Prune belly syndrome is a rare anomaly complex associated with absence of abdominal muscle combined with urinary tract abnormalities. We have encountered stillbirth female with severely distended abdomen without external genitalia end anus who was Finally confirmed as prune belly syndrome by an autopsy. Herein we report a case with review of literature.
Abdomen ; Abdominal Muscles ; Anal Canal ; Autopsy ; Female ; Genitalia ; Humans ; Prune Belly Syndrome* ; Stillbirth ; Urinary Tract

We experienced a case of transureteroureterostomy in a single kidney with multiple distal ureteral strictures. The patient had received nephrectomy due to staghorn calculi 14 years ago. We have utilized the abandoned ureter from the transureteroureterostomy with stenting. We have confirmed good drainage through the anastomosed ureter by radiological imaging. No other complications were observed except Pseudomonas urinary tract infection. Thereby we report this unique procedure of transureteroureterostomy using the 14-year-age abandoned ureter.
Calculi ; Constriction, Pathologic ; Drainage ; Humans ; Kidney ; Nephrectomy ; Pseudomonas ; Stents ; Ureter ; Urinary Tract Infections

No abstract available.
Antirheumatic Agents/therapeutic use ; Arthritis, Rheumatoid/blood/*complications/diagnosis/drug therapy/physiopathology ; Biological Markers/blood ; Drug Therapy, Combination ; Facial Dermatoses/complications/diagnosis ; Female ; Hand Joints/physiopathology/radiography ; Humans ; Immunosuppressive Agents/therapeutic use ; Inflammation Mediators/blood ; Knee Joint/physiopathology/radiography ; Lupus Erythematosus, Systemic/blood/*complications/diagnosis/drug therapy ; Middle Aged ; Syndrome ; Treatment Outcome

Aortic saddle embolus accounts for approximately 10% of all peripheral arterial emboli. The most common sources of emboli are left atrial thrombi associated with atrial fibrillation and vegetation. A 22-year-old male patient was admitted due to acute onset of orthopnea, tachypea and cough. Transthoracic and transeophageal echocardiography showed huge vegetation (3X2cm) of the posterior mitral valve leaflet which was associated with severe mitral regurgitation. On 14th hospital day, he suffered from sudden onset of weakness, pain, and coldness on both lower extremities. Follow-up echocardiography showed marked size reduction of the original mitral valve vegetation. Angiography showed aortic saddle embolus. The embolectomy of aortic saddle embolus was performed through the transfemoral approach with a Forgarty catheter. At the same time, removal of the infected mitral valve and mitral valve replacement were performed.
Angiography ; Atrial Fibrillation ; Catheters ; Cough ; Echocardiography ; Embolectomy ; Embolism* ; Follow-Up Studies ; Humans ; Lower Extremity ; Male ; Mitral Valve Insufficiency ; Mitral Valve* ; Young Adult

BACKGROUND: The increasing prevalence of type 2 diabetes mellitus (T2DM) is associated with the rapid spread of obesity. Obesity induces insulin resistance, resulting in beta-cell dysfunction and thus T2DM. Green tea extract (GTE) has been known to prevent obesity and T2DM, but this effect is still being debated. Our previous results suggested that circulating green tea gallated catechins (GCs) hinders postprandial blood glucose lowering, regardless of reducing glucose and cholesterol absorption when GCs are present in the intestinal lumen. This study aimed to compare the effect of GTE with that of GTE coadministered with poly-gamma-glutamic acid (gamma-PGA), which is likely to inhibit the intestinal absorption of GCs. METHODS: The db/db mice and age-matched nondiabetic mice were provided with normal chow diet containing GTE (1%), gamma-PGA (0.1%), or GTE+gamma-PGA (1%:0.1%) for 4 weeks. RESULTS: In nondiabetic mice, none of the drugs showed any effects after 4 weeks. In db/db mice, however, weight gain and body fat gain were significantly reduced in the GTE+gamma-PGA group compared to nondrug-treated db/db control mice without the corresponding changes in food intake and appetite. Glucose intolerance was also ameliorated in the GTE+gamma-PGA group. Histopathological analyses showed that GTE+gamma-PGA-treated db/db mice had a significantly reduced incidence of fatty liver and decreased pancreatic islet size. Neither GTE nor gamma-PGA treatment showed any significant results. CONCLUSION: These results suggest that GTE+gamma-PGA treatment than GTE or gamma-PGA alone may be a useful tool for preventing both obesity and obesity-induced T2DM.
Absorption ; Adipose Tissue ; Animals ; Appetite ; Blood Glucose ; Catechin ; Cholesterol ; Diabetes Mellitus, Type 2 ; Diet ; Eating ; Fatty Liver ; Glucose ; Glucose Intolerance ; Incidence ; Insulin Resistance ; Intestinal Absorption ; Islets of Langerhans ; Mice ; Obesity ; Polyglutamic Acid ; Prevalence ; Tea ; Weight Gain

