An extremely unusual case of epidermoid cyst showing diffuse parakeratosis and aggressive clinical behavior is presented. A destructive bone lesion with surrounding ill-defined soft tissue lesion was found by computed tomography in a 63 year-old man complaining of painful swelling of the right buttock. He had a history of surgical excision twice for epidermoid cysts of soft tissue of the right hip during recent one year. On aspiration cytology, the aspirate was highly cellular and mostly composed of desquamated nucleated squamous cells. Operation finding revealed that the iliac bone was irregularly destroyed and filled with gray-white cheesy material and necrotic bone debris. Adjacent gluteus muscle showed scattered gray-white lesions. The curettage specimen showed bone necrosis and desquamated squamous cells filling the marrow spaces. The lesion within muscle revealed epidermoid cyst with diffuse parakeratosis.
Child ; Male ; Female ; Humans ; Cysts

No abstract available.
Angiotensin II* ; Angiotensins* ; Animals ; Epidermal Growth Factor* ; Rats* ; Ureter* ; Ureteral Obstruction*

Cryptorchidism is one of the most common anomalies of genitourinary tract in childhood but its pathogenesis has not been determined. And because the long term efficacy of treatment for cryptorchidism is difficult to evaluate in humans, many investigators have developed animal models. We used an animal model to study the effects of cryptorchidism on the fertility and histologic changes. Sprague-Dawley rats were treated to create mechanical cryptorchidism at 5 weeks of age and orchiopexies were done with varing intervals. After they reached puberty, each male rat was mated with two female rats five times. At 28 week old, all testes of rats were enucleated and examined microscopically. Fertility rate was 13% in control rats and there was no difference in fertility between control rats and rats with mechanical cryptochidism. Testicular volume proportionally decreased according to the duration of abdominal testis. Interestingly, in unilateral cryptorchidism, scrotal testicular volume decreased, too. Microscopically, the size and content of the seminiferous tubule and the spermatogenic index showed tendencies to decrease according to the duration of abdominal testis.
Adolescent ; Animals ; Birth Rate ; Cryptorchidism* ; Female ; Fertility* ; Humans ; Male ; Models, Animal ; Orchiopexy* ; Puberty ; Rats ; Rats, Sprague-Dawley ; Research Personnel ; Seminiferous Tubules ; Testis

The application of personal computer (PC) to manage urologic patient data is now popular in many institutes. many users were accustomed to the IBM PC and familiar with the dBASE program in managing urologic records. But in recent days, the number of Macintosh PC users are increasing because it is easy to learn and perform Macintosh which provides the excellent output under the given input data. We developed the patient management system with Excel program in Macintosh PC focusing on minimizing the effort to input the data and maximizing the output. The data fields consist of eight fields. They are chart number. name. sex. date of admission data of discharge. diagnosis and international classification of diseases. There is no need of typing the international classification of diseases because it is automatically registered by previous coding with diagnosis. We think that the application of international classification of diseases is essential to minimize the input errors. The output of data include sex ratio and variable statistics. which ere provided with graphic mode. Another output is the extract of data under the variable criteria. which are provided with worksheet mode.
Academies and Institutes ; Clinical Coding ; Diagnosis ; Humans ; International Classification of Diseases ; Microcomputers* ; Sex Ratio

PURPOSE: We assessed the significance of renal resistive index (RI) in the diagnosis of unilateral ureteral obstruction in children. MATERIALS AND METHODS: Duplex Doppler ultrasonography was performed in 4 children with unilateral ureteral obstruction which was proved by excretory urography, diuretic renal scan, and/ or pressure flow study. Renal RI values and RI ratios were calculated. RESULTS: They were 3 males and one female 4 to 26 months old. In all cases, mean RI values of obstructed kidneys were higher than 0.70 which was discriminatory level for obstruction in adults. In contralateral normal kidneys, RI values were widely distributed (0.61 to 0.79). Mean RI values of obstructed kidneys were larger than that of contralateral normal kidneys, and RI ratios were larger than 1.11 in all patients. CONCLUSION: We believe that the comparison of RI value between obstructed and contralateral normal kidney is valuable in the diagnosis of unilateral ureteral obstruction in children, and that RI ratio is also significantly. A prospective study with a larger number of patients is required to confirm this finding.
Adult ; Child* ; Child, Preschool ; Diagnosis ; Female ; Humans ; Kidney ; Male ; Ultrasonography, Doppler, Duplex ; Ureter* ; Ureteral Obstruction* ; Urography

Angiomyolipoma is considered by many authors to be a hamartoma, occurring in a sporadic form or in association with tuberous sclerosis. This lesion consists of thick walled blood vessels, smooth muscle, and mature adipose tissue in varying amounts. We have experienced a case of the angiomyolipoma composed of monotypic epithelioid cells. The patient was a 69-year-old female. Clinically, there was no evidence of tuberous sclerosis. Microscopically, the tumor was composed of polygonal cells with abundant eosinophilic granular or clear cytoplasm, pleomorphic nuclei, prominent nucleoli, and multinucleated giant cells. The tumor cells showed positive reaction for HMB45, CD68, smooth muscle actin, and S-100, and negative reaction for epithelial membrane antigen, cytokeratin, vimentin, desmin, CD34, estrogen receptor, and progesterone receptor. Ultrastructual analysis showed the presence of glycogen, mitochondria, and other microorganelles in neoplastic cells. Melanosome or premelanosome was not identified.
Actins ; Adipose Tissue ; Aged ; Angiomyolipoma* ; Blood Vessels ; Cytoplasm ; Desmin ; Eosinophils ; Epithelioid Cells ; Estrogens ; Female ; Giant Cells ; Glycogen ; Hamartoma ; Humans ; Keratins ; Kidney* ; Melanosomes ; Mitochondria ; Mucin-1 ; Muscle, Smooth ; Receptors, Progesterone ; Tuberous Sclerosis ; Vimentin

