Three-dimensional linear and volumetric computed tomography analysis of the frontal sinus / 대한해부학회지

The frontal sinus is one of the four paranasal sinuses in humans, and knowledge of its anatomy is important when performing surgery involving the frontal bone or sinus. Although many studies have measured the frontal sinus using radiography and computed tomography (CT), few studies have evaluated by using three-dimensional (3D) analysis. The purpose of this study was to analyze the frontal sinus using 3D reconstruction analysis and determine the differences in linear and volumetric measurements between sexes, sides, and ages. The sample comprised 281 facial CT scans: 173 and 108 from males and females, respectively. The width, height, and length of each frontal sinus and total volume were all larger in males than in females. Almost all linear and volumetric measurements were larger in young adults than in older for both sexes, but not all of the differences were statistically significant. Linear and volumetric measurements were larger for males than females regardless of age group. There were no statistically significant differences between the right and left sides except the width in males. The size of the frontal sinus was strongly influenced by sex and age. The measurements reported here might be useful for improving surgical procedures involving the frontal sinus.

Effects of Reading a Free Electronic Book on Regional Anatomy with Schematics and Mnemonics on Student Learning

BACKGROUND@#To help medical students learn anatomy effectively in limited hours, a regional anatomy book enhancing students' memorization was developed.@*METHODS@#Only anatomical terms essential for basic cadaver dissection are included along with schematic figures which enable memorization of complicated anatomical structures. Learning comics and comic strips that depict anatomy mnemonics and jokes were appended and sentences were written to be comfortably readable. The electronic book titled “Visually Memorable Regional Anatomy” has been distributed without payment or registration. With the help of 246 volunteer students from three Korean medical schools, the book's learning effects were evaluated.@*RESULTS@#These students' book reading led to increase in their anatomy scores, including written examination scores and tag examination scores. It was an encouraging result that almost 20% of students spontaneously read the book no matter who presented their lecture or examination. A webpage version of the book was visited by thousands of users.@*CONCLUSION@#The book with unique features may suggest a new perspective in the field of anatomy learning. After having acquaintance with essential structures from reading the book, students are able to and willing to study more from other resources.

Use of the orbito-occipital line as an alternative to the Frankfort line / 대한해부학회지

Frankfort horizontal line, the line passing through the orbitale and porion, is one of the most widely used intracranial landmarks in cephalometric analysis. This study investigated the use of the orbito-occipital line extending from the orbitale to the external occipital protuberance as a novel horizontal line of the skull for substituting the Frankfort horizontal line. We evaluated the reproducibility of the new landmark and measured the angle between the orbito-occipital line and the Frankfort line. This study was conducted on 170 facial computed tomography (CT) scans of living adults from the Department of Plastic Surgery. After three-dimensionally reconstructed images were obtained from facial CT, the porion, orbitale, and external occipital protuberance were indicated by two observers twice. The angles between the orbito-meatal line (inferior orbital rim to porion; the Frankfort line) and the orbito-occipital line (inferior orbital rim to external occipital protuberance) were measured. There was no significant intraobserver or interobserver bias. The overall angle between the Frankfort line and orbito-occipital line was –0.5°±2.2° (mean±standard deviation). There was no statistically significant difference among side and sex. This study demonstrated good reproducibility of a new landmark—the external occipital protuberance—tested to replace the porion. The orbito-occipital line is a reliable, reproducible, and easily identifiable line, and has potential as a novel standard horizontal line to replace or at least supplement the Frankfort line in anthropological studies and certain clinical applications.

Effects of Reading a Free Electronic Book on Regional Anatomy with Schematics and Mnemonics on Student Learning

BACKGROUND@#To help medical students learn anatomy effectively in limited hours, a regional anatomy book enhancing students' memorization was developed.@*METHODS@#Only anatomical terms essential for basic cadaver dissection are included along with schematic figures which enable memorization of complicated anatomical structures. Learning comics and comic strips that depict anatomy mnemonics and jokes were appended and sentences were written to be comfortably readable. The electronic book titled “Visually Memorable Regional Anatomy” has been distributed without payment or registration. With the help of 246 volunteer students from three Korean medical schools, the book's learning effects were evaluated.@*RESULTS@#These students' book reading led to increase in their anatomy scores, including written examination scores and tag examination scores. It was an encouraging result that almost 20% of students spontaneously read the book no matter who presented their lecture or examination. A webpage version of the book was visited by thousands of users.@*CONCLUSION@#The book with unique features may suggest a new perspective in the field of anatomy learning. After having acquaintance with essential structures from reading the book, students are able to and willing to study more from other resources.