PURPOSE: The study was conducted to examine the usefulness of somatosensory evoked potentials (SEP) and proton magnetic resonance spectroscopy (1H-MRS) in predicting poor outcomes for comatose survivors after cardiopulmonary resuscitation. METHODS: We investigated 36 patients who were comatose after cardiac arrest. Among them, 35 had short latency SEP, and 27 had 1H-MRS. Both tests were performed in 26 patients. To estimate the cerebral outcome, we used the cerebral performance category (CPC) to classify the outcomes for our patients as good (CPC 1-2) or poor (CPC 3-5). RESULTS: Of the 36 patients, 11(31%) presented with good outcomes (CPC 1-2). A bilaterally absent N20 peak (n=35) predicted poor outcomes with a sensitivity of 54.2% and a specificity of 100%. A lactate-positive resonance (n=27) predicted poor outcomes with a sensitivity of 78.9% and a specificity of 100%. Using a combination of a bilaterally absent N20 peak and a lactate-positive resonance (n=26) predicted poor outcomes with a sensitivity of 94.4% and a specificity of 100%. CONCLUSION: The combination of a bilaterally absent N20 peak and a lactate-positive resonance is better than either alone in predicting poor outcomes in patients who are comatose after cardiac arrest.
Cardiopulmonary Resuscitation* ; Coma* ; Evoked Potentials, Somatosensory* ; Heart Arrest ; Humans ; Magnetic Resonance Spectroscopy* ; Protons* ; Sensitivity and Specificity ; Survivors*

An iliopsoas abscess is a collection of pus in the iliopsoas muscle caused by the direct spread of infection from adjacent internal organs or by hematogenous or lymphatic spread from distal sites. Its symptoms are vague back, hip, thigh or lower abdomen pain with insidious onset, similar to those of ankylosing spondylitis (AS). Therefore diagnosing an iliopsoas abscess in patients with AS is difficult. A forty-three year-old man was treated with adalimumab, a tumor necrosis factor inhibitor, and clinical symptoms were subsequently observed to improve. One year after voluntary discontinuation of adalimumab, the patient returned with a recurrence of right buttock pain and was diagnosed as having aggravated AS. Following re-initiation of adalimumab, symptoms did not improve and fever developed. On the basis of imaging studies, the patient was diagnosed as having an iliopsoas abscess and was successfully treated with intravenous antibiotics.
Abdomen ; Anti-Bacterial Agents ; Buttocks ; Fever ; Hip ; Humans ; Psoas Abscess* ; Recurrence ; Spondylitis, Ankylosing* ; Suppuration ; Thigh ; Tumor Necrosis Factor-alpha

