Hepatoblastoma (HB) is a rare embryonic malignant tumor of the liver. Most morphological studies on HB have limited to the histological characteristics and only 3 cases of HB have been described in the cytology literature. We present 2 cases of HB occurring in children aged 1 year and 3 years, respectively. The distinctive cytologic features of fine needle aspiration of HB were clusters of tumor cells showing acinar and trabecular pattern, smaller tumor cells with a high nuclear-cytopalsmic ratio and hyperchromatic nuclei having prominent nucleoli, and the presence of extramedullary hematopoiesis and osteoid material. These features were also found in the cell block and the biopsy specimen, and appeared very useful in the differentiation of HB from hepatocellular carcinoma.
Acute Kidney Injury* ; Biopsy ; Biopsy, Fine-Needle ; Carcinoma, Hepatocellular ; Child* ; Hematopoiesis, Extramedullary ; Hepatoblastoma ; Humans ; Liver ; Nephrosis, Lipoid*

No abstract available.
Meningitis*

No abstract available.
Biopsy, Fine-Needle* ; Breast*

No abstract available.
Tibial Fractures*

No abstract available in English.
Ankle Fractures ; Ankle ; Clinical Study

PURPOSE: Endopyelotomy is a minimally invasive surgical alternative to the classic open surgery in the treatment of ureteropelvic junction obstruction with similar success rates. We analyzed factors influencing success rates after endopyelotomy based on clinical data. MATERIALS AND METHOD: Between 1989 and 1997, we performed percutaneous antegrade endopyelotomy in 53 cases of ureteropelvic junction obstructions. Among these patients, 47 patients have been followed with range from 3 to 70 months(mean 18.1 months). Of the 47 patients, 36 had primary UPJ obstruction and 11 had secondary UPJ obstruction. A rigid urethrotome(cold knife) was employed in 31 cases, a electrotome(hot knife) in 10 and a balloon dilator in 6. A stent(14/7Fr endopyelotomy stent or 6Fr double-J stent) was placed for 4 to 12 weeks after the procedure. Coexisting stones or infundibular strictures were managed simultaneously. RESULTS: Overall success rate(measured by symptom-free status and improved uroradiographic findings) was 80.9%(86.1% in primary and 63.6% in secondary cases). Success rates related to the method of incision were as follows; 87.1% with a cold knife, 80% with a electric knife and 50% with a balloon dilator only. 14/7Fr endopyelotomy stent was used in 21 patients with a successful outcome in 19(90.5%), while 25 received 6Fr double stent with a successful outcome in 18(72%). Success rates according to the duration of stenting were as follows; 86.7% in the 8-week group, 78.6% in the 6-week group and 66.7% in the 4-week group. CONCLUSIONS: Our experience indicates that endopyelotomy can be selected as the initial procedure of choice for the selected patients with UPJ obstruction. The small number of patients in each parameter did not reach statistical significance. However, there was a trend for better results in patients with primary UPJ obstruction and with the use of 14/7Fr endopyelotomy stent.
Constriction, Pathologic ; Humans ; Stents

