PURPOSE: We performed laparoendoscopic single-site (LESS) partial nephrectomy in a porcine model with the objectives of overcoming the technical challenges of this surgery and exploring its feasibility. MATERIALS AND METHODS: Six partial nephrectomies were performed on a pig aged 5 months, three cases on each kidney, by four surgeons: two urologists with much experience in laparoscopic surgery (E1, E2) and two less-experienced urologists (B1, B2). While under general anesthesia, the swine was placed in a lateral flank position. Umbilical placement of an Octoport was done with a 2.5 cm incision. After dissection of the renal hilum and Gerota's fascia, a bulldog clamp was applied on the renal artery and parenchymal resection was done. Renorrhaphy was then performed with interrupted sutures with the use of a sliding knot technique. RESULTS: All six partial nephrectomies were performed successfully after repair of the vascular and collecting system at the resection margin and renorrhaphy without the need to introduce any additional ports. There were no noticeable intra- or postoperative complications. The mean warm ischemic time was 42 minutes (range, 30-60 minutes). The shortest warm ischemic time, 30 minutes, was achieved by using the early unclamping technique during renorrhaphy. The longest warm ischemic time was 60 minutes. The average number of renorrhaphy stitches was 3.2 (range, 2-5). CONCLUSIONS: LESS partial nephrectomy was successfully performed in a porcine model but resulted in a longer ischemic time than that of conventional laparoscopic surgeries. Therefore, further laboratory disciplinary efforts are needed to decrease the warm ischemic time and to improve this surgical technique.
Aged ; Anesthesia, General ; Fascia ; Humans ; Kidney ; Kidney Neoplasms ; Laparoscopy ; Nephrectomy ; Postoperative Complications ; Renal Artery ; Sutures ; Swine ; Warm Ischemia

Purpose: Gastric subepithelial tumor (GST) is a disease entity that includes all gastric subepithelial lesions. The oncologically safe surgical technique is complete resection with adequate resection margins. Most of the studies about laparoscopic gastric wedge rsection (LGWR) in GST focus on oncologic curability or surgical effectiveness. However, studies on the factors associated with the operation time are rare. Therefore, this study was conducted to analyze and compare the factors associated with the operation time of LGWR. Methods: From 2010 to 2019, 145 consecutive patients undergoing LGWR were reviewed retrospectively. Clinical characteristics of GST and operation time were analyzed and compared. Results: A total of 145 patients was enrolled and reviewed. There were 59 males (40.7%) and 86 females (59.3%) with a mean age of 53.6 years and mean body mass index (BMI) of 23.9 kg/m 2 . Mean tumor size was 2.9 cm and mean operation time was 66.0 minutes. In statistically, the mean operation time showed significant association with tumor size, BMI, longitudinal tumor location and tumor location between lesser and greater curvature. In multivariate analysis, tumor size, BMI and longitudinal classification of tumor location are statistically significant. Conclusion A shorter operation time is expected when there is a small tumor, low BMI and mid portion of the stomach GST. Preoperative evaluation for tumor size and body weight is important. In patients with large GST, obesity and both end stomach GST, we think that pre-operative preparation for long operation time should be considered.

We investigate the resistance of Cryptosporidium (C.) parvum oocysts to commercial bleach treatment. The viability and infectivity of C. parvum oocysts suspended in 100, 50, 25, 12.5, 6.3 or 3.2% aqueous commercial bleach for 10, 30, 60, 120 or 180 min at room temperature were assessed by nucleic acid Syto-9 staining, histologic examination of ileum and infectivity to immunosuppressed neonatal C57BL/6N mice. Although the viability was decreased compared with normal oocysts, all oocysts in contact with serially diluted commercial bleach for 180 min were alive by nucleic acid dye Syto-9 staining. And, microscopic examination of ileum sections revealed developmental stages of C. parvum in all mice. The oocyst shedding patterns between mice infected with oocysts contacted with commercial bleach and normal control mice were not significantly different each other. Although commercial bleach is widely used as a bacterial and viral disinfectant, the present findings indicate that it is not an effective disinfectant for C. parvum oocysts under practical conditions. Authors conclude that, therefore, it is undesirable to recommend commercial bleach as a disinfectant for C. parvum oocysts.
Animals ; Cryptosporidium ; Cryptosporidium parvum ; Ileum ; Mice ; Oocysts ; Organic Chemicals ; Sodium Hypochlorite

