• 제목/요약/키워드: Final Transplant

검색결과 13건 처리시간 0.025초

간이식 수혜자의 삶의 질 예측모형 (A Structural Model on Quality of Life for Recipients of Liver Transplants)

  • 김은만;김금순
    • 기본간호학회지
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    • 제14권3호
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    • pp.340-350
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    • 2007
  • Purpose: This study was done to construct a quality of life (QOL) model for recipients of a liver transplant. Method: In consideration of the main factors influencing QOL in recipient of liver transplants, a hypothetical model was constructed with 16 paths. A questionnaire was used to collect data from recipients of liver transplants who were being followed at one of 3 university hospitals. For the final analysis, there were 189 completed questionnaires and the hypothetical model was verified through covariance structure using LISREL program. Results: Overall fitness indices of hypothetical model were GFI= .99, AGFI= .97, NNFI= .96 and RMR=.020. After considering modification indices and paths that proved not to be significant and to improve model fitness, the hypothetical model was modified. In the final model, 3 paths from the hypothetical model were excluded. Overall fitness indices of the final model were GFI= .99, AGFI= .98, NNFI= .98 and RMR= .020. Eleven of fifteen paths proved to be significant. QOL was influenced by duration after transplantation, perceived health status, self-esteem, uncertainty, social support, self efficacy and depression and these variables explained 65% of the variance. Conclusion: This study presents a theoretical model for QOL for recipients of a liver transplant. Based on the results of this study and to improve QOL for recipients of a liver transplant, it is suggested that interventions to re-enforce self efficacy and self-help are needed.

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폐이식 환자 삶의 질 영향 요인 (Factors Influencing the quality of life of lung transplant patients)

  • 황병희;민혜숙
    • 중환자간호학회지
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    • 제16권3호
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    • pp.73-86
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    • 2023
  • Purpose : This study aimed to identify the factors affecting the quality of life of lung transplant patients. Method : The participants were patients who received lung transplants at a general hospital in City Y. Data were collected through structured questionnaires from June 2023 to August 2023. General characteristics, lung transplantation-related characteristics, quality of life, functional disability, treatment compliance, social support, anxiety, and depression-were measured. For data analysis, hierarchical multiple regression was performed using SPSS/WIN 29.0. Results : In the final model, quality of life was associated with income, self-help group attendance, functional disability, social support, treatment compliance, and anxiety and depression. Together, they explained 61.2% of the total variance in the results. Conclusion : Our findings suggest that improving lung transplant patients' quality of life requires active intervention in stress management to perform treatment instructions well, a social support system that can help them financially, and encouraging and participating in social activities as patients.

훼손 수목의 이식을 위한 토양의 물리·화학적 특성 분석과 개선 방안 (Analysis and Improvement of Soil Physical and Chemical Properties for Transplantation of Damaged Trees)

  • 김혜수;김정호;문윤정;이선미
    • 환경영향평가
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    • 제31권6호
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    • pp.423-437
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    • 2022
  • 환경영향평가서 작성 및 검토 매뉴얼에 따라 훼손되는 수목의 일부를 이식하고 있다. 수목이 원래 서식하고 있는 산림에서 가이식장과 최종 이식장으로 이식하는 과정에서 고사하거나 생육이 불량한 등의 문제점이 지속적으로 제기되고 있다. 이 연구의 목적은 가이식장과 최종 이식장의 토양 특성을 파악하여 기존에 서식하던 산림 토양과의 차이를 분석하고, 이식한 수목의 생육에 적합한 토양으로 개선하는 방안을 제시하는 것이다. 10개의 환경영향평가 사업을 대상으로, 원래의 서식지인 주변의 산림지역, 훼손수목의 일부를 임시로 이식하고 있는 가이식장, 공사가 완료된 후 최종 이식을 하게 되는 공사장을 대표하는 지점에서 각각 2개씩, 총 60개의 토양을 샘플링하여 물리적 특성과 화학적 특성을 분석하였다. 물리적 특성 중에서 투수계수, 유효수분율, 경도, 화학적 특성 중에서 산도, 유기물함량, 전질소, 유효인산에서 집단 간 유의한 차이가 있는 것으로 나타났다. 공사장의 토양은 공사 장비로 인한 답압으로 주변의 산림보다 경도가 높고, 모래 함량이 많아 투수계수는 높으며 유효수분율은 낮아 식물이 필요한 토양 내 수분을 보유하지 못하고 배수되는 양이 많다. 경도가 높은 토양의 공극량을 증가시키고 물리적 구조를 개선하기 위하여 경운을 실시할 필요가 있다. 또한 토양의 물리성과 화학성을 함께 개선하기 위하여 토양 내 부숙된 유기물을 첨가한 후 우드칩이나 낙엽으로 표면을 덮어주는 것이 필요하다.

