PURPOSE: To evaluate normal variations and thus to avoid confusion in differentiation from lesions of the accessory structures (rhomboid fossa, foramen for supraclavicular nerve, conold tubercle) of the clavicle in chest radiographs. MATERIALS AND METHODS: We studied the variations of the clavicle in 300 chest radiographs (134 men, 166 women) and 355 dry bones (right 166, left 189; 151 men, 74 women, 130 unknown sex). RESULTS: In chest radiographs, the incidence of the depressed rhomboid fossa was 229 cases (39.5%;male 52.0%, female 29.9%);the flat type was 329 cases (56.9%;male 45.7%, female 65.7%);and the elevated type was 20 cases (3.5%; male 2.4%, female 4.3%). In the dry bones, the incidence of the depressed thombold fossa was 129 cases (57.3%;male 59.6%, female 52.7%);the flat type was 65 cases (28.9%;male 24.5%, female 37. 8%) ;and the elevated type was 31 cases (13.8%;male 15.9%, female 9.5%). The incidence of the foramen for supraclavicular nerve was 0.8% in chest radiographs, and 1.4% in the dry bones. The incidence of the elevated conold tubercle was 65.1% (male 64.0%, female 65.9%) in chest radiographs, and 96.9% (male 95.4%, female 100.0%) in the dry bones. CONCLUSIONS: The incidence of the depressed rhomboid fossa in chest radiographs was higher in men and the right clavicle. The incidence of flat rhombo~d fossa in chest radiographs decreased according to increase of age. The foramen for supraclavicular nerve was occasionally found (0.8% in chest radiographs; 1.4% in the dry bones).
Clavicle* ; Female ; Humans ; Incidence ; Male ; Radiography, Thoracic* ; Thorax*

PURPOSE: To evaluate normal variations and thus to avoid confusion in differentiation from lesions of the accessory structures (rhomboid fossa, foramen for supraclavicular nerve, conold tubercle) of the clavicle in chest radiographs. MATERIALS AND METHODS: We studied the variations of the clavicle in 300 chest radiographs (134 men, 166 women) and 355 dry bones (right 166, left 189; 151 men, 74 women, 130 unknown sex). RESULTS: In chest radiographs, the incidence of the depressed rhomboid fossa was 229 cases (39.5%;male 52.0%, female 29.9%);the flat type was 329 cases (56.9%;male 45.7%, female 65.7%);and the elevated type was 20 cases (3.5%; male 2.4%, female 4.3%). In the dry bones, the incidence of the depressed thombold fossa was 129 cases (57.3%;male 59.6%, female 52.7%);the flat type was 65 cases (28.9%;male 24.5%, female 37. 8%) ;and the elevated type was 31 cases (13.8%;male 15.9%, female 9.5%). The incidence of the foramen for supraclavicular nerve was 0.8% in chest radiographs, and 1.4% in the dry bones. The incidence of the elevated conold tubercle was 65.1% (male 64.0%, female 65.9%) in chest radiographs, and 96.9% (male 95.4%, female 100.0%) in the dry bones. CONCLUSIONS: The incidence of the depressed rhomboid fossa in chest radiographs was higher in men and the right clavicle. The incidence of flat rhombo~d fossa in chest radiographs decreased according to increase of age. The foramen for supraclavicular nerve was occasionally found (0.8% in chest radiographs; 1.4% in the dry bones).
Clavicle* ; Female ; Humans ; Incidence ; Male ; Radiography, Thoracic* ; Thorax*

Coronary artery fistula is an unusual anomaly in elderly patients that consists of a communication bet- ween one of the coronary arteries and other cardiac chambers or veins. It causes many cardiac compli- cations due to hemodynamic changes, and thus has recognized its clinical significance. It occurs usually in congenital origin, but also occurs secondarily in traumatic or neoplastic or artherosclerotic coronary diseases. Congenital coronary artery fistula is a very rare congenital anomaly that results in multiple hemodynamic complications. It has reported rarely in elderly patients, that induces myocardial ischemia due to coronary steal syndrome and heart failure that caused by diastolic volume overload via a left to left shunt. We observed a 68-year-old male patient with exertional chest pain and dyspnea, in whom selective coronary angiography revealed abnormal reticular communication between left anterior descending artery and left circumflex artery and drained to left ventricle through multiple microfistulous channels. We report this patient case who complicated by myocardial ischemia and left ventricular failure those caused by hemodynamic complication due to multiple coronary artery-left ventricular fistulae.
Aged ; Arteries ; Cations ; Chest Pain ; Coronary Angiography ; Coronary Disease ; Coronary Vessels ; Dyspnea ; Fistula ; Heart Failure* ; Heart Ventricles ; Heart* ; Hemodynamics ; Humans ; Male ; Myocardial Ischemia ; Veins

