O treinamento em cadáveres nas disciplinas de Técnica Cirúrgica e Ortopedia vem sendo utilizado na Faculdade de Medicina Veterinária e Zootecnia da Universidade de São Paulo, como método alternativo ao uso de animais vivos em aulas. Neste trabalho avaliou-se a possibilidade de treinamento cirúrgico em cadáveres quimicamente preservados com Solução de Larssen modificada e criopreservados. A preservação torna-se necessária para que os cadáveres mantenham características como cor, consistência e textura dos tecidos e flexibilidade das articulações o mais semelhante possível às encontradas no animal vivo e para que possam ser utilizados várias vezes diminuindo assim o número de animais necessários para as aulas. As características dos cadáveres foram observadas durante as aulas práticas e o método de ensino foi avaliado através de um questionário respondido pelos alunos. Foi possível concluir através da análise dos questionários que o método de ensino utilizado foi bem aceito pelos alunos e que o uso de cadáveres quimicamente preservados com Solução de Larssen modificada permite treinamento intenso e adequado das técnicas cirúrgicas realizadas durante as disciplinas. A técnica de conservação com a Solução de Larssen modificada em conjunto com a criopreservação mantiveram as características organolépticas dos cadáveres semelhantes às encontradas nos animais vivos. / Training with cadavers in surgical techniques and orthopedics is being done at the Faculty of Veterinary Medicine and Zootechnics of the University of São Paulo, as an alternative to the use of live animals in classes. In this work we evaluate the possibility of surgical training with cadavers chemically preserved with modified Solution of Larssen and cryopreservation techniques. Preservation is necessary so that the cadavers maintain characteristics as close as possible to those found in the live animal, such as color, tissue consistency and texture, and joint flexibility, and so that they can be used several times, thereby reducing the number of animals necessary for classes. The characteristics of the cadavers were observed during practice classes, and the teaching method was evaluated through a questionnaire completed by the students. From the responses to this questionnaire it was possible to conclude that the teaching method described here is being well accepted by the students and that the use of cadavers chemically preserved with modified Solution of Larssen allows intense and adequate training in the surgical techniques performed during the course. The method of preservation with modified Solution of Larssen and cryopreservation techniques kept the organoleptic characteristics of the cadavers similar to those found in live animal.

Blocking the contents of the pterygopalatine fossa (PPF) is a highly effective method in alleviating pain in trigeminal neuralgia (TN) and other facial pain syndromes. This, however, is not a widely used technique, due to the difficulty in locating the PPF which is obscured by bony and soft tissue structures. Despite the various unspecific techniques that have been attempted, in many cases radiography still seems to be used as it is the most effective method in locating the PPF. The aim of this study was therefore to achieve a safe and alternative method of locating the PPF including its contents without the aid of radiography. A total of 160 skulls from the Pretoria Bone Collection at the University of Pretoria were used. Distinct anatomical landmarks and the use of existing and new anthropometric measurements were used to define the location of the PPF in any individual. Regression analysis provided the strength of influence each measurement had on the location of the PPF. From the results, two mathematical formulae were devised (one for each side). These formulae were tested on 47 cadavers by substituting the measurements of each individual into the created formulas. A needle was then inserted at the calculated points, and the area around the needle dissected to determine whether or not it was in the PPF. Our results showed an accuracy of 65.22% on the right and 54.35% on the left. It is hoped that this new technique will aid researchers and clinicians alike in the management of various pain disorders as well as pain management during surgery. AFRIKAANS : Daar is bevind dat ‘n lokale verdowingsblok van die inhoud van die pterygopalatine fossa (PPF) die pyn effektief verlig vir trigeminale senuweepyn, sowel as ander pyn sindrome. Die tegniek word egter nie gereeld gebruik nie as gevolg daarvan dat dit moeilik is om die PPF te betree deurdat dit deur verskeie benige en sagte weefsels verberg word. Die literatuur beskryf verskeie onspesifieke metodes om die prosedure uit te voer, maar in die meeste gevalle moes radiografie gebruik word om sukses te behaal. Die doel van hierdie projek was om ’n alternatiewe metode te ontwikkel wat veilige en effektiewe toegang tot die PPF bied, sonder om radiografie te gebruik. ’n Totaal van 160 skedels was gebruik om anatomies landmerke en bestaande sowel as nuwe antropologiese metings te maak. Regresie analise het die sterkte van die invloed van die onderskeie metings met die pterygopalatine fossa gemeet. Vanuit die resultate van die statistiese analise is twee formules ontwerp (een vir elke kant van die gesig). Die formules was getoets op 47 kadavers deur die metings vir elke individu in die formules te plaas. ‘n Naald is dan geplaas in die uitgewerkte punt, die area om die naald was gedisekteer om te sien of die naald in die fossa en dus by die ganglion was of nie. Die resultate toon ‘n akkuraatheid van 65.22% aan die regterkant en 54.35% aan die linkerkant. Daar word gehoop dat hierdie nuwe tegniek ‘n effektiewe manier van pyn behandeling word in verskeie pyn sindrome sowel as gedurende chirurgie vir beide navorsers en chirurge. / Dissertation (MSc)--University of Pretoria, 2011. / Anatomy / unrestricted

