• Journal of Chest Surgery
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• v.34 no.12
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• pp.956-959
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• 2001

The Iymphoproliferative disease after the organ transplantation is more commonly seen with the increase according to the increasing number of the organ transplantations and it occurs more frequently in the cases of heart and lung transplantations that needs more aggressive immunosuppression. It demands urgent evaluation and management because of poor prognosis. We transplanted left lung of a man to the woman who suffered from severe dyspnea due to terminal pulmonary emphysema in discrepancy of ABO blood type. Postoperatively, We used triple regimen immunotherapy(cyclosporin, azathioprine, prednisolone) and followed up in the out patient clinic. During the follow up, we found abnormal mass lesion on the transplanted lung and performed gun biopsy. We confirmed malignant lymphoma on the pathollgic examination and two cycled chemotherapy was given after reducing dose of immunosupression. The patient died of sudden onset of pulmonary edema of the transplanted lung.

• Tuberculosis and Respiratory Diseases
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• v.46 no.4
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• pp.533-541
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• 1999

Background: Lung cancer in younger patients seems to be a more aggressive disease and their prognosis may be worse than that of older patients. Abnormal p53 expression in primary lung cancer may be an independent prognostic factor for poor prognosis. This study was conducted to determine the difference of abnormal p53 mutation in patients with primary non-small cell lung cancer (NSCLC) under 45 years of age and 55 years old or greater. Method: The present study was performed to compare the clinical and pathological features of primary NSCLC between patients younger than 45 years old and older than 55 years old and to evaluate the difference of abnormal p53 mutation between two groups. Immunohistochemical detection of abnormal p53 mutation was assessed in all primary NSCLC specimens by pathologist. Results: Positive nuclear staining of p53 mutation was found in 76.0% of younger patients and in 76.9% of older patients with variable intensity of staining. And there was no significant correlation between abnormal p53 mutation according to the disease stage or histologic subtype. Conclusion: In this investigation, these were no difference in p53 mutation between two groups.

• Investigative Magnetic Resonance Imaging
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• v.14 no.1
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• pp.64-68
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• 2010

Brain aspergillosis has been increasing remarkably. They are known to occur commonly in immunocompromised individuals by hematogenous spread from other primary sites or by direct extension from adjacent structures to central nervous system. We report a rare case of a 29-year-old male without any known medical history, who had isolated brain lesion and the pathology from stereotactic biopsy confirmed cerebral aspergillosis.

• Clinical and Experimental Pediatrics
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• v.49 no.5
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• pp.533-538
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• 2006

Purpose : The headache, one of the symptoms of meningitis, is related to abrupt elevation of intracranial pressure(ICP) or stimulation of intracranial nociceptive structure. However, in cases of mild elevation of ICP or normal findings of cerebrospinal fluid(CSF) analysis, patients sometimes complain of headaches. Therefore, other pathways may contribute to the occurrence of headaches in aseptic meningitis or meningismus. We intend to investigate the role of substance P(SP) and calcitonin gene-related peptide(CGRP) in aseptic meningitis or meningismus. Methods : We measured leukocyte count, the concentration of protein and glucose in CSF and ICP of patients with meningeal irritation sign. We also measured SP and CGRP levels by using immunoassay. We analyzed the relationship between the presence of headache and the value of SP and CGRP. Results : The concentrations of CGRP($18.8{\pm}10.5ng/mL$) in CSF and ICP($14.8{\pm}4.5cmH_2O$) in aseptic meningitis group were significantly higher than in those($14.1{\pm}7.4ng/mL$ and $12.0{\pm}5.1cmH_2O$, respectively) of the meningismus group(P<0.05). There was no significant difference in the SP levels between the two groups. In the aseptic meningitis group, the concentrations of SP and CGRP were significantly higher in the normal ICP group than in the elevated ICP group(P<0.05). Conclusion : Headaches in children with aseptic meningitis or meningismus is considered to be related to the elevation of the CSF levels of SP and CGRP.

