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.

『천의소감(闡義昭鑑)』에 대한 서지적(書誌的) 연구

임기영 ( Kee Young Lim ) 경북대학교 영남문화연구원 2011 嶺南學 Vol.0 No.19

조선 후기 당쟁서를 언급할 때 빠뜨릴 수 없는 자료 중의 하나가 『闡義昭鑑』과 『戡亂錄』 및 『明義錄』의 간행이다. 이러한 저술들은 한결같이 내적 분쟁의 혼란 속에 이루어졌고, 따라서 그 출판의 동기도 대등소이하다. 그 중 특히, 『闡義昭鑑』은 영조의 집권 중반에 중앙의 집권층에서 반대 세력을 다스리고, 집권층의 대의명분을 표명하기 위한 임금과 중앙 관료들이 이루어낸 의도적인 출판의 결과물이다. 이 연구는 이처럼 영조대에 이루어진 『闡義昭鑑』의 편찬과 간행 과정, 그리고 후속 작업으로 의궤의 작성까지 이어진 조선 후기 관찬서의 출판 과정을 서지적 관점에서 다루었다. 그리고 무엇보다 이러한 자료의 출판이 이루어지기까지 당시 임금과 중앙 관료들의 구체적인 업무 논의, 진행 절차와 과정을 사료와 관련 기록을 토대로 소급하여 살펴보고자 하였다. 이러한 검토 작업은 18세기 중엽 임금 주도로 추진된 관찬서의 간행 과정을 정리하고, 그 구체적인 모습을 재구성하여 본다는 측면에서 의미가 있을 것으로 판단된다. This study dealt with the book 『CheonEuSoGam(闡義昭鑑)』 which is related Party strife book in the late period of Chosun Dynasty. 『CheonEuSoGam(闡義昭鑑)』, 『Gamranrok(戡亂錄)』 and 『Myungeurok(明義錄)』is representative book which related with political party strike in 18th. Especially 『CheonEuSoGam(闡義昭鑑)』 is published with the aim of suppression to opposition party and representation of judification in ruling party, including King Young-jo(英祖) So this study is focused at the process of compilation and publication details with 『CheonEuSoGam(闡義昭鑑)』. Besides, we examined the publication of Korean annotation version and the completion of Eugye(儀軌) to that book. Chansoochung-Eugye(纂修廳儀軌) reveals the participants and pay of the people, and the list of articles used with the publication, that is paper, brush, ink stick, desk, stool, beeswax, etc. Therefore the Chansoochung-Eugye(纂修廳儀軌) is the most important material that notify the related factor of 『CheonEuSoGam(闡義昭鑑)』. To achieve this, we tried to investigate detail discussion between King Young-jo(英祖) and central courtier, publication progress and stage, every other process related with the publication of 『CheonEuSoGam(闡義昭鑑)』 This kind of examination in our study allows us to arrange the process of book publication at central government of late period in Chosun Dynasty. Also it helps the composition of actual proceedings in book publication at that times.

모체 Thyroxine 투여가 태아알코올효과를 가진 흰쥐 대뇌겉질 및 해마에서 NPY함유 신경세포의 생후 발달에 미치는 영향

김복,박상기,박영란,김종중,문정석,김주수,문영민,현영식,천관영,정윤영 朝鮮大學校 附設 醫學硏究所 2005 The Medical Journal of Chosun University Vol.30 No.2

