The field of renal transplantation has undergone continual evolution to become the standard treatment for patients with end-stage renal diseases. The attempts to improve organ shortage, studies for clinical and basic science, empirical trial of new immunosuppressive drugs and technical challenges are very important for the development of renal transplantation medicine and improved patient outcome. This review will focus on the recent advancement and current hot issues of living donor renal transplantation worldwide.
Humans ; Kidney Transplantation* ; Living Donors*

BACKGROUND: The aim of study was to confirm the clinical effectiveness and results of wide and single anterior approach for fractures occurring along length of humerus. METHODS: A total of 23 patients with humeral fracture were enrolled into our study who were able to participate in at least one year of follow-up. Seven patients had segmental comminuted humeral fractures and 16 patients had distal humeral fractures. We made various tractions of the muscles to expose the proximal and the middle third humerus between the biceps and brachialis and the distal humerus by partial splitting of lateral side of biceps through a single incision. Postoperatively, we measured the Mayo elbow performance index (MEPI). RESULTS: we achieved bone union in all 23 patients. Solid union of the bone was achieved at an average 13.9 weeks. Postoperatively, two complications were observed screw loosening and nonunion. Revision surgery was performed in both patients. The patient with bone nonunion was treated using bone grafts. No postoperative infections or peripheral neuropathies were observed. At the final follow-up (average 20 months), we found that the average MEPI functional score of the patients was 91.7 points regardless of the fracture site. CONCLUSIONS: Our whole humerus with a single incision was effective for the treatment of segmental comminuted and distal fractures. we believe it is a useful alternative to preexisting methods of fracture fixation.
Elbow ; Follow-Up Studies ; Fracture Fixation* ; Humans ; Humeral Fractures ; Humerus* ; Muscles ; Peripheral Nervous System Diseases ; Traction ; Transplants ; Treatment Outcome

Meningiomas, one of the most common neoplasms of the central nervous system, may be encountered incidentally during autopsy. Most of these tumors, however, are benign and hence, are not considered as the chief cause of death. Further, sudden unexpected death caused by meningioma is very unusual. Moreover, the diagnosis of an incidental meningioma as the cause of sudden death may sometimes be difficult. In the present report, we describe an autopsy case of a sudden, unexpected death due to a large olfactory groove meningioma accompanied by severe cerebral edema and tonsillar herniation.
Autopsy ; Brain Edema ; Brain Neoplasms ; Cause of Death ; Central Nervous System ; Death, Sudden ; Diagnosis ; Encephalocele ; Meningioma*

PURPOSE: To evaluate and compare visual acuity and reading speed for Korean language between a diffractive bifocal and trifocal intraocular lens (IOL) of the same material and haptic design. METHODS: We reviewed the medical records of the patients who had undergone bilateral cataract surgery with bifocal IOLs (AT LISA 801) on the both eyes (bifocal group) and trifocal IOLs (AT LISA tri 839 MP, trifocal group). The main outcome measures were the uncorrected distance, intermediate, and near visual acuity (uncorrected distance visual acuity [UCDVA], uncorrected intermediate visual acuity [UCIVA], and uncorrected near visual acuity [UCNVA]) and corrected distance, near, and distance-corrected intermediate visual acuity (corrected distance visual acuity [CDVA], corrected near visual acuity [CNVA], and distance-corrected intermediate visual acuity [DCIVA]) at last postoperative follow-up month. Reading speeds for Korean language were measured to check near visual function. RESULTS: Fourteen eyes (7 patients) were included in the bifocal group and 32 eyes of 16 patients in the trifocal group. There were no statistical differences between the two groups with respect to UCDVA, UCNVA, CDVA, and CNVA. However, UCIVA (0.35 vs. 0.22 logarithm of the minimum angle of resolution [logMAR], p < 0.01) and DCIVA (0.34 vs. 0.20 logMAR, p < 0.01) were significantly better in the trifocal group than in the bifocal group. The mean reading speed for logMAR 0.5 optotype (point 10) was 86.50 words per minute (wpm) in the bifocal group and 81.48 wpm in the trifocal group without a significant difference (p = 0.70). CONCLUSIONS: Trifocal IOLs provided the same level of distance and near visual acuity and reading speed as that of bifocal IOLs with better intermediate visual acuity.
Cataract ; Follow-Up Studies ; Humans ; Lens Implantation, Intraocular* ; Lenses, Intraocular* ; Medical Records ; Outcome Assessment (Health Care) ; Visual Acuity

