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Purpose Some cochlear implant (CI) patients lose their residual hearing during surgery. Two factors that might play a role in residual hearing loss are the change in intracochlear hydraulic pressure and force on the cochlear wall during electrode insertion. The aim of this study is to investigate whether a difference in peak hydraulic pressure and peak force on the cochlear wall exists during a CI electrode insertion with different insertion techniques. Materials and methods Twenty fresh frozen temporal bones were used. Hydraulic pressure and force on the cochlear wall were recorded during straight electrode insertions with 1) slow versus fast insertion speed, 2) manual versus automatic insertion method and 3) round window approach (RWA) versus extended RWA (ERWA). Results When inserting with a slow compared to a fast insertion speed, the peak hydraulic pressure is 239% (95% CI: 130–399%) higher with a RWA and 58% (95% CI: 6–137%) higher with an ERWA. However, the peak force on the cochlear wall is a factor 29% less (95% CI: 13–43%) with a slow insertion speed. No effect was found of opening and insertion method. Conclusions As contradictory findings were found for hydraulic pressure and force on the cochlear wall on insertion speed, it remains unclear which insertion speed (slow versus fast) is less traumatic to inner ear structure.

Objective: Intracochlear hydraulic pressure change that occurs during cochlear implant surgery is thought to play a role in hearing preservation. Presence of intracochlear air might be a problem when performing pressure measurements in temporal bones. In this study, we aimed to examine if air could enter the cochlea due to decomposition through the opening of the labyrinth and through electrode insertion. Furthermore, the effect of a large amount of insufflated intracochlear air on peak hydraulic pressure during electrode insertion was also examined in fresh frozen heads (FFHs). Methods: Three human FFHs were used. An electrode was inserted three consecutive times, while the peak hydraulic pressure was measured. Air was then insufflated, and a second series of electrode insertions was performed. Computed tomography scans were performed on each FFH before each experiment and after insufflation of air. Volume in mm(3) and location of air were reported. Results: All FFHs had air, especially in the subarachnoid and intravascular space. One FFH had air in both cochleae (3-5 mm(3)). All FFHs showed air near the stapes footplate (1-3 mm(3)) after opening of the labyrinth. Air was present in the vestibule and scala vestibuli (1-23 mm(3)) of all FFHs after the electrode insertions and removal of the pressure sensor. The mean peak hydraulic pressure during electrode insertion decreased with insufflation of air (from 0.68 mmHg (standard deviation [SD] 0.34) to 0.24 mmHg (SD 0.14). Conclusion: Future studies on FFH or temporal bones should consider intracochlear air when performing hydraulic pressure measurements.

Purpose The COVID-19 pandemic has led to concerns over transmission risk from healthcare procedures, especially when operating in the head and neck such as during surgical repair of facial fractures. This study aims to quantify aerosol and droplet generation from mandibular and midface open fixation and measure mitigation of airborne particles by a smoke evacuating electrocautery hand piece. Materials and methods The soft tissue of the bilateral mandible and midface of two fresh frozen cadaveric specimens was infiltrated using a 0.1% fluorescein solution. Surgical fixation via oral vestibular approach was performed on each of these sites. Droplet splatter on the surgeon's chest, facemask, and up to 198.12 cm (6.5 ft) away from each surgical site was measured against a blue background under ultraviolet-A (UV-A) light. Aerosol generation was measured using an optical particle sizer. Results No visible droplet contamination was observed for any trials of mandible or midface fixation. Total aerosolized particle counts from 0.300–10.000 μm were increased compared to baseline following each use of standard electrocautery (n = 4, p

Background and aims With the introduction of Olaparib as target therapy for High Grade Serous Ovarian Cancer (HGSOC) patients with germline and somatic BRCA1/2 mutations, the genetic test performed on tumor tissue has become important like the germline test. In somatic testing the evaluation of Large Genomic Rearrangements (LGRs) represents the main challenge. We describe a droplet digital PCR (ddPCR) assay for the evaluation of target BRCA1 LGRs on blood and formalin-fixed paraffin-embedded (FFPE)/Fresh Frozen Tissue (FFT) samples. Materials and methods We analyzed blood, FFPE and FFT samples in a validation setting of n = 78 HGSOC patients. We applied the ddPCR to BRCA1 exons 2, 20 and 21 as some of the most common BRCA1 exons involved in LGRs in our cohort of patients. Results The ddPCR custom assays allowed the identification of LGRs in all sample types, including FFPE specimens. Moreover, we were able to clearly detect LGRs accounted as somatic event. Conclusion The introduction of ddPCR in a comprehensive workflow, encompassing both germline and somatic tests, represents an improvement in BRCA1/2 testing. ddPCR can overcome challenges related to BRCA testing, especially on FFPE analysis. Finally, ddPCR represents a promising alternative strategy to the established standard methods currently used in clinical setting.

Background The endoscope-assisted subtemporal key-hole epidural approach (ESKEA) has been recently described. The aim of this study was to measure working volumes and exposure of key areas of the middle cranial fossa provided by this approach. Methods Four fresh frozen cadaver heads were dissected to analyze 3 modular corridors (1A, 1B, and 2) harvested through ESKEA. A step-by-step dissection was performed, and key anatomic landmarks were recorded. A GTxEyesII-ApproachViewer was used to quantify the working volume and exposure of 4 different regions (sphenoorbital, parasellar, superior petrous apex, and squamopetrous). For each corridor, 3 incremental degrees of temporal dural retraction (5, 10, and 15 mm) were tested. Results The working volume of all corridors progressively increased with degree of retraction: Corridors 1A, 1B, and 2 showed a gain in working volume of 21%, 27%, and 19% from 5 mm to 10 mm retraction, respectively, and a gain of 40%, 45%, and 44% from 5 mm to 15 mm retraction, respectively. The sphenoorbital area was exposed (27%−45%) through corridor 1A, and exposure significantly increased with the degree of retraction. Corridor 1B provided optimal exposure of parasellar areas (86%−100%) and superior petrous apex (70%−87%) regardless of the degree of retraction. The squamopetrous area was satisfactorily addressed through corridor 2 (88%) only with the highest degree of retraction. Conclusions ESKEA can be conceived as a modular approach: the 3 surgical corridors have specific working volumes, which are clearly influenced by the degree of temporal lobe retraction, and provide exposure of different middle cranial fossa areas.

Purpose Although the fresh frozen (FF) cadaver is preferred for surgical applications, it is limited due to short usage time, unsuitable for reuse and the risk of infection. Due to its limited use, FF cadavers, which are covered by import in countries with insufficient body donation cause low-cost effectiveness. With the increase of real human tissue specimen necessities for surgical training, long-term preservation of the cadavers is crucial due to changes in mechanical properties. Therefore, studies on embalming solutions have increased in recent years. Methods We quantify the biomechanical properties of human parietal bones preserved via modified larssen solution (MLS) and compare the results with the specimens preserved as FF and fixed with 10% formalin-based solution (F10). The rectangular samples of 24 parietal bones of male individuals were resected from MLS-embalmed, F10-embalmed and FF cadavers to form three groups each containing eight samples. These specimens were tested longitudinally to identify mechanical properties. Results The tensile test results showed that there is not a significant difference between the groups in terms of stiffness, elastic modulus, strain at ultimate stress, failure strain and effective plastic strain. However, the yield stress, ultimate stress, yield strain, failure stress and total energy and post-yield properties are significantly lower in F10 than MLS and FF groups. Conclusion It is observed that the mechanical properties of MLS preserved and FF parietal bones have almost similar properties. Thus, it can be concluded that MLS is a suitable fixative solution for bone studies and bone-related surgical anatomy training applications.

