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1.
Journal of the Korean Society for Vascular Surgery ; : 23-29, 2009.
Artículo en Coreano | WPRIM | ID: wpr-161866

RESUMEN

PURPOSE: Deep vein thrombosis is usually managed conservatively or with radiologic intervention. Yet deep vein reconstruction is of value as one of the treatments for a small group of patients who present with significant chronic venous insufficiency due to hypoplastic, absent or occluded deep venous outflow such as occurs because of chronic ilio-femoral vein thrombosis. Therefore, we evaluate the improvement of symptoms and graft patency after a Palma-Dale operation as a treatment modality for chronic ilio-femoral vein thrombosis. METHODS: From January 2001 to August 2008, a retrospective study was performed on 15 patients with chronic ilio-femoral vein thrombosis that was treated with a Palma-Dale operation. RESULTS: The mean age of the patients was 51.1+/-15.9 years. The ratio of males to females was 8 to 7. All the patients had lower limb swelling. A Palma-Dale operation was performed on all the patients. Simultaneous thrombectomy was done for 1 patient and arteriovenous fistulas were used to improve graft patency in four patients. The mean follow-up period was 36.3+/-24.0 months. Postoperatively, there was improvement of symptoms in all the patients. However, there was recurrence of symptoms in three patients after two or three months. The rate of graft patency was 84.1% at one year after surgery. CONCLUSION: The Palma-Dale operation has the possibility of recurrence of deep vein thrombosis and postoperative complications. Yet in patients with significant chronic venous insufficiency due to chronic ilio-femoral vein thrombosis, this type of surgery is obviously of value with respect to improvement of symptoms and an acceptable graft patency rate.


Asunto(s)
Femenino , Humanos , Masculino , Fístula Arteriovenosa , Estudios de Seguimiento , Extremidad Inferior , Complicaciones Posoperatorias , Recurrencia , Estudios Retrospectivos , Trombectomía , Trombosis , Trasplantes , Venas , Insuficiencia Venosa , Trombosis de la Vena
2.
The Journal of the Korean Society for Transplantation ; : 238-242, 2008.
Artículo en Coreano | WPRIM | ID: wpr-100341

RESUMEN

BACKGROUND: In the era of surgical advancement of transplantation, renal transplant patients with risks of atherosclerosis have improved its survival rate. And these renal transplant patients with aortic or peripheral arterial diseases required surgical treatment. Herein, we discussed the prevalence and treatment options for the atherosclerotic disease in renal transplant patients. METHODS: We retrospectively reviewed 1,163 patients who underwent renal transplant surgery from Jan. 1990 to May. 2007. Among them, we found 10 patients with atherosclerotic disease of aorta and peripheral arteries. Four patients had abdominal aortic aneurysm (AAA), five patients had atherosclerosis obliterans in the lower extremities, and one had renal artery stenosis in transplanted kidney. RESULTS: Four patients with AAA had aorto-biiliac bypass surgery with bifurcated grafts. Two of them had transplanted kidney protection during surgery, the others did not. Five patients with atherosclerosis obliterans in lower extremities had arterial bypass surgery. One patient with renal artery stenosis had patch angioplasty with great saphenous vein graft. CONCLUSIONS: Renal transplant patients also have possibilities to have severe atherosclerotic disease. Furthermore, transplanted kidney could be damaged during operation. Therefore, we have to do our best to prevent development and aggravation of atherosclerotic condition and try to minimize the ischemic injury of transplanted kidney during vascular operation in renal transplant patients.


