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.

유아의 자연물에 대한 연상, 유사성, 생명 개념에 관한 연구

최진승,김지영 동아대학교 교육대학원 1998 동아교육논총 Vol.24 No.-

본 연구는 유아가 자연물에 대한 지식을 연상하고 생명 유무와 유사성을 판단하는 기준을 공통적인 준거로써 찾고 그 준거별 반응정도가 연령 및 성별, 자연물의 범주에 따라서 어떠한 양상을 보이면서 발달하는지 밝히는데 그 목적을 두었다. 본 연구의 대상은 부산 시내 유치원에 재원하는 3, 4, 5세 유아 90명이며 유아에게 제시된 자연물은 예비 조사와 친숙도 검사를 통해 선정하였으며, 범주에 따라서 동물, 식물, 천체, 기타 무생물 범주로 나뉘며 각 범주별로 3개씩 총 12개이다. 자료는 인터뷰식으로 진행하여 수집되었으며 유아의 반응은 모두 녹음하여 준거에 따라 수량화하였고, 통계처리는 일원변량분석, 다변량분석, t-검증, Duncan(.05)사후 검증 등을 활용하였다. 본 연구의 결과 및 논의를 통해 얻어진 결론은 다음과 같다. 첫째, 자연물의 소유, 형태, 주제에 관한 개념은 3세에 이미 발달되어 있으며, 색깔과 기능에 관한 개념은 4세와 5세 사이에 크게 발달하는 것으로 보인다. 둘째, 여아는 남아보다 자연물의 기능 및 행위에 관한 개념을 더 먼저 획득한다. 셋째, 동물 및 기타 무생물 범주에 관한 자연물의 개념은 식물 범주 및 천체 범주에 대한 개념보다 더 먼저 발달한다. 넷째, 유아의 자연물의 유사성 판단은 주제-지각-기능-개념 이행으로 변화하며 발달한다. 여섯째, 유아들이 자연물과 유사한 대상으 판단할 때 근거하는 기준은 자연물의 범주에 따라 다른데, 생물 범주는 기능적인 법칙에 근거하고 무생물 범주는 지각적인 특징에 근거하여 판단한다. 일곱째, 자연 법칙에 근거하여 자연물의 생명성을 판단할 수 있는 능력은 5세에 갖추어어지며, 자연물의 범주에 따라 생명성의 판단의 기준이 다르다. 동물 범주는 자연법칙에 근거하며 식물 범주는 사람들의 활동과 개입 유무에 근거하고, 무생물 범주는 의인적인 준거에 근거하여 판단하는 경향이 높다. The purpose of this study is that how the young childrens' association, simialrity, life concept on natural kinds changes with age, sex, and the categories of natural kinds. The subjects in this study were 90 young children who were 3, 4, and 5 years old, and sampled from 3 kindergartens in Pusna. Natural kinds were selected through the pilot test and the categories of natural kinds were divided into animal, plant, planet, and dnonbiological category. Following conclusions were derived from discussion on the results to this study: 1.Young children's association about natural kinds' having, shape, thematic knowledge don't change with age, and their association for the color, functional knowledge of natual kinds were increaed with age. 2.Female childrens' association is higer than male in the natural kinds' functional knowledge. 3.Young childrengs association about plant, planet is increasing with age. Therefore, young childrens' concept about animal, nonbiological kinds is formed nearly at 3 age olds, and young childrens' concept about plant, planet develops highly between the age of 4 and 5 years old. 4.Young children's association about natural kinds' shape is high in the all categories of natural kinds, their assocaition about natural kinds' thematic knowledge is high in nonbiological category. In addition, their association about natural kinds' function is high in animal category at most. 5.Young childrens' reponses about natural kinds' thematic simiarity are decreasing with age. On the other hand, their responses about natural kinds' perceptual, functional simiarity are increasing with age. The result suggests that young childrens' concept on natural kinds is developing thematic-perceptural-founctional-conceptual shift. 6.Young childrens' assocaition about the simiarity is based on objects' founctional character in biological category. On the other hand, their assocaition about inanimates' similarity is based on the perceptual character in nonbiological category. 7.Young childrens' ability to discriminate the animates-nonanimates is increasing at 5 years old. Therefore, young childrens' life concept is formed nearly at 5 years old. 8.Young childrens discriminate between animate and inanimate things in animal category at the based of animals' functional character and in plant category at the based of persons' activity. However they justify the objects' lives at the based of perceptual character in nonbiological category.

