• Journal of Chest Surgery
• /
• v.32 no.1
• /
• pp.1-4
• /
• 1999

Background: The transplantation of organs between phylogenetically disparate or harmonious species has invariably failed due to the occurrence of hyperacute rejection or accerelated acute rejection. But, concordant cardiac xenograft offer us an opportunity to study xenotransplantation in the absence of hyperacute rejection. Current therapeutics for the prolongation of survival of rodent concordant xenotransplantation are not ideal with many regimens having a high mortality rate. Cyclosporine A & Mycophenolate Mofetil are new immunosuppresive agent which has been shown to be effective at prolonging survival of allograft, as purine synthesis inhibitor. Material and Method: We used white mongrel rats as recipient and mice as donor, divided 4 groups(n=6), control group(Group 1) has no medication or pretreatment, Group 2 has splenectomy as pretreatment 7∼10 days before transplantation, Group 3 has Cyclosporine A treatment group, Group 4 has combined treatment of Cyclosporine A & Mycophenolate Mofetil(RS 61443). We compared survival time. Reuslt: We can't find significant difference of survival time between each groups. Conclusion: We concluded that rejection of cardiac xenograft was different from rejection of allograft, and new immunossuppresive Agent(Mycophenolate Mofetil, Cyclosporine A) was not effective for prolongation of survival time after cardiac xenograft.

• Journal of Chest Surgery
• /
• v.29 no.6
• /
• pp.606-613
• /
• 1996

Cardiac transplantation has been the treatment of patients with end-stage heart disease since it was first performed in 1967. In Korea the first case was performed in 1992 and 42 patients underwent heart trans- plantation so far. The purpose of this article is to report short-term result of cardiac transplantation at our center. Between April 1994 and September 1995, 14 patients had undergone orthotopic heart transplantations. There was 12 male and 2 female patients. Mea recipient age was 34 years(range 11 to 54 years) and mean donor age was 28.4 years(16 to 50 years). Mean graft ischemic time was 120.7minutes(80 to 280 minutes). The follow-up period after transplantation was 11 months(3 to 17 months). Recipient diagnosis included dilated cardiomyopathy in 10, ischemic cardiomyopathy in 2, valvular cardiomyopathy in 1, congenital complex heart disease in 1 patient. The preoperative status of the recipients were state I (50%) and ll (50%) by UNOS classification and class 111 (5 patients) and class IV (9) by NYHA functional class. All patients were treated with triple-drug immunosuppression (cyclosporine, azathioprine, steroid) and induction with RATG. The rejection episodes were 5 times in 3 patients during the follow-up. Causes of infection were aspergillosis (2), and hepes zoster (1), CMV pneumonitis (1). Permanent pace- maker was inserted in 1 patient. Currently 9 patients are alive with seven patients in WYHA functional class I and two in class l . The ejection fraction increased from preoperative value of 19.9 $\pm$ 3.4% to postoperative value of 69.0 $\pm$ 5.6%. The causes of death were cellular rejection (1),chronic graft failure due to size-mismatching (1),respirat- oxy insufficiency due to asthma attack (1), subarachnoid hemorrhage (1), and RIO humoral rejection (1).

• Journal of Chest Surgery
• /
• v.30 no.12
• /
• pp.1219-1224
• /
• 1997

Although several reports were presented recently about bronchial arterial revascularization in clinical lung transplantation, one factor peculiar to the lung transplantation is the ischemia of the donor bronchus. Poor bronchial healing occurs frequently following clinical lung transplantation and this has been major cause of mortality and morbidity. There have been many attempts to solve bronchial anastomotic complications. Telescoping technique, one of those attempts, was advocated by San Antonio Group recently. This experiment was per(armed to evaluate the effect of telescoping anastomotic technique upon th healing of the tracheo-bronchial anastomosis. We used rabbits(weighing about 800 g) as experimental animal. Method: Resection of middle one third of cervical trachea and reanastomosis was performed by simple interrupted anastomotic technique in Group 1(n=15) and by telescoping anastomotic technique in Group 2(n= 15). Result: Anastomotic sites in the telescoping technique group showed significant increase of fibrosis in the early postoperative days(< Sdays) and remarkable band-like fibrous union compared to the simple interrupted group.

