BACKGROUND: Diastolic dysfuction can be assessed by Doppler echocardiography of mitral inflow. Multiple factors including atrioventricular (AV) delay affect the mitral inflow Doppler indexes. This study was designed to assess the changes of mitral inflow patterns after successful radiofrequency catheter ablation (RFCA) of accessory pathway associated with a short AV interval during pre-excitation in patients with WPW syndrome. METHOD: Echocardiogram, ECG and BP were recorded before and after RFCA for treatment of accessory pathway in 15 patients with WPW syndrome (mean age : 39.7+/-14.6). Doppler indexes including E wave velocity and its velocity time integral (EVTI) ,A wave velocity and its VTI (AVTI), deceleration time (DT), isovolumic relaxation time (IVRT), atrial filling fraction (AFF)and total mitral inflow VTI were measured. RESULTS: 1) PR interval prolonged 94+/-18msec to 174+/-34msec (p<0.001) without significant increment of heart rate and blood pressure after successful RFCA. 2) E/A ratio decreased from 1.29+/-0.58 to 1.1+/-0.53 (<0.001) but E wave velocity, DT and IVRT were not changed significantly after RFCA. 3) A wave velocity and AFF was 55.8+/-17.4msec and 0.35+/-0.08 and increased to 61.8+/-19.9msec and 0.42+/-0.1, respectively after RFCA (p<0.05). 4) Total mitral inflow VTI was 13.6+/-3.5cm and 14.9+/-3.6cm before and after RFCA, respectively (p<0.05) CONCLUSION: These results suggested that normalization of the PR interval after RFCA in patients with WPW syndrome had beneficial hemodynamic effects on the stroke volume by changing mitral inflow Doppler indexes. Therefore, the effect of AV delay is an another parameter to consider when evaluating Doppler indexes of LV filling.
Blood Pressure ; Catheter Ablation ; Deceleration ; Echocardiography, Doppler ; Electrocardiography ; Heart Rate ; Hemodynamics ; Humans ; Relaxation ; Stroke Volume ; Wolff-Parkinson-White Syndrome*

BACKGROUND: The objective responses of cisplatin and etoposide (PVP) combination chemotherapy as second-line therapy following CAV was high (40~50%) and, in several reports, PVP yields survival results that are at least as good as those obtained with cyclophosphamide or doxorubicin-based regimens and with less host-related toxicity in chemotherapy-naive patients. We conducted a phase II study to evaluate the effect of a combination of cisplatin and etoposide as a first-line therapy in patients with small cell lung cancer. METHODS: Sixty-one previously untreated small cell lung cancer patients with measurable lesion(s) received cisplatin(30 mg/m2 IV, day 1~3) and etoposide(100 mg/m2 IV, day 1~3). In patients with limited disease, after completion of 6 cycles of PVP chemotherapy, chest and prophylatic brain irradiation was performed in case of complete responder, chest irradiation only in partial responder. RESULTS: 1) Of 55 evaluable patients, 13(24%) had a complete response and 29(53%) had a partial response. 2) The median survival time was 55.8 weeks for all patients(N=55), 61.1 weeks for limited disease(N=31), 51.3 weeks for extensive disease(N=24). 3) The response duration was 29.1 weeks for responders(N=42). 4) There was no significant prognostic factors iufluencing response rates. 5) The toxicity was tolerable and there was no treatment-related deaths. CONCLUSION: The PVP combination chemotherapy as a first-line therapy was effective and well-tolerated in patients with small cell lung cancer.
Brain ; Cisplatin* ; Cyclophosphamide ; Drug Therapy ; Drug Therapy, Combination* ; Etoposide* ; Humans ; Small Cell Lung Carcinoma* ; Thorax

