• Archives of Plastic Surgery
• /
• v.47 no.5
• /
• pp.435-443
• /
• 2020

Background The innervated radial artery superficial palmar branch (iRASP) flap was designed to provide consistent innervation by the palmar cutaneous branch of the median nerve (PCMN) to a glabrous skin flap. The iRASP flap is used to achieve coverage of diverse volar defects of digits. However, unexpected anatomical variations can affect flap survival and outcomes. Methods Cases in which patients received iRASP flaps since April 1, 2014 were retrospectively investigated by reviewing the operation notes and intraoperative photographs. The injury type, flap dimensions, arterial and neural anatomy, secondary procedures, and complications were evaluated. Results Twenty-eight cases were reviewed, and no flap failures were observed. The observed anatomical variations were the absence of a direct skin perforator, large-diameter radial artery superficial palmar branch (RASP), and the PCMN not being a single branch. Debulking procedures were performed in 16 cases (57.1%) due to flap bulkiness. Conclusions In some cases, an excessively large RASP artery was observed, even when there was no direct skin perforator from the RASP or variation in the PCMN. These findings should facilitate application of the iRASP flap, as well as any surgical procedures that involve potential damage to the PCMN in the inter-thenar crease region. Additional clinical cases will provide further clarification regarding potential anatomical variations.

• Asian Pacific Journal of Cancer Prevention
• /
• v.17 no.2
• /
• pp.491-495
• /
• 2016

Background: Small B-cell non-Hodgkins lymphoma (NHL) is difficult to be distinguished from non-neoplastic reactive processes using conventional haematoxylin-eosin (HE) staining due to different interpretations among pathologists with diagnosis based on morphologic features. Ancillary examinations such as immunohistochemical (IHC) staining are essential. However, negative or doubtful results are still sometimes obtained due to unsatisfactory tissue processing or IHC technique. The polymerase chain reaction (PCR) as a molecular diagnostic technique is very sensitive and specific. Clonality detection of heavy chain immunoglobulin (IgH) gene rearrangement has been widely used to establish diagnosis of B-cell NHL. Aims: To elaborate interobserver variation in small B-cell NHL diagnosis based on morphologic features only and to confirm sensitivity and specificity of the PCR technique as an ancillary method. Materials and Methods: A toptal of 28 samples of small B cell NHL and suspicious lymphoma were interpreted by 3 pathologists in Sardjito General Hospital based on their morphology only. The reliability of assessment and the coefficient of interobserver agreement were calculated by Fleiss kappa statistics. Interpretation results were confirmed with IHC staining (CD20, CD3, Bcl2). PCR was performed to analyze the clonality of IgH gene rearrangement. Results: Interobserver agreement in morphologic evalution of small B cell NHL and chronic lymphadenitis revealed kappa coefficient 0.69 included in the substantial agreement category. The cases were divided into 3 groups based on morphology and IHC results; lymphoma, reactive process and undetermined group. PCR analysis showed 90% sensitivity and 60% specificity. Conclusions: The present study revealed a substantial agreement among pathologists in small B-cell NHL diagnosis. For difficult cases, PCR is useful as complementary method to morphologic and IHC examinations to establish definitive diagnosis.

• Imaging Science in Dentistry
• /
• v.50 no.4
• /
• pp.281-290
• /
• 2020

Purpose: The objective of the present study was to evaluate the prevalence of dental implants positioning errors and their associations with adjacent structures and anatomical variations by means of cone-beam computed tomography (CBCT). Materials and Methods: CBCT images of 207 patients (584 dental implants) were evaluated by 2 oral radiologists. The distance between the implant and the adjacent teeth/implants was measured and classified as adequate (≥1.5 mm and ≥3 mm, respectively) or inadequate. The presence of thread exposure, cortical perforation, implant dehiscence, implant penetration into adjacent structures, and anatomical variations was also recorded. The incisor canal diameter and the depth of the concavity of the submandibular fossa were measured in order to evaluate their correlations with the frequency of implant penetration in these structures. Descriptive analyses, the Fisher exact test, and Spearman correlation analysis were performed (α=0.05). Results: The overall prevalence of positioning errors was 82.9%. The most common error was the inadequate distance between the implant and the adjacent teeth/implants. The presence of anatomical variations did not significantly influence the overall prevalence of errors (P>0.05). There was a positive correlation between the diameter of the incisor canal and the frequency of implant penetration in this structure (r=0.232, P<0.05). Conclusion: There was a high prevalence of dental implant positioning errors, and positioning errors were not associated with the presence of anatomical variations. Professionals should be aware of the space available for implant placement during the preoperative planning stage.

• Archives of Reconstructive Microsurgery
• /
• v.20 no.1
• /
• pp.14-17
• /
• 2011

Autologous breast reconstruction after mastectomy in breast cancer patient is now increasing. The deep inferior epigastric artery (DIEA) free flap is well known as an ideal donor site for the microsurgical breast reconstruction. The branching pattern of the DIEA was well described in the literature. In that study, DIEA has three branching patterns near the arcuate line. We describe a case in which branching variation of the DIEA before entering the posterior surface of the rectus abdominis muscle. In three cases, DIEA originated from the external iliac artery ascended as a double trunk at 1cm, 2cm, and 4cm above the originating point, respectively. In one case, DIEA ascended as a single trunk along the linea alba toward to the umbilicus until it supply overlying subcutaneous tissue. Preoperative 3D computed tomographic angiography to identify the anomaly is recommended and meticulous dissection to the originating point of DIEA is needed.

