PURPOSE: To investigate the usefulness of urine cytology in the detection of tumor recurrence in terms of practicality and cost-effectiveness. MATERIALS AND METHODS: We retrospectively analyzed 393 patients who underwent transurethral resection of bladder tumor (TURBT) for non-muscle-invasive bladder cancer (NMIBC) from January 2010 to June 2013. All patients underwent cystoscopy, urine cytology, urinalysis, and computed tomography (CT) at 3 and 6 months after TURBT. In 62 cases, abnormal bladder lesions were identified on cystoscopy within 6 months. Suspicious lesions were confirmed pathologically by TURBT or biopsy. Patients were grouped by modalities: group I, urine cytology; group II, CT; group III, urinalysis; group IV, urine cytology plus CT; group V, urine cytology plus urinalysis; group VI, CT plus urinalysis; group VII, combination of all three modalities. Each group was compared by cost per cancer detected. RESULTS: Forty-nine patients were confirmed to have tumor recurrence and 13 patients were confirmed to have inflammation by pathology. The overall tumor recurrence rate was 12.5% (49/393) and recurrent cases were revealed as NMIBC. Sensitivity in group I (24.5%) was lower than in group II (55.1%, p=0.001) and group III (57.1%, p<0.001). However, in group VII (77.6%), the sensitivity was statistically similar to that of group VI (75.5%, p=0.872). Under the Korean insurance system, total cost per cancer detected for group VII was almost double that of group VI (p=0.041). CONCLUSIONS: Routine urine cytology may not be useful for follow-up of bladder cancer in terms of practicality and cost-effectiveness. Application of urine cytology needs to be adjusted according to each patient.
Aged ; Aged, 80 and over ; Cost-Benefit Analysis ; Cystoscopy/economics ; Cytodiagnosis/economics/methods ; Female ; Health Care Costs/*statistics & numerical data ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local/*diagnosis/economics/pathology ; Neoplasm Staging ; Republic of Korea ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, X-Ray Computed/economics ; Urinalysis/economics/methods ; Urinary Bladder Neoplasms/*diagnosis/economics/pathology/surgery ; Urine/*cytology

This study examined the prevalence of oral microbes in the saliva of oncological patients and healthy subjects. PCR was used to assess the frequency of oral microbes including 3 cariogenic bacteria, 5 periodontopathic bacteria and 4 Candida species in the saliva of 104 oncological patients and 52 healthy subjects. Among these microorganims, Streptococcus mutans, Fusobacterium nucleatum and Candida albicans were most frequently detected in both groups. There were no significant differences in the prevalence of cariogenic bacteria between the patient and healthy groups, whereas significant differences in the frequency of Porphyromonas gingivalis and Tannerella forsythia were observed between the two groups (p < 0.05). The prevalence of all five periodontopathogens was higher in the healthy group than in the patient group. The prevalence of C. albicans in patients was significantly higher than that of healthy group (p < 0.05). In conclusion, there were significant differences in the prevalence of P. gingivalis, T. forsythia and C. albicans between the oncological patient group and healthy group.
Bacteria ; Candida ; Candida albicans ; Forsythia ; Fusobacterium nucleatum ; Humans ; Polymerase Chain Reaction ; Porphyromonas gingivalis ; Prevalence ; Saliva ; Streptococcus mutans

BACKGROUND: Since its reemergence in 1993, a number of cases of Plasmodium vivax malaria have been reported in Korea. We analyzed the cases of malaria patients living in Chuncheon and its neighboring communities, to characterize its clinical manifestations and laboratory findings, and to identify any differences between our clinical findings and those of previous studies. METHODS: We reviewed the clinical records of cases that were confirmed as malaria by peripheral blood smear at Chuncheon Sacred Heart Hospital from July 1998 to September 2001. RESULTS: Forty-four cases were included in the study. All patients were infected with Plasmodium vivax, and presented with high fever; however, tertian fever developed in only 15 patients (35.7%). A number of cases showed various symptoms, which included headache, abdominal pain, nausea and vomiting. Of the 44 cases identified, 41 (93.2%) developed malaria between June and September. Thrombocytopenia was a prominent finding in 75% of the cases at diagnosis, but resolved during or after therapy. Other laboratory abnormalities such as, anemia, elevated transamines, coagulopathies, and elevated lactose dehydrogenase (LDH) were also noted. Cerebrospinal fluid (CSF) studies were performed in five cases, one of which showed pleocytosis in the CSF. CONCLUSION: We noted only 15 patients (35.7%) with tertian fever; the other patients showed variable fever patterns. Thrombocytopenia was the most prominent laboratory finding. Therefore, we suggest that malaria should be included in the differential diagnosis of febrile diseases with an onset between June to and September, regardless of the pattern of the fever.
Adult ; Animals ; Comparative Study ; Diagnosis, Differential ; Female ; Human ; Malaria/blood/cerebrospinal fluid/*diagnosis/*microbiology ; Male ; Plasmodium vivax/*isolation & purification ; Retrospective Studies ; Thrombocytopenia/diagnosis

