Ultrasonography is a useful diagnostic modality in evaluating the non-visualized kidney on IVP because visualization by this technique depends only on the morphologic and acoustic characteristics of the kidney and is independent of renal function. This non-invasive technique can accurately guide percutaneous puncture of the collecting system, permitting antegrade localization of the obstructing lesion, and percutaneous nephrostomy under the ultrasonic guidance can be performed as a means for rapid, usually temporary, urinary diversion in patients with obstructive uropathy. Many causes of IVP non-visualization have a typical sonographic appearance. 35 patients with non-visualized kidney were examined ultrasonically and 13 AGP were carried out.
Acoustics ; Humans ; Kidney ; Nephrostomy, Percutaneous ; Punctures ; Ultrasonics* ; Ultrasonography ; Urinary Diversion

No abstract available.

Renal angiomyolipoma is a relatively uncommon benign tumor and may be associated with tuberous sclerosis, which is characterized by adenoma sebaceum, epilepsy and mental retardation. When a renalangiomyolipoma occurs with tuberous sclerosis, it can be easily diagnosed and the incidence of multiple and bilateral angiomyolipoma is high in patients with multiple sclerosis. Recently we experienced a case of unilateral renal angiomyolipoma associated with tuberous sclerosis which occurred in a 38 year-old housewife, who had right flank mass, adenoma sebaceum on the face, shagreen patches of the back and sublingual fibromas. So we report a case of unilateral renal angiomyolipoma associated with tuberous sclerosis with review of literatures.
Adult ; Angiomyolipoma* ; Epilepsy ; Fibroma ; Humans ; Incidence ; Intellectual Disability ; Multiple Sclerosis ; Tuberous Sclerosis*

A total of 26 consecutive patients underwent total cystectomy and ileal conduit for bladder cancer, 6 patients without preoperative radiation therapy, 16 patients after planned preoperative radiation therapy and 4 patients with postoperative radiation therapy. The operative death was none. Early complications occurred in 38% and included wound infection, wound disruption, parastromal dermatitis, acute pyelonephritis, intestinal obstruction and urine leak. Late complications included stromal stenosis, intestinal obstruction, acute pyelonephritis, enterocutaneous fistula, peritonitis and ureteroileal stricture. Errors in clinical staging of bladder carcinoma occurred in about 38% of patients. The pathologic stage was higher (clinical understaging) in 6 (23%), and lower (clinical overstaging) in 4 (15%). Deaths during follow-up were 7 patients and the average survival period was 15 months, with a range of 6 to 38 months.
Constriction, Pathologic ; Cystectomy* ; Dermatitis ; Follow-Up Studies* ; Humans ; Intestinal Fistula ; Intestinal Obstruction ; Peritonitis ; Pyelonephritis ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Urinary Diversion ; Wound Infection ; Wounds and Injuries

Pigmented spindle cell nevus (PSCN) is often interpreted as a Spitz nevus or misdiagnosed as a malignant melanoma. Some authors consider PSCN as a pigmented variant of Spitz nevus, but many dermatologists classify it as a separate disease. We report a case of pigmented spindle cell nevus which occurred in a 4-year-old boy. The lesion was a well-demarcated, 3x3mm sized, black macule on the dorswn part of the 4th finger, left hand. The histopathologic findings of the excisional biopsy specimen revealed the proliferation of uniform, spindle shaped, pigmented melanocytes at the dermoepidermal junction and sharply defined lateral margins. The pathologic features were consistent with PSCN.
Biopsy ; Child, Preschool ; Fingers ; Hand ; Humans ; Male ; Melanocytes ; Melanoma ; Nevus, Epithelioid and Spindle Cell ; Nevus, Spindle Cell*

Ecthyma gangrenosum is usually seen in the immunocompromised patients or in the patients with underlying malignancy. Ecthyma gangrenosum is a rapidly progressing skin infection characterized by edema, hemorrhage, bullae and necrosis. We experienced the case of a 13-month-old male who had ecthyma gangrenosum associated with liver absess and renal abscess. The patient initially presented with skin lesions of multiple well defined central necrotic black colored large erythematous bullae. The multiple liver abscess with hepatomegaly and multifocal pyelonephritis with focal renal abscess revealed by abdominal ultrasonogram and computed tomogram. In the bacterial cultures of skin, urine and liver aspiration fluid, Pseudomonas aeruginosa was grown. The patient had no immune deficiency disease. We report this case with a review of related literatures.
Abscess* ; Deficiency Diseases ; Ecthyma* ; Edema ; Hemorrhage ; Hepatomegaly ; Humans ; Immunocompromised Host ; Infant ; Liver Abscess* ; Liver* ; Male ; Necrosis ; Pseudomonas aeruginosa ; Pyelonephritis ; Skin ; Ultrasonography

