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No abstract available.

No abstract available.
Carpal Tunnel Syndrome*

PURPOSE: To evaluate diagnostic usefulness of ultrasonography(US) in pediatric patient with urinary tract infection. MATERIALS AND METHODS: Fifty-five children with urinary tract infection underwent renal ultrasonography and voiding cystourethrography(VCUG). The imaging findings were analyzed retrospectively. RESULTS: Renal sonograms were normal in 34 of 55 children(62%). Five of 34 patients with normal sonogram had vesicoureteral reflux of grade I to III on VCUG. Renal sonograms were abnormal in 21 of 55 children(38%). Sonographic findings included hydronephrosis, hyperechoic kidney, nephromegaly, atrophic kidney, renal abscess, and duplex ureter. Eleven of 21 patient with abnormal SOhogram had vesicoureteral reflux of grade I to IV on VCUG. CONCLUSION: Ultrasonography is an useful and reliable initial screening examination in the investigation of children with UTI. Unfortunately US is neither sufficiently sensitive nor specific for detecting VUR. VCUG provides confirmative and valuable information about vesicoureteral reflux, and VCUG should be considered as a next modality for UTI. The combined use of sonography and VCUG provides more valuable information in urinary tract infection.
Abscess ; Child* ; Humans ; Hydronephrosis ; Kidney ; Mass Screening ; Retrospective Studies ; Ultrasonography* ; Ureter ; Urinary Tract Infections* ; Urinary Tract* ; Vesico-Ureteral Reflux

There had been total 20 patients with early onset(4 months~2 years) primary nephrotic syndrome in the Department of Pediatrics, Seoul National University Children's Hospital, during the period from March 1987 to February 1993. We analysed clinical courses, response to treatment, pathological findings and prognosis of the patients And the results were as follows; 1) The initial responders to steroid treatment were 10(50%), of whom 3 became late nonresponders. Of the 10 initial nonresponders, 8 revealed continuing nonresponsiveness. 2) Incidence of hypertension was significantly higher in the intial nonresponders than in the initial responders. 3) Renal biopsies were performed in 9 initial nonresponders and 2 late nonresponders. And the results were 6 with minimal change lesion, 4 with focal segmental glomerulosclerosis and 1 with mesangiocapillary glomerulonephritis. 4) Six continuing or late nonresponders received methylprednisolone pulse therapy or cyclophosphamide. And partial remission was induced in 4 of them. 5) The overall 3 year maintenance rate of normal renal function was 81%(100% in the initial responders and 64% in the initial nonresponders). In conclusion, the initial steroid responsiveness and prognosis were poorer in patients with early onset nephrotic syndrome than in patients with usual childhood nephrotic syndrome.
Biopsy ; Cyclophosphamide ; Glomerulonephritis, Membranoproliferative ; Glomerulosclerosis, Focal Segmental ; Humans ; Hypertension ; Incidence ; Methylprednisolone ; Nephrotic Syndrome* ; Pediatrics ; Prognosis ; Seoul

Hemangioblastomas comprise 1 to 2% of all intracranial neoplasm, and 8 to 12% of tumors within the posterior fossa. They are composed of admixtures of three different cell types; endothelial cells, pericytes and stromal cells. Although most hemangioblastomas arise sporadically, they are associated with von Hippel-Lindau disease in about 20% cases. We have experienced a case of multiple hemangioblastomas occuiing in the cerebellum, medulla oblongata and cervical spinal cord simultaneously in a 55-year-old male. He had complained of headache, dizziness, generalized weakness and gait disturbance for 2 weeks. The patient had neither specific family history nor increased hematocrit. MRI showed a nonenhancing cystic lesion with an enhancing mural nodule in the right cerebellar hemisphere and two separate enhancing nodules in the medulla oblongata and dorsal cervical spinal cord at the 5-6th. Grossly, the excised mass of the cerebellum, 2.5 x 2 x 1.8cm, was solid to partly cystic, and that of spinal cord, lcm in diameter, was mostly solid. Microscopically, the tumor was composed of thin-walled blood vessels in variable size and interspersed stromal cells. The stromal cells revealed dimorphic cytoplasm that were either homogeneous and eosinophilic, or clear and vacuolated. Immunohistochemically, the endothelial cells reacted positively for glial fibrfllaty acidic protein(GFAP) and vimentin. The stromal cells reacted diffusely positively for vimentin, focally positively for GFAP and S-100 protein near the periphery of the tumor, focally positivel for neuro specipic enolase(NSE), and negatively for lysozyme, desmin and chromogranin. Ultrastructurally, the stromal cells contained numerous microfilaments and lipid droplets.

