• 제목/요약/키워드: Cadavers

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지간 신경종 발생 위치와 심부 횡 중족 골간 인대의 해부학적 연구 (Anatomical Study of Interdigital Neuroma Occurring Site and the Deep Transverse Metatarsal Ligament (DTML))

  • 김재영;최재혁;이경태;양기원;박정민
    • 대한족부족관절학회지
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    • 제11권2호
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    • pp.182-186
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    • 2007
  • Purpose: We examined the relationship of interdigital neuroma occurring site and the surrounding structures, including the deep transverse metatarsal ligament (DTML) by cadaver study and clinical results. Materials and Methods: Seventeen fresh frozen cadavers study were done to evaluate the relationship of interdigital neuroma occuring site and the DTML at two phase of the gait cycle with 60 degree of metatarsophalangeal dorsiflexion and with 15 degrees of ankle dorsiflexion. We measured the distance from interdigital nerve bifurcation of the common digital nerve to anterior margin of the DTML and longitudinal length of DTML itself. Clinically, we checked the location of interdigital neuroma and DTML length during surgery in 32 feet. Results: In the second and third web space, the mean distance from bifurcation of the common digital nerve of foot to the anterior margin of DTML was 16.7 mm, 15.1 mm in the mid-stance position, and 15.9 mm. 14.6 mm in heel-off position. Second, Third web space ligament itself length were average 12.8 mm, 10.6 mm. Clinically, all of the cases of interdigital neuroma started at the bifurcation area of the common digital nerve and interdigital neuroma was average 7.5 mm (range; 6-11 mm). Conclusion: Interdigital neuroma were located more distally than DTML in both the mid-stance and heel off stage. The main lesion was located between metatarsal head and metatarsophalangeal joint and more distal than the DTML anterior margin.

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Lateral Nasal Artery Perforator Flaps: Anatomic Study and Clinical Applications

  • Lombardo, Giuseppe AG;Tamburino, Serena;Tracia, Luciano;Tarico, Maria Stella;Perrotta, Rosario Emanuele
    • Archives of Plastic Surgery
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    • 제43권1호
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    • pp.77-83
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    • 2016
  • Background Previous studies have investigated facial artery perforators, but have reported inconsistent results regarding lateral nasal artery (LNA) perforators. Although several authors have described the use of LNA perforators for ala nasi and nasal sidewall reconstruction, the literature contains little information regarding the cadaveric dissection of LNA perforators, and most previously published studies have focused on facial artery perforators. Methods Sixteen hemifaces from eight fresh cadavers were dissected to study the LNA perforators. After the dissection was performed, the total length and diameter of the LNA and its perforators were measured. The quantity and the distribution of the LNA perforators supplying the overlying skin were then assessed. LNA perforator flaps were used for reconstruction in 10 nasal and perinasal defects. Results The mean total lengths of the LNA and its perforators were 49.37 mm and 16.06 mm, respectively. The mean diameters of the LNA and its perforators were 2.08 mm and 0.91 mm, respectively. Based on our findings, we mapped the face to indicate zones with a higher probability of finding perforators. No infection, hematoma, or complete flap necrosis were observed after the procedures. Conclusions Nasal reconstruction is a challenging procedure, and LNA propeller/V-Y perforator flaps are an excellent reconstructive option in certain cases. Based on our cadaveric study, we were able to identify an area in the upper third of the nasolabial groove with a high density of perforators.

Skin Thickness of the Anterior, Anteromedial, and Anterolateral Thigh: A Cadaveric Study for Split-Skin Graft Donor Sites

