Cadaver Body Research Articles

Evidence and Mechanisms of Embodiment in the Developing Dentition

abstract: Existing research supports both embodiment of stress through epigenetics and epigenetic impacts on dental development. This article proposes two models for embodiment of stress in dental development: the stress-delay model, with increased stress during development producing delays in dental development, and the inflammation-acceleration model, with increased stress producing faster dental development through inflammatory pathways. These models were tested on dental development scores from the New Mexico Decedent Image Database, using (a) nonaccidental death (homicide, suicide, and natural) as proxy for elevated stress exposure during life and (b) cadaver body mass index (BMI) percentile as proxy for living BMI. Sex was treated as a positive control because typically dental development is faster in females than in males. Nonaccidental death and male sex were both associated with slower dental development; however, manner of death was significant only for 7 of 32 (22%) of teeth. Mean BMI percentile was highest for natural death and lowest for homicide. These findings support the stress-delay model and accord with existing studies that found limited evidence that embodied effects on dental development are sufficiently large to affect estimates of age.

Abstract 17295: In Situ Recovery of Multiple Organs Using Venoarterial ECMO in a Murine Model of Uncontrolled DCD

Introduction: The utilization of extracorporeal membrane oxygenation (ECMO) for Donation after Circulatory Death (DCD) can substantially increase the donor pool, organ yield per donor, and organ shelf life. Clinical attempts to recover organs for transplantation after uncontrolled DCD are very complex and hard to reproduce. As a preliminary strategy for completing this endeavor, experimental protocols employing feasible animal models are strongly recommended. Hypothesis: The objective of the investigation was to develop a mouse model of ECMO-based cadaver management protocol for uncontrolled DCD donation after "out-of-hospital" death. Methods: Following 10 min after confirmed death, murine cadavers (C57BL/6 background) were administered with heparin-streptokinase and cannulated for veno-arterial ECMO. Cadaver bodies were connected to a murine ECMO machine 1 h post-mortem and subjected to extracorporeal circulation for subsequent 2 hrs. Blood gas parameters, cardiac activity, and general organ state were assessed using BGA analysis, ECG, and histology, accordingly. We have designed and incorporated into an ECMO circuit a previously unreported, miniaturized murine hemodialysis for the treatment of severe hyperkalemia and metabolic acidosis that arose following death. Results: Control BGA parameters recorded 1 h after death were incompatible with normal physiology: extremely low blood pH, profound negative base excess, and extraordinarily high lactate and K + levels. Two hours after ECMO support, blood pH values of a cadaver body restored from <6.5 to 7.3 ± 0.05, pCO 2 was lowered from >130 to 41.7 ± 10.5 mmHg, sO2, base excess, and HCO 3 were all elevated from below detection thresholds to 99.5 ± 0.6%, -4 ± 6.2 and 22.0 ± 6.0 mmol/L, respectively (Student T-test, p < 0.05). The implementation of hemodialysis resulted in a significant decrease in both hyperlactatemia and hyperkalemia. Conclusions: Our model presents novel opportunities for the management of cadaver organs in order to promote uncontrolled DCD donation, thereby contributing to the resolution of the organ shortage problem. Our approach enables the implementation of a variety of modern blood purification techniques in cadaveric organ recovery using ECLS.

Multiorgan recovery in a cadaver body using mild hypothermic ECMO treatment in a murine model

