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ABSTRACT: Total phallic reconstruction remains a great challenge in reconstructive surgery. The search for a suitable donor site is never ending. Based on the experiences in using free deep inferior epigastric perforator flap for breast reconstruction, the authors describe a new usage of the deep inferior epigastric perforator flap for phallic reconstruction. In this procedure, the neourethra is centrally located. The rigidity is provided with the 12th rib. The donor site can directly be closed. Over the past 4 years, this surgical procedure has been used successfully for total phallic reconstruction in 2 patients. Four years of follow-up has revealed that an aesthetically acceptable functional neopenis was achieved. The scar of the donor site is inconspicuous and is easily concealed by underwear. Moreover, this new procedure is a nonmicrosurgical technique. Although more clinical experience is needed, this flap can be chosen as an alternative option in phallic reconstruction.
Annals of plastic surgery 07/2011; 69(1):64-6. · 1.29 Impact Factor
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ABSTRACT: To compare the effects, relapse ratio and outcomes between mycophenolate mofetil (MMF) and pulse intravenous cyclophosphamide (CTX) for the induction therapy in patients with crescentic lupus nephritis.
This is a retrospective, controlled study. Twenty-seven MMF therapeutic and twenty-five CTX therapeutic lupus patients with >or=50% crescent formation were enrolled in this study. The general conditions, clinicopathological findings, remission and relapse ratio, and outcomes of them were compared.
There was no significant difference of general condition and clinicopathological findings between MMF and CTX group. At 12 months, the total remission ratio in MMF and CTX group were 73.1% and 69.6%, while the complete remission ratio in MMF group (53.8%) was significantly higher than that in CTX group (26.1%). The relapse ratio in MMF group (10.5%) was significantly lower than in CTX group (43.8%). Forty per cent of PR patients in CTX group suffered from relapse. Until June 2005, the patients in CTX group received a follow time with 38.5 +/- 21.2 (range 10 approximately 80) months, and in MMF group the follow time was 41.1 +/- 27.0 (range 12 approximately 90) months. Two patients in MMF group and two in CTX group entered into end stage renal failure. The side effect of infection was more significant in CTX group.
Higher complete remission ratio and lower relapse ratio were observed in MMF group than in CTX group. The side effect of infection was more infrequent in MMF group, which showed preferable security of MMF.
Nephrology 10/2008; 13(8):702-7. · 1.31 Impact Factor
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Plastic and reconstructive surgery 10/2007; 120(3):810-1; author reply 811-3. · 2.74 Impact Factor
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ABSTRACT: To investigate the clinical efficacy of tonsillectomy on long-term clinical remission and renal survival of immunoglobulin A nephropathy (IgAN) patients in China.
We performed a 130-month retrospective case-control study of 112 patients with idiopathic biopsy-diagnosed IgAN from 1983 to 1999. Fifty-four patients underwent tonsillectomy and 58 patients did not. The clinical remission rate during follow-up and variables to predict clinical remission were estimated by chi2 test and multivariate Cox regression analysis; renal survival was evaluated by Kaplan-Meier analysis.
Up to 2006, the follow-up period lasted 130 +/- 50.3 months (60-276 months). The clinical remission rate was 46.3% in patients with tonsillectomy and 27.6% in those without tonsillectomy during follow-up. Multivariate analysis demonstrated that tonsillectomy was not an independent impact factor for renal clinical remission (p = 0.386). By Kaplan-Meier analysis, there was no significant difference in renal survival rate between patients with tonsillectomy and those without tonsillectomy (p = 0.059).
The clinical remission rate in IgAN patients with tonsillectomy was higher than that in patients without tonsillectomy during follow-up. But within 130 months, it was difficult to find statistical difference in renal survival between IgAN patients with and without tonsillectomy.
American Journal of Nephrology 02/2007; 27(2):170-5. · 2.54 Impact Factor
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ABSTRACT: Idiopathic IgA nephropathy is one of the main causes of secondary malignant hypertension, especially in Chinese population. But little information has been available about malignant hypertension secondary to IgA nephropathy (IgANMHT). The purpose of this study is to evaluate the clinico-pathological features and outcomes of IgANMHT patients.
A case control retrospective study was carried out in 45 cases of IgANMHT and 26 cases of primary malignant hypertension (PMHT) diagnosed by renal biopsy. Their clinical features and pathological findings were investigated. Their average follow-up time was 37.4 months. Univariate analysis and multivariate Cox regression analysis were performed to select variables to predict renal survival.
In the study, 1.2% of all the IgA nephropathy patients presented malignant hypertension. The amounts of urine protein excretion and red blood cells in IgANMHT patients were significantly higher, while the levels of serum creatinine were significantly lower than those in PMHT patients. The glomerular injury in IgANMHT patients was more severe than that in PMHT patients. The two characteristic vascular lesions of primary malignant hypertension, proliferative endoarteritis and fibrinoid necrosis were also found in IgANMHT patients but with less severity. Renal survival of IgANMHT patients was significantly higher than that of PMHT patients (p = 0.0043). However, log-rank test showed no significant difference in the renal survival between IgANMHT and PMHT patients with similar SCr levels at admission. Multivariate Cox regression analysis revealed that a high amount of urine protein excretion(> or =1.5 g/24 h), mesangial proliferation and elevated serum creatinine (> or =2 mg/dl) were statistically independent risk factors for renal prognosis (RR = 1.90, 2.72, 2.84, respectively). Conversely, strict blood pressure control had a favorable effect on renal prognosis.
The clinico-pathological features and outcomes of IgANMHT patients were different from those of PMHT patients. The renal survival of IgANMHT patients was poor, which was determined by many factors. Early control of proteinuria, early monitoring and strictly controlling blood pressure may contribute to the renal survival.
Kidney and Blood Pressure Research 02/2005; 28(4):251-8. · 1.46 Impact Factor
