Os Subtibiale, inconstant bone over the tip of the medial malleolus, is the very unusual findings and extreme rarity of the condition. We experienced a case of Os subtibiale in a 24 year old man who complained pain and tenderness an the bilateral medial malleolar region. The patient was treated by excision with satisfactory result.
Humans

PURPOSE: This study was done to identify factors that influence self-rated health in elderly women. METHOD: The research design for this study was a descriptive survey design using a convenience sampling method. Data collection was done using a self-questionnaire with 201 women participating in the study. Frequencies, percentages, means, standard deviations, Pearson's correlation coefficients and stepwise multiple regression with the SPSS 10.0 program were used to analyze the data. RESULTS: The age of the women ranged from 65 to 89 and mean was 72.9. The main factors that affected self-rated health were depression, sleep, family APGAR, economic level, social activities and number of illnesses. These variables accounted for 44% of self-rated health. CONCLUSION: The findings of this study provide useful information for constructing intervention programs for elderly women.
Aged ; Data Collection ; Depression ; Female ; Humans ; Research Design

An adenoma is a rare benign tumor arising in the extra-hepatic biliary duct. Adenocarcinomatous changes are often observed in the background of an adenoma. Double or triple cancer with an adenoma and adenocarcinoma in the biliary tract can be the crucial evidence of the adenoma-carcinoma sequence. We first performed laparoscopic surgery on a 63-year old male patient complaining of pain in the right upper quadrant of the abdomen and jaundice a week earlier, which was initially diagnosed by a radiologist as a sessile polyp of the gallbladder along with stones in the gallbladder and the common bile duct. A mass was found in the distal common bile duct and ampullary area during intraoperative choledochoscopy. The frozen sections taken during surgery indicated a cancer or dysplasia in the gallbladder and the distal common bile duct. The patient underwent a pylorus-preserving pancrea-toduodenectomy. The final diagnosis was a double primary can-cer originating in the gallbladder and the ampulla of Vater with an adnocarcinoma in an adenoma. We report this case with review of the relevant literature.
Abdomen ; Adenocarcinoma ; Adenoma ; Ampulla of Vater* ; Biliary Tract ; Common Bile Duct ; Diagnosis ; Frozen Sections ; Gallbladder ; Gallbladder Neoplasms* ; Humans ; Jaundice ; Laparoscopy ; Male ; Middle Aged ; Polyps

Recently the alanine/valine (A/V) polymorphism of the 5,10-methylenetetrahydrofolate reductase (MTHFR) gene, one of the key enzymes catalyzing remethylation of homocysteine, has been reported to its association with coronary artery disease. lhe homozygous of C677T mutation (VV genotype) correlates with increased plasma homocysteine levels as a result of the reduced activity and increased thermolability of MTHFR. We investigated whether this rnutation and homocysteine influence risk for coronary artery disease (CAD) in normal control subjects and CAD patients and two risk groups, A (>2 risk factors) and B (<1 risk factor). The MTHFR genotype and plasma homocysteine were determined by PCR followed by HinA digestion and high performance liquid chromatography (HPLC) system, respectively. From this study, statistical significance of V mutation of MTHFR between four groups was not found. Homocysteine level was the highest in CAD patients and the lowest in risk group B. Plasma homocysteine level in VV genotype of CAD patients was significantly higher than in other two genotypes and normal control subjects. We concluded that homozygisty for the C677T mutation of MTHFR was not an independent risk factor of CAD but associated with a prediposition to increased plasma homocysteine levels in CAD patients.
Chromatography, Liquid ; Coronary Artery Disease* ; Coronary Vessels* ; Digestion ; Genotype ; Homocysteine* ; Humans ; Oxidoreductases ; Plasma ; Polymerase Chain Reaction ; Risk Factors ; Statistics as Topic

BACKGROUND: Skin thickness for parameter of skin aging has been analysed with various methods. Skin thickness variations between the young and the old has been studied with various methods such as biopsies, calipers, micrometers, computer tomography, ultrsonography. But none of these methods evaluates skin thickness exactly. OBJECTIVE: For the evaluation of age-dependent skin thickness changes, we compared the skin thickness of an old-aged group and a young group with 20MHz-ultrasonography. METHODS: In order to identify the skin thickness variation between different age groups, 60 subjects, 30 aged 23-33, and 30 over 60, were studied with 20MHz-high frequency ultrasonogrphy (Dermascan C, Cortex Technology, Hadsund, Denmark) on fourteen skin sites. This machine was designed to measure the thickness from the top of the epidermis to the bottom of the dermis. After storage of cross-sectional skin imaging, skin thickness was calculated with a computer assisted image-analysis program. Skin thickness of the old was analysed by age, sex, height and weight.
Biopsy ; Dermis ; Epidermis ; Humans ; Skin Aging ; Skin* ; Ultrasonography*

