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Cadavers
Kinds of Cadavers Terms modified by Cadavers Selected AbstractsRobotic Replacement of the Descending Aorta in Human CadaverARTIFICIAL ORGANS, Issue 9 2006Norihiko Ishikawa Abstract:, Robot-assisted replacement of the thoracic aorta was performed in a human cadaver. Temporary shunt bypass was established by inserting a left axillary artery catheter and directing it through the aortic arch toward the right femoral artery through the abdominal aorta. The technique utilized the da Vinci surgical system inserted through the 4-cm supramammary working port and two additional thoracoscopic ports. The working port allowed the introduction of an endoscope, endoscopic instruments, and artificial graft and suture materials. The aorta was dissected using the robotic instruments and was clamped with two transthoracic clamps. After transaction of the aorta, a 20-mm polytetrafluoroethylene graft was cut and an end-to-end anastomosis was then performed with running 3-0 Prolene sutures with robotic instruments. The robotic system provides superior optics and allows for enhanced dexterity. Minimally invasive robotic replacement of the descending aorta is an effective procedure and may add benefits for both surgeon and patients. [source] Commodified Cadavers and the Political Economy of the Spectacle,INTERNATIONAL POLITICAL SOCIOLOGY, Issue 2 2010Renée Marlin-Bennett Traveling anatomy exhibitions import plasticized, posed human cadavers and place them on display. We explore the current industry, its history, and the spectacle of anatomy exhibits. The commodification of cadavers is examined as a problem in global political economy. The absence of global rules identifying plastinated cadavers as human remains allows a globalized plastination and exhibition industry. The spectacle of the exhibitions themselves divert attention away from important moral questions about the proper use of human remains and about the provenance of the cadavers used to create plastinates. The absence of global norms and the distraction of spectacle results in a global regime permitting commodification of cadavers. [source] The influence of greenhouse chrysanthemum on the interaction between the beet armyworm, Spodoptera exigua, and the baculovirus SeMNPV: parameter quantification for a process-based simulation modelJOURNAL OF APPLIED ENTOMOLOGY, Issue 9-10 2001F. J. J. A. Bianchi During the building of a process-based simulation model for the epidemiology of the multicapsid nucleopolyhedrovirus of S. exigua (SeMNPV) in populations of Spodoptera exigua (Hübner) in greenhouse chrysanthemum, it was found that the effect of host plants had been under-rated. ,Missing links' included (i) the ,natural' background mortality of larvae of S. exigua in practical cropping conditions; (ii) the developmental rate of larvae of S. exigua on plant substrate in a glasshouse as compared to artificial medium in the laboratory; (iii) the validity of the results of dose-mortality and time-mortality bioassays conducted on artificial medium as compared to natural plant substrate; (iv) the distribution of inoculum released from deceased caterpillars over chrysanthemum leaves; and (v) the leaf visit rate of healthy caterpillars (as it affects horizontal transmission). Experiments were carried out to quantify these processes. Developmental rates of S. exigua larvae on greenhouse chrysanthemum were 36% lower than on an artificial diet. The fraction survival during the first, second, third and fourth instar S. exigua larvae in greenhouse chrysanthemum was 0.60, 0.80, 0.88 and 0.95, respectively. Forty percent of the first instar larvae reached the fifth larval stage. Second instar S. exigua larvae reared on chrysanthemum were significantly more susceptible to SeMNPV than larvae reared on an artificial diet. The food source had no effect on the time to kill S. exigua larvae. Cadavers of second, third and fourth instar S. exigua larvae contaminated on average 1.4, 2.5 and 3.3 chrysanthemum leaves. Second to fourth instar S. exigua larvae visited 2,3 leaves per day and spent 15,55% of the time on the underside of leaves. The above information is of critical importance for a trustworthy simulation of the epidemiology of SeMNPV in chrysanthemum. [source] Facial Soft Tissue Thicknesses in Australian Adult Cadavers,JOURNAL OF FORENSIC SCIENCES, Issue 1 2006Monica Domaracki B.Sc. ABSTRACT: Craniofacial identification methods heavily rely on the knowledge of average soft tissue depths. This study measured soft tissue thicknesses of an Australian cadaver sample (N=33) using published needle puncture techniques at 13 anatomical locations. Data were compared and contrasted with other studies that used essentially identical samples and methods. Full descriptive statistics were calculated for measurements made in this study and means, medians, and modes were reported. Differences between mean values for males and females were found to be minimal (2.2 mm or less) and considerable overlap was found between the groups. There were no statistically significant differences between the soft tissue depths of the sexes (P>0.05). These findings indicate that differences between male and female soft tissue depths are of little practical significance for craniofacial identification and, therefore, data (means, standard deviations, and sample sizes) reported for Australians were pooled across the sexes and the studies. Although these new pooled means have increased statistical power, data distributions at some landmarks were skewed and thus emphasis is placed on median and modes reported for this study rather than upon the collapsed data means. [source] Use of an Embalming Machine to