Erich Brenner

Innsbruck Medical University · Institute for Clinical and Functional Anatomy

This review deals with the art of (anatomical) embalming. The first part contains a brief historical review of the history of embalming, starting with ancient cultures such as the Egyptians and the lesser known Chinchorro culture, then going down the centuries and describing the anatomical techniques developed over the last two centuries. The secon...

Previously, we have reported on the legal and ethical aspects and current practice of body donation in several European countries, reflecting cultural and religious variations as well as different legal and constitutional frameworks. We have also established good practice in body donation. Here we shall further extend the legal and ethical framewor...

Venous valves are still discussed controversially, mainly because it is still uncertain whether primarily missing or insufficient valves or the weakness of the venous walls cause varices. Furthermore, the distribution and frequencies of major superficial tributary veins (MSTVs), which should discharge the great saphenous vein (GSV) between the term...

Breast-cancer-related lymphoedema, either caused by the tumour itself or its therapy, can be found in approximately 24% of all patients. It results in disabilities, psychological distress and reduced quality of life. Therefore, proper therapy for this entity is very important. Guidelines recommend a therapy in two phases, an intensive phase I for 3...

Citation: Starke, V.; Wallner, J.; Stigler, R.; Mannschatz, S.; Müller, J.; Brenner, E. Is the Sublingual Artery a Reliable Abstract: Background/Objectives: Head and neck free-flap reconstructions are often required to treat tumors or extensive post-traumatic jaw defects. The facial artery is the standard receiving vessel for intraoral microvascula...

Zusammenfassung Die vorliegende S2k‐Leitlinie wurde auf Initiative und unter Federführung der Deutschen Gesellschaft für Phlebologie und Lymphologie (DGPL) e.V. erstellt. Ihr Ziel ist es, die Diagnostik und Therapie des Lipödems zu optimieren. Sie soll die unterschiedlichen Herangehensweisen der jeweiligen Berufsgruppen konsensbasiert zusammenführe...

This S2k guideline was developed on the initiative and under the German Society of Phlebology and Lymphology (DGPL) leadership. The guideline aims to optimize the diagnosis and treatment of lipedema. It is intended to bring together the different approaches of the respective professional groups in a consensus‐based manner and thus offer a basic con...

A vital prerequisite for any tissue is the constant supply of oxygen, nutrients, messenger substances, etc., to the individual cells. These are transported into the tissues by the blood vessel system, dissolved in water, and then enter the interstitium. To do this, the blood plasma is filtered through the capillary wall. The resulting filtrate flow...

Background/Objectives: Head and neck free flap reconstructions are often required to treat tumors or extensive post-traumatic jaw defects. The facial artery is the standard receiving vessel for intraoral microvascular anastomoses. However, its use is associated with several disadvantages, such as lesions of buccal nerve branches or the parotid duct...

Das wesentliche klinische Problem gestauter Beckenvenen ist das pelvine Stauungssyndrom. Damit verbunden sind auch Refluxe aus dem Beckenvenensystem über diverse Anastomosen, auch als Insuffizienzpunkte bezeichnet, die zu einer varikösen Erweiterung der Venen des äußeren Genitals, aber auch des Beins selbst führen können.

Background The standard therapy for lymphedema of any origin is complex physical decongestive therapy (CDT). It comprises manual lymph drainage (MLD), compression therapy (CT), exercise therapy (ET), skincare, and patient education. Additionally, intermittent pneumatic compression (IPC) can be applied. However, the contribution of MLD to decongesti...

Background: In 2008, members of the TEPARG provided first insights into the legal and ethical framework governing body donation in Europe. In 2012, a first update followed. This paper is now the second update on this topic and tries to extend the available information to many more European countries. Methods: For this second update, we have asked a...

The upper and lower urinary tract includes the two urine-producing kidneys and the entire urinary-discharging system consisting of the renal pelvises, the ureters, the urinary bladder, and the urethra. The entire system extends from the retroperitoneum of the upper abdomen into the small pelvis; the urethra finally penetrates the pelvic floor. The...

