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.

Comparison of Melanoma Subtypes among Korean Patients by Morphologic Features and Ultraviolet Exposure

( Hong Sun Jang ),( Jee Hung Kim ),( Kyu Hyun Park ),( Jae Seok Lee ),( Jung Min Bae ),( Byung Ho Oh ),( Sun Young Rha ),( Mi Ryung Roh ),( Kee Yang Chung ) 대한피부과학회 2014 Annals of Dermatology Vol.26 No.4

Background: Genetic alterations have been identified in melanomas according to different levels of sun exposure. Whereas the conventional morphology-based classification provides a clue for tumor growth and prognosis, the new classification by genetic alterations offers a basis for targeted therapy. Objective: The purpose of this study is to demonstrate the biological behavior of melanoma subtypes and compare the two classifications in the Korean population. Methods: A retrospective chart review was performed on patients found to have malignant melanoma in Severance Hospital from 2005 to 2012. Age, sex, location of the tumor, histologic subtype, tumor depth, ulceration, lymph node invasion, visceral organ metastasis, and overall survival were evaluated. Results: Of the 206 cases, the most common type was acral melanoma (n=94, 45.6%), followed by nonchronic sun damage-induced melanoma (n=43, 20.9%), and mucosal melanoma (n=40, 19.4%). Twenty-one patients (10.2%) had the chronic sun-damaged type, whereas eight patients (3.9%) had tumors of unknown primary origin. Lentigo maligna melanoma was newly classified as the chronic sun-damaged type, and acral lentiginous melanoma as the acral type. More than half of the superficial spreading melanomas were newly grouped as nonchronic sun-damaged melanomas, whereas nodular melanoma was rather evenly distributed. Conclusion: The distribution of melanomas was largely similar in both the morphology-based and sun exposure-based classifications, and in both classifications, mucosal melanoma had the worst 5-year survival owing to its tumor thickness and advanced stage at the time of diagnosis. (Ann Dermatol 26(4) 485~490, 2014)

분석심리학적 관점에서 본 동의보감의 정신치료

박선영 ( Park Sun Young ),정인모 ( Jung In Mo ),여한구 ( Yeo Han Koo ) 한국정신분석심리상담학회 2022 정신분석심리상담(구 정신역동치료) Vol.8 No.-

본 연구는 Jung의 분석심리학적 관점에서 동의보감의 병리와 치료원리를 탐구한 연구이다. 연구 결과, 분석심리학의 핵심 개념인 대극의 원리가 동의보감을 관통하는 기본적인 철학임을 알 수 있고, 동의보감에 나타난 정신치료 원리는 3가지로 구분할 수 있다. 첫째, 정신의 작용은 에너지 균형과 순환을 나타내는 소장평형(消長平衡)의 원리로 모든 우주 만물이 형태나 성격이 바뀔 뿐 에너지는 사라지지 않고 균형을 이루는, 대극의 초월과 합일을 통해 계속 순환하는 만물의 생성과 소멸의 원리이다. 둘째, 정신병리는 대극의 불균형을 극복하려는 물극필반(物極必反)의 원리로 에너지가 한쪽으로 치우쳐 불균형이 심화되면 다시 반대쪽으로 에너지가 기울게 된다는 상호작용의 원리이다. 정신병리는 불균형을 만드는 에너지의 일방성과 에너지의 상호작용의 부재 및 부조화, 들고나는 에너지의 속도 차이에 의해 초래된다. 셋째, 정신치료는 불균형에서 조화와 균형을 회복하는 것이며 치우침 없이 균형을 유지하는 중화(中和)의 원리로 설명한다. 중화는 신체뿐만 아니라 정신의 에너지 불균형을 다루는 정신치료 원리이며, 이는 마음을 다스려 양생(養生)을 돕는 음평양비(陰平陽秘)와 대극의 균형과 합일을 통해 치료적 작용을 돕는 치이권형(治以權衡)으로 구분할 수 있다. 요컨대 동의보감은 정기신(精氣神) 대극(對極)의 상호관계 속에서 신체와 정신이 조화와 균형을 이루고 생리와 병리 및 치료의 원리를 다루고 있으며, 그 치료원리는 분석심리학적 관점의 대극의 합일과 개성화 과정으로 이해할 수 있다. 이를 통해 한의학의 치료에서 분석심리학을 기초로 한 개입 가능성을 살펴볼 수 있었다. The present study reviews the pathology and treatment principles of Donguibogam from the perspective of Jung’s analysis psychology in order to explore psychotherapy principles inherent in Donguibogam. The results indicate that the principle of opposing poles, a core concept of analytical psychology, is in line with Donguibogam. More specifically, three principles of psychotherapy are derived from Donguibogam. First, Sojangpyeonghyeong, a concept of the balance and circulation of energy, describes psychological functioning. Sojangpyeonghyeong, in which all things in the universe change only in forms or characteristics whereas their energy does not disappear but maintains its balance, is a principle of generation and extinction of things that circulate consistently through the unity and transcendence of two opposing poles. Second, Mulgeukpilban, a concept of overcoming the imbalance of opposing poles, accounts for psychopathology. It is a principle of interactions that, if energy is skewed to one side and its imbalance intensifies, the energy is tilted back to the other side. Psychological disorders develop if unilateral tendencies of energy create imbalance and occur from the absence and incongruity of interactions due to the confinement of energy and speed discrepancy in the ebb and flow of energy. Third, psychotherapy restores harmony and balance from imbalance, and is explained through JoongHwa, a concept of maintaining balance without bias. JoongHwa is a principle dealing with psychological as well as physical imbalances. It is categorized into two parts. One is Yinpyeongyangbi that helps protection from psychological disfunction. The other is Chiygwonhyeong, which helps therapeutic action through balance and unity of opposing poles. In summary, Donguibogam deals with the principles of physiology, pathology and treatment where the body and mind are harmonized and balanced in the mutual relationship of the Jung (精), Qi (氣) and Shin (神) polarities. The treatment principle could be interpreted as the unity and individualization of opposing poles from the perspective of analytical psychology. The findings implicate the plausibility of the psychotherapeutic application based on analytical psychology to the interventions of Korean medicine.

