Hemangioams are usually present at birth of appeat shortly thercafter, as red or purple patches varying in size and most often in the skin. Hemangiomas include the cervix in their ubiquitous distribution; the cervix itself is very vascular and many reported hemangiomas are nothing more than a conspicuous demonstration of local casculatity. The cervical hemangioma is a rare condition which usually presents as vaginal bleeding of unusual cause, Many of the capillary hemangiomas and some of the cavermous types frequently resolve spontaneously. However, some hemagiomas ulcerate and a severe hemorrhage results. We recently encountered a case of cervical hemangioma involving the vagina in a 56-year-old woman. This case os especially interesting in that the histologic type was a cavernous hemangioma with uncommon cariety n the uterine cervix.
Cervix Uteri* ; Female ; Hemangioma ; Hemangioma, Capillary ; Hemangioma, Cavernous* ; Hemorrhage ; Humans ; Middle Aged ; Parturition ; Skin ; Ulcer ; Uterine Hemorrhage ; Vagina*

Hemangioams are usually present at birth of appeat shortly thercafter, as red or purple patches varying in size and most often in the skin. Hemangiomas include the cervix in their ubiquitous distribution; the cervix itself is very vascular and many reported hemangiomas are nothing more than a conspicuous demonstration of local casculatity. The cervical hemangioma is a rare condition which usually presents as vaginal bleeding of unusual cause, Many of the capillary hemangiomas and some of the cavermous types frequently resolve spontaneously. However, some hemagiomas ulcerate and a severe hemorrhage results. We recently encountered a case of cervical hemangioma involving the vagina in a 56-year-old woman. This case os especially interesting in that the histologic type was a cavernous hemangioma with uncommon cariety n the uterine cervix.
Cervix Uteri* ; Female ; Hemangioma ; Hemangioma, Capillary ; Hemangioma, Cavernous* ; Hemorrhage ; Humans ; Middle Aged ; Parturition ; Skin ; Ulcer ; Uterine Hemorrhage ; Vagina*

Recently, the possibility of inappropriate management of undiagnosed early cancers increased with spreading laparoscopic approach of adnexal tumors. The pathologic diagnosis of frozen section biopsy(FBx) guide the surgeon to perform the appropriate surgical procedure of adnexal tumors. This study was conducted to verify preliminarily the criteria for the laparoscopic management and determine the accuracy and efficacy of conditioned FBx according to the criteria. The inclusive criteria of FBx results in this study was designed by means of the preoperative transvaginal sonography(morphologic score >or=10) or tumor marker level of serum(CA-125 level>or=35 U/ml in postmenopause and >or=65 U/ml in postmenopause) or suspected gross findings of the malignancy during operation. On the other hand, cases which were convinced as dermoid cysts, endometriomas and advanced(>or=IIIb) ovarian cancers on the basis of gross findings were excluded in this study. Two hundred seventy-six operations of adnexal tumors were performed between January 1995 and June 1996 and 74 results of FBx were picked up in this study. The overall rate of conditioned FBx was 26.8%(74/276). The applied criterion in this study had the sensitivity of 0.97, specificity of 0.78, negative predictive value of 0.99, positive predictive value of 0.36. The accuracy of frozen sectional biopsy were 87.8% in the histopathologic diagnosis and 97.3% in the clinicopathologic diagnosis. The sensitivity, specificity, negative predictive value and positive predictive value for ovarian cancers(borderline+malignant) were 1 in all. It was thought that frozen sectional biopsy was a appropriate guide for the decision of methods during operation of adnexal tumors and that the criteria in this study could be used as a guideline for frozen section biopsy in the laparoscopic surgery of adnexal tumors.
Biopsy* ; Dermoid Cyst ; Diagnosis* ; Endometriosis ; Female ; Frozen Sections* ; Hand ; Laparoscopy ; Ovarian Neoplasms ; Postmenopause ; Sensitivity and Specificity

No abstract available.

No abstract available.

Wegener's granulomatosis is a disease of unknown etiology that is characterized by the clinicopathologic complex of necrotixing granulomatous vasculitis of the upper and lower respiratory tract, glomerulonephritis, and variable degrees of small vessel vasculitis. Recently Antineutrophil Cytoplasmic Antibody (ANCA) has been reported to be a highly specific test for the diagnosis of Wegener's granulomatosis. We have experienced a patient of Wegener's granulomatosis in a 11 year old girl who was admitted with complaints f arthralgia, hematuria, convulsion and associated with otitis media and sinusitis. Serologic test of C-ANCA was positive and histologic findings of the kidney showed crescentic glomerulonephritis with sclerosis and surrounding infiltration of multinucleated giant cells. Patient was treated with pulse methylprednisolone without improvement. The clinical course progressed rapidly and expired due to the renal failure, gastrointestinal bleeding and status epilepticus. A brief review of literatures was made.
Antibodies, Antineutrophil Cytoplasmic* ; Arthralgia ; Child ; Diagnosis ; Female ; Giant Cells ; Glomerulonephritis ; Hematuria ; Hemorrhage ; Humans ; Kidney ; Methylprednisolone ; Otitis Media ; Renal Insufficiency ; Respiratory System ; Sclerosis ; Seizures ; Serologic Tests ; Sinusitis ; Status Epilepticus ; Vasculitis ; Wegener Granulomatosis*

