Quantitative and qualitative assessment of airborne microorganisms during gross anatomical class and the bacterial and fungal load on formalin-embalmed corpses.

Mold growth on body donations remains an underreported yet serious issue in anatomical teaching. Bacterial and fungal growth pose health risks to lecturers and students, alongside with ethical and aesthetic concerns. However, limited information exists on the presence of bacteria and fungi on body donations and their underlying causes. To investigate the potential impact of airborne germs on body donation contamination, we conducted indoor air measurements before, during, and after our anatomical dissection course, with outdoor measurements serving as a control. Tissue samples from the dissected body donations were collected to assess the germ load, with qualitative and quantitative microbiological analyses. Air samples from the dissection hall contained no fungi, but various fungal species were identified in the adjacent stairways and outdoors which implies that fungal occurrence in the dissection hall air was independent of lecturers' and students' presence. Moreover, our results indicate that adequate ventilation filters can effectively reduce indoor fungal germs during courses, while the bacterial load in room air appears to increase, likely due to the presence of lecturers and students. Additionally, the tissue samples revealed no bacterial or fungal germs which implies that our ethanol-formalin-based embalming solution demonstrates an effective long-term antimicrobial preservation of corpses.

A comparison of 1- versus 3-month regional anatomy exposure on learning outcomes of undergraduate medical students.

Regional anatomy teaching forms a cornerstone of undergraduate medical education. Owing to an increase in teaching and learning content throughout the medical curriculum in recent years, contact hours and overall course durations in anatomy are under review worldwide. This study aimed to assess whether shortening the course content duration impacts learning gain and the ability to identify anatomical structures correctly. Undergraduate medical students of the Johannes Kepler University Linz (JKU; n = 310) and at the Medical University of Graz (MUG; n = 156) participating in regional anatomy courses were included. Whole body regional anatomy courses, including hands-on dissection and accompanying lectures, were delivered over one or three months. Course content and examination mode were kept consistent, while the duration of knowledge delivery was one or three months, respectively. Objective structured practical examinations (OSPE) were then carried out on prosections for the neck, thorax, and abdomen. 3-month course exposure resulted in significantly higher OSPE scores for the neck (49 vs. 37%), thorax (65 vs. 54%), and abdomen (65 vs. 45%), respectively. Further evaluation of the utility of different embalming types yielded higher 3-month scores in the neck and thorax regions with Thiel-embalmed tissues and thorax and abdomen regions in ethanol-glycerin-embalmed tissues. Course exposure over a more extended period, like three months, appears to be highly beneficial.

Surgical cystectomy training using human cadavers embalmed using Thiel's method: a pilot study.

OBJECTIVES: To develop the use of Thiel soft embalmed human cadavers (TeC) in open radical cystectomy (ORC) training for the first time, to investigate the effect of cadaveric training on surgical trainees' technical skills/performance and to determine how trainees perceive the use of cadaveric workshops. METHODS: A 3-day hands-on workshop was organised. Ten trainees performed ORC on five TeC, supervised by five experts. Feedback from trainees and mentors was evaluated on a five-point Likert scale. All procedures were completed in a fully equipped surgical environment and complied with the principles outlined in the Declaration of Helsinki. RESULTS: The workshop participants evaluated the anatomical and manipulation characteristics of the TeC as similar to real-life conditions. The colour and consistency of the urethra and ureter differed little from those in live patients. The trainees stated that the TeC were beneficial for learning the stages of ORC and urinary diversion (UD), while their self-confidence increased. In terms of realism, all steps of radical cystectomy (RC) were rated 4 out of 5 or higher on the Likert scale by both trainees and faculty. CONCLUSIONS: The use of TeC for RC und UD was perceived as favourable by trainees and faculty. The TeC demonstrated a surprising ability to mimic real-life anatomy and represent a new and effective surgical training tool.

Historical roots of modern neurosurgical cadaveric research practices: dissection, preservation, and vascular injection techniques.

