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

PURPOSE: recent studies have reported that the expression of Drg-1 is up-regulated by androgen. It has been suggested that Drg-1 gene be used as a molecular marker for prostate cancer therapies like PSA. To de termine the role of Drg-1 gene as a molecular marker during intermittent androgen deprivation(IAD) therapy, we investigated the expression of Drg-1 and compared it with PSA expression in human prostate cancer cell lines treated with dihydrotestosterone (DHT) continuously or intermittently. MATERIALS AND METHODS: Two prostate cancer cells having different status of androgen receptor [LNCaP (androgen dependent) and PC-3 (androgen independent)] were used in this study. To know the change in PSA and Drg-1 expression after DHT treatment the cells were cultured in steroid-free RPMI media for 24 hours. 10(-7) and 10(-8)M of DHT and 10(-7)M bicalutimide was added into the cells and then cultured for 72 hours. And we established in vitro IAD model using LNCaP cells. Northern analyses were performed to determine the expression level of both PSA and Drg-1genes. Also, western analyses were performed to determine the protein level of proliferating cellular nuclear antigen and androgen receptor. RESULTS: Transcripts of Drg-1 were detected in both LNCaP and PC-3 cells but PSA was not expressed in PC-3 cells. The expression of Drg-1gene in LNCaP cells was up-regulated by 10(-8)M of DHT like PSA gene and down-regulated by 10(-7)M bicalutamide. In the treatment of intermittent androgen deprivation, the expression pattern of Drg-1was similar to that of PSA. However, up-regulation of PSA was detected earlier than of Drg-1. CONCLUSIONS: Based on observation, Drg-1 was up-regulated by androgen and down-regulated by anti-androgen. This suggests that Drg-1gene is useful for determining the androgen independency of prostate cancer during IAD.
Cell Line ; Dihydrotestosterone ; Humans ; Prostate* ; Prostatic Neoplasms* ; Receptors, Androgen ; Up-Regulation

No abstract available.

To evaluate the value of MR imaging in the examination of ligament injury of the knee, we retrospectively analysed the MR images of 61 injured knees of 60 patients. The presence of tear was determined by arthroscopy in all cases. Anterior/posterior cruciate ligaments(ACL/PCL) were demonstrated by sagittal images. Media/lateral collateral ligaments(MCL/LCL) were evaluated on coronal images. The diagnostic accuracy were 91.8%, 96.7% and 100% for ACL, PCL and MCL, respectively. The specificity for the lateral collateral ligament was 100%. It is concluded that magnetic resonance imaging is an accurate method in detecting injury of the ligaments of the knee.
Arthroscopy ; Humans ; Knee* ; Lateral Ligament, Ankle ; Ligaments* ; Magnetic Resonance Imaging ; Methods ; Retrospective Studies ; Sensitivity and Specificity ; Tears

PURPOSE: To compare 2 surgical techniques, endoscopic transnasal reconstruction and transcaruncular reconstruction in isolated medial orbital wall fractures. METHODS: This study included 79 isolated medial orbital wall fracture patients from January 2011 to December 2012 of Department of Ophthalmology, Inha University Hospital. The authors compared computed tomographic scans, diplopia, extraocular muscle (EOM) movements, and Hertel's exophthalmometer exams pre- and post-surgery. Thirty-five patients received endoscopic transnasal reconstruction and 44 received transcaruncular reconstruction. RESULTS: The 2 surgical methods showed no significant differences in primary gaze diplopia (p = 0.50), restriction of EOM movements (p = 0.48), remaining enophthalmos of more than 2 mm (p = 0.99), and improvement in enophthalmos (p = 0.07) when compared 6 months after surgery. Statistically significant differences were observed in peripheral diplopia (p = 0.04) 6 months after surgery. CONCLUSIONS: The 2 surgical methods present similar effectiveness in postoperative primary gaze diplopia, EOM restriction, and enophthalmos. With respect to postoperative peripheral diplopia, endoscopic transnasal reconstruction method showed advantages. The surgical method should be selected by comparing advantages and disadvantages.
Diplopia ; Enophthalmos ; Humans ; Ophthalmology ; Orbit*

