• Childhood Kidney Diseases
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• v.6 no.2
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• pp.131-141
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• 2002

Purpose : Renal transplantation which allows children normal growth and development and a return to normal life. is now proven to be the best modality for children with ESRD Up to Recently, the number of renal transplantations in Asia has rapidly increased and the outcome has also improved. This investigation was planned to estimate the current status of pediatric renal transplantation in Asia and to find the keys for better improvement of outcome in pediatric renal allograft in Asian countries. Material and methods : The participating countries and institutions for this investigation were China, Hong Kong, India, Indonesia, Japan, Malaysia, Pakistan, Philippines, Singapore, Thailand, Korea, KSPN (Korean Society of Pediatric Nephrology), KONOS (Korean Network for Organ Sharing). Results : Many countries in Asia still do not have a well organized nation wide renal transplantation registration system independently in the pediatric field. So it's very difficult to evaluate the real state of pediatric transplantation among Asian countries. According to the estimation with fragmented data from each countries, in the front running countries of pediatric renal transplantation in Asia, about 40 or more transplants were performed in each country per year and the five year actuarial renal allograft survival was around 80% which is similar to that of western countries. But there were large gaps among the behind groups. Conclusion : Vigorous attempts to perform renal transplantation for children especially younger than 5 years old would be encouraged as well as organ donation from brain dead donor and non heart beating cadaveric donor also should be activated to cope effectively with the shortage of living donor supply. Large number of recent reports shows the favorable outcome of pre-emptive renal transplantation, we should make more efforts toward pre-emptive renal transplantation. First of all, in order to improve the outcome and to narrow the gap between Asian countries in pediatric renal transplantation, effective and continuous efforts to establish nationwide pediatric renal transplantation registration program as well as official, nation-to-nation data sharing program should be needed.

• Childhood Kidney Diseases
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• v.10 no.2
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• pp.219-227
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• 2006

Purpose : We aim to identify the clinical and demographic characteristics in children who underwent renal transplantation(RTx) and to evaluate the influence on growth of RTx in children. Methods : We reviewed 17 medical records of chronic renal failure patients who underwent RTx from April 1992 and June 2004 at Busan Paik Hospital. Age and sex distribution, cause of disease, donor analysis, patient and graft survival rate, and the status of growth after RTx were analysed by retrospective study. Results : Eighteen RTx were performed in 17 patients(8 boys, 9 girls). The mean age at the time of RTx was $15.8{\pm}3.5$ years and the mean duration of dialysis therapy before RTx was $22.4{\pm}18.0$ months. The 1 year and 5 year patient survival rate were each 100%, and the 1 year and 5 year graft survival rate were 88%, 36% respectively. The most common cause of graft failure was chronic rejection. The mean final height of male patients was $162.8{\pm}10.0$ cm(143.0-172.5 cm) and of female patients was $154.5{\pm}12.1$ cm(135.8-160.0 cm). The mean height standard deviation score(Ht SDS) increased after RTx from -1.95 to -1.53 but the increment rate was not statistically significant. Similar changes were noted in individual patient analysis. Also there was no significant difference between the living-related donors and cadaveric donors. Conclusion : Our data shows that even successful RTx rarely results in full growth rehabilitation. To overcome retarded growth in children with chronic renal failure, appropriate combined management of metabolic and nutritional problems, correction of anemia, proper use of recombinant growth hormone therapy, early renal transplantation and shortening of the duration of dialysis would be necessary.

• 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.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.8 no.2
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• pp.177-193
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• 2005

Purpose: To identify genes specifically expressed in biliary atresia, we compared the patterns of gene expression between biliary atresia and neonatal hepatitis syndrome using cDNA microarray analysis. Methods: Liver tissues were taken from livers of 11 patients (7 patients with biliary atresia and four with neonatal hepatitis) with neonatal cholestasis by needle biopsy. Normal control could be obtained from donor liver tissue during living-related liver transplantation. Total RNA was extracted from each samples and reversely transcribed to make cDNA. Then fluorescent cDNA were pooled and hybridized to the clones on the microarray. Fluorescence intensities at the immobilized targets were measured. Utilizing cDNA arrays of 4.7 K human genes, gene expression profiles were analyzed. Results: Among 4,700 microarray clones, 17 cDNA clones were significantly over-expressed in all 11 patients with neonatal cholestasis, while 20 clones were significantly decreased. Genome-wide expression analysis was carried out in livers obtained at the time of diagnosis. We could identify 49 genes, in which there showed differential expression between biliary atresia and neonatal hepatitis syndrome. Conclusion: This study shows the pattern of differentially expressed genes in biliary atresia and neonatal hepatitis syndrome. We believe that this study can contribute to the understanding of pathogenesis of neonatal cholestasis.