PURPOSE: The aim of this study was to examine the volume differences of human brain 3-D MR images obtained by automatic segmentation methods depending on brain templates and image acquisition conditions, respectively. MATERIALS AND METHODS: 3D T1-weighted MR images oriented in coronal and sagittal plane were acquired from eight healthy subjects (29.5+/-5.66 years) using two identical 3T MR scanners at different sites. Caucasian brain template and Korean elderly brain template were applied for the same subject to segment brain structural region. Volumetric differences and variation of gray matter, white matter and hippocampus depending on scan orientations and brain template types were statistically evaluated. RESULTS: Volumetric measurements have some different results for the same subject images depending on scan orientation in identical MR scanners but not significantly. However, all segmented volumes relied upon brain templates were significantly different (p<0.05). Small variation of the volume in gray matter, white matter (coefficient of variation, CV< or =1%) and hippocampus (CV< or =3%) were obtained. Comparing the mean CV in all segmented regions, variation of scan orientation was not significantly different with inter scanner variation but variation relied upon brain templates were significantly different (p<0.001). CONCLUSION: Authors found that brain template regarding the specific properties of the subjects is required to reduce the errors of brain volumetry.
Aged ; Brain ; Hippocampus ; Humans ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Magnetics ; Magnets ; Orientation

BACKGROUND: Familial aggregation of the phenotypes can be caused by common environmental and genetic factors, but there has been no family study on familial aggregation of the bronchial asthma, and genetic role of atopy and bronchial responsiveness in the development of asthma in Korean families. OBJECTIVE: We did family study to evaluate the familial aggregation of bronchial asthma, and the genetic role of atopy and bronchial responsiveness in the development of asthma. MATERIALS AND METHODS: Questionnaire, serum total IgE level, skin prick test with 10 common aeroallergens, and bronchial responsiveness to methacholine were performed in 154 parents of atopic asthmatics, 72 parents of atopic control, and 65 parents of non-atopic control. RESULTS: Bronchial asthma was more prevalent in parents of atopic asthmatics(7.1% ) than in parents of non-atopic control(0% ). Geometric mean of serum total IgE level was not different among parents of atopic asthmatics, atopic control, and non-atopic control(2.03+0.06, 2.10 +0.07, and 1.89 +0.09 IU/ml). Positive rates of skin prick test to 10 common aeroallergens were more prevalent in parents of atopic asthmatics(43.0% ) and atopic control(43.0% ) than in parents of non-atopic control(27.8%). Prevalence of bronchial hyperresponsiveness to methacholine was more prevalent in parents of atopic asthmatics(17.0% ) than in parents of atopic control(7.2%) and non-atopic control(1.5%), and slope of dose-response curve was more increased in parents of atopic asthmatics(11.0+ 1.5) than in parents of atopic control and non-atopic control(4.8+ 0.7 and 3.0+ 0.5). CONCLUSION: Bronchial asthma runs in Korean families, and genetic role of atopy and bronchial responsiveness may be important in the development of asthma.
Asthma* ; Humans ; Immunoglobulin E ; Methacholine Chloride ; Parents ; Phenotype ; Prevalence ; Skin ; Surveys and Questionnaires

BACKGROUND: It is known that HLA molecule can restrict specific IgE responses, but few studies have documented the association between HLA and sensitization to house dust mite(HDM). OBJECTIVE: To evaluate whether a specific HLA type can be a risk or protective factor for the development of HDM sensitivity. METHOD: Total 146 subjects were genotyped for HLA-DRB1 using PCR-SSP technique and HDM sensitivity, determined by skin prick test using two mite allergens, D. pteronyssinus (Dp) and D. farinae (Df). Subjects were grouped according to Dp or Df sensitivity and linkage analysis between HDM sensitivity and HLA-DRB1 genotype was performed. RESULTS: The data revealed higher allele frequencies of DRB1*07 in Dp or Df sensitive groups compared to insensitive groups (11.6% vs. 2.6% in Dp, 11.5% vs. 3.3% in Df group, p<0.05), but the other allele frequencies showed no difference. CONCLUSION: There was a significant association between HLA-DRB1*07 genotype and HDM sensitization. These results indicate that antigen presentation by HLA class II molecule restricts the development of specific IgE response to HDM.
Allergens ; Antigen Presentation ; Dust* ; Gene Frequency ; Genotype* ; HLA-DRB1 Chains* ; Immunoglobulin E ; Mites ; Pyroglyphidae* ; Skin

