A rate com;lication of hysterectomy is complete prolapse and inversion of vagina. This can occur whether the hysterectomy was abdominal or vaginal and cystocele and/or enterocele is often associated with this condition. Traditionally, prolapse has been treated by surgery, the types of operation for prolapse are generally but not always, carried out through the vaginal rather than through the abdominal surgical route. We experienced five cases who had repair of posthysterectomy vaginal vault prolapse by transabdominal sacral colpopexy and report with brief review of literatures.
Cystocele ; Hernia ; Hysterectomy* ; Pelvic Organ Prolapse* ; Prolapse ; Vagina

No abstract available.
Lower Extremity ; Saphenous Vein

The aqueous bumor makes an important role to maintain intraocular pressure. The production and outflow of aqueous humor controls the intraocular pressure. The accurate understanding of the pathway of aqueous outflow and the rate of outflow is essential to the study of glaucoma. The purpose of this study is to investigate the pathway of aqueous outflow after injection of dye into the anterior chamber, the duration of staining and the degree of delay of aqueous outflow after the use of viscoelastics. Three dyes. Gentian Violet, Methylene Blue and Viscoelastics mixed with Gentian Violer were injected into the anterior chambers of 20 eyes of 10 rabbits. The eyes were enucleated at 1 hour, 2 hour, 3 hour, 4 hour after injection of Gentian Violer and Methylene Blue. After injiection of viscoelastics mixed with Gentian violet, the eyes were enucleated at 2 hour, 4 hour, 6 hour, 8 hour, and 9 hour. The enucleated eyes were performed for frozen section and the fragments were observed by light microscopee. Gentian violet and Merhylene Blue were stained in the pathway of the pectinate ligaments, trabecular meshwork, intrascleral plexus and the pathway of the capillary network of iris and suprachoroidal space. The disappearance of injected dye was ended between 3 hour and 4 hour. And the viscoelastics mixed with dye was removed between 8 hour and 9 hour. This means that viscoelastics make the outflow of aqueous delay.
Anterior Chamber* ; Aqueous Humor* ; Capillaries ; Coloring Agents ; Frozen Sections ; Gentian Violet ; Gentiana ; Glaucoma ; Intraocular Pressure ; Iris ; Ligaments ; Methylene Blue ; Rabbits ; Trabecular Meshwork

Multiple involvement of arterial fibromuscular dysplasia is unusal and such a case is quite limited in the literature. We present a case of multiple arterial fibromuscular dysplasia with aneurysm formation in a 38-year-old non-hypertensive man. Angiographic study showed multiple aneurysmal dilatations of the right renal, superior mesenteric, celiac axis, and left colic arteries. The resected right kidney demonstrated an aneurysm of the main renal artery and extensive infarction in the midportion of the renal parenchyma. The segmentally resected superior mesenteric artery disclosed a similar nature of aneurysm occluded by recent thrombi. Microscopically, all the resected arterial walls showed both intimal and medial fibroplasia together with periadventitial fibrosis resulting in marked narrowing of the lumen and subsequent thrombus formation.

No abstract available.
Pregnancy*

Melkersson-Rosenthal syndrome (MRS) is a rare form of hereditary angioedema characterized by a triad of orofacial swelling, relapsing facial paralysis, and a fissured tongue. However, the classic triad is not frequently seen in its complete form, and monosymptomatic or oligosymptomatic forms are more common. Case: A 20-year-old man presented with recurrent labial swelling 9 months ago and recently with a fissured tongue. The surface of the tongue showed deep furrows characteristic of lingua plicata, and an edematous enlargement was observed on the lower lips. Upon neurologic examination, a left sided facial palsy of a peripheral type was noted without abnormalities in the taste sense or lacrimation. An electromyography of the left frontal muscle showed positive sharp waves and fibrillation potentials. Biopsies performed on the lower lips revealed the congested vessels and perivascular inflammatory cells. We report a 20-year-old man with a classical triad of symptoms of Melkersson-Rosenthal syndrome.
Angioedemas, Hereditary ; Biopsy ; Electromyography ; Estrogens, Conjugated (USP) ; Facial Paralysis ; Humans ; Lip ; Melkersson-Rosenthal Syndrome* ; Neurologic Examination ; Tongue ; Tongue, Fissured ; Young Adult

No abstract available.
Polychondritis, Relapsing*

No abstract available.
Polychondritis, Relapsing*

Leiomyosarcoma is a malignant tumor showing smooth muscle differentiation, and it accounts for 2% to 8% of soft tissue sarcoma. Clinically, substantial mortality and morbidity are related to the propensity for distant metastasis and local recurrence, respectively. Microscopic findings characteristically reveal intersecting bundles of spindle-shaped cells having fibrillar cytoplasm and blunt-ended nuclei. Immunohistochemistry for intermediate filaments is helpful in establishing a definitive diagnosis. We experienced a case of large protruding leiomyosarcoma that developed on an old burn scar of the medial calf of a 45-year-old man. On preoperative evaluation, we recommended amputation due to a distant metastasis to the lung(stage IV). As the patient refused amputation of his lower leg, the tumor was radically excised and immediate reconstruction was done using free latissimus dorsi muscle flap and skin graft. Four months after excision despite adjuvant chemotherapy, amputation was performed due to local recurrence.
Amputation ; Burns ; Chemotherapy, Adjuvant ; Cicatrix ; Cytoplasm ; Diagnosis ; Humans ; Immunohistochemistry ; Intermediate Filaments ; Leg ; Leiomyosarcoma* ; Middle Aged ; Mortality ; Muscle, Smooth ; Neoplasm Metastasis ; Recurrence ; Sarcoma ; Skin ; Superficial Back Muscles ; Transplants ; Ulcer*

BACKGROUND: This study aimed to investigate bradycardia as an adverse effect after administration of dexmedetomidine during 33degrees C target temperature management. METHODS: A retrospective study was conducted on patients who underwent 33degrees C target temperature management in the emergency department during a 49-month study period. We collected data including age, sex, weight, diagnosis, bradycardia occurrence, target temperature management duration, sedative drug, and several clinical and laboratory results. We conducted logistic regression for an analysis of factors associated with bradycardia. RESULTS: A total of 68 patients were selected. Among them, 39 (57.4%) showed bradycardia, and 56 (82.4%) were treated with dexmedetomidine. The odds ratio for bradycardia in the carbon monoxide poisoning group compared to the cardiac arrest group and in patients with higher body weight were 7.448 (95% confidence interval [CI] 1.834-30.244, p = 0.005) and 1.058 (95% CI 1.002-1.123, p = 0.044), respectively. In the bradycardia with dexmedetomidine group, the infusion rate of dexmedetomidine was 0.41 +/- 0.15 microg/kg/h. Decisions of charged doctor's were 1) slowing infusion rate and 2) stopping infusion or administering atropine for bradycardia. No cases required cardiac pacing or worsened to asystole. CONCLUSIONS: Despite the frequent occurrence of bradycardia after administration of dexmedetomidine during 33degrees C target temperature management, bradycardia was completely recovered after reducing infusion rate or stopping infusion. However, reducing the infusion rate of dexmedetomidine lower than the standard maintenance dose could be necessary to prevent bradycardia from developing in patients with higher body weight or carbon monoxide poisoning during 33degrees C targeted temperature management.
Atropine ; Body Weight ; Bradycardia* ; Carbon Monoxide Poisoning ; Dexmedetomidine* ; Diagnosis ; Emergency Service, Hospital ; Heart Arrest ; Humans ; Hypothermia, Induced ; Logistic Models ; Odds Ratio ; Retrospective Studies