Clinical Adaptation According to Anatomical Types of Nasal Septum / Adaptación Clínica Según Tipos Anatómicos de Tabique Nasal

SUMMARY: The purpose of this study was to inform the anatomical types of the nasal septum of which including variations by dissection and to provide guidelines for clinical adaptation. For this purpose dissections were performed on 70 nasal septums of formalin fixed Korean adult cadavers (20 males, 11 females, and 39 of unknown sex) with an age at death of 13-105 years. The septal deviation was checked before midsagittal section the nasal cavity with the aid of a laryngoscope. The mucosa on the nasal septum was then removed to observe the morphology of the nasal septum. The shape of each component of the nasal septum was identified, and photographs were taken from a midsagittal plane. This study has discovered various anatomical types of the nasal septum and its variations. The correlations between septal types according to their proportions were also analyzed. The results reported herein provide detailed anatomical knowledge that can be used as a valuable reference for rhinoplasty procedures.

El propósito de este estudio fue informar los tipos anatómicos del tabique nasal incluyendo las variaciones por disección y brindar pautas para la adaptación clínica. Para este propósito, se realizaron disecciones en 70 tabiques nasales de cadáveres adultos coreanos fijados con formalina (20 hombres, 11 mujeres y 39 de sexo desconocido) con una edad de muerte de 13 a 105 años. La desviación septal se comprobó antes de la sección medio sagital de la cavidad nasal con la ayuda de un laringoscopio. A continuación, se retiró la mucosa del tabique nasal para observar la morfología del tabique nasal. Se identificó la forma de cada componente del tabique nasal y se tomaron fotografías desde un plano mediano sagital. En el estudio se descubrieron varios tipos anatómicos del tabique nasal y sus variaciones. También se analizaron las correlaciones entre los tipos septales según sus proporciones. Los resultados informados en este documento proporcionan un conocimiento anatómico detallado que se puede utilizar como una referencia valiosa para los procedimientos de rinoplastía.

Distinct impacts of major El Niño events on Arctic temperatures due to differences in eastern tropical Pacific sea surface temperatures.

The El Niño Southern Oscillation (ENSO) is a climate mode in the tropical Pacific. The ENSO teleconnections are known to affect Arctic temperature; however, the robustness of this relationship remains debated. We find that Arctic surface temperatures during three major El Niño events are remarkably well simulated by a state-of-the-art model when nudged to the observed pantropical sea surface temperatures (SSTs). SST perturbation experiments show that the 1982-1983 warm pan-Arctic and the 1997-1998 cold pan-Arctic during winter can be explained by far eastern equatorial Pacific SSTs being higher during 1997-1998 than 1982-1983. Consistently, during the 2017-2018 La Niña, unusually low SSTs in the same region contributed to pan-Arctic warming. These pan-Arctic responses to the SSTs are realized through latent heating anomalies over the western and eastern tropical Pacific. These results highlight the importance of accurately representing SST amplitude and pattern for Arctic climate predictions.

Different expressions of AQP1 and AQP4 in hyponatremic rat brain / Diferentes expresiones de AQP1 y AQP4 en cerebro de rata hiponatrémico

SUMMARY: The expression of aquaporin-1 (AQP1) in choroid plexus and aquaporin-4 (AQP4) in astrocyte of the hippocampal formation (HF) was studied in the rat to determine the role of AQP1 and AQP4 in the pathophysiology of systemic hyponatremia (SH). SH was induced by coadministration of dextrose solution intraperitoneally and through subcutaneous implantation of an osmotic minipump containing 8-deamino-arginin vasopressin (50ng/µl/h) for 24 and 48 h. Twenty- four and 48 h after the drug administration, there were significant reductions in Na+ concentration (111 ± 5 and 104 ± 2 mmol) and serum osmolarity (240 ± 13 and 221 ± 14 mOsm/L) as compared with control values (140 ± 4.7 mmol and 296 ± 5.2 mOsm/L), (p<0.01). The expression of AQP1 in the choroid plexus was increased three to five times from 24 h to 48 h after SH (329.86 ± 10.2 % and 531.5 ± 4.4 %, n=4, p<0.01). In contrast, AQP4 expression was significantly decreased up to 48 h after SH (36 ± 9 %, n=4, p<0.01). Quantitative immunoblotting revealed significant decreases of neuronal proteins in the HF after 24 to 48 h of SH. Therefore, we suggest that altered expression of AQP1 and AQP4 plays important role in the pathogenesis of systemic hyponatremia.

