No abstract available.
Carcinoma, Renal Cell* ; Neoplasm Metastasis*

No abstract available.
Carcinoma, Renal Cell* ; Neoplasm Metastasis*

Aortic rupture caused by migration of a clavicular pin is a rare complication sometimes seen after clavicular fracture. There are many reviews of the complications of pin migration following surgery on the shoulder girdle. It is uncommon, though, for clavicular pin migration to result in aortic rupture and a subsequent cardiac tamponade. This unusual injury can be presented as acute shock symptoms after the previous pinning operation of a clavicle fracture, and it manifests characteristics that can be detected through computed tomography (CT) and focused by abdominal sonography for trauma (FAST). We report a case in which a patient suffered an aortic rupture induced cardiac tamponade caused by clavicular pin migration following surgery for a clavicular midshaft fracture.
Aortic Rupture ; Bone Wires ; Cardiac Tamponade* ; Clavicle* ; Emergencies* ; Emergency Service, Hospital* ; Fracture Fixation ; Humans ; Shock ; Shoulder

BACKGROUND: Since the introduction of cyclosporine, the short-term renal allograft survival has significantly improved. However, the long-term success is still limited by the development of chronic rejection and recurrent disease. Post-transplant glomerulonephritis (post-Tx GN) including recurrent disease is becoming an important cause of graft dysfunction. METHODS: From November 1988 to June 2004, a total of 629 renal transplants involving 588 patients were performed at our medical center. RESULTS: The prevalence rate of post-Tx GN was 11.9% in 629 renal transplant. Among 75 transplants diagnosed as post-Tx GN, IgA nephropathy (62.7%) was the most common histologic diagnosis, followed by focal segmental glomerulosclerosis (26.7 %), membranous glomerulonephritis (8.0%), membranoproliferative glomerulonephritis (1.3%) and diabetic nephropathy (1.3%). Documented histologic recurrence occurred in only 24.2% of patients with prior biopsy-proven glomerulonephritis of their native kidneys. The actuarial allograft survival at 5 and 10 years posttransplantation with post-Tx GN was 80.5 % and 27.9%, respectively; and the corresponding graft survival for patients without post-Tx GN was 74.9% and 52.3%, respectively (p<0.05). However, there was no significant difference in the graft survival according to type of post-Tx GN. The 5 and 10 year graft survival for patients with proteinuria over than 3.5 g/24 hr were 62.5% and 0%, which is significantly lower compared with 85.3% and 28.7% for patients with proteinuria less than 3.5 g/24 hr (p<0.01). CONCLUSION: In conclusion, post-Tx GN is associated with decreased long-term graft survival and nephrotic range proteinuria is most important prognostic factor for graft survival. A prospective study with rigorous efforts to make pretransplant diagnosis and standardized criteria for allograft biopsy will more accurately characterize the natural history of post-Tx GN and may provide insight regarding treatment.
Allografts* ; Biopsy ; Cyclosporine ; Diabetic Nephropathies ; Diagnosis ; Glomerulonephritis* ; Glomerulonephritis, IGA ; Glomerulonephritis, Membranoproliferative ; Glomerulonephritis, Membranous ; Glomerulosclerosis, Focal Segmental ; Graft Survival ; Humans ; Kidney ; Natural History ; Prevalence ; Proteinuria ; Recurrence ; Transplants

Adult ; Angiomyoma ; Diagnostic Errors ; Humans ; Nasal Obstruction ; Recurrence

OBJECTIVE: The aim of this study was to investigate DNA fragmentation status in human spermatozoa according to specific tail swelling patterns determined via hypo-osmotic swelling test (HOST).METHODS: Frozen semen samples from 21 healthy donors were thawed and prepared by the swim-up technique for use in intracytoplasmic sperm injection. The semen samples were treated for 5 minutes as part of the HOST procedure and then underwent the sperm chromatin dispersion test using a Halosperm kit. DNA fragmentation status (large halo, medium halo, small halo, no halo, or degraded) and the specific tail swelling pattern (“a”–“g”) were assessed at the level of a single spermatozoon. A total of 42,000 spermatozoa were analyzed, and the percentage of spermatozoa without DNA fragmentation (as evidenced by a large or medium halo) was assessed according to the specific tail swelling patterns observed.RESULTS: The HOST examinations showed that >93% of spermatozoa across all types displayed no DNA fragmentation. The percentage of spermatozoa without DNA fragmentation was 100% in type “d”, 98.67% in type “g”, and 98.17% in type “f” spermatozoa.CONCLUSION: We found that the type “d” spermatozoa displayed no DNA fragmentation, but the other types of spermatozoa also displayed very low rates of DNA fragmentation. This result may be associated with the processing of the spermatozoa by density gradient centrifugation and the swim-up technique.
Centrifugation, Density Gradient ; Chromatin ; DNA Fragmentation ; DNA ; Humans ; Infertility ; Semen ; Semen Preservation ; Sperm Head ; Sperm Injections, Intracytoplasmic ; Spermatozoa ; Tail ; Tissue Donors

