• Title/Summary/Keyword: Pelvic ultrasonography

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Predictive Value of Malignancy Risk Indices for Ovarian Masses in Premenopausal and Postmenopausal Women

  • Ertas, Sinem;Vural, Fisun;Tufekci, Ertugrul Can;Ertas, Ahmet Candost;Kose, Gultekin;Aka, Nurettin
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.2177-2183
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    • 2016
  • Background: To evaluate the predictive role of a risk of malignancy index in discriminating between benign and malignant adnexal masses preoperatively. Materials and Methods: A total of 408 patients with adnexal masses managed surgically between January 2010 and February 2014 were included. The risk of malignancy indices (RMI) 1, 2, 3 and 4 were calculated using findings for ultrasonography, menopausal status, and CA125 levels. Histopathologic results were the end point. ROC analysis was used for the sensitivity and the specificity of the models. Results: Some 37.6 % of the cases were malignant in the postmenopausal group while 7.9 % were malignant in the premenopausal group. Pelvic pain was the most common complaint, and the majority of the cases were diagnosed at stage 3. The RMI 1, 2, 3 and 4 yielded percentage sensitivities of 76.1, 79.1, 76.1 and 76.1 and specificities of 91.5, 89.1, 90.6, 88.6, respectively. RMI 1 was the most reliable test in the general population according to AUC levels and Kappa statistics. From ROC analysis results of post/premenopausal women, the RMI 1 (cut off: 200) yielded sensitivities of 84.0/60.9 and specificities of 87.7/92.5. With RMI 2 they were 88.6/60.9 and 80.0/91.0, with RMI 3 84.0/60.9 and 87.7/91.8, and with RMI 4 (cut off:400) 81.8/47.8 and 83.6 /44.0. Although test performance of RMI methods were good in a general population and postmenopausal women, the RMI inter-agreement validity was only moderate or fair in premenopausal women. Conclusions: Our study confirms the effectiveness of RMI algorithms in postmenopausal women. However, more sensitive tests are needed for premenopausal women.

A Case of Transient Pseudohypoaldosteronism Secondary to Ureteropelvic Junction Obstruction (신우요관이행부폐색과 동반된 일과성 가성저알도스테론혈증 1례)

  • Choi Jun-Gi;Hahn Hye-Won;You Han-Wook;Park Young-Seo
    • Childhood Kidney Diseases
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    • v.8 no.1
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    • pp.91-95
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    • 2004
  • We report a 2-month-old boy who presented with severe hyponatremia and hyperkalemia secondary to ureteropelvic junction(VPJ) obstruction. By prenatal ultrasonography at 19 weeks of gestation, severe hydronephrosis was found which was confirmed postnatally Pyeloplasty was done on the 45th day of life, and fifteen days after pyeloplasty, non-bilious vomiting, decreased activity and dehydration developed. Severe hyponatremia and hyperkalemia were observed, as a result of elevated serum aldosterone and plasma renin activity. The anterior posterior pelvic diameter(APPD) and Society for Fetal Urology(SFU) grade measured showed no interval change before and after pyeloplasty. Pseudohypoaldosteronism was diagnosed, and 2M NaCl was administrated orally for 7 days. The electrolyte imbalance was corrected, and 8 weeks later, the elevated levels of aldosterone and plasma renin activity were normalized. The left hydronephrosis was improved at 5 months of age. We hereby report a transient pseudohypoaldosteronism secondary to UPJ obstruction with a review of the literature.

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Imaging Diagnosis: Biphasic Synovial Sarcoma in a Dog (개에서 발생한 이상성 활막육종 증례)

  • Eom, Ki-Dong;Sung, Yun-Sang;Park, Jong-Im;Park, Hee-Myung;Jung, Soon-Wuk;Kim, Jae-Hoon
    • Journal of Veterinary Clinics
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    • v.24 no.1
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    • pp.26-28
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    • 2007
  • An 11-year-old castrated male, Shih-tzu dog was admitted for progressive weight-bearing lameness and mass on the right hindlimb. Radiography and ultrasonography revealed a large well-marginated multinodular mass with mixed echogenicity. On T1 and T2-weighted magnetic resonance imaging (MRI), the mass has a heterogenous signal intensity similar to or higher than muscle. The masses were extended to the pelvic cavi쇼 through obturator foramen and displaced the rectum dorsally. It was diagnosed as synovial sarcoma which was composed with mesenchymal and epithelial elements on histopathological findings of the multifocal biopsied specimen. MRI was helpful to determine the definitive margin for surgical resection of the mass. The mass was recurred at the 6th month after surgery. On the 10th month, the patient was euthanasiuzed by owner's request.

