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PubMed2006

Complete ureteral duplication associated with megaureter and ureteropelvic junction dilatation: report on an adult cadaver case with a brief review of the literature.

Although ureteral duplication, megaureter (MU) or ureteropelvic junction obstruction is a common anomaly of the urinary tract, complete ureteral duplication accompanied by MU and ureteropelvic junction dilatation (UPD) appears to be rare. In this paper, a case of a Japanese female cadaver with complete ureter duplication associated with MU in the upper pole ureter (UpU) and UPD in the lower pole ureter (LoU) is described. Besides describing and illustrating this case, we discuss the anatomy and etiology of these anomalous structures with a brief review of the literature.

Aged, 80 and over↗
PubMed2005

Discrepancies between classic anatomy and modern gynecologic surgery on pelvic connective tissue structure: harmonization of those concepts by collaborative cadaver dissection.

OBJECTIVE: The purpose of this study was to solve a disagreement regarding the anatomy of the pelvic connective tissue in 19th and 20th century, and to establish new surgical anatomy. STUDY DESIGN: The study involved the dissection 26 female cadavers. The ligamentous structure of the pelvis was examined by developing the paravesical and pararectal spaces, using our standard procedure of radical hysterectomy. RESULTS: The lateral ligamentous structure of the pelvis was a plate complex, which consisted of the vesicohypogastric fascia, the transverse cervical ligament, and lateral ligament of the rectum. The 3-dimensional relationship of this complex and the pelvic organs was sagittaly perpendicular. The pelvic connective tissue was classified into 2 systems, musculofascial and mesentery-like structures. CONCLUSION: The authors examined the discrepancies in 19th century anatomy for the pelvic connective tissue that is widely accepted in today's medical field, therewith proposing a new surgical anatomy for this structure.

Aged↗
PubMed2006

Vascular anatomy of the presacral space in unembalmed female cadavers.

OBJECTIVE: The purpose of this study was to characterize the vascular anatomy of the female presacral space (PSS) and to correlate findings to the abdominal sacrocolpopexy. STUDY DESIGN: Detailed dissections of the PSS were performed in 52 unembalmed female cadavers. RESULTS: The closest cephalad vessel to the mid sacral promontory (MSP) was the left common iliac vein (LCIV), mean distance 27 mm (9-52 mm). The closest vessel lateral to MSP was also the LCIV, mean distance 22 mm (9-35 mm). The average distance of the middle sacral artery and vein to the MSP was 4 mm (0-15 mm) and 7 mm (0-17 mm), respectively. The mean distance of the sacral venous plexuses to the MSP was 34 mm (4-86 mm). CONCLUSION: Anatomic location of the vascular boundaries and contents of the PSS is highly variable. Careful dissection and exposure of the anterior longitudinal ligament of the sacrum before suture placement should minimize potentially life-threatening vascular complications.

Aged↗
PubMed2006

Concomitant rotator cuff and capsuloligamentous lesions of the shoulder: a cadaver study.

PURPOSE: Rotator cuff lesions have not yet been evaluated in association with capsuloligamentous lesions in an otherwise intact shoulder model. Our hypothesis was that less extensive capsuloligamentous lesions are necessary to allow dislocation in the presence of rotator cuff lesions. METHODS: The supraspinatus and infraspinatus, or the subscapularis, or all 3 tendons were carefully detached from their insertion without damage to the underlying capsule. Adjacent combinations of 4 zones of the capsuloligamentous complex were then sequentially detached from the glenoid or from the humerus in 80 cadaver shoulders. Stability was tested before and after each resection step; this included testing of inferior stability with a sulcus test, and of anterior stability with a drawer test and with an apprehension maneuver. Findings from these specimens were statistically compared with those from the same types of tests in specimens with intact rotator cuffs. RESULTS: Subluxation during the drawer and sulcus tests is already reached after the tendon lesion has been created, or after only 1 ligamentous zone has been cut. In the presence of a tendon lesion, at least 1 less cutting step is necessary for dislocation to occur in the apprehension position. There is a difference, however, between glenoid- and humerus-based lesions. CONCLUSIONS: The humeral head dislocates easily with less extensive capsuloligamentous lesions when rotator cuff lesions are present. In the present experimental model, passive stabilization provided by the rotator cuff appears more easily disrupted when associated with ligamentous lesions on the humeral side than with lesions on the glenoid side. This may be so because interdigitation of the cuff tendons with each other and with the capsule through the rotator cable is maintained with glenoid-sided lesions. CLINICAL RELEVANCE: Rotator cuff lesions destabilize the glenohumeral joint. This effect is less pronounced when cuff tendons continue to interact with underlying capsuloligamentous structures. This finding may be relevant for small cuff tears and for partial cuff tears, especially those seen after dislocation.

