• Clinics in Orthopedic Surgery
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• v.10 no.4
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• pp.462-467
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• 2018

Background: Significant discrepancy exists between anatomical plate designs and the anatomy of the native distal radius, which may be attributable to considerable morphometric variations in the volar aspect of the distal radius. We aimed to evaluate the degree of variability in the morphometry of the distal radius and identify factors associated with this variability. Methods: We measured the volar surface angle (VSA) of the intermediate and lateral columns and the volar surface width (VSW) in the distal radius from three-dimensional computed tomography scans acquired from 81 cadaveric forearms. These morphometric parameters were compared between the lateral and intermediate columns, between males and females, and between Koreans and Caucasians. Caucasian morphometric data were obtained and pooled from the previous studies. The coefficient of variation was used to assess the variability of the parameters and Cohen's d to estimate the effect size of the difference between groups. Results: The average VSA of the lateral column was $22^{\circ}{\pm}6^{\circ}$, and that of the intermediate column was $29^{\circ}{\pm}8^{\circ}$ in Koreans (p < 0.001). The variability was high for both VSAs. The VSA of the intermediate column was significantly larger in males than in females (p < 0.001) and in Caucasians than in Koreans (p < 0.001). The average VSW of distal radius was $30{\pm}3mm$ at the watershed line, and it became narrower proximally. The VSW was significantly larger in males than in females (p < 0.001) and in Koreans than in Caucasians (p < 0.001). The effect sizes of the difference for the VSA and VSW between sexes, races and columns were medium to large. Conclusions: Considerable variability exists in the morphometry of the volar distal radius, with sex, race, and column as contributing factors. These results suggest that surgeons should carefully choose an anatomical volar locking plate with appropriate angulation characteristics for each patient to achieve patient-specific alignment of the distal radius.

• Anatomy and Cell Biology
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• v.57 no.1
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• pp.31-44
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• 2024

The exocrine part of the pancreas has a duct system called the pancreatic ductal system (PDS). Its mechanism of development is complex, and any reorganization during early embryogenesis can give rise to anatomical variants. The aim of this study is to collect, classify, and analyze published evidence on the importance of anatomical variants of the PDS, addressing gaps in our understanding of such variations. The MEDLINE, Web of Science, Embase, and Google Scholar databases were searched to identify publications relevant to this review. R studio with meta-package was used for data extraction, risk of bias estimation, and statistical analysis. A total of 64 studies out of 1,778 proved suitable for this review and metanalysis. The meta-analysis computed the prevalence of normal variants of the PDS (92% of 10,514 subjects). Type 3 variants and "descending" subtypes of the main pancreatic duct (MPD) predominated in the pooled samples. The mean lengths of the MPD and accessory pancreatic duct (APD) were 16.53 cm and 3.36 cm, respectively. The mean diameters of the MPD at the head and the APD were 3.43 mm and 1.69 mm, respectively. The APD was present in only 41% of samples, and the long type predominated. The pancreatic ductal anatomy is highly variable, and the incorrect identification of variants may be challenging for surgeons during ductal anastomosis with gut, failure to which may often cause ductal obstruction or pseudocysts formation.

• Korean Journal of Computational Design and Engineering
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• v.16 no.6
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• pp.458-466
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• 2011

The morphology of a bone is closely associated with its biomechanical response. Thus, much research has been focused on analyzing the effects of variation of bone morphology with subject-specific models. Subject-specific models, which are generally achieved from 3D imaging devices like CT and MRI, incorporate more of the detailed information that makes a model unique. Hence, it may predict individual responses more accurately. Despite these powerful characteristics, specific models are not easily parameterized to the extent possible with statistical models because of their morphologic complexities. Thus, it is still proven challenging to analyze morphologic variations of subject-specific models across changes due to aging or disease. The aim of this article is to propose a generic and robust parametric morphing method for a subject-specific bone structure. We demonstrate this by using the proposed method on a model of a human proximal femur. Automatic segmentation algorithms are also presented to parameterize the specific model efficiently. A total of 48 femur models were evaluated for defining morphing vector fields. Also, several anatomical and mechanical functions of femur were considered as morphing constraints, and the NURBS interpolating technique was applied in the method to guarantee the generality of our morphed results.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.2
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• pp.118-128
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• 2001

Two major salivary glands, submandibular duct, lingual nerve, and vessels are situated beneath the mouth floor. Among these, passing through the pterygomandibular space, lingual nerve is innervated to the lingual gingiva and the mucosa of mouth floor, and is responsible for the general sensation of the anterior two thirds of the tongue. So, the injury of the lingual nerve during an anesthesia or surgery in the retromolar area may cause complications such as a numbness, a loss of taste of the tongue and the other dysfunctions. Therefore, to find out the morphology and the course of lingual nerve and to clarify the topographical relationships of lingual nerve at the infratemporal fossa and paralingual space area, 32 Korean hemi-sectioned heads were dissected macroscopically and microscopically with a viewpoint of clinical aspect in this study. This study demonstrated various anatomical characteristics with relation to the course and topography of the lingual nerve in Koreans. And clinical significances based on the anatomical variations through the topography of the courses and communications between the mandibular nerve branches were described in details.

