Ultrasonography is a useful tool for the differential diagnosis of acute flank pain. Renal stones appear as a focal area of echogenicity with acoustic shadowing on ultrasonography. In acute pyelonephritis (APN), the kidneys may be enlarged and have a hypoechoic parenchyma with loss of the normal corticomedullary junction. However, clinical and laboratory correlations are essential for the diagnosis of renal stones and APN through imaging studies. This review describes the typical ultrasonography features of renal stones and APN. Moreover, in daily practice, cross-sectional imaging is essential and widely used to confirm renal stones and APN and to differentiate them from other diseases causing flank pain. Other diseases causing acute flank pain are also described in this review.
Acoustics ; Diagnosis ; Diagnosis, Differential ; Flank Pain* ; Kidney ; Pyelonephritis* ; Shadowing (Histology) ; Ultrasonography* ; Urinary Calculi

This study was designed to determine the attitude and degree of satisfaction of recipients toward the meal service program for elderly people. Nine hundred and eight elderly people(male: 301, female: 607) were interviewed by trained personnel. The results were as follows. Forty two percent of them had no income and 43.8% of the respondents were supported economically by the government. Their main reasons for attending the free congregated meal program was economic hardship(37.9%) The channels of becoming aware of the free meal program were through their friends(33.4%) and the meal service centers were located in the respondents residence area(36.0%) Thus any other advertisement from local government of official channels about the free meal program were not effective for the elderly 26.9% of the respondents felt inconvenience in visiting the meal service centers because they had some difficulty in walking, 53.5% of them however answered that they didn t have any complains and were quite satisfied with the meal service. The average satisfaction score for the free meal service was 63.4(maximum score 75) As for each evaluation item respondents were highly satisfied with volunteers attitude in meal serving(4.58+/-0.65: maximum 5 point) The evaluation score of females was generally lower than that of males(p<0.05) Oncemore, respondents who were in lowere socio-economic classes were marked by having significantly lower satisfaction scores for the meal service compared with higher scocio-economic classes. For the welfare of elderly people, meal service programs should be extended to more elderly persons and developed considering the elderlys ecological factors.
Aged* ; Surveys and Questionnaires ; Female ; Humans ; Local Government ; Meals* ; Volunteers ; Walking

Obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome is an uncommon congenital abnormality of the female urogenital tract characterized by the triad of uterine didelphys, obstructed hemivagina, and ipsilateral renal agenesis. A 13-year-old female presented with acute lower abdominal pain. Magnetic resonance imaging (MRI) revealed uterine didelphys, hematometrocolpos, obstructed hemivagina, and right ipsilateral agenesis, consistent with OHVIRA syndrome. Also, a well-defined mass with fluid signal intensity, mimicking adnexal neoplasm was seen in the right lower pelvic cavity adjacent to the posterior wall of the bladder. Vaginal septotomy and drainage of hematometrocolpos were done initially, but unilateral hysterectomy was later performed to relieve the patient's symptoms. The cystic mass in the right lower pelvic cavity was also excised and confirmed as a blind megaureter.
Abdominal Pain ; Adolescent ; Congenital Abnormalities ; Drainage ; Female ; Humans ; Hysterectomy ; Magnetic Resonance Imaging* ; Urinary Bladder

We report an extraordinary case in which the venous route for pulmonary artery catheterization was unusual. A 41 year-old woman with an end-stage liver disease underwent a living-donor liver transplantation. After induction of anesthesia, the pulmonary artery catheter was revealed to be advanced into the left brachiocephalic vein and then slipped into another vein that drains into the left brachiocephalic vein. In this case, we assumed that the catheter had most likely slipped into the left pericardiophrenic vein since the catheter follows the left heart border similarly to the route of this vein according to the chest X-ray. Patients with liver cirrhosis develop many collateral vessels and have enlarged veins due to portal hypertension, which makes this vascular route possible. We present this case for anesthesiologists to be aware of the possibilities of unusual venous route due to dilated collateral vessels especially in liver transplant patients.
Anesthesia ; Brachiocephalic Veins ; Catheterization, Swan-Ganz ; Catheters* ; Female ; Heart ; Humans ; Hypertension, Portal ; Liver Cirrhosis ; Liver Diseases ; Liver Transplantation ; Liver* ; Pulmonary Artery* ; Thorax ; Transplantation* ; Veins*

Adenosarcoma of the uterus is a rare biphasic tumor containing benign glandular epithelial and malignant mesenchymal components. The tumor has been reported to be associated with antiestrogen therapy, particularly tamoxifen, but there have been a few case reports with MRI. We present two cases of MRI findings of uterine adenosarcoma after antiestrogen therapy, tamoxifen and toremifene in breast cancer patients. The tumor presents as a large polypoid mass occupying the endometrial cavity, and may protrude into the vagina. On MRI, the tumor typically shows solid components with scattered small cysts and heterogeneous enhancement. These findings are not significantly different from conventional adenosarcoma.
Adenosarcoma* ; Breast Neoplasms ; Estrogen Receptor Modulators ; Humans ; Magnetic Resonance Imaging* ; Tamoxifen ; Toremifene ; Uterus ; Vagina

