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At least 361 records · Page 20Linked to original sources
PubMed2005

Analysis of intrinsic-extrinsic muscle function through interactive 3-dimensional kinematic simulation and cadaver studies.

PURPOSE: To revisit the analysis of intrinsic muscle function and its relationship to the overall flexion moment at the index metacarpophalangeal (MCP) joint. Prior studies reported inconsistent levels of intrinsic contribution varying from 12.5% to 73% of the total flexion moment at the index MCP joint. This study hypothesized that 26% is a more realistic figure using computer simulation moment arms combined with known muscle-tension fractions. This study tested the hypothesis using a 2-part fresh cadaver study, the objectives of which were to measure actual muscle moment arms throughout index MCP range of motion and then combine these measurements with tension fractions to calculate normal intrinsic minus and low ulnar nerve palsy moments and then using the same specimens to apply loads to the muscles and measure resultant moments directly. METHODS: An interactive computer simulation was constructed to replicate the position and loading orientation of an earlier experiment reported in the literature and known muscle-tension fractions were combined with the resultant moment arm structure to calculate the moment at the index MCP joint for maximum isometric contraction of the normal, intrinsic minus, and low ulnar nerve palsy finger. Eleven fresh cadaver specimens were used. For experiment A the excursion and angle data were used to determine moment arms of each muscle and moments were calculated. For experiment B the muscles were connected to weights based on muscle-tension fractions and the resultant moment was measured at the fingertip. RESULTS: Experiment A determined the muscle-tendon moment arms at the index MCP joint throughout the flexion-extension range of motion. Combining the flexor moment arms with known tension fractions determined that the intrinsics contributed 24% to the total flexion moment, the dorsal and palmar interossei contributed 22%, and the lumbrical contributed 2%. The results of experiment B confirmed the results of experiment A. CONCLUSIONS: Intrinsic muscle contribution to flexion moment at the index MCP joint is not as high or as low as previously reported. The relative moment production is governed by both the moment arms and tension produced by the muscle; thus a more precise knowledge of moment arms is essential to understand muscle balance at a joint. Clinically the hand surgeon should expect a loss of 24% of index MCP flexion moment-generating capacity in the intrinsic-minus index finger and a loss of 22% in the index finger on a hand with low ulnar nerve palsy. Furthermore the flexion moment from the lumbrical of only 2% appears to be adequate to prevent clinical clawing of the digit.

Aged↗
PubMed2005

Development of a new method and device for adaptation and suture of tissues during transoral surgery: in vitro and cadaver experiments.

OBJECTIVE: The objective of this study was to present cadaver and model experiments of a technique using an instrument that may overcome the problems of achieving adaptation and suture of mucous membrane and other tissues during transoral surgery in narrow anatomical circumstances. STUDY DESIGN: The following interventions were carried out on cadavers: adaptation and suture of mucous membrane by uvulopalatopharyngoplasty (UPPP); release and anteroposition of the epiglottis and fixation to the vallecula or to the base of the tongue; denudation and closing the lumen of the larynx; release and retroposition and fixation of the epiglottis to the posterior part of the larynx; creation, adaptation, and suturing of mucosal flaps in the posterior part of the larynx; craniolateral mobilization and fixation of the vocal cord; submucous excision of excess tissues; and adaptation and suture of the edges of the mucosa. RESULTS: The safety and reduced need for microclips in surgeries in these areas can be accomplished by introducing the Ligature-Suture device, which makes it possible to pass a suture under the tissues with a single movement. CONCLUSIONS: This new technique and instrument for the Ligature-Suture device has the potential to be applied successfully in other fields of surgery. The main advantages of this technique are its simplicity and safety.

Cadaver↗
PubMedDate not supplied

The middle interscalene block: cadaver study and clinical assessment.

