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.

한방 이화주의 미백 및 피부 주름 개선 효과

이상진(Sang-Jin Lee),권이영(Yi-Young Kwon),조성원(Sung-Won Cho),권희숙(Hee-Suk Kwon),신우창(Woo-Chang Shin) 한국식품영양과학회 2013 한국식품영양과학회지 Vol.42 No.4

본 연구에서는 한방이화주의 피부 생리기능 활성을 알아보기 위해 70% EtOH 추출물의 피부 미백, 주름 개선 및 항염증 효과를 조사하였다. HEE은 tyrosinase 활성 억제 및 tyrosine을 기질로 melanin이 형성되는 pathway에 관여하는 주요한 인자인 TRP-1과 TRP-2를 저해하는 작용 기전을 통해 피부 색소침착의 주요 원인 물질인 melanin 생합성을 농도 의존적으로 저해하는 것을 확인하였다. HEE은 피부진피 내 피부 탄력을 유지하는 elastin을 분해하는 효소인 elastase의 활성을 저해하였고, 피부의 keratinocyte가 생성분비하는 MMP-2와 MMP-9의 단백질 발현과 proteolytic 활성을 억제하여 노화에 따른 피부 주름 생성 억제할 수 있는 가능성을 확인하였다. 또한 세포 독성 없이 LPS에 의해 유도된 염증 반응을 50% 저해하는 HEE의 농도(IC50)는 24.9 μg/mL이며, 50 μg/mL 농도로 처리하였을 때 염증 반응 저해 효과가 70%로 높은 효과를 가지는 것을 확인하였다. 이상의 결과를 종합하면 HEE의 피부 미백, 주름 개선 및 항염증에 우수한 효과를 나타내고 있으므로 기능성 화장품의 주요한 소재로 이용 가치가 높을 것으로 사료된다. Extrinsic skin aging is characterized by the loss of skin tone and resilience, irregular pigmentation, and deep wrinkles. The aim of this study was to investigate the effects of Ehwa Makgeolli containing oriental herbs (Glycyrrhiza uralensis Fisch., Lycium chinense MILL., Morus alba L., and Saururus chinensis Baill) on skin whitening and wrinkling in human skin cells. We prepared Makgeolli extracts (HEE) with 70% ethanol. HEE significantly inhibited in vitro mushroom tyrosinase activity and reduced the cellular and secreted melanin content of mouse melanoma melanocytes (B16F1 cells). HEE down-regulated the protein expression of tyrosinase related protein (TRP)-1/-2, a key player in melanogenesis. Treatment with HEE in human keratinoctyes (HaCaT cells) inhibited the proteolytic activities of matrix metalloproteinase (MMP)-2/-9 in a dose-dependent manner and dramatically reduced the expression of MMP-2/-9. In addition, HEE attenuated lipopolysaccharide (LPS)- induced nitric oxide production in murine macrophages (RAW264.7 cells). These results indicate that HEE may be a great cosmeceutical ingredient for its whitening, anti-wrinkle, and anti-inflammatory effects.

초·중·고등학교 학생, 학부모, 일반교사의 보건교육 요구

윤순녕,김영임,최정명,조희순,김영희,박영남,오경순,이분옥,조선녀,조소영,한선희,하영미 韓國學校保健學會 2004 韓國學校保健學會誌 Vol.17 No.2

Purpose : The purpose of this study was to identify needs of health education of the students, parents, general teachers, and health teacher of the elementary, middle, and high schools. Method : 279 schools of elementary, middle, and high school were sampled nonproportionally during the period from June 28 to July 26, 2004 . The data were collected by the questionnaire from 1,888 students, 1,876 parents, 1,695 general teachers, 279 health teachers. A frequency, % and χ2-test were used to analysis by SAS program. Result : 1. It showed that 98.1% of elementary school students, 92.3% of middle school students, 89.6% of high school students answered that they need health education. The most of students, parents, and general teachers had high interests in health education. 2. In the case of students, main causes of needs of health education was 'to prevent diseases or accidents''. But parents answered that it was 'to build up a healthier behavior'. General teachers answered that it was 'more effective systematic and continuous health education'. 3. Over 80% of students, parents, and general teachers about the question of who qualified person is to teach health education as a regular class responded that health teacher is available. Especially 93% of elementary school students answered like that. 4. The most of students, parents, and general teachers answered that health education in the classroom is favorable 1 to 2 hours per week. Conclusion : As results of the study , the majority of students, parents, general teachers agreed needs of health education. Therefore, on the basis of this study, systematic and continuous health education is necessary. Additionally the establishment of independent health subject is required certainly.

