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1.
Medicina (Kaunas) ; 60(5)2024 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-38792872

RESUMO

Background and Objectives: The interspace between the popliteal artery and the posterior capsule of the knee (iPACK) block has been widely used in perioperative settings to control posterior knee pain and can additionally be used for chronic knee pain. In this cadaveric study, we aimed to investigate the needle tip position and its proximity to the articular branch of the tibial nerve (ABTN) during an iPACK-targeted radiofrequency procedure. Materials and Methods: An ultrasound-guided iPACK block was performed on 20 knees of 10 cadavers. We injected 0.1 mL each of blue and green gelatinous dye near the tibial artery (point A) and posterior knee capsule (point B), respectively, and evaluated the spread of both around the ABTN. For a hypothetical conventional radiofrequency ablation (RFA) lesion (diameter, 2.95 mm) and cooled RFA lesion (diameter, 4.9 mm), we counted the number of specimens in which the ABTNs would be captured. Results: The percentage of specimens in which the ABTN would be captured by a cooled RFA lesion was 64.71% at point A and 43.75% at point B (p = 0.334). Meanwhile, the percentage of specimens in which the ABTN would be captured by a conventional RFA lesion was 58.82% from point A and 25% from point B (p = 0.065). Conclusions: When performing an RFA-based iPACK block, the needle tip may be positioned either lateral to the tibial artery or in the space between the posterior knee capsule and the tibial artery. However, more studies with larger samples are needed to verify these results before the clinical use of this procedure can be recommended.


Assuntos
Cadáver , Artéria Poplítea , Ablação por Radiofrequência , Humanos , Artéria Poplítea/cirurgia , Ablação por Radiofrequência/métodos , Feminino , Masculino , Bloqueio Nervoso/métodos , Agulhas , Idoso , Articulação do Joelho/cirurgia , Idoso de 80 Anos ou mais , Nervo Tibial , Ultrassonografia de Intervenção/métodos
2.
Anesth Analg ; 136(3): 597-604, 2023 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-36727847

RESUMO

BACKGROUND: The pericapsular nerve group (PENG) block was recently suggested as a regional technique for managing acute pain after hip surgery. However, few anatomical studies have confirmed the spread of injectate during the PENG block. This cadaver study aimed to analyze injectate spread to the target nerves during single-injection ultrasound-guided PENG block. METHODS: Ultrasound-guided PENG block with 3 different injectate volumes (10, 20, or 30 mL) was performed in 18 cadavers. Injectate spread by the volume was first evaluated on computed tomography, followed by cadaver dissection. The spread of the dye over the pelvis and lower limb was evaluated. RESULTS: The articular branches of the femoral nerve were stained nearly sufficiently with 20- and 30-mL specimens. The femoral nerve itself was stained simultaneously in six of 12 (50%) 20-mL specimens and 12 of 12 (100%) 30-mL specimens. The accessory obturator nerve was observed only in three (9%) of 36 specimens. The articular branches of the obturator nerve were rarely affected, regardless of injectate volume (1/12, 10 mL specimens; 2/12, 20 mL specimens; 1/12, 30 mL specimens; P > .999). Rather, the obturator nerve was affected. However, the obturator nerve was not stained consistently even with 30 mL of injectate (50%). CONCLUSIONS: After combining the dissection and radiological findings, the single-injection ultrasound-guided PENG blocks with volumes of 10, 20, and 30 mL do not support motor sparing or selective anterior hip capsule innervation in a clinical setting. If early rehabilitation is needed, high-volume PENG block might not be the ideal option, and persisting pain after PENG block might be attributed in part to the lack of obturator nerve articular branches blockade.


