Living donor liver transplantation (LDLT) has been an established treatment modality for patients with end- stage liver diseases, especially in countries with scarcity of deceased donors. The annual number of LDLT cases in Korea has been steeply increasing, exceeding that of Japan and even doubling that of United States in 2007. When comparing LDLT and deceased donor liver transplantation (DDLT), the timely availability and quality of liver grafts are superior in LDLT, but there are definite drawbacks from anatomical sharing of 1 liver organ by 2 individuals as well as potential donor risk. Biliary complications seem to be the most intractable problems following adult LDLT. The indications for LDLT are nearly identical to those of DDLT. The optimal timing for performing LDLT is not clearly defined, but an earlier transplantation is often recommended before serious worsening of general conditions. The post - transplant management following LDLT is often more difficult than that of DDLT although early liver regeneration makes the liver graft large enough. Current situation in Korea requires a heavy demand on DDLT, but it is still very difficult to expect a rapid rise of deceased donor number within a few years. Thus, LDLT may continue to play the pivotal role to compensate for the serious shortage of deceased donor organs. Coercion to living donors should be prohibited in any situation. The medical team and our whole society should pay special attention to caring of living donors in order to encourage organ donation.
Adult ; Coercion ; Hepatitis B ; Humans ; Japan ; Korea ; Liver ; Liver Diseases ; Liver Regeneration ; Liver Transplantation ; Living Donors ; Tissue Donors ; Transplants ; United States

Purpose: We explored the relationship between dry eye syndrome (DES) and parity in women over 20 years of age. Methods: We retrieved data from the Fifth Korean National Health and Nutrition Examination Survey. Of women over 20 years of age, 7,573 diagnosed with DES by ophthalmologists and 7,347 who self-diagnosed DES were included. We used logistic regression to explore the relationship between DES prevalence and parity, and the chi-squared test to compare differences in DES prevalence by someo children. Results: On univariate logistic regression, the DES incidence was significantly affected by residential status, educational level, hours of sleep, and hyperlipidemia, osteoarthritis, thyroid disorder, and menopause status. We subjected these parameters (and age) to multivariate logistic regression. We found no significant relationship between the doctor-diagnosed DES rate and the number of children. Subjectively, the number of children significantly reduced the prevalence of self-diagnosed DES but not that diagnosed by ophthalmologists. The self-diagnosed DES prevalence was significantly lower in women with than without children. Conclusions The KNHANES-V data showed that the prevalence of self-diagnosed DES decreased with the number of children in women aged over 20 years. The prevalence of self-diagnosed DES in women with children was significantly less than that in women without children. However, we found no significant correlation between the number of children and DES status, because DES does not simply reflect poor tear secretion, being rather multifactorial.

Sweet's syndrome was originally described as an "acute febrile neutrophilic dermatosis". Sweet's syndrome presents in three clinically settings: (1) classical or idiopathic Sweet's syndrome, (2) malignancyassociated or paraneoplastic Sweet's syndrome, (3) drug-induced Sweet's syndrome. Sweet's syndrome is known to respond well to systemic corticosteroids, and mortal case associated without any other predisposing factors is hardly found. Twenty-nine year old male was transferred from local clinic with the chief complaint of recurrent thrombophlebitis which occurred 10 days ago after IV treatment of antibiotics for burn. The symptom did not get well with conventional treatment for the thrombophlebitis such as antibiotics or drainage. After several days of pyrexia, the patient died suddenly. Grossly abnormal findings including pulmonary thrombus which could explain sudden death were not found. Disseminated intravascular microthrombi was the most peculiar finding. It was prominent in small sized vein, and lung was the most severely affected. Heart and liver were also involved. Large thrombi within deep vein of the legs were also noted. Minor collections of inflammatory cells, even apart from the main lesion, were noted in skin adnexa or small vessles within aorta wall. No tumorous area was found. The disseminated intravascular coagulation, which was associated with vasculitis was thought to be the direct cause of death. Several points about the Sweet's syndrome including the unusualness of this case were discussed.
Adrenal Cortex Hormones ; Anti-Bacterial Agents ; Aorta ; Burns ; Causality ; Cause of Death ; Death, Sudden ; Disseminated Intravascular Coagulation ; Drainage ; Fever ; Heart ; Humans ; Leg ; Liver ; Lung ; Male ; Neutrophils ; Skin ; Sweet Syndrome* ; Thrombophlebitis ; Thrombosis ; Vasculitis ; Veins

