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The BCG scar after percutaneous multiple puncture vaccination may help establish the nationalities of unidentified cadavers.

BCG vaccination using the multiple puncture device (the Heaf gun) has been used in Japan and in the United Kingdom. The appearance of the BCG scars therefore differs from that caused by the conventional intradermal BCG vaccination, which is used throughout the world. The aim of this study was to investigate the usefulness of examining BCG scars to identify the nationalities of unidentified cadavers. We investigated the BCG vaccination program not only in Japan, but also in other countries, along with the relation between the BCG scar and nationality. The results showed that the countries which domestically make and use the Heaf gun are Japan (where it is the only method that has been in use since 1968), the United Kingdom (where it has been used, in part, since 1982), and South Africa (where it has been used, in part, since 1972). In addition, for the past 10 years, the Japanese Heaf gun method has been partially applied in the Republic of Korea and in Brazil. The Heaf gun scar can be clearly distinguished from the intradermal scar, and is visible throughout a person's life when good technique is used to administer the vaccination. If the Heaf gun scar is found on the left upper arm of an unidentified Asian cadaver, it is sure to be that of a Japanese. The findings of this present study indicate that the Heaf gun scar can be examined to identify the nationalities of unidentified cadavers.

Journal Article↗

Both-bone forearm osteotomy for supination contracture: a cadaver model.

PURPOSE: To quantify the magnitude of rotational correction possible when comparing a single forearm bone osteotomy and fixation with stepwise osteotomy and fixation of both bones in a cadaver model and to determine if the order in which the stepwise osteotomies are performed influences the amount of correction. METHODS: Ten fresh-frozen cadaveric forearms were fixed to a frame positioned in the field of view of a motion-capture system. An experimental supination contracture was induced in full supination. Cadaver forearms were assigned randomly to group I (ulna osteotomy, rotation, plating) or group II (radius osteotomy, rotation, plating). Cadavers in group I were used later in group III (ulna + radius) by completing a radial osteotomy, rotation, and fixation in the forearms with the plated ulna. Similarly the specimens assigned to group II were used later in group IV (radius + ulna) by completing an ulna osteotomy, rotation, and fixation in the forearms with the plated radiuses. Measurements of forearm pronation were made after single-bone (groups I, II) and stepwise both-bone (groups III, IV) rotational osteotomies. RESULTS: Stepwise rotational osteotomy and fixation of the ulna followed by the radius produced significantly more corrective pronation (101 degrees) than rotating the radius followed by the ulna (65 degrees). Rotating the radius gave only moderate correction (58 degrees) and minimal correction was produced by ulna osteotomy alone (15 degrees). CONCLUSIONS: Rotational osteotomy of both forearm bones can create approximately 100 degrees of correction when performed at the proximal ulna followed by the distal radius. If less rotation is needed then the distal radius osteotomy alone can provide approximately 60 degrees of correction.

Biomechanical Phenomena↗

Effect of exposure method to Beauveria bassiana and conidia concentration on mortality, mycosis, and sporulation in cadavers of Chilo partellus (Lepidoptera: Pyralidae).

The effects of exposure methods, conidial concentrations, and temperature on mortality, mycosis and sporulation in second instar Chilo partellus cadavers infected by Beauveria bassiana was investigated in laboratory studies. Larvae directly sprayed with conidia, exposed to conidia-treated leaves, and dipped into conidial suspension resulted in high mortality (98-100%). The longest LT50 (3.5 days) and days to mortality (2.6 days) were observed in the treated-leaves exposure method. The shortest LT50 (1 day) and days to mortality (1 day) were recorded for the dipping method. With increasing conidial concentrations, there were decreasing LT50 and days to mortality. Larvae exposed to treated leaves and larvae directly sprayed with conidial suspensions produced high mycoses in cadavers. Exposure of larvae to treated-leaves resulted in high sporulation. At lower concentrations of conidia, both mycosis and sporulation in cadavers were high. The optimum temperature for mycosis was 20 and 15 degrees C for sporulation.

Animals↗

Staining of zonules during posterior chamber lens implantation in a cadaver eye model.

