The surgical technique of renal transplantation has been well established, but surgical complications are not uncommon and still be important factors in postoperative mortality and morbidity. From August 1990 to May 1998, we performed 250 consecutive renal transplantations at Maryknoll hospital. The authors analyzed the kinds and incidences of surgical complications in a single center by using information from hospital records. The results were as follows: 1. The overall surgical complication rate was 9.6% (24 episodes in 250 cases). 2. These were composed of 6 vascular, 8 urologic, 4 lymphatic, and 6 wound complications. 3. Vascular complication included renal artery stenosis in 1 case and bleeding and hematoma in 5 cases. 4. Urologic complication included urine leakage in 4 cases, ureter stenosis in 2 cases and bladder stone in 2 cases. 5. Lymphatic complication was all lymphoceles. 6. One case in which renal artery stenosis had occured progressed to graft loss after 4 years later. There was no complication related mortality. 7. 1 year, 3 year and 5 year graft survival rate was 97.2%, 94.8% and 90.0%, respectively. and patient survival rate was 98.0%, 95.6% and 94.7%, respectively.
Constriction, Pathologic ; Graft Survival ; Hematoma ; Hemorrhage ; Hospital Records ; Humans ; Incidence ; Kidney Transplantation ; Lymphocele ; Mortality ; Renal Artery Obstruction ; Survival Rate ; Transplants ; Ureter ; Urinary Bladder Calculi ; Wounds and Injuries

BACKGROUND: Laparoscopic cholecystectomy has become the standard treatment of benign gallbladder disease. It requires the skill of a trained surgeon, and its safe performance. The advantages of laparoscopy are less postoperative pain, absence of cosmetic damage, shorter recovery times, and decreased length of hospital stays compared with conventional open surgery. METHODS: We reviewed 500 consecutive laparoscopic cholecystectomies retrospectively at the department of general surgery of Maryknoll Hospital from February 1992 to May 1999. RESULTS: There were 175 males and 325 females(M:F=1:1.86) with ages ranged from 21 to 78 years (mean: 50.0 year). Preoperatively, 72 patients underwent endoscopic retrograde cholagiography and 7 patients underwent endoscopic sphincterotomy due to common bile duct stone. Mean operation time was 73.7 minutes. Operative cholangiogram was attempted in 8 patients. Conversion to open cholecystectomy during operation was done in 8 cases(1.6%) and leading causes were severe adhesion, uncontrolled bleeding, suspected malignancy, bile duct injury. Operative Complications occured in 18 patients(3.6%): bile duct injury 1, postoperative bleeding 1, bile leakage 4,subcutaneous emphysema 1, abdominal wall hematoma 3, wound infection 8. There was no operative mortality. The length of hospital stay ranged from 2 to 15 day with average of 4.7 day. CONCLUSION: Laparoscopic cholecystectomy is a safe and effective operation in patients with benign gallbladder diseases.
Abdominal Wall ; Bile ; Bile Ducts ; Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Common Bile Duct ; Emphysema ; Gallbladder Diseases ; Hematoma ; Hemorrhage ; Humans ; Laparoscopy ; Length of Stay ; Male ; Mortality ; Pain, Postoperative ; Retrospective Studies ; Sphincterotomy, Endoscopic ; Wound Infection

PURPOSE: The symptoms of female urethral syndrome (FUS) can originate from mechanical or functional obstructions of the bladder neck or urethra. From retrospective reviews of women referred for evaluation of lower urinary tract symptoms (LUTS), 2.7 to 23% had urodynamic evidence of a bladder outlet obstruction (BOO). However, few urodynamic studies (UDS) have been performed on the prevalence of BOO in FUS. This study was aimed at identifying the causative factors of FUS symptoms, including BOO, as evidenced by UDS. MATERIALS AND METHODS: One hundred and sixteen women with FUS were enrolled in our UDS evaluations. An additional 247 patients, presenting for evaluation of stress urinary incontinence (SUI), served as controls. Comparisons of the maximum flow rate (Qmax), voided volume, post-void residual, detrusor pressure at maximum flow rate (PdetQmax), maximum detrusor pressure (Pdetmax) were made between the FUS and SUI cases. By definition, the FUS cases were divided into normal, BOO, detrusor under activity, detrusor instability and low compliance. These sub-groups were compared with controls in a similar way. RESULTS: Women with FUS showed a lower Qmax (15.9 versus 23.8ml/sec, p<0.05), higher post-void residual (86 versus 22ml, p<0.05), PdetQmax (24.0 versus 18.0 cmH2O, p<0.05) and Pdetmax (33.3 versus 27.9cmH2O, p<0.05) compared to those with SUI. The incidence of BOO, detrusor under activity and detrusor instability were 31.9, 25 and 16%, respectively, in the FUS group. Only 22% of women with FUS showed normal UDS findings. CONCLUSIONS: These results indicated the importance of UDS in identifying the causative factors of the symptoms of FUS. Treatment of a BOO will help provide new treatment modalities for FUS.
Classification* ; Compliance ; Female* ; Humans ; Incidence ; Lower Urinary Tract Symptoms ; Neck ; Prevalence ; Retrospective Studies ; Urethra ; Urinary Bladder ; Urinary Bladder Neck Obstruction ; Urinary Incontinence ; Urodynamics*

