Clear cell sarcoma of the kidney(CCSK) is one of the rare malignant renal tumors in childhood and is different from Wilms tumor by its pathologic features, clinical manifestations and propensity to metastasize to the skeletal system and brain. We report a case of CCSK on the right kidney in a 14-month-old girl presented with abdominal distention and palpable huge abdominal mass on physical examination, followed by metastasis to the rib on the left upper thorax. After right nephrectomy, chemotherapy with National Wilms Tumor Study DD regimen(vincristine+dactinomycin+adriamycin) was continued without any evidence of relapse until the last follow-up, 1 year after beginning chemotherapy. A brief review of related literatures was made.
Brain ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Infant ; Kidney* ; Neoplasm Metastasis ; Nephrectomy ; Physical Examination ; Recurrence ; Ribs ; Sarcoma, Clear Cell* ; Thorax ; Wilms Tumor

Benzo(a)pyrene (BaP) is a polycyclic aromatic hydrocarbon (PAH) that is easily introduced to humans via consumption of grilled or smoked meat. BaP causes harmful oxidative effects on cell development, growth and survival through an increase in membrane lipid peroxidation, oxidative DNA damage and mutagenesis. Therefore, the present study was conducted to evaluate the synergistic effects of BaP on oxidative stress in hepatic tumors. In this study, we established a hepatic tumor model by injecting rat hepatoma N1-S1 cells into healthy rats. Changes in the abundance of heat shock proteins (HSPs), antioxidant enzymes and pro-inflammatory cytokines were then investigated by western blot analysis. In addition, we examined changes in oxidative stress levels. Injection of N1-S1 cells or concomitant injection of BaP and N1-S1 cells resulted in the formation of hepatic tumors at the injection site. Evaluation of rat plasma reveals that hepatic tumors induced by BaP and N1-S1 cells expresses higher levels of Hsp27, superoxide dismutase (SOD), and tumor necrosis factor-alpha (TNF-alpha) when compared to those induced by N1-S1 cells only. The collective results of this study suggest that BaP exerts synergistic effects on the expression of HSP, cytokines and antioxidant enzymes in hepatic tumors induced by rat hepatoma N1-S1 cells.
Animals ; Antioxidants/*metabolism ; Benzo(a)pyrene/*pharmacology ; Carcinoma, Hepatocellular/metabolism/pathology ; Cell Line, Tumor/*drug effects ; Cytokines/*metabolism ; Heat-Shock Proteins/*metabolism ; Humans ; Liver Neoplasms/*enzymology/*metabolism/pathology ; Male ; Neoplasms, Experimental/metabolism/pathology ; Oxidative Stress/drug effects ; Rats ; Rats, Sprague-Dawley

We report a rare case in which a 35-year-old multiparous healthy woman developed a right sciatic neuropathy after epidural anesthesia and analgesia for caesarean section.She presented with premature rupture of membrane at 37 weeks and 4 days gestation.Epidural anesthesia was done without any paresthesia or pain and there were no special events during operation. Postoperative pain was controlled by fentanyl, ropivacaine and saline through epidural catheter for 2 days.When the epidural catheter was removed, the patient complained of both legs weakness and hypoesthesia.On the 4th day after surgery, she gained normal sensation and motor function of left leg but was still unable to move and sense her right leg without medial side of femur. She dragged her right feet.MRI of the lumbarsacral spine showed no evidence of a lesion in the spinal cord.Electomyographic study (EMG) performed 25 days after surgery showed incomplete right sciatic nerve lesion.She received persistent physical therapies and put a ankle brace.Four months after surgery she had made a recovery but not full yet.
Adult ; Amides ; Analgesia ; Anesthesia ; Anesthesia, Epidural ; Animals ; Ankle ; Anniversaries and Special Events ; Catheters ; Cesarean Section ; Female ; Femur ; Fentanyl ; Humans ; Leg ; Membranes ; Pain, Postoperative ; Paresthesia ; Pregnancy ; Rupture ; Sciatic Nerve ; Sciatic Neuropathy ; Sensation ; Spine