A cadaver eye model was used to study the effects of extracapsular lens removal and implantation on the zonules and capsule. Five staining solutions were instilled in the posterior and anterior chambers of human cadaver eyes and washed out three to five minutes later. Gomori's chrom hematoxylin-eosin most clearly revealed the zonules. Three eyes stained in this way had lens removal (including the continuous circular capsulorhexis technique for anterior capsulectomy) and intraocular lens implantation. The effects of the surgery on the zonules and capsule were clearly visualized and appeared quite satisfactory. This staining technique may prove useful in other cadaver eye models.

Cataract Extraction↗

Transantral endoscopic orbital floor exploration: a cadaver and clinical study.

A cadaver and clinical study was performed to determine the value of transantral endoscopy in diagnosis and treatment of orbital floor fractures. Six fresh cadaver heads were dissected using a 30 degree, 4-mm endoscope through a 1 cm2 antrotomy. In the cadaver, the orbital floor and the course of the infraorbital nerve were easily identified. The infraorbital nerve serves as a reference point for evaluation of fracture size; three zones of the floor are described that are oriented relative to the infraorbital nerve. In the clinical study, nine patients with orbital floor fracture initially underwent endoscopy at the time of fracture repair: three patients had comminuted zygomatico-orbital fractures, five had monofragmented tetrapod fractures, and one had an isolated orbital blowout fracture. Endoscopic dissection of the orbital fractures revealed seven fractures with an area > 2 cm2 and two fractures with an area of < 2 cm2. The isolated orbital floor blowout fracture had entrapped periorbital tissue, which was completely reduced endoscopically. A separate patient with a < 2 cm2 displaced fracture also had stable endoscopic reduction. In the remaining seven patients, the endoscopic technique assisted with the floor reconstruction by identifying the precise fracture configuration as well as identifying the stable posterior ledge of the orbital floor fracture. There have been no complications in any of our patients to date. We conclude: (1) Transantral orbital floor exploration allows precise determination of orbital floor fracture size, location, and the presence of entrapped periorbita. The information obtained through endoscopic techniques may be used to select patients who would not benefit from lid approaches to the orbital floor and may possibly eliminate nontherapeutic exploration. (2) Transantral endoscopic orbital floor exploration assists the reduction of complex orbital floor fractures and allows precise identification of the posterior shelf for implant placement. (3) Transantral endoscopic techniques can completely reduce entrapped periorbital tissue caught in a trapdoor type of fracture.

Endoscopy↗

Influence of cadaver donor age on the success of kidney transplants.

To investigate the impact of donor age on the outcome of renal transplants, a retrospective analysis of 440 consecutive cadaver donor kidney transplants were performed by dividing the transplants into six groups, according to the decade of donor age. These groups were comparable with regard to recipient age, sex, race, and HLA matching grade, while the pediatric group received kidneys preferentially from the first and second decade donors. Although cadaver donor age, between 11 and 50 years, did not appear to influence the result of kidney transplants, the kidneys retrieved from the first and sixth or higher decades of donors fared significantly worse. Improved criteria for the evaluation, selection, and management of cadaver donors of extreme ages is needed to achieve a satisfactory result.

Adolescent↗

Cadaver evaluation of EMG needle insertion techniques used to target muscles of the thorax.

STUDY DESIGN: Measure the accuracy of needle insertion in thoracic muscles of human cadavers. OBJECTIVES: Evaluate the effectiveness of known EMG techniques for sampling thoracic innervated muscles. SUMMARY OF BACKGROUND DATA: The evaluation of thoracic radiculopathies requires accurate electrodiagnostic techniques for evaluating the thoracic myotomes. METHODS: An American Board of Electrodiagnostic Medicine certified physician placed needles into pertinent muscles of the thorax and an anatomist serving as a blinded dissector recorded the path and accuracy of needle. RESULTS: Needle examination of thoracic muscles was as accurate as limb needle examination. No notable risks are noted in multifidus sampling. However, in the cadaver, some risks were noted in association with placements in the intercostal muscles. The target muscle was reliably sampled, but the rib or vertebral level was difficult to landmark in the cadaver. CONCLUSIONS: Needle examination of the thoracic multifidus and intercostals is reliable, although further confirmation is needed to accurately verify the appropriate vertebral or rib level being sampled.

Adult↗

Post-mortem survival of hippuric acid formation in rat and human cadaver tissue samples.

