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        Is renal replacement therapy necessary in deceased donor liver transplantation candidates with hepatorenal syndrome?: a 2-year experience at a high-volume center

        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.

      • Concurrent Chemoradiation Therapy in Stage Ⅲ Non-small Cell Lung Cancer

        Song, Jung Sub,Jang, Jie Young,Shinn, Kyung Sub,Lee, Sun Hee,Choi, Ihl Bhong,Kim, In Ah,Kang, Ki Mun,Park, Jae Gil,Kuak, Mun Sub THE CATHOLIC UNIVERSITY OF KOREA 1997 Bulletin of The Catholic Research Institutes of Me Vol.25 No.-

        This study was tried to evaluate the potential benefits of concurrent chemoradiation therapy(low dose daily cisplatin combined with split course radiation therapy) compared with conventional radiation therapy alone in stage Ⅲ non-small cell lung cancer. The end points of analyses were response rate, overall survival, survival without locoregional failure, survival without distant metastasis, prognostic factors affecting survival and treatment related toxicities. Between April 1992 and March 1994, 32 patients who had stage Ⅲ non-small cell lung cancer were treated with concurrent chemoradiation therapy. Radiation therapy for 2 weeks (300 cGy given 10 times up to 3000 cGy) followed by a 3 weeks rest period and then radiation therapy for 2 more weeks(250 cGy given 10 times up to 2500 cGy) was combined with 6㎎/M^2 of cisplatin. Follow-up period ranged from 13 months to 48 months with median of 24 months. Historical control group consisted of 32 patients who had stage Ⅲ non-small cell lung cancer were received conventionally fractionated(daily 170-200 cGy) radiation therapy alone. Total radiation dose ranged from 5580 cGy to 7000 cGy with median of 5940 cGy. Follow-up period ranged from 36 months to 105 months with median of 62 months. Complete reponse rate was higher in chemoradiation therapy(CRT) group than radiation thernpy(RT) group(18.8% vs. 6.3%). CRT group showed lower in-field failure rate compared with RT group(25% vs. 47%). The overall survival rate and no significant differences in between CRT group and RT group(17.5% vs. 9.4% at 2 years). The survival without locoregional failure (16.5% vs. 5.3% at 2 years) and survival without distant metastasis(17% vs. 4.6% at 3 years) also had no significant differences. In subgroup analyses for patients with good performance status(Karnofsky performance scale≥80), CRT group showed significantly higher overall survival rate compared with RT group(62.5% vs. 15.6% at 2 years). The prognostic factors affecting survival rate were performance status and pathologic subtype(sqamous cell cancer vs. nonsquamous cell cancer) in CRT group. In RT alone group, performance status and stage (Ⅲa vs. Ⅲb) were identified as a prognostic factors. RTOG/EORTC grade 2-3 nausea and vomiting(22% vs. 6%) and bone marrow toxicities(25% vs. 15.6%) were significantly higher in CRT group compared with RT alone group. The incidence of RTOG/EORTC grade 3-4 pulmonary toxicity had no significant differences in between CRT group and RT group(16% vs. 6%). The incidence of WHO grade 3-4 pulmonary fibrosis also had no significant differences in both group(38% vs. 25%). In analyses for relationship of field size and pulmonary toxicity, the patients who treated with field size beyond 200㎠ had significantly higher rates of pulmonary toxicities. Conclusions: The CRT group showed significantly higher local control rate than RT group. There were no significant differences of survival rate in between two groups. The subgroup of patients who had good performance status showed higher overall survival rate in CRT group than RT group. In spite of higher incidence of acute toxicities with concurrent chemoradiation therapy, the survival gain in subgroup of patients with good performance status were encouraging. CRT group showed higher rate of early death within 1 year, higher 2 year survival rate compared with RT group. Therefore, to evaluate the accurate effect on survival of con- current chemoradiation therapy, systematic follow-up for long termsurvivors are needed.

      • In-situ fabrication of TiC-Fe<sub>3</sub>Al cermet

        Kim, Yong-In,Seok An, Gye,Lee, Wonsik,Man Jang, Jin,Park, Bong-Geun,Jung, Yeon-Gil,Choi, Sung-Churl,Ko, Se-Hyun Elsevier 2017 CERAMICS INTERNATIONAL Vol.43 No.8

