Embryonal carcinoma, a very rare ovarian germ cell tumor, involves pure and mixed phenotypes. Pure-type embryonal carcinoma has never been reported in postmenopausal women. The current case was, thus, misdiagnosed as an epithelial ovarian carcinoma based on radiologic findings. Herein, we describe the case of ovarian embryonal carcinoma in a 75-year-old woman along with a literature review. Magnetic resonance imaging findings were suggestive of epithelial ovarian malignancy associated with endometrioma, including ureteral invasion. The patient underwent complete surgical staging, and a pathologic diagnosis of pure-type embryonal carcinoma was made. The patient’s postoperative course was uneventful, and adjuvant chemotherapy was administered. Embryonal carcinoma in the postmenopausal woman is a clinical challenge owing to the possibility of its misdiagnosis as epithelial ovarian carcinoma. To the best of our knowledge, this is the first report of pure-type ovarian embryonal carcinoma in a postmenopausal woman, with a description of the clinicopathologic characteristics and review of the relevant literature.

OBJECTIVES: Children with attention-deficit hyperactivity disorder (ADHD) have problems in social interactions. We compared the effect of 10-session social skill training (SST) among two groups, children with pure ADHD, and those with ADHD with comorbidity. METHODS: Consecutive 10-session SST was conducted for 34 children from 2006 to 2012. There were 22 children with pure ADHD (male 20, female 2), and 12 children suffering from ADHD with comorbidity (male 11, female 1). All children took medication as prescribed by their doctors before the start of SST. The Child Behavior Checklist (CBCL), the Korean Personality Inventory for Children (K-PIC), the Conner's Rating Scale, the ADHD Rating Scale, and the Home Situation Questionnaire were completed by mothers before and after the SST. All children completed the Child Depression Inventory, the Stat-Trait Anxiety Inventory for Children, the Self-Concept Scale and the ADHD Diagnostic System before and after the SST. RESULTS: Only children with pure ADHD showed improvement in anxiety and self-concept in scales rated by children. In the CBCL rated by parents, the pure ADHD group and the ADHD with comorbidity showed improvement in both externalizing and internalizing subscales. In the K-PIC rated by parents, the pure ADHD group showed improvement in most outcomes and ADHD with comorbidity showed positive change in verbal development. CONCLUSION: These results suggest that SST has significant positive effects on both the pure ADHD and ADHD with comorbidity group. Further research is needed in order to target diverse comorbidity groups with ADHD to improve the effectiveness of the SST.
Anxiety ; Checklist ; Child Behavior ; Child* ; Comorbidity* ; Depression ; Female ; Humans ; Interpersonal Relations ; Mothers ; Only Child ; Parents ; Personality Inventory ; Weights and Measures

We experienced the case of infected mesh with subsequent infective cellulitis of obturator foramen after a TOT procedure. We reported our case of a 47-year-old woman who presented with persistent vaginal discharge, pain and motion limitation of left leg after having a TOT placed for stress incontinence. Inflammation around obturator foramen was demonstrated on computed tomography (CT) scan. We performed total excision of the mesh material. She ultimately had an uneventful postoperative course and no recurrence of incontinence after follow-up 1 month.
Cellulitis* ; Female ; Follow-Up Studies ; Humans ; Inflammation ; Leg ; Middle Aged ; Recurrence ; Suburethral Slings* ; Vaginal Discharge

Hemangiomas result from proliferation of immature capillary vessels. This disorder in the genitourinary tract is a rare lesion. We experienced one case of a 31 years old man suffered from cavernous hemangioma of the penis shaft with painful erection. He was treated successfully with surgical excision. Herein, we report our experience and a critical review of the literature.
Capillaries ; Caves ; Hemangioma ; Hemangioma, Cavernous ; Male ; Penis

