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In 2008, members of the TEPARG provided first insights into the legal and ethical framework governing body donation in Europe. In 2012, a first update followed. This paper is now the second update on this topic and tries to extend the available information to many more European countries. For this second update, we have asked authors from all European countries to contribute their national perspectives. By this enquiry, we got many contributions compiled in this paper. When we did not get a personal contribution, one of us (EB) searched the internet for relevant information. Perspectives on the legal and ethical framework governing body donation in Europe. We still see that a clear and rigorous legal framework is still unavailable in several countries. We found national regulations in 18 out of 39 countries; two others have at least federal laws. Several countries accept not only donated bodies but also utilise unclaimed bodies. These findings can guide policymakers in reviewing and updating existing laws and regulations related to body donation and anatomical studies. [ABSTRACT FROM AUTHOR]

Background The purpose of this study was to evaluate the posterior ridge of the greater tuberosity, a palpable prominence during surgery, as a landmark for the posterior approach to the glenohumeral joint. Methods Twenty-five human cadaveric shoulders were dissected. In 5 cases, a full-thickness rotator cuff tear was present. The posterior surgical anatomy was defined, and the distance from the ridge to the interval between the infraspinatus (IS) and teres minor (TM) muscle, the distance from the ridge to the inferior border of the glenoid (IBG), and the distance between the IS-TM interval and the IBG were determined. Results In all specimens, a prominent ridge on the posterior greater tuberosity lateral to the articular margin could be identified. The IS-TM interval was located, on average, 3 mm proximal to this ridge. The IS-TM interval corresponded to a point 5 mm proximal to the IBG. In all shoulders, the ridge was located, on average, 8 mm proximal to the IBG. The plane of the IS-TM interval showed a vertically oblique direction. Conclusion The posterior ridge of the greater tuberosity is a suitable landmark to locate the internervous plane between the IS and TM and should not be crossed distally. Unlike other landmarks, the ridge moves with the humeral head, making it is less dependent on the patient's size, sex, and arm position and the quality of the rotator cuff. The ridge is always located proximal to the insertion of the TM and IBG. [ABSTRACT FROM AUTHOR]

Bone infections are difficult to treat and can lead to severe tissue destruction. Acute bone infections are usually caused by Staphylococcus aureus . Osteoclasts, which belong to the monocyte/macrophage lineage, are the key cells in bone infections. They are not well equipped for killing bacteria and may serve as a reservoir for bacterial pathogens. Silver has been known for centuries for its bactericidal activity. Here, we investigated the bactericidal effects of nano-silver particles in bacteria infected human osteoclasts. We found that nano-silver in per se non-toxic concentration enhanced the bactericidal activity in osteoclasts against intracellular Methicillin-resistant, virulent Staphylococcus aureus. The reduced bacterial survival in nano-silver pretreated cells correlated with increased reactive oxygen responses towards the invading pathogens. Overall, these results indicate that nano-silver compounds should be considered as an effective treatment and prevention option for bacterial bone and orthopedic implant infections. [ABSTRACT FROM AUTHOR]

Vascular casting is a widely used method for the representation of body vascularization. Many different injection materials have been described throughout the time to enhance the arterial vascular supply within a specifically defined anatomical location. The use of industrial polyurethane has been recently evaluated and applied to animal and human anatomy. The aim of this study was to confirm the safe and reliable use of industrial polyurethane in knee specimen in order to obtain a three-dimensional vascular tree of the distal femur. 10 fresh-frozen knees (mid-thigh to mid tibia) were used to assess the vascularity around the femoral condyles. Industrial polyurethane foam (Soudal™ foam) was diluted with acetone in order to obtain a runny fluid, easy to inject. After injection, the knees were bathed in a 10% NaOH solution, heated at 30°. The corrosion process took from 20 to 24 h and allowed all the soft tissue surrounding the knee to be subsided, leaving only the bone with polyurethane vascular architecture. After soft tissue corrosion, the vascular network around the knees was easily identified underlying the relation of the vessels to the bone. Even small arterioles (diameter< 1 mm) were distinguished with a good resistance to breakage. Corrosion casting remains an easy and reliable alternative to dissection for the understanding of tissue perfusion as the handling of the polyurethane is easy and has low costs. The described author's method can be used osteo-articular specimen as well as in other organs. The protocol of injection and corrosion needs however to be adapted to the different specimen and anatomical location. Polyurethane associated to acetone can safely be used as injection material in order to demonstrate the vascularity of a specimen and remains easy to use. [ABSTRACT FROM AUTHOR]