Factors associated with the risk of colorectal neoplasia in young adults under age 40

Ilsoo Kim,Han Hee Lee,Young Jae Ko,Ho Eun Chang,Dae Young Cheung,Bo-In Lee,Young-Seok Cho,Jin Il Kim,Myung-Gyu Choi 대한내과학회 2022 The Korean Journal of Internal Medicine Vol.37 No.5

Background/Aims: Recent epidemiologic studies have shown a continued increase in colorectal cancer incidence among younger adults. Little is known about the factors that contribute to the development of young-onset colorectal neoplasia (CRN). Methods: A cross-sectional analysis was performed for individuals younger than 40 years who underwent colonoscopy in Seoul St. Mary’s Hospital and its affiliated health screening center. High-risk CRN was defined as adenoma or sessile serrated lesion ≥ 10 mm, with three or more adenomas, villous histology, high grade dysplasia, or carcinoma. Results: Of these 13,621 included participants, 2,023 (14.9%) had one and more CRN. Young patients with CRN tended to be elderly, male, obese, smoker, having a habit of drinking, and having comorbidities such as hypertension, dyslipidemia, diabetes, and chronic kidney disease. In a multivariate analysis adjusted for age, sex, obesity, smoking status, and alcohol intake, old age (odds ratio [OR], 1.086; 95% confidence interval [CI], 1.054 to 1.119), male sex (OR, 1.748; 95% CI, 1.247 to 2.451), obesity (OR, 1.439; 95% CI, 1.133 to 1.828), and smoking (OR, 1.654; 95% CI, 1.287 to 2.127) were independent risk factors for overall CRN. Obesity and smoking as two modifiable factors increased the risk for high-risk CRN even more than for overall CRN (OR, 1.734; 95% CI, 1.168 to 2.575 and OR, 1.797; 95% CI, 1.172 to 2.753, respectively). Conclusions: Obesity and smoking were modifiable risk factors for CRN in young adults. They increased the risk for highrisk CRN even more than for overall CRN. A colonoscopy might be beneficial for young individuals with these factors.

노년기 주관적 연령과 건강노화와의 관계: 연령집단별 분석

최은영 ( Choi Eun Young ),조성은 ( Cho Sung Eun ),오영삼 ( Oh Young Sam ),장희수 ( Chang Hee Su ),김영선 ( Kim Young Sun ) 한국보건사회연구원 2017 保健社會硏究 Vol.37 No.1

