[Adaptation Experience of Living Kidney Donors after Donation].

PURPOSE: This study was done to explore adaptation experience of living kidney donors after donation. Specific aims were to identify challenges donors face in the process of adaptation following surgery and how they interact with recipients and other people. METHODS: Grounded theory methodology was utilized. Participants were 13 living kidney donors at six months or more after donation. Data were collected by in-depth interviews with individual participants. Data were analyzed using constants comparative method with theoretical saturation. RESULTS: A core category emerged as 'keeping the fences of my family in spite of vulnerability'. The adaptation process after donation was manifested in four phases: exploration, balance, maintenance, and acclimatization. Phenomenon was perception of vulnerability. Strategies to manage the vulnerability were assessing changes of body awareness, tailoring regimen to one's own body condition, coping with health problems, keeping restoration of health, and ruminating on the meaning of one's kidney donation. Consequences were reestablishing family well-being, realizing the values of one's kidney donation, and living with uncertainty. CONCLUSION: Findings of the study indicate that there is a need for health professionals to understand the vulnerability of living kidney donors and help their family system maintain a healthy and productive life. The results of this study can be used to develop phase-specific, patient-centered, and tailored interventions for living kidney donors.

Efficacy of real-time polymerase chain reaction for rapid diagnosis of endobronchial tuberculosis.

OBJECTIVES: The definitive diagnosis of endobronchial tuberculosis (EBTB) is challenging because the disease manifests in various non-specific ways, and acid-fast bacilli (AFB) are often undetectable by sputum smear. The objective of this study was to evaluate the efficacy of real-time PCR of bronchoscopic biopsy specimens for the diagnosis of EBTB. METHODS: Real-time PCR amplification of Mycobacterium tuberculosis DNA in biopsy tissue from EBTB patients was performed prospectively. Diagnostic yields were compared for real-time PCR and for auramine O-stained sputum smears and bronchial brush smears. Whether diagnostic yield depended on bronchoscopic subtype of EBTB was also evaluated. RESULTS: Diagnostic yields were 4.1% (3/74) for sputum smear, 39.2% (29/74) for bronchial brush smear, and 89.2% (66/74) for real-time PCR. Real-time PCR melting curve analysis showed significantly higher yields than did AFB staining of bronchial brush smears for granular and caseating EBTB (p<0.01). CONCLUSIONS: Real-time PCR detection of M. tuberculosis DNA in EBTB biopsy tissue is more sensitive than sputum smear and bronchial brush smear, including at early disease stages. This PCR method may be a useful adjunct to culture- and smear-based techniques to allow more rapid EBTB diagnosis and timelier treatment.