Aged↗
PubMed2006

Mini-open arthroscopically assisted Bristow-Latarjet procedure for the treatment of patients with anterior shoulder instability: a cadaver study.

PURPOSE: The purpose of this study was to evaluate the arthroscopically assisted Bristow-Latarjet procedure. The aim was to use arthroscopic guidance to assist in positioning of the coracoid bone block onto the anterolateral aspect of the glenoid. The feasibility of this technique and its efficacy, reproducibility, and potential neurovascular complications were evaluated. METHODS: A minimally invasive technique was used to harvest the coracoid bone block and the attached coracobiceps tendon. A portal was created through the subscapularis muscle and, under arthroscopic guidance, the anterior aspect of the glenoid was cleaned and reamed before the bone block was placed. Cannulated screws (3.5 mm) were used to fix the vertically oriented bone block to the glenoid. The size of the bone block, its position on the glenoid, and its relation to the subscapularis tendon and the musculocutaneous and axillary nerves were recorded. RESULTS: In all 5 cadavers, the bone block was well positioned and was fixed to the anteroinferior part of the glenoid. No lesions of the cephalic vein or of the surrounding neurovasculature were observed. CONCLUSIONS: This study demonstrated the safe and effective use of this arthroscopically assisted technique for correct positioning of the coracoid bone block at the anterolateral aspect of the glenoid in the cadaveric shoulder. Arthroscopy facilitated adequate reaming of the anterior glenoid and aided in optimal positioning of the bone block. CLINICAL RELEVANCE: This cadaveric study highlights the advantages offered by an arthroscopically assisted Bristow-Latarjet procedure, which optimizes positioning of the block and ensures adequate reaming of the anterior glenoid, thereby potentially reducing the risks of early nonunion and late arthritis--complications commonly associated with the classical Bristow-Latarjet technique.

Arthroscopy↗
PubMed2004

Trans-nasal endo-assisted pharyngoplasty: a cadaver study.

A possible new technique of endoscopic pharyngoplasty is described and has been developed in cadavers. The trans-nasal route is used for endoscopic visualisation of the velopharyngeal sphincter. Hynes pharyngoplasty is performed using both trans-oral and trans-nasal routes. This approach allows better visualisation and performance of the Hynes pharyngoplasty at the desired level, "high" in the nasopharynx, without splitting the soft palate.

Cadaver↗
PubMed2005

Regional differences in trabecular BMD and micro-architecture of weight-bearing bone under habitual gait loading--a pQCT and microCT study in human cadavers.

