亞細亞 諸國의 臟器移植에 關한 法律 : Ⅱ. 日 本: 角膜 및 腎臟의 移植에 關한 法律(昭和 五十四年 十二月 十八日-法律 第六十三號) Ⅱ. Japna : Cornea and Kidney Transplantation Act(Law No. 63, December 18, 1979)

이영균 최신의학사 1993 最新醫學 Vol.36 No.5

제1형 당뇨병 환자에서 췌도세포 동종이식의 반복시행

양태영,정인경,서인아,오은영,조건영,오승훈,김성주,정재훈,민용기,이명식,이문규,김광원,도영수,주성욱 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.24 No.4

연구배경:췌도세포 이식은 시술이 간편하고 안전하기 때문에 반복이식이 가능하여 그 동안 여러 센터에서 반복이식의 성공을 보고한 바 있다. 국내에서도 본 병원을 비롯하여 몇몇 센터에서 췌도세포 이식이 활발히 시도되고 있으나 사람에서의 동종이식 및 동종 이식의 반복시행은 보고된 바 없는 실정이다. 저자 등은 국내 최초로 췌도세포 동종이식을 시행하여, 혈청 C­펩타이드가 증가하고 인슐린 요구량이 감소하였으며, 혈당농도와 당화혈색소의 안정을 보였다. 그러나 이식 70일 후 다시 인슐린 요구량이 증가하고 C­펩타이드가 감소하여 췌도세포 이식을 다시 시행한 바 있다. 2차 이식 후 70여일이 지난 현재 다시 혈청 C­펩타이드가 증가하고, 인슐린 요구량이 더 감소되어 췌도세포 이식에서 반복 시행의 유용성을 보고하는 바이다. 방법:환자는 32세 남자로 17년전 당뇨병 진단 후 인슐린 치료 중이었으며, 3년전 부터는 만성신부전증으로 혈액툭석을 하고있었다. 1999년 12월 25일 신장이식을 하였고 3일 후 췌도이식을 하였으며, 두번째 이식은 70일 후 시행하였다. 췌도분리는 변형된 Recordi방법과 비연속성 자당 농도차(discontinuous density gradient)를 이용하였으며 분리한 췌도는 배양 후 환자의 신장기능이 정상화되고 미생물학 검사에서 음성을 확인한 후 경피경간으로 간문맥을 접근하여 16G 폴리 에틸렌 카테터를 이용하여 간실질에 이식하였다. 결과:1차 췌도이식시 순수분리전 췌도수는 210,000개, 순수분리후 획득한 췌도수는 90,000개, 순도 95%, 세포양 1.0mL 이었고, 2차 췌도이식시 순수분리전 췌도수는 420,000개, 순수분리후 획득한 췌도수는 370,000개, 순도 95%, 세포양 1.5mL 이었다. 1,2차 모두 간문맥을 통해 약 20분에 걸쳐 간실질에 주입하였다. 췌도이식전 인슐린요구량은 75∼75U/일, HbA1e 8∼10%, C­펩타이드 0.6ng/mL 였으며, 1차 췌도이식수 7일째 인슐린 요구량은 40U/일, C­펩타이드 1.5ng/mL, FPS 109mg/mL 였고, 40일 추적관찰 후 인슐린 요구량이 36U/일, C­펩타이드 1.8ng/mL, HbA1e 6.5∼7.0%로 안정되었다. 그러나 이식 50일째부터 인슐린 요구량이 50∼56U/일, C­펩타이드 0.6ng/mL, FPS 130∼200mg/dL로 혈당 조절이 불안정하여 다시 췌도이식을 시행하였다. 2차 이식후 50일이 경과한 현재, 인슐린 요구량은 26U/일, C­펩타이드 1.8ng/mL, FPS 90∼120mg/dL로 다시 안정되었다. 결론:췌도이식은 반복이식이 가능하며, 본 환자의 경우 인슐린요구량 감소, 혈당의 안정화 및 C­펩타이드가 상승하여 이식한 췌도의 기능을 확인할 수 있었고, 향후 스테로이드 등 면역억제가 유지 용량으로 감량되면 인슐린 요구량은 더 감소될 것으로 기대된다. Over the past 20 years, significant advances have been made in human islet transplantation. However, cases of prolonged insulin independence after islet allotransplantation have rarely been reported and over time, a slight, gradual decrease in insulin secretion appears to occur, as suggested by the lower C-peptide. Although preliminary clinical success achieved over the past few years has been considerably higher with whole pancreatic transplant than with isolated islet grafts, both approaches remain experimental. Islet grafts might gain, over time, increasing credibility and might eventually provide an easier alternative in terms of grafting procedures and patient management, as compared with the more "traumatizing" whole-pancreas transplantation. Also, using islet, re-transplantation is possible. But it is not known whether re-transplantation of islet could be suitable for those patients who lost grafted islet function. The aim of the present study was to investigate the benefits of re-transplantation of islet in previously simultaneous islets-kidney transplant (SIK) patient who have lost graft function. Methods : The recipient was a 32 year old male. First islet transplantation was underwent at December 25, 1999. However, the grafted islets lost function after 70 days. So we performed re-transplantation of islets. The isolation of islet was conducted sterilely on a laminarflow hood and isolated by a modified Recordimethod. The islet was injected slowly into the liver via a cannular placed in the potalvein for 20 minutes. Results : Transplanted islets were 90,000 IEq at first islet transplantation, 370,000 IEq at second islet transplantation. The insulin requirement was reduced from 75-85 to 35-40 U/day, the basal C-peptide level was 1.5 ng/mL at 7 days posttransplant Unfortunately, the grafted islets lost function after 70 days. After second transplantation, the insulin requirement was reduced to 26 U/day. Conclusions : Despite the continuous need for exogenous insulin therapy, islet transplantation can prevent wide glucose fluctuations, thus resulting in normalization of glycemic control and improvement in HbAlc, and also, show that islets can be successfully and safely re-transplanted intraportally in patients who have lost previously grafted islet function (J Kor Diabetes Asso 457~466, 2000).

