The purpose of this study was to investigate variations in the communicating branch between the musculocutaneous and the median nerves and to discuss their clinical significance. Seventy two arms from 36 Korean adults were used. Twenty four cases (33.4%) among 72 arms had communications between the musculocutaneous and the median nerves. In 19.5%, a communicating branch ran from the musculocutaneous to the median nerves and in 4.2% of these a communicating branch formed a loop. A branch running from the median to the musculocutaneous nerves was observed in 6.9%. There were more than two communicating branches between two nerves in 5.6%. The average angle between the musculocutaneous nerve proximal and distal to the coracobrachialis was 159+/-9degrees at adduction of the arm. The musculocutaneous nerve did not pierce the coracobrachialis muscle in 2.8%. One case (1.4%) showed partial fusion of the trunks of the musculocutaneous and median nerves. The musculocutaneous nerve ran next to the median nerve after the coracobrachialis muscle and coursed laterally in 5.6% with or without a communicating branch. In these cases, the angle of the musculocutaneous nerve was more acute. The musculocutaneous nerve entrapment is discussed with this angle.
Adult ; Arm ; Humans ; Median Nerve* ; Musculocutaneous Nerve ; Running

Systemic lupus erythematosus(SLE) is a multisystem disease. Gastrointestinal manifestations are common in SLE, occurring in 35% to 40% of patients at some stage of their illness. Acute pancreatitis is a rare complication of SLE. To date, seventy cases of acute pancreatitis related to SLE have been reported and fourteen cases were unrelated to drugs such as steroids, diuretics or other immunosuppressive agents. Furthermore, only seven out of fourteen cases manifested acute pancreatitis in their initial course of SLE as was seen in our case. Additionally, there have been no such cases reported in Korea. Corticosteroids have been considered as both a cause and as a therapy for acute pancreatitis. We report a case of acute pancreatitis in a 40 year old Korean man presenting with multi-organ manifestations and diagnosed to have SLE. Renal biopsy showed membranous glomerulonephritis(WHO Class V). His serum amylase and lipase returned to normal on high dose prednisolone treatment.
Adrenal Cortex Hormones ; Adult ; Amylases ; Biopsy ; Diuretics ; Humans ; Immunosuppressive Agents ; Korea ; Lipase ; Lupus Erythematosus, Systemic* ; Pancreatitis* ; Prednisolone ; Steroids

OBJECTIVES: Automobile exhaust gases contain benzene and toluene, which are excreted in human urine as trans,trans-muconic acid and hippuric acid, respectively. Sorbic acid and benzoic acid, used as food preservatives, are also metabolized into trans,trans-muconic acid and hippuric acid in the human body. The purpose of this study is to estimate the level of benzene and toluene exposure according to the commuting mode and duration, residential environment, and preservative-added foods intake in university students who are not occupationally exposed to benzene or toluene. METHODS: Spot urine samples were collected from 211 university students who had no occupational exposure to volatile organic compounds. Information about their smoking history, residence type, traffic environments, commuting mode and duration, and their intake of bottled or canned food or beverages was gathered through a self-administered questionnaire. Urinary concentrations of trans,trans-muconic acid and hippuric acid were measured and statistically correlated to the individual's life style factors. RESULTS: There was no significant difference in the urinary concentrations of trans,trans-muconic acid or hippuric acid according to the smoking history. Mean urinary concentration of hippuric acid in females was higher than that found in males. Subjects living in districts with a population density of 1,000~4,999 people/km2 showed the highest urinary hippuric acid level; individuals living in cities of 5,000~9,999 people/km2 population density were next. The mean urinary trans,trans-muconic acid concentration was higher in students who were living where traffic jams are common compared to those who did not, and in subjects whose residence were within 149 m from a 4-lane road compared to those whose residence was not. However, neither mode nor duration of the commute showed any effect on the urinary trans,trans-muconic acid or hippuric acid concentrations of the students. Urinary hippuric acid levels increased when consuming canned fruit or canned coffee, and urinary trans,trans-muconic acid levels increased when consuming fruit juices or pickled radishes. CONCLUSIONS: The inhalation of vehicle exhaust and the ingestion of canned or pickled food may increase urinary hippuric acid and trans,trans-muconic acid levels in individuals who are not occupationally exposed to benzene or toluene.
Benzene ; Benzoic Acid ; Beverages ; Coffee ; Eating ; Female ; Food Preservatives ; Food, Preserved ; Fruit ; Gases ; Hippurates ; Human Body ; Humans ; Inhalation ; Life Style ; Male ; Occupational Exposure ; Occupations ; Population Density ; Questionnaires ; Smoke ; Smoking ; Sorbic Acid ; Toluene ; Transportation ; Vehicle Emissions ; Volatile Organic Compounds

