A case of 26 years old male having horseshoe kidney associated with giant hydronephrosis due to aberrant vessel was presented with a brief review of the literatures. The patient was managed by division of isthmus and nephrectomy with good result.
Adult ; Humans ; Hydronephrosis* ; Kidney* ; Male ; Nephrectomy

A 27-year-old female with low back pain and paresthesia on the left lower extremity had been treated. Lumbar myelography showed total block of the dye column at the L3 vertebral body level with a brush border. After myelography, total laminectomy on the L3 and L4 vertebrae was done. The result of operation and biopsy revealed an extradural meningioma of angioblastic type. 9 days after the surgery all neurological deficits were completely recovered.
Adult ; Biopsy ; Female ; Humans ; Laminectomy ; Low Back Pain ; Lower Extremity ; Meningioma* ; Microvilli ; Myelography ; Paresthesia ; Spine

A rare case of primary reticulum cell sarcoma(microglioma) of the brain in a 30-year-old female is reported. The tumor was located in the left parietal lobe. Brain CT scan showed a slightly high attenuated area with well demarcation in the left parietal lobe, and a tumor staining was appeared in the delayed arterial phase of the left carotid angiogram. Osteoplastic craniotomy on the left parietal area was performed for removal of tumor. Then the patient received radiation therapy with a good result.
Adult ; Brain* ; Craniotomy ; Female ; Humans ; Parietal Lobe ; Rabeprazole ; Reticulum* ; Tomography, X-Ray Computed

BACKGROUND: Propofol has a high incidence of pain with intravenous injection, and different methods have been used to minimize the incidence and severity of this pain. In this study, we have compared the effect of lidocaine pretreatment with that of ketamine pretreatment on propofol injection pain. METHODS: Ninety healthy female patients scheduled for general anesthesia were randomly divided into three groups; saline group (n=30), lidocaine group (n=30) and ketamine group (n=30). Each patient received 2 ml of pretreatment solution (normal saline, 1% lidocaine, 0.5% ketamine) via 18G angiocatheter inserted in the antecubital fossa after applying an arm tourniquet inflated to 50 mmHg. The tourniquet was released 1 minute later, followed by intravenous injection of 2.5 mg/kg of propofol. The assessment of pain was made at the induction of anesthesia and in the recovery room, and the severity of pain was classified as none, mild, moderate, severe by one observer. RESULTS: The severity and incidence of pain diminished significantly in the lidocaine group and the ketamine group compared with the saline group at the induction of anesthesia (p<0.05) and there was no significant difference between the lidocaine group and the ketamine group. We had similar results in the recovery room and one patient from the saline group and the ketamine group had no recall regarding injection pain. CONCLUSION: Intravenous ketamine pretreatment is as effective as intravenous lidocaine pretreatment in alleviating the propofol injection pain.
Anesthesia ; Anesthesia, General ; Arm ; Female ; Humans ; Incidence ; Injections, Intravenous ; Ketamine* ; Lidocaine* ; Propofol* ; Recovery Room ; Tourniquets

The Acknowledgements was published incorrectly.

OBJECTIVE: Circulating cell-free tumor DNA (cfDNA) is the DNA released by apoptotic and necrotic cells of the primary tumor into the blood during the period of tumor development. The cfDNA reflects the genetic and epigenetic alterations of the original tumor. TP53 mutations are a defining feature of high-grade serous ovarian carcinoma. We optimized the methods for detecting TP53 mutations in cfDNA from blood samples. We confirmed the correlation of TP53 mutation in primary ovarian cancer tissue and it in cfDNA using digital polymerase chain reaction (dPCR). METHODS: We found 12 frequent mutation sites in TP53 using The Cancer Genome Atlas and Catalogue of Somatic Mutations in Cancer data and manufactured 12 primers. The mutations in tissues were evaluated in fresh-frozen tissue (FFT) and formalin-fixed paraffin-embedded tissue (FFPET). We performed a prospective analysis of serial plasma samples collected from 4 patients before debulking surgery. We extracted cfDNA and calculated its concentration in blood. dPCR was used to analyze TP53 mutations in cfDNA, and we compared TP53 mutations in ovarian cancer tissue with those in cfDNA. RESULTS: Ten primers out of 12 detected the presence of TP53 mutations in FFT, FFPET, and cfDNA. In FFT and FFPET tissue, there were no significant differences. The average cfDNA concentration was 2.12±0.59 ng/mL. We also confirmed that mutations of cfDNA and those of FFT were all in R282W site. CONCLUSION: This study developed detection methods for TP53 mutations in cfDNA in ovarian cancer patients using dPCR. The results demonstrated that there are the same TP53 mutations in both ovarian cancer tissue and cfDNA.
Biomarkers ; DNA* ; Epigenomics ; Genome ; Humans ; Ovarian Neoplasms* ; Plasma ; Polymerase Chain Reaction ; Prospective Studies

