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At least 739 records · Page 41Linked to original sources
PubMed2006

Etiology of lingual nerve injuries in the third molar region: a cadaver and histologic study.

PURPOSE: It has been suggested that different etiologies of lingual nerve damage in the third molar area will produce a different clinical and histologic appearance in the nerve. If the clinical and histologic pictures were different, it could result in different treatments being recommended. MATERIALS AND METHODS: Eight preserved cadavers (16 lingual nerves) were used for this study. As far as possible, the nerves were left in situ and damaged in a way that could be envisaged during third molar surgery. In each case, the damaged sections of nerve were photographed, resected, embedded in paraffin wax, sectioned in 5 mum sections, stained with hematoxylin-eosin, and examined histologically. RESULTS: The scalpel clinically produced a clean wound with sharply defined edges; this was confirmed histologically with minimal disruption to the fascicles. The 702 fissure bur produced a ragged stretch-type injury clinically, and histologically this was confirmed with an irregular-edged border to the lesion and stretching and internal damage to the fascicles immediately adjacent to the wound. The crush injury clinically caused considerable apparent damage to the nerve, which was confirmed histologically with crushing and disruption of the fascicles and reduction to approximately 25% of their preinjury thickness. The stretch injury clinically showed no damage, but histologically showed irregular internal disruption of the fascicles over the whole area subject to stretching movements. CONCLUSION: It does appear that different modalities in nerve injury produce a different type of injury both clinically and histologically. This information has implications for both natural clinical recovery and the indications for surgical intervention. Clinical recovery may occur best with close approximation of a sharp scalpel-type wound or excision of a crushed area of nerve with reapproximation of the nerve endings, but a ragged wound caused by a fissure bur may require excision back to healthy nerve with subsequent reapproximation, whereas with the stretching injury it may be difficult to ascertain the edges and limits of the wound, and difficult to repair, and it may be most appropriate to rely on a natural healing process for the best results.

Cadaver↗
PubMedDate not supplied

The coracoid impingement of the subscapularis tendon: a cadaver study.

To study the anatomic relationships and varieties of anterior impingement of the rotator cuff, an examination of 124 shoulder joints from 62 embalmed cadavers was performed. The distance between the lesser tuberosity and the coracoid was measured at different degrees of humeral rotation in the shoulder joint. Neither lateral differences nor differences with respect to donor gender were found in the distance measurements between the coracoid process and the lesser tuberosity for any rotational angle. In addition, no significant differences were found between shoulders with and without rupture of the subscapularis tendon. No lateral dominance was found for the subscapularis tunnel area.

Adult↗
PubMed2005

The accuracy of computer-aided surgery in neurotologic approaches to the temporal bone: a cadaver study.

OBJECTIVE: To assess the accuracy of computer-aided surgery for common neurotologic approaches to the temporal bone. STUDY DESIGN AND SETTING: Cadaveric heads were dissected by using standard neurotologic approaches to the temporal bone including translabyrinthine, middle fossa, and retrosigmoid. Dissected anatomic landmarks from each approach were compared with CT images that were obtained before dissection on the VectorVision 2 system (BrainLAB Corp, Munich, Germany) and the variability measured from digital images. Each approach was performed 5 times, with each anatomic landmark measured 3 times from each approach. RESULTS: The accuracy of the computer-aided surgery system was less than 1 mm for all anatomic points measured. Forty-two of the 49 measured points were accurate to less than 0.5 mm. CONCLUSIONS: Computer-aided surgery of the temporal bone using common neurotologic approaches can be performed accurately and reliably in cadaver specimens. SIGNIFICANCE: The utility and limitations of computer-aided surgery in the temporal bone are discussed. EBM RATING: B-2.

Cadaver↗
PubMed2004

Quality of life in cadaver and living-related renal transplant recipients in Kuala Lumpur hospital.