PURPOSE: The symptoms of female urethral syndrome (FUS) can originate from mechanical or functional obstructions of the bladder neck or urethra. From retrospective reviews of women referred for evaluation of lower urinary tract symptoms (LUTS), 2.7 to 23% had urodynamic evidence of a bladder outlet obstruction (BOO). However, few urodynamic studies (UDS) have been performed on the prevalence of BOO in FUS. This study was aimed at identifying the causative factors of FUS symptoms, including BOO, as evidenced by UDS. MATERIALS AND METHODS: One hundred and sixteen women with FUS were enrolled in our UDS evaluations. An additional 247 patients, presenting for evaluation of stress urinary incontinence (SUI), served as controls. Comparisons of the maximum flow rate (Qmax), voided volume, post-void residual, detrusor pressure at maximum flow rate (PdetQmax), maximum detrusor pressure (Pdetmax) were made between the FUS and SUI cases. By definition, the FUS cases were divided into normal, BOO, detrusor under activity, detrusor instability and low compliance. These sub-groups were compared with controls in a similar way. RESULTS: Women with FUS showed a lower Qmax (15.9 versus 23.8ml/sec, p<0.05), higher post-void residual (86 versus 22ml, p<0.05), PdetQmax (24.0 versus 18.0 cmH2O, p<0.05) and Pdetmax (33.3 versus 27.9cmH2O, p<0.05) compared to those with SUI. The incidence of BOO, detrusor under activity and detrusor instability were 31.9, 25 and 16%, respectively, in the FUS group. Only 22% of women with FUS showed normal UDS findings. CONCLUSIONS: These results indicated the importance of UDS in identifying the causative factors of the symptoms of FUS. Treatment of a BOO will help provide new treatment modalities for FUS.
Classification* ; Compliance ; Female* ; Humans ; Incidence ; Lower Urinary Tract Symptoms ; Neck ; Prevalence ; Retrospective Studies ; Urethra ; Urinary Bladder ; Urinary Bladder Neck Obstruction ; Urinary Incontinence ; Urodynamics*

No abstract available.
Dermoid Cyst*

OBJECTIVES: The previous genome-wide association studies have revealed several candidate genes for restless legs syndrome (RLS). The PTPRD (protein tyrosine phosphatase receptor type delta) gene is one of the candidate genes for RLS. The occurrence of antipsychotic-related RLS could also be attributable to differences in genetic susceptibility. This study aimed to investigate whether PTPRD polymorphism is associated with antipsychotic-related RLS in schizophrenia. METHODS: We assessed symptoms of antipsychotic-induced RLS in 190 Korean schizophrenic patients and divided the subjects into two groups according to the International Restless Legs Syndrome Study Group diagnostic criteria : (i) subjects that met all of the criteria (n=44) and (ii) the remaining subjects who were not considered to be RLS patients (n=146). PTPRD rs462664 was genotyped by PCR in 190 individuals. The chi2-test was performed to compare differences between two groups. RESULTS: The frequencies of genotype (chi2=1.31, p=0.519) of the PTPRD rs462664 did not differ significantly between schizophrenic patients with and without RLS. The difference of allele frequencies (chi2=1.30, p=0.25) of the PTPRD rs462664 between the schizophrenic patients with and without RLS were not significant. CONCLUSION: These results suggest that PTPRD gene polymorphism does not play a major role in susceptibility to antipsychotic-related RLS in schizophrenia. This finding suggests that antipsychotic-induced RLS may have a different pathogenesis compared to primary RLS.
Gene Frequency ; Genetic Predisposition to Disease ; Genome-Wide Association Study ; Genotype ; Humans ; Polymerase Chain Reaction ; Restless Legs Syndrome* ; Schizophrenia* ; Tyrosine*

No abstract available.
Nocardia Infections*

A case of congenital absence of right atriovntricular (A-V) connection of heart is reported. Patient was 81 day old male infant with chief complaints of dyspnea and irritability. Clinical evaluation revealed increased pulmonary vascularity on chest x-ray, absence of right A-V connection, regurgitation of left A-V valve, right-sided ventricular hypoplasia and L-TGA. Clinical assessment of the case was tricupsid atresia with LTGA and mitral regurgitation. Pulmonary artery banlding and artial septectomy was performed. Parenteral alimentation through the femoral veins resulted in obstruction of IVC and subsequent multiorgan failure. The autopsy findings of the heart were corrected transposition of great arteries with associated anomallies of right-sided mitral atresia, Ebstein's malformation of left-sided tricuspid valve, ventricular septal defect, muscular hypertrophy of right-sided left ventricle with luminal obliteration. Long segment of IVC was completely occluded due to occlusive thrombi with fungal infection. Bilateral kidneys were infarcted and azygos vein was markedly engorged. Microscopic examination revealed candidal colonization in the inferior vena cava and septic embolzation in brain.
Infant ; Male ; Female ; Humans

A case of congenital absence of right atriovntricular (A-V) connection of heart is reported. Patient was 81 day old male infant with chief complaints of dyspnea and irritability. Clinical evaluation revealed increased pulmonary vascularity on chest x-ray, absence of right A-V connection, regurgitation of left A-V valve, right-sided ventricular hypoplasia and L-TGA. Clinical assessment of the case was tricupsid atresia with LTGA and mitral regurgitation. Pulmonary artery banlding and artial septectomy was performed. Parenteral alimentation through the femoral veins resulted in obstruction of IVC and subsequent multiorgan failure. The autopsy findings of the heart were corrected transposition of great arteries with associated anomallies of right-sided mitral atresia, Ebstein's malformation of left-sided tricuspid valve, ventricular septal defect, muscular hypertrophy of right-sided left ventricle with luminal obliteration. Long segment of IVC was completely occluded due to occlusive thrombi with fungal infection. Bilateral kidneys were infarcted and azygos vein was markedly engorged. Microscopic examination revealed candidal colonization in the inferior vena cava and septic embolzation in brain.
Infant ; Male ; Female ; Humans

No abstract available.
Decompression* ; Follow-Up Studies* ; Spine* ; Titanium*