BACKGROUND/AIMS: Renal aging-related changes are characterized by oxidative stress. SIRT1 regulates cellular conditions by activating Nrf2. The present study investigated the processes of renal changes by antioxidant enzymes and the relationship between SIRT1 and Nrf2. METHODS: We used male 2-, 12-, and 24-month-old C57BL/6 mice. We measured renal function, histological changes, oxidative stress, and expression of SIRT1–Nrf2 signaling in the kidneys. RESULTS: 24-month-old mice exhibited increased albuminuria and serum creatinine. Creatinine clearance was decreased in 24-month-old mice compared with 12-month-old mice. There were increases in mesangial volume and tubulointerstitial fibrosis in 24-month-old mice. Moreover, oxidative stress marker, 3-Nitrotyrosine, expression and apoptosis were increased in 24-month-old mice. The 24 h urinary 8-isoprostane and 8-hydroxy-deoxyguanosine excretion increased with aging. The levels of expression of SIRT1 and nuclear Nrf2 were decreased in 24-month-old mice. The antioxidant enzymes HO-1 and NQO-1 were down-regulated in 24-month-old mice. Another antioxidant enzyme, SOD2, was decreased in 24-month-old mice. CONCLUSIONS: Our results demonstrated that SIRT1 was down-regulated with aging, and this may be related to changes in the expression of target molecules including Nrf2. As a result, oxidative stress was induced. The pharmacological targeting of these signaling molecules may reduce the pathological changes associated with aging in the kidney.
Aging ; Albuminuria ; Animals ; Apoptosis ; Child, Preschool ; Creatinine ; Fibrosis ; Humans ; Infant ; Kidney* ; Male ; Mice ; NF-E2-Related Factor 2 ; Oxidative Stress ; Sirtuin 1

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Kidney*

BACKGROUND/AIMS: Patients who undergo repeat kidney transplantations (KTs) are considered at high risk for experiencing immunologic and non-immunologic complications. In this study, we investigated the clinical outcomes, including medical and surgical complications, of patients who underwent a third KT at our center. METHODS: Between March 1969 and December 2012, a total of 2,110 KTs were performed at the Seoul St. Mary's Hospital. Of them, we examined 11 patients who underwent a third KT, and investigated the allograft outcomes and complication rates. RESULTS: The mean follow-up duration after KT was 72.4 ± 78.3 months. The mean age at KT was 38.2 ± 8.0 years, and seven patients (63.6%) were males. Nine patients (81.8%) underwent living-donor KT. A cross-match test yielded positive results in four of the nine patients, and all underwent pretransplant desensitization therapy. After KT, three patients (27.2%) showed delayed graft function. Acute rejection developed in four patients (36.4%), and surgical complications that required surgical correction occurred in three patients. Allograft failure developed due to acute rejection (n = 3) or chronic rejection (n = 1) in four patients. Allograft survival rates at 1, 5, and 10 years were 81.8%, 42.9%, and 42.9%, respectively; however, the allograft survival rate at 5 years was > 80% in patients who underwent KT only after results of the panel reactive antibody test became available. CONCLUSIONS: Thus, a third KT procedure may be acceptable, although aggressive pretransplant immune monitoring and patient selection may be required to reduce the risks of acute rejection and surgical complications.
Acute Disease ; Adult ; Allografts ; Chronic Disease ; Delayed Graft Function/diagnosis/*etiology/therapy ; Female ; Graft Rejection/diagnosis/*immunology/therapy ; Graft Survival ; *Histocompatibility ; Humans ; Immunosuppressive Agents/therapeutic use ; Kidney Transplantation/*adverse effects ; Male ; Middle Aged ; Patient Selection ; Reoperation ; Republic of Korea ; Risk Assessment ; Risk Factors ; Time Factors ; Treatment Outcome

PURPOSE: This study was done to examine the effects of aroma hand massage on stress response and sleep in hospitalized elderly patients. METHODS: A non-equivalent pre-and post-test design was used. Sixty-six hospitalized patients were recruited using a convenience sampling method and assigned to the experimental (n=34) or the control group (n=32). For the experiment, bergamot, lavender, and roman camomile oil were mixed in 2:1:1 ratio to provide aroma hand massage to both hands of each patient in the experimental group for 5 minutes per hand, for 3 days. Post-test data collection was conducted three days after completion of the hand massage. RESULTS: The experimental group had significantly lower stress score (t=-2.648, p=.010, and anxiety scores (t=-4.166, p=.000), and higher sleep measurement scores (t=2.328, p=.023) than those in the control group. CONCLUSION: These results indicate that short-term application of aroma hand massage for hospitalized elderly patients has a positive effect on hospitalization stress, anxiety, and sleep. Therefore, aroma hand massage should be applied as a nursing intervention to reduce stress response and enhance sleep in elderly hospitalized patients.
Aged ; Anxiety ; Aromatherapy ; Chamaemelum ; Data Collection ; Hand ; Hospitalization ; Humans ; Inpatients ; Lavandula ; Massage

