BACKGROUND: Thoracoscopic sympathicotomy was, at first, thought to be a simple and safe method for treatment of hyperhydrosis. However, the main disadvantage of this procedure is irreversibility in additions so-called rebound sweating occurred in 30 40% of patients during the first 1 2 weeks after operation. Some patients regret the surgery, even to the extend of preferring the original sweaty hands. Recently clipping has been suggested one of the way to minimize such problem. Hypothesis of this study was that sympathetic nerve block effect by clipping may be weak compared to sympathicotomy. The aim of this study was to evaluate and compare the sympathicotomy by clipping effect on cardiovascular system. METHODS: Sixty-five patients with essential hyperhydrosis in ASA physical status class 1 undergoing thoracoscopic sympathetic block were randomly divided into two groups: The Clipping group (N = 21) and the sympathicotomy (N = 44) group. Anesthesia was induced with thiopental sodium (5 mg/kg) and pancuronium (0.05 mg/kg) and maintained with enflurane. The operation was done to the left side first and the to the right by an experienced surgeon. During the procedure, we measured blood pressure using a non invasive technique at the right forearm, heart rate and temperature after anesthetic induction as baseline values, immediately after the left side resection of the T2 sympathetic trunk or clipping, and after completely both sides resection. All the records were coded and analysed single blind by one author. RESULTS: After the T2 sympathicotomy, heart rate decreased from 87 +/- 14 to 76 +/- 17 (P < 0.05) and the mean blood pressure was reduced from 77 +/- 14 to 64 +/- 10 mmHg (P < 0.05). After T2 clipping, heart rate decrease from 88 +/- 18 to 73 +/- 14 (P < 0.05) and mean blood pressure was reduced from 74 +/- 12 to 67 +/- 13 mmHg (P < 0.05). CONCLUSION: The main result of this study was that there was no significant difference in sympathetic block effects on blood pressure and heart rate between clipping and sympathicotomy during the procedure.
Anesthesia ; Autonomic Nerve Block ; Blood Pressure* ; Cardiovascular System ; Enflurane ; Forearm ; Hand ; Heart Rate* ; Heart* ; Humans ; Pancuronium ; Sweat ; Sweating ; Thiopental

Pleural aspergillosis is an uncommon disease; only 29 cases have reported in the literature since 1958. We reported a patient with a pleural aspergillosis complicated a preexisting chronic empyema. Treatment consisted of pleuropneumonectomy, creation of an pleurocutaneous window followed by an intrapleural instillation of nystatin.
Aged ; Aspergillosis/diagnosis/*etiology/therapy ; Case Report ; Empyema/complications ; Human ; Lung Diseases, Fungal/diagnosis/*etiology/therapy ; Male

No abstract available.
Carcinoid Tumor*

BACKGROUND: Systemic lupus erythematosus (SLE) is one of chronic autoimmune diseases of which the central pathophysiologic derangement has not been yet established. Recently, it has been suggested that immune-regulatory cells might affect the development of autoimmune diseases such as SLE and RA. NKT cells were reported to be strong candidate for regulatory cells to regulate immune responses in vivo. To elucidate the roles of immune regulatory cells in the pathogenesis of SLE, we investigated the fractional distribution and functional status of NK and NKT cells in peripheral blood mononuclear cells (PBMC) of SLE patients and healthy volunteers. METHODS: Twenty-two SLE patients and 18 age-matched healthy volunteers were included in this study. The analysis for NK and NKT cells fraction in PBMCs of patients and normal controls were performed by flow cytometric analysis. In addition, to explore the functional status of these cells in SLE patients, we stimulated PBMCs using phorbol ester and ionomycin and measured cytoplasmic IL-4 and IFN-gamma by flow cytometry. RESULTS: The number (percentage) of NK cells was lower in SLE patients (CD3-CD56+: 4.93+/-1.30%, CD3-CD94+: 4.03+/-1.00%) than in controls (11.28+/-1.77%, 8.15+/-1.40%; p< 0.01, respectively). Peripheral NK cell numbers negatively correlated with anti-dsDNA Ab levels (r=-0.431, p< 0.05) and ESR (r= -0.475, p< 0.05). However, the percentage of these cells was not correlated with renal activity or corticosteroid doses. SLE patients showed, compared with controls, significantly decreased numbers of NKT cells (CD3+CD56+: 1.79+/-0.42% vs 5.04+/-0.44%, CD3+CD94+: 1.21+/-0.27% vs 4.39+/-0.45%; p< 0.01, respectively). The cytoplasmic expression of IL-4 and IFN-gamma in NK and NKT cells of SLE patients stimulated using phorbol ester and ionomycin were almost similar to those of normal controls, suggesting the NKT cells from SLE patients are functionally intact. CONCLUSION: Our results suggested that the decreased numbers of immune regulatory cells were associated with the immune dysregulation of SLE patients. The cellular replacement of NKT cells may be one of useful therapeutic approaches for autoimmune diseases such as SLE.
Autoimmune Diseases ; Cytoplasm ; Flow Cytometry ; Healthy Volunteers ; Humans ; Interleukin-4 ; Ionomycin ; Killer Cells, Natural* ; Lupus Erythematosus, Systemic* ; Natural Killer T-Cells

