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Sang-Hyun Kang,Shin Hwang,Tae Yong Ha,Gi Won Song,Dong-Hwan Jung,Chul-Soo Ahn,Deok-Bog Moon,Ki-Hun Kim,Gil-Chun Park,Young-In Yoon,Yo Han Park,Hui-Dong Cho,권재현,Yong-Kyu Chung,Jin-Uk Choi,Sung Gyu Lee 대한이식학회 2019 Korean Journal of Transplantation Vol.33 No.4
Background: The mammalian target of the rapamycin inhibitor has dual inhibitory effects on cell growth and angiogenesis. This study aimed to analyze the usage of everolimus on actual immunosuppression (IS) regimens through a cross-sectional study in a high-volume liver transplantation (LT) center. Methods: Our institutional LT database was searched for adult patients who underwent primary LT surgery between January 2010 and December 2016. We identified 2,093 LT recipients with observation periods of 1 to 8 years. Results: We divided the 2,093 recipients into three groups according to the posttransplant follow-up period as follows: group A (12–36 months; n=680), group B (37–60 months; n=560), and group C (>60 months; n=853). The individual IS agents were tacrolimus in 1,807 patients (86.3%), cyclosporine in 169 patients (8.1%), mycophenolate mofetil (MMF) in 1,310 patients (62.6%), and everolimus in 115 patients (5.5%). The most common IS regimens were tacrolimus-MMF combination and tacrolimus monotherapy, regardless of the posttransplant period. Patients with pretransplant malignancies were administered everolimus more frequently than those without pretransplant malignancies (P<0.001). In 102 patients with hepatocellular carcinoma recurrence or de novo malignancies, IS regimens included everolimus-tacrolimus in 41 patients (40.2%), tacrolimus-MMF in 27 patients (26.4%), tacrolimus in 20 patients (19.6%), MMF in 10 patients (9.8%), cyclosporine in three patients (2.9%), and cyclosporine-MMF in one patient (1.0%). Conclusions: Administration of everolimus after LT has been gradually increasing with the expansion of indications in our institutional practice. Currently, the role of everolimus is minimal and not comparable to that of tacrolimus, but it has a unique position in the field of IS after LT.
Sung Il Kim,Won Jin Kang,Yeseul Choi,Hyunah Kim,Bueyong Park,Hyun Kyung Kim,Hyun-Ha Koo,Gil-Hah Kim 한국응용곤충학회 2018 한국응용곤충학회 학술대회논문집 Vol.2018 No.04
The two-spotted spider mite, Tetranychus urticae Koch (Acari: Tetranychidae), is one of the most important pest species devastating many horticultural and ornamental crops and fruit trees. In the present study, a field strain was collected in January 2001 and has been selected for sixteen years with acequinocyl. The resistance ratio calculated from the LC50 of eggs and adults was 191- and 4,237-fold, respectively. The laboratory-selected acequinocyl resistance (LSAR16) strain was screened with 11 acaricides for cross-resistance. The detoxifying enzyme activities and quantitative real-time PCR analysis were performed in the LSAR16 strain. Crossing experiments revealed that LSAR16 strain was inherited maternally, incompletely dominant and monogenic. Most importantly, we identified two new point-mutations at mitochondrial cytb from acequinocyl resistant T. urticae.
Sung-Gyu Lee,Shin Hwang,Tae Yong Ha,Gi Won Song,Dong-Hwan Jung,Gil-Chun Park,Chul-Soo Ahn,Deok-Bog Moon,Ki Hun Kim,Young-In Yoon,Yo Han Park,Hui-Dong Cho,Yong-Kyu Chung,Sang-Hyun Kang,Jin-Uk Choi,Sung 대한이식학회 2019 Korean Journal of Transplantation Vol.33 No.4
Background: Autologous portal vein Y-graft (PYG) interposition has been the standard procedure for reconstruction of double portal vein (PV) orifices of right liver grafts during living donor liver transplantations. However, it has the disadvantage of being vulnerable to anastomotic stenosis. A refined technique of conjoined unification venoplasty (CUV) was developed to secure PV reconstruction. Methods: We reviewed the surgical outcomes in PV reconstructions using CUVs in 21 cases which were followed up for >3 years. Results: The mean age of recipients was 51.7±4.9 years. The model for end-stage liver disease score was 15.3±6.4. The graft-recipient weight ratio was 1.12±0.21. Recipient PYGs were harvested in all cases. All living donors were blood relatives or relatives through marriage with type III PV anomalies. The number of right liver graft PV orifices was two in 19 cases and three in two cases. For the central intervening vein patch, a PV segment was used in six cases, and an autologous greater saphenous vein patch was used in the remaining 15 cases. The 21 patient cohort displayed a 100% 4-year patient survival rate. None of them underwent any PV interventions including interventional stenting. Serial follow-up computed tomography scans revealed that the reconstructed PV showed early reshaping with a stable streamlined configuration for over 3 years. Conclusions: PV reconstruction using the CUV technique appears to be significantly more effective in preventing PV complications. We believe that CUV is a useful technique to reconstruct right liver grafts with multiple PV orifices.
