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경피경간 경로를 통한 전기수압쇄석법에 의한 담도 결석의 제거
허정,양웅석,송근암,조몽,이재승,송철수,옥창민,김광하 대한소화기학회 1998 대한소화기학회지 Vol.31 No.1
Background/Aims: The advent of endoscopic sphincterotomy and percutaneous techniques has allowed for nonoperative removal of biliary calculi from the common bile duct, from intrahepatic ducts, and even from the gallbladder. These days, electrohydraulic lithotripsy (EHL) has been used widely in case of large stones difficult to remove by nonoperative methods such as Dormia basket, balloon dilatation, and so on, Methods: Percutaneous transhepatic choledochoscopic lithotorny with EHL was performed in 19 patients, including 7 patients with only hepatolithiasis, 7 with only choledocholithiasis and 5 with both. As a route for choledochoscopy, a T-tube tract was used in 5 patients while percutaneous transhepatic biliary drainage (PTBD) followed by dilatation of the tract was established in 14. Results: Complete removal of the stones was achieved in 18 of 19 patients. In one patient with hepatolithiasis, small stones located deep in inaccessible braches of the intrahepatic duct due to the stricture remained incompletely removable. The mean number of choledochoscopic sessions from biliary catheterization to completion of lithotomy was 2.7, and that of EHL sessions was 1.7. Minor complications occurred in 5 patients, including minor bleeding in one patient, mild right upper quadrant pain in 2, and transient fever and chills in 2. One case had severe hemorrhage during PTBD tract dilatation and needed transarterial embolization by metallic coil to control the active bleeding. Conclusions: Choledochoscopic lithotomy with EHL is safe, efficient, and useful in patients with hepatolithiasis who are in high surgical risks as the first choice and in patients who have large common bile duct stones unrernovable by other nonsurgical methods.
Evaluation of Human MSCs Treatment Frequency on Airway Inflammation in a Mouse Model of Acute Asthma
허정,Ji Young Kang,김영균,이숙영,Sora Jeon,Yourha Kim,정찬권,이진국 대한의학회 2020 Journal of Korean medical science Vol.35 No.23
Background: Studies in experimental models of allergic asthma have shown that mesenchymal stem cells (MSCs) have therapeutic potential for T-helper 2 (TH2) cell-mediated inflammation. However, the mechanisms underlying these therapeutic effects are not fully understood and their safety has not been confirmed. Methods: Using a mouse model of experimental allergic asthma, we investigated the efficacy of human adipose-derived mesenchymal stem cells (hADSCs) or human bone marrow- derived mesenchymal stem cells (hBMSCs) according to treatment frequency and timing. Results: Ovalbumin (OVA)-sensitized and -challenged mice exhibited airway hyperresponsiveness (AHR), airway inflammation, and significant increases in TH2 cytokine levels. Both double and single human mesenchymal stem cell (hMSC) treatments significantly decreased AHR and bronchoalveolar lavage fluid counts. In addition, single treatment with hMSCs showed significant attenuation of allergic airway inflammation. However, double treatment with hMSCs during OVA -sensitization and -challenge further increased inflammatory cell infiltration, and TH2 cytokine levels. Conclusion: The results of treatment with hADSCs or hBMSCs suppresses AHR and airway inflammation. However, double hMSC treatment significantly induces eosinophilic airway inflammation and lung histological changes. Therefore, double hMSC treatment is ineffective against asthma and single injection frequency appears to be more important for the treatment of asthma. These results suggest that hMSC therapy can be used for treatment of asthma patients but that it should be used carefully.
허정 대한간호학회 간호행정학회 2007 간호행정학회지 Vol.13 No.4
Purpose: Purpose of the this study is to define the hemodialysis noncompliance Indicators and discriminant standards levels for low Flux Hemodialysis patients and development of Hemodialysis noncompliance measurement - brief form. Method: Data was collected from 269 hemodialysis patients. To establish the hemodialysis noncompliance Indicators and to discriminate standards, 13 hemodialysis nurses and 2 nephrology doctors are participated in professional group. To verify the indicators and discriminant standards, data was ananlyzed by the canonical discriminant analysis method using by SAS 8.3 program. Result: 4 Indicators- interdialysis weight gain(IWG); average of recent 4weeks, serum phophate level, skipping of hemodialysis and hemodialysis time shortening without permission- of hemodialysis noncompliance are established and discriminant standards are developed. Discriminant ability of these 4 noncompliance indicators is 99.7%(p=.000). Hemodialysis noncompliance measurement - brief form has 96.3% discriminant accuracy. Conclusion: Hemodialysis noncompliant patients have high risks. It means that special intervention to noncompliance is needed. Also continuous and objective assessment and standards of noncompliance are needed.