This study is to develope a phantom for MOSFET (Metal Oxide Semiconductors Field Effect Transistors) dosimetry and compare the dosimetric properties of standard MOSFET and microMOSFET with the phantom. In this study, the developed phantom have two shape: one is the shape of semi-sphere with 10 cm diameters and the other one is the flat slab of 30 cm x 30 cm with 1 cm thickness. The slab phantom was used for calibration and characterization measurements of reproducibility, linearity and dose rate dependency. The semi-sphere phantom was used for angular and directional dependence on the types of MOSFETs. The measurements were conducted under 10 x 10 cm2 fields at 100 cm SSD with 6 MV photon of Clinac (21EX, Varian, USA). For calibration and reproducibility, five standard MOSFETs and microMOSFETs were repeatedly irradiated by 200 cGy five times. The average calibration factor was a range of 1.09+/-0.01~1.12+/-0.02 mV/cGy for standard MOSFETs and 2.81+/-0.03~2.85+/-0.04 mV/cGy for microMOSFETs. The response of reproducibility in the two types of MOSFETs was found to be maximum 2% variation. Dose linearity was evaluated in the range of 5 to 600 cGy and showed good linear response with R2 value of 0.997 and 0.999. The dose rate dependence of standard MOSFET and microMOSFET was within 1% for 200 cGy from 100 to 600 MU/min. For linearity, reproducibility and calibration factor, two types of MOSFETs showed similar results. On the other hand, the standard MOSFET and microMOSFET were found to be remarkable difference in angular and directional dependence. The measured angular dependence of standard MOSFET and microMOSFET was also found to be the variation of 13%, 10% and standard deviation of +/-4.4%, +/-2.1%. The directional dependence was found to be the variation of 5%, 2% and standard deviation of +/-2.1%, +/-1.5%. Therefore, dose verification of radiation therapy used multidirectional X-ray beam treatments allows for better the use of microMOSFET which has a reduced angular and directional dependence than that of standard MOSFET.
Calibration ; Hand ; Semiconductors ; Silver Sulfadiazine

Glycogen storage disease (GSD) IV is a rare autosomal recessive inherited disorder caused by mutations in the gene coding for glycogen branching enzyme leading to progressive liver disease. GSD IV is associated with mutations in GBE1, which encodes the glycogen branching enzyme. We report a case of GSD IV with rare homozygous mutations in the GBE1 gene (c.791G>A (p.Gly264Glu), which was successfully treated by liver transplantation.
1,4-alpha-Glucan Branching Enzyme* ; Clinical Coding ; Glycogen Storage Disease Type IV ; Glycogen Storage Disease* ; Glycogen* ; Liver Diseases ; Liver Transplantation

PURPOSE: There are no studies of hepatic glycogen storage diseases (GSDs) other than type I and III in Korea. We aimed on investigating the characteristics of hepatic GSDs in Korea diagnosed and followed at a single center. METHODS: We retrospectively analyzed patients who were diagnosed as GSD and followed at Samsung Medical Center from January, 1997 to December, 2013. Clinical manifestations, laboratory results, treatment, and prognosis were investigated. RESULTS: Twenty-one patients were included in the study. The types of 17 patients were confirmed by enzyme activity tests and/or gene analysis. GSD Ia was diagnosed in 7 patients (33.3%), Ib in 1 patient (4.8%), III in 2 patients (9.5%), IV in 1 patient (4.8%), and IX in 6 patients (28.6%). Types other than GSD I constituted 52.9% (9/17) of the patients diagnosed with a specific type of hepatic GSD. The median age at presentation was 2 years. Hepatomegaly was observed in 95.2%, elevated liver transaminases in 90.5%, and hyperlactacidemia in 81.0% of the patients. The duration for follow-up was 77+/-62.0 months. Uncooked corn starch was initiated in all the patients. No mortality was observed during the follow-up period, and liver transplantation was performed in 14.3%. CONCLUSION: Types other than GSD I comprised more than half of the patients diagnosed with a specific type of hepatic GSD. Clinical suspicion and thorough evaluation of hepatic GSDs in Korea should be focused not only on GSD I, but also on other types.
Follow-Up Studies ; Glycogen Storage Disease ; Hepatomegaly ; Humans ; Korea ; Liver ; Liver Glycogen* ; Liver Transplantation ; Mortality ; Prognosis ; Retrospective Studies ; Starch ; Transaminases ; Zea mays

