PURPOSE: Congenital Iobar agenesis of the liver is a rare anomaly. We report five cases (three cases of right Iobar agenesis and two cases of left Iobar agenesis) and discuss the radiologic findings of this congenital anomaly. MATERIALS AND METHODS: Between July, 1992 and February, 1993, three cases of right Iobar agenesis and two cases of left Iobar agenesis of the liver were diagnosed by means of computed tomography(CT) and/or sonography. MR imging was performed in two patients, cholangiography in two, and digital subtraction angiography in one. RESULTS: The main findings of right Iobar agenesis of the liver were nonvisualization of the right portal vein and absence of liver tissue to the right of gallbladder. The findings of left Iobar agenesis were nonvisualization of left portal vein, absence of liver tissue to the left of the gallbladder, and absence of ligamentum teres. The ancillary finding of the Iobar agenesis was visualization of less than three hepatic veins. CONCLUSION: It is important to consider Iobar agenesis of the liver in differential diagnosis when imaging studies reveal abnormal portal vein branches, unusual position of gallblader, absence of ligamentum teres, and visualization of less than three hepatic veins.
Angiography, Digital Subtraction ; Cholangiography ; Diagnosis, Differential ; Gallbladder ; Hepatic Veins ; Humans ; Liver ; Portal Vein

Authors have reviewed a series of 41 cases of fibrous dysplasia which were treated surgically at the Department of Orthopedic Surgery, College of Medicine, Seoul National University. After mean follow-up of 25 months, we summarized the results as follows; 1. Among the 41 patients, 20 were male patients(M:F= 1:1.05). The average age was 20.2 years old. It was the most common in the 2nd decade(44%). The most common site was femur (53.6%) followed by tibia (28.6%) in monostotic type. Each polyototic patient had 3.8 locations in average. 2. The results were better in skeletally mature patients (86%) than in immature patients (42%). 3. Satisfactory results seemed to be expected in monostotic type (71%) than polyostotic type(33 %) 4. Satisfactory results seemed to be expected in sclerotic type(78%) than cystic type(50%) or ground glass appearance type (62%). 5. Autograft(71%) was superior to xenograft(40%) in our study. However, xenograft only or xenograft with autograft can be a recommendable method of treatment for a very large lesion or for a patient with insufficient graft donor site.
Autografts ; Femur ; Follow-Up Studies ; Glass ; Heterografts ; Humans ; Male ; Methods ; Orthopedics ; Seoul ; Tibia ; Tissue Donors ; Transplants

The modified supracervical hysterectomy with intrafascial cylindriform enucleation of cervix via endoscopy or vaginal approach enables to do an minimal invasive and organ preserving surgery. The pelvic floor support is maintained and sexual sensation is preserved, and there may be nearly little concern of cancer on cervix. The physical stress to the patient is minimized. But, Intrafascial Vaginal Hysterectomy is rarely performed in case of large uterus size. We performed Intrafascial Vaginal Hysterectomy in patient of adenomyosis with cystocele and rectocele and then report that with review of journal and text book.
Adenomyosis* ; Cervix Uteri ; Cystocele* ; Endoscopy ; Female ; Humans ; Hysterectomy ; Hysterectomy, Vaginal* ; Pelvic Floor ; Rectocele* ; Sensation ; Uterus

Although neutrophilia can manifest from various causes, it is important to be able to distinguish chronic neutrophilic leukemia (CNL) from neutrophilic leukemoid reactions (NLR). In this paper, we describe four cases of leukocytosis with neutrophilia, including one case of CNL with a T618I mutation in colony stimulating factor 3 receptor (CSF3R) and three cases of NLR associated with malignancy or sepsis, which were initially suspected as CNL. Of the three NLR cases, one was associated with ovarian cancer, one with monoclonal gammopathy of undetermined significance and one with multiple myeloma with sepsis. This study demonstrated that confirming the clonality of myeloid cells with CSF3R T618I could contribute to making an accurate differential diagnosis between CNL and NLR in patients with solid cancers or plasma cell neoplasms caused by paraneoplastic syndromes and/or infection.
Colony-Stimulating Factors ; Diagnosis, Differential ; Humans ; Leukemia, Neutrophilic, Chronic* ; Leukemoid Reaction* ; Leukocytosis ; Monoclonal Gammopathy of Undetermined Significance ; Multiple Myeloma ; Myeloid Cells ; Neoplasms, Plasma Cell ; Neutrophils* ; Ovarian Neoplasms ; Paraneoplastic Syndromes ; Sepsis

