The infantile polycystic kidney disease is rare fetal urinary tract anomaly. It is inherited with an autosomal recessive pattern and recurrence rate is 25%. The gene locus is on chromosome 6p. The pathogenesis of infantile polycystic kidney is the primary defect of the collecting ducts. The ultrasonographic finding of infantile polycystic kidney is oligohydramnios, bilaterally symmetrical enlarged kidneys with maintenance of their reinform shape. The differential diagnosis with adult polycystic kidney disease is important. The massive enlargement of the kidneys is rarely seen in adult polycystic kidney disease and the examination of the parents and other members of the family is helpful to confirm the adult polycystic kidney disease. If there is severe renal involvements, stillbirth or neonatal death secondary to pulmonary hypoplasia would be developed. If it were diagnosed before viability, termination of pregnancy is recommended. In a fetus at risk, diagnosed after viability, pregnancy termination is also recommended since this condition is uniformly fatal. We present a case of infantile polycystic kidney.
Diagnosis, Differential ; Female ; Fetus ; Humans ; Kidney ; Oligohydramnios ; Parents ; Polycystic Kidney Diseases* ; Polycystic Kidney, Autosomal Dominant ; Pregnancy ; Recurrence ; Stillbirth ; Urinary Tract

This study was carried out to research the adaptation patterns of head posture after activator therapy in functional class ill malocclusion patients. For this purpose, 29 functional class III malocclusion patients, from the ages of 8 to 13 years old, were used. 1. Increase in capacity of oral cavity capacity were found in all the samples, but craniocervical angulation were varied into increased group and decreased group after activator therapy. 2. Head posture exhibited the compensatory adaptation in the relative growth increments of the vertical dimension, ALFH and PLFH. 1) A group with more PLFH and less sagittal angle showed relatively small growth increment in PLFH during the treatment period, thus craniocervical angulation was increased. 2) A group with less PLFH and more sagittal angle showed relatively great growth incrmenet in PLFH during the treatment period, thus craniocervical angulation was decreased.
Adolescent ; Head* ; Humans ; Malocclusion* ; Mouth ; Posture* ; Vertical Dimension

No abstract available.
Peripheral Vascular Diseases*

PURPOSE: This study aimed to evaluate the tumor biologic behavior and prognostic value of inverted papilloma (IP) of the urinary tract. MATERIALS AND METHODS: Thirty-one cases (27 males and 4 females, mean age 55.2 years) of urinary IP that were treated at a single center were retrospectively reviewed. There were 21 cases with bladder IP only (group 1), 8 cases with bladder IP and transitional cell carcinoma (TCC) within a single neoplasm (group 2), and 2 cases with IP and TCC in a different location (group 3). The patient and tumor characteristics were analyzed. RESULTS: There was a male predominance with hematuria being the main presenting symptom in all groups. The most common macroscopic feature of IP was a polypoid lesion in group 1. The most common location of IP was bladder neck (57.1%) in group 1 and lateral bladder wall (75%) in group 2. The most common associated urologic disease was benign prostatic hyperplasia in group 1. Transurethral resection was performed in 30 cases (96.8%). There were no recurrences at a mean follow-up of 19.4 (3-68) months after surgery in 27 cases followed for 3 months or longer. CONCLUSIONS: One-third of urinary IP were associated with TCC within a single neoplasm or in a different location, and this suggests that IP has a malignant potential. However, because there was no recurrence in IP of the urinary tract, a surveillance protocol as frequent as the one suggested for urothelial cancer does not seem to be necessary.
Carcinoma, Transitional Cell ; Female ; Follow-Up Studies ; Hematuria ; Humans ; Male ; Neck ; Papilloma, Inverted* ; Prostatic Hyperplasia ; Recurrence ; Retrospective Studies ; Urinary Bladder ; Urinary Tract* ; Urologic Diseases

PURPOSE: Some authors noted unilateral testicular torsion often leading to a damage in the contralateral testis. But it is not known whether this is the result of an intrinsic abnormality in the remaining testis or testicular injury associated with the ischemic event. Recently some authors noted an increase in germ cell apoptosis in the contralateral testis and suggested the involvement of nitric oxide (NO) in the apoptosis of germ cells. We aimed at the NO involvement in testicular torsion in this study, in which we measured inducible nitric oxide synthase (iNOS) expressions and found pathological changes in the torsed and detorsed testes of the rats. MATERIALS AND METHODS: Adult, male, Sprague-Dawley rats were divided into two groups: I) unilateral left testicular torsion persisting for 1, 4, 8 hours. II) torsion for 4 or 8 hours followed by detorsion. Testes were fixed in scrotal wall with a suture. Testes were fixed in formalin solution and prepared in paraffin blocks and slide mounted. All histologic examinations were done by a single observer. The expression of iNOS gene in the testis was determined by reverse transcriptase-polymerase chain reaction and relative iNOS mRNA levels were assessed with normalization to beta-actin mRNA levels. RESULTS: Histologically, the degeneration and inflammation were found in 4 hours after torsion and the necrosis was found in 8 hours after torsion. In contralateral testis, normal findings were noted in 4 hours and 8 hours after torsion. iNOS gene expression was found in the normal control testis. In the torsed testis, iNOS gene expression significantly increased in 1 hour after torsion, then decreased to the control level. In contralateral testis, iNOS gene expression was also increased in 1 hour to 8 hours after torsion. After detorsion, iNOS gene expression significantly decreased in detorsed testis, but constantly increased in contralateral testis. CONCLUSIONS: In rats, iNOS gene expression and histological changes were observed in torsed and detorsed testes. These results support the hypothesis that NO by iNOS protein may play a role in contralateral testicular damage, such as ischemic-reperfusion injury.
Actins ; Adult ; Animals ; Apoptosis ; Formaldehyde ; Gene Expression ; Germ Cells ; Humans ; Inflammation ; Male ; Necrosis ; Nitric Oxide ; Nitric Oxide Synthase Type II ; Paraffin ; Rats* ; Rats, Sprague-Dawley ; RNA, Messenger ; Spermatic Cord Torsion ; Sutures ; Testis*

