• Title/Summary/Keyword: 간이식

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Clinical Features of Delirium in Liver Transplantation in a General Hospital in Korea-Retrospective Study (일병원에서 나타난 간이식 환자들의 섬망 양상-후향적 연구)

  • Choi, Soon-Ho;Son, Jung-In;Kim, Sang-Eok;Han, Oh-Su
    • Korean Journal of Psychosomatic Medicine
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    • v.15 no.2
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    • pp.93-99
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    • 2007
  • Object : This study aimed to investigate the characteristics of delirium in liver transplanted patients in a hospital in Korea. Method : We reviewed the medical records of 29 liver transplanted patients who were confirmed as delirium by psychiatrists with DSM-IV-TR diagnostic criteria. We estimated the correlation between delirium and clinical conditions of liver transplantations. Result : Post-operative delirium duration was significantly correlated with frequency of hepatic encephalopathy, pre-operative mental status, and stay of intensive care unit. Conclusion : Although there were many limitations of this study, it seemed that pre-operative hepatic encephalopathy affected post liver transplantation delirium.

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Role of Whole Body FDG-PET in the Diagnosis of Hidden Distant Metastasis before Liver Transplantation in Patients with Primary Liver Cancer (고식적 검사로 간외 전이를 진단하지 못한 원발성 간암 환자에서 간이식 전에 시행한 전신 FDG-PET의 역할)

  • Lee, Won-Woo;Ryu, Jin-Sook;Yang, You-Jung;Kim, Jae-Seung;Yeo, Jeong-Seok;Moon, Dae-Hyuk;Lee, Sung-Gyu
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.6
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    • pp.368-380
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    • 2002
  • Purpose: Liver transplantation (LT), one of the therapeutic options of primary liver cancer has been suffering from recurrence caused by metastasis in 8-54% of patients. This study was performed to investigate whether FDG-PET is useful for detecting hidden metastasis in LT candidates. Materials and Methods: Twenty-six patients (male:female=23:3, mean age 55.7 years) underwent FDG-PET. Their previous conventional diagnostic studies (CDS) like abdomen US and CT, chest x-ray and CT, and bone scan were negative (n=22) or equivocal (n=4) for metastasis. Positive FDG-PET findings were confirmed by biopsy or clinical follow-up. Results: Among 4 patients with equivocal metastatic lesions on CDS, 3 had 6 hypermetabolic lesions on FDG-PET, which were confirmed as metastasis and subsequently LTs were cancelled. Of these, 5 lesions were initially negative on CDS. Remained 1 patient underwent LT with a negative FDG-PET result. Among 22 patients without metastasis on CDS, 5 had 7 hypermetabolic lesions on FDG-PET. One of these patients proved to have 2 metastatic lesions, and LT was cancelled. The other 4 patients had S hypermetabolic lesions on FDG-PET, which were confirmed as benign lesions, and 3 patients of them underwent LT. In summary, FDG-PET was useful in avoiding 4 unwarranted LT by detecting unsuspected metastatic lesions on CDS. A total of 17 patients underwent LT. In comparison with pathology, the sensitivity and specificity of FDG-PET for detecting viable primary liver cancer were 55.6% (5/9) and 87.5% (7/8), respectively. Conclusion: FDG-PET can detect additional hidden metastasis and contribute to reducing unwarranted LT in the patients with primary liver cancer.

A Case of Biliary Cast Syndrome After Endoscopic and Percutaneous Management of Common Bile Duct Stone (총담관 결석 환자에서 내시경적, 경피적 담관 시술 후 발생한 담관 원주 증후군)

  • Jae Chun Park;Jung Gu Park
    • Journal of the Korean Society of Radiology
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    • v.83 no.1
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    • pp.224-229
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    • 2022
  • Biliary cast syndrome is an unusual complication in patients who have previously undergone liver transplantation. It occurs in approximately 5%-18% of such patients. Rare cases of biliary cast syndrome in patients without liver transplants have also been reported. The pathogenesis of biliary cast has not been clearly identified, although etiologic factors including post-transplant bile duct damage, ischemia, biliary infection, and presence of a post-operative biliary drainage tube have been proposed. Here we present a case of biliary cast that developed in a 49-year-old male who underwent a non-liver surgery after endoscopic and percutaneous management of common bile duct stone.

