• Archives of Plastic Surgery
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• 제33권6호
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• pp.715-722
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• 2006

Purpose: The main advantages of the perforator flap are minimal donor site morbidity, preservation of any main source artery and its thin characteristics. Most perforator flaps for hand reconstruction need primary and secondary procedures such as a flap debulkiness and liposuction etc. However, flap thickness of calf area is thinner than any other perforator flaps. Methods: We performed an anatomical study and clinical application of medial sural artery perforator flap. We found that there are two or more medial sural perforators located on a straight line drawn from the mid-point of popliteal crease to the mid-point of medial malleolus. Most pathway of medial sural artery comes along with this line. It is possible to observe the first perforators almost exactly 8 cm from midpoint of popliteal crease in a distal half circle drawn with a radius of 2 cm. Results: We report 12 cases in 11 patients of hand reconstruction with medial sural perforator free flap from Febrary 2003 to Febrary 2006. Complete healing was possible in 11 cases. Total flap loss for venous insufficiency was in 1 patient. During the follow-up, good contour and full range of motion was observed on hand reconstruction with medial sural perforator free flap. Conclusion: In the authors' experience, this anatomical study made it possible to prepare a diagram of the exact location of the medial sural perforators. This flap can be used to achieve acceptable functional and aesthetic results for hand reconstruction because of its thin characteristics.

• Journal of Oral Medicine and Pain
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• 제45권4호
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• pp.97-109
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• 2020

Purpose: Cervicogenic headache (CGH) is pain referred to the head/ face from the structures in vicinity of upper cervical spinal nerves via trigeminocervical pathway. Ponticulus Posticus (PP) and Elongated Styloid Process (ESP) are anatomical structures that cause compression of vasculature present around upper cervical nerve plexus. Recently, computational fluid dynamics (CFD) has shown to play an essential role in identification of these high-pressure zones in the brain. The aim of this research is to study the association of ESP and PP in patients with CGH and to develop a hypothesis by CFD to analyse vertebrobasilar insufficiency as a contributing factor in occurrence of CGH. Methods: Retrospective analysis of 4500 full skull CBCT scans was done for the presence of partial or complete PP and length of Styloid Process (SP). Research was divided into two phases; In first Preliminary Phase, 150 scans that showed the presence of PP and ESP were analysed, and only 134 patients gave consent to fill the questionnaire containing 96 question items pertaining to symptoms associated with CGH. In the second phase, simulation of Vertebral and Carotid Artery was done using Fluent 14.5 Software and by CFD, pressure distribution on arteries was obtained that helped to identify high pressure regions. Results: Both PP and ESP showed a statistically significant association with CGH (p<0.001). By CFD analysis, both steady and transient phases of simulation showed drop in pressure due to constriction of internal carotid and vertebral artery by ESP and PP respectively and were found to decrease the volume of blood reaching the brain, 0.12 /0.13 mL and 0.06 mL respectively. Conclusions: Our analysis proves ESP and PP as contributing factors towards CGH. Hence for proper diagnosis and management of headache disorders, clinicians should have adequate knowledge about these anatomical structures and their resulting clinical symptoms.

• Physical Therapy Rehabilitation Science
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• 제12권3호
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• pp.207-213
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• 2023

Objective: The purpose of this study was to understand the complex anatomical structure and function of the midbrain to better understand the patient's symptoms and plan effective treatment including pharmacological and rehabilitation interventions. Design: A single case study Methods: A 17-year-old girl presented with acute onset of drowsiness, gait disturbance, mutism, and ptosis. Physical examination revealed postural instability, rigidity of all limbs, and limitations in extraocular movement. The brain MRI revealed an isolated acute infarction in the bilateral midbrain. Considering the location of the infarction, the presenting symptoms were the result of an impairment of the dopaminergic pathway in addition to lesions in the nuclei of the oculomotor nerve. Levodopa/carbidopa was prescribed. And the intensive and comprehensive rehabilitation program was done. Results: As a result of the study, through comprehensive intervention, which encompassed assessments such as the manual muscle test, Korean Modified Barthel Index score, and Trail-making test, significant enhancements in the patient's condition were observed. These findings provide evidence supporting the effectiveness of the intervention in promoting the patient's physical functioning and overall well-being. Conclusions: The results of this case highlight the significance of comprehending the intricate anatomical structure and functional aspects of the midbrain, which led us to approach appropriate pharmacological and rehabilitation interventions. Through active communication among the medical team, we were able to establish a therapeutic plan, which demonstrated that effective treatment can be achieved.

