• Annals of Surgical Treatment and Research
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• 제95권5호
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• pp.267-277
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• 2018

Purpose: The aim of this study was to analyze survival outcomes in 1,000 consecutive liver transplantations (LTs) performed at a single institution from 1993 to April 2017. Methods: The study population was divided into 2 groups based on donor type: deceased donor LT (DDLT; n = 181, 18.1%) and living donor LT (LDLT; n = 819; 81.9%), and into 3 periods based on the number of cases (first 300 cases, middle 300 cases, last 400 cases). Results: Infection was the most common cause of death, accounting for 34.8% (95 of 273). Mortality due to hepatocellular carcinoma recurrence occurred most frequently between 1 and 5 years after transplantation. Mortality rate by graft rejection was highest between 5 and 10 years after transplantation. And mortality by de novo malignancy occurred most frequently after 10 years after transplantation. The patient survival rates for the entire population at 5 and 10 years were 74.7%, and 68.6%, respectively. There was no difference in survival rate between the LDLT and DDLT groups (P = 0.188). Cause of disease, disease severity, case period, and retransplantation had a significant association with patient survival (P = 0.002, P = 0.031, P = 0.003, and P = 0.024, respectively). Conclusion: Surgical techniques and perioperative management for transplant patients have improved and undergone standardization. Controlling perioperative infection and managing patients with HCC as LT candidates will result in better outcomes.

• 대한이식학회지
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• 제31권4호
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• pp.200-206
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• 2017

Background: Risk factors for bone avascular necrosis (AVN), a common late complication after kidney transplantation (KT), are not well known. Methods: Patients that underwent living-donor KT at Asan Medical Center between January 2009 and July 2016 were included in this retrospective study to determine the incidence and risk factors for AVN after KT. Results: Among 1,570 patients that underwent living-donor KT, 33 (2.1%) developed AVN during a mean follow-up of 49.8±25.0 months. Additionally, AVN was diagnosed at a mean of 13.9±6.6 months after KT. The mean cumulative corticosteroid dose during the last follow-up in patients without AVN (9,108±3,400 mg) was higher than that that in patients with AVN (4,483±1,114 mg) until AVN development (P<0.01). More patients among those with AVN (n=4, 12.1%) underwent steroid pulse treatment because of biopsy-proven rejections during the first 6 months after KT than patients without AVN (n=68, 4.4%; P=0.04). Female (hazard ratio [HR], 2.29; P=0.04) and steroid pulse treatment during the first 6 months (HR, 2.31; P=0.02) were significant AVN risk factors as revealed by the Cox proportional multivariate analysis. However, no significant differences in rejection-free graft survival rates were observed between the two groups (P=0.67). Conclusions: Steroid pulse treatment within 6 months of KT and being female were independent risk factors for AVN development.

• Advances in nano research
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• 제14권6호
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• pp.507-519
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• 2023

Postsurgical infections are caused by implant-related pathogenic microorganisms that lead to graft rejection. Hence, an intrinsically antibacterial material is required to produce a biocompatible biomaterial with osteogenic properties that could address this major issue. Hence, this current research aims to make strontium-doped hydroxyapatite nanorods (SrHANRs) via an ethylene diamine tetraacetic acid (EDTA)-enable microwave mediated method using Anodontia alba seashells for biomedical applications. This investigation also perceives that EDTA acts as a soft template to accomplish Sr-doping and mesoporous structures in pure hydroxyapatite nanorods (HANRs). The X-ray diffraction (XRD) and transmission electron microscopy (TEM) analysis reveals the crystalline and mesoporous structures, and Brunauer-Emmett-Teller (BET) indicates the surface area of all the samples, including pure HANRs and doped HANRs. In addition, the biocidal ability was tested using various implant-related infectious bacteria pathogens, and it was discovered that Sr-doped HANRs have excellent biocidal properties. Furthermore, toxicity evaluation using zebrafish reports the non-toxic nature of the produced HANRs. Incorporating Sr²⁺ ions into the HAp lattice would enhance biocompatibility, biocidal activity, and osteoconductive properties. As a result, the biocompatible HANRs materials synthesized with Sr-dopants may be effective in bone regeneration and antibacterial in-built implant applications.