Assuntos
Nervo Femoral , Bloqueio Nervoso , Humanos , Ultrassonografia de Intervenção/métodos , Bloqueio Nervoso/efeitos adversos , Bloqueio Nervoso/métodos , Nervo Obturador/diagnóstico por imagem , Cadáver
3.
Clin Anat ; 34(4): 624-633, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-32889737

RESUMO

BACKGROUND: The purpose of this study is to analyze and classify morphological features of the nasolacrimal duct (NLD) through 3D reconstruction to help understand the causes and treatment of NLD obstruction. METHODS: In this study, we included 63 males and 55 females who underwent autopsy without NLD obstruction with ages ranging from 20 to 78 years. The NLD was defined from the lacrimal fossa to the opening of the BNLD to the inferior meatus, and all continuous CT images showing the NLD were selected. Segmentation was performed semi-automatically, and the reconstruction and measurement of NLD was performed using the Mimics program. RESULTS: Overall NLD length, bony nasolacrimal duct (BNLD) length, anteroposterior and transverse diameters at the entrance to the BNLD, anteroposterior and transverse smallest diameters of the BNLD, BNLD volume, and lacrimal sac BNLD angle were significantly higher in males than females (p < .05). BNLD direction in the coronal plane was slightly more likely to be inward. The most common type in both sexes was cylinder type (42.0%), males were more likely to have lower-thicker types (34.1%), and females more likely to have upper-thicker types (22.7%). CONCLUSION: There were sex differences in NLD measurements, and females had significantly smaller NLDs. These results may partially explain the increased prevalence of primary acquired NLD obstruction in females. The BNLD tends toward the midline, and inclines posteriorly.


Assuntos
Imageamento Tridimensional , Ducto Nasolacrimal/anatomia & histologia , Ducto Nasolacrimal/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adulto , Idoso , Cadáver , Dacriocistorinostomia , Feminino , Humanos , Obstrução dos Ductos Lacrimais/terapia , Masculino , Pessoa de Meia-Idade , Adulto Jovem
4.
Surg Radiol Anat ; 42(5): 617-626, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31960087

RESUMO

PURPOSE: The purpose of this study was to evaluate age-related changes of orbital rim in Koreans and construct a reference data set for the aging phenomenon in Asians. METHODS: Data were collected from computed tomography (CT) scans of orbits and facial bones obtained from 107 Korean (55 males and 52 females) at intervals of 0.60 mm. Subjects was categorized according to sex and age as follows: young group (20-35 years) and old group (60 years and above). CT scans were reconstructed via three-dimensional (3D) modeling programs. The most lateral, medial, superior and inferior points of orbital rim were used as reference points. The orbital aperture area in each 3D model was measured using an analytical software program such as 3-Matic. RESULTS: The orbital aperture height showed no overall statistically significant difference (P > 0.05) with age in either sex. Changes were irregular with a combination of decrease and increased components. The mean change did not exceed about 0.1 mm. The orbital aperture area showed no significant change with increasing age in either male or female study populations. CONCLUSIONS: In this study, there was no significant enlargement of the orbital rim with increasing age in Koreans. The measurement data in the present study differ from previous studies involving White subjects, which revealed a significant increase in orbital aperture area.


Assuntos
Envelhecimento/fisiologia , Povo Asiático , Órbita/anatomia & histologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Conjuntos de Dados como Assunto , Feminino , Humanos , Imageamento Tridimensional , Masculino , Pessoa de Meia-Idade , Órbita/diagnóstico por imagem , Órbita/fisiologia , Valores de Referência , República da Coreia , Tomografia Computadorizada por Raios X , População Branca , Adulto Jovem
6.
Clin Anat ; 32(1): 137-142, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29770497

RESUMO

One branch of the radial nerve to the medial head of the triceps brachii muscle (MHN) has been described as accompanying or joining the ulnar nerve. Mostly two MHN branches have been reported, with some reports of one; however, the topographical anatomy is not well documented. We dissected 52 upper limbs from adult cadavers and found one, two, and three MHN branches in 9.6%, 80.8%, and 9.6% of cases, respectively. The MHN accompanying the ulnar nerve was always the superior MHN. The relationship between the ulnar nerve and the MHN was classified into four types according to whether the MHN was enveloped along with the ulnar nerve in the connective tissue sheath and whether it was in contact with the ulnar nerve. It contacted the ulnar nerve in 75.0% of cases and accompanied it over a mean distance of 73.6 mm (range 36-116 mm). In all cases in which the connective tissue sheath enveloped the branch of the MHN and the ulnar nerve, removing the sheath confirmed that the MHN branch originated from the radial nerve. The detailed findings and anatomical measurements of the MHN in this study will help in identifying its branches during surgical procedures. Clin. Anat. 00:1-16, 2018. © 2018 Wiley Periodicals, Inc.


