Typical nephroblastoma arise within the renal parenchyme and have pseudocapsules composed of compressed renal tissue, renal capsule and adjacent perirenal tissue. Therefore, it is rarely possible to determine whether the tumor arose from the cortex or medulla. Many authors believe that they are probably cortical in origin and arise from nodular renal blastema just beneath the renal capsule or in the centers of columns of Bertin. We experienced a nephroblastoma supposed to arise from peripelvic region. The patient was a 7 months old male infant with an abdominal mass. Left nephrectomy was done under the impression of nephroblastoma. Received specimen was a diffusely enlarged kidney with preserved normal outline, so it looked like a hydronephrotic kidney. On section, the pelvis and calyceal system were dilated and totally filled with a gray white soft mass. Most portion of the mass was floating freely in the calyces and pelvis, and only a small portion was attached to the renal parenchyme but without invasion to it. Microscopically the mass was a nephroblastoma containing many well developed glomeruli and tubules. We presumed that the tumor arose from a nodular renal blastema in the peripelvic region, because the tumor had no connection to the renal cortex.
Infant ; Male ; Female ; Humans

Increased splenic uptake of radiocolloid is a helpful sign in the scintigraphic diagnosis of diffuse hepatocellular diseases, but any attempt has been made to quantify this phsiologic phenomenon. The purpose of thestudy is to evaluate a simple computer quantitation of S/L ratio and to determine normal range and S/L ratios forvarious hepatic diseases. Authors analized S/L ratios of 194 cases of liver scintigraphy from July 1984 to May1985. The results are as follows; 1. The age distribution of normal and various heptic disases was most frequentin 30 to 40 decade. 2. The classification of studied groups were normal subjects (80 cases), hepatitis(30 cases),liver cirrhosis (59 cases), hepatoma(8 cases), metastasis(10 cases), and miscellaneous diseases(7 cases). 3. Thesimple computer quantitation method exhibits small interobserver variation.(r=0.92, p<0.001) 4. The mean S/L ratioin normal group was determined 0.34 (S.D=0.12) with a its range from 0.10 to 0.58 (0.34±2 S.D). The mean S/Lratios in various hepatic diseases were as follows; 0.52 (S.D=0.18) in hepatitis, 1.10 (S.D=0.43) in cirhhosis,0.77 (S.D=0.38) in hepatoma, 0.47 (S.D=0.21) in metastasis, and 0.43(S.D=0.17) in miscellaneous diseases. 5. Theelevated S/L ratios rather than normal values were found in hepatitis (30%), cirrhosis(51%), hepatoma(63%), and metastasis(20%). 6. The sensitivity of single scintigraphic diagnosis of liver cirrhosis was 63%, but thesensitivity was improved to 90% when combined with S/L ratio. 7. The simple computer quantitation of the S/L ratiois a valid and useful method in the interpreation of liver scintigraphy and also may increase the sensitivity inthe diagnosis of liver cirrhosis and hepatoma combined with cirrhosis.
Age Distribution ; Carcinoma, Hepatocellular ; Classification ; Diagnosis ; Fibrosis ; Hepatitis ; Liver Cirrhosis ; Liver ; Methods ; Neoplasm Metastasis ; Radionuclide Imaging ; Reference Values

The cystic disease of the kidney include a heterogeneous group of developmental, hereditary, and acquired disorders. Based on extensive microdissection studies, Potter concluded all renal cystic diseases could be categorized into four types. We have experienced 5 cases of cystic kidney disease which were confirmed by aoutopsy and classified as Type I, Type II, Type III, Boderline between types II and III and Type IV according to Potter's classification. We report these cases with a review of literatures.
Classification* ; Kidney ; Kidney Diseases, Cystic* ; Microdissection

Cyclooxygenase (COX) is an enzyme involved in the conversion of arachidonic acid to prostaglandins(PGs), and exists in two forms, COX-1 and COX-2. COX has been reported to be involved in early implantation by secretion of PGs which causes permeability of vessels and reaction of decidual cells around the implantation site. Recently, in mice and sheep studies, COX-1 and COX-2 expression in the endometrium has been reported to be different according to implantation and stages of the estrous cycle, but expression of COX-1 and COX-2 in human endometrium during the menstrual cycle has not yet been established. The purpose of this stuffy was to observe the variances of COX-1 and COX-2 expression by immunohistoehemical staining in endometrial samples obtained from human hysterectomy specimens and biopsies of women of reproductive age according to different stages of the menstrual cycle. Also, we attempted to observe COX-1 and COX-2 expression in the epithelial and stromal cells of the endometrium obtained during the mid-secretory phase, which were cultured separately. COX-2 showed a cyclic pattern of expression according to the different stages of the menstrual cycle and was strongly expressed particularly at the mid-secretory phase which corresponds to the time of implantation. However, COX-1 tended to be increased in the early proliferative, and mid- and late secretory phases, but was also expressed in the whole menstrual cycle showing no particular pattern. In the separately cultured cells COX-1 was expressed in epithilial cells and COX-2 in the stromal cells. The above results suggest that since COX-2 is expressed at the same time as implantation and cultured cells display a specific secretory pattern, COX-2 has inductive endocrine enzyme properties and has an important effect on endometrial cells during implantation. Also, COX-2 expression in endometrial cells may be utilized as a useful marker of endometrial maturation.
Animals ; Arachidonic Acid ; Biopsy ; Cells, Cultured ; Cyclooxygenase 1* ; Endometrium* ; Estrous Cycle ; Female ; Humans* ; Hysterectomy ; Menstrual Cycle ; Mice ; Permeability ; Prostaglandin-Endoperoxide Synthases ; Sheep ; Stromal Cells