PURPOSE: To evaluate MR findings of postoperative diskitis following operation for intervertebral disk herniation. MATERIALS AND METHODS: Twelve cases with postoperative diskitis following operation for intervertebral disk herniation were included in this study. MR findings of postoperative diskitis were analysed to determine 1) the extent and pattern of alteration of the involved disks, 2) the pattern of destruction of endplates and vertebral bodies, and 3) the pattern of inflammatory extension into the surrounding soft tissue. RESULTS: 1) Disk alteration developed mainly at the middle and posterior portions of the disk, and was characterized by loss of intranuclear cleft at the involved portion of the disk and intranuclear abscess formation 2) Vertebral bodies involved ware symmetrically adjacent to involved disks and in three cases, bone abscesses within the endplates were detected. 3) The extension of inflammation yielded prevertebral or pre-/paravertebral masses (7 cases), epidural abscesses (5 cases), arachnoiditis (6 cases), and inflammatory masses (2 cases) beneath the posterior longitudinal ligament. CONCLUSION: Disk involvement was mainly at the middle and posterior portions of the disks, and there was accompanying intranuclear cleft loss. Symmetric involvement of the vertebral bodies adjacent to the involved disks was noted.
Abscess ; Arachnoid ; Arachnoiditis ; Discitis* ; Epidural Abscess ; Inflammation ; Intervertebral Disc ; Longitudinal Ligaments ; Spondylitis

Malignant melanoma of the vulva is a rare neoplasm and accounts for approximately 10% of all vulvar malignancies. Five-year survival rates range from 8% to 54%, with occuring predominantly in postmenopausal white women. As compared with malignant melanoma of the skin, vulvar melanoma infiltrates early deep into the tissues with abundant lymphatic channels and blood vascularization, so its prognosis is mostly poor. Depth of invasion has been reported as the single most important indicator of prognosis. Historically the treatment of choice for vulvar melanoma has been en bloc radical vulvectomy with bilateral inguinofemoral lymphadenectomy. But recently there have been reports suggesting that acceptable survival may be achieved by less radical operation. The authors report a 84-year old woman with malignant melanoma of the vulva. She underwent wide local excision of the lesion. Now we are following her up with no clinical evidence of cancer recurrence and remnant.
Aged, 80 and over ; Female ; Humans ; Lymph Node Excision ; Melanoma* ; Prognosis ; Recurrence ; Skin ; Survival Rate ; Vulva*

OBJECTIVE: This study was performed to evaluate and introduce the clinicopathologic characteristics and treatment modalities of vulvar vestibulitis, a subset of vulvodynia, may cause physical disabilities, phycological or emotional distress, sexual dysfunction and limitation of daily activities. But its etiologies and treatments are not defined yet. We want to summarize the diagnostic methods and treatments patients of vulvar vestibulitis syndrome, could be easily overlooked in your offices. METHODS: This retrospective study was based on medical records including pathologic reports of 30 patients who underwent skin biopsy among the patients who were diagnosed as vulvar vestibulitis syndrome from August 1999 to February 2002 at Kyung-Hee University Medical Center. Skin biopsy was taken at a most painful area of vestibule in Dermatology Department to improve the accuracy of diagnosis. We evaluated the clinicopathologic characteristics of patients RESULTS: The mean age of these patients was 53.4+/-10.4 years and the mean parity was 3.13+/-1.4 times. The mean duration from symptom onset to diagnosis was 26.2+/-24.1 months. The skin biopsies showed chronic inflammation in 21 cases (70.0%), chronic inflammation with koilocytosis in 5 cases (16.7%), subacute inflammation in 3 cases (10.0%), and acute inflammation in 1 case (3.3%). The most predominant painful area is right posterior vestibular site and all patients felt pain on that site with swab test. There were 70% improvement among 30 patients with non-surgical modalities. CONCLUSION: Vulvar vestibulitis syndrome is a syndrome of severe pain, burning, stinging, irritative or raw sensation within the vestibular area by vestibular touch or attempted vaginal entry such as tampon use or intercourse. It also has vestibular redness, urge to urinate frequently or suddenly and is confirmed by history, moistened cotton-tipped swab test and gentian violet staining on the lesions. Its prevalence is 15% and it is frequently accompanied by physical disabilities, limitation of daily activities, sexual dysfunction and psychologic distress. Even though it could be seen frequently in our offices and has a tendency to become a chronic disease requiring long-term treatments, it has been being overlooked in offices due to lack of understanding of its etiologies, diagnostic criteria and treatments. Here we need more concerns and studies of vulvar vestibulitis syndrome.
Academic Medical Centers ; Biopsy ; Bites and Stings ; Burns ; Chronic Disease ; Dermatology ; Diagnosis ; Female ; Gentian Violet ; Humans ; Inflammation ; Medical Records ; Parity ; Prevalence ; Retrospective Studies ; Sensation ; Sexual Behavior ; Skin ; Vulvar Vestibulitis* ; Vulvodynia

