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Kim HS, Pae C, Bae JH, Hu KS, Chang BM, Tansatit T, Kim HJ. An anatomical study of the risorius in Asians and its insertion at the modiolus. Surg Radiol Anat 2014; 37:147-51. [PMID: 24969170 DOI: 10.1007/s00276-014-1330-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2013] [Accepted: 06/12/2014] [Indexed: 11/29/2022]
Abstract
PURPOSE Detailed explanations of the insertion, interaction patterns, and arrangement of the risorius muscle fibers at the modiolus have still not been clearly shown. The aim of this study is to clarify the arrangement of the risorius muscle by means of topographic examination, and to evaluate the anatomical variations in its attachments and pattern of shape to other perioral muscles, and eventually to understand the various features of the facial animation of Asians. MATERIALS AND METHODS Eighty embalmed Korean and Thai adult hemifaces from cadavers of both genders were dissected in this study. Detailed dissection at the modiolus revealed the insertion of the risorius muscle in relation to its attachments and fiber interaction forms. RESULTS When categorized into three common anatomical types--zygomaticus risorius (ZR), platysma risorius (PR), and triangularis risorius (TR). PR was most common with 45 % (36 cases) frequency. Risorius muscle also inserted into the modiolus in three distinct layers in relation to the depressor anguli oris: superficial, flush, and deep. Superficial attachment was most commonly found with 56.3 % (45 cases) frequency. CONCLUSIONS These results will provide critical information for future planning and performing of reconstructive, reanimation, and cosmetic surgical procedures for cases such as developmental defect, facial trauma, facial muscle paralysis, and restoring the natural personal appearances.
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Jung W, Youn KH, Won SY, Park JT, Hu KS, Kim HJ. Clinical implications of the middle temporal vein with regard to temporal fossa augmentation. Dermatol Surg 2014; 40:618-23. [PMID: 24852465 DOI: 10.1111/dsu.0000000000000004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND The middle temporal vein (MTV) traverses the temporal fossa between the superficial and deep layers of the deep temporal fascia. During filler injection into a deficient temporal fossa, filling agents may be inadvertently injected into the MTV, which results in vascular complications. OBJECTIVE To investigate the course of the MTV to enable safe filler injection in the temple area. MATERIALS AND MATERIALS The course and diameter of the MTV were measured in 18 hemifaces from 9 Korean cadavers. RESULTS The MTV was located 23.5 and 18.5 mm above the zygomatic arch at the jugale and the zygion, respectively. The diameter of the MTV at its thickest point was 5.1 mm. A splitting and reuniting pattern, such that the MTV occupied more space than a single trunk, was observed in 28% of cases. CONCLUSION We propose that the safest area for filler injection in temporal fossa augmentation is one finger width above the zygomatic arch.
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Lee JG, Yang HM, Hu KS, Lee YI, Lee HJ, Choi YJ, Kim HJ. Frontal branch of the superficial temporal artery: anatomical study and clinical implications regarding injectable treatments. Surg Radiol Anat 2014; 37:61-8. [PMID: 24841991 DOI: 10.1007/s00276-014-1306-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Accepted: 04/22/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND The frontal branch of the superficial temporal artery (Fbr) is vulnerable to damage triggered by iatrogenic manipulation by both dermal filler and BoNT-A injection. The purpose of this study was to elucidate the branching pattern of Fbr and to determine its location and course on the lateral border of the frontal belly of the occipitofrontalis muscle (FB). METHODS Sixty-four hemifaces from 38 Korean cadavers (26 males and 12 females; mean age 71.9 years) were dissected, and the location and course of the Fbr were identified with reference to the lateral border of the FB. RESULTS The ramification of the frontal branch from the superficial temporal artery (STA) occurred 36.9 ± 14.24 mm (mean ± SD) superior and 17.2 ± 8.2 mm anterior to the posterior-most point of the tragus [i.e., tragion (Tg)]. The Fbr was observed as a single branch in 96.9% of cases and reached its destination at a single point in 71.9%. It reached the Fbr 14.8 ± 7.7 mm superior to the uppermost point of the eyebrow and 15.8 ± 9.1 mm from the lateral epicanthus. The Fbr bifurcated into superior and inferior branches before reaching the FB in 25.0% of cases. In two cases (3%), the Fbr ramified from the STA within 1 mm of the Tg. The diameter of the superior division of Fbr was 1.6 ± 0.5 mm at the lateral border of the FB and 1.8 ± 0.6 mm at other locations. CONCLUSION Physicians performing injection treatments such as botulinum toxin type A and dermal filler injection to the posterior frontal area should be aware of the various distributions of the Fbr.
