Anomalous systemic arterial supply to the lung is a rare congenital anomaly. The lung supplied by the anomalus systemic artery has a normal bronchial tree, which is usually in the basal segment of the lung, especially in the left lung. Most of patients are asymptomatic, but the main clinical symptoms of this disease are hemoptysis and exertional dyspnea. CT is useful for the diagnosis and showed a retrocardiac nodular shadow connected to the descending aorta branching into the basal segments of the relatively normal lower lobe. Surgery is indicated for all patients. Here we report a case of anomalous systemic arterial supply to normal basal segments of left lower lobe in a patient with hemoptysis with a review of the relevant literature.
Aorta, Thoracic ; Arteries ; Diagnosis ; Dyspnea ; Hemoptysis ; Humans ; Lung

Demonstration of an overall superiority in the accuracy of discriminating crossed-disparity targets should be noted as opposed to uncrossed-disparity targets.We investigated the difference in stereoacuity between crossed and uncrossed disparities using dynamic stereoacuity and superiority of crossed disparity stereopsis.We examined dynamic stereoacuity in 73 normal subjects at 120 cm test distance and 96 subjects at 150 cm test distance.At 120cm test distance, the mean dynamic stereoacuity of crossed disparity was 313.4 +/-261.4 (mean +/-standard deviation)sec of arc, and, the mean dynamic stereoacuity of uncrossed disparity was 343.1 +/-261.4 sec of arc.At 150 cm test distance, the mean dynamic stereoacuity of crossed disparity was 263.2+/-196.8 sec of arc, and, the mean dynamic stereoacuity of uncrossed disparity was 310.6 +/-310.6 sec of arc.Statistical significance shows a higher stereoacuity of crossed disparity than uncrossed disparity in both test distance (Wilcoxon matched pairs signed ranks test, p<0.05).

BACKGROUND: There are contradictory reports concerning hypercapnia as a predictor of a better outcome in COPD. This study examined the clinical implications of hypercapnea in COPD patients (M:F = 59:19) who required mechanical ventilation. METHODS: The clinical parameters at the time of MICU admission, the total ventilation time, the APACHE II score and the pulmonary function testing were retrospectively analyzed between the survivors and nonsurvivors. RESULTS: Univariate analysis showed that compared with the nonsurvivors, the survivors had lower AaDO2 values (59.8+/-53.5 vs. 105.0+/-73.3 mmHg, p=0.000), higher PaCO2 values (64.9+/-16.0 vs. 48.9+/-17.8 mmHg, p=0.000), lower APACHE II scores (19.0+/-3.8 vs. 24.1+/-5.1, p=0.002), the more frequent application of initial noninvasive positive pressure ventilation (44.0 vs. 14.3%, p=0.008), and a lower combined rate of septic shock (4.0 vs. 39.3%, p=0.000). Multivariate analysis revealed that a lower PaCO2 (OR: 0.94, p=0.008), the presence of septic shock (OR: 10.16, p=0.011), a higher APACHE II score (OR: 1.22, p=0.040) and a longer ventilation time (OR: 1.002, p=0.041) were the risk factors for mortality. A lower PaCO2 was also verified as the predictor for mortality by multivariate analysis when excluding septic shock. CONCLUSIONS: Hypercapnia at admission is thought to be an independent predictor of better survival for the COPD patients who require mechanical ventilation.
*Treatment Outcome ; Survival Analysis ; Risk Factors ; Retrospective Studies ; Respiratory Insufficiency ; *Respiration, Artificial/methods ; Pulmonary Disease, Chronic Obstructive/*mortality/therapy ; Prognosis ; Patient Admission ; Multivariate Analysis ; Male ; *Hypercapnia ; Humans ; Female ; Biological Markers ; Aged ; APACHE

