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PubMed1991

Energy levels and probe placement in contact transscleral semiconductor diode laser cyclophotocoagulation in human cadaver eyes.

We investigated the effects of semiconductor diode laser contact transscleral cyclophotocoagulation in human cadaver eyes by gross examination, light microscopy, and scanning electron microscopy to determine optimum clinical treatment parameters. Irradiation was performed using a continuous-wave semiconductor diode laser with a fiber-optic probe. At 1.0 to 1.25 mm posterior to the limbus, spots were centered on the pars plicata by gross examination. Exposures of less than 2 J produced no visible damage. A 2- to 3-J exposure produced mild whitening of the ciliary processes, while 4- to 5-J exposures created more intense whitening of the pars plicata. Energies higher than 5 J frequently produced explosive tissue damage. Light microscopy of tissue treated with 1.8 to 6 J at 1.0 to 1.25 mm posterior to the limbus revealed coagulation necrosis of the nonpigmented and pigmented epithelium, with evidence of thermal coagulation of the ciliary stroma and stromal vasculature. Coagulation necrosis was more intense with longer exposure times. We found the optimum parameters for contact transscleral diode laser cyclophotocoagulation in cadaver eyes to be 3 to 4.5 J of energy delivered with the anterior edge of the probe 1.0 to 1.25 mm posterior to the limbus.

Ciliary Body↗
PubMed1978

Significance of microbial contamination of stored cadaver kidneys.

The importance of microbial contamination of cadaver kidneys was assessed in 83 consecutively stored and transplanted kidneys. Fourteen kidneys had a single positive culture during storage and five had multiple positive cultures. Only one postoperative infection could be traced to kidney contamination during storage (Candida wound infection). In three of 64 patients who received noncontaminated kidneys, posttransplant wound infections developed. No wound infections occurred in 35 patients who received prophylactic antibiotics, whereas four wound infections occurred in 48 patients without antibiotic coverage. It is concluded that, although microbial contamination of stored cadaver kidneys occurs commonly, it is not an important source of infection in renal transplant recipients.

Candidiasis↗
PubMed1994

Permeability of ketorolac acid and its ester analogs (prodrug) through human cadaver skin.

The in vitro skin permeabilities of ketorolac acid (KA), a potent nonsteroidal analgesic, and its two ester analogs as prodrug through human cadaver skin were investigated. The two esters of KA, namely, the ethyl ester (KEE) and [(N,N-dimethylamino)carbonyl]methyl ester (KDAE), were selected. The melting temperature of the two esters was significantly lower than that of ketorolac free acid. The partition coefficients (KO/W) were 600, 3541, and 124 for KA, KEE, and KDAE, respectively. The enzymatic hydrolysis of KEE and KDAE by human pooled serum at 37 degrees C was investigated. The esters were hydrolyzed to KA by the serum esterases; the metabolic rate constants were 0.0418 and 0.0148 min-1 for KDAE and KEE, respectively. The serum half-life of KDAE was about 3 times shorter than KEE. When split-thickness cadaver skin was incubated with ester solution at 32 degrees C, the enzymatic hydrolysis of these esters was observed. The metabolic rate in the skin, however, was significantly lower than in the human pooled serum. The skin permeations of KA, KEE, and KDAE through heat-separated epidermis from propylene glycol (PG), PG/glyceryl monocaprylate (GMC) (9:1), and PG/Azone (19:1) vehicle mixtures were evaluated using modified Franz flow-through diffusion cells. The skin fluxes of KA, KEE, and KDAE from PG/GMC (9:1) were 50 +/- 10, 15 +/- 4, and 57 +/- 6 micrograms/cm2/h, respectively. KA was detected in the receiver compartment, albeit to a lesser extent. In conclusion, KDAE appeared to be a better ester prodrug than KEE because it exhibited relatively higher skin flux and faster enzymatic hydrolysis by human serum to liberate the parent drug.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed2001

Sporulation by Entomophthora schizophorae (Zygomycetes: Entomophthorales) from housefly cadavers and the persistence of primary conidia at constant temperatures and relative humidities.

