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1.
As more and more emphasis is placed on the use of prosected specimens to support teaching and learning of gross anatomy, consideration must be given to developing new methods to preserve human cadaveric material, and in ways which will resist the wear and tear to which they are necessarily subjected. Taxidermists have developed techniques for freeze-drying whole small animals as a method of long term preservation (Metcalf, 1981). We have explored the use of this methodology to preserve small prosected specimens for use in the teaching of gross anatomy. The technique we report here was tested initially on larynges (Fig. 1) but has since been applied with equal success to other structures, including pieces of small intestine dissected to show the arterial arcades (Fig. 2). We have used material from cadavers which were preserved using our standard embalming procedure (O'Sullivan & Mitchell, 1993).  相似文献   

2.
Over the past decade, the role of anatomical teaching in the undergraduate medical curriculum has changed considerably. At some medical schools, active dissection of cadaveric specimens is gradually being replaced by prosection-based methods and other resources such as e-learning. Warwick Medical School has recently obtained a large collection of plastinated prosections, which replace wet cadaveric specimens in undergraduate anatomy teaching. The aim of this study was to examine students' views on the use of plastinated prosections for their anatomical learning. A mixed method approach was employed using a questionnaire and focus group for data collection. The questionnaire was completed by 125 first-year medical students (response rate 68%). The majority of students (94%) rated plastinated prosections as a valuable resource for their anatomical learning. Various features of the specimens were highlighted, such as the detailed view of relevant anatomy, appreciation of relations between structures, and visualization of anatomy in real life. However, learning on plastinated prosections was perceived to be compromised because of limitations in terms of tactile and emotional experience. We conclude that plastinated prosections are an adequate resource for the early stages of undergraduate training, but that the learning experience may be further enhanced by providing opportunity for the study of wet cadaveric material.  相似文献   

3.
Attitudes of professional anatomists to curricular change   总被引:3,自引:0,他引:3  
Throughout the world, recent developments in medical curricula have led to marked changes in the teaching of gross anatomy. This change has involved decreasing curricular student contact time and the use of new methods for anatomical teaching. Some "modern" anatomists have welcomed the arrival of these novel methods while other, more "traditional," anatomists have fought to maintain the use of cadaveric dissection. Consequently, controversy over teaching methods has developed to the point that "modernist" and "traditionalist" views within the community of professional anatomists seem to have diverged such that the importance of gross anatomy in the medical curriculum is disputed and that cadaveric dissection by students is no longer the preferred method of teaching. This study tests this hypothesis using Thurstone and Chave attitude analyses to assess attitudes to educational change and the importance of anatomy in medicine and a matrix questionnaire that required professional anatomists to relate course aims to different teaching methods. In total, 112 completed questionnaires were received from anatomists who are employed at higher education institutions that use various teaching methods and who span the academic hierarchy. The results suggest that over 90% of anatomists favor educational change and approximately 98% of professional anatomists believe that gross anatomy has an important role to play in clinical medicine. A clear majority of the anatomists (69%) favored the use of human cadaveric dissection over other teaching methods (this method seeming to achieve a range of different course aims/objectives) (P < 0.001; Kruskal-Wallis). Using Kruskal-Wallis statistical tests, the order-of-preference for teaching methods was found to be as follows: 1. Practical lessons using cadaveric dissection by students. 2. Practical lessons using prosection. 3. Tuition based upon living and radiological anatomy. 4. Electronic tuition using computer aided learning (CAL). 5. Didactic teaching alone (e.g. lectures/class room-based tuition). 6. Use of models. The preference for the use of human cadaveric dissection was evident in all groups of anatomists, whether "traditionalist" or "modernist" (P = 0.002, Chi-squared). These findings are therefore not consistent with our initial hypothesis.  相似文献   

