Purpose: With the revision of the Organ and Transplantation Act in 2018, the hand has become legal as an area of transplantable organs in Korea. In January 2021, the first hand allotransplantation since legalization was successfully performed, and we have performed a total of three successful hand transplantation since then. By comparing and incorporating our experiences, this study aimed to provide a comprehensive reconstructive solution for hand amputation in Korea. Materials and Methods: Recipients were selected through a structured preoperative evaluation, and hand transplantations were performed at the distal forearm level. Postoperatively, patients were treated with three-drug immunosuppressive regimen, and functional outcomes were monitored. Results: The hand transplantations were performed without intraoperative complications. All patients had partial skin necrosis and underwent additional surgical procedures in 2 months after transplantation. After additional operations, no further severe complications were observed. Also, patients developed acute rejection within 3 months of surgery, but all resolved within 2 weeks after steroid pulse therapy. Motor and sensory function improved dramatically, and patients were very satisfied with the appearance and function of their transplanted hands. Conclusion Hand transplantation is a viable reconstructive option, and patients have shown positive functional and psychological outcomes. Although this study has limitations, such as the small number of patients and short follow-up period, we should focus on continued recovery of hand function, and be careful not to develop side effects from immunosuppressive drugs. Through the present study, we will continue to strive for a bright future regarding hand transplantation in Korea.

Purpose: We aimed to investigate manifestations and patterns of care for patients with brain metastasis (BM) from breast cancer (BC) and compared their overall survival (OS) from 2005 through 2014 in Korea. Materials and Methods: We retrospectively reviewed 600 BC patients with BM diagnosed between 2005 and 2014. The median follow-up duration was 12.5 months. We categorized the patients into three groups according to the year when BM was initially diagnosed (group I [2005-2008], 98 patients; group II [2009-2011], 200 patients; and group III [2012-2014], 302 patients). Results: Over time, the median age at BM diagnosis increased by 2.2 years (group I, 49.0 years; group II, 48.3 years; and group III, 51.2 years; p=0.008). The percentage of patients with extracranial metastasis was 73.5%, 83.5%, and 86.4% for group I, II, and III, respectively (p=0.011). The time interval between BC and BM was prolonged in patients with stage III primary BC (median, 2.4 to 3 years; p=0.029). As an initial brain-directed treatment, whole-brain radiotherapy alone decreased from 80.0% in 2005 to 41.1% in 2014. Meanwhile, stereotactic radiosurgery or fractionated stereotactic radiotherapy alone increased from 13.3% to 34.7% during the same period (p=0.005). The median OS for group I, II, and III was 15.6, 17.9, and 15.0 months, respectively, with no statistical significance. Conclusion The manifestations of BM from BC and the pattern of care have changed from 2005 to 2014 in Korea. However, the OS has remained relatively unchanged over the 10 years.

BACKGROUND: Oxidation plays an important role in acute lung injury. This study was conducted in order to elucidate the effect of repetitive post-treatment of N-acetylcysteine (NAC) in lipopolysaccaride (LPS)-induced acute lung injury (ALI) of rats. METHODS: Six-week-old male Sprague-Dawley rats were divided into 4 groups. LPS (Escherichia coli 5 mg/kg) was administered intravenously via the tail vein. NAC (20 mg/kg) was injected intraperitoneally 3, 6, and 12 hours after LPS injection. Broncho-alveolar lavage fluid (BALF) and lung tissues were obtained to evaluate the ALI at 24 hours after LPS injection. The concentration of tumor necrosis factor alpha (TNF-alpha) and interleukin 1beta (IL-1beta) were measured in BALF. Nuclear factor kappaB (NF-kappaB), lipid peroxidation (LPO), and myeloperoxidase (MPO) were measured using lung tissues. Micro-computed tomography (micro-CT) images were examined in each group at 72 hours apart from the main experiments in order to observe the delayed effects of NAC. RESULTS: TNF-alpha and IL-1beta concentration in BALF were not different between LPS and NAC treatment groups. The concentration of LPO in NAC treatment group was significantly lower than that of LPS group (5.5+/-2.8 nmol/mL vs. 16.5+/-1.6 nmol/mL) (p=0.001). The activity of MPO in NAC treatment group was significantly lower than that of LPS group (6.4+/-1.8 unit/g vs. 11.2+/-6.3 unit/g, tissue) (p<0.048). The concentration of NF-kappaB in NAC treatment group was significantly lower than that of LPS group (0.3+/-0.1 ng/microL vs. 0.4+/-0.2 ng/microL) (p=0.0001). Micro-CT showed less extent of lung injury in NAC treatment than LPS group. CONCLUSION: After induction of ALI with lipopolysaccharide, the therapeutic administration of NAC partially attenuated the extent of ALI through the inhibition of NF-kappaB activation.
Acetylcysteine ; Acute Lung Injury ; Animals ; Antioxidants ; Humans ; Interleukin-1beta ; Lipid Peroxidation ; Lung ; Lung Injury ; Male ; NF-kappa B ; Peroxidase ; Rats ; Rats, Sprague-Dawley ; Therapeutic Irrigation ; Tumor Necrosis Factor-alpha ; Veins

