Body donation is essential for medical education and research, supporting anatomical training and clinical competence. In Italy, national data on awareness of the legislation regulating body donation and factors shaping donation-related decisions among healthcare trainees remain limited. This study investigated knowledge of the legal framework, attitudes, and willingness for body donation among Italian medical students and residents. A two-phase mixed-methods study was conducted. In phase 1, qualitative interviews informed the development of a structured questionnaire. In phase 2, a national cross-sectional survey was carried out in 2023 using a CAWI questionnaire. Items explored exposure to body-based training, awareness of body donation and related legislation, perceived barriers and facilitators, and willingness to donate. Group comparisons and multivariable logistic regression analyses were performed. A total of 1044 participants completed the survey. Most were aware of body donation (92.8%), awareness of regulating law was limited (78.2% unaware), and public information was perceived as insufficient (69.6%). Overall, 53.8% reported willingness for body donation. Cultural and spiritual beliefs, emotional discomfort, and bureaucratic procedures emerged as major barriers. Students more often identified knowledge as a facilitator and less often viewed emotional involvement as a barrier compared with residents. In multivariable analysis, willingness to donate was negatively associated with male gender and lack of exposure or interest in body-based training. Among Italian healthcare trainees, willingness to consider body donation is high but coexists with limited legal awareness and persistent social barriers. Educational strategies within healthcare training contexts may support informed decision-making and greater engagement.

The inferior olivary nucleus (IO), the source of climbing fibers, is a key component of olivocerebellar circuitry involved in motor coordination and learning, and its broader contribution to higher-order cerebellar functions remains of growing interest. Although the neurochemical organization of the human IO has been partially described, the distribution of dopamine D2 receptors (D2R) within this nucleus has not previously been characterized. In the present study, we investigated the topographic distribution of D2R immunoreactivity in the human IO in neurological control, Alzheimer’s disease (AD), and Parkinson’s disease (PD) cases using immunoperoxidase and immunofluorescence staining. D2R immunoreactivity displayed a punctate pattern throughout the IO and was observed across its major subregions. Quantitative analysis revealed a significantly greater D2R-immunoreactive area in AD cases than in controls, whereas no significant regional differences were detected among the examined IO subregions. These findings provide the first description of D2R distribution in the human IO and extend current knowledge of its chemoarchitectural organization. The increased D2R immunoreactivity observed in AD suggests that the olivary dopaminergic microenvironment may be altered in neurodegenerative disease. Given the limited number of PD cases, however, these observations should be regarded as preliminary, and further studies in larger cohorts are needed to clarify the potential relevance of D2R-related changes in the human IO.

Biomonitoring plays a crucial role in assessing human exposure to hazardous substances by determining the presence and concentration of pollutants in the body. This study is part of the PRIN 2022 PNRR project "Integrated systemic detection of pollutants in the human body" (INSYDE-HU), which focuses on developing analytical methods to quantify selected pollutants in human tissues from nonoccupationally exposed individuals. The aim of this research is to develop and validate a reliable analytical methodology for the quantitative determination of toxic polycyclic aromatic hydrocarbons (PAHs) in human adipose tissue, a complex and rarely studied matrix in biomonitoring due to the invasiveness of sampling. PAHs are lipophilic, toxic compounds widely present in the environment and are prone to bioaccumulate in fat tissue. The method was developed by using the QuEChERS extraction technique followed by analysis through gas chromatography coupled with mass spectrometry (GC-MS). Validation was performed on bovine fat, followed by application to human adipose tissue samples provided by the Plastic Surgery Unit of the University Hospital of Padua. Fourteen PAHs were validated with method detection (MDLs) and quantification (MQLs) limits ranging from 0.11 to 4.13 and 0.30 to 13.76 ng g-1, respectively. Phenanthrene, anthracene, and pyrene were detected in human samples, with pyrene quantified between 2.34 and 4.88 ng g-1. To our knowledge, this is one of the few methods for the determination of these compounds in such a complex matrix and the only one that successfully combines QuEChERS and GC-MS.

The deep fascia of the upper limb represents a pivotal anatomical structure essential for effective force transmission, dynamic compartmentalization and musculoskeletal stability. Its composition (rich in type I collagen fibers) enables both mechanical resilience and functional adaptability, crucial for the upper limb's complex movements. Recent advancements in high-resolution ultrasonography, complemented by anatomical/histological studies, have provided unprecedented insights into the fascia's microarchitecture and clinical significance. This paper delivers a simple and systematic guide as regards the sono-anatomy of deep fasciae in the upper limbs, including brachial, antebrachial and palmar fasciae as well as their continuity with adjacent structures. Integrating anatomical, histological and sonographic evidence, this article sheds light on the clinical relevance of fascia-centric approaches applied in rehabilitative and surgical treatments.

