Objectives : There have been several studies documenting the changing level of the conus throughout infancy and childhood, but there is only a little detailed study that documents the range of conus positions in a living adult population, especially in Korean, without spinal deformity. Methods : we made a sequential study of magnetic resonance images of the lumbar spine to determine the variation in position of the conus medullaris in 650 living korean adults population without spinal deformity who checked MRI to identify the cause of low back pain. The study population consisted of patients over the age of 16 years. A T1-weighted, midline, sagittal image was reviewed for identifying the postion of conus. This location was recorded in relation to the upper, middle, or lower third of the adjacent vertebral body or the adjacent intervertebral disc. Results : The study group consisted of 305 men(47%) and 345 women(53%) with a mean age 45.9 years(range, 16-79 years). The conus existed commonly at the middle third of L1(131cases, 20.2%), at the L1-2 intervertebral space(129cases, 19.8%), and the lower third of L1(123cases, 18.9%). The mean position of conus was the lower third of L1(range, middle third of T12 to middle third of L3). Conclusions : The mean position of conus was at the lower third of L1(range, middle third of T12 to middle third of L3). This results was same as that of foreign study. Our results of living korean adult population could allow for safe clinical procedures such as lumbar puncture, spinal anesthesia, and help to explain the differences among observed neurologic injuries from fracture-dislocation at the thoracolumbar junction.
This study was carried out to investigate geographic variation in needle characteristics of Pinus densiflora, one of the most economically important tree species in Korea. Needles were collected from 35 natural populations and their morphological and anatomical characteristics were studied. ANOVA showed statistically significant differences among populations as well as among individuals within populations in needle length, needle width, number of stomata row, density of stomata in $0.25mm^{2}$, number of serrations in 0.5mm, and number of resin ducts. In all these traits, variance components among individuals within populations were larger than those among populations. The density of stomata in $0.25mm^{2}$ increased as the latitudes and elevations of the populations increased, while the number of serrations in 0.5mm decreased as the decrease of latitudes and elevations. The number of resin ducts was higher in inland populations than in coastal populations. The resin duct index appeared to be higher in western populations than in eastern populations. Cluster analysis based on morphological characteristics divided populations into three groups. The third group was composed of populations selected from the Taebaek mountains. The number of serrations in 0.5mm of this group was lower than that of other two groups, while the density of stomata in $0.25mm^{2}$ was higher.
This study was conducted to investigate the morphological and anatomical characteristics of needle and the genetic diversity of Pinus pumila Regel which is a unique and the southern peripheral population in South Korea. ANOVA test showed that there were significant differences among individuals within population in all 8 needle characteristics. Average characteristics of 66 individuals were 53.59 mm in needle length, 0.78 mm in needle width, 68.98 in needle index, 0.65 mm in needle thickness, 4.56 ea. in maximum stomata row, 3.80 ea. in minimum stomata row, 8.36 ea. in total stomata row and 1.71 ea. in resin canals, respectively. Resin canal per needle of this species ranged from one to three, depending on external type. Especially, arrangement types were 69.47% in two resin canals and 30.45% in a single resin canal. A total of 78 bands was generated from 9 selected I-SSR primers. The estimates of genetic variation were 61.5% in proportion of polymorphic bands (P), 1.698 in effective number of alleles ($A_e$), 0.388 in expected heterozygosity ($H_e$) and 0.567 in Shannon's information index (S.I.), respectively.
This report describes a variation of the tendinous slip of the flexor digitorum longus (FDL) for the great toe. In addition, compositions of the long flexor tendons for all five toes were examined. The tendons of the FDL in the foot were investigated in 66 specimens of embalmed Korean adult cadavers. The tendons of the flexor hallucis longus (FHL) and the FDL with the lumbrical muscles were cut at the calcaneus and the metatarsophalangeal joints and were removed en bloc specifically to observe the FDL and the FHL tendons of the great toe. The tendinous slip of the FDL for the great toe was found bilaterally in the foot of a 52-year-old male. Its prevalence was two of 66 specimens (3.0%). The tendinous slip of the FDL for the great toe passed forward the great toe, and it constituted the superficial portion of the long flexor tendon for the great toe. The tendon of the FHL passed forward to constitute the deep portion of the long flexor tendon for the great toe. Thus, both the tendinous slip of the FDL and the tendon of the FHL composed the long flexor tendon for the great toe. The tendinous slip of the FDL and the tendon of the FHL for the great toe were similar in thickness; thus, each tendinous slip of the FDL and the tendon of the FHL were approximately one-half of the long flexor tendon for the great toe in thickness. The present study demonstrated an anatomical variation of the interconnection between the FHL and the FDL tendons, which will be useful for various surgeries and biomechanical research.