BACKGROUND: Oxidation plays an important role in acute lung injury. This study was conducted in order to elucidate the effect of repetitive post-treatment of N-acetylcysteine (NAC) in lipopolysaccaride (LPS)-induced acute lung injury (ALI) of rats. METHODS: Six-week-old male Sprague-Dawley rats were divided into 4 groups. LPS (Escherichia coli 5 mg/kg) was administered intravenously via the tail vein. NAC (20 mg/kg) was injected intraperitoneally 3, 6, and 12 hours after LPS injection. Broncho-alveolar lavage fluid (BALF) and lung tissues were obtained to evaluate the ALI at 24 hours after LPS injection. The concentration of tumor necrosis factor alpha (TNF-alpha) and interleukin 1beta (IL-1beta) were measured in BALF. Nuclear factor kappaB (NF-kappaB), lipid peroxidation (LPO), and myeloperoxidase (MPO) were measured using lung tissues. Micro-computed tomography (micro-CT) images were examined in each group at 72 hours apart from the main experiments in order to observe the delayed effects of NAC. RESULTS: TNF-alpha and IL-1beta concentration in BALF were not different between LPS and NAC treatment groups. The concentration of LPO in NAC treatment group was significantly lower than that of LPS group (5.5+/-2.8 nmol/mL vs. 16.5+/-1.6 nmol/mL) (p=0.001). The activity of MPO in NAC treatment group was significantly lower than that of LPS group (6.4+/-1.8 unit/g vs. 11.2+/-6.3 unit/g, tissue) (p<0.048). The concentration of NF-kappaB in NAC treatment group was significantly lower than that of LPS group (0.3+/-0.1 ng/microL vs. 0.4+/-0.2 ng/microL) (p=0.0001). Micro-CT showed less extent of lung injury in NAC treatment than LPS group. CONCLUSION: After induction of ALI with lipopolysaccharide, the therapeutic administration of NAC partially attenuated the extent of ALI through the inhibition of NF-kappaB activation.
Acetylcysteine ; Acute Lung Injury ; Animals ; Antioxidants ; Humans ; Interleukin-1beta ; Lipid Peroxidation ; Lung ; Lung Injury ; Male ; NF-kappa B ; Peroxidase ; Rats ; Rats, Sprague-Dawley ; Therapeutic Irrigation ; Tumor Necrosis Factor-alpha ; Veins

OBJECTIVE: Sinapic acid (SA, Sinapine), small naturally occurring hydroxycinnamic acid, has a GABA(A) receptor agonistic property and free radical scavenging activity. We examined potential neuroprotective effects of sinapic acid (SA) using global cerebral ischemia animal model. METHODS: MTT assay was performed to determine cytotoxic effects of SA. To examine the neuroprotective effects of SA, SA was administrated for 14 d before 4-vessel occlusion. Also, to determine whether SA prevents cognitive impairment, Morris water maze was performed. RESULTS: In this study, the efficacy of SA for the prevention of neuronal damage and for the reduction of memory impairment was investigated. CONCLUSION: The results indicate that SA confers significant neuroprotection especially for ischemic hippocampal neurons.
Animals ; Brain Ischemia ; Coumaric Acids ; Glycosaminoglycans ; Hippocampus ; Ischemia ; Maze Learning ; Memory ; Neurons ; Neuroprotective Agents ; Rats ; Receptors, GABA-A

OBJECTIVES: Mental health and work efficiency are adversely affected by exposure to physical and chemical hazards in the workplace. This study is the first large scale evaluation of the relationship between physical and chemical hazard exposure in the workplace in relation to the mental health of Korean workers. METHODS: A national survey of a random sample of workers (n=10,043) was conducted between June and September 2006 in Korea. Physical and chemical hazards in the workplace were considered if exposure occurred over more than a quarter of the time spent at work. Mental health problems were defined as work-related depression, anxiety or insomnia. We analyzed whether physical and chemical hazards were independent risk factors for work-related mental health problems by multiple logistic regression analysis after adjusting for age, gender, employment type, education, occupation, duty schedule, work hours, smoking, and alcohol consumption. RESULTS: The mean age of surveyed workers was 42 years and 58% were male. A total of 7.8% of workers had work-related mental health problems. Exposure to high temperature, mist, fumes, dust, chemicals, and radiation were associated with an increased risk of work-related mental health problems. CONCLUSIONS: This study reaffirmed that physical and chemical hazard exposure in the workplace significantly elevates the risk of work-related mental health problems.
Anxiety ; Appointments and Schedules ; Depression ; Dust ; Employment ; Hot Temperature ; Humans ; Korea ; Logistic Models ; Male ; Mental Health ; Occupations ; Risk Factors ; Sleep Initiation and Maintenance Disorders ; Smoke ; Smoking ; Vibration

