For identification of the risk factors for lower urinary tract injuries in patients with pelvic fractures, we reviewed the records of 332 patients with pelvic fractures and 60 patients with urethral or bladder ruptures not associated with pelvic fractures seen at our hospital during recent 5 years. The incidence of lower urinary tract injuries in patients with pelvic fractures was 9.9 per cent (urethra 57.6 per cent, bladder 36.4 per cent. and both 6.0 per cent).Of the 181 simple rami fractures 21 (11.6 percent) had lower urinary tract injuries. Of the 90 rami fractures combining other fractures 11 (12.2 per cent} had lower urinary tract injuries, especially 5 (50.0 per cent) of the 10 combining symphysis pubis diastasis. Of the 14 bladder ruptures 13 had gross hematuria, and of the 21 urethral ruptures all had blood at urethral meatus. For evaluation of significance of hematuria as a indicator for bladder ruptures, we reviewed 257 pelvic fractures without urethral ruptures and upper tract injuries. While of the 25 cases with gross hematuria 13 (52.0 percent) had bladder ruptures, of the 76 cases with only microscopic hematuria 1 case had bladder rupture. We conclude that the high risk factors for lower urinary tract injuries in patients with pelvic fractures are both rami fracture, dispacement of hemipelvis, and symphysis pubis diastasis. Therefore prompt diagnostic procedures for urethral and bladder ruptures must be performed in those cases, especially when combined with gross hematuria or blood at urethral meatus.
Hematuria ; Humans ; Incidence ; Pubic Symphysis Diastasis ; Risk Factors* ; Rupture ; Urinary Bladder ; Urinary Tract*

A total or 44 patients with superficial bladder cancer underwent flow cytometric analysis of nuclei obtained from paraffin embedded specimens(44 first and 8 recurrent). Tumors could be classified according to their DNA content as diploid or aneuploid and to the proportion of proliferating cells (S-phase fraction). The degrees of cellular differentiation were related to the DNA patterns and to S-phase fractions. And reccurence-free rates were compared according to the DNA patterns. Of the total 52 specimens, 22 (42% ) showed aneuploid DNA patterns. The majority (83.9%) of low grade tumors had diploid pattern and the majority (81%) of high grade tumors had aneuploid pattern (p<0.005). Mean S-phase fraction of tota1 52 paraffin blocks was estimated as 11.17% (S.D.: 5.75). Mean S-phase fraction by grade was estimated as 9.95% (S.D. : 5.l4) in low grade tumors and 13.89%(S.D. : 6.10) in high grade tumors (p<0.05). Five-year recurrence-free rate was 77.8% in diploid group and 29.4% in aneuploid group (p<0.005). Mean S-phase fraction of the non-recurrent tumors was 8.91% (S.D. : 3.49). and that of the recurrent tumors 14.32% (S.D. : 7.76). The above results suggest that DNA ploidy and S-phase fraction as measured flow cytometry appear to be an important prognostic factors for superficial bladder cancer. And this information may be used to plan patient treatment according to the predicted risks.
Aneuploidy ; Diploidy ; DNA* ; Flow Cytometry* ; Humans ; Paraffin ; Ploidies ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Hemangioma of the testis is an extremely rare lesion, more or less than 10 cases having been reported in infancy or early childhood in the world. We have experienced one case of capillary hemangioma of the left testis in 6 year old Korean male, which was suspicious to be a malignant tumor.
Capillaries* ; Child ; Hemangioma ; Hemangioma, Capillary* ; Humans ; Male ; Testis*

To evaluate the prevalence and the role of mutation of p53 gene in the transitional ceI1 carcinoma of the urinary bladder with special attention to the clinicopathologic features, we examined p53 expression in paraffin-embedded tissues from 95 transitional cell carcinomas with various stages and grades and 5 specimens of morphologically normal bladder. Nuclear expression of p53 protein was detected by immunohistochemical analysis with avidin -alkaline phosphatase method, using the monoclonal antibody DO-7. And to evaluate the correlation of p53 expression with cell proliferation, expression of proliferating cell nuclear antigen(PCNA) was also assessed immunohistochemically in 43 specimens, using the monoclonal antibody PC1O. Median follow-up duration was 36 months(12-117 months). Immunohistochemical staining with p53 in 5 normal bladder specimens showed that 4 specimens exhibited absence of nuclear staining in urothelial and stromal cells and 1 specimen exhibited nuclear staining less than 5% of urothelial cells in the basal layer. Forty six(48%) of 95 specimens with transitional cell carcinoma of the bladder showed positive nuclear staining. Nuclear expression of p53 was observed with significantly higher frequency and stronger intensity(p<0.01 and p<0.005, respectively) in cases with invasive tumors(17,27, 70%) than superficial tumors(27/68, 40%). Nuclear expression of p53 was observed with signi6cantly higher frequency and stronger intensity(p<0.005 and p<0.005, respectively) in. cases with high grade tumors(32,43, 74%) than in cases with low grade tumors(14/52, 27%). Patients with bladder tumors were stratified into two groups with different patterns of staining for p53 protein (group A: <20%, group B: >20%). Recurrence rates of patients with superficial tumors were 2.2% per month for group A and 4.2% for group B, and patients in group B had a significantly 1ower disease-free interval(P<0.005). Disease progression rates of patients with T1 tumors were 4% per year and 21.2% for group B, and patients in group B had a significantly lower progression- free interval(P<0.025). Difference of survivorship of patients with invasive tumors between group A and B was not statistically significant(p>O.1). Mean value of PCNA expression rates of 43 transitional cell carcinomas of the bladder was 12.1+8.34%(mean + SD). Mean value of PCNA expression rates was slightly higher in p53 positive-stained group(13.2+/-7.81%) than negative stained group(10.8+/-8.89%), but difference was not statistically significant(p>0.1). These results suggest that p53 mutations play an important role in the acquisition of aggressive biological natures in invasive bladder transitional cell carcinomas rather than in the genesis of tumors of low malignant potentials. This study also suggests that immunohistochemical examination of p53 in superficial bladder transitional cell carcinomas (especially, T1 tumors) offers significant information, and the degree of p53 expression might be a useful prognostic indicator which can be considered in treatment planning.
Avidin ; Carcinoma, Transitional Cell* ; Cell Proliferation ; Disease Progression ; Follow-Up Studies ; Genes, p53 ; Humans ; Immunohistochemistry ; Prevalence ; Proliferating Cell Nuclear Antigen ; Recurrence ; Stromal Cells ; Survival Rate ; Urinary Bladder Neoplasms ; Urinary Bladder*

