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김성민,이종호,김남열,안강민,최원재,최시호,차미주,이주영,황순정,장정원,명훈,최진영,서병무,정필훈,김명진 大韓顎顔面成形再建外科學會 2003 Maxillofacial Plastic Reconstructive Surgery Vol.25 No.4
Schwann cells(SCs), an important component of the peripheral nervous system, intract with nerous to mutually support growth and replication for the peripheral nerve regentation. Recently, ading SCs to the lumen of guidance channel is widely tried to improve regeneration or to make regeneration possible over otherwise irreparable gaps. however, it is not easy to isolate and multiplicate SCs as much as enough to help the axonal regeneration. For the allogeneic SCs source for tubular nerve guidance, we developed a little bit improved technique of harvesting and multiplicating SCs. by culturing dispersed dorsal root ganglia in specially designed medium with growth factors and serial processing, we repeatedlly generate relatively homogenous SC cultures. Our technique was compared with other methods of literature using immunostaining methods such as GFAP, S100, BDNF and the total SC count assessment at different time interval after primary culture.
이종호,이세영,김명진,이은진,안강민,김성민,최원재,명훈,황순정,서병무,최진영,정필훈 大韓顎顔面成形再建外科學會 2003 Maxillofacial Plastic Reconstructive Surgery Vol.25 No.2
The surgery of oral and maxillofacial area poses the risk of cranial nerve damage such as trigeminal nerve or facial nerve. Inferior alveolar nerve is prone to damage in the third molar extraction, implant installation, orthognathic surgery, open reduction and rigid fixation, and tumor ablation surgery. On the other hands,facial nerve is likely to be damaged or sacrificed with trauma or parotidectomy. In case of inferior alveolar nerve injury, the incidence is reported to be about 1.3%. The nerve function will almost recover in minimal damage, but it won't recover at last in total damage of a part of nerve unit. In latter cases, nerve regeneration in intended by allograft as nerve substitute or various route of merve condit. But the recovery with autograft is believed to be most relialbe mrthod in the rapair of long-span(longer than 15㎜)nerve defect. We have performed autologous sural nerve graft in the repair of nerve defect, which is caused by resection of benign or malignant tumor. Hereby we report the method of nerve harvesting, recovery of defected peripheral nerve and the complications of donor site with the discussion of sural nerve anatomy.
( Soung Won Jeong ),( Moon Young Kim ),( Seong Hee Kang ),( Young Kwon Kim ),( Jae Young Jang ),( Yong Jae Kim ),( Dong Erk Goo ),( Su Yeon Park ),( Soon Koo Baik ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1
Aims: To investigate correlation between hepatic venous pressure gradient (HVPG) and transient elastography (TE) in patients with cirrhosis and identify a cut-off value of TE in clinically significant portal hypertension (CSPH, HVPG ≥10mmHg) and severe portal hypertension (SPH, HVPG >12 mmHg). Methods: Between January 2008 and March 2017, 406 patients who underwent HVPG and TE were consecutively enrolled at the two Korean tertiary medical centers. HVPG and TE were performed within 1 month interval. Results: The mean age was 53.1±9.9 years, and the majority (82%) were males. The most common etiology of cirrhosis was alcohol (63%) followed by hepatitis B virus infection (22%). A significant positive correlation was noted between liver stiffness and HVPG levels (r=0.549, p < 0.001). Figure presents the median TE values in various stages of portal hypertension (HVPG ≤ 5 mmHg, 9.8 kPa, HVPG > 5 to < 10 mmHg, 18.1 kPa, HVPG ≥ 10 to 12 mmHg, 27.0 kPa, HVPG > 12 to ≤ 20 mmHg, 41.3 kPa, HVPG > 20 mmHg, 62.7 kPa). The area under receiver operating characteristic curves for TE to diagnose portal hypertension (HVPG >5mmHg), CSPH, and SPH were 0.839 (95%CI: 0.737-0.941), 0.809 (95%CI: 0.761-0.858), and 0.782 (95%CI: 0.737-0.826), respectively. A cut-off values of TE of 27.2 and 35.5 kPa were obtained by using Youden index to best predict CSPH and SPH, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of a TE value ≥ 27.2 and ≥ 35.5 kPa to diagnose CSPH and SPH were 70.1%, 78.6%, 91.1%, and 45.6%, and 52.3%, 86.7%, 92.5%, 36.6%, respectively. Conclusions: TE can be used as a non-invasive modality to assess the degree of portal hypertension. A cut-off TE value of 27.2 and 35.6 kPa identifies CSPH and SPH with a PPV of 91.1% and 92.5%, respectively.