OBJECTIVES: Our study examined the dose-response relationship between smoking amounts (pack-years) and the risk of developing pancreatic cancer in Korean men. METHODS: Of 125,743 participants who underwent medical health checkups in 2009, 121,408 were included in the final analysis and observed for the development of pancreatic cancer. We evaluated the associations between smoking amounts and incident pancreatic cancer in 4 groups classified by pack-year amounts. Cox proportional hazards models were used to estimate the adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of incident pancreatic cancer by comparing groups 2 (<20 pack-year smokers), 3 (20-≤40 pack-year smokers), and 4 (>40 pack-year smokers) with group 1 (never smokers). RESULTS: During 527,974.5 person-years of follow-up, 245 incident cases of pancreatic cancer developed between 2009 and 2013. The multivariate-adjusted HRs (95% CIs) for incident pancreatic cancer in groups 2, 3, and 4 were 1.05 (0.76 to 1.45), 1.28 (0.91 to 1.80), and 1.57 (1.00 to 2.46), respectively (p for trend=0.025). The HR (95% CI) of former smokers showed a dose-response relationship in the unadjusted model, but did not show a statistically significant association in the multivariate-adjusted model. The HR (95% CI) of current smokers showed a dose-response relationship in both the unadjusted (p for trend=0.020) and multivariate-adjusted models (p for trend=0.050). CONCLUSIONS The risk of developing pancreatic cancer was higher in current smokers status than in former smokers among Korean men, indicating that smoking cessation may have a protective effect.

Dural arteriovenous fistula (DAVF) is a rare condition affecting approximately 1.5% of 1,000,000 individuals annually. It frequently occurs in the transsigmoid and cavernous sinuses. An isolated sigmoid sinus is extremely rare and is treated by performing transfemoral transvenous embolization along the opposite transverse sinus.A 69-year-old woman presented with asymptomatic Borden type III/Cognard type III DAVF involving an isolated sigmoid sinus. She underwent a staged operation in which a navigation system was used to expose the sigmoid sinus in the operating room before transferring the patient to the angio suite for transvenous embolization.Various modalities have been used to treat DAVF, including surgical disconnection, transarterial embolization, transvenous embolization, and stereotactic radiosurgery. However, treating DAVF cases where the affected sinus is isolated can be challenging because an easily accessible surgical route may not be available. In this case, direct sinus cannulation and transvenous embolization were the most effective treatments.

PURPOSE: Over the last 30 years, Serratia marcescens (S. marcescens) has emerged as an important pathogen, and a common cause of nosocomial infections. The aim of this study was to identify risk factors associated with mortality in patients with S. marcescens bacteremia. MATERIALS AND METHODS: We performed a retrospective cohort study of 98 patients who had one or more blood cultures positive for S. marcescens between January 2006 and December 2012 in a tertiary care hospital in Seoul, South Korea. Multiple risk factors were compared with association with 28-day all-cause mortality. RESULTS: The 28-day mortality was 22.4% (22/98 episodes). In a univariate analysis, the onset of bacteremia during the intensive care unit stay (p=0.020), serum albumin level (p=0.011), serum C-reactive protein level (p=0.041), presence of indwelling urinary catheter (p=0.023), and Sequential Oran Failure Assessment (SOFA) score at the onset of bacteremia (p<0.001) were significantly different between patients in the fatal and non-fatal groups. In a multivariate analysis, lower serum albumin level and an elevated SOFA score were independently associated with 28-day mortality [adjusted odds ratio (OR) 0.206, 95% confidential interval (CI) 0.044-0.960, p=0.040, and adjusted OR 1.474, 95% CI 1.200-1.810, p<0.001, respectively]. CONCLUSION: Lower serum albumin level and an elevated SOFA score were significantly associated with adverse outcomes in patients with S. marcescens bacteremia.
Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents/therapeutic use ; Bacteremia/drug therapy/microbiology/*mortality ; Cross Infection/mortality ; Female ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Multiple Organ Failure ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors ; Serratia Infections/diagnosis/drug therapy/*mortality ; Serratia marcescens/drug effects/*isolation & purification ; Severity of Illness Index ; Survival Rate ; Time Factors ; Treatment Outcome