No abstract available.
Arthritis* ; Knee Joint* ; Knee* ; Salmonella typhi* ; Salmonella*

No abstract available.
Humans*

PURPOSE: Blood loss and transfusions during a liver resection are associated with higher morbidity and mortality rates. With applying hepatic vascular inflow occlusion (Pringle maneuver), persistent bleeding during a hepatic transection is caused by back flow from the hepatic veins. Therefore, low central venous pressure facilitates to reduce-bleeding from the hepatic veins by lowering the back flow pressure gradient. An intermittent hepatic vascular inflow occlusion was applied, with a lowering of the central venous pressure, during a hepatic resection in our series of patient. The effect of these maneuvers in reducing bleeding and the postoperative complication rates were analyzed. METHODS: Between December 2000 and September 2003, in 153 hepatic resection patients, where this technique was used, the intermittent vascular inflow occlusion and maintenance of the central venous pressure as low as possible were accrued in this study. The overall outcomes of patients that had a hepatic resection, focusing on the amount of bleeding, blood product transfusion and complication rates, were analyzed. RESULTS: The median blood loss was 652.5 ml, and 111 patients (72.5%) required no perioperative blood transfusion. The median units of blood required in the patients who needed a transfusion were 2.3 U. There was no evidence of renal derangement related with low blood flow into the kidney by keeping central venous pressure as low as possible. There were minor complications in 34 patients (22.4%) and two in-hospital mortalities (1.3%) associated with hepatic failure in cirrhotics. CONCLUSION: A hepatic resection, with an intermittent Pringle maneuver and a low central venous pressure, is a very simple and effective modality to reduce bleeding during a hepatic transection, with low morbidity and mortality rates and without hepatic and renal dysfunctions.
Blood Transfusion ; Central Venous Pressure* ; Hemorrhage ; Hepatic Veins ; Hospital Mortality ; Humans ; Kidney ; Ligation ; Liver ; Liver Failure ; Mortality ; Postoperative Complications

INTRODUCTION: Comparing with living donor renal transplantation, cadaveric renal transplantation is usually performed as an emergency procedure and has prolonged preservation time and increased incidence of delayed graft function. Korean Network for Organ Sharing (KONOS) was launched from February 2000 to manage the organ transplantation in Korea and expected to increase donor organs supply and an effective organ allocation. PURPOSE: In order to compare the result of cadaveric renal transplantation before and after KONOS system, 108 cadaveric renal transplants performed in Dongsan hospital until October 2003 were reviewed and analyzed. METHODS: Donors and recipients were divided into two groups (group 1; transplantation performed before KONOS, group 2; transplantation after KONOS) and their characteristics and results were analyzed retrospectively. RESULTS: Among donor factors, number of multi-organ procurement increased (23.1% vs 78.6%), and use of inotrophic agent decreased (63% vs 46%) significantly after KONOS, however cold preservation time was not changed even after KONOS system. Procured organs per one donor in our hospital was increased from 2.25 to 2.65. Increased recipient age (from 30.1 to 41.9 years old), more chance to diabetic patient and decreasing number of HLA mismatching (4.6 to 3.9) were considered as a result of KONOS allocation system. However, early results including incidence of acute rejection episode and delayed graft function, and serum creatinine level at the end of one year were no statistic differences. The number of early graft loss were decreased up to 2 years after transplantation. CONCLUSION: Renal transplantation from cadaveric donor after KONOS resulted in lower early graft loss but increased waiting time due to organ shortage is a serious problem to be solved in the future.
Cadaver* ; Creatinine ; Delayed Graft Function ; Emergencies ; Humans ; Incidence ; Kidney Transplantation* ; Korea ; Living Donors ; Organ Transplantation ; Retrospective Studies ; Tissue Donors ; Transplantation ; Transplants

BACKGOUND: Recurrent peritonitis and catheter-related infection, in which removal of the PD catheter and temporary hemodialysis are required, are the main cause of limited technical survival in peritoneal dialysis (PD). The aim of this study was to verify whether the simultaneous catheter removal and replacement (SRR) is feasible and safe in patients with recurrent peritonitis and catheter-related infection. METHODS: From January 2001 to December 2004, We performed 47 SRR in 42 PD patients for the treatment of recurrent peritonitis and catheter-related infection to avoid the interruption of PD. RESULTS: Indications for SRR were recurrent peritonitis in 16 (34.0%), catheter infection without peritonitis in 16 (34.0%), catheter infection with peritonitis in 11 (23.5%) and peritonitis with dialysate leakage in 4 (8.5%). SRR was successful in 89.4%. However, SRR was failed in 10.6% due to persistent tunnel infection in three, drainage failure and hernia in each one. PD was continued after SRR during 14.5+/-11.8 months and subsequent catheter longevity ranged from 3 to 47 months. The most common causative organism of recurrent peritonitis and catheter-related infection was MRSA (25.5%). Subsequent peritonitis occurred in 52.4% of patients with the mean of 10.5+/-9.6 months after SRR. However, 81.8% of subsequent peritonitis were due to new organisms. Postoperative complications occurred in 16 cases (34.0%) including five cases with dialysate leakage, four with persistent tunnel infection, four with early peritonitis, two with drainage failure and one with bleeding. CONCLUSION: We conclude that SRR is a safe and effective procedure in patients with recurrent peritonitis and catheter-related infection without the interruption of PD.
Catheter-Related Infections* ; Catheters* ; Drainage ; Hemorrhage ; Hernia ; Humans ; Longevity ; Methicillin-Resistant Staphylococcus aureus ; Peritoneal Dialysis* ; Peritonitis* ; Postoperative Complications ; Renal Dialysis