Ultrasound guidance has improved the accuracy and safety of peripheral nerve blocks, yet intraneural and even intrafascicular needle placement remains possible. The true incidence of fascicular injury after direct nerve transfixion is uncertain due to limited histological data. This study aimed to determine the frequency of fascicular damage after needle transfixion of the sciatic nerve using a human anatomical model. A sciatic nerve segment was harvested from a fresh-frozen male cadaver without neurological disease. One hundred full-thickness transfixions were performed using a 22-gauge sharp needle, simulating accidental intraneural penetration. Each transfixion was replicated using a standardized technique. The nerve was fixed in formalin, sectioned every 5 mm, embedded in paraffin, and stained with hematoxylin and eosin for histological evaluation. The presence of fascicular injury or displacement was assessed microscopically. Descriptive statistics were used to summarize findings, and proportions with 95

Polycyclic aromatic hydrocarbons (PAHs) are widespread, persistent pollutants that can be sequestered within human adipose tissue due to their lipophilic nature. While this accumulation poses toxicological risks depending on dose and individual susceptibility, the specific morphological impact of chronic PAH storage on tissue architecture remains poorly defined. Here, we performed a histopathological and morphometric analysis on human subcutaneous adipose tissue samples characterized by high pyrene levels. We evaluated tissue organization, collagen distribution, the presence of inflammatory, neural, and vascular alterations and adipocyte morphometry to assess the structural response to PAH sequestration. Despite high pyrene concentrations, PAH-positive tissues maintained preserved overall architecture with normal collagen distribution, absence of lymphocytic infiltration, low macrophages, unaltered nerve fiber patterns, without evidence of vascular remodeling. Morphometry revealed smaller adipocyte area in PAH-positive samples, although not statistically significant. Our experimental data indicate that high PAH accumulation does not necessarily induce subcutaneous adipose tissue remodeling, suggesting that biochemical or metabolic alterations might occur even in the absence of evident histological changes. Further studies, with a broadened cohort, are needed to define the threshold at which PAHs’ presence translates into permanent tissue damage.

BackgroundA suitable tracheal substitute must support revascularization and regeneration, while resisting necrosis and infection. Decellularized tracheas are promising candidates; however, degradation limits their shelf life, making tissue banking essential. Although various decellularization methods have been developed, few studies assess the impact of storage, particularly cryopreservation, on tissue quality, limiting their clinical translation.MethodsIn this study, decellularized tracheas and decellularized + cryopreserved tracheas were developed from three human donors, segmented and processed accordingly. These were compared to native tracheas in terms of macroscopic appearance and structural integrity. Thus, residual nuclei/DNA were assessed using DAPI staining and DNA quantification. Histological stains (Hematoxylin and Eosin, Alcian Blue, Masson’s Trichrome, Weigert Van Gieson) assessed tissue and extracellular matrix architecture. Glycosaminoglycans and elastic fibers were quantified through both quantitative and semiquantitative methods. Immunostaining and semi-quantification for Human Leukocyte Antigen–DR (HLA-DR) was performed to preliminarily evaluate residual immunogenicity reduction. Ultrastructure and mechanical properties were analyzed using scanning electron microscopy and compression tests.ResultsThe decellularization protocol effectively reduced DNA content to <50 ng/mg, confirmed after cryopreservation. Native tracheas showed normal respiratory epithelium, whereas decellularized tracheas and decellularized + cryopreserved tracheas retained only the basal lamina. Submucosa was similar across groups, except for the absence of nuclei in treated samples. Glycosaminoglycans and collagen were well preserved, as showed by Alcian Blue and Masson’s trichrome stainings. Elastic fibers integrity and content were reduced in accordance with Weigert Van Gieson staining and morphometric analysis. Only few HLA-DR immuno-positive elements were recognized after treatments, as confirmed by semi-quantitative analysis. Scanning electron microscopy revealed epithelial cell removal with preserved basal lamina and adventitial collagen, although less compact. Treated cartilage showed empty lacunae. Mechanical testing revealed no significant differences in stiffness between groups.ConclusionStudy results indicate that combining decellularization with cryopreservation effectively preserves tracheal structure and further reduces HLA-DR–immunopositive elements compared with decellularized trachea. These findings support the clinical potential of decellularized + cryopreserved grafts for tracheal replacement.