4.
Preservation techniques have evolved over the years to respond to the need of longer dissection periods, with formaldehyde being widely used for this purpose. In recent years, efforts have been focusing on reducing the health hazards of this fixative and the rigidity of the tissues embalmed with it. With every embalming technique that they are either developing or resurrecting from various protocols, institutions need to assess the fire and health hazards of all the chemicals being used. Compliance with the storage and handling safeguards listed in the Material Safety Data Sheet of each chemical, needs to be accompanied by infrastructure changes. To reduce the health hazards of formaldehyde, institutions are taking appropriate countermeasures directed at the source itself, by using substitutes or injecting formaldehyde chelating agents, and are adopting high performance air extraction systems to protect the users. However, little is known about the flammability risk of embalmed human bodies. During a recent visit to McGill University morgue by architects and safety inspectors to expand it, we were asked about the flammability risk of the embalmed specimens, so we carried out a flashpoint test to evaluate the flammability potential of specimens embalmed with each of our three embalming techniques: formaldehyde-based, Thiel, and phenol-based. With the phenol-based embalming showing the most risks, attention should be drawn to all institutions who are experimenting with various embalming techniques to evaluate the flammability potential of their embalmed specimens.  相似文献   

5.
Changes in the teaching of gross anatomy have often involved decreasing student contact time alongside the use of new methods for teaching. However, there remains controversy over teaching methods and about whether cadaveric dissection by students should remain the preferred method. Furthermore, decisions concerning changes to curricula are more likely to be taken by choosing a method of teaching rather than by proper evaluation of what are the desired learning outcomes for a course in anatomy. The purpose of this study was to ascertain the attitudes of anatomists in Europe towards the methods of teaching best fitting a series of learning outcomes for anatomy and secondarily to test the hypothesis that, from evaluation of learning outcomes, anatomy is best taught by cadaveric dissection by the students. About 113 completed questionnaires were received from anatomists who are employed at higher education institutions that use various teaching methods. Most anatomists (69%) favored the use of cadaveric dissection above other teaching methods when considering the whole series of learning comes, this method seeming to achieve a range of different course aims/objectives, P < 0.001; Kruskal-Wallis). Consequently, these findings are consistent with our initial hypothesis. However, when individual learning outcomes were considered, the relationship was not so clear cut and, for example, little difference was discernible between teaching methods when considering learning outcomes related to the acquisition of anatomical knowledge. The use of human cadaveric dissection gained more approval when the skills-base was considered rather than just the content(knowledge)-base of an anatomical course.  相似文献   

6.
The aims of this study were to estimate the importance of vaccine failure (VF) in cases of mumps during 2002-2004 in the city of Novosibirsk, Western Siberia, Russia, and to genotype the responsible virus strain. Mumps virus-specific RT-PCR testing of saliva was performed for 18 cases of mumps. Sera were tested for IgM and IgG, IgG avidity, and the ability to neutralise a panel of mumps viruses, including the Leningrad-3 mumps vaccine virus. Of the 12 patients for whom vaccination status was positively determined, 11 showed serological evidence of primary VF. Sequence analysis of virus RNA amplified from saliva revealed a genotype C2 virus in 2002, a genotype H2 virus in 2003, and both genotypes in 2004. Although several vaccinated patients were positive for mumps virus IgG at the time of first sampling, only nominal levels of neutralising antibody were detected, and these were effective in neutralising the vaccine strain, but not genotype C and H mumps virus strains. These results suggest that the majority of cases of mumps in vaccinees are caused by primary VF, defined as either a lack of seroconversion or a lack of IgG maturity, as based on avidity testing. The results also support the hypothesis that sera of low neutralising antibody titre have a limited ability to neutralise heterologous mumps virus strains, suggesting that antigenic differences between circulating and mumps vaccine virus strains may play a role in cases of breakthrough infection. Consistent with previous reports, mumps virus genotypes C and H continue to circulate in Novosibirsk.  相似文献   