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Won SY, Cho YH, Choi YJ, Favero V, Woo HS, Chang KY, Hu KS, Kim HJ. Intramuscular innervation patterns of the brachialis muscle. Clin Anat 2014; 28:123-7. [PMID: 24596238 DOI: 10.1002/ca.22387] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2013] [Revised: 02/08/2014] [Accepted: 02/09/2014] [Indexed: 11/06/2022]
Abstract
The aim of this study was to provide accurate anatomical descriptions of the patterns of innervation of the brachialis muscle by the musculocutaneous, radial, and median nerves. Sihler's staining method was applied to 20 brachialis muscles from 10 cadavers to reveal the intramuscular distribution patterns of the musculocutaneous, radial, and median nerves. Three patterns of innervation of the brachialis muscle by the three studied nerves were found: single, double, and triple. These innervation patterns were categorized into four types: Type I--only the musculocutaneous nerve; Type II--double innervation by the musculocutaneous and radial nerves; Type III--double innervation by the musculocutaneous and median nerves; and Type IV--triple innervation by all three nerves. Single, double, and triple innervation patterns occurred 25%, 70% (Type II, 55%; Type III, 15%), and 5% of the samples, respectively. The brachialis muscle is not solely innervated by the musculocutaneous nerve but also by the radial and median nerves, thus making it a potentially triply innervated muscle. Double innervation of this muscle with either the musculocutaneous and median nerve or the musculocutaneous and radial nerves was also observed.
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Won SY, Yang HM, Woo HS, Chang KY, Youn KH, Kim HJ, Hu KS. Neuroanastomosis and the innervation territory of the mental nerve. Clin Anat 2013; 27:598-602. [DOI: 10.1002/ca.22310] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Revised: 07/12/2013] [Accepted: 07/24/2013] [Indexed: 11/12/2022]
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Yang HM, Won SY, Kim HJ, Hu KS. Sihler staining study of anastomosis between the facial and trigeminal nerves in the ocular area and its clinical implications. Muscle Nerve 2013; 48:545-50. [PMID: 23588799 DOI: 10.1002/mus.23875] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2013] [Indexed: 12/21/2022]
Abstract
INTRODUCTION The trigeminal nerve (CN V) supplies mostly sensory innervation to the face, and the facial nerve (CN VII) conveys primarily motor fibers. The aim of this study was to elucidate their distributions and anastomoses. METHODS Fourteen specimens of hemisectioned faces were gathered from human cadavers and stained with Sihler staining. RESULTS The temporal (Tbr), zygomatic (Zbr), and buccal (Bbr) branches of CN VII formed trigeminofacial anastomoses in the ocular area. Communications were observed between the supraorbital nerve and the Tbr (85.7%), the infraorbital nerve and the Bbr (100%) and Zbr (28.6%), and the zygomaticofacial nerve and the Zbr (41.7%). Anastomoses were formed between the supratrochlear nerve and the Tbr (57.1%) and Bbr (50%), and the infratrochlear nerve and the Bbr (85.7%). CONCLUSIONS Motor and sensory axons to the face contribute to trigeminofacial anastomoses, which may play key roles in subtle movements of muscles of facial expression.
