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

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: The diagnosis of renal scarring is very important for the pediatric patient because it has been associated with the later development of hypertension, renal failure, and end-stage kidney disease. Recent studies indicate that the sensitivity and specificity of the99mTc-DMSA single photon emission computerized tomography (SPECT) is better than IVP, USG, and 99mTC-DMSA Planar ThG Purpose Of this Study iS tO Compare 2 types Of 9%nTh DMSA renal scan(planar and SPECT) and IVP/USG in the diagnosis of renal scars. MATERIALS AND METHOD: We reviewed retrospectively the data of 49 children(72 renal units) with vesicoureteral reflux(VUR) who underwent renal cortical imaging with IVP/USG from January 1987 to August 1996. Patient ages ranged from 3 months to 14 years with a mean age 3.7 years. There were 17 boys and 12 girls(44 venal units) with 99mTc-DMSA planar with IVP/USG, and 12 boys and 8 girls(28 renal units) with 99mTc-DMSA SPECT with IVP/USG. RESULTS: The 99mTc-DMSA planar imaging identified 94.7% sensitivities while 99mTC-DMSA SPECT imaging identified 96.3% Sensitivities. And the IVP/USG identified 75.3% sensitivities. CONCLUSIONS: Recently, the 99mTc-DMSA renal scan has replaced IVP/USG in detecting renal scarring. And we show that 99mTc-DMSA SPECT studies are superior to IVP/USG, 99mTc-DMSA planar studies in detecting renal scarring. We believe that the role of 99mTc-DMSA SPECT will become increasingly important in detecting renal scarring of VUR.
Child* ; Cicatrix ; Diagnosis* ; Humans ; Hypertension, Renal ; Kidney Failure, Chronic ; Retrospective Studies ; Sensitivity and Specificity ; Succimer ; Technetium Tc 99m Dimercaptosuccinic Acid* ; Tomography, Emission-Computed, Single-Photon* ; Vesico-Ureteral Reflux*

PURPOSE: Finasteride, a 5-alpha reductase inhibitor, has recently been used as a treatment for men with benign prostate hyperplasia(BPH). This study was undertaken to determine whether free-to-total(f/t) PSA ratio changed during the finasteride therapy in patient with BPH and whether it is possible to use this new discriminant ratio after prolonged treatment with finasteride. MATERIALS AND METHODS: The study comprised 31 men (mean age 66 years) with finasteride therapy for BPH. Blood samples were taken before and after 3-13months of therapy with finasteride and f/t PSA ratio is determined using radioimmunometric assay. RESULTS: Although the mean t-PSA, f-PSA are significantly decreased after the treatment with finasteride, f/t PSA ratio remained unchanged. The duration of treatment and the level of initial t-PSA did not affect the f/t PSA ratio. CONCLUSIONS: The f/t PSA ratio is unchanged among the patients with finasteride therapy for BPH.
Finasteride* ; Humans ; Hyperplasia* ; Male ; Oxidoreductases ; Prostate* ; Prostatic Hyperplasia ; Prostatic Neoplasms

Background: The purpose of the present study was to assess the daily protein uptake and its relationship with sarcopenia, as defined by the Asian Working Group for Sarcopenia (AWGS), among elderly patients with hip fractures. Methods: Forty-seven elderly patients with hip fractures were enrolled in this retrospective observational study. The main outcome measures included protein uptake, muscle mass, and grip strength for sarcopenia in elderly patients. Sarcopenia was diagnosed according to AWGS. Wholebody densitometry was used to measure skeletal muscle mass, and muscle strength was evaluated using handgrip testing. Results: Of 47 patients with hip fractures (12 men and 35 women), 37 (79%) patients exhibited insufficient protein intake (range, 0.01-0.588 g/kg/day), and 10 (21%) patients exhibited excessive protein intake (range, 1.215-2.121 g/kg/day). The mean daily protein intake was 56.5 g (range, 7.2–136.0 g). Prevalence of low muscle strength (handgrip strength <18 kg in women and <26 kg in men) was detected in 13 (37%) women and 8 (67%) men (P=0.076). Sarcopenia (lower muscle mass and lower muscle strength) was detected in 9 (26%) women and 6 (50%) men (P=0.119). Although lower protein intake was marginally associated with sarcopenia (P=0.189), it was significantly associated with lower grip strength (P=0.042). Conclusions The present study demonstrated that insufficient protein intake in elderly patients with hip fractures was common, and lower protein intake was significantly associated with lower muscle strength.

