Clinical application and progress on adult donor dual kidney transplantation / 器官移植

Full application of marginal donor organs is a critical method to expand donor pool and alleviate organ shortage. After accurate donor evaluation, allocation and recipient selection, adult donor dual kidney transplantation (DKT) can not only achieve equivalent clinical efficacy to single kidney transplantation (SKT), but also effectively reduce the discard rate of marginal donor kidney. In this article, the clinical application and progress on adult donor DKT were reviewed from the perspectives of the development situation, allocation standard, recipient selection, surgical methods and complications as well as clinical efficacy of DKT, aiming to provide reference and guidance for subsequent development of marginal donor DKT.

Effects of Nutrition Education Providing School Lunch by Personalized Daily Needed Food Exchange Units for Adolescent Athletes in Jeonbuk Province / 대한지역사회영양학회지

OBJECTIVES: The purpose of this study was to investigate effects of nutrition education providing school lunch by personalized daily needed food exchange units using Food Exchange System for adolescent athletes. METHODS: The subjects were 60 sports high school students (educated group, 30 vs. non-educated group 30). Nutrition education was provided for 4 weeks (40 min/lesson/week). In addition, personalized school lunch was served for 4 weeks, nutrition education period. The personalized lunch were provided Food Exchange Units according to personalized daily needed energy. The lessons were '5 Major nutrients, functions and foods', 'My daily needed energy and food exchange units by Food Exchange System', 'My meal plan by food exchange units according to my daily needed energy' and 'Smart choice of healthy snacks and eating outs'. After nutrition education, we examined the differences in anthropometric characteristics, nutrition knowledge, dietary attitude and dietary intake between the educated and the non-educated group. RESULTS: We observed improvements in lean body mass in the educated group. With regard to nutrition knowledge, there were improvements in 'Functions of vitamins', 'Functions of minerals', 'Foods of fat', 'Foods of vitamin', and 'Foods of mineral' in the educated group. In relation to dietary attitude, there were improvements in 'Taking a meal with family and friend', 'Taking a meal at ease', 'Taking a meal with kimchi and vegetables', 'Taking a meal with three kinds of side dishes', 'Priority of choosing snacks' and 'Type of snacks' in the educated group. With regard to dietary intakes according to Dietary Reference Intakes for Koreans, there were improvements in intakes levels of fiber, vitamin A, vitamin C, folate, calcium, iron and zinc. The index of nutrition quality, as indicated by nutrition adequacy ratio also improved in the educated group. CONCLUSIONS: These results showed that a nutrition education program providing education lessons and personalized school lunch by food exchange units according to daily needed energy showed positive changes in nutrition knowledge, dietary attitude and dietary intake of adolescent athletes. Nutrition education program providing personalized school lunch by Food Exchange Units may improve dietary behaviors and dietary intakes of adolescents.

Validation of the KDRI in Korean Deceased Donor Kidney Transplantation / 대한이식학회지

BACKGROUND: The United Network for Organ Sharing developed the continuous kidney donor risk index (KDRI) for measurement of the spectrum of risk associated with the various factors known to influence graft failure. This study was conducted in order to validate the KDRI in assessment of deceased donor kidney in Koreans. METHODS: Patients (n=404) who underwent kidney transplants performed at five transplantation centers from 2000 to 2010 were studied retrospectively. The distribution of the KDRI of donor kidneys was calculated and the distribution of kidney donors by standard criteria donor (SCD)/expanded criteria donor (ECD) and KDRI was compared. The KDRI were divided into five groups: or =1.4. Graft function and graft survival among KDRI groups were analyzed. RESULTS: The mean KDRI was 1.01 (range, 0.55~1.88). More than 90% of donors had KDRI or =1.4 were ECD. The estimated GFR at one-year in the KDRI groups was 72.2, 65.8, 63.2, 69.1, and 47.1 mg/dL, respectively. Graft function was significantly lower in those with KDRI > or =1.4 (P or =1.4 (P=0.001). CONCLUSIONS: The KDRI is a useful tool for estimation of posttransplant outcomes in the Korean population. The KDRI can be used by physicians as an additional assessment tool to assist in the decision making process regarding donor organ selection.

A Study on the Nutrient Intakes and Zinc Nutritional Status of Preschool Children in Ulsan

The purpose of this study was to determine the zinc status of preschool children in Ulsan. The study was conducted in 95 children aged 3 to 6 years by investigating the anthropometric indices and assessing the biochemical analysis. The blood was analysed to assess serum zinc and alkaline phosphatase. And a questionnaire for dietary intakes using 24-hr recall method were performed by mothers of 95 subjects. The dietary intakes of children were analysed to determine the prevalence of inadequate and excessive intakes of zinc with Dietary Reference Intakes for Koreans (KDRIs). WHL (Weight-Length Index) and Kaup index were used to define obesity. The overall prevalence of overweight and obese subjects were 14.7% and 6.3% by WHL, were 15.8% and 13.7% by Kaup index. The mean intakes of zinc by children aged 3~5y and 6y were 5.5 +/- 1.4 mg/d (75.7% RDA) and 6.7 +/- 2.0 mg/d, respectively, that was the level exceeding the estimated average requirement (EAR) and the recommended intake (RI) of Korean Dietary Reference Intakes. Less than 1.3% and 7.9% of children had usual zinc intakes below EAR and RI of KDRIs, respectively. The percentages of children with intakes exceeding the tolerable upper intake level (UL) were 2.6%. The zinc nutritional status by biological assay was found that mean serum zinc and alkaline phosphatase (ALP) of total subjects were 64.0 +/- 8.4 microgram/dl and 72.8 +/- 14.9 U/L, there was not a significant difference between boys and girls. The range of serum zinc level was 45~89 microgram/dl and children with a low serum zinc concentration by several cut-off points were 18.9~55.8%, especially. Serum zinc level was positively correlated to the intakes of calorie, calcium, fiber, iron, zinc, zinc/kg and height (p < 0.001). Serum ALP was positively correlated height, weight and WLI. The zinc intake of children also showed a positive correlation with height and weight. These results indicate that there were significant correlations between the zinc status and growth of preschool children. Preschool children in Ulsan have dietary zinc intakes that exceed the new DRIs. The present level of intake does not seem to pose a health problem, but if zinc intakes with fortified foods and supplements were considered, the amount of zinc consumed by children may become excessive.