Spontaneous rupture of the kidney is a rare condition which usually presents as an acute abdominal process requiring prompt diagnostic evaluation and proper therapy. We experienced 2 cases of spontaneous rupture of the kidney secondary to hydronephrosis in a 31 year old man and intrarenal artery aneurysm in a 62 year old woman. The operative procedures were nephrectomy in both cases.
Adult ; Aneurysm ; Arteries ; Female ; Humans ; Hydronephrosis ; Kidney* ; Middle Aged ; Nephrectomy ; Rupture, Spontaneous* ; Surgical Procedures, Operative

Spontaneous rupture of the kidney is a rare condition which usually presents as an acute abdominal process requiring prompt diagnostic evaluation and proper therapy. We experienced 2 cases of spontaneous rupture of the kidney secondary to hydronephrosis in a 31 year old man and intrarenal artery aneurysm in a 62 year old woman. The operative procedures were nephrectomy in both cases.
Adult ; Aneurysm ; Arteries ; Female ; Humans ; Hydronephrosis ; Kidney* ; Middle Aged ; Nephrectomy ; Rupture, Spontaneous* ; Surgical Procedures, Operative

PURPOSE: We tried to evaluate whether high resolution chest CT with a 1,024 matrix has a significant advantage in image quality compared to a 512 matrix. MATERIALS AND METHODS: Each set of 512 and 1024 matrix high resolution chest CT scans with both 0.625 mm and 1.25 mm slice thickness were obtained from 26 patients. Seventy locations that contained twenty-four low density lesions without sharp boundary such as emphysema, and forty-six sharp linear densities such as linear fibrosis were selected; these were randomly displayed on a five mega pixel LCD monitor. All the images were masked for information concerning the matrix size and slice thickness. Two chest radiologists scored the image quality of each arrowed lesion as follows: (1) undistinguishable, (2) poorly distinguishable, (3) fairly distinguishable, (4) well visible and (5) excellently visible. The scores were compared from the the aspects of matrix size, slice thickness and the different observers by using ANOVA tests. RESULTS: The average and standard deviation of image quality were 3.09 (+/-.92) for the 0.625 mmx512 matrix, 3.16 (+/-.84) for the 0.625 mmx1024 matrix, 2.49 (+/-1.02) for the 1.25 mmx512 matrix, and 2.35 (+/-1.02) for the 1.25 mmx1024 matrix, respectively. The image quality on both matrices of the high resolution chest CT scans with a 0.625 mm slice thickness was significantly better than that on the 1.25 mm slice thickness (p < 0.001). However, the image quality on the 1024 matrix high resolution chest CT scans was not significantly different from that on the 512 matrix high resolution chest CT scans (p = 0.678). The interobserver variation between the two observers was not significant (p = 0.691). CONCLUSION: We think that 1024 matrix image reconstruction for high resolution chest CT may not be clinically useful.
Emphysema ; Fibrosis ; Humans ; Image Processing, Computer-Assisted* ; Masks ; Observer Variation ; Thorax* ; Tomography, X-Ray Computed*

Purpose: The diagnostic performance of thyroid biopsy is influenced by several factors, including differences in the Bethesda categorization for malignancy, the inclusion or exclusion of non-diagnostic results, the definition used for the final diagnosis, and the definition of an inconclusive diagnosis. The purpose of this study was to provide an understanding of the factors influencing the diagnostic performance of thyroid biopsy. Methods: We collected data retrospectively between January and December 2013 from a cohort of 6,762 thyroid nodules from 6,493 consecutive patients who underwent biopsy. In total, 4,822 nodules from 4,553 patients were included. We calculated the biopsy sensitivity according to the inclusion of different Bethesda categories in the numerator and the exclusion of non-diagnostic results, as well as the diagnostic accuracy according to different definitions of a benign diagnosis. We obtained the conclusive and inconclusive diagnosis rates. Results: The sensitivity increased when more Bethesda categories were included in the numerator and when non-diagnostic results were excluded. When a benign thyroid nodule diagnosis was defined as benign findings on surgical resection, concordant benign results on at least two occasions, or an initial benign biopsy result and follow-up for more than 12 months, the accuracy was higher than when the diagnosis was based on surgical resection alone (68.7% vs. 91.1%). A higher conclusive diagnosis rate was obtained (78.3% vs. 72.8%, P<0.001) when Bethesda categories I and III were considered inconclusive. Conclusion Understanding the concepts presented herein is important in order to appropriately interpret the diagnostic performance of thyroid biopsy.