Plenary Session 2 : PS-2-1 ; Outcomes of hepatitis B virus recurrence after liver transplantation: a multicenter analysis in Korea

( Hee Yeon Kim ),( Jong Young Choi ),( Dong Goo Kim ),( Myoung Soo Kim ),( Soon Il Kim ),( Shin Hwang ),( Sung Gyu Lee ),( Kwang Woong Lee ),( Kyung Suk Suh ),( Young Seok Han ),( Dong Lak Choi ),( Se 대한간학회 2012 춘·추계 학술대회 (KASL) Vol.2012 No.-

Background: The outcome of hepatitis B virus (HBV) infection after liver transplantation (LT) was improved by hepatitis B immunoglobulin (HBIG) and nucles(t)ide analogue (NUA). However, HBV recurrence after LT is critical because the recurrence is occasionally accompanied by a progressive destruction of graft and poor survival. The aims of this study were to investigate the significance HBV recurrence and identity factors associated with HBV recurrence. Methods: From October 1999 to February 2011, a total of 2684 consecutive LT recipients who underwent HBV-associated LT were retrospectively enrolled from 7 transplantation centers in Korea. Results: Prophylaxis regimens were HBIG monotherapy (67.7%) or a combination of HBIG with NUA (22.3%). The recurrence rate of HBV was 6.1% (164 recipients) during mean follow-up duration of 10.9 years. The median time from transplantation to recurrence was 2.1 years (0.1-7.9 years). Of the 1,071 patients with hepatocellular carcinoma (HCC) prior to LT, 155 patients (14.5%) had HCC recurrence after transplantation, and 48 patients (31.0%) had HBV recurrence. Of the 48 patients with recurrence of both HBV and HCC, 25 patients (52.1%) experienced HBV recurrence after HCC recurrence. In the multivariate analysis, pretransplant HCC, pretransplant HBV DNA above 5.5 log copies/mL was independent clinical factors influencing HBV recurrence after LT. The mortality rate among the recipients with HBV recurrence was 34.1% (56 recipients). Mean overall survival was 6.4 years in the HBV-recurrence group and 9.9 years in the HBV-nonrecurrence group (p<0.001). HBV recurrence was not an independent prognostic factor for overall survival. HCC recurrence was the most important factor for overall survival. Conclusions: The overall outcome of LT in HBV-related liver disease was excellent with the current prophylaxis regimen Choon Hyuck David Kwon,8 Suk-Koo Lee8 Pretransplant HBV DNA and HCC were important factors for HBV recurrence. HBV recurrence after LT did not significantly influence on the overall survival without combining of HCC recurrence.

Vibrio vulnificus에 의한 패혈증 3예

김신무,김유현,신상희,오재세,강숙희,윤여안,이화재,김영옥 대한임상병리사협회 1986 임상병리사회지 Vol.18 No.1

간호 지식관리시스템 개발

민효숙,문원희,김미자,김선미,황윤신,황관옥,심희숙 충남대학교 간호과학연구소 2006 충남대 간호학술지 Vol.9 No.1

The purpose of this study were to develop Knowledge Management System for the nurse and to identify its effectiveness. The program was developed in development of the contents and programing. And the system was operated to 85 nurse for three weeks. Data collection were performed during the period of May 1, 2005 to December 30, 2005. The data was collected from 85 nurses using questionnaires. In order to ascertain the validity of clinical application of the system, Prior experience of the computer mediated communication, user satisfaction and utilization were analyzed. The instruments for the study were satisfaction(Kim, 2000), utilization(Kim, 2002). The collected data were analysed by descriptive statistics, using SPSS WIN 11.0 program. The results showed average score which is the satisfaction(6.09) showed middle satisfaction scores. It is concluded that if Nursing Knowledge Management System is operated considering all the above factors, It wound be one of the best qualified continuing clinical method for nurses.

입원 중인 베트남 참전 군인의 삶의 만족도와 관련된 요인

김애리,박종,김율,노희송,박광희,김은숙,김형철,홍강식,류소연,강명근,김기순 朝鮮大學校 附設 醫學硏究所 2007 The Medical Journal of Chosun University Vol.32 No.2

Background and Objectives: The aim of the study was to identify the factors associated with life satisfaction of hospitalized Vietnam veterans. Material and Methods: The data were collected from 200 hospitalized Vietnam veterans of 5 veterans hospitals in Korea from September 13 to 23, 2004. Information of general characteristics, health behavior, disease history, family function, depression and life satisfaction were collected by structured questionnaire. Results: The mean of life satisfaction was 21.48(±6.03), and the mean of depression was 53.10(±9.64). The prevalence of depression was mild depression 24.0%, moderate depression 43.5% and severe depression 25.0%. Depression was associated with life satisfaction and depression was higher, life satisfaction was lower. Family function and age were positively associated with life satisfaction, Conclusion: Life satisfaction was affected by depression and family function in hospitalized Vietnam veterans. Therefore, it was thought that psychosocial approaches such as improve depression and family function in care of hospitalized Vietnam veterans is required.

