Commercial livestock facilities are faced with the challenge of managing large amounts of waste including manure and animal mortalities. One method of disposing of dead animals is composting. The ...cadavers are enveloped in carbon material that creates a barrier between the dead tissue and the surrounding environment. Dead tissue can release materials that not only contaminate the soil but also the groundwater and nearby surface water. Animal cadaver composting is designed to facilitate decomposition without the aid of carrionfeeding insects and reduce the presence of common pathogens associated with animal waste and dead tissue. The aim of this study was to evaluate insect activity associated with composted and exposed beef cadavers, specifically filth flies that can serve as mechanical vectors of important human pathogens such as E. coli 0157:H7. Greater numbers of all types of arthropods were trapped overall at the exposed animal site than the composted animal site. Most importantly, the number of filth flies was significantly lower at the composted site (P = 0.0009). Laboratory analysis of volatile organic compounds from composted and noncomposted rats indicated that known fly attractants such as dimethyl disulfide may be inhibited by the composting process. Implementing composting programs at livestock facilities could reduce the risk of flies spreading harmful pathogens to surrounding areas, including farms that grow fresh produce.
Background:
Meniscal root tears are an increasingly recognized subset of meniscal injury. The menisci are critical secondary stabilizers of the anterior cruciate ligament (ACL). The kinematic effect ...of lateral meniscus posterior root tear in the setting of ACL injury is not known.
Purpose/Hypothesis:
The purpose of this study was to determine the effect of tear of the lateral meniscal root on stability of the ACL-deficient knee. The hypothesis was that disruption of the lateral meniscal root will further destabilize the ACL-deficient knee during a simulated pivot shift.
Study Design:
Controlled laboratory study.
Methods:
Pivot-shift testing of 8 fresh-frozen cadaveric knees was performed after attachment of photoreflective flags and preparation of CT scans. Each knee was mounted in a custom activity simulator and dynamically loaded from 15° to 90° of flexion with all the permutations of the following: iliotibial band force (50, 75, 100, 125, 150, and 175 N), internal rotation moments (1, 2, and 3 N·m), and valgus moments (5 and 7 N·m). In addition, anterior stability tests were performed by applying a 90-N anterior force to the tibia at flexion angles of 15°, 30°, 45°, 60°, and 90°. During each test, the anterior tibial translation and rotation of the tibia were measured with a high-resolution multiple infrared camera motion analysis system for the following 3 conditions: ACL-intact (ACL-I), ACL-deficient (ACL-D), and ACL-deficient/lateral meniscal posterior root avulsion (ACL-D/LMR-A).
Results:
A pivot-shift phenomenon was observed in the ACL-D and ACL-D/LMR-A conditions. The mean tibial translation of the lateral tibial condyle during the pivot-shift maneuver was 2.62 ± 0.53 mm for the ACL-I knees, 6.01 ± 0.51 mm for the ACL-D knees (P value vs intact: .0005), and 8.13 ± 0.75 mm for the ACL-D/LMR-A knees (P value vs intact: <.0001). During the pivot-shift maneuver, translation was significantly increased in the ACL-D/LMR-A condition compared with the ACL-D condition (P = .0146). Compared with the intact group, anterior tibial translation during the Lachman maneuver also increased at 30° and 90° of flexion in the ACL-D group (P < .0001) and the ACL-D/LM group (P < .0001). No statistically significant difference was found between the ACL-D and ACL-D/LMR-A groups during the Lachman maneuver at 30° and 90° (P = .16 and .72, respectively).
Conclusion:
A tear of the lateral meniscal posterior root further reduces the stability of the ACL-deficient knee during rotational loading.
Clinical Relevance:
This study shows that lateral meniscal root injury further destabilizes the ACL-deficient knee and thus advances the concept that the lateral meniscus is a secondary stabilizer of the knee under pivot-shift loading. In the absence of stronger evidence, the study data suggest a rationale for surgical repair of lateral meniscal root tears encountered in the setting of ACL tears.
