UItrasound provides the ideal means to examine the fetal developing organs and during the last few years urogenital anomalies in fetus have been discovered with increasing frequency. Obstuctive and non-obstructive urinary tract dilation have been diagnosed in utero as early as l4 weeks gestation and intrauterine intervention designed to relieve hydronephrosis have been performed even at 2l weeks gestation. The major benefit of prenatal ultrasound is to permit early identification of the fetus at risk and to enable treatment to be performed in the neonatal period before infection intervens to worsen the prognosis further. Recentry we have experienced 2 cases of fetal uropathy which was detected with obsterical ultrasonography and treated with neonatal corrective surgery.
Fetus ; Hydronephrosis ; Pregnancy ; Prenatal Diagnosis* ; Prognosis ; Ultrasonography ; Urinary Tract

No abstract available.

There are several causes developing diplopia after cataract surgery. Among these causes, central fusion disruption may be developed in longstanding unilateral traumatic cataract and uncorrected aphakia. The pathophysiology is unknown, but time interval between sensory deprivation and optical correction is an important factor. The characteristic signs and symptoms are exotropic, hypotropic or excyclotropic deviation, and intractable diplopia with vertical bobbing movement of non-fixing eye, particularly near the angle of superimposition with prism or haploscopic device. The authors report two cases of central fusion disruption in longstanding unilateral traumatic cataract and uncorrected aphakia.
Aphakia ; Cataract ; Diplopia ; Sensory Deprivation

Purpose: To evaluate the various factors that affect renal function following percutaneous radiofrequency ablation (RFA) therapy in patients with renal tumors. Materials and Methods: Between 2010 and 2018, 91 patients diagnosed with renal tumors using ultrasonography and CT-guided RFA were enrolled. We retrospectively investigated the serum creatinine (SCr) level and estimated glomerular filtration rates immediately prior to RFA and during post-treatment follow-up. The patients were divided into two groups based on the degree of change in SCr level (0.3 mg/dL). Group comparisons were performed using univariable and multivariable logistic regression analyses to determine the factors impacting renal function. Results: Impaired renal function was associated with solitary kidney, chronic kidney disease (CKD) over stage 3, and pyeloureteral injury. Sex, age, other cancers, tumor size, location, growth pattern, and proximity to the collecting system were not significantly associated with impaired renal function. There was a difference in the overall change over time between the association with and without solitary kidney, CKD stage 3, and pyeloureteral injury. Conclusion Among the medical conditions present prior to RFA, solitary kidney and CKD over stage 3 could be considered as risk factors for impaired renal function. Post-procedural pyeloureteral injury can also be considered a risk factor.

It has not been elucidated whether the initiation of condylar development of the mandible is related with the periosteum of the mandible, or if it derives from a separate programmed blastema not related with the mandible. Also, although the mandibular condylar cartilage is known to promote growth, few studies have dealt with molecular-biologic mechanisms such as the expression of specific genes according to the differentiation of the mandibular condyle. To elucidate the unique cellular characteristics, development, and differentiation process of the mandibular condyle, an examination of expressions of genes characteristic of cartilage and bone were carried out using RT-PCR and mRNA in situ hybridization. 1. Type?collagen mRNA was detected with type II collagen mRNA in the differentiation and growth process of the cartilage of the mandibular condyle. Type II collagen mRNA was demonstrated in the whole resting and upper part of the proliferative zone, whereas type II collgen mRNA was observed in the resting, proliferative and upper hypertrophic cartilage zone of the mandibular condyle. 2. The condylar cartilage rapidly increased in size due to the accumulation of hypertrophic chondrocytes as characterized by the expression of type II collagen mRNA during postnatal development. 3. BMP-4 mRNA was present in the anlage of the future condylar process and also in the ossifying mandibular body. 4. IHH mRNA was limited exclusively to the lower part of the proliferative zone and the upper part of the hypertrophic cartilage zone during condylar development. These findings were different from those in the growth-plate cartilage of the long bone, indicating a characteristic feature of the differentiation of the chondrocytes in the condylar cartilage present in prenatal and postnatal development. Furthermore, it was also suggested that chondroblasts of condylar cartilage rapidly differentiate into hypertrophic chondrocytes with increased functional Load force such as muscle activity and mastication.
Animals ; Cartilage* ; Chondrocytes ; Collagen ; Collagen Type II ; In Situ Hybridization ; Mandible ; Mandibular Condyle* ; Mastication ; Mice* ; Periosteum ; RNA, Messenger*

