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At least 703 records · Page 39Linked to original sources
PubMed1999

Loss of correction after lateral closing wedge high tibial osteotomy--a human cadaver study.

In 12 human cadaver tibiae, osteotomies were carried out at two levels (2 and 3 cm from the distal joint line) with three different wedges (5 degrees, 10 degrees, 15 degrees) to evaluate the influence of displacement of the osteotomy fragments on areas of cortical contact. In undisplaced osteotomies (medical cortical edges superposed) cortical contact areas formed 28% (level 2 cm) and 40.5% (level 3 cm) of the cortical circumference of the proximal fragments (NS). Wedge angles and levels of osteotomy displayed no statistical differences. In displaced osteotomies cortical contact decreased significantly (P < 0.05). Displacing the distal fragment laterally, medial cortical contact is lost, and weight-bearing leads to revarisation as cancellous bone sustains only 3 MPa, and the measured compressive stresses at the medial edge amounted to 6 MPa on average. Displacing the distal fragment medially leads to a decrease of total cortical contact, too, but at the medial edge of the osteotomy cortical contact areas are still present. As a result of the study, postoperative weight-bearing without additional plaster cast fixation is recommended only in cases with undisplaced fragments.

Cadaver↗
PubMed2001

Corona mortis: an anatomic study in seven cadavers and an endoscopic study in 28 patients.

BACKGROUND: The corona mortis is defined as the vascular connections between the obturator and external iliac systems. While detailed information on the arterial anastomoses in corona mortis is available, a complete description of the venous system is lacking. Although the tiny anastomoses behind the pubic symphysis between the obturator and external iliac arteries have been described in classical anatomy textbooks, these texts neglect to mention that these anastomoses can be life threatening. Attention needs to be paid to these anastomoses between the arterial and the venous system located over the superior pubic ramus during laparoscopic procedures. METHODS: Fifty retroinguinal regions were dissected in seven cadavers and 28 patients. RESULTS: During the dissections, a venous anastomosis on the superior pubic ramus was a consistent finding in 96% of cases. This vein coursed vertically to the inferior border of the superior pubic ramus and connected to the obturator vein. Accessory branches of the obturator artery were observed in only 8% of the dissections. The tiny connections between the obturator and external iliac arteries are less important, since their diameter is <1 mm. CONCLUSIONS: We have termed the venous connection between the external iliac and obturator veins over the superior pubic ramus "the communicating vein". This structure forms the corona mortis. Surgeons dealing with direct, indirect, femoral, or obturator hernias need to be aware of these anastomoses and their close proximity to the femoral ring. In classical anatomy textbooks, a description of the veins that form corona mortis is found less often than descriptions of the arteries. Since a venous connection is more probable than an arterial one, its importance must be appreciated by surgeons in order to avoid venous bleeding.

Cadaver↗
PubMed1977

Cadaver renal transplantation in children with cystinosis.

Five children with end-stage renal disease resulting from cystinosis received seven cadaver renal allografts. Four recipients have functioning grafts eight to 55 months after receiving the transplant and one recipient lost two grafts at 17 and 26 months after the transplant. There was no florid recurrence of the Fanconi syndrome although proximal renal tubular dysfunction developed in two patients, in one in association with chronic rejection and in one without apparent etiology. Free cystine content of white blood cells, cultured skin fibroblasts and allograft tissue was significantly increased. Cystine crystals were observed in the mesangium of two grafts and in the interstitial tissue of all grafts; however, no cystine crystals were found in the tubules. The location of the cystine crystals, as well as the fact that the highest free level of cystine of allograft tissue was observed in the graft undergoing chronic rejection. led to the hypothesis that recipient cells infiltrating the graft were the source of cystine deposition. The data indicate that successful cadaveric transplantation does not correct the primary metabolic defect in cystinosis, thereby explaining the persistence of the extrarenal clinical manifestations, such as photophobia and hypothyroidism, after renal transplantation in cystinosis.

Bone Diseases↗
PubMed1979

Fixation of cadaver eyes for surgical practice.

