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1.
Yeungnam University Journal of Medicine ; : 265-269, 2017.
Article in Korean | WPRIM | ID: wpr-174340

ABSTRACT

Chylothorax or chylous ascites are rare manifestations of liver cirrhosis. We report a rare case of simultaneous chylothorax and chylous ascites in a patient with hepatitis B virus-related liver cirrhosis. A 76-year-old woman was referred to our hospital with a pleural effusion on her right side. She had no history of recent medical procedures, trauma or tumor. There was no evidence of mass or thoracic duct obstruction in a computed tomography scan. Pleural fluid and ascites were confirmed as chylothorax and chylous ascites by chemistry analysis. Despite thorough conservative care, there was no improvement. Pleurodesis was planned, but hepatic encephalopathy developed suddenly and she did not recover.


Subject(s)
Aged , Female , Humans , Ascites , Chemistry , Chylothorax , Chylous Ascites , Hepatic Encephalopathy , Hepatitis B , Liver Cirrhosis , Pleural Effusion , Pleurodesis , Thoracic Duct
2.
Yeungnam University Journal of Medicine ; : 270-274, 2017.
Article in English | WPRIM | ID: wpr-174339

ABSTRACT

A nodular density was detected on a chest radiograph taken from a 57-year-old Korean woman who was visiting a hospital for a routine check. Chest computed tomography revealed a 4.8 cm lobulated mass in the right lung and another focal nodular lesion in the left lung; biopsies of both lungs revealed adenocarcinoma. We conducted DNA sequencing and peptide nucleic acid clamping to investigate the potential double primary lung cancer. The results verified that the mass in the right lung had a mutation in the epidermal growth factor receptor, whereas the nodule in the left lung had a wild-type sequence, showing that these two were genetically different cancers from one another. Thus, we demonstrate that genetic testing is useful in determining double primary lung cancer, and we herein report on this case.


Subject(s)
Female , Humans , Middle Aged , Adenocarcinoma , Biopsy , Constriction , Diagnosis, Differential , Epidermal Growth Factor , Genetic Testing , Lung Neoplasms , Lung , Radiography, Thoracic , ErbB Receptors , Sequence Analysis, DNA , Thorax
3.
Yeungnam University Journal of Medicine ; : 265-269, 2017.
Article in Korean | WPRIM | ID: wpr-787063

ABSTRACT

Chylothorax or chylous ascites are rare manifestations of liver cirrhosis. We report a rare case of simultaneous chylothorax and chylous ascites in a patient with hepatitis B virus-related liver cirrhosis. A 76-year-old woman was referred to our hospital with a pleural effusion on her right side. She had no history of recent medical procedures, trauma or tumor. There was no evidence of mass or thoracic duct obstruction in a computed tomography scan. Pleural fluid and ascites were confirmed as chylothorax and chylous ascites by chemistry analysis. Despite thorough conservative care, there was no improvement. Pleurodesis was planned, but hepatic encephalopathy developed suddenly and she did not recover.


Subject(s)
Aged , Female , Humans , Ascites , Chemistry , Chylothorax , Chylous Ascites , Hepatic Encephalopathy , Hepatitis B , Liver Cirrhosis , Pleural Effusion , Pleurodesis , Thoracic Duct
4.
Yeungnam University Journal of Medicine ; : 270-274, 2017.
Article in English | WPRIM | ID: wpr-787062

ABSTRACT

A nodular density was detected on a chest radiograph taken from a 57-year-old Korean woman who was visiting a hospital for a routine check. Chest computed tomography revealed a 4.8 cm lobulated mass in the right lung and another focal nodular lesion in the left lung; biopsies of both lungs revealed adenocarcinoma. We conducted DNA sequencing and peptide nucleic acid clamping to investigate the potential double primary lung cancer. The results verified that the mass in the right lung had a mutation in the epidermal growth factor receptor, whereas the nodule in the left lung had a wild-type sequence, showing that these two were genetically different cancers from one another. Thus, we demonstrate that genetic testing is useful in determining double primary lung cancer, and we herein report on this case.