PURPOSE: We wanted to present the feasibility and safety of hand-assisted laparoscopic donor nephrectomy(HALDN) for treating patients with multiple renal arteries. MATERIALS AND METHODS: Between February 2000 and July 2006, 252 patients underwent HALDN. The results for the patients with a single renal artery (n=187)(Group I) and those patients with multiple renal arteries(n=65) (Group II) were compared in terms of the donor and recipient outcomes. A retrospective chart review was performed and statistical analysis included Student's t-test, the chi square test and Kaplan-Meier survival probability analysis. RESULTS: HALDN was technically successful in 251 patients(1 patient had to be converted to open donor nephrectomy). The operative times were increased in group II, but the differences between the groups were not statistically significant. The warm ischemic times were significantly longer in group II. The intraoperative blood loss, postoperative hospital stay and complication rate in the donor group were not associated with the number of renal arteries. The recipients' renal function and overall graft survival were similar between groups I and II. CONCLUSIONS: In our single-center study, the presence of renal artery multiplicity when performing HALDN does not have a significant impact on the outcomes of the renal donors or recipients.

PURPOSE: We wanted to present the feasibility and safety of hand-assisted laparoscopic donor nephrectomy(HALDN) for treating patients with multiple renal arteries. MATERIALS AND METHODS: Between February 2000 and July 2006, 252 patients underwent HALDN. The results for the patients with a single renal artery (n=187)(Group I) and those patients with multiple renal arteries(n=65) (Group II) were compared in terms of the donor and recipient outcomes. A retrospective chart review was performed and statistical analysis included Student's t-test, the chi square test and Kaplan-Meier survival probability analysis. RESULTS: HALDN was technically successful in 251 patients(1 patient had to be converted to open donor nephrectomy). The operative times were increased in group II, but the differences between the groups were not statistically significant. The warm ischemic times were significantly longer in group II. The intraoperative blood loss, postoperative hospital stay and complication rate in the donor group were not associated with the number of renal arteries. The recipients' renal function and overall graft survival were similar between groups I and II. CONCLUSIONS: In our single-center study, the presence of renal artery multiplicity when performing HALDN does not have a significant impact on the outcomes of the renal donors or recipients.

Genistein is a naturally occurring isoflavone that has been identified predominantly in soybean. It has been found that genistein can inhibit the growth of various cancer cell lines. Melanoma continues to increase in incidence in many parts of the world and remains among the top six cancers as a cause of death and morbidity. Understanding and overcoming resistance mechanism(s) of melanoma to apoptosis would therefore facilitate identification of new therapeutic targets and development of new treatments. This study was undertaken to investigate whether genistein induced apoptosis on human melanoma cells (G361). Genistein had a significant dose- and time-dependent inhibitory effect on the viability of G361 cells. The death of cells was further demonstrated to be due to apoptosis characterized by chromatin condensation and apoptotic bodies by hoechst staining, and DNA electrophoresis. p53 levels were not altered by genistein treatment. Genistein treatment induced caspase-3 cleavage and activation. Poly (ADP-ribose)-polymerase (PARP) and DNA fragmentation factor 45 (DFF45), which are caspase-3 substrates, were cleaved during genistein-induced apoptosis. It was found that the caspase-6 substrate lamin A was cleaved, whose cleavage has been reported to be necessary for complete condensation of DNA during apoptosis. The expression level and phosphorylation of focal adhesion kinase (FAK) were reduced by genistein treatment. These results suggest that genistein may constitute a potential antitumor compound against melanoma occurring at oral mucosa and skin.
Apoptosis ; Caspase 3 ; Caspase 6 ; Cause of Death ; Cell Line ; Chromatin ; DNA ; DNA Fragmentation ; Electrophoresis ; Focal Adhesion Protein-Tyrosine Kinases ; Genistein ; Humans ; Incidence ; Lamin Type A ; Melanoma ; Mouth Mucosa ; Phosphorylation ; Proteins ; Soybeans

We encountered a case of coincidental congenital complete absence of the posterior arch of the atlas and the unilateral lumbosacral articular process. A 21-year-old man presented with pain in the lower back and right buttock. The patient was a swimming coach. On plain radiography, computerized tomography and magnetic resonance imaging, the congenital absence of the unilateral lumbosacral articular process was noted. Six months later, the patient developed severe neck pain and suboccipital headaches without neurological signs. On plain radiography and computerized tomography, the congenital complete absence of the posterior arch of the atlas was noted. Magnetic resonance imaging showed no abnormal signs originating from the posterior spinal cord. There was no segmental instability. For this case, the lower back pain and neck pain were managed by conservative treatment. To the best of our knowledge, this is the first case of a coincidental congenital complete absence of the posterior arch of the atlas and the unilateral lumbosacral articular process.
Buttocks ; Headache ; Humans ; Low Back Pain ; Magnetic Resonance Imaging ; Neck Pain ; Radiography ; Spinal Cord ; Swimming ; Young Adult

