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At least 145 records · Page 8Linked to original sources

PubMed2003

The iliolumbar ligament: its influence on stability of the sacroiliac joint.

STUDY DESIGN: In human specimens the influence of the iliolumbar ligament on sacroiliac joint stability was tested during incremental moments applied to the sacroiliac joints. OBJECTIVES: To assess whether the iliolumbar ligament is able to restrict sacroiliac joint mobility in embalmed cadavers. BACKGROUND: Firstly, the sacroiliac joint can play an important role in non-specific low back pain; hence, its mobility and stability are of special interest. Secondly, the iliolumbar ligament is considered to be an important source of chronic low back pain. Data on a functional relation between the iliolumbar ligament and sacroiliac joint mobility are lacking. METHODS: In 12 human specimens an incremental moment was applied to the sacroiliac joint to induce rotation in the sagittal plane. After the assessment of the relationship between rotation angle and moment in the intact situation, specific parts of the iliolumbar ligaments were transected. After each partial transection the measurements were repeated. RESULTS: Sacroiliac joint mobility in the sagittal plane was significantly increased after a total cut of both iliolumbar ligaments. This increase was in particular due to the transection of a specific part of the iliolumbar ligament, the ventral band. CONCLUSIONS: The main conclusions are: (a) the iliolumbar ligaments restrict sacroiliac joint sagittal mobility; (b) the ventral band of the iliolumbar ligament contributes most to this restriction. RELEVANCE: In embalmed human cadavers, the mobility of the sacroiliac joint increases after sequential cutting of specific parts of the iliolumbar ligaments. It can be expected that severance of this ligament during surgery will lead to increase of mobility and hence loss of stability of the sacroiliac joint. As a consequence adjacent structures will be affected. This may well be a cause of pain in patients with failed back surgery.

Aged↗

PubMed1975

Formaldehyde and paraformaldehyde study in funeral homes.

Formaldehyde is a toxic gas and classed as an upper respiratory irritant. The gas possesses distinctive physiological properties causing symptoms familiar to many formaldehyde workers, such as: burning of the eyes, lacrimation, and general irritation of the upper respiratory passages. To demonstrate this toxic action of formaldehyde a study was conducted in embalming rooms of funeral homes to determine the concentration and its effect on the embalmers at this level. The control measures in these establishments were also evaluated and found to be inadequate in some respects. Paraformaldehyde powders were sized and found to contain a respirable fraction. The results of the study show that these workers verified the fact that formaldehyde is an irritant at levels that are below the present Threshold Limit Value.

Air Pollutants, Occupational↗

PubMed2002

Ultrasound guidance for the psoas compartment block: an imaging study.

UNLABELLED: We conducted this study to develop an ultrasound-guided approach to the psoas compartment and to assess its feasibility and accuracy by means of computed tomography (CT). Two examiners performed ultrasound-guided approaches at three levels (L2-3, L3-4, and L4-5) on 10 embalmed cadavers, which were seated prone. After each needle had been advanced into the psoas compartment under ultrasound guidance, the positions of their tips were computed by using two coordinates (A and B). Subsequently, axial transverse CT scans were made to verify the ultrasound measurements by using the same coordinates. In total, 48 approaches were performed (Examiner 1, n = 20; Examiner 2, n = 28). CT revealed that 47 of 48 ultrasound-guided approaches were performed exactly. In 1 of 48 approaches (L3-4), the tip of the needle was located posterior to the psoas muscle. The median differences between ultrasound and CT coordinates were 0.3 plus minus 0.3 cm for A and 0.2 plus minus 0.3 for B. Kendall's coefficient of concordance was 0.9 (P < 0.001) between ultrasound and CT measurements for both coordinates. These results indicate that ultrasound enables exact needle placement, as proved by CT. We conclude that ultrasound guidance might be a useful adjunct to increase the safety and efficacy of the psoas compartment block at these levels. IMPLICATIONS: We developed an ultrasound-guided approach to the psoas compartment at the levels L2-3, L3-4, and L4-5. Feasibility and accuracy were tested on embalmed cadavers and verified by means of computed tomography. Ultrasound guidance proved to be feasible and accurate for the performance of psoas compartment blocks.

