OBJECTIVETo investigate the clinical manifestations, pathological characteristics, and treatments of urothelial-type mucinous adenocarcinoma of the prostate (UMAP).

METHODSWe reported a case of UMAP, reviewed relevant literature, and analyzed the clinicopaothological features, diagnosis, treatment, and prognosis of the disease.

RESULTSThe patient was a 60-year-old male and underwent transurethral resection of the prostate for dysuria. Postoperative pathology indicated mucinous adenocarcinoma and sigmoidoscopy revealed no primary colon cancer. Immunohistochemical staining showed the negative expressions of PSA and P504s and positive expressions of CK7, CK34 β E12, CK20, and CDX2. Thus UMAP was confirmed and treated by intensity-modulated radiotherapy. Then the patient was followed up for 30 months, which showed desirable therapeutic result, with neither local progression nor distant metastasis.

CONCLUSIONUMAP has a bad prognosis and its diagnosis depends on pathological and immunohistocchemical examinations. It responds well to radical prostatectomy but is not sensitive to endocrine therapy. Radiotherapy can be considered for those who are not fit to receive radical prostatectomy.

Adenocarcinoma, Mucinous ; metabolism ; pathology ; therapy ; Humans ; Keratins ; metabolism ; Male ; Middle Aged ; Neoplasm Proteins ; metabolism ; Prognosis ; Prostatectomy ; Prostatic Neoplasms ; metabolism ; pathology ; therapy ; Racemases and Epimerases ; metabolism

OBJECTIVE: Autologous transfusion is frequently used with orthognathic surgery. The necessity of autologous transfusion has begun to question alone in bilateral sagittal split ramus osteotomy. The aim of this study was to evaluate the availability of autologous transfusion. METHODS: The chart reviews of sixty patients who had undergone bilateral sagittal ramus osteotomy were done. The subjects were divided into two groups : In experimental group, 30 patients who autodonated 320ml in the preoperative 3 weeks actually received a transfusion in the postoperative 6 hours were included. In control group, 30 patients who underwent the same operation without preoperative donation and any other transfusion were included. Hemoglobin, hematocrit, and changes of these values in both groups were evaluated. RESULTS: 1. From postoperative 3 hours to postoperative 1 day, the increases of hemoglobin(0.8g/dL in experimental group, 0.2g/dL in control group) and hematocrit(0.3% in experimental group, 0.6% in control group) were not statistically significant between both groups. 2. From postoperative 1 day to postoperative 1 week, the increase of hemoglobin(0.6g/dL in experimental group, 0.3g/dL in control group) was not statistically significant between both groups. But the increase of hematocrit(2.5% in experimental group, 1.0% in control group) was statistically significant between both groups over the same period(hematocrit p=0.043). 3. On postoperative 1 week, the values of hemoglobin(12.3% in both groups) and hematocrit(35.6% in experimental group, 36.8% in control group) were not statistically significant between both groups. CONCLUSION : The autologous transfusion in surgery of just a little blood loss was not effective. The most results show that there is little availability of autologous transfusion according to changes of hemoglobin and hematocrit in bilateral sagittal split ramus osteotomy.
Hematocrit ; Humans ; Orthognathic Surgery ; Osteotomy ; Osteotomy, Sagittal Split Ramus* ; Prognathism*

The purpose of this study is to understand anxiety in patients undergoing third molar extraction and care patients of third molar extraction. The subjects in the study were Sixty-three patients who visited the department of dentistry at Pusan Paik Hospital from May 2006 to September 2006 and who underwent third molar extraction. Patients' anxiety(state anxiety and trait anxiety) to use Spielberger's state-trait anxiety inventory(STAI) were measured. They were asked to fill out STAI question paper immediately before third molar extraction(pre-extraction) and on the day after the extraction(post-extraction). And visual analog scale(VAS) to measure patient's postoperative pain on the day after extraction(postextraction day) was used. Then Differences in anxiety before and after extraction, between men and women, between the first and second extraction, with impacted versus nonimpacted third molar extraction, between extraction time and anxiety, and between postoperative pain and anxiety were evaluated. The anxiety status of patients undergoing third molar extraction could be quantitatively evaluated using the STAI-KYZ. There were significant difference before and after third molar extraction. Especially women and patients of more severe postoperative pain was more anxious. We need to alleviate patient's anxiety(especially women) and to control postoperative pain throughout the tooth removal process.
Anxiety* ; Busan ; Dentistry ; Female ; Humans ; Male ; Molar, Third* ; Pain, Postoperative ; Tooth

OBJECTIVETo investigate the safety and feasibility of intracorporeal Roux-en-Y reconstruction after laparoscopic distal gastrectomy.

