No abstract available.
Humans ; Purpura, Thrombocytopenic, Idiopathic* ; Splenectomy*

PURPOSE: Hand-assisted laparoscopic live donor nephrectomy (HALDN) are being performed at our institution in an attempt to make live donor more attractive to the potential donor. We review the results of HALD N retrospectively and compare them with those obtained using the standard open approach. MATERIALS AND METHODS: 9 consecutive HALDN were performed from February 2000 through June 2000. The control group consisted of the 22 open donor nephrectomy at the same institution from January 1999 through December 1999 immediately before the initiation of HALDN. Live donors were considered candidates for HALDN if they possessed left normal renal anatomy with single renal vessels and ureter. Among 9 HALDN patients, one patient had two main renal arteries and another one patient had a polar artery. We evaluated sex, age, body weight, BMI (Body Mass Index) basically. And we evaluated renal ischemic time, operation time, to normal activities, postoperative serum creatinine level, and postoperative complications. RESULTS: There was no significant difference in male-female ratio, age distribution and weight-height ratio between two groups. Warm ischemic time for HALDN group was 3 to 4 min and it was not different with open surgery. Operation time was prolonged in HALDN group (284.4+/-72.8 min) compared to open group (193.1+/-26.7 min) (p Age Distribution ; Arteries ; Body Weight ; Chylous Ascites ; Creatinine ; Humans ; Kidney Transplantation ; Length of Stay ; Nephrectomy* ; Pneumothorax ; Postoperative Complications ; Renal Artery ; Retrospective Studies ; Tissue Donors* ; Ureter ; Warm Ischemia

No abstract available.
Catheters*

PURPOSE: We studied the usefullness of intravenous administration of contrast material to facilitate in situ shock wave lithotripsy(SWL) of ureteral stones in cases that stone localization was difficult as radioluscent, less radiodense, small stone, and interference with visualization by bone or intestinal gas. MATERIALS AND METHODS: From March 1992 to June 1997 we treated 831 patients with ureteral stone by in-situ SWL using EDAP-LT02 piezoelectric lithotriptor which utilizes ultrasono and fluroscopy for stone localization. Among 831 patients, intravenous contrast material were used in 53 cases to facilitate stone localization during SWL treatments. To evaluate the effectiveness of stone localization by the assistance of intravenous contrast media we compared success rate, storages, treatment sessions, durations, and side effects of two groups with or without intravenous contrast material, based on the location and the size of stones. RESULTS: Among 53 patients, stone was localized without ureteral catheterization in 5.7%(25/437) of upper ureteral stone, 18.2%(18/99) of mid-ureteral stone, and 3.4%(10/295) of lower ureteral stone after administration of intravenous contrast material. There were no significant differences in success rate, storages, treatment sessions, and durations(p>0.05). There were no significant complications except dye hypersensitivity in two patients, who were managed conservatively. CONCLUSIONS: The administration of intravenous contrast material during SWL allows effective localization of ureteral stones that otherwise could not be imaged adequately without ureteral catheterization. We believe that the use of intravenous contrast material for localization of ureteral stone in SWL have the benefits of inexpensiveness, noninvasiveness, and painlessness.
Administration, Intravenous ; Contrast Media ; Humans ; Hypersensitivity ; Shock ; Ureter* ; Urinary Catheterization ; Urinary Catheters

No abstract available.
Kidney Transplantation* ; Wegener Granulomatosis*

A 24-year-old man visited our hospital with painless scrotal mass 2 weeks in duration. Physical examination revealed about 3cm in diameter, ovoid, hard, movable and painless mass in the left side of the scrotum. He had no history of trauma, voiding difficulty or infection sign. CBC, blood chemistry and tumor marker were normal. Left orchiectomy was done. Tumor was a well encapsulated white-gray ovoid mass filled with yellowish gray material and histogically diagnosed as epidermoid cyst. Benign tumors of testis are rare, acounting for less than 1% of all testicular tumors. Herein we report a case of epidermoid cyst of testis and review the literatures.
Chemistry ; Epidermal Cyst* ; Humans ; Orchiectomy ; Physical Examination ; Scrotum ; Testicular Neoplasms ; Testis* ; Young Adult

No abstract available.
Animals ; Dogs* ; Liver Transplantation* ; Liver* ; Metabolism*

