• Journal of Korean Neurosurgical Society
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• 제58권6호
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• pp.499-503
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• 2015

Objective : The transradial catheterization (TRC) is becoming widespread, primarily for neurointerventions. Therefore, the evaluation of radial artery puncture in clinical practice and a better understanding of the anatomy are important to improve the safety of neuroendovascular surgery. Methods : Ten formalin-fixed adult Korean cadavers were dissected to expose radial artery (RA), brachial artery (BrA) and subclvian artery (ScA), bilaterally. Vessel lengths and diameters were meaured using a caliper and distance between the specific point of vessels and the anatomical landmarks including the radial styloid process, the medial epicondyle of the humerus, the sternoclavicular joint, and the vertebral artery orifice were also measured. Results : The average length between the radial (RAPS) and the BrA puncture sites (BrAPS) and between the vertebral artery orifice (VAO) and the BrA bifurcation (BrAB) did not differ between sides (p>0.05). The average length between the radial styloid process (RSP) and the RAPS was $13.41{\pm}2.19mm$, and the RSP was $26.85{\pm}2.47mm$ from the median nerve (MN). The mean length between the medial epicondyle (ME) and the BrAPS as $44.23{\pm}5.47mm$, whereas the distance between the ME and the MN was $42.23{\pm}4.77mm$. The average VAO-ScA angle was $70.94{\pm}6.12^{\circ}$, and the length between the ScA junction (SCJ) and the VAO was $60.30{\pm}8.48mm$. Conclusion : This study provides basic anatomical information about the radial artery and the brachial route and can help improving new techniques, selection of size and shape of catheters for TRC. This can help neurointerventionists who adopt a transradial neuroendovascular approach and offers comprehensive and safe care to their patients.

• Imaging Science in Dentistry
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• 제51권3호
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• pp.251-260
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• 2021

Purpose: Dental implants are widely used for the rehabilitation of edentulous sites. This study investigated the occurrence of dental implant malpositioning as shown on post-implantation cone-beam computed tomography (CBCT) and to identify related factors. Materials and Methods: Samples with at least 1 malpositioned dental implant were collected from a central radiology clinic in Tehran, Iran from January 2017 to January 2019. Variables such as demographic characteristics, length and diameter of implants, type of implant, sites of implant insertion, different types of implant malpositioning problems (cortical plate perforation, interference with anatomical structures), angulation of the implant, and the severity of malpositioning were assessed. In addition, the incidence of implant fracture and over-drilling was evaluated. Data were statistically analyzed using the chi-square test, 1-sample t-test, and Spearman correlation coefficients. Results: In total, 252 patients referred for implant postoperative CBCT evaluations were assessed. The cases of implant malpositioning included perforation of the buccal cortical plate (19.4%), perforation of the lingual cortical plate (14.3%), implant proximity to an adjacent implant (19.0%), implant proximity to an adjacent tooth (3.2%), interference with anatomical structures(maxillary sinus: 18.3%, mandibular canal: 11.1%, nasal cavity: 6.3%, mental foramen: 5.6%, and incisive canal: 0.4%). Implant fracture and over-drilling were found in 1.6% and 0.8% of cases, respectively. Severity was categorized as mild (9.5%), moderate (35.7%), severe (37.7%), and extreme (17.1%), and 52.4% of implants had inappropriate angulation. Conclusion: CBCT imaging is recommended for detecting dental implant malpositioning. The most common and severe type of malpositioning was buccal cortex perforation.

• 구강회복응용과학지
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• 제35권2호
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• pp.64-71
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• 2019

무치악 환자의 교합평면 수준을 결정할 때 후구치삼각융기는 흔하게 이용하는 해부학적 지표 중 하나로 연조직 덩어리이며 의치의 의해 피개 되어야 한다. 후구치삼각융기의 형태는 다양성을 보이며 이는 최후방 치아 발거에 따른 치유과정을 통해 형성되는 변화는 필연적이기 때문이다. 본 문헌고찰은 후구치삼각융기의 형태에 있어서 해부학적 관계와 임상적인 가치를 고려하고 형태적인 분류에 관해 고찰하고자 하였다.