Hemangioblastomas comprise 1 to 2% of all intracranial neoplasm, and 8 to 12% of tumors within the posterior fossa. They are composed of admixtures of three different cell types; endothelial cells, pericytes and stromal cells. Although most hemangioblastomas arise sporadically, they are associated with von Hippel-Lindau disease in about 20% cases. We have experienced a case of multiple hemangioblastomas occuiing in the cerebellum, medulla oblongata and cervical spinal cord simultaneously in a 55-year-old male. He had complained of headache, dizziness, generalized weakness and gait disturbance for 2 weeks. The patient had neither specific family history nor increased hematocrit. MRI showed a nonenhancing cystic lesion with an enhancing mural nodule in the right cerebellar hemisphere and two separate enhancing nodules in the medulla oblongata and dorsal cervical spinal cord at the 5-6th. Grossly, the excised mass of the cerebellum, 2.5 x 2 x 1.8cm, was solid to partly cystic, and that of spinal cord, lcm in diameter, was mostly solid. Microscopically, the tumor was composed of thin-walled blood vessels in variable size and interspersed stromal cells. The stromal cells revealed dimorphic cytoplasm that were either homogeneous and eosinophilic, or clear and vacuolated. Immunohistochemically, the endothelial cells reacted positively for glial fibrfllaty acidic protein(GFAP) and vimentin. The stromal cells reacted diffusely positively for vimentin, focally positively for GFAP and S-100 protein near the periphery of the tumor, focally positivel for neuro specipic enolase(NSE), and negatively for lysozyme, desmin and chromogranin. Ultrastructurally, the stromal cells contained numerous microfilaments and lipid droplets.

The recently proposed Bethesda system for cervical/vaginal cytology has made a standardization related to "atypia". In cellular changes due to inflammation or repair, the word "benign cellular change" has been suggested as a substitute for atypia. Terminology related to atypical cells may become standardized, but the cytologic criteria has not been well defined yet. We evaluated 160 cases of atypical squamous cells of undetermined significance(ASCUS) by the Bethesda System(TBS). Among 30,428 cases screened, a cytologic diagnosis of ASCUS was made in 498 cases(1.6%) and 160 cases were histologically verified. ASCUS was diagnosed based on nuclear enlargement and nonclassical signs of condyloma. The results are as follows: One hundred and twenty three cases(76.9%) revealed chronic cervicitis. Thirty seven cases(23.1%) demonstrated squamous intraepithelial lesion. Among intraepithelial lesions, condyloma and mild dysplasia were 28 cases(75.7%). Moderate and severe dysplasia were 5 cases(13.5%) and 4 cases(10.8%), respectively. It is concluded that patients with ASCUS should be colposcopically examined.
Breast ; Diagnosis ; Hemolytic-Uremic Syndrome* ; Humans ; Inflammation ; Pneumococcal Infections* ; Streptococcus pneumoniae* ; Streptococcus* ; Uterine Cervicitis

Giant cell tumor (GCT) occurs very unusually in the rib (less than 1% of GCT). We present the cytologic features of GCT of the rib. It showed multiple cellular clusters composed of characteristic, benign looking osteoclast-like multinucleated giant cells and fibroblast-like mononuclear cells. The multinucleated giant cells contained numerous nuclei (average, 30 to 40 per cell, which were closely packed. The nuclei in giant cells were remarkably uniform and round to oval. The mononuclear, neoplastic stromal cells were elongated and spindle-shaped, There was no cytologically malignant portion in the tumor.
Child* ; Giant Cell Tumors ; Giant Cells ; Humans ; Ribs ; Stromal Cells ; Urinary Tract*

Malignant fibrous histiocytoma is the most common soft tissue sarcoma of late adult life, but it is rare in the pleura. We recently experienced a case of cytology of malignant fibrous histiocytoma in pleural fluid. The smear revealed histiocytic malignant cells, spindle malignant cells and inflammatory cells. The histiocytic cells showed abundant, pale cytoplasm and ovoid, irregular, eccentrically-placed nuclei. The spindle cells showed elongated nuclei. Intercellular collagen was also present.
Adult ; Child* ; Collagen ; Cytoplasm ; Diagnostic Errors ; Follow-Up Studies* ; Histiocytoma, Malignant Fibrous ; Humans ; Hypercalciuria* ; Pilomatrixoma ; Pleura ; Sarcoma