BackgroundTransplant candidates on the waiting list are increasingly challenged by the lack of organs. Most of the organs can only be kept viable within very limited timeframes (e.g., mere 4–6 h for heart and lungs exposed to refrigeration temperatures ex vivo). Donation after circulatory death (DCD) using extracorporeal membrane oxygenation (ECMO) can significantly enlarge the donor pool, organ yield per donor, and shelf life. Nevertheless, clinical attempts to recover organs for transplantation after uncontrolled DCD are extremely complex and hardly reproducible. Therefore, as a preliminary strategy to fulfill this task, experimental protocols using feasible animal models are highly warranted. The primary aim of the study was to develop a model of ECMO-based cadaver organ recovery in mice. Our model mimics uncontrolled organ donation after an “out-of-hospital” sudden unexpected death with subsequent “in-hospital” cadaver management post-mortem. The secondary aim was to assess blood gas parameters, cardiac activity as well as overall organ state. The study protocol included post-mortem heparin–streptokinase administration 10 min after confirmed death induced by cervical dislocation under full anesthesia. After cannulation, veno-arterial ECMO (V–A ECMO) was started 1 h after death and continued for 2 h under mild hypothermic conditions followed by organ harvest. Pressure- and flow-controlled oxygenated blood-based reperfusion of a cadaver body was accompanied by blood gas analysis (BGA), electrocardiography, and histological evaluation of ischemia–reperfusion injury. For the first time, we designed and implemented, a not yet reported, miniaturized murine hemodialysis circuit for the treatment of severe hyperkalemia and metabolic acidosis post-mortem.ResultsBGA parameters confirmed profound ischemia typical for cadavers and incompatible with normal physiology, including extremely low blood pH, profound negative base excess, and enormously high levels of lactate. Two hours after ECMO implantation, blood pH values of a cadaver body restored from < 6.5 to 7.3 ± 0.05, pCO2 was lowered from > 130 to 41.7 ± 10.5 mmHg, sO2, base excess, and HCO3 were all elevated from below detection thresholds to 99.5 ± 0.6%, − 4 ± 6.2 and 22.0 ± 6.0 mmol/L, respectively (Student T test, p < 0.05). A substantial decrease in hyperlactatemia (from > 20 to 10.5 ± 1.7 mmol/L) and hyperkalemia (from > 9 to 6.9 ± 1.0 mmol/L) was observed when hemodialysis was implemented. On balance, the first signs of regained heart activity appeared on average 10 min after ECMO initiation without cardioplegia or any inotropic and vasopressor support. This was followed by restoration of myocardial contractility with a heart rate of up to 200 beats per minute (bpm) as detected by an electrocardiogram (ECG). Histological examinations revealed no evidence of heart injury 3 h post-mortem, whereas shock-specific morphological changes relevant to acute death and consequent cardiac/circulatory arrest were observed in the lungs, liver, and kidney of both control and ECMO-treated cadaver mice.ConclusionsThus, our model represents a promising approach to facilitate studying perspectives of cadaveric multiorgan recovery for transplantation. Moreover, it opens new possibilities for cadaver organ treatment to extend and potentiate donation and, hence, contribute to solving the organ shortage dilemma.

38 (PB-038) Poster - Breast cancer axillary dissection a “lost procedure, sometimes still necessary…” how to prevent the lost of a surgical technique using cadaver body and Simlife

Background: Sentinel lymphonodal biopsy (SLB) is nowadays regarded has a standard procedure in breast cancer surgical treatment. Moreover some authors are investigating the option to omit SLB in tumor less than two cm. On the other hand axillary dissection has become a “rare” indication for breast cancer surgery, thus decreasing surgeon performance and the possibility of learning this procedure among young surgeons. To utilize cadaver body for learning is a valuable tool for surgery competence acquisition. Sim- life is a patented device helping cadaver body utilization for learning process. Material and methods: We analyze the ideal steps to learn axillary dissection, for young breast cancer surgeon throughout an individual experience of a trainee. The doctor attended the fourth year specialization school in Gynecology, with a dedicated time (8 months) at the breast cancer treatment at the University of Turin (Breast cancer Unit around 1000 cases per yr). The learning process developed throughout five steps for eight months duration: the first at the master of senology helping teacher in preparing anatomical lesson. The second as assistant in 20 surgical breast cancer procedures. The third as first operator in 20 breast cancer surgical procedures including SLB and starting with treating the axilla (axillary dissection) in a gradual manner. The fourth phase included a cadaver-lab course at University center of Poitier together with the senior tutor for two days, utilizing Sim- life patented device (revitalized cadaver system) and performing 4 complete axillary dissections (both sides per cadaver). In the fifth step the trainee performed two axillary dissections on patients under senior tutor assistance. The trainee had to fill a form developed to describe time of different surgical procedures, surgical difficulties and competences acquisition. Results: Both timing criteria and surgical items increases during the training period of 8 months with a decrease in time performing SLB of 50% (p = 0.005) and increase of more than 80% (p = 0.04) in competence acquisition in identifying anatomical structures during axillary dissection procedure in a statistically significant manner. Trainee self- confidence was also increased together with satisfaction even from a psychological point of view (data registered with a questionnaire). Conclusions: Programmed learning/tutoring process through pre-defined steps, in association with cadaver-lab, Sim-life device and hands-on practice improve surgical competences acquisition permitting practice also surgery that nowadays remains necessary, even though more rarely than in the past according to clinical indications, such as axillary dissection. No conflict of interest.

