Elderly kidney transplant recipients have favorable outcomes but increased infection-related mortality

임정훈,Lee Ga Young,Jeon Yena,Jung Hee-Yeon,Choi Ji Young,CHO, JANG-HEE,Park Sun Hee,김용림,Kim Hyung-Kee,Huh Seung,유은상,Won Dong Il,Kim Chan-Duck 대한신장학회 2022 Kidney Research and Clinical Practice Vol.41 No.3

Background: The number of elderly patients with end-stage kidney disease has been increasing, but the outcomes of kidney transplants (KT) remain poorly understood in elderly patients. Therefore, we evaluated the clinical outcomes of elderly KT recipients and analyzed the impact of elderly donors. Methods: This retrospective cohort study included patients who underwent KT between 2000 and 2019. KT recipients were divided into four groups according to a combination of recipient and donor age (≥60 or <60 years); elderly recipients: old-to-old (n = 46) and young-to-old (n = 83); young recipients: old-to-young (n = 98) and young-to-young (n = 796). We compared the risks of mortality, graft failure, and acute rejection between groups using Cox regression analysis. Results: The incidence of delayed graft function, graft failure, and acute rejection was not different among groups. Annual mean tacrolimus trough level was not lower in elderly recipients than young recipients during 10-year follow-up. Mortality was significantly higher in elderly recipients (p = 0.001), particularly infection-related mortality (p < 0.001). In multivariable Cox regression analysis, old-toold and young-to-old groups had increased risk of mortality (adjusted hazard ratio [aHR], 2.89; 95% confidence interval [CI], 1.14– 7.32; p = 0.03; aHR, 3.06; 95% CI, 1.51–6.20; p = 0.002). However, graft failure and acute rejection risks were not increased in elderly recipients. Conclusion: In elderly recipients, graft survival and acute rejection-free survival were not inferior to those of young recipients. However, mortality, especially risk of infection-related death, was increased in elderly recipients. Thus, low immunosuppression intensity might help decrease mortality in elderly recipients.

폐콘크리트 재활용을 위한 재생골재 혼합에 따른 강도특성분석

조규태,서영찬 漢陽大學校 工學技術硏究所 2002 工學技術論文集 Vol.11 No.-

본 연구에서는 최근들어 다량으로 증가되고 있는 폐콘크리트의 재활용 여부를 판단하기 위해서 천연골재에 대한 재생골재를 중량비로 0%, 30%, 50%, 70%, 100%비율로 혼합한 재생콘크리트의 강도특성을 비교하였다. 재생골재 각 조합의 물성시험을 통해 골재의 물성치를 확인한 다음 콘크리트의 배합설계를 하였다. 배합설계는 상대비교를 위해 단위골재량 값만을 변화시키고 다른조건들은 동일하게 하였다.또한 플라이애쉬, 고성능 감수제를 첨가한 혼합물의 내구성과 작업성 문제에 대해서 고찰하였다. 재생골재의 물리적 특성 시험결과 재생굵은골재와 재생잔골재 모든 조합에서 비중은 KS의 1종 재생골재,흡수율은 2종 재생골재 기준을 만족하였으며, 특히 재생골재 대체율 50%까지는 자연골재와 동일한 물성값이 나타났다. 기존의 폐콘크리트는 대지조성재, 기초 매립재등으로 이용하고 있으나 본 시험을 통해 재생골재를 사용한 콘크리트의 적용이 도로포장재료로서 가능하다는 결론을 얻었다. The strength characteristics of recycled concrete is compared to study the feasibility of the recycled aggregate made of the scrapped dump cement concrete for five compound aggregate types consisted of natural aggregate and recycled aggregate as the ratio of weight(0%, 30%, 50%, 70%, 100%). First of all, the physical characteristics of recycled aggregate compounds were tested and the mix design was conducted. Every factors, except the unit aggregate amount, were fixed for the relative comparison. Fly-ash and the super water reducing agent were added to the recycled concrete to ensure the workability. The results of test, the recycled coarse aggregate, recycled fine aggregate and all compounds of recycled aggregate were satisfied with the specification(KS) of the type Ⅰ recycled aggregate in terms of the specific gravity, and the type Ⅱ specification in terms of the absorption. Especially, up to the maximum 50% replacement of recycled aggregate, the properties were equal to natural aggregate. Although most of recycled concrete were used for the land fill, this study showed the feasibility of recycled aggregate as the concrete mix.

