Tissue Perfusion and the Braden Scale as Predictors of Pressure Injury Risk in the Intensive Care Unit Patient

Purpose@#The national rate of pressure injury (PI) in the intensive care unit (ICU) 2016-2018 was 5.97%, while at one hospital in Honolulu, Hawaii it averaged 13%. The Braden scale is the gold standard PI risk assessment tool. Researchers have reported the Braden scale has limited value in the ICU setting and consider tissue perfusion to be the better indicator. The aim was to determine if tissue perfusion, as measured by noninvasive transcutaneous tissue oxygen levels, was a predictor of PI risk development. @*Methods@#Electronic medical records of 161 patients admitted from January 1, 2017 to June 30, 2019 were retrospectively reviewed. Patients’ characteristics were summarized using descriptive statistics. Bivariate associations with the development of PI were examined using Fisher’s exact test for the categorical variables, and Wilcoxon rank-sum test for the continuous variables. A multivariable logistic model was fitted for the development of PI with adjustments for potential confounders. @*Results@#Of 161 patients, 125 met the inclusion criteria. Length of stay, Acute Physiology and Chronic Health Evaluation II score, use of vasopressors, and the Braden score were statistically significant predictors of PI risk development; tissue perfusion was not significant. @*Conclusion@#ICU patients have a higher mortality and severity of illness. The Braden score guides implementation of PI preventative measures. The relationship between tissue perfusion and PI development may warrant further research. A broader clinical picture to incorporate the Braden scale and other risk factors in PI development such as Acute Physiology and Chronic Health Evaluation II score and use of vasopressors should be considered.

Aqueous extract of freeze-dried Protaetia brevitarsis larvae promotes osteogenesis by activating β-catenin signaling

Objective: To investigate the effect of an aqueous extract of Protaetia brevitarsis (AEPB) on osteogenesis using preosteoblast MC3T3-E1 cells and zebrafish larvae. Methods: Flow cytometric analysis was used to measure the cytotoxicy. Alkaline phosphatase activity was detetmined using p-nitrophenyl phosphate as a substrate. Calcium deposition was detected using alizarin red staining along with osteogenic marker expression in preosteoblast MC3T3E1 cells. In addition, vertebral formation in zebrafish larvae was detected using calcein staining and osteogenic gene expression. Results: AEPB highly promoted the expression of osteogenic markers including runt-related transcription factor 2, osterix, and alkaline phosphatase, along with elevated levels of mineralization in MC3T3-E1 cells. Moreover, AEPB accelerated vertebral formation in zebrafish larvae accompanied by upregulated expression of osteogenic genes. FH535, an inhibitor of Wnt/β-catenin, suppressed AEPB-induced osteogenic gene expression and vertebral formation, indicating that AEPB stimulates osteogenesis by activating the Wnt/β-catenin signaling pathway. Conclusions: AEPB stimulates osteoblast differentiation and bone formation by activating β-catenin. Therefore, AEPB is a promising material that induces osteogenesis, and is useful for the treatment of bone resorption diseases.

Aqueous extract of freeze-dried Protaetia brevitarsis larvae promotes osteogenesis by activating β-catenin signaling

Objective: To investigate the effect of an aqueous extract of Protaetia brevitarsis (AEPB) on osteogenesis using preosteoblast MC3T3-E1 cells and zebrafish larvae. Methods: Flow cytometric analysis was used to measure the cytotoxicy. Alkaline phosphatase activity was detetmined using p-nitrophenyl phosphate as a substrate. Calcium deposition was detected using alizarin red staining along with osteogenic marker expression in preosteoblast MC3T3E1 cells. In addition, vertebral formation in zebrafish larvae was detected using calcein staining and osteogenic gene expression. Results: AEPB highly promoted the expression of osteogenic markers including runt-related transcription factor 2, osterix, and alkaline phosphatase, along with elevated levels of mineralization in MC3T3-E1 cells. Moreover, AEPB accelerated vertebral formation in zebrafish larvae accompanied by upregulated expression of osteogenic genes. FH535, an inhibitor of Wnt/β-catenin, suppressed AEPB-induced osteogenic gene expression and vertebral formation, indicating that AEPB stimulates osteogenesis by activating the Wnt/β-catenin signaling pathway. Conclusions: AEPB stimulates osteoblast differentiation and bone formation by activating β-catenin. Therefore, AEPB is a promising material that induces osteogenesis, and is useful for the treatment of bone resorption diseases.