BACKGROUND AND OBJECTIVES: A variety of brachial plexus block techniques via the interscalene approach have been proposed. We describe here a new middle interscalene perivascular approach to the brachial plexus. To verify its effectiveness, we studied 719 patients scheduled for shoulder arthroscopy. Furthermore, to verify the accuracy of the proposed bony landmarks to use in the case of inability to palpate the subclavian artery pulse, we simulated the block on 10 cadavers. METHODS: The aim of our technique is to cannulate the neurovascular bundle by inserting a 35-mm needle lateral to the subclavian arterial pulse near the midpoint of the upper edge of the clavicle in a horizontal or slightly cephalad direction while pointing toward the seventh cervical vertebra. If the pulse of the subclavian artery is not palpable, we localize the direction of the needle with reference to 3 bony landmarks (the middle point of the clavicle, the spinous process of C7, and the sternoclavicular joint). By connecting these 3 landmarks, we obtain an angle whose apex lies at the midpoint of the clavicle and its bisecting line points to the plexus. The needle is introduced in the transverse plane of C7. RESULTS: The block was performed successfully in 692 of 719 cases (96.2%). Horner's syndrome occurred in 93.5% of the cases, arterial puncture with hematoma occurred in <1%, phrenic nerve block without respiratory impairment in 60%, with transient respiratory failure in <1%, and laryngeal nerve block in <1%. The incidence of severe complications or permanent injuries was zero (upper limit 95% confidence interval = 0.4% or 1:250 patients). The technique performed on cadavers showed that the previously mentioned bony landmarks were reliable reference points in reaching the brachial plexus. CONCLUSIONS: Our technique via a middle interscalene approach is easy to perform and provides a high success rate. Even in the absence of a subclavian artery pulse, the easily recognizable bony landmarks reliably guide us in the insertion of the needle. Furthermore, this technique appears to avoid complications that are theoretically possible in other supraclavicular perivascular approaches (pneumothorax) and paravertebral approaches (injection into the vertebral artery and subarachnoidal injection). However, further comparative studies will be required to assess the clinical relevance of the block.

Adult↗
PubMed2004

Right hemiliver transplants from cadavers or living donors: a comparative analysis.

INTRODUCTION: The aim of this article was to compare the results of right hemiliver transplants from living versus cadaver donors in a single institution. METHODS: Between March 1999 and May 2003, we performed 10 right hemiliver transplants from living donors (LD) and 8 right hemiliver transplants from cadavers (CD). The procedure consisted of grafting liver segments 5, 6, 7, and 8. The procedure was performed with a fully perfused liver also in the CD group (in situ split). RESULTS: With follow-up between 7 days and 26 months in the LD group, 2 patients died with functioning grafts: 1 patient died because of massive pulmonary bleeding due to Rendu-Osler Syndrome; the other one died as a consequence of systemic aspergillosis. One patient underwent retransplantation due to arterial thrombosis. In the CD group with a follow-up between 31 days and 48 months, 3 patients died due to sepsis, including 2 who were status 2A. There were 4 early complications among the LD group and 5 in the CD group. The patient and graft survival rates were 80% and 70%, respectively, in the LD group; and both about 62% in the CD group. CONCLUSION: Right hemiliver grafts are at high risk due to technical and septic complications. A higher morbidity is observed in the CD group, where the vascular and biliary tree anatomy cannot be investigated with accuracy. We must avoid transplanting status 2A recipients with this kind of graft.

Cadaver↗
PubMed2004

Simultaneous cadaver pancreas-living donor kidney transplantation.