Asunto(s)
Humanos , Angioplastia , Aorta , Aneurisma de la Aorta Abdominal , Enfermedades de la Aorta , Arterias , Aterosclerosis , Riñón , Trasplante de Riñón , Extremidad Inferior , Enfermedad Arterial Periférica , Prevalencia , Obstrucción de la Arteria Renal , Estudios Retrospectivos , Vena Safena , Tasa de Supervivencia , Trasplantes
3.
Journal of the Korean Society for Vascular Surgery ; : 106-112, 2008.
Artículo en Coreano | WPRIM | ID: wpr-77789

RESUMEN

PURPOSE: Takayasu's arteritis (TA) is a chronic inflammatory, stenotic or aneurysmal disease of an unknown etiology. TA occurs worldwide, but it disproportionately affects young females of Asian descent. TA is known to affect a variety of vessels, but the subclavian artery, axillary artery, carotid arteries and infraabdominal aorta are most frequently affected. In this article, we evaluated surgical treatment as a modality for the management for TA. METHOD: We retrospectively reviewed 20 patients with TA and who were operated on from January 1994 to December 2007. RESULT: The ages of patients were ranged from 12 to 56 years. The ratio of males to females was 1 to 19. The main affected vessels were the subclavian artery (n=10), the common carotid artery (n=10), the abdominal aorta (n=4) and the renal artery (n=4). 20 patients with TA were operated on. 17 of them underwent arterioarterial bypass, and 5 patients received angioplasty. There were 8 cases of reoperation due to the effect on other arteries, or due the stenosis or occlusion of the previous bypass graft. Angioplasty and stenting can be used in the treatment of shorter stenoses such as those encountered in the renal arteries. CONCLUSION: Symptomatic patients who have Takayasu's arteritis can be operated on. Our surgical experiences have showed low mortality and the surgical procedures relieved the symptoms. Surgical therapy for Takayasu's arteritis was safe and it showed good results.


Asunto(s)
Femenino , Humanos , Masculino , Aneurisma , Angioplastia , Aorta , Aorta Abdominal , Arterias , Pueblo Asiatico , Arteria Axilar , Arterias Carótidas , Arteria Carótida Común , Constricción Patológica , Arteria Renal , Reoperación , Estudios Retrospectivos , Stents , Arteria Subclavia , Arteritis de Takayasu , Trasplantes
4.
Korean Journal of Nephrology ; : 116-121, 2007.
Artículo en Coreano | WPRIM | ID: wpr-184510

RESUMEN

Combined liver-kidney transplantation (LKT) has been increasingly performed procedure for end-stage liver and kidney disease. We experienced four cases of LKT. All patients were affected by viral hepatopathy. There were three patients of hepatocellular carcinoma, treated with trans-arterial chemoembolization or chemotherapy and one cirrhotic patient. The causes of chronic renal failure were polycystic kidney disease in one patient, glomerulonephropathies in two, and diabetes mellitus in one. Three of them were on dialysis treatment. All patients were selected based on blood group identity and negative cross-match before LKT. There was no post-operative surgical complication or acute rejection. At the mean follow-up of 37 months after LKT, all patients showed normal hepatic and renal function except for one case of biopsy-proven tacrolimus nephrotoxicity. Seroconversions of HBsAg, HBeAg, and HBV-DNA were achieved in hepatitis B positive patients. However, HCV-RNA was sustained in hepatitis C positive patient after LKT. Alpha-fetoprotein was normalized in every HCC patient. Combined liver-kidney transplantation can be a proper therapeutic procedure for the patient with liver failure and irreversible renal disease, and it can be done safely and effectively.


Asunto(s)
Humanos , alfa-Fetoproteínas , Carcinoma Hepatocelular , Diabetes Mellitus , Diálisis , Quimioterapia , Estudios de Seguimiento , Hepatitis B , Antígenos e de la Hepatitis B , Antígenos de Superficie de la Hepatitis B , Hepatitis C , Riñón , Enfermedades Renales , Fallo Renal Crónico , Hígado , Fallo Hepático , Enfermedades Renales Poliquísticas , Tacrolimus , Trasplante
5.
Korean Journal of Medicine ; : 67-75, 2007.
Artículo en Coreano | WPRIM | ID: wpr-16968

