Multilocular cystic renal cell carcinoma is a distinct subtype of renal cell carcinoma with its pathological characteristics and good prognosis. Multilocular renal cysts and renal cell carcinoma with cystic change are important differential diagnoses. We report a case of multilocular cystic renal cell carcinoma in a 37-year-old woman who came to the hospital because of the right renal mass. The removed right kidney showed a 6x4 cm well defined cystic mass in the lower pole. On cut section there were multiple cavities in the mass, filled with serosanguineous fluid and focal yellowish solid area. Microscopically, these cysts were lined by a single layer of flat or cuboidal cells consisted of clear cytoplasm with small central nuclei. In some portions of the tumor, the clear neoplastic cells formed sheets within the septa or walls of the cysts.
Adult ; Carcinoma, Renal Cell* ; Cytoplasm ; Diagnosis, Differential ; Female ; Humans ; Kidney ; Multicystic Dysplastic Kidney ; Prognosis

BACKGROUND: Discrepancies exist in the existing researches regarding the association between social capital and self-efficacy, and most of these researches have been done in developed countries. The aims of this study were to assess the independent association between individual social capital and self-efficacy and to assess the associations between individual social capital, self-efficacy and self-rated health. METHODS: Data were obtained from the Gyeongnam health survey (6,500 persons) conducted in 2008. A self-administered questionnaire was additionally administered to gather information on demographic variables, health behaviors, chronic diseases, self-efficacy, social capital, and self-rated health status. Total study population was 3,843 as those with chronic diseases were excluded. RESULTS: In males, trust was positively associated with confidence and preference to task difficulty, and participation was negatively associated with confidence and positively associated with regulation and preference to task difficulty. In females, trust was positively associated with confidence and preference to task difficulty and negatively associated with regulation. Participation was positively associated with preference to task difficulty. In males, the odds for self-rated health status was better for persons with confidence (95% confidence interval, CI 1.088-1.705), trust (95% CI 1.172-1.821) and participation (95% CI 1.268-2.117). In females, the odds for self-rated health status was better for those with confidence (95% CI 1.250-1.803), preference of task difficulty (95% CI 1.019-1.683) and participation (95% CI 1.024-1.555). CONCLUSIONS: High social capital measured at an individual level may promote self-efficacy and health status.
Chronic Disease ; Developed Countries ; Female ; Health Behavior ; Health Surveys ; Humans ; Male ; Self Efficacy ; Surveys and Questionnaires

No abstract available.
Adenoids* ; Carcinoma, Adenoid Cystic* ; Maxillary Sinus*

The association between blood lead children and Intelligent Quotient(IQ) was investigated in a sample of l00 boys and girls aged 6-8 years from one primary school within an industrial area of Pusan. The trained undergraduates in school of public health administered an I.Q. test one by one. Parents answered a questionnaire on demographic, perinatal and socioeconomic variables. Atomic Absorbtion spectrophotometer was used to determine blood lead levels. The geometric mean of blood lead value was 7.99 microgram/dl. In total children, there was no significant relationship between blood lead level and I.Q. But in the children who were born of gestational age of less than 38 weeks, children with higher levels of blood lead performed more poorly on I.Q. test with correlation coefficient from -0.68 to -0.71. But, the children who were born of gestational age of 38 weeks and more were same as total children. These results suggest that exposure to low levels of lead in the children who were born premature probably may result in impaired intelligent development. But, we think that more profound study should be performed with sufficient numbers of subjects.
Busan ; Child* ; Female ; Gestational Age ; Humans ; Intelligence* ; Parents ; Public Health ; Surveys and Questionnaires

