The variations of the occipital sinus were studied in 50 Korean adult cadavers. The morphology of the sinus was classified into 5 types accordingo to its number and the connection with the marginal sinus. These results were compared with the data of the occipital sinus of bones (Sir and Chung, 1907). And the opening of the occipital sinus in the confluens sinuum was observed. 1. A single small occipital sinus was found in 40%. Single occiital sinus with two large marginal sinuses was observed in 8%. The single sinus with a left marginal sinus (6%) and with a right marginal sinus(4%) were present. Double occipital sinuses were observed in 10% of the cadavers. No occipital sinus was discernible in 32%. 2. There were 39 openings of the occipital sinus including the double sinuses. The occipital sinuses communicated with the confluence sinuum in 35 cases (89.7%), with the straight sinus in 5.1% and with the right or left transverse sinus in 1 case, respectively. The openings in the confluens sinuum were found on the left side(51.3%), on the right side (10.3%) and in the center(28.2%). 3. The diameters of the occipital sinus were variable according to the connection with the sigmoid sinus. 4. The difference was found between the data of the morphological types of the occipital sinus that were studied in cadavers and in dry bones.
Adult* ; Cadaver ; Colon, Sigmoid ; Humans

No abstract available.
Animals ; Rats*

BACKGROUND: Adult-onset Still's disease (AOSD) is a rare systemic inflammatory disease of an unknown etiology, and this is characterized by spiking fever, evanescent rash, arthritis and multiorgan involvement. OBJECTIVE: This study was conducted to better understand the clinical characteristics of patients with AOSD, and especially the cutaneous features. METHODS: We reviewed the medical records and cutaneous findings of 21 patients who were diagnosed with AOSD at our hospital from 2003 to 2009. The diagnosis of AOSD was based on the criteria proposed by Yamaguchi et al. RESULTS: Eighteen (86%) out of the 21 patients were women, and the age of onset ranged from 18 to 55 years. Fever occurred in 21 (100%) patients, skin rash in 20 (95%), arthralgia in 18 (86%), sore throat in 10 (48%) and lymphadenopathy in 7 (33%). The cutaneous features were as follows: typical maculopapular eruption (70%), urticaria (10%), petechia and purpura (10%), persistent plaques and linear pigmentation (5%) and acne-like lesions (5%). The most common sites of skin lesion were the trunk (80%) and thighs (80%). The histopathologic findings of 9 patients showed non-specific chronic inflammation with a perivascular mononuclear preponderance in 6 patients, and the others were consistent with urticaria or leukocytoclastic vasculitis. CONCLUSION: The various cutaneous features of this study suggest that dermatologists should consider AOSD in any patient with cutaneous eruption associated with fever and arthralgia.
Adult ; Age of Onset ; Arthralgia ; Arthritis ; Exanthema ; Female ; Fever ; Humans ; Inflammation ; Lymphatic Diseases ; Medical Records ; Pharyngitis ; Pigmentation ; Purpura ; Skin ; Still's Disease, Adult-Onset ; Thigh ; Urticaria ; Vasculitis ; Vasculitis, Leukocytoclastic, Cutaneous

OBJECTIVES: It is known that the high fibrogenecity of particles is connected with their cytotoxicity for macrophages. Although the molecular mechanism leading to fiber-induced fiber-induced cytotoxicity is still not clear, several mechanism have been suggested. The release of reactive oxygen species (ROS) from activated alveolar macrophages (AM) by dust have been suggested as a possible mechanism of particle-induced cell damage. But the mechanism which man-made vitreous fiber (MMVF) induces the production of ROS in AM is still not clear. In this study, we evaluated the relationship between ROS production and lactate dehydrogenase (LDH) release from alveolar treated with refractory ceramic fiber (RF2) or rock wool (RW1) and signal transduction path-way of ROS production in RF2 or RW1 exposed AM. METHODS: We investigated LDH release from MMVF-stimulated AM for index of cytotoxicity. To determine what kind of signal transduction pathways are involved in MMVF-stimulated ROS generation, we used some drugs which have an effect on the signal transduction pathway. RESULTS: RF2 and RW1 induced increase of LDH release with dose-dependent manner with RF2 having greater effect than RW1. There was a dose-dependent increase in the production of ROS by RF2 or RW1. At all level of concentration,. RF2 induced more ROS production than RW1. Inhibitors of PKC (bisindolylmaleimide), PLC (U73122 and neomycine) and PTK (genistein and erbstatin) suppressed RF2 or RW1-induced ROS production. CONCLUSION: There was significant correlation between LDH release and ROS production from AM treated with RF2 or RW1. RF2 and RW1 induced ROS generation through protein kinase C (PKC), phospholipase C (PLC) and protein tyrosin kinase (PTK) pathways.
Ceramics* ; Dust ; L-Lactate Dehydrogenase ; Macrophages ; Macrophages, Alveolar* ; Phosphotransferases ; Protein Kinase C ; Reactive Oxygen Species* ; Signal Transduction* ; Type C Phospholipases ; Wool

It is well known that suprasternal notch is at the midpoint between the carina and vocal cords. We evaluated the distance from the endotracheal tube tip on the suprasternal notch to upper incisor using flexible lightwand. 97 male(height 155~187 cm) and 100 female(height 144~167 cm) patients of undergoing elective surgery were included in the study. After adjust the lamp of the tracheal lightwand at the tube tip, endotracheal tube was placed under anesthesia at the suprasternal notch using the light glow. The distance between upper incisor to suprasternal notch was recorded. The average distance from upper incisor to suprasternal notch was 20.0(+/-1.0)cm in males, 17.9(+/-0.7)cm in females. We demonstrated that the placing the tracheal tube at the suprasternal notch using lightwand was rapid and reliable method for identification of proper tube positioning. We have shown that securing endotracheal tube at upper incisor 23 cm in males and 21 cm in females are positioned distally.
Adult* ; Anesthesia ; Female ; Humans ; Incisor* ; Male ; Trachea ; Vocal Cords