RESUMEN

BACKGROUND: Strong immunosuppressive regimens have steadily improved both graft and patient survival, but posttransplant malignancy is still a clinical issue that needs to be resolved. METHODS: There were 1,500 transplant recipients between 1969 and 2005 at Kangnam St. Mary's hospital. The mean follow-up period was 108 77 months. We retrospectively analyzed the incidence, clinical course, treatment and prognosis of malignancy in the kidney transplant recipients. RESULTS: The incidence of malignancy after transplantation was 7.0% (10.5 cases out of 103 patients). The incidence of malignant lymphoma, thyroid cancer, renal cell carcinoma and Kaposi's sarcoma were higher in the renal transplanted patients than in the general population. The cancer incidence for women was higher than that for men, with stomach cancer being the most common in males and uterine cervix cancer the most common in females. The cumulative incidence of posttransplant malignancy at 1990, 1995, 2000 and 2005 were 0.72%, 2.91%, 4.62% and 7.0%, respectively. The cancer incidence with the use of initial immunosuppressive agents was 8.3% for azathioprine, 7.6% for cyclosporine, and 3.4% for tacrolimus. The mean times for making the diagnosis of malignancy after transplantation were 172+/-61 months for azathioprine, 91+/-49 months for cyclosporine, and 57+/-28 months for tacrolimus, respectively. During the observational period, 37 patients died (21 patients died of cancer) and 51 patients were still alive (7 grafts failed). CONCLUSIONS: The incidence of malignancy after renal transplantation increases according to the longer follow-up period. An active screening program is needed to lower the incidence of malignancy in renal transplant recipients.


Asunto(s)
Femenino , Humanos , Masculino , Azatioprina , Carcinoma de Células Renales , Cuello del Útero , Ciclosporina , Diagnóstico , Estudios de Seguimiento , Inmunosupresores , Incidencia , Riñón , Trasplante de Riñón , Linfoma , Tamizaje Masivo , Pronóstico , Estudios Retrospectivos , Sarcoma de Kaposi , Neoplasias Gástricas , Tacrolimus , Neoplasias de la Tiroides , Trasplante , Trasplantes
6.
Journal of the Korean Society for Vascular Surgery ; : 30-34, 2006.
Artículo en Coreano | WPRIM | ID: wpr-171387

RESUMEN

Marfan syndrome is an inherited autosomal dominant disorder of the connective tissues, and the afflicted patients present with abnormalities of the skeletal, ocular, and cardiovascular system. The progressive dilatation of the proximal aorta leading to dissection and rupture is the typical feature and this can be a lethal complication of this disease. The incidence of Marfan syndrome is estimated to be 1 in 10,000 in most racial and ethnic groups. We experienced two cases of aortic aneurysm in Marfan syndrome. The first case was 32-year-old woman. She was admitted because of sudden onset of a painful abdominal mass for 2 days. Aortic aneurysm was diagnosed by CT and an echocardiogram showed severe mitral regurgitation (area ratio: 13/15). She underwent successful abdominal aortic aneurysm (AAA) repair and was discharged on postoperative 14th day; she was then prepared for open cardiac surgery for mitral valve replacement. The second case was 19- year-old woman. She was admitted with a known abdominal aortic aneurysm that she'd had for 1.5 years. She also underwent abdominal aortic aneurysm (AAA) repair that was technically successful, but she died on postoperative 10th day due to sudden cardiac arrest.