Proton therapy using the Bragg peak is one of the radiation therapies and can deliver its maximum energy to the tumor with giving least energy for normal tissue. A cross-sectional image of the human body taken with the computed tomography (CT) has been used for radiation therapy planning. The HU values change according to the tube voltage, which lead to the change in the boundary and thickness of the anatomical structure on the CT image. This study examined the changes in the Bragg peak of the brain region according to the thickness variation in the head phantom composed of several materials using the Geant4. In the phantom composed of a single material, the Bragg peak according to the type of media and the incident energy of the proton beams were calculated, and the reliability of Geant4 code was verified by the Bragg peak. The variation of the peak in the brain region was examined when each thickness of the head phantom was changed. When the thickness of the soft tissue was changed, there was no change in the peak position, and for the skin the change in the peak was small. The change of the peak position was mainly changed when the bone thickness. In particular, when the bone was changed only or the bone was changed together with other tissues, the amount of change in the peak position was the same. It is considered that measurement of the accurate bone thickness in CT images is one of the key factors in depth-dose distribution of the radiation therapy planning.
Despite of the development of medical equipments and technology. Pancreatic cancer has maked high false positive rate and low survival rate compared to other cancers. Therefore, early catch of pancreatic cancer is the only way to enhance the viability. It is important to find the exact location of the pancreas cancer in early stage. The method of optimum scan for early detection of pancreatic cancer on PET/CT exam is proposed. Examined the anatomical region that potentially can be missing from the supine position of ordinary pet/ct exam. The characteristics and usefulness of angle variation ($0^{\circ}$, $30^{\circ}$, $45^{\circ}$, $60^{\circ}$, $90^{\circ}$) of patients scan position is analyzed. The proposed scan method (named JJ-projection) is bringing advantage of anatomical discrimination by separating stomach, liver, gallbladder duodenum and pancreas. ROC curve analysis is shows to advantage of the JJ-Projection method. The sensitivity has increased 4.6% than the supine delay scan method, the results sensitivity has increased from 91% to 95.2%. The specificity has increased from 75.1% to 84%. Compared with the results observed in cancer by biological biopsy, The accuracy has increased from 86.8% to 94.1%.
Background: Although ramicotomy (division of the rami communicantes of the thoracic sympathetic ganglia) is a selective and physiological surgical method for essential hyperhidrosis, it has some problems such as higher recurrence rates and the different surgical results among the patients and between left and right sides in the same individual. As one of the factors that are related to the differences in surgical result and recurrences, we investigated the anatomical variations of the rami communicantes. The purpose of this study is to help develop new surgical methods to decrease surgical differences among the patients or between the left and right sides of the same individual and recurrence rates in the clinical application of ramicotomy. Material and Method: We dissected 118 thoracic sympathetic chains in 59 adult Korean cadavers (male: 33, female: 26) to examine the anatomical variations of the rami communicantes from the second to the fourth thoracic sympathetic ganglia that have major components innervating to the hands. After the dissection of bilateral thoracic sympathetic chains, we compared the anatomy of left and right sides and examined the anatomical variations of rami communicantes. Result: The number and variation of communicating rami connecting the spinal nerves and the second sympathetic thoracic ganglion were much larger than lower levels. There was considerably less variability in the anatomy of the rami communicantes at successive levels. Among the 59 cadavers dissected, only 14.3% (9/59) had similar anatomy of thoracic sympathetic chains at both sides. As the components related to the essential palmar hyperhidrosis, intrathoracic nerve of Kuntz from the second thoracic sympathetic ganglion to the first intercostal nerve or brachial plexus were observed in 55.9% (66/118). The incidence of descending rami communicates from the second thoracic sympathetic ganglion to the third intercostal nerve and from the third thoracic sympathetic ganglion to the fourth intercostal nerve were 49.2% (58/118) and 28.0% (33/118). And the incidence of ascending rami communicates from the third thoracic sympathetic ganglion to the second intercostal nerve and from the fourth thoracic sympathetic ganglion to the third intercostal nerve were 6.8% (8/118) and 3.4% (4/118), respectively. Conclusion: Based on the various anatomical evidences of the rami communicantes from this study, only the ramicotomy at the third sympathetic ganglion level is insufficient for the treatment of the essential palmar hyperhidrosis to decrease the difference of surgical results and recurrences. When one is planning to perform the ramicotomy for the essential palmar hyperhidrosis, it is advantageous to divide the intrathoracic nerve of Kuntz on the second rib and the descending or ascending rami communicantes on the third and the fourth ribs as well as all the communicating rami from the third sympathetic ganglion.