• Journal of Korea Multimedia Society
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• v.13 no.3
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• pp.430-437
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• 2010

It is essential for living donor liver transplantation that surgeon must understand the hepatic vessel structure to improve the success rate of operation. In this paper, we extract the liver boundary without other surrounding structures such as heart, stomach, and spleen using the contrast enhanced MDCT liver image sequence. After that, we extract the major hepatic veins (left, middle, right hepatic vein) with morphological filter after review the basic structure of hepatic vessel which reside in segmented liver image region. The purpose of this study is provide the overall status of transplantation operation with size estimation of resection part which is dissected along with the middle hepatic vein. The method of liver extraction is as follows: firstly, we get rid of background and muscle layer with gray level distribution ratio from sampling process. secondly, the coincident images match with unit mesh image are unified with resulted image using the corse coordinate of liver and body. thirdly, we extract the final liver image after expanding and region filling. Using the segmented liver images, we extract the hepatic vessels with morphological filter and reversed the major hepatic vessels only with a results of ascending order of vessel size. The 3D reconstructed views of hepatic vessel are generated after applying the interpolation to provide the smooth view. These 3D view are used to estimate the dissection line after identify the middle hepatic vein. Finally, the volume of resection region is calculated and we can identify the possibility of successful transplantation operation.

• Clean Technology
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• v.24 no.2
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• pp.87-98
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• 2018

Phosphorus (P) is an essential and irreplaceable element for all living organisms, and it is widely used as a fertilizer. Unfortunately, it is estimated that phosphate reservoir is depleted within about 100 years. Sewage sludge ash (SSA) is an alternative resource for P recovery because of its high P content. However, SSA cannot be directly used as a fertilizer due to heavy metals in it and low P bioavailability. Thermochemical treatment with Cl donor is known to reduce heavy metal contents and increase P bioavailability of SSA. Literature review on thermochemical technologies of SSA for the reduction of heavy metals and bioavailability enhancement has been carried out to estimate the status of current P recovery technology and to develop strategic future research plan for P recovery. The review showed that $CaCl_2$ and $MgCl_2$ were the most effective Cl donors and reaction temperature (< $1000^{\circ}C$) was the critical operation condition for the reduction. The removal efficiency depends on the species of heavy metals. Thermochemical technology of SSA for P recovery showed the possibility of commercial application in the near future to overcome the coming crisis of human sustainability by P depletion, but it needs cost effectiveness and more ecofriendly process to reduce energy consumption.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.6 no.1
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• pp.32-38
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• 2003

Purpose: Hepatic allografts from donors with hepatitis B core antibody have been demonstrated to transmit hepatitis B virus (HBV) infection to recipients after liver transplantation (LT). The efficacy of hepatitis B immune globulin (HBIg) to prevent de novo hepatitis B was investigated by comparing active immunization in the early phase to HBIg monotherapy in the late phase of pediatric liver transplants at Samsung Medical Center. Methods: Among pediatric liver transplants, from May, 1996 to June, 2002, 15 recipients who were hepatitis B surface antigen (HBsAg) (-) received an allograft from a donor with hepatitis B core antibody (HBcAb) (+). Except two who died from unrelated causes, eleven of 13 recipients were HBsAb (+), and 2 were naive (HBsAb(-), HBcAb(-)). All patients were vaccinated for HBV before LT. In the early phase (January, 1997~November, 1997, 3 patients), HBsAb (+) recipients received booster vaccination after LT. In the late phase (December, 1997~, 10 patients), all recipients were given booster vaccination and received HBIg therapy in order to maintain HBsAb titer greater than 200 IU/L. Lamivudine was given in one case because of severe side effect of HBIg. We retrospectively analyzed the effect of the preventive therapy for de novo hepatitis B through medical records. Results: De novo hepatitis B developed in three of 13 recipients (23.1%). All of 3 patients who received active immunization in the early phase became HBsAg (+) at 7~19 months after transplantation. One of them was naive before LT and the other two were HBsAb (+). All of 10 recipients who were given HBIg in the late phase remained HBsAg (-) at 7~55 months' follow-up. Conclusion: Passive immunization with HBIg was effective for prevention of de novo hepatitis B in HBsAg (-) recipients of hepatic allografts from HBcAb (+) donors.