Create a Central Venous Access Model in Human CadaversACADEMIC EMERGENCY MEDICINE, Issue 2009Lee Wilbur Background:, Human cadavers provide an effective model for procedural training; however, inconsistent blood return during central venous cannulation compromises the overall reliability of this procedure. Objective:, To create and quantitatively assess a human cadaver central venous access model using a continuously-run embalming machine. Curriculum:, Emergency medicine (EM) faculty at Indiana University created this model for a procedure lab designed for EM residents. The right femoral artery was identified by superficial dissection and cannulated distally towards the lower leg. This cannula was connected to a Duotronic embalming machine with a solution composed of 16 oz of 24-index fluid and 3 gallons of tap water at a fixed output of 13 pounds per square inch (psi). Next, the left subclavian vein and artery were identified by dissection and each was cannulated with an 18 gauge angiocath connected to a continuous pressure monitor. Pressures (mmHg) in the subclavian vein and artery were measured continuously while study personnel cannulated the left femoral, right subclavian, right supraclavicular, and right internal jugular veins. This model was assessed for dual sessions lasting two hours each with a two hour break in-between. Results:, During the first session, subclavian pressures were measured at 3 mmHg venous and 22 mmHg arterial, increasing to 11 mmHg venous and 27 mmHg arterial during the second session. Residents were able to withdraw at least 5 milliliters at each central venous site in the embalmed cadaver. Conclusions:, We created a reliable and measurable central venous access model in a fresh-frozen human cadaver using a standard embalming machine. [source] Cadavers, plastinates, and mummiesCLINICAL ANATOMY, Issue 1 2010D. Gareth Jones No abstract is available for this article. [source] Effect of Cog Threads under Rat SkinDERMATOLOGIC SURGERY, Issue 12 2005Hyo Jook Jang MD Background. The aging face loses the tensile strength of structural integrity. Cog threads have been used recently to tighten lax skin and soft tissue. Objective. A comparative study of the effects of cog, monofilament, and multifilament threads under rat skin. Methods. Each cog, monofilament, and multifilament thread was inserted under the facial skin of a cadaver and the panniculus carnosus of rat dorsal skin. The maximum holding strength (MHS) of the thread and the tearing strength of the skin around the thread were measured with a tensiometer. The thickness of the capsule around the thread and the myofibroblasts was observed histologically. Results. In the cadaver, the MHS of the cog thread was 190.7 ± 65.6 g. It was greater than that of the monofilament (22.4 ± 7.7 g) or multifilament (40.4 ± 19.7 g) thread. In the rat, the MHS of the cog thread was 95.1 ± 18.8 g. It was greater than that of the monofilament (4.3 ± 1.3 g) or multifilament (10.9 ± 2.1 g) thread in the second week. The thickness of the capsule around the cog thread was 93.0 ± 3.2 ,m. It was thicker than the monofilament thread's capsule, 39.2 ± 12.1 ,m, in the fourth week. The number of myofibroblasts presented significantly more in the cog (96.0 ± 72.4) than in the monofilament thread (4.3 ± 4.4). The rumpled in-between skin suspended by each of the three different threads returned to its original state in 2 weeks. Conclusion. The cog thread placed under the rat skin immediately pulled the skin and subcutaneous tissue. The myofibroblasts around the thread played a role in fibrous tissue contracture 4 weeks postinsertion of the thread. These findings could be the basis for clinical application. THIS STUDY WAS SUPPORTED BY A GRANT FROM THE KOREA HEALTH 21 R&D PROJECT, MINISTRY OF HEALTH AND WELFARE, REPUBLIC OF KOREA. [source] An Evaluation of a Blind Rotational Technique for Selective Mainstem IntubationACADEMIC EMERGENCY MEDICINE, Issue 10 2004Aaron E. Bair MD Abstract Objectives: Although rare, massive hemoptysis and major bronchial disruptions are associated with high mortality. Selective ventilation of the uninvolved lung can increase the likelihood of survival. Specialized devices used for single lung ventilation are often not readily available and can be difficult to place in the emergency department. The authors evaluated a blind rotational technique for selective mainstem intubation using either a standard endotracheal tube (ET) or a directional-tip endotracheal tube (DTET). Methods: This was a prospective, randomized trial on 25 human cadavers. The desired side of mainstem intubation was determined by randomization. Each cadaver was used for four ET, four DTET, and four control intubations. In the ET group, the trachea was intubated. The tube was then rotated 90° in the direction of the desired placement and advanced until resistance was met. In the DTET group, the technique was identical, except the trigger was activated to flex the tip during advancement. In the control group, an ET was advanced in neutral alignment until resistance was met. A bronchoscopist blinded to the desired placement determined tube position. Comparison testing was performed using Pearson's chi-square test. Results: When attempting to intubate the left mainstem, use of the ET with the rotational technique was successful 72.3% of the time (95% confidence interval [95% CI] = 57% to 84%). Intubation of the left mainstem using the DTET was successful 68.5% of the time (95% CI = 54% to 81%; p = 0.67). Attempts to selectively intubate the right mainstem using the rotational technique were highly successful in both groups: 94% for the ET (95% CI = 84% to 99%) versus 97.8% for the DTET (95% CI = 89% to 100%). Among