본 연구의 목적은 노년기 주관적 연령(스스로를 노인 혹은 비(非)노인으로 인지하는지 여부)과 건강노화와의 관계를 연령집단에 따라 검증하는 것이다. 이를 위해 2014년 노인실태조사 대상자 중 연소노인(65~74세)과 고령노인(75~84세)을 연구대상으로 선정하였다. 연구의 주목적인 주관적 연령과 건강노화 간의 관련성을 검증하기 위해 연소노인 및 고령노인 집단별로 다중회귀분석(multiple regression analysis)을 실시하였다. 연구결과, 주관적 연령과 건강노화의 관계는 연령집단별로 다른 양상을 보이는 것으로 나타났다. 연소노인에서 주관적 연령이 비(非)노인인 경우, 높은 수준의 인지기능과 적은 만성질환 수, 낮은 수준의 우울, 그리고 높은 수준의 사회활동 참여를 보이는 것으로 밝혀졌다. 반면, 고령노인인 경우 주관적 연령은 인지기능을 제외하고 건강노화의 다른 세 요소와 유의미한 관련이 없었다. 본 연구는 주관적 연령을 건강노화의 새로운 고려요소로 제시하여, 두 요소의 관련성을 통합적인 차원에서 살펴보았다는 의의가 있다. 또한 노인을 연령대에 따라 구별된 집단으로 살펴봄으로써, 주관적 연령과 건강노화의 연관성이 연령집단마다 상이한 양상을 보임을 밝혔다는 의의를 가진다. The purpose of this study is to examine the relationship between subjective age (whether one subjectively perceives himself as `the elderly` or `not the elderly`) and healthy aging. Using data from the 2014 National Elderly Survey (KIHASA), this study selected a total of 9,653 participants consisting of young-olds (aged 65-74) and old-olds (aged 75-84) For both the young-old and the old-old, multiple regression analyses were conducted to examine the research model. In the young-old population, one`s considering oneself as “non-elderly” was significantly associated with higher cognitive functioning, fewer chronic diseases, lower depressive symptoms, and higher level of social engagement. On the other hand, in the old-old population, one`s considering oneself as “non-elderly” was associated only with higher cognitive functioning, and not with the other domains of healthy aging. The findings suggest that subjective age can be considered as an important predictors of older adults` healthy aging. These findings indicate that the association between subjective age and healthy aging has a different pattern depending on the age group.

초·중·고등학교 학생·학부모·일반교사의 보건교육 영역별 요구도와 보건교육

윤순녕,김영임,최정명,조희순,김영희,박영남,오경순,이분옥,조선녀,조소영,한선희,하영미 韓國學校保健學會 2005 韓國學校保健學會誌 Vol.18 No.1

Purpose: The purpose of this study was to identify the needs of health education in students, their parents and teachers in the elementary, middle and high schools and the current situation of health education class. Method: The subjects of this study were a total of 9450 persons including students, their parents and teachers from 279 schools throughout the country. They were selected through convenient sampling. Data were analyzed through x^(2)­test and ANOVA. Result: Students, their parents and teachers replied that 18 dimensions of health education class (DHEC) are necessary. The four DHEC - healthier life style, sex education, mental health and safety education - showed high educational needs in students, their parents, and teacher. High school students had higher educational need of 'symptom management for daily living' than elementary and middle school students. Students, their parents and teachers in elementary school had higher educational needs of 17 DHEC that those in middle and high school. The percentages of schools with health education class taught by health teachers were 99.2%, 75.5% and 66.0% respectively in elementary, middle and high schools. Health education was given mainly using physical education classes at elementary schools, and creative class hours at middle and high schools. In general, health education took 1-3 hours per week at elementary schools, and less than an hour at middle and high schools. Conclusion: Therefore, based on the results, systematic health education class should begin from elementary school to meet the need of health education in students, their parents and teachers, and further study should be made on the number of hours required and the amount of contents of 18 DHEC.

40세 이하 관상동맥 질환자에서 장기적 임상 관찰

이승욱,정명호,박종철,박형욱,조상희,김원,김계훈,이상현,강경태,조장현,김남호,김건형,안영근,조정관,박종춘,강정채 全南大醫大 2001 전남의대학술지 Vol.37 No.2

간호실무에서 신봉이론(Espoused theories)에 대한 탐색적 연구

서문자,김혜숙,이은희,박영숙,조경숙,강현숙,임난영,김주현,이소우,조복희,이명하,지성애,하양숙,손영희,권성복,김희진,추진아 성인간호학회 2001 성인간호학회지 Vol.13 No.1