Objectification, Desensitization, and Personification: Medical Student Strategies for Dealing with Human Body in the Anatomy Lab

Introduction &amp; PurposeCadaver labs play a significant role in supporting learners form a professional attitude towards human body. Most medical students have their first authoritative encounter with human body in a cadaver lab where they get a right to manipulate and cut through the body. Dealing with death and dissection of the body may simply be a unique learning experience for some but it can be an emotional roller coaster for others. A few student strategies for dealing with cadaver bodies (such as objectification of the body) are documented in the literature but a full range of such strategies is rarely investigated. This study sought to understand the range of strategies medical students use for dealing with cadaver bodies in the anatomy lab at one medical school.MethodsTwenty semi‐structured interviews and four focus groups were conducted with a total of 44 students from all four years of undergraduate medical education at Indiana University School of Medicine, in 2019. All sessions were audio‐recorded and later transcribed verbatim. A qualitative thematic analysis was performed by developing an inductive coding scheme which resulted in emergence of salient themes from the data.ResultsThe full spectrum of student strategies for dealing with cadaver bodies included: 1) complete, effortless objectification of cadaver’s body as a non‐living thing, 2) actively desensitizing oneself toward cadaver’s body as so to be able to work with it, and 3) paralyzing personification of the cadaver’s body that impedes learning from it let alone dissecting it. Falling within this spectrum were also the so‐called middle ground strategies that were chosen by students attempting to adopt a more balanced behavior between desensitization and personification but still found themselves alternating between those two positions at certain times.ConclusionStudents employ certain strategies for handling human body in the cadaver lab. These strategies are based on their personal values and/or actively chosen to help them make the most out of their experience working with cadavers in the anatomy lab.Significance/ImplicationsLearning to deal with cadaver bodies in a professional manner is an impactful part of medical students’ professional identity formation process. The way students handle those bodies is likely to impact their attitude toward their patients’ bodies in the future as a doctor. Understanding the full range of student strategies for handling bodies in cadaver lab is a critical step for anatomy lab educators to facilitate a healthy, professional, ethical, and at the same time humane relationship between students and their cadaver’s body. Future studies should dig deeper into each of the strategies identified here and explore the best ways to oversee them for an effective medical professional identity formation in medical students.

Real Color Sectioned Images and Correspondence with Ultrasound Images of the Palmar Wrist

The aim of this study was to identify sequential changes in the actual sites and shapes of wrist structures on the high-resolution sectioned images and to compare these with those on ultrasound (US) images. These images of the wrist may yield guidelines for diagnosing various pathological lesions in the wrist. In the sectioned images of a whole cadaver body, and the images including the wrist were selected, and part of the hand was cropped. A wrist of one healthy Korean subject was scanned by ultrasonography to obtain US images of the wrist. Wrist structures were identified and labeled in detail on the sectioned images and the corresponding US images. Serial changes of the sites and shapes of the wrist structures mainly occurred in the bones, median nerve, ulnar artery, ulnar nerve, and the flexor pollicis longus tendon, along with thickening of the thenar and hypothenar muscles. The present results could provide a new guide for anatomy mapping, diagnosing, and detecting various lesions of the wrist. They can also be useful and effective for educational purposes related to interpreting US images.

The impact of the decomposition process of shallow graves on soil mite abundance.

Burial of a cadaver results in a slower decomposition rate, due to more stable below‐ground temperatures and restricted access to necrophagous insects. In such circumstances, analysis of the soil mesofauna, with emphasis on mites (Acari) may be more valuable in time‐of‐death estimations. The production of volatile organic compounds of cadaveric decay results in changes, especially in the soil pH, which in turn would affect the abundance and diversity of the associated mites. In general, the effects of decomposition and the consequently altered pH levels on the abundance of mites in shallow graves, as well as the effects of fluctuating above‐ground environmental parameters (temperature, relative humidity, and precipitation) remain unknown. Here, we found that the decay of three pig cadavers buried in shallow graves (<30 cm below) caused a significant increase in the soil pH throughout decomposition, from neutral to alkaline. Cadaver decay attracted an abundance of mites: with 300 mites collected from the three pig cadavers compared to 129 from the control soil samples at the same depth. Mites rapidly became more abundant in cadaver‐associated soils than in control soils after the fresh stage. Increasing soil pH had a positive impact on the abundance of mites in graves and there was a significant interaction between cadaver body temperature and soil pH. Above‐ground fluctuations in temperature, relative humidity, and precipitation were found to have no significant direct effect on mite abundance in grave or control soils.