Assuntos
Nervo Radial/anatomia & histologia , Nervo Ulnar/anatomia & histologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/inervação
7.
Int Urogynecol J ; 27(2): 213-8, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26224385

RESUMO

INTRODUCTION AND HYPOTHESIS: The aims of this study were to determine the topographical relationships between the obturator nerve (ON), artery (OA), and vein (OV) in the lateral pelvic wall. METHODS: One hundred and fifty hemipelvises of 84 Korean cadavers were dissected. RESULTS: The ON, OA, and OV ran in that order (from upper to lower) within the lateral pelvic wall in 46.7 % of specimens. In 32 % of cases, the three structures were separated at the posterior portion of the wall and then converged toward the obturator canal (OC). In 10 %, the OA and OV were in contact with each other and separate from the ON; in 2 %, the ON was contiguous with the OA and separate from the OV; in 2.7 %, all three structures were in contact with each another. Alternately, the order of ON, OA, and OV was altered in the lateral pelvic wall in 41.3 % of specimens. Finally, in 12 % specimens, either the OA or OV or both were absent from the lateral pelvic wall. CONCLUSIONS: The possibility of the presence of either the OA or OV being between the ON and the external iliac vein, and the potential contact between the ON and either the OA or OV in the lateral pelvic wall, should be borne in mind during pelvic procedures.


Assuntos
Artérias/anatomia & histologia , Nervo Obturador/anatomia & histologia , Pelve/irrigação sanguínea , Pelve/inervação , Veias/anatomia & histologia , Adolescente , Adulto , Idoso , Povo Asiático , Cadáver , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , República da Coreia , Adulto Jovem
8.
J Ultrasound Med ; 35(2): 305-10, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26740490

RESUMO

OBJECTIVES: We aimed to estimate the spread of injections for ultrasound-guided cervical nerve root blocks and to determine the optimal injectate volume required in this procedure. METHODS: A total of 32 ultrasound-guided injections (C5-C8) were made in 4 fresh cadavers. The target on each cervical root was the space between the posterior tubercle and the cervical root at the most proximal location possible on the sonogram. After ultrasound-guided needle insertion, 0.5 mL of a contrast medium was injected 4 times. The dye flow patterns were confirmed with fluoroscopy each time, and we recorded whether the contrast medium reached the dorsal root ganglion level or the epidural space. After the injections, the needle tip location was determined by computed tomography and image reconstruction. RESULTS: All injections produced typical neurograms. The contrast medium reached the dorsal root ganglion in 29 of 32 (90.6%) injections (mean ± SD, 0.84 ± 0.42 mL of contrast medium) and the epidural space in 10 of 32 (31.3%) injections (1.30 ± 0.54 mL of contrast medium). The mean distance between the needle tip and neural foramen was 9.64 ± 3.68 mm, and this distance correlated positively with the volume of contrast medium necessary to reach the dorsal root ganglion or the epidural space. CONCLUSIONS: Ultrasound-guided cervical nerve root blocks show potential utility for targeting an anesthetic into the cervical root area. This study may be helpful for deciding the most appropriate volume for the procedure.


