MR Imaging of Shaken Baby Syndrome Manifested as Chronic Subdural Hematoma

Shaken baby syndrome (SBS) is a form of child abuse that can cause significant head injuries, of which subdural hematoma (SDH) is the most common manifestation. We report the MRI findings of chronic SDH in three cases of SBS, involving two-, three- and eight-month-old babies. The SDH signal was mostly low on T1-weighted images and high on T2-weighted images, suggesting chronic SDH. In chronic SDH, a focal high signal on T1-weighted images was also noted, suggesting rebleeding. Contrast-enhanced MRI revealed diffuse dural enhancement

Bronchus-Associated Lymphoid Tissue (BALT) Lymphoma of the Lung Showing Mosaic Pattern of Inhomogeneous Attenuation on Thin-section CT: A Case Report

The authors present a case of histologically proven bronchus-associated lymphoid tissue (BALT) lymphoma of the lung in a patient with primary Sjögren's syndrome that manifested on thin-section CT scan as a mosaic pattern of inhomogeneous attenuation due to mixed small airway and infiltrative abnormalitie

Initial Experience with Robotic-Assisted Laparoscopic Partial Cystectomy in Urachal Diseases

Purpose: In this study, we report our initial experience with robot-assisted laparoscopic partial cystectomy (RLPC) in urachal diseases. Materials and Methods: Two men and two women with a mean age of 51.5??9.3 years underwent RLPC between June 2009 and December 2009. In each case, a single surgeon using the da Vinci-S robotic system (Intuitive Surgical, Sunnyvale, CA, USA) used a transperitoneal approach with a 0?? robotic camera. After careful observation of the intravesical portion of the mass, the mass was excised by use of monopolar scissors circumferentially. The bladder was closed in two layers with watertight running sutures made with 2-0 Vicryl. Results: The mean operative time was 198 minutes (range, 130-260 minutes), the mean console time was 111 minutes (range, 70-150 minutes), and the mean estimated blood loss was 155 ml. The urethral catheter was removed on postoperative day 7 after a normal cystogram, and the surgical drain was removed on postoperative day 2.5 (range, 2-3 days). The mean hospital stay was 6 days (range, 4-7 days). There were no major complications. The pathology report revealed that one patient had a urachal cystadenoma, two patients had a urachal cyst, and one patient had a patent urachus. Conclusions: Our initial experience with RLPC for benign urachal disease is that it is a safe and feasible treatment modality. However, more cases are required to confirm the efficacy of RLPC. ?? The Korean Urological Association, 2010

The Role of TURP in the Detection of Prostate Cancer in BPH Patients with Previously Negative Prostate Biopsy

Purpose: We aimed to investigate the significance of early detection of transition zone prostate cancer by transurethral resection of prostate (TURP) in benign prostatic hyperplasia (BPH) patients with lower urinary tract symptoms (LUTS) in whom prostate cancer was suspected despite a negative transrectal ultrasonography (TRUS) biopsy result. Materials and Methods: From January 2006 to January 2009, a total of 165 patients who underwent TURP were evaluated. The prostate cancer detection rate was compared between patients who underwent TRUS biopsy before TURP (group A) and those who did not (group B). All charts were evaluated retrospectively, including prostate-specific antigen (PSA), digital rectal examination (DRE), TURP results (including resection volume and pathology report), TRUS, and TRUS biopsy results. Group A was subdivided into group A1, who were diagnosed with prostate cancer after TURP, and group A2, who were diagnosed with BPH after TURP. Results: The cancer detection rate showed no significant difference between groups A and B (8.9% vs. 7.5%, p > 0.05). The mean PSA levels in groups A1 and A2 were 15.5??14.0 ng/ml and 9.1??5.1 ng/ml, respectively (p > 0.05). In group A1, 40% had an abnormal DRE, compared with 6.7% in group A2 (p < 0.05). After TURP, the mean percentage of resected prostatic chips of the prostate cancer group and BPH group were 33.9% and 18.6%, respectively (p=0.001). A positive correlation was found between the detection rate of prostate cancer and PSA (p=0.01). Conclusions: BPH patients in whom prostate cancer is suspected and who have lower urinary tract symptoms (LUTS) with a previously negative TRUS biopsy result can undergo TURP, which results in immediate improvement in bladder outlet obstruction and early diagnosis of clinically significant transition zone prostate cancer. ?? The Korean Urological Association, 2010

