Clinical Outcomes of Lung Transplantation: Experience at Asan Medical Center

정용호,최세훈,박승일,김동관,Asan Medical Center Lung Transplantation Team 대한흉부외과학회 2018 Journal of Chest Surgery (J Chest Surg) Vol.51 No.1

Background: Lung transplantation is a life-saving procedure in patients with end-stage lung disease, and is increasingly performed in Korea. Methods: We retrospectively evaluated the outcomes of patients who received a lung transplant at Asan Medical Center between January 2008 and December 2016. Thirteen of 54 patients experienced multiorgan transplantation; the remaining 41 who received only lung grafts were included. Results: The mean age of the lung transplant recipients was 44.6 years; 27 were men and 14 were women. The most frequent reasons were idiopathic interstitial pneumonia (21 of 41 patients, 51.2%), interstitial lung disease (9 of 41, 22.0%), and bronchiolitis obliterans after bone marrow transplantation (7 of 41, 17.1%). The median waiting time was 47 days, and many patients received preoperative intensive care (27 of 41, 65.9%), ventilator support (26 of 41, 63.4%), or extracorporeal life support (19 of 41, 46.3%). All 41 patients received bilateral lung grafts. Ten deaths occurred (24.3%), including 5 cases of early mortality (12.2%) and 5 cases of late mortality (12.2%). The 1-, 3-, and 5-year survival rates were 78.9%, 74.2%, and 69.3%, respectively. Conclusion: Despite a high percentage of patients who required preoperative intensive care, the transplantation outcomes were acceptable.

Clinical Outcomes of Heart-Lung Transplantation: Review of 10 Single-Center Consecutive Patients

윤재광,최세훈,박승일,Asan Medical Center Heart-Lung Transplantation Team 대한흉부외과학회 2016 Journal of Chest Surgery (J Chest Surg) Vol.49 No.3

Background: Heart-lung transplantation (HLT) has provided hope to patients with end-stage lung disease and irreversible heart dysfunction. We reviewed the clinical outcomes of 10 patients who underwent heart-lung transplantation at Asan Medical Center. Methods: Between July 2010 and August 2014, a total of 11 patients underwent HLT at Asan Medical Center. After excluding one patient who underwent concomitant liver transplantation, 10 patients were enrolled in our study. We reviewed the demographics of the donors and the recipients’ baseline information, survival rate, cause of death, and postoperative complications. All patients underwent follow-up, with a mean duration of 26.1±16.7 months. Results: Early death occurred in two patients (20%) due to septic shock. Late death occurred in three patients (38%) due to bronchiolitis obliterans (n=2) and septic shock (n=1), although these patients survived for 22, 28, and 42 months, respectively. The actuarial survival rates at one year, two years, and three years after HLT were 80%, 67%, and 53%, respectively. Conclusion: HLT is a procedure that is rarely performed in Korea, even in medical centers with large heart and lung transplant programs. In order to achieve acceptable clinical outcomes, it is critical to carefully choose the donor and the recipient and to be certain that all aspects of the transplant procedure are planned in advance with the greatest care.

Can Calprotectin Show Subclinical Inflammation in Familial Mediterranean Fever Patients?

Gökmen Asan,Mehmet Emin Derin,Halef Okan Doğan,Meliha Bayram,Mehtap Şahin,Ali Şahin 대한의학회 2020 Journal of Korean medical science Vol.35 No.10