There are few reports on aggravation of asthma by mint flavor although it is a common ingredient of many products. A 40-year-old male patient with aspirin-sensitive asthma experienced anaphylaxis after using a gargle that contained mint flavor. Skin prick tests and ELISA for serum specific IgE to mint showed negative responses. Challenge tests with mint oil and menthol were positive and the immediate bronchoconstriction was completely inhibited by premedication with cromolyn sodium. These findings suggest that mast cells may be involved in the pathogenesis of mint-induced asthma or anaphylaxis. To our knowledge, this is the first case of mint-induced anaphylaxis. It is important to alert physicians to the possibility of aggravation of asthmatic symptoms or the development of anaphylaxis by mint flavor.
Adult ; Anaphylaxis* ; Asthma ; Bronchoconstriction ; Cromolyn Sodium ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunoglobulin E ; Male ; Mast Cells ; Mentha* ; Menthol ; Premedication ; Skin

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is sometimes complicated with pneumonia, but little is known about the risk factors that promote the development of pneumonia in COPD. These risk factors were evaluated in the present study. METHODS: The data of 324 patients with COPD from a prospective multi-center observational cohort with obstructive lung disease were evaluated retrospectively. To identify risk factors for the development of pneumonia in COPD, the clinical and radiological data at enrollment and the time to the first episode of pneumonia were analyzed by Cox proportional hazard analysis. RESULTS: The median follow-up time was 1,099 days and 28 patients (8.6%) developed pneumonia. The Cox analysis showed that post-bronchodilator forced expiratory volume in one second (FEV1, % of predicted) and the computed tomography (CT) emphysema extent (inspiratory V950) were independent risk factors for the development of pneumonia (post-bronchodilator FEV1: hazard ratio [HR], 0.97; 95% confidence interval [CI], 0.94-1.00; p=0.048 and inspiratory V950: HR, 1.04; 95% CI, 1.01-1.07; p=0.01). CONCLUSION: Emphysema severity measured by CT and post-bronchodilator FEV1 are important risk factors for the development of pneumonia in COPD.
Cohort Studies ; Emphysema* ; Follow-Up Studies ; Forced Expiratory Volume ; Humans ; Lung Diseases, Obstructive ; Lung* ; Pneumonia* ; Prospective Studies ; Pulmonary Disease, Chronic Obstructive* ; Retrospective Studies ; Risk Factors ; Tomography, X-Ray Computed

Hepatitis B virus (HBV) and human immunodeficiency virus (HIV) have a common route like sexually transmitted infections (STIs), vertical transmission and blood transfusion, etc. Therefore, it was necessary to be an attempt to confirm the relationship of HBV and HIV in Korea. We investigated the prevalence of Hepatitis B surface antigen (HBsAg) and Hepatitis B core antibody (anti-HBc) in HIV positive groups (n=430) and HIV negative groups (n=434) from January 2014 to October 2015. When comparing the prevalence of anti-HBc between the two groups, HIV positive group (36.0%) showed a higher prevalence than HIV negative group (24.7%), the result was statistically significant (p < 0.05). However, there was a little difference on HBsAg and not significant. Therefore, by showing a clear difference in anti-HBc between the two groups of HIV in Korea, it was confirmed to be associated with co-infections between Hepatitis B and HIV.
Blood Transfusion ; Coinfection* ; Hepatitis B Surface Antigens ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; HIV* ; Korea* ; Prevalence* ; Sexually Transmitted Diseases

BACKGROUND: Paraquat is known to induce oxidant injury that results in multiorgan failure and lung fibrosis. Iron has been considered to play a key role in paraquat-induced oxidant lung injury. This study examined the effect of deferoxamine, an iron-chelating agent, in the treatment of paraquat poisoning. METHODS: From September, 2001 to April, 2005, 28 patients with paraquat poisoning who were admitted at a medical intensive care unit of a University-affiliated hospital, were enrolled in this study. Sixteen patients were treated according to the paraquat poisoning treatment guidelines and 12 received an intravenous infusion of deferoxamine in addition to the treatment guidelines. RESULTS: There were no differences between the two groups in terms of age, gender, severity of paraquat poisoning, and the time elapsed from ingestion to presentation at hospital. There was no difference in overall mortality between the two groups but the incidence of respiratory failure in the deferoxamine group was higher than in the conventional group(4/7 versus 0/9, p=0.019). CONCLUSIONS: Deferoxamine seems to have no clinical benefit compared with the conventional treatment.
Deferoxamine* ; Eating ; Fibrosis ; Humans ; Incidence ; Infusions, Intravenous ; Intensive Care Units ; Iron ; Lung ; Lung Injury ; Mortality ; Paraquat* ; Poisoning* ; Respiratory Insufficiency

