Pseudo-Bartter syndrome is a rare medical disease of the kidney characterized by normal blood pressure, hypokalemic metabolic alkalosis, hyperreninemia and hyperaldosteronism with drug history of diuretics. We report US, CT and MRI findings of a patient with clinically proved pseudo-Bartter syndrome. The patient was a 37-year-old woman with a history of long term ingestion of the diuretics(furosemide) for 20 years. Renal US revealed hyperechoic renal medulla at both kidneys. The resistive index(RI), calculated from the duplex doppler waveform is 0.61. Unenhanced CT revealed faint high attenuation along the medulla. Tl-weighted MRI revealed indistinct corticomedullary differentiation.
Adult ; Alkalosis ; Blood Pressure ; Diuretics ; Eating ; Female ; Humans ; Hyperaldosteronism ; Kidney ; Magnetic Resonance Imaging

PURPOSE: To evaluate the radiologic characteristics of axillary lymph nodes which are found on mediolateral oblique(MLO) view of mammography and to assess their clinical significance. MATERIALS AND METHODS: We retrospectively evaluated 119 cases axillary lymph nodes on MLO view of 410 cases of mammography in 205 patients regarding the size, bilaterality, number, grade of density, presence of central lucency, calcification of lymph nodes and presence of associated parenchymal pathologic lesions in breast. RESULTS: Axillary lymph nodes on MLO view were demonstrated in 119 (29%) among 410 cases. Axillary lymph nodes(112 cases) in cases without breast parenchymal lesions or with benign breast lesions showed; unilaterality in 68 cases(61%), smaller than 1.5cm in 100 cases(89%), lower density than breast parenchyma in 99 cases(88%), presence of central lucency in 99 cases(88%) and calcification in 3 cases(2.7%). Axillary lymph nodes(7 cases)in cases with breast cancer showed small size of less than 1.5cm in 4 cases(57%), absence of central lucency in 7 cases(100%) and iso-to higher density than breast parenchyma in 7 c&ses(100%). CONCLUSION: Axillary lymph nodes noted on MLO view of mammography, more than 1.5cm in diameter, absence of central lucency and iso to higher density than breast parenchyma could be suggested as clinically significant.
Breast ; Breast Neoplasms ; Humans ; Lymph Nodes* ; Mammography ; Retrospective Studies

PURPOSE: To evaluate the radiologic characteristics of axillary lymph nodes which are found on mediolateral oblique(MLO) view of mammography and to assess their clinical significance. MATERIALS AND METHODS: We retrospectively evaluated 119 cases axillary lymph nodes on MLO view of 410 cases of mammography in 205 patients regarding the size, bilaterality, number, grade of density, presence of central lucency, calcification of lymph nodes and presence of associated parenchymal pathologic lesions in breast. RESULTS: Axillary lymph nodes on MLO view were demonstrated in 119 (29%) among 410 cases. Axillary lymph nodes(112 cases) in cases without breast parenchymal lesions or with benign breast lesions showed; unilaterality in 68 cases(61%), smaller than 1.5cm in 100 cases(89%), lower density than breast parenchyma in 99 cases(88%), presence of central lucency in 99 cases(88%) and calcification in 3 cases(2.7%). Axillary lymph nodes(7 cases)in cases with breast cancer showed small size of less than 1.5cm in 4 cases(57%), absence of central lucency in 7 cases(100%) and iso-to higher density than breast parenchyma in 7 c&ses(100%). CONCLUSION: Axillary lymph nodes noted on MLO view of mammography, more than 1.5cm in diameter, absence of central lucency and iso to higher density than breast parenchyma could be suggested as clinically significant.
Breast ; Breast Neoplasms ; Humans ; Lymph Nodes* ; Mammography ; Retrospective Studies

No abstract available.
Female ; Fetomaternal Transfusion* ; Pregnancy

Since Paget`s first description in 1874 of what is presently known as Paget`s disease of the nipple, similar lesions have been reported rarely on the penis and scrotum, vulva, perineum, axilla and the eyelids. Because it is often associated with a subjacent or visceral malignancy and recurrence, extramammary Paget`s disease(EPD) is considered as malignant condition. This case report describes two patients with extramammary Paget`s disease of the penoscrotal area. One of them had renal cell carcinoma in left kidney and was managed by radical nephrectomy. Treatments for EPD were initiated by CO2 laser 3 or 4 times, but failed and then we excised the lesion widely and closed primarily with split thickness skin graft in one of the cases.
Axilla ; Carcinoma, Renal Cell ; Eyelids ; Humans ; Kidney ; Lasers, Gas ; Male ; Nephrectomy ; Nipples ; Penis ; Perineum ; Recurrence ; Scrotum ; Skin ; Transplants ; Vulva

