PURPOSE: We investigated the efficacy of transurethral needle ablation (TUNA) of prostate for benign prostatic hyperplasia (BPH) in patients with low compliance to medical therapy and high risk operative morbidity and mortality. MATERIALS AND METHODS: Total 38 patients with BPH and low compliance to medical therapy and high risk operative morbidity and mortality were treated with TUNA under the local anesthesia and evaluated prospectively using the international prostate symtom score (IPSS), Qmax, satisfaction score and postvoid residuals (PVRs), and followed for 3 months after treatment. RESULTS: The mean pretreatment symptom score was 24.82+/-5.76. At 1 and 3 months after treatment, the mean symptom score was decreased to 13.63+/-7.07 and 9.21+/-6.28, respectively (p<0.01). The mean pretreatment satisfaction score was 4.63+/-0.85. It was decreased to 2.84+/-1.26, 1.92+/-1.34 at 1, 3 months (p<0.01). The mean pretreatment Qmax was 5.26+/-3.37mL/s. It was increased to 9.53+/-4.54mL/s, 11.97+/-4.52mL/s at 1, 3 months (p<0.01). The mean pretreatment PVRs were 131.85+/-123.05mL. It was decreased to 49.68+/-38.28mL, 26.77+/-17.92mL at 1, 3 months (p<0.01). CONCLUSIONS: TUNA treatment in the management of BPH improved symptom scores, peak flow rates with lower morbidity. TUNA appears to be a useful alternative treatment for BPH in patients with low compliance to medical therapy and high risk operative morbidity and mortality.
Anesthesia, Local ; Compliance* ; Humans ; Mortality* ; Needles* ; Prospective Studies ; Prostate ; Prostatic Hyperplasia* ; Tuna

ESWL is an effective treatment for renal and ureteral calculi with few serious side effects. Most complications are related to an obstruction from stone fragments lodged within the ureter with an accompanying colic and/or infection and subcapsular or perirenal hematoma. Here we report a patient with a protein S deficiency sustaining a deep vein thrombosis following an ESWL for a mid ureter stone.
Colic ; Hematoma ; Humans ; Protein S Deficiency* ; Protein S* ; Thrombosis ; Ureter ; Ureteral Calculi ; Veins ; Venous Thrombosis*

ESWL is an effective treatment for renal and ureteral calculi with few serious side effects. Most complications are related to an obstruction from stone fragments lodged within the ureter with an accompanying colic and/or infection and subcapsular or perirenal hematoma. Here we report a patient with a protein S deficiency sustaining a deep vein thrombosis following an ESWL for a mid ureter stone.
Colic ; Hematoma ; Humans ; Protein S Deficiency* ; Protein S* ; Thrombosis ; Ureter ; Ureteral Calculi ; Veins ; Venous Thrombosis*

Spontaneous urine extravasation due to metastatic cancer is extremely rare. We experienced a case of urine extravasation caused by ureteral metastasis from a cervical adenocarcinoma in a 69-year-old woman. On operating, a 3cm length ureter stricture was found in the upper third of the left ureter. There were no malignant cells in a frozen biopsy, and no urine leakage site was detected. An end-to-end ureteroureterostomy was performed by the tension-free method. The permanent histology of the ureterectomy specimen revealed a metastatic adenocarcinoma, identical to that obtained from the punch biopsy of the cervix. The urine leakage persisted following the end-to-end ureteroureterostomy, whereupon a nephroureterectomy was performed.
Adenocarcinoma* ; Aged ; Biopsy ; Cervix Uteri ; Constriction, Pathologic ; Female ; Humans ; Neoplasm Metastasis* ; Ureter*

Background: Although the Korean Society for Cytopathology has developed educational goals as guidelines for cytopathology education in Korea, there is still no systematic approach to cytopathology education status for pathology residents. Furthermore, satisfaction with cytopathology education and with the outcome of the current training/educational program has not been investigated in Korea. This study aimed to obtain comprehensive data on the current state of cytopathology education for residents and evaluate education outcomes. Methods: An online survey was conducted in December 2020 for the board-certified pathologists and training residents registered as members of the Korean Society for Cytopathology. The questionnaire comprised questions that investigated the current status of cytopathology at each training institution, the degree of satisfaction with the work and education related to cytopathology, outcomes of cytopathology training, and educational accomplishments. Results: Of the participants surveyed, 12.3% (132/1,075) completed the questionnaire, and 36.8% (32/87) of cytopathology residents participated. The mean overall satisfaction with cytopathology education was 3.1 points (on a 1- to 5-point scale, 5: very satisfied). The most frequent suggestion among the free description format responses was to expand educational opportunities, such as online education opportunities, outside of the individual institutions. Conclusions Our results showed that cytopathology training in Korea needs further improvement. We expect that this study will inform systematic training of competent medical personnel armed with broad cytopathology knowledge and strong problem-solving abilities.

