A papillary adeno-carcinoma of the renal pelvis is very rare tumor and mostly diagnosed by histopathologic findings. A 10-years-old female was admitted to Fatima Hospital with Rt. flank pain and intermittent gross hematuria.Herein, we report a case of papillary adeno-carcinoma of the renal pelvis.
Adenocarcinoma ; Female ; Flank Pain ; Humans ; Kidney Pelvis*

A 17-year-old man was referred for aborted sudden cardiac death. Ventricular fibrillation (VF) was recorded by automated external defibrillator. Post-resuscitation electrocardiograms showed frequent monomorphic premature ventricular complexes (PVCs), with left bundle branch block configuration and inferior axis. Cardiac arrest due to VF recurred twice within the initial 42 hours. Rhythm monitoring revealed multiple episodes of sustained VF triggered by a triplet of monomorphic PVCs having similar morphology with isolated PVCs. Comprehensive cardiologic workup revealed no structural heart disease and ion-channelopathies. With the impression of idiopathic VF triggered by unifocal PVCs of right ventricular outflow tract (RVOT) origin, radiofrequency catheter ablation was performed to prevent frequent VF recurrence before implantable cardioverter-defibrillator (ICD) implantation. After successful ablation of the origin of unifocal PVCs at anterolateral wall of RVOT, the burden of PVCs decreased remarkably and VF did not recur. The patient was discharged after ICD implantation.
Adolescent ; Axis, Cervical Vertebra ; Bundle-Branch Block ; Catheter Ablation ; Death, Sudden, Cardiac ; Defibrillators ; Defibrillators, Implantable ; Electrocardiography ; Heart ; Heart Arrest ; Heart Diseases ; Humans ; Recurrence ; Triplets ; Ventricular Fibrillation ; Ventricular Premature Complexes

Basal cell carcinoma(BCC) and squamous cell carcinoma (SCC) are very prevalent neoplasms of the human skin. Ultraviolet radiation in sunlight is a well-established mutagen of the p53 gene and is one of basal cell carcinoma and squamous cell carcinoma. The newly-formed vascular network is important for neoplasms to grow beyond a size of about 1 mm2. Recent reports have suggested the hypothesis that a mutant p53 protein is closely related with capillary density. Immumohistochemistry for p53 protein and CD34 was performed in 20 cases of BCCs and 14 SCCs to evaluated the relationship between p53 protein and capillary density. The results were as follows:1. The microvessels stained by CD34 were mainly located in the interface of tumor cells and stroma. 2. There was no difference in the microvessel density according to the histologic types and age of the patients, but a higher microvessel density was noted in male patients. 3. The aggressive BCCs and the less-differentiated SCCs showed higher p53 immunostaining. 4. The mean microvessel density of cases showing strong positive immunostaining of the p53 gene(54.73+/-17.75) was higher than that of others(39.75+/-18.30). These results suggested that p53 protein expression and microvessel density are not related to the histologic types and age of the patients, but that differentiation and biologic behavior such as the infiltrating property of tumors and the microvessel density are closely related to p53 protein expression.
Capillaries ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell* ; Genes, p53 ; Humans ; Male ; Microvessels* ; Skin* ; Sunlight

OBJECTIVES: Glioblastomas, the most common type of primary brain tumors, are highly invasive and cause massive tissue destruction at both the tumor invading edges and in areas that are not in direct contact with glioma cells. As a result, patients with high-grade gliomas are faced with a poor prognosis. Such grim statistics emphasize the need to better understand the mechanisms that underlie glioma invasion, as these may lead to the identification of novel targets in the therapy of high grade gliomas. Protein kinase C(PKC) is a family of serine/threonine kinases and an important signal transduction enzyme that conveys signals generated by ligand-receptor interaction at the cell surface to the nucleus. PKC appears to be critical in regulating many aspects of glioma biology. The purpose of this study was to assess accurately the role of PKC in the invasion regulation of human gliomas based on hypothesis that protein kinase C(PKC) is functional in the process of glial tumor cell invasion. METHOD: To test this hypothesis, U-87 malignant glioma cell line intracellular PKC levels were up and down regulated and their invasiveness was tested. Intracellular PKC level was characterized using PKC activity assays. Invasion assays including barrier migration and spheroid confrontation were used to study the relationship between PKC concentration and invasiveness. RESULT: The cell line which were treated by PKC inhibitor tamoxifen and hypericin exhibited decreased PKC activity and decreased invasive abilities dose dependently both in matrigel invasion assay and tumor spheroid fetal rat brain aggregates(FRBA) confrontation assay. However, the cell line that was treated by PKC activator 12-O-tetradecanylphorbol-13acetate(TPA) did not exhibit increases in either PKC activity or invasive ability. CONCLUSION: These studies suggest that PKC may be a useful molecular target for the chemotherapy of glioblastoma and other malignancies and that a therapeutic approach based on the ability of PKC inhibitors may be helpful in preventing invasion.
Animals ; Biology ; Brain ; Brain Neoplasms ; Cell Line ; Drug Therapy ; Glioblastoma ; Glioma* ; Humans ; Phosphotransferases ; Prognosis ; Protein Kinase C* ; Protein Kinases* ; Rats ; Signal Transduction ; Tamoxifen

