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A. Kim, k.f. Anderson, j. Berliner, j. Hassan, j. Jensen, h.j. Mertz, h. Pietsch, a. Rao, R. Scherer, and a. Sutterfield.

In this study, three dummies were evaluated on the component level and as a whole. Their responses were compared with available volunteer and embalmed Post Mortem Human Subject (PMHS) data obtained under similar test conditions to evaluate their biofidelity. The volunteer and PMHS data, used as comparators in this study, were used previously to establish some of the biofidelity requirements of the Hybrid III. The BioRID II, the Hybrid III, and the RID2 were all subjected to rear impact HYGE sled tests with deltaVs of 17 and 28 km/hr to determine their biofidelity in these conditions. A static pull test, where a load was manually applied to the head of each dummy, was used to evaluate the static strength of their necks in flexion and extension. Finally, pendulum tests were conducted with the Hybrid III and RID2 to evaluate the dynamic characteristics of their necks in flexion and extension. The sled test results indicate that out of the three dummies, the overall flexibility of the Hybrid III is comparable to that of the volunteer anticipating the impact. The overall flexibilities of the BioRID II and the RID2 are greater than those of all the comparators used in this study (the tensed volunteer and the two embalmed PMHSs). The responses of the Hybrid III are closer to those of the tensed volunteer than those of the PMHSs. The responses of the BioRID II and the RID2 are closer to those of the PMHSs than to the tensed volunteer.

Journal Article↗

Real-time sonographic imaging for periradicular injections in the lumbar spine: a sonographic anatomic study of a new technique.

OBJECTIVE: We conducted this study to develop a sonographically guided approach to the spinal nerve of the lumbar spine and to assess its feasibility and accuracy by means of computed tomography (CT). METHODS: Fifty sonographically guided approaches at 5 levels (L1-S1) were performed on 5 embalmed cadavers, which were positioned prone. The spinal nerves of the lumbar spine were shown under sonographic guidance. In 1 cadaver, the most lateral aspect of the roof of the intervertebral foramen was defined as a reference point. Its position was computed as a distance from the tip of the spinal process (A), the midline (B), and the intervertebral disk (C). Subsequently, axial transverse CT scans were made to verify these distances. In a second part of the experiment, a spinal needle was advanced under sonographic guidance to the spinal nerves for each lumbar spinal level on 1 embalmed cadaver. The exact placement of the needle tips was checked with the help of CT. RESULTS: This technique for a sonographically guided approach to the periradicular area proved to be feasible and accurate. Sonography and CT provided the same mean measurements of 4.0, 2.5, and 1.4 cm for distances A, B, and C, respectively. The Pearson correlation coefficient was 0.99 (P < .001) between sonography and CT. In the experimental study, all 10 needle tips were placed periradicular to the spinal nerves. CONCLUSIONS: Sonographic guidance is a useful adjunct to increase the safety and efficacy of periradicular injections in the lumbar spine.

Humans↗

Formaldehyde concentration in the air and in cadavers at the gross anatomy laboratory in Hiroshima University.

The formaldehyde concentration in the air and in various tissues of 35 human cadavers were measured during a gross anatomy course held at the Faculty of Medicine of Hiroshima University in the 2003 educational year. Atmospheric formaldehyde levels were 0.25-0.55 ppm and thus less than the upper limit of the guideline for formaldehyde exposure (0.5 ppm) set by the Japan Society for Occupational Health (1988) except for one out of 10 measurements. The formaldehyde concentrations in tissues were as follows: the lung, 0.12 +/- 0.09% (n=29); the liver, 0.12 +/- 0.09% (n=29); and the brachioradialis muscle, 0.11 +/- 0.09% (n=30). Considerable variation was found among the cadavers and these values were lower than those of Tsurumi University which provided the only other data (average formaldehyde concentrations ranged from 0.27 to 0.32%). At Hiroshima University, blood is allowed to drain during embalming, whereas it is not at Tsurumi University. Differences in the embalming procedure are thus responsible for low and fluctuating formaldehyde concentrations in cadavers at Hiroshima University, and it is conceivable that relatively low formaldehyde levels in the air result from low formaldehyde concentrations in cadavers and good room ventilation (10 room-air changes per hour). However, the Japanese Ministry of Health and Welfare recommended lower formaldehyde exposure levels (0.08 or 0.25 ppm) in 2002. Thus, it may be necessary to further reduce formaldehyde levels in the gross anatomy laboratory by means of such measures as neutralizing formaldehyde with ammonium carbonate; using a locally ventilated dissection work-table, etc.