BACKGROUND: Coronary arterigraphy has been used as a tool to assess the degree of coronary artery narrowing and the result of balloon angioplasty, which frequently underestimates the degree of atherosclerosis. Intravascular ultrasound(IVUS) can give more delicate information about plaque morphology and the result of coronary intervention. We compared qualitaive and quantitative measurement between IVUS and coronary angiography after coronary intervention. METHODS: We used 30 or 20 MHz intravascular ultrasound catheter which was connected to Hewlett Packard Sonos 1500 Intravasscular equiment in 5 coronary balloon angiopasty and 3 Palmaz-Schatz stent implantation cases. Sites of intervention were at the left anterior descending coronary artery in 7 patients and at the left circumflex artery in one patient. Quantitative coronary angiography(QCA) was done by CAAS II system. We measured referenc diameter(RD), minimal lumen diamter(MLD), Lumen and vessel cross sectional areas(LCSA,VCSA) obstraction area(OA) and plaque area(PA) and also analysed plaque morphology. RESULTS: 1) IVUS is more sensitive in the detection of eccentricity, Calcification and dissection. 2) Before intervention, the mean reference diameter was 2.87+/-0.42mm,3.07+/-0.39mm,% diameter stenosis was 52.4+/-11.6%,65.3+/-9.22% and MLD was 1.32+/-0.24mm, 1.07+/-0.23mm in IVUS and QCA, respectively, which were no statistical significance between these parameters(p>0.05). After intervention, MLD and OA increased significantly(p<0.01) com pared with basal values but there were no significant difference between MLD and OA between 2 measurements(p>0.05). Plaque area measured by IVUS decreased from 9.84 to 7.26mm2 without statistical significance(p>0.05). 3) There was a good correlation in the measurement of the reference segments before intervention but this correlation was much lower after intervention in the reference and stenosis segments between 2 methods(r=0.8723 vs 0.6538, p<0.01). CONCLUSION: IVUS is considered as a sensitive tool in the detection of calcification, eccentricity and dissection and in evaluationg the results of the coronary intervention.
Angioplasty, Balloon ; Arteries ; Atherosclerosis ; Catheters ; Constriction, Pathologic ; Coronary Angiography ; Coronary Vessels ; Humans ; Stents ; Ultrasonography*

Wegener's granulomatosis (WG) is characterized by necrotizing granulomatous vasculitis of small or medium sized vessels affecting the upper and lower respiratory tracts and kidney. It is well known that peripheral neuropathy is one of the leading manifestations of WG in western countries but there are rare cases of WG showing peripheral neuropathy in Korea. We report a patient with WG having peripheral neuropathy in his pathological and immunological findings.
Humans ; Kidney ; Korea ; Peripheral Nervous System Diseases* ; Respiratory System ; Vasculitis ; Wegener Granulomatosis*