Use of the orbito-occipital line as an alternative to the Frankfort line / 대한해부학회지

Frankfort horizontal line, the line passing through the orbitale and porion, is one of the most widely used intracranial landmarks in cephalometric analysis. This study investigated the use of the orbito-occipital line extending from the orbitale to the external occipital protuberance as a novel horizontal line of the skull for substituting the Frankfort horizontal line. We evaluated the reproducibility of the new landmark and measured the angle between the orbito-occipital line and the Frankfort line. This study was conducted on 170 facial computed tomography (CT) scans of living adults from the Department of Plastic Surgery. After three-dimensionally reconstructed images were obtained from facial CT, the porion, orbitale, and external occipital protuberance were indicated by two observers twice. The angles between the orbito-meatal line (inferior orbital rim to porion; the Frankfort line) and the orbito-occipital line (inferior orbital rim to external occipital protuberance) were measured. There was no significant intraobserver or interobserver bias. The overall angle between the Frankfort line and orbito-occipital line was –0.5°±2.2° (mean±standard deviation). There was no statistically significant difference among side and sex. This study demonstrated good reproducibility of a new landmark—the external occipital protuberance—tested to replace the porion. The orbito-occipital line is a reliable, reproducible, and easily identifiable line, and has potential as a novel standard horizontal line to replace or at least supplement the Frankfort line in anthropological studies and certain clinical applications.

Three-dimensional microstructures of the intracortical canals in the animal model of osteoporosis / 대한해부학회지

Osteoporosis is a major disease in aged women, increasing the risk for fractures accompanied by changes in the microarchitecture. The aim of this study was to investigate the three-dimensional (3D) histomorphology of femur diaphysis in the animal model for postmenopausal osteoporosis. The cortical bone of femur diaphysis of the rat was serially sectioned at a thickness of 5 μm and evaluated age-associated changes of the intracortical (osteonal) canal networks three-dimensionally. Cortical microstructures of 10-month old rats were not affected by ovariectomy. Intracortical canal networks were radial toward endosteal aspect and frequently interconnected across the neighboring canals with short arciform and irregular canals reminiscent for resorption spaces in ovarectomized 16-month old rats, contrary to intact canals in 16-month old control rat. Increased proportion of the periosteal circumference lamella and deformed endosteal regions with rare cortical canals hampered reconstructive histomorphology in ovarectomized rats of 26 month age. We have shown that 3D reconstruction of rat femur of the aged model over 16-month old is suitable methods that evaluate and microstructural change of the intracortical canals and cortical bone porosity by estrogen depletion.

Three-dimensional microstructures of the intracortical canals in the animal model of osteoporosis / 대한해부학회지

Osteoporosis is a major disease in aged women, increasing the risk for fractures accompanied by changes in the microarchitecture. The aim of this study was to investigate the three-dimensional (3D) histomorphology of femur diaphysis in the animal model for postmenopausal osteoporosis. The cortical bone of femur diaphysis of the rat was serially sectioned at a thickness of 5 μm and evaluated age-associated changes of the intracortical (osteonal) canal networks three-dimensionally. Cortical microstructures of 10-month old rats were not affected by ovariectomy. Intracortical canal networks were radial toward endosteal aspect and frequently interconnected across the neighboring canals with short arciform and irregular canals reminiscent for resorption spaces in ovarectomized 16-month old rats, contrary to intact canals in 16-month old control rat. Increased proportion of the periosteal circumference lamella and deformed endosteal regions with rare cortical canals hampered reconstructive histomorphology in ovarectomized rats of 26 month age. We have shown that 3D reconstruction of rat femur of the aged model over 16-month old is suitable methods that evaluate and microstructural change of the intracortical canals and cortical bone porosity by estrogen depletion.

Effects of Reading a Free Electronic Book on Regional Anatomy with Schematics and Mnemonics on Student Learning

BACKGROUND: To help medical students learn anatomy effectively in limited hours, a regional anatomy book enhancing students' memorization was developed.METHODS: Only anatomical terms essential for basic cadaver dissection are included along with schematic figures which enable memorization of complicated anatomical structures. Learning comics and comic strips that depict anatomy mnemonics and jokes were appended and sentences were written to be comfortably readable. The electronic book titled “Visually Memorable Regional Anatomy” has been distributed without payment or registration. With the help of 246 volunteer students from three Korean medical schools, the book's learning effects were evaluated.RESULTS: These students' book reading led to increase in their anatomy scores, including written examination scores and tag examination scores. It was an encouraging result that almost 20% of students spontaneously read the book no matter who presented their lecture or examination. A webpage version of the book was visited by thousands of users.CONCLUSION: The book with unique features may suggest a new perspective in the field of anatomy learning. After having acquaintance with essential structures from reading the book, students are able to and willing to study more from other resources.