Air↗

Recognition of cemetery remains in a forensic context.

The purpose of this paper is to provide guidelines for the recognition of human remains from modem and historic cemeteries found in a forensic context. Three avenues of evidence may be pursued to confirm the origin of cemetery remains: context, condition of the body, and associated artifacts. This article outlines types of North American cemeteries, demonstrating how land use over time has resulted in many being closed, moved, or forgotten, leaving only the context to indicate their presence. The condition of human cemetery remains varies considerably depending on cultural practices and burial environment, but many exhibit combinations of the following traits: dried or embalmed tissue; erosion of bony pressure points; cortical bone flaking; and bone damage due to autopsy or embalming. Examples of artifact types useful in recognizing cemetery remains are also provided. Two cases from British Columbia, Canada are presented to demonstrate the diagnostic features of a disturbed cemetery burial.

Autopsy↗

Gynecomastia in a mortician. A case report.

The fine needle aspiration (FNA) observations in a case of gynecomastia occurring in a mortician are described. The FNA smear showed cytomorphologic features typical of a gynecomastia. Morticians use an embalming cream that contains estrogens or estrogenlike compounds; these substances may be absorbed percutaneously and cause the development of gynecomastia. The mortician should be made aware of the potential risk of such an occupational exposure and development of the "embalmer's curse. "Recognition by the clinicians and cytopathologists of such an occurrence and its implications can help with the proper management.

Adult↗

The influence of storage temperature and chemical preservation on the stability of succinylcholine in canine tissue.

Succinylcholine (SCh) has been detected six months postmortem in liver, kidney, and injection site muscle of rats given 10 to 200 mg/kg by intramuscular injection. SCh stability was studied in canine tissue to evaluate three storage temperatures and two chemical preservatives at three time periods after injection. Nine mongrel dogs weighing 17.2 to 28 kg were divided equally into three groups and administered either 0.5, 1.0, or 5.0 mg SCh/kg intravenously into the cephalic vein. Liver, kidney, and gastrocnemius muscle were removed 90 min post-injection and divided into twelve portions. Each portion was treated with embalming fluid, physostigmine, the combination (50/50), or nothing. Chemically treated tissues and nontreated tissues were then stored at either 27, 5, or -20 degrees C for a period of up to forty days. Tissue portions were analyzed using ion-pair extraction, chemical demethylation, and gas chromatography with nitrogen phosphorous detection. Stability of SCh was greatest for samples stored at -20 degrees C and preserved with the combination of embalming fluid plus physostigmine. Kidney concentrations of SCh were significantly higher than those in liver or muscle at all doses. SCh was detected 24 h post-injection in all cases. By 40 days, only trace amounts of SCh, if any, could be detected in samples stored at room temperature with no chemical preservatives.

Animals↗

Brief communication: twentieth-century replication of an Egyptian mummy: implications for paleopathology.

Replication in a modern human cadaver of ancient Egyptian mummification focused on tools used by ancient Egyptian embalmers, the use of natron (a mixture of sodium carbonate, bicarbonate, and chloride) in the preparation of the mummy, surgical procedures in the removal of the viscera and brain, and histologic examination of the viscera. The first three areas have been reported separately (Brier and Wade [1997] ZAS 124:89-100). In this paper, we demonstrate a degree of histologic preservation comparable to that seen in Egyptian mummies, indicating the effectiveness of ancient mummification and that the histologic appearance of such mummies is little altered by the passage of millennia.

Aged↗

Borate in mummification salts and bones from Pharaonic Egypt.

