BACKGROUND: The purpose of this study was to evaluate the factors influencing quality of life (QOL) in liver transplant recipients. METHODS: The subjects of this study were 103 liver recipients who received their follow-up more than 3 months after liver transplantation at one general hospital in Seoul. A questionnaire survey was perfomed from September 1, 2012 to September 30, 2012. QOL and factors were evaluated using SF-36, Transplant Symptom Distress Scale and Multidimensional Scale of Perceived Social Support. RESULTS: Symptom distress, work change after transplant, duration after transplant were significant factors influencing QOL (Cum R2=0.39, F=19.34, P<0.001). Symptom distress was the most important factors related QOL. There were significant differences in QOL according to general characteristics such as education (t=2.16, P=0.033), work change after transplant (t=3.67, P=0.000), duration after transplant (t=2.25, P=0.027), and economic status (t=3.08, P=0.027). CONCLUSIONS: In conclusion, symptom distress had an influence on the QOL of liver transplant recipients. Thus, it is necessary to develop interventions for symptom distress to improve the QOL of liver transplant recipients.
Follow-Up Studies ; Hospitals, General ; Liver ; Liver Transplantation ; Quality of Life ; Surveys and Questionnaires ; Transplants

PURPOSE: We designed this study to identify the risk factors affecting the quality of graft after live donor kidney transplantation. METHODS: The study cohort included 259 adult patients who had been followed up for an average of 37 months after transplantation. Cyclosporine (CsA) and steroids were used as main immunosuppressive agents. Seven variables [HLA match, numbers of acute rejection (AR) within post-transplant 1 year, blood type compatibility, use of anti-lymphocyte antibody, age of donor (DA), age of recipient, and the donor kidney weight to recipient body weight ratio (KW/BW)] were examined by multiple regression analysis during the first 3 years. Serum creatinine (Scr), creatinine clearance rate (Ccr) and the 24 hours urinary excretion of protein (24 UP) were used as parameters. RESULTS: AR, DA, or KW/BW independently affected the quality of graft function. Scr, Ccr, or 24 UP at post-transplant 1 year was strongly correlated with AR (p<0.0001, p=0.002, or p=0.002, respectively). However, Scr, Ccr, or 24 UP at post-transplant 3 years was strongly affected by KW/BW (p<0.0001, p<0.0001, or p=0.008, respectively) or DA (p<0.0001, p=0.001, or p=0.039, respectively). CONCLUSION: Non-immunologic factors independently affected the graft function through the study periods. The impact of non-immunologic factors on the function of the graft increased year by year. During renal allocation, KW/BW and DA should be included as reference indices to improve the long-term graft function.
Adult ; Body Weight ; Cohort Studies ; Creatinine ; Cyclosporine ; Humans ; Immunosuppressive Agents ; Kidney Transplantation* ; Kidney* ; Risk Factors ; Steroids ; Tissue Donors* ; Transplants*

The purpose of this study was to analyze the statistical errors of articles in the Journal of Korean Academy of Periodontology from 1973 to 1999. Of the 662 articles examined, 263 were included which analyzed the data. They were classified into 2 groups with time lapse; group 1: 1973~1989, group 2: 1990~1999. Authors made checklists for analyzing the data and detecting the errors and analyzed them with professional statistician. The results were as follows: 1. Of 263 atricles which applied statistical method, 40(19.3%) was in group 1, 223(49.0%) in group2. 2. In the number of statistical method applied, 170(64.6%) were analyzed with 1 statistical method, 73(27.8%) with 2 methods, 18(6.8%) with 3 methods, and 2(0.8%) with 4 methods 3. The number of statistical methods applied was 14, and they were applied in order of 119 of ANOVA, 72 of Student t-test, 63 of Paired t-test, 36 of CORRELATION, and 21 of Mann-Whitney U test. 4. In 87(33.1%) of 263 articles and in 18 error items, statistical errors were found out. In group I, 9 items (55%) of error were found out, and were in order of 5 of Student t-test instead of Paired t-test, and 4 of unnecessary statistical analysis. In group II, 16 items (29.1%) of error were found out, and were in order of 22 of Student t-test instead of Paired t-test, 7 of no multiple comparison test after ANOVA, 6 of Student t-test instead of ANOVA, 6 of unnecessary statistical analysis, and 5 of ANOVA instead of Paired t-test. In conclusion, the results noted that statistical analyses were increased, but statistical errors were decreased with time. But authors suggest that researchers should refer to standard statistical texts and seek advice from professional statisticians to avoid the statistical errors.
Checklist ; Humans