Background: Familial Mediterranean fever (FMF) is an autoinflammatory disease that has self-limiting inflammatory attacks during polyserositis. Hepcidin is a protein, and interleukin-6 stimulation increases hepcidin levels. Calprotectin (CLP) is a recently defined cytokine released from monocytes and neutrophils in response to tissue trauma and inflammation. There are studies in the literature showing that it can be used as a biomarker in rheumatic diseases such as ankylosing spondylitis and rheumatoid arthritis. Here, we compared the levels of hepcidin and CLP in healthy individuals and FMF patients during an attack-free period and show its relation to genetic mutations. Methods: This is a cross-sectional study. Between July 2017 and December 2017, 60 patients diagnosed with FMF an admitted to the Cumhuriyet University Faculty of Medicine Department of Internal Medicine Rheumatology as well as 60 healthy volunteers without any rheumatic, systemic, or metabolic diseases were enrolled in this study. Blood was collected from a peripheral vein to measure serum CLP and hepcidin levels. Blood tests were examined by ELISA; the study protocol was approved by the local ethics committee. Results: Median serum hepcidin level was 468.1 (210.3–807.8) pg/mL in FMF group and 890.0 (495.0–1,716.9) pg/mL in the healthy control (HC) group. There was a statistically significant difference between the two groups (P < 0.001). The median serum levels of CLP in the FMF group were measured as 1,331.4 (969.3–1,584.6 pg/mL and 73.8(45.0–147.9) pg/ mL in the HC group. There was a statistically significant difference between the two groups (P < 0.001). Receiver operating characteristic analysis showed that the sensitivity was 66.7% and the specificity was 71.7% at serum hepcidin < 581.25 pg/mL (P < 0.05); the sensitivity was 96.7% and specificity was 100% at CLP > 238 pg/mL (P < 0.05). There was no significant difference between serum hepcidin and CLP levels in FMF patients with M694V homozygous and M694V heterozygous (P > 0.05). There was no significant difference in serum hepcidin levels between FMF patients with and without arthritis, proteinuria, and amyloidosis (P < 0.05). There was no significant correlation between laboratory findings, gender, age, and serum CLP and hepcidin levels (P > 0.05, r < 0.25). Conclusion: Serum CLP levels in FMF patients during an attack-free period are significantly higher than in the HC groups. Serum hepcidin levels in FMF patients are significantly lower than in the HC group. Low levels of hepcidin may be explained by including FMF patients during an attack-free period in the study. CLP may be an important biomarker in FMF. A better understanding of the role of these biomarkers in the diagnosis of FMF is needed to evaluate the results in a more comprehensive way.

Lactobacillus fermentum strains from human breast milk with probiotic properties and cholesterol-lowering effects

Meltem Asan-Ozusaglam,Ayse Gunyakti 한국식품과학회 2019 Food Science and Biotechnology Vol.28 No.2

The study aimed to identify two lactic acidbacteria from human breast milk and evaluate for theirprobiotic potential. Lactobacillus fermentum strainsshowed various degree of antibiotic susceptibility profile toclinical commercial antibiotics. The MA-7 and MA-8strains have never lost their vitality at pH 2 and 3. Lactobacillusfermentum MA-8 exhibited more resistance to 0.3and 1% bile concentrations than MA-7 strain. Both of theL. fermentum strains can tolerate the simulated gastric andintestinal juices. The strains showed high auto-aggregationpercentages varied from 95 to 98%. Both isolates alsoexhibited gamma hemolytic activity. The cholesterol loweringactivity of MA-7 and MA-8 strains was varied from34.84 to 91.15%. The supernatants showed higher anticholesterolactivity compared to pellets. The resultsdemonstrated that both L. fermentum strains maybe goodprobiotic candidates and may have potential as healthbiotherapeutic with cholesterol-lowering effects.

Comparative Study of the Accuracy of At-Point Clinical Frailty Scale and Morse Fall Scale in Identifying High-Risk Fall Patients among Hospitalized Adults

Sunghwan Ji,Hee-Won Jung,Jeounghee Kim,Younghye Kwon,Yeonmi Seo,Semin Choi,Hyoun Jin Oh,백지연,Il-Young Jang,Eunju Lee,for the Asan Multidisciplinary Committee for Seniors (AMCS) 대한노인병학회 2023 Annals of geriatric medicine and research Vol.27 No.2

