Body Donation Research Articles

Breaking strength and bone microarchitecture in osteoporosis: a biomechanical approximation based on load tests in 104 human vertebrae from the cervical, thoracic, and lumbar spines of 13 body donors

BackgroundThe purpose of the study was to investigate associations between biomechanical resilience (failure load, failure strength) and the microarchitecture of cancellous bone in the vertebrae of human cadavers with low bone density with or without vertebral fractures (VFx).MethodsSpines were removed from 13 body donors (approval no. A 2017-0072) and analyzed in regard to bone mineral density (BMD), Hounsfield units (HU), and fracture count (Fx) with the aid of high-resolution CT images. This was followed by the puncture of cancellous bone in the vertebral bodies of C2 to L5 using a Jamshidi™ needle. The following parameters were determined on the micro-CT images: bone volume fraction (BVF), trabecular thickness (Tb.Th), trabecular separation (Tb.Sp), degree of anisotropy (DA), trabecular number (Tb.N), trabecular pattern factor (Tb.Pf), and connectivity density (Conn.D). The axial load behavior of 104 vertebral specimens (C5, C6, T7, T8, T9, T12, L1, L3) was investigated with a servohydraulic testing machine.ResultsIndividuals with more than 2 fractures had a significantly lower trabecular pattern factor (Tb.Pf), which also proved to be an important factor for a reduced failure load in the regression analysis with differences between the parts of the spine. The failure load (FL) and endplate sizes of normal vertebrae increased with progression in the craniocaudal direction, while the HU was reduced. Failure strength (FS) was significantly greater in the cervical spine than in the thoracic or lumbar spine (p < 0.001), independent of sex. BVF, Tb.Th, Tb.N, and Conn.D were significantly higher in the cervical spine than in the other spinal segments. In contrast, Tb.Sp and Tb.Pf were lowest in the cervical spine. BVF was correlated with FL (r = 0.600, p = 0.030) and FS (r = 0.763, p = 0.002). Microarchitectural changes were also detectable in the cervical spine at lower densities.ConclusionsDue to the unique microarchitecture of the cervical vertebrae, fractures occur much later in this region than they do in the thoracic or lumbar spine.Trial registrationApproval no. A 2017-0072.

Questionnaire-based study evaluating awareness for organ and body donation and cadaveric dissection among the general population attending mid Gujarat region

Introduction: Organ transplantation provides benefits to society as a whole as well as to the individuals who receive transplants. However, the success of transplantation for end-stage organ failure is limited due to the availability of suitable organs for transplant Public awareness is critical for the development of donation program. Methods: Total 200 adult participants were included in the studies from outpatient department by consecutive sampling method. A self-administered semi structured questionnaire was filled by participants in the presence of researchers. Results: Awareness of organ donation (67.5%) was higher than awareness of body donation (34.5%) and cadaveric dissection (32.5%). About 28% and 24% participants were aware of live organ donation and brain death. Willingness for organ donation was observed 21.5% participants, unwillingness in 51.5% of participants and 27.0% in undecided state of mind. Conclusion: Knowledge level regarding organ donation was found sufficient but same did not reflect in their attitude and practice towards organ donation. Educational session of health care professional through internet and television can play critical role in rising up positive attitude towards organ donation. Fear of misuse of donated organ is the most common reason for unwillingness to be a donor.

The John A. Williams Human Skeletal Collection at Western Carolina University

This manuscript serves to introduce The John A. Williams Human Skeletal (JAW) Collection, which is a donated skeletal collection consisting of individuals from the Body Donation Program at Western Carolina University. Full body donors decompose naturally at the Forensic Osteology Research Station (FOREST) before curation within the JAW Collection. As of 31 December 2021, the JAW Collection has 98 skeletal donors and 16 cremated donors. There are also nearly 40 donors within various stages of the decomposition and curation processes. The importance of a willed-body collection such as the JAW Collection is its ability to be utilized in educational efforts for both students and members of the public. Undergraduate students at Western Carolina University learn from our willed-body donors from the initial intake at FOREST through processing and curation within the Western Carolina Human Identification Lab (WCHIL). The JAW Collection also enables a thriving outreach program through continuing education efforts. Courses are offered throughout the year that would not be possible without a donated skeletal collection. Additionally, the FOREST and JAW Collection serve a larger community purpose by offering environmentally friendly alternatives to traditional burials for community members, demonstrating that these collections have a variety of purposes outside of academic research.

