No abstract available.

Primary aortoenteric fistulae (AEFs) are extremely rare vascular disease entities, with a mortality ranging from 33 to 85%. Only two cases of Salmonella mycotic aortic aneurysms causing primary AEFs have been reported. We experienced a rare case of a 57-year-old man with intermittent gastrointestinal bleeds and who was diagnosed as having primary aortoenteric fistula with abdominal aortic aneurysm, confirmed by CT. In the operation room, the fistula was closed and a temporary proximal duodenojejunostomy was created. The aneurysm was replaced with an aorto-biiliac bypass using Dacron Graft with an inter-positioning omental flap. The microbiology report of aneurysm wall, blood and periaortic tissue showed infection with group D salmonella. He was treated with ciprofloxacin and discharged in good general condition on the 21st post-operative day.
Aneurysm ; Aortic Aneurysm* ; Aortic Aneurysm, Abdominal ; Ciprofloxacin ; Fistula* ; Humans ; Middle Aged ; Mortality ; Polyethylene Terephthalates ; Salmonella* ; Transplants ; Vascular Diseases

Renal transplant recipients currently survive for many years with a consequent increase in the risk of presentation with vascular diseases. So aortic reconstruction in transplant patients is being reported in an increasing number, and the most common among them is aneurysm of the abdominal aorta. Most important problem of the operation is the ischemic injury of the transplanted kidney during aortic clamping. If the transplanted kidneys were damaged by ischemic injury, the creatinine level would elevate and proceed to acute tubular necrosis and chronic renal failure. For the graft kidney protection from the ischemic or reperfusion injury, many procedures are carried out, such as permanent or temporary axillo-femoral bypass, femoro- femoral bypass, aorto-iliac bypass, cold perfusion, local cold preserving, kidney autotransplantation. These days, some authors reported that they could protect the function of the transplanted kidney without any other procedures. We had experienced direct reconstruction of AAA in kidney transplantation recipients without any other surgical protection with good result. Most important factor for protecting the transplanted kidney function is total ischemic time of kidney.
Aneurysm ; Aorta, Abdominal ; Aortic Aneurysm, Abdominal* ; Autografts ; Constriction ; Creatinine ; Humans ; Kidney Failure, Chronic ; Kidney Transplantation ; Kidney* ; Necrosis ; Perfusion ; Reperfusion Injury ; Transplantation ; Transplants ; Vascular Diseases

OBJECTIVES: Previous studies have shown that the endogenous opioid system, which plays an important role in drinking behavior, might be related to the genetic etiology of alcohol dependence. And a recent study reported that the affinity of micro opioid receptor, which is closely related to the endogenous opioid system activity, is affected by the genotype of micro opioid receptor gene (OPRM1) A118G. To investigate the gender difference in genetic etiology of alcohol dependence, this study examined the association of the genotype of OPRM1 A118G with female alcohol dependence in Koreans. METHODS: The author studied the genotype of OPRM1 A118G in 106 male and 35 female Korean with alcohol dependence and 80 male and 60 female healthy Koreans as control. RESULTS: 1) A statistically significant increase in A/G or G/G (G+) genotype of OPRM1 A118G was observed in women with alcohol dependence compared to the controls. 2) Among men with alcohol dependence, no significant difference in OPRM1 A118G polymorphism was observed relative to the age at which drinking started, age of onset of alcohol-related problems, age of first admission to psychiatric hospital for alcohol-related problems, drinking days per month, drinks per drinking day, family history of alcohol dependence in the first-degree relatives or history of severe alcohol withdrawal symptoms. But the drinking days per month is significantly less in those who have A/G or G/G genotypes of OPRM1 A118G. CONCLUSION: These results suggest that G+ genotypes of micro opioid receptor gene A118G are important genetic factors in the etiology of female alcohol dependence.
Age of Onset ; Alcoholics* ; Alcoholism ; Drinking ; Drinking Behavior ; Female* ; Genotype* ; Hospitals, Psychiatric ; Humans ; Male ; Receptors, Opioid* ; Substance Withdrawal Syndrome

