• Title/Summary/Keyword: Small renal mass

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Thin Glomerular Basement Membrane Disease with Herlyn-Werner-Wunderlich Syndrome : Uterus Didelphys, Blind Hemivagina and Ipsilateral Renal Agenesis (비박형 사구체 기저막 질환이 동반된 중복 자궁 일측성 폐쇄질 및 동측 신장 무형성 증후군 ( Herlyn - Werner- Wunderlich syndrome ) 1례)

  • Kim, Myoung-Soo;Park, Yong-Jun;Park, Young-Jun;Park, Noh-Hyuck;Song, Ji-Sun;Kim, Pyung-Kil
    • Childhood Kidney Diseases
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    • v.11 no.2
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    • pp.299-305
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    • 2007
  • Herlyn-Werner-Wunderlich syndrome(HWWs) is a rare variant of Mullerian ductal anomalies characterized by the presence of a hemivaginal septum, a didelphic uterus, and ipsilateral renal agenesis. It usually presents after menarche with progressive pelvic pain, and palpable mass due to hemihematocolpos. If a cystic mass is detected behind the urinary bladder in children, in association with the absence of a kidney, the diagnosis of uterus didelphys with imperforate vagina and hydrocolpos should be considered. When renal agenesis is found in asymptomatic children, the small size and the tubular shape of the uterus makes it almost impossible to evaluate uterine anomalies, so follow-up should be performed until the end of puberty. Appropriate preoperative diagnosis and treatment will prevent unnecessary procedures and offer relief of symptoms. We report one case of didelphic uterus with blind hemivagina and ipsilateral renal agenesis with biopsy- proven thin glomerular basement membrane disease which is not related to the above syndrome.

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Analysis of Radiofrequency Ablation of Small Renal Tumors in Patients at High Anesthetic and Surgical Risk: Urologist Experience with Follow-up Results in the Initial Six Months

  • Yuksel, Mehmet Bilgehan;Karakose, Ayhan;Gumus, Bilal;Tarhan, Serdar;Atesci, Yusuf Ziya;Akan, Zafer
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.11
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    • pp.6637-6641
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    • 2013
  • Background: To evaluate the results of various types of radiofrequency ablation (RFA) treatment of renal tumors in patients with excessive anesthetic and surgical risk. Materials and Methods: Data for RFA performed in in high risk patients were retrospectively evaluated. Other RFA applications in patients with no anesthetic and/or surgical risk were excluded. RFA was by ultrasound or CT guided percutaneous (USG/CT-PRFA) and retroperitoneally or transperitoneally laparoscopic (R/T-LRFA) techniques under general or local anethesia. Follow-up data of enhanced CT or MRI after 1, 3 and 6 months were analysed for twelve RFA applications. Results: The RFA applications included 4 (40%) left-sided, 5 (50%) right-sided and 1 (10%) bilaterally RFA (simultaneously 1 right and 2 left). The localizations of tumors were 2 (16.6%) upper, 5 (41.6%) mid and 5 (41.6%) lower pole. The RFA applications included 9 (75%) USG-PRFA, 1 (8.3%) CT-PRFA, 1 (8.3%) T-LRFA and 1 (8.3%) R-LRFA. The mean age was $65.3{\pm}8.5$ (52-76) years. The mean tumor size was $29.6{\pm}6.08$ (15-40) mm. No complications related to the RFA were encountered in any of the cases. Failure (residual tumour) was determined in 8.3% (1/12) of USG-RFA application. The success rate was thus 91.7% (11/12). Other 1st, 3rd and 6th months follow-up data revealed no residua and recurrence. Conclusions: RFA application appears to be safe as a less invasive and effective treatment modality in selected cases of small renal tumors in individuals with excessive anesthetic and also surgical risk.

Identification of Protein Markers Specific for Papillary Renal Cell Carcinoma Using Imaging Mass Spectrometry

