PURPOSE: In the treatment of symptomatic renal cysts, sclerotherapy has high recurrence rate. Laparoacopic cyst excision has high success rate but has some limitations concerning expensive devices, CO2 use and requiring trained laparoscopist. We conceived less invasive surgical technique for renal cyst excision. MATERIALS AND METHODS: The method is as follows. 1) Minimal skin incision of camera port size at PCN site nearest to the cyst. 2) Access to retroperitoneum by Kelly clamp and finger dilatation. 3) Finger dissection with or without ballooning. 4) Aspiration of cystic fluid. 5) Drawing the redundant cyst wall out of the incision. 6) Excision of the redundant cyst wall by open surgical method. RESULTS: Clinical trials of 5 patients have been performed since March 1999, with a mean age for the patients of 60 years old (range, 56-66), cyst size of 8.3cm (7.7-9.8), wound length of 2.4cm (2.1-3), operation time of 28 minutes (20-35) and blood loss of 1.6 Hb (0.5-3). There was no drain insertion except in one case, and no use of narcotics post op 2 days. Patients were discharged post op 3 days (2-5). There is no evidence of recurrence in short term follow up (mean 8 months, range 3-15). CONCLUSIONS: Though limited trials, we think expected merits over conventional laparoscopic surgery are better or comparative cosmetic results, no CO2 use, short operation time, less technical expertise and additionally economical advantages. If necessary, conversion to laparoscopic surgery, using the initial incision as camera port is possible during the procedures. So we suggest trial of this method before conventional laparoscopic renal cyst excision.
Dilatation ; Fingers ; Follow-Up Studies ; Humans ; Laparoscopy ; Middle Aged ; Narcotics ; Pregnenolone Carbonitrile ; Professional Competence ; Recurrence ; Sclerotherapy ; Skin ; Wounds and Injuries

No abstract available.
Sleep Initiation and Maintenance Disorders*

Any compound which disrupts the integrity of psychological aspects of performance, in particular, cognitive ability and psychomotor function analogous to the psychological behaviors of routine life, is known to be behaviorally toxic. A significant level of behavioral toxicity will interfere with patient safety and quality of life, and also may be counter-therapeutic by exacerbating the condition that the drug was prescribed for. Now, behavioral toxicity of psychotropic drugs has become one of the main growth areas of psychopharmacological research. Evaluation of the potential of drug-induced behavioral toxicity is important not only to the experimental researcher involved in human psychopharmacology, but also to the clinical practitioner treating psychiatric patients. This article attempts to describe behavioral toxicity of the three classes of psychotropic drugs-benzodiazepines, antidepressants and neuroleptics. After a brief discussion of some methodological issues arising in the investigation of behavioral toxicity, each of these drug classes is reviewed in the context of practical importance rather than purely scientific concern. The last session summarizes some suggestions for future studies on drug-induced behavioral toxicity.
Antidepressive Agents ; Antipsychotic Agents ; Humans ; Patient Safety ; Psychopharmacology ; Psychotropic Drugs* ; Quality of Life

Colonic sarcomatoid carcinomas are known to be extremely rare tumors, with only 22 cases reported either as sarcomatoid carcinomas or carcinosarcomas in the literature. The known characteristics are rapid growth, a high recurrence rate, and an extremely poor prognosis. Herein we report a case of a patient who had a sarcomatoid carcinoma of the sigmoid colon and died only 22 days after surgery due to rapid tumor growth.
Carcinosarcoma ; Colon ; Colon, Sigmoid ; Humans ; Prognosis ; Recurrence

Urachal carcinoma is an uncommon neoplasm associated with a poor prognosis. We have encountered two another cases of urachal adenocarcinoma recently 5 years after our first report. The common sign of urachal cancer was painless hematuria. We diagnosed the specific site of origin preoperatively by means of computerized tomography. One patient was performed partial cystectomy and another was total cystectomy with double barrel ureterocutaneostomy. A brief review of the literature of urachal adenocarcinoma was also made.
Adenocarcinoma* ; Cystectomy ; Hematuria ; Humans ; Prognosis

A case of torsion of the right cryptorchid testis was herein reported. The patient was 6-year-old boy who was rolled on a staircase and traumatized his right inguinal area. There after painful and tender swelling developed on the area, and it spent 4 days prior to visit our department The involved cryptorchid testis showed dark reddish discoloration and external rotation of 360 degrees and was removed because of no re-establishment of blood supply in spite of detorsion for 30 minutes.
Child ; Humans ; Male ; Testis*