PURPOSE: Garlic has anti-microbial and anti-inflammatory effects. We investigated its actions and preventive effects on chronic bacterial prostatitis (CBP) using a rat model. MATERIALS AND METHODS: Bacterial suspension was inserted into the prostatic urethra of 75 rats. Then 15 were grouped as garlic group, and 60 as control group. Garlic and saline were given to each group for 4 weeks, respectively. After partial resection of the prostate, microbiological culture and histological examination were done. The incidence of CBP was compared between two groups. To evaluate the anti-microbial and anti-inflammatory effect of garlic, the 41 rats proved as CBP models among the control group were divided into 4 groups randomly: I, control; II, garlic; III, ciprofloxacin; IV, garlic plus ciprofloxacin. After 3 weeks of treatment, microbiological cultures of urine, prostate and histological examination of prostate were done. RESULTS: In study of the preventive effects, 5 rats in garlic treatment group and 41 rats in control group were shown to be CBP models. In anti-microbial and anti-inflammatory evaluation, positive urine culture rate and prostate tissue show no significant difference among four groups, but bacterial growth in urine and prostate tissue were lower in groups II, III, and IV than group I. Bacterial growth was the slowest in prostate tissue of group IV. Histologic findings were more improved in groups II, III and IV than group I, with Group IV being the most improved. CONCLUSIONS: These results show that garlic has preventive and therapeutic effects on CBP. Combination treatment with antibiotics may be considered in the future.
Animals ; Anti-Bacterial Agents ; Ciprofloxacin ; Garlic ; Incidence ; Inflammation ; Prostate ; Prostatitis ; Rats ; Urethra

Superficial CD34-positive fibroblastic tumor (SCPFT) is a recently described disease entity characterized by marked nuclear pleomorphism, low mitotic count, and diffuse CD34 positivity. It is a rare, distinctive, low-grade fibroblastic neoplasm. To date, only 44 cases have been reported in the English-language literature. Herein, we report two cases of SCPFT involving a 48-year-old male and a 22-year-old male with superficial tumors on the right and left thighs, respectively. Excision was performed in both cases. Histologically, both tumors showed spindle-to-epithelioid cells arranged in fascicular or sheet-like patterns. Most cells displayed granular or eosinophilic glassy cytoplasm, marked nuclear pleomorphism, and a low mitotic rate. On immunohistochemical staining, tumor cells were diffusely positive for CD34 and negative for S100 protein, smooth muscle actin, and desmin. After wide excision, neither patient experienced recurrence or metastasis after 16 months and 11 months of clinical follow-up, respectively. To the best of our knowledge, these are the first two cases of SCPFT reported in Korea. We believe these case reports would contribute to the clinicopathological understanding of SCPFT and assist clinicians in differentiating this tumor from other superficial soft tissue neoplasms.

Spindle cell lipoma is a rare benign neoplasm that features a mixture of evenly aligned spindle cells, mature adipocytes, and ropey collagen. Most cases of spindle cell lipoma are found in the subcutaneous tissue, and intradermal spindle cell lipoma is rarely reported. We present a case of intradermal spindle cell lipoma in a 46-year-old female who presented with a 0.7-cm flesh-colored and dome-shaped nodule on the right temple that had developed 6 years ago. This mass was excised, and upon histopathologic examination, an unencapsulated lesion was located in the dermis, which consisted of bland spindle cells, scanty mature adipocytes, rare lipoblasts, and ropey collagen bundles with prominent basophilic myxoid stroma. Immunohistochemical staining showed diffuse positivity for CD34, negativity for the S-100 protein, and loss of retinoblastoma protein expression. Based on these features, intradermal low-fat spindle cell lipoma was diagnosed. No evidence of local recurrence was observed 4 months after excision. Intradermal low-fat spindle cell lipomas are extremely rare and can easily be mistaken for tumors that have similar clinical and histopathological findings. Herein, we report a globally rare case of an intradermal low-fat spindle cell lipoma.