부산·울산·경남지역 직업병 감시체계

김정일,김병권,김정원,채창호,이철호,강동묵,김지홍,김진하,김영욱,이영하,이지호,김정호,윤형렬,유철인,정백근,장태원,김운규,윤동영,강진욱,김종은,안진홍,이동준,장준호,이광영,송혜란,최영희,이용환,조병만,최홍렬,고상백,김은아,이유진,홍영습,정갑열,김정만,김준연 大韓産業醫學會 2004 대한직업환경의학회지 Vol.16 No.1

Objective: Occupational medicine specialists in the Busan, Ulsan and Kyung-Nam areas established an area-based occupational disease surveillance system and used this system to collected case information for the purpose of preventing occupational diseases Methods: l l hospital participated in this system. The authors selected five main diseases, which were hand-arm vibration syndrome (HAVS), work-related musculoskeletal disorder (WRMSD), occupational asthma, occupational skin disease and occupational and occupational lung cancer and established their case definitions. All cases were reported on the web, and real time analysis was conducted. Results: Between April 2001 and April 2003, 192 cases of HAVS, 118 cases of WRMSD, 33 cases of occupational asthma, 17 cases of occupational skin disease and 17 cases of occupational lung cancer (for a total of 377 cases of these five main diseases) were reported. most of the HAVS cases came from shipbuilding, and 172 of them (92.7%) were associated with grinding. Of the four main types of WRMSD, carpal tunnel syndrome (CTS) was the most prevalent with 46 cases and shipbuilding was also the main industry involved (83.9%). The ergonomic risk factors involved mainly associated with the hand. In 19 (57.6%) and 4 (12.1%) cases of occupational asthma, the agents involved. The causative agents of occupational lung cancer included Cr, welding fume, PAH, Ni, etc. 10(58.8%) of the cases were diagnosed as squamous cell carcinoma and 5(29.4%) as adenoma. Conclusion: This result showed that an area-based occupational disease surveillance system might provide an effective method of evaluating the prevalence of such diseases, however the Busan, Ulsan and Kyung-Nam provinces are too large to be treated as individual areas. Therefore, the authors suggest that each province should establish its own surveillance system.

Hepatocellular Carcinoma in the Elderly: Clinical Characteristics, Outcomes and Treatment Efficacy, Safety in Older than 75 Years

( Ji Ho Seo ),( Sunmin Kim ),( Eunae Cho ),( Chung Hwan Jun ),( Sun Young Park ),( Sung Bum Cho ),( Chang Hwan Park ),( Hyun Soo Kim ),( Sung Kyu Choi ),( Jong Sun Rew ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1