  • Na, Chan Hyun;Hong, Ji Hye;Kim, Wan Sup;Shanta, Selina Rahman;Bang, Joo Yong;Park, Dongmin;Kim, Hark Kyun;Kim, Kwang Pyo
    • Molecules and Cells
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    • v.38 no.7
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    • pp.624-629
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    • 2015
  • Since the emergence of proteomics methods, many proteins specific for renal cell carcinoma (RCC) have been identified. Despite their usefulness for the specific diagnosis of RCC, such proteins do not provide spatial information on the diseased tissue. Therefore, the identification of cancer-specific proteins that include information on their specific location is needed. Recently, matrix-assisted laser desorption ionization (MALDI) mass spectrometry (MS) based imaging mass spectrometry (IMS) has emerged as a new tool for the analysis of spatial distribution as well as identification of either proteins or small molecules in tissues. In this report, surgical tissue sections of papillary RCC were analyzed using MALDI-IMS. Statistical analysis revealed several discriminative cancer-specific m/z-species between normal and diseased tissues. Among these m/z-species, two particular proteins, S100A11 and ferritin light chain, which are specific for papillary RCC cancer regions, were successfully identified using LC-MS/MS following protein extraction from independent RCC samples. The expressions of S100A11 and ferritin light chain were further validated by immunohistochemistry of human tissues and tissue microarrays (TMAs) of RCC. In conclusion, MALDI-IMS followed by LC-MS/MS analysis in human tissue identified that S100A11 and ferritin light chain are differentially expressed proteins in papillary RCC cancer regions.

$^{99m}Tc$-HDP Bone Scintigraphy Finding of Metastatic Renal Cell Carcinoma Bone Lesion Changed from Hot to Cold Lesion: Comparing with $^{18}F$-FDG PET/CT ($^{99m}Tc$-HDP 뼈스캔의 열소에서 냉소로 변한 신세포암 뼈전이 소견: $^{18}F$-FDG PET/CT와의 비교)

  • Seo, Young-Duk;Kim, Seong-Min;Kim, Kun-Ho
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.6
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    • pp.588-591
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    • 2009
  • A 26-year-old man with renal cell carcinoma underwent $^{99m}Tc$-HDP bone scintigraphy for detecting bony metastasis after left total nephrectomy for renal cell carcinoma. $^{99m}Tc$-HDP bone scintigraphy showed small hot lesion in the first lumbar spine. About 12 months later, he underwent spinal MRI for lower back pain. A large mass was seen around spinous process of the first lumbar spine (L1) on spinal MRI and confirmed as metastatic renal cell carcinoma by bone biopsy. $^{99m}Tc$-HDP bone scintigraphy and $^{18}F$-FDG PET/CT were underwent for further evaluation. $^{99m}Tc$-HDP bone scintigraphy showed cold lesion in the first lumbar spine which was initially hot and newly developed hot lesion in the twelfth thoracic spine, and which were shown as hypermetabolic lesions in $^{18}F$-FDG PET/CT. We report a case of bony metastasis from renal cell carcinoma which is changed from hot lesion to cold lesion in $^{99m}Tc$-HDP bone scintigraphy and compare with $^{18}F$-FDG PET/CT.

Renal Lymphoma with Mesenteric Lymphomatosis in a Cat

  • Jeon, Jin-ha;Song, Doo-won;Ro, Woong-bin;Kim, Heyong-seok;Lee, Ga-won;Cho, Jun-ho;Jeong, Woo-chang;Kim, Soo-hyeon;Sur, Jung-hyang;Park, Hee-myung
    • Journal of Veterinary Clinics
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    • v.37 no.4
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    • pp.208-212
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    • 2020
  • A 6-year-old castrated male Russian Blue cat was presented for evaluation of dyschezia. Abdominal ultrasound revealed hyperechoic nodules in both kidneys, heterogeneous mass in abdomen, and extensive mesenteric thickening with multiple hypoechoic nodules. Computed tomography showed multiple hypodense lesions in both kidneys and diffuse nodular infiltration around the mesentery. Fine needle aspirates (FNA) acquired under ultrasound guidance from the mesentery consisted of large lymphocytes which have round to irregular nuclei with granular chromatin, prominent nucleoli and a small amount of basophilic cytoplasm. Polymerase chain reaction (PCR) for antigen receptor gene rearrangement result of FNA sample revealed a T-cell malignancy. The cat died from acute renal failure after 1 cycle of modified Madison-Wisconsin L-CHOP protocol. Postmortem examination revealed bilaterally enlarged lumpy-bumpy shaped kidneys. Histopathologic examination showed an infiltration of malignant lymphocytes into the renal parenchyma and mesentery. Immunohistochemical staining of the renal sample displayed a negative expression of CD3, PAX5, MUM-1, and CD79. The clinical features and prognosis of the cat with renal lymphoma with mesenteric lymphomatosis have been described in this report.

