BACKGROUNDS/AIMS: The aim of this study is to clarify the safety and feasibility of laparoscopic hepatectomy, through comparing the early and late periods of perioperative outcomes. METHODS: We retrospectively analyzed 138 patients who underwent laparoscopic hepatectomy from January 2003 to June 2011, at Yeungnam University Hospital. We divided the total patients to early period (from January 2003 to February 2007, n=49) and late period (from March 2007 to June 2011, n=89) groups and compared the perioperative outcomes including the mean operation time, intra-operative blood loss, postoperative hospital stay, intensive care unit (ICU) stay, and duration of liver function test (LFT) normalization. RESULTS: The mean operation time was 308 minutes (range: 140-510) in the early group and 193 minutes (range: 40-350) in the late period group (p<0.001). The mean intraoperative blood loss was 171 ml (range: 50-1,200) in the early and 44 ml (range: 0-400) in the late group (p=0.005). The postoperative hospital stay was 9.7 days (range: 4-31) in the early and 6.8 days (range: 2-9) in the late period (p<0.001). The ICU stay hour was 21.6 hours (range: 0-120) in the early and 2.8 hour (range: 0-24) in the late period (p<0.001). The duration of LFT normalization was 5.7 days (range: 0-39) in the early and 2.1 days (range: 0-20) in the late period (p=0.003). The perioperative outcomes in the late period were better than the early period, which showed a statistically significant difference. CONCLUSIONS: Laparoscopic hepatectomy is feasible and can be safely performed in selected patients but requires a long experience in open liver resection and mastery of laparoscopic surgical skills.
Hepatectomy ; Humans ; Intensive Care Units ; Laparoscopy ; Length of Stay ; Liver ; Liver Function Tests ; Postoperative Hemorrhage ; Retrospective Studies

The goal of this study was to examine the characteristics of the histo- immunological changes following induction of autoimmune prostatic inflammation achieved by subcutaneous allograft injection of the tissue homogenate of mouse ventral prostate. We also investigated the effect of the administration of androgen upon the development of mouse autoimmune prostatitis. Eight week old male C57BL/6 mice were selected and the presence, location and the degree of inflammation were identified after injection. The extent of infiltrations of the inflammatory cells in the prostate following the administration of the exogenous testosterone, the variation of the CD4/CD8 ratio of splenic lymphocyte and the variations of the interleukin-2 and tumor necrosis factor-alpha secreted by the splenic cells were also examined. The autoimmune prostatitis of the mouse induced by subcutaneous allograft injection of the mouse ventral prostate showed histological findings similar to that of human. The degree of induction was in proportion to the amount of tissues injected and showed organ-specificity. Exogenous administration of testosterone resulted in partial inhibitory effect on the induction of inflammation which was thought to be related to the decrease in the CD8+ T lymphocyte count and the functional inhibitory effect of the splenic T lymphocyte on the production of Interleukin- 2. However, tumor necrosis factor-alpha is presumed to be not closely related to the inhibitory effect of the administration of testosterone. In the future, further studies on the variation of cytokine levels and the value of sex hormones within the prostate and, moreover investigations in related to the humoral immune mechanism should be encouraged.
Allografts ; Animals ; Gonadal Steroid Hormones ; Humans ; Inflammation ; Interleukin-2 ; Lymphocyte Count ; Lymphocytes ; Male ; Mice* ; Prostate ; Prostatitis* ; Testosterone* ; Tumor Necrosis Factor-alpha

PURPOSE: The inflammation associated with leukocytospermia and infection has been implicated as a cause of infertility. Inflammatory cells cause subfertility through the effects of chemical mediators or cytokines. The seminal inflammatory cytokines are present in increased quantities if inflammatory white blood cells are present in semen and this increase under removed white blood cells may be related to sperm motility. Impairments in sperm motility reported that were induced by exposure of human sperm to recombinant interferon-gamma although this findings have been debated. We examined the change of parameters of sperm motility after administration of Interferon gamma(IFN-gamma) to sperm to evaluate the effect of cytokine on sperm motility. MATERIALS AND METHODS: Semens from 20 healthy males were obtained. With swim up procedure, sperms with active motility were got and incubated in HAM`s F10 culture media for 24 hours. IFN-gamma 1000ng/ml, 10ng/ml and 0.1ng/ml were administered before incubation, respectively. Parameters of sperm motility such as curvilinear velocity(VCL), average path velocity(VAP), straight line velocity(VSL), lateral head displacement(ALH) and beat cross frequency(BCF) were recorded with Hamilton-Thorne computer semen analysis system before incubation, 5, 7 and 24 hour thereafter. They were expressed as percentage of the value of parameters before incubation. RESULTS: There were statistically significant decreases of VCL, VAP, VSL, BCF in IFN-gamma 1000ng/ml administration after 24 hours. CONCLUSIONS: The administration of IFN-gamma decrease the parameters of sperm motility and the increase of IFN-gamma was presumed to affect sperm motility. It is suggested that seminal IFN-gamma may affect sperm motility.
Culture Media ; Cytokines ; Head ; Humans ; Infertility ; Inflammation ; Interferon-gamma ; Interferons* ; Leukocytes ; Male ; Semen ; Semen Analysis ; Sperm Motility* ; Spermatozoa*

