PURPOSE: Caliceal diverticular calculi are mostly asymptomatic. In certain cases they may be associated with chronic or recurrent pain, recurrent urinary tract infections, progressive renal damage and hematur ia. The treatment of symptomatic caliceal diverticular calculi has evolved from open surgery to less invasive procedures, such as extracorporeal shock wave lithotripsy (SWL), percutaneous techniques, retrograde ureteroscopy and laparoscopy, but it remains controversial. Percutaneous techniques are frequently used to address the diverticular stone burden, to fulgurate the diverticular wall, to dilated the diverticular neck and improve drainage. For this reason, we reviewed 33 patients with caliceal diverticular calculi to determine whether they could be treated successfully by percutaneous nephrolithotomy (PCNL) as the initial treatment. MATERIALS AND METHODS: A total of 33 patients with caliceal diverticular calculi underwent PCNL between February 1990 and February 2000. The majority of diverticula were located at the upper pole. Access was gained via a direct target puncture. After sequential dilatation of the tract, stones were removed and the diverticular wall was fulgurated. The diverticular neck was dilated with the Amplatz dilator upto 24-30 Fr. and a 20 Fr. nephrostomy catheter was placed. RESULTS: PCNL was performed successfully in 30 patients (90.9%), but puncture was failed in 3. Mean operative time was 105 minutes and mean hospital stay was 4.5 days. All patients who were treated successfully with PCNL became stone-free without any complication. Mean follow-up was 20 months (ranged from 1 to 108 months). Of the 26 patients with symptoms preoperatively, 25 patients were rendered symptom-free (96.2%). Twenty-four patients were assessed with an intravenous urogram at 1 or 3 months and 6, 12 months and there was no stone recurrence. The diverticula were obliterated or had improved drainage in 95.8% (23/24) of assessable cases. CONCLUSIONS: We confirmed that PCNL is a safe, less invasive and effective procedure and should be considered an acceptable form of primary management of patients with caliceal diverticular stone.
Calculi ; Catheters ; Dilatation ; Diverticulum ; Drainage ; Follow-Up Studies ; Humans ; Laparoscopy ; Length of Stay ; Lithotripsy ; Neck ; Nephrostomy, Percutaneous ; Operative Time ; Punctures ; Recurrence ; Shock ; Ureteroscopy ; Urinary Tract Infections

PURPOSE: We applied lateral lithotomy position to the severe ureteral stricture cases supposed to fail with only retrograde approach. MATERIAL AND METHODS: From October 1997 to April 1999, 13 patients with severe ureteral stricture (lenghth>2cm or complete obstruction) supposed to fail with only retrograde approach and one patient with study. The causes of ureteral strictures were pelvic malignancy in 5, tuberculosis in 4, trauma in 2 and others in 2. The patient's ipsilateral shoulder was rotated and fixed like lateral position. And ipsilateral pelvis was elevated with sandbag or pad and rotated about 45 degrees, too. The retrograde approach was tried at first, if fail, antegrade approach was combined. RESULTS: We could insert ureteral stent via retrograde approach only in 3 patients and we needed aid of antegrade approach for passage through ureteral stricture in the other 11 patients (79%). Percutaneous antegrade approaches were combined in those 11 patients and we could pass the guide wire and indwell the stent in 10 of 11 patients (91%) using this position. CONCLUSIONS: The lateral lithotomy position was very helpful to the simultaneous retrograde and antegrade approach in severe fibrotic or malignant ureteral strictures.
Constriction, Pathologic ; Humans ; Pelvis ; Shoulder ; Stents ; Tuberculosis ; Ureter*

The cataract extraction in vitrectomized proliferative diabetic retinopathy(PDR) may be different from the ordinary non-vitrectomized patients in several points. We tried to know what`s the problems during the operation, how`s the visual outcomes and the postoperative complications in these eyes. In 18 previously vitrectomized PDR patients(25 eyes), we performed the extracapsular cataract extraction(ECCE) in 7 eyes and the phacoemulsification in 18 eyes. The intraoperative problems were insufficient dilation of pupil, unstability of (anterior and posterior) chamber depth, and difficulty in removal of cortex, which is firmly adherent to the posterior lens capsule. Opacity of posterior lens capsule, elevation of intraocular pressure, exudative pupillary membrane, posterior synechia and corneal edema were the major postoperative complications. In 22 eyes(88%), the visual acuity was increased more than 2 lines, Cataract extraction was easier and less postoperative complications these cases.
Cataract Extraction* ; Cataract* ; Corneal Edema ; Diabetic Retinopathy* ; Humans ; Intraocular Pressure ; Membranes ; Phacoemulsification ; Postoperative Complications ; Pupil ; Visual Acuity

