Nuclear DNA content of 32 cases of prostate adenocarcinoma diagnosed 1986-1991 was determined by flow cytometry, with the use of paraffin-embedded archival tissue. The present study was done to define the relationship between clinical stage, histopathological grade, and DNA ploidy. Aneuploidy was found in 10(31.3%) cases including 7 cases of near-tetraploidy. Among diploid tumors, 36.4% were localized disease(stage A and B), 13.6% were characterized by invasion outside the prostate(stage C), and 50.0% showed distant metastasis(stage D). Among aneuploid tumors, 10.0% were stage B, 50.0% stage C, and 40.0% stage D. The degree of glandular differentiation was characterized by the Gleason score and the percentage of sampled tissue involved by carcinoma was graded by Dhom's method. Apparent correlation was found between Gleason grade and Dhom grade(P<0.05). All 13 tumors with a Gleason grade I(score of 2 to 5) were diploid. Four of 9 tumors with a Gleason grade II(score of 6 to 7) were aneuploid(near-tetraploidy 33.3%, aneuploidy 11.1%) and 60.0%, of tumors with a Gleason grade III(score of 8 to 10) were aneuploid(near-tetraploidy 40.0%, aneuploidy 20%). The percentage of aneuploid cases increased with advanced clinical stage, but the relationship between aneuploidy versus clinical stage was not significant. However, it can be concluded that DNA ploidy correlates well with Gleason grade(p<0.05), which may have predictive prognostic value for prostate adeno-carcinomas.
Adenocarcinoma

The treatment modalities of bilateral renal cell carcinoma are variable, but many urologists have had serious difficulties in choosing the best one. We experienced a very rare case of bilateral synchronous multifocal renal cell carcinoma in a 38-year-old female. First, We have planned for partial nephrectomy of the right kidney and radical nephrectomy of the left kidney. However, tumor extended into parenchyme of the low 1/3 portion of the right kidney on the frozen section. Therefore, we performed selective ligation of the anterior branch of the right renal artery, which was mainly supplied the tumor mass and left radical nephrectomy was also performed. During one year after operation, renal function was well maintained.
Adult ; Carcinoma, Renal Cell* ; Female ; Frozen Sections ; Humans ; Kidney ; Ligation ; Nephrectomy ; Renal Artery

No abstract available.
Emergencies* ; Emergency Medicine* ; Humans

PURPOSE: Autogenous vein graft as an alternative to autogenous nerve graft for bridging the gap of the peripheral nerve has been widely accepted. The purpose of this study was to find the comparative superiority between the two grafting techniques of inside-in and inside-out vein graft in rat model. MATERIALS AND METHODS: Thirty-three Sprague-Dawley rats were divided into three experimental groups: inside-in vein graft (group A), inside-out vein graft (group B) and control group. In group A, 15 mm jugular vein was grafted to a 10 mm gap created in the sciatic nerve. In group B, the same procedure was performed with group A, however, the vein was pulled through itself and its normal orientation was inverted before grafting. To compare the results of the two groups, electromyography and histologic studies were performed at 4, 8 and 12 weeks postoperative. RESULTS: In the electromyographic study, the mean of peak amplitude of compound motor action potential in group B was significantly higher than in group A at each experimental week. In the light and electron microscopic study, group B had more abundant regenerated axons and myelinized axonal fibers than group A at 4 weeks. At 8 and 12 weeks, there were no significant differences in the numbers and extents of myelinization of regenerated axons in both groups. CONCLUSION: This study demonstrates that inside-out vein grafting technique induces more faster axonal regeneration and earlier reinnervation to the denervated distal muscles in rat model.
Action Potentials ; Animals ; Axons ; Electromyography ; Jugular Veins ; Models, Animal ; Muscles ; Myelin Sheath ; Nerve Regeneration* ; Peripheral Nerves ; Rats* ; Rats, Sprague-Dawley ; Regeneration ; Sciatic Nerve ; Transplants* ; Veins*

