• Childhood Kidney Diseases
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• 제9권2호
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• pp.275-281
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• 2005

저자들은 생체신장이식을 받은 후 발열과 빈혈을 주소로 내원한 2명의 환아에서 혈청 PCR을 통해 PV B19 감염을 진단한 후 면역글로불린 정맥투여로 싱공적으로 치료하고 재발 없이 관찰중인 2례를 경험하였기에 보고하는 바이다.

• 대한간호학회지
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• 제48권6호
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• pp.731-742
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• 2018

Purpose: The purpose of this study was to test a hypothesis explaining direct and indirect relationships among the factors affecting self-care behaviors of kidney transplant patients, based on self-determination theory. Methods: Data were collected from 222 outpatients with kidney transplantation. The endogenous and exogenous variables of the hypothetical model consisted of healthcare provider's autonomy support, duration after kidney transplantation, basic psychological need satisfaction, autonomous and controlled motivation, depression, and self-care behaviors. Collected data were analyzed using SPSS/WIN 24.0 and AMOS 24.0. Results: The hypothetical model demonstrated a good fit: RMSEA=.06, SRMR=.04, TLI=.94, CFI=.97. Statistically significant explanatory variables for the self-care behaviors of kidney transplant patients were duration after transplantation and basic psychological need satisfaction. Healthcare provider's autonomy support was indirectly significant, while autonomous motivation, controlled motivation and depression were not statistically significant for self-care behaviors. The variables accounted for 59.5% of the self-care behaviors of kidney transplant patients. Conclusion: It is necessary to develop an autonomy support program for healthcare providers to enhance the self-care behaviors of kidney transplant patients. Preventing the deterioration of self-care behaviors will be possible by conducting this program at one year and six years post-transplantation. In addition, the results suggest the need to developing personalized autonomy support programs for healthcare providers that can meet the basic psychological need satisfaction of kidney transplant patients.

• 한국의료질향상학회지
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• 제11권1호
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• pp.32-45
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• 2004

Objective : The aim of this study were to measure quality of life(QOL) in liver transplant recipients, to compare QOL between living donor liver transplant recipients and cadaveric liver transplant recipients and to investigate whether SF-36 may be used as a disease-specific instrument in liver transplant recipients. Methods : We conducted a single-center cross-sectional study of 133 LT recipients ages 13 to 65 years, all of whom had had Liver Transplantation(LT) at least 1 months previously. QOL was assessed using a self-completion questionnaire consisting of the Bang Whal Ran(1991) instruments and the 36-Item Short-Form Health Survey(SF-36) health status profile measure. We investigated whether the SF-36 instrument may be used as a disease-specific instrument in LT recipients. Individual scale scores range from 0 to 100, with higher score reflecting better health. Data on demographics, clinical status at pre transplantation 1 day, post transplantation clinical status, and graft function were collected to identify predictors of post transplantation QOL. Results : Standard measures for test-retest reliability, internal consistency, and discriminant and concurrent validity were examined. The reliability of the SF-36, as measured by test-retest correlation(Pearson coefficients: 0.729, p=0.002) and by internal consistency(Cronbach's alpha: 0.9431) exceeded conventional acceptability criteria. The correlation between domain scores of SF-36 and the Bang Whal Ran(l991) was clear and logical in that the clinical characteristics of SF-36 strongly correlated with the clinical component summary score of the Bang Whal Ran(l991)(r = 0.8155, P<.01). SF-36 scale scores were compared between Cadaveric Liver Transplant recipients and Living Donor Liver Transplant recipients. Donor types of post LT did not influence HRQOL(p>0.05). 87% of the liver transplant recipients were satisfied to get LT. Satisfaction of post LT showed significantly greater HRQOL(p<0.001). Conclusion : SF-36 is found reliable and valid. This study indicates thet Donor Type did not influence HRQOL after LT. The information gained from this study will help us to better define expectations and the clinical course after liver transplantation to patients and their families.

