Ionizing radiation has proved to be most valuable in clinical diagnosis and radiotherapy. And also it is used very common in industries especially such as industrial radiography, atomic energy plant, inspectoring by gamma-ray, etc. However, inadvertent exposure to relatively high doses of ionizing radiation is capable of injuring and killing cells. The lungs, because of their rich vascularization, are vulnerable to radiation injury. It is now known that IL-6 is a pleiotrophic cytokine produced by various cells that regulates the immune reponses, acute phage reactions. We performed the immunohistochemical staining of IL-6 on radiation induced lung injury by duration, to clarify the role of IL-6 in tissue damage. IL-6 was strongly expressed in early phase of radiation from alveolar macrophages and damaged endothelial cells. These findings not only have important implications for increasing our understanding of mechanisms of radiation lung injury but they also have an impact on strategies for diagnosis and therapy of radiation damage.
Bacteriophages ; Diagnosis ; Endothelial Cells ; Homicide ; Interleukin-6* ; Lung Injury ; Lung* ; Macrophages, Alveolar ; Nuclear Energy ; Plants ; Radiation Injuries ; Radiation, Ionizing ; Radiography ; Radiotherapy

PURPOSE: The demand for suitable organs in the world greatly outweighs the supply of transplantable organs. Perceptions and attitudes of the attending physician to brain death are pivotal for the organ donation process in brain dead donors. The purpose of this study is to evaluate the perceptions and attitudes of the attending physician on brain death and organ donation in order to promote the organ donation from brain dead donors in Korea. METHODS: Questionnaires were collected from 194 (17.9%) among 1,018 physicians and were analyzed by descriptive statistics. RESULTS: 97.5% (189/194) of respondents have positive attitudes toward organ donation. Although 97.9% (190/194) have experienced donor management, the referral rate was no more than half (96/194, 49.5%). The main barriers against organ donation were lack of knowledge on organ donation and transplantation (60/129, 46.5%), cultural background (27/120, 20.9%) and complexity in the organ donation process (12/129, 9.3%). CONCLUSION: Promotion of organ procurement organization and well trained-education programs are crucial to help attending physicians to understand the organ donation process, and eventually to increase the rate of organ donations in brain dead donors.
Brain Death* ; Brain* ; Humans ; Korea ; Surveys and Questionnaires ; Referral and Consultation ; Surveys and Questionnaires ; Tissue and Organ Procurement* ; Tissue Donors* ; Transplantation

Organ shortage remains a main obstacle to the development of organ transplantation for end stage organ disease. Identification of potential donors is a key point of donation/transplantation process. We evaluated the entire potential organ donor developed in intensive care unit and emergency room to find out the way to improve the real donation program .Pro-and retrospective analysis were performed in death patient occurred in intensive care unit and emergency room between May. 1997 and Oct. 1997. There are 394 death patients in ICU and 324 in ER during study period. 293 patients (74.3%) were eliminated by age under 1 year or over 70 years, and medical disease unsuitable for organ transplantation. After a series of elimination due to no possibility of brain death or organ unsutability, 35 patients (8.9%) finally were found to be a acceptable potential donors for organ transplantation in ICU, and 3 (0.9%) in ER. 28 of the 35 potential donors (80.0%) were found in neurology or neurosurgery ICU. Causes of brain death in 35 potential donors were traumatic intracerebral injury in 10 (29.4%), and non traumatic intracranial cerebral catastrophe in 21 (61.8%). Actual multiorgan harvest was performed in 2 (5.7%) among 35 medically acceptable potential donors in ICU. Three (8.6%) among 35 potential donors refused organ donation by donor families, 29 (82.9%) could not be actual donors due to absence of any information on organ donation to families of donors. Conclusively organ donation rate and efficacy from the potential donor are very poor in this series. Comprehensive donor action programs including practical donor detection program with donor linker, education program to medical staff and public are mandatory to increase the cadaveric organ donation effectively.
Brain Death ; Cadaver ; Critical Care* ; Education ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Intensive Care Units* ; Kidney Transplantation* ; Medical Staff ; Neurology ; Neurosurgery ; Organ Transplantation ; Retrospective Studies ; Tissue and Organ Procurement ; Tissue Donors* ; Transplants