controls, the right mainstem was intubated 93% of the time (95% CI = 86% to 97%). Conclusions: In a cadaveric model, the left mainstem bronchus can be selectively intubated with moderate reliability using this rotational technique. Use of a DTET confers no significant advantage. The ability to generalize these findings to living subjects is unknown. [source] Development of equine upper airway fluid mechanics model for Thoroughbred racehorsesEQUINE VETERINARY JOURNAL, Issue 3 2008V. RAKESH Summary Reason for performing study: Computational fluid dynamics (CFD) models provide the means to evaluate airflow in the upper airways without requiring in vivo experiments. Hypothesis: The physiological conditions of a Thoroughbred racehorse's upper airway during exercise could be simulated. Methods: Computed tomography scanned images of a 3-year-old intact male Thoroughbred racehorse cadaver were used to simulate in vivo geometry. Airway pressure traces from a live Thoroughbred horse, during exercise was used to set the boundary condition. Fluid-flow equations were solved for turbulent flow in the airway during inspiratory and expiratory phases. The wall pressure turbulent kinetic energy and velocity distributions were studied at different cross-sections along the airway. This provided insight into the general flow pattern and helped identify regions susceptible to dynamic collapse. Results: The airflow velocity and static tracheal pressure were comparable to data of horses exercising on a high-speed treadmill reported in recent literature. The cross-sectional area of the fully dilated rima glottidis was 7% greater than the trachea. During inspiration, the area of highest turbulence (i.e. kinetic energy) was in the larynx, the rostral aspect of the nasopharynx was subjected to the most negative wall pressure and the highest airflow velocity is more caudal on the ventral aspect of the nasopharynx (i.e. the soft palate). During exhalation, the area of highest turbulence was in the rostral and mid-nasopharynx, the maximum positive pressure was observed at the caudal aspect of the soft palate and the highest airflow velocity at the front of the nasopharynx. Conclusions and clinical relevance: In the equine upper airway collapsible area, the floor of the rostral aspect of the nasopharynx is subjected to the most significant collapsing pressure with high average turbulent kinetic during inhalation, which may lead to palatal instability and explain the high prevalence of dorsal displacement of the soft palate (DDSP) in racehorses. Maximal abduction of the arytenoid cartilage may not be needed for optimal performance, since the trachea cross-sectional area is 7% smaller than the rima glottidis. [source] New insights in the vascular supply of the human parotid gland,Consequences for parotid gland-sparing irradiationHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 7 2010Marjolein J. van Holten MD Abstract Background. Xerostomia is caused by irradiation for head and neck cancer, depending on the dose to the parotid gland. To investigate which part of the parotid gland has to be spared with radiotherapy, detailed information about the vascular supply of the parotid gland is necessary. Methods. Arterial vessels of the head of a human cadaver were colored. A 3-dimensional reconstruction of the parotid gland and the arterial vessels was made and analyzed. Results. Five arterial vessels were responsible for the vascular supply of the parotid gland: the posterior auricular artery, 2 branches so far unnamed, the superficial temporal artery, and the transverse facial artery. All arteries were branches off the external carotid artery, and supplied different parts of the parotid gland. Conclusions. This study describes the detailed vascular supply of the human parotid gland. These results may contribute to improve parotid sparing radiotherapy, thus reducing complications such as xerostomia in the future. © 2009 Wiley Periodicals, Inc. Head Neck, 2009 [source] Host behaviour and exposure risk in an insect,pathogen interactionJOURNAL OF ANIMAL ECOLOGY, Issue 4 2010Benjamin J. Parker Summary 1.,Studies of variability in host resistance to disease generally emphasize variability in susceptibility given exposure, neglecting the possibility that hosts may vary in behaviours that affect the risk of exposure. 2.,In many insects, horizontal transmission of baculoviruses occurs when larvae consume foliage contaminated by the cadavers of virus-infected conspecific larvae; so, host behaviour may have a strong effect on the risk of infection. 3.,We studied variability in the behaviour of gypsy moth (Lymantria dispar) larvae, which are able to detect and avoid virus-contaminated foliage. 4.,Our results show that detection ability can be affected by the family line that larvae originate from, even at some distance from a virus-infected cadaver, and suggest that cadaver-detection ability may be heritable. 5.,There is thus the potential for natural selection to act on cadaver-detection ability, and thereby to affect the dynamics of pathogen-driven cycles in gypsy moth populations. 