( Jeong-ju Yoo ),( Hyeon Jeong Goong ),( Sang Gyune Kim ),( Young Seok Kim ),( Soung Won Jeong ),( Jae Young Jang ),( Sae Hwan Lee ),( Hong Soo Kim ),( Baek Gyu Jun ),( Young Don Kim ),( Gab Jin Cheon 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1
Aims: The indiscriminate use of sedative drug during endoscopy can pose a risk of minimal hepatic encephalopathy (MHE) in patient with liver cirrhosis, . However, it has not been studied yet which drugs are safest and most inviting on these patients. The aim of this study is to evaluate which one among midazolam, propofol, or combination therapy, was the least likely to cause complications including MHE by using Stroop application in cirrhotic patients. Methods: This randomized prospective study included consecutive 32 patients who underwent upper GI endoscopy at tertiary hospitals in Korea. Patients were randomly assigned to one of three groups, midazolam, propofol, or combination group, and underwent Stroop test before endoscopy, and 2 hours after the completion of endoscopy. The vital signs was checked before and after the drug administration and the patient / physician / nurse satisfaction was scored after endoscopy. Results: Mean age of the patients was 54.0 ± 9.30 years and 81.3% were male. Fifteen patients (46.9%) were child-pugh class A, and 17 (53.1%) were child-pugh class B or C. Alcohol was the most common etiology (21, 65.6%). Patients did not show significant changes in Ontime, Offtime on Stroop test before and after drug administration, and there was no significant difference between the three treatment groups. Also, there was no significant vital sign changes after drug use in all groups. However, with respect to subjective indicators, the satisfaction scores of patient and nursing staff was higher in the combined group than in the other two groups, and time to recovery was shorter in propofol than other groups. Conclusions: In patients with cirrhosis, sedative endoscopy using midazolam, propofol, or combination therapy is relatively safe, and was not associated with increased risk of MHE. However, since there is subjective satisfaction or recovery time difference among sedative agents, it should be considered according to each individual patient.
Management of viral hepatitis in Liver transplant recipients
( Soung Won Jeong ),( Young Rok Choi ),( Jin Wook Kim ) 대한간학회 2014 Clinical and Molecular Hepatology(대한간학회지) Vol.20 No.4
Recurrence of viral hepatitis after liver transplantation (LT) can progress to graft failure and lead to a decrease in longterm survival. Recently, there have been remarkable improvement in the treatment of chronic hepatitis B (CHB) using potent antiviral agents. Combination of hepatitis B immunoglobulin and potent antiviral therapy has brought marked advances in the management of CHB for liver transplant recipients. Post-transplant antiviral therapy for hepatitis C virus infection is generally reserved for patients showing progressive disease. Acheiving a sustained virological response in patients with LT greatly ameliorates graft and overall survival, however this only occurs in 30% of transplant recipient using pegylated interferon and ribavirin (RBV). Direct acting antivirals such as protease inhibitors, polymerase or other non-structural proteins inhibitors are anticipated to establish the new standard of care for transplant recipients. In liver transplant recipients, hepatitis E virus infection is an uncommon disease. However, it can lead to chronic hepatitis and cirrhosis and may require retransplantation. Recently, 3-month course of RBV monotherapy has been reported as an effective treatment. This review focuses on the recent management and therapeutic approaches of viral hepatitis in liver transplant recipient. (Clin Mol Hepatol 2014;20:338-344)