This review summarizes current data to bring the discussion about lipoedema, which was conducted emotionally by Bertsch and Erbacher in their series of articles “Lipoedema – Myths and Facts”, back to a factual level. The issue of progression cannot be answered from the available data. The issue of psychological disorders preceding the onset of li...

Zusammenfassung Hintergrund Das Lipödem, auch Lipohyperplasia dolorosa (LiDo) genannt, ist eine schmerzhafte Erkrankung von Frauen, die zu einer unverhältnismäßigen Ansammlung von subkutanem Fettgewebe in den Extremitäten führt. Das Risiko für Diabetes und kardiometabolische Störungen ist im Vergleich zur Adipositas geringer, doch kann eine gleich...

In den Venen des „Venensterns“ am saphenofemoralen Übergang sind der physiologische und der pathologische Fluss fußwärts gerichtet. Die Unterscheidung kann nur an der Flussmenge und Dauer festgemacht werden. Ihre routinemäßige, gezielte Untersuchung zur Diagnostik des venösen Refluxes und insbesondere vor der Therapie der Varikose wird helfen, stan...

Carpal tunnel syndrome is the most frequent compression neuropathy with an incidence of one to three subjects per thousand. As specific anatomical variations might lead to unintended damage during surgical interventions, we present a review to elucidate the anatomical variability of the carpal tunnel region with important considerations for daily c...

Background: Lipedema, also known as lipohyperplasia dolorosa (LiDo), is a painful condition affecting women, causing a disproportionate accumulation of subcutaneous adipose tissue in the extremities. It carries a lower risk of diabetes and cardio-metabolic dysfunctions compared to obesity, but coincident obesity can complicate diagnosis and treatm...

Praxisnahe Handlungsanweisungen für Ärzte zur optimalen Betreuung ihrer Patienten. Anschauliche Darstellung moderner Therapieoptionen und deren Indikationsstellung. Wertvolle Hinweise für Physiotherapeuten für die Vorbereitung und Nachsorge bei operativer Behandlung.

Background: The standard therapy for lymphedema of any origin is complex physical decongestive therapy. It comprises manual lymph drainage (MLD), compression therapy, exercise therapy, skincare, and patient education. However, the contribution of MLD to decongestion is repeatedly questioned. Patients and Methods: This study re-analyses a previous s...

A vital prerequisite for any tissue is the constant supply of oxygen, nutrients, messenger substances, etc., to the individual cells. These are transported into the tissues by the blood vessel system, dissolved in water, and then enter the interstitium. To do this, the blood plasma is filtered through the capillary wall. The resulting filtrate flow...

Varicose veins are one of the most common chronic diseases in the western world. Not only the diagnosis of this pathology, but also the treatment options have been subject to constant change since the introduction of duplex sonography. Nevertheless, its causes are not really known yet, and there is still a lot of debate about recurrences after the...

The upper and lower urinary tract includes the two urine-producing kidneys and the entire urinary-discharging system consisting of the renal pelvises, the ureters, the urinary bladder, and the urethra. The entire system extends from the retroperitoneum of the upper abdomen into the small pelvis; the urethra finally penetrates the pelvic floor. The...

Anatomy as a basic science discipline is “vanishing” in recent competencies-based medical curricula. The fundamental requirement of these curricula to apply the knowledge from the basic disciplines in practical and clinical everyday life contributes to this disappearance. Anatomical educational objectives are in many cases not yet adapted to these...

Lipohyperplasia dolorosa (LiDo) – commonly referred to as lipedema – is a painful disproportionate but symmetrical fat distribution disorder of the extremities. An accompanying proportional symmetrical adipose tissue proliferation in the sense of coincidental obesity can complicate the diagnosis and treatment of LiDo. Surprisingly, no valid anthrop...

As elsewhere, the cadavers of Nazi victims were used at the ‘Alpenunversität Innsbruck’ for the education of medical students. They were also used by members of the Institute of Anatomy and the Institute of Histology for scientific research and publications. In 2018, over 300 drawers were discovered in a laboratory anteroom of the Innsbruck Histolo...

