• Title/Summary/Keyword: Organ transplant

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Effects of Biomedical Ethics Education using Movies on Biomedical Ethics Awareness of Nursing Students (영화를 이용한 생명의료윤리교육이 간호대학생의 생명의료윤리의식에 미치는 효과)

  • Kim, Seon Young
    • The Journal of the Korea Contents Association
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    • v.14 no.7
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    • pp.281-290
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    • 2014
  • This study is a quasi-experimental research using non-equivalent control group pre-post design in order to understand the effectiveness of biomedical ethics education using movies. This study selected the first-year 45 students and 63 students who were attending at two 4-year-course nursing colleges as an experimental group and control group, respectively. Then, this study provided the experimental group with the lecture on biomedical ethics for 16 weeks using the movie related to the ethical issues covering 10 areas. Data collection was done for 5 days from August 26, 2013 until December 5, 2013, and conducted pre-post questionnaire survey on the 1st week session and 16th session after explaining there search purpose and getting a written agreement from the subjects. As a result of analysis of the collected data using SPSS Statistics 18, it was found that students' average point of biomedical ethics awareness improved to 3.31 from 3.07; additionally, in the analysis of the data by sub-area, the point in artificial abortion improved to 3.69 from 3.08; artificial insemination from 2.99 to 3.57; fetal diagnosis from 3.10 to 3.45; a newborn's right to life from 3.39 to 3.55 and organ transplant from 3.26 to 3.53, respectively(P<.001). On the contrary, the research results showed that there was no change in the point of the mercy-killing, brain death, and human biotechnology areas, respectively(p>.05). Conclusively, movie-aided education could be diversely used for nursing education provided movie contents should be in accord with a lecture subject in a way that can arouse students' interest and concern, and improve educational satisfaction.

Detection of Hepatitis B Virus DNA in Liver Grafts Obtained from HBsAb and HBcAb Positive Organ Donors (HBsAb와 HBcAb가 양성인 장기 공여자의 간조직에서 Hepatitis B Virus DNA의 발현)

  • Jung, Chang-Woo;Jang, Joo-Young;Kim, Kyung-Mo;Lee, Sung-Gyu
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.10 no.2
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    • pp.166-172
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    • 2007
  • Purpose: It has recently been reported that de novo HBV infection following liver transplantation is caused by grafts from HBcAb positive donors, and this phenomenon has been observed in one third of the liver transplant patients in our center. Therefore, we investigated the presence of HBV virus DNA in liver tissues obtained from HBcAb positive donors to determine the mechanism by which de novo HBV infection occurs. Methods: This study was conducted on 6 patients that were HBsAg negative, HBsAb positive, and HBcAb positive who were donors for liver transplantation between November 1997 and November 1998 at Asan Medical Center. We isolated DNA from a portion of liver biopsy tissues that were obtained during the operation, and then identified the surface and core region of HBV DNA using nested PCR. In addition, four children who received liver grafts from these donors were monitored to determine if they became afflicted with non-HBV related diseases while receiving prophylaxis consisting of short-term HBIG treatment and long-term treatment with an antiviral agent. Results: The surface antigen region was identified in all 6 donors and the core antigen region was observed in 4 of the 6 donors. However, no episodes of de novo HBV infection with prophylaxis were observed. Conclusion: The results of this study support the results of previous studies, which indicated that HBV infection may be the main cause of de novo HBV infection in patients that receive HBsAb positive and HBcAb positive donor grafts.

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Comparison of hematological values of conventional pigs and transgenic pigs supressed in immune rejection response (일반돼지와 면역 거부반응이 억제된 형질전환돼지의 혈액 성상 비교)