Isolated Petroclival Craniopharyngioma with Aggressive Skull Base Destruction

We report a rare case of petroclival craniopharyngioma with no connection to the sellar or suprasellar region. MRI and CT images revealed a homogenously enhancing retroclival solid mass with aggressive skull base destruction, mimicking chordoma or aggressive sarcoma. However, there was no calcification or cystic change found in the mass. Here, we report the clinical features and radiographic investigation of this uncommon craniopharyngioma arising primarily in the petroclival region

Influence of Donor's Renal Function on the Outcome of Living Kidney Transplantation: 10-Year Follow-up

Purpose: With the improved surgical techniques and immunosuppression available today, conventional prognostic factors have taken on less significance. Accordingly, the native renal function of the donor is thought to be more important. Thus, we analyzed the prognostic significance of the donor’s renal function as assessed by 24-hour urine creatinine clearance on kidney graft survival for 10 years after living kidney transplantation. Materials and Methods: From January 1998 to July 2000, 71 living kidney transplantations were performed at a single institution. From among these, 68 recipients were followed for more than 6 months and were included in the present analysis. We analyzed kidney graft survival according to clinical parameters of the donor and the recipient. Results: Mean follow-up duration of recipients after living kidney transplantation was 115.0±39.4 months (range, 10 to 157 months), and 31 recipients (45.6%) experienced kidney graft loss during this time period. Estimated mean kidney graft survival time was 131.8±6.2 months, and 5-year and 10-year kidney graft survival rates were estimated as 88.2 % and 61.0%, respectively. Donor’s mean 24-hour urine creatinine clearance (Ccr) before kidney transplantation was 122.8±21.2 ml/min/1.73 m 2 (range, 70.1 to 186.6 ml/min/1.73 m 2). The 10-year kidney graft survival rates for cases stratified by a donor’s Ccr lower and higher than 120 ml/min/1.73 m 2 were 39.0 % and 67.2%, respectively (p=0.005). In univariate and multivariate analysis, donor’s Ccr was retained as an independent prognostic factor of kidney graft survival (p=0.001 and 0.005, respectively). Conclusions: Donor’s 24-hour urine Ccr before living kidney transplantation was an independent prognostic factor of kidney graft survival. Therefore, it should be considered before living kidney transplantation

Differences in complications and asymmetry in patients who did not receive a balancing procedure in two-stage and direct-to-implant breast reconstruction

Background Implant-based immediate breast reconstruction surgery with nipple-sparing mastectomy has recently been favored by patients. However, in patients who do not wish to undergo balancing procedures, it is difficult to select the appropriate implant size, making it challenging to achieve a symmetrical breast shape. Therefore, this study investigated the differences in breast asymmetry and other complications in patients who underwent a two-stage procedure or direct-to-implant (DTI) breast reconstruction to determine whether the two-stage procedure can produce more favorable outcomes. Methods The participants of this study were patients who underwent immediate two-stage breast reconstruction or DTI breast reconstruction from May 2018 to April 2022, did not receive postoperative radiotherapy, and did not wish to undergo any balancing procedures. An acellular dermal matrix was used for breast reconstruction in all patients, and a single reconstructive surgeon performed all the operations. Statistical significance was set at P<0.05. Results No significant differences in complications were found between the patients who underwent DTI breast reconstruction and those who underwent two-stage breast reconstruction. In the two-stage breast reconstruction group, breast volume asymmetry was observed in 18.4% (seven patients), which was significantly lower than the percentage of 44.7% (17 patients) observed in the DTI group. Conclusions Breast asymmetry was observed in a significant proportion of the patients in both groups. However, because breast volume asymmetry was more common in the DTI group than in the two-stage breast reconstruction group, two-stage breast reconstruction may be a favorable method for patients who do not wish to undergo balancing procedures