• 대한치과보철학회지
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• 제27권1호
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• pp.55-81
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• 1989

Recently the instantaneous center concept has been to understand the biomechanics by which a tissue derangement causes a mechanical derangement in human joint. Therefore, to understand the biomechanics of temporomandibular joint (T.M.J.) as a part of human joint, it is necessary to clarify the instantaneous center of rotation (I.C.R.) in the mandibular movement. Twenty male subjects without T.M.J. disorder and mandibular deviation during the mandibular movement were selected for this study. The habitual opening and closing paths were recorded on the paper of the sagittal metal plate by two pencil markers connected to the resin open clutch attached on the lower teeth, which was designed for this study. The coordinates of the 33-target points and the 109-anatomical landmarks were obtained using a Summagraphic digitizer connected to a 18AT computer. The original raw data of the opening and closing paths were smoothed by B-spline curve fitting technique and then the I.C.R. pathways were determined mathematically by the computer using algorithm for finding the I.C.R. of a planer rigid body model. Also the opening and closing movements of the mandible were simulated according to the determined I.C.R. The results obtained from this study were as follows. 1. At the early opening and the last closing, I.C.R's were almost distributed around the mastoid process outside the mandibular body without the presence in the region of the mandibular condyle. 2. The I.C.R. pathway showed variable patterns to each subject at the opening and closing movements. 3. The K constant with uniform pattern was obtained by the rotation angle times the radius, which was assumed to the index of the mandibular movement. 4. The opening and closing movements of the mandible were simulated by the I.C.R. pathways at the habitual opening and closing movements. 5. The mandibular condyle was rotated or translated accordng to the relative rotation angle and radius of the determinant factors of K contant.

• 대한약침학회지
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• 제24권2호
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• pp.68-75
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• 2021

Objectives: The hair follicle is composed of more than 20 kinds of cells, and mesoderm derived dermal papilla cells and keratinocytes cooperatively contribute hair growth via Wnt/β-catenin signaling pathway. We are to investigate β-catenin expression and regulatory mechanism by CBD in alopecia hair tissues and dermal papilla cells. Methods: We performed structural and anatomical analyses on alopecia patients derived hair tissues using microscopes. Pharmacological effect of CBD was evaluated by β-catenin expression using RT-PCR and immunostaining experiment. Results: Morphological deformation and loss of cell numbers in hair shaft were observed in alopecia hair tissues. IHC experiment showed that loss of β-catenin expression was shown in inner shaft of the alopecia hair tissues, indicating that β-catenin expression is a key regulatory function during alopecia progression. Consistently, β-catenin expression was decreased in testosterone or PMA treated dermal papilla cells, suggesting that those treatments are referred as a model on molecular mechanism of alopecia using dermal papilla cells. RT-PCR and immunostaining experiments showed that β-catenin expression was decreased in RNA level, as well as decreased β-catenin protein might be resulted from ubiquitination. However, CBD treatment has no changes in gene expression including β-catenin, but the decreased β-catenin expression by testosterone or PMA was restored by CBD pretreatment, suggesting that potential regulatory effect on alopecia induction of testosterone and PMA. Conclusion: CBD might have a modulating function on alopecia caused by hormonal or excess of signaling pathway, and be a promising application for on alopecia treatment.

• 대한한의학원전학회지
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• 제25권2호
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• pp.43-74
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• 2012

Objective : Due to the tendency of researchers to avoid anatomical approach to East Asian medical classics, their ideas on seminal pathways have not been clearly reconstructed yet. So we tried to concretely reconstruct the pathway of semen described in ancient East Asian classics. Methods : Besides analysing the literal description about seminal pathways, we gathered and classified the ancient Viscera Drawings drawn in East Asian countries - especially the drawings in lateral view, and morphologically analysed them with some literal material. Results : We found that there were 3 major streams in the ancient Asian ideas on the seminal pathways. The first one was the modality originated from Hwangjenaegyeong(黃帝內經), which suggested the semen flew out of the kidney. The second one was the modality arose under the influence of Taoist thinking, which suggested the semen was originated from the brain and spinal cord. The last one was revision of the first modality by Janggaebin(張介賓), which asserted semen was originated from the kidney, but was ejaculated via Myeongmun(命門). Conclusion : On the seminal pathways, there had been 2 types of ideas focussing on kidney and one idea focussing on brain and spinal cord in East Asian tradition.