Background and Objectives: Maternal alcohol abuse is considered to be one of the most prominent cause of neurobiological malformations in the postnatal and adult life of the offspring. In this study, we investigated the effects of maternal alcohol drinking on the postnatal development of NPY-containing neuron, and, the influence of thyroxine treatment on the cerebral cortex and hippocampus of pups of alcohol abused mother. Materials and Method: Time-pregnant rats were divided into three groups. Alcohol-fed group A received 35 calories of liquid alcohol diet daily from gestation day 6; control pair-fed group B was fed a liquid diet in dextrin replaced alcohol isocalorically: alcohol + T4 group C received 35 calories liquid alcohol diet and exogenous thyroxine subcutaneously. Results: Group C showed prominent NPY immunoreactivity in the cerebral cortex compared to group A and B at P7. In group C, NPY-containing neurons were widely distributed in the all layers of cerebral cortex after P14. Besides, numerical decrease of NPY-containing neuron as age increases was not found in group C. However, the decrease of NPY-containing neuron was clearly observed in group A compared to group C after P14. In hippocampus, group Band C were appeared similar patterns after P7. Additionally, in group C, NPY immunoreactivity was prominently appeared in CA2 and CA3 at P14 as compared to group B. Conclusions: The present results showed the increase of intensity and number of NPY-containing neurons in cerebral cortex and hippocampus of pups of exogenous T₄ supplemented alcohol-exposed dams as compared to control pair-fed and alcohol-exposed pups at P7. It presumably suggest that NPY-containing neurons might be regulated by the early postnatal growth stimulatory effect of the exogenously supplemented T₄. Therefore, the increase of NPY synthesis caused by maternal administration of exogenous thyroxine may ameliorate fetal alcohol effect, one of the ill effects as a result of the dysthyroid state following maternal alcohol abuse.

노화가 인체 중간엽 줄기세포로부터 조골세포로의 증식 및 분화에 미치는 영향

백기현,태현정,오기원,이원영,조정기,권순용,강무일,차봉연,이광우,손호영,강성구,김춘추 대한내분비학회 2003 Endocrinology and metabolism Vol.18 No.3