Background: The model for end-stage liver disease 3.0 (MELD3.0) is expected to address the flaws of the current allocation system for deceased donor liver transplantation (DDLT). We aimed to validate MELD3.0 in the Korean population where living donor liver transplantation is predominant due to organ shortages. Methods: Korean large-volume single-centric waitlist data were merged with the Korean Network for Organ Sharing (KONOS) data. The 90-day mortality was compared between MELD and MELD3.0 using the C-index in 2,353 eligible patients registered for liver transplantation. Patient numbers and outcomes were compared based on changes in KONOS-MELD categorization using MELD3.0. Possible gains in MELD points and reduced waitlist mortality were analyzed. Results: MELD3.0 performed better than MELD (C-index 0.893 for MELD3.0 vs. 0.889 for MELD). When stratified according to the KONOS-MELD categories, 15.9% of the total patients and 35.2% of the deceased patients were up-categorized using MELD3.0 versus MELD categories. The mean gain of MELD points was higher in women (2.6 ± 2.1) than men (2.1 ± 1.9, P < 0.001), and higher in patients with severe ascites (3.3 ± 1.8) than in controls (1.9 ± 1.8, P< 0.001); however, this trend was not significant when the MELD score was higher than 30. When the possible increase in DDLT chance was calculated via up-categorizing using MELD3.0, reducible waitlist mortality was 2.7%. Conclusion MELD3.0 could predict better waitlist mortality than MELD; however, the merit for women and patients with severe ascites is uncertain, and reduced waitlist mortality from implementing MELD3.0 is limited in regions suffering from organ shortage, as in Korea.

Pure red cell aplasia (PRCA) is characterized by severe anemia with reticulocytopenia and absence of erythroblast from the bone marrow. Sinus histiocytosis with massive lymphadenopathy (SHML : Rosai-Dorfman disease) is rare systemic disease characterized by painless cervical, axillary, inguinal and mediastinal lymphadenopathy and frequent extranodal invasion. Histologically, lymph node sinuses are expanded by numerous distinctive histiocytes which contains well preserved lymphocytes. We report a case of sinus histiocytosis with massive lymphadenopathy in inguinal lymph node biopsy with polyclonal gammopathy and pure red cell aplasia in bone marrow biopsy who was infected by Epstein-Barr virus.
Anemia ; Biopsy ; Bone Marrow ; Erythroblasts ; Herpesvirus 4, Human ; Histiocytes ; Histiocytosis, Sinus* ; Lymph Nodes ; Lymphatic Diseases* ; Lymphocytes ; Red-Cell Aplasia, Pure*

Acetic Acid ; Chloroform ; Cryotherapy ; Epithelium ; Ethanol ; Mandible ; Odontogenic Cysts ; Recurrence

Background: Considering the interactions between heavy metals, a comprehensive evaluation of the effects of exposure to various types of co-interacting heavy metals on health is required.This study assessed the association between dyslipidemia markers and blood mercury, lead, cadmium, iron, zinc, and nickel levels in residents of an abandoned refinery plant. Methods: A total of 972 individuals (exposed group: 567, control group: 405) living near the Janghang refinery plant in the Republic of Korea were included. Blood mercury, lead, cadmium, iron, zinc, nickel, cholesterol, and triglyceride levels were measured. The combined effect of the six heavy metals on dyslipidemia markers was evaluated using a Bayesian kernel machine regression (BKMR) model and compared with the results of a linear regression analysis. The BKMR model results were compared using a stratified analysis of the exposed and control groups. Results: In the BKMR model, the combined effect of the six heavy metals was significantly associated with total cholesterol (TC) levels both below the 45th percentile and above the 55th percentile in the total population. The combined effect range between the 25th and 75th percentiles of the six metals on TC levels was larger in the exposed group than that in the total population. In the control group, the combined effects of the changes in concentration of the six heavy metals on the TC concentration were not statistically significant. Conclusion These results suggest that the cholesterol levels of residents around the Janghang refinery plant may be elevated owing to exposure to multiple heavy metals.