Lung transplantation has been successfully employed for variety of obstructive lung disease. Single lung transplantation has become a therapeutic option for end-stage obstructive lung disease. The patient, a 57 year old man with emphysema, suffered from severe dyspnea, which progressively aggravated him for the last three years. A single lung transplantation was performed from a young brain-dead donor on April 7th, 1999 in the department of thoracic surgery, Respiratory Center, Yongdong Severance hospital, yonsei University. The immunosuppressive regimen was based on cyclosporine A and azathioprine from beginning, adding steroid. Single lung transplantation was feasible and beneficial in patients with end-stage emphysema.
Azathioprine ; Cyclosporine ; Dyspnea ; Emphysema ; Humans ; Lung Diseases, Obstructive ; Lung Transplantation* ; Lung* ; Middle Aged ; Pulmonary Emphysema* ; Respiratory Center ; Thoracic Surgery ; Tissue Donors

BACKGROUND: High blood pressure is prevalent in obesity and diabetes, especially noninsulin dependent diabetes mellitus, and both conditions are insulin resistant state. METHOD: To test whether resistance to insulin-stimulated glucose uptake and hyperinsulinemia are involved in the pochogenesis of hypertension, author measured glucose, insulin and C-Peptide reponse after oral glucose loading in 52 cases of essential hypertension and 62 cases of normal controls who had been admitted to the ward of internal medicine, Pusan National University Hospita. RESULTS: Basal plasma glucose, insulin and C-Peptide levels in control subjects were 92.1+/-36.8mg/dl, 8.7+/-5.5microu/ml and 2.2+/-1.8ng/ml and in hypertensive subjects were 95.7+/-32.6mg/dl, 12.2+/-5.3microu/ml and 2.9+/-1.6ng/ml. The basal insulin level was markedly higher than tat of control subjets (p<0.05). The basal glucose and C-Peptide levels in hypertensive patioents were higher than controls but statistically not significant. Plasma glucose levels in time course after glucose load in hypertensive patients showed significantly higher levels in 60,90minutes than controls. Plasma insulin levels in hypertensives in 90 minutes were significantly higher. The C-Peptide levels in hypertensives showed significantly higher in each times 30,60,90,120 minutes than controls. In hypertensive patients, body weight, blood pressure levels and duration of hypertension were not significantly correlated with responses of glucose, insalin and c-peptioce. Hypertensive patients aboce the age of 50 showed significantly higher glucose levels in 60,90,120 minutes than under age of 50. CONCLUSION: These results indicate some tendency of disturbed glucose turnover or insulin-resistant state in essential hypertension. This metabolic disturbance in essential hypertension should be considered in the management of hypertensive patients.
Blood Glucose* ; Blood Pressure ; Body Weight ; Busan ; C-Peptide* ; Diabetes Mellitus ; Glucose ; Humans ; Hyperinsulinism ; Hypertension* ; Insulin Resistance ; Insulin* ; Internal Medicine ; Obesity ; Plasma*

BACKGROUND AND OBJECTIVES: Though patients who have undergone surgery due to pathologic voice with benign laryngeal diseases are concerned about postoperative voice quality, there was no way to propose postoperative voice objectively. For this reason, the authors studied to synthesize predictive postoperative voice based on preoperative voice. MATERIALS AND METHOD: The authors evaluated 47 patients who experienced laryngeal microsurgery due to pathologic voice with benign laryngeal diseases. The voice was analysed by Computerized Speech Lab 4300B. Linear Prediction and Pitch Synchronous Overlap and Add methods were used to synthesize the predictive voice. Assessments for the synthetic voice were sound waves, spectrographic patterns with preoperative voice, and an acoustic evaluation of the postoperative voice. RESULTS: Synthetic voice showed improvement of noise component in a high frequency range that was seen in preoperative voice on spectrographic analysis. In the perceptual test, the degree of similarity in both postoperative and synthetic voice was similar and almost the same in 75% of test voice. CONCLUSION: The synthesized voice from this program was not completely identical to the real postoperative voice, but most of the tested synthetic voice was satisfactory in the perceptual test. So we conclude that this study is meaningful as a first trial that showed the possibility of synthesizing a postoperative voices by using its preoperative voice.
Acoustics ; Humans ; Laryngeal Diseases* ; Microsurgery ; Noise ; Sound ; Voice Quality ; Voice*

