No abstract available.

Intestinal malrotation with volvulus is generally presented as a bilious vomiting and acute intestinal obstruction in the newborn period. It could compromise vascular supply of the small bowel secondary to torsion of superior mesenteric artery (SMA) and without urgent surgical management, it could lead to detrimental outcomes such as transmural bowel infarction and sepsis. However, in chronic cases, it is rarely obstructs the vascular supply and propagates to an acute bowel infarction. Rarely, chronic malrotation with midgut volvulus may not reduce the mesenteric blood supply because of collateral vessels, and the chronically stagnated blood flow of the superior mesenteric vein (SMV) favors thrombus formation within the lumen. The recommended treatment is Ladd's procedure and anticoagulation therapy. The authors present an unusual case of intestinal malrotation with chronic volvulus resulting in superior mesenteric vein and portal vein thrombosis in a 28-year-old patient.
Adult ; Humans ; Infant, Newborn ; Infarction ; Intestinal Obstruction ; Intestinal Volvulus ; Mesenteric Artery, Superior ; Mesenteric Veins ; Portal Vein ; Sepsis ; Thrombosis ; Vomiting

PURPOSE: Because cryptorchid testes are known to undergo histopathologic changes affecting development, maturation, and tertility, early surgical correction is usually recommended. However there are differing opinions concerning whether retractile testes are affected by similar changes and also whether there is a need for surgical treatment. We aimed to assess the histopathologic changes in retractile testis by studying the changes in testes artificially placed back in the abdomen after they have descended to scrotum in experimental rat models. MATERIALS AND METHODS: Male Sprague-Dawley rats were divided into 3 groups; a control group(controls), prepubertal ascent group (P) in which testis were placed back intraabdominally by bilateral inguinal canal obstruction at 6 weeks, a neonatal group(N) in which intraabdminal testis was induced by bilateral inguinal canal obstruction at birth. The relative weight of the testis, morphology of the seminiferous tubules including Leydig cells, tubular degeneration phase(TDP), spermatogonia per tubules(S/T), and Sertoli cell index (SCI) of these three groups were analyzed and compared. RESULTS: The relative weight of testis was significantly decreased in the group of N(0.0016+/-0.001) and P(0.0015+/-0.0002) compared to controls(0.0037+/-0.0002) (p<0.05). The S/T value was also decreased in P(2.05+/-18.2) and N(73.2+/-32.4) when compared to controls (360.2+/-21.3). Similar changes were observed in SCI of both P(64.5+/-6.4) and N (91.2+/-14.2) when compared to controls (227.9+/-31.1). Only minority of N and P showed higher TDP values. However, although statistically insignificant, TDP was increased in both P and N when compared to controls. The Leydig cells in N and P showed cellular distortion and hypertrophy. CONCLUSIONS: This study demonstrate that prepubertal ascent, similar to that of innate cryptorchid testis, also can induce histopathologic changes such as changes in testicular seminiferous tubule, decrease in the S/T value and decrease in SCI value. Our findings supports that hypothesis that retractile testis may cause histological damage thus surgical correction may also be warranted similar to in case of genuine cryptorchism.
Abdomen* ; Animals ; Cryptorchidism ; Humans ; Hypertrophy ; Inguinal Canal ; Leydig Cells ; Male ; Models, Animal ; Models, Theoretical ; Parturition ; Rats* ; Rats, Sprague-Dawley ; Scrotum ; Seminiferous Tubules ; Spermatogonia ; Testis*

No abstract available.
Homocystine ; Homocystinuria*

No abstract available.
Female ; Humans

BACKGROUND: It has been a standard practice in many institutions to combine light general anesthesia with epidural block for abdominal and pelvic surgery. We attempted to prove the effectiveness of prehydration and to find an suitable epidural local anesthetic dose in terms of hemodynamic stability for upper abdominal surgery. METHODS: For preliminary studies, 11 patients scheduled for elective upper abdominal surgery had received general anesthesia immediately after epidural anesthesia. After epidural injection of 10~16 mL of 2% plain lidocaine into the T9~10 intervertebral space, the changes in blood pressure were observed. Thirty-two patients scheduled for elective upper abdominal surgery were divided into two groups. In group A (study group), after prehydration with Hartmann solution (10 mL/kg), 5~7 mL of 2% plain lidocaine was injected into T8~9 or T9~10 intervertebral space and general anesthesia was then induced. Group B (control group) received general anesthesia only. RESULTS: There were no significant differences in hemodynamics between the epidural with general anesthesia and the control group except SVR (systemic vascular resistance). SVR in group A increased in contrast to the group B in which it remained unchanged. CONCLUSIONS: The combined epidural and general anesthesia, using prehydration and 0.5~1 mL/segment of 2% plain lidocaine at the T8~9 or T9~10 intervertebral space was safe without significant hemodynamic changes.
Anesthesia, Epidural ; Anesthesia, General* ; Blood Pressure ; Hemodynamics* ; Humans ; Injections, Epidural ; Lidocaine

