PURPOSE: To search for a safer and easier approach for laparoscopic donor nephrectomy, hand-assisted laparoscopic techniques have been added to the surgical armamentrium. Hand-assisted live donor nephrectomy (HALDN) for renal transplantation is being performed in increasing numbers with the goal of broadening organ supply while minimizing pain and duration of convalescence for donors. Here, we compared our initial series of HALDN with open donor nephrectomy (ODN). MATERIALS AND METHODS: Between July 2001 and February 2003, a total of 63 patients underwent consecutive live donor nephrectomy in our hospital, which were all performed by a single surgeon. Of these patients 22 underwent HALDN and 41 underwent ODN. Objective data and subjective recovery information was obtained from medical records, telephone interviews, and questionnaires. RESULTS: Twenty-two HALDNs were performed successfully without open conversion. There was a significant reduction in postoperative visual analogue pain scale (p<0.05), and there were characteristics of rapid return to normal activities (p<0.05) in the HALDN group. The mean operative time, estimated blood loss, hospitalization, and complications were similar in both groups. The mean warm ischemic time was significantly longer in the HALDN group (p<0.05). However, warm ischemic time between the latter HALDN and the ODN group was not significant (p=0.46). In terms of allograft function, serum creatinine at 1, 2 days, 1 week, 2 weeks, 1 month, 2 months, delayed graft function, episodes of rejection, and ureteral complication were similar in both groups. Transfusion was required in one patient of the HALDN group. CONCLUSIONS: HALDN is efficacious and reproducible, and it is safe for live donor nephrectomy. Compared with ODN, HALDN significantly lessened the pain for the donor, and it allows a more complete convalescence, while enabling excellent allograft function.
Allografts ; Convalescence ; Creatinine ; Delayed Graft Function ; Hand ; Hospitalization ; Humans ; Interviews as Topic ; Kidney ; Kidney Transplantation ; Laparoscopy ; Medical Records ; Nephrectomy* ; Operative Time ; Pain Measurement ; Surveys and Questionnaires ; Tissue Donors* ; Transplantation ; Ureter ; Warm Ischemia

OBJECTIVE: This study was performed to assess agreements among screening tests, to estimate prevalence, and to identify related factors with postpartum depression. METHODS: For 323 women at 7 days postpartum, self-administered questionnaires were given including postpartum depression screening test such as EPDS, QIDS-SR16, BDI and questionnaires for their demographic and psycho-social information. Obstetric information were collected from medical records. Simultaneous positive cases in EPDS and BDI were defined as gold standard and used to estimate the prevalence of postpartum depression and agreements between 3 kind of screening test and gold standard. Related factors of postpartum depression were analysed by using SPSS. RESULTS: The prevalence of postpartum depression was 19.8% and the Kappa indices were 0.711 in BDI, 0.803 in EPDS, and 0.395 in QIDS-SR16. Feeding method, smoking history, antenatal anxiety/depression symptoms, residence status, marital satisfaction, relationship with husband's parents, and postpartum care method in univariate analysis and premature delivery (odds ratio: 2.9), formulated feeding (odds ratio: 3.8), marital dissatisfaction (odds ratio: 4.3), professional husband's occupation (odds ratio: 4.4), and antenatal anxiety/ depression symptoms (odds ratio: 4.4) in the logistic regression analysis were significantly related to postpartum depression (P<0.05). CONCLUSIONS: Simultaneous test of BDI and EPDS was effective to evaluate postpartum depression prevalence at 1-week postpartum and highly agree with EPDS. Significant related factors were defined and further prospective community-based studies are warranted.
Depression ; Depression, Postpartum ; Feeding Methods ; Female ; Humans ; Logistic Models ; Marital Status ; Mass Screening ; Medical Records ; Occupations ; Parents ; Postnatal Care ; Postpartum Period ; Prevalence ; Surveys and Questionnaire ; Smoke ; Smoking

A review of 234 patients with cervical cancer during the last 5 years was undertaken to evaluate the efficacy of routine cystoscopic examination in staging cervical cancer. Cystoscopic abnormalities suggesting bladder invasion of the cervical cancer were found in none of the 127 patients with clinical stage 1 and 65 patients with clinical stage 2. In 7(22.6%) out of 31 patients with clinical stage 3 and in 4(80%) out of 5 patients with clinical stage 4. markedly bullous edema and hyperemia suggesting suspicious bladder invasion was identified on cystoscopy. Mucosal biopsy was done in 5 or them which revealed no pathologic invasion. Incidentally found transitional cell carcinoma was found in one patient. From these observations, it can be concluded that routine cystoscopy is not recommended in cervical cancer with clinical stage 1 and 2, and is indicated only in clinical stage 3 or greater.
Biopsy ; Carcinoma, Transitional Cell ; Cystoscopy* ; Edema ; Humans ; Hyperemia ; Urinary Bladder ; Uterine Cervical Neoplasms*

Iatrogenic implantation has been the main cause in the majority of cases of transitional call carcinoma (TCC) with metastasis to the abdominal wall. A 66-year-old woman had undergone radical cystectomy 20 years prior to presenting. Radiological investigations revealed one mass in the left lower abdominal wall and one mass in the right inguinal area. She underwent wide excision of the lesions that revealed metastasis of TCC. This report describes this case of a woman with bladder carcinoma who developed a metastasis in the anterior abdominal wall following an apparent disease-free interval of 20 years.
Abdominal Wall/*pathology ; Aged ; Bladder Neoplasms/*pathology/*surgery ; Carcinoma, Transitional Cell/*secondary/*surgery ; Cystectomy ; Female ; Humans ; Soft Tissue Neoplasms/*secondary ; Time Factors