Immunostimulatory effect of ethanol extract of Chondracanthus tenellus in RAW 264.7 macrophages in vitro

Objective: To investigate whether ethanol extracts of Chondracanthus tenellus (EECT) could improve immunomodulatory property of murine monocyte/macrophage RAW 264.7 cells. Methods: Cell viability, phagocytic ability, and nitric oxide were measured. The levels of prostaglandin E

Ethanol extract of Chondracanthus tenellus (Harvey) Hommersand attenuates lipopolysaccharide-induced inflammatory and oxidative response by blocking the NF-κB, MAPKs, and PI3K/Akt signaling pathways

Objective: To investigate whether the ethanol extract of Chondracanthus tenellus (Harvey) Hommersand, a type of red algae, could exhibit anti-inflammatory potential in lipopolysaccharide (LPS)-stimulated macrophages. Methods: The ethanol extract of Chondracanthus tenellus was applied to 100 ng/mL LPS-stimulated RAW 264.7 cells, and cell viability, phagocytic ability, levels of pro-inflammatory factors, and the production of reactive oxygen species were measured. To identify the underlying mechanism of the ethanol extract of Chondracanthus tenellus, the expression of inflammation-regulated genes was estimated. Results: The ethanol extract of Chondracanthus tenellus had no cytotoxic effect at concentrations below 300 μg/mL, and reduced the LPS-induced production of inflammatory mediators including nitric oxide (NO) and prostaglandin E 2. Furthermore, the extract markedly suppressed the expression of inducible NO synthase and cyclooxygenase-2, as well as the production of reactive oxygen species. The LPS-induced up-regulation of pro-inflammatory cytokines was attenuated by treatment with the ethanol extract of Chondracanthus tenellus, reducing their extracellular secretion. The Chondracanthus tenellus extract also inhibited LPS-mediated activation of nuclear factor-kappa B (NF-κB). In addition, the phosphorylation of mitogen activated protein kinases (MAPKs) and phosphatidylinositol 3 kinase (PI3K)/Akt was markedly increased by LPS, which was significantly abolished by the Chondracanthus tenellus extract. Conclusions: Our findings indicate that the ethanol extract of Chondracanthus tenellus exhibited potential anti-inflammatory and antioxidant effects through downregulating the NF-κB, MAPKs, and PI3K/Akt signaling pathways in LPS stimulated RAW 264.7 macrophages.

Immunostimulatory effect of ethanol extract of Chondracanthus tenellus in RAW 264.7 macrophages in vitro

Objective: To investigate whether ethanol extracts of Chondracanthus tenellus (EECT) could improve immunomodulatory property of murine monocyte/macrophage RAW 264.7 cells. Methods: Cell viability, phagocytic ability, and nitric oxide were measured. The levels of prostaglandin E

Ethanol extract of Chondracanthus tenellus (Harvey) Hommersand attenuates lipopolysaccharide-induced inflammatory and oxidative response by blocking the NF-κB, MAPKs, and PI3K/Akt signaling pathways

Objective: To investigate whether the ethanol extract of Chondracanthus tenellus (Harvey) Hommersand, a type of red algae, could exhibit anti-inflammatory potential in lipopolysaccharide (LPS)-stimulated macrophages. Methods: The ethanol extract of Chondracanthus tenellus was applied to 100 ng/mL LPS-stimulated RAW 264.7 cells, and cell viability, phagocytic ability, levels of pro-inflammatory factors, and the production of reactive oxygen species were measured. To identify the underlying mechanism of the ethanol extract of Chondracanthus tenellus, the expression of inflammation-regulated genes was estimated. Results: The ethanol extract of Chondracanthus tenellus had no cytotoxic effect at concentrations below 300 μg/mL, and reduced the LPS-induced production of inflammatory mediators including nitric oxide (NO) and prostaglandin E 2. Furthermore, the extract markedly suppressed the expression of inducible NO synthase and cyclooxygenase-2, as well as the production of reactive oxygen species. The LPS-induced up-regulation of pro-inflammatory cytokines was attenuated by treatment with the ethanol extract of Chondracanthus tenellus, reducing their extracellular secretion. The Chondracanthus tenellus extract also inhibited LPS-mediated activation of nuclear factor-kappa B (NF-κB). In addition, the phosphorylation of mitogen activated protein kinases (MAPKs) and phosphatidylinositol 3 kinase (PI3K)/Akt was markedly increased by LPS, which was significantly abolished by the Chondracanthus tenellus extract. Conclusions: Our findings indicate that the ethanol extract of Chondracanthus tenellus exhibited potential anti-inflammatory and antioxidant effects through downregulating the NF-κB, MAPKs, and PI3K/Akt signaling pathways in LPS stimulated RAW 264.7 macrophages.