6. We argue that host behaviour is a neglected component in studies of variability in disease resistance. [source] Using Ninhydrin to Detect Gravesoil,JOURNAL OF FORENSIC SCIENCES, Issue 2 2008David O. Carter Ph.D. Abstract:, Some death scene investigations commence without knowledge of the location of the body and/or decomposition site. In these cases, it is necessary to locate the remains or the site where the body decomposed prior to movement. We hypothesized that the burial of a mammalian cadaver will result in the release of ninhydrin reactive nitrogen (NRN) into associated soil and that this reaction might have potential as a tool for the identification of clandestine graves. Juvenile rat (Rattus rattus) cadavers were buried in three contrasting soil types in Australian tropical savanna ecosystems and allowed to decompose over a period of 28 days. Soils were sequentially harvested and analyzed for NRN. Cadaver burial resulted in an approximate doubling (mean = 1.7 ± 0.1) in the concentration of soil NRN. This reaction has great potential to be used as a presumptive test for gravesoil and this use might be greatly enhanced following more detailed research. [source] Sequential Monitoring of Burials Containing Large Pig Cadavers Using Ground-Penetrating RadarJOURNAL OF FORENSIC SCIENCES, Issue 3 2006John J. Schultz Ph.D. ABSTRACT: Ground-penetrating radar (GPR) was used to monitor 12 pig burials in Florida, each of which contained a large pig cadaver. Six of the cadavers were buried in sand at a depth of 0.50,0.60 m, and the other six were buried at a depth of 1.00,1.10 m and were in contact with the upper surface of a clay horizon. Control excavations with no pig internment were also constructed as blank graves and monitored with GPR. The burials were monitored with GPR for durations of either 12,13 or 21,21.5 months when they were then excavated to correlate the decomposition state of the cadaver with the GPR imagery. Overall, cadavers in sand were easily detected for the duration of this study at 21.5 months, even when completely skeletonized. Conversely, in clay it became increasingly difficult to image the pig cadavers over the first year of burial, even when they still retained extensive soft tissue structures. [source] Horizontal transmission of Beauveria bassiana (Bals.) VuillAGRICULTURAL AND FOREST ENTOMOLOGY, Issue 1 2000David W. Long Summary 1 Factors influencing horizontal transmission of the entomopathogen Beauveria bassiana in the Colorado potato beetle (CPB) were examined through a series of laboratory studies. 2 Cadaver density, cadaver life stage, ambient temperature and conidial density were the factors manipulated. 3 Mortality and sporulation of burrowing CPB prepupae both increased significantly with increased sporulating second-instar cadaver density on the soil surface. 4 Mortality rates were significantly higher when prepupae were released into laboratory arenas containing third-instar cadavers compared to second-instar cadavers. 5 Mortality and sporulation decreased significantly as temperature increased from 15 °C to 30 °C, however, no temperature-dependent behavioural response by prepupae could be identified as a potential cause. 6 An 86.1% decrease in conidial density per cadaver had no significant effect on mortality or sporulation of prepupae, indicating that this level of environmental degradation of cadavers may not significantly reduce the probability of horizontal transmission. [source] Cranial cruciate stabilitv in the rottweiler and racing greyhound: an in vitro studyJOURNAL OF SMALL ANIMAL PRACTICE, Issue 5 2000C. Wingfield An in vitro biomechanical study of cadaver stifles from rottweilers and racing greyhounds was undertaken to evaluate the contribution of the cranial cruciate ligament to stifle joint stability. This was performed at differing stifle joint angles, first with the joint capsules and ligaments intact and then with all structures removed except for the cranial cruciate ligament. Craniocaudal laxity increased in both breeds as stifle flexion increased. The rottweiler stifle showed greater craniocaudal joint laxity than the racing greyhound at all joint angles between 150° and 110°, but the actual increases in joint laxity between these joint angles were similar for both breeds. Tibial rotation during craniocaudal loading of the stifle increased craniocaudal laxity in both breeds during joint flexion. The relative contribution of the cranial cruciate ligament to cranial stability of the stifle joint increased as the joint flexed and was similar in both breeds. [source] Assessment of a New Model for Femoral Ultrasound-guided Central Venous Access Procedural Training: A Pilot StudyACADEMIC EMERGENCY MEDICINE, Issue 1 2010Michael C. Wadman MD Abstract Objectives:, Repetitive practice with feedback in residency training is essential in the development of procedural competency. Lightly embalmed cadaver laboratories provide excellent simulation models for a variety of procedures, but to the best of our knowledge, none describe a central venous access model that includes the key psychomotor feedback elements for the procedure, namely intravascular contents that allow for determination of correct needle position by either ultrasonographic imaging and/or aspiration or vascular contents. Methods:, A cadaver was lightly embalmed using a technique that preserves tissue texture and elasticity. We then performed popliteal fossa dissections exposing the popliteal artery and vein. Vessels were ligated distally, and 14-gauge catheters were introduced into the lumen of each artery and vein. The popliteal artery and vein were then infused with 200 mL of icterine/gel and 200 mL of methylene blue/gel, respectively. Physician evaluators then performed ultrasound (US)-guided femoral central venous line placements and rated the key psychomotor elements on a five-point Likert scale. Results:, The physician evaluators reported a median of 10.5 years of clinical emergency medicine (EM) experience with an interquartile range (IQR) of 16 and a median of 10 central lines placed annually (IQR = 10). Physician evaluators rated the key psychomotor elements of the simulated procedure as follows: ultrasonographic image of vascular elements, 4 (IQR = 0); needle penetration of skin, 4.5 (IQR = 1); needle penetration of vein, 5 (IQR = 