No abstract available.
Glomerulonephritis, IGA* ; Immunity, Cellular* ; Immunoglobulin A*

No abstract available.
Glomerulonephritis, IGA* ; Immunity, Cellular* ; Immunoglobulin A*

No abstract available.
Acute Kidney Injury* ; Nifedipine* ; Plasma* ; Renin*

Posterior epidural migration of a sequestrated intervertebral lumbar disc is rare with only five cases ever reported in the literature so far. The objective of this paper is to report our experience of such a extremely rare case with a review the literature

The vertebral pedicle is an important structure used as an implant site for spinal instrumentation surgery. Since precise anatomical knowledge of lumbar pedicles in vivo is essential for risk - free surgery, we analyzed Korean vertebrae with radiologic imaging techniques. The authors analayzed 500 pedicles from L1 to L5 vertebrae with computerized tomograms (CT) and simple radiograms taken from patient free of vertebral abnormality. Five morphometric parameters: transverse pedicle width, transverse pedicle angle, sagittal pedicle width, sagittal pedicle angle depth to anterior cortex were measured. The transverse diameter and angle of pedicle increased gradually from L1 to L5, while the sagittal diameter and angle decreased from L1 to L5. The depth to anterior cortex from posterior elements was longer along the pedicle axis than along axis parallel to midline.
Axis, Cervical Vertebra ; Humans ; Lumbar Vertebrae* ; Spine

PURPOSE: Cardiovascular diseases are a common cause of mortality in patients with end stage renal disease and are associated with vascular calcification (VC) and arterial stiffness. In addition to high turnover bone disease, there is substantial evidence that low levels of serum intact PTH (iPTH) are associated with vascular calcium deposition. The objective was to evaluate the association of iPTH levels with VC, arterial stiffness, and to identify risk factors contributing to VCs and arterial stiffness. METHODS: One hundred five hemodialysis (HD) patients were divided into three groups according to iPTH levels: A, <150 pg/mL; B, 150< or =and< or =400 pg/mL; and C, >400 pg/mL. The simple vascular calcification score (SVCS) was obtained by X-ray; the brachial ankle-pulse wave velocity (ba-PWV) and the serum fetuin-A level was mesured. RESULTS: Patients in group A were older and had a higher SVCS, a prevalence of diabetes, and an increased arterial stiffness. Severe VCs (SVCS> or =3) were associated with the low iPTH group (iPTH<150)/a higher CRP/a lower diastolic blood pressure (DBP)/diabetes/ increased arterial stiffness/older age and a lower serum fetuin-A level. The log [ba-PWV] had a positive correlation with age, systolic blood pressure (SBP)/DBP/PP/CRP/presence of diabetes and low iPTH and a negative correlation with serum albumin. Based on multivariate analysis, the low iPTH group and diabetes were identified as independent risk factors of severe VC and age/SBP/CRP and diabetes were risk factors for arterial stiffness. CONCLUSION: Low iPTH levels and/or diabetes had a greater risk of developing VCs and age/SBP/CRP/diabetes were associated with increased arterial stiffness in HD patients.
alpha-2-HS-Glycoprotein ; Blood Pressure ; Blood Vessels ; Bone Diseases ; Calcium ; Cardiovascular Diseases ; Humans ; Kidney Failure, Chronic ; Multivariate Analysis ; Parathyroid Hormone ; Prevalence ; Renal Dialysis ; Risk Factors ; Serum Albumin ; Vascular Calcification ; Vascular Stiffness

BACKGROUND AND OBJECTIVES: Recurrent squamous carcinoma of head and neck carcinoma is not encountered infrequently. Surgical salvage is the most reasonable treatment for recurrence. The aim of the present review is to provide more information on the results and prognosis of surgical salvage after surgery alone or surgery with combined radiotherapy. MATERIALS AND METHODS: The operative salvage of recurrent head and neck carcinoma after surgery alone or surgery with combined radiotherapy was retrospectively studied in 18 patients treated between 1994 and 1999. Of the 18 patients in this retrospective review, there were 6 with local recurrence, 8 with regional recurrence, and 4 with stomal recurrence. RESULTS: The operative mortality was 16.6% and 72% of patients had one or more surgical complications. The 2-year crude survival rate in this series was 30% and the mean period of survival was 11.4 months. The 2-year survival rate were 33.3% for local recurrence and 50% for regional recurrence, and 0% for stomal recurrence. CONCLUSION: We concluded that surgical salvage had unsatisfactory results for patients with recurrent head and neck carcinoma after surgery alone or surgery with combined radiotherapy. Because of this low salvage rate, we should regard salvage surgery as palliative rather than therapeutic.
Carcinoma, Squamous Cell ; Head and Neck Neoplasms* ; Head* ; Humans ; Mortality ; Neck ; Neoplasm Metastasis ; Prognosis ; Radiotherapy* ; Recurrence ; Retrospective Studies ; Salvage Therapy ; Survival Rate