Position and size of the sphenoid door jamb in the lateral orbital wall for the orbital decompression / 대한해부학회지

The aim of this study was to identify the three-dimensional topography of the sphenoid door jamb (SDJ) in the lateral orbital wall and to propose navigational guidelines for safe deep lateral decompression using surgical landmarks. The 120 orbits and SDJs of 60 subjects were three-dimensionally reconstructed using Mimics software. The mean volumes of the orbit and SDJ were 24.3 mm³ and 2.0 mm³, respectively. The mean distances from the lateral orbital margin (LOM) to the anterior and posterior margins of the SDJ were 13.2 and 36.3 mm, respectively. The mean distances from the superior orbital fissure to the LOM and to the posterior margin of the SDJ were 40.2 mm and 4.6 mm, respectively. The mean distances from the inferior orbital fissure (IOF) to the anterior and posterior margins of the SDJ were 3.8 mm and 20.5 mm, respectively. In the superior approach of the orbit, it can be predicted that the area up to 3 cm posterior from the LOM is safe, while 1 cm posterior from the safe zone could be a dangerous zone. In the inferior approach of the orbit, the safe area will be about 1 cm posterior from the anterior tip of the IOF, and the area up to 1 cm posterior from the safe zone should be approached with extreme care.

Three-dimensional and topographic relationships between the orbital margins with reference to assessment of eyeball protrusion / 대한해부학회지

This study investigated the topographic relationships among the eyeball and four orbital margins with the aim of identifying the correlation between orbital geometry and eyeball protrusion in Koreans. Three-dimensional (3D) volume rendering of the face was performed using serial computed-tomography images of 141 Koreans, and several landmarks on the bony orbit and the cornea were directly marked on the 3D volumes. The anterior-posterior distances from the apex of the cornea to each orbital margin and between the orbital margins were measured in both eyes. The distances from the apex of the cornea to the superior, medial, inferior, and lateral orbital margins were 5.8, 5.8, 12.0, and 17.9 mm, respectively. Differences between sides were observed in all of the orbital margins, and the distances from the apex of the cornea to the superior and inferior orbital margins were significantly greater in females than in males. The anterior-posterior distance between the superior and inferior orbital margins did not differ significantly between males (6.3 mm) and females (6.2 mm). The data obtained in this study will be useful when developing practical guidelines applicable to forensic facial reconstruction and orbitofacial surgeries.

High-Set or Low-Set of Korean Face / 체질인류학회지

The face is the most important for individual identification, which showed racial and regional differences. The aim of the present study was to investigate that how much highly locate the facial structures in the face. In total, 551 Korean young adult volunteers with no deformity or surgical history of the face (218 males and 333 females) were selected. Subjects were photographed while sitting and assuming a standard head position, such that the porion and inferior orbital margin were in the same horizontal plane (Frankfurt plane), and they were gazing forward. The total face height was measured vertically from trichion to gnathion. And total face height was divided three heights such as upper, mid, and lower face height. Total face height of male was larger about 6% than female. The ratio of lower face height about upper face height was calculated, it showed 55.7% in male and 50.3 in female. The face was classified into three sets including high-set, mid-set, and low-set according the ratio. The male face showed relatively high-set face, while female face showed relatively low-set face. The present study is the first study to investigate about high- or low-set face, and the result is useful data to identify characteristics of the east Asian population including Korean.

History of the Korean Anatomical Terminology / 체질인류학회지

In this study, the origin of anatomical terms, the process by which international anatomical terms were made, and the making principles of international anatomical terminology were confirmed. We also describe the process in which the Japanese anatomy terminology (Termonologia Anatomica Japonica), which has been influential in Korea, has developed. Most of the past Korean anatomical terminology used the Japanese term. However, the Korean association of anatomists gradually recognized the necessity of own terminology and decided to refine the terms by forming a terminology committee. The terminology committee first laid down the direction for refining terms and made the basic principles of revising them. Through many meetings, the terms were refined and made into terminology book (Korean anatomical terminology). The Korean anatomical terminology has been revised five times since its first edition in 1979 to the sixth edition in 2014. Here, we illustrate the difference between Japanese terms and Korean terms and the process of refining Korean terms using examples.