열전대(thermocouple)를 이용한 Buchanan Plugger 표면의 온도상승 분석

조진숙,황윤찬,김선호,황인남,최보영,정영진,정우남,오원만 大韓齒科保存學會 2003 Restorative Dentistry & Endodontics Vol.28 No.4

This study was performed to evaluate the actual temperature rise on the surface of Buchanan plugger using thermocouple. The heat carrier system 'System B Heatsource'(Model 1005, Analytic Technologies, Redmond, WA, USA) and the Buchanan pluggers of F, FM, M and ML sizes are used for this study. The temperature was set to 200℃ on digital display and the power level on it was set to 10. Five thermocouples were placed in direct contact with the surface of each size of Buchanan's pluggers at 1 mm increments from the tip to the 4 mm length of shank. The heat control spring was touched for 5 seconds, and temperature rise on the surface of the pluggers were measured at 1 sec intervals for more than 5 seconds with an accuracy of 0.01 using Data Logger. The data were statistically analyzed by one-way ANOVA. The results were as follows. 1. The position at which the temperature peaked was approximately at 1~2 mm far from the tip of Buchanan plugger (p<0.01). 2. The peak temperature was 215.25±2.28℃ in F plugger, 185.94±2.19℃ in FM plugger, 169.51±9.12℃ in M plugger, and 160.79±1.27℃ in ML plugger and the peak temperature was highest in F plugger and followed by, in descending order, FM plugger, M plugger. ML plugger showed the lowest peak temperature (p<0.01). 3. The temperature on the pluggers was decreased with the increase of touching time. This results suggest that the actual temperature on the surface of the pluggers dose not correlate well with the temperature set on digital display. Heat concentrates around the up. The larger plugger reveals lower temperature rise relatively.

좌새골하정맥을 통하여 중심정맥도관 삽입 3 일 후에 발생한 상대정맥천공과 우흉수 : 증례 보고 A case report

조형찬,손주태,최준영,신일우,이헌근,정영균 대한마취과학회 2002 Korean Journal of Anesthesiology Vol.43 No.4

A 67-year-old male patient had coronary artery bypass graft. Before the induction of general anesthesia, 16 gauge central venous catheter was inserted via left subclavian vein. Initial chest anteroposterior (AP) radiograph showed adequate position, and the central venous pressure measurement through it was satisfactory. This patient's progress was satisfactory, and he was extubated on the second postoperative day. Daily chest AP radiograph had been unremarkable until the third postoperative day, when a right-sided pleural effusion was seen. A day later, the patient complained severe chest pain and dyspnea. We suspected perforation of superior vena cava wall by tip of central venous catheter on the chest computerized tomograph (CT). The injection of radiopaque dye through the central venous catheter confirmed spillage into the mediastinum on the chest CT. Right chest tube was inserted. The patient's condition dramatically improved after chest tube insertion. (Korean J Anesthesiol 2002; 43: 525~530)

시클러 캡슐(세파클러 250㎎)에 대한 경보세파클러 캡슐의 생물학적동등성

조혜영,강현아,김세미,박찬호,오인준,임동구,문재동,이용복 한국약제학회 2005 Journal of Pharmaceutical Investigation Vol.35 No.1

The purpose of the present study was to evaluate the bioequivalence of two cefaclor capsules, Ceclor (Lilly Korea Co., Ltd.) and Kyongbocefaclor (Kyongbo Pharm. Co., Ltd.), according to the guidelines of the Korea Food and Drug Administration (KFDA). The release of cefaclor from the two cefaclor formulations in vitro was tested using KP VIII Apparatus II method with various dissolution media (pH 1.2. 4.0. 6.8 buffer solution and water). Twenty four healthy male subjects. 22.96±1.52 years in age and 67.03±7.90 kg in body weight, were divided into two groups and a randomized 2x2 cross-over study was employed. After one capsule containing 250 mg of cefaclor was orally administered, blood was taken at pre-determined time intervals and the concentrations of cefaclor in serum were determined using HPLC method with UV detector. The dissolution profiles of two formulations were similar at all dissolution media. In addition. the pharmacokinetic parameters such as AUC_(t), C_(max) and T _(max) were calculated and ANOVA test was utilized for the statistical analysis of the parameters using logarithmically transformed AUC_(t). C_(max) and untransformed Tmaa. The results showed that the differences between two formulations based on the reference drug, Ceclor. were -1.90%, 2.68% and -7.60% for AUCt, C_(max) and T_(max), respectively. There were no sequence effects between two formulations in these parameters. The 90% confidence intervals using logarithmically transformed data were within the acceptance range of log 0.8 to log 1.25 (e.g., log 0.91-log 1.06 and log 0.92-log 1.18 for AU', and C_(max), respectively). Thus. the criteria of the KFDA bioequivalence guideline were satisfied, indicating Kyongbocefaclor capsule was bioequivalent to Ceclor capsule.

