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El objeto de este trabajo es contribuir al desarrollo conceptual de la categoría jurídica del cadáver en razón a la dificultad que representa la dualidad de sujeto–objeto y que eventualmente puede generar una desprotección al mismo. El estudio se limita a las legislaciones de España y Colombia, cuya regulación, además de estar estrechamente relacionada en sus orígenes, es similar en muchos aspectos. La hipótesis sostenida es que el cadáver es una sustancia corpórea que contiene información personal y en virtud de ello, la bioética se convierte en una fuente útil para su tratamiento y regulación.

En el presente artículo compartiré reflexiones principalmente del orden de lo ético en relación a las implicancias de indagar etnográficamente sobre muertos y muertes. Dichas inquietudes surgieron durante la realización de mi doctorado, donde me centré en la construcción de la figura del “otro” considerado como un “subversivo”. Particularmente me interesaba el tratamiento al momento del deceso de esos “enemigos”, específicamente en Córdoba, en el 75, periodo en el cual los asesinatos de personas relacionadas con la “subversión” adquieren repercusiones. Por tratamiento me refiero tanto a la gestión administrativa de esos cuerpos, como a los sentidos, relatos y prácticas plasmados en los rastros escritos a los cuales accedemos en la actualidad. A partir de los registros de campo, las entrevistas realizadas, la ausencia de la mayoría de los “sujetos implicados” -ya muertos- y una serie de escenas de campo que compartiré en las hojas siguientes, diversos interrogantes se fueron tejiendo en torno a la posición como investigadora frente al trabajo de relatar la muerte, investigarla, objetivarla. Dichos interrogantes refieren a ¿cómo es escribe sobre los muertos? ¿qué de esos muertos nos interpela? ¿Qué legitimidad existe en nuestro relato como investigadores al hablar sobre lo ausente? ¿se ejerce alguna ética del cuidado en la indagación y en la escritura sobre los muertos en nuestros procesos de investigación? Estas y otras cuestiones serán las que iré compartiendo a lo largo de este escrito, abierto al debate y a la reflexión, en la interrelación entre la disciplina antropológica y la reflexión filosófica.

Introdução: A negativa familiar para autorização da doação de órgãos e tecidos humanos mantém-se elevada ao longo dos anos. Dentre as muitas causas de não efetivação da doação, destacam-se a falta de informação sobre o processo e o desconhecimento da família sobre o desejo do doador em vida, além de outras questões, como a aparência do corpo do doador após a captação. Nesse sentido, torna-se necessário trazer à luz da discussão os aspectos que permeiam os conceitos de morte, dignidade humana e zelo pela imagem do doador, principalmente no caso de doadores de tecidos, nos quais a retirada pode apresentar-se mais perceptível. Objetivos: Realizou-se uma revisão integrativa da literatura (RI), buscando evidenciar lacunas e caracterizar o processo da doação de órgãos e tecidos humanos, com foco na reconstrução do corpo do doador e na dignidade humana. Em complemento, também se propôs descrever um relato de experiência de um profissional de um banco de tecidos humanos (BTH). Métodos: Por meio da estratégia PICO, elaborou-se a questão norteadora do estudo, após a RI realizada nos últimos 10 anos, operacionalizada por descritores controlados nas bases de dados SciELO, LILACS, Google Acadêmico e PubMed. Adicionado à busca, foi descrito um relato de experiência referente às técnicas de reconstrução do corpo do doador após a captação dos tecidos utilizados por um BTH localizado no interior do estado de São Paulo. Resultados: Foram encontrados nove estudos específicos sobre doação e utilização de próteses para reconstrução de áreas doadas. Os resultados demonstram os motivos que envolvem a recusa familiar, assim como o cuidado que as equipes técnicas têm na reconstituição do corpo dos doadores. A preocupação da família em relação à situação estética do doador influencia a aceitação para doação, portanto, torna-se necessário investir na seguridade e na qualidade dos serviços prestados pelos BTH, a fim de diminuir a recusa familiar para doação. Conclusão: A comunicação clara e a seguridade dos processos que envolvem a captação de órgãos e tecidos humanos mostraram-se o melhor caminho para facilitar a doação, podendo, assim, aumentar as doações.

Abstract Objective To evaluate the technical reproducibility of a block of the pericapsular nerve group (PENG) of the hip aided or not by ultrasound in cadavers. Materials and Methods The present is a randomized, descriptive, and comparative anatomical study on 40 hips from 2 cadaver groups. We compared the PENG block technique with the method with no ultrasound guidance. After injecting a methylene blue dye, we verified the dispersion and topographical staining of the anterior hip capsule through dissection. In addition, we evaluated the injection orifice in both techniques. Results In the comparative analysis of the techniques, there were no puncture failures, damage to noble structures in the orifice path, or differences in the results. Only 1 hip from each group (5%) presented inadequate dye dispersion within the anterior capsule, and in 95% of the cases submitted to either technique, there was adequate dye dispersion at the target region. Conclusion Hip PENG block with no ultrasound guidance is feasible, safe, effective, and highly reliable compared to its conventional counterpart. The present is a pioneer study that can help patients with hip pain from various causes in need of relief.

ABSTRACT Objective: To compare anatomic anterior cruciate ligament (ACL) reconstruction between two tunnel positions in knees with isolated ligament tears. Methods: Anatomic ACL reconstruction was performed, from hip-to-toe, on 15 fresh cadaveric specimens. No associated lesions were created to enhance knee instability. The protocol was conducted in three states: (1) complete isolated ACL deficiency; (2) anatomic femoral and tibial anteromedial ACL reconstruction (AM REC); and (3) anatomic femoral and tibial central ACL reconstruction (Central REC). The reconstruction protocols were randomly assigned. The continuous mechanized pivot-shift test was recorded dynamically with a tracking system. Results: The Central REC group showed a smaller degree of internal rotation (0.6° ± 0.3° vs. 1.8° ± 0.3°, respectively, P < 0.05) and no difference in anterior translation (4.7 mm ± 0.4 mm vs. 4.5 mm ± 0.4 mm, respectively, P > 0.05) in the pivot-shift test, compared with the AM REC group. Conclusion: The central anatomic ACL reconstruction resulted in greater restriction of internal rotation than the anteromedial anatomic ACL reconstruction. Experimental Study on Cadaver.

