No abstract available.
Agaricales* ; Morus*

Holt-Oram Syndrome is an autosomal dominant disorder characterized by the association of upper-limb abnormalities and congenital heart disease. A woman with no family history of genetic disease underwent antenatal sonography at 27 weeks' menstrual age to screen for fetal anomalies. Ultrasonography revealed abnormalities in the upper limbs. The limb abnormalities included abscence of bilateral thumbs and radius: the left humus was short. Pregnancy termination was performed. The postnatal chromosomal analysis revealed a normal 46XX karyotype and the autopsy finding confirmed the Holt-Oram syndrome. We report a case of Holt-Oram Syndrome in fetus with unaffected parents with brief of the literatures.
Autopsy ; Extremities ; Female ; Fetus ; Heart Defects, Congenital ; Humans ; Karyotype ; Parents* ; Pregnancy ; Radius ; Soil ; Thumb ; Ultrasonography* ; Upper Extremity

No abstract available.

Endometriosis is defined as the presence of endometrial tissue(gland and stroma) outside the uterus. The incidence of scar endometriosis is quite rare, and must differentiate with cellulitis and abscess. We have experienced one case of perineal endometriosis and one case of abdominal wall endometriosis at the site of postoperative wound scar. The possible pathogenesis of endometriosis and treatment were discussed.
Abdominal Wall ; Abscess ; Cellulitis ; Cicatrix* ; Endometriosis* ; Female ; Incidence ; Uterus ; Wounds and Injuries

We report a case of recurrent dermatofibrosarcoma in a 30-years-old woman who had undergone operations three times during 60 months and had received post-operative radiotherapy. On neurological examination, no neurological deficits were noticed. In brain magnetic resonance image(MRI), there was right parieto-occipital scalp mass with high signal in T2-weighted image, low signal in T1-weighted image with homogeneous enhancement. The removal was done including about 2cm uninvolved margins and pathologic examination of the lesion revealed dermatofibrosarcoma protuberans(DFSP). The prognostic factors of local recurrence may be related to surgical margins for resection; the length from the grossly intact margins, and the microscopically controlled excision in margins.
Brain ; Dermatofibrosarcoma* ; Female ; Humans ; Neurologic Examination ; Radiotherapy ; Recurrence ; Scalp*

A hepatic angiosarcoma is a rare primary malignant neoplasm, which accounts for only 2% of all primary hepatic tumors. The prognosis of a hepatic angiosarcoma is very poor, and most patients die within a year of the initial diagnosis. We report a case of a hepatic angiosarcoma in a 57-year-old man. Although a dynamic CT had suggested a carvenous hemangioma 12 months earlier, the tumor size increased and spontaneously ruptured, so surgical resection was mandatory. A pathological examination, including immunohistochemical studies, showed positive staining for CD34 and Factor VIII, which confirmed the diagnosis of an angiosarcoma. Although dynamic CT is an excellent modality for the diagnosis of a cavernous hemangioma of the liver, hepatic angiosarcomas should be ruled out in selected cases, because they may present with very similar CT findings to benign hemangioma.
Diagnosis ; Factor VIII ; Hemangioma ; Hemangioma, Cavernous* ; Hemangiosarcoma* ; Humans ; Liver ; Middle Aged ; Prognosis ; Rupture, Spontaneous

OBJECTIVE: Ectopic pregnancy can still cause maternal death, though we have undergone it frequently. So, we survey 80 cases ectopic pregnancies treated our hospital for early detection and proper management. METHODS: In this study, the authors studied retrospectively 80 cases which had been admitted and treated at the department of Obstetrics and Gynecology, National Police Hospital from Jan. 1, 1991 to Dec. 31, 2000. RESULTS: Incidence of ectopic pregnancy was one in 68 normal deliveries for 10 years, 63.7% of cases occurred in 25~34 years-old age group, and 52.6% of patients had previous abdominal surgery including cesarean section. Average interval of tubal ligation was 6.5 years between the onset of ectopic pregnancy and tubal ligation. Lower abdominal pain was the most common clinical symptom developed in 91.3% of the patients. Average interval between the onset of symptom and LMP was 7.6 weeks. Most ectopic pregnancies were tubal pregnancies and salpingectomy was done in 56.3% of the patients. CONCLUSION: According to our study, ectopic pregnancy occurred most frequently in women in their reproductive age and one of most important prognostic factors is time between onset of symptom and arrival of patient at hospital. We must make our efforts to preserve utero-ovarian function in treatment of patients with ectopic pregnancy.
Abdominal Pain ; Cesarean Section ; Female ; Gynecology ; Humans ; Incidence ; Maternal Death ; Obstetrics ; Police ; Pregnancy ; Pregnancy, Ectopic* ; Pregnancy, Tubal ; Retrospective Studies ; Salpingectomy ; Sterilization, Tubal

