The present study was performed to provide an anatomical basis of the coracoacromial (CA) arch and the articular surfaces of the scapula which can be applied to the diagnosis and treatment of some common shoulder problems. The standard dimensions and the range of variation of the CA arch, the acromial articular surface and the glenoid cavity were investigated in 114 dry scapulae obtained from 57 (male, 35 ; female, 22) Korean cadavers ranging in age from 18 to 97 years (average age of 67). The results were as follows : 1. The length (46.3mm), width(25.2mm), thickness (8.2mm) and height (4.5mm) of the acromion were measured. The length, width and thickness were significantly larger in the males. The slope of the acromion was 51.5°, and the slope of the scapular spine was 118.5°. 2. The height (13.5mm), slope of the root (138.4°) and the horizontal part (25.3°) of the coracoid process, and the angle between the root and the horizontal part (106.6°) were measured. There were no significant differences between sexes and sides in all morphometric values related to the coracoid process. 3. The length (67.6mm) and height (24.7mm) of the CA arch, the height of the CA ligament from the supraglenoid tubercle (13.1mm), and length of the CA ligament (27.6mm) were measured. Both the length and height of the CA arch and the length of the CA ligament were significantly larger in the males. The slope and anterior and posterior angles of the CA arch were 16.8°, 42.2°, and 34.7°, respectively. 4. The long (13.8mm) and short (8.0mm) diameters of the acromial articular surface were measured, and both diameters were significantly longer in the males. The acromial articular surface was 8.4mm away from the tip of the acromion and extended 1.4mm inferiorly below the inferior surface of the acromion. 5. The long (34.8mm) diameter, and superior (15.0mm), middle (19.5mm), and inferior (25.6mm) short diameters of the glenoid cavity were measured. The long and both superior and inferior short diameters were significantly longer in the males.
Acromion ; Cadaver ; Diagnosis ; Female ; Glenoid Cavity ; Humans ; Ligaments ; Male ; Scapula* ; Shoulder ; Spine

Pigmented lesions of palmar and plantar skin may cause diagnostic problems, because some features of benign lesions in these sites may raise the suspicion of melanoma if considered alone. Transepidermal elimlnation is a mechanism by which a substance is eliminated through the epidermis, and it is apt to be confused with a feature of melanoma that tumor cells are located at all layers of the epidermis. We report a case of transepidermal elimination of nevus cells in acral letiginous nevus which needs a differential dignosis of melanoma.
Epidermis ; Melanoma ; Nevus* ; Skin

Purpose: This study was performed to identify the effects of the alpha1A adrenoceptor antagonist on the urethral perfusion pressure (UPP), and also to assess its therapeutic potentials for female bladder outlet obstruction (BOO). Materials and Methods: A cannula was placed in the femoral artery for drug administration and systemic blood pressure monitoring in each female rat. The UPP and vesical pressure (Pves) were monitored using a triple-lumen catheter. Tamsulosin (group I), doxazosin (group II) and phentolamin (group III) were injected into female rats via the femoral cannula. Tamsulosin was also injected to male rats (group IV) for comparison with Group I. Results: After administration of tamsulosin in group I, the frequency was significantly decreased and the duration of minimal urethral relaxation with high frequency oscillations (Dhfo) was significantly prolonged. None of the parameters were significantly different compared with groups II and III, with the exception of the mean arterial blood pressure (MAP). The changes of MAP after tamsulosin were significantly lower than those after doxazosin and phentolamin. In the male rats (group IV), prior to the administration of tamsulosin, the UPP and Pves curves were similar to those of the female rats, but the maximal Pves was significantly higher than in group I. After the administration of tamsulosin to group IV, the prolongation of the frequency and Dhfo were significant. Conclusions: In the female rat urethra, the alpha1A adrenergic receptor may be a functional subtype. The alpha1A adrenoceptor antagonist was found to prolong the Dhfo and decrease the frequency of involuntary bladder contraction. It might be possible that the alpha1A adrenoceptor antagonist improves not only the obstructive symptoms, but the bladder irritative symptoms also, by prolonging the Dhfo and frequency of an involuntary bladder contraction.
Adrenergic alpha-Antagonists ; Animals ; Arterial Pressure ; Blood Pressure Monitors ; Catheters ; Doxazosin ; Female* ; Femoral Artery ; Humans ; Male ; Perfusion* ; Rats* ; Receptors, Adrenergic ; Relaxation ; Urethra ; Urinary Bladder ; Urinary Bladder Neck Obstruction