BACKGROUND: Although renal transplantation is known as the best treatment for patients with end-stage renal disease, there are few of literature to identify economic evaluation of renal replacement therapies in Korea. This study was conducted to determine the cost-effectiveness of renal replacement treatments, particularly renal transplantation and hemodialysis. METHODS: We used the quality adjusted life year (QALY) calculated from survey data, which was collected from 124 patients who underwent kidney transplantation and 90 patients who were receiving hemodialysis. Medical costs were collected from five hospitals in Korea. The ERA-EDTA registry data (European Renal Association-European Dialysis and Transplant Association) were used for transition probability. A Markov model was used for predicting the cost-utility of transplantation and hemodialysis over the 10-year period. RESULTS: Renal transplantation offers lower cost and better outcome compared to hemodialysis. QALY per year of transplantation patients is higher than that of hemodialysis patients (transplantation 0.9465 vs. hemodialysis 0.8297). Cost per QALY gained is 15,566,000 won in transplantation patients whereas 32,765,000 won per QALY gained in hemodialysis patients was required. CONCLUSIONS: Although cost of first year after transplantation was expensive, over 2 years, transplantation was more effective and less costly than hemodialysis. The results suggest that transplantation is more cost-effective than hemodialysis in Korea.
Cost-Benefit Analysis ; Dialysis ; Humans ; Kidney Failure, Chronic* ; Kidney Transplantation* ; Korea ; Quality of Life* ; Quality-Adjusted Life Years ; Renal Dialysis* ; Renal Replacement Therapy

The purpose of the study was to examine the current status of nutritional management at elderly nursing homes. A survey was performed of 83 nursing homes from January 5, 2011 to January 21, 2011 via mail. A total of 34 nursing homes responded to the survey and 149 elderly subjects were analyzed according to the presence of a dietitian. Among the 34 nursing homes, 70.6% had a dietitian on duty. All of the facilities with a dietitian had the dietitian making the meal plan, whereas 70% of the facilities without dietitian served meals planned by a non-professional person. Overall, however, a low proportion of nursing homes implemented dietetic treatments for residents with diseases. For the nutritional assessment of these residents, a mini nutritional assessment (MNA) was performed. MNA scores were significantly associated with body mass index (BMI), mid-arm circumference (MAC), calf circumference (CC), ingestion problems, and weight loss during the last 3 months (P<0.001). Among the elderly studied, 5.4% were malnourished, and 36.9% were at risk for malnutrition by MNA score. The results of this survey show that the current management of nutrition at nursing homes is insufficient because the elderly who needed dietetic treatment did not receive proper care. Dietetic management is the most important service in all nursing homes. Therefore, to improve the nutritional status of elderly residents in nursing homes, systematic nutrition management by nutrition experts should be implemented.
Aged* ; Body Mass Index ; Eating ; Humans ; Insurance, Long-Term Care ; Malnutrition ; Meals ; Nursing Homes* ; Nursing* ; Nutrition Assessment ; Nutritional Status ; Postal Service ; Weight Loss

The evaluation of a patient referred for kidney transplantation is divided into 3 phases. First, a through evaluation is carried out, both to identify risk factors for undergoing transplantation. Second, a surgical evaluation is carried out to look for signs of vascular disease and urological abnormalities, and finally an immunologic evaluation is initiated to assess the patient's blood and HLA types. In patients with chest pain, chronic heart failure, or abnormal EEG, non-invasive cardiac test, when necessary followed by coronary angiography, is indicated. Patients with significant narrowing of the major coronary vessels should undergo percutaneous angioplasty or bypass grafting before transplantation. In diabetic patients over the age of 45, coronary artery disease is a common occurrence even in the absence of symptoms or clinical signs. Non-invasive cardiac evaluation during exercise should be performed routinely. The decision to perform a renal transplantation in a patient who has previously been treated for a malignancy is not an easy one. A waiting period of 2 years seems justified for most neoplasm. A waiting time of more than 2 years is required in malignant melanoma, breast carcinoma, or colorectal carcinomas. The advantages of immediate function after kidney transplantation include a higher long-term success rate, the ability to use potentially nephrotoxic immunosuppressive agents at an earlier time, shortened hospitalization and cost of the procedure as well as the avoidance of post-operative dialysis. Deliberate hydration of the patients during surgery is carried out in order to reduce the risk of acute tubular necrosis. This can be done with either crystalloid or colloid solution. The amount of intravenous solution depends on the patient's hydration status at the start of the procedure and CVP reading during the operation. Close monitoring of urine output is maintained in the early post-operative period. Intravenous hydration is maintained to keep up with the post-operative diuresis. Hypertension is very common in the post-operative period and must be controlled to reduce the risk of post-operative bleeding. If the patient is oliguric in the immediate post-operative period, an attempt at deliberate hydration is employed, however, if the oliguria persists, such hydration must be abandoned in order to avoid pulmonary edema. Dialysis will be required if the kidney does not function adequately. The price a transplant recipient pays for effective immunosuppression is an increased risk of developing infectious complications. Empirical administration of antibiotics, anti-viral agents, or anti-fungal agents in clinically declining patients is justified.
Angioplasty ; Anti-Bacterial Agents ; Breast Neoplasms ; Chest Pain ; Colloids ; Colorectal Neoplasms ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels ; Dialysis ; Diuresis ; Electroencephalography ; Heart Failure ; Hemorrhage ; Hospitalization ; Humans ; Hypertension ; Immunosuppression ; Immunosuppressive Agents ; Kidney Transplantation* ; Kidney* ; Melanoma ; Necrosis ; Oliguria ; Perioperative Care* ; Pulmonary Edema ; Risk Factors ; Transplantation ; Transplants ; Vascular Diseases