Small bowel metastasis of pleomorphic carcinoma of the lung is very rare. A 58-year-old man was admitted to our hospital with abdominal palpable mass in the right upper quadrant area. He underwent right middle and lower lobectomy for early stage pleomorphic carcinoma of the lung approximately 3 months ago. USG-guided biopsy was performed for abdominal mass. Pathologic examination revealed a metastatic pleomorphic carcinoma from the lung. He received chemotherapy followed by radiation therapy but died due to septic shock caused by intestinal stenosis and adhesion. We report the first case of small bowel metastasis by pleomorphic carcinoma of the lung after curative surgery.
Biopsy ; Constriction, Pathologic ; Humans ; Intestine, Small ; Lung ; Lung Neoplasms ; Middle Aged ; Neoplasm Metastasis ; Shock, Septic

Benign metastasizing pulmonary leiomyoma is a rare disease that is usually detected several years after hysterectomy or myomectomy. Recently, we experienced two cases, one with monthly chest pain and the other without symptoms, which were diagnosed with benign metastasizing leiomyoma in the lung. A 48-year-old woman who underwent hysterectomy 12 years earlier was referred to us because of multiple pulmonary nodules on chest radiography, and chest pain for 6 months. Thoracoscopic tumor excision was performed. Pathologically, she was diagnosed with benign metastasizing leiomyoma in the lung. After that, chest computed tomography showed tumors with a progressive reduction in size. The other 48-year-old woman, who had undergone myomectomy for uterine leiomyoma 8 years before, visited our hospital for evaluation of incidentally revealed bilateral multiple nodules on chest radiography. The microscopic finding of percutaneous transthoracic needle biopsy revealed a benign pulmonary metastasizing leiomyoma originating from uterine leiomyoma. Multiple nodules on chest radiography were more increased than those performed 1 year and 3 months prior to admission. However, chest X-ray showed tumors that had progressively decreased in size at 6 months after diagnosis of menopause.
Biopsy, Needle ; Chest Pain ; Female ; Humans ; Hysterectomy ; Leiomyoma ; Lung ; Menopause ; Middle Aged ; Multiple Pulmonary Nodules ; Rare Diseases ; Thorax

The JNK inhibitor SP600125 strongly inhibits cell proliferation in many human cancer cells by blocking cell-cycle progression and inducing apoptosis. Despite extensive study, the mechanism by which SP600125 inhibits mitosis-related effects in human leukemia cells remains unclear. We investigated the effects of SP600125 on the inhibition of cell proliferation and the cell cycle, and on microtubule dynamics in vivo and in vitro. Treatment of synchronized leukemia cells with varying concentrations of SP600125 results in significant G2/M cell cycle arrest with elevated p21 levels, phosphorylation of histone H3 within 24 h, and endoreduplication with elevated Cdk2 protein levels after 48 h. SP600125 also induces significant abnormal microtubule dynamics in vivo. High concentrations of SP600125 (200 microMeter) were required to disorganize microtubule polymerization in vitro. Additionally, SP600125-induced delayed apoptosis and cell death was accompanied by significant poly ADP-ribose polymerase (PARP) cleavage and caspase-3 activity in the late phase (at 72 h). Endoreduplication showed a greater increase in ectopic Bcl-2-expressing U937 cells at 72 h than in wild-type U937 cells without delayed apoptosis. These results indicate that Bcl-2 suppresses apoptosis and SP600125-induced G2/M arrest and endoreduplication. Therefore, we suggest that SP600125 induces mitotic arrest by inducing abnormal spindle microtubule dynamics.
Anthracenes/*therapeutic use ; Antineoplastic Agents/*therapeutic use ; Apoptosis/*drug effects ; Cell Cycle/drug effects ; Enzyme Inhibitors/therapeutic use ; Humans ; JNK Mitogen-Activated Protein Kinases/*antagonists & inhibitors/*metabolism ; Leukemia/drug therapy ; Tubulin/*metabolism

Congenital cystic adenomatoid malformation (CCAM), which is classified into five types according to size and bronchial invasion, is a rare type of developmental anomaly of the lung. CCAM is occasionally accompanied by malignancy, such as bronchioloalveolar carcinoma (BAC) or rhabdomyosarcoma. As defined by the WHO, atypical adenomatous hyperplasia (AAH) is a non-invasive spread of atypical epithelial cells in single rows along the alveolar wall, within a lesion that is usually less than 5 mm in diameter. AAH was also regarded as a pre-invasive neoplasia, especially associated with BAC and adenocarcinoma. We report a case of type II CCAM with AAH in adults, with a review of the references.
Adenocarcinoma ; Adenocarcinoma, Bronchiolo-Alveolar ; Adult ; Cystic Adenomatoid Malformation of Lung, Congenital ; Epithelial Cells ; Humans ; Hyperplasia ; Lung ; Rhabdomyosarcoma