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박원서,백윤재,도레미,김기덕,정복영,방난심,윤희정,유태민,Park, Wonse,Baik, Yoon-Jae,Doh, Re-Mee,Kim, Kee-Deog,Jung, Bock-Young,Pang, Nan-Sim,Yun, Hee-Jung,You, Tae-Min 대한치과마취과학회 2012 Journal of Dental Anesthesia and Pain Medicine Vol.12 No.3
Background: The major goal of dental management before and after liver transplantation is the prevention of bacteremia from an oral source that could lead to systemic infection. However dental treatment in liver transplant patients have the risk of infection and bleeding. so it is needed special dental consideration. Methods: 42 liver transplant candidates who visited department of Advanced General Dentistry in Yonsei University College of dentistry from March 1, 2010 to February 29, 2012 were selected. The clinical data of those patients were analyzed; coagulation status such as PT, INR, aPTT, platelet count before and 6 months after liver transplantation, dental infectious foci, time interval between dental visit and operation date of liver transplantation. Results: Before liver transplant, the patient's PT and INR was prolonged, and the platelet count was lower than normal range. But 6 months later from liver transplantation, most of the figures turned into a normal range. The dental infection foci were chronic periodontitis, dental caries, chronic apical periodontitis, root rest et al but we did extraction of 6 root rest before liver transplantation and postponed other treatment after liver transplantation due to bleeding and infection risk of patients. Because of insufficient interval between dental visit and operation date, 64.3% of patients could not finish the dental treatment. Conclusions: The patients before liver transplantation have the risk of bleeding. The treatment of those patient should be removal of only factors that can cause dental infections after transplantation and other treatment must be postponed until the stable period of the transplant that patient's condition has improved.
Ho Kim, Chan,Jin Lim, Beom,Sung Bae, Yoon,Eun Kwon, Young,Ly Kim, Yung,Heon Nam, Ki,Sook Park, Kyoung,Yeong An, Seong,Mo Koo, Hyang,Mee Doh, Fa,Jung Lee, Mi,Jung Oh, Hyung,Yoo, Tae-Hyun,Kang, Shin-Woo Springer Science and Business Media LLC 2014 Modern pathology Vol.27 No.7
<P>Recently, there has been emerging concern that crescents, the main histologic feature of Henoch-Sch?nlein purpura nephritis, merely reflect active inflammation, and may not be useful in predicting long-term outcomes. We therefore conducted a single-center retrospective study to evaluate whether the new Oxford classification of immunoglobulin A nephropathy can be used to predict long-term outcome in patients with Henoch-Sch?nlein purpura nephritis. We included 61 biopsy-proven patients with Henoch-Sch?nlein purpura nephritis between January 1991 and August 2010. In addition to the International Study of Kidney Disease in Children classification, pathologic findings were also evaluated by the Oxford classification. Primary outcomes were defined as either the onset of estimated glomerular filtration rate <60?ml/min per 1.73?m(2) with 30% decrease in estimated glomerular filtration rate from baseline or end-stage renal disease. During a median follow-up of 49.3 months, 13 (21%) patients reached the primary end point. A Kaplan-Meier plot showed that renal event-free survival was significantly longer in patients with <50% crescents than in those with crescents in 50% of glomeruli (P=0.003). Among the components of the Oxford classification, patients with endocapillary hypercellularity (E1; P=0.016) and tubular atrophy/interstitial fibrosis (T1/T2; P=0.018) had lower renal survival rates than those with E0 and T0. In a multivariate Cox model adjusted for clinical and pathologic factors, E1 (hazard ratio=8.91; 95% confidence interval=1.47-53.88; P=0.017) and T1/T2 (hazard ratio=8.74; 95% confidence interval=1.40-54.38; P=0.020) were independently associated with reaching a primary outcome, whereas the extent of crescentic lesions was not. Our findings suggest that the Oxford classification can be used in predicting long-term outcomes of Henoch-Sch?nlein purpura nephritis.</P>