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Jaehun Yang,Jinsoo Rhu,Jieun Kwon,Gyu-Seong Choi,Jong Man Kim,Woo Kyoung Jeong,Jae-Won Joh 대한외과학회 2023 Annals of Surgical Treatment and Research(ASRT) Vol.104 No.6
Purpose: This study evaluated the clinical implication of hepatic venous territory mapping in living donor liver transplantation. Methods: Living donor liver transplantations performed using right graft since 2017 were included. Hepatic venous volume mapping was started in 2019. Risk factors for graft failure and overall survival were analyzed. Analysis for factors related to occlusion of reconstructed vein was performed. Results: Among 445 patients included, 213 underwent hepatic venous mapping. Hepatic venous mapping itself was not a significant factor for graft (hazard ratio [HR], 0.958; 95% confidence interval [CI], 0.441–2.082; P = 0.913) and overall survival (HR, 0.627; 95% CI, 0.315–1.247; P = 0.183). Inferior hepatic vein occlusion was a significant risk factor for both graft survival (HR, 8.795; 95% CI, 1.628–47.523; P = 0.012) and overall survival (HR, 11.13; 95% CI, 2.460–50.300; P = 0.002). In a subgroup with middle hepatic vein reconstruction, occlusion was a significant risk factor for overall survival (HR, 3.289; 95% CI, 1.304–8.296; P = 0.012). In patients with middle hepatic vein reconstruction whose venous territory volumes were measured, right anterior volume of ≥300 cm3 was protective for vein occlusion (OR, 0.317; 95% CI, 0.152–0.662; P = 0.002). In patients with V5 reconstruction, V5 volume of ≥150 cm3 was protective for vein occlusion (OR, 0.253; 95% CI, 0.087–0.734; P = 0.011). Conclusion: Inferior and middle hepatic vein reconstruction has significant impact on clinical outcome. Hepatic venous territory mapping can provide an objective measure for successful reconstruction of venous branches.
Jaehun Yang,Jong Man Kim,Jinsoo Rhu,Sangjin Kim,Seohee Lee,Gyu-Seong Choi,Jae-Won Joh 한국간담췌외과학회 2020 Annals of hepato-biliary-pancreatic surgery Vol.24 No.1
Backgrounds/Aims: This study aims to compare differences between laparoscopic donor right hemihepatectomy (LDRH) and open donor right hemihepatectomy (ODRH) in the quality of the operation, postoperative complications, and liver regeneration measured via volumetry. Methods: This study included 119 patients who underwent living donor right hemihepatectomy at Samsung Medical Center from January 2016 to December 2017. We compared several aspects of LDRH and ODRH and analyzed the results using the independent t-test, chi-square test and Fisher’s exact test. Results: Among 119 enrolled patients, 66 patients (55.5%) underwent open surgery, and 53 patients (44.5%) underwent laparoscopic surgery. The mean operation time was significantly shorter for ODRH (290.57±54.04 minutes) than LDRH (312.28±53.5 minutes) (p=0.031). Estimated blood loss was significantly less in LDRH (258.49±119.99 ml) than ODRH (326.52±157.68 ml) (p=0.011). The remnant liver recovered to 83.35±10.71% of the preoperative estimate whole liver volume (pre-EWLV) in the ODRH group and 84.04±8.98% of the pre-EWLV in the LDRH group (p=0.707). The percentage of increased estimated liver volume to postoperative estimate remnant liver volume (post-ERLV) was 137.62±40.34% in the ODRH group and 130.56±36.78% in the LDRH group, and there was no statistically significant difference between the two groups (p=0.326). An analysis of postoperative complications showed no significant differences. Conclusions: LDRH is safe, and there is no significant difference in hepatic regeneration compared with ODRH. Therefore, LDRH can be applied for living donation of liver.
