A clinicopathological study was made on 17 case with leukemia cutis diagnosed in a period of 10 years frorn 1980 to 1989 in Seoul Xational University I-lospital. The results were summarized as follows : 1. There were 4 cases with acute lyrnphocytic leukernia, 7 with acute myelocytir. leukemia (AML), 5 with chronic myelocytic leukemia (CML), 1 with eosinophilic leukemia. 2. The clinical appearance of leukemia cutis included nodules (88.2%), papules, macules, plaques and ulcerative lesions. Leukemia cutis dis not show any discernible clinical qppearance with each different type of leukemia. 3. Leukemia cutis showed a wide spectrum of histopathologic features, diffuse infiltration, patchy infiltration with linear infiltration between collagen bundles, perivascular and peridnexal involvement, perivascular involvement, and mainly subcutaneous tissue involvement. There was no distinctive histopathologic pattern with each different type of leukemia. 4. The demonstration of intracytoplasmic chloroacetate esterase and lysozyme was helpful to refine the diagnosis of leukemia cutis.
Collagen ; Diagnosis ; Hypereosinophilic Syndrome ; Leukemia* ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Muramidase ; Seoul ; Subcutaneous Tissue ; Ulcer

Osteomyelitis of the patella is a very uncommon condition that occurs mostly in the pediatric population. In addition to its rarity, nonspecific and variable clinical presentations usually lead to postponement in making the correct diagnosis. Moreover, it is often missed as prepatellar bursitis or septic arthritis of the knee. Nonetheless making early diagnosis and initiating prompt treatment is most important to preventing this condition from becoming chronic. In this case report, the authors encountered this rare condition of the patella in a child that was first misdiagnosed with pyogenic arthritis or prepatellar bursitis of the knee. The delay in making the diagnosis led to intractable progression of the disease, and sequestrectomy was required to stabilize the condition.
Arthritis ; Arthritis, Infectious ; Bursitis ; Child* ; Diagnosis ; Early Diagnosis ; Humans ; Knee ; Osteomyelitis* ; Patella

PURPOSE: Acute dysbarism is a potentially lethal injury associated with environmental medicine. Therefore, prompt treatment, including transportation of victims, is important for the best prognosis. The aim of this study was to examine transportation routes of patients with acute dysbarism for the best prognosis in Korea. METHODS: Geography of South Korea was analyzed using the geographic information system (GIS). The study examined two scenarios using transportation analysis, which relies on a GIS base and pressure variation during air and ground transportation. Given the practical assumptions, we propose some heuristic transportation routes based on the simulation of altitude, transportation time, and availability of related factors. RESULTS: Currently, transportation by ground to the treatment facilities always passes high altitude areas above 152 feet. Also, available helicopters for air transportation could not approach the treatment facilities due to the limitation of flying distance and insufficiency of medical staff and treatment equipment. Altitude variation and delayed time were identified during the period of transportation by ground from Ganneung or Incheon to Tongyoung. Heuristic algorism through the above facts recommends air transport along coasts as the best method for transportation from Ganneung or Incheon to Tongyoung. CONCLUSION: In Korea, transportation by ground was not expected to result in the best prognosis for patients with acute dysbarism. Transportation by air should be considered first as the method of transportation. Also, for the best treatment of patients with acute dysbarism, additional treatment facilities need to be established in the west coast region.
Aircraft ; Altitude ; Decompression Sickness ; Diptera ; Environmental Medicine ; Foot ; Geographic Information Systems ; Geography ; Geography, Medical ; Humans ; Incheon ; Korea ; Medical Staff ; Prognosis* ; Transportation of Patients ; Transportation*

