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

Oxidative stress plays various roles in the development and progression of IgA nephropathy, while bilirubin is known as a potent antioxidant. We therefore hypothesized that serum bilirubin would be associated with renal prognosis in IgA nephropathy. The study subjects comprised 1,458 adult patients with primary IgA nephropathy in Korea. We grouped patients according to the following quartile levels of bilirubin: <0.4 mg/dL (Q1), 0.4-0.5 mg/dL (Q2), 0.6-0.7 mg/dL (Q3), and >0.8 mg/dL (Q4). The outcome data were obtained from the Korean Registry of end-stage renal disease (ESRD). Eighty patients (5.5%) contracted ESRD during a mean follow-up period of 44.9 months. The ESRD incidences were 10.7% in Q1, 8.2% in Q2, 2.8% in Q3, and 2.8% in Q4 (p<0.001). The relative risk of ESRD compared to that in Q1 was 0.307 (95% confidence interval [CI], 0.126-0.751) in Q3 and 0.315 (95% CI, 0.130-0.765) in Q4. The differences of ESRD incidence were greater in subgroups of males and of patients aged 35 yr or more, with serum albumin 4.0 g/dL or more, with normotension, with eGFR 60 mL/min/1.73 m2 or more, and with proteinuria less then 3+ by dipstick test. In conclusion, higher bilirubin level was negatively associated with ESRD incidence in IgA nephropathy.
Adult ; Bilirubin/*blood ; Disease Progression ; Female ; Glomerular Filtration Rate ; Glomerulonephritis, IGA/*blood/complications ; Humans ; Hypertension/complications ; Incidence ; Kidney Failure, Chronic/*blood/complications ; Male ; Middle Aged ; Risk ; Risk Factors ; Treatment Outcome

The purpose of this study was to evaluate the viability of periodontal ligament cell in rat teeth using slow cryopreservation method with magnetic field through MTT assay and TUNEL test. For each group, 12 teeth of 4 weeks old white female Sprague-Dawley rat were used for MTT assay, and 6 teeth in TUNEL test. The Maxillary left and right, first and second molars were extracted as atraumatically as possible under tiletamine anesthesia. The experimental groups were group1 (immediately extraction), group 2 (cold preservation at 4degrees C for 1 week), group 3 (rapid cryopreservation in liquid nitrogen), group 4 (slow cryopreservation with magnetic field of 1 G), and group 5 (slow cryopreservation). F medium was used as preservation medium and 10% DMSO as cryoprotectant. After preservation and thawing, the MTT assay and TUNEL test were processed. One way ANOVA and Scheffe method were performed at the 95% level of confidence. The value of optical density obtained after MTT analysis was divided by the value of eosin staining for tissue volume standardization. In both MTT assay and TUNEL test, it had showed no significant difference among group 3, 4, and 5. And group 3 had showed higher viability of periodontal ligament cell than group 2. From this study, slow cryopreservation method with magnetic field can be used as one of cryopreservation methods.
Anesthesia ; Animals ; Cryopreservation ; Dimethyl Sulfoxide ; Eosine Yellowish-(YS) ; Female ; Humans ; In Situ Nick-End Labeling ; Magnetic Fields ; Magnetics ; Magnets ; Molar ; Periodontal Ligament ; Rats ; Tiletamine ; Tooth

PURPOSE: The purpose of this study were to investigate the self-reported quality of life and family burden and to examine the factors associated with the quality of life in patients with cancer. METHODS: 216 patients participated in the cross-sectional study. The European Group of Research and Treatment of Cancer Quality of life Questionnaire (EORTC QLQ-C30) and the Family Burden Scale were sent by mail to 2,000 cancer patients. Two hundred and sixteen patients answered the questionnaire. The stepwise multiple regression was conducted to analyze predictors of overall quality of life. RESULTS: All subscales of EORTC QLQ-C30 were significantly correlated with family burden. The regression analysis of patients with cancer revealed some variables as significant predictors; performance, perceived severity, family burden, time since diagnosis, and sex. CONCLUSION: The results offer a number of recommendations for future research and nursing practice focused on primary care for patients with cancer and their family for improving quality of life.
Cross-Sectional Studies ; Diagnosis ; Humans ; Nursing ; Postal Service ; Primary Health Care ; Quality of Life* ; Surveys and Questionnaires

