A Case of Renal Cell Carcinoma(Adenocarcinoma) in Nine Years Old Girl

A 9 years old girl has been admitted to hospital because of 5 days history of gross hem aturia. Physical examination on admission, She was eassentially normal except enlarged tonsils. Hb, Hct, WBC and Platelets were also nornal, ESR was 5mm/Hr. ASO titer was less than 1:60, C3 was 58mg%(normal:43-200mg%), BUN 11mg%, Creatinine 0.8mg% Serum cholesterol 160mg%, Total Protein 7.1mg% with albumin 4.9mg%, 24 hours urine protein 209mg and creatinine clearance 84ml/min/1.7m2. PT and PTT were also within normal range. Throat and urine cultures revealed no microorganisms. Excretory urogram, renal scan, renal angilgram showed 3.5X4cm sized space occuupying lesion on right upper pole of kidney. Right neprectomy was performed under impression of intramural wilms' tumor and followed intravenovenous injection of actinomycin D gamma/kg. Histopathological finding revealed partially clear dell type renal cell carcinoma which is extremely rare in pediatric age. Regional lymphnode and vessels disclosed no malignant cells. She received 3,000 rad radiati on on tumor bed on the 3rd postoperative day and two weeks later, hemotherapeutics were followed with actinomycin D 15 gamma/kg for 5 days per week for total 8 weeks and vincristine 1.5mg/M2/week for total 12 weeks. Six months later afeter completion of above treatment, she is doing well and attending to school.

Clinical Study and Diagnostic Value of Monocytosis

The usefullness of monocytosis in routine CMC as an aid in diagnosis of several diseases was evaluated in infancy and children. 234 cases in which the absolute count was more than 750 mono cyte per cubic millimeter were the subject of this study. The following results were obtained; 1) 234 cases (2.9%) of total 8069 patients from Oct. 1977 to Aug. 1978 showed monocytosis. 2) monocytosis was found in infectious diseases, hematologic disorders and malignant diseases. Most common cause of absolue monocytosis was infectious diseases(73%). 3) The 171 cases in infectious diseases group included congenital syphilis, pneumonia, tuberculosis, bacterial meningitis, bacillary dysentery, etc. And weconcluded that the monocytosis is useful as an aid in diagnosing several disease.

Clinical and Statistical Study on the Congenital Anomalies of the Digestive system

A study was conducted to present clinical and statistical analysis of pediatric patients admitted to Severance Hospital between Jan. 1966 and Dec. 1975. Remakable progress has been made in the field of pediatrics and pediatric surgery, particularly in physiology, anesthesiology and operative technique. However, the ultimate result hasn't been totally satisfactory, largely due to the lack of cognizance of early diagnosis and prompt treatment. Futhermore, most of the patients with associated abnormal conditions, such as congenital heart disease, other associated G.I. anomalies and chromosomal anomalies, require surgery, urgently A total of 250 cases were analyzed according to systems. The following results were obtained; 1. 1. In the sex ratio male to female was 6-7:1. 2. 2. The order of frequency of diseases was as follows; Congenital megacolon 50 cases(20.0%), Imperforated anus 45 cases (18.0%), Congenital hypertrophic pyloric stenosis 41 cases(16.4%), Congenital anomalies of intestine 29 cases (11.6%), Congenital anomalies of hepatobiliary system 25 cases(10.0%), Meckel's diverticulum 18 cases(7.2%), Situs inversus 11 cases (4.4%), Congenital diaphragmatic hernia 6cases(2.4%), Congenital anomalies of cecum 6 cases(2.4%), Esophageal diverticulum 6 cases (2.4%), Esophagealatresia 4 cases (1.6%), Congenital anomalies of pancreas 4 cases (1.6%), Patent omphalomessentric duct 2 cases (0.8%), Congenital intestinal perforation 2 cases (0.8%), and Congenital stomach perforation 1 cases (0.4%). 3. There was an overall mortality rate of 36 cases (18.9%), the causes of death were frequently associated with respiratory failure. 4. Associated congenital anomlies were found in 57 cases. They were G. I. Anomalies, congenital heart diseases, Down's syndrome and cleft palate. 5. Of significance was the fact in this study, congenital megacolon had the highest incidence which was in sharp contrast to accidental series in which congenital hypertrophic pyloric stenosis showed the peak incidence. These figures are very similar to that reported in various publications. This analysis suggest that a more keen understanding of neonatal physiology, embryology, surgical technique and improved post-operative care for anomalous patients, may certainly improve the ultimate outcome of corrective surgery.