Omental Torsion and Infarction Secondary to Omental Hernia in the Right Inguinal Canal (오른쪽 서혜부 탈장에 의해 이차적으로 발생한 대망의 염전 및 경색)

  • Yu Hyun Lee;Jae Hoon Lim;Heon-Kyun Ha
    • Journal of the Korean Society of Radiology
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    • v.81 no.4
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    • pp.1003-1007
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    • 2020
  • Omental torsion secondary to inguinal hernia has rarely been reported as a cause of acute abdominal pain. However, in our case, omental infarction due to prolonged inguinal hernia-associated omental torsion led to the formation of a large omental mass with marginal fibrosis, and the patient presented with chronic abdominal pain. A 74-year-old man presented with complaints of lower abdominal pain for 1 month; subsequently, bilateral inguinal hernias were identified through inguinal ultrasonography. CT scans revealed that the greater omentum was trapped within the right inguinal canal, leading to omental torsion. The greater omentum, distal to the pedicle, appeared as a 30 cm-sized oblong fibrofatty mass in the right lower abdomen and pelvic cavity. Laparoscopic omentectomy with hernia repair was successfully performed.

Clinical study of urinary tract infection, natural courses, and prenatal ultrasonographic results according to the grades of hydronephrosis (수신증의 정도와 요로감염 및 자연경과, 산전초음파상의 수신증 여부와의 관련성에 대한 임상적 고찰)

  • Lee, Jee-Hee;Kim, Jun-Woo;Yoon, Ji-Eun;Ha, Tae-Sun
    • Clinical and Experimental Pediatrics
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    • v.52 no.8
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    • pp.917-921
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    • 2009
  • Purpose : Although renal ultrasonography (USG) has improved the detection rate of hydronephrosis (HN), its clinical courses and postnatal management remains controversial. Here, we reviewed the clinical features of patients with HN according to the grades. Methods : We retrospectively studied 207 patients who were regularly followed-up among 367 patients with HN detected by renal USG postnatally between April 1998 and December 2007. These patients were grouped into four groups, grades 1-4, according to renal pelvic diameter (RPD). For analysis, each group was merged into two categories (mild: grade 1, 2; severe: grade 3, 4). Results : During follow-up, 128 episodes of urinary tract infection (UTI) occurred in 91 patients. According to grades from 1 to 4, 35/89 (39.3%), 41/88 (46.5%), 11/22 (50%), and 4/8 (50%), respectively, had UTI, without any significance between the mild and severe groups. However, the severe group presented a higher risk in cumulative episodes of UTI per year (P=0.041). The spontaneous resolution of HN was observed in 103 (58.8%) of the 175 mild group patients and in 3 (10.7%) of the 28 severe group patients (P<0.001). Furthermore, the detection rate of prenatal HN by prenatal USG was much higher in patients with severe RPD (P<0.001). Conclusion : We found that the severer the grade of HN, the lower was the rate of spontaneous resolution and higher was the frequency of UTI. Therefore, the establishment of guidelines for managing treatments such as antibiotic prophylaxis for patients with HN is needed to improve renal prognosis.