The Course of Posterior Antebrachial Cutaneous Nerve: Anatomical and Sonographic Study with a Clinical Implication.

The course of the posterior antebrachial cutaneous nerve (PACN) was studied via ultrasound (US) and dissection. The aim of this study was to reveal the anatomical relationships of PACN with the surrounding structures along its pathway to identify possible critical points of compression. Nineteen cryopreserved cadaver body donor upper extremities were explored via US and further dissected. During US exploration, two reference points, in relation with the compression of the nerve, were marked using dye injection: (1) the point where the RN pierces the lateral intermuscular septum (LIMS) and (2) the point where the PACN pierces the deep fascia. Anatomical measurements referred to the lateral epicondyle (LE) were taken at these two points. Dissection confirmed the correct site of US-guided dye injection at 100% of points where the RN crossed the LIMS (10.5 cm from the LE) and was correctly injected at 74% of points where the PACN pierce the deep fascia (7.4 cm from the LE). There were variations in the course of the PACN, but it always divided from the RN as an only branch. Either ran close and parallel to the LIMS until the RN crossed the LIMS (84%) or clearly separated from the RN, 1 cm before it crossed the LIMS (16%). In 21% of cases, the PACN crossed the LIMS with the RN, while in the rest of the cases it always followed in the posterior compartment. A close relationship between PACN and LIMS, as well as triceps brachii muscle and deep fascia was observed. The US and anatomical study showed that the course of PACN maintains a close relationship with the LIMS and other connective tissues (such as the fascia and subcutaneous tissue) to be present in its pathology and treatment.

The use of mid-arm circumference for the estimation of adult body weight: A post mortem computed tomography approach

• The study translates a pre-hospital method for estimating an adult's body weight from the mid upper arm circumference to post mortem computed tomography. • The method showed a strong relationship between mid-arm circumference and post mortem body weight. • The mid-arm circumference measurement method using post mortem computed tomography yielded excellent intra- and inter-observer reliability. • The quick, easy and cost-effective post mortem computed tomography technique to estimate adult body weight may be useful if weighing equipment is unavailable or the body is incomplete. Cadaver body weight (BW) is to be documented, where possible, in all forensic autopsy examinations. However, it may not always be possible to ascertain an accurate BW if, for example, functioning weighing equipment is unavailable or the body is incomplete. This research aimed to translate an adult clinical prehospital method which uses a mid-arm circumference (MAC) measurement to estimate BW to establish a post mortem computed tomography (PMCT) technique for adult cadaver BW estimation. The clinical method was adapted for PMCT bone and soft tissue methods. Right and left MAC measurements were obtained by four independent observers from sixty-six (45 males and 21 females) consented research adult PMCT scans using the Osirix DICOM viewer. All observers rated MAC quality score on each arm from 0 (very poor) to 3 (good). In the final group of fifty-five with MAC quality score ≥ 1, MAC measurements correlated well with actual BW ( r =0.87) and yielded excellent intra- and inter-observer reliability. There were no statistical differences between the two MAC methods, sexes or side of arm. Mean estimated BW by previous study Equation, BW=(4×MAC)-50, was 0.47 kg greater than mean actual BW with limits of agreement of 12.7 kg; this would be reduced to 9.2 kg if an outlier were excluded. The study identifies a quick and easy PMCT technique to estimate adult BW using PMCT. However, the result remains only an estimation and caution should be expressed if a result is applied to medico-legal cases.

Durability of cling film plastic wrap usage on dead body towards human decomposition changes

This study explores the practicability and usability of the cling film plastic wrap on the dead body with decomposition changes, whereby the feasibility of wrapping the remains to ensure the containment of the decomposition fluid within the cling film plastic wrap. Unknown and unclaimed dead bodies were used. Wrapping and preservation of human remains using the cling film plastic wrap could be the best operational practices for first responders rather than leaving bodies exposed on the disaster site, when the supplies of the cadaver body bags are inadequate. Thinking out of the box, the conventional way of using cadaver body bags to the cling film plastic wrap forms a new perspective in managing the dead and facilitating the human identification needs. New inventive idea of adopting the cling film plastic wrap as means of protecting the dignity of the dead person, could be the way forward in humanitarian forensic action.

