A Pair of Atypical Rhomboid Muscles / 체질인류학회지

We report a pair of atypical rhomboideus muscles which originated higher than normal observed in a 49-year-old Korean male. Rhomboid muscles were not paralleogram shape but trapezoid with rhomboideus tertius attached inferior to the rhomboideus major muscles. Rhomboideus minor originated as tendon from the ligamentum nuchae of fourth and sixth cervical vertebrae level. The upper end of the origin of the rhomboideus major was the ligamentum nuchae between fifth and sixth cervical vertebrae level on the left side and the ligamentum nuchae at the sixth cervical vertebra level on the right side. The lower end of the origin of the rhomboideus major was the spinous process of the fourth thoracic vertebra on the left side and the spinous process of the second thoracic vertebra on the right side. The upper end of the origin of the rhomboideus tertius were the same as the lower end of the rhomboideus major and the lower end of the origin of the rhomboideus tertius were the spinous process of the fifth thoracic vertebrae on both sides. Whole rhomboideus muscle spanned over nine vertebrae. We compared these rhomboidei with previously reported variations and discussed its embryological and clinical significance.

Improved analysis of palm creases / 대한해부학회지

Palm creases are helpful in revealing anthropologic characteristics and diagnosing chromosomal aberrations, and have been analyzed qualitatively and quantitatively. However, previous methods of analyzing palm creases were not objective so that reproducibility could not be guaranteed. In this study, a more objective morphologic analysis of palm creases was developed. The features of the improved methods include the strict definition of major and minor palm creases and the systematic classification of major palm creases based on their relationships, branches, and variants. Furthermore, based on the analysis of 3,216 Koreans, palm creases were anthropologically interpreted. There was a tendency for palm creases to be evenly distributed on the palm, which was acknowledged by the relationship between major and minor creases as well as by the incidences of major creases types. This tendency was consistent with the role of palm creases to facilitate folding of palm skin. The union of major palm creases was frequent in males and right palms to have powerful hand grip. The new method of analyzing palm creases is expected to be widely used for anthropologic investigation and chromosomal diagnosis.

Serially Sectioned Images of the Whole Body (Eighth Report: Segmentation of the Upper Limb's Structures) / 대한해부학회지

Whole body of a Korean male cadaver was serially milled to make sectioned images. Segmentation of various anatomical structures can expand the utilization of the sectioned images such as three-dimensional (3D) reconstruction of the structures of real human. Following previous outlining of lower limb's structures, we decided to make segmented images of upper limb's structures in detail. Ninety-one structures (a skin, 32 bones, 49 muscles, 6 arteries, and 3 nerves) in the left upper limb were segmented in 628 sectioned images. While doing this, we developed more efficient technique for segmentation. To draw the outlines of various structures more quickly, sectioned images were filtered first and then outlines were drawn by 'quick selection' tool and other tools on the Photoshop. Also, outlines were automatically generated by interpolation using Combustion software. We made coronal and sagittal segmented images, browsing software of the serially sectioned images, volume 3D images, and surface 3D images for verifying segmentation. These segmented and sectioned images of the upper limb are expected to help other researchers make 3D images and various software of upper limb and to have widespread applications in both medical learning and research.

Long-Term Results of Radical Cystectomy in Elderly Patients with Comorbidity

PURPOSE: Radical cystectomy is a standard treatment for muscle-invasive bladder cancer in healthy individuals. However, few data are available on radical cystectomy in elderly patients with comorbidity. We determined the safety of radical cystectomy and the long-term benefit and survival outcomes after radical cystectomy in elderly patients with comorbidity. MATERIALS AND METHODS: We reviewed the records of all patients undergoing radical cystectomy between 1986 and 2005. We identified 31 elderly patients with comorbidity, as defined by age 75 years or greater and American Society of Anesthesiologist (ASA) classification 3. We analyzed patient characteristics, presenting symptoms, surgical outcomes including perioperative complications, pathologic stage, and survival. RESULTS: The patients' median age was 77 years (range, 75-89 years). ASA class was 3 in 31 patients. Complications developed in 8 cases (25.8%). Postoperatively, 6 of the 31 patients (20%) were transferred directly to the general urology floor. No patients died in the perioperative period or were hospitalized within 6 months of discharge home. During the follow-up period of 54 months (range, 11-135 months), 11 (31.4%) patients were alive. Cause of death was known in 20 patients, with majority (7/20) because of bladder cancer. Kaplan-Meier survival curves demonstrated that patients with organ-confined disease had a significantly longer overall survival than did patients with non-organ-confined disease. CONCLUSIONS: Our results support the safety and feasibility of radical cystectomy in elderly patients with comorbidity. Palliation of local symptoms, local cancer control, and long-term survival benefit might be expected after radical cystectomy, especially in patients with organ-confined disease.