RESUMEN: En este análisis se estudió la expresión de acuaporina-1 (AQP1) en plexo coroideo y acuaporina-4 (AQP4) en astrocitos de la formación hipocampal (FH) en ratas para determinar el papel de AQP1 y AQP4 en la fisiopatología de la hiponatremia sistémica (HS). La HS fue inducida mediante la coadministración de solución de dextrosa por vía intraperitoneal y mediante la implantación subcutánea de una minibomba osmótica que contenía vasopresina 8-desaminoarginina (50 ng /µ l / h) durante 24 y 48 h. Veinticuatro y 48 h después de la administración del fármaco, hubo reducciones significativas en la concentración de Na + (111 ± 5 y 104 ± 2 mmol) y la osmolaridad sérica (240 ± 13 y 221 ± 14 mOsm /µL) en comparación con los valores de control (140 ± 4,7 mmol y 296 ± 5,2 mOsm / L), (p <0,01). La expresión de AQP1 en el plexo coroideo se incrementó de tres a cinco veces de 24 a 48 h después de HS (329,86 ± 10,2 % y 531,5 ± 4,4 %, n = 4, p <0,01). Por el contrario, la expresión de AQP4 se redujo significativamente hasta 48 h después de HS (36 ± 9 %, n = 4, p <0,01). La inmunotransferencia cuantitativa reveló disminuciones significativas de proteínas neuronales en el FH después de 24 a 48 h de SH. Por lo tanto, sugerimos que la expresión alterada de AQP1 y AQP4 juega un papel importante en la patogénesis de la hiponatremia sistémica.

Sectioned and segmented images of the male whole body, female whole body, male head, and female pelvis from the Visible Korean.

In the Visible Korean, serially sectioned images with real color and high resolution have been prepared from four cadaveric subjects: male whole body, female whole body, male head, and female pelvis. Recently, segmented images of the female whole body were manufactured, permitting the distribution of the complete four data sets. The purpose of this report was to promote the applications of sectioned and segmented images from the Visible Korean by announcing them. Reduced image data were loaded to self-developed browsing software; using the browsing software, the contents could be quickly grasped and evaluated by other investigators. The four data sets were compared to disclose the individual merits and demerits. The sectioned and segmented images showed the possibility to be used to reconstruct the stereoscopic volume and surface models of body structures. The Visible Korean is expected to contribute to the interactive simulation of medical learning and clinical practice.

Mid-Holocene Northern Hemisphere warming driven by Arctic amplification.

The Holocene thermal maximum was characterized by strong summer solar heating that substantially increased the summertime temperature relative to preindustrial climate. However, the summer warming was compensated by weaker winter insolation, and the annual mean temperature of the Holocene thermal maximum remains ambiguous. Using multimodel mid-Holocene simulations, we show that the annual mean Northern Hemisphere temperature is strongly correlated with the degree of Arctic amplification and sea ice loss. Additional model experiments show that the summer Arctic sea ice loss persists into winter and increases the mid- and high-latitude temperatures. These results are evaluated against four proxy datasets to verify that the annual mean northern high-latitude temperature during the mid-Holocene was warmer than the preindustrial climate, because of the seasonally rectified temperature increase driven by the Arctic amplification. This study offers a resolution to the "Holocene temperature conundrum", a well-known discrepancy between paleo-proxies and climate model simulations of Holocene thermal maximum.

Assessment of Zn pollution sources and apportionment in agricultural soils impacted by a Zn smelter in South Korea.