BACKGROUND AND OBJECTIVES: Local compression of the ulnar nerve occurs most commonly at the elbow and optimal surgical intervention should be directed at the specific site of involvement. This study is designed to localize the more discrete region by using the method of short segment stimulation in ulnar neuropathy at the elbow. METHODS: Thirty seven patients who were diagnosed as entrapment ulnar neuropathy at the elbow by routine nerve conduction studies were investigated. Latency changes and amplitude changes including conduction block were determined by stimulating the ulnar nerve at 2cm intervals across the elbow. Six of these patients had orthopedic surgery after undergoing short segment stimulation studies. RESULT: All patients had significant latency changes(> OR =0.7msec) in specific segments by short segment stimulation and 6 patients of them showed conduction block. The most frequently involved segments were between medial epicondyle and 2cm proximal(20 patients) and between medial epicondyle and 2cm distal(9 patients). Only two patients exhibited significant latency changes between 2 and 4cm distal to the medial epicondyle, suggesting cubital tunnel syndrome. Lesions, as identified by surgery, proved to be accurately predicted by preoperative short segment stimulation in 5 of 6 patients. CONCLUSION: Short segment stimulation studies are helpful in localizing more accurate involved segment in ulnar neuropathy at the elbow. And the most commonly involved site is within 2cm of the medial epicondyle suggesting tardy ulnar nerve palsy.
Cubital Tunnel Syndrome ; Elbow* ; Humans ; Neural Conduction ; Orthopedics ; Ulnar Nerve ; Ulnar Nerve Compression Syndromes ; Ulnar Neuropathies*

STUDY DESIGN: A retrospective analysis of five cases of late spinal infection after spinal instrumentation and fusion. OBJECTIVES: These cases are reviewed to verify risk factors for late spinal infection after elective instrumentation and to manifest the treatment of this complication. SUMMARY OF LITERATURE REVIEW: Late spinal infection after elective spinal instrumentation and fusion are uncommon. The diagnosis is usually hard and requires much clinical suspicion. MATERIALS AND METHODS: 5 cases were in total 374 patients of the author's cases. These cases are reviewed retrospectively. RESULTS: All patients reported aggravated back pain. 4 patients had elevated erythrocyte sedimentation rates, averaging 44.8 mm/hour and elevated C-reactive protein, averaging 26.2mg/L. No distance foci of infection was identified. All patients got the radiolucent zone around screw fixation site, averaging 4.6mmwidth. The organisms were S. epidermidis in 1 case and coagulase(-) staphylococcus in 1 case. All cases were treated by operative method with debridement, instrument removal with or without revision and postoperative intravenous antibiotics. The average follow-up period was 18.2 months, one patient recurred back pain at 7 months after operation. CONCLUSION: The diagnosis of late infection after elective spinal instrumentation and fusion requires high suspicion of clinical symptoms and signs. All except one were successfully treated by operative treatment.
Anti-Bacterial Agents ; Back Pain ; Blood Sedimentation ; C-Reactive Protein ; Debridement ; Diagnosis ; Follow-Up Studies ; Humans ; Retrospective Studies ; Risk Factors ; Spine ; Staphylococcus

BACKGROUND: Idiopathic membranoproliferative glomerulonephritis (MPGN) is a chronic primary glomerular disease that occurs in both children and adults, with generally progressive course. We have examined the clinical and long-term outcome of patients with idiopathic MPGN at Keimyung University Dongsan Medical Center. METHODS: Of the total 1,971 patients with biopsy-proven glomerulonephritis over the 21-year period from June 1982 and June 2003, there were 51 cases of idiopathic MPGN of whom 49 had type I and two type II. RESULTS: Of the total 51 idiopathic MPGN, male to female ratio was 1.7:1, a mean age at diagnosis was 32 +/- 17 years (range; 6-70) and 50% of the patients were under the age of 30. The clinical presentations at the time of diagnosis were nephrotic syndrome (70%), asymptomatic urinary abnormality (18%), acute nephritic syndrome (6%), and recurrent gross hematuria (6%). Of the 40 patients who followed more than 6 months, with a mean follow-up of 71months, 10 patients progressed to end-stage renal disease. The renal survival at 5 and 10 years after diagnosis were 86 and 52%, respectively. Eight (20%) patients obtained a complete remission and none of them progressed to end-stage renal failure. The quantity of proteinuria at the time of biopsy was much more prominent in deteriorating group, though not significant (p=0.05) and young age and female seemed associated with the complete remission (p<0.05). CONCLUSION: Idiopathic MPGN remains a disease with a poor prognosis. Age, gender and quantity of proteinuria at the time of diagnosis were associated with the prognosis. Further prospective study with larger number of patients would be necessary to assess the prognostic factors and effective therapy for idiopathic MPGN.
Adult ; Biopsy ; Child ; Diagnosis ; Epidemiology ; Female ; Follow-Up Studies ; Glomerulonephritis ; Glomerulonephritis, Membranoproliferative* ; Hematuria ; Humans ; Kidney Failure, Chronic ; Male ; Nephrotic Syndrome ; Prognosis ; Proteinuria

PURPOSE: This study aimed to set priorities for improving the medical device distribution structure and to suggest an innovative improvement plan for the distribution structure using the analytic hierarchy process (AHP) method, focusing on stakeholders in the medical device industry. METHODS: This study conducted a survey with 35 specialists using the AHP method, which is a multiple-criteria decisionmaking methodology, in order to set priorities for improvement plans to address the problems faced by the medical device distribution structure. RESULTS: The AHP analysis showed that supply stability was the most important factor, followed by greater transparency, efficiency, smart supply, and cost reduction. CONCLUSIONS: It is necessary to establish a stable supply system and manage crises through supply stability, as well as to provide opportunities for fair trade through greater transparency. As steps towards those goals, we propose establishing a unique device identification system, an information disclosure system, online distribution, and a group purchasing organization system in Korea.
Disclosure ; Group Purchasing ; Korea ; Methods ; Online Systems ; Specialization