Purpose: With the revision of the Organ and Transplantation Act in 2018, the hand has become legal as an area of transplantable organs in Korea. In January 2021, the first hand allotransplantation since legalization was successfully performed, and we have performed a total of three successful hand transplantation since then. By comparing and incorporating our experiences, this study aimed to provide a comprehensive reconstructive solution for hand amputation in Korea. Materials and Methods: Recipients were selected through a structured preoperative evaluation, and hand transplantations were performed at the distal forearm level. Postoperatively, patients were treated with three-drug immunosuppressive regimen, and functional outcomes were monitored. Results: The hand transplantations were performed without intraoperative complications. All patients had partial skin necrosis and underwent additional surgical procedures in 2 months after transplantation. After additional operations, no further severe complications were observed. Also, patients developed acute rejection within 3 months of surgery, but all resolved within 2 weeks after steroid pulse therapy. Motor and sensory function improved dramatically, and patients were very satisfied with the appearance and function of their transplanted hands. Conclusion Hand transplantation is a viable reconstructive option, and patients have shown positive functional and psychological outcomes. Although this study has limitations, such as the small number of patients and short follow-up period, we should focus on continued recovery of hand function, and be careful not to develop side effects from immunosuppressive drugs. Through the present study, we will continue to strive for a bright future regarding hand transplantation in Korea.

PURPOSE: This study aimed to study the antibody response of Japanese encephalitis vaccination in children using different kinds of vaccines (inactivated vaccine, live attenuated vaccine or interchanged) and evaluate the effectiveness of the vaccines to provide the basis of efficient immunization schedule of Japanese encephalitis. METHODS: Measurement of the neutralization antibody (NTAb) titers following Japanese encephalitis vaccination using different vaccines for 170 children, 2-6 year of age, who visited six university hospitals and are confirmed by immunization records. RESULTS: Among 170 children who were given primary immunization on Japanese encephalitis, 103 children were given inactivated vaccine, 64 children were given live attenuated vaccine and 3 children were given interchangeably. NTAb titers were more than 1:10 in all children of three groups. The geographic mean antibody titer was 322 in inactivated vaccine group and 266 in live attenuated vaccine group. However, there was no significant difference between two groups. In both groups, the NTAb titer showed the peak at 1-4 months after the third immunization and declined. The NTAb titers of three children who were given two kinds of vaccines alternately were 1:135, 1:632, and 1:2511, respectively. CONCLUSION: According to the results of this study in children younger than 6 years old, there is no significant difference in effectiveness between inactivated and live attenuated vaccines. However, further studies for the changes of antibody titers for a longer period of time on larger population are required.
Antibodies, Neutralizing ; Antibody Formation ; Asian Continental Ancestry Group* ; Child ; Cohort Studies* ; Encephalitis, Japanese* ; Hospitals, University ; Humans ; Immunization ; Immunization Schedule ; Prospective Studies* ; Vaccination ; Vaccines ; Vaccines, Attenuated

Citrus fruit contain various flavonoids that have multiple biological activities. However, the content of these flavonoids are changed during maturation and immature Citrus is known to contain larger amounts than mature. Chemokines are significant mediators for cell migration, while thymus and activation-regulated chemokine (TARC/CCL17) and macrophage-derived chemokine (MDC/CCL22) are well known as the typical inflammatory chemokines in atopic dermatitis (AD), a pruritic and chronic inflammatory skin disease. We reported recently that the EtOH extract of immature Citrus unshiu inhibits TARC and MDC production. Therefore, we investigated the activity of flavonoids contained in immature Citrus on TARC and MDC levels. As a result, among the various flavonoids, quercetagetin has stronger inhibitory effects on the protein and mRNA expression of TARC and MDC than other flavonoids. Quercetagetin particularly has better activity on TARC and MDC level than quercetin. In HPLC analysis, the standard peak of quercetagetin matches the peaks of extract of immature C. unshiu. This suggests that quercetagetin is an anti-inflammatory component in immature C. unshiu.
Cell Movement ; Chemokine CCL17 ; Chemokine CCL22 ; Chemokines ; Chromatography, High Pressure Liquid ; Citrus* ; Dermatitis, Atopic ; Flavonoids ; Humans* ; Keratinocytes* ; Quercetin ; RNA, Messenger ; Skin Diseases

