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Incidence and risk factors for herpes zoster after adult liver transplantation
Wontae Kim,Sangjin Kim,Jongwook Oh,Young Jae Jeong,Jinsoo Rhu,Kyung Sik Kim,Jisoo Lee,Gyu-Sung Choi,Jong Man Kim,Jae-Won Joh 대한외과학회 2019 Annals of Surgical Treatment and Research(ASRT) Vol.96 No.2
Purpose: Herpes zoster (HZ) is caused by reactivation of the varicella zoster virus, which occurs frequently in liver transplant recipients with impaired cellular immunity. The purpose of this study was to evaluate the incidence and risk factors for HZ after adult liver transplantation (LT). Methods: In our institution, 993 patients underwent adult LT from January 1997 to December 2013. We retrospectively analyzed the incidence rate of HZ and risk factors for HZ after LT. Results: Of 993 LT recipients, 101 (10.2%) were diagnosed with HZ. The incidence of HZ at 1, 3, 5, and 10 years was 6.6%, 9.1%, 10.0%, and 11.9%, respectively. Therefore, we observed that the incidence of HZ after LT was 16.3 per 1,000 personyears. Older age (≥50 years) at LT and mycophenolate mofetil (MMF) exposure were independent risk factors of HZ infection after adult LT. Conclusion: Patients older than 50 years or with MMF exposure are considered to be at high risk for HZ. Therefore, adult liver recipients with such factors should not be given strong immunosuppression treatments.
Wontae Cho,Choon Hyuck David Kwon,Jin Yong Choi,Seung Hwan Lee,Jong Man Kim,Gyu Seong Choi,Jae-Won Joh,Sung Joo Kim,Gaab Soo Kim,Kwang Chul Koh 대한외과학회 2019 Annals of Surgical Treatment and Research(ASRT) Vol.96 No.1
Purpose: Laparoscopic major liver resection (major LLR) remains a challenging procedure because of the technical difficulty. Several significant technical innovations have been applied in our center since 2012. They include routine application of bipolar electrocautery, initiation of temporary increase of intra-abdominal pressure during bleeding events from veins to balance the central venous pressure, and use of temporary inflow control of the Glissonean pedicle. This study evaluated the impact of these technique modifications in patients with major LLR. Methods: Between January 2004 and February 2015, a total of 606 patients underwent LLR at Samsung Medical Center in Seoul, Korea. Major LLR was employed in 233 cases. All major LLR procedures were anatomical resections performed with a totally laparoscopic approach. We compared surgical parameters of right hepatectomy (RH), left hepatectomy (LH), and right posterior sectionectomy (RPS) before and after 2012. Results: Open conversion rates of RH and LH and estimated blood loss in RPS significantly decreased after 2012. The postoperative complication rate of major LLR was 12.7% and was similar before and after 2012. Bile leakage was the most common complication (3.2%). Conclusion: The modifications of surgical techniques resulted in good outcomes for laparoscopic major LLR. We recommend routine application of these techniques to improve outcomes, especially in patients requiring major liver resection.
Wontae Gong 국제물리치료연구학회 2018 Journal of International Academy of Physical Ther Vol.9 No.1
The purpose of this study is to investigate the effect of pelvic, Lumbar spine and Cervical spine manipulation on the joint position sense in normal adults. Thirty normal adults were divided into an experimental group of 15 subjects and a control group of 15 subjects. The experimental group was treated with pelvic, Lumbar spine and Cervical spine manipulation with massage, whereas the control group received only massage. Both groups were evaluated in terms of joint position errors (JPEs) using a digital dual clinometer before and after the experiment. The comparison of the JPEs of the experimental group and the control group before and after the experiment showed that the experimental group’s cervical spine results were significantly different in the flexion, left lateral flexion, and right rotation (p < .05) and lumbar spine results were significantly different in the flexion and extension (p < .05), but the control group’s results were not statistically significant in all items (p > .05). The pelvic, lumbar spine and cervical spine manipulation makes an effect on the joint position sense in normal adults. The findings of this study suggest that the pelvis, lumbar spine and cervical spine manipulation improve the motor ability in people with low joint position sense.
Wontae Kim 한국응용곤충학회 2012 한국응용곤충학회 학술대회논문집 Vol.2012 No.05
I conducted experiments in Drosophila to investigate the consequences of altered acetylcholinesterase (AChE) activity in the nervous system. In ace hypomorphic mutant larvae, the amount of ace mRNA and the activity of AChE both in vivo and in vitro were significantly reduced compared with those of controls. Reduced Ace in Drosophila larvae resulted in significant down-regulation of branch length and the number of boutons in Type 1 glutamatergic neuromuscular junctions (NMJs). These defects in ace hypomorphic mutant larvae were suppressed when Musca domestica AChE was transgenically expressed. Because AChE inhibitors are utilized for medications for Alzheimer’s disease, we investigated whether pharmacological inhibition of AChE activity induced any synaptic defects. I found that controls exposed to a sublethal dose of DDVP phenocopied the synaptic structural defects of the ace hypomorphic mutant. These results suggest that down-regulation of AChE activity, regardless of whether it is due to genetic or pharmacological manipulations, results in altered synaptic architecture. This study suggests that exposure to AChE inhibitors for 6-12 months may induce altered synaptic architectures in human brains with Alzheimer’s diseases, similar to those reported here. These changes may underlie or contribute to the loss of efficacy of AChE inhibitors after prolonged treatment.
Outcome of total proctocolectomy with ileal pouch - anal anastomosis for ulcerative colitis
Wontae Cho,Yong Beom Cho,Jin Yong Kim,Dong Kyung Chang,Young-Ho Kim,Hee Cheol Kim,Seong Hyeon Yun,Woo Yong Lee,Ho-Kyung Chun 대한외과학회 2012 Annals of Surgical Treatment and Research(ASRT) Vol.83 No.3
Purpose: We evaluated the risk factors for late complications and functional outcome after total proctocolectomy (TPC) with ileal pouch-anal anastomosis (IPAA) for ulcerative colitis (UC). Methods: Pre- and postoperative clinical status and follow- up data were obtained for 55 patients who underwent TPC with IPAA between 1999 and 2010. The median follow-up duration was 4.17 years. Late complications were defined as those that appeared at least one month after surgery. For a functional assessment, telephone interviews were conducted using the Global Assessment of Functioning Scale. Twenty-eight patients completed the interview. Results: Late complications were found in 20 cases (36.3%), comprising pouchitis (n = 8), bowel obstruction (n = 5), ileitis (n = 3), pouch associated fistula (n = 2), and intra-abdominal infection (n = 2). The preoperative serum albumin level for patients with late complications was lower than for patients without (2.4 ± 0.5 vs. 2.9 ± 0.7, P = 0.04). Functional outcomes were not significantly associated with clinical characteristics, follow-up duration, operation indication, or late complications. Conclusion: This study demonstrated that a low preoperative albumin level could be a risk factor for late complications of TPC with IPAA. Preoperative nutritional support, especially albumin, could reduce late complications. Functional outcomes are not related to late complications.