We present a case of 15 months old male with Multilocular cystic nephroma (MLCN) which contains fibroblast, smooth muscles, skeletal muscles and well differentiated tubular structure in the septa without evidence of blastemal or embryonal elements. There is no evidence of metastasis and local recurrence after post-op 2 years.
Child* ; Fibroblasts ; Humans ; Infant ; Male ; Muscle, Skeletal ; Muscle, Smooth ; Neoplasm Metastasis ; Recurrence

From January 1988 to January 1996, 42 infants and children (44 renal units) had undergone surgical management to correct ureteropelvic junction obstruction. Median patient age was 8.5 years (range from 2 months to 17 years) and 11 patients were less than 1 year old at operation. Of 44 renal units surgically managed, 30 were on the left side and 10 were right side. 2 patients had undergone bilateral surgical management. Presenting symptoms were febrile urinary tract infection in 14 cases, abdominal pain in 14 cases, abdominal mass in 5 cases, gross hematuria in 3 cases and 3 cases were detected prenatally. We used imaging antegrade pyelography (AGP) in 15 cases, additional retrograde pyelography (RGP) in 12 cases and both AGP and RGP were performed in 1 case. To correct ureteropelvic junction obstruction, we performed dismembered pyeloplasty in 33 renal units, ureterolysis in 2 renal units, ureterocalycostomy in 1 renal unit, endopyelotomy in 1 renal unit and nephrectomy in 7 renal units. To diverge the urinary flow, we used nephrostomy in 19 renal units, ureteral stenting in 6 renal units and both nephrostomy and ureteral stenting were used in 10 renal units. As postoperative complications, restenosis was developed in 5 renal units, delayed open in 5 renal units, urinary tract infection in 2 renal units and wound infection, prolonged urine leakage, ureteral stone in each 1 renal unit. Postoperative success rate in followed-up patients, who had undergone pyeloplasty, was 91.6%. The success rate in children, who was less than 1 year old, was 100% and in children, who was more than 1 year old, was 88.4%. Finally we suggest that the surgical correction is safe and proper method for ureteropelvic junction obstruction in children. Additionally early operation of ureteropelvic junction obstruction is recommendable.
Abdominal Pain ; Child* ; Hematuria ; Humans ; Infant ; Nephrectomy ; Postoperative Complications ; Stents ; Ureter ; Urinary Tract Infections ; Urography ; Wound Infection

Proper management of childhood and adolescent varicocele remains still controversial. In general, all methods for varicocele ablation for adults are available and include open surgical ligation, laparoscopic ligation, or percutaneous ablation. We evaluated the usefulness of percutaneous embolization of internal spermatic vein in boys with varicocele. Between February 1988 to May 1996, 48 boys of 53 varicoceles underwent percut aneous embolization. In 49 cases, the embolization were technically possible and in the other 4 cases, we could not access the internal spermatic vein because of vasospasm and venous abnormality. The results were successful in 40 cases (81.6%) and failed in 9 cases (18.4%), including 4 (8.2%) of persistent and 5 (10.2%) of recurred cases. There were no major complications except 3 cases of extravasation of contrast material. Percutaneous embolization may be recommended as a primary treatment for childhood and adolescent varicocele.
Adolescent* ; Adult ; Humans ; Ligation ; Varicocele* ; Veins*

PURPOSE: To evaluate the hemodynamic status of varicocele, 99m Tc-RBC venography was performed in 29 varicocele patients and 10 normal controls from January to July 1996. MATERIALS AND METHODS: The mean age of varicocele patients was 23 years old and of normal controls was 27 years old. Among 29 varicocele patients, 26 had varicocele in left side and 3 had in both side. In unilateral varicocele group. 2 cases had grade I, 8 cases had grade II and 16 cases had grade III varicocele. In bilateral varicocele group, all had grade III in le% side and grade II varicocele in right side. RESULTS: The mean+/-SD of left to right radionuclide uptake ratio in pampiniform plexus during resting and Valsalva maneuver state was 1.01 +/-0.04:1 and 1.05+/-0.05:1 in normal control, 1.05+/-0.02:1 and 1.10:1 in varicocle grade I, 1.21+/-0.19:1 and 1.21 +/-0.12:1 in varicocele glade II, 1.60+/-0.63:1 and 1.27+/-0.18:1 in varicocele grade III, 1 18+/-0.06:1 and 1.26 in bilateral varicocele. As varicocele grade be higher, the mean left to right radionuclide uptake ratio be larger during resting and Valsalva maneuver state. CONCLUSIONS: 99mTc-RBC venography can quantify the hemodynamic state of varicocele so we suggest that it is useful as a method of diagnosis and follow up in varicocele patient.
Adult ; Diagnosis ; Follow-Up Studies ; Hemodynamics* ; Humans ; Phlebography* ; Valsalva Maneuver ; Varicocele* ; Young Adult

We report two cases of mucocele of the frontal sinus presenting with exophthalmos and diplopia. Total removal involved the transfrontal approach and neurological deficits were eliminated. Details of clinical manifestations are presented, and a review of the literature is included.
Diplopia ; Exophthalmos ; Frontal Sinus* ; Mucocele*

