• Title/Summary/Keyword: Anatomic Variation

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Acoustic and Stroboscopic Characteristics of Normal Person's Voices with Advancing Age (연령증가에 따른 정상 노인의 음향분석학적 특징)

  • 진성민;권기환;강현국
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.8 no.1
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    • pp.44-48
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    • 1997
  • Anatomic and physiological changes of the larynx with advancing age result in morphologic changes of the vocal fold and reduced control of the phonatory mechanism in elderly individuals and are reflected in increased unstability of fundamental frequency (Fo). The purpose of this study is to increase current understanding of acoustic and stroboscopic characteristics of normal elderly persons voices. First, phonated /a/ vowel productions by 40 normal adults (20 to 40 years, 20 men and 20 women) and 40 normal elderly persons (60 to 80 years,20 men and 20 women) were analyzed, using CSL (model 4300B) acoustic analysis software, to obtain acoustic measures related to fundamental frequency stability nd vocal resonance characteristics. Second, stroboscopic images of the vocal fold behavior in all subjects were analyzed by experienced specialists. In the men, fundamental frequency variation (vFe) (p<0.01), jitter. (p<0.05), and shimmer (p<0.05) for the older group were significantly higher than the value for the adult group. In the stroboscopic findings, edema of vocal fold had a significant finding in aged men (15%). In the women, vFo (p<0.05), jitter (p<0.05), and noise to harmonic ratio (NHR) (p<0.05) for the older group were significantly higher than the value for e adult group and first formant frequency (F1) (p<0.01) and second formant frequency (F2) (p<0.01) for. the older group were significantly lower than the value for the adult group. In the stroboscopic findings, vocal fold atrophy had a significant finding in aged women (25%). Frequency stability, as reflected by vFo, jitter, shimmer, and NHR, decreases with advancing age in men and women and spectral analysis of phonated /a/ vowel productions reveals the lowering of the frequency of F1 and second F2 with advancing age, especially in aged women. Change in the mass of vocal folds, due to atrophy or edema, is considered to be the greatest factor in these acoustic changes.

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Pretreatment Neutrophil/Lymphocyte Ratio as a Prognostic Aid in Colorectal Cancer

  • Ozdemir, Yavuz;Akin, Mehmet Levhi;Sucullu, Ilker;Balta, Ahmet Ziya;Yucel, Ergun
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.6
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    • pp.2647-2650
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    • 2014
  • Background: Colorectal cancers(CRC) are the third most common cancer in the western world, with surgery preferred for management of non-metastatic disease and post surgical treatment usually arranged according to the TNM staging system. However, there is still prognostic variation between patients who have the same stage. It is increasingly recognized that variations within disease course and clinical outcome in colorectal cancer patients are influenced by not only oncological characteristics of the tumor itself but also host response factors. Recent studies have shown correlation between the inflammatory response and clinical outcomes in various cancers. The neutrophil/lymphocyte ratio (NLR) has been described as a marker for immune response to various stimuli including cancer. Material-Methods: Two hundred eighty-one CRC patients were included in our retrospective analysis, separated into two groups according to a cut-off value for the NLR. Patient data including age, gender, vertical penetration, anatomic location, and differentiation of the tumor, TNM stage, survival rate, and disease-free survival were analyzed for correlations with the NLR. Results: Using ROC curve analysis, we determined a cut-off value of 2.2 for NLR to be best to discriminate between patient survival in the whole group. In univariate analysis, high pretreatment NLR (p=0.001, 95%CI 1.483-4.846), pathologic nodal stage (p<0.001, 95%CI 1.082-3.289) and advanced pathologic TNM stage (p<0.001, 95%CI 1.462-4.213) were predictive of shorter survival. In multivariate analysis, advanced pathologic TNM stage (p=0.001, 95%CI 1.303-26.542) and high pretreatment NLR (p=0.005, 95%CI 1.713-6.378) remained independently associated with poor survival. Conclusions: High pre-treatment NLR is a significant independent predictor of shorter survival in patients with colorectal cancer. This parameter is a simple, easily accessible laboratory value for identifying patients with poorer prognosis.