• 대한핵의학회지
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• 제34권6호
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• pp.497-507
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• 2000

목적: 저자들은 이식 초기 이식신의 기능을 평가하기 위하여 시행한 $^{99m}Tc$-MAG3 신신티그라피에서 측정한 관류기 지표의 특성과 소견을 알아보고 신장 기능 이상을 초래하는 합병증의 진단에 이들 지표들이 얼마나 유용하게 이용될 수 있는 지를 규명하고자 하였다. 대상 및 방법: 신장 이식을 받은 환자 80명(남자: 48명, 여자: 32명, 평균 나이: 40.3세)을 대상으로 하였고, 조직검사, 검사실시험 소견 및 임상 경과 등을 종합하여 진단하였다. 신신티그라피는$^{99m}Tc$-MAG3, 100 MBq을 사용하여 이식 후 11일-23일 사이에 얻었다. 신전체 및 신피질 레노그람에서 측정한 신관류 지포는 Hilson관류지표(PI), 이식신 관류지표(TP)와 이식신 기능지표(TF)였고, 신기능 지표는 최대방사능 도달시간(Tmax)과 3분과 20분 방사능 비(K20/3)였다. 결과: 신신티그라피 시행 당시의 진단은 정상 신기능을 보인 경우가 44예, 급성거부가 14예, 급성 세뇨관괴사가 10예이었고 싸이클로스포린 A 신독성은 12예이었다. TP와 TF는 정상 신기능 군에 비해 합병증 군에서 통계적으로 유의하게 높았지만 PI는 유의한 차이가 없었다. 또한 정상 신기능 군에 비해 K20/3은 급성 거부와 급성세뇨관괴사에서, 신전체 Tmax은 급성거부에서 각각 유의하게 높았다. 합병증 군들 사이에서 유의한 차이를 보인 관류기 지표는 없었고 신기능 지표 중 K20/3은 싸이클로스포린 A 신독성에 비해 급성거부에서, 신피질 K20/3은 급성세뇨관괴사에서 각각 유의하게 증가하였다. 결론: $^{99m}Tc$-MAG3 신신티그라피를 이용한 이식 초기 이식신의 기능 평가에는 최초 동맥기 이후의 미세 관류와 초기 세뇨관 섭취를 나타내는 지표들인 TP와 TF가 중요한 역할을 하며, 신신티그라피 일 회 검사로 신장 기능의 이상을 초래하는 합병증의 감별은 쉽지 않지만 신 관류와 기능 지표를 연관시키고 검사 당시 질병의 진행 과정과 정도를 고려하면 진단에 도움이 되리라 생각한다.

• Journal of Chest Surgery
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• 제30권7호
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• pp.733-738
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• 1997

순차적 양측 폐이식수술은 수술시 및 수술후 합병증이 매우 다양하며 수술후 결과가 매우 불량하다. 저자 등은 양측 폐 이식수술후의 혈역학적 변화를 연구관찰하고자 하였으며 수술후 발생할 수 있는 거부반 응을 예방하기 위하여 양측 폐재식수술을 선택,시행하였으며 폐동맥의 뒤틀림이나 협착, 좌심방내의 혈전발 생 등을 예방하기 위하여 폐동맥 및 좌심방 부위를 혈관감자로 폐쇄시킨 후 폐측 폐동맥의 전면을 절단하였고, 폐측 상하 폐정맥부위 좌심방 전면을 절단한 후 1시간동안 폐동맥 절단부위를 통해 PGEI이 함유된 I-C 용액을 주입하였고 1시간동안 I-C용액이 함유된 거즈를 이용하여 냉각을 유지하였다. 다시 5-0 prolene을 이 용하여 봉합하였다. 좌심방을 봉합할 때 내면이 외 전되게끔 everted suture 방법으로 봉합하였다. 주기관지는 완전 절단후 telescope방법으코 단단문합하였으며 폐재식 수술전후의 동맥혈 산소가스치, 대퇴동맥 및 폐동맥 압을 측정하여 비교하였으며 수술전후의 뚜렷한 혈역학적 변화는 없었다. 절단 결찰된 폐는 PcEl이 함유된 I-c용액을 폐동맥으로 4o cmHlo 압력으로 Is ~h입분의 속도로 총량이 70 mfg되도록 주입하\ulcorner으며 그후 1시간동안 냉각된 I-C용액이 함유된 거즈를 이용하여 절단된 폐를 감싸서 냉각저류보관하여 허혈성 손상을 예방함으로써 수술수기에 대한 합병증이 없는한 양측 폐 이식수술후 성 적은 양호할 것으로 생각된다.

