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.

연령집단에 따른 노인의 허약(Frailty) 예측요인 분석

조성은 ( Cho Sung Eun ),최은영 ( Choi Eun Young ),오영삼 ( Oh Young Sam ),김영선 ( Kim Young Sun ),김성복 ( Kim Seong Bok ) 한국보건사회연구원 2017 保健社會硏究 Vol.37 No.3

본 연구의 목적은 연령집단에 따른 허약의 예측요인을 분석하는 것이다. 연구의 목적을 위해 2014년 노인실태조사를 사용하여 총 4,123명을 분석의 대상으로 설정하였다. 허약을 예측하는데 있어 연령의 중요성을 고려하여, 본 연구는 대상자를 75세 이상 85세 미만의 중 고령노인집단(n=3,373명)과 85세 이상의 초 고령노인집단(n=750명)으로 분류하여 연구모형을 검증하였다. 중 고령노인집단에서 전 허약노인과 허약노인은 각각 1453명(약 43%), 1,268명(약 37%)으로 나타났으며, 초 고령노인 집단에서 전 허약과 허약노인은 304명(약 40%), 396명(약 52%)으로 나타났다. 회귀분석의 결과 건강단계에서 허약전 단계로 진입하는 예측요인은 중 고령노인집단에서는 여성, 낮은 교육수준, 많은 만성질환, 낙상 유경험자, 높은 우울, 낮은 인지기능이 허약 전 단계를 예측하는 유의한 변인으로 밝혀졌으며 초 고령노인집단은 여성, 높은 우울, 낮은 사회활동이 유의한 예측요인으로 밝혀졌다. 허약 전 단계에서 허약 단계로의 진입을 예측하는 요인으로는 중 고령노인집단은 여성, 높은 연령, 미취업, 많은 만성질환, 낙상 유경험자, 높은 우울, 낮은 인지기능이 유의한 변인이었으며, 초 고령노인 집단은 높은 연령, 많은 만성질환, 높은 우울, 낮은 인지기능이 유의한 예측요인으로 밝혀졌다. 본 연구는 연령의 세분화와 다각적인 요인의 접근으로 허약의 예측요인을 밝히고자 하였다. 연구를 통해 밝혀진 예측요인은 추후 허약에 대한 다각적 연구의 기초자료로서 활용되리라 기대한다. This study aims to investigate the predictors of frailty in different age groups. To address this purpose, this study used the 2014 Survey of the Living Conditions of the Elderly (SLCE). In the research model, 4,123 older adults aged 75 and older were included from the SLCE. All participants were subdivided into two age groups based on their age; the young old group (75-85) and the old-old group (85+). The young old group consisted of 1,453 (43%) pre-frail older adults and 1,268 (37%) frail older adults; the old-old group consisted of 304 (40%) pre-frail older adults and 396 (52%) frail older adults. Our regression analysis showed that in the young-old, being female, lower levels of education, having more chronic diseases, having fall experience, higher depression, lower cognitive functioning significantly predicted transition to pre-frailty from non-frail status. In the old-old, being female, higher depression, lower level of social activity were significant predictors. On the other hand, predictors of transition to frailty from pre-frail status in the young-old were being female, higher age, being unemployed, having more chronic diseases, having fall experience, higher depression, lower cognitive functioning. In the old-old, predictors of transition to frailty from pre-frail status were only higher age, having more chronic disease, higher depression, and lower cognitive functioning. The research findings can be used as a reference point in the making of strategies for preventing frailty.

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.

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.

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.

Case Report : A Case of Epstein-Barr Virus-associated Hydroa Vacciniforme

Sun Young Huh,Mira Choi,Kwang Hyun Cho 대한피부과학회 2009 Annals of Dermatology Vol.21 No.2

Hydroa vacciniforme (HV) is a photosensitivity disorder characterized by recurrent necrotic vesiculopapules on sun-exposed areas, which heal spontaneously during adolescence. Recently, an association has been reported between latent Epstein-Barr virus (EBV) infection and atypical HV-like eruption and malignant potential. However, latent EBV infection has also been reported in the setting of typical HV. An 11-year-old girl presented with recurrent, scattered, discrete vesicular eruptions with scarring on the face and the extensor surfaces of both forearms. In-situ hybridization was carried out to detect latent EBV infection. Based on the clinical and histopathological findings, typical EBV-associated HV was suspected. (Ann Dermatol 21(2) 209~212, 2009)

물질남용 치료프로그램 후 재범여부에 대한 예비적 추적조사 연구

김현수,조선미,오은영,임기영,정영기,윤웅장,이영미 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.6

