Surgical management was considered on 61 cases of renal stone, admitted to the Dept of Urology, National Medical Center from Jan, 1976 to Dec 1979. In the 4 years of period, there were 798 inpatients which included 207 patients of urinary stone, Renal stone occupied 29% of urolithiasis. Pyelolithotomy was performed in 26 patients, nephrectomy in 12, nephrolithotomy in 11, extended pyelolithotomy in 7 and partial nephrectomy in one patient. The major reasons of nephrectomy were severely damaged kidney in 3 cases and vascular injury in 3 cases. Urine leakage over 15 days was not noted in any case. Massive bleeding occurred in 1 case after nephrolithotomy, which required subsequent nephrectomy on postoperative 12th day. No death was experienced among the cases.
Hemorrhage ; Humans ; Inpatients ; Kidney ; Nephrectomy ; Urinary Calculi ; Urolithiasis ; Urology ; Vascular System Injuries

PURPOSE: The purpose of this study was to investigate whether the expressions of alpha-1 -antichymotrypsin(ACT) and/or p53 protein in advanced prostate cancer were related with bony metastases. MATERIALS AND METHODS: The immunohistochemical study with ACT and p53 included 7 archival transurethral resection and 14 prostate biopsy specimens from patients with prostate cancer who showed high serum PSA level(>10ng/ml) and periprostatic or lymph node involvement on imaging study. Whole body bone scan was perfomed to detect bony metastatis in all patients. RESULTS: Four out of 5 cases showing strong expression patterns with ACT protein showed abnormal hot uptakes on whole body bone scan. ACT proteins were weakly expressed in seven out of eight cases without bony metastases. p53 protein was expressed in 13 cases, but there was no statistically significant relation between the expression of p53 protein and bony metastasis. Either, there was no significant relation between ACT and p53 protein expression patterns. CONCLUSIONS: Our results suggested that the strong expression of ACT protein combined with high serum PSA level(>10ng/ml) and whole body bone scan could be the useful method for confirming bony metastasis although not adequate for screening test. The expression of p53 protein appears to be associated with progression of prostate cancer, but there was no statistically significant relation with bony metastasis.
Biopsy ; Humans ; Lymph Nodes ; Mass Screening ; Neoplasm Metastasis* ; Prostate* ; Prostatic Neoplasms*

PURPOSE: Laparoscopic total gastrectomy (LTG) for gastric cancer is still uncommon because of technical difficulties, especially in esophagojejunostomy (EJ). There are many reports for various laparoscopic procedures of EJ using linear or circular staplers. On the other hands, there has been no report for hand-sewn anastomosis. We report successfully performed intracorporeally hand-sewn EJ after LTG. MATERIALS AND METHODS: The clinicopathologic data and short-term surgical outcomes of 6 patients who underwent totally laparoscopic total gastrectomy for upper gastric cancer from December 2010 and July 2011 were retrospectively reviewed. RESULTS: The mean age was 66.5 years and mean body mass index (kg/m2) was 24.6. All patients had medical comorbidities. The mean patient ASA score was 2.17. Among the 6 patients, previous abdominal operation was performed for 2 patients and combined operation was performed for 3 patients. The mean blood loss, operation time, and EJ anastomosis time was 130 ml, 379.7 minutes, and 81.5 minutes, respectively. The mean time to first flatus, first oral intake, and postoperative hospital stay was 3.0, 3.0, and 12.5 days, respectively. There was no 30-day mortality case. Postoperative aspiration pneumonia and multiple periventricular lacunar infarctions developed in 1 patient. There were no anastomosis-related complications and other major surgical complications. CONCLUSIONS: When the intracorporeal anastomotic technique becomes popular in LTG the intracorporeally hand-sewn EJ may be accepted as one method among the various laparoscopic procedures of EJ.
Body Mass Index ; Comorbidity ; Flatulence ; Gastrectomy ; Hand ; Humans ; Laparoscopy ; Length of Stay ; Pneumonia, Aspiration ; Reconstructive Surgical Procedures ; Retrospective Studies ; Stomach Neoplasms ; Stroke, Lacunar