Tacrolimus의 혈중농도측정법 비교 및 간이식환자에서의 집단 약동학 (Comparison of Analytical Methods of Tacrolimus in Plasma and Population Pharmacokinetics in Liver Transplant Recipients)

  • 김은영;강원구;곽혜선
    • 한국임상약학회지
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    • 제18권1호
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    • pp.60-67
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    • 2008
  • This study aimed to compare a microparticle enzyme immunoassay (MEIA) with a liquid chromatography-tandem mass spectrometry (LC/MS/MS) technique for the measurement of tacrolimus concentrations in adult liver transplant recipients, to investigate how the assay choice influenced the population pharmacokinetics of tacrolimus and to identify patient characteristics that affected pharmacokinetic parameters in each assay. Tacrolimus concentrations from 29 liver (n=52 paired-samples) transplant recipients measured by both MEIA and LC/MS/MS were used to evaluate the performance of these methods in the clinical setting. Tacrolimus pharmacokinetics was studied independently using MEIA and LC/MS/MS data in 70 adult patients using a population approach performed with NONMEM. Patient characteristics which influenced pharmacokinetic parameters in each assay were compared. The relation between LC/MS/MS and MEIA measurements was best described by the regression equation MEIA=1.465*LC/MS/MS-1.336 (r=0.91). Multiple linear regression analysis showed significant inverse relationships between assay difference and hematocrit (Hct) (p<0.025) in liver graft recipients. In MEIA, the population estimate of tacrolimus CL/F and apparent volume of distribution (Vd/F) were found to be 10.1 L/h and 226 L, and in LC/MS/MS, 13 L/h and 305 L respectively. Neither patient's age, weight, gender, grafted hepatic weight, albumin concentration, nor markers of liver function influenced tacrolimus CL/F The final model of CL/F was found to be 10.1+(Hct/Hct mean)$^{12.0}$ in MEIA and 13+(1+Hct/578) in LC/MS/MS indicating that CL/F was influenced by hematocrit.

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우리나라 자포니카 벼 품종의 등숙 한계온도 분석 (Critical Temperature for Grain Filling of Japonica Rice in Korea)

  • 양운호;강신구;이대우;채미진
    • 한국작물학회지
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    • 제68권4호
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    • pp.225-235
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    • 2023
  • 벼의 수확기 기준온도 결정에 활용하기 위하여 2020~2021년 포장 조건에서 우리나라 자포니카 벼 품종(오대, 하이아미, 삼광)의 4회 이앙 처리에서 등숙 한계온도를 분석한 결과는 다음과 같다. 1. 이앙차수별 출수기 범위는 2020년에는 1차 8월 27~28일, 2차 9월 14~15일, 3차 9월 23~25일, 4차 9월 28~30일이었으며, 2021년에는 1차 8월 20~23일, 2차 9월 9~15일, 3차 9월 20~22일, 4차 9월 28~30일이었다. 2. 등숙비율, 정조 천립중, 정조중, 완전립 비율 중 등숙 한계온도 분석에 적합한 특성은 등숙비율과 정조중이었다. 3. 등숙비율과 정조중은 2020년 1~2차 이앙과 2021년 1~3차 이앙에서 sigmoid curve 형태의 변화를 나타내었으며, 2020년 3차와 2021년 4차 이앙에서는 일정 시기까지 증가한 이후 정체 또는 감소하는 양상을 보였다. 4. 비선형회귀 분석에서 등숙비율과 정조중이 최고값의 95%에 도달한 시기는 2020년 2차 이앙에서 출수 후 49~62일, 2021년 2차와 3차 이앙에서 각각 출수 후 37~46일과 30~36일이었으며, 2020년 3차와 2021년 4차 이앙에서 등숙특성의 실측 최고값은 출수 후 42일에 나타났다. 5. 비선형회귀 분석에서 등숙 한계온도 분석에 적합한 경우 최고값 대비 95% 시기의 7일 이동 평균기온은 품종과 특성에 따라 2020년 2차 이앙에서 8.4~9.4℃, 2021년 2차와 3차 이앙에서 9.4~10.9℃로 나타났으며, 품종별로 평가한 등숙 한계온도는 7일 이동 평균기온 8.4~8.7℃였다. 6. 2020년 3차와 2021년 4차 이앙에서 등숙비율과 정조중의 증가가 나타난 가장 낮은 7일 평균기온은 품종에 따라 9.4~10.1℃ 범위였으며, 정체 또는 감소가 나타난 가장 높은 온도는 8.7~9.1℃ 범위였다. 7. 종합적으로, 비선형회귀 분석에서 나타난 자포니카 벼의 등숙 한계온도는 품종에 따라 7일 이동 평균기온 기준 8.4~8.7℃로 분석되었으며, 실측 등숙 특성의 변화로 분석한 등숙 한계온도는 이전 7일 평균기온 기준 9.1~9.4℃ 사이로 나타났다. 8. 벼의 수확 한계기 기준 온도는 품종에 따라 등숙 진전이 관찰된 가장 낮은 온도인 이전 7일 평균기온 9.4~10.1℃에서 높은 온도인 10℃ 정도를 적용하는 것이 재배 안전성 측면에서 유리할 것으로 평가되었다.