Anatomical Positions of Vermiform Appendix in Bangladeshi People: A Postmortem Study

The vermiform appendix is a worm-like, narrow, elongated, blind-ended extension of the large intestine of certain mammals, projecting from the posteromedial wall of the cecum, near its junction with the small intestine. It varies in position from person to person. Appendicitis is the most important clinical condition of vermiform appendix. The clinical presentation of appendicitis varies according to position of the vermiform appendix. An appropriate knowledge of the position of the vermiform appendix is important for surgeons, pathologists and other physicians for proper diagnosis and management of appendicitis and other appendicular diseases. In Bangladesh there is no sufficient data regarding position of the vermiform appendix. The present study is aimed to observe the anatomical position of the vermiform appendix among collected samples. With this aim the present study was carried out in the department of Anatomy, Sir Salimullah Medical College, Dhaka, from January 2008 to June 2009. After taking approval from the Institutional Ethics Committee sixty (60) postmortem vermiform appendices of different age groups collected by convenient sampling from unclaimed dead bodies of Bangladeshi cadavers which were under autopsy examination in the Department of Forensic Medicine of Dhaka Medical College (DMC) and Sir Salimullah Medical College (SSMC), Dhaka. The position of vermiform appendix was noted during collection of the sample from the dead bodies. In all the age groups, the pelvic position was the commonest (43.33%), followed by retrocecal-retrocolic position (33.33%), postileal position (20%) and subcecal-paracolic position (3.3%). Preileal variety was not found.

High-resolution ultrasound in the assessment of the distal biceps brachii tendinous complex.

To establish a high-resolution US technique that enables a systematic morphometric examination of the three components that form the distal biceps brachii tendinous complex; the internal bicipital aponeurosis, the distal biceps brachii tendon and the external bicipital aponeurosis (also known as lacertus fibrosus). Fifty cryopreserved cadaver body donor elbows were dissected to obtain morphometric reference values and to establish reliable landmarks for the US examination. Then, a systematic US technique was designed and validated by a one-to-one US/dissection analysis of 11 cryopreserved cadaver body donor elbows. Finally, the systematic US technique was carried out in 44 healthy volunteers and morphometric parameters were compared to those obtained in the first part of the study. Mean dissection reference values: internal bicipital aponeurosis width 39.61mm (10.02 SD) and thickness 0.75mm (0.24 SD), distal biceps brachii tendon width 8.38mm (1.87 SD) and thickness 2.73mm (0.69 SD), external bicipital aponeurosis width 11.17mm (5.84 SD) and thickness 0.85mm (0.28 SD). One-to-one US/dissection correlation was overall good (intraclass correlation coefficient 0.876, p < 0.0001). When comparing volunteer US/dissection measurements, significant differences were encountered in all measures except for internal bicipital aponeurosis width. However, the overall magnitude of such significant differences was <0.7mm. Using the systematics hereby proposed, high-resolution US is reliable for the morphometric assessment of the distal biceps brachii tendinous complex. The external bicipital aponeurosis is morphometrically the most variable structure.

Reprint of: Cling film plastic wrap: An innovation for dead body packaging, preservation and transportation by first responders as a replacement for cadaver body bag in large scale disasters

Cadaver body bags are the conventional method to contain a human body or human remains, which includes the use for storage and transportation of the deceased at any crime scene or disaster scene. During disasters, most often than not, the first responders including the police will be equipped with cadaver body bags to do scene processing of human remains and collection of personal belongings at the disaster site. However, in an unanticipated large scale disasters involving hundreds and thousands of fatalities, cadaver body bags supplies may be scarce. The authors have therefore innovated the cling film plastic wrap as an alternative for the cadaver body bag used at the disaster site. The plastic wrap was tested on six different experimental subjects, i.e. both adult and child mannequins; body parts of the mannequin figure (arm and hand); a human adult subject and an unknown dead body. The strengths of the cling film plastic wrap are discussed in comparison with the cadaver body bag in the aspects of costing, weight, duration of the wrap, water and body fluid resistant properties, visibility and other advantages. An average savings of more than 5000% are noted for both adult body wrap and child body wrap compared to the cadaver body wrap. This simply means that the authors can either wrap 25 adult dead bodies or 80 children dead bodies with the cost of 1 cadaver body bag. The cling film plastic wrap has proven to have significant innovation impact for dead body management particularly by the first responders in large scale disasters. With proper handling of dead bodies, first responders can manage the dead with dignity and respect in an overwhelmed situation to facilitate the humanitarian victim identification process later.