Cadaver eyes for surgical practice may be prepared by melting No. 7 dental wax in a 1-ounce medicine glass and fixing the globe with melted dental wax. The preparation is then placed in a styrofoam wig stand with openings prepared for the medicine glass.

Cadaver↗
PubMed1983

Antithymocyte globulin, pretransplant blood transfusion, and tissue typing in cadaver kidney transplantation.

Three hundred forty-seven recipients of primary cadaver kidney transplants were analyzed in relation to ATG therapy, pretransplant transfusion, HLA-A, -B and -DR antigen matches, and level of PRA to the panel. Prophylactic ATG treatment increased transplant survival significantly when compared with the non-ATG group. The beneficial effect of pretransplant blood transfusions was not apparent when the recipients received prophylactic ATG treatment. No correlation was noted between HLA-A and -B antigen matches and transplant survival. There was no significant difference in the transplant survival between patients with zero DR antigen match kidneys and those with one DR antigen-match kidney. The number of transplants with two DR antigen-match kidneys was too small to be conclusive. The recipients in whom PRA did not develop despite pretransplant blood transfusions seemed to have better transplant survival than those in whom PRA did develop in response to blood transfusions.

Antilymphocyte Serum↗
PubMed1983

Otoplasty: something old, something new. Reconstruction of the external ear using fresh cadaver homograft ear cartilage and a sternomastoid myocutaneous flap.

By combining the very old concept of using fresh cadaver homograft ear cartilage with the more modern idea of a musculo-cutaneous flap, a new ear has been constructed for a patient who was considered unsuitable for standard reconstructive procedures. The early cosmetic result appears satisfactory and the patient's hearing has been significantly improved.

Adult↗
PubMed1989

Ultrasonic non-destructive measurements of cortical bone thickness in human cadaver femur.

The knowledge of the cortical bone thickness profile in human bone has a two-fold clinical significance: to study the stress occurring in a loaded bone structure to optimize the design of prostheses; and to predict the onset of advanced bone disease such as osteoporosis. In this study, the cortical bone thickness in three embalmed human cadaver femora were measured non-destructively using an ultrasonic technique. These thickness measurements were also made using a computed tomographic (CT) scanning method. Subsequently bones were sectioned and the actual bone thicknesses in the same regions were measured using a micrometer. The correlation coefficient between the actual thickness and the ultrasonically measured thickness was 0.95 and with the CT was 0.62. Thus, these results show that, under present experimental conditions, ultrasonic thickness measurements compare well with the micrometer actual thickness results. This technique, when fully developed, can be used as a non-destructive tool for quantitative cortical bone thickness measurements. Moreover, the ultrasonic technique does not use ionizing radiation.

Bone and Bones↗
PubMed1986

Impaired fibrinolysis and protein C increase after cadaver kidney transplantation.

Severe rejection crises occurred in 13 out of 20 cadaver kidney recipients; removal of the graft was inevitable in 10 cases. The plasminogen levels were found to be lower (76.5 +/- 2.9%) in the 13 patients with impaired graft acceptance (group B) than in the 7 patients experiencing only moderate rejection (group A, 93.7 +/- 5.2%, p less than 0.01) or the 41 patients with chronic renal disease (group C, 88.2 +/- 2.3%, p less than 0.01). Since alpha 2-antiplasmin was found to be enhanced, the alpha 2-antiplasmin/plasminogen ratio was high (1.56 +/- 0.07) in group B as compared with group A (1.19 +/- 0.05, p less than 0.002) and group C (1.11 +/- 0.04, p less than 0.001). The fibrinolytic capacity, which was assessed by a "reversed fibrin plate" assay, declined significantly after transplantation, and was lower in group B greater than 20 days after grafting. The neoantigen alpha 2-antiplasmin-plasmin complex was not detected in any patient; thus hyperfibrinolysis is unlikely to be responsible for the plasminogen decrease. Protein C rose above preoperative values (group A 117.1 +/- 8.7%; group B 133.7 +/- 9.0%) and reached higher levels in group A (221 +/- 24.1%) than in group B (157.4 +/- 14.8%, p less than 0.05) between days 11 and 20 after transplantation. No constant alterations were found with respect to antithrombin III and fibrinogen. Fibrin deposits, which reduce perfusion, can be found in the vessels of rejected kidney grafts. An impaired fibrinolytic capacity and a subsequent inability to remove these clots may be significant for the outcome of transplantation.

