Primary pyogenic psoas abscess is rare lesion, and often is not suspected. Reasons for delayed diagnosis are unfamility with the lesion and the fact that symptoms often resemble those of primary disease of the hip. We present a case of primary pyogenic psoas abscess in child, which was diagnosed by MRI, and completely recovered after surgical treatment.
Child ; Delayed Diagnosis ; Hip ; Humans ; Magnetic Resonance Imaging ; Psoas Abscess

Multicystic dysplastic kidney is the most frequent cause of abdominal mass in the neonate, but its presentation is variable depending on the size of cystic kidney, state of the opposite kidney and associated anomalies. multicystic dysplastic kidney also represents a spectrum of pathology from unilateral multicystic kidney through segmental and focal multicystic dysplasia to bilateral multicystic kidney. Herein we report 5 cases of MCK with different presentation and histology, a bilateral MCK associated with horseshoe kidney, a large MCK with uremia, a focal segmental MCK with contralateral UPJ obstruction, a small focal segmental MCK with contralateral megaureter and a small MCK detected by ultrasonogram for localization of impalpable testis.
Humans ; Infant, Newborn ; Kidney ; Kidney Diseases, Cystic ; Multicystic Dysplastic Kidney* ; Pathology ; Testis ; Ultrasonography ; Uremia

Chemotherapeutic agents were evaluated for their effect on the development of urinary bladder tumors, induced by N-butyl-N-(4-hydroxybutyl) nitrosamine (BBN) in female Sprague-Dawley rats. For 16 weeks, 0.05% BBN was administered orally, and then chemotherapeutic agents (adriamycin and cisplatin) were injected intraperitoneally for 12 weeks. In our preliminary experimental series, an experimental bladder tumor model induced by BBN was useful in evaluating the effectiveness of chemotherapeutic agents. Cisplatin appears to be effective in inhibiting precancerous histologic changes and carcinoma in rat urinary bladder mucosa by BBN. However, the effectiveness of adriamycin was inconclusive.
Animals ; Carcinogenesis* ; Cisplatin ; Doxorubicin ; Female ; Humans ; Injections, Intraperitoneal* ; Mucous Membrane ; Rats* ; Rats, Sprague-Dawley ; Urinary Bladder Neoplasms ; Urinary Bladder*

The purpose of this study is to evaluate the results of the reconstruction of acetabular bone defect with morselized bone graft in revision of failed acetabular cup, used screw fixed hemispherical cup or bipolar cup as a component. Forty five revisions of an acetabular component that had been performed in 42 patients between 1988 and 1993 at SNUH, and had followed more than two years were included in this study. The revised acetabulum was evaluated by Harris hip score, in terms of osseous union and resorption of the graft, the amount of the migration of the revised components. Cup angle change and radiolucency were also evaluated in screw fixed hemispherical cup. The mean Harris hip score was improved 54 to 87 in screw fixed hemispherical cup and 56 to 78 in bipolar cup. In screw fixed hemispherical cup, osseous union showed within 6 months is 91.3% (21 cases), the graft bone resorption less than 10% of the initial graft thickness is 73.9% (17 cases). In bipolar cup, osseous union within 6 months is 52.2% (12 cases), the graft bone resorption less than 10% of the initial graft thickness is 40.9% (9 cases). The failure of revised acetabular component was five in bipolar cup cases and one in screw fixed hemispherical cup cases. In conclusion, screw fixed hemispherical cup showed better clinical results, earlier graft osseous union, less graft bone resorption and lower failure rate than bipolar cup. There was no significant difference between pure allograft mixed with autograft in clinical and radiological results. So we recommend the technique used morselized allograft with screw fixed hemispherical cup, to reconstruct the acetabular bone defect in acetabular cup revision, though bipolar cup was used in staged operation in severe acetabular bone defect with was unable to fix the acetabular cup with screws.
Acetabulum ; Allografts ; Autografts ; Bone Resorption ; Hip ; Humans ; Transplants