7.
There is an insufficient number of cadavers in anatomy education in Turkey. This is because of decreased number of unclaimed bodies and very few cadaver donations. Increasing the number of cadaver donation is one of the probable solutions. Although anatomists encourage people to donate bodies, the attitudes of anatomists toward donating their own bodies for dissection is not well known. In this study, the attitudes of Turkish anatomists toward cadaver donation were evaluated. The questionnaires were sent to the anatomists in Turkey by mail and E-mail. Eighty-three anatomists replied to the questionnaire. The main solutions proposed for cadaver insufficiency included increasing the supply of unclaimed bodies (77.1%) and increasing body donation (78.3%). Further, 51.8% of the respondents thought that increasing body donation was a long-term solution. The general belief (83.1%) was that a campaign would help to increase body donation and 47% of respondents were willing to participate in such a campaign. Of the 83 anatomists, 20.5% of the respondents donated their organs and 49.4% were planning to donate them. Further, 15.7% were planning to donate their bodies; however, 63.9% did not consider donating. The main reasons of the respondents to object the donation were: to be dissected by a colleague (15.7%), the unacceptability of donation by family (26.5%), psychological reasons (43.4%), the anxiety of disrespectful behavior to cadavers (26.5%), and religious beliefs (3.6%). Although the majority of the respondents objected to donating their bodies due to psychological reasons, body donation was proposed as the main solution of cadaver insufficiency.  相似文献   

8.
The primary cause of mortality in patients of coronavirus disease 2019 (COVID-19) is the cytokine storm and not directly due to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. Therefore, it is being stressed by transfusion medicine specialists to use COVID-19 convalescent plasma (CCP) therapy early in the course of the disease, preferably within 72 h of diagnosis. The authors herein, propose a scoring system for the rapid assessment of the patients who have tested positive for SARS-CoV-2. Therefore, a systematic approach may be followed where the patients are categorised into two groups, namely, the low-risk group [LRG; score < 5] and the high-risk group [HRG; score ≥ 5] based on this scoring system. Those classified as an HRG should be administered CCP therapy within 72 h of a confirmed diagnosis of COVID-19 to neutralise the SARS-CoV-2 virus and prevent the occurrence of the cytokine storm. This in turn could help reduce the overall mortality in the recipients.  相似文献   

9.
Most medical curricula rely on human bodies for teaching macroscopic anatomy. Over the past 20 years, plastination has become an important means of preservation of organs, for well dissected specimens or for body slices. Here, several critical points regarding body donation with legal and ethical considerations for long-term preservation, the use of cadavers in teaching and the preparation of plastinates as an additional teaching tool will be discussed. Silicone S10 is the gold standard in the preparation of plastinates. An important point to respect is the preparation of specimens, since only very well dissected body parts or excellent tissue sections should be plastinated to show the extraordinary aspects of the human anatomy. The preparation of thin and transparent sections and preservation with P40 polyester provides an additional technique to prepare resistant body slices. A selection of samples prepared by S10 and P40 are shown and compared. In addition, Prussian or Berlin blue staining of brain slices is shown to discriminate better between gray and white matter and demonstrate neuroanatomical structures. These plastinates have been used for many years in teaching first-and second-year medical students and have not lost their appeal. Students and staff appreciate the use of such plastinates. One of the advantages is that their use is not restricted to the dissection hall; slices and body parts can be used in any lecture room or in small group teaching. Therefore, ethical and legal questions need to be addressed regarding their specific use. Plastinates do not replace the traditional dissection courses, since students learn best the anatomical features of a given region by hands-on dissection and by exploratory anatomy. Furthermore, plastinates are more rigid and do not allow demonstration of hidden structures; they also become more cumbersome for endoscopy or are too rigid for demonstrating mechanical features of joints. However, although not a replacement for traditional dissections, plastination provides an additional tool for long-term preservation and for teaching human anatomy.  相似文献   

10.
Surgeons using a fresh tissue dissection laboratory need specimens with tissue color and texture as close as possible to those of a living body. Completely unembalmed specimens kept in a cooler remain in good condition only for a few days, and then decay rapidly. Unembalmed specimens can be frozen for later use, but freezing harms their texture, and decay is suspended only for as long as they remain frozen. Since 1998, we have used a method of light embalming adapted from funeral home techniques, on over 250 cadavers used in our fresh tissue dissection laboratory. Lightly embalmed cadavers can be kept in a cooler for up to 6 weeks before use, with negligible loss of tissue quality and color. Once dissection is begun, the cadavers remain in excellent condition, free from odor, for at least two further weeks. Light embalming overcomes the practical problems seen with completely unembalmed specimens, avoids the use of freezing, and extends the range of activities that can be planned in the laboratory. This paper presents details of the light embalming technique. We assume that light embalming does not kill all transmissible pathogens.  相似文献   