Purpose: This study aimed to compare the intraoperative and postoperative outcomes between robotic and laparoscopic transperitoneal adrenalectomies. Methods: In this retrospective study, 93 patients underwent adrenalectomy using 2 surgical modalities: 45 patients underwent adrenalectomy using the da Vinci Xi system (robotic group), and 48 patients using laparoscopic devices (laparoscopic group). We compared the operation time, intraoperative bleeding, and hospital stay according to the surgical modality and tumor characteristics. Results: There were no significant differences in the operative time (P = 0.827), hospital stay (P = 0.177), and intraoperative bleeding (P = 0.174) between the groups. However, the robotic group showed a lower coefficient of variation in total operative time than that of the laparoscopic group (100.6 ± 23.3 minutes vs. 101.9±32.7 minutes, 0.230 vs. 0.321). When divided into 2 subgroups based on the tumor size (<3 cm and ≥3 cm), the robotic group with a tumor sized >3 cm had a shorter operative time than that of the laparoscopic group (P = 0.032). The robotic group also had fewer cases of intraoperative bleeding (P = 0.034). Conclusions Compared to the laparoscopic transperitoneal adrenalectomy, the robotic one achieved a lower deviation in total operative time and showed less bleeding and a shorter operative time, especially for tumors sized >3 cm.

PURPOSE: During the past decade, various endoscopic thyroid surgeries have been conducted, each with its own benefits. The incorporation of robotic systems to endoscopic thyroid surgery has improved the visualization and precision of endoscopic techniques. We previously reported our initial experience with robotic modified radical neck dissection (MRND) of papillary thyroid carcinoma (PTC) with lateral neck node metastasis (LNM). The aim of this study was to compare surgical outcomes of robotic vs. conventional open MRND of PTC with LNM using propensity score matching. METHODS: From January 2008 to February 2011, 515 patients with PTC with LNM were enrolled. One hundred patients underwent robotic MRND, and 415 patients underwent conventional open MRND. These two groups were retrospectively compared with respect to their clinicopathological characteristics, surgical outcomes, and surgical completeness. Furthermore, to avoid selection bias, propensity score matching analysis was used to compare surgical outcomes of each group without any compounding factors. RESULTS: The operative time for the robotic MRND was longer than for the open MRND (297.9±60.2 min vs. 212.1±55.6 min, P=0.089). However, the mean numbers of retrieved lymph nodes and mean hospital stay after surgery were similar in the two groups (36.0±12.9 vs. 40.8±13.3, P=0.235), (6.1±1.6 days vs. 6.1±2.1 days, P=0.577). The complication rates were similar between the two groups, and there was no statistical difference in postoperative thyroglobulin levels between groups (0.51±0.83 ng/ml vs. 0.89±2.46 ng/ml, P=0.593). CONCLUSION: According to our study, robotic MRND shows similar surgical outcomes to conventional open MRND after case-matched analyses. We suggest that robotic MRND is an acceptable alternative as an operative method for PTC with LNM, resulting in excellent cosmesis and patient satisfaction.
Humans ; Length of Stay ; Lymph Nodes ; Methods ; Neck Dissection ; Neck* ; Neoplasm Metastasis* ; Operative Time ; Patient Satisfaction ; Propensity Score* ; Retrospective Studies ; Selection Bias ; Thyroglobulin ; Thyroid Gland* ; Thyroid Neoplasms*

PURPOSE: We attempt to heal the defect of meniscus using fibrin glue and allogenic meniscal cells in rabbit. MATERIALS AND METHODS: Meniscal cells were isolated from medial meniscus of knee joint of rabbit and cultured and expanded in vitro. The mixture of fibrin glue and meniscal cells implanted to the defect of rabbit meniscus. Examination of gross morphology, histological and immunohistochemical staining of retrieved specimens were performed at 3 and 6 weeks. RESULTS: Cultured cells uniformly displayed an elongated, fibroblastic and fibrocartilagenous morphology. The histological and immunohistochemical analysis revealed regeneration of meniscal tissue at the defect site. CONCLUSION: Meniscal cell transplantation with fibrin glue resulted in the regeneration of meniscus tissue successfully in rabbit model. This approach could be applied for treatment of meniscus injury.
Cell Transplantation ; Cells, Cultured ; Fibrin Tissue Adhesive* ; Fibrin* ; Fibroblasts ; Knee Joint ; Menisci, Tibial ; Regeneration ; Transplants