        <P><B>Abstract</B></P> <P>Titanium carbide has high hardness, resistance to oxidation and abrasion while iron aluminide has proper ductility as well as good strength and excellent oxidation resistance up to high temperatures. Therefore, it can be expected TiC-iron aluminide cermet to have excellent mechanical properties as a cutting tool and a wear-resistance material. In this study, mechanical milling and hot press sintering processes were used to manufacture in-situ TiC-Fe<SUB>3</SUB>Al cermet, whose microstructure and mechanical properties were examined according to the changes in volume fraction of TiC and milling time. After 48h of milling each mechanically alloyed powder crystallized in a TiC and Fe<SUB>3</SUB>Al biphasic material. The milled powder was hot-pressed at 1250℃ and 50MPa for 30min to obtain sintered bodies also consisting of only TiC and Fe<SUB>3</SUB>Al phases. The hard phase, TiC, had a size of 100–300nm with overall uniform distribution decreasing as the volume fraction of TiC increased. The hardness of each sintered body showed a linearly increasing tendency according to the increase in TiC content, the hardness for 90vol% TiC cermet being as high as 1813Hv. On the other hand, the bending strength was 1800MPa and 1780MPa when TiC volume fraction was 50% and 70%, respectively, while it showed an abrupt decrease up to 580MPa at 90% TiC volume fraction. Fe<SUB>3</SUB>Al phase is effective to toughening of TiC-Fe<SUB>3</SUB>Al cermet and the volume fraction of Fe<SUB>3</SUB>Al phase significantly influences the bending strength of the cermet.</P>

      • 유효미생물에 의한 하수슬러지의 효율적 처리

        최충식,주길재,이동훈,최충렬,이인구,최정 경북대학교 농업과학기술연구소 1999 慶北大農學誌 Vol.17 No.-

        This study was conducted to evaluate the effects of microbial inoculation on sewage sludge composting. The number and species of microorganisms in sewage sludge sampled on February were higher than those sampled on August. The composting of sewage sludge is inhibited by the polyacrylamide cation, which was used as a coagulant and known to repress the growth of microorganisms. The growth of all microorganisms was inhibited by the addition of the polyacrylamide cation at a concentration of more than 0.8%. The species and viable counts of microorganisms were observed to increase during composting sewage sludge by inoculation of the effective microorganisms and addition of the pine tree sawdust as a bulking agent, compared with those without inoculation. A variety of organisms in compost(sewage sludge plus sawdust) were observed after composting for 30 days, such as Fragilaria sp., Proales sp., Vorticella sp., Schizothrix sp., Anabaena sp., Zoothaminium sp., Epstylis sp., Arcella sp., Balantidium sp., Actinophrys sp., Synedra sp., Euglypha sp., Ulothrix sp., Anacystis sp., and Clostium sp.

      • KCI등재

        약물 용출 스텐트와 일반 금속 스텐트에서 혈전증에 대한 발생과 예후

        김인수(In-Soo Kim),최남길(Nam-Gil Choi),장성주(Seong-Joo Jang),한재복(Jae-Bok Han),장영일(Young-Ill Jang) 한국콘텐츠학회 2012 한국콘텐츠학회논문지 Vol.12 No.7

        급성심근경색증 환자에서 약물 용출 스텐트(drug-eluting stents, DES)는 일반 금속 스텐트(bare-metal stents, BMS)에 비해 재협착은 감소하지만 구조적인 특성으로 스텐트 혈전증(stent thrombosis, ST)이 증가한다고 알려져 있다. 이에 본 연구에서는 ST의 발생빈도, 임상양상, 그리고 1년간 예후를 알아보고자 하였다. 대학병원 심혈관센터에서 급성심근경색증으로 관상동맥 중재술을 받은 2,667명에서 스텐트 혈전증이 발생한 환자 80명을 대상으로 DES-ST를 I군(n=57), BMS-ST(n=23)를 II군으로 분류하여 양군 간의 특징을 분석하였다. 양군간의 ST는 I군에서 57명(2.7%)과 II군에서 23명(4.3%)로 양군 간에 유의한 차이는 없었다(p>0.064). ST의 유형으로는 acute ST는 I군5(8.8%), II군3(2.3%), subacute ST는 I군 29(50.9%), II군14(60.9%), late ST 는 I군11(19.3%), II군2(8.7%), very late ST는 I군12(21.1%), II군4(17.4%)로 양군간의 차이는 없었다(p>0.605). DES와 BMS를 삽입 후 1년 예후에 미치는 인자로는 ST(OR 8.166 95% CI 2.825-23.608 p<0.001), 좌심실구혈율(<40) (OR 6.409 95% CI 2.422-16.955 p<0.001), 나이(≥75세) (OR 4.979 95% CI 1.946-12.744 p=0.001) 이었다. ST의 발생율은 양군 사이에 차이가 없었고, 1년 예후에 미치는 인자로는 ST의 발생, 좌심실 구혈률의 저하 및 환자의 연령 등 이었다. Drug-eluting stents (DES) have significantly reduced in-stent restenosis, compared to bare-metal stents (BMS). However, there remains concern for the increased risk of stent thrombosis (ST) associated with DES. The present study sought to evaluate the incidence, clinical characteristics and outcome of ST in patients with acute myocardial infarction (MI) during a 1-year follow-up. 80 patients who developed ST were divided into 2 groups according to stent type: group I (DES-ST, n = 57 ) and group II (BMS-ST, n = 23 ). There were no differences between group I and II in the overall incidence of ST (2.7% vs. 4.3%, p=0.064) and in the incidence of each type of ST: acute ST (8.8% vs. 2.3%), subacute ST (50.9% vs. 60.9%), late ST (19.3% vs. 8.7%), and very late ST (21.1% vs. 17.4%) (p=0.605). Predictors of 1-year mortality were the occurrence of ST (OR 8.12, 95% CI 2.83-23.61, p<0.001), left ventricular ejection fraction<40% (OR 6.41, 95% CI 2.42-16.96, p<0.001), and age≥75 years (OR 4.98, 95% CI 1.95-12.74, p=0.001).