Aims: The number of elderly patients diagnosed with hepatocellular carcinoma (HCC) has been increasing because the increase in the longevity of the general population. But there is no proper management based on age stratification in elderly patients. We compared clinical characteristics, outcomes and treatment efficacy, safety between oldest-old (aged more than 85 years), middle-old (aged between 80 and 85 years) and young-old (aged between 75 and 80 years) patients with HCC. Methods: We conducted a retrospective cohort study, from January 2010 to December 2016, at Chonnam National University Hospital. A total of 550 elderly patients whose data included demographics, co-morbidity, etiology of liver disease, presence of cirrhosis, staging of HCC, treatment modality and treatment related adverse event were evaluated retrospectively. Also overall survival was assessed in enrolled patient. Results: Fifty one patients (oldest-old; median 87 years old), 153 patients (middle-old; median 82 years old) and 346 patients (young-old; median 77 years old) were diagnosed with HCC. Both oldest- and middle-old patients, compared to young-old patients had significantly lower rate of alcohol-related disease (13.7% vs 20.9% vs 34.1%, P = 0.001). There were no significant difference in underlying sex, body mass index, presence of co-morbidity, hepatitis C-related disease and stage of HCC. The Child-Pugh class (CPT class A 88.9% vs 84.1% vs 83.6%, CPT class B 11.1% vs 15.9% vs 15.0% and CPT class C 0.0% vs 0.0% vs 1.3%, respectively, P = 0.912) and Model for End Stage Liver Disease score (mean MELD score 7.22±3.34 vs 5.88±3.01 vs 5.77±3.14, P = 0.166) were no significant difference between the patients with active treatment. The modified UICC staging (stage I 5.6% vs 17.1% vs 18.6%, stage II 55.6% vs 46.3% vs 47.3%, Stage III 22.2% vs 24.4% vs 24.8%, Stage IV-A 11.1% vs 6.1% vs 4.9% and Stage IV-B 5.6% vs 6.1% vs 4.4%, respectively, P = 0.826) and Barcelona Clinic Liver Cancer staging (stage 0 5.6% vs 9.8% vs 9.3%, stage A 16.7% vs 17.1% vs 22.1%, stage B 27.8% vs 29.3% vs 24.8%, stage C 50.0% vs 43.9% vs 41.2% and stage D 0.0% vs 0.0% vs 2.7%, respectively, P = 0.878) were no significant difference between the patients with active treatment. Furthermore, there were no difference between the age groups in treatment modality (Surgical resection 0.0% vs 3.3% vs 5.2%, P = 0.166; Radiofrequency ablation 2.0% vs 8.5% vs 11.0%, P=0.113; Transcatheter arterial chemoembolization 21.6% vs 34.6% vs 41.6%, P=0.014; Best supportive care 62.7% vs 40.5% vs 29.2%, P < 0.001), adverse event related treatment (P = 0.731) and disease-free survival days (329 .3±309.1 days vs 271.7 ± 414.2 days vs 357.2 ± 511.6 days, P = 0.336). Multivariate analysis showed that age, performance status, CTP class, MELD score, modified UICC staging, presence of portal vein thrombosis and ruptured HCC are risk factors for mortality. Conclusions: Clinician should make an active treatment in elderly patients with HCC not a age but performance status, liver function and disease status of cancer.

A Research of Hwang ji-young’s work - “Without people and people” performance

Ji-Young Hwang,Sung-ok Choi 한국콘텐츠학회 2019 한국콘텐츠학회 ICCC 논문집 Vol.2019 No.12

인터넷 중독 고위험 청소년의 성별에 따른 임상적, 정신병리적 특성

이지윤(Ji Yoon Lee),권준근(Jun-Gun Kwon),이준영(Jun-Young Lee),정희연(Hee Yeon Jung),손보경(Bo Kyung Sohn),최삼욱(Sam Wook Choi),김대진(Dai Jin Kim),최정석(Jung-Seok Choi) 한국중독정신의학회 2016 중독정신의학 Vol.20 No.1

Objectives : Most previous studies of Internet addiction (IA) have been performed on males, and little is known about gen-der differences in IA. We examined gender differences in the clinical and psychopathological features related to high-risk for IA among adolescents. Methods : 714 (male : N=389 ; fe-male : N=325) have reported questionnaires as follows ; 1) clinical and psychopathological features (depression, anxiety, Attention Deficit Hyperactivity Disorder (ADHD) symptoms, Smartphone addiction, impulsivity, behavioral inhibition and approach systems, state-trait anger, aggression, beliefs about aggression, and resilience) 2) Internet and Smartphone usage patterns. In 691 who completed the Young’s Internet Addiction Test (YIAT), A total of 487 adolescents were classified into the normal Internet use group, with YIAT scores of 20-39 (male :N=232 ; female : N=255) and 204 adolescents were classified into high-risk for IA group (male : N=144 ; female : N=60). Results : Most factors described above predicted high-risk for IA in male and female adolescents. Especially, the present study found that psychological resilience had negative association with possibility of IA in female, while cognitive impulsivity and hostile aggression were associated with possibility of IA in male adolescents. Conclusion : This study found gender-re-lated features in adolescents at high-risk for IA. Thus, gender-specific strategies are needed to maximize prevention and treatment effectiveness of IA.