The duration of discharge of Entomophthora schizophorae (Zygomycetes: Entomophthorales) conidia from house fly (Musca domestica, Diptera) cadavers was measured at 7, 18, and 25 degrees C. The higher the temperature, the shorter the duration of conidia discharge. Significantly more conidia were produced per cadaver at 7 degrees C over a period of 120 h than at 18 and 25 degrees C. At 25 degrees C, the initial discharge over the first 10 h was much larger than at the other temperatures, and at 7 degrees C, no peak in discharge was observed. The persistence of E. schizophorae primary conidia was measured on fabricated non-host surfaces typically found in stables (straw, wood, plaster, and glass) at 7, 18, and 25 degrees C or constant relative humidities of 45, 65, and 85%. Persistence, as measured by the subsequent ability to infect flies, was usually only a few days and depended on the temperature and type of surface. It was greatest on straw, followed by wood, glass, and plaster, and at 7 degrees C, followed by 18 and 25 degrees C. Limited transmission took place between flies exposed to conidia and previously unexposed mates.

Animals↗
PubMed1996

The lateral temporal vein: a cadaver, CT and MRI study.

The author studied a superficial temporal vein, the "lateral temporal vein", which runs over the superior, middle and inferior temporal gyri on the lateral surface of the temporal lobe, and in front of the inferior anostomatic vein of Labbé. A search for this vein was undertaken in 20 cadavers, 200 CT and 200 MRI studies. The lateral temporal vein was present on both sides in 80% of cadavers, and seen on one or both sides in 0.5% of the CT studies, and in 24% of those using MRI. Although recognition of the lateral temporal vein appears to be of interest mainly from an anatomical perspective, it may be mistaken for a venous malformation on CT or MRI, especially when it is prominent and seen unilaterally.

Adolescent↗
PubMed1996

Effects of Er:YAG laser trabecular ablation on outflow facility in cadaver porcine eyes.

BACKGROUND: Mid-infrared laser technology opens new perspectives in experimental glaucoma surgery. The aim of this study was to establish the effectiveness of Er:YAG laser photoablation of the trabecular meshwork in increasing outflow facility in cadaver porcine eyes. METHODS: Eye cups of 20 freshly enucleated cadaver porcine eyes were fixed in an anterior segment perfusion system, measuring outflow facility under constant pressure conditions (7-13 mmHg) over a period of 45 min. Trabecular ablation was performed using a pulsed Er:YAG (2.94 microns) laser. Radiation was delivered in a single 4-mJ pulse of 200 microseconds duration by means of an articulated zirconium fluoride optical fibre and a 320-microns quartz-fibre tip. RESULTS: Er:YAG laser treatment yielded reproducible ablation areas confined to the trabecular meshwork, with a diameter corresponding to that of the fibre tip. Collateral thermal damage extended up to a depth of 30 microns. Outflow facility measurements revealed an increase (mean +/- SD) from 0.128 +/- 0.041 microliter min-1 mmHg-1 in control eyes (n = 11) to 0.308 +/- 0.093 microliter min-1 mmHg-1 in treated ones (n = 9). CONCLUSION: Application of the photoablative Er:YAG laser technique in non-fistulating trabecular surgery produces patent trabecular perforation with minimal collateral tissue damage and effects a significant reduction (79%) in outflow resistance.

Animals↗
PubMed1999

[Significance of the height and width of the alveolar ridge in implantology in the edentulous maxilla. Analysis of 95 cadaver jaws and 24 consecutive patients].

Consideration of alveolar profiles and clinical experience demonstrate that the transversal dimension has been neglected in dental implantology so far. For a comprehensive evaluation of the impact of alveolar bone height and width, 95 edentulous bony maxillae with standardized, measured, and classified cross-sections were analyzed. With four types of implants (minimum length, 10 mm), 1076 insertions were simulated at 269 cross-sections and evaluated with regard to type of implant, position of cross-section, and class of atrophy. Similar evaluation was carried out in the clinical part of the study on 24 consecutive patients with edentulous maxillae. Implant insertion could only be simulated in 35% of the cadaver cross-sections, but had been expected in an additional 4.5% based on their sufficient bone height; length reductions were necessary in another 6%. These results depended largely on the class of atrophy. Anterior cross-sections offered better conditions than posterior ones. In contrast, implant insertion was impossible in all 24 patients. Height was primarily inadequate in 22 patients, and in two patients with sufficient bone height inadequate transversal dimensions were only recognised intraoperatively. These results allow a quantification of the impact of vertical and transversal maxillary alveolar bone dimensions. This impact primarily depends on bone height, but even with sufficient height, reductions of implant length often become necessary. Both for the cadaver maxillae (12% of the cross-sections with expected implant insertion) and for the patients (8%), alveolar profiles remain in which height measurement alone leads to incorrect assessment and may even result in the interruption of precisely planned surgical procedures. The complexity and expense of implant-borne rehabilitation and the consequences resulting from incorrect preoperative planning therefore generally justify extended cross-sectional diagnostic measuring.

