• Korean Journal of Psychosomatic Medicine
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• v.31 no.2
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• pp.43-49
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• 2023

In Korea, the dependence on living donations is high due to the shortage of organs available for donation compared to the number of people waiting for transplants and the number of living organ donations continues to increase. In particular, the number of living-donor transplantations is high worldwide, highlighting the importance of pre-transplant psychosocial evaluation of living kidney donors. According to previous studies, when evaluating living organ donors before transplantation, it is crucial to determine whether the donor can give informed consent and be aware of the risks after surgery. Pre-transplant evaluation tests such as 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) and Temperament and Character Inventory (TCI) are conducted for donors. After reviewing the literature on these pre-transplant psychosocial assessment tools, we will also look at legal considerations for living kidney donors in Korea and suggest an effective and essential pre-transplant screening evaluation method for living kidney transplant donors.

• Molecules and Cells
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• v.46 no.11
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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.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.14 no.3
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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.

• Korean Journal of Adult Nursing
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• v.18 no.1
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• pp.136-145
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• 2006

Purpose: This study was performed to identify relationships among stress, hardiness, and the level of self-care in kidney transplant patients and use the results of this study as baseline data for developing self-care promotion programs. Method: Subjects were 41 patients who undergone a kidney transplantation surgery at least one month before and were receiving regular follow-up care via OPD. Four researchers interviewed each subjects by filling out questionnaires. Results: The mean score of the level of stress was 2.32(SD=0.54) on a 4 point scale and the mean score of hardiness was 4.68(SD=0.62) on a 6 point scale. The mean score of self-care among the subjects was 3.83(SD=0.55). There was statistically a significant positive relationship between selfcare and hardiness(r=0.42). Especially, relationships between self-care and commitment (r=.51) and control(r=.36) as the subdimensions of hardiness were significant. The item suggested as most stressful was economic burden and the item suggested as least stressful was sexual activity. Conclusion: Although transplant patients have various stressors, the positive self-care activities of the patients could be increased if the commitment and control were enhanced by proper intervention programs.

• Journal of Chest Surgery
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• v.55 no.4
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• pp.325-331
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• 2022

Postoperative critical care management for lung transplant recipients in the intensive care unit (ICU) has expanded in recent years due to its complexity and impact on clinical outcomes. The practical aspects of post-transplant critical care management, especially regarding ventilation and hemodynamic management during the early postoperative period in the ICU, are discussed in this brief review. Monitoring in the ICU provides information on the patient's clinical status, diagnostic assessment of complications, and future management plans since lung transplantation involves unique pathophysiological conditions and risk factors for complications. After lung transplantation, the grafts should be appropriately ventilated with lung protective strategies to prevent ventilator-induced lung injury, as well as to promote graft function and maintain adequate gas exchange. Hypotension and varying degrees of pulmonary edema are common in the immediate postoperative lung transplantation setting. Ventricular dysfunction in lung transplant recipients should also be considered. Therefore, adequate volume and hemodynamic management with vasoactive agents based on their physiological effects and patient response are critical in the early postoperative lung transplantation period. Integrated management provided by a professional multidisciplinary team is essential for the critical care management of lung transplant recipients in the ICU.

• Journal of Gastric Cancer
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• v.14 no.2
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• pp.117-122
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• 2014

Purpose: Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have been shown to improve survival in select patients with gastric cancer and peritoneal metastases. It remains unclear, however, whether this multimodal treatment protocol is also beneficial for signet-ring cell gastric cancer (SRC) patients with peritoneal metastases. Materials and Methods: Clinical data of patients scheduled for upfront systemic chemotherapy consisting of 5-FU (2,600 $mg/m^2$), folinic acid (200 $mg/m^2$), docetaxel (50 $mg/m^2$), and oxaliplatin (85 $mg/m^2$) followed by CRS and HIPEC using cisplatin (50 $mg/m^2$) at the Comprehensive Cancer Center, University Hospital T$\ddot{u}$bingen, Germany were retrospectively analyzed. Results: Eighteen consecutive patients for whom irresectability has been ruled out by a computed tomography scan were enrolled. However, complete cytoreduction could only be achieved in 72% of patients. When categorizing patients with respect to the completeness of cytoreduction, we found no difference between both groups considering tumor- or patient-related factors. The overall complication rate following complete cytoreduction and HIPEC was 46%. Within a median follow-up of 6.6 (0.5~31) months, the median survival for CRS and HIPEC patients was 8.9 months as opposed to 1.1 months for patients where complete cytoreduction could not be achieved. Following complete cytoreduction and HIPEC, progression-free survival was 6.2 months. Conclusions: In SRC with peritoneal metastases, the prognosis appears to remain poor irrespective of complete CRS and HIPEC. Moreover, complete cytoreduction could not be achieved in a considerable percentage of patients. In SRC, CRS and HIPEC should be restricted to highly selective patients in order to avoid exploratory laparotomy.

• PNF and Movement
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• v.16 no.2
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• pp.161-168
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• 2018

Purpose: This study aimed to investigate the effects of postural control exercise on the delayed heart rate increase in heart transplant patients. Methods: The subject was a female heart transplant recipient who had a delayed increase in heart rate during exercise. The intensity of exercise was performed at MBorg level 4. The A-B-A' and A-B-A'-B' designs were used to identify the changes in heart rate during active-assisted exercise, lower limb postural control exercise, and upper limb postural control exercise. Experiments were performed for four weeks. The heart rates at pre- and post-exercise were compared, and the time to reach MBorg 4 was measured. Results: In the active-assisted exercise, the average heart rates at pre- and post-exercise and after 10 min of exercise were 88, 89, and 87.7 bpm, respectively. In the repetitive comparison of pre- and post-exercise in the lower limb postural control exercise, the difference in the mean heart rate was 3.5 and 3 bpm in stable support and 14 and 14.5 bpm in unstable support, respectively. In the repetitive comparison of pre- and post-exercise in the upper limb postural control exercise, the difference in the mean heart rate was 6 and 4 bpm in stable support and 4 and 4.5 bpm in unstable support. The time required to reach MBorg 4 was short when both the upper and lower postural control exercises were performed in an unstable state. Conclusion: We suggest that combining proper postural control exercise with strength exercise and aerobic exercise, among others, may be effective in rehabilitating patients in the recovery stage after a heart transplant.