Atomic Force Microscopy를 이용한 Al0.5Ga0.5As/GaAs 다중 에피층 구조의 단면관찰에 관한 연구

김희진,김재성,김용,김무성,민석기 숙명여자대학교 자연과학연구소 1994 자연과학논문집 Vol.- No.5

다중 에피층 구조(Al0.5Ga0.5As/GaAs)의 단면을 AFM(atomic force microscopy)으로 관찰하는데 성공하였다. AFM을 이용한 다중 에피층 구조의 단면 관찰은 0.1M HCl을 이용해서 이미 다른 그룹에서 관찰한 바가 있으나, 본 실험에서는 처음으로 5% NaClO용액을 사용하여 시료를 선택에칭(stain etching)처리하였고, 선택적 산화와 에칭으로 AlGaAs와 GaAs를 서로 구분해 내었다. 5% NaClO로 처리한 시료의 AFM 이미지는 3초 미만 에칭하여도 관찰이 가능했다. 층간 구분이 선명하였고, 심지어 NaClO에 의한 GaAs층의 에칭 morphology까지 확인했다. 10mm정도의 구조는 쉽게 AFM을 이용해서 관찰이 가능했다. 반대로 0.1M HCl용액으로 에칭한 AFM이미지는 상대적으로 좋지 못한 것을 확인했고, 이것으로 HCl용액의 에칭선택성이 5% NaClO에 비해서 좋지 못함을 알 수 있었다. 5% NaClO용액을 사용한 단면관찰은 간단한 시료준비와 짧은 측정시간으로 nanostructure연구에 많은 활용이 있을 것으로 기대된다. We investigate the cross-section of Al0.5Ga0.5As/GaAs multilayered epitaxial structure by an atomic force microscope to see the feasibility of the technique. For the first time, we employ 5% NaClO etchant to discern each layer and obtain well resolved AFM images of the layers whose thicknesses are about nanometer scale. In contrary, we get relatively poor AFM images by applying. HCl etchants and it is attributed to poor Al0.5Ga0.5As/GaAs etching selectivity of HCl solution compared to that of 5% NaClO solution.

