• Childhood Kidney Diseases
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• v.12 no.1
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• pp.23-29
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• 2008

Kidney allograft transplantation is the most effective method of renal replacement for end stage renal disease patients. Still, it is another kind of 'disease', requiring immunosuppression to keep the allograft from rejection(allograft immune reaction). Immune system of the allograft recipient recognizes the graft as a 'pathogen (foreign or danger)', and the allograft-recognizing commanderin-chief of adaptive immune system, T cell, recruits all the components of immune system for attacking the graft. Proper activation and proliferation of T cell require signals from recognizing proper epitope(processed antigen by antigen presenting cell) via T cell receptor, costimulatory stimuli, and cytokines(IL-2). Thus, most of the immunosuppressive agents suppress the process of T cell activation and proliferation.

• Proceedings of the Korean Society of Applied Pharmacology
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• 1993.04a
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• pp.166-166
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• 1993

만성 신부전환자에서 isoniazid(INH)의 약동학적 변화여부를 검토하고 특히 N-acetylation 대사능의 억제 여부를 평가함으로써 만성신부전환자에서 적정 INH 항결핵 요법율 위한 기본자료를 제공코자 하였다. 본 연구는 pararell group 디자인에 의한 일차 연구와 sequential 디자인에 의한 2차연구로 진행하였다. 일차 연구는 37명의 정상 성인군과 14명의 만성신부전 환자군을 대상으로 INH 400 mg 경구 투여 후 INH 및 AcINH의 약동학적 성상을 비교하였다. 이차연구는 만성신부전 환자에서 신이식에 따른 INH의 acetylation 대사능의 변화를 관찰코자 1차연구에 참여하고 성공적인 신이식을 받은 환자 10명을 대상으로 INH 및 AcINH의 약동학적 검토를 재시행하였으며, 이러한 연구 방법을 통하여 만성 신부전 환자에서 Acetylation 대사능의 변화를 검토하였다.

• Proceedings of the Korean Society of Broadcast Engineers Conference
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• 1999.11b
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• pp.67-70
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• 1999

디지털 TV의 다채널의 프로그램과 다양한 부가 서비스가 가능하도록 하는 PSIP 전송 서버는 시스템의 안정성, 유지, 보수의 용이함, 이식성 등의 보장과 출력 데이터의 STD 규격 적합성 등의 요구 사항을 만족해야 한다. 현재 개발되어 있는 PSIP 전송 서버는 이러한 요구 사항을 충족 시키지 못하고 있다 본 논문에서는 PSIP 전송 서버를 PSIP Generator와 PSIP Streamer로 분리하고, PSIP Generator를 Java 언어로 구현하는 것을 제안한다. 이는 이식성과안정성, 규격 적합성을 충족하여 실제로 운용될 방송국의 요구 사항을 보장할 것이다.

• Proceedings of the Korean Society of Embryo Transfer Conference
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• 2003.10a
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• pp.68-68
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• 2003

• Childhood Kidney Diseases
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• v.18 no.1
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• pp.51-55
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• 2014

Primary renal artery aneurysm has been estimated to account for an incidence of 0.015-1% with associated morbidities including renovascular hypertension and rupture. Renovascular hypertension associated renal artery aneurysms in children is not a common disease. In patients with complicated renal vascular disease, renal autotransplantation has been used as an alternative to percutaneous transluminal angioplasty, which may be hazardous in these situations. We report a case of a renal artery aneurysm in a 13-year-old Korean child presenting hypertension detected during school health examination. Preoperative workup demonstrated a $2.8{\times}2.1{\times}1.9$ cm saccular aneurysm in the right renal hilum that was not amendable to endovascular repair. A surgical strategy including extracorporeal renal artery reconstruction with autotransplantation was applied in order to restore renal artery anatomy and to treat renovascular hypertension. Immediately he complained of severe right flank pain and postoperative doppler sonography revealed lack of perfusion. On the 5th day after autotransplantation, the patient underwent a transplant nephrectomy. He was well postoperatively and was found to have a normal kidney function and stable blood pressure control without antihypertensive medication. This is the first pediatric case of renal artery aneurysm in Korea who underwent extracorporeal repair followed by autotransplantation failure. More pediatric cases with renal artery aneurysm should be reported to identify therapeutic outcome and long term prognosis.