• Journal of Korean Biological Nursing Science
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• v.18 no.2
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• pp.118-125
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• 2016

Purpose: The present study examines the current influenza immunization rate among kidney transplant patients in an effort to identify the factors influencing their decisions pertaining to the immunization. Methods :Participants in the study included 150 adults over the age of 64 years who visited a General Surgery Department in Korea on April 2015, who had had a kidney transplant at least two years prior to the visit. We compared the characteristics of transplant patients who were immunized against those of the patients who had not been immunized. Results: The average age of the participants was $48.5{\pm}9.6years$, consisting of 87 males (58.0%) and 63 females (42.0%). The average post-surgery period was $91.0{\pm}59.0months$. Between September and December 2014, the immunization rate among these participants was 61.3%. Factors which influenced the participant's decision to get immunized in 2014 and drove up the immunization rate were: previous immunization in 2013 (OR=24.57, CI= 8.79-68.70, p<.001), marital status (OR=3.33, CI 1.05-10.56, p=.041), and awareness (OR=1.58, CI=0.99-2.52, p=.056). Conslusion: The current study found that the previous year's immunization record, marital status, and awareness increased the rate of immunization among the participants.

• Korean Journal of Adult Nursing
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• v.13 no.2
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• pp.223-232
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• 2001

The purpose of this study is to develop and evaluate the Self Efficacy Promotion and Exercise Training Program to decrease anxiety and depression and to increase the quality of life for kidney transplant recipients. The subjects were selected randomly among the patients who underwent renal transplant at three major transplantation hospitals in Seoul, Korea. The observed subjects in this study consisted of 56 patients who had renal transplantations between one to twelve months prior to this study. The patients did not take any regular physical exercise. This study was carried out between November, 1999 and March, 2000. The study groups were divided into 3 groups; exercise training group (n=16), self efficacy group (n=18) and control group (n=22). The exercise training group received self efficacy promotion and exercise training program for 12 weeks. The self efficacy group received self efficacy promotion education, but no exercise training was given. The control group was not offered any education. The anxiety, depression and quality of life were evaluated 3 times, before the experiment, after 8 weeks and after 12 weeks. The data were analyzed with mean, standard deviation, Chi-square test, ANOVA and $Scheff\acute{e}$ test. The results were as follows: 1. After the experiment, anxiety and depression scores of the exercise training group and self efficacy group were more significantly decreased than those of the control group (p=.05). 2. After the experiment, the quality of life score of the exercise training group and self efficacy group were more significantly increased than those of the control group (p=.05). This study showed that the Self Efficacy and Exercise Training Programs were effective. Therefore, it is expected that the Self Efficacy Promotion and Exercise Training Program could be widely applied as an effective independent nursing intervention to decrease anxiety and depression and to increase quality of life for kidney transplant recipients.

• Korean Journal of Animal Reproduction
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• v.21 no.3
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• pp.229-238
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• 1997

Chromosome condensation and swelling of the donor nucleus have been known as the early morphological indicators of chromatin remodelling after injection of a foreign nucleus into an enucleated recipient cytoplasm. The effects of non-preactivation and electrical preactivation of recipient cytoplasm, prior to fusing a donor nucleus, on the profile of nuclear remodelling in the nuclear transplant rabbit embryos were evaluated. The embryos of 16-cell stage were collected and synchronized to G1 phase of 32-cell stage. The recipient cytoplasms were obtained by removing the first polar body and chromosome mass by non-disruptive microsurgical procedure. The separated G1 phase blastomeres of 32-cell stage were injected into non-preactivated recipient cytoplasms. Otherwise, the enucleated recipient cytoplasms were preactivated by electrical stimulation and the separated G1 phase blastomeres of 32-cell stage were injected. After culture until 20h post-hCG injection, the nuclear transplant oocytes were electrofused by electrical stimulation. The nuclei of nuclear transplant embryos fused into non-preactivated and/or preactivated recipient cytoplasm were stained by Hoechst 33342 at 0, 1.5, 2, 4, 6, 8, 10 hrs post-fusion and were observed under an fluorescence microscopy. Accurate measurements of nuclear diameter were revealed with an ocular micrometer at 200$\times$. Upon blastomere fusion into non-preactivated recipient cytoplasm, a prematurely chromosome condensation at 1.5 hrs post-fusion and nuclear swelling at 8 hrs post-fusion were occurred as 91.6% and 86.1%, respectively. But the nuclei of nuclear transplant embryos fused into preactivated recipient cytoplasm, as o, pp.sed to non-preactivated recipient cytoplasm, were not occurred chromosome condensation and extensive nuclear swelling. Nuclear diameter fused into non-preactivated and preactivated recipient cytoplasm at hrs post-fusion was 30.2$\pm$0.74 and 15.2$\pm$1.32${\mu}{\textrm}{m}$, respectively. These results indicated that onset of unclear condensation and swelling which was associated with oocytes activation were critical steps in the process of chromatin swelling. Futhermore, complete reprogramming seemed only possible after remodelling of the donor nucleus by chromosome condensation and nuclear swelling.