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SUMMARY: Variation in the biceps brachii muscle is extremely frequent and has a clinical significance. During an educational dissection, third head of the biceps brachii muscle was found on the left side in a Korean cadaver. The short and long heads showed normal morphology and course: however, additional head originated from the greater tubercle connected to long head of biceps brachii muscle and crossed the musculocutaneous nerve perpendicularly. And then, it was inserted into short head of the biceps brachii muscle. The author describes this previously novel case report and discusses the clinical implications of such a variant.

PURPOSE The retention and capture functions of hand can be achieved by the consistent manner work of the extensor and flexor muscles. Therefore, it is important to know variations of the extensor and flexor muscles. METHODS During an educational dissection, accessory heads of the extensor carpi radialis longus muscle were found on the right side in a Korean cadaver. RESULTS The extensor carpi radialis longus muscle was originated from the lateral supracondylar ridge of the humerus and trifurcated into three heads as lateral, intermediated, and medial heads. The lateral and intermediated heads merged and inserted to the base of the second metacarpal bone. However, medial head of extensor carpi radialis longus muscle was merged with the extensor carpi radialis brevis muscle. CONCLUSIONS Knowledge of the variations of the ECRL is important for surgeons because the presence of the ECRL variations increases the incidence of iatrogenic injuries during surgery and invasive procedures.

Variations in the upper limbs are common and are the main causes for iatrogenic injury during invasive procedures. A rare division of the axillary artery was found on the left side of a Korean cadaver during an educational dissection. The subscapular artery originated from the second part of the axillary artery. And then it gave off an aberrant branch to the pectoralis major muscle, as pectoral branch. The author describes this previously unreported case and discusses its prevalence and the clinical implications.

Aims and background The incidence rate of colorectal cancer (CRC) increases every year in Korean populations. However, association between the GNAS mutation and colorectal precancerous lesions has not been studied in in Korean populations. To contribute to better understanding of colorectal carcinogenesis, we analyzed GNAS mutation in 100 cancerous and 96 precancerous colorectal lesions. Methods The records of colonoscopic polypectomy performed at Dongsan Medical Center between 1999 and 2003 were reviewed retrospectively. Precancerous lesions included 7 villous adenomas, 59 tubular adenomas, and 18 sessile serrated adenomas, and 12 hyperplastic polyps. Keimyung Human Bio-Resource Bank at Dongsan Medical Center provided 100 CRC samples. Results GNAS mutation was not found in any colorectal cancer or any precancerous colorectal lesions, including villous adenoma, which is thought to harbor the mutation. Conclusions The role of GNAS mutation might be limited in colorectal neoplasms of the Korean population.

The purpose of this case report is to report vascular variations in the abdomen because of its clinical importance for the surgeries like acute abdominal emergencies and symptomatic aneurysms. Here, we report an extremely rare case with an ileocolic vein passing through the annulus of the ileocolic artery.During the routine dissection, we found an ileocolic vein perforating through a ring-shaped ileocolic artery.A ring-shaped ileocolic artery was originating from the superior mesenteric artery as a single branch. After forming the circle, it maintained the regular branching patterns. The ileocolic vein was drained from the ascending colon, cecum, appendix and the distal part of the ileum and passed the center of the ring-shaped part of the ileocolic artery from posterior to anterior. Other structures of the abdomen were normal.We reported this rare variation and suggest that the clinicians should be aware of this variation for succeeding surgery and making a good diagnosis for the patients.

Gantzer’s muscle (GM) is an additional muscle in the forearm, which develops as an accessory head of the flexor pollicis longus or the flexor digitorum profundus. The study aimed to determine the topography of the GM and to define the topographical relationship between the GM and the neurovascular structures surrounding it. After confirming the presence of GM, its topography and the neurovascular structures were analyzed to determine the correlation between them in 73 upper limbs. The incidence of GM was 47.95% (35/73) and the average insertion point of GM was identified at 49.33 ± 7.47‰ (119.82 ± 20.80 mm) on the reference line between the medial epicondyle and the pisiform bone. And the branching points of the median nerve and the ulnar artery were located 19.91 ± 11.23‰ (52.21 ± 24.67 mm), 17.45 ± 8.39‰ (42.53 ± 20.54 mm) on the reference line, respectively. The presence of GM had no significant correlation with the position of the nerve branches. On the other hand, the branching point of the ulnar artery was distally located in the cases with the presence of the GM (17.35 ± 8.65 vs 19.42 ± 10.87, p = 0.031). There was a significant positive correlation between the point of arterial bifurcation and the length of the GM (r = 0.407, p = 0.015). This study suggested that the GM has a topographical relation with the arterial structures, perhaps for embryological reasons.