Mummification processes in Pharaonic Egypt were successful using sodium salts. Quite frequently sodium concentrations in mummified bones ranged from 300 to 4000 micromol/g. In the search for an effective inorganic conservation compound our choice fell on boric acid. The possible presence of borate in mummification salts used in Pharaonic Egypt was of special interest both historically and biochemically. In two salt samples, one from the embalming material of Tutankhamen (18th dynasty, 1336-1327 BC) and the second from Deir el-Bahari (25th dynasty, 700-600 BC) borate was found, amounting to 2.1+/-0.2 and 3.9+/-0.1 micromol/g, respectively. In five of the examined bone fragments from the Junker excavation at Giza (Old Kingdom) similar borate concentrations i.e., 1.2 micromol borate/g bone were seen. It must be emphasized that the usual borate content of contemporary autopsy is far below the detection limit. The elevated borate content in both mummification salt and ancient bone samples support the suggestion that borate-containing salt had been used. There is a striking correlation of both borate concentration and alkaline phosphatase activity. When both sodium salts and borate were essentially absent no activity at all was detectable. With increasing borate concentrations the enzyme activity rises significantly. Attributable to the distinct biochemistry of the tetrahydroxyborate anion it was of interest whether or not borate may stabilize alkaline phosphatase, an important and richly abundant bone enzyme. This enzyme was chosen, as it is known to survive more than 4000 years of mummification. In the presence of borate oligomeric species of this zinc-magnesium-glycoprotein at 400,000 Da became detectable. Attributable to this borate-dependent stabilization of the enzyme molecule a significant temperature resistant increase of the enzymic activity was measured in the presence of up to 2.5 mM borate.

Alkaline Phosphatase↗

Applied anatomy of the superior vena cava-the carina as a landmark to guide central venous catheter placement.

BACKGROUND: Cardiac tamponade is a serious complication of central venous catheter (CVC) insertion. Current guidelines strongly advise that the CVC tip should be located in the superior vena cava (SVC) and outside the pericardial sac. This may be difficult to verify as the exact location of the pericardium cannot be seen on a normal chest x-ray. The carina is an alternative radiographic marker for correct CVC placement, suggested on the basis of studies of embalmed cadavers. METHODS: We set out to confirm this radiographic landmark in 39 fresh cadavers (age 58.4 (3.4) (mean and SE) yr) and to compare the results with those from ethanol-formalin-fixed cadavers. RESULTS: We found that the carina was 0.8 (0.05) cm above the pericardial sac as it transverses the SVC. In no case was the carina inferior to the pericardial reflection and our study confirmed the previous findings. All the measured distances were significantly greater in fresh cadavers. CONCLUSIONS: We confirm that the carina is a reliable, simple anatomical landmark that can be identified in vivo for the correct placement of CVCs outside the boundaries of the pericardial sac.

Adult↗

Growth of Hansenula holstii on cadavers.

Growth of a yeast was observed on prosected cadavers used for demonstration purposes in a medical school. An asporogenous yeast was isolated and identified as an atypical form of Hansenula holstii by analysis of the extracellular polysaccharide. The isolate showed resistance to embalming fluid but was eventually eradicated by addition of picloxidine digluconate to the fluid.

Antifungal Agents↗

[Gold amulets of Ra: a step towards immortality].

In Ancient Egypt, the priest-embalmer laid the gold on the whole of the king's body. For simple citizens, he more modestly applied fine leaves or amulets of golden wax for certain parts. Possessing the same magical powers as gold, they participated in the complete preservation.

Egypt, Ancient↗

Mummification to plastination. Revisited.

A brief summary of the history of anatomy is presented with particular focus on important scientists who contributed significantly to the development of anatomical education and recognition of anatomy as a discipline of science. An attempt has been made to review the history of preservation of human cadavers from earliest mummification methodology used by ancient Egyptians to the most modern technique of embalming and plastination of human cadavers, developed by Von Hagens during the period from 1979 to 1987. The need for use of modern teaching aids for instruction of topographic anatomy is also highlighted.

Anatomy↗

[Neuroscience in ancient Egypt and in the school of Alexandria].