No abstract available.
Animals ; Rats* ; Urinary Bladder*

No abstract available.
Intercellular Signaling Peptides and Proteins*

To identify the developmental characteristics of intermediate filaments, the expressions of various cytokeratines (CK), desmin and vimentin in fetal (14032 weeks of gestations) and adult epidermis were studied immunohistochemically. The primary antibodies used were CK7, 8, 10, 14, 18, AE8, 5D3, and MNFl16 for cytokeratins, D33 for desmin, and V9 for vimentin. At 14 weeks of gestation, the epidermis consisted of basal cells and periderm. The periderm exhibited positive staining for CK8 and AE8, and weak staining for MNF116 and D33. The basal cells showed positive staining for MNF116 and D33. The epidermis did not reacted for CK7, 10, 14, 18, 5D3, and V9 at this period. At 16-20 weeks of gestation, the epidermis was composed of basal, intermediate, and periderm layers. The periderm was positive for CK8, 18, AE8, MNF116, and D33. The intermediate cells were positive for CK10 and the basal cells CK14, MNF116, and D33. Few cells were stained positively with V9 among the basal cells. At 24-32 weeks of gestation, the epidermis exhibited no longer positive reactions for CK8, 18, AE8 and D33. The intermediate cells were positive for CK10. Immunoreactivity for MNF116 was noted in intermediate layer just above the basal layer. CKl4, MNFl16, D33, and often V9 were expressed in basal cells. The expressions of CK7 and 5D3 were not observed at any period of gestation. In adult epidermis, basal cells exhibited positive staining for CKl4, MNFl16, and D33. The intermediate cells were strongly positive for CK10, and weakly positive for CK7, 8, and MNFl16. The cells positive for V9 were often present among the basal cells. These results indicate that CK8 and 18 may serve as useful markers for periderm, CK10 for intermediate cells, CKl4 for basal cell, and suggest that the vimentin immunoreactive cells in basal cell layer are Langerhans cells.
Adult ; Antibodies ; Desmin ; Epidermis* ; Fetus* ; Humans* ; Immunohistochemistry ; Intermediate Filaments ; Keratins* ; Langerhans Cells ; Pregnancy ; Vimentin

The PACS system built and used in hospitals nowadays has quite significant overload on the central server of it because of both treatment of very large data and full management of medical images. We suggest a distributed communication and management methodology using Peer to Peer multicasting strategy for efficient management of medical images produced by DICOM modalities. It is absolutely necessary for reducing strict degradation of PACS system due to large size of medical images and its very high transport rates. DICOM Peer to Peer component is composed a service manager to execute requested queries, a communication manager to take charge of file transmission, and a DICOM manager to manage stored data and system behavior. Each manager itself is a component to search for requested file by interaction or transmit the file to other Peers. Distributed management and transformation of medical information based on Peer to Peer multicasting methodology will enhance performance of central server and network capacity reducing overload on them.

No abstract available.
Aging*

No abstract available.

During the period from 1988 to 1993, 86 cases of varicose vein in lower extremity were treated at Department of General surgery, Chonnam University Hospital. 36 outpatients were treated by compression sclerotherapy and 50 inpatients by surgery. The results were as follows ; 1) The prevalent age group were 4th and 5th decade. 2) The predisposing factors of varicose vein were profession requiring long time standing (48.8%), pregnancy (14%) and hereditary (4.7%), in order. 3) Varicose veins were located in the greater saphenous system (50%), the lesser saphenous system (46.5%) and both (3.5%). 4) The cardinal symptoms and signs were tortuosity of veins(100%), aching pain(29.1%), leg heaviness(14.0%), walking discomfort(8.1%) and leg edema(7.0%). 5) The used sclerosing agent was 5% ethanolamine oleate in compression sclerotherapy group and the operation method in surgery group was high ligation and vein stripping. 44.4% of patients treated initially by compression sclerotherapy and 80% of those treated surgically were given no further treatment. 6) The postoperative complications in surgery group were recurred or remained varicosity (5 cases), hematoma(2 cases), recurrent ulcer(1 case), wound dehiscence(1 case) and thrombophlebitis(1 case). 7) The complications in sclerotherapy group were recurred or remained varicosity(10 cases), induration and bluish discoloration(1 case).
Causality ; Ethanolamine ; Humans ; Inpatients ; Jeollanam-do ; Leg ; Ligation ; Lower Extremity* ; Oleic Acid ; Outpatients ; Postoperative Complications ; Pregnancy ; Sclerotherapy ; Varicose Veins* ; Veins ; Walking ; Wounds and Injuries