Cadaver transplantation in recent era: is cadaveric graft survival similar to living kidney transplantation?

Renal transplantation is the procedure of choice for most of patients with end-stage renal disease. The graft, however can be procured from either cadaver or living donors. To compare graft and patient survival among patients who underwent kidney transplantation from cadaver donor vs. living donor. From April 2002 to February 2010, we performed 138 cadaver kidney transplantations. We reviewed and compared one-year graft and patient survival with 138 living kidney transplantations. One-year graft and patient survivals in cadaveric groups were 93% and 96%, respectively, and in living groups were 92% and 97%, respectively. There was no significant difference in one-year graft and patient survival between living and cadaver donor kidney transplantation

[Measurement component of effective manpower productivity]

The main mission of management is accessing more efficient which be taken into care by managers for managing and new engineering. Today human efficient is the most common of managers' concerned. Many factors are effective in promoting human efficient that cannot be identifying all of them. So we have to give an advantage model. Using factor analysis is one of the efficient models. To determine the components of effective manpower productivity, using factor analysis. This Descriptive, analytic and cross -sectional study was performed in two stages: August, September and October 2009 The owners of qualitative step were 45 experts and factor analysis step were 321 faculty members, educational expert and human resources expert who affiliated to Guilan University of Medical Sciences. Data was collected by made questionnaire and Library Studies and Help study. the validity of its content were done as Expert panel and their credit structure using exploratory factor analysis [main component analysis] and confirmatory factor analysis [maximum likelihood], using alpha internal parallelism of Coranbach. The first section of questionnaire contains 8 individual characteristics and demographic questions and the second part includes 42 questions about the variables affecting the productivity of human resources based on 5-degree Likert Scale. For adequacy of sample size Mayraklyn scale and for suitable data, Bartlett test was used respectively. The exploratory analysis identified 5 main components according the importance degree included of: 1. Organizational culture, with 18 variables and variance 26.29% 2. Environmental condition with 7 variables and variance 12.96% 3. Motivation factors with 10 variables and variance 12.84% 4. Empowerment with 4 variables and variance 7.47% 5. Leadership style with 3 variables and variance 5.05%. The organizational culture, environmental conditions, Motivational factors, empowerment and leadership style, are effective factors or increasing manpower productivity. There was a significant relationship between organizational culture and man power productivity which is the most important factors

[Comparison of pathology and prevalence of Prostate Cancer in patients with PSA between 4-10ng/ml]

Prostate cancer is the forth common cancer in the world with different prevalence rate based on age, race and geographic area. Prevalence of prostate cancer in patients with PSA between 4-10ng/ml is reported to be about 20% in some studies. The aim of this study was to define the prevalence of prostate cancer in patients with 4-10 ng/ml PSA, in different age groups, based on Gleason grade. In this cross sectional descriptive-analytic study, after taking informed consent, TRUS [Tran rectal ultrasound biopsy] was done in all patients with PSA of 4-10 ng/ml who referred to Labafinejad hospital from 2005 to 2006. Their pathology was classified into 3 groups, from 1-10, according to Gleason grade. Patients with cancers were divided into three groups; 50-60, 60-70 and 70-80 years old, according to their age. Collected data were analyzed with SPSS software and descriptive tests. Prevalence of prostate cancer in 155 studied patients that underwent TRUS biopsy was 17.4%. Considering the age of patients, the rate of prostate cancer was 29%, 48.1% and 22.2% in 50-60, 60-70, and 70-80 years old patients. According to Gleason grade, the rate of prostate cancer was 3.7%, 74% and 22.2% in grades 1-4, 5-7 and 8-10, respectively. Prevalence of prostate cancer in patients with PSA between 4-10 ng/ml in this study was 17.4 percent and most of these patients were in 50-60 year-old age groups and have Gleason grade less than 7. The majority of these patients are curable by radical prostatectomy

Laparoscopic ureteropelvic junction decompression for the management of obstruction

