Twin pregnancies have a higher rate of premature delivery than singleton pregnancies and a substantially higher perinatal mortality. Twin gestation complicted by a single anomalous fetus diffculties in obstetric management. Options available to patients include continuing the entire pregnancy, selective termination of the anomalous fetus, or termination of the entire pregnancy. The incidence of one anomalous fetus in twin pregnancy is rare. Gastroschisis is intestinal herniation through a defect in the anterior abdominal wall usually to the right of umblicus. There is no sac and the intestines are covered with a thickened inflammatory exudate. Most case of gastroschisis occur sporadically and chromosomal anomaly are less common. A case of one gastroschisis in twin pregnancies diagnosed by ultrasonography is reported with a brief review of the literature.
Abdominal Wall ; Exudates and Transudates ; Fetus ; Gastroschisis ; Humans ; Incidence ; Intestines ; Perinatal Mortality ; Pregnancy ; Pregnancy, Twin* ; Twins* ; Ultrasonography

This article is the case report of primary gastric malignant lymphoma which was diagnosed by laparatomy. A 24-year-old male was admitted because of epigastric pain and general weakness, He was taken by gastrofiberoscopy with biopsy, upper gastrointestinal series, ultrasonogram, and abdominal computerized tomogram. Endoseopic pieture demonstrated whitish to yellowish exudate in the ulcer base and the surround.ing mucosal elevation in the poterior wall of the antrum and lower body. In the X-ray and endoseapic findings, the lesion was considered as Borrmann III type carcinoma, but on the second endoscopic biopsy gastric lymphoma was suapected. Reaected stomach revealed an irregular ulceration with the surrounding mucosal elevation with a size of 5X7X10cm at the pasterior wall of the antrum. Bridging folds were observed on the surrounding elevated mucosa of the lesion. Histologically, the lesion was diagnosed as malignant lymphoma (poorly differentiated lymphocytic).
Biopsy ; Exudates and Transudates ; Humans ; Lymphoma* ; Male ; Mucous Membrane ; Stomach ; Ulcer ; Ultrasonography ; Young Adult

Percutaneous treatment of benign renal cysts has been proposed as a method of reducing the morbidity associated with surgical treatment. The results of percutaneous aspiration and sclerosing therapy of 12 benign renal cysts and 5 infected renal cysts were reviewed. Percutaneous aspiration and daily sclerosing therapy with 99% ethanol for 4-5 days were performed in 12 benign renal cysts. Sclerosing therapy with 10% tetracycline solution following aspiration was done in the remaining 5 infected renal cysts. The aspirates were analyzed for color, total lipid, protein. lactic acid dehydrogenase (LDH). amylase. glucose and smear/culture. Also, cell block was performed for detection of malignant cells. All laboratory data were transudate except 5 infected renal cysts. Cytologic and bacteriological findings were negative except 1 infected renal cyst which had positive E. coli. All were followed by ultrasound or CT from 3 to 48 months (mean follow-up 26 months). In The 17 renal cysts, 9 cysts (53%) disappeared completely and 4 cysts (24%) decreased to half the original volume within 3 months period. In the 10 cysts who had been followed for 6 months. 4 cysts (40%) were collapsed completely and 2 cysts (20%) were reduced to half rhe original volume. The cystic cavity disappeared completely in 4 of 8 cysts (50%) and was decreased to half the original volume in 2 of 8 cysts (25%) for l year period. Overall efficacy was 71%. In summary, percutaneous aspiration and sclerosing therapy using 99% ethanol or 10% tetracycline solution was effective in the treatment of benign renal cysts and infected renal cysts. Also, differential diagnosis with malignant tumor was easily made by analysis of cystic fluid. In the recurred cysts, aspiration and sclerosing therapy were performed without significant complication and morbidity, repeatedly. But long-term follow-up evaluation will be necessary to document the results of aspiration with sclerosing therapy because of the diverse natural history of the renal cyst.
Amylases ; Diagnosis, Differential ; Ethanol ; Exudates and Transudates ; Follow-Up Studies ; Glucose ; Lactic Acid ; Natural History ; Oxidoreductases ; Tetracycline ; Ultrasonography

Hypereosinophilic syndrome, the disease with continuous over production of eosinophil from bone marrow without any identifiable underlying disorder, causes various symptoms or signs by infiltrating organs. As many as 28,780/mm3 eosinophils in peripheral blood, the eosinophilic hyperplasia in bone marrow and features of hepatic involvement -revealed elevated serum AST, ALT and ultrasonogram of abdomen showed the multiple nodules scattered throughout the liver, we have reached to make a diagnosis of the rare hyper eosinophilic syndrome carrying the eosinophil-rich exudate in pleural effusion. The patient showed improvement of clinical symptoms with oral administration of predinisolone, and we report this case with literature consideration.
Abdomen ; Administration, Oral ; Bone Marrow ; Diagnosis ; Eosinophils ; Exudates and Transudates ; Humans ; Hypereosinophilic Syndrome ; Hyperplasia ; Liver ; Pleural Effusion* ; Ultrasonography

