No abstract available.
Rectovaginal Fistula*

Parapelvic renal cyst, also designated as pericalyceal lymphangiectasis, is an unusual lesion that is usually brought to light during surgery for ureteropelvic junction obstruction or recurrent pyelonephritis. Grossly, the renal pelvis is enveloped by a multilocular cystic mass filled with clear fluid. This lesion is confined to the peripelvic tissues and does not extend into the parenchyma, which, however, may show the effects of hydronephrosis or pyelonephritis. A 50-year-old man presented with hydronephrosis. An ultrasonography revealed hydronephro-sis of the left kidney. Intravenous pyelography and DMSA ("Tc-Dimercaptosuccinic acid) scan showed nonfunctioning kidney of the same side. Simple left nephrectomy was done. The renal pelvis was mildly dilated and a cyst was found buldging into the renal pelvis. The content was watery clear and the cyst was not connected to the renal pelvis or calyces. The cyst was round unilocular and lined by attenuated single layer of endothelial cells. The endothelial cells showed no reactivity to factor-VIII related antigen. With these findings, we concluded that this cystic lesion is basically lymphatic cyst and hydronephrosis was caused by the compression of pelvic out-flow of the kidney.
Male ; Humans ; Cysts

Under usual conditions, anal fistulas have an internal (primary) opening, an external (secondary) opening, and a tract connecting the two. Uncommonly, there are more than one external opening, although they still usually lead to a single internal opening. In rare cases, the multiple external openings lead to more than one internal opening. Anal sepsis originated in the anal ducts which open into crypts and which allow a ready path for infection to spread from the anal canal into the perianorectal tissue, forming abscesses and fistulas. Therefore each different internal opening is considered as a different (independent) fistula. In this rare case, two internal openings are connected by one branched tract and lead to a single external opening, and these were not considered as different independent fistula. Because this patient had received fistula operations two-times previously, this fistula did not seem to be the result of the natural pathological process. However this case study may be helpful in improving in the treatment of fistulas.
Abscess ; Anal Canal ; Fistula ; Humans ; Rectal Fistula* ; Sepsis

In most cases of anal fistulas external openings are located within 2.5 cm of the anal verge. It is rare for an anal fistula to involve the scrotum diffusely. This article present a case of anal fistula with multiple external openings involving the scrotum. The fistula was transsphincteric. The internal opening was located at the dentate line in the anterior midline. Surgery was undertaken on outpatient basis. The primary fistula tract was cored out under local anesthesia, and the defect of the cored out tunnel in the sphincter muscles and mucosa were repaired by layered suture closure with absorbable suture material. The secondary tracts involving the scrotum were curetted and left open for drainage. The operative wounds had healed at the 6 months follow-up after surgery.
Ambulatory Surgical Procedures ; Anesthesia, Local ; Drainage ; Fistula ; Follow-Up Studies ; Humans ; Mucous Membrane ; Muscles ; Outpatients ; Rectal Fistula* ; Scrotum* ; Sutures ; Wounds and Injuries

Usually a patient has an anal fistula, which has an internal (primary) opening, an external (secondary) opening, and a tract connecting the two. Uncommonly, the external openings are more than one but mostly lead to a single internal opening. Rarely the multiple external openings lead to more than one internal opening. Each internal opening, its corresponding tract(s), and its external opening(s) are considered as a separate (independent) fistula. The patient in question had three external openings leading to three separate internal openings. When multiple external openings are present, injection of a dye or hydrogen peroxide to identify the internal openings must be considered.
Fistula ; Humans ; Hydrogen Peroxide ; Rectal Fistula*

