The prognostic significance of vascular (blood and lymphatic vessels) invasion was evaluated in a retrospective review of 27 patients with upper urinary tract transitional cell carcinoma from January 1985 to December 1993, who underwent a nephroureterectomy with bladder cuff resection. Vascular invasion was found in 10 patients (37%). The incidence of vascular invasion was well correlated with tumor grade and stage. The incidence of postoperative metastases was significantly higher in the patients with (70%) than without (17.6%) vascular invasion (p<0.05). The survival rate of the patients with vascular invasion was significantly lower than in those without vascular invasion (p<0.01). In multivariate Cox`s regressional analysis the prognostic value of vascular invasion was independent of tumor grade and stage. These results indicate that vascular invasion should predict a more unfavorable outcome in patients with upper urinary tract transitional cell carcinoma as an independent morphological indicator.
Carcinoma, Transitional Cell* ; Humans ; Incidence ; Lymphatic Vessels* ; Neoplasm Metastasis ; Prognosis ; Retrospective Studies ; Survival Rate ; Urinary Bladder ; Urinary Tract*

We conducted a retrospective study of 41 cases of clinically localized renal cell carcinoma (RCC) treated with radical nephrectomy by our department between January 1987 and December 1993. The prognostic pathological parameters considered were tumor extension (pT stage), nuclear grading, histological grading, cell type, histologic growth pattern and tumor size. In the univariate analysis by log-rank test, three parameters showed prognostic significance, including pT stage, nuclear grading and tumor size. However, in the multivariate analysis using Cox's regressional hazard model, only two parameters including pT stage (p<0.001), nuclear grade (p<0.05) were found to have significantly independent prognostic value. But, nuclear grade considered in a given stage provided no significant influence (p>0.05). We think that nuclear grading cannot predict the outcome of patients at the same surgical stage. These results suggest that pathological stage of RCC may be the most important prognostic factor and the nuclear grade of tumor may provide additional important prognostic information.
Carcinoma, Renal Cell* ; Humans ; Multivariate Analysis ; Nephrectomy ; Proportional Hazards Models ; Retrospective Studies

Renal angiomyolipomas are uncommon benign neoplasms composed of mature fat tissue, thick-walled blood vessels and smooth muscle in varying proportions, which art often associated with tuberous sclerosis. During the last 5 years, 7 patients of renal angiomyolipoma were managed at Hanyang University Medical College. All cases were unilateral and were not associated with tuberous sclerosis. One patient was managed by radical nephrectomy because we could not distinguish from renal cell carcinoma. In 6 patients preoperative diagnosis were possible and one of them was managed by nephrectomy due to spontaneous rupture with severe bleeding and 5 patients were managed by conservative treatment. One patient was managed by enucleation of angiomyolipoma, and 2 patients were successfully managed with selective renal angioinfarct. Another 2 patients were incidentally found, small sized asymptomatic cases, so they were managed byobservation. All 7 patients were free of recurrence for follow up.
Angiomyolipoma* ; Blood Vessels ; Carcinoma, Renal Cell ; Diagnosis ; Follow-Up Studies ; Hemorrhage ; Humans ; Muscle, Smooth ; Nephrectomy ; Recurrence ; Rupture, Spontaneous ; Tuberous Sclerosis

Malignant mesothelioma of the tunica vaginalis is an externally rare tumor arising from the serosal surface of the pleural, pericardial, peritoneal cavities. The pathologic diagnosis was based upon the clinical, gross and microscopic findings and immunohistochemical studies. Appropriate treatment of malignant mesothelioma consists of inguinal orchiectomy with close follow up. Treatment of locally recurrent and distant metastasis have not been standardized. We report a case of metastatic malignant mesothelioma from the tunica vaginalis of the right spermatic cord with coincident finding of left renal cell carcinoma, that was metastasis to the abdominal wall, 17months after right radical orchiectomy and left radical nephrectomy.
Abdominal Wall ; Carcinoma, Renal Cell* ; Diagnosis ; Follow-Up Studies ; Mesothelioma* ; Neoplasm Metastasis ; Nephrectomy ; Orchiectomy ; Spermatic Cord*