Evaluation of the presence of TRPC6 channels in human vessels: A pilot study using immunohistochemistry.

The TRPC6 channel is permeable to calcium ions as well as other ions and plays an important role in the physiology and pathophysiology of vessels. Findings from animal and cell culture experiments have shown its involvement in important vascular processes such as the Bayliss effect or endothelial-mediated vasodilatation. Furthermore, the relevance of TRPC6 channels in humans has become apparent based on diseases such as idiopathic pulmonary arterial hypertension, focal segmental glomerulosclerosis and atherosclerosis, amongst others. However, histological evidence that systematically detects TRPC6 channels in human vessels has not been provided to date. In this study, 40 vessel sections from nine body donors were obtained, processed and stained with a knockout-validated antibody against the TRPC6 protein using immunohistochemistry and western blotting. More than half of the samples yielded evidence of TRPC6 channel expression in the intima and adventitia. TRPC6 channels were detected in the tunica media in only one of 40 cases. TRPC6 detection in the human intima confirmed several demonstrated physiological aspects of the TRPC6 channels in the vasculature and may also be involved in associated human diseases. The near absence of TRPC6 channels in the tunica media was in contrast to a view that is primarily based on animal studies, from which its presence was assumed.

Microarchitecture of historic bone samples with tuberculosis.

Tuberculosis is among the leading causes of death from infectious diseases and affects many organ systems, including the skeleton. Skeletal tuberculosis is an extrapulmonary stage of tuberculosis, which occurs after the early and post-primary pulmonary stages of the disease. The aim of our study was to assess the microarchitecture of historic dry bone samples of subjects who have died of tuberculosis documented by post-mortem examinations. These preparations date to the pre-antibiotic era, and were provided by the Pathological-Anatomical Collection in the “Fools Tower” of the Natural History Museum Vienna (PASiN-NHM).We investigated macerated samples of 20 vertebral bodies, 19 femoral heads, and 20 tibiae of a total of 59 individuals diagnosed with tuberculosis from the nineteenth and early twentieth century. 10 femora and 10 tibiae from body donors that did not exhibit signs of infection and 10 (unaffected) vertebrae kept at the PASiN-NHM were studied as controls. The affected regions of the bone samples (and the corresponding regions of the control bones) were analyzed by microcomputed tomography using a Viscom X 8060 II system. Obtained images were analyzed semi-quantitatively. In samples with tuberculosis, independent of the investigated skeletal region, trabecular defects and decreased trabecular thickness were observed. Cortical porosity was seen in affected vertebrae and tibia; in tuberculous tibiae (but not in the femora) cortical thickness was decreased. In half of the individuals, cortical sclerosis was present; signs of ankylosis were observed mainly at the femoral heads affected with tuberculosis. We conclude that a combination of several alterations at the trabecular compartment could be suggestive of the presence of tuberculosis in historic skeletal remains.Supplementary InformationThe online version of this article (10.1007/s00508-022-02017-y) contains supplementary material, which is available to authorized users.

Implementation of use of hand-made three-dimensional models to teach Anatomy with supplement to traditional methods with limited resources