Objective: This study aims to explore the opinions on the insurance coverage of artificial intelligence (AI), as categorized based on the distinct value elements offered by AI, with a specific focus on patient-centered outcomes (PCOs). PCOs are distinguished from traditional clinical outcomes and focus on patient-reported experiences and values such as quality of life, functionality, well-being, physical or emotional status, and convenience. Materials and Methods: We classified the value elements provided by AI into four dimensions: clinical outcomes, economic aspects, organizational aspects, and non-clinical PCOs. The survey comprised three sections: 1) experiences with PCOs in evaluating AI, 2) opinions on the coverage of AI by the National Health Insurance of the Republic of Korea when AI demonstrated benefits across the four value elements, and 3) respondent characteristics. The opinions regarding AI insurance coverage were assessed dichotomously and semi-quantitatively: non-approval (0) vs. approval (on a 1–10 weight scale, with 10 indicating the strongest approval). The survey was conducted from July 4 to 26, 2023, using a web-based method. Responses to PCOs and other value elements were compared. Results: Among 200 respondents, 44 (22%) were patients/patient representatives, 64 (32%) were industry/developers, 60 (30%) were medical practitioners/doctors, and 32 (16%) were government health personnel. The level of experience with PCOs regarding AI was low, with only 7% (14/200) having direct experience and 10% (20/200) having any experience (either direct or indirect). The approval rate for insurance coverage for PCOs was 74% (148/200), significantly lower than the corresponding rates for other value elements (82.5%–93.5%; P ≤ 0.034). The approval strength was significantly lower for PCOs, with a mean weight ± standard deviation of 5.1 ± 3.5, compared to other value elements (P ≤ 0.036). Conclusion There is currently limited demand for insurance coverage for AI that demonstrates benefits in terms of nonclinical PCOs.

Neuropathic pain is usually managed pharmacologically, rather than with botulinum toxin type A (BTX-A). However, medications commonly fail to relieve pain effectively or have intolerable side effects. We present the case of a 62-year-old man diagnosed with an intracranial chondrosarcoma, which was removed surgically and treated with radiation therapy. He suffered from neuropathic pain despite combined pharmacological therapy with gabapentin, amitriptyline, tramadol, diazepam, and duloxetine because of adverse effects. BTX-A (100 units) was injected subcutaneously in the most painful area in the posterior left thigh. Immediately after the injection, his pain decreased significantly from 6/10 to 2/10 on a visual analogue scale. Pain relief lasted for 12 weeks. This case report describes intractable neuropathic pain caused by a brain tumor that was treated with subcutaneous BTX-A, which is a useful addition for the management of neuropathic pain related to a brain tumor.
Amitriptyline ; Botulinum Toxins* ; Botulinum Toxins, Type A* ; Brain Neoplasms* ; Brain* ; Chondrosarcoma ; Diazepam ; Duloxetine Hydrochloride ; Humans ; Middle Aged ; Neuralgia* ; Thigh ; Tramadol

We experienced a case of acute postpartum cardiomyopathy after cesarean section. A twin-pregnant woman at 36 weeks gestation showed pregnancy-induced hypertension. After an emergency cesarean section, shortness of breath, paroxysmal dyspnea, hypertension, and tachycardia developed in the recovery room. She was diagnosed with acute peripartum cardiomyopathy.
Cardiomyopathies ; Cesarean Section ; Dyspnea ; Dyspnea, Paroxysmal ; Emergencies ; Female ; Humans ; Hypertension ; Hypertension, Pregnancy-Induced ; Peripartum Period ; Postpartum Period ; Pregnancy ; Recovery Room ; Tachycardia

