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

CT is a valuable diagnostic modality in evaluation of bladder injury, extension of paravesical hematoma, pelvic bone fracture or injury of adjacent soft tissue although the diagnostic accuracy of bladder injury itself is lower than that of retrograde cystography. We analized CT findings in thirty cases of bladder injury or paravesical hematoma due to blunt lower abdominal or pelvic trauma and compared them with operation fildings in eight cases. IVP in eight cases and cystography in fifteen cases. The types of bladder injury were classified as contusion, intraperitoneal bladder rupture, extraperitoneal bladder rupture and combined rupture. The locations of paravesical hematoma were classified as perivesical, prevesical or combined. There was no close relationship between the types of pelvic bone fracture and distribution of paravesical hematoma. The paravesical hematomas in fifteen patients without bladder injury were located in prevesical space only. Perivesical hematomas were noted in nine of fifteen patients with bladder injury and were not noted in patients without bladder injury. Thus, we concluded that the presence of perivesical hematoma on CT is a diagnostic sign of bladder injury even though extravasation of contrast from the bladder is not identified, and if there is extraperitoneal hematoma, possibility of bladder injury or other pelvic trauma should be considered.
Contusions ; Hematoma ; Humans ; Pelvic Bones ; Rupture ; Urinary Bladder

Perigraft seroma is uncommon complication of polytetrafluoroethylene(PTFE) grafts applied as an arteriovenous shunt for hemodialysis. It is a collection of clear, sterile fluid confined to nonsecretory fibrous pseudomembrane, most commonly localized around the middle and distal portion of graft. The possible etiologic factors of perigraft seroma include poor graft incorporation, mechanical graft damage caused by alcohol and povidone-iodine, intraoperative streching of the graft, variations in quality control at the time of manufacture and contributing factors such as anemia and coagulopathy in uremia. The best strategy for management of perigraft seroma is not clear. spiration or drainage alone is not effective, and some authors advocate graft removal. We report a case of perigraft seroma around arterial end of PTFE graft along with a brief review of the literatures.
Anemia ; Drainage ; Humans ; Polytetrafluoroethylene ; Povidone-Iodine ; Quality Control ; Renal Dialysis* ; Seroma* ; Transplants ; Uremia

Congenital diverticulum of the left ventricle is a very rare disease. Ventricular diverticulum is usually associated with other anomalies including intracardiac and midline thoracoabdominal defect. We describe a case with congenital left ventricular diverticulum presenting as an isolated lesion. A 37-year-old man presented with 4-year history of chest pain. Diverticulum was diagnosed by echocardiography and left ventriculogram.
Adult* ; Chest Pain ; Diverticulum* ; Echocardiography ; Heart Ventricles ; Humans ; Rare Diseases

Azithromycin* ; Doxycycline* ; Scrub Typhus*

Nevus lipomatosus cutaneous superficialis is a very rare skin disease which usually is present from birth. This uncommon condition is due to collections of ectopic. fat cells within the upper and mid dermis. There are two clinical varieties. The first is a lesion of zonal distribution, present from birth or childhood, usualIy on the buttocks or the lower back. The second form, a dome or sessile, papule, begins. in adult life and is less restricted in distribution. Cerebriform plaques tend to form from the coalescence of soft, yellowish papules. The authors observed two cases of typical nevus lipomatosus cutaneous superficialis. The first case is a 25-year-old female who has had asymptomatic, soft, skin colored, and huge confluent nodules on the right infragluteal fold and upper thigh for 15 years; and the second case is a 15-year-old male who has had multiple, skin colored and soft papules or nodules in zosteriform distribution affecting the right side of the lower back and coccygeal area and right buttock for 4 years. The authors made the diagnosis of nevus lipomatosus cutaneous superficialis from the characteristic clinical and histopathological findings.
Adipocytes ; Adolescent ; Adult ; Buttocks ; Dermis ; Diagnosis ; Female ; Fluconazole ; Humans ; Male ; Nevus* ; Parturition ; Skin ; Skin Diseases ; Thigh

BACKGROUND: The external jugular vein (EJV) is a useful intravenous (IV) cannulation site for anesthesiologists, although it has a relatively high failure rate. Unlike other central veins, visualization of the EJV is important during IV cannulation, and the Valsalva maneuver distends the jugular venous system. However, the relationship between the maneuver and EJV visibility remains unknown. This study compared EJV visibility before and after the Valsalva maneuver. METHODS: This was a prospective observational study that included 200 participants. After the induction of anesthesia, EJV visibility grade, depth from the skin to the EJV superficial surface (EJV depth), and EJV cross-sectional area (CSA) before the Valsalva maneuver were measured. The same parameters were measured after the Valsalva maneuver was performed. The EJV visibility grade was defined as grade A: good appearance and good palpation, grade B: poor appearance and good palpation, and grade C: poor appearance and poor palpation. RESULTS: Patient body mass index and EJV depth affected the EJV visibility grade before the Valsalva maneuver (p < 0.05), although EJV CSA did not. The Valsalva maneuver distended EJV CSA and reduced EJV depth, although these changes were not correlated with EJV visibility grade. With regard to EJV visibility, 34.0% of grade B cases and 20.0% of grade C cases were improved by the Valsalva maneuver. CONCLUSIONS: Although the Valsalva maneuver improved EJV CSA and EJV depth, it did not greatly affect EJV visibility grade.
Anesthesia ; Body Mass Index ; Catheterization ; Humans ; Jugular Veins* ; Observational Study ; Palpation ; Prospective Studies ; Skin ; Ultrasonography ; Valsalva Maneuver* ; Veins

Post-traumatic tricuspid insufficiency is a rare condition and may be clinically silent and imprecise. The diagnosis may be difficult when it progreses slowly and other acute lesions exist concomittantly. Two-dimenstional Doppler echocardiography appears to be an essential procedure in diagnosting the rupture of chordae tendineae or papillary muscle following traumatic injury. We report a case of tricuspid insufficiency of which symptom developed 8 years later following a blunt chest trauma. The patient was operated by tricuspid vlave repair with chordal replacement and ring annuloplasty successfully. We would like to emphasize that patients sustaining major thoracic trauma should be carefully examine for possible blunt chest trauma including cardiac valve rupture or tear.
Chordae Tendineae ; Diagnosis ; Echocardiography, Doppler ; Heart Valves ; Humans ; Papillary Muscles ; Rupture ; Thorax*

No abstract available.
Myelitis, Transverse*

Multilocular cystic renal cell carcinoma appears to be a distinct and rare subtype of renal cell carcinoma with characteristic gross and microscopic features. Multilocular cystic renal cell carcinoma should be separated from multilocular cyst, multilocular cystic nephroma, and renal cell carcinoma with cystic degeneration. We present a case of multilocular cystic renal cell carcinoma. A 61-year-old man presented with right flank pain for 4 years. The computerized tomography revealed multilocular cystic mass in the upper pole of right kidney. The cystic mass measured 4.5x4 cm. The cyst was multilocular and locules not communicated with each other. The solid area was not present. Microscopically, the locules were lined by flat or cuboidal neoplastic clear cells. The clear cells were focally aggregated in the septa. The nephron was not present in the septa.
Male ; Humans ; Cysts