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Hwang S, Moon DB, Ahn CS, Kim KH, Ha TY, Song GW, Jung DH, Park GC, Lee H, Lee Y, Chung YH, Abdulkarim B, Lee SG. Risk-Based Long-Term Screening for Hepatocellular Carcinoma Recurrence After Living Donor Liver Transplantation. Transplant Proc 2013; 45:3076-84. [DOI: 10.1016/j.transproceed.2013.08.068] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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477
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Moon DB, Lee SG, Hwang S, Kim KH, Ahn CS, Ha TY, Song GW, Jung DH, Park GC, Namkoong JM, Park HW, Park YH, Park CS. No-Touch En Bloc Right Lobe Living-Donor Liver Transplantation with Inferior Vena Cava Replacement for Hepatocellular Carcinoma Close to Retrohepatic Inferior Vena Cava: Case Report. Transplant Proc 2013; 45:3135-9. [DOI: 10.1016/j.transproceed.2013.08.052] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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478
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Wu N, Sarna L, Hwang S, Zhu Q, Wang P, Siow Y, K O. Regulation of Hmg-Coa Reductase in Diet-Induced Non-Alcoholic Fatty Liver Disease. Can J Cardiol 2013. [DOI: 10.1016/j.cjca.2013.07.648] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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479
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Kim H, Chee H, Yang J, Hwang S, Han K, Kang J, Park J, Kim J, Lee S, Ock S, Park M, Park K, Byeongchun L, Cho K, Noh J, Park W, Yun I, Ahn C. Outcomes of Alpha 1,3-GT-knockout Porcine Heart Transplants Into a Preclinical Nonhuman Primate Model. Transplant Proc 2013; 45:3085-91. [DOI: 10.1016/j.transproceed.2013.08.049] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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480
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Park YJ, Hwang S, Kim KH, Lee YJ, Ahn CS, Moon DB, Park KM, Ha TY, Song GW, Jung DH, Park GC, Lee JH, Lee SG. Prognosis of patients with pT1b/T2 gallbladder carcinoma who have undergone laparoscopic cholecystectomy as an initial operation. KOREAN JOURNAL OF HEPATO-BILIARY-PANCREATIC SURGERY 2013; 17:113-7. [PMID: 26155224 PMCID: PMC4304525 DOI: 10.14701/kjhbps.2013.17.3.113] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Revised: 08/04/2013] [Accepted: 08/12/2013] [Indexed: 02/06/2023]
Abstract
BACKGROUNDS/AIMS Laparoscopic cholecystectomy (LC) has become a standard procedure for treatment of benign gallbladder diseases. There has been a small proportion of gallbladder cancer (GBC) which was incidentally found in the gallbladder specimen, and LC has been tried in some patients with faintly suspected GBC. This study intended to analyze the prognosis of patients with pT1b/T2 GBC who have undergone LC and the outcome of extended re-operation. METHODS After analyzing the institutional profiles of 500 GBC patients who have undergone surgical resection, we selected 64 patients who underwent LC initially from January 1996 to December 2008 and whose gallbladder pathology was confined to pT1b or pT2 lesions. Of them, 34 patients (53.1%) underwent extended reoperation. Their medical records were reviewed retrospectively. RESULTS In the LC only group (n=30), mean age of the 16 pT1 patients was 65.7±12.5 years and mean age of the 14 pT2 patients was 66.7±10.1 years. In the reoperation group (n=34), mean age of the 8 pT1b patients was 52.6±9.9 years and in 26 pT2 patients, mean age was 59.2±7.9 years. The reoperation group showed a younger patient age pattern than the LC only group (p=0.001). The types of reoperation were liver resection with lymph node (LN) dissection in 17, bile duct resection with LN dissection in 2, and hepatectomy and bile duct resection with LN dissection in 15. In the LC only group, the 5-year survival rate (5-YSR) was 70.3% in pT1b and 43.2% in pT2. In the reoperation group, 5-YSR was 62.5% in pT1b (n=8) and 59.5% in pT2 (n=26). A survival comparison between the two groups showed no significant survival gain in pT1 patients (p=0.69) and in pT2 patients (p=0.14). In our whole database analysis, 5-YSR of pT1bNx lesions was 70% after cholecystectomy and 78% after extended cholecystectomy. Lymph node metastasis was identified in 11% of pT1b lesions. For pT2N0 lesions, overall 5-YSR was 62% after R0 resection, showing no survival difference between primary extended surgery and LC-redo operation (p=0.45). CONCLUSIONS The survival gain of reoperation was not evident in pT1b lesions. In contrast, some noticeable but not statistically significant survival difference was observed in pT2 lesions. Thus, reoperation for pT1b/T2 GBC following LC is indicated for individualized reasons, especially in patients with pT1b lesions. Old age was one of the important factors in deciding not to reoperate.
