No abstract available.
Arthralgia*

There have only been 35 pediatric cases and one adult case reported on segmental multicystic dysplastic kidney (MCDK) from our search in PubMed, including 19 cases detected antenatally. There is little documentation of segmental MCDK, particularly concerning its natural history. Segmental MCDK can be presented atypically, making diagnosis more difficult. We report an another case with segmental MCDK. Multicystic abdominal mass detected on antenatal sonogram in this infant was diagnosed as segmental MCDK by renal ultrasonography and computed tomography. If a definitive diagnosis of segmental MCDK can be made on imaging, surgery is not required for a diagnostic biopsy.
Adult ; Biopsy ; Female ; Humans ; Infant ; Multicystic Dysplastic Kidney ; Natural History

In order to study the effects of aminoglycosides on leukochemotaxis in rats, the degree of leukocyte infiltration and differential leukocyte count were observed at the experimentally inflamed tissue by incision of the skin and the application of endotoxin subcutaneously after the administration of gentamicin and streptomycin respectively. The results obtained were as follows. 1) In the control group treated with physiological, saline, the infiltration of leukocytes was relatively scant in the first nne hour, conspicuously increased three hours later, and persisted for 24 hours. 2) In the gentamicin and streptomycin treated groups, infiltration of leukocytes was srnall in number in the first hour. There after it gradually increased over a period of time. However it was a little less in the gentamicin and streptomycin injected group compared with the control. 3)In the control group, about 90% of the infiltrated cells was neutrophils up to three hours. However 24 hours later, the neutrophils reached about 40%. On the other hand, monocytes and lymphocytes were 4% in the first hour, and after 24 hours the monocytes was 19 to 24% and lymphocytes were 31 to 36%. 4) In the gentamicin and streptomycin injected grougs, about 90% of the infiltrated cells was neutrophils for the first three hours. The numbers gradually decreased to 56-66% and 51~54% after 24 hours, respectively. The percentage of both monocytes and lymphocytes was 2~4% after ome hour, and increased to 15~29 and 17~29% after 24 houre, respectively.
Aminoglycosides* ; Animals ; Gentamicins ; Hand ; Leukocyte Count ; Leukocytes ; Lymphocytes ; Monocytes ; Neutrophils ; Rats* ; Skin ; Streptomycin

No abstract available.
Animals ; Doxorubicin* ; Mononuclear Phagocyte System* ; Rats* ; Vincristine*

No abstract available.
Emergencies* ; Emergency Service, Hospital* ; Humans ; Statistics as Topic*

PURPOSE: Minimally invasive management of small renal tumors has become more common. We compared the results of partial nephrectomy by video-assisted minilaparotomy surgery (VAMS), open, and laparoscopic techniques. MATERIALS AND METHODS: We retrospectively compared clinicopathological, oncological, and functional outcomes in 271 patients who underwent partial nephrectomy for renal tumors at one institution from 1993 to 2007; including 138 by VAMS, 102 by open, and 31 by laparoscopic technique. RESULTS: Mean follow-up was 47.7+/-29.1 months. No statistically significant differences in the three groups were found in tumor size, tumor location, estimated blood loss, complication rate, preoperative glomerular filtration rate (GFR), and GFR at last follow-up. Ischemic time was shorter in the open (26.9 min) and VAMS (29.3 min) groups than in the laparoscopic group (31.0 min, p=0.021). Time to normal diet and hospital stay were shorter in the VAMS (1.8 days and 5.4 days) and laparoscopic (1.8 days and 4.7 days) groups than in the open group (2.4 days and 7.3 days, p=0.036 and p<0.001, respectively). Of 180 patients with cancer, positive surgical margins occurred in 2 of 82 patients (2.4%) in the VAMS group, none of 75 patients in the open group, and 3 of 23 patients (13.0%) in the laparoscopic group (p=0.084). In the VAMS, open, and laparoscopic groups, 5-year disease-free survival was 94.8%, 95.8%, and 90.3% (p=0.485), and 5-year cancer-specific survival was 96.3%, 98.6%, and 100%, respectively (p=0.452). CONCLUSION: Partial nephrectomy using VAMS technique provides surgical, oncologic, and functional outcomes similar to open and laparoscopic techniques.
Adult ; Aged ; Carcinoma, Renal Cell/mortality/*surgery ; Female ; Humans ; Kidney Neoplasms/mortality/*surgery ; Laparoscopy/instrumentation/*methods ; Laparotomy/instrumentation/*methods ; Male ; Middle Aged ; Nephrectomy/instrumentation/*methods ; Retrospective Studies ; Treatment Outcome ; Video-Assisted Surgery/instrumentation/*methods