Alveolar Process↗
PubMed1999

Peripheral focal low signal intensity areas in the degenerated annulus fibrosus on T2-weighted fast spin echo MR images: correlation with macroscopic and microscopic findings in elderly cadavers.

OBJECTIVE: To correlate the peripheral focal low signal intensity areas in the degenerated annulus fibrosus on T2-weighted fast spin echo MR images with the macroscopic and microscopic findings in cadavers derived from elderly subjects. DESIGN: Twenty-eight intervertebral disks (16 lumbar and 12 cervical) derived from four nonembalmed cadavers were examined with T1-weighted spin echo and proton density-weighted and T2-weighted fast spin echo MR imaging. The signal intensities of the annulus fibrosus were evaluated on sagittal MR images and correlated with the findings on corresponding sagittal anatomic sections. The MR imaging-histologic correlation was then studied. RESULTS: Peripheral focal low signal intensity areas and adjacent regions of high signal intensity were found in five lumbar intervertebral disks. Peripheral focal low signal intensity regions consisted of disorganized compact annular fibers, tiny fissures, and dense fibrosis. The high signal intensity regions, adjacent to the areas of low signal intensity, consisted of mucoid degeneration, tiny fissures, and chondroid metaplasia. CONCLUSIONS: Awareness of the histologic findings in regions that reveal peripheral focal low signal intensity with adjacent regions of high signal intensity in the degenerated annulus fibrosus on T2-weighted images may facilitate effective interpretation of clinical MR images of the spine.

Aged↗
PubMed2004

Quantitative evaluation of the utero-ovarian venous pattern in the adult human female cadaver with plastination.

We described the anatomy of the utero-ovarian venous system in the adult postmenopausal female cadaver using casts and the von Hagen's plastination technique. To qualitatively and quantitatively evaluate the uterine vein, the utero-ovarian arcade, the ovarian vein and the ramus communicans between left and right parametrium, we injected epoxy resin into the internal iliac vein and artery and the ovarian vein and artery in six cadavers. In two cases the internal genital organs were excised before injection and in the other four after the injection and polymerization of the resin. All specimens were macroscopically examined and venous diameters were digitally measured, the average values of the measured diameters being 3.38 mm for the uterine vein, 3.71 mm for the utero-ovarian arcade, 3.49 mm for the ovarian vein, and 3.71 mm for the ramus communicans. The veins were completely filled out and could be best examined in the four cases where in situ injection was performed. We could observe that the utero-ovarian arcade is an important vein with a caliber similar to that of the ovarian and uterine veins, that there is an impressive network of venous anastomoses between the left and right parametrium and that the fallopian tubes are drained by three separate veins: internal, median, and external tubal veins. Pelvic venous congestion was present in two specimens; in one of them it was located in the region of the left uterine vein and in the other one in the region of the left ovarian vein. Given the similar average diameters of the uterine vein, ovarian vein, and utero-ovarian arcade, we assume that there is no preferential uterine or ovarian venous drainage and that the veins of the internal genital organs are behaving like a venous pool. Nevertheless, congestion can affect limited sites, which can and should be treated locally.

Aged↗
PubMed2005

Neuronavigational neuroendoscopic surgery. Frameless free-hand maneuvering of a handy rigid-rod neuroendoscope on visualized three-dimensional computerized image guidance: trajectory to the prepontine cistern in cadaver study.