A well designed transplant software program with its database is a valuable tool in the management of transplant patients and transplant associated works. PURPOSE: The purpose of this study is to make the organ transplantation information system associated with Hospital Order Communicating System (OCS) and Korean Networking for Organ Sharing (KONOS) METHODS: We used the Hospital Order Communicating System in Asan Medical Center as a data capture source. Web EDI system was going to be used to connect the Korean Networking for Organ Sharing. RESULTS: Electronic link to Order Communicating System in our hospital can eliminate the necessity of double entry of data and eliminates the manual entry errors while increasing the efficacy of service. Multicentric accessibility to this new software system makes the data entry be easy. This program can capture the necessary data including text, numeric, scanned data at all stages of treatments, from the pretransplant to posttransplant follow-up using data transmission with Order Communicating System. The built-in tools for data analysis and other services can assist the coordinators in performing their daily tasks. Complying with timely reporting demanded by KONOS overburdened the transplant center staff and coordinators. We are already prepared to connect to KONOS reporting system using EDI system, and we are waiting for response of KONOS. CONCLUSION: Even though it was not simple to make the well designed transplant software because it involves several concerns, we were able to make the organ transplant information system linked to OCS successfully. We hope this system can be connected to KONOS in the near future.
Chungcheongnam-do ; Follow-Up Studies ; Hope ; Humans ; Information Systems* ; Organ Transplantation* ; Statistics as Topic ; Transplantation ; Transplants*

BACKGROUND: We introduce a new, simple portable inhalational induction device (PD) that provides co-operative inhalational induction of anaesthesia using N2O and subsequent sevoflurane in the preanaesthetic induction area in children. METHODS: Forty-five children (30 to 94 months old age, <35 kg) who were scheduled to undergo simple operations were assigned randomly to one of three regimens. Patients were encouraged by their parents to inhale N2O followed by sevoflurane (PD N2O-sevo group) or sevoflurane (PD sevo group) using a portable inhalational induction device in the preanaesthetic induction area until they were unable to respond to their names. They were then transferred to the operating room while maintaining inhalation of sevoflurane via the device. The control group underwent conventional inhalational induction in the operating room with the parents in attendance. RESULTS: Patients in the PD N2O-sevo group had a higher co-operative inhalation frequency than the patients in the PD sevo or the control group. Anaesthesia induction in the PD N2O-sevo and the PD sevo groups were faster than in the control group. Parent satisfaction score (0-100) was higher for the PD N2O-sevo group than for the control group. CONCLUSIONS: A new portable inhalational induction device allows faster induction in co-operation with parents present in the preanaesthetic induction area compared to conventional inhalational induction in the unfamiliar operating room with the parents in attendance.
Child ; Humans ; Inhalation ; Methyl Ethers ; Nitrous Oxide ; Operating Rooms ; Parents