This study used both multi-slice pQCT and microCT to investigate regional changes in bone mineral density and structural parameters in the ultradistal tibia and in the mid-femoral neck under habitual gait loading. Twenty cadavers with 2 females and 18 males aged 70.8 +/- 8.5 were used in this study. Seventy-two cylindrical bone cores with 5 mm in diameter and 10 mm in length from the anterior/posterior and superior/inferior regions were obtained from ultradistal tibia and mid-femur neck, respectively, so that their differences in terms of volumetric trabecular bone mineral density (tBMD) as well as micro-architectural parameters could be studied. The results showed that the mean volumetric tBMD at both the organ (including the bone marrow spaces) and tissue levels (excluding the bone marrow spaces) were a 49.2% and 28.3%, respectively, lower in the anterior bone cores than in the posterior bone cores from the ultradistal tibia (P < 0.01). MicroCT measurements on BV/TV, BS/TV, Tb.N, Tb.Th, and DA were found to be on average of 33.5%, 23.6%, 9.1%, 18.0%, and 14.6%, respectively, lower in the anterior trabecular bone cores (P < 0.001), while Tb.Sp and SMI were 12.5% and 29.3%, respectively, higher in the anterior trabecular bone cores (P < 0.01). No significant difference in micro-architectural parameters was found in the trabecular bone cores obtained from mid-femoral neck, except that the mean DA of the inferior bone cores was significantly higher by 30.1% than that of the superior bone cores (P = 0.01). A statistically significant linear relationship with the correlation coefficient, ranging from 0.37 to 0.94 and -0.62 to -0.85, respectively, was shown between the tBMD at the organ level and all of the micro-architectural parameters (P < 0.05). We suggest that dynamic loading changes during the striking of the heel in normal gait, as well as the peaks of the hip joint reaction force occur during the heel strike and before toe off positions in the lifetime of the subject may account for such regional differences in BMD and micro-architecture. The findings from the correlation study also suggest that, apart from BMD, the micro-architecture may exhibit adaptation in response to such excessive loading.

Absorptiometry, Photon↗
PubMed2006

A comparison of conventional versus locking plates in intraarticular calcaneus fractures: a biomechanical study in human cadavers.

BACKGROUND: Internal fixation of displaced intraarticular calcaneal fractures in patients older than 50 years remains controversial. This is, in many cases, due to fear of loss of fixation and the risk of implant failure in osteoporotic bone. It is the objective of this study to compare the fixation strength obtained using calcaneal plates with and without locking screws, in the fixation of osteoporotic cadaveric intraarticular calcaneal fractures. METHODS: In seven pairs of fresh frozen lower limbs cadavers, intraarticular calcaneal fractures were created with a dynamic single impact loading device and stabilized using either the low profile locking plate, or the conventional calcaneus plate. Radiographs were obtained to assess reduction. The specimens were then subjected to cyclic loading followed by loading to failure, using matched pairs of cadaveric lower limbs. The Wilcoxon signed rank test was used to test for differences in the results. FINDINGS: The locking plate showed a significant lower irreversible deformation during cyclic loading and a significant higher load to failure. The difference between the ultimate displacement, and work to failure was not significant. A low bone mineral content in the area of the posterior facet correlated only in the conventional plate group with increased irreversible deformation. INTERPRETATION: This study supports the mechanical viability of using locking calcaneal plates for the fixation of intraarticular calcaneal fractures in elderly patients.

Aged↗
PubMed2005

The V2 segment of the vertebral artery in anterior and anterolateral cervical spinal surgery: a cadaver angiographic study.