A nematode species belonging to the genus Cosmocephalus was collected from the stomach of 2 common gulls, Larus canus. The common gulls were found dead on the seaside of Gangneung City, the Republic of Korea. The worms were identified and classified by light (LM) and scanning electron microscopy (SEM) on the basis of important taxonomic characters. The nematodes were characterized by a body length 9.1-9.3 mm (males) and 15.5-15.9 mm (females) and cordons recurrent in anterior direction and anastomosing laterally at about the level of anterior quarter of the buccal cavity. The salient bicuspid deirids were located on the posterior to the cordons. Lateral alae were well-developed, extending from the level just posterior of deirids to the level about middle of the body. LM and SEM observations identified the worms as C. obvelatus. This is the first reported case of C. obvelatus infection in common gulls in Korea.
Animals ; Charadriiformes/*parasitology ; Female ; Male ; Microscopy ; Republic of Korea ; Spirurida/anatomy & histology/*isolation & purification ; Spirurida Infections/parasitology/*veterinary

A nematode species belonging to the genus Cosmocephalus was collected from the stomach of 2 common gulls, Larus canus. The common gulls were found dead on the seaside of Gangneung City, the Republic of Korea. The worms were identified and classified by light (LM) and scanning electron microscopy (SEM) on the basis of important taxonomic characters. The nematodes were characterized by a body length 9.1-9.3 mm (males) and 15.5-15.9 mm (females) and cordons recurrent in anterior direction and anastomosing laterally at about the level of anterior quarter of the buccal cavity. The salient bicuspid deirids were located on the posterior to the cordons. Lateral alae were well-developed, extending from the level just posterior of deirids to the level about middle of the body. LM and SEM observations identified the worms as C. obvelatus. This is the first reported case of C. obvelatus infection in common gulls in Korea.
Animals ; Charadriiformes/*parasitology ; Female ; Male ; Microscopy ; Republic of Korea ; Spirurida/anatomy & histology/*isolation & purification ; Spirurida Infections/parasitology/*veterinary

BACKGROUND: Carotid artery intima-media thickness (IMT) is an early structural marker of the atherosclerotic process and an elevated total homocysteine level is an early biochemical marker of atherosclerosis. But there are few reports about serum homocysteine level and carotid IMT between ischemic stroke, hypertensive intracerebral hemorrhage (HICH) and control group. METHOD: We studied about 173 patients with ischemic stroke, HICH and control group. Carotid IMT was defined as the mean of IMT measured by B-mode ultrasonography. Serum homocysteine level was measured by fluorescence polarization immunoassay method in fasting state. We compared serum homocysteine level and carotid IMT between ischemic stroke, HICH and control group. In statistics, One-Way ANOVA was used. RESULTS: A significant increase in carotid IMT was noted in ischemic stroke and HICH compared with that in the control group (p<0.05), whereas there was no significant differences in carotid IMT between ischemic stroke and HICH. The serum homocysteine level of ischemic stroke was significantly higher than that of control group (p<0.05). But there were no significant differences between HICH and control group, HICH and ischemic stroke. CONCLUSIONS: In our study, we thought a carotid IMT of ischemic stroke, HICH and serum homocysteine level in ischemic stroke can be used as early diagnostic marker. Therefore, our results address the need of further prospective clinical studies in patients with ischemic stroke and HICH in order to evaluate a possible diagnostic ability of carotid IMT and serum homocysteine level.
Atherosclerosis ; Biomarkers ; Carotid Arteries ; Carotid Intima-Media Thickness* ; Cerebral Hemorrhage ; Fasting ; Fluorescence Polarization Immunoassay ; Homocysteine* ; Humans ; Intracranial Hemorrhage, Hypertensive* ; Stroke* ; Ultrasonography