We report two cases of mucocele of the frontal sinus presenting with exophthalmos and diplopia. Total removal involved the transfrontal approach and neurological deficits were eliminated. Details of clinical manifestations are presented, and a review of the literature is included.
Diplopia ; Exophthalmos ; Frontal Sinus* ; Mucocele*

BACKGROUND AND OBJECTIVE: Precise assessment of lesion severity is fundamental for the clinical decision making in the patients with coronary artery disease. Coronary angiography has limitation to projection imaging techniques. Intravascular ultrasound (IVUS) has been known to be a gold standard of morphological severity of coronary stenosis. Fractional flow reserve (FFR) is known to be a lesion specific functional index of epicardial stenosis that can be derived from intracoronary pressure assessed during maximal vasodilation. The objective of this study was to investigate the validity of fractional flow reserve for stenosis severity in comparison with IVUS. METHODS: The study population consisted of 24 patients with angina pectoris (M:F=19:5, age: 58+/-12 yrs). The IVUS and intracoronary pressure wire performed at 26 lesions after diagnostic coronary angiography. We measured angiographical diameter stenosis (DST), minimal luminal diameter (MLD), minimal luminal area (MLA) and reference area stenosis (r-AST). FFR was defined by the ratio of distal mean coronary pressure (Pd) to aortic mean pressure (Pa). RESULTS: FFR showed significant correlation with both r-AST (r=-0.93, p<0.00001) than DST (r=-0.79, p<0.0001). When the lesions with MLD less than 1.1 mm were excluded, considering the limitation of IVUS for the thickness of its catheter, FFR showed excellent correlation with r-AST with higher correlation coefficient (r=-0.96, p<0.00001). FFR showed significant correlation with MLA (r=0.87, p=0.0001) or MLD (r=0.83, p=0.0005). CONCLUSION: FFR with excellent correlation with r-AST measured by IVUS seems to be a useful lesion specific functional index for the assessment of coronary stenosis in angina patients.
Angina Pectoris ; Catheters ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Stenosis ; Coronary Vessels* ; Decision Making ; Humans ; Phenobarbital ; Ultrasonography* ; Ultrasonography, Interventional ; Vasodilation

Renal angiomyolipomas are uncommon benign neoplasms composed of mature adipose tissue, thick walled blood vessels and smooth muscle in varying proportions. Accurate preoperative diagnosis of renal angiomyolipoma is essential if conservative resection or angiographic embolization is to be used. In recent years, abdominal computerized tomography (CT) and renal ultrasonography have resolved the diagnostic dilemma, making detection of angiomyolipomas possible in almost all cases. Recently, we performed selective renal angioembolizations in 3 patients (2 females, 1 male). After followup period of 6 months to 1 year, all patient got better in clinical symptoms. In two of them the lesions decreased in size on followup CT but one patient showed suspicious malignant change and we performed the exploration to rule out renal malignancy. In our opinion, it is appropriate to perform the selective renal angioembolization for initial treatment of renal angiomyolipomas.
Adipose Tissue ; Angiomyolipoma* ; Blood Vessels ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Muscle, Smooth ; Ultrasonography

No abstract available.
Catheters* ; Stents*

PURPOSE: This study was performed to investigate whether the free to total PSA ratio(F/T PSA ratio) offers a better discriminant for the detection of patient with prostatic cancer(CaP) and those with benign prostatic hyperplasia(BPH) than serum total PSA alone. MATERIALS AND METHODS: From September 1996 to February 1999, free and total PSA levels were measured on frozen sera samples of 154 men with BPH and 46 with CaP using immunoradiometric assay. RESULTS: In all subjects, the mean total PSA was significantly higher in CaP group(72.59+/-66.58ng/ml) than BPH group(3.12+/-4.10ng/ml). The mean PSAD was significantly higher in CaP group(1.64+/-1.86) than BPH group(0.08+/-0.01). The mean F/T PSA ratio was significantly lower in CaP group(0.19+/-0.07) than BPH group(0.30+/-0.13). Among 41 subjects whose total PSA were between 4-20ng/ml, the mean PSAD was significantly higher in CaP group(0.37+/-0.16) than BPH group(0.17+/-0.07), but the mean F/T PSA ratio was not significantly different between CaP(0.19+/-0.10) and BPH group(0.25+/-0.13). By comparing the sensitivity and specificity of total PSA alone, PSAD and F/T PSA ratio on receiver operating characteristic(ROC) curve in all subjects and subjects with total PSA between 4-20ng/ml, F/T PSA ratio had no superiority than total PSA alone and PSAD for. discrimination between CaP and BPH. CONCLUSIONS: We suggest that the F/T PSA ratio is not superior to total PSA alone and PSAD in the detection of prostatic cancer, and further evaluation of the usefulness of F/T PSA ratio should be required.
Discrimination (Psychology) ; Humans ; Immunoradiometric Assay ; Male ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Hyperplasia* ; Prostatic Neoplasms* ; Sensitivity and Specificity