• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제21권4호
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• pp.297-305
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• 2018

Purpose: There is a lack of scholarly reports on pediatric emergency department (PED) exposure to hyperbilirubinemia. We aimed to describe the epidemiology of hyperbilirubinemia in patients presenting to a PED over a three-year period. Methods: This was a retrospective cohort study, completed at an urban quaternary academic PED. Patients were included if they presented to the PED from 2010 to 2012, were 0 to 18 years in age, and had an elevated serum bilirubin for age. A chart review was completed to determine the incidence of hyperbilirubinemia, etiology, diagnostic work up and prognosis. The data set was stratified into four age ranges. Results: We identified 1,534 visits where a patient was found to have hyperbilirubinemia (0.8% of all visits). In 47.7% of patients hyperbilirubinemia was determined to have arisen from an identifiable pathologic etiology (0.38% of all visits). First-time diagnosis of pathologic hyperbilirubinemia occurred in 14% of hyperbilirubinemia visits (0.11% of all visits). There were varying etiologies of hyperbilirubinemia across age groups but a male predominance in all (55.0%). 15 patients went on to have a liver transplant and 20 patients died. First-time pathologic hyperbilirubinemia patients had a mortality rate of 0.95% for their initial hospitalization. Conclusion: Hyperbilirubinemia was not a common presentation to the PED and a minority of cases were pathologic in etiology. The etiologies of hyperbilirubinemia varied across each of our study age groups. A new discovery of pathologic hyperbilirubinemia and progression to liver transplant or death during the initial presentation was extremely rare.

• 한국정보통신학회논문지
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• 제16권8호
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• pp.1765-1772
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• 2012

의료기기 및 진단 기술의 발달로 신체 장기의 이식에 대한 성공률이 향상되었으며 특히 간 기능 장애에 의한 간이식이 늘어나는 추세이다. 영상처리 및 분석의 발달로 간 이식을 위한 간의 체적을 구하는 방법들이 정확성과 효율성이 높아졌다. 본 논문은 각 알고리즘들의 신속한 비교 및 분석, 빠른 프로토타입 개발에 효과적인 MeVisLab을 사용하여 간 영역을 분할하고 재구성하였다. 원본 영상에 문턱치 값 적용과 영역 확장법을 적용하여 간 영역을 분할하고 Morphology와 구멍 채우기, 관심영역 설정으로 노이즈 및 불필요한 객체를 제거하여 간을 분할하였다. MeVisLab의 사용으로 높은 시간적 효율과 다양한 비교 및 분석 모듈 사용 방법을 제시하여 의료영상처리 연구의 저변 확대에 기여하리라 판단된다.

• 한국보건간호학회지
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• 제19권1호
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• pp.129-138
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• 2005

As the patients who need to undergo liver transplant operation continues to grow. the number of livers that are donated can not keep pace with the demand. With the development of surgery skills, the necessity for operations from living donors is increasing. Nevertheless, satisfactory research has been conducted on the factors which generally affect the living donors. In this article. therefore. researchers focused on the factors which generally affect the donating liver donor in order to design a plan for recommending liver donation from living donors. The subjects were 91 living liver donors in C university hospital from October 1. 2000 to December 31. 2003. The results on the uncertainty of living donor, by test sheet. were analyzed with SAS program. The final results were as follows: 1. The uncertainty of the living donors was 51.54 marks per full credit 100. 2. The factor with the greatest effect on donation was the possibility of survival of the donor, followed by the admission period. marriage status and age. In recommending the living donation, the rate of donor survival after the operation was 5.2 times higher than death, 5.2 times higher when the admission period was under 20 days. 5.0 times higher when married. and 27.3 times higher when the family-related donation was very active at the age of 20s than in the 50s. These results suggest that all medical staffs should care for living donors with more interest and activity to give them the least complaints in admission and the lowest possibilities for complication. To enhance the survival rate and improve the surgical success rate. on-going monitoring should include regular health-checks. and continual efforts and education should be made to care for the health condition of the living donors after donation.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제25권6호
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• pp.489-499
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• 2022