매복 하악 견치의 자가이식술을 이용한 치험례 (Autotransplantation of impacted mandibular canine)

  • 홍성수;이상호;김동필
    • 대한소아치과학회지
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    • 제24권3호
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    • pp.710-717
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    • 1997
  • Autotransplantation is the transplantation of embeded, impacted, or unerupted tooth, into extraction socket or surgically prepared socket in the same individual. Clinically, successful autotransplantation must show radiolucent space(periodontal ligament space) between transplanted tooth and supporting bone, lamina dura, no root resorption, no ankylosis, no inflammatory change, and physiologic tooth mobility. It is important that procedure is atraumatic, and the instruments should not contact the root surface during procedure. We performed autotransplantation of impacted mandibular canine that transversely located beneath the apices of the mandibular incisors with uncompletely developed apex. In radiographs and clinical evaluation, this transplant showed successful clinical finding except irregularity of mesial root surface after 14 months. It is conclued that transplantation of canine with $\frac{1}{2}{\sim}\frac{3}{4}$ root development provides a good chance of pulp survival, limited risk of root resorption and ensures sufficient final length, and is thus recommended.

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Poor Prognostic Factors in Patients with Parenteral Nutrition-Dependent Pediatric Intestinal Failure

  • Choi, Shin Jie;Lee, Kyung Jae;Choi, Jong Sub;Yang, Hye Ran;Moon, Jin Soo;Chang, Ju Young;Ko, Jae Sung
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제19권1호
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    • pp.44-53
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    • 2016
  • Purpose: Parenteral nutrition (PN) not only provides nutritional support but also plays a crucial role in the treatment of children with intestinal failure. The aim of this study was to evaluate the clinical significance and clinical outcomes of long-term PN. Methods: Retrospective cohort study was conducted using the medical records of patients treated at Seoul National University Children's Hospital. This study included 19 patients who received PN for over six months. Most patients received home PN. Results: The indications for PN included short bowel syndrome, chronic intestinal pseudo-obstruction, and intractable diarrhea of infancy. The median age of PN initiation was 1.3 years, and the median treatment duration was 2.9 years. Two patients were weaned from PN; 14 continued to receive PN with enteral feedings; and 3 patients died. The overall survival rates at 2 and 5 years were 93.3% and 84.0%, respectively. The incidence of catheter-related bloodstream infections was 2.7/1,000 catheter-days and was associated with younger age at PN initiation and lower initial height Z-score. Six patients developed catheter-related central vein thrombosis, with an incidence of 0.25/1,000 catheter-days. Eleven patients experienced PN-associated liver disease (PNALD), and one patient underwent multi-visceral transplant. The patients with PNALD exhibited lower final heights and body weight Z-scores. All patients experienced micronutrient deficiencies transiently while receiving PN. Conclusion: PN is an important and safe treatment for pediatric intestinal failure. PNALD was linked to final anthropometric poor outcomes. Micronutrient deficiencies were common. Anthropometric measurements and micronutrient levels must be monitored for successful PN completion.

