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Sang-Hyun Kang,Shin Hwang,Chul-Soo Ahn,Ki-Hun Kim,Deok-Bog Moon,Tae-Yong Ha,Gi-Won Song,Dong-Hwan Jung,Gil-Chun Park,Jung-Man Namgoong,Young-In Yoon,Hui-Dong Cho,Jae-Hyun Kwon,Yong-Kyu Chung,Jin Uk Ch 대한이식학회 2020 Korean Journal of Transplantation Vol.34 No.1
Background: To understand the changing demands and recent trends in the indications for living donor liver transplantation (LDLT), the present study aimed to analyze the indications for LDLT performed in a high-volume transplantation center over 10 years. Methods: The liver transplantation database at our institution was searched to identify patients who underwent LDLT during a 10-year period from January 2008 to December 2017. The study subjects (n=3,145) were divided into two groups: adult patients (n=3,019, 92.7%) and pediatric patients (n=126, 3.9%). Results: In the adult recipients, the primary diagnoses were hepatitis B virus (HBV)- associated liver cirrhosis (n=1,898, 62.9%), alcoholic liver disease (n=482, 16.0%), hepatitis C virus-associated cirrhosis (n=203, 6.7%), acute liver failure (n=127, n=4.2%), and other diseases (n=157, 5.2%). The mean Model for End-Stage Liver Disease score was 15.6±8.8 (range, 6–40). The proportion of patients with HBV-associated liver disease gradually decreased, but the proportion of those with alcoholic liver disease increased. Hepatocellular carcinoma (HCC) was diagnosed in 1,467 patients (48.6%). The mean proportion of patients with HCC was 63.1% among those with HBVassociated liver disease. In pediatric recipients, the primary diagnoses were biliary atresia (n=51, 40.5%), liver failure of various causes (n=37, 29.4%), metabolic disease (n=22, 17.5%), hepatoblastoma (n=12, 9.5%), and infectious diseases (n=4, 3.2%). Conclusions: Our results showed that there were some significant changes in the indications of LDLT. We believe that our results may reflect the real changes in the indications of LDLT and they will be useful for predicting further changes in the future.
Sung-Hwa Kang,Shin Hwang,Tae-Yong Ha,Gi-Won Song,Dong-Hwan Jung,Ki-Hun Kim,Chul-Soo Ahn,Deok-Bog Moon,Gil-Chun Park,Bo-Hyun Jung,Young-In Yoon,Sung-Gyu Lee 한국간담췌외과학회 2014 한국간담췌외과학회지 Vol.18 No.2
Backgrounds/Aims: There are few guidelines for tailored immunosuppressive regimens for liver transplantation (LT) recipients with hepatocellular carcinoma (HCC). To establish long-term immunosuppressive regimens suitable for Korean adult LT recipients, we analyzed those that were currently in use at a single high-volume institution. Methods: This cross-sectional study comprises three parts including review of the immunosuppressive regimens used to manage 2,147 adult LT outpatients, review of LT recipients who were diagnosed of HCC at LT, and review of LT recipients who suffered from HCC recurrence. Results: In 1,000 adult LT recipients who were living more than 5 years with no adverse events, 916 received a calcineurin inhibitor (CNI)-based therapy (CNI only in 520; CNI with mycophenolate mofetil [MMF] in 396) and 84 were receiving an MMF-based therapy (MMF only in 45; MMF with minimal CNI in 39). Tacrolimus was preferred over cyclosporine for both monotherapy and combination therapy along the passage of posttransplant period. There was no difference in selection of immunosuppressants, target blood concentration, and rate of combination therapy between LT recipients with and without HCC, except for the first 1 year. Sirolimus-based regimens were applied in 21 patients who showed HCC recurrence. Sorafenib was often used after conversion to sirolimus. Conclusions: Tailored immunosuppressive regimen covering the long-term posttransplant period should be established after consideration of individualized patient profiles including HCC.
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.
