Anatomy of the superior hypogastric plexus and its application in nerve-sparing paraaortic lymphadenectomy.

BACKGROUND: The purpose of this study was to clarify the anatomy of the superior hypogastric plexus, which would contribute to advancement of nerve-sparing paraaortic lymphadenectomy. MATERIALS AND METHODS: Eighteen cadavers were dissected and morphometrically analysed based on photographic images. Anatomical landmarks such as aortic bifurcation, transitional points of abdominal aorta to bilateral common iliac arteries, and cross point of the right ureter and pelvic brim, and cross point of sigmoid mesentery and pelvic brim were selected as reference points. RESULTS: The left lowest lumbar splanchnic nerve was located more laterally to transitional point of abdominal aorta to in 11/18 specimens, whereas the right lowest lumbar splanchnic nerve passed onto the right transitional point in only one specimen. The lowest lumbar splanchnic nerves or the superior hypogastric plexus covered the aortic bifurcation in 11/18 specimens. The superior hypogastric plexus was separate from the cross point of right ureter and pelvic brim as well as cross point of sigmoid mesentery and pelvic brim. CONCLUSIONS: The superior hypogastric plexus is at risk of injury during paraaortic lymphadenectomy because of its topography. Preservation of the superior hypogastric plexus regarding its anatomic basis during paraaortic lymphadenectomy is required.

Anatomical changes in the East Asian midface skeleton with aging.

BACKGROUND: Understanding the aging process of the midface skeleton is considered crucial for correct facial rejuvenation. However, the canine fossa, an important morphological feature of the midface skeleton, has not yet been observed in connection with aging, despite the fact that it is the most main part of the maxillary bone. Here, the authors focus on the depression of the canine fossa to evaluate the Asian midface skeleton. MATERIALS AND METHODS: Computed tomography (CT) scans of the facial skeleton of 114 Koreans (59 males and 55 females) were reconstructed to three-dimensional (3D) images using a 3D analysis software programme. The study subjects included 27 young males, 32 old males, 28 young females and 27 old females. The angular measurements of three bony regions were measured for each 3D model: the canine fossa angle (assessing depth of the canine fossa), the maxillary angle (assessing orientation of the lateral maxilla) and the piriform angle (assessing orientation of the medial maxilla). RESULTS: The canine fossa angle showed a statistically significant decrease with aging in both sexes, indicating the canine fossa actually becomes more concave with age. In contrast, the maxillary and piriform angle showed statistically insignificant changes with aging in female subjects. CONCLUSIONS: These results suggest that the canine fossa may be one of the effective markers to evaluate the anatomical changes to the facial skeleton with midface aging. (.

Pre-harvest foliar application of ethephon strengthens gibberellins-induced fruit expansion in Pyrus pyrifolia.

To identify the roles of ethylene in fruit development in Japanese pear Pyrus pyrifolia 'Niitaka', one of the non-climacteric genotypes, source-sink strength and fruit development during fruit expansion were investigated when ethephon was applied after a conventional gibberellic acid (GA) lanolin paste treatment on the pedicel. The results demonstrate that the conventional GA treatment during the early stage of fruit expansion resulted in larger fruit size and advanced fruit maturation, but pre-harvest foliar application of ethephon only advanced fruit maturation. However, pre-harvest foliar application of ethephon with a preceding conventional GA treatment during the early stage of fruit expansion dramatically improved fruit size and advanced fruit maturation over GA or ethephon alone. Moreover, the early foliar application of ethephon showed a better efficacy in increasing fruit size than the late spraying. A further study revealed that when ethephon was applied after the conventional GA treatment, it improved source-sink strength associated with leaf photosynthesis and the specific rate of [13C] accumulation in fruit, and also strengthened cell expansion more than did GA or ethephon alone.

Forensic odontological examination of a 1500 year-old human remain in ancient Korea (Gaya).

Forensic odontological examination was performed on one of the 1500-year old human remains of ancient Korea (Gaya) excavated from a burial site at Songhyeon-dong, Changnyeong, South Korea in April, 2008. The main purpose of the examination was to age estimate the remains and record any dental characteristics to aid full-body reconstruction and life history data collection. Oral and radiographic examinations and metric data collection were conducted. During the oral examination, the following observations were made: dental caries, semi-circular abrasion on the maxillary right lateral incisor and enamel hypoplasia on the left and right canines and first premolars in the mandible. The metric data was similar to that of average metric data of modern Koreans. Age estimation was initially conducted using the degree of dental attrition with methods of Takei and Yun, and was estimated to be approximately 40 years. However, it was observed in the radiographic examination, that the maxillary right second molar, together with the mandibular left and right second and third molars had incompletely developed root apices. The age estimation was then performed using the developmental status of the lower second and third molars. The age was estimated to be approximately 16 years using Lee's method which was consistent with the estimation using forensic anthropology. This case study highlights that the degree of attrition should not be used as a sole indicator for age estimation.

Morphological characteristics of the infraorbital foramen and infraorbital canal using three-dimensional models.