There are different patterns of muscular response according to the type of megaureter. These patterns can be used in determining the cause of the wide ureters. We studied 20 dilated ureters quantitatively and quantitatively by standard pathologic techniques using the average size and population of muscle cells in the dilated ureter as the quantitative index of workload or obstruction. In the obstructed type. the smooth muscle in the wall of the proximal dilated ureter was hypertrophic and hyperplastic. In contrast. in the refluxing type. there was neither hypertrophy nor hyperplasic of muscle in the wall of the proximal dilated ureter. By this morphometric study of muscle cells, it can be possible to identify the megaureters which are caused by obstruction not only in the excised specimen but also by a frozen section biopsy specimen.
Biopsy ; Frozen Sections ; Hypertrophy ; Muscle Cells ; Muscle, Smooth ; Ureter

We performed a retrospective study to analyze the relationship between renal scar and urinary tract infection(UTI) in children with primary vesicoureteral reflux(VUR). During the last 4 years, 24 children with VUR including 15 bilateral cases were managed in this hospital. Median followup was 2 years. Renal scar was noticed in 26(67%) out of 39 renal units. The incidence and the severity of renal scar were increased according to the grade of VUR(r=0.694, p<0.005). The correlationships between the No. of UTI and the grade of VUR and between the No. of UTI and the grade of renal scar were statistically significant(r=0.394, p<0.05, respectively). However, the age of patients did not influence the grade of VUR and the grade of renal scar. In conclusion, the incidence and the severity of renal scar in patients with VUR were significantly correlated with the grade of VUR and the No. of UTI.
Child ; Cicatrix* ; Follow-Up Studies ; Humans ; Incidence ; Retrospective Studies ; Urinary Tract ; Vesico-Ureteral Reflux*

Unilateral ureteral obstruction(UUO) in early development impairs renal growth. To investigate the potential role of growth-related peptides in this response, Sprague-Dawley rats underwent UUO or sham operation in the first 48 hours of life, and kidneys were harvested 1 to 14 days later. Renal mRNA was quantitated by Northern and dot blot with complementary DNA probes for renin and transforming growth factor beta 1(TGF-beta1). Renin distribution was determined by immunohistochemistry. Adult rats were also studied 3 or 14 days after UUO or sham operation. Unlike the neonate, in which renal DNA failed to increase with chronic ipsilateral UUO, renal DNA increased in the adult. UUO increased renal renin mRNA and protein distribution in the neonate,but mRNA expression did not change in the adult.TGF-beta1 expression increased in the obstructed kidney in both neonates and adults. Since renal renin expression is increased by UUO, it was hypothesized that by activation of angiotensin II type 1 receptor, angiotensin II regulates expression of TGF-beta1 in the obstructed kidney. Sprague-Dawley rats underwent left UUO or sham operation within the first 48 hours of life, and received losartan or saline. After 14 days, steady-state renal mRNA was determined for renin and TGF-beta1. Losartan reduced the DNA content of the intact kidneys, but did not further decrease that of the obstructed kidney. Losartan increased renal renin expression regardless of UUO. In contrast, losartan reduced TGF-beta1 expression by 34% in obstructed kidneys, but did not affect TGF-beta1 in intact kidneys. In conclusion, neonatal UUO delays renal maturation, possibly related to altered renin and TGF-beta1 expression and activation of the angiotensin II type 1 receptor is necessary for normal renal growth, and TGF-beta1 is regulated by angiotensin II type 1 receptor in the obstructed, but not intact kidneys.
Adult ; Angiotensin II ; Animals ; DNA ; DNA, Complementary ; Humans ; Immunohistochemistry ; Infant, Newborn ; Kidney ; Losartan ; Peptides ; Rats* ; Rats, Sprague-Dawley ; Receptor, Angiotensin, Type 1 ; Renin* ; RNA, Messenger ; Transforming Growth Factor beta* ; Transforming Growth Factor beta1 ; Transforming Growth Factors* ; Ureter* ; Ureteral Obstruction*

Effect of Enoxacin (Flumark), an oral pyridone carboxylic acid, in the urinary tract infection was evaluated clinically and susceptibility of 292 strains of microorganism isolated from urine to the various antimicrobial agents was tested and compared. Thirty six patients with urinary tract infection were given with 300 to 600mg of Enoxacin daily for 7 to 14 days according to severity of urinary tract infection. The clinical symptoms and urinary findings improved in 30 patients (83.3%) and no clinical response was achieved in 6 patients (16.7%), but revealing 100% response in 9 patients of acute uncomplicated cystitis. In the antimicrobial susceptibility test, Enoxacin was much superior to aminoglycoside, especially against Pseudomonas aeruginosa. Serratia spp., Enterobacter spp. and other Pseudomonas spp.. Enoxacin is a very effective and safe antimicrobial agent in treatment of the urinary tract infection.
Anti-Infective Agents ; Cystitis ; Enoxacin ; Enterobacter ; Humans ; Pseudomonas ; Pseudomonas aeruginosa ; Serratia ; Urinary Tract Infections* ; Urinary Tract*