Purpose To measure the variations in length during flexion and internal tibial rotation of the 3 different femoral insertions of the anterolateral ligament (ALL) while maintaining a fixed tibia ...insertion. Methods Twelve fresh-frozen cadaver knees were analyzed using a navigation system. Maximal distance variations of the 3 different anatomic femoral insertions of the ALL were measured during knee flexion and internal tibial rotation at 20° (IR20°) and 90° (IR90°). The 3 different femoral attachments were, as published, at the center of the lateral epicondyle, distal and anterior from this position, and proximal and posterior. Each of these 3 femoral insertions was coupled to the same tibial insertion at the tibial margin, halfway between the tip of the fibular head and the prominence of the Gerdy tubercle. Results During IR20°, variation in the distance between paired points is not different between the proximal-posterior, epicondyle, and distal-anterior femoral insertions. These variations were statistically different during IR90° for the 3 different femoral locations. In increasing degrees of flexion, there was a length decrease between paired points observed with the proximal-posterior position. A length increase was observed for both the epicondyle location and the distal-anterior location. Conclusions The ALL did not reveal an isometric behavior at any of the femoral insertion locations but had different length change patterns during knee flexion and internal tibial rotation at 90°. The proximal and posterior to epicondyle femoral position is the only position with a favorable isometry, as shown by being tight in extension and in internal rotation at 20° and then relaxed when the knee goes to flexion at 120° and during internal rotation at 90°. Clinical Relevance Clinical relevance is significant with respect to optimizing the femoral position of an ALL reconstruction.
Background:
Although the use of hip arthroscopy continues to increase, capsular management remains a controversial topic.
Purpose:
To investigate the biomechanical effect of capsulotomy and capsular ...repair techniques on hip joint kinematics in varying combinations of sagittal and coronal joint positions.
Study Design:
Controlled laboratory study.
Methods:
Eight fresh-frozen hemi-pelvises (78.3 ± 6.0 years of age; 4 left, 6 male) were dissected of all overlying soft tissue, with the exception of the hip joint capsule. The femur was potted and attached to a load cell, while the pelvis was secured to a custom-designed fixture allowing static alteration of the flexion-extension arc. Optotrak markers were rigidly attached to the femur and pelvis to track motion of the femoral head with respect to the acetabulum. After specimen preparation, 7 conditions were tested: (1) intact, (2) after portal placement (anterolateral and midanterior), (3) interportal capsulotomy (IPC) (35 mm in length), (4) IPC repair, (5) T-capsulotomy (IPC +15-mm longitudinal incision), (6) partial T-repair (repair of longitudinal incision with IPC left open), (7) full T-repair. All conditions were tested in 15° of extension (–15°), 0°, 30°, 60°, and 90° of flexion. Additionally, all flexion angles were tested in neutral, as well as in specimen-specific maximum abduction and adduction, resulting in 15 testing positions. Internal rotation (IR) and external rotation (ER) moments of 3 N·m were manually applied to the femur via the load cell at each position. Rotational range of motion and joint kinematics were recorded.
Results:
In the neutral coronal plane, T-capsulotomy significantly increased IR/ER rotational range of motion compared with intact state at −15° (55.96°± 6.11° vs 44.92°± 7.35°, P < .001), while IPC significantly increased rotation compared with the portal state at 0° (60.09°± 6.82° vs 51.68°± 10.35°, P = .004). No statistically significant increases were found in mediolateral joint translation after IPC or T-capsulotomy. Similarly, no statistically significant increases were noted in anteroposterior translation after IPC or T-capsulotomy. Complete capsular repair restored near native joint kinematics, with no significant differences in rotation or translation between any complete capsular repair groups and the intact state, regardless of joint position.
Conclusion:
Universally, across all conditions, complete capsular repair after interportal or T-capsulotomy restored rotational range of motion and joint translation to values observed in the native joint.
Clinical Relevance:
Where feasible, complete capsular closure should be performed, especially after T-capsulotomy. However, further clinical evaluation is required to determine whether adverse kinematic parameters of an unrepaired capsule are associated with reduced patient-reported outcomes.