1. A rapid and sensitive semi-micro method for the determination of hippuric acid formation by tissue samples in vitro is described and applied to the determination of the post-mortem survival of hippuric acid formation in rat and human cadaver tissue samples. 2. Hippuric acid formation survived in rat and human cadaver liver for at least 72 h when corpses were stored at 4 degrees. 3. Hippuric acid formation was detected in human cadaver liver and kidney samples and was absent from brain, intestine, heart and lung. 4. Post-mortem liver samples from a case of acute pancreatitis failed to form hippuric acid as did kidney samples from a case of systemic lupus erythematosus with renal involvement.

Adult↗

Development of a transdermal patch of methadone: in vitro evaluation across hairless mouse and human cadaver skin.

A 3-day monolithic polyacrylate adhesive dispersion type delivery system containing methadone was fabricated and in vitro permeation through hairless mouse and human cadaver skins was conducted. The effect of skin permeation enhancers was also investigated. Skin permeation rate across human cadaver skin was found to be lower than that of hairless mouse. Skin permeation profiles across both types of skins showed a membrane permeation controlled cumulative amount permeated (Q) versus time (t) relationship. Skin permeation rate was found to be dependent on both adhesive film thickness and loading dose of the drug in the matrix. Effective skin permeation rate across the hairless mouse skin was obtained from a patch with 1.5 mm thickness and 15% w/w loading dose. n-Decylmethyl sulfoxide and Azone were found to produce an effective skin permeation rate of methadone through human cadaver skin at a 5% w/w concentration. These initial studies demonstrated the feasibility of methadone administration through intact skin from a transdermal patch.

Administration, Cutaneous↗

Three-dimensional image and virtual dissection program of the brain made of Korean cadaver.

The three-dimensional (3D) structure of the brain needs to be understood for accurate diagnosis and treatment of brain diseases. The brain of a cadaver may not always be available for dissection when it is needed. To overcome this problem, we attempted to create a 3D image and virtual dissection program of the brain using a Korean cadaver. The brain extracted from a Korean male cadaver was embedded in gelatin solution. 130 MRI of the brain were taken and 130 serially-sectioned specimens were made. All of MRI and specimens were inputted into the computer, and 10 brain components were manually segmented. A 3D image and virtual dissection program of the brain was made. Various virtual dissection functions were established, such as 1) sectioning the 3D image of the brain at free angles to represent its plane as a real image, segmented image, and MRI, 2) identifying the brain components represented in the sectioned plane, and 3) rotating the 3D image of the whole brain or the selected brain components at free angles. The resulting virtual dissection program of the brain is helpful in better understanding the 3D location and shape of the brain components and it is expected to be used as a CD-title or through Internet as an educational tool for medical students and doctors.

Brain↗

[Anatomy cadaver ceremonies in Taiwan].

The practice of holding annual ceremonies in honor of cadaver donors in Taiwan's medical schools has a history of nearly a hundred years. It originated in Japan, where such ceremonies have been widely held in medical schools since the practice was founded by Toyo Yamawaki, who was the first medical scholar in Japan to engage in dissection of the human body and was the author of the first anatomy book to appear in Japan, the Zoshi. The practice of holding donor ceremonies was introduced into Taiwan after the Jaiwu Sino - Japanese war, when the island became a Japanese colony. The tradition was upheld in the Viceroy's Medical School, the Viceroy's College of Medicine, and Taihoku (Taipei) Imperial University College of Medicine, and continued since the restoration of Chinese power to the present. The practice of holding cadaver donor ceremonies in institutions of medical education is intended to express respect for the donor as well as to encourage the practice of cadaver donation to the benefit of medical education.

Anatomy↗

Evaluation of maxillary sinus membrane response following elevation with the crestal osteotome technique in human cadavers.

