To prevent extensive manipulation of the kidney and profuse bleeding, the exact information of the renal vessels is very important. On the basis of the intraoperative observations of 127 donor kidneys and preoperative angiography, we studied the renal vascular variations. Both kidneys had single renal arteries in 70.1% of the cases and multiple renal arteries were found in 29.9% of the cases. 89% of the cases had single renal arteries and single renal veins, and 4.8% of the cases were drained by multiple renal veins on operative field. Left renal veins had three branches, adrenal vein, gonadal vein and lumbar vein in 84% of the cases. Only adrenal vein and gonadal vein were identified in 13% of the cases. Anomalies of the IVC were identified in two cases. One case was left postrenal IVC and the other case was persisting left IVC. Right renal veins had no branch in 88.9% of the cases and gonadal vein was identi5ed in 11.1% of the cases in our study. In surgical procedures about the renal area, familiarity with common variations of the renal vessels and anomalies of IVC is very important for the surgeon.
Angiography ; Gonads ; Hemorrhage ; Humans ; Kidney* ; Recognition (Psychology) ; Renal Artery ; Renal Veins ; Tissue Donors* ; Veins

Renal cell carcinoma in the pediatric age group has been considered as a rare clinical disease entity but perhaps not as rare as once thought. This neoplasm should be considered in the differential diagnosis of hematuria and/or abdominal masses in children. Herein a case of pathologically confirmed pediatric renal cell carcinoma with multiple cysts in liver is presented with a brief review of literature.
Carcinoma, Renal Cell* ; Child ; Diagnosis, Differential ; Hematuria ; Humans ; Liver

OBJECTIVES: In this study, we compared anxiety, depression, and maternal-fetal attachment between high-risk pregnant women and normal pregnant women, and investigated whether there was a correlation between anxiety, depression, and maternal-fetal attachment in each group.METHODS: Two hundred and eleven pregnant women(118 high-risk pregnant women, 93 normal pregnant women) were recruited. All subjects were administered a sociodemographic and obstetric questionnaire, Stait Trait Anxiety Inventory-State(STAI-S), Beck Depression Inventory- II(BDI-II), and Maternal-Fetal Attachment Scale(MFAS).RESULTS: Total score of STAI-S in high-risk pregnant women was 13.704 point higher than that in normal pregnant women(95% CI=10.449–16.959, p<0.001). Also, total BDI-II score in high-risk pregnant women was 5.325 higher than that in normal pregnant women(95% CI=1.850–3.711, p<0.001). There was no significant difference between total MFAS score of normal pregnant women and that of high-risk pregnant women(t=1.594, p=0.112). There was a significant positive correlation between anxiety and depression in both normal(r=0.529, p<0.001) and high-risk(r=0.582, p<0.001) groups. In normal pregnant women, there was a significant negative correlation between anxiety and maternal-fetal attachment(r=−0.284, p=0.006).CONCLUSION: High-risk pregnant women experienced more anxiety and depression than normal pregnant women, and the maternal-fetal attachment was not significantly different between the two groups. The higher the level of anxiety of the pregnant women, the lower the degree of maternal-fetal attachment. Psychological support for dealing with the emotional problems of high-risk pregnant women and promoting maternal-fetal attachment is needed.
Anxiety ; Depression ; Female ; Humans ; Pregnancy, High-Risk ; Pregnant Women

No abstract available.
Mesothelioma*

PURPOSE: To evaluate the effect of different doses of intravitreal triamcinolone acetonide on diffuse diabetic macular edema. METHODS: In a retrospective study, 44 eyes with diffuse diabetic macular edema were treated with an intravitreal injection of 4 mg (n=12 eyes), 8 mg (n=17) or 25 mg (n=15) of triamcinolone acetonide (TA). Optical coherence tomography, best-corrected logMAR visual acuity and Goldmann tonometry were performed at baseline, 1 week, and 1, 3, 6, 9 and 12 months after treatment. Mean follow-up was 9.8 months (standard deviation=2.3) with a range of 5-12 months. RESULTS: The duration of intravitreal TA effects on macular thickness and visual acuity increased with increasing dosage. An observed increase in intraocular pressure induced by TA was not significantly associated with dosage. CONCLUSIONS: In patients with diffuse diabetic macular edema who receive intravitreal TA, effects may last longer after a dosage of 25 mg, than after lower doses of 8 mg or 4 mg.
Adult ; Aged ; Aged, 80 and over ; Diabetic Retinopathy/*complications/drug therapy/pathology ; Dose-Response Relationship, Drug ; Female ; Follow-Up Studies ; Glucocorticoids/*administration & dosage ; Humans ; Injections ; Intraocular Pressure ; Macular Edema/diagnosis/*drug therapy/etiology ; Male ; Middle Aged ; Retrospective Studies ; Time Factors ; Tomography, Optical Coherence ; Treatment Outcome ; Triamcinolone Acetonide/*administration & dosage ; Visual Acuity ; Vitreous Body