Purpose: To investigate the correlation between preoperative De Ritis ratio (aspartate transaminase [AST]/alanine transaminase [ALT]) and postoperative clinical outcome in patients with upper urinary tract carcinoma (UTUC) who underwent radical nephroureterectomy (RNU) and adjuvant chemotherapy (ACH). Materials and Methods: We respectively analyzed the clinical and pathological data of 102 patients who underwent RNU and ACH for UTUC. Patients were divided into 2 groups, according to the optimal value of AST/ALT ratio. The effect of the AST/ALT ratio was analyzed by the Kaplan-Meier method and Cox regression hazard models for patients’ cancer-specific survival (CSS) and overall survival (OS). Results: Mean survival time was 50.5±41.2 months. Mean age was 61.4±9.7years. Forty-one of the patients (46.5%) were in the high AST/ALT group. According to receiver operating characteristic analysis, the optimal AST/ALT ratio was 1.2. In Kaplan-Meier analyses, the high AST/ALT group showed worse outcomes in OS (p=0.007) and CSS (p=0.011). Using Cox regression models of clinical and pathological parameters to predict OS, high AST/ALT ratio (hazard ratio [HR], 5.428; 95% confidence interval [CI]; 1.803–16.334; p=0.002), pathological T3 (pT3) or higher (HR, 1.464; 95% CI; 1.156-1.857; p=0.002), and to predict CSS, high AST/ALT ratio (HR, 4.417; 95% CI; 1.545–12.632; p=0.005), and pT3 or higher (HR, 1.475; 95% CI; 1.172–1.904; p=0.002) were determined as independent prognostic factors. Conclusions Pretreatment AST/ALT ratio is a significant independent predictor of CSS and OS in advanced UTUC patients receiving systemic ACH after RNU.

Purpose: The use of gallium-68 prostate-specific membrane antigen-11 positron emission tomography/computed tomography (Ga-68 PSMA-11 PET/CT) is becoming increasingly common among men with prostate cancer (PCa). However, it remains uncertain which patients will derive the most benefit, and there is a scarcity of real-world data regarding its impact on altering treatment plans. This study investigated which patients would most benefit from Ga-68 PSMA-11 PET/CT, focusing on detection rates and changes in treatment strategies, drawing from a single-center experience. Materials and Methods: In total, 230 men with PCa who underwent Ga-68 PSMA-11 PET/CT between November 2021 and August 2022 were included in this retrospective study. The patients were classified into 5 groups based on their disease status: group 1, further work-up for high-risk localized PCa; group 2, de novo metastatic PCa; group 3, biochemical recurrence after definitive treatment; group 4, castration-resistant PCa; group 5, others. The positivity rate, positive lesions, predictive value of lymph node metastases, comparison with conventional images, and treatment changes after Ga-68 PSMA-11 PET/CT were analyzed in each group. Results: Of the 230 patients, 40 (17.4%), 20 (8.7%), 77 (33.5%), 76 (33.0%), and 17 (7.4%) were classified into groups 1–5, respectively. Ga-68 PSMA-11 PET/CT showed lesions in 74.8% of patients, and the optimal cutoff value for PSA was 1.99 ng/mL. Lesions not observed on conventional imaging were found in 62 patients (33.2%). In 38 patients (13.5%), treatment was changed due to Ga-68 PSMA-11 PET/CT. Conclusions These real-world data suggest that Ga-68 PSMA-11 PET/CT may be clinically useful for various disease conditions, as substantial stage migration and subsequent treatment changes occur in men with PCa. However, the prognostic impact of this modality remains unclear; thus, a well-designed prospective study is needed to address this issue.

Purpose: The use of gallium-68 prostate-specific membrane antigen-11 positron emission tomography/computed tomography (Ga-68 PSMA-11 PET/CT) is becoming increasingly common among men with prostate cancer (PCa). However, it remains uncertain which patients will derive the most benefit, and there is a scarcity of real-world data regarding its impact on altering treatment plans. This study investigated which patients would most benefit from Ga-68 PSMA-11 PET/CT, focusing on detection rates and changes in treatment strategies, drawing from a single-center experience. Materials and Methods: In total, 230 men with PCa who underwent Ga-68 PSMA-11 PET/CT between November 2021 and August 2022 were included in this retrospective study. The patients were classified into 5 groups based on their disease status: group 1, further work-up for high-risk localized PCa; group 2, de novo metastatic PCa; group 3, biochemical recurrence after definitive treatment; group 4, castration-resistant PCa; group 5, others. The positivity rate, positive lesions, predictive value of lymph node metastases, comparison with conventional images, and treatment changes after Ga-68 PSMA-11 PET/CT were analyzed in each group. Results: Of the 230 patients, 40 (17.4%), 20 (8.7%), 77 (33.5%), 76 (33.0%), and 17 (7.4%) were classified into groups 1–5, respectively. Ga-68 PSMA-11 PET/CT showed lesions in 74.8% of patients, and the optimal cutoff value for PSA was 1.99 ng/mL. Lesions not observed on conventional imaging were found in 62 patients (33.2%). In 38 patients (13.5%), treatment was changed due to Ga-68 PSMA-11 PET/CT. Conclusions These real-world data suggest that Ga-68 PSMA-11 PET/CT may be clinically useful for various disease conditions, as substantial stage migration and subsequent treatment changes occur in men with PCa. However, the prognostic impact of this modality remains unclear; thus, a well-designed prospective study is needed to address this issue.