INTRODUCTION: About five thousand years ago, one of the most ancient, important and enduring civilisations in the history of Mankind flourished on the banks of the Nile. In Egypt, all the branches of human knowledge attained a high degree of development and today it is considered the mother of medicine. Despite the marked religious component that affected all its activities, the medicine of the Pharaohs was practised in a rational and deductive manner, and the Egyptians were the inventors of clinical observation. METHOD: The desert climate of the Nile Valley has preserved monuments, mummies and papyruses which have enabled us to get a certain idea of the degree of development reached in medical matters. The aim of this work is to analyse them from a neuroscientific point of view. The anatomical discoveries of the Egyptians originated in the inspection of wounds and the practice of embalming. They came to know a large number of diagnoses and were able to prescribe many different forms of treatment. They also attained a certain proficiency in dealing with neurotraumatological patients. They practised anamnesis, prognostics and a regulated surgery that infrequently included trephination. Their conservatism meant that, after the Macedonian domination, the traditional Egyptian medicine was replaced the Greek medicinal arts, which reached their maximum period of splendour in the School of Alexandria, where Herophilus and Erasistratus, pioneers in the study of anatomy and brain circulation, were especially renowned. CONCLUSIONS: From the point of view of the neurosciences, the Egyptians were the first to describe the brain, migraine, epilepsy, strokes, tetanus, Bell s palsy and the sequelae of head injuries and of spinal transection. Their artwork sometimes shows neurological patients and, according to Herodotus, there were doctors who were specialised in head diseases and could therefore be considered the precursors of our present day neurologists.

Egypt, Ancient↗

[The preservation of the whole corpse with natural color].

An especially low-odor embalming technique was developed over a 30-years-period using a total of 977 complete cadavers, numerous cadavers after autopsy, and in vitro series of fresh beef. The color, consistency, and transparency of the tissue were very well preserved. The technique met high standards of preservation without releasing harmful substances into the environment. Concentrations of formaldehyde in room air remained under the limit of detection by Dräger capillaries. The efficacy for disinfection of the method was confirmed by bacteriologic tests. None of the cadavers or samples developed molds.

Animals↗

[Embalmers/physicians in ancient Egypt].

On a daily basis, priest embalmers carefully carried out mummification of bodies to give them a certain immortality. Could they also have practised the profession of medicine?

Egypt, Ancient↗

Dangerous dissections: the hazard from bodies supplied to Edinburgh anatomists, winter session, 1848-9.

After the 1832 Anatomy Act, all bodies that were to be used by medical students for dissection were supplied to Schools of Anatomy based on their needs. During the Winter Session of 1848-9, a high proportion of the bodies supplied to the University of Edinburgh, and the majority of those supplied to the Argyle Square School had died of an infectious disease. Most had died from cholera, while others had died from typhus, tuberculosis or other infectious diseases. These bodies were not embalmed before dissection. Therefore, both medical students and their teachers in the Departments of Anatomy, in addition to those in the hospitals in which they had died, would have been at risk of becoming infected or even dying as a consequence of exposure to these infected individuals.

Anatomy↗

Preparation of veterinary gross anatomy specimens: a method that allows storage at room temperature for four years.

On the basis of methods used to prepare human anatomic specimens, 2 Yucatan miniature pigs were embalmed over 4 years ago. Results obtained suggest that specimens commonly used in the teaching of veterinary gross anatomy may be fixed in this manner. Advantages include no requirement for refrigeration, superior long-term preservation, less offensive odor, and better tissue texture qualities, including less evidence of dehydration.

Anatomy, Veterinary↗

Formalin fixation strongly influences biomechanical properties of the spine.

As fresh human cadaveric spine specimens for in vitro testing are hard to obtain and carry a potential risk of infection, the possibility of using embalmed spine specimens has been considered. The cross-linking effect of formalin fixation, however, raises uncertainties regarding the biomechanical likeness of preserved specimens. They have been reported to be stiffer, but no quantitative data exist. The purpose of this study was to determine the biomechanical differences between fresh and formalin-fixed spine specimens, using L1-2 motion segments from six 16-week-old calf spines. The range of motion and neutral zone were determined in flexion-/extension, left/right axial rotation, and right/left lateral bleeding. The range of motion decreased in the formalin fixed specimens by as much as 80%, and the neutral zone by as much as 96%. The results of this study therefore imply that, for biomechanical testing, formalin-fixed specimens are not representative of the in vivo conditions.

Animals↗