Crohn's disease is a chronic and insidious condition characterized by an inflammatory process that may extend across all layers of the entire gastrointestinal tract. The common sites involved by Crohn's disease are the terminal ileum and ascending colon. Crohn's disease limited to the appendix is uncommon. Since its first report in 1953 by Meyerding and Bertram, 156 cases of appendiceal Crohn's disease have been documented in the world literature. We experienced a case of Crohn's disease limited to the appendix in a-35year-old female who were performed an ileocecectomy.
Appendix* ; Colon, Ascending ; Crohn Disease* ; Female ; Gastrointestinal Tract ; Humans ; Ileum

Colorectal varix (CRV) is a rare cause of lower gastrointestinal bleeding and usually associated with portal hypertension from liver cirrhosis or portal venous obstruction. Idiopathic CRV have no identifiable underlying cause and can only be diagnosed after the cause of portal or mesenteric vein circulation have been excluded. We report a case of idioipathic CRV presented with rectal bleeding for a week. Colonoscopy revealed markedly dilatated tortuous, and bluish veins in the rectum as well as coexistent adenomatous polyp and internal hemorrhoid. Despite extensive investigation, there was no evidence of portal hypertension or any other cause. Family history was also negative. Although blood transfusions were required, the patient remained asymptomatic without further rectal bleeding.
Adenomatous Polyps ; Blood Transfusion ; Colonoscopy ; Hemorrhage ; Hemorrhoids ; Humans ; Hypertension, Portal ; Liver Cirrhosis ; Mesenteric Veins ; Rectum ; Varicose Veins* ; Veins

BACKGROUND: Kidney transplantation (KT) is the treatment of choice for end-stage renal disease patients. The spouse is a major donor in living KT. Clinical outcomes of spousal donor KT are not inferior to those of living related donor KT. In this study, we compared clinical outcomes between ABO-compatible (ABOc) and ABO-incompatible (ABOi) spousal donor KTs. METHODS: Thirty-two cases of spousal donor KT performed from January 2011 to August 2013 were analyzed retrospectively. Twenty-one ABOc KTs and 11 ABOi KTs were performed. We investigated patient survival, graft survival, acute rejection, graft function, and complications. RESULTS: During follow-up, patient and graft survival rates were 100% in both groups. There were no significant differences in the incidence of delayed graft function, acute rejection, and the change in graft function between the 2 groups. Medical and surgical complications were not significantly different between the groups. CONCLUSION: The clinical outcomes of ABOc and ABOi spousal donor KTs were equivalent. In ABOi KT, an emotionally motivated spousal donor KT may be a good alternative to the problem of the absolute shortage of kidney donations.
Blood Group Incompatibility ; Delayed Graft Function ; Follow-Up Studies ; Graft Rejection ; Graft Survival ; Humans ; Incidence ; Kidney Failure, Chronic ; Kidney Transplantation* ; Kidney* ; Retrospective Studies ; Spouses ; Tissue Donors* ; Transplants

BACKGROUND: Endoscopic ultrasonography (EUS) and endoscopic retrograde cholangiography (ERC) are accurate for the diagnosis of commom bile duct stone. But sometimes, endoscopic sphincterotomy is done unnecessarily in patients with suspected choledocholithiasis. Endoscopic ultrasonography is a promising procedure for the diagnosis of extrahepatic cholestasis due to noninvasiveness and accuracy. We compared the effectiveness of endoscopic ultrasonography with endoscopic retrograde cholangiography in detecting the extrahepatic choledocholithiasis. METHODS: sixty nine patients suspected choledocholithiasis were evaluated using endoscopic ultrasonography (EUS) and endoscopic retrograde cholangiography (ERC). Endoscopic sphincterotomy with instrumental exploration was then done when EUS or ERCP image showed the stones. RESULTS: Choledocholithiasis was confirmed in 53 (76.8%) patients. Seven patients were false negative on ERC, of whom all were true positive on endoscopic ultrasonography. Six patients false negative on ERC had small stone (<5 mm in diameter) in dilated bileduct and one patients had impacted stone on the ampulla of Vater. CONCLUSION: EUS could be an accurate for the diagnosis of choledocholithiasis and may prevent inappropriate invasive exploration of the common bile duct.
Ampulla of Vater ; Bile Ducts ; Cholangiography* ; Cholangiopancreatography, Endoscopic Retrograde ; Choledocholithiasis* ; Cholestasis, Extrahepatic ; Common Bile Duct ; Diagnosis ; Endosonography* ; Humans ; Prospective Studies* ; Sphincterotomy, Endoscopic

BACKGROUND: This study was conducted to assess the immunogenicity and safety of GC1107 (adult tetanus diphtheria [Td] vaccine). The primary goal was to evaluate the non-inferiority of the immunogenicity of GC1107 compared to the control vaccine. Additionally, the safety profiles of GC1107 and the control vaccine were compared. METHODS: The subjects were adults ≥ 18 years old who were not injected with Td or adult tetanus-diphtheria-pertussis (TdaP) vaccine within the recent 5 years. A total of 253 subjects were enrolled and randomized to either the GC1107 group or the control group. For immunogenicity assessment, blood samples were collected at baseline and 28 days after vaccination and antibody titer of diphtheria and tetanus were assessed. RESULTS: The seroprotection rates of diphtheria and tetanus were 89.76% and 91.34%, respectively, in the GC1107 group, and 87.80% and 86.99% in the control group. The geometric mean titer (GMT) of the anti-diphtheria antibody increased after vaccination in both groups, showing no significant difference between the groups (P = 0.139). The anti-tetanus GMTs after vaccination also showed comparable increases in both groups, and showed no significant difference (P = 0.860). In the safety evaluation, solicited local adverse reactions occurred in 81.2% of the subjects in the GC1107 group and in 86.4% of the subjects in the control group. Solicited systemic adverse events occurred in 33.2% of the subjects in the GC1107 group and in 47.2% of the subjects in the control group, which did not reach statistical significance. CONCLUSION: This phase III study demonstrated non-inferiority in immunogenicity and comparable safety of GC1107 compared with the control Td vaccine. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02361866
Adult* ; Diphtheria* ; Humans ; Tetanus* ; Vaccination

Since 2013, the Hospital-based Influenza Morbidity and Mortality (HIMM) surveillance system began a H7N9 influenza surveillance scheme for returning travelers in addition to pre-existing emergency room (ER)-based influenza-like illness (ILI) surveillance and severe acute respiratory infection (SARI) surveillance. Although limited to eastern China, avian A/H7N9 influenza virus is considered to have the highest pandemic potential among currently circulating influenza viruses. During the study period between October 1st, 2013 and April 30th, 2016, 11 cases presented with ILI within seven days of travel return. These patients visited China, Hong Kong, or neighboring Southeast Asian countries, but none of them visited a livestock market. Seasonal influenza virus (54.5%, 6 among 11) was the most common cause of ILI among returning travelers, and avian A/H7N9 influenza virus was not detected during the study period.
Asian Continental Ancestry Group ; China ; Emergency Service, Hospital ; Hong Kong ; Humans ; Influenza A Virus, H7N9 Subtype ; Influenza, Human ; Livestock ; Mortality ; Orthomyxoviridae ; Pandemics ; Seasons