Secondary amyloidosis occurs in patients with chronic inflammatory diseases, such as rheumatoid arthritis (RA) and ankylosing spondylitis (AS). The major therapeutic approach to secondary amyloidosis involves controlling the underlying inflammatory disease. Tumor necrosis factor-alpha (TNF-alpha) inhibitors have revolutionized the treatment of rheumatic diseases; in many cases dramatic clinical improvement of secondary amyloidosis due to AS has been observed in response to treatment with these agents. However, the development of secondary amyloidosis associated with AS refractory to treatment with TNF-alpha inhibitors has been infrequently reported. Here, we described a case of a 37-year-old male patient with longstanding AS who was diagnosed with secondary amyloidosis due to high disease activity despite treatment with etanercept, adalimumab and infliximab.
Adult ; Amyloidosis* ; Arthritis, Rheumatoid ; Humans ; Male ; Rheumatic Diseases ; Spondylitis, Ankylosing* ; Tumor Necrosis Factor-alpha* ; Adalimumab ; Infliximab ; Etanercept

There have been controversies on the effect of albumin in treating edema in nephrotic syndrome patients. We evaluated the additive diuretic effect of coadministration of furosernide with albumin in the six patients with nephrotic syndrome. We administered 160mg of furosemide intravenously for 1 hour with 100rnl of 20% albumin or 5% dextrose by random cross-over design. The urine and plasma furosemide concentrations were measured by HPLC. After the administration of furosemide alone, urine volume, urinary excretions of sodium and chloride were increased significantly compared to those of basal state (P<0.05). But, coadministration of furose-mide with albumin did not increase significantly the urine voume (2285+/-445ml vs. 3023+/-715ml), urinary excretions of sodium (194+/-58rnmol/day vs. 282+/-85 mmol/day) and chloride (213+/- 54mmoVday vs. 286+/- 74mmoVday) comparing to those of furosemide only cases. Addition of albumin to furosemide did not significantly changed pharmacokinetic parameters such as AUC (28.3+/-5.5ug/ml hr vs 36.0+/-6.7ug/ml hr), total plasma clearance (115+/-30mVmin vs 108+/-41ml/min), volume of distribution (0.13+/-0.02L/kg vs 0.10+/- 0.01L/kg), elirnination half life (1.4+/-0.3hr vs 1.5+/-0.3hr), and urine furosemide excretion (44+/-8% vs 43+ 10%). We concluded that albumin infusion did not enhance the diuretic action of furosemide pharmacodynamically and pharmacokinetically in patients with nephrotic syndrome.
Area Under Curve ; Chromatography, High Pressure Liquid ; Cross-Over Studies ; Diuretics ; Edema ; Furosemide* ; Glucose ; Half-Life ; Humans ; Nephrotic Syndrome* ; Pharmacokinetics ; Plasma ; Sodium

Background and Objectives: Most laryngeal imaging modalities used continuous light source. However, videostroboscopy adopted the unique stroboscopic flashing light triggered externally and is consistent with fundamental voice frequencies. If laryngeal stroboscopic effect could be obtained in the field of continuous illumination, it woud be more compatible with conventional video. In this study, we established the mathematical algorithm for stroboscopic effect with continuous light and tried to determine the feasibility of laryngeal stroboscopic effect with conventional laryngoscopy using continuous light in the mechanical model.Materials and Method The mechanical model of fan motor system was used to validate to the present study. Rotational images of the fan motor were captured using conventional laryngoscope with continuous light source. Results: On the basis of the mathematical model, the optimal ranges of the frequency for stroboscopic effect were expected as (multiples of sampling rate [S])±(S/5). In the fan motor model, the stroboscopic effects could be confirmed on the basis of the mathematical model using conventional videolaryngoscopy with continuous light source. Conclusion Laryngeal stroboscopic effect with continuous light source might be feasible. The stroboscopic effect with continuous light would be expected to provide greater compatibility to integrate with the other imaging modalities for the vocal folds.