Hematuria has been the most reliable sign of injury to the urinary system. Thus. the rapid and accurate detection of hematuria in the emergency room is essential. In 149 patients with renal trauma in whom radiographic studies defined the severity of injury, we compared the degree of microscopic hematuria determined by dipstick and microscopic urinalysis. Falge positive dipstick occurred in 5(3.6%) patients and false negative dipstick in 4(3.3% ) patients. The dipstick method had greater than 96.4 percent sensitivity and specificity for detection of microscopic hematuria. The correlation between the 2 methods was low (Person`s coefficient 0.4114). However. 85.5 percent or the urine sample with more than 20 red blood cells per high power field corresponded to a dipstick results of 3+ (Regression Y = 0.0129x + 2.93, F = 28.12. p < 0.005). Although microscopic hematuria may be quantified more accurately by microscopic analysis, the urine dipstick is a rapid and reliable screening test with high degree of sensitivity and specificity for the microscopic hematuria in patients with renal trauma.
Emergency Service, Hospital ; Erythrocytes ; Hematuria* ; Humans ; Mass Screening ; Sensitivity and Specificity ; Urinalysis

This report details a case of 8-year-old girl showing failure of odontogenesis after chemo-radiation therapy for rhabdomysarcoma at the age of 4. The observed results were as follows ; 1. Past history revealed that she had received for a total radiation dose od 4430cGy, 29 fractions in 6 weeks and chemotherapy with vincristine, actinomycin D and cytoxan, followed as maintenance phase for 2 years. 2. The patient was symptom-free and appointed for the treatment of multiple dental caries. 3. Oral examination showed hypoplastic enamel on whole erupted permanent teeth and showed retarded eruption. 4. Conventional radiograms showed failure of root development including abrupt cessation of root formation and root agenesis, and microdobtia, missing teeth, irregular enamel, dislocation of the impacted teeth. Additional finding showed good healing bone pattern on the left mandibular ramus and angle area. 5. Cehalometric analysis revealed failure of bite raising due to incomplete eruption of all the first molars and made it possible to suspect entrapped mandibular growth and then Class II tendency growth. 6. There was correlation between the time of chemo-radiation therapy and the damage of the teeth.
Child ; Cyclophosphamide ; Dactinomycin ; Dental Caries ; Dental Enamel ; Dental Enamel Hypoplasia ; Diagnosis, Oral ; Dislocations ; Drug Therapy ; Female ; Humans ; Molar ; Odontogenesis* ; Rhabdomyosarcoma* ; Tooth ; Tooth, Impacted ; Vincristine

Coronary artery fistula is an unusual anomaly in elderly patients that consists of a communication bet- ween one of the coronary arteries and other cardiac chambers or veins. It causes many cardiac compli- cations due to hemodynamic changes, and thus has recognized its clinical significance. It occurs usually in congenital origin, but also occurs secondarily in traumatic or neoplastic or artherosclerotic coronary diseases. Congenital coronary artery fistula is a very rare congenital anomaly that results in multiple hemodynamic complications. It has reported rarely in elderly patients, that induces myocardial ischemia due to coronary steal syndrome and heart failure that caused by diastolic volume overload via a left to left shunt. We observed a 68-year-old male patient with exertional chest pain and dyspnea, in whom selective coronary angiography revealed abnormal reticular communication between left anterior descending artery and left circumflex artery and drained to left ventricle through multiple microfistulous channels. We report this patient case who complicated by myocardial ischemia and left ventricular failure those caused by hemodynamic complication due to multiple coronary artery-left ventricular fistulae.
Aged ; Arteries ; Cations ; Chest Pain ; Coronary Angiography ; Coronary Disease ; Coronary Vessels ; Dyspnea ; Fistula ; Heart Failure* ; Heart Ventricles ; Heart* ; Hemodynamics ; Humans ; Male ; Myocardial Ischemia ; Veins