• Clinical and Experimental Pediatrics
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• v.48 no.3
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• pp.292-297
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• 2005

Purpose : It is known that 3-50 percent of type 1 diabetes mellitus(T1DM) patients develop autoimmune thyroid disease. We analyzed the clinical characteristics of autoimmune thyroid disease(AITD) developed in patients with T1DM in Korean. Methods : The medical records of 139 patients, who were followed up in Department of Pediatrics, Seoul National University Children's Hospital from Jan. 1981 to Jul. 2004, were analyzed retrospectively. Results : Forty-four males and 95 females were enrolled. At least one of the autoantibodies for thyroid was positive in 54 cases. The detection rate for AITD was not correlated with sex ratio, control of T1DM, body mass index, age at diagnosis of T1DM, and familial history of thyroid disease, between two groups. In the male group, AITD was more frequently found at a younger age than in the female group. The frequency of AITD was significantly higher in the goiter group without sex differences. In the thyroid disease group, 40 patients(74.0 percent) were euthyroid, seven patients(12.9 percent) were hypothyroid, and seven patients(12.9 percent) were hyperthyroid. Conclusion : We should monitor thyroid function and autoantibodies routinely in T1DM patients who develop goiters, or young boys with T1DM.

• Tuberculosis and Respiratory Diseases
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• v.66 no.3
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• pp.220-224
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• 2009

Coccidioidomycosis is a fungal infection caused by the soil fungus, Coccidioides immitis, which is endemic to the south-western United States. However, the incidence of coccidioidomycosis has recently increased due to the increase in overseas travel to endemic areas. We report a case of pulmonary coccidioidomycosis diagnosed in an immunocompetent person. A 28-year-old female, who had lived in Phoenix, Arizona, USA for 2 years, was admitted for an evaluation of persistent cough with fever lasting for 2 weeks. The chest X-ray and Chest CT revealed multifocal patchy consolidation and ground-glass opacity in both lungs as well as multiple enlarged right hilar and paratracheal lymph nodes. A percutaneous needLe biopsy of the main mass-like consolidation confirmed mature spherules of Coccidioides immitis in lung tissue. Pulmonary coccidioidomycosis should be considered in patients presenting with persistent cough with fever and a history of travel to or immigration from an endemic area.

• Tuberculosis and Respiratory Diseases
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• v.47 no.2
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• pp.195-208
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• 1999

Background: Pulmonary infiltrate in immunocompromised hosts has many infectious and non-infectios etiologies. To evaluate the diagnostic yield and therapeutic implication of two invasive diagnostic methods, such as bronchoscopy and surgical lung biopsy, we performed retrospective analysis of these patients. Methods: All immunocompromised patients admitted to Samsung Medical Center from October 1995 to August 1998 who underwent bronchoscopy and/or surgical lung biopsy for the diagnosis of pulmonary infiltrates were included in this study. Confirmative diagnostic yield, the rate of changed therapeutic plan and patients' survival were investigated. Results: Seventy-five episodes of pulmonary infiltrates developed in 70 patients(M : F=46 : 24, median age 51). Underlying diseases of patients were hematologic malignancy(n=30), organ transplantation(n=11), solid tumor(n= 12), connective tissue disease(n=6) and others. Confirmative diagnosis was made in total 53 cases (70.7%), of which 70.2% had infectious etiology. Diagnostic yields of bronchoscopy, bronchoalveolar lavage(BAL), transbronchiallung biopsy(TBLB) and surgical lung biopsy were 35.0%(21/60), 31.4%(16/51), 25.0%(9/36) and 80.0%(20/25). Therapeutic plan was changed in 40%(24/60) of patients after bronchoscopy and in 36%(9/25) of patients after surgical lung biopsy. More patients survived (84.4% vs 60.5%, p=0.024) when therapeutic plan was changed after invasive diagnostic study. Conclusion: Bronchoscopy and surgical lung biopsy are helpful for the therapeutic implication of pulmonary infiltrates in immunocompromised hosts. Large-scale prospective case-control study may further clarify their limitation and usefulness.