BACKGROUND: Methods to detect and quanitify Mycobacterium leprae(M. leprae)are needed for studies involving the epidemiology, pathogenesis, and chemotherapy of leprosy. Serological assays and skin tests lack the sensitivity and specificity to serve as diagnostic tool for M. leprae infection. The polymerase chain reaction(PCR) based on the selective amplification of an 530-bp frangment of the gene encoding the proline-rich antigen of M. leprae was performed with sections of fixed or frozen biopsy samples from leprosy patients. OBJECTIVE: This study was done to investigate the applicability of PCR for the detection of low numbers of M. leprae in tissues and peripheral blood. METHODS: The PCR was used to amplify a 530-base-pair M. leprae DNA with the thermoxtable Taq DNA polymerase. RESULTS: The In frozen skin tissues and peripheral blood of leprosy patients. relatively high detection rates of PCR products was achieved by using direct gel analysis as well as Southern blot hybridization. CONCLUSION: These results suggest that PCR amplification for the detection of M. leprae may be useful for the epidemiologic study of large papulations as well as coinical astudies on the individual patients.
Biopsy ; Blotting, Southern ; DNA ; Drug Therapy ; Epidemiologic Studies ; Epidemiology ; Humans ; Leprosy ; Mycobacterium leprae* ; Mycobacterium* ; Polymerase Chain Reaction* ; Sensitivity and Specificity ; Skin ; Skin Tests ; Taq Polymerase

Total hip replacement, with a prosthesis replacing both the acetabular socket and the femoral head, has been developed during the last decade and is now being used extensively. Its major advantage is rapid rehabilitation of the patient, particularly when both the femorsl head and the acetabulum are diseased. Nine Cases of total hip replacements were performed at the Department of Orthopedic Surgery, Hanyang University Hospital from January 1972 to March 1976. Although the follow-up (range 4 months to 3 years) in the majority is too short to permit a complete assessment of the results, in our series, most patients presented for surgical treatment for the relief a pain and mobility has been complete.
Acetabulum ; Arthroplasty, Replacement, Hip ; Follow-Up Studies ; Head ; Humans ; Orthopedics ; Prostheses and Implants ; Rehabilitation

A 6-year old boy was admitted with high fever and redness of the right eyelids and the surrounding area. He had previously suffered cerebral contusion, basal skull fracture and pneumocephalus following a traffic accident which required six months' hospitalization. Since then, and prior to admission, he had twice suffered probable bacterial meningitis and had been treated at an outstanding hospital. At the time of this admission, the patient again developed high fever, with redness of the right eyelid and surrounding area. His symptomatology suggested bacterial meningitis and cerebrospinal fluid culture revealed Streptococcus pneumoniae sensitive to penicillin. In accordance with the clinical course of meningitis and accompanying sinusitis, the appropriate antibiotic and its duration of usage were determined. Recurrent episodes of bacterial meningitis in this child raised the possibility of anatomical defect as an a contributory factor. Computerized tomographic(CT) cisternography suggested leakage of cerebrospinal fluid and revealed herniated frontal brain tissue protruding through a gap in the right frontal skull base, three dimensional CT(3-D CT) confirmed this defect, which was 3X4cm in size. After recovery from meningitis, surery to prevent recurrent meningitis, was performed. To locate pathologic areas, the subfrontal approach,involving bicoronal skin incision and bifrontal bone flap was used. Multiple fracture lines and a large bony defect on the orbital roof were observed, together with a dural defect, through which cerebromalatic tissue was herniated as encephalocele. Using lyophilized dura, the dural defect was made watertight; the bony defect was packed with autologous fats and covered with titanium mesh. The patient improved after surgery. Recurrent meningitis with anatomical pathologic focus after head trauma requires surgical intervention.
Accidents, Traffic ; Brain ; Cerebrospinal Fluid ; Child ; Contusions ; Craniocerebral Trauma ; Encephalocele ; Eyelids ; Fats ; Fever ; Hospitalization ; Humans ; Male ; Meningitis* ; Meningitis, Bacterial ; Orbit* ; Penicillins ; Pneumocephalus ; Sinusitis ; Skin ; Skull Base ; Skull Fractures* ; Skull* ; Streptococcus pneumoniae ; Titanium