The authors analysed the results of 300 microvascular decompression(MVD) procedures for hemifacial spasm. The follow up period ranged from 6months to 3years. Of these, 70% were women(mean age 54). The vessel most frequently found to compress the facial nerve was the posterior inferior cerebellar artery(43.3%) followed by anterior inferior cerebellar artery(26.7%). For the surgical results, 210 patients(70%) had complete relief of spasm within 3 days after MVD, 65 patients(21.7%) subsequently experienced complete relief, noted in 4 days to 6 months after MVD, ten patients had delayed partial relief and remaining 15 patients showed no improvement. Twelve patients of these 15 unresponsive patients underwent reoperation without beneficial results. Recently the authors have monitored facial elctromyography(EMG) intraoperatively to observe the abnormal late response. There were few cases of permanant major complications, including two cases of ipsilateral hearing loss, ataxia and no operation-related death. These results suggest that MVD is a safe and definite treatment for hemifacial spasm, if performed by experienced surgeon with gentle operative technique, and with intraoperative monitoring such as auditory evoked potential and facial EMG, better surgical results with less complications can be expected.
Ataxia ; Evoked Potentials, Auditory ; Facial Nerve ; Follow-Up Studies ; Hearing Loss ; Hemifacial Spasm* ; Humans ; Microvascular Decompression Surgery* ; Monitoring, Intraoperative ; Reoperation ; Spasm

Although fibromas are the most common renal medullary tumor identified at autopsy. their small sized and benign course make clinical detection extremely difficult. Only 9 clinical cases of renal medullary fibromas have been reported. Many fibromas of the renal medulla, previously considered as bamahomas. seemed to be composed of tumerous transformation of renomedullary interstitial calls Herein we report on a patient with huge renal medullary fibroma treated by right radical nephrectomy.
Autopsy ; Brain Stem Neoplasms ; Fibroma ; Humans ; Nephrectomy

PURPOSE: This prospective study conducted to estimate mortality and activity of hip fracture among persons over 50 years of age, in Jeju island, Korea during the year 2002. MATERIALS AND METHODS: One hundred forty-nine patients among 150 patients over 50 years of age who lived in Jeju island and sustained a femoral neck or intertrochanteric fracture during the year 2002 were followed-up for average 2 years. Standardized annual mortality ratio was calculated and comparison was made between hip fracture patients and general population in Jeju island. RESULTS: One hundred forty-nine patient were followed-up (35 in men, 114 in women). The mean age of patients was 77.4 years (range 50-98 years). Mortality at 2 years (range, 1.6-2.6 years) was 28.2% (42 patients), mortality at 1 year was 16.8% (25 patients) and mortality at 6 months was 12.1% (18 patients). Patients who were classified as poor (Halpin grade III and IV) increased in number from preoperative 11 patients to postoperative 37 patients. CONCLUSION: Considering 28.2% of high mortality and 25.2% of poor activity who can not do outside activity at average 2 year follow up, the hip fracture is life threatening risk factor of elderly. Prevention falling and hip fracture risk is needed.
Aged ; Femur Neck ; Follow-Up Studies ; Hip* ; Humans ; Korea ; Male ; Mortality* ; Prospective Studies* ; Risk Factors

