Use of the rigid ureteroscope has become widely accepted for the removal of ureteral calculi. We evaluated retrospectively the experience with rigid ureteroscopy from March 1992 to February 1993. We performed 68 ureteroscopies for the removal of stone in 67 patients, overall success rate was 86,8%. 52 stones were treated with sedatives only and l6 stones under the anesthesia. The success rates were 86.5% ( 45/52) and 87.5% (l4/l6) each. We failed to remove ureteral stones in 9 case, the failure of ureteroscope introduction was the most common cause of failure. The most common complication was the ureteral mucosal trauma, that was treated by indwelling of ureteral stent. We conclude that ureteroscopy may be an effective and useful procedure for the treatment of 1ower ureter stone (smaller than 10mm in size) under non-anesthesia.
Anesthesia* ; Humans ; Hypnotics and Sedatives ; Retrospective Studies ; Stents ; Ureter* ; Ureteral Calculi ; Ureteroscopes ; Ureteroscopy

Femoral neuropathy may be associated with various etiologies and can cause severe walking disability. We present the case of a 25-year-old woman who underwent surgical repair for a patella fracture and complained of lower extremity pain, paresthesia, and weakness postoperatively. Electromyography and magnetic resonance imaging (MRI) revealed partial peripheral neuropathy of the left femoral nerve associated with the patella fracture. To our knowledge, this is the first reported case of femoral neuropathy associated with a patella fracture.
Adult ; Electromyography ; Female ; Femoral Nerve ; Femoral Neuropathy ; Humans ; Lower Extremity ; Magnetic Resonance Imaging ; Muscle Weakness ; Paralysis ; Paresthesia ; Patella ; Peripheral Nervous System Diseases ; Walking

Purpose: We report on the 10-year clinical hip function and radiologic outcomes of patients who underwent hip arthroplasty using a COREN stem. Materials and Methods: A consecutive series of 224 primary cementless hip arthroplasty implantations were performed using a COREN stem between 2009 and 2011; among these, evaluation of 128 hips was performed during a minimum follow-up period of 10 years. The mean age of patients was 65.4 years (range, 40-82 years) and the mean duration of follow-up was 10.8 years (range, 10-12 years). Evaluation of clinical hip function and radiologic implant outcomes was performed according to clinical score, thigh pain, and radiologic analysis. Results: Dramatic improvement of the mean Harris hip score (HHS) from 59.4 preoperatively to 93.5 was observed at the final follow-up (P≤0.01). Stable fixation was demonstrated for all implants with no change in position except for one case of Vancouver type B2 periprosthetic femur fracture. A radiolucent line (RLL) was observed in 16 hips (12.5%). Thigh pain was observed in only two hips (1.6%) at the final follow-up. There were no cases of osteolysis around the stem. The survival rate for the COREN stem was 97.7%. Conclusion Good long-term survival with excellent clinical and radiological outcomes can be achieved using the COREN femoral stem regardless of Dorr type.

Papillary renal cell carcinoma is a histological variant that may be cystic in appearance. This variety has been termed cystadenocarcinoma to distinguish it from a renal cell carcinoma that has been rendered cystic through necrosis and hemorrhage. Because a greater proportion presented as stage I lesion, papillary renal cell carcinoma has been reported to have a better prognosis than renal cell carcinoma in general. We report a case of cystadenocarcinoma of the kidney that was confirmed by surgical exploration.
Carcinoma, Renal Cell ; Cystadenocarcinoma* ; Hemorrhage ; Kidney* ; Necrosis ; Prognosis