PURPOSE: Vascular endothelial growth factor (VEGF) known as an angiogenic factor is a potent inducer of pathologic neovascularization. The purpose of this study is identifying the relationship between serum PSA, invasiveness and VEGF expression in prostatic cancer. MATERIALS AND METHODS: Ex-vivo study with immunohistochemical stain analysis for VEGF expression was performed on 18 paraffin embedded specimens of prostatic cancer patients who were treated with radical prostatectomy. VEGF expressions were classified by three groups (1+ , 2+ , 3+ ) according to the degree of staining of cancer cell. Biochemical failure and recurrence were determined by Takayama's IMx PSA assay criterion (>0.1ng/ml) following radical prostatectomy. RESULTS: Immunohistochemical studies demonstrated that each group contained 1, 2, 8 patients in advanced disease (n=11), and 3, 2, 2 patients in localized disease (n=7), respectively. All cases in strong positive (3+ ) group had Gleason sum higher than 7 and nadir PSA values were lower than 0.1ng/ml except one case. We found no correlation between initial PSA and VEGF expression (p=0.361). Three biochemical recurrent patients were identified as strong positive VEGF expression. CONCLUSIONS: Our study indicates that patients with advanced stage and higher Gleason sum have a trend with more VEGF expression than patients with localized disease. Identifying the angiogenesis factors especially, VEGF involved in prostatic cancer growth and understanding their regulation will lead to the developement of anti-angiogenic strategies useful for diagnostic studies and therapeutic interventions.
Angiogenesis Inducing Agents ; Humans* ; Neovascularization, Pathologic ; Paraffin ; Prostate-Specific Antigen* ; Prostatectomy ; Prostatic Neoplasms* ; Recurrence ; Vascular Endothelial Growth Factor A*

For the treatment of coarction of aorta, surgical intervention has been known as a standard therapy.During last decade balloon angioplasty for coarctation of the aorta has been reported as a successful and safe procedure in about 300 cases. This angioplasty was done mainly in infants and children, and little cases in adults and adolescents. A 22 year-old adult with coarctation of aorta have recieved balloon angioplasty. He visited to emergency room due to severe headache and the blood presure of arm was 240/130mmHg at emergency room. The blood pressure at ward was 168/92mmHg in upper extremities, 104/82mmHg in lower extrimities. His aortogram showed coarctation of thoracic aorta below left subclavian artery. The pressure gradient beween ascending aorta and right femoral artery was decreased from 60mmHg to 0mmHg after balloon dilatation (2 times, balloon diameter 18mm). There were no significant complications. The follow-up magnetic resonance image in 4 month after balloon angioplasty showed no evidence of restenosis or saccular aneurysm. Initial hypertension turned to normal blood pressure in 4 months after balloon angioplasty. This adult case of successful balloon angioplasty for coarctation of aorta is the first case reported in Korea.
Adolescent ; Adult* ; Aneurysm ; Angioplasty ; Angioplasty, Balloon* ; Aorta ; Aorta, Thoracic ; Aortic Coarctation* ; Arm ; Blood Pressure ; Child ; Dilatation ; Emergency Service, Hospital ; Femoral Artery ; Follow-Up Studies ; Headache ; Humans ; Hypertension ; Infant ; Korea ; Subclavian Artery ; Upper Extremity ; Young Adult

A case of multiple intradural schwannomas of the cauda equina is reported without evidence of any other manifestations of neurofibromtosis. The patient had symptoms of cauda equina compression. Following a diagnosis of multiple intradural tumors of the cauda equina, based on lumbar spine MRI with contrast enhancement, the tumors at the L1 body, L3 body, L3-L4 intervertebral space level were removed completely, involving two rootlets. After the operation, the patient is asymptomatic apart from left S3 dermatome hypesthesia.
Cauda Equina* ; Diagnosis ; Humans ; Hypesthesia ; Magnetic Resonance Imaging ; Neurilemmoma* ; Neurofibromatoses* ; Spine