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Song GW, Lee SG, Hwang S, Ahn CS, Moon DB, Kim KH, Ha TY, Jung DH, Park GC, Namgung JM, Park CS, Park HW, Park YH. Successful experiences of ABO-incompatible adult living donor liver transplantation in a single institute: no immunological failure in 10 consecutive cases. Transplant Proc 2013; 45:272-5. [PMID: 23375314 DOI: 10.1016/j.transproceed.2012.06.079] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2012] [Revised: 06/04/2012] [Accepted: 06/19/2012] [Indexed: 02/07/2023]
Abstract
ABO-incompatible (ABOi) adult living donor liver transplantation (ALDLT) is a feasible therapeutic option for countries with a scarcity of deceased donors. This report presents our initial experiences in ABOi ALDLT in 10 patients between December 2008 and September 2009. The mean age of recipients was 48.5 ± 5.7 years (range, 40-54 years). The mean Model for End-stage Liver-Disease score was 13.9 ± 4.0 (range, 9-22). All patients were administered preoperative rituximab once and plasma exchanges according to the hemagglutinin titer. The spleen was preserved in all cases. For local infusion therapy, hepatic arterial infusion was performed in 9 patients and portal vein infusion in 1 subject. The 10 patients experienced no in-hospital mortality. At a mean follow-up period of 31.8 ± 2.9 months (range, 4.1-34.9 months), 1 patient has died (postoperative month 4 due to sepsis following a biliary stricture. The 3-month patient and graft survivals were 100%, and 1- and 2-year survivals, 90.0%. There was no episode of antibody-mediated rejection. The promising results of our initial experience may have been due to the use of preoperative rituximab and the good preoperative conditions of the patients.
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482
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Lee SJ, Hwang S, Ha TY, Kim KH, Ahn CS, Moon DB, Song GW, Jung DH, Park GC, Lee SG. Technical knacks and outcomes of extended extrahepatic bile duct resection in patients with mid bile duct cancer. KOREAN JOURNAL OF HEPATO-BILIARY-PANCREATIC SURGERY 2013; 17:109-12. [PMID: 26155223 PMCID: PMC4304529 DOI: 10.14701/kjhbps.2013.17.3.109] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Revised: 08/20/2013] [Accepted: 08/22/2013] [Indexed: 01/29/2023]
Abstract
BACKGROUNDS/AIMS Mid bile duct cancers often involve the proximal intrapancreatic bile duct, and resection of the extrahepatic bile duct (EHBD) can result in a tumor-positive distal resection margin (RM). We attempted a customized surgical procedure to obtain a tumor-free distal RM during EHBD resection, so that R0 resection can be achieved without performing pancreaticoduodenectomy through extended EHBD resection. METHODS We previously reported the surgical procedures of extended EHBD resection, in which the intrapancreatic duct excavation resembles a ≥2 cm-long funnel. This unique procedure was performed in 11 cases of mid bile duct cancer occurring in elderly patients between the ages of 70 and 83 years. RESULTS The tumor involved the intrapancreatic duct in all cases. Deep pancreatic excavation per se required about 30-60 minutes. Cancer-free hepatic duct RM was obtained in 10 patients. Prolonged leakage of pancreatic juice occurred in 2 patients, but all were controlled with supportive care. Adjuvant therapies were primarily applied to RM-positive or lymph node-positive patients. Their 1-year and 3-year survival rates were 90.9% and 60.6%, respectively. CONCLUSIONS We suggest that extended EHBD resection can be performed as a beneficial option to achieve R0 resection in cases in which pancreaticoduodenectomy should be avoided due to various causes including old age and expectation of a poor outcome.