BACKGROUND: The expansion of the donor pool achieved with living kidney donation (LKD) is particularly beneficial for diabetic patients, who have a worse prognosis during dialysis when compared to other kidney recipients. Simultaneous cadaver pancreas-living kidney transplantation (SPLKTx) merges the advantages of LKD with those of cadaver donation, and may be an attractive alternative to simultaneous pancreas kidney transplantation (SPKTx). METHODS: The outcomes of 18 SPLKTx were compared with those of 33 SPKTx. RESULTS: LKD expanded the donor pool from 33 to 51 (P =.004). Median wait time was shorter for SPLKTx (14 days) than for SPKTx (95 days) (P =.006). The risk for surgical complications was not increased by SPLKTx, as witnessed by relaparotomy rates (SPLKTx: 2/18, 11.1%; SPKTx: 2/33, 6.1%; P >.05). Hospital stay averaged 26.1 +/- 11.2 days for SPLKTx and 27.1 +/- 16.3 for SPKTx (P >.05) with equivalent 30-day readmission rates (SPLKTx: 5.5%; SPKTx: 6.1%); (P >.05). One acute kidney rejection occurred in SPLKTx (5.5%) as compared with four in SPKTx (12.1%); (P >.05). Equivalent rates for the pancreas were 5.5% (1/18) for SPLKTx and 3.0% (1/33) for SPKTx (P >.05). Two-year recipient survival rates were 100% for SPLKTx as compared with 96.9% for SPKTx. Equivalent figures for kidney and pancreas were 80.0% and 84.0% for SPLKTx and 96.9% and 96.9% for SPKTx. CONCLUSIONS: SPLKTx is a valuable alternative to SPKTx. Further development of SPLKTX relies on increased rates of living kidney donation.

Adult↗
PubMed2004

Observations of the marginal incision and lateral crura alar cartilage asymmetry in rhinoplasty: a fixed cadaver study.

OBJECTIVE: This anatomical cadaver study was intended to incrementally determine the precise relationship between the alar rim skin margin and the caudal aspect of the lateral crus of the nose. The second intention was to preliminarily test the hypothesis of sexual dimorphism in the lateral crura size and of right to left asymmetry of the lateral crura in the same individual. STUDY DESIGN: Demographic information of 39 Caucasian cadavers was collected. Dissection of 28 unilateral and 11 bilateral noses included the removal of all of the soft tissue from the lateral surface of lateral crura cartilages. The distance from the caudal edge of the lateral crus to the alar margin was measured beginning at the junction of the middle and lateral crura moving posteriorly. The lateral crus was then completely dissected out from the remaining surrounding soft tissue for measurement of the length, height, and thickness. RESULTS: Comparison of the cartilage dimensions between the sexes showed significant differences between the length, height, and thickness of the cartilages. The distance between the caudal aspect of the lateral crus and alar skin margin was less than 6.7 mm on average for the anterior 15 mm of the lateral crus. Comparison for intraindividual right to left asymmetry showed significant differences in 3 infracartilaginous-alar skin margin distance measurements and in cartilage length and height. CONCLUSION: The marginal incision can be close to the alar skin margin in the first 15 mm. Right to left intraindividual asymmetry in the first 20 mm was significant. Intraindividual right to left asymmetry was significant in the lateral crura length and height. Sexual dimorphism in the lateral crura length, height, and thickness was observed.

Adult↗
PubMed2005

Comparison of linear tomography and direct ridge mapping for the determination of edentulous ridge dimensions in human cadavers.

OBJECTIVE: The purpose of this study was to compare the accuracy of linear tomography (LT) and direct ridge mapping (RM) for determining alveolar ridge dimensions. STUDY DESIGN: One site in the posterior mandible was selected for evaluation in each of 5 cadaver heads. Vacuum-formed stents made from models of the cadaver ridges were used to identify 3 sets of measurement points for each specimen: coronal (intersection of coronal and middle third of ridge), middle (intersection of middle and apical third), and apical (base of vestibule). The imaging stent contained 2-mm metal balls at each point, while the RM stent had holes drilled at corresponding locations. Linear tomograms and periapical radiographs (PA) were taken of the selected sites. RM measurements were made with calipers. Five blinded examiners measured ridge width at the designated measurement points with both LT and RM as well as distance from the ridge crest to mandibular canal (using PAs for RM group). Mandibles were then sectioned and an independent examiner made direct measurements (DM). MANOVA was used to determine whether LT and RM differed significantly from DM. RESULTS: There were no significant differences between LT and RM for ridge width measurements. However, both techniques underestimated ridge dimensions compared to DM ( P < .05). Measurement of mandibular canal height was accurate when determined by periapical radiographs but not by LT. CONCLUSION: Neither LT nor RM proved to be completely accurate in determining ridge width in the posterior mandible.

