No abstract available.
Laparotomy* ; Nephrectomy*

No abstract available.
Humans ; Laparotomy* ; Nephrectomy* ; Tissue Donors*

Minimally invasive surgery has gained wide acceptance as a method of reducing postoperative pain and curtailing the convalescence period. We have devised a modified surgical technique of laparoscopy-assisted surgery through minilaparotomy. It is a hybridized form of conventional open and laparoscopic surgery and it combines the benefits of both techniques by reducing postoperative pain and scarring as in laparoscopy, but at the same time maintaining the safety of conventional open surgery. From January 1992 to September 1999, we performed laparoscopy-assisted surgery through minilaparotomy in 167 patients. The operative time for laparoscopy-assisted surgery through minilaparotomy ranged from 79 to 290 minutes (mean 125). There was no conversion to open surgery, no peri- or postoperative complications, and only 3 patients needed a blood transfusion at any stage. Pain was significant on the first day but resolved quickly. All patients resumed consistent oral intake on the second day. All patients commenced ambulation by the second postoperative day and were able to resume full ambulatory activity by the fourth postoperative day. The final would size did not exceed 10 cm in size and all patients expressed satisfaction with their wounds. In conclusion, we believe that laparoscopy-assisted minilaparotomy surgery is a truly minimally invasive technique maintaining the advantages of conventional surgery. Our method could become a first-line approach for simple nephrectomy, living donor nephrectomy and radical nephrectomy, as well as surgery for kidney and ureter stones.
Adolescence ; Adult ; Aged ; Child ; Human ; Kidney/surgery* ; Laparoscopy* ; Laparotomy* ; Middle Age ; Nephrectomy ; Ureter/surgery*

OBJECTIVES: This study was carried out to evaluate the effects of industrial noise on blood pressure and heart rate. METHODS: Resting blood pressure, hearing loss, and general characteristics of the 102 subjects who were engaged in a factory in Pusan were measured from March to June for two years, in 1998 and 1999. With noise dosimeter, noise exposure level was measured from 8 A.M. to 4 P.M. Ambulatory blood pressure and heart rate were also measured every 30 minutes from 8 A.M. to 10 P. M. RESULTS: Controlling for age, smoking, and Quetelet's index, in subjects of under 40 years old exposed to higher than 85dBA, noise exposure and systolic blood pressure had a statistically significant correlation, and the same result was obtained in all subjects. The daily variability of ambulatory blood pressure and heart rate were observed in older than 40 years old group, but only heart rate in under 40 years old. CONCLUSIONS: The blood pressure and heart rate would be elevated when the workers exposed to noise. And in under 40 years old, the systolic blood pressure was elevated to the workers exposed to higher than 85dBA.
Adult ; Blood Pressure* ; Body Mass Index ; Busan ; Hearing Loss ; Heart Rate* ; Heart* ; Humans ; Noise* ; Smoke ; Smoking

OBJECTIVE: In recent years, the neurosurgeon's role in managing cerebrovascular diseases (CVD) has becomes rapidly challenged and overlapped with other specialists. Furthermore, the patterns of CVD and patient recruitment have also changed. We conducted a retrospective study regarding the practical trends of CVD with reference to the management paradigms at our institute. METHOD: We reviewed all the available data, including the annual reports, the daily department records, the medical records and the radiographic films of the CVD patients who had been admitted to our Neurosurgery Department during the five years between Jan. 2004 and Dec. 2008. RESULTS: The total numbers of CVD operations showed a slight initial increase, but then they remained steady for the latter 3 years. The number of cases of non-angiomatous hemorrhage has been relatively steady, regardless of surgery. The total numbers of treated aneurysms increased, but the main body of this increment was attributed to the initiation of endovascular treatment and increased identification of unruptured vascular lesions. Vascular malformations were sustained with a small number of cases due to referring them to other institutes for radiosurgery, except for the cases that required urgent hemorrhagic evacuation. CONCLUSION: Hemorrhagic CVDs tended to decrease either due to increasing identification before rupture or shifting such patients into a large volume hospital. The increasing awareness of ischemic CVD, the early detection of unruptured aneurysms, and the separation of medical responsibilities from neurologists have all pushed neurosurgeons to make treatment plans in a more cooperative fashion, instead of a competitive way. Neurosurgeons should be furnished with several revolutionary surgical options to widen their scope of managing patients with CVD.
Academies and Institutes ; Aneurysm ; Hemorrhage ; Humans ; Infarction ; Intracranial Aneurysm ; Medical Records ; Neurosurgery ; Patient Selection ; Radiosurgery ; Retrospective Studies ; Rupture ; Specialization ; Subarachnoid Hemorrhage ; Vascular Malformations ; X-Ray Film

No abstract available.

