Primary intestinal mast cell tumor in a Russian Blue cat: ultrasonographic and histopathological findings

A 11-year-old, female Russian Blue cat was presented with anorexia, vomiting, and diarrhea lasting for 3 days. Abdominal ultrasonography revealed a hypoechoic, non-circumferential, and eccentrically formed intestinal loop with altered wall layering and thickening of the tunica muscularis. After surgical resection, histopathologic examination confirmed an infiltrative, round-cell neoplasm composed of sheets and cords of neoplastic mast cells within a fibrotic, edematous stroma. The cat was alive and healthy 6 months after surgery. To the best of our knowledge, this is the first reported case of an intestinal mast cell tumor in a Russian Blue cat in South Korea.

Exploration of a Leadership Competency Model for Medical School Faculties in Korea / 한국의학교육

PURPOSE: To adapt to rapid and turbulent changes in the field of medicine, education, and society, medical school faculties need appropriate leadership. To develop leadership competencies through education, coaching, and mentoring, we need a leadership competency model. The purpose of this study was to develop a new leadership competency model that is suitable for medical school faculties in Korea. METHODS: To collect behavioral episodes with regard to leadership, we interviewed 54 subjects (faculties, residents, nurses) and surveyed 41 faculties with open-ended questionnaires. We classified the behavioral episodes based on Quinn and Cameron's leadership competency model and developed a Likert scale questionnaire to perform a confirmatory factor analysis. Two hundred seven medical school faculties responded to the questionnaire. RESULTS: The competency clusters that were identified by factor analysis were professionalism, citizenship, leadership, and membership to an organization. Accordingly, each cluster was linked with a dimension: self, society, team (that he/she is leading), and organization (to which he/she belongs). The clusters of competencies were: professional ability, ethics/morality, self-management, self-development, and passion; public interest, networking, social participation, and active service; motivating, caring, promoting teamwork, nurturing, conflict management, directing, performance management, and systems thinking; organizational orientation, collaboration, voluntary participation, and cost-benefit orientation. CONCLUSION: This competency model that fits medical school faculties in Korea can be used to design and develop selection plans, education programs, feedback tools, diagnostic evaluation tools, and career plan support programs.

Prognostic Value of Tumor Angiogenesis and Microvascular Invasion in Renal Cell Carcinoma / 대한비뇨기과학회지

PURPOSE: This study was performed to evaluate the impact of microvessel density (MVD), a reflection of tumor angiogenesis, and microvascular invasion (MVI) on the prognosis of patients with renal cell carcinoma (RCC). MATERIALS AND METHODS: Formalin-fixed, paraffin-embedded tissue sections of RCC from 81 patients who had undergone radical nephrectomy were stained immunohistochemically for CD34, which decorate endothelial cells, in order to assess MVD and MVI. The immunostaining results of MVD and MVI were compared with the clinicopathological variables. RESULTS: Twenty-two patients had either synchronous or metachronous metastases and fourteen patients died during the follow-up. MVD was significantly correlated with only metastasis (synchronous or metachronous; p=0.020). MVI was significantly correlated with tumor size (p=0.005), TNM stage (p<0.001), T stage (p<0.001), M stage (p=0.001), and metastasis (synchronous or metachronous; p=0.007). MVD was not significantly associated with MVI (p=0.232). The survival rate of patients with higher MVD or MVI-positive tumors was significantly lower than that of patients with lower MVD or MVI-negative tumors, respectively (p<0.0001, p=0.0002). Multivariate analyses indicated that tumor size, M stage and MVI were independent prognostic factors for cancer-specific survival. MVD was not an independent factor. CONCLUSIONS: MVD and MVI were associated with metastasis and a worse prognosis in RCC, which suggests that tumor angiogenesis and MVI may play an important role in the progression of RCC. MVI was an independent prognostic factor for cancer-specific survival.

The Effect of Semen Contamination on the Urine Dipsticks / 임상검사와정도관리

BACKGROUND: The dipstick methodology is the most fundamental urinalysis but interfered by many factors. We evaluated the effect of semen contamination on the urine dipsticks. METHODS: Thirty-two specimens for semen analysis were enrolled. After semen was directly applied on urine dipsticks, residual samples were diluted in pooled normal urine. Urine dipsticks were performed at each dilution titer. Seminal plasma separated by centrifugation of semen were also tested in the same manner. RESULTS: All semen showed positive results for blood, protein and leukocytes. The intensities of reaction for blood and leukocytes were correlated with sperm concentration. The negative conversion of blood and protein occurred at 1:100, and that of leukocytes occurred at 1:50. Seminal plasma showed nearly the same findings. CONCLUSIONS: Semen contamination of urine may cause false positive reaction especially for blood and protein on the urine dipsticks. It should therefore be considered when assessing unexplained, transient hematuria or proteinuria.