OBJECTIVE: To evaluate whether the removal of an intraductal mass using an ultrasound (US)-guided directional vacuum-assisted device can eliminate symptoms in patients presenting with abnormal nipple discharge. MATERIALS AND METHODS: Between March 2004 and October 2006, 36 patients who presented with abnormal nipple discharge, underwent US-guided, 11-gauge vacuum-assisted biopsy for a benign intraductal single mass on US. The ability of the procedure to eliminate nipple discharge was evaluated by physical examination during follow-up US. Lesion characteristics, biopsy variables, and histologic features were analyzed to identify factors affecting symptom resolution. RESULTS: Of the 36 lesions, 25 (69%) were intraductal papillomas, 10 (28%) were fibrocystic changes, and one (3%) was a fibroadenoma. The nipple discharge disappeared in 69% (25 of 36) of the women at a mean follow-up time of 25 months (range 12-42 month). There was no difference in the lesion characteristics, biopsy variables, and the histologic features between groups that eliminated the symptom compared those with persistent nipple discharge. CONCLUSION: US-guided directional vacuum-assisted removal of an intraductal mass appears to eliminate nipple discharge in only 69% of patients and thus, it should not be considered as an alternative to surgical excision.
Adult ; Biopsy/*methods ; Breast Neoplasms/pathology/*ultrasonography ; Chi-Square Distribution ; Exudates and Transudates/*ultrasonography ; Female ; Humans ; Mammography ; Middle Aged ; Nipples/pathology/*ultrasonography ; Papilloma, Intraductal/pathology/*ultrasonography ; Retrospective Studies ; *Ultrasonography, Interventional ; *Ultrasonography, Mammary ; Vacuum

Ovarin hyperstimulation syndrome (OHSS), an iatrogenic complication of ovarian stimulation, shows varying degrees of clinical manifestations. The pathogenesis of OHSS is an increase of vascular permeability resulting in hypovolemia, thromboembolism, ARDS, and death in sometimes. Pleural effusion is also a result of an increase of vascular permedability in the pleura. Thoracentesis is sometimes required to relieve dyspnea. We report a case of OHSS with bilateral exudative pleural effusfion is a 23 year-old female with resting dyspnea. She was received clomi;hen, FSH, and LH for the treatment of irregular menstruation twenty days previously. The ultrasonogram showed severe ascites and bilaterally huge ovary, and chest radiography showed bilateral effusion. Therapeutic thoracentesis and paracentesis were done for relief of the dyspnea. Two weeks later the bilateral effusion and symptoms disappeared spontaneously.
Ascites ; Capillary Permeability ; Dyspnea ; Exudates and Transudates ; Female ; Humans ; Hypovolemia ; Menstruation ; Ovarian Hyperstimulation Syndrome* ; Ovary ; Ovulation Induction ; Paracentesis ; Pleura ; Pleural Effusion* ; Radiography ; Thorax ; Thromboembolism ; Ultrasonography

Umbilical cord cyst is correlated with the fetal chromosomal defects or its structural abnormality; therefore, the follow-up evaluations on fetal growth, lesion size, and concomitant congenital malformation are essential. Thus, when a prenatal ultrasonogram suspects an umbilical cord cyst, karyotyping is strongly recommended to rule out any chromosomal abnormality. The pathologic findings of necrotizing funisitis are paraumbilical exudates due to inflammatory changes, the secondary calcification change of the exudates, thrombosis, and sometimes edema of the umbilical cord. Even though incidence of umbilical cord cyst is rare, it must be differentiated from a cord edema caused by necrotizing funisitis. We have encountered a patient with a suspicious umbilical cord cyst in the third trimester of her pregnancy but the postpartum diagnosis turned out to be an umbilical cord edema by necrotizing funisitis, so we investigated the case with brief comparison to other literature.
Chorioamnionitis* ; Chromosome Aberrations ; Diagnosis ; Edema* ; Exudates and Transudates ; Female ; Fetal Development ; Follow-Up Studies ; Humans ; Incidence ; Karyotyping ; Postpartum Period* ; Pregnancy ; Pregnancy Trimester, Third ; Thrombosis ; Ultrasonography* ; Umbilical Cord*