Because of the complexity of the brain and its structures, anatomical knowledge is fundamental in neurosurgery. Anatomical dissection, body preservation, and vascular injection remain essential for training, teaching, and refining surgical techniques. This article explores the historical development of these practices and provides the contextual background of modern neurosurgical cadaveric brain models. Body preservation has ancient beginnings, evident in the Chinchorro mummifications and Egyptian embalming. However, brain preservation techniques for education were scarce until the beginning of the Renaissance in Europe. At the University of Bologna in the 13th century, occasional dissections were performed only in winter because of the lack of preservation techniques. Pope Sixtus IV's 1482 papal bull (official decree) formalized and expanded the use of dissection in medical education, leading to an explosion in anatomical studies. This surge brought advances in body preservation, such as soaking bodies in vinegar and distilled liquors. In subsequent centuries, Andreas Vesalius and Charles Bell advanced brain anatomical techniques and knowledge, combining novel illustrations and instruction. To better understand brain vasculature, Richard Lower developed vascular injection techniques using india ink and spirits of wine, leading to the 1664 description of the circle of Willis by Thomas Willis. In 1868, August Hofmann synthesized formaldehyde, markedly improving tissue preservation. Later, William Kruse introduced latex in 1939, and Sidney Sobin introduced silicone in 1965 for vascular studies. These advancements laid the foundation for modern neurosurgical cadaveric studies, many remaining relevant today.

Precision in Preservation: Mastering Cadaver Embalming with the Femoral Artery Approach - a technical note.

Human anatomy is a fundamental aspect of a physician's knowledge. While novel technologies offer innovative ways to teach anatomy, cadavers remain an essential component of anatomical education. The quality of specimens begins with well-preserved cadavers, and the chosen vascular access for injection plays a crucial role. Unfortunately, there is a lack of literature regarding embalming procedures, as discourse on such practices could enhance the quality, safety, and effectiveness of anatomical instruction. In this study, a femoral artery approach is described for embalming, which entails a meticulous process of cutting through the skin, navigating through fascias and adipose tissue by means of blunt dissection, ultimately reaching the artery for embalming injection. Tips and techniques pertaining to this technique are provided, including vital details for convenient accessibility and minimal impairment of tissue. The objective of this study is to facilitate anatomists and technicians in the adoption of the femoral artery approach, and to encourage further exploration of alternative embalming methods, thus contributing to the continuous advancement of anatomical sciences.

Comparison of Laryngeal Mask Airway Seal Between Anesthesiologists and Individuals Without Previous Airway Experience.

BACKGROUND: Tracheal intubation is the gold standard for airway management in emergency medicine, but more difficult to apply for inexperienced individuals than laryngeal mask airway (LMA). OBJECTIVE: The aim of our study was to investigate if inexperienced individuals are able to secure the airway with the help of LMA after a short introduction. A second aim was to evaluate Thiel-fixed specimens against unfixed ones. METHODS: In a body donor model, LMA application was evaluated between medical students without previous airway experience and anesthesiologists by comparing the sealing of the larynx using a water column applied to the esophagus. RESULTS: LMAs were successfully applied in 46 out of 55 (83.6%) attempts by medical students and in 30 out of 39 (76.9%) attempts by anesthesiologists. Among medical students, 14.1% of all LMA applications were primarily leaky, compared with 18.8% in anesthesiologists. Esophageal sealing was better in Thiel-fixed specimens (leakage 10.9%) compared with unfixed specimens (leakage 22.9%). Our data showed no significant difference between anesthesiologists and medical students in terms of sealing of LMA. Therefore, we conclude that medical students without previous airway experience can quickly learn to apply LMA sufficiently and thus, achieve aspiration protection similar to anesthesiologists. CONCLUSION: Medical students without previous airway experience can successfully insert LMAs after a short introduction. Thiel-fixed specimens are suitable for studies as well as for training in LMA application.

Investigation of the use of gelatine-glycerine and gelatine-polyvinyl alcohol mixtures as tissue consistency preservatives in cadavers fixed with modified SEFS solution.

