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

No abstract available.
Sleep Initiation and Maintenance Disorders*

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

PURPOSE: When Managing metastatic bladder tumors, to overcome the resistance mechanism of cisplatin is a main problem to be solved. The objective is to confirm the changes of general and ultrastructural morph ology with the induction of cisplatin resistance from the bladder cell line. MATERIALS AND METHODS: The samples of this investigation are 2ng/ml-cisplatin resistant human bladder cell lines T24R2 established by SNUH Urology and the drug resistant bladder cell lines T24 was obtained from ATCC, as a control group. We cultured the resistant cell line on the slide and observed it using light microscopy to see the general morphology. For the ultrastructural morphology, we fixed cultured cells, made an epon block, sliced an ultrathin section and observed it using H-71000 EM. RESULTS: Under light microscopy, the cytoplasm of the resistant cell line shows a plumper pattern than that of the parent cell. Under electronmicroscopy, the chromatin of the resistant cell line has a relatively finely dispersed chromatin pattern when compared to the parent cell line, which shows a coarse and aggregated chromatin pattern. Within the cytoplasm, the mitochondrial volume, dilated rough endoplasmic reticulum, polyribosomes and ribosomes are moderately increased in the resistant cell line when compared to the parent cell line. In particular, we found a great amount of double membrane vesicle near the cell surface and pinocytic vesicles on the surface, which are seldom observed within the parent cells. CONCLUSIONS: We concluded that the cisplatin resistant human bladder cell lines (T24R2) underwent a morphological change with the induction of cisplatin resistance, and we hypothesize that the resistant cell's ultrastructure, which shows morphological change, will be involved in the drug resistance mechanism. Regarding this matter, further research will be needed.
Cell Line* ; Cells, Cultured ; Chromatin ; Cisplatin* ; Cytoplasm ; Drug Resistance ; Endoplasmic Reticulum, Rough ; Humans ; Membranes ; Microscopy ; Mitochondrial Size ; Parents ; Polyribosomes ; Ribosomes ; Urinary Bladder Neoplasms ; Urinary Bladder* ; Urology

No abstract available.
Receptors, Antigen*

While the therapeutic efficacy of antipsychotic drugs is not in doubt, a variety of undesirable side effects are common. They can be a disincentive to good compliance with treatment, resulting in increased possibilities for relapse and hospitalization. They can be distressing and disabling and thus interfering with patient safety and quality of life. Furthermore, they may be counter-therapeutic by exacerbating the condition that the drug was prescribed for. In this article, we will provide an overview of management of antipsychotic-induced side effects, with a particular emphasis on the most common side effects as well as less common but serious side effects. In addition, some practical issues regarding the management of side effects will b discussed.
Antipsychotic Agents ; Compliance ; Hospitalization ; Motivation ; Patient Safety ; Quality of Life ; Recurrence

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

Access to the craniofacial skeleton and skull base requires osteotomies. An adequate exposure of neoplasms occupying the skull base and the oral cavity and oropharynx, especially retromolar trigone, is very important for precise tumor ablation. The demonstration by Tessier of the capacity for large segments of bone to survive removal and replacement has enabled skull base tumor surgery to grow into a subspeciality. Through the refined craniofacial exposure osteotomies, the surgery is safer, the operation shorter, and the result better both oncologically and reconstructively. We experienced 24 cases of exposure osteotomies consisting of 12 cases transzygomatic approaches, 1 case tranglabellar osteotomy, 1 case lateral transmaxillary approach, 1 case Le Fort II & midline splitting, and 9 cases mandibulotomy. There was no significant complication except a local wound infection in transzygomatic approach and one case of minimal malocclusion after parasymphyseal mandibulotomy. The orthotopic bone graft and the rigid fixation enables the postoperative morbidity to decrease. It seems that the previously inaccessible craniofacial tumors can be treated through the various exposure osteotomies.
Malocclusion ; Mouth ; Oropharynx ; Osteotomy* ; Skeleton ; Skull Base ; Transplants ; Wound Infection

No abstract available.
Kidney Failure, Chronic* ; Tuberculosis*