ABSTRACT Objective: Demonstrate the feasibility of endoscopic assisted L5S1 intraforaminal lumbar interbody fusion (iLIF) through a transiliac approach. Methods: Ten transiliac iLIF and ten supra iliac iLIF were performed bilaterally at L5S1 in five randomly selected fresh-frozen human cadavers. The following measurements were recorded: distances from the transiliac track to the iliac crest, posterior superior iliac spine, and superior gluteal neurovascular bundle; pelvic parameters; approach angles; cage’s lateral and AP center point ratio (CPR); percentage of the cage crossing the midline in the AP and lateral views. Endplate integrity was assessed through endoscopic visualization. In addition, the facet joint, sacroiliac joint, iliolumbar ligament, and exiting and traversing nerve roots were checked for integrity through anatomic dissection. Results: In the transiliac technique, the axial and coronal approach angles were significantly decreased by 13.5º (95% CI -15.5; -11.5; p value

Resumo: Introdução: O cadáver é uma peça insubstituível no aprendizado da anatomia humana, pois permite uma visão tridimensional das estruturas anatômicas. Entretanto, observa-se um cenário de escassez e aumento da demanda das peças cadavéricas nas universidades brasileiras. Logo, diversas instituições, amparadas no artigo 14 da Lei nº 10.406/2002 do Código Civil brasileiro, implementaram programas de doação de corpos interessados em trazer melhorias significativas na qualidade de ensino da disciplina de anatomia. Objetivo: Este estudo teve como objetivo analisar o grau de conhecimento e as perspectivas de uma comunidade universitária a respeito da doação voluntária de corpos cadavéricos para fins educacionais e de pesquisa. Método: Trata-se de um estudo observacional, transversal e prospectivo com abordagem quantitativa e coleta de dados por meio de questionário individual. Os sujeitos incluídos foram os docentes e discentes da Universidade Federal do Maranhão (Ufma), campus Dom Delgado. Os questionários eram relativos à obtenção de informações sobre o conhecimento e a opinião acerca da temática da doação de corpos. Resultado: Obteve-se um total de 264 questionários respondidos, os quais mostraram que 85,65% dos discentes e 87,1% dos docentes tinham conhecimento acerca da possibilidade da doação do próprio corpo. Contudo, observou-se que 94% dos entrevistados não sabiam que procedimentos eram necessários para a doação, e 86% não possuíam conhecimento acerca da legislação que permitia tal prática. Ademais, 27,65% dos participantes estavam aptos a doar o próprio corpo, 33,7% apontaram que não doariam e 38,9% informaram que não tinham opinião formada. O principal motivo apontado para doar foi: “para contribuir com o avanço da educação na área da saúde”, e para não doar: “quero ser enterrado ou cremado”. Conclusão: Existe um alto percentual de indivíduos que não conhecem os meios para realizar a doação de corpos, sendo evidenciado que os participantes apresentam baixa aptidão para doação. Contudo, existe um percentual significativo de indivíduos que não tem opinião formada sobre o assunto, demonstrando que a divulgação dessa temática é um meio para aumentar a adesão a tal prática. É importante realizar o desenvolvimento de programas de doação de corpos para solucionar a problemática.

Este artigo expõe uma reflexãoem torno dos vivos e mortos, enfocando os aspectossensoriais da relação entre ambos. Apesar da morte ser um tema antigo naantropologia, a maioria dos estudos da disciplina centram-se ou nasrepresentações coletivas dopost-mortemou nos rituais fúnebres,deixando emsegundo plano a condição materialdo morto, expressa pela presença de seucadáver.Mais do que mero objeto de reflexão e/ou intervenção, o cadáversensibiliza quem o toca, olhae cheira. Taisrelaçõesnão ocorrem fora do escopo dacultura:atualmente, a morte tornou-se um assunto da medicina, e amanipulaçãodos cadáveres passou a ser executada por indivíduos qualificados.A tanatopraxiaé um dos muitos serviços criados para se lidar com o corpo morto.A fim deaprofundar o entendimento dasrelações entre vivos e mortos, é defendido, aqui,uma antropologia dos sentidos da morte, isto é, uma investigação de como os vivossentem os mortos, tendoa tanatopraxia como um caso prolífero de estudo.

Varios autores han descrito variaciones en el calibre de las arterias palmares y dorsales propias de cada dedo, que podrían condicionar el éxito de la cirugía reconstructiva de los dedos, especialmente en lo que respecta al uso de colgajos. El objetivo de este estudio es comparar cualitativamente el tamaño de dichas arterias en cada dedo de la mano. Para ello, se han inyectado con látex seis manos procedentes de cadáveres frescos criopreservados. Los dedos han sido preparados mediante la técnica de transparentación de Spalteholz y una variante de ésta con glicerina.

Introdução: O trígono cistepático (triângulo de Calot) é um espaço anatômico delimitado pelo ducto hepáti- co comum, o ducto cístico e a borda inferior do fígado. A importância desse marco anatômico é indiscutível para a realização da colecistectomia. Relato do caso: Foi realizada a dissecação da região abdominal de um cadáver do sexo masculino, seguido pela dissecação do pedículo hepático para individualização das estruturas estudadas. Observou-se que a junção hepatocística se deu a uma distância de 2,6 cm em relação ao hilo hepático, bem como a junção do ducto cístico se fez à direita do ducto hepático. Em relação às estruturas encontradas no trígono cistohepático, observou-se que o trígono era ocupado pela veia porta-hepática posteriormente e pela artéria cística e artéria hepática direita anteriormente. Comentários: Na cirurgia videolapa-roscópica é imprescindível o conhecimento detalhado da anatomia topográfica do abdômen, em específico, das vias biliares extra-hepáticas, bem como suas variações anatômicas para evitar complicações durante o procedimento cirúrgico.