Implant placement in the posterior maxilla often requires elevation of the sinus floor, which can be achieved through either the modified Caldwell-Luc or the crestal osteotome technique. The objectives of this study were to evaluate (a) the resistance to perforation of maxillary sinus membranes obtained from formaldehyde-fixed cadavers in vitro, (b) the frequency and extent of membrane perforations occurring after sinus floor elevation in cadavers using the crestal approach, and (c) the amount of membrane elevation (doming) that can be achieved using the crestal approach. Pretreatment of maxillary sinus membrane tissues with commonly used tissue softeners did not have a statistically significant effect on resistance to perforation. Maxillary sinus membranes were elevated 4 to 8 mm in formaldehyde-fixed cadavers using the osteotome technique; implants were placed. Of the 25 sites that received implants, only 6 showed perforations, as assessed by double-blind investigation after dissection of the lateral wall of the nose, allowing direct examination of the sinus cavity. Perforations were categorized as Class I (< or = 2 mm with exposure of the implant into the sinus cavity and loss of doming); Class II perforations (> or = 2 mm) were associated with proximity of the osteotomy site to the medial wall of the sinus or the presence of septae. These results indicated that the crestal osteotome approach compared favorably to the modified Caldwell-Luc technique as it relates to the frequency of maxillary sinus membrane perforations and the degree of achievable membrane elevation.

Biocompatible Materials↗

The prevalence of an Onodi cell in adult Thai cadavers.

Endoscopic sinus surgery in patients who have an Onodi cell (sphenoethmoid cell) carries a high risk for optic nerve injury. We meticulously dissected 65 embalmed cadaver adult half-heads and attempted to identify an optic canal bulge in each with a nasal endoscope. Our aims were to determine the prevalence of an Onodi cell in adult Thai cadavers, to ascertain the prevalence of an overriding ethmoid cell, and to measure the length of an overriding ethmoid cell's superior and posterior extensions in relation to the anterior sphenoid wall. Moreover, we attempted to determine the minimum amount of bone thickness between an Onodi cell and the optic nerve. We found that an Onodi cell was present in 39 of the 65 specimens (60.0%). We also found that an overriding ethmoid cell was present in 14 specimens, which accounted for 21.5% of the total number of specimens and 36.8% of 38 Onodi cell-positive specimens (the presence or absence of an overriding ethmoid cell was not recorded in one of the 39 Onodi cell-positive specimens). The distance of the overriding ethmoid cell's superior and posterior extensions from the anterior sphenoid wall ranged from 3 to 13 mm (median: 7) and from 4 to 16 mm (median: 9.5), respectively. Measurements of the minimum amount of bone thicknesses between each Onodi cell and optic nerve ranged from 0.03 to 0.54 mm (median: 0.08). Our study demonstrated that the prevalence of an Onodi cell in adult Thai cadavers was as great as the prevalence reported in the only other gross anatomic dissection study performed in Asia and much higher than rates generally reported in Western countries.

Adult↗

Paradiscal extraforaminal technique for lumbar sympathetic block: report of a proposed new technique utilizing a cadaver study.

Knowledge of the relationship of the lumbar sympathetic chain to the vertebral bodies is needed to perform sympathetic block and sympatholysis. This information should be correlated with fluoroscopy to determine the best method to perform this technique clinically. Twenty cadavers were dissected to demonstrate the lumbar sympathetic chain. In five cadavers, a 17 G Hustead needle was introduced inferior to the transverse process in the concavity of the body of L2 vertebra utilizing an extraforaminal (paraforaminal) approach and images were obtained in both the anteroposterior and lateral views. Needles were placed by utilizing either the loss of resistance technique (just piercing the psoas muscle) or by placing the needle posterior to the anterior border of the vertebral body. The cadavers were then dissected to demonstrate needle position in relationship to the lumbar sympathetic chain. Each lumbar sympathetic chain was located on the anterolateral aspect of the vertebral body at the medial attachment of psoas major to the vertebral body. When needles were inserted using the loss of resistance technique, dissection revealed needle tips considerably anterior to the ganglia and missing it. When the needle was placed just on the anterior border of the vertebral body, the tip was close to the sympathetic chain. In all of the dissections, lumbar segmental vessels were found in the concavity of the vertebral body ventrodorsally and closely related to the sympathetic chain. The chain varies in both size and location of the ganglia. In the majority of cases, lumbar ganglia were 3 in number. We believe the extraforaminal technique of lumbar sympathetic block is superior to the paramedian approach considering that there should be a reduced chance of passing through viscera and a lower incidence of genitofemoral neuralgia. However, with the extraforaminal technique, two important possible complications need to be highlighted. Chances of injury to the segmental lumbar vessels and the anterior ramus are present. Therefore, the extraforaminal technique needs to be modified. We advocate the extraforaminal paradiscal technique for lumbar sympathetic block. The initial target point for entry should be the lateralmost tip of the transverse process. Advancement of the needle should be extraforaminal with minimal chance of injury to the nerve or the anterior ramus. Final target point should be paradiscal. The needle tip should be positioned just posterior to the anterior border of the vertebral body. Loss of resistance technique should not be utilized and is potentially dangerous. Use of at least two needles is advisable (L2 and L3 vertebral body). Care should be taken to avoid the lumbar vessels. A transdiscal technique recently advocated may also avoid some of the complications with the paramedian technique, but chances of discitis, nerve root injury, accelerated disc degeneration, disc herniation and rupture of the anterior annulus have to be considered when using this technique.

