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PubMed1999

[Learning and optimising minimally invasive techniques by operating on embalmed human corpses].

The expansion of minimally invasive surgery worldwide provokes an intensive interest of all surgical disciplines in gaining possibilities for research, learning and teaching by operating on human corpses. Despite the fact that German anatomical institutes in general have the infrastructure to realise such clinical cooperations, at present they may offer such opportunities only to a restricted degree, since the concentration on student teaching and anatomic research limits the capacity of the staff for a commitment in this field of applied science. To provide a basis for future estimations of the efforts necessary to perform solo surgery on the human cadaver, especially with emphasis on research, quality control and teaching, this article reports on practical experiences with such a project named "ANAtoMIC", identifying minimal conditions which have to be realised.

Cadaver↗
PubMed1976

"The soft embalmer of the still midnight": a problem of prescribing hypnotics in general practice.

Was it euthanasia or was it even murder? That is the rather dramatic question with which the case history ends. However, none of those taking part in this conference had any doubts that it was neither murder nor euthanasia. But all had doubts as to whether the patient received the best care which the medical and allied professions can command. The barrister declared that in law there would have been no case to answer but the consensus of opinion of the other participants was that as no real diagnosis had been made the treatment was essentially superficial - ensuring sleep for the patient by prescribing barbiturates. The most fundamental criticism of the management of this patient was that individuals looked after her rather than an interdisciplinary team, some member of which might properly have sought to overrule Dorothy (the patient's daughter) when she took her mother away from a nursing home. However, what makes this case conference fascinating is not the facts of the case or the treatment so much as the avenues for moral and social discussion opened for the reader.

Aged↗
PubMed1998

Tuberculosis risk in funeral home employees.

In order to estimate the risk of tuberculosis infection among employees in the funeral service industry, we conducted a risk-assessment study of a convenience sample of funeral home employees. Study participants completed a risk-assessment questionnaire and underwent tuberculin skin testing. Of 864 employees tested, 101 (11.7%) had a reactive tuberculin skin test. Reactivity to the tuberculin skin test was significantly associated with job category; funeral home employees with a present or past history of embalming deceased-human remains were twice as likely to be reactive as were non-embalming personnel (14.9% versus 7.2%, P < 0.01). Reactivity was also associated with age, gender, race, past history of close contact with a person diagnosed with tuberculosis, and work history. After controlling for age and other factors, tuberculin reactivity was found to be associated in embalming personnel with the number of years spent performing embalmings (> or = 20), and, in non-embalming personnel, with a history of close contact with infected individuals. Based on these results, it is recommended that funeral home employees who routinely embalm cadavers undergo annual tuberculin skin testing, receive initial training on tuberculosis prevention, and wear respiratory protection when preparing known tuberculosis cases.

Adult↗
PubMed1998

[A new studie of embalment in ancient Egypt].

The instruments of the Embalmer Priest. Studies on the practice of embalming in ancient Egypt have mostly neglected the instruments used by embalmers to make their activity easier. Only three embalmer's caches contained embalmers' instruments, but some further objects have been found in museum collections. We have created bronze reproductions of these tools which then used on a corpse at the Faculty of Medicine of Paris VII.

Egypt, Ancient↗
PubMedDate not supplied

Cytogenetic effects of formaldehyde exposure in students of mortuary science.

The effect of low-level exposure to formaldehyde on oral, nasal, and lymphoycte biological markers was studied prospectively in a group of 29 mortician students who were about to take a course in embalming. During the 85-day study period, the subjects performed an average of 6.9 embalmings and had average cumulative formaldehyde exposures of 14.8 ppm-h, with an average air concentration of 1.4 ppm during embalming. Since the average time spent embalming was 125 min, formaldehyde exposures calculated as an 8-h time-weighted average were 0.33 ppm on days when embalmings were done, which was less than the Occupational Safety and Health Administration permissible exposure limit of 0.75 ppm. Epithelial cells from the buccal area of the mouth showed a 12-fold increase in micronucleus frequency during the study period, from 0.046 +/- 0.17/1000 cells preexposure to 0.60 +/- 1.27/1000 cells at the end of the course (P < 0.05). Nasal epithelial micronuclei increased 22%, from 0.41 +/- 0.52/1000 cells to 0.50 +/- 0.67/1000 cells (P = 0.26). In blood cells, the frequency of micronucleated lymphocytes increased 28%, from 4.95 +/- 1.72/1000 cells to 6.36 +/- 2.03/1000 cells (P < 0.05), while sister chromatid exchanges decreased 7.5% (P < 0.05). A dose-response relationship was observed between cumulative exposure to formaldehyde and increases in buccal micronuclei in the 22 male subjects but not in the 7 female subjects. We conclude that low-level exposure to formaldehyde is associated with cytogenetic changes in epithelial cells of the mouth and in blood lymphocytes. These cytogenetic effects may be useful as markers of biologically effective dose.