Die subtile Kenntnis der Anatomie des epifaszialen Venensystems sowie seiner Verbindungen zum tiefen Venensystem ist eine unabdingbare Voraussetzung für jeden, der sich der invasiven Therapie der Varikose zuwendet. Sie ist eine Grundvoraussetzung, um strategische und taktische Überlegungen bei der Planung von Behandlungsmaßnahmen bei dieser nicht h...

The functions of the subclavius muscle (SM) are described as stabilization of the sternocla-vicular joint (SCJ) and resisting elevation of the lateral end of the clavicle. During systematic cadaveric dissections, we observed additional fibrous structures, previously described as variants of the anatomy, extending from the SM and inserting into the...

The attitudes of medical students towards the clinical importance of neuroanatomy have been little studied. Because it has been reported that medical students find neuroanatomy difficult and can have „neurophobia‟, here we test the hypothesis that early-stage medical students across Europe have a low regard for neuroanatomy‟s clinical relevance. Th...

Objectives External valvuloplasty (eVP) is a reconstructive surgical method to repair the function of the terminal and preterminal valves. We evaluated the 6-month outcomes of eVP regarding the diameter of the great saphenous vein (GSV). Methods Patients from five vein centres were included in this observational study. Follow-up involved detailed...

Objectives: Cellular senescence could play a role in the development of venous disease. Superficial venous reflux at the saphenofemoral junction is a common finding in patients with primary varicose veins. Furthermore, reflux in this essential area is associated with higher clinical stages of the disease and recurrent varicose veins. Therefore, th...

Das pelvine Stauungssyndrom beruht in weiten Teilen auf der komplexen anatomischen Situation der Beckenvenen und ihren zahlreichen Anastomosen. Bedingt wird diese Komplexität zum Teil durch die diffizile Entwicklung des Venensystems des (unteren) Stammes. Aus anatomischer Sicht sind folgende Faktoren relevant: • Die venöse Drainage der Beckenorgane...

Zusammenfassung Hintergrund: Venensporne in der linken V. iliaca communis sind eine bekannte Entität, insbesondere im Zusammenhang mit schweren tiefen Beckenvenenthrombosen. Allerdings sind fundierte Kenntnisse über diese Sporne nur spärlich vorhanden. Es wurden 5 Formen von Venenspornen beschrieben: zentrale Sporne, Adhäsionen, Brücken, Klappen un...

Aim: The Austrian Competence Level Catalogue for Medical Skills clearly states the importance of teaching communicative and social competence in the different subject areas of undergraduate medical and dental education. This paper aims to present an overview of the academic courses at the Medical University of Innsbruck that explicitly address the...

The aim of the following investigation was to explore Max Clara’s (1899–1966) early academic activity in Italy at the University of Padua. While Clara’s career during the National-Socialist Party dictatorship was extensively studied in literature, little to no information is available regarding Clara’s early academic years, with particular regard t...

An essential part of the gastrointestinal tract is the pancreas, a gland which is both exocrine and endocrine and which is located retroperitoneally dorsal to the omental bursa. Anatomically, a head, neck, body, and tail are distinguished, but physiologically, the main part of the endocrine islets is in the pancreatic tail. Presumably, Herophilos o...

In Giacomini’s first description (1873), a vein was reported that runs via the popliteal fossa (without entering the popliteal vein) to the dorsal thigh and then passed to join the great saphenous vein. Since then, numerous other types of termination (including those that lead into the popliteal vein) have been published. In clinical practice, howe...

This investigation aims to summarize hitherto scattered pieces of evidence of the early biography of Max Clara, especially considering his connections with the Histological Institute of the University of Innsbruck. Max Clara was born in 1899 in South Tyrol, at that time part of the Habsburg Empire. After high school in Bozen and his participation i...

Das Lymphatische System hat die Aufgabe, die in die Extrazelluläre Matrix aus den Blutkapillaren filtrierte Flüssigkeit aufzunehmen und abzutransportieren. Das Lymphatische System beginnt in der Peripherie mit zwei- oder dreidimensionalen Netzen initialer Lymphgefäße. Diese initialen Lymphgefäße nehmen die interstitielle Flüssigkeit auf, die aus de...

