Three hundred renal transplantations were performed by the transplantation team in the Kosin Medical College from December, 1984 to August, 1993. Prognosis and complications with affecting factors and demographic data were analysed and the results were as follows; 1. In 300 recipients, 206 cases were male and 94 cases were female. 146 cases were male and 154 cases were female in 300 donors 2. All 300 cases were living transplantations ; among them, 207 cases were related and 93 cases were unrelated donors. 3. The most common underlying disease of recipients was chronic glomerulonephritis (89%). 4. In 263 donors, the left kidney was selected for graft. 5. For donor nephrectomy, flank incision( anterior incision) was used in all cases and among them 12th transcostal incision was made in 134 cases. 6. For ureteroneocystostomy, modified MacKinnon`s method was performed in 297 cases and Politano-Leadbetter procedure was used in only 3 cases. 7. Postoperative urologic complications occurred in 26 cases( 8.3%) ; perirenal hematoma, 16 cases for which revision was done; urine leakage, 8 cases for which 6 cases needed revision. 8. Complications of donor nephrectomy occurred in 8 cases( 2.6%) ; retroperitoneal hematoma, 2 cases; pneumothorax, 2 cases; pleural effusion, atelectasis, ulcer perforation and stress ulcer, one case respectively. 9. The survival rate for the graft was 91.6% for one year, 88.1 % for 2 years, 81.5% for 3 years, 77.7% for 4 years and 74.3% for 5 years. The survival rates of the recipients were 94.4%, 93.6%, 91.4%, 89.7% and 89.7% according to each year respectively.
Female ; Glomerulonephritis ; Hematoma ; Humans ; Kidney ; Kidney Transplantation* ; Male ; Nephrectomy ; Pleural Effusion ; Pneumothorax ; Prognosis ; Pulmonary Atelectasis ; Survival Rate ; Tissue Donors ; Transplants ; Ulcer ; Unrelated Donors

Stress induced cardiomyopathy (SC) is characterized by transient left ventricular (LV) dysfunction in the absence of coronary artery disease. We report on a patient with panhypopituitarism who developed SC resulting from withdrawal of hormonal replacement therapy (HRT). A 52-year-old male visited our hospital for progressively worsening dyspnea. The patient had discontinued HRT 7 days ago, which had been administered for 18 months after transsphenoidal adenomectomy for pituitary macroadenoma. Initial electrocardiogram showed marked sinus bradycardia. Transthoracic echocardiography showed apical ballooning with an LV ejection fraction of 25%. No significant obstructive lesions were observed on coronary angiography. With a clinical diagnosis of SC associated with panhypopituitarism, HRT was restarted, including glucocorticoid and thyroxine, along with standard heart failure management. His LV function had normalized at 2-month follow-up. He remains asymptomatic and administration of beta-blocker and angiotensin converting enzyme inhibitor were discontinued He currently only requires HRT.
Bradycardia ; Cardiomyopathies* ; Coronary Angiography ; Coronary Artery Disease ; Diagnosis ; Dyspnea ; Echocardiography ; Electrocardiography ; Follow-Up Studies ; Heart Failure ; Hormone Replacement Therapy* ; Humans ; Hypopituitarism ; Male ; Middle Aged ; Peptidyl-Dipeptidase A ; Takotsubo Cardiomyopathy ; Thyroxine

No abstract available.
Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Biopsy ; Chemoradiotherapy, Adjuvant ; Diagnostic Errors ; Dupuytren Contracture/diagnosis ; *Fingers/pathology/ultrasonography/virology ; Hematopoietic Stem Cell Transplantation ; Herpesvirus 4, Human/genetics ; Humans ; Immunohistochemistry ; In Situ Hybridization, Fluorescence ; *Lymphoma, Extranodal NK-T-Cell/diagnosis/therapy/virology ; Male ; Middle Aged ; Neoadjuvant Therapy ; Predictive Value of Tests ; RNA, Viral/genetics ; *Tendons/chemistry/pathology/ultrasonography/virology ; Treatment Outcome ; Tumor Markers, Biological/analysis ; Ultrasonography, Doppler, Color

