Evaluation of Correlation between Psychomotor Vigilance Task Scores and Drowsiness Estimation Levels Obtained from Facial Videos.

This paper reports the results of an experiment to evaluate the relationship between results obtained with a drowsiness estimation system we have developed using facial videos and those obtained with the Psychomotor Vigilance Task (PVT), which is a standard index of sleepiness used in sleep medicine. The correlation between PVT scores and the output of the drowsiness estimation system, which outputs drowsiness levels from assigned facial expressions, was calculated using data from 30 subjects. The Spearman's correlation coefficients between the drowsiness estimation results and the PVT mean response time, the slowest 10% response time, and the number of lapses were 0.36 (p <0.001), 0.43 (p <0.001), and 0.40 (p <0.001), respectively. Since this experiment showed a correlation between the drowsiness estimation results and those with PVT, it would seem possible to make specific interventions based on drowsiness estimation results learned from ground-truth drowsiness levels. Such estimation results could help prevent accidents resulting from drowsiness or insufficient vigilance while driving or working.

Rare case of inguinal ureteral hernia in a child diagnosed by drip infusion pyelography-computed tomography.

INTRODUCTION AND IMPORTANCE: Inguinal hernias are the most commonly experienced disease in pediatric surgery. However, it is rare for the organs of the urinary system to prolapse as the contents of the hernia. CASE PRESENTATION: We report a case of a 14-year-old boy with congenital paraperitoneal inguinal herniation of the ureter. Intraoperatively, we found an unfamiliar tubular loop structure arising from the deep inguinal ring in the left inguinal canal. The tubular structure, which may have been part of the ureter, was left in the inguinal canal to avoid damage. Postoperative drip infusion pyelography-computed tomography showed anatomical irregularity of the ureter in the inguinal canal. Follow-up in the 5th postoperative year showed no recurrence of hydrocele and complications associated with ureteral obstruction. CLINICAL DISCUSSION: Inguinal ureteral hernias are rarely reported in children. Paraperitoneal inguinal hernias are reported to be associated with vesicoureteral reflux and posterior urethral valve. Patients rarely present with symptoms like those observed in our case report. Whilst general surgical treatment is to return the ureter to the retroperitoneal space, we opted to leave the ureter in the inguinal canal to avoid unnecessary damage. However, this intraoperative management resulted in slight hematuria. The ureter should be placed back where it belongs, and postoperative monitoring using computed tomography may be important. CONCLUSION: This case provides valuable insight into preoperative diagnostic difficulties and intra- and postoperative management of an inguinal ureteral hernia in children, highlighting the importance of accurate diagnosis and appropriate surgical intervention in the treatment of this disease.

Laparoscopic treatment of an abdominoscrotal hydrocele: A case report.

INTRODUCTION: Abdominoscrotal hydrocele (ASH), a composite of scrotal and abdominal hydroceles connected through the inguinal canal, is rare and no consensus regarding its mechanisms and surgical treatments has been reached to date. PRESENTATION OF THE CASE: We report a case of an 11-month-old boy with a large ASH. Ultrasonography and magnetic resonance imaging (MRI) revealed a huge hydrocele (maximum length: 8 cm). The patient underwent laparoscopic percutaneous extraperitoneal closure (LPEC) and the orifice of the processus vaginalis (PV) was completely closed. The postoperative course was uneventful. Follow-up ultrasonography and MRI in the first postoperative year showed no recurrence of ASH. DISCUSSION: An ASH with a length >8 cm is considered rare in pediatric patients. There is no consensus regarding its etiology and surgical intervention is selected according to the patient's condition and the characteristics of ASH. We opted to perform early surgical intervention considering the ASH size and the adverse effects on testicular development. LPEC helped identify the condition and location of the ASH and allowed safe and reliable operation of the large intrapelvic hydrocele. In patients with no PV patency, a change in approach from LPEC to an open anterior approach should be considered even if LPEC is feasible. CONCLUSION: This case provides valuable insight into successful LPEC of a large ASH without any complications, highlighting the importance of elucidating the morphological mechanisms and making an accurate diagnosis and the challenges associated with these processes.

Exosomal miR-214-3p as a potential novel biomarker for rhabdoid tumor of the kidney.

PURPOSE: Rhabdoid tumor of the kidney (RTK) is a rare, highly aggressive pediatric renal tumor. No specific biomarkers are available for detection of RTK, and the initial differential diagnosis from other pediatric abdominal tumors, including neuroblastoma (NB), is difficult. Exosomal miRNAs are novel cancer biomarkers that can be detected in biological fluids. We explored candidate RTK-specific exosomal miRNAs as novel biomarkers of RTK. METHODS: Exosomal miRNAs were collected from conditioned media of human RTK-derived cell lines, a human embryonic renal cell line, and human NB-derived cell lines. miRNA sequencing (miRNA-Seq) was performed to detect candidate RTK-specific exosomal miRNAs. The exosomal miRNA expression in conditioned media of tumor cell lines and serum from RTK xenograft-bearing mice was analyzed by quantitative reverse transcription-polymerase chain reaction (qRT-PCR). RESULTS: The expression of exosomal miR-214-3p detected by miRNA-Seq was highest in RTK-derived cell lines. Exosomal miR-214-3p expression level determined by qRT-PCR was significantly higher in RTK-derived cell lines than in the human embryonic renal cell line or NB-derived cell lines. Furthermore, the serum exosomal miR-214-3p expression level was significantly higher in RTK xenograft mice than controls. CONCLUSION: Our data indicated that exosomal miR-214-3p has potential as a novel biomarker of RTK.

[A Case of Solitary Metastatic Diaphragmatic Tumor from Resected Rectal Cancer].

A 54-year-old woman underwent high anterior resection with D3 lymphadenectomy for rectal cancer at another hospital. She was diagnosed with well-differentiated adenocarcinoma of rectal cancer, pT3, N1, H0, P0, M0, fStage III a. She did not receive adjuvant chemotherapy. Eighteen months after surgery, abdominal CT at our hospital showed a 19mm-sized mass in S7 of the liver. EOB-MRI also showed a mass in the same location. The mass was a ring contrast-enhanced lesion on dynamic phase, had a low signal pattern on liver cell phase, and had high signal pattern on diffusion-weighted imaging. As such, it was diagnosed as liver metastasis of rectal cancer, and surgery was performed. During surgery, the tumor was found to be located between the liver and diaphragm. Thus, we performed partial resection of the liver diaphragm. Histopathologically, the tumor was the same well-differentiated adenocarcinoma as the primary tumor. In addition, the tumor existed only in the diaphragm and was pumping out the liver. Therefore, we diagnosed the tumor as a diaphragm metastasis of rectal cancer. On literature review, only 8 reports of colorectal metastatic tumors involving the diaphragm were found.

[A Case of Ileocecal Intussusception Due to Small Intestinal Adenocarcinoma].

A 67-year-old female with abdominal pain and vomiting was admitted to our hospital. Abdominal X-ray showed dilated small bowel in the left upper abdomen. She was diagnosed with ileocecal intussusception based on abdominal contrastenhanced computed tomography. Computed tomography showed a "pseudo kidney sign" in the right flank region. We also observed an enhanced mass lesion in the presenting portion ofthe intussusception. Laparotomy was performed to treat the invagination. We tried to reduce the invagination, without success. Ileocecal resection was performed. Pathological findings revealed that poorly differentiated adenocarcinoma in the ileum end portion had induced the invagination. Intussusception in adults should be treated with the knowledge that about 80% ofsuch cases have an organic lesion in the presenting portion.