Long-Term Outcomes of Adult Lung Transplantation Recipients: A Single-Center Experience in South Korea

( Kyung-wook Jo ),( Sang-bum Hong ),( Dong Kwan Kim ),( Sung Ho Jung ),( Hyeong Ryul Kim ),( Se Hoon Choi ),( Geun Dong Lee ),( Sang-oh Lee ),( Kyung-hyun Do ),( Eun Jin Chae ),( In-cheol Choi ),( Dae 대한결핵 및 호흡기학회 2019 Tuberculosis and Respiratory Diseases Vol.82 No.4

Background: Recently, the number of lung transplants in South Korea has increased. However, the long-term outcome data is limited. In this study, we aimed to investigate the long-term outcomes of adult lung transplantation recipients. Methods: Among the patients that underwent lung transplantation at a tertiary referral center in South Korea between 2008 and 2017, adults patient who underwent deceased-donor lung transplantation with available follow-up data were enrolled. Their medical records were retrospectively reviewed. Results: Through eligibility screening, we identified 60 adult patients that underwent lung (n=51) or heart-lung transplantation (n=9) during the observation period. Idiopathic pulmonary fibrosis (46.7%, 28/60) was the most frequent cause of lung transplantation. For all the 60 patients, the median follow-up duration for post-transplantation was 2.6 years (range, 0.01-7.6). During the post-transplantation follow-up period, 19 patients (31.7%) died at a median duration of 194 days. The survival rates were 75.5%, 67.6%, and 61.8% at 1 year, 3 years, and 5 years, respectively. Out of the 60 patients, 8 (13.3%) were diagnosed with chronic lung allograft dysfunction (CLAD), after a mean duration of 3.3±2.8 years post-transplantation. The CLAD development rate was 0%, 17.7%, and 25.8% at 1 year, 3 years, and 5 years, respectively. The most common newly developed post-transplantation comorbidity was the chronic kidney disease (CKD; 54.0%), followed by diabetes mellitus (25.9%). Conclusion: Among the adult lung transplantation recipients at a South Korea tertiary referral center, the long-term survival rates were favorable. The proportion of patients who developed CLAD was not substantial. CKD was the most common post-transplantation comorbidity.