FCT 11 : Successful treatment of longitudinal melanonychia with Q-switched Nd:YAG laser
( Gil Han ),( Sang Don Yoon ),( Sung Ae Kim ),( Kyu Suk Lee ) 대한피부과학회 2014 대한피부과학회 학술발표대회집 Vol.66 No.2
Background: Longitudinal melanonychia is a common cosmetic problem in dermatology. To confirm the diagnosis of longitudinal melanonychia and rule out the malignant melanoma, dermatologists recommend patients to get the biopsy of the nail matrix which is painful and can result in permanent nail dystrophy. Objectives: The purpose of this study is to investigate the effect of Q-switched Nd:YAG laser in patients with longitudinal melanonychia without malignant melanoma risk. Methods: 10 patients were enrolled. We selected the patients who has longitudinal melanonychia without any malignantrisk through clinical appearance and dermoscopic finding. Two to four sessions of Q-switched Nd:YAG laser treatment were performed to patients depending on their individual melanonychia states. Improvement was evaluated using visual analoque scale by both dermatologists and patients. Results: All longitudinal melanonychia showed remarkableimprovement after two to four sessions of treatment. The remained lesions were completely treated within additional two sessions. Clinical improvement were very good or good in both dermatologists and no recurrence was observed during the follow up period.Conclusion: In conclusion, we suggest that Q-switched Nd:YAG laser is a safe and effective treatment option for stable longitudinal melanonychia.
Sang-Rae Moon,Sun-Ran Cho,Jin-Won Jeong,Youn-Ho Shin,Jeong-Oh Yang,Ki-Su Ahn,Changmann Yoon,Gil-Hah Kim 한국응용생명화학회 2011 Applied Biological Chemistry (Appl Biol Chem) Vol.54 No.4
Attraction responses of plant essential oils were investigated, and the electrophysiological response to nymphs and adults of spot clothing wax cicada (Lycorma delicatula) was confirmed. Of the ten tested oils, only spearmint oil was found attractive. In dose responses of spearmint oil, second to fourth instar nymphs, as well as adults, were significantly attracted to a dose of 5 μL; for nymphs, fourth instar nymph showed greatest attraction response (90.9%), and second and third instar nymphs showed mild attraction. At a dose of 10 μL, fourth instar nymphs and adults were significantly attracted to spearmint oil. Only fourth instar nymphs were attracted to spearmint oil at 2.5 μL. After analyzing spearmint oil using gas chromatography (GC) and GC/mass spectrometry, carvone constituent was found as a significant attractant for both nymphs and adults, except for first instar nymphs. Limonene did not show any attraction response. All constituents mixed with each other appeared to have an additive effect. In electrophysiological response to spearmint oil, antennae of only fourth instar nymphs and female adults responded to carvone. Therefore, spearmint oil may be effective as an attractant for control of L. delicatula populations. In a field test, fourth nymphs and female adults were highly attracted to 20 μL of spearmint oil. This is the first report on attraction response of L. delicatula to spearmint oil in the laboratory and the field.
Gil-Chun Park,Shin Hwang,Dong-Hwan Jung,Tae-Yong Ha,Gi-Won Song,Chul-Soo Ahn,Deok-Bog Moon,Ki-Hun Kim,Young-In Yoon,Hwui-Dong Cho,Jin-Uk Choi,Sung-Gyu Lee 대한외과학회 2020 Annals of Surgical Treatment and Research(ASRT) Vol.99 No.5
Purpose: A cryopreserved iliac artery homograft (IAH) has not been considered suitable for middle hepatic vein (MHV) reconstruction during living donor liver transplantation (LDLT), primarily due to the low patency from its small diameter. We revised our surgical techniques for MHV reconstruction using an IAH to improve its patency. Methods: This study analyzed the causes of early conduit occlusion and developed revised techniques to address this that had clinical application. Results: The potential risk factors for early conduit occlusion were the small IAH size, small graft in the segment V vein (V5) and segment VIII vein (V8) opening, and small recipient MHV-left hepatic vein stump. These factors were reflected to our revised surgical methods which included endarterectomy of the atherosclerotic plaque, unification of the internal and external iliac artery branches for large V5, and branch-patch arterioplasty for large V8. IAH endarterectomy, branch unification technique, and branch-patch arterioplasty were applied to 8, 5, and 5 patients, respectively and resulted in 1-month occlusion rates of 37.5%, 20.0%, and 40.0%, respectively. The overall patency rates of the IAH-MHV conduits in our 18 patients were 66.7% at 1 month, 38.9% at 3 months, and 33.3% at 1 year. Conclusion: Our refined MHV reconstruction using an IAH improved short-term MHV conduit patency, but did not effectively prevent early conduit occlusion, particularly with a small- or medium-sized IAH. Individualized reconstruction designs during LDLT operation are needed when an IAH is used for a modified right liver graft.