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Kim DH, Won SY, Bae JH, Jung UW, Park DS, Kim HJ, Hu KS. Topography of the greater palatine artery and the palatal vault for various types of periodontal plastic surgery. Clin Anat 2013; 27:578-84. [DOI: 10.1002/ca.22252] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Accepted: 03/12/2013] [Indexed: 11/09/2022]
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Hu KS, Kim S. Reply on "Reliability of two different presurgical preparation methods for implant dentistry based on panoramic radiography and cone-beam computed tomography in cadavers". J Periodontal Implant Sci 2012; 42:145. [PMID: 22977745 PMCID: PMC3439527 DOI: 10.5051/jpis.2012.42.4.145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2012] [Accepted: 08/23/2012] [Indexed: 11/08/2022] Open
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Won SY, Rha DW, Kim HS, Jung SH, Park ES, Hu KS, Kim HJ. Intramuscular nerve distribution pattern of the adductor longus and gracilis muscles demonstrated with Sihler staining: guidance for botulinum toxin injection. Muscle Nerve 2012; 46:80-5. [PMID: 22644785 DOI: 10.1002/mus.23273] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2011] [Indexed: 01/28/2023]
Abstract
INTRODUCTION The aims of this study were to clarify the intramuscular branching patterns and arborizing area of hip adductor muscles with reference to surface landmarks on the thigh and to thus suggest effective and safe injection points for botulinum neurotoxin (BoNT). METHODS Ten gracilis and 10 adductor longus specimens were subjected to Sihler staining to reveal intramuscular nerve arborization patterns, and findings were matched with and referred to surface landmarks. Using these results, we determined the optimal location for BoNT injection in hip adductors in relation to the long axis of the femur. RESULTS The corrected, most dense areas of innervation in adductor longus and gracilis were typically 30-50% and 40-50% from the anterior superior iliac spine (ASIS) along the vertical line of the femur, respectively. CONCLUSIONS The most effective and safest point for BoNT injection into adductor muscles appears to be between 35% and 50% from ASIS, where neuromuscular junctions are most densely distributed.
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Hu KS, Choi DY, Lee WJ, Kim HJ, Jung UW, Kim S. Reliability of two different presurgical preparation methods for implant dentistry based on panoramic radiography and cone-beam computed tomography in cadavers. J Periodontal Implant Sci 2012; 42:39-44. [PMID: 22586521 PMCID: PMC3349045 DOI: 10.5051/jpis.2012.42.2.39] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2012] [Accepted: 03/08/2012] [Indexed: 11/08/2022] Open
Abstract
PURPOSE Special care is necessary to avoid invading important anatomic structures during surgery when presurgical planning is made based on radiographs. However, none of these types of radiography represents a perfect modality. The purpose of this study was to determine the reliability of presurgical planning based on the use of two types of radiographic image (digital panoramic radiography [DPR] and cone-beam computed tomography [CBCT]) by beginner dentists to place implants, and to quantify differences in measurements between radiographic images and real specimens. METHODS Ten fresh cadavers without posterior teeth were used, and twelve practitioners who had no experience of implant surgery performed implant surgery after 10 hours of basic instruction using conventional surgical guide based on CBCT or DPR. Two types of measurement error were evaluated: 1) the presurgical measurement error, defined as that between the presurgical and postsurgical measurements in each modality of radiographic analysis, and 2) the measurement error between postsurgical radiography and the real specimen. RESULTS The mean presurgical measurement error was significantly smaller for CBCT than for DPR in the maxillary region, whereas it did not differ significantly between the two imaging modalities in the mandibular region. The mean measurement error between radiography and real specimens was significantly smaller for CBCT than for DPR in the maxillary region, but did not differ significantly in the mandibular region. CONCLUSIONS Presurgical planning can be performed safely using DPR in the mandible; however, presurgical planning using CBCT is recommended in the maxilla when a structure in a buccolingual location needs to be evaluated because this imaging modality supplies buccolingual information that cannot be obtained from DPR.