PURPOSE: Behcet's disease is a systemic condition with multiple clinical manifestations, the basis of which is a vasculitis with unknown etiology. The most common cause of death in Behcet's disease is secondary to arterial complications. The pathogenesis of these arterial complications is related to the diseased arterial wall or vasa vasorum seen in the Behcet's disease process. Although vascular lesions are not listed among the criteria for diagnosis of Behcet's disease, up to 25~35% of patients develop vascular complications and probably even a greater proportion of patient may have small vessel vasculitis as the pathological basis for the systemic manifestation. Therefore, early diagnosis and aggressive management can result in the long-term salvaging of both limbs and may allow early intervention of arterial complications and prevent the usual fatal outcome. METHOD: We report 59 cases of Behcet's disease, involving the abdominal aorta and its main branches with variable operative procedure. The medical records of these 59 cases were retrospectively reviewed to examine the operation characteristics. RESULT: To manage recurrent aneurysms at previous anastomosis sites, we used PTFE (polytetrafluoroethylene), or autogenous vein and artery (internal iliac artery) as bypass or patch material. The results of the autogenous vessel grafts for arterial reconstructions in Behcet's vasculitis were superior to those of artificial grafts. CONCLUSION: In one case of multiple recurrent anastomotic aneurysm, we attempted aortic blood flow diversion after closure of the false anastomotic aneurysm. This aortic blood flow diversion should be considered as an adopted surgical treatment of recurrent false AAA in Behcet's vasculitis.
Aneurysm ; Aneurysm, False* ; Aorta, Abdominal ; Arteries ; Cause of Death ; Diagnosis ; Early Diagnosis ; Early Intervention (Education) ; Extremities ; Fatal Outcome ; Humans ; Medical Records ; Polytetrafluoroethylene ; Retrospective Studies ; Surgical Procedures, Operative ; Transplants ; Vasa Vasorum ; Vasculitis* ; Veins

PURPOSE: To report the clinical characteristics of patients with opacification of intraocular lens (IOL) after cataract surgery with hydrophilic acrylic IOL. METHODS: Retrospective evaluation was performed for 102 eyes of 74 patients who had undergone cataract extraction, with insertion of hydrophilic acrylic IOL (ACRL-C160). The medical records of 91 eyes of 69 patients who were followed up for more than 6 months were reviewed retrospectively. The clinical characteristics of the patients with IOL opacification were analyzed, and the characteristics were compared between the groups of patients with and without IOL opacification. RESULTS: In 70 eyes of 52 patients IOL opacification developed. The incidence was 19.8% at 6 months, 52.3% at 1 year, and 84.1% at 2 years after cataract surgery. The onset of IOL opacification ranged from 2 to 25 months (11.1 months on average). The incidence of IOL opacification was not affected by systemic disease such as diabetes mellitus and hypertension. In the group of patients with IOL opacification, the onset of IOL opacification occured earlier than in the patient group with diabetes mellitus and it also developed earlier in patients with longer duration of diabetes mellitus and diabetic retinopathy. IOL opacification was more severe in patients with retinopathy than in those without diabetic retinopathy. CONCLUSIONS: The incidence of hydrophilic acrylic IOL opacification increased over time and had risen to 84.1% of cases at 2 years after surgery. Although patients with generalized disease were not associated with the development of IOL opacification, the presence of diabetes mellitus and diabetic retinopathy affected the onset and severity of IOL opacification.
Cataract Extraction ; Cataract* ; Diabetes Mellitus ; Diabetic Retinopathy ; Humans ; Hypertension ; Incidence ; Lenses, Intraocular* ; Medical Records ; Retrospective Studies

