• Title/Summary/Keyword: Organ Transplantation

검색결과 224건 처리시간 0.032초

Utility of a modified components separation for abdominal wall reconstruction in the liver and kidney transplant population

  • Black, Cara K;Zolper, Elizabeth G;Walters, Elliot T;Wang, Jessica;Martinez, Jesus;Tran, Andrew;Naz, Iram;Kotha, Vikas;Kim, Paul J;Sher, Sarah R;Evans, Karen K
    • Archives of Plastic Surgery
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    • 제46권5호
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    • pp.462-469
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    • 2019
  • Background Incisional hernia is a common complication following visceral organ transplantation. Transplant patients are at increased risk of primary and recurrent hernias due to chronic immune suppression and large incisions. We conducted a retrospective review of patients with a history of liver or kidney transplantation who underwent hernia repair to analyze outcomes and hernia recurrence. Methods This is a single center, retrospective review of 19 patients who received kidney and/or liver transplantation prior to presenting with an incisional hernia from 2011 to 2017. All hernias were repaired with open component separation technique (CST) with biologic mesh underlay. Results The mean age of patients was $61.0{\pm}8.3years\;old$, with a mean body mass index of $28.4{\pm}4.8kg/m^2$, 15 males (78.9%), and four females (21.1%). There were seven kidney, 11 liver, and one combined liver and kidney transplant patients. The most common comorbidities were hypertension (16 patients, 84.2%), diabetes (9 patients, 47.4%), and tobacco use (8 patients, 42.1%). Complications occurred in six patients (31.6%) including hematoma (1/19), abscess (1/19), seroma (2/19), and hernia recurrence (3/19) at mean follow-up of $28.7{\pm}22.8months$. With the exception of two patients with incomplete follow-up, all patients healed at a median time of 27 days. Conclusions This small, retrospective series of complex open CST in transplant patients shows acceptable rates of long-term hernia recurrence and healing. By using a multidisciplinary approach for abdominal wall reconstruction, we believe that modified open CST with biologic mesh is a safe and effective technique in the transplant population with complex abdominal hernias.

Surgical outcome and risk scoring to predict survival after hepatic resection for hepatocellular carcinoma with portal vein tumor thrombosis

  • Tae-Seok Kim;Kwangho Yang;Gi Hong Choi;Hye Yeon Yang;Dong-Sik Kim;Hye-Sung Jo;Gyu-Seong Choi;Kwan Woo Kim;Young Chul Yoon;Jaryung Han;Doo Jin Kim;Shin Hwang;Koo Jeong Kang
    • 한국간담췌외과학회지
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    • 제28권2호
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    • pp.134-143
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    • 2024
  • Backgrounds/Aims: The hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) is classified as the advanced stage (BCLC stage C) with extremely poor prognosis, and in current guidelines is recommended for systemic therapy. This study aimed to evaluate the surgical outcomes and long-term prognosis after hepatic resection (HR) for patients who have HCC combined with PVTT. Methods: We retrospectively analyzed 332 patients who underwent HR for HCC with PVTT at ten tertiary referral hospitals in South Korea. Results: The median overall and recurrence-free survival after HR were 32.4 and 8.6 months, while the 1-, 3-, and 5-year overall survival rates were 75%, 48%, and 39%, respectively. In multivariate analysis, tumor number, tumor size, AFP, PIVKA-II, neutrophil-to-lymphocyte ratio, and albumin-bilirubin (ALBI) grade were significant prognostic factors. The risk scoring was developed using these seven factors-tumor, inflammation and hepatic function (TIF), to predict patient prognosis. The prognosis of the patients was well stratified according to the scores (log-rank test, p < 0.001). Conclusions: HR for patients who have HCC combined with PVTT provided favorable survival outcomes. The risk scoring was useful in predicting prognosis, and determining the appropriate treatment strategy for those patients who have HCC with PVTT.

Computational Study of Magnetically Suspended Centrifugal Blood Pump (The First Report: Main Flow and Gap Flow)

  • Ogami, Yoshifumi;Matsuoka, Daisuke;Horie, Masaaki
    • International Journal of Fluid Machinery and Systems
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    • 제3권2호
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    • pp.102-112
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    • 2010
  • Artificial heart pumps have attracted the attention of researchers around the world as an alternative to the organ used in cardiac transplantation. Conventional centrifugal pumps are no longer considered suitable for long-term application because of the possibility of occurrence of blood leakage and thrombus formation around the shaft seal. To overcome this problem posed by the shaft seal in conventional centrifugal pumps, the magnetically suspended centrifugal pump has been developed; this is a sealless rotor pump, which can provide contact-free rotation of the impeller without leading to material wear. In Europe, clinical trials of this pump have been successfully performed, and these pumps are commercially available. One of the aims of our study is to numerically examine the internal flow and the effect of leakage flow through the gap between the impeller and the pump casing on the performance of the pump. The results show that the pressure head increases compared with the pump without a gap for all flow rates because of the leakage of the fluid through the gap. It was observed that the leakage flow rate in the pump is sufficiently large; further, no stagnant fluid or dead flow regions were observed in the pump. Therefore, the present pump can efficiently enhance the washout effect.

