Multilocular cystic renal cell carcinoma appears to be a distinct and rare subtype of renal cell carcinoma with characteristic gross and microscopic features. Multilocular cystic renal cell carcinoma should be separated from multilocular cyst, multilocular cystic nephroma, and renal cell carcinoma with cystic degeneration. We present a case of multilocular cystic renal cell carcinoma. A 61-year-old man presented with right flank pain for 4 years. The computerized tomography revealed multilocular cystic mass in the upper pole of right kidney. The cystic mass measured 4.5x4 cm. The cyst was multilocular and locules not communicated with each other. The solid area was not present. Microscopically, the locules were lined by flat or cuboidal neoplastic clear cells. The clear cells were focally aggregated in the septa. The nephron was not present in the septa.
Male ; Humans ; Cysts

No abstract available.
Gallstones* ; Prevalence*

To observe the role of oxygen free radical and enzymatic scavengers in cerebral ischemia, an infarction model was made using transorbital occlusion of the middle cerebral artery in cats. The changes of the superoxide radical production and the activities of superoxide dismutase and catalase were measured. The results were as follows ; 1) The infarction of the left middle cerebral artery(MCA) territory was identified with intracardiac perfusion of a TTC solution after transorbital occlusion. 2) The superoxide radical activities after occlusion of the left MCA were not changed in all groups except for the decrease in 6 hours group of the right side compared to the control group(p<0.05). 3) The Mn-superoxide dismutase activities of the left side in the 12 hours group were significantly higher than those of the right side(p<0.01) and those in the control group(p<0.05). 4) The Cu, Zn-superoxide dismutase activities of the left side in the 3 hours group after occlusion of the left MCA were significantly higher than those in the control group(p<0.05). 5) The catalase activities of the left side in the 3 hours, 6 hours and 12 hours groups after occlusion of the left MCA were significantly higher than those of the right side(p<0.05). 6) The catalase activities of the left side in the 12 hours group after occlusion of the left MCA were significantly higher than those in the control group(p<0.05). The authors suggest that the enzymatic scavangers such as Mn-SOD, Cu, Zn-SOD and catalase increased in the infarcted brain, which means an involvement of free radicals in cerebral infarction.
Animals ; Brain ; Brain Ischemia ; Catalase* ; Cats ; Cerebral Infarction* ; Free Radicals ; Infarction ; Middle Cerebral Artery ; Oxygen ; Perfusion ; Superoxide Dismutase* ; Superoxides*

Tow surgically treated cases of thoracic tuberculous spondylitis with multievel involvement are presented. Radical debridement produced large deficit in the anterior structures and spinal instability. A reconstruction with mesh cylinder graft and combined anterior instrumentation surgery in one stage operation. Anterior Instrumentation provided immediate stability and protected against development of kyphotic deformity. There was no persistence or recurrence of infection after surgery. The average length of follow up was 24month including 12month, 18month course of chemotherapy.
Congenital Abnormalities ; Debridement ; Drug Therapy ; Follow-Up Studies ; Recurrence ; Spondylitis* ; Transplants

PURPOSE: The purpose of this study was to evaluate the diagnostic accuracy of [18F]FDG PET in the diagnosis of recurrent head and neck cancer after the completion of surgery and radiotherapy in patients with head and neck cancers. MATERIALS AND METHODS: In fifty-nine patients with head and neck cancers, whole body [18F]FDG PET studies were performed. According to the different therapeutic modalities, patients were divided into four groups (Group I; pre-treatment, Group II; surgery, Group III; radiotherapy, Group IV; both surgery and radiotherapy). [18F]FDG PET images were compared with clinical, CT and histopathologic findings. RESULTS: For detection of metastatic lymph nodes in 14 patients of pre-treatment group (group I), the sensitivity and specificity of PET were 100% (10/10) and 75% (3/4), and those of CT were 80% (8/10) and 100% (4/4). For detection of recurrence in 45 patients of post-treatment group, overall sensitivity and specificity of PET were 96.2% (25/26) and 78.9% (15/19) [(100% and 75% in group II, 80% and 50% in group III, and 100% and 100% in group IV)] without significant difference from pre-treatment group (p>0.1). In detecting recurrence, the sensitivity and specificity of [18F]FDG PET were 90.9% (10/11) and 20% (1/5) in 16 patients who underwent [18F]FDG PET within 2 months after the completion of treatment. The specificity of these patients was significantly lower than that of 29 patients (100% of sensitivity and specificity) who underwent [18F]FDG PET 2 months after treatment (p<0.05). CONCLUSION: [18F]FDG PET is an accurate diagnostic modality for the detection of recurrence in head and neck cancer. Post-therapy [18F]FDG PET should be obtained at least 2 months after the completion of surgery or radiotherapy.
Diagnosis ; Head and Neck Neoplasms ; Head* ; Humans ; Lymph Nodes ; Neck* ; Radiotherapy* ; Recurrence ; Sensitivity and Specificity