우리나라 장기이식의 현황과 법률문제

문성제 ( Moon Seong-jea ) 한국외국어대학교 법학연구소 2006 외법논집 Vol.24 No.-

Organ transplantation, the finest example of modem medicine, is based on respect for human life in that it can deliver patients from malignant diseases incurable in past. Since the first successful operation in 1969 as followed by successful transplantation of liver extracted from a person with brain death in 1988, organ transplantation has been already one of most crucial medical arts in Korean and global medicine. Here, organ transplantation consists of 2 processes; one is transplanting organs for medical treatment of patients, and the other is extracting necessary organs from organ donor. The organ transplantation includes auto-transplantation(organ recipient = organ donor), xenograft(replacement with animal organs), insertion of mechanical organs and more. These cases don't involve any special legal issue except general issues in surgical operation such as medical adaptation for such treatments, technical criteria about such medical behaviors and patient’s agreement. But in case of xenograft that needs different organ donor from organ recipient, any one party concerned faces inevitable issues like lost organs or damaged corpse, and the other party benefits from survival or recovered health via transplantation. Because of this contradiction, the organ transplantation involves a question about how to resolve relevant legal issues. As shown here, it is also necessary to discuss extra legal considerations about different interests in organ transplantation between organ donor and recipient. Although there are issues concerned with organ transplantation in terms of organ recipient, it may be construed as general medical behaviors in regard to the nature of medical cure. However, from the standpoint of organ donor, even though the extraction of organ is indispensable for the cure of organ recipient, such extraction itself is not inherent behaviors of medical cure, so it is necessary to build up a series of legal principles to legitimate such behaviors. Here, they depend on whether certain organ is extracted from living organism or dead one. Furthermore, the extraction of organ from living or dead body involves a series of questions like whether to follow the intent of person who has a disposition authority, who the person is, which legitimate effects the expression of his/her intent may have in force, and so forth. In addition, in terms of organ transplantation from living organism for successful transplantation, conflicts concerned with brain death related to beginning and end of person as principal with capacity of enjoyment of rights have been already controversial in discussions between legal and medical circles since long decades ago. Fortunately, the latest enactment and enforcement of “Organ and Equivalent Transplantation Act” gives a clue to resolve these conflicts, but there are still little reviews and studies about potential issues concerned with human respect. It is possibly expected that there will be a series of brisk academic discussions about these issues. From this viewpoint, this paper focuses on posing questions related to organ transplantation and suggesting corresponding solutions.

Technology of Decision-Making Support Regarding the Possibility of Donation and Transplantation Considering Civil Law

Hnatchuk, Yelyzaveta,Hovorushchenko, Tetiana,Drapak, Georgii,Kysil, Tetiana International Journal of Computer ScienceNetwork S 2022 International journal of computer science and netw Vol.22 No.9

The review of known decision-making support systems and technologies regarding the possibility of donation and transplantation showed that currently there are no systems and technologies of decision-making support regarding the possibility of donation and transplantation considering civil law. The paper models the decision-making support process regarding the possibility of donation and transplantation, which is a theoretical basis for the development of rules, methods and technology of decision-making support regarding the possibility of donation and transplantation considering civil law. The paper also developed the technology of decision-making support regarding the possibility of donation and transplantation considering civil law as a component of the Unified State Information System for Organ and Tissue Transplantation, which automatically and free of charge determines the possibility/impossibility of donation and transplantation. In the case of the possibility of donation, the admissible type of donation is also determined - over-life or after-life donation - and data about potential donor is entered in the relevant Donor Register. In the case of the possibility of transplantation, if the recipient needs a transplant of one of the paired organs or a part of the organ/tissue, then data about potential recipient are entered in the Transplantation List from both over-life and after-life donor, otherwise, if the recipient needs a transplant of a non-paired organ or both paired organs, then data about potential recipient are entered only in the Transplantation List from after-life donor.

안면이식에 대한 최근 동향: 한국에서의 안면이식은 어떤 단계에 있는가?

홍종원,김영석,윤인식,이동원,이원재,노태석,유대현,김용욱,나동균,탁관철,박병윤,Hong, Jong Won,Kim, Young Seok,Yun, In Sik,Lee, Dong Won,Lee, Won Jai,Roh, Tai Suk,Lew, Dae Hyun,Kim, Yong Oock,Rah, Dong Kyun,Tark, Kwan Chul,Yun Park, Be- 대한두개안면성형외과학회 2012 Archives of Craniofacial Surgery Vol.13 No.2

The world's first face transplantation was performed in France, in 2005. Since then, 21 cases of face transplantation have been performed. Face transplantation is one of the most prominent part of composite tissue allotransplantation (CTA) along with hand transplantation. Since these fields are not deal with life-saving organs, there are many arguments about immunosuppression therapy. Recent paradigm of face transplantation shows that surgical ranges are expanded from partial face transplantation to full face transplantation. Most immunosuppression protocols are triple therapy, which consists of tacrolimus (FK-506), mycophenolate mofetil and prednisolone. Anatomical researches, immunosuppression, and immunotolerance take great parts in the researches of CTA. The medical fields directly related to face transplantation are microsurgery, immunology, and transplantation. Nowadays, each field is performed widely. Therefore people, even medical teams think face transplantation could be easily realized, sooner or later. But there are lots of things that should be prepared for not only practice and immunosuppression therapy but also for the cooperation with relevant fields. That's the reason why only 21 cases of face transplantation have been done, while more than 70 cases of hand transplantation have been done in the past years. Especially in Korea, brain death patients are not enough even for organ transplantation and furthermore there are some troubles in taking part in the society of transplantation. Face transplantation has lots of problems concerning variable medical fields, administration, society, ethics, and laws. Therefore, for the realization of face transplantation in Korea, not only medical skills but also political powers are needed.