This study aimed to improve the effectiveness of SEFS, a fixing solution composed of soap and ethanol. This was achieved by modifying the formulation of SEFS. Additionally, this study aimed to preserve the consistency of organs by perfusing cadavers with mixtures of gelatine-glycerin (gelatine-Gls) and gelatine-polyvinyl alcohol (gelatine-PVA) through vascular access. The modified SEFS embalmed cadavers were divided into two groups: Group I was treated with gelatine-glycerin, and Group II was treated with gelatine-polyvinyl alcohol and each group comprised of two goats and three rabbits. Over one year, cadavers were objectively assessed for hardness, colour, and joint range of motion. Additionally, the cadavers were subjectively evaluated after dissection and palpation. For the modified SEFS embalmment haptic and optic examinations of the muscles revealed they maintained a vivid colour tone, closely resembling their natural colour. The thoracic organs displayed natural colour, with the lungs retaining their shape without collapse. Notably, the walls of the atrium and ventricles of the heart remained intact without inward collapse. The use of gelatine-PVA yielded better outcomes than gelatine-Gls in preserving the volumes of both chest and abdominal organs. This was particularly evident in the heart, lungs, liver, spleen, and kidney. Overall, the modified SEFS and gelatin-PVA mixtures were superior in maintaining certain properties better than expected from cadavers.

Challenges associated with vascular access through the common carotid artery during embalming procedures in humans: A technical note.

BACKGROUND: The teaching of anatomy is a key component in the training of physicians, and the foundation of this teaching is the human body, which must be properly prepared to be used as a teaching aid. Due to a lack of modern literature on this topic, we decided to write a technical note discussing access to the carotid artery. MATERIALS AND METHODS: We pre-qualified 43 donor bodies for the study. The bodies had to meet standards such as no signs of post-mortem decomposition, preservation of body integrity, and the absence of known infections. Carotid artery access was performed based on descriptions of the types of vascular access performed in surgery and our own observations. RESULTS: We consider carotid artery access to be a convenient option due to its ease of location. When performed correctly and with attention to the surrounding structures, it is relatively low in tissue trauma, which translates into a higher quality of preparation. Data analysis has revealed several factors that can have a significant impact on the success of the embalming procedure. CONCLUSIONS: Proper execution of minimally invasive access to the common carotid artery minimizes tissue damage and ensures a high success rate of the procedure. Knowledge of the types of vascular access is essential for preparing the highest quality specimens.

Embalming with honey: Quest for an eco-friendly and non-toxic museum.

According to Codex Alimentarius, 'Honey is the natural sweet substance, produced by honeybees from the nectar of plants or from secretions of living parts of plants, or excretions of plant-sucking insects on the living parts of plants, which the bees collect, transform by combining with specific substances of their own, deposit, dehydrate, store and leave in honeycombs to ripen and mature'. It can also penetrate deep into the tissue and can prevent autolysis and putrefaction. This paper highlights the usefulness of honey as an embalming agent.

Genotyping strategies for tissues fixed with various embalming fluids for human identification, databasing, and traceability.

Within anatomical willed body programs and skeletal collections, whole bodies and their disassociated limbs and organs are identified and tracked. However, if these tracking mechanisms fail, DNA recovered from the formalin-fixed tissues/organs could provide an additional layer of quality assurance. Embalming fluids preserve biological tissues; however, they also damage, fragment, and cross-link DNA and protein molecules. This project investigated the success of STR-typing from various soft tissue and bone samples that were fixed with embalming solutions with a range of formaldehyde concentrations. Formalin-fixed samples dissected from five cadavers, including skin, muscle, bone, heart, and kidney were used in Phase 1 of this study. In Phase 2, an additional 57 tissue samples from various embalmed organs and body parts were collected to demonstrate long-term fixation and direct applicability within a body donor program. DNA was extracted from the samples using the QIAamp® FFPE Tissue Kit (QIAGEN), quantified with the Investigator® QuantiPlex® Pro RGQ qPCR Kit (QIAGEN), and amplified using the Investigator® 24plex and 26plex QS Kits and the Investigator® DIPplex Kit (QIAGEN). The results show the DNA was severely damaged, degraded, and often in low amounts (after one year post-embalming). Sampling from skin and muscle tissues embalmed with ~2.5%-5% formaldehyde solutions appears to be the best strategy for identification, while also maintaining the preservation of the tissues. The results of this project can provide informative data when determining which genotyping strategy may be best suited for the identification, re-association, and establishment of a database for the provenance of formalin-fixed human remains.

Preparation of Soft Embalmed Cadavers by the Modified Thiel Embalming Technique for Surgical Skill Training and Development of a Universal Quantitative Scoring System to Assess the Suitability of Soft Embalmed Cadavers for Such Training Purposes.