Asunto(s)
Adulto , Femenino , Humanos , Aorta , Aneurisma de la Aorta , Aneurisma de la Aorta Abdominal , Sistema Cardiovascular , Tejido Conectivo , Muerte Súbita Cardíaca , Dilatación , Etnicidad , Incidencia , Síndrome de Marfan , Válvula Mitral , Insuficiencia de la Válvula Mitral , Rotura , Cirugía Torácica
7.
Journal of the Korean Society for Vascular Surgery ; : 35-39, 2006.
Artículo en Coreano | WPRIM | ID: wpr-171386

RESUMEN

An aberrant right subclavian artery is the most common arch anomaly, and it occurs in approximately 1.0% of the population. It is caused by obliteration of the right fourth aortic arch during the early embryologic development. Aberrant right subclavian artery originates from a diverticulum; this was originally described by Kommerell. Aneurysms arising in an aberrant subclavian artery are rare, but they constitute a potentially lethal condition that can be treated successfully when this is appropriately identified. The presence of an aneurysm of the artery or Kommerell's diverticulum at its aortic origin is more likely to produce symptoms from the esophageal compression. Virtually all these patients have a superior mediastinal mass that may be asymptomatic, but such patients usually have symptoms of dysphagia, chest pain, or shortness of breath. The presence of an aneurysm of an anomalous subclavian artery is an indication for surgical resection. Resection of the aneurysm may be approached through either a right or left thoracotomy. We present here a case of an aberrant origin of the right subclavian artery together with a review of the literature.


Asunto(s)
Humanos , Aneurisma , Aorta Torácica , Arterias , Dolor en el Pecho , Trastornos de Deglución , Divertículo , Disnea , Arteria Subclavia , Toracotomía
8.
The Journal of the Korean Society for Transplantation ; : 69-72, 2006.
Artículo en Coreano | WPRIM | ID: wpr-93710

RESUMEN

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.


Asunto(s)
Femenino , Humanos , Cadáver , Causas de Muerte , Ciclosporina , Supervivencia de Injerto , Terapia de Inmunosupresión , Trasplante de Riñón , Riñón , Donadores Vivos , Mortalidad , Trasplante de Órganos , Calidad de Vida , Insuficiencia Renal , Estudios Retrospectivos , Donantes de Tejidos , Trasplantes
9.
The Journal of the Korean Society for Transplantation ; : 107-109, 2006.
Artículo en Coreano | WPRIM | ID: wpr-93703

RESUMEN

Retroperitoneal cysts are rare, usually asymptomatic, lesions. Mullerian cyst of the retroperitoneum is one of extremely rare disease entities and is considered to be a subtype of urogenital cysts. We present the case of a 38-year-old woman with retroperitoneal Mullerian cyst which was found during her second cadaveric kidney transplantation operation. The two-fist sized cyst was found in left retroperitoneal pelvic space extended from left common iliac artery to pre-vesical region, which compromised iliac vessels for vascular anastomosis during kidney transplantation. After complete cyst excision, the kidney transplant operation could be performed. Histologically, the cyst was lined with benign Mullerian-type epithelium. We report the pathologic findings in a rare case of benign retroperitoneal cyst of Mullerian type which was incidentally found during kidney transplant surgery.


Asunto(s)
Adulto , Femenino , Humanos , Cadáver , Epitelio , Arteria Ilíaca , Trasplante de Riñón , Riñón , Enfermedades Raras
10.
The Journal of the Korean Society for Transplantation ; : 172-180, 2006.
Artículo en Coreano | WPRIM | ID: wpr-97786

RESUMEN

Purpose: The present study aims to determine the clinical outcome of kidney transplantation and to provide data of long-term graft and patient survival. Methods: Between 1969 and 2005, 1,500 kidney transplants were performed at the Kangnam st. Mary's hospital. We analyzed the clinical characteristics and outcomes of kidney transplant recipients retrospectively. Results: The mean follow-up period was 112 months. Chronic glomerulonephritis was the leading cause of primary renal diseases, but the proportion of has increased from 1 % before 1985 to 6% afterwards. First renal transplantation was 94.5% (n=1418), and retransplantation was 5.4% (n=82). Type of donor source was mostly living-related, with the recent decrease in the number of living- unrelated donors. Currently, 72l patients are alive with functioning grafts, 297 cases had graft failure, 277 cases died, 205 cases were transferred or lost during follow-up. Main cause of graft failure was chronic allograft nephropathy (n=316). Overall, 1-, 5-, 10-, and 20-year graft survival were 92%, 81%, 66%, and 29% respectively. 1-, 5-, 10-, and 20-year patient survival were 93%, 88%, 81%, and 69% respectively. Conclusion: This review of 36-years experience in a single center showed that the graft survival has improved compared to the initial transplantation era.