Living-Related Liver Transplantation with Heterozygote Carrier Graft in Children with Wilson Disease (윌슨병 환아에서 이형 접합 보인자 공여간을 이용한 혈연간 생체 부분 간이식)

  • Kim, Jin-Taek;Chang, Soo-Hee;Choi, Bo-Hwa;Kim, Kyung-Mo;Yoo, Han-Wook;Lee, Young-Joo;Lee, Sung-Gyu
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.6 no.2
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    • pp.161-166
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    • 2003
  • Purpose: The purpose of this study was to evaluate the efficiency of treatment of living-related liver transplantation (LRLT) with the parental heterozygote carrier graft in children with Wilson disease. Methods: We retrospectively evaluated 7 children with Wilson disease who had received liver transplantation from 1994 to 2002 at Asan Medical Center. All the donors were parental. Liver functions, Kayser-Fleischer ring, and other factors regarding to copper metabolism were analyzed. Results: Of the 7 children, 5 had fulminant hepatitis and 2 had decompensated liver cirrhosis irresponsive to medical therapy. All donors being parental, all grafts came to be heterozygote carrier grafts. Survival rate was 100% in those 7 children, 87% in all children with liver transplantation in the same period, and 84% in children with non-metabolic liver disease. After liver transplantation, all 7 children could stop low copper diet and penicillamine therapy and their AST, total bilirubin and prothrombin time were recovered to normal. After liver transplantation, ceruloplasmin and serum copper levels were also recovered to normal. A marked reduction in 24 hr-urinary copper excretion was observed in all recipients after transplantation. During follow-up, Kayser-Fleischer rings resolved completely after LRLT in 5 children and partially in 1 child. Conclusion: We concluded that living-related liver tranplantation in children with Wilson disease with parental heterozygote carrier graft is an effective treatment modality.

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Efficacy of Hepatitis B Immune Globulin for Prevention of De Novo Hepatitis B in Living-related Liver Transplantation (생체 부분 간이식에서 De Novo Hepatitis B에 대한 B형 간염 면역글로불린의 예방적 효과)

  • Kim, Sang-Jong;Hwang, Soo-Jung;Park, Sung-Eun;Choe, Yon-Ho;Lee, Suk-Koo;Joh, Jae-Won;Kim, Sung-Joo;Lee, Kwang-Woong;Seo, Jeong-Meen
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.6 no.1
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    • pp.32-38
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    • 2003
  • Purpose: Hepatic allografts from donors with hepatitis B core antibody have been demonstrated to transmit hepatitis B virus (HBV) infection to recipients after liver transplantation (LT). The efficacy of hepatitis B immune globulin (HBIg) to prevent de novo hepatitis B was investigated by comparing active immunization in the early phase to HBIg monotherapy in the late phase of pediatric liver transplants at Samsung Medical Center. Methods: Among pediatric liver transplants, from May, 1996 to June, 2002, 15 recipients who were hepatitis B surface antigen (HBsAg) (-) received an allograft from a donor with hepatitis B core antibody (HBcAb) (+). Except two who died from unrelated causes, eleven of 13 recipients were HBsAb (+), and 2 were naive (HBsAb(-), HBcAb(-)). All patients were vaccinated for HBV before LT. In the early phase (January, 1997~November, 1997, 3 patients), HBsAb (+) recipients received booster vaccination after LT. In the late phase (December, 1997~, 10 patients), all recipients were given booster vaccination and received HBIg therapy in order to maintain HBsAb titer greater than 200 IU/L. Lamivudine was given in one case because of severe side effect of HBIg. We retrospectively analyzed the effect of the preventive therapy for de novo hepatitis B through medical records. Results: De novo hepatitis B developed in three of 13 recipients (23.1%). All of 3 patients who received active immunization in the early phase became HBsAg (+) at 7~19 months after transplantation. One of them was naive before LT and the other two were HBsAb (+). All of 10 recipients who were given HBIg in the late phase remained HBsAg (-) at 7~55 months' follow-up. Conclusion: Passive immunization with HBIg was effective for prevention of de novo hepatitis B in HBsAg (-) recipients of hepatic allografts from HBcAb (+) donors.

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A Study on the Analysis of the Natural Frequencies and the Development of the Simplified Formulas for Bellows (벨로스의 고유진동수 해석 및 간이식 개발에 관한 연구)

  • 이영신;윤기석;김태완
    • Journal of KSNVE
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    • v.9 no.2
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    • pp.331-339
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    • 1999
  • This paper presents the simplified formulas for calculating the fundamental frequencies of the cantilevered bellows in the axial and lateral directions. The frequencies of the bellow are evaluated based on analogies with those of the beam. It is shown that the results calculated by the simplified formulas are in good agreement with those obtained from FEM analysis and the experiment.

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