There are some clinical evidences that hepatitis B virus(HBV) infection may cause IgA nephropathy. To evaluate clinical significances and pathogenetic roles of HBV infection in patients with IgA nephropathy, we studied that varius clinical and lab- oratory findings in 172 patients with IgA nephrop-athy as serum hepatitis B surface antigen (HBsAg) positive (19 cases) and negative group (153 cases). The result was as following: 1) The incidence of positive serum HRsAg was 11.0%(19/172 cases) in patients with IgA nephropathy and it was higher than that of the randomized age-sex matched general population(4.1%) but has no significance statistically. 2) There was no significant differences in incidence of hypertension, serum levels of IgA, C3, SGOT, SGFf between HBsAg postive and negative group. 3) The cases of nephrotic range proteinuria (3.5g/ day) was more prevalent in HBsAg positive group (31.6%) than that in negative group(7.2%). significantly (p<0.05). 4) The cases of impaired renal function (serum creatinine more than 1.4mg/dL) were more frequent in HBsAg positive group (42.19%) than that in neg-ative group (13.1%) significantly(p<0.05).
Aspartate Aminotransferases ; Creatinine ; Glomerulonephritis, IGA* ; Hepatitis B Surface Antigens* ; Hepatitis B* ; Hepatitis* ; Humans ; Hypertension ; Immunoglobulin A* ; Incidence ; Prognosis ; Proteinuria

Intravenous leiomyomatosis (IVL) is rare and it is characterized by intravascular nodular masses of histologically benign smooth muscle that may extend along the inferior vena cava or reaching the right-sided cardiac chamber, and eventually the lung. Although histologically benign, IVL might be malignant in its mode of behavior. We report a case of IVL that grew in a vessel of myometrium of uteri.
Animals ; Female ; Leiomyomatosis* ; Lung ; Mice ; Muscle, Smooth ; Myometrium ; Uterus ; Vena Cava, Inferior

A stenotic spinal canal in the cervical or lumbar region is a well-known clinical entity. However, stenosis involving a thoracic vertebra is rarely mentioned in the literature. Improved neuroimaging facilities, especially MRI, let us detect the thoracic canal stenosis not so infrequently as in the past years. The authors are reporting six operative cases of thoracic myelopathy associated with thoracic spinal stenosis. Motor & sensory abnormalities were found in all cases during the clinical course. Magnetic resonance imaging and Metrizamide CT scanning were useful in the diagnosis of thoracic spinal stenosis. Treatment consited of wide posterior decompression resulting in symptomatic improvement in five of six patients.
Constriction, Pathologic ; Decompression ; Diagnosis ; Humans ; Linear Energy Transfer ; Lumbosacral Region ; Magnetic Resonance Imaging ; Metrizamide ; Neuroimaging ; Spinal Canal ; Spinal Cord Diseases ; Spinal Stenosis* ; Spine ; Tomography, X-Ray Computed

Background and Objectives: Veno-arterial extracorporeal membrane oxygenation (VAECMO) as a bridge to eventual heart transplantation (HT) is increasingly used worldwide.However, the effect of different VA-ECMO types on HT outcomes remains unclear. Methods: This was a retrospective observational study of 111 patients receiving VA-ECMO and awaiting HT. We assessed 3 ECMO configuration groups: peripheral (n=76), central (n=12), and peripheral to central ECMO conversion (n=23). Cox proportional hazards regression and landmark analysis were conducted to analyze the effect of the ECMO configuration on HT and in-hospital mortality rates. We also evaluated adverse events during ECMO support. Results: HT was performed in the peripheral (n=48, 63.2%), central (n=10, 83.3%), and conversion (n=11, 47.8%) ECMO groups (p=0.133) with a median interval of 10.5, 16, and 30 days, respectively (p<0.001). The cumulative incidence of HT was significantly lower in the conversion group (hazard ratio, 0.292, 95% confidence interval, 0.145–0.586, p=0.001).However, there was no difference in in-hospital mortality (log-rank p=0.433). In the landmark analysis, in-hospital mortality did not differ significantly among the 3 groups.Although we did note a trend toward lower HT in the conversion group, the difference was not statistically significant. Surgical site bleeding occurred mainly in the central, while limb ischemia occurred mainly in the peripheral groups. Conclusions We suggest that if patients are being stably supported with their initial ECMO configuration, whether it is central or peripheral, it should be maintained, and ECMO conversion should only be cautiously performed when necessary.