Asunto(s)
Humanos , Aloinjertos , Estudios de Seguimiento , Glomerulonefritis , Supervivencia de Injerto , Trasplante de Riñón , Riñón , Corea (Geográfico) , Estudios Retrospectivos , Factores de Riesgo , Donantes de Tejidos , Trasplante , Trasplantes , Donante no Emparentado
11.
Journal of the Korean Society for Vascular Surgery ; : 120-123, 2006.
Artículo en Coreano | WPRIM | ID: wpr-138651

RESUMEN

The overall life expectancy of the population is rising and more elderly patients with abdominal aortic aneurysm (AAA) have been reported. The management of AAA is open surgical or endovascular repair because neglected AAA usually yields an eventually fatal course. Older age is commonly considered as a risk factor for AAA repair due to the concomitant age-related diseases such as coronary artery disease. The chronological and physiological age are not always identical, and sometimes a patient's physiological age appears younger than the chronological age. We report here on successful open surgical repair of AAA in a 95 years old man (birth date: April 11, 1911) who looked younger and healthier than his chronological age. The preoperative CT angiography showed an infrarenal saccular AAA 4.2 cm in diameter with fingertip-sized outpouching of the aneurysmal wall, which suggested possible impending rupture. His preoperative work-up was within normal limits. This 95 years old gentleman well tolerated all the surgical procedures with a smooth postoperative course. We propose that the age limitation for AAA repair should be considered individually for each case.


Asunto(s)
Anciano , Humanos , Aneurisma , Angiografía , Aneurisma de la Aorta Abdominal , Enfermedad de la Arteria Coronaria , Esperanza de Vida , Factores de Riesgo , Rotura
12.
Journal of the Korean Society for Vascular Surgery ; : 120-123, 2006.
Artículo en Coreano | WPRIM | ID: wpr-138650

RESUMEN

The overall life expectancy of the population is rising and more elderly patients with abdominal aortic aneurysm (AAA) have been reported. The management of AAA is open surgical or endovascular repair because neglected AAA usually yields an eventually fatal course. Older age is commonly considered as a risk factor for AAA repair due to the concomitant age-related diseases such as coronary artery disease. The chronological and physiological age are not always identical, and sometimes a patient's physiological age appears younger than the chronological age. We report here on successful open surgical repair of AAA in a 95 years old man (birth date: April 11, 1911) who looked younger and healthier than his chronological age. The preoperative CT angiography showed an infrarenal saccular AAA 4.2 cm in diameter with fingertip-sized outpouching of the aneurysmal wall, which suggested possible impending rupture. His preoperative work-up was within normal limits. This 95 years old gentleman well tolerated all the surgical procedures with a smooth postoperative course. We propose that the age limitation for AAA repair should be considered individually for each case.


Asunto(s)
Anciano , Humanos , Aneurisma , Angiografía , Aneurisma de la Aorta Abdominal , Enfermedad de la Arteria Coronaria , Esperanza de Vida , Factores de Riesgo , Rotura
13.
Journal of the Korean Society for Vascular Surgery ; : 1-9, 2005.
Artículo en Coreano | WPRIM | ID: wpr-210830

