Streptococcus agalactiae or group B streptococcus (GBS) is associated with infectionsin neonates and pregnant women. Herein, we describe a rare case of GBSrenal abscess with peritonitis and pleural effusion in a 17-year-old girl with type 1diabetes mellitus. The girl was admitted due to fever and right flank pain. Laboratoryfindings included leukocytosis and increased C-reactive protein level anderythrocyte sedimentation rate. Her serum glucose level was 484 mg/dL. Urinalysisshowed no pyuria. Renal sonography revealed parenchymal swelling in the rightkidney. The patient was administered intravenous cefotaxime. Urine and bloodcultures were negative. Fever seemed to improve, but the following day, she complainedof abdominal pain and fever. Antibiotic was switched to imipenem, andabdominal and pelvic CT revealed a ruptured right renal abscess, peritonitis, andbilateral pleural effusion with atelectasis. Pigtail catheter drainage of the abscesswas performed. Culture from the abscess was positive for GBS, and fever subsided2 days after the drainage. She was discharged with oral cefixime. The clinical courseof urinary tract infections (UTIs) can be atypical in patients with diabetes, and GBScan be a cause of UTIs. Prompt diagnosis and management are necessary to preventcomplications in patients showing atypical courses.

The kidneys play a fundamental role in the long-term control of arterial pressure by regulating sodium balance and extracellular fluid volume. The renin-angiotensin system (RAS) is at the center of the regulation of hypertension and progressive renal injury. It has gradually become clear that not only systemic RAS, but also intrarenal RAS has specific effects in the pathogenesis and progression of hypertension and renal damage. All of the RAS components are exhibited in the kidney and intrarenal angiotensin II (Ang II) is formed by multiple mechanisms. The demonstration of much enhanced levels of Ang II within specific renal compartments points out selective local regulation of Ang II in the kidney, showing that intrarenal Ang II levels are regulated in a way different from circulating Ang II. The importance of the RAS in involving proper nephrogenesis is also well known, and suppression of the RAS during fetal development may play a key role in mediating the structural and physiological changes observed in models of fetal programming of hypertension.
Angiotensin II ; Arterial Pressure ; Blood Pressure ; Extracellular Fluid ; Fetal Development ; Hypertension ; Kidney ; Negotiating ; Renin-Angiotensin System ; Sodium

No abstract available.
Humans ; Pregnancy, Twin* ; Twins*

No abstract available.
Cervix Uteri* ; Female ; Hysterectomy*

Forty cases of infiltrating duct carcinoma of the breast were examined immunohistochemically for expression of TGF-beta and angiogenesis in order to analyze significant correlation with prognostic parameters including tumor size, axillary lymph node metastasis, clinical stage, histologic grade, estrogen receptor and progesterone receptor status. The TGF-beta expression was observed in tumors center and advancing edges of tumors. To determine microvessel density for angiogenesis, we stained endothelial cells for Factor VIII related antigen and counted microvessel within tumor. The results were as follows: 1) The strong immunohistochemical expression of TGF-beta and higher counts of microvessels were observed in advancing edges of tumors (p<0.05). 2) The TGF-beta expression in the advancing edges of tumors was closely related to clinical stage and presence of axillary lymph node metastasis (p<0.05). 3) The mean microvessel counts were significantly higher in tumors from patients with axillary lymph node metastasis and increased with increasing clinical stage (p<0.05). 4) The TGF-beta expression was not related to histologic grade, estrogen receptor and progesterone receptor status(p>0.05). Therefore, the results suggested that the TGF-beta expression and angiogenesis in infiltrating duct carcinoma of the breast may play an important part in prognostic factors, closely related to the lymph node metastasis and clinical stage.
Neoplasm Metastasis

Various forms of hypogammaglobulinemia can occur in patients with autoimmune diseases and vice versa. We report a 13-yr-old boy with membranous nephropathy and common variable immunodeficiency. He presented with the nephrotic syndrome, pneumonia with bronchiectasis, and profound hypogammaglobulinemia. Renal biopsy showed diffusely thickened glomerular capillary walls with 'spikes' suggesting a membranous nephropathy. Secondary causes were ruled out by laboratory studies; however, heavy proteinuria persisted with steroid therapy. Cyclosporine and intravenous immunoglobulin were added, and the patient was discharged with decreased proteinuria. Hypogammaglobulinemia may have a deleterious impact on the immune dysregulation in some patients with membranous nephropathy.
Adolescent ; Bronchiectasis/etiology ; Common Variable Immunodeficiency/complications/*diagnosis/drug therapy ; Cyclosporine/therapeutic use ; Drug Therapy, Combination ; Glomerulonephritis, Membranous/complications/*diagnosis/drug therapy ; Humans ; Immunoglobulins/therapeutic use ; Immunosuppressive Agents/therapeutic use ; Injections, Intravenous ; Kidney/pathology ; Male ; Pneumonia/etiology ; Proteinuria/etiology ; Steroids/therapeutic use