BACKGROUND: Use of single donor apheresis platelets and concerning for the quality of apheresis platelets has been rapidly increased. Apheresis platelets depleted white blood cell (WBC) are used to prevent or to reduce febrile non-hemolytic transfusion reactions, alloimmunization and cytomegalovirus infection. We compared COBE Spectra LRSTM (leukoreduction system) and COBE Spectra with PALL PXLTM8 in terms of the yield predictors, processing times, and WBC contamination. METHOD: Seventy-two single donors who visited Apheresis Unit (APU) in St. Mary's hospital were prospectively randomized into COBE Spectra LRSTM and COBE Spectra followed by PALL PXLTM8 between September 1997 and October 1998. We used Coulter counting for platelet and Nageotte hemocytometer for WBC count. Data were analyzed by independent t-test. RESULTS: The mean platelet yield per unit was 3.6 +/- 1.0X1011 with COBE spectra LRSTM compared to 2.9 +/- 1.1X1011 with COBE Spectra (p=0.002), and the mean WBC content per unit with COBE spectra LRSTM was 4.1X104 (0.4-23.5) compared to 3.7X104 (0.43-17.9) with PALL PXLTM8 (p=0.0728). CONCLUSIONS: This study shows that COBE Spectra LRSTM has higher platelet yields than that of COBE Spectra, and similar WBC contamination compared to PALL PXLTM8. Therefore, this data suggests that COBE Spectra LRSTM is conveient than COBE Spectra with PALL PXLTM8 in clinical practice.
Blood Component Removal ; Blood Group Incompatibility ; Blood Platelets* ; Cytomegalovirus Infections ; Humans ; Leukocytes* ; Prospective Studies ; Tissue Donors*

BACKGROUND/AIMS: There is increasing interest in the use of propofol as a sedative agent for colonoscopy. We evaluated the safety and efficacy of the synergistic sedation with midazolam combined with low-dose propofol versus that of midazolam alone. METHODS: A total of 56 patients from among those who underwent total colonoscopy between August 2004 and October 2004 were randomly assigned to one of three medication treatment groups. Group A (n=18) received low-dose midazolam (0.03 mg/kg IV) plus propofol, group B (n=19) received high-dose midazolam (0.07 mg/kg IV) plus propofol, and group C (n=19) received high-dose midazolam alone. The patients' vital signs were monitored throughout the course of the study. The recovery time and quality as well as the patients' comfort level were also assessed. RESULTS: There were no significant differences in baseline characteristics among the treatment groups. There were also no differences in the duration and insertion time of the colonoscopy among the three groups. The patients' comfort level and cardiorespiratory parameters during colonoscopy were similar among the three groups. The sedation efficacy and recovery times were also similar among the three groups. CONCLUSIONS: Midazolam combined with low-dose propofol as a sedative for colonoscopy exhibits similar effects on safety, patient' comfort level and recovery time to those of midazolam alone.
Colonoscopy* ; Conscious Sedation* ; Humans ; Midazolam* ; Propofol* ; Vital Signs

BACKGROUND: Brain death donors may require continuous renal replacement therapy (CRRT) in severe acute renal failure (ARF) during management. To maximize donor organ usage we performed renal transplantation from deceased donors requiring CTTR with informed consent. This single-center study reviewed the clinical outcomes of kidney transplant recipients from extreme marginal donors requiring CRRT. METHODS: Medical records of all patients using a graft from extreme marginal donors who underwent CRRT in Asan Medical Center between June 2007 and September 2014 were reviewed retrospectively. RESULTS: Between June 2007 and September 2014, 27 kidneys were transplanted from 19 CRRT donors. Mean donor age was 35.1 years (range; 16~56), male donors were 14 (74%). The causes of brain death included head trauma in 6, hypoxia in 5, stroke in 4, and others in 4. The main causes of CRRT were anuria in 14, electrolyte imbalance or acidosis in 5, and mean duration of donor CRRT was 3.6 days (range; 1~11). Delayed graft function (DGF) developed in 24 (88.9%), but all recovered renal function; they can be free from dialysis 11 days after transplantation. Mean serum creatinine level at 1 month, 1 year, and 5 years was 1.85, 1.26, and 1.31 mg/dL, respectively. CONCLUSIONS: Five-year follow-up data showed that renal transplantation from severe ARF donor has an excellent outcome. Although CRRT donor kidney transplants have a higher rate of DGF, the presence of DGF, unlike other donation after brain death donor kidney transplants, does not portend a worse prognosis.
Acidosis ; Acute Kidney Injury ; Anoxia ; Anuria ; Brain Death ; Chungcheongnam-do ; Craniocerebral Trauma ; Creatinine ; Delayed Graft Function ; Dialysis ; Follow-Up Studies ; Humans ; Informed Consent ; Kidney Transplantation* ; Kidney* ; Male ; Medical Records ; Prognosis ; Renal Replacement Therapy ; Retrospective Studies ; Stroke ; Tissue Donors* ; Transplantation ; Transplants