급성 백혈병 환자에서 감염증의 양상 및 예후인자에 관한 연구 : 1988년∼1995년까지

정희진,김병수,신상원,김열홍,김우주,김민자,김준석,박승철,김권범 대한감염학회 1998 감염 Vol.30 No.3

목적 : 급성 백혈병의 경우 골수기능이 억제되고 항암화학요법에 따른 골수기능 저하로 감염의 위험이 증가하며 감염의 치료가 환자의 생존에 큰 영향을 미치게 된다. 이에 저자들은 1988년부터 1995년까지 고대 구로병원에 급성 백혈병으로 입원했던 환자들 중 입원 기간 내 감염이 있었던 경우를 대상으로 하여 감염의 위험인자 및 감염증의 예후를 후향적으로 분석함으로써 향후 급성 백혈병환자의 감염의 치료에 대한 지침을 얻고자 하였다. 방법 : 급성 백혈병으로 확진된 환자들 중 감염병에 이환된 경우를 대상으로 하여 각각을 미생물학적 확인감염, 임상적 확인감염, 그리고 설명 불가열로 구분하였다. 각각의 경우에서 감염 당시의 호중구 수, 호중구 감소 기간, 항암화학요법과의 연관성, 감염 병소, 배양된 검체 및 원인균, 선택적 소화관 살균법의 사용여부 및 골수회복 여부 등을 조사한 후 환자의 예후와 어떤 관계가 있는 지 조사하였다. 결과 : 연구 대상은 총 113예로 남녀비는 46:67 이었고 평균연령은 34±13세, 진단은 급성 골수성 백혈병 (AML)이 84예, 급성 림프구성 백혈병(ALL)이 29예였으며, 감염시 평균 호중구수는 663±1678/㎣이었고, 호중구 감소 기간은 평균 18±13일이었다. 감염양상은 항암화학요법과 연관된 감염이 84예로 대부분이었고 미생물학적 확인 감염이 40예로서 35%였으며, 폐렴과 원발성 패혈증이 각각 20예와 19예로 가장 많았고, 카테터 연관 감염이 7예로 나타났다. 배양된 균주는 E. coli가 10예(25%)로서 가장 많았으며, 전체적으로 E. coli, P. aeruginosa, K. pneumoniae 등의 그람음성균이 63%로 대부분을 차지하였으나 최근 그람양성구군 및 진균의 분리율이 증가하는 양상을 보였다. 감염증의 예후를 분석한 결과 진균 감염인 경우나 호중구 감소 기간이 긴 경우 사망률이 높았으며 그 중에서도 골수 기능이 회복 여부가 환자들의 생존과 통계적으로 유의한 연관이 있었다.(P=0.01). 결론 : 급성 백혈병 환자들에서의 감염은 관해유도화학요법 후 초래되는 호중구 감소와 유의한 관계가 있으며, 폐렴 및 패혈증의 임상양상을 보이는 경우가 흔하고, 원인균별로는 그람 음성균이 주류를 이루나 최근 그람 양성균 감염이 증가하는 추세를 보였다. 감염의 예후 인자로는 진균 감염인 경우나 호중구 감소 기간이 긴 경우 사망률이 높았으나 골수 기능의 회복여부가 결정적인 역할을 하는 것으로 나타나, 향후 급성 백혈병 환자의 치료에 있어 감염 빈도의 감소와 감염에서의 조속한 회복을 위해서는 골수 기능의 회복에 중점을 두어야 할 것으로 사료된다. Background : Infection is one of the most important and fatal complications in patients with acute leukemia. The characteristics of infection in acute leukemic patients are different from those in other diseases by the lack of normal inflammatory responses or distinct clinical evidence except fever. To improve the outcome of acute leukemia, it is very important to recognize the risk factors, patterns and prognostic factors of acute leukemia. Methods : We analyzed retrospectively the patterns of infection from 113 febrile patients with acute leukemia from January, 1988 to December, 1995. To determine the prognostic factors and the outcome of infection, the following variables were analyzed: the presence of neutropenia, use of chemotherapeutic agents, type and site of infections, isolated organisms, gastrointestinal decontamination, duration of neutropenia, and bone marrow recovery. Results : Out of 113 febrile patients with acute leukemia, 84 infection episodes(74%) occurred after chemotherapy. The mean duration of neutropenia was 18±13 days. The incidence of microbiologically-documented infection(MDI) was 35%(40/113). Pneumonia was the most common infection(26%), followed by primary sepsis(24%), catheter-related infection(9%). In cases of MDI, 63% were caused by gram-negative bacteria, followed by gram-positive bacteria(28%), and fungi(10%). Escherichia coli(25%) was the most common isolated in MDI. Regarding the prognostic factors in cases with infections, the recovery of bone marrow function was the only statistically significant factor(P=0.01). Conclusion : Infection has been a major cause of morbidity and mortality in acute in acute leukemic patients. To prevent infection and thereby improve the prognosis of acute leukemia, restoration of bone marrow function at early stage is important.

삼풍백화점 붕괴사고 희생자들의 신원확인을 위한 유전자검사

남용석,이혜린,김경훈,김희선,이희석,황적준 大韓法醫學會 1996 대한법의학회지 Vol.20 No.1

A DNA typing was performed to identify decomposed body remains from Sampoong Department mass disaster in June 1995. These body parts include bone fragment, skin tissue, hairs, from which the extracted DNAs were highly degraded. Two VNTR loci, 4STR loci, and amelogenin gene were chosen for AMP-FLP, and mtDNA sequence analysis for the confirmation of maternal relationship. The results of AMP-FLP of the selected polymorphic loci showed different sucess rate for PCR. DIS80 and D17S5 loci were amplified successfully form 64.5%, and 67% of the samples, respectively. HUMTHOI, HUMCSF1PO, and HUMTPOX loci were amplified successfully from 90.3% of the samples each. HUMACTBP2 and amelogenin was amplified in 87% of the cases submitted. THE DNA types of 33 remains were compared with those of 81 bereaved families consisting of 173 member. Thirty three samples were reduced to 28 in numbers according to results of the same DNA types. Among them, the DNA types of 15 remains matched with those of bereaved families and the identified remains were reconfirmed by amelogenin sex typing and mitochondrial DNA sequence analysis. The others were not identified a family by failures of PCR amplification or non-matching of DNA types. Also it is confirmed that one hair sample should be artificial by non-digestion of protease and another be animal bone by result of dot blotting with human Alu probe. Our results indicate that multiplex PCR system consisting of several STR loci like HUMCSF1PO, HUMTPOX, and HUMTHO1 is more effective for the identification of highly decomposed human remains from mass disaster.

