Lung transplantation has been successfully employed for variety of obstructive lung disease. Single lung transplantation has become a therapeutic option for end-stage obstructive lung disease. The patient, a 57 year old man with emphysema, suffered from severe dyspnea, which progressively aggravated him for the last three years. A single lung transplantation was performed from a young brain-dead donor on April 7th, 1999 in the department of thoracic surgery, Respiratory Center, Yongdong Severance hospital, yonsei University. The immunosuppressive regimen was based on cyclosporine A and azathioprine from beginning, adding steroid. Single lung transplantation was feasible and beneficial in patients with end-stage emphysema.
Azathioprine ; Cyclosporine ; Dyspnea ; Emphysema ; Humans ; Lung Diseases, Obstructive ; Lung Transplantation* ; Lung* ; Middle Aged ; Pulmonary Emphysema* ; Respiratory Center ; Thoracic Surgery ; Tissue Donors

No abstract available.
Erythrocyte Membrane* ; Erythrocytes* ; Hydroxyl Radical* ; Lipid Peroxidation* ; Macrophages, Alveolar* ; Mineral Fibers*

No abstract available.
Angiofibroma*

OBJECTIVE: To evaluate the clinical efficacy of a new air cleaning device (LG Electronics, Korea) equipped with electrostatic precipitator (EP) and photocatalytic plasma filter (PCP) in 24 respiratory allergic subjects. MATERIAL AND METHOD: Air cleaning conditioner and air cleaner were placed in living room and bedroom. Both EP and PCP (EP/PCP) filters were used for the first 4 weeks and for another 4 weeks, PCP without EP filter (PCP) was used. We measured symptom scores of asthma and rhinitis, peak expiratory flow rate (PEFR), serum eosinophil cataionic prote in? in ECP, Dermatophagoides farinae (DF) specific IgE and IgG in sera, concentrations of major allergens of DF in floor dust of living room, bedroom and in airborne dust. RESULTS: Both asthma and rhinitis symptom scores were significantly improved not only with EP/PCP filters but also with PCP filter. The morning PEFR was significantly improved with EP/PCP filters, but not with PCP filter. Frequency of salbutamol inhalation by air cleaner with EP/PCP filter tended to de crease(p=0.051), with no significant difference in serum ECP concentration. DF specific IgE significantly decreased at the 8th week with no differences in specific IgG. However, the mean Der f I levels in floor dust of bedroom (1, 128 vs. 374 ng/gm dust, p<0.01) and living room (1,516 vs 812 ng/gm dust, p<0.01) decreased, Der f1 in airborne dust measured only in 8 out of 22 subjects, and they decreased significantly with the trial of EP/PCP filter (172.2 pg/4.5m vs. 62.1 pg/4.5m, p<0.01). CONCLUSION: These results suggest that the EP/PCP air cleaner may be an effective tool for environmental control in respiratory allergic subjects.
Albuterol ; Allergens ; Asthma ; Dermatophagoides farinae ; Dust ; Eosinophils ; Humans ; Immunoglobulin E ; Immunoglobulin G ; Inhalation ; Peak Expiratory Flow Rate ; Plasma* ; Rhinitis

Lung transplantation in the treatment of end-stage emphysema has been increasing in number since the recent rise in the 5 year survival rate. For the shortage of donor lungs, the single lung transplantation or transplantation in ABO compatible, nonidentical recipients has also been increasing. The lung transplantation in compatible, nonidentical recipients show good results as with identical recipients with the proper application of immunosuppressive agents. We transplanted the left lung of a 41 year-old male donor to a 35 year-old female recipient who had been suffering from severe dyspnea due to end-stage emphysema. For postoperative immunosuppression, we applied conventional triple immunotherapy(cyclosporine, azathioprine, prednisolone) and we could suppress the rejection response of transplanted lung by adding the anti-CD3 antibody(OKT3) during the operation. The patient could be discharged without any specific problem at 18th postoperative day.
Adult ; Azathioprine ; Dyspnea ; Emphysema ; Female ; Humans ; Immunosuppression ; Immunosuppressive Agents ; Lung Transplantation* ; Lung* ; Male ; Survival Rate ; Tissue Donors