[P509] Lichen planus pigmentosus presenting with flexural area

( Young Bin Shin ),( Jeong Won Jo ),( Hae Bong Jeong ),( Yun Sun Moon ),( Do Seon Jeong ),( Eui Chang Jung ),( Chi Yeon Kim ),( Tae Jin Yoon ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.1

Lichen planus pigmentosus (LPP) is an uncommon variant of lichen planus that tends to occur in middle-aged individuals with darker pigmented skin. Clinical findings include hyperpigmented, brown to gray-brown macules and patches on sun-exposed areas and, in the rare inversus variant, on the flexural areas and intertriginous zones. The pattern of pigmentation is generally diffuse, although follicular, reticular, and unilateral linear variants have been described. We recently encountered a rare case of LPP developed in flexural area, not in sun-exposed area. A 58-year-old male patient presented with brown macules on the inguinal area for 6 months. One or two dark brown macules first appeared and spread gradually. A physical examination showed multiple, ill-defined, dark brown macules on inguinal area. The dermoscopic finding showed mottled pattern and elevated margin. The incisional biopsy was performed and a diagnosis of LPP was made. The fact that LPP can develop in non-sun-exposed areas as well as sun-exposed ones requires a new hypothesis for the pathogenesis of LPP.

The Efficacy and Safety of 4-n-butylresorcinol 0.1% Cream for the Treatment of Melasma: A Randomized Controlled Split-face Trial

( Sun Young Huh ),( Jung Won Shin ),( Jung Im Na ),( Chang Hun Huh ),( Sang Woong Youn ),( Kyoung Chan Park ) 대한피부과학회 2010 Annals of Dermatology Vol.22 No.1

Background: Melasma is a common acquired symmetrical hypermelanosis that occurs on sun-exposed areas, and it is frequently observed among women. Various treatment modalities have been tried, but none are completely satisfactory. 4-n-butylresorcinol, which is a resorcinol derivative that has an inhibitory effect on both tyrosinase and tyrosinase-related protein-1, was introduced in 1995 and it has received increasing attention as a new hypopigmenting agent. However, the hypopigmenting effect of 4-n-butylresorcinol in human subjects has only been shown in a few studies. Objective: The aim of this study was to investigate the hypopigmenting efficacy and safety of 4-n-butylresorcinol 0.1% cream for the treatment of melasma. Methods: Twenty patients with melasma were enrolled to this randomized, double-blind, vehicle-controlled, split-face comparative study. The patients were instructed to apply 4-n-butylresorcinol 0.1% cream or vehicle to each side of the face twice daily for 8 weeks. Mexameter measurements were performed along with photography at baseline, 4 weeks and 8 weeks. Adverse events were observed and recorded throughout the study. Results: All the patients completed the study. Mexameter measurements demonstrated that the melanin index of the treated side showed a significant decrease when compared with that of the vehicle-treated side after 4 weeks (p=0.006) and after 8 weeks (p<0.0005). All the adverse reactions were mild and transient. Conclusion: 4-n-butylresorcinol 0.1% cream showed rapid efficacy and it was well tolerated when used for the treatment of melasma. (Ann Dermatol 22(1) 21∼25, 2010)