OBJECTIVE: To examine the quality of life in cadaver (CAD) and living-related (LRRT) renal transplant recipients. METHODS: A cross-sectional study was done on patients followed in renal transplant clinic from 1/4/03 to 1/7/03 using the SF-36 questionnaire. Inclusion criteria were age >16 years,minimum of 3 months' posttransplant, and informed consent. Exclusion criteria were current treatment for rejection or infection or any life-threatening conditions. Information on duration of transplant, duration of dialysis prior to transplant, number of co-morbidities, and sociodemodraphic data were collected. RESULTS: Sixty-four among 110 patients (58.1%) completed the SF36 questionnaire. The LRRT recipients were younger, had a longer duration of transplant, and had spent significantly less time on dialysis prior to transplant compared to CAD transplant patients. Overall, the physical composite and the mental composite scores were not significantly different between the two transplant groups. Age was negatively associated with the physical composite score (Spearman's rho -0.251, P < .05) and bodily pain (Spearman's rho -0.266, P < .05). Duration of dialysis prior to transplant was negatively correlated with social functioning (Spearman's rho -0.28, P < .05) and mental health (Spearman's rho -0.39, P < .005). In multiple regression analysis, age was a significant predictor of the SF36 physical composite score (P < .05). CONCLUSION: This study shows that the quality of life between LRRT and CAD recipients was not significantly different. Increased age was associated with poorer physical capacity.

Adult↗
PubMed1994

Instruction in surgical anatomy for gynecology residents using prosected human cadavers.

Prosected human cadavers were used by a team of anatomists and gynecologic surgeons to teach surgical anatomy to gynecology residents. The course was offered at the start of each 8-week gynecologic surgery rotation. Hemisections and other similar prosections were used to demonstrate anatomic relationships and surgical procedures from vantage points unobtainable at the operating table. The initial response from the faculty and residents was encouraging. The residents believed the program to be beneficial and were satisfied with it. Both the anatomy faculty and the gynecology faculty found new insights into teaching issues during the interdisciplinary process of course preparation and teaching.

Anatomy↗
PubMed1998

Biomechanical study of sternal closure using rigid fixation techniques in human cadavers.

BACKGROUND: We believe rigid plate fixation may be superior to wire fixation in sternal closure, as rigid fixation used in the craniofacial skeleton has shown greater stability, lower postoperative pain, and accelerated bone healing. We hypothesize that sterna fixed with titanium plates are more stable mechanically than sterna fixed with wires. METHODS: The sterna from human cadavers were used in this two-phased study. Phase I compared wires to four-hole titanium straight plates. Phase II compared wires to four-hole titanium custom H plates. The sterna were tested biomechanically using all fixation methods. RESULTS: Phase I showed no statistically significant difference in the stiffness or lateral displacement between the wired and straight plated sterna. Phase II showed a statistically significant greater stiffness (p < 0.05) and less lateral displacement (p < 0.05) in the custom plated sterna over the wired sterna. CONCLUSIONS: Our results showed that custom titanium H plates were superior to wire fixation. Furthermore, our results established the importance of plate configuration in sternal fixation. Our study may have beneficial clinical implications, as decreased motion at the sternotomy site could mean less postoperative pain, a decreased incidence of infection, and accelerated bone healing.

Aged↗
PubMed2002

Intact genetic material is present in commercially processed cadaver allografts used for pubovaginal slings.

PURPOSE: We determined the presence, quantitated the concentration and assessed the length of DNA present in 4 commercially available human cadaver allografts. MATERIALS AND METHODS: We evaluated 10 tissue samples from each of 4 commercial sources of human allograft (Mentor Corp., Santa Barbara, California; Musculoskeletal Transplant Foundation, Edison, New Jersey; Regeneration Technologies, Inc., Alachua, Florida; and Life Cell Corp., Woodlands, Texas) for intact DNA segments. All allograft samples underwent a standard extraction technique (proteinase K/sodium dodecyl sulfate/phenol) to isolate genetic material. Spectrophotometry evaluation was done to quantify DNA concentrations. Polymerase chain reaction was performed to amplify the retrieved DNA material. Agarose gel electrophoresis was performed to determine the size of DNA fragments. RESULTS: Of the 49 samples tested from all 4 commercial sources of human allograft fascia 39 (97.5%) contained DNA of 400 to 2,000 bp segments. A 400 bp DNA segment was present in 9 Mentor, 10 Musculoskeletal Transplant Foundation, 10 Regeneration Technologies and 10 Life Cell samples. A 700 bp DNA segment was present in 10 Musculoskeletal Transplant Foundation, 10 Regeneration Technologies and 10 Life Cell allografts. A 2,000 bp DNA segment was present in 10 Life Cell tissues. CONCLUSIONS: Intact genetic material was present in all 4 commercially processed human allografts. Tissue processing did not completely eliminate intact DNA segments. The size of the intact DNA and the concentration of DNA varied widely based on tissue processing methods.