BACKGROUND: A Stellate ganglion block (SGB) is a sympathetic nerve block method which has been used most frequently in pain clinics due to its wide range of indications. However, SGB leads to regional sympathetic denervation of the heart and to changes in the hemodynamics. The aim of this study was to compare hemodynamic effects as well as echocardiographic changes after a left SGB (LSGB). METHODS: Fourteen healthy male volunteers were studied. The LSGB was performed with 1% mepicacaine 6 ml. Arterial blood pressure, electrocardiographic and echocardiographic variables were measured before the LSGB, 15 and 30 minutes after the LSGB. RESULTS: Arterial blood pressure, ejection fraction and transmitral inflow velocity variables showed no significant changes compared to pre-LSGB values. P-P interval increased significantly 15 minutes after the LSGB, and the Q-T interval increased significantly 30 minutes after the LSGB. The diastolic pulmonary venous flow velocity decreased significantly 15 minutes after the LSGB. CONCLUSIONS: These results showed that a LSGB decreased the heart rate without detrimental changes of left ventricular relaxation in healthy male volunteers.
Arterial Pressure ; Autonomic Nerve Block ; Echocardiography ; Electrocardiography ; Heart ; Heart Rate ; Hemodynamics ; Humans ; Male ; Pain Clinics ; Relaxation ; Stellate Ganglion* ; Sympathectomy ; Ventricular Function, Left* ; Volunteers

PURPOSE: To define computed tomographic (CT) appearance according to voiding patterns and to evaluate the significance of CT in patients with voiding dysfunction after orthotopic bladder substitution following radical cystectomy. MATERIALS AND METHODS: We evaluated a total of 50 male patients in whom 25 had undergone an ileocolic and 25 had undergone an ileal neobladder. We performed uroflowmetry, postoperative voiding cystourethrography (VCUG) and CT for evaluation of configuration of neobladder according to voiding pattern. We defined a good voider (n=37) as the patients with maximum flow rate greater than 15 ml/sec and postvoid residual urine amount less than 200ml and a poor voider (n=13) as those with less than 15 ml/sec or greater than 200ml. RESULTS: Voiding cystourethrography revealed that the neobladder outlet was well funneled and wide open at the most dependent portion of the neobladder in good voider group. However, in poor voider group, the neobladder outlet was not funneled or deviated from its caudal location. CT revealed that the neobladder was symmetric in 28 cases (75.7%) and had soft tissue density in the neobladder base in 9 cases (24.3%) of good voider group. However, neobladder was asymmetric in 8 cases (61.5%) and had soft tissue density in the neobladder base in 8 cases (61.5%) of poor voider group. CONCLUSIONS: The asymmetry of neobladder and soft tissue density around base of neobladder on CT may be associated with the deviated neobladder outlet. This CT finding might be useful to presume the cause of voiding pattern.
Cystectomy ; Humans ; Male ; Urinary Bladder ; Urinary Bladder Neoplasms

BACKGROUND/AIMS: To reduce the rate of recurrence and to prevent postoperative liver failure, it is necessary to determine the extent of hepatic resection preoperatively in primary liver cancer patients. The aim of this study was to examine the clinical significance and correlation among several preoperative liver function tests. METHODS: Twenty-nine patients who underwent hepatic resection for hepatocellular carcinoma from November 1994 to March 1995 at the Department of Surgery, Seoul National University Hospital were analyzed. Fifteen patients had gross cirrhosis. Major resections were performed in two patients, segmentectomy in 6 patients, subsegmentectomy and limited resection in 21 patients. Maximal removal rate of indocyanine green (ICG Rmax), ICG retention rate at 15 min(ICG R15), oral glucose tolerance test(oral GTT), arterial ketone body ratio(AKBR) and computed tomographic volumetry, as well as conventional liver function test and prothrombin time were done preoperatively. RESULTS: There were significant correlations among Child's class, prothrombin time and ICG R15. AKBR, oral GTT, ICG Rmax, liver volume had no correlations with any other tests. Liver failure occurred in 2 patients(6.9%). No tests, except ICG R15, could predict the patients with liver failure. ICG R15 value of these two patients were 27% and 29%, respectively while those of the remaining 27 patients ranged from 1 to 22% (mean 11.9%). CONCLUSION: Neither standard liver function tests nor hepatic function studies such as AKBR, oral GTT, CT volumetry were useful as preoperative prognostic indicators in hepatic resection. ICG R15 test is a simple test and good predictor of liver failure after hepatic resection.
Carcinoma, Hepatocellular ; Fibrosis ; Glucose Tolerance Test ; Hepatectomy ; Humans ; Indocyanine Green ; Liver ; Liver Failure ; Liver Function Tests ; Liver Neoplasms ; Mastectomy, Segmental ; Prothrombin Time ; Recurrence ; Seoul