• 대한핵의학회:학술대회논문집
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• 1980.05a
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• pp.11.2-11.2
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• 1980

• Korean Journal of Clinical Pharmacy
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• v.9 no.2
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• pp.81-87
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• 1999

췌장이식의 성공률은 지난 10년 동안 상당히 상승되었다. International Pancreas Transplant Registry에 따르면 1995년 이래 미국에서만 매년 1,000건 이상의 췌장이식이 실시되고 있다. 장기이식후 나타나는 급성 거부반응은 이식 후 6개월 이내에 가장 높은 빈도수로 나타난다. 췌장이식환자에서는 신장을 이식한 것보다 두배나 높은 거부반응을 나타나며 이로 인한 입원율의 증가 항림프제(antilyinphocyte) 사용과 감염의 증가로 이환율이 높다. 더구나 Cyclosporine (CsA)을 기초로 한 면역억제제요법의 사용은 높은 급성 거부반응률(acute graft rejection)을 초래하여 이식한 장기의 조직손실이 문제가 되고 있다. 새로운 면역억제제인 Tacrolimus (FK506)의 사용은 이식환자에서의 거부반응을 감소시켜 생존율을 증가시키는 것으로 알려져 있다. Tacrolimus는 neutral macrolide로 cyclic peptide인 CsA과는 화학 구조는 매우 다르나 비슷한 면역억제 효과를 보인다. 하지만 Tacrolimus의 사용시 신경독성, 신독성, 특히 고혈당증의 발생률이 높아 일부 이식센터에서는 장기 이식 후에 사용하기를 꺼리기도 한다. 하지만 여러 연구논문에서 간과 신장 이식 후 급성 거부반응 예방에 Tacrolimus는 CsA에 비해 이점이 있는 결과를 발표하였다. 결과적으로, 현재 췌장이식 후 Tacrolimus를 기초로 한 면역억제의 효과에 대한 연구가 활발히 진행중이다. 따라서 본 연구에서는 1994-1996년 사이에 Tacrolimus 또는 CsA를 기초로 한 면역억제요법을 투여 받은 췌장이식환자 101명을 후향적으로 조사하여 Tacrolimus (n=54)와 CsA(n=57)의 급성 거부반응 예방 효과와 신부전 발생률을 비교하였다. 모든 환자는 항림프구 약물, Azathioprine, Prednisone을 이식 후 면역억제제로 투여 받았다 기준선으로부터 $20\%$ 이상의 혈청 creatinine의 상승이 있는 환자에서는 급성 신부전으로 정의하였고 신장생검법으로 거부반응을 진단하였다 Matched-pair analysis에 따르면 췌장이식환자의 6개월 생존율은 CsA군에서 $97\%$, Tacrolimus군에서 $96\%$로 별다른 차이가 없었으며 (p=0.57), 6개월간의 이식한 췌장의 보존율은 CsA군에서는 $88\%, Tacrolimus에서 $91\%$. 유의한 차이는 없었다(p=0.29). 췌장이식 후 6개월 동안 Tacrolimus의 사용은 생검으로 증명되는(biopsy-proven) 급성 거부반응의 발생빈도는 CsA보다 유의하게 낮았을 뿐만 아니라 (p<0.05) 거부반응 증상의 심각도 또한 감소시켰다 (p=0.03). 급성거부반응 발생빈도의 감소로 Tacrolimus군에서 antilymphocyte 치료가 유의하게 줄어들었다(p=0.01). CsA군에서 Tacrolimus보다 신부전의 발생률이 높았으나 통계학적 차이는 없었다. 췌장이식후의 최적의 면역억제요법의 결정하기 위해서는 향후 Tacrolimus와 CsA을 비교하는 전향적 무작위 연구가 필요하다.

