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

The purpose of this study was to develop pneumococcal typing by multiplex PCR and compare it with conventional serotyping by quellung reaction. Pneumococcal strains used in this study included 77 isolates from clinical specimens collected from children at Seoul National University Children's Hospital from 2006 to 2010. These strains were selected as they represented 26 different serotypes previously determined by quellung reaction. Molecular type was determined by 8 sequential multiplex PCR assays. Bacterial DNA extracted from cultured colonies was used as a template for PCR, and primers used in this study were based on cps operon sequences. Types 6A, 6B, 6C, and 6D were assigned based on the presence of wciNbeta and/or wciP genes in 2 simplex PCRs and sequencing. All 77 isolates were successfully typed by multiplex PCR assays. Determined types were as follows: 1, 3, 4, 5, 6A, 6B, 6C, 6D, 7C, 7F, 9V, 10A, 11A, 12F, 13, 14, 15A, 15B/15C, 19A, 19F, 20, 22F, 23A, 23F, 34, 35B, and 37. The results according to the PCR assays were in complete concordance with those determined by conventional quellung reaction. The multiplex PCR assay is highly reliable and potentially reduces reliance upon conventional serotyping.
Child ; DNA Primers/chemistry/metabolism ; DNA, Bacterial/chemistry/genetics ; Humans ; Multiplex Polymerase Chain Reaction ; Pneumococcal Infections/microbiology ; Serotyping ; Streptococcus pneumoniae/*classification/genetics/isolation & purification

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

BACKGROUND: We studied the quality of life (QOL) of patients with restless legs syndrome (RLS) and compared it to that of normal controls and patients with hypertension or diabetes in Korea. METHODS: We developed a Korean version of the Johns Hopkins RLS QOL questionnaire by translating this into Korean and then back into English to check its accuracy. In total, 250 RLS patients were included in this study. The scores of RLS patients were compared with those of 215 normal controls, 196 patients with hypertension, and 185 diabetics. All subjects completed the questionnaires, including the Korean versions of the Short Form 36, Johns Hopkins RLS QOL, Pittsburgh Sleep Quality Index, and the Beck Depression Inventory. The associations between the severity of RLS and the QOL scores were examined using Pearson correlations. RESULTS: The QOL scores were lower in subjects with RLS than in the normal controls and the patients with hypertension or diabetes. More severe RLS symptoms were associated with a lower QOL score. Correlation analysis revealed a significant negative correlation between the severity of RLS symptoms and QOL score (r=-0.702, p<0.001). However, neither the gender of the RLS subjects nor the age at symptom onset (early or late onset) affected the QOL score. The factors most related to QOL score in RLS patients were depression and sleep quality. CONCLUSIONS: We found that Koreans with RLS have a considerably diminished QOL, with this being worse than in Korean subjects with diabetes or hypertension. These findings are comparable with studies conducted in Western countries.
Chronic Disease ; Depression ; Humans ; Hypertension ; Korea ; Quality of Life ; Surveys and Questionnaires ; Restless Legs Syndrome ; Sleep Wake Disorders ; Translating