Sexual dimorphism in peri-articular tissue anatomy - More keys to understanding sex-differences in osteoarthritis?

Objective: Osteoarthritis prevalence differs between women and men; whether this is the result of differences in pre-morbid articular or peri-articular anatomical morphotypes remains enigmatic. Albeit sex within humans cannot be reduced to female/male, this review focusses to the sexual dimorphism of peri-articular tissues, given lack of literature on non-binary subjects.

Methods: Based on a Pubmed search and input from experts, we selected relevant articles based on the authors' judgement of relevance, interest, and quality; no "hard" bibliometric measures were used to evaluate the quality or importance of the work.

Sexual dimorphism in articular tissue anatomy - Key to understanding sex differences in osteoarthritis?

Objective: Osteoarthritis (OA) prevalence and incidence varies between women and men, but it is unknown whether this follows sex-specific differences in systemic factors (e.g. hormones) and/or differences in pre-morbid joint anatomy.

How the Ends of Bones Evolve and What They Do: The Anatomical and Biomechanical Perspective.

Skeletal ossification occurs either directly within mesenchymal tissues or indirectly through a template of hyaline cartilage. Between the epiphyses and diaphyses of long bones, hyaline cartilaginous growth plates remain and constitute the progenitor cell reservoir from which the tissue develops toward the diaphysis and determines longitudinal bone size. Growth plates exhibit a characteristic architecture with columnar cell organization and different zonal morphology.

The mechanical properties of fresh versus fresh/frozen and preserved (Thiel and Formalin) long head of biceps tendons: A cadaveric investigation.

Human cadaveric specimens commonly serve as mechanical models and as biological tissue donors in basic biomechanical research. Although these models are used to explain both in vitro and in vivo behavior, the question still remains whether the specimens employed reflect the normal in vivo situation. The mechanical properties of fresh-frozen or preserved cadavers may differ, and whether they can be used to reliably investigate pathology could be debated.

Development of the competency-based medical curriculum for the new Augsburg University Medical School.

With the resolution from April 28, 2014, the Bavarian state government in Germany decided to found a new medical school at Augsburg University, thereby requiring the development of a competency-based medical curriculum. Two interdisciplinary groups developed a spiral curriculum (following Harden) employing the model of Thumser-Dauth & Öchsner. The curriculum focuses on specifically defined competencies: medical expertise, independent scientific reasoning, argumentation and scholarship, as well as communication skills.

Diffusion-tensor imaging of human articular cartilage specimens with early signs of cartilage damage.

Purpose: To assess the use of diffusion-tensor (DT) imaging of articular cartilage to detect and grade early cartilage damage in human specimens with early signs of cartilage damage.

Materials And Methods: This study was approved by the institutional review board. Forty-three cartilage-on-bone samples drilled from 21 human patellae were examined with 17.

Ultra-high field diffusion tensor imaging of articular cartilage correlated with histology and scanning electron microscopy.

Object: To investigate the relationship of the different diffusion tensor imaging (DTI) parameters (ADC, FA, and first eigenvector (EV)) to the constituents (proteoglycans and collagen), the zonal arrangement of the collagen network, and mechanical loading of articular cartilage.

Material And Methods: DTI of eight cartilage-on-bone samples of healthy human patellar cartilage was performed at 17.6 T.

Change of diffusion tensor imaging parameters in articular cartilage with progressive proteoglycan extraction.

Objective: To investigate changes of diffusion tensor imaging (DTI) parameters (mean apparent diffusion coefficient [ADC], fractional anisotropy [FA], and first eigenvector) with increasing proteoglycan (PG) extraction of articular cartilage.

Material And Methods: Twelve cylindrical cartilage-on-bone samples were drilled from 4 human patellae (3 per patella). Each sample was divided into 2 pieces.

Morphological adaptation of the tarso-metatarsal joints onto load transmission in the foot.