Cyclooxygenase-2 and p53 Expression as Prognostic Indicators in Conventional Renal Cell Carcinoma

The aim of this study was to investigate the relationship of cyclooxygenase (COX) -2 and p53 expression with prognosis in patients with conventional renal cell carcinoma (RCC). Formalin-fixed, paraffin-embedded tissue sections of conventional RCC from 92 patients, who had undergone radical nephrectomy, were examined for COX-2 and p53 expression by immunohistochemistry and compared with clinicopathological variables. The COX-2 expression significantly correlated only with tumor size (p=0.049), whereas the p53 expression profoundly correlated with the TNM stage (p=0.024), M stage (p=0.001), and metastasis (synchronous or metachronous; p= 0.004). The COX-2 overexpression did not significantly associate with p53 positivity (p=0.821). The survival rate of patients correlated with the p53 expression (p < 0.0001) but not with the COX-2 expression (p=0.7506). Multivariate analyses indicated that tumor size, M stage, and p53 expression were independent prognostic factors for cancer-specific survival. The COX-2 expression was not an independent factor. These results show that the increased expression of p53 was associated with metastasis and a worse prognosis in conventional RCC, which suggests that p53 might have played an important role in the progression of conventional RCC. The increased expression of COX-2 was associated only with tumor size, but may not be an important prognostic factor in conventional RCC. No association was observed between COX-2 overexpression and p53 positivity in conventional RCC.

Primary Testicular Tumors in Children: Histopathological Distribution and Clinical Behavior / 대한비뇨기과학회지

PURPOSE: It has generally been accepted that the most common primary testicular tumor in the pediatric population is yolk sac tumor. Recently, there have been some reports that teratoma is the most common tumor in this age group. The histopathological distribution and clinical behavior of primary pediatric testicular tumors from three hospitals were retrospectively reviewed. MATERIALS AND METHODS: A retrospective review was performed on 30 pediatric patients, who had been treated for primary testicular tumors, at three hospitals. The records of the patients were reviewed with respect to age at diagnosis, affected sites, presentation, operation, pathology and prognosis. The mean age of the patients was 68.3 months (1-234). RESULTS: The most common presentation was a painless scrotal mass (86.7%). In patients younger than 15 years, the most common testicular tumor was teratoma at one hospital and yolk sac tumor at the other two hospitals. Totally, the most common testicular tumor was teratoma (52%), followed by yolk sac tumor (40%). In 5 patients, aged 15-20 years, the pathological distribution of the testicular tumor was the same as that observed in adults. No patients had had a recurrence after a mean follow- up of 30.6 months (3-109). CONCLUSIONS: Our results suggest that the prognosis for children with testicular tumors is favorable. The most common primary prepubertal testis tumor is teratoma, followed by yolk sac tumor, although yolk sac tumor was the most common tumor at two of the hospitals in this study. A large prospective multi-center study will be required to determine the pathological distribution of pediatric testicular tumors.

Experiences of 313 Cases of Acute Scrotum: Properties of Acute Epididymitis and Differential Diagnosis of Testicular Torsion / 대한비뇨기과학회지

PURPOSE: An acute scrotum is a pathologic condition of the scrotum or intrascrotal contents that require emergency medical or surgical treatment. Because proper treatment and the outcomes are very important in reproduction, the records of patients who had acute scrotal diseases were reviewed for early and proper diagnosis and treatment. MATERIALS AND METHODS: The medical records of 313 patients with acute scrotal pain and swelling were retrospectively reviewed. The final diagnoses were made from the symptoms, a physical examination, the laboratory tests, a color Doppler ultrasound (US), and the surgical findings in cases that underwent surgery. Age, the presence of a urinary tract infection, an underlying disease, seasonal distributions, laterality and the accuracy of color Doppler US in acute epididymitis and testicular torsion were all analyzed. The missed cases of testicular torsion were also reviewed carefully. RESULTS: The most common disease of an acute scrotum was acute epididymitis in both adults and children. Urinary tract infections were not common in children with acute epididymitis. Testicular torsion occurred commonly in the left side, while acute epididymitis developed in same distributions. The mean age of an acute scrotum were 24.1 years; a testicular torsion was 16.0 years and an acute epididymitis was 25.4 years. The color Doppler US demonstrated a 82.5% sensitivity, a 100% specificity, a 100% positive predictive value and a 97.5% negative predictive value for testicular torsion. CONCLUSIONS: Acute epididymitis is also common in children. Although color Doppler US is useful in a differential diagnosis of an acute scrotum, a careful physical examination and follow up of the patient status are important to reduce the incidence of a misdiagnosis.

Intracorporeal Needle Breakage during Intracavernous Self-injection of Vasoactive Agent: A Case Report / 대한남성과학회지

Intracavernous self-injection of vasoactive agents for erectile dysfunction has been widely used in recent years due to its effectiveness and low rate of complications. Intracorporeal needle breakage during intracavernous self-injection represents an unusual complication. We report a case of intracorporeal needle breakage during self-injection of prostaglandin E1 in a 61-year-old man.

Strangulation of the Penis by Self-circumcision Device: A Case Report / 대한남성과학회지

Penile strangulation developed by wearing metallic or non-metallic objects is unusual but potentially serious. We report a case of 33-year-old man who presented with penile strangulation after applying the device for self-circumcision. The device was removed and after debridement of the infected necrotic tissues and antibiotic therapy, conventional circumcision was performed. It is stressed that circumcision should be performed by urologists.