PURPOSE: The BTA stat test is a one-step immunochromatographic assay to detect bladder tumor antigen in the urine. We evaluated the efficacy of the BTA stat test and bladder wash cytology(BWC) in the detection and follow-up of bladder cancer. MATERIALS AND METHODS: A voided urine sample for BTA stat test and bladder washing urine for cytology were obtained. The BTA stat test with or without BWC was performed in normal volunteers(n=20), patients with hematuria of unknown origin(n=29), patients with benign genitourinary(GU) disease(n=17), patients with other GU cancer(n=12), patients with bladder cancer(n=46) and patients with a history of bladder cancer(n=54). RESULTS: The overall sensitivities of the BTA stat and BWC in bladder cancer were 69.6% and 41.3%, respectively(p<0.01). For T2 or higher stage tumors, sensitivity was 94.1% for BTA stat and 64.7% for BWC(p<0.05). Grade II tumors were detected at 64.3% with BTA stat and 35.7% with BWC(p<0.05). The sensitivities of the BTA stat and BWC in the follow-up of patients after transurethral resection of bladder tumor were 45.5%(5/11) and 27.3% (3/11), respectively. The specificities of the BTA stat and BWC in the same patients were 88.4%(38/43) and 100%(43/43), respectively(p<0.05). The specificity in patients with hematuria but without disease was 69% for BTA stat and 100% for BWC. The specificities of the BTA stat in healthy volunteers, benign GU disease and other GU cancer were 95%, 82.4% and 75%, respectively. CONCLUSIONS: Our results demonstrate that BTA stat test is a simple, noninvasive test that is superior to bladder wash cytology for detection of bladder cancer in its sensitivity and a useful adjunct of cystoscopy in surveillance and diagnosis of bladder cancer. However, the BTA stat test can not replace cystoscopy due to low specificity.
Cystoscopy ; Diagnosis* ; Follow-Up Studies* ; Healthy Volunteers ; Hematuria ; Humans ; Immunochromatography ; Sensitivity and Specificity ; Urinary Bladder Neoplasms* ; Urinary Bladder*

The effect of topical application on the number of S. mutans was tested in a group of 44 orthodontic patients (mean age, 12Y 3M). They were divided into 5 groups according to the method using NaF and SnF2. The number of S. mutans CFU were counted in stimulated saliva of each subject at baseline, and after one, two, three, and eight weeks. The following results were obtained. 1. In NaF rinsing group, and NaF topical application and NaF rinsing group, the number of S. mutans per ml saliva was not significantly changed. 2. In SnF2 topical application group, and SnF2 topical and NaF rinsing group, the number of S. mutans per ml saliva was significantly reduced. 3. After 8 weeks, there were no significant reduction of the number of S. mutans in comparison with baseline.
Fluorides* ; Humans ; Saliva ; Streptococcus mutans* ; Streptococcus*

Anastomosing hemangioma (AH), a rare benign vascular tumor, is a newly recognized variant of capillary hemangioma. In the microscopic examination, this tumor has characteristic feature of the unique anastomosing sinusoidal capillary sized vessels. It can be misdiagnosed as a malignancy such as renal cell carcinoma or angiosarcoma. Herein, we report a case of AH originating in the right kidney of a 43-year-old man, which was initially considered as cystic renal cell carcinoma on computed tomography (CT). The patient underwent laparoscopic radical nephrectomy, but pathologic result was AH of the kidney. There was no evidence of recurrence or metastasis 5 months after the surgery.
Adult ; Capillaries ; Carcinoma, Renal Cell* ; Hemangioma* ; Hemangioma, Capillary ; Hemangiosarcoma ; Humans ; Kidney ; Neoplasm Metastasis ; Nephrectomy ; Recurrence

The present study evaluated the effects of guided tissue regeneration using biodegradable membrane, with and without calcium-phosphate thin film coated deproteinated bone powder in beagle dogs. Contralateral fenestration defects(6 x 4 mm) were created 4 mm apical to the buccal alveolar crest on maxillary canine teeth in 5 beagle dogs. Ca-P thin film coated deproteinated bone powder was implanted into one randomly selected fenestration defect(experimental group). Biodegradable membranes were used to provide bilateral GTR. Tissue blocks including defects with overlying membranes and soft tissues were harvested following a four- & eight-week healing interval and prepared for histologic analysis. The results of this study were as follows. 1. The regeneration of new bone, new periodontal ligament, and new cementum was occurred in experimental group more than control group. 2. The collapse of biodegradable membranes into defects were showed in control group and the space for regeneration was diminished. In experimental group, the space was maintained without collapse by graft materials. 3. In experimental group, the graft materials were resorbed at 4 weeks after surgery and regeneration of bone surrounding graft materials was occurred at 8 weeks after surgery. 4. Biodegradable membranes were not resorbed at 4 weeks and partial resorption was occurred at 8 weeks but the framework and the shape of membranes were maintained. No inflammation was showed at resorption. In conclusion, the results of the present study suggest that Ca-P thin film coated deproteinated bone powder has adjunctive effect to GTR in periodontal fenestration defects. Because it has osteoconductive property and prohibit collapse of membrane into defect, can promote regeneration of much new attachment apparatus.
Animals ; Cuspid ; Dental Cementum ; Dogs* ; Guided Tissue Regeneration* ; Inflammation ; Membranes* ; Periodontal Ligament ; Regeneration ; Transplants

