Outcome of Multipair Donor Kidney Exchange by a Web-Based Algorithm

Kim, Beom Seok,Kim, Yu Seun,Kim, Soon Il,Kim, Myoung Soo,Lee, Ho Yung,Kim, Yong-Lim,Kim, Chan Duck,Yang, Chul Woo,Choi, Bum Soon,Han, Duck Jong,Kim, Yon Su,Kim, Sung Joo,Oh, Ha-Young,Kim, Dae Joong American Society of Nephrology 2007 Journal of the American Society of Nephrology Vol.18 No.3

<P>Donor kidney exchange is an established method to overcome incompatibility of donor-recipient pairs (DRP). A computerized algorithm was devised to exchange donor kidney and was tested in a multicenter setting. The algorithm was made according to the consensus of participating centers. It makes all possible exchange combinations not only between two incompatible DRP but also circularly among three DRP and selects an optimum set of exchange combinations, considering several factors that can affect the outcome of the exchanged transplant. The algorithm was implemented as a web-based program, and matching was performed five times. Fifty-three DRP were enrolled from five transplant centers. The numbers of DRP that were enrolled in each matching were 38 (25:13), 39 (34:5), 33 (31:2), 32 (28:4), and 34 (30:4) (carryover:newcomer). The numbers of generated exchange combinations were 4:11, 3:17, 2:12, 2:3, and 2:3 (two-pair exchange:three-pair exchange), and the numbers of DRP in selected exchange combinations were six, 12, six, five, and four in each matching. The numbers of DRP with blood type O recipient or AB donor were five and one, respectively, in selected exchange combinations. Six DRP of two-pair exchange combinations and six DRP of three-pair exchange combinations underwent transplantation successfully. Computerized algorithm of donor kidney exchange was tried not only between two incompatible DRP but also circularly among three DRP. It showed that the algorithm has potential to improve the outcome of donor kidney exchange, especially for disadvantaged DRP with blood type O recipients or AB donors.</P>

The Multifaceted Clinical Characteristics of Congenital Cytomegalovirus Infection: From Pregnancy to Long-Term Outcomes

Kim Yejin,Kim Yoo-min,Kim Doo Ri,Kim Han Gyeol,Sung Ji-Hee,Choi Suk-Joo,Oh Soo-young,Kim Yae-Jean,Chang Yun Sil,Kim Dongsub,Kim Jung-Sun,Moon Il Joon,Roh Cheong-Rae 대한의학회 2023 Journal of Korean medical science Vol.38 No.32

Background: The aim of this study was to capture multifaceted clinical characteristics of congenital cytomegalovirus (CMV) infection from diagnosis to treatment using a multidisciplinary approach including obstetrics, pediatrics, pathology, and otorhinolaryngology-head and neck surgery. Methods: This is a retrospective study including 30 consecutive cases of congenital CMV infection that were diagnosed at a single tertiary hospital located in Seoul, Korea from January 2009 to December 2020. Congenital CMV infection was defined as a positive result by polymerase chain reaction from urine, saliva or cerebrospinal fluid or positive CMV IgM from neonatal blood sampled within 3 weeks after birth. All cases were analyzed with respect to whole clinical characteristics from diagnosis to treatment of congenital CMV by a multidisciplinary approach including prenatal sonographic findings, maternal immune status regarding CMV infection, detailed placental pathology, neonatal clinical manifestation, auditory brainstem response test, and antiviral treatment (ganciclovir or valganciclovir). Long-term outcomes including developmental delay and hearing loss were also investigated. Results: The total number of births during the study period in our institution was 19,385, with the prevalence of congenital infection estimated to be 0.15%. Among 30 cases of congenital CMV, the median gestational age at delivery was 32.2 weeks [range, 22.6–40.0] and 66.7% of these infants were delivered preterm at less than 37 weeks. Suspected fetal growth restriction was the most common prenatal ultrasound finding (50%) followed by ventriculomegaly (17.9%) and abnormal placenta (17.9%), defined as thick placenta with calcification. No abnormal findings on ultrasound examination were observed in one-third of births. Maternal CMV serology tests were conducted in only 8 cases, and one case each of positive and equivocal IgM were found. The most common placental pathologic findings were chronic villitis (66.7%) and calcification (63.0%), whereas viral inclusions were identified in only 22.2%. The most common neonatal manifestations were jaundice (58.6%) followed by elevation of aspartate aminotransferase (55.2%) and thrombocytopenia (51.7%). After excluding cases for which long-term outcomes were unavailable due to death (n = 4) or subsequent follow up loss (n = 3), developmental delay was confirmed in 43.5% of infants (10/23), and hearing loss was confirmed in 42.9% (9/21) during the follow-up period. In our cohort, 56.7% (17/30) of neonates were treated for congenital CMV with ganciclovir or valganciclovir. Conclusion: Our data show that prenatal findings including maternal serologic tests and ultrasound have limited ability to detect congenital CMV in Korea. Given that CMV is associated with high rates of developmental delay and hearing loss in infants, there is an urgent need to develop specific strategies for the definite diagnosis of congenital CMV infection during the perinatal period by a multidisciplinary approach to decrease the risks of neurologic impairment and hearing loss through early antiviral treatment.

