PURPOSE: To investigate the usefulness of urine cytology in the detection of tumor recurrence in terms of practicality and cost-effectiveness. MATERIALS AND METHODS: We retrospectively analyzed 393 patients who underwent transurethral resection of bladder tumor (TURBT) for non-muscle-invasive bladder cancer (NMIBC) from January 2010 to June 2013. All patients underwent cystoscopy, urine cytology, urinalysis, and computed tomography (CT) at 3 and 6 months after TURBT. In 62 cases, abnormal bladder lesions were identified on cystoscopy within 6 months. Suspicious lesions were confirmed pathologically by TURBT or biopsy. Patients were grouped by modalities: group I, urine cytology; group II, CT; group III, urinalysis; group IV, urine cytology plus CT; group V, urine cytology plus urinalysis; group VI, CT plus urinalysis; group VII, combination of all three modalities. Each group was compared by cost per cancer detected. RESULTS: Forty-nine patients were confirmed to have tumor recurrence and 13 patients were confirmed to have inflammation by pathology. The overall tumor recurrence rate was 12.5% (49/393) and recurrent cases were revealed as NMIBC. Sensitivity in group I (24.5%) was lower than in group II (55.1%, p=0.001) and group III (57.1%, p<0.001). However, in group VII (77.6%), the sensitivity was statistically similar to that of group VI (75.5%, p=0.872). Under the Korean insurance system, total cost per cancer detected for group VII was almost double that of group VI (p=0.041). CONCLUSIONS: Routine urine cytology may not be useful for follow-up of bladder cancer in terms of practicality and cost-effectiveness. Application of urine cytology needs to be adjusted according to each patient.
Aged ; Aged, 80 and over ; Cost-Benefit Analysis ; Cystoscopy/economics ; Cytodiagnosis/economics/methods ; Female ; Health Care Costs/*statistics & numerical data ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local/*diagnosis/economics/pathology ; Neoplasm Staging ; Republic of Korea ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, X-Ray Computed/economics ; Urinalysis/economics/methods ; Urinary Bladder Neoplasms/*diagnosis/economics/pathology/surgery ; Urine/*cytology

OBJECTIVE: To evaluate the efficacy of temozolomide (TMZ) chemotherapy for recurrent anaplastic oligodendroglioma (AO) and anaplastic oligoastrocytoma (AOA). METHODS: A multi-center retrospective trial enrolled seventy-two patients with histologically proven AO/AOA who underwent TMZ chemotherapy for their recurrent tumors from 2006 to 2010. TMZ was administered orally (150 to 200 mg/m2/day) for 5 days per 28 days until unacceptable toxicity occurred or tumor progression was observed. RESULTS: TMZ chemotherapy cycles administered was median 5.3 (range, 1-41). The objective response rate was 24% including 8 cases (11%) of complete response and another 23 patients (32%) were remained as stable disease. Severe side effects (> or =grade 3) occurred only in 9 patients (13%). Progression-free survival (PFS) of all patients was a median 8.0 months (95% confidence interval, 6.0-10.0). The time to recurrence of a year or after was a favorable prognostic factor for PFS (p<0.05). Overall survival (OS) was apparently differed by the patient's histology, as AOA patients survived a median OS of 18.0 months while AO patients did not reach median OS at median follow-up of 11.5 months (range 2.7-65 months). Good performance status of Eastern Cooperative Oncology Group 0 and 1 showed prolonged OS (p<0.01). CONCLUSION: For recurrent AO/AOA after surgery followed by radiation therapy, TMZ could be recommended as a salvage therapy at the estimated efficacy equal to procarbazine, lomustine, and vincristine (PCV) chemotherapy at first relapse. For patients previously treated with PCV, TMZ is a favorable therapeutic option as 2nd line salvage chemotherapy with an acceptable toxicity rate.
Disease-Free Survival ; Drug Therapy* ; Follow-Up Studies ; Humans ; Lomustine ; Oligodendroglioma* ; Procarbazine ; Recurrence ; Retrospective Studies ; Salvage Therapy ; Vincristine