• 한국간호교육학회지
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• 제6권2호
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• pp.171-185
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• 2000

The twenty-first century may be said to be entering into a specialized qualification age to meet the needs of new technical innovations such as environmental changes, demographical changes, changes in the constitution of diseases, changes in the needs of the national health, reforms of information and knowledge, etc., which requires the provision of competitive services that can fulfill the high level needs of consumers. In consequence, it is needed to apply a practical nursing model that can serve as a guide for healthy society and to secure the sphere that can affect nursing policy-making by keeping pace with the changing environment. Furthermore, it is also urgent to expand more the activity sphere of nurse specialists with authority and autonomy, establish their legal foundation, establish a qualification accreditation system for nurse specialists, and develop educational programs. In Korea, the law relative to organ transplant past the national assembly on February 9, 2000, legally acknowledged brain death, which indicated to us the emergence of an age of organ transplant. Therefore, it necessitates to find out those of brain death from whom organ transplant is feasible in clinical practices, with their families' consent link to those terminal organ failure patients who are in need of an organ, and mediate both parties so that smooth transplant can be accomplished. A series of these complicated procedures require systematically trained specialists with high level techniques of organic management. With this in mind, this study was conducted on 69 clinical nurse specialists for organ transplant, accredited by the hospital, who are in active service in clinical practices. The resultant findings were revealed, as follows: 1. The qualifications of clinical nurse specialists for organ transplant should be accredited by Ministry of Health and Welfare or Korea Nurses Association. 2. The validity of qualifications should be for three years, and their renewal should be based on marks of a supplemental training or an education course for more than 12 hours a year. 3. The qualification of the clinical nurse specialist necessitates theoretical lectures and practices on those nurses who have had clinical experience in the pertinent field. 4. The course of training is required to be one year in the length of training and take more than 20 credits (320 hours) and 5 credits (240 hours).

• 한국수정란이식학회지
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• 제12권1호
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• pp.11-20
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• 1997

The influence of cryopreservation of donor embryos on the in vitro developmental potential in the nuclear transplant rabbit embryos was evaluated. The embryos of 16-cell stage were collected and cryopreserved with EFS solution by vitrification method. The frozen embryos were thawed and synchronized to S and G$_1$ phase of 32-cell stage. The recipient/ cytoplasms were obtained by removing the first polar body and chromosome mass from the oocytes collected by non-disruptive microsurgery procedure. The separated S and G$_1$ phase blastomeres of 32-cell stage were injected into enucleated recipient cytoplasms by micromanipulation. After culture until 20 hrs post-hCG injection, the nuclear transplant oocytes were electrofused and activated by electrical stimulation. The fused nuclear transplant embryos were co-cultured with rabbit oviduct epithelial cells. After in vitro culture for 120 hrs, the nuclear transplant embryos developed to blastocyst stage were stained with Hoechst 33342 dye and their blastomeres were counted. The electrofusion rate was significantly (P<0.05) reduced in the frozen nuclear donor,compared with fresh donor nuclei as 80.0 vs 62.8% in S phase and 81.7 vs 64.8% in G$_1$phase, respectivley. The in vitro developmental rate to blastocyst stage with the S and G$_1$phase of fresh embryos(26.3 and 61.1%, respectively) was found significantly (P<0.05) higher, compared to the S and G]phase of frozen embryos(11.9 and 34.6%, respectively). When frozen as well as fresh donor embryos were synchronized to G$_1$ phase, the in vitro developmental rate to blastocyst stage was significantly (P<0.05) higher, compared with S phase donor nuclei. The cell counts of nuclear transplant embryos developed to blastosyst stage were significantly (P<0.05) more in G$_1$ phase of fresh or frozen embryos (180.1 and 125.7 cells, respectively), compared with S phase nuclear donor (145.1 and 103.7 cells, respectively). From the above results it was concluded that the rabbit embryos cryo- preserved by vitrification might be available as nuclear donor, though the developmentalpotential and cell counts of nuclear transplant rabbit embryos were decreased significantly.