BACKGROUND: Considering the separate benefits of neuronavigation and neuroendoscopy, neuroendoscopic surgery with the aid of neuronavigation systems will play an increasingly important role in the future. Bearing this in mind, the present research project was conducted to facilitate neuronavigational neuroendoscopic surgery along the pathway to the prepontine cistern using cadaver heads. MATERIALS AND METHODS: A computer-aided, frameless image-guided stereotactic navigation system and a new type of handy rigid-rod neuroendoscope were used. The ideal entry point and the safest trajectory to the prepontine cistern through the foramen of Monro were defined in two formalin-fixed cadaver heads and clinical brain MRI data. Then, maneuvering of the neuroendoscope with the aid of the neuronavigation system was performed. RESULTS: Straight trajectories from the entry point to the prepontine cistern could be designed. For the registration accuracy of the tip of the neuroendoscope, the virtual image registered a mean error distance of 5.42 mm away from the reference point along the axis of vertical line. However, free-hand maneuvering enabled the neuroendoscope to be finely manipulated without damaging brain tissues. Neuroendoscopic anatomical views of the interpeduncular and prepontine cistern were also acquired. CONCLUSION: Interactive use of free-hand maneuvering of the handy rigid-rod neuroendoscope together with frameless neuronavigation systems plot the way to true neuronavigational neuroendoscopic surgery in a safe and reliable manner. This pairing of the most recent technological neurosurgical options with better understanding of neuroendoscopic anatomy enables the neurosurgeon to acquire broader treatment options for central nervous system diseases.

Adult↗
PubMed2004

Morphometry of the lumbar zygapophyseal facet capsule and cartilage with special reference to degenerative osteoarthritic changes: an anatomical study using fresh cadavers of elderly Japanese and Korean subjects.

Morphometric data were obtained from fresh cadaver dissections, and observations of degenerative changes in the joint cartilage (DCs) were analyzed to determine whether the morphometric parameters of the lumbar zygapophyseal joint capsule varied according to the presence and severity of DCs. There have been no previous morphometric studies of the facet capsule that describe age-related DCs. Using 23 fresh osteoligamentous lumbar spines from donated cadavers, we performed morphometric investigations of the surface areas of the joints and their capsules and measured the capsular thickness. We hypothesized that the ratio of the inner capsular area to the joint surface area for each facet (the capsule/facet index) could serve as an index showing a functional aspect of a large or small capsule. Our results showed that the joint surface area increased significantly with increasing severity of DCs, according to Grogan's classification. Facets with advanced DCs tended to have a small inner capsular surface. The capsule/facet index generally correlated positively with capsular thickness, especially the dorsal portion; however, this was not true for the ventral portion. The index also correlated negatively with DC progression. Thus, lumbar facet DCs were strongly linked to reconstructive alterations in capsular size, thickness, and looseness. The occurrence and progression of DCs narrowed the joint capsule, especially the dorsal portion, and this seemed to decrease the potential looseness of the joint. Conversely, these capsular alterations seemed to accelerate DC progression. A negative adaptation cycle seemed to occur.

Age Factors↗
PubMed2002

[Endoscopically assisted Le Fort 1 osteotomy: a study in human cadaver heads].

METHODS AND RESULTS: Endoscopically assisted Le Fort 1-osteotomy was performed in a cadaver study with six human skulls. Vertical incisions were used to approach the maxilla using the endoscope. The bone cuts could be carried out with a 4-mm osteotome preserving the buccal mucosa. The downfracture of the maxilla was accomplished without damaging the descending palatal arteries, which could be verified endoscopically. Rigid fixation was performed using 1.5-mm titanium plates (Synthes, Mathys AG, Bettlach, Switzerland) and self-drilling screws. DISCUSSION: This cadaver study showed that the Le Fort 1 osteotomy could be carried out through limited approaches using endoscopic techniques and self-drilling fixation tools. Further experimental work and improvements will help to introduce this technique into clinical application.

Bone Plates↗
PubMed1993

A study of the posterior interosseous nerve (PIN) and the radial tunnel in 30 Thai cadavers.