Background Cadaver dissection plays an important role in learning anatomy. A surgeon must have a thorough knowledge of anatomy of the operating region to perform safe surgery. Skill laboratories give opportunities to surgeons to practice on cadavers before venturing onto real patients. The most common method of cadaver preservation is through formalin fixation. In the process of fixation, formalin destroys the tissue characteristics and also has issues such as smell, eye irritation, hardening of tissue, and risk of carcinogenesis. The Thiel embalming technique and its modifications were developed to address those issues. Our primary objective was to find the benefits of soft embalmed cadavers over formalin-fixed bodies and, secondly, to find out microbial flora in soft embalmed cadavers. Study design This is a basic study. Methods Four cadavers were prepared for the soft embalming purpose for our workshop for surgeons on spine fixation. Due to unavailability, we replaced 4-chloro-3-methylphenol 1% with phenol 1%. The bodies were preserved in refrigerators at 4°C before being used for the workshop purpose. The delegates and faculties were given a questionnaire to assess their experience of the cadavers in terms of odor, irritation, tissue characteristics, joint mobility, and imaging characteristics. The results were calculated using statistical analysis. Swabs were taken from a few of the cadavers for culture to find the organisms. Results There were 14 questions in the questionnaire, and the data collected were divided into two groups, faculties, and delegates. JASP software was used to analyze the data. The questions addressed various aspects of cadavers such as color, odor, tissue pliability, joint flexibility, imaging characteristics, mucosal irritation, and earlier experience in working with cadavers. Cronbach α was used to find the correlation between the various characteristics analyzed. The authors intend to name the domains being measured: surgical suitability (scores of items 8 to 12), imaging suitability (scores of items 5 and 6), and smell score (scores of items 5 and 6). It can be a guide to constructing and refining a better quantitative scale to measure the "quality of soft-embalmed cadavers for surgical training." Conclusions Skill laboratories give opportunities to young surgeons and trainees to learn and improve their skills before applying them to real patients. This was our first attempt to develop soft embalmed cadavers at our center and our state. We used the parent solution with some variations as per the availability of chemicals at our place and found that the features of the preserved cadavers were good and well-suited to address our purpose. Therefore, with some variations in the parent formulations, centers situated in remote and less developed places can formulate their own solution to develop soft embalmed cadavers and establish cadaver skill laboratories. This will benefit the local surgeons and trainees. The authors tried to develop a few domains through statistical analysis, which can be used to assess and compare the quality of cadavers prepared at various centers.

Honores a Sir Ernest Shackleton en Sanidad Militar / Honors to Sir Ernest Shackleton in Military Health / Honras a Sir Ernest Shackleton em Saúde Militar

Ernest Shackleton ha sido en la historia, un personaje que dejó huella como ejemplo de resiliencia y liderazgo. En 1914 realizó como jefe de expedición su segundo viaje antártico, frustrado por el hundimiento de su buque insignia. La operación de rescate del grueso de la tripulación varada en el continente más meridional lo llevó a recalar en Montevideo. Desde este puerto partió el buque Instituto de Pesca N°1, con tripulación de Uruguay y Shackleton incluido, no logrando completar el salvamento. De esta acción nació el aprecio hacia la persona del explorador por parte del gobierno de la República. En su postrer travesía, ya fallecido llegó a las Islas Georgia del Sur y a su cuerpo se le realizó un proceso de conservación para ser traído a nuestro país y continuar viaje al puerto de origen en Inglaterra. Es en esa circunstancia que el gobierno del doctor Baltasar Brum solicitó a la Comisión Permanente del Parlamento, se le rindieran honores fúnebres de Ministro de Estado. El embalsamado del cuerpo fue realizado el 30 de enero de 1922, por parte de personal médico y técnico del Hospital Militar, así como los honores que le rindieron por el Servicio de Sanidad del Ejército y la Armada.

Ernest Shackleton has been in history, a character who left his mark as an example of resilience and leadership. In 1914, as expedition leader, he made his second Antarctic voyage, frustrated by the sinking of his flagship. The operation to rescue the bulk of the crew stranded on the southernmost continent led him to Montevideo. The Instituto de Pesca N°1, with Uruguayan crew and Shackleton included, departed from this port, but was unable to complete the rescue. From this action was born the appreciation of the explorer by the government of the Republic. In his last voyage, when he died, he reached the South Georgia Islands and his body underwent a preservation process to be brought to our country and continue his voyage to the port of origin in England. It is in this circumstance that the government of Dr. Baltasar Brum requested the Permanent Commission of the Parliament to pay him the funeral honors of a Minister of State. The embalming of the body was carried out on January 30, 1922, by medical and technical personnel of the Military Hospital, as well as the honors rendered by the Army and Navy Health Service.

