No abstract available.

"Big Incision, Big Surgeon !!" At the beginning of surgery, excellence was associated with big incisions and rapidity of the operation because of the anesthesia. But, nowadays there has been a big change after the development of laparoscopic surgery. It is not a discipline unto itself, but more a philosophy of surgery, a way of thinking. " Small Incision, Best Surgeon!!" So-called Minimally invasive surgery (MIS) is a means of performing major operations through small incisions, often using miniaturized, high-tech imaging systems, to minimize the trauma of surgical exposure. Laparoscopic cholecystectomy became the stepping stone of the present status of MIS and is opening the dawn of the least invasive and eventually to non-invasive surgery, for exemple, Natural Orifice Transluminal Endoscopic Surgery (NOTES). I review the history of laparoscopic cholecystectomy cholecystectomy and introduce what procedures the surgeons are performing in the field of hepatopancreato biliary diseases.
Anesthesia ; Cholecystectomy ; Cholecystectomy, Laparoscopic ; Laparoscopy ; Natural Orifice Endoscopic Surgery ; Philosophy ; Thinking

Kimura's disease is a rare benign disease characterized by subcutaneous or dermal tumors occurring predominantly on the head and the neck. It usually occurs in young adults without constitutional symptoms, except for peripheral blood eosinophilia. The histopathologic features of the tumor are characterized by dense lymphoid aggregates containing a prominent germinal center and by the proliferation of endothelial cells associated with varying degrees of lymphocytic, histiocytic, and eosinophilic infiltration. We report a case of Kimura's disease without peripheral blood eosinophilia in a 24-year-old male who had had a painless and slowly growing tumor-like swelling on his right groin for one year. The mass was excised, and the specimen was confirmed as Kimura's disease. After surgical excision, the lesion recurred, so 30 mg of oral prednisone was given daily for one month and then decreased gradually for another one month. Now, the lesion is completely healed.
Endothelial Cells ; Eosinophilia ; Eosinophils ; Germinal Center ; Groin* ; Head ; Humans ; Male ; Neck ; Prednisone ; Young Adult

The progress of transplantation has been propelled forward by animal experiments.Animal models have not only provided opportunities to understand complex immune mechanisms in transplantation but also served as a platform to assess therapeutic interventions. While small animals have been instrumental in uncovering new therapeutic concepts related to immunosuppression and immune tolerance, the progression to human trials has largely been driven by studies in large animals. Recent research has begun to explore the potential of porcine organs to address the shortage of available organs. The consistent progress in transplant immunology research can be attributed to a thorough understanding of animal models. This review provides a comprehensive overview of the available animal models, detailing their modifications, strengths, and weaknesses, as well as their historical applications, to aid researchers in selecting the most suitable model for their specific research needs.

The progress of transplantation has been propelled forward by animal experiments.Animal models have not only provided opportunities to understand complex immune mechanisms in transplantation but also served as a platform to assess therapeutic interventions. While small animals have been instrumental in uncovering new therapeutic concepts related to immunosuppression and immune tolerance, the progression to human trials has largely been driven by studies in large animals. Recent research has begun to explore the potential of porcine organs to address the shortage of available organs. The consistent progress in transplant immunology research can be attributed to a thorough understanding of animal models. This review provides a comprehensive overview of the available animal models, detailing their modifications, strengths, and weaknesses, as well as their historical applications, to aid researchers in selecting the most suitable model for their specific research needs.

The progress of transplantation has been propelled forward by animal experiments.Animal models have not only provided opportunities to understand complex immune mechanisms in transplantation but also served as a platform to assess therapeutic interventions. While small animals have been instrumental in uncovering new therapeutic concepts related to immunosuppression and immune tolerance, the progression to human trials has largely been driven by studies in large animals. Recent research has begun to explore the potential of porcine organs to address the shortage of available organs. The consistent progress in transplant immunology research can be attributed to a thorough understanding of animal models. This review provides a comprehensive overview of the available animal models, detailing their modifications, strengths, and weaknesses, as well as their historical applications, to aid researchers in selecting the most suitable model for their specific research needs.

The progress of transplantation has been propelled forward by animal experiments.Animal models have not only provided opportunities to understand complex immune mechanisms in transplantation but also served as a platform to assess therapeutic interventions. While small animals have been instrumental in uncovering new therapeutic concepts related to immunosuppression and immune tolerance, the progression to human trials has largely been driven by studies in large animals. Recent research has begun to explore the potential of porcine organs to address the shortage of available organs. The consistent progress in transplant immunology research can be attributed to a thorough understanding of animal models. This review provides a comprehensive overview of the available animal models, detailing their modifications, strengths, and weaknesses, as well as their historical applications, to aid researchers in selecting the most suitable model for their specific research needs.