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Abstract Currently there is an increasing interest in publications on the use of corpses for research in Brazil and worldwide. Scientific evidence reveal that these studies have little ethical and regulatory control. In Brazil, the regulation of this subject is scarce and scattered among laws and sublegal normative acts, hindering the knowledge of ethical and legal practices adopted by researchers. This article analyzes the laws and norms for scientific research on corpses in Brazil through a corpus that underlies this type of research. From the 1940-2012 period, we found seven documents of the Brazilian legislation that gather information for ethical and clear research. Finally, we present guidelines and a protocol to be followed by researchers for the development of ethical and legal studies with corpses in Brazil.

Abstract Objective The purpose of the present study was to analyze the structures in the radial tunnel that can cause posterior interosseous nerve entrapment. Methods A total of 30 members of 15 adult cadavers prepared by intra-arterial injection of a 10% solution of glycerol and formalin were dissected. All were male, belonging to the laboratory of anatomy of this institution. Results The branch for the supinator muscle originated from the posterior interosseous nerve in all limbs. We identified the Frohse arcade with a well-developed fibrous constitution in 22 of the 30 dissected limbs (73%) and of muscular constitution in 8 (27%). The distal margin of the supinator muscle presented fibrous consistency in 7 of the 30 limbs (23.5%) and muscular appearance in 23 (76.5%). In the proximal margin of the extensor carpi radialis brevis muscle, we identified the fibrous arch in 18 limbs (60%); in 9 (30%) we noticed the arcade of muscular constitution; in 3 (10%) there was only the radial insertion, so that it did not form the arcade. Conclusion The Frohse arcade and the arcade formed by the origins of the extensor carpi radialis brevis are normal anatomical structures in adult cadavers. However, from the clinical point of view, these structures have the potential to cause entrapment of the posterior interosseous nerve.

Abstract Objective To evaluate the biomechanical effect of graft thickness compared with the double-bundle technique on posterior cruciate ligament (PCL) reconstruction in human cadaveric knees. Methods A total of 9 human cadaveric knees were tested in 5 conditions: intact knee (INT); single-bundle reconstruction with a 10-mm quadriceps tendon (SB); double-bundle reconstruction with a 10 mm-quadriceps tendon for the anterolateral bundle and a 7-mm doubled semitendinosus tendon for the posteromedial bundle (DB); single-bundle reconstruction with a 10-mm quadriceps tendon plus a 7-mm doubled semitendinosus tendon (SBT); and PCL-deficient (NoPCL). The posterior tibial translation (PTT) was measured in response to a 134-N posterior tibial load at 0º, 30º, 60º e 90º of knee flexion. Results The PTT values of the DB and SBT techniques were always significantly lower (better stability) than those of the SB technique. The PTT values of the SBT technique were significantly lower than those of the DB technique at 60º (p = 0.005) and 90º (p = 0.001). Conclusions Graft enlargement improves knee stability in isolated PCL reconstructions, whereas the graft division in the two-bundle technique worsens this stability at 60º and 90º of knee flexion. The findings of the present study suggest that knee stability in PCL reconstructions may be improved with the use of thicker grafts in the SB technique rather than performing the DB technique.

ABSTRACT Objective: This anatomical study aimed to analyze the possibility of transferring the radial nerve branches destined to the brachioradialis (BR), extensor carpi radialis longus (ECRL), extensor carpi radialis brevis (ECRB), and supinator (SM) muscles to innervate the AIN. Methods: Ten limbs from five male cadavers were prepared by intra-arterial injection of a solution of 10% glycerol and formalin. Results: The presence of only one branch to the BR muscle was noted in 7 limbs and two branches were noted in three limbs. In two members of a common trunk with branch to the ECRL. In eight cases, we identified one branch for the ERLC and two branches in two cases. We identified only one branch for the ECRB, while in six limbs, two branches were noted, penetrating the muscular body at two different points. We identified at least two branches innervating the supinator muscle. The AIN was detached from the median nerve distal to the intercondylar line of the humerus. In seven limbs, it originated from the nervous fascicles of the posterior region of the median nerve and from the posterolateral fascicles in three limbs. The flexor pollicis longus and flexor digitorum profundus muscles received more than one branch of the AIN in all limbs. Conclusion: The radial nerve branches for the ECRL, ECRB, and supinator muscles can be transferred directly to the AIN or to one of its branches after intraneural dissection, without tension even in elbow movements. Level of Evidence IV; Case series.

Introduction: Even though the anatomy of the knee and its ligaments are well characterized in the literature, several studies have found new structures associated with this joint, such as the anterolateral ligament (ALL) of the knee. The prevalence of this ligament varies significantly across the globe, and studies addressing this topic in the Colombian population are scarce. Objective: To determine the prevalence of the ALL and its morphometric characteristics in a sample of Colombian human cadavers. Materials and methods: Cross-sectional study in which the knee joints of 15 human cadavers were dissected and analyzed. In order to preserve the integrity of anatomical structures such as ligaments and tendons, specimens should not have undergone previous dissections, so only 29 knees were included for analysis. The presence of the ligament was confirmed, and the proximal and distal insertion site, as well as its length and width, were established through dissection. Results: The prevalence of ALL was 24.13%, as it was identified in 7 of the 29 dissected knees (4 left and 3 right knees). The average length and width of the ALLs found were 37.5mm (range: 24-52.4mm) and 3.9mm (range: 2.6-6mm), respectively. Conclusions: This study allowed confirming the presence of the ALL in the Colombian population, although with a lower prevalence than that described in countries such as France, India, China, USA, and Brazil. In turn, its morphometric characteristics were similar to those reported worldwide, since the average length and width found here are consistent with those described in the literature.