Assuntos
Anestésicos Locais/administração & dosagem , Gânglios Espinais , Bloqueio Nervoso/métodos , Raízes Nervosas Espinhais , Ultrassonografia de Intervenção , Idoso , Cadáver , Feminino , Humanos , Injeções , Masculino
9.
Biomed Eng Lett ; 14(4): 867-876, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38946817

RESUMO

Purpose: The sacroiliac joint (SIJ), a synovial joint with irregular surfaces, is crucial for stabilizing the body and facilitating daily activities. However, recent studies have reported that 15-30% of lower back pain can be attributed to instability in the SIJ, a condition collectively referred to as sacroiliac joint dysfunction (SIJD). The aim of this study is to investigate how the morphological characteristics of the auricular surface may influence the SIJ range of motion (ROM) and to examine differences in SIJ ROM between females and males, thereby contributing to the enhancement of SIJD diagnosis and treatment. Methods: We measured SIJ ROM using motion-analysis cameras in 24 fresh cadavers of Korean adults (13 males and 11 females). Using three-dimensional renderings of the measured auricular surface, we investigated the correlations between the morphological characteristics of the auricular surface and the ROM of the SIJ. Results: The SIJ ROM was between 0.2° and 6.7° and was significantly greater in females (3.58° ± 1.49) compared with males (1.38° ± 1.00). Dividing the participants into high-motion (3.87° ± 1.19) and low-motion (1.13° ± 0.62) groups based on the mean ROM (2.39°) showed no significant differences in any measurements. Additionally, bone defects around the SIJ were identified using computed tomography of the high-motion group. In the low-motion group, calcification between auricular surfaces and bone bridges was observed. Conclusion: This suggests that the SIJ ROM is influenced more by the anatomical structures around the SIJ than by the morphological characteristics of the auricular surface.

10.
Leg Med (Tokyo) ; 66: 102363, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38065055

RESUMO

The nose is a prominent feature for facial recognition and reconstruction. To investigate the relationship of the nasal shape with the piriform aperture in Korean adults and juveniles, we performed regression analysis. By regression analysis, prediction equations for nasal shape were obtained in relation to the shape of the piriform aperture considering sex and age groups. Three-dimensional skull and face models, rendered from computed tomography images, were assessed (331 males and 334 females). Juveniles (<20 years) were divided into three age groups according to the development of the dentition. Adults were divided into three age groups of two decades each, according to their age. To measure the nasal area, nine landmarks and nine measurements were chosen, while seven landmarks and five measurements were selected to measure the piriform aperture area. Four measurements were defined to explain the direct relationship between the nasal aperture and nasal shape. First, descriptive statistical analyses were performed according to sex and age groups. Subsequently, the correlation of nasal soft tissue measurements with piriform measurements was analyzed. Last, we performed a linear regression analysis of the measurements with higher correlations, considering sex and age groups as variables. Prediction equations were used to estimate the nasal bridge length, height, protrusion, and width. Equations considering sex and age groups showed better explanation ability. Measurements related to the height of the nasal bridge presented improvement. This study may assist in the more accurate approximation of nasal shape in facial reconstruction.


Assuntos
Antropologia Forense , Imageamento Tridimensional , Adulto , Masculino , Feminino , Humanos , Antropologia Forense/métodos , Nariz/diagnóstico por imagem , Nariz/anatomia & histologia , Análise de Regressão , Crânio/anatomia & histologia
11.
Anat Sci Educ ; 17(2): 396-412, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38053470

RESUMO

Anatomy instructional methods varied widely during the COVID-19 pandemic and programs are assessing innovations for retention. Learning preferences were assessed among medical students dichotomized as elective dissectors (ED) or non-dissectors (ND) during the COVID-19 partial re-opening in 2020 (preclinical) and again in 2022 after clinical exposure (post-clinical) to assess the viability of elective dissection post-pandemic. A mixed-method approach was used for the assessment of test scores, learning preference surveys, learning activities rankings, and thematic analyses. No significant differences occurred in anatomy examination scores. Dissection was considered useful by both preclinical groups but significantly more so by ED, while the presence of an instructor was significantly preferred by ED although a majority of ND agreed. Elective dissection was significantly preferred by ND but also by a large minority of ED students. Pre- and post-clinical ND believed that elective dissection offered more academic flexibility, did not hinder clinical learning, and did not negatively impact medical education. The corresponding ED stated that confidence improved, clinical experiences were enhanced, and dissection was irreplaceable. Preclinical ND preferred self-learning, while ED students preferred online learning, but these differences largely disappeared post-clinically. Learning activity rankings were not significantly different among all groups (ND, ED, preclinical, and post-clinical). A hybrid laboratory with a virtual learning environment ranked highest across groups and preferences increased over time suggesting that students benefited from this instructional method during clinical exposure. The absence of laboratory experience ranked lowest, and preference decreased over time suggesting that anatomy dissection is valued.