Aged↗

PubMedDate not supplied

Biomechanical evaluation of the dynamic hip screw with two- and four-hole side plates.

OBJECTIVES: To determine the biomechanical strength and stiffness of a dynamic hip screw (DHS; Synthes USA, Paoli, PA, U.S.A.) with a two-hole side-plate as compared with a four-hole side-plate design for the reconstruction of unstable three-part intertrochanteric fractures. DESIGN: Eight matched pairs of embalmed human femurs were tested in two modes: (a) 2,000 cycles of simulated physiologic loading; (b) test to failure. SETTING: Laboratory. Simulated single leg stance using a simulated pelvic loading mechanism with abductor loading. Strain and displacement sensors were used to measure fragment shear and distraction and surface strain in the proximal side plate. SPECIMENS: Eight pairs of skeletonized embalmed cadaveric specimens were selected on the basis of femoral neck angle and absence of old fracture, anatomic anomaly, or pathology. INTERVENTION: The specimens were divided into two groups: (a) left femurs received the two-hole side-plate design; (b) right femurs received the four-hole side-plate design. All fractures were reconstructed by the same surgeon using the manufacturer's instructions. MAIN OUTCOME MEASUREMENTS: Implant placement was verified by radiographic measurement of tip-to-apex distance. In cyclic testing, the amount of femoral neck fragment migration in both distraction and shear was quantified. Strain magnitude in the side plate was measured in both cyclic and failure testing. The peak load withstood by the reconstruction was quantified in the failure test. RESULTS AND CONCLUSIONS: Peak load in the failure test was not found to be statistically different between the two-hole and four-hole designs. In cyclic testing, the two-hole configuration exhibited statistically smaller fragment migration in both shear and distraction than the four-hole design (p < 0.05). The strain magnitude in the side plate was not statistically different in the cyclic or failure tests. The femurs with a greater neck angle failed by crushing of the bone in the neck. The femurs with a lesser neck angle failed due to bending of the hardware. The results of this investigation revealed that the two-hole DHS is biomechanically as stable as the four-hole DHS in cyclic and failure loads under the conditions tested. These results, in concert with clinical experience, can be used to support the use of the two-hole DHS for the reconstruction of intertrochanteric fractures without a diaphyseal extension.

Adult↗

PubMed1994

Clinical implications of the surgical anatomy of the sural nerve.

The exact anatomy of the sural nerve remains important for many clinical situations. To better understand this anatomy, 25 embalmed and 10 fresh cadaver pairs were studied. The origin of the common sural nerve in relation to the fibular head and its medial and lateral sural components were investigated. The lateral sural nerve was absent in 4 percent of the embalmed cadavers. The lateral and medial sural nerves united in the popliteal fossa in 12 percent and in the lower third of the leg in 84 percent of the cadavers. A site was identified where the lateral sural and lateral cutaneous nerve of the calf pierced the deep fascia. This site was centered about the fibular head and may be viewed as a potential site of nerve compression. There is application of these findings to nerve grafting, neuroma prevention and treatment, and sural nerve biopsy.

Humans↗

PubMed1997

The peritoneal free flap: an anatomic study.

In view of a possible clinical application of an isolated microvascular peritoneal flap, an anatomic study was performed in order to determine the peritoneal vascular territory of the deep inferior epigastric artery. For this, the deep inferior epigastric artery was injected unilaterally with Araldite in 30 embalmed cadavers and bilaterally with india ink in 15 fresh cadavers. In 70 percent of the embalmed cadavers, a constant pattern of three branches from the deep inferior epigastric artery could be identified. The peritoneal vascular supply is not derived solely from these three branches but also from multiple small branches sprouting directly from the main stem of the deep inferior epigastric artery and from segmental and muscular branches. Therefore, classification of peritoneal branches arising from the deep inferior epigastric artery seems to be of little clinical importance. In all cases, the india ink injected in the deep inferior epigastric artery colored a similar territory of the parietal peritoneum. Considering the magnitude of the peritoneal vascularization by the deep inferior epigastric artery, implementation of an isolated free or pedicled peritoneal flap seems to be possible. Such a microvascular peritoneal flap vascularized by the deep inferior epigastric artery may be used, for example, for reconstruction of mucosal defects in the head and neck region.