PURPOSE: Hyperlipidemia and diabetes mellitus are common metabolic disorders associated with transplantation and also are risk factors of cardiovascular disease which is leading cause of patient death in kidney transplant recipients. We compared blood lipid and glucose levels of patients receiving tacrolimus (Tac) with those of patients receiving cyclosporine (CyA). METHODS: Patients were grouped as Tac (n=124) or CyA (n=77). Minimal follow up duration was 18 months. Both groups have no difference in age, sex, HLA match, numbers of transplantation and proportion of the patients with pretransplant hypercholesterolemia (>220 mg/dL) or diabetes. Prevalence of hypercholesterolemia and diabetes in Tac and CyA groups were compared at posttransplant 1, 3, 6, and 12 months. RESULTS: Prevalence of diabetes in CyA versus Tac group were 18.9 vs. 13.8% (P=0.348), 8.6% vs. 18.8% (P=0.060), 5.9% vs. 18.6% (P=0.016), and 10.4% vs. 21.1% (P=0.067) at 1, 3, 6 and 12 months after transplantation respectively. Prevalence of hypercholesterolemia in CyA versus Tac group were 52.5% vs. 16.9% (P=0.000), 37.7% vs. 8.3% (P=0.000), 30.3% vs. 7.4% (P= 0.000) and 22.6% vs. 8.3% (P=0.001) at 1, 3, 6, and 12 months after transplantation. CONCLUSION: CyA group was more prone to develop hypercholesterolemia than Tac group, whereas incidence of diabetes in Tac group was not different from CyA group. In terms of cardiovascular risk, there was no significant difference between CyA treated group and Tac treated group in renal allograft recipients.
Allografts* ; Cardiovascular Diseases ; Cyclosporine* ; Diabetes Mellitus ; Follow-Up Studies ; Glucose ; Humans ; Hypercholesterolemia ; Hyperlipidemias ; Incidence ; Kidney ; Prevalence ; Risk Factors ; Tacrolimus* ; Transplantation

We report here on our technique and outcomes of the first two cases of robot-assisted laparoscopic nephroureterectomy with a bladder cuff excision(RLNU). RLNU was performed on two female patients who both had a muscle invasive lower ureter tumor. For the first step, nephroureterectomy was performed in the lateral flank position. For the second step, bladder cuff excision and bladder repair were performed in a steep Trendelenburg position. The specimen was extracted through a 6 cm sized incision in the umbilical trocar site. Both procedures were successfully completed with using the robot without conversion to open surgery. The total operative time, including the lymphadenectomy and the robot docking times, was 320 and 241 minutes, respectively, for the 2 patients. The estimated blood loss was 40 and 200 ml, respectively. The pathological examinations showed stage T3 and T2 invasive transitional cell carcinoma of the ureter. The patients' postoperative recoveries were uneventful and the bladder cuff was free of tumor. RLNU may have potential advantages over open and laparosopic surgery due to its minimal invasiveness. This approach can be an alternative to open surgery or laparoscopic technique.
Carcinoma, Transitional Cell ; Conversion to Open Surgery ; Female ; Head-Down Tilt ; Humans ; Laparoscopy ; Lymph Node Excision ; Muscles ; Operative Time ; Resin Cements ; Robotics ; Surgical Instruments ; Ureter ; Ureteral Neoplasms ; Urinary Bladder

Osteochondromas make up about 30% to 40% of benign bone tumors. Most are solitary lesions but some are multiple, usually with autosomal dominant inheritance. From 1% to 4% of osteochondromas occur in the spine, where they can cause a variety of signs and symptoms, including those of spinal cord compression. Isolated osteochondromas are usually of little significance. However, if they are located near neural structures, they may cause irritation due to mechanical compression. In patients with hereditary multiple exostoses who present with neck or back pain, and particularly in those who have neurologic symptoms in the upper or lower extremities, a diagnosis of intracanalicular osteochondroma should be presumed until proven otherwise. Computerized tomography(CT) and MRI are the imaging procedures of choice. Prompt surgical excision affords the best prognosis for these patients who have spinal cord compression secondary to intracanalicular osteochondroma.
Back Pain ; Diagnosis ; Exostoses* ; Exostoses, Multiple Hereditary ; Humans ; Lower Extremity ; Magnetic Resonance Imaging ; Neck ; Neurologic Manifestations ; Osteochondroma* ; Prognosis ; Spinal Cord Compression ; Spine ; Wills