We experienced a case of acute postpartum cardiomyopathy after cesarean section. A twin-pregnant woman at 36 weeks gestation showed pregnancy-induced hypertension. After an emergency cesarean section, shortness of breath, paroxysmal dyspnea, hypertension, and tachycardia developed in the recovery room. She was diagnosed with acute peripartum cardiomyopathy.
Cardiomyopathies ; Cesarean Section ; Dyspnea ; Dyspnea, Paroxysmal ; Emergencies ; Female ; Humans ; Hypertension ; Hypertension, Pregnancy-Induced ; Peripartum Period ; Postpartum Period ; Pregnancy ; Recovery Room ; Tachycardia

BACKGROUND/AIMS: The recently published Oxford classification of IgA nephropathy (IgAN) proposed a split system for histological grading, based on prognostic pathological features. This new classification system must be validated in a variety of cohorts. We investigated whether these pathological features were applicable to an adult Korean population. METHODS: In total, 69 adult Korean patients with IgAN were analyzed using the Oxford classification system at Soonchunhyang University Hospital, Seoul, Korea. All cases were categorized according to Lee's classification. Renal biopsies from all patients were scored by a pathologist who was blinded to the clinical data for pathological variables. Inclusion criteria were age greater than 18 years and at least 36 months of follow-up. We excluded cases with secondary IgAN, diabetic nephropathy combined other glomerulopathies, less than 36 months of follow-up, and those that progressed rapidly. RESULTS: The median age of the patients was 34 years (range, 27 to 45). Mean arterial blood pressure was 97 +/- 10 mmHg at the time of biopsy. The median follow-up period was 85 months (range, 60 to 114). Kaplan-Meier analysis showed significant prognostic predictions for M, E, and T lesions. A Cox proportional hazard regression analysis also revealed prognostic predictions for E and T lesions. CONCLUSIONS: Using the Oxford classification in IgAN, E, and T lesions predicted renal outcome in Korean adults after taking clinical variables into account.
Adult ; *Asian Continental Ancestry Group ; Biopsy ; Chi-Square Distribution ; Disease Progression ; Female ; Fish Oils/therapeutic use ; Glomerulonephritis, IGA/classification/*diagnosis/ethnology/pathology/therapy ; Hospitals, University ; Humans ; Immunosuppressive Agents/therapeutic use ; Kaplan-Meier Estimate ; Kidney/*pathology ; Male ; Middle Aged ; Multivariate Analysis ; Predictive Value of Tests ; Prognosis ; Proportional Hazards Models ; Reproducibility of Results ; Republic of Korea/epidemiology ; Retrospective Studies ; Severity of Illness Index ; Time Factors

PURPOSE: Purposes of this study were to understand the current trends on complementary therapy in relieving chemotherapy-induced nausea and vomiting and to suggest the future research direction. METHOD: Subjects were selected on CINAHL, MEDLINE, Korean Academy Data Base from 1980 to 2001 which used nausea, vomiting, chemotherapy and complementary therapy as key words in experimental studies. Eight korean articles and twenty-one international articles were analyzed in terms of general characteristics, research methods, and types of complementary therapy. Data were analyzed by using descriptive statistical methods. RESULT: Since 2000, researchers have more actively used complementary therapy. In subject characteristics, mean age was 35.5 years old, 45% of the researchers were performed with high level of incidence of chemotherapy induced vomiting, 14% of them set limit of consecutive cycle during research, and 65% of them did not comment the selecting criteria of sample. About 60% of them were designed post-test only control group; 35% used INV by Rhodes, 31% used Likert scale, and 24% used VAS for dependent variable. Muscle relaxation therapy was mostly applied for relief of nausea and vomiting. CONCLUSION: Further studies will be needed to control extrinsic variables affecting nausea and vomiting in research design and to accumulate evidence with studies applying various complementary therapies.
Complementary Therapies ; Drug Therapy ; Incidence ; Muscle Relaxation ; Nausea* ; Research Design ; Vomiting*