Panoramic radiographs underestimate extensions of the anterior loop and mandibular incisive canal

  • de Brito, Ana Caroline Ramos;Nejaim, Yuri;de Freitas, Deborah Queiroz;Santos, Christiano de Oliveira
    • Imaging Science in Dentistry
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    • v.46 no.3
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    • pp.159-165
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    • 2016
  • Purpose: The purpose of this study was to detect the anterior loop of the mental nerve and the mandibular incisive canal in panoramic radiographs (PAN) and cone-beam computed tomography (CBCT) images, as well as to determine the anterior/mesial extension of these structures in panoramic and cross-sectional reconstructions using PAN and CBCT images. Materials and Methods: Images (both PAN and CBCT) from 90 patients were evaluated by 2 independent observers. Detection of the anterior loop and the incisive canal were compared between PAN and CBCT. The anterior/mesial extension of these structures was compared between PAN and both cross-sectional and panoramic CBCT reconstructions. Results: In CBCT, the anterior loop and the incisive canal were observed in 7.7% and 24.4% of the hemimandibles, respectively. In PAN, the anterior loop and the incisive canal were detected in 15% and 5.5% of cases, respectively. PAN presented more difficulties in the visualization of structures. The anterior/mesial extensions ranged from 0.0 mm to 19.0 mm on CBCT. PAN underestimated the measurements by approximately 2.0 mm. Conclusion: CBCT appears to be a more reliable imaging modality than PAN for preoperative workups of the anterior mandible. Individual variations in the anterior/mesial extensions of the anterior loop of the mental nerve and the mandibular incisive canal mean that is not prudent to rely on a general safe zone for implant placement or bone surgery in the interforaminal region.

Bifid Mandibular Canal: Radiographic Observation and Clinical Relevance -A Case Report- (이열 하악관(Bifid Mandibular Canal): 방사선적 소견과 임상적 의의 -증례보고-)

  • Lee, Hyun-Woo;Kim, Yeo-Gab;Lee, Baek-Soo;kwon, Yong-Dae;Choi, Byung-Jun;Kim, Young-Ran
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.9 no.1
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    • pp.24-29
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    • 2009
  • When performing the inferior alveolar nerve block anesthesia, surgeon often faced a difficulty of the surgical operation due to the incomplete anesthesia. One of the reason is the variety of mandibular canal anatomy. Up to now, there are some reports of index cases about bifid mandibular canal among mandibular canal anatomic variation, and some classification is applied according to anatomical location and configuration. When surgical operation is performed involving mandible such as dantal implant treatment, extraction of an impacted third molar, sagittal split ramus osteotomy, etc, the position of mandibular canal should be considered. Bifid mandibular canal clinically causes troublesome cases of anesthesia when inferior alvelor nerve block, especially is performed extraction of an impacted third molar. Therefore, It is important for clinicians to recognize the presence of bifid canals on radiographys. Nowadays, the position of mandibular canal can be measured precisely by using Dental CT. It is not found by panorama image but is found by Dental CT sometimes. Among the patients, which take panorama and Dental CT simultaneously, for tooth extraction of lower impacted third molar in our department, we report the case that did not identifying in panorama but identifying it in Dental CT.

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Effects of Material Properties and Fabric Structure Characteristics of Graduated Compression Stockings (GCS) on the Skin Pressure Distributions

  • Liu Rong;Kwok Yi-Lin;Li Yi;Lao Terence-T;Zhang Xin
    • Fibers and Polymers
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    • v.6 no.4
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    • pp.322-331
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    • 2005
  • Graduated compression stockings (GCS) have been widely used for the prophylaxis and treatment of venous diseases. Their gradient pressure function largely related to their fabric structure and material properties. By combing fabric physical testing and wear trials, this study investigated the GCSs fabric structure and material properties at different locations along the stocking hoses, and quantitatively analyzed the effects of fabrics on skin pressure longitudinal and transverse distributions. We concluded that, Structural characteristics and material properties of stocking fabrics were not uniform along the hoses, but a gradual variation from ankle to thigh regions, which significantly influenced the corresponding skin pressure gradient distributions; Tensile (WT, EM) and shearing properties (G) generated most significant differences among ankle, knee and thigh regions along the stocking hose, which significantly influenced the skin pressure lognitudinal gradient distribution. More material indices generating significant gradual changes occurred in the fabric wale direction along stocking hose, meaning that materials properties in wale direction would exert more important impact on the skin pressure gradient performances. And, the greater tensibility and smoother surface of fabric in wale direction would contribute to put stocking on and off, and facilitate wearers' leg extension-flexion movements. The indices of WT and EM of stocking fabrics in series A have strong linear correlations with skin pressure lognitudinal distribution, which largely related to their better performances in gradual changes of material properties. Skin pressure applied by fabric with same material properties produced pronounced differences among four different directions around certain cross-sections of human leg, especially at the ankle region; and, the skin pressure magnitudes at ankle region were more easily influenced by the materials properties, which were considered to be largely related to the anatomic structure of human leg.