The coronary arteries of young individuals are histologically studied. Fourteen cases in pediatric age group and three adult hearts were used. No case had clinical and pathological evidences of heart disease. Inner circumference, thickness of tunicae intima, media and adventitia were measured at eight different sites of coronary arteries. The thickness of tunica media was used as a standard scale of cardiac growth, and the heart weight, body weight, height and age were compared with the medial thickness. The morphological changes were assessed in five groups by the heart weights. Group I ( less than 10 gm) showed single endothelial lining with cytoplasmic vacuolization or endothelial denudation. Group II (more than 10 but less than 20 gm) consisted of full term babies and showed first stigma of focal intimal thickening and intimal collagen fibers. Diffuse intimal thickening more than 1/1 of medial thickness was first seen in a case with 46 gm of heart weight. Elastic fiber was not seen in internal elastic laminae of groups I and II. Fragmentation of internal elastic lamina and smooth muscle proliferation as a form of musculoelastic layer were the major findings of intimal thickening in childhood and no case showed complicated atherosclerotic lesions.
Child ; Adult ; Male ; Female ; Humans

No abstract available.
Abdominal Pain* ; Child* ; Gastritis* ; Helicobacter pylori* ; Helicobacter* ; Humans

Maintaining the blood supply of the interdental alveolar bone is crucial for preserving the interdental papilla. Rebuilding the interimplant papilla between adjacent implants is more difficult than rebuilding the interdental papilla between the natural tooth and implant. Therefore, preserving the interimplant tissue is necessary when adjacent implants are closely placed. In this case report, three effective methods for maintaining the surrounding tissue, namely strategic serial extraction, immediate implantation, and provisionalization of adjacent maxillary central incisors, were performed. The marginal gingiva and interimplant papilla were well maintained for 24 months.
Gingiva* ; Incisor ; Serial Extraction* ; Tooth

There are few reports on major complications after stapled hemorrhoidectomy, because it recently has been introduced to treat hemorrhoids and rectal mucosal prolapse. This presentation is a case of rectovaginal fistula that developed four days after stapled hemorrhoidectomy which was performed at another clinic. In this case, a relatively simple local repair with layered closure via a transanal approach was used. It worked well and satisfied the patient, while relieving her unpleasant, distressing symptoms. In my opinion, early surgical repair of a relatively large postoperative rectovaginal fistula is valid.
Hemorrhoidectomy* ; Hemorrhoids ; Humans ; Prolapse ; Rectovaginal Fistula*

Chronic idiopathic intestinal pseudo-obstruction syndrome is a clinical condition induced by an impaired function of intestinal motility. Although its clinical symptoms are those of intestinal obstruction, mechanical obstruction of the intestine cannot be found by vigorous studies, even by operative exploration. We have experienced nine cases of chronic idiopathic intestinal pseudo-obstruction syndrome. It will help in diagnosis and treatment of the pseudo-obstruction to present the patients with these syndromes. In all cases severely delayed intestinal transit times were noted in radiological gastrointestinal studies without evidence of mechanical obstruction. The most frequent tentative diagnoses were congenital megacolons. But all of the patients showed the presence of ganglion cells in the intestinal wall. Histological abnormalities of the muscle layer were found in three patients. We could not resolve the symptoms by the surgical decompression of the intestine (such as colostomy, ileostomy etc.). But the symptoms were improved after total colectomy in a patient whose main affected site was confined to the colon. The megacystis was the most frequent combined anomaly. All patients had been improved with NPO and total parenteral nutrition therapies were inevitable. The drugs which facilitate the intestinal activities such as cisapride could not resolve the symptoms of obstruction. Three patients were died with the complications of total parenteral nutrition, and four patients improved clinically. Early diagnosis and proper management will reduce the mortality and morbidity.
Child ; Cisapride ; Colectomy ; Colon ; Colostomy ; Decompression, Surgical ; Diagnosis ; Early Diagnosis ; Ganglion Cysts ; Gastrointestinal Motility ; Hirschsprung Disease ; Humans ; Ileostomy ; Intestinal Obstruction ; Intestinal Pseudo-Obstruction* ; Intestines ; Mortality ; Parenteral Nutrition, Total