BACKGROUND AND OBJECTIVES: Most reports about coronary angiographic findings in acute myocardial infarction were done after thrombolytic therapy or several days after onset of symptom. The aim of this study is to evaluate coronary angiographic findings in patients with AMI within 24 hours after onset of symptoms and without thrombolytic therapy. Also we evaluated the correlation between the risk factors and severity of coronary artery disease. MATERIALS AND METHODS: We studied 70 patients with acute myocardial infarction admitted to Kyungpook National University Hospital (KNUH) from November 1997 to January 1999, and evaluated the clincial and coronary angiographic findings. We analyzed risk factors of coronary artery disease: age, total cholesterol, tiglyceride, high density lipoprotein (HDL)-cholesterol, low density lipoprotein (LDL)-cholesterol, hypertension, smoking, diabetes and family history of CAD. Coronary angiography was done immediately after the arrival at emergency room (door-to- angiography time). Exclusion criteria were delayed arrival (more than 24 hours after symptom onset), previous history of anticoagulation or medication of antiplatelet agents. RESULTS: 1) Among 70 patients (M/F: 53/17), 59 patients had Q wave myocardial infarction (QMI) (84%), 11 patients had non-Q wave-MI (NQMI) (16%). 2) The mean age was 61+/-12.2 years (range: 26 to 82 years). 3) The mean time from the onset of chest pain to angiography was 6.2+/-4.7 hours. 4) Twenty eight patients (40%) had one-vessel disease, 25 (36%) had two-vessel disease and 17 (24%) had three-vessel disease. 5) The location of infarct related arteries were as follows: LAD in 33 (47%), LCX in 13 (19%) and RCA in 24 (34%). 6) The mean diameter stenosis of infarct related artery (IRA) was 95+/-10.9%. According to the American College of Cardiology/American Heart Association (ACC/AHA) classification of IRA, type B lesion occurred most commonly in 56 patients (80%). 7) Thrombus was observed in 44 patients (63%) with QMI versus 3 patients (27%) with NQMI (p=0.006). 8) Calcifications of the wall of coronary arteries were observed in 28 patients (40%) and correlated with ages of patients. 9) History of cigarette smoking was present in 73%, hypertension in 31% and hypercholesterolemia in 15% of patients. The mean number of risk factor for each patient was 1.3. 10) Multivessel disease was significantly more frequent in patients who had two more risk factors. 11) The frequency of cigarette smoking was greater and the level of plasma triglyceride were higher in patients under 50 years of age. 12) One patient died during coronary angiography and another 2 patients died at 5 and 8 days after coronary angiography due to cardigenic shock. CONCLUSION: In immediate coronary angiographic findings in patients with AMI, multivessel disease and thrombus, and severe stenosis of IRA were observed more frequently than other studies after thrombolytic therapy or after several days of delay. Multivessel disease was significantly more frequent in the patients who had two or more risk factors of atherosclerosis.
Angiography ; Arteries ; Atherosclerosis ; Chest Pain ; Cholesterol ; Classification ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels ; Emergency Service, Hospital ; Gyeongsangbuk-do ; Heart ; Humans ; Hypercholesterolemia ; Hypertension ; Lipoproteins ; Myocardial Infarction* ; Plasma ; Platelet Aggregation Inhibitors ; Risk Factors ; Shock ; Smoke ; Smoking ; Thrombolytic Therapy ; Thrombosis ; Triglycerides

BACKGROUND AND OBJECTIVES: The intracoronary stent may be useful in the preventing of abrupt closure and coronary restenosis after coronary angioplasty, and recently primary stenting has been one of therapeutic modalities. We assessed the clinical and angiographic results of primary NIR stenting in patients with acute myocardial infarction (AMI). MATERIALS AND METHODS: Between November 1997 to January 1999, 55 stentings with NIR stents were done in 51 patients with acute myocardial infarction. Angiographic follow-up was available at 7+/-2.3 days in 35 patients. RESULTS: 1) Among 51 patients (M/F: 37/14), 44 patients had Q-wave MI (86%), 7 patients had non-Q-wave MI (14%). 2) The mean age was 61+/-12.4 years (range: 26 to 82 years). 3) The mean time from the onset of chest pain to the arrival at emergency room was 4.6 +/- 4.2 hours. The mean door-to-balloon time was 93+/-46 minutes 4) Treated vessels were as follows: 28 in LAD, 17 in RCA, 10 in LCX. 5) The indications for stent implantation were suboptimal angiographic results after PTCA in 38 lesions (69%), dissection in 9 lesions (16%), abrupt vessel closure in 1 lesion and elective in 7 lesions (13%). 6) Single stent implantation was done in 47 patients. Overlapping stents were done in 4 patients. 7) A procedure related complication occurred in one patient, peri-stent dissection without flow limitation. 8) Full expansion of the stent failed in three lesions with coronary calcifications and the residual stenosis was 35, 40, 50% in each case. In these cases, in-stent thrombus was not demonstrated in follow up angiography. 9) The minimal lumen diameter increased from 0.11+/-0.39 to 2.96+/-0.40 mm. 10) Angiographic follow-up on 38 stents in 35 patients demonstrated in-stent thrombus in 3 stents, in-stent restenosis in 1 stent. But in-stent flow limitations were not found in these 4 cases and TIMI III flow were maintained. Patients with Q-wave MI and coronary thrombus on initial angiography were more prone to subacute thrombosis. CONCLUSION: The NIR stent could be used successfully in primary coronary stenting in acute myocardial infarction. The present study shows relatively low risk of subacute stent thrombosis. The rate of restenosis needs to be confirmed by long term study.
Angiography ; Angioplasty ; Chest Pain ; Constriction, Pathologic ; Coronary Restenosis ; Emergency Service, Hospital ; Follow-Up Studies ; Humans ; Myocardial Infarction* ; Stents* ; Thrombosis

Last year, we had experienced 2 cases of frontal mucocele from which exophthalmos was induced. In both cases, all were male and exophthalmos was unilateral at right eye. They revealed visual disturbances and ocular deviations to the temporal and inferior direction, a]so with the diplopia in one case. The duration of the exophthalmos was 5 months in one case, and 10 years long in another case. They were treated by means of external sinusotomy through the anterior orbitotomy with good results. In one case visual disturbance was also recovered to the normal.
Diplopia ; Exophthalmos* ; Humans ; Male ; Mucocele*

The incidence of vivax malaria in Korea was reduced to a low plateau. For successful elimination of vivax malaria, socio-behavioral changes in the communities are essential. This study aimed to figure out awareness of the inhabitants on the vivax malaria endemicity. The 407 participants including vivax malaria patients and uninfected inhabitants in Gimpo- and Paju-si, Gyeonggi-do, known as high-risk areas in Korea. We used a community-based study design and non-probability sampling method using primary data. Except for the perception about the public health facilities’ capability to cope with anti-malaria programs, the 2 groups of participants shared the same level of awareness about public promotional and educational measures and opinions for malaria elimination from the community. Thus, our future goals for malaria prevention and elimination are to develop more active and well-organized community-based education and evaluation programs collaborating with the community healthcare authorities and local governments.