PURPOSE: Laparoscopic nephrectomy has become accepted as a method of simple nephrectomy replacing with open nephrectomy in patients in whom a kidney requires removal for benign disease. Laparoscopic nephrecto my is widely performed and extends its indications. We evaluated our experience with the laparoscopic nephrectomy to assess the clinical efficacy. MATERIALS AND METHODS: Between April 1996 and September 1999, 23 patients (7 men and 16 women, mean age 44.1 years old) underwent laparoscopic nephrectomy, 16 by women, mean age 44.1 years old) underwent laparoscopic nephrectomy, 16 by the transperitoneal approach and 7 by the retroperitoneal approach. Operative and clinical records were reviewed. The underlying pathological conditions included 20 cases of non-functioning kidney, 2 cases of hypoplastic kidney with complete duplication and ectopic ureter, and 1 case of ureter tumor. Four ports (21 cases, two 12mm ports and two 5mm ports) or 5 posts ( 2 cases, two 12mm ports and three 5mm ports) were used. RESULTS: The laparoscopic procedure were successful in 20 cases (87%). Three patients had open conversion due to unclear anatomy, severe adhesion, and adrenal bleeding. In successful cases, mean operative time was 253+/-83 minutes (range 140-545), mean hospital stay was postoperative 5.2 days. Intraoperative and perioperative complications were noted in 6 patients, including bleeding requiring transfusion in 3, wound infection in 1, severe subcutaneous emphysema in 1, diarrhea in 1. CONCLUSIONS: Laparoscopic simple nephrectomy is feasible, effective, and safe treatment option. It is a less invasive alternative to open surgery providing a more rapid recuperation and superior cosmetic effect.
Diarrhea ; Female ; Hemorrhage ; Humans ; Kidney ; Laparoscopy ; Length of Stay ; Male ; Nephrectomy* ; Operative Time ; Subcutaneous Emphysema ; Ureter ; Wound Infection

Recently, in leprosy patients the frequency of the blindness due to corneal disorder has been increased. We evaluated factors influencing corneal involvement in leprosy patients for the purpose of early detection and treatment of the preventable causes of the blindness. In 100 eyes of 100 leprosy patients and 50 eyes of 50 control who had no abnormality in ocular examination. Each patient was examined with corneal sensitivity test, Schirmer test(Type I) and was graded according to severity of lagophthalmos. The results were as follows: 1. 28 eyes(28%) of the leprosy patients and 3 eyes(3%) of the control patients showed less than 5mm wetting of fiter paper respectively. 2. Corneal sensation was decreased moderately or markedly in 42 eyes(42%) of the leprosy patients and 7 eyes(14%) of the control patients respectively. 3. The values of Schirmer test and corneal sensation were decreased with increasing duration of the disease. 4. In leprosy patients, 32 patients(32%) were showed lagophthalmos. The grade of lagophthalmos was increased with increasmg duration of the disease. These results suggest that leprosy patients should be followed closely for factors(corneal sensation, decreased lacrimation, lagophthalmos) affecting cornea and that treatment directed towards this problem should be initiated early.

Hereditary theory was first proposed by Joachimsthal in 1905. However, a family history of congenital muscular torticollis is uncommon. This is a report of two female children who are interrelated and have congenital muscular torticollis. They are sisters. No environmental factor could be identified that would predispose the the children to congenital muscular torticollis. In this family, it is apparent that genetic factors are influencing the development of this condition. The cause of congenital muscular torticollis is unknown, but heredity may play a more important role than has previously been supected.
Child ; Female ; Heredity ; Humans ; Siblings ; Torticollis

Yellow nail syndrome is characterized by yellow discoloration of nails, chrnnic lymphedema and respiratory dieorders such as chronic bronehitis, bronchiectasis, pleural effusion and chronic sinusitis. Other changes of nail in this syndrome are the exaggerated lateral curvature and disappearance of lunula and cuticle. These nail changes are caused by greatly slow nail growth than in normal due to the defective lymphatic drainage. We report a case of yellow nail syndrome in a 55 year-old woman who has pulmanary edema, congestive heart failure for 3 years, and yellow naiIs of all fingers and toes for 1 year.
Bronchiectasis ; Drainage ; Edema ; Female ; Fingers ; Heart Failure ; Humans ; Lymphedema ; Middle Aged ; Pleural Effusion ; Sinusitis ; Toes ; Yellow Nail Syndrome*

