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

BACKGROUND: Respiratory depression with high dose of propofol during induction is one of the major complications. We studied the effects of midazolam as premedicant on frequency and duration of apnea and frequency of loss of consciousness in relation to single dose of propofol. METHODS: We selected 194 adult patients who had clear consciousness and no depression of respiration. We allocated patients randomly to control group and midazolam group. In midazolam group, we injected 0.06mg/kg of midazolam intravenously 10min before induction, and in control group, we did nothing. Under mask oxygenation with 100% oxygen, we administered a bolus of propofol (1, 1.5, 2 mg/kg to subgroup 1, 2, 3 respectively) intravenously. The change of respiration and loss of consciousness were observed. RESULTS: The frequency and duration of apnea increased with the dose of propofol in both control and midazolam group. But there were no difference between groups except frequency of apnea with 1.5 mg/kg of propofol. In control group, frequency of loss of consciousness increased with the increasing dose of propofol. But in midazolam group, nearly all the patients was slept without difference by the dose. CONCLUSIONS: Premedication with midazolam reduce the sleeping dose of propofol to induce anesthesia, so the frequency and duration of apnea which is caused by high dose of propofol can be decreased.
Adult ; Anesthesia ; Apnea* ; Consciousness ; Depression ; Humans ; Masks ; Midazolam* ; Oxygen ; Premedication ; Propofol* ; Respiration ; Respiratory Insufficiency ; Unconsciousness*

BACKGROUND: A fully automated enzyme-immunoassay (EIA) analyzer, Enzymun System, ES-300 (Boehringer Mannheim, Germany) uses streptavidin technology and performs single test or panels of up to 12 tests per run. We evaluated the results of ES-300 for anti-HCV by comparing the results with microplate-EIA, radioimmunoassay (RIA), and confirmatory test. METHODS: Total 79 sera (51 positive, 24 negative, 4 indeterminate results confirmed by Lucky HCD Confirm) were analysed. ES-300 with Enzymun-Test(R) Anti-HCV (Boehringer Mannheim, Germany) and microplate-EIA (Green Cross Center Innotest HCV 3.0(R)) were used. Fifty one sera were examined additionally by 2nd-generation RIA method, NANBDINE 125C(General Biologicals Corp., R.O.C.). And all results were compared to the results of Lucky HCD Confirm. RESULTS: The overall concordance rate of ES-300 and Innotest(R) was 72/79 (91.1%). The results of Lucky HCD Confirm on seven discrepant samples were five negative and two indeterminate. The results of ES-300 and NANBDINE 125C showed concordance rate of 90.2%. The sensitivity and specificity of ES-300 with regard to Lucky HCD Confirm were 94.5%, and 87.5%, respectively, and that of Innotest(R) were 98.2% and 66.7%, respectively. Clear distinction of positive and negative results by signal/cut off ratio was available in both EIAs. The positive predictive values of ES-300 and Innotest(R) were 94.5%, and 87.1%, respectively. CONCLUSIONS: ES-300 showed relatively good results in sensitivity and positive predictive value with regard to confirmatory test. In EIA-positive persons, however, follow-up study would be necessary for reliable evaluation of HCV infection.
Humans ; Radioimmunoassay ; Sensitivity and Specificity ; Streptavidin

The authers performed long coloaofiherscopy with barium enema study on 134 cases, of coloreatal diseasea, who had been admitted to the department of Internal Medicine, Kwangiu Christian Hospital from July 1984 to Aupist 1986, The results were following: 1) Among 134 cases of colonoacopy, abnormal findings were 70 cases (52.2%) and normal findings 64 cases (47.8%). 2) among 70 cases of colonoscopic abnormal findings, nonspecific inflammatory colitis were 27 cases, colon tuberculosis 15 cases, colon and rectal cancer 14 cases, colon polyps 8 cases, ulcerative colitis 3 cases, internal hemorrhoid 2 cases, sigmoid diverticular 1 case. 3) The cases in which the findings of barium contrast enema were compatible with those of colonoscopy were 84 cases (62.7%), not compatible 50 cases(37.3%). There were not compatible with findings in 4 cases of colon cancer (10 cases), 7 cases of colon tuberculosis (15 cases), 4 cases of colon polyps (8 cases), 1 case of ulcerative colitis (3 cases). 4) The insertion ratio to ileocecal valve was 79.1%. The rate of correct approach by a colonoscopy to the lesion site shown at barium contrast enema was 94.1%
Barium ; Colitis ; Colitis, Ulcerative ; Colon ; Colon, Sigmoid ; Colonic Neoplasms ; Colonoscopes* ; Colonoscopy ; Enema ; Hemorrhoids ; Ileocecal Valve ; Internal Medicine ; Polyps ; Rectal Neoplasms ; Tuberculosis