PURPOSE: This study was intended to evaluate the value of the FNAB in the diagnosis of the suspected metastatic cervical lymphadenopathy. MATERIALS AND METHODS: 221 patients diagnosed as metastatic cervical lymphadenopathy by FNAB from Jan., 1990 to Oct., 1994 were analyzed retrospectively. They represented 92.1% of metstatic cervical lymphadenopathy managed and 15.7% of 1,411 FNAB's performed during the same period. 33 cases with lymphoma were excluded in this study. RESULTS: In 107 patients with cervical lymphadenopathy who also received confirmatory node biopsy, the sensitivity, specificity, positive and negative predictive values of FNAB for the metastatic cervical lymphaenopathy were 79.3%, 100%, 100% and 44.1% respectively. In 76 (33.4%) patients the histopathologic types of the primary cancers were decided by information gained from FNAB alone. There were two kinds of tendency that GI cancers metastasized to left-sided cervical nodes (88.1%) and breast and lung cancers to ipsilateral supraclavicular nodes in high frequencies (94.1% and 86.8%, respectively). No complications were associated with FNAB. CONCLUSION: FNAB is a simple, rapid, inexpensive and highly specific diagnostic tool in the evaluation of suspected metastatic cervical lymphadenopathy. The sensitivity and negative predictive value, however, are relatively low. When the clinical findings strongly suggest metastatic lymphadenopathy, the negative FNAB should be followed by confirmatory biopsy. Information gained from it guides further diagnostic and therapeutic plans. Surrounding normal tissues are not damaged, and the theoretical hazards of local implantation of tumor cells and complication are negligible.
Biopsy* ; Biopsy, Fine-Needle* ; Breast ; Diagnosis ; Humans ; Lung Neoplasms ; Lymphatic Diseases* ; Lymphoma ; Retrospective Studies ; Sensitivity and Specificity

Rupture of teratoma is rare. Ovary cystic teratoma was occurred 95% in benign ovary tumor, but chemical peritonitis arising from ruptured cystic teratoma is a scarce case. Peritoneal tuberculosis is also rare disease nowadays. It causes easily fatigue, abdominal distension, intermittent abdominal pain and ascities insidiously. We have recently experienced a case of chemical peritonits from ruptured both ovary cystic teratoma of ovary with superimposed peritoneal tuberculosis in 44 year-old woman and report our scarce case with a brief review of the literature.
Abdominal Pain ; Adult ; Fatigue ; Female ; Humans ; Ovarian Cysts* ; Ovary ; Peritonitis* ; Peritonitis, Tuberculous* ; Rare Diseases ; Rupture ; Teratoma*

Mucormycosis is a fungal infection, which is difficult to treat due to its rapid dissemination and low susceptibility to anti-fungal agents. Peritonitis preceded by gastrointestinal mucormycosis is very rare, and only a few cases have been reported. We present a case of peritonitis and disseminated mucormycosis caused by Mucor circinelloides in an immunocompromised patient. A 59-year-old man, diagnosed with nodal marginal zone B-cell lymphoma, was diagnosed with liver failure due to severe septic shock. A white, woolly cotton-like growth, which was consistent with that of Mucor species, was isolated from ascites and sputum specimens. Targeted DNA sequencing confirmed the isolate as M. circinelloides with 100% identity. Despite anti-fungal treatment, the patient died after four days. This is a rare case of peritonitis and disseminated mucormycosis that was probably preceded by gastrointestinal mucormycosis caused by M. circinelloides, as determined by molecular methods. Accurate and rapid identification of mold using molecular methods might be necessary for early treatment in critical cases, and more cases should be clinically evaluated further.