Effects of a Free Electronic Book on Systemic Anatomy with Schematics on Student Learning / Efectos de un Libro Electrónico Gratuito sobre Anatomía Sistémica con Esquemas sobre el Aprendizaje de los Estudiantes

SUMMARY: For students in schools of nursing, health sciences, and premed, a systemic anatomy textbook with minimized contents, schematics, and mnemonics may be helpful for learning an otherwise often unappealing subject. In this study, we assess the educational effect of such a textbook. Schematic drawings, anatomy comics, and easily readable text were generated for the chapters of the book (e.g., skeletal system, articular system). The book was presented without charge via a webpage (anatomy.co.kr). Nursing students who were exposed to the book and those who were not exposed were compared; a survey was administered to those who were exposed. The students who read the presented textbook were more knowledgeable than those who used other textbooks. Hours spent reading the presented textbook and scores of fill-in-the-blank questions were positively correlated. In general, the students replied that the presented textbook was helpful for learning systemic anatomy. The systemic anatomy textbook accompanies preexisting textbooks in regional anatomy, neuroanatomy, and the histology, all of which are written by the same authors. We suggest anatomy instructors generate their own books with unique style to enrich the student learning process.

Para los estudiantes de las escuelas de enfermería, ciencias de la salud y premedicina, un libro de texto de anatomía sistémica con contenidos, esquemas y mnemónicos minimizados puede ser útil para aprender un tema que de otro modo sería poco atractivo. En este estudio, evaluamos el efecto educativo de dicho libro de texto. Se generaron dibujos esquemáticos, cómics de anatomía y texto de fácil lectura para los capítulos del libro (por ejemplo, sistema esquelético, sistema articular). El libro se presentó sin costo a través de una página web (anatomy.co.kr). Se compararon los estudiantes de enfermería que estuvieron expuestos al libro y los que no estuvieron expuestos. Se administró una encuesta a quienes estuvieron expuestos. Los estudiantes que leyeron el libro de texto presentado tenían más conocimientos que aquellos que usaron otros libros de texto. Las horas dedicadas a leer el libro de texto presentado y las decenas de preguntas para completar espacios en blanco se correlacionaron positivamente. En general, los estudiantes respondieron que el libro de texto presentado fue útil para aprender anatomía sistémica. El libro de texto de anatomía sistémica acompaña a los libros de texto preexistentes de anatomía regional, neuroanatomía e histología, todos escritos por los mismos autores. Sugerimos que los instructores de anatomía generen sus propios libros con un estilo único para enriquecer el proceso de aprendizaje de los estudiantes.

Anti-Pollutant Activity of Porphyra yezoensis Water Extract and Its Active Compound, Porphyra 334, against Urban Particulate Matter-Induced Keratinocyte Cell Damage.

Urban particulate matter (UPM) causes skin aging and inflammatory reactions by influencing skin cells through the aryl hydrocarbon receptor (AhR) signaling pathway. Porphyra yezoensis (also known as Pyropia yezoensis), a red alga belonging to the Bangiaceae family, is an edible red seaweed. Here, we examined the anti-pollutant effect of P. yezoensis water extract. While UPM treatment induced xenobiotic response element (XRE) promoter luciferase activity, P. yezoensis water extract reduced UPM-induced XRE activity. Next, we isolated an active compound from P. yezoensis and identified it as porphyra 334. Similar to the P. yezoensis water extract, porphyra 334 attenuated UPM-induced XRE activity. Moreover, although UPM augmented AhR nuclear translocation, which led to an increase in cytochrome P450 1A1 (CYP1A1) mRNA levels, these effects were reduced by porphyra 334. Moreover, UPM induced the production of reactive oxygen species (ROS) and reduced cell proliferation. These effects were attenuated in response to porphyra 334 treatment. Furthermore, our results revealed that the increased ROS levels induced by UPM treatment induced transient receptor potential vanilloid 1 (TRPV1) activity, which is related to skin aging and inflammatory responses. However, porphyra 334 treatment reduced this reaction by inhibiting ROS production induced by CYP1A1 activation. This indicates that porphyra 334, an active compound of P. yezoensis, attenuates UP-induced cell damage by inhibiting AhR-induced ROS production, which results in a reduction in TRPV1 activation, leading to cell proliferation. This also suggests that porphyra 334 could protect the epidermis from harmful pollutants.