Purpose: Undefined middle foot pain among older individuals is an increasingly problem. Thereby the tarso-metatarsal joints (Lisfranc's joint, TMT joints) are particularly important for foot structure. The aim of this study was to obtain into force transmission in TMT joints by analysing degenerative morphological changes (DMC) of the articular cartilage and subchondral density patterns.

Spatial patterns of cartilage loss in the medial femoral condyle in osteoarthritic knees: data from the Osteoarthritis Initiative.

The objective of this study was to develop a technique for analyzing spatial patterns of cartilage loss in the medial femoral condyle (MF), and to study MF cartilage loss in participants of the Osteoarthritis Initiative. Using a 0.7 mm sagittal double echo at steady state (DESS) sequence, 160 osteoarthritic knees from 80 participants with varying degrees of medial joint space narrowing were imaged at baseline and 1-year follow-up.

Student learning preferences and the impact of a multimedia learning tool in the dissection course at the University of Munich.

How do students use multimedia tools to support their learning during a gross anatomy dissection course? We investigated this question in the anatomic dissection course for first year medical students at the University of Munich (n=850) by giving all participating students access to an anatomical multimedia CD-ROM. The use of this multimedia learning tool was voluntary and it was not essential for the end-of-course examination. After the examination, two questionnaires (return rate first questionnaire n(1)=347, approximately 41%; return rate second questionnaire n(2)=644, approximately 76%) were given to the surveyed students with the following content: evaluation of the multimedia learning tool, details about the usage of different kinds of available learning media, and finally an evaluation of the media used for teaching during the course.

Mineralization density and apparent density in mandibular condyle bone.

Objectives: This study evaluated a method for determining the density and distribution of bone of mandibular condyles using proprietary computerized tomography (CT) software.

Study Design: Thirty-eight condylar specimens were investigated with a high-resolution multislice CT. The density was determined by using bone density analysis algorithms available within the proprietary software.

The trabecular architecture of the superior articular process of the lumbar spine (L2-S1).

The role of the facet joint in low back pain has gained public attention lately. The objective of our study was to investigate whether there is any difference in the adaptation of the cancellous bone in the superior articular process depending on the specific stress condition in different levels of the spine. Therefore, the trabecular structure of the superior articular processes of L2 and S1 of 15 cadavers (aged 63-100 years) were studied using muCT (micro-computer tomography).

[Concept, implementation and evaluation of an interfaculty Master of Medical Education Programme].

The implementation of new medical licensing regulations (AAppO 2003) was the starting point for radical curricular changes in all German medical schools. In 2004, the postgraduate and interfaculty Master of Medical Education (MME) degree programme was established at the University of Heidelberg under the auspices of the Medical Faculty Association (Medizinischer Fakultätentag, MFT) and supported by the Association for the Promotion of Science and Humanities in Germany (Stifterverband für die Deutsche Wissenschaft). This new degree programme is intended to train multipliers and leaders in medical education, to build a German-speaking network and to strengthen educational research.

[Integration of a seminar on the anatomical basis of otorhinolaryngology (ENT) into the clinical course improves the confidence and performance of students in the clinical discipline].

A sound knowledge of the scientific basis of medicine is a prerequisite for successful learning and understanding of clinical issues. Teachers of clinical medicine, however, often complain that their students' knowledge on the scientific basis of medicine is too low. In the clinical curricula of most medical schools in Germany, students rely on self-directed learning efforts to optimize their knowledge of basic issues for the study of clinical medicine.

An immunohistochemical study of the tissue bridging adult spondylolytic defects--the presence and significance of fibrocartilaginous entheses.

Unlabelled: Introduction Spondylolytic spondylolisthesis is an osseous discontinuity of the vertebral arch that predominantly affects the fifth lumbar vertebra. Biomechanical factors are closely related to the condition. An immunohistochemical investigation of lysis-zone tissue obtained from patients with isthmic spondylolisthesis was performed to determine the molecular composition of the lysis-zone tissue and enable interpretation of the mechanical demands to which the tissue is subject.

Detailed pathological changes of human lumbar facet joints L1-L5 in elderly individuals.