Ende Juni 2020 hat die Redaktion verschiedene lymphologische Einrichtungen in Deutschland, Österreich, Italien und der Schweiz angeschrieben, ob sie bereit wären, die Frage „Wie hat sich die Symptomatik bei Lymphödempatientinnen und -patienten nach der Wiedereröffnung der Lymph-Kliniken nach dem COVID-19-Lockdown verändert/verschlechtert?“ aus Sich...

Lymphedema is one of the complications of varicose vein therapy. Pittaluga and Chastanet found lymphedema in only 0.25 % after surgical intervention. Flessenkämper and colleagues were able to show that this occurs in 2.8 % (high ligature and stripping) to 9.2 % (endovenous laser ablation), depending on the therapy method used. One of the possible r...

Neuronal diversity in the cochlea is largely determined by ion channels. Among voltage-gated channels, hyperpolarization-activated cyclic nucleotide-gated (HCN) channels open with hyperpolarization and depolarize the cell until the resting membrane potential. The functions for hearing are not well elucidated and knowledge about localization is cont...

Objectives Recurrent varicose veins after surgery are a frequent burden and the saphenofemoral junction is the most common source of reflux. Pre-existing branches of the common femoral vein near the saphenofemoral junction, which may increase due to haemodynamic or other reasons, could play a role in the development of recurrent varices. There exis...

This article describes the influence of COVID-19 on the development of lymphedema. It summarizes the specific pandemic-related recommendations for patients with lymphedema published by the different medical associations. For example, key phlebological and lymphological societies have published a consensus paper in which they have agreed to a Venous...

Background: Varicosis of the great saphenous vein (GSV) is a common disease. Most of the therapeutic concepts attempt to remove or destroy the truncal vein. However, the absence of the GSV could be harmful for further treatments of artherosclerotic disease as the GSV is often used as bypass graft in lower extremity or coronary artery revascularisat...

From an anatomical point of view, recurrences at the saphenofemoral junction (SFJ) could result from various sources. For one, it could be caused by a recanalisation of an originally occluded great saphenous vein (GSV). Secondly, another vein in the junction region could take over the function of the GSV and dilate. A third variation is a – more or...

Background Peripheral nerve pathologies of the upper extremity are increasingly assessed by high-resolution ultrasonography (HRUS), yet rapid identification of nerve segments can be difficult due to small nerve diameters and complex regional anatomy. We propose a landmark-based approach to speed up and facilitate evaluation and intervention in this...

Background: In fundoplication, mobilization of the distal oesophagus and proximal stomach is essential to obtain a sufficient tension-free intra-abdominal oesophageal length for creation of an efficient antireflux barrier. Most surgical literature and anatomical illustrations do not describe nerve branches running from the diaphragm to the stomach...

Abstract Background: The functions of the subclavius muscle (SM) are described as stabilization of the sternoclavicular joint (SCJ) and resisting elevation of the lateral end of the clavicle. During systematic cadaveric dissections we observed additional fibrous structures, previously described as variants of the anatomy, extending from the SM and...

Einleitung: Die Diagnostik des Lipödems basiert bislang auf rein klinischen Befunden, objektive Parameter fehlen bislang. Ziel dieser Studie ist es, einen möglichen Zusammen-hang zwischen einer standardisierten, sonographisch gemessenen Kompressibilität der subkutanen Fettschicht sowie dem Vergleich der Hautfettfalten an Abdomen und Oberschenkel un...

The scientific interest in cadmium (Cd) as a human health damaging agent has significantly increased over the past decades. However, particularly the histological distribution of Cd in human tissues is still scarcely defined. Using inductively coupled plasma-mass spectrometry (ICP-MS), we determined the concentration of Cd in 40 different human tis...

We report a very rare case of a unilaterally absent piriformis muscle in a 60 year old woman. Accompanying variations comprised a common gluteal artery (instead of two distinct superior and inferior gluteal arteries), and an absent gemellus inferior muscle. The contralateral left side showed a normally developed piriformis muscle. In hominoids, the...

