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Martin Van Butchell (1735-1814): the eccentric, "kook" dentist of old London.

This article is a thumbnail sketch of the life and times of Martin Van Butchell (1735-1814), an eccentric, "kook" advertising dentist of Old London. Van Butchell earned these descriptive labels by displaying an unorthodox lifestyle, an outrageous personal appearance and outlandish, extreme and socially unacceptable personal and professional behaviors. While the general populace seemed to be fascinated by his strange ways, dentists and physicians were generally alienated by them. Nevertheless, he was considered a good dentist for his time, and he was extremely popular with his patients. Martin practiced dentistry for 23 years, and he practiced medicine as well, specializing in the treatment of ruptures and anal fistulas. Van Butchell interacted greatly with both John and William Hunter, who became two of the most famous and talented physicians, surgeons, anatomists and biologists of all time. When his first wife, Mary died, Martin arranged for her body to be embalmed and publicly displayed in his dental office for advertising purposes. Her preserved body was shown at the Museum of the Royal College of Surgeons (London), until it was destroyed by a German fire bomb in May, 1941. Mary's remains were on public display for a total of 166 years.

Dentists↗

[Screws versus screw-plate fixation of type 2 Schatzker fractures of the lateral tibial plateau. Cadaver biomechanical study. Arthroscopy French Society].

PURPOSE OF THE STUDY: We compared in vitro the efficacy of screw-plate fixation versus double screw fixation on a model of type 2 Schatzker fracture of the lateral tibial plateau. MATERIALS AND METHODS: Ten screw-plate fixations using a lateral prebent plate and 10 double-screw fixations (6.5 mm screws) were made on 10 pairs of non-embalmed cadaver knees after simulation of type 2 Schatzker fractures. The strength of each fixation was tested with a compression device. Criteria indicating failure were displacements greater than 2 mm of one or more fracture lines. The force applied at rupture and the stiffness of each type of fixation were compared. Wilcoxon's test was used for statistical analysis. RESULTS: Force at rupture and stiffness of the fixation were similar for the two types of fixation. There was no statistical difference (p > 0.05) between the screw-plate and the double-screw fixations. DISCUSSION: Our findings on a model of type 2 Schatzker fractures are in agreement with previous data obtained by other authors working on models of type 1 Schatsker fractures. The biomechanical stability of the double-screw fixation is as good as that obtained with screw-plate fixation for the treatment of fractures of the lateral tibial plateau.

Aged↗

Myocardial bridges.

Recently, many cases of sudden death on strenuous exercise attributed to muscular bridges on the coronary arteries have been reported in the literature. The incidence of such bridges, pooling all reports, is 5.4-85.7% of autopsies. In the present study, 30 hearts from postmortems and 76 hearts from departmental collections from embalmed cadavers (making a total of 106 hearts) were studied. Fifteen hearts (14.2%) showed muscular bridges. The length of the bridges varied from 4mm to 40mm, the majority being 10-19mm in length. Only two arteries viz, the left anterior descending artery and the left diagonal artery showed muscular bridges.

Adult↗

A study on the morphology of the coracobrachialis muscle and its relationship with the musculocutaneous nerve.

Thirty-six arms from embalmed adult cadavers were utilised for this investigation. Coracobrachialis muscle was carefully examined to record variations in its attachments, morphology and its relationship with the musculocutaneous nerve. The results of the present work identified the presence of two heads of origin for the coracobrachialis muscle, which are situated superficial (anterior) and deep (posterior) to the musculocutaneous nerve. The superficial head arises mainly from most of the medial border of the tendon of the short head of the biceps brachii muscle. The deep head arises from the apex of the coracoid process of the scapula and the adjoining lateral border of the tendon of the short head of the biceps brachii muscle. The musculocutaneous nerve provides a separate branch for each head. In cases where the coracobrachialis muscle was not pierced by the musculocutaneous nerve, the muscle was formed of one head that has an origin analogous to that of the superficial head. One case showed a splitting of the deep head into two bellies shortly after its origin, where the muscle appeared as being formed of three heads. Variations in the insertion were present as an additional aponeurotic insertion above the usual insertion and an aponeurotic extension to the deep fascia on the medial aspect of the arm. Variations in the musculocutaneous nerve were in the form of lower origin from the lateral root of median nerve and a nerve with a short course after which it united with the median nerve. This investigation supplied evidence of the double heads of origin for the coracobrachialis muscle. The detected variability in insertion and association of the muscle with the musculocutaneous nerve further supports the idea that the coracobrachialis muscle is a complex muscle.