Ethanol extracts of Hizikia fusiforme induce apoptosis in human prostate cancer PC3 cells via modulating a ROS-dependent pathway

Objective: To investigate whether ethanol extracts of Hizikia fusiforme could induce apoptosis in human prostate cancer PC3 cells. Methods: Cell viability was evaluated using 3-(4,5-dimethylthiazol- 2-yl)-2,5-diphenyltetrazolium bromide. Apoptosis and mitochondrial membrane potential (MMP) were measured using flow cytometry in PC3 cells. DNA damage was assessed by nuclear staining and DNA fragmentation assay. Expressions of apoptosis-associated proteins were determined by Western blotting assays. Activities of caspase-3, -8, and -9 were determined by colorimetric assay. Moreover, intracellular reactive oxygen species (ROS) generation was detected using a flow cytometer and fluorescence microscope. Results: Treatment of PC3 cells with ethanol extracts of Hizikia fusiforme inhibited proliferation, which was associated with induction of apoptosis, and accompanied by increased expression of Fas, Fas-ligand (FasL), Bax and tBid, and decreased expression of Bcl-2. In addition, ethanol extracts of Hizikia fusiforme reduced c-Flip expression and activated caspase-8, -9 and -3, resulting in an increase in poly (ADP-ribose) polymerase (PARP)cleavage. However, in the presence of a pan-caspase inhibitor, ethanol extracts of Hizikia fusiforme-mediated growth inhibition and apoptosis were significantly attenuated. Ethanol extracts of Hizikia fusiforme also destroyed the integrity of mitochondria due to the loss of MMP, leading to cytosolic release of cytochrome c. Moreover, the levels of ROS were markedly increased by treatment with ethanol extracts of Hizikia fusiforme, which was significantly suppressed by the ROS scavenger N-acetyl-L-cysteine. Further investigation of whether ethanol extracts of Hizikia fusiforme-induced apoptosis was related to the generation of ROS was conducted and the results showed that N-acetyl-L-cysteine fully blocked ethanol extracts of Hizikia fusiforme-induced apoptotic events including loss of MMP, activation of caspase-3, the cytosolic release of cytochrome c and cytotoxicity. Conclusions: Ethanol extracts of Hizikia fusiforme have chemopreventive potential via induction of ROS-dependent apoptosis. Therefore, ethanol extracts of Hizikia fusiforme may be useful for developing effective and selective natural sources to inhibit cancer cell proliferation.

Ethanol extracts of Hizikia fusiforme induce apoptosis in human prostate cancer PC3 cells via modulating a ROS-dependent pathway

Objective: To investigate whether ethanol extracts of Hizikia fusiforme could induce apoptosis in human prostate cancer PC3 cells.Methods: Cell viability was evaluated using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide. Apoptosis and mitochondrial membrane potential (MMP) were measured using flow cytometry in PC3 cells. DNA damage was assessed by nuclear staining and DNA fragmentation assay. Expressions of apoptosis-associated proteins were determined by Western blotting assays. Activities of caspase-3, -8, and -9 were determined by colorimetric assay. Moreover, intracellular reactive oxygen species (ROS) generation was detected using a flow cytometer and fluorescence microscope. Results: Treatment of PC3 cells with ethanol extracts of Hizikia fusiforme inhibited proliferation, which was associated with induction of apoptosis, and accompanied by increased expression of Fas, Fas-ligand (FasL), Bax and tBid, and decreased expression of Bcl-2. In addition, ethanol extracts of Hizikia fusiforme reduced c-Flip expression and activated caspase-8, -9 and -3, resulting in an increase in poly (ADP-ribose) polymerase (PARP)cleavage. However, in the presence of a pan-caspase inhibitor, ethanol extracts of Hizikia fusiforme-mediated growth inhibition and apoptosis were significantly attenuated. Ethanol extracts of Hizikia fusiforme also destroyed the integrity of mitochondria due to the loss of MMP, leading to cytosolic release of cytochrome c. Moreover, the levels of ROS were markedly increased by treatment with ethanol extracts of Hizikia fusiforme, which was significantly suppressed by the ROS scavenger N-acetyl-L-cysteine. Further investigation of whether ethanol extracts of Hizikia fusiforme-induced apoptosis was related to the generation of ROS was conducted and the results showed that N-acetyl-L-cysteine fully blocked ethanol extracts of Hizikia fusiforme-induced apoptotic events including loss of MMP, activation of caspase-3, the cytosolic release of cytochrome c and cytotoxicity.Conclusions: Ethanol extracts of Hizikia fusiforme have chemopreventive potential via induction of ROS-dependent apoptosis. Therefore, ethanol extracts of Hizikia fusiforme may be useful for developing effective and selective natural sources to inhibit cancer cell proliferation.