The status of anatomical education in modern medical programs is a cornerstone of medicine. Anatomy is one of the basic subjects in First Year MBBS curriculum. Apart from important it is also a lengthy subject to complete in allocated time duration of First MBBS. There are various subdivisions of anatomy like gross anatomy, developmental anatomy, microscopic anatomy, genetics, surface anatomy, radiological anatomy etc. Out of which gross anatomy is difficult to understand as time constraint is there in duration of First MBBS. In medical and allied branches total hours allocated for anatomy teaching and laboratory practical hours have reduced. Result in triggered the emergence of innovative ideas to maximize students learning. While studying the gross anatomy three-dimensional orientation is must to learn actual structure and relation with other viscera and vessels. Traditional way of teaching anatomy uses wall charts, books, slides, anatomical specimens, and practical anatomy as teaching resources and methods. It is fact that in most institutes, three dimensional models are available in their Anatomy Museum, but many Anatomists have complained about fault in exact structure, labelling and it’s relationship in these models because sometime these models are made by amateur technicians. As the medical education expanded and the reduction in human anatomical specimens due to shortage of dead body donations, as well as the limitations of time, place and other resources for anatomical training, the quality of anatomy teaching has been seriously affected. Apart from shortage of these resources, another big issue with development of skill laboratory which is now mandatory as per new NMC guidelines. Establishment of skill lab requires ample amount of finance. Though, skill lab can provide excellent resources to meet the existing lacunae in teaching Anatomy to students by virtual media and simulations. Latest innovations in better teaching aids in Anatomy, in market virtual dissection table is available now, which can provide in depth understanding and orientation of three-dimensional body structures. But as mentioned above, the cost of this virtual dissection table is too high that every institute can not able to afford it. In this situation, to provide better understanding and three-dimensional orientation to students making hand made models from cheap and easily available materials are better options for teachers and students as they can make themselves.Anatomy is a discipline where spatial visualization is of importance. Even anatomy textbooks and atlases provide two-dimensional static anatomical illustrations. To teach some anatomical structures by traditional cadaveric dissection or by traditional lectures is difficult. Some of the structures like gross anatomy of urinary bladder or facial nerve anatomy are difficult to learn by textbook which cannot give exact perception of real anatomy. Additionally, many structure get distorted while removing from cadaver or not able to trace even. In some cases, specific models are also not available for instance course of facial nerve from origin to its termination where hand-made models give excellent three-dimensional understanding. For students’ proper anatomical knowledge of anatomy/organs help them to improve surgical skills. Finally, surgical outcome will be better with less morbidity and mortality.

Biomechanical Characterization of a New Acellular Dermal Matrix for Oral Soft Tissue Regeneration

Objectives Acellular dermal matrices (ADM) are a suitable alternative to autogenous soft tissue grafts (ASG). The aim of this study was to analyze the biomechanical properties and architectural features of ASG and ADM. Materials and methods ASG were harvested from the hard palate of fresh frozen body donors as connective tissue grafts and compared to ADM of porcine origin (NovoMatrix, NM; mucoderm, MD). Maximum load (ML, Newton [N]) and expansion (E, [mm]) were measured after rehydration in saline solution by tensile strength measurement. Light microscopy (LM) and scanning electron microscopy (SEM) were performed to analyze the architectural features of ASG and ADM in high resolution. Results ASG demonstrated a significantly decreased ML compared to NM and MD (p < 0.0001 and p = 0.019). NM showed a significantly increased ML compared to MD (p = 0.001). ASG demonstrated a non-significantly reduced E compared to NM (p = 0.13) and a significantly increased E compared to MD (p = 0.025). NM showed an increased E compared to MD (p < 0.0001). LM and SEM highlighted the surface characteristics and internal structures of ASG and ADM, such as the surface compact layer of MD and the densely packed, parallel running and ordered collagen fibers of NM and MD. Conclusions Significant differences concerning the biomechanical properties and architectural features of ASG, and ADM were found. Clinical relevance Information about the biomechanical properties and architectural features of ASG and ADM can contribute to a better understanding of the clinical performance and extend the application area.

Evaluation of the ideal length of the Seldinger needle for internal jugular vein catheter placement

Placement of central venous catheters (CVC) into the internal jugular vein represents a routine clinical intervention. The periprocedural complication rate ranges from 5 to 20% and can be reduced by ultrasound guidance, training of residents and other measures. We aimed to proof that the average Seldinger needle is too long, increasing the risk of periprocedural injury, best epitomized in the stellate ganglion injury/irritation. The first part of the study was an online market analysis to investigate the standard needle length currently offered as part of the CVC placement sets. The second part of the study involved 35 hospitalized patients (14 female; median age 74.5 years). In those the distance between the skin and the internal jugular vein as well as the diameter of the internal jugular vein was measured by ultrasound in both, supine position as well as 45° semi-sitting position. In the third part of the study 80 body donors (45 female; median age 83.0 years) preserved by the ethanol/formaldehyde method were studied. In those the distance and angle between the typical landmark for insertion of the Seldinger needle for internal jugular vein catheter placement to the stellate ganglion was measured. The median [interquartile range] Seldinger needle length was 7 [4.0–10.0] cm. In the examined patients the maximum distance between the skin and the internal jugular vein was 1.87 cm. The minimum distance was 0.46 cm and the median distance averaging supine and 45° position was 1.14 [0.94–1.31] cm. Regarding the body donors the median distance from the insertion point of the internal jugular vein to the stellate ganglion was longer in men 5.5 [4.95–6.35] cm than in women 5.2 [4.7–5.9] (p = 0.031 unpaired t-test). With 7 cm average length the Seldinger needle currently sold as part of CVC sets is long enough to physically reach the stellate ganglion, not to mention more proximal structures. A shorter needle length would be sufficient to reach the internal jugular vein even in obese patients and with a small insertion angle while minimizing the possibility to cause severe injury as structures like the pleura and the stellate ganglion could not be reached by shorter needles.