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Jung UW, Hwang JW, Choi DY, Hu KS, Kwon MK, Choi SH, Kim HJ. Surface characteristics of a novel hydroxyapatite-coated dental implant. J Periodontal Implant Sci 2012; 42:59-63. [PMID: 22586524 PMCID: PMC3349048 DOI: 10.5051/jpis.2012.42.2.59] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2012] [Accepted: 03/20/2012] [Indexed: 11/20/2022] Open
Abstract
Purpose This study evaluated the surface characteristics and bond strength produced using a novel technique for coating hydroxyapatite (HA) onto titanium implants. Methods HA was coated on the titanium implant surface using a super-high-speed (SHS) blasting method with highly purified HA. The coating was performed at a low temperature, unlike conventional HA coating methods. Coating thickness was measured. The novel HA-coated disc was fabricated. X-ray diffraction analysis was performed directly on the disc to evaluate crystallinity. Four novel HA-coated discs and four resorbable blast medium (RBM) discs were prepared. Their surface roughnesses and areas were measured. Five puretitanium, RBM-treated, and novel HA-coated discs were prepared. Contact angle was measured. Two-way analysis of variance and the post-hoc Scheffe's test were used to analyze differences between the groups, with those with a probability of P<0.05 considered to be statistically significant. To evaluate exfoliation of the coating layer, 7 sites on the mandibles from 7 mongrel dogs were used. Other sites were used for another research project. In total, seven novel HA-coated implants were placed 2 months after extraction of premolars according to the manufacturer's instructions. The dogs were sacrificed 8 weeks after implant surgery. Implants were removed using a ratchet driver. The surface of the retrieved implants was evaluated microscopically. Results A uniform HA coating layer was formed on the titanium implants with no deformation of the RBM titanium surface microtexture when an SHS blasting method was used. Conclusions These HA-coated implants exhibited increased roughness, crystallinity, and wettability when compared with RBM implants.
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Lee JY, Kim JN, Yoo JY, Hu KS, Kim HJ, Song WC, Koh KS. Topographic anatomy of the masseter muscle focusing on the tendinous digitation. Clin Anat 2012; 25:889-92. [DOI: 10.1002/ca.22024] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2011] [Revised: 11/17/2011] [Accepted: 12/03/2011] [Indexed: 11/08/2022]
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Lee JY, Kim JN, Kim SH, Choi HG, Hu KS, Kim HJ, Song WC, Koh KS. Anatomical verification and designation of the superficial layer of the temporalis muscle. Clin Anat 2011; 25:176-81. [PMID: 21739477 DOI: 10.1002/ca.21212] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2011] [Revised: 04/20/2011] [Accepted: 05/09/2011] [Indexed: 11/08/2022]
Abstract
The temporalis muscle, which is one of the masticatory muscles, enables elevation and retraction of the mandible. Direct injury to the temporalis muscle, facial nerve, or temporal fat pad during cranial-base surgery can cause temporal hollowing. The temporalis muscle is currently described in almost all atlases and textbooks as comprising a single layer. In this study, a superficial layer of the temporalis muscle is described, clarifying the anatomy of this muscle. Twenty heads of adult cadavers were dissected. The gross anatomy of the temporalis muscle was examined after removing the skin, subcutaneous tissue, superficial temporal fascia, and deep temporal fascia. The superficial layer of the temporalis muscle was clearly distinguishable from the deep layer. The superficial layer originated from the same region as the deep layer, and the muscle fibers of the two layers were intermingled in the superior part of the muscle. The deep layer of the temporalis muscle, which is referred to in textbooks and atlases simply as the temporalis muscle, was exposed after removing the superficial layer. The existence of this superficial layer was confirmed herein both histologically and by magnetic resonance imaging. Henceforth, the superficial layer of the temporalis muscle must be included in descriptions of the temporalis muscle in anatomy textbooks and atlases. The findings of this study are important not only from the perspective of simply acquiring correct anatomical knowledge, but also from the surgical perspective in preventing temporal hollowing during related surgical procedures.