PURPOSE: We performed this study to evaluate the alterations in renal function for patients with ileal conduit and ileal orthotopic neobladder MATERIALS AND METHODS: From January 1999 to June 2004, 48 patients who had undergone radical cystectomy with urinary diversion were included in our study. The patients were divided into two groups according to the types of urinary diversion. One group consisted of 29 patients with ileal conduit and the other group consisted of 19 patients with ileal W neobladder. The mean age of the ileal conduit group and the ileal W neobladder group were 65.6+/-9.9 years and 60.8+/-8.3 years, respectively. The preoperative and postoperative blood urea nitrogen/creatinine (BUN/Cr) levels, postoperative complications and postoperative GFR, as measured by (99m)Tc-DTPA scans, were compared between the two groups. RESULTS: For the postoperative complications, stricture at the ureterovesical anastomosis site occurred in 1.7% (1/58 renal units) of the ileal conduit group and in 10.5% (4/38 renal units) of the ileal W neobladder group. Acute pyelonephritis occurred in 5.2% (3/58 renal units) of the ileal conduit group and in 5.3% (2/38 renal units) of the ileal W neobladder group. The pre- and postoperative serum BUN/Cr levels were 20.8/1.3 and 24.8/1.6, respectively, in the ileal conduit group, and 17.2/1.1 and 18.8/1.2, respectively, in the ileal W neobladder group. There were no statistical significant differences between the pre- and postoperative changes of the serum BUN/Cr levels for both groups. The GFR, as measured by (99m)Tc-DTPA scans, were 77.6 and 78.7ml/ min/1.73m2 in the ileal conduit group and the ileal W neobladder group, respectively. There were no statistical significant differences between the two groups. CONCLUSIONS: There were no significant differences in renal function between the ileal conduit and ileal W neobladder.
Constriction, Pathologic ; Cystectomy ; Humans ; Postoperative Complications ; Pyelonephritis ; Urea ; Urinary Diversion*

BACKGROUND: Continuous ambulatory peritoneal dialysis (CAPD) is an important method of renal replacement therapy in chronic renal failure, and reduction of dialysis-associated complication is essential to successful peritoneal dialysis. But catheter related infection is a major cause of catheter loss and transferring to hemodialysis. We use an unique catheter revision method for the treatment of intractable exit-site/tunnel infection in CAPD patients. METHODS: We reviewed 322 CAPD patients on the ESI/TI from May 1995 to January 2003 at Yeungnam University Hospital. Forty-four patients had exit-site infection more than one times. Prevalence of exit-site infection, kinds of causative micro- organism and results of catheter revision were analyzed retrospectively. RESULTS: Total follow-up was 5, 834 patient months. ESI occurred on 141 occasions in 44 patients out of 322 patients and cumulative incidence of ESI was 1 per 41.4 patient months. We started empiric antibiotic therapy with oral penicillinase- resistant penicillin and quinolones, thereafter adjusted antibiotics according to the results of culture and sensitivity. The most common organism responsible for ESI was Staphylococcus aureus (MSSA, 34.8%), followed by Pseudomonas aeruginosa (25.5%). Nineteen patients had to be treated with catheter revision to control intractable ESI/TI. With analysis of ten patients who showed relapsed ESI after catheter revision, 5 patients improved with antibiotic therapy and 3 patients improved with additional secondary revision, but remaining 2 patients showed removal of peritoneal catheter to treat combined peritonitis. CONCLUSION: Catheter revision technique can be regarded as an effective alternative method to treat intractable exit site/tunnel infection before removal of catheter in CAPD patients.
Anti-Bacterial Agents ; Catheters* ; Follow-Up Studies ; Humans ; Incidence ; Kidney Failure, Chronic ; Penicillins ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis ; Prevalence ; Pseudomonas aeruginosa ; Quinolones ; Renal Dialysis ; Renal Replacement Therapy ; Retrospective Studies ; Staphylococcus aureus