The research question explored in this exhibition and dissertation was to review the conventional notions of craftsmanship and the use of the specific medium of oil paint with reference to the art of Rembrandt and Damien Hirst. The subject matter is flesh. This study foregrounds the involvement and acknowledgment of the corporeal body, the hand of the artist, and of the organic material reality of our existence and the objects that surround us. The paintings reflect a series of interventions that resulted in abstracted images based on photographs of meat. Once a detail had emerged that emphasised the fleshiness of the selected image, it was printed by a professional printing company. These details were then translated into oil paintings. What is explored is the specific material qualities of the binding mediums traditionally associated with the use of oil painting to create expressive paintings. In the creation of the series of paintings, I prepared binding mediums consisting of wax, stand oil, damar varnish, zel-ken liquin and acrylic paste medium mixed with manufactured readymade oil paints. Consequently the choice and exploration of the material possibilities of a specific medium becomes content, using art to explore the idea of art. Paint becomes flesh-like, having congealed over the surface of the technical support. These paintings propose an internal and an external reality simultaneously referenced through the flesh-like surface, pierced and cut to reveal multiple layers created on the supporting structure (wood and canvas) with the use of a specific medium, oil paint, combined with a variety of other binding mediums. The edges of the unframed paintings play an important role assuming a specific physical presence, enabling them to define themselves as boundaries, both of the paintings particular field of forces and of the viewer’s aesthetic experience. They are no longer edges or frames in the conventional sense, but become other surfaces that are of equal significance in the reading or viewing of the work. Finally, the notion of an exhibition site being neutral or given is contested and, as a result, the contemporary artist needs to be mindful of site specificity in relation to the exhibition of the artworks. This series of paintings is intended to communicate as a body of work, reflecting an individual vision: a recurring, introspective process that is always unfolding. The body is constantly recreated by each individual viewer, and the context or site of display. The artist’s intention is to activate the viewer’s heightened awareness and response to the conscious arrangement of the collection of canvases, as each one represents a fragment or detail of a flayed carcass.

Background: Over 700,000 patients per year undergo open-heart surgery. Healing complication rates can be up to 5% of patients who undergo this procedure, with a morbidity rate of 50% if mediastinitis supervenes. A secure and rigid fixation of surgically divided sternum is critical to avoid healing complications. The purpose of this study was to compare the yield load, construct stiffness, ultimate load, displacement at ultimate load, and post-yield behavior of three sternotomy closure methods (Peristernal wires or Sternalock titanium plates) when stressed in each of three directions: lateral distraction, rostro-caudal (longitudinal) shear distraction, and anterior-posterior (transverse) shear in a cadaveric model. Methods: Forty-two fresh cadaver models were divided into three test groups: group A, B, and C. A cardiothoracic surgeon divided each cadaveric sternum longitudinally and repaired peristernal wires or one of two Sternalock configurations. Tests were performed using a materials testing system that applied force at a constant displacement rate in a uniaxial direction until the construct catastrophically failed. Mechanical behavior was monitored using a 3D texture correlation system to create a real-time three-dimensional representation of strain directions. The resulting displacement pattern is analogous to a finite element contour plot of displacements, Lagrange Strain, or velocity. Statistical analysis was used to show the different mechanical properties of each closure method. Results: When loaded in lateral distraction, both Sternalock configurations surpassed the rigidity of peristernal wires by 600%. Some evidence was also found linking Sternalock with stiffer behavior in the rostro-caudal direction. Though not statistically significant, a trend was observed showing that constructs using the Sternalock also had higher yield loads, as well as, less post-yield displacement when compared to peristernal wires. Conclusions: Data gathered showed the superior performance of the Sternalock system in stiffness in both longitudinal distraction and rostro-caudal shear. Implications for use of the Sternalock system are faster healing times, lower complication rates, and success of the procedure.