Amyloidosis is a disorder characterized by extracellular deposition of amyloid materials in multiple organs and tissues. Amyloidosis commonly shows a systemic involvement. Gastrointestinal involvement is common in amyloidosis and is usually asymptomatic. The gastrointestinal manifestations include gastroparesis, diarrhea, steatorrhea, constipation, intestinal pseudo-obstruction, and bleeding. The diagnosis of amyloidosis is difficult because there are absence of systemic symptoms and nonspecific endoscopic findings. Asymptomatic multiple myeloma is an asymptomatic plasma-cell proliferative disorder associated with a high risk of progression to symptomatic multiple myeloma or amyloidosis. Recently, we experienced a 60-year-old man who presented with hematochezia and weight loss as manifestations of gastrointestinal amyloidosis involving the stomach and the colon induced in asymptomatic multiple myeloma confirmed by endoscopic biopsies and bone marrow biopsy. We report a case with a review of the literature.
Amyloid ; Amyloidosis ; Biopsy ; Bone Marrow ; Colon ; Constipation ; Diarrhea ; Gastrointestinal Hemorrhage ; Gastroparesis ; Hemorrhage ; Humans ; Intestinal Pseudo-Obstruction ; Middle Aged ; Multiple Myeloma ; Steatorrhea ; Stomach ; Weight Loss

Amyloidosis is a disorder characterized by extracellular deposition of amyloid materials in multiple organs and tissues. Amyloidosis commonly shows a systemic involvement. Gastrointestinal involvement is common in amyloidosis and is usually asymptomatic. The gastrointestinal manifestations include gastroparesis, diarrhea, steatorrhea, constipation, intestinal pseudo-obstruction, and bleeding. The diagnosis of amyloidosis is difficult because there are absence of systemic symptoms and nonspecific endoscopic findings. Asymptomatic multiple myeloma is an asymptomatic plasma-cell proliferative disorder associated with a high risk of progression to symptomatic multiple myeloma or amyloidosis. Recently, we experienced a 60-year-old man who presented with hematochezia and weight loss as manifestations of gastrointestinal amyloidosis involving the stomach and the colon induced in asymptomatic multiple myeloma confirmed by endoscopic biopsies and bone marrow biopsy. We report a case with a review of the literature.
Amyloid ; Amyloidosis ; Biopsy ; Bone Marrow ; Colon ; Constipation ; Diarrhea ; Gastrointestinal Hemorrhage ; Gastroparesis ; Hemorrhage ; Humans ; Intestinal Pseudo-Obstruction ; Middle Aged ; Multiple Myeloma ; Steatorrhea ; Stomach ; Weight Loss

BACKGROUND: This study evaluated the effects of family type and sociodemographic factors on medical treatment, health behavior, and subjective health status in Koreans 60 years and older. METHODS: This study was based on data from the 5th Korea National Health and Nutrition Examination Survey (KNHANES), a nationwide health interview survey using a rolling sampling design involving complex, stratified, multistage, probability cluster. Our subjects included those > or =60 years of age (n=1,946) participating in the KNHANES 2010. Family type was categorized into 7 groups according to cohabitation: alone, couple cohabitation (living with a spouse), parent(s) cohabitation (couple living with parent(s)), offspring cohabitation (no spouse, living with offspring), couple offspring cohabitation (couple living with offspring), couple offspring parents cohabitation (couple living with parent(s) and offspring), and others. Logistic regression analyses were used to examine the association of family type and sociodemographic factors with health care. RESULTS: The most common family type was couple cohabitation (38.26+/-1.8%). In this group, the percentage of non-receipt of needed medical care (odds ratio [OR], 0.60; 95% confidence interval [CI], 0.42 to 0.87) and current smoking rate (OR, 0.32; 95% CI, 0.20 to 0.50) were significantly lower than those living alone. Among the sociodemographic charicteristics, male gender, apartment dwelling, high middle household income, 2 member family, education higher than middle school, and possessing own house were associated with good health care behavior. CONCLUSION: This study shows that couples have better health care behavior than other family types, in particular, limited smoking, appropriate medical treatment, and positive subjective health status. Those living alone visit medical clinics less often and have a negative subjective health status.
Delivery of Health Care ; Family Characteristics ; Health Behavior ; Humans ; Korea ; Logistic Models ; Male ; Nutrition Surveys ; Parents ; Smoke ; Smoking ; Spouses

