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

Despite the continually improving results of total knee arthroplasty, infection remains the most debilitating complication. The treatments of infected total knee arthroplasty were variable, but initially we removed infected implants and inserted antibiotic containing cemented spacer. Postoperatively, patients were mobilized in a 30 knee flexion state and treated with parenteral antibiotics. After control of infection was clinically and radiologically determined, we inserted PCL substitute total knee prosthesis. Five days postoperatively, patient began touch down standing exercise. We observed two cases in whom infected total knee arthroplasty had been salvaged successfully with two-stage implantation using cement spacers containing antibiotics.
Anti-Bacterial Agents* ; Arthroplasty* ; Humans ; Knee Prosthesis ; Knee* ; Replantation*

We investigated whether the two variant elements of CRE(TGcCGTCA[5'CRE], TGACcTCA[3'CRE]) in the 5'flanking region of the rat TRH gene, which are different from the CRE consensus sequence(5'-TGACGTCA-3') by one base pair, are responsive to cAMP, and whether the one base pair difference is responsible for the degree of cAMP responsiveness of the gene. When CA 77 cells were stimulated with forskolin and isobutylmethylxanthine for 4 hours, the level of TRH mRNA was increased by only two fold. The transient gene expression study using serial 5'deletion of the TRH gene in PC12 cells showed that the region between-113 and-77, which includes 5'CRE, was crucial for the cAMP resonsiveness. When the plasmid, which contains the 30 bp oligonucleotide including either 5'CRE or 3'CRE ligated to the enhancerless RSV promoter, was transfected into PC12 cells, it did not significantly affect not only the basal transcription but cAMP responsiveness. The 65 bp oligonucleotide including both 5'CRE and 3'CRE, however, increased both of the basal transcription and cAMP-stimulated transcription by 2-3 fold. When the sequence of 5'CRE was converted to that of the CRE consensus by replacing one base pair, the cAMP responsiveness was increased by two fold although the basal transcription was not increased. The one base pair mutant of 3'CRE increased both of the basal and cAMP-stimulated transcription by 3-4 fold. These results suggest that there are the two variant CREs in rat TRH gene, which are relatively weak CRE compared to the CREs of other neuropeptide genes and cooperative for the activation of both the basal and cAMP-stimulated transcription. The one base pair difference of the variant CREs from the CRE consensus sequence is responsible for the weak responsiveness to cAMP.
Animals ; Base Pairing ; Colforsin ; Consensus ; Consensus Sequence ; Cyclic AMP ; Gene Expression ; Neuropeptides ; PC12 Cells ; Plasmids ; Rats ; Response Elements ; RNA, Messenger ; Thyrotropin ; Thyrotropin-Releasing Hormone

A case of pulmonary alveolar proteinosis is reported. Most of the alveolar spaces were filled with amorphous deep eosinohilic material which revealed strong positive reaction to periodic acid-Schiff staining. Electron microscopic observation of this material showed numerous lamellar bodies in the alveolar spaces and cytoplasms of alveolar macrophages. A part of them were concentric multilamellated type A lamellar bodies and the other were finger printlike type B bodies. Combined type A and type B lamellar bodies were rarely present. From the above features it is suggested that both type A and B lamellar bodies could be transformed one another and those lamellar bodies may be originated from pulmonary surfactant.

No abstract available.
Fracture Fixation, Intramedullary*

No abstract available.
Paraplegia* ; Spondylitis, Ankylosing*

Stasis dermatitis is one of the important skin manifestations of venous stasis. Therefore, the searching for the cause of venous stasis is importrnt. Two cases of stasis dermatitis with inferior vena caval obstruction are reported and possible etiologic factor is discussed. Case I The patient, 38-year-old carpenter, was admitted at Choong Buk Medical Center in April, 1974 with superficial venous engorgement of the lower extremities which had begun to appear two years after severe blunt trauma to both legs in 1962. 5 years prior to admission, abdomial venous engorgement and abdominal fullness developed and was exaggerated gradually. Since 2 years prior to admission, he has been suffered from the recurrent exudative ulcer on the right lower leg The physical examination revealed mild icteric sclera, hepatomegaly, abdominal distension, tortuous venous engorgement on the abdomen, the lateral chest wall and the lower extremities, and edematous scaly brawny pigmentation of the lower legs. Esphagogram showed no esphageal varices. Inferior vena cavogram showed complete obstruction at the level of upper border of 2nd lumbar vertebra and well developed collateral circulation, Findings of skin biopsy on the right lower leg showed moderate acanthosis, increased pigmentation of bosal cell layer in the epidermis, capillary proliferation, diffuse inflammatory cell infiltration with increased fibrosis and hemosiderin granules in the dermis. Case II The patient. 36-year-old farmer, was admitted at Dept. of Dermatology, St. Mary's Hospital, Catholic Medical College in Sept., 1973.The physical examination revealed hepatomegaly, abdominal distension, superficial venous engorgement on the abdomen, the neck and the lower extrcmities, severe edema and pigmentation of the lower legs, and the multiplc. Exudative ulcers on the left lower leg. Liver scanning showed somewhat general enlargement with some mottlings along the margin and relative prominance of the left lobe. Liver biopsy revealed findings of non specific chrcnic hepatitis. Inferior vena cavogram through the left femoral vein showed complete obstruction at the level between 11th and 12th thoracic vertebrae.His peripheral edema and ascites was much subsided after adequate bed rest and the skin lesion improved with scar formation.
Abdomen ; Adult ; Ascites ; Bed Rest ; Biopsy ; Capillaries ; Cicatrix ; Collateral Circulation ; Dermatitis* ; Dermatology ; Dermis ; Edema ; Epidermis ; Femoral Vein ; Fibrinogen ; Fibrosis ; Hemosiderin ; Hepatitis ; Hepatomegaly ; Humans ; Hyperemia ; Leg ; Liver ; Lower Extremity ; Neck ; Physical Examination ; Pigmentation ; Sclera ; Skin ; Skin Manifestations ; Spine ; Thoracic Wall ; Ulcer ; Varicose Veins

Myocardial infarction is almost regularly associated with severe and widespread obstructive coronary artery disease. Recently, there have been some reports of myocardial infarction with normal of near normal coronary arteries on cineangiography. The following report concerns 6 cases (4% of a series of 142 consecutively studied patients with myocardial infarction) of myocardial infarction proved on clinical grounds with normal or near normal coronary arteries at coronary angiography obtained several months later. The clinical data was shown in Table 1 and Table 2. All 6 patients were male. Three were in the fifth, two in the sixth, and one in the seventh decade. Multiple risk factors were present in only one patient. Areas of localized dyskinesia or hypokinesia were demonstrated in five on the left ventricular cineangiography. The left ventricular end-diastolic pressure was greater than 12 mmHg in all 6 patients. One patient had hypertrophic cardiomyopathy and the remaining 5 patients had no underlying heart diseases. One patient had moderate congestive heart tailure. It is possible that prolonged, localized coronary artery spasm or platelet thrombi that subsequently resolved are a part of the pathogenic mechanism.
Blood Platelets ; Cardiomyopathy, Hypertrophic ; Cineangiography ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels* ; Dyskinesias ; Estrogens, Conjugated (USP) ; Heart ; Heart Diseases ; Humans ; Hypokinesia ; Male ; Myocardial Infarction* ; Risk Factors ; Spasm

No abstract available.
Diabetes Insipidus, Nephrogenic* ; Urinary Bladder*

No abstract available.
Child* ; Diabetes Insipidus* ; Eosinophilic Granuloma* ; Eosinophils* ; Humans ; Pituitary Gland*