RESUMEN

PURPOSE: Mechanical forces, including shear stress (SS), trigger signal transducing events and modulate gene expression in vascular endothelial cells (ECs). However, the primary steps of mechanoreception are still unknown. PECAM-1 (CD31), a member of the immunoglobulin (Ig) superfamily of cell adhesion molecules, is localized to the interendothelial cell adhesion site. PECAM-1 tyrosine phosphorylation has been observed following mechanical stimulation, but the role it plays in mechanosensing in ECs is controversial. The aim of this study was to confirm the involvement of PECAM-1 in ECs signaling cascades in response to SS. METHOD: In this study, PECAM-1 knock-out (KO) and wild-type (WT) rat microvascular ECs, and 50 and 100% confluent bovine aortic ECs (BAECs) were exposed to oscillatory SS (14 dyne/cm2) for 0, 5, 10, 30 or 60 minutes. Activation of the PECAM-1 and the mitogen activated protein (MAP) kinase were assessed by determining the phosphorylation of PECAM-1, extracellular signal-regulated kinase1/2 (ERK1/2) and p38 using immunoprecipitation and immunoblotting. RESULT: The tyrosine-phosphorylation level of PECAM-1 immunoprecipitated from SS-stimulated WT ECs increased. While PECAM-1 was phosphorylated in 100% confluent BAECs, its phosphorylation level in 50% confluent BAECs was not detected by SS. However, ERK1/2 and p38 were also activated by SS in both PECAM-1 KO ECs and 50% confluent BAECs. CONCLUSION: Our results indicate that ERK1/2 and p38 were activated by SS in PECAM-1 KO ECs and 50% confluent BAECs despite no PECAM-1 phosphorylation. This suggests that PECAM-1 can not be a major mechanoreceptor for the activation of MAP kinase in ECs; therefore, other more important mechanoreceptors maybe present in ECs to detect SS and trigger intercellular signal transduction.


Asunto(s)
Animales , Ratas , Molécula-1 de Adhesión Celular Endotelial de Plaqueta , Adhesión Celular , Moléculas de Adhesión Celular , Células Endoteliales , Expresión Génica , Immunoblotting , Inmunoglobulinas , Inmunoprecipitación , Mecanorreceptores , Fosforilación , Fosfotransferasas , Transducción de Señal , Tirosina
14.
Journal of the Korean Society for Vascular Surgery ; : 10-15, 2005.
Artículo en Coreano | WPRIM | ID: wpr-210829

RESUMEN

While endovascular aneurysm repair (EVAR) is prevailing for the treatment of abdominal aortic aneurysm (AAA) in modern vascular practice, PURPOSE: we conducted nationwide questionnaire survey to investigate the current status of AAA treatment and their results in Korea. METHOD: We reviewed the replies from 28 hospitals (33 departments) to the questionnaire inquiring annual number, clinical features, mode of treatment and results of AAA patients during the period from Jan. 2000 to Jul. 2004. Results: 980 AAA patients were reported including 292 ruptured AAA (29.8%) and 688 non-ruptured AAA (70.2%). For treatment of AAA, 834 (85.1%) surgical repairs (SRs) and 111 (11.3%) endovascualr aneurysm repairs (EVARs) were performed while 35 patients (3.6%) died of AAA rupture before operation. The locations of AAA were infrarenal in 889 (90.7%), juxtarenal in 62 (6.3%), and suprarenal in 29 patients (3.0%). Among 834 patients undergoing SR, 577 patients (69.2%) had non-ruptured AAAs and 257 patients (30.8%) had ruptured AAAs. Mean operative mortality rate was 4.1% after elective SRs, 30.7% after SR for ruptured AAAs, and 2.3% after EVARs. The reported brand name of stent graft devices were various including domestic custom-made in 56 (50.5%), imported brand in 18 (16.2%) while 37 (33.3%) stent grafts were not reported their brand name. The frequencies of type I and III endoleaks after EVAR were reported 5.8% and 5.8% respectively in 86 patients with an available data. CONCLUSION: SR has been used as a major treatment option in Korea for the treatment of AAA patients while EVAR is increasing. The mortality rate of SR of AAA was comparable to western multi-center trial reports but mortality or morbidity rates of EVAR were unable to know in this questionnaire survey.


