No abstract available.
Alcoholism* ; Hospitals, General* ; Humans ; Prevalence*

PURPOSE: Penile and scrotal involvements in extramammary Paget's disease (EMPD) are exceedingly rare, with only small series or case reports having been reported in the literature. Our study was undertaken to clarify the uncertainty of the clinical outcome of this disease. MATERIALS AND METHODS: Between 1995 and 2003, 32 patients with penile or scrotal EMPD were treated and followed up. Local wide excision was performed in all patients, with or without an intraoperative frozen biopsy. RESULTS: Of the 32 patients, 12 (37.5%) underwent local wide excision with an intraoperative frozen biopsy; 1 patient (8.3%) had a positive surgical margin. Conversely, 20 (62.5%) underwent local wide excision with an excessive surgical margin of upto 1 to 2cm only due to the gross findings, but 15 (75.0%) had a positive surgical margin (p<0.001). 8 of the 16 patients with a positive surgical margin had a local recurrence at the 8 month follow-up (p<0.05). One patient with invasion to the subcutaneous tissue had died of metastatic EMPD and internal malignancy (renal cell carcinoma) at the 17 month postoperative follow-up. There was no underlying adnexal carcinoma in any case. CONCLUSIONS: Local wide excision with intraoperative frozen biopsy was essential for the complete treatment of EMPD. There was no associated internal malignancy or underlying adnexal carcinoma at the initial diagnoses.
Biopsy ; Diagnosis* ; Follow-Up Studies ; Humans ; Male ; Paget Disease, Extramammary* ; Penis* ; Prognosis* ; Recurrence ; Scrotum* ; Subcutaneous Tissue ; Uncertainty

PURPOSE: Vesicoureteral reflux (VUR) in a transplanted kidney may affect the function of a grafted kidney with a recurrent urinary tract infection (UTI), and is a factor of graft failure. Our experience of surgical correction was investigated by performing transvesical ureteral reimplantation in VUR recipients. MATERIALS AND METHODS: Among 2,265 recipients, who had received a living kidney transplantation at Yonsei University Severance Hospital between April 1979 and October 2003, and 29 VUR recipients (7 Men, 22 Women), diagnosed with VCUG after recurrent UTI, were retrospectively analyzed. The mean age of the patients was 43.9, ranging from 24 to 61 years, with a mean follow up of 3.6, ranging from 0.7 to 8.0 years. The changes in the serum creatinine and complications after a transvesical ureteral reimplantation were analyzed. RESULTS: The incidence of VUR was 1.28% (29/2,265) and the mean diagnosis was made after 5.0, ranging from 0.8 to 13.4 years. The grades of VUR were 2 (I), 2 (II), 20 (III) and 5 (IV). Twenty-five recipients underwent a transvesical ureteral reimplantation. The mean serum creatinine decreased from 2.5+/-2.2 to 1.8+/-1.4mg/dl (p=0.14) 1 year after surgical correction, and was significantly decreased from 2.5+/-2.2 to 1.4+/-0.7mg/dl (p=0.017) 3 years after surgical correction. There were no UTI and acute pyelonephritis after a ureteral reimplantation. CONCLUSIONS: VUR, with recurrent UTI, in recipients administered an immunosuppressive agent may cause deterioration of the graft function. The suspicion of VUR should be borne in mind for renal recipients with recurrent UTI, which can be safely corrected by a transvesical ureteral reimplantation.
Creatinine ; Diagnosis ; Follow-Up Studies ; Humans ; Incidence ; Kidney ; Kidney Transplantation ; Male ; Pyelonephritis ; Replantation ; Retrospective Studies ; Transplantation* ; Transplants ; Ureter ; Urinary Tract Infections ; Vesico-Ureteral Reflux*

BACKGROUND: Recently, younger prostate cancer (PCa) patients have been reported to harbour more favourable disease characteristics after radical prostatectomy (RP) than older men. We analysed young men (< 50 years) with PCa among the Korean population, paying attention to pathological characteristics on RP specimen and biochemical recurrence (BCR). METHODS: The multi-centre, Severance Urological Oncology Group registry was utilized to identify 622 patients with clinically localized or locally advanced PCa, who were treated with RP between 2001 and 2017. Patients were dichotomized into two groups according to age (< 50-year-old [n = 75] and ≥ 50-year-old [n = 547]), and clinicopathological characteristics were analysed. Propensity score matching was used when assessing BCR between the two groups. RESULTS: Although biopsy Gleason score (GS) was lower in younger patients (P = 0.033), distribution of pathologic GS was similar between the two groups (13.3% vs. 13.9% for GS ≥ 8, P = 0.191). There was no significant difference in pathologic T stage between the < 50- and ≥ 50-year-old groups (69.3% vs. 68.0% in T2 and 30.7% vs. 32.0% in ≥ T3, P = 0.203). The positive surgical margin rates were similar between the two groups (20.0% vs. 27.6%, P = 0.178). BCR-free survival rates were also similar (P = 0.644) between the two groups, after propensity matching. CONCLUSION: Contrary to prior reports, younger PCa patients did not have more favourable pathologic features on RP specimen and showed similar BCR rates compared to older men. These findings should be considered when making treatment decisions for young Korean patients with PCa.
Biopsy ; Humans ; Korea ; Male ; Middle Aged ; Neoplasm Grading ; Passive Cutaneous Anaphylaxis ; Prognosis ; Propensity Score ; Prostate ; Prostatectomy ; Prostatic Neoplasms ; Recurrence ; Survival Rate ; Young Adult