En este artículo me propongo demostrar la tesis de que el hades es el logos. Para esto examinaré las nociones de psyche, eidolon y soma en la poesía homérica y el cambio semántico que sufren con Platón. Mostraré también, a partir de Hegel, que el logos implica la muerte de la cosa nombrada y un horror ante la desaparición del ser animado. Este horror encuentra su objeto específico en el cadáver. Por último, basándome en Blanchot explicaré que este miedo antropogénico genera dos efectos al interior del logos: la idea (el lenguaje corriente) y el espectro (el lenguaje literario).

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N/a.

A Anatomia Humana é a ciência que estuda a composição e a morfologia do corpo humano, ela nomeia e descreve suas estruturas em níveis macro e microscópicos. Os objetivos do presente estudo consistem em descrever métodos de conservação de tecidos biológicos humanos, com ênfase às técnicas de formolização, glicerinação, criodesidratação e plastinação, utilizadas para o estudo da anatomia humana, destacando suas vantagens e desvantagens. Foi realizado um estudo descritivo por meio de um levantamento bibliográfico dos artigos publicados nas bases virtuais BIREME, Scielo, Lilacs e PubMed, do período de 2007 a 2017. Os resultados mostram que a maioria das instituições de ensino ainda utiliza a formolização como técnica padrão na conservação das peças anatômicas, por ser, financeiramente, a mais vantajosa, porém, com relação às demais técnicas, a que melhor apresenta uma relação custo/benefício é a glicerinação, pois apresenta maiores vantagens em relação à saúde da pessoa exposta e ao meio ambiente, por ter uma toxicidade consideravelmente menor em relação ao formol. A criodesidratação também consiste em uma alternativa viável ao uso do formaldeído, para isto, ela deve ser mais difundida no meio acadêmico. Quanto à plastinação, esta ainda é uma alternativa para exposições de peças em museus, devido ao seu alto custo. Portanto, a técnica mais indicada atualmente para o estudo da Anatomia é a glicerinação, nas demais técnicas apresentadas, as desvantagens acabam por inviabilizar e dificultar o seu uso para conservação dos tecidos biológicos.

Os autores clássicos da Medicina Legal brasileira fornecem uma base sólida para o estudo da decomposição cadavérica. Por meio da leitura de seus livros, notou-se que a marcha da decomposição é composta de fases ocorridas em períodos específicos, que podem se sobrepor ou ter seus rumos alterados por fatores que vão, desde o ambiente em que o cadáver se encontra, até sua compleição física e comorbidades em vida. Com o objetivo específico de aprender como contornar tais dificuldades durante as investigações e necropsias destes casos, foi realizado levantamento bibliográfico de artigos científicos nas bases PubMed, Scielo e Scopus, pelos unitermos Putrefied, Cadaveric Putrefaction, Diagnosis e Causa Mortis, que resultou em dez artigos em língua inglesa, publicados de 2000 a 2019, a respeito de cadáveres de seres humanos. Foi possível depreender que métodos já conhecidos pelos pesquisadores (a saber: equipamentos de imagem, histopatologia, e análises químicas de fluidos corporais), são capazes de alterar deduções feitas antes de seu uso. Entretanto, apesar de todo o auxílio que oferecem, não substituem o olhar atento de uma equipe forense bem treinada. Ao contrário, devem caminhar juntos, reforçando ainda mais a certeza de que a necropsia de um cadáver em decomposição é indispensável de ser realizada.

Introdução: O objectivo do presente estudo é o relato de um caso de variação anatómica do nervo isquiático, por origem baixa e divisão alta bilateral. Material e Métodos: Foi dissecado um cadáver feminino de 66 anos, conservado pelas técnicas originais desenvolvidas no nosso departamento. Resultados: No trabalho regular de dissecção cadavérica da disciplina de Anatomia Regional II detectou-se nervo isquiático, em ambos os membros, com pequeno trajecto, de aproximadamente, 8 - 10 cm, dividido em nervos fibular comum e tibial, ao nível da margem inferior do músculo glúteo máximo. Discussão: Casos semelhantes aos do presente estudo, foram descritos por alguns autores desde Leonardo da Vinci, Da Cortona, ou Eustachius, demonstrando a importância desse conhecimento, tanto em termos clínicos, como cirúrgicos ou anestesiológicos. Diversas ilações são possíveis, por revisão do presente caso, infrequente. Conclusão: Para além de proporcionar conhecimento prévio da anatomia loco-regional, o estudo das variações do nervo isquiático orienta o melhor seguimento de patologias, bem como acessos cirúrgicos e/ou anestésicos. Por mais meticulosos que sejam os nossos estudos anatómicos, jamais poderemos considerar terminada ou definitiva a investigação em anatomia humana.

ABSTRACT Objective: The purpose of this study was to demonstrate, in a case series, a new sacrectomy technique using an iliac crest dowel graft from a cadaver. Study design: Report of a case series with description of a new surgical technique. Methods: The technique uses four bars to support the posterior spine and a dowel graft in the iliac wings, with compression of the spine and pelvis above it, to support the anterior spine. Three cases were operated on, and in all of them, a vertebrectomy was used. Results: In the first two cases, the technique was performed as a two-stage surgery. The first stage was performed via the anterior and peritoneal access routes, and the second stage via the posterior access route. In the third case, retroperitoneal access via the anterior route meant that the technique could be performed in one stage, resulting in an overall reduction in surgical time (1250 vs. 1750 vs. 990 minutes, respectively). Conclusion: The new technique enables fixation with biomechanical stability, which is essential to support the stress in the lumbosacral transition and promote earlier rehabilitation. Level of evidence IV, case series.

ABSTRACT Objective: The arcade of the flexor digitorum superficialis muscle (FDS) is an anatomical structure which has not yet been widely studied and is a site of nerve compression. The aim of this study was to analyze the arcade of the FDS muscle and its relations with the median and anterior interosseous nerves through anatomic dissections. Method: Fifty arms from 25 adult cadavers (21 males and 4 females) were dissected; 18 were previously preserved in formalin and glycerin and 7 fresh specimens were dissected in the Laboratory of Anatomy. Results: The arcade of the superficial flexor muscle was identified in all dissected limbs. The radial and humeral heads were present in all specimens, and the ulnar head in 16 (32%). We identified two varieties of the arcade structure: a fibrous arcade in 32 specimens (64%), and a muscular arcade in 11 specimens (22%). In 4 specimens (8%) the arcade was very fine and so transparent that the nerve could be seen within the arcade. In 3 forearms the arcade was considered irregular because of discontinuity between the fibers that comprised this structure. Conclusion: The fibrous arcade of the FDS muscle may be a potential cause of nerve compression of the median and interosseous anterior nerves. Level of Evidence IV; Case series.