OBJECTIVE: The second segment of the vertebral artery is under the risk of injury during anterior and anterolateral cervical spine procedures. To avoid such a risk, one needs to be familiar with the regional anatomy. The aim of this study was to measure the distance between the vertebral artery and the uncinate process, midline, and the medial side of the longus colli muscle using vertebral artery angiograms at the level of C6, C5, C4, and C3 vertebrae. MATERIALS AND METHODS: In 12 human cadavers, the vertebral arteries were first irrigated with water. Then the arteries were filled with silicon and barium, and finally their angiographic images were obtained. RESULTS: The transverse diameter of the vertebral artery was measured at C6, C5, C4, C3, and C2 level. The values on the left were bigger than the values on the right (p>0.05). The distance between the vertebral artery and the midline decreased from C6 (17.2+/-5.6mm on the right, 17.2+/-2.3mm on the left) to C3 (15.8+/-5.3mm on the right, 13.8+/-2.1mm on the left) (p>0.05). The distance between the apex of the uncinate process and the medial side of the vertebral artery was found to be longer at C4 (2.7+/-1.0 mm on the right, 2.2+/-1.0mm on the left) and C5 (2.5+/-1.1mm on the right, 2.5+/-1.0mm on the left) vertebra levels on the right side (p=0.339 at C4, p=0.862 at C5). The distance between the medial side of the longus colli muscle and the medial side of the vertebral artery was measured as 9.7+/-2.7 mm (9.5+/-2.9 mm on the right, 9.8+/-2.6mm on the left) at C6 level, 9.2+/-2.6mm (8.6+/-2.4mm on the right, 9.8+/-3.1mm on the left) at C5, 9.4+/-1.9 mm (9.2+/-2.1mm on the right, 9.5+/-2.0mm on the left) at C4, and 10.4+/-2.7 mm (10.5+/-3.0mm on the right, 10.1+/-2.6mm on the left) at C3 vertebra level. No significant difference was found between the right and the left (p>0.05). The angle between the vertebral artery and the midline was measured as 4.0+/-1.9 degrees on the right and 2.2+/-1.4 degrees on the left side (p=0.030). CONCLUSION: It was considered that the values obtained could be useful in anterolateral and anterior cervical approaches in terms of evaluating the position of the vertebral artery and its relation to vertebral structures. It is also concluded that the risk of injury in upper subaxial cervical spine is higher than in the lower part of the subaxial cervical spine.

Angiography↗
PubMed2006

Rat epidermal keratinocyte organotypic culture (ROC) compared to human cadaver skin: the effect of skin permeation enhancers.

The objective of this study was to evaluate the response of the rat epidermal keratinocyte organotypic culture (ROC) to permeation enhancers, and to compare these responses to those in human cadaver skin. Different concentrations of two mixtures for enhancing permeation were investigated, sodium dodecyl sulfate:phenyl piperazine and methyl pyrrolidone:dodecyl pyridinium chloride, using skin impedance spectroscopy and two experimental compounds, the lipophilic corticosterone and the hydrophilic sucrose. The chemical irritation effects of the formulations were evaluated based on leakage of lactate dehydrogenase enzyme (LDH) and cellular morphological perturbation. This study provides evidence for direct correlations of permeation/permeation, impedance/impedance and permation/impedance between the culture model and human skin. The only exception was the enhancer induced permeation of sucrose which was 1-40-fold higher in ROC compared to human skin, reflecting the more disordered lipid organization in stratum corneum and consequently the greater number of polar pathways. LDH leakage and cellular morphology indicated that it was possible to differentiate between safe permeation enhancers from irritating agents. This is not only the first study to have compared the enhancer effects on a cultured skin model with human skin, but also it has demonstrated enhancer induced irritation using an artificial skin model.

Administration, Topical↗
PubMed2006

Alloantibodies and the outcome of cadaver kidney allografts.