Abrupt progression of renal scarring associated with vesicoureteral reflux (VUR) is rare in males over 2 years old of age. We report a 5 year old boy with sustained unilateral high grade VUR who experienced abrupt progression of renal scarring; he had a relative renal radionuclide uptake of 38% at 2 years of age that dropped to 8% after three years. Per his parent's wishes, he took prophylactic antibiotics for 25 months after his first febrile urinary tract infection (UTI) at 4 months old without surgical management. One episode of recurrent breakthrough infection occurred at the age of 2 years. This observation reminds us that a recommending surgical management for sustained high grade VUR associated with renal scarring might be needed. Close follow up of DMSA for renal scanning, and long term follow up of patients after the first febrile UTI are important.
Anti-Bacterial Agents ; Cicatrix ; Follow-Up Studies ; Humans ; Male ; Succimer ; Urinary Tract Infections ; Vesico-Ureteral Reflux

A 6-month-old boy with vesicoureteral reflux exhibited features of transient type 1 pseudohypoaldosteronism (PHA) in the course of urinary tract infection. PHA presents hyponatremia, hyperkalemia, and metabolic acidosis, accompanying with high urinary sodium, low potassium excretion, and high plasma aldosterone concentration. Severe electrolyte disturbance can occur in an infant with vesicoureteral reflux because of secondary PHA. Appropriate treatment of dehydration and sodium supplementation induces rapid improvement of electrolyte imbalance and metabolic acidosis resulting from secondary PHA associated with vesicoureteral reflux.
Acidosis ; Aldosterone ; Dehydration ; Failure to Thrive ; Humans ; Hyperkalemia ; Hyponatremia ; Infant ; Plasma ; Potassium ; Pseudohypoaldosteronism ; Sodium ; Urinary Tract Infections ; Vesico-Ureteral Reflux

Henoch-Schonlein purpura (HSP) is the most common vasculitis in children and is characterized by cutaneous purpura, arthritis, abdominal pain, and nephritis. Bullous skin lesions are rare in children. We report a case involving a 9-year-old female with HSP who displayed rapidly evolving hemorrhagic bullae from the primary purpuric lesions during systemic corticosteroid therapy. The bullae disappeared within 7 days of systemic corticosteroid therapy. Some scar lesions of the skin developed on acute phase recovered completely after 6 months. Bullae should not be considered as a poor prognostic factor of HSP and its renal outcome. Skin biopsy in HSP children with bullae is not necessary if clinical diagnostic criteria of HSP are met. However, further evaluation of more pediatric HSP with bullae is needed to get the clearer conclusions. We report a 9-year-old female with HSP who showed the rapidly evolving hemorrhagic bullae from primary purpuric lesions during systemic corticosteroid therapy.
Abdominal Pain ; Arthralgia ; Arthritis ; Biopsy ; Blister ; Child ; Cicatrix ; Female ; Hematuria ; Humans ; Nephritis ; Purpura ; Purpura, Schoenlein-Henoch ; Skin ; Vasculitis

BACKGROUND: Iron and vitamin D deficiencies cause a variety of health issues in children, which might have long-lasting effects even in asymptomatic cases. The present study sought to elucidate the potential association between iron status and serum vitamin D levels in infants. METHODS: We evaluated 102 infants aged 3-24 months who visited the CHA Bundang Medical Center from August 2010 to July 2011. Questionnaire and laboratory data were collected. The infants were classified into iron deficiency anemia (IDA), iron deficiency (ID), and normal groups according to hemoglobin (Hb) and ferritin levels. They were then classified into vitamin D deficiency (VDD), vitamin D insufficiency (VDI), and vitamin D sufficiency (VDS) groups according to 25-hydroxyvitamin D [25(OH)D] levels. RESULTS: VDD was present in 67% of IDA, 53% of ID, and 29% of normal subjects. The proportion of breastfed infants was the highest in the IDA (97%) and VDD (96%) groups. The odds ratio for the likelihood of iron-deficient infants to have subnormal vitamin D levels was 4.115. There was a significant correlation between Hb and 25(OH)D levels. Plasma 25(OH)D levels were lower in the winter/spring. Body mass index values were higher in the IDA/ID groups. Iron, age, and season were predictors of 25(OH)D levels. CONCLUSION: The prevalence of iron and vitamin D deficiency was high in breastfed infants. There was also a significant association between Hb and 25(OH)D levels in infants. Since all breastfed infants should receive vitamin D supplementation, there should also be concern about concurrent deficiencies in infants with IDA.
Aged ; Anemia, Iron-Deficiency ; Body Mass Index ; Breast Feeding ; Child ; Ferritins ; Hemoglobins ; Humans ; Infant ; Iron ; Odds Ratio ; Plasma ; Prevalence ; Seasons ; Vitamin D ; Vitamin D Deficiency ; Vitamins ; Surveys and Questionnaires