BACKGROUND: The management of penetrating neck injuries presents a difficult problem. Although many authors have stated that surgical exploration should be mandatory for all neck injuries that penetrate platysma, recent reports from many centers now claim selective exploration. The aim of this study was to review a policy of selective neck exploration based on clinical presentation, anatomic location, and the result of diagnostic studies. METHOD: We reviewed retrospectively medical records of 66 patients who were admitted and managed at Yongdong Severance hospital, Yonsei university college of medicine due to penetrating neck injuries from Jan. 1990 to Dec. 1996. RESULTS: Forty-one patients(62%) were underwent immediate neck exploration, while the remaining 25 patients(38%) were admitted and observed. Three had esophagoscopy, four had esophagogram, and three had direct laryngoscopy, all of which revealed normal result except one patient had blood tinged larynx on laryngoscopy. Results of 12 neck explorations(29%) were negative. There was no delayed diagnosis during conservative treatment. There was no mortality. CONCLUSION: We concluded that selective exploration of penetrating neck injuries is both safe and resonable.
Delayed Diagnosis ; Esophagoscopy ; Humans ; Laryngoscopy ; Larynx ; Medical Records ; Mortality ; Neck Injuries* ; Neck* ; Retrospective Studies ; Tolnaftate

Primary ovarian choriocarcinoma is an extremely rare germ cell neoplasm, and the prognosis is poor. Especially, the diagnosis of primary ovarian nongestational chori-ocarcinoma can be reliably established in a girl or innocent virgin. We report a case of primary ovarian, nongestational, pure choriocarcinoma in a 16-year-old woman. She died within 1 year after diagnosis in spite of the treatment with surgery and combin-ation chemotherapy.
Adolescent ; Choriocarcinoma ; Choriocarcinoma, Non-gestational* ; Diagnosis ; Drug Therapy ; Female ; Germ Cells ; Humans ; Pregnancy ; Prognosis

Ultrasonography is a predominantly accurate, relatively simple unique diagnsotic method of obstructive jaundice. The ultrasonographic findings of obstructive jaundice are dilated intra- and extrahepatic duct with intraluminal hyperreflective echo or mass in and/or around the bile duct. The superiority of high resolution real time ultrasonography for the diagnosis of obstructive jaundice is based on the easy detectability of extra-and intrahepatic bile ducts by its multiple sectional images in a short time, the flexibility of probe and the small crystal size. Author evaluated real time sonographic findings 46 obstructive jaundice patients confirmed by surgery or radiographical examinations. The results were: 1. Diameter of extrahepatic duct in obstructive jaundice were varied from normal to 4.0 cm, mostly 8 to 10 mm in diameter (26%). Degree of dilatation of biliary duct appeared more prominent in cancer patients than any other causes of obstruction. 2. The site of obstruction was detected in85% (39/46) and its common site was common bile duct in 63% (29/46). 3. The diagnostic accuracy of choledocholithiasis and cancer was 82% (22/27) and 44% (4/9), respectively. Diagnostic accuracy of the real time ultrasonography in obstructive jaundice was over all 75% (34/46).
Bile Ducts ; Bile Ducts, Intrahepatic ; Choledocholithiasis ; Common Bile Duct ; Diagnosis ; Dilatation ; Humans ; Jaundice, Obstructive ; Methods ; Pliability ; Ultrasonography

The recent development of microsurgical tissue transfer has enabled any defect in any area to be reconstructed with free flaps. However, the need for a more functional and thinner flap has been raised due to bullkiness of the flap and donorsite morbidity. For better functional and aesthetic results, various perforator flaps excluding muscles or adjacent subcutaneous tissue have been recently reported. We report 44 cases of perforating artery pedicled flaps from April 1995 to August 1998, including 21 cases of anterolateral thigh flap, 12 cases of gluteal artery perforator flap, 4 cases of posterior interosseous flap, and 7 cases of paraumbilical perforator flap for various soft tissue defects. Even though marginal necrosis of flap occurred in 9 cases, complete healing without significant problem was possible. The advantages of perforator flaps are as follows: 1. It is possible to obtain a relatively thin fasciocutaneous flap, but still with sufficient volume 2. Donor site morbidity was reduced without damage of main artery. 3. In spite of diverse vascular pattern of the perforator, the location of perforating arteries can be Detected with relative ease and mapped preoperatively with an ultrasound Doppler. The need of meticulous and tedious dissection could be a sole disadvantage of these flaps. This report describes the clinical experience with a perforator-based flap, anticpating applications of many other types of perforator flap in the future.
Arteries* ; Free Tissue Flaps ; Humans ; Muscles ; Necrosis ; Perforator Flap ; Subcutaneous Tissue ; Surgical Flaps* ; Thigh ; Tissue Donors ; Ultrasonography