Verotoxin-producing Escherichia coli O157 is a primary cause of severe and bloody diarrhea. Campylobacter spp. are one of the commonly reported bacterial cause of gastrointestinal infections throughout the world. Only a few cases involving both E. coli O157 and Campylobacter species have been reported. The authors simultaneously isolated verotoxin-producing E. coli O157 and Campylobacter species from the stool of a 3 year-old male with bloody diarrhea, fever and abdominal pain.
Abdominal Pain ; Campylobacter* ; Child, Preschool ; Diarrhea ; Escherichia coli O157* ; Escherichia coli* ; Escherichia* ; Fever ; Gastroenteritis* ; Humans ; Male ; Shiga Toxins ; Shiga-Toxigenic Escherichia coli

Biliary-enteric fistula is in 0.5% to 5% of patients undergoing biliary tract surgery. The most common cause of biliary-enteric fistula is gallstones and their complications, Much less common causes are complieation of peptic ulcer, malignancy, trauma, and rarely, Crohns, disease. The most common type of biliary-enteric fistula is cholecysto-duadenal. Cholecysto-colic, cholecysto-gastric, and choledocho-duodenal fistula are reported much less frequently. The combination of cholecysto-duodenal fistula with cholecysto-colic fistula is a very rare. Symptoms are generally nonspecific, so diagnosis has depended on plain film of abdomen and barium studies. Recently, endoscopic examination and cannulation of the fistula for precise radiographic delineation will help to make a diagnosis. A 78-year-old man was admitted our hospital because of epigastric discomfort, indigestion, nausea and vomiting for 10 days. He was confirmed as cholecysto-duodeno-colic fistula by gastroduodenoscopy, colonoscopy, and endoscopic cholangio-graphic techniques. So, we report a case of cholecysto-duodeno-colic fistula of the patient with a review of relevant literatures.
Abdomen ; Aged ; Barium ; Biliary Tract ; Catheterization ; Colic* ; Colonoscopy ; Diagnosis ; Dyspepsia ; Fistula* ; Gallstones ; Humans ; Nausea ; Peptic Ulcer ; Vomiting

Purpose: To report a case of Descemet stripping automated endothelial keratoplasty (DSAEK) for graft failure after re-penetrating keratoplasty (PK).Case summary: A 33-year-old man of Indian nationality who had developed right eye amoeba keratitis and had received two penetrating keratoplasties and allogeneic kerato-limbal transplant in India sought treatment at our hospital. During the follow-up, Ahmed valve transplantation was performed under the diagnosis of secondary glaucoma in his right eye; the patient also underwent conjunctival recession and conjunctival permanent amniotic membrane transplantation as corneal neovascularization had progressed. Subsequently, the corneal transplantation failed and DSAEK was performed. At 7 months after the operation, the right-eye visual acuity was 20/320 without any complications. Conclusions DSAEK may restore good vision without complications in patients with repeated corneal graft failure after PK from corneal endothelial cell failure followed by corneal neovascularization and glaucoma surgery but with good stromal conditions. We present this case, along with a review of the literature. Future studies will require more surgical patients.