Umbilical cord cyst is correlated with the fetal chromosomal defects or its structural abnormality; therefore, the follow-up evaluations on fetal growth, lesion size, and concomitant congenital malformation are essential. Thus, when a prenatal ultrasonogram suspects an umbilical cord cyst, karyotyping is strongly recommended to rule out any chromosomal abnormality. The pathologic findings of necrotizing funisitis are paraumbilical exudates due to inflammatory changes, the secondary calcification change of the exudates, thrombosis, and sometimes edema of the umbilical cord. Even though incidence of umbilical cord cyst is rare, it must be differentiated from a cord edema caused by necrotizing funisitis. We have encountered a patient with a suspicious umbilical cord cyst in the third trimester of her pregnancy but the postpartum diagnosis turned out to be an umbilical cord edema by necrotizing funisitis, so we investigated the case with brief comparison to other literature.
Chorioamnionitis* ; Chromosome Aberrations ; Diagnosis ; Edema* ; Exudates and Transudates ; Female ; Fetal Development ; Follow-Up Studies ; Humans ; Incidence ; Karyotyping ; Postpartum Period* ; Pregnancy ; Pregnancy Trimester, Third ; Thrombosis ; Ultrasonography* ; Umbilical Cord*

Actinomyces species are anaerobic or microaerophilic non-spore-forming gram-positive rods that may reach, occasionally, the normal female genital tract. Actinomycosis is uncommon and often presents as a complication of an intrauterine device (IUD). IUD and pessaries facilitate the access of the microorganisms to the pelvis. Almost 85% of cases occur in women who have had an IUD in place for 3 or more years. In fact, the detection rate of Actinomyces in patients with pelvic actinomycosis is as low as 2%. The diseases caused by Actinomyces spp. is often of difficult diagonsis. The diagnosis of actinomycosis can be confirmed by culture. However, it is often difficult to culture Actinomyces. Therefore a diagnosis of actinomycosis can be made from the finding of sulfur granules within inflammatory exudate on histologic examination after surgery. However, it may be possible to diagnose actinomycosis before surgery by the finding of Actinomyces-like organisms on Papanicolaou smears. The endometrial involvement is extremely rare. The authors report an unusual case of endometrial infection by Actinomyces in a 21 year-old female without intercourse, admitted into the institute with menorrhagia. She had received oral pills. Abdominal ultrasonography showed a endometrial thickening. The pre-diagnosis was endometrial hyperplasia. The endometrial biopsy was done. The sample from the endometrium developed actinomycosis. After procedure and treatment, the menorrhagia was disappeared.
Actinomyces ; Actinomycosis* ; Biopsy ; Diagnosis ; Endometrial Hyperplasia ; Endometrium ; Exudates and Transudates ; Female ; Gram-Positive Rods ; Humans ; Intrauterine Devices ; Menorrhagia ; Papanicolaou Test ; Pelvis ; Pessaries ; Sulfur ; Ultrasonography ; Young Adult

PURPOSE: The author wanted to evaluate the usefulness and safety of the trocar technique for US-guided bedside catheter placement into thoracic fluid collections, and this technique has generally been reserved for the larger or superficial fluid collections. Materials and Methods: 42 drainage procedures were performed in 38 patients at the bedside. The patients were positioned supine or semi-upright. A drainage catheter system with a stylet and cannula assembly was used and all of the catheters were inserted using the trocar technique. The procedures consisted of drainage of empyema (n=14), malignant effusion (n=13), lung abscess (n=3), massive transudate (n=8), hemothorax (n=2) and chest wall hematoma (n=2). The clinical results were classified as successful (complete & partially successful), failure or undetermined. The medical records and images were retrospectively reviewed to evaluate the success rate, the complications and the procedure time. Results: Technical success was achieved in all of the 42 procedures. With using the trocar technique, all the catheters were placed into even the small collections without significant complications. Drainage was successful in 36 (85.7%) of the 42 procedures. The average volume of thoracic fluid that was aspirated manually at the time of catheter placement was 420 mL (range: 35 to 1470 mL). The procedure time was less than 10 minutes from US-localization to complete catheter placement in all of the procedures. Conclusion: The trocar technique under US guidance can be an efficient and safe alternative to the Seldinger or guide-wire exchange technique for bedside catheter placement in the critically ill or hemodynamically unstable patients.
Catheters* ; Critical Illness ; Drainage* ; Empyema ; Exudates and Transudates ; Hematoma ; Hemothorax ; Humans ; Lung Abscess ; Medical Records ; Retrospective Studies ; Surgical Instruments* ; Thoracic Wall ; Thorax ; Ultrasonography*