1); US image of needle penetrating vein, 4 (IQR = 2); aspiration of vein contents, 3 (IQR = 2); passage of dilator into vein, 4 (IQR = 2); insertion of central venous catheter, 5 (IQR = 1); US image of catheter insertion into vein, 5 (IQR = 1); and overall psychomotor feedback of the simulated procedure compared to the evaluators' actual patient experience, 4 (IQR = 1). Conclusions:, For the key psychomotor elements of central venous access, the lightly embalmed cadaver with intravascular water-soluble gel infusion provided a procedural model that closely simulated clinicians' experience with patients. ACADEMIC EMERGENCY MEDICINE 2010; 17:88,92 © 2009 by the Society for Academic Emergency Medicine [source] Minimal Illumination for Direct Laryngoscopy and Intubation in Different Ambient Light SettingsACADEMIC EMERGENCY MEDICINE, Issue 1 2010FRCPC, Ka Wai Cheung MD Abstract Objectives:, This study sought to investigate the minimal laryngoscope illumination required for proper laryngoscopy and intubation in different ambient light settings as determined by paramedics. Methods:, Paramedics qualified to intubate patients in the field were recruited to intubate a cadaver embalmed with a minimal fixation technique designed to maintain tissue integrity. All paramedic participants intubated the cadaver under three different ambient light settings representing possible out-of-hospital settings: an outdoor night setting, an indoor setting, and an outdoor day setting. Paramedics were asked to determine the minimal illumination required for intubation of the cadaver under each of these settings. Results:, Twenty-three paramedics participated in the study. The mean (±SD) minimal illumination required for intubation was 39.1 (±35.4) lux at the night setting, 92.5 (±57.3) lux at the indoor setting, and 209.7 (±117.4) lux at the day setting. There was a statistically significant difference in minimal illumination required between each of the three light settings (p < 0.0001). Conclusions:, Minimal illumination requirements in the out-of-hospital setting may be lower than previously recommended. Ambient light intensity affects this minimal illumination requirement, with brighter ambient light conditions necessitating more laryngoscope light output. Further studies assessing out-of-hospital laryngoscope illumination should consider ambient light conditions. ACADEMIC EMERGENCY MEDICINE 2010; 17:103,107 © 2010 by the Society for Academic Emergency Medicine [source] Mutualism and pathogenesis in Xenorhabdus and Photorhabdus: two roads to the same destinationMOLECULAR MICROBIOLOGY, Issue 2 2007Heidi Goodrich-Blair Summary Photorhabdus and Xenorhabdus bacteria colonize the intestines of the infective soil-dwelling stage of entomophagous nematodes, Heterorhabditis and Steinernema, respectively. These nematodes infect susceptible insect larvae and release the bacteria into the insect blood. The bacteria kill the insect larvae and convert the cadaver into a food source suitable for nematode growth and development. After several rounds of reproduction the nematodes are recolonized by the bacteria before emerging from the insect cadaver into the soil to search for a new host. Photorhabdus and Xenorhabdus bacteria therefore engage in both pathogenic and mutualistic interactions with different invertebrate hosts as obligate components of their life cycle. In this review we aim to describe current knowledge of the molecular mechanisms utilized by Photorhabdus and Xenorhabdus to control their host-dependent interactions. Recent work has established that there is a trade-off between pathogenicity and mutualism in both these species of bacteria suggesting that the transition between these interactions must be under regulatory control. Despite the superficial similarity between the life cycles of these bacteria, it is now apparent that the molecular components of the regulatory networks controlling pathogenicity and mutualism in Photorhabdus and Xenorhabdus are very different. [source] The Surgical Anatomy of Lumbar Medial Branch Neurotomy (Facet Denervation)PAIN MEDICINE, Issue 3 2004Peter Lau FRACR ABSTRACT Objective., To demonstrate the validity of placing electrodes parallel to the target nerve in lumbar radiofrequency neurotomy. DESIGN., Previous data on the anatomy of the lumbar dorsal rami were reviewed and a demonstration cadaver was prepared. Under direct vision, electrodes were placed on, and parallel to, the L4 medial branch and the L5 dorsal ramus. Photographs were taken to record the placement, and radiographs were taken to illustrate the orientation and location of the electrode in relation to bony landmarks. Results., In order to lie in contact with, and parallel to, the target nerve, electrodes need to be inserted obliquely from below, so that their active tip crosses the neck of the superior articular process. At typical lumbar levels, the tip should lie opposite the middle two quarters of the superior articular process. At the L5 level, it should lie opposite the middle and posterior thirds of the S1 superior articular process. Conclusion., If electrodes are placed parallel to the target nerve, the lesions made can be expected to encompass the target nerves. If electrodes are placed perpendicular to the nerve, the nerve may escape coagulation, or be only partially coagulated. Placing the electrode parallel to the nerve has a demonstrated anatomical basis, and has been vindicated clinically. Other techniques lack such a basis, and have not been vindicated clinically. Suboptimal techniques may underlie suboptimal outcomes from lumbar medial branch neurotomy. [source] Allograft diabetic nephropathy may progress to end-stage renal diseasePEDIATRIC TRANSPLANTATION, Issue 