Online Registry for Nationwide Database of Current Trend of <i>Helicobacter pylori</i> Eradication in Korea: Interim Analysis

Kim, Beom Jin,Kim, Hyun-Soo,Song, Hyun Joo,Chung, Il-Kwun,Kim, Gwang Ha,Kim, Byung-Wook,Shim, Ki-Nam,Jeon, Seong Woo,Jung, Yun Jin,Yang, Chang-Hun,Kim, Ji Hyun,Kim, Tae Ho,Kim, Sang Gyun,Shin, Woon Ge The Korean Academy of Medical Sciences 2016 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.31 No.8

<P>Eradication of <I>Helicobacter pylori</I> using first-line therapy is becoming less effective. Subjects who had been treated for <I>H. pylori</I> infection were prospectively enrolled through an on-line database registry from October 2010 to December 2012. Demographic data, detection methods, treatment indication, regimens, durations, compliance, adverse events, and eradication results for <I>H. pylori</I> infection were collected. Data of 3,700 patients from 34 hospitals were analyzed. The overall eradication rate of the first-line therapy was 73.0%. Eradication failure was significantly associated with old age, concomitant medication, and comorbidity. Regional differences in eradication rates were observed. The most common first-line therapy was proton pump inhibitor-based triple therapy (standard triple therapy, STT) for 7 days (86.8%). The eradication rates varied with regimens, being 73% in STT, 81.8% in bismuth-based quadruple therapy, 100% in sequential therapy, and 90.3% in concomitant therapy. The eradication rate in treatment-naïve patients was higher than that in patients previously treated for <I>H. pylori</I> infection (73.8% vs. 58.5%, <I>P</I> < 0.001). The overall eradication rate for second-line therapy was 84.3%. There was no statistical difference in eradication rates among various regimens. <I>H. pylori</I> eradication rate using STT is decreasing in Korea and has become sub-optimal, suggesting the need for alternative regimens to improve the efficacy of first-line therapy for <I>H. pylori</I> infection.</P>