This study was conducted to assess the anthropogenic impact on the metal concentration in agricultural soils in the vicinity of a Zn smelter. We determined Pb isotope ratios to trace source of metals and calculate source apportionment. 19.7% of the agricultural soil samples had Zn concentrations exceeding the Korean worrisome level (WL). The isotopic variation in the contaminated agricultural soils reflected the input of contaminants derived from the Zn smelter. The spatial distribution of Zn concentrations and Pb isotopes suggested that the Zn smelter dust fallout was the major source of heavy metal pollution in the agricultural soils. Lead isotope compositions of soil horizon I was comparable to those of soil horizon II, indicating that smelter-origin Zn had migrated vertically. Binary mixing between Zn concentrates and background soils could explain the variations in Pb isotope ratios in the contaminated agricultural soils. Source apportionment calculations showed that for agricultural soils that were found to exceed the Korean countermeasure standard (CS), the average proportion of smelter-origin Zn was 45.8%-83.3% while for agricultural soils that exceeded the WL but were below the CS, the average proportion of smelter-origin Zn was 36.3%-68.1%. The remainder was derived from a geogenic source.

The impact of Arctic sea ice loss on mid-Holocene climate.

Mid-Holocene climate was characterized by strong summer solar heating that decreased Arctic sea ice cover. Motivated by recent studies identifying Arctic sea ice loss as a key driver of future climate change, we separate the influences of Arctic sea ice loss on mid-Holocene climate. By performing idealized climate model perturbation experiments, we show that Arctic sea ice loss causes zonally asymmetric surface temperature responses especially in winter: sea ice loss warms North America and the North Pacific, which would otherwise be much colder due to weaker winter insolation. In contrast, over East Asia, sea ice loss slightly decreases the temperature in early winter. These temperature responses are associated with the weakening of mid-high latitude westerlies and polar stratospheric warming. Sea ice loss also weakens the Atlantic meridional overturning circulation, although this weakening signal diminishes after 150-200 years of model integration. These results suggest that mid-Holocene climate changes should be interpreted in terms of both Arctic sea ice cover and insolation forcing.

Quantifying climate feedbacks in polar regions.

The concept of feedback is key in assessing whether a perturbation to a system is amplified or damped by mechanisms internal to the system. In polar regions, climate dynamics are controlled by both radiative and non-radiative interactions between the atmosphere, ocean, sea ice, ice sheets and land surfaces. Precisely quantifying polar feedbacks is required for a process-oriented evaluation of climate models, a clear understanding of the processes responsible for polar climate changes, and a reduction in uncertainty associated with model projections. This quantification can be performed using a simple and consistent approach that is valid for a wide range of feedbacks, offering the opportunity for more systematic feedback analyses and a better understanding of polar climate changes.

Anomalous branching patterns of the axillary artery / Patrones de ramificación anómalos de la arteria axilar

Arterial variations in the upper limbs can cause iatrogenic injury during invasive procedures. During educational dissection of countered uncommon branching patterns of the axillary artery which have not yet been reported yet, to our knowledge. First, the second part of the axillary artery was divided into three trunks. The lateral trunk ran downward as a superficial brachioradial artery. The medial trunk raised the lateral thoracic artery, and was divided into the subscapular artery and the posterior circumflex humeral artery. The intermediate trunk branched off the anterior circumflex humeral artery as expected for an axillary artery. Second, in the other cadaver, we found a common trunk containing the thoracoacromial artery and a bulk artery dividing into three branches, the subscapular, posterior circumflex humeral, and lateral thoracic arteries. Taken together, we discuss the clinical implications and possible developmental origins of variations in the axillary artery branching and course.

Las variaciones arteriales en los miembros superiores pueden causar lesiones iatrogénicas al realizarse procedimientos invasivos. Durante una disección de rutina de los patrones de ramificación de la arteria axilar, se encontró una disposición aún no informada. En primer lugar, la segunda porción de la arteria axilar se presentó dividida en tres troncos. El tronco lateral se desplazó hacia abajo como una arteria braquiorradial superficial (arteria radial originándose de la arteria axilar). El tronco medial dio origen a la arteria torácica lateral, y se dividió en arteria subescapular y arteria circunfleja humeral posterior. El tronco intermedio dio origen a la arteria circunfleja humeral anterior como se espera para una arteria axilar. En un segundo cadáver, encontramos un tronco común entre la arteria toracoacromial y una arteria de mayor tamaño que se dividió en tres arterias: subescapular, circunfleja humeral posterior y torácica lateral. Consideradas estas variaciones arteriales en conjunto, se discuten las implicaciones clínicas y posibles orígenes del desarrollo de las variaciones en la ramificación de la arteria axilar y su trayecto.