No abstract available.
Pleasure*

Eighty long bone open fractures were treated with immediate internal fixation within an average of 7.4 hours after trauma from June, 1984 to September, 1989. Mean follow-up was 17 months ranging from 1 year to 3 years and 4 months. Fifty-four tibia, 11 femur, 9 forearm, and 6 humerus open fractures were encountered. According to Gustilo and Anderson's wound classification, there were 19 Type I, 26 Type II, and 35 Type III open fractures. Internal fixation was facilitated with plate and screws in 58 cases, Ender nails in 13 cases, Kuntscher nails in 3 cases, and screws only in 5cases. Bone grafting was performed in 47 cases. Uncomplicated union was achieved in 16cases (84 %) in type I, 23 cases (88%) in Type II, and 18 cases (51%) in Type III. Transient soft tissue infection was noted in 3 cases(16%) in Type I, 3 cases(8%) in Type II, and 5 cases(14%) in Type III. Transient osteomyelitis was present in 1 caes(4%) in Type II, and 4 cases(11%) in Type III, and all were resolved within 1 month. Three cases of Type III open fractures where mutilated injury was associated with severe vascular injuries were ended up with amputation. Five unions (14%) in Type III were complicated with chronic osteomyelitis. Overall uncomplicated union was achieved in 38 cases (87%) in Type I & II, and 18 cases (51%) in Type III. Soft tissue coverage especially with viable muscle and stable fixation with good cortical contact seemed to be important prognostic factors. While there exists potential disadvantages of higher minor and major complication rates and more sophisticated management of the patient, this one-stage open reduction and internal fixation with bone graft which converts open fracture into stable closed fracture might be of some value especially in Type I & II open fractures in terms of simultaneous management of fracture and open wound, prevention of secondary infection, anatomical reduction including joint congruity, stable maintenance of reduction, elimination of deformity, and early joint motion.
Amputation ; Bone Transplantation ; Classification ; Coinfection ; Congenital Abnormalities ; Femur ; Follow-Up Studies ; Forearm ; Fractures, Closed ; Fractures, Open ; Humans ; Humerus ; Joints ; Osteomyelitis ; Soft Tissue Infections ; Tibia ; Transplants ; Vascular System Injuries ; Wounds and Injuries

The authors have reviewed 63 resistant clubfeet of 40 patients who were treated by modified Turco's operstion at the Department of Orthopaedic Surgery, Seoul National University Hospital during the eight years period from July, 1979 to June, 1987. The procedure performed by the senior author(D.Y.L.) is essentially similar to Turco's original technique, but with the following modifications :(a) A curvilinear skin incision instead of Turco's straight oblique incision. (b) Aponeurotic tenotomy of the abductor hallucis. (c) Medial capsulotomies of the first metatarso-medial cuneiform joint, medial cuneiformnavicular joint and release of the medial extension of the tibialis anterior insertion. (d) Z-plastic lengtening of the tibialis posterior tendon instead of tenotomy (e) Plantar fasciotomy The average age at the time of operation was 23.4 months, the youngest being 4 months and the oldest being 6 year and 7 months. The follow-up period was minimum 12 months and maximum 6 years, the average being 27.4 months. The cases were analysed radiologically and clinically, and following observations were made. l. AP and lateral talocalcaneal angles were corrected satiafactorily in 60 feet(95%) and 59 feet(94%), respectively. The Talocalcaneal indices were corrected satisfactorily to over 40 in 60 feet(95%). 2. The talo-first metatarsal angles, which reflect adduction of the fore-foot, were corrected satisfactorily to within +10°in 55 feet(87%). 3. Good and fair results were obtained in 54 feet(86%) in the radiological evaluation. 4. Adduction deformity of the forefoot was responsible in most cases of radiologically unsatisfactory results. 5. Among 40 feet of 26 pstients who were evaluated clinically by the Wynne-Davis method, 33 feet were rated good and 7 feet were rated fair. No poor results were found clinically. 6. Senior author's modification of additional forefoot medial release is an important addition to Turco's original technique and effectively reduced unsatisfacotory results.
Clubfoot ; Congenital Abnormalities ; Follow-Up Studies ; Foot ; Humans ; Joints ; Metatarsal Bones ; Methods ; Seoul ; Skin ; Tendons ; Tenotomy

No abstract available.
Skin*

No abstract available.
Humans ; Irritable Bowel Syndrome*

Eight bacterial strains were examined whether they have phoP/phoQ genes which were known to be involved in the intracellular survival of Salmonella typhimurium. The phoP/phoQ operon were known to sense the stimuli of the genes involved in the adaptation of the environment. Using 514-basepairs EcoRV DNA fragment of phoP region of Salmonella typhimurium as a probe, dot blot hybridization were performed. Chromosomal DNAs of Klebsiella pneumonia, Pseudomonas aeruginosa, Serratia marscescens, Enterobacter cloacae, Salmonella typhimurium, Escherichia coli, Shigella dysenteriae, and Listeria monocytogenes were examined by DNA hybridization assay. Against our expectation, intracellular pathogen, L. monocytogenes, did not have similar DNA sequences to phoP/phoQ of S. typhimurium, while E, coli, S. dysenteriae, and E. cloacae showed the positive signal even though they were not intracellular pathogens. This result suggested that the phoP/phoQ operon was absent in intracellular pathogenic bacterias other than S. typhimurium. Rather it was found in phylogenetically closer bacterias to S. typhimurium, which were not able to survive in intracellular environment. Some different mechanism, which is not dependent on phoP/phoQ operon, could be involved in the intracellular survival of L. monocytogenes.
Bacteria* ; Base Sequence ; Cloaca ; DNA ; Enterobacter cloacae ; Escherichia coli ; Klebsiella ; Listeria monocytogenes ; Operon ; Pneumonia ; Pseudomonas aeruginosa ; Salmonella typhimurium ; Serratia ; Shigella dysenteriae