Progressive transformation of germinal centers (PTGC) is an atypical feature seen in lymph nodes with unknown pathogenesis. PTGC most commonly presents in adolescent and young adult males as solitary painless lymphadenopathy with various durations. Cervical nodes are the most commonly involved ones while involvements of axillary and inguinal nodes are less frequent. PTGC develops extremely rarely in other locations. We report a rare case of solitary mass present in the presacral space. The mass as subsequently proven to be PTGC. To the best of our knowledge, PTGC in the presacral space has not been previously reported in the literature.
Adolescent ; Germinal Center* ; Humans ; Lymph Nodes ; Lymphatic Diseases ; Magnetic Resonance Imaging* ; Male ; Young Adult

BACKGROUND AND OBJECTIVE: There have been some reports on the expression of TGF beta-an anti-inflammatory and fibrosing cytokine in airway mucosa of asthmatics. However, the ex- pression of TGF beta1 in bronchial mucosa of TDI-induced asthma is not known. The aim of this study was to observe immunolocalization of TGF beta1 in airway mucosa of TDI-induced asthma. METHODS: TGF beta1 expressions were compared using immunohistochemistry in bronchial muco- sa from 22 subjects with TDI-induced asthma (group I: 10 newly diagnosed, group II: 12 subjects with persistent asthma symptoms for more than 4 years after diagnosis), and 8 non- asthmatics undergoing pneumonectomy from lung tumor. The distribution and intensity of expression were analyzed by two observers in four areas of bronchial tissue-epithelium(EP), vascular endothelium(VE), smooth muscle(SM), and mucous glands(MG). RESULTS: Positive rates of TGF beta1 expression for groups I and II in the four areas were as follows; EP (50% vs 100%, p<0.05), VE(40% vs 100%, p<0.05), SM(33.3% vs 100%, p<0.05), and MG(66.7% vs 80%, p>0.05). Grades of TGF beta1 expression of EP, VE, and SM were significantly higher in group II than in group I(p<0.05, respectively). There was no significant difference in distribution and intensity of TGF beta1 expression between TDI-induced asthma and controls(p>0.05, respectively). CONCLUSION: TGF beta1 expressions of EP, VE, SM and MG were noted in airway mucosa of TDI-induced asthma and expressions of EP, VE, and SM were more intense and frequent in patients with persistent asthma symptoms.
Asthma* ; Humans ; Immunohistochemistry ; Lung ; Mucous Membrane* ; Pneumonectomy ; Toluene* ; Transforming Growth Factor beta1* ; Transforming Growth Factors*

Gastric metastasis from renal cell carcinoma (RCC) is extremely rare, occurring in 0.2% of all RCC cases. Owing to its low prevalence, metachronous gastric metastasis from RCC may be underdiagnosed, and the imaging findings have not been well-established. Herein we present a case of metastatic RCC manifesting as a gastric polyp in a 70-year-old female along with a literature review on the imaging findings of gastric metastases from RCC. In patients presenting with gastric hyper-enhancing polypoid masses, metastasis from RCC should be considered as a differential diagnosis.

Schwannoma is a benign nerve sheath tumor that involves Schwann cells mostly found in the head, neck, posterior mediastinum and extremities. Schwannoma develops rarely in the retroperitoneum; thus, renal schwannoma is extremely uncommon. Differentiation of renal schwannoma from renal cell carcinoma is difficult with radiologic analysis. A few cases of these tumors have been reported in literature, and little has been described regarding imaging appearances. In this study, we present a rare case of a renal schwannoma, resembling renal cell carcinoma, with radiological correlations.

Gastrointestinal tract involvement in undifferentiated pleomorphic sarcoma (UPS) is extremely rare. To the authors' knowledge, only 21 cases of primary small bowel UPS have been reported in the literature available in English. Reported CT findings in primary small bowel UPS have been nonspecific, and MRI findings have been reported in only one case. The present article describes a case involving a 72-year-old male with histologically confirmed primary UPS arising from the ileum, focusing on both CT and magnetic resonance enterography findings. On CT, primary small bowel UPS was noted as a heterogeneously enhanced small bowel mass without obstruction. Magnetic resonance enterography revealed heterogeneous intermediate T1 and T2 signal intensity, with hemorrhagic or necrotic foci within the mass and heterogeneous enhancement. The differential diagnosis included malignant gastrointestinal tumor; however, the prognosis of UPS is worse, with higher incidences of extra-abdominal metastasis.