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483
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Hollingworth A, Hwang S, Luck SJ. The Influence of Saccade Execution on Spatial Working Memory Precision. J Vis 2013. [DOI: 10.1167/13.9.1351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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484
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Moon DB, Hwang S, Wang HJ, Yun SS, Kim KS, Lee YJ, Kim KH, Park YK, Xu W, Kim BW, Lee DS, Lee DH, Kim HJ, Lim JH, Choi JS, Park YH, Lee SG. Surgical outcomes of hepatocellular carcinoma with bile duct tumor thrombus: a Korean multicenter study. World J Surg 2013. [PMID: 23188531 DOI: 10.1007/s00268-012-1845-0] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND The long-term outcomes after resection for hepatocellular carcinoma (HCC) with macroscopic bile duct tumor thrombus (BDTT) are unclear. This multicenter study was conducted to determine the prognosis of HCC patients with macroscopic BDTT who underwent resection with curative intent. METHODS Of 4,308 patients with HCC from four Korean institutions, this single-arm retrospective study included 73 patients (1.7 %) who underwent resection for HCC with BDTT. RESULTS Jaundice was also present in 34 patients (46.6 %). According to Ueda classification, BDTT was type 2 in 34 cases (46.6 %) and type 3 in 39 cases (53.4 %). Biliary decompression was performed in 33 patients (45.2 %), decreasing the median lowest bilirubin level to 1.4 mg/dL before surgery. Systematic hepatectomy was performed in 69 patients (94.5 %), and concurrent bile duct resection was performed in 31 patients (42.5 %). Surgical curability types were R0 (n = 57; 78.1 %), R1 (n = 11; 15.1 %), and R2 (n = 5; 6.8 %). Patient survival rates were 76.5 % at 1 year, 41.4 % at 3 years, 32.0 % at 5 years, and 17.0 % at 10 years. Recurrence rates were 42.9 % at 1 year, 70.6 % at 3 years, 77.3 % at 5 years, and 81.1 % at 10 years. Results of univariate survival analysis showed that maximal tumor size, bile duct resection, and surgical curability were significant risk factors for survival, and surgical curability was a significant risk factor for recurrence. Multivariate analysis did not reveal any independent risk factors. CONCLUSIONS Hepatocellular carcinoma patients with BDTT achieved relatively favorable long-term results after resection; therefore extensive surgery should be recommended when complete resection is anticipated.
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Kim YH, Kim BJ, Kim BG, Lee YA, Kim KJ, Chung HJ, Hwang S, Woo JS, Park JK, Schmidt JA, Pang MG, Ryu BY. Stage-specific embryonic antigen-1 expression by undifferentiated spermatogonia in the prepubertal boar testis1. J Anim Sci 2013; 91:3143-54. [DOI: 10.2527/jas.2012-6139] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
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486
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Chapman J, Panighetti A, Hwang S, Crawford B, Powell B, Chan J, Chen L. Comparing coordinated versus sequential salpingo-oophorectomy for BRCA1 and BRCA2 mutation carriers with breast cancer. Gynecol Oncol 2013. [DOI: 10.1016/j.ygyno.2013.04.307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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487
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Lee SJ, Kim KW, Kim SY, Park YS, Lee J, Kim HJ, Lee JS, Song GW, Hwang S, Lee SG. Contrast-enhanced sonography for screening of vascular complication in recipients following living donor liver transplantation. JOURNAL OF CLINICAL ULTRASOUND : JCU 2013; 41:305-312. [PMID: 23553428 DOI: 10.1002/jcu.22044] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2012] [Revised: 10/22/2012] [Accepted: 02/04/2013] [Indexed: 06/02/2023]
Abstract
The purpose of this article is to discuss the role of CEUS for screening of vascular complication in recipients admitted to ICU following LDLT, effect of microbubble contrast agent on Doppler phenomenon, CEUS technique, and illustrate CEUS findings in recipients with complication following LDLT. CEUS can enhance the role of US in the diagnosis of postoperative vascular complication in recipients following living donor liver transplantation at the bedside.