A Fresh Cadaver Study on Indocyanine Green Fluorescence Lymphography: A New Whole-Body Imaging Technique for Investigating the Superficial Lymphatics.

Identification of the lymphatic system in cadavers is painstaking because lymphatic vessels have very thin walls and are transparent. Selection of appropriate contrast agents is a key factor for successfully visualizing the lymphatics. In this study, the authors introduce a new imaging technique of lymphatic mapping in the whole bodies of fresh cadavers. Ten fresh human cadavers were used for this study. The authors injected 0.1 ml of indocyanine green fluorescence solution subcutaneously at multiple spots along the watershed lines between lymphatic territories and hand and foot regions. After the body was scanned by the near-infrared camera system, fluorescent tissues were harvested and histologic examination was performed under the microscope equipped with the infrared camera system to confirm that they were the lymphatics. Subcutaneously injected indocyanine green was immediately transported into the lymphatic vessels after gentle massage on the injection points. Sweeping massage along the lymphatic vessels facilitated indocyanine green transport inside the lymphatic vessel to move toward the lymph nodes. The lymphatic system was visualized well in the whole body. Histologic examinations confirmed that indocyanine green was detected in the lymphatic lumens specifically, even when located far from the injected points. The lymphatic system could be visualized in whole-body fresh cadavers, as in living bodies, using indocyanine green fluorescence lymphography. Compatibility of indocyanine green lymphography would facilitate the use of cadaveric specimens for macroscopic and microscopic analyses.

Discrepancies between reported and cadaveric body size measurements associated with a modern donated skeletal collection

Body mass and stature estimation methods used in biological anthropology require materials with known body size information. There are several types of body size data that can be associated with skeletal collections. However, discussion regarding the reliability and suitability of these types of information for anthropological research is scarce. This paper focuses on differences between reported and recorded cadaver weights and heights associated with a modern donated skeletal collection, similar to these commonly used in anthropological research. In addition, the study identifies factors that may influence these discrepancies. The results show statistically significant differences between reported and cadaver body size information. Generally, reported weights, statures and body mass indices (BMI) were greater compared to the cadaver information in this sample. However, potential effects on these discrepancies varied depending on sex and information type. Age was found to influence stature discrepancy in females, and donation type had an effect on the female weight discrepancy. The results also show that body size range (weight, stature and BMI) can contribute to these discrepancies. Even though the differences between reported and cadaver data may not be significant at the population level, the individual variation can cause misclassifications of individuals depending on the data used. This study encourages researchers using modern documented collections and their body size information to openly acknowledge the types of weight and stature data used and to discuss potential problems associated with them.

Cling film plastic wrap: An innovation for dead body packaging, preservation and transportation by first responders as a replacement for cadaver body bag in large scale disasters

Cadaver body bags are the conventional method to contain a human body or human remains, which includes the use for storage and transportation of the deceased at any crime scene or disaster scene. During disasters, most often than not, the first responders including the police will be equipped with cadaver body bags to do scene processing of human remains and collection of personal belongings at the disaster site. However, in an unanticipated large scale disasters involving hundreds and thousands of fatalities, cadaver body bags supplies may be scarce. The authors have therefore innovated the cling film plastic wrap as an alternative for the cadaver body bag used at the disaster site. The plastic wrap was tested on six different experimental subjects, i.e. both adult and child mannequins; body parts of the mannequin figure (arm and hand); a human adult subject and an unknown dead body. The strengths of the cling film plastic wrap are discussed in comparison with the cadaver body bag in the aspects of costing, weight, duration of the wrap, water and body fluid resistant properties, visibility and other advantages. An average savings of more than 5000% are noted for both adult body wrap and child body wrap compared to the cadaver body wrap. This simply means that the authors can either wrap 25 adult dead bodies or 80 children dead bodies with the cost of 1 cadaver body bag. The cling film plastic wrap has proven to have significant innovation impact for dead body management particularly by the first responders in large scale disasters. With proper handling of dead bodies, first responders can manage the dead with dignity and respect in an overwhelmed situation to facilitate the humanitarian victim identification process later.