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Won SY, Choi DY, Kwak HH, Kim ST, Kim HJ, Hu KS. Topography of the arteries supplying the masseter muscle: Using dissection and Sihler's method. Clin Anat 2011; 25:308-13. [PMID: 21647969 DOI: 10.1002/ca.21205] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2011] [Revised: 04/11/2011] [Accepted: 04/19/2011] [Indexed: 11/09/2022]
Abstract
Various surgical procedures require surgeons to have detailed knowledge of the course of blood vessels in the masseter muscle, such as masseter muscle flap formation, mandibular angle resection, parotidectomy, and mandibular ramus osteotomy. Without this knowledge serious complications can occur, endangering the lives of patients. Occasionally, during routine dissections we sometimes encounter an additional branch. The purpose of this study was to provide a comprehensive detailed anatomic description of the blood supply of the masseter muscle. This will provide critical information for various surgical procedures. Twenty-five Korean cadavers were dissected and subjected to modified Sihler's method to reveal the branching patterns of the arteries surrounding the masseter muscle, and its intramuscular blood supply. The masseter can be supplied by seven branches from the external carotid artery. Among these, the masseteric branch from the deep temporal artery has not been described previously. This previously undescribed branch enters the medial surface of the masseter, turning medially around the anterior border of the ramus immediately after the branching point of the deep temporal artery. The branch originating from the transverse facial artery was the largest, and the branches originating from the external carotid artery and deep temporal artery were the smallest. Examination of intramuscular patterns revealed that the branches of the transverse facial artery were the most widely distributed. When considering arterial diameters and distribution areas, the branches of the transverse facial artery can be considered the main components of the seven branches supplying the masseter muscle.
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Won SY, Kim DH, Yang HM, Park JT, Kwak HH, Hu KS, Kim HJ. Clinical and anatomical approach using Sihler's staining technique (whole mount nerve stain). Anat Cell Biol 2011; 44:1-7. [PMID: 21519543 PMCID: PMC3080003 DOI: 10.5115/acb.2011.44.1.1] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2011] [Revised: 03/04/2011] [Accepted: 03/08/2011] [Indexed: 02/07/2023] Open
Abstract
Sihler's staining allows visualization of the nerve distribution within soft tissues without extensive dissection and does not require slide preparation, unlike traditional approaches. This technique can be applied to the mucosa, muscle, and organs that contain myelinated nerve fibers. In particular, Sihler's technique may be considered the best tool for observing nerve distribution within skeletal muscles. The intramuscular distribution pattern of nerves is difficult to observe through manual manipulation due to the gradual tapering of nerves toward the terminal end of muscles, so it should be accompanied by histological studies to establish the finer branches therein. This method provides useful information not only for anatomists but also for physiologists and clinicians. Advanced knowledge of the nerve distribution patterns will be useful for developing guidelines for clinicians who perform operations such as muscle resection, tendon transplantation, and botulinum toxin injection. Furthermore, it is a useful technique to develop neurosurgical techniques and perform electrophysiological experiments. In this review, Sihler's staining technique is described in detail, covering its history, staining protocol, advantages, disadvantages, and possible applications. The application of this technique for determining the arterial distribution pattern is also described additionally in this study.
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Hur MS, Hu KS, Youn KH, Song WC, Abe S, Kim HJ. New anatomical profile of the nasal musculature: dilator naris vestibularis, dilator naris anterior, and alar part of the nasalis. Clin Anat 2011; 24:162-7. [PMID: 21254248 DOI: 10.1002/ca.21115] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2010] [Revised: 11/03/2010] [Accepted: 11/10/2010] [Indexed: 11/07/2022]
Abstract
The aim of this study was to clarify the morphology and topography of the dilator naris vestibularis, dilator naris anterior, and alar part of the nasalis. Anatomical variations in the topographic relationships are also described to provide critical data for understanding nasal muscular functions. Anatomical and histological examinations were performed on 40 specimens of embalmed Korean adult cadavers. The dilator naris vestibularis muscle (named by the present authors) was located between the external and vestibular skin of the alar lobule. The muscle fibers radiated along the dome-shaped nasal vestibule. The dilator naris anterior muscle originated from the frontal surfaces of the lateral half of the lateral crus and the accessory alar cartilage adjacent to the lateral crus. The extent of the lower insertion of the dilator naris anterior muscle was at the alar groove. The alar part of the nasalis originated with the transverse part of nasalis from the maxilla. It ascended to attach to the alar crease and the adjacent deep surface of external skin of the alar lobule. These findings may provide anatomical knowledge required to understand the structure and function of these nasal muscles such as during rhinoplasty or other surgery of the face.
