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Seventy one surgical procedures on abdominal aorta in patients with horseshoe kidney have been reported in literature until 1980. Bergan reviewed 30 operations of abdominal aortic aneurysms (AAA) in these patients until 1974. Of them 3 AAA were ruptured. ⋯ In our patients, the transperitoneal approach was used, isthmectomy was not neccessary and graft was placed behind the isthmus. The operation of the abdominal aorta in patients with horseshoe kidney can be difficult due to anomalous renal arteries, anomalous excretory urinary system and is Ehmus. In these patients a more precise preoperative diagnosis is neccessary.
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Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disorder. Median survival from symptom onset is about 3.5 years, but some patients live for longer than 5 years. Because of fatal termination of ALS, searching for the prognostic factors related to the length of illness is very important. ⋯ Advanced age and bulbar signs at onset indicated poorer prognosis in our population. The patients under 49 years had significantly higher survival rates than the older patients. The more benign course of ALS in younger patients was also confirmed by the other authors. The bulbar form of ALS had a significantly lower survival rate in comparison to the spinal form. These findings are also consistent with findings in other populations. Some possible explanations for different survivals of ALS patients are also discussed, including the hypothesis that the apolipoprotein Eepsilon 4 allele may influence the pattern of motor neuron loss.
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Most of the patients with aortoiliac occlusive diseases have a multilevel localization of atherosclerotic diseases. In patients with aortoiliac occlusive diseases, the femoro-popliteal segment is involved in 28 to 66% of cases. These patients are usually old persons with many risk factors. Therefore, simultaneous proximal and distal reconstruction is often associated with a higher morbidity and mortality rates. In contrast, can proximal reconstruction help only patients with multilevel occlusive diseases? The aim of this paper is: definition of factors determining late patency rate of aortobifemoral bypass graft in patients with multilevel occlusive diseases; definition of factors determining clinical effects after aortobifemoral bypass procedures. ⋯ (1) Only location of distal anastomosis has a statistically significant influence on the patency of aorto-bifemoral bypass graft. (2) The location of distal anastomosis and type of occlusive disease have a statistically significant influence on the clinical effect of the operation. (3) The simultaneous distal bypass had no influence on the late patency of aortobifemoral bypass graft and on the number of asymptomatic patients. Also, it increased inhospital mortality rate.