• 생명과학회지
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• 제12권3호
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• pp.294-305
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• 2002

흰쥐에서 간부분 절제술 후 비장내 배자줄기세포를 이식하여 배자줄기세포가 간세포로 분화하여 장기간에 걸쳐서 비장내에서 간세포의 기능적인 구조를 유지하는지를 조사 하였으며 간세포로의 재생 효과에 미치는 영향을 조사하여 다음과 같은 결론을 얻었다. 비장내 세포이식에서 배자줄기 세포를 이식하면 처음에는 동맥주위림프초 근처에 위치하여 그 수가 먼저 증가하면 육주 주위에 소엽상으로 모여서 세포의 크기가 커졌다. 세포내 소기관의 발달은 이식 후20일에 가장 현저한 발달을 보이며 이때 EGF의 반응도 가장 현저하였다. 이식 후 40일이 되면 세포질내 소기관의 발달이 간세포의 기능이 가능할 정도로 분화되었으며 TGF 반응이나 apoptosis 반응은 증가하였다.

• 대한의용생체공학회:의공학회지
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• 제43권6호
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• pp.434-440
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• 2022

Liver transplantation is a critical used treatment method for patients with end-stage liver disease. The number of cases of living donor liver transplantation is increasing due to the imbalance in needs and supplies for brain-dead organ donation. As a result, the importance of the accuracy of the donor's suitability evaluation is also increasing rapidly. To measure the donor's liver volume accurately is the most important, that is absolutely necessary for the recipient's postoperative progress and the donor's safety. Therefore, we propose liver segmentation in abdominal CT images from pre-operation, POD 7, and POD 63 with a two-dimensional U-Net. In addition, we introduce an algorithm to measure the volume of the segmented liver and measure the hepatectomy rate and regeneration rate of pre-operation, POD 7, and POD 63. The performance for the learning model shows the best results in the images from pre-operation. Each dataset from pre-operation, POD 7, and POD 63 has the DSC of 94.55 ± 9.24%, 88.40 ± 18.01%, and 90.64 ± 14.35%. The mean of the measured liver volumes by trained model are 1423.44 ± 270.17 ml in pre-operation, 842.99 ± 190.95 ml in POD 7, and 1048.32 ± 201.02 ml in POD 63. The donor's hepatectomy rate is an average of 39.68 ± 13.06%, and the regeneration rate in POD 63 is an average of 14.78 ± 14.07%.

• Korean Journal of Radiology
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• 제25권1호
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• pp.24-32
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• 2024

Despite improvements in operative techniques and perioperative care, post-hepatectomy liver failure (PHLF) remains the most serious cause of morbidity and mortality after surgery, and several risk factors have been identified to predict PHLF. Although volumetric assessment using imaging contributes to surgical simulation by estimating the function of future liver remnants in predicting PHLF, liver function is assumed to be homogeneous throughout the liver. The combination of volumetric and functional analyses may be more useful for an accurate evaluation of liver function and prediction of PHLF than only volumetric analysis. Gadoxetic acid is a hepatocyte-specific magnetic resonance (MR) contrast agent that is taken up by hepatocytes via the OATP1 transporter after intravenous administration. Gadoxetic acid-enhanced MR imaging (MRI) offers information regarding both global and regional functions, leading to a more precise evaluation even in cases with heterogeneous liver function. Various indices, including signal intensity-based methods and MR relaxometry, have been proposed for the estimation of liver function and prediction of PHLF using gadoxetic acid-enhanced MRI. Recent developments in MR techniques, including high-resolution hepatobiliary phase images using deep learning image reconstruction and whole-liver T1 map acquisition, have enabled a more detailed and accurate estimation of liver function in gadoxetic acid-enhanced MRI.

• 대한약리학회지
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• 제26권2호
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• pp.177-183
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• 1990

간-부분절제후 재생과정에서 간 polyamine 대사에 교감신경계가 촉진적으로 간여하는지를 확인하기 위하여 본 실험을 시행하였다. Guanethidine 25mg/kg를 1회 (G-1), 또는 매일 1회씩 3(G-3), 5(G-5) 및 6일간(G-6) 각각 복강내-주사하고, diethyl ether 마취하에서 웅성 백서의 간을 부분$(70.4{\pm}1.99%)$-절제하여, 절제 전후의 혈압, 혈장 catecholamine치 및 간 polyamine 함량의 변동을 검토하여 다음의 성적을 얻었다. 1. 백서 꼬리에서 측정한 정상 수축기 혈압은 $98.0{\pm}3.9mmHg$이며, 이는 G-1에 별 영향을 받지 않았으나, G-3, G-5 및 G-6에 의하여는 25% 이상 현저히 저하되었다. 2. 혈장 norepinephrine 및 epinephrine치는 간-부분절제하고 3시간 후에 각각 $20.38{\pm}2.23pmole/ml$ 및 $56.06\pm4.63pmole/ml$로써 현저한 증가를 보였으며 그 증가율은 G-1 및 G-6에 의하여 80.46% 이상 현저히 억제되었다. 3. 간-부분절제 전의 putrescine, spermidine 및 spermine 함량은 각각 $118.6{\pm}14.1$, $873.8{\pm}27.7$ 및 $875.6{\pm}42.1nmole/g$ wet liver로서 절제후 6시간에 각각 5.5배, 1.5배 및 1.3배 이상 증가되었으며, putrescine의 증가만이 G-6에 의하여 유의하게 억제되었을 뿐 guanethidine-전처치에 별 영향을 받지않았다. 이상의 성적으로 미루어 볼 때, 간-부분절제후 재생과정에서 나타나는 polyamine대사의 촉진현상에 교감신경성 catecholamine들이 직접적으로 중요한 역할을 수행한다고 보기는 어렵다.