The palmaris longus (PL) is a slender, spindle-shaped weak flexor of the wrist. Congenital absence of the PL is estimated to occur in 15% among individuals worldwide. However, the frequency of its absence varies considerably among different population groups and with different detection techniques. In the present study, the presence of the PL tendon was examined in a Korean population (n=269) using three clinical tests, namely the Traditional Test, Mishra's Test II, and the Gangata Test. We classified subjects into six types based on whether inspection or palpation was required to determine the presence of the PL and flexor carpi radialis. The most reliable test was determined using Kendall's coefficient of concordance. Our results showed that the PL tendon was absent in 4.1% of the subjects in our study, and bilateral and unilateral absences were 2.2% and 1.8%, respectively. Statistical analysis revealed that these tests had similar reliability for assessing the PL tendon, and the Traditional Test showed the highest effectiveness, at 93%. Therefore the Traditional Test was found to be the most effective for revealing the PL in this Korean population.

Spin polarized tunneling through a hybrid tunnel barrier of a Spin filter (SF) based on a EuO ferro-magnetic semiconductor and an organic semiconductor (OSC) (rubrene in this case) was investigated. For quasi-magnetic tunnel junction (MTJ) structures, such as Co/rubrene/EuO/Al, we observed a strong spin filtering effect of the EuO layer exhibiting I-V curves with high spin polarization (P) of up to 99% measured at 4 K. However, a magnetoresistance (MR) value of 9% was obtained at 4.2 K. The low MR compared to the high P could be attributed to spin scattering caused by structural defects at the interface between the EuO and rubrene, due to nonstoichiometry in the EuO.

This study was aimed to examine whether the changes of protein expression of sodium transporters in the ischemic penumbra are associated with the pathogenesis of ischemia-induced brain edema and/or brain cell injury. An experimental model of cerebral ischemia was made by permanent middle cerebral artery occlusion (pMCAO) in rats and the changes of protein expression of sodium transporters in the ischemic penumbra were examined by immunoblotting. Extensive infarction was observed in the frontal and parietal cortical and subcortical areas at 3 and 6h after pMCAO. Immunoblotting analyses revealed significantly increased expressions of electrogenic NBC (241 +/- 11% at 3 h and 154 +/- 9% at 6 h, P < 0.05) and NHE1 (144 +/- 3% at 3 h and 170 +/- 9% at 6 h, P < 0.05), compared with sham-operated controls. In contrast, Na-K-ATPase expression (78 +/- 6% at 3 h and 85 +/- 3% at 6 h, P < 0.05) was significantly decreased. The expression of NCX1 was unchanged at 3 h, but was significantly increased at 6 h (141 +/- 3%, P < 0.05). In addition, the expressions of neuronal (NeuN) and astroglial cell (GFAP) proteins were decreased, whereas the expression of oligodendrocyte protein (CNPase) was unchanged. Taken together, the selectively increased expressions of NHE1, electrogenic NBC, and NCX1 and decreased expression of Na-K-ATPase in the ischemic penumbra are likely to contribute to the secondary brain cell damages presumably through intracellular Na(+) accumulation, cell swelling, and intracellular Ca(2+) overload.

The axillary vein is a large-blood vessel that lies on the medial side to the axillary artery. The veins of the axilla are more abundant than the arteries and their variations were extremely common. During educational dissection, a rare form of the axillary vein accompanying arterial variation was founded in left arm of 70-year-old female cadaver. The axillary vein was divided into two large veins, anterior and posterior axillary veins according to their anatomical position. The lateral-thoracic artery arose from the second part of the axillary artery and passed through the gap of duplicated axillary vein. Before the lateral-thoracic artery passed through the gap of duplicated axillary vein, the lateral-thoracic artery gave-off an additional branch, which descended superficial to the anterior axillary vein. It surrounded the anterior axillary vein as annular form and the diameter of surrounded part of the anterior axillary vein became narrow. This novel case was reported and its clinical implications of such a variant were discussed.

Gantzer’s muscle is an additional muscle in the forearm. We studied the incidence and the morphology of Gantzer’s muscle and its relation with neurovascular structures. However, unlike the previous suggestion by Eid et al., there is no significant difference in the frequency of the variations of these nerves whether Gantzer’s muscle is present or not.

Continuous attention has been developed on the anatomical variations of the axilla in anatomist and surgeon due to their clinical importance. The axillary region is an anatomical space between the lateral part of the chest wall and the medial aspect of the upper limb. During the routine dissection of embalmed cadavers, we found variant muscular slip originating from the lateral border of tendinous part of the latissimus dorsi and continuing 9 cm more crossing the axilla. And then, it inserted into the superior margin of the insertion of the pectoralis major. We considered this muscular variation as axillary arch muscle. Correct identification of the relevant anatomy and subsequent simple surgical division is curative, paying special attention to anatomical variations in this region and its clinical importance due to its close relationship to the neurovascular elements of the axilla.

