PURPOSE: A retroperitoneoscopic adrenalectomy is theoretically the ideal procedure for an adrenalectomy. However, it is not popular due to its technical difficulty. Herein, we report our experience with retroperitoneoscopic adrenalectomies and describe the difficulties encountered during the operations. METHODS: From November 1996 to October 1999, a total of 41 retroperitoneoscopic adrenalectomies were performed. Forty (40) patients had a unilateral adrenal tumor (size: 1-6 cm): 21 aldosteronomas, 12 Cushing adenomas, 3 neurogenic tumors, 2 nonfunctioning adenomas, 1 vascular cyst, and 1 angiomyolipoma of the kidney. One (1) had bilateral hyperplasia. The operations were carried out in prone position in all cases with 3 trochars. RESULTS: Thirty five (35) operations were completed endoscopically. Five were converted to open procedures, and one was converted to a transperitoneal laparoscopic approach. The causes of conversion were 1 severe subcutaneous emphysema, 2 technical difficulties, 1 bleeding, 1 partial nephrectomy, and 1 missing tumor. The average operating time for the complete endoscopic adrenalectomies was 183 minutes in the first 14 cases and 142 minutes in the next 21 cases. There was no operative morbidity or mortality. The average hospital stay was 4.3 days in the first 14 cases and 2.8 days in the next 21cases. CONCLUSION: A retroperitoneoscopic adrenalectomy is a less invasive procedure than any other adrenalectomy procedure, and its only disadvantage is technical difficulty. However, the technical difficulty can be overcome with increasing experience.
Adenoma ; Adrenalectomy* ; Angiomyolipoma ; Hemorrhage ; Humans ; Hyperplasia ; Kidney ; Length of Stay ; Mortality ; Nephrectomy ; Prone Position ; Subcutaneous Emphysema

No Abstract Available.
Animals ; Apoptosis* ; Rats*

This study, whose subjects are forty stroke patients in discharging who have been using FIM Western medical (Neurology, Neurosurgery, Rehabilitation Medicine) and Chinese herb medical base of D Hospital in Pusan from the first of May to the eleventh of July, has been made to evaluate the patients' functional conditions and analyze the factors affecting them. The result of study is as followings: FIM total score in discharging is avarage 85.83+/-28.96; the motor FIM score is 57.55+/-24.40 and the cognitive FIM score 29.95+/-6.99. The items recorded the highest score reveal the eating bowel management; the former is 5.68:t 1.73, the latter 5.33+/-2.23. The item recorded the lowest score reveal bathing and stairs, each 2.35+/-1.69 and 3.23+/-2.13. Analysis reveal it is in the case of age(p=.005) and durations of admission(p=.01) that there is significant difference of FIM score when stroke patients in discharging.
Asian Continental Ancestry Group ; Baths ; Busan ; Eating ; Humans ; Neurosurgery ; Rehabilitation ; Stroke*

The glucose nonfermenting gram-negative bacilli encountered about 10% of all gram-negative bacilli isolated from clinical material. Therefore, a rapid and correct identification of glucose nonfermenting gram-negative bacilli is impotent for a better management of infectious disease. There are many conventional systems for the identification of glucose nonfermenting gram-negative bacilli but most of them have problems and difficulties. Commercial Kit Systems exist and they are too expensive for daily use in Korea because of high cost. Based on 12 selected tests we propose a new code system, MCRCODE-N for rapid and inexpensive identification of glucose nonfermenting gram-negative bacilli. The selective 12 tests are oxidase, glucose oxidation motihty, urease, DNase arginine dehydrolase, nitrate reduction, gelatin Liquefaction, esculin hydrolysis, mannitol oxidation, maltose oxidation, Lactose oxidation. The 12 tests are divided 4 group and then each group has 3 tests. The result of each group is expressed by the number as below. The positive test is given by specific number (1st test=1, 2nd test=2, 3rd test=4), while any negative result is 0. Each 3 numbers of one group are added and make number of 1 digit. Four digit number is referred to the code book of MCRCODE-N system or MCRCODE system using computer (Apple-II model) created by authors. This MCRCODE-N system is suitable ones for out use in Korea. We propose the MCRCODE-N system for clinical use.
Arginine ; Clinical Coding* ; Communicable Diseases ; Deoxyribonucleases ; Esculin ; Gelatin ; Glucose Oxidase ; Glucose* ; Hydrolysis ; Korea ; Lactose ; Maltose ; Mannitol ; Urease

No abstract available.