Subject(s)
Female , Humans , Middle Aged , Adenocarcinoma , Biopsy , Constriction , Diagnosis, Differential , Epidermal Growth Factor , Genetic Testing , Lung Neoplasms , Lung , Radiography, Thoracic , ErbB Receptors , Sequence Analysis, DNA , Thorax
5.
The Journal of the Korean Society for Transplantation ; : 109-119, 2016.
Article in Korean | WPRIM | ID: wpr-207936

ABSTRACT

Transplant tourism (TT) has developed into a global concern for international organizations, transplant communities, researchers, and the press. Increasing the knowledge of organ trafficking and TT is essential to raise awareness and prepare responses that will prevent the occurrence of illicit organ transplantation through TT. This review article describes the current status and legal framework of international organ trafficking and TT. Collection and analysis of data concerning TT from national and international registries will provide the best estimates of global activities, which are necessary to develop an appropriate local and worldwide collaborative response to organ trafficking and TT. International collaboration and multifaceted strategies are needed to address the complex challenges of TT.


Subject(s)
Cooperative Behavior , Organ Trafficking , Organ Transplantation , Registries , Transplants
6.
The Journal of the Korean Society for Transplantation ; : 227-232, 2015.
Article in English | WPRIM | ID: wpr-114110

ABSTRACT

BACKGROUND: The number of pregnancies in renal transplant recipients has increased. Many studies have shown that pregnancy increases the risk of graft, fetal, and maternal complications but does not affect the long-term outcome of the graft. We assessed the incidence and effect of pregnancy after renal transplantation and examined graft, fetal, and maternal outcomes. METHODS: Our study included 145 female recipients of child-bearing age (15~45 years) in our center from January 1990 to December 2011. The subjects were divided into two groups: pregnancy (n=17) and control (n=128). The 26 pregnancies in the 17 recipients were categorized as live births (n=10) or no-live births (n=16). These were analyzed for evaluation of pregnancy outcomes, graft function, and long-term graft survival. RESULTS: The pregnancy and control group had similar graft function and graft survival rates 5- and 10-year after renal transplantation. Outcomes of pregnancy were 10 live births, 8 therapeutic abortions, 7 spontaneous abortions, and 1 stillbirth. The mean serum creatinine levels of the pregnant recipients diminished during the first trimester (1.14+/-0.37 mg/dL) and increased slightly during the third trimester (1.18+/-0.37 mg/dL) to levels nearer the baseline (1.23+/-0.37 mg/dL). These ranges were stable. The mean time from transplantation to pregnancy was 20.73+/-3.57 months. Live birth rates were associated with the time from transplantation to pregnancy (71.78+/-37.75 months for live births and 19.38+/-12.71 months for no-live births, P=0.000). There were no significant differences in graft function, graft failure rates, and survival. CONCLUSIONS: Pregnancy does not appear to have an adverse effect on graft function and the long-term outcomes of renal transplantation. Recipients with stable renal function who want to become pregnant can have successful pregnancies.


Subject(s)
Female , Humans , Pregnancy , Abortion, Spontaneous , Abortion, Therapeutic , Allografts , Creatinine , Graft Survival , Incidence , Kidney Transplantation , Live Birth , Parturition , Pregnancy Outcome , Pregnancy Trimester, First , Pregnancy Trimester, Third , Stillbirth , Transplantation , Transplants
7.
Tuberculosis and Respiratory Diseases ; : 375-379, 2015.
Article in English | WPRIM | ID: wpr-20104

ABSTRACT

A 45-year-old man presented with dyspnea and hemoptysis during exercise. A chest computed tomography (CT) revealed multifocal diffuse patchy ground glass opacity and interlobular septal thickening in both the lungs. Permeability pulmonary edema or pulmonary hemorrhage was suspected. Serologic studies for autoimmune disorders and vasculitis were negative. There was no laboratory evidence of coagulopathy, other hematopoietic disease or infectious disease. Considering correlation with exercise, we diagnosed exercise-induced pulmonary hemorrhage (EIPH) or exercise-induced pulmonary edema (EIPE). The patient was managed with antifibrinolytics, antibiotics, and antitussive agent. After a week, follow-up chest CT revealed completely resolved pulmonary hemorrhage. About 2 months after the first event, he visited again with dyspnea and hemoptysis during running. In the present study, we report a case of recurrent pulmonary hemorrhage after exercise.