止浦 金坵의 詩文 연구 : 불교시문과 表箋文을 중심으로

김상일(Kim, Sang-Il) 동악어문학회 2020 동악어문학 Vol.80 No.-

이 글은 고려후기를 살았던 金坵(1211-1278)가 지은 시문의 제재적 성격과 문학적 품질을 분석한 것이다. 1. 김구의 시는 현재 14題 16首가 전한다. 먼저, 그의 시 중에는 매우 감각적인 작품이 있다. 특히 그의 詠物詩에 보이는 섬세한 관찰과 형상은 매우 뛰어나다. 이러한 그의 시 짓기 능력은 ‘시인의 솜씨’라 하겠다. 한편, 그의 『北征錄』에 실렸다는 시작품에는 사대부 의식이 투영되어 있다. 이런 점은 고려말 新興士大夫의 巡行詩의 作風과 조선시대의 燕行詩와 상통한다. 2. 김구의 불교시문은 그의 불교에 대한 깊은 인식을 보여준다. 그리고, 고려후기의 사회 현실에 대한 깊은 인식을 보여주는 점에 특징이 있다. 3. 김구의 시와 산문을 모아 엮은 『止浦集』에는 시 12제 외에도, 敎冊 5편, 啓 1편, 䟽 5편, 書 3편, 碑銘2편, 表箋 69편 등의 산문이 들어 있다. 이 중의 표전은 대개 몽고에 대한 외교문서로 지은 것인데, 당시 몽고의 강압적 요구에 대응해 오랜 전쟁으로 民生이 도탄에 빠진 현실을 들어 받아들이기 어렵다는 고려쪽의 의지가 짙게 투영되어 있다. 그러므로 이러한 표전은 文章報國을 위한 문장임을 알 수 있다. 따라서, 김구는 시문에 뛰어난 문신 관료 출신 작가로서, 불교에 대한 깊은 인식을 가지고 있었고, 고려사회에 대한 깊은 성찰을 토대로 抗蒙時期 위험에 처한 고려를 문장으로 구하고자 했던 表箋 전문의 작가였다고 하겠다. This paper analyzes the sanctions and literary quality of poems and prose written by Kim Gu (金坵), a late the Goryeo (高麗後期) writer. 1. Kim"s poem is currently only 14 episodes. There is a very sensual piece in his poem. In particular, the delicate observations and images of his youngmool [詠物] (the poems made of grass, trees, birds, and beasts) are outstanding. His ability to write poetry is called the poet"s skill. On the other hand, his Bookjeongrock [北征錄: A collection of poems written while traveling north.] is reflected in the idea of Confucian scholars. This is in common with the Joseon Dynasty (朝鮮) poems, which were created by visiting and visiting diplomats in Beijing(北京). 2. Kim"s Buddhist poetry (Buddhist poetry and prose) shows his deep appreciation of Buddhism. In addition, his Buddhist poems show deep reflection and recognition of society in the late Goryeo period. 3. The collection of Kim Poem"s poems and prose contains 14 poems, 5 books, 1 a long letter, 5 Prayer sentences, 3 letters, 2 writing on a tombstones, and 69 diplomatic documents. The representation of these was usually built during the time that Koryo (고려) opposed Mongolia (蒙古, 元). This expression contains diplomatic content, and the author"s willingness to overcome the dangerous situation that was considered at the time is deeply projected. Therefore, it can be seen that these symbols are for sentence-serving states (文章報國: sentence means to rescue the nation"s crisis). Therefore, it can be seen that Kim Gu was a Confucian scholars who had a deep understanding of Buddhism. And based on a deep reflection on Korea society, it can be seen that he was a professional writer who tried to defend the Goryeo and defeat Mongolia"s invasion.

한국인 직무 스트레스 측정도구의 개발 및 표준화

장세진,고상백,강동묵,김성아,강명근,이철갑,정진주,조정진,손미아,채창호,김정원,김정일,김형수,노상철,박재범,우종민,김수영,김정연,하미나,박정선,이경용,김형렬,공정옥,김인아,김정수,박준호,현숙정,손동국 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Background and Purposes: Over the past three decades, numerous studies performed in Korea have reported that job stress is a determinant risk factor for chronic diseases and work disability. Every society has its own culture and occupational climate particular to their organizations, and hence experiences different occupational stress. An occupational stress measurement tool therefore needs to be developed to estimate it objectively. The purpose of this study is to develop and standardize the Korean Occupational Stress Scale (KOSS) which is considered to be unique and specific occupational stressors in Korean employees. Subjects and Methods: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project: 2002-2004). A total of 12,631 employees from a nationwide sample proportional to the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were administered. The KOSS was developed for 2 years (2002-2004). In the first year, we collected 255 items from the most popular job stress measurement tools such as JCQ, ERI, NIOSH and OSI, and 44 items derived from the a qualitative study (depth interview). Forty-three items of KOSS, in the second year, were retained for use in the final version of the KOSS by using Delphi and factor analysis. Items were scored using conventional 1-2-3-4 Likert scores for the response categories. Results: We developed eight subscales by using factor analysis and validation process: physical environment (3 items), job demand (8 items), insufficient job control (5 items), interpersonal conflict (4 items), job insecurity (6 items), organizational system (7 items), lack of reward (6 items), and occupational climate (4 items). Together they explained 50.0% of total variance. Internal consistency alpha scores were ranged from 0.51 to 0.82. Twenty-four items of the short form of the KOSS (KOSS-SF) were also developed to estimate job stress in the work setting. Because the levels of the subscales of occupational stress were gender dependent, gender-specific standard norms for both the 43-item full version and the 24-item short form using a quartile for the subscales of KOSS were presented. Conclusion: The results of this study suggest that KOSS might be an appropriate measurement scale to estimate occupational stress of Korean employees. Further and more detailed study needs to be conducted to improve the validity of this scale.