This study examined the mechanism of action of a local anesthetic, lidocaine.HCl. Energy transfer between the surface fluorescent probe, 1-anilinonaphthalene-8-sulfonic acid, and the hydrophobic fluorescent probe, 1,3-di(1-pyrenyl) propane, was used to determine the effect of lidocaine.HCl on the thickness (D) of the synaptosomal plasma membrane vesicles (SPMV) isolated from the bovine cerebral cortex, and liposomes of the total lipids (SPMVTL) and phospholipids (SPMVPL) extracted from the SPMV. The thickness (D) of the intact SPMV, SPMVTL and SPMVPL were 1.044+/-0.008, 0.914+/-0.005 and 0.890+/-0.003 (arbitrary units, n=5) at 37degrees C (pH 7.4), respectively. Lidocaine.HCl decreased the thickness of the neuronal and model membrane lipid bilayers in a dose-dependent manner with a significant decrease in the thickness, even at 0.1 mM. The decreasing effect of lidocaine.HCl on the membrane thickness might be responsible for some, but not all of its anesthetic action.
Anilino Naphthalenesulfonates ; Cell Membrane ; Cerebral Cortex ; Energy Transfer ; Lipid Bilayers ; Liposomes ; Membranes ; Neurons ; Phospholipids ; Propane

BACKGROUND/AIMS: The aim of the study was to evaluate the efficacy of i-scans for the diagnosis of gastroesophageal reflux disease, especially where only minimal change is involved. METHODS: The esophageal mucosa was inspected using an i-scan following conventional white light endoscopy. The examination with iscan was performed under tone enhancement (TE) esophagus (e) mode. Patients with subtle distal esophageal mucosal changes without definite mucosal breaks, such as blurring of Z-line (B), mucosal coarseness (C), hyperemic or purplish discoloration (D), erythema (E), ectopic gastric mucosal islet (I) and mixed type were classified as minimal change. RESULTS: A total of 156 patients were included. Using i-scan endoscopy, the number of minimal change was found to further increase from 94 (conventional endoscopy; 19B, 9C, 29D, 13E, 5I, 19 mixed type) to 109 (i-scan; 15B, 8C, 29D, 16E, 5I, 36 mixed type). And 14 patients who had single type by conventional endoscopy were converted to mixed type after i-scan. Therefore, 29 of 156 patients were upgraded after i-scan, they were account for 19% (p<0.0001; 95% confidence interval, 0.13 to 0.25). CONCLUSIONS: The use of i-scan endoscopy significantly improves the identification of minimal change and helps to identify more precisely the type of minimal change.
Endoscopy ; Erythema ; Esophagus ; Gastroesophageal Reflux ; Humans ; Light ; Mucous Membrane

BACKGROUND/AIMS: The aim of the study was to evaluate the efficacy of i-scans for the diagnosis of gastroesophageal reflux disease, especially where only minimal change is involved. METHODS: The esophageal mucosa was inspected using an i-scan following conventional white light endoscopy. The examination with iscan was performed under tone enhancement (TE) esophagus (e) mode. Patients with subtle distal esophageal mucosal changes without definite mucosal breaks, such as blurring of Z-line (B), mucosal coarseness (C), hyperemic or purplish discoloration (D), erythema (E), ectopic gastric mucosal islet (I) and mixed type were classified as minimal change. RESULTS: A total of 156 patients were included. Using i-scan endoscopy, the number of minimal change was found to further increase from 94 (conventional endoscopy; 19B, 9C, 29D, 13E, 5I, 19 mixed type) to 109 (i-scan; 15B, 8C, 29D, 16E, 5I, 36 mixed type). And 14 patients who had single type by conventional endoscopy were converted to mixed type after i-scan. Therefore, 29 of 156 patients were upgraded after i-scan, they were account for 19% (p<0.0001; 95% confidence interval, 0.13 to 0.25). CONCLUSIONS: The use of i-scan endoscopy significantly improves the identification of minimal change and helps to identify more precisely the type of minimal change.
Endoscopy ; Erythema ; Esophagus ; Gastroesophageal Reflux ; Humans ; Light ; Mucous Membrane

Organ shortage is a serious problem in the field of solid organ transplantation. Increasing number of death on the waiting list, transplant tourism, black market for organ selling are all caused by organ shortage and these eventually causing poor quality of life for patient and family, and may give rise to a serious confusion in domestic transplant system. Since the KONOS launched in the year 2000, some portion of the illegal side of organ supply were corrected but the number of organ donor was hardly to increase. In order to search any solution for this problem, organ allocation study group under the Korean society for organ transplantation was actively worked from August 2008 through February 2009, and got some solution. Among them, amendment of the transplantation law including brain death committee, reporting system of suspected brain dead patients, and set up an independent organ procurement organization system for an effective organ procurement. Organ donation and increasing the number of donor is not a task only for transplant society, but is closely related with quality of life for peoples. This also can change the execution of budget of national medical health insurance. To give a correct understanding about this and activate the nationwide organ donation, the transplant society should have a key role with various medical and nursing society, hospital association, government, national assembly and every voluntary groups.
Brain Death ; Budgets ; Humans ; Insurance, Health ; Jurisprudence ; Organ Transplantation ; Quality of Life ; Societies, Nursing ; Tissue and Organ Procurement ; Tissue Donors ; Transplants ; Waiting Lists