Oligoadenylate synthase-like (OASL) proteins: dual functions and associations with diseases

The study of antiviral pathways to reveal methods for the effective response and clearance of virus is closely related to understanding interferon (IFN) signaling and its downstream target genes, IFN-stimulated genes. One of the key antiviral factors induced by IFNs, 2'-5' oligoadenylate synthase (OAS), is a well-known molecule that regulates the early phase of viral infection by degrading viral RNA in combination with RNase L, resulting in the inhibition of viral replication. In this review, we describe OAS family proteins from a different point of view from that of previous reviews. We discuss not only RNase L-dependent (canonical) and -independent (noncanonical) pathways but also the possibility of the OAS family members as biomarkers for various diseases and clues to non-immunological functions based on recent studies. In particular, we focus on OASL, a member of the OAS family that is relatively less well understood than the other members. We will explain its anti- and pro-viral dual roles as well as the diseases related to single-nucleotide polymorphisms in the corresponding gene.

Polyubiquitin chain-dependent protein degradation in TRIM30 cytoplasmic bodies

Viral infection induces numerous tripartite motif (TRIM) proteins to control antiviral immune signaling and viral replication. Particularly, SPRY-containing TRIM proteins are found only in vertebrates and they control target protein degradation by their RING-finger and SPRY domains, and proper cytoplasmic localization. To understand TRIM30 function, we analyzed its localization pattern and putative roles of its RING-finger and SPRY domains. We found that TRIM30 is located in actin-mediated cytoplasmic bodies and produces colocalized ubiquitin chains in SPRY domain- and RING-finger domain-dependent ways that are degraded by autophagy and the proteasome. These results suggest a TRIM protein-dependent degradation mechanism by cytoplasmic body formation with actin networks.

Neural Differentiation of Bone Marrow-Derived Mesenchymal Stem Cells: Applicability for Inner Ear Therapy

BACKGROUND AND OBJECTIVES: Regeneration or replacement of damaged hair cells and neurons in the cochlea might be an ideal treatment for sensorineural hearing loss (SNHL). The purpose of the present study was to investigate whether mesenchymal stem cells (MSCs), derived from the bone marrow of rats, could differentiate into auditory hair cells and neurons. MATERIALS AND METHODS: The centrifuge gradient method was used to isolate MSCs from the bone marrow of rats. To confirm whether bone marrow-derived MSCs can differentiate into neuronal cells, culture medium with glial cell-derived neurotrophic factor, brain-derived neurotrophic factor and neurotrophin-3 for 14 days. In addition, immunofluorescence staining and RT-PCR were performed for characterization of the neurospheres and differentiated cells from 7 and 14 day cultures. RESULTS: The results showed that MSCs could differentiate into neuron-positive and hair cell-positive cells, using different compositions of growth factors. And RT-PCR result was identified high or low of gene expression all these differentiated cells. CONCLUSIONS: Rat bone marrow-derived MSCs differentiated into neuronal progenitor cells. These cells might be useful for the treatment of SNHL.

A Survey on Activities of Daily Living and Occupations of Upper Extremity Amputees

