Yanguk Heo;Miyoung Yang;Sung Min Nam;Hyun Seung Lee;Yeon-Dong Kim;Hyung-Sun Won
The Korean Journal of Pain
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v.37
no.2
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pp.132-140
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2024
Background: This study aimed to identify exact anatomical landmarks and ideal injection volumes for safe adductor canal blocks (ACB). Methods: Fifty thighs from 25 embalmed adult Korean cadavers were used. The measurement baseline was the line connecting the anterior superior iliac spine (ASIS) to the midpoint of the patellar base. All target points were measured perpendicular to the baseline. The relevant cadaveric structures were observed using ultrasound (US) and confirmed in living individuals. US-guided dye injection was performed to determine the ideal volume. Results: The apex of the femoral triangle was 25.3 ± 2.2 cm distal to the ASIS on the baseline and 5.3 ± 1.0 cm perpendicular to that point. The midpoint of the superior border of the vasto-adductor membrane (VAM) was 27.4 ± 2.0 cm distal to the ASIS on the baseline and 5.0 ± 1.1 cm perpendicular to that point. The VAM had a trapezoidal shape and was connected as an aponeurosis between the medial edge of the vastus medialis muscle and lateral edge of the adductor magnus muscle. The nerve to the vastus medialis penetrated the muscle proximal to the superior border of the VAM in 70% of specimens. The VAM appeared on US as a hyperechoic area connecting the vastus medialis and adductor magnus muscles between the sartorius muscle and femoral artery. Conclusions: Confirming the crucial landmark, the VAM, is beneficial when performing ACB. It is advisable to insert the needle obliquely below the superior VAM border, and a 5 mL injection is considered sufficient.
Purpose: The harvest of hamstring tendon is technically demanding because of the inadequate identification of hamstring tendon separation and accessory tendon of semitendinosus tendon. We conducted therefore conducted an anatomic study, aiming at the anatomic knowledge for graft harvest. Materials and Methods: 20 human cadaveric knees (10 cadavers) were used for the study. The location of tendon separation in conjoined tendon and accessory tendon of semitendinosus tendon were described and recorded. Results: The location of tendon separation of conjoined tendon was average $39.68{\pm}9.97mm$ vertically and $18.57{\pm}2.91mm$ horizontally from the tibial spine. We found that the accessory structure of the semitendinosus tendon was mostly fascia-like structure(17 knees), the tendinous structure, 3 cases which was straightly located 15cm from the tibial crest. Conclusion: We propose that the expected incision for hamstring tendon harvest is centered on the inferior 40mm, medial 20mm from the tibial spine. The accessory structure of the semitendinosus tendon was mostly found of fascia-like structure.
Journal of the Korea Academia-Industrial cooperation Society
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v.16
no.1
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pp.585-592
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2015
The objective of this study is to determine if when chymopapain is loaded onto a nano-carrier, an injection of it reduces the spreading range of the drug within the discs. The materials for the experiment, which were conducted for three weeks, included fifteen intervertebral discs taken from two cadavers, which were divided according to the types of injected chymopapain solutions as follows: ordinary chymopapain group and nano-carrier system group. The nano-carrier system group was again divided into two subgroups according to the types of pluronics, the basic material for the nano-carriers: Pluronic F 127(DA-PF 127) in the nano-carrier group and Pluronic F 68(DA-PF 68) in the nano-carrier group. The results showed that the action of chymopapain using a pluronic-based nano-carrier system was localized around the center of the injection site instead of broad spreading, compared to that of the ordinary chymopapain group (p<0.01). This characteristic suggests a possible application to effective agents for minimally invasive spinal treatment through which disc lesions were removed selectively.