It has been suggested that diseased and anomalous kidneys are more susceptible to injury. While horseshoe kidney is the most common congenital anomaly of renal fusion, occurring in about one in every 400-500 births, reports of the horseshoe kidneys associated with renal trauma are rare. Herewe now report our experiences with two cases of renal trauma on horseshoe kidney.
Kidney* ; Parturition

No abstract available.
Hodgkin Disease*

BACKGROUND: The main cause of atherosclerotic peripheral vascular disease is known to be atherosclerotic processing. In patients with atherosclerotic peripheral vascular disease, other atherosclerotic diseases are frequently combined, especially coronary artery disease. There were some suggestions that the risk factors of the atherosclerotic peripheral vascular disease be different from the those of the coronary artery disease. The aim of this study was to evaluate the independent risk factors for the atheroslerotic peripheral vascular disease(PVD) without influence of coronary artery disease(CAD). METHODS: The study population was male patients with atherosclerotic peripheral vascular disease(n=66) documented by peripheral angiogram form February 1991 to Octobor 1993, and during their abmission all patients with suspected atherosclerotic peripheral vascular diaease underwent both peripheral angiogram and coronary angiogram. Careful history taking and physical examination and lipid battery sampling after at least 14 hours of fasting were also performed. RESULTS: 60% of patients with peripheral vascular disease also had coronary artery disease. There was no significant difference in total cholesterol, HDL cholesterol, LDL cholestrerol, triglyceride between patients with peripheral vascular disease and age-matched control. The prevalence of hypertension was higher in patients with peripheral vascular disease but with no statistical significance. Smoking(p<0.0001) and diabetes(p<0.05) were strongly associated with peripheral vascular disease. When patients without coronary artery disease were compared to control from the viewpoint of risk factors again, the results were the same, that is, smoking and diabetes were also associated with periperal vascular diseaes. CONCLUSION: The prevalence of associated coronary artery disease was relatively high in patients with atherosclerotic peripheral vascular disease. And smoking and diabetes seem to be important risk factors of atherosclerotic peripheral vascular disease.
Cholesterol, HDL ; Cholesterol, LDL ; Coronary Artery Disease ; Coronary Vessels ; Diabetes Mellitus ; Fasting ; Humans ; Hypertension ; Male ; Peripheral Vascular Diseases ; Physical Examination ; Prevalence ; Risk Factors* ; Smoke ; Smoking ; Triglycerides

The most common cause of acute pancreatitis is gallstones. However, idiopathic causes comprise about 10 to 15% of all cases of acute pancreatitis. Biliary sludge is thought to be a cause of idiopathic acute pancreatitis and mainly via obstruction of the common bile duct. Cholesterol polyps of the gallbladder, cholesterolosis and hemobilia can be associated with biliary pain. Fragments of the gallbladder polyps and blood clots can lead to acute pancreatitis in a way similar to that of biliary sludge. Yet it has never been reported that the necrotic tissue of gallbladder cancer can lead to acute pancreatitis. Herein, we report on the case of a 52-year-old man with acute pancreatitis that was caused by the necrotic tissue of gallbladder cancer. The necrotic tissue in the bile duct was revealed on endoscopic retrograde cholangiopancreatography (ERCP). The patient was successfully treated by laparoscopic cholecystectomy along with liver segmentectomy.
Bile ; Bile Ducts ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystectomy, Laparoscopic ; Cholesterol ; Common Bile Duct ; Gallbladder ; Gallbladder Neoplasms ; Gallstones ; Hemobilia ; Humans ; Liver ; Mastectomy, Segmental ; Middle Aged ; Pancreatitis ; Polyps

BACKGROUND: Some diabetic feet heal without complication, but others undergo amputation due to progressive wounds. This study investigates the risk factors for amputation of diabetic feet. METHODS: A total of 55 patients who visited our institution from 2008 to 2012 were included in the study. The patients with abnormal fasting blood sugar levels, lower leg vascularity, and poor nutrition were excluded from the study group, and the wound states were unified. The patients were categorized into a treatment success group (n=47) and a treatment failure group (n=8), and their hemoglobin A1C (HgA1C), C-reactive protein (CRP), white blood cell count (WBC), and serum creatinine levels were analyzed. RESULTS: The initial CRP, WBC, and serum creatinine levels in the treatment failure group were significantly higher than that of the treatment success group, and the initial HgA1C level was significantly higher in the treatment success group. The CRP and WBC levels of both groups changed significantly as time passed, but their serum creatinine levels did not. CONCLUSIONS: The initial CRP, WBC, and serum creatinine levels were considered to be risk factors for amputation. Among them, the serum creatinine level was found to be the most important predictive risk factor. Because serum creatinine represents the renal function, thorough care is needed for the feet of diabetic patients with renal impairment.
Amputation ; Blood Glucose ; C-Reactive Protein ; Creatinine ; Diabetes Complications ; Diabetic Foot ; Fasting ; Foot ; Foot Ulcer ; Hemoglobins ; Humans ; Leg ; Leukocyte Count ; Risk Factors ; Treatment Failure ; Ulcer

Malignant duodenocolic fistula is a rare complication of advanced right colon cancer. The surgeon becomes involved not only with the cancer lesion, but also with the physiologic complications, such as electrolyte imbalance and malnutrition. We experienced 2 cases of duodenocolic fistulas arising from right side colon cancers. One of the patients was surgically treated by right hemicolectomy and pancreatico-duodenectomy and another case was lost to follow-up. We report these cases with a brief review of the literature.
Colonic Neoplasms ; Fistula* ; Humans ; Lost to Follow-Up ; Malnutrition