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*

IVRO is one of the most common procedures to setback prognathic mandible. Since 1993 we have set-up our own protocol for functional physiotherapy(Park's protocol) after IVRO. This is a study on openbite and relapse tendency after IVRO followed by our protocol. We obtained lateral cephalograms of twenty-seven patients which were taken immediately after surgery, 3 months, 6 months and 1 year postoperatively. Changes in positions of each point were analyzed. The results were as follows: 1. No remarkable openbite occured during the first year after IVRO. Upper teeth, lower teeth and anterior mandible moved upward, it seems to show that post-op orthodontic treatment did not contribute to reduce openbite tendency during post-op period. Rater, the lower teeth and mandible moved with the upper teeth as the compensation mechanism. 2. Lower Incisal Edge moved anteriorly up to 6 months, so overjet decreased from 3.3mm to 2.9mm during the first six months. Skeletal changes in anterior mandible showed slight anterior movement, therefore showing slight relapse tendency, but it represented no statistical significance. 3. The physiotherapy according to our protocol was used for only a month after operation, but there was no openbite tendency, and the occlusion was stable over one year.
Compensation and Redress ; Humans ; Mandible ; Open Bite* ; Prognathism* ; Recurrence* ; Tooth

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.
Germ Cells* ; Neoplasms, Germ Cell and Embryonal*

No abstract available.
Colitis, Ulcerative* ; Ulcer*