Epigastric Arteries↗

PubMed1996

An anatomic evaluation of L5 nerve stretch in spondylolisthesis reduction.

STUDY DESIGN: Lumbosacral spondylolisthesis was simulated using four embalmed human spines, and the path of the L5 nerve was studied. OBJECTIVES: To quantify the change in length of the L5 nerve root associated with reduction of spondylolisthesis, correction of slip angle, and changing disc height. SUMMARY OF BACKGROUND DATA: Stretch injury to the lumbar nerves remains a complication of spondylolisthesis reduction. To date, no anatomic studies have been performed to quantify this effect of reduction on the lumbar nerves. METHODS: The L5 vertebral body and the sacrum of four embalmed human spines were constrained in an adjustable jig, and the length of a simulated nerve was determined for various position variables--sagittal translation (0-100% slip), slip angle (-40 degrees to +20 degrees), and disc height (5 or 10 mm). Two standard points of reference were chosen to represent fixed points along the path of the L5 nerve. An inelastic cord was used to measure the path length between these points as L5 was reduced from 100% to 0% slip. Testing was performed using a 5-mm and a 10-mm disc height. The effect of varying slip angle alone was also studied. RESULTS: The effect of spondylolisthesis reduction and slip angle correction on nerve length varied depending on the location of L5 with respect to the sacrum. There was an increasing effect of partial reduction on nerve length as L5 approached full reduction. Initially, little strain was produced in the L5 nerve as L5 was reduced in higher grade slips. However, as L5 approached full reduction, the strain per increment of reduction increased rapidly. On average, the mean nerve strain was 4.0% for the first 50% of reduction and 10.0% for the second half of reduction. Increasing lordosis relaxed the nerve in high-grade slips and stretched the nerve in fully reduced slips. At 100% slip, the mean nerve excursion decreased 5.1 mm (nerve slackening) when L5 was rotated from +20 degrees to -40 degrees. At 0% slip, the mean nerve excursion increased 3.1 mm (nerve stretch). Increasing disc height directly stretched the L5 nerve. However, given a larger disc height, the strain on the nerve per increment of reduction was less than for the smaller height. CONCLUSION: The findings suggest that the risk of stretch injury to the L5 nerve with reduction of a high-grade spondylolisthesis is not linear; with 71% of the total L5 nerve strain occurring during the second half of reduction, partial reduction may be a significantly safer treatment approach for high-grade spondylolisthesis than complete reduction. Correction of lumbosacral kyphosis in high-grade spondylolisthesis may be protective of the L5 nerve.

Cadaver↗

PubMed1996

Anatomy of the retroperitoneum: observations of the distribution of pathologic fluid collections.

PURPOSE: To correlate anatomic dissections with clinical observations regarding anatomic distribution of retroperitoneal fluid, and to document the existence of planes that lie between classically described retroperitoneal spaces. MATERIALS AND METHODS: Latex was injected in varying amounts into the pancreatic tail in three fresh cadavers to simulate peripancreatic fluid collections. Spiral computed tomography (CT) was performed of the abdomen and pelvis after each latex injection. Two cadavers were subsequently frozen and sectioned in axial planes; limited dissections were performed on these specimens. One was embalmed and underwent extensive anatomic dissection. Five embalmed, unprepared cadavers were also dissected to confirm observations made in the three prepared cadavers. RESULTS: Latex injected into the tail of the pancreas entered a retromesenteric plane that was posterior to the anterior pararenal space and anterior to the anterior renal fascia. The plane continued superiorly, extending to the diaphragm near the esophageal hiatus; inferiorly, extending to the pelvis along the anterolateral surface of the psoas muscle; and laterally, posterior to the descending colon and its mesentery. The plane also communicated with a retrorenal plane lying between the posterior renal fascia and the posterior pararenal space. CONCLUSION: Embryologic development of the dorsal mesenteries suggests the existence of retromesenteric planes, and clinical observations further support their existence. These findings may explain the observed distribution of retroperitoneal fluid collections from diaphragm to pelvis.

Cadaver↗

PubMedDate not supplied

Gynecomastia in a mortician. A case report.