OBJECTIVE: To assess prosthetic use by upper extremity amputees, and their difficulties with prostheses in activities of daily living and occupations. METHOD: This study is based on a survey of 307 subjects, who were using prostheses manufactured in the Center of Prosthetics and Orthotics. The survey questionnaire included items about general demographic characteristics, side and level of amputation, type of prosthesis and its use, and difficulties in the activities of daily living, employment and driving. RESULTS: The most common type of prosthesis was the cosmetic hand type (80.2%). There were no statistically significant correlations between satisfaction with prosthesis and the amputation level or type of prosthesis. The most common difficulties in daily living activities experienced by amputees were lacing shoes, removing bottle-tops with a bottle opener, and using scissors. Only 7.3% of amputees received rehabilitation services. Less than half of the amputees (44.7%) used their prostheses for eight or more hours a day, and 76.9% used their prostheses for regular or irregular cosmetic purposes. After amputation, most of the respondents (69.0%) became unemployed or changed workplaces. CONCLUSION: In our study, respondents preferred cosmetic usage to functional usage. Only 30.0% of respondents reported satisfaction with their prostheses. Many of the amputees had difficulties in complex tasks and either changed jobs or became unemployed. Clerical workers were the occupation group, which was most likely to return to work. The development of a more functional prosthetic hand and additional rehabilitation services are required.

Effect of Tracheostomy Tube on Swallowing in Patients with Stroke

OBJECTIVE: To investigate the characteristics and severity of swallowing difficulties among stroke patients with a tracheostomy tube, compared to those without. METHOD: A retrospective study was performed on two groups of 17 stroke patients with a tracheostomy tube (58.8 years) and without a tracheostomy tube (69.8 years) fed by Levine tube or a gastrostomy tube. There were no differences in the FIM (functional independence measure) score and brain lesions between the two groups. We evaluated the functional dysphagia scale (FDS) and aspiration; classified before, during, and after swallowing aspiration and silent aspiration. The swallowing task consisted of 2 ml of fluid and a videofluoroscopic swallowing study. RESULTS: There were no significant differences between the oral preparatory, oral and pharyngeal phase for the two groups in FDS. However, frequency of silent aspiration (p=0.007) and the total frequency of aspiration (p=0.038) were significantly higher in patients with tracheostomy. CONCLUSION: Patients with stroke who underwent tracheostomy showed no meaningful difference in FDS. However, there were significant differences in terms of silent aspiration and the total frequency of aspiration; caused by laryngopharyngeal desensitization and the anterior tethering effect on the tracheostomy tube. We have to pay more attention to the treatment and care of patients with tracheostomy tubes.

Gait Characteristics of Transfemoral Amputees in Long Term Users of Poly Centric Knee

OBJECTIVE: To evaluate characteristic gait patterns of transfemoral amputees who have been using polycentric knee for a long time. METHOD: Subjects were 22 transfemoral amputees using prosthesis for 29.0 years and 23 age-matched healthy adults. The three-dimensional gait analysis was performed. Temporospatial, kinematic and kinetic parameters were measured. RESULTS: Cadence and walking velocity of amputees decreased (p<0.05). Single support period decreased in amputee limb. There were no significant differences in hip flexion moment and power. In amputated limb, knee flexion in loading response was not observed and ankle plantar flexion was less than sound limb and control group. Excessive compensations of amputee side hip joint were not significant. CONCLUSION: Long term polycentric knee unit transfemoral prosthesis users show asymmetry of gait pattern which can increase the risk of musculoskeletal problems. Epidemiologic investigation would be necessary for prevention and proper management.

Crossing Obstacles of Different Heights in Hemiplegic Stroke Patients

OBJECTIVE: To evaluate the changes of gait patterns during crossing obstacles of different heights in hemiplegic stroke patients and to compare gait characteristics with those of healthy control subjects. METHOD: Subjects were 13 hemiplegic stroke patients and 9 age-matched healthy adults. Subjects stepped over obstacles with each height of 3, 8 and 13 cm. The three- dimensional gait analysis was performed. Temporospatial, kinematic and kinetic parameters were measured in both lead and trail limb. The pre- and post-obstacle distance, pre- and post-obstacle swing time and toe clearance were also measured. RESULTS: With increase in height of obstacles, ratio of single limb support time, angle of hip, knee flexion in swing phase and hip extensor moment increased in both lead and trail limbs. In the lead limb, post-obstacle distance and toe clearance also increased (p<0.05). Compared with control groups, the angle of knee flexion, hip extensor and hip flexor moment and pre- and post-obstacle distance decreased significantly in the lead limb of hemiplegic patients (p<0.05). In the trail limb of hemiplegic patients, the angle of hip flexion, hip flexor moment and post-obstacle distance decreased (p<0.05). CONCLUSION: Understanding strategies for adequate control and coordination of the swing limb during crossing obstacles may be the basis for the safe training of obstacle crossing in hemiplegic stroke patients.