• 대한한의학회지
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• 제36권4호
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• pp.69-73
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• 2015

Objectives: This study was carried out to analyse the skin of the Hand lesser yang in human. Methods: The Hand lesser yang meridian was labeled with latex in the body surface of the cadaver, subsequently dissecting a body among superficial fascia and muscular layer in order to observe internal structures. Results: This study has come to the conclusion that a depth of the skin has encompassed a common integument and a immediately below superficial fascia, and this study established the skin boundary with adjacent structures such as relative muscle, tendon as compass. The skin area of the Hand lesser yang in human is as follows: The skin close to the ulnar root angle of 4th finger nail, above between 4th and 5th metacarpal bone, between extensor digit. minimi tendon(t.) and extensor digit. t., extensor digit. m(muscle). at 2, 4, 7 cun above dorsal carpal striation, triceps brachii m. t., deltoid m., trapezius m., just around the ear, upper orbicularis oculi m. Conclusions: The skin area of the Hand lesser yang from anatomical viewpoint seems to be the skin area outside the superficial fascia or the muscle involved in the pathway of the Hand lesser yang meridian, the collateral meridian, the meridian muscle, with the condition that we consider adjacent skins.

• The Korean Journal of Physiology and Pharmacology
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• 제6권4호
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• pp.193-197
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• 2002

In spite of abundant anatomical evidences for the fiber connection between vestibular nuclei and inferior olivary (IO) complex, the transmission of vestibular information through the vestibulo- olivo-cerebellar climbing fiber pathway has not been physiologically established. The aims of the present study were to investigate whether there are IO neurons specifically responding to horizontal rotation and also in which subregions of IO complex these vestibularly-activated neurons are located. The extracellular recording was made in 68 IO neurons and responses of 46 vestibularly-activated cells were analyzed. Most of the vestibularly-activated IO neurons responded to signals of vertical rotation (roll), while a small number (13/46) of recorded cells were activated by horizontal canal signal (yaw). Regardless of yaw-sensitive or roll-sensitive, vestibular IO neurons were excited, when the animal was rotated to the side contralateral to the recording side. The gain and excitation phase were very similar to otolithic or vertical-canal responses. Histologic identification of recording sites showed that most of vestibular IO neurons were located in ${\beta}$ subnucleus. Electrical stimulation of a HSC evoked an inhibitory effect on the excitability of the ipsilateral IO neurons. These results suggest that IO neurons mainly in the ${\beta}$ subnucleus receive vestibular signals from semicircular canals and otolithic organs, encode them, and transmit vestibular information to the cerebellum.

• The Korean Journal of Physiology
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• 제4권2호
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• pp.19-24
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• 1970

Since the discovery of the muscle spindle by Hassall (1831), an intensive studies of its anatomical and physiological characteristics had been undertaken. Recent morphological studies of Boyd (1962) demonstrated that the muscle spindles have two different intrafusal muscle fibers, nuclear bag and nuclear chain fiber, and these intrafusal fibers are under independent motor innervation by ${\gamma}_1$ and ${\gamma}_2$ motor neurone. Neurophysiological studies of Hunt and Kuffler (1951) showed regulatory effect of ${\gamma}$ motor neurone upon the excitability of the spindle afferents. Harvey and Mathews (1961) observed the dynamic and static characteristics of the two different spindle afferents, the primary and secondary ending. Furthermore, Mathews (1962) postulated the functional existance of two kind of ${\gamma}$ motor neurones, namely, the dynamic and static fusimotor fiber. Recent report of Kim and Partridge(1969) pointed out that the descending vestibular signals had increased the slope of the length-tension relationship in stretch reflex; Kim (1967) demonstrated that the descending vestibular impulses act upon the stretch reflex loop through the ${\gamma}$ motor pathway. These experimental evidences from the morphological and neurophysiological studies on the muscle spindles support the concept that the stretch reflex action of the skeletal muscle operates as a negative feedback control system. The author had discussed the way by which the f system participates in the control of stretch relfex feed back system. that was taken for a prototype of posture and movement.

• 한국임상수의학회지
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• 제34권5호
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• pp.347-352
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• 2017

Pain, an adaptive but unpleasant sensation, is the most common symptom of numerous diseases in humans and animals. Although animal patients express this symptom frequently, a lack of communication abilities hinders its recognition by veterinary physicians, thereby leading to unsatisfactory management of the symptom. On the other hand, pain itself has its own neurological mechanisms, regardless of the disease that causes it. Thus, a physician may need to know the mechanisms underlying pain development in order to properly manage the symptom in a particular disease. In this review, we attempt to provide a brief introduction to the anatomical, physiological, and neurological basis of pain transmission and sensation. Although most knowledge about these mechanisms comes from studies in humans and laboratory animals, it is generally applicable to pet, farm, or zoo animals. In addition, we summarize pain behavior in several pet, farm, and laboratory animals for its proper identification. This information will help to identify and manage pain, and thus improve welfare, in animals.