Cadaver↗
PubMed1989

Evaluation of pediatric cadaver kidneys transplanted into adult recipients receiving cyclosporine.

The major problem in clinical transplantation is the imbalance between the need for cadaveric organs and the available numbers of donors. If pediatric kidneys were transplanted into adult recipients when no pediatric recipient was available, the potential number of renal donors would be increased by 15 to 20%. Some centers are reluctant to use pediatric kidneys for adult recipients because of recent reports indicating poorer patient and allograft survival, increased delayed graft function, increased post-transplant hypertension and increased technical complication. (There also has been concern that the nephrotoxic effect of cyclosporine A would retard the organ growth that is necessary to provide normal renal function in adults.) A retrospective analysis was performed on 18 adult recipients who received kidneys from cadaver donors 14 months to 12 years old (group 1). These patients were compared to 106 adult recipients who received kidneys from donors greater than 12 years old (group 2). Actuarial patient survival at 1 year was 85% for group 1 and 95.8% for group 2 (p equals 0.13), while 1-year actuarial allograft survival was 83.1% for group 1 and 81.1% for group 2 (p equals 0.87). There was no significant difference between groups 1 and 2 in the frequency of delayed graft function, serum creatinine at 1, 3 and 6 months after transplantation, incidence of post-transplant hypertension or frequency of surgical complications. It is of interest that the pediatric kidneys had significant growth during the initial post-transplant month. Sonographic examination at postoperative days 1 and 30 demonstrated a mean increase in size from 80.7 to 143.5 cm. (p less than 0.001). In this series pediatric kidneys were safe and effective donor organs in adult recipients, and increased the available number of organs by 15%.

Adolescent↗
PubMed1987

Nerve crossover techniques for urinary bladder reinnervation: animal and human cadaver studies.

Interruption of spinal pathways integrating central and peripheral bladder control mechanisms will result in neurogenic bladder dysfunction. If central pathways could be restored to the decentralized bladder through a microneural reconstructive technique a return of useful function might be achieved. This anatomical study describes the nerve crossover techniques used in human cadaver dissections for connecting intercostal nerves to sacral roots intraspinally. The techniques were modified from and compared to similar procedures used in an animal model where adjacent extradural roots were connected through a nerve graft. We have shown previously that the unilaterally decentralized bladder of the cat can be recentralized after a nerve crossover procedure. If additional laboratory studies can document return of useful bladder function we anticipate that selected patients may benefit from similar nerve crossover techniques to bypass a spinal cord lesion to recentralize the bladder.

Animals↗
PubMed1986

Multiple organ donation: its impact on the recovery of cadaver kidneys.

Cyclosporin A not only has improved renal allograft survival but it also has caused a renewed interest in cardiac and hepatic transplantation. The South Texas Organ Bank was sensitive to the need for multiple organ donors and also concerned that the recovery of multiple organs could have a negative impact on the quantity or quality of kidneys recovered. From July 1983 through March 1985 cadaveric kidneys were obtained from 43 renal donors and multiple vital organs were obtained from 11 additional donors. There was no statistical difference between the renal and multiple organ donors in the incidence of renal contamination, post-transplant acute renal failure or renal discard rate (p greater than 0.3 in each comparison). No donor family rescinded permission for renal donation because other vital organs were requested. Urologists involved in cadaveric renal recovery are encouraged to view every cadaver donor as a potential multiple organ donor.

Adolescent↗
PubMed1984

Second cadaver kidney transplants: improved graft survival in secondary kidney transplants using cyclosporin A.

A total of 42 patients who had failed prior renal transplantation underwent repeat cadaveric transplantation using cyclosporin A and low dose steroid immunosuppression. Patient survival at 1 year was 100 per cent. Over-all graft survival was 83 per cent at 1 year, which was significantly better than had been obtainable previously in this high risk group. Repeat cadaver transplantation with cyclosporin A is safe and offers those who have failed previous transplantation an opportunity for existence free of dialysis.