We reviewed MR angiograms to evaluate its efficacy for visualizing the renal arteries and detecting renovascular disease. 41 renal arteries in 19 patients were examined by MR angiography. 3-D time-of-flight technique was used as routine examination method for MR angiography and 2-D time-of-flight technique was added in some particular cases to visualize venous flow. Within two weeks after MR angiography was performed, 23 renal arteries in 10 patients were additionally examined by conventional angiography or intraarterial DSA. The success rates of vessel visualization on MR angiography in normal renal arteries were 100% in main 67.7% in segmental, and 11.8% in intrarenal arteries. As a result of comparative study in normal main renal arteries with MR angiograms and conventional angiograms, overall correspondence in the number and the shape was noted and the caliber discrepancy between two examination did not exceed 3.0 mm. one arteriovenous fistula with aneurysm, one stenotic artery and two occluded arteries were well evaluated One arteriovenous fistula with aneurysm, and two occluded arteries were well evaluated by MR angiography. However three stenotic lesions were misdiagnosed as occlusions on MR angiography. and the overall accuracy was 87%. We conclude that MR angiography has the potential to be a noninvasive and useful screening method for determining the number of renal arteries and for detection of abnormalities of main renal arteries.
Aneurysm ; Angiography* ; Arteries ; Arteriovenous Fistula ; Humans ; Mass Screening ; Methods ; Renal Artery*

OBJECTIVES: To determine if hysterectomy with or without ovarian preservation is asso-ciated with obesity in premenopausal women. METHODS: 581 women for routine check up from Jan. 1985 to Dec. 1995 in the depart-m ent of Gynecology at Korea Veterans Hospital were included. The obesity was evaluated by BMI(body mass index) scores. 80% of hysterectomy were confirmed from the hospital records. The age, weight, height, blood pressure, menstr- ual history, history of DM and hypertension, social history of alcohol and smoking and other cardiovascular risk factors such as cholesterol, HDL-cholesterol, triglycerides were checked. The 248 women with natural postmenopausal status before hysterectomy, taking hormonal replacement therapy after hysterectomy and having performed hysterectomy due to malign- ancy were excluded. RESULTS: All women performed hysterectomy were in premenopausal status in this study. Therefore, the final numbers of subjects included in the analysis was 333. Hysterectomy wit- hout ovarian preservation were performed in 58 cases and hysterectomy with ovarian pres- ervation were in 57 cases. The 218 premenopausal cases which did not performed hystere- ctomy were considered control group. BMI scores were higher in cases without ovarian pres- ervation than with ovarian preservation. And BMI score was associated with the postoper- ative duration in hysterectomy with ovarian preservation. CONCLUSIONS: We suggest that hysterectomy without ovarian preservation in premeno- paussal women were associated with increased obesity, especially BMI scores.
Blood Pressure ; Cholesterol ; Female ; Gynecology ; Hospital Records ; Hospitals, Veterans ; Humans ; Hypertension ; Hysterectomy* ; Korea ; Obesity* ; Risk Factors ; Smoke ; Smoking ; Triglycerides

We report the CT findings of diffuse esophageal spasm (DES) in a patient with dysphagia. Although an uncommon condition, DES should be included in the differential diagnosis if relatively long and symmetric segmental esophageal wall thickening and an epiphrenic esophageal diverticulum are noted at CT.
Deglutition Disorders ; Diagnosis, Differential ; Diverticulum, Esophageal ; Esophageal Spasm, Diffuse* ; Humans

No abstract available.
Pregnancy, Heterotopic*

Spontaneous coronary artery dissection is a rarely identified entity whose exact incidence, etiology, pathogenesis, medium-term evolution and optimal treatment have not yet been firmly estabilished. The cause of spontaneous disection remains unclear but theories of etiology include a medial eosinophilic angiitis, pregnancy induced degeneration of collagen and rupture of the vasovasoum. Most paients die suddenly, but a clinical spectrum is seen including and unstable angina, myocardial infarction and cardiogenic shock. We experienced 4 cases with spontaneous coronary artery dissection found angiographically which caused myocardial infarction and unstable angina. Our patients were treated medically.
Angina, Unstable ; Collagen ; Coronary Vessels ; Eosinophils ; Humans ; Incidence ; Myocardial Infarction ; Myocardial Ischemia* ; Pregnancy ; Rupture ; Shock, Cardiogenic ; Vasculitis