PURPOSE: The laparoscopic adrenalectomy (LA) has become the preferred procedure for adrenal tumors since it has many advantages; a more rapid and comfortable recovery, shorted hospitalization, and fewer complications. The purpose of this study was to report the initial 4 years experiences of LA and describe the unusual findings encountered during the operations. METHODS: From February 1997 to November 2000, a total of 20 LA were performed. Several techniques of LA have been described already. We prefer the transabdominal approach in the lateral decubitus position using 3 or 4 trocars. RESULTS: 20 patients had all unilateral tumor. The pathological findings were 11 aldosteronomas, 6 Cushing adenomas, 2 pheochromocytomas and 1 cortical carcinoma. 18 cases of 20 patients were successfully operated by laparoscopic procedure and 2 cases were converted to open adrenalectomy. The reasons of conversion were sudden cardiac arrest due to unknown origin and intraoperative bleeding due to periadrenal massive fat. During the laparoscopic operation, 2 patients showed abnormal EKG findings. The pathologies of those patients were non-catecholamine-secreting cortical adenomas. After operation, they have been completely normal in EKG. The average operating time for the complete laparoscopic adrenalectomies was 186 minutes in the first 9 cases and 132 minutes in the next 9 cases. The first oral intake was started within 24 hours in all cases. There was no postoperative complication and no operative morbidity or mortality. The average hospital stay was 6.2 days in the first 9 cases and 4.2 days in the next 9 cases. CONCLUSION: The LA is relatively fast and safe method and is accepted as the preferred procedure for the adrenal tumors but it should be well prepared perioperatively. Surgeons and anesthesiologists should be aware of those possible cardiovascular complications and of the problems inherent in the manipulation of the adrenal gland during LA.
Adenoma ; Adrenal Glands ; Adrenalectomy* ; Death, Sudden, Cardiac ; Electrocardiography ; Hemorrhage ; Hospitalization ; Humans ; Length of Stay ; Methods ; Mortality ; Pathology ; Pheochromocytoma ; Postoperative Complications ; Surgeons ; Surgical Instruments

Pancreatic heterotopia and adenomyoma are variants of the same process. Pancreatic heterotopia is characterized by the presence of pancreatic acinar, islet, and/or ductular elements, usually associated with smooth muscle proliferation, outside the topographic boundaries of the pancreas. Adenomyoma differs from pancreatic heterotopia in that acinar and islet-like tissue are not present. The common sites are stomach, duodenum, and jejunum, but ectopic pancreatic tissue may also be encountered in Meckel's diverticulum, the ampulla of Vater, gallbladder, umbilicus, fallopian tube, and mediastinum. Most examples are encountered incidentally during surgery, and on rare occasions, epigastric pain, weight loss, hemorrhage, gastric outlet obstruction, and intussusception have been attributable directly to the presence of the heterotopic pancreas. But intestinal obstruction of small bowel by pancreatic adenomyoma has not been reported as of yet. The authors have experienced one case of intestinal obstruction by pancreatic adenomyoma requiring operation in a 28-year-old female. We found the 3-fold distened proximal jejunal loop, about 1 meter length, and abrupted narrowed point, and a normal sized distal loop. We treated this case by performing longitudinal incision and transverse suture of the narrowed point, so that the diameter of narrowed point was enlarged. At that time we found the 0.7Cm sized intraluminal mass at the narrowed point. We concluded that intestinal obstruction in this case was made by contraction of circular muscle due to pancreatic adenomyoma, not by a mass effect.
Adenomyoma* ; Adult ; Ampulla of Vater ; Duodenum ; Fallopian Tubes ; Female ; Gallbladder ; Gastric Outlet Obstruction ; Hemorrhage ; Humans ; Intestinal Obstruction* ; Intussusception ; Jejunum* ; Meckel Diverticulum ; Mediastinum ; Muscle, Smooth ; Pancreas ; Stomach ; Sutures ; Umbilicus ; Weight Loss

BACKGROUND/AIMS: The diagnosis and treatment of benign hepatic lesions remain controversal. The widespread availability of ultrasonography, computed tomography (CT) and magnetic resonance imaging (MRI), and their frequent application in evaluating abdominal pain, has resulted in more frequent discovery of incidental benign hepatic lesions. To address these points, the clinical data of patients with benign hepatic lesions treated with surgical resections at our hospital were reviewed retrospectively. METHODS: We reviewed the clinical records of thirty nine patients with benign hepatic lesions who had undergone hepatic resection from January, 1985 to August, 2002 at Hanyang University Hospital. RESULTS: There were 39 patients, whose mean age was 47.0 years. The ages ranged from 24~74 years. There were 14 male patients and 25 female patients. The ratio of male and female was 1:1.8. Major symptoms were right upper quadrant pain, mass, epigastric pain, and non-specific GI symptoms. 22 cases of anatomical resections (10 right lobectomy, 5 left lobectomy, 7 left lateral segmentectomy) and 17 non anatomical resections were done. There were no postoperative deaths in this series. Fourteen patients (35.9%) developed operative complications. All of them were minor complications. During the mean follow up time, symptomatic relief was achieved in patients out of patients who we could contact with opd follow up or telephone interview. Three patients died of massive pleural effusion 4 years after operation, myocardial infarction 14 months after operation, alcoholic liver cirrhosis and diabetes mellitus 33 months after operation. CONCLUSION: Hepatic resection in patients who had benign hepatic lesions in the liver was safe and effective treatment modality if patients were selected with suitable indications.
Abdominal Pain ; Diabetes Mellitus ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Interviews as Topic ; Liver ; Liver Cirrhosis, Alcoholic ; Magnetic Resonance Imaging ; Male ; Myocardial Infarction ; Pleural Effusion ; Retrospective Studies ; Ultrasonography