Journal Article↗

[The anatomy lesson of Dr Nicolaes Tulp by Rembrandt (1632) and the findings during dissection of the forearm of a cadaver: anatomical discrepancies].

OBJECTIVE: To compare The anatomy lesson of Dr Nicolaes Tulp by Rembrandt (1632) with the findings during dissection of the forearm of a cadaver. DESIGN: Descriptive. METHOD: The left forearm of a 41-year-old white male cadaver was dissected, photographs being taken at every stage of dissection. The anatomical structures in the original painting and during dissection were described and compared. At dissection, several structures were displaced in an attempt to reproduce the anatomical structures as shown in the painting. RESULTS: Dissection revealed four anatomical differences in comparison with Rembrandt's painting: (a) the muscle belly seen at the proximal ulnar side of the forearm in the painting was not seen on dissection; section of the insertion of the M. flexor carpi radialis and transposition of this muscle to the location of the muscle belly created the possibility of lifting up the M. flexor digitorum superficialis and reproducing the muscle belly; (b) in the painting, Tulp lifted only the M. flexor digitorum superficialis, but the amount of muscle tissue found in the forceps was increased in the painting compared with the dissection; (c) the positions of the bellies of the M. flexor digitorum superficialis to the index finger and 5th digit and to the 3rd and 4th digits were found to be reversed; (d) the longitudinal white structure situated in the ulnar part of the 5th digit in the painting was not found on dissection. This may have been an anatomical variant of the ulnar nerve. CONCLUSION: The anatomical characteristics of the painting could not be reproduced by dissection of the forearm of a cadaver.

English Abstract↗

[Herpes simplex type I virus observed in the superior cervical ganglion from human cadavers and autopsy materials].

Herpes Simplex Type I (HSV I) causes some infections such as herpes labialis, encephalitis, keratoconjunctivitis and also some cranial nerve syndromes such as acute vestibular neuritis, migraine and Meniere's disease in human. We used 4 fixated and 16 fresh cadavers to isolate HSV I virus from the Superior Cervical Ganglia. The ganglia materials are inoculated to PRK (primary rabbit kidney), VERO (African Green Monkey Kidney) and BHK 21 (Baby Hamster Kidney) cell lines in order to isolate the virus. We isolated HSV I virus from 12 fresh cadavers' cervical ganglia (75%) and neutralisation test is performed in order to characterize HSV I. But we could not isolate the virus from any of the fixated cadavers.

Adult↗

[Studies on the estimation of the postmortem interval 7. Cadavers in the water and privy (author's transl)].

The authors have investigated 17 kinds of findings of 34 cadavers in the water and 17 newborn-infant cadavers in liquid feces-urine mixture in privies which had remained at known postmortem interval and had been subjected to medico-legal autopsies in our laboratory. The conclusions are as follows: The progress of the cadaveric phenomena in the water and liquid feces-urine mixture is slower than in the air. The time ratio of the progress of the phenomena in the media to those in the air is not the same for all kinds of the findings, and hence it is not possible to apply the criterion of the estimation of the postmortem interval for the cadavers in the air to those in the water and liquid feces-urine mixture by any correction.

Adolescent↗

Perfusion time and the survival of cadaver transplants.

Perfusion of cadaver kidneys up to 48 hours did not adversely affect the long-term renal allotransplant function and did not result in an increased rate of rejection. In fact, cadaver kidneys perfused for longer periods of time had a slightly better functional survival rate than did kidneys perfused for shorter periods. From 100 perfused cadaver kidneys, we can conclude that the length of perfusion had little if any effect on the immunogenicity of the renal allograft in the immunosuppressed transplant patient.

Adolescent↗