4 2004Moro O. Salifu Abstract:, Mesangial expansion and glomerular basement membrane thickening characteristic of diabetic nephropathy recur in diabetic recipients of renal allografts from non-diabetic donors but progression to renal failure is minimally documented. Three female renal allograft recipients (aged 40, 62 and 73 yr), who developed end-stage renal disease (ESRD) due to recurrent diabetic nephropathy (two patients) and de novo diabetes (one patient) are reported. Onset of proteinuria, uncontrolled hypertension, azotemia, renal allograft pathologic findings and the need for hemodialysis were analyzed. None of the kidney donors (one cadaver, two living related) had known diabetes or perturbed glucose metabolism pre-transplantation. The three patients presented had different varieties of diabetes; type 1, type 2 and new onset diabetes after transplantation (NODAT). In each subject, proteinuria was detected by dipstick at a mean of 8.3 yr (range 8,9) post-transplantation and increased to the nephrotic range (3.7,4.8 g/day) inducing hypoalbuminemia and azotemia. A histopathologic diagnosis of allograft diabetic nephropathy was made in a mean of 11.7 yr (range 10,14), based on glomerular basement membrane thickening, nodular and diffuse intercapillary glomerulosclerosis, arteriolosclerosis, and tubular atrophy with marked tubular basement membrane thickening characteristic of advanced diabetic nephropathy. All three patients manifested uremia and resumed hemodialysis. Two patients died from sepsis within 2 months and one patient died 2.5 yr later after resumption of maintenance hemodialysis. We infer that recurrent or de novo diabetic nephropathy in renal allografts follows a clinical decade-long course irrespective of diabetes. Reports of ESRD due to allograft diabetic nephropathy (ADN) have been limited because of shorter survival of diabetic transplant recipients and few kidney biopsies performed in patients with chronic allograft dysfunction. The occurrence of allograft diabetic nephropathy in some, but not all patients, however, suggests that individual genetic variability modulates disease expression. [source] Mycophenolate mofetil without antibody induction in cadaver vs. living donor pediatric renal transplantationPEDIATRIC TRANSPLANTATION, Issue 2 2003O. Ojogho Abstract: Mycophenolate mofetil (MMF) is a new immunosuppressive agent that blocks de novo purine synthesis in T and B lymphocytes via a potent selective inhibition of inosine monophosphate dehydrogenase. MMF has been shown to significantly reduce the incidence of acute rejection in both adult and pediatric renal transplantation. The impact of MMF on routine antibody induction therapy in pediatric renal transplantation has not been defined. Remarkably, a recent North American Pediatric Transplant Cooperative Study concluded that T-cell antibody induction therapy was deleterious for patients who received MMF. Our study examines the use of MMF in an evolving immunosuppressive strategy to avoid antibody induction in both living (LD) and cadaver (CAD) donor pediatric renal transplantation. We retrospectively analyzed the records of 43 pediatric renal transplants that received MMF-based triple therapy without antibody induction therapy between November 1996 and April 2000. We compared CAD (n = 17) with LD (n = 26). The two groups were similar demographically except that CAD had significantly younger donors than LD, 26.1 ± 13.7 vs. 36.2 ± 9.2 yr (p = 0.006). All the patients received MMF at 600 mg/m2/b.i.d. (maximum dose of 2 g/d) and prednisone with cyclosporine (86%) or tacrolimus (14%). Mean follow-up was >36 months for each group. Acute rejection rate at 6 months was 11.8% (CAD) vs. 15.4% (LD) (p = 0.999) and at 1 yr was 23.5% (CAD) vs. 26.9% (LD) (p = 0.999). Mean estimated glomerular filtration rate (ml/min/1.73 m2) at 6 months was 73.3 ± 15.3 (CAD) vs. 87.6 ± 24.2 (LD) (p = 0.068). Patient survival at 1, 2, and 3 yr was 100, 100, and 100% for CAD vs. 100, 96, and 96% for LD, respectively. Graft survival at 1, 2, and 3 yr was 100, 100, and 94% for CAD vs. 96, 88, and 71% for LD, respectively. Graft loss in CAD was because of chronic rejection (n = 2) while in LD it was because of non-compliance (n = 6), post-transplant lymphoproliferative disorder (n = 1), and sepsis (n = 1). In conclusion, MMF without antibody induction in both CAD and LD pediatric renal transplantation provides statistically similar and effective prophylaxis against acute rejection at 6 months and 1 yr post-transplant. The short-term patient and graft survival rates are excellent, however, non-compliance remains a serious challenge to long-term graft survival. Additional controlled studies are needed to define the role of MMF without antibody induction therapy in pediatric renal transplantation. [source] Development of an anatomically based whole-body musculoskeletal model of the Japanese macaque (Macaca fuscata)AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY, Issue 3 2009Naomichi Ogihara Abstract We constructed a three-dimensional whole-body musculoskeletal model of the Japanese macaque (Macaca fuscata) based on computed tomography and dissection of a cadaver. The skeleton was modeled as a chain of 20 bone segments connected by joints. Joint centers and rotational axes were estimated by joint morphology based on joint surface approximation using a quadric function. The path of each muscle was defined by a line segment connecting origin to insertion through an intermediary point if necessary. Mass and fascicle length of each were systematically recorded to calculate physiological cross-sectional area to estimate the capacity of each muscle to generate force. Using this anatomically accurate