No abstract available.
Prolapse*

No abstract available.
Prolapse*

Wilms' tumor is malignant renal tumor, originated from undifferentiated mesonephric blastema. Adult Wilms' tumor, unlike that of childhood, is a rare disease and a total of l67 cases have been reported in the world medical literature until 1980. Diagnosis of adut Wilms` tumor is very difficult preoperatively and the pathologic hallmark is the presence of abortive or embryonal glomerulotubular structure with an immature spindle cell stroma. The therapeutic guidelines and surgical principles that govern childhood Wilms' tumor should be applied to adult Wilms' tumor. We reported a case of Wilms' tumor developed in 34 year-old male patient complaining of right flank pain with gross hematuria for 2 months.
Adult* ; Diagnosis ; Flank Pain ; Hematuria ; Humans ; Male ; Rare Diseases ; Wilms Tumor*

No abstract available.
Hemorrhage* ; Hemorrhoids*

Purpose: This study developed a Korean sentiment questionnaire by adapting an existing English survey using focus group interview (FGI)-based cognitive interview (CI) techniques to investigate the utilization of outcome measures (OMs) among Korean physical therapists. Methods: The existing OMs survey questionnaire was adapted by dividing eight physical therapists into two groups: mid-experienced (n=4) and high-experienced (n=4). Each group participated in a 120-minute FGI-based CI session. All interviews were recorded, and the researcher transcribed the data immediately after each interview. The data were then organized and categorized into themes using Excel 2021 and verified with the participants. Results: FGI-based CI sessions were conducted with Korean physical therapists to revise the English version of the questionnaire, tailoring it to the local context. Four main themes emerged from the interviews: inappropriate items or translations, questionnaire length and organization, questionnaire improvements, and additional items. The questionnaire was revised based on the feedback obtained during these interviews. Conclusion The questionnaire was modified according to the themes derived from the interviews. The questionnaire was developed to represent the clinical environment of Korean physical therapy accurately by removing elements of the questionnaire unsuitable for the Korean sentiment and incorporating the perspectives of Korean physical therapists.

Short-chain acyl-CoA dehydrogenase deficiency (SCADD) is a rare autosomal recessive mitochondrial disorder of fatty acid β-oxidation, and is associated with mutations in the acyl-CoA dehydrogenase (ACADS) gene. Recent advances in spectrometric screening for inborn errors of metabolism have helped detect several metabolic disorders, including SCADD, without symptoms in the neonate period. This allows immediate initiation of treatment and monitoring, so they remain largely symptomless metabolic disease. Here, we report a 15-month-old asymptomatic male, who was diagnosed with SCADD by newborn screening. Spectrometric screening for inborn errors of metabolism 72 hours after birth revealed an elevated butyrylcarnitine (C4) concentration of 2.25 µmol/L (normal, <0.99 µmol/L). Urinary excretion of ethylmalonic acid was also elevated, as detected by urine organic acid analysis. To confirm the diagnosis of SCADD, direct sequencing analysis of 10 coding exons and the exon-intron boundaries of the ACADS gene were performed. Subsequent sequence analysis revealed compound heterozygous missense mutations c.164C>T (p.Pro55Leu) and c.1031A>G (p.Glu344Gly) on exons 2 and 9, respectively. The patient is now growing up, unretarded by symptoms such as seizure and developmental delay.
Acyl-CoA Dehydrogenase* ; Butyryl-CoA Dehydrogenase ; Clinical Coding ; Diagnosis ; Exons ; Humans ; Infant ; Infant, Newborn* ; Male ; Mass Screening ; Metabolic Diseases ; Metabolism, Inborn Errors ; Mitochondrial Diseases ; Mutation, Missense ; Neonatal Screening ; Parturition ; Seizures ; Sequence Analysis