Subject(s)
Humans , Middle Aged , Anti-Bacterial Agents , Antifibrinolytic Agents , Communicable Diseases , Dyspnea , Follow-Up Studies , Glass , Hemoptysis , Hemorrhage , Lung , Permeability , Pulmonary Edema , Running , Thorax , Tomography, X-Ray Computed , Vasculitis
8.
The Journal of the Korean Society for Transplantation ; : 144-153, 2014.
Article in Korean | WPRIM | ID: wpr-86707

ABSTRACT

BACKGROUND: Normal renal function and health have been recognized as important factors in living donors after kidney donation. The purpose of this study was to evaluate the health status and health-promoting lifestyle in living donors after kidney donation. METHODS: A total of 678 living-kidney donors were counted in our center from January 1990 to December 2011. Only 84 donors agreed to participate in the survey by telephone. We received consent for participation in our survey from 48 donors (57.1%). Data were collected from May to August 2013 using donor characteristics, health status, and Health Promoting Lifestyle Profile I (HPLP-I). RESULTS: The donors were predominantly female (62.5%) and the average age was 48.9+/-11.8 years, and the average period after nephrectomy was 9.7+/-5.7 years. The characteristics of donors included ideal body weight (37.5%), overweight (37.5%) in body mass index, and good health status (81.3%). Most donors underwent an annual medical check-up (56.2%), no health problem (81.3%), and no disease (64.6%). However, one patient was treated with dialysis for renal failure due to diabetes. The total average score for HPLP-I was 128.3+/-13.9. Higher than average scores (116.3+/-19.1) were observed for the general middle-aged woman. There were statistically significant differences in self-realization and nutrition in subsection of HPLP-I. Self-realization showed a higher score for Christian (F=2.743, P=0.041) and good health (F=3.389, P=0.017). Nutrition showed a higher score for overweight, obesity (F=6.783, P=0.000), and older than 60 (F=3.854, P=0.009). CONCLUSIONS: Most living kidney donors were healthy after their donation and had relatively high scores for health-promoting lifestyle. However, one patient had a serious health problem. In addition, younger, longer period after donation, and the rare health examination of donors showed a lower health-promoting lifestyle. Designed and continuous health-care management after transplantation is needed for kidney donors.


Subject(s)
Female , Humans , Body Mass Index , Dialysis , Ideal Body Weight , Kidney Transplantation , Kidney , Life Style , Living Donors , Nephrectomy , Obesity , Overweight , Renal Insufficiency , Telephone , Tissue Donors
9.
The Journal of the Korean Society for Transplantation ; : 204-210, 2014.
Article in English | WPRIM | ID: wpr-60452

ABSTRACT

BACKGROUND: Immunosuppression after kidney transplantation is associated with increased risk of malignancy, which has become the second most common cause of death among kidney transplant recipients. In this review, we report the incidence of malignancies after kidney transplantation in a single center and evaluate the incidence, characteristics, relationship to immunosuppressive drugs and discuss what clinicians must consider during a follow-up of patients after kidney transplantation. METHODS: Between May 1978 and September 2013, a total of 748 kidney transplant patients who were able to undergo a follow-up process through electronic medical records were enrolled in this retrospective cohort study to determine the potential incidence and types of malignancy that may occur after kidney transplantation and the associated impact on patients and graft survival. RESULTS: Among 748 patients, 63 cases of malignancy appeared in 54 patients (7.2%). Gastrointestinal cancer (12 cases, 19%) and post-transplant lymphoproliferative disorder (12 cases, 19%) were the two most common types of malignancy. The second most common type of malignancy was urinary tract malignancy in 10 patients. Two different types of malignancy were diagnosed in nine patients during our follow-up. The overall graft survival in malignancy patients was better, which may mean that malignancy did not affect the overall graft loss. CONCLUSIONS: Clinicians should be aware of the incidence of malignancy in transplant patients and perform routine examinations for early detection of malignancy.