Since Vienna University’s 1997/98 inquiry into the background of Eduard Pernkopf’s anatomical atlas, German and Austrian anatomical institutes have been forced to confront their past, particularly the widespread procurement of bodies of victims of National Socialism. This paper focuses on the Anatomical Institute in Innsbruck, which received bodies...

Die neun Ursachen und das Fehlen einer einheitlichen Definition chronischer Wunden zeigen unter Berücksichtigung diverser Komorbiditäten die Schwierigkeiten einer einheitlichen Beurteilung. Trotz der Widerlegung zahlreicher Mythen bleibt der Verbandwechsel die große Schmerzquelle für den Betroffenen. Zahlreiche mögliche Ansätze aus Pharmakologie, P...

Urine is produced in the two kidneys, conveyed by their respective pelvises and ureters to the bladder where it is stored temporarily, and finally exuded via the unique urethra at the individual’s convenience. The kidneys and the ureters form the paired upper urinary tract; the bladder and the urethra build up the unpaired lower urinary tract.

Aims: Injection therapies play an increasingly decisive role in the treatment of lower back pain. Cumulative studies could show the benefits of ultrasound-guided instillation procedures in the cervical and lumbar spine. We conducted this study to provide a new simple sonographic approach for pararadicular injections of the sacral spinal nerves and...

Very often, descriptions of the scientific discovery of the lymphatic system start with Gaspare Aselli, probably because of his so captivating account. Nevertheless, there was prior and even very old evidence of the lymphatic vessels, which was of course known to Aselli himself, as he cited most of these antique references. In fact, the first insig...

The superficial venous system of the leg starts with the epifascial veins, i.e. the various subcutaneous venous networks, the accessory saphenous veins, superficial epigastric vein, the superficial iliac circumflex vein, and the external pudendal veins. These flow into the two intrafascial veins, the great and the small saphenous veins. These, in t...

In der letzten Ausgabe der Zeitschrift Lymphologie in Forschung und Praxis habe ich über die Beziehung zwischen Lymphsystem und dem Starlingschen Gleichgewicht berichtet. Trotz sorgfältiger Literaturrecherche ist mir der Lapsus unterlaufen, dass ich eine äußerst relevante Publikation von Prof. Dr. Hubert Schad in ausgerechnet dieser Zeitschrift übe...

Per definitionem ist ein Ulcus ein tiefliegender Substanzdefekt der Haut (oder Schleimhaut) mit Durchbrechung der Basalmembran. Typische Arten von Ulcera sind das Ulcus cruris, das Malum perforans bei Polyneuropathie (häufig in Kombination mit Diabetes mellitus), der Dekubitus („Druckgeschwür“), das arterielle/venöse Ulcus oder ein neoplastisches U...

The practice of human and veterinary medicine is based on the science of anatomy and dissection courses are still irreplaceable in the teaching of anatomy. Embalming is required to preserve body donors, for which process formaldehyde (FA) is the most frequently used and well characterized biocidal substance. Since January 2016, a new occupational e...

Problemstellung: Die Lehre in der Anatomie ist einem umfassenden Druck unterworfen; zahlreiche andere Disziplinen fordern Ressourcen, vor allem Unterrichtszeit. Die konsistente Einbindung neuer wissenschaftlicher Erkenntnisse sowie das Eingehen auf populär-wissenschaftliche Schlagzeilen muss daher für die anatomische Lehre oberste Pflicht sein. Zwe...

Background In laparoscopic fundoplication the mobilisation of the distal esophagus and the proximal stomach are mandatory in order to obtain enough intraabdominal esophageal length and to enable a posterior fundoplication. In surgical literature and in most anatomic illustrations there are no nerves described between diaphragm and stomach. Moreover...

Introduction: Neuronavigation is widely used for intracranial neurosurgical procedures and commonly based on the standard reference array being fixed to the headholder. Some cases, however, require the reference array to be attached directly to the head. The objective of this cadaveric study is to compare the operational accuracy of a head-mounted...

Design and implantation of bionic implants for restoring impaired hair cell function relies on accurate knowledge about the microanatomy and nerve fiber pathways of the human inner ear and its variation. Non-destructive isotropic imaging of soft tissues of the inner ear with lab-based microscopic X-ray computed tomography (microCT) offers high reso...