11.
12.
Thiel embalming is recommended as an alternative to formalin‐based embalming because it preserves tissue elasticity, color, and flexibility in the long term, with low infection and toxicity risk. The degree to which Thiel embalming preserves elasticity has so far been assessed mainly by subjective scoring, with little quantitative verification. The aim of this study is to quantify the effect of Thiel embalming on the elastic properties of human ankle tendons and ligament. Biomechanical tensile tests were carried out on six Thiel‐embalmed samples each of the peroneus longus, peroneus brevis, and calcaneal tendons, and the calcaneofibular ligament, with strain rates of 0.25%s?1, 2%s?1, and 8%s?1. The stress?strain relationship was calculated from the force‐extension response with cross‐sectional area and gauge length. Young's modulus was determined from the stress?strain curve. The results showed that the tendon and ligament elasticity were lower after Thiel embalming than the literature values for fresh nonembalmed tendons and ligament. The biomechanical tensile test showed that the measured elasticity of Thiel‐embalmed tendons and ligaments increased with the strain rate. The Thiel embalming method is useful for preserving human ankle tendons and ligaments for anatomy and surgery teaching and research, but users need to be aware of its softening effects. The method retains the mechanical strain rate effect on tendons and ligament. Clin. Anat. 28:917–924, 2015. © 2015 Wiley Periodicals, Inc.  相似文献   

13.
Human cadaveric specimens are recommended as the best option for in-vitro tests. However, fresh human spine specimens are often difficult to obtain. Further problems are the potential risk of infection and they can only be used over a limited test period. Therefore, the use of embalmed specimens is often discussed. The most common method is formalin fixation. However, this type of embalming can result in failure, because the biomechanical properties of the tissue is partially influenced. In recent years the development of the new method, the fixation according to Thiel, could provide an alternative to fresh or formalin-fixed specimens. The aim of the present study is to compare the biomechanical properties between fresh and Thiel-fixed spine specimens, and to compare the data to previous data of a test with formalin fixation. For the study, six L1-L2 spinal segments from 16-week-old calves were biomechanically tested. The parameters, range of motion and neutral zone, were determined in flexion/extension, right/left lateral bending and left/right axial rotation. The results showed that the specimens kept their non-linear load-deformation-characteristic after Thiel fixation. The range of motion of Thiel-fixed specimens increased relative to the unembalmed state by approximately 22% in flexion-extension, 23% in lateral bending (p<0.05) and 45% in axial rotation (p<0.05). In conclusion, the results still suggest a preference for fresh cadaveric spine specimens for quantitative biomechanical in-vitro testing, because they provide the best physiological conditions. However, for preliminary tests, which may only be used for orientation, embalmed specimens using the Thiel fixation method might serve as an alternative. Compared to formalin-fixated specimens which become approximately 5 times stiffer and completely lose their non-linear load-deformation-characteristic, as found in a previous study; the Thiel fixation maintains the non-linear load-deformation-characteristic but increases the range of motion.  相似文献   

14.
Biomechanical research and orthopedic training is regularly carried out on human cadavers. Given the post‐mortem decay, these cadavers were usually frozen or embalmed. The embalming method according to Dr. Thiel was often praised for the preservation of natural texture. The main aim of this article was to quantitatively analyze the impact of this embalming technique on the biomechanical properties. To that extent, Achilles tendons (calcaneal tendons) of seven cadavers have been tested. For each cadaver, a first tendon was tested following a fresh‐frozen conservation, the other following the Thiel embalming process. The results indicated a significant difference in Young's modulus between both groups (P values = 0.046). The secondary aim of this article was to analyze the impact of exposure to room conditions and associated dehydration on the biomechanical properties of cadaver tissue. Therefore, each tendon was tested before and after 2 hr of exposure to room conditions. The resulting dehydration caused a significant increase of the Young's modulus for the thawed fresh‐frozen tendons. The properties of the Thiel embalmed tendons were not significantly altered. In conclusion, this research promoted the use of fresh‐frozen specimens for biomechanical testing. Effort should, however, be made to minimize dehydration of the tested specimens. Clin. Anat. 28:994–1001, 2015. © 2015 Wiley Periodicals, Inc.  相似文献   