Background: Falls are a major concern among hospitalized adults, and it is essential to identify high-risk patients to prevent falls. This retrospective cohort study conducted at the Asan Medical Center, Korea, compared the screening abilities of the at-point Clinical Frailty Scale (CFS) and Morse Fall Scale (MFS) to identify patients at high risk for falls among hospitalized adults. Methods: We assessed the records of at-point CFS, MFS, and fall incidence during hospitalization of 2,028 patients aged 18 or older included in this study. We calculated the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC) for each tool. Results: Twenty-five patients (1.23%) experienced falls during hospitalization. The mean at-point CFS score was significantly higher in those with falls than in those without falls. The mean MFS score did not differ significantly between the two groups. The optimal cutoff points for the at-point CFS and MFS scores were 5 and 45, respectively. At these cutoffs, the at-point CFS demonstrated a sensitivity of 76.0%, specificity of 54.0%, PPV of 2.0%, and NPV of 99.4%, whereas the MFS demonstrated a sensitivity of 60.0%, specificity of 68.1%, PPV of 2.2%, and NPV of 99.4%. The AUC values for the at-point CFS and MFS were 0.68 and 0.63, respectively, with no significant difference (p=0.31). Conclusion: The at-point CFS is a valid screening tool for assessing fall risk in hospitalized adults, as it effectively identifies fall risk with a performance similar to that of the MFS.

First Experience of Using Two-stage Resection of the Liver (Split in situ) in Patients with Metastatic Colorectal Cancer

( Zhanat Spatayev ),( Asan Zhexembayev ),( Adilbek Mukazhanov ),( Baurzhan Ibrayev ) 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1

Aims: To present the first in Kazakhstan performed split in situ surgical procedure in a patient with sT4aN2bMOG2 colorectal cancer at National Oncology & Transplant Center. Introduction: Two-stage liver surgery with preliminary right portal vein occlusion procedure (ligation or embolisation) became standard in clinical practice and allows liver resections in 60-82% of initially inoperable patients. Right portal vein ligation with concomitant liver partition in situ (in situ splitting, ISS) is innovatory and promising approach. This case report of a 67 y.o. male with three colon meta- stasis in right liver lobe. Methods: A case report of the patient``s two-stage surgical procedure and results Results: Right portal vein ligation and in situ splitting was performed in 67 years old male with three colon metastases in right liver lobe (figure-1) and insufficient volume of future liver remnant (FLR/SLV = 550/1294=29%). After completion of dissection of liver parenchyma and portal vein ligation subsequent hepatico-jejunoanostomosis was performed as shown in figure-2. The early post-first operative period went without complications. CT angiography on 11th postoperative day showed left liver lobe hypertrophy rate of 58% (FLR/SLV = 750/1294) and left liver lobe volume increase from 29 to 58%. During surgery the left liver hypertrophy was seen (as shown in figure-3), there was no visible parenchymal injury in observation during laparotomy. Right hemihepatectomy was performed on day 13 after the first stage. There were no signs of postoperative liver failure. According to the dynamical transaminases (shown in the figure-2) in situ split procedure doesn’t induce liver injury. Conclusions: New two-stage surgery approach (ISS) can decrease number of patients who were inoperable because of insufficient volume of future liver remnant and high risk of postoperative liver failure.

Investigation of Eosin B Removal from Aqueous Solution Employing Combined Graphene Oxide Adsorption and Zinc Oxide Coagulation Processes

Milad Sangashekan,Shahin Asan,Hossein Ghanadzadeh Gilani 한국섬유공학회 2019 Fibers and polymers Vol.20 No.7