Zusammenfassung In seiner bahnbrechenden Arbeit aus dem Jahr 1896 leitete Ernest Henry Starling ab, "dass eine Resorption der Flüssigkeit durch die Blutgefäße durch Rückwärtsfiltration (zumindest) in den Bindegeweben der Extremitäten, in den Muskeln und in allen Drüsenstrukturen (…) unmöglich ist". Dennoch wurde - und wird teils immer noch - angen...

In his pioneering work in 1896, Ernest Henry Starling determined "that an absorption of fluid by the blood vessels by a process of backward filtration is impossible in the connective tissues of the limbs, in muscles and inali glandular structures (...)." Nevertheless, it has been - and still is - accepted and taught that continuous capillaries filt...

Stable posture and body movement in humans is dictated by the precise functioning of the ampulla organs in the semi-circular canals. Statistical analysis of the interrelationship between bony and membranous compartments within the semi-circular canals is dependent on the visualization of soft tissue structures. Thirty-one human inner ears were prep...

Flow chart of the modules used in Amira®. The labels were cropped to the size of the SCCs to reduce computing time. Arithmetic modules were used to extract the volumes of the membranous labyrinth, the perilymphatic spaces and a representation for the bony labyrinth. Volumes were then down sampled and thinned by Distance-Ordered Thinner modules. The...

Selected sites of bony labyrinth excision along the centroid of individual specimens. (A) Posterior centerline cut off plane; (B) Superior centerline cut off plane; (C) Lateral centerline cut off plane on the opposite side of the ampulla; (D) Lateral centerline cut off plane on the side of the ampulla; (E) Common crus cut off plane.

Averaged normal vectors of fit planes.

Selected sites of membranous labyrinth excision along the centroid of individual specimens. (A) Posterior ampulla start node; (B) Posterior centerline cut off plane; (C) Superior ampulla start node; (D) Superior centerline cut off plane; (E) Lateral centerline cut off plane on the opposite side of the ampulla; (F) Lateral ampulla start node; (G) La...

Centerlines of 31 manually segmented SCC bony labyrinths aligned along Reid's coordinate system. The average centerlines of all the specimens in bold (green) for the bony labyrinth and dashed lines (red) for the membranous labyrinth. (A) Centerlines of the bony labyrinth on the sagittal plane. (B) Centerlines of the bony labyrinth on the coronal pl...

Cross-sectional area of the bony labyrinth arrayed on the centerline of the bony labyrinth. Shown are the average cross-sectional areas of the bony labyrinth in the posterior SCC (A), superior SCC (B), lateral SCC (C), and the common crus (D). The average area is represented by the red line (bold). Light gray areas indicate the values lying in the...

Extracted cross-sectional images. (A) Cross-sectional image of the perilymphatic space; (B) Membranous labyrinth; (C), and the actual μCT image; (D) Overlay of (A–C).

Background Recent findings on the pathogenesis of frontal migraine headache support, besides a central vasogenic cause, an alternative peripheral mechanism involving compressed craniofacial nerves. Supported further by the efficiency of Botulinum Toxin injections as a new treatment option in frontal migraine headache patients. Methods The supraorb...

Pain is an important criterion for diagnosing lipedema. This pain, however, has not been properly investigated or characterized in the literature, and in most cases, authors have settled for putting forward hypotheses. Comparison of these hypotheses with actual findings, if even available, it becomes obvious that many of these hypotheses cannot be...

We describe the heart from a 79-year-old woman with no medical history of cardiac complaints. Her heart shows a regular right coronary artery (RCA) and a variant left coronary artery (LCA) arising from the right sinus of Valsalva. The common stem of the RCA and the LCA is extremely short. The LCA depicts a preinfundibular course with a cranial-ante...

Many studies have been undertaken to assess the attitudes of medical students to the clinical importance of gross anatomy. However, much less is known about their attitudes towards the clinical importance of histology. Using Thurstone and Chave methods to assess attitudes, over 2,000 early stage medical students across Europe provided responses to...