Sixty fresh cadaver upper extremities were dissected for a study of the course of the posterior interosseous nerve (PIN) in the radial tunnel, an area that varies but begins in the furrow between the brachioradialis and brachialis in the distal arm and ends at the distal edge of the supinator muscle in the proximal forearm. The radial nerve pierces the lateral intermuscular septum 13 cm above the elbow joint line. At 1.3 cm above the joint line the nerve divides into its posterior interosseous and superficial radial branches. The extensor carpi radialis brevis muscle received nerve supply from the superficial radial nerve, radial nerve, and PIN in 43%, 55%, and 2%, respectively. The PIN passed through the radial tunnel anterior to the radiohumeral joint and then coursed laterally and posteriorly beneath the arcade of Frohse, which is the proximal edge of the superficial layer of the supinator muscle. The arcade was tendinous in 57% of the cadavers and membranous in 43%. The distal edge of the supinator was tendinous in 65% of the specimens and membranous in 35%. The purpose of this article was to measure the various lengths of the PIN and to study possible compression sites at normal variations along the course of the PIN in the radial tunnel. No cases showed evidence of PIN compression in the radial tunnel.

Adolescent↗
PubMed2006

Arthroscopic visualization of the posterior subtalar joint in the prone position: a cadaver study.

PURPOSE: Subtalar arthroscopy in the prone position is thought to allow broader access to the posterior aspect of the joint than in the standard supine or lateral position. This study is aimed to assess if using the posteromedial (PM) portal in the prone position can increase the working area available through the dorsal and ventral posterolateral (PL) portals commonly used in the standard techniques. TYPE OF STUDY: In vitro cadaver study. METHODS: Six below-knee cadaver specimens were subjected to experimental arthroscopy on the posterior subtalar joint in a simulated prone position. On both the talar and calcaneal surfaces, the working areas (the maximal extent available to a working instrument while preserving surrounding cartilage) for the PL portals and the PM portal were identified. The combined area was compared with the area available from the PL portals alone, to assess the area extended with the PM portal. RESULTS: The talar working areas provided by the PL portals and PM portal were 31% +/- 13% and 26% +/- 8% of the total articular surface, respectively. The combined working area (43% +/- 13%) was greater than the PL working area alone; use of the PM portal increased the working area by a factor of 1.45. The calcaneal working areas from the PL and PM portals were 25% +/- 11% and 20 +/- 7%, respectively. The combined working area (35% +/- 14%) was similarly increased by a factor of 1.46 using the PM portal compared with PL portals alone (P < .05). CONCLUSIONS: In prone subtalar arthroscopy, significant extension of the working area was found by adding the PM portal to the standard PL portals, on both the talar and calcaneal surfaces. CLINICAL RELEVANCE: The PM portal that can be used in the prone position has a potential to increase the arthroscopic working area in the posterior subtalar joint.

Aged↗
PubMed1999

Reduced ischemia-reperfusion injury with rolipram in rat cadaver lung donors: effect of cyclic adenosine monophosphate.

BACKGROUND: The perfusion of rat lungs retrieved from cadavers with a solution containing isoproterenol has been shown to ameliorate the ischemia-reperfusion injury seen in lungs retrieved after death, and this protective effect parallels increases in tissue cyclic adenosine monophosphate levels. In this study, we investigated the effect of rolipram, a phosphodiesterase inhibitor, on capillary permeability and lung cyclic adenosine monophosphate levels in lungs retrieved from circulation-arrested rats. METHODS: Using an isolated perfused lung circuit, we retrieved lungs from circulation-arrested donor rats either ventilated with 100% oxygen or not ventilated for varying postmortem times. The lungs were reperfused with or without rolipram (2 micromol/L). The capillary filtration coefficient and wet to dry weight ratio, indicators of pulmonary vascular integrity, were determined, and tissue levels of adenine nucleotides and cyclic adenosine monophosphate were measured by high-performance liquid chromatography. RESULTS: The capillary filtration coefficient was significantly reduced in nonventilated cadaver lungs reperfused with rolipram 120 minutes after death (p<0.05). Oxygen ventilation or reperfusion with rolipram had a similar effect on the capillary filtration coefficient. Cyclic adenosine monophosphate levels were significantly higher in rolipram-reperfused lungs retrieved 120 minutes after death in both oxygen-ventilated (p<0.01) and nonventilated (p<0.01) lungs. CONCLUSIONS: In lungs from nonventilated, circulation-arrested donors, reperfusion with rolipram reduces the ischemia-reperfusion injury that may be due to intracellular cyclic adenosine monophosphate. Alteration of perfusate may have an impact on capillary leak caused by antecedent ischemia. Thus, rolipram may be a useful adjunct in the preservation of donor lungs retrieved after death.