We reported the outcome and complications of laparoscopic aberrant vessels transposition without performing pyeloplasty in patients with ureteropelvic stenosis. A total of 10 patients with ureteropelvic stenosis accompanying with aberrant vessels underwent laparoscopic transposition of vessels between June 2001 and March 2003. 4 of the cases were male and 6 were female, and 4 out of 10 had right side and 6 had left side involvement. The mean age was 31.9 [14-59]. Reaction of aberrant vessels was performed by cutting the vain and fixing the artery to the lipid layer around the kidney and renal pelvis. The procedure was successful in all the cases without any perioperative complications. The operative time was 2.20 hours [1.45-2.50] including cystoscopy, DJ placement, and transposition. Mean hospital stay was 2.9 [2-5] days, and patients were followed up an average of 9.1 [3-22] months. Except one case of rehospitalization due to pain, no complication occurred. The rate of clinical and radiological improvement was 100% and IVP showed a decrease in the degree of hydronephrosis as well as the resolution of obstruction observed in renogram. With regard to our findings, it seems, at least in a proportion of patients with UPJ stenosis accompanied with crossing vessels, that mechanical compression is the mere cause of obstruction and primary stenosis does not coexist. As a result, treatment is achieved by transposition of the crossing vessels without entering the renal unit

Endourology: a comparison between laparoscopic and open pyeloplasty in patients with ureteropelvic junction obstruction

To compare clinical and radiological outcomes, complications, and hospital stay in laparoscopic and open pyeloplasty. From February 2002 to February 2003, 69 patients with ureteropelvic junction obstruction [UPJO] were assigned into two groups. Thirty-seven patients underwent transperitoneal laparoscopic pyeloplasty and 32 underwent open surgical pyeloplasty. Clinical symptoms were assessed before and after surgery, subjectively. Radiological assessment was also done three months postoperatively. Mean operative time was 3.2 hours and 2.2 hours in laparoscopic and open pyeloplasty groups, respectively. Intraoperative bleeding was trivial in both groups and no complication or conversion to open surgery occurred. Postoperative complication rates were 24% and 6% in laparoscopic and open pyeloplasty groups, respectively. Mean hospital stay was similar [6.2 days] in the two groups. Mean follow-up was 16.5 months versus 11.4 months. Clinical and radiological success rates were 89% and 83.8% for laparoscopy group versus 96.5% and 87% for open pyeloplasty group. Due to recurrence of stricture, repeated surgery was performed in 4 patients of laparoscopy and 1 of open pyeloplasty groups. Laparoscopic pyeloplasty is a less invasive method with less pain, cosmetic advantages, no long incision, and outcome comparable with open surgery. Hospital stay is also not longer than that in open surgeries. Hence, laparoscopic pyeloplasty can be a substitute for skilled surgeons

PCNL in the management of lower pole caliceal calculi

Several therapeutic methods are used in the management of lower pole caliceal calculi. This survey has been conducted to evaluate the safety and efficacy of percutaneous nephrolithotomy in the management of lower pole calculi. Fifty-five patients, 43 males and 12 females with a mean age of 41.5 [range 11 to 75] years, who had suffered from lower pole caliceal calculi and treated by standard percutaneous nephrolithotomy [PCNL] between 1997 and 2001, were enrolled in this study. The stones were classified as follows: small [less than 25 mm], intermediate [25 to 34 mm] and large [more than 35 mm]. Mean follow-up was 6.2 months [range 2 weeks to 34 months]. The stones were completely extracted by one session PCNL in 43 patients [79%]. Repeat PCNL was needed in one patient and another method was used for stone extraction in another patient. Regarding the size of stone, 88%, 79%, and 74% of small, intermediate, and large stones were completely extracted, respectively. No major complication was noted. PCNL has high success rate in patients with stones larger than 2 cm and its morbidity would be low, provided that it is performed by skilled surgeons