Objective To bring forward an arthroscopic classification of the popliteomeniscal fascicles of the lateral meniscus (PFLM) tears. Design Six fresh frozen knee joint samples of adult males were chosen, and the lateral meniscus at the popliteal hiatus region were measured to analyze their anatomic relationship. Patients who had received magnetic resonance imaging scan at knee joint before the surgery and diagnosed as PFLM tears by arthroscopy from April 2014 to October 2017 were selected. Data regarding the integrity of PFLM were prospectively recorded in a data registry. Tear morphology and treatment received were subsequently extracted by 2 independent reviewers from operative notes and arthroscopic surgical photos. Results The average length and thickness of the popliteal hiatus of the lateral meniscus were 2.09 ± 0.21 cm and 0.43 ± 0.08 cm, respectively. The average length of anterosuperior popliteomeniscal fascicle (APF) was 0.87 ± 0.18 cm, and the posterosuperior popliteomeniscal fascicle (PPF) was 0.72 ± 0.15 cm. A total of 36 PFLM tears in 36 patients were divided as type I (APF tear; n = 5, 13.9%), type II (PPF tear; n = 20, 55.6%), and type III (both APF and PPF tears; n = 11, 30.6%). All patients were treated with arthroscopic all-inside repair using a suture hook for the PFLM tears and follow-up for 21.1 months. All patients have done well with significantly improved Lysholm and International Knee Documentation Committee scores at the last follow-up relative to preoperative scores ( P < 0.01). Conclusion This study suggests to possibly classify the PFLM tears for clinical practice.

Uterine leiomyomas are benign smooth muscle tumors occurring in 70% of women of reproductive age. The majority of leiomyomas harbor one of three well-established genetic changes: a hotspot mutation in MED12, overexpression of HMGA2, or biallelic loss of FH. The majority of studies have classified leiomyomas by complex and costly methods, such as whole-genome sequencing, or by combining multiple traditional methods, such as immunohistochemistry and Sanger sequencing. The type of specimens and the amount of resources available often determine the choice. A more universal, cost-effective, and scalable method for classifying leiomyomas is needed. The aim of this study was to evaluate whether RNA sequencing can accurately classify formalin-fixed paraffin-embedded (FFPE) leiomyomas. We performed 3&prime, RNA sequencing with 44 leiomyoma and 5 myometrium FFPE samples, revealing that the samples clustered according to the mutation status of MED12, HMGA2, and FH. Furthermore, we confirmed each subtype in a publicly available fresh frozen dataset. These results indicate that a targeted 3&prime, RNA sequencing panel could serve as a cost-effective and robust tool for stratifying both fresh frozen and FFPE leiomyomas. This study also highlights 3&prime, RNA sequencing as a promising method for studying the abundance of unexploited tissue material that is routinely stored in hospital archives.

PURPOSE The goal of the present study was to evaluate a potential tunnel convergence in combined anterior cruciate ligament (ACL) reconstruction using the anteromedial portal technique and lateral extra-articular tenodesis (LET). METHODS Ten fresh frozen femora were dissected and a K-wires were inserted into the middle of the ACL stump, according to an ACL reconstruction at 110° and 140° knee flexion. ACL reconstruction at 120° and 130° was simulated. Seven K-wires with different femoral insertion sites and angulations were drilled into the lateral femoral condyle relative to the lateral epicondyle (E3: 8 mm proximal and 4 mm posterior; E1: 5 mm proximal and 5 mm anterior and E2: over-the-top position). Tunnel conflict rate was evaluated using a measuring arm and a metrology software. RESULTS Drilling the femoral ACL tunnel in low knee flexion (110°-120°) significantly (P < .001) reduced the tunnel conflict rate compared to the ACL drilled in high knee flexion (130°-140°). Changing the insertion point from proximal and posterior (E3) to proximal and anterior (E1) showed a reduced tunnel conflict rate from 40 ± 21.2% to 15 ± 26% and no tunnel conflict for an ACL drilled at 110°-130° knee flexion. CONCLUSION A possible tunnel conflict in simultaneous ACL reconstruction using the AMP technique and LET was dependent on ACL knee flexion angle, LET insertion site, and angulation. This posed the dilemma that no generally applicable LET configuration could be recommended to avoid a tunnel conflict. However, it appears that an insertion point located proximal and anterior to the lateral epicondyle results in less tunnel conflicts than an insertion point located proximal and posterior. CLINICAL RELEVANCE An insertion point located proximal and anterior to the lateral epicondyle with a 30° proximal and 30° anterior angulation could reliably avoid a tunnel conflict when the ACL was drilled between 110 and 130° using a low anteromedial portal.

Background This study was conducted to evaluate the progress in the standardization of the gamma‐glutamyl transferase (GGT) to achieve metrological traceability of routine in vitro diagnosis (IVD) medical devices. Methods We collected 25 single fresh frozen serum samples for GGT analysis. Candidate reference materials (RMs), calibrators, internal quality controls (IQC), and external quality assessment (EQA) materials from the National Center for Clinical Laboratory (NCCL), Beijing Center for Clinical Laboratory (BCCL), and College of American Pathologists (CAP) were randomly added to these serum samples. A total of 42 samples were examined using IFCC reference method and four different IVD medical devices to perform the comparability and commutability study. Results The four IVD medical devices achieved trueness assessment within the measurement range. Linear analysis showed the agreement of Siemens ADVIA 2400, Hitachi 7600‐020/BioSino, Beckman AU 5800, and Roche Cobas 501 with the reference method. These assay pairs were comparable at the medical decision levels. The GGT in‐house candidate RMs, and Beckmann and Roche calibrators were all within the limits of the 95% prediction intervals, the commutability of BioSino calibrators was indeterminate, and some internal and external quality controls were not commutable for comparisons of certain IVD medical devices vs the reference method. Conclusions By comparing with the reference method, we found that performance of GGT conventional measurement systems to be traceable to the higher order references was improved. The commutable materials for calibration and trueness controls of routine methods were significant to promote the standardization of GGT analysis., Commutability of reference materials for GGT between IFCC reference method and IVD medical devices (A‐D). The solid lines are the regression lines, and dashed lines are the limits of the 95% prediction intervals. Cross represents NCCL, BCCL, and CAP external quality assessment substances, asterisk represents internal quality control products, diamond represents calibrators, and triangle represents homemade candidate reference materials.