Asunto(s)
Humanos , Aneurisma , Aneurisma de la Aorta , Aneurisma de la Aorta Abdominal , Prótesis Vascular , Endofuga , Corea (Geográfico) , Mortalidad , Encuestas y Cuestionarios , Rotura , Resultado del Tratamiento
15.
Journal of the Korean Society for Vascular Surgery ; : 237-241, 2004.
Artículo en Coreano | WPRIM | ID: wpr-199263

RESUMEN

PURPOSE: Deep vein thrombosis (DVT) is recognized as a common complication in surgical patients in western countries, and especially for high risk patients. However there is little informations on the incidence and risk factors of DVT after gastrointestinal cancer surgery in Korea. The aim of this study is to evaluate the incidence and risk factors of DVT after gastrointestinal cancer surgery that is performed without antithrombotic prophylaxis. METHOD: From August 2003 to February 2004, 107 patients who underwent gastrointestinal cancer surgery were evaluated prospectively. Hypercoagulability studies were done before the operation or before any blood transfusion, and the other clinical risk factors were also examined. All the patients were examined between the 5th and 10th postoperative day with duplex ultrasonographic assessment of both lower extremities. RESULT: DVT was found in 8 patients (7.5%) and two patients had symptomatic DVT. Five patients showed thrombi in there calf veins, two patients in the popliteal vein, and one patient in the iliac vein. The DVT group showed a significantly higher incidence of hyperhomocysteinemia than non-DVT group. There was no statistically significant difference between the DVT and non-DVT group according to other risk factors. CONCLUSION: The incidence of DVT after intra-abdominal cancer surgery in Koreans is significantly lower than for the patients in western countries. Considering the lower rate of proximal DVT, routine prophylaxis for DVT appears to be unwarranted in Koreans before and after intra-abdominal cancer surgery. Finally we did not identify a correlation between DVT and the so-call risk factors except for hyperhomocysteinemia. It would be interesting to perform further studies to clarify the association between hyperhomocysteinemia and DVT in cancer patients.


Asunto(s)
Humanos , Transfusión Sanguínea , Neoplasias Gastrointestinales , Hiperhomocisteinemia , Vena Ilíaca , Incidencia , Corea (Geográfico) , Extremidad Inferior , Vena Poplítea , Estudios Prospectivos , Factores de Riesgo , Trombofilia , Venas , Trombosis de la Vena
16.
Journal of the Korean Society for Vascular Surgery ; : 259-263, 2004.
Artículo en Coreano | WPRIM | ID: wpr-199259

RESUMEN

The tuberculous aortic aneurysm is exceedingly rare. Kamen L. first described tuberculous aortic aneurysm in 1899. Since then, only about 40 cases have been reported in the literature 1945 to 2001, and among them only 19 cases have affected the thoracic aorta. The incidence and prevalence of tuberculosis is still reported to be far too high, and the demographic and geographic disease distribution has changed rapidly because of immigration and traveling from endemic areas, and also this is due to the increasing use of immunosuppression or because of HIV cases. Multi-resistant strains and comorbidities impair the effects of medical therapy and so this might result in surgical complications. The tuberculous aortic aneurysm generally occurs in the setting of disseminated tuberculosis, and it has a high mortality rate. This report describes a 35-year-old woman who had miliary pulmonary tuberculosis, and she underwent a surgical operation for tuberculous pseudoaneurysm of the thoracic aorta. Early detection and the proper surgical and medical combination therapy are essential for the optimal treatment of thoracic aortic pseudoaneurysm, as was done in this successful case.