사람의 눈지방유래 줄기세포의 간세포 분화 (Hepatic Differentiation of Human Eyelid Adipose-Derived Stem Cells)

  • 박수연;박세아;강현미;김해권
    • 한국발생생물학회지:발생과생식
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    • 제12권2호
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    • pp.183-194
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    • 2008
  • A variety of stem cells has been emerging as therapeutic cells that can replace organ transplantation in human liver diseases. The present study focused on whether human eyelid adipose-derived stem cells (HAD) might differentiate into functional hepatocyte-like cells in vitro. HAD were isolated from human eyelid adipose tissue. Effect of dimethyl sulfoxide (DMSO), fibroblast growth factor (FGF)-2 and FGF-4 on the hepatic differentiation of HAD have been examined in vitro. Immunocytochemical analysis and PAS staining showed that HAD cultured in both DMSO and FGF-4 exhibited the most intense staining than HAD of the other experimental groups. These HAD expressed numerous hepatocyte-related genes. Immunoblotting analyses showed that HAD cultured in the presence of DMSO and FGF-4 secreted higher amount of human albumin than HAD cultured in other conditions. Urea analysis also demonstrated that these HAD produced higher amount of urea than any other groups of HAD. In conclusion, combined treatment of DMSO and FGF-4 could effectively induce the functional differentiation of HAD into hepatocyte-like cells.

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Cyclosporin A에 의한 치은 증식증에서 FGF-5와 FGF-7의 발현 양상에 대한 연구 (THE EXPRESSION OF FGF-5 AND FGF-7 IN THE CYCLOSPORIN A-INDUCED GINGIVAL HYPERPLASIA)

  • 정미향;김성곤;윤경인;남동석
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제32권3호
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    • pp.216-221
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    • 2006
  • Cyclosporin A-induced gingival hyperplasia is frequently found in the patients who have been received an immunosuppressant for the organ transplantation. However, its exact mechanism is still unknown. The expression of FGF-5 and FGF-7 were studied in cyclosporine A-induced gingival hyperplasia (CGH) and inflammatory gingival hyperplasia (IGH). Immunohistochemistry and in situ hybridization were used for localization of protein and mRNA. The expression of FGF-5 and FGF-7 was different from CGH and IGH. FGF-5 and FGF-7 was strongly expressed in fibroblast in CGH (P<0.005 and P<0.05, respectively). FGF-5 mRNA was localized in the middle portion of connective tissue. FGF-7 mRNA was also identified in fibroblasts and mast cells. In conclusion, FGF-5 and FGF-7 were produced excessively by fibroblasts in CGH. Considering their known functions, their expression in CGH is important for production of collagen and proliferation of fibroblasts.

PER3, a novel target of miR-103, plays a suppressive role in colorectal cancer in vitro

  • Hong, Zhang;Feng, Zhang;Sai, Zhang;Tao, Su
    • BMB Reports
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    • 제47권9호
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    • pp.500-505
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    • 2014
  • Colorectal cancer has become the third most common cancer and leads to high mortality worldwide. Although colorectal cancer has been studied widely, the underlying molecular mechanism remains unclear. PER3 is related to tumor differentiation and the progression of colorectal cancer. High expression of miR-103 is associated with poor prognosis in patients with colorectal cancer. However, the relationship between miR-103 and PER3 in CRC cells remains unclear. In this study, we found that PER3 was downregulated in CRC tissues and CRC cell lines, whereas miR-103 was upregulated in CRC cell lines. We also found that PER3 promoted CRC cells apoptosis. These results indicate that PER3 plays a suppressive role in CRC cells. Moreover, we found that PER3 was targeted, at least partially, by miR-103. Taken together, we provide evidence to characterize the role of PER3 in CRC, which may be a new therapeutic target for CRC.