Kim, Jun Sik;Shin, Sang Ho;Choi, Tae Hyun;Lee, Kyung Suk;Kim, Nam Gyun
Archives of Plastic Surgery
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v.33
no.6
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pp.695-699
/
2006
Purpose: In the 1990s, skin island flap supplied by the vascular axis of the sensitive superficial nerves had been introduced. For example, neurocutaneous flaps supplied by the vascular axis of the sural nerve and saphenous nerve have been used. But the flap supplied by the vascular axis of superficial peroneal nerve has not been used commonly. Because there have been few anatomical reports about the superficial peroneal nerve accessory artery(SPNAA), we could not apply the neurocutaneous flap supplied by SPNAA. The aim of this study is to investigate the anatomy of SPNAA, number and location of its perforators, and septocutaneous perforators from the anterior tibial artery in anterior intermuscular septum. Methods: So, we dissected a total of eight cadavers. Measurements were made of the positions of the dissected arteries and perforators from the head of the fibula. Results: In all cadavers the superior lateral peroneal artery was originated from the anterior tibial artery and contributed SPNAA. Arising from the anterior tibial artery an average of 5.63 cm inferior to the fibular head, it varied from 10 cm to 16 cm in length. SPNAA gave off an average of 4.38 perforators to supply lateral aspect. In one case the inferior lateral peroneal artery was present and arose from the anterior tibial artery 18 cm inferior to the fibular head. There were an average of 3.38 direct septocutaneous perforators from the anterior tibial artery. Conclusion: Septocutaneous perforators from SPNAA mainly exist from proximal 1/6 to 3/5 of lower leg. In the distal 1/3 of lower leg where the accessory artery was disappeared, exist mainly direct septocutaneous perforators from the anterior tibial artery. Our results can be helpful to applications of the neurocutaneous flap using SPNAA or fasciocutaneous flap based on direct septocutaneous perforators.
The intervertebral foramen is formed by two adjacent vertebrae and an intervertebral disc. Previous studies examining the foramen have been performed using various methods. The author obtained characteristics of the intervertebral foramen based on silicon mold. The author used 18 cadavers and dissected the lumbar intervertebral foramen. First, positional levels of the spinal nerve in the intervertebral foramen were measured. Second, after being removed all tissues covering the intervertebral, bony foramen was filled with melted silicon to mold the cross section. Subsequently, the solidified silicon mold was removed and stamped on a paper. The paper was scanned and analyzed area, perimeter, height and width of the intervertebral foramen on a computer. Area (average, $9.43mm^2$) and perimeter (average, 48.02 mm) did not show any statistical significant pattern for any lumbar vertebral levels. However, the height and width significantly differed at the fifth lumbar vertebra, which had the shortest height (the fifth, 13.00 mm; average, 15.78 mm) and longest width (the fifth, 8.61 mm; average, 7.87 mm), although there were similar patterns in case of area and perimeter of the first to fourth lumbar vertebra. Height had a decrease tendency while width had an increase tendency both from the second to fifth lumbar vertebra. Spinal nerves went through near the intervertebral disc level from the first to fourth lumbar vertebra, although they passed below the disc at the fifth level. This study provides a different view of methodology for the 3-dimensional aspect for the intervertebral foramen. Results of this study may indicate that height and width of the intervertebral foramen changed along all lumbar vertebral levels; nevertheless, area and perimeter of the intervertebral foramen remained constant.