구조적 차원성 탐색을 통한 ‘노인 생활 만족도 척도’의 재발견

최혜지(Choi Hye-Ji),이영분(Lee Young-Boon) 한국사회복지학회 2006 한국사회복지학 Vol.58 No.3

본 연구는 구조적 차원성 탐색을 통한 최성재의 ‘노인 생활 만족도 척도’의 재검증을 목적으로 한다. 이를 위해 충주지역에 거주하는 65세 이상 노인 275명의 자료가 분석되었다. 연구 결과 ‘노인 생활 만족도 척도’는 세 개의 이론적 구인으로 구성된 다차원 구조를 갖는 것으로 분석되었다. 규명된 구인은 ‘긍정적 정서와 주관적 만족감’, ‘부정적 자아상과 부정적 정서’, 그리고 ‘자기 가치’로 명명되었다. 세 구인 모두 높은 신뢰도를 보였으며 ‘내적 구조에 근거한 타당도’ 또한 모두 높은 것으로 분석되었다. ‘긍정적 정서와 주관적 만족감’ 그리고 ‘부정적 자아상과 부정적 정서’는 수렴 타당도와 판별 타당도가 모두 높은 것으로 나타났다. ‘자기 가치’는 높은 수렴 타당도를 보인 반면 판별 타당도는 상대적으로 낮은 것으로 나타났다. 본 연구의 결과는 ‘노인 생활 만족도 척도’를 단일 차원 구조로 제시한 개발자의 견해와 달리 ‘노인 생활 만족도 척도’의 다차원 구조를 검증함으로써 다수의 선행 연구 결과를 지지한다. 끝으로 ‘노인 생활 만족도 척도’의 구조적 차원성이 개발자의 연구와 본 연구에서 상이하게 나타난 원인이 논의되었다. The purpose of the present study was to investigate dimensionality and psychometric properties of identified theoretical constructs of the 'Life Satisfaction Scale for Elderly(LSSE)', which was developed by Choi, Sung-Jae in 1986. Data was obtained from 'The survey of health and welfare status of the elderly aged 65 or older in Chung-Choo city'. The subjects were 275 elderly. Results showed that LSSE had a multi-dimensional structure with three theoretical constructs. Each theoretical construct was named as 'positive affect and subjective satisfaction', 'negative self image and affect', and 'self-value'. Three theoretical constructs had high levels of reliability and validity based on internal construct. 'Positive affect and subjective satisfaction' and 'negative self image and affect' showed high levels of convergent and discriminant validity. 'Self-value' had a high level of convergent validity but acceptable level of discriminant validity. Results of this study revealed that there was a difference in theoretical dimensionality of LSSE between this study and Choi's study, which explained the dimensionality of LSSE as a single dimension. However, the result of this study regarding theoretical dimensionality supported findings from existing studies which insisted that life satisfaction had a multi-dimensional structure.

골수염으로 발현된 재발성 콕시디오이데스 진균증 1예

백지현,박은영,정윤숙,홍재원,채윤태,진성준,최희경,신소연,한상훈,진범식,김창오,최준용,송영구,조남훈,김준명 대한감염학회 2009 감염과 화학요법 Vol.41 No.4

Coccidioidomycosis is a fungal infection that results from inhaling the airborne arthroconidia of the Coccidioides species. It is an endemic disease in the southwest part of North America and rarely diagnosed in Korea. As tourism to endemic areas and the number of immunocompromised patients have been increasing, the incidence of this infection has increased in non-endemic areas. Treatment is usually successful with antifungal agents; however, recurrence is common. It is difficult to decide when to discontinue the antifungal treatment especially in non-endemic areas where doctors are not familiar with the disease. We report a case of recurrent coccidioidomycosis manifesting as osteomyelitis after the treatment of the patient for disseminated coccidioidal infection. The complement fixation test was a useful tool for the assessment of patient response and to evaluate suspected recurrence.

황지영의 작품을 평론한다

황지영(Ji-Young Hwang ),최성옥(Sungok Choi) 한국콘텐츠학회 2018 한국콘텐츠학회 종합학술대회 논문집 Vol.2018 No.5

폐 내 병변으로 인한 소아 급성 호흡부전의 원인 질환과 예후

이혜영,박지숙,최희라,서지현,김점수,임재영,최명범,박찬후,우향옥,윤희상 대한소아과학회 2004 小兒科 Vol.47 No.5