Copyright of Lex Medicinae: Revista Portuguesa de Direito da Saúde is the property of Centro de Direito Biomedico and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

ABSTRACT Objective: To verify the incidence and characterize morphologically the anterolateral ligament of the knee (ALL) in cadaveric samples of the collection of the Laboratory of Anatomy of the Department of Morphology of the Universidade Federal do Espírito Santo. Methods: Dissections and cross sections were performed for mesoscopic analysis of the anterolateral region of 15 knees preserved in 4% formalin solution in order to identify the ALL. Results: After dissection of the skin and subcutaneous tissue of the knee anterolateral region, it was possible to identify the iliotibial tract (ITT), the patellar ligament and the femoral biceps tendon. The ITT was removed from the Gerdy tubercle and the following structures were visualized: knee joint capsule, fibular collateral ligament and popliteal tendon. However, the ALL was not identified in any of the samples. Conclusions: The ALL could not be identified in any of the specimens studied, either through dissection or mesoscopic analysis. Level of Evidence III, Diagnosis Studies - Investigation of an Exam for Diagnosis.

Introdução: Os cirurgiões devem estar cientes das variações anatômicas do pulmão durante as ressecções lobares ou segmentares do pulmão. O conhecimento dessas variações impede a má interpretação das imagens radiológicas quando essas variações ocorrem. Objetivo: Investigar a incidência de variações anatômicas no padrão dos lobos e fissuras pulmonares em cadáveres humanos. Método: Setenta e dois pulmões humanos foram selecionados da coleção de partes de cadáveres do Departamento de Anatomia da UFPE. Em cada pulmão humano cadavérico foi analisado: antimeria (direito e esquerdo), a presença de fissuras e lobos pulmonares. Resultados: Dos 72 pulmões humanos selecionados, 35 eram pulmões direitos e 37 pulmões esquerdos. Após a análise dos pulmões esquerdos, não foram observadas variações anatômicas quanto à lobulação pulmonar ou quanto às fissuras pulmonares. Na análise dos pulmões direitos, foram observadas duas variações em pulmões distintos. No primeiro caso, não foi observada a fissura horizontal e com isso o pulmão apresentou apenas dois lobos pulmonares, enquanto no segundo caso o pulmão apresentou uma fissura horizontal incompleta. Nos demais pulmões do lado direito não foram observados variações anatômicas quanto aos lobos e fissuras pulmonares. Conclusão: Foram observadas duas variações anatômicas no padrão lobar e das fissuras pulmonares no pulmão direito, correspondendo a uma incidência de 5,4%, bem como não foram encontradas variações nos pulmões esquerdos.

Objective: To analyze the anatomical variations of the innervation of the flexor digitorum superficialis muscle and to determine if the branch of the median nerve that supply this muscle is connected to the branches to the extensor carpi radialis brevis and the pronator teres muscles, without tension, and how close to the target-muscles the transfer can be performed. Methods: Fifty limbs of 25 cadavers were dissected to collect data on the anatomical variations of the branches to the flexor digitorum superficialis muscle. Results: This muscle received innervation from the median nerve in the 50 limbs. In 22 it received one branch, and in 28 more than one. The proximal branch was identified in 22 limbs, and in 12 limbs it shared branches with other muscles. The distal branch was present in all, and originated from the median nerve as an isolated branch, or a common trunk with the anterior interosseous nerve in 3 limbs, and from a common trunk with the flexor carpi radialis muscle and anterior interosseous nerve in another. It originated distally to the anterior interosseous nerve at 38, in 5 on the same level, and in 3 proximal to the anterior interosseous nerve. In four limbs, innervation came from the anterior interosseous nerve, as well as from the median nerve. Accessory branches of the median nerve for the distal portion of the flexor digitorum superficialis muscle were present in eight limbs. Conclusion: In 28 limbs with two or more branches, one of them could be connected to the branches to the extensor carpi radialis brevis and pronator teres muscles without tension, even during the pronation and supination movements of the forearm and flexion- extension of the elbow. [ABSTRACT FROM AUTHOR]

Objective: To examine the association between donor plasma cytokine levels and the development of primary graft dysfunction of organs transplanted from deceased donors. Methods: Seventeen deceased donors and the respective 47 transplant recipients were prospectively included in the study. Recipients were divided into two groups: group 1, patients who developed primary graft dysfunction; and group 2, patients who did not develop primary graft dysfunction. Donor plasma levels of TNF, IL-6, IL-1ß, and IFN-γ assessed by ELISA were compared between groups. Results: Sixty-nine organs were retrieved, and 48 transplants were performed. Donor plasma cytokine levels did not differ between groups (in pg/mL): TNF, group 1: 10.8 (4.3 - 30.8) versus group 2: 8.7 (4.1 - 33.1), p = 0.63; IL-6, group 1: 1617.8 (106.7 - 5361.7) versus group 2: 922.9 (161.7 - 5361.7), p = 0.56; IL-1ß, group 1: 0.1 (0.1 - 126.1) versus group 2: 0.1 (0.1 - 243.6), p = 0.60; and IFN-γ, group 1: 0.03 (0.02 - 0.2) versus group 2: 0.03 (0.02 - 0.1), p = 0.93). Similar findings were obtained when kidney transplants were analyzed separately. Conclusion: In this sample of transplant recipients, deceased donor plasma cytokines TNF, IL-6, IL-1ß, and IFN-γ were not associated with the development of primary graft dysfunction. [ABSTRACT FROM AUTHOR]