Coronary artery fistula is an unusual anomaly in elderly patients that consists of a communication bet- ween one of the coronary arteries and other cardiac chambers or veins. It causes many cardiac compli- cations due to hemodynamic changes, and thus has recognized its clinical significance. It occurs usually in congenital origin, but also occurs secondarily in traumatic or neoplastic or artherosclerotic coronary diseases. Congenital coronary artery fistula is a very rare congenital anomaly that results in multiple hemodynamic complications. It has reported rarely in elderly patients, that induces myocardial ischemia due to coronary steal syndrome and heart failure that caused by diastolic volume overload via a left to left shunt. We observed a 68-year-old male patient with exertional chest pain and dyspnea, in whom selective coronary angiography revealed abnormal reticular communication between left anterior descending artery and left circumflex artery and drained to left ventricle through multiple microfistulous channels. We report this patient case who complicated by myocardial ischemia and left ventricular failure those caused by hemodynamic complication due to multiple coronary artery-left ventricular fistulae.
Aged ; Arteries ; Cations ; Chest Pain ; Coronary Angiography ; Coronary Disease ; Coronary Vessels ; Dyspnea ; Fistula ; Heart Failure* ; Heart Ventricles ; Heart* ; Hemodynamics ; Humans ; Male ; Myocardial Ischemia ; Veins

OBJECTIVES: From February 1995 to April 1998, those patients who had visited for evaluation of infertility, shown abnormal endometrial pattern on hysterosalpingography underwent resectoscopic operation. We evaluated about its therapeutic effect, recurrence rate of uterine adhesion and effectiveness of its assisted method. METHOD: We have reviewed 45 cases of intrauterine adhesion, classified as a central type, marginal type and multiple type. We used 26F resectoscope made in Storz for operation and inserted Lippes loop or pediatric foley catheter for prevention of readhesion. For promoting reepithelialization, conjugated estrogens(premarin) 5mg daily for 30 - 50 days were given and then 10mg of medroxyprogesterone acetate(provera) were added daily for the last 10 days. We evaluated the uterine cavity condition preoperatively and postoperatively by using hysterosalpingography. RESULT: In 45 cases, 41 cases were followed up postoperatively. 21 cases were markedly improved, 12 cases were improved and 8 cases were not improved or recurred on hysterosalpingography. In 41 cases, for prevention of readhesion 20 cases were used pediatric foley catheter and 5 cases(25%) were recurred. 21 cases were used Lippes loop and 3 cases(14%) were recurred. Pregnancy outcome was as follows;15 cases were pregnant and 10 cases delivered a viable infant, 3 cases aborted spontaneously, 1 case was ectopic pregnancy and laparoscopic salpingectomy was done, 1 case was ongoing pregnancy. CONCLUSION: This report suggests that resectoscopic operation is very effective in the treatment of intrauterine adhesion(therapeutic rate of 81%) and that the use of Lippes loop seems like to have the less recurrence rate than the use of pediatric foley catheter in prevention of postoperative readhesion, but more experience and further follow-up are necessary to obtain more detailed conclusions.
Catheters ; Female ; Follow-Up Studies ; Humans ; Hysterosalpingography ; Infant ; Infertility ; Medroxyprogesterone ; Pregnancy ; Pregnancy Outcome ; Pregnancy, Ectopic ; Recurrence ; Salpingectomy

PURPOSE: This study was conducted to examine the late effects, social adjustment, and quality of life in adolescents who had been completely treated for childhood leukemia and their parents. METHODS: Participants consisted of 41 pairs of adolescent survivors (13-18 years) and their parents. Parents checked for their child's physical late effects. The Korean Version of Post-Traumatic Symptoms for psychological late effects, social functioning questionnaire for social adjustment and the PedsQL 4.0 Generic Core Scales for quality of life were completed by adolescents and parents. Data were analyzed using SPSS. RESULTS: Twenty out of 41 adolescents had one or more physical late effects. Adolescents showed more serious psychological late effect than parents. Five children and seven parents had above cut-off scores and they were considered the high risk group for posttraumatic symptoms. Parent-reported scores were significantly higher than child-reported scores in terms of social adjustment and emotional functioning of quality of life. Low school functioning in adolescents was associated with physical late effects. CONCLUSION: The results indicate that long-term and systematic management for childhood leukemia survivors affect positive social adjustment and can further improve quality of life.
Adolescent ; Adult ; Humans ; Leukemia/*psychology ; Parents/psychology ; *Quality of Life ; Questionnaires ; *Social Adjustment ; Stress, Psychological ; Survivors/*psychology ; Time Factors ; Translating