The pyramidalis muscle is one ef the muscles in the body whose nature and function remain unknown. Some authors consider it to be a vestigial muscle phylogenetically derived from monotremes in which it is highly developed, but others believe it to be a newly formed structure in the primate, reaching its highest development in man. Among the human races, the white race is reported to have greater percentage of absence (17.7%) than in the black and yellow races. Some authors hesitate to accept the progressive muscle theory due to racial prejudice. For the Chinese, only 40 bodies have been studied and the percentage of absence is only 1.25%. In order to re-estimate the frequency of absence of this muscle in the Chinese and to seek for evidences that might throw light on the nature of this muscle, 112 children of different ages and 10 adults have been studied. In the children this muscle grows twice in length and width from the time of birth to early adolescence (body ength 130 cm), since then no further development is observed. The perc- entage of absence, in this group, is 5.7% in term of side which is slightly higher than that of the Japanese but is still much lower than the other races. It was found that some muscle fibers of the m. rectus abdominis may arise from the linea alba directly opposite the insertion of the pyramid alis muscle. The occurrence of such fibers leads one to consider that they, together with the pyramidalis muscle, may be able to draw the lower abdominal wall inward which tends to bulge in an upright position at the time of increased abdominal pressure. This tends to direct the abdominal pressure towards the pelvic cavity, facilitating the evacuation of the content of the pelvic viscerae. Since this condition develops as a sequence of the upright position in the human bcdy, it should be progressive in nature. It has also been observed that the pyramidalis muscle is enclosed in a special sheath formed by the aponeurosis of the united lower portion of the m. obliquus internus abdominis and m. transversus abdominis. The relation of this muscle with the aponeurosis of the internal oblique muscle and the continuance of this muscle with the rectus abdominis at the linea alba suggest its origin from the rectus muscle.

PURPOSE: To elucidate the dynamic features of CT scans in peripheral cholangiocarcinoma for the differentiation of this tumor from various primary hepatic neoplasms. MATERIALS AND METHODS: Materials were 24 cases of pathologically confirmed peripheral cholangiocarcinoma. Contrast enhancement patterns of central and peripheral portion of the masses were analyzed at three phases including arterial dominant(22), tissue equilibrial(24), and postequilibrial(9). Other associated CT findings and laboratory data were analyzed. RESULTS: Serum total billrubin was mostly below 2mg/dl(22/24), hepatitis B surface antigen was positive in 0nly 9%, serum alphafetoprotein was elevated in 18%, carcinoembryonic antigen in 47%, cancer antigen 19-9 in 60%. In the arterial dominant image(22), 50% of the cases showed peripheral hyperdensity and 50% total hypodensity. In the tissue equilibrial images(24), 63% showed total hypodensity, 25% peripheral hyperdensity, and 13% total isodensity. In the postequilibrial images(9), 45% showed peripheral hypodensity, 33% total hyperdensity, and 22% total hypodensity. The relative CT density of central portion of mass was higher in later phase than earlier phase. Associated findings were IHD dilatation(18) or stone(2), lymphadenopathy(11), ipsilateral lebar shrinkage(7), surrounding cystic mass(2), calcification within the mass(2) and choledochal cyst (2). CONCLUSION: Dynamic features of CT scans were useful for the systematic differentiation of the peripheral cholangiocarcinoma from various primary hepatic neoplasm.
Carcinoembryonic Antigen ; Cholangiocarcinoma* ; Choledochal Cyst ; Hepatitis B Surface Antigens ; Liver Neoplasms ; Tomography, X-Ray Computed*

Sixty seven cases of segmental arterial hyperperfusion and thirty one cases of segemental portal hypoprfusion detected among 803 cases of arterial and portal dominant CT were studied for he evaluation of etiology and mechanism causing intrahepatic segmental abnormal perfusion in normal portion of the liver around hepatic mass. Hepatic masses causing segmental abnormal perfusion were hepatocellular carcinoma, peripheral cholangiocarcinoma, metastasis, abscess, and cavernous hemangioma. Segmental portal hypoperfusion was seen on the area of segmental arterial hyperperfusion in all the cases and segmental arterial hyperperfusion was seen on the area of segmental portal hypoperfusion in 77% of cases. In conclusion, there are intrahepatic segmental portal and arterial abnormal perfusions in normal portion around hepatic mass, and these phenomena may be developed with close reciprocal alteration between both portal and hepatic arterial flows.
Abscess ; Carcinoma, Hepatocellular ; Cholangiocarcinoma ; Hemangioma, Cavernous ; Liver* ; Neoplasm Metastasis ; Perfusion* ; Portal Vein*