Recently, a novel type of dendritic antigen‐presenting cell has been identified in the dermis of normal human and mouse skin. These dermal dendritic cells (DDC) occur in higher numbers than epidermal Langerhans cells, represent a distinct differentiation pathway of dendritic cells, and are as potent as Langerhans cells in the activation of superantigen specific T cells. As yet, nothing is known about their capacity to take up, process, and present soluble protein antigens. We used the model of tetanus toxoid (TT) driven T cell proliferation to address these questions. To test for active internalization of TT protein, gold labeled TT was incubated with Langerhans cells and DDC and could be traced to multivesicular endo‐lysosomal compartments. DDC internalize TT through a receptor‐mediated, clathrin‐independent pathway, whereas Langerhans cells predominantly use macropinocytosis. To verify that DDC process TT by the exogenous pathway of antigen presentation, we pulsed DDC with TT protein or TT peptide after preincubation with chloroquine. Preincubation with chloroquine diminished the capacity of DDC to induce TT protein specific T cell proliferation (70–80%), but was not effective to suppress TT peptide induced T cell responses. DDC were as potent as Langerhans cells and 5–10 × more potent than plastic adherent monocytes in the presentation of TT to autologous resting T cells. Furthermore, as few as 50 DDC (stimulator:responder ratio of 1:1000) were able to induce a significant TT specific T cell proliferation. Because a subpopulation of DDC expresses low levels of CD1a, a phenotypic marker of Langerhans cells, sorting of CD1a positive and negative DDC was performed. On a per cell basis, CD1a positive and negative DDC were equally potent at mediating TT specific T cell proliferation. Thus, DDC are able to internalize, process, and present soluble protein antigens such as TT and may therefore play an important role in... [ABSTRACT FROM AUTHOR]

The pterion is an H-shaped suture complex. This study's goal was to determine the location of its external and internal surfaces and extension and emphasize and discuss its surgical importance. Fifty dried adult human skulls were obtained from the Department of Anatomy. A 2-mm drill bit was placed externally over the pterion, and the pterion was drilled through the bone perpendicular to the skull's surface. The midpoint of the H shape in the pterion area was not at the same level on the skull's external and internal pterion surfaces. According to these measurements, the external pterion lay above the internal pterion when the skull was viewed externally. Furthermore, the internal pterion was on average longer than the external pterion. The internal and external pterions were schematized such that the skull was viewed from the outside. These areas were divided into 4 quadrants (anterior-superior, anterior-inferior, posterior-superior, and posterior-inferior) by a vertical and horizontal line. In 30 cases (60%), sulci of the middle meningeal artery's parietal branches entered the posterior-superior quadrant on the bone, whereas the artery's frontal branches were located in the anterior-superior and anterior-inferior quadrants, and the Sylvian fissure's origin was in the posterior-inferior quadrant. By using a subdivision into 4 quadrants, and considering our anatomic findings, we determined the way surgical procedures can be performed more easily and reliably. Even with modern localization technologies, anatomic landmarks can be useful to the neurosurgeon. [ABSTRACT FROM AUTHOR]

Abstract: Background: Severe brain trauma leads to an activation of the immune system. To this date, neither the exact perturbation of the specific immune reaction induced by the traumatic brain injury (TBI), nor the interactions leading to the infiltration of peripheral immune cells into the brain are fully understood. Patients and methods: Serum was collected from 17 patients with TBI and a long bone fracture, 24 patients with an isolated long bone fracture and from healthy individuals. The effect of the serum on normal human monocytes and T-lymphocytes was tested in vitro by assessing proliferation and expression of surface markers, chemokine receptors and cytokines. Results: Serum collected from patients with a TBI and a long bone fracture increased the expression of the chemokine receptor CCR4 in monocytes when compared to patients with an isolated long bone fracture. Extending this comparison to T-lymphocytes, the serum from TBI patients induced lower proliferation rates and decreased expression of the pro-inflammatory cytokine TNF-α, while simultaneously increasing the secretion of immune-modulatory cytokines (IL-4, IL-10 and TGF-β) (p <0.05). Conclusion: Patients with a TBI release currently unknown soluble factors into the circulating blood that up regulate expression of chemokine receptor CCR4 in peripheral blood monocytes whilst concurrently inducing expression of immunosuppressive cytokines by activated T-lymphocytes. [Copyright &y& Elsevier]