model, muscle moment arms and force vectors generated by individual limb muscles at the foot and hand were calculated to computationally predict muscle functions. Furthermore, three-dimensional whole-body musculoskeletal kinematics of the Japanese macaque was reconstructed from ordinary video sequences based on this model and a model-based matching technique. The results showed that the proposed model can successfully reconstruct and visualize anatomically reasonable, natural musculoskeletal motion of the Japanese macaque during quadrupedal/bipedal locomotion, demonstrating the validity and efficacy of the constructed musculoskeletal model. The present biologically relevant model may serve as a useful tool for comprehensive understanding of the design principles of the musculoskeletal system and the control mechanisms for locomotion in the Japanese macaque and other primates. Am J Phys Anthropol, 2009. © 2008 Wiley-Liss, Inc. [source] Adaptations to humeral torsion in medieval BritainAMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY, Issue 2 2006Jill A. Rhodes Abstract Adaptations to the humeral torsion angle have been identified in the professional throwing athlete. This movement pattern increases the humeral torsion angle, and also increases the extent of external rotation movements in the dominant, throwing limb when compared with the nondominant limb. The purpose of this paper is to test the hypothesis that the humeral torsion angle is an adaptation to upper limb use. This project examines the humeral torsion angle in a number of medieval British populations, as well as a modern cadaver-based sample. The results identify significant differences in the humeral torsion angle both between and within male (P < 0.001, ANOVA) and female (P < 0.014, ANOVA) populations, although the results are not consistent with expected behavior patterns. Statistically significant differences between males and females within the same site were identified in 2 of the 5 samples examined. The mean level of bilateral asymmetry does not approach that reported for the professional throwing athlete. However, a number of individuals have high levels of asymmetry in excess of that identified in the professional throwing athlete. This analysis demonstrates the need for individual rather than population-based analyses, as the heterogeneity within population samples obscures individual variation in activity patterns. The diversity within British medieval society and a lack of specific known behaviors prevent further identification of the functional significance of the humeral torsion angle within the archaeological record examined here. Am J Phys Anthropol, 2006. © 2005 Wiley-Liss, Inc. [source] Target registration and target positioning errors in computer-assisted neurosurgery: proposal for a standardized reporting of error assessmentTHE INTERNATIONAL JOURNAL OF MEDICAL ROBOTICS AND COMPUTER ASSISTED SURGERY, Issue 4 2009Gerlig Widmann Abstract Background Assessment of errors is essential in development, testing and clinical application of computer-assisted neurosurgery. Our aim was to provide a comprehensive overview of the different methods to assess target registration error (TRE) and target positioning error (TPE) and to develop a proposal for a standardized reporting of error assessment. Methods A PubMed research on phantom, cadaver or clinical studies on TRE and TPE has been perfomed. Reporting standards have been defined according to (a) study design and evaluation methods and (b) specifications of the navigation technology. Results The proposed standardized reporting includes (a) study design (controlled, non-controlled), study type (non-anthropomorphic phantom, anthropomorphic phantom, cadaver, patient), target design, error type and subtypes, space of TPE measurement, statistics, and (b) image modality, scan parameters, tracking technology, registration procedure and targeting technique. Conclusions Adoption of the proposed standardized reporting may help in the understanding and comparability of different accuracy reports. Copyright © 2009 John Wiley & Sons, Ltd. [source] Pterygopalatine Fossa Infiltration Through the Greater Palatine Foramen: Where to Bend the NeedleTHE LARYNGOSCOPE, Issue 7 2006FRACP, FRACS, Richard Douglas MD Abstract Objective: In the literature, there has been controversy regarding the length of the greater palatine canal. If the pterygopalatine fossa is infiltrated in an attempt to reduce bleeding during sinus surgery, this information is important to be able to place local anesthetic with maximal effect and the least likelihood of complications. Study Design: The authors conducted a prospective cadaver-based study using high-definition computed tomography (CT) scans. Methods: Twenty-two cadaver heads were CT scanned and the greater palatine canal length, pterygopalatine fossa height, and thickness of the soft tissue in the roof of the mouth were measured on parasagittal images using the CT scanner workstation. Results: The mean length of the greater palatine canal was 18.5 mm (95% confidence interval [CI] = 17.9,19.1) and the mean height of the pterygopalatine fossa was 21.6 mm (95% CI = 20.7,22.5). The mean thickness of the soft tissue in the roof of the mouth overlying the foramen of the greater palatine canal was 6.9 mm (95% CI = 6.2,7.6). Conclusion: To perform an effective infiltration of the pterygopalatine fossa, the needle should be bent at 25 mm from the tip at an angle of 45°. [source] Assessment of Intraoperative Safety in Transoral Robotic Surgery,THE LARYNGOSCOPE, Issue 2 2006Neil G. Hockstein MD Abstract Introduction: Robotic technology has been safely integrated into thoracic and abdominopelvic surgery, and the early