BACKGROUND: Recently, the diagnosis of non-alcoholic fatty liver disease (NAFLD) has been made more frequently, as the use of ultrasonography on health screening has been on the rise. The aim of this study was to elucidate the relationship between NAFLD and the metabolic syndrome defined by NCEP-ATP III criteria. METHODS: A total of 1,675 subjects, who attended for routine physical check?ups, were screened. Among those, 401 subjects were selected after excluding the subjects with either significant alcohol consumption, evidence of viral or toxic hepatitis, significant liver or renal dysfunction, or overt thyroid disease. NAFLD was diagnosed if the subjects had a "bright liver" on ultrasonographic examination. The diagnosis of metabolic syndrome was made according to the criteria of NCEP-ATP III established in 2001. RESULTS: The prevalence of NAFLD was 27.2%. Blood pressure, body weight, body mass index, waist circumference, and serum levels of total cholesterol, triglyceride, fasting glucose and liver enzymes were higher among the subjects with NAFLD than the control. The prevalence of obesity, IFG/DM, dyslipidemia and hypertension was higher in the NAFLD group. The prevalence of the metabolic syndrome was 19.2%, which was higher in the NAFLD group than the control group. The odds ratio of NAFLD for the metabolic syndrome was 6.458 (95% C.I. 3.178~13.124). CONCLUSION: NAFLD was closely associated with the metabolic syndrome regardless of the presence of obesity.
Alcohol Drinking ; Blood Pressure ; Body Mass Index ; Body Weight ; Cholesterol ; Diagnosis ; Drug-Induced Liver Injury ; Dyslipidemias ; Fasting ; Fatty Liver* ; Glucose ; Hypertension ; Liver ; Mass Screening ; Obesity ; Odds Ratio ; Prevalence ; Thyroid Diseases ; Triglycerides ; Ultrasonography ; Waist Circumference

PURPOSE: To decide diagnostic titer in a single determination of antibody by indirect particle agglutination test and to characterize the occurrence of Mycoplasma pneumoniae during a 9 year-period in Seoul. METHODS: M. pneumoniae pneumonia diagnosed serologically at the Seoul National University Children's Hospital from 1986 to 1995 were reviewed, retrospectively. Antimycoplasma antibody was measured by indirect particle agglutination test. Diagnosis was based on 4 fold-rise or single high titer. Single diagnostic titer was set up by the value greater than the 90th percentile of the titer at one year of the children who initially had 4 fold-rise or > or =160. RESULTS: The geometric mean titer and the 90th percentile at 1 year of the 15 children who initially had antibody titer > or =160 or 4 fold-rise were 122 and 639, respectively, and single diagnostic titer was established as > or =640. A total of 126 childern were included by our diagnostic criteria. Male and female ratio was 1.17:1 and the mean age was 6 years 4 months. Pneumonia by M. pneumonuae occurred every years during the study period showing increased cases every 3 years. In the epidemic years, the cases occurred in late spring, summer and early fall. CONCLUSIONS: It is concluded that the occurrence of Mycoplasma pneumoniae pneumonia in Seoul from 1986 to 1995 was characterized by epidemics every 3 years as well as its endemicity.
Agglutination Tests ; Child ; Diagnosis ; Epidemiology ; Female ; Humans ; Korea* ; Male ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pneumonia* ; Pneumonia, Mycoplasma* ; Retrospective Studies ; Seoul*