Adult↗
PubMed1999

Studies of organic residues from ancient Egyptian mummies using high temperature-gas chromatography-mass spectrometry and sequential thermal desorption-gas chromatography-mass spectrometry and pyrolysis-gas chromatography-mass spectrometry.

The techniques of gas chromatography-mass spectrometry (GC-MS) and sequential thermal desorption-gas chromatography-mass spectrometry (TD-GC-MS) and pyrolysis-gas chromatography-mass spectrometry (Py-GC-MS) have been utilised to characterise the constituents of tissue-derived or applied organic material from two Pharaonic Egyptian mummies with a view to identifying embalming practices/substances. The results obtained using TD-GC-MS revealed a series of monocarboxylic acids with the C16:0, C18:1 and C18:0 components dominating in both mummies. The thermal desorption products related to cholesterol, i.e., cholesta-3,5,7-triene and cholesta-3,5-diene (only in Khnum Nakht), were detected in both mummies. Khnum Nakht also contained a number of straight chain alkyl amides (C16-C18) and an alkyl nitrile (C18). Other products included the 2,5-diketopiperazine derivative (DKP) of proline-glycine (pro-gly) which was a major component (7.9%) in Khnum Nakht but only a very minor component in Horemkenesi. Py-GC-MS of samples of both specimens yielded a series of alkene/alkane doublets (Horemkenesi C6-C18, Khnum Nakht C6-C24) which dominated their chromatograms. Series of methyl ketones in the C9-C19 chain length range were also present, with C5-C7 cyclic ketones occurring in Horemkenesi only. These ketones are indicative of covalent bond cleavage, probably of polymerised acyl lipids. Nitrogenous products included nitriles (C9-C18) which were significant in both samples, and amides which were only detected in Khnum Nakht. Also present amongst the pyrolysis products were three steroidal hydrocarbons, cholest-(?)-ene, cholesta-3,5,7-triene and cholesta-3,5-diene. High temperature-GC-MS of trimethylsilylated lipid extracts yielded similar monocarboxylic acids to that obtained using TD-GC-MS, while a series of alpha, omega-dicarboxylic acids and a number of mono- and di-hydroxy carboxylic acids not seen in the thermal desorption or pyrolysis GC-MS analyses were significant constituents in both mummy samples. Overall, the use of GC-MS and sequential TD-GC-MS and Py-GC-MS has demonstrated in both mummies the presence of a complex suite of lipids and proteinaceous components whose compositions indicates extensive alteration via oxidative and hydrolytic processes during long-term interment. None of the classical embalming resins was detected but an exogenous origin for at least a proportion of these components cannot be discounted since fats, oils and gelatin have been proposed as embalming agents in mummification. The combined approach of sequential TD- and Py-GC-MS has potential for application to the characterisation of embalming materials in mummies. Most importantly these techniques virtually eliminate any destruction of the mummified bodies thereby allowing the scope of investigations of ancient Egyptian funerary practices to be significantly extended.

Embalming↗
PubMed1996

Surgical neck fractures of the proximal humerus: a laboratory evaluation of ten fixation techniques.

OBJECTIVE: A biomechanical cadaver study was performed to compare the stability and ultimate strength of ten standard fixation techniques used for the treatment of surgical neck fractures of the proximal humerus. DESIGN: One hundred twenty (60 fresh frozen, 60 embalmed) proximal humerus specimens were selected and divided into two groups: fresh frozen specimens represented a nonosteopenic group and embalmed specimens an osteopenic group. Simulated fractures were created at the level of the surgical neck, reduced, and randomly assigned to one of ten methods of fixation (six fresh frozen and six embalmed specimens per fixation group). These constructs were then mechanically tested with the humeri oriented to create primarily shear loading of the fixation. RESULTS AND CONCLUSIONS: The T-plate and screws provided significantly stronger fixation (p < 0.005) in the fresh frozen specimens than all other methods. The Ender nails/tension band construct was the second strongest fixation technique, providing significantly stronger fixation (p < 0.01) than all the remaining techniques. Four Schanz pins with one pin placed through the greater tuberosity followed by the T-plate and screws provided the strongest fixation in embalmed specimens. Tension band fixation in both humeral groups was shown to provide the least effective fixation.

Biomechanical Phenomena↗