Unclaimed Cadavers Research Articles

Patho-mechanical comparative morpho-characterization of contre-coup injuries of liver by cadaveric experimental simulation for medico-legal and forensic implications

BackgroundLiver is the most common organ to get injured in cases of blunt force trauma to the abdomen (BFTA). It is the 2nd commonest organ after brain to sustain injuries out of all the trauma related fatalities. However, the literature about contre-coup injuries to the liver due to BFTA is scarce in-spite of the high mortality rates seen out of injury to this particular organ. PurposeThe authors intended to systematize the characteristic morphogenesis of the contre-coup injuries of the liver on the basis of the patho-mechanics involved in various types of BFTA. MethodologyOne hundred and sixty three cases of BFTA were identified, and interpretation was attempted for the contre-coup rupture of the liver seen in twenty out of all the trauma related fatalities that presented for post-mortem examination during the study period. However, the mechanics of the pattern of the rupture injuries to the liver were indiscernible. This motivated the authors to conduct the comparative characterization of injuries to the liver by experimental simulation of BFTA after necessary permission via inflicting pre-calculated forces on unclaimed cadavers. ResultsThe patterns of contre-coup rupture/s of liver were established in all the twenty out of one sixty-three cases of BFTA. The rupture depicted patterns of injury in the situations of - 1) strong hits with a limited surface trauma, 2) very strong hits with a generalized surface trauma, 3) and collision with a solid surface resulting due to fall onto the side of the abdomen. The causative mechanism discerned was deformation of the liver, followed by its parenchymal rupture due to the shear and strain types of force/s consequent upon tissue compression. The minimum force and energy of impact required for the liver to rupture was estimated to be 2000 N and 141.5 J. ConclusionThis series of the simulation experiments revealed two variants of liver rupture in the contre-coup impact zone. The pattern of injury was maintained in cases, those studied at post-mortem examinations, but the relief ruptures were found to vary depending upon the overall mechanics of the traumatic forces involved in the simulation experiments performed on the cadavers. The anti-shock ruptures were formed during shock trauma, and shockproof ruptures were not seen in cases of underlying compressive forces. The morphogenetic characterization of the relief rupture surface of the liver was also delineated in relation to its surface orientation to the spine on the basis of the terms “large” and “very large” depicting the quantum of force/s delivered out of an impact or blow.

Research on dead human bodies: African perspectives on moral status.

A useful concept that can be invoked to resolve complex bioethical issues is that of moral status (or, human dignity). In this article, we apply this concept to dead human bodies in order to support our view that research on such bodies is permissible. Instead of drawing from salient Western theories of human dignity that account for it by appeals to autonomy or rationality, we will base our investigation on emerging conceptions in African theories of moral status as articulated by Thaddeus Metz and Munamato Chemhuru. Our conclusion is that neither of these theories of moral status, one secular, and the other religious, can accommodate the intuition that we have direct duties of respect towards such bodies because, in relation to Metz's conception, they lack the capacity to enter into social relationships while on Chemhuru's conception, dead bodies appear not to have any meaningful purpose within the hierarchy that captures the ontological systems that determine such status. Consequently, we argue that our analysis provides support for the use of unclaimed cadavers in training and research in medical institutions.

An Ethical, Cultural and Historical Background for Cemetery-Based Human Skeletal Reference Collections

OPEN ACCESS-PAID-CC BY-NC-ND In historically Protestant countries, human skeletal reference collections curated by research institutions have been amassed from bodies dissected by anatomists, typically unclaimed cadavers from morgues and hospitals, or from remains donated to science. In contrast to these anatomy-based and donation-based collections, skeletal reference collections in historically Roman Catholic countries on mainland Europe and in Latin America are for the most part derived from unclaimed remains exhumed from modern cemeteries and ossuaries at the end of the mandated interment period. While much has been written in English about the history, context and ethical framework of anatomy-derived collections, cemetery-based collections have received very little critical attention. The current paper addresses this gap, with particular reference to cemetery-derived collections in Portugal. The cultural and historical context of southern Europe is discussed, particularly Roman Catholic mortuary traditions and the influence of the Napoleonic Code, and these provide the background for an overview of the ethical issues raised by cemetery-derived collections. Here, general principles that should guide the work of human osteologists working in archaeological contexts are relevant, as regards consent, dignity and respect and benefits to science and education, because unlike their anatomy-derived counterparts, cemetery-based collections include individuals who were once buried.