Alveolar Process↗
PubMed1990

Total body burdens and tissue concentrations of lead, cadmium, copper, zinc, and ash in 55 human cadavers.

Trace metal contents of human tissues and total body burdens are useful for studies of nutrition and certain diseases. Data are summarized and analyzed for individuals exposed to the normal Cincinnati environment, for 29 tissues from 55 cadavers for lead and ash concentrations, and from 26 cadavers for cadmium, copper, and zinc concentrations. Total body burdens also were calculated and correlated against each other and age. The distributions for ash, copper, and zinc were close to normal, but those for lead and cadmium were closer to lognormal. Bone lead increased with age, whereas soft tissue lead did not. The calculated mean percentage of total body lead in the bones ranged from 78% at age 20 to 96% at age 80. Correlations of blood concentrations with total body burdens were negligible for cadmium and zinc. For copper the correlation coefficient was a poor 0.54. For lead in blood vs soft tissue burden it was a very poor 0.37, and vs total body lead it was negligible. Thus the use of blood samples as a convenient clinical measure of body burdens for these metals may be of limited value. These and other findings provide a useful bank of information for health studies.

Adult↗
PubMedDate not supplied

Toxicology and fly larvae on a putrefied cadaver.

Toxicological analyses on a putrefied cadaver are sometimes difficult to achieve, due to the absence of blood and/or urine. In this study, morphine and phenobarbital were simultaneously identified and assayed in several tissues of a putrefied cadaver and in the fly larvae of Calliphoridae found on the corpse.

Adult↗
PubMedDate not supplied

Analysis of opiates in fly larvae sampled on a putrefied cadaver.

Toxicological analyses on a putrefied cadaver are sometimes difficult to achieve, because of the absence of blood and/or urine. Drugs present in a decomposing corpse may be identified through analysis of maggots feeding off it. In this study, morphine and codeine were simultaneously identified and assayed in blood and bile of a putrefied cadaver and in the fly larvae of Calliphoridae found on the corpse.

Animals↗
PubMed1997

Minimally invasive plate osteosynthesis and vascularity: preliminary results of a cadaver injection study.

A cadaver arterial injection study was performed to analyse the vascular supply to the femur and to study the effects of two surgical plating techniques on femoral vascularity. A 16-hole LC-DCP was applied on the intact femora of five fresh human cadavers. On one side, the plate was inserted using a conventional lateral plate osteosynthesis (CLPO) technique with elevation of the vastus lateralis muscle to expose the shaft. On the contralateral side, the plate was inserted percutaneously beneath the muscle using a minimally invasive plate osteosynthesis (MIPO) technique. After plating, blue silicone dye was injected through the common femoral artery. Cadaveric dissection was then performed to identify the femoral perforating arteries (PAs) and the nutrient artery (NA) of the femur. The pattern of periosteal filling and medullary perfusion of the injected dye was analysed and the topography of the PAs and NA was determined. CLPO placed the PAs and NA of the femur at risk. MIPO maintained the integrity of the PAs and NA and was associated with superior periosteal and medullary perfusion. The results of this study indicate that MIPO is superior to the CLPO in maintaining arterial femoral vascularity and perfusion.

Aged↗
PubMed2002

Host cadavers protect entomopathogenic nematodes during freezing.