• 생명과학회지
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• 제25권3호
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• pp.336-344
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• 2015

비타민 C는 신진대사에 연관되어 있으며 특히 항산화 기능을 가지고 있다. 본 연구에서는 생체에서 비타민 C를 합성할 수 없는 SMP 30 녹아웃 마우스에 간 절제술을 시행하여 간 재생에서 비타민 C의 역할을 관찰하였다. 간 절제술은 마우스 중간엽 및 좌엽을 제거한 부분절제술을 수행하였다. 마우스는 간 절제술 후 비타민 C를 투여한 군(KV)와 비타민 C를 투여하지 않는 군(KO)로 나누어서 비타민 C의 효과를 관찰하였다. 결과 비타민 C를 투여한 KV 마우스의 간 회복이 투여하지 않는 KO 마우스에 비해 촉진되었다. KV 마우스의 혈액에서 관찰된 간소상 지표인 아스파르타산 아미노전달효소 및 간 손상 정도가 KO 마우스에 비해 낮게 관찰되었다. KV 마우스에서는 HGF와 c-Met에 의해서 TGF-베타 수용체 신호전달계가 활성화되고 세포주기 조절인자인 cyclin D1과 PCNA의 발현이 빠르게 증가되었다. 반면 KO 마우스에서는 활성화 되지 않았다. 또한 ERK와 GSK-3β 단백질의 활성화가 관찰되었으며 세포분열 간세포들의 유의적인 증가가 관찰되었다. 그리고 KV 마우스에서는 혈중 알부민의 농도가 높은 것으로 확인되었다. 따라서 본 실험결과는 SMP 30 결핍 마우스에서 비타민 C 투여는 간 재생시스템의 활성화와 이에 따른 빠른 회복을 초래한다.

• 약학회지
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• 제32권4호
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• pp.239-244
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• 1988

Transcriptional rate of lactate dehydrogenase A-gene(LDH-A) during the prereplicative phase of regenerating rat liver was determined by in vitro run-off transcription assay. The results show that the transcription rate of LDH A-gene increases between 12 hours and 15 hours peaking at 13 hours after partial hepatectomy of rat liver. The increased rate of LDH A-gene transcription was interfered after DL-propranolol treatment intraperitoneally injected twice at 1 hour and 8 hours after partial hepatectomy indicating that the transcriptional control of LDH A-gene expression may be mediated by beta adrenergic receptor and cAMP as a second messenger. And also was it shown that the temporally increased rate of LDH A-gene transcription was maximum one hour after the second cAMP-surge which is known to play an important role for the initiation of DNA replication during regeneration of rat liver. And the transcriptional rate of LDH A-gene was decreased to the basal level at the time period when the hepatocytes proliferate rapidly suggesting that the induced LDH Aisozyme may be required for the initiation of DNA replication during regeneration of rat liver. These data may be supporting for the hypothesis suggesting that the induced LDH A-isozyme during the pre-replicative phase of regenerating rat liver may play bifunctional roles as a glycolytic enzyme and a helix destablizing protein as well.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권6호
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• pp.608-612
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• 2019

Gastric volvulus (GV) is an uncommon pathology, with 10-20% of cases occurring in children, typically before one year of age. It often occurs in people with congenital diaphragmatic hernias, intestinal malrotation, eventration of the diaphragm, paraesophageal hernias, wandering spleens, asplenism, or intra-abdominal adhesions. We report a rare case of chronic GV after left hemihepatectomy for hepatoblastoma in a child. The patient was a 9-year-old boy who complained of upper abdominal pain and postprandial upper abdominal distension for one year. At the age of 4 months, he was diagnosed with hepatoblastoma and had undergone left hemihepatectomy. The upper gastrointestinal contrast study revealed chronic organoaxial gastric volvulus. After a surgical procedure involving adhesiolysis and an anterior wall gastropexy, the patient improved and the symptoms resolved. Although GV is a rare disease, it should be suspected in a patient with a previous abdominal surgical history who is complaining of abdominal distension and pain.

