Renal function of donors and recipients after living donor kidney transplantation in a Chinese cohort / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Living donor kidney transplantation (LKT) has been booming in China. This study aimed to elucidate the renal function of both Chinese donors and recipients after the donation and transplantation.</p><p><b>METHODS</b>One hundred and forty-one pairs of donors and recipients for LKT were randomly selected and followed up for up to seven years. The donors' and recipients' renal function was recorded before and after operation.</p><p><b>RESULTS</b>The donors presented a mean age of (43.9 ± 7.5) years at donation. The female contributed 101/141 (71.6%) in all donors, and no effect was shown between genders on healthy donors' renal function. The donors' glomerular filtration rates (GFR) were (119.5 ± 20.4) ml/min, (85.2 ± 17.6) ml/min, (87.2 ± 15.9) ml/min, (82.1 ± 14.6) ml/min and (83.0 ± 13.7) ml/min preoperatively, and for five days, three months, one year and beyond one year after the operation. The donors for the period of 1 - 3 years, 3 - 5 years and more than 5 years after donation showed GFR as (83.9 ± 12.7) ml/min, (83.0 ± 17.6) ml/min, and (80.9 ± 20.8) ml/min, respectively, no statistically significant difference was found. Moreover, no significant clinical changes in blood pressure and proteinuria were found among the donors. In the recipients, delayed graft function (DGF) rate was 6.4%, acute rejection rate was 11.3%, and GFR were (66.5 ± 16.4) ml/min, (73.2 ± 19.6) ml/min and (63.9 ± 18.6) ml/min respectively at three months, one year and beyond one year post-transplantation respectively.</p><p><b>CONCLUSION</b>The donors/recipients of LKT in Chinese population experience well-functioning remaining/donor kidneys.</p>

Technology and application of simultaneous pancreas-kidney transplantation with modified enteric drainage / 中华外科杂志

<p><b>OBJECTIVE</b>To report the modified technique and the short-term results of simultaneous pancreas-kidney transplantation (SPK) with the enteric drainage (ED) of exocrine secretions.</p><p><b>METHODS</b>From June 2000 to August 2006, thirty-eight patients with diabetes complicated with uremia underwent SPK. The pancreas graft was placed intraperitoneally with exocrine secretions drained into the proximal jejunum without Roux-en-Y procedure. The mean cold ischemic times of pancreas and kidney were (10 +/- 2.0) h and (7 +/- 2.0) h, respectively. Quadruple immunosuppressive therapy with antilymphocyte globulin or anti-CD25 monoclonal antibody, tacrolimus, mycophenolate mofetil and steroids was adopted except one patient.</p><p><b>RESULTS</b>The 6-month survival rates of patients and grafts were both 97.4% after transplantation. All patients achieved insulin-free euglycemia at (7 +/- 6.9) d postoperative except one. For preoperative patients, mean fasting insulin and C-peptide values were (9 +/- 8.1) mU/L and (6 +/- 4.5) mU/L. After operation, fasting insulin and C-peptide values of patients were (12 +/- 5.8) mU/L and (6 +/- 4.7) mU/L, respectively, which peaked to an insulin level of (57 +/- 43.0) mU/L and a C-peptide level of (11 +/- 6.8) mU/L with stimulation. There were eight cases of delayed renal graft function. All other patients achieved immediate renal graft function. No graft losses occurred due to leakage or intra-abdominal infection. The most common surgical complications were wound infection (n = 12), enteric anastomostic hemorrhage (n = 5) and perirenal hemorrhage (n = 2). Three patients (7.9%) had been reoperated for the reasons of intra-abdominal hemorrhage and perirenal hemorrhage.</p><p><b>CONCLUSIONS</b>SPK is an effective treatment option for selected patients with diabetes mellitus and approaching end-stage renal disease. Enteric exocrine drainage by direct side-to-side anastomosis (without Roux-en-Y) seems to be a simple and reliable technique.</p>

Eyelid tumors in southern Taiwan: a 5-year survey from a medical university.

This retrospective case analysis investigated the epidemiology of eyelid tumors in a subtropical area. The study assessed the proportion of all eyelid tumors that were malignancies, the accuracy of diagnosis, and surgical results. We retrospectively collected all cases of eyelid tumors in the Department of Ophthalmology, Kaohsiung Medical University, Taiwan, between January 1994 and December 1998. Among the 144 cases collected, about half of the tumors were located in the upper eyelids and the other half in the lower eyelids. Nearly 50% of cases underwent tumor resection with eyelid reconstruction. When followed up to April 1999, 97% of patients were satisfied with the surgical results. There were 18 cases (12.5%) of malignant tumors, including 14 basal cell carcinomas, three sebaceous carcinomas, and one squamous cell carcinoma. Before surgery, two malignancies were presumed to be benign tumors while another two were thought to be different malignant tumors. The benign tumors included 38 nevi, 15 squamous papillomas, 13 cysts, 11 verrucae, 10 seborrheic keratoses, four hemangiomas, and others. All tumors that were thought to be malignancies were treated using complete resection with margin monitoring by frozen section. At the end of follow-up, no recurrence was noted. More than 10% of cases of eyelid tumors in this subtropical teaching hospital were malignant. All surgeons should be alert to this phenomenon when they operate on an eyelid tumor. The best policy is to send all specimens for pathologic examination.

Correction of astigmatism after penetrating keratoplasty by relaxing incision with compression suture: a comparison between the guiding effect of photokeratoscope and of computer-assisted videokeratography.

PURPOSE: To report the results of astigmatism correction after penetrating keratoplasty by relaxing incision with compression suture and to compare the guiding ability of a photokeratoscope with that of computer-assisted videokeratography. METHODS: In the two independent retrospective series, 11 eyes received a relaxing incision with compression suture guided by photokeratoscope or computer-assisted videokeratography. RESULTS: In 22 eyes, the relaxing incision with compression suture showed a mean 56% reduction in astigmatism and 78% reduction in vector-calculated astigmatism. The mean postoperative visual acuity was improved 2.92 Landolt lines. The 11 eyes in which treatment was guided by photokeratoscope demonstrated a mean reduction of 50% and 71% in astigmatism and vector-calculated astigmatism, respectively, and visual acuity increased 2.44 Landolt lines. Another 11 eyes in which treatment was guided by computer-assisted videokeratography achieved a mean reduction of 67% and 90% in astigmatism and vector-calculated astigmatism, respectively, together with 3.41 Landolt lines improvement in visual acuity. There were no significant differences in astigmatism correction and visual acuity improvement between the two groups. CONCLUSION: The results demonstrate that the relaxing incision with compression suture is an effective and safe procedure for correcting high astigmatism after penetrating keratoplasty. The two instruments have no significant difference in their guiding capacities for this procedure.