• Journal of Korean Dental Science
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• 제14권2호
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• pp.101-109
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• 2021

Purpose: For minimally invasive procedures, three-dimensional (3D) anatomical knowledge of the structures of the face is essential. This study aimed to describe the thickness of the skin and subcutaneous tissue and depths of the facial muscles located in the infraorbital region using a 3D scanner to provide critical clinical anatomical guidelines for improving minimally invasive cosmetic procedures. Materials and Methods: The 3D scanning images of 38 Korean cadavers (22 males and 16 females; age range: 51~94 years at the time of death) were analyzed. Eight facial landmarks (P1~P8) were marked on the cadaveric faces. The images were scanned in three steps-undissected face, hemiface after skinning, and revealing the facial muscles. Student's t-test was used to identify significant differences. Result: The skin and subcutaneous tissue tended to become thicker from the upper to lower and medial to lateral aspects, and the muscles followed the same pattern as that of the most superficial located muscle and the deepest located muscles. No significant sex-related differences were found in the skin at any landmark. However, the muscles tended to be deeper in the female participants. Conclusion: The study data can serve as a basis for creating or enhancing clinical anatomy-based guidelines or improving procedures in the infraorbital region.

• 대한두개안면성형외과학회지
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• 제24권6호
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• pp.266-272
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• 2023

Background: In recent years, there has been an increase in reports of perioral vascular complications resulting from filler injections, such as necrosis of the lip or alar rim, occlusion, and in severe cases, blindness. Conversely, the use of perioral arterial flaps is becoming more prevalent in the treatment of cleft lips, cancer, and trauma. A thorough understanding of perioral arteries is essential to minimize complications and maximize the success of these flaps. However, the course of the facial artery (FA) in the perioral region remains incompletely understood. The aim of this study was to describe the variations of the FA in the perioral region. Methods: We dissected 52 embalmed and formaldehyde-fixed Vietnamese cadavers. We then studied the size and distribution of perioral arteries in 102 specimens. Results: The superior labial artery (SLA) was the most common branch, occurring in 87.25% of cadavers, followed by the inferior labial artery (ILA) at 78.43%. The SLA primarily originated above the mouth corner (cheilion), accounting for 91.01% of cases, and predominantly exhibited a tortuous course within the submucosa (78.65%). The ILA's branching pattern varied, but it was primarily located below the cheilion (91.25%). The ILA also followed a twisted path, generally within the submucosa. The ILA exhibited two patterns: the typical pattern, distributed at the vermilion border of the lower lip (8.82%), and the horizontal labiomental artery pattern, which ran horizontally in the middle of the lower lip area (69.61%). At their origin, the SLA and ILA had average external diameters of 1.29 mm and 1.28 mm, respectively. Conclusion: Numerous anatomical variations in the FA in the perioral region were found. A detailed anatomic description, suggested landmarks, and angiography before the procedure will be useful to help doctors avoid complications.

• Anatomy and Cell Biology
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• 제56권3호
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• pp.334-341
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• 2023

Anterior talofibular ligament (ATFL) injuries are the most common cause of ankle sprains. To ensure anatomically accurate surgery and ultrasound imaging of the ATFL, anatomical knowledge of the bony landmarks around the ATFL attachment to the distal fibula is required. The purpose of the present study was to anatomically investigate the ATFL attachment to the fibula with respect to bone morphology and attachment structures. First, we analyzed 36 feet using micro-computed tomography. After excluding 9 feet for deformities, the remaining 27 feet were used for chemically debrided bone analysis and macroscopic and histological observations. Ten feet of living specimens were observed using ultrasonography. We found that a bony ridge was present at the boundary between the attachments of the ATFL and calcaneofibular ligament (CFL) to the fibula. These two attachments could be distinguished based on a difference in fiber orientation. Histologically, the ATFL was attached to the anterodistal part of the fibula via fibrocartilage anterior to the bony ridge indicating the border with the CFL attachment. Using ultrasonography in living specimens, the bony ridge and hyperechoic fibrillar pattern of the ATFL could be visualized. We established that the bony ridge corresponded to the posterior margin of the ATFL attachment itself. The ridge was obvious, and the superior fibers of the ATFL have directly attached anteriorly to it. This bony ridge could become a valuable and easy-to-use landmark for ultrasound imaging of the ATFL attachment if combined with the identification of the fibrillar pattern of the ATFL.