No abstract available.
Pulmonary Atelectasis*

Pulmonary thromboembolism (PTE) is a serious postoperative complication. Prompt diagnosis of PTE is important but it is difficult because clinical manifestations of PTE are not obvious in most cases. A 59 year-old woman received cholecystectomy and choledocholithotomy under general anesthesia. At the 9th postoperative day, syncope, hypoxemia and hypotension were developed suddenly and the patient was transfered to intensive care unit. PTE was suspected with hemodynamic monitoring from pulmonary arterial catheter and echocardiography and diagnosed with lung perfusion scan and venogram of lower extremities. Proper cardiopulmonary support was done and the patient was recovered and discharged in improved condition. In conclusion, if a patient have syncopal attack with shock in postoperative period, PTE must be thought to be an one of possible causes of syncope and thoroughly investigated.
Anesthesia, General ; Anoxia ; Catheters ; Cholecystectomy ; Diagnosis ; Echocardiography ; Female ; Hemodynamics ; Humans ; Hypotension ; Intensive Care Units ; Lower Extremity ; Lung ; Middle Aged ; Perfusion ; Postoperative Complications ; Postoperative Period ; Pulmonary Embolism* ; Shock ; Syncope

BACKGROUND: It has been reported that Cortex mori ( Morus alba L, Sangbaikpi ; CM ), the root bark of mulberry tree, plays a role in inhibiting mast cell activation. Human seminal plasma ( HSP ) modulates immune systems and activates rat peritoneal mast cells ( RPMC ). However, the inhibitory agents of HSP - induced mast cell activation have not been disclosed yet. OBJECTIVE AND METHOD: This study was undertaken to determine the effects of CM on HSP-induced mast cell activation by morphologic and functional methods. Morphological changes of RPMC by HSP alone or CM plus HSP were observed with the inverted light microscope. And the amounts of histamine and calcium were measured by radioisotopic enzymatic histamine and radioisotopic calcium assays. RESULTS: By inverted microscopy, HSP-induced RPMC degranulation occurred in a dose-dependent fashion. After pretreatment of RPMC with CM, there was no HSP-induced degranulation. Degranulation index (DI) of RPMC treated with Hanks balanced salt solution (HBSS), CM or HSP was 7.0+/-4.3, 9.0+/-6.2, 56.5+/-16.9, respectively. After pretreatment of RPMC with CM, HSP-induced DI was 11.0 +/-7.1. These results indicate that CM inhibited HSP-induced degranulation of RPMC. HSP-induced RPMC histamine release (HR) was dose-dependent. HR of RPMC treated with HBSS, CM or HSP was 0.18+/-0.10, 0.30+/-0.19, 4.48+/-0.86 ug/ml, respectively. After pretreatment of RPMC with CM, HSP-induced HR was 0.52+/-0.21 ug/ml. These results indicate that CM inhibited HSP-induced HR from RPMC. Intracellular calcium level ( ICL) of RPMC was also increased according to the concentration of HSP. ICL of RPMC treated with HBSS, CM or HSP was 6.1+/-1.0, 9.0+/-2.1, 30.2+/-6.5 pmole, respectively. After pretreatment of RPMC with CM, HSP-induced ICL of RPMC was 11.6 +/- 3.3 pmole. These results indicate that CM inhibited HSP-induced calcium uptake of RPMC. CONCLUSION: From these results, it is suggested that CM contains some substances which inhi-
Animals ; Calcium ; Histamine ; Histamine Release ; Humans* ; Immune System ; Mast Cells* ; Microscopy ; Morus ; Rats* ; Semen* ; Trees

No abstract available.
Aorta, Thoracic* ; Blood Flow Velocity* ; Female ; Hypertension, Pregnancy-Induced* ; Pregnancy ; Umbilical Arteries*

158 cases of pulmonary metastasis having satisfactory histological proof of the primary malignant tumor, the frequency and pattern of which were analysed by conventional radiologically. The results are as follows: 1. The frequency of pulomonary metastasis according to the primary sites was 24%(38/158) hepatobiliary system,19.6%(31/158) gastrointestinal tract, 18.9%(30/158) uterine cervix and 12%(13/158) head and neck. 2. Pulmonary metastatic pattern showed nodular type 74% (117/158), granular type 10.1%(16/158), streaky type 9.5%(15/158),hilar enlargement 3.8%(6/158), patchy type 1.9% (3/158) and others 0.6%(1/158). Of all these type, nodular type was predominant. 3. The nodular type of pulmonary metastasis was classified into less than 10 nodules56.4%(66/17), 10-50 nodules 25.6%(30/117), more than 50, 17.9%(21/117), less than 1cm 12.8%(15/117) and more than5cm in 5.2%(1/117) of the cases. 4. The size of nodule was 1-3cm 36.6%(43/117), 2-3cm 20.5%(24/117), less than 1cm12.8%(15/117) and more than 5cm in 5.2%(1/117) of the cases. 5. Most cases of pulmonary metastasis involved bothlung fields 69.2%(110/58). Others were right lung field only 17.7% (28/158), left lung only 12.7%(20/158). 6. Theages between 40 and 70 represented 79.8%(126/158) of the cases and the raio of male and female was about 1.5:1.
Cervix Uteri ; Female ; Gastrointestinal Tract ; Head ; Humans ; Lung ; Male ; Neck ; Neoplasm Metastasis