Adenine Nucleotides↗
PubMed1998

Psychological impact of cadavers and prosections on physiotherapy and occupational therapy students.

The short and long term impact of exposure to cadavers and prosections was examined with 114 occupational therapy and physiotherapy students attending the Auckland Institute of Technology. Pre-exposure measures included a shortened version of the Hopkins Symptom Checklist to assess general distress, and an event-specific apprehension questionnaire. Thirty per cent of students exhibited a post-traumatic stress reaction as measured by the Impact of Event Scale. Eighteen months later, 7 per cent still exhibited symptoms of stress. Multivariate regression analysis revealed that high general distress, high event-specific apprehension and being a member of the physiotherapy student group were associated with high scores on the Impact of Event Scale. These findings indicate that the cadaver experience had a significant impact on these students, although the effect diminished over time.

Journal Article↗
PubMed1989

Cyclosporine versus azathioprine: a review of 200 consecutive cadaver renal transplant recipients.

Most renal transplant centers report an increase in graft survival when cyclosporine is used as a primary immunosuppressant. We report the outcome of 200 consecutive cadaver renal transplant recipients among whom initial immunosuppression and risk factors were similar except for the substitution of cyclosporine for azathioprine in the second 100 recipients. Azathioprine-treated recipients had significantly increased (p less than 0.05) mean hospital stays (31.9 versus 18.3 days), incidence of first rejection episodes (85 versus 31) and methylprednisolone dose (3.38 versus 0.06 gm. per patient). Cyclosporine-treated recipients had a significantly higher 1-year mean serum creatinine level (1.85 versus 1.56 mg. per dl.) and 1-year actual graft survival (83 versus 58 per cent). Despite mild nephrotoxicity, cyclosporine is superior to azathioprine as a primary immunosuppressant in cadaver kidney transplantation.

Azathioprine↗
PubMed2001

Experimental increase in accommodative potential after neodymium: yttrium-aluminum-garnet laser photodisruption of paired cadaver lenses.

PURPOSE: Loss of lens elasticity is one of several proposed mechanisms responsible for the decline in accommodation with age and is the most accepted explanation for presbyopia. We wish to confirm the lens elasticity premise and attempt to experimentally reverse the age-dependent loss of accommodative potential as measured by polar strain. DESIGN: Experimental human autopsy eye study. PARTICIPANTS AND CONTROLS: Thirty-six cadaver lenses were tested to determine the age-dependent polar strain. Eleven lens pairs were then tested with one lens treated with neodymium:yttrium-aluminum-garnet (Nd:YAG) laser and the other left untreated before rotation as an age control. TESTING: Using a custom-made rotational apparatus (described by Fisher, 1971), freshly excised cadaver lenses (<48 hours postmortem) were rotated at 1000 rpm on a 9-mm diameter pedestal to simulate the physiologic pull of the zonules. Lenses were initially tested to determine the age-dependent polar strain. One lens in a pair was then treated with an Nd:YAG laser and the other left untreated before testing. Treatment consisted of 100 suprathreshold pulse placed in a central annular pattern of 2- to 4-mm diameter. Treatment energies varied from 2.5 to 7.0 mJ/pulse, depending on the relative clarity of the lenses. Polar strain was both microscopically measured and calculated from projected photographs before and after rotation of both lased and unlased lenses. Statistically significant differences were determined by paired t test. MAIN OUTCOME MEASURES: Polar strain (decrease in axial thickness with rotation) of the lens. RESULTS: An age-dependent decrease in polar strain was observed that paralleled the findings of Fisher. Both measured and projected polar strain were greater in the lased than unlased lens, and this difference was highly significant by paired t test (P = 0.001 and P = 0.004, respectively). CONCLUSIONS: Age-dependent loss of lens elasticity (polar strain) can be experimentally reversed (increased) by selective intralenticular photodisruption.

Accommodation, Ocular↗