The arrangement considered normal in humans and more frequent of arteries originating from the aortic arch is the left subclavian, left common carotid and brachiocephalic trunk. However, anatomical variations in the origin and trajectory of the aortic arch's blood vessels are frequently observed and documented in the literature. Thus, the aim of the study was to report two cases of anatomical variation observed in branches of the aortic arch in corpses. During the anatomical pieces' preparation for the practical classes in the laboratory of human anatomy of the University Center of Rio Preto (UNIRP), two cases of anatomical variation of the aortic arch's branches were found. We observed the presence of the left vertebral artery originating from the aortic arch and the left common carotid artery arising attached to the origin of the brachiocephalic trunk artery. These anatomical variations found in the aortic arch are important for clinical diagnoses and surgical treatments, since they reduce the risks of vascular diseases and injuries. [ABSTRACT FROM AUTHOR]

Objective : The Bernese periacetabular osteotomy (PAO) is a widely used technique for the treatment of non-arthritic, dysplastic, painful hips. It is considered a highly complex procedure with a steep learning curve. In an attempt to minimize complications, a double anterior-posterior approach has been described. We report on our experience while performing this technique on cadaveric hips followed by meticulous dissection to verify possible complications. Methods : We operated on 15 fresh cadaveric hips using a combined posterior Kocher-Langenbeck and an anterior Smith-Petersen approach, without fluoroscopic control. The PAO cuts were performed and the acetabular fragment was mobilized. A meticulous dissection was carried out to verify the precision of the cuts. Results : Complications were observed in seven specimens (46%). They included a posterior column fracture, and posterior and anterior articular fractures. The incidence of complications decreased over time, from 60% in the first five procedures to 20% in the last five procedures. Conclusions : We concluded that PAO using a combined anterior-posterior approach is a reproducible technique that allows all cuts to be done under direct visualization. The steep learning curve described in the classic single incision approach was also observed when using two approaches. Evidence Level: IV, Cadaveric Study.

RESUMO Objetivo: descrever a presença de linfonodos e suas relações com características demográficas e antropométricas em uma região específica ainda não descrita pelos compêndios de anatomia, por nós denominada de Recesso Carotídeo Recorrencial (RCR), localizada entre o nervo laríngeo recorrente direito, a artéria carótida comum direita e a artéria tireoidea inferior direita. Métodos: foram dissecadas 32 regiões cervicais à direita de cadáveres com até 24 horas de post mortem. O tecido fibrogorduroso do RCR foi ressecado e preparado com fixação em formol. Em seguida, foi submetido a uma sequência crescente de álcoois (70%, 80% e 90%), posteriormente a uma solução de Xilol e, por fim, a uma solução de Salicilato de Metila, respeitando o tempo necessário de cada etapa. O estudo macroscópico foi realizado na peça diafanizada, observando a presença ou não de linfonodos. Quando presentes, foram fotografados e suas medidas foram aferidas com um paquímetro digital. No estudo microscópico, foi utilizada a coloração hematoxilina-eosina para confirmação do linfonodo. Resultados: observou-se a presença de linfonodos em 22 dos 32 espécimes (68,75%), com o número de linfonodos por cadáver variando de zero a seis (média de 1,56±0,29) e tamanho com média de 7,82mmx3,86mm (diâmetros longitudinal x transversal). Conclusão: a relação entre dados antropométricos e presença de linfonodos no RCR (teste exato de Fischer) foi significante para indivíduos normolíneos (p=0,03) e também significante entre a etnia branca (p=0,04).

ABSTRACT OBJECTIVES: To put forward an anatomical description of the innervation of the elbow capsule, illustrated through morphological analysis on dissections. METHODS: Thirty elbows from fresh fixed adult cadavers aged 32-74 years, of both sexes, were dissected. RESULTS: Among the dissected arms, we observed that the median nerve did not have any branches in two arms, while it had one branch in five arms, two branches in two arms, three branches in ten arms, four branches in nine arms and five branches in two arms. The radial nerve did not have any branches in two arms, while it had one branch in two arms, two branches in nine arms, three branches in ten arms, four branches in five arms and five branches in two arms. The ulnar nerve did not have any branches in three arms, while it had one branch in six arms, two branches in four arms, three branches in five arms, four branches in seven arms, five branches in four arms and six branches in one arm. CONCLUSIONS: We observed branches of the radial, ulnar and medial nerves in the elbow joint, and a close relationship between their capsular and motor branches.

Cineangiocoronariografia é um exame invasivo utilizado para verificar a presença de obstruções das artérias coronárias, avaliar o funcionamento das valvas, e do miocárdio, além da localização da obstrução coronariana. Para ter um exame satisfatório é necessário o conhecimento anatômico e assim planejar a melhor estratégia de intervenção. Para evidenciar o procedimento realizou-se a dissecção cadavérica.O presente trabalho objetiva relatar a demonstração do trajeto da cineangiocoronariografia utilizando como acesso a artéria femoral.Trata-se de uma pesquisa descritiva exploratória com abordagem qualitativa a partir da dissecação de um cadáver adulto do laboratório da FAMENE/PB em abril de 2013, utilizou-se látex, cateter nº 6, seringa 10ml, além de material usual de dissecação, assim como técnicas adequadas para este fim. Se deu prioridade à visualização de estruturas pertinentes ao procedimento. Pôde-se identificar a A. Femoral E, A. Ilíaca E, Aorta Abdominal, AortaTorácica, A. Coronária E e D, tendo coerência com a literatura, trajeto este da cineangiocoronariografia.A realização da cineangiocoronariografia em cadáver contribuiu como treinamento e aprendizado e inserção à pesquisa.