Purpose and Scope of the Procedure - Rapid blocking, embedding and freezing of human lung tissue in no freezing media, 100% OCT or 5% CMC - Rapid freezing of non-lung tissue in no freezing media, 100% OCT or 5% CMC

Introduction/Purpose Larger lumen catheters are associated with improved reperfusion using aspiration for the treatment of stroke. Significant scope remains to improve the rate of first pass effect, which has been associated with significantly improved clinical outcomes. To date, the degree of tortuosity encountered during neurovascular procedures has limited the ability of larger lumen catheters to navigate distally to the target vessels. Perfuze Ltd (Galway, Ireland) have developed a novel aspiration catheter (Millipede 088) which has an 8F OD and 0.088’’ ID. The purpose of this study was to evaluate the navigability of Millipede 088 to the M1 segment of the MCA in a fresh-frozen cadaver model. Methods In total six cadavers were investigated, allowing evaluation of navigation to twelve MCAs. Commercially available 6F aspiration catheters (Terumo Sofia Plus, Penumbra ACE 64 and 68) were used as a control for baseline comparison. Slow perfusion using warm water was maintained throughout the procedure. The study was conducted at MERI, Memphis, TN, USA, using Siemens Artis Pheno for imaging. Control A Penumbra Neuron Max was placed at the petrous segment of the ICA. The 6F aspiration catheter was navigated triaxially over a microcatheter and microwire. Initially, 2.1F microcatheters and 0.014’’ microwires were used for support. Where additional support was required, microcatheters of up 2.7F or Penumbra 3Max and/or a 0.016’’ microwire were used. Test: Via femoral access, an 80 cm long sheath Super Arrow-Flex (Teleflex) or Flexor Shuttle (Cook) was placed in the proximal ICA. Various combinations of internal support were investigated 1) 2.1F microcatheters and 0.014’’ microwire, 2) 6F aspiration catheters. Where additional support was required to cross the ophthalmic artery, microcatheters of up 2.7F or Penumbra 3Max and/or a 0.016’’ microwire were used. Results Varying tortuosity was encountered; aortic-arch (Type I-III, bovine), cervical (s-shaped); siphon (U, C, S, o). In 11/12 instances it was possible to navigate to the distal M1 using test (Millipede 088) and control (6F aspiration catheters) devices. In the instance of unsuccessful navigation, both Millipede 088 and the 6F aspiration catheters were unable to cross the ophthalmic artery. In general, navigation of Millipede 088 to the M1 was facilitated by the support of a 6F aspiration catheter. Conclusions Navigation of the Millipede 088 catheter to the M1 is feasible in a cadaver model. The ophthalmic artery can represent a challenge which in the majority of cases can be overcome using the support of standard neurovascular devices. Disclosures R. Nogueira: 2; C; Perfuze Ltd. 4; C; Perfuze. L. Mullins: 4; C; Perfuze Ltd. 5; C; Perfuze Ltd. D. Finneran: 4; C; Perfuze Ltd. 5; C; Perfuze Ltd. W. Allen: 4; C; Perfuze Ltd. 5; C; Perfuze Ltd. J. Thornton: 2; C; Perfuze Ltd. 4; C; Perfuze Ltd.

Understanding of the exact topography of the distal radioulnar ligaments insertions remains limited. An anatomical study was performed in 21 fresh frozen cadaveric wrists, where the superficial and deep ligaments were sequentially transected sharply at their ulnar insertions. The relationships between the distal radioulnar ligament footprints relative to the bony landmarks of the ulnar styloid were digitized. Our study demonstrated that in the coronal plane, the superficial distal radioulnar ligaments inserted at an average of 87% of the styloid height proximally to the styloid tip distally. The deep distal radioulnar ligaments inserted at an average of 81% of the styloid height distally to the fovea proximally. The superficial footprint had an area of 10.6 mm2on the ulnar styloid. The deep distal radioulnar ligaments attachment was asymmetric and generally had two separate footprints. This study adds important topographical knowledge about the footprint of the distal radioulnar ligaments and may contribute to understanding the consequences of ulnar styloid fractures and distal radioulnar ligaments lesions.

Human and animal tissues are frequently fresh frozen for archival storage. These specimens can be used for proteomic analysis to analyze proteome composition. A critical step in these proteomic analyses is the extraction of proteins from fresh frozen samples, which can affect the sampling of the proteomes. Here, we compare three different methods for protein extraction from fresh frozen mouse heart tissue: 1) extraction using SDS buffer followed by FASP purification, 2) extraction using SDS buffer followed by S-Trap purification, and 3) extraction using a guanidine hydrochloride buffer followed by in-solution digestion. Based on bicinchoninic acid assay, all three methods display similar recovery of total protein content. However, proteomics-based analysis identified far fewer proteins from the extraction guanidine hydrochloride. SDS-FASP identifies as many proteins as the SDS-STrap method with good coverage of proteins from different cellular compartments.

Background: Meniscal allograft transplant (MAT) is considered an effective procedure for reducing pain and improving knee function. Nevertheless, the current knowledge regarding the results of MAT is limited to short- to mid-term follow-up studies, especially for arthroscopic techniques. Purpose: To evaluate the long-term clinical outcomes, reoperations, and failures with a minimum follow-up of 10 years after fresh-frozen MAT performed arthroscopically with soft tissue fixation. Study Design: Case series; Level of evidence, 4. Methods: A total of 46 patients (age, 36.6 ± 10.6 years; 36 male, 10 female) who underwent medial MAT (n = 27) or lateral MAT (n = 19) with a minimum 10-year follow-up were evaluated with the Lysholm score, Knee injury and Osteoarthritis Outcome Score (KOOS), visual analog scale for pain, and Tegner score. Surgical failure was defined as the need for partial or total graft removal (meniscectomy or knee replacement), and clinical failure was defined as the need for partial or total graft removal in addition to a poor Lysholm score (Results: 10-year survival and clinical data were available for 38 patients. Because 6 meniscectomies were required, the rate of survival free from surgical failure was 91% at 5 years and 86% at 10 years. Lower survival was reported in lateral MAT (73%) compared with medial MAT (96%). Because a further 4 patients had poor Lysholm scores, the rate of survival free from surgical and clinical failure was 87% at 5 years and 70% at 10 years. The average Lysholm score at final follow-up was 82 ± 20, and 60% to 82% of patients achieved PASS of the various KOOS subscales. The Tegner score and the KOOS Sport score significantly decreased from mid-term to long-term evaluation ( P < .001 and P < .05, respectively). Other KOOS subscales and the Lysholm score remained stable at long-term evaluation. No significant differences were found between isolated MAT or combined MAT regarding subjective scores, surgical failures, or clinical failures. Conclusion: Up to 10 years after surgery, 86% of fresh-frozen MATs with soft tissue fixation were still in situ, and satisfactory clinical results were present for about 70% of patients. Decline of clinical outcomes from midterm to long term was noted only in sports-related scores. A higher number of overall reoperations was noted in female patients, whereas a higher risk of failure was present in the patients with lateral MAT.

When septal cartilage is lacking, commercially available costal cartilage allograft can be used. Such allografts have "off-the-shelf" accessibility, are available in multiple sizes, are aseptically processed to meet sterility, and are screened to minimize infectious risks. The purpose of this study was to evaluate the effect of donor age, storage temperature, and orientation of a bilayered construct on the degree of warping of a commercialized fresh frozen costal cartilage allograft in vitro over time. A total of 140 fresh frozen costal cartilage cadaveric specimens were separated into three donor age groups. These were allocated into three harvesting subgroups: group a, single pieces (cephalocaudal segments); group b, two laminated pieces of the same rib sutured together in anatomical position (laminated group); and group c, two pieces from the same rib reversed onto each other and sutured together (oppositional group). Photographs were examined and analyzed to determine the degree of cartilaginous warping. Decreased rates of warping were seen in commercially available, aseptically processed costal cartilage allografts procured from older cadavers. Warping was also decreased when oppositional suturing techniques were used as a way to address those intrinsic cartilage forces.