BACKGROUND:The increasing availability of body donations and the expansion of reference centers provide forensic clinical anatomy with the opportunity to experimentally reproduce, in ex vivo settings, the effects of specific interactions on the human body, such as needle-tissue interaction in medical procedures. OBJECTIVES:The primary objective of this study was to develop a reproducible, standardized benchtop methodology that enables the identification of the trajectory traveled by the needle when piercing soft tissue, causing detectable iatrogenic tissue damage. MATERIAL AND METHODS:Skeletal muscle tissue samples were harvested from a fresh-frozen 78-year-old male body housed at our Reference Center, Center for Body Donation. Needle transfixions were then tested using a novel technique designed for this purpose (PassTrue® methodology): full-thickness tissue transfixion by a needle, insertion into the needle of a coaxial thread, grasping the thread with forceps, and needle withdrawal, so that the in-place thread indicates the route of transfixion. This procedure was tested against the control procedure without a thread. RESULTS:Microscopic analysis revealed a pattern consistent with the needle's course during transfixion in all cases with the PassTrue® technique (10/10), but not in controls (0/10). CONCLUSION:Our novel methodology improves the efficiency of assessing needle-tissue interactions, enabling identification of the needle's trajectory within biological tissues.

The evolution of regional anesthesia techniques has markedly influenced the management of postoperative pain, particularly in thoracic surgery. As part of a multimodal analgesic approach, fascial plane blocks have gained prominence due to their efficacy in providing targeted analgesia with minimal systemic side effects. Among these, the superficial intercostal plane (SPIP) block and deep parasternal intercostal plane (DPIP) block are of notable interest. The aim of this study was to investigate the dye spread to the anterior chest wall space and its spread pathway through anatomical morphometric analyses on cadavers for single-injection and double-injection SPIP blocks versus DPIP blocks. In both qualitative and quantitative evaluations, the single-injection SPIP block with 10 mL of dye demonstrated a broader and more extensive spread compared to the double-injection SPIP block, which used 5 mL of dye per injection site (p < 0.05), and the DPIP block with 10 mL of dye (p < 0.05). All the blocks had a positive correlation between the distances from the sternum border and the area of dye spread, suggesting that the crucial role of volume in fascial blocks is that it significantly affects the opening of the fascial compartment, enabling optimal spread of the anesthetic. Adequate volume facilitates proper spread and diffusion across the fascial plane, ensuring more comprehensive fascia coverage and thus enhancing the block’s effectiveness. Finally, precise volume management is key to maximizing both efficacy and safety.

OBJECTIVES:To compare injectate spread between superficial parasternal intercostal plane (SPIP) and deep parasternal intercostal plane (DPIP) blocks, and to evaluate anatomical factors relevant to procedural safety. We hypothesized that DPIP blocks provide greater cranio-caudal distribution than SPIP blocks. DESIGN:An anatomical cadaveric study. SETTING:Secondary-level academic anatomy facility in northern Italy, within a body donation program. PARTICIPANTS:Five fresh-frozen human cadavers (10 hemithoraces). INTERVENTIONS:Ultrasound-guided SPIP and DPIP blocks were performed bilaterally at the third intercostal level using a 22-gauge, 50 mm needle. Each injection delivered 20 mL of diluted black tissue-marking dye (1:5 ratio with saline). MEASUREMENTS AND MAIN RESULTS:Gross dissection assessed the cranio-caudal spread of dye by the number of intercostal spaces. Histology measured the distance between the internal thoracic artery and the fourth rib. DPIP blocks spread across more intercostal spaces than SPIP blocks (median 4, IQR 4-5 vs median 2, IQR 2-2; p < 0.001). Histological analysis showed the internal thoracic artery was a median 1.9 mm (IQR 1.7-2.2) from the fourth rib, separated only by soft tissue. CONCLUSIONS:DPIP blocks produce a wider craniocaudal spread than SPIP blocks, which may enhance clinical efficacy. However, their close proximity to the internal thoracic artery and pleura underscores safety considerations.

Intraoperative ultrasound (IOUS) has developed from a rudimentary adjunct into a versatile modality that now plays a crucial role in neurosurgery. Offering real-time, radiation-free and repeatable imaging at the surgical site, it provides distinct advantages over intraoperative magnetic resonance (MRI) and computed tomography (CT) in terms of accessibility, workflow integration and cost. The clinical spectrum of IOUS is broad: in cranial surgery it enhances the extent of resection of gliomas and metastases, supports dissection in meningiomas and enables localization of MRI-negative pituitary adenomas; in spinal surgery, it guides resection of intradural and intramedullary tumors, assists in myelotomy planning and confirms decompression in degenerative conditions such as cervical myelopathy and ossification of the posterior longitudinal ligament. IOUS also offers unique insights into cerebrospinal fluid disorders, including arachnoid webs, cysts, syringomyelia and Chiari malformation, where it visualizes cord compression and CSF flow restoration. In trauma and oncological emergencies, it provides immediate confirmation of decompression, directly influencing surgical decisions. Recent innovations, including contrast-enhanced ultrasound, elastography, three-dimensional navigated systems and experimental integration with artificial intelligence and robotics, are extending its functional scope. Despite heterogeneity of evidence and operator dependence, IOUS is steadily transitioning from an adjunctive tool to a cornerstone of multimodal intraoperative imaging, bridging precision, accessibility and innovation in contemporary neurosurgical practice.