Onycholysis is defined as a distal or distal lateral separation of the nail plate from the underlying or lateral supporting structures including nail bed, hyponychium, and lateral nail fold. Trauma, infection, psoriasis, thyrotoxicosis, and numerous drugs are common causes of onycholysis. However, there are few specific data on nail findings in Behcet's disease (BD). In this paper, we report on a 60-year-old man with BD, with no past history except BD, who developed recurrent onycholysis. The symptoms of onycholysis are considered to be recurrent depending on the activity of BD. The nail lesion showed improvement after classic treatment of BD and topical steroid ointment.
Humans ; Middle Aged ; Onycholysis* ; Psoriasis ; Thyrotoxicosis

In accidental or suicidal methanol ingestion, bilateral necrosis of the putamen and hemispheric white matter lesions are the most common findings on CT and MRI. There are a few reports that have demonstrated abnormal CT findings in methanol intoxication, however, to our knowledge, contrast enhancement of these lesions have not been reported in Korea. We report the case of a 36-year-old male who had a brain MRI performed 3 weeks after accidental methanol intoxication. T2 weighted MRI showed bilateral symmetrical high signal lesions in the frontal lobe and basal ganglia with hemorrhaegic necrosis. A postcontrast MRI demonstrated multifocal enhancing lesions in both frontal lobes, right temporal lobe, both basal ganglias and both cerebellar hemispheres. We suggest that the characteristic brain MRI finding and careful history taking are helpful in diagnosis of methanol intoxication.
Adult ; Basal Ganglia ; Brain* ; Diagnosis ; Eating ; Frontal Lobe ; Humans ; Korea ; Magnetic Resonance Imaging* ; Male ; Methanol* ; Necrosis ; Putamen ; Temporal Lobe

PURPOSE: Inflammatory white blood cells are related to semen quality, affection fertility. In these cases, inflammatory cytokines are present in increased quantities, and this increase may be related to sperm motility. We examined changes in measures of motility after administration of cytokines to sperm in vitro. MATERIALS AND METHODS: Semen from 30 healthy men were obtained. With the swim-up procedure, actively motile sperm were isolated and incubated in Ham's F10 culture medium. Interleukin(IL)-1 alpha(10ng/mL) was added, and measures of sperm motility were examined ater 5 and 24 hours using the Hamilton-Thorne computer semen analysis system. These measures were expressed as a percentage of the values before incubation. RESULTS: The decreases of the average path velocity (VAP) in the IL-1 alpha-treated and IL-8treated specimens after 24 hours are statistically significant. None of the decrease in values for straight-line velocity (VSL) is statistically significant. There were statistically significant decreases in the curvilinear velocity (VCL)in IL-6-treated and TNF-1 alpha-treated specimens after 24 hours. None of the changes in the lateral head displacement (ALH)or the beat cross frequency (BCF)was statistically significant. CONCLUSION: The administration of cytokines decreases sperm motility in vitro. It is suggested that seminal cytokines may affect sperm motility in vivo.
Cytokines* ; Fertility ; Head ; Humans* ; Interleukin-1 ; Leukocytes ; Male ; Semen ; Semen Analysis ; Sperm Motility* ; Spermatozoa*

PURPOSE: Inflammatory white blood cells are related to semen quality, affection fertility. In these cases, inflammatory cytokines are present in increased quantities, and this increase may be related to sperm motility. We examined changes in measures of motility after administration of cytokines to sperm in vitro. MATERIALS AND METHODS: Semen from 30 healthy men were obtained. With the swim-up procedure, actively motile sperm were isolated and incubated in Ham's F10 culture medium. Interleukin(IL)-1 alpha(10ng/mL) was added, and measures of sperm motility were examined ater 5 and 24 hours using the Hamilton-Thorne computer semen analysis system. These measures were expressed as a percentage of the values before incubation. RESULTS: The decreases of the average path velocity (VAP) in the IL-1 alpha-treated and IL-8treated specimens after 24 hours are statistically significant. None of the decrease in values for straight-line velocity (VSL) is statistically significant. There were statistically significant decreases in the curvilinear velocity (VCL)in IL-6-treated and TNF-1 alpha-treated specimens after 24 hours. None of the changes in the lateral head displacement (ALH)or the beat cross frequency (BCF)was statistically significant. CONCLUSION: The administration of cytokines decreases sperm motility in vitro. It is suggested that seminal cytokines may affect sperm motility in vivo.
Cytokines* ; Fertility ; Head ; Humans* ; Interleukin-1 ; Leukocytes ; Male ; Semen ; Semen Analysis ; Sperm Motility* ; Spermatozoa*