Adolescent↗
PubMed1983

Why do secondary cadaver renal transplants succeed? Results of the South-Eastern Organ Procurement Foundation prospective study, 1977-1982.

We report the selective and therapeutic factors affecting multiple kidney transplant success from a prospective multicenter study of the South-Eastern Organ Procurement Foundation. From June 1977 to March 1982, 3,215 cadaver kidney transplants were performed at 39 institutions. There were 2,535 first, 564 second, 103 third and 13 fourth grafts. The actuarial graft survival rates at 1 and 2 years were 52 plus or minus 1 and 45 plus or minus 1 per cent, respectively, for first grafts, 44 plus or minus 2 and 40 plus or minus 3 per cent for second grafts, and 42 plus or minus 5 and 31 plus or minus 6 per cent for third grafts. Graft survival rates were significantly lower for second and third than for first transplants (p less than 0.003). There was no difference in patient survival rates. The data were analyzed to determine which selective and therapeutic variables governed success of primary and secondary grafts. Pre-transplant blood transfusions were associated with a significant increase in graft survival rates in primary (p less than 0.00005) and secondary transplants (p less than 0.01), and did not affect patient survival rates. The administration of antilymphocyte serum also improved graft survival rates significantly in primary (p less than 0.00005) and secondary grafts (p less than 0.00002), without alteration of patient survival rates. HLA compatibility improved primary graft survival rates (p less than or equal to 0.022) but this did not reach statistical significance in secondary graft survival rates. Second transplant graft survival rates were best when the primary graft functioned for more than 12 months (Breslow p less than or equal to 0.02) but were not related to the reason for loss of the first graft. Pre-transplant bilateral nephrectomy improved graft survival rates significantly but this phenomenon was linked to other treatment factors. No beneficial effect on graft survival rate could be shown after pre-transplant splenectomy in patients with primary or secondary grafts and this procedure was associated with reduced patient survival rates in both groups.

Adolescent↗
PubMed1982

Improved cadaver allograft survival in transfused recipients who remain serologically negative for cytomegalovirus.

Between April 1976 and October 1979, 100 consecutive cadaver renal transplants were done. Before transplantation 48 recipients were seronegative and 52 were seropositive for cytomegalovirus. After transplantation there were 20 primary and 38 secondary cytomegalovirus infections. The development of post-transplant cytomegalovirus infection, with or without overt symptoms, had no effect on graft survival. The 1-year graft survival was significantly better (p less than 0.05) in high transfused (more than 5 units) recipients (70 per cent) compared to nontransfused recipients (36 per cent). The beneficial effect of transfusions was not diminished in patients with positive post-transplant cytomegalovirus serology. Of the transfused recipients those who remained serologically negative for cytomegalovirus pre-transplant had significantly better 1-year graft survival (78 per cent) than those who were cytomegalovirus positive before transplantation (58 per cent) (p less than 0.05). The improved graft survival in patients who remain cytomegalovirus seronegative after multiple blood transfusions may be a manifestation of unresponsiveness to immunologic as well as virogenetic stimulation.

Adult↗
PubMed1980

An analysis of 100 primary cadaver kidney transplants.

A multifactorial analysis of 100 consecutive first cadaver kidney transplants was done to document the current status of this treatment for end stage renal disease and to determine the influence of the following variables on kidney losses owing to rejection: splenectomy, pre-transplant transfusions, transfusion at the transplantation, recipient sex, pre-transplant nephrectomy, donor and recipient A, B or O blood group, human leukocyte A and B antigen mismatches, kidney preservation method, donor treatment with methylprednisolone and cyclophosphamide, recipient treatment with antilymphocyte serum or antilymphoblast globulin and a low dose of steroid treatment for rejection. Pre-transplant splenectomy for leukopenia, 5 or more pre-transplant blood transfusions and pre-transplant transfusions without development of circulating cytotoxic antibodies significantly reduced kidney losses owing to rejection (p less than 0.05)., A low dose of steroid treatment for rejection resulted in a trend towards improved patient survival without sacrificing kidney graft survival. Clinical studies demonstrating decreases in kidney graft rejection should be controlled for pre-transplant blood transfusions and, possibly, for pre-transplant splenectomy for hypersplenism.