      • Packed-bed column에서 산림부식질의 중금속 흡착 특성

        안세희,손성길,이동화,최인규 대구대학교 과학기술연구소 1999 科學技術硏究 Vol.5 No.5

        This experiment investigates the adsorption characteristic of heavy metals by humic substances of Forest soil in a packed bed column. Forest humic substances contain various components such as carboxyl group, phenol group which provide active sites for heavy metal binding. Humic substances of high cation exchange capacity have been utilized for removing metal ions. The analysis of chemical structure of humic substances was investigaed by FT-IR and CP/MAS Carbon-13 NMR Spectrometer at last year. Adsorption experiments of heavy metal cation by humic substances was conducted to the optimum adsorption condition. The adsorption isotherms for Cu, Zn, Cd, Cr conformed to Langmuir's equation. In the packed bed column, the adsorption ratios of Cu, Zn, Cd, Cr on the humic substances were more than 90%. There were no significant differences between the adsorption ratio and the species of humic substances. With increasing retention time, the removal efficiency of heavy metal ions were not changed greatly. The adsorption ratio of the heavy metal ions were considerably greater for the packed bed reactor than for the stirred reactor. The stirred and column methods give similar result for the adsorption characteristics of heavy metal ion in humic substances.

      • 스퍼터된 바나듐 산화막의 구조적, 전기적 특성에 미치는 진공 어닐링의 효과

        이승철,황인수,최복길 公州大學校 工學硏究院 生産技術硏究所 2003 論文集 Vol.11 No.-

        Thin films of vanadium oxide(VO_(x)) have been deposited by RF magnetron sputtering from V₂O_(5) target in gas mixture of argon and oxygen. The oxygen/(oxygen+argon) partial pressure ratio of 0% and 8% is adopted. Crystal structure and optical properties of films sputter-deposited under different oxygen gas pressures and in situ annealed in vacuum at 400℃ for 1h and 4h are characterized through XRD, XPS, RBS, FTIR, and optical absorption measurements. The films as-deposited are amorphous, but 0%O₂ films annealed for time longer than 4h and 8%O₂ films annealed for time longer than 1h are polycrystalline. I-v characteristics were distinguished between linear and nonlinear region. In the low field region the conduction is due to Schottky emission, while at high fields it changes to Fowler-Nordheim tunneling type conduction. The conductivity measurements have shown an Arrhenius dependence of the conductivity on the temperature.

      • KCI등재

        전력수용가포털을 위한 구내 통신 및 컴퓨터 네트워크 용량 설계

        홍준희(Jun-Hee Hong),최중인(Jung-In Choi),김진호(Jin-Ho Kim),김창섭(Chang-Sub Kim),손성용(Sung-Young Son),손광명(Kwang-Myung Son),장길수(Gil-Soo Jang),이재복(Jea-Bok Lee) 한국조명·전기설비학회 2007 조명·전기설비학회논문지 Vol.21 No.10