기원과 이식 -근대초극론에 대한 대항으로의 ‘이식’ 개념을 중심으로-

김학중 ( Kim Hak Joong ) 한국언어문화학회(구 한양어문학회) 2020 한국언어문화 Vol.0 No.73

본고는 임화의 <신문학사>에 나타난 ‘이식’에 대한 임화의 사유를 은유적 사고를 중심으로 살펴보려는 시도이다. 은유적 사고를 통해 임화의 ‘이식’ 개념을 살펴보면 기존에 ‘이식’ 개념을 바라보던 지평과는 다른 차원에서 ‘이식’을 조망할 수 있게 된다. 무엇보다 임화의 ‘이식’이 일본의 <근대초극론>에 대한 대항으로 역사의 가능성을 문학사를 통해서나마 지켜내려 했던 시도였음을 알 수 있다. 임화는 우리 근대문학사에서 누구보다 다양한 영역에서 활약했다. 그는 시인이자 비평가이자 문학사가이며 영화배우였다. 동시에 그러한 지평들에 제한되는 것이 아니라 그 지평들을 가로지르고자 하는 상상력을 지닌 사람이었다. 그 상상력은 혁명이었다. 혁명에 대한 상상력은 임화가 역사를 이해하는 방식이었다. 일제에 의한 카프 해산, 폐병으로 인한 건강 악화 등 악재 속에서도 임화는 ≪현해탄≫ (1938)을 펴냈고 학예사를 통해 비평적 작업을 수행했다. 특히 일제가 만주사변을 일으키고 태평양전쟁으로 전쟁을 확대해 나가던 시기에도 <신문학사>에 대한 작업을 수행하며 역사의 가능성을 사유하려고 하였다. 역설적으로 <신문학사>는 ‘이식’이란 개념을 기반으로 문학사 방법론을 산출하려 시도하는데 이런 이유로 일제의 파시즘의 사상적 영향권에 있는 것으로 이해될 여지를 남겼다. 하지만 임화는 ‘이식’을 통해서 일제의 파시즘이 은폐하고자 하는 지점을 오히려 밝히면서 일본이 내세운 ‘대동아공영’나 ‘오족협화’ 같은 제국주의 영광의 슬로건들에 맞섰다. 물론 임화의 ‘이식’ 개념은 외관상 일제의 담론에 반하는 것으로 보이지 않았기 때문에 이 작업은 은밀성을 지닌다. 이 은밀함에 기반하여 임화는 ‘이식’의 은유적 사고를 전진시킨다. 그 결과 그가 문학사를 겨냥하여 전개한 논의는 <근대초극론>에 대한 대항으로서 작동할 지점을 확보하게 된다. <근대초극론>은 태평양전쟁을 전후로 일본에서 논의된 것으로 일본의 군국주의에 이론적 기틀을 마련해준 사상이다. 이 논의의 주체는 일본의 군대, 교토 학파 및 일본 낭만파 등으로 다양했다. 철학과 문학은 물론이고 정치 및 군대에도 영향을 미쳤고 당대 일본의 젊은 지식인들에게도 큰 각광을 받았다. 이들의 논의에 따르면 근대는 이미 쇠퇴의 기미를 보이고 있다. 자본주의는 대공황과 같은 문제에 대응하지 못하고 러시아 혁명을 추동한 마르크스주의도 문제를 보이고 있다. 소련은 인터네셔널의 가치를 지키지 못한다. 왜냐하면 이제 소련을 중심으로 마르크스주의 운동을 재편하려 하기 때문이다. 더구나 마르크스주의에 대한 반발로 서구는 나치즘과 파시즘으로 기울어 가는 모양세다. 이런 점들을 비판하며 일본의 지식인들은 다가올 세계전쟁, 즉 동양과 서양의 전쟁에 대비하기 위해 근대를 초극할 필요성을 논한다. 그들의 결론은 일본의 천황을 중심으로 하여 서구적 근대를 넘어선 새로운 토대를 만들어야 한다는 논의이다. 여기서 천황은 고오야마 이와오에 의하면 일본은 세계사의 주도적 역할을 떠맡게 되는데, 그 역할을 수행하는 주체가 천황이라 주장한다. 야스다의 일본 낭만파는 일본의 미, 즉 비어있음의 아름다움이란 일본적 아이러니를 드러내는 자리가 천황의 자리라고 말한다. <근대초극론>은 결국 천황이란 텅 빈 기표를 대타자의 지평에 놓는 것을 통해 헤겔이 말한 ‘역사의 종말’을 수행한 것이었다. 서구의 근대가 지닌 한계를 넘어서려는 긍정적 시도는 결국 역사의 가능성을 은폐하고 천황이라는 ‘통치의 주관적 명령’을 국가라는 차원으로 대신하여 표명해줄 텅 빈 기표에 <세계사>를 맡겨 버리려고 했던 것이다. 이것이 <근대초극론>이 추구한 기원화이다. 텅 빈 기표인 천황이 근대 이전의 일본의 미적 토대였으며 근대를 넘어설 초극의 기원이라고 그들은 믿었던 것이다. 이와는 반대로 임화는 역사의 가능성을 문학사를 경유해 우리 앞에 도래시키려고 했다. 그 지평에 놓인 것이 <신문학사> 작업인 것이다. 임화의 <신문학사>는 일반적으로 고전문학과 근대문학으로 문학사를 구분하는 것 대신 구문학사와 신문학사로 나눈다. 기존의 문학사 기술의 일반적 구분법과는 다른 ‘단절’을 기입하는 작업은 ‘이식’에 의해 이뤄진다. 여기서 임화는 ‘이식’과 ‘번역’ 그리고 ‘수입’ 등을 엄격하게 구분하여 쓰고 있다. ‘번역’과 ‘수입’은 자기화가 수반되지 않는다. 반대로 ‘이식’은 우리가 자기화와 관련될 때 사용한다. 임화는 이를 통해 신문학의 특성을 밝히려고 했다. 임화는 ‘이식’을 통해 신문학이 성립되었다고 말한다. 여기서 임화는 ‘이식’을 통해 자기화되면서 자기화되지 않는 잔여까지를 모두 ‘이식’의 개념 안으로 통합하려 하였다. ‘이식’은 바로 이 자리에 주체의 신체를 환기한다. 신체야말로 외부적인 타자와 주체의 자기화가 지속적으로 마주하고 길항하며 자기를 성장시키는 장소이기 때문이다. 임화는 이를 ‘이식’ 개념을 통해 은유적으로 드러내고 있다. 무엇보다 자기화의 주체인 신체는 외부라는 사태 전체를 ‘이식’하지 못한다. 모든 ‘이식’은 부분적이다. 때문에 주체의 생사를 결정할 수 있을 정도로 강력한 외부의 타자라할지라도 외부성 그 자체를 ‘이식’할 수는 없다. 다시 말해 외부성을 환기하는 ‘이식’은 역설적으로 주체의 자리를 비추는 역할을 한다는 것이다. 이는 <근대초극론>이 텅 빈 기표인 대타자인 천황으로 역사의 주체를 대체하려고 했던 시도와는 상반된다. 이것은 문학사를 추동하는 주체의 차원을 환기한다. 주체의 차원을 보존하는 ‘이식’의 개념은 또한 외부성으로 인해 파편화된 역사의 차원을 현재화한다. 이러한 역사는 역사적 사건들 속에서 나타나는 수많은 요소가 서로 길항하며 단절되었다가 나타나는 것이다. 역사적 기술의 현재화의 가능성은 이러한 단절의 연속을 통해 열린다. 문학사는 바로 이러한 역사의 특성을 잇는 특수한 역사이다. <신문학사>에서 ‘이식’이 여는 차원의 특성은 바로 여기에 있다. 그렇기 때문에 문학사는 포착불가능하며 결코 우리의 손안에 주어지지 않는 통제 불가능한 가능성을 내포한 것으로 주어지는 것이다. 임화는 특히 ≪신문학사의 방법론≫에서 이 가능성의 지평을 <전통> 항목에 기입해 두었다. 여기서 임화가 ‘이식’을 통해 환기하는 지평은 물론 파편화이다. 역사는 역사를 일관된 형식에 대항하여 전통을 파괴하면서 동시에 파편화된 전통을 현재화한다. 문학은 이 파편화의 힘으로 역사를 끌어안는다. 임화가 연 이러한 역사성은 역사를 텅 빈 미의 기표로 대체하려는 어떠한 시도도 불가능하게 한다. 어떠한 기원화의 시도도 여기에서 자리를 잡지 못한다. 이것이 임화가 ‘이식’의 은유적 사고를 통해 추동 해낸 작업이다. 임화의 ‘이식’은 그 개념이 지닌 기표적 특성이 환기하는 것과 달리 역사의 가능성을 탐침하고자 시도한 작업이었다. 그것은 역사의 가능성은 물론이고 임화가 늘 고심했던 혁명적 가능성을 예비할 수 있는 차원을 열어낼 토대였다. 혁명은 결국 역사가 지닌 힘, 즉 파편화의 가능성에서 발생하기 때문이다. 임화의 <신문학사>는 일본의 파시즘과 <근대초극론>이 역사의 가능성을 은폐하고 자기화하려던 것에 은밀한 대항을 하였다. 근대초극의 시도를 파편화하는 ‘이식’의 도입으로 파시즘이 은폐하려던 역사의 차원을 우리 앞에 나타나게 한 작업이 <신문학사>였던 것이다. This is an attempt to focus on metaphorical thinking as to why Lim Hwa’s ‘transplantation’ appears in Lim Hwa’s < New Literary History >. If you look at Lim Hwa’s concept of ‘transplantation’ through metaphorical thinking, you will be able to view ‘transplantation’ on a different level from the horizon that previously looked at the concept of ‘transplantation.’ Above all, it can be seen that Lim Hwa’s ‘transplantation’ was an attempt to protect the possibility of history through literary history in response to Japan’s < theory of overcoming the modern >. Lim Hwa has played in more diverse fields than anyone else in the history of modern literature. He was a poet, critic, literary historian, and movie star. At the same time, he was not limited to such horizons, but had the imagination to cross them. The imagination was a revolution. The imagination of the revolution was the way Lim Hwa understood history. Despite unfavorable factors such as the dissolution of the Japanese cape and poor health caused by lung disease, Lim Hwa published a book titled Hyeonhatan (1938) and carried out critical work through a curator. In particular, during the period when the Japanese colonists caused Manchuria and expanded the war into the Pacific War, they worked on < New Literary History > and tried to reason with the possibility of history. Ironically, < New Literary History > attempts to derive the methodology of literary history based on the concept of ‘transplantation,’ which left room for it to be understood as being within the ideological influence of Japanese fascism. Lim Hwa, however, rather revealed where the Japanese fascism wanted to cover up through the transplantation, and confronted Japan’s imperialistic slogans such as ‘the Greater East Asia Co-prosperity’ and ‘harmony of five races.’ Of course, the ‘transplantation’ concept of Lim Hwa did not seem to go against the Japanese discourse on the surface, so the work is covert. Based on this secrecy, Lim Hwa advances the metaphorical thinking of ‘transplantation.’ As a result, his discussions aimed at literary history have secured a point to act as a counter to the < theory of overcoming the modern >. The < theory of overcoming the modern > was discussed in Japan before and after the Pacific War, which provided a theoretical foundation for Japan’s militarism. The subjects of this discussion varied from the Japanese army to the Kyoto and the Romanticists of Japan. It influenced not only philosophy and literature, but also politics and the military, and received great attention from young Japanese intellectuals of the time. According to their discussions, modern times are already showing signs of decline. Capitalism has failed to respond to problems like the Great Depression and Marxism, which has driven the Russian revolution, is also showing problems. The Soviet Union does not preserve the values of the International. Because now they’re trying to reorganize the Marxist movement around the Soviet Union. Moreover, the West seems to be leaning toward Nazism and fascism due to resistance to Marxism. Criticizing these points, Japanese intellectuals discuss the need to overcome the modern to prepare for the upcoming global war, namely the Eastern and Western wars. Their conclusion is that we should create a new foundation that goes beyond the Western modern era, centering on the Japanese emperor. Here, Emperor Oyama Iwao says that Japan takes on a leading role in world history, which he claims is the emperor. Yasuda’s Japanese romanticists say that the beauty of Japan’s beauty, or emptiness, is the place where Japanese irony is revealed. The < theory of overcoming the modern > is eventually followed by Hegel’s ‘end of history’ by placing the empty signifier of the emperor on the horizon of the pinch hitter. The positive attempt to go beyond the limitations of Western modernity was to eventually cover up the possibility of history and leave < world history > to an empty signifier that would represent the emperor’s “subjective order of rule” on behalf of the state. This is the origin of the < theory of overcoming the modern >. They believed that the emperor, an empty sign, was the foundation of Japan’s pre-modern beauty and the origin of overcoming beyond modern times. On the contrary, Lim Hwa tried to bring the possibility of history to our fore via the history of literature. It is the work of the < New Literary History > that is at its horizon. Lim Hwa’s < New Literary History > is generally divided into the History of Old Literature and the History of New Literature instead of the Classical Literature and Modern Literature. The work of filling out the ‘cut-off,’ which is different from the general classification of existing literary history techniques, is done by ‘transplantation.’ Here, Lim Hwa uses a strict distinction between ‘transplantation,’ ‘translation,’ and ‘import.’ Translation and import do not involve magnetization. Conversely, ‘transplantation’ is used when we are concerned with magnetization. Lim Hwa says that journalism was established through ‘transplantation.’ Here, Lim Hwa tried to integrate all the remaining magnetized and unmagnetized through ‘transplantation’ into the concept of ‘transplantation.’ The ‘transplantation’ is where the body of the subject is evoked. This is because the body is a place where the magnetization of external batters and subjects constantly faces, navigates, and grows itself. Lim Hwa reveals it metaphorically through the concept of ‘transplantation.’ Above all, the body, which is the main body of magnetization, cannot ‘transplant’ the whole situation of the outside world. All ‘transplantations’ are partial. Therefore, even an outside hitter who is powerful enough to determine the life or death of a subject cannot ‘transplant’ the externality itself. In other words, ‘transplantation,’ which evokes externality, paradoxically serves to illuminate the subject’s place. This is in contrast to the attempt by the < theory of overcoming the modern > to replace the subject of history with an empty signifier, the Great Emperor. It evokes the dimension of the subject that drives literary history. The concept of ‘transplantation’ preserving the dimension of the subject also currentizes the dimension of history fragmented by externality. This history is where numerous elements that appear in historical events are cut off from each other. The possibility of the currentization of historical technology releases through this series of disconnection. Literary history is a special history that connects these characteristics of history. Here is the characteristic of the dimension that transplantation releases in the < New Literary History >. That is why the history of literature is given as having an uncontrollable possibility that is unobtainable and never in our hands. In particular, Lim Hwa recorded the horizon of this possibility in the < traditional > in the book ‘the methodology of the history of the new literature.’ Here, it is a fragmentation as well as the horizon that Lim Hwa evokes through a ‘transplantation.’ History destroys history against a consistent form and at the same time currentize fragmented traditions. Literature embraces history by the power of this fragmentation. This historicity of Lim Hwa makes any attempt to replace history with empty signifiers of beauty impossible. No attempt of origin can be established here. This is the work driven by Lim Hwa through metaphorical thinking of the ‘transplantation.’ Lim Hwa’s ‘transplantation’ was an attempt to explore the possibilities of history, unlike the signifying characteristics of the concept evoked. It was the foundation to open up not only the possibility of history but also the possibility of revolution that Lim Hwa has always struggled with. Because revolutions eventually arise from the power of history, the possibility of fragmentation. Lim Hwa’s < New Literary History > secretly opposed Japan’s fascism and the < theory of overcoming the modern > to cover up and magnetize the possibilities of history. With the introduction of a ‘transplantation’ that fragmented the attempt at the overcoming the modern, it was the < New Literary History > that brought the historical dimension that fascism tried to cover up before us.