Correlation between the Severity of Hydronephrosis and the Presence of VUR in Neonate (신생아에서 수신증의 심한 정도와 방광요관역류 존재와의 연관성)

  • Lee, Hyo-Jung;Noh, Seong-Hoon;Lee, Soo-Yeon;Kim, Min-Sun;Lee, Dae-Yeol
    • Childhood Kidney Diseases
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    • v.13 no.1
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    • pp.26-32
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    • 2009
  • Purpose : The increasing use of ultrasonography has allowed for an increase in the of the detection of congenital hydronephrosis, and the clinical outcomes of congenital hydronephrosis are widely varied. In this study, the necessity of voiding cystourethrography in neonate with hydronephrosis to rule out vesicoureteral reflux (VUR) was evaluated. Methods : Between January 2004 and December 2007, we reviewed the medical record of 157 childrens with congenital hydronephrosis detected within 1 month of age. The severity of hydronephrosis was graded by SFU (Society of Fetal Urology) system, and anterior posterior pelvic diameter (APPD). We evaluated the relationship between severity of hydronephrosis and incidence of VUR by using SPSS windows version 16.0. A P-value<0.05 is considered to be statistically significant. Results : Total renal unit number was 254, and 20(7.8%) renal units had VUR. We did not find any relationship between hydronephrosis grade the presence of VUR grade (P>0.05). In addition, there was no statistical significance between APPD, laterality of hydronephrosis and VUR incidence. However, renal units with VUR had lower spontaneous resolution rate (P<0.05), compared to renal units without VUR. Conclusion : In this study, there was no statistical significance between the severity of hydronephrosis and presence of VUR. Therefore, voiding cystourethrogram is recommended for all children with hydronephrosis to rule out VUR, regardless of the severity of hydronephrosis.

Burnt-out Metastatic Prostate Cancer

  • Shin, Dong Suk;Koo, Dong Hoe;Yoo, Suhyeon;Ju, Deok Yun;Jang, Cheol Min;Joo, Kwan Joong;Shin, Hyun Chul;Chae, Seoung Wan
    • Journal of Yeungnam Medical Science
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    • v.30 no.2
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    • pp.116-119
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    • 2013
  • A burnt-out prostate cancer tumor is a very rare clinical entity. The term 'burnt-out' refers to a primary tumor that has spontaneously and nearly completely regressed without treatment. Since metastasis of prostate cancer is usually encountered in the presence of advanced disease, distant metastasis with an undetectable primary tumor is very rare. We report herein a case of a burnt-out prostate cancer tumor that metastasized to the thoracic (T) spine and caused cord compression. A 66-year-old man visited the Emergency Department due to weakness of both legs for the past two days. His blood and urine tests were normal at the time. His spine magnetic resonance imaging (MRI) scans looked like bone metastasis that involved the T-7 vertebral body and a posterior element, and caused spinal cord compression. Other images, including from the brain MRI, neck/chest/abdomino-pelvic computed tomography (CT) scan and 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET) and endoscopy, revealed no lesions that suggested malignancy. After total corpectomy T-7 and screw fixation/fusion at T5 to T10, the pathology report revealed a metastatic carcinoma that was strongly positive for prostate-specific antigen (PSA). The serum PSA value was 1.5 ng/mL. The transrectal 12-core prostate biopsy and ultrasonography showed no definitive hypoechoic lesion, but one specimen had slight (only 1%) adenocarcinoma with a Gleason score of 6 (3+3). The final diagnosis was burned-out prostate cancer with an initial normal PSA value. Although metastatic disease with an unknown primary origin was confirmed, a more aggressive approach in seeking the primary origin could provide a more specific treatment strategy and greater clinical benefit to patients.

A Case of Bronchiectasis with Elevated Serum CA 125 Level (혈중 CA 125 수치가 지속적으로 상승되었던 기관지확장증 1예)

  • Shin, Bong Chul;Koo, Tae Hyoung;Kim, Sang Ock;Ter, Hsing Chien;Um, Soo Jung;Lee, Soo-Keol;Son, Choon Hee;Kim, Ki Nam;Lee, Ki-Nam;Roh, Mee Sook;Choi, Pil Jo
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.6
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    • pp.467-470
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    • 2009
  • Serum CA 125 is the most useful marker for monitoring patients with epithelial ovarian cancer. However, it can be elevated above normal level in a variety of conditions other than ovarian cancer such as endometriosis, pelvic inflammation disease, and other malignant or nonmalignant disorders, including pulmonary diseases. Recently, we experienced a case of bronchiectasis in which the serum CA 125 level was elevated, changing with the patient's condition. There was no evidence of underlying malignant disease on positron emission tomography or on gynecologic examination, including transvaginal ultrasonography. During follow-up for 14 months, we could not find any clue of malignant disease that could have been the cause of the elevated levels of serum CA 125. Elevated serum CA 125 level should be interpreted carefully according to the patient's clinical condition. In addition, our case suggests that CA 125 may be used as a surrogate marker for acute inflammatory status for chronic pulmonary diseases.