Haversian system of compact bone and comparison between endosteal and periosteal sides using three-dimensional reconstruction in rat / 대한해부학회지

The current model of compact bone is that of a system of Haversian (longitudinal) canals connected by Volkmann's (transverse) canals. Models based on either histology or microcomputed tomography do not accurately represent the morphologic detail and microstructure of this system, especially that of the canal networks and their spatial relationships. The aim of the present study was to demonstrate the morphologic pattern and network of the Haversian system and to compare endosteal and periosteal sides in rats using three-dimensional (3D) reconstruction. Ten Sprague-Dawley rats aged 8-10 weeks were used. The femurs were harvested from each rat and fixed, decalcified with 10% EDTA-2Na, serially sectioned at a thickness of 5 microm, and then stained with hematoxylin and eosin. The serial sections were reconstructed three-dimensionally using Reconstruct software. The Haversian canals in the endosteal region were found to be large, highly interconnected, irregular, and close to neighboring canals. In contrast, the canals in the periosteal region were straight and small. This combined application of 3D reconstruction and histology examinations to the Haversian system has confirmed its microstructure, showing a branched network pattern on the endosteal side but not on the periosteal side.

Anatomical study of the nerve regeneration after selective neurectomy in the rabbit: clinical application for esthetic calf reduction / 대한해부학회지

The purposes of this study were therefore to characterize the degeneration and regeneration of nerves to the calf muscles after selective neurectomy, both macroscopically and microscopically, and to determine the incidence of such regeneration in a rabbit model. Seventy four New Zealand white rabbits were used. Selective neurectomy to the triceps surae muscles was performed, and the muscles were subsequently harvested and weighed 1-4 months postneurectomy. The gastrocnemius muscles were stained with Sihler's solution to enable the macroscopic observation of any nerve regeneration that may have occurred subsequent to neurectomy. The change in triceps surae muscle weight was measured along the time course of the experiment. After neurectomy, nerve degeneration was followed by regeneration in all cases. The weight of the triceps surae muscle decreased dramatically between completion of the neurectomy and 1 month postneurectomy, but increased thereafter. The nerve branches were weakly stained with Sihler's solution until 2 months postneurectomy, and then strongly stained after 3 months. The number of myelinated axons was decreased at 2 month after neurectomy compared to nonneurectomized controls, but then gradually increased thereafter. Although there are currently no reports on the incidence of recovery after calf reduction, it may be a very common occurrence in the clinical field based on our findings. The findings of this study provide fundamental anatomical and surgical information to aid planning and practice in calf-reduction surgery.

The Angles of the Mandible in Korean - Three Dimensional Reconstruction Study / 체질인류학회지

The aim of this study was to analyze the difference of the measurements of mandible between young male and female using three dimensional reconstruction images derived from the facial bone CT images. Type classification of mandible was performed based on the angle of base of mandible and the angle of mandibular margin observed from the anterior view and the correlation among the measurement items was analyzed. One hundred-ninety five young adults facial CT were collected from the Konkuk University medical center (98 females, 97 males; mean age 25.9 years, range 18~38 years). Three dimensional images of the face were reconstructed using software from CT images of whole specimens. The angle of the base of the mandible, the angle of the mandibular margin, total length of mandibualr margin, and the height of mandibular symphysis were measured. All measurement items were larger and longer in male than female (P<0.05). Three types were classified according to the mandibular angle. In female, the subjects were evenly distributed among groups, but group I which had large mandibular angle was most common in male. The smaller the height of mandibular symphysis, the larger the angle of base of mandible or the angle of mandibular margin (P<0.05).

Anthropometric Analysis of Mid-face; Senile Changes of Nasal Dimensions

The objective of this study is anthropometric analysis of nose and mid-face in Korean. This study was based on extensive sample size and variable measurement points. Total 3,000 healthy volunteers (18 to 79 years of age) were took two standardized photographs (frontal and lateral view). And 21 items were measured per person. Age groups were classified into three as young, middle-aged, and elderly. Average nasal length was around 4 cm and height was 5 cm. Female was 5~6% smaller than male. Facial width was 3.5 times larger than nasal length. Nasal length reduced by 5% as get older. Nasofrontal angle was 141degrees and nasolabial angle was 92degrees. Nasal width was 39mm and intercanthal distance was 35 mm. The significant age-related changes were eyeball depth (se-pu) and intercanthal distance. The characteristic senile change of male mid-face was downward deflection of soft tissue but female was soft tissue atrophy. The goal of augmentation rhinoplasty is not filling up sellion point depression but superior shifting of that point. Similarity between nasal length and width was another interesting finding of Korean nose. The results of this study will represent typical values of Korean nose and facilitate exact prediction of surgical results.