Three-Dimensional Postoperative Results Prediction for Orthognathic Surgery through Deep Learning-Based Alignment Network.

To date, for the diagnosis of dentofacial dysmorphosis, we have relied almost entirely on reference points, planes, and angles. This is time consuming, and it is also greatly influenced by the skill level of the practitioner. To solve this problem, we wanted to know if deep neural networks could predict postoperative results of orthognathic surgery without relying on reference points, planes, and angles. We use three-dimensional point cloud data of the skull of 269 patients. The proposed method has two main stages for prediction. In step 1, the skull is divided into six parts through the segmentation network. In step 2, three-dimensional transformation parameters are predicted through the alignment network. The ground truth values of transformation parameters are calculated through the iterative closest points (ICP), which align the preoperative part of skull to the corresponding postoperative part of skull. We compare pointnet, pointnet++ and pointconv for the feature extractor of the alignment network. Moreover, we design a new loss function, which considers the distance error of transformed points for a better accuracy. The accuracy, mean intersection over union (mIoU), and dice coefficient (DC) of the first segmentation network, which divides the upper and lower part of skull, are 0.9998, 0.9994, and 0.9998, respectively. For the second segmentation network, which divides the lower part of skull into 5 parts, they were 0.9949, 0.9900, 0.9949, respectively. The mean absolute error of transverse, anterior-posterior, and vertical distance of part 2 (maxilla) are 0.765 mm, 1.455 mm, and 1.392 mm, respectively. For part 3 (mandible), they were 1.069 mm, 1.831 mm, and 1.375 mm, respectively, and for part 4 (chin), they were 1.913 mm, 2.340 mm, and 1.257 mm, respectively. From this study, postoperative results can now be easily predicted by simply entering the point cloud data of computed tomography.

Volumetric Change in the Masseter and Lateral Pterygoid after Mandibular Setback.

In this study, we evaluated changes in the masseter and lateral pterygoid muscles in the prognathic mandible group after a mandibular setback by comparing the volume-to-length ratios. Preoperative and postoperative 1-year computed tomography was used to calculate the volume-to-length ratio of the lateral pterygoid and masseter muscle in 60 Korean individuals. Three-dimensional images were reconstructed, the results of which showed no significant differences in the volume-to-length ratios of the masseter and lateral pterygoid muscles after a mandibular setback (p > 0.05). This result was found for both vertical ramus osteotomy and sagittal split ramus osteotomy, and for both males and females. No significant differences in the volume-to-length ratio of the masseter and lateral pterygoid muscles were found up to 1 year after a mandibular setback. Therefore, this study can contribute to the prediction of soft-tissue profiles after mandibular setback.

Anti-Aging Effects of Leontopodium alpinum (Edelweiss) Callus Culture Extract Through Transcriptome Profiling.

Edelweiss (Leontopodium Alpinum) in the family Asteraceae is a wildflower that grows in rocky limestone places. Here, we investigated the efficacy of edelweiss callus culture extract (Leontopodium Alpinum callus culture extract; LACCE) using multiple assays from in vitro to in vivo as well as transcriptome profiling. Several in vitro assay results showed the strong antioxidant activity of LACCE in response to UVB treatment. Moreover, LACCE suppressed inflammation and wrinkling; however, moisturizing activity was increased by LACCE. The clinical test in vivo demonstrated that constant application of LACCE on the face and skin tissues improved anti-periorbital wrinkles, skin elasticity, dermal density, and skin thickness compared with the placebo. The RNA-Sequencing results showed at least 16.56% of human genes were expressed in keratinocyte cells. LACCE up-regulated genes encoding several KRT proteins; DDIT4, BNIP3, and IGFBP3 were involved in the positive regulation of the developmental process, programmed cell death, keratinization, and cornification forming skin barriers, which provide many advantages in the human skin. By contrast, down-regulated genes were stress-responsive genes, including metal, oxidation, wounding, hypoxia, and virus infection, suggesting LACCE did not cause any harmful stress on the skin. Our comprehensive study demonstrated LACCE is a promising agent for anti-aging cosmetics.

Sectioned images and 3D models of a cadaver head with reference to dermal filler injection.