Physical examination education begins early for medical learners. A hindrance to physical exam competency is lack of exposure to pathology in standardized patient settings. This research focuses on improving medical education through the utilization of cadavers that have undergone a soft-embalming technique: the Thiel method. Three scenarios were created in four Thiel cadavers: anterior cruciate ligament (ACL) tear, posterior cruciate ligament (PCL) tear, and sham incision. Students were asked to diagnose ACL tears using the Lachman exam. A total of 54 learners participated in the study. Post-surveys indicated most learners: (1) prefer to use standardized patients (SPs) and soft-embalmed cadavers in their physical examination courses, (2) increased their confidence in performing the Lachman exam on real patients, and (3) enhanced their Lachman technique. SPs ultimately cannot volitionally reproduce the physical exam findings of ACL deficiency. Consequently, learners cannot accurately identify positive versus negative examination findings. Thiel-embalmed cadavers are a valuable resource for physical examination education. (Journal of Surgical Orthopaedic Advances 30(2):112-115, 2021).

There are 5 distinct aspects to this study. (i) Two histological stains for collagen were compared against each other for the first time, namely Herovici's technique and picrosirius-polarization. (ii) Skin samples from embalmed cadaveric tissue from human cadavers were compared against samples taken from surgical patients. (iii) Skin samples were studied from different regions of the body to assess if dermal structure correlates with scarring potential. (iv) Skin samples were sectioned in a plane parallel to the epidermis to gain further insight into dermal structure. (v) A novel basement membrane stain was produced. Type I and type III collagen are important structural constituents of dermis and play a crucial role in wound healing. Only two traditional histological methods are thought to differentiate between them, so avoiding the need for antibodies. These were compared against each other for the first time in order to establish differences in image quality and discrimination between Type I and type III collagen. Neither technique requires antibodies, however picrosirius requires polarisation microscopy. to result in a clearer, consistently reproducible collagen staining pattern than the picrosirius method and more importantly did not require elaborate apparatus to analyze. Additionally other cellular elements were visible. Skin samples for research are often obtained from surgical excision. This clearly limits which tissues are available for comparative study to those areas operated on. Studying samples from embalmed medical school cadavers has the great advantage of studying areas of the body not routinely available from common surgical procedures. It was therefore desirable to assess whether embalmed cadaveric tissues exhibited different properties by virtue of their age and the embalming process compared to fresh surgical specimens, in order to give confidence that studies utilising the former would be equally valid. To test this, 58 skin samples from embalmed medical school cadavers were compared to skin samples from 38 fresh operative specimens. The levels of tissue preservation and processing artefacts were similar in both groups. Embalmed medical school cadavers clearly offer an opportunity to study tissue areas not routinely available during surgery. This is the first time such a comparison has been made. Many things will affect the final appearance of the scar, but the single most important determinant is the body region affected. The most common areas for unfavourable scarring, specifically keloid or hypertrophic scarring have been shown to be the ear, deltoid and sternal areas. To test the hypothesis that there is no difference in histological structure of skin that correlates to body region, comparative histology was undertaken exploring the regional variations of skin characteristics in 58 cadaveric samples. Closely comparable samples were taken from the deltoid (9), abdomen (13), sternum (10), post-auricular (5), earlobe (12) and eyelid (9). Epidermal thickness, epidermal appendage density and collagen fibre orientation were examined and qualitative structural differences were assessed for each region Skin samples were then grouped by both topographical location of the body and scarring potential. Skin samples exhibited qualitative and quantifiable regional variations in the characteristics studied. Epidermal thickness and appendage counts did not correlate with scarring potential. Both however were statistically significantly higher in skin sampled from the head compared to the trunk. Bundles of collagen fibres in the reticular dermis were grouped according to their orientation in relation to the coronal plane; either parallel, oblique or perpendicular. The ratio of oblique to parallel fibres was statistically significantly higher in body areas with poorer scarring prognosis. This corresponds to a more disorganised arrangement of collagen fibres in these areas. Further qualitative understanding of dermal collagen fibres came from perpendicular to conventional histological samples. This new method stained basement membranes purple, cytoplasm was stained greenish-brown and nuclei dark brown. Collagen fibres were either thin and blue or thick and green. This method was compared to PAS staining and although required more preparative steps allows greater identification of other cellular structures.