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Park JT, Jang Y, Park MS, Pae C, Park J, Hu KS, Park JS, Han SH, Koh KS, Kim HJ. The trend of body donation for education based on Korean social and religious culture. ANATOMICAL SCIENCES EDUCATION 2011; 4:33-8. [PMID: 21265035 DOI: 10.1002/ase.198] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2010] [Revised: 11/09/2010] [Accepted: 12/13/2010] [Indexed: 05/13/2023]
Abstract
Until a century ago, Korean medicine was based mainly on Oriental philosophies and ideas. From a religious perspective, Chinese Confucianism was prevalent in Korea at that time. Since Confucianists believe that it is against one's filial duty to harm his or her body, given to them by their parents, most Koreans did not donate their bodies or organs for education in the past. However, by the end of the 20th century, a unique fusion of Western and Oriental medicines were produced on the Korean Peninsula, revolutionizing traditional perspectives on the human body, mortality, and the relationship of medical science to society. Koreans began to think about others' lives as well as their own by realizing the importance of donating one's organs and bodies for scientific purposes. Since then, the number of people donating their bodies to Korean medical and dental schools for the purpose of improving academic learning has increased dramatically. In response, Korean medical schools have begun to hold various types of funeral ceremonies to honor body donors. We have compared such ceremonies performed in Korea with those performed in the United States of America and Taiwan. These ceremonies are viewed as a suitable way to pay proper respect to the dead and to promote knowledge about body donation programs in Korea. Overall, the transition of religions and social ethics in Korea has greatly facilitated body bequeathal programs, benefiting both medical education and the Korean public health administration.
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Hu KS, Kim ST, Hur MS, Park JH, Song WC, Koh KS, Kim HJ. Topography of the masseter muscle in relation to treatment with botulinum toxin type A. ACTA ACUST UNITED AC 2010; 110:167-71. [DOI: 10.1016/j.tripleo.2009.12.036] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2009] [Revised: 12/02/2009] [Accepted: 12/23/2009] [Indexed: 11/26/2022]
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Hur MS, Hu KS, Park JT, Youn KH, Kim HJ. New anatomical insight of the levator labii superioris alaeque nasi and the transverse part of the nasalis. Surg Radiol Anat 2010; 32:753-6. [PMID: 20512646 DOI: 10.1007/s00276-010-0679-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2009] [Accepted: 05/06/2010] [Indexed: 11/24/2022]
Abstract
PURPOSE The aim of this study was to clarify the morphology and topography of the deep layer of levator labii superioris alaeque nasi muscle (LLSAN) and the transverse part of the nasalis. Anatomical variations in the topographic relationships were also described to understand the function of the LLSAN and the transverse part of the nasalis. METHODS Anatomical dissections were performed on 40 specimens of embalmed Korean adult cadavers. RESULTS The LLSAN was divided into two layers, which were superficial and deep in the levator labii superioris muscle (LLS), respectively. The superficial layer of LLSAN descended on the LLS, and the deep layer was located deep in the LLS. The deep layer of LLSAN originated from the superficial layer of LLSAN and the frontal process of the maxilla. It inserted between the levator anguli oris and the orbicularis oris muscles. This transverse part of the nasalis received some muscle fibers from the superficial layer of LLSAN in 90% (36/40) of specimens. The transverse part of the nasalis originated from the maxilla and ascended, passing posterior to the superficial layer of LLSAN in 65% (26/40) of specimens. However, it originated as two muscle bellies from the maxilla and the upper half of the alar facial crease, respectively, in 35% (14/40) of specimens. CONCLUSIONS These findings will be crucial data to understand the structure and function of the LLSAN and the transverse part of the nasalis.