The purpose of this study was to describe anatomical consideration with reference to dermal filler injection on sectioned images and three dimensional (3D) models using Visible Korean for medical education and clinical training purposes in the field of facial surgery. Serially sectioned images of the head were acquired from a cadaver. Anatomic structures related to dermal filler injection were 3D-reconstructed based on sectioned images, and additional structures were built on the basis of the established ones using a semi-automatic method. The anatomical 3D models were assembled and converted to a PDF file (66MB), which can be downloaded and used for free. In the PDF file, noticeable anatomical structures related with dermal filler injection can be identified on the 3D models as well as on the sectioned anatomical images. The 3D models in PDF were optimized and displayed in real time. These state-of-the-art sectioned images, outlined images, and 3D models will aid students and trainees to acquire a better understanding of the anatomy related to dermal filler injection, and will also improve medical understanding of patients and the general public. The 3D models in PDF files also can be used on dermal filler injection simulations.

Surface Reconstruction and Optimization of Cerebral Cortex for Application Use.

For the purposes of virtual surgery, medical education, medical communication, and realistic surface models of anatomic structures are required. In the most involved method, surface models can be made using segmentation and three-dimensional reconstruction procedures. Such models, however, are computationally expensive, and can be difficult to use. Therefore, optimization is often performed manually, but this is a time-consuming job that requires considerable artistic talent. In this article, the authors describe a method that uses Maya and ZBrush to construct optimized surface models of anatomic structures. The authors take 235 anatomic images generated from a cadaver, and perform segmentation and surface reconstruction using Photoshop and Mimics. Reconstructed surface models of the cerebral cortex are then optimized and divided by a morphing technique in Maya and ZBrush for use in medical applications. The optimized surface models do not require significant storage space, and are easily manufactured and modified. The resulting surface models can be displayed off-line and on-line in real time, as well as on smart phones. Using commercial software with the specialized functions described in this study, it is expected that the efficiencies produced by the proposed method will enable researchers to conveniently create surface models from serially sectioned images such as computed tomographs and magnetic resonance images. The surface models created in this research will also have widespread applications in both medical education and communication.

Portable Document Format File Containing the Surface Models to Learn the Stereoscopic Shape of Foot Muscles / Archivos en Formato de Documento Portátil con Modelos de Superficie para Aprender la Forma Estereoscópica de los Músculos del Pié

We intended to present a portable document format (PDF) file containing stereoscopic surface models of the foot. While other surface models are subjectively drawn based on anatomical knowledge, our models are reconstructed from high quality sectioned images. Unlike other models, ours in the complimentary PDF file can also be saved on individual user computers to be manipulated off-line. The skin, 27 bones, 24 muscles, and 19 ligaments in the foot were delineated on a male cadaver's sectioned images from the Visible Korean project. After stacking the outlines of the structures, other than those of the ligaments, surface reconstruction was performed. The resultant surface models were placed in a PDF file, in which the models could be superimposed on either the corresponding sectioned images or the color-filled outline images. PDF bookmarks were established to exhibit the groups of foot muscles conveniently. The PDF file prepared in this research is likely to be very useful for comprehension of the topographic anatomy of the foot muscles. The models it contains can be extracted by other researchers for their own virtual dissection or surgery visualization of foot as desired.

El objetivo de este estudio fue un archivo en formato de documento portátil (PDF) que contiene modelos de superficie estereoscópicas del pie. Mientras que otros modelos de superficie se dibujan subjetivamente sobre la base de los conocimientos anatómicos, nuestros modelos seccionados se reconstruyen a partir de imágenes de alta calidad. A diferencia de otros modelos, nuestro modelo en el archivo PDF también se puede guardar en los computadores de los usuarios individuales para ser manipulados fuera de línea. Se delineó la piel, 27 huesos, 24 músculos, y 19 ligamentos en los pies de un cadáver de sexo masculino del proyecto Visible Korean. Después de apilar los contornos de las estructuras, que no fuera las de los ligamentos, se llevó a cabo la reconstrucción de las superficies. Los modelos de superficie resultantes se colocan en un archivo PDF, en el que los modelos podrían ser superpuestos en cualquiera de las correspondientes imágenes seccionadas o las imágenes de contorno a color. Se establecieron marcadores de PDF para exhibir los grupos de músculos del pie cómodamente. El archivo PDF preparado de esta investigación probablemente sea muy útil para la comprensión de la anatomía topográfica de los músculos del pie. Los modelos que contiene pueden ser extraídos por otros investigadores para la disección o cirugía de visualización virtual de los pies.