Topographic Relationship between the Zygomatic Arch and Coronoid Process of the Mandible / 체질인류학회지

Illustrations in almost all textbooks and atlases of anatomy normally show that the zygomatic arch (ZA) and coronoid process (CP) of the mandible overlap vertically. Their topographic relationship is important for plastic surgeons in various situations, such as restorations of ZA fractures. The present study investigated the topographic relationship between the ZA and CP of the mandible in three-dimensional models of Korean human cadavers. The topographic relationship was classified into three types: overlapped, tangential, and separate. The overlapped type was the most common, but the three types showed similar incidences in three-dimensional models. There were no lateral or sex differences according to the three types. The incidence of both sides showing the same type was 70.1%. In conclusion, the predominance of illustrations in almost all textbooks and atlases showing the overlapped type is misleading, since the other two types - where the CP of the mandible does not overlap the ZA - are almost as common.

Fabrication of Korean Skull Model / 체질인류학회지

Anatomy education using skull models has been widely performed for a long time and known that it is actually much convenient and economical. However, until now, most of skull models used in anatomy class are imported from the United State or Europe. Therefore, the models showed characteristics of Caucasian skulls, and had several differences from skulls of Koreans. Hence, we made a specific replica model of skull which have various Korean characteristics. We used Korean male skull (aged 50 years) without defect due to diseases or fractures. The silicon was poured over the skull in the cubic frame and hardened. We took out the skull from the silicon frame and poured the resin into the frame to duplicate the original skull. After defoamation and hardening the resin, the skull model was taken out of frame. And we modified defects which occurred during duplicated process and made detailed structures which unrevealed in real skull. After completion of the skull model, we measured ten items of anthropological characteristics of the Korean and American skull models and compared 9 categories of index. As a result, there were significant differences in length-breadth index, length-height index, frontozygomatic index, nasal index between the Korean and American skull models; As aforementioned, the skull model, compared to Caucasian skull models, had numerous distinctive Korean skull features and this model can be used for anatomy education in South Korea.

Sex Determination of the Mandible Focusing on the Ramus / 체질인류학회지

The mandible is the largest and strongest bone in the face. The mandible retains its structure better than other skeletons in the forensic and physical anthropologic field. It can be used to distinguish the ethnic groups, genders and ages. However, it is often discovered as a part, not complete form. Therefore, it would be needed that sex determination must be performed using a part of mandible. The purpose of the present study was to investigate the possibility for sex determination of the mandible focusing on the ramus in Korean. We examined 92 Korean mandibles (68 males and 24 females). The range of age was 16~92 years (mean 60 years). The mandibles were photographed from the both lateral sides at standard position. Nine angular and fifteen linear items were measured by the computer-based image analyzer. Statistical analyses were performed using the Microsoft Excel and SPSS 12.0 software. The vertical height of the coronoid process was greater than that of the condylar process in almost cases (81.6%) regardless of sex. Three angular (gonion-condylion posterior, coronion-condylion, coronion-condylion but passing gonion) and two linear (gonion-condylion, gonion-coronion) items had statistically significant difference between both sexes. Five variables were used in making a series of discriminant functions for which an accuracy of 86.6% was attained.

The Application of the Dissection Seminar in Anatomical Practice / 체질인류학회지

Recently, in most medical schools of Korea, the educational method of gross anatomy, the first subject in medical education, has changed in several directions such as integrated lecture or problem-based learning (PBL). Therefore, the time of the lecture was constrained to reduce. The name of the gross anatomy integrated with embryology changed to 'human body and development' in Konkuk university since 2006. In addition to the classical dissection practice, the 'dissection seminar' was introduced since 2006. It was a method of dissection practice that one group demonstrate the procedure of dissection and explains the structures of the predissected cadaver to other students about the assigned subject. The questionnaire about dissection seminar was performed after the anatomy course. The most common opinion about dissection seminar was 'interesting and helpful for studying anatomy'. The common answers about the attitude were 'very positive' and 'positive'. The affirmatives during dissection seminar were in depth study and improve in collaboration. The inconveniences or lacks were insufficient time to prepare, unfairness in difficulty between the subjects, and discord among group members. The propositions for development were requirement of sufficient preparation time, request of guideline, and consideration of other schedule. As a result of self-estimation about dissection seminar, the direction of the dissection seminar have been advancing with time, and students became more interested in studying anatomy. The most important thing for maintaining the dissection seminar is making proper plan such as avoidance of examination of another subject.