No abstract

The inguinal canal is an anatomically complex region. Although much has been written about the gubernaculum and the descent of the testis, little is known about the development of the abdominal wall itself. We dissected this inguinal canal in 75 fetuses between 10 and 25 weeks of gestation, 42 males and 33 females. We identified the anterior body-wall muscular layers, located the gonads and uterus, and observed the formation of the scrotum. The gubernaculum was dissected, from the deep to the superficial ends and its distal attachments were determined. We proved that the muscular-fibrous layers of the wall were well-differentiated and observed how the inguinal canal enlarged with embryological development. In only one of the cases, an abnormal testis was found located in the scrotum. The upper end of the gubernaculum inserted into the inferior pole of the testis or the lateral angle of the uterus, according to gender. The lower end was attached by one or multiple tails, mainly on the pubic bone. This fact explained the clinical findings of ectopic testis. Observations of the abdominal wall and its relationship with the gubernaculum assisted us in explaining the development of the inguinal region, the formation of the inguinal canal, and the presence of the gubernaculum, in both genders. We intend to explain how the deep inguinal ring moves upwards, bringing the gubernaculum along with it, and thus determines the final form of the inguinal canal.

Medicine and Dentistry are the only careers performing human body dissection and teaching-learning of Anatomy with cadaveric material in our university. Physicians and dentists’ knowledge and opinion on the topic are particularly important because they could be considered as potential procurators due to their contact and influence on patient’s decisions. We surveyed 528 professionals (429 physicians and 99 dentists) collecting some demographic data and questions about organ and whole body donation. Results showed that 94% should donate organs for transplantation, 66% knew about body donation, 66% was interested in further information and 48% should be willing to donate the own body for teaching and research. Main reasons to donate were to support teaching and research, contribute to the science and to be useful. In conclusion, we found that professionals had a very positive attitude in relation to body donation, independently of gender, age, religion, regional origin or specialities, but with significant differences between physicians and dentists. Compared with students, they had better attitude which could be related to a better information and experience. In comparison with the few published articles we found, our results were similar to Ireland and very different to India, improving our expectances about the success of developing a donation program. Organ and body donation are always an act of altruism and social solidarity.

El estudio consistió en evaluar el impacto que tiene en los estudiantes de primer año de Medicina el contacto inicial con el cadáver, tanto en trastornos físicos como emocionales, su modificación en el transcurso del cursado y la incidencia que tendría en su voluntad de donar el propio cuerpo o al propiciar la donación por parte de terceras personas. Se realizó mediante una encuesta con respuestas de múltiples opciones y algunas semiestructuradas, en una muestra de 191 estudiantes de primer año de Medicina. Casi la totalidad acordaron en la importancia del cadáver para el estudio de la Anatomía y de ésta para la carrera médica. Los síntomas más frecuentes manifestados por el primer contacto con el cuerpo fueron irritación ocular (54%), congestión o irritación nasal (52%) y olor desagradable (28%); mientras que las emociones más referidas fueron entusiasmo (38%) y sorpresa (25%). Se adjudicaron principalmente al olor de la sala (40%) y del cadáver (55%), y para superar estos trastornos los recursos más empleados fueron: centrarse en el tema (39%), ver el cuerpo como un objeto (29%) y el humor (20%). Solo el 29% donaría su cuerpo y el 83% donaría sus órganos para trasplante; a pesar que el 80% considera que los estudiantes de primer año deberían disecar y el 73% querría ser ayudante en la cátedra. Reconocen que falta información y concientización sobre la donación de cuerpos para docencia e investigación en Anatomía y consideramos que es imprescindible contar con un programa de procuración y donación. Our objective was the evaluation of first year Medicine student’s perception at their first contact with the corpse in the dissection room. We considered as well physical and emotional aspects, change during the Anatomy course, impact on their will to donate the own body or propitiate other people’s donation. The study consisted on a survey with multiple choice and semi-structured responses, on a sample of 191 first year medical students. Nearly all agreed in the importance of corpses to study Anatomy and Anatomy for the medicine career. Most frequent symptoms on the first contact were ocular irritation (54%), nasal congestion (52%) and unpleasant smell (28%); while mostly mentioned emotions were enthusiasm (38%) and surprise (25%). Those perceptions were mainly caused by the room (40%) and the cadaver (55%) smell, and the resources used to endure them were: focus on the topic (39%), consider the body as an object (29%) and humor (20%). Only 29% of students should donate their own bodies and 83% should donate their organs for transplantation; instead 80% consider that first year students should dissect by themselves and 73% should like to be student-assistants at the Anatomy Chair. They recognize the lack in information on body donation for teaching and research in Anatomy, and we consider it is absolutely necessary a program for procurement and donation.

Este Debate fue propuesto para aportar diferentes puntos de vista y conocer la diversidad de circunstancias involucradas en la procuración y uso de cadáveres para la enseñanza de la Anatomía, a estudiantes de pre y post-grado, en el mundo. Un grupo reducido pero representativo de profesores de Anatomía de todos los continentes fueron invitados a participar. Se distribuyeron algunos lineamientos para que los escritos tuvieran similar orientación, aunque los autores podían incluir cualquier concepto que consideraran de interés para los lectores. Además de los profesores de diversos países, el Prof. Bernard Moxham (Presidente de IFAA) aportó al Debate la posición oficial de la Federación Internacional de Asociaciones de Anatomistas. Los panelistas acordaron en la importancia de utilizar material cadavérico para la enseñanza de la Anatomía, sin embargo, la provisión, las fuentes y los procedimientos utilizados para adquirirlos fueron algo diferentes de un país y/o universidad a otro. La experiencia de los países europeos, las limitaciones culturales en los asiáticos y africanos, y el retraso y los problemas estructurales en Sudamérica, son algunas de las particularidades que se señalan. Después de esta publicación se recibirán las preguntas y comentarios no solo de los participantes sino también de los lectores en general, las cuales serán respondidas y ambas, preguntas y respuestas, publicadas en el próximo número. Entonces, el Debate alcanzará su punto máximo al permitir a todas las personas involucradas en el tema, en cualquier lugar  del mundo, participar y aportar información adicional.  This Debate was proposed to provide different points of view and to know the diversity of circumstances involved in the procurement and use of cadavers to teach Anatomy, to pre and post-graduate students, all over the world. A reduced but representative group of professors of Anatomy of all continents were invited to participate. Some guidelines were distributed to give a common orientation to each paper instead authors were able to include whatever they considered to be of reader’s interest. Within the professors from different countries, Prof. Bernard Moxham (IFAA President) supported the Debate with the International Federation of Associations of Anatomists official position. The panelists agreed about the importance of using cadaveric material to teach Anatomy, but the provision, sources and procedures followed to get them are quite different from one to another country and/or university. The experience of European countries, the cultural limitations in Asiatic and African ones, the delay and structural problems in South America, are some of the pointed peculiarities. After this publication we will receive the questions and comments, not only from the Debate participants but also from general readers, which will be answered and both, questions and answers, published in the next issue. Then, the Debate may reach its top point by letting involved people from all over the world to take part and provide additional information.