45 cases of proved renal cell carcinoma which were operated on during last 10 years between March 1972 and February 1982 in the department of Urology of Yonsei University College of Medicine were clinically observed with the reference to the operative morbidity due to the surgical incisions of both anterior transperitoneal approach (25 cases or 55%) and modified thoracoabdominal approach which is 11th-rib resection with extrapleural and transperitoneal exposure (20 cases of 45%). According to the experience with modified thoracoabdominal incision for the 17 radical nephrectomies and 3 open biopsies and through the review of the literatures, some results were obtained and summarized as follows. 1. Modified Thoracoabdominal approach is superior to the anterior transperitoneal approach for the operation of renal malignancy because of better exposure for the renal pedicle and upper pole as well as low morbidity rate (1:1.6). 2.We could also be sure by our self experiences of a few advantages of Modified Thoracoabdominal approaches as others reported previously. (1) An undisturbed intrathoracic space avoids a source of complications. (2) Because of adequate exposure of renal pedicle and upper pole even in the large renal tumor, operativemanipulation is easier and safer. (3) As muscle layers to be cut are not heavy, postoperative pain is less complained. The incision is also relatively simple to make and close. (4) Modified Thoracoabdominal approach is worth to apply to any urologic operations for the kidney and upper ureter. 3. In case tumor thrombi were involved in the supradiaphragmatic vena cava and vena caval resection is inevitable, either midline abdominal incision with sternotomy or conventional thoracoabdominal incision should be chosen rather than Modified thoracoabdominal approach.
Biopsy ; Carcinoma, Renal Cell* ; Humans ; Kidney ; Nephrectomy* ; Pain, Postoperative ; Sternotomy ; Ureter ; Urology

A group of 180 men who visited Urology Department of Severance hospital, including 115 patients with nongonococcal urethritis (N.G.U.), 27 patients with prostatitis, 13 patients with gonococcal urethritis (G.U.) and 25 healthy medical student controls were investigated for the isolation of Ureaplasma urealyticum (T-strain mycoplasma) from the specimen of urethral discharge, urine and semen. Taylor-Pobinson media of T-broth and T-agar was used for the isolation of Ureaplasma urealyticum. To the best of our knowledge, the study on the culture of Ureaplasma urealyticum was reported for the first time in Korea. The following results were obtained: 1. The isolation rate of Ureaplasma urealyticum in nongonococcal urethritis (53.0%) revealed highest of those in the other three groups of prostatitis, gonococcal urethritis and control (40.7%, 38.4% and 16.0% respectively). 2. As for the specimens, urethral discharge revealed higher isolation rate of Ureaplasma urealyticum (54.6%)than first voided urine (50.0%). 3. The more consorts patients had, the higher positive culture rate of Ureaplasma urealyticum were revealed. The isolation rate in case of more than one causal in nongonococcal urethritis (71.1%) revealed much higher than in case of marital only (42.8%), one regular (41.1%) and one causal (41.0%). 4. 18.7% of isolation rate of Ureaplasma urealyticum revealed in patients with nongonococcal urethritis who visited the clinic in later than 4 weeks after the symptoms developed. However, the isolation rate in patients who visited within 4 weeks revealed 58.9%. The lower isolation rate of Ureaplasma in the late treatment seekers might be probably due to the suppression effect against Ureaplasma urealyticum from the possible previous self antibiotic treatment. 5. Attachment of Ureaplasma urealyticum mostly to the neck and head portion of the spermatozoa seemed to play a role to affect the motility of sperms.
Head ; Humans ; Korea ; Male ; Neck ; Prostatitis ; Semen ; Spermatozoa ; Students, Medical ; Ureaplasma urealyticum* ; Ureaplasma* ; Urethritis* ; Urology

No abstract available.
Animals ; Dynorphins* ; Enkephalins* ; Prosencephalon* ; Rats* ; RNA, Messenger*