Anatomic basics and technical approaches: sacral preauricular extensions, preauricular sulci and dorsal pubic pits in modern anatomical specimens.

The aim of this study is the evaluation of three selected osseous pelvic features in modern anatomical specimen - the sacral preauricular extension, the preauricular sulcus and pits on the dorsal side of the pubic bone laterally to the symphysis. The specificity and significance of these features are under debate and their genesis is largely unclear. Descriptive data of specific soft tissue structures surrounding the anterior sacroiliac joint gap and the pubic symphysis were generated by assessing 20 fresh pelves and 12 embalmed hemipelves from human body donors. Computed tomography (CT) was performed on all specimens and three-dimensional (3D) surface models were generated and analysed. Afterwards, all the specimens underwent anatomical dissection and finally maceration. During dissection, it became apparent that the anterior sacroiliac ligament, due to its position, shape and potential impact on the sacroiliac joint and adjacent osseous structures, requires a detailed analysis of its dimension. The most promising result, in terms of the sacral preauricular extension, was that the measurements of the triangular part of the anterior sacroiliac ligament were significantly longer in females than in males. Pelvic floor muscle fibres and fascial parts were directly connected to this ligament in some specimens, which is an important starting point for a larger in-depth study. The evaluation of the anatomic structures in connection to dorsal pitting refutes the assumption that the pelvic floor muscles or fasciae could exert influence on its formation. A histological evaluation of the ligaments of the pubic symphysis, especially the dorsal pubic ligament, would be expedient to clarify the etiology of this feature.

Classification of the popliteofibular ligament.

The purpose of this study was to characterize the morphological variations in the distal attachment of the popliteofibular ligament (PFL) and create an accurate classification for use in planning surgical procedures in this area and in evaluating radiological imaging. One hundred and thirty-seven lower limbs of body donors fixed in 10% formalin solution were examined for the presence and course of the PFL. The PFL was present in 88.3% of cases. We propose the following three-fold classification: type I (72.3%), the most common type, characterized by the attachment onto the apex of the head of the fibula, type II (8.7%), characterized by a bifurcation, with the dominant band inserting on the anterior slope of the styloid process of the fibula and the smaller band onto the posterior surface of the styloid process of the fibula and type III (7.3%), characterized by a double PFL: the first PFL (main) originated from the popliteus tendon and inserted onto the anterior slope of the styloid process of thefibula, while the second originated from the musculotendinous junction of the popliteus muscle and inserted on the posterior surface of the styloid process of the fibula. The PFL was characterized by high morphological variation, as reflected in our proposed classification. This variation may present clinical and biomechanical issues for both medical personnel and researchers. Our proposed classification may be valuable for clinicians who evaluate and perform surgical procedures within the knee joint area.

Aquaporin-4 expression in the human choroid plexus

The choroid plexus (CP) consists of specialized ependymal cells and underlying blood vessels and stroma producing the bulk of the cerebrospinal fluid (CSF). CP epithelial cells are considered the site of the internal blood-cerebrospinal fluid barrier, show epithelial characteristics (basal lamina, tight junctions), and express aquaporin-1 (AQP1) apically. In this study, we analyzed the expression of aquaporins in the human CP using immunofluorescence and qPCR. As previously reported, AQP1 was expressed apically in CP epithelial cells. Surprisingly, and previously unknown, many cells in the CP epithelium were also positive for aquaporin-4 (AQP4), normally restricted to ventricle-lining ependymal cells and astrocytes in the brain. Expression of AQP1 and AQP4 was found in the CP of all eight body donors investigated (3 males, 5 females; age 74–91). These results were confirmed by qPCR, and by electron microscopy detecting orthogonal arrays of particles. To find out whether AQP4 expression correlated with the expression pattern of relevant transport-related proteins we also investigated expression of NKCC1, and Na/K-ATPase. Immunostaining with NKCC1 was similar to AQP1 and revealed no particular pattern related to AQP4. Co-staining of AQP4 and Na/K-ATPase indicated a trend for an inverse correlation of their expression. We hypothesized that AQP4 expression in the CP was caused by age-related changes. To address this, we investigated mouse brains from young (2 months), adult (12 months) and old (30 months) mice. We found a significant increase of AQP4 on the mRNA level in old mice compared to young and adult animals. Taken together, we provide evidence for AQP4 expression in the CP of the aging brain which likely contributes to the water flow through the CP epithelium and CSF production. In two alternative hypotheses, we discuss this as a beneficial compensatory, or a detrimental mechanism influencing the previously observed CSF changes during aging.