Virtual movement of the ankle and subtalar joints using cadaver surface models / Movimiento virtual de las articulaciones talocrural y subtalar utilizando modelos de superficie de cadáveres

Medical students in the dissection room do not fully understand the ankle joint for dorsiflexion and plantar flexion as well as the subtalar joint for inversion and eversion. Thus, a three-dimensional simulation of the movements would be beneficial as a complementary pedagogic tool. The bones and five muscles (tibialis anterior, tibialis posterior, fibularis longus, fibularis brevis, and fibularis tertius) of the left ankle and foot were outlined in serially sectioned cadaver images from the Visible Korean project. The outlines were verified and revised; and were stacked to build surface models using Mimics software. Dorsiflexion and plantar flexion were simulated using the models on Maya to determine the mediolateral axis. Then, inversion and eversion were done to determine the anteroposterior axis. The topographic relationship of the two axes with the five affecting muscles was examined to demonstrate correctness. The models were placed in a PDF file, with which users were capable of mixed display of structures. The stereoscopic image data, developed in this investigation, clearly explain ankle movement. These graphic contents, accompanied by the sectioned images, are expected to facilitate the development of simulation for the medical students' learning and the orthopedic surgeons' clinical trial.

Los estudiantes de medicina en la sala de disección no entienden completamente la dorsiflexión y flexión plantar de la articulación talocrural, así como la inversión y eversión de la articulación subtalar. Por tanto, la simulación 3D de estos movimientos resultaría beneficiosa como herramienta pedagógica complementaria. Los huesos y cinco músculos (tibial anterior, tibial posterior, fibular largo, fibular corto y fibular tercero), se describen en imágenes del proyecto "Visible Korean", de cadáveres seccionados en serie. Los contornos fueron verificados, revisados, y agrupados para construir modelos de superficie utilizando el programa Mimics. Los movimientos de dorsiflexión y flexión plantar fueron simulados utilizando los modelos generados en el programa Maya, para determinar el eje mediolateral. La inversión y eversión se realizó para determinar el eje anteroposterior. Se examinó la relación topográfica de los dos ejes con los cinco músculos estudiados para demostrar la exactitud de movimientos. Los modelos fueron colocados en un archivo PDF, mediante el cual los usuarios fueron capaces de obtener una visualización combinada de las estructuras. Los datos procedentes de imágenes estereoscópicas, obtenidos en esta investigación, permiten explicar claramente el movimiento de las articualciones talocrural y subtalar. Estos contenidos gráficos, acompañados de las imágenes seccionadas, facilitarán el desarrollo de la simulación en el aprendizaje de los estudiantes y su uso en ensayos clínicos por parte de cirujanos ortopédicos.

Sectioned Images and Surface Models of a Cadaver for Understanding the Dorsalis Pedis Flap.

The aim of this study was to represent the dorsalis pedis (DP) flap on sectioned images and surface models using Visible Korean for medical education and clinical training in the field of maxillofacial reconstructive surgery. Serially sectioned images of the foot were obtained from a cadaver. The important structures in the sectioned images were outlined and stacked to create a surface model. The PDF file (53 MB) of the assembled models is accessible for free download on the Department of Anatomy at Ajou University School of Medicine Web site (http://anatomy.co.kr). In this file, the significant anatomic structures of the DP flap can be inspected in the sectioned images. All surface models and stereoscopic structures of the DP flap are described in real time. We hope that these state-of-the-art sectioned images, outlined images, and surface models will help students and trainees gain a better understanding of the DP flap anatomy.

Virtual dissection table including the Visible Korean images, complemented by free software of the same data / Mesa de disección virtual que incluye las imágenes de Visible Korean, complementadas por programa de libre acceso con igual información

The objective of this study was to introduce the complementary relationship between virtual dissection table (simply, table) and free software, since authors tried to aid interested people in their studying digital human anatomy. Visible Korean (VK) team had presented the serially sectioned images and outlined images of a male cadaver. Thereafter, Anatomage (San Jose, CA) manufactured the table by making 3-dimensional (3D) volume models from the data. Separately, the VK team reconstructed surface models from the same data and inputted the models in portable document format (PDF) file, which can be opened on the personal computer. The software to browse the sectioned and outlined images was also programmed by VK team. In this report, the table and the VK free software were compared to establish their supplementary potentiality. Both the table and free software displayed equivalent 3D models reconstructed from the same sectioned images. In both platforms, the models were labeled for users to recognize the individual structures. Both the table and the free software had respective features to enhance the virtual dissecting experience. The table came with its designated hardware with life-sized display, whereas VK software could be run in any personal computer without burden. The coexistence of the table and free software will enrich the people learning anatomy. With increasing VK data and free software, more and more commercial or complimentary products are expected to be produced.