PURPOSE: The aim of this study was to evaluate new cardiac deformity indexes (CDIs) for diagnosis of pectus excavatum as well as morphological assessment of heart on computed tomography (CT). MATERIALS AND METHODS: We retrospectively evaluated the CT images of the control group (n=200), and the pectus excavatum before and after correction groups (n=178), and calculated the CDIs; cardiac compression index (CCI), and cardiac asymmetry index (CAI). We also calculated chest wall compression index (CWCI) and asymmetry index (CWAI) on the axial images. We performed logistic regression analysis using each index and age as predictor variables. RESULTS: The CDIs (CCI and CAI) were significant (p < 0.05) in the diagnosis of pectus excavatum, regardless of age (p = 0.4033, p = 0.8113). The CWCI and CWAI were significant (p < 0.05) and significantly affected by age (p < 0.05). If we selected 1.82 as the cutoff of the CCI, the sensitivity and specificity were 99.4% and 98%, respectively. The following cutoffs and the sensitivity and specificity were obtained: 1.15 for the CAI gave 94.4% and 94.5%, 3.05 for the CWCI gave 92.1% and 92%, and 1 for the CWAI gave 62.4% and 65%, respectively. The CCI after repair improved from 2.83 +/- 0.84 to 1.84 +/- 0.33, while the CWCI improved from 4.49 +/- 1.61 to 2.57 +/- 0.44. CONCLUSION: CDIs such as the CCI and CAI may be potentially useful to detect and estimate repair for pectus excavatum.
Adolescent ; Age Factors ; Child ; Child, Preschool ; Female ; Funnel Chest/*radiography ; Heart Defects, Congenital/*radiography ; Humans ; Logistic Models ; Male ; Postoperative Period ; Retrospective Studies ; Tomography, X-Ray Computed/*methods ; Young Adult

PURPOSE: To evaluate the clinical and radiologic findings of atypical ductal hyperplasia (ADH) using mammography and ultrasonography, and to correlate the radiologic and histopathologic findings. MATERIALS AND METHODS: Sixty-four pathologically proven lesions in 64 patients who were examined between March 2000 and March 2003 were the subject of this study. Mammography was performed in all 64 cases, and ultrasonography in 30. Two radiologists retrospectively evaluated the radiologic findings, classifying them as one of four types: mass, microcalcification, other finding, and no detected lesion. At mammography, masses were classified according to their shape, margin, and density and microcalcifications according to their shape and distribution. At ultrasonography, masses were evaluated in terms of their shape, margin, internal and posterior echotexture, ductal extension, and parallelism to skin. Geographic correlation between the radiologic and histopathologic findings was classified as direct, near direct, or remote correlation. RESULTS: Mammography demonstrated 37 cases of microcalcification (57.8%), 14 in which masses were present (21.9%), two in which there were other findings (3.1%), and 11 in which lesions were not detected (17.2%). The "other finding" was ductectasia. Microcalcifications were round in 19 cases, pleomorphic heterogeneous in 16, and branching linear in one. The most common distribution of microcalcification was clustered (29 cases; 78.4%). Masses were oval or round in nine cases and irregular in three, and in seven cases their margin was ill-defined. In 13 cases, the density of the masses was equal to that of breast tissue. Ultrasonography showed that the masses were round or oval in 15 cases and irregular in 14, and that the margin was ill-defined in 16 cases and circumscribed in ten. In 19 cases, the echotexture of the masses was low, and in 20 cases, heterogeneous. Parallel orientation was seen in 25 cases, and ductal extension in 22. Category 4 was the most common final assessed BI-RADS category, found in 75% of cases. Radiologic-histopathologic correlation was direct in 44 cases, near direct in 13, and remote in seven. Clinically, self or clinical examination of the breast revealed no abnormality in 47 cases, a palpable mass in seven, nipple discharge in seven, and breast pain in three. CONCLUSION: At mammography, the most common finding of ADH was clustered round or pleomorphic heterogeneous microcalcifications, and at ultrasonography, illdefined, round or oval, or irregular-shaped, hypoechoic masses with parallel orientation and ductal extension. Clinically, most ADH was incidentally discovered at radiologic examination. In this study, 17.2% of ADH cases were not demonstrated by mammography but were detected at ultrasonography, and for the detection of ADH, the use of this latter modality, alongside mammography, is thus feasible.
Breast Neoplasms ; Breast* ; Humans ; Hyperplasia* ; Mammography ; Mastodynia ; Nipples ; Retrospective Studies ; Skin ; Ultrasonography