Effect of Growth Factors on Hearing Restoration in Deafened Animal Model / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Sensorineural hearing loss is caused by ototoxic drugs, radiation therapy, noise exposure and trauma, etc. They make irreversible changes in cochlear hair cells and degeneration of spiral ganglion neurons. It is known that neurotrophins and other growth factors have an important role in protectingcochlear hair cells and spiral ganglion neurons. We designed this study to analyze the effect of neurotrophins and growth factors delivered to the inner ear of deafened guinea pig. MATERIALS AND METHOD: Healthy 15 guinea pigs with normal Preyer's reflex were chosen, and were made deaf by infusion of kanamycin and ethacrynic acid. Myringotomy was done to both ears, normal saline injected into the left ear, and BDNF (brainderived neurotrophic factor), GDNF (glial cell derived neurotrophic factor), NT-3 (neurotrophin-3), IGF (insulin-like growth factor), EGF (epidermal growth factor), FGF (fibroblast growth factor) were injected in the right ear. RESULTS: Statistically significant hearing gain was obtained up to 35.00+/-13.78 dB in the group 1 (BDNF, GDNF, NT-3 treated group), and up to 34.0+/-5.47 dB in the group 2 (IGF treated group). However, no statistically significant hearing gain was observed in the group 3 (EGF, FGF treated group). CONCLUSION: We observed statistically important improvement of hearing threshold in the BDNF, GDNF, NT-3 treated group and IGF treated group.

Mean Values and Correlations between Rotational Profiles of Bilateral Lower Extremities in Korean Elderly Men

0OBJECTIVE: To investigate the mean values and correlations between the rotational profiles of bilateral lower extremities in Korean elderly men. METHOD: 100 lower extremities were examined for the rotational profiles of bilateral lower extremities with radiographic examination. RESULTS: The mean values of femoral anteversion, axial rotation of the knee joint, proximal and distal tibial torsion, bimalleolar axis (BMA), and Q angle were 8.72degrees, 0.19degrees, 34.53degrees, 26.25degrees, 20.97degrees, 5.65degrees. In Korean elderly men, the result of tibial torsion and Q angle was smaller than the results of other studies, and the bilateral differences were detected in the measured profiles of lower extremities, except axial rotation of the knee joint. However, all profiles represented a positive correlation between right and left lower extremities. The correlation between proximal tibial torsion and BMA had a positive correlation, But the femoral anteversion and tibial torsion had no correlations among the profiles in Korean elderly men. CONCLUSION: We suspected that Korean elderly healthy men have reduced tibial torsion and more genu varus alignment, and the rotational profiles of lower extremities showed side to side difference, but there were symmetrical tendency. It will be helpful in assessing the evaluation, treating, researching of the musculoskeletal problem in Korean elderly people.

Sclerosing Epithelioid Fibrosarcoma of the Kidney / 대한비뇨기과학회지

Sclerosing epithelioid fibrosarcoma(SEF) is an uncommon tumor of the deep soft tissue. It was first described in 1995 by Meis-Kindblom et al. Histologically, this tumor is characterized by uniform, small, round to ovoid epithelioid cells with clear cytoplasm, and the cells are arranged in distinct nests and cords. On immunohistochemistry, the most consistently positive marker is vimentin, although other antigens(cytokeratin, epithelial membrane antigen, S100 protein and neuron specific enolase) have been recorded as being inconsistently positive. We report here on a case of a 46-year-old woman who presented with back pain. The radiologic findings revealed a right renal mass and multiple bone metastases. The patient underwent radical nephrectomy and the pathologic finding was primary SEF of the kidney.

Primary Urethral Adenocarcinoma in a Young Man Who Presented with Voiding Dysfunction / 대한비뇨기과학회지

Primary urethral carcinoma accounts for less than 1% of the malignancies in males and adenocarcinoma accounts for 5% of all urethral carcinomas. A 36-year-old man with a history suggestive of urethral stricture was scheduled to undergo retrograde urethrography and visual urethrotomy. On urethroscopic examination, an abnormal polypoid mass was found in the proximal bulbous urethra, so transurethral resection biopsy was added to the urethrotomy. Histopathologic examination demonstrated urethral adenocarcinoma with no invasion to the corpus spongiosum and cavernosa on the magnetic resonance imaging. There was no evidence of metastasis and the search for the primary focus of adenocarcinoma revealed that the tumor originated from the urethra. The patient underwent segmental urethral resection and there has been no recurrence for 1-year follow-up.