Pyriform sinus fistula (PSF) is a persistent embryologic third or fourth pharyngeal pouch, which typically presents as a congenital sinus tract that originates from the pyriform sinus. PSF is among the most uncommon congenital malformation of the neck. The usual clinical manifestations are either acute thyroiditis or abscess, usually on the left side of the neck. We report a case of PSF in a 9-year old female with a left cervical abscess who had been diagnosed by barium esophagogram and treated endoscopically by injection of histoacryl.
Abscess ; Barium ; Child ; Enbucrilate* ; Female ; Fistula* ; Humans ; Neck ; Pyriform Sinus* ; Thyroid Gland ; Thyroiditis

No abstract available.
Nephrotic Syndrome*

Last year, an epidemic of infantile urinary stone disease developed in China. Investigation revealed that melamine-tainted diary product caused urinary stone in these infants. Young infants were susceptible to the melamine toxicity and dehydration or other stone-prone factors aggravated the toxicity. Melamine-related urinary stones were small, multiple, and mainly composed of uric acid, thus conservative treatment of hydration and urine alkalinization worked well in majority of the patients.
China ; Dehydration ; Humans ; Infant ; Triazines ; Uric Acid ; Urinary Calculi

Nocturnal polyuria is one of the main pathogenic mechanisms of enuresis. Disturbance of circadian rhythm of antidiuretic hormone (ADH or AVP), hypercalciuria, and/or solute diuresis are considered to cause nocturnal polyuria, which in turn causes enuresis in patients with relatively small bladder capacity and high threshold for awakening. Evaluation of these factors would guide the therapeutic approach for enuresis.
Circadian Rhythm ; Diuresis ; Enuresis ; Humans ; Hypercalciuria ; Polyuria ; Urinary Bladder

Kidney allograft transplantation is the most effective method of renal replacement for end stage renal disease patients. Still, it is another kind of 'disease', requiring immunosuppression to keep the allograft from rejection(allograft immune reaction). Immune system of the allograft recipient recognizes the graft as a 'pathogen(foreign or danger)', and the allograft-recognizing commander- in-chief of adaptive immune system, T cell, recruits all the components of immune system for attacking the graft. Proper activation and proliferation of T cell require signals from recognizing proper epitope(processed antigen by antigen presenting cell) via T cell receptor, costimulatory stimuli, and cytokines(IL-2). Thus, most of the immunosuppressive agents suppress the process of T cell activation and proliferation.
Humans ; Immune System ; Immunosuppression ; Immunosuppressive Agents ; Kidney ; Kidney Failure, Chronic ; Receptors, Antigen, T-Cell ; Rejection (Psychology) ; Transplantation Tolerance ; Transplantation, Homologous ; Transplants

For solid organ transplant, ABO blood type of donor and recipient should be compatible in principle. Recent improvement of immunosuppressant made HLA typing not so important while no-mismatch transplant still shows the longest graft survival. PRA(panel reactive antibody) test is to screen and identify recipients with HLA sensitization. When solid organ transplant is scheduled, cross-match test of donor cell and recipient serum should be performed and positive result of cross-match prohibits transplantation. Donor specific antibody (DSA) test can predict the severity of recipient immune reaction against donor organ. Today's mainstay of allograft immunosuppressant regimen is triple therapy of steroid, calcineurin inhibitor(cyclosporine, tacrolimus), azathioprine or mycophenolate mofetil(MMF). Antibody induction using Thymoglobulin or anti-IL-2 receptor antibody(basiliximab or daclizumab) is frequently practiced as well.
Antilymphocyte Serum ; Azathioprine ; Calcineurin ; Graft Survival ; Histocompatibility Testing ; Humans ; Immunosuppression ; Kidney ; Kidney Transplantation ; Tissue Donors ; Transplantation, Homologous ; Transplants

Pediatric kidney transplantation is the best option since it can achieve near normal glomerular filtration rate, adequate fluid balance, and autonomic endocrine function of the kidney in end-stage kidney disease. However, pediatric kidney transplantation is difficult because children are developing and growing, management and complications of pediatric kidney transplantation are different from those of adults. This review covers the current status of pediatric kidney transplantation in Korea, key considerations that must be taken before kidney transplantation in children, and management strategy of immunosuppression and common complications.

Pediatric kidney transplantation is the best option since it can achieve near normal glomerular filtration rate, adequate fluid balance, and autonomic endocrine function of the kidney in end-stage kidney disease. However, pediatric kidney transplantation is difficult because children are developing and growing, management and complications of pediatric kidney transplantation are different from those of adults. This review covers the current status of pediatric kidney transplantation in Korea, key considerations that must be taken before kidney transplantation in children, and management strategy of immunosuppression and common complications.

Focal segmental glomerulosclerosis (FSGS) is the most common glomerulopathy that progresses to end-stage renal disease in children. It is also notorious for frequent recurrence after transplantation. The recurrence of FSGS after transplant leads to the loss of the grafts in nearly half of the recurrent cases, especially in those who did not respond to treatment. Remission can be achieved in majority of the recurrent patients as long as the treatment is initiated early enough (<48 hours after onset). Since recurrence typically manifests as massive proteinuria, usually within a few days after the engraftment, close monitoring of proteinuria and prompt treatment on recurrence is advisable. Plasmapheresis to remove the 'circulating factor' been used as a mainstay of treatment of the recurrence; on each session, one to two times of plasma volume is exchanged, and the treatment is continued for 8~12 sessions or until remission is achieved. High dose cyclosporine is another arm of commonly practiced treatment with good result. Recently, depletion of B cells by rituximab has been tried as another option of treatment of recurrence, with excellent response by some and no response by others. Again, prompt administration of the treatment seems critical to achieve remission. The efficacy of pre-emptive, prophylactic plasmapheresis before transplantation is controversial. In summary, the recurrence of primary FSGS is observed in more than half of the children after transplantation. Prompt initiation of treatment would improve the survival. To improve the prognosis of recurrent primary nephrotic syndrome/FSGS, close monitoring and multidisciplinary approach is required.
Antibodies, Monoclonal, Murine-Derived ; Arm ; B-Lymphocytes ; Child ; Cyclosporine ; Glomerulosclerosis, Focal Segmental ; Humans ; Kidney Failure, Chronic ; Nephrotic Syndrome ; Plasma Volume ; Plasmapheresis ; Prognosis ; Proteinuria ; Recurrence ; Rituximab ; Transplants ; Treatment Outcome

Forty eight female Sprague-Dawley rats received a subcutaneous implant containing 12.5 mg estradiol ant the age of 3 weeks. Three rats were killed in 1, 2, 3, 4, 6 weeks and in every month during 2~12 months after implantation, and the breasts were examined by light microscope. In all rats, enlargement of terminal end buds was obseved in 1~2 weeks, maximum development of hyperplastic alveolar nodules in 3 weeks, and marked dilatation and secretion of alveoli or ducts in 1~12 months after implantation. Ductal epithelial hyperplasia was observed in 27 rats and carcinomas developed in 23 rats in 2~12 months after implantation. It was thought that the changes induced by estradiol are more similar to the human breast lesions, compared with changes induced by chemical carcinogens such as dimethylbenzanthracene(DMBA), because breast carcinomas developed in close relationship with ductal epithelial hyperplasia in both estradiol-treated rats and humans, but not in DMBA-treated rats.
Female ; Humans ; Rats ; Animals ; Carcinogens