Subject(s)
Humans , Cause of Death , Cohort Studies , Electronic Health Records , Follow-Up Studies , Gastrointestinal Neoplasms , Graft Survival , Immunosuppression Therapy , Incidence , Kidney , Kidney Transplantation , Lymphoproliferative Disorders , Retrospective Studies , Transplantation , Transplants , Urinary Tract
10.
Journal of the Korean Society for Vascular Surgery ; : 98-102, 2013.
Article in English | WPRIM | ID: wpr-726634

ABSTRACT

Spontaneous pseudoaneurysm of the superior mesenteric artery (SMA) is rare. However, it may have severe life-threatening complications such as ruptures or thrombosis. Our patient has developed a pseudoaneurysm, which was being misdiagnosed as superior mesenteric vein dissection by the computed tomography angiography. The pseudoaneurysm is revealed from branches of the SMA with no specific causes and is being treated by endovascular embolization after emergency exploratory laparotomy.


Subject(s)
Humans , Aneurysm, False , Angiography , Embolization, Therapeutic , Emergencies , Laparotomy , Mesenteric Artery, Superior , Mesenteric Veins , Rupture , Thrombosis
11.
The Journal of the Korean Society for Transplantation ; : 132-137, 2013.
Article in Korean | WPRIM | ID: wpr-29957

ABSTRACT

Cryptococcosis commonly affects patients with immune dysfunction, as in the case of immunosuppression in organ transplant patients or as acquired immunodeficiency syndrome in patients afflicted with human immunodeficiency virus. The varied appearance of cryptococcal skin lesion makes clinical diagnosis of cutaneous cryptococcosis difficult. Cryptococcosis proves to be a fatal fungal infection in the immunocompromised patient. Therefore, diagnosis and early treatment of cryptococcosis become vital. A 56-year-old renal transplant recipient, with an ongoing immunosuppression regimen of cyclosporine, prednisolone, and mycophenolate mofetil, was admitted with a 2-week history of pain and edema of right arm without respiratory symptoms. Despite empiric antibiotic therapy, the patient continued to complain of severe tenderness of the involved arm and fever persisted as well. On the third day of hospital stay, a biopsy of the erythematous skin lesion was acquired. On the eighth day of hospital stay, results of both skin biopsy and blood cultures showed the presence of Cryptococcus neoformans. The treatment was begun with intravenous fluconazole (400 mg/day). After 4 days of antifungal treatment, the patient developed fever along with cough with purulent sputum. As the new developing symptoms were suggestive of pneumonia, especially of pulmonary cryptococcosis, the antifungal agent was changed from fluconazole to amphotericin B treatment (0.8 mg/kg, 50 mg/day). Chest computer tomography showed improvement in the pneumonic infiltration and consolidation after 4 weeks of amphotericin B treatment. In conclusion, cellulitis in immunocompromised patients should be suspected in case of highly atypical infectious etiology, and skin biopsy should not be delayed if empiric antibiotic therapy does not control the inflammatory response. Additionally, the patient should be treated with intravenous amphotericin B treatment in case of severe cryptococcosis.


Subject(s)
Humans , Middle Aged , Acquired Immunodeficiency Syndrome , Amphotericin B , Arm , Biopsy , Cellulitis , Cough , Cryptococcosis , Cryptococcus neoformans , Cyclosporine , Edema , Fever , Fluconazole , HIV , Immunocompromised Host , Immunosuppression Therapy , Kidney Transplantation , Length of Stay , Mycophenolic Acid , Pneumonia , Prednisolone , Skin , Sputum , Thorax , Transplants
12.
The Journal of the Korean Society for Transplantation ; : 15-22, 2012.
Article in Korean | WPRIM | ID: wpr-209737