Resectional surgery of sympathetic nerves has been known to be the most effective treatment for essential hyperhidrosis and the application of thoracoscopic electrocauterization has provided a minimally-invasive procedure with the least morbidity and a resultant higher satisfaction rate. This paper describes our experience on the 1,167 cases of thoracoscopic sympathetic surgery for the treatment of essential hyperhidrosis. A total of 1,167 patients (674 males (58%) and 493 females (42%), mean age of 26.4 years with palmar (930), craniofacial (190) or axillary (47) hyperhidrosis underwent thoracoscopic sympathetic surgery from July 1992 to March 1999. Since the T2-4 sympathectomy, first performed in July 1992 for a patient of palmar hyperhidrosis, the operative methods have been altered to achieve a higher satisfaction level with the least complication by adopting less invasive procedures. Our current standard procedures being performed are T3 and T2 clipping for palmar and craniofacial hyperhidrosis and T3,4 sympathicotomy for axillary hyperhidrosis, all using a 2 mm needle thoracoscope. As the surgical procedures have been transited to a less invasive method with limited resection using the newest endoscopic devices, the average operation time and complications such as Horner's syndrome and compensatory hyperhidrosis have gradually decreased and thus the long-term satisfaction rate has been raised up to 98% for palmar hyperhidrosis, 92% for craniofacial hyperhidrosis and 89% for axillary hyperhidrosis. The recurrent cases (14/1167) were treated successfully with reoperations of thoracoscopic sympathetic surgery. The optimal goal of therapy could be achieved by complete elimination of the hyperhidrotic symptom, by decreasing the incidence and degree of compensatory hyperhidrosis through a selective and limited resection, and by adopting the least invasive procedures. Sympathicotomy has provided the advantages of a limited extent of denervation and the resultant decrease of compensatory hyperhidrosis compared to sympathectomy. The reversible method of clipping may be an effective, provisionary means for cases of severe, intractable compensatory sweating. For craniofacial hyperhidrosis, T2 sympathicotomy or clipping has been proven to be superior to the T1 sympathectomy due to the decreased occurrence of Horner's syndrome and T3,4 sympathicotomy providing a satisfactory outcome with less compensatory hyperhidrosis for axillary hyperhidrosis.
Adolescence ; Adult ; Aged ; Child ; Female ; Human ; Hyperhidrosis/surgery* ; Male ; Middle Age ; Sympathectomy* ; Thoracoscopy*

PURPOSE: Assessment of the diameters of the aortic arches in the human fetus may be helpful in the prenatal diagnosis of aortic arch anomalies. The purpose of this study is to construct valuable reference ranges of fetal aortic arch for various fetal growth parameters in an unselected Korean population. METHODS: A prospective, cross-sectional study was performed in 98 normal singleton fetuses between 20 and 38 weeks of gestation. The transverse aortic arch diameter (TAD) and distal aorta isthmus diameter (AID) were measured in the longitudinal view during systole. The bi-parietal diameter (BPD), head circumference (HC), abdominal circumference (AC) and femur length (FL) were obtained at the same time. Ultrasound examinations were performed with a 2.0-6.0 MHz convex probe by abdominal ultrasound. RESULTS: TAD and AID as a function of gestational age (GA) was expressed by the regression equation TAD= -1.246+0.168 X GA, and AID = -1.341+0.180 X GA; TAD and AID are expressed in millimeters and GA in weeks. TAD and AID as a function of BPD was expressed by the regression equation TAD= -1.147+0.664 X BPD, and AID = -1.152+0.696 X BPD. TAD and AID as a function of HC was expressed by the regression equation TAD = -1.187+0.182 X HC, and AID = -1.350+0.198 X HC. TAD and AID as a function of AC was expressed by the regression equation TAD = -0.528+0.173 X AC, and AID = -0.533+0.183 X AC. TAD and AID as a function of FL was expressed by the regression equation TAD = -0.519+0.799 X FL, and AID = -0.601+0.860 X FL; BPD, HC, AC and FL are expressed in centimeters. Correlations were found to be highly statistically significant in relation to GA, BPD, HC, AC, and FL respectively (P<0.0001 in all). Normal mean of TAD and AID per GA, BPD, HC, AC and FL and 95% prediction limits were also defined, respectively. CONCLUSION: New reference ranges of fetal aortic arch related to other fetal bio-parameters representing fetal growth were obtained successfully. The normative date will be helpful in the prenatal accurate diagnosis of aortic anomalies and abnormal growth of fetal aortic arches in Korea.
Aorta ; Aorta, Thoracic ; Cross-Sectional Studies ; Echocardiography ; Femur ; Fetal Development ; Fetus ; Gestational Age ; Head ; Humans ; Korea ; Pregnancy ; Prenatal Diagnosis ; Prospective Studies ; Reference Values ; Systole

Curative hepatectomy is the most important prognostic factor for hepatic cancer, but also has a high rate of morbidity and mortality. Liver failure due to insufficient liver volume is the main cause of postoperative mortality. Preoperative portal vein embolization can induce hypertrophy of the remnant liver, and a two-stage hepatectomy, with or without portal vein embolization, could be used to treat patients with unresectable liver tumors. We report the case of a successful two-staged hepatectomy for bilateral hepatocellular carcinoma with tumor thrombi.
Bile ; Bile Ducts ; Carcinoma, Hepatocellular ; Hepatectomy ; Humans ; Hypertrophy ; Liver ; Liver Failure ; Liver Neoplasms ; Portal Vein