PURPOSE: To evaluate the usefulness of introital ultrasonography in the assessment of female urinary incontinence. MATERIALS AND METHODS: Introital ultrasonography was performed in fifteen patients with stress urinasy incontinence(mean age 50) and six patients without symptoms of incontinence(mean age 37). Using a sagittalsection of the anterior pelvis in the plane of the symphysis pubib the posterior rethrovesical angle, the pubourethral distance and the pubo-yretgrak abgle were measured at rest and during stree(Valsalva's maneuverstate). The student T-test and the ANOVA test were used in statistical analysis. RESULTS: The posterior urethrovesical angles of the controls were 125.3 degrees (+/- 10.9) at rest and 125.7 degrees (+/-7.6) during stress. In thepatients, the corresponding angles were 135.3 degrees (+/-11.3) and 139.6 degrees (+/-10.8). The posterior urethrovesical angles increased 0.3 degrees (+/-4.7) in the controls and 5.6 degrees (+/-4.0) in the patients(p=0.018). In the controls, thepubo-urethral distances were 21.8mm(+/- 5.8) at rest and 18.2mm(+/-7.1) during stress, while in the patients thesedistances were 18.4mm(+/-3.9) and 12.6mm(+/-4.4). The pubo-urethra distance decreased 3.5mm(+/-1.5) in the controls and 5.8mm(+/-2.3) in the patients(p=0.039). In the patients with mild incontinence(Gradel), the posterior urethrovesical angles increased 3.4 degrees (+/-2.8) : 132.3 degrees (+/-12.5) at rest and 135.6 degrees (+/-12.8) during stress. In the patients with moderate incontinence(Grade II), the angles increased 8.1 degrees (+/-3.8) : 136.0 degrees (+/-6.5) at rest and 144.1 degrees (+/-5.9) during stress. The change of the posterior urethrovesical angle was related to the grade of urinary incontinence in the patients(p<0.05). There was no statistical significancy in the pubo-urethral angle(p=0.315). CONCLUSION: Introital ultrasonography may be useful for assessment of stress urinary incontinence.
Female* ; Humans ; Pelvis ; Ultrasonography* ; Urinary Incontinence*

Thirty cases of gastric adenocarcinoma were examined immunohistochemically for expression of transforming growth factor-beta(TGF-beta) in order to analyze significant correlation with clinical stage and pathologic grade of gastric adenocarcinoma. Specific immunostaining was clearly detected in the cytoplasm of the neoplastic cells. The TGF-,6 expression in the gastric adenocarcinoma is closely related to the depth of invasion, the degree of invasiveness and the presence of metastasis. Thus, we observed the stronger immunohistochemical. expression of TGF-beta in the deeper portion of invasion and in the invasive gastric adenocarcinomas with the lymph nodal metastasis than in the superficial portion of invasion and in those without the lymph nodal metastasis. There results suggest that the transforming growth factors expression in carcinoma cells may play an important role in the carcinomatous invasion resulting in metastasis.
Adenocarcinoma ; Neoplasm Metastasis

We observed the gastric varices in l89 variceal patients with liver cirrhosis and in 129 patients with UGI bleeding by endoscopy. Gastric varices was found in 27 cases(14.2%) amoag 189 variceal cases. There was variceal bleeding in 74 cases(57.4%) beieg the toy cause of UGI: bleeding among l29 cases with UGI bleeding and 6(4.7%) had endoscopically proved gastric Variceal bleeding. Cardiac and fundic varices were observed in l8 and 12 cases, respectively end 12 cases of cardiac varices were mainly observed on the lesser curvature side. The incidence of isolated gastric varices being 30 % amoag gastric varices was far less than that of esophagogastric varices. There was no significant relations between the severity of liver cirrhosis and the kinds of varices These results suggest that gastric varices are not infrequent cause of UGI bleeding cases. Therefore all must have attention in gastric intestinal fiberscopic examination in portal hypertensive patients.
Endoscopy ; Esophageal and Gastric Varices* ; Hemorrhage ; Humans ; Incidence ; Liver Cirrhosis ; Play and Playthings ; Varicose Veins

PURPOSE: The E-cadherin gene, located on chromosome 16q22, may play principal roles in cell adhesion with the loss of E-cadherin expression leading to a propensity for a great number of malignant properties. The loss of heterozygosity (LOH) on 16q22 has rarely been studied in invasive ductal carcinomas. Our objectives were to evaluate the LOH of E-cadherin and the protein expression in invasive ductal carcinomas and their correlation with various clinicopathological factors. METHODS: The LOH analysis was performed using polymerase chain reactions with three polymorphic microsatellite markers (D16S419, D16S3106 and D16S498) in 50 surgically resected tumors and their non-tumorous counterparts. The E-cadherin protein expression was studied using immunohistochemistry. RESULTS: The LOH and loss of protein expression were detected in 54% and 46% of the tumors, respectively. There was no LOH or protein loss detected in the non-tumor lesions. The LOH results were well correlated with the tumor size and lymph node metastasis. The protein loss results were well correlated with tumor histological grade. No correlation was found between LOH and protein loss. CONCLUSION: These results suggest that the LOH of E-cadherin may be associated with tumor metastasis and tumor progression and E-cadherin protein loss may be related with the dedifferentiation in some portions of invasive ductal carcinomas. We propose the LOH of E-cadherin and protein loss may contribute to tumor progression by independent mechanism.
Cadherins* ; Carcinoma, Ductal* ; Cell Adhesion ; Immunohistochemistry ; Loss of Heterozygosity* ; Lymph Nodes ; Microsatellite Repeats ; Neoplasm Metastasis ; Polymerase Chain Reaction

Acute onset of shock presented in a 23 years old male patient due to gastrointestinal bleeding. He had been in a car crash 49 days before presentation. On initial presentation, a small amount of intraperitoneal hemorrhage had been seen on a CT scan. An emergency selective superior mesenteric artery (SMA) arteriography revealed a pseudoaneurysm in the branch of SMA, but successive embolization of the terminal branch controlled the bleeding. It is hard to initially diagnose an aneurysm as the cause of spontaneous gastrointestinal bleeding in a patient that has suffered an abdominal trauma, so it poses a therapeutic challenge. Recognition of an aneurysm, and its early diagnosis based on the patient's past history, and its adoption as a judicious diagnostic tool are essential in the management of such patients.
Aneurysm ; Aneurysm, False* ; Angiography ; Early Diagnosis ; Emergencies ; Hemorrhage* ; Humans ; Male ; Mesenteric Artery, Superior* ; Shock ; Tomography, X-Ray Computed ; Young Adult