The role of humoral immunity in causing antibody-mediated rejection (AMR) of organ allografts has been extensively documented. For this reason, negative complement-dependent cytotoxicity (CDC) cross-matches between recipient sera and donor T and B lymphocytes have become a mandatory requirement for cadaveric kidney transplantation. However, the significance of donor-specific antibodies (DSAs) detectable only by flow cytometry (FC) or solid phase assays (SPA) but not CDC is still controversial. We have performed a retrospective analysis of FC cross-matching results in 80 consecutive cadaver kidney allograft recipients. Antibodies against HLA class I and class II antigens were measured by CDC and SPA in sequential samples of sera obtained prior to transplantation. The preoperative cross-match was performed by CDC using magnetically sorted T and B cells from donor spleen. Sera obtained from each patient before and at the time of transplantation were included in the final cross-match. The sample of serum obtained at the time of transplantation was cross-matched retrospectively by FC and analyzed for anti-HLA antibody specificity on high resolution SPA. The actuarial kidney allograft survival at one year was 98%. Two of these eighty patients lost the graft, one due to AMR, the other for reasons unrelated to DSAs. Donor-specific antibodies were detected by FC in 17 of 80 patients, yet only 6 of 17 had an early episode of AMR. This episode was successfully reversed by desensitization therapy using intravenous immunoglobin (IVIG) and plasmapheresis. Flow cytomery cross-matching showed 95% specificity but only 35% sensitivity for prediction of AMR (p = 0.002). There was a significant correlation between high panel reactive antibodies (PRA) and positive FC cross-matching (p = 0 .0001), as well as high PRA and AMR (p = 0.0004 by CDC and 0.0011 by Luminex). Reversible AMR occurred 12-30 days post-transplantation in 8 patients. Of these 8 patients, 3 had no detectable DSAs in spite of C4d positivity, 4 had C4d deposition in conjunction with anti-HLA antibodies, and 1 patient had DSAs (anti-MICA) yet no C4d deposition. We conclude that early initiation of desensitization protocols can prevent transplant failure and that retrospective FC cross-matches may facilitate the diagnosis of AMR. Extensive analysis of patients' sera using a comprehensive set of tests may contribute to early treatment and better understanding of the mechanism underlying humoral rejection.

Cadaver↗
PubMed2005

Screw fixation of the syndesmosis: a cadaver model comparing stainless steel and titanium screws and three and four cortical fixation.

We assessed syndesmotic set screw strength and fixation capacity during cyclical testing in a cadaver model simulating protected weight bearing. Sixteen fresh frozen legs with artificial syndesmotic injuries and a syndesmotic set screw made of stainless steel or titanium, inserted through three or four cortices, were axially loaded with 800 N for 225,000 cycles in a materials testing machine. The 225,000 cycles equals the number of paces taken by a person walking in a below knee plaster during 9 weeks. Syndesmotic fixation failure was defined as: bone fracture, screw fatigue failure, screw pullout, and/or excessive syndesmotic widening. None of the 14 out of 16 successfully tested legs or screws failed. No difference was found in fixation of the syndesmosis when stainless steel screws were compared to titanium screws through three or four cortices. Mean lateral displacement found after testing was 1.05 mm (S.D. = 0.42). This increase in tibiofibular width exceeds values described in literature for the intact syndesmosis loaded with body weight. Based on this laboratory study it is concluded that the syndesmotic set screw cannot prevent excessive syndesmotic widening when loaded with a load comparable with body weight. Therefore, we advise that patients with a syndesmotic set screw in situ should not bear weight.

Aged↗
PubMed2006

Biomechanical analysis of the percutaneous compression plate and sliding hip screw in intracapsular hip fractures: experimental assessment using synthetic and cadaver bones.

We compared the mechanical behaviour of osteosynthesis with the percutaneous compression plate (PCCP) compared with the standard osteosynthesis sliding hip screw (SHS) in intracapsular hip fractures. We created 10 stable and 10 unstable intracapsular hip fractures in 20 synthetic femurs. Each fracture was fixed with either the SHS or PCCP. In six pairs of cadaver femurs, we created unstable intracapsular hip fractures and fixed them with the SHS or PCCP, at random on the left or right side. All femoral heads were exposed to a cyclic, combined axial and torque load until failure. In each group, the PCCP resisted a significantly higher load than the SHS. Clinical prospective studies are needed to confirm these in vitro findings that the PCCP is more stable than the SHS.

Biomechanical Phenomena↗
PubMed2004

A cadaver model to evaluate the accuracy and reproducibility of plain radiograph step and gap measurements for intra-articular fracture of the distal radius.