A case of esophageal atresia associated with malrotation and segmental dilatation of the ileum is described. To our knowledge, this is the first such report of this combination of features. The prenatal sonogram showed polyhydramnios. Esophageal atresia was diagnosed 3 days after birth. The diagnosis of malrotation and segmental dilatation of the ileum was made using a barium enema and an explolaparotomy 10 days after the first operation. The facts indicate that abnormal findings on a prenatal sonography and esophageal atresia may be associated with many congenital anomalies should be considered.
Barium ; Diagnosis ; Dilatation* ; Enema ; Esophageal Atresia* ; Ileum* ; Parturition ; Polyhydramnios

OBJECTIVE: The purpose of this study was to describe the MR imaging appearance of the dural ligaments which is connected between the anterior dura mater and the posterior longitudinal ligament. MATERIALS AND METHODS: In 10 cadavers with formalin fixation, the dural ligaments were evaluated and photographed after removal of the posterior element of the spinal canal. MR studies of 12 patients who had distinct dural ligaments were evaluated. Spin-echo MR images were obtained on a 1. 5T unit. RESULTS: In seven of the ten cadavers, the midline dural ligament was observed; the lateral dural ligament was observed in 3 cadavers. On MR, the dural ligaments were imaged as thin lines of low signal intensity between the anterior dural margin and the posterior longitudinal ligament. Dural ligaments were well-visualized at the level of the lower lumbar spine which had a more prominent anterior epidural space than that of the upper level of the spine. Eight of 12 cases had well developed midline dural ligaments. Two cases showed distinct lateral dural ligaments and the remaining 2 cases had distinct midline and lateral dural ligaments. CONCLUSION: MR images of the dural ligament demonstrate a thin low signal line at the anterior epidural space.
Cadaver* ; Dura Mater ; Epidural Space ; Formaldehyde ; Humans ; Ligaments ; Longitudinal Ligaments ; Magnetic Resonance Imaging* ; Spinal Canal ; Spine

PURPOSE: The purpose of the present study was to examine the changes in bladder compliance of a spinal cord injured population, and analyze the effects of several factors, related to the clinical and urodynamic findings, on bladder compliance. MATERIALS AND METHODS: The charts, videourodynamic and upper tract radiographic studies of 114 patients with a spinal cord injury were retrospectively reviewed. The patients were categorized according to their bladder and urethral activities from the videourodynamic study, the interval since the time of the injury and the bladder emptying method, including intermittent catheterization (IC), self voiding and Foley catheterization. The association of bladder compliance with upper/lower tract complications was also identified in the population. A bladder compliance threshold values of 12.5ml/cm H2O was selected for the comparison between a normal and decreased compliance. RESULTS: No significant differences in compliance were noted in relation to sex, age or level of injury. Of the 114 patients, 43 (37.4%), by definition, had a low bladder compliance. The patients whose interval since the time of injury was more than one year had a significantly higher incidence of low compliance than those of less than one year. Low compliance was more common in patients using an indwelling catheter than in those using the other methods. A low compliance was statistically associated with more deformity of the bladder shape (p<0.05) and upper tract complications (p<0.05). CONCLUSIONS: In a spinal cord injured population, compliance may be one of the most important factors resulting in upper/lower urinary tract complications. With time, or due to the wrong treatment, there is a great possibility of a low compliance. Therefore, regular observation of the compliance, and other factors, using urodynamic studies, is warranted.
Catheterization ; Catheters ; Catheters, Indwelling ; Compliance* ; Congenital Abnormalities ; Humans ; Incidence ; Retrospective Studies ; Spinal Cord Injuries ; Spinal Cord* ; Urinary Bladder* ; Urinary Catheterization ; Urinary Tract ; Urodynamics

Post-micturition dribble is defined as leakage coming after voiding has been completed. Such leakage is often associated with bending or sitting down, and is seldom associated with any demonstrable abnormality. The diagnosis can be made by videourodynamic study. The patient is instructed to press the bulbar urethra manually in the perineum after micturition and evacuate the residue, and symptomatic relief is almost always obtained. We report three cases of patient with postmicturition dribble.
Diagnosis ; Humans ; Perineum ; Urethra ; Urination