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488
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Mahmoud D, Hudgens S, Taylor F, Pompilus F, Hwang S, Beach C. P-264 Health-related quality of life and productivity impact of myelodysplastic syndromes (MDS): The patient perspective. Leuk Res 2013. [DOI: 10.1016/s0145-2126(13)70311-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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489
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Abstract
When dynamics in a system proceeds under suppressive external bias, the system can undergo an abrupt phase transition, as can happen when an epidemic spreads. Recently, an explosive percolation (EP) model was introduced to understand such phenomena. The order of the EP transition has not been clarified in a unified framework covering low-dimensional systems and the mean-field limit. We introduce a stochastic model in which a rule for dynamics is designed to avoid the formation of a spanning cluster through competitive selection in Euclidean space. We use heuristic arguments to show that in the thermodynamic limit and depending on a control parameter, the EP transition can be either continuous or discontinuous if d < d(c) and is always continuous if d ≥ d(c), where d(c) is the spatial dimension and d is the upper critical dimension.
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490
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Park YH, Hwang S, Ahn CS, Kim KH, Moon DB, Ha TY, Song GW, Jung DH, Park GC, Namgoong JM, Park HW, Park CS, Kang SH, Jung BH, Lee SG. Living donor liver transplantation for patients with alcoholic liver disease. KOREAN JOURNAL OF HEPATO-BILIARY-PANCREATIC SURGERY 2013; 17:14-20. [PMID: 26155208 PMCID: PMC4304503 DOI: 10.14701/kjhbps.2013.17.1.14] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2013] [Revised: 02/05/2013] [Accepted: 02/18/2013] [Indexed: 12/20/2022]
Abstract
Backgrounds/Aims Since most transplantation studies for alcoholic liver disease (ALD) were performed on deceased donor liver transplantation, little was known following living donor liver transplantation (LDLT). Methods The clinical outcome of 18 ALD patients who underwent LDLT from Febraury 1997 to December 2004 in a large-volume liver transplantation center was assessed retrospectively. Results The model for end-stage liver disease score was 23±11, and mean pretransplant abstinence period was 16±13 months, with 14 (77.8%) patients being abstinent for at least 6 months. Graft types were right lobe grafts in 11, left lobe grafts in 2 and dual grafts in 5. Graft to recipient body weight ratio was 0.94±0.16. The relapse rates in patients who did and did not maintain 6 months of abstinence were 7.1% and 50%, respectively (p=0.097). Younger recipient age was a significant risk factor for alcohol relapse (p=0.027). Five recipients with antibody to hepatitis B surface antigen (HBsAg) received core antibody-positive liver graft, but two of them showed positive HBsAg seroconversion. Overall 5-year patient survival rate following LDLT was 87.8%, with a 5-year relapse rate of 16.7%. Conclusions Pretransplant abstinence for 6 months appears to be benefical for preventing posttransplant relapse. Life-long prophylactic measure should be followed after use of anti-HBc-positive liver grafts regardless of hepatitis B viral marker status of the recipient.
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491
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Hwang S, Ahn CS, Kim KH, Moon DB, Ha TY, Song GW, Jung DH, Park GC, Lee SG. Liver retransplantation for adult recipients. KOREAN JOURNAL OF HEPATO-BILIARY-PANCREATIC SURGERY 2013; 17:1-7. [PMID: 26155206 PMCID: PMC4304506 DOI: 10.14701/kjhbps.2013.17.1.1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Revised: 02/11/2013] [Accepted: 02/16/2013] [Indexed: 01/19/2023]
Abstract
Living donor liver graft can be used for the first or second liver transplantation. The timing of retransplantation also should be stratified as 2 types according to the reoperation timing. Combination of these two classifications results in 6 types of living donor liver transplantation (LDLT)-associated retransplantation. However, late retransplantation to LDLT might have not been performed in most LDLT programs, thus other 4 types of LDLT-associated retransplantation can be taken into account. The most typical type of LDLT-associated retransplantation might be early living donor-to-deceased donor retransplantation. For early living donor-to-living donor retransplantation, its eligibility criteria might be similar to those of early living donor-to-deceased donor retransplantation. For early deceased donor-to-living donor retransplantation, its indications are exactly the same to those for aforementioned living donor-to-living donor retransplantation. Late deceased donor retransplantation after initial LDLT has the same indication for ordinary late deceased donor retransplantation.