• Imaging Science in Dentistry
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• 제34권1호
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• pp.13-18
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• 2004

Purpose : This study was to evaluate the influence of slice thickness of computed tomography (CT) and rapid protyping (RP) type on the accuracy of 3-dimensional medical model. Materials and Methods: Transaxial CT data of human dry skull were taken from multi-detector spiral CT. Slice thickness were 1, 2, 3 and 4 mm respectively. Three-dimensional image model reconstruction using 3-D visualization medical software (V-works /sup TM/ 3.0) and RP model fabrications were followed. 2-RP models were 3D printing (Z402, Z Corp., Burlington, USA) and Stereolithographic Apparatus model. Linear measurements of anatomical landmarks on dry skull, 3-D image model, and 2-RP models were done and compared according to slice thickness and RP model type. Results: There were relative error percentage in absolute value of 0.97, 1.98,3.83 between linear measurements of dry skull and image models of 1, 2, 3 mm slice thickness respectively. There was relative error percentage in absolute value of 0.79 between linear measurements of dry skull and SLA model. There was relative error difference in absolute value of 2.52 between linear measurements of dry skull and 3D printing model. Conclusion: These results indicated that 3-dimensional image model of thin slice thickness and stereolithographic RP model showed relative high accuracy.

• Imaging Science in Dentistry
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• 제32권1호
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• pp.27-33
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• 2002

Purpose: To evaluate the influence of threshold value of computed tomography on the accuracy of rapid prototyping (RP) medical model Material and Methods : CT datas of a human dry skull were transferred from CT scanner via compact disk to a personal computer (PC). 3-dimensional image reconstruction on PC by V-works/sup TM/ 3.0 (CyberMed. Inc.) software and RP models fabrication were followed. 2-RP models were produced by threshold value of 500 and 800 selected in surface rendering process. Linear measurements between arbitrary 12 anatomical landmarks on dry skull, 3-D image model, and 2-RP models were done and compared. Thus, the accuracy of 500 RP and 800RP models was respectively evaluated. Results: There was mean difference (% difference) in absolute value of 2.27 mm (2.73%) between linear measurements of dry skull and 500 RP model. There was mean difference (% difference) in absolute value of 1.94 mm (2.52%) between linear measurements of dry skull and 800 RP model. Conclusion: Slight difference of threshold value in rendering process of 3-D modelling made a influence on the accuracy of RP medical model.

• Archives of Reconstructive Microsurgery
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• 제22권2호
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• pp.43-47
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• 2013

Purpose: Un-healing and centrally located defect on back area, it is sometimes a challenge for the reconstructive surgeon. Although skin grafts are considered as the first choice for reconstruction of large skin defect on the back region, it is not always helpful but vascularized flaps provide a superior functional and aesthetic outcome. The present study was designed to investigate the clinical anatomy of the lumbar artery perforator flap to reconstruct back ulcer. Materials and Methods: Clinical anatomy study was undertaken using computed tomographic angiographic analysis. We identified the courses of lumbar arteries and its perforators, measured pedicle length by layers. The location of the perforator vessel was charted against anatomical landmarks. Results: The pedicle lengths of the third and fourth lumbar artery perforator reached a mean of 27.8 mm and 37.1 mm respectively from superficial fascia to deep fascia. The fourth perforator was more laterally located than the third perforator and less than 1 cm above the iliac crest. A case in which the fourth lumbar artery perforator was used as flap pedicle is described. Conclusion: For the reconstruction of central defect on the back area, the lumbar artery perforator flap coverage may be a good alternative option. Computed tomographic angiography can easily identify the course and location of lumbar artery perforators and can be helpful to elevate the flap successfully.

• Journal of Korean Neurosurgical Society
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• 제40권3호
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• pp.206-209
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• 2006

Objective : Traditionally, standard access to the posterior fossa was a suboccipital craniectomy. After introducing the technique and benefit of posterior fossa craniotomy, several surgeons have used this procedure to manage various pathologies in posterior fossa in children. Though this approach offers several advantages over conventional suboccipital craniectomy, the elevation of bone flap is not easy in adult because of the irregular contour of inner bone surface and tight adhesion of dura to the skull. The aim of this article is to describe the technical aspects of this approach and to delineate the important landmarks for a safe and quick performance in adult. Methods : We report on our series of twenty-five adult patients who underwent craniotomy for posterior fossa pathologies between 2002 and 2005. The maximal follow-up period was 4 years. Results : None of the patients complained of persistent headache and no CSF leaks have occurred postoperatively. We have encountered only two cases of transient subcutaneous CSF retention after craniotomy. Three-dimensional reconstruction of the CT scan confirmed the well-fitted suboccipital bone contour after craniotomy. And patients were satisfied with the cosmetic results. Conclusion : This method is safer and simpler. It restores normal anatomical planes and improves protection of the contents of the posterior fossa. The authors recommend craniotomy as an alternative method of access to the posterior fossa in all age groups.