The C-shaped canal system is an anatomical variation mostly seen in mandibular second molars, although it can also occur in maxillary and other mandibular molars. The main anatomical feature of C-shaped canals is the presence of fins or web connecting the individual root canals. The complexity of C-shaped canals prevents these canals from being cleaned, shaped, and obturated effectively during root canal therapy, and sometimes it leads to an iatrogenic perforation from the extravagant preparation. The purpose of this study was to provide further knowledge of the anatomical configuration and the minimal thickness of dentinal wall according to the level of the root. Thirty extracted mandibular second molars with fused roots and longitudinal grooves on lingual or buccal surface of the root were collected from a native Korean population. The photo images and radiographs from buccal, lingual, apical direction were taken. After access cavity was prepared, teeth were placed in 5.25% sodium hypochlorite solution for 2 hours to dissolve the organic tissue of the root surface and from the root canal system. After bench dried and all the teeth were embedded in a self-curing resin. Each block was sectioned using a microtome (Accutom-50, Struers, Denmark) at interval of 1 mm. The sectioned surface photograph was taken using a digital camera (Coolpix 995, Nikon, Japan) connected to the microscope. 197 images were evaluated for canal configurations and the minimal thickness of dentinal wall between canal and external wall using 'Root Thickness Gauge Program' designed with Visual Basic. The results were as follows : 1. At the orifice level of all teeth, the most frequent observed configuration was Melton's Type C I (73%), however the patterns were changed to type C II and C III when the sections were observed at the apical third. On the other hand, the type C III was observed at the orifice level of only 2 teeth but this type could be seen at apical region of the rest of the teeth. 2. The C-shaped canal showed continuous and semi-colon shape at the orifice level, but at the apical portion of the canal there was high possibility of having 2 or 3 canals 3. Lingual wall was thinner than buccal wall at coronal, middle, apical thirds of root but there was no statistical differences.
This research experimented on the change of the multiple colleague scan angle facing one scan object facet to many directions of the form of 3D about the visual angle nervous system forming the cubic distribution with the gradient magnetic field of the mri system and considered the existing basic angle oblique direction test coverage and comparison. MR system can freely select various pulse sequence and image slice. To oblique imaging for optic nerve viewing, we have studied the variation of scan angle between typical oblique scan method (sagittal-coronal plane) and multi directional angles oblique scan method (sagittal-coronal-axial plane) using gradient of MR system. In this study, the subjects of the experiment were normal adults in our country. As a result, we confirmed that multi directional angles oblique scan method can display anatomical information of more wider area than typical oblique scan method. In addition, to clearly display optic nerve, we also confirmed that image slice thickness and pulse sequence have effect on it.
Purpose: Thumb reconstruction plays most important role in hand injuries because total loss of a thumb constitutes about 40% disability in the hand. The reconstruction can be accomplished by pollicization, free toe-to-thumb transfer, wrap around procedure and lengthening extraction. However, we sometimes need consecutive or double free flaps in the reconstruction of mutilating hand injuries. Methods: We reconstructed a mutilating hand injury in a 54-years old man. Because of severe crushing injury of right thumb and index fingers, we reconstructed a thumb with pollicization using nearly amputated middle finger. Although it survived completely, the adjacent soft tissues which had been covered by fillet flap from the space past was necrosed on 1 month. We debrided the necrotic tissues and covered it with anteromedial thigh perforator free flap consecutively because he had an anatomical variation in branches of lateral femoral circumflex artery. Results: He had an uneventful postoperative course without any complication such as infection, dehiscence and flap necrosis. Three months later, he had undergone tenolysis and defatting procedure of flap site. He recovered the some amount of grip function and was happy with the result. Conclusion: In severe hand trauma including thumb amputation, thumb reconstruction using pollicization and perforator free flap could be an alternative option. It provides minimal donor site morbidity and an acceptable functional result.
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