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At least 757 records · Page 42Linked to original sources
PubMed1977

Effect of blood-group on relation between HLA match and outcome of cadaver kidney transplants.

In a series of 4998 cadaver kidney transplants the extent of HLA matching correlated with transplant outcome in patients with blood-groups other than O (non-O) but not in patients of blood-group O. The high survival-rate of poorly matched kidneys in O recipients was responsible for the lack of correlation between HLA matching and graft survival in these patients. Survival-rates of transplants with 4 HLA mismatches were 52 +/- 3% at one year in 222 O-to-O grafts compared with 24 +/- 5% in 65 B-to-B grafts (P less than 0.0001). In 2827 non-O patients, there was a strong correlation between HLA matching and graft survival (P less than 0.0001 at one year). One possible reason for the cancelling out of the effect of HLA mismatching in type-O recipients is that these patients waited longer on dialysis for a transplant and consequently received more blood-transfusions.

ABO Blood-Group System↗
PubMedDate not supplied

Cyclosporin A in patients receiving renal allografts from cadaver donors.

Seven patients on dialysis with renal failure received transplants from mismatched cadaver donors and were treated with cyclosporin A (CyA), initially as the sole immunosuppressive agent. CyA was effective in inhibiting rejection but there was clear evidence of both nephrotoxicity and hepatotoxicity. A cyclophosphamide analogue was added to the CyA treatment in six of the patients. Five patients are out of hospital with functioning allografts, and two of these have received no steroids. One patient required an allograft nephrectomy because of pyelonephritis in the graft. Another died of systemic aspergillus and candida infection. Further careful study of this potentially valuable drug will by required before it can be recommended in clinical practice.

Acute Disease↗
PubMed1986

Recipient lymphocyte sensitivity to methylprednisolone affects cadaver kidney graft survival.

In 42 recipients of mixed-lymphocyte-culture (MLC) incompatible cadaver kidneys and conventional immunosuppressive treatment (azathioprine and steroids) the concentrations of methylprednisolone suppressing the in-vitro response of pretransplant lymphocytes to phytohaemagglutinin by 50% (ED50) were determined. 1-year graft survival was significantly higher in 21 recipients with methylprednisolone ED50 values below the median than in 21 patients with higher than median ED50s (86% v 29%; p less than 0.0002). Thus, the steroid sensitivity of recipients strongly influences the survival of MLC-mismatched kidneys. In 42 transplant recipients treated with cyclosporin and steroids, the effect of steroid sensitivity was also apparent (1-year graft survival 76% and 57% for recipients with low and high ED50, respectively), though not significant. Determination of the sensitivity to steroids may be valuable in determining which recipients can be given HLA-DR-mismatched kidneys and may serve as a guideline for determining the dose of steroids to be used.

Cadaver↗
PubMed1981

Radial keratotomy in fresh human cadaver eyes.

Radial keratotomy in fresh human cadaver eyes produced corneal flattening varying from 6 to 11 diopters (D). There was no significant difference in the effectiveness of the incisions to the incisions to the limbus compared to incisions through the limbus. Eighty to ninety percent of the flattening effect was obtained after the first eight incisions. The preoperative keratotomy reading was not helpful in predicting the final result. Histopathology of the incised corneas revealed considerable variation in incision depth and demonstrates the difficulty in achieving deep incisions safely.

Aged↗
PubMed1995

A cadaver study of the effects of dorsal angulation and shortening of the metacarpal shaft on the extension and flexion force ratios of the index and little fingers.

Two experiments were performed on the second and fifth metacarpals of five normal cadaver hands. The forces obtained on full extension and flexion of the digits were measured. An oblique osteotomy was performed on the shaft of the metacarpal and fixed with dorsal angulation. The forces obtained on extension and flexion of the digits were measured. The relationships between the changes in force and the angle were analyzed. Flexion force decreased and extension force increased as the dorsal angulation increased, and these were significant beyond 30 degrees of dorsal angulation. The differences between index and little fingers were not significant. In the second experiment, the metacarpal bone was shortened at the osteotomy site, and the same measurements made. Flexion and extension forces both decreased, and were significant beyond 3 mm of shortening. The differences between index and little fingers were not significant.

Analysis of Variance↗
PubMed1996

Experimentally induced ulno-carpal instability. A study on 13 cadaver wrists.