Purpose: The use of gallium-68 prostate-specific membrane antigen-11 positron emission tomography/computed tomography (Ga-68 PSMA-11 PET/CT) is becoming increasingly common among men with prostate cancer (PCa). However, it remains uncertain which patients will derive the most benefit, and there is a scarcity of real-world data regarding its impact on altering treatment plans. This study investigated which patients would most benefit from Ga-68 PSMA-11 PET/CT, focusing on detection rates and changes in treatment strategies, drawing from a single-center experience. Materials and Methods: In total, 230 men with PCa who underwent Ga-68 PSMA-11 PET/CT between November 2021 and August 2022 were included in this retrospective study. The patients were classified into 5 groups based on their disease status: group 1, further work-up for high-risk localized PCa; group 2, de novo metastatic PCa; group 3, biochemical recurrence after definitive treatment; group 4, castration-resistant PCa; group 5, others. The positivity rate, positive lesions, predictive value of lymph node metastases, comparison with conventional images, and treatment changes after Ga-68 PSMA-11 PET/CT were analyzed in each group. Results: Of the 230 patients, 40 (17.4%), 20 (8.7%), 77 (33.5%), 76 (33.0%), and 17 (7.4%) were classified into groups 1–5, respectively. Ga-68 PSMA-11 PET/CT showed lesions in 74.8% of patients, and the optimal cutoff value for PSA was 1.99 ng/mL. Lesions not observed on conventional imaging were found in 62 patients (33.2%). In 38 patients (13.5%), treatment was changed due to Ga-68 PSMA-11 PET/CT. Conclusions These real-world data suggest that Ga-68 PSMA-11 PET/CT may be clinically useful for various disease conditions, as substantial stage migration and subsequent treatment changes occur in men with PCa. However, the prognostic impact of this modality remains unclear; thus, a well-designed prospective study is needed to address this issue.

Purpose: The use of gallium-68 prostate-specific membrane antigen-11 positron emission tomography/computed tomography (Ga-68 PSMA-11 PET/CT) is becoming increasingly common among men with prostate cancer (PCa). However, it remains uncertain which patients will derive the most benefit, and there is a scarcity of real-world data regarding its impact on altering treatment plans. This study investigated which patients would most benefit from Ga-68 PSMA-11 PET/CT, focusing on detection rates and changes in treatment strategies, drawing from a single-center experience. Materials and Methods: In total, 230 men with PCa who underwent Ga-68 PSMA-11 PET/CT between November 2021 and August 2022 were included in this retrospective study. The patients were classified into 5 groups based on their disease status: group 1, further work-up for high-risk localized PCa; group 2, de novo metastatic PCa; group 3, biochemical recurrence after definitive treatment; group 4, castration-resistant PCa; group 5, others. The positivity rate, positive lesions, predictive value of lymph node metastases, comparison with conventional images, and treatment changes after Ga-68 PSMA-11 PET/CT were analyzed in each group. Results: Of the 230 patients, 40 (17.4%), 20 (8.7%), 77 (33.5%), 76 (33.0%), and 17 (7.4%) were classified into groups 1–5, respectively. Ga-68 PSMA-11 PET/CT showed lesions in 74.8% of patients, and the optimal cutoff value for PSA was 1.99 ng/mL. Lesions not observed on conventional imaging were found in 62 patients (33.2%). In 38 patients (13.5%), treatment was changed due to Ga-68 PSMA-11 PET/CT. Conclusions These real-world data suggest that Ga-68 PSMA-11 PET/CT may be clinically useful for various disease conditions, as substantial stage migration and subsequent treatment changes occur in men with PCa. However, the prognostic impact of this modality remains unclear; thus, a well-designed prospective study is needed to address this issue.

