We present a case of meningeal and brain metastasis of multiple myeloma. A 60-year-old woman who had been diagnosed as multiple myeloma two years ago, was referred to neurosurgery department because of headache and nausea. The magnetic resonance image of the brain showed a large epidural mass and the parenchymal enhancement. The patient received an operation of tumor removal and cranioplasty. A histological diagnosis of metastatic multiple myeloma was made.
Brain ; Diagnosis ; Female ; Headache ; Humans ; Immunoglobulin G* ; Middle Aged ; Multiple Myeloma* ; Nausea ; Neoplasm Metastasis ; Neurosurgery ; Plasmacytoma*

No abstract available.
Drug Therapy* ; Gestational Trophoblastic Disease*

Kidney transplantation is a treatment of choice which improves survival and quality of life for patients with end-stage renal disease. Due to the growing waiting list for kidney transplantation, expansion of the donor pool to use of deceased pediatric kidneys is of critical importance. However, the use of pediatric kidneys has been limited due to concerns about early graft failure, hyperfiltration injury, and technical difficulties. Performing ureteroneocystostomy using small pediatric en bloc kidneys is sometimes difficult due to the small diameter and short length of the ureter in the adult kidney recipient. We hereby report on a partial bladder wall transplantation using pediatric en bloc kidneys. Pediatric en bloc kidneys and partial bladder wall from a 12-month-old female donor who weighed 9.13 kg was transplanted into a 49-year-old male recipient. The urinary tract was reconstructed with a partial bladder wall of the donor. At 12 months post-transplantation, Doppler ultrasonograpy and renogram showed stable graft renal function without urological complications. Pediatric en bloc kidney transplantation with a partial bladder wall can be a safe and feasible surgical technique to reduce urological complications.
Adult* ; Female ; Humans ; Infant ; Kidney Failure, Chronic ; Kidney Transplantation* ; Kidney* ; Male ; Middle Aged ; Quality of Life ; Tissue Donors ; Transplants ; Ureter ; Urinary Bladder* ; Urinary Tract ; Waiting Lists

Residual urine can be erroneously estimated due to cystic pelvic pathology by portable ultrasound scanning. We report a case involving a false-positive elevated postvoid residual urine result using a bladder ultrasound caused by an ovarian cystadenoma unrelated to the urinary tract.
Cystadenoma* ; Ovarian Neoplasms ; Pathology ; Ultrasonography* ; Urinary Bladder ; Urinary Tract

OBJECTIVE: For the treatment of osteoporotic vertebral compression fracture, percutaneous vertebroplasty (PVP) is currently widely used as an effective and relatively safe procedure. However, some patients do not experience pain relief after PVP. We performed several additional PVP procedures in those patients who did not have any improvement of pain after their initial PVP and we obtained good results. Our purpose is to demonstrate the effective results of an additional PVP procedure at the same previously treated level. METHODS: We reviewed the medical records and the radiologic data of the PVP procedures that were performed at our hospital from November 2005 to May 2008 to determine the patients who had undergone additional PVP. We identified ten patients and we measured the clinical outcomes according to the visual analogue scale (VAS) score and the radiologic parameters, including the anterior body height and the kyphotic angulation. RESULTS: The mean volume of polymethylmethacrylate injected into each vertebrae was 4.3 mL (range: 2-8 mL). The mean VAS score was reduced from 8 to 2.32. The anterior body height was increased from 1.7 cm to 2.32 cm. The kyphotic angulation was restored from 10.14 degrees to 2.32 degrees. There were no complications noted. CONCLUSION: The clinical and radiologic outcomes suggest that additional PVP is effective for relieving pain and restoring the vertebral body in patients who have unrelieved pain after their initial PVP. Our study demonstrates that additional PVP performed at the previously-treated vertebral levels could provide therapeutic benefit.
Body Height ; Fractures, Compression ; Humans ; Medical Records ; Polymethyl Methacrylate ; Spine ; Vertebroplasty

PURPOSE: The proper indication for laparoendoscopic single-site surgery (LESS) in urology is still under debate, especially for malignant diseases. We compared the perioperative outcomes between LESS and conventional laparoscopy (CL) for upper urinary tract malignancies. MATERIALS AND METHODS: We reviewed the records of 75 patients who underwent radical nephrectomy, nephroureterectomy with bladder cuff excision, or partial nephrectomy with the LESS or CL approach between December 2008 and December 2010. We compared characteristics and perioperative outcomes between patients who underwent LESS or CL. All operations were performed by three surgeons using the transperitoneal approach. RESULTS: For all three surgery types, no differences in patient characteristics, estimated blood losses, transfusion rates, or durations of hospital stay were found between the two groups. No complications were found between the two groups in those who underwent nephroureterectomy with bladder cuff excision; however, significantly more complications were found in the LESS group than in the CL group in those who underwent radical nephrectomy or partial nephrectomy. Most of the complications with LESS radical nephrectomy occurred in the early introduction period of the technique. CONCLUSIONS: No significant differences in perioperative outcomes were found between the LESS and CL groups in those who underwent radical nephrectomy or nephroureterectomy with bladder cuff excision. Therefore, the use of LESS in these cases is expected to expand as surgeons gain more experience with this technique and as other technical advances in laparoscopic instruments occur. However, partial nephrectomy with LESS should be performed restrictively considering the current level of surgical skill.
Carcinoma, Renal Cell ; Humans ; Laparoscopy ; Length of Stay ; Nephrectomy ; Ureteral Neoplasms ; Urinary Bladder ; Urinary Tract ; Urology