OBJECTIVE: The aim of this study was to establish a neurovascular safety zone for surgical access in the middle third of the clavicle, by means of dissection on cadavers.METHODS: Twenty shoulders were dissected in 10 cadavers, with deep dissection of the middle third of the clavicle. The following structures were identified: subclavian vein, upper trunk of the brachial plexus (anterior and posterior divisions) and suprascapular nerve. These structures were marked out in order to measure their distances from the most proximal point of the middle third of the clavicle.RESULTS: The mean distances from the middle third of the clavicle to the suprascapular nerve, subclavian vein, upper trunk, anterior division of the upper trunk and posterior division of the upper trunk were respectively, for the right side: 15.92 cm, 10.77 cm, 23.68 cm, 14.60 cm and 15.42 cm; and for the left side: 12.69 cm; 9.82 cm; 22.19 cm; 12.16 cm and 13.46 cm.CONCLUSION: There was a statistical difference in the distances to the suprascapular nerve and anterior division of the upper trunk, in comparing between the right and left sides. The closest neurovascular structures to the middle third of the clavicle were the suprascapular nerve and subclavian vein.

OBJECTIVE: To establish the radiographic distances from posterior cruciate ligament (PCL) tibial insertions centers to the lateral and medial tibial cortex in the anteroposterior view, and from these centers to the PCL facet most proximal point on the lateral view, in order to guide anatomical tunnels drilling in PCL reconstruction and for tunnel positioning postoperative analysis.STUDY DESIGN: Controlled laboratory study.METHODS: Twenty cadaver knees were evaluated. The PCL's bundles tibial insertions were identified and marked out using metal tags, and the knees were radiographed. On these radiographs, the bundles insertion sites center location relative to the tibial mediolateral measure, and the distances from the most proximal PCL facet point to the bundle's insertion were determined. All measures were calculated using the ImageJ software.RESULTS: On the anteroposterior radiographs, the mean distance from the anterolateral (AL) bundle insertion center to the medial tibial edge was 40.68 ± 4.10 mm; the mean distance from the posteromedial (PM) bundle insertion center to the medial tibial edge was 38.74 ± 4.40 mm. On the lateral radiographs, the mean distances from the PCL facet most proximal point to AL and PM bundles insertion centers were 5.49 ± 1.29 mm and 10.53 ± 2.17 mm respectively.CONCLUSIONS: It was possible to establish a radiographic pattern for PCL tibial bundles insertions, which may be useful for intraoperative tunnels locations control and for postoperative tunnels positions analysis.

OBJECTIVE: The relationship of Gantzer muscle to the median and anterior interosseous nerve is debated.METHODS: Ìn an anatomical study with 80 limbs from 40 cadavers the incidence, origin, insertion, nerve supply and relations of Gantzer muscle have been documented.RESULTS: The muscle was found in 54 forearms (68% of limbs) and was supplied by the anterior interosseous nerve. It arose from the deep surface of the flexor digitorum superficialis muscle, (42 limbs), coronoid process (eight limbs) and medial epicondyle (seven limbs). Its insertion was to the ulnar part of flexor pollicis longus muscle. The Gantzer muscle always lay posterior to both the median and anterior interosseous nerve.CONCLUSION: The Gantzer muscle may contribute to the median nerve and anterior interosseous nerve compression. The muscle was found in 68% of limbs and should be considered a normal anatomical pattern rather than an anatomical variation.Level of Evidence IV, Case Series.

The anatomy of the palmar cutaneous branch of the median nerve (PCBMN) and its clinical implications have been described by various authors. Most of them report the palmar cutaneous branch of the median nerve in the carpal tunnel release surgery. However, few reports in the literature discuss the anatomical variations of this nerve which may represent a risk during palmar access to the approach of distal radius fractures, access to scaphoid and surgical tendon graft involving the carpal radial and long palmar flexor tendons. We reported a rare anatomical variation, in which we identified the duplication of the PCBMN, since we recorded only one case in the literature associating doubling the palmar cutaneous branch of the median nerve with a proximal branch originating from more than 17 cm above the palmar crease of the wrist. These variations endanger the PCBMN during surgical access to the distal forearm, and the proximal region of the palm. We did not identify any position of the two branches from the ulnar side of the tendon of the flexor carpi radialis muscle. [ABSTRACT FROM AUTHOR]

Objective:To study the anatomy of the posterior cruciate ligament (PCL) and define anatomical parameters with the knee flexed at 90°.Methods:Eight knees from cadavers were dissected in order to make measurements from the center of the anterolateral band to the roof (AL1), from the center of the anterolateral band to the anterior cartilage (AL2), from the center of the posteromedial band to the roof (PM1), from the center of the posteromedial band to the anterior cartilage (PM2), from the center of the tibial insertion to the medial region of the tibia (TIM), from the center of the tibial insertion to the lateral region of the tibia (TIL), from the center of the medial insertion to the medial meniscus (IMM) and the width of the origin of the PCL (WO). To obtain the results from each anatomical structure, the means and standard deviations of the measurements were calculated.Results:The measurements in millimeters that were found were AL1, 6.2; AL2, 4.9; PM1, 11.7; PM2, 5.5; TIM, 32.5; TIL, 40.6; IMM, 9.4; and WO, 32.5.Conclusions:The PCL has an extensive origin. The center of the anterolateral band is 6 mm from the roof and 5 mm from the anterior cartilage of the knee. The tibial insertion is slightly medial and 10 mm distal to the posterior cornu of the medial meniscus.

Objective:To determine the reference points for the exit of the tibial guidewire in relation to the posterior cortical bone of the tibia.Methods:Sixteen knees from fresh cadavers were used for this study. Using a viewing device and a guide marked out in millimeters, three guidewires were passed through the tibia at 0, 10 and 15 mm distally in relation to the posterior crest of the tibia. Dissections were performed and the region of the center of the tibial insertion of the posterior cruciate ligament (PCL) was determined in each knee. The distances between the center of the tibial insertion of the PCL and the posterior tibial border (CB) and between the center of the tibial insertion of the PCL and wires 1, 2 and 3 (CW1, CW2 and CW3) were measured.Results:In the dissected knees, we found the center of the tibial insertion of the PCL at 1.09 ± 0.06 cm from the posterior tibial border. The distances between the wires 1, 2 and 3 and the center of the tibial insertion of the PCL were respectively 1.01 ± 0.08, 0.09 ± 0.05 and 0.5 ± 0.05 cm.Conclusion:The guidewire exit point 10 mm distal in relation to the posterior crest of the tibia was the best position for attempting to reproduce the anatomical center of the PCL.

