ABSTRACT
PURPOSE: To evaluate the feasibility of a currently available robotic surgical system in performing various general surgical laparoscopic procedures in an acute porcine model. METHODS: Telepresence robotic laparoscopic surgeries, comprising cholecystectomy, Nissen-fundoplication, choledochocholedochostomy and gastrojejunostomy were performed in 5 swine models for 3 consecutive days by the same surgeon who is experienced in advanced conventional laparoscopic surgery. Data were collected from the da VinciTM Robotic System. RESULTS: Mean operative times were 24.4+/-10.6 minutes for cholecystectomy (N=5) 41.2+/-5.5 for Nissen fundoplication (N=5) 51+/-5.6 for choledochocholedochostomy (N=5), and 53.3+/-7.6 for gastrojejunostomy (N=3) but there were 2 cases of failure in the latter. In the case of choledochocholedochostomy, operative time was reduced from 76 minutes in the first case to 42 minutes in the last. Intra- operative blood loss was minimal and there was no intra- operative complication related with malfunction of robotic system. CONCLUSION: Robotic laparoscopic procedures can be performed effectively using the da VinciTM System. In this limited study, the learning curve and operative times were shorter with the da VinciTM System, and the intraoperative technical movements appeared inherently more intuitive. Additional chronic study comparing conventional laparoscopic with robotic surgery is mandatory.
Subject(s)
Cholecystectomy , Fundoplication , Gastric Bypass , Laparoscopy , Learning Curve , Operative Time , Pilot Projects , SwineABSTRACT
PURPOSE: To determine the incidence of asymptomatic bacteriuria in Korean preschool children, we performed national survey. MATERIALS AND METHODS: We surveyed kindergardens in seven representative cities of Korea. Before performing urine culture, we selected children by urine dipstick screening method(leukocyte esterase and nitrite test). And we analysed the incidence according to sex, age and socioeconomic status. RESULTS: Total registered population was 2,239 children and male to female ratio was 1.16. Overall, asymptomatic bacteriuria was found in 1.03%(23 children). In the male the incidence was 0.3%(3 children) and in the female it was 2.0%(19 children). Less than 4 years old children showed higher incidence (2.9%) than those of any other age groups, such as, 0.5% in 4, 1.1% in 5 and 1.3% in 6 years old. High, middle and low socioeconomic status groups showed the incidence as 0%, 0.9% and 1.4%, respectively The number of leukocyte esterase positive children was 184(8.2%) and that of nitrite positive children was 115(5.1%). Among them urine culture was performed in 175children and 23 children showed significant bacteriuria(colony count> 100,000/ml), so predictability of asymptomatic bacteriuria by dipstick test was 13.1% Radiologic study was performed in 9 children who had bacteriuria, but none of them showed urological abnormalities. CONCLUSIONS: From the above data, we found that asymptomatic bacteriuria is more common in female, younger age and lower socioeconomic status among the Korean preschool children. Considering cost-benefit aspects of the screening for asymptomatic bacteriuria, however, we should re-evaluate the necessity of our study on these particular age groups.
Subject(s)
Child , Child, Preschool , Female , Humans , Male , Bacteriuria , Incidence , Korea , Leukocytes , Mass Screening , Social ClassABSTRACT
From January 1974 to December 1990, 54 patients with stage D2 carcinoma of the prostate. androgen deprivation therapy was initiated in 50 and no treatment in 4. The analyzed prognostic factors were age. urinary retention, bone pain, Karnofsky performance index. serum acid and alkaline phosphatase, anemia. Gleason`s sum, and EOD grading system (new EOD grade and EOD score). The 1. 3 and 5-year survival rates were 66.1 %, 40.1% and 21.6 %, respectively. Mean follow-up was 22 months ranging from 1 to 80 months. Evaluation of response to endocrine therapy in 42 evaluable patients based on NPCP criteria, 6 (15%) showed stabilization of disease with mean duration of 23 months, 8 (19%) partial response with mean duration of 28.4 months and 28 (66%) progression with mean duration of 12.1 months. Forty five patients with bone metastasis who received androgen deprivation therapy had their pretreatment bone scans reviewed using a semi-quantitative grading system based upon the extent of disease (EOD) observed on the bone scan. Using Soloway's 4 grade system, the survival of patients in categories between EOD grade 2 and S didn`t differ from each other. Based on Saitt new EOD 3 grade system, the survival in etch new EOD categories significantly differed from each other (p<0.05). When EOD score system was used employing ALP to overcome the false positive findings and inactive metastatic lesion. the mean survival of patients in EOD score system was improved from 59.8% to 60.4 %. Using the stepwise Cox regression procedure with 7 candidate factors. only two factors (anemia. EOD score) were statistically significant (p<0.1). We conclude anemia and EOD score are two most important prognosticators of the analyzed factors.
Subject(s)
Humans , Alkaline Phosphatase , Anemia , Follow-Up Studies , Neoplasm Metastasis , Prostate , Prostatic Neoplasms , Survival Rate , Urinary RetentionABSTRACT
VUR is usually diagnosed by standard voiding cystourethrography(VCU). However, we are sometimes puzzled not being able to find VUR on VCU in the group of patients in whom VUR is highly suspected from accompanying obvious clinical, urographic and endoscopic features. For the purpose of detecting this type of VUR or 'subclinical VUR, VCU was performed after subcutaneous injection of bethanechol chloride in 3 patients who were highly suspected of VUR and two were diagnosed as subclinical VUR . Case 1 was diagnosed left VUR(grade II ) and case 2 was diagnosed right VUR(grade II) on VCU after' subcutaneous injection of bethanechol chloride. Both underwent unilateral ureteroneocystostomy and are on follow-up. Bethanechol chloride induced voiding cystourethrography is suggested to be a highly method to detect subclinical vesicoureteral reflux.
Subject(s)
Humans , Bethanechol , Follow-Up Studies , Injections, Subcutaneous , Vesico-Ureteral RefluxABSTRACT
Forty five patients (46 kidneys) who were admitted to the Department of Urology, Pusan National University Hospital between Jan. 1971 and July 1989 and confirmed histopathologically as renal cell carcinoma were analyzed for 11 host and 5 tumor factors relating to prognosis. The results were as follows. 1. Overall 1 and 2 to 5 year survival rates were 66.6 % and 56.3%, respectively. 2. There was no relationship between survival rates and sex, laterality or age of patients. 3. As host factors, palpable mass, fever, weight loss, Hgb, ESR, alpha2-globulin and CRP were clinically significant parameters for survival, whereas hematuria, pain, ALP and LDH were insignificant. 4. As tumor factors, stage, grade, cell type, infiltration, and vessel invasion were clinically significant parameters for survival. Therefore, aforementioned host and tumor factors suggest to be significant parameters for the selection of appropriate therapy and prognosis for renal cell carcinoma.