No abstract available.
Autografts ; Goldenhar Syndrome

The surgical construction of vagina could certainlty be done by skin grafting or flaps, but it involves hospitalization, discomfort,scarring of donor area and vaginal tract, hygiene problem. The tissues of the vagina are soft and distensible and it is reasonable to assume that these same tissues could be stretched, elongated or dilated with gradual external pressure. So, we performed the expansion of vaginal lining by self designed set of graduated dilators. The patients was a 27-years-old female whose chief complaint is amenorrhea and incapability to engage in sexual intercourse. On physical examination, this patients had a feminine figure with a normal vulva but only a vaginal dimple was observed. The patient was educated to carry out the mechanical dilation of this dimply by pressure 15 minutes twice a day. In the evening, with insertion of a dilator, the patient was asked to sit on a bicycle chair for 10 minutes. After 8 weeks, the overall outcome of vaginoplasty was successful. The vaginal tract was 8 cm in length and the largest vaginal speculum could be passed into vagina. The patient was able to engage in sexual intercourse without lubrication. The progressive dilatation of vaginal lining is non-invasive and probably the simplest way to treat the patients with congential vaginal atresia. So we recommend this method as the first treatment strategy before surgery.
Amenorrhea ; Coitus ; Dilatation* ; Female ; Hospitalization ; Humans ; Hygiene ; Lubrication ; Physical Examination ; Skin Transplantation ; Surgical Instruments ; Tissue Donors ; Vagina ; Vulva

No abstract available.
Bone Density* ; Child* ; Humans

We obtained sixty normal chest postero-anterior(PA) radiographs with high kilovoltage technique(90-110kVp), 10 radiographs from the consecutive normal persons in each decade from twenties to seventies to analyze normal course and appearance of azygoesophageal recess (AER) line. (AER) line. CT scans from sixty consecutive normal persons were correlated with the radiographs to see how the line is formed and what structure the line abuts. In 20 patients with a lesion in AER area(10 with subcarinal lymphadenopathy of various size, five with left atrial enlargement, three with lesions in the esophagus, and two with dilated azygos vein), radiographic and CT correlation was done with main attention to the pattern of displacement of the azygoesophageal line. In normal chest PA radiographs, AER was shown as a straight line in young adults. As age increased, it was seen as a smooth are with convexity to the left. Sigmoid shape with midline cross was noted in an aged person. At the level of the right main bronchus on CT, AER was noted along the right lateral aspect to the vertebral margin in young adults. It extended medially as age increased. Caudally the recess extended more medially. The azygos vein usually bordered the recess. The esophagus or mediastinal fat sometimes bordered the recess in caudal level. In normal persons, the recess appeared deeper on plain radiographs than on CT. On plain radiographs, there were no changes in contour of AER with subcarinal lymphadenopathy of less than 2.5cm in diameter. However right sided and downward displacement of AER line just below the carina was noted with lymphadenopathy of more than 2.5cm in diameter. With left atrial enlargement, obliteration of the line was noted at T8-10 level. Focal right sided bulging of the line was noted with esophageal cancer Dilatation of azygos vein caused the line to appear with right sided displacement. In conclusion, AER line can be delineated with various features on radiographs with high KVP technique, depending on the age of normal persons and the formation of the line can be explained with CT. Displacement and change in the contour of the line can be seen with various mediastinal diseases.
Azygos Vein ; Bronchi ; Colon, Sigmoid ; Dilatation ; Esophageal Neoplasms ; Esophagus ; Humans ; Lymphatic Diseases ; Mediastinal Diseases ; Thorax ; Tomography, X-Ray Computed ; Young Adult

The CT findings were reviewed in two patients with injuries to the gallbladder following blunt trauma. In one patient high attenuation of intraluminal blood clot within the gallbladder and associated hemoperitoneum were identified. Another patient was represented hemoperitoneum and bile leakage into the peritoneal cavity due to laceration of the fundus of the gallbladder which appeared contrasted.
Bile ; Gallbladder ; Hemoperitoneum ; Humans ; Lacerations ; Peritoneal Cavity

PURPOSE: To evaluate further the right minor and major fissure on thin-section narrow-interval CT scans with particular emphases on orientation, degree of completeness. MATERIALS AND METHODS: Thin section CT scans from 10 mm distal to carina to the proximal basal segmental bronchus were obtained at 5 mm invervals in 50 consectutive subjects. Orientation, degree of completeness, and the relationship of the minor and major fissure on thin-section CTscans were analyzed. RESULTS: Four principal types of the minor fissure could be identified according to the highest point of the upper surface of the middle lobe. At bronchus intermedius level, the major fissure appeared with its medial end anterior to lateral end in 45 subjects. The minor fissure was complete in only 10 subjects (20%). Completely absent minor fissure was noted in four subjects (8%). The major fissure was incomplete in 17 subjects (34%) at bronchus intermedius level. the minor and major fissure intersected each other in only 27 subjects (54%). The hig best point of intersection was variable. CONCLUSION: There are much more variations in the fissural complex in our study than in previous reports and these variations can be visualized well on thin-section CTscans.
Bronchi ; Lung* ; Tomography, X-Ray Computed*

No abstract available.
Echocardiography* ; Mucocutaneous Lymph Node Syndrome*

Cholangiocarcinomas have several histologic types, but intrahepatic cholangiocarcinoma with sarcomatous change is rare. A 71-year-old man was admitted to our hospital because of fever which had lasted two months. Ultrasonography (US) of the upper abdomen demonstrated a huge hepatic mass with central solid and peripheral cystic portions, and computed tomography (CT) revealed a heterogeneous hepatic mass with a central area in which enhancedment was delayed. Magnetic resonance imaging (MRI) disclosed a huge mass of predominantly low signal intensity at T1WI, and peripheral portions of high signal intensity and a central portion of intermediate signal intensity at T2WI. The pathologic diagnosis was cholangiocarcinoma with sarcomatous change.
Abdomen ; Aged ; Cholangiocarcinoma* ; Diagnosis ; Fever ; Humans ; Magnetic Resonance Imaging ; Ultrasonography

Acute tubular necrosis has been rarely reported as a complication of typhoid fever in the literature. We experienced four cases of acute tubular necrosis associated with typhoid fever in children. Patients showed significant titer of widal reaction associated with acute renal failure and one of them rised in 2 months after onset of clinical symptoms. Renal biopsy findings were compatible with acute tubular necrosis and immune complexes were not deposited in the glomeruli. Clinical and urinary findings were normalized by hemodialysis and antibiotic therapies. In conclusion, close longterm follow up of widal titer is mandatory in acute tubular necrosis, especially when associated with high fever.
Acute Kidney Injury ; Antigen-Antibody Complex ; Biopsy ; Child ; Fever ; Follow-Up Studies ; Humans ; Necrosis* ; Renal Dialysis ; Typhoid Fever*

No abstract available.
Nephrotic Syndrome*