PURPOSE: There are no specific clinical and histopathologic characteristics of malignant pheochromocytoma and the optimal treatment modality has not been established yet. We analyzed the clinical and histopathologic features of malignant pheochromocytoma and treatment results. MATERIALS AND METHODS: We reviewed the clinical records of 10 patients with malignant pheochromocytoma diagnosed at Seoul National University Hospital from March 1987 to June 1998. RESULTS: Nine of 10 (90%) patients had functional tumors. The biochemical laboratory findings showed elevated 24-hour urine VMA level in nine patients available. The median size of the tumors was 11x11 cm. Six of 10 (60%) patients were initially diagnosed as malignant tumors because of direct invasions to adjacent tissues or distant metastases. On the other hand, remaining 4 patients were initially diagnosed as benign, but the distant metastases developed metachronously after resection of the primary lesion. The median duration between the initial operation and the detection of metastases was 57 months (range: 47~72 months) in these patients. The liver was the most common site of metastases (60%). With regards to the histopathological features, most of the tumors (87.5%) showed capsulation, necrosis and hemorrhage. The findings of lymphatic invasion, angio-invasion, and mitosis were found in 62.5% of the cases. All but 2 patients were initially treated with radical operation for the primary lesions. The disease recurrences or metastases occurred in 7 out of 10 patients. Of these, 4 patients were treated with chemotherapy or interferon- a after recurrences. Overall, the median survival for all patients was 82 months (range: 37~143 months). Two patients is alive and only one patient is alive without recurrence. CONCLUSION: The careful follow-up for at least 5 years and the aggressive multi-disciplinary therapy may be needed for the diagnosis and the management of malignant pheochromocytoma.
Diagnosis ; Drug Therapy ; Follow-Up Studies ; Hand ; Hemorrhage ; Humans ; Liver ; Mitosis ; Necrosis ; Neoplasm Metastasis ; Pheochromocytoma* ; Recurrence ; Seoul

PURPOSE: H rthle cell neoplasm of the thyroid gland is a rare disease. The reported cases in Korea are not so many; thus, there has been a lack of common therapeutic and prognostic guidance. METHODS: The cases of 15 patients with a H rthle cell neoplasm of the thyroid gland, hospitalized at Seoul National University Hospital from Nov. 1981 to Feb. 1998, were retrospectively reviewed. RESULTS: There were 4 males and 11 females. The ages varied from 23 to 69 years old (mean: 46.3 years old). Among them, 13 had neck masses with a mean size of 3.3 cm (1.2-6.0 cm), and the mean duration of the symptom was 4 years (5 months-8 years). Of the other two, one had laryngeal discomfort for 2 months, and the other one was diagnosed through a fine needle aspiration follow-up. One of the 15 patients had hyperthyroidism whereas the others had euthyroidism. The thyroid scans for 10 of them showed cold nodules. The operations consisted of a unilateral lobectomy in 2 cases, a unilateral lobectomy and isth mectomy in 11 cases, a unilateral lobectomy, isthmectomy and contralateral partial lobectomy in 1 case, and a total thyroidectomy and neck lymph node dissection in the 1 case that was combined with a papillary carcinoma. Thirteen patients (86.7%) had a H rthle cell adenoma, and two of them (13.3%) had a H rthle cell carcinoma. The mean duration of follow-up was 33 months (range 1 month-12 years), and no recurrence or death occurred during the follow-up period. CONCLUSIONS: The incidence of H rthle cell neoplasms is higher in women and the sex ratio is 1:2.8. The incidence of H rthle cell carcinomas among H rthle cell neoplasms is 13.3% (2/15). We found no specific clinical features for differentiating a H rthle cell adenoma from a H rthle cell carcinoma and no factors for adequate operative methods and prognosis due to the rarity of the condition and the short duration of the follow-up. Because of the low incidence of H rthle cell neoplasms and our limited experience, not only co-research of centers but also pathologic research is needed.
Adenoma ; Aged ; Biopsy, Fine-Needle ; Carcinoma, Papillary ; Female ; Follow-Up Studies ; Humans ; Hyperthyroidism ; Incidence ; Korea ; Lymph Node Excision ; Male ; Neck ; Prognosis ; Rare Diseases ; Recurrence ; Retrospective Studies ; Seoul ; Sex Ratio ; Thyroid Gland* ; Thyroidectomy