BACKGROUND: Molecular techniques are fundamental for establishing an accurate diagnosis and therapeutic approach of glycogen storage diseases (GSDs). We aimed to evaluate SLC37A4 mutation spectrum in Korean GSD Ib patients. METHODS: Nine Korean patients from eight unrelated families with GSD Ib were included. SLC37A4 mutations were detected in all patients with direct sequencing using a PCR method and/or whole-exome sequencing. A comprehensive review of previously reported SLC37A4 mutations was also conducted. RESULTS: Nine different pathogenic SLC37A4 mutations were identified in the nine patients with GSD Ib. Among them, four novel mutations were identified: c.148G>A (pGly50Arg), c.320G>A (p.Trp107*), c.412T>C (p.Trp138Arg), and c.818G>A (p.Gly273Asp). The most common mutation type was missense mutations (66.7%, 6/9), followed by nonsense mutations (22.2%, 2/9) and small deletion mutations (11.1%, 1/9). The most common mutation identified in the Korean population was c.443C>T (p.Ala148Val), which comprised 39.9% (7/18) of all tested alleles. This mutation has not been reported in GSD Ib patients in other ethnic populations. CONCLUSIONS: This study expands knowledge of the SLC37A4 mutation spectrum in Korean patients with GSD Ib.
Alleles ; Codon, Nonsense ; Diagnosis ; Glycogen Storage Disease* ; Glycogen* ; Humans ; Methods ; Mutation, Missense ; Polymerase Chain Reaction ; Sequence Deletion

OBJECTIVE: This multi-center, randomized, double-blind, phase 3 trial was conducted to compare the safety and efficacy of contrast agents iohexol-380 and iohexol-350 for coronary CT angiography in healthy subjects. MATERIALS AND METHODS: Volunteers were randomized to receive 420 mgI/kg of either iohexol-350 or iohexol-380 using a flow rate of 4 mL/sec. All adverse events were recorded. Two blinded readers independently reviewed the CT images and conflicting results were resolved by a third reader. Luminal attenuations (ascending aorta, left main coronary artery, and left ventricle) in Hounsfield units (HUs) and image quality on a 4-point scale were calculated. RESULTS: A total of 225 subjects were given contrast media (115 with iohexol-380 and 110 with iohexol-350). There was no difference in number of adverse drug reactions between groups: 75 events in 56 (48.7%) of 115 subjects in the iohexol-380 group vs. 74 events in 51 (46.4%) of 110 subjects in the iohexol-350 group (p = 0.690). No severe adverse drug reactions were recorded. Neither group showed an increase in serum creatinine. Significant differences in mean density between the groups was found in the ascending aorta: 375.8 ± 71.4 HU with iohexol-380 vs. 356.3 ± 61.5 HU with iohexol-350 (p = 0.030). No significant differences in image quality scores between both groups were observed for all three anatomic evaluations (all, p > 0.05). CONCLUSION: Iohexol-380 provides improved enhancement of the ascending aorta and similar attenuation of the coronary arteries without any increase in adverse drug reactions, as compared with iohexol-350 using an identical amount of total iodine.
Angiography* ; Aorta ; Contrast Media ; Coronary Vessels ; Creatinine ; Drug-Related Side Effects and Adverse Reactions ; Image Enhancement ; Iodine ; Phenobarbital ; Volunteers

BACKGROUND: There are few published studies on the relationship between occupational lumbar load and facet joint degeneration (FJD). This cross-sectional study was conducted to evaluate the effect of physical lumbar load on FJD by comparing magnetic resonance imaging (MRI) findings of firefighters (FFs) and hospital office workers (HOWs). METHODS: We randomly sampled 341 male FFs and 80 male HOWs by age stratification. A questionnaire and clinical examination, including MRI of the lumbar spine (T12-S1), were conducted. FJD was diagnosed and graded by using the classification of Pathria et al., and reclassified into two groups as follows: no FJD (grade 0) and FJD (grades 1, 2, and 3). The prevalence of FJD was analyzed according to occupational group. RESULTS: The prevalence of FJD ranged from 31% (L1–L2) to 75% (L4–L5) in the FFs, and from 18% (L1–L2) to 69% (L4–L5) in the HOWs. After adjustment for age, body mass index, and frequency of physical exercise, the adjusted odds ratios (OR) for FJD in the FFs were significantly higher than those in the HOWs at all lumbar spinal levels, except for L3–L4 (L1–L2: OR, 2.644; 95% confidence interval [CI], 1.317–5.310; L2–L3: OR, 2.285; 95% CI, 1.304–4.006; L4–L5: OR, 1.918; 95% CI, 1.037–3.544; L5–S1: OR, 1.811; 95% CI, 1.031–3.181). CONCLUSION: This study shows that FFs exhibit a greater likelihood of having FJD than HOWs after controlling for other risk factors of FJD. This suggests that the physical occupational demands of FFs affect their risk of developing FJD.
Body Mass Index ; Classification ; Cross-Sectional Studies ; Exercise ; Firefighters* ; Humans ; Low Back Pain ; Magnetic Resonance Imaging ; Male ; Occupational Groups ; Odds Ratio ; Prevalence ; Risk Factors ; Spine ; Zygapophyseal Joint*