Nonfunctioning carcinoma of the adrenal cortex is an extremely rare disease. We have presented a case of nonfunctioning adrenocortical carcinoma. The patient was a 35 year-old female who had complained of discomfort and gradually growing mass in the left upper quadran1. No significant laboratory findings or evidence of hormonal disturbance wee clinically noted. Ultrasonography and abdominal CT revealed about 15 x 13cm sized mass in the left suprarenal area. Left adrenal gland. kidney and spleen were removed. The tumor was multilobulated but well encapsulated. measuring 16 x 15 x 13cm in size and weighing 420 grams. Cut surface of the tumor showed massive hemorrhage and necrosis, Microscopically, the tumor showed marked cellular pleomorphism, nuclear hyperchromatism and increased mitoses with some atypical mitoses. Capsular and vascular invasion of tumor cells was observed.
Adrenal Cortex ; Adrenal Glands ; Adrenocortical Carcinoma* ; Adult ; Female ; Hemorrhage ; Humans ; Kidney ; Mitosis ; Necrosis ; Rare Diseases ; Spleen ; Tomography, X-Ray Computed ; Ultrasonography

In an effort to reduce the false-negative rate of PAP smear, several new technologic screening methods have recently evolved. Cervicography is one of these methods. The purpose of this study was to evaluate the screening use of cervicography as an adjunctive method and the clinical effectiveness of cervicography in korean reports, compared with other countries. And we estimated the specificity and sensitivity of cervicography in cervical cancer screening in several korean reports. The results were : 1. The sensitivity of cervicography and pap smear was 89.2% and 85.7%. 2. The false negative rate of cervicography and pap smear was 3.8% and 22.4%. 3. When cervicography and Pap smear were used conjointly, the sensitivity was higher than for cervicography or pap smear used alone(95.7% vs 89.2%, 95.7% vs 85.7%) Cervicography is one of the useful screening method for detect cervical cancer, However when cervicography are used in conjunction with Pap smear, the detection rate of cervical cancer will be increased.
Mass Screening* ; Sensitivity and Specificity ; Uterine Cervical Neoplasms*

BACKGROUNDS/AIMS: Hepatitis B virus (HBV) infection and chronic alcoholism are major risk factors for chronic liver disease in Korea. METHODS: We investigated the prevalence of occult HBV infection in 198 non-alcoholic (group I) and 85 chronic alcoholic subjects (group II), none of whom showed the hepatitis B surface antigen (HBsAg). Among chronic alcoholics, 25 patients showed cirrhosis. Using serum samples stored at -70 degrees C, liver enzymes, anti-Hbs, and IgG anti-HBc were measured via EIA and serum HBV DNA was quantified via real time PCR. RESULTS: IgG anti-HBc seropositivity, an indicator of past infection, was higher in group II (64.7%) than in group I (43.4%; p<0.01). Eleven of 283 patients (3.2%) were seropositive for HBV DNA, indicating occult infection, but this value did not differ between groups (group I: 3.5%, 7/198; group II: 4.7%, 4/85; p=0.64). In group II, HBV DNA seropositivity was higher in cirrhotic patients (12%, 3/25) than in non-cirrhotic alcoholic liver disease (1.7%, 1/60; p=0.074). CONCLUSIONS: Past HBV infection was more prevalent in alcoholics than non-alcoholics, but the prevalence of occult HBV infection did not differ between groups. However, alcoholics with cirrhosis tended to show a higher prevalence of occult HBV infection.
Alcoholics ; Alcoholism ; DNA ; Fibrosis ; Hepatitis ; Hepatitis B ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Humans ; Immunoglobulin G ; Korea ; Liver ; Liver Diseases ; Liver Diseases, Alcoholic ; Prevalence ; Real-Time Polymerase Chain Reaction ; Risk Factors

Purpose: To evaluate the reliability and validity of the Cataract-related Visual Function Questionnaire (CVFQ). Methods: A prospective cross-sectional study of 141 cataract patients was conducted from March 2022 to June 2022. The questionnaire was created based on a literature review and advice from an expert panel. This study determined its construct validity, criterion validity, internal consistency, and test-retest reliability. Results: The CVFQ consists of 15 items distributed among five categories: overall visual quality, overall visual function, distance vision, near vision, and glare. In the exploratory factor analysis of validity, the first three principal components explained 77.8% of the variance. The p-values in the Spearman correlation test comparing the pre- and postoperative total CVFQ score and best-corrected visual acuity (BCVA) were 0.006 and 0.004, respectively. In the reliability analysis, Cronbach’s alpha was > 0.9 for internal consistency and the p-values of each subcategory were all significant in the analysis of test-retest reliability. Conclusions Our results indicate that the CVFQ is useful for measuring the visual quality and visual function of cataract patients in Korea.