Cadaver procurement challenges and body donation trends in South Africa

Cadaver procurement challenges and body donation trends in South Africa

Accuracy of Percutaneous Pedicle Screw Placement: Does Training Level Matter?

In vitro human cadaveric surgical technique study. To assess the accuracy of percutaneous pedicle screw placement in a human cadaveric model using standard fluoroscopic guidance technique, compared across varying levels of experience. The current literature varies widely in the reported frequency of facet violation during placement of percutaneous pedicle screws. However, as of yet there are no studies examining the effect that training level has on accuracy of placement. Four surgeons with differing levels of training (PGY-2, PGY-4, fellow, attending) were evaluated on their accuracy of percutaneous placement of screws in a uniform manner. Each of the 10 cadavers was instrumented from L1 to S1 bilaterally, for a total of 120 screws. Specimens were dissected to evaluate for facet and pedicle wall violations. These were then recorded and analyzed to evaluate for correlation among participating surgeons, laterality, spinal level, and cadaver body mass index. Of 120 screws placed, there were 35 total violations [26 superior articular facet violations (21.7%), 5 intra-articular facet joint violations (4.2%), and 4 pedicle breaches (3.3%)]. Among the trainees there was no difference in the likelihood of causing a violation (P=0.8863) but there was a difference when compared with the attending surgeon (P=0.0175). Laterality (P=0.1598), spinal level (P=0.3536), and body mass index (P=0.8547) did not correlate with the likelihood of a violation. Surgeons of differing training levels are able to safely and accurately place lumbar pedicle screws in a percutaneous manner, with a low likelihood of facet and pedicle wall violations.

温度对蚜科专化菌暗孢耳霉休眠孢子形成的影响

PDF HTML阅读 XML下载 导出引用 引用提醒 温度对蚜科专化菌暗孢耳霉休眠孢子形成的影响 DOI: 10.5846/stxb201401070048 作者: 作者单位: 浙江农林大学 林业与生物技术学院,浙江农林大学 林业与生物技术学院,浙江农林大学 林业与生物技术学院,浙江农林大学 林业与生物技术学院,浙江农林大学 林业与生物技术学院 作者简介: 通讯作者: 中图分类号: 基金项目: 国家自然科学基金(31300550); 国际科学基金(IFS, C/5146-1) The effect of temperature on in vivo resting spore formation of the aphid-specific pathogen Conidiobolus obscurus Author: Affiliation: Zhejiang Agricultural and Forestry University Fund Project: 摘要 | 图/表 | 访问统计 | 参考文献 | 相似文献 | 引证文献 | 资源附件 | 文章评论 摘要:为探究虫霉休眠孢子形成的关键影响因素,通过孢子浴接种和多浓度生物测定实验,观察蚜科专化菌暗孢耳霉(Conidiobolus obscurus)在5个温度处理(10,15,20,24,28 ℃)和3个接种浓度梯度下感染寄主桃蚜(Myzus persicae)的情况,并观测不同处理下蚜尸内产休眠孢子的比例。暗孢耳霉对桃蚜的毒力随温度和接种浓度升高而提高。同时,感病致死的蚜尸镜检结果表明:温度显著影响休眠孢子形成,温度越高,形成几率越大;接种浓度的影响次之,在15-24 ℃间,形成几率随接种浓度提高而增大。这一现象可能的解释:高温环境将使寄主种群增长停滞或消退,暗孢耳霉通过感知环境温度情况,倾向于在较高温时于寄主体内形成休眠孢子来规避接下来可能出现的寄主匮乏期。 Abstract:Fungi belonging to the order of Entomophthorales are found to induce host epizootics under natural conditions, restraining many agroforestry pest populations below economic damage level. For decades, researchers have focused on exploring these valuable resources with respect to their application in pest biocontrol programs, but the process has proven to be difficult. A poor understanding of the fungal epizootic mechanism and survival strategies in the nature, including the mechanism of in vivo resting spore formation, is one of the main obstacles hindering this effort. Entomophthorales can actively eject numerous conidia to infect nearby hosts, thus transmitting within the host populations. When the host population decreases dramatically, the fungi tend to form thick-walled spores (resting spores, RS) within the bodies of cadavers. Once the conditions improve, RS germinate to restart the infection cycle and regulate the host population. Thus, the RS formation is an important step for fungal survival and the subsequent initiation of the epizootic. Previous reports indicated that many biotic and abiotic factors influence in vivo RS formation, including temperature, humidity, light duration, host age, nutritive conditions, and inoculum levels. However, no consistent conclusion has been formed regarding the vital factors, as contradictory results have been reported for different pathogen-host systems. Temperature and inoculum levels were recently found to exert dominant effects on the formation of Pandora nouryi RS in Myzus persicae inhabiting fields in cold climates. To investigate the main factors influencing in vivo RS formation of the aphid-specific pathogen Conidiobolus obscurus, we performed a series of multi-concentration bioassays of C. obscurus against the host M. persicae under five different temperature treatments (10 ℃, 15 ℃, 20 ℃, 24 ℃, and 28 ℃). The results of the bioassays showed that aphid mortality increased with increasing conidial concentrations used to inoculate the aphids (inoculum level) under each temperature condition. The data were well fitted to the time-concentration-mortality model, and the lowest calculated median lethal concentration (LC50) with 95% confidence intervals was estimated to be 13.6 (11-16.8) conidia/mm2 on day 4 at 28 ℃. Within the crushed cadaver bodies, proportion of the RS formation significantly increased with increased temperature, reaching a peak of 0.66 at 28 ℃. The proportion also increased with inoculum levels at temperatures from 15-24 ℃. Thus, C. obscurus tends to form RS more readily at higher temperatures and inoculum levels. We explain this phenomenon as follows: the rise of temperature to high levels signals the upcoming variation in the host population to C. obscurus, because high temperatures always cause host diapause and population collapse in the fields. For survival in the successive period of host shortage, the fungi tend to form thick-walled RS in host cadavers. Further observation of other entomophthoralean fungi and their hosts is required to verify this prediction. The present results also showed that C. obscurus possesses high infectivity under higher temperature conditions and is thus suitable for aphid control in thefields. 参考文献 相似文献 引证文献