The fine needle aspiration (FNA) observations in a case of gynecomastia occurring in a mortician are described. The FNA smear showed cytomorphologic features typical of a gynecomastia. Morticians use an embalming cream that contains estrogens or estrogenlike compounds; these substances may be absorbed percutaneously and cause the development of gynecomastia. The mortician should be made aware of the potential risk of such an occupational exposure and development of the "embalmer's curse. "Recognition by the clinicians and cytopathologists of such an occurrence and its implications can help with the proper management.

Adult↗

PubMed1988

The influence of storage temperature and chemical preservation on the stability of succinylcholine in canine tissue.

Succinylcholine (SCh) has been detected six months postmortem in liver, kidney, and injection site muscle of rats given 10 to 200 mg/kg by intramuscular injection. SCh stability was studied in canine tissue to evaluate three storage temperatures and two chemical preservatives at three time periods after injection. Nine mongrel dogs weighing 17.2 to 28 kg were divided equally into three groups and administered either 0.5, 1.0, or 5.0 mg SCh/kg intravenously into the cephalic vein. Liver, kidney, and gastrocnemius muscle were removed 90 min post-injection and divided into twelve portions. Each portion was treated with embalming fluid, physostigmine, the combination (50/50), or nothing. Chemically treated tissues and nontreated tissues were then stored at either 27, 5, or -20 degrees C for a period of up to forty days. Tissue portions were analyzed using ion-pair extraction, chemical demethylation, and gas chromatography with nitrogen phosphorous detection. Stability of SCh was greatest for samples stored at -20 degrees C and preserved with the combination of embalming fluid plus physostigmine. Kidney concentrations of SCh were significantly higher than those in liver or muscle at all doses. SCh was detected 24 h post-injection in all cases. By 40 days, only trace amounts of SCh, if any, could be detected in samples stored at room temperature with no chemical preservatives.

Animals↗

PubMed1998

Brief communication: twentieth-century replication of an Egyptian mummy: implications for paleopathology.

Replication in a modern human cadaver of ancient Egyptian mummification focused on tools used by ancient Egyptian embalmers, the use of natron (a mixture of sodium carbonate, bicarbonate, and chloride) in the preparation of the mummy, surgical procedures in the removal of the viscera and brain, and histologic examination of the viscera. The first three areas have been reported separately (Brier and Wade [1997] ZAS 124:89-100). In this paper, we demonstrate a degree of histologic preservation comparable to that seen in Egyptian mummies, indicating the effectiveness of ancient mummification and that the histologic appearance of such mummies is little altered by the passage of millennia.

Aged↗

PubMed2003

Borate in mummification salts and bones from Pharaonic Egypt.

Mummification processes in Pharaonic Egypt were successful using sodium salts. Quite frequently sodium concentrations in mummified bones ranged from 300 to 4000 micromol/g. In the search for an effective inorganic conservation compound our choice fell on boric acid. The possible presence of borate in mummification salts used in Pharaonic Egypt was of special interest both historically and biochemically. In two salt samples, one from the embalming material of Tutankhamen (18th dynasty, 1336-1327 BC) and the second from Deir el-Bahari (25th dynasty, 700-600 BC) borate was found, amounting to 2.1+/-0.2 and 3.9+/-0.1 micromol/g, respectively. In five of the examined bone fragments from the Junker excavation at Giza (Old Kingdom) similar borate concentrations i.e., 1.2 micromol borate/g bone were seen. It must be emphasized that the usual borate content of contemporary autopsy is far below the detection limit. The elevated borate content in both mummification salt and ancient bone samples support the suggestion that borate-containing salt had been used. There is a striking correlation of both borate concentration and alkaline phosphatase activity. When both sodium salts and borate were essentially absent no activity at all was detectable. With increasing borate concentrations the enzyme activity rises significantly. Attributable to the distinct biochemistry of the tetrahydroxyborate anion it was of interest whether or not borate may stabilize alkaline phosphatase, an important and richly abundant bone enzyme. This enzyme was chosen, as it is known to survive more than 4000 years of mummification. In the presence of borate oligomeric species of this zinc-magnesium-glycoprotein at 400,000 Da became detectable. Attributable to this borate-dependent stabilization of the enzyme molecule a significant temperature resistant increase of the enzymic activity was measured in the presence of up to 2.5 mM borate.