Cephalometric landmark variability among orthodontists and dentomaxillofacial radiologists: a comparative study

  • Durao, Ana Paula Reis;Morosolli, Aline;Pittayapat, Pisha;Bolstad, Napat;Ferreira, Afonso P.;Jacobs, Reinhilde
    • Imaging Science in Dentistry
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    • v.45 no.4
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    • pp.213-220
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    • 2015
  • Purpose: The aim this study was to compare the accuracy of orthodontists and dentomaxillofacial radiologists in identifying 17 commonly used cephalometric landmarks, and to determine the extent of variability associated with each of those landmarks. Materials and Methods: Twenty digital lateral cephalometric radiographs were evaluated by two groups of dental specialists, and 17 cephalometric landmarks were identified. The x and y coordinates of each landmark were recorded. The mean value for each landmark was considered the best estimate and used as the standard. Variation in measurements of the distance between landmarks and measurements of the angles associated with certain landmarks was also assessed by a subset of two observers, and intraobserver and interobserver agreement were evaluated. Results: Intraclass correlation coefficients were excellent for intraobserver agreement, but only good for interobserver agreement. The least reliable landmark for orthodontists was the gnathion (Gn) point (standard deviation [SD], 5.92 mm), while the orbitale (Or) was the least reliable landmark (SD, 4.41 mm) for dentomaxillofacial radiologists. Furthermore, the condylion (Co)-Gn plane was the least consistent (SD, 4.43 mm). Conclusion: We established that some landmarks were not as reproducible as others, both horizontally and vertically. The most consistently identified landmark in both groups was the lower incisor border, while the least reliable points were Co, Gn, Or, and the anterior nasal spine. Overall, a lower level of reproducibility in the identification of cephalometric landmarks was observed among orthodontists.

Rare Normal Variation Between Biceps Anchor and Superior Labrum - A Case Report - (상완 이두근 장두의 관절내 부착부위와 상부 관절와 순 간의 드문 변형 - 증례보고 -)

  • Kim, Yong-Ju;Jeong, Hoon;Ha, Jong-Kyoung;Lee, Kwan-Hee;Lee, Woo-Jin
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.245-249
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    • 2009
  • Purpose: Labral lesions and its anatomic variants have been studied by several authors in the last decade. Buford complex and sublabral recess are most common variants. Their recognition is important in order to distinguish them from superior and anterior labral tear. Materials and Methods: We report one case of a 19-year-old female who was mistaken SLAP lesion for normal variant and was treated with arthroscopic surgery. Results: The arthroscopic finding shows rare normal variant of biceps anchor and superior labrum. The biceps long head tendon was inserted at superior labrum and supraspinatus tendon area. This finding was mistaken to SLAP lesion. Conclusion: We report rare normal variant of biceps anchor and superior labrum that was observed during arthroscopic surgery for SLAP lesion.