Adult↗

[Applied anatomy of the transverse rectus abdominis musculocutaneous (TRAM) flap in relation to the eleventh or twelfth thoracic nerve].

OBJECTIVE: To observe the distribution of the terminal branches of the eleventh and twelfth thoracic nerve(T11, T12) for the anatomical basis and operation key points of the transverse rectus abdominis musculocutaneous(TRAM) flap with T11, T12. METHODS: The anterior abdominal wall was investigated through anatomical dissection in 22 embalmed cadavers. RESULTS: Cutaneous nerve distribution in the TRAM flap came mainly from T11, T12. They run obliquely between transverse abdominis and obliquus internus abdominis muscle. At the lateral edge of the rectus abdominis, they piece the anterior rectus sheath into the muscle. While supplying the muscle they pass on to supply the anterior rectus sheath and the overlying skin. CONCLUSION: It is possible to preserve T11, T12 in the TRAM flap, which would favour rapid return of flap sensation.

Female↗

[Medicine in ancient Egypt, a fascinating level of modernity].

Our knowledge about ancient Egyptian medicine (throughout more than three millennia) comes from some papyri, as those of Ebers and Smith, thousands of mummies or skeletons and multiple temples and tumbs decorations. Doctors were initially priests and embalmers which explain their good level in anatomy. The most famous of all, imhotep, who was also architect and minister, became a god of medicine. First hospitals developed from temples. Modern investigation tools are useful for studying on human remains the most prevalent diseases at these times which are comparable with our current medical problems. An increasing number of scientific data, which some examples are reported herein, argue in favor of a fascinating level of advancement of ancient Egyptian medicine in the field of diagnosis and therapy.

Anatomy↗

[History of the "charitable works" of Philibert Guybert].

This report, made in two parts, relates Philibert Guybert's Charitable works history which were reprinted at least sixty times between 1623 and 1679 - quite an exceptional number for that period. Le Médecin charitable (The Charitable Physician) (1623), was followed by other works such as Le Prix et valeur des médicaments (Price and value of medicines) (1625), l'Apothicaire charitable (The charitable Apothecary) (1625), la Manière d'embaumer les corps morts (The way of embalming corpses) (1627), etc. As an indication of methods then used in the Parisian Faculty of Medicine, Guybert's works were compiled at many times under the title (Euvres charitables de Philibert Guybert, until the reference edition in 1633, in which other authors works were added. Philibert Guybert's objective was to help people, particulary the poor, to treat themselves by making their own remedies, in other words, fighting against privileges, as well as the apothecaries' lure of profit-making and their corrupted methods. The first part recalls the period between 1623 and 1629, with regard to Guybert's first works and the controversy between doctors and apothecaries. The second part begins by relating the history of the reference edition, in 1633, which came out few months before Guybert's death. Gui Patin, the well-known parisian doctor, took an important part in this edition: he wrote a Traité de la Conservation de la Santé (Treaty of health conservation), and also many annotations concerning l'Avis sur la peste (Advice on the plague) by Nicolas Ellain - in which Patin expresses his disapproval of certain remedies such as theriac, mithridate, arsenic, pearls, bezoaa, etc. -, and also how he felt about le Traité de la Saignée de Galien (The treaty of blood-letting by Galien) - with his approval of both the blood-letting and Galien! Then the author recalls the posthumous editions, some of them clandestine, and also evokes latine and english editions (Medici officiosi opera and The charitable Physician respectively). The nature of Guybert's works, and also various similar events (such as the 1647 trial between Patin and apothecaries) show the importance of conflicts occurred between Parisian apothecaries and doctors of the time.

Antidotes↗

[Constructing one's own history].

Constructing one's own history is a necessity for each subject in order to be able to think about and to invest oneself in a reality, external as well as psychic, that will, for the most part, remain unknown. It will then come as no surprise that the appropriation of the kind of self knowledge derived from psychoanalysis comes up against issues proper to history. Nonetheless, it does not follow automatically that psychoanalytical theory can borrow models from the historical method and knowledge. For, while in treatment this is said, heard, understood, repeated, and finally disappears into limbo, the historian, for his part establishes, writes, and embalms in the temple of Mnemosyme. And, despite his theoretical positions in the matter of subjectivity in historical writings, it is nonetheless the case that the collective facts so created by the historian's account are of an altogether different nature than the infantile and singular individual history that the psychoanalyst and the analysand must deal with. The conceptualization of auto-historization in psychoanalysis involves a different activity than that of the historian, but nonetheless, in the form of metaphor or of suggestion, the reference to history haunts the Freudian text and probably every psychoanalytical thought process whether or not one is aware of it.