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492
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Chung YK, Hwang S, Kim YI, Kang CM, Ko GY, Kwon DI, Lee SK. Spontaneous rupture of intrahepatic bile duct following portal vein embolization in a patient with perihilar cholangiocarcinoma: a case of successful curative resection. KOREAN JOURNAL OF HEPATO-BILIARY-PANCREATIC SURGERY 2013; 17:42-7. [PMID: 26155212 PMCID: PMC4304505 DOI: 10.14701/kjhbps.2013.17.1.42] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2013] [Revised: 02/21/2013] [Accepted: 02/25/2013] [Indexed: 11/17/2022]
Abstract
We herein present a case of spontaneous rupture of intrahepatic bile duct in a patient with perihilar cholangiocarcinoma, which were successfully treated by curative resection. A 60-year-old male patient with perihilar cholangiocarcinoma was decompressed with single percutaneous transhepatic biliary drainage. Two days after right portal vein embolization, the patient suffered from paralytic ileus with marked abdominal distension. Imaging study revealed that marked fluid collection around the liver and whole abdomen, suggesting intrahepatic bile duct rupture. With abdominal drainage and biliary decompression for 2 weeks, the biliary rupture was controlled. To enhance the safety of right hepatectomy, additional right hepatic vein embolization was performed. The patient underwent routine surgical procedures for right hepatectomy, caudate lobectomy and bile duct resection, and recovered uneventfully and discharged 18 days after surgery. This is the first report of a case of spontaneous rupture of intrahepatic bile duct in a patient with perihilar cholangiocarcinoma.
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493
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Misak H, Zacharias N, Song Z, Hwang S, Man KP, Asmatulu R, Yang SY. Skin cancer treatment by albumin/5-Fu loaded magnetic nanocomposite spheres in a mouse model. J Biotechnol 2013; 164:130-6. [PMID: 23395619 DOI: 10.1016/j.jbiotec.2013.01.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2012] [Revised: 12/30/2012] [Accepted: 01/04/2013] [Indexed: 12/12/2022]
Abstract
Albumin/drug loaded magnetic nanocomposite spheres were fabricated using an oil-in-oil emulsion/solvent evaporation method, and tested on a mouse model (experimental squamous cell carcinoma) to determine the efficacy of the drug delivery system (DDS) on skin cancer. This novel DDS consists of human serum albumin, poly(lactic-co-glycolic acid) (PLGA), 5-fluorouracil (5-Fu), magnetic nanoparticles (10 nm) and fluorescent labeling molecule (diphenylhexatriene). One of the major purposes of using albumin is that it likely provides internal binding to and retention by the inflammatory tissues to reduce the amount of magnetic nanoparticles needed in the drug loaded microspheres (750–1100 nm). This study is aimed at reducing many negative side effects of conventionally used chemotherapy drugs by localizing the chemotherapy drug, controlling the release of the therapeutic agent and encouraging uptake of the DDS into cancerous cells. A group of mice treated with (1) the magnetic targeted DDS were compared to the other three groups, including, (2) DDS without a magnet, (3) 5-Fu local injection, and (4) untreated groups. The fluorescent tracer was ubiquitously identified inside the tumor tissue, and the DDS/tumor tissue boundary presented a leaky interface. The test results clearly showed that the magnetic targeted DDS exhibited significantly superior therapeutic effects in treating the skin cancer, with the increased efficacy to halt the tumor growth.
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494
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Kwon HJ, Won Kim K, Song GW, Hwang S, Ha HK, Lee SG. Uncommon gastrointestinal complications after liver transplantation: radiologic findings and clinical features. Acta Radiol 2013; 54:1-7. [PMID: 23125393 DOI: 10.1258/ar.2012.120522] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
There are various uncommon gastrointestinal complications, as liver transplantation becomes increasingly popular as the only curative method for patients with end-stage liver diseases. It is important for radiologists evaluating postoperative liver transplantation recipients to have a perspective on the possible gastrointestinal complications after liver transplantation and their radiologic features for early detection and early treatment. This article illustrates radiologic findings and clinical features of various uncommon gastrointestinal complications after liver transplantation.