  • Chan, Jeffrey C.Y.;Ward, John;Quondamatteo, Fabio;Dockery, Peter;Kelly, John L.
    • Archives of Plastic Surgery
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    • 제41권6호
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    • pp.673-678
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    • 2014
  • Background The depth of graft harvest and the residual dermis available for reepithelization primarily influence the healing of split-skin graft donor sites. When the thigh region is chosen, the authors hypothesize based on thickness measurements that the anterolateral region is the optimal donor site. Methods Full-thickness skin specimens were sampled from the anteromedial, anterior, and anterolateral regions of human cadavers. Skin specimens were cut perpendicularly with a custom-made precision apparatus to avoid the overestimation of thickness measurements. The combined epidermal and dermal thicknesses (overall skin thickness) were measured using a digital calliper. The specimens were histologically stained to visualize their basement membrane, and microscopy images were captured. Since the epidermal thickness varies across the specimen, a stereological method was used to eliminate observer bias. Results Epidermal thickness represented 2.5% to 9.9% of the overall skin thickness. There was a significant difference in epidermal thickness from one region to another (P<0.05). The anterolateral thigh region had the most consistent and highest mean epidermal thickness ($60{\pm}3.2{\mu}m$). We observed that overall skin thickness increased laterally from the anteromedial region to the anterior and anterolateral regions of the thigh. The overall skin thickness measured $1,032{\pm}435{\mu}m$ in the anteromedial region compared to $1,220{\pm}257{\mu}m$ in the anterolateral region. Conclusions Based on skin thickness measurements, the anterolateral thigh had the thickest epidermal and dermal layers. We suggest that the anterolateral thigh region is the optimal donor site for split-skin graft harvests from the thigh.

Forensically Important Blow Flies Chrysomya pinguis, C. villeneuvi, and Lucilia porphyrina (Diptera: Calliphoridae) in a Case of Human Remains in Thailand

  • Monum, Tawatchai;Sukontason, Kabkaew L.;Sribanditmongkol, Pongruk;Sukontason, Kom;Samerjai, Chutharat;Limsopatham, Kwankamol;Suwannayod, Suttida;Klong-klaew, Tunwadee;Wannasan, Anchalee
    • Parasites, Hosts and Diseases
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    • 제55권1호
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    • pp.71-76
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    • 2017
  • This is the first study to report Chrysomya pinguis (Walker) and Lucilia porphyrina (Walker) (Diptera: Calliphoridae) as forensically important blow fly species from human cadavers in Thailand, in addition to Chrysomya villeneuvi (Patton) already known in Thailand. In 2016, a fully decomposed body of an unknown adult male was discovered in a high mountainous forest during winter in Chiang Mai province. The remains were infested heavily with thousands of blow fly larvae feeding simultaneously on them. Morphological identification of adults reared from the larvae, and molecular analysis based on sequencing of 1,247 bp partial mitochondrial cytochrome c oxidase subunit 1 gene (CO1) of the larvae and puparia, confirmed the above mentioned 3 species. The approving forensic fly evidence by molecular approach was described for the first time in Thailand. Moreover, neighbor-joining phylogenetic analysis of the CO1 was performed to compare the relatedness of the species, thereby affirming the accuracy of identification. As species of entomofauna varies among cases in different geographic and climatic circumstances, C. pinguis and L. porphyrina were added to the list of Thai forensic entomology caseworks, including colonizers of human remains in open, high mountainous areas during winter. Further research should focus on these 3 species, for which no developmental data are currently available.

Labial and lingual/palatal bone thickness of maxillary and mandibular anteriors in human cadavers in Koreans

  • Han, Ji-Young;Jung, Gyu-Un
    • Journal of Periodontal and Implant Science
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    • 제41권2호
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    • pp.60-66
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    • 2011
  • Purpose: The aim of this study is to evaluate the buccal and lingual bone thickness in the anterior teeth and the relationship between bone thickness and the tissue biotype. Methods: Three male and two female human cadaver heads (mean age, 55.4 years) were used in this study. First, the biotype of periodontium was evaluated and categorized into a thick or a thin group. Next, full thickness reflections of the mandible and the maxilla to expose the underlying bone for accurate measurements in the anterior regions were performed. After the removal of the half of the alveolar bone, the probe with a stopper was used to measure the thickness of bone plate at the alveolar crest (AC), 3 mm apical to the alveolar crest (AC-3), 6 mm apical to the alveolar crest (AC-6), and 9 mm apical to the alveolar crest (AC-9). The thickness of the buccal plates at the alveolar crest were $0.97{\pm}0.18\;mm$,$0.78{\pm}0.21\;mm$, and $0.95{\pm}0.35\;mm$ in the maxillary central incisors, lateral incisors, and canines, respectively. The thickness of the labial plates at the alveolar crest were $0.86{\pm}0.59\;mm$, $0.88{\pm}0.70\;mm$, and $1.17{\pm}0.70\;mm$ in the mandibular central incisors, lateral incisors and canines, respectively. Conclusions: The thickness of the labial plate in the maxillary anteriors is very thin that great caution is needed for placing an implant. The present study showed the bone thickness of maxillary and mandibular anteriors at different positions. Therefore, these data can be useful for the understanding of the bone thickness of the anteriors and a successful implant placement.