History↗

Contribution of acetabular labrum to articulating surface area and femoral head coverage in adult hip joints: an anatomic study in cadavera.

The purpose of our study was to describe the gross anatomy of the adult acetabular labrum and to determine its contribution to the depth, surface area, and volume of the acetabulum. Fifty-five embalmed hips were studied. Each hip was disarticulated, and standardized measurements were taken. Calculations of the acetabular articulating surface area and volume, with and without the labrum, were performed based on these measurements. Average width of the acetabular labrum was 5.3 mm (SD, 2.6 mm). The labrum was wider anteriorly and superiorly than posteriorly. The surface area of the acetabulum without the labrum was 28.8 cm2; with the labrum, it was 36.8 cm2 (P < .0001). The volume of the acetabulum without the labrum was 31.5 cm3; with the labrum, it was 41.1 cm3 (P < .0001). There was no side-to-side difference in contribution of the labrum to either surface area or volume between right and left hips. Comparison of these indices for males and females showed statistically significant differences in absolute but not relative increases.

Acetabulum↗

Variations in the nerves of the thumb and index finger.

The digital nerves to the thumb and index finger have been studied by dissecting twenty-five embalmed upper limbs. The palmar digital nerves to the thumb were constant in position and course, with a short lateral cutaneous branch from the radial palmar digital nerve in 30 per cent of cases. The palmar digital nerves to the index finger had a variable pattern, the commonest arrangement, well described in Gray's Anatomy, occurring in 74 per cent of cases. The variations and their frequency are described. By examining histological cross-sections of the index finger it was found that of about 5,000 endoneurial tubes entering the finger, 60 per cent passed beyond the distal digital crease to supply the pulp and nail bed. The depth of the palmar digital nerves was about 3 millimetres, but less at the digital creases, and their diameter lay between 1 and 1.5 millimetres as far as the distal digital crease. Clinical applications of the findings are discussed.

Adult↗

[Microscopic vascular study of the colon with the corrosion casting technique].

The aim of this study is, firstly, to assess the accuracy of vascular casts obtained at various times after death and secondly to describe the mucosal microvascular architecture of the cat colon. Two injections were realized, the first one on a non-embalmed human corpse, 12 days after the death, and the other one on a cat, immediately following euthanasia. Results show that this second cast seems finer and more detailed than the cast stemming from the human corpse; indeed, the finest vessels obtained are about 6 microns while they are about 15 microns on the human corpse. This could be explained by a post-mortem obstruction of microvessels, that prevented the passage of the injected product or by an insufficient amount of product injected. Finally, the vascular cast of the cat colic mucosa presents a regular honeycomb-like network that bounds the colonic mucosal glands, a finding consistent with the results reported previously.

Aged↗

Detection of herpes simplex virus type 1 in human ciliary ganglia.

PURPOSE: To determine whether herpes simplex virus type 1 (HSV-1) DNA is present in the ciliary ganglion (CG). METHODS: Fifty CG and 47 trigeminal ganglia (TG) were resected from 63 formalin-fixed cadavers between 56 and 98 years of age that had been embalmed within 12 hours of death. The donors had no known active HSV infection at the time of death. DNA was extracted from all ganglia by proteinase-K digestion (TG) or digestion by a mild lysis buffer (CG). DNA was amplified by polymerase chain reaction for sequences from human chromosome 18, D18S1259 (positive control), and from the HSV-1 DNA polymerase gene, U(L)30. The amplified DNA was separated by agarose gel electrophoresis, transferred to nylon membranes, and hybridized with the appropriate digoxigenin-labeled probe that was detected by alkaline phosphatase-conjugated monoclonal antibody. RESULTS: The D18S1259 sequence was amplified from 47 TG and 30 CG samples. Of these samples, 32 (68.0%) of the 47 TG samples and 20 (66.6%) of the 30 CG samples were positive for the UL(30) HSV-1 sequence. CONCLUSIONS: Using amplification of HSV-1 DNA as a surrogate marker of latency, the finding that the frequency of HSV-1 in the CG was approximately the same as that of the TG suggests that the CG may be an additional site of HSV-1 latency in humans. Active infection in or reactivation of HSV-1 from non-TG sites may explain why this virus is able to infect sites, such as the retina, that have no direct connections to the trigeminal nerve.

Aged↗

[Study on cross-sections at the plane of the aortic arch and its adjacent structures].