Alkaline Phosphatase↗

PubMed1973

Growth of Hansenula holstii on cadavers.

Growth of a yeast was observed on prosected cadavers used for demonstration purposes in a medical school. An asporogenous yeast was isolated and identified as an atypical form of Hansenula holstii by analysis of the extracellular polysaccharide. The isolate showed resistance to embalming fluid but was eventually eradicated by addition of picloxidine digluconate to the fluid.

Antifungal Agents↗

PubMed2000

[Gold amulets of Ra: a step towards immortality].

In Ancient Egypt, the priest-embalmer laid the gold on the whole of the king's body. For simple citizens, he more modestly applied fine leaves or amulets of golden wax for certain parts. Possessing the same magical powers as gold, they participated in the complete preservation.

Egypt, Ancient↗

PubMed2001

Mummification to plastination. Revisited.

A brief summary of the history of anatomy is presented with particular focus on important scientists who contributed significantly to the development of anatomical education and recognition of anatomy as a discipline of science. An attempt has been made to review the history of preservation of human cadavers from earliest mummification methodology used by ancient Egyptians to the most modern technique of embalming and plastination of human cadavers, developed by Von Hagens during the period from 1979 to 1987. The need for use of modern teaching aids for instruction of topographic anatomy is also highlighted.

Anatomy↗

PubMedDate not supplied

[Neuroscience in ancient Egypt and in the school of Alexandria].

INTRODUCTION: About five thousand years ago, one of the most ancient, important and enduring civilisations in the history of Mankind flourished on the banks of the Nile. In Egypt, all the branches of human knowledge attained a high degree of development and today it is considered the mother of medicine. Despite the marked religious component that affected all its activities, the medicine of the Pharaohs was practised in a rational and deductive manner, and the Egyptians were the inventors of clinical observation. METHOD: The desert climate of the Nile Valley has preserved monuments, mummies and papyruses which have enabled us to get a certain idea of the degree of development reached in medical matters. The aim of this work is to analyse them from a neuroscientific point of view. The anatomical discoveries of the Egyptians originated in the inspection of wounds and the practice of embalming. They came to know a large number of diagnoses and were able to prescribe many different forms of treatment. They also attained a certain proficiency in dealing with neurotraumatological patients. They practised anamnesis, prognostics and a regulated surgery that infrequently included trephination. Their conservatism meant that, after the Macedonian domination, the traditional Egyptian medicine was replaced the Greek medicinal arts, which reached their maximum period of splendour in the School of Alexandria, where Herophilus and Erasistratus, pioneers in the study of anatomy and brain circulation, were especially renowned. CONCLUSIONS: From the point of view of the neurosciences, the Egyptians were the first to describe the brain, migraine, epilepsy, strokes, tetanus, Bell s palsy and the sequelae of head injuries and of spinal transection. Their artwork sometimes shows neurological patients and, according to Herodotus, there were doctors who were specialised in head diseases and could therefore be considered the precursors of our present day neurologists.

Egypt, Ancient↗

PubMed1992

[The preservation of the whole corpse with natural color].

An especially low-odor embalming technique was developed over a 30-years-period using a total of 977 complete cadavers, numerous cadavers after autopsy, and in vitro series of fresh beef. The color, consistency, and transparency of the tissue were very well preserved. The technique met high standards of preservation without releasing harmful substances into the environment. Concentrations of formaldehyde in room air remained under the limit of detection by Dräger capillaries. The efficacy for disinfection of the method was confirmed by bacteriologic tests. None of the cadavers or samples developed molds.

Animals↗

PubMed1984

Preparation of veterinary gross anatomy specimens: a method that allows storage at room temperature for four years.

On the basis of methods used to prepare human anatomic specimens, 2 Yucatan miniature pigs were embalmed over 4 years ago. Results obtained suggest that specimens commonly used in the teaching of veterinary gross anatomy may be fixed in this manner. Advantages include no requirement for refrigeration, superior long-term preservation, less offensive odor, and better tissue texture qualities, including less evidence of dehydration.

Anatomy, Veterinary↗