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495
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Hwang S, Kim KH, Kim DY, Kim KM, Ahn CS, Moon DB, Ha TY, Song GW, Jung DH, Namgoong JM, Park GC, Cronin DC, Lee SG. Anomalous hepatic vein anatomy of left lateral section grafts and customized unification venoplasty for pediatric living donor liver transplantation. Liver Transpl 2013; 19:184-90. [PMID: 23045153 DOI: 10.1002/lt.23557] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2012] [Accepted: 09/18/2012] [Indexed: 02/07/2023]
Abstract
In liver transplantation, a left lateral section (LLS) graft may have an unusual variant left hepatic vein (LHV) anatomy. This study was designed to analyze the incidence of unusual LHV variants and to determine technical methods for effective reconstruction in infant recipients weighing approximately 10 kg or less. The study comprised 3 parts: an LHV variation analysis, a simulation-based design for the technical modification of graft LHV venoplasty, and its clinical application. The LHV anatomy of 300 potential LLS graft donors was classified into 4 types according to the number and location of the hepatic vein openings: (1) a single opening (n = 218 or 72.7%); (2) 2 large adjacent openings (n = 29 or 9.7%); (3) 2 adjacent openings, 1 large and 1 small (n = 34 or 11.3%); and (4) 2 widely spaced openings (n = 19 or 6.3%). Types 2 and 3 required wedged unification venoplasty, and type 4 required additional vein interposition. In a series of 49 cases using LLS grafts, the graft hepatic vein complication rate was 4.5% at 3 years; stenting was necessary for 1 of the 36 type 1 LHV grafts (2.8%) and for 1 of the 13 type 2-4 LHV grafts (7.7%, P = 0.46). A customized interposition-wedged unification venoplasty technique for coping with type 4 vein variations was developed with a simulation-based approach, and it was successfully applied to a 10-month-old male infant receiving an LLS graft with a type 4 LHV. In conclusion, nearly all LHV variations can be effectively managed with customized unification venoplasty. These venoplasty techniques represent beneficial surgical options as part of graft standardization for hepatic vein reconstruction in pediatric living donor liver transplantation.
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496
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Hwang S, Lee DS, Kahng B. Origin of the hub spectral dimension in scale-free networks. PHYSICAL REVIEW. E, STATISTICAL, NONLINEAR, AND SOFT MATTER PHYSICS 2013; 87:022816. [PMID: 23496577 DOI: 10.1103/physreve.87.022816] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2012] [Indexed: 06/01/2023]
Abstract
The return-to-origin probability and the first-passage-time distribution are essential quantities for understanding transport phenomena in diverse systems. The behaviors of these quantities typically depend on the spectral dimension d(s). However, it was recently revealed that in scale-free networks these quantities show a crossover between two power-law regimes characterized by d(s) and the so-called hub spectral dimension d(s)((hub)) due to the heterogeneity of connectivities of each node. To understand the origin of d(s)((hub)) from a theoretical perspective, we study a random walk problem on hierarchical scale-free networks by using the renormalization group (RG) approach. Under the RG transformation, not only the system size but also the degree of each node changes due to the scale-free nature of the degree distribution. We show that the anomalous behavior of random walks involving the hub spectral dimension d(s)((hub)) is induced by the conservation of the power-law degree distribution under the RG transformation.
