The New Anatomy: A Forecast of Hope As we move into the new millennium, the popular press is replete with forecasts of what will transpire. To that end, what will be the face of anatomy, as a discipline, in the 21st century? In particular, will anatomy, especially gross anatomy, be recognized by all concerned with medical education as an integral and vital component of the professional curriculum? Will the undeclared war that sometimes exists between cell/molecular biologists and gross anatomists be terminated? Will anatomy departments (whatever they are named) still exist? I am convinced that the answer to all of the above is a resounding yes, as detailed here.
Many anatomy departments currently are an amalgam of traditional anatomical disciplines and varying amounts of molecular and cellular biology. Much of the rationale of the need for knowledge of molecular, cellular, and developmental biology (MCDB) is based upon the potential for its use in gene therapy and organ replacement. Knowing the gene (and its location) that is responsible for a disease means that methods can be devised either to suppress the expression of that gene or modify its expression such that the normal gene product is synthesized.
How does this gene therapy relate to gross anatomy? Gross anatomy and surgery must continually deal with variation of the human body. Although the textbooks are geared to what is the norm for the location of a given structure, the fact remains that often what is considered the normal location for a given structure occurs in no more than 60% of the population. Are these variations genetic? Often, they are. Kartagener's syndrome (situs inversus) is one such example in which a genetic alteration causes not only a lateraltransposition of viscera, but also causes a defect in the axonemes of cilia. Given this example, if the molecular biologists were to elucidate which genes either were activated or suppressed to bring about a given variant structure, such knowledge would be invaluable to both surgeons and gross anatomists. Knowing which genes lead to the development of variance of a given structure or organ would be a formidable task, but it may be, as in the situs inversus case, that cellular