We describe a case of traumatic aortic dissection associated with cardiac compression in a patient with anaphylactic cardiac arrest who underwent cardiopulmonary resuscitation (CPR). A 54-year-old man who was scheduled to undergo surgery for gastric cancer went into cardiac arrest caused by an anaphylactic reaction to prophylactic antibiotics in the operating room. Veno-arterial extracorporeal membrane oxygenation (ECMO) was performed. CPR, including chest compressions, was performed for 35 minutes, and the patient was transferred to the intensive care unit (ICU) after spontaneous circulation returned. The patient received ECMO for 9 hours until confirmation of normal cardiac function on transthoracic echocardiography. Twenty days after cardiac arrest, an aortic dissection and fractures in the left fourth and fifth ribs due to chest compression were detected by abdominal computed tomography. The DeBakey type III aortic dissection extended from the distal arch of the thoracic aorta to the proximal level of the renal artery, involving the celiac trunk. It was considered an uncomplicated type B aortic dissection with no sign of malperfusion of the major vessels. This case demonstrates the potential traumatic injuries that can occur after CPR and encourages proper management of mechanical complications in cardiac arrest survivors.
Anaphylaxis ; Anti-Bacterial Agents ; Aorta, Thoracic ; Cardiopulmonary Resuscitation* ; Echocardiography ; Extracorporeal Membrane Oxygenation ; Heart Arrest ; Humans ; Intensive Care Units ; Middle Aged ; Operating Rooms ; Renal Artery ; Ribs ; Stomach Neoplasms ; Survivors* ; Thorax ; Tomography, Spiral Computed

No abstract available.
Humans ; Infant, Newborn*

No abstract available.
Denture, Partial, Removable*

No abstract available.
Osteotomy*

PURPOSE: A retroperitoneoscopic adrenalectomy is theoretically the ideal procedure for an adrenalectomy. However, it is not popular due to its technical difficulty. Herein, we report our experience with retroperitoneoscopic adrenalectomies and describe the difficulties encountered during the operations. METHODS: From November 1996 to October 1999, a total of 41 retroperitoneoscopic adrenalectomies were performed. Forty (40) patients had a unilateral adrenal tumor (size: 1?? cm): 21 aldosteronomas, 12 Cushing adenomas, 3 neurogenic tumors, 2 nonfunctioning adenomas, 1 vascular cyst, and 1 angiomyolipoma of the kidney. One (1) had bilateral hyperplasia. The operations were carried out in prone position in all cases with 3 trochars. RESULTS: Thirty five (35) operations were completed endoscopically. Five were converted to open procedures, and one was converted to a transperitoneal laparoscopic approach. The causes of conversion were 1 severe subcutaneous emphysema, 2 technical difficulties, 1 bleeding, 1 partial nephrectomy, and 1 missing tumor. The average operating time for the complete endoscopic adrenalectomies was 183 minutes in the first 14 cases and 142 minutes in the next 21 cases. There was no operative morbidity or mortality. The average hospital stay was 4.3 days in the first 14 cases and 2.8 days in the next 21 cases. CONCLUSION: A retroperitoneoscopic adrenalectomy is a less invasive procedure than any other adrenalectomy procedure, and its only disadvantage is technical difficulty. However, the technical difficulty can be overcome with increasing experience.
Adenoma ; Adrenalectomy* ; Angiomyolipoma ; Hemorrhage ; Humans ; Hyperplasia ; Kidney ; Length of Stay ; Mortality ; Nephrectomy ; Prone Position ; Subcutaneous Emphysema