Peripheral neuropathies occur in lymphoma patients. Causes of neuropathy include chemotherapy, opportunistic infections, and the lymphoma itself. We report a patient with lymphoma whose chief complaint was a sensory loss in the hands and feet. Electrophysiologic studies and sural nerve biopsy showed sensory polyneuropathies. We hypothesize that this neuropathy is associated with lymphoma-related ganglionopathy, and among the possible causes, we suspect that a systemic cause such as a paraneoplastic syndrome is the most likely pathogenic etiology. However, further follow-up will be necessary to see whether sensory symptoms change with lymphoma treatment.
Adult ; Biopsy ; Electrophysiology ; Hodgkin Disease/*complications/*diagnosis ; Human ; Lymphatic Metastasis ; Lymphoma/*metabolism ; Male ; Peripheral Nervous System Diseases/*complications/*pathology ; Sensation Disorders/complications/pathology

More than 90% of bladder cancers are transitional cell carcinomas. Transitional cell carcinoma of the urinary bladder ordinarily does not pose diagnostic difficulties and is well known its clinical behavior. However, variation from the classic histology can cause problems in recognition. Recently several variants of transitional cell carcinoma of the urinary bladder have been described to promote the recognition of, or to draw attention to, possible differences in clinical behavior. The presence of a micropapillary component in transitional cell carcinoma is associated with high-stage and high-grade transitional cell carcinoma with a tendency of vascular invasion, and with poor prognostic histologic feature. We report a case of micropapillary transitional cell carcinoma of the urinary bladder.
Carcinoma, Transitional Cell* ; Urinary Bladder Neoplasms ; Urinary Bladder*

Acute osteomyelitis after the contusion is a rare clinical entity. The complications of contusion are large hematoma formation, compartment syndrome, myositis ossificans and acute osteomyelitis. Authors experienced an acute osteomyelitis in the shaft of the radius after contusion of the forearm and report this case with references.
Compartment Syndromes ; Contusions* ; Forearm* ; Hematoma ; Myositis Ossificans ; Osteomyelitis* ; Radius*

Intra-aortic ballon pump(IABP) has been widely used since 1968 when Kantrowitz reported its design and clinical application for the patient with cardiogenic shock. However, information regarding clinical effectiveness of this device in terms of hemodynamic status had been limited. Consequently, using a simple random sampling method we retrospectively selected 23( 65+/-9.7 yr, mean+/-S.D.) out of 223 cases in which IABP had been inserted for a period of 13 months (from September, 1986 through October, 1987) in Yale-New Haven Hospital and evaluated their hemodynamic parameters. Six of 23 cases had IABP inserted in the coronary care units(CCU) and 17 had undergone cardiopulmonary bypass(CPB) for coronary artery bypass graft(CABG) except one case for aneurysmectomy and VSD repair. Nine of these 17 had IABP inserted for improvement of their preoperative cardiovascular functions and eight of then for successful weaning from CPB following CABG. While the diastolic pressure, cardiac output and cardiac index(CI) had increased from 62+/-11.0mmHg, 4.4+/-1.40 I/min, and 2.5+/-0.80 I/min/m2 to 69+/-10.8, 5.1+/-1.34, and 2.8+/-0.83, respectively, pulmonary arterial diastolic pressure(PAD) and pulmonary capillary wedge pressure(PCWP) decreased from 22+/-9.7 and 19+/-4.9 to 20+/-4.5 and 16+/-5.9 mmHg, respectively, after IABP counterpulsation. Despite their poor preoperative hemodynamic function (ASA Class IV or V), 18 out of these 34 (78.3%) had survived during hospitalization. Under the condition of our study IABP appears to be an alternative beneficail therapeutic aid for the patient with cardiogenic shock.
Blood Pressure ; Capillaries ; Cardiac Output ; Coronary Artery Bypass ; Counterpulsation ; Hemodynamics* ; Hospitalization ; Humans ; Retrospective Studies ; Shock, Cardiogenic ; Weaning