OBJECTIVE: In order to elucidate the retrogressive degeneration of orofacial cleft, the fissured tissues of prenatal and postnatal cleft lip and palate were examined by histological and immunohistochemical methods. DESIGN: Totally 42 cases of prenatal (n=17) and postnatal (n=25) cleft lip and/or palate were examined in comparison with 10 cases of normal lip and oral mucosa using immunohistochemical stainings of MMP-3, MMP-9, MMP-10, cathepsin G, PCNA, E-cadherin, TGase 2, HSP-70, vWF, and VEGF. MAIN OUTCOME MEASURES: In the fissured tissue the sebaceous glands were strongly positive for PCNA and grew into the underlying fibromuscular tissue (24/42). Some hyperplastic sebaceous glands of prenatal cleft lip produced infundibular follicular cyst (9/17). The skin and mucosal epithelia from the postnatal cleft lip and palate (10/25) showed severe basal hyperplasia (11/25) and melanocyte infiltration (7/25). RESULTS: The immunostaining of MMP-3 and HSP-70 were strongly positive in the hyperplastic sebaceous glands and nearby atrophying muscle bundles of the fissured tissue, while MMP-9, MMP-10, and cathepsin G were almost negative. The immunoreactions of the other antibodies used in this study were similar between in the fissured tissues and in the normal controls. CONCLUSIONS: These data suggest that the over-expression of MMP-3 is closely related to the sebaceous gland hyperplasia, epithelial dysplasia, and the muscle degeneration, and that the over-expression of MMP-3 in the fissured tissue may continuously aggravate the cleft condition in the later life.
Adult ; Antibodies ; Cadherins ; Cathepsin G ; Cleft Lip* ; Follicular Cyst ; Humans ; Hyperplasia ; Lip ; Melanocytes ; Mouth Mucosa ; Outcome Assessment (Health Care) ; Palate* ; Proliferating Cell Nuclear Antigen ; Sebaceous Glands ; Skin ; Vascular Endothelial Growth Factor A

BACKGROUND/AIMS: To optimize efficacy of National Liver Cancer Screening Program (NLCSP) for subjects with chronic hepatitis B (CHB), it is needed to know the incidence of liver cancer and its predisposing factors in the program. METHODS: From January 2010 to December 2014, all the hepatitis B surface antigen (HBsAg) positive participants who received at least two or more abdominal ultrasonography under NLCSP were retrospectively enrolled in a single tertiary hospital. Annual incidence of primary liver cancer was calculated and related clinical factors were investigated. RESULTS: During 5 years, 541 subjects were enrolled. Mean age was 53 years old and 292 subjects (54%) were receiving antiviral agents. Liver cirrhosis (LC) was diagnosed in 212 (39.2%). Mean follow-up time was 2.36 years and 15 hepatocellular carcinoma and 1 intrahepatic cholangiocarcinoma were diagnosed. Annual incidence of primary liver cancer was 9.8 per 1,000 patient year. Cumulative incidence at 1, 3, and 5 year was 0.6%, 2.6%, and 6.4%, respectively. In multivariate analyses, LC (hazard ratio [HR] 8.74, 95% confidence interval [CI] 1.97–38.71, P=0.024), age (HR 1.08, 95% CI 1.01–1.15, P=0.024) were significantly associated with cancer development. CONCLUSIONS: Despite of high rate of oral antiviral therapy, incidence of primary liver cancer is not low in CHB patients in Korea. Old age and presence of LC are independently associated with higher risk of cancer development during surveillance. This study could be used as baseline data for quality control of NLCSP.
Antiviral Agents ; Carcinoma, Hepatocellular ; Causality ; Cholangiocarcinoma ; Follow-Up Studies ; Hepatitis B Surface Antigens ; Hepatitis B, Chronic* ; Hepatitis, Chronic* ; Humans ; Incidence* ; Korea ; Liver Cirrhosis ; Liver Neoplasms* ; Liver* ; Mass Screening* ; Multivariate Analysis ; Quality Control ; Retrospective Studies ; Tertiary Care Centers ; Ultrasonography