Ernest Shackleton deixou sua marca na história como um exemplo de resiliência e liderança. Em 1914, ele fez sua segunda viagem à Antártica como líder da expedição, frustrado pelo naufrágio de seu navio principal. A operação para resgatar a maior parte da tripulação encalhada no continente mais ao sul o levou a Montevidéu. O Instituto de Pesca N°1, com tripulação do Uruguai e Shackleton incluído, partiu desse porto, mas não conseguiu concluir o resgate. Essa ação deu origem ao reconhecimento do explorador pelo governo da República. Em sua última viagem, quando morreu, chegou às Ilhas Geórgia do Sul e seu corpo foi preservado para que pudesse ser trazido ao nosso país e continuar sua viagem até o porto de origem na Inglaterra. Foi nessa circunstância que o governo do Dr. Baltasar Brum solicitou ao Comitê Permanente do Parlamento que lhe prestasse as honras fúnebres de um Ministro de Estado. O embalsamamento do corpo foi realizado em 30 de janeiro de 1922, pela equipe médica e técnica do Hospital Militar, bem como as honras prestadas a ele pelo Serviço de Saúde do Exército e da Marinha.

Quantification and persistence of COVID-19 virus in recently deceased individuals before and after embalming.

The COVID-19 pandemic severely affected the medical education worldwide. The infection risk for medical students and healthcare personnel who work with COVID-19 positive cadavers or tissues remains unclear. Moreover, COVID-19 positive cadavers have been rejected by medical schools, adversely impacting the continuum of medical education. Herein, the viral genome abundance in tissues from four COVID-19 positive donors before and after embalming were compared. Tissue samples were collected from the lungs, liver, spleen, and brain both pre- and postembalming. The possible presence of infectious COVID-19 was determined by inoculating human tissue homogenates onto a monolayer of human A549-hACE2 cells and observing for cytopathic effects up to 72 h postinoculation. A real- time quantitative reverse transcription polymerase chain reaction was performed to quantify COVID-19 present in culture supernatants. Fully intact viral genome sequence was possible to obtain in samples with higher levels of virus, even several days postmortem. The embalming procedure described above substantially reduces the abundance of viable COVID-19 genomes in all tissues, sometimes even to undetectable levels. However, in some cases, COVID-19 RNA can still be detected, and a cytopathic effect can be seen both pre- and postembalmed tissues. This study suggests that embalmed COVID-19 positive cadavers might be used safely with appropriate precautions followed in gross anatomy laboratories and in clinical and scientific research. Deep lung tissue is the best specimen to test for the virus. If the tests on the lung tissues are negative, there is a very low likelihood that other tissues will show positive results.

Undergraduate medical student perceptions and learning outcomes related to anatomy training using Thiel- and ethanol-glycerin-embalmed tissues.

Anatomical dissection is known to serve as an integral tool in teaching gross anatomy, including postgraduate training. A variety of embalming techniques exist, resulting in different haptic and optical tissue properties. This study aimed to objectify learning outcomes and medical student perceptions related to the use of two widely used embalming techniques, namely Thiel and ethanol-glycerin embalming. Between 2020 and 2022, first- and second-year medical students enrolled in the course on topographic anatomy participated in this study. Objective structured practical examinations were carried out for the head, neck, thorax, abdomen, pelvis, and extremity regions following regional dissection just before the oral examinations began. Six to ten numbered tags were marked in prosections of each region in Thiel- and ethanol-glycerin-embalmed specimens. Following the examinations, the students were surveyed regarding the suitability of the two embalming techniques with respect to preservation, colorfastness, tissue pliability, and the suitability in preparing for their anatomy examinations. Consistently higher scores were achieved for the thoracic and abdominal regions in ethanol-glycerin-embalmed specimens when compared to Thiel. No benefit was found for Thiel-embalmed upper or lower extremities. Tissues embalmed with ethanol-glycerin were rated higher for preservation and suitability to achieve the learning objectives, tissue pliability was rated higher for Thiel-embalmed tissues. Ethanol-glycerin embalming appears to offer certain advantages for undergraduate students in recognizing visceral structures, which may align with students' ideas on tissue suitability for their learning. Consequently, the benefits reported for Thiel embalming for postgraduate study unlikely reflect its suitability for novices.