This study examined the prevalence of oral microbes in the saliva of oncological patients and healthy subjects. PCR was used to assess the frequency of oral microbes including 3 cariogenic bacteria, 5 periodontopathic bacteria and 4 Candida species in the saliva of 104 oncological patients and 52 healthy subjects. Among these microorganims, Streptococcus mutans, Fusobacterium nucleatum and Candida albicans were most frequently detected in both groups. There were no significant differences in the prevalence of cariogenic bacteria between the patient and healthy groups, whereas significant differences in the frequency of Porphyromonas gingivalis and Tannerella forsythia were observed between the two groups (p < 0.05). The prevalence of all five periodontopathogens was higher in the healthy group than in the patient group. The prevalence of C. albicans in patients was significantly higher than that of healthy group (p < 0.05). In conclusion, there were significant differences in the prevalence of P. gingivalis, T. forsythia and C. albicans between the oncological patient group and healthy group.
Bacteria ; Candida ; Candida albicans ; Forsythia ; Fusobacterium nucleatum ; Humans ; Polymerase Chain Reaction ; Porphyromonas gingivalis ; Prevalence ; Saliva ; Streptococcus mutans

A low iodine diet (LID) is the recommended preparation for radioactive iodine treatment. However, the recommended duration and stringency of LID are different among each recommendation. More stringent LID is expected in Korea because Korea is a iodine-rich region. We investigated the decrement of urine iodine excretion by two-week stringent LID for remnant thyroid ablation with radioactive iodine in Korean patients with thyroid cancer, prospectively. MATERIAL AND METHOD: From November 2006, patients who referred to our hospital for remnant ablation after total thyroidectomy were included in this study. To decrease total body iodine, our protocol included three strategies. First, we checked medication which could inhibit the radioactive iodine uptake. Second, the date of I-131 treatment was scheduled at least 3 months later if contrast agent had been used. The last strategy was two-week stringent LID education by specialized nutritionist. Before and after two-week stringent LID, 24hr-urine iodine was analyzed respectively. 24hr-urine creatinine was also analyzed for determining more valid 24hr urine sampling subgroup. RESULTS: Total 51 patients were finally enrolled. Average of 24hr-urine iodine excretion was significantly lowered (787+/-2242 -> 85+/-85 microgram/d, p=0.03) after LID and 74.4% of patients reached below the recommended urine iodine excretion level (<100 microgram/d). In subgroup (n=14), similar results was showed (505+/-666 -> 99+/-116 microgram/d, p=0.05) and 78.6% of patients met the criteria. CONCLUSION: Most patients could reach below the recommended urine iodine level after two-week stringent LID. Therefore, in our opinion, at least two-week stringent LID should be recommended in Korea.
Creatinine ; Diet ; Humans ; Iodine ; Korea ; Prospective Studies ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy

PURPOSE: In order to evaluate the spectrum of mitochondrial DNA (mtDNA) mutations in the patients with suspected Leber's hereditary optic neuropathy (LHON). METHODS: We investigated 14 primary mtDNA mutations at nucleotide positions (nps 3460A, 4160C, 5244A, 9101C, 9804A, 10663C, 11778A, 13730A, 14459A, 14482G, 14484C, 14495G, 14498T, and 14568T) and one common secondary mutation (np15257A) in 82 Korean patients with suspected LHON. RESULTS: Among them, only three kinds of LHON mutations were identified in 60 (73%) of 82 probands, which were comprised of 46 (56%) cases with the 11778A, 13 (16%) with the 14484C, and 1 (1%) with the 3460A. None of the other mtDNA mutations was detected. Of the 60 probands with LHON positive mutations, 19 (32%) had relevant family histories. Heteroplasmy was determined in 2 (4%) of the 46 probands with the 11778A and 1 (8%) of 13 probands with the 14484C. CONCLUSIONS: In conclusion, the 11778A was the most common cause (56%), and higher prevalence of the 14484C and the lower prevalence of the 3460A were characteristic in Korean patients with LHON. Especially, the 3460A had a remarkable racial difference compared with Caucasians. Except 3460A, 11778A, and 14484C, the other mutations screened may not be involved in pathogenesis and not have a synergistic effect on the clinical expression of LHON in Koreans.
Asian Continental Ancestry Group ; DNA, Mitochondrial* ; Humans ; Molecular Biology* ; Optic Atrophy, Hereditary, Leber* ; Prevalence