PURPOSE: Deep infection after hip and knee arthroplasty is a serious complication and is difficult to treat due to its toxicity. The aims of our study were to find out the differences of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive Staphylococcus aureus (MSSA) infection after hip and knee arthroplasty focusing on clinical course and laboratory findings. MATERIALS AND METHODS: We retrospectively reviewed 61 staphylococcal infection cases after hip and knee arthroplasty (MSSA in 25 patients, MRSA in 36 patients). Vital signs, laboratory tests, microbiology and clinical courses were analyzed. The average follow-up period was 3.8 years (range, 2 to 10.1 years). RESULTS: At initial visit, MRSA group showed significant higher erythrocyte sedimentation rate, C-reactive protein (CRP) and neutrophil percentage. The average duration for the normalization of CRP was longer in MRSA group (MRSA: 36.7+/-25.1 days, MSSA: 24.7+/-13.6 days; P=0.008). The mean interval between staging operation was longer in MRSA group (MRSA: mean 8.7 weeks [range, 6.4 to 21.4 weeks], MSSA: mean 6.8 weeks [range, 6 to 13.1 weeks]; P=0.012). MRSA group (13.9%) revealed higher recurrence rate than MSSA group (4%). Two patients (5.6%) from MRSA group expired by sepsis. One limb amputation (2.7%) was carried out in MRSA group. CONCLUSION: MRSA infection after arthroplasty showed more toxic serologic parameter and poorer prognosis. Aggressive treatment should be considered for MRSA infection following arthroplasty.
Amputation ; Arthroplasty ; Blood Sedimentation ; C-Reactive Protein ; Drug Resistance, Microbial ; Extremities ; Follow-Up Studies ; Hip* ; Humans ; Knee* ; Methicillin-Resistant Staphylococcus aureus* ; Neutrophils ; Prognosis ; Recurrence ; Retrospective Studies ; Sepsis ; Staphylococcal Infections ; Staphylococcus aureus ; Vancomycin ; Vital Signs

PURPOSE: To identify the effect of insufficient lymph node dissection (LND) on the survival of patients with pT2 gastric cancer. MATERIALS AND METHODS: A total of 340 patients (120 patients with insufficient LND and others with D2 LND) who underwent gastrectomy for pT2 gastric cancer between January 2008 and December 2010 were included. RESULTS: The incidence of preoperatively diagnosed early gastric cancer was higher and there were fewer metastatic lymph nodes (LNs) in the insufficient LND group than the D2 group, but there was no survival difference between two groups (p=0.365). Among the 89 patients with metastatic LNs after D2 LND, 13 patients (14.6%) had metastatic LNs at selected N2 stations (#10, 11, or 12a), but none of these patients were in the pN1 category. One patient had five metastatic LNs at station #11p with no metastatic LNs at any other stations. The number of metastatic LNs was identified as the only risk factor for LN metastasis at selected N2 stations by logistic regression. CONCLUSION: If a patient has pN0 or pN1 category after insufficient LND for pT2 gastric cancer, the surgery can be regarded as secure. However, for patients with pN2 or pN3 category, more careful examination is required.
Aged ; Female ; Gastrectomy ; Humans ; Lymph Node Excision/*methods ; Male ; Middle Aged ; Stomach Neoplasms/*diagnosis/*surgery

PURPOSE: To analyze the clinical result of a conventional reconstruction plate (CRP) fixation and locking compressive plate (LCP) fixation on the surgical treatment of an adult's displaced intercondylar fracture of humerus. MATERIALS AND METHODS: A total of 40 patients enrolled in the study were treated between August 2002 and May 2012. Fixation with a CRP was performed in 20 patients (group A) and anatomical locking compression plate fixation was performed in 20 patients (group B). The clinical and functional evaluation was performed according to the Mayo elbow performance score and Cassebaum classification of elbow range of motion (ROM), disabilities of the arm, shoulder and hand score. RESULTS: The Mayo elbow functional evaluation scores, eight cases were excellent, 10 cases were good, and two cases were fair in group A, and 12 cases were excellent, seven cases good, and one case fair in group B; both groups showed satisfactory results. The durations of attaining 90 to 120 degrees of the ROM of joints postoperatively were 8.3 days on average (6 to 15 days) in group A and 5.5 days on average (5 to 9 days) in group B, demonstrating a significant difference between the two groups (p=0.04). Although the correlations of clinical results according to the difference of bone mineral densities (BMDs) were not statistically significant between the two groups (p=0.35), loss of fixation occurred due to loosening of screws in two patients with low BMDs in whose operations reconstruction plates were used. CONCLUSION: The use of locking compressive plate on the surgical treatment of an diaplaced intercondylar fracture of humerus have a good clinical results because that permits early rehabilitation through good fixation and reduces the complications such as loosening of screws.
Arm ; Bone Density ; Bone Plates ; Classification ; Elbow ; Fracture Fixation, Internal ; Hand ; Humans ; Humeral Fractures ; Humerus* ; Intra-Articular Fractures ; Joints ; Osteotomy ; Range of Motion, Articular ; Rehabilitation ; Retrospective Studies* ; Shoulder