A radial artery originating from the thoracoacromial artery.

PURPOSE: The purpose of this case report is to report a rare vascular variation in the upper limbs because of its clinical importance and embryological implication. METHODS: During the educational dissection of a 73-year-old Korean male cadaver`s right upper limb, we found a variant branch which is originated from the thoracoacromial artery. RESULTS: The variant branch from the thoracoacromial artery ran to the distal forearm in the deep fascia. Because it finally coursed like the radial artery in the forearm and the palm, we defined the variant artery as superficial brachioradial artery (SBRA). In the cubital region a little below the intercondylar line, the brachial artery gave off a small communicating branch to SBRA, and continued as the ulnar artery. CONCLUSIONS: We reported this unique variation and discussed its clinical and embryological implication.

Improved Sectioned Images and Surface Models of the Whole Female Body / Mejoramiento de Imágenes Seccionadas y Modelos de Superficie del Cuerpo Femenino Completo

The objective of this research was to present high-quality sectioned images of a whole female body which would be helpful in creating an atlas, virtual dissection, and various applications for medical education and clinical trial. In addition, the authors sought to demonstrate the applicabilities of sectioned images. A female cadaver was ground serially using the cryomacrotome and photographed to make the sectioned images. Structures in the images were segmented to produce segmented images in Photoshop. In the self-developed browsing software, the sectioned and segmented images were stored. Based on the segmented images, surface models were built on commercial software and saved as PDF file. High-quality sectioned images of the female body were taken (intervals, 0.2 mm or 1 mm; pixel size, 0.1 mm; color depth, 48 bit color). In the images obtained, very small and complicated structures could be identified in color of living body. In order to ascertain the applicability of the images, the browsing software including sectioned and segmented images and the PDF file including surface models were produced. The sectioned images and surface models produced during this research will prove to be a useful source for medical software. All data generated is available free of charge.

El objetivo fue presentar imágenes seccionadas en alta calidad de un cuerpo femenino que sería de gran ayuda en la creación de un atlas, en la disección virtual y en diversas aplicaciones para la educación médica y los ensayos clínicos; además, se trata de demostrar la aplicabilidad de las imágenes seccionadas. Un cadáver de sexo femenino fue seccionado en serie utilizando un criomicrótomo y luego fue fotografiado. Las estructuras en las imágenes fueron segmentadas para producir imágenes en Photoshop. En un programa de navegación de desarrollo propio se almacenaron las imágenes seccionadas y segmentadas. Basado en las imágenes segmentadas, los modelos de superficie fueron construidas en el programa y guardadas como archivo PDF. Las imágenes seccionadas de alta calidad del cuerpo femenino fueron tomadas con intervalos entre 0,2 o 1 mm; tamaño en píxeles de 0,1 mm y profundidad de color de 48 bits). En las imágenes obtenidas, las estructuras muy pequeñas y complicadas pudieron ser identificadas a color en el cuerpo. Con el fin de determinar la aplicabilidad de las imágenes, se produjo un programa de navegación que incluye imágenes seccionadas y segmentadas y el archivo PDF que incluye modelos de superficie. Las imágenes seccionadas y los modelos de superficie producidos durante esta investigación demostraron ser una fuente útil como programa médico. Todos los datos generados se encuentran disponibles gratuitamente.

Whole courses of the oculomotor, trochlear, and abducens nerves, identified in sectioned images and surface models.

