Delta Neutrophil Index as a New Early Mortality Predictor after Liver Transplantation

Background: Patients with liver disease display numerous defects of the immune system, so infection is a frequent complication of both acute and chronic liver disease. These infections are independently associated with poor outcomes after liver transplantation. Our objective was to evaluate the delta neutrophil index (DNI), a new inflammation marker, as a predictor of survival after liver transplantation (LT). Methods: This observational study retrospectively evaluated the records of 712 patients who underwent LT from January 2010 to February 2018. DNI was evaluated at pre-transplantation and 1, 7, 14, and 30 days after operation. Statistical analysis was performed using the T-test or chi-square test, and logistic regression analysis. Results: The mean MELD score was 16.7 ± 9.4 (0-48). There were 125 mortality cases (17.8%) after liver transplantation. Mean DNI was 1.61 at pre-transplantation, 3.94 one day after operation, 2.67 seven days after operation, 1.61 fourteen days after operation, and 1.64 thirty days after operation, respectively. In multivariate analysis, DNI seven and fourteen days after operation was revealed as an independent prognostic factor for mortality after liver transplantation (p = 0.040 and p < 0.0001). Conclusions: The DNI is a simple and reliable predictor of patient mortality after liver transplantation.ope

A Cross-Sectional Analysis of Health Literacy and Compliance to Treatment in Organ Transplant Recipients

This study was conducted to determine the correlations between health literacy, transplant effects, and compliance to treatment in organ transplant recipients and to identify the factors influencing compliance to treatment. The participants (n = 130; males = 66.9%; mean age = 56.4 years) were organ transplant recipients visiting an organ transplantation center in Seoul, South Korea. The regression model explained 32% of the variance in participants' compliance to treatment. Among the health literacy variables, "Scale 3: Actively managing my health" (β = 0.38, p = 0.001) and "Scale 4: Social support for health" (β = 0.25, p = 0.019) had a significant effect on compliance to treatment. In this study, health literacy was identified as a key factor influencing compliance to treatment. Therefore, patients' health literacy should be assessed prior to transplantation to identify potential high-risk patients for treatment nonadherence. In addition, after transplantation surgery, patient-tailored interventions should be developed and provided for self-management that reflects the patient's health literacy level to ultimately enhance patient outcomes.ope

Clinical Characteristics and Risk Factors for Renal Cell Carcinoma after Kidney Transplantation

Background The occurrence of malignancy following kidney transplantation has been estimated three to five times the incidence compared to that of the general population. It is estimated that particularly in renal cell carcinoma (RCC), the relative risk increases. The aim of this study was to analyze the characteristics, risk factors, and prognosis of RCC following kidney transplantation. Methods Total number of 3,272 kidney recipients who underwent transplantation from April 1979 to December 2012 and patients who had RCC following kidney transplantation were retrospectively reviewed and analyzed. Results We found that among 232 cases of posttransplant malignancies, 25 recipients were diagnosed with RCC. We have observed in our study that it took an average of 175.2±71.0 months to develop RCC after their first kidney transplantation. However, with longer follow up period, interval incidence of RCC increased. Fourteen patients (56%) were diagnosed with RCC 15 years after transplantation. We also found that with reference to the risk factor analysis for posttransplant RCC, the long-term follow-up period was the only independent risk factor. In our study, 21 patients with RCC were treated with radical nephrectomy. Of them, 16 patients survived, and four RCC-related deaths occurred. Furthermore, the patient survival rate of RCC recipients was lower than that of the nonmalignancy group despite the graft survival rate were not different. Conclusions We conclude that the incidence of RCC increased in a time-dependent manner following kidney transplantation. Therefore, we strongly recommend the procedure of regular-interval screening for the patients who are on compulsive long-term immunosuppression.ope

Clinical Characteristics of Acute Appendicitis in Kidney Transplant Recipients

Background: Appendicitis is a common surgical disease. There are many problems for the early diagnosis of acute appendicitis in kidney transplant patients; differential diagnosis for acute rejection, limitation in imaging study, problems of immunosuppressant and non-characteristic symptoms. Methods: We reviewed medical records and transplant database of 2,947 renal transplant patients between April, 1979 and September, 2009 retrospectively. Patient`s characteristics, diagnostic methods for appendicitis and operative/postoperative progresses were analyzed. Results: Of the 2,947 renal transplant patients, there were 15 (0.51%, 13 males and 2 females) acute appendicitis patients. Mean age at the diagnosis of appendicitis was 37.2±10.1 years. Fourteen (93.3%) patients suffered from prodromal symptom, such as abdominal pain, direct or rebound tenderness, nausea and vomiting. There were 12 (80%) patients with leukocytosis (WBC count ＞10,000/μL). Computed tomography scans were performed in 5 (33.4%) patients for diagnosis. Laparoscopic appendectomies were applied for 8 (53.4%) patients. In pathologic diagnosis, 2 cases were reported as `non pathologic diagnosis` complications occurred in 2 patients as remnant appendicitis and pancreatitis. However, there was no patient with mortality and renal failure during the hospitalization. Conclusions: There were no significant differences between the transplant patients and the general population in the incidence, clinical features, diagnosis and postoperative progresses of acute appendicitis.ope

(A)Study on readjustment of the R.O.K.-U.S. alliance in the Kim Dae-Jung administration

