Mayer-Rokitansky-Kuster-Hauser Syndrom is characterized by the absence of the vagina and the uterus, the presence of apparently normal tubes and ovaries, feminine appearance, normal female secondary sexual characteristics, a normal 46, XX karyotypes, and a feminine psychosexual orientation. Absence of the vagina results from an embryological arrest in the development of the lower portion of the Mullerian system. Various methods of surgical treatment for the vaginal absence in this syndrom have been introduced but the ideal method to restore the original dimension and function of the normal vagina was not found. The two cases reviewed in this paper were all treated with modified McIndoe operation using full thickness skin grafts. Postoperatively both women were satisfied without complications, i,e. lack of skin graft, bleeding, urethrovaginal fistula, perforation of the rectum, rectovaginal fistula and significant vaginal stricture. This paper reveals the satisfactory results that were uniformly good.
Constriction, Pathologic ; Female ; Fistula ; Hemorrhage ; Humans ; Karyotype ; Ovary ; Rectovaginal Fistula ; Rectum ; Skin* ; Transplants* ; Uterus ; Vagina

Although bimaxillary surgery enhances patients' self-esteem and mood by improving their facial appearance, surgical outcome assessments for this procedure are limited. This preliminary study investigated differences in brain activity on functional magnetic resonance imaging (fMRI) during self-face evaluation before and after bimaxillary surgery. Three patients (1 man and 2 women, age range: 20–27 years) underwent fMRI while viewing self-face images before and after bimaxillary surgery for maxillofacial deformity. The activation in the left postcentral gyrus, and medial orbital frontal cortex was significantly great in response to after-surgery self-face images compared to before-surgery images. Our preliminary results may facilitate the development of an objective measure for patient satisfaction after orthognathic surgery including bimaxillary surgery.

While the domain of gastrointestinal endoscopy has made great strides over the last several decades, endoscopic assessment of the small bowel continues to be challenging. Recently, with the development of new technology including video capsule endoscopy, device-assisted enteroscopy, and computed tomography/magnetic resonance enterography, a more thorough investigation of the small bowel is possible. In this article, we review the systematic approach for patients with suspected small bowel disease based on these advanced endoscopic and imaging systems.
Capsule Endoscopy ; Endoscopy, Gastrointestinal ; Hemorrhage ; Humans ; Inflammation

We report a case of congenital vellus hamartoma, which consists of numerous matured vellus hair follicles and sebaceous glands. This patient is 4-month-old male with multiple, variable sized nodules on the right epicanthsl fold area since birth. Histopathologically, some of the infundibular portion of the vellus hair shows irregular and reticulated hyperplasia. There are numerous well-formed vellus hair follicles surrounded with thick fibrous sheath and some of them are associated with rudiment sebaceous glands.
Hair ; Hair Follicle ; Hamartoma* ; Humans ; Hyperplasia ; Infant ; Male ; Parturition ; Sebaceous Glands

Spondylolisthesis is the slippage of all or part of one vertebra onto another. The term is derived from the Greek words spondylos and olisthesis. Wiltse, Macnab, and Newman combined their concepts in what remains the most widely accepted classification. Wiltse and Rothman in 1989 suggested a common congenital component in the etiology of dysplastic and isthmic types and added the postsurgical group to the original classification. The precise anatomy of the pars lesion is extremely important in understanding the pathogenesis. The pars interarticularis is the connecting link between pedicles, transverse processes, laminae, and the two articular facets acting as the pivot center. The L5-S1 articulation, being in the coronal plane, is more stable than the sagittal placement of the L4-5 facet joint. The fifth lumbar vertebra is stabilized by a large L5 transverse process, which supports strong muscular and ligamentous(iliolumbar) attachment. An increased lumbar lordosis increases the shear stress at the L4-5 level. Both congenital and isthmic types are often associated with spina bifida of the L5 or S1 segments. There seems to be a definite sex and racial difference, with black women (1.1%) having the lowest prevalence and white men(6.4%) the highest. The increased prevalence is in Alaskan natives and young sportsmen, ranging from 11% to 35%. Repetitive flexion, combined flexion-extension and both forcible hyperextension and rotation of the lumbar spine predispose to a pars stress fracture. Most of isthmic type develops during the first year of school, and by age 7 the prevalence is 4%. A further 1.4% of cases occur during adolescence, most between 11 and 15 years of age. In patients under 25 years of age with low back pain and isthmic spondylolisthesis, this lesion is most probably the cause of the symptoms(18.9%). In patients older than 40 years, it is seldom the only cause of low back pain (5.2%). The radicular pain is found in 14% of patients with isthmic spondylolisthesis. Degenerative spondylolisthesis results from long standing intersegmental instability. 10% of women over 60 years had a 1st or 2nd degree. It occurs 6 times more often at the L4-5 level and 5 times more often in women, mostly in those older than 40 years. The patient may have back pain (5.6%) with or without leg pain and/or may have intermittent claudication (80%). In traumatic spondylolisthesis, acute fractures of the pars interarticularis are rare and are always due to fracture of the other part of the posterior elements caused by severe trauma. In pathological spondylolisthesis, the bony strength is insuffient to resist forward motion of the proximal vertebra on the one below. In postsurgical spondylolisthesis, the most common etiology is extensive decompression with sacrifice of the facet joints.
Adolescent ; Animals ; Back Pain ; Classification* ; Decompression ; Female ; Fractures, Stress ; Humans ; Intermittent Claudication ; Leg ; Lordosis ; Low Back Pain ; Natural History* ; Population Groups ; Prevalence ; Spinal Dysraphism ; Spine ; Spondylolisthesis* ; Zygapophyseal Joint