Injuries from sea urchins are induced by from penetration of the calcareous spines into the skin. Apart from the transient episode of excruciating pain, there is usually no residual disability. Complications arise, however, when spines are embedded over bony prominences, or within joints. Two cases are reported with injury and protracted disability of fingers resulting from contact with the purple sea urchin, Anthocidaris crassispina, a common echinoderm inhabitant of the Korean east coast. After a latent period of several months in both cases, Case 1 presented as caseating granulomas in the synovium and case 2 exhibited as the usual soft tissue nonsynovial foreign body and noncaseating granulomas. There appears to be a paucity of published data regarding the effects of puncture wounds caused by the spines of this animal. The granulomas have appeared after a latent interval of several months in a proportion of the sufferers, suggests a delayed hyperserisitivity reaction similar to that produced by Mycobacterium species.
Animals ; Anthocidaris ; Bites and Stings* ; Fingers ; Foreign Bodies ; Granuloma ; Hand* ; Hypersensitivity, Delayed ; Inflammation* ; Joints ; Mycobacterium ; Punctures ; Sea Urchins* ; Skin ; Spine ; Strongylocentrotus purpuratus ; Synovial Membrane ; Wounds and Injuries

A variety of anesthetic equipment has been introduced for one-lung ventilation (OLV) during video-assisted thoracoscopic surgeries. A double-lumen endobronchial tube or bronchial blockers are the most common techniques used for achieving OLV. We herein describe a case of general anesthesia requiring both the OLV and two-lung ventilation with a Coopdech bronchial blocker and a single-lumen endotracheal tube. A 43-year-old woman is being scheduled to undertake mediastinal mass removal and tonsillectomy. After performing tonsillectomy by using an endotracheal tube, a Coopdech bronchial blocker is being inserted into her right bronchus for video-assisted thoracoscopic surgery. After her surgery, we have encountered resistance while carefully trying to remove the bronchial blocker. When using fiberoptic bronchoscopy, we have observed that the cuff was being avulsed, which could be removed without difficulty. We thus describe a case in which the balloon cuff was detached and retained in the right bronchus.
Adult ; Anesthesia, General ; Bronchi ; Bronchoscopy ; Female ; Humans ; One-Lung Ventilation* ; Thoracic Surgery, Video-Assisted ; Tonsillectomy ; Ventilation

OBJECTIVE: Post-traumatic cerebral infarction (PTCI) is one of the most severe secondary insults after traumatic brain injury (TBI), and is known to be associated with poor outcome and high mortality rate. We assessed the practical incidence and risk factors for the development of PTCI. METHODS: We conducted retrospective study on 986 consecutive patients with TBI from the period May 2005 to November 2012 at our institution. The definition of PTCI was made on non-enhanced CT scan based on a well-demarcated or fairly discernible region of low attenuation following specific vascular territory with normal initial CT. Clinical and radiological findings that related to patients' outcome were reviewed and statistically compared. RESULTS: PTCI was observed in 21 (2.1%) patients. Of various parameters, age (p=0.037), initial Glasgow coma scale score (p<0.01), brain herniation (p=0.044), and decompressive craniectomy (p=0.012) were significantly higher in patients with PTCI than patients who do not have PTCI. Duration between accident and PTCI, patterns of TBI and vascular territory of PTCI were not specific. The mortality rates were significantly higher in patients with PTCI than without PTCI. CONCLUSION: The development of PTCI is rare after TBI, but it usually results in serious outcome and high mortality. Early recognition for risks and aggressive managements is mandatory to prevent PTCI.
Brain ; Brain Injuries* ; Cerebral Infarction* ; Craniocerebral Trauma ; Decompressive Craniectomy ; Glasgow Coma Scale ; Hernia ; Humans ; Incidence* ; Mortality ; Retrospective Studies ; Risk Factors* ; Tomography, X-Ray Computed

Cases showing memory disturbances with isolated retrograde memory without any definitive brain lesions are classified as dissociative amnesia. Improvements in imaging techniques have allowed the organic causes of this disease to be identified in several recent cases. Several studies have diagnosed cases of memory disorders as pure retrograde amnesia (PRA). The patient reported here had no psychiatric disorder and had normal MRI results, but showed hypometabolism in PET that met the criteria for PRA.
Amnesia ; Amnesia, Retrograde ; Brain ; Humans ; Memory ; Memory Disorders