As a nursing practice involves nurses' actions in a specific context of health care, this study has focused on exploring the espoused theories in nursing practice within the action science perspectives, Espoused theories are the belief, principles, and rationale expressed by the practitioner as guiding her/his actions in a situation of practice. The data were analysed qualitatively and 25 elements of espoused theories of nursing action were identified and clustered into 6 categories. The 25 elements of espoused theories are as follows: The clinical nurse worked in wholistic and individual nursing, focussed on the patient's needed, comfort and supportive nursing (5 theories of nursing goal) ; excellent skills, knowledge based, assessment and data collection, explaining, educating or a scientific basis(6 theories of nursing intervention): advocacy, value oriented, treatment, account- ability and commitment(4 theories of nursing ethics) ; human respect. partnership, trust(3 theories of patient-nurse relationship) : knowledgable, accumulated clinical experiences and personally lived experiences. positive perspectives(4 theories of nurse), role of intervention. rewarding peer relationship(3 theories of situations) The above mentioned espoused theories are similar to that of nursing textbooks which students learned through basic nursing education and almost the same as the Acts ofa Nurse in Korean. However, we are doubtful whether nurses actually do as they think. Therefore. it is recommended to review the theories-in-use in order to and any discrepancies between the espoused theories and the reality of nursing actions

야뇨증 환아들의 심리사회적 특성에 대한 다기관 연구 : 행동 및 정서 문제를 중심으로

조수철,김재원,신민섭,황준원,한상원,박관현,이상돈,김경도,김건석,서홍진,이유식,정재용,김영균,문두건,남궁미경,한창희,조원열,김영식,배기수,이종국,정우영,신의진 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.6

Objectives : The aim of this study was to examine the behavioral and emotional problems associated with nocturnal enuresis in Korean children. Methods : Three hundred eighteen children with nocturnal enuresis, together with their parents, completed the Child Behavior Checklist (CBCL), Disruptive Behavior Disorder Scale according to DSM-IV (DBDS), Children's Depression Inventory (CDI), State-Trait Anxiety Inventory for Children (STAIC), and Piers-Harris Children's Self-Concept Scale (PHCSC). Ninety-three normal students were selected as the control group. Results : Compared to the normal control group, the mean scores with regard to the withdrawn, social problems, attention problems, delinquent behavior, aggressive behavior, externalizing problems and total problems profiles were significantly higher in the nocturnal enuresis group according to the CBCL results. The nocturnal enuresis group also scored significantly higher in the ADHD and ODD profiles of the DBDS. The nocturnal enuresis group was more depressed and anxious than the control group according to the results of the CDI and STAI. The mean score of the PHCSC was significantly lower in the nocturnal enuresis group when compared to the normal control group. Conclusion : The results of this study suggest that children with nocturnal enuresis in Korea have clinically relevant behavioral and emotional problems. The findings support the link between nocturnal enuresis and psychopathology in Korean children.

Helicobacter pylori와 대장균의 Shuttle Vector 개발

조명제,이우곤,이상룡,김경희,안영숙,김성희,김현주,류복덕,최여정,윤영혜,백승철,전영석,이광호 경상대학교 유전공학연구소 1997 遺傳工學硏究所報 Vol.16 No.-

In this study, a vehicle vector using cryptic plasmids was constructed for gene transfer in Helicobacter pylori. pHP51(3.9 kb) and pHP489(1.2 kb) were selected for constructing vectors from cryptic plasmid of H. pylori isolates in Korea. The HindⅢ-digestedDNA fragment(1.2kb) of pHP489 and 1.6kb DNA fragment of pHP51 were ligated with a kanamycin resistance gene(aph3'-Ⅲ) from C. jejuni to produce the recombinant plasmids pHP489K and pHP51K, respectively. Transformation frequency of pHP51K by electroporation was low. But pHP489K could be effectively transformed into various H. pylori strains. In order to design an intermdiate vehicle vector for gene transfer into H. pylori, pBlueHP489K was prepared by recloning pHP489K DNA into pBluescript and pTZ19R vector. This vector permitted the DNA fragment containing pHP489 sequence, aph3'-Ⅲ, and cloned DNA to be cut and self-ligated in the SacⅠ site after cloning. ureA and ureB gene were inserted into pBlueHP489K, resulting in pBlueHP489K/AB. The DNA fragment containing pHP489, kanamycin resistance gene(aph3'-Ⅲ), and urease structural gene was cut away from pBlueHP489K/AB and self-ligated to generate pBlueHP489K/AB. pBlueHP489K/AB made urease-negative H. pylori strains restore their urease activity. By this experiment, pBlueHP489K was confirmed to be the vehicle system for transferring H. pylori genes.