Evaluating the integration of body donor imaging into anatomical dissection using augmented reality.

Augmented reality (AR) has recently been utilized as an integrative teaching tool in medical curricula given its ability to view virtual objects while interacting with the physical environment. The evidence for AR in medical training, however, is limited. For this reason, the purpose of this mixed method study was to evaluate the implementation of overlaying donor-specific diagnostic imaging (DSDI) onto corresponding body donors in a fourth-year, dissection-based, medical elective course entitled anatomy for surgeons (AFS). Students registered in AFS course were separated into groups, receiving either DSDI displayed on Microsoft HoloLens AR head-mounted display (n=12) or DSDI displayed on iPad (n=15). To test for the change in spatial ability, students completed an anatomical mental rotation test (AMRT) prior to and following the AFS course. Students also participated in a focus group discussion and completed a survey at the end of AFS, analyzed through thematic triangulation and an unpaired, Mann Whitney U test respectively, both addressing dissection experience, DSDI relevancy to dissection, and use of AR in anatomical education. Although statistically significant differences were not found when comparing student group AMRT scores, survey and discussion data suggest that the HoloLens had improved the students' understanding of, and their spatial orientation of, anatomical relationships. Trunk dissection quality grades were significantly higher with students using the HoloLens. Although students mentioned difficulties with HoloLens software, with faculty assistance, training, and enhanced software development, there is potential for this AR tool to contribute to improved dissection quality and an immersive learning experience.

Altered Prostaglandin E Receptor Subtype 3 Expression in Lacrimal Glands of Patients with Chronic Stevens-Johnson Syndrome

ABSTRACT Purpose To compare the prostaglandin E2 receptor subtype 3 (EP3) distribution in the lacrimal glands of normals, non-specific dacryoadenitis, and chronic Stevens-Johnson syndrome (SJS) patients. Methods Biopsies from lacrimal glands of four chronic SJS patients with severe dry eye disease, four dacryoadenitis patients, and five fresh body donors were assessed for EP3 expression using immunohistochemistry. Results In normal main and accessory lacrimal glands, EP3 is expressed strongly in nuclei and cytoplasm of majority (>75%) of acini with no ductular expression. In dacryoadenitis, EP3 expression was similar to normal glands. However, lacrimal glands from SJS patients (5–20/HPF mononuclear cells) showed a weak and reduced (<10% acini) EP3 expression within acinar cells. The reduction in intensity was more in glands with higher mononuclear cell infiltration (>10/HPF). Conclusion There is downregulation of EP3 expression in the lacrimal glands of SJS patients, whereas EP3 expression is preserved in non-specific lacrimal gland inflammations.

An anatomical study on intersphincteric space related to intersphincteric resection for ultra-low rectal cancer.

Intersphincteric resection (ISR) has been proposed to offer sphincter-sparing solution for patients with ultra-low rectal cancer. However, complete and accurate concepts about the intersphincteric space (ISS) related anatomy are not demonstrated clearly. This study aimed to provide a comprehensive description about the anatomic structure of ISS related to ISR. This was a descriptive morphological study. 28 pelvic specimens were obtained from body donors. Macroscopic and microscopic observation of ISS was performed via gross anatomy, plastinated sections and histologic staining. The anatomical parameters of the anal canal were measured. Images of laparoscopic ISS dissection procedures were real-timely captured during ISR. The hiatal ligament, microvessels on supra fascia of LAM and rectal longitudinal muscle at the level of anorectal ring, especially at 1, 5, 7, and 11o'clock, could be the preferred entrance of ISS. The conjoint longitudinal muscle (CLM), the major component of ISS, was the continuum of the rectal longitudinal muscle and got reinforcement from the elastic fibers from LAM and EAS. Microvessels and neuro tissues were also found in ISS. The ISS was split into two spaces by the CLM in the middle and might subjectively be divided into three segments according to its different compositions. The length and width of ISS varied from different segments and directions. We provided a systemic description of boundaries, contents and topographic structure of ISS, which may help proper determination of surgical approaches and dissection planes during ISR.