신장이식 환자의 치료지시이행에 영향을 미치는 요인 (Factors Affecting Treatment Adherence of Kidney Transplantation Recipients)

  • 이정아;김영아;정향인
    • 한국콘텐츠학회논문지
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    • 제19권2호
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    • pp.619-628
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    • 2019
  • 본 연구는 신장이식 환자를 대상으로 치료지시이행에 미치는 영향을 분석하기 위한 설명적 조사연구이다. 연구대상은 일 대학병원 외래를 방문하는 신장이식 환자 132명이었다. 자료수집은 2017년 7월 17일부터 2017년 8월 22일까지 이루어졌으며, 수집된 자료는 SPSS WIN 24.0을 이용하여 빈도와 백분율, 평균과 표준편차, 분산분석, 상관관계, 회귀분석을 통해 분석되었다. 연구결과, 대상자의 연령, 종교의 유무, 이식 후 경과기간에 따라 치료지시이행에 유의한 차이가 나타났다(p<.05). 또한 총 사회적 지지(r=.54, p<.001), 가족의 지지(r=.43, p<.001), 의료인의 지지(r=.57, p<.001) 및 자가 간호지식(r=.21, p=.015) 역시 치료지시이행과 통계적으로 유의한 양의 상관관계를 보였다. 회귀분석의 결과, 치료지시이행의 영향요인은 의료인의 지지, 신장이식 후 경과기간, 배우자 유무, 종교의 유무였고, 최종 설명력은 41.9%였다. 결론적으로, 신장이식 환자들의 치료지시이행을 높이기 위해 의료인의 지지를 증진시킬 수 있는 효율적인 중재방안이 도입되어야 할 것이다.

Mini Wrap-around 유리 피판술을 이용한 무지 원위부 재건술 (Microsurgical Distal Thumb Reconstruction Using a Mini Wrap-around Free Flap)

  • 권기두;안병문;여용범
    • Archives of Reconstructive Microsurgery
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    • 제17권2호
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    • pp.101-107
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    • 2008
  • Purpose: Free flaps from the great toe are an established method for reconstruction of absent or partially amputated thumbs. However, options differ as to which technique represents the ideal solution for each level of amputation. Various methods of distal thumb reconstruction have been proposed. We prefer to transplant the entire great toe nail complex with the almost all of the pulp rather than a portion of the nail. This paper reflects our experience in using the great toe mini wrap-around flap for distal thumb reconstruction. Materials and Methods: In the period from October of 2005 to July of 2007, 9 patients were treated for traumatic thumb defects localized at the distal phalanx of the thumb. The patients included seven men and two women. The mean age was 44 years (range, 21~60) and the dominant right hand was involved in seven of nine patients. Results: The transferred flaps have survived completely in all cases. The mean range of motion in the interphalangeal joints was 51o, with 73% of the normal uninjured opposite hands. The two-point discrimination was 10.5 mm (range, 5~13 mm). In Semmes-Weinstein monofilament test, the sensibility was 4.31 in 4 cases, 3.61 in 3 cases and 2.83 in 2 cases. The pinch power was 64% (range, 55~95%) of the opposite hand. All patients were satisfied with the appearance of the reconstructed thumb and felt comfortable at final follow-up. Conclusion: We have successfully reconstructed 9 cases of traumatic distal thumb defects using the mini wrap-around free flap. The mini wrap-around free flap in great toe is an excellent alternative method for distal thumb reconstruction in selected patients.

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생체 간이식 공여자의 불확실성과 간 공여 영향 요인 (Uncertainty and Factors Affecting Organ Donation in Living Liver Donors)

  • 전희옥;박호란;박진희
    • 한국보건간호학회지
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    • 제19권1호
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    • pp.129-138
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    • 2005
  • As the patients who need to undergo liver transplant operation continues to grow. the number of livers that are donated can not keep pace with the demand. With the development of surgery skills, the necessity for operations from living donors is increasing. Nevertheless, satisfactory research has been conducted on the factors which generally affect the living donors. In this article. therefore. researchers focused on the factors which generally affect the donating liver donor in order to design a plan for recommending liver donation from living donors. The subjects were 91 living liver donors in C university hospital from October 1. 2000 to December 31. 2003. The results on the uncertainty of living donor, by test sheet. were analyzed with SAS program. The final results were as follows: 1. The uncertainty of the living donors was 51.54 marks per full credit 100. 2. The factor with the greatest effect on donation was the possibility of survival of the donor, followed by the admission period. marriage status and age. In recommending the living donation, the rate of donor survival after the operation was 5.2 times higher than death, 5.2 times higher when the admission period was under 20 days. 5.0 times higher when married. and 27.3 times higher when the family-related donation was very active at the age of 20s than in the 50s. These results suggest that all medical staffs should care for living donors with more interest and activity to give them the least complaints in admission and the lowest possibilities for complication. To enhance the survival rate and improve the surgical success rate. on-going monitoring should include regular health-checks. and continual efforts and education should be made to care for the health condition of the living donors after donation.

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