Ureteral transitional cell papilloma is an uncommon tumor acting similar to malignant tumor. A small percentage of patients with von Recklinghaeusen's syndrome have pheochromocytomas simultaneously. A case of ureteral transitional cell papilloma with protrusion into the bladder in nonfunctioning pheochromocytoma patient associated with von Recklinghaeusen's syndrome developed in a 40 years old is with brief review of literature.
Adult ; Humans ; Papilloma* ; Pheochromocytoma* ; Ureter* ; Urinary Bladder

STUDY DESIGN: Retrospective study. OBJECTIVES: To analyze the clinical results of patients who were treated by pedicle screw fixation in osteoporotic spine and suggest the methods for preventing a loss of fixation strength. SUMMARY OF THE LITERATURE REVIEW: There are some methods to decrease failure rate and increase fixation strength in the osteoporotic spine: use bicortical screw, cement augmentation and supporting anterior column by interbody fusion using cages. MATERIALS AND METHODS: Forty-four patients treated by spinal instrumentation using pedicle screw from 2004 to 2011 were followed for at least 12 months. Five men and 39 women were diagnosed as osteoporotic spine (T score <-3.0). Two hundred forty eight pedicle screws were included and statistically analyzed the correlation between the use of bicortical screw, cement augmentation, anterior column support and fixation loss of the pedicle screw. Radiologic results were evaluated to find out the mechanical complications, like loosening of the screw, fixation failure, and nonunion. RESULTS: There were 9 complications associated with mechanical strength, loosening of pedicle screws in 7, sinking down of cage in 4, and nonunion in 4 cases. Using bicortical pedicle screw, cement augmentation and anterior column support were significantly correlated with the increasing fixation strength (P=0.001, P=0.047, P=0.014). In addition, these three factors contribute to stabilize the instrumentation (Linear by linear association, P=0.012). CONCLUSIONS: These 3 methods, using bicortical pedicle screw, cement augmentation and supporting anterior column, are effective to enhance the fixation strength and prevent loss of holding power in the osteoporotic spine.
Female ; Humans ; Male ; Osteoporosis ; Retrospective Studies ; Spine

PURPOSE: To evaluate the MR findings of gestational trophoblastic tumor(GTT) in correlation with pathological results. MATERIALS AND METHODS: Nine patients who confirmed the diagnosis (four choriocarcinomas and five invasive moles) constituted the basis of our study. Pathologic specimens were taken from the tumors corresponding to the regions of interest on MR images. The MR images were analyzed in respect of the morphology and signal intensity of the tumors, uterine and adnexal vascularity, and the adnexal lesion. RESULTS: The MR findings of four choriocarcinomas were well-defined, hemorrhagic masses with central necrosis;the masses were hyperintense on Tl-weighted images. In contrast, the five invasive moles showed irregular and permeative masses with densely enhanced solid components and tiny cystic lesions. The trophoblastic proliferation, coagulation necrosis, and molar villi had variable signal intensities on Tl-and T2-weighted images. CONCLUSION: Our results suggest that MR imaging is a promising tool for noninvasive morphologic analysis of GTTS.
Choriocarcinoma ; Diagnosis ; Female ; Humans ; Hydatidiform Mole, Invasive ; Magnetic Resonance Imaging* ; Molar ; Necrosis ; Pregnancy ; Trophoblastic Neoplasms* ; Trophoblasts*

In this case study, we investigated the effects of robot-assisted gait training on the plasticity of motor system in a stroke patient using functional MRI. A patient who suffered from the left hemiparesis following the right MCA infarction performed gait training with a robot-assisted gait orthosis. Before and after gait training, motor performances were assessed and functional MRIs were acquired with motor activation task of affected lower limb. After gait training with a robot-assisted orthosis, the patient's motor performances were improved and cortical activities were changed. Activation in the ipsilesional primary sensorimotor cortex was increased and cortical reorganization was induced in a way that nearby regions were recruited for the movement of affected lower limb. The results of this study showed that gait training with a robot-assisted orthosis induced cortical reorganization of the motor network that resulted in enhancement of motor performance of the lower limb.

Cyclic ADP-ribose (cADPR) releases Ca²⁺ from ryanodine receptor (RyR)-sensitive calcium pools in various cell types. In cardiac myocytes, the physiological levels of cADPR transiently increase the amplitude and frequency of Ca²⁺ (that is, a rapid increase and decrease of calcium within one second) during the cardiac action potential. In this study, we demonstrated that cADPR levels higher than physiological levels induce a slow and gradual increase in the resting intracellular Ca²⁺ ([Ca²⁺](i)) level over 10 min by inhibiting the sarcoendoplasmic reticulum Ca²⁺ ATPase (SERCA). Higher cADPR levels mediate the tyrosine-dephosphorylation of α-actin by protein tyrosine phosphatase 1B (PTP1B) present in the endoplasmic reticulum. The tyrosine dephosphorylation of α-actin dissociates phospholamban, the key regulator of SERCA, from α-actin and results in SERCA inhibition. The disruption of the integrity of α-actin by cytochalasin B and the inhibition of α-actin tyrosine dephosphorylation by a PTP1B inhibitor block cADPR-mediated Ca²⁺ increase. Our results suggest that levels of cADPR that are relatively higher than normal physiological levels modify calcium homeostasis through the dephosphorylation of α-actin by PTB1B and the subsequent inhibition of SERCA in cardiac myocytes.
Action Potentials ; Adenosine Diphosphate* ; Adenosine Triphosphatases ; Calcium ; Cyclic ADP-Ribose ; Cytochalasin B ; Endoplasmic Reticulum ; Homeostasis ; Muscle Cells* ; Myocytes, Cardiac ; Protein Tyrosine Phosphatase, Non-Receptor Type 1* ; Protein Tyrosine Phosphatases* ; Reticulum ; Ryanodine Receptor Calcium Release Channel ; Tyrosine