PWM AC-DC 컨버터의 입력전류 직접추종제어

우정인,최선영,정영일,서정기,허태원 東亞大學校 大學院 1999 大學院論文集 Vol.24 No.-

본 논문에서는 PWM AC-DC 컨버터의 정상상태 제어오차를 제거하고, 과도 특성을 향상시키기 위한 새로운 전류제어계를 제안한다. 먼저, 일반적인 PWM 컨버터에 대한 상태공간 모델로 표현된 수학적 모델이 제시된다. 컨버터의 상태공간 모델은 제안하는 전류제어계를 포함한 PWM 컨버터의 시뮬레이션에 사용된다. 본문에서 제안하는 정현추종 제어계는 교류성분의 전류를 직접추정 제어 하기때문에 좌표변환 알고리즘을 필요로하지 않는다. 입력전류 제어계의 전달함수롤부터 정상상태 오차가 영이되는 것을 입증한다. 그리고, 시뮬레이션과 실험을 통하열 본 제어방식의 타당성을 입증하고자 한다.

여성 연소노인의 지각연령에 따른 사회무용 지도자 선호에 대한 연구

정문미(Jung, Moon Mi),원영신(Won, Young Shin),고대선(Ko, Dae Sun) 한국노년학회 2010 한국노년학 Vol.30 No.2

본 연구는 여성 연소노인의 사회 인구학적 특성에 따른 지각연령의 차이를 알아보고 지각연령이 사회무용 지도자 선호에 미치는 영향을 규명하는 데 목적이 있다. 이와 같은 연구목적을 달성하기 위하여 서울지역 소재 노인교육기관(노인교실, 노인대학, 노인학교, 노인복지회관, 사회복지회관, 대학부설 평생교육원 및 사회교육원, 종교기관 등)에서 사회무용 프로그램에 참여한 경험이 있는 여성 연소노인을 모집단으로 설정한 다음, 유의표본표집법을 이용하여 450명의 연구대상을 표집하였으며, 불성실하게 응답한 자료를 제외하고 총 428명의 자료를 최종분석에 사용하였다. 자료처리는 SPSS Windows 15.0 version을 이용하여 빈도분석, 탐색적 요인분석, 신뢰도분석, 카이검정, 독립표본 t-test, 일원분산분석, 이항 로지스틱 회귀분석을 실시하였으며, 다음과 같은 결론을 도출하였다. 첫째, 사회 인구학적 특성에 따른 지각연령은 역연령, 교육수준에 있어서 지각연령 하위요인(보이는 연령, 느끼는 연령, 관심사 연령, 활동 연령) 모두에 유의한 차이가 나타났다. 또한 결혼유지 상태는 관심사 연령과 느끼는 연령, 경제수준은 보이는 연령, 관심사 연령, 느끼는 연령에 있어서만 유의한 차이가 나타났다. 둘째, 사회 인구학적 특성에 따른 사회무용 지도자 선호는 교육수준에 있어서 사회무용 지도자 선호 하위특성(성별, 연령, 교육수준, 전공경력) 모두에 유의한 차이가 나타났다. 또한 역연령은 지도자의 전공경력을 제외, 경제수준은 지도자의 성별을 제외한 모든 사회무용 지도자 선호 하위특성에 유의한 차이가 나타났으며, 결혼유지 상태는 지도자의 교육수준에 있어서만 유의한 차이가 나타났다. 셋째, 지각연령이 사회무용 지도자 선호에 미치는 영향을 분석한 결과, 지각연령의 하위 요소 중 보이는 연령만이, 사회무용 지도자 선호하위특성 중 전공경력을 제외한 성별(B=.458), 연령(B=.483), 교육수준(B=.76) 모두에 유의한 정적(+) 영향을 미치는 것으로 나타났다. The purpose of this study was to examine the demographic characteristics of the female young-old to their self-perceived age and the impact of their self-perceived age on preference for a social dance instructor. The subjects in this study were 450 women who were selected by purposive sampling from a population of the female young-old who had ever participated in social dance programs in senior education institutions senior class, senior college, senior shool, Senior welfare center, social welfare center, university, school of lifelong education, religion community) in Seoul. After a survey was conducted, the answer sheets from 428 respondents were analyzed except some incomplete ones. As for data handling, a SPSS Windows Ver. 15.0 program was employed, and a frequency analysis, exploratory factor analysis, reliability analysis, pearson chi-square, independent-samples t-test, one-way ANOVA and binary-logistic regression were utilized. The findings of the study were as follows: First, self-perceived age by social population characteristics shows significant difference in all lower factors of self-perceived age(Look age, Feel age, Interest age, Do age) as chronological age, education level. Also, the marriage status shows significant difference only in interest age and feel age, the economic level shows only in look age, interest age and feel age. Second, the social dance instructor preference by social population characteristics shows significant difference in the all lower facts of social dance coaches preference(gender, age, education level, instructor career) up to educational level. Also, chronological age without the instructor career, economic level without instructor gender show the significant difference in the lower facts of all social dance instructor preference. Also, marriage status shows the significant difference in the educational level of the instructor. Third, the analysis of the influence of self-perceived age on the instructor preference shows all gender(B=.458), age(B=.483) and educational lever(B=.76) without career were influenced in significant (+) way.