In medicine, the neuroanatomy of the oculomotor (III), trochlear (IV), and abducens nerves (VI) is learned essentially by cadaver dissection, histological specimens, and MRI. However, these methods have many limitations and it is necessary to compensate for the insufficiencies of previous methods. The aim of this research was to present sectioned images and surface models that allow the whole courses of III, IV, and VI and circumjacent structures to be observed in detail. To achieve this, the structures of whole courses of III, IV, and VI were traced on the sectioned images, and surface models of the structures were reconstructed. As a result, nucleus of III, Edinger-Westphal nucleus, nucleus of IV, and nucleus of VI and their fibers were identified on brainstem in the sectioned images. In the sectioned images, III, IV, and VI passed both sides of the cavernous sinus and entered at the orbit through the superior orbital fissure. In the sectioned images, III, IV, and VI innervated extraocular muscles in orbit. In surface models, the whole courses of III, IV, and VI and circumjacent structures could be explored freely three-dimensionally. The greatest advantage of the sectioned images was that they allowed the whole courses of III, IV, and VI and circumjacent structures to be observed as real colored in an unbroken line. In addition, the surface models allowed the stereoscopic shapes and positions of III, IV, and VI to be comprehended. The sectioned images and surface models could be applied for medical education purposes or training tools. All data generated during this study is available free of charge at anatomy.dongguk.ac.kr/cn/.

Improved sectioned images and surface models of the whole dog body.

The objective of this research was to produce high-quality sectioned images of a whole dog which can be used to create sectional anatomy atlases and three-dimensional (3D) models. A year old female beagle was sacrificed by potassium chloride injection and frozen. The frozen dog was then serially ground using a cryomacrotome. Sectioned surfaces were photographed using a digital camera to create 3555 sectioned images of whole dog body (intervals, 0.2 mm; pixel size, 0.1 mm; 48 bit color). In a sectioned image, structures of dimension greater than 0.1mm could be identified in detail. Photoshop was used to make segmented images of 16 structures. Sectioned and segmented images were stored in browsing software to allow easy access. Segmented images were reconstructed to make surface models of 16 structures using Mimics software and stored in portable document format (PDF) using Adobe 3D Reviewer software. In this research, state-of-art sectioned images and surface models were produced for the dog. The authors hope that the sectioned images produced will become a useful source of software for basic and clinical veterinary medicine, and therefore, are distributing the sectioned images and surface models through browsing software and PDF file available free of charge.

Accessible and informative sectioned images, color-coded images, and surface models of the ear.

In our previous research, we created state-of-the-art sectioned images, color-coded images, and surface models of the human ear. Our ear data would be more beneficial and informative if they were more easily accessible. Therefore, the purpose of this study was to distribute the browsing software and the PDF file in which ear images are to be readily obtainable and freely explored. Another goal was to inform other researchers of our methods for establishing the browsing software and the PDF file. To achieve this, sectioned images and color-coded images of ear were prepared (voxel size 0.1 mm). In the color-coded images, structures related to hearing, equilibrium, and structures originated from the first and second pharyngeal arches were segmented supplementarily. The sectioned and color-coded images of right ear were added to the browsing software, which displayed the images serially along with structure names. The surface models were reconstructed to be combined into the PDF file where they could be freely manipulated. Using the browsing software and PDF file, sectional and three-dimensional shapes of ear structures could be comprehended in detail. Furthermore, using the PDF file, clinical knowledge could be identified through virtual otoscopy. Therefore, the presented educational tools will be helpful to medical students and otologists by improving their knowledge of ear anatomy. The browsing software and PDF file can be downloaded without charge and registration at our homepage (http://anatomy.dongguk.ac.kr/ear/).

Outlining of the detailed structures in sectioned images from Visible Korean.

PURPOSE: Sectioned images of cadavers enable creation of realistic three-dimensional (3D) models. In order to build a 3D model of a structure, the structure has to be outlined in the sectioned images. The outlining process is time consuming; therefore, users want to be provided with outlined images. The more detailed structures are outlined, the greater potential for wider application of the outlined images. METHODS: In the Visible Korean, sectioned images (intervals 0.2 mm) of the entire body of a male cadaver were prepared. In the available 1,702 sectioned images (intervals 1 mm), 937 structures were outlined over a period of 8 years. The outlined images were altered to black-filled images for each structure; black-filled images were selected for distribution in order to maintain small file sizes. RESULTS: We attempted to determine whether black-filled images could be used in various situations. The outlines of these images were interpolated for production of new images at 0.2 mm intervals. The outlines were then filled with different colors for construction of color-filled images of all structures. Volume and surface reconstructions of the black-filled images were executed in order to build volume and surface models. CONCLUSION: The black-filled images with corresponding sectioned images presented here are the source of realistic 3D models for use in medical simulation systems.