Estimation of ‘Stature’ from Long Bones of the Lower Limb-A Cadaver based Study

Background and objectives: Stature of a person is an important parameter of personal identification. Inthis study stature ( body total length) was estimated from the measurement of length of femur and tibiabelonging to unclaimed cadavers. Methodology: a total number of 51 unidentified dead bodies (42 maleand 9 female) in age group of 18-80 years were studied. Length of the body of the study subject in lyingposition on autopsy table, length of the fresh and dry bones of femur and tibia were measured. Regressionformulae and Multiplication factors were derived for both sexes for fresh and dry bones of femur and Tibiafor estimation of stature. Results: Among males; Wet femur shows highest correlation with the stature,while wet tibia shows least correlation, though both show significant correlation for the estimation of stature(P< 0.0001). Among females ; Dry femur, and combined dry femur and tibia shows highest correlationwith the stature, while wet tibia shows least correlation, though both shows significant correlation for theestimation of stature (P< 0.0001). Interpretation and Conclusion: This study will be useful to the forensicmedical experts when only the lower limb is available for forensic investigation in estimating stature andin anthropological research projects. Regression formulae are dependable than multiplication factor forestimation of stature [52].

Significance of weight for sexual dimorphism of talus bone

The present study aims to determine the sexual dimorphism of talus bone by using weight as a parameter. 100 pair of talus bones of known sex obtained from unknown or unclaimed cadavers brought to the mortuary for autopsy were included in the study. Weight of right talus and left talus of 50 males and 50 females was measured using an electronic weighing scale in this cross-sectional study. All the measurements in male talus were greater than the measurements in female talus bones. Univariate discriminant and logistic regression analyses were conducted on the data to estimate sex from the weight of the talus bone. The overall accuracy came out to be 89% in both sexes (84%-90% in males and 88% - 94% in females). In contrast to Identification and Demarcating points, Limiting point showed maximum classification accuracy in sex determination. Weight of talus bone thus showed statistically significant sexual dimorphism results and can be used to estimate sex along with other parameters

Morphometry of the Digastric Ridge and Its Significance for Mastoid Surgeries-A Cadaveric Study.

Digastric ridge (DR) is an important landmark to locate facial nerve (FN) and sigmoid sinus for mastoid surgeries and transmastoid approaches. We aim to look for the effect of temporal bone pneumatization on the morphometry of the DR and its relation to the adjoining structures. Temporal bones were harvested from unclaimed cadavers after the approval of the ethical committee. The dissection of the temporal bones was performed under a microscope, and the length of the DR and the distance between the mastoid segment of the FN and the anterior end of DR (FN-DR distance) were measured using a digital caliper. Stata version 14.0 was used to perform the statistical calculations. Ninety-three temporal bones were microdissected (right:left = 47:46; well pneumatized:poorly pneumatized = 58:35). Mean length of the DR was 17.1 mm and was significantly longer in well-pneumatized bones (P = .0000). The mean distance between the anterior end of the digastric ridge and the mastoid part of the facial nerve was 4 mm. The distance was significantly more in well-pneumatized bones. Prominence and the length of the DR, as well as the FN-DR distance, are significantly more in well-pneumatized bones compared to poorly pneumatized bones. This finding has potential surgical implications with reduced risk of injury to the FN resulting from a conspicuous DR in well-pneumatized bones.

Moral Considerations in Medical Education: Buying Unclaimed Human Cadavers

Is it morally virtuous for a medical school to buy and to use unclaimed cadavers? Because of his exalted status as the creature who is the imago Dei, the human person has an inviolable dignity that is his simply because he is the kind of being that he is. This is why we cannot buy and sell people. However, since you cannot distinguish the human person from his body without doing violence to his identity as an embodied creature, the same argument can also be made against the buying and selling of human bodies. I therefore conclude that it is immoral for unclaimed bodies to be used in medical schools, and even more morally problematic for them to be sold and to be bought. Instead, Catholic citizens should exercise the corporal act of mercy by providing for the burial of the bodies of these brothers and sisters of ours. And in response to the lack of cadavers, they should also organize programs to increase the bequeathing of bodies for medical education and research.