PURPOSE: The purpose of this study was to determine the accuracy and reproducibility of intra-articular step-off and gap displacements measured on plain radiographs using a standard cadaver model. METHODS: Twenty-two physicians, in a blinded randomized fashion using a standard technique, examined the radiographs of 12 unique combinations of step and gap displacement created by a 3-part intra-articular osteotomy of the distal radius. Observer accuracy, inter- and intraobserver agreement, and tolerance limits were calculated. RESULTS: The results of this study suggest that observers, independent of skill level, may measure step-off and gap displacements accurately to within .62 +/- .53 mm (95% confidence interval = .59-65). The accuracy of measurement was influenced by the quality of the radiograph. Intraclass correlation coefficient scores showed "substantial" (.78) to "almost perfect" (.81) inter- and intraobserver agreement. CONCLUSIONS: These data can aid in the interpretation of clinical studies of acute distal radius fractures that are based on plain radiography.

Cadaver↗
PubMed2005

Reconstruction of the ulnar collateral ligament of the thumb metacarpophalangeal joint: a cadaver study.

PURPOSE: The purpose of this study was to compare the stiffness and strength of the native ulnar collateral ligament with 4 methods of static ulnar collateral ligament (UCL) reconstruction at the thumb metacarpophalangeal (MCP) joint. METHODS: Eleven fresh-frozen cadaver specimens were amputated at the carpometacarpal and interphalangeal joints and all soft tissues were removed except for the extensor pollicis brevis tendon, the proper and accessory collateral ligaments, and the volar plate. Each thumb metacarpal was potted in cement and the native UCL was loaded to failure at 30 degrees of MCP flexion. Ulnar collateral ligament reconstructions as described by Strandell, Osterman, Fairhurst, and a modification of the Glickel procedure then were performed. Each specimen was again loaded to failure and the moment at failure, stiffness, and angle at failure were calculated. RESULTS: None of the reconstructions duplicated the strength or stiffness of the native UCL. The modification of the Glickel procedure with interference knot fixation had a significantly higher moment at failure and was significantly stiffer than any of the other procedures. The differences in strength and stiffness between the Strandell, Osterman, and Fairhurst reconstructions were not statistically significant. There were no significant differences in angle at failure for any of the reconstructions. CONCLUSIONS: No static ligament reconstruction restores the normal stability characteristics of the thumb UCL. The anatomic reconstruction of the UCL with interference knot fixation of the tendon graft has far better strength and stiffness than any of the other reconstructions tested. These characteristics may allow for early motion at the MCP joint.

Cadaver↗
PubMed2006

Reconstruction of the interosseous ligament unloads metallic radial head arthroplasty and the distal ulna in cadavers.

PURPOSE: Longitudinal radioulnar dissociation may result when a compressive load to the hand results in excessive proximal migration of the radius with interosseous ligament (IOL) disruption and radial head fracture. Interosseous ligament reconstruction has been proposed to restore more normal forearm mechanics. The objective of this study was to evaluate the effect of IOL reconstruction on compressive load transfer through the forearm after excision and metallic replacement of the radial head in cadavers. METHODS: In 8 cadaveric forearms, 138 N of compressive load was applied to the hand in neutral forearm rotation and neutral elbow varus-valgus alignment. We measured proximal radial migration and 3-dimensional force vectors acting on the distal radius, distal ulna, IOL, proximal radius, and proximal ulna. The experiment was repeated in order for 5 conditions: (1) with the IOL intact, (2) with the IOL reconstructed with a double-bundle flexor carpi radialis construct, (3) with the radial head excised, (4) after metallic radial head arthroplasty, and (5) after cutting the IOL reconstruction. Analysis of variance was used for statistical comparisons. RESULTS: With the IOL intact the resultant load in the distal radius was 94% +/- 3% of hand load, with 75% +/- 2% transmitted to the proximal radius. Double-bundle flexor carpi radialis reconstruction effectively restored this relationship. After radial head excision the resultant distal radius load decreased whereas great increases were seen in the resultant distal ulna load, the resultant load in the IOL reconstruction, the resultant load in the proximal ulna, and proximal radial migration. Force continued to transfer through the proximal radius transversely, with a 400% increase in transverse force, a consequence of abutment of the radial stump caused by proximal radioulnar convergence (there was no contact at the capitellum). After radial head arthroplasty loads transferred across the wrist remained closer to intact but the resultant load on the distal ulna and proximal radius remained increased. With cutting of the IOL reconstruction transverse forces in the forearm became negligible, the resultant distal ulna load increased by 50%, and the resultant radial head load increased by 25%. Proximal migration of the radius was small and was increased by 4.6 mm with radial head excision and by 1 mm after radial head replacement compared with the IOL-reconstructed, radial head-intact state. CONCLUSIONS: Interosseous ligament reconstruction may help improve treatment of longitudinal radioulnar dissociation but remains an experimental procedure.