The chemicals between us-First results of the cluster analyses on anatomy embalming procedures in the German-speaking countries.

Hands-on courses utilizing preserved human tissues for educational training offer an important pathway to acquire basic anatomical knowledge. Owing to the reevaluation of formaldehyde limits by the European Commission, a joint approach was chosen by the German-speaking anatomies in Europe (Germany, Austria, Switzerland) to find commonalities among embalming protocols and infrastructure. A survey comprising 537 items was circulated to all anatomies in German-speaking Europe. Clusters were established for "ethanol"-, formaldehyde-based ("FA"), and "other" embalming procedures, depending on the chemicals considered the most relevant for each protocol. The logistical framework, volumes of chemicals, and infrastructure were found to be highly diverse between the groups and protocols. Formaldehyde quantities deployed per annum were three-fold higher in the "FA" (223 L/a) compared to the "ethanol" (71.0 L/a) group, but not for "other" (97.8 L/a), though the volumes injected per body were similar. "FA" was strongly related to table-borne air ventilation and total fixative volumes ≤1000 L. "Ethanol" was strongly related to total fixative volumes >1000 L, ceiling- and floor-borne air ventilation, and explosion-proof facilities. Air ventilation was found to be installed symmetrically in the mortuary and dissection facilities. Certain predictors exist for the interplay between the embalming used in a given infrastructure and technical measures. The here-established cluster analysis may serve as decision supportive tool when considering altering embalming protocols or establishing joint protocols between institutions, following a best practice approach to cater toward best-suited tissue characteristics for educational purposes, while simultaneously addressing future demands on exposure limits.

Development of the McMaster Embalming Scale (MES) to assess embalming solutions for surgical skills training.

Human cadavers used for surgical training are embalmed using various methods to facilitate tissue storage and longevity while preserving the natural characteristics required to achieve high fidelity functional task alignment. However, there are no standardized means to evaluate the suitability of embalming solutions for this purpose. The McMaster Embalming Scale (MES) was developed to assess the extent to which embalming solutions allow tissues to achieve physical and functional correspondence to clinical contexts. The MES follows a five-point Likert scale format and evaluates the effect of embalming solutions on tissue utility in seven domains. This study aims to determine the reliability and validity of the MES by presenting it to users after performing surgical skills on tissues embalmed using various solutions. A pilot study of the MES was conducted using porcine material. Surgical residents of all levels and faculty were recruited via the Surgical Foundations program at McMaster University. Porcine tissue was unembalmed (fresh- frozen) or embalmed using one of seven solutions identified in the literature. Participants were blinded to the embalming method as they completed four surgical skills on the tissue. After each performance, participants evaluated their experience using the MES. Internal consistency was evaluated using Cronbach's alpha. Domain to total correlations and a g-study were also conducted. Formalin-fixed tissue achieved the lowest average scores, while fresh frozen tissue achieved the highest. Tissues preserved using Surgical Reality Fluid (Trinity Fluids, LLC, Harsens Island, MI) achieved the highest scores among embalmed tissues. The Cronbach's alpha scores varied between 0.85 and 0.92, indicating a random sample of new raters would offer similar ratings using the MES. All domains except odor were positively correlated. The g-study indicated that the MES is able to differentiate between embalming solutions, but an individual rater's preference for certain tissue qualities also contributes to the variance in scores captured. This study evaluated the psychometric characteristics of the MES. Future steps to this investigation include validating the MES on human cadavers.

Substantial decrease in SARS-CoV-2 RNA after fixation of cadavers intended for anatomical dissection.

