No abstract available.
Sleep Initiation and Maintenance Disorders*

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

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

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

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

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

Granuloma pyogenicum is a benign vascular tumor, usually about 0.5 to 2cm in diameter. It occurs as a single lesion with few exceptions and consists of pedunulated nodule with a dull red or slightly purplish color. We observed a 29-year old man who had multiple satellite recurrences in the scapular region which developed after excision of a single lesion of granuloma pyogenicum. Histapathologic findings showed many newly formed capillaries that had prominant endothelial cells and showed varying degrees of dilation without appearance of epiderrnal collarette sign. The lesions were much improved by X-ray irradiation.
Adult ; Capillaries ; Endothelial Cells ; Granuloma* ; Granuloma, Pyogenic* ; Humans ; Recurrence ; Shoulder*

No abstract available.
Humans* ; Melanocytes* ; Tretinoin*

BACKGROUND: The blunted tip of a reusable with multiple uses can cause problems with the passing procedure in arthroscopic Bankart repair. This study assessed the advantage of Scorpion with a 70° arthroscope in arthroscopic Bankart repair compared to hook typed suture passer. METHODS: Scorpion in 19 patients, the hook type suture passer (conventional group) in 18 patients were used. All patients underwent the same procedure except for the type of suture passer used. Another different point of the procedure were telescopes and the number of portals used; three arthroscopic portals (posterior, anterorsuperiorlateral, and mid-anterior) and a 30° arthroscope in the conventional group, but two portals and a 70° arthroscope as well as the 30° one in the Scorpion group. The surgery time and the surgical complications including an iatrogenic axillary nerve injury were recorded. RESULTS: The Scorpion group showed a significant decrease in surgery time compared to the conventional group. In contrast to the conventional group, Scorpion provided an easy estimation of the exit of suture passing, no iatrogenic labral injury during the passing procedure with straight movement and the sharp tip of the knife installed. Iatrogenic supraspinatus injuries could be avoided when making an accessory anteosuperiorlateral portal due to the 70° arthroscope. CONCLUSIONS: In arthroscopic Bankart repair, the use of the Scorpion suture passer and a 70° arthroscope can reduce the surgery time, avoid unnecessary supraspinatus injury, and avoid iatrogenic axillary nerve damage through the relatively easy and precise suture passing and saving of the anterosuperior portal.
Arthroscopes* ; Arthroscopy ; Humans ; Scorpions* ; Sutures* ; Telescopes