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Yang HM, Hu KS, Song WC, Park JT, Kim HJ, Koh KS, Kim HJ. Innervation Patterns of the Canine Masticatory Muscles in Comparison to Human. Anat Rec (Hoboken) 2009; 293:117-25. [DOI: 10.1002/ar.21006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Yang HM, Bae HEK, Won SY, Hu KS, Song WC, Paik DJ, Kim HJ. The buccofacial wall of maxillary sinus: an anatomical consideration for sinus augmentation. Clin Implant Dent Relat Res 2009; 11 Suppl 1:e2-6. [PMID: 19438968 DOI: 10.1111/j.1708-8208.2009.00138.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE This study aimed to quantify the thickness of the buccofacial wall of the maxillary sinus where sinus augmentations are often performed. MATERIALS AND METHODS Fourteen sites located 15 and 20 mm superior to the anatomical cervical line (named as groups H15 and H20, respectively) and along the long axes of the mid and the interproximal of two premolars and two molars were measured from 74 Korean hemiface cadavers. RESULTS The buccofacial wall of the maxillary sinus was thinnest at the area between the maxillary second premolar and first molar in groups H15 and H20. The lowest mean thickness was 1.2 mm in both groups. The walls were thicker in males than in females, with statistically significant gender differences found at four and two sites on the anterior horizontal reference in groups H15 and H20, respectively. However, the thickness did not differ significantly with age or laterality. Incomplete septa were found in seven of the 74 specimens, and they were present in the area between the first and second molars in six (86%) of these cases. CONCLUSIONS These observations indicate that anatomical characteristics of the buccofacial wall thickness of the maxillary sinus need to be considered when performing a window opening procedure for sinus augmentation.
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Sheverdin VA, Hur MS, Won SY, Song WC, Hu KS, Koh KS, Kim HJ. Extra- and intramuscular nerves distributions of the triceps surae muscle as a basis for muscle resection and botulinum toxin injections. Surg Radiol Anat 2009; 31:615-21. [PMID: 19300894 DOI: 10.1007/s00276-009-0490-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2009] [Accepted: 02/25/2009] [Indexed: 11/26/2022]
Abstract
PURPOSE To compare the distribution of extramuscular nerve branches with their intramuscular ramifications in the triceps surae muscle, thus providing anatomical substantiation for the topography of muscle resection and botulinum toxin injections. METHODS Dissection and modified Sihler's staining of 18 whole-mount human cadaveric specimens. RESULTS The distance between the areas with the highest extramuscular branch density and the area of densest intramuscular arborization in gastrocnemius and soleus muscles is approximately 10% of the calf length. This finding should be taken into consideration during nerve blocking and botulinum toxin injections for the treatment of spasticity. Intramuscular nerve arborization patterns make it possible to outline neuromuscular segments in the gastrocnemius and soleus muscles. CONCLUSIONS Surgical or therapeutic interventions in areas of high extramuscular and intramuscular nerve density can increase the efficacy and safety of botulinum toxin injections and neurotomy. Intramuscular nerve branching patterns should be taken into consideration during triceps surae resection.
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Hwang WS, Hur MS, Hu KS, Song WC, Koh KS, Baik HS, Kim ST, Kim HJ, Lee KJ. Surface Anatomy of the Lip Elevator Muscles for the Treatment of Gummy Smile Using Botulinum Toxin. Angle Orthod 2009; 79:70-7. [DOI: 10.2319/091407-437.1] [Citation(s) in RCA: 91] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2007] [Accepted: 02/01/2008] [Indexed: 11/23/2022] Open
Abstract
Abstract
Objective: To propose a safe and reproducible injection point for botulinum toxin-A (BTX-A) as a supplementary method for the treatment of gummy smile, as determined by assessment of the morphologic characteristics of three lip elevator muscles.
Materials and Methods: A total of 50 hemi-faces from 25 adult cadavers (male 13, female 12; ages, 47 to 88 years) were used in this study. Topographic relations and the directions of the lip elevator muscles (ie, levator labii superioris [LLS], levator labii superioris alaeque nasi [LLSAN], and zygomaticus minor [ZMi]), were investigated. Possible injection points were examined through the study of predetermined surface landmarks.