This experimental work studies the role of ligamentous structures in suspending the carpal bones from the radius and ulna. Thirteen human cadaver wrists underwent a distal radio-ulnar arthrodesis in a neutral position and an arthrodesis between the three bones of the first carpal row. Progressive postero-anterior forces in a palmar direction were applied to the fused carpal bones. Displacement was measured by two dial gauges before and after sequential section of the different fibrous structures. The largest absolute average displacement (both, dorso-palmar and induced rotational displacement) was observed after section of the ulnar styloid process. No significant differences were observed after section of the extensor retinaculum, extensor carpi ulnaris sheath, posterior ulno-carpal and posterior radio-carpal ligaments. This work suggests that the carpus is suspended not only from the radius, but also from the distal ulna and particularly at the ulnar styloid and the structures which insert onto it.

Arthrodesis↗
PubMed1998

Distribution of human Pacinian corpuscles in the hand. A cadaver study.

The subcutaneous distribution and number of Pacinian corpuscles were studied in ten fresh cadaver hands. They were found to cluster close to nerves and vessels at the metacarpophalangeal joints and the proximal phalanx. The total mean number in the hand was 300 (192-424). The percentage of the total was 44 to 60% in the fingers, 23 to 48% in the metacarpophalangeal area and 8 to 18% in the thenar and hypothenar regions. Corpuscles in palmar skin overlying the distal phalanx were smaller than receptors in the metacarpophalangeal area. The lowest density of corpuscles was along the nerves and vessels of the middle phalanx.

Aged↗
PubMed1998

Flexor tendon repair using a stainless steel internal anchor. Biomechanical study on human cadaver tendons.

We have developed a stainless steel internal tendon anchor that is used to strengthen a tendon repair. This study tested its use in vitro to produce a repair that can withstand the tensile strength demands of early active flexion. Fresh human cadaver flexor digitorum profundus tendons were harvested, divided, and then repaired using four different techniques: Kessler, Becker or Savage stitches, or the internal tendon anchor. The internal splint repairs demonstrated a 99-270% increase in mean maximal linear tensile strength and a 49-240% increase in mean ultimate tensile strength over the other repairs. It is hoped that this newly developed internal anchor will provide a repair that will be strong enough to allow immediate active range of motion.

Cadaver↗
PubMed1994

Simultaneous development of diffuse immunoblastic lymphoma in recipients of renal transplants from a single cadaver donor: transmission of Epstein-Barr virus and triggering by OKT3.

Rapidly progressive diffuse immunoblastic lymphoma is an uncommon but devastating complication of organ transplantation that typically occurs early in the postoperative period. The fulminant course is characterized by progressive encephalopathy and coagulopathy, with malignant B-cell infiltration in the graft and other sites. Both de novo infection with Epstein-Barr virus (EBV) and treatment with the monoclonal antibody OKT3 have been implicated in the development of this disorder. We report two patients who received renal transplants from the same cadaver donor, with transmission of EBV from the same source, in whom treatment with OKT3 for acute rejection triggered the simultaneous development of fulminant and fatal B-cell immunoblastic lymphoma. We suggest that antilymphocyte agents be used with caution in EBV-seronegative graft recipients who receive a transplant from an EBV-seropositive donor to minimize the risk of this lethal complication.

Adolescent↗
PubMed1994

Allocation of cadaver kidneys: new pressures, new solutions.

Equitable allocation of human cadaver kidneys is complex and challenging, both from the ethical and scientific points of view. It is based on the principles of distributive justice and medical utility. However, the optimal application of ethical principles will require further resolution of medical issues that currently focus on the number of transplants for a single patient, six antigen matches, lesser degrees of HLA matching, marginal recipients, various positive cross-match situations, and cold ischemia time. New HLA matching techniques and enhanced computer organ allocation systems have the potential to surmount racial differences and increase significantly the number of compatible renal allografts.

Cadaver↗
PubMed1997

Minimizing racial disparity regarding receipt of a cadaver kidney transplant.

This report describes the impact of race on waiting list entry and receipt of a cadaver kidney transplant, after accounting for self-reported income, health and functional status, and patients' attitudes about dialysis and transplantation as treatment alternatives. Previous studies did not account for these race-related factors and therefore produced biased estimates of the impact of race on waiting list entry and receipt of a transplant. Data for this investigation came from a telephone survey of a national sample of 456 end-stage renal disease patients and from files maintained by the United Network for Organ Sharing and the Health Care Financing Administration. Proportional hazard models were estimated with these data. The results indicated that approximately 60% of the differences between black and white waiting list entry rates and 52% of the black-white differences in transplantation rates were due to race-related differences in socioeconomic status, health and functional status, severity of illness, biological factors, the existence of contraindications to transplantation, transplant center characteristics, and patients' attitudes about dialysis and transplantation. Potential ways to narrow racial differences further include better education about treatment alternatives for black patients, more vigorous efforts to obtain donor organs from minorities, continued research and thoughtful policy on the access-related impacts of United Network for Organ Sharing point system variances, and consolidation of some smaller waiting lists into larger regional lists.

