Long-term follow-up of children with steroid-responsive Nephritic Syndrome

Nephrotic syndrome is one of the most remarkable diseases in childhood. The majority of patients have prompt response to corticosteroids. Methods: In this study, we retrospectively evaluate the outcome of patients with steroid-responsive nephritic syndrome. Medical records from January 1996 to September 2006 were reviewed to identify all children with steroid sensitive nephrotic syndrome at the Pediatric Medical Center, Tehran, Iran. Initial steroid therapy was 60 mg/m[2] per day for four weeks. Levamisole, a steroid-sparing agent, was prescribed at a dose of 2.5 mg/kg on alternate days in conjunction with alternate-day prednisolone. If no benefit was observed by three months, levamisole was discontinued and immunosuppressive therapy with cyclophosphamide at a dose of 3 mg/kg daily for 8 weeks, or cyclosporin A at a dose of 3-5 mg/kg was prescribed. Of 745 children with steroid sensitive nephrotic syndrome, 63.1% of patients were male. The most common causes were minimal change disease [98/324, 30.2%] and focal segmental glomerulosclerosis [81/324, 25%]. At presentation, microscopic hematuria was found in 22.6% of the patients. During follow-up, 9.2% had no relapse at any time, while 15.8% were frequent relapsers. The remission period ranged from 3.5 to 168 months. At the last follow-up, 57.6% of the patients were in remission, 37.7% relapsed and 29 children developed chronic renal failure. The outcome of nephrotic syndrome was not associated with age or gender. The end clinical status of patients correlated with duration of remission, number of subsequent relapses and response to cytotoxic agents. Conclusion: Steroid-responsive nephrotic syndrome in children should be followed over a long period, especially patients with early relapse. Relapse was seen in more than 90% of patients. Documentation of histopathology by renal biopsy may be helpful to identify those at increased risk for a poor outcome

case report of urachal adenocarcinoma

The urachus connects the bladder with the allantois during development, at birth it retracts from the bladder, but its lumen may persist within the bladder wall and results in cyst or epithelial neoplasms. In this paper a very rare case is presented, that is a male 68 years old patient, who admitted with a huge abdominal mass. He had a history of a small periumblical mass that was positional. Laparatomy was done and the mass resected and path-lab report was urachal adenocarcinoma

Evaluation of breast scan with[99m] tc-mibi in differential diagnosis of breast masses

Introduction: Breast cancer in women is second only to lung cancer with respect to cancer deaths. Early detection of this cancer is believed to improve patient survival and to prevent metastasis

Material and Method: This descriptive study was designed to evaluate the value of [99m] TC-MIBI-breast scintigraphy in differential diagnosis of breast masses. A total of 20 patients during a 12-months period [from March 2003 to March 2004] in Imam Reza Hospital evaluated. After clinical examinations and breast MIBI scan, excisional biopsy was done

Result: We studied 21 breast masses. 14 masses were malignant tumours and 7 masses were benign tumours. The mean value of MIBI uptake in malignant masses of breast was significantly greater than benign masses [P=0.05]. The sensitivity and specifity of breast scan with [99m] TC-MIBI using qualitative interpretation was 78.5% and 85.7% respectively. The sensitivity and specifity of [99m] TC-MIBI using tumour/background ratio in detection of malignancy was 92.3% and 71.4% respectively

Conclusion: In this study it was found that quantitative interpretation of [99m] TC-MIBI scintimammography considering tumour/background uptake ratio [>1.3] is highly sensitive for detection of breast cancer