Atypical medullary carcinomas and carcinosarcoma have unique histopathological features. Here we present a case with a breast malignancy that had pathological characteristics of both. A 54-year old patient with a malignant breast mass received 6 cycles of adriamycin-based chemotherapy, followed by 3 cycles of paclitaxel monotherapy, and had a poor clinical response to treatment. A modified radical mastectomy was performed. The pathological diagnosis was complicated by an inability to distinguish between atypical medullary carcinoma and carcinosarcoma. The findings included a tumor that was well-circumscribed, high grade and a syncytial growth pattern as well as biphasic sarcomatous and carcinomatous characteristics. In conclusion, atypical medullary carcinoma and carcinosarcoma of the breast have entirely different prognoses and should be managed differently. Both should be treated by surgical resection, and additional therapy should be considered based on the cancer with the poorer prognosis.
Breast Neoplasms* ; Breast* ; Carcinoma, Medullary* ; Carcinosarcoma* ; Diagnosis ; Diagnosis, Differential* ; Drug Therapy* ; Humans ; Mastectomy, Modified Radical ; Middle Aged ; Paclitaxel ; Prognosis

OBJECTIVE: The aims of the present study were to evaluate the changes in the maximum lip-closing force (MLF) after orthodontic treatment with or without premolar extractions and verify the correlation of these changes with dentoskeletal changes. METHODS: In total, 17 women who underwent nonextraction orthodontic treatment and 15 women who underwent orthodontic treatment with extraction of all four first premolars were included in this retrospective study. For all patients, lateral cephalograms and dental models were measured before (T0) and after (T1) treatment. In addition, MLF was measured at both time points using the Lip De Cum LDC-110R® device. Statistical analyses were performed to evaluate changes in clinical variables and MLF and their correlations. RESULTS: Both groups showed similar skeletal patterns, although the extraction group showed greater proclination of the maxillary and mandibular incisors and lip protrusion compared to the nonextraction group at T0. MLF at T0 was comparable between the two groups. The reduction in the arch width and depth and incisor retroclination from T0 to T1 were more pronounced in the extraction group than in the nonextraction group. MLF in the extraction group significantly increased during the treatment period, and this increase was significantly greater than that in the nonextraction group. The increase in MLF was found to be correlated with the increase in the interincisal angle and decrease in the intermolar width, arch depth, and incisor–mandibular plane angle. CONCLUSIONS This study suggests that MLF increases to a greater extent during extraction orthodontic treatment than during nonextraction orthodontic treatment.

Polyatreritis nodosa is a rare autoimmune disease (the immune system attacking its own body) characterized by spontaneous inflammation of the arteries (arteritis) of the body. Because arteries are involved, the disease can affect any organ of the body. The most common areas of involvement include the muscles, joints, intestines (bowels), nerves, kidneys, and skin. Gastrointestinal involvement is reported in about 50% of the cases, but bleeding complications are rare and result in a poor prognosis. Polyarteritis nodosa is most common in middle-age persons. Recently, we experienced polyarteritis nodosa which presented as small bowel bleeding and which was diagnosed by angiography, a small-bowel series, and patholgic examination of the surgically removed ileum specimen. We report this case with a brief review of the literature.
Angiography ; Arteries ; Autoimmune Diseases ; Hemorrhage ; Humans ; Ileum ; Immune System ; Inflammation ; Intestines ; Joints ; Kidney ; Muscles ; Polyarteritis Nodosa* ; Prognosis ; Skin

PURPOSE: To evaluate the efficacy of a modified small bowel follow-through (SBFT) and to optimize this technique. MATERIALS AND METHODS: Ninety-nine subjects without small bowel pathology underwent modified SBFT using oral administration of methylcellulose after taking 100ml of 120% or 100, 150, or 200ml of 70% barium. Thirty-three and 39 normal subjects undergoing enteroclysis or conventional SBFT, respectively, were also evaluated for comparison of image qualities and transit time. RESULTS: Enteroclysis was the most successful ofthree types of small bowel examination for obtaining the best quality of bowel transradiency and distension. Modified SBFT was, however much superior to the conventional series for obtaining good bowel transradiency and rapid transity time (mean, 37-49 minutes). The use of 150ml of 70% barium was better than the other three modified techniques in achieving good bowel transradiency, rapid transit time, and less flocculation. CONCLUSION: Our modified SBFT is a simple and safe method for easily improving bowel transradiency and transit time.
Administration, Oral ; Barium ; Flocculation ; Methylcellulose* ; Pathology