Kaplan fibers (KF) have been described as connections between the iliotibial band and the distal femur. They are divided into two distinct structures, proximal (PKF) and distal (DKF) fibers, which may participate in the control of the rotatory knee stability. Their anatomical characteristics have not been investigated completely, in particular with respect to reconstruction procedures. The aim was to determine their anatomical characteristics and their morphological variation. Twenty-one nonpaired fresh frozen human cadaveric knees (from whole leg) were used for the analysis of PKF and DKF through an anterolateral approach. The anatomical relationships between the adjacent anterolateral structures were reported and anatomical characteristics of PKF and DKF (thickness, width and length) measured at 50° knee flexion under different rotational conditions (neutral: NR, Internal at 5Nm: IR applied with a dynamometric torque rig). Bony ridges of PKF and DKF were measured. PKF and DKF and their respective bony ridges were individually identified in all knees studied (n = 21). The PKF and DKF were proximal and posterior to the lateral femoral epicondyle, respective distances 49.20 ± 7.38 and 27.54 ± 7.69 mm. DKF were thicker (p

Background Peripheral triangular fibrocartilage complex (TFCC) tears may induce instability of the distal radioulnar joint (DRUJ). In this biomechanical study, simulated peripheral tears of the TFCC were examined on the stability of the DRUJ. Restabilization effect of the DRUJ by ulnar shortening and direct repair of those injuries were sequentially examined. Method The DRUJ stiffness was measured in intact, simulated two types of peripheral tears (ulnar and extended ulnodorsal) at three forearm positions: neutral, 60° pronation and 60° supination in 8 fresh frozen cadaver specimens. After the tears were sutured with stitches or after simulated ulnar shortening of 3 mm, the DRUJ stiffness was again measured. Results The ulnar and ulnodorsal TFCC tears decreased the DRUJ stiffness significantly compared with the intact in all forearm positions. When ulnar shortening was done for the ulnar tear, the DRUJ stiffness increased significantly in the neutral and 60° pronated positions. When the ulnar TFCC tear was repaired, the DRUJ stiffness increased significantly in all forearm positions. DRUJ stiffness did not increase either with ulnar shortening or repair in ulnodorsal tear of the TFCC, however. Conclusion The simulated TFCC tears indicated significant loss of DRUJ stiffness. Direct repair or ulnar shortening was effective only on treatment of the ulnar tear of the TFCC in this study.

Background: The aim of this study was to compare the histological structure (cross-sectional area [CSA] and number of nerve fascicles) of the distal part of the tibial nerve (TN) and its terminal branches (medial plantar nerve [MPN], lateral plantar nerve [LPN]) in the fresh and fresh-frozen cadavers using computer assisted image analysis. Materials and methods: The TNs with terminal branches (MPN and LPN) were dissected from the fresh and fresh-frozen cadavers. Each nerve was harvested 5 mm proximally and respectively 5 mm distally from the TN bifurcation, marked, dehydrated, embedded in paraffin, sectioned at 2 μm slices and stained with haematoxylin and eosin. Then the specimens were photographed and analysed using Olympus cellSens software. Results: The fresh cadavers’ group comprised 60 feet (mean age 68.1 ± 15.2 years). The mean CSA and the number of nerve fascicles were respectively 15.25 ± 4.6 mm2, 30.35 ± 8.45 for the TN, 8.76 ± 1.93 mm2, 20.75 ± 7.04 for the MPN and 6.54 ± 2.02 mm2, 13.40 ± 5.22 for the LPN. The fresh-frozen cadavers’ group comprised 21 feet (mean age 75.1 ± 9.0 years). The mean CSA and the number of nerve fascicles were respectively 13.71 ± 5.66 mm2, 28.57 ± 8.00 for the TN, 7.55 ± 3.25 mm2, 18.00 ± 6.72 for the MPN and 4.29 ± 1.93 mm2, 11.33 ± 1.93 for the LPN. Only LPNs showed statistical differences in the CSA and the number of nerve fascicles between examined groups (p = 0.000, p = 0.037, respectively). A positive correlation was found between donors age and tibial nerve CSA in the fresh cadavers group (r = 0.44, p = 0.000). A statistical difference was found between the MPN and LPN both in the CSA and the number of nerve fascicles (p < 0.001, p < 0.001, respectively). Conclusions: The CSA and the number of nerve fascicles of the tibial and medial plantar nerves were similar in the fresh and fresh-frozen cadavers whilst different in the LPN. The TN showed increasing CSA with the advanced age in the fresh cadavers. The MPN had larger CSA and more nerve fascicles than the LPN.

It is widely accepted that the internal mammary vein (IMV) is valveless. However, few anatomical studies are available on the presence or absence of IMV valves. To test the hypothesis that the IMV is valveless, we performed microscopic histological examination of the IMV. IMV samples were collected from 10 human fresh frozen cadavers. For a control, the small saphenous vein (SSV) was obtained. Histological stains were performed. Microscopic examination showed that a venous valve was found in 8 of 20 IMVs. The structure of the valve leaflet consisted of two parts. There was a “thick part” located near the wall of the vein that consisted of smooth muscle cells and fibers. There was also a “thin part” located near the center of the venous lumen that lacked smooth muscle cells. The size of the thick part of the IMV valve was smaller than the SSV valve, whereas there was no difference in the size of the thin part between the IMV and SSV. IMV valves exist. Our results that an IMV valve was present in less than half of IMVs and there was a small-sized valve leaflet suggest that the IMV valve may be rudimentary.

A crooked nose is challenging for a surgeon and needs to be treated using a systematic approach. Correction of nasal deformities such as a retracted columella in a revision rhinoplasty may need additional cartilage to correct the framework. Fresh frozen cartilage graft has been used as an extended spreader graft and a columellar strut graft to correct this problem. This option prevents donor-site morbidity associated with harvesting autologous cartilage.

Background Virtual reality (VR) training is widely used for surgical training, supported by comprehensive, high-quality validation. Technological advances have enabled the development of procedural-based VR training. This study assesses the effectiveness of procedural VR compared to basic skills VR in minimally invasive surgery. Methods 26 novice participants were randomised to either procedural VR (n = 13) or basic VR simulation (n = 13). Both cohorts completed a structured training programme. Simulator metric data were used to plot learning curves. All participants then performed parts of a robotic radical prostatectomy (RARP) on a fresh frozen cadaver. Performances were compared against a cohort of 9 control participants without any training experience. Performances were video recorded and assessed blindly using GEARS post hoc. Results Learning curve analysis demonstrated improvements in technical skill for both training modalities although procedural training was associated with greater training effects. Any VR training resulted in significantly higher GEARS scores than no training (GEARS score 11.3 ± 0.58 vs. 8.8 ± 2.9, p = 0.002). Procedural VR training was found to be more effective than both basic VR training and no training (GEARS 11.9 ± 2.9 vs. 10.7 ± 2.8 vs. 8.8 ± 1.4, respectively, p = 0.03). Conclusions This trial has shown that a structured programme of procedural VR simulation is effective for robotic training with technical skills successfully transferred to a clinical task in cadavers. Further work to evaluate the role of procedural-based VR for more advanced surgical skills training is required.