Assuntos
Anatomia , COVID-19 , Educação de Graduação em Medicina , Estudantes de Medicina , Humanos , Pandemias , Anatomia/educação , Aprendizagem , Educação de Graduação em Medicina/métodos
12.
J Ultrasound Med ; 32(4): 617-24, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23525386

RESUMO

OBJECTIVES: The purpose of this study was to evaluate normal nasolabial dimensions using the images of facial profiles in normal Korean fetuses. METHODS: We conducted a cross-sectional study of 355 normal fetuses at 14 to 39 weeks' gestation. After the exclusion of inadequate images and inadequate numbers of fetuses at 14 to 19 and 37 to 39 weeks' gestation, the sonographic facial profiles from 222 fetuses at 20 to 37 weeks' gestation were evaluated. Five parameters, nose length, nose protrusion, pronasal-subnasal distance, distance between the upper philtrum and mouth, and distance between the tip of the nose and mouth, were measured and are presented according to gestational age. Data were analyzed by intraclass correlation coefficients and regression analysis. RESULTS: There were significant linear correlations between gestational age and nose length (R = 0.390; P < .001), pronasal-subnasal distance (R = 0.415; P < .001), and distance between the upper philtrum and mouth (R = 0.315; P < .001). There were significant quadratic relationships between gestational age and nose protrusion (R(2) = 0.213; P < .001) and distance between the tip of the nose and mouth (R(2) = 0.173; P < .001). CONCLUSIONS: We provide preliminary normative nasolabial dimensions of facial profiles at 20 to 37 weeks' gestation in normal Korean fetuses. These data may be of help not only in the understanding of normal nasolabial growth in utero but also in the diagnosis of abnormal facial dimensions.


Assuntos
Cefalometria , Feto/anatomia & histologia , Lábio/diagnóstico por imagem , Lábio/embriologia , Nariz/diagnóstico por imagem , Nariz/embriologia , Ultrassonografia Pré-Natal , Povo Asiático , Estudos Transversais , Feminino , Idade Gestacional , Humanos , Gravidez , Segundo Trimestre da Gravidez , Terceiro Trimestre da Gravidez , Valores de Referência , República da Coreia
13.
Anat Histol Embryol ; 52(1): 101-114, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36317584

RESUMO

Educational technologies in veterinary medicine aim to train veterinarians faster and improve clinical outcomes. COVID-19 pandemic, shifted face-to-face teaching to online, thus, the need to provide effective education remotely was exacerbated. Among recent technology advances for veterinary medical education, extended reality (XR) is a promising teaching tool. This study aimed to develop a case resolution approach for radiographic anatomy studies using XR technology and assess students' achievement of differential diagnostic skills. Learning objectives based on Bloom's taxonomy keywords were used to develop four clinical cases (3 dogs/1 cat) of spinal injuries utilizing CT scans and XR models and presented to 22 third-year veterinary medicine students. Quantitative assessment (ASMT) of 7 questions probing 'memorization', 'understanding and application', 'analysis' and 'evaluation' was given before and after contact with XR technology as well as qualitative feedback via a survey. Mean ASMT scores increased during case resolution (pre 51.6% (±37%)/post 60.1% (± 34%); p < 0.01), but without significant difference between cases (Kruskal-Wallis H = 2.18, NS). Learning objectives were examined for six questions (Q1-Q6) across cases (C1-4): Memorization improved sequentially (Q1, 2 8/8), while Understanding and Application (Q3,4) showed the greatest improvement (26.7%-76.9%). Evaluation and Analysis (Q5,6) was somewhat mixed, improving (5/8), no change (3/8) and declining (1/8).Positive student perceptions suggest that case studies' online delivery was well received stimulating learning in diagnostic imaging and anatomy while developing visual-spatial skills that aid understanding cross-sectional images. Therefore, XR technology could be a useful approach to complement radiological instruction in veterinary medicine.