Infraorbital nerve blocking through the infraorbital foramen and infraorbital canal is used to anesthetize the lower eyelid, upper lip, lateral nose, upper teeth and related gingivae. For this, it is important to know the position of the infraorbital foramen, structures around the foramen, and the direction of the injecting needle related to the angle of the infraorbital canal. Many reports have described the anatomical location of the infraorbital foramen; however, not many have described the angle of the infraorbital canal and those structures around the infraorbital foramen that help the physician visualize the correct direction of the needle. Dried skulls of 42 Korean subjects (27 male and 15 female) were studied to analyze structures around the infraorbital foramen. The morphology of the infraorbital canal was also investigated using three-dimensional models. Structures around the infraorbital foramen were classified into four types according to the existence of a distinct tuberosity above the infraorbital foramen, and the degree of prominence of the canine fossa. Types I and II have a tuberosity above the infraorbital foramen, whereas types III and IV have no distinct tuberosity. Types I and III have a prominent canine fossa, whereas this is less prominent in types II and IV. We analyzed the skulls based on the angle of the infraorbital canal to the median plane. We compared the left and right sides and analyzed differences between the sexes, the three canal shapes, and the four structure types around the infraorbital foramen. Type IV was the most common in this series (38%). The infraorbital canal could be classified into three morphologies: 'tube-like' (69%), 'funnel' (25%) and 'pinched' (6%). The mean angle of the infraorbital canal relative to the median plane was 12 degrees , and the angle relative to the Frankfurt plane was 44 degrees . The mean angle between the infraorbital canal and the Frankfurt plane was 4 degrees larger in males than in females in this series of Korean subjects. The operator of the infraorbital nerve block should pay attention towards directing the needle upward at an angle of about 44 degrees for avoiding nerve damage and consider the different angles of the canal according to the individual's sex.

Arterial supply and biliary drainage of the dorsal liver: a dissection study using controlled specimens.

Liver surgeons favor using the entity called the 'dorsal liver' (i.e. the caudate lobe and other paracavally located liver parenchyme of segments 7 and 8). According to minute dissection of 48 livers, we describe the territories of the left/right portal veins, hepatic ducts and hepatic arteries in the dorsal liver. In the caudate lobe, the right hepatic artery, rather than the left hepatic artery (23/48 vs 19/48 for right vs left, respectively), tended to supply the 'left' portal vein territory. Similarly, paradoxical drainage patterns, such as the right hepatic duct draining the left portal vein territory, were found in seven of 48 livers. In the territory of the hilar bifurcation, right hepatic artery dominance was also evident and various bile drainage patterns were found. These included double drainage by the bilateral hepatic ducts (3/48) and drainage into the confluence of bilateral ducts (6/48). In contrast, the arterial supply and biliary drainage of the paracavally located parenchyme of segments 7 and 8 usually depended on the proper segmental arteries and ducts and their variations were within the range of those found in other parts of the right lobe. Therefore, the dorsal liver concept may not be anatomical but, rather, simply aimed at usefulness in surgery. Nevertheless, clear subdivision of the caudate lobe according to biliary drainage and/or arterial supply seemed difficult because of the paradoxical relatioships among the portal vein, hepatic artery and bile duct. Consequently, the present results support extended surgery based on the dorsal liver concept for carcinomas involving the caudate lobe.

Left lobe hypoplasia of the human liver: a report of two cases.

Two cases of left lobe hypoplasia of the human liver were dissected minutely to show the intrahepatic vessels and ducts. In the left side of the round ligament, one case had a large cyst-like mass containing dilated vessels and ducts, while the other was accompanied by three rugby-ball-like parenchymal masses, each of which was covered by the peritoneum. The former specimen carried the usual Spiegel's lobe, while the latter was very small. Fascial and peritoneal fusion was evident at and around these two left lobes. In both cases the left hepatic vein showed the usual course and terminal end, segment IV was present to a greater or lesser degree. Thus, we hypothesized that, due to fascial and peritoneal fusion, membranous stricture occurred at the peripheral portions of the left portal trunk and left hepatic duct. The discussion focuses on a comparison of intrahepatic vascular configurations in four recently reported cases, including the present two livers.

Role of protein kinase Cdelta in transmitting hypoxia signal to HSF and HIF-1.

An hypoxic microenvironment is an important modulator of gene expression in many pathophysiological conditions. In this study, we show a coordinate activation of heat shock transcription factor (HSF) and hypoxia-inducible factor-1 (HIF-1) in RIF tumor cells by hypoxia. Since heat shock protein (hsp) and angiogenic factor genes that are regulated by HSF and HIF-1 are thought to contribute to the malignant progression of hypoxic tumor cells, it was of our major interest to identify the components that are responsible for the activation of both HSF and HIF-1. Our finding that a bioflavonoid quercetin (QCT), a well known inhibitor of hsp gene expression, significantly inhibited the transcriptional activation of HSF and HIF-1 strongly suggests that QCT-sensitive molecule(s) is involved in the transcriptional activation of HSF and HIF-1 by hypoxia. Our results revealed that PCKalpha, delta and epsilon isoforms are expressed in RIF cells, but only PKCdelta was specifically translocated to the membrane by hypoxia. Our results also revealed that the translocation of PKCdelta was completely abrogated by QCT. Moreover, inhibiting the PKCdelta activation, either pharmacologically with phorbol 12-myristate 13-acetate or with bisindolymaleimide II or genetically by transient transfection of a dominant negative PKCdelta, significantly inhibited the transcriptional activation of HSF and HIF-1 by hypoxia. These results strongly substantiate a view that the PKCdelta isozyme is the QCT-sensitive molecule that plays an important role in transmitting hypoxia signals to both HSF and HIF-1. Here we show that the membrane translocation of PKCdelta is dependent on the activation of phosphoinositol 3-kinase (PI3K). Treatment with PI3K inhibitor, wortmannin or LY294002, abrogated not only PKCdelta translocation but the subsequent transcriptional activation of HSF and HIF-1 by hypoxia. Together, our study shows that the PKCdelta isozyme acts as a shared component in transmitting hypoxia-induced signals to both HSF and HIF-1, and that the upstream regulator of PKCdelta is PI3K.