The entomopathogenic nematodes Heterorhabditis bacteriophora, Steinernema carpocapsae, Steinernema glaseri, and Steinernema feltiae were exposed to freezing while inside their hosts. Survival was assessed by observing live and dead nematodes inside cadavers and by counting the infective juveniles (IJs) that emerged after freezing. We (1) measured the effects of 24h of freezing at different times throughout the course of an infection, (2) determined the duration of freezing entomopathogenic nematodes could survive, (3) determined species differences in freezing survival. Highest stage-specific survival was IJs for S. carpocapsae, and adults for H. bacteriophora. When cadavers were frozen two or three days after infection, few IJs emerged from them. Freezing between five and seven days after infection had no negative effect on IJ production. No decrease in IJ production was measured for H. bacteriophora after freezing. H. bacteriophora also showed improved survival inside versus outside their host when exposed to freezing.

Animals↗
PubMed1992

Eversion endarterectomy of the cadaver donor renal artery: a method to increase the use of elderly donor kidney allografts.

Eversion endarterectomy was used to treat severe arteriosclerosis of the renal artery in 34 cadaver kidneys from elderly donors that have been considered unsuitable by other transplant centers. All kidneys were transplanted after biopsy confirmed normal histology. Graft survival and mean serum creatinine level at 4 years were 76.4% and 2.3 mg./dl., respectively. Use of these kidneys increased the number of cadaver kidney transplants at our center by 18%.

Adult↗
PubMed1984

Cultures of normal human urothelial cells from ureters of perfused cadaver transplant kidneys.

In this comparative study, we report that urothelial cultures initiated from ureters of mechanically perfused cadaver-obtained transplant kidneys display characteristics of explant attachment, explant viability, cellular morphology and area of outgrowth essentially indistinguishable from cultures established from ureters of living donor kidneys. We conclude that ureter specimens from cadaver kidneys are a suitable, routinely available source of tissue from which cultures of normal human urothelial cells can be propagated.

Cadaver↗
PubMed1984

Improved results of cadaver renal transplantation with azathioprine, prednisone and antilymphoblast globulin.

From 1980 to 1982, 100 consecutive cadaver renal transplants were performed. All but 2 recipients received preoperative transfusion and all received an initial 2-week course of antilymphoblast globulin. A prospective controlled evaluation of high versus low maintenance prednisone, and antilymphoblast globulin versus intravenous methylprednisolone for first rejection therapy was done. Over-all 1-year graft and patient survivals were 77 and 96 per cent, respectively. Graft survival was equal in the high and low steroid groups. Antilymphoblast globulin was as effective as intravenous methylprednisolone in reversing first rejections. Graft survival was improved with better donor-recipient matched grafts. We conclude that excellent results can be obtained in transfused cadaver renal allograft recipients managed with azathioprine, prednisone and antilymphoblast globulin. The regimen of prophylactic antilymphoblast globulin, low maintenance prednisone and antilymphoblast globulin alone for first rejections is immunologically effective and steroid sparing.

Antilymphocyte Serum↗
PubMed1983

Extended cadaver renal preservation with combined simple cold storage and hypothermic pulsatile perfusion.

Although simple cold storage and hypothermic pulsatile perfusion are each accepted methods of cadaver kidney preservation the efficacy of combining these techniques for extended renal preservation is unclear. In 18 patients cadaver allografts were used that had been preserved with combined simple cold storage (range 6 to 20 hours) and hypothermic pulsatile perfusion (range 9 to 38 hours). The total interval of preservation for these kidneys ranged from 25 to 48 hours. Excellent post-transplant graft function was achieved in all cases, with a mean serum creatinine nadir of 1.4 mg./dl. In 14 patients (78 per cent) grafts continued to function at intervals of 3 to 38 months after transplantation. Of the remaining 4 patients 3 lost the grafts to rejection, while 1 died 7 months after transplantation with a well functioning graft. These data suggest that the combination of simple cold storage and hypothermic pulsatile perfusion provides a safe and effective method for extended renal preservation.