Background: The scuticociliate Miamiensis avidus is a major pathogenic agent that causes significant economic losses in the flounder aquaculture industry. Many different types of drugs are being tested to control this disease, including mebendazole, which is a broad-spectrum antiprotozoal agent. The purpose of this study was to determine whether mebendazole worked in vitro against M. avidus and to explore its mechanism of action. Methods: Transcriptome and gene ontology analyses were conducted to investigate the specifically expressed gene profile. We confirmed the cytotoxic effect of mebendazole against M. avidus when it was applied intermittently for a total of three times. We also identified differentially expressed genes using transcriptome analysis. Results: Most of the upregulated genes were membrane transport-related genes, including Na+/K+-ATPase. Most of the downregulated genes were categorized into three groups: tubulin-related, metabolism-related, and transport-related genes. The expression levels of glucose uptake-related genes decreased due to the inhibition of tubulin polymerization, but this was not statistically significant. Conclusions Our results demonstrate that intermittent treatment with mebendazole has a significant cytotoxic effect on M. avidus. Furthermore, mebendazole induces downregulation of the tubulin-alpha chain and metabolism-related genes. It is presumed that this leads to a glucose shortage and the death of M. avidus. Transcriptome analysis will provide useful clues for further studies on mebendazole applications for scutica control.

PURPOSE: We investigated the change of bone mineral density (BMD) one year after renal transplantation, and examined the risk factors that affect the BMD by performing the dual energy X-ray absorptiometry in Korean adults renal transplants. METHODS: The results of pre-transplant and post-transplant BMD of 99 patients were analyzed in respect to sex, age, method and duration of dialysis before transplantation, immunosuppressive methods, history of previous graft and episode of acute rejection. Alfacalcidol or biphosphonate was not used postoperatively. Data were expressed as T-score and calculated percentage. Uni-variate analysis, T-test and ANOVA were used for the statistical analysis. P values less than 0.05 were considered significant. RESULTS: There were 66 male and 33 female patients. Change of T-score (and percentage) of lumbar vertebra and average of femur area in male were -0.353 (-2.3%) and -0.059 (-1.2%), respectively. Those of female patients were -0.483 (-5.2%) and 0.115 (-1.7%), respectively. The significant loss of BMD in the female lumbar spine was evident. Patients in 20's showed the largest loss of BMD [lumbar spine: -0.739 (-2.3%), femur: -0.206 (-3.1%), compared to other age groups. There were no significant differences by the mode and duration of dialysis, presence of diabetes, degree of HLA matching, history of previous graft, immunosuppression methods, and number of acute rejection episode. However we could accept the positive trend of BMD loss related to the kind of immunosuppression methods and number of acute rejection. CONCLUSION: There was significantly different loss of BMD after renal transplantation by the age and sex of the recipients. Although statistically not significant, kinds of immunosuppression and episode of acute rejection are likely to affect the BMD loss one year after renal transplantation.
Absorptiometry, Photon ; Adult ; Bone Density* ; Dialysis ; Female ; Femur ; Humans ; Immunosuppression ; Kidney Transplantation* ; Male ; Risk Factors* ; Spine ; Transplants

