A case report of transplanted pancreas survival longer than 18 years after simultaneous pancreas-kidney transplantation and literature review / 中华器官移植杂志

Objective To explore the influencing factors and treatment strategies of long-term survival after simultaneous pancreas and kidney transplantation (SPK ) .Methods One case of long-term post-SPK survival was reviewed and its influencing factors were analyzed along with the relevant literature .Results At 10 years post-SPK ,the patient lost transplanted kidney due to rejection and underwent secondary kidney transplantation . The transplanted pancreas functioned well and has survived for more than 18 years .Conclusions Strict preoperative screening ,adopting mature surgical approaches ,aggressive managements of various perioperative complications ,strengthening of health education of recipients ,improving of compliance and long-term regular follow-ups are conducive for enhancing long-term survival of recipients and grafts of SPK .

One case report on Kawasaki disease complicated with coronary aneurysm and secondary cardio-cerebrovascular disease and literature review / 中国中西医结合急救杂志

Kawasaki disease, also known as infantile skin mucous membrane lymph node syndrome, is an acute vasculitis syndrome in pediatricdepartment. The lesion mainly involves medium and small arteries, particularly the coronary artery, being a major cause of pediatric coronary lesion and also a potential risk factor of coronary heart disease during later adulthood. Here the clinical data and treatment of one case of Kawasaki disease complicated with coronary aneurysm and 4 years later the occurrence of cardiocerebrovascular lesion (CCVL) were retrospectively analyzed, and the related literatures were reviewed and analyzed to approach the clinical characteristics of this disease complications. It is suggested that at early stage regular treatment should be applied and afterwards periodical follow-up should be performed; long-term monitoring coronary changes ought to be carried out to decrease the occurrence of CCVL accident.

Analysis of the compliance and the influencing factors of the treatments of children with congenital hypothy-roidism / 中国基层医药

Objective To analyze the compliance and the influencing factors of the children with congenital hypothyroidism (CH).Methods 231 children with CH were collected for this study.The questionnaire survey and referring the case were used to collect relative factors.According to regular follow -up treatment,the children were divided into two groups,one group was good compliance and the other one was bad compliance.The results were ana-lyzed by two -independent sample t -test,2 -test and unconditioned logistic regression analysis.Results (1)Blood TSH(χ2 =59.870,P =0.00) and blood FT4 (χ2 =6.468,P =0.01) were normal,short distance from the hospital (χ2 =16.375,P =0.00),level of education of their mothers was high(χ2 =7.483,P =0.02),and regular compli-ance treatment of children with CH(χ2 =7.483,P =0.024) was good.(2) Logistic stepwise regression analysis showed that serum TSH value(OR =17.135),the short distance(OR =1.692) and diagnosis of CH(OR =4.028) were introduced into the logistic regression model (all P <0.05).Conclusion It is essential to take measures actively and reinforce the management of children with long distance,low -educated,and the diagnosis of TSH.More-over,enhancing the regular treatment compliance of children with CH is the key to improve the growth and develop-ment status of children with CH.

Endometrial carcinoma in an asymptomatic patient using the levonorgestrel-releasing intrauterine system / 동물의과학연구지

The levonorgestrel-releasing intrauterine system (LNG-IUS) is used for contraception and treatment of heavy menstrual bleeding as well as endometrial hyperplasia and early endometrial carcinoma. A 48-year-old woman visited an Internal Medicine outpatient clinic due to significantly elevated CA-125 and CA-19-9 levels in a routine health examination. She had been using LNG-IUS for 3 years. Before LNG-IUS insertion, she suffered from heavy menstrual bleeding and severe dysmenorrhea. Her endometrial sampling and ultrasonographic imaging showed no evidence of endometrial carcinoma at the time of LNS-IUS insertion. After insertion, she complained of neither abnormal uterine bleeding nor dysmenorrhea. She received a routine health checkup every year and showed results within normal range until last year. To rule out pancreatic cancer due to significantly elevated CA-19-9 levels, her physician performed positron emission tomography-computed tomography, which demonstrated increased FDG uptake in the endometrial cavity. We obtained endometrial biopsy and found endometrial carcinoma in her uterus and performed radical hysterectomy with bilteral pelvic lymphadectomy. Permanent pathology confirmed endometrial carcinoma with lymph node metastasis. She received concurrent chemoradiation therapy. We emphasize the necessity of regular follow-ups with ultrasonography and assessment of serum tumor markers for the early detection of endometrial carcinoma, although rare, in women using LNG-IUS, including those without abnormal uterine bleeding.

Clinical Analysis of Failed Back Surgery Syndrome

One hundred thirty-five patients undergone microdiscectomy of lumbar disc disease were analysed with soft-ware program which designed for effective analysis for spinal in-patients since February, 1990. Owing to that program, all the patients could be easily analyzed and get a regular follow-up. The surgical result was evaluated by our own score rating system which consists of 4 items:1) Frequency of medication, 2) Degree of social activity, 3) Post-operative symptom compared to pre-operative state and 4) Patient's satisfaction with the operation. According to that system, 21 patients(15.6%) were estimated with failure following microdiscectomy. Among them 6 patients of psychosocial problem, 4 patients of technical errors and 2 patients of recurrence were an important causes of failure. For the purpose of effective surgery for lumbar disc surgery, a careful analysis of the cases of surgical failure should be attempted and also a regular follow-up can be importment factor for more accurate estimation of surgical result.