Objective For many years, BRCA mutational status has only been considered as a predictor of ovarian cancer susceptibility and as a prognostic factor. Nonetheless, in the era of precision medicine, it has also become a predictive biomarker of response to platinum-based-chemotherapy and, more recently, to PARP-inhibitors, also in the frontline setting. We assessed the feasibility of a fresh frozen tissue-based-BRCA-screening workflow in a tertiary referral center. Methods We consecutively enrolled a series of 456 newly diagnosed FIGO-Stage IIIC-IV, high grade serous-ovarian cancer patients. All patients receiving tumor-biopsy underwent tBRCA-testing. Results Clinically relevant tissue-BRCA (tBRCA) variants were observed in 145 women (31.8%), particularly we recognized 89 (61.4%) patients with BRCA1-pathogenetic variants (PVs) and 56 women (38.6%) with BRCA2-PVs. Among 292 tBRCA wild-type (wt) patients, 88 cases were germline BRCA tested (gBRCA) and 86 (97.8%) were confirmed as gBRCAwt, while 1 (1.1%) had gBRCA variant of uncertain significance and 1 had gBRCA mutation (1.1%). The concordance of tumor test versus germline BRCA test was 86.3% (209/242). Large genomic rearrangements (LGRs) were suspected in 13/292 tBRCAwt patients (4.5%) by using bioinformatic algorithm and multiplex ligation-dependent probe amplification (MLPA) was performed, with evidence of PVs in only 1 case. Conclusions Fresh-frozen tissue-based BRCA screening workflow is feasible and reliable. It allows to enlarge the BRCA mutated population that might receive PARPi with the greatest benefit, without missing cascade testing for family members and therefore, maintaining its preventive role.

Background Research grade Fresh Frozen (FF) DNA material is not yet routinely collected in clinical practice. Many hospitals, however, collect and store Formalin Fixed Paraffin Embedded (FFPE) tumor samples. Consequently, the sample size of whole genome cancer cohort studies could be increased tremendously by including FFPE samples, although the presence of artefacts might obfuscate the variant calling. To assess whether FFPE material can be used for cohort studies, we performed an in-depth comparison of somatic SNVs called on matching FF and FFPE Whole Genome Sequence (WGS) samples extracted from the same tumor. Methods Four variant callers (i.e. Strelka2, Mutect2, VarScan2 and Shimmer) were used to call somatic variants on matching FF and FFPE WGS samples from a metastatic prostate tumor. Using the variants identified by these callers, we developed a heuristic to maximize the overlap between the FF and its FFPE counterpart in terms of sensitivity and precision. The proposed variant calling approach was then validated on nine matched primary samples. Finally, we assessed what fraction of the discrepancy could be attributed to intra-tumor heterogeneity (ITH), by comparing the overlap in clonal and subclonal somatic variants. Results We first compared variants between an FF and an FFPE sample from a metastatic prostate tumor, showing that on average 50% of the calls in the FF are recovered in the FFPE sample, with notable differences between callers. Combining the variants of the different callers using a simple heuristic, increases both the precision and the sensitivity of the variant calling. Validating the heuristic on nine additional matched FF-FFPE samples, resulted in an average F1-score of 0.58 and an outperformance of any of the individual callers. In addition, we could show that part of the discrepancy between the FF and the FFPE samples can be attributed to ITH. Conclusion This study illustrates that when using the correct variant calling strategy, the majority of clonal SNVs can be recovered in an FFPE sample with high precision and sensitivity. These results suggest that somatic variants derived from WGS of FFPE material can be used in cohort studies.

Here, I will only include tips and notes related to snATAC workflow. Thus, I assume you are familiar with Frankenstein protocol below: - These are ONLY a collection of my lab notes. This is not a protocol. -These notes are derived from trial and error in order to get successful runs applied to fresh, snap/flash and cryopreserved frozen cell lines as well as to tissue derived from solid tumours and other tissues using Chromium Platform (10x Genomics). -Be mindful these are just my notes and by no means are ground truth of how snATAC-Seq needs to be performed. I WELCOME to comments, suggestions and amendments.

Background: Next generation sequencing (NGS)-based multi-gene panel tests have been performed to predict the treatment response and prognosis in patients with colorectal cancer (CRC). Whether the multi-gene mutation results of formalin-fixed paraffin-embedded (FFPE) tissues are identical to those of fresh frozen tissues remains unknown.Methods: A 22-gene panel with 103 hotspots was used to detect mutations in paired fresh frozen tissue and FFPE tissue from 118 patients with CRC.Results: In our study, 117 patients (99.2%) had one or more variants, with 226 variants in FFPE tissue and 221 in fresh frozen tissue. Of the 129 variants identified in this study, 96 variants were present in both FFPE and fresh frozen tissues; 27 variants were found in FFPE tissues only; 6 variants were found only in fresh frozen tissues. The mutation results demonstrated >94.0% concordance in all variants, with Kappa coefficient >0.500 in 64.3% (83/129) of variants. At the gene level, concordance ranged from 73.8 to 100.0%, with Kappa coefficient >0.500 in 81.3% (13/16) of genes.Conclusions: The results of mutation analysis performed with a multi-gene panel and FFPE and fresh frozen tissue were highly concordant in patients with CRC, at both the variant and gene levels. There were, however, some important differences in mutation results between the two tissue types. Therefore, fresh frozen tissue should not routinely be replaced with FFPE tissue for mutation analysis with a multi-gene panel. Rather, FFPE tissue is a reasonable alternative for fresh frozen tissue when the latter is unavailable.

Background:. Management of facial rejuvenation by the thread lift procedure has evolved over the past few years. The role of deep plane thread lift for buccal fat pad reposition was advocated. However, there are concerns about the risks and the feasibility of the deep plane thread lift. This study was designed to determine whether the deep plane thread lift could achieve effective aesthetic results and to investigate the possible risks of critical tissue injury through cadaveric studies. Methods:. Twelve fresh frozen cephalic specimens of 8 male and 4 female Asian body donors (mean age, 63.3 ± 8.0 years) were investigated. The deep plane thread lifts for reposition of the buccal fat pads were performed for all the left hemifaces. Cadaveric dissections were performed to investigate the moving distance of the buccal fat pad and to examine the surrounding tissue of the passage of the deep plane thread lift. Results:. The average moving distance of the buccal fat pads after the deep plane thread lift was 3.73 cm. The difference in moving distance of buccal fat pads between bilateral sides was statistically significant (P < 0.001). No injuries of the critical vessels or nerves were found after cadaveric dissection. The passage of the deep plane thread lift was evaluated. Conclusion:. The deep plane thread lift for reposition of the buccal fat pad is a safe, effective, and practical method.

Here, I will only include tips and notes related to snATAC workflow. Thus, I assume you are familiar with Frankenstein protocol below: - These are ONLY a collection of my lab notes. This is not a protocol. -These notes are derived from trial and error in order to get successful runs applied to fresh, snap/flash and cryopreserved frozen cell lines as well as to tissue derived from solid tumours and other tissues using Chromium Platform (10x Genomics). -Be mindful these are just my notes and by no means are ground truth of how snATAC-Seq needs to be performed. I WELCOME to comments, suggestions and amendments.