Effective nerve conduits development remains a significant challenge in regenerative medicine, with the potential to greatly improve patients’ quality of life in case of peripheral nerve injury. To date, several tubular devices have been introduced into clinical practice; however, the outcomes remain suboptimal. As empty conduits, lacking internal guidance structures or bioactive elements, they provide minimal support for nerve regeneration and fail especially in cases of long-gap nerve injuries. In this scenario, intense research efforts are directed toward improving conduit-associated results in vivo. Among the most promising strategies, the in-situ addition of luminal fillers has shown great potential in creating favorable microenvironment for axonal growth and tissue remodeling. Considering the many luminal fillers explored and reported in the literature, Self-Assembling Peptides (SAPs) have achieved significant attention by the scientific community due to their unique ability to arrange into biocompatible, extracellular matrix-like hydrogels that can favorably support axons and Schwann cells regeneration and organization within the conduit, guiding growth toward the distal stump. This review focuses on the use of SAP-based hydrogels as luminal fillers for sciatic nerve repair, summarizing the most relevant in vivo findings and highlighting their potential to enhance nerve regeneration.

Knee osteoarthritis (OA) has long been considered as a cartilage disease. However, it is now well established that cartilage defects are the ultimate OA feature only. Several studies investigating the mechanisms of OA onset/progression have recognized the infrapatellar fat pad as an active OA-player but also as a possible source of stem cells with regenerative potential for cartilage. Is it really like that? a cautious approach should be adopted.

In recent years, the interest in the comprehension of the fasciae has significantly grown, together with the necessity of finding a consensus for a terminology of the fasciae in the research and clinical fields. Furthermore, it is becoming necessary to categorize the various types of fascia (superficial, deep, visceral, neural) since they possess different anatomical characteristics, and are implicated in different pathophysiological pathways. While in the past we have described the deep/muscular fascia, the aim of this work is to summarize and catalog the information relating to the human superficial fascia (thickness, cellular end extracellular matrix component, innervation, vascularization).

Multidirectional instability (MDI) of the shoulder joint involves the looseness of the joint capsule in multiple directions, resulting in difficulties in keeping the head of the humerus centered within the glenoid fossa. There is still considerable debate about the optimal treatment approach, ranging from conservative management to surgical intervention and it is even more challenging for complex or bilateral cases. An 18-year-old male with a rare congenital bilateral multidirectional glenohumeral hyperlaxity and instability is reported. After excluding other medical conditions, the patient was diagnosed with benign joint hypermobility syndrome. Despite undergoing four months of conservative treatment with physical therapy, there was no significant improvement, leading to the decision for bilateral surgical intervention. The procedure combined an autograft Posterior Bone Block procedure with the Arthroscopic Subscapularis Augmentation (ASA) Technique to enhance anterior stability. The latter involved a tenodesis of the superior third part of the subscapularis tendon. The fixating hole was drilled at the top position of the glenoid edge, and the insertion on the subscapularis tendon was positioned inferiorly to the superior border of the tendon. After surgery, an accelerated post-operative rehabilitation protocol for each shoulder was implemented. At the one-year follow-up after the second surgery, the patient demonstrated substantial improvements in shoulder stability and functional outcomes. The Constant Shoulder Score (CSS) improved from 53 to 77 for both shoulders, indicating a 45.3% improvement and progression from “Moderate” to “Good” function. Similarly, the American Shoulder and Elbow Surgeons (ASES) Orthopaedic Scores improved from 58.33 to 88.32 for the right shoulder (51.4% improvement) and from 61.65 to 94.99 for the left shoulder (54.1% improvement), reflecting a transition from “Fair” to “Good” and “Excellent” function, respectively. Importantly, no short- or medium-term adverse events were reported, and the patient achieved a full return to normal activities. The combination of autograft Posterior Bone Block and ASA techniques has proven to be a successful option in this case for restoring function and stability, even in rare and complex cases of congenital bilateral multidirectional glenohumeral hyperlaxity and instability. Nonetheless, in these complex cases, critical surgical, anatomical, and forensic issues should be carefully considered.