Purpose : We aim to identify the clinical and demographic characteristics in children who underwent renal transplantation(RTx) and to evaluate the influence on growth of RTx in children. Methods : We reviewed 17 medical records of chronic renal failure patients who underwent RTx from April 1992 and June 2004 at Busan Paik Hospital. Age and sex distribution, cause of disease, donor analysis, patient and graft survival rate, and the status of growth after RTx were analysed by retrospective study. Results : Eighteen RTx were performed in 17 patients(8 boys, 9 girls). The mean age at the time of RTx was $15.8{\pm}3.5$ years and the mean duration of dialysis therapy before RTx was $22.4{\pm}18.0$ months. The 1 year and 5 year patient survival rate were each 100%, and the 1 year and 5 year graft survival rate were 88%, 36% respectively. The most common cause of graft failure was chronic rejection. The mean final height of male patients was $162.8{\pm}10.0$ cm(143.0-172.5 cm) and of female patients was $154.5{\pm}12.1$ cm(135.8-160.0 cm). The mean height standard deviation score(Ht SDS) increased after RTx from -1.95 to -1.53 but the increment rate was not statistically significant. Similar changes were noted in individual patient analysis. Also there was no significant difference between the living-related donors and cadaveric donors. Conclusion : Our data shows that even successful RTx rarely results in full growth rehabilitation. To overcome retarded growth in children with chronic renal failure, appropriate combined management of metabolic and nutritional problems, correction of anemia, proper use of recombinant growth hormone therapy, early renal transplantation and shortening of the duration of dialysis would be necessary.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.33
no.4
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pp.307-311
/
2007
Purpose: The aim of this study was simply assessing linear measurements in the lateral and medial approach, respectively, for bone harvesting using anatomic and three-dimensional(3D) computed tomographic(CT) analyses on a dried cadaveric proximal tibia. In addition, the availability of the three-dimensional computed tomographic(3D-CT) analysis was also estimated. Materials and methods: Ten dried proximal tibia were obtained from five Korean cadavers. Four the reference points, the SM(superior-medial), IM(inferior-medial), SL(superior-lateral), and IL(inferior-lateral) were marked around the tibial tuberosity. The PM(posterior-medial) and PL(posterior-lateral) points were randomly marked at points farthest from the lateral and medial reference points, respectively, in the posterior border of the superior articular surface of both condyles. All measurements were obtained on the dried proximal tibia. After computed tomography had been performed, the three dimensional images were reconstructed using V works $4.0^{TM}$(Cybermed Inc., Seoul, Korea), and the length between the reference points were measured three dimensionally using the method described above. The error between the mean actual and mean 3D-CT measurements was calculated in order to determine the availability of the three dimensional computed tomographic analysis. Results: The length between the reference points was greatest at the IL-PM, which averaged $65.39mm{\pm}10.35$. This was followed by the SL-PM with $63.24mm{\pm}8.10$, the IM-PL with $58.09mm{\pm}10.02$, and the SM-PL with $51.99mm{\pm}9.06$. The differences between the IL-PM and SM-PL were 13.4 mm. The mean values were 55.04 mm in the medial approach and 64.32 mm in the lateral approach, and the differences between medial and lateral were 9.28 mm. The error between the mean actual and mean 3D-CT measurements was 0.31% and the standard deviation was 0.28%. Conclusion: The anatomical and three dimensional computed tomographic analysis indicates that there was only a 9.28 mm linear difference between the lateral and medial approach. This is consistent with previous studies, which showed that there was little difference between the two approaches in terms of the bone volume. In addition, the error(0.31%) and the standard deviation(0.28%) were considered low, demonstrating high accuracy of 3D-CT. Therefore it can be used in preoperative treatment planning.
Kim, Jooho;Heo, SuYoung;Na, Jiyoung;Kim, Namsoo;Lee, Kichang;Jeong, Seongmok;Lee, HaeBeom
Journal of Veterinary Clinics
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v.32
no.6
/
pp.481-485
/
2015
The present study determined the normal reference ranges for overall pelvic limb alignment of small-breed dogs. For this purpose, 60 cadaveric canine pelvic limbs from normal small-breed dogs (Maltese, Poodle, Shih Tzu, Yorkshire Terrier). A frontal full-limb radiograph of each pelvic limb was obtained, and mechanical tibiofemoral angle (mTFA), mechanical metatarsotibial angle (mMTTA), mechanical axis-femur angle (MAFA), and mechanical axis-metatarsus angle (MAMTA) were measured from each radiograph, along with mechanical deviation of the stifle (SMAD) and tarsal joints (TMAD). The 95% CI for radiographic values of all pelvic limbs were mTFA, 5.7-7.4; mMTTA, $-2.2--0.8^{\circ}$; MAFA, $3.5-4.5^{\circ}$; MAMTA, 1.0-2.0; SMAD, 2.1-2.7%; TMAD, 0.5-1.0%. There values varied among the breeds, except for mTFA. The reference ranges can be used for diagnosing pelvic limb deformities in small-breed dogs and for planning corrective osteotomies.
