• Korean Journal of Transplantation
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• v.31 no.4
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• pp.193-199
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• 2017

Background: Although there more than 1,000 liver transplantations (LTs) are performed in Korea annually, their immense cost remains a great hurdle. Hence, in an attempt to reduce the medical costs of LT, a program was initiated at a public hospital affiliated with the Seoul National University Hospital. Methods: A total of 11 LTs have been successfully executed since the first LT performed at Seoul Metropolitan Government Seoul National University Boramae Medical Center in July 2011 through December 2014. Results: Nine patients (81.8%) were male and two (18.2%) were female. The mean age of patients was 53.4±11.4 years. Hepatitis B virus-related liver disease (n=6, 54.5%) was the most common causative disease, followed by alcoholic liver disease (ALD) (n=4, 36.4%). The actuarial 3-year survival rate was 90.9%. The median total medical cost of LTs was US $41,583 (calculated from operation to discharge), but only $11,860 was actually charged for patients with health insurance coverage. One female patient who had undergone deceased donor LT for alcoholic liver cirrhosis died during follow-up. This patient was non-compliant with the medical instructions after discharge, and finally expired due to septic shock at 10 months post-LT. Conclusions: In the public hospital, LT was successfully performed at a much lower cost. However, LT guidelines and peritransplant management protocols for patients with ALD must be established before escalating LT at public hospitals since ALD with poor compliance is one of the most common causes of complications at public hospitals.

• The Korean Journal of Rehabilitation Nursing
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• v.6 no.1
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• pp.61-69
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• 2003

The purpose of this phenomenological study was to understand and describe the essence and the structure of lived experience of liver transplant recipient. Five individual interviews were conducted to gather data regarding their subjective experiences. About 130 significant statements were extracted and these were clusterd into 9 themes. End stage liver disease patients chose their last treatment - liver transplantation. After liver transplantation, recipients experience vague anxiety and uneaseness related to much information and life style change that they had to accept. And they feared to lose their health again. But they felt free from medication and restriction of food. And they satisfied with regaining their physical status. Most of the recipients also had financial difficulties and social restrictions. And they experience uncertainty about their future. But they restored their previous social life. And they experience psychological wellbeing and hope. The results of this study might help nurses who work with liver transplant recipient in establishing and implementing an effective nursing intervention by understanding their lived experience.

• Proceedings of the Korea Information Processing Society Conference
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• 2009.04a
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• pp.155-156
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• 2009

In this paper we present 3D image analysis of liver and blood vessels using MDCT. The purpose is to enhance the performance of clinician in assessing anatomical information of liver and blood vessels. The system consists of two parts: 3D image reconstruction and analysis of the 3D liver and blood vessel image. The central vein of the liver is the most important blood vessel for the liver transplantation. We will find the central vein's location and characteristic, and will scheme out a computer assistant liver transplantation planning. It will be an effective tool for interventional radiology, surgical planning, and quantitative diagnosis.

• Journal of Oral Medicine and Pain
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• v.34 no.1
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• pp.1-9
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• 2009

Liver transplantation is definitive treatment for the patients suffering from hepatitis, severe liver cirrhosis and liver cancer. In these patients, systemic infections under immunosuppression may occur easily. Therefore, primary object of dental treatments before liver transplantation is absolute removal of oral infection source. In addition, comprehensive dental management plan is essential for success of liver transplantation. The present study has been performed to investigate decayed, missing and filled permanent teeth index(DMFT index), degree of oral hygiene, past medical history, need of dental treatment, completion of dental treatment need and time interval between dental visit and operation date of liver transplantation in liver transplant candidates. Obtained results were as follows; 1. Decayed teeth of the patients were 2.68, missing teeth were 4.02 and filled teeth were 3.42. DMFT index was 10.12. 2. Twenty percents of patients showed moderate to severe food impactions, 42.2% of patients had moderate to heavy calculus and 37.8% of patients displayed gingival inflammation with swelling. 3. Patients needed periodontal treatments more than any other dental treatments. Periodontal treatments were needed for 88.9% of patients, operative & endodontic treatments were 46.7% of patients and 33.3% of patients needed for oral & maxillofacial surgical treatments. 4. Among 90 patients, time interval between scheduled operation date of liver transplantation and dental visit was within 2 weeks for 32.2% of patients, within 1 week for 20.0% of patients. In conclusion, most liver transplant candidates needed dental treatments for removal of potential infection sources. However because of insufficient interval between dental visit and operation date, they had taken liver transplantation procedures without comprehensive dental management. Development of preventive and comprehensive dental management program is mandatory for these patients. Cooperative interdisciplinary management will play a positive role for successful liver transplantation.

• The Korean Journal of Nuclear Medicine Technology
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• v.28 no.1
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• pp.23-29
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• 2024

Purpose: 99mTc-mebrofenin hepatobiliary scintigraphy (HBS) is an important and clinically useful diagnostic imaging study for detecting complications after liver transplantation. CT contrast agents due to their high atomic numbers, lead to a decrease in gamma ray count rates. This study investigated the impact of CT contrast agents on the uptake of 99mTc-mebrofenin in the liver. Materials and Methods: The quantitative HBS was performed on sixty-two liver transplantation patients (male:female=36:26), with a mean age of 59.4±6.4 years. Statistical comparison of hepatic uptake reduction ratio (HURR%) before and after the injection of CT contrast agents was performed using a paired t-test. Results: Hepatic uptake of the reduction ratio was 94.47±3.65% for the pre-CT contrast agents and 92.17±4.00% for the post-CT contrast agents. HURR% after CT contrast agent injection showed a statistically significant difference compared to before the injection (t=11.09, P<0.001). Conclusion: It will be necessary to pay attention when examining the HBS of patients with liver transplantation after the injection of CT contrast medium. It is advisable to schedule the examination on a different day to prevent residual contrast medium in the body from interfering with the quantitative evaluation of the nuclear medicine examination.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.2 no.1
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• pp.85-88
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• 2002