산발성 장형 위선암 환자의 Microsatellite Instability와 병리학적 양상

조창희,홍유찬,안지현,최경현,이상호,신영명,윤기영,정민정,장희경 고신대학교의과대학 2007 고신대학교 의과대학 학술지 Vol.22 No.2

Background : Through many researches, microsatellite is expected to be a good diagnositic and prognostic factor in colorectal cancer, endometrial cancer, gastric cancer, and the others. The prevalence of microsatellite instability (MSI) in gastric carcinoma has reported variously, 13~44%. Purpose : We aimed to determine the prevalence of MSI-high and the relationship between MSI and pathological characteristics of sporadic intestinal type adenocarcinoma of stomach. Material and Methods : We analyzed 106 sporadic intestinal type adenocarcinoma specimens excised from patients who were over thirty-five years old to determine the statue of microsatellite by DNA sequencing. The tissues were formalin-fixed and paraffin embedded. DNA were extracted and amplified by polymerase chain reaction (PCR). MSI was determined using five markers recommended by National Cancer Institute (NCI). Specimens were also studied with five patholical factors-differenciation of tumor cells, depth of invasion, lymph node metastasis, vessel invasion, and perineural invasion- to determine pathological state. Result : The microsatellite statue was determined as MSI-High in 5 cases (4.7%), no MSI-low, and MSS (microsatellite stable) in 101 cases (95.3%). Within the frequency, there was no large gap in the distinction of gender in MSI cases, but in MSS cases, there was three-times more cases in male. MSI cases had moderate-to-poor differenciation and trend to invade toward serosa. All MSI cases showed no perineural invasion. But we could not find any statistical significance between MSI and pathological characteristics of sporadic intestinal type adenocarcinoma. Conclusion : Results suggest that MSI can not make any certain pathological significance in sporadic intestinal type adenocarcinoma. Even though less than 5% of sporadic intestinal type adenocarcinoma patients showed MSI, it can be used as a influential prediagnostic factor of gastric cancer. Further study with large scale of cases will be followed to verify these results.

요로감염이 진단되었거나 의심되는 영아에서 방광요관역류를 예측할 수 있는 임상적, 실험실적 지표들에 대한 연구

조승만,홍성완,홍찬의,정철주,노영일 朝鮮大學校 附設 醫學硏究所 2007 The Medical Journal of Chosun University Vol.32 No.3

Background: Vesicoureteral reflux (VUR) in infants may be the main cause of recurrent urinary tract infection (UTI) and renal scarring. So the early diagnosis of VUR is helpful to prevent recurrence of UTI and to alleviate the grade of VUR. This study is to examine the predictability of clinical and laboratory variables for VUR in infants with confirmed or suspected UTI. Material and Methods: Data of infants younger than 12 months who underwent voiding cystourethrography (VCUG) between 2003 and 2006 were evaluated retrospectively. Among the infants with suspected UTI, infants with VUR (Group 1) vs no VUR (Group 2) were compared. And among the Infants with confirmed UTI, infants with VUR (Group 3) vs no VUR (Group 4) were compared, Variables selected in this study were age at onset, gender, fever, laboratory data and imaging (ultrasonography). Results: Among the variables, the mean of C-reactive protein (CRP) in Group 1 and Group 2 were 5.24±6.82 and 2.46±3.75, respectively, showing that Group 1 had a higher value than Group 2 (P=0.0104). And the number of patients with fever □38.5℃ in Group 1 was higher than in Group 2 (U=0.0004). The mean of C-reactive protein (CRP) in Group 3 and Group 4 were 8.95±6.1 and 5.39±6.0, respectively, showing that Group 3 had a higher value than Group 4 (P=0.0409). Conclusion: Fever≥38.5℃ and CRP≥0.6 ㎎/dL were closely associated with VUR in infants with suspected UTI. And CRP□3.4㎎/dL was closely associated with VUR in infants with confirmed UTI. However, further evaluations and studies for these variables will be needed to use them as predictors for VUR.