Expression of TLR2, TLR4, and TLR9 in dermatomyositis and polymyositis

Kim, Geun-Tae,Cho, Mi-La,Park, Young-Eun,Yoo, Wan Hee,Kim, Jung-Hee,Oh, Hye-Jwa,Kim, Dae-Sung,Baek, Seung-Hoon,Lee, Sun-Hee,Lee, Jun-Hee,Kim, Ho-Youn,Kim, Sung-Il Springer-Verlag 2010 CLINICAL RHEUMATOLOGY Vol.29 No.3

<P>The aim of this study was to investigate the expressions of Toll-like receptor (TLR) 2, TLR4, TLR9, and their correlations with the expression of cytokines that are associated with activation of CD4<SUP>+</SUP> T cells and inflammation including interferon γ (IFNγ), interleukin 4 (IL4), interleukin 17 (IL17), and tumor necrosis factor α (TNFα) in muscle tissues of patients with dermatomyositis (DM) and polymyositis (PM). The expressions of TLR2, TLR4, TLR9, IFNγ, IL4, IL17, and TNFα were measured by real-time reverse transcription–polymerase chain reaction in muscle tissues from 14 patients with DM and PM (nine patients with DM, five patients with PM) and three controls. The expressions of TLR2, TLR4, and TLR9 were also localized with immunohistochemistry. The expression levels of TLR2, TLR4, TLR9, IFNγ, IL4, IL17, and TNFα were significantly high in patients with DM and PM compared with those in the controls, and the expression levels of TLR4 and TLR9 had significant positive correlations with the expressions of IFNγ, IL4, IL17, and TNFα. Immunohistochemistry showed that TLR2, TLR4, and TLR9 were expressed by infiltrating cells of perimysium in DM, whereas they were expressed by infiltrating cells of endomysium in PM. These results suggest that the involvement of TLR4 and TLR9 in immunopathogenesis of DM and PM might be connected with activation of CD4<SUP>+</SUP> T cells.</P>

Vitamin C prevents stress-induced damage on the heart caused by the death of cardiomyocytes, through down-regulation of the excessive production of catecholamine, TNF-α, and ROS production in <i>Gulo(</i>−/−<i>)</i> <sup> <i>Vit C-Insuffic

Kim, Hyemin,Bae, Seyeon,Kim, Yejin,Cho, Chung-Hyun,Kim, Sung Joon,Kim, Yong-Jin,Lee, Seung-Pyo,Kim, Hang-Rae,Hwang, Young-il,Kang, Jae Seung,Lee, Wang Jae Elsevier 2013 FREE RADICAL BIOLOGY AND MEDICINE Vol.65 No.-

<P><B>Abstract</B></P> <P>It is thought that vitamin C has protective roles on stress-induced heart damage and the development of cardiovascular diseases, but its precise role and mechanisms are unclear. In the present study, we investigated the specific mechanisms by which vitamin C leads to protecting the heart from stress-induced damage in the <I>Gulo(</I>−/−<I>)</I> mice which cannot synthesize vitamin C like humans. By exposure to stress (1h/day), the heartbeat and cardiac output in vitamin C-insufficient <I>Gulo(</I>−/−<I>)</I> mice were definitely decreased, despite a significant increase of adrenaline (ADR) and noradrenaline (NA) production. A change of cardiac structure caused by the death of cardiomyocytes and an increased expression of matrix metalloprotease (MMP)-2 and -9 were also found. Moreover, lipid peroxidation and the production of tumor necrosis factor-alpha (TNF-α) in the heart were increased. Finally, all vitamin C-insufficient <I>Gulo(</I>−/−<I>)</I> mice were expired within 2 weeks. Interestingly, all of the findings in vitamin C-insufficient <I>Gulo(</I>−/−<I>)</I> mice were completely prevented by the supplementation of a sufficient amount of vitamin C. Taken together, vitamin C insufficiency increases the risk of stress-induced cardiac damage with structural and functional changes arising from the apoptosis of cardiomyocytes.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Vitamin C insufficiency accelerates the stress-induced death of <I>Gulo(</I>−/−<I>)</I> mice. </LI> <LI> Oxidative stress in the heart is increased by stress and vitamin C insufficiency. </LI> <LI> TNF-α, ADR, and NA are excessively produced by stress and vitamin C insufficiency. </LI> <LI> Structural/functional cardiac changes are induced by stress and vitamin C insufficiency. </LI> <LI> Vitamin C supplementation prevents cardiac changes and death of <I>Gulo(</I>−/−<I>)</I> mice. </LI> </UL> </P>

The risk of lymph node metastasis makes it unsafe to expand the conventional indications for endoscopic treatment of T1 colorectal cancer : A retrospective study of 428 patients