PURPOSE: To evaluate the efficacy of photodynamic therapy of choroidal neovascularization (CNV) associated with large serous pigment epithelial detachment (PED) in eyes with age-related macular degeneration. METHODS: The records of nine eyes of nine patients were reviewed. Mean follow-up period was 11.4 months (range, 6 ~ 26 months). The photodynamic therapy was done using a spot size with a diameter larger than the greatest linear dimension of the CNV lesion revealed on indocyanine green angiography (ICGA). RESULTS: In 7 of 9 eyes, the PED persisted with progression of neovascular membrane, and retinal pigment epithelial tear occurred in 3 eyes. In one eye, visual improvement could be achieved with decreased extent of PED until the follow up period of 6 months. In remaining one eye, the caliber of new vessel decreased on ICGA accompanied by improvement of vision and PED after first photodynamic therapy. However, 3 months after second photodynamic therapy, CNV proliferated extensively with resultant visual loss. CONCLUSIONS: The results of our study suggest that photodynamic therapy provide no benefit in the treatment of CNV associated with large serous PED in age-related macular degeneration.
Angiography ; Choroid* ; Choroidal Neovascularization ; Follow-Up Studies ; Humans ; Indocyanine Green ; Macular Degeneration ; Membranes ; Photochemotherapy* ; Retinaldehyde

We report a 18 years old man of brainstem encephalitis with acute ataxia, areflexia and gaze evoked vertical and horizontal nystagmus which is mimicking Miller Fisher syndrome. He had evidences of both peripheral neuropathy in nerve conduction studies and a brainstem encephalitis in MR findings. The possible relationship of the Miller Fisher syndrome and brainstem encephalitis are discussed with brief review of literature.
Adolescent ; Ataxia ; Brain Stem* ; Encephalitis* ; Humans ; Miller Fisher Syndrome* ; Neural Conduction ; Nystagmus, Pathologic ; Peripheral Nervous System Diseases

High dose intravenous immunoglobulin (IVIg) therapy can improve the clinical course of several immune mediciated diseases. We evaluated clinical effects and side effects of IVIg in Guillain-Barre syndrome (GBS). 19 Patients with GBS were studied prospectively in a placebo-controlled trial. 11 Patients were received high dose IVIg (400mg/kg for 5 days) and controls received only conservative treatment. The disability scores using modified Rankin scores before and after treatment of each group were compared. Four weaks later, mean Rankin Score of IVIg group was 2.5 + 0.7 and control group was 3.3+ 0.5which showed significant difference(p<0.05). There were no serious advers effer of promote early improvement with safety in acute phase of Guillan-Barre syndrome.
Guillain-Barre Syndrome* ; Humans ; Immunization, Passive* ; Immunoglobulins* ; Immunoglobulins, Intravenous ; Prospective Studies

Here we report a case of successful heart transplantation (HT) in a patient with high risk on HT due to her complex congenital heart disease and its consequent complications; physiologic single lung and severe pulmonary arterial hypertension. HT was successfully performed in our patient using meticulous perioperative management techniques, such as control of collateral vessels, appropriate donor selection, pulmonary vasodilator therapy, post-transplant extracorporeal membranous oxygenation support, and atrial septostomy for right ventricular unloading.

Malignant eccrine poroma, or eccrine porocarcinoma, is a rare malignant cutaneous appendageal tumor arising from the intraepidermal eccrine sweat duct(acrosyringium), and usually develops ia an eccrine poroma of long-standing. We report a case of malignant eccrine poroma on the left buttock in a 72 year-old female. She was presented with a slightly pruritic, well-defined, reddish, firm, 4.5 x 4.5 x 0.7cm sized, protruding, ulcerated tumor. Histopathological examination revealed well-defined tumor cell nests in the epidermis and dermis. The tumor nests consisted of areas of eccrine poroma cells with benign appearance adjoining areas of anaplastic cells. Duct-like structures were observed within the tumor nests and showed a PAS-positive, diastase-resistant reaction. On immunohistochemical staining, the tumor cells were, positive for EMA, and most of tumor cells were negative but the duct-like structures were positive for CEA. She was treated with surgical excision. During the three year follow up period after excision, there was no recurrence.
Aged ; Buttocks ; Dermis ; Eccrine Porocarcinoma* ; Epidermis ; Female ; Follow-Up Studies ; Humans ; Poroma ; Recurrence ; Sweat ; Ulcer

Urinary tract anomaly is the most common anomaly in childhood. We reviewed medical records of 45 patients who were confirmed urinary tract anomalies on radiologic studies as Chuncheon Sacred Hospital, from Dec. 1984 to Sep. 1992. We analyzed incidence and clinical characteristics of urinary tract anomalies. The results obtained were as follows: 1) The age distribution were: 1)7 cases (37.8%) under 3 years, 6 cases (13.3%) from 4 to 6 years, 10 cases (22.2%) from 7 to 9 years, 9 cases (20.0%) from 10 to 12 years and 3 cases (6.7%) from 13 to 15 years. 2) Main symptoms were fever, dysuria and hematuria. 3) 26 cases (59.8%) were combined with urinary tract infection, and main causative organism were E. coli and Staphylococcus. 4) The most common anomalies were hydronephrosis, duplication of urinary tract and renal agenesis in order of sequence. 5) 34 cases (75.6%) were simple anomaly and 11 cases (24.4%) were complex anomalies. 6) Operative correction was needed on 20 cases.
Age Distribution ; Dysuria ; Fever ; Gangwon-do ; Hematuria ; Humans ; Hydronephrosis ; Incidence ; Medical Records ; Staphylococcus ; Urinary Tract Infections ; Urinary Tract*