• KSBB Journal
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• 제20권4호
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• pp.278-284
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• 2005

식물세포의 느린 생장과 낮은 생산량의 이유로 지금까지 는 주로 미생물이나 동물세포에서 유전자 재조합 단백질을 생산하여 왔다. 그러나 저렴한 배지 가격, 동물 유래 바이러스 감염 위험성으로부터의 안정성, glycosylation 등의 post-translational modification이 가능하다는 장점들로 인하여 최근 들어 식물세포배양은 생물학적 활성을 가진 고부가가치의 단백질을 생산하는데 많이 이용되고 있다. 본 연구에서는 생장배지에 첨가했던 sucrose의 소비와 induction 배지로의 교환에서 오는 배지내의 삼투압을 조절하여 hCTLA4-Ig의 생산성을 높이고자 하였다. 다양한 삼투압 조절제 첨가 실험을 통해 sorbitol을 선별하고, 40 mM의 sorbitol 첨가에서 상대적으로 높은 생존도와 induction 후 7일째 대조구보다 1.7배 높은 생산성을 확인하였다. 또한, 저농도의 glucose 첨가를 통한 생산성 증대에 있어서는 8 mM glucose에서 induction 이후에도 높은 세포농도를 유지하면서 최대 37.3 mg/L까지 hCTLA4-Ig 생산량을 증가시켰다. 5-L bioreactor에서 회분식 배양과 induction시의 hCTLA4-Ig 생산량을 비교한 결과 induction시 배양 18일째 최고 45.3 mg/L까지 높일 수 있었으며, 회분식 배양에 비해 2.1배 증가됨을 확인하였다.

• Journal of Periodontal and Implant Science
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• 제44권5호
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• pp.235-241
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• 2014

Purpose: Regulatory T cells (Tregs), expressing CD4 and CD25 as well as Foxp3, are known to play a pivotal role in immunoregulatory function in autoimmune diseases, cancers, and graft rejection. Dendritic cells (DCs) are considered the major antigen-presenting cells (APCs) for initiating these T-cell immune responses, of which $CD103^+$ DCs are derived from precursor human peripheral blood mononuclear cells (PBMCs). The aim of the present study was to evaluate the capacity of these PBMC-derived $CD103^+$ DCs to promote the differentiation of antigen-specific Tregs. Methods: Monocyte-derived DCs were induced from $CD14^+$ monocytes from the PBMCs of 10 healthy subjects. Once the $CD103^+$ DCs were purified, the cell population was enriched by adding retinoic acid (RA). Peptide numbers 14 and 19 of Porphyromonas gingivalis heat shock protein 60 (HSP60) were synthesized to pulse $CD103^+$ DCs as a tool for presenting the peptide antigens to stimulate $CD3^+$ T cells that were isolated from human PBMC. Exogenous interleukin 2 was added as a coculture supplement. The antigen-specific T-cell lines established were phenotypically identified for their expression of CD4, CD25, or Foxp3. Results: When PBMCs were used as APCs, they demonstrated only a marginal capacity to stimulate peptide-specific Tregs, whereas $CD103^+$ DCs showed a potent antigen presenting capability to promote the peptide-specific Tregs, especially for peptide 14. RA enhanced the conversion of $CD103^+$ DCs, which paralleled the antigen-specific Treg-stimulating effect, though the differences failed to reach statistical significance. Conclusions: We demonstrated that $CD103^+$ DCs can promote antigen-specific Tregs from naive T cells, when used as APCs for an epitope peptide from P. gingivalis HSP60. RA was an effective reagent that induces mature DCs with the typical phenotypic expression of CD103 that demonstrated the functional capability to promote antigen-specific Tregs.

• Asian Pacific Journal of Cancer Prevention
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• 제16권17호
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• pp.8009-8013
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• 2015

Background: Orthotopic organ transplantation, a treatment option for irreversible organ dysfunction according to organ failure, severe damaged organ or malignancy in situ, was usually accompanied with massive blood loss thus transfusion was required. We aimed to evaluate the adverse impact of blood transfusion on solid organ transplantation. Materials and Methods: From January, 2009 to December, 2014, patients who received orthotopic organ transplantation at Far Eastern Memorial Hospital medical center were enrolled. Clinical data regarding anemia status and red blood cell (RBC) transfusion before, during and after operation, as well as patient outcomes were collected for further univariate analysis. Results: A total of 105 patients who underwent orthotopic transplantation, including liver, kidney and small intestine were registered. The mean hemoglobin (Hb) level upon admission and before operation were $11.6{\pm}1.8g/dL$ and $11.7{\pm}1.7g/dL$, respectively; and the nadir Hb level post operation and the final Hb level before discharge were $8.3{\pm}1.6g/dL$ and $10.2{\pm}1.6g/dL$, respectively. The median units (interquartile range) of RBC transfusion in pre-operative, peri-operative and post-operative periods were 0 (0-0), 2 (0-12), and 2 (0-6) units, respectively. Furthermore, the median (interquartile range) length of hospital stay (LHS) from admission to discharge and from operation to discharge were 28 (17-44) and 24 (16-37) days, respectively. Both peri-operative and post-operative RBC transfusion were associated with longer LHS from admission to discharge and from operation to discharge. Furthermore, it increased the risk of post-operative septicemia. While peri-operative RBC transfusion elevated the risk of acute graft rejection in patients who received orthotopic transplantation. Conclusions: Worse outcome could be anticipated in those who had received massive RBC transfusion in transplantation operation. Hence, peri-operative RBC transfusion should be avoided as much as possible.

