction is a heavy cost but irreplaceable mean of simulation with previously defined angles.

[Double mitral orifice. An anatomical case]

A double mitral orifice was discovered at autopsy in a 74 year old woman. Death resulted after several episodes of cardiac failure complicating mixed mitral and aortic valve disease. A vertical limbus bridged the mitral annulus separating it into two distinct right and left orifices, with oblique long axes aligned towards the lower part of the limbus perpendicular to each other from the left atrial view. After opening the left ventricle, both orifices were observed to have their own sets of chordae tendinae attached to normal papillary muscles: the right orifice to the posterior and the left to the anterior papillary muscle. The inferior end of the limbus was attached to a supplementary papillary muscle. Echocardiography and CT scanning were performed before dissection. This malformation results from symphysis of the mid parts of the two mitral leaflets during embryonic stages 15 and 16 (8-10 mm vertex-coccyx, 31st-33rd days).

[Volume of the spine in the post-somite stage: morphometric quantification]

The volume of the spine was measured in 9 embryos from 8 to 31 mm Crown-Rump length (complete series of cross-sections). Spine morphometry was performed by planimetric point counting of horizontal projection on a 5 mm square grid. Total spine volume was integrated by multiplication of the thickness by the area. The integrated volumes (including the base of the skull around the foramen magnum) were aligned on the diagram : linear length v.s. semi-logarithmic volume. The correlation between the spine volume and the total length is very high (r = 0.94; p less than 0.01). There was no significant variation of the whole spine curvature during this period (angular value and curve radius). Linear measurements of the maximal width on the entire embryos and their spine were expressed with the crown-rump length, drawing linear curvatures with slight irregularity, emphasized by plotting the values of indices. These variations could be due both to the imprecision in section thickness and to the individual variation during the spinal growth for this embryonic phase.

[Study of atrial conduction tissue in the 17 mm V-C human embryo. Morphological contribution to the pathogenesis of sinoauricular node dysfunction]

Is there a specialised conduction pathway connecting the sinoatrial and atrioventricular nodes within the crista terminalis? As lesions of this zone can cause sinus node dysfunction and the sick-sinus syndrome, we decided to study this structure at the beginning of its embryonic development. Serial 10 micronthichness transverse sections of a 17 mm vertex-coccyx (Stage 19) human embryo were studied by light microscopy, anatomical reconstruction (Born) and morphometry. The region of the sinus venosus and venous valves, of the superior vena cava and the atrioventricular region were drawn and reconstructed with 150 X magnification by Born's method using wax plates of the following dimensions: 175 X 95X 1.5 mm. The volume of the region of the sino-atrial node was determined by multiplying the thickness of the sections by the surface of the region (measured by planimetry using the point counting method); its value was 15.4 X 10(6) microns3 with an antero-posterior diameter of 490,0 micron. These results show that this region is already proportionally larger in Stage 19 embryos. Reconstruction showed the sinoatrial node region to be a round bulge with a groove on either side: that of the sulcus terminalis and the superior vena cava on the left and the same vein with the mesocardium on the right. The right venous valve connects this zone with the interatrial septum and comprises two distinct cellular components, on derived from the atrial wall and the other from the muscle of the sinus venous. The artery fo the sinoatrial node was identified.(ABSTRACT TRUNCATED AT 250 WORDS)

[Biometry of the lumbar spine using scanography]

Biometry of one human lumbar spine was performed on a series of computed tomographic cross-sections every six millimetres. Linear and density measurements were multiplied on each level. Biometrical results confirm date of the litterature, but are more numerous by means of CT scan. Effectiveness on the living is acquired by whole body apparatus.

[Biometry of the thoracic spine using scanography]

Biometry was performed on CT scan of a human thoracic spine. The entire spine was removed from the fresh corpse of an adult man. Horizontal cross-sections were performed, every 6 mm from C7 to L1. Measurements involved the main diameters of the vertebrae, spinal canal and spinal cord, muscular depth and punctures. Several density measurements were noted.

Horizontal cross-sections of the cervical spine. Computed tomography and anatomy every 6 mm

Comparison between the anatomical and computed tomographical aspects, was performed on horizontal cross-sections every 6 mm, of one human cervical spine. The entire spine was taken off from a fresh man's cadaver with the head and neck. The sample was first computed tomographied and then anatomically sawn on the same levels with the same thickness. The differences between both techniques are minimal, dued to the analysis of a plane for the anatomy and the integration of a volume for the C.T. scan. Clinical and fundamental applications are pointed.

Computed-tomographical biometry of the cervical spine on horizontal cross-sections every 6 mm

Biometry was performed on the computed tomographical cross-sections of one human cervical spine. The entire spine was removed with the head and neck from a fresh cadaver of an adult man. Horizontal cross-sections were performed with a C. T. scan from the base of the skull to the thoracic level. The measurements concerned the diameters of the vertebrae, spinal canal and spinal cord; the depth of the posterior and anterior walls, and of the para-vertebral muscles. Clinical and fundamental applications are underlined.

[The role of the psoas muscle: apropos of the dissection of the muscles from 10 adults and 10 newborn infants]

The action of the iliopsoas muscle (Musculus iliopsoas) on movements of the hip is studied by direct traction on fresh cadavers (10 still-born and 10 adults). The psoas muscle is a powerful flexor of the hip but also an external rotator. The action of external rotation is moderate but obvious in every position of the femur (Os femoris) and more important if previously in abduction and internal rotation.

[Sub-astragalar articulation: functional approach using load imprints]

The prints of the subtalar articulation were studied in several positions. An original set allowed the fixation of the articulation under pressure and in the desired position. Contact areas of articular surfaces were coloured by Safranin 0. In inversion and eversion, the rate of incongruency of articular surfaces increased, while the contact was maximal in a mid-position, fixed by a passive blocking of the articulation. According to our results, the support is the main position transmitting the pressures during the gait when the talocrural joint is in motion; the inversion is the essential movement when the foot is not in contact with the ground.

[Tomodensitometry of the humeral distal extremity. Morphologic and biometric study of the pillars]

Biometry by computerized tomography on osseous series has not yet been applied in physical anthropology. I performed computed tomographical cross-sections on nine distal human humeri, every three millimetres, up to five centimetres of their length. The bi-epicondylar width was the reference level to compare the bones. I took several measurements at each level for each bone, and each area was calculated. The results confirmed our previous data on dry bones. Many reproducible and valuable measurements were possible, the accuracy of several was increased, and new measurements were defined. The morphological analysis of density measurements added new data. The osseous areas were easily integrated. This method which does not alter bones is precise and important in osteological studies in modern and paleo-anthropological primatology.

[The nerve of the posterior muscle of the leg]

The nerve of the musculus tibialis posterior was dissected to prepare its elective neuroclasia in a girl with cerebral palsy. Numerous variations relative to the other branches in the neighbourhood were proved, but one may conclude that the origin of this branch from the nervus tibialis at the level of the arcus tendineus musculi solei, as the apparent termination on the muscle's surface are the most proximal of the branches for the deep muscles of the leg. The surgical approach prohibits a complete dissection and it was only the electrical stimulation which identified the nerve with certainty.