PURPOSE: The purpose of this study was to identify differences between intake and output balance and body weight changes and to identify factors related to differences in critically ill patients. METHODS: The participants for this descriptive correlational study were 65 medical surgical ICU patients. The data were collected from patient medical records. RESULTS: Mean age of the patients was 63.80 years (+/-15.21). Body weight changes for 48 hours averaged 281.54g (+/-2210.48). I&O balance for 48 hours corrected for insensible loss averaged 398.1mL. Differences ranged from 45mL to 7,535mL. In the distribution of absolute difference between body weight change and intake and output balance, only 40% of the patients were within less than 1,000mL. Factors relating to accurate measure of intake and output were ventilation methods, respiration patterns, and edema status. CONCLUSION: Although mean values of weight change and I&O balance for all patients were very close, the range of differences was very wide indicating that, for many patients, intake and output is not an appropriate indicator of body fluid balance. Therefore, because of the frequency fever and/or hyperventilation, nurses need to use caution when using intake and output balance only to estimate current body fluid status for critically ill patients.
Body Fluids ; Body Weight ; Body Weight Changes ; Critical Illness ; Edema ; Fever ; Humans ; Hyperventilation ; Critical Care ; Intensive Care Units ; Respiration ; Ventilation ; Water-Electrolyte Balance

Calcineurin (CaN) is activated in diabetes and plays a role in glomerular hypertrophy and extracellular matrix (ECM) accumulation. Here, kidneys from diabetic model mice were investigated for the expression of the regulator of CaN 1 (RCAN1) isoform 4 (RCAN1.4) which had been shown to be transcriptionally upregulated by CaN activation. We found the increased immunoreactivity for RCAN1 in the glomerular cells of db/db mice and streptozotocin-induced diabetic mice. In concordance, the expression of RCAN1 protein and RCAN1.4 mRNA were elevated in the whole kidney sample from db/db mice. Interleukin-1beta (IL-1beta), tumor necrosis factor-alpha, and glycated albumin (AGE-BSA) were identified as inducers of RCAN1.4 in mesangial cells. Pretreatment of cyclosporine A blocked the increases of RCAN1.4 stimulated by IL-1beta or AGE-BSA, suggesting that activation of CaN is required for the RCAN1.4 induction. Stable transfection of RCAN1.4 in Mes-13 mesangial cells upregulated several factors relevant to ECM production and degradation. These results suggested that RCAN1.4 might act as a link between CaN activation and ECM turnover in diabetic nephropathy.
Aluminum Hydroxide ; Animals ; Calcineurin ; Carbonates ; Cyclosporine ; Diabetic Nephropathies ; Extracellular Matrix ; Glycosylation End Products, Advanced ; Hypertrophy ; Interleukin-1beta ; Kidney ; Mesangial Cells ; Mice ; RNA, Messenger ; Serum Albumin ; Serum Albumin, Bovine ; Transfection ; Tumor Necrosis Factor-alpha

BACKGROUND/AIMS: Kidney transplantations at our center rely mainly on living donors. The purpose of this study was to suggest future donor supply directions by reviewing changing trends in donor type. METHODS: During the past 40 years, 1,690 kidney transplantations were performed at our center. We divided the follow-up period into four decades and the donor population into three groups: living related, living unrelated, and deceased. We analyzed changing trends in donors from each group for each decade. Patients receiving overseas transplantation were also included. RESULTS: The proportion of living related donors decreased from 84% (54/64) in the 1970s to 61% (281/458) in the 2000s. Living unrelated donors showed a sustained proportion of around 20% after 1990. However, among living unrelated donors, the proportion of spouse donors increased from 4.6% (17/369) in the 1980s to 8.5% (39/458) in the 2000s. Transplants from deceased donors were only 3.3% (12/369) in the 1980s. However the proportion of deceased donors increased gradually, reaching 13.2% (105/799) in the 1990s and 19.9% (91/458) after 2000. Overseas transplantations increased after 2000 and reached 20% of all cases treated in our center during the 2000s. Such transplantations peaked in 2006 and decreased markedly thereafter. CONCLUSIONS: The proportion of each donor type has continuously changed, and the changes were associated with changes in the social structure and system. We expect that this study could be an important reference for other countries to estimate future changes of donor type.
Adult ; Female ; History, 20th Century ; History, 21st Century ; Humans ; Kidney Transplantation/*history/statistics & numerical data/trends ; Korea ; Living Donors/history/statistics & numerical data ; Male ; Middle Aged ; Tissue Donors/*history/statistics & numerical data ; Tissue and Organ Procurement/history/statistics & numerical data/trends