Rhabdomyosarcoma is the most common soft tissue sarcoma in childhood and young adult. Rhabdomyosarcoma can be classified into one of four type; embryonal, alveolar, pleomorphic, undifferentiated. Embryonal rhabdomyosarcomas of the female genital tract are rare, malignant tumors derived from primitive myogenic precursor and generally occur during infancy and childhood. About twenty percent of rhabdomyosarcoma arise in the genitourinary tract, with slightly more than half being embryonal rhabdomyosarcoma. Vaginal primaries are 5-times more common than cervical primaries. Overall, cervical tumor may predominate in adolescent. In perimenopausal women, the uterus is the most common site of rhabdomyosarcoma. The management of rhabdomyosarcoma of genitourinary tract has changed slowly from pelvic exenteration without adjuvant therapy to neoadjuvant chemotherapy followed by less radical surgery and postoperative radiation. Embryonal rhabdomyosarcomas originates in the uterine cervix are extremely rare especially in the thirties. So, little information is available regarding its prognosis and therapy. We present a case of a woman 31 years old with embryonal rhabdomyosarcoma of the uterine cervix with a review of a literature.
Adolescent ; Adult* ; Cervix Uteri* ; Drug Therapy ; Female ; Humans ; Pelvic Exenteration ; Prognosis ; Rhabdomyosarcoma ; Rhabdomyosarcoma, Embryonal* ; Sarcoma ; Uterus ; Young Adult

Aconite, derived from the roots of certain aconitum species (Racunculaceae), is widely distributed in Korea. Aconitine, an extremely toxic substance present in aconite, has pharmacological effects, including anti-inflammatory, analgesic, and positive inotropic actions. Due to its relatively low safe dose, we sometimes encounter cases of serious aconite intoxication. The toxic compound mainly affects the CNS, heart, and muscle tissues, resulting primarily in cardiovascular complications. Aconite poisoning presents with a combination of neurological, cardiovascular, and gastrointestinal features. The main cause of death is severe cardiotoxicity causing refractory ventricular tachyarrhythmias and asystole. As there is no specific antidote, management of aconite poisoning is supportive. All patients require close monitoring of blood pressure and cardiac rhythm since ventricular arrhythmias may occur during the first 24 hours of poisoning, resulting in sudden deterioration in the patient's clinical condition. Extracorporeal membrane oxygenation (ECMO) has traditionally been utilized for perioperative cardiac failure and cardiomyopathies. More recently, the indications for ECMO have expanded to patients with acute cardiovascular decompression including intractable arrhythmias. We report on a patient who developed life threatening ventricular tachyarrhythmia after ingestion of herbal tablets containing aconite alkaloids. Our patient was resuscitated with intravenous infusion of amiodarone, repeated cardioversion/defibrillation, and mechanical circulatory support with ECMO.
Aconitine ; Aconitum* ; Alkaloids ; Amiodarone ; Arrhythmias, Cardiac* ; Blood Pressure ; Cardiomyopathies ; Cause of Death ; Decompression ; Eating ; Extracorporeal Membrane Oxygenation* ; Heart ; Heart Arrest ; Heart Failure ; Humans ; Infusions, Intravenous ; Korea ; Poisoning ; Tablets ; Tachycardia ; Tachycardia, Ventricular

Bromate salt is very toxic oxidant. The clinical manifestations of bromate intoxications are vomiting, diarrhea, depression of central nervous system, oliguric or non-oliguric renal failure, hemolytic anemia and deafness. Most of the toxic manifestations are reversible with the exception of renal failure and deafness. Since bromate is a small hydrophilic molecule, its removal by dialysis, especially hemodialysis, can reasonably be expected. Since the serious complications such as deafness, acute renal failure usually occur concurrently within 4-16 hours after ingestion, dialysis should therefore be considered in every patient presenting within a few hours of a significant amount of bromate. Recently, we encountered a 40-year-old female, past hairdresser, who was admitted to Asan Kangnung Hospital due to frequent diarrhea, vomiting and anuria after ingestion of sodium bromate. The patient required regular hemodialysis therapy and has not any evidence of complication such as hearing loss, blindness and irreversible renal failure. The clinician must assess the potential for preventing irreversible ototoxicity and nephrotoxicity and weigh the importance of early intervention against the possible risks of aggressive treatment in bromate intoxication.
Acute Kidney Injury* ; Adult ; Anemia, Hemolytic ; Anuria ; Blindness ; Central Nervous System ; Chungcheongnam-do ; Deafness ; Depression ; Dialysis ; Diarrhea ; Early Intervention (Education) ; Eating ; Female ; Hearing Loss ; Humans ; Renal Dialysis ; Renal Insufficiency ; Sodium ; Vomiting