• Childhood Kidney Diseases
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• v.7 no.2
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• pp.245-252
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• 2003

Posttransplant lymphoproliferative disease(PTLD) has emerged as a potential life-threatening complication of immunosuppressive therapy after organ transplantation. The occurrence of PTLD is usually associated with an Epstein-Barr virus(EBV) infection in patients who are treated by aggressive immunosuppressive therapy. PTLD is represented by diverse manifestations ranging from reactive lymphoid hyperplasia to high grade malignant lymphoma. This is a case report of a late PTLD in a child. The patient is a 14-year-old girl, who presented as malignant lymphoma 44 months after successful renal transplantation. There was no evidence of EBV infection. On bone marrow study, many neoplastic lymphoid cells were defected. Aggressive chemotherapy for PTLD had resulted in clinical remission. However the patient expired from uncontrolled sepsis and septic shock after 77 days.

• Korean Journal of Transplantation
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• v.28 no.3
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• pp.135-143
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• 2014

Background: Kidney injury molecule-1 (KIM-1) is known as a good ancillary marker of acute kidney injury (AKI) and its expression has also been observed in acute rejection and chronic graft dysfunction. We tested usefulness of KIM-1 as an indicator of acute and chronic renal graft injury by correlating KIM-1 expression with renal graft function and histology. Methods: A total of 133 zero-time biopsies and 42 follow-up biopsies obtained within 1 year posttransplantation were selected. Renal tubular KIM-1 staining was graded semiquantitatively from 0 to 3 and the extent of staining was expressed as the ratio of KIM-1 positive/CD10 positive proximal tubules using Image J program. Results: KIM-1 was positive in 39.8% of zero-time biopsies. KIM-1 positive cases were predominantly male and had received grafts from donors with older age, deceased donors, and poor renal function at the time of donation, compared with KIM-1 negative cases. KIM-1 expression showed correlation with delayed graft function and acute tubular necrosis. In comparison of KIM-1 expression between stable grafts (n=23) and grafts with dysfunction (n=19) at the time of repeated biopsy, the intensity/extent of KIM-1 staining and renal histology at zero-time did not differ significantly between the two groups. Histologically, KIM-1 expression was significantly increased with both acute and chronic changes of glomeruli, tubules and interstitium, peritubular capillaritis, and arteriolar hyalinosis. Conclusions: KIM-1 can be used as an ancillary marker of AKI and a nonspecific indicator of acute inflammation and tubulointerstitial fibrosis. However, KIM-1 expression at zero-time is not suitable for prediction of long-term graft dysfunction.

• Journal of the Korea Convergence Society
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• v.11 no.12
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• pp.457-467
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• 2020

This study was conducted to for the development of nursing education programs suitable for the period by identifying the unmet needs of kidney transplant surgery patients who need continuous self-care according to the elapsed period. The subjects of the study consisted of 84 inpatients and outpatients for up to 1 year after kidney transplant surgery. The data collection period was from February 17 to May 31, 2020, and the collected data were analyzed by Chi-square, independent t-test, one-way ANOVA, and post-test by Scheffé using the IBM SPSS 21.0 program. As a measurement tool, the Comprehensive Needs Assessment Tool in Cancer(CNAT), a tool to assess unmet needs of cancer patients, was modified and supplemented to receive expert validity, and then self-report through a questionnaire consisting of a total of 57 questions. As a result of the study, the average of the total score out of 171points for the unmet needs of kidney transplant patients was 68.28(±38.88), and information and education accounted for the highest score of 17.92(±8.36) out of the eight sub-areas. The unmet needs according to the elapsed period were significantly higher in the 6 months ~1 year group(F=7.57, p=.001) compared to the 3-6 months group. Based on this, it is necessary to develop a nursing intervention program that can provide appropriate information and support at a time when the unmet needs of patients up to increase from 6 months to one year after kidney transplantation increase.