OBJECTIVE: Massive intracerebral hemorrhage (ICH) is devastating neurosurgical disease. Decompression surgery has been performed to manage the uncontrolled increased intracranial pressure and good clinical result has been reported. Authors analyze the ICP trend after the decompression surgery and report the clinical usefulness. METHODS: Thirty patients data with massive ICH were analyzed retrospectively. Surgical indication was constantly followed in these patient ; Glasgowcoma scale score less than 8, midline shift more than 6 mm on brain CT. In all patients ventricular puncture was done before the decompression and monitored the ventricular pressure changes during and after the surgery. RESULTS: In massive ICH patients, the ICP was maintained in physiological range if the hematoma was removed more than 80%. And when we tried additional therapies like hypothermia or coma therapies in another group, the ICP was elevated at the time of the additional therapy. CONCLUSION: From this study, if the ICH removed more than 80% and The ICP was not exceed 20 mmHg during the first post-operation day, the ICP hardly exceed 20 mmHg after than. Authors thought that decompression surgery is not an essential treatment for the massive ICH patient if their hematoma removed enough.
Brain ; Cerebral Hemorrhage ; Coma ; Decompression ; Decompressive Craniectomy ; Hematoma ; Humans ; Hypothermia ; Intracranial Pressure ; Punctures ; Retrospective Studies ; Ventricular Pressure

OBJECTIVES: To investigate the incidence of antiphospholipid antibodies in patients with proven endometriosis and apparently normal controls, and to evaluate the changes in profiles of humoral immune factors in endometriosis after treatment with gonadotropin releasing hormone agonist (GnRHa). METHODS: Sera of 92 patients with endometriosis, 40 patients without endometriosis and 128 normal male blood doners (normal controls) were tested for the presence of autoantibodies to six phospholipids (cardiolipin, phosphatidylserine, phosphatidyglycerol, phosphatidylethanolamine, phosphatidylinositol, phosphatidic acid) and beta 2-glycoprotein I(GPI)- dependent anticardiolipin antibodies. Also, antiendometrial antibodies (AEA), antiphospholipid antibodies (APA), Immunoglobulin (Ig)G, IgA, IgM, complement C3, C4 and CA-125 were measured in 26 endometriosis patients before and after 3 months of GnRHa treatment. RESULTS: Eighteen (19.6%) patients with endometriosis had at least one of the APA compared with normal controls (8.3%). The prevalence of beta 2-GPI-dependent anticardiolipin antibodies was higher in patients with endometriosis than in normal controls. There were no significant changes in the positivity and levels of AEA and APA after GnRHa Treatment and the levels of immunoglobulins and complement showed similiar pattern. However, the numbers of patients with the level of CA-125 > 35 IU/ml, which is defined as the upper limit of normal level and the levels of CA-125 decreased. CONCLUSIONS: Around 20% of patients with endometriosis had APA and CA-125 measurement may be better than humoral factor tests in monitoring patients with endometriosis after GnRHa treatment.
Antibodies ; Antibodies, Anticardiolipin ; Antibodies, Antiphospholipid ; Autoantibodies ; Complement C3 ; Complement System Proteins ; Endometriosis* ; Female ; Gonadotropin-Releasing Hormone* ; Gonadotropins* ; Humans ; Immunoglobulin A ; Immunoglobulin M ; Immunoglobulins ; Immunologic Factors ; Incidence ; Male ; Phosphatidylinositols ; Phospholipids ; Prevalence

No abstract available.
Bronchopulmonary Sequestration*

We have previously demonstrated that specific antigens involved in autoimmunity in endometriosis may be endometrial proteins with molecular weight (mw) of 71, 92, and 103 kilodalton (kDa). The purposes of this study were to determine the incidence of IgG antibodies against these endometrial antigens in peritoneal fluid of patients with endometriosis and to evaluate the antigenic differences between the endometria of patients with and without endometriosis. Forty peritoneal fluid (PF) from 24 patients with endometriosis and 16 patients without endometriosis (control patients) were tested against endometrial protein from patients (n=8) with endometriosis and from control patients (n=10) by western blot. Fifteen (62.5%) of 24 PF samples from patients with endometriosis had specific Immunoglobuiin (Ig) G antibodies against one of three endometrial proteins with mw of 71, 92 and 103 kDa but none of PF samples from control patients had these antibodies. The electrophoretic pattern of endometrial proteins from patients with endometriosis was similar to that from control patients. Furthemore there was no significant difference in specific PF Immunoglobulin G binding to endometrial proteins regardless of origin of these proteins. Our data indicate that specific humoral immune response can be found in PF of patients with endometriosis and that specific antigens inducing this immune response are present in human endometrium and that there is no antigenic difference between the endometria of patients with and without endometriosis.
Antibodies* ; Ascitic Fluid* ; Autoimmunity ; Blotting, Western ; Endometriosis* ; Endometrium ; Female ; Humans ; Immunity, Humoral ; Immunoglobulin G ; Incidence ; Molecular Weight