ABSTRACT

BACKGROUND: The impact on quality of life (QOL) and safety has increasingly been an important consideration for living donors after kidney transplantation. The purposes of this study were to evaluate the QOL of living kidney donors and to indentify factors for impediment of their QOL. METHODS: The subjects of this study were 69 living kidney donors with whom transplantations were performed in our center from 1990 to 2010. The data was collected from May to July 2010 using donor characteristics and SF-36. RESULTS: The donors were predominantly female (60.9%) and the average age was 45.4+/-12.0 years. The total numbers of donors, categorized by their relationship to the recipients, included 20 siblings (29.0%), 17 parents (24.6%) and 13 spouses (18.8%). The measured characteristics as related to donation included the full return to normal pre-donation activities (72.5%), no visit to a hospital or pharmacy after donation (69.6%) and donation decision as propria persona (97.1%). Most donors were satisfied with their donation (92.8%) and had no regrets for making the donation (87.0%). The average score for QOL of all subjects was 71.89. The overall QOL of living kidney donors revealed lower scores (48.56+/-5.45) as compared to average scores (50) of the healthy population in the USA. In particular, the scores for PCS (52.87) on the SF-36 were higher than the scores for MCS (44.25). CONCLUSIONS: Most living kidney donors were satisfied with their donation and showed good physical recoveries despite a lower QOL. Consequently, carefully pre-transplantation psychological assessment and programs are necessary to support donors. Systematic and continuous management after transplantation, as well as preoperatively appropriate information and counsel, is needed for kidney donors.


Subject(s)
Female , Humans , Kidney , Kidney Transplantation , Living Donors , Parents , Pharmacy , Quality of Life , Siblings , Spouses , Tissue Donors , Transplants
13.
Journal of the Korean Surgical Society ; : 69-74, 2012.
Article in English | WPRIM | ID: wpr-11330

ABSTRACT

PURPOSE: We wished to compare the clinical effectiveness of cystatin C (CyC) and serum creatinine (sCr) to assess renal function in renal transplantation patients. METHODS: We compared the clinical effectiveness of CyC with that of the sCr to estimate 24-hour urine creatinine clearance (CrCl) in 72 adult recipients who underwent renal transplantation from January 2001 to December 2008. We analyzed the data in terms of accuracy, bias, precision and sensitivity as a function of length of time posttransplantation and CrCl value. RESULTS: The patients were divided into four groups according to CrCl value or =90 mL/min/1.73 m2. The corresponding Cr-based glomerular filtration rate (GFR) estimates had accuracies of 0.71, 0.906, 0.963, and 1.00 within 50% of the reference, with biases (mean percentage errors) of 4.7, 5.32, -5.79, -31.33 mL/min/1.73 m2, and precisions (mean absolute percentage errors) of 7.57, 10.03, 14.52, and 31.33 mL/min/1.73 m2, respectively. The CyC-based GFR estimates had accuracies of 0.35, 0.79, 0.93, and 0.67 within 50% of the reference, respectively, with biases of 15.03, 13.37, -5.58, and -34.79 mL/min/1.73 m2 and precisions of 15.03, 14.80, 17.91, and 34.79 mL/min/1.73 m2. The sensitivity for detecting GFR below 60 mL/min/1.73 m2 was higher for CyC (0.96, 1, and 0.95) than for Cr (0.77, 0.75, and 0.82). CONCLUSION: CyC is a more sensitive indicator of low GFR (CrCl <60 mL/min/1.73 m2) than sCr. However, CyC-based GFR estimates are restrictive data, and are neither accurate nor specific. Therefore, to evaluate renal function, we may need a revised CyC-based GFR formula and close monitoring of sCr.


Subject(s)
Adult , Humans , Bias , Creatinine , Cystatin C , Glomerular Filtration Rate , Kidney Transplantation , Transplants
14.
Journal of the Korean Society for Vascular Surgery ; : 14-18, 2011.
Article in Korean | WPRIM | ID: wpr-165164

ABSTRACT

PURPOSE: Hyperhomocysteinemia is accepted as an independent risk factor for peripheral arterial disease (PAD). The purpose of this study is to evaluate the correlation between the preoperative plasma homocysteine concentration and restenosis after therapeutic revascularization. METHODS: We retrospectively analyzed the clinical records of 58 consecutive patients (they were confined to Trans Atlantic Inter-Society Consensus [TASC] type C & D) among 103 patients who were diagnosed as having infrainguinal PAD and who were treated with bypass surgery or endovascular surgery from July 2003 to July 2009. We analyzed the effect of several factors such as gender, age, the plasma lipid profile and the protein C, protein S, fibrinogen, C-reactive protein, diabetes mellitus, hypertension, ankle-brachial index (ABI), and homocysteine levels, which are all considered to be risk factors for restenosis. Multivariate and univariate analyses were performed to assess the effect of possible confounders. RESULTS: The subjects were 50 men and 8 women (mean age: 63.8+/-10.9). There were 33 (56.9%) cases of bypass surgery and 25 (43.1%) cases of endovascular surgery. Of them, 19 cases (32.8%) showed restenosis after revascularization. In the patients with restenosis, 18 cases (94.7%) showed a preoperative high plasma homocysteine level and 1 case (5.2%) showed a normal level. A lower ABI and hyperhomocysteinemia were significantly more common in the patients with restenosis (P=0.025, P<0.001). There were no significant differences of the other factors, except for the plasma homocysteine level on multivariate analysis (P=0.001). CONCLUSION: We can regard the preoperative hyperhomocysteinemia level as a predictive marker of restenosis after revascularization. Special attention may need to be given to the patients who have a lower preoperative ABI and hyperhomocysteinemia after revascularization.