Disseminated cryptococcosis is a systemic infection that occurs most commonly in immunocompromised patients, especially those with human immunodeficiency virus (HIV) infection. Although the attack rate is much higher among immunocompromised patients, cryptococcal disease does occur in persons without any apparent predisposing conditions. A previously healthy 26-year- old man was admitted to the hospital because of persistent fever and cervical lymphadenopathy. Despite empirical antibiotic therapy, he developed cutaneous erythematous papules, generalized lymphadenopathy, miliary pulmonary infiltration, and meningitis successively soon after admission. Biopsy of the skin and the cervical lymph node revealed chronic granuloma with cryptococcal organisms and tissue culture of lymph node confirmed cryptococcal infection. He was treated with intravenous amphotericin B plus flucytosine for 2 weeks, and then with fluconazole for 2 months. After the therapy, there was no evidence of recurrence for 2 years.
Adult* ; Amphotericin B ; Biopsy ; Cryptococcosis* ; Fever ; Fluconazole ; Flucytosine ; Granuloma ; HIV ; Humans ; Immunocompromised Host ; Lymph Nodes ; Lymphatic Diseases ; Meningitis ; Recurrence ; Skin

Disseminated cryptococcosis is a systemic infection that occurs most commonly in immunocompromised patients, especially those with human immunodeficiency virus (HIV) infection. Although the attack rate is much higher among immunocompromised patients, cryptococcal disease does occur in persons without any apparent predisposing conditions. A previously healthy 26-year- old man was admitted to the hospital because of persistent fever and cervical lymphadenopathy. Despite empirical antibiotic therapy, he developed cutaneous erythematous papules, generalized lymphadenopathy, miliary pulmonary infiltration, and meningitis successively soon after admission. Biopsy of the skin and the cervical lymph node revealed chronic granuloma with cryptococcal organisms and tissue culture of lymph node confirmed cryptococcal infection. He was treated with intravenous amphotericin B plus flucytosine for 2 weeks, and then with fluconazole for 2 months. After the therapy, there was no evidence of recurrence for 2 years.
Adult* ; Amphotericin B ; Biopsy ; Cryptococcosis* ; Fever ; Fluconazole ; Flucytosine ; Granuloma ; HIV ; Humans ; Immunocompromised Host ; Lymph Nodes ; Lymphatic Diseases ; Meningitis ; Recurrence ; Skin

Malignant melanoma occurs most frequently on the skin. However, it can also arise in other organs and tissues of the body. Primary pulmonary malignant melanoma is a very rare non-epithelial neoplasm accounting for 0.01% of all primary pulmonary tumors. The treatment of choice is surgical resection of the tumor with an oncologically adequate margin as in lobectomy or pneumonectomy. The prognosis of this condition is rather poor. Based on previous data, its 5-year survival is at least 10%. Here, we report a case of an 82-year-old woman whose primary pulmonary melanoma was detected incidentally.
Aged, 80 and over ; Female ; Humans ; Lung ; Melanoma* ; Pneumonectomy ; Prognosis ; Skin

Mesenteric vein thrombosis (MVT) is an infrequent but old form of acute mesenteric ischemia, various forms of which have been recognized through imaging techniques. Pre- viously, diagnosis was made only by a laparotomy or autopsy. MVT is an abdominal emergency that is rarely diagnosed early. Review of the literature has shown that most cases have been treated by intestinal resection, and a few by thrombectomy with or with- out resection. Most are primary thromboses, but some are related to thromboembolic dise- ases, sepsis, cirrhosis, coagulopathy, abdominal neoplasms, traurna, or use of oral contra- ceptives. We report a case of superior mesenteric vein thrombosis with acute ischemic bowel disease, diagnosed early through a duodenoscopy and definitively assessed by superior mesenteric angiography and computed tomography. The predisposing factor for this case was a pelvic abscess post placenta previa operation. The first symptoms were hematemesis and abdominal pain. An intestinal mucosal lesion and clinical symptoms were improved by only heparinization and symptomatic treatment without resection.
Abdominal Neoplasms ; Abdominal Pain ; Abscess ; Angiography ; Autopsy ; Causality ; Diagnosis ; Duodenoscopy ; Emergencies ; Enteritis* ; Fibrosis ; Hematemesis ; Heparin ; Ischemia ; Laparotomy ; Mesenteric Veins ; Placenta Previa ; Sepsis ; Thrombectomy ; Thrombosis ; Venous Thrombosis*

BACKGROUND: Analysis of mutations in the epidermal growth factor receptor gene (EGFR) is important for predicting response to EGFR tyrosine kinase inhibitors. The overall rate of EGFR mutations in Korean patients is variable. To obtain comprehensive data on the status of EGFR mutations in Korean patients with lung cancer, the Cardiopulmonary Pathology Study Group of the Korean Society of Pathologists initiated a nationwide survey. METHODS: We obtained 1,753 reports on EGFR mutations in patients with lung cancer from 15 hospitals between January and December 2009. We compared EGFR mutations with patient age, sex, history of smoking, histologic diagnosis, specimen type, procurement site, tumor cell dissection, and laboratory status. RESULTS: The overall EGFR mutation rate was 34.3% in patients with non-small cell lung cancer (NSCLC) and 43.3% in patients with adenocarcinoma. EGFR mutation rate was significantly higher in women, never smokers, patients with adenocarcinoma, and patients who had undergone excisional biopsy. EGFR mutation rates did not differ with respect to patient age or procurement site among patients with NSCLC. CONCLUSIONS: EGFR mutation rates and statuses were similar to those in published data from other East Asian countries.
Adenocarcinoma ; Asian Continental Ancestry Group ; Biopsy ; Carcinoma, Non-Small-Cell Lung* ; Diagnosis ; Epidermal Growth Factor* ; Female ; Humans ; Lung Neoplasms ; Mutation Rate ; Pathology ; Protein-Tyrosine Kinases ; Receptor, Epidermal Growth Factor* ; Smoke ; Smoking