Laparoscopic Radical Nephrectomy in Obese and Non-Obese Patients: Comparison with Open Surgery

PURPOSE: The aim of this research was to compare surgical outcomes and complications of obese and non-obese patients who underwent open radical nephrectomy (ORN) and laparoscopic radical nephrectomy (LRN). MATERIALS AND METHODS: The data of 26 ORN patients and 30 LRN patients between January 2006 and December 2008 were analyzed. Patients with a body mass index (BMI) of 25.0 kg/m2 or more were defined as obese, and those with a BMI of <25.0 kg/m2 were defined as non-obese. All patients were divided into two groups according to the criteria above to compare demographic and clinical and pathologic parameters. RESULTS: The mean BMIs of the 15 obese patients in the ORN group and the 13 obese patients in the LRN group were 26.8+/-1.1 and 27.7+/-2.4, respectively. LRN was enormously effective for lowering estimated blood loss (EBL) and postoperative days compared with ORN. Operation times and EBL in ORN were affected by obesity, both of which were increased. In contrast, the data of both LRN groups indicated similar outcomes. The perioperative data of obese patients revealed LRN to have reduced blood loss (143.0+/-62.7 vs. 446.7+/-222.4 ml, p=0.001) and not significantly different postoperative days (7.3+/-2.2 vs. 8.4+/-1.5 days, p=0.065). Operation time, however, did not differ significantly among obese patients between ORN and LRN. The complications due to LRN had no relation with obesity, whereas ORN had an increased complications rate (34.6% vs. 3.8%). CONCLUSIONS: This study shows that LRN is more effective than ORN for both obese and non-obese patients with regard to perioperative outcomes and complication rates.

A Hybrid Treatment for Large Bladder Stones: Laparoscopic Cystolithotomy with Combined Direct Visual Lithotripsy

There are diverse surgical methods for treating large bladder stones, such as transurethral cystolithotripsy (TUCL), percutaneous suprapubic cystolithotripsy (PCCL), open surgery, and laparoscopic methods. We report here a case of two large bladder stones treated by using a combined surgical method of a laparoscopic approach and direct visual lithotripsy.

Bilateral Cryptorchidism in Silver-Russell Syndrome: Initial Experience with Laparoscopic Orchiopexy

Silver-Russel syndrome (SRS) is a disorder present at birth that involves poor growth, low birth weight, differences in the size of the two sides of the body, and genital anomalies. The diagnosis is based on distinct prenatal growth restriction and the presence of typical dysmorphic features, including short stature and limb asymmetry. We report a case of bilateral cryptorchidism with no other genital anomalies in SRS. This report provides an overview of the genital anomalies of SRS and describes, for the first time, a laparoscopic orchiopexy in SRS.

A case of typhoid fever complicated with pleurisy and hepatitis / 대한내과학회지

Typhoid fever often manifests hepatic involvement but pleural involvement has rarely been reported to occur as a complication of typhoid fever. One case of typhoid pleurisy, in which Salmonella was isolated from the blood, is presented with the brief review of the literature. A 44 year old female was admitted to the hospital because of high fever, abdominal pain. Typhoid fever was diagnosed by blood culture, Widal test, and liver function test. Chest X-ray and pleural effusion examination demonstrated pleurisy. With the administration of ceftriaxone and pleural aspiration, she became afebrile with subsidence of pleural effusion.

A case of typhoid fever complicated with pleurisy and hepatitis / 대한내과학회지

Typhoid fever often manifests hepatic involvement but pleural involvement has rarely been reported to occur as a complication of typhoid fever. One case of typhoid pleurisy, in which Salmonella was isolated from the blood, is presented with the brief review of the literature. A 44 year old female was admitted to the hospital because of high fever, abdominal pain. Typhoid fever was diagnosed by blood culture, Widal test, and liver function test. Chest X-ray and pleural effusion examination demonstrated pleurisy. With the administration of ceftriaxone and pleural aspiration, she became afebrile with subsidence of pleural effusion.

Defect of Acid-base Transporters in Distal Renal Tubular Acidosis / 대한신장학회잡지

The purpose of this study was to elucidate whether the molecular defect of acid-base transporters in renal tubules is related to the functional defect of urinary acidification in distal renal tubular acidosis(RTA). We performed NH4Cl, furosemide, or bicarbonate loading test to evaluate renal acidification function, and immunohistochemistry using antibodies to H+- ATPase, Cl-/HCO3- exchanger(band-3 protein), and Na+/K+-ATPase in kidney tissue in 6 patients with RTA and renal cell carcinoma patients as normal controls. Kidney tissue was obtained either by percutaneous needle biopsy(RTA) or nephrectomy(NC). The results were as follows; 1) In all six RTA patients, proton secretory defect of distal acidification was shown by a failure to lower the urine pH after NH4Cl loading or furosemide test or abnormally low urine-blood pCO2 difference during bicarbonate loading. In two patients with RTA, proximal acidification defect was combined, which was demonstrated by increased fractional excretion of bicarbonate. 2) In normal control, intense H+-ATPase and band-3 protein staining was observed in collecting ducts. 3) In distal RTA patients, H+-ATPase and band- 3 protein staining was not demonstrable or markedly decreased in the intercalated cells of distal nephron. 4) In two patients who had both proximal and distal RTA, H+-ATPase staining was markedly decreased in the brush border of proximal tubules as well as the distal nephron. In conclusion, the defect of acid-base transporters in renal tubule was related with the functional defect of urinary acidification in distal RTA.

Report of a Case of Menetrier's Disease / 대한소화기내시경학회지

Menetriers disease is a rare disease, characterized by a marked hypertrophy of the mucosa of the fundus and corpus of the stomach and gastrointestinal loss af protein often causing transient edema. The 16-Year-old female patient was admitted to the Seoul Adventist Hospital and she complained epigastric pain & discomfort for 20 days. Under the UGI & endoscoyy, pathologic examination was done. The diagnosis was estabilished. She wes treated medically.