Subject(s)
Female , Humans , Male , Ankle Brachial Index , C-Reactive Protein , Consensus , Diabetes Mellitus , Fibrinogen , Homocysteine , Hyperhomocysteinemia , Hypertension , Multivariate Analysis , Peripheral Arterial Disease , Plasma , Protein C , Protein S , Retrospective Studies , Risk Factors
15.
The Journal of the Korean Society for Transplantation ; : 204-209, 2010.
Article in Korean | WPRIM | ID: wpr-180484

ABSTRACT

BACKGROUND: Despite significant advances in immunosuppression, supportive therapies, and operative skills, several factors still compromise long-term graft survival of patients who undergo renal transplantation. This study was designed to evaluate the risk factors influencing graft outcomes of living donor renal transplantation. We matched the recipient and donor age, gender, and body mass index (BMI). METHODS: A total of 527 living renal transplantations were evaluated. The patients were divided into matching groups by donor and recipient age; group 1 (50< or =/; 2, 50< or =/<50; 3, <50/50< or =; 4, <50/<50), gender (A, female/female; B, female/male; C, male/female; D, male/male), and BMI ratio (recipient/donor) (I, <0.8; II, 0.8< or =/<1.3; III, 1.3< or =). We compared 1, 3, 5, and 10 year graft survival and analyzed the donor and recipient variables of age, HLA matching, and acute rejection. RESULTS: The risk factors affecting long-term graft survival were recipient gender, acute rejection rate, and HLA-AB matching. In the groups divided according to donor and recipient age, no statistical difference was observed among the groups, but the 3-5 yr graft survival of group 1 (94.1/86.9%) was much higher than group 2 (86.5/75.6%). In the groups divided according to donor and recipient gender, graft survival in group C was higher than that in the other groups. No statistical difference in acute rejection or graft survival were observed in the groups with different BMI ratios. CONCLUSIONS: Meticulous preoperative donor and recipient matching for living renal transplantation may improve graft survival and expand the donor and recipient pool.


Subject(s)
Humans , Body Mass Index , Graft Survival , Immunosuppression Therapy , Kidney Transplantation , Living Donors , Rejection, Psychology , Risk Factors , Tissue Donors , Transplants
16.
The Journal of the Korean Society for Transplantation ; : 264-271, 2010.
Article in Korean | WPRIM | ID: wpr-86051

ABSTRACT

BACKGROUND: Immunosuppressive regimens with the fewest possible toxic effects are desirable for transplant recipients. This study evaluated the efficacy and relative toxic effects of four immunosuppressive regimens. METHODS: We assigned 299 renal-transplant recipients to receive group A (standard-dose cyclosporine, mycophenolate mofetil, and corticosteroids), group B (low-dose cyclosporine, basiliximab induction, mycophenolate mofetil, and corticosteroids), group C (standard-dose tacrolimus, mycophenolate mofetil, and corticosteroids), or group D (low-dose tacrolimus, basiliximab induction, mycophenolate mofetil, and corticosteroids) regimens. We compared the groups according to graft function through estimated glomerular filtration rate (GFR), acute rejection, and allograft survival. RESULTS: The mean calculated GFR in patients receiving low-dose tacrolimus (76.4 mL per minute) was higher than in the other three groups (range, 66.3 to 73.8 mL per minute). The rate of biopsy-proven acute rejection was lower in patients receiving low-dose tacrolimus (14.3%) than in those receiving standard-dose cyclosporine (29.6%), low-dose cyclosporine (19.8%), or standard-dose tacrolimus (23.8%). Allograft survival rates differed significantly among the four groups (P=0.006) and were highest in the low-dose tacrolimus group (99.9%). Serious adverse events were more common in the standard-dose tacrolimus group than in the other groups (51.2% vs a range of 41.4 to 42.3%), although a similar proportion of patients in each group had at least one adverse event during treatment (81.1 to 90.5%). CONCLUSIONS: A regimen of basiliximab, mycophenolate mofetil, and corticosteroids in combination with low-dose tacrolimus may be advantageous for renal function, allograft survival, and acute rejection rates, compared with regimens containing basiliximab induction plus either low-dose cyclosporine or standard-dose tacrolimus or with standard-dose cyclosporine without induction.