Steam Kettle Skeletal Preparation

This paper presents methods for the disarticulation and steam kettle maceration of embalmed and non-embalmed decedents for forensic casework and curation in anatomical collections. As steam kettles are becoming more commonly used, details on infrastructure and necessary tools for steam kettle maceration are included. This technique was developed over the course of four years of steam kettle use for forensic anthropological casework and full body anatomical donation macerations for Western Michigan University Homer Stryker M.D. School of Medicine’s (WMed) Body Donation Program. Steam kettle maceration efficiently processes decedents and results in high quality skeletal specimens with little to no damage. Furthermore, this method has the advantage of requiring minimal disarticulation, no chemical agents, and minimal intervention or attention by the processor.

Reevaluation of the Layered Anatomy of the Forehead: Introducing the Subfrontalis Fascia and the Retrofrontalis Fat Compartments.

Novel imaging methods have provided new insights into the layered anatomy of the forehead. This study seeks to critically reevaluate the layered anatomy of the forehead by using ultrasound imaging and cadaveric dissection to provide an accurate anatomical description that can be used to guide safer surgical and minimally invasive frontal procedures. This study used ultrasound imaging in a sample of 20 volunteers (12 female and eight male volunteers; aged 35.25 ± 4.2 years; body mass index, 24.28 ± 3.5 kg/m2) and cadaveric dissections of 16 body donors (12 female and four male body donors; aged 72.76 ± 9.5 years) to reevaluate the layered anatomy of the forehead. Layer-by-layer dissections and ultrasound-based measurements of the frontal structures guided conclusions. The following layered arrangement was identified: layer 1, skin; layer 2, superficial fatty layer; layer 3, suprafrontalis fascia; layer 4, orbicularis oculi and frontalis muscle (same plane); layer 5, a homogenous layer of fat [preseptal fat (in the upper eyelid), retro-orbicularis fat (deep to the orbicularis oculi muscle), and retro-frontalis fat (deep to the frontalis muscle); layer 6, subfrontalis fascia; layer 7, preperiosteal fat within the prefrontal space in the lower forehead and deep compartments in the upper forehead; and layer 8, periosteum. The results of this study add to the current understanding of the layered arrangement of the forehead. The combination of ultrasound imaging and cadaveric dissections provided evidence for a continuous fatty layer deep to the frontalis muscle.

Integration of innovative educational technologies in anatomy teaching: new normal in anatomy education.

COVID-19 pandemic has created a lot of turmoil in medical teaching, the magnitude of impact is many folds in the subject of anatomy, as it is practical based. A major challenge for anatomy teachers is to replicate the experience of practical exposures. These exposures range from cadaveric dissection to demonstration of bones, museum specimens, and histology slides, where they will have interactive communication with students, and thus help in the enhancement of communication and clinical skills among them. In recent days, anatomy teachers throughout the globe started using various advanced technology to make the teaching–learning session more interesting. In pre-pandemic era, usage of such advancements in information and communication technology was a ‘choice’. But pandemic has changed the situation drastically, what was a ‘choice’ earlier is now an ‘obligation.’ Presently although infection rate is low, vaccination rate is high, most of the medical schools re-opened for usual offline teaching, still body donation is all time low making the situation ‘back to square one’. Keeping such unprecedented situations in mind, we need to incorporate various innovative educational technologies in day-to-day teaching–learning methodologies.

Emotional Involvement and Attitude of First Year Medical Students towards Cadaveric Dissection: A Study from Andhra Pradesh, India