• Pediatric Infection and Vaccine
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• 제24권1호
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• pp.44-53
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• 2017

목적: 소아 심장이식 환자에서 림프증식성 질환(posttransplant lymphoproliferative disorder [PTLD]) 발생과 Epstein-Barr virus (EBV) 정량값의 상관관계를 분석하고, PTLD의 발생에 영향을 주는 인자들에 대해서 알아보고자 하였다. 방법: 2006년 1월부터 2015년 3월까지 최근 9년간 서울아산병원 어린이병원에서 심장이식을 받은 18세 미만 환자 중 이식 후 최소 1개월 이상 추적 관찰이 가능한 경우를 대상으로 후향적으로 의무기록을 분석하였다. 결과: 총 40명의 심장이식 환자의 진단 시 나이의 중앙값은 11.5세(범위, 0.3-17.8세)였으며 이 중 3명에서 이식 후 4.3개월, 6.3개월 및 17개월째 PTLD가 발생하였다. 이식 후 혈중 EBV 정량 검사를 시행한 28명 중 최소 1회 이상 EBV 바이러스혈증이 관찰된 경우는 7명이었으며, PTLD로 진단받은 환자 3명이 모두 ${\geq}10,000copies/mL$의 EBV 바이러스혈증이 선행되어 있었다. PTLD 발생군은 PTLD 비발생군에 비해 어린 나이에 이식을 받았으며(P=0.021), 초기 및 최고 혈중 EBV 역가가 더 높은 경향을 보였으나 통계적인 차이는 없었다. 결론: 소아 심장이식 환자에서 이식 당시 어린 연령 및 이식 후 EBV 바이러스혈증 동반 여부가 PTLD 발생과 관련이 있었다. 추후 전향적인 연구를 통해서 소아 심장이식 환자에서 PTLD 발생을 적절히 예측할 수 있는 EBV 정량값의 지표를 구하는 것이 필요하겠다.

• 한국수정란이식학회지
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• 제13권1호
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• pp.11-19
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• 1998

This study was to determine the effect of ionomycin and 6-dimethylaminopurine (6-DMAP) and/or elcetrical stimulation on the oocyte activation and production of rabbit nuclear transplant embryos. The oocytes were collected from the oviduct of superovulated rabbits at 14 h post hCG injection and cultured in TCM-199 containing 10% FBS until 19 h post hCG injection. To determine the optimum concentration and exposure time of 6-DMAP, some oocytes were activated with 5 $\mu$M ionomycin for 5 min and then in 2.0 mM 6-DMAP for 0.5 to 3.0 h, or in 1.0 to 3.0 mM 6-DMAP for 2.0 h. Other control oocytes were stimulated electrically(3X, 1.25 kV/cm, 60 $\mu$sec) in 0.3 M mannitol solution supplemented with 100 $\mu$M CaCl$_2$ and MgCl$_2$. The nuclear donor embryos of 8-cell stage were synchronized to G$_1$ phase of 16-cell stage, and the recipient cytoplasms were obtained from removal of the first polar body and a portion of membrane bound cytoplasm of the oocytes collected at 15 h post hCG injection. A separated blastomere was injected into the perivitelline space of the enucleated oocytes. The oocytes injected with nucleus were cultured until 19 h post hCG and then electrofused and activated by electrical stimulation with or without ionomycin and 6-DMAP. These nuclear transplant embryos were cultured in TCM-199 containing 10% FBS in 39˚C, 5% CO2 incubator for 120 h. For the oncytes activated parthenogenetically with electrical stimulation with or with-out ionomycin and the various concentration of exposure time of 6-DMAP, the highest cleavage(92.3%) and development to blastocyst stage(41.0%) were resulted from the oocytes activated by ionomycin and 2.0 mM 6-DMAP for 2.0 h, which were found to be significantly(P<0.05) higher than the cleavage(45.2%) and developement to blastocyst stage(14.3%) from the oocytes activated with electrical stimulation. The significantly(P<0.05) more oocytes(71.4%) developed to 4 cell stage at 24 h post activation by ionomycin and 6-DMAP than those by electrical stimulation(18.9%). For the nuclear transplant embryos, the cleavage rate was similarly high in oocyte activation by electrical stimulation with(79.4%) or without ionomycin and 6-DMAP(70.5%). However, the embryo development to blastocyst stage was significantly(P<0.05) higher in oocyte activation by electrical stimulation with ionomycin and 6-DMAP(44.4%) than by electrical stimulation only(25.0%). The significantly(P<0.05) more nuclear transplant embryos(45.6%) developed to 4 cell stage at 18 h post activation by electrical stimulation with ionomycin and 6-DMAP than those by electrical stimulation only(10.6%). These results indicated that the supplemental oocyte activation by ionomycin and 6-DMAP with electrical stimulation enhanced and accelerated the preimplanted in vitro development of the rabbit nuclear transplant embryos.

