No abstract available.

No abstract available.
Lymphangioma, Cystic*

Primary malignant melanornn of the vagina is rare, with only about 130 reported cases worldwide. They presumably arise from melanocytes that are present in the vagina in 3% of normal wornen. Vaginal melanoma accounts for less than 1% of melanomas and less than 3% of primary malignant tumors of the vagina. Most of patients complain vaginal bleeding, vaginal discharge, foreign body sensation in order. The best treatment of vaginal melanoma rernains eni.gmatic, Many authors indicate that radical surgery may be the pcferred approach and the number of reported cases treated with radical surgery is increasing. But other author comment that no significant change in survival is apparent with radical surgery. Overall prognosis is poor as most patients have deeply penetrating lesions at the time of diagnosis. Recently, not only the effort to increase the survival rate but the quality of life including sexual function after treatment is becoming an important issue about treatment ot cancer patients. We experienced a case of primary malignant melanoma of the vagina treated with radical surgery and restored the sexual function by vulvovaginal reconstruction using gracilis myocutaneous flap. So we report this case with brief literature review.
Diagnosis ; Foreign Bodies ; Humans ; Melanocytes ; Melanoma* ; Myocutaneous Flap ; Prognosis ; Quality of Life ; Sensation ; Survival Rate ; Uterine Hemorrhage ; Vagina* ; Vaginal Discharge

Angiographic findings were analysed in 22 cases of coronary occlusive disease which were selected from 50 cases of coronary arteriographies done in Department of Radiology, Seoul National Un iversity Hospital from September, 1981 to August, 1984. There were 16 cases of single vessel disease, in which 12 were LAD involvement and 4 were RCA involvement, 2 cases of two vessel and 4 cases of three vessel disease. Site, degree and extent of stenotic involvement in those occlusive coronary diseases were anal ysed with review of literature for selective coronaryarteriography. Since coronary arteriography is the final and accurate examination for the evaluation of occlusive coronary arterial disease, it is expected to be widely used for the diagnosis of occlusive coronary arterial disease which is rapidly increasing recently in this country.
Angiography ; Coronary Disease ; Diagnosis ; Seoul ; United Nations

PURPOSE: To compare the clinical characteristics between intraperitoneal and extraperitoneal bladder ruptures. MATERIALS AND METHODS: 58 patients with a bladder rupture were divided into group A (34 intraperitoneal rupture) and group B (24 extraperitoneal rupture). The medical records and radiological findings were retrospectively reviewed. RESULTS: The follow up period in all patients was 5.8 4.5 months (1-20 months). The male to female ratios and the mean ages in groups A and B were 14:3, 17:7 and 43.9+/-14.2, 46.4+/-14.8 years, respectively (p>0.05), with the peak incidence being in the fifth and sixth decades. There were no statistical differences in the urologic symptoms and signs between groups A and B. The common cause of injuries in groups A and B were direct blow (41.3%) and out-car traffic accident (54.1%), respectively (p<0.05). The main associated injuries in groups A and B were pelvic bone fractures or intestinal injuries and pelvic bone fractures, respectively. The treatment modalities were an operation in 32 (94.1%) in group A; all group B cases were conservatively managed. The durations of catheter indwelling were 17.0+/-9.4 and 22.7+/-10.9 days in groups A and B, respectively (p<0.05). CONCLUSIONS: The bladder rupture occurred commonly in the fifth and sixth decades, especially in males. The most frequent causes of intraperitoneal and extraperitoneal ruptures were a direct blow and a traffic accident, respectively. Pelvic bone fractures were the most common associated injury, especially with extraperitoneal ruptures. In contrast to an extraperitoneal rupture, most intraperitoneal ruptures were managed by operative methods. The duration of catheter indwelling was significantly shorter with intraperitoneal than extraperitoneal ruptures.
Accidents, Traffic ; Catheters ; Female ; Follow-Up Studies ; Humans ; Incidence ; Male ; Medical Records ; Pelvic Bones ; Retrospective Studies ; Rupture* ; Urinary Bladder*

Myxoma is the commonest intracardiac tumor and it is well known to present in bizarre ways. Calcification of the tumor is uncommon, though probably more frequent in right than in left heart tumors. Diagnosis can be followed by surgery with satisfactory results. A 36 years old man with partially calcified right ventricular myxoma and a 51 years old man with calcified left atrial myxoma, which were revealed different echogenic densities on 2-dimensional echocardiogram and gross calcification on fluoroscopy, were treated with surgical removal. We report above two cases of calcified myxoma with literature review.
Adult ; Diagnosis ; Fluoroscopy ; Heart Neoplasms ; Humans ; Middle Aged ; Myxoma*