Purpose: To report a case of Descemet stripping automated endothelial keratoplasty (DSAEK) for graft failure after re-penetrating keratoplasty (PK).Case summary: A 33-year-old man of Indian nationality who had developed right eye amoeba keratitis and had received two penetrating keratoplasties and allogeneic kerato-limbal transplant in India sought treatment at our hospital. During the follow-up, Ahmed valve transplantation was performed under the diagnosis of secondary glaucoma in his right eye; the patient also underwent conjunctival recession and conjunctival permanent amniotic membrane transplantation as corneal neovascularization had progressed. Subsequently, the corneal transplantation failed and DSAEK was performed. At 7 months after the operation, the right-eye visual acuity was 20/320 without any complications. Conclusions DSAEK may restore good vision without complications in patients with repeated corneal graft failure after PK from corneal endothelial cell failure followed by corneal neovascularization and glaucoma surgery but with good stromal conditions. We present this case, along with a review of the literature. Future studies will require more surgical patients.

Gastric metaplasia of the duodenum, defined as the presence of groups of gastric mucosal cell within normal duodenal epithelium, is an almost constant feature of duodenal ulcer. The pathogenesis of gastric metaplasia is unclear, but acid and Helicobacter pylori infection are contributory factors to the development of gastric metaplasia. Generally, endoscopic finding of gastric metaplasia in duodenum is typically patchy distribution in duodenal bulb, but polypoid gastric metaplasia in duodenum is very rare. We report that the patient who complaints of abdominal pain has a villous, polypoid gastric metaplasia in duodenal bulb without duodenal ulcer.
Abdominal Pain ; Duodenal Ulcer ; Duodenum ; Epithelium ; Helicobacter pylori ; Humans ; Metaplasia*

BACKGROUND: Although most of aerobic gram-positive bacilli have been considered to be contaminants, gram-positive bacilli should be identified to the species level if they are isolated from sterile body sites such as blood, and from adequately collected clinical specimens if they are the predominant organisms. However, identification of gram-positive bacilli are difficult due to the enormous diversity of these organisms and the small number of readily available commercial identification systems in clinical laboratories. Gram-positive bacilli and coccorods isolated from blood cultures were tested with BBL Crystal Gram-Positive (GP) Identification (ID) system in order to evaluate the system's usefulness of identifying these bacteria. METHODS: Thirty-seven stock strains of aerobic gram-positive bacteria isolated from blood cultures between October 1998 and November 1999 at Wonju Christian Hospital were simultaneously tested by BBL Crystal GP ID system and API system. Three kinds of API system (API Coryne, API 50 CHB, and API 20 Strep) were tested according to gram stain results. Gram-positive bacilli or gram-positive coccorods consecutively isolated from blood cultures from May to November in 2000 were identified by BBL Crystal GP ID system. RESULTS: Among the 37 stock strains of aerobic gram-positive bacteria, agreement rate of identification between Crystal GP ID system and API system were 88% to the genus level and 63% to the species level in Bacillus species, and 90% to the genus level in Corynebacterium species. The isolation rate of gram-positive bacteria from blood cultures from May to November in 2000 to the genus level were: Bacillus; 41.9%(18/43), Corynebacterium; 37.2%(16/43), and the other grampositive coccorods; 20.9%(9/43). CONCLUSIONS: Crystal GP ID system is a useful identification system which, when combined with basic microbiological tests, should lead to satisfactory identification results for gram-positive bacteria isolated from blood cultures.
Bacillus ; Bacteria ; Corynebacterium ; Gangwon-do ; Gram-Positive Bacteria*

A total of 1,132 pleural fluid culture results obtained from October 2012 to July 2014 were analyzed to elucidate the microbiological characteristics according to transudative and exudative pleural fluid. The pleural fluid cultures were performed using aerobic and anaerobic blood culture bottles. The blood and pleural fluid for total protein, lactate dehydrogenase, and glucose measurement were submitted to laboratory at the same time with pleural fluid cultures. The rates for culture positivity, anaerobes isolation, and polymicrobials between transudative and exudative pleural fluid were 5.2% vs. 10.4%, 14.8% vs. 7.8%, and 14.8% vs. 10.9%.
Exudates and Transudates ; Glucose ; L-Lactate Dehydrogenase