Early Use of Everolimus Improved Renal Function after Adult Deceased Donor Liver Transplantation
( Jaehun Yang ),( Sunghae Park ),( Young Ju Oh ),( Sang Oh Yun ),( Manuel Lim ),( Ji Eun Kwon ),( Eun Sung Jeong ),( Jinsoo Rhu ),( Gyu-seong Choi ),( Jong Man Kim ),( Jae-won Joh ) 대한간학회 2021 춘·추계 학술대회 (KASL) Vol.2021 No.1
Early use of everolimus improved renal function after adult deceased donor liver transplantation
Jaehun YANG,Sunghae PARK,Young Ju OH,Sang Oh YUN,Manuel LIM,Ji Eun KWON,Eun Sung JEONG,Jinsoo RHU,Gyu-Seong CHOI,Jong Man KIM,Jae-Won JOH 한국간담췌외과학회 2021 Annals of hepato-biliary-pancreatic surgery Vol.25 No.-
( Jaehun Yang ),( Jinsoo Rhu ),( Sangjin Kim ),( Seohee Lee ),( Gyu-seong Choi ),( Jong Man Kim ),( Jae-won Joh ) 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1
Aims: This study aims to compare differences between laparoscopic donor right hemihepatectomy (LDRH) and open donor right hemihepatectomy (ODRH) in the quality of the operation, postoperative complications, and liver regeneration measured via volumetry. Methods: This study included 119 patients who underwent living donor right hemihepatectomy at Samsung Medical Center from January 2016 to December 2017. We compared several aspects of LDRH and ODRH and analyzed the results using the independent t-test, chi-square test and Fisher’s exact test. Results: Among 119 enrolled patients, 66 patients (55.5%) underwent open surgery, and 53 patients (44.5%) underwent laparoscopic surgery. The mean operation time was significantly shorter for ODRH (290.57 ± 54.04 minutes) than LDRH (312.28 ± 53.5 minutes) (P=0.031). Estimated blood loss was significantly less in LDRH (258.49 ± 119.99 ml) than ODRH (326.52 ± 157.68 ml) (P=0.011). The remnant liver recovered to 83.35 ± 10.71% of the preoperative estimate whole liver volume (pre-EWLV) in the ODRH group and 84.04 ± 8.98% of the pre-EWLV in the LDRH group (P=0.707). The percentage of increased estimated liver volume to postoperative estimate remnant liver volume (post-ERLV) was 137.62 ± 40.34% in the ODRH group and 130.56 ± 36.78% in the LDRH group, and there was no statistically significant difference between the two groups (P=0.326). An analysis of postoperative complications showed no significant differences. Conclusions: LDRH is safe, and there is no significant difference in hepatic regeneration compared with ODRH. Therefore, LDRH can be applied for living donation of liver.
정재훈(Jaehun Chung),양민식(Minsik Yang),손지훈(Jihoon Son),배철호(Cheolho Bai),심재술(Jaesool Shim),배영화(Younghwa Bae),김우엽(Wooyoub Kim),김정재(Jungjae Kim),김청산(Chungsan Kim) 대한기계학회 2021 대한기계학회 춘추학술대회 Vol.2021 No.4
자동차 도어 래치는 차량에 승객이 탑승하기 위해 반드시 필요한 부품으로 도어의 Open/Close 뿐만 아니라 Lock/Unlock 과 같이 복합적인 기능을 수행한다. 차량 주행 중에 도어를 닫힌 상태로 유지하여야 하고 비상시 승객의 신속한 탈출을 위해 반드시 작동하여야 한다. 이와 같이 도어 래치는 자동차 안전 법규가 적용되는 부품으로 대단히 높은 신뢰도가 요구된다. 그러나 도어 래치는 다양한 기후에 의한 광범위한 기온에 노출되고 내부 기어류는 모터 동작에 의해 반복적인 하중을 받는다. 그러므로 스트레스 환경에서 높은 신뢰도를 만족하기 위해 누적고장률을 통한 정확한 수명 예측이 필수적이다. 본 연구는 도어 래치 내부의 다양한 부품에 대해 FMECA 와 QFD 기법을 이용하여 고장 메커니즘과 고장 인자를 정의하였으며 HALT를 통해 가속 수준을 결정하였다. 고장 메커니즘은 저온/고온과 하중에 의한 기어 파손이며 평화정공㈜의 시험 장비를 사용하여 -45℃ ~ 100℃의 온도 조건과 18V, 24V의 전압에 의한 하중 조건을 적용해 고장을 가속하였다. 10 개의 가속수명시험과 2 개의 보증 시험이 실시되었으며 신뢰구간을 고려하여 시험 조건별로 10 개의 샘플을 사용하였다. 다수준, 다인자 가속수명시험을 통해 공통형상모수와 수준별 척도모수를 구하였으며, 아이링 모형을 이용하여 온도와 하중의 복합 조건하에서 수명을 예측할 수 있다. Door latch of automobile is a necessary component for automobile passengers which performs not only Open/Close but also Lock/Unlock. Also, door latch is strongly controlled by automobile safety regulation and requires high reliability. Door latch is exposed to wide range of temperatures due to climate and repetitive load of motor is applied to gears. Therefore, estimation of cumulative failure rate and lifespan under stress condition is necessary. This research investigated various parts inside of latch and organized FMECA and QFD to analyze failure mechanisms and factors. Also, HALT was performed for acceleration level decision. Failure mechanism of door latch is gear damage due to high/low temperature and repetitive load. This research utilized PHA Co. Ltd’s testing equipment and applied temperature (-45℃ ~ 100℃) and load (18V, 24V) conditions to accelerate failure. 10 ALTs and 2 proof tests were conducted. Considering confidence interval, 10 samples were used for each test. Common shape parameter and scale parameters were derived as a result of multi-levels, factors ALT. By applying Eyring model, lifespan under specific temperature and load condition is estimated.