Purpose: The survival rate of pediatric patients undergoing liver transplantation has increased considerably. Despite this, the period after transplantation is still complex and poses several challenges to the recipient's family, which is responsible for care management. Recently, more attention has been paid to the impact of this complex procedure on the quality of life of caregivers. Hence, this study is aimed at assessing the quality of life of caregivers of patients who have undergone liver transplantation and the aspects that influence it. Methods: This was an observational and cross-sectional study. From November 2020 to January 2021, short-form-36 questionnaires and additional questions were given to the main caregivers of children and adolescents who underwent pediatric liver transplantation. Results: Thirty-eight questionnaires were completed and the results revealed a lower quality of life in comparison to Brazilian standards, primarily in the mental domains (41.8±14.1 vs. 51.1±2.8; p<0.001). It did not show a significant association with socioeconomic or transplant-related factors, but it did show a negative impact on parents' perception of the child's health. Parents who reported worse health status for their children had a lower mental quality of life (44.1±13.8 vs. 33.3±12.6; p<0.05). Conclusion: The caregivers of transplanted children have a lower quality of life than those of the local population. Psychological assistance should be routinely provided to parents for long-term follow-up to mitigate potential negative effects on the transplanted child's care.

• 약학회지
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• 제57권1호
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• pp.43-54
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• 2013

Viral hepatitis is the inflammation of liver cells caused by viruses, and still one of the major health-care problems worldwide. A number of viruses to cause hepatitis are type A, B, C, D, E or G. Among these viruses leading to hepatitis, B and C are more troublesome being more prone to chronic illness which can cause the potentially fatal conditions of hepatocellular carcinoma (HCC) and/or liver failure. If immediate treatment is not initiated, liver transplant is the only option left. Over the past few decades there has been remarkable progress in diagnose and monitor all hepatitis virus infections for treatment and prevention. Nonetheless, important challenges remain to develop more effective and safe vaccines for prevention as well as antiviral agents to reduce viremia/viral load by inhibiting viral replication. The development and evaluation of antiviral agents through carefully designed clinical trials over the last 25 years has heralded a new dawn in the treatment of patients chronically infected with the hepatitis B and C viruses, but not so for the D virus. The introduction of Direct Acting Antivirals (DDAs) for the treatment of HBV carriers has permitted the long term use of these compounds for the continuous suppression of viral replication. This review aims to summarize the current status and development approaches of antiviral drugs for the treatment of viral hepatitis and future perspectives.

• 대한영상의학회지
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• 제83권1호
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• pp.224-229
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• 2022

담관 원주 증후군은 간이식을 받은 환자들에게서 발생하는 흔치 않은 합병증이다. 간이식을 받은 환자의 약 5%-18%에서 발생한다. 간이식을 받지 않은 환자에게서 드물게 담관 원주 증후군이 발생하는 것으로 보고되었다. 이식 후 담관 손상, 허혈, 담도 감염, 수술 후 거치된 담도 배액관 등이 병리요인으로 제안되었으나 담도 원주의 병리현상은 아직 명확히 규명되지 않았다. 이에 저자들은 간이식을 받지 않은 49세 남성에게서 총담관 결석에 대해 내시경과 경피적 담관 조영 시술 후에 발생된 담관 원주 증후군의 사례를 소개한다.

• 대한간호학회지
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• 제49권3호
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• pp.340-348
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• 2019