Case report of an arc of Bühler pancreatic variant in a Brazilian cadaver

The present study concerns the persistence of an arc of Bühler pancreatic variant in a Brazilian cadáver. The arc of Bühler, reported by Bühler and Tandler in 1904, is an important and rare vascular anatomical variation of the abdominal cavity. Although the first description dates back more than a century, it is estimated that this variation represents only 1% to 4% of all variations found worldwide, and its presence is often admitted as controversial, because it is not the arc of Bühler per se, but a similar collateral variation. In this context, the aim of the present study is to examine the role of this variation in clinical and surgical presentations of the abdominal cavity, punctuating both the benefits and harms of the presence of this vasculature variant of considerable caliber. The importance of adequately classifying similar structures with different functions is demonstrated, given different medical practice situations. Possible pathologies created exclusively by the presence of this anatomical variation are also highlighted. It is concluded that knowledge concerning the present structure reaffirms the study of human anatomy as one of the foundations of medicine and of its safe, resolutive and inclusive practice within medical aspects. The study was carried out within the parameters established by decree No. 8.501, of November 30, 1992, of the Federative Republic of Brazil1,on the use of unclaimed cadavers for study or scientific research purposes. Support or Funding Information The work had funding from the present authors and support from college of medicine, Campus João Uchôa, Universidade Estácio de Sá. Anterior view of the abdominal cavity, exposing the larger omentum. Anterior view of the upper abdomen.-Blue: Left gastric artery.- White: Splenic artery.- Red: Hepatic Artery Proper.- Green: Arc of Bühler. Lateral view. Arc of Bühler contouring the SMA and performing anastomosis on the posterior side. Morphometric analysis of the Arc of Bühler -Anterior view of the abdominal cavity. This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Current status of cadaver sources in Turkey and a wake-up call for Turkish anatomists.

Persisting difficulties in body procurement in Turkey led to the acquisition of donated, unclaimed, autopsied, and imported bodies regulated under current legislature. Yet, no study had investigated the extent of the on-going cadaver problem. This study was aimed to outline cadaver sources in anatomy departments and their effectiveness by means of an online survey. Additionally, official websites of each department were investigated regarding any information on body donation. Unclaimed cadavers (84.8%) were the major source for anatomy departments, followed by donated (50%) and imported cadavers (39.1%). Foundation-based medical faculties were more likely to import cadavers (P = 0.008). There was a moderate increase (rs = 0.567; P = 0.018) in donation registrations to our department after 2000. The departments in cities with significantly higher City-Based Gross Domestic Product measures (US$9,900 vs. US$16,772, P = 0.041), frequencies for mid- or high-school graduates (30.4% vs. 31.3%, P = 0.041), and frequencies for under- or post-graduates (13.1% vs. 15.8%, P = 0.24) had managed to use donated cadavers. Anatomy departments' major reasons for using unclaimed cadavers were education (45.9%), unclaimed cadavers being the only source (24.3%), and receiving inadequate donations (21.6%). Nine out of seventy-four departments (12.2%) provided information regarding body donation on their websites. Body procurement remains as a serious problem in Turkey and it is apparent that current legislature does not provide a sufficient cadaver inflow. Similarly, anatomy departments' effectiveness in public awareness of body donation and support in the National Body Donation Campaign seems questionable. Anat Sci Educ 11: 155-165. © 2017 American Association of Anatomists.

Transformation of a cadaver population: Analysis of a South African cadaver program, 1921-2013.

Anatomy has served as a cornerstone in the training of various allied and clinical disciplines and has traditionally been based on dissection of the human body. Thus, to pursue this method of teaching and learning, access to cadavers is of continuing importance. Over a significant period of time unclaimed cadavers have performed an essential role in the teaching of anatomy in South Africa and in Africa. As recent cadaver numbers were declining at the School of Anatomical Sciences, University of the Witwatersrand, Johannesburg and difficulty in procurement was being experienced, the purpose of this study was to critically evaluate the composition of our cadaver population over time so as to provide possible strategies to arrest the decline. A retrospective, quantitative analysis of cadaver records from the School of Anatomical Sciences between 1921 and 2013 was undertaken. Analysis included a comparison of Poisson counts and Fischer's exact test. A significant decrease in the number of cadavers received during the period 2000-2013 and a slow bequest program over the same period of time has led to concerns about the sustainability of teaching anatomy through dissection. Decreases in the numbers of males and cadavers of the black population group occurred between 1990 and 2013, and of bequests from 2000 to 2013. An influence on the cadaver population from a changing political climate and change in socioeconomic status of part of the population was perceived. Changes in sex and population group of the cadavers may have a long-term effect on teaching and research.