Browsing software of the Visible Korean data used for teaching sectional anatomy.

The interpretation of computed tomographs (CTs) and magnetic resonance images (MRIs) to diagnose clinical conditions requires basic knowledge of sectional anatomy. Sectional anatomy has traditionally been taught using sectioned cadavers, atlases, and/or computer software. The computer software commonly used for this subject is practical and efficient for students but could be more advanced. The objective of this research was to present browsing software developed from the Visible Korean images that can be used for teaching sectional anatomy. One thousand seven hundred and two sets of MRIs, CTs, and sectioned images (intervals, one millimeter) of a whole male cadaver were prepared. Over 900 structures in the sectioned images were outlined and then filled with different colors to elaborate each structure. Software was developed where four corresponding images could be displayed simultaneously; in addition, the structures in the image data could be readily recognized with the aid of the color-filled outlines. The software, distributed free of charge, could be a valuable tool to teach medical students. For example, sectional anatomy could be taught by showing the sectioned images with real color and high resolution. Students could then review the lecture by using the sectioned and color-filled images on their own computers. Students could also be evaluated using the same software. Furthermore, other investigators would be able to replace the images for more comprehensive sectional anatomy.

Segmentation and surface reconstruction of the detailed ear structures, identified in sectioned images.

The structure of the ear, which intervenes between gross anatomy and histology in size, can be best understood by means of three-dimensional (3D) surface models on a computer. Furthermore, surface models are the source of interactive simulation for clinical trials, such as tympanoplasty. The objective of this research was to elaborate the surface models of detailed ear structures, which contribute to learning anatomy or the practice of otology. We produced sectioned images of a cadaver head (pixel size, 0.1 mm; 48-bit color). In the sectioned images, the external, middle, and internal ear structures and other related components were delineated on Photoshop to acquire segmented images at 0.5-mm intervals. Segmented images of each structure were stacked, and the surface was reconstructed to generate a 3D-surface model on commercial software. Thirty surface models showed fine ear topographic anatomy (e.g., semicircular ducts), as expected. Herein, we present the corresponding sectioned images, segmented images, and surface models of ear structures that will be released together. It is hoped that these image data will stimulate the development of medical simulations. The efficient technique of segmentation and surface reconstruction enables the manufacture of surface models from other serial images (e.g., CTs and MRIs).

Segmentation of cerebral gyri in the sectioned images by referring to volume model.

Authors had prepared the high-quality sectioned images of a cadaver head. For the delineation of each cerebral gyrus, three-dimensional model of the same brain was required. The purpose of this study was to develop the segmentation protocol of cerebral gyri by referring to the three-dimensional model on the personal computer. From the 114 sectioned images (intervals, 1 mm), a cerebral hemisphere was outlined. On MRIcro software, sectioned images including only the cerebral hemisphere were volume reconstructed. The volume model was rotated to capture the lateral, medial, superior, and inferior views of the cerebral hemisphere. On these four views, areas of 33 cerebral gyri were painted with colors. Derived from the painted views, the cerebral gyri in sectioned images were identified and outlined on the Photoshop to prepare segmented images. The segmented images were used for production of volume and surface models of the selected gyri. The segmentation method developed in this research is expected to be applied to other types of images, such as MRIs. Our results of the sectioned and segmented images of the cadaver brain, acquired in the present study, are hopefully utilized for medical learning tools of neuroanatomy.

A proposal of new reference system for the standard axial, sagittal, coronal planes of brain based on the serially-sectioned images.

Sectional anatomy of human brain is useful to examine the diseased brain as well as normal brain. However, intracerebral reference points for the axial, sagittal, and coronal planes of brain have not been standardized in anatomical sections or radiological images. We made 2,343 serially-sectioned images of a cadaver head with 0.1 mm intervals, 0.1 mm pixel size, and 48 bit color and obtained axial, sagittal, and coronal images based on the proposed reference system. This reference system consists of one principal reference point and two ancillary reference points. The two ancillary reference points are the anterior commissure and the posterior commissure. And the principal reference point is the midpoint of two ancillary reference points. It resides in the center of whole brain. From the principal reference point, Cartesian coordinate of x, y, z could be made to be the standard axial, sagittal, and coronal planes.