Introduction: Teaching anatomy in medical colleges has been conventionally based on use of human cadaveric specimens, either whole body specimens for dissection or individual specimens. Cadavers are to be held in high esteem and regarded as the first teacher of a medical student as cadaveric dissection allows students to grasp the three dimensional anatomy and skill development. Aim: To know the physical and psychological effects experienced by students while doing cadaveric dissection and also to know the attitude of the medical students towards dissection in learning anatomy. Materials and Methods: A descriptive cross-sectional study was conducted among the 181 first year medical students in a Government Medical College, Andhra Pradesh, India, during the month of May 2021. The study was undertaken after two months of cadaveric dissection classes and the responses were the cumulative subjective effect of all the classes. Data was collected using a predesigned, prestructured and pretested questionnaire, entered in MS Excel and descriptive statistics like simple frequencies, percentages were used. Chi-square test was used to statistically analyse the data. Results: Total 181 students participated in this study (out of 250 first year medical students). Nearly, 88% of the students were older than 18 years of age. Nearly, 2/3rd of the students were females (65.7%). Out of 181 participants, 152 (84%) experienced psychological symptoms while doing dissection. Out of 152 students, who experienced psychological symptoms, 40.8% experienced excitement followed by anxiety 22.4%, fear 17.8% stress 16.4%. Among those who experienced excitement nearly 70% were females. Sweating was the most common physical symptom experienced by the participants. Among the study participants 98.3% students had sense of gratitude to people who donated their body and 96.1% had sympathy and respect for the cadaver. A 20.4% want to donate body for dissection. While assessing the attitude, 97.2% students agreed that cadaveric dissection is important in the curriculum, 97% agreed that dissection is required for understanding the structure of human body. Conclusion: Student-cadaver encounter is of paramount importance in medical education. Computer assisted and multimedia methods should be complementary but not a substitute to dissection. Introducing cadaver oath has resulted in students reflecting about organ donation and body donation, showing respect to the dead body.

A mixed-methods examination of public attitudes toward vascularized composite allograft donation and transplantation.

Background:This mixed-methods study examined the general public’s knowledge and attitudes about vascularized composite allografts. The availability of these anatomical gifts to treat individuals with severe disfiguring injuries relies largely on decisions made by family members. If vascularized composite allograft transplantation is to become more readily available, the knowledge and beliefs of the general public must be explored to ensure vascularized composite allograft donation approaches adequately support the donation decision-making process.Methods:We conducted six focus groups with 53 members of the general public, which were audio-recorded for accuracy and transcribed. Before each session, participants completed a brief survey assessing donation-related knowledge, attitudes, and beliefs. Analysis of qualitative data entailed the constant comparison method in the development and application of a schema for thematic coding. Descriptive statistics and Spearman’s rank coefficient were used in the analysis of the quantitative data.Results:Respondents were most knowledgeable about solid organ donation and least knowledgeable about vascularized composite allograft donation. Six major themes emerged: (1) strong initial reactions toward vascularized composite allografts, (2) limited knowledge of and reservations about vascularized composite allografts, (3) risk versus reward in receiving a vascularized composite allograft, (4) information needed to authorize vascularized composite allograft donation, (5) attitudes toward donation, and (6) mistrust of the organ donation system.Conclusion:The general public has low levels of knowledge and high levels of hesitation about vascularized composite allograft donation and transplantation. Education campaigns to familiarize the general public with vascularized composite allografts and specialized training for donation professionals to support informed family decision-making about vascularized composite allograft donation may address these issues.

Residual properties of silicone (MED-4719) lead with leads from retrieved devices

Leads are designed for in vivo applications, however, for a definite period of time. In-vivo environment affects the mechanical behavior of implantable devices, therefore, there is a need to evaluate the residual properties of implantable leads used with pacemakers, defibrillator and neuro-stimulators. Silicone (MED-4719) lead is widely used in cardiac implantable electronic devices made by different manufacturers. . We collected 150 devices (with or without leads) from Anatomical Gift Program of the Wright State University. The objective of this study was to investigate the residual properties of Silicone (MED-4719) lead with different in vivo exposure time and compare the properties of a new, unused lead supplied by Medtronic for the purposes of this research. The tensile test was performed by applying specific load on the samples, percentage elongation at 5N and the corresponding displacement measured. Load to failure, percentage elongation, ultimate tensile strength, and modulus of elasticity were determined for each lead. Methods to collect and compile data were standardized, and statistical models were used to assess the sensitivity of measured parameters with in vivo performance. Load to failure, elongation to failure, ultimate tensile strength, and percentage elongation at 5N showed a significant decrease after 94 months (P = 0.0063), 8 months (P = 0.0136), 94 months (P = 0.0244) and 71 months (P-value = 0.0326) after implantation, respectively. On the other hand, modulus of elasticity was found proportional to the number of months device was exposed and showed significant increase after 71 months (P = 0.0446) of in-vivo environment.