Newcastle Disease Virus의 Fusion 단백 유전자의 제한효소분절형태(RELP)의 특이성

장경수,김지영,김석,김태용,송영환,허지연,김현수,송희종,전무형 충남대학교 수의과대학 동물의과학연구소 2001 動物醫科學硏究誌 Vol.9 No.-

To evaluate the specificity of restriction fragment length polymorphism (RFLP) of Newcastle disease virus (NDV) fusion (F) protein gene for various NDV strains. F protein genes of NDV CBP-1 isolate, LaSota, B1 and Kyojungwon (KJW) were amplified by reverse transcriptase-polymerase chain reaction (RT-PCR) and RFLP were examined. In RT-PCR using F primer sets for 1.7 kb F gene, the amplified products were observed in CBP-1, LaSota and B1 except KJW. However, F2 primer set for 521 bp yielded the amplified bands with all strains. The amplified F genes (1.7 kbp) were treatd with 15 different restriction enzymes to analyze RFLP and the cleavage patterns. CBP-1 showed various cleavage patterns with 8 enzymes, LaSota, with 11 enzymes and B1, with 11 enzymes. According to the cleavage patterns, the physical maps were constructed, and it was found that CBP-1, LaSota and B1 strains had specific cleavage sites with HinfI, XbaI and XhoI. These findings suggest that RFLP are worth applying in the diagnosis and molecular epidemiological studies of Newcastle disease.

다발성 대장암 간전이 환자의 간절제를 위한 새로운 시도

주종우,김형철,임철완,신응진,조규석,유기원,송옥평,홍대식,박성진,조준희,이혜경,김희경,권계원,고은석 순천향의학연구소;Soonchunhyang Medical Research Institute 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Multiple bilobar liver matastases (MBLM) are the main cause of low resectability in the colon cancer liver metastases. The authors experienced one case of initially non-resectable colon cancer liver metastases. He was curatively and safely treated with a two-stage hepatectomy using the new method of future remnant liver volume growing. A 54-year-old man was referred to our department with the sigmoid colon cancer combined with MBLM, which were checked in two small metastatic lesions in the left lobe and five large sized lesions in the right lobe in the computed tomogram (CT). A laparoscopic assisted anterior resection was primarily performed. We performed the 1^(st) stage hepatectomy 3 weeks after the colon resection. Intra-operative Ultrasonogram (US) found 9 small superficial metastatic lesions in the left lobe. All that lesions were completely removed by non-anatomical wedge resection. An occlusion ballon catheter was placed in the right portal vein through a small branch of the inferior mesenteric vein at that time. The future remnant liver volume was sufficiently increased 3 weeks after the 1^(st) hepatectomy. A right hepatectomy was safely performed 22 days after the 1^(st) hepatectomy. The patient received a regional chemotherapy (interleukin2 based immuno-chemotherapy through hepatic artery) for 4 months, then received 9 cycles of systemic chemotherapy (biweekly Oxaliplation, leucovorin, plus 5-fluorouracil) without any recurrence evidence.

Kidney Toxicity Induced by 13 Weeks Exposure to the Fruiting Body of Paecilomyces sinclairii in Rats

Jeong, Mi-Hye,Kim, Young-Won,Min, Jeong-Ran,Kwon, Min,Han, Beom-Suk,Kim, Jeong-Gyu,Jeong, Sang-Hee Korean Society of ToxicologyKorea Environmental Mu 2012 Toxicological Research Vol.28 No.3

Paecilomyces sinclairiis (PS) is known as a functional food or human health supplement. However concerns have been raised about its kidney toxicity. This study was performed to investigate the kidney toxicity of PS by 13 week-oral administration to rats. Blood urea nitrogen (BUN), serum creatinine, and kidney damage biomarkers including beta-2-microglobulin (${\beta}2m$), glutathione S-transferase alpha (GST-${\alpha}$), kidney injury molecule 1 (KIM-1), tissue inhibitor of matrix metalloproteinase 1 (TIMP-1), vascular endothelial growth factor (VEGF), calbindin, clusterin, cystatin C, neutrophil gelatinase-associated lipocalin (NGAL) and osteopontin were measured during or after the treatment of PS. BUN, creatinine and kidney damage biomarkers in serum were not changed by PS. However, kidney cell karyomegaly and tubular hypertrophy were observed dose-dependently with higher severity in males. KIM-1, TIMP-1 and osteopontin in kidney and urine were increased dose dependently in male or at the highest dose in female rats. Increased urinary osteopontin by PS was not recovered at 2 weeks of post-exposure in both genders. Cystatin C in kidney was decreased at all treatment groups but inversely increased in urine. The changes in kidney damage biomarkers were more remarkable in male than female rats. These data indicate that the PS may provoke renal cell damage and glomerular filtration dysfunction in rats with histopathological lesions and change of kidney damage biomarkers in kidney or urine. Kidney and urinary KIM-1 and cystatin C were the most marked indicators, while kidney weight, BUN and creatinine and kidney damage biomarkers in serum were not influenced.