외음부의 기저세포암

김보영 ( Bo Young Kim ),황선정 ( Sun Jung Hwang ),박병준 ( Byung Joon Park ),이은실 ( Eun Sil Lee ),한호섭 ( Ho Suap Han ),김용욱 ( Yong Wook Kim ),김태응 ( Tae Eung Kim ),노덕영 ( Duck Yeong Ro ),이안희 ( An Hi Lee ) 대한산부인과학회 2010 Obstetrics & Gynecology Science Vol.53 No.9

Basal cell carcinoma (BCC) is the most common human malignant neoplasm, accounting for 75% of all non-melanoma skin cancer. The incidence of BCC is strongly correlated with sun exposure as well as older age. Therefore, the vast majority of BCCs is observed in elderly patients on the sun-exposed skin of the head and neck with a frequency of more than 80%. BCC is very rare on sun-protected skin such as the perianal and genital regions and other etiologic factors must be considered in these cases. Although the pathogenesis of vulvar BCC is unclear, early diagnosis is very important. Because BCC in these areas sometimes seems innocuous, it is recommended that a biopsy of all suspect lesions be performed. We report a woman with BCC of the vulva treated with wide local resection and reviews the literatures on this subject.

위암 환자의 복강내 투여를 위한 Activated Charcoal-Alginate Bead 제형으로부터 Mitomycin C의 용출 거동

이진호,최선웅,서중기,김동민,정경수,오정연,김진향,노승무,민병무,김용백,김창식,박근성,강대영,송규상,양준묵,조준식,정현용,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

Locoregional recurrence is the most common type of recurrence in surgical operation of gastric adenocarcinoma, and peritoneal dissemination is one of the most difficult problems in advanced gastric adenocarcinoma treatment. Because the peritoneal cavity is the most common site of the first recurrence after gastric cancer resection, intraperitoneal chemotherapy seems a logical choice for cancer chemotherapy. In this study, Mitomycin C (MMC)-activated charcoal (CH)-alginate (ALG) beads were prepared by the mixtures of CH particles adsorbed with MMC as an anti-cancer drug and aqueous alginate solution. The alginate is recognized as biodegradable, nontoxic, and biocompatible. The release of MMC from the beads in 0.1 M Tris buffer was stable and continuous until about 1 week. The MMC-CH-ALG beads can be applied in the peritoneal cavity for intraperitoneal chemotherapy since they provide a good adhesiveness on the tissue and controlled release pattern of the drugs.

서울·경기지역 병원직원의 혈액매개 감염노출에 대한 다기관 조사연구

박미라,김정은,박은숙,최정실,정선영,송영구,홍성관,김준명,허애정,양동규,조영주 대한병원감염관리학회 2003 의료관련감염관리 Vol.8 No.1