Purpose: This study aimed to investigate the nutritional status of liver transplantation (LT) recipients and explore certain factors that influence nutritional status, including dietary patterns and physical activities. Methods: This was a cross-sectional, descriptive study. The subjects included 211 LT recipients at a medical center outpatient clinic located in Seoul, Korea. The nutritional status, dietary patterns, and physical activities of each subject were measured using the body mass index (BMI), Mini Dietary Assessment (MDA), and Global Physical Activity Questionnaire. Independent t-test, one-way analysis of variance, and multiple linear regression analysis were used to analyze the data. Results: The percentages of living and deceased donor LTs were 81.0% and 19.0%, respectively. The mean BMIs pre- and post-LT were 23.88 and $23.16kg/m^2$, respectively, and the average MDA score was 36.55. More than 60.0% of the subjects had a moderate or high level of physical activity. In multivariate analysis, a higher BMI before LT (${\beta}=.72$, p<.001), a lower Model for End-stage Liver Disease (MELD) score (${\beta}=-.18$, p<.001), and being male (${\beta}=-.10$, p=.024) contributed to better nutritional status post-LT. Patients within six months of LT were less engaged in muscle exercises than those post six months of LT (p=.020). Conclusion: LT recipients in Korea have good nutritional status and a good level of physical activity. To improve recipients' post-LT nutritional status, the pre-LT nutritional status should be considered, particularly in those with a higher MELD score. In addition, physical activity including muscle-strengthening exercises should be encouraged from an earlier stage.

• 대한간호학회지
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• 제52권4호
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• pp.435-450
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• 2022

Purpose: The purpose of the study was to understand the care experiences of the family of living donor liver transplantation (LDLT) patients where the donation had occurred within the family. Methods: Participants were eight family caregivers who cared for recipients and donors of LDLT. Data were collected through individual in-depth interviews from November, 2020 to April, 2021. Data analysis was performed through a cyclical process of data collection and analysis by applying Giorgi's phenomenological research method. Results: The five main components extracted from the experiences of the family caregivers were: "A double-edged choice to save the family", "The harsh daily life of liver transplantation care", "The yoke of double care on both shoulders", "The power to withstand the adversity of caring", and "The recovery and growth of life pursued by trusting each other". Conclusion: The participants tried to do their best in their daily lives, while providing reassurance and care to the LDLT patients in the family; however, they expressed some worry and hardship while doing so. The results of this study provide a deeper understanding of the caring experience of the family caregivers, which may contribute to the development of nursing interventions that will aid these caregivers in providing care to their LDLT family members. Furthermore, the development and application of an integrated management program for LDLT patients in the family is required.

• 대한의용생체공학회:의공학회지
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• 제31권3호
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• pp.177-186
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• 2010

In 3D ultrasound color Doppler imaging (CDI), 8-16 pulse transmissions (ensembles) per each scanline are used for effective clutter rejection and flow estimation, but it yields a low volume acquisition rate. In this paper, we have evaluated three flow estimation methods: autoregression (AR), eigendecomposition (ED), and autocorrelation combined with adaptive clutter rejection (AC-ACR) for a small ensemble size (E=4). The performance of AR, ED and AC-ACR methods was compared using 2D and 3D in vivo data acquired under different clutter conditions (common carotid artery, kidney and liver). To evaluate the effectiveness of three methods, receiver operating characteristic (ROC) curves were generated. For 2D kidney in vivo data, the AC-ACR method outperforms the AR and ED methods in terms of the area under the ROC curve (AUC) (0.852 vs. 0.793 and 0.813, respectively). Similarly, the AC-ACR method shows higher AUC values for 2D liver in vivo data compared to the AR and ED methods (0.855 vs. 0.807 and 0.823, respectively). For the common carotid artery data, the AR provides higher AUC values, but it suffers from biased estimates. For 3D in vivo data acquired from a kidney transplant patient, the AC-ACR with E=4 provides an AUC value of 0.799. These in vivo experiment results indicate that the AC-ACR method can provide more robust flow estimates compared to the AR and ED methods with a small ensemble size.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권5호
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• pp.479-486
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• 2019

Progressive familial intrahepatic cholestasis (PFIC) is a group of severe genetic disorders, inherited in an autosomal recessive manner, causing cholestasis of hepatocellular origin, later progressing to biliary cirrhosis and liver failure. This is the first report of PFIC type 1 with novel compound heterozygous mutations in Korea. The patient was presented with intrahepatic cholestasis, a normal level of serum ${\gamma}-glutamyl$ transferase, steatorrhea, and growth failure. Genetic testing of this patient revealed novel compound heterozygous mutations (p.Glu585Ter and p.Leu749Pro) in the ATP8B1 gene. After a liver transplantation at age 19 months, the patient developed severe post-transplant steatohepatitis.