OBJECTIVE: Avascular necrosis (AVN) of the vertebral body is known as a relatively uncommon phenomenon in a vertebral compression fracture (VCF). The outstanding radiologic findings of AVN are intravertebral vacuum phenomenon with or without fluid collection. Several reports revealed that PVP or balloon kyphoplasty might be the effective treatment modalities for AVN. We also experienced excellent results when using PVP for the treatment of AVN of the vertebral body, and intend to describe the treatment's efficacy in this report. METHODS: Thirty-two patients diagnosed with AVN of the vertebral body were treated with PVP. We measured the pre- and post-operative anterior body height and kyphotic angulation. The visual analogue scale (VAS) was used to determine the relief of back pain. RESULTS: The anterior body height (pre-operative : 1.49 cm, post-operative : 2.22 cm) and kyphotic angulation (pre-operative : 14.47 degrees, post-operative : 6.57 degrees) were significantly restored (p<0.001). VAS was improved from 8.9 to 3.7. Pseudoarthrosis was corrected in all cases, which was confirmed by dynamic radiographs. Fluid collection was found in sixteen cases and was aspirated with serous nature. No organism and tumor cell were noted. CONCLUSION: PVP proved to be an effective procedure for the treatment of AVN of the vertebral body, which corrected dynamic instability and significantly restored the anterior body height and kyphotic angulation.
Back Pain ; Body Height ; Fractures, Compression ; Humans ; Kyphoplasty ; Necrosis ; Pseudarthrosis ; Vacuum ; Vertebroplasty

PURPOSE: To evaluate the efficacy of posterior lumbar interbody fusion utilizing pedicle screw fixation and chip bone graft, and to compare the radiologic and clinical results in two group which use local chip bone and autoiliac chip bone respectively. MATERIALS AND METHODS: We analyzed 58 cases of single segment chip bone posterior lumbar interbody fusion which were followed up for more than 1 year. Group I was operated with local chip bone and group II with autoiliac chip bone. Radiologic union was assessed, based on Brantigan & Steffee method and functional outcome by Kirkaldy-Willis criteria. Student t-test and Fisher's exact test were used for statistical analysis. RESULTS: Clinical satisfaction of group I and II were 81.3% and 88.1% respectively (p>0.05). Though 12% of group II complained about pain on the donor site, no one among them were assessed as unsatisfactory. Radiological union was confirmed in 75% in group I and 90% in group II (p>0.05). Twenty five percent of group I and nineteen percent of group II showed collapsed union without significant differences. There were no significant differences between group I and II in loss of disc height, segmental lordosis, operation time and blood loss. CONCLUSION: Both local and autoiliac chip bone posterior lumbar interbody fusion are useful methods in the aspect of radiologic union and functional outcome and there are no significant differences between two groups. However, considerable collapsed unions were observed in both groups. It is necessary to investigate long term influence of collapsed union on the adjacent segment and functional outcome.
Animals ; Humans ; Lordosis ; Tissue Donors ; Transplants*

PURPOSE: The objective of the present article is to determine whether there are differences in vertical enlargement ratio among various sites within both jaws in a panoramic radiograph. MATERIALS AND METHODS: Two hundred and seventy-threeimplant sites in panoramic radiographs were evaluated by two observers. Magnification ratios at various sites in both jaws were calculated and compared with each other. RESULT: The average vertical enlargement ratio in the panoramic radiograph was 1.264 and this value was larger than original ratio 1.250. Although vertical magnification ratio of maxillary molar area was higher than that of mandibular molar area, every group showed similar magnification ratio in clinical respect. CONCLUSION: Vertical magnification ratio of the maxillary molar area is statistically higher than that of the mandibular molar area in the panoramic radiograph, but it is clinically negligible.
Dental Implants ; Jaw ; Molar ; Radiographic Magnification ; Radiography

PURPOSE: This study was designed to evaluate the usefulness of 3T-TOF MR angiography (3T-TOF MRA) compared with transcranial Doppler sonography (TCD) and conventional angiography (CA) in patients with suspected cerebral infarction. MATERIALS AND METHODS: Fifty four patients with clinical symptoms of cerebral infarction were involved in this study, and had undergone 3T-TOF MRA and TCD, with CA in 11 patients. On the basis of divisions of the carotid artery, four groups were designated: group I, both vertebral arteries and basilar artery; group II, segment between 2 cm below bifurcation of common carotid artery and genu portion of internal carotid artery; group III, segment between petrous portion of internal carotid artery and bifurcation of anterior and middle cerebral artery; group IV, from bifurcation of anterior and middle cerebral artery to thier distal branches. Two radiologists retrospectively reviewed the vascular imaging and stenosis in 3T-TOF MRA, TCD, and CA. RESULTS: A total of 432 arteries, 108 in each group, were available. The assessment of vascular imaging quality in 3T-TOF MRA is scored 2.98, 2.96, 2.91, 2.88 in 4 groups, respectively. Agreement among 3TTOF MR angiography, TCD, and CA was high. CONCLUSION: 3T-TOF MR angiography may be useful method for the assessment of stenotic lesions of cranial vasculature in patients with cerebral infarction.
Angiography* ; Arteries ; Basilar Artery ; Carotid Arteries ; Carotid Artery, Common ; Carotid Artery, Internal ; Cerebral Infarction* ; Constriction, Pathologic ; Humans ; Middle Cerebral Artery ; Retrospective Studies ; Ultrasonography, Doppler, Transcranial ; Vertebral Artery