Asunto(s)
Adulto , Femenino , Humanos , Aneurisma , Aneurisma Falso , Aorta Torácica , Aneurisma de la Aorta , Comorbilidad , Emigración e Inmigración , VIH , Terapia de Inmunosupresión , Incidencia , Mortalidad , Prevalencia , Tuberculosis , Tuberculosis Pulmonar
17.
The Journal of the Korean Society for Transplantation ; : 134-139, 2004.
Artículo en Coreano | WPRIM | ID: wpr-199251

RESUMEN

BACKGROUND: HLA antibodies have been shown to be associated with graft loss of organ transplants in prior studies. This study was designed to analyze the results of ELISA- panel reactive antibody (ELISA-PRA) in kidney transplant patients and the impact of this test on the clinical outcome. METHODS: We have investigated ELISA-PRA results from 110 living donor renal transplant patients from Nov. 2001 to Apr. 2004. RESULTS: ELISA-PRA positivity was found in 22 (20%) patients and was higher in the female patients than male (P<0.05). Pretransplant transfusion, pregnancy or transplantation history was not significantly correlated with ELISA- PRA result. ELISA-PRA (+)patients had more rejection episodes of 41% (n=9) (P=0.0005) and graft failures of 18% (n=4) (P=0.028) than ELISA-PRA (-), which had 8% (n=7) and 3% (n=3), respectively. Patients group with a result of ELISA-PRA/flowcytometric crossmatch (FCXM) (+/ -) or (+ / +) had worse clinical outcome than ELISA- PRA/FCXM ( -/- ). ELISA-PRA/FCXM (+ /+ ) correlated with higher incidence of allograft rejection than ELIS- PRA/FCXM (+ /- ) or ( -/+ ). CONCLUSION: These results suggest that in conjunction with FCXM results, pretransplant ELISA-PRA test is useful predictor of clinical outcome in renal transplant recipients.


Asunto(s)
Femenino , Humanos , Masculino , Embarazo , Aloinjertos , Anticuerpos , Ensayo de Inmunoadsorción Enzimática , Incidencia , Riñón , Donadores Vivos , Trasplante , Trasplantes
18.
The Journal of the Korean Society for Transplantation ; : 88-92, 2003.
Artículo en Coreano | WPRIM | ID: wpr-183662

RESUMEN

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.


Asunto(s)
Humanos , Aneurisma , Aorta Abdominal , Aneurisma de la Aorta Abdominal , Autoinjertos , Constricción , Creatinina , Fallo Renal Crónico , Trasplante de Riñón , Riñón , Necrosis , Perfusión , Daño por Reperfusión , Trasplante , Trasplantes , Enfermedades Vasculares
19.
Journal of the Korean Society for Vascular Surgery ; : 79-82, 2003.
Artículo en Coreano | WPRIM | ID: wpr-53966

RESUMEN

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.


Asunto(s)
Humanos , Persona de Mediana Edad , Aneurisma , Aneurisma de la Aorta , Aneurisma de la Aorta Abdominal , Ciprofloxacina , Fístula , Mortalidad , Tereftalatos Polietilenos , Salmonella , Trasplantes , Enfermedades Vasculares
20.
Journal of the Korean Society for Vascular Surgery ; : 177-182, 2003.
Artículo en Coreano | WPRIM | ID: wpr-146569

RESUMEN

PURPOSE: Arterial bypass with common ostium distal arteriovenous fistulas (dAVFs) is one of the methods preserving the critical ischemic legs. We could successfully preserve legs with this procedures. METHOD: We reviewed nine cases that common ostium distal arteriovenous fistulas were constructed as adjuncts to distal tibial and peroneal artery bypasses in critically ischemic legs from Jan. 2000 to Dec. 2002. RESULT: In 9 case of this procedure, 6 grafts preserved and 7 legs could avoid amputation until our study termination. CONCLUSION: Although long term follow up results are needed to realize the final role of dAVF, we concluded that the dAVF seems to be an attractive option especially in these desperate patients by its excellent early patency rate. In this reports, recent 3 years' experience with a new use of an old modality for treating vascular ischemia is detailed.


Asunto(s)
Humanos , Amputación Quirúrgica , Arterias , Fístula Arteriovenosa , Estudios de Seguimiento , Isquemia , Pierna , Trasplantes
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