A previously healthy 44-year-old male was admitted with the chief complaint of intermittent gross hematuria. On initial ultrasonographic and CT examination, a grossly protruding intravesical tumor was noted and, under the impression of a malignant bladder tumor, transurethral resection was performed. The histological findings were spindle cells with elongated cytoplasm with rare mitotic figures distributed in myxoid stroma, consistent with diagnosis of inflammatory pseudotumor of the bladder. The benign nature of this tumor warrants conservative surgical management, usually consisting of transurethral resection or partial cystectomy. No reports of metastasis have been reported following complete excision. Therefore, any suspicion and recognition of this entity is imperative to avoid performing an irreversible radical procedure.
Adult ; Bladder Diseases/surgery ; Bladder Diseases/pathology* ; Case Report ; Granuloma, Plasma Cell/surgery ; Granuloma, Plasma Cell/pathology* ; Human ; Male

No abstract available.

PURPOSE: To evaluate the merit of umbilical artery Doppler study as a predictive marker of perinatal outcome in preterm small for gestational age (SGA) infants. MATERIALS AND METHODS: A total of 218 patients at 27 - 36 weeks of gestational age (GA) who received antenatal umbilical artery Doppler velocimetry and delivered singleton infants with SGA. The ratio of peak-systolic to end-diastolic blood flow velocities (S/D) in the umbilical artery was measured in each patient. The patients were divided into 3 groups: the normal group with S/D ratios of less than 95th percentile (n = 134), elevated S/D ratio group of 95th or more percentile (n = 41), and those with absent/reversed end diastolic flow (n = 43). Maternal characteristics and neonatal outcomes of these groups were comparatively analyzed. RESULTS: The gestational age (GA) at the time of diagnosis of SGA, the mean GA at delivery, and the mean birth weight showed statistically significant difference among three groups (p < 0.001). Also, poor perinatal outcome was significantly increased in infants with abnormal S/D ratio (13.4% vs. 31.7% vs. 67.4%, p < 0.001). Multivariate logistic regression analysis revealed umbilical artery Doppler study as a significant independent factor for prediction of poor perinatal outcome (odds ratio: 3.7, 95% confidence interval 1.4 - 9.5, p = 0.007). CONCLUSION: Antenatal umbilical artery Doppler velocimetry is shown as a significantly efficient marker in predicting perinatal outcome in preterm SGA infants.
Blood Flow Velocity ; Female ; Humans ; Infant, Newborn ; *Infant, Small for Gestational Age ; Multivariate Analysis ; Predictive Value of Tests ; Pregnancy ; *Pregnancy Outcome ; Retrospective Studies ; Ultrasonography, Doppler/*methods ; Ultrasonography, Prenatal/*methods ; Umbilical Arteries/*ultrasonography

Hepatie hilar ductal carcinoma is relatively rare, but the prognosis is known to be poor because an early diagnosis is difficult. Because the majority of patients are already infiltrated into adjacent organ by itself at the diagnosis, the rate of resectability is low. The best method of treatment is curative resection, and the range of tumor invasion is very important. The preoperative diagnosis is difficult because the cholangiography may be normal in cases of superficial invasion. Multifocal lesions within the biliary tract may be identified in as many as 10 percent of patients, Especially, the papillary type has the best prognosis and is associated with multiple tumors within the bile duct. We report a case that percutaneous transhepatic cholangiogram showed normal distal common bile duct, but the hepatic hilar confluence and ampulla of Vater lesion was confirmed as adenocarcinoma.
Adenocarcinoma ; Ampulla of Vater* ; Bile Ducts ; Biliary Tract* ; Carcinoma, Ductal ; Cholangiocarcinoma* ; Cholangiography ; Common Bile Duct ; Diagnosis ; Early Diagnosis ; Humans ; Pancreas* ; Prognosis