Gil-Chun Park,Shin Hwang,Dong-Hwan Jung,Gi-Won Song,Chul-Soo Ahn,Ki-Hun Kim,Deok-Bog Moon,Tae-Yong Ha,Young-In Yoon,Hui-Dong Cho,Jae-Hyun Kwon,Yong-Kyu Chung,Sang-Hyun Kang,I-Ji Jung,Jin Uk Choi,Sung- 대한외과학회 2020 Annals of Surgical Treatment and Research(ASRT) Vol.98 No.2
Purpose: Hepatorenal syndrome (HRS) is a fatal complication in patients with end-stage liver disease awaiting liver transplantation (LT). HRS often develops in patients with high model for end-stage liver disease (MELD) score. This study investigated the outcomes of peritransplant management of HRS in a high-volume LT center in Korea for 2 years. Methods: A total of 157 recipients that deceased donor liver transplantation (DDLT) from January 2017 to December 2018 were included. In-hospital mortality (IHM) was analyzed in relation to pre- and posttransplant application of renal replacement therapy (RRT). Results: Primary diagnoses for DDLT were alcoholic liver disease (n = 61), HBV-associated liver cirrhosis (n = 48), retransplantation for chronic graft failure (n = 24), and others (n = 24). Mean MELD score was 34.6 ± 6.2 with 72 patients at Korean Network for Organ Sharing MELD status 2 (45.9%), 43 at status 3 (27.4%), 36 at status 4 (22.9%), and 6 at status 5 (3.8%). Pretransplant RRT was performed in 16 patients (10.2%) that did not show IHM. Posttransplant RRT was performed in 69 patients (44.0%), for whom IHM incidence was 15.9%. In 53 patients that had undergone de novo posttransplant RRT, IHM incidence increased to 20.8%. IHM in the 88 patients not requiring RRT was 2.3%. Conclusion: The majority of adult DDLT recipients in Korean MELD score-based allocation system have very high MELD scores, which is often associated with HRS. Pretransplant RRT appears to improve posttransplant survival outcomes. We thereby recommend that, if indicated, pretransplant RRT be performed while awaiting DDLT.
Seabed Liquefaction with Reduction of Soil Strength due to Cyclic Wave Excitation
Choi, Byoung-Yeol,Lee, Sang-Gil,Kim, Jin-Kwang,Oh, Jin-Soo Korean Society of Ocean Engineers 2017 Journal of advanced research in ocean engineering Vol.3 No.2
This study introduces the case of pipelines installed in subsea conditions and buried offshore. Such installations generate pore water pressure under the seabed because of cyclic wave excitation, which is an environmental load, and consistent cyclic wave loading that reduce the soil shear strength of the seabed, possibly leading to liquefaction. Therefore, in view of the liquefaction of the seabed, stability of the subsea pipelines should be examined via calculations using a simple method for buried subsea pipelines and floating structures. Particularly, for studying the possible liquefaction of the seabed in regard to subsea pipelines, high waves of a 10- and 100-year period and the number of occurrences that are affected by the environment within a division cycle of 90 s should be applied. However, when applying significant wave heights (HS), the number of occurrences within a division cycle of 3 h are required to be considered. Furthermore, to research whether dynamic vertical load affect the seabed, mostly a linear wave is used; this is particularly necessary to apply for considering the liquefaction of the seabed in the case of pile structure or subsea pipeline installation.
Sang-Tae Choi,Shin Hwang,Hea-Nam Hong,You-Jin Won,Chul-Soo Ahn,Tae-Yong Ha,Gi-Won Song,Dong-Hwan Jung,Gil-Chun Park,Sung-Gyu Lee 한국간담췌외과학회 2013 한국간담췌외과학회지 Vol.17 No.1
Backgrounds/Aims: Mesenchymal stem cells (MSCs) have the capacity to differentiate into hepatocytes, The purpose of this study is to investigate the MSCs’ differentiation process and therapeutic potentials by comparing isolated MSCs with HGF-treated MSCs in rat’s model with thiacetamide (TAA)-induced cirrhosis. Methods: Male Sprague-Dawley (SD) rats, weighing 100-150 g were used in this study. To induce liver fibrosis, recipient rats were taken with 0.04% thioacetamide (TAA) in the drinking water (400 mg TAA/L) for 8 weeks. The rats underlying liver cirrhosis were divided into 3 groups according to the transplanted materials, compared to normal saline as control (I) and isolated MSCs (II) HGF-treated MSCs. Results: Severe hepatic fibrosis and hepatocyte destruction were detected in the control group. Less hepatic cirrhosis and collagen formation, more hepatocyte regeneration and glycogen storage were detected in isolated MSCs compared to HGF-treated MSCs group, Distribution of red autofluorescence is mainly localized near the sinusoids in isolated MSCs, scattered away the sinusoids in HGF-treated MSCs group. MSCs transdifferentiated into CK-19 postive Oval cells and then to albulmin-producing hepatocytes, HGF treated MSCs differentiated into hepatocyte without the intermediate oval cells phase. HGF treated MSCs became the CK18-positive, MSCs became CD 90-positive. Conclusions: Significant hepatocyte differentiation occurred in not HGF-treated MSCs but isolated MSCs group unexpectedly. These results suggest that the beneficial effect of MSCs on in rat’s model with TAA-induced cirrhosis may occur during early differentiation course of MSCs. Mature hepatocyte itself has a little effect on the accelerated differentiation and functional capacity of hepatic lineage cell-line.