experience has been very promising with very rare complications related to robotic device failure. Recently, several reports have documented the technical feasibility of transoral robotic surgery (TORS) with the daVinci Surgical System. Proposed pharyngeal and laryngeal applications include radical tonsillectomy, base-of-tongue resection, supraglottic laryngectomy, and phonomicrosurgery. The safety of transoral placement of the robotic endoscope and instruments has not been established. Potential risks specific to the transoral use of the surgical robot include facial skin laceration, tooth injury, mucosal laceration, mandible fracture, cervical spine fracture, and ocular injury. We hypothesize that these particular risks of transoral surgery are similar with robotic assistance compared with conventional transoral surgery. Methods: To test this hypothesis, we attempted to intentionally injure a human cadaver with the daVinci Surgical System by impaling the facial skin and pharyngeal and laryngeal mucosa with the robotic instruments and endoscope. We also attempted to extract or fracture teeth and fracture the cadaver's mandible and cervical spine by applying maximal pressure and torque with the robotic arms. Experiments were documented with still and video photography. Results: Impaling the cadaver's skin and mucosa resulted in only superficial lacerations. Tooth, mandible, and cervical spine fracture could not be achieved. Conclusions: Initial experiments performing TORS on a human cadaver with the daVinci Surgical System demonstrate a safety profile similar to conventional transoral surgery. Additionally, we discuss several strategies to increase patient safety in TORS. [source] Computed Tomographic, Magnetic Resonance Imaging, and Cross-Sectional Anatomic Features of the Manus in a Normal American Black Bear (Ursus americanus)ANATOMIA, HISTOLOGIA, EMBRYOLOGIA, Issue 3 2010C. P. Ober With 11 figures and 1 table Summary The purpose of this study was to provide a detailed description of cross-sectional anatomic structures of the manus of a black bear cadaver and correlate anatomic findings with corresponding features in computed tomographic (CT) and magnetic resonance (MR) images. CT, MR imaging, and transverse sectioning were performed on the thoracic limb of a cadaver female black bear which had no evidence of lameness or thoracic limb abnormality prior to death. Features in CT and MR images corresponding to clinically important anatomic structures in anatomic sections were identified. Most of the structures identified in transverse anatomic sections were also identified using CT and MR imaging. Bones, muscles and tendons were generally easily identified with both imaging modalities, although divisions between adjacent muscles were rarely visible with CT and only visible sometimes with MR imaging. Vascular structures could not be identified with either imaging modality. [source] Non-Rotated Midgut in a DogANATOMIA, HISTOLOGIA, EMBRYOLOGIA, Issue 1 2009E. J. Kirk Summary Macroscopic observations of the partly-dissected abdomen of the preserved cadaver of a Labrador bitch were recorded and photographs taken. Neither the duodenum nor the colon looped around the root of the great (jejuno-ileal) mesentery, but both were long enough to have done so. The abdominal organs appeared to be otherwise normal, as did the other parts of the body. The condition appeared to have resulted from non-rotation of the midgut during embryonic development and to have no adverse effect on the animal. [source] Lumbrical muscle with an additional origin in the forearmANZ JOURNAL OF SURGERY, Issue 5 2001Gurmit Singh Background: Although variations in the attachments of the lumbrical muscles have been commonly reported, these have been seen mainly in the Caucasian population. The present study is the first reported case of such an anomaly in a Chinese cadaver in the literature. Methods: The upper extremities of 26 Chinese (23 male and three female) cadavers were examined. Results: Dissection of a male 66-year-old Chinese cadaver has revealed the rare case of a bipennate first lumbrical muscle with an additional origin extending from the distal part of the forearm. Its first origin arose from the flexor digitorum profundus in the hand distal to the flexor retinaculum. The intrinsic muscles in the hands of all the other cadavers were normal. Conclusions: An anomalous origin of the lumbrical from muscles in the forearm has the potential to cause compression of the median nerve in the carpal tunnel. [source] Robotic Replacement of the Descending Aorta in Human CadaverARTIFICIAL ORGANS, Issue 9 2006Norihiko Ishikawa Abstract:, Robot-assisted replacement of the thoracic aorta was performed in a human cadaver. Temporary shunt bypass was established by inserting a left axillary artery catheter and directing it through the aortic arch toward the right femoral artery through the abdominal aorta. The technique utilized the da Vinci surgical system inserted through the 4-cm supramammary working port and two additional thoracoscopic ports. The working port allowed the introduction of an endoscope, endoscopic instruments, and artificial graft and suture materials. The aorta was dissected using the robotic instruments and was clamped with two transthoracic clamps. After transaction of the aorta, a 20-mm polytetrafluoroethylene graft was cut and an end-to-end anastomosis was then performed with running 3-0 Prolene sutures with robotic instruments. The robotic system provides superior optics and allows for enhanced dexterity. Minimally invasive robotic replacement of the descending aorta is an effective procedure and may add benefits for both surgeon and patients. [source] | |||||||||||||||||||