Famous lines in history: Langer lines.

The orientation of surgical incisions over the skin iswidely considered to affect scarring and the final cosmetic outcome for patients. Whenmost surgeons visualize lines on the skin surface to guide such incisions, it is Langer lines (alsoknownasskincleavageor tension lines) thatmost readilycometomind.KarlLanger(1819-1887),themanbehindthefamouslines, was born in Vienna, Austria, where he spentmost of his life and later becameprofessor of anatomy at Joseph’s Academy. In 1861, Langer began publishing a series of 5 articles detailing his seminalwork on the physical andmechanicalpropertiesof theskin. In thefirstof thesearticles,Langer creditedDupuytrenandMalgaigne for their earlierobservations. In 1834, Dupuytren reported seeing a youngmanwhohad attempted to commit suicidebystabbinghimselfover theheart3 times.Thepatient claimedto haveusedaroundawlasthe instrument,buthedidnotfashionroundstab wounds onhis chest. This ledDupuytren to study thematter in cadavers anddiscover thata round instrument indeedproduced linearcleftswhen thrust throughtheskin.Healsonoticedthat thesecleftshaddifferentorientations in different parts of thebody.Malgaigne confirmed these findingsandobserved fromhisexperienceasa surgeon that the retractionof wounds differedwith the direction of incisions. Langer went on to use sharp conical spikes to produce wounds all over the body of a large series of cadavers—of different ages and body constitutions—toanalyze the relationshipof each small cleft to thenext. He further attempted to shed light on wound retraction and the tension in human skin bymaking small circular incisions all over the bodies of cadavers and documenting in the directions in which the resulting woundsnarrowedandbroadened, if at all. Bywayof these incredibly meticulous efforts, Langer was able to draw his famous lines. Unfortunately, Langer’sworkwas largely unappreciated and ignored during his lifetime. In fact, because his original publications were written in the classical scientific German of his era, with hints of his local Austrian dialect, it was not until 1978 that a translation of his work wasmade available to the English-speaking world. Today, elective surgical incisions may not follow Langer lines in all body areas, andother guides, such as relaxed skin tension lines running perpendicular to the direction of muscle contraction, may serve patients better. However, the concept of skin tension lines has helped improve the practice of surgery and forensicmedicine, and Langer’swork hasbeen instrumental inourunderstandingof themanyfascinatingproperties of the skin.