• Korean Journal of Head & Neck Oncology
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• v.9 no.2
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• pp.183-192
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• 1993

This study reports a prospective analysis of anatomical variations of recurrent laryngeal nerves during 300 thyroidectomies. During thyroidectomies for variable thyroid diseases. the course of recurrent laryngeal nerve was completely isolated from root of neck to the inferior comus of thyroid cartilage. In left side, nerve(53.7%) predominantly ran posterior to the inferior thyroidal artery(p<0.05) but in right side there was no predominant pattern. There were three nonrecurrent laryngeal nerves in the right side. About half of the cases in both sides(51.2% in right, 50.5% in left side) had one or more branches before terminating at cricothyroidal muscles. The average length of branches from inferior comus of thyroid cartilage to the origination of individual branch were l2.0mm in right side and 13.3mm in left side. In right side, majority(50.7%) of nerves ran though paratracheal space but difference did not reach the statistical but in left side, majority(88.3%) ran through tracheoesophageal groove and it was the dominant pattern(p<0.01), the overall status of passages of the nerve were relatively straight in left side(straight 87.8%, oblique 52.1%).

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

• Anatomy and Cell Biology
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• v.56 no.3
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• pp.328-333
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• 2023

The first extensor compartment of the wrist is a distinctly variable anatomical area. Anatomical variations in this region contribute to the pathophysiology and treatment failure of de Quervain's disease, which is a kind of tenosynovitis that develops in the first extensor compartment of the wrist. We aim to describe the first extensor compartment morphology, to evaluate the septum frequency, location of the septum, and the number of tendons of abductor pollicis longus (APL) and extensor pollicis brevis muscles (EPB). First extensor compartment of 87 wrists of 45 cadavers were dissected. The presence or absence of septum and number of tendon slips of APL and EPB revealed. The proximal and distal widths of the compartments were measured. Septums were detected in 60.9% (n=53) of the wrists. Incomplete (distal) and complete (proximal) septa were present in 35.6% (n=31) and 25.3% (n=22) of the cases. Only 26.4% of the wrists had a single slip of APL tendon. The Remaining had multiple slips. The median inner width of the proximal and distal compartments in all wrists were calculated as in the order of 9.11±1.14 mm and 8.55±1.12 mm. We believe that understanding the anatomy of the first extensor compartment in the Turkish population would be helpful to surgeons, radiologists, and physiotherapists to diagnose and manage de Quervain's disease.

• Journal of the Korean Society of Radiology
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• v.84 no.1
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• pp.286-290
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• 2023

Various branch anomalies of the aortic arch have been reported, but cases with separate origins of the internal and external carotid arteries with combined direct aortic arch origin of the left vertebral artery are extremely rare. Herein, we present a rare case of aplasia of the left common carotid artery with separate origins of the ipsilateral internal and external carotid arteries and vertebral artery from the aortic arch in a 10-year-old girl. In addition, we review the embryological development and clinical implications of these anatomical variations.

• Nuclear Engineering and Technology
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• v.54 no.8
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• pp.3006-3016
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• 2022

In this study, the images of specific prompt gamma (PG)-rays of 719 keV emitted from proton-boron reactions were analyzed using single-photon emission computed tomography (SPECT). Quantitative evaluation of the images verified the detection of anatomical changes in tumors, one of the important factors in daily adaptive proton therapy (DAPT) and verified the possibility of application of the PG-ray images to DAPT. Six scenarios were considered based on various sizes and locations compared to the reference virtual tumor to observe the anatomical alterations in the virtual tumor. Subsequently, PG-rays SPECT images were acquired using the modified ordered subset expectation-maximization algorithm, and these were evaluated using quantitative analysis methods. The results confirmed that the pixel range and location of the highest value of the normalized pixel in the PG-rays SPECT image profile changed according to the size and location of the virtual tumor. Moreover, the alterations in the virtual tumor size and location in the PG-rays SPECT images were similar to the true size and location alterations set in the phantom. Based on the above results, the tumor anatomical alterations in DAPT could be adequately detected and verified through SPECT imaging using the 719 keV PG-rays acquired during treatment.

• The Korean Journal of Pain
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• v.27 no.3
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• pp.253-259
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• 2014

Background: Caudal block is a common technique in children for reducing postoperative pain, and there have been several reports on the variations of the sacral canal in children. However, previous studies have mainly focused on the needle trajectory for caudal block, and there is limited information on the structural variations of the sacrum in children. The purpose of this study was to analyze the anatomic variations of sacral canals in children. Methods: Three-dimensional computed tomographic images were analyzed. The data from the images included (1) fusion of the sacral vertebral laminae and the sacral intervertebral space (2) existence of the sacral cornua and (3) the types of sacral hiatus. The types of sacral hiatus were classified into 3 groups: group I (fusion of S3 or S4 vertebral laminae), group II (unfused vertebral arch with the distance of the S3 and S4 vertebral laminae < 50% of the distance between the cornua), and group III (unfused vertebral arch with the distance of the S3 or S4 vertebral laminae ${\geq}50%$ of the distance between the cornua). Results: A total of 143 children were included in this study. All of the sacral vertebral arches were not fused in 22 children (15.4%). Cornua were not identified bilaterally in 5 (3.5%) and unilaterally in 6 (4.2%) children. In the sacral hiatus, group II and group III were identified in 22 (15.4%) and 31 (21.7%) children, respectively. Conclusions: The sacral canal has various anatomical variations in children. Careful attention must be paid to identify the correct anatomic landmark.