METHODSClinical data of 20 patients undergoing laparoscopic distal gastrectomy and intracorporeal Roux-en-Y reconstruction in our hospital from August 2012 to March 2013 were analyzed retrospectively.

RESULTSTotally laparoscopic distal gastrectomy was successfully performed in all the patients. The mean operation time was (190.8±53.6) min, the mean operative blood loss was(122.4±57.7) ml, and mean number of harvested lymph node was 31.2±5.7. Tumor-free proximal margin was confirmed by pathological examination in all the patients. The mean time to first flatus and hospital stay were (2.6±1.6) d and (8.1±2.0) d. One case developed pulmonary infection postoperatively, but no anastomosis related complication was observed.

CONCLUSIONIntracorporeal Roux-en-Y reconstruction after laparoscopic distal gastrectomy is safe and feasible.

Anastomosis, Roux-en-Y ; Gastrectomy ; Humans ; Laparoscopy ; Lymph Nodes ; Operative Time ; Postoperative Complications ; Reconstructive Surgical Procedures ; Retrospective Studies ; Stomach Neoplasms

PURPOSE: Bone marrow biopsy is a standard method for the evaluation of bone marrow infiltration by lymphoma; however, it is an invasive and painful procedure. Fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET-CT) is a noninvasive imaging technique with the potential to detect bone marrow involvement by lymphoma. MATERIALS AND METHODS: We retrospectively reviewed medical records of lymphoma patients. All patients were examined by FDG PET-CT and iliac crest bone marrow biopsy for initial staging work-up. RESULTS: The study population comprised 94 patients (median age, 60 years; 56 males) with Hodgkin's lymphoma (n=8) or non-Hodgkin's lymphoma (n=86). Maximum standardized uptake values on the iliac crest of patients with lymphoma infiltrated bone marrow were significantly higher than those of patients with intact bone marrow (2.2+/-1.2 g/mL vs. 1.3+/-0.4 g/mL; p=0.001). The calculated values for FDG PET-CT during evaluation of bone marrow involvement were as follows: sensitivity 50%, specificity 96%, positive predictive value 80%, negative predictive value 85%, and positive likelihood ratio (LR+) 11.7. The value of LR+ was 16.0 in patients with aggressive subtypes of non-Hodgkin's lymphoma (NHL). CONCLUSION: FDG PET-CT could not replace bone marrow biopsy due to the low sensitivity of FDG PET-CT for detection of bone marrow infiltration in lymphoma patients. Conversely, FDG PET-CT had high specificity and LR+; therefore, it could be a useful tool for image-guided biopsy for lymphoma staging, especially for aggressive subtypes of NHL. In addition, unilateral bone marrow biopsy could be substituted for bilateral bone marrow biopsy in lymphoma patients with increased FDG uptake on any iliac crest.
Biopsy ; Bone Marrow Examination ; Bone Marrow* ; Electrons ; Hodgkin Disease ; Humans ; Image-Guided Biopsy ; Lymphoma* ; Lymphoma, Non-Hodgkin ; Medical Records ; Positron-Emission Tomography ; Retrospective Studies ; Sensitivity and Specificity