15.
The use of social media opens content to the general public and, as a result, places images of cadaveric dissection in an open forum. This raises the question: should the general public have access to such material? A survey was conducted examining whether the general public should have access to gross cadaveric dissection images and videos for educational purposes via social media. Both medical and laypersons were queried. Questions included in the survey considered whether images were too graphic, whether online cadaveric content should be age‐restricted, and whether consent by the deceased was necessary. A link to the survey was accessible to 63,562 followers through the Seattle Science Foundation's Facebookpage for 3 weeks. Among 300 responders, 89% (267/300) agreed that portrayals of cadaveric specimens/dissection on social media should be accessible by the general public for anatomical education, and 84.67% (254/300) stated that cadaveric dissection is not too graphic for untrained eyes. There was agreement by 60.33% (181/300) that an age restriction should be in place for the viewing of cadaveric dissection on social media, and 39.33% (253/300) of responders suggested restriction to 18 years and older. No statistically significant association was noted between a prior or current history of anatomy education and the frequency of positive responses to the survey questions. Social media is an innovative tool for dispensing anatomical education. The use of cadaveric images and videos provides accessibility to the general public who wish to learn more about human anatomy and their own body. Clin. Anat. 32:1033–1041, 2019. © 2019 Wiley Periodicals, Inc.  相似文献   

16.
We presented two kinds of advance organizers (AOs), video clips and prosection, for a gross anatomy dissection course and compared their effects on academic achievement and student perception of the learning experience. In total, 141 students at Chonnam National University Medical School were randomly assigned to two groups: Group 1 (n = 70) was provided with video clips AO, whereas Group 2 (n = 71) was provided with prosection AO, the use of cadaveric specimens dissected by the course instructor. Student self‐assessment scores regarding the learning objectives of upper limb anatomy improved significantly in both groups. Academic achievement scores in Group 2 were significantly higher than those in Group 1, although the self‐assessment scores were not significantly different between the groups. Additionally, students in Group 2 responded significantly more positively to the statements about perception of the learning experience such as helping them understand the course content and concepts, decreasing anxiety about the dissection course, and participating actively in the dissection. It would seem that the application of prosection as an AO improved academic achievement and increased student engagement and satisfaction. This study will contribute to designing effective AOs and developing a teaching and learning strategy for a gross anatomy dissection course. Clin. Anat. 2013. © 2012 Wiley Periodicals, Inc.  相似文献   

17.
Anatomy is the cornerstone of education for healthcare professionals with the use of human material providing an excellent teaching tool in the modern curricula. The ability and quality of preservation of human remains has enabled such use. The introduction of formaldehyde as a preservative in 1893 was an important step in the history of preservation. With the European Union directive on the use of formaldehyde and its expected banning, anatomists are trying to find a more convenient and safe substitute. In this review, we compare the different techniques used based on the need for embalming, fixative used, period of preservation and the features of the embalmed specimen. The fact that embalming is used in different disciplines, multiple purposes and described in different languages has led to the development of ambiguous interchangeable terminology. Overall, there is a lack of information specifically classifying, listing and comparing different embalming techniques, and this may be due to the fact that no internationally recognized experimental standards are adhered to in this field. Anatomists strive to find an embalming technique that allows the preserved specimen to accurately resemble the living tissue, preserve the body for a long period of time and reduces health risk concerns related to working with cadavers. There is a need for embalming to shift to an independent modern day science with well‐founded research at the heart of it. While this may take time and agreement across nations, we feel that this review adds to the literature to provide a variety of different methods that can be employed for human tissue preservation depending on the desired outcome. Clin. Anat. 28:725–734, 2015. © 2015 Wiley Periodicals, Inc.  相似文献   