연구배경: 일반적으로 골다공증과 연관된 위험인자로는 연령, 폐경, 약물, 불충분한 칼슘섭취, 만성질환 및 운동부족 등이 있는데, 특히 노화가 진행할수록 골밀도가 감소하는 것은 잘 알려져 있다. 노화와 관련하여 진행되는 골소실은 조골세포 및 전구조골세포의 기능적 결핍에 의한 골형성의 감소가 주요한 요인으로 여겨지고 있다. 그 동안 연령이 조골모 세포의 양과 조골모 세포로부터 성숙조골세포로의 분화 및 증식에 미치는 영향에 대한 일부 보고들이 있었으나 아직 일치된 견해는 없는 형편이다. 방법: 다양한 연령의 사람으로부터 골수를 채취, 중간엽 줄기세포가 포함된 단핵세포를 분리한 후 조골세포로 분화하기 좋은 조건하에서 배양하였다. 대상군은다시 젊은군과 노령군으로 구분하여 다양한 변수를 비교 분석하였다. 일차배양에서는 CFU-F를 계수하여 골수내 중간엽 줄기세포의 수를 추산하였고, 칼슘측정을 통하여 기질의 무기화 정도를 비교하였다. 계대배양후 이차배양에서는 시기별로 알카리성 포스파타제 활성도를 측정하고 오스테오칼신 mRNA의 발현을 관찰하여 젊은군과 노령군 사이의 증식능 차이를 비교하였다. 또한 이차배양 시기별로 MTT 측정을 하여 양군간에 증식능 차이가 있는지 알아보았다. 결과: 1. 일차배양 15일째에 평균 CFU-F의 수는 젊은군에서 유의하게 많았다(젊은군 148.3±28.9, 노령군 54.3±9.1, p=0.02). CFU-F의 평균면적은 젊은군에서 넓은 경향을 보였으나 통계적으로 유의하지는 않았다. 2. 일차배양 17일 경과 후 양군간에 기질 칼슘 침착정도는 유의한 차이를 보이지 않았다(젊은군 103.6±50.6, 노령군: 114.0±56.5, p=NS). 3. 이차배양 10일째에 젊은군에서 알카리성 포스파타제 활성도가 고령군에 비해 유의하게 높았다(젊은군: 935.5±115.0 U/mg, 노령군: 578.4±115.7U/mg,p.0.05). 고령군에서는 시간 경과에 따른 변화가 미약했으며 전반적으로 알카리성 포스파타제의 활성도가 젊은군에 비해 낮았다. 4. 이차배양도중 오스테오칼신 mRNA의 발현은 배양시기별로 젊은군에 비해 고령군에서 더 낮은 경향을 관찰할 수 있었다. 5. 이차배양 10일과 15일에 젊은군에서 노령군보다세포증식이 유의하게 증가된 양상을 보였다(10앓 젊은군 0.73±0.05, 노령군 0.58±0.04, p=0.05, 15일; 젊은군 0.80±0.05, 노령군 0.70±0.03, p=0.05).결론: 이상의 연구에서 저자들은 노령군에서 젊은군보다 골수 내 중간엽줄기세포의 수가 적고, 노령군에서 유래한 전구조골세포의 성숙조골세포로의 증식 및 분화가 젊은군 보다 감소해 있는 것을 관찰할 수 있었다. Background: Osteoblasts originate from osteoprogenitor cells in bone marrow stroma, termed mesenchymal stem cells (MSCs) or bone marrow stromal cells. Each MSC forms colonies (colony forming units-fibroblasts [CFL-Fs]) when cultured ex vivo. There are some reports about the age-related changes of the number and osteogenic potential of osteoprogenitor cells, but any relationship has not been clearly established in humans. In this study, we counted MSCs using CFU-Fs count and examined the proliferative capacity and differentiation potential of osteoprogenitor cells. Finally, we analyzed how these parameters varied with donor age. Methods: Bone marrow was obtained from the iliac crest of young (n=6, 27.2±8.6 years old) and old (n= 10, 57.4k6.7 years old) healthy donors. Mononuclear cells, including MSCs, were isolated and cultured in osteogenic medium. In primary culture, we compared the colony-forming efficiency of MSCs between the two groups and determined the matrix calcification. When primary culture showed near confluence, the cells were subcultured. Alkaline phosphatase activity, osteocalcin expression by RT-PCR and proliferative potential by MTT assay were examined by the time course of secondary culture. Results: At the 15th day of primary culture, the mean number of CFU-Fs was significantly higher in the younger donors (young: 148.3±28.9, old: 54.3±9.1, p=0.02) and the mean size of CFL-Fs was also larger in the younger donors than the older donors. However, matrix calcification was not different between the two groups (young: 103.6±50.6, old: 114.0±56.5, p=NS). In secondary culture, alkaline phosphatase activities were significantly lower in the older donors. The younger donors showed peak alkaline phosphatase activity at day 10, while the older donors didn't showed a remarkable peak (young: 935.5±115.OU/mg, old: 578.4±115.7U/mg, p<0.05). Total cell number as a proliferative index increased progressively during the secondary culture and a significantly greater cell number was noted in the younger donors. Osteocalcin expression was generally upregulated in the younger donors, but this was not statistically significant. Conclusion: Our study shows that the number of osteoprogenitor cells is decreased during aging and that the proliferative capacity and differentiation potential of osteoprogenitor cells seem to be reduced during aging (J Kor SOC Endocrinol 18:296-305, 2003).