Assuntos
Doenças do Gato , Doenças do Cão , Educação a Distância , Educação em Veterinária , Estudantes de Medicina , Animais , Cães , Humanos , COVID-19/epidemiologia , Doenças do Cão/diagnóstico por imagem , Aprendizagem , Pandemias , Tomografia Computadorizada por Raios X/veterinária , Doenças do Gato/diagnóstico por imagem , Educação em Veterinária/organização & administração , Estudantes de Medicina/psicologia , Educação a Distância/organização & administração , Avaliação Educacional
14.
Sci Rep ; 13(1): 4014, 2023 03 10.
Artigo em Inglês | MEDLINE | ID: mdl-36899072

RESUMO

Eyebrows are the most important facial feature in facial recognition with its shape rated to be more helpful than color or density for facial reconstruction or approximation. However, little extant research has estimated the position and morphological territory of the eyebrow from the orbit. Three-dimensional craniofacial models, produced from CT scans of 180 Koreans autopsied at the National Forensic Service Seoul Institute, were used to conduct metric analyses of subjects (125 males and 55 females) between 19 and 49 (mean 35.1) years. We employed 18 craniofacial landmarks to examine the morphometry of the eyebrow and orbit with 35 pairs of distances per subject measured between landmark and reference planes. Additionally, we used linear regression analyses to predict eyebrow shape from the orbit for every possible combination of variables. The morphology of the orbit has more influence on the position of the superior margin of the eyebrow. In addition, the middle part of the eyebrow was more predictable. The highest point of the eyebrow in female was located more medially than the male. Based on our findings, the equations for estimating the position of the eyebrow from the shape of the orbit is useful information for face reconstruction or approximation.


Assuntos
Sobrancelhas , Órbita , Humanos , Masculino , Feminino , Sobrancelhas/anatomia & histologia , Tomografia Computadorizada por Raios X , Análise de Regressão , Medicina Legal , Imageamento Tridimensional
15.
Reg Anesth Pain Med ; 2023 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-37657889

RESUMO

BACKGROUND: We compared the spread of an injectate into the thoracic sympathetic chain resulting from a single-injection intertransverse process (ITP) block with that of a single-injection PV block at the T2 level. METHODS: Sixteen soft-embalmed cadavers were used. The right hemithorax was randomly allocated to receive either an ultrasound-guided single-injection ITP block or ultrasound-guided single-injection PV block at the T2 vertebral level, with the opposite block administered to the other side. Approximately 10 mL of latex dye solution was injected into each hemithorax using a random allocation technique. The presence of dye at the nerve root in the sympathetic chain and intercostal nerves at the injection and additional levels was examined by dissection. RESULTS: The injectate spread into the T2 sympathetic ganglion on both ITP (11/16, 68.8%) and PV (16/16, 100%) blocks. The ITP block demonstrated greater uniformity of dye staining in both the dorsal rami and dorsal root ganglion, which contrasts with the less consistent staining outcomes of the PV block in these regions. CONCLUSIONS: At the T2 level, we observed a lower efficacy of the ITP block for analgesic coverage of the sympathetic nerve. This suggested a potential preference by clinicians for the application of the T2 PV block over the ITP block, specifically for the management of sympathetically maintained pain in the upper extremities. In addition, our findings may hint at the potential advantages of the ITP block in specific clinical contexts where targeted nerve involvement, such as the medial branch block or dorsal root ganglion block, is sought.