The purpose of this study was to describe and explain the normal appearances of aortic arch and its adjacent structures on the transaxial sections and to provide anatomical data for the diagnosis of CT and MR images. Dissections were performed on 1.2 cm interval cross-sections of the thorax of 30 embalmed cadavers. The results showed 20.00 +/- 7.30% of the aortic arch and arch of the azygos vein at the same plane and 40.00 +/- 8.94% of the arch of the azygos vein at the level of concavity of the aortic arch. 80.00 +/- 7.30% of the top of the superior aortic recess extended to the level of the aortic arch from which the branchiocephalic trunk arises. At the level of the aortic arch, 100% of the lymph nodes of superior vena cava were located among the aortic arch, superior vena cava and trachea. At the level of azygos vein, 100% of the lymph nodes of azygos vein and the superior aortic recess were located among the superior vena cava, arch of azygos vein, trachea and concavity of aortic arch. These data suggest that aortic arch and arch of azygos vein are the key structures to identify the superior aortic recess and lymph nodes. They are essential for understanding the related pathologic changes depicted on CT and MR images.

Adult↗

Clinical anatomy of the fibrous capsule of human lumbar facet joint.

OBJECTIVE: To describe the anatomical and histological characteristics of the fibrous capsule of human lumbar facet joints. METHODS: Specimens of the facet joint capsules were obtained from 5 embalmed cadavers for macroscopic investigation, and microscopic observation of L5 facet joint capsules obtained from 2 fresh cadavers was performed after the specimens were stained by way of resorzinoroseine-van Gieson method. RESULTS: The outer layer of the fibrous capsule was constituted by dense regular connective tissue that was in turn composed of parallel bundles of collagenous fibers. In the superior part of the joint capsules, the fibers were arranged in the direction different from that taken by the fibers in the inferior part. In the middle layer of the joint capsules, large quantities of elastic fibers were identified in the roots of the capsule. CONCLUSIONS: The anatomical and histological complexities adapt the lumbar facet joint to better withstand loads from various directions. Immoderate rotatory manipulations may result in capsule injuries, which may aggravate low back pain in some cases.

Adolescent↗

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↗

Multiple muscular variations in the neck region--case study.

During routine educational dissection studies, we encountered multiple muscular anomalies in a 25-year-old embalmed male cadaver. The muscular anomalies were observed on the right side. In accordance with their origin, insertion and innervation features, the abnormal muscles were considered sternocleidooccipital, sternomastoid and cleidomastoid muscles. The unilateral muscle variations were observed in both the superficial and deep layer. In the superficial layer, there were two muscles and one muscle bundle, while there was only one muscle in the deep layer. The first muscle in the superficial layer, known as sternocleidooccipital muscle, consisted of clavicular head and sternal head. The second muscle in the superficial layer was sternomastoid muscle. The muscle observed in the deep layer was cleidomastoid muscle. Additionally, a muscular bundle was observed between the sternocleidooccipital and sternomastoid muscles. A combination of these variations in the same case has not, to our knowledge, been previously described in the available literature.

Adult↗

[Fatality in diabetic coma during foreign travel].

The case history and the autopsy findings of a 44-year-old women who died shortly after her flight to Khartoum (Sudan) in a hospital is presented. The clinical diagnosis in Africa was "shock caused by gastroenteritis". The body was embalmed thoroughly and brought back to Germany. The autopsy was performed just prior to the cremation (according to "section 3 Abs. 2 Nr. 2 Feuerbestattungsgesetz"). Morphological findings (nodular glomerulosclerosis and glycogen nephrosis with Armanni-Ebstein-cells) and postmortem biochemical analyses of vitreous humour led to the diagnosis of a hyperglycaemic coma. The fatal course might have been prevented by sufficient health information to the patient (who suffered from type 1 diabetes); the diagnostic errors in the hospital could have easily been avoided by careful anamnesis and diagnostic procedures.

Adult↗

Precision of a needle localization technic in the lumbosacral multifidus muscles for segmental specific needle electromyographic study: a cadaveric study.

The authors studied 14 cadavers to evaluate the claimed precision of needle placement into segment specific multifidus fascicles when using the "paraspinal mapping" electromyographic technic. Injection of acrylic dye was made according to landmarks proposed by Haig. The dissection showed 86.6 per cent of the injected dye in the correct fascicles. Only 1.4 per cent of the dye was lost. Spinous process level misidentification was the cause of the other 11.8 per cent incorrect injection. The authors expected that in living humans, in which the spinous processes are move identificable than embalmed cadavers, the precisions may be as high as 98.5 per cent. This remains to be studied in a further "in vivo" study.

Cadaver↗