Case 1 was a 55-year-old housewife with the 1-year history of mild recurrent gross hematuria and recent history of massive hematuria following radiation treatment for uterine cancer 7 years ago. Various conservative treatments showed no effect but complete hemostasis was obtained immediately after instillation of 100 ml of 4% formalin solution for 30 minutes under sedation. And to date, there has been no recurrence of hematuria or significant complications for 5 months after the treatment. Case 2 was a 45-year-old housewife with the 3-month history of symptomless gross hematuria following irradiation for a gynecologic malignancy 8 years ago. Complete hemostasis was obtained one day after instillation of 100 ml of 4% formalin solution for 30 minutes under sedation. and to date, there has been no recurrence of hematuria or any complications for 2 months after the treatment. Postradiation vesical bleeding is a very difficult condition to control and may result in total cystectomy and urinary diversion. The treatment by intravesical instillation of formalin solution for the intractable vesical bleeding is simple to perform, shows excellent effect and no significant complications, and is a highly recommendable mode of treatment for massive, uncontrollable vesical bleeding before total cystectomy and urinary diversion.
Administration, Intravesical* ; Cystectomy ; Formaldehyde* ; Hematuria ; Hemorrhage* ; Hemostasis ; Humans ; Middle Aged ; Recurrence ; Urinary Diversion ; Uterine Neoplasms

Lichen nitidus is a comparatively rare, asymptomatic, chronic disease displaying small, sharpIy defined, fresh colored papules usually localized on the penis, arms and the abdomen. Waisman found immunoglobulin at the dermo-epidermaI junction in lichen planus, but not in lichen nitidus. This settled the argument whether lichen nitidus is a variant of lichen planus. A 11 year old healthy girI was brought to the clinic because of many flesh colored discrete papules on the cubital fossae and the anterior chest. The papules are skin colored. pinhead sized, round, and flat-topped The lesions appeared first at the age of 8 on the antecubital folds and in the following years, increased in number and extended slowly to the upper arms and the anteior chest.
Abdomen ; Arm ; Child ; Chronic Disease ; Humans ; Immunoglobulins ; Lichen Nitidus* ; Lichen Planus ; Lichens* ; Male ; Penis ; Skin ; Thorax

Fundamental pathologic cianges of secondary syphilid are said to be swelling and proliferation of endothelials and a predominantly parivascular infiltrates composed chiefly of lymphoid cells and plasma cells. But recentIy this theory has heen challenged. We present bistologic observation made on 10 patients who agreed to go through a biopsy, during 2 years period. from 1975 to l977. Male to female ratio was 9: 1 The age of patient ranged from 20 to 33, with a mean of 26. 8. The duration of lesion before the visit to the department ranged frorn 6 weeks to 20 weeks, with a mean of 11.9. The lesions in 2 were classified as macule, 3 as papule (1 as moist papule), and 5 as papulo-squamous lesions. The VDRL titer was higher in papular type. Dark fieId examination was performed on all patient and 6 showed positive result. The edidermal changes consist of hyperkeratosis (in 6 cases), parakeratosis (in 5), acanthosis (in 6), elongation of rete ridges (in 8) and exocytosis (in 3). The dermis showed mild to severe perivascular infiltration consist chiefly of lymphoid cells and histiocytic cells (in 10), plama cells (in 7), eosinophils (in 4), neutrophils (in 2), chromatophores (in 4), extra vasation of RBC (in 5), and dilated bload vessels endothelial swellings (in 8). Of particular interest was the finding that plasma cell infiltration is more pronounced at the lower portion of dermal infiltrate and in 3 cases plasma cell infiltration was totally absent. Vascular changes were seen in 8 cases.
Biopsy ; Chromatophores ; Dermis ; Eosinophils ; Exocytosis ; Female ; Humans ; Lymphocytes ; Male ; Neutrophils ; Parakeratosis ; Plasma Cells ; Syphilis, Cutaneous*

A new crush anastomosis model which can be evaluated as crush energy was established on the femoral artery and vein of the rats weighing 250g on the average. The degrees of vessel injury were evaluated as crush energy. The arteries underwent the crush injury with the energy of 0.3J, 0.4J, 0.5J, while the reins were crushed with the energy of 0.2J, 0.3J, 0.4J respectively then the vessels in each group were divided and anastomoses by a standard microsurgical technique. Saline and heparin were used as a luminal topical agent and systemic one, which allowed contact with the damaged endothelium. The heparin treated group had a patency rate of 95%(0.3J), 87.5%(0.4J), 40%(0.5J) vs. 55%(0.3J), 15%(0.4J), 10%(0.5J) in the saline irrigated group in the femoral arteries, which had the patency rate of 82.5%(0.2J), 72.5%(0.3J), 42.5%(0.4J) vs. 35%(0.2J), 12.5%(0.3J), 7.5%(0.4J) in the saline irrigated group in the femoral vein at 1 day. There was a energy-related decrease in patency rate. These findings indicate that the crush model of 0.4J in the rat femoral artery, 0.3J in the rat femoral vein is a reliable and reproducible thrombosis model. The model described in this study is to be used to evaluate and assess the ability of antithrombotic agent in preventing thrombosis at the anastomotic site.
Animals ; Arteries ; Endothelium ; Femoral Artery ; Femoral Vein ; Heparin ; Phenobarbital ; Rats* ; Thrombosis ; Veins