OBJECTIVE: The purpose of this study is to determine the effects of the methods of anesthesia on fetal acidemia following elective cesarean delivery among uncomplicated healthy parturients at term, with a single fetus and is to see the correlation of that results with maternal age, Apgar score. MATERIALS AND METHODS: The gestational age more than 37 weeks, singleton, estimated birth weight more than 2.5 kg with ultrasonographic profiles, 98 cases of uncomplicated parturients were included. Three methods of anesthesia - general, epidural, spinal - were chosen randomly. Umbilical artery blood samples just after delivery were obtained from a double clamped segment of cord using a 3 ml syringe that had been flushed with heparin, then transported in ice to the laboratory. RESULTS: There was no statistically significant difference between the three anesthesia groups in regarding to maternal age, birth weight, and Apgar score. The incidence of fetal acidemia was more prevalent in the epidural anesthesia group than the others, and less in the general anesthesia group. No clinically pathologic neonatal outcome was happened even one case of pathologic fetal acidemia among the spinal anesthesia group. The average PO2 of umbilical artery was 19.7 mmHg, and there was no statistically significant difference between the three anesthesia groups. The average PCO2 of umbilical artery was statistically high in the epidural anesthesia group. CONCLUSION: This study shows that the fetal acidemia can occur in three methods of anesthesia. Because there is no difference between the three methods of anesthesia with regarding to 1-minute, 5-minute Apgar scores and there is no specific finding for postpartum follow up of 1month. In conclusion, any method of anesthesia can be used safely in the view of neonatal outcome for elective cesarean delivery.
Anesthesia* ; Anesthesia, Epidural ; Anesthesia, General ; Anesthesia, Spinal ; Apgar Score ; Birth Weight ; Fetus ; Follow-Up Studies ; Gestational Age ; Heparin ; Ice ; Incidence ; Maternal Age ; Postpartum Period ; Syringes ; Umbilical Arteries

OBJECTIVE: The purpose of this study is to determine the effects of the methods of anesthesia on fetal acidemia following elective cesarean delivery among uncomplicated healthy parturients at term, with a single fetus and is to see the correlation of that results with maternal age, Apgar score. MATERIALS AND METHODS: The gestational age more than 37 weeks, singleton, estimated birth weight more than 2.5 kg with ultrasonographic profiles, 98 cases of uncomplicated parturients were included. Three methods of anesthesia - general, epidural, spinal - were chosen randomly. Umbilical artery blood samples just after delivery were obtained from a double clamped segment of cord using a 3 ml syringe that had been flushed with heparin, then transported in ice to the laboratory. RESULTS: There was no statistically significant difference between the three anesthesia groups in regarding to maternal age, birth weight, and Apgar score. The incidence of fetal acidemia was more prevalent in the epidural anesthesia group than the others, and less in the general anesthesia group. No clinically pathologic neonatal outcome was happened even one case of pathologic fetal acidemia among the spinal anesthesia group. The average PO2 of umbilical artery was 19.7 mmHg, and there was no statistically significant difference between the three anesthesia groups. The average PCO2 of umbilical artery was statistically high in the epidural anesthesia group. CONCLUSION: This study shows that the fetal acidemia can occur in three methods of anesthesia. Because there is no difference between the three methods of anesthesia with regarding to 1-minute, 5-minute Apgar scores and there is no specific finding for postpartum follow up of 1month. In conclusion, any method of anesthesia can be used safely in the view of neonatal outcome for elective cesarean delivery.
Anesthesia* ; Anesthesia, Epidural ; Anesthesia, General ; Anesthesia, Spinal ; Apgar Score ; Birth Weight ; Fetus ; Follow-Up Studies ; Gestational Age ; Heparin ; Ice ; Incidence ; Maternal Age ; Postpartum Period ; Syringes ; Umbilical Arteries