PURPOSE: Deep vein thrombosis and pulmonary embolism are common and potentially fatal complication among hospitalized patients. The first clinical manifestation of venous thromboembolism may be fatal pulmonary embolism. Therefore, some form of prophylaxis is warranted for patients at risk. Prolonged major surgery is well known as high risk factor in development of venous thromboembolism and venous thromboembolism following surgery remains a significant health care problem. But little data are available concerning the changes of venous hemodynamic during prolonged surgery. METHOD: To access the relationship of the lower leg venous congestion that occurred during prolonged and position-fixed surgery to the development of postoperative deep vein thrombosis, the venous pressure of lower leg were measured continuously. A flexible indwelling angiocatheter was inserted into the greater saphenous vein near ankle area and venous pressure was measured by pressure monitor. The data of patients (experimental group:n=10) who performed spinal operation in Jack-Knife position over 180 minutes, healthy volunteers (n=10) and patients (venous hypertension group) who diagnosed as lower leg deep vein thrombosis (n=7), chronic venous insufficiency (n=3) were collected and analyzed. RESULT: The mean age was 34 years old in experimental group and the patients were 7 males and 3 females. The mean lower leg venous pressures of healthy volunteer in Jack-Knife position were 42.89+/-3.52 mmHg at 30 minutes. In acute deep vein thrombosis and chronic venous insufficiency patients, the mean venous pressures were 73.14+/-4.78, 57.33+/-2.52 mmHg at 30 minutes and these data were statistically significant compared with control group (P<0.05). In experimental group, the changes of the mean venous pressures at 30, 60, 90, 120 and 180 minutes were 48.78+/-2.38, 45.89+/-2.09, 45.33+/-2.24, 45.11+/-2.03 and 46.33+/-2.18 mmHg and these data were not statistically significant compared with control group. There was no postoperative development of deep vein thrombosis. CONCLUSION: The surgical factors (prolonged operation time, fixed position) and anesthetic factor may not play a major role in development of postoperative deep vein thrombosis and other postoperative factors will intervene the development of deep vein thrombosis.
Adult ; Ankle ; Delivery of Health Care ; Female ; Healthy Volunteers ; Hemodynamics ; Humans ; Hyperemia ; Hypertension ; Leg* ; Male ; Pulmonary Embolism ; Risk Factors ; Saphenous Vein ; Venous Insufficiency ; Venous Pressure* ; Venous Thromboembolism ; Venous Thrombosis

PURPOSE: p53 and p21 act as a cell cycle regulator. p21 has been thought to be an important mediator of p53-induced cell cycle arrest. p53 alterations can induce the uncontrolled growth of tumor cells by loss of p21 expression in cancer patients. The objective of this study was to characterize the alterations of p53 and p21 expression and to assess the relationship between p53 and p21 in bladder cancer patients. MATERIALS AND METHODS: p53 and p21 expressions were evaluated immunohistochemically in 97 patients of bladder cancer according to grade, stage and recurrence. We compared p53 expression with p21. Nuclear expression was scored as negative, patchy(<20%), heterogeneous(20-75%) or homogeneous(>75%). RESULTS: p53 was expressed in 34(35.1%) of 97 patients and p21 in 23 patients(23.7%). p53 expression was significantly related with grade(18.2% in lower grade vs. 71% in higher) and stage(18.2% in superficial vs. 57.1% in invasive). p21 was not expressed in 74(76.3%) of 97 patients and not correlated with grade and stage. Recurrence in superficial bladder cancer was lower for patients with p53-negative(27%) than patients with p53-positive(64.3%). There was no correlation between loss of p21 expression and recurrence. Inverse expression of these two proteins was seen in 39 patients(40.2%). CONCLUSIONS: These results suggest that p21 is induced by p53-dependent pathway, but that there may also indicate p53-independent pathways of induction. p53 could be a reliable indicator of recurrence in superficial bladder cancer.
Cell Cycle ; Cell Cycle Checkpoints ; Humans ; Immunohistochemistry ; Recurrence ; Urinary Bladder Neoplasms* ; Urinary Bladder*