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Type 1 Diabetes (T1D) involves the autoimmune destruction of insulin-producing β-cells in the pancreas. Exogenous insulin injections are the current therapy but are user-dependent and ...cannot fully recapitulate physiological insulin secretion dynamics. Since the emergence of allogeneic cell therapy for T1D, the Edmonton Protocol has been the most promising immunosuppression protocol for cadaveric islet transplantation, but the lack of donor islets, poor cell engraftment, and required chronic immunosuppression have limited its application as a therapy for T1D. Encapsulation in biomaterials on the nano-, micro-, and macro-scale offers the potential to integrate islets with the host and protect them from immune responses. This method can be applied to different cell types, including cadaveric, porcine, and stem cell-derived islets, mitigating the issue of a lack of donor cells. This review covers progress in the efforts to integrate insulin-producing cells from multiple sources to T1D patients as a form of cell therapy.
The last few decades have witnessed the emergence of the field of bioethics. Students entering medical college face unique ethically charged situations. Cadaveric dissection is one such area of ...ethical uncertainty. Studies have shown that an appropriate orientation towards the values inherent in a doctor's relationship with patients, colleagues, and society might help medical students learn how to navigate ethical dilemmas they face. The aim of this article is to examine the feasibility of incorporating ethics teaching in anatomy education, and to emphasize the crucial role of professional identity in shaping the inner image of the “to-be” physician. We also discuss ways by which professional identity can be emphasized right from the 1st-year of medical school. Such endeavors may help learners find ways to respond ethically in their professional life. Understanding the role of bioethics in anatomy education with regard to professional identity formation can guide policy-makers and medical educationists.
Objectives
To analyze the impact of South Asia’s first cadaveric hands‐on workshop on urologists’ training in inflatable penile prosthesis surgery.
Methods
A total of 72 urologists/andrologists ...participated in the 2019 South Asian Society for Sexual Medicine Pre‐congress Penile Prosthesis hands‐on workshop. The workshop included 4 h of lectures and 2 h of hands‐on cadaveric laboratory experience using three‐piece inflatable penile prosthesis. The Shapiro–Wilk test was used on self‐rated procedural confidence levels, which proved the normality. A non‐parametric McNemar test was used to examine the change in the number of correct answers.
Results
Of those who attended the cadaver laboratory, just 45 who answered the survey both before and after the workshop were included for analysis. Significant objective improvements were noted in procedural knowledge test scores (44.30 ± 0.027 vs 72.44 ± 0.024, P < 0.05) and median surgical confidence levels (4 vs 3 and 2, P < 0.001) of the urologists after the completion of the workshop.
Conclusions
Cadaveric hands‐on workshop training improves urologists’ procedural knowledge and surgical confidence levels in carrying out three‐piece inflatable penile prosthesis surgery. The feasibility of such workshops should be considered in increasing the surgical expertise of general urologists in prosthetic urology.
Hepatocellular carcinoma (HCC) presenting with another primary cancer is rarely documented, and when occurring in the setting of HCC metastasis to the left supraclavicular lymph node (Virchow node), ...documentation is even rarer. The purpose of this article is to report such an occurrence. Here we describe evidence supporting the presence of two distinct primary tumors from the liver and lung of a 44-year-old female cadaver, consistent with synchronous or metachronous tumors.
The reported cause of death in a 44-year-old female cadaver was hepatocellular carcinoma of the liver with metastasis to the lung and lymph nodes. However, complete investigation of the body with histologic sections revealed two distinct malignant tumor processes – one involving the lung with features compatible with a neuroendocrine carcinoma, and the other involving the liver and left supraclavicular lymph node with features compatible with hepatocellular carcinoma. Interestingly, both tumors showed multifocal involvement of the organs in which they were discovered.
Given the discrepancy between the reported cause of death and cadaveric findings, this case highlights the importance of closely comparing the histologic features between tumors in order to allow for accurate diagnosis and treatment. In addition, the findings highlight the utility for thorough gross and histopathological examination of cadaveric specimens to inform not only medical students, researchers, and educators but also physicians in their approach to diagnosis.
•Hepatocellular carcinoma with metastasis to left supraclavicular lymph node.•Gross and histologic findings highly suggest metachronous/synchronous tumor process.•Cadaveric study during medical school gross anatomy lab reveals potential error in previously shared cause of death.•Utility of histology and gross anatomy education for greater understanding of malignant processes including metastasis.