학위논문(석사)--서울대학교 행정대학원 :행정학과 정책학전공,2005.Maste

음파화학, 화학기상증착법 및 나노세공탄소를 이용하여 제조한 수첨탈황용 촉매의 특성

Thesis(doctoral)--서울대학교 대학원 :응용화학부,2004.Docto

Plasticity of vestibulo-ocular reflex in slow harmonic acceleration test

의학과/석사[한글] 회전운동검사(Rotation test)는 머리의 회전운동에 의해 유발되는 전정안구반사 (vestibulo-ocular reflex, VOR)를 이용하여 피검자의 전정기능을 검사하는 방법으로, 온도자극을 통해 전정안구반사를 유발하는 냉온자극검사(Caloric test)에 비해 자극이 생리적이고, 자극의 정도를 다양하게 변화시킬 수 있다는 장점 때문에 많이 사용되고 있다. 그러나 회전운동검사는 양측 전정기관이 동시에 자극을 받는다는 점과 피검자의 주의집중, 안구의 개폐, 시야자극 등에 의해 검사결과에 영향을 받는다는 점이 단점으로 지적되고 있다. 특히 검사조건에 따른 검사결과의 변동성에 대하여는 보고자에 따라 다른 연구결과를 보이고 있어 계속적인 연구가 필요한 상황이다. 저자는 이신경학적으로 정상인 20대의 남자 18명과 여자 12명을 대상으로 안구의 개폐와 피검자의 주의 집중 여부가 전정안구반사에 어떤 영향을 미치는지 알아보기 위하여 회전운동검사(sinusoidal harmonic acceleration test)를 시행하여 아래와 같은 결과를 얻 었다. 회전운동검사는 암시야에서 0.05 Hz의 주파수와 120˚의 진폭으로 고정하여 시행하였다. 1. 안구의 개폐에 따라 가. 주의 집중시에는 개안시의 평균 획득도가 0.56으로 폐안시의 평균획득도 0.51에 비해 통계학적으로 의미있게 높았다 (P<O.05). 나. 주의 집중을 안한 경우 개안시의 평균 획득도가 0.45로 폐안시의 평균획득도 0.42와 통계학적으로 차이가 없었다 (P>0.05). 2. 주의 집중 여부에 따라 가. 개안시 주의 집중을 한 경우 평균 획득도가 0.56으로 주의 집중을 안한 경우의 평균 획득도 0.45에 비해 통계학적으로 의미있게 높았다 (P<0.05). 나. 폐안시 주의 집중을 한 경우 평균 획득도가 0.51로 주의 집중을 안한 경우의 평균 획득도 0.42에 비해 통계학적으로 의미있게 높았다 (P<0.05). 결론적으로 회전운동검사에서 안구의 개폐와 피검자의 주의 집중 여부는 검사 결과에 영향을 미치는 중요한 변수로서 이중 피검자의 주의집중여부가 더욱 중요한 변수이며 이 두가지의 조건을 조합하여 만들어진 네가지 검사조건중 피검자가 눈을 뜨고 주의 집중을 한 경우 가장 높은 값의 획득도를 나타낸다는 것을 알 수 있었다. [영문] The effect of eye-open or eye-closure and alertness on the rotational vestibular stimulation was assessed by evaluating 30 otoneurologically normal subjects with earth vertical axis in sinusoidal harmonic acceleration test. The maxiaml slow phase eye velocity, gain and asymmetry were obtained and compared with each other in four different conditions with properly flexed conditions such as in darkness and 0.05 Hz frequency. At least five minutes interval was gives between the tests and recalibrations were done before each tests. The results of this test were as follows. 1. VOR changes according to eye open or closure In cases of examinees which were given alerting tasks, larger gain was obtained with eyes opened than with eyes closed, and that was statistically significant (P<0.05). In cases of examinees which were not given alerting tasks, larger gain was obtained with eyes opened than with eyes closed, but that was not statistically significant (P>0.05). 2. VOR changes according to alertness In cases of examinees which opened their eyes, larger gain was obtained with alerting tasks than without alerting tasks, and that was statistically significant(P<0.05). In cases of examinees which closed their eyes, larger gain was obtained with alerting tasks than without alerting tasks, and that was statistically significant(P<O.05). 3. There was no significant changes of asymmetry according to the conditions. Therefore, from above results, we recommend the condition in which examinees open their eyes and be given alerting tasks as one of the optimal condition in sinusoidal harmonic acceleration test.restrictio

Assessing the residual life of high-temperature structural materials by instrumented indentation testing

학위논문(석사) --서울대학교 대학원 :재료공학부,2007.Maste

우리나라 中小企業의 共同프랜브 戰略에 관한 事例硏究

학위논문(석사)--서울大學校 大學院 :經營學科 經營學專攻,1997.Maste

Static analysis of private data leakage risk on android application reflective call

학위논문(석사) - 한국과학기술원 : 전산학부, 2017.2,[v, 34 p. :]모바일 기기는 이제 우리 생활에서 필수 불가결한 요소로 존재하며, 컴퓨터가 수행했던 대부분의 일을 대신 처리하고 있다. 이렇듯 모바일 기기는 우리 생활에 편리함을 가져다 주었지만, 개인 정보 유출의 위험도 같이 수반한다. 특히, 안드로이드 앱은 많은 악성 공격의 표적이 되고 있다. 이와 같은 악성 공격을 탐지하려는 정적 분석 도구들이 개발되고 있지만, 기존의 방법으로는 리플렉션 호출을 통한 데이터 흐름을 적절히 탐지하지 못한다. 본 논문에서는, 리플렉션을 통한 개인 정보 유출을 탐지하는 방법을 제안한다. 우선 상수 전달 언어 모델을 통해 리플렉션 호출을 가진 분석 대상 애플리케이션을 개량한 후, 이 앱을 정적 분석 도구에 입력하여 결과를 도출한다. 테스트 앱 및 구글 플레이 스토어에서 판매 중인 앱들을 대상으로한 실험을 통해, 제안하는 방법이 리플렉션 호출을 통한 데이터 흐름을 적절히 탐지함을 알 수 있다.한국과학기술원 :전산학부