비강내 투여된 Midazolam의 용량에 따른 진정효과의 비교연구

김영광,김용기 大韓小兒齒科學會 1996 大韓小兒齒科學會誌 Vol.23 No.1

The purpose of this study was to assess the sedative effect and physiological parameter of two doses of intranasal midazolam in sedating young children for dental treatment. Twenty-five uncooperative children, mean age of 36.6 months, who needed at least two separate restorative visits, requiring local anesthesia participated in this study. The patients randomly received either 0.2㎎/㎏ or 0.3㎎/㎏ of midazolam intranasally, with the alternate regimen administered at the second appointment. All the children were restrained in a Papoose board and were monitored with Pulse oximeter for their heart rate and oxygen saturation. Degree of alertness, crying, and movement were evaluated at the start of treatment and the subsequent seven intervals throughout the procedure. Evaluation of overall behavior at each session was performed by one investigator, blind to the dose, using a separate rating scale. The reliability of ratings was assessed by two investigators using videotapes of the procedures. Statistical analysis showed no significantly different behavior (P>.05) between children receiving the two different doses. Successful sedation, as assessed by lack of or minimal crying and/or movement that interrupted treatment, was observed in most of the treatment visits with both doses (mean score 4.48±1.58 for 0.2㎎/㎏ and 4.40±1.38 for 0.3㎎/㎏). No adverse effect was observed, and most of treatments were successfully completed without difficulties.

공황장애 집단인지행동치료의 12개월 추적 연구

최영희,박기환,우영재,윤혜영 한국정신신체의학회 2003 정신신체의학 Vol.11 No.2

생활체육참여자의 여가활동 유형이 생활만족에 미치는 영향

김의영,김의영,김영숙,윤대중,이병기 龍仁大學校 體育科學硏究所 2002 體育科學硏究論叢 Vol.12 No.1

This research is designed to make a comparative analysis of the types of leisure activities and the degree of and life satisfaction by demographic background variable and to present basic materials necessary for the development of programs for local policies on leisure in accordance with the local autonomous system with a view to determining the relationship between life satisfaction by type of leisure activity. The following are the findings. First, the survey failed to test a statistically significant difference between family member's mutual satisfaction, or the subordinate variable of age, job and health and general life satisfaction, or the subordinate variable of income. But there was a statistically significant difference in life satisfaction by gender, age, education, job, income and health at a level of 1 percent. Second, the survey on the influences of the types of leisure activities on leisure satisfaction and life satisfaction revealed that there was a statistically significant influences in all the subordinate variables of and life satisfaction.

상아질에 대한 자가 산부식 접착제의 전단결합강도와 SEM 분석 비교

조영곤,노기선,김수미,이영곤,정진호,기영재 大韓齒科保存學會 2003 Restorative Dentistry & Endodontics Vol.28 No.3

The purpose of this study was to compare shear bond strength and interfacial pattern of composite bonded to dentin using self-etching adhesive systems. Sixty extracted human molars with exposed occlusal dentin were divided into four groups and bonded with four adhesives and composites: Single Bond/Filtek Z 250(SB), Tyrian SPE-One-Step Plus/Aelitefil(TY), Prompt L-Lpop/Filtek Z 250(LP), and one-Up Bond F/Palfique Toughwell(OU). The results of this study were as follows; 1. Shear bond strength for OU was significantly lowet than that of other groups(p<0.05). No significant difference was founded among SB, TY, and LP. 2. Failure modes to dentin showed adhesive and mixed for SB, TY, and LP, but them for OUT showed adhesive in all spceimens. 3. Dentin-resin interface showed close adaptation for SB, TY, and LP, but it showed gap for OU. 4. The hybrid layers for TY, LP, OU were thinner than that of SB. Adhesive layers were observed between composite and hybrid layer, which were 5 ㎛ thick for TY and 10 ㎛ thick for OU.

부산지역 무균성 뇌막염 원인 바이러스의 분리 및 동정 : 1998년을 중심으로

김영희,정영기,김기순,지영미,윤재득,김병준,구평태,민상기,정구영,김만수,조경순 동의대학교 기초과학연구소 2000 基礎科學硏究論文集 Vol.10 No.1

The incidence of aseptic meningitis infection is ensuing and threatening the health of children. Enteroviruses are the major agents of aseptic meningitis and identification of virus has been a clue to diagnosis and epidemiology. The outbreak of aseptic meningitis occurred in Pusan, 1998. Patients were concentrated from April through November. Children were more susceptible than adults. Among 306 cases of specimens from stool, throat swab tested, only 7.2% were positive on virus isolation, 12 cases from stool and 10 from throat, respectively. All isolated 7 serotypes of viruses represented cytopathic effect on cultured cells. Three types of echovirus 6, 25, 30 and coxsackievirus B2, B3, B4, B6 were identified by neutralizing anti body test. Isolated coxsackievirus and echovirus were observed by an electron microscope with negative staining.

