Sung Kyoung Moon

Preoperative Factors Predictive of Continence Recovery after Radical Retropubic Prostatectomy

Purpose We assessed the factors predictive of continence recovery after radical retropubic prostatectomy performed by use a single operative technique by a single surgeon. Materials and Methods Preoperative factors, including age, body mass index (BMI), prostate volume, prostate-specific antigen level, and anatomical information from preoperative magnetic resonance imaging (MRI), such as membranous urethral length, thickness of the levator ani muscle, and urogenital diaphragm, were evaluated in 94 consecutive patients who underwent radical retropubic prostatectomy between April 2005 and October 2010. Patients were also categorized into four different groups according to the overlying pattern of the prostatic apex and the membranous urethra. Continence status was evaluated by direct patient questioning at 12 months after the operation. Results The overall continence rate at 12 months after the operation was 79.8%. In the age- and BMI-adjusted logistic regression analysis, the membranous urethral length and the overlying pattern of the prostatic apex were significant predictive factors of the continence rate at 12 months after the operation (p=0.006 and p=0.007, respectively). Other predictive factors were not contributory. Patients with no overlapping observed between the prostatic apex and membranous urethra had longer membranous urethral lengths (14.24±2.73 mm) and higher rates of recovery of continence compared with other groups. Conclusions Membranous urethral length and shape of the prostatic apex as assessed by preoperative MRI are significantly associated with recovery of urinary continence after radical retropubic prostatectomy.

Association of C1q deposition with renal outcomes in IgA nephropathy.

BACKGROUND/AIMS IgA nephropathy (IgAN) is characterized by a highly variable clinical course. It has been reported that histopathologic lesions are risk factors for the progression of IgAN. The aim of this study was to investigate the relationships between co-deposition of C1q, clinicopathological features, and renal outcomes in patients with IgAN. METHODS This retrospective cohort study included 221 patients with primary IgAN who underwent renal biopsy at the Kyung Hee University Medical Center from January 1996 to December 2008. Patients were divided in two groups: C1qpositive and C1q-negative. Using propensity scores to minimize confounding factors, we selected 36 matched C1q-negative patients from among the 203 unmatched C1q-negative patients and compared them with the 18 C1q-positive patients. We evaluated baseline characteristics and the severity of histologic lesions. We expressed the average rate of monthly renal function decline as the slope of eGFR (ΔGFR/M). RESULTS 18 patients with IgAN showed mesangial deposition of C1q (8.1%). The C1q-positive patients had higher mean systolic blood pressure values and more impaired renal function than the unmatched C1q-negative patients. However, this association was not seen when the C1qpositive patients were compared with the matched C1q-negative patients. The slope of eGFR (ΔeGFR/M) declined steeply in the C1q-positive group. The incidence of severe cases of tubulointerstitial inflammation (TII) and fibrosis (TIF) was also greater in the C1q-positive group than the unmatched C1qnegative group, while only the incidence of severe TIF was significantly greater in the C1q-positive group than the matched C1qnegative group. Biopsies from C1q-positive patients showed more intense IgA staining as well as positive rates of IgG and IgM staining than those of unmatched C1q-negative patients. However, compared with the matched C1q-negative group, only the IgG positive rate was significantly higher in the C1q-positive patients. Multiple regression analysis of C1q-positive and matched C1q-negative patients revealed that C1q deposition was a critical determinant of a poorer renal prognosis. CONCLUSIONS Mesangial C1q deposition in the glomerulus is associated with a poor renal outcome and severe pathologic features in patients with IgAN. The deposition of C1q in IgAN could therefore serve as an indicator of a poor renal prognosis.

Distribution of Epididymal Involvement in Mumps Epididymo-orchitis

To evaluate characteristic sonographic findings for mumps orchitis with epididymal involvement.

Unilateral spermatic cord metastasis from gastric cancer: a case report.

Malignant spermatic cord tumor is rare. Spermatic cord metastasis is less common and the prognosis of these patients is poor. Here we report a case of unilateral spermatic cord metastasis from advanced gastric cancer. A 57-year-old male underwent total gastrectomy due to advanced gastric cancer. Three years later, a painless hard palpable mass in the left inguinal area developed and the pathology revealed a spermatic cord metastasis from stomach cancer.

Sonography of Abdominal Wall Masses and Masslike Lesions Correlation With Computed Tomography and Magnetic Resonance Imaging

Sonography is usually regarded as a first‐line imaging modality for masses and masslike lesions in the abdominal wall. A dynamic study focusing on a painful area or palpable mass and the possibility of ultrasound‐guided aspiration or biopsy are the major advantages of sonography. On the other hand, cross‐sectional imaging clearly shows anatomy of the abdominal wall; thereby, it is valuable for diagnosing and evaluating the extent of diseases. Cross‐sectional imaging can help differentiate neoplastic lesions from non‐neoplastic lesions. This pictorial essay focuses on sonographic findings of abdominal wall lesions compared with computed tomographic and magnetic resonance imaging findings.

Interval changes of an extrauterine adenomyoma on magnetic resonance imaging

Extrauterine adenomyomas are rare tumors that present as uterus-like masses. Uterine adenomyomas can show interval changes according to hormone status. However, interval changes in imaging studies have not been reported in adenomyomas. We report a rare case of an extrauterine adenomyoma showing unique interval changes in magnetic resonance imaging.

Sonography of Gastrointestinal Tract Diseases Correlation with Computed Tomographic Findings and Endoscopy

Sonographic evaluation of the gastrointestinal (GI) tract may be difficult because of overlying intraluminal bowel gas and gas‐related artifacts. However, in the absence of these factors and with the development of high‐resolution scanners and the technical experience of radiologists, sonography can become a powerful tool for GI tract assessment. This pictorial essay focuses on sonographic findings of GI tract lesions compared with endoscopic, computed tomographic, and magnetic resonance imaging findings. Neoplastic and non‐neoplastic diseases and postoperative complications are illustrated, and the distinctive sonographic characteristics of these entities are highlighted.

Cystic Duct Enhancement: A Useful CT Finding in the Diagnosis of Acute Cholecystitis Without Visible Impacted Gallstones.

OBJECTIVE The purpose of this study was to determine the incremental value of the presence of cystic duct enhancement for diagnosing acute cholecystitis without visible impacted gallstones. MATERIALS AND METHODS CT scans of 63 patients with acute cholecystitis and 63 control subjects were retrospectively and independently reviewed by two radiologists to determine the presence of cystic duct enhancement or impacted stones. Two additional radiologists were then asked to independently evaluate all CT images using a 5-point scoring system for diagnosing acute cholecystitis. They conducted the evaluations both before and after being informed that cystic duct enhancement could be substituted for a CT finding of impacted gallstones. RESULTS The prevalence of either cystic duct enhancement or stone impaction was observed to be significantly more common in the patient group (86-91%) than in the control group (6-14%) (p < 0.001) with good interobserver agreement (κ = 0.79). Diagnostic sensitivities increased significantly from 60.3% to 85.7% for reviewer 1 (p = 0.001) and from 71.4% to 87.3% for reviewer 2 (p = 0.028) after the reviewers were informed of the presence of cystic duct enhancement. Diagnostic accuracy increased significantly for the less experienced radiologist, from 75.4% to 87.3% (p = 0.015). CONCLUSION The accuracy and sensitivity of CT for the diagnosis of acute cholecystitis improved significantly when cystic duct enhancement was used as an alternative to impacted gallstones as a diagnostic criterion.