Thermocouple을 이용한 Buchanan Plugger 표면의 온도상승 분석

조진숙,황윤찬,김선호,황인남,최보영,정영진,정우남,오원만 전남대학교 치의학연구소 2003 구강과학 Vol.15 No.4

This study was performed to confirm the actual temperature rise on the surface of Buchanan plugger by evaluating the temperature rise on the surface of it, the peak temperature of pluggers of various size using thermocouple. The heat carrier system 'System B Heatsource' (Model 1005, Analytic Technologies, USA) and the Buchanan pluggers of F, FM, M and ML sizes are used for this study. The temperature was set to 200 which Dr. Buchanan's "Continuous wave of condensation" technique recommended on digital display and the power level on it was set to 10. The touch mode was used. Five thermocouples were placed in direct contact with the surface of each size of Buchanan's pluggers at 1 ㎜ increments from the tip to the 4 ㎜ length of shank. Each thermocouple was secured with cyanoacrylate adhesive and orthodontic resin block. The two wire leads of each thermocouple were connected to the appropriate channels of Data Logger. This was configured to simultaneously record input from the five thermocouples. The heat control spring was touched for 1, 2, 3, 4 and 5 seconds, and the temperature rise on the surface of the pluggers were measured at 1 sec intervals for more than 5 seconds with an accuracy of 0.01. Ten trials was determined for each plugger. The average of temperature rise and standard deviation was calculated for each size of plugger. The data were statistically analyzed by one-way ANOVA to determine their significance. The results as follows. 1. The position at which the temperature peaked was approximately at 1∼2㎜ far from the tip of Buchanan plugger (p<0.01). 2. The peak temperature was 215.25±2.28℃ in F plugger, 185.94±2.19℃ in FM plugger, 169.51±9.12℃ in M plugger, and 160.79±1.27℃ in ML plugger and the peak temperature was highest in F type and followed by, in descending order, FM type, M type. ML type showed the lowest peak temperature (p<0.01). This results suggest that the actual temperature on the surface of the pluggers does not correlate well with the temperature set on digital display. Heat concentrates around the tip. The larger plugger reveals lower temperature rise relatively.

도로포장시공시 세립분 함유량변화에 따른 입상재료의 적용성 연구

조규태,서영찬 漢陽大學校 工學技術硏究所 2002 工學技術論文集 Vol.11 No.-

도로포장재료중 보조기충과 동상방지층 재료로 강자갈등의 천연재료 사용이 일반적이었으나 90년대이후 하천골재의 고갈로 인하여 석산에서 채취한 파쇄골재를 사용하고있다. 골재 생산과정에서 세립분의 혼입은 보조기층 및 동상방지층 재료의 역학적 특성과 동상에 많은 영향을 미치게 된다. 본 연구에서는 보조기층 및 동상방지층 재료의 중량비로 세립분 함유중량을 10%, 20%로 변화시키고 소성지수갑(pl)을 6, 10, 15로 변화시켜 재료의 물성시험, 다짐시험, 실내CBR시험, 투수시험, 동결융해시험을 하였다. 실내시험을 통하여 얻은 결론은 지지력, 투수성, 동결융해저항성을 만족한 보조기층은 소성지수 10, 세립분 함유량 10%까지 적용이 가능하며, 동상방지층은 소성지수 15, 세립분 함유량 10%까지 사용이 가능한 것으로 판단되었다. Generally natural materials such as river gravel are used for the subbase and non-frostsusceptible base of the pavement. However, site substitute of the crushed stone for natural materials, due to the shortage of aggregate resources has been prevail since 1990_s. The clayey soil mingles with crushed stone during the process of production, and this affects on the mechanical characteristics and the freezing of pavements. Lab tests conducted includes materials test, compaction test, CBR test, permeabillity test, and freezing & thawing test. The ratio of clay content of the specimens were 10% and 20%. the plastic index values were 6, 10, and 15. Considering the bearing capacity, permeability, and the resistance of freezing & thawing, the plastic index of 10 and the clay content of 10% for the subbase and the plastic index of 15, the day content of 10% for non-frost layer showed satisfactory results, respectively.

Compatibility를 이용한 다수 전문가의 가중치 종합화에 관한 연구

조성훈,김태성,이영찬 한국경영과학회 1998 韓國經營科學會誌 Vol.23 No.4

The objective of this study is to propose a new procedure to synthesize the multi-experts priorities in AHP. if multi-experts with different expertise are involved in a AHP decision, we need some way to aggregate their opinions. AHP model used to do numerical aggregation by taking only the geometric mean or the weighting geometric mean in past. To aggregate the multi-experts priorities, in this paper, we suggest a way which Decision Maker can exclude outlier matrix from group using the concept of the Compatibility and we introduce Delphi method to use Compatibility in AHP. A numerical example is shown to illustrate the procedure.