PURPOSE: To describe the technical features of CT-guided percutaneous ethanol injection therapy (PEIT) for hepatic tumors that are undetectable or inaccessible under ultrasound guidance, to analyze its short-term therapeutic results, and to discuss its feasibility and limitations with a review of the related literature. MATERIALS AND METHODS: During a 22-month period, 17 patients with 28 hepatic tumors (27 hepatocellular carcinomas and one metastasis) underwent 38 sessions of CT-guided PEIT. Follow-up CT scanning was also performed. All tumors were undetectable or inaccessible under ultrasound guidance. The quantity of ethanol injected depended on their maximum diameter, which was 0.9 -5.1 (mean, 2.2) cm. To determine the puncture site and direction of the needle, the graduated grid system was used. A 21 or 22-G PEIT needle was introduced into the tumor stepwise, with intermittent CT monitoring, and if the CT images obtained immediately after initial injection demonstrated incomplete perfusion, an additional dose of ethanol was administered. During the follow-up period of 28 -619 (mean, 261) days, three-phase spiral CT scans were obtained. We focused on whether or not a viable portion of ablated tumor was present, and if so, the interval during which the extent of viable portion had changed, as well as the CT findings which suggested a predisposition to incomplete ablation. RESULTS: PEIT was successfully performed in all patients. During each session, 3 -30 (mean, 12.1) mL of ethanol was injected for 35 -115 (mean, 85) mins, with 1 -7 (mean, 3.7) trials to determine the puncture site and needle direction. The follow-up CT results showed that 20 tumors (71.4%) contained no viable portion, that this portion had decreased in four (14.3%), and was unchanged or had increased in four (14.3%). In the eight tumors for which multiple sessions were required, follow-up CT showed that the viable portion was absent or had decreased in size in all except one. In five of the patients with a tumor containing a viable portion at follow- up CT, the procedure was incomplete because of unendurable pain (n = 2) or noncooperation (n = 3). A CT finding which suggested a predisposition to incomplete ablation was a poor margin (n = 3). Complications included severe pain (n = 6) and scanty peritoneal hemorrhage (n = 1). CONCLUSION: Despite several limitations of our study, the therapeutic results of CT-guided PEIT appeared to be similar to or slightly worse than those of well-established ultrasound-guided PEIT with the former procedure, however, intermittent CT monitoring indicates whether perfusion is complete, and for this reason, CT-guided PEIT is believed to be an effective treatment modality when a hepatic tumor is undetectable or inaccessible under ultrasound guidance.
Carcinoma, Hepatocellular ; Ethanol* ; Follow-Up Studies ; Hemorrhage ; Humans ; Needles ; Perfusion ; Punctures ; Tomography, Spiral Computed ; Tomography, X-Ray Computed ; Ultrasonography

A 25-year-old Korean woman was referred for uncontrolled hypertension. Laboratory examination revealed increased plasma renin activity and microscopic hematuria. Computed tomography demonstrated compression of the left renal vein (LRV) between the aorta and superior mesenteric artery; however, both renal arteries were intact and there was no adrenal mass. Renal vein catheterization showed external compression with a pressure gradient of up to 8 mm Hg between the LRV and the inferior vena cava. Plasma renin activity in the LRV was almost five times higher than that in the right renal vein. In this patient, renin-dependent hypertension was caused by renal congestion due to LRV obstruction.
Adult ; Aorta ; Catheterization ; Catheters ; Estrogens, Conjugated (USP) ; Female ; Hematuria ; Humans ; Hypertension* ; Mesenteric Artery, Superior ; Plasma ; Renal Artery ; Renal Nutcracker Syndrome ; Renal Veins ; Renin ; Vena Cava, Inferior

We report the case of a 16-year-old boy with a solid pancreatic mass which proved to be a nonfunctioning, malignant pancreatic neuroendocrine tumor (PNET). In pediatric patients, malignant pancreatic tumors are rare, especially malignant PNET. When dynamic contrast enhanced MRI showed a well enhancing solid pancreatic tumor on arterial and delayed phases and combined with malignant features, such as vascular invasion, invasion of adjascent organs, and lymphadenopathy, we should include malignant pancreatic neuroendocrine tumor in the differential diagnosis of childhood pancreatic tumors.
Adenoma, Islet Cell ; Adolescent ; Child ; Diagnosis, Differential ; Humans ; Lymphatic Diseases ; Neuroectodermal Tumors, Primitive ; Neuroendocrine Tumors

Spinal extradural arachnoid cysts usually cause symptoms related to spinal cord or nerve root compression. Here, we report an atypical presentation of a spinal extradural arachnoid cyst combined with congenital hemivertebra which was presented as a retroperitoneal mass that exerted mass effects to the abdominal organs. On image studies, the communication between the cystic pedicle and the spinal arachnoid space was indistinct. Based on our experience and the literature of the pathogenesis, we planned anterior approach for removal of the arachnoid cyst in order to focus on mass removal rather than ligation of the fistulous channel. In our estimation this was feasible considering radiologic findings and also essential for the symptom relief. The cyst was totally removed with the clogged 'thecal sac-side' end of the cystic pedicle. The patient was free of abdominal discomfort by one month after the surgery.
Arachnoid ; Arachnoid Cysts ; Humans ; Ligation ; Radiculopathy ; Spinal Cord