A clinicostatistical study was made in 405 cases who were admitted to department of pediatrics, general surgery, urology, gynocology of N.M.C. for abdominal surgery from 1973 to 1978 and following results were obtained. 1. Distribution and incidece of surgical abdomen diseases showed acute appendicitis 107 cases(26.4%), inguinal hernia 82 cases(20.2%), intussusception 73 casese(18.0%) and intestinal obstructuction due to congenital origin 47 cases(11.6%). 2. Male was more predominant than female in proportion of 2.32:1. Age distribution revealed highest frequency in 10-15 years with 125 cases(30.8%) followed by 1 month to 1 year with 105 cases(25.9%). 3. In 47 casess of intestinal obstruction due to congenital origin, 3 common diseases were imperforated anus 14 cases, congenital megacolon 12 cases and congenitalpyloric stenosis 12 cases. 4. In 19 cases of acquired intestinal obstruction except intussusception and inguinal hernia, the most common cause was adhesion 10 sease(52.6%). 5. In 30 cases of abdominal mass, wilm's tumor was the commonest with 8 cases(26.7%). 6. In 19 cases of intestinal bleeding and perforation, accidental injury was the commonest cause with 12 cases(63.2%). 7. Highest incidence of diseases in relation to age group were as follows: newborn infant: intestinal obstruction due to congenital origin(96.7%), 1 month-1 year: intussusception (55.7%), 1-2year and 2-6year; inguinal hernia(46.3% and 50.0%), 6-10years and 10-15years; acute appendicitis(52.1% and 61.2%). 8. Overall mortality rate was 6.2%(25 out of 405 cases) and the highest mortality rate was noted in congenital anomaly with 23.1%(12 out of 52 cases).
Abdomen* ; Age Distribution ; Anal Canal ; Appendicitis ; Child* ; Constriction, Pathologic ; Female ; Hemorrhage ; Hernia, Inguinal ; Hirschsprung Disease ; Humans ; Incidence ; Infant, Newborn ; Intestinal Obstruction ; Intussusception ; Male ; Mortality ; Pediatrics ; Urology ; Wilms Tumor

BACKGROUND AND OBJECTIVES: The purpose of this study was to evaluate the efficacy of revision cochlear implant (CI) surgery for better speech comprehension targeting patients with low satisfaction after first CI surgery. SUBJECTS AND METHODS: Eight patients who could not upgrade speech processors because of an too early CI model and who wanted to change the whole system were included. After revision CI surgery, we compared speech comprehension before and after revision CI surgery. Categoies of Auditory Performance (CAP) score, vowel and consonant confusion test, Ling 6 sounds, word and sentence identification test were done. RESULTS: The interval between surgeries ranged from eight years to 19 years. Same manufacturer’s latest product was used for revision surgery in six cases of eight cases. Full insertion of electrode was possible in most of cases (seven of eight). CAP score (p-value=0.01), vowel confusion test (p-value=0.041), one syllable word identification test (p-value=0.026), two syllable identification test (p-value=0.028), sentence identification test (pvalue=0.028) had significant improvement. Consonant confusion test (p-value=0.063), Ling 6 sound test (p-value=0.066) had improvement but it is not significant. CONCLUSIONS: Although there are some limitations of our study design, we could identify the effect of revision (upgrade) CI surgery indirectly. So we concluded that if patient complain low functional gain or low satisfaction after first CI surgery, revision (device upgrade) CI surgery is meaningful even if there is no device failure.
Cochlear Implants ; Comprehension ; Electrodes ; Equipment Failure ; Humans