Osteopontin (OPN) is a glycosylated phosphoprotein which mediates cell adhesion and migration, and is produced by bone, macrophages, endothelial cells, and epithelial cells. The many regulatory functions of OPN include bone remodeling, tumor invasion, wound repair, and promotion of cell survival. It is produced by renal tubular epithelial cells, and expression is upregulated in glomerulonephritis, hypertension, ischemic acute renal failure, renal ablation, and UUO. In this review, we discuss about osteopontin in general aspect, expression, role on the development and pathologic condition of neonatal kidney.
Acute Kidney Injury ; Bone Remodeling ; Cell Adhesion ; Cell Survival ; Endothelial Cells ; Epithelial Cells ; Glomerulonephritis ; Hypertension ; Kidney* ; Macrophages ; Osteopontin* ; Wounds and Injuries

A primary squamous cell carcinoma of the thyroid is extremely rare disease. We evaluated this disease by fine needle aspiration cytology in a 43 year-old female. On physical examination, the thyroid was moderately enlarged and palpated with hard consistency. The cytologic aspirate revealed nests of squamous cells, malignant squame and thyroid follicular cells in the necrotic background. We diagnosed this tumor as squamous cell carcinoma with cytologic evidence. Surgically resected thyroid revealed well differentiated squamous cell carcinoma. Immunohistochemical staining for antithyroglobulin proved that this tumor was primary in origin and clinical study confirmed this lesion to be of primary thyroid origin rather than metastasis or direct invasion from contiguous structures.
Adult ; Biopsy, Fine-Needle* ; Carcinoma, Squamous Cell* ; Female ; Humans ; Neoplasm Metastasis ; Physical Examination ; Rare Diseases ; Thyroid Gland*

Four patients were treated who had limited flexion of the hips and various degrees of contracture of the abduction and external rotator muscles because of fibrosis of the gluteus maximus muscle. Each patient had a typical restriction of motion such that an affected hip could not be flexed in the usual sagittal plane, but had to be flexed in abduction. Genetic, congenital and postnatal factors have been suggested as the cause of fibrosis of gluteus maximus muscle. Three of the 4 patients reported here are of congenital origin and another one is of postnatal factor repeated intramuscular injections. Excellent correction of the hip contracture was achieved in all patients by division of the fibrotic bands.
Contracture ; Fibrosis ; Hip Contracture ; Hip ; Humans ; Injections, Intramuscular ; Muscles

Purpose: The aim of this study is to evaluate the clinical utility of late 6-month dimercapto-succinic acid (DMSA) renal scan in predicting vesicoureteral reflux (VUR) and long-lasting renal scars in children with first acute pyelonephritis (APN). Methods: A retrospective case study of children admitted with APN from January 2010 to July 2017 was performed. The study included patients with voiding cystourethrography (VCUG) and acute and late 6-month DMSA scan. We analyzed the clinical, laboratory and imaging findings of patients with and without late cortical defects at 6 months and those with or without VUR. Results: Among 145 children with APN, 50 (34.5%) had cortical defects on the late DMSA renal scan and 60 (41.4%) showed VUR. Thirteen of 38 (34.2%) children undergoing 18-month DMSA renal scan showed a long-lasting renal scars. Compared with children without late cortical defects, patients with late 6-month cortical defects had a higher incidence of VUR and long-lasting renal scars, and relapse of UTI (all P<0.05). In a multivariable analysis, both high-grade VUR and relapse of UTI were independently correlated with the presence of late 6-month cortical defects (P<0.05). Late cortical defects and relapse of UTI were also associated with the presence of VUR (P<0.05). Only the late 6-mo cortical defects was an independent predictor of long-lasting renal scars in children with APN (P<0.05). Conclusion An abnormal late 6-month DMSA renal scan may be useful in identifying VUR and long-lasting renal scars in children diagnosed with APN.