The following research examined the overall biological profile of an anatomized human skeletal assemblage discovered in Winchester, Massachusetts (Middlesex County) in 2020. This assemblage was discovered during construction of a private house in a suburban neighborhood. In addition, this project examined the history of medical teaching specimens and how this new collection connected to the anthropological understanding of this history. For centuries, marginalized individuals, including Black people, poor people, and criminals, were utilized as the cadaver supply for medical schools. The author examined the general biological profile, including sex, age, population affinity, and stature, of the Winchester assemblage. Since none of the fragmented postcranial bones were able to be matched to particular individuals, these estimations served as a profile for the general population of the Winchester assemblage. The skulls were the only parts of the sample that could be treated as specific individuals. Craniofacial nonmetric traits were observed as well as postcranial aspects of the skeleton. The total number (NISP) of adult remains was 14,469. The MNI of the adult remains was 35 based on the left femora. The author hypothesized that the majority of the remains would consist of male individuals, and the age profile would reflect the average age at death during the mid-1800s, which was about 20-40 years old. In addition, it was hypothesized that the majority of individuals would be of Black population affinity, which might indicate that the remains were robbed from Black cemeteries. The majority of the assemblage was indeed comprised of males. Specifically, 60.5% of the pubic symphyses and 58.8% of the greater sciatic notches analyzed were determined to be male. The general average age at death of the sample was 23 to 45 years old. Estimation of population affinity of the sample was attempted; however, the results were not compelling due to the fragmentation of the remains and limited ability to reconstruct crania. The stature of the remains was estimated to range from 58.1 to 69.9 inches or 4 feet 10 inches to 5 feet 10 inches. This biological profile was compared to the demographics of Middlesex County, Massachusetts, and the United States presented by the 1850 U.S. Census and data from the military during that time. The Winchester adult remains had more males than females, similar to the sex representation in Massachusetts’ poorhouses, penitentiaries, jails, and houses of correction during 1850. Unlike these institutions, the general population of Middlesex County had more females than males. The 1850 Census indicates that the majority of individuals in Massachusetts’ poorhouses, penitentiaries, jails, and houses of correction were 24 years and older, which aligns with the estimated aged range for the Winchester adult remains. White and Black individuals were the only population affinities compared in the 1850 Census, and there were significantly more White individuals. The average height of a White male in the US military was 63.7 inches, which aligned with the general stature interval of 58.1 to 69.9 inches for the adult Winchester remains. Future research, including DNA and isotope analyses, could provide further insights into the origins of these individuals discovered at this site.

No description available.

No description available.

Transplant medicine has been developing fast, bringing about also development of nursing care in this field. The purpose of this thesis was to examine the experience of perioperative nurses with organ procurement at the IKEM Transplant Centre and to obtain information on the procurement of different organs, organ storage, the organisation of perioperative nurses' work and on how the nurses perceive their work. This thesis applied a qualitative method, using semi-structured interviews divided into several parts, and the results were subsequently categorized. Meister's questionnaire was used to assess the mental workload of perioperative nurses. A total of 8 perioperative nurses working in full-time positions at the IKEM Transplant Centre and 8 perioperative nurses working in surgery units, all of them chosen by non-probability sampling, participated in the survey. Perioperative nurses perceive differences in the procurement of different organs from cadaver donors and know the possible modification of the procedure. What matters to them is the organ that is procured - kidney procurement or multiple organ procurement in cooperation with multiple surgeon teams, split-liver or reduction-liver transplantation or the donor's age. The nurses emphasize that their job requires responsibility, is demanding and causes stress. More experienced nurses participate in organ procurement in donor hospitals, bearing their own responsibility, but at the same time working in a well-functioning transplant team that includes also the coordinator and procurement surgeon. These nurses work on-call and are responsible for organising the work in the surgery room. They know that their job is demanding and are proud of where they work; however, they very often point out the stressfulness of their work. They know it is necessary to take time to relax and regenerate. Transplant centre perioperative nurses can be assessed as the second category of Meister's questionnaire, while perioperative nurses in surgery units as Meister's first category. This thesis may be used as study material and was used for a presentation at a medical conference.