ABSTRACT
PURPOSE: The purpose of this study was to evaluate the usefulness of 99mTc DMSA scintigraphy on the dignosis of a renal scar in children with urinary tract infections. MATERIALS AND METHODS: Eighty three patients were included in this study, who were diagnosed as the urinary tract infection on the basis of symptom, urinalysis and urine culture. 99mTc DMSA scintigraphy and voiding cystoureterography were performed within 7days before the treatment in all patients. We classified the scintigraphic findings as follows: 1; a large hypoactive upper or lower pole. 2; a small hypoactive area. 3; single defect resulting in localized deformity of the outlines. 4; deformed outlines in a small or normal sized kidney. 5; multiple defects. 6; diffuse hypoactive kidney without regional impairment. Follow-up scintigraphy was done at least 6 months after the initial study. When the abnormality on the initial scintigraphy was not completely resolved on the follow-up scan, the lesion was defined as containing a scar. RESULTS: One hundred and fifteen renal units of 166 units (69.3%) showed abnormal findings on the DMSA scintigraphy. 65 units (56.5%) was diagnosed as containing renal scars on follow-up scintigraphies. Incidences of renal scar among renal units showing pattern 3, 4 and 5 on the initial scan was 75%, 78% and 78%, respectively. Whereas many of renal units showing 1, 2 and 6 pattern were recovered (65%, 76%, 50%). Sensitivity, specificity and accuracy of pattern-based DMSA scintigraphic findings on the diagnosis of renal scar was 76.9%, 85.1% and 81.9%, respectively. VUR was significantly associated with the renal scar when the initial DMSA shows unrecoverable findings (pattern 3, 4, 5). Odds ratio of the renal scar in a kidney showing unrecoverable initial scintigraphic findings was 19.1. Odds ratio in a kidney with mild or moderate-to-severe VUR was 3.5 and 14.4 respectively. CONCLUSION: In the urinary tract infection, renal scar was significantly developed in a kidney showing unrecoverable findings on the initial DMSA scan and VUR on voiding cystoureterography.
Subject(s)
Child , Humans , Cicatrix , Congenital Abnormalities , Diagnosis , Follow-Up Studies , Incidence , Kidney , Odds Ratio , Radionuclide Imaging , Sensitivity and Specificity , Succimer , Technetium Tc 99m Dimercaptosuccinic Acid , Urinalysis , Urinary Tract Infections , Urinary Tract , Vesico-Ureteral RefluxABSTRACT
Gasless endoscopic surgery was applied to thyroidectomy. The procedure is a safe and technically feasible method producing good cosmetic results. Compared to the previous endoscopic thyroidectomies, this method is superior with respect to performing hemostasis and minimizing the possible complications resulting from gas insufflating surgery (e.g. hypercapnea or massive subcutaneous empysema). We successfully performed the removal of 37 thyroid tumors of 35 cases by gasless endoscopic surgery without any significant complications. No scars remained in the neck and all patients were satisfied with the cosmetic results. Gasless endoscopic thyroidectomy will become a strong alternative to conventional thyroidectomy for cases of benign thyroid tumors requiring good cosmetic results.
Subject(s)
Humans , Cicatrix , Hemostasis , Methods , Neck , Thyroid Gland , ThyroidectomyABSTRACT
Metaplastic carcinoma of the human mammary gland is a very rare disease that undergoes metaplastic changes,including squamous cell, spindle cell, and heterologous mesenchymal growth. We report a case of metaplasticcarcinoma of the breast, together with its radiologic and pathologic findings.
Subject(s)
Breast , Mammary Glands, Human , Rare DiseasesABSTRACT
A hypoplastic internal carotid artery is rare condition of uncertain etology, but the associated arterial anomaly in the circle of willis suggests a congenital origin. We report a case of hypoplasia of the right internal carotid artery in 55 year old female suffering from hypertension and showing cerebral ischemic symptoms. The patient was diagnosed with computed tomography(CT), single photon emission computed tomography(SPECT), and conventional angiography and magnetic resonance angiography(MRA). The angiographic examination raised a suspision of right internal carotid agenesis, but the MRA demonstrated conclusively a correct diagnosis as a right internal carotid artery hypoplasia.