초등학생 입학 후 발생한 두통의 유병률과 임상적 특성

노영일,김은영,양은석,문경래,박상기,박영봉 朝鮮大學校 附設 醫學硏究所 2003 The Medical Journal of Chosun University Vol.28 No.2

Purpose : The purpose of the study was to determine prevalence and clinical features of the occurrence of childhood headache after the start of elementary school. Method : The survey was performed by a special questionnaire on 552 children in grade 1 (195 children) and grade 6 (357 children) at the three elementary schools from 1 to 31 August, 2002 in Gwangju city. We have analyzed the prevalence and the clinical features of headache of them. Result: The prevalence of headache in grade 6(49.0%) was statistically higher than grade 1(22.6%). The onset time of headache within 6 months in grade 1 (88.2%) was significantly higher than grade 6 (64.1 %). The frequency of headache is more often in grade 6. As for the timing of occurrence of headache, grade 1 student suffered from it after school (36.4%), grade 6 student suffered from it at school (30.9%). Children who suffered from severe headache can't live in the routine life were grade 1 20.5 % and grade 6 21.1 %, respectively. According to the duration of headache, there were within 1 hour grade 1 90.9%, grade 6 81.8%, respectively. Risk factors of headache were, in grade 1, fatigue (34.0%), stress (25.0%), weather change (18.2%), anxiety (11.4%), and others (11.4%). In grade 6, there were fatigue(44.3%), stress (34.0%), weather change(10.9%), others (5.7%) and anxiety (5.1%). Conclusion : Starting school represents a remarkable life event for children. Starting school results in significantly increasing prevalence of overall headache. 목적 : 입학 전에 비해 입학 후 두통의 증가률을 알아보고, 1학년의 두통의 임상적 특징을 알아보고자 하였다. 방법 : 2002년 8월 1일부터 31일까지 광주시내 3개 초등학교 1학년과 6학년 학생 612명에게 설문지 (두통 에 대한 주요 설문지 내용 :부록)를 배부하여 그 중 작성이 불량한 60명을 제외한 552명 (1학년 195명, 6학년 357명)을 대상으로 두통의 유병률을 알아보았으며, 임상적 특징은 두통이 있는 학생 219명 (1학년 44명, 6학년 175명)을 대상으로 분석하였다. 결과 : 두통의 빈도는 1학년 44명 (22.6%), 6학년 175명 (49.0%)로 6학년에서 의의 있게 높았다(0.001). 두통의 초발 시기가 6개월 이상인 경우 1학년 11.8%, 6학년 35.9%이였으며, 6개월 미만인 경우는 1학년 88.2%, 6학년 64.1%로 입학 전보다 입학 후에 더 높았으며 6개월 미만의 초발 두통이 1학년에서 의의 있게 높았다(p=o. 03). 두통의 발생빈도는 6학년에서 통계학적으로 의의 있게 높았다(P=0. 03). 두통이 가장 자주 발생하는 시기는 1학년에서 학교 수업 후 (36.4%)이었고, 6학년에서는 학교 수업 중(30.9%)이었다. 학교나 일상 생활을 하기 힘들 정도의 두통은 각각 1학년에서 20.5%, 6학년에서 21.1%이었다. 두통의 지속시간은 1시간 이내인 경우가 각각 1학년 90.9%,6학년 81.8%이었다. 두통의 유별인자는 1학년에서 피로, 수면 부족이 34.0%로 가장 많았으며, 스트레스, 기후 변화, 불안, 기타 순이었고, 6학년은 피로 수면 부족 44.3%로 가장 많았으며, 스트레스 34.0%, 기후 변화, 기타, 불안 순이었다.