BACKGROUND/AIMS: Pancreas transplantation (PT) as the ultimate treatment for insulin-dependent diabetes has been the subject of debate clinically. Marked improvements in patient and graft survival, and decreases in postoperative morbidity have been achieved due to technical refinements, improved immunosuppressants, and better postoperative management. Here, we report our 18-year experience with PT performed at our institute. METHODS: All recipients who underwent deceased donor or living donor PT between July 1992 and December 2009 were included. We reviewed the medical records, including operation records, progress, and laboratory findings during follow-up. Graft and patient survival were analyzed using the Kaplan-Meier method. RESULTS: In total, 119 cases of pancreas transplantation were performed between July 1992 and December 2009 at our institute. Indications for pancreas transplantation were type I diabetes in 93 (78.2%) patients and type II diabetes in 16 (13.4%) patients. The transplanted pancreas was obtained from a deceased donor in 108 cases (90.8%) and a living donor in 11 cases (9.2%). Median follow-up duration was 39.3 months posttransplantation (range 0~176 months). Overall graft survival rates at 1, 5, and 10 years were 81.6%, 63.4%, and 57.1%, respectively. Following the introduction of tacrolimus as an immunosuppressant in 1999, graft survival at 1, 5, and 10 years was 89.1%, 72.9%, and 66.2%, and overall patient survival at 1, 5, and 10 years was 93.0%, 86.0%, and 86.%, respectively. CONCLUSIONS: Considering the quality of life and long-term patient survival, PT is an effective treatment strategy in non-obese diabetic patients requiring insulin regardless of the type of diabetes.
Follow-Up Studies ; Graft Survival ; Humans ; Immunosuppressive Agents ; Insulin ; Korea ; Living Donors ; Medical Records ; Pancreas ; Pancreas Transplantation ; Quality of Life ; Tacrolimus ; Tissue Donors ; Transplants

BACKGROUND/AIMS: Chronic pancreatitis (CP) is characterized clinically by a broad spectrum of variable features depending on many factors such as etiology, stage of the disease, and the presence of local complications. The aims of this study were to investigate the clinical aspect of CP and to analyze the characteristics according to the history of pancreatitis. METHODS: Eighty nine medical records from the patients who were diagnosed as CP at Korea University Ansan Hospital from January 1997 through December 2007 were reviewed retrospectively. After patients were divided into two groups according to the previous history of pancreatitis: the group I (n=34, no history of pancreatitis) and II (n=43, history of pancreatitis more than once), the clinical characteristics of two groups were compared. RESULTS: The mean age was 50+/-13.2 years and the male to female ratio was 5:1. Alcohol was the cause of CP in 71.9%, and 23.6% had no evident cause. Age (53.4+/-15.5 vs. 46.2+/-11.5, p=0.021), etiology (idiopathic 41.2% vs. 11.6%, p=0.004), and the presence of abdominal pain (73.5% vs. 100%, p=0.030) were significantly different between group I and II. However, in comparison of other factors that reflected the advanced stage of CP such as presence of pancreatic calcification, complications, and Cambridge grade on ERCP, there was no significant difference. CONCLUSIONS: Since CP which present, as the first manifestation shows much an advanced stage, the method for early diagnosis of CP is particularly needed.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Alcoholism/complications ; Child ; Cholangiopancreatography, Endoscopic Retrograde ; Diagnosis, Differential ; Female ; Humans ; Male ; Middle Aged ; Pancreatitis/*diagnosis ; Pancreatitis, Chronic/*diagnosis/etiology/ultrasonography ; Predictive Value of Tests ; Retrospective Studies ; Tomography, X-Ray Computed