  • Cho, Ara;Oh, Keon Bong;Roh, Jae-Hee;Jung, Young-Hun;Jung, Suk-Han;Kang, Myoung-Geum;Kim, Mi-Suk;Do, Yoon Jung;Oh, Sang-Ik;Kim, Eunju;Yoo, Jae Gyu;Choe, Changyong
    • Korean Journal of Veterinary Service
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    • v.42 no.4
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    • pp.193-200
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    • 2019
  • Blood test is a useful tool in establishing medical treatment for livestock. It provides information such as disease diagnosis, treatment effects, prognostic judgment, and health status. This study compared the value of erythrocytes and leukocytes among conventional, transgenic miniature, and transgenic conventional pigs aged six months to 24 months. Further, it analyzed the aspects of hematological value changes according to the pigs' ages. As a result, the number of red blood cells (RBC), which include hemoglobin, and hematocrit, and the number of white blood cells (WBC), which include neutrophils, and lymphocyte, were high among transgenic miniature pigs, compared with the conventional and transgenic conventional pigs. Conventional pigs showed similar values of RBC and WBC regardless of transgenesis. In comparing their age, the RBC decreased as the age increased compared with the pigs among all the three groups aged of 6~12 months. On the other hand, WBC and neutrophils showed no significant difference regardless of different ages among all the three groups. However, various counts in RBC and WBC were mostly found to be higher in each age in transgenic miniature pigs than in conventional and transgenic conventional pigs. The results of this study show that the values of RBC and WBC were generally higher in transgenic miniature pigs than in conventional and transgenic conventional pigs. Based on this research, hematological values can be widely used in diagnosing diseases or checking the health status of transgenic pigs that are used as disease models, organ transplant source and alike.

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
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.28 no.2
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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.

Development of a Value Inquiry Model in Biology Education (생물교육에서의 가치 탐구 모형 개발)

  • Jeong, Eun-Young;Kim, Young-Soo
    • Journal of The Korean Association For Science Education
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    • v.20 no.4
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    • pp.582-598
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    • 2000
  • There are many bioethical issues in line with the rapid advance of biology. In this situation, it is important for students to make a rational decision on value problem. In this study 'value inquiry in biology education' is defined as 'the process of rational value judgement and wise decision-making in the biology-related value problem' and the model was developed. To develop the model, value inquiry models were reviewed. Value clarification model is helpful for the formation of the personal value as the process of individual value inquiry, but it isn't helpful for clarifying the value conflicts. Value analysis model focuses on the rational solution of value problem through the logical procedure. But it has the limitations that overemphasizing the logical and systematic aspects results in devaluating students' affective aspects. So it is necessary to coordinate psychological and logical aspects of value inquiry. In this regard, the model was developed, including identifying and clarifying value problem, understanding biological knowledge related to conflict situation, considering on the related persons, searching for alternatives, predicting the consequences of each alternative, selecting the alternative, evaluating the alternative, and final value judgement and affirming it. The educational objectives of value inquiry were selected in consideration of the ability to carry out the steps of the developed model. And the selected contents were animal duplication, test-tube baby, genetic engineering, growth hormone injection problem, brain death, organ transplant, animal to be experimented and were organized on the basis of the 6th and the 7th science curriculum. And the suitable instructional models for the value inquiry education were selected: bioethical value clarification decision-making model, group presentation according to the value analysis model, role play and debate, and discussion through web forum. And the interview was considered to be suitable to evaluate the students' value inquiry ability and the rubric was made to evaluate the attainment of the educational objectives for value inquiry.

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Comparison of Clinical Characteristics of Pneumocystis Carinii Pneumonia Between HIV Infected and Non-infected Persons (인간 면역결핍 바이러스 감염자와 비감염자에서 발생한 주폐포자충 폐렴의 임상 양상 비교)

