RESUMEN
A series of seven cases of hepatic artery aneurysms is reported. Guidelines for diagnosis and therapeutic approach to this rare disease are specified based on our own results and on the work of other authors. Because of high mortality, hepatic and biliary complications in cases of ruptured hepatic aneurysms elective vascular surgery is recommended in symptomatic and asymptomatic patients. In cases of intrahepatic localization percutaneous catheter embolization may be the method of choice except for some cases of false aneurysms in transplanted livers.
Asunto(s)
Aneurisma/cirugía , Arteria Hepática/cirugía , Anastomosis Quirúrgica , Aneurisma/diagnóstico , Aneurisma/mortalidad , Disección Aórtica/diagnóstico , Disección Aórtica/mortalidad , Disección Aórtica/cirugía , Aneurisma Falso/diagnóstico , Aneurisma Falso/mortalidad , Aneurisma Falso/cirugía , Aneurisma Roto/diagnóstico , Aneurisma Roto/mortalidad , Aneurisma Roto/cirugía , Prótesis Vascular , Embolización Terapéutica , Humanos , Masculino , Persona de Mediana Edad , Politetrafluoroetileno , Tasa de Supervivencia , TrombectomíaRESUMEN
BACKGROUND: The purpose of this study was to compare the genetic background of superficial (SVT) and deep vein thrombosis (DVT). METHODS: Factor V (FV)-Leiden (G16891A)-, factor II(G20210A)-mutations, protein C- and S, as well as methylenetetrahydrofolate reductase (MTHFR) polymorphisms at C677T and A1298C, and serum homocysteine levels (hcy) were determined in 29 patients with SVT and 26 with DVT. Findings FV- and -II-mutations were less frequent in patients with SVT (2/3) compared with DVT (9/5), respectively (P < 0.002 in case of FV). However, the frequency of the MTHFR C677T polymorphism was significantly higher in patients with SVT compared with DVT (CT 12 versus 10, and TT 7 versus 1, respectively, P << 0.001). The distribution of the MTHFR A1298C genotype and serum hcy levels was similar in both patient groups. Protein S-deficiency was recorded once (SVT). Interpretation These results suggest that the MTHFR C677T-mutant genetically predisposes its carriers to SVT which may contribute to hypercoagulation in pre-existing varicose vein disease.
Asunto(s)
Predisposición Genética a la Enfermedad/genética , Metilenotetrahidrofolato Deshidrogenasa (NADP)/genética , Mutación Missense , Tromboflebitis/genética , Várices/genética , Adulto , Anciano , Anciano de 80 o más Años , Sustitución de Aminoácidos , Factor V/genética , Factor V/metabolismo , Femenino , Homocisteína/sangre , Homocisteína/genética , Humanos , Masculino , Metilenotetrahidrofolato Deshidrogenasa (NADP)/sangre , Persona de Mediana Edad , Protrombina/genética , Protrombina/metabolismo , Tromboflebitis/sangre , Tromboflebitis/complicaciones , Várices/sangre , Várices/etiología , Trombosis de la Vena/sangre , Trombosis de la Vena/etiología , Trombosis de la Vena/genéticaRESUMEN
The effect of 15-Deoxyspergualin, a novel drug which has been described to have anti-tumour activity, on allogeneic graft survival (Dark Agouti----Lewis rats) after pancreatic islet transplantation was tested. A marked prolongation of graft survival could be shown using doses of 1.0, 2.5 and 5.0 mg Deoxyspergualin/kg on day 0 until day +9 post transplantation. A maximum of 55.6 days (average) survival time was observed using 2.5 mg/kg Deoxyspergualin compared to 5.2 +/- 0.6 days without immunosuppression. Using the chemiluminescence reaction of recipient monocytes after islet transplantation, a marked suppression of the monocyte system exceeding the treatment period could be observed. Since, in contrast to cyclosporin, B-cell toxicity could not be shown, the new drug seems to be a hopeful step towards successful allogeneic islet transplantation for treatment of diabetes.
Asunto(s)
Supervivencia de Injerto/efectos de los fármacos , Trasplante de Islotes Pancreáticos , Animales , Guanidinas/farmacología , Masculino , Ratas , Ratas Endogámicas LewRESUMEN
(-)15-Deoxyspergualin, originally discovered as an antitumoral drug, was shown to have different immunosuppressive effects, when pancreas and orthotopic allogeneic liver transplantations in rats were compared. In the strong rejection model dark agouti----Lewis (RT1a----RT1(1)) we could only show a minor immunosuppressive effect, as far as pancreaticoduodenal and pancreas segment transplantations are concerned: graft survival was prolonged by 9 days in pancreas segment allografts (p less than 0.01) and by 6 days in pancreaticoduodenal allografts (p less than 0.01), when recipients were treated by ten doses of 2.5 mg/kg deoxyspergualin. Pretreatment of recipients with 15-deoxyspergualin was not efficient. On the contrary, in orthotopic liver transplantation done by the cuff technique, a remarkable prolongation of allograft survival could be demonstrated: about half of the animals showed prolongation of allograft survival for more than 80 days, compared with about 11 days in the control group (p less than 0.01). The substance is considered to be valuable for clinical application.