Mass paraquat poisoning in a small island community (case report) (한 작은 섬에서의 파라콰트 집단중독)

  • Lee, Sung-Woo;Chung, Tae-Wha;Choe, Kang-Won;Lim, Jung-Ki;Lee, Duk-Hyoung
    • Journal of Preventive Medicine and Public Health
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    • v.22 no.4 s.28
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    • pp.454-465
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    • 1989
  • In a small island community with a population of less than 100 residents, nine persons died and five experienced severe illnesses during the period from November 1986 to May 1988. Their initial symptoms were sore throat and fever. Renal failure and hepatitis developed within one week after the onset. Oral mucosal ulcer developed in some cases. After one week, progressive respiratory failure and dyspnea developed evidently and severe respiratory distress and hypoxia preceded those fatal cases. Chest X-ray findings revealed bilateral diffuse multiple cystic lesion with occasional multiple large emphysematous bullae. Based on these features paraquat poisoning was diagnosed and route of poisoning was investigated. In three sources of drinking water, trace amount of paraquat was detected in November 1988, six months after the incidence of recent fatal case. In November 1988, soybean sauces and soybean pastes from 12 households were found contaminated with high concentration of paraquat, the cause could not be identified. The possibility of the contamination of drinking water as the cause of this mass poisoning has been suggested.

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Mucinous Tubular and Spindle Cell Carcinoma of the Kidney: Touch Imprint Cytologic and Histologic Findings - A Case Report - (점액성 세관 방추세포 신장암종의 압착도말 세포소견 - 1예 보고 -)

  • Won, Kyu-Yeoun;Kim, Gou-Young;Lim, Sung-Jig;Kim, Hyun-Cheol;Jeon, Seung-Hyun
    • The Korean Journal of Cytopathology
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    • v.19 no.2
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    • pp.194-199
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    • 2008
  • The recent WHO classification has recognized mucinous tubular and spindle cell carcinoma (MTSCC) as a distinct entity of renal cell carcinoma, exhibiting a mixed pattern of tubules and a surrounding spindle cell proliferation within a myxoid stroma, with low-grade nuclear features. A 51-year-old woman had an incidentally discovered renal mass. Radiologic examination revealed a large, well defined mass in the lower pole of the right kidney; a right radical nephrectomy was performed. Imprint cytologic smears from fresh surgical specimens showed cellular, cohesive clusters with thick, broad trabecular arrangements and branching structures. On high power fields, the tumor was composed of round-to-oval low-grade nuclei with vesicular chromatin and small nucleoli. The tumor cells had indistinct borders and pale, eosinophilic cytoplasm, In some areas, round-to-elongated tubular structures and spindle cell patterns were noted. Chronic inflammatory cell infiltration was noted, along with a mucinous back-ground and occasional psammoma bodies. Neither significant cytologic atypia nor mitosis was seen.

DaVinci SP-based simultaneous bilateral partial nephrectomy from the midline transperitoneal approach: a case report

  • Young Hwii Ko;Jong Gyun Ha;Jae Yoon Jang;Yeung Uk Kim
    • Journal of Yeungnam Medical Science
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    • v.41 no.1
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    • pp.48-52
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    • 2024
  • While simultaneous bilateral partial nephrectomy with a conventional multiport robot has been consistently reported since the 2010s, the introduction of the DaVinci SP system (Intuitive Surgical, Sunnyvale, CA, USA) could provide a novel way to perform surgery on bilateral kidneys while innovatively reducing the number of incisions. In our first report worldwide, the patient with bilateral small renal mass (2.0 cm for the left and 1.5 cm for the right side) and preoperative normal renal function was placed in the lateral decubitus position on an inverted bed. After tilting the bed to be as horizontal as possible, a 4-cm incision was made in the lower part of the umbilicus for the floating trocar technique. The partial nephrectomy was performed reliably as with the conventional transperitoneal approach, and then the patient could be repositioned to the contralateral side for the same procedure, maintaining all trocars. Total operation time (skin to skin), total console time, and the left- and right-side warm ischemic times were 260, 164, 27, and 23 minutes, respectively, without applying the early declamping technique. The estimated blood loss was 200 mL. The serum creatinine right after the operation, on the first day, 3 days, and 90 days after surgery were 0.92, 0.77, 0.79, and 0.81 mg/dL, respectively. For 90 days after the procedure, no complications or radiologic recurrence were observed. Further clinical studies will reveal the advantages of using the DaVinci SP device for this procedure over traditional multiport surgery, maximizing the benefit of a single port-based approach.