Sixty seven cases of segmental arterial hyperperfusion and thirty one cases of segemental portal hypoprfusion detected among 803 cases of arterial and portal dominant CT were studied for he evaluation of etiology and mechanism causing intrahepatic segmental abnormal perfusion in normal portion of the liver around hepatic mass. Hepatic masses causing segmental abnormal perfusion were hepatocellular carcinoma, peripheral cholangiocarcinoma, metastasis, abscess, and cavernous hemangioma. Segmental portal hypoperfusion was seen on the area of segmental arterial hyperperfusion in all the cases and segmental arterial hyperperfusion was seen on the area of segmental portal hypoperfusion in 77% of cases. In conclusion, there are intrahepatic segmental portal and arterial abnormal perfusions in normal portion around hepatic mass, and these phenomena may be developed with close reciprocal alteration between both portal and hepatic arterial flows.
Abscess ; Carcinoma, Hepatocellular ; Cholangiocarcinoma ; Hemangioma, Cavernous ; Liver* ; Neoplasm Metastasis ; Perfusion* ; Portal Vein*

PURPOSE: The purpose of our study was to characterize the enhancing patterns of hepatic metastasis from gastric adenocarinoma using multi-phase incremental bolus dynamic CT with obtained both in early and late phase contrast scan and to evaluate the its advantages. METHODS AND MATERIALS: Of 33 cases of multi-phase incremental bolus dynamic CT with proved hepatic~metastasis from gastric adenocarinoma, we classified dynamic enhancement patterns as three types according to early phase contrast enhancement, and then analized the late phase contrast enhancement, more metastasis detection, segmental abnormal arterial perfusions and correlation between pathologic type. RESULTS: Type I (totally hypodense lesion) was in 18 patients(55%), type II (peripheral high density area) was seen in 13 patients (39%), and type III (near totally hyperdense lesion) was seen in two patients(6%). But in late phase, masses showed totally hypodense area in 26 patients(79%), central high with peripheral low density area(PLDA) in six patients(18%) and totally isodense in one patient(3%). More metastatic masses were detected with early phase in 11 patients(33%) as compared with late phase contrast. Segmental arterial hyperperfusion around the lesions, which could represent intrahepatic portal branch invasion, was seen in 10 patients(30%). There was no correlation between pathologic type and enhancement pattern of lesions. CONCLUSION: Multi-phase incremental bolus dynamic CT could represent variable hemodynamic changes of hepatic metastatic masses and was useful to evaluate the qualitative and quantitative analysis of hepatic metastases.
Hemodynamics ; Humans ; Neoplasm Metastasis* ; Perfusion ; Stomach Neoplasms* ; Stomach*

Health Literacy ; Humans

AIM:To investigate the peripapillary retinal nerve fiber layer ( RNFL ) thickness and the macular ganglion cell complex ( GCC ) thickness in primary open angle glaucoma ( POAG ) eyes and to compare them with normal control eyes, and to evaluate the diagnostic ability of peripapillary RNFL thickness and macular GCC thickness in POAG.
●METHODS:This was a cross-sectional study consisting of 56 POAG patients. The control group consisted of 60 normal subjects (60 eyes) were matched in terms of age, sex, diopter and axial length. The peripapillary RNFL thickness and the macular GCC thickness of POAG eyes and normal control eyes were measured and compared by RTVue-100 optical coherence tomography ( OCT ) . To assess the diagnostic utility of peripapillary RNFL thickness and macular GCC thickness in POAG, receiver operating characteristic curves ( ROC ) and areas under the ROC ( AUC) were used.
●RESULTS:The POAG eyes had a thinner peripapillary RNFL and macular GCC than the control eyes at all the regions ( P < 0. 001 ). Multivariable linear regression analysis showed that the peripapillary RNFL thickness and macular GCC thickness was significantly thinner in association with the POAG diagnosis. ROC and AUC analysis showed that the best AUC parameters were C/D (AUC=0. 936; 95% Cl=0. 903, 0. 964) and superior RNFL thickness (AUC=0. 910;95% Cl=0. 889, 9. 455). The AUC of nasal RNFL thickness, inferior RNFL thickness, temporal RNFL thickness, superior GCC thickness, inferior GCC thickness, and average GCC thickness were all above 0. 8 with a good diagnostic value.
●CONCLUSION:The peripapillary RNFL thickness and macular GCC thickness in POAG eyes are thinner than that of normal control eyes. Decreased peripapillary RNFL thickness and macular GCC thickness may be associated with POAG. The peripapillary RNFL thickness and macular GCC thickness have a good diagnostic value.