PURPOSE: To evaluate the safety and efficacy of a laparoscopic nephroureterectomy in patients with a transitional cell carcinoma of the renal pelvis and ureter. MATERIALS AND METHODS: All patients underwent a nephroureterectomy for an upper tract transitional cell carcinoma. Of these, 23 and 22 underwent a laparoscopic nephroureterectomy (LNU) and open nephroureterectomy (ONU), respectively, between January 2002 and June 2006. After the nephrectomy had been performed, a 5-6cm modified Gibson incision was created to allow dissection of the lower ureter and bladder cuff, and extraction of the intact specimen. A retrospective analysis was performed on the operating time, blood loss, analgesic requirement, ambulation time, interval to resume oral intake, hospital stay, complications and follow-up results for both groups. RESULTS: The LNU was superior to the ONU with regard to the mean operation time; 275 (190-390) versus 258 (180-400) (p=0.259), blood loss; 188 (130-250) versus 488ml (350-750) (p<0.05), ambulation time; 2.5 versus 3.3 days (p<0.05), interval to resume oral intake 2.1 versus 2.8 days (p<0.05), and hospital stay; 8.3 versus 11.1 days (p<0.05). Complications developed in 4 and 5 of the LNU and ONU patients, respectively, but all were resolved with conservative management. The mean follow-up duration of the LNU and ONU groups were 29 versus 14 months, respectively. CONCLUSIONS: Based on our experience, a laparoscopic nephroureterectomy is better tolerated with respect to pain, has less blood loss, shorter hospital stays, ambulation time and time to oral intake. LNU is safe for an upper tract transitional cell carcinoma, and is also an efficacious alternative to open surgery. However, a long-term follow-up will be warranted to ascertain accurate oncologic data.
Carcinoma, Transitional Cell* ; Follow-Up Studies ; Humans ; Kidney Pelvis ; Length of Stay ; Nephrectomy ; Retrospective Studies ; Ureter ; Urinary Bladder ; Urinary Tract* ; Walking

Lately, surgical treatment for lumbar disc herniations has advanced markedly with new improvements of neurosurgical procedures using microscope and microinstruments. The following is the authors' report of the surgical outcomes of 3,913 consecutive patients with lumbar disc herniations treated during a 230year period. These patients received treatments of laminectomy, hemilaminectomy or partial laminectomy with or without discectomy. After 1987, we also performed microdiscectomies using microscopes and microinstruments. The ratio of male to female was 71% to 29% and the fourth and fifth decades were most common with respect to age distribution. The causes of herniated discs include lifting, traffic accidents, falls or slipping, and sports Almost all patients had complained of low back pain and leg pain(99%), and 81% had radicular pain or sensory abnormality in a dermatomal distribution. The diagnosis was made by lumbar myelogram, CT scan and/or MRI. Complications were developed in 6.2% of the surgical cases. Several conclusions can be drawn from the above indicated results of this series: 1) male patients predominate in the lumbar disc herniation which are most common the fourth and fifth decades; 2) the incomplete herniation of disc was common; 3) MRI had the highest specificity as a single diagnostic tool, while the combination of myelogram, CT scan and MRI seems to e the best diagnostic method; 4) almost all patients had low back pain and leg pain and 90% of the patients were positive in Laseque test; 5) microdiscectomy is the most recommended treatment for lumbar disc herniations ; 6) The complication rate was 6.2% and the failed back surgery syndrome was most common.
Accidents, Traffic ; Age Distribution ; Diagnosis ; Diskectomy ; Failed Back Surgery Syndrome ; Female ; Humans ; Intervertebral Disc Displacement ; Laminectomy ; Leg ; Lifting ; Low Back Pain ; Magnetic Resonance Imaging ; Male ; Neurosurgical Procedures ; Sensitivity and Specificity ; Sports ; Tomography, X-Ray Computed

The chin is located on the center of the face and plays an important role in making an esthetic and harmonious appearance of the face. A deformity of this part can either be an isolated problem, or coexist with malformations of the jaw or other facial structures. Surgery of the chin is performed to correct the size, shape, and appearance of the tip of the chin. The operation, also known as a genioplasty(chin reshaping), is performed most commonly to enlarge the chin. For those with a receded chin, it would improve the projection of the chin and result in better balance with the remainder of the face. Occasionally, the operation may also be performed to reduce the volume of an over-sized chin. Since the first description of the genioplasty by Hofer, 1942, it was performed more frequently and effectively in that patient's satisfaction has been higher than any other esthetic surgery. We have carried out 20 cases of esthetic genioplasty in recent 10 years from 1990 to 2000. We have restored the chin contour by using several methods including silastic or Medpor implant onlay support, ostectomy, horizontal sliding osteotomy. In this paper, we have retrospectively reviewed the experiences with many kinds of genioplasty through the patient's records, photographs and radiologic films. The results were summarized as follows: 1) The mean age of the patients was 26.2 years old, and the sex ratio was nearly equal. 2) The methods of operations included 8 cases of augmentation genioplasty, 8 cases of reduction genioplasty, 4 cases of horizontal osteotomy. 3) The procedures were done mainly with intraoral approach. 4) No special postoperative complications were noted except one case of infection. We have noted that all the patients who received the esthetic genioplasty were satisfied with the results and had no special complications except in one case. In this study, we present the various clinical experiences of correcting each malformed chin. The preoperative planning, operation methods, and postoperative complications are presented in detail.
Chin ; Congenital Abnormalities ; Genioplasty* ; Humans ; Inlays ; Jaw ; Osteotomy ; Postoperative Complications ; Retrospective Studies ; Sex Ratio ; Surgery, Plastic