• Journal of Trauma and Injury
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• 제19권1호
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• pp.59-66
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• 2006

Purpose: Acute liver failure after massive partial hepatectomy is critical condition with high mortality. To prevent postoperative liver failure from being induced by a massive partial hepatectomy, many doctors do a minimal resection on the single lobe of the liver that might cause postoperative bleeding from the remaining ruptured parenchyma. The objective of this study was to assess clinical experience with postoperative hepatic arterial embolization to control bleeding from the remaining ruptured liver during the postoperative period. Methods: This retrospective 4-year study was conducted from May 2002 to April 2006 and included consecutive patients who had sustained massive hepatic injuries and who had undergone a laparotomy, followed by postoperative hepatic arterial angiographic embolization to control bleeding. Data on the injury characteristics, the operative treatment and embolization, and the amount of transfused packed red cells (PRBC) were gathered and analyzed. In addition, data on the overall complications and survival rate were collected and analyzed. Results: Every case showed severe liver injury, higher liver injury scaling grade IV. Only ten cases involved a ruptured bilateral liver lobe. A lobectomy was done in 6 cases, a left lobectomy was done in 3 cases, and a primary suture closure of the liver was done in 2 cases. Suture closure was also done on the remaining ruptured liver parenchyma in cases of lobectomies. The postoperative hepatic arterial embolizations were done by using the super-selection technique. There were some cases of arterio-venous malformations and anomalous vessel branches. The average amount of transfused PRBC during 24 hours after embolization was $2.36{\pm}1.75$, which statistically significantly lower than that before embolization. Among the 11 cases, 9 patients survived, and 2 died. There was no specific complications induced by the embolization. Conclusion: In cases of postoperative bleeding in severe hepatic injury, if there is still a large amount of bleeding, postoperative hepatic arterial embolization might be a good therapeutic option.

• Asian Pacific Journal of Cancer Prevention
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• 제16권10호
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• pp.4421-4427
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• 2015

Objectives: To investigate the prognosis significance of preoperative serum alpha-fetoprotein (AFP) and the correlation with clinicopathological factors of hepatocellular carcinoma (HCC) patients who underwent hepatectomy. Materials and Methods: Clinicopathological data of retrospective analysis were collected for 251 HCC patients undergoing hepatectomy in this study. According to preoperative AFP level, patients were categorized into AFP-negative (0-20ng/mL) and AFP-positive (>20 ng/mL) groups for Kaplan-Meier analysis and Cox proportional hazard regression modeling. Results: The results demonstrated that increased AFP was associated with longer prothrombin time (PTs), liver capsule invasion, low grade differentiation, and late Barcelona Clinic Liver Center (BCLC) stage. Moreover, the female patients had a greater prevalence of increased preoperative AFP than male patients [284.8 (3.975-3167.5) vs (3.653-140.65); Z-2.895, p=0.004]. The 1-, 3-, and 5-year recurrence-free survival (RFS) rates were 78.1, 57.5, and 40.6 % in the AFP-negative group and 61.8, 37.7, and 31.4 %, respectively, in the AFP-positive group (log-rank test 8.312, p=0.004). The 1-, 3-, and 5-year overall survival (OS) rates were 94.4, 83.8, and 62.3% in the AFP-negative group and 87.2, 60.0, and 36.7%, respectively, in the AFP-positive group. The difference was statistically significant (log-rank test, 16.884, p=0.000). Cox proportional-hazards model identified preoperative AFP to be an independent prognostic predictor of overall survival. Conclusions: Preoperative serum AFP is an independent predictor of prognosis among HCC patients following surgical resection. Female patients have a higher preoperative AFP than their male counterparts.

• 한국식품영양과학회지
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• 제13권4호
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• pp.451-458
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• 1984

18% casein식(食)을 대조식이(對照食餌)로 하여 분지쇄(分枝?) 아미노산(Leu. lie. Val.)을 첨가(添加)한 실험식이(實驗食餌)의 간부분절제후(肝部分切除後)의 Rat에 대한 영양학적(營養學約) 효과(效果)를 검토(檢討)하였다. 자유채취(自由攝取)시키면, 실험식이군(寶驗食餌群)은 대조식이군(對照食餌群)에 비하여 6일(日)째까지 식이채취량(食餌攝取量)이 적지만, 8 일(日)째부터는 증가하고 체중증가(體重增加)도 그와 평행하였다. 14 일(日)째에 간(肝)의 부분절제(部分切除)를 행하면, 7 일후의 체중(體重)은 식이채취량(食餌攝取量)은 동일(同一)하면서도 실험식이군(實驗食餌群)에서 유의(有意)하게 증가(增加)하였다. 또한 간부분절제후(肝部分切除後) 5 일(日)째의 간재생중량(肝再生重量) 및 간재생지수(肝再生指數)도 유의(有意)하게 증가(增加)를 나타내었다. 이상으로 보아, 분지쇄(分枝?)아미노산 첨가식이(添加食餌)는 재생간(再生肝) Rat에 대하여 체중증가(體重增加) 및 간재생(肝再生) 보호작용(促進作用)에 있어서 영양학적(營養學論) 효과(效果)가 있다는 것이 인정(認定)된다.