Pre-operative evaluation of the anatomy of the axis, such as the size and angle of the axial isthmus, is very important to minimize complications in atlantoaxial transarticular screw fixation. To provide basic data useful for atlantoaxial transarticular screw fixation in Korean, the width and height of the axial isthmus as well as ideal insertion angle of the screw were measured in this study. Fifty seven (male, 36; female, 21) dried axes obtained from Korean adult cadavers, 60.5 years old in average, were used. The shortest distance in the width and height of the axial isthmus was measured at the level of transverse foramen by using Vernier calliper. The ideal screw insertion angle was set up as an angle between a parasagittal line and the line passing through the center of the isthmus and screw insertion point which is located 2 mm lateral to and 3 mm superior to the posteromedial end of the inferior articular surface of the axis. The mean width of the axial isthmus was 8.14 mm (8.42 mm in male; 7.86 mm in female) in the right and 8.46 mm (8.80 mm in male; 8.12 mm in female) in the left side, and 8.61 mm in male and 7.99 mm in female. Although the width of the axial isthmus was slightly greater in the left and in male, there was no significant difference between both sides or sexes. The mean height of the axial isthmus was 7.17 mm (7.49 mm in male; 6.84 mm in female) in the right and 7.43 mm (7.90 mm in male; 6.96 mm in female) in the left side, and 7.69 mm in male and 6.90 mm in female. However there was no significant difference between both sides or sexes, as like in the width. In the atlantoaxial transarticular screw fixation, the axis with isthmus lesser than 5 mm in its width or height is regarded as risk group in general. The frequency of the risk group in the width was 3.5% (2 cases) in the right and 1.8% (1 case) in the left, while that in the height was 8.8% (5 cases) in the right and 7.0% (4 cases) in the left. The mean ideal insertion angle of the screw was 5.6 degrees, 4.4 degrees in the right and left side of male, and 4.7 degrees, 5.5 degrees in the right and left side of female respectively. However the insertion angle dispersed over a wide range between 0 degree ~ 12 degrees. In conclusion, measurement of the isthmus height and insertion angle, besides the isthmus width, should be involved in the pre-operative examination, to minimize complications during the atlantoaxial transarticular screw fixation.
Adult ; Axis, Cervical Vertebra ; Cadaver ; Female ; Humans ; Male

An ectopic ureter inserts at a point other than the normal trigonal position of the bladder and its association with ectopic renal dysgenesis is extraordinarily rare. We report two cases of ectopic ureter associated with ipsilateral ectopic renal dysgenesis. One was a 44-year-old man whose right ureteral opening was identified at the right seminal vesicle and who was treated successfully by nephroureterectomy and ipsilateral seminal vesiculectomy. The kidney drained by the ectopic ureter was dysplastic. The other was a 32-year-old woman whose right ureter drained into the right anterior vaginal wall and who was also treated successfully by nephroureterectomy. On pathologic examination, there was no renal tissue in the postoperative specimen. From the marked dilatation of the right ureter, this condition was interpreted as an acquired form of renal agenesis, in which renal tissue developed but atrophied during development or during childhood because of an associated ureteral obstruction rather than true renal agenesis which is defined as the complete congenital absence of renal tissue.
Adult ; Dilatation ; Female ; Humans ; Kidney ; Seminal Vesicles ; Ureter* ; Ureteral Obstruction ; Urinary Bladder

Changes in morphology, immunophenotypes and proliferative activity of neuroglia are key features in most forms of CNS pathology. We compared proliferative activity of neuroglial cells in response to two different types of brain injury induced by medial forebrain bundle (MFB) axotomy. In the cannula track where acute necrosis occurs due to mechanical lesion caused by cannula inserted to incise the MFB, many BrdU-immunoreactive (ir) cells appeared around the cannula track already at 1 day post-lesion (1 dpl). Their number significantly increased by 7 dpl and then decreased, but considerable number of BrdU-ir cells was still found at 14 dpl. Some of the BrdU-ir cells were double-labeled with either OX-42 or GFAP. This finding suggests that both microglia and astrocytes are activated and proliferate immediately after the mechanical damage, and the proliferative activity is maintained in a considerable number of these cells by 14 dpl. In general, the main cell type showing BrdU immunoreactivity was amoeboid microglia within the necrotic zone immediately surrounding the cannula track, and was astrocytes in the periphery of the necrotic zone more or less apart from the cannula track. Previously, we reported that MFB axotomy induces apoptosis of dopaminergic (DA) neurons in the substantia nigra (SN). In the SN where axotomized DA neurons undergo apoptosis, only a few BrdU-ir cells were found at 1 dpl. Their number increased gradually from 3 dpl and peaked at 7 dpl, then significantly reduced at 14 dpl. Most of them were double-labeled with OX -42-positive ramified microglia but not with GFAP. This data indicates that microglia but not astrocyte are the cell type that proliferate in response to apoptotic neuronal cell death, and their morphology and proliferative activity are different from those observed in the cannula track. Meanwhile, in the both cannula track and SN, some BrdU-ir cells were thought to be neither GFAP-positive nor OX-42-positive, and thus they were presumed to be infiltrated peripheral immune cells. These results demonstrate that different types of neuronal cell death are accompanied with different neurogilal proliferative activities.
Apoptosis ; Astrocytes ; Axotomy* ; Brain Injuries ; Bromodeoxyuridine ; Catheters ; Cell Death ; Medial Forebrain Bundle* ; Microglia ; Necrosis ; Neuroglia ; Neurons ; Pathology ; Substantia Nigra