• Title/Summary/Keyword: Living donor liver transplantation

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The Use of Locally Applied Vibration to Minimize Pain during Fractional CO2 Laser Therapy in Living Liver-Donor Scar Management

  • Song, Sinyoung;Choi, Dong Hoon;Oh, Tae Suk
    • Archives of Plastic Surgery
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    • v.43 no.6
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    • pp.570-574
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    • 2016
  • Background Fractional $CO_2$ laser is an effective treatment for scars, but most patients complain about sharp burning pain, even after the application of lidocaine ointment. This study analyzed the impact of a vibrating device to nonpharmacologically reduce the acute pain of laser treatment, in accordance with the gate control theory of pain management. Methods This is a prospective study performed from May 2013 through March 2014. Fifty-three patients (mean age, 26.7 years; range, 16-44 years) who had donated livers for liver transplantation were treated with a fractional $CO_2$ laser (10,600 nm; model $eCO_2$, Lutronic Corp) for their abdomen scars. Laser treatment was applied 4 months after surgery. A commercially available, locally applied vibrating device (model UM-30M, Unix Electronics Co. Ltd.) was used, in an on-and-off pattern, together with the $CO_2$ laser. A visual analogue scale (VAS; 0, no pain; 10, most severe pain) of pain sensation was assessed and statistically analyzed using a paired t-test. Results The average VAS score for pain with the vibrating device was 4.60 and the average VAS score without the vibrating device was 6.11. The average difference between scores was 1.51 (P=0.001). Conclusions A locally applied vibrating device was demonstrated to be effective in reducing pain when treating with a fractional $CO_2$ laser. Vibration treatment could be helpful when treating scars with fractional $CO_2$ laser in pain-sensitive patients, particularly children.

Efficacy of Hepatitis B Immune Globulin for Prevention of De Novo Hepatitis B in Living-related Liver Transplantation (생체 부분 간이식에서 De Novo Hepatitis B에 대한 B형 간염 면역글로불린의 예방적 효과)

  • Kim, Sang-Jong;Hwang, Soo-Jung;Park, Sung-Eun;Choe, Yon-Ho;Lee, Suk-Koo;Joh, Jae-Won;Kim, Sung-Joo;Lee, Kwang-Woong;Seo, Jeong-Meen
    • 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.

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Patterns of Intrahepatic Gene Expression in Neonatal Cholestasis (신생아 담즙정체성 간질환에서 간조직 유전자의 발현 양상)

  • Choi, BoHwa;Choe, Byung Ho;Chung, Eun Jung;Kim, Kyung Mo;Kim, Heng Mi;Park, Jin Young;Park, Woo Hyun;Kim, Moon Kyu;Kim, Jung Chul
    • 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.

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