There are various problems associated with the surgical management of concomitant abdominal aortic aneurysm (AAA) and gastrointestinal malignancy. Our surgical strategy for the treatment of concomitant AAA and gastrointestinal malignant diseases, with the exception of colorectal diseases is basically a one-stage operation. This report reviews 6 cases involving concomitant AAA and gastrointestinal malignancy (colon cancer in 3 cases, gastric cancer in 2 and hepatoma in one). In 2 cases involving gastric cancer, we selected a one-stage operation for the coexistent AAA and gastrointestinal malignancy. The postoperative courses were uneventful. In a 69-yearold man with concomitant AAA, hepatoma and ischemic heart disease, a hepatectomy and coronary revascularization preceded AAA repair because the AAA diameter was too small. AAA repair was performed after 4 months when its diameter had been enlarged. In one of the 3 cases involving concomitant AAA and colon cancer, the malignancy was resected first and the patient died of recurrence 7 months after the operation and prior to the operation for AAA. In the second case of colon cancer, AAA repair preceded the resection of the malignancy. A right hemicolectomy was performed 53 days after the AAA operation. The third case had a one-stage operation for coexistent AAA and colon cancer. His postoperative course was uneventful. In this case, we took particular care to avoid graft infection. The 5 cases that underwent both operations have survived without major complications or evidence of recurrence during a follow-up period ranging from 2 months to 4 years.

We have reported that many chrysanthemum- and lettuce-growers have dermatitis caused by juice of the leaves of these plants and that this dermatitis is caused by an allergic mechanism. In arecent questionnaire on the cause of this dermatitis, half the farmers answerd that it was due to agricultural chemicals. Therefore, we tested the farmers by skin patch tests with several widely used chemicals. In the tests, daconil gave the strongest reaction, results being positive in 60% of the farmers. Daconil was very irritative and phototoxic, the percentage of positive reactions in the patch test with 800 times diluted daconil solution of the concentration commonly used being about 30% after 48 hours and about 60% at 48 hours after peeling off the patch.
The parcentage of positive reactions in the skin patch test with several fractions of chrysanthemums on chrysanthemum-growers were significantly higher than non-farm-workers. Similary, tests with allergen extracted from lettuce showed a significantly higher percentage incidence in lettuce -growers than in other subjects. The patch test with 4000 times diluted daconil solution showed ahigher incidence in farmers than in other subjects. Therefore, 4000 times diluted daconil solution seems to cause allergic contact dermatitis in farmers, and as farmers reported, dermatitis seems to be caused by allergy to farm products, and the irritability, phototoxicity and allergenicity of TPN (Daconil).

Three patients with hypersensitivity pneumonitis caused by inhalation of spores of Cortinus shiitake (Lentinus edodes) cultivated in vinyl houses were observed. These three patients developed the disease after harvesting shiitake for several hours in closed frame houses with a heater in the autum and winter. The frames were full of spores of shiitake and the patients suffered from a discordant feeling, systemic weakness, a feeling of cold, fever (over 38 C), a feeling of airway occlusion, a slight cough and sputum. These symptoms disappeared during rest the next day.
Case 1 was examined by the inhalation provocation test with a suspension of shiitake spores and spore-allergen. This test caused several clinical symptoms (fever, airway occlusion and various symptomatic feelings), leucocytosis, decrease of PaO₂ a positive reaction of CRP and X-ray findings (appearance of interstitial pneumonitis shadows).
The 3 patients were considered to be suffering from allergic hypersensitivity pneumonitis due to inhalation of spores of Cortinus shiitake, because of their work, the development of symptoms after work in specific occupational conditions, a positive reaction to precipitating antibody against spore-allergen of shiitake, negative reactions to precipitation antibodies to 11 molds-allergens, various abnormal values in immunological tests and a positive reaction in a provocation test in one case.
In a survey of 45 shiitake-grower, it was found that 6 (13.3%) suffered from respiratory disease. No difference was found in the incidence of intracutaneous reactions to spore-allergen or allergen of dried shiitake in non-farm workers. Among 31 growers of shiitake a precipitation antibody to spore-allergen was observed only in these three patients. These results indicate that an allergic disposition is very important for development of hypersensitivity pneumonitis.

INTRODUCTIONThis study aims to compare the long-term efficacy of 25-gauge vitrectomy to that of intravitreal bevacizumab (IVB) for the treatment of macular edema (ME) secondary to branch retinal vein occlusion (BRVO).

MATERIALS AND METHODSThe medical records of 46 eyes of 46 consecutive patients were reviewed. Twenty-seven eyes underwent 25-gauge vitrectomy (VIT Group) and 19 eyes received 1.25 mg of IVB (IVB Group). The best-corrected visual acuities (BCVAs) in logarithm of minimum angle resolution units and central macular thicknesses (CMTs) were evaluated before and 3, 6, and 12 months after the initial treatment.

RESULTSThere was no significant difference in the pre-treatment BCVA and CMT between the 2 groups. In the VIT Group, the preoperative BCVA was 0.59 and the CMT was 587.3 μm and the BCVA was 0.35 and the CMT was 286.6 μm, 12 months after the vitrectomy. Both values were significantly (P <0.05) better at 12 months than the preoperative values. In the IVB Group, the average number of IVB was 2.4 during the 1-year period. The BCVA was 0.69 and the CMT was 590.9 μm before the IVB, and the BCVA was 0.36 and the CMT was 360.1 μm, 12 months after the initial IVB. The improvements of these 2 parameters were significant (P <0.05) at 12 months after the initial IVB. The differences in the BCVA and CMT at 12 months between the 2 groups were not significant.

CONCLUSIONThese results suggest that the 25-gauge vitrectomy and IVB have similar effects in improving the BCVA and CMT in eyes with ME secondary to BRVO. However, IVB often required several injections to preserve the improvement.

Aged ; Angiogenesis Inhibitors ; therapeutic use ; Antibodies, Monoclonal, Humanized ; therapeutic use ; Bevacizumab ; Female ; Follow-Up Studies ; Humans ; Intravitreal Injections ; Macula Lutea ; pathology ; Macular Edema ; etiology ; therapy ; Male ; Middle Aged ; Retinal Vein Occlusion ; complications ; Retrospective Studies ; Treatment Outcome ; Vascular Endothelial Growth Factor A ; antagonists & inhibitors ; Visual Acuity ; Vitrectomy ; methods