This article describes Kimura’s disease as a rare case of lymphadenitis and reviews its epidemiology, clinical aspects, diagnosis and treatment methods. The role of surgical procedures was also underlined. Kimura disease is a rare and benign chronic inflammatory soft tissue disorder of unknown origin. The definitive histological description was published by Kimura et al. in 1948 and henceforth, the disease has born his name. Since that time, there has been a gradual increase in the number of reports. While most cases of Kimura disease have originated in China, Japan or Southeast Asia, there have been sporadic case reports from Europe and America. The data suggest that Kimura’s disease should be included in the list of differential diagnoses for all neck lymph node involvements. If a otolaryngologist maintains a high index of suspicion, an early diagnosis can be made to contribute to a more successful outcome of the disease.
PL
Artykuł opisuje chorobę Kimury – rzadką przyczynę limfadenopatii, jej epidemiologię, objawy kliniczne, diagnostykę i leczenie, w tym leczenie chirurgiczne. Choroba Kimury jest rzadkim, łagodnym, przewlekłym zapaleniem tkanki łącznej nieznanego pochodzenia. Cechy histologiczne tej choroby zostały po raz pierwszy opisane przez Kimurę i wsp. w 1948 r. i nazwane jego nazwiskiem. Większość przypadków choroby Kimury pochodzi z Chin, Japonii bądź południowo-wschodniej Azji, natomiast nieliczne z Europy i Ameryki. Obraz kliniczny choroby nakazuje uwzględnienie jej w diagnostyce różnicowej powiększenia węzłów chłonnych szyi. Daje to możliwość pomyślnego wyleczenia.
Liver transplantation is the only method of treatment of patients with end stage liver insufficiency. Inadequate number of transplantations in Poland in relation to demands causes a need of new liver transplantation centres formation.The aim of the study was to present process of introduction of liver transplantation programme and results of the first 12 transplantations.Material and methods. Preparations to transplantation were based on training of surgical, anaesthetics and nephrological teams in transplant centres in Paris, Birmingham and Warsaw. Own protocols of organ harvesting, recipients' qualification, transplantation and postoperative treatment were worked out; they were a result of experience acquired in teaching centres. From October 16, 2005 to October 2006, 12 liver transplantations were performed in patients with end stage liver insufficiency of different origin. Patients' age varied from 21 to 67 years. The stage of liver failure according to Child-Pough was 8.6±2.8, and MELD 18.6±7.2. All elective operations were performed using Piggyback technique. Immunosuppression regimen was uniform and consisted of tacrolimus and prednisolone.Results. One patient died due to post reperfusion syndrome with no respond to catecholamine treatment. In 1 patient developed primary lack of the liver graft function that required re-transplantation, which was successfully performed on 2nd postoperative day. Among 10 patients who were discharged from the hospital on mean 31 postoperative day all are alive, and 7 of them returned to full live activity.Conclusion. Training in famous liver transplant centres and own experience in kidney and pancreas transplantation allowed for successful introduction of liver transplantation programme.
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