• Journal of Chest Surgery
• /
• v.39 no.11 s.268
• /
• pp.854-857
• /
• 2006

The patient was an eight-year-old female. She was diagnosed as dilated cardiomyopathy. She was supported with bi-ventricular assist because of heart failure for 15 days. After 7 days, she was suffered from prerenal type ARF and support with continuous veno-veno hemodyalisis(CVVHD). And then heart transplantation was performed, heart donor's blood type was A. Immune suppressants were used after due consideration for renal toxicity. ARF was resolved on post operative $14^{th}$ day. She was discharged on post operative $52^{nd}$ day without any specific post operative complication. She has been followed up without any immune rejection reaction upto 14 months.

• Korean Journal of Transplantation
• /
• v.31 no.4
• /
• pp.157-169
• /
• 2017

Regulatory T cells (Treg) naturally rein in immune attacks, and they can inhibit rejection of transplanted organs and even reverse the progression of autoimmune diseases in mice. The initial safety trials of Treg against graft-versus-host disease (GVHD) provided evidence that the adoptive transfer of Treg is safe and capable of limiting disease progression. Supported by such evidence, numerous clinical trials have been actively investigating the efficacy of Treg targeting autoimmune diseases, type I diabetes, and organ transplant rejection, including kidney and liver. The limited quantity of Treg cells harvested from peripheral blood and subsequent in vitro culture have posed a great challenge to large-scale clinical application of Treg; nevertheless, the concept of CAR (chimeric antigen receptor)-Treg has emerged as a potential resolution to the problem. Recently, two CAR-T therapies, tisagenlecleucel and axicabtagene ciloleucel, were approved by the US FDA for the treatment of refractory or recurrent acute lymhoblastic leukemia. This approval could serve as a guideline for the production protocols for other genetically engineered T cells for clinical use as well. The phase I and II clinical trials of these agents has demonstrated that genetically engineered and antigen-targeting T cells are safe and efficacious in humans. In conclusion, both the promising results of Treg cell therapy from the clinical studies and the recent FDA approval of CAR-T therapies are paving the way for CAR-Treg therapy in clinical use.

• Journal of Chest Surgery
• /
• v.41 no.1
• /
• pp.25-33
• /
• 2008

Background: A critical shortage of donor organs has necessitated an investigation of new strategies to increase the availability of additional organs available for human transplantation. We investigated the amount of apoptosis and expression of GADD45 ${\beta}$ in two groups, a GADD45 ${\beta}$-transfected group and untransfected group. Material and Method: The experimental groups consist of a control group (normal H9C2 cell line) and GADD45 ${\beta}$-transfected group. After injury of the each group, we evaluated the expression of GADD45 ${\beta}$ and the level of apoptosis in each group. Result: There was a significant increase in the expression of GADD45 ${\beta}$ in the GADD45 ${\beta}$-transfected group at 1 hour, 2 hours, and 3 hours after stimuli as compared with the control group. The amount of cardiac myoblast cell line apoptosis was significantly lower in the GADD45 ${\beta}$-transfected group as compared with the control group. The concentration of annex in in the GADD45 ${\beta}$-transfected group was significantly lower than that of the control. group after cell. injury. Conclusion: Transfection of a rat myoblast cell line with the GADD45 ${\beta}$ gene results in. decreased susceptibility to cell injury of human serum.

• Childhood Kidney Diseases
• /
• v.12 no.1
• /
• pp.23-29
• /
• 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 Materials Research Society of Korea Conference
• /
• 2011.05a
• /
• pp.17.2-17.2
• /
• 2011