As snowboarding has become one of the most popular winter sports, lots of young people enjoy it and they have become the center of this winter sports. However, this increased number of snowboarding lovers results in raising the number of injuries. In the case of severe chest injury caused by snowboarding can be a source of a serious injury such as cardiac tamponade. The development of cardiac tamponade is an acute, life-threatening emergency. To test a cardiac tamponade, a patient with chest trauma should be diagnosed from the information given by a physical examination and simple chest radiography. If the heart is doubted to be wounded, an emergency echocardiography has to be executed. An emergency treatment for the cardiac tamponade patient is to normal saline infusion quickly to augment the capacity of a blood vessel. Extremely, surgeries such as pericardiocentesis or pericardiotomy can be applied to ease the pressure inside the heart. Some patients with chest blunt trauma while snowboarding developed cardiac tamponade and they were successfully recovered through pericardiocentesis. This precedent is reported here with the consideration of the references.
Blood Vessels ; Cardiac Tamponade* ; Echocardiography ; Emergencies ; Emergency Treatment ; Heart ; Humans ; Pericardiectomy ; Pericardiocentesis ; Physical Examination ; Radiography ; Skiing* ; Sports ; Thoracic Injuries ; Thorax* ; Wounds and Injuries

BACKGROUND: Since Plasmodium vivax malaria reemerged in Korea in 1993, a number of patients with malaria have been reported. We analyzed the cases with malaria who lived in Chuncheon and neighboring communities to find out clinical manifestations, laboratory findings and the differences in clinical findings compared to previous studies. METHODS: We reviewed the clinical records of the cases who were confirmed as malaria by peripheral blood smear in Chuncheon Sacred Heart Hospital from July, 1998 to Octorber, 2001. RESULTS: Forty-four cases were included. All cases were Plasmodium vivax with high fever, but tertian fever developed only in 15 patients (35.7%). A number of cases showed various symptoms including headache, abdominal pain, nausea, vomiting. Of the all cases, 41 cases (93.2%) developed malaria between June and September. Thrombocytopenia was prominent finding which was noted in 75% of the cases at diagnosis, and recovered during or after treatment. Other laboratory abnormalities such as anemia, elevated transaminases, coagulopathies, and elevated LDH level were also noted. Five patients were performed CSF studies, one patient showed pleocytosis in CSF. CONCLUSION: We observed that only 15 patients (35.7%) had tertian fever, the others had variable fever patterns. Thrombocytopenia was the prominent findings. Therefore we suggest that malaria should be included in the differential diagnosis of febrile diseases which developed from June to September regardless of the fever patterns.
Abdominal Pain ; Anemia ; Diagnosis ; Diagnosis, Differential ; Fever ; Gangwon-do ; Headache ; Heart ; Humans ; Korea ; Leukocytosis ; Malaria ; Malaria, Vivax* ; Nausea ; Plasmodium vivax* ; Plasmodium* ; Thrombocytopenia ; Transaminases ; Vomiting

PURPOSE: An appropriate emergency medical support system is required at sites of large-scale congregations because different kinds of emergencies may be encountered. My colleagues and I initiated this project to present the information required for the process of devising an onsite plan for large crowds. The basic structure is based on an analysis of patients who were injured while attending large scale street-cheering demonstrations in Seoul during the period of the 2002 World Cup. METHOD: The analysis concentrated on the period from May 31, 2002, to June 30, 2002, during the 2002 Korean-Japan World Cup. Seven soccer games involving the Korean team and 8.91 million people from 116 places were considered. The following report was generated from the supporting schedules and the activity reports of emergency rescue crews from fire departments. It is largely based on rescue activity journals and transportation records. RESULT: There were 796 patients among the in 8.91 million people. Male patients were 383 (42.8%) and female 413 (51.2%). Patients in their 20's were 267, and that was the largest age group. In Korean game against Germany, 183 patients were treated, and that was the largest among the seven games involving Korean's team. There was one patient in every 10,000 people on average. Sicknesses were not that serious, and most of them were headaches, stomachaches and exhaustion. CONCLUSION: The frequency and pattern of generation of patients were affected by the scale of the cheering crowd, the sex and age composition of the crowd, and the weather. In planning future medical support for similar events, the structure of the plan should be based on the site and the size of the crowd, after which the plan can be finalized by considering details such as the importance of the game and the weather.
Appointments and Schedules ; Disaster Planning ; Emergencies ; Female ; Fires ; Germany ; Headache ; Humans ; Male ; Seoul* ; Soccer ; Transportation ; Weather