El objetivo de este estudio fue introducir la relación complementaria entre una mesa virtual de disección (simplemente, la mesa) y un programa de libre acceso. Mediante este proceso los autores trataron de ayudar a aquellas personas interesadas en el estudio de la anatomía humana digital. El equipo Visible Korean (VK) había presentado las imágenes de secciones consecutivas e imágenes de un cadáver de sexo masculino. Partiendo de ese punto, la compañía Anatomage fabricó la mesa produciendo con los datos modelos dimensionales de volumen (3D). En forma paralela, el equipo VK reconstruyó los modelos de superficie con los mismos datos y de entrada de los modelos en formato de documento portátil (PDF), que se pudieran abrir en el ordenador personal. El equipo VK además lo programó para navegar a través de las imágenes seccionadas y descritas. En este informe, la mesa y el programa VK fueron comparados para establecer su potencialidad complementaria. Tanto la mesa como el programa de libre acceso muestran modelos 3D equivalentes reconstruidos a partir de las mismas imágenes seccionadas. En ambas plataformas, se marcaron los modelos para que los usuarios reconozcan las estructuras individuales. Tanto la mesa y el programa libre tenían características respectivas para mejorar la experiencia de disección virtual. La mesa incluía el hardware designado con la pantalla de tamaño natural, mientras que el programa VK podía ser ejecutado en cualquier ordenador personal sin dificultad alguna. La coexistencia de la mesa y el programa libre pueden ser un apoyo importante para quienes estudien anatomía. Con el aumento de los datos de VK y el programa libre, se espera que exista una mayor cantidad de productos comerciales o gratuitos.

Virtual Endoscopic and Laparoscopic Exploration of Stomach Wall Based on a Cadaver's Sectioned Images.

We intended to determine that virtual endoscopy and laparoscopy of the stomach based on serially sectioned cadaver images is beneficial. Therefore, the outlines between the gastric wall and lumen were traced using the new female data of the Visible Korean to build a volume model. While the outlines were expanded at appropriate thicknesses, the stomach was observed endoscopically and laparoscopically in comparison with a chosen sectioned image. Four layers (mucosa, submucosa, muscular layer, and serosa) of the stomach were discernible by their proper colors in the sectioned images. All layers except the submucosa were identified in the endoscopic and laparoscopic views by using consistent colors. The stepwise expansion of the outlines revealed thickness of each layer as well as whether the thickness was uniform. Our ideas and the Visible Korean images could be a robust resource of virtual reality learning for medical students and clinicians.

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/.

Hip joint ligaments, a cadaver imaging study for education / Ligamentos de cadera, un estudio cadavérico imagenológico para educación

The stereoscopic morphology of the iliofemoral, pubofemoral, and ischiofemoral ligaments in hip joint is hard to understand, either in anatomy books or from cadaver dissection. To aid in understanding, three-dimensional models were built from the sectioned images of cadaver hip, which demonstrate fine components better than CTs and MRIs. In the female data of Visible Korean project, the ligaments and neighboring structures were recognized and outlined in detail. Successively, the outlines were stacked and reconstructed to manufacture their surface models by using the sophisticated computer method. The surface models were overlapped with the original sectioned images, which enhanced comprehension of the hip joint anatomy. With the surface models, hip joint was hyperextended to suggest the function of the ligaments. The graphic data of the surface reconstructed hip ligaments are expected to be the source of interactive simulators for anatomy and surgery of the hip joint.