Methylmalonic acidemia is an inborn error of branched chain amino acid metabolism, clinically characterized by lethargy, vomiting, and hypertonia with abnormal movements, and biochemically characterized by ketoacidosis, hyperammonemia, and sometimes hyperglycinemia. Conventional treatment of methylmalonic acidemia incluides dietary protein restriction, bicarbonate, carnitine, and metronidazole. However, most patient have recurrent episodes of acidosis, and a significant number have neurologic deficits and renal impairment. We report the successful treatment of a patient with methylmalonic acidemia by liver transplantation.

• Journal of Gastric Cancer
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• v.16 no.1
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• pp.51-53
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• 2016

Laparoscopic gastrectomy for cancer has some significant postoperative benefits over open surgery with similar oncologic outcomes. This procedure is more popular in the Far East countries where obesity is not a serious public health problem. In the Western countries, laparoscopic gastrectomy for cancer is not a common procedure, yet obesity is more common. Herein, we aimed to demonstrate the feasibility of laparoscopic gastrectomy for advanced gastric cancer in a morbidly obese patient. Additionally, we used natural orifice specimen extraction as an option to decrease wound-related complications, which are more prevalent in morbidly obese patients. In this case, we performed a fully laparoscopic subtotal gastrectomy with lymph node dissection and Roux-en-Y gastrojejunostomy with the specimen extracted through the vagina. To the best of our knowledge, this was the first report of a natural orifice surgery in a morbidly obese patient with gastric cancer.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.20 no.4
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• pp.259-262
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• 2017

Mitochondria play essential role in eukaryotic cells including in the oxidative phosphorylation and generation of adenosine triphosphate via the electron-transport chain. Therefore, defects in mitochondrial DNA (mtDNA) can result in mitochondrial dysfunction which leads to various mitochondrial disorders that may present with various neurologic and non-neurologic manifestations. Mutations in the nuclear gene polymerase gamma (POLG) are associated with mtDNA depletions, and Alpers-Huttenlocher syndrome is one of the most severe manifestations of POLG mutation characterized by the clinical triad of intractable seizures, psychomotor regression, and liver failure. The hepatic manifestation usually occurs late in the disease's course, but in some references, hepatitis was reportedly the first manifestation. Liver transplantation was considered contraindicated in Alpers-Huttenlocher syndrome due to its poor prognosis. We acknowledged a patient with the first manifestation of the disease being hepatic failure who eventually underwent liver transplantation, and whose neurological outcome improved after cocktail therapy.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.6 no.2
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• pp.161-166
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• 2003

Purpose: The purpose of this study was to evaluate the efficiency of treatment of living-related liver transplantation (LRLT) with the parental heterozygote carrier graft in children with Wilson disease. Methods: We retrospectively evaluated 7 children with Wilson disease who had received liver transplantation from 1994 to 2002 at Asan Medical Center. All the donors were parental. Liver functions, Kayser-Fleischer ring, and other factors regarding to copper metabolism were analyzed. Results: Of the 7 children, 5 had fulminant hepatitis and 2 had decompensated liver cirrhosis irresponsive to medical therapy. All donors being parental, all grafts came to be heterozygote carrier grafts. Survival rate was 100% in those 7 children, 87% in all children with liver transplantation in the same period, and 84% in children with non-metabolic liver disease. After liver transplantation, all 7 children could stop low copper diet and penicillamine therapy and their AST, total bilirubin and prothrombin time were recovered to normal. After liver transplantation, ceruloplasmin and serum copper levels were also recovered to normal. A marked reduction in 24 hr-urinary copper excretion was observed in all recipients after transplantation. During follow-up, Kayser-Fleischer rings resolved completely after LRLT in 5 children and partially in 1 child. Conclusion: We concluded that living-related liver tranplantation in children with Wilson disease with parental heterozygote carrier graft is an effective treatment modality.

• Journal of The Korean Society of Clinical Toxicology
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• v.6 no.2
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• pp.110-116
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• 2008

Purpose: Acute toxic hepatitis is a common cause of acute liver failure (ALF). We investigated the causes, clinical manifestation, and outcomes of ALF patients who underwent liver transplantation due to acute toxic hepatitis caused by herbal medicines and preparations. Methods: Between January 1992 and May 2008, we retrospectively reviewed the medical records of 24 patients who were transplanted due to acute toxic hepatitis caused by herbal medicines and preparations. We applied the RUCAM score to patients with acute toxic hepatitis and assessed the relationship between herbal preparations and liver injury. We studied the patients' medication history, liver function tests, and clinical outcomes. Results: The type of liver injury was divided into three groups: hepatocellular type, 14 patients (58.3%); cholestatic type, 4 patients (16.7%); and mixed type, 6 patients (25%). Polygonum multiflorum Thunberg (3 cases) was the most common cause of acute toxic hepatitis, followed by Acanthopanax senticosus (2 cases), pumpkin juice (2 cases), Dictamnus dasycarpus Turcz (2 cases), Hovenia dulcis (1 case), Phellinus linteus (1 case), and Artemisia capillaries (1 case). One year survival after liver transplantation was 76%. Conclusion: We identified the herbal preparations leading to acute liver failure. Many patients consider herbal remedies to be completely free of unwanted side effects. However, we found that many herbal products have biological activities that can lead to severe hepatotoxicity.