나선축 개념을 이용한 팔꿈치 관절의 3차원 회전축 측정과 측정 결과를 반영한 인체 팔 모델의 개발 (Determination of the Elbow Transverse Joint Using the Helical Axis Concept and its Application to the Development of a Kinematic Arm Model)

  • 우범영;정의승;윤명환
    • 대한산업공학회지
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    • 제26권1호
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    • pp.73-80
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    • 2000
  • To determine the exact direction and location of the human joint in motion is crucial in developing a more accurate human model and producing a more fitting artificial joint. There have been several reports on the biomechanical analysis of the joint to determine the anatomy and movement of joints. However, all the previous researches were made in vitro study, that is, they investigated the passive movement of the joint from cadavers and the suggested location of the joint axis was difficult to make practical applications due to the lack of the direction of joint axis. Also, in many biomechanical models, each joint axis is assumed to lie horizontally or vertically to the adjacent links. Such an assumption causes inherent inaccuracy. In this study, the direction and location of the transverse elbow axis was obtained with respect to the global coordinate system whose origin is on the lateral epicondyle of the humerus. The suggested result based on the global coordinate system lying on the external landmark will be helpful to understand the information of the axis and to make an application. From the experiments conducted for five subjects, the direction and location of the elbow transverse joint was determined for each subject by the helical axis method. A statistical validation was also performed to confirm the result. Finally, the result was applied to develop a simple elbow model which is a part of the kinematic arm model. The simple elbow movement model was developed to validate the significance of the result and the kinematic arm model was able to describe the geometry of any complex linkage system. As a result, the errors incurred from the proposed model were significantly reduced when compared to the ones from the previous approach.

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The Morphometric Study for the Rolandic Fissure

  • Choi, Jin-Gu;Bae, Hack-Gun;Sim, Jae-Jun;Park, Heung-Ki;Sim, Ki-Bum;Choi, Soon-Kwan
    • Journal of Korean Neurosurgical Society
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    • 제41권3호
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    • pp.171-176
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    • 2007
  • Objective : The purpose of this study was to characterize the Rolandic fissure[Rf] and was to identify the Rf using the surface bony landmarks which can be usually exposed on craniotomy. Methods : After morphological evaluation of the Rfs using 21 Korean adult formalin fixed cadavers, craniometric measurement was carried out from the surface bony landmarks of nasion, glabella, bregma, and lambda. Results : The Rfs of both hemispheres did not show the mirror image. The Rfs ran forward and downward toward the sylvian fissure keeping the mean angle of $67^{\circ}$ from mid-sagittal line as elongated S-shape in left and the elongated reverse S-shape in right hemisphere. Connections between the Rf and the longitudinal fissure and between the Rf and the sylvian fissure were found in 3 [7.1%] and 2 [4.8%] of 42 hemispheres, respectively. Most Rfs extended superiorly to 2-3mm lateral to the most superomedial surface of hemispheres and extended inferiorly to 3-5mm superior to the sylvian fissures. The mean distances from the nasion, glabella, bregma, and lambda to the most superomedial aspect of the Rf were $18.8{\pm}0.9cm,\;16.6{\pm}0.8cm,\;5.2{\pm}0.6cm$, and $6.9{\pm}1.0cm$, respectively. The mean distance measured between the Rf and the nasion using traditional method was $18.4{\pm}0.6cm$. Conclusion : The distance between the Rf and the nasion roughly correspond within the range of mean 4 mm compared with that measured by the traditional measurement. These data may be more helpful to delineate the Rf after the placement of drapes for craniotomy.

Pedicle Screw Placement in the Thoracolumbar Spine Using a Novel, Simple, Safe, and Effective Guide-Pin : A Computerized Tomography Analysis