OBJECTIVES: Fluorescein angiography (FAG) is currently the most useful diagnostic modality for examining retinal circulation, and it is frequently used for the evaluation of patients with diabetic retinopathy, occlusive diseases, such as retinal venous and arterial occlusions, and wet macular degeneration. This paper presents a method for objectively evaluating retinal circulation by quantifying circulation-related parameters. METHODS: This method allows the semiautomatic preprocessing and registering of FAG images. The arterial input function is estimated from the registered set of FAG images using gamma-variate fitting. Then, the parameters can be computed by deconvolution on the basis of truncated singular value decomposition, and they can finally be presented as parametric color images in a combination of three colors, red, green, and blue. RESULTS: After the estimation of arterial input function, the parameters of relative blood flow and mean transit time were computed using deconvolution analysis based on truncated singular value decomposition. CONCLUSIONS: The parametric color image is helpful to interpret the status of retinal blood circulation and provides quantitative data on retina ischemia without interobserver variability. This system easily provides the status of retinal blood circulation both qualitatively and quantitatively. It also helps to standardize FAG interpretation and may contribute to network-based telemedicine systems in the future.
Biomedical Engineering ; Blood Circulation ; Capillaries* ; Diabetic Retinopathy ; Diagnosis, Computer-Assisted ; Eye Diseases ; Fluorescein Angiography ; Fluorescein* ; Humans ; Ischemia ; Observer Variation ; Ophthalmology ; Retina ; Retinaldehyde ; Telemedicine ; Wet Macular Degeneration

Infiltrative hepatocellular carcinoma (HCC) patients have a poor prognosis because most patients present with advanced disease. Although tumor size is small, ablation therapy is difficult because it is difficult to delineate tumor boundary and tumor often combined vascular invasion. Therefore many clinicians still try locoregional therapy (LRT) such as transarterial chemoembolization (TACE), radiation therapy (RT), or combination with LRT and sorafenib in this situation. Stereotactic body radiation therapy (SBRT) is new technology providing very highly conformal ablative radiation dose and is expected to salvage modality for HCC showed incomplete response of TACE due to combined arteriovenous (AV) shunts. Based on above suggestions, we herein offer our experience of a complete remission of tumor by combination of SBRT and TACE in a patient with infiltrative HCC. Further study, maybe regarding a combination of locoregional and systemic therapy is necessary on how to manage infiltrative HCC with AV shunts.
Carcinoma, Hepatocellular* ; Humans ; Prognosis

OBJECTIVETo obtain fundamental information for the standardization of herbal medicine in Korea.

METHODSWe analyzed the herbal medicine prescription data of patients at the Pusan National University Korean Medicine Hospital from March 2010 to February 2013. We used the Dongui-Bogam (Dong Yi Bao Jian) to classify prescribed herbal medicines.

RESULTSThe study revealed that the most frequently prescribed herbal medicine was 'Liuwei Dihuang Pill (LWDHP, )' which was used for invigorating 'Shen (Kidndy)-yin'. 'LWDHP' was most frequently prescribed to male patients aged 50-59, 60-69, 70-79 and 80-89 years, and 'Xionggui Tiaoxue Decoction (XGTXD, )' was most frequently prescribed to female patients aged 30-39 and 40-49 years. According to the International Classification of Diseases (ICD) codes, 'Diseases of the musculoskeletal system and connective tissue' showed the highest prevalence. 'LWDHP' and 'XGTXD' was the most frequently prescribed in categories 5 and 3, respectively. Based on the percentage of prescriptions for each sex, 'Ziyin Jianghuo Decoction ()' was prescribed to mainly male patients, and 'XGTXD' with 'Guima Geban Decoction ()' were prescribed to mainly female patients.

CONCLUSIONThis study analysis successfully determined the frequency of a variety of herbal medicines, and many restorative herbal medicines were identified and frequently administered.

Adult ; Aged ; Cross-Sectional Studies ; Drug Prescriptions ; Electronic Health Records ; Female ; Herbal Medicine ; Hospitals ; Humans ; Male ; Medicine, Korean Traditional ; Middle Aged ; Phytotherapy ; Republic of Korea