  • Choi, Jun Yong;Lee, Kkot Sil;Park, Yoon Soo;Cho, Cheong Ho;Han, Sang Hoon;Choi, Suk Hoon;Chin, Bum Sik;Park, Yoon Seon;Chang, Kyung Hee;Song, Young Goo;Kim, June Myung
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.4
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    • pp.370-377
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    • 2003
  • Background : Pneumocystis carinii pneumonia (PCP) is one of the most common cause of infection in patients with HIV infection. Recently, the incidence of PCP have been increasing in immunocompromised hosts without HIV infection. We compared the clinical characteristics of PCP between HIV infected and non-infected persons. Patients and Methods : We retrospectively reviewed the charts of 25 patients diagnosed as PCP from 1996 to 2002. Age, sex, underlying conditions, use of immunosuppressants, clinical courses, laboratory findings, treatment and prognosis were compared between HIV infected and non-infected persons. Results : Twenty-five patients with PCP were identified. 16 were HIV infected, and 9 were HIV non-infected. The mean age of overall patients was $43.4{\pm}13.2$ years. Underlying conditions in HIV non-infected persons were hematologic malignancy (7 cases), solid organ transplant (1 case), and autoimmune disease (1 case). Seven cases (77.8%) of HIV non-infected persons had a history of steroid use. Mean duration of symptoms was longer in HIV infected persons than in HIV non-infected persons, but it was not statistically significant. PaO2 was lower in HIV infected persons ($61.2{\pm}16.9$ mmHg vs. $65.4{\pm}15.4$), but it was not statistically significant. Chest X ray showed typical ground glass opacity in 12 cases (75%) of HIV infected persons and in 4 cases (44.4%) of HIV non-infected persons. Twelve cases (75%) of HIV infected persons were treated with steroid, as were 6 cases (66.7%) of HIV non-infected persons. Ventilator care was needed in 6 cases (37.5%) of HIV infected persons and in 2 cases (22.2%) of HIV non-infected persons. Mortality of HIV infected persons was 50%, and that of HIV non-infected persons was 11.1%. Conclusions : PCP showed some different clinical characteristics between HIV infected and non-infected persons. Prospective studies regarding the risk factors of PCP, prophylaxis, treatment and prognosis in HIV infected and non-infected persons are warranted.

Legislative Study on the Mitigation of the Burden of Proof in Hospital Infection Cases - Focusing on the revised Bürgerliches Gesetzbuch - (병원감염 사건에서 증명책임 완화에 관한 입법적 고찰 - 개정 독일민법을 중심으로 -)

  • Yoo, Hyun Jung
    • The Korean Society of Law and Medicine
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    • v.16 no.2
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    • pp.159-193
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    • 2015
  • Owing to causes such as population aging, increased use of various medical devices, long-term hospitalization of various patients with reduced immune function such as cancer, diabetes, and organ transplant patients, and the growing size of hospitals, hospital infections are continuing to increase. As seen in the MERS crisis of 2015, hospital infections have become a social and national problem. In order to prevent damage due to such hospital infections, it is necessary to first strictly implement measures to prevent hospital infections, while, on the other hand, providing proper relief of damage suffered due to hospital infections. However, the mainstream attitude of judicial precedents relating to hospital infection cases has been judged to in fact shift responsibility over damages due to hospital infections on the patient. In light of the philosophy of the damage compensation system, whose guiding principle if the fair and proper apportionment of damages, there is a need to seek means of drastically relaxing the burden of proof on the patient's side relative to conventional legal principles for relaxing the burden of proof, or the theory of de facto estimation. In relation to such need, the German civil code (Burgerliches Gesetzbuch), which defines contracts of medical treatment as typical contracts under the civil code, and has presumption of negligence provisions stipulating that, in cases such as hospital infections which were completely under the control of the medical care providers, if risks in general medical treatment have been realized which cause violations of the life, body, or health of patients, error on the part of the person providing medical care is presumed, was examined. Contracts of medical treatment are entered into very frequently and broadly in the everyday lives of the general public, with various disputes owing thereto arising. Therefore, it is necessary to, by defining contracts of medical treatment as typical contracts under the civil code, regulate the content of said contracts, as well as the proof of burden when disputes arise. If stipulations in the civil code are premature as of yet, an option may be to regulate through a special act, as is the case with France. In the case of hospital infection cases, it is thought that 'legal presumption of negligence' relating to 'negligence in the occurrence of hospital infections,' which will create a state close to equality of arms, will aid the resolution of the realistic issue of the de facto impossibility of remedying damages occurring due to negligence in the process of occurrence of hospital infections. Also, even if negligence is presumed by law, as the patient side is burdened with proving the causal relationships, such drastic confusion as would occur if the medical care provider side is found fully liable if a hospital infection occurs may be avoided. It is thought that, alongside such efforts, social insurance policy must be improved so as to cover the expenses of medical institutions having strictly implemented efforts to prevent hospital infections in the event that they have suffered damages due to a hospital infection accident, and that close future research and examination into this matter will be required.