BACKGROUND: Bronchoconstriction associated with aerosolized agents delivered by a metered dose inhaler (MDI) is relatively uncommon, but has been of particular interest. MATERIAL AND METHOD: In this study, we investigated to what extent the inert ingredients and propellants (freons) influence pulmonary function in 25 asthmatic patients. Forced expiratory volume in one second(FEV,) was measured by spirometry, Autospira HI 498(Chest, Japan) before and 1, 3, 5 and 10 minutes after the inhalation of saline control and MDI-placebo containing freons and inert ingredients. RESULT: Twenty four % (6/25) of asthmatics experienced a decrease in FEV20 by 10% or greater when compared to saline control. Number of positive cases in steroid dependent asthmatics is significantly higher compared to non-steroid dependent asthmatics. (p<0.05) Bronchoconstriction associated with the use of MDI-placebo appeared within 3 to 5 minutes and resolved spontaneouly at 10 minutes after the inhalation. CONCLUSION: The bronchoconstrictive response induced by MDI might be caused by the pro-pellants and/or the other inert ingredients contained in MDIs.
Bronchoconstriction ; Chlorofluorocarbons ; Forced Expiratory Volume ; Humans ; Inhalation ; Metered Dose Inhalers ; Spirometry

BACKGROUND: Exercise can aggravate asthmatic symptoms in many patients with bronchial asthma. It is caused by that inhaled air bypasses nasal cavity and goes directly to the lower airways through open mouth dring exercise. Although the pathogenetic mechanisms of exercise-induced asthma(EIA) have not been clarified yet, there is evidence that chemical mediators, released from the inflammatory cells triggered by airway cooling or drying, might be responsible for induction of bronchoconstriction. However, it has been controversial which chemical mediators or cells are involved in such process. Objectiye . The aim of this study was to evaluate the role of activated mast cells in the pathogenesis of EIA and find out whether or not sulfidopeptide leukotrienes (LTC4/d4/E4) are involved in the exercise-induced bronchoconstriction. MATERIAL AND METHOD: Eleven asthmatics with documented exercise-induced bronchoconstriction and 10 control subjects were studied. Before and 6 hours after free running for 6 minutes, forced expiratory volume in 1 second (FEV,) and the concentrations of N- methylhistamine, LTE4, and creatinine in unine collected for 6 hours after exercise were determined. RESULT: Urinary concentrations of N-methylhistamine(mean+SE, ng/mg creatinine) of EIA patients before and after exercise were 159+40 and 450+75, respectively. Those of control subjects were 208+ 54 and 275+ 62, respectively. Uninary N-methylhistamine levels of EIA group increased significantly after exercise, while those of control group did not change. Urinary concentrations of LTE,(mean+SE, pg/mg creatinine) of EIA patients before and after exercise were 15.6 k2.6 and 22.2+5.8, respectively. Those of control subjects were 10.4+ 4.0, 18.2 +7.0, respectively. The concentrations of LTE4 in the urine samples collected before exerise revealed no difference between EIA and control subjects (p=0.07). There was no change after exercise in both groups. Percent fall of FEV, was 29.1+8.0% (mean+SD) in EIA group and 3.4 + 4.0% in control group, respectively. There was no correlation between reduction of FEV, and change in urinary concentrations of N-methyl-histmine after exercise. CONCLUSTION: Chemical mediators of activated mast cells may be involved in exercise-induced bronchoconstriction, but there is little evidence for enhanced sulfidopeptide leukotriene generation as assessed by urinary LTE4.
Asthma ; Asthma, Exercise-Induced* ; Bronchoconstriction ; Creatinine ; Forced Expiratory Volume ; Humans ; Leukotriene E4 ; Leukotrienes ; Mast Cells ; Mouth ; Nasal Cavity ; Running