Changes in the urinary tract associated with prolapse uteri have been known for a long time. However, women who have a prolapse uteri are often free of symptoms. When symptoms are present they are above all, urinary tract infection, difficulties in emptying the bladder, increased frequency of micturition, stress incontinence, and ureteral obstruction. We reviewed 82 patients who had prolapse uteri of grade II and III in order to evaluate the effects of prolapse uteri to the urinary tract. There were 5 patients (6.1%) who had urinary tract infection and urine culture revealed the growth of E. coli in 3 of them. Only 1 patient (1.2%) had high blood urea nitrogen. 51 (62.2%) out of 82 patients showed voiding problems (frequency, voiding difficulty, stress incontinence) and 53 (64.6%) out of 82 patients had cystocele of several degrees, but there was no difference between the degree of prolapse uteri and both voiding problems and cystocele. Vaginal hysterectomy with anterior and posterior colpoperineorraphy was performed in 68 (88. 3%) out of 77 patients who underwent surgical treatment by gynecologists, and in 22 (91.7%) out of 24 patients who showed difficult urination, their symptoms were improved immediately after surgery. Bladder neck suspension was performed simultaneously in 3 patients who showed stress urinary incontinence with prolapse uteri. Intravenous pyelography or abdominal ultrasonography was performed to evaluate accompanied ureteral obstruction in 8 patients who had severe cystocele. In 5 patients, upper tract deteriorations were noted. Bilateral hydroureteronephrosis was found in 3 patient, unilateral lower ureteral dilatation in 1 patient, and severe parenchymal damage in 1 patient. In conclusion, we believe that urologist should participate in managing those patients who have prolapse uteri to improve their voiding problems and prevent upper urinary tract deterioration.
Blood Urea Nitrogen ; Cystocele ; Dilatation ; Female ; Humans ; Hysterectomy, Vaginal ; Neck ; Prolapse* ; Ultrasonography ; Ureter ; Ureteral Obstruction ; Urinary Bladder ; Urinary Incontinence ; Urinary Tract ; Urinary Tract Infections ; Urination ; Urography ; Uterus*

No abstract available.
Blood Transfusion, Autologous*

Biliary ascariasis is a rare complication of intestinal ascaris infestation. Retrograde migration of the adult worm through the papilla of Vater causes biliary colic, and may give rise to pancreatic and biliary obstruction, choledocholithiasis, cholecystitis, cholangitis, hemobilia, and if the worm lodges in intrahepatic bile ducts, to liver absceases. In the past, treatment of biliary ascariasis has usually involved the direct removal of ascaris throagh a surgical choledochatomy and subsequent saline lavage of the common duct through an indwelling T tube. Recently, the worm in the bile duct can be seen by ERCP and it can be removed during the endoscopic procedure. A 55-year-old woman with intermittent colicky right upper quadrant abdominal pain was admitted to out hospital. Abdominai sonogram disclosed an echogenic structure within a mildly dilated common bile duct and a high ehogenic structure with acoustic shadowing in the distal common bile duct(CBD), which suggests a CBD stone. ERCP after obtaining the sonogram revealed a thick, long, linear, smooth filling defect in the CBD with a distal CBD stone. A distal CBD stone was removed by sphinctetotomy and lithotripsy, then we directly extracted ascaris with a tripod forcep without any complication.
Abdominal Pain ; Acoustics ; Adult ; Ascariasis* ; Ascaris ; Bile ; Bile Ducts ; Bile Ducts, Intrahepatic ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Cholecystitis ; Choledocholithiasis ; Colic ; Common Bile Duct* ; Female ; Hemobilia ; Humans ; Lithotripsy ; Liver ; Middle Aged ; Shadowing (Histology) ; Surgical Instruments ; Therapeutic Irrigation

In an attempt to investigate the pattern of the urinary acidification process in the Korean, the urinary excretion of phosphate, ammonia, and the titratable acid were measured in 20 medical students (A group) and in 15 psychiatric patients (B group) under regular Korean diets, while the effects of high protein diets on them were studied in 4 subjects. In addition, TmPO4 was also determined in 11 subjects. The urinary excretions of phosphate, titratable acid, and ammonia under regular Korean diets were markedly lower as compared to those of the Europeans. However, there was no difference in the plasma concentration of phosphate between the Korean and the European. Upon administration of high protein diets, the urinary excretions of phosphate and titratable acid increased while the urine pH and the ammonia excretion were little affected. Thus, the correlations between urinary nitrogen and titratable acidity were 0.50 and 0.65, respective1y, showing a linear relationship. However, the correlation between urinary nitrogen and ammonia excretion was slight. The value of TmPO4 ranged from 74 to 355 muM/min with the mean of 193 muM/min, which is considerably higher than that of the European. On the basis of these findings, the overall pattern of the urinary acidification processes in the Korean is discussed.
Acids/*urine ; Adult ; Ammonia/*urine ; Asian Continental Ancestry Group ; Dietary Proteins ; Human ; Kidney Function Tests ; Korea ; Male ; Phosphates/*urine ; Protein Deficiency/metabolism