• Asian-Australasian Journal of Animal Sciences
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• 제31권4호
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• pp.595-606
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• 2018

Objective: The Fusarium mycotoxins of deoxynivalenol (DON) and zerolenone (ZEN) cause health hazards for both humans and farm animals. Therefore, the main intention of this study was to reveal DON and ZEN effects on the mRNA expression of pro-inflammatory cytokines and other immune related genes in the liver of piglets. Methods: In the present study, 15 six-week-old piglets were randomly assigned to the following three different dietary treatments for 4 weeks: control diet, diet containing 8 mg DON/kg feed, and diet containing 0.8 mg ZEN/kg feed. After 4 weeks, liver samples were collected and sequenced using RNA-Seq to investigate the effects of the mycotoxins on genes and gene networks associated with the immune systems of the piglets. Results: Our analysis identified a total of 249 differentially expressed genes (DEGs), which included 99 upregulated and 150 downregulated genes in both the DON and ZEN dietary treatment groups. After biological pathway analysis, the DEGs were determined to be significantly enriched in gene ontology terms associated with many biological pathways, including immune response and cellular and metabolic processes. Consistent with inflammatory stimulation due to the mycotoxin-contaminated diet, the following Kyoto encyclopedia of genes and genomes pathways, which were related to disease and immune responses, were found to be enriched in the DEGs: allograft rejection pathway, cell adhesion molecules, graft-versus-host disease, autoimmune thyroid disease (AITD), type I diabetes mellitus, human T-cell leukemia lymphoma virus infection, and viral carcinogenesis. Genome-wide expression analysis revealed that DON and ZEN treatments downregulated the expression of the majority of the DEGs that were associated with inflammatory cytokines (interleukin 10 receptor, beta, chemokine [C-X-C motif] ligand 9), proliferation (insulin-like growth factor 1, major facilitator superfamily domain containing 2A, insulin-like growth factor binding protein 2, lipase G, and salt inducible kinase 1), and other immune response networks (paired immunoglobulin-like type 2 receptor beta, Src-like-adaptor-1 [SLA1], SLA3, SLA5, SLA7, claudin 4, nicotinamide N-methyltransferase, thyrotropin-releasing hormone degrading enzyme, ubiquitin D, histone $H_2B$ type 1, and serum amyloid A). Conclusion: In summary, our results demonstrated that high concentrations DON and ZEN disrupt immune-related processes in the liver.

• 한국임상수의학회지
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• 제26권5호
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• pp.441-444
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• 2009

허혈/재관류 손상은 장기이식 분야에서 해결해야 할 주요 문제점으로 알려져 있다. 본 연구에서는 대퇴 동,정맥 부위에서 기존의 혈관 문합법 대신 맥관 connector를 이용하여 간단하면서 효과적인 체외 재관류 모델을 개발하였기에 소개하고자 한다. 개발된 모델이 허혈/재관류 손상연구에 효과적인지 알아보기 위해 혈액 동력학적 평가와 신장의 재관류 후 손상 양상을 분석하였다. 기존의 재관류 모델에서 사용되는 문합 부위인 복강 대동맥의 혈압과 본 연구에서 재관류 부위로 활용된 대퇴동맥의 혈압은 유의적 차이가 없었다. 허혈 손상 후 재관류 효과를 알아보기 위해 미니돼지에서 적출한 신장을 HTK 용액에 24, 48시간 동안 각각 저온보관 후 대퇴부에 이식하여 재관류 한 결과, 신장의 재관류까지 수술시간은 평균 $7.0{\pm}1.1$분 소요되었으며, 3시간 재관류 후 재관류 손상 정도는 저온보관시간에 따라 증가되는 것이 확인되었다. 이는 개발된 모델이 맥관 문합 없이 간단한 관류방법이면서도 기존의 복잡한 수술에 의한 재관류 방법과 유사한 손상 모델을 만들 수 있는 효과적인 허혈/재관류 동물모델이라는 것을 의미한다. 따라서 본 연구에서 개발한 신장 재관류 모델은 초기 허혈/재관류 손상 연구와 장기이식에서 이식면역연구에 효과적인 모델이라 사료된다.