Subject(s)
Humans , Adrenal Cortex Hormones , Antibodies, Monoclonal , Cyclosporine , Glomerular Filtration Rate , Graft Survival , Kidney Transplantation , Mycophenolic Acid , Recombinant Fusion Proteins , Rejection, Psychology , Survival Rate , Tacrolimus , Transplantation, Homologous , Transplants
17.
Journal of the Korean Society for Vascular Surgery ; : 141-146, 2010.
Article in Korean | WPRIM | ID: wpr-30239

ABSTRACT

The management of abdominal aortic aneurysms has dramatically changed since the endovascular aneurysm repair (EVAR) procedure was introduced in 1991 for the treatment of abdominal aortic aneurysm (AAA). EVAR is a less invasive alternative as compared to conventional open repair for abdominal aortic aneurysms. The use of EVAR has increased and is used in fit patients provided that they are regarded as anatomically suitable for a device. Endovascular repair has been shown to decrease the early mortality rate, shorten the hospital stay and decrease blood loss. However, EVAR has a higher rate of graft-related complications and fewer systemic complications. So, the patients who are treated by EVAR need close follow up and diligent graft surveillance. This review of endovascular complications will help physicians gain a thorough understanding of the complications and appropriate managements strategies of AAA.


Subject(s)
Humans , Aneurysm , Aortic Aneurysm, Abdominal , Follow-Up Studies , Length of Stay , Transplants
18.
Journal of the Korean Society for Vascular Surgery ; : 176-182, 2010.
Article in Korean | WPRIM | ID: wpr-30234

ABSTRACT

PURPOSE: Untreated deep vein thrombosis (DVT) is associated with morbidity and mortality, such as pulmonary embolism and post-thrombotic syndrome. Anticoagulation therapy is efficient for reducing thrombus propagation but is insufficient for clot lysis or preventing post thrombotic syndrome. Current catheter-directed thrombolysis is an important DVT treatment. We compared the outcomes between anticoagulation therapy and DVT catheter-directed thrombolysis. The purpose of this study was to evaluate treatment outcomes in patients with symptomatic DVT who had undergone catheter-directed thrombolysis. METHODS: From January 2003 to January 2009, we retrospectively reviewed 91 patients who had been admitted and treated for DVT in our hospital. We divided 91 patients into two groups according to treatment method; 42 patients (46.2%) were treated with only anticoagulation, and 49 patients (53.8%) were treated with catheter-directed thrombolysis. We compared the results of the two treatments groups. The results included gender, symptom onset, age, location, complications, risk factors, days to improved patient symptoms and patency. All patients underwent Doppler sonography or CT-venography at 3 and 6 months to evaluate venous patency after treatment. RESULTS: 49 patients who underwent catheter-directed thrombolysis for DVT had more symptom-relief days (25.00 days, P<0.001). The 43 patients (88%) of the catheter-directed thrombolysis group showed more complete resolution on Doppler sonography or CT-venography after 6 months (P=0.001). We obtained better clinical outcomes in the catheter-directed thrombolysis group than in the anticoagulation only group. CONCLUSION: Catheter-directed thrombolysis is an effective treatment for acute DVT.