With the onset of the COVID-19 pandemic, a problem arose with classic body donation programmes for obtaining cadavers for anatomical dissections, science and research. The question has emerged whether bodies of individuals who died of COVID-19 or were infected by SARS-CoV-2 could be admitted to Departments of Anatomy. To determine the risk of SARS-CoV-2 transmission to employees or students, the presence and stability of SARS-CoV-2 RNA in cadavers after fixation agents' application and subsequent post-fixation baths over time were examined. The presence of viral RNA in swabs from selected tissues was assessed by the standardized routine RNA isolation protocol and subsequent real-time PCR analysis. To support the results obtained from the tissue swabs, samples of RNA were exposed in vitro to short and long-term exposure to the components of the injection and fixation solutions used for the bodies' conservation. Substantial removal of SARS-CoV-2 RNA was observed in post-mortem tissue following perfusion with 3.5% phenol, 2.2% formaldehyde, 11.8% glycerol and 55% ethanol, and subsequent post-fixation in an ethanol bath. In vitro experiments showed significant effects of formaldehyde on SARS-CoV-2 RNA, while phenol and ethanol showed only negligible effects. We conclude that cadavers subjected to fixation protocols as described here should not pose a considerable risk of SARS-CoV-2 infection while being handled by students and staff and are, therefore, suitable for routine anatomical dissections and teaching.

Bacterial species-specific antimicrobial efficacies of three different body embalming solutions for anatomical studies.

While body decompensation is mainly facilitated by bacteria, investigating the antimicrobial properties of body preservation methods is still a neglected research area. We performed microbiological sampling for potentially pathogenic bacteria species of brain, lung, liver, colon, and subcutis samples obtained from bodies perfused with embalming solutions of variable composition with emphasis on variable formaldehyde concentrations. We, thereby, identified spore-forming aerobic and anaerobic bacteria mainly in the samples obtained from the colon of ethanol- and lower-concentrated formaldehyde formulation embalmed bodies. Moreover, we could identify Enterococcus species in bodies preserved with the latter method. Tissue samples of the subcutis remained sterile. Long-term incubation of special mycobacteria growth indicator tubes revealed no growth of mycobacteria in all 60 samples analyzed. Overall, we show survival of bacterial genera known to be especially environmentally resistant but also include potentially pathogenic members. Knowledge of bactericidal capacities of embalming solutions are therefore critical to assess risk and apply appropriate disinfection routines while working with human bodies. Moreover, new formulations to reduce potentially toxic substances for embalming needs to be evaluated regarding their bactericidal capacities.

SARS-CoV-2 Transmission from Virus-Infected Dead Hamsters.

Although it has been 2.5 years since the coronavirus disease 2019 (COVID-19) pandemic began, the transmissibility of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from a dead infected body remains unclear, and in Japan, bereaved family members are often not allowed to view in person a loved one who has died from COVID-19. In this study, we analyzed the possibility of SARS-CoV-2 transmission from a dead body using a hamster model. We also analyzed the effect of "angel care"--in which the pharynx, nostrils, and rectum are plugged--and embalming on reducing transmissibility from dead bodies. We found that SARS-CoV-2 could be transmitted from the bodies of animals that had died within a few days of infection; however, angel care and embalming were effective in preventing transmission from the dead bodies. These results suggest that protection from infection is essential when in contact with a SARS-CoV-2-infected dead body and that sealing the cavities of a dead body is an important infection control step if embalming is not performed. IMPORTANCE We found that SARS-CoV-2 could be transmitted from a dead body, presumably via postmortem gases. However, we also found that postmortem care, such as plugging the pharynx, nostrils, and rectum or embalming the corpse, could prevent transmission from the dead body. These results indicate that protection from infection is essential when handling infected corpses and that appropriate care of SARS-CoV-2-infected corpses is important.

Thiel embalming method used for anatomy dissection as an educational tool in teaching human anatomy, in research, and in training in comparison of different methods for long term preservation.

The use of human cadavers is beneficial in teaching gross human anatomy, training, and development in medicine. Fresh-frozen cadavers initially exhibit natural colour, tenderness, and flexibility. They also present innumerable difficulties, including the requirement of freezers for storage and a few weeks' work time because of fast decay. The risk of infection is also significant. A possible choice for fresh-frozen cadavers is embalmed cadavers. The requested characteristic needed for successful embalming is acceptable long-term structural preservation of organs and tissues with minimal deformity and prevention of outward aspects. Scientists are trying to develop an ideal embalming solution to preserve the human body. Such a solution renders the flexibility of internal organs, preventing dryness, and reducing fungal or bacterial growth. Cadavers should be in a condition comparable to that of an unembalmed cadaver, and the chemicals used in the solution should not be harmful to persons during manipulation. The promising results have been obtained by the use of different embalming techniques by many faculties of medicine as a tool to enhance the teaching of anatomy to students.