Gall bladder wall varices are unusual manifestations of protal hypertention. Authors report 4 cases of gall bladder wall varices which were easily detected in IV bolus CT. All of our cases showed main portal vein obstruction but preserved intrahepatic portal flows with development of cavernous transformation. We could easily identify tortous and tubular structures with strong contrast enhancement in the gall bladder wall, compatible with gall bladder wall varices, at the early phase of IV bolus CT. Comparing with Doppler sonography, IV bolus CT is an easy and useful method for detection of gall bladder wall varices even in case of no prior information for portal vein abnormality.
Diagnosis* ; Methods ; Portal Vein ; Urinary Bladder* ; Varicose Veins

Psoriasis vulgaris is a common skin disease usually affects the traumatic joints and scalp in young adult. I reviewi 14l6 patients and the results were as follows; 1. Sex incidence was 991 in male and 425 in female(2.3: 1). 2. The peak age at onset of disease was between from 11 to 80 year of age. 3. The onset of psoriasis showed higher incidence in summer and lower in autumn. 4. Sites affected by psoriasis were most frequent in elbow joint(31.8%), 5. Koebner Phenomenon was found in 12.9% and the incubation period was 16 days on the average. 6. Family incidence was found in 198 cases(13.9%). 7. Joint pain was associated in 155 cases(10.9%), mainly in knee joint. 8. Nail involvement was in 84 cases(5.9). 9. Mucous membrane involvement was in 103 cases(7. 2% ). 10. Other skin diseases in those study were variable but the predominated in neurodermatitis, ll. A significant difference between man and woman for the medication, man was treated by specialist while the woman was medicated by pharmacist advised 12. Approximately half of the cases(56.6%) were ignorant for psoriasis. 13. A significant difference between man and woman about psychiatric problem, was observed. The man had a sought of incurability while the woman had anxiety for the life threaten.
Anxiety ; Arthralgia ; Elbow ; Female ; Humans ; Incidence ; Joints ; Knee Joint ; Male ; Mucous Membrane ; Neurodermatitis ; Pharmacists ; Psoriasis* ; Scalp ; Skin Diseases ; Specialization ; Young Adult

PURPOSE: To prove whether the arterioportal shunt, especially transvasal shunt is one of the cause of the hypovascular hepatocellular carcinoma. MATERIALS AND METHODS: We evaluated the early phase images of table incremental dynamic CT and hepatic angiography in 20 cases of hepatoceltular carcinomas with transvasal arterioportal shunt. RESULTS: In hepatic arteriography, 18 cases were hypovascular and the remained 2 cases showed hypervascular tumor staining than surrounding normal hepatic parenchyme. In the early phase dynamic CT, 18 cases were hypodense(including 4 cases of focal hyperdensity in hypodense background), one was isodense and remaining one was hyperdense. CONCLUSION: Arterioportal shunt, especially transvasal shunt may make originally hypervasular hepato-cellular carcinoma to hypovascular lesion in the early phase dynamic CT or hepatic arteriography. In attempt to differentiate hepatic masses by tumor vascularity in recently widely used table incremental dynamic CT, the vascular patterns of the mass should be considered by close evaluation of vascular pattern of the liver, such as morphology of perfusion abnormality and arterioportal shunt, etc.
Angiography ; Carcinoma, Hepatocellular* ; Liver ; Perfusion