대학병원 종사자의 감염성 폐기물에 대한 지식, 태도 및 실천 (A University Hospital Employee's Knowledge, Attitude Toward, and Practice of Hospital Infectious Wastes)

  • 유혜숙;양인화;소향숙
    • 성인간호학회지
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    • 제21권1호
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    • pp.53-61
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    • 2009
  • Purpose: This study was to provide baseline data to arrange systematic management for the infectious waste. Methods: This data was collected by self-reported questionnaires from a total of 419 subjects, ie nurses, nurse's aides and laboratory technicians working at a university hospital located in G city. The collected data were analyzed by t-test or ANOVA, Tukey test, Pearson's correlation, and multiple regression analysis using SPSS/WIN 12.0. Results: The knowledge of the infectious waste was statistically significant in type of staff and level of education. Attitude was statistically significant in type of staff, age group, level of education, working period, and marital status. And also the practice of the subject was statistically significant in type of staff, age group, education level, the working periods, and marital status. There was positive association between attitude and practice(r=.63, ${\rho}$< 001). By means of multiple stepwise regression analysis, total variance explained by the attitude towards infectious wastes, single employee, and the working periods less than ten years was 44% of the practice of infectious wastes. Conclusion: An educational program focusing on strategy to change employee's attitude can be effective for building a well-organized management system.

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간호사의 업무스트레스, 자기효능감과 직무만족에 관한 연구 (A Study on the Relationship between Job Stress, Self-Efficacy and Job Satisfaction in Nurses)

  • 봉영숙;소향숙;유혜숙
    • 간호행정학회지
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    • 제15권3호
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    • pp.425-433
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    • 2009
  • Purpose: This study was conducted to examine relationships among job satisfaction, job stress, and self-efficacy and to identify predicting factors on the job satisfaction among a general hospital nurses. Method: The subjects were 266 nurses working at C university hospital in G city. Data were collected using a self-reported questionnaires. The data were analyzed using t-test, one-way ANOVA, Scheffe test, Pearson's correlation coefficients, & multiple stepwise regression by SPSS 12.0 program. Result: The job satisfaction indicated a significant relationship to self-efficacy (r=.310, p<.001) and work stress (r=-.273, p<.001) respectively. The powerful predictors of job satisfaction were general self-efficacy (22.6%), over ₩2,500,000 at monthly income (7.3%), job stress (4.9%), work period at present unit (2.6%), which explained 41.3% of total variance of job satisfaction. It has been confirmed that the regression equation model of this research may serve as a predictor of clinical nurses' job satisfaction. Conclusions: We need to develop self-efficacy promoting and stress relief program for clinical nurses in order to improve job satisfaction.

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생체 신장 공여자의 공여 후 적응 경험 (Adaptation Experience of Living Kidney Donors after Donation)

  • 강다해솜;양진향
    • 대한간호학회지
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    • 제46권2호
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    • pp.271-282
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    • 2016
  • Purpose: This study was done to explore adaptation experience of living kidney donors after donation. Specific aims were to identify challenges donors face in the process of adaptation following surgery and how they interact with recipients and other people. Methods: Grounded theory methodology was utilized. Participants were 13 living kidney donors at six months or more after donation. Data were collected by in-depth interviews with individual participants. Data were analyzed using constants comparative method with theoretical saturation. Results: A core category emerged as 'keeping the fences of my family in spite of vulnerability'. The adaptation process after donation was manifested in four phases: exploration, balance, maintenance, and acclimatization. Phenomenon was perception of vulnerability. Strategies to manage the vulnerability were assessing changes of body awareness, tailoring regimen to one's own body condition, coping with health problems, keeping restoration of health, and ruminating on the meaning of one's kidney donation. Consequences were reestablishing family well-being, realizing the values of one's kidney donation, and living with uncertainty. Conclusion: Findings of the study indicate that there is a need for health professionals to understand the vulnerability of living kidney donors and help their family system maintain a healthy and productive life. The results of this study can be used to develop phase-specific, patient-centered, and tailored interventions for living kidney donors.

Oral Hairy Leukoplakia in Patient with Human Immunodeficiency Virus Infection

  • Park, Gunwoo;Ahn, Hyung Joon;Choi, Jong-Hoon;Kwon, Jeong-Seung
    • Journal of Oral Medicine and Pain
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    • 제40권2호
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    • pp.79-81
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    • 2015
  • Oral hairy leukoplakia occurs on the lateral surface of the tongue that clinically as an asymptomatic white lesion. It is mainly found in patient with human immunodeficiency virus infection. However, it rarely outbreak immunosuppressed patients after organ transplantation, or the patients taking steroids or immunosuppressants. It is the result of proliferating Epstein-Barr virus in the oral epithelium. Most of human immunodeficiency virus infected patients with oral hairy leukoplakia are highly contagious and possible to progress acquired immunodeficiency syndrome. Therefore, the early diagnosis of oral hairy leukoplakia is very important. Taking a thorough history and human immunodeficiency virus screening test is highly recommended in case oral hairy leukoplakia is detected. In this case, a 29-year-old man presented with whitish lesion on lateral border of tongue is diagnosed as oral hairy leukoplakia and human immunodeficiency virus infection.