Adolescent↗
PubMed1997

Functional perineal colostomy with pudendal nerve anastomosis following anorectal resection: a cadaver operation study on a new procedure.

BACKGROUND: We have previously studied functional perineal colostomy that used skeletal muscle with pudendal nerve anastomosis (PNA) following anorectal resection in an animal model. In that study the neosphincter reconstructed with PNA achieved the proper functions of the external anal sphincter resulting in a satisfactory defecatory condition. This study was a preliminary step before applying this procedure to human beings. METHODS: We reconstructed a new anal sphincter by using the lower part of the gluteus maximus muscle (lower GMM) with PNA in a total of six sides of four human cadavers and investigated the anatomic problems associated with this procedure. RESULTS: We classified the branching patterns of the inferior gluteal nerve into three types. The length of the branches of the inferior gluteal nerve to the lower GMM varied from 32 to 76 mm (median, 57 mm). The length of the pudendal nerve (PN) passing out below the sacrotuberous ligament varied from 21 to 44 mm (median, 29.5 mm). The PN was anastomosed to the nerve innervating the lower GMM with the redundancy of 17 to 36 mm (median, 24.5 mm). In all cases the anal sphincter reconstruction with a PNA maneuver was anatomically feasible by using the lower GMM. The length of the new anal canal was 65 to 80 mm (median, 67.5 mm). CONCLUSIONS: The PNA maneuver was an anatomically applicable method to make a neoanus in human beings. Preparation for the application of this method to human beings was accomplished.

Aged↗
PubMed1977

Malakoplakia in a cadaver renal allograft: a case study.

Malakoplakia is an uncommon chronic inflammatory disease characterized by histocytes with intracellular Michaelis-Gutmann bodies. The etiology is uncertain, but it is thought that depressed macrophage phagocytosis of bacteria is important. This presentation describes a case of malakoplakia arising in a cadaver renal transplant. The association of long term immunosuppression and repeated E. coli urinary tract infections is discussed.

Cadaver↗
PubMed1976

Transformation of lymphocytes from patients awaiting cadaver renal transplants.

The response of lymphocytes from prospective kidney transplant recipients to inactivated donor lymphocytes (one-way mixed-lymphocyte reaction (M.L.R.)) and to phytohaemagglutinin (P.H.A. response) was measured before transplantation of cadaver kidney allografts in 78 and 75 cases respectively. M.L.R. results from patients whose grafts had failed within 3 or 6 months compared with M.L.R. results from patients whose grafts continued to function at the same times showed only slight differences irrespective of whether the data was expressed as a relative response or a mitotic index. Because of the large overlap in values, it was concluded that the M.L.R. test was of limited value in predicting graft prognosis. Pretransplantation P.H.A. responses from patients whose grafts failed within 3 or 6 months were significantly different from those shown by patients whose grafts remained functioning at those times. It is suggested that lymphocyte responsiveness to P.H.A. before transplantation may be of value in predicting the fate of renal allografts.

Adolescent↗
PubMed1977

Effect of antilyphocyte-globulin potency on survival of cadaver renal transplants. Prospective randomised double-blind trial.

71 recipients of cadaver primary and secondary renal transplants were investigated in a prospective randomised double-blind study. Patients were given one of two rabbit antilymphocyte globulin (A.L.G.) preparations made by similar techniques but differing in potency as measured by skin-graft prolongation in rhesus monkeys. Patient selection and management were otherwise similar. A statistically significant difference (P less than 0-05) in graft survival (78% vs. 42%) developed between the two groups at a mean follow-up of 18-4 months and patient entry into the study was terminated. After a 3-5 year interval from the start of the trial the double-blind code was broken. It was found that the high-potency-A.L.G. group had better graft survival and fewer rejection episodes (P less than 0-05) than the moderate-potency group. The results suggest that preclinical testing of A.L.G. by the primate skin graft test can be a valid indicator of the potential efficacy of an A.L.G. preparation in renal-transplant recipients. It is suggested that quality-control standards may improve the clinical results of A.L.G. therapy.

Adolescent↗