Aged↗
PubMed2006

The effect of radial shortening on wrist joint mechanics in cadaver specimens with inherent differences in ulnar variance.

PURPOSE: To assess load changes in the wrist and forearm resulting from surgically-induced radial shortening in wrists with inherent differences in ulnar variance. METHODS: Eleven fresh cadaver upper extremities, 4 with ulnar-plus variance of 2 mm or greater and 7 with ulnar-minus variance of 2 mm or greater were used. The radius and ulna of each specimen were instrumented with load cells, a 15-mm segment of the radius was resected and replaced with aluminum blocks of various sizes, and the specimens were loaded with 143 N (32 lb) at 1-mm differences of radial length. The load distribution between the radius and ulna was measured. RESULTS: The load distribution in the specimens with an ulnar-plus variance averaged 69% through the radius and 31% through the ulna. In the wrists with ulnar-minus variance, the load distribution averaged 94% through the radius and 6% through the ulna. The mean force in the ulna increased and the mean force in the radius decreased with incremental shortening of the distal end of the radius. The mean force through the ulna in the ulnar-plus-variance group was always higher than that of the ulnar-minus-variance group. When compared not by the number of millimeters of radial shortening but by the adjusted ulnar variance, there was no difference between the ulnar-plus-variance and the ulnar-minus-variance groups. CONCLUSIONS: Wrists with ulnar-minus variance could accommodate radial shortening without as much increase in the ulna load as wrists with ulnar-plus variance. The clinical relevance is that a patient with an ulnar-minus variance may accommodate more radial shortening after a wrist fracture without developing an ulnar impaction syndrome than a patient with an ulnar-plus-variant wrist.

Aged↗
PubMed2006

Frequency domain near-infrared spectroscopy technique in the assessment of brain oxygenation: a validation study in live subjects and cadavers.

BACKGROUND: Studies with continuous wave near infrared spectroscopy (CW-NIRS) have shown little difference in brain oxygenation of dead compared to live subjects. We determined brain oxyhemoglobin (OHb) and deoxyhemoglobin (HHb) concentrations in healthy volunteers and cadavers using frequency domain near infrared spectroscopy (FD-NIRS). METHODS: Regional OHb and HHb, brain oxygen saturation (SO2), and total hemoglobin (tHb) were determined. Nine patients who died in the hospital were evaluated by FD-NIRS in the morgue 7-96 h after death was confirmed. Ten volunteers served as a control group. RESULTS: Absolute concentrations of brain tissue OHb and HHb were 24.9 +/- 9.1 uM and 13.8 +/- 32 uM, respectively, in live subjects. In dead subjects, OHb was 1.3 +/- 2.1 uM and HHb was 30.8 +/- 14.4 uM (both P < 0.05 compared to live). OHb showed a 90% decrease within 7h of death. There was a significant trend for a continued decrease in OHb from 7 to 96 h. CONCLUSION: OHb decreased and HHb increased in dead patients compared to live volunteers. Depletion of OHb primarily occurred within 7 h of death but continued gradually over 96 h. FD-NIRS was a novel technique for determining OHb and HHb changes following death.

Adult↗