모든 생물은 늙어가면서 그 생물체를 이루고 있는 생체조직들이 낡게 되고 약해지기 마련이며, 이외에도 자동차 사고 등 재해에 의해 생체 장기의 손상을 가져올 수도 있다. 또한 인간의 평균수명 연장과 함께 소득 수준이 높아지고 또한 'quality of life'를 추구하는 고령화 시대로 접어듦에 따라, 인공골, 인공치아 또는 인공 고/슬관절 등의 골조직 대체재료의 수요가 빠르게 증가하고 있다. 이와 같은 골조직 대체, 즉 골이식은 크게 자기골 이식(autografting), 동종이식(allografing), 인공재료(man-made materials)의 이식으로 구분된다. 현재 대체물질의 약 58%를 차지하고 있는 자기골 이식의 경우, 거부면역 반응이 없어 임상성공율이 80%에 달한다는 장점을 가지고 있으나, 비용이 비싸고 감염과 통증의 위험이 있다. 또한 시신으로부터 골을 이식하는 동종이식의 경우 대체물질의 약 34%를 차지하고 있는데, 성공률이 떨어지고 질병 감염의 위험이 있는 단점이 있다. 이외에 약 8%를 차지하고 있는 인공재료 이식의 경우, 파단, 독성반응, 마모, 골조직의 remodeling 등이 일어나는 단점이 있으나, 앞에서 언급한 바와 같이 그 필요성이 급격히 증가함에 따라 보다 나은 치료법과 골이식 대체물질의 개발에 많은 노력이 경주되고 있다. 2003년 6월 미국 Financial Times에 의하면, 인체내 식립형 생체재료의 세계시장 규모는 약 650억 달러에 이르며, 매년 200% 이상씩 신장하고 있다고 한다. 따라서 세계 각국의 의학, 약학, 임상학, 생명과학, 공학 등의 관련 연구 분야에서는 이 수요를 충족시키기 위한 활발한 연구활동을 펼치고 있다. 한편 인체내 식립용 임플란트의 국내 시장규모는 치과 임플란트의 경우 2006년 현재 2000억원 규모로, 정형외과, 악안면 성형외과, 이비인후과를 포함하면 소위 'bone-anchored metal implant' 영역의 시장 규모는 4~5조원에 이를 것으로 추산 되고 있다. 또한 소비 신장률 10~15%를 감안하면 향후 시장 규모는 폭발적으로 증가될 것으로 예상된다. 이에 발맞추어, 최근 들어 선진국은 물론, 국내에서도 인체내 식립을 목적으로 하는 생체재료에 관한 연구개발이 활발히 진행되고 있으며, 일부는 실용화 단계에 진입하고 있다. 본 강연에서는 금속 임플란트의 시장현황과 앞으로의 추세에 대하여 조망하고, Ti 임플란트를 중심으로 이의 생체활성을 부여하는 표면개질 필요성 및 최근의 연구개발 동행에 대해 소개하고자 한다.

• Journal of Chest Surgery
• /
• v.31 no.5
• /
• pp.531-535
• /
• 1998

In 1964, Abbott and Colleagues published the world's first heterotopic heart transplantation technique in the rat. Their method established circulation by end-to-end anastomoses of the graft's aorta and pulmonary artery to the recipient's abdominal aorta and Inferior Vena Cava(IVC), respectively. In 1966, Tomita et al altered Abbott's technique by employing end-to-side rather than end-to-end anastomoses, thus eliminating the hind leg paralysis that sometimes resulted from Abbott's technique. In order to prevent postsuture hemorrhage (since 7-0 silk suture was the finest available at that time), Tomita's aortic anastomosis was done with double up-and-down continuous suture technique. A single layer continuous anstomosis effected the pulmonary artery-IVC anastomosis. The availability of Nylon monofilament suture made it possible for Ono and Lindsey to use a single layer suture technique for the aortic end-to-side anastomosis in their modified rat heart transplantation. We observed survival time between control group and Immunosuppression(Cyclosporine administration, 10mg/Kg${\times}$4 times postoperatively) group after heterotopic heart transplantation in the rat model. The cyclosporine adminstration group survived longer than the control group, thus we concluded that cyclosporine was based on Immunosuppressive drugs.

• The Science & Technology
• /
• v.31 no.4 s.347
• /
• pp.70-71
• /
• 1998

면역 억제제인 「마이크로 에멀션 제제기술 」을 개발한 한미약품 중앙연구는 다국적기업인 노바티스사로부터 향후 20년 총 2천억원 규모의 로열티를 받게 되었다. 장기의식 후에 따르는 조직이식거부반응을 막아 환자의 생존율을 늘려주는 획기적인 면역억제제의 신기술 개발은 "세계최고의 위업"이라는 평을 받고 있다. 외환에 시달리는 요즘 막대한 달러의 로열티는 시민들의 주름살을 펴주는 낭보가 아닐 수가 없다.