PURPOSE: To evaluate the efficacy and safety of retroperitoneoscopic nephroureterectomy in patients with a transitional cell carcinoma of the renal pelvis and the ureter. MATERIALS AND METHODS: A total of 30 patients underwent nephroureterectomy for an upper tract transitional cell carcinoma. Of these, 16 underwent a retroperitoneoscopic nephroureterectomy(RNU) and 14 an open nephroureterectomy(ONU). After the retroperitoneal radical nephrectomy had initially been performed, a 5-6cm modified Gibson incision was then created to allow dissection of the lower ureter and bladder cuff and extraction of the intact specimen. A retrospective chart review was performed and the operating time, blood loss, analgesic requirement, ambulation time, interval to resume oral intake, hospital stay and complications assessed in both surgical groups. RESULTS: The RNU was superior to the ONU group with regard to blood loss(240.6+/-103.1 versus 519.3+/-62.3ml, p<0.05), analgesic requirement (118.8+/-24.7 versus 240+/-26mg, p<0.05), ambulation time(21.5+/-3.7 versus 36.3+/-5.1 hours, p<0.05), interval to resume oral intake(34+/-3.3 versus 58+/-7.1 hours, p<0.05), and hospital stay(5.5+/-1.4 versus 10.9+/-3.9days, p<0.05). Complications developed in 6 and 14 of the RNU and ONU patients, but all of complications in both group were resolved with conservative management. The mean operating time of the RNU group was longer than that of the ONU group(270.6+/-53.2 versus 233.6+/-20.2 mins, p<0.05). The operating time of the initial 8 patients in the RNU group(311.3+/-38.8 mins) was significantly longer than that of the ONU group(p<0.05). However, the difference in the operating times between the final 8 patients in the RNU group(230+/-7.5 mins) and those in the ONU group were not significant(p>0.05). CONCLUSIONS: A retroperitoneoscopic nephroureterectomy is better tolerated by patients than an open nephroureterectomy as the surgery for an upper tract transitional cell carcinoma, and is also an efficacious alternative to open surgery. However, a long-term oncological evaluation will be required.
Carcinoma, Transitional Cell* ; Humans ; Kidney Pelvis ; Laparoscopy ; Length of Stay ; Nephrectomy ; Pelvis ; Retrospective Studies ; Ureter ; Urinary Bladder ; Walking

Pachydermoperiostosis (PDP) is a primary hypertrophic osteoarthropathy characterized by digital clubbing, pachydermia, and periostosis, which is inherited as an autosomal dominant or recessive trait. We report on a patient suffering from bilateral knee arthritis for 6 years who was newly diagnosed as PDP. PDP was confirmed by bilateral digital clubbing, hyperhidrosis, and cutis verticis gyrata, findings of pachydermatosis on the forehead and scalp, X-ray findings of proliferative periostitis. This case indicates that PDP is one of several possible rare diseases that should be considered in patients with undifferentiated arthritis.
Arthritis* ; Forehead ; Humans ; Hyperhidrosis ; Knee ; Osteoarthropathy, Primary Hypertrophic* ; Periostitis ; Rare Diseases ; Scalp

This correction is being published to correct the third author's Korean name.

BACKGROUND/AIMS: The serum cytokeratin-18 (CK-18) has been suggested to be a surrogate marker of non-alcoholic fatty liver disease (NAFLD). The aim of this study was to investigate the correlation between CK-18 and metabolic parameter in NAFLD patients. Correlation between CK-18 and macronutrient composition was also assessed. METHODS: A total of 212 subjects were recruited. Blood chemistry including fasting glucose, cholesterol level, AST, ALT, and CK-18 were compared. Data on calorie intake and carbohydrate consumption were acquired by five-day-diet diary using 24 hour recall method. RESULTS: Plasma CK-18 were markedly increased in patient with NAFLD compared with control group (420.4+/-282.3 vs. 313.6+/-179, p<0.001). Plasma CK-18 were positively correlated with systolic blood pressure (r=0.130), ALT (r=0.503) and negatively correlated with HDL cholesterol (r=-0.246). NAFLD patients with metabolic syndrome had higher CK-18 level than those without metabolic syndrome (484.0 vs. 372.1 U/L, p=0.021). When NAFLD patients were subdivided into two groups with CK-18 cut-off value of 400 U/L, patients with CK-18 level over 400 U/L showed higher body mass index (28.0+/-4.5 vs. 25.5+/-4.3), subcutaneous abdominal fat (283.5+/-172.2 vs. 195.7+/-147.8), AST (52.7+/-26.3 vs. 40.7+/-23.5) and ALT (102.0+/-52.6 vs. 61.2+/-32.2). Calorie intake (r=0.301) and carbohydrate intake (r=0.305) also showed positive correlation with CK-18. CONCLUSIONS: Plasma CK-18 showed positive correlation with metabolic parameters as well as calorie and carbohydrate intake when its cut-off value of greater than 400 U/L was used.
Abdominal Fat ; Biological Markers ; Blood Pressure ; Body Mass Index ; Carbohydrates ; Chemistry ; Cholesterol ; Cholesterol, HDL ; Fasting ; Fatty Liver* ; Glucose ; Humans ; Keratin-18* ; Plasma ; Ultrasonography*