        고전력수용가포털(Consumer Portal)은 소비자의 다양한 장치들과 광역 네트워크, 그리고 에너지서비스사업자 (ESP: 한전 등)의 서비스 애플리케이션 플랫폼을 연결하는 물리적 링크이자 논리적 결합으로, 전력서비스 체계에서 소비자-공급자 간 정보교환과 서비스 거래를 담당하는 양방향 통신의 핵심 인프라로서 포털이다. 전력수용가포털(Consumrr Portal)의 성공적인 설계와 개발을 위해서는 효율성, 경제성, 확장성을 고려한 네트워크 설계가 선행되저야 한다. 그러나 전력수용가 포털의 네트워크 설계에 필요한 네트워크 용량 설계 모델링에 대한 공학적 연구는 아직 부족한 실정이다. 본 논문에서는 전력수용가포털의 네트워크 설계에 필요한 네트워크 용량 설계 모델링 방법을 논하고 실제 구축중인 시스템에 적용하였다. 그 결과 기존 네트워크 설계방법의 문제점을 파악하고, 개선하여 네트워크의 최대수용 단말기의 수를 30~40배 증대시킬 수 있는 데이터 수집 알고리즘을 개발할 수 있게 되었다. Consumer Portal is defined as a combination of hardware and software that enables two-way conmunication between energy service providers(ESP, like KEPCO) and equipment within the consumer's premises. The portal provides both a physical link (between wires, radio waves, and other media) and a logical link (translating among language-like codes and etiquette-like protocols) between in-building and wide-area access networks. Thus, the consumer portal is an important, open public shared infrastructure in the future vision of energy services. In this paper, we describe a new methodology for local communication and computer network capacity design of consumer portal, and also presents capacity calculation method using a network system limitation factors. By the approach, we can check into the limitations of existing methods, and propose an improved data processing algorithm that can expand the maximum number of the networked end-use devices up to 30-40 times. For validation, we applies the proposed methode to our real system design. Our contribution will help electrical power information network design.

      • SCISCIESCOPUS

        Enhanced activation of NAD(P)H: quinone oxidoreductase 1 attenuates spontaneous hypertension by improvement of endothelial nitric oxide synthase coupling via tumor suppressor kinase liver kinase B1/adenosine 5&vprime;-monophosphate-activated protein kina

        Kim, Yong-Hoon,Hwang, Jung Hwan,Kim, Kyung-Shim,Noh, Jung-Ran,Gang, Gil-Tae,Oh, Won Keun,Jeong, Kyeong-Hoon,Kwak, Tae Hwan,Choi, Hueng-Sik,Lee, In-Kyu,Lee, Chul-Ho Wolters Kluwer Health | Lippincott Williams Wilkin 2014 Journal of Hypertension Vol.32 No.2

        AIMS:: Guanosine 5&vprime;-triphosphate cyclohydrolase-1 (GTPCH-1) is a rate-limiting enzyme in de-novo synthesis of tetrahydrobiopterin (BH4), an essential cofactor for endothelial nitric oxide synthase (eNOS) coupling. Adenosine 5&vprime;-monophosphate-activated protein kinase (AMPK) is crucial for GTPCH-1 preservation, and tumor suppressor kinase liver kinase B1 (LKB1), an upstream kinase of AMPK, is activated by NAD-dependent class III histone deacetylase sirtuin 1 (SIRT1)-mediated deacetylation. &bgr;-Lapachone has been shown to increase cellular NAD/NADH ratio via NAD(P)H:quinone oxidoreductase 1 (NQO1) activation. In this study, we have evaluated whether &bgr;-lapachone-induced NQO1 activation modulates blood pressure (BP) through preservation of GTPCH-1 in a hypertensive animal model. METHODS AND RESULTS:: Spontaneously hypertensive rats (SHRs), primary aortic endothelial cells, and endothelial cell line were used to investigate the hypotensive effect of &bgr;-lapachone and its action mechanism. &bgr;-Lapachone treatment dramatically lowered BP and vascular tension in SHRs and induced eNOS activation in endothelial cells. Consistent with these effects, &bgr;-lapachone treatment also elevated levels of both aortic cGMP and plasma nitric oxide in SHRs. Meanwhile, &bgr;-lapachone-treated SHRs showed significantly increased levels of aortic NAD, LKB1 deacetylation, and AMPK Thr phosphorylation followed by increased GTPCH-1 and tetrahydrobiopterin/dihydrobiopterin ratio. In-vitro study revealed that AMPK inhibition by overexpression of dominant-negative AMPK nearly abolished GTPCH-1 protein conservation. Enhanced LKB1 deacetylation and AMPK activation were also elicited by &bgr;-lapachone in endothelial cells. However, inhibition of LKB1 deacetylation by blocking of NQO1 or SIRT1 blunted AMPK activation by &bgr;-lapachone. CONCLUSION:: This is the first study demonstrating that eNOS coupling can be regulated by NQO1 activation via LKB1/AMPK/GTPCH-1 modulation, which is possibly correlated with relieving hypertension. These findings provide strong evidence to suggest that NQO1 might be a new therapeutic target for hypertension.

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