PURPOSE: Intracavernosal self injection therapy is now being widely used to treat patients with erectile dysfunction. However, there is a large number of patients who give up the self injection program due to the fear of injection. Therefore, less invasive route of drug administration is highly recommended. We investigated the efficacy of intraurethral instillation of Prostaglandin El (PGE1 ) solution in the patients who showed full erection with intracavernosal injection of PGE1. MATERIALS AND METHODS: Twenty-nine impotent patients who showed full erection with intracavernosal injection of PGE1 were included in this study. We estimated the grades and durations of the penile erection after intraurethral instillation of PGE1 RESULTS: Sixteen out of 29 patients(55.2%) showed full erection with intraurethral instillation. Two patients(6.9%) showed urethral pain which disappeared within 24 hours. But there was no systemic side effect CONCLUSIONS: Intraurethral instillation of PGE1 appears to be safe, well tolerated, and less invasive treatment modality Thus it can be selected as an alternative treatment of impotence in selected cases.
Alprostadil* ; Erectile Dysfunction* ; Humans ; Male ; Penile Erection

Infectious diseases, particularly pneumonia, remain a major cause of morbidity and mortality in patients with systemic lupus erythematous (SLE), accounting for 30~50% of all death. Because infection appears in various forms in lupus patients, early detection and appropriate treatment is very important. In the case of diffuse infiltration in the whole lung field, we should make a differential diagnosis with drug-induced pneumonitis, interstitial lung disease and pneumonia caused by atypical microorganism infection. In particular, in case of atypical microorganism pneumonia, we usually suspect cytomegalovirus, pneumocystis jiroveci and ebstein-barr virus, but influenza pneumonia is relatively neglected. Here, we report on the case of a 26-year-old female patient with lupus nephritis who presented with dyspnea and diffuse pulmonary infiltration immediately after intravenous cyclophosphamide. She was diagnosed with primary influenza B pneumonia and successfully treated with oseltamivir.
Accounting ; Adult ; Communicable Diseases ; Cyclophosphamide ; Cytomegalovirus ; Diagnosis, Differential ; Dyspnea ; Female ; Humans ; Influenza, Human ; Lung ; Lung Diseases ; Lung Diseases, Interstitial ; Lupus Nephritis ; Oseltamivir ; Pneumocystis jirovecii ; Pneumonia ; Viruses

Endometrial cancer is the third most common gynecologic cancer in the Korea and occurs mainly in menopausal women. Although it can develop in young premenopausal women cancer as well, an attack in the adolescent girl is very rare. A 13-year-old girl visited gynecology department with the complaint of abnormal uterine bleeding. An endometrial biopsy revealed FIGO (International Federation of Gynecology and Obstetrics) grade II endometrial adenocarcinoma. In the treatment of endometrial cancer, conservative management should be considered if the patient is nulliparous or wants the fertility preservation. Therefore, we decided to perform a hormonal therapy and a follow-up endometrial biopsy after progestin administration for eight months revealed no residual tumor. We report a case of endometrial cancer occurred in a 13-year-old girl with a brief review of the literature.
Adenocarcinoma* ; Adolescent* ; Biopsy ; Endometrial Neoplasms ; Female* ; Fertility Preservation ; Follow-Up Studies ; Gynecology ; Humans ; Korea ; Neoplasm, Residual ; Uterine Hemorrhage

As the development of Doppler ultrasonography, many cases of uterine arteriovenous malformation (AVM) have beed diagnosed. But there is no case of cervical AVM in pregnant uterus. We present a 33-year-old pregnant woman who was diagnosed with AVM of the uterine cervix during the midtrimester. Color Doppler sonography and magnetic resonance image were used for diagnosis. We performed Cesarean section because of the risk of massive bleeding from the cervical AVM at 34 weeks' gestation. This is the first case of cervical AVM during pregnancy with a successful outcome and an uneventful postpartum course.
Adult ; Arteriovenous Malformations* ; Cervix Uteri* ; Cesarean Section ; Diagnosis ; Female ; Hemorrhage ; Humans ; Postpartum Period ; Pregnancy Trimester, Second ; Pregnancy* ; Pregnant Women ; Ultrasonography, Doppler ; Uterus

Among the hazards in anesthesiologic field, the radiation exposure is not uncommon and is mainly from the exposure to imaging equipment. The presented case is a very extraordinary one of radiation exposure from the patient taking radioactive iodine (I-131). Recently we experienced a radiation exposure during the emergency surgery of a thyroid cancer patient who was administered I-131 before surgery. The oral administration of I-131 is recognized as a standard medical treatment for thyroid carcinoma. But the patient treated with I-131 can be a potential radiation source of external exposure to surroundings and the radiation was actually near the recommended limit of yearly exposure in spite of short surgery time. Hereby we report the case and contemplate the peri-operative risk of radiation exposure.
Administration, Oral ; Emergencies* ; Humans ; Iodine ; Radiation Protection ; Thyroid Neoplasms