This prospective cohort study was performed to estimate the morbidity and mortality with 790 patients over 50-yr of age that sustained a femoral neck or intertrochanteric fracture from 2002 to 2006, followed-up for a mean of 6 yr (range, 4 to 9 yr). Crude and annual standardized mortality ratios (SMRs) were calculated; and mortalities in the cohort and the age and sex matched general population were compared. The risk factors on mortality and activities pre- and post-injury were assessed. Accumulated mortality was 16.7% (132 patients) at 1 yr, 45.8% (337 patients) at 5 yr, and 60% (372 patients) at 8 yr. SMR at 5 yr post-injury was 1.3 times that of the general population. Multivariate analysis demonstrated that age (OR, 1.074; 95% CI, 1.050-1.097; P<0.001), woman (OR, 1.893; 95% CI, 1.207-2.968; P=0.005), and medical comorbidity (OR, 1.334; 95% CI, 1.167-1.524 P<0.001) were independently associated with mortality after hip fracture. Only 59 of the 150 patients (39.3%) who were able to ambulate normally outdoors at preinjury retained this ability at final follow-up. Patients with a hip fracture exhibits higher mortality at up to 5 yr than general population. Age and a preinjury comorbidity are associated with mortality.
Age Factors ; Aged ; Aged, 80 and over ; Aging ; Cohort Studies ; Female ; Hip Fractures/*epidemiology/mortality ; Humans ; Male ; Prospective Studies ; Republic of Korea/epidemiology ; Risk Factors ; Sex Factors

Coronary artery anomalies are diagnosed in 0.6 to 1.5% of patients who undergo coronary angiography (CAG). They may present with life threatening conditions but are generally asymptomatic. Recognition and adequate visualization of the anomaly is essential for correct management of the condition. However, in some cases the exact orifice and course of an anomalous coronary vessel cannot be selectively identified by CAG. In this report, a 54-year-old man was admitted to the hospital with acute inferior myocardial infarction and had an anomalous origin of the left circumflex coronary artery (LCX) from the first diagonal branch (D1). In CAG, the right CAG showed no significant stenosis and fortunately we found an anomalous origin of the LCX from the D1. The course of LCX was precisely established by 64-slice multi-detector computed tomography.
Constriction, Pathologic ; Coronary Angiography ; Coronary Vessel Anomalies ; Coronary Vessels ; Glycosaminoglycans ; Humans ; Inferior Wall Myocardial Infarction ; Middle Aged ; Myocardial Infarction

Transvenous coil embolization has been successfully applied for the treatment of cavernous sinus dural arteriovenous fistula (CSDAVF). Unfortunately, the technique cannot be applied in cases of poor or absent inferior petrosal sinus or facial venous access route to the fistula. Recently, we experienced a successful embolization using direct superior ophthalmic vein approach in cases of CSDAVF which were no opacification of inferior petrosal sinus or facial vein.
Carotid-Cavernous Sinus Fistula ; Cavernous Sinus ; Caves ; Central Nervous System Vascular Malformations ; Endovascular Procedures ; Fistula ; Veins

Between 1987 and 1994, the authors analysed 29 patients who underwent limb sparing resection for shoulder girdle neoplasms. Follow up averaged 24 months. Primary bone and soft tissue malignancy were 23 cases, metastatic carcinoma 3, aggressive giant cell tumor 2, aneurysmal bone cyst 1. By Enneking's criteria, stage IIB 23 cases, stage III 3, stage I 2. The surgical margins were: wide(20), marginal(7), and intralesional(2). In 4 cases with S2345B resections(by Musculoskeletal Tumor Society classification), shoulder fusion were done with Ender nail and bone cement. Among twenty patients with S345A(3), S34A(6), S345B(11) resections, arthroplasty with Ender nail and bone cement were done in 11 cases, endoprothesis and its combination with bone cement in 4, vascu- larized fibula graft in I, shoulder fusion with fibula graft in 1, combination of autoclaved bone and endoprothesis were done in 3 cases. Four patients with S12B, no reconstruction were done. For one patient with S45A, segmental resection and reconstruction with autogenous pasteurized bone were done. Oncologic results are CDF 14, DOD 5, NED 3, AWD 7 cases. Complications were local recur- rence 3(10.3%), distal fragment loosening 1, subluxation of humeral head 1, graft site fracture 1, and infection in 1 case. MSTS functional scores for the whole 29 cases were 22.5(75% of normal). S2345B with fusion was 20(67%). For S345A(3) and S34A(6) score was 23.2(77%). For S345B(11), score was 21.7(72%). For S12B(4) and S45A(1), score was 25.8(86%). Although functional results are depend on the extent of bone and soft tissue resection, reconstruction of soft tissue seems to be important. The options for reconstruction of bony defect(endoprothesis complex, living fibula graft or IM nail and cement as a prothesis) did not affect functional outcome.
Aneurysm ; Arthroplasty ; Bone Cysts ; Extremities ; Fibula ; Follow-Up Studies ; Giant Cell Tumors ; Humans ; Humeral Head ; Limb Salvage ; Shoulder ; Transplants

Diagnosis ; Diagnosis, Differential ; Humans ; Leukemia ; Mouth Mucosa ; Mucositis ; Necrosis ; Opportunistic Infections ; Prognosis ; Reference Values