Facet joints play an important role in intervertebral load transmission and are crucial for rotational kinematics. Clinically, the role of facet joints as a possible source of low back pain is seen as controversial and at present is not sufficiently investigated. In this study, human lumbar facet (zygapopyhysial) joints from donors with advanced age were analyzed macroscopically, for degenerative changes.

An immunohistochemical study of the extracellular matrix of the tarsal plate in the upper eyelid in human beings.

The superior tarsus is a plate of tissue that stiffens the upper eyelid, gives it support and determines its form. The purpose of the present study was to relate the composition of its extracellular matrix to its function and to report regional differences that may influence the activity of its Meibomian glands. Fourteen methanol-fixed specimens were cryosectioned for immunohistochemistry and labelled with a panel of monoclonal antibodies against a wide range of collagens, glycosaminoglycans and proteoglycans.

The medial sural artery perforators: anatomic basis for a surgical plan.

We performed an anatomic study on 20 fresh lower limbs. Resin was injected in the popliteal artery. Medial sural artery perforator flaps were sculptured according to anatomic markings.

Wnt 6 regulates the epithelialisation process of the segmental plate mesoderm leading to somite formation.

In higher vertebrates, the paraxial mesoderm undergoes a mesenchymal to epithelial transformation to form segmentally organised structures called somites. Experiments have shown that signals originating from the ectoderm overlying the somites or from midline structures are required for the formation of the somites, but their identity has yet to be determined. Wnt6 is a good candidate as a somite epithelialisation factor from the ectoderm since it is expressed in this tissue.

University reform and introduction of the Harvard system to medical education.

At this point we may observe that problems in medical education should be sought for neither in the tutor-student ratio nor in the conditions of studies, but rather in the universities' general dilemma, in the conflict between patient care, research, and education. It is furthered by the absence of academic teaching's "market value" and of a specific didactic training. A series of teaching experiments, the Munich model among them, have shown that a successful strategy is viable toward developing a new system of teaching once the foundations have been laid by a clear-sighted analysis of the existing problem and of a precise definition of educational targets.

Tumescent and dry liposuction of lower extremities: differences in lymph vessel injury.

Lipectomy is a standard procedure in plastic surgery. Until now, however, there was no definite information about the influence of different liposuction techniques (tumescent versus dry liposuction) on the integrity of lymph collectors during this procedure. To study the effect of these liposuction techniques on the incidence of lymph vessel injury, postmortem lymphatic preparations were done in nine human cadavers (18 lower extremities).

Influence of adducting and abducting muscle forces on the subacromial space width.

Purpose: Strengthening of the shoulder depressors is an important component in the treatment of impingement syndrome. However, the quantitative effect of various muscle forces on the width of the subacromial space has never been demonstrated in vivo. Therefore, the purpose of this study was to analyze the influence of adducting and abducting muscle forces on the subacromial space width in healthy volunteers in various arm positions.

Immunohistochemical analysis of the extracellular matrix in the posterior capsule of the zygapophysial joints in patients with degenerative L4-5 motion segment instability.

Object: Although the hypertrophied shape of the zygapophysial joints in degenerative instability of the lumbar spine is well known, its underlying pathophysiological mechanism is unclear. The authors sought to provide evidence that there is increased fibrocartilaginous metaplasia in the posterior joint capsule resulting from greater mechanical loading; the authors suggest that these capsular changes are central to understanding the altered joint shape.

Methods: The LA-5 posterior articular complex was removed in 14 patients undergoing fusion for degenerative instability.

Expression of a wide range of fibrocartilage molecules at the entheses of the alar ligaments - possible antigenic targets for rheumatoid arthritis?

Objective: To provide evidence for the existence of a wide range of molecules characteristic of fibrocartilage at normal alar ligament entheses, that may have a bearing on the pathogenesis of rheumatoid arthritis. The alar ligaments provide the mechanical restraint for head rotation and their integrity can be compromised in patients with RA and occasionally in those with spondyloarthropathy.

Methods: Both alar ligaments from 6 cadavers were fixed in 90% methanol and cryosectioned longitudinally.