PURPOSE: Transabdominal sonography has been widely used in the diagnosis of suspected urinary calculi, assisted by secondary findings from urinary tract obstruction, but this method shows low specificity and relatively high incidence of false-positives. Recently, detection of stone itself with new Doppler finding and bladder distension on sonography has demonstrated high sensitivity. METHODS: We performed prospective transabdominal ultrasonography for emergency department patients with acute urinary colic pain over a 3 month period. With adequate bladder distension by intravenous hydration and initial spontaneous voiding drive, stones itself could be tracked along the entire length of urinary tract by emergency physician who received short-term education course. RESULTS: One hundred and thirty one patients enrolled; 86 received a sonographic exam and 57 showed urinary calculi. The detection rate of urinary calculi was 71.3%. The most common sonographic feature used in the diagnosis of urinary calculi was a distinct echogenic stone appearance within the dilated urinary tract with posterior acoustic shadowing. CONCLUSION: We concluded that detection of urinary calculi by transabdominal ultrasonography could be very useful in mbination with secondary sonographic finding from urinary tract obstruction in the evaluation of suspected urinary colic.
Acoustics ; Colic ; Diagnosis ; Education ; Emergencies ; Emergency Service, Hospital ; Humans ; Incidence ; Prospective Studies ; Sensitivity and Specificity ; Shadowing (Histology) ; Ultrasonography* ; Urinary Bladder ; Urinary Calculi* ; Urinary Tract

It is no doubt that flaps for resurfacing the face and neck should have appropriate thickness and good color match. Tissue expansion has been widely used for this purpose but, its result may be sometimes disappointed for resurfacing the face and neck, especially anterior neck, because of obtuse cervicomental angle. For resurfacing, various techniques such as tissue expansion, postauricular free flap and submental flap have been used and supraclavicular flap was also provided as a good tool with good color and texture match. In the aspect of easy approach for neighboring face and neck resurfacing, supraclavucular area can be recommended as the first choice of flap selection. We experienced 8 patients who require to resurface the face and neck by using supraclavicular flap and we obtained good results without complications. All the flaps were based on the supraclavicular pedicle originated from transverse cervical artery and various pattern of modification such as expanded, supercharged or free flap. Patients were listed with postburn contracture or posttraumatic deformity and supraclavicular flap was used as a free flap in 4 cases and an island flap in 4 cases. Supraclavicular flap as a free flap is one of ideal methods for face and upper neck resurfacing and may be used for neck reconstruction as an island flap. Although tissue expansion of neck was not ideal for resurfacing of low face and anterior neck, but it was effective for lateral neck and infraauricular region resurfacing with insertion of tissue expander into supraclavicular area. In conclusion, supraclavicular flap can be effectively used as various patterns including expansion, island flap and free flap without noticeable donor scar.
Arteries ; Cicatrix ; Congenital Abnormalities ; Contracture ; Free Tissue Flaps ; Humans ; Neck* ; Tissue Donors ; Tissue Expansion ; Tissue Expansion Devices

Coarctation of the aorta is frequently associated with intracardiac disease. It is very difficult to decide on the best method for surgically treating adult patients with these combined heart diseases. We performed single-stage repair via a modified Bentall operation and by creating an intrapericardial ascending-descending aortic bypass through a median sternotomy in a patient with coarctation of the aorta and annuloaortic ectasia, and the latter was associated with aortic valve regurgitation.
Adult ; Aorta ; Aortic Aneurysm, Thoracic ; Aortic Coarctation ; Aortic Valve ; Dilatation, Pathologic ; Heart Diseases ; Humans ; Sternotomy