Recent technological advances have made magnetic resonance images (MR) of the knee a clinical reality. MR is rapidly replacing the conventional arthrography as the imaging modality of choice of the knee joints. To evaluate the diagnostic accuracy of MR in the internal derangement of the knee. MR findings of 244 menisci and 488 ligaments of 122 knees were correlated with those of subsequent arthroscopy or surgery in all cases. The sensitivity, specificity, and accuracy of MR diagnosis for the medial meniscus were 87%, 93%, 91%, for the lateral meniscus 91%, 95%, 93%, for the anterior cruciate ligament 80%, 97%, 92%, for the posterior cruciate ligamant 73%, 99%, 97%, for the medial collateral ligament 67%, 100%, 99%, for the lateral collateral ligament 100%, 100% and 100%. These results imply that MR is an excellent diagnostic modality in the preoperative evaluation of clinically suspected internal derangement of the knee.
Anterior Cruciate Ligament ; Arthrography ; Arthroscopy ; Collateral Ligaments ; Diagnosis ; Knee ; Knee Joint ; Lateral Ligament, Ankle ; Ligaments ; Magnetic Resonance Imaging* ; Menisci, Tibial ; Sensitivity and Specificity

Recent technological advances have made magnetic resonance images (MR) of the knee a clinical reality. MR is rapidly replacing the conventional arthrography as the imaging modality of choice of the knee joints. To evaluate the diagnostic accuracy of MR in the internal derangement of the knee. MR findings of 244 menisci and 488 ligaments of 122 knees were correlated with those of subsequent arthroscopy or surgery in all cases. The sensitivity, specificity, and accuracy of MR diagnosis for the medial meniscus were 87%, 93%, 91%, for the lateral meniscus 91%, 95%, 93%, for the anterior cruciate ligament 80%, 97%, 92%, for the posterior cruciate ligamant 73%, 99%, 97%, for the medial collateral ligament 67%, 100%, 99%, for the lateral collateral ligament 100%, 100% and 100%. These results imply that MR is an excellent diagnostic modality in the preoperative evaluation of clinically suspected internal derangement of the knee.
Anterior Cruciate Ligament ; Arthrography ; Arthroscopy ; Collateral Ligaments ; Diagnosis ; Knee ; Knee Joint ; Lateral Ligament, Ankle ; Ligaments ; Magnetic Resonance Imaging* ; Menisci, Tibial ; Sensitivity and Specificity

PURPOSE: To compare two combined surgical techniques, endoscopic endonasal surgery with transconjunctival reconstruction and transcaruncular surgery with transconjunctival reconstruction, when used to treat both medial and inferior orbital wall fractures. METHODS: A retrospective review of 63 patients who were followed up from January 2011 to December 2014 at Inha University Hospital for surgical reconstruction of combined medial and inferior orbital wall fractures was undertaken. We compared between the patients the computed tomographic scans, diplopia, extraocular muscle (EOM) movements, and Hertel's exophthalmometer exams pre- and post-6 months surgery. A total of 29 patients received endoscopic transnasal surgery with trasconjunctival reconstruction, and 34 received transcaruncular surgery with trans-conjunctival reconstruction. RESULTS: There were no significant differences between the two combined methods in terms of the primary and peripheral gaze diplopia or the restriction of EOM movement 6 months after surgery. However, statistically significant differences were observed in exophthalmometer measurements 6 months after surgery. CONCLUSIONS: The two combined surgical methods showed similar results in terms of postoperative primary and peripheral gaze diplopia, EOM restriction, and enophthalmos. With respect to postoperative peripheral diplopia, endoscopic endosnasal surgery with transconjunctival reconstruction showed several advantages over the other method considered in this study. An appropriate surgical method should be selected by comparing the relative advantages and disadvantages.
Diplopia ; Enophthalmos ; Humans ; Methods ; Orbit* ; Retrospective Studies

No abstract available in English.
Female ; Humans ; Urinary Incontinence*

To evaluate the role of magnetic resonance(MR) imaging in the diagnosis of the discoid meniscus, the authors reviewed 31 cases of discoid menisci diagnosed by MR imaging among which 16 cases received arthroscopy. Using knee surface coil, sagittal T1, T2, & protein density images and coronal T1 weighted images were obtained with 18 cm FOV & 4mm/1 mm thickness/gap. A discoid meniscus was considered if three or more contiguous sagittal images demonstrated continuity of the meniscus between the anterior and posterior horns or the diameter of the mid-portion of the meniscus exceeded 15 mm on the coronal image. The authors also observed the associated abnormalities including tears of meniscus and ligament, meniscal cyst, and osteochondral defects. All discoid menisci were lateral menisci and torn discoid lateral menisci were present in 26 cases(83%). In two cases, tears of the contralateral medial meniscus were present. The tears of anterior and posterior cruciate ligaments, meniscal cyst, and osteochondral defects were present in 4, 2, 4, and 5 cases respectively. All collateral ligaments were intact. In conclusion MR imaging was useful for the detection of discoid meniscus and associated abnormalities.
Animals ; Arthroscopy ; Collateral Ligaments ; Diagnosis ; Horns ; Knee* ; Ligaments ; Magnetic Resonance Imaging* ; Menisci, Tibial ; Posterior Cruciate Ligament ; Tears