The reactive airway dysfunction syndrome (RADS), a subset of irritant-induced asthma, has been described following exposure to various irritant gas. We describe a case of RADS occuring following a single exposure to high levels of chlorine gas in the workplace. No documented pre-existing respiratory illness and atopy was identified. Cough, dyspnea, and wheezing were developed with the single accidental exposure to chlorine gas and methacholine provocation test was positive. He was completely recovered with the treatment of corticosteroid and oxygen therapy.
Angioedema ; Asthma ; Cellulitis ; Chlorine* ; Cough ; Dyspnea ; Eosinophilia ; Hypereosinophilic Syndrome ; Methacholine Chloride ; Oxygen ; Respiratory Sounds

Refractory asthma with hypercapnia is a near-fatal disease. Pumpless Extracorporeal Interventional Lung Assist (iLA) may be considered as an alternative therapy for the disease as it removes the carbon dioxide effectively. Nevertheless, clinical outcome studies regarding iLA in patients suffering from refractory asthma have rarely been applied. Here, we reported our experience with iLA for the treatment of refractory asthma with hypercapnia. In our case, the patient had refractory asthma which was not controlled with medical treatment or mechanical ventilation. We applied iLA since hypercapnia was not resolved despite mechanical ventilation. After iLA implantation effectively reduced the carbon dioxide, the clinical condition of our patient improved. In conclusion, iLA is a useful tool for patient suffering from refractory asthma with hypercapnia.
Asthma ; Carbon Dioxide ; Humans ; Hypercapnia ; Lung ; Outcome Assessment (Health Care) ; Respiration, Artificial ; Stress, Psychological

BACKGROUND: Initiation of renal replacement therapy (RRT) in critically ill septic shock patients with acute kidney injury is highly subjective and may influence outcome. The aim of this study is to evaluate the relationship between initiation of RRT and 28 day mortality in patients with severe sepsis and septic shock (SSSS). METHODS: All patients diagnosed with SSSS and treated at the medical intensive care unit (ICU) in university-affiliated hospital from January 2005 to December 2006 were reviewed. Initiation of RRT was stratified into "early" and "late" by RIFLE (Risk, Injury, Failure, Loss, and End-stage) criteria and blood urea nitrogen (BUN) at the time RRT began. The primary outcome was death after 28 days from any cause. RESULTS: Of the 326 patients diagnosed with SSSS and admitted into the medical ICU during the study period, 78 patients received RRT. Mean age was 61.5 +/- 14.7 years old and 54 patients were male (69.2%). The initiation of RRT was categorized into early (Risk, and Injury) and late (Failure) by RIFLE criteria and also categorized into early (BUN < 75 mg/dl) and late (BUN > or = 75 mg/dl). When the relationship between RIFLE criteria and 28 day mortality was compared, no significant difference was shown (70.8% vs. 73.3%, p = 0.81). The initiation of RRT by BUN also showed no significant difference in 28 day mortality (77.3% vs. 69.6%, p = 0.50). CONCLUSIONS: Initiation of RRT, stratified into "early" and "late" by RIFLE and BUN, showed no significant difference in 28 day mortality regarding patient with SSSS.
Acute Kidney Injury ; Blood Urea Nitrogen ; Critical Illness ; Humans ; Intensive Care Units ; Male ; Renal Replacement Therapy ; Sepsis ; Shock, Septic