• Archives of Plastic Surgery
• /
• v.49 no.6
• /
• pp.750-754
• /
• 2022

Trigger wrist, characterized by a clicking or snapping sensation around the wrist joint during finger or wrist motion, and bifid or trifid median nerve, which occurs in carpal tunnel syndrome along with anatomical variation of median nerve, are rare conditions. We report the case of a patient with a thickened tendon caused by severe tenosynovitis and flexor tendon subluxation to the hamate hook due to bowing of the flexor retinaculum, thereby resulting in trigger wrist as well as an anatomical median nerve variation (bifid median nerve in the right wrist and trifid median nerve in the left wrist). A 59-year-old housewife visited our hospital with bilateral fingertip numbness, tingling sensation, and aggravated severe night cramping that began 2 months ago. She also complained about trigger wrist during small finger flexion. Based on magnetic resonance imaging, ultrasonography, and nerve conduction study, trifid median nerve and bilateral severe median nerve neuropathy of the wrist were diagnosed; therefore, transverse carpal tunnel release and exploration under wide-awake anesthesia were planned. Intraoperative findings showed trifid and bifid median nerves in left and right wrists, respectively. Additionally, bowing of flexor retinaculum and severe flexor tendon tenosynovitis were observed. Tenosynovitis with thickened flexor sheath resulted in subluxation of the small finger flexor tendon above the hamate hook. After transverse carpal ligament release with antebrachial fascia release and tenosynovectomy, subluxation of the flexor tendon was resolved. At 6 months postoperatively, the tingling and dullness in fingertips also resolved, and no trigger wrist or any other complications were noted.

• Korean Journal of Plant Resources
• /
• v.13 no.1
• /
• pp.66-79
• /
• 2000

Anatomical characters such as stem, leaf, ovary, calyx lobe, ultrastructure of stigma, epidermis of leaf blade and midvein, corolla lobe, nectary, seed coat and pollen were examined on 6 taxa of Korean Ophelia, including 5 taxa distributed in south Korea and one taxon considered to be the variation type of Ophelia wilfordi, in order to clarify the limits of intersection and interspecies and to establish the taxonomic position. One taxon distributed in north Korea was also included in the description of species by observation of herbarium specimen of the University of Tokyo in Japan. The two sections were successfully distinguished by internal structure of ovary, morphology of nectary, surface sculpturing of corolla lobe and pollen, ultrastructure of seed and seed coat, which were useful characters to distinguish taxa higher than species. The variation type of Ophelia wilfordi was not distinguished with other species except for absent or present of purple spot in corolla lobe.

• Journal of the Korean Wood Science and Technology
• /
• v.10 no.3
• /
• pp.46-47
• /
• 1982

1. The physical and anatomical properties investigated in this study are the ones, which may give more effect on absorption of preservatives, such as variation of annual ring, specific gravity, shrinkage, E.M.C. of desorption and adsorption at 70 percent relative humidity condition, general and minute properties of wood. 2. On this study, the positive effects of wood structure, in particular, the appearances of tyloses in vessel element upon the absorption of creosote were observed. 3. Thirteen percent sodium chloride solution treatment and boiling hot water treatment have shown poor results to improve the preservative absorption characteristics of tested species however, some slight difference between treated and control could be seen. (see Tables 6 and 7).

• Journal of Veterinary Clinics
• /
• v.34 no.6
• /
• pp.429-433
• /
• 2017

The purpose of this study was to find anatomical variation of each small breed dog's dentition for designing more effective dental chews. Small breed dogs were volunteered for dental impressions with dental stone and alginate under tiletamine-zolazepam, tramadol, and medetomidine intravenous anesthesia. Twenty-two criteria were measured to compare dental impressions. Twenty-five dogs (9 Malteses, 8 Miniature Poodles, and 8 Shih-Tzus) were recruited. Statistically, Shih-Tzus had smaller teeth and shorter interdental spaces than those of Maltese and Miniature Poodles. Grossly, the distance between upper teeth and lower teeth was wider in Shih-Tzus. Shih-Tzu had different dental anatomy in comparative to Miniature Poodle and Maltese. It was recommended to design the dental chew considering these differences.

• Restorative Dentistry and Endodontics
• /
• v.38 no.4
• /
• pp.253-257
• /
• 2013

Maxillary lateral incisors usually exhibit a single root with a single canal. However, maxillary lateral incisor teeth with unusual morphology of root canal system are frequently reported. These cases of variable root canal anatomy can be treated well by nonsurgical endodontic methods. A detailed description of root canal morphology is fundamental for successful endodontic treatment. Treatment using an operating microscope, radiographs from different angles, and cone-beam computerized tomography (CBCT) can produce more predictable endodontic outcomes.

• Korean Journal of Pharmacognosy
• /
• v.35 no.1 s.136
• /
• pp.45-51
• /
• 2004

Panax ginseng C. A. Meyer (Araliaceae) is listed in Shen Nung Pentsao Ching(神農本草經) as the remedy for replenishing the primodial qi(氣), restoring pulse, treating collapse, tonifing the spleen and lag, promoting the production of body fluid to quench thirst, tranquilizing the mind, and improving the function of brain. The prescriptions of In Sam Tang(人參揚) are also recorded in many other Chinese medical books. The identification of the age of Panax ginseng is very important in commercial market as well as in research field. However, any reports about it have not been clearly established yet. To clarify the criterion, the morphological and anatomical characteristics of the roots of various age Panax ginseng cultivated in Korea were studied. The characteristics of cork layer, secretory canal, and vessel were shown to bε useful keys to confirm the age of Panax ginseng.