Objective:To investigate the clinical features and prognosis of male with anti-melanoma differentiation-associated gene 5 (MDA5) autoantibody.Methods:The clinical data of 246 patients with DM and anti-MDA5 autoantibodies hospitalized by Jiangsu Myositis Cooperation Group from 2017 to 2020 were collected and retrospectively analyzed. Chi-square test was performed to compared between counting data groups; Quantitative data were expressed by M ( Q1, Q3), and rank sum test was used for comparison between groups; Single factor survival analysis was performed by Kaplan-Meier method and Log rank test; Cox regression analysis were used for multivariate survival analysis. Results:①The male group had a higher proportion of rash at the sun exposure area [67.1%(47/70) vs 52.8%(93/176), χ2=4.18, P=0.041] and V-sign [50.0%(35/70) vs 30.7%(54/176), χ2=8.09, P=0.004] than the female group. The male group had higher levels of creatine kinase [112(18, 981)U/L vs 57 (13.6, 1 433)U/L, Z=-3.50, P<0.001] and ferritin [1 500 (166, 32 716)ng/ml vs 569 (18, 14 839)ng/ml, Z=-5.85, P<0.001] than the female group. The proportion of ILD [40.0%(28/70) vs 59.7%(105/176), χ2=7.82, P=0.020] patients and the red blood cell sedimentation rate[31.0(4.0, 101.5)mm/1 h vs 43.4(5.0, 126.5)mm/1 h, Z=-2.22, P=0.026] in the male group was lower than that of the female group, but the proportion of rapidly progressive interstitial lung disease (PR-ILD) [47.1%(33/70) vs 31.3%(55/176), χ2=5.51, P=0.019] was higher than that of the female group. ②In male patients with positive anti-MDA5 antibodies,the death group had a shorter course of disease[1.0(1.0, 3.0) month vs 2.5(0.5,84) month, Z=-3.07, P=0.002], the incidence of arthritis [16.7%(4/24) vs 42.2%(19/45), χ2=4.60, P=0.032] were low than those in survival group,while aspartate aminotransferase (AST)[64(22.1, 565)U/L vs 51(14,601)U/L, Z=-2.42, P=0.016], lactate dehydrogenase (LDH) [485(24,1 464)U/L vs 352(170, 1 213)U/L, Z=-3.38, P=0.001], C-reactive protein (CRP) [11.6(2.9, 61.7) mg/L vs 4.95(0.6, 86.4) mg/L, Z=-1.96, P=0.050], and ferritin levels [2 000(681, 7 676) vs 1 125 (166, 32 716)ng/ml, Z=-3.18, P=0.001] were higher than those in the survival group, and RP-ILD [95.8%(23/24) vs 22.2%(10/45), χ2=33.99, P<0.001] occurred at a significantly higher rate. ③Cox regression analysis indicated that the course of disease LDH level, and RP-ILD were related factors for the prognosis of male anti-MDA5 antibodies [ HR (95% CI)=0.203(0.077, 0.534), P=0.001; HR (95% CI)=1.002(1.001, 1.004), P=0.003; HR (95% CI)=95.674 (10.872, 841.904), P<0.001]. Conclusion:The clinical manifestations of male anti-MDA5 antibody-positive patients are different from those of female. The incidence of ILD is low, but the proportion of PR-ILD is high. The course of disease, serum LDH level, and RP-ILD are prognostic factors of male anti-MDA5 antibody-positive patients.

Background/Aims: We evaluated the feasibility and long-term efficacy of the combination of cytarabine, idarubicin, and all-trans retinoic acid (ATRA) for treating patients with newly diagnosed acute promyelocytic leukemia (APL). Methods: We included 87 patients with newly diagnosed acute myeloid leukemia and a t(15;17) or promyelocytic leukemia/retinoic acid receptor alpha (PML-RARα) mutation. Patients received 12 mg/m2/day idarubicin intravenously for 3 days and 100 mg/m2/day cytarabine for 7 days, plus 45 mg/m2/day ATRA. Clinical outcomes included complete remission (CR), relapse-free survival (RFS), overall survival (OS), and the secondary malignancy incidence during a 20-year follow-up. Results: The CR, 10-year RFS, and 10-year OS rates were 89.7%, 94.1%, and 73.8%, respectively, for all patients. The 10-year OS rate was 100% for patients that achieved CR. Subjects were classified according to the white blood cell (WBC) count in peripheral blood at diagnosis (low-risk, WBC < 10,000/mm3; high-risk, WBC ≥ 10,000/mm3). The low-risk group had significantly higher RFS and OS rates than the high-risk group, but the outcomes were not superior to the current standard treatment (arsenic trioxide plus ATRA). Toxicities were similar to those observed with anthracycline plus ATRA, and higher than those observed with arsenic trioxide plus ATRA. The secondary malignancy incidence after APL treatment was 2.7%, among the 75 patients that achieved CR, and 5.0% among the 40 patients that survived more than 5 years after the APL diagnosis. Conclusions Adding cytarabine to anthracycline plus ATRA was not inferior to anthracycline plus ATRA alone, but it was not comparable to arsenic trioxide plus ATRA. The probability of secondary malignancy was low.