18.
In the age of a pandemic, such as the ongoing one caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the world faces a limited supply of tests, personal protective equipment, and factories and supply chains are struggling to meet the growing demands. This study aimed to evaluate the efficacy of specimen pooling for testing of SARS-CoV-2 virus, to determine whether costs and resource savings could be achieved without impacting the sensitivity of the testing. Ten previously tested nasopharyngeal and throat swab specimens by real-time polymerase chain reaction (PCR), were pooled for testing, containing either one or two known positive specimens of varying viral concentrations. Specimen pooling did not affect the sensitivity of detecting SARS-CoV-2 when the PCR cycle threshold (Ct) of original specimen was lower than 35. In specimens with low viral load (Ct > 35), 2 of 15 pools (13.3%) were false negative. Pooling specimens to test for Coronavirus Disease 2019 infection in low prevalence (≤1%) areas or in low risk populations can dramatically decrease the resource burden on laboratory operations by up to 80%. This paves the way for large-scale population screening, allowing for assured policy decisions by governmental bodies to ease lockdown restrictions in areas with a low incidence of infection, or with lower-risk populations.  相似文献   

19.
Background and objectivesSeroprevalence estimation of COVID-19 is quite necessary for controlling the transmission of SARS-CoV-2 infection. Seroprevalence rate in recovered COVID-19 patients help us to identify individual with anti-SARS-CoV-2 antibodies and its protective nature. The objective of present study was to evaluate seroprevalence of SARS-CoV-2 among potential convalescent plasma donors and analysis of their deferral reasons.Materials and methodsA total 400 potential convalescent plasma donors were enrolled over five-month period for this prospective study. Inclusion criteria were lab confirmed COVID-19 recovered patients and 14 days of symptoms free period. All prospective plasmapheresis donors were tested for IgG SARS-CoV-2 antibody through chemiluminescent microparticle immunoassay, CBC, serum protein, blood grouping along with other required test for normal blood donation as per Drugs & Cosmetics Act. After pre donation testing and medical examination if donor was found to be ineligible for plasmapheresis was deferred. Seroprevalence rate was calculated by positive IgG antibody test results among the potential plasma donors.ResultsSeroprevalence rate was 87% for IgG SARS-CoV-2 antibodies in prospective convalescent plasma donors (recovered COVID-19 patients). There was no significant difference in seroprevalence rate between different sub-groups with respect to gender, age, blood groups, Rh factor, mode of treatment, day of Ab testing and repeat plasma donation. Most common reason for their deferral was absent IgG SARS-CoV-2 antibodies (13%) followed by absenteeism of eligible screen donors (6.7%), low Hb (1.7%) and poor veins for plasmapheresis (1.7%). Till five-month study period none of the plasmapheresis develop symptoms of reinfection with COVID-19.ConclusionIn all, 13% recovered patients did not develop IgG antibodies after SARS-CoV-2 infection. SARS-CoV-2 IgG antibodies persist for quite some time and are protective against reinfection. More long-term serology studies are needed to understand better antibody response kinetics and duration of persistence of IgG antibodies.  相似文献   

20.
IntroductionThough moderate to severely ill COVID-19 patients are being treated using COVID Convalescent plasma across the world, there is a lack of standardization or information about the relative neutralizing capacity of antibodies from convalescent plasma donors. The current study aimed to compare the neutralizing antibody inhibition levels between COVID-Convalescent plasma from apheresis donors who had symptomatic COVID-19 history and asymptomatic blood donors, i.e., whole blood donors without prior any COVID-19 positive diagnosis nor symptoms/contact history related to COVID-19.MethodsObservational study conducted at the Blood Centre, Tertiary Care Hospital, South India on blood donor samples during the period July–December 2020. A total of 90 samples (43 convalescent plasma donors and 47 whole blood donors) were tested for SARS-CoV-2-IgG and Neutralising antibodies.ResultsNo significant difference in neutralization capacity was observed between these symptomatic vs. asymptomatic donors. Also, inhibition % appeared similar in the two groups with respect to age, gender, blood group, donation status, or type of donation without any statistical significance. On analyzing the correlation between the SARS-CoV-2-IgG levels and neutralizing antibodies among the WBD and CCP, both the groups showed a positive correlation, while neutralizing antibodies showed a significant correlation with SARS-CoV-2-IgG levels among the whole blood donors (Pearson correlation P = 0.000).ConclusionNo significant difference in neutralizing antibody capacity was observed in asymptomatic whole blood donors and convalescent plasma donors. Therefore, donors having adequate levels of SARS-CoV-2-IgG antibody levels on screening can be considered for convalescent plasma donation irrespective of prior COVID-19 diagnosis or COVID-related symptoms.  相似文献   

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