In the event of an outbreak of a livestock epidemic, it has been considered that the existing burial-centered carcass disposal method should be improved ecofriendly for prevention of leachate and odors from burial basically in regard of pathogen inactivation. Therefore, the aim of this study is whether it was possible to treat the carcass of cattle and chickens using the chemical carcass treatment method. It was conducted to establish detailed treatment standards for the chemical treatment method of cattle and chicken carcasses based on the results of the proof of the absence of infectious diseases in cattle chickens. After inoculating cattle carcass with 10 pathogens (foot and mouth disease virus, bovine viral diarrhea virus, Mycobacterium bovis, Mycobacterium avium subsp. Paratuberculosis, Brucella abortus, Bacillus anthracis, Clostridium chauvoei, Clostridium perfringens, Escherichia coli, and Salmonella Typhimurium) and chicken carcasses with low pathogenic avian influenza virus, Clostridium perfringens type C, E. coli and Salmonella Typhimurium, these were treated at 90℃ for 5 hours in a potassium hydroxide liquid solution corresponding to 15% of the body weight. This method liquefies all cadaveric components and inactivates all inoculated pathogens by PCR and culture. Based on these results, it was possible to prove that chemical treatment of cattle and chicken carcasses is effective in killing pathogens and is a safe method without the risk of disease transmission. The chemical treatment method of livestock carcasses can be suggested as an alternative to the current domestic burial-centered livestock carcass treatment method, preventing environmental pollution, and contributing to public health.
Objective : The intralaminar screw (ILS) fixation technique offers an alternative to pedicle screw (PS) and lateral mass screw (LMS) fixation in the C7 spine. Although cadaveric studies have described the anatomy of the pedicles, laminae, and lateral masses at C7, 3-dimensional computed tomography (CT) imaging is the modality of choice for pre-surgical planning. In this study, the goal was to determine the anatomical parameter and optimal screw trajectory for ILS placement at C7, and to compare this information to PS and LMS placement in the C7 spine as determined by CT evaluation. Methods : A total of 120 patients (60 men and 60 women) with an average age of $51.7{\pm}13.6$ years were selected by retrospective review of a trauma registry database over a 2-year period. Patients were included in the study if they were older than 15 years of age, had standardized axial bone-window CT imaging at C7, and had no evidence of spinal trauma. For each lamina and pedicle, width (outer cortical and inner cancellous), maximal screw length, and optimal screw trajectory were measured, and the maximal screw length of the lateral mass were measured using m-view 5.4 software. Statistical analysis was performed using Student's t-test. Results : At C7, the maximal PS length was significantly greater than the ILS and LMS length (PS, $33.9{\pm}3.1$ mm; ILS, $30.8{\pm}3.1$ mm; LMS, $10.6{\pm}1.3$; p<0.01). When the outer cortical and inner cancellous width was compared between the pedicle and lamina, the mean pedicle outer cortical width at C7 was wider than the lamina by an average of 0.6 mm (pedicle, $6.8{\pm}1.2$ mm; lamina, $6.2{\pm}1.2$ mm; p<0.01). At C7, 95.8% of the laminae measured accepted a 4.0-mm screw with a 1.0 mm of clearance, compared with 99.2% of pedicle. Of the laminae measured, 99.2% accepted a 3.5-mm screw with a 1.0 mm clearance, compared with 100% of the pedicle. When the outer cortical and inner cancellous height was compared between pedicle and lamina, the mean lamina outer cortical height at C7 was wider than the pedicle by an average of 9.9 mm (lamina, $18.6{\pm}2.0$ mm; pedicle, $8.7{\pm}1.3$ mm; p<0.01). The ideal screw trajectory at C7 was also measured ($47.8{\pm}4.8^{\circ}$ for ILS and $35.1{\pm}8.1^{\circ}$ for PS). Conclusion : Although pedicle screw fixation is the most ideal instrumentation method for C7 fixation with respect to length and cortical diameter, anatomical aspect of C7 lamina is affordable to place screw. Therefore, the C7 intralaminar screw could be an alternative fixation technique with few anatomic limitations in the cases when C7 pedicle screw fixation is not favorable. However, anatomical variations in the length and width must be considered when placing an intralaminar or pedicle screw at C7.
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