PURPOSE: To evaluate the results of five-pin external fixation, with the fifth pin stabilizing the distal radius articular fragment, for unstable distal radial fractures. MATERIALS AND METHODS: Twenty cases of unstable distal radial fractures were treated with five-pin external fixation (5-pin group). The fifth pin was inserted into the distal articular fragment and attached to the external fixation frame. Metacarpal pins were removed at sixth week in 12 cases and at third in 8 cases, and radial pins were removed at eighth or ninth week. The radiographic results of 5-pin group were compared with those of 20 cases of traditional four-pin external fixation (4-pin group). RESULTS: The postoperative radial inclination was 23.1 degrees in 5-pin group and 22.2 degrees in 4-pin group; while at last follow-up 21.8o and 15.1 degrees respectively. Postoperative volar tilt was 8.5 degrees and 7.3o; while at last follow-up 6.3 degrees and 0.1 degrees respectively. Postoperative radial shortening was 0.3 mm, 0.4 mm; while at last follow-up 1.1 mm and 2.1 mm respectively. In 5-pin group, there were no significant differences in results whether the metacarpal pins were removed at sixth or third week. CONCLUSION: Five-pin external fixation, with the fifth pin stabilizing the distal articular fragment, enhanced early motion of the wrist maintaining fracture stability in unstable fractures of the distal radius.
Follow-Up Studies ; Radius* ; Wrist

PURPOSE: Childhood acute immune thrombocytopenic purpura (ITP) is a benign hematologic disease. Therapy does not affect the natural history of the illness. We evaluated the clinical and laboratory findings, treatment and prognosis of childhood acute ITP in Korea through a retrospective multicenter study. METHODS: We analyzed retrospectively the data of 1, 829 children with acute ITP through survey of 33 hospitals among 43 hospitals in Korea from Sep. 1992 to Aug. 2001. RESULTS: Male to female ratio was 1.3: 1 and the median age at the diagnosis of ITP was 2.9 (0.1 17) years. Median duration of follow up was 6 months. One hundred and forty nine cases of the total 1, 829 patients (8.1%) received no treatment. The initial median platelet count of the non-treated group was 42, 500/mm3. Among the 861 cases who were followed up over 6 months, 315 cases (36.6%) progressed into chronic ITP. Associated with this high rate of chronicity of childhood acute ITP patients in Korea, we must consider the fact that acute ITP patients with fast improvement in the first episode tend not to follow up. Considering that fact, the rate of chronicity becomes 17.2% of the 1, 829 acute ITP patients. The treated group used many kinds of treatment methods. Intravenous immunoglobulins (IVIG) with or without prednisolone (PD) (67.5%) were the most commonly used regimens. In the group treated with IVIG alone, the platelet count began to rise above 50, 000/mm3 at 2.6 days, 100, 000/mm3 at 3.7 days and 150, 000/mm3 at 4.9 days. Four hundred and twenty two cases of the 1, 686 (25.0%) cases followed up after first episode of ITP relapsed. The relapse rate was significantly higher in older patients and in girls than in younger patients and in boys (P< 0.05). The chronicity of ITP statistically increased with age (P< 0.05) and that was the only valuable factor. CONCLUSION: Despite the fact that childhood acute ITP is a pretty common disaese, there is no agreement on the best treatment method for this disease. The establishment of Korean treatment guideline of childhood acute ITP, based on an analysis of multicenters, seems to be needed.
Child ; Diagnosis ; Female ; Follow-Up Studies ; Hematologic Diseases ; Humans ; Immunoglobulins, Intravenous ; Korea* ; Male ; Natural History ; Platelet Count ; Prednisolone ; Prognosis ; Purpura, Thrombocytopenic, Idiopathic* ; Recurrence ; Retrospective Studies

OBJECTIVE: To compare the degree of improvement of conduction block in carpal tunnel syndrome (CTS) between the patients who received operation and those who received conservative treatment. METHOD: Subjects included 33 hands of 27 CTS patients who received operation (operation group) and 20 hands of 17 patients who were managed conservatively (non-operation group). Median antidromic sensory responses were recorded with wrist and palm stimulation. The criterion for conduction block was more than 50% drop of baseline to negative peak amplitude of sensory nerve action potential with wrist stimulation compared to palm stimulation. The degree of conduction block was measured before and aftertreatment, and the improvement of conduction block was compared between the two groups. RESULTS: The degrees of conduction block were 59.9+/-14.3% in operation group and 60.5+/-14.5% in the non-operation group at initial evaluation. The improvements of conduction block were 32.1+/-15.1% (5~58.9%) in operation group and 7.8+/-19.8% (-27.3~36.7%) in non-operation group after treatment and the difference was statistically significant. CONCLUSION: The results suggest that operative treatment may be useful even in patients with carpal tunnel syndrome with conduction block.
Action Potentials ; Carpal Tunnel Syndrome* ; Follow-Up Studies* ; Hand ; Humans ; Wrist