PURPOSE: This study was to examine the change of stress and nursing needs in preterm labor women after hospitalization. METHOD: Forty seven women with preterm labor who were admitted in two university hospitals participated in the survey and they were completed the questionnaires on admission day and 5thday after admission. Questionnaires included in modified Antepartum Hospital Stressor Inventory (AHSI) and Nursing Needs for Preterm Labor. The collected data were analyzed by paired t-test and Pearson correlation test. RESULT: The stress level was not decreased significantly after hospitalization. Among them, the stresses about fetus and medical staff were decreased significantly after hospitalization, but those about pregnant women, husband and environment were increased significantly after hospitalization. The difference in the level of nursing needs between the two different days was not significant except the physical needs. The total level of stress and nursing needs were correlated significantly on the 5th day after hospitalization. CONCLUSION: These results indicate that stress and nursing needs of preterm labor women undergo changes after hospitalization. Therefore, development of the program being followed by stressors which change from day to day and further studies are required in order to examine the decreasing of the stress.
Female ; Fetus ; Hospitalization ; Hospitals, University ; Humans ; Medical Staff ; Obstetric Labor, Premature ; Pregnancy ; Pregnant Women ; Surveys and Questionnaires ; Spouses

PURPOSE: This study was conducted to analyze the factors that influence the life satisfaction of the elderly according to their cognitive impairment level. METHODS: This study was conducted by dividing 3,012 elderly residents of a regional community into three groups based on the scores of the Korean version of the Mini-Mental State Examination: a normal group without any cognitive impairment, a suspicious group with a mild level of cognitive impairment, and a high risk group with a high level of cognitive impairment. Researchers made phone calls, house calls, and personal visits to health centers and shelters for the elderly to gather the information required for this study. RESULTS: The results of this study revealed that social relationships, depression, and activities of daily living had a significant impact on life satisfaction for the normal group, while social relationships and depression had a high impact on life satisfaction for the suspicious group, and social relationships had high impact on the life satisfaction of the high risk group. CONCLUSION: Based on the results of this study, we suggest that programs that promote development of the social relationship networks of the elderly should be established to promote their life satisfaction.
Activities of Daily Living ; Aged ; Aged, 80 and over ; Cognition Disorders/*psychology ; Demography ; Depression ; Female ; Humans ; Interviews as Topic ; Male ; *Personal Satisfaction ; *Quality of Life ; Risk Factors ; Social Support

PURPOSE: The purpose of this study was to develop visions of nursing service, nursing strategies and key performance indicators (KPIs) for an intensive care unit (ICU) based on a Balanced Scorecard (BSC). METHODS: This study was undertaken by using methodological research. The development process consisted of four phases; the first phase was to develop the vision of nursing in ICUs. The second phase was to develop strategies according to 4 perspectives of a BSC. The third phase was to develop KPIs according to the 4 perspectives of BSC and the final phase was to combine the nursing visions, strategies and KPIs of ICUs. RESULTS: Two main visions of nursing service for ICUs were established. These were 'realization of harmonized professional nursing with human respect' and 'recovery of health through specialized nursing' respectively. In order to reach the aim of developing nursing visions, thirteen practical strategies and nineteen KPIs were developed by four perspectives of the BSC. CONCLUSION: The results will be used as objective fundamental data to attain business outcomes for the achievement of nursing visions and strategies of ICUs.
Adult ; *Employee Performance Appraisal ; Female ; Humans ; *Intensive Care Units ; Interviews as Topic ; Middle Aged ; Models, Nursing ; Nurse Administrators/*organization & administration ; Nursing Process/*standards ; Program Development ; Quality Indicators, Health Care ; Questionnaires