The body donation program at the Federal University of Health Sciences of Porto Alegre: A successful experience in Brazil

The use of dissection to study human anatomy is the foundation for educational excellence among future health professionals, as it offers an ideal opportunity to learn the body's morphology in three dimensions while also providing students with a more humanistic education. The shortage of bodies for dissection, combined with the Brazilian population's lack of knowledge concerning the possibility of voluntarily donating their own bodies, led to the creation of the Body Donation Programs for Education and Research in Anatomy at the Federal University of Health Sciences of Porto Alegre (UFCSPA). The program is based on three pillars: Informing the general public about the program, donor registration, and donation itself. Since the creation of the donor program in 2008, there has been an increase in both the number of donations made during donor's lifetime and the number of bodies received by the university. There has also been a shift in relation to the origin of these bodies, as before the creation of the program most bodies were unclaimed cadavers, while today most of the bodies are sourced from voluntary donations. The initial results regarding the public's acceptance of the possibility of making body donations have been encouraging, as shown by the annual growth in donor registrations. Consequently, the quality and quantity of the material available for educational purposes have greatly improved.

The treatment of human remains

Concerns regarding treatment of the dead in scientific and public arenas, issues related to consent, respect for human dignity, scientific integrity, societal expectations, and why treatment of cadavers are ethically significant are highlighted. The display of human remains claimed as ‘edutainment’ or ‘anatomy art’ in Body Worlds is discussed. In this regard, the issues of consent, legal controversy surrounding Body Worlds’ innovator, copycat competitor exhibitions, human rights violations and the legal vacuum within which anatomical specimens are permitted to cross international boarders are explored. The display of Saartjie Baartman, a Khoisan woman, as a popular novelty, curiosity and political caricature is examined. The role of anatomists, controversies and difficulties in repatriation, and the need for respect for indigenous cultural, religious and traditional values, are discussed. The exhumation by the Truth and Reconciliation Commission (TRC) and final laying to rest of Phila Portia Ndwande are explored. The TRC report relating to the treatment of human remains, including cultural rights of the dead, sacred rituals and the demand that the ‘amadlozi’ (spirit of the dead) be officially brought home and inaugurated as an ‘ancestor’ are examined. Boundaries will be pushed only as far as society condones it. Key recommendations include valuable lessons recommended by the TRC; the formation of a multi-stakeholder forum to consider definitive answers to complex issues in the use of unclaimed cadavers; policy relating to legacy collections; guidelines by healthcare and scientific associations; and revision of the National Health Act, 2003.

The reliance on unclaimed cadavers for anatomical teaching by medical schools in Africa

The study of gross Anatomy through the use of cadaveric dissections in medical schools is an essential part of the comprehensive learning of human Anatomy, and unsurprisingly, 90% of the surveyed medical schools in Africa used cadaveric dissections. Donated cadavers now make up 80% of the total cadavers in North American medical schools and all the cadavers used for dissection in the United Kingdom are donated. Because the sources of cadavers used in Africa are not clearly known, a questionnaire to gather information on cadavers used at medical schools was designed from the relevant literature and was sent by electronic mail to 123 Anatomy lecturers in 23 African countries (48 medical schools). Fourteen lecturers from 14 medical schools in ten countries responded to the questionnaires. The results indicate that, in most countries, the cadavers are unclaimed bodies from the hospitals and prisons, and the bodies of dead bandits. In South Africa and Zimbabwe, the donations are mostly from the white community, and medical school in the Islamic country of Libya is importing cadavers from India. The lack of knowledge about body donation programes and firmly held cultural and religious burial traditions may explain the lack of bequests from black communities. The use of unclaimed bodies may disproportionally affect people who were homeless and poor, criminals, people with fewer social links, and social outcasts. The Anatomy lecturers felt that there should be broader national awareness programes for body donations, although the benefits of this could take decades to materialize.

Internal mammary lymph nodes identification from isolated sternum of human cadaver

To identify the lymph nodes positioned along the internal mammary vessels in isolated sternum of human cadaver and to standardize the surgical approach to those nodes, in order to establish anatomical landmarks to be used with the current techniques of mammary gland sentinel lymph node detection. Ten sternum plates removed from unclaimed cadavers were used in this study. Sternal plates were removed using bilateral incisions of the ribs at the midclavicular lines. The characterization of the internal mammary vessels and the anatomical integrity of the parietal pleura were indispensable requirements during the procedure. A total of 29 lymph nodes were removed from the 2nd (13) and the 3rd (16) intercostals spaces. Almost 50% of all nodes collected were located medially to the vessels. The approach used is a reliable surgical technique for removing lymph node from sternal plates. The model is therefore valuable for breast surgeons training in sentinel node biopsy, an important procedure for breast cancer patients.