PURPOSE: To report a case of sclerocorneal cyst found in a 4-year-old female following strabismus surgery treated with cyst wall excision and scleral graft. CASE SUMMARY: A 4-year-old female with a history of strabismus surgery performed 1.5 year prior presented with a whitish lesion in cornea and sclera which developed 1 month ago. Slit-lamp examination revealed a 4.2 x 3.5 mm-sized cyst at the superotemporal part of the cornea, extending into the sclera at 3-o'clock. Cyst fluid, precipitate aspiration, and cyst wall excision were performed. Scleral patch graft was used to cover the scleral defects after excision. Upon histopathological examination, the cyst wall was lined with nonkeratinized stratified squamous epithelium and numerous degenerated epithelial cells were present in the cyst aspirate. CONCLUSIONS: Sclerocorneal cyst can rarely develop following trauma or surgery. In this report, the sclerocorneal cyst, possibly induced by previous strabismus surgery, was treated successfully without recurrence using cyst wall resection.
Child, Preschool* ; Cornea ; Cyst Fluid ; Epithelial Cells ; Epithelium ; Female ; Humans ; Recurrence ; Sclera ; Strabismus ; Transplants

No abstract available.
Humans*

Emergence and spread of low-level mupirocin resistance in staphylococci have been increasingly reported in recent years. The aim of this study was to characterize missense mutations within the chromosomal isoleucyl-tRNA synthetase gene (ileS) among clinical isolates of methicillin-resistant Staphylococcus aureus (MRSA) with low-level mupirocin resistance. A total of 20 isolates of MRSA with low-level mupirocin resistance (minimal inhibitory concentration, 16-64 microgram/mL) were collected from 79 patients in intensive care units for six months. The isolates were analyzed for isoleucyl-tRNA synthetase (IleS) mutations that might affect the binding of mupirocin to the three-dimensional structure of the S. aureus IleS enzyme. All isolates with low-level mupirocin resistance contained the known V588F mutation affecting the Rossman fold, and some of them additionally had previously unidentified mutations such as P187F, K226T, F227L, Q612H, or V767D. Interestingly, Q612H was a novel mutation that was involved in stabilizing the conformation of the catalytic loop containing the KMSKS motif. In conclusion, this study confirms that molecular heterogeneity in ileS gene is common among clinical MRSA isolates with low-level mupirocin resistance, and further study on clinical mutants is needed to understand the structural basis of low-level mupirocin resistance.
Staphylococcus aureus/drug effects/*genetics ; *Mutation, Missense ; Mupirocin/*pharmacology ; Methicillin Resistance ; Isoleucine-tRNA Ligase/*genetics ; Intensive Care Units ; Humans ; Electrophoresis, Gel, Pulsed-Field ; Drug Resistance, Bacterial

OBJECTIVE: This study aimed to investigate the difference in micronutrient levels between oral feeding and enteral feeding in chronic stroke patients to assess the risks of enteral feeding. METHODS: Patients with chronic stroke who were admitted to the Department of Rehabilitation Medicine between January 2011 and June 2012 were enrolled. The serum concentrations of iron, copper, zinc, folate, and vitamin B12, as well as the absolute CD4 and CD8 lymphocyte counts, were assessed. RESULTS: Of the 73 patients enrolled in this study, 50 were fed orally, while the other 23 were fed through a percutaneous endoscopic gastrostomy (PEG) or nasogastric (NG) tube. The serum concentrations of vitamin B12 and folate were significantly higher in the enteral feeding group than in the oral feeding group. However, the serum concentration of zinc was significantly lower in the enteral feeding group. CONCLUSION: There is little difference between enteral feeding and oral feeding in terms of micronutrient provision except that the serum concentration of zinc in the enteral feeding group was significantly lower than that in the oral feeding group. Clinicians should recognize that chronic stroke patients who require tube feeding have a risk of micronutrient deficiency. Early detection of malnutrition and micronutrient deficiency is important for providing the necessary nutrients.
Copper ; Enteral Nutrition* ; Folic Acid ; Gastrostomy ; Humans ; Iron ; Lymphocyte Count ; Malnutrition ; Micronutrients* ; Rehabilitation ; Stroke* ; Vitamin B 12 ; Zinc

Anterior cervical hyperostosis may be a cause of dysphagia. For anterior cervical hyperostosis, medical or surgical treatments can be adhibited in view of the causative mechanisms and intensities of dysphagia. We report 3 cases of cervical hyperostosis-derived progressive dysphagia that underwent operation. Radiologic diagnosis and Video Fluoroscopic Swallowing Study were performed on the three patients for evaluation. One had history of recurrent aspiration pneumonia accompanied by weight loss, another complained of dysphagia only when swallowing pills, and the third experienced recurrence symptom with reossification. All patients reported gradual improvement of dysphagia immediately after their cervical osteophytes were resected through the anterior approach. In relation to postoperative improvement, however, they expressed different degrees of satisfaction according to severity of symptoms. Surgical treatment, performed for the anterior cervical hyperostosis-derived dysphagia, can immediately relieve symptoms of difficulty in swallowing. This might especially be considered as an appropriate treatment option for severe dysphagia.
Deglutition ; Deglutition Disorders ; Humans ; Hyperostosis ; Osteophyte ; Pneumonia, Aspiration ; Recurrence ; Weight Loss