Subject(s)
Humans , Pulmonary Embolism , Retrospective Studies , Risk Factors , Thrombosis , Venous Thrombosis
19.
The Journal of the Korean Society for Transplantation ; : 154-160, 2009.
Article in Korean | WPRIM | ID: wpr-35659

ABSTRACT

BACKGROUND: The shortage of living related and deceased donor groups is one of the major problems of kidney transplantation. We examined the results of spouse and spousal exchange among living kidney transplantation. METHODS: Living donor kidney transplants at a single center between 1991 and 2005 were studied, retrospectively (n=593). We compared the graft survival rates of 24 spousal, 53 spousal exchange transplantations with those of 125 sibling, 142 other living related donor (LRD) or 249 other living unrelated donor (LURD) procedures. We analyzed graft survival rate, acute rejection rate among each groups. RESULTS: The 5, 10 year graft survival rates of spousal donor were 75.0%, 69.2%, those of other LURD and spousal exchange were 74.6%, 64.5% (P=0.80) and 86.6%, 84.8% (P=0.11), those of sibling and other LRD were 82.3%, 75.9% (P=0.37) and 75.7%, 65.4% (P=0.84). Spousal exchange donor were more good graft survival rates rather than other LRD and LURD (P=0.01, 0.01). Acute rejection rates of spousal donor were not significant difference among sibling, other LRD and LURD groups. But acute rejection rates of spousal exchange donor (22.6%) were lower than spousal (45.8%) and other LURD (38.7%) (P=0.04, 0.04). In the multivariate analysis of donor groups, other LRD and LURD groups were associated with a high relative odds of graft survival (odds ratio 2.88+/-0.38 (P=0.02), 2.35+/-0.37 (P=0.01)) compared to spousal exchange donor groups. CONCLUSIONS: The spousal exchange donors had more good graft survival rates than other LRD and LURD groups and spousal donors were as good as other living donors. We expect that the spousal and spousal exchange transplantations are one of the good programs for donor pool expansion.


Subject(s)
Humans , Graft Survival , Kidney , Kidney Transplantation , Living Donors , Multivariate Analysis , Odds Ratio , Rejection, Psychology , Retrospective Studies , Siblings , Spouses , Tissue Donors , Transplants , Unrelated Donors
20.
Journal of the Korean Society for Vascular Surgery ; : 7-11, 2009.
Article in Korean | WPRIM | ID: wpr-161869

ABSTRACT

PURPOSE: The diameter of the abdominal aorta is an important criterion for making the diagnosis of abdominal aortic aneurysm. But the diagnostic criteria for the aortic diameters and the aneurysms are based on western people' s data, and there is scant data on this for Koreans. In this study, we measured a normal range of the abdominal aortic diameter of Korean adults and we classified the diameters according to age, gender and the body mass index (BMI). METHODS: The data is based on 496 patients (male: 281, female: 215) who had no evidence of vascular disease on abdominal multi detector computed tomography exams that were been done between October through December of year 2007 at our hospital. The abdominal aorta was measured at the smallest outer diameter of the infrarenal aorta and the upper bifurcation level. The age of the patients was from 20 to 70 years-old and the patients were divided into 6 groups by age. The patients were also divided into three groups according to their BMI (the low weight, normal weight and over weight groups). We computed the average and standard deviation of the aortic dimensions from each group. RESULTS: The average diameter at the infrarenal aorta was 18.32 mm and that at the upper bifurcation level was 17.25 mm. The males' average aortic diameter at the infrarenal aorta and at the upper bifurcation level was 19.23 mm and 18.10 mm, respectively, and those values for the females were 17.09 mm and 16.20 mm, respectively. In both the males and females, the diameter increased with increasing patient age (P<01). For the BMI, the diameter was larger for the higher BMI group. CONCLUSION: For the normal Korean population, the diameter of the abdominal aorta increases with aging and with an increased BMI, but the changes were relatively smaller as compared with the western normal range. More studies are needed to determine Koreans' normal range of the diameter of the abdominal aorta and this data can be applied to the diagnosis and treatment of abdominal aortic aneurysm.


Subject(s)
Adult , Female , Humans , Male , Aging , Aneurysm , Aorta , Aorta, Abdominal , Aortic Aneurysm, Abdominal , Body Mass Index , Reference Values , Vascular Diseases
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