BACKGROUND: For the treatment of generalized vitiligo patients with oral PUVA, we can use two different methods; one is to treat the lesions while the whole body is exposed. Another one is to treat the lesions while only the lesions are exposed. PURPOSE: This study was performed to determine whether lesional and whole body exposure in oral PUVA for generalized vitiligo show any therapeutic differences in effectiveness. METHODS: The vitiligo lesions were distributed over the whole body skin of the subjects and the lesion area was less than 6% of the whole skin area. PUVA was done to the subjects more than 20 times after oral administration of psoralen. The patients were classified into two different groups. One is the lesional exposure group in which the patient exposed only the vitiligo lesion. The other is the whole body exposure group in which the patient exposed almost their whole body. RESULTS: Our results show that there is no statistical difference of the therapeutic effectiveness between the two methods. CONCLUSIONS: We recommend lesional treatment rather than whole body treatment to prevent the oral PUVA side effects.
Administration, Oral ; Ficusin ; Humans ; Skin ; Vitiligo*

A nine year old boy presented asymptomatic multiple papular lesions for 6 months. Biopsy revealed typical features of xanthogranuloma with Touton type giant cells. Authors observed natural course of the lesions for about 2 years thereafter, which showed shrinkage of the existing papules in general in spite of newly appearing lesions. Review of the previous cases reported by the name of juvenile xanthogranuloma showed that the age of the onset of the most of the cases with multiple lesions was before one year after birth, but adolescent cases were rare. It was also noted that previous cases with such multiple lesions had a course of spontaneous regression regardless of the onset of its age.
Adolescent* ; Biopsy ; Giant Cells ; Humans ; Male ; Parturition ; Xanthogranuloma, Juvenile

Nevus sebaceus is a congenital cutaneous hamartoma which has a potential to develop both benign and malignant neoplasm in late life. The most common benign tumor developed within the nevus is syringocystadenoma papilliferum and the most common malignant tumor basal cell epithelioma. Although two different tumors often develop simultaneously on the lesion, it is rare to see more than two different tumors developing on the lesion of nevus sebaceus. In Korean literatures only three such cases were reported. We report an additional case of nevus sebaceus developing three different tumors, syringocystadenoma papilliferum, sebaceous epithelioma, and basal cell carcinoma, in a 67-year-old female patient.
Aged ; Carcinoma* ; Carcinoma, Basal Cell* ; Female ; Hamartoma ; Humans ; Nevus*

Diffuse alopecia due to occult syringoma of the scalp has rarely been reported but the authors of the cases presented different opinions about which one is the primary event between the two conditions and if the syringoma is true or a reactive ductal proliferation. We have found a case whose diffuse alopecia is believed to be due to true syringoma of the scalp. A 43-year old woman showed simultaneous and gradual development of diffuse alopecia and multiple papular elevations on the face and neck adjoining the frontal and temporal hair lines. Histopathology of the scalp and the facial papular elevations all revealed typical syringomatous infiltrations with epithelial comma-tails and sclerotic stroma. All of the clinicopathological findings supported that the diffuse alopecia of the patient was due to the occult syringoma of the scalp.
Adult ; Alopecia* ; Female ; Hair ; Humans ; Neck ; Scalp ; Syringoma*

To identify risk factors and causative organisms, and to evaluate clinical manifestations, methods and results of treatment in infectious keratitis, an epidemiological study was performed prospectively under the identical protocol from April 1995 to March 2000.Logistic regression analysis was used to evaluate possible risk factors. The 1474 cases of infectious keratitis reported from 22 hospitals were studied. Five hundred forty-four organisms(442 bacteria, 82 fungi, 20 A c a n t h a m o e b a)were detected in 1320 eyes with infectious keratitis excluding 154 herpetic keratitis. The Pseudomonas aeruginosa was the most common organism in bacterial keratitis, and Fusariumspp. was the major isolate in fungal keratitis. Contact lens wear and occupation(industry, forester, miner, fisherman)were the risk factors for bacterial keratitis. Risk factors in fungal keratitis were fifth decade of age, farmer, and systemic diseases(diabetes mellitus etc.). Risk factors in herpetic keratitis were male and occupation(office worker, service, student, housewife). Risk factors in Acanthamoeba keratitis was contact lens wear.
Acanthamoeba Keratitis ; Bacteria ; Epidemiologic Studies ; Epidemiology* ; Fungi ; Humans ; Keratitis ; Keratitis, Herpetic ; Male ; Prospective Studies ; Pseudomonas aeruginosa ; Risk Factors