Computed Tomographic Evaluation of the Nasal Septum Deviation in Clinically Normal Dogs (정상 개에서 컴퓨터단층촬영을 이용한 비중격 변위 평가)

  • Lee, Ki-Ja;Lee, In;Lee, Hee-Chun;Han, Woo-Sok;Choi, Ho-Jung;Lee, Young-Won
    • Journal of Veterinary Clinics
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    • v.28 no.5
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    • pp.506-509
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    • 2011
  • This study was performed to determine a comprehensive anatomic variation and deviation of the nasal septum in clinically normal dogs by use of computed tomography (CT). The nasal septum was evaluated in 36 shihtzu dogs and 16 beagle dogs. A degree of a septal deviation was evaluated by measuring a maximum angle and a distance of the septal deviation. The angle and distance of the septal deviation were significantly higher in shih-tzu dogs than in beagle dogs. There was no significant relationship between body weight and age and all measurements (angle and distance) in both breed dogs. Results of this study suggest that nasal septum deviation and its defect are observed on CT images of clinically normal dogs, especially in shih-tzu dogs.

Surgical Dilemma of Facial Nerve Invasion (안면신경 침범시의 수술적 처치)

  • Rho, Young-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.24 no.1
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    • pp.9-14
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    • 2008
  • The most important concern to do parotidectomy is correct identification of the facial nerve and preservation of the nerve function. Many descriptions for the localization and branching types of the facial nerve trunk have existed. During the parotid surgery, it is necessary to have knowledges about the incidence and prognostic aspect of a invasion of the facial nerve by the parotid tumors. The method of the dissection and the surgical extent of the parotid gland would be decided not only by the anatomic variation of the facial nerve. but also the size and location of the tumor. Invasion of the facial nerve in parotid malignancies is the most significant factors affecting the prognosis, so radical parotidectomy which consists of the total extirpation of the parotid gland in conjunction with resection of the facial nerve is often required for proper management. Radical parotidectomy is advocated for the surgical treatment of high grade malignancies and in selective recurrent benign tumors intimately involving the facial nerve. Unfortunately, the morphologic and functional deficits created by sacrificing the facial nerve can be emotionally and physically traumatizing to the patient. Therefore, when the facial nerve is sacrificed, immediate reconstruction of the facial nerve should be necessary. Immediate nerve repair with direct anastomosis of the resected nerve ends or placement of a cable nerve graft provides the better cosmetic and functional results. Surgical resection remains the mainstay of treatment for cancer of the parotid gland, and there is general agreement that facial nerve should not be sacrificed unless the tumor is adherent to, or surrounds the nerve. The following statement is described general principles of troublesome management of the facial nerve during surgery for parotid tumor.

Spinal Enumeration by Morphologic Analysis of Spinal Variants: Comparison to Counting in a Cranial-To-Caudal Manner

  • Yun, Sam;Park, Sekyoung;Park, Jung Gu;Huh, Jin Do;Shin, Young Gyung;Yun, Jong Hyouk
    • Korean Journal of Radiology
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    • v.19 no.6
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    • pp.1140-1146
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    • 2018
  • Objective: To compare the spinal enumeration methods that establish the first lumbar vertebra in patients with spinal variants. Materials and Methods: Of the 1446 consecutive patients who had undergone computed tomography of the spine from March 2012 to July 2016, 100 patients (62 men, 38 women; mean age, 47.9 years; age range, 19-88 years) with spinal variants were included. Two radiologists (readers 1 and 2) established the first lumbar vertebra through morphologic analysis of the thoracolumbar junction, and labeled the vertebra by counting in a cranial-to-caudal manner. Inter-observer agreement was established. Additionally, reader 1 detected the 20th vertebra under the assumption that there are 12 thoracic vertebra, and then classified it as a thoracic vertebra, lumbar vertebra, or thoracolumbar transitional vertebra (TLTV), on the basis of morphologic analysis. Results: The first lumbar vertebra, as established by morphologic analysis, was labeled by each reader as the 21st segment in 65.0% of the patients, as the 20th segment in 31.0%, and as the 19th segment in 4.0%. Inter-observer agreement between the two readers in determining the first lumbar vertebra, based on morphologic analysis, was nearly perfect (${\kappa}$ value: 1.00). The 20th vertebra was morphologically classified as a TLTV in 60.0% of the patients, as the first lumbar segment in 31.0%, as the second lumbar segment in 4.0%, and as a thoracic segment in 5.0%. Conclusion: The establishment of the first lumbar vertebra using morphologic characteristics of the thoracolumbar junction in patients with spinal variants was consistent with the morphologic traits of vertebral segmentation.