  • Hyun, Seung-Jae;Kim, Yongjung J.;Rhim, Seung-Chul;Cheh, Gene;Cho, Samuel K.
    • Journal of Korean Neurosurgical Society
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    • 제58권1호
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    • pp.9-13
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    • 2015
  • Objective : To improve pedicle screw placement accuracy with minimal radiation and low cost, we developed specially designed K-wire with a marker. To evaluate the accuracy of thoracolumbar pedicle screws placed using the novel guide-pin and portable X-rays. Methods : Observational cohort study with computerized tomography (CT) analysis of in vivo and in vitro pedicle screw placement. Postoperative CT scans of 183 titanium pedicle screws (85 lumbar and 98 thoracic from T1 to L5) placed into 2 cadavers and 18 patients were assessed. A specially designed guide-pin with a marker was inserted into the pedicle to identify the correct starting point (2 mm lateral to the center of the pedicle) and aiming point (center of the pedicle isthmus) in posteroanterior and lateral X-rays. After radiographically confirming the exact starting and aiming points desired, a gearshift was inserted into the pedicle from the starting point into the vertebral body through the center of pedicle isthmus. Results : Ninety-nine percent (181/183) of screws were contained within the pedicle (total 183 pedicle screws : 98 thoracic pedicle screws and 85 lumbar screws). Only two of 183 (1.0%) thoracic pedicle screws demonstrated breach (1 lateral in a patient and 1 medial in a cadaver specimen). None of the pedicle breaches were associated with neurologic or other clinical sequelae. Conclusion : A simple, specially designed guide-pin with portable X-rays can provide correct starting and aiming points and allows for accurate pedicle screw placement without preoperative CT scan and intraoperative fluoroscopic assistance.

Meningeal Layers Around Anterior Clinoid Process as a Delicate Area in Extradural Anterior Clinoidectomy : Anatomical and Clinical Study

  • Yoon, Byul Hee;Kim, Han Kyu;Park, Mun Sun;Kim, Seong Min;Chung, Seung Young;Lanzino, Giuseppe
    • Journal of Korean Neurosurgical Society
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    • 제52권4호
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    • pp.391-395
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    • 2012
  • Objective : Removal of the anterior clinoid process (ACP) is an essential process in the surgery of giant or complex aneurysms located near the proximal internal carotid artery or the distal basilar artery. An extradural clinoidectomy must be performed within the limits of the meningeal layers surrounding the ACP to prevent morbid complications. To identify the safest method of extradural exposure of the ACP, anatomical studies were done on cadaver heads. Methods : Anatomical dissections for extradural exposure of the ACP were performed on both sides of seven cadavers. Before dividing the frontotemporal dural fold (FTDF), we measured its length from the superomedial apex attached to the periorbita to the posterolateral apex which connects to the anterosuperior end of the cavernous sinus. Results : The average length of the FTDF on cadaver dissections was 7 mm on the right side and 7.14 mm on the left side. Cranial nerves were usually exposed when cutting FTDF more than 7 mm of the FTDF. Conclusion : The most delicate area in an extradural anterior clinoidectomy is the junction of the FTDF and the anterior triangular apex of the cavernous sinus. The FTDF must be cut from the anterior side of the triangle at the periorbital side rather than from the dural side. The length of the FTDF incision must not exceed 7 mm to avoid cranial nerve injury.

Morphometric Relationship between the Cervicothoracic Cord Segments and Vertebral Bodies

  • Kim, Ji Hoon;Lee, Chul Woo;Chun, Kwon Soo;Shin, Won Han;Bae, Hack-Gun;Chang, Jae Chil
    • Journal of Korean Neurosurgical Society
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    • 제52권4호
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    • pp.384-390
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    • 2012
  • Objective : The objective of this study was to investigate the morphologic characteristics between the vertebral body and the regions of the cervical and thoracic spinal cords where each rootlets branch out. Methods : Sixteen adult cadavers (12 males and 4 females) with a mean age of 57.9 (range of 33 to 70 years old) were used in this study. The anatomical relationship between the exit points of the nerve roots from the posterior root entry zone at each spinal cord segment and their corresponding relevant vertebral bodies were also analyzed. Results : Vertical span of the posterior root entry zone between the upper and lower rootlet originating from each spinal segment ranged from 10-12 mm. The lengths of the rootlets from their point of origin at the spinal cord to their entrance into the intervertebral foramen were 5.9 mm at the third cervical nerve root and increased to 14.5 mm at the eighth cervical nerve root. At the lower segments of the nerve roots (T3 to T12), the posterior root entry zone of the relevant nerve roots had a corresponding anatomical relationship with the vertebral body that is two segments above. The posterior root entry zones of the sixth (94%) and seventh (81%) cervical nerve roots were located at a vertebral body a segment above from relevant segment. Conclusion : Through these investigations, a more accurate diagnosis, the establishment of a better therapeutic plan, and a decrease in surgical complications can be expected when pathologic lesions occur in the spinal cord or vertebral body.