16.
Korean J Pain ; 36(3): 328-334, 2023 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-37345308

RESUMO

Background: Among the four genicular nerves innervating the anterior aspect of the knee, the inferior lateral genicular nerve has been omitted as a target of blocking. Some authors have suggested that the inferior lateral genicular nerve of the knee might pass beneath the lateral collateral ligament of knee. The authors aimed to study the location of the inferior lateral genicular nerve and the spread of injectate during the inferior lateral genicular nerve block. Methods: In ten knees from fresh frozen cadavers, the authors performed on each an ultrasound-guided block of the inferior lateral genicular nerve of the knee just below the lateral collateral ligament. The needle was inserted below the lateral collateral ligament, and 2 mL of blue dye was injected. A week later, the cadavers were dissected, and the existence of the inferior lateral genicular nerve and the spread of dye around it was investigated. Results: The proportion of inferior lateral genicular nerves branching from the common peroneal nerve was found in 8 of 10 (80.0%) cadavers. Of these eight cadavers with inferior lateral genicular nerve, five specimens (62.5%) were stained with blue dye. The common peroneal nerve was not infiltrated with dye in any specimens. Conclusions: When 2 mL of dye was inserted inferiorly to the lateral collateral ligament, the inferior lateral genicular nerve could be blocked in 62.5% of specimens. Because the common peroneal nerve was not involved in any specimen, motor weakness would be avoided with this method.

17.
J Ultrasound Med ; 31(4): 569-76, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22441913

RESUMO

OBJECTIVES: The purpose of this study was to evaluate a normal range for prenatal craniofacial inclination using images of fetal profiles at 14 to 39 weeks' gestation in normal Korean fetuses. METHODS: We conducted a cross-sectional study of 308 normal fetuses at 14 to 39 weeks' gestation. After the exclusion of images with inadequate quality, the sagittal plane of the sonographic fetal facial profile from 250 normal fetuses was evaluated. The frontomaxillary facial, frontonasal, maxilla-nasion-mandibular, and mandibulomaxillary facial angles were measured and are presented according to gestational age. RESULTS: The overall mean frontomaxillary facial angle ± SD was 86.0° ± 7.6° between 14 weeks 6 days' and 39 weeks 2 days' gestation without a significant association between the frontomaxillary facial angle and gestational week. The overall mean frontonasal, maxilla-nasion-mandibular, and mandibulomaxillary facial angles were 125.8° ± 7.2°, 4.7° ± 3.3°, and 83.2° ± 8.5° between 14 weeks and 39 weeks 6 days. There was a significant linear correlation between gestational age and the frontonasal angle (r = -0.1534; P = .0187; y = -0.188 × gestational age + 130.7), maxilla-nasion-mandibular angle (r = -0.2773; P < .0001; y = -0.160 × gestational age + 9.0), and mandibulomaxillary facial angle (r = -0.2861; P < .0001; y = -0.432 × gestational age + 94.6). CONCLUSIONS: We provide preliminary normative data for fetal facial angles related to craniofacial inclination across gestational ages in normal Korean fetuses. These data may be of help not only for the understanding of normal facial growth in utero but also for diagnosis of abnormal fetal facial dimensions.


Assuntos
Face/diagnóstico por imagem , Crânio/diagnóstico por imagem , Ultrassonografia Pré-Natal/estatística & dados numéricos , Feminino , Idade Gestacional , Humanos , Coreia (Geográfico)/epidemiologia , Masculino , Valores de Referência , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
18.
Transl Res Anat ; 272022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-36133355