OBJECTIVE: This study was designed to use different segments of the cervical spine in cadavers to determine how much lateral mass should be resected for adequate foraminal decompression. METHODS: Six cadavers were used. The region of the cervical spine from C1 to the C7-T1 transition was dissected and exposed. The lateral mass of each vertebra was measured bilaterally before the foraminotomy in the following segments: C2-C3, C3-C4, C4-C5, C5-C6 and C6-C7. The procedure was performed with a high-speed drill and through surgical microscopy. Three foraminotomies were performed (F1, F2, F3) in each level. Lateral masses were measured after foraminotomy procedures and compared to the initial measurement, creating a percentage of lateral mass needed for decompression.. The value of the entire surface was defined as 100%. RESULTS: There was a statistical difference between the amounts of the resected lateral mass through each foraminotomy (F1, F2, F3) at the same level. However, there was no statistical significant difference among the different levels. The average percentage of resection of the lateral masses in F2 were 27.7% at C2-C3, 24.8% at C3-C4, 24.4% at C4-C5 and 23.8% and 31.2% at C5-C6 and C6-C7, respectively. In F3, the level that needed greater resection of the lateral masses was C6-C7 level, where the average resection ranged between 41.2% and 47.9%. CONCLUSION: In all segments studied, the removal of approximately 24 to 32% of the facet joint allowed adequate exposure of the foraminal segment, with visualization of the dural sac and the exit of the cervical root.

Ao longo da História, a importância da utilização de cadáveres humanos para o ensino e investigação não tem sido consensual. No passado, a obtenção dos cadáveres indispensáveis ao ensino passou pelo recurso a cadáveres de reclusos, de não reclamados e ao roubo e/ou compra. Para além da inadmissibilidade ética e jurídica destas soluções, estas revelaram-se insuficientes para as necessidades das escolas médicas. Nas últimas décadas, a consciência global da legitimidade da doação de cadáveres foi-se intensificando, considerando-se, hoje, a forma digna de colmatar essa falta. Neste artigo realizou-se uma revisão da literatura com o objetivo de se fazer uma resenha histórica, jurídica e pedagógica sobre a importância da utilização de cadáveres humanos no ensino da Anatomia Humana nos cursos de Medicina, incluindo em Portugal, nomeadamente pelo recurso à dissecação cadavérica em complementaridade com outras ferramentas pedagógicas.

Objective: To determine the distance between the axillary nerve and the antero-lateral (AL) edge of the acromion, its anatomical variability and relationship to humeral length and body height.Methods: Twenty-two shoulders were dissected. The anterosuperior (AS) approach was used; the deltoid was detached from the acromion and the distance between the AL portion and the axillary nerve was measured and submitted to statistical analysis.Results: The distance varied from 4.3 to 6.4 cm (average 5.32 ± 0.60 cm). The axillary nerve distance increased as the humeral size (p

Objective: To study the insertion of the pectoralis major tendon to the humerus, through knowledge of its dimensions in the coronal and sagittal planes. Methods: Twenty shoulders from 10 cadavers were dissected and the pectoralis major tendon insertion on the humerus was identified and isolated. The dimensions of its "footprint" (proximal to distal and medial to lateral borders) and the distance from the top edge of the pectoralis major tendon to apex of the humeral head structures were measured. Results: The average proximal to distal border length was 80.8 mm (range: 70 -90) and the medial-to-lateral border length was 6.1 mm (5 -7). The average distance (and range) from the apex of the pectoralis major tendon to the humeral head was 59.3 mm. Conclusions: We demonstrate that the insertion of the pectoralis major tendon is laminar, and the pectoralis major tendon has an average footprint height and width of 80.8 mm and 6.1 mm, respectively.

OBJECTIVE: To study the anatomy of the oblique popliteal ligament, as regards its dimensions, expansion and anatomical relationships. METHODS: Eleven cadaver knees were dissected in order to study the anatomy and take mea-surements of anatomical structures and relationships of the oblique popliteal ligament. The dissection was for posterior access to the proper exposure of the oblique popliteal ligament, the semimembranosus muscle and its expansions. For measurement of dimensions, 40 × 12 needles were used for marking the specific points and a caliper. The angles were calculated using the software ImagePro Plus(r) . RESULTS: The distance from the origin of the oblique popliteal ligament to the tibial plateau was 7.4 mm, the thickness at its origin was 7.3 mm, length was 33.6 mm and the tibial plateau angle 34.8°. The length of the expansion of the proximal oblique popliteal ligament was 39.2 mm, thickness 7.8 mm and angle of the oblique popliteal ligament with its expansion 32.2°. CONCLUSION: The oblique popliteal ligament is thick, rises in the semimembranosus and protrudes proximally forming an acute angle with the joint interline, crossing the popliteal fossa. In some cases it has a proximal expansion.

OBJECTIVE: To study the anatomy of the hamstring tendons insertion and anatomical rela-tionships. METHODS: Ten cadaver knees with medial and anterior intact structures were selected. The dissection was performed from anteromedial access to exposure of the insertion of the flexor tendons (FT), tibial plateau (TP) and tibial tuberosity (TT). A needle of 40 × 12 and a caliper were used to measure the distance of the tibial plateau of the knee flexor tendons insertion at 15 mm from the medial border of the patellar tendon and tibial tuberosity to the insertion of the flexor tendons of the knee. The angle between tibial plateau and the insertion of the flexor tendons of the knee (A-TP-FT) was calculated using Image Pro Plus software. RESULTS: The mean distance TP-FT was 41 ± 4.6 mm. The distance between the TT-FT was 6.88 ± 1 mm. The (A-TP-FT) was 20.3 ± 4.9°. CONCLUSION: In the anterior tibial flexor tendons are about 40 mm from the plateau with an average of 20°.