Immunohistochemistry (IHC) is a useful technique for the localization and semiquanti- fication of protein expression within tissues. Adult human intervertebral disc (IVD) tissues contain a large amount of auto-fluorescence which often makes immunofluorescence tech- niques inappropriate on tissue samples but can be applied to isolated cell samples. Thus, IHC remains one of, if not the most common application for protein detection within IVD tissue. Immunostaining localizes antigen expression through specific epitope-antibody inter- actions. Within the field of IVD research, IHC is commonly used on fresh frozen and paraf- fin embedded tissues to elucidate the expression of antigens. Here, we discuss the principles of IHC applied to formalin fixed paraffin embedded IVD tissue and supply opti- mized protocols for antibodies used within our group to guide research within the IVD field.

Histomorphology and immunohistochemistry are the most common ways of cancer classification in routine cancer diagnostics, but often reach their limits in determining the organ origin in metastasis. These cancers of unknown primary, which are mostly adenocarcinomas or squamous cell carcinomas, therefore require more sophisticated methodologies of classification. Here, we report a multiplex protein profiling-based approach for the classification of fresh frozen and formalin-fixed paraffin-embedded (FFPE) cancer tissue samples using the digital western blot technique DigiWest. A DigiWest-compatible FFPE extraction protocol was developed, and a total of 634 antibodies were tested in an initial set of 16 FFPE samples covering tumors from different origins. Of the 303 detected antibodies, 102 yielded significant correlation of signals in 25 pairs of fresh frozen and FFPE primary tumor samples, including head and neck squamous cell carcinomas (HNSC), lung squamous cell carcinomas (LUSC), lung adenocarcinomas (LUAD), colorectal adenocarcinomas (COAD), and pancreatic adenocarcinomas (PAAD). For this signature of 102 analytes (covering 88 total proteins and 14 phosphoproteins), a support vector machine (SVM) algorithm was developed. This allowed for the classification of the tissue of origin for all five tumor types studied here with high overall accuracies in both fresh frozen (90.4%) and FFPE (77.6%) samples. In addition, the SVM classifier reached an overall accuracy of 88% in an independent validation cohort of 25 FFPE tumor samples. Our results indicate that DigiWest-based protein profiling represents a valuable method for cancer classification, yielding conclusive and decisive data not only from fresh frozen specimens but also FFPE samples, thus making this approach attractive for routine clinical applications., Proteomic profiling may contribute to the analysis and classification of cancer. The authors applied the digital western blot technique DigiWest with a panel of 102 proteins and phosphoproteins in combination with a machine learning algorithm to classify the tissue origin of five common cancer types in fresh frozen and formalin-fixed paraffin-embedded tissue. DigiWest profiling represents a valuable method for cancer classification, yielding conclusive and decisive data, thus making this approach attractive for routine clinical applications.

Objective To describe the feasibility of a fresh frozen human cadaver model for research and training of endovascular image guided procedures in the aorta and lower extremity. Methods The cadaver model was constructed in fresh frozen human cadaver torsos and lower extremities. Endovascular access was acquired by inserting a sheath in the femoral artery. The arterial segment of the specimen was restricted by ligation of collateral arteries and, in the torsos, clamping of the contralateral femoral artery and balloon occlusion of the supratruncal aorta. Tap water was administered through the sheath to create sufficient intraluminal pressure to manipulate devices and acquire digital subtraction angiography (DSA). Endovascular cannulation tasks of the visceral arteries (torso) or the peripheral arteries (lower extremities) were performed to assess the vascular patency of the model. Feasibility of this model is based on our institute’s experiences throughout the use of six fresh frozen human cadaver torsos and 22 lower extremities. Results Endovascular simulation in the aortic and peripheral vasculature was achieved using this human cadaver model. Acquisition of DSA images was feasible in both the torsos and the lower extremities. Approximately 84 of the 90 target vessels (93.3%) were patent, the remaining six vessels showed signs of calcified steno-occlusive disease. Conclusions Fresh frozen human cadavers provide a feasible simulation model for aortic and peripheral endovascular interventions, and can potentially reduce the need for animal experimentation. This model is suitable for the evaluation of new endovascular devices and techniques or to master endovascular skills.

Aim Aberrant Sonic hedgehog (Shh) pathway signaling has been described in small cell lung cancer (SCLC), as well discrepancies, when analyzing expression of pathway components in SCLC cell lines vs tumor biopsies. Shh key component GLI1 was evaluated in advanced SCLC and data correlated with patient survival. Materials and methods GLI1 expression was analyzed by quantitative real-time polymerase chain reaction in pre-treatment fresh frozen tumor biopsies of 12 advanced SCLC patients and mRNA level of GLI1 was compared in short-term vs long-term survivor's samples (stratified by median survival, independent samples t-test). Results Expression of GLI1 mRNA was significantly higher in long-term (> 9.6 months, n = 6) survivor's biopsies than in short-term (≤ 9.6 months, n = 6) survivors (p = 0.0196, 95% CI: 0.000016 to 0.000147, two-tailed independent samples t-test). Conclusion High GLI1 mRNA expression in SCLC was found to be positive prognostic marker associated with longer survival. Further research is needed for validation of these results due to the small number of patients in the study.

Ethical Tissue (ET) is a Research Tissue Bank specialising in researcher led prospective collection of tissues. ET does not focus on specific conditions nor is it restricted in who it can supply. We consider requests for any type of tissue, including biofluids such as blood, serum, plasma and urine, from researchers in academia or industry from any part of the world. Tissues and biofluids are collected under generic and lasting consent, maximising reuse/sharing potential. ET also provides tissue processing services including tissue micro-arrays from both fresh frozen tissues and FFPE blocks, primary cell cultures, subcellular fractions and DNA/RNA preparations. A list of banked tissues, including biofluids, cell lines and processed samples is available on the ET website. Funding statement: The major source of income for Ethical Tissue is through cost recovery. In addition the authors would like to acknowledge the ongoing support of the University of Bradford.

Bewegungsdefizite am Ellenbogengelenk treten haufig posttraumatisch oder postoperativ (u. a. Kapselfibrose) auf und konnen alltagliche Einschrankungen generieren. Bei persistierender Ellenbogensteife kann eine arthroskopische Arthrolyse mit Entfernung der dorsalen und ventralen Kapselanteile durchgefuhrt werden. Ziel der Arbeit war die Uberprufung der Kapsulektomie nach Arthroskopie (ASK) am anatomischen Praparat zur Beurteilung der Vollstandigkeit des Verfahrens. Bei insgesamt 5 Fresh-frozen-Ellenbogenpraparaten wurde jeweils eine standardisierte Ellenbogen-ASK mit ventraler und dorsaler Kapsulektomie durchgefuhrt und bilddokumentiert. Im Anschluss wurde der Gelenkbereich ventral und dorsal eroffnet und eine Erfolgskontrolle mittels Fotodokumentation erbracht. Bei allen Praparaten waren unabhangig von Operateur und operativer Erfahrung Restkapselanteile ventral und dorsal verblieben. Insbesondere dorsal waren Kapselstrange um die jeweiligen Standard-ASK-Portale und hier vermehrt im Bereich des hohen dorsolateralen Kameraportals aufgefallen. Eine inkomplette Kapsulektomie zeigte sich ulnarseitig auf Hohe des posteromedialen Ligaments (PML) in unmittelbarer Nachbarschaft des N. ulnaris. Ventral wurde eine Kapsulektomie bis auf den Brachialismuskel sowohl von radial als auch von ulnar durchgefuhrt und zusatzlich eine vollstandige Kapsulektomie bis zum anteromedialen Ligament (AML) und radialen kollateralen Ligament (RCL) erreicht. Nach proximal wurde die Kapsel komplett reseziert. Distal zeigten sich fur die Steife irrelevante Kapselreste im Bereich des Lig. anulare und distal der Processus-coronoideus-Spitze. Eine arthroskopische Arthrolyse kann mit einer hohen Radikalitat durchgefuhrt werden. Selbstkritisch muss im eigenen Vorgehen die Radikalitat beachtet werden. Ventral ist die Radikalitat durch den Portalwechsel vielleicht sogar hoher als bei einer isolierten „column procedure“. Dorsal muss dagegen kritisch betrachtet werden, dass das PML arthroskopisch aufgrund der Gefahr einer N.-ulnaris-Verletzung nicht adaquat adressiert werden kann. Abhilfe zur Resektion relevanter Kapselreste kann ein mehrfacher Portalwechsel schaffen, um so auch schwer zugangliche Bereiche zu erreichen. Ist ein Release des PML erforderlich, muss dieses ggf. in Kombination mit einem Ulnaris-Release in Mini-open-Technik durchgefuhrt werden.

