Laparoscopic Nephrectomy for Ectopic Dysplastic Kidney / 대한비뇨기과학회지

A single dysplastic ectopic kidney associated with ectopic ureter or ureterocele defies detection even with repeated examinations using conventional imaging modalities and cystovaginoscopy under anesthesia, thus leading to significant delay in diagnosis and appropriate treatment. Laparoscopy can be a useful modality for the diagnosis, and also the treatment, of small ectopic kidney not found with conventional diagnostic method. We report three cases of transperitoneal laparoscopic nephrectomy for ectopic dysplastic kidney.

The Efficacy of Transcatheter Arterial Embolization in Renal Cell Carcinoma in Patients with a Poor Performance Status or at an Advanced Stage / 대한비뇨기과학회지

PURPOSE: To evaluate the efficacy of transcatheter arterial embolization (TAE) in patients with a renal cell carcinoma who were ineligible to undergo a nephrectomy due to their poor performance status and advanced stage. MATERIALS AND METHODS: The study included 42 patients ineligible for a nephrectomy due to their poor performance status and advanced stage. The patients were classified into three groups; 13 patients with TAE for poor performance status (group A-1), 15 patients with TAE for advanced stage (group A-2) and 14 patients without TAE (group B). Group A-1 was composed of patients with a low stage and poor performance status, but there were no significant differences in the clinical factors between groups A-2 and B. RESULTS: After TAE the tumor size became smaller in 19 cases, with the other 9 cases showing no response. TAE was more effective in group A-1 than A-2. The mean survivals of the three groups were 22 (A-1), 12.3 (A-2) and 4.8 months (B). In the A groups, 19 of the 28 patients were still alive, with a prolonged mean survival, which might due to the composition of group A-1, but group A-2 had a better mean survival than group B (p<0.001). Based on the above outcomes, those who underwent TAE had significantly better prognoses than those who did not. The adverse effects in the patients that underwent TAE included fever, back pain on the affected side, nausea and vomiting, but all the patients recovered from these adverse effects. CONCLUSIONS: TAE, with Ivalon, is a safe and effective treatment for the patients who are unable to undergo nephrectomy due to their poor performance status and advanced stage. TAE not only induces ablasion of the primary tumor, but also prolongs the survival.

Emphysematous Cystitis with Fungus Ball / 대한비뇨기과학회지

Genitourinary fungal infections are uncommon, but the incidence is increasing due to the wider use of antibiotics, steroids, radiating treatment, immunosuppressive and antineoplastic drugs. Hospitalized patients are at the highest risk, which includes those with hematologic neoplasms and other neoplastic disorders, diabetes mellitus, and those with prolonged preterminal diseases. Candidal urinary tract infections typically occur in hosts with a compromised immune function. Emphysematous cystitis is a rare disease, usually caused by aerobic bacteria, most commonly Escherichia coli. However emphysematous cystitis occasionally complicates fungal infections of the lower urinary tract, especially in diabetic patients. Because emphysematous cystitis has potentially high morbidity and mortality, early diagnosis and treatment is very important. We report a case of emphysematous cystitis with fungus ball due to Candida albicans.

The Measurement of Strain of the Anterior Cruciate Ligament in vivo / 대한정형외과학회잡지

PURPOSE: The purpose of this study was to measure the strains of normal and lax anterior cruciate ligament (ACL) under serial loading using specially designed ACL strain analyzer (ASA) during arthroscopic examination. MATERIALS AND METHODS: The study is based on sixty-eight patients. Before the arthroscopic examination, all cases were divided into three groups according to their laxity based on Lachman test, KT2000 arthrometer, and magnetic resonance imaging. During arthroscopic examination, the ASA was connected with ACL using anteromedial portal with the knee flexed in 90. Under serial loading to ACL, the strains were illustrated and calculated. RESULTS: A statistically significant differences had been shown in strains between normal and lax ACL. Using ANOVA test, the ASA results according to preoperatively divided groups showed no significant differences between all groups and each loads. CONCLUSION: We had designed newly diagnostic method for estimate of ACL laxity, and measured the strains of lax ACL compared with normal ACL. This diagnostic method will be helpful to establish treatment plan for injuried ACL during arthroscopic examination.