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497
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Choi ST, Hwang S, Hong HN, Won YJ, Ahn CS, Ha TY, Song GW, Jung DH, Park GC, Lee SG. Therapeutic potentials occurring during the early differentiation process of mesenchymal stem cells in a rats model with thioacetamide-induced liver fibrosis. KOREAN JOURNAL OF HEPATO-BILIARY-PANCREATIC SURGERY 2013; 17:21-33. [PMID: 26155209 PMCID: PMC4304508 DOI: 10.14701/kjhbps.2013.17.1.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2013] [Revised: 02/10/2013] [Accepted: 02/15/2013] [Indexed: 11/17/2022]
Abstract
BACKGROUNDS/AIMS Mesenchymal stem cells (MSCs) have the capacity to differentiate into hepatocytes, The purpose of this study is to investigate the MSCs' differentiation process and therapeutic potentials by comparing isolated MSCs with HGF-treated MSCs in rat's model with thiacetamide (TAA)-induced cirrhosis. METHODS Male Sprague-Dawley (SD) rats, weighing 100-150 g were used in this study. To induce liver fibrosis, recipient rats were taken with 0.04% thioacetamide (TAA) in the drinking water (400 mg TAA/L) for 8 weeks. The rats underlying liver cirrhosis were divided into 3 groups according to the transplanted materials, compared to normal saline as control (I) and isolated MSCs (II) HGF-treated MSCs. RESULTS Severe hepatic fibrosis and hepatocyte destruction were detected in the control group. Less hepatic cirrhosis and collagen formation, more hepatocyte regeneration and glycogen storage were detected in isolated MSCs compared to HGF-treated MSCs group, Distribution of red autofluorescence is mainly localized near the sinusoids in isolated MSCs, scattered away the sinusoids in HGF-treated MSCs group. MSCs transdifferentiated into CK-19 postive Oval cells and then to albulmin-producing hepatocytes, HGF treated MSCs differentiated into hepatocyte without the intermediate oval cells phase. HGF treated MSCs became the CK18-positive, MSCs became CD 90-positive. CONCLUSIONS Significant hepatocyte differentiation occurred in not HGF-treated MSCs but isolated MSCs group unexpectedly. These results suggest that the beneficial effect of MSCs on in rat's model with TAA-induced cirrhosis may occur during early differentiation course of MSCs. Mature hepatocyte itself has a little effect on the accelerated differentiation and functional capacity of hepatic lineage cell-line.
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Kwon HJ, Kim KW, Lee SJ, Kim SY, Lee JS, Kim HJ, Song GW, Kim SA, Yu ES, Lee J, Hwang S, Lee SG. Value of the ultrasound attenuation index for noninvasive quantitative estimation of hepatic steatosis. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2013; 32:229-235. [PMID: 23341377 DOI: 10.7863/jum.2013.32.2.229] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVES To assess the value of the ultrasound (US) attenuation index for noninvasive estimation of hepatic steatosis and determine its optimal cutoff value for severe steatosis in potential living liver donors. METHODS Two hundred forty potential donors underwent US-guided biopsy. The target site was scanned at 4 and 8 MHz. On the sonogram, the observer drew 3 × 3-mm square regions of interest in superficial (3-cm) and deep (5-cm) areas. The attenuation index was defined as the difference between superficial and deep echogenicity/superficial echogenicity × 100. On biopsy specimens, replacement of hepatic parenchyma was evaluated on a percentage scale. Severe steatosis was defined as macrovesicular fatty change of 30% or greater. Spearman rank correlation (ρ) was used to determine correlation coefficients between the attenuation index and steatosis degree; receiver operating characteristic analysis was performed to determine the optimal attenuation index cutoff value for severe steatosis. RESULTS The median steatosis degree was 3% (interquartile range [IQR], 0%-10%). Severe steatosis was found in 10 donors. The attenuation index ranged from -27.4 to 36.6 (median, 4.0; IQR, -1.6-10.4) at 4 MHz and -18.0 to 78.1 (median, 14.5; IQR, 7.2-21.9) at 8 MHz. There was a minimal positive correlation between steatosis and the attenuation index at 4 MHz (total steatosis: ρ = 0.339; P < .001; macrovesicular steatosis: ρ = 0.360; P < .001). However, there was a significant moderate correlation between steatosis and the attenuation index at 8 MHz (total steatosis: ρ = 0.669; P < .001; macrovesicular steatosis: ρ = 0.645; P < .001). The optimal attenuation index cutoff value for severe steatosis at 8 MHz was 31.0. CONCLUSIONS The US attenuation index at 8 MHz is a useful indicator for noninvasive quantitative estimation of hepatic steatosis and diagnosis of severe steatosis in potential living liver donors.
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Hwang S. Recent advances in hepatic resection and liver transplantation for hepatocellular carcinoma. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2013. [DOI: 10.5124/jkma.2013.56.11.956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Yoon YI, Song GW, Lee SG, Hwang S, Ahn CS, Kim KH, Moon DB, Ha TY, Jung DH, Park GC, Namgung JM, Park YH, Park CS, Park HW, Kang SH, Jung BH. Analysis of Biliary Stricture after ABO Incompatible Adult Living Donor Liver Transplantation. KOREAN JOURNAL OF TRANSPLANTATION 2012. [DOI: 10.4285/jkstn.2012.26.4.277] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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