We recently described a pulsatile fresh frozen human cadaver model (PHCM) for training endovascular practitioners. This present study aims to assess the construct validity of PHCM; its ability to differentiate between participants of varying expertise.Twenty-three participants with varying endovascular experience (12 novice, 4 intermediate, and 7 expert) were recruited. Each attempted catheterization of the left renal artery on PHCM within 10 min under exam conditions. Performances were video recorded and scored using a validated scoring tool by 2 independent endovascular experts, blinded to performer status. Each participant was given a task-specific checklist score (TSC), global rating score (GRS), and overall procedure score (OPS). Finally, examiners were asked whether they would be happy to supervise the participant in theater, with each participant graded as "fail", "borderline," or "pass".All expert and intermediate participants completed the index procedure within the allotted 10 min; however, only one of the 12 novice participants achieved this (P 0.0005). Endovascular novices had significantly lower TSC, GRS, and OPS than both intermediate participants and endovascular experts. There were no significant differences in TSC, GRS, or OPS between intermediate participants and endovascular experts. When participants were graded as "fail", "borderline," or "pass," there were significant differences between groups (P = 0.001). All of the intermediate and expert participants received a pass. Out of the 12 novice participants, 2 received a pass, 6 received a borderline, and 4 were failed.The PHCM demonstrates construct validity. Further work is required to determine its educational impact in endovascular training.

Hypothesis Placing cartilage grafts on different tympanic membrane (TM) locations will affect sound transfer function, and the effects will differ according to the part of the TM modified. Background Cartilage tympanoplasty is increasingly popular because of lower reperforation rates, and better long-term stability. In this temporal bone study, we investigated the effect of placing cartilage grafts over different parts of the normal TM on sound transmission. Methods In 10 human fresh frozen temporal bones, umbo and stapes vibrations to acoustic stimuli from 250 to 8000 Hz were measured at multiple points using a scanning laser vibrometer. Four different cartilage arrangements were measured in each temporal bone. 1) Overlay condition leaving an umbo rim of normal TM (Umbo Rim). 2) Overlay condition leaving annular rim of normal TM (Annular Rim). 3) Overlay condition leaving both rims of normal TM (Two Rims). 4) Overlay condition leaving no normal TM exposed (No Rims). Results At low frequencies, there was a statistically significant decrease in velocity from baseline for the No Rims (umbo mean -4 dB; stapes -6 dB) and Umbo Rim (umbo -4 dB; stapes -3.7 dB) conditions. All conditions showed significant decreases for middle frequencies (umbo -4.0, -5.9, -7.4 and -6.3 dB; stapes -10.8, -6.6, -6.3 and -7.7 dB) and high frequencies (umbo -13.2, -3.0, -3.1 and -5.5 dB; stapes -4.6, -2.4, -2.6 and -3.5 dB). Results are in order for No Rims, Umbo Rim, Two Rims, and Annular Rim conditions. Conclusion In the low frequencies, it seems to matter where the cartilage is placed, and in particular the annular rim of the TM seems to be important for the low-frequency acoustic transfer function. In the higher frequencies, all graft placements caused some drop at all frequencies. In all frequencies, effects were modest by clinical standards.

Background: With rising concerns about changing fungal epidemiology and azole resistance in Aspergillus species, identifying fungal species and susceptibility patterns of mucorales and aspergillosis are crucial in the management of these diseases. The objectives of this study were to evaluate performance of panfungal PCR assays on formalin-fixed paraffin embedded (FFPE) samples for fungal species identification, and the detection of azole-resistance mutations in the Aspergillus fumigatus ( A.fumigatus ) cyp51A gene at a South Korean hospital. Methods: A total of 75 FFPE specimens with a histopathological diagnosis of aspergillosis or mucormycosis were identified during the 10-year study period (2006-2015). After deparaffinization and DNA extraction, panfungal PCR assays were conducted on FFPE samples for fungal species identification. The identified fungal species were compared with histopathological diagnosis. On samples identified as A.fumigatus , sequencings to identify frequent mutations in the cyp51A gene (tandem repeat 46 [TR46], L98H, and M220 alterations) that confer azole resistance were performed. Results: Specific fungal DNA was identified in 31 (41.3%) FFPE samples, and of these, 16 samples of specific fungal DNA were in accord with histopathological diagnosis of aspergillosis or mucormycosis. 15 samples had discordant histopathology and PCR results. No azole-mediating cyp51A gene mutation was revealed among nine cases of A. fumigatus . Moreover, no cyp51A mutations were identified among three cases with history of prior azole use. Conclusion: The pan-fungal PCR assay with FFPE sample may provide additional information on fungal species identification. No azole-resistance mediating mutations in the A. fumigatus cyp51A gene were identified among FFPE samples during study period.

IntroducciónLa infección posquirúrgica en la columna lumbar es desafortunadamente común, multifactorial y una complicación potencialmente devastadora, que se asocia a un incremento de la morbilidad y la necesidad de futuras cirugías, y en última instancia, puede ser mortal. Con la intención de disminuir la morbilidad posquirúrgica, la medicación y los días de internación, comenzamos a utilizar aloinjerto fresco congelado de cabeza femoral de donantes vivos, en la artrodesis lumbar corta. El objetivo de este estudio fue comparar el índice de infección en la artrodesis lumbar corta en pacientes con aloinjerto fresco congelado y con autoinjerto.Materiales y MétodosEstudio retrospectivo de 153 pacientes divididos en dos grupos: grupo A: 84 pacientes con autoinjerto de cresta ilíaca y grupo B: 69 pacientes con aloinjerto fresco congelado, desde marzo de 2009 hasta enero 2014, sometidos cirugía instrumentada de fusión espinal lumbar posterolateral.ResultadosTres de los 153 pacientes operados se perdieron en el seguimiento (2 del grupo A y 1 del grupo B) y la muestra incluyó 150 pacientes (82 del grupo A y 68 del grupo B). Se produjeron tres infecciones por Staphylococcus aureus sensible a la meticilina, todas en el grupo A (4,5%). Ningún paciente de los dos grupos necesitó transfusión.ConclusionesEl uso de aloinjerto fresco congelado en las cirugías de columna lumbar posterolateral de causa degenerativa no se asocia a un aumento en la tasa de infección. Consideramos que el aloinjerto fresco congelado es una excelente alternativa, porque disminuye el tiempo quirúrgico y de hospitalización.