Adult↗
PubMed1988

Renal cell carcinoma in cadaver donor kidney.

A cadaver kidney, reported to contain a "simple cyst," was received from another institution. Frozen section biopsy prior to transplant showed renal cell carcinoma. The contralateral kidney already had been transplanted at the other medical facility.

Cadaver↗
PubMed1993

Use of kidneys from older cadaver donors for renal transplantation.

From 1971-1990, 51 patients underwent renal transplantation with a kidney from a cadaver donor more than fifty-five years of age. Following transplantation, 19 kidneys (37%) functioned immediately while initial nonfunction occurred with 32 kidneys (63%). The one-year graft survival rate for kidneys with immediate function versus initial nonfunction was 84 percent and 63 percent, respectively. Graft survival was significantly impaired by increased recipient weight (p < 0.05) and by an elevated donor serum creatinine level (p < 0.05). We conclude that well-functioning kidneys from older donors can be safely and successfully used for renal transplantation. Such kidneys appear to be more susceptible to ischemic damage and should not be used when the donor serum creatinine level is elevated.

Adolescent↗
PubMed1993

Anatomy of cavernous nerves distal to prostate: microdissection study in adult male cadavers.

Retrograde and antegrade dissections from the penile hilum to the prostatic area and the glans penis were performed in 4 formalin-preserved adult male cadavers. In addition to the medial branches accompanying the urethra, the lateral branches of the cavernous nerves pierced the urogenital diaphragm 4 to 7 mm from the striated muscles of the external sphincter. At the penile region, multiple communications between the cavernous and dorsal nerves were noted that suggest that either the cavernous nerves use the dorsal nerve as a carrier to the distal portion of the penis or the dorsal nerve may itself contain autonomic fibers. These findings will improve our ability to preserve erectile function during pelvic, urethral, and penile surgery.

Adult↗
PubMed1979

Humanizing the student--cadaver encounter.

In a recently accredited medical school, the curriculum, which emphasizes the psychologic and social aspects of disease, includes innovative features aimed toward training students to provide humanistic health care in underserved areas. As part of this curriculum, an educational experiment was designed to explore issues concerning the medical student's first exposure to a cadaver. The authors describe the experiment as it evolved over a three-year period, and they discuss its value based on student evaluation and faculty opinion.

Anatomy↗
PubMed1980

A comparison of psychosocial disability in males undergoing maintenance hemodialysis or following cadaver transplantation.

Sixteen males undergoing maintenance hemodialysis were evaluated for social disability through the use of the Ruesch Social Disability Rating Scale and were compared with a group of 16 cadaver renal transplant recipients, matched for age and marital status. All 16 had excellent functioning of their transplanted kidney. In both groups most patients experienced a major degree of social disability, indicating significant interference with life-style. Patients who were married had lower social disability scores (DS) than those who were divorced or single (P less than 0.01). Contrary to expectation, no differences were noted between these two groups with regard to the overall degree of social disability. The DS data are corroborated by other clinical indices, such as employment status, financial stability, degree of depression and sexual functioning, which indicated similar degrees of impairment in both groups. New approaches, aimed at the preservation and enhancement of social and avocational skills, are mandatory of a comprehensive effort seriously geared towards rehabilitation is to be implemented in the overall treatment of these patients. The expertise of the mental health professional, especially the liaison psychiatrist, is critical for this task.

Adult↗
PubMed1994

Comparison of proximal and distal one portal entry techniques for endoscopic carpal tunnel release. A cadaver study.