In this study, graphene oxide was synthesized and investigated as an adsorbent for eosin B elimination. Thefeatures and structure of graphene oxide were determined by employing scanning electron microscopy, transmission electronmicroscopy, Raman spectrometry, and X-ray diffractometry. Graphene oxide can remove dyes in water solutions, but it isconfronted by separation challenges. Therefore, zinc oxide was used as a coagulant for separation of the dye solution fromgraphene oxide. Adsorption properties such as contact time, dye concentration, dosage of adsorbent, zinc oxide content, pHeffect, and temperature were regularly investigated extensively. Concentrations of dyes in the supernatant suspension wereevaluated employing a visible spectrophotometric method at the maximum wavelength (λmax) of 514 nm. The eosin B dyeshowed maximum sorption capacity of 68.027 mg/g at pH 4 and T=298 K. Isotherm models such as Freundlich andLangmuir isotherms were used to determine the better suitable isotherm model. It was discovered that this dye adsorptioncapacity on adsorbent particles was monolayer and had a good agreement with the Langmuir isotherm. Pseudo-first-order andpseudo-second-order kinetic models were investigated to determine adsorption kinetics. The pseudo-second-order forsorption of this dye on adsorbents was followed by kinetic data analysis. This research shows that this sorbent and coagulantare efficacious and applicable for the removal of eosin B from wastewaters.

Reference-assisted chromosome assembly

Kim, J.,Larkin, D.M.,Cai, Q.,Asan,Zhang, Y.,Ge, R.-L.,Auvil, L.,Capitanu, B.,Zhang, G.,Lewin, H.A. National Academy of Sciences 2013 PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF Vol.110 No.5

Phase equilibrium data for aqueous solutions of formic acid with 2-ethyl-1-hexanol at T=(298.2, 308.2, 318.2, and 328.2) K

Hossein Ghanadzadeh Gilani,Syrous Noury,Shain Asan 한국화학공학회 2013 Korean Journal of Chemical Engineering Vol.30 No.6

Liquid-liquid equilibrium (LLE) data for the system of (water+formic acid+2-ethyl-1-hexanol) were experimentally determined at T=(298.2, 308.2, 318.2, and 328.2) K and atmospheric pressure. A type-2 LLE was obtained for this ternary system. The influence of temperature on the equilibrium characteristics was found to be smallat the temperatures studied. Distribution coefficients and separation factors were calculated over the immiscibility regions. The experimental tie-line data were correlated using the UNIQUAC model. The values of the interaction parameters between each pair of the components were obtained for this thermodynamic model. The root mean square deviation (RMSD) between the observed and calculated mass fractions was 0.61%.

Extraction and Characterization of Chitin and Chitosan with Antimicrobial and Antioxidant Activities from Cosmopolitan Orthoptera Species (Insecta

Murat Kaya,Talat Baran,Meltem Asan-Ozusaglam,Yavuz Selim Cakmak,Kabil Ozcan Tozak,Abbas Mol,Ayfer Mentes,Goksal Sezen 한국생물공학회 2015 Biotechnology and Bioprocess Engineering Vol.20 No.1

This study examined two gregarious Orthopteraspecies (Calliptamus barbarus and Oedaleus decorus) aspotential sources of chitin. The chitin content of the dryweight of C. barbarus was 20.5 ± 0.7%, and it was 16.5 ±0.7% for O. decorus. Furthermore, the yield of chitosan (70~ 75% deacetylation degree) from the grasshopper specieswas found to be 74 ~ 76%, which is close to the yield ofcommercial preparations obtained from the unused parts ofcrabs and shrimp. The chitin and chitosan obtained in thisway were analyzed using FTIR, TGA, XRD and SEMtechniques, and the antimicrobial properties of chitosansobtained from C. barbarus and O. decorus against pathogenicmicroorganisms of humans and fish were investigatedusing the disc diffusion and microdilution broth methods. The antimicrobial screening procedures indicated that thechitosan showed significant antimicrobial activity againstall of the tested pathogenic microorganisms. The MBC orMFC values were determined to be 0.16 ~ 2.50 mg/mL. The IC50 values for the chitins obtained from C. barbarusand O. decorus were 10.68 ± 0.27 and 10.91 ± 0.96 mg/mL,respectively, which were greater than the value forbutylated hydroxytoluene (BHT): 0.04 ± 0.01 mg/mL. These results suggest that these two species, which arecurrently considered to be pests because of over-breeding,are potentially alternative sources of chitin and chitosan,which are used in the food/feed industry for theirantimicrobial and antioxidant properties.