Results: The insertion of the LLS was covered partially or entirely by the LLSAN and the ZMi, and the three muscles converged on the area lateral to the ala. The mean angle between the facial midline and each muscle vector was 25.8 ± 4.8 degrees for the LLS, 55.7 ± 6.4 degrees for the ZMi, and −20.2 ± 3.2 degrees for the LLSAN; no significant differences were noted between male and female subjects or between left and right sides. The three vectors passed near a triangular region formed by three surface landmarks. The center of this triangle, named the “Yonsei point”, was suggested as an appropriate injection point for BTX-A. The clinical effectiveness of the injection point was demonstrated in selected cases with or without orthodontic treatment.
Conclusions: Under careful case selection, BTX-A may be an effective treatment alternative for patients with excessive gingival display caused by hyperactive lip elevator muscles.
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Hu KS, Kang MK, Kim TW, Kim KH, Kim HJ. Relationships between Dental Roots and Surrounding Tissues for Orthodontic Miniscrew Installation. Angle Orthod 2009; 79:37-45. [DOI: 10.2319/083107-405.1] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2007] [Accepted: 02/01/2008] [Indexed: 11/23/2022] Open
Abstract
Abstract
Objective: To elucidate relationships between the dental roots and surrounding tissues in order to prevent complications after placement of a miniscrew.
Materials and Methods: Twenty human mandibles and maxillas were used for this study. In the 200 sections of each mandible and maxilla, nine items were measured to investigate the relationships between the dental roots.
Results: The interroot distance increased from anterior to posterior teeth and from the cervical line to the root apex in both the maxilla and the mandible. In the maxilla, the greatest interroot distance was between the second premolar and the first molar. In the mandible, the greatest interroot distance was between the first and second molars. The maxillary buccolingual bone width exceeded 10 mm from 7 mm (between canine and first premolar), 5 mm (between second premolar and first molar), and 4 mm (between first and second molars) above the cervical line. The mandibular buccolingual bone width exceeded 10 mm from 7 mm (between second premolar and first molar) and 4 mm (between first and second molars) below the cervical line.
Conclusions: The safest zone for placement of a miniscrew in the maxilla was between the second premolar and the first molar, from 6 to 8 mm from the cervical line. The safest zone for placement of a miniscrew in the mandible was between the first and second molars, less than 5 mm from the cervical line.
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Choi SW, Park JY, Hur MS, Park HD, Kang HJ, Hu KS, Kim HJ. An anatomic assessment on perforators of the lateral circumflex femoral artery for anterolateral thigh flap. J Craniofac Surg 2007; 18:866-71. [PMID: 17667679 DOI: 10.1097/scs.0b013e3180a03304] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The anterolateral thigh flap was originally described in 1984 as a septocutaneous flap based on the descending branch of the lateral femoral circumflex artery (LCFA). This flap has many advantages for head and neck reconstruction. However, it is not widely used as a result of the broad range of anatomic variation of the cutaneous perforators and because dissection of these perforators is tedious when they are small. The purposes of this study are to classify the vascular anatomy of the LCFA and to assess the suitability of the anterolateral thigh flap for head and neck reconstruction in Koreans. From 38 thigh dissections of Korean cadavers, the LCFA commonly arose from the deep femoral artery and divided into ascending, transverse, and descending branches. In five cases, the LCFA arose directly from the femoral artery. The cutaneous perforators were present in 37 cases except one and the septocutaneous perforators were found in 17 of the 38 cases. Of the 160 perforators, 28 (17.5%) were the septocutaneous perforators and 132 (82.5%) were the musculocutaneous perforators. The average number of cutaneous perforators for the anterolateral thigh flap was 4.2 (range, 0-8), and these perforators were concentrated in the middle third of the anterolateral thigh. The septocutaneous perforators were located more proximally than the musculocutaneous perforators. The average length of the vascular pedicle derived from the descending branch or the transverse branch was 83.3 mm (range, 53.4-124.3 mm). The results of this study suggest that the vascular anatomy of the anterolateral thigh flap was reliable and well suited for head and neck reconstruction in Koreans.
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