The purpose of this study was to determine the biomechanical characteristics of an innovative surgical technique based on a tension banding principle using a suture anchor in the repair of bony avulsions of the flexor digitorum profundus tendon. After injury simulation in 45 fresh frozen distal phalanges from human cadavers, repair was performed with minifragment screws, interosseous sutures and the innovative technique (15 per group). All repairs were loaded for a total of 500 cycles. Subsequently the specimens were loaded to failure. Load at failure, load at first noteworthy displacement (>2 mm), elongation of the system, gap formation at the avulsion site, and the mechanism of failure were assessed. The new techniques’ superior performance in load at failure (mean: 100.5 N), load at first noteworthy displacement (mean 77.4 N), and gap formation (median 0 mm) was statistically significant, which implies a preferable rigidity of the repair. No implant extrusion or suture rupture during cyclic loading were recorded when the new technique was applied. This innovative repair technique is superior biomechanically to other commonly used surgical tendon reattachment methods, particularly with respect to an early passive mobilisation protocol. Further, due to its subcutaneous position, reduction of complications may be achieved.

Background Compare the biomechanical stability of a novel “U” posterior cervical fixation construct to four other posterior cervical atlantoaxial fixation constructs. Methods Eight fresh frozen human cadaver spines were tested after a simulated odontoid fracture, and following stabilization with each construct. Results All constructs significantly decreased flexion-extension and axial rotation compared to the destabilized spine. The U construct provided significantly more axial stability than the Brooks wire technique. Conclusion The novel U construct demonstrated comparable biomechanical stability to the existing constructs in all three planes of motion with the exception of axial rotation, in which it was inferior to TAS.

OBJECTIVES To evaluate the accuracy, safety, and anticipation effect of a novel electrical conductivity device (SG) in maxillary osteotomy preparation for placement of dental implants. MATERIALS AND METHODS Thirty-seven osteotomies were prepared by three operators with different levels of expertise, using the SG protocol in the maxilla of six fresh frozen cadavers. A pre-op CT measurement of the length of bone in the desired implant location was taken and compared with the final length of the osteotomy created using SG during surgery. A comparison was made between the results of the different operators. RESULTS The pre-op CT bone length measurements and the final depth assessment of the osteotomy with SG had a very high correlation level (0.977) with a significant mean difference of 0.639 mm (P

This study proposed a surgical technique that solves three-dimensional conditions of extreme bone atrophy. A total of 278 surgeries with transcrestal sinus lift and fresh frozen allogenous bone blocks were performed. A total of 1,024 implants were placed. After 60 months of observation, 969 implants were considered grade I (successful), 24 grade II (satisfactory survival), and 8 grade III (compromised survival). The cumulative success and survival rates, respectively, were 94.6% and 97.7%. This innovative procedure is very effective in selected cases. Fresh-frozen human bone allografts have been shown to be a reliable biomaterial to increase bone volume with simultaneous dental implant placement.

The effects of preanalytical variables in tissue processing and storage periods on RNA quality of tissues have been well documented in each type of cancer. However, few studies have been performed on a comparative assessment of the impacts across different cancer tissues, even though it is well known that RNase activity is highly variable in various tissue types and RNase-rich tissues have been found to yield low-quality RNA.We investigated the impacts of cold ischemia times and long-term storage on RNA integrity in various types of cancer tissue, which had been fresh-frozen and collected at the Samsung Medical Center Biobank. RNA quality was also evaluated with regard to histopathological variables. We analyzed RNA integrity number (RIN) data, which had been obtained from our quality control (QC) processes over the last 7 years. Approximately 2% of samples were randomly selected and processed to measure RIN quarterly and after 6 years of storage for QC purposes.Fresh-frozen tumor tissues yielded high-quality RNA regardless of tumor type and histopathological features. Up to 1-hour cold ischemia times and up to 6-year storage times did not adversely influence RNA integrity. Only 3 samples showed RIN of7 out of a total of 396 analyzed tumor tissues.Tissue quality was not adversely affected by long-term storage or limited variations of cold ischemia times. The low-quality samples could be correlated with the structural composition or intratumoral heterogeneity of tissues. The strict application of standardized protocols for tissue collection is the key for high-quality biobanking.

Different types of intraosseous suture anchors can be used for thumb ulnar collateral ligament (UCL) repair surgery. Some of them have already been tested biomechanically in intact bone; however, there exists little knowledge of their stability when implanted in avulsion fracture. In this biomechanical in vitro study, three anchor types (hard, soft and novel BoneWelding) were tested on 24 fresh frozen human thumbs from 12 body donors. After the repair of an iatrogenic ligamentous UCL rupture, the thumbs were cyclically loaded. A new set of anchors was implanted at the contralateral radial side of the same specimen into an iatrogenic avulsion fracture and pulled out of the bone. The most common mode of failure in ligamentous UCL repairs was the suture-ligament interface, especially when using soft anchors. In avulsion fractures, the novel anchor withstood significantly higher pullout forces than the hard or soft anchor (65 N vs. 42 N vs. 27 N; p = .006). The BW anchor provides sufficient anchorage in trabecular bone for UCL repair in case of avulsion fractures.

Variability in anatomic terminology, dissection protocols, and use of embalmed as opposed to fresh frozen specimens has led to the controversy surrounding the "anterolateral ligament of the knee." Conceptually the complex anatomy of the anterolateral knee is made up of the superficial, middle, deep, and capsulo-osseous layers of the iliotibial band. The anterolateral capsule is deep to these tissues and is directly attached to the lateral meniscus. These structures collectively form the anterolateral complex of the knee. The anterolateral complex in conjunction with the anterior cruciate ligament function to prevent anterolateral rotatory instability of the knee.

Background The authors have published their design of a pulsatile fresh frozen human cadaver circulation model (PHCM) for endovascular training the face validity of the PHCM for training endovascular practitioners was subsequently assessed. Methods Twelve endovascular clinicians performed the same 2 procedures (catheterization of the left renal artery and left subclavian artery) on PHCM and Simbionix angiomentor virtual reality simulator (SVR). They were randomized to begin on either the PHCM or SVR. A pretrial questionnaire determined participants' endovascular experience. After training, participants rated statements relating to their experience on a numerical scale from 1 to 5, with 1 representing the strongest agreement with the statement. Results When participants were asked to compare the realism of training modalities with live patients, PHCM scored significantly higher than SVR on statements regarding “realism of vascular access” (P = 0.002), “guide-wire manipulation” (P = 0.001), and “vessel catheterization” (P = 0.004). Candidates again favored PHCM as “a valuable learning exercise” (P = 0.016) and strongly favored PHCM as a “useful training model” compared to SVR (P = 0.004). Conclusions This is the first published trial in world literature to assess the validity of a PHCM for training endovascular practitioners. The PHCM demonstrates good face validity when compared to both real patients and the SVR model and holds exciting potential.