A technique for Thallium-201 imaging after two separate injections of the tracer, which took less than I hour, was performed to evaluate if this technique could be used clinically as a noninvasive screening test of angina pectoris. 29 patients who complained of chest pain were included in this study: 18 patients were proven to have coronary artery disease by coronary angiography and 11 patients had normal coronary arteries. With the patient supine at rest, 1.0 mCi of Thallium was injected intravenously and imaging was performed in the anterior and 50degrees left anterior oblique projections for a preset time according to Okada's protocol. Immediately after acquisition of the rest images, without moving the camera head, an infusion of dipyridamole was done at the rate of 0.14 mg/Kg/min for 4 minutes. Two minutes after stopping the infusion, 1.0 mCi of Thallium was injected intravenously and 50degrees left anterior oblique and anterior projection images were acquired. Images of the same projection were realigned using computer image registration approach (PDP-11/34 computer of DEC company). The rest image was then subtracted from the realigned dipyridamole image to produce an image representing perfusion during dipyridamole induced hyperemia (subtraction image). The results were as follows; 1) All of the subtraction images were of adequate quality for interpretation. 2) 16 cases in 18 patients of angina pectoris and 1 case in 11 normal control showed perfusion defects, so the over all sensitivity and specificity of the subtraction versus rest Thallium image technique for diagnosis of angina pectoris were 89% and 91%, respectively. 3) All patients (8 cases) whose left ventriculography revealed abnormality of regional wall motion showed perfusion defects in corresponding segments. But qualitative analysis of Thallium image could not predict if the patient whose Thallium image revealed perfusion defect has abnormality of regional wall motion. 4) segmental analysis was performed to know the association between the site of coronary artery stenosis and the perfusion defects in Thallium scan, which revealed the sensitivities for detecting stenosis of LCX, LAD & RCA were 50-60% in range and the range of specificities were 89-92%. 5) Adverse effects of dipyridamole were headache (2 cases) and chest pain (4 cases) but aminophylline was not needed in any case. In conclusion, split dose Thallium dipyridamole scan can be used as a noninvasive screening test of angina pectoris reducing the total duration of imaging to less than one hour. Futher applications of this technique may include the assessment of myocardial perfusion before and immediately after coronary angioplasty and coronary artery bypass graft and the evaluation of the impact of pharmacotheraphy on regional myocardial perfusion.
Aminophylline ; Angina Pectoris* ; Angioplasty ; Chest Pain ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Bypass ; Coronary Artery Disease ; Coronary Stenosis ; Coronary Vessels ; Diagnosis* ; Dipyridamole* ; Head ; Headache ; Humans ; Hyperemia ; Mass Screening ; Perfusion ; Sensitivity and Specificity ; Thallium ; Transplants

PURPOSE: This study was performed to investigate prolyl 4-hydroxylase (P4H) expression changes and an inhibitor-mediated effect on bladder fibrosis in rats with partial bladder outlet obstruction(PBOO). MATERIALS AND METHODS: Twenty female Sprague-Dawley rats were divided into four groups. Group A(n=5) consisted of rats with PBOO treated with 2mg/kg P4H inhibitor, group B(n=5) consisted of rats with PBOO treated with 20mg/kg P4H inhibitor, group C(n=5) consisted of rats with PBOO treated with normal saline and group D(n=5) consisted of normal control animals. After PBOO for two weeks in the A, B, and C group rats, each amount of inhibitor was administered orally once a day for two weeks. After a total of four weeks, the bladders from all of the group rats were removed and evaluated. RESULTS: The muscle thickness calculated from Masson's trichrome staining was 0.85+/-0.22mm, 1.06+/-0.15mm, 1.19+/-0.30 and 0.49+/-0.10mm for group A, B, C, and D rats, respectively. The overall P4H expression was 65.7+/-15.2%, 13.4+/-8.4%, 73.8+/-15.5% and 10.0+/-10.0% for group A, B, C, and D rats, respectively. The overall collagen I protein expression was 16.9+/-18.0%, 17.0+/-24.1%, 30.5+/-13.4% and 8.8+/-8.7% for group A, B, C, and D rats, respectively. The overall collagen III protein expression was 9.6+/-4.2%, 8.8+/-2.9%, 12.5+/-10.6% and 7.5+/-3.5% for group A, B, C, and D rats, respectively. These results showed that PBOO led to increased muscle thickness and to an increased expression of P4H, collagen I and III protein, as compared with the group D control animals. Muscle thickness and expression of P4H, collagen I and III protein was decreased in rats treated with the P4H inhibitor-treated groups decreased as compared with rats in group C (saline-treated animals). The ratio of collagen I/III was 1.8, 1.9, 2.4 and 1.2 in group A, B, C, and D rats, respectively. CONCLUSIONS:Our results suggest that the P4H inhibitor may be potentially utilized to reduce bladder fibrosis caused by PBOO.
Female ; Humans ; Rats ; Animals