Reported complications of endoscopic carpal tunnel release have increased as more surgeons use this technique to release the flexor retinaculum. We used a cadaver model to compare the results of endoscopic carpal tunnel release through a one-portal distal (Group A, 15 specimens) and a one-portal proximal (Group B, 15 specimens) entry site with a new endoscopic technique. Our custom-made glass tube of three different sizes (5, 7, and 9 mm in diameter) is designed to house an endoscope and accommodate a meniscus knife for releasing the flexor retinaculum. Complete release of the flexor retinaculum was obtained in all limbs in both groups. In Group A the one complication (7%) was loss of the cotton tip from the cotton swab stick within the carpal tunnel. In Group B, there was a single case of injury to the superficial palmar arch in one hand and breakage of a glass tube in another hand, for a total complication rate of 13%. No other damage to anatomical structures was noted.

Cadaver↗
PubMed1985

Grafting with epidermal Langerhans cell depressed cadaver split skin.

Viable cadaver split skin is very useful as a temporary coverage of excised burns. However, the functional time on the patients is short (2-3 weeks) due to rejection of the tissue. By depression of the epidermal Langerhans cell by ultraviolet light B and glucocorticosteroid, a prolongation of the allograft survival can be obtained.

Adolescent↗
PubMed1994

Acute dislocation of the carpometacarpal joint of the thumb: an anatomic and cadaver study.

An anatomic study was undertaken to provide an understanding of the ligamentous disruption that occurs during acute dislocation of the thumb carpometacarpal joint. Thirty-eight cadaver thumbs were dissected free of soft tissue, with the ligaments preserved. The dorsoradial, posterior oblique, anterior oblique, and intermetacarpal ligaments were identified in all specimens. A dorsal dislocating force was applied to the base of the thumb metacarpal to recreate the mechanism of clinical dislocation. Serial sectioning of the ligaments was performed with the metacarpal in neutral, flexion, and extension. The primary restraint to dorsal dislocation was found to be the dorsoradial ligament, with the anterior oblique ligament allowing dislocation by subperiosteal stripping from the base of the first metacarpal. After reduction, the joint was most stable in pronation and extension, which tightened the anterior oblique ligament. We conclude that the dorsoradial ligament is the primary restraining force with respect to acute dorsal dislocation of the thumb carpometacarpal joint.

Acute Disease↗
PubMed1993

Cricothyrotomy performed by prehospital personnel: a comparison of two techniques in a human cadaver model.

Little is known about the proficiency of prehospital personnel when performing cricothyrotomies. The authors compared two techniques for establishing an airway through the cricothyroid membrane used by paramedic students. One technique used a prepackaged kit that consisted of a dilator that is passed percutaneously through a breakaway needle. This percutaneous device (PD) was compared with a standard surgical approach (SA) using a scalpel and endotracheal tube. Data was collected on a total of 44 paramedic students who were allowed to attempt each of the procedures. No significant difference in the success rate on the first attempt was found between the two procedures (86% for the SA and 73% for the PD; P = .186). The surgical approach was significantly faster (46 +/- 17 seconds v 103 +/- 62 seconds; P < .01). It was also judged to be significantly easier to perform when evaluated on a linear analog scale (SA, 2.6 +/- 2.0 v PD, 5.1 +/- 2.8; P < .001). Because some procedures were performed on cadavers whose cricothyroid membranes had already been violated, the procedures performed on intact membranes only were also analyzed. Similar, statistically significant differences for insertion time and ease of insertion were again found. Prehospital personnel can be trained to perform cricothyrotomies with a reasonable degree of proficiency. A traditional surgical approach, however, may be faster and less difficult to perform than a comparable procedure using a commercially available percutaneous device.

Airway Obstruction↗
PubMed1989

Meniscus suture techniques: a comparative biomechanical cadaver study.

The primary stability of four common meniscus suture techniques was tested on human cadaver menisci. The test series was carried out under standard conditions (25 degrees C, 100% air humidity) using the Instron 1122 Tensometer. The tearing stress of different sutures was reproducible in different specimens dependent only on the suture technique. Knot-end techniques gave inferior results (tearing stress, 24 +/- 9 N) compared with arthroscopic techniques using a loop placed on the meniscus surface (tearing stress, 89 +/- 4 N). When an open meniscus repair is performed, a vertical stitching technique (tearing stress, 105 +/- 4 N) should be the preferred method. Horizontal sutures are weaker (tearing stress, 44 +/- 18 N).

Adult↗