A Risk Factor for Chronic Kidney Disease after Liver Transplantation

( Jung Hyun Kwon ),( Sun Hong Yoo ),( Soon Woo Nam ),( Jong Youl Lee ),( Young Chul Yoon ),( Jun Suh Lee ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1

Aims: Post-liver transplant chronic kidney disease (CKD) is a significant morbidity. The aim of this study is to evaluate the risk factors for post LT CKD. Methods: A total of 57 consecutive patients undergoing liver transplantation at Incheon St. Mary’s Hospital were analyzed from 2013 to 2017. CKD was defined as glomerular filtration rate (GFR) < 60 ml/min/1.73 m². Risk factors for developing CKD were investigated. Results: 37 (64.9%) patients underwent deceased donor liver transplantation (DDLT) and 27 (47.4%) patients had hepatocellular carcinoma at the timing of liver transplantation. Before liver transplantation, 17 (29.8%) patients had prior diabetes and 16 (28.1%) patients had prior hypertension. 14 (24.6%) patients were renal replacement therapy (RRT) at the perioperative period (12 (54.1%) patients in DDLT versus 2 (20%) patients in Living donor liver transplantation (LDLT), P=0.013)) but only one patient (1/14) maintained RRT after liver transplantation. Three new patients started de novo RRT after liver transplantation. The cumulative incidences of CKD were 31.8% (14/44) at 3 months and 44.8% (13/29) at one year after liver transplantation. The GFR at baseline and post operation 7 day, and the volume of blood loss during operation were proved the risk factors of CKD at one year after liver transplantation. However, the perioperative RRT, the presence of prior diabetes or hypertension, DDLT were not influenced on developing CKD at one year after liver transplantation. Conclusions: The present study showed the baseline and post-operation 7 days GFR, blood loss during operation were predictive factors for post LT CKD. Personalized care about GFR directed may improve post-transplant outcomes.