OBJECTIVE: To investigate whether the serum levels of IL-10 in patients with rheumatoid arthritis are different from those of normal controls and SLE patients and to find out any correlation with disease activity parameters of rheumatoid arthritis. METHODS: Sera from 20 healthy normal persons, 16 rheumatoid arthritis patients and 16 patients with systemic lupus erythematosus were collected and measured for IL-10 and IL-6. Various disease activity parameters were measured in RA patients. RESULTS: The serum level of IL-10 in RA patients was significantly elevated compared to normal controls but lower than those of SLE patients. In RA patients there was no definite correlation between the disease activity parameters and serum IL-10 levels. Despite significant improvements in terms of various disease activity parameters, there was no significant change of serum IL-10 levels after treatment in RA patients. In seropositive RA patients, positive correlation was found between serun IL-10 and rheumatoid factor levels. CONCLUSION: Our findings show that the serum IL-10 levels in patietns with RA are elevated compared to normal controls but lower than those of SLE patients. There was no correlation between serum IL-10 levels and disease acivity parameters of RA.
Arthritis, Rheumatoid* ; Humans ; Interleukin-10* ; Interleukin-6 ; Lupus Erythematosus, Systemic ; Rheumatoid Factor

BACKGROUND: Many physiologic, pharmacologic and immunologic abnormalities were reported in atopic dermatitis but the cause and pathogenesis of the disease remain obscure. OBJECTIVE: This study was done to investigate the systemic immunologic abnormalities in atopic dermatitis. METHOD: To evaluate the cell mediated immunity, me quantified pei ipheral blood T lymphocytes and their subsets, using flow cytometery, and assessed plasma neopteiin levels by means of radioimmunoassay. To evaluate the abnormal humoral immunity, we assessed the serum IgE levels by means of enzyme-immunoassay. RESULTS: Mean proportions of peripheral blood T lymphocytes and, heir subsets in atopic Dermatitis patients were within normal limits. Hut the suppvessor/cytotoxic T lyrphocytes(T8) were significantly decreased in the group of se"ere atopic dermatitis compared with the group of mild atopic dermatitis(P<0.05). Plasma neopterin lervels in the group of atopic dermatitis were found to be significantly elevated as compared vith the control group(P<0.01), but no significant cifference was found between the mild and severe group of atcpic dermatitis(P>0.05). Mean serum IgE levels in the patients with atopic dermatitis were higher than reference value. But there was no significant difference between the mild and severe atopic dermatitis group. Serum IgE levels ivere negatiiely correlated with T8(r=-0.3774, P<0.05) and positively with T4/T8 ratio(r =0.5007, P<0.05). Conclusions : These data;uggest that the atopic der matitis has abr ormalities in cell mediated immunity as well as elevated IgE level.
Dermatitis, Atopic* ; Humans ; Immunity, Cellular ; Immunity, Humoral ; Immunoglobulin E ; Neopterin* ; Plasma* ; Radioimmunoassay ; Reference Values ; T-Lymphocyte Subsets* ; T-Lymphocytes

PURPOSE: It is not easy to determine the cause of pulmonary consolidative lesion. Even without any definite mass, malignancy cannot be ruled out. And sometimes, it is difficult to differentiate tuberculosis from pneumonia. To differentiate malignant consolidative lesion from benign one, we studied patterns of air bronchogram, mucoid impaction, and computed tomographic anglogram etc. MATERIALS AND METHODS: Fifty seven cases of pulmonary consolidative lesions(23 cases of malignancy,34 cases of benign lesion) were retrospectively reviewed by three radiologists. RESULTS: Among the 28 cases which showed a little air bronchogram(less than 1/3 of the whole lesion in volumetric measure with the eye) 19 cases were malignancy and nine cases were benign lesions. All of the 12 cases which showed profound air bronchogram over 2/3 of the whole lesion were benign lesions. Bronchiectasis was detected in 31 cases(four of malignancy and 27 of benign lesions). Among the 20 cases which didn't show the mucoid impaction five cases were malignancy and 15 cases were benign lesions. Out of eight cases with mucoid impaction filling the long segments(branching tree shape), seven cases were malignancy and one case was benign lesion. So called CT anglogram was detected in nine cases of malignancy and two cases of benign lesions. All of nine cases of malignancy showed CT anglogram which was like arborizing tree. CONCLUSION: Scanty air bronchogram, profound arborizing mucoid impaction and/or CT angoigram within consolidative lesion could suggest malignancy.
Bronchiectasis ; Pneumonia ; Retrospective Studies ; Thorax* ; Tomography, X-Ray Computed* ; Tuberculosis

No abstract available.
Humans ; Hydronephrosis* ; Radioisotope Renography*

BACKGROUND: It has been generally accepted that Cisapride (Prepulsid?or propulsid?), a widely used gastrointestinal prokinetic agent, is associated with Torsades de Points, a life-threatening arrhythmia. Recently, cisapride-induced APD (action potential duration)-prolongation was inhibited by glibenclamide, a KATP channel blocker. But the direct effect of cisapride on K(ATP) channels has not been studied until now. Therefore, we investigated cisapride's effects on KATP channels of isolated rat ventricular myocytes. METHODS: After the isolation of rat ventricular myocytes, we analysed the single channel current with patch pipettes. The method of analysis was the student t-test. RESULTS: 1) Cisapride (10(-6) M- 10(-4) M) inhibited KATP channel opening without changing channel conductance Ki was about 20micronM, and Hill coefficient was 0.75. 2) Cisapride inhibited pinacidil-induced KATP channel opening in the cell attached mode. CONCLUSIONS: These results suggest that cisapride-induced APD prolongation and arrythmic effects may be partly related to KATP channel inhibition.
Animals ; Arrhythmias, Cardiac ; Cisapride* ; Glyburide ; Humans ; KATP Channels ; Muscle Cells ; Rats