Kim, Bun,Kim, Eun Hye,Park, Soo Jung,Cheon, Jae Hee,Kim, Tae Il,Kim, Won Ho,Kim, Hoguen,Hong, Sung Pil Wolters Kluwer Health 2016 Medicine Vol.95 No.37

<P><B>Abstract</B></P><P>Though endoscopic treatment is an option for T1 colorectal cancer (CRC), the optimal indications and long-term outcomes of this strategy need to be validated. Therefore, the aim of this study is to investigate long-term outcomes of endoscopy versus surgery and optimal indications for endoscopic treatment of T1 CRC.</P><P>This retrospective study included 428 T1 CRC patients treated with initial endoscopy (n = 224) or surgery (n = 204) at Severance Hospital between 2005 and 2012. Patients were subdivided into 4 groups according to conventional indications (CIs) for endoscopic treatment: negative lateral/vertical margins; submucosal invasion depth within 1000 μm; no lymphovascular invasion (LVI); well or moderately differentiated. For prognosis evaluation, short-term outcomes (resection margin and complications) and long-term outcomes (recurrence and cancer-specific mortality) were evaluated.</P><P>Endoscopic treatment achieved en bloc resection in 86.6% of 224 patients. Recurrence and mortality did not differ between the endoscopy and surgery groups with or without CIs. For patients with CIs, although 80 patients were treated endoscopically with 1 (1.3%) recurrence and 0 mortality, 75 patients were treated surgically with 2 (2.7%) recurrence and 1 (1.3%) mortality. Multivariate analysis revealed that LVI positivity and poorly differentiated histology were independently associated with lymph node metastasis (LNM; <I>P</I> < 0.001 and <I>P</I> = 0.001, respectively).</P><P>To determine whether the depth of submucosal invasion among criteria of CIs could be extended for endoscopic treatment, LNM was analyzed by extending the depth of submucosal invasion. There was no LNM in 155 patients within conventional indication. When the depth of submucosal invasion was extended up to 1500 μm, LNM was occurred (1/197 patient [0.5%]). In addition, when the depth of submucosal invasion was extended up to 2000 μm, LNM was increased (4/271 patient [1.5%]).</P><P>Endoscopic treatment is safe, effective, and is associated with favorable long-term outcomes compared to surgery for initial treatment of T1 CRC patients with CIs. However, the risk of LNM makes it unsafe to extend the CIs for endoscopic therapy in these patients.</P>

A Simple Mouse Model for the Study of Human Immunodeficiency Virus

Kim, Kang Chang,Choi, Byeong-Sun,Kim, Kyung-Chang,Park, Ki Hoon,Lee, Hee Jung,Cho, Young Keol,Kim, Sang Il,Kim, Sung Soon,Oh, Yu-Kyoung,Kim, Young Bong Mary Ann Liebert 2016 AIDS research and human retroviruses Vol.32 No.2

Recovery of pigmentation following selective photothermolysis in adult zebrafish skin: clinical implications for laser toning treatment of melasma

Kim, Jae Hwan,Kim, Do Hyun,Kim, Ji Hae,Lee, Sang Geun,Kim, Hyeon Soo,Park, Hae Chul,Kim, Il-Hwan Informa Healthcare 2012 Journal of cosmetic and laser therapy Vol.14 No.6

<P>In recent years, laser toning has gained popularity for the treatment of melasma, and tyrosinase inhibitors are conventionally used to prevent its recurrence after this treatment. The effectiveness of this treatment modality, however, is still questionable, and additional <I>in vivo</I> studies are needed to validate the method. In this study, we used adult zebrafish skin as an adult melanocyte regenerative system and examined the simulated human skin response to laser toning. Melanosomes regenerated after selective photothermolysis, and these organelles showed a bi-directional translocation pattern in accordance with the changes of intact melanosome patterns. Furthermore, a tyrosinase inhibitor, 1-phenyl-2-thiourea (PTU), completely blocked melanosome regeneration after laser irradiation, but this inhibitor failed to prevent melanosome regeneration after the medication was discontinued. Finally, arbutin and kojic acid, the commercially available tyrosinase inhibitors, slowed down but did not completely block melanosome regeneration. Based on these findings, we describe the limitations of laser toning treatment of melasma and the combined use of tyrosinase inhibitors. We suggest that melanosomes in adult zebrafish skin can be utilized for studying melanosome regeneration response to laser irradiation and for developing a system to assess the comparative efficacy of melanogenic regulatory compounds.</P>