Adolescent↗
PubMed1992

Endoscopic carpal tunnel release: an anatomic study of the two-incision method in human cadavers.

To determine the relationship of neurovascular structures to the sites of portal placement and transverse carpal ligament division during two-portal endoscopic carpal tunnel release, a study of 20 fresh cadaver specimens was carried out. Open dissection of the carpal tunnel after endoscopic surgery showed complete ligamentous release in 18 hands (90%). In 10 specimens, the procedure was performed as described by Chow. There was one partial transection of the superficial palmar arch (5%), and five specimens (50%) had complete divisions of the superficial palmar fascia with considerable pressure placed on the ulnar nerve at the wrist. A modified technique was used in 10 specimens in which the proximal incision was made in a more distal location and a distally based ligamentous flap was created. The superficial palmar arch and the distal edge of the transverse carpal ligament were visualized directly before passage of the trocar. No complications were noted with this method.

Anthropometry↗
PubMed1996

Tensile strength of flexor tendon repairs in a dynamic cadaver model.

Twenty-six fresh-frozen cadaver hands (78 tendons) underwent sharp zone II profundus tendon transection and repair with Bunnell, Kessler, Kessler with circumferential epitenon, or epitenon-alone sutures. Suture assignment was randomized, and core sutures were placed either palmarly or dorsally (also randomized) within the flexor tendon. Ten trials of each suture type and placement were performed. Flexion of the repaired digit at a constant excursion rate was performed up to tendon rupture. In all cases, dorsally placed sutures provided significantly more tensile strength than palmarly placed sutures. In light of the previous evidence that tendon viability is dependent on diffusion and not dependent on the vascular supply, we believe that a dorsally placed core suture and circumferential epitenon repair for zone II profundus repairs should be considered because of their increased strength. All future testing of tendon repairs should be performed in an anatomic "curvilinear" model because it simulates the specific biomechanical conditions that are unique to the flexing digit.

Cadaver↗
PubMed1997

Reconstruction of the interosseous membrane of the forearm in cadavers.

The biomechanical function of the interosseous membrane of the forearm was examined in 12 fresh cadaver forearms. The strain in the central band of the interosseous membrane was found to be greatest in full pronation and was significantly increased with excision of the radial head. The proximal/distal location of the lunate fossa of the radius with respect to the ulna was measured and was found to be most distal in supination and most proximal in pronation, in both the intact specimen and after excision of the radial head. Serial sectioning of the interosseous membrane and the triangular fibrocartilage complex (TFCC) demonstrated that both the central band and the TFCC are important to the axial stability of the forearm. Reconstruction of the central band, using a graft based upon the flexor carpi radialis, was performed in all 12 specimens after the interosseous membrane and the TFCC were sectioned. It was successful in preventing complete migration of the radius to the capitellum, but it was not capable of completely restoring the longitudinal stability of the forearm. Central band reconstruction as described here has not been performed in the clinical setting and is not advocated for clinical application at this time.

Biomechanical Phenomena↗
PubMed1997

Comparison of transthecal and subcutaneous single-injection digital block techniques in cadaver hands.

A controlled, randomized single-blinded study was performed on the thumbs and little fingers of 20 cadaver hands. The digits were randomly divided into 2 groups. In the transthecal group, 2 mL of 0.5% methylene blue was injected into the tendon sheath at the A1 pulley. In the subcutaneous group, the same amount of dye was injected into the subcutaneous tissue superficial to the A1 pulley. The injections were performed by 2 investigators. They exchanged specimens and performed dissections on the injected digits without knowledge of which technique had been used. The distributions of dye along the digit and the color intensity of the dye on the digital nerves were studied. There was no significant difference (p > .05) between results for the 2 techniques. It was expected that both techniques would result in similar anesthetic distribution in the clinical setting. In the transthecal group, intra-articular staining of the metacarpophalangeal joint was noted in 3 little fingers and 1 thumb. This complication did not occur in the subcutaneous group. This difference was significant (p < .05).

Cadaver↗
PubMed1998

The role of ulnar nerve transposition in ulnar nerve repair: a cadaver study.