Assessment of Systemic Arterial Thromboembolism with Multi-Slice Spiral CT in a Dog (개에서 다중나선형 CT촬영에 의한 동맥혈전색전증의 평가)

  • Shin, Seung-Ho;Lee, Ki-Chang
    • Journal of Veterinary Clinics
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    • v.24 no.2
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    • pp.208-213
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    • 2007
  • A 15 kg 6-year-old intact male Jindo dog with a history of a respiratory distress, hindlimb paralysis with necrosed skin of dorsal digit for three weeks was referred to Animal Medical Center, Chonbuk National University. Heartworm infection was identified by kit examination. In plain thoracic radiographs, dilated pulmonary arteries reverse D sign and focal interstitial pattern was compatible with heartworm infection and possible pulmonary thromboembolism. Abdominal radiographs showed poor serosal detail indicating fluid accumulation within peritoneal cavity. No evidence of musculoskeletal abnormalities was found. Ultrasonography presented focal wedge-shaped hyperechogenecity on the both poles of left kidney, weak or absent pulse on the distal to the external iliac artery as well as ascites and irregular liver margin. Multi-organ failure was strongly supposed by blood profile including leukocytosis, anemia, hemoglobinuria bililubinemia, hypoalbuminemia, imbalance of electrolytes, and increased hepatic and renal function values. Interestingly, the glucose level is remarkably lower in pelvic limb compared to thoracic limb. Suspected pulmonary thromboembolism, renal infarction and femoral arterial embolization causing hindlimb paralysis and dermatic necrosis were confirmed by 3D reconstructed CT imaging. Prior to taking a consideration of euthanasia, interventional radiology was experimentally attempted but failed due to not recovered from general anesthesia. Early and accurate diagnosis of thromboembolism is valuable and 3D reconstructed CT images might be very useful to show the correct way to treat effectively.

The Effect of Abdominal Draw-in Maneuver with Leg Movements on Transversus Abdominis Thickness and Trunk Control in Stroke Patients (다리 움직임을 동반한 복부 드로우-인 기법이 뇌졸중 환자의 배가로근 두께와 몸통 조절에 미치는 영향)

  • Kang, Jeong-Il;Moon, Young-Jun;Jeong, Dae‐Keun
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.8
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    • pp.287-294
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    • 2020
  • The purpose of this study was, base on the observation that the leg movement has effect on muscles around trunk, to provide clinical fundamental data to develop effective abdominal draw-in technique by investigating the effect of abdominal draw-in exercise accompanying leg movement on the thickness of transversus abdominis muscle and trunk control ability in patients with stroke. The subjects were assigned randomly to experimental group I (n=9) on which the abdominal draw-in technique is applied and experimental group II (n=9) on which the abdominal draw-in technique accompanying leg movement is applied. The thickness of transversus abdominis muscle in the affected side and the trunk control ability were measured before and after treatment using ultrasonography and trunk impairment scale. A session of 30 minutes per day were performed four days a week for four weeks and the measured outcomes were analyzed. The in-group comparison showed significant difference both thickness of transversus abdominis muscle during abdominal draw-in technique application (p<0.01) and trunk control ability (p<0.001) between before and after treatment. The significant difference between two groups were observed only in trunk control ability (p<0.05). It was concluded that the abdominal draw-in technique accompanying leg movement is an intervention that has positive effect not only on transversus abdominis muscle but also on tunk control ability by inducing more efficient contraction reaction in muscles around trunk through autonomic pelvic movement caused by leg movement.