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The Clinical Outcomes of Marginal Donor Hearts: A Single Center Experience

  • Soo Yong Lee;Seok Hyun Kim;Min Ho Ju;Mi Hee Lim;Chee-hoon Lee;Hyung Gon Je;Ji Hoon Lim;Ga Yun Kim;Ji Soo Oh;Jin Hee Choi;Min Ku Chon;Sang Hyun Lee;Ki Won Hwang;Jeong Su Kim;Yong Hyun Park;June Hong Kim;Kook Jin Chun
    • Korean Circulation Journal
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    • v.53 no.4
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    • pp.254-267
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    • 2023
  • Background and Objectives: Although the shortage of donor is a common problem worldwide, a significant portion of unutilized hearts are classified as marginal donor (MD) hearts. However, research on the correlation between the MD and the prognosis of heart transplantation (HTx) is lacking. This study was conducted to investigate the clinical impact of MD in HTx. Methods: Consecutive 73 HTxs during 2014 and 2021 in a tertiary hospital were analyzed. MD was defined as follows; a donor age >55 years, left ventricular ejection fraction <50%, cold ischemic time >240 minutes, or significant cardiac structural problems. Preoperative characteristics and postoperative hemodynamic data, primary graft dysfunction (PGD), and the survival rate were analyzed. Risk stratification by Index for Mortality Prediction after Cardiac Transplantation (IMPACT) score was performed to examine the outcomes according to the recipient state. Each group was sub-divided into 2 risk groups according to the IMPACT score (low <10 vs. high ≥10). Results: A total of 32 (43.8%) patients received an organ from MDs. Extracorporeal membrane oxygenation was more frequent in the non-MD group (34.4% vs. 70.7, p=0.007) There was no significant difference in PGD, 30-day mortality and long-term survival between groups. In the subgroup analysis, early outcomes did not differ between low- and high-risk groups. However, the long-term survival was better in the low-risk group (p=0.01). Conclusions: The outcomes of MD group were not significantly different from non-MD group. Particularly, in low-risk recipient, the MD group showed excellent early and long-term outcomes. These results suggest the usability of selected MD hearts without increasing adverse events.

Comparative growth and development of the metacercariae of Fibricola seorszensis (Trematoda: Diplostomidae) in vitro, in vivo and on the chick chorioallantois (Fibricolu seoulensis (Trematoda: Diplostomidae) 피낭유충의 in vitro, in vivo 및 닭 장뇨막 상에서의 생존 및 발육 성장 비교)

  • 서병설
    • Parasites, Hosts and Diseases
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    • v.27 no.4
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    • pp.231-248
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    • 1989
  • The growth and development of the metacercariae of F. seoulensis cultivated in vitro or on the chick chorioallantois were assessed by comparison with the optimum process of maturation in albino rats and new born chickens. The process of maturation was divided for convenience into six stages: Stage 1 ; cell multiplication, Stage 2; body shaping, Stage 3; separation of genital anlagen, Stage :1 organogeny, Stage 5; gametogony, and Stage 6: oviposition. In Hank's and Tyrode's .solutions, the metacercariae were alive up to 200 days or more at $4^{\circ}C$ without any development. The in vivo maturation process in rats or chicks was as follows: stage 1 from 6 hours; stage 2 from 24 hours; stage 3 from 48 to 72 hours; stage 4 from 3 to 4 days; stage 5 from 4 to 5 days; and stage 6 from 5 to 8 days. Despite unsuccessful infection of the metacercariae to 12 day old chicks, fully mature worms of stage 5 or 6 were recovered from new born chicks (1 to 2 days old), The metacercariae of F. seoulensis grown in vitro were up to stage 3 and no further maturation was observed. Of various media employed, the medium NCTC 109 (Gibco) or NCTC 135(Gibco) supplemented with 20% egg yolk or 20% whole egg macerate or 0.5% yeast was basically required for the earlier development of the fluke. It took 16.1 days(in average) to reach the stage 3 after cultivation. The metacercariae cultivated on the chorioallantoic membranes of 6∼13 day old chick embryo at 37∼38℃ showed their full development up to stage 5 or 6. However, the worms were in general remarkably retarded, compared with those grown in rats or chickens. In the experiments of worm transplant, although the transfer was failed from in vitro culture to in vivo of rats(Per os), the transplants from in vitro culture to the chorioallantois and from the choriollantois to in vivo of rat host were successful with or without development of the transferred worms. In the present study, it was observed that the metacercariae of F, seoulensis can be maintained in vitro media with poor development as well as fully matured in 1 to 2 day-old chicks or on the chorioallantois at a very low rate.

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