Fifteen-year follow-up of transplantation of a cadaveric polycystic kidney: a case report.

INTRODUCTION: Kidneys from donors affected by autosomal-dominant polycystic kidney disease (ADPKD) are in general considered unsuitable for transplantation. To the best of our knowledge, only 12 cases of ADPKD transplanted renal units have been reported in the English literature; most have only short-term follow-up. METHODS: We provide a review of these patients and share our experience with an ADPKD patient who received a 21-year-old deceased donor ADPKD-affected renal transplant and has been closely followed for 15 years. Based on the current literature, this report is the longest follow-up of a ADPKD donor transplant. RESULTS: Over the 15-year follow-up period, there have been no complications related to the ADPKD-affected donor kidney, including three kidney transplant biopsies. The graft continues to function well with the serum creatinine currently 1.2 mg/dL. Serial axial imaging has demonstrated that the cystic disease has slowly progressed in the donor renal unit, with the largest cyst having only increasing from 1.2 to 2.9 cm in diameter. Metachronous, bilateral laparoscopic nephrectomies of the native kidneys were performed owing to intractable pain from cystic enlargement. CONCLUSIONS: Normal functioning deceased donor kidneys that show signs of early ADPKD should be considered acceptable for donation in select cases. These organs provide the recipient a safe, reasonable period of graft survival and have not been shown to cause adverse effects.

Is there an association between season of birth and reading disability?

Reported associations between season of birth and reading failure suggest medical causation and prevention. The relationship between season of birth and two measures of reading outcome in two cohorts of children (n1 = 2411 and n2 = 1972) was studied using chi2 tests. None was significant. Logistic regression was used to investigate the joint associations of gender, age at school entrance, and season of birth with reading outcome. A significant interaction between reading failure and age category (overage at school entrance vs correct age) by season of birth was observed. It was shown that this significant interaction was probably caused by kindergarten entrance cutoff birth dates. Although 67.8% of all overage children had summer births, only 15.3% failed in reading, which is not statistically different from the percentage of summer-born, correct-age low readers (13.6%). Results suggest that reported associations may be attributed to selective samples rather than the total population of school children who experience reading failure.

Sciatic spinal deformity-lumbosacral list: an "unusual" presentation with review of the literature.

Sciatic spinal deformity or lumbosacral list has received little attention in the literature. The phenomenon was first described in 1881 by Remak, but it was not until 1942 that Duncan and Hoen made the association between disk herniation and lumbosacral list. Since that time, the literature concerning this topic has been sparse and the terminology inconsistent. A case of lumbosacral list associated with disk herniation is presented with documented resolution after surgery. The pathogenesis of the list is described with a comprehensive review of the literature.

Giant cell tumor of metacarpal treated by cryosurgery.

We report the case of a 44-year-old woman with a giant cell tumor of the fourth metacarpal head of her dominant left hand that was treated with cryoprobe freezing, curettage and bone grafting. Three years after operation the metacarpophalangeal joint remained normal both functionally and radiologically. The tumor has not recurred. Cryoprobe killing of giant cell tumors of the hand can offer effective direct tumor eradication, as well as maintaining normal bone architecture and preserving full function.