RESUMO

Background: The purpose of this study is to characterize a full-term conjoined twins' cadaver curated by Dr. Jacob Henle sometime between 1844 and 1852 and demonstrate digital distribution of an old and rare medical museum specimen using an extended reality (XR) model workflow. Methods: The cadaver (Preparation 296) is in the Department of Anatomy and Cell Biology at the University of Heidelberg. An XR display workflow comprises image capture, segmentation, and visualization using CT/MR scans derived from the cadaver. Online radiology presentation to medical students focuses on diagnostic characteristics of anatomical systems depicted with XR models. Results: Developmental defects in Preparation 296 include duplicated supradiaphragmatic structures and abnormal osteological features. Subdiaphragmatically, the gut is continuous on the right, but terminates at the distal esophagus on the left. One large liver occupies the abdomen with one spleen located on the left side. Observations suggest duplication of the primitive streak and separate notochords rostrally. Duplication occurs near the yolk sac and involves midgut formation while secondary midline fusion of the upper extremities and ribs likely results from the proximity of the embryos during development. Medical students access the model with device agnostic software during the curricular topic "Human Body Plan" that includes embryology concepts covering mechanisms of twinning. Conclusions: The workflow enables ease-of-access XR visualizations of an old and rare museum specimen. This study also demonstrates digital distribution and utilization of XR models applicable to embryology education.

19.
Eur J Radiol ; 146: 110043, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34844172

RESUMO

PURPOSE: Extended reality (XR) technology enhances learning in medical education. The purpose of this study was to develop and apply a case-based approach for teaching radiological anatomy utilizing XR technology for improved student exploration and engagement. METHODS: The workflow consisted of MRI scanning cadavers followed by radiological, pathological, and anatomical assessment, and finally case presentation based on XR visualizations and student interaction. Case information (Subject, History, and Physical Exam) was presented to student groups who generated and recorded hypotheses using Google Forms. RESULTS: Use of all components of the system was voluntary and a total of 74 students responded to the survey request (response rate = 95%). Assessment of the experience was conducted through a qualitative survey comprising four Likert scale questions (1-5, 1 lowest), three binary questions, and open-ended comments. Mean, standard deviation, and overall agreement (mean ± SD, OA) showed that students found MRI scans of cadavers to be helpful for dissections (4.14 ± 1.1, 74.3%) and provided an understanding of relevant anatomy (4.32 ± 0.9, 79.7%), while 78.4% of students used the DICOM viewer to visualize scans of cadavers. The difficulty of use was found to be average (2.90 ± 1.0, 23%). zSpace visualizations were used by 40.5% of students, generally agreeing that an understanding of spatial relationships improved as a result (3.60 ± 1.0, 43.2%). More case-based sessions were favored by 97.3% of students. CONCLUSIONS: Results suggest that cadaveric MRI radiological visualization and XR technology enhance understanding of case-based anatomical dissections and encourage student exploration and engagement.


Assuntos
Anatomia , Instrução por Computador , Educação de Graduação em Medicina , Estudantes de Medicina , Anatomia/educação , Cadáver , Currículo , Avaliação Educacional , Humanos , Imageamento por Ressonância Magnética , Inquéritos e Questionários , Tecnologia
20.
Leg Med (Tokyo) ; 48: 101823, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33307311

RESUMO

The nose is an important facial feature that affects facial reconstruction quality and its recognition. We reviewed a selection of papers that researched the nose with regression analysis and applied their regression formulae to our sample to compare the estimated value and measurements. One-hundred computed tomography (CT) scans of Korean adults were selected for this study. The subjects were patients without head trauma, severe deformities, or asymmetry at St. Mary's Hospital in Seoul, Korea. Three dimensional (3D) models of the cranium and face were remodelled and measured by Mimics 14.1 (Leuven, Belgium, Materialise). A measurement system for 3D models that referred to landmarks from previous studies was used to facilitate the comparison process. Estimation formulae were applied to the subjects and compared with the measurement results of this study's population. Corresponding measurements showed that the measurements were statistically significantly different from estimated values obtained with regression formulae. A difference in the results was expected because of the different sample population, but the age of subjects could also impact the results and cause variability. Therefore, the results of this study emphasise the necessity of basal research for a specific target population.


Assuntos
Antropologia Forense/métodos , Nariz/anatomia & histologia , Adulto , Povo Asiático , Face/anatomia & histologia , Face/diagnóstico por imagem , Feminino , Humanos , Imageamento Tridimensional , Masculino , Pessoa de Meia-Idade , Nariz/diagnóstico por imagem , República da Coreia , Crânio/anatomia & histologia , Crânio/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adulto Jovem
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