Ulnar nerve transposition at the elbow is recommended to diminish nerve gaps during neurorrhaphy. We undertook a cadaver study to determine the gap distance that can be overcome by subcutaneous transposition at the elbow, evaluating lacerations 2.0 cm distal to the medial epicondyle and 2.0 cm proximal to the wrist crease. With a 100-g load on each nerve stump, gaps that could be overcome were measured before and after transposition in different elbow and wrist positions. For the distal forearm lacerations, wrist position significantly affected nerve gap, while transposition and elbow position did not. Nerve gap was significantly reduced by approximately 11 mm with wrist flexion from 0 degrees to 45 degrees. For proximal forearm lacerations, gap distance was significantly affected by transposition and was dependent to a greater extent on the interaction between transposition and elbow position, with wrist position having no effect. A clinically relevant scenario for the proximal laceration compared the pretransposition gap with the elbow and wrist at neutral with the posttransposition gap with the elbow and wrist flexed. Posttransposition gap reduction, with elbow and wrist flexion at 45 degrees, was approximately 9 mm and was not significant. To span a gap near the elbow, we estimate that more than 45 degrees of elbow flexion is required.

Aged↗
PubMed1998

Estimation of age from the femur of Japanese cadavers.

The purpose of this study is to estimate the age of cadavers by histomorphometry of the femur. Seventy-two Japanese males ranged from 43 days to 92 years old and 26 females ranged from 2 to 88 years old were used. The thickness of sections was adjusted at 50 to 70 microns by grinding with sand paper. The sections were not decalcificated. They were stained with Villanueva's bone staining powder and with thionin dye. Microradiographs of the sections were obtained by the soft X-ray apparatus. The area, maximum and minimum diameter, and perimeter of the perfect osteon and Haversian canal were measured. In addition, the type II osteon number, osteon fragment number, and area of triangle were also determined. All these parameters were examined by an image analyzer. The parameters of the osteon showed high correlation coefficient with age (magnitude of r > 0.77), while those of the Haversian canal were low (magnitude of r < 0.11). All parameters were subjected to multiple regression analysis for producing a multiple regression equation of age estimation. For the stepwise selecting method, the perimeter of osteon, maximum length of the Haversian canal and osteon fragment number were selected for the equation. Their multiple r2 and standard error of estimation were 0.8874 and 6.39, respectively. For the forward selection method, in addition to the above items, three parameters, the maximum length of Haversian canal, triangle area, osteon fragment number were selected. Their multiple r2 and standard error of estimation were 0.9484 and 4.884, respectively. Bone staining was useful to clarify the demarcation between osteon and fragment, leading to an increase in the accuracy of age estimation. However, the entire range from birth to 90 years was difficult to cover for precise age estimation.

Adolescent↗
PubMed2003

A dissection and computer tomograph study of tarsal coalitions in 100 cadaver feet.

Most of the clinical studies report the incidence of tarsal coalitions (TC) as less than 1% but they disregard the asymptomatic coalitions. TC have been associated with degenerative arthritic changes. After X-rays, computer tomography (CT) is the most commonly used diagnostic test in the detection of TC. The aims of our study were to establish the incidence of TC; the association between TC and accessory tarsal bones and between TC and tarsal arthritis; and to assess the sensitivity of CT as a diagnostic tool in TC. We performed spiral CT scans of 100 cadaver feet (mean age at death 77.7+/-10.4), which were subsequently dissected. The dissections identified nine non-osseous TC: two talocalcaneal and seven calcaneonavicular. There was no osseous coalition. Tarsal arthritis was identified in 31 cases. Both talocalcaneal coalitions were associated with arthritis while none of the calcaneonavicular coalitions were associated with tarsal arthritis. The CT diagnosed an osseous talocalcaneal coalition and was suspicious of fibrocartilaginous coalitions in eight cases. There was correlation between dissection and CT in two talocalcaneal coalitions and three calcaneonavicular coalitions thus CT identifying 55.5% of the coalitions. CT did not diagnose four non-osseous coalitions and diagnosed errouresly four possible coalitions. In conclusion our study demonstrated that the incidence of non-osseous TC is higher than previously thought (12.72%). The calcaneonavicular coalitions are the most common single type (9.09%) and they do not seem to be associated with arthritic changes in the tarsal bones. Our CT results suggest that spiral CT has a low sensitivity in the detection of non-osseous coalitions and questions if multislice CT should be used routinely when TC are suspected.

Adult↗