• Journal of Acupuncture Research
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• v.21 no.2
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• pp.89-101
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• 2004

홍채학은 대체의학의 한 분야로서 홍채 침착의 불규칙성을 주시함으로써 의학적 상태를 진단한다. 홍채학적 분류에 의한 체질은 가족력을 보이고 있으며 이는 홍채체질의 유전성을 의미한다. 강력한 면역조절자이며 전 염증성 사이토카인인 종양괴사인자(tumor necrosis factor-a, TNF-${\alpha}$)는 많은 병리적 과정에서 중요한 역할을 한다. 따라서 본 연구자는 고혈압환자에서 홍채체질과 TNF-${\alpha}$ 유전자 다형성과의 관련성을 조사하였다. 87명의 고혈압 환자와 79명의 정상인을 홍채체질에 따라 분류하였으며 이들의 TNF-${\alpha}$ 유전자형을 분석하였다. 결과적으로 정상인에 비하여 TNF-${\alpha}$ GA 이형접합체의 빈도가 고혈압 환자군에서 감소하였다. 이 같은 결과는 TNF-${\alpha}$ 다형성이 고혈압에 대한 저항성과 관련 있음을 의미한다. 또한 고혈압환자에서 콜레스테롤 침착체질과 심신 결합조직 허약 체질은 42.5%로서 정상인 16.5%에 비하여 현저하게 증가하였다 (P<0.001). GG TNF-${\alpha}$ 유전자형을 갖고 있는 군에서 심신 결합조직 허약체질과 콜레스테롤 침착체질의 빈도는 정상인보다 환자에서 유의하게 높았다(P<0.001). 본 연구에서 저자는 홍채체질과 고혈압사이의 관련성을 발견함과 동시에 TNF-${\alpha}$ 유전자 다형성과 고혈압, 그리고 홍채 체질과의 관련성을 최초로 입증하였다.

• The Korean Journal of Nuclear Medicine
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• v.34 no.3
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• pp.243-251
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• 2000

Purpose: This prospective study was performed to evaluate the usefulness of preoperative radioimmunoscintigraphy and intraoperative scintimetric examination (radioimmunoguided surgery: RIGS) using $^{99m}Tc-anti-CEA\;F(ab')_2$ fragment. Materials and Methods: Nineteen patients with rectal cancer underwent preoperative whole body planar scintigraphy at 4 hours after injection of $^{99m}Tc-anti-CEA\;F(ab')_2$ fragment and SPECT imaging at 18 hours. Surgical operation was performed at 24 hours after injection. During laparotomy, radioactivities from intraabdominal viscera were measured by gamma probe. The radioactivities from excised tumor and lymph nodes were also measured and compared with pathology. Results: All nineteen patients were confirmed to have adenocarcinomas in the rectum. Twenty-seven of 97 excised lymph node groups had metastasis and 2 patients had liver metastasis in pathology Preoperative radioimmunoscintigraphy detected primary tumors in 11 patients (sensitivity 55%) and it could not detect any lymph nodes or liver metastasis. All patients showed high radioactivity in the kidneys, liver, spleen, and major vessels in intraoperative measurement by gamma probe, and tumor activity was not discriminated from background activity However, radioactivity from excised tumor was higher than normal rectum (T/B ratio; $3.47{\pm}2.25$). When excised lymph node activity/background activity ratio >1.5 was considered as positive criteria of metastasis, sensitivity, specificity, positive and negative predictive values were 78.6%, 73.9%, 55.0% and 89.5%, respectively. Conclusion: Radioimmunoscintigraphy using $^{99m}Tc-anti-CEA\;F(ab')_2$ has no additional value for preoperative staging and use of early RIGS using $^{99m}Tc-anti-CEA\;F(ab')_2$ is inappropriate. For early RIGS using $^{99m}Tc$ labeled antibodies in rectal cancer patients, further development of more specific antibodies and methods to reduce background activity are needed.

• Clinical and Experimental Pediatrics
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• v.49 no.9
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• pp.987-990
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• 2006

Intravenous immunoglobulin (IVIG) infusion is an effective therapy for acute Kawasaki disease (KD). Nonetheless, approximately 10 percent to 20 percent of patients have persistent or recrudescent fever despite IVIG treatment, leading to a higher risk for coronary artery aneurysms (CAA). This unresponsiveness may pose a challenge to the clinicians. Tumor necrosis $factor-{\alpha}$ levels are elevated in the acute phase of the disease, especially in patients who develop CAA. We report a 10-month-old male with KD who failed to respond to multiple doses of IVIG and methylprednisolone and who then was treated with infliximab (5 mg/kg single dose). After infliximab treatment, he became afebrile with normalization of inflammatory markers and no further progression of CAA.