Analysis of Digital Media and Image Delivery System of Human Anatomic Dissection for Medical Students and Clinicians / 체질인류학회지

In the traditional cadaver dissection course, it is hard to demonstrate dissection skills to all the medical students because of limitations such as the high ratio of students to instructors and the lack of facilities. To overcome these limitations, we developed a digital anatomy dissection course. Through this system, it was possible to perform effective instruction of anatomic dissection. This method could provide the appropriate teaching in a short period of time. Furthermore, students can review the dissection course on digital files saved on a CD-ROM. Clinical cadaveric workshops can be provided by this method not only for students but also for continuing medical education for clinicians.

Effects of Prenatal Stress and Restraint Stress on Amygdala Complex of the Rat: II. Effects on the Astrocytic Cell Processes / 체질인류학회지

The hypothesis that adverse experience alters the balance of neurotransmitters in the amygdala rendering it hyperresponsive to stress was examined in the present study. Since astrocytes regulate the brain's neurochemical milieu by uptaking neurotransmitters, we have examined these cells in the amygdala of prenatally stressed rats, a model of pathological anxiety. Here we examined morphometric changes on the cell bodies of astrocytes in the amygdala induced by prenatal stress and restraint stress. For this purpose, rats were classified into 4 groups; control group (CON), only restraint stressed (starting on P90 for 3 days) group (CONR), prenatally stressed group (PNS), and prenatally and restraint (on P90 for 3 days) stressed group (PNSR). Astrocytes stained with GFAP immunohistochemistry were counter stained with methylene blue/azure II and were examined using the Neurolucida. The present study showed that prenatal and restraint stress caused the significant increase in the total number and length of the amygdaloid astrocytic processes. In conclusion, astrocytes show structural indices of activation with stress.

Topographic Anatomy of the Median Nerve and the Pronator Teres and the Flexor Digitorum Superficialis Muscles / 대한해부학회지

The pronator teres syndrome can occur when the median nerve is compressed by the adjacent structures in the proximal forearm. The pronator teres and the flexor digitorum superficialis muscles have been suggested to contribute to this syndrome. This study was performed to clarify the topographical relationship among the median nerve, the pronator teres muscle and the flexor digitorum superficialis muscle in 55 Korean adult cadavers (100 sides of arms). The two heads of the pronator teres muscle met at the point of 61.3 mm distal to the biepicondylar line and inserted to the radius at the point of 141.5 mm distal to the line. The ulnar side of its ulnar head was muscular in 8%, tendinous in 70%, and mixed in 20%. The radial side of its humeral head was muscular in 53%, tendinous in 14%, and mixed in 33%. The median nerve was completely covered by the pronator muscle within 26.5 mm from the biepicondylar line and entered between the two heads of the pronator muscle at 54.2 mm from the line and exited it after running 25.5 mm. The most distal part of the musculotendinous arch of the flexor digitorum superficialis muscle was located at the average 80.9 mm from the biepicondylar line. The distalmost radial head of the flexor digitorum superficialis muscle originated from the distal point of the pronator teres insertion in 28.6%, distal to that point in 54.3%, and proximal to that point in 14.3%.

Topographical Relationship of the Superficial Temporal Vessels and the Auriculotemporal Nerve / 대한해부학회지

The anatomy of the superficial temporal vessels and the auriculotemporal nerve is important when harvesting various skin flaps in the temporal region. But Anatomy textbooks describe only one pattern of topographical relationship between these structures. A total of 65 Korean cadavers with 121 sides were used. We examined the topographical relationship between the superficial temporal artery and vein and the auriculotemporal nerve. And the bifurcating location of the superficial temporal artery and its distance from the lamina tragi were measured. The running patterns of the superficial temporal vessels were classified into 4 types according to their distance from each other and their parallelism. The artery and vein run parallel to each other in 61.2%. The running patterns of the superficial temporal vessels were classified into 5 types according to their anterior and posterior relationship. The artery runs anterior to the vein in most of the cases (72.7%). The topographic relationships of the auriculotemporal nerve and the superficial temporal vessels were classified into 6 types according to their anterior, posterior, superficial or deep position. In this classification, the relationship between the artery and the vein was not considered. The frequencies of 6 types were within 10~20%. The bifurcation of the artery occurred above the zygomatic arch in 85.3%. The superficial temporal artery ran 5.1 mm anterior to the tragus.