PURPOSE: This study performed to identify the association between various nutritional indices including biochemical, anthropometric variables and mortality in Korean elderly. METHODS: Among a total of 151,000 subjects over 40 years of living in Jung-up district, 1051 was selected using a random cluster sample method. Between Dec 1996 and Feb 1997, they underwent the blood tests and anthropometric measurements. Three years later, on Dec 2000, we investigated the mortality of the 340 subjects that had been over 65 years at the enroll time. RESULTS: Of the 1051 subjects(M:F=410:641), 340 were over 65 years at the enroll time, 34(10%) had died by 3 years follow up. After adjustment of age and sex, decreased Hb, Hct, serum protein, albumin, increased serum creatinine were significantly associated with an increased risk of mortality(p<0.05) among the variables. Especially serum albumin remained strong predictors of mortality after cont rolling for other significant variables(RR=0.15, 95% CI=0.03-0.63, p=0.01). CONCLUSION: We confirmed the strong independent association with serum albumin and mortality in the rural community dwelling ambulatory elderly Koreans.
Aged* ; Creatinine ; Follow-Up Studies ; Hematologic Tests ; Humans ; Jeollabuk-do ; Mortality ; Nutrition Assessment ; Rural Population ; Serum Albumin

Lipoma involving brain and spinal cord is a rare tumor that most commonly located in the midsagittal region. This lesion is usually asymptomatic and has been reported incidentally at postmortem examination. Recently, the CT scan establishes the diagnosis of intracranial lipoma on the basis of typical X-ray absorption and location. The authors experienced a case of intracranial lipoma of occipital lobes. The patient was 7 months-old male who had protruding mass on the occipital region after birth. The mass revealed an uncapsulated lipoma with foca cartilage formation. We report this case with brief review of literatures.
Male ; Humans

Background: Univent(R) tube was designed to overcome the disadvantages of double lumen endotracheal tube for one lung anesthesia. But overinflation of the blocker cuff of an endobronchial tube can cause pressure damage to the bronchus. The purpose of this study was to evaluate whether the blocker cuff pressure and the duration of ballooning using the Univent(R) tube is correlated with the degree of bronchial mucosal damage (BMD). Methods: A total of 13 men and 7 women intubated with the Univent(R) tube were enrolled for the study. The BMD were evaluated by direct visualization using fiberoptic bronchoscopy prior to intubation and following extubation and the degree of the BMD were scored from 0 to 4 as follows; 0: normal, 1: erythema, 2: swelling, 3: hemorrhage, 4: mucosal wall tearing. Results: No change in bronchial mucosa (score 0) were observed in 11 patients (55%), erythema (score 1) in 5 patients (25%), swelling (score 2) in 3 patients (15%), hemorrhage (score 3) in 1 patient (5%) and mucosal wall tearing (score 4) is none in 20 patients. The bronchial blocker cuff pressure required to "just sealing" the bronchus was 178.1+/-37.4 mmHg with corresponding cuff volume of 6.7+/-1.0 cc. The duration of ballooning was 115.5+/-26.4 min. The correlation coefficient between the blocker cuff pressure and duration of ballooning to the degree of bronchial mucosal damage were 0.125 and 0.137, respectively, which was not statistically significant. Conclusions: The bronchial blocker of Univent(R) tube doesn't cause any severe BMD and the degree of BMD are correlated with neither the bronchial blocker cuff pressure nor duration of ballooning of Univent(R) tube.
Anesthesia ; Bronchi ; Bronchoscopy ; Erythema ; Female ; Hemorrhage ; Humans ; Intubation ; Lung ; Male ; Mucous Membrane

No abstract available.
Appendicitis* ; Humans

Retroperitoneal duodenal rupture is rare and is often difficult to diagnose on the plain abdominal x-ray. From a review of the plain abdomen films of 21 cases with retroperitoneal duodenal rupture, confirmed by operation, pneumoretroperitoneum was revealed in 16 cases; Air in the peritoneum was manifested as a bubbly shadow in 12 cases, a renal halo in 9 cases, air shadow along the right psoas margin in 2 cases, air along the diaphragmatic crus in 2 cases and air in the right properitoneal fat in 2 cases, US and CT also revealed air bubbles and fluid collection around the right kidney. We recommend the plain abdomen as a useful diagnostic method for detection of pneumoretroperitoneum.
Abdomen* ; Kidney ; Methods ; Peritoneum ; Retropneumoperitoneum ; Rupture*

Prenephrectomy therapeutic renal artery embolization by injecting gelfoam into therenal artery was done in a 47 year-old female patient with hypernephroma. This technique facilitated nephrectomy and decreased blood loss. A post-infarction syndrome characterized by flank pain, fever and nausea also occurred in this patient. We report our experience herein with review of literature.
Arteries ; Carcinoma, Renal Cell* ; Female ; Fever ; Flank Pain ; Gelatin Sponge, Absorbable ; Humans ; Middle Aged ; Nausea ; Nephrectomy ; Renal Artery*

No abstract available.