BACKGROUND/AIMS: As bacterial resistance to antimicrobial agents has grown due to the increasing use of antimicrobial agents, we sought to evaluate the suitability of ceftriaxone usage (representative of third generation cephalosporins) at 10 university hospitals in Korea. METHODS: We prospectively evaluated the appropriateness of antibiotic usage in 400 adult patients who received ceftriaxone between February 1, 2006 and June 30, 2006. Drug utilization evaluation (DUE) methods were based on standards set forth by the American Society of Hospital Pharmacists. The DUE criteria used in this study were modified to be more suitable in our hospital setting: justification of drug use, critical and process indications, complications, and outcome measures. RESULTS: The average patient age was 64.4 years. The utilization of ceftriaxone was appropriate in 262 cases (65.5%) for the justification of use, while inappropriate use was observed in 138 cases (34.5%). Common reasons for inappropriate use of ceftriaxone included continued empiric use for presumed infections, prophylactic perioperative injection, and empiric therapy for fever. Most of the critical indications showed a high rate of suitability (66.5-98.5%). Complications occurred in 37 cases (9.3%). With respect to outcome measures, clinical responses were observed in 60.7% of cases, while only 15.7% of cases showed evidence of infection eradication via negative cultures. CONCLUSIONS: Appropriate use (65.5%) of ceftriaxone was higher than inappropriate use (34.5%) at university hospitals in Korea. Inappropriate utilization, however, including continued empiric use for presumed infections and prophylactic perioperative injection remained high. Intensification of educational programs and antibiotic control systems for ceftriaxone is needed to improve the suitability of antimicrobial use.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents/*therapeutic use ; Ceftriaxone/adverse effects/*therapeutic use ; Child ; Child, Preschool ; *Drug Utilization Review ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Treatment Outcome

BACKGROUND/AIMS: The prevalence of malignancies associated with human immunodeficiency virus (HIV) is rapidly increasing. The aim of the present study was to identify clinical features associated with malignancies in South Korean patients infected with HIV. METHODS: From January 1990 to June 2007, we reviewed an electronic database containing pathological reports obtained from HIV-infected patients and then retrospectively analyzed a total of 27 malignancy cases treated at four different institutions. RESULTS: Among 683 patients infected with HIV, malignant diseases were diagnosed in 27 cases (4.0%). Twenty-five of these patients were male, and the median age was 48 (range; 24-76). At the time of diagnosis, the median CD4+ lymphocyte count was 42/uL (range 3-339). Acquired immune deficiency syndrome (AIDS)-defining malignancies were diagnosed in 13 patients (48%) and non-AIDS-defining malignancies were diagnosed in 14 patients (52%). Two patients each were diagnosed with AIDS-defining and non-AIDS-defining malignancies during the pre-highly active anti-retroviral therapy (HARRT) period. In contrast, 11 patients (48%) and 12 patients (52%) were diagnosed with AIDS-defining and non-AIDS-defining malignancies during the HARRT period, respectively. Among AIDS-defining malignancies, non-Hodgkins lymphoma was the most frequently observed (9/13), followed by Kaposi's sarcoma (4/13). Among the 9 patients with non-Hodgkins lymphoma, diffuse large B-cell lymphoma was most common (5/9), followed by primary CNS lymphoma (3/9) and Burkitt's lymphoma (1/9). Gastrointestinal (GI) malignancies [i.e., gastric cancer (3/14), rectal cancer (3/14), and esophageal cancer (1/14)] and hepatocellular carcinoma (3/14) were the most commonly observed among the non-AIDS-defining malignancies. Other observed non-AIDS-defining malignancies were thyroid cancer (1/14), tonsillar cancer (1/14), angiosarcoma (1/14), and eccrine cancer (1/14). Finally, median CD4+ lymphocyte counts at the time of diagnosis were significantly different (18 vs. 114/uL, p=0.001) between AIDS-defining malignancies and non-AIDS-defining malignancies. CONCLUSIONS: Malignancies were diagnosed in 4.0% of patients infected with HIV. This study showed similar rates of incidence between AIDS-defining and non-AIDS-defining malignancies. Non-Hodgkins lymphoma was the most frequently observed malignancy, whereas GI malignancies and hepatocellular carcinoma were common among non-AIDS-defining malignancies.
Acquired Immunodeficiency Syndrome ; Burkitt Lymphoma ; Carcinoma, Hepatocellular ; Electronics ; Electrons ; Esophageal Neoplasms ; Hemangiosarcoma ; HIV ; Humans ; Incidence ; Lymphocyte Count ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, Non-Hodgkin ; Male ; Prevalence ; Rectal Neoplasms ; Retrospective Studies ; Sarcoma, Kaposi ; Stomach Neoplasms ; Thyroid Neoplasms ; Tonsillar Neoplasms

No abstract available.
Hypertrophy ; Obesity ; Obesity, Abdominal

No abstract available.
Chest Pain ; Echocardiography ; Esophageal Achalasia ; Heart Atria ; Humans ; Thorax