La morfología estereoscópica de los ligamentos iliofemoral, pubofemoral e isquiofemoral de la articulación de la cadera es difícil de entender, ya sea a partir de lo hallado en los libros de anatomía como en la disección de cadáveres. Para ayudar en su comprensión, se construyeron modelos tridimensionales a partir de imágenes de secciones cadavéricas de la cadera, que demuestran de mejor manera los componentes finos, en comparación a las imágenes de tomografía axial computada y resonancia magnética nuclear. En los datos obtenidos del "Visible Korean Project", correspondientes a mujeres, los ligamentos de la articulación y sus estructuras vecinas fueron reconocidos y descritos en detalle. Sucesivamente, se identificaron los contornos y se reconstruyeron para la fabricación de modelos de superficie, mediante el uso de un sofisticado método informático. Los modelos de superficie se asociaron con las imágenes de sección originales, que aumentaron la comprensión de la anatomía de la articulación de la cadera. En los modelos de superficie se provocó la hipertensión de la articulación de la cadera para permitir evidenciar la función de los ligamentos. Se espera que los datos gráficos obtenidos de los modelos de superficie de los ligamentos de la cadera sirvan como fuente para el desarrollo de simuladores interactivos que permitan el estudio de la anatomía y la cirugía de la articulación de la cadera.

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.

Sectioned images and surface models of a cadaver for understanding the deep circumflex iliac artery flap.

The aim of this study was to describe the deep circumflex iliac artery (DCIA) flap from sectioned images and stereoscopic anatomic models using Visible Korean, for the benefit of medical education and clinical training in the field of oromandibular reconstructive surgery. Serially sectioned images of the pelvic area were obtained from a cadaver. Outlines of significant structures in the sectioned images were drawn and stacked to build surface models. The PDF (portable document format) file (size, 30 MB) of the constructed models is available for free download on the Web site of the Department of Anatomy at Ajou University School of Medicine (http://anatomy.co.kr). In the PDF file, the relevant structures of the DCIA flap can be seen in the sectioned images. All surface models and stereoscopic structures associated with the DCIA flap are displayed in real time. We hope that these state-of-the-art sectioned images, outlined images, and surface models will help students and trainees better understand the anatomy associated with DCIA flap.

Laparoscopic and endoscopic exploration of the ascending colon wall based on a cadaver sectioned images.

For realistic virtual dissection, the sectioned images of a cadaver are a desirable material because of their high resolution and real body color. After a volume model is made of the sectioned images, it can be piled or peeled at the intended thickness as if a structure's surface is expanded and shrunken. The purpose of our study was to confirm whether laparoscopic and endoscopic exploration of the processed volume model plays a part in anatomy investigation. The ascending colon was outlined in serially sectioned images and accumulated to build a volume model. While the volume model was being piled or peeled, the ascending colon was observed laparoscopically and endoscopically in comparison with the original sectioned image. The trial efficiently demonstrated layers of the colon wall and surrounding tissues which could not be visualized by conventional macroscopic or microscopic techniques. The availability and contribution of this new method will be confirmed by application to other various organs.

Evaluation of anatomy comic strips for further production and applications.

The corresponding author of the study has been sketching comic strips to explain anatomy in a humorous manner. All the anatomy comic strips, including those in Korean (650 episodes) and English (451 episodes), can be viewed on the homepage (http://anatomy.co.kr). Such comic strips were created with the aim of assisting medical students. However, their impact was unknown, and therefore, we surveyed the students' responses. We noted that anatomy grades were better in the students who read the comic strips. The comics helped the trainees chat with individuals with and without a medical background. The authors also considered comments on the problems with the comic strips and attempted to find solutions. The episodes are being currently used and further produced for educational purposes. To support this effort, the readers' valuable opinions will be continuously collected and assessed.

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/).

Two-dimensional sectioned images and three-dimensional surface models for learning the anatomy of the female pelvis.

In the Visible Korean project, serially sectioned images of the pelvis were made from a female cadaver. Outlines of significant structures in the sectioned images were drawn and stacked to build surface models. To improve the accessibility and informational content of these data, a five-step process was designed and implemented. First, 154 pelvic structures were outlined with additional surface reconstruction to prepare the image data. Second, the sectioned and outlined images (in a browsing software) as well as the surface models (in a PDF file) were placed on the Visible Korean homepage in a readily-accessible format. Third, all image data were visualized with interactive elements to stimulate creative learning. Fourth, two-dimensional (2D) images and three-dimensional (3D) models were superimposed on one another to provide context and spatial information for students viewing these data. Fifth, images were designed such that structure names would be shown when the mouse pointer hovered over the 2D images or the 3D models. The state-of-the-art sectioned images, outlined images, and surface models, arranged and systematized as described in this study, will aid students in understanding the anatomy of female pelvis. The graphic data accompanied by corresponding magnetic resonance images and computed tomographs are expected to promote the production of 3D simulators for clinical practice.