This study was undertaken to evaluate the incidence of bifurcated distal biceps tendons and the tendon's insertional footprint on the radial tuberosity.Twenty-five embalmed cadaveric specimens were dissected. The relationships and orientation of the muscle bellies and distal biceps tendon were examined. The insertional length, width, and footprint area of the distal biceps tendon on the radial tuberosity were evaluated.In 12 specimens (48%), the distal biceps tendon was in 2 distinct, easily separated parts. The average footprint length, width, and area of the tendon's insertion on the radial tuberosity were 20.5 mm ± 2.0 mm, 9.7 mm ± 1.3 mm, and 156.3 mm(2) ± 29.4 mm(2), respectively. We calculated that the tendon's insertion occupied approximately 35.9% of the area of the radial tuberosity. In the specimens with a bifurcated distal biceps tendon, the long head of the tendon inserted at the posterosuperior portion of the radial tuberosity, and the average area was 71.4 mm(2) ± 11.3 mm(2). The short head of the distal biceps tendon inserted at the anteroinferior portion, and the average area was 88.3 mm(2) ± 24.1 mm(2).This study confirmed that bifurcated distal biceps tendon insertion is not a rare anatomical variation, showed by recent investigations, and found that the short head of the distal biceps tendon was inserted more anteriorly than the long head on the radial tuberosity. These findings may allow functional independence and isolated rupture of each portion. It can make correct diagnosis possible and allow for a more anatomical orientation of the tendon during surgical repair.

The purpose of this study was to report variations of the cubital superficial vein patterns in the Korean subjects, which was investigated by using venous illuminator, AccuVein. The 200 Korean subjects were randomly chosen from the patients and staff of the Keimyung University Dongsan Medical Center in Daegu, Korea. After excluding the inappropriate cases for detecting venous pattern, we collected 174 cases of right upper limbs and 179 cases of left upper limbs. The superficial veins of the cubital fossa were detected and classified into four types according to the presence of the median cubital vein (MCV) or median antebrachial vein. The type II, presenting the both cephalic and basilic vein connected by the MCV, was most common (177 upper limbs, 50.1%). Although the most common type in male and female was different as type I (108 upper limbs, 49.3%) and type II (75 upper limbs, 56.0%), respectively, statistical significance was not detected (P=0.241). The frequency of the each types between right and left upper limbs was also not different (P=0.973). Among 154 subjects who were observed the venous pattern in the both upper limbs, 76 subjects (49.3%) had the same venous pattern. Using AccuVein to investigate the venous pattern has an advantage of lager scale examination compared to the cadaver study. Our results might be helpful for medical practitioner to be aware of the variation of the superficial cubital superficial vein.

Colorectal cancer is a heterogeneous disorder than arises via multiple distinct pathways, from tubular adenomas (TAs) and serrated polyps (SPs), which are clinically, morphologically, and molecularly different. We examined PIK3CA amplification in colorectal precancerous legions, including TAs and SPs. DNA was isolated from paired normal and tumoral tissues in 64 TAs and 32 SPs. PIK3CA amplification, KRAS mutation, and BRAF mutation were analyzed by real-time PCR. PIK3CA amplification was found in 25% of TAs and 9.4% of SPs, respectively and low and high grade of TAs showed similar frequency of PIK3CA amplification. KRAS and BRAF mutations were mutually exclusive in both TAs and SPs. In TAs, PIK3CA amplification was associated with distal colon and it was mutually exclusive with KRAS mutation. These results suggest that PIK3CA amplification may be early and important event in colorectal carcinogenesis and may drive the development of TAs independently with KRAS mutation. Keyword: colorectal cancer, PIK3CA amplification, serrated polyps, tubular adenomas Note: This abstract was not presented at the meeting. Citation Format: Jae-Ho Lee, Dae-Kwang Kim, In-Jang Choi, IlSeon Hwang, Yu-Na Kang, Shin Kim. PIK3CA amplification was not associated with serrated polyps but tubular adenomas in colorectal lesions. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 2202. doi:10.1158/1538-7445.AM2014-2202

The digastric muscle, as the landmark in head and neck surgery, has two bellies, of which various variations have been reported. In the submental region of a 72-year-old Korean male cadaver, bilateral variations were found in the anterior belly of the digastric muscle. Two accessory bellies, medial to the two normal anterior bellies of the digastric muscle, ran posterior and medially, merging and attaching at the mylohyoid raphe of the mylohyoid muscle. The 3rd accessory belly originated from the right intermediate tendon and ran horizontally, merging the right lower bundle of the right accessory belly and inserted together. These accessory bellies had no connection with the left anterior belly. This unique variation has not been reported in the literature previously, and this presentation will guide clinicians during surgical interventions and radiological diagnoses.