• 정신신체의학
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• 제31권2호
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• pp.43-49
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• 2023

우리나라의 경우, 이식 대기자에 비해 공여 장기 수가 부족하여 생체 장기기증에 대한 의존도가 높으며, 생체 장기기증 건수도 지속적으로 증가하고 있다. 특히, 생체 신장 이식 건수는 전 세계적으로 높기 때문에 생체 신장 공여자에 대한 이식 전 정신사회적 평가의 중요성이 부각되고 있다. 이전 연구에 따르면 이식 전 공여자 평가 시 사전 동의 여부 및 수술 위험성에 대한 인지 여부를 파악하는 것이 중요하며 이를 위해 다음과 같은 평가 도구들을 시행할 수 있다. ELPAT living organ donor Psychological Assessment Tool (EPAT), Live Donor Assessment Tool (LDAT), Living Donation Expectancies Questionnaire (LDEQ), Minnesota Multiphasic Personality Inventory-2 questionnaire (MMPI-2). 이식 전 정신사회적 평가 도구에 관한 문헌을 검토한 후, 한국의 생체 신장 기증자에 대한 법적 고려 사항을 살펴본 후 생체 신장 공여자에 대한 효과적인 이식 전 선별 평가 방법을 제안하려 한다.

• Molecules and Cells
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• 제46권11호
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• pp.688-699
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• 2023

We set up this study to understand the underlying mechanisms of reduced ceramides on immune cells in acute rejection (AR). The concentrations of ceramides and sphingomyelins were measured in the sera from hepatic transplant patients, skin graft mice and hepatocyte transplant mice by liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS). Serum concentrations of C24 ceramide, C24:1 ceramide, C16:0 sphingomyelin, and C18:1 sphingomyelin were lower in liver transplantation (LT) recipients with than without AR. Comparisons with the results of LT patients with infection and cardiac transplant patients with cardiac allograft vasculopathy in humans and in mouse skin graft and hepatocyte transplant models suggested that the reduced C24 and C24:1 ceramides were specifically involved in AR. A ceramide synthase inhibitor, fumonisin B₁ exacerbated allogeneic immune responses in vitro and in vivo, and reduced tolerogenic dendritic cells (tDCs), while increased P3-like plasmacytoid DCs (pDCs) in the draining lymph nodes from allogeneic skin graft mice. The results of mixed lymphocyte reactions with ceranib-2, an inhibitor of ceramidase, and C24 ceramide also support that increasing ceramide concentrations could benefit transplant recipients with AR. The results suggest increasing ceramides as novel therapeutic target for AR, where reduced ceramides were associated with the changes in DC subsets, in particular tDCs.

• 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.