PURPOSE: As average life expectancies are prolonged, the elderly population is steadily increasing. The increasing number of elderly persons has been accompanied by cases of acute appendicitis in the elderly. In order to understand the clinical significance and to improve the treatment of elderly patients with appendicitis. we analyzed patients over 60 years of age with appendicitis. METHODS: We retrospectively reviewed the medical records of 268 patients over 60 years of age who were pathologically diagnosed with appendicitis. We analyzed the patients' clinicopathologic factors and outcomes, dividing them into 3 age groups: 60~69, 70~79, 80 and over. RESULTS: Of the 268 patients, there were 109 male and 159 female. The sex ratio was 1:1.46. The numbers of patients in each group were 169 (63.1%) in the 60-69 group, 73 (27.2%) in the 70~79 group, and 26 (9.7%) in the over 80 group. There was no difference in the leukocyte count and the time delay in surgical treatment between the groups. In the older groups, compared to the younger groups, there were more frequent paramedian and median incisions in the operation (P=0.02), a longer duration of postoperative admission (P=0.001) and starvation after the operation (P<0.001). In the pathologic findings, the gangrenous and abscess stages of appendicitis were more frequent in the older groups than in the younger groups (P<0.001). CONCLUSIONS: Early aggressive diagnostic intervention, such as ultrasound and CT, is essential in managing appendicitis in elderly patients who complain of vague abdominal pain.
Abdominal Pain ; Abscess ; Aged* ; Appendicitis* ; Female ; Humans ; Leukocyte Count ; Life Expectancy ; Male ; Medical Records ; Retrospective Studies ; Sex Ratio ; Starvation ; Ultrasonography

A 23 year-old female patient complained of recurrent abdominal cramps and underwent emergency appendectomy in a private clinic. Two weeks later, she complained of lower GI bleeding and was referred to our hospital. On admission, she had abdominal pain and arthralgia but no hematuria. On physical examination, she was hemodynamically stable but was pale. There was no specific finding in laboratory test, except slightly lower level of blood hemoglobin. EGD revealed no specific findings. Colonoscopy showed fresh blood in the colon with small ulcers and erosions in the ileocecal valve but no source of active bleeding. On third admission day, she developed palpable macular rash initially over her lower legs, ankles, wrist joints and later on anterior abdominal wall. Capsule endoscopy revealed several small and large ulcers and erosions in the entire small bowel with blood clots. She was diagnosed clinically as a case of Henoch-Schonlein purpura through her clinical history and skin lesions. She was administered prednisolone 40 mg/day for a period of one week. Her symptoms, G-I bleeding as well as the skin lesions responded well to steroid therapy and she remained asymptomatic afterwards.
Abdominal Pain ; Abdominal Wall ; Ankle ; Appendectomy ; Arthralgia ; Capsule Endoscopy* ; Colic ; Colon ; Colonoscopy ; Emergencies ; Exanthema ; Female ; Hematuria ; Hemorrhage* ; Humans ; Ileocecal Valve ; Leg ; Physical Examination ; Prednisolone ; Purpura, Schoenlein-Henoch* ; Skin ; Ulcer ; Wrist Joint ; Young Adult

We describe a 39-year-old man with spontaneous rupture of a gastric stromal tumor causing hemoperitoneum. Ultrasonography showed a large mass broadly abutting the stomach and liver. Computed tomography demonstrated a heterogeneous enhanced mass arising from the stomach and focal perforation of the tumor with hemoperitoneum; endoscopic ultrasonography showed an exophytic heterogeneous mass originating from the gastric muscle layer. Angiography revealed that the right gastric artery was the main artery supplying the tumor. A gastric stromal tumor with bloody fluid in the peritoneal cavity was seen at the laparotomy. The tumor was excised completely, and subsequent histological and immunohistochemical studies indicated that it was a gastric stromal tumor. We report a relatively rare case of gastric stromal tumor causing hemoperitoneum due to spontaneous rupture of the tumor.
Adult ; Angiography ; Arteries ; Endosonography ; Hemoperitoneum ; Humans ; Laparotomy ; Liver ; Muscles ; Peritoneal Cavity ; Rupture, Spontaneous ; Stomach

Interstitial pneumonia (IP) frequently occurs in patients with scrub typhus, but its clinical significance is not well known. This study was designed to evaluate interstitial pneumonia as a marker of severity of the disease for patients with scrub typhus. We investigated clinical parameters representing the severity of the disease, and the chest radiographic findings for 101 patients with scrub typhus. We then compared these clinical factors between patients with and without IP. We also studied the relationship between IP and other chest radiographic findings. The chest radiography showed IP (51.4%), pleural effusion (42.6%), cardiomegaly (14.9%), pulmonary alveolar edema (20.8%), hilar lymphadenopathy (13.8%) and focal atelectasis (11.8%), respectively. The patients with IP (n=52) had higher incidences in episode of hypoxia (p=0.030), hypotension (p=0.024), severe thrombocytopenia (p=0.036) and hypoalbuminemia (p=0.013) than the patients without IP (n=49). The patients with IP also had higher incidences of pleural effusion (p<0.001), focal atelectasis (p=0.019), cardiomegaly (p<0.001), pulmonary alveolar edema (p=0.011) and hilar lymphadenopathy (p<0.001) than the patients without IP. Our data suggest that IP frequently occurs for patients with scrub typhus and its presence is closely associated with the disease severity of scrub typhus.
Adult ; Aged ; Aged, 80 and over ; Female ; Fluorescent Antibody Technique, Indirect ; Humans ; Incidence ; Lung/microbiology/radiography ; Lung Diseases, Interstitial/epidemiology/*microbiology/*radiography ; Male ; Middle Aged ; Pleural Effusion/epidemiology/microbiology/radiography ; Predictive Value of Tests ; Prognosis ; Scrub Typhus/*complications/epidemiology/*radiography ; *Severity of Illness Index