뇌사에 대한 의사와 일반인의 태도 조사

손현균,김광일,김이영 大韓神經精神醫學會 1994 신경정신의학 Vol.33 No.1

In this attitude survey using Q-methodology, the authors attemped to identify the physician`s & public attitudes toward brain death. Thirty three statements related to attitude toward brain death were Q-sorted by 71 physicians & 71 laymen. The data were statistically analysed by Q-factor analysis. Five factors in physician group and six factors in layman group could be extracted. Characteristic features of five factors in the physicians were as follows: Factor A: Physicians of this factor positively approve of brain death by pragmatic reason. They agree to organ transplantation, but they resist donation of their own organs in organ transplantation. They are selfish and treasure their body. These people could be named as 「The egoistic brain death advocators」. Factor B: Physicians of this factor approve of brain death for organ transplantation. Most of them are religious. These people could be named as「The humanitarian brain death advocators」. Factor C: Attitude toward brain death in this group is vague. They agree to organ transplantation and also have intention of donation of their own organs and receipt of others. These people could be named as 「The transplantation devotees」. Factor D: These physicians are indifferent in attitude brain death and organ transplantation basically. These people could be named as「The bystanders」. Factor E: These physicians have no trust in phsysicians, religion and modern medicine. They agree to organ transplantation but strongly oppose to brain death. These people could be named as「The doctor mistrustees」. Characteristic features of factors in the laymen were as follows: Factor A: Subjects of this factor positively approve of brain death. They also agree to organ transplantation. They want to receive organs from others but do not intend to donate their own organs because they selfish and treasure their body. These people could be named as「The egoistic brain death advocators」. Factor B: People of this factor approve of brain death and organ transplantation. They are will to donate their own organs. They are mostly post graduated, single females. These people could be named as「The active brain transplantation advocators」. Factor C: People of this factor have somewhat negative attitude toward brain death but approve of organ transplantation. They have no intention of donation of their own organs in viewing traditional concept and attitude. They are mostly religious. These people could be named as 「The traditionals」. Factor D: These persons have no trust in physicians and religion. They have somewhat negative attitude toward brain death. They have no conspicuous opinion toward brain death and organ transplantation. These people could be named as「The doctor mistrustees」. Factor E: This factor was polarized. 「The extreme opposites to brain death」versue「The extreme brain death advocators」were named.「The extreme opposites to brain death」strongly oppsed to brain death and organ transplantation. Attitude of「The extreme opposites to brain death」are mirror image of「The extreme brain death advocators」. Discussion was carried out on the various attitude toward brain death in physicians and laymen.

마우스 태생간 조혈세포이식시 이식거부 반응을 극복하기 위한 조혈세포 용량 및 흉선세포의 역할에 관한 연구

김승택(Seung Taik Kim),박선양(Seon Yang Park),김병국(Byong Kook Kim),이홍복(Hong Bock Lee),김은실(Eun Shik Kim),계경채(Kyung Chae Kye),서정선(Jeong Sun Seo),강위생(Wee Saing Kang),이현순(Hyun Soon Lee),궁성수(Sung Soo Koong),이재훈(J 대한내과학회 1990 대한내과학회지 Vol.39 No.5

N/A To observe whether an increase in cell doses can overcome graft rejection, whether sustained chimerism is present, and whether fetal thymic cell transplantation has any effect on the survival and the cell dose needed, fetal liver transplantation was done from 17-18-day old DDY fetus to an ICR mouse (syngeneic transplantationl) previously irradiated. The results revealed that better survival was obtained, regardless of syngeneic of allogeneic fetal liver cell transplantion, through an increase of the cell dose. A 90F long- term survial was noticed with a cell dose of 15×108/kg in syngeneic transplantation. In the case of allogeneic transplantation, however, only a 50% long - term survival rate was observed with the same dose. The concurrent thymic cell transplantation had a good effect on the long - term survival and the reduction of cell dose required, The cell dose needed for the achievement of a 90% long - term survival in syngeneic and allogeneic transplantation was 5x108/kg and 15x108/kg, respectively The sustained chimerism was evident and the graft-versus-host disease was mininal in fetal liver cell transplantation. It was evident that fetal liver cell transplantation could be one of substitution in solving the problems of bone marrow transplantation The cell dose required to prevent graft failure decreased with fetal thymic cell transplantation The mechanism of the salutary effect of concurrent thymic cell transplantation is not yet to be elucidated.