Spindle cell hemangioendothelioma was first described in 1986 by Weiss and Enzinger as a low grade angiosarcoma resr mbling a cavernous hemangioma and kaposis sarcoma. Recently, it is suggested to be non neoplastic lesion or reactive process arising from pre-existing vascular mal- formation. We report a case of spindle cell hemangioendothelioma in a 9-month-old boy. He had multiple, variable sized, colorful, cutaneous or subcutaneous nodules on the forearm and hand. The tumor first appeared on the forearm as erythematous patches at birth and grew rapidly with- in 3 months. Histopatholgical findings showed that the lesion was composed of thin walled cavernous spaces mixed with spindle cells and occasional epithelioid endothelial cells containing intracytoplasmic vacuole. Most af the endothelial cells lining the cavernous spaces and intracytoplasmic lumina, were positive for factor VIII associated antigen. But the spindle cells were negative. Atypical vascular structures resembling arteriovenous shunts were noted around the tumor suggesting a reactive proliferation due to disturbance of local blood flow. Several turnors were excised. No recurrence has been recognized in the one year- follow-up period.
Endothelial Cells ; Factor VIII ; Follow-Up Studies ; Forearm ; Hand ; Hemangioendothelioma* ; Hemangioma, Cavernous ; Hemangiosarcoma ; Humans ; Infant ; Male ; Parturition ; Recurrence ; Sarcoma, Kaposi ; Vacuoles

A 12-year-old boy developed pure red cell anemia(PRCA) during a combination therapy of antiepileptic drugs(AEDs) for epilepsy. His complex partial seizure was intractable to monotherapy. During 7 months of treatment, he was treated with Vigabatrin, Carbamazepine and Valproate. While switching from Carbamazepine to Valproate, he presented anemia but with no jaundice. His hemoglobin was 4.1g/dl bone-marrow biopsy revealed erythroid hypoplasia with normal myelopoiesis and megakaryocytopoiesis, indicating PRCA. Rapid recovery from PRCA was observed 1 month after discontinuation of Valproate, without immunosuppressive therapy. Although the hematologic toxicity of AEDs is well documented, isolated cessation of red cell production is uncommon. Our observation suggests that the synergistic toxicity caused by Valproate and Carbamazepine may induce PRCA through the inhibitory effect beyond the differentiation stage of BFU-E and CFU-E.
Anemia* ; Anticonvulsants* ; Biopsy ; Carbamazepine ; Child ; Epilepsy ; Erythroid Precursor Cells ; Humans ; Jaundice ; Male ; Myelopoiesis ; Seizures ; Thrombopoiesis ; Valproic Acid ; Vigabatrin

To investigate the influence of age on the remnant kidney, unilateral nephrectomy was performed in rats at 1week(group N-1), 3weeks(group N-3), 5weeks(group N-5), 7weeks(group N-7). 9weeks(group N-9), and 10weeks(group N-10) of age and sham operation was performed in the control group of rats at the same ages. Proteinuria in spot urine, serum BUN/creatinine, compensatory renal growth and histologic changes were compared with in each group at 32weeks after uninephrectomy. The results were as follows : 1. A compensatory renal growth in nephrectomy group was significantly greater than that in sham operated groups(p <0.001 ) and a compensatory renal growth in prepubertal groups( N-1, 3, 5. 7) was significantly greater than that in postpubertal groups ( N-9, IO) between the nephrectomy groups. 2. In histologic changes, visceral glomerular epithelial proliferation, mesangeal widening and proliferation, obliteration of capillary lumen were more marked in nephrectomy group than sham operated group and group N-1, N-3, N-5, N-7 than in groups N-9, N-10 at week 32. 3. The proteinuria in spot urine was more marked in nephrectomy groups than sham operated groups at week 32 and there was no significant difference in serum BUN/creatinine between nephrectomy group and sham operated groups. It is concluded that in rat, uninephrectomy at young ages leads to more marked compensatory renal growth and histologic change than uninephrectomy in the adult and functionally, proteinuria precedes change of serum BUN and creatinine.
Adult ; Animals ; Capillaries ; Creatinine ; Humans ; Kidney* ; Nephrectomy ; Proteinuria ; Rats*