PURPOSE: The purpose of this study was to analyze the clinical effectiveness of open reduction in the treatment of distal humeral fracture using a newly designed combined approach of anterolateral and lateral approaches to protect the radial nerve. MATERIALS AND METHODS: We investigated 24 consecutive cases of distal humeral fracture who received open reduction and internal fixation with a plate and screws with a minimum follow-up period of 1 year. We analyzed the patients' age, sex, fracture pattern, timing of the union, range of motion of the elbow joint, and complications. The Mayo elbow performance index (MEPI) was employed for the assessment of elbow joint function. RESULTS: Clinical union was observed at 10.8 weeks (6~20 weeks) on average. Pre-operatively, there were 3 cases of incomplete radial nerve palsy. All of the cases recovered, and there was no additional radial nerve palsy due to surgery. According to the MEPI, 13 cases were "excellent" and 10 cases were "good" or better, comprising 95.83% of the cases. The range of motion at the elbow was 5.5 degrees (0~15 degrees) of extension, and 131.5 degrees (120~145 degrees) of flexion, suggesting no functional disability. The duration of return to work was 11.2 weeks (5~32 weeks) on average. There were no nonunion, malunion, or infection complications. CONCLUSION: The combined anterolateral and lateral approach we designed is a clinically effective approach due to facilitation of protection of the radial nerve and attainment of adequate fixation space.
Elbow ; Elbow Joint ; Follow-Up Studies ; Humeral Fractures ; Humerus ; Paralysis ; Radial Nerve ; Range of Motion, Articular ; Return to Work

BACKGROUND: Postoperative infection occurs when bone graft material is dislodged into the maxillary sinus cavity and most of the patients are often uncomfortable with the drainage and irrigation procedures to eradicate the infection. In this case report, we share a technique in treating patients with such condition. MATERIAL AND METHODS: A 47-year-old patient was referred after sinus elevation using the crestal socket osteotome, bone graft, and implant insertion at a local clinic. Clinical and radiographic findings confirmed the diagnosis of right maxillary sinusitis. A surgical and medical treatment regimen was applied. RESULTS: By using this technique for irrigation, we were able to achieve successful results, and the patient was satisfied due to less discomfort during the irrigation process. CONCLUSION: This method is a patient-friendly technique for sinus irrigation. It is not only limited to sinus grafted patients, but also maxillary sinusitis patients in any other type of odontogenic infection.
Diagnosis ; Drainage ; Humans ; Maxillary Sinus* ; Maxillary Sinusitis* ; Methods ; Middle Aged ; Transplants*

BACKGROUND: Due to the anatomical nature of the radial nerve, dissection and attainment of an adequate operative field in mid to distal humerus fracture is dangerous and limited. We devised a combined anterolateral and lateral approach that ensures protection of the radial nerve. This is achieved by performing bimodal dissection of the proximal humerus anteriorly and the distal humerus laterally. METHODS: Thirty-five consecutive patients were treated using a combined anterolateral and lateral approach for a minimum follow-up period of 24 months. We analyzed time to bony union, time to return to daily work, range of motion, elbow joint function as assessed by the Mayo elbow performance index and complications. RESULTS: Radiologic bony union was observed at 11.2 weeks (range, 8 to 20 weeks) on average. Four cases of incomplete radial nerve palsy before surgery all recovered. Time to return to work was 10.2 weeks (range, 2 to 32 weeks) on average. The average range of motion of the elbow was 3.3degrees (range, 0degrees to 10degrees) of extension and 135.9degrees (range, 125degrees to 145degrees) of flexion. There were 21 cases of excellent and 13 cases of good or better recovery, comprising over 97.1% on the Mayo elbow performance index. There were no complications of radial nerve palsy, non-union, mal-union, or infection. CONCLUSIONS: Our a modified combined anterolateral and lateral approach is a clinically effective surgical method of achieving protection of the radial nerve and securing easy and firm internal fixation.
Adolescent ; Adult ; Aged ; Female ; Humans ; Humeral Fractures/radiography/*surgery ; Male ; Middle Aged ; Orthopedic Fixation Devices ; Orthopedic Procedures/adverse effects/instrumentation/*methods ; Pain, Postoperative ; Prospective Studies ; Range of Motion, Articular ; Return to Work ; Treatment Outcome