Coronary artery fistula is an unusual anomaly in elderly patients that consists of a communication bet- ween one of the coronary arteries and other cardiac chambers or veins. It causes many cardiac compli- cations due to hemodynamic changes, and thus has recognized its clinical significance. It occurs usually in congenital origin, but also occurs secondarily in traumatic or neoplastic or artherosclerotic coronary diseases. Congenital coronary artery fistula is a very rare congenital anomaly that results in multiple hemodynamic complications. It has reported rarely in elderly patients, that induces myocardial ischemia due to coronary steal syndrome and heart failure that caused by diastolic volume overload via a left to left shunt. We observed a 68-year-old male patient with exertional chest pain and dyspnea, in whom selective coronary angiography revealed abnormal reticular communication between left anterior descending artery and left circumflex artery and drained to left ventricle through multiple microfistulous channels. We report this patient case who complicated by myocardial ischemia and left ventricular failure those caused by hemodynamic complication due to multiple coronary artery-left ventricular fistulae.
Aged ; Arteries ; Cations ; Chest Pain ; Coronary Angiography ; Coronary Disease ; Coronary Vessels ; Dyspnea ; Fistula ; Heart Failure* ; Heart Ventricles ; Heart* ; Hemodynamics ; Humans ; Male ; Myocardial Ischemia ; Veins

Rapid crestal bone resorption following maxillary tooth loss is further accentuated in the posterior regions because of pneumatization and enlargement of the maxillary sinuses. A treatment rationale that allows preservation and augmentation of vertical available bone at the time of posterior maxillary tooth extraction may offer numerous therapeutic benefits which are more short courses of therapy and no needs of additional surgical augmentation. The present study comprised 3 patients who had 4 posterior maxillary teeth with no evident bone between the tooth apex and sinus floor, as estimated through preoperative radiographic analysis. Sinus floor augmentation at the time of tooth extraction was chosen for the ltreatment of these patients. After the tooth was carefully extracted, the empty alveolus was thoroughly debrided and a trephine approach was performed. Particulated autogenous bone was gently pushed beyond the empty alveolus to elevate the sinus membrane using an osteotome. The distance between bone crest and sinus floor was radiographically estimated 4 months after the first procedure. Another procedure was then carried out to place the implants of 11 mm length without another augmentation procedure. All implant were clinically stable, with no sign of infection. The presented surgical procedure performed at the time of extraction of posterior maxillary teeth in close proximity to the sinus floor allowed placement of implants of proper length.
Bone Resorption ; Humans ; Maxillary Sinus ; Membranes ; Sinus Floor Augmentation* ; Tooth Apex ; Tooth Extraction ; Tooth Loss ; Tooth*

No abstract available.
Temporomandibular Joint*

No abstract available.
Temporomandibular Joint*

To determine effects of the direction of the rotational work shifting on the circadian rhythm and adaptation of physiological and psychological components were investigated with nursing students. Two groups of seven volunteers participated as experimental subjects, and eight nursing students participated as a control group. The directions of rotation work shift were as follows : CW(clockwise)-shift system rotation in the direction of day shift(3 lays), evening shift(3days), off duty(1day) and night shift(5days). and CCW(counterclockwise)-shift system rotation in the reverse direction. Urinary free cortisol and 17-hydroxycorticoster oids in the urine were measured by the solid-phase radioimmunoassay and the colorimetry methods, re spectively. Plasma melatonin was measured by radioimmunoassay. The urinary free cotisol rhythm changed to ir-regular on the evening and night shift in the CCW shift system, whereas the rhythm seems to adapt on night shift in the CW shift system. The daily rhythms of urinary 17-OHCS indicate that they are well synchronized to shift work. These results show that the rotation of shift in the CW direction is more acceptable in terms of the adaptation of hormonal rhythms. These results indicate that the CCW rotation of shift work makes it more difficult for the workers to adapt on a physiological level, and has many more negative effects on nurses when compared with the CW rotation. Thus, a clockwise rotating shift systern seems to be more desirable for the optimal health and performance of nurses.
Circadian Rhythm* ; Colorimetry ; Humans ; Hydrocortisone* ; Melatonin ; Plasma ; Radioimmunoassay ; Students, Nursing ; Volunteers

Angiomyofibroblastoma of the vulva is a rare mesenchymal tumor. It has been diagnostically confused with aggressive angiomyxoma which has a somewhat different clinical course and therapy. Herein we report a case of angiomyofibroblastoma of the vulva in a 46-year-old female. Microscopically, there were alternating hypercellular and hypocelluar edematous zones in which abundant capillary blood vessels were irregularly distributed. Spindle, plump spindle, and oval stromal cells were concentrated around the blood vessels, or loosely dispersed in the hypocellular area. Immunohistochemically, the stromal cells were positive for desmin, vimentin, muscle-specific actin and weakly positive for S-100 protein. Ultrastructural studies showed well developed rough endoplasmic reticulum, abundant intermediate filaments, and pinocytic vesicles in the stromal cells.
Female ; Humans

To evaluate the incidence and clinico-pathologic correlation of benign epithelial changes of endometrium, we tried to classify the changes into squamous cell change, ciliary change, eosinophilic cell change, papillary surface epithelial change, and mucinous cell change by the criteria of Hendrickson. Based on the 450 hysterectomy specimens obtained from Jan. 1994 to Dec. 1994 in PMC, the incidence of the cell changes was as follows: squamous cell change: 1.1%, eosinophilic cell change: 6.8%, mucinous cell change: 6.6%, ciliary change: 10.4%, papillary surface epithelial change: 16.4%. Squamous cell change was noted in severe endometritis or endometrial hyperplasia and papillary surface epithelial proliferation was mainly associated with plasma cell infiltration in adenomyosis or leiomyoma. Eosinophilic change and ciliary change were sometimes concomitantly found in dilated glands of the basal layer or in the invaded glands of adenomyosis. The results of this study suggested a correlation of benign epithelial changes with endometritis, adenomyosis, leiomyoma and dysfunctional uterine bleeding.
Incidence