Technical Improvement Using a Three-Dimensional Video System for Laparoscopic Partial Nephrectomy

  • Komatsuda, Akari;Matsumoto, Kazuhiro;Miyajima, Akira;Kaneko, Gou;Mizuno, Ryuichi;Kikuchi, Eiji;Oya, Mototsugu
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.5
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    • pp.2475-2478
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    • 2016
  • Background: Laparoscopic partial nephrectomy is one of the major surgical techniques for small renal masses. However, it is difficult to manage cutting and suturing procedures within acceptable time periods. To overcome this difficulty, we applied a three-dimensional (3D) video system with laparoscopic partial nephrectomy, and evaluated its utility. Materials and Methods: We retrospectively enrolled 31 patients who underwent laparoscopic partial nephrectomy between November 2009 and June 2014. A conventional two-dimensional (2D) video system was used in 20 patients, and a 3D video system in 11. Patient characteristics and video system type (2D or 3D) were recorded, and correlations with perioperative outcomes were analyzed. Results: Mean age of the patients was $55.8{\pm}12.4$, mean body mass index was $25.7{\pm}3.9kg/m^2$, mean tumor size was $2.0{\pm}0.8cm$, mean R.E.N.A.L nephrometry score was $6.9{\pm}1.9$, and clinical stage was T1a in all patients. There were no significant differences in operative time (p=0.348), pneumoperitoneum time (p=0.322), cutting time (p=0.493), estimated blood loss (p=0.335), and Clavien grade of >II complication rate (p=0.719) between the two groups. However, warm ischemic time was significantly shorter in the 3D group than the 2D group (16.1 min vs. 21.2min, p=0.021), which resulted from short suturing time (9.1 min vs. 15.2 min, p=0.008). No open conversion occurred in either group. Conclusions: A 3D video system allows the shortening of warm ischemic time in laparoscopic partial nephrectomy and thus may be useful in improving the procedure.

Regional Differences of Entry Rate of Freely Diffusible Substances from Peritoneal Cavity (복강내 확산성 물질의 부위별 흡수속도)

  • Cho, Byeong-Deuck;Shin, Dong-Hoon
    • The Korean Journal of Physiology
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    • v.1 no.2
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    • pp.157-168
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    • 1967
  • The entry of antipyrine and urea from the peritoneal cavity of rabbit into organ tissue and blood plasma was studied. Two hundred mg of antipyrine plus 300 mg of urea in 10 ml Ringer's solution was injected into the peritoneal cavity of anesthetized rabbit. The injection was made from above of a rabbit kept tying right side down and it enabled part of the abdominal organs (liver, intestine, kidney) was immersed in the injected solution and kept high concentration gradient throughout the experimental period. The remaining part of the organs was revered only by a thin film of the test solution. Subsequently, in this part of the organs the concentration gradient of the diffusible substances during entry was presumed to decrease as time elapsed. Four pieces of the liver tissue were taken namely, the right superficial, right deep, left superficial and left deep portions. Two were taken from the small intestine, one from the portion which was immersed in. the fluid and the other from that above the fluid mass. Both kidneys were separately analyzed. As a remote organ the gastrocnemius muscle was taken from the right leg of the animal. The intervals which were the time periods elapsed after injections were 5,7,10,15 or 30 minutes. At each point 5 animals were sacrificed and the concentrations of the test substances in the tissue water were measured. The results obtained were as follows. 1. In the liver the right portion which was immersed in the fluid showed higher concentration if the test substances than the left portion and the superficial region exceeded the deep region. The concentrations diminished as the time elapsed after infusion, particulary in the case of antipyrine, suggesting circulatory removal of the substances. In urea such decreasing tendency of the concentration was not obvious, and suggested slower removal rate of it as compared with that of antipyrine. 2. In the small intestine there was no regional difference in the concentration of the test substances. Because of the intestinal motility different portions of the intestine were seemed to have bathed in the fluid of the same concentration. In general the concentrations in the intestinal wall exceeded those of the liver, suggesting a slower removal rate than in the latter. 3. In the kidney the accumulation of the endogenous urea was predominant, and the accumulating mechanism in the renal tissue went on during the period of the experiment. Therefore it revealed increasing tendencies as the time elapsed. The penetration of the test substances in this organ from the peritoneal cavity seemed to be slower than in other abdominal organs, namely liver or small intestine. Part of the test substances in the kidney were obviously brought by the blood stream. 4. Rapid exponential decay of the concentration of antipyrine and of the osmolality of the peritoneal fluid was attributed to the extensive removal through the whole dimension of the peritoneal surface, and the remote organ such as the gastrocnemius muscle attained a fairly close value to that of the abdominal organs in less than 30 minutes. The factors which related to the absorption rate were discussed. They were the concentration gradient, permeability and the regional perfusion rate.

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