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

No abstract available.
Antipsychotic Agents* ; Biomarkers*

No abstract available.
Child* ; Humans ; Pneumonia*

BACKGROUND: Identification of specific antinuclear antibodies is useful for the diagnosis, subclassification and determination of prognosis in autoimmune disorders. In many diseases, multiple autoantibodies are detected, and simultaneous detection of multiple autoantibodies has been shown to be useful. Recently, a commercial kit (EL-ANA/6 profiles, TheraTest Laboratories, USA) losing enzyme-linked immunosorbent assay (ELISA) method for detection of six specific autoantibodies is avallable. In this study, we attempted to compare the results of EL-ANA/6 profiles with those of routinely used methods and evaluated usefulness of EL-ANA/6 profiles. METHODS: EL-ANA/6 profiles were performed with 28 sera which were positive for fluorescent antinuclear antibody (FANA) Simultaneously we tested anti-dsDNA antibodies with immnofluorescent (If) method and anti-Sm, anti-RNP, anti-SSA and anti-SSB antibodies with double immunodiffusion (DID). To evaluate specificity, EL- ANA/6 profiles tests were performed on 10 sera from healthy blood donors. RESULTS: Ten sera of healthly blood donors were all negative for EL-ANA/6 pro biles. In the results of EL-ANA/6 profiles on sera positive for FANA, the concordance rate with IF method for the anti-dsDNA antibodies was 89.3% (25/28) and the con- cordance rates with DID for anti-Sm, anti-Sm/RNP, anti-SSA and anti-SSB antibodies were 85.7% (24/28), 82.1% (23/28), 92.9% (26/28) and 82.1% (23/28), respectively. In 16 discordant settings, thirteen (81.3%) were negative on DID and positive on EL-ANA/6 profiles. CONCLUSIONS: The results of the EL-ANA/6 profiles show good concordance rates with If and DID. EL-ANA/6 profiles showing quantitative profiles for multiple autoantibodies is useful for diagnosis and tool)ow-up of autoimmune disorders.
Antibodies ; Antibodies, Antinuclear* ; Autoantibodies ; Bile ; Blood Donors ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunodiffusion ; Prognosis ; Sensitivity and Specificity

No abstract available.
Animals ; Corrosion Casting* ; Corrosion* ; Head* ; Rats*

The purpose of this study was to investigate the patency rates and the histologic findings of neoen- dothelialization according to the length of implanted polytetrafluoroethylene (PTFE) with an internal diameter of 3 mm. Under the operating microscope, grafts of 8 and 24 mm in length were implanted in the right carotid arteries of thirty rabbits by interrupted end-to-end microanastomosis. They were divided into two groups according to the length of implanted PTFE. Each group compised fifteen rabbits. All implanted grafts were 25 pm in fibril length and 0.39 mm in wall thickness. Three grafts per group were harvested at 1, 2, 4, 8, and 12 weeks after implantation respectively and all grafts were observed for patency rates and the histologic findings with light microscope and scanning electron microscope. In conclusion, there was no difference in patency rates according to the length of implanted PTFE and histologically the formation of neointima and subintimal tissue was delayed and incomplete in longer implanted PTFE.
Carotid Arteries ; Neointima ; Polytetrafluoroethylene* ; Rabbits ; Transplants

No abstract available in English.
Arm

The circadian system represents a temporal order which is mediated by the mutual coupling of oscillators and by the synchronizing effects of zeitgebers. It is known that well-being of man depends partly on the maintenance of this order, and that repeated or long lasting disturbances to it such as shift work will cause harmful effects. This study was a quasi-experimental study to test the effect of shift directions for the clinical nurses on the circadian rhythm. Fourteen nurses working at the general units of Y hospital were selected according to the established criteria. Fourteen subjects were assigned to a weekly shift but the directions of shift work were phase delay first and then phase advance or vice versa. Oral temperature, total sleeping time, frequency of sleep-wake cycle, fatigue, mental performance, and physical symptom were measured during these days except holidays. The data collection period was from April 26, 1993 to July 3, 1993. MANOVA and Wilcoxon signed rank test were used for statistical analysis. The results are summarized as follows. 1. Having worked on evening and night shifts in either phase delay or phase advance schedules, temperature rhythms of shift workers were gradually adapted to the new sleep-wake cycles. A complete adaptation to work on the night shift was achieved the sixth day of the night shift in the phase delay schedule compared to the partial adaptation to the work on the night shift in the phase advance schedule. Accordingly, by putting evening shift between day and night shifts, it will be possible for circadian rhythm to adapt easily to the night shift. 2. There were differences in the total sleeping time, frequency of sleep-wake cycle, fatigue, and physical symptom except for mental performance between night shift and day, evening shift. This indicates further that shift workers working on the night shift have a hard time adapting to the shift work compared to the other shifts. 3. Evaluating all the acrophases of temperature rhythm either in phase delay or phase advance schedules, it was shown that night to evening shift in the phase advance schedule revealed the smallest phase move. Also phase advance schedule showed poorer adaptation to shift work than phase delay schedule in connection with total sleeping time, frequency of sleep-wake cycle, fatigue, mental performance, and physical symptom. It is suggested, taken together, these findings reflect that phase delay schedule facilitated the degree of adjustment to the shift work compared to the phase advance schedule.
Appointments and Schedules ; Circadian Rhythm* ; Data Collection ; Fatigue ; Holidays ; Mental Fatigue

Osteonecrosis of the femoral head seems to be due to circulatory disturbance of the femoral head, usually idiopathic in origin, but also associated with chronic alcoholism, gout, prolonged treatment with corticosteroids, sickle cell disease, Caisson's disease and surface and degenerative changes in the hip joint. Aims of this procedure are to decompress the femoral head hence allowing better circulation, to revitalize the dead head by insertion of vascularized pedicle bone and to give a mechanical support preventing further collapse of the femoral head. Authors reviewed 19 cases of the vessel pedicled iliac bone graft performed for the idiopathic osteonecrosis of femoral head from January, 1984 to April, 1988 with follow-up periods from 23 months to 66 months, average 37.5 months. The purpose of this follow-up note is to report the long term follow-up result and to show the critical points of this technique.
Adrenal Cortex Hormones ; Alcoholism ; Anemia, Sickle Cell ; Bone Transplantation ; Follow-Up Studies ; Gout ; Head ; Hip Joint ; Osteonecrosis ; Transplants

PURPOSE: To describe the MR characteristics of giant cell tumor of bone. MATERIALS AND METHODS: MR iraagings of 15 cases of pathologically proved giant cell tumor were retrospectively analyzed. Signal intensity and homogeneity, involvement of articular surface, low signal intensity rim around the tumor, cortical disruption and soft tissue involvement were evaluated. RESULTS:Tumor showed low signal intensity on T1 weighted images(93%), inhomogenous high signal on T2 or T2* weighted images(93%) and inhomogeneous enhancing pattern(88%). In 11 cases of giant cell tumor of long bones, all cases showed involvement of articular margin and 10 cases(90%) showed rim of low signal intensity between tumor and normal marrow. Disruption of cortical bone(25%) and soft tissue involevement(7%) were also demonstrated. CONCLUSION: We concluded that giant cell tumor showed characteristic MR findings could be helpful in making correct diagnosis.
Bone Marrow ; Diagnosis ; Giant Cell Tumor of Bone ; Giant Cell Tumors* ; Giant Cells* ; Retrospective Studies