PURPOSE: Occurrence of renal failure and its related complications such as hypertension are long-term problems after donor nephrectomy for living donor kidney transplantation. We retrospectively reviewed renal function of unilateral kidney donor. METHODS: From 669 living donors for kidney transplantation from December 1998 to October 2006, laboratory data related to renal function are collected from hospital medical record retrospectively in 251 (37.5%) donors who were followed-up after discharge. The selection criteria of donors were: 1) pre-nephrectomy serum creatinine level below 1.5 mg/dL, 2) no radiologic abnormality in bilateral kidney. The donor nephrectomy was performed by conventional open nephrectomy or video assisted minilaparotomy surgery. The estimated glomerular filtration rate (e-GFR) by Modification of Diet in Renal Disease (MDRD) study was used as renal function monitoring parameter. RESULTS: In immediate post-nephrectomy period, e-GFR was decreased to 67.8+/-4.6% of pre-nephrectomy level (93.8+/-9.9 mL/min/1.73 m2). The urinary protein excretion for 24 hours was increased to 255% of pre-nephrectomy level (76.4+/-4.6 mg/day), but cases with proteinuria more than 300 mg per day were only 4 cases (1.7%, 4/251). After 14.0+/-5.2 months follow-up (range: 1~80 months), two cases (0.8%, 2/251) of renal failure (chronic kidney disease stage 5) were found. Relative renal function (post-nephrectomy e-GFR ratio versus pre-nephrectomy e-GFR, %) was increased by post-nephrectomy duration. The mean scores of e-GFR ratio within post-nephrectomy 2 months, 3~11 months, 12~23 months and after 24 months were 64.8+/-10.4%, 66.4+/-9.7%, 69.5+/-10.9% and 75.8+/-17.6% respectively. The relative e-GFR ratio after 24 months was significantly different from those of within 24 months (P<0.0001 by ANOVA). In linear regression analysis, mean increment of e-GFR ratio per post-nephrectomy year was 2.88%. CONCLUSION: In spite of possibility of renal failure, our study shows the long-term compensation of residual renal function after nephrectomy.
Compensation and Redress ; Creatinine ; Diet ; Follow-Up Studies ; Glomerular Filtration Rate ; Humans ; Hypertension ; Kidney Diseases ; Kidney Transplantation* ; Kidney* ; Laparotomy ; Linear Models ; Living Donors ; Medical Records ; Nephrectomy* ; Patient Selection ; Proteinuria ; Renal Insufficiency ; Retrospective Studies ; Tissue Donors*

PURPOSE: Serum level of soluble form CD30 (sCD30), a marker for T helper 2-type cytokine-producing T cells, is used as a marker of immunologic status of pre-transplant recipient that can predict graft rejection and graft survival. This study compared pre-transplant serum sCD30 levels with conventional pre-transplant immunologic parameter, such as panel- reactive antibodies (PRA) and lymphocyte cross matching (LCM). METHODS: Adult seventy two patients were enrolled this study. The blood for tests was sampled simultaneously. Measurement of serum sCD30 level was performed using enzyme-linked immunosorbent assay kit (Bender MedSystems, Co. CA, USA). We tested PRA using a commercial ELISA kit (Lambda Cell Tray Lymphocytotoxicity assay)(One Lambda Inc. CA, USA). We established LCM tests for T cells by Modified NIH (National institute center of health)/Johnson's Method/AHG (Anti human globulin), and for B cells by warm test. RESULTS: Mean score of sCD30 was 90.3+/-6.4 U/mL, ranged from 12.2 to 244.4 U/mL. There was no significant correlation between patient's age or sex and sCD30 level. The correlation between sCD30 and mode or duration of dialysis was not statistically significant clinical situation. The result of LCM didn't show significant correlation with sCD30 level (87.3+/-55.7 U/mL in LCM positive group versus 91.9+/-1.3 U/mL in LCM negative group, P=0.696). And sCD30 level equal to or more than 86 U/mL could not predict the positive result of LCM. The positive and negative predictive value of sCD30 to LCM was merely 27.8% and 58.3% (P=0.322). Also the correlation between sCD30 level and PRA was not significant (P=1.0). CONCLUCION: There was no significant correlation between serum sCD30 level and conventional immunologic parameter such as PRA or LCM. That means the pre-transplant monitoring of the sCD30 level can be used as an independent immunologic parameter.
Adult ; Antibodies* ; B-Lymphocytes ; Dialysis ; Enzyme-Linked Immunosorbent Assay ; Graft Rejection ; Graft Survival ; Humans ; Lymphocytes* ; T-Lymphocytes