Adolescent↗
PubMed2004

[Anterior cruciate ligament reconstruction: biomechanical comparison on cadaver specimens using a single or double hamstring technique].

PURPOSE OF THE STUDY: We worked with cadaver specimens to evaluate control of anterior knee laxity after reconstruction of the anterior cruciate ligament (ACL) comparing double two-strand anterolateral and posteromedial reconstruction with the classical four-strand technique. We hypothesized that the double reconstruction would provide better control of anterior laxity in both flexion and extension. MATERIAL AND METHODS: Sixteen cadaver knees were randomly assigned to reconstruction technique. Anterior tibial translation was measured with an arthrometer (Rolimeter) at maximal manual tension at 20 degrees, 60 degrees and 90 degrees flexion on the intact knee, after section of the ACL and after arthroscopic reconstruction using either the classical four-strand hamstring technique or a double two-strand anteromedial and posterolateral technique. An EndoButtonCL was used for the femoral fixation and a interference screw with staples for the tibial fixation. Variation in the length of each construct was measured between 0 degrees and 90 degrees flexion. RESULTS: In the single reconstruction group, the length of the graft varied by 0.5 +/- 0.7 mm between 0 degrees and 90 degrees flexion. In the double reconstruction group, the length varied by 0.5 +/- 0.9 mm for the anteromedial construct and 3.4 +/- 0.5 mm for the posterolateral construct. When studied with an intact ACL, anterior laxity of the 16 knees was 3.2 +/- 1.1, 3.5 +/- 1.5 and 2.6 +/- 1.1 mm at 20 degrees, 60 degrees, and 90 degrees respectively. After section of the ACL, laxity increased significantly at all angles: 9.4 +/- 3.3, 6.1 +/- 2.5 and 6.8 +/- 2.9 at 20 degrees, 60 degrees, and 90 degrees respectively. After classical four-strand single graft reconstruction, the residual anterior laxity was 3.7 +/- 0.9, 3.1 +/- 1.1, and 2.3 +/- 1.6 mm at 20 degrees, 60 degrees, and 90 degrees flexion. Statistical analysis using parametric or non-parametric tests as appropriate showed a significant difference in laxity at 20 degrees, 60 degrees, and 90 degrees of flexion between knees with a cut ACL and knees with reconstructed ACL. At 20 degrees flexion, residual laxity was greater after single-construct reconstruction. At 60 degrees and 90 degrees there was no significant difference in anterior translation of the tibia in knees with intact or reconstructed ACL. After reconstruction with the dual-construct technique, laxity was 3.4 +/- 1.3, 2.6 +/- 1.5, and 2.4 +/- 1.2 mm at 20 degrees, 60 degrees and 90 degrees flexion respectively. Laxity was significantly greater with a cut ACL than after reconstruction at 20 degrees, 60 degrees, and 90 degrees flexion, but there was no significant difference in anterior translation of the tibia at 20 degrees, 60 degrees, and 90 degrees flexion between knees with an intact and a reconstructed ACL. DISCUSSION: These results based on a clinical evaluation measuring anterior translation of the tibia with an arthrometer are in agreement with results in the literature using robots. Compared with the classical technique, reconstruction of the ACL with a dual-construct technique provides a statistically significant improvement in control of anterior tibial translation at 20 degrees of flexion. The advantage of the dual anteromedial and posteriolateral construct technique is thus not found in the control of anterior laxity but rather in control of rotation laxity. CONCLUSION: Reconstruction of the ACL with a two-bundle graft technique provides control of anterior laxity at 20 degrees, 60 degrees, and 90 degrees flexion similar to that observed in knees with an intact ACL while the single construct technique re-establishes physiological laxity at 60 degrees and 90 degrees only. This improved control of anterior laxity with the two-bundle reconstruction is a small improvement regarding anterior laxity, the more potential advantage concerning rotational stability.

Aged↗