Recently, it has been reported that curcumin, which is known as a potent antioxidant, acts as a non-stressful and non-cytotoxic inducer of the cytoprotective heme oxygenase (HO)-1. In this study, naturally occurring curcuminoids, such as pure curcumin, demethoxycurcumin (DMC) and bis-demethoxycurcumin (BDMC), were compared for their potential ability to modulate HO-1 expression and cytoprotective activity in human endothelial cells. All three curcuminoids could induce HO-1 expression and HO activity with differential levels. The rank order of HO activity was curcumin, DMC and BDMC. In comparison with endothelial protection against H2O2-induced cellular injury, cytoprotective capacity was found to be highest with curcumin, followed by DMC and BDMC. Interestingly, cytoprotective effects afforded by curcuminoids were considerably associated with their abilities to enhance HO activity. Considering that the main difference among the three curcuminoids is the number of methoxy groups (none for BDMC, one for DMC, and two for curcumin), the presence of methoxy groups in the ortho position on the aromatic ring was suggested to be essential to enhance HO-1 expression and cytoprotection in human endothelial cells. Our results may be useful in designing more efficacious HO-1 inducers which could be considered as promising pharmacological agents in the development of therapeutic approaches for the prevention or treatment of endothelial diseases caused by oxidative damages.
Signal Transduction ; Models, Biological ; Hydrogen Peroxide/adverse effects ; Humans ; Heme Oxygenase-1/*metabolism/physiology ; Endothelial Cells/*drug effects/*metabolism ; DNA Damage/drug effects ; Cytoprotection/*drug effects ; Curcumin/*analogs & derivatives/*pharmacology

PURPOSE: The aim of this study was to design and evaluate a scale for measuring reliability and validity in the field of oriental nursing education. METHOD: A questionnaire was administered to 495 university nursing students using a convenience sampling method. The period of time for collecting data was from September 2003 to January 2004. RESULT: The derived outcome tool consisted of 6 factors and 22 inquires on the basis of a conceptual frame of three domains (knowledge, attitude, and skill), As a result of the item analysis, 22 items were selected and the internal consistency alpha coefficient was .767. The value of Cronbach' Alpha of knowledge(factor 1) was .885, attitude(factor2)was .756, and skill (factor 3) was .610. The three factors accounted for 65.110% of the variance in the total scale. Addressing the explanatory variance of each domain Cognitive domain was 22.477%, affective domain was 20.543%, and psychomotor domain was 17.090%. CONCLUSION: Further studies need to be done to verify educational evaluation and apply our outcomes to oriental nursing education.
*Medicine, Oriental Traditional ; Korea ; Humans ; Female ; Educational Measurement ; *Education, Nursing ; Adult

BACKGROUND: Chronic total occlusion (CTO) has been considered as an unsuitable lesion for percutaneous coronary intervention (PCI) because of technical difficulty and low success rate. Owing to technical advances and increased operator's experience, PCI has been attempted in a large number of patients with CTO in recent years, but there are few long-term follow-up reports for PCI to CTO. METHODS: We analyzed 83 patients (59.7+/-9.2 years, 28 female) with CTO on diagnostic coronary angiogram at the Heart Center and Coronary Care Unit of Chonnam National Hospital from January 1996 to July 1997. The patients were divided into two groups according to revascularization by PCI or CABG (coronary artery bypass graft): the revascularized group (received PCI or CABG, Group I) and non-revascularized group (Group II). RESULTS: PCI was tried in 46 patients and successful in 33 patients (71.7% of the success rate). Eleven patients (13.3%) were treated with the coronary artery bypass graft (CABG) and 31 (37.3%) patients were medically treated. During 5-year clinical follow-up 11 patients died [13.1%; cardiac death 6 (7.1%), non-cardiac death 5 (6.0%)] and the major adverse cardiac events occurred to 24 (28.6%) patients. Cardiac death occurred to one patient of the Group I and 5 patients of Group II (p=0.06). The mean survival time was significantly different (57.8+/-9.2 months in Group I and 50.9+/-19.5 months in Group II, p=0.038). CONCLUSIONS: Revascularization for CTO prolonged the mean survival time of the patients on long- term clinical follow-up.
Angioplasty ; Arteries ; Coronary Artery Bypass ; Coronary Care Units ; Coronary Disease ; Coronary Vessels* ; Death ; Follow-Up Studies* ; Heart ; Humans ; Jeollanam-do ; Percutaneous Coronary Intervention ; Survival Rate ; Transplants