BACKGROUND: To investigate the role of sympathetic nervous system (SNS) in moxibustion-induced immunomodulation, the effects of chemical sympathectomy on moxibustion-induced changes in splenic NK cell cytotoxicity, T and B cell proliferation were studied in Sprague-Dawley male rats. METHODS: Chemical sympathectomy was achieved with intraperitoneal injection of 6-hydroxydopamine 50 mg/kg/day for 3 successive days. Direct moxibustion (6-minute interval, 9 moxa ball, each of which weighing 0.007 g and burning for 40 seconds) was applied on unilateral anterior tibial muscle region where Zusanli (ST36) acupoint is located, once a day for 7 successive days. NK cell cytotoxicity was measured by 4hr-51Cr release assay. Mitogen-induced lymphocyte proliferation was analyzed by [3H]-thymidine incorporation assay. RESULTS: NK cell cytotoxicity was suppressed by moxibustion, more in sympathectomized rats than in vehicle-treated rats. T cell proliferation induced by concanavalin A was not affected by moxibustion. B cell proliferation induced by lipopolysaccharide showed no significant change in vehicle- treated rats, but an increase in sympathectomized rats by moxibustion. Sympathectomy alone induced augmentation of NK cell cytotoxicity and suppression of T cell proliferation. CONCLUSION: These results suggest that SNS has no direct relation with moxibution-induced immunomodulation but has an important role in the mechanism to keep the homeostasis of immune system by tonically inhibiting excessive changes of various immune components.
Acupuncture Points ; Animals ; B-Lymphocytes ; Burns ; Cell Proliferation ; Concanavalin A ; Homeostasis ; Humans ; Immune System ; Immunomodulation* ; Injections, Intraperitoneal ; Killer Cells, Natural ; Lymphocytes ; Male ; Moxibustion ; Muscle, Skeletal ; Oxidopamine ; Rats* ; Rats, Sprague-Dawley ; Spleen* ; Sympathectomy ; Sympathectomy, Chemical* ; Sympathetic Nervous System ; T-Lymphocytes

PURPOSE: Since 2000, the Korea University Medical College has conducted Comprehensive Basic Medical Sciences Examination as a summative test. Summative assessment must be dependable in that it meets the highest standards of reliability and validity. The purpose of this study were to examine the validity and reliability of Comprehensive Basic Medical Sciences Examination and to improve the quality of the examination. METHODS: The subject of this study was the examination materials and scores of the test. We conducted exploratory factor analysis to testify validity. Cronbach alpha coefficient was used to examine the reliability. RESULTS: Only one factor was extracted from exploratory factor analysis. Its eigen value was 4.61 and it explained 65.93% of total variance. We could infer the extracted factor as an ability of basic medical sciences knowledge. The reliability coefficient of the test was ranged from 0.45 to 0.74. Of the total 335 item, overall acceptable items were 206(58.0%); the range of difficulty was 0.21~1.00 and discriminative indices were higher than 0.20. CONCLUSION: We confirmed the Comprehensive Basic Medical Sciences Examination in 2000 met the relative highest standards of reliability and validity. Item analysis could be of help to improve the quality of examination
Korea ; Psychometrics* ; Reproducibility of Results

BACKGROUND: Transforming growth factor (TGF)- has a large variety of biological functions, including the modulation of inflammation and the immune system, and is presumed to play important roles in repairing wounds and reducing scarring. The objective of this study is to examine the effects of TGF-1 on healing wounds and reducing scarring. We have also analysed the ability of the hemagglutinating virus of Japan (HVJ) liposome mediated antisense oligodeoxynucleotides (ODNs) to specifically inhibit wound-induced expressions of TGF-1 proteins and mRNA in the rat skin. METHODS: Skin wounds were created on the backs of 80 anesthetized rats. The first group of wounds, as the controls, was unmanipulated. The second group of wounds, as positive controls or an excessive scarring model, was injected with TGF-1 subcutaneously. The third group of wounds was injected with anti-TGF-1 antibody subcutaneously. The fourth group of wounds was injected with HVJ liposome mediated antisense ODNs for TGF-1 subcutaneously. The wounds of all groups were bisected and analysed histologically 5, 10, 15, 30, and 50 days after the wounds were made. RESULTS: All control wounds (TGF-1 or no injection) healed with scarring, whereas the wounds treated with the antibody or antisense ODNs healed with less scar formation compared to the control group. The wounds treated with the antibody or antisense ODNs had fewer macrophages, less collagen and fibronectin contents than the other wounds. Northern blotting and in situ hybridization analysis showed that wound sites treated with HVJ liposome mediated antisense ODNs for TGF-1 exhibited decreased levels of TGF-1 mRNA after injury. CONCLUSIONS: These findings suggest an important new approach to controlling scarring in normal wound healing, complementing the practice of adding exogenous growth factors to chronic wounds in the attempt to inhibit collagen deposition.
Animals ; Blotting, Northern ; Cicatrix* ; Collagen ; Complement System Proteins ; Fibronectins ; Genetic Therapy* ; Immune System ; In Situ Hybridization ; Inflammation ; Intercellular Signaling Peptides and Proteins ; Liposomes ; Macrophages ; Oligodeoxyribonucleotides ; Oligoribonucleotides ; Rats ; RNA, Messenger ; Sendai virus ; Skin ; Transforming Growth Factor beta ; Transforming Growth Factors ; Wound Healing ; Wounds and Injuries