We retrospectively analyzed the Magnetic Resonance (MR) imaging findings in 41 cases of histologically proved malignant tumors of oral cariey. The diagnostic value of MR imaging in detection and delineation of the lesions was assessed. The value of MRI was compared with that of Computed Tomography (CT) in 14 patients. Thirty-four cases of 41 malignant tumors were squamous cell carcinomas. Adenoic cystic carcinomas (2 cases), malignant melanomas (2 cases), non-Hodgkin lymphomas (2 cases) and mucoepidermoid carcinoma(1 cases) were also included in this study. Most of the lesions were isointense or slightly hyperintense to muscle on T1 weighted images and showed variable degrees of high signal intensity on T2 weighted images. Two cases of malignant melanomas showed characteristic hyperintensity on T1 weighted images. T2 weighted image was better in detection and delineation of tumor in most of the cases. In 6 cases, Gd-DTPA-enhanced T1 weighted image was better than T2 weighted image. T2 weighted image was useful for the evaluation of deep tissue infiltration and T1 weighted image was useful for the evaluation of bone invasion and superficial tissue plane invasion. The lesion was detected only by MR in 3 cases of 14 in which CT was also performed. MR imaging was more sensitive in the evalustion of bone marrow involvement. MR imaging is very useful modality in evaluating oral cavity malignany and is superior to CT in delineation of the as well as in the evaluation of mandible invasion.
Bone Marrow ; Carcinoma, Squamous Cell ; Humans ; Lymphoma, Non-Hodgkin ; Magnetic Resonance Imaging* ; Mandible ; Melanoma ; Mouth* ; Retrospective Studies

OBJECTIVE: The pathogenesis of endometriosis is generally accepted that retrograde menstruation and alterations in the local pelvic immune environment. This study was performed to help elucidate what kind of role various cytokines might play in the pathogenesis of endometriosis. METHOD: Concentrations of peritoneal fluid cytokines were compared in 7 women with normal pelvic finding and 23 women with endometriosis by enzyme-linked immunosorbent assay(ELISA). The patterns of cytokine mRNA expression in 8 ovarian endometrioma and 12 superficial pelvic endometriosis lesions were investigated by reverse transcription-polymerase chain reaction(RT-PCR) amplification method. RESULT: Both IL-6 and IL-10 levels in peritoneal fluid specimens with endometriosis tended to be higher than normal. However, there were no significant differences between peritoneal fluid concentrations of IFN-gamma, TNF-alpha, IL-1beta, and IL-5 of women with and without endometriosis. The levels of IL-6 and IL-10 were significantly higher in peritoneal fluid of women with severe endometriosis compared to women with mild endometriosis. IL-1beta mRNA was expressed in all of 8 deep and 12 superficial endometriosis lesions. IL-5 and IL-6 mRNA were expressed in only two black lesions respectively, however, both were not expressed in the all deep lesions. Expressions of IL-10 mRNA occurred in one red and one black lesion while this was expressed in only one of the deep lesions. TNF-alpha mRNA was expressed in one red and one black lesion of 12 superficial lesions compared with four of the deep lesions. There was the difference between kinds of increased cytokines in the peritoneal fluid and those of expressed cytokines in the endometriotic lesions of patients with endometriosis. CONCLUSION: This study supports the concept that local immunologic factors may be important in the pathogenesis and pathophysiology of endometriosis. The pattern of cytokine mRNA expression of endometriotic lesions would seem to indicate that proinflammatory cytokines such as IL-1beta and TNF-alpha are responsible for the development or progression of endometriosis.
Ascitic Fluid ; Cytokines ; Endometriosis* ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Immunologic Factors ; Interleukin-10 ; Interleukin-5 ; Interleukin-6 ; Menstruation Disturbances ; RNA, Messenger* ; Tumor Necrosis Factor-alpha

Mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) is a syndrome with complex genetics and diverse manifestations. Diffuse alveolar hemorrhage is caused by alveolar microcirculation injury associated with lung illness or systemic disorders. To date, the relationship between diffuse alveolar hemorrhage and MELAS has not been reported. We report a MELAS patient who presented complications with diffuse alveolar hemorrhage.