PURPOSE: This study was designed to review the results of 2nd and 3rd kidney transplantation at our center. METHODS: Total 1,500 patients who had undergone kidney transplantation from 1968 to Aug 2005 at the Catholic Medical Center were retrospectively analyzed. The graft and patient survival were determined using Kaplan-Meier actuarial survival curves, compared with those of first transplant and assessed for significance using the log rank test. RESULTS: The patient of 2nd transplantation was 77 cases (male 55, female 22, mean age: 48.9+/-2.4 years) and 3rd transplantation was 5 patients (male 4, female 1, mean age 46.8+/-6.0 years). The 82 kidneys included from living donors in 67 patients and from cadaveric donors in 15 patients. The most common cause of renal failure of retransplanted kidney was chronic GN (2nd: 62 cases (80.5%), 3rd: 5 cases (100%)). The immunosuppressive regimen was mainly based on cyclosporine (2nd: 61 cases (79.2%), 3rd: 3 cases (60%)). The mean duration of the second transplantation from the first was 89.0 months and the third transplantation from the second was 32.7 months. There were 16 cases of death patients and the main cause of death was infection and cardiovascular events. The graft survival of 2nd & 3rd transplantation in 1 year were over 80%. CONCLUSION: Renal retransplantation is safe, effective, and the treatment of choice in patients with failed previous kidney transplantation for patient's quality of life and not associated with increased mortality retransplantation. The results of graft survival for retransplantation seem to be excellent for primary transplantation under cyclosporine or tacrolimus-based immunosuppression. The use of the potent and appropriate immunosuppression and surgical technique for retransplantation could help to improve better results.
Cadaver ; Cause of Death ; Cyclosporine ; Female ; Graft Survival ; Humans ; Immunosuppression ; Kidney Transplantation* ; Kidney* ; Living Donors ; Mortality ; Organ Transplantation* ; Quality of Life ; Renal Insufficiency ; Retrospective Studies ; Tissue Donors ; Transplants*

Hypereosinophilic syndrome (HES) is a heterogeneous group of disorders with the common feature of prolonged eosinophilia of unknown cause and associated dysfunctions of organ systems, including the hematologic, cardiovascular, cutaneous, neurologic and respiratory systems, as well as the spleen, liver, eye, and gastrointestinal tract. Bone marrow is involved in almost all subjects, and the most severe complications involve the heart and the central nervous systems. We report a case of HES observed in a 37-year-old man with digital necrosis and persistent eosinophilia lasting for more than 6 months. This patient also showed signs of peripheral neuropathy, cutaneous manifestations, and eosinophilic hyperplasia on the bone marrow biopsy.
Adult ; Biopsy ; Bone Marrow ; Central Nervous System ; Eosinophilia ; Eosinophils ; Gastrointestinal Tract ; Heart ; Humans ; Hypereosinophilic Syndrome* ; Hyperplasia ; Liver ; Necrosis* ; Peripheral Nervous System Diseases ; Respiratory System ; Spleen ; Vasculitis

Budd-Chiari Syndrome (BCS) is unusual form of portal hypertension caused by occlusion of the hepatic venous outflow and it is often frequently complicated by inferior vena cava (IVC) occlusion. It may vary in its presentation from very mild symptomatology, suggestive of a viral illness, to a very acute form with a fulminant course. In the cases of BCS caused by occlusion of IVC and hepatic vein, none of the standard portal-systemic shunt can be utilized for satisfactory decompression of the liver. We have experienced two cases of BCS, 43 year-old male and 40 year-old male patients, caused by hepatic vein thrombosis associated thrombosis of the IVC. Cavoatrial shunt using Dacron graft and interposition graft between portal vein to cavoatrial graft were performed. Combined porto-cavo-atrial bypass that decompress both the portal system and IVC has been effective in relieving BCS caused by occlusion of hepatic vein with IVC.
Adult ; Budd-Chiari Syndrome* ; Decompression ; Hepatic Veins ; Humans ; Hypertension, Portal ; Liver ; Male ; Polyethylene Terephthalates ; Portal System ; Portal Vein ; Thrombosis ; Transplants ; Vena Cava, Inferior

According to the donor shortage, the marginal donor should be concerned as one of the potential kidney sources. The pediatric kidney could be transplanted to adult recipient, but it is well known that small functioning nephron mass could cause the late graft dysfunction according to the hyperfiltration syndrome. Here, we report a case of successful kidney transplantation in adult using en bloc kidneys from a child with good long term graft function.
Adult* ; Cadaver* ; Child ; Humans ; Kidney Transplantation ; Kidney* ; Nephrons ; Tissue Donors ; Transplants