연구목적: 본 연구는 물질사범에게 시행되는 수강명령 프로그램의 효과를 재범률을 중심으로 살펴보고자 한 것이다. 방 법: 이 연구의 대상집단은 보호관찰소에서 의뢰받은 물질남용자집단이다. 이들은 법원으로부터 보호관찰, 수강명령, 치료명령, 사회봉사 등을 부과받았다. 총 104명의 대상자집단을 치료프로그램을 이수한 수강군과 비수강군으로 나누었으며 이들에 대한 재범률을 조사하였다. 결 과: 프로그램을 이수한 수강군이 비수강군에 비해 재범률이 낮았다(p<.05). 또한 단기 수강군과 장기수강군의 재범률의 차이를 조사하였는데 대상자 집단의 수가 적기 때문에 장기 수강군의 효과가 통계적으로 입증되지는 않았다. 결 론: 우리는 물질남용자에 대한 정책이 보다 교육적으로 변화할 것을 본 논문을 통하여 제시하려 하였으며 정부 및 법무부는 물질남용자에게 교육과 치료를 제공해주어야만 한다. Objectives: Using recidivism rate, we investigated the outcome after our substance abuse treatment program had been implemented. Methods: Our target population was substance abuse criminals referred by probational office. They either received the parole and probation order, treatment order or social service order from the court. We divided 104 substance abuse criminals into treatment group and non-treatment group. We examined their recidivism rate. Results: We reached a conclusion that treatment group had lower recidivism rate than non-treatment group(p<.0.5). We examined the effectiveness of short-term and long-term programs. However, no effectivess of long-term program was found because the sabject number was too small. Conclusion: We suggest that the strategies for substance abuse should be changed to more educative ones. The Government and Ministry of Justice must provide education and treatment to the substance abuse criminals.

지루각화증의 임상 및 병리조직학적 고찰

박세영 ( Se Young Park ),박현선 ( Hyun Sun Park ),조광현 ( Kwang Hyun Cho ) 대한피부과학회 2011 대한피부과학회지 Vol.49 No.1

Background: Although seborrheic keratosis is one of the most common epidermal tumors, there are only rare studies on the clinicohistopathologic features of seborrheic keratosis in Korea. The majority of cases of typical seborrheic keratosis can be clinically differentiated with ease from other dermatoses such as melanocytic nevi, lentigo, basal cell carcinoma and melanoma. However, its differential diagnosis can sometimes be difficult. Objective: This study was designed to investigate the clincohistopathologic characteristics of seborrheic keratosis, the frequency of biopsy and the accuracy of making the clinical diagnosis, as well as to analyze the cases where there is a mismatch between the clinical diagnosis and the histological diagnosis. Methods: We conducted a retrospective study and we searched for patients who were clinically diagnosed as having seborrheic keratosis between January 2000 and December 2008. The search found 1,248 patients and the patients were divided into two groups: a non-biopsy group (n=891) and a biopsy group (n=357). The clinical features, including age, gender, the anatomic site of lesion and the treatment method, were investigated in each group. In addition, the frequency of biopsy, the accuracy of the clinical diagnosis and the histopathological features were studied in the biopsy group. Results: Between the two groups, we found that the clinical features, including the proportions between the involved body sites, such as trunk/face, and the treatment methods were different. However, these differences might be partly attributed to the clinical decisions such as the frequency of performing biopsy for making the differential diagnosis of skin malignancy. In both groups, the most frequent age period was in the seventh decade and the most common anatomical site was the face. Only one-third of patients who were clinically diagnosed as having seborrheic keratosis received biopsy for histopathologic confirmation and the lesions were mostly located on the face. The clinical diagnosis matched the histological diagnosis in 282/357(79.0%) patients. In 75 patients who revealed a mismatch between the clinical and histological diagnosis, the skin lesion most frequently involved the face(57.3%) and the most common final diagnosis was basal cell carcinoma (13.3%). The frequency of a mismatch for the sun-exposed lesion was significantly higher than that of the non-sun exposed lesion (p=0.035). Conclusion: We present the clinical and histopathological features of seborrheic keratosis. If the lesion is presented with an atypical appearance or it located on a sun-exposed area and so it requires a differential diagnosis from other premalignant diseases or cutaneous malignancies, then we should perform a biopsy to make the differential diagnosis. (Korean J Dermatol 2011;49(1):12~19)

忠南 錦山郡 西臺山 一帶의 나비目 昆蟲相

남상호,조영호,장석원,박영준,이선영,나선희 대전대학교 기초과학연구소 2002 自然科學 Vol.13 No.2

충청남도 금산군 서대산 일대의 나비목 곤충상을 조사한 결과 22과 344종 1,936개체가 조사되었다. 이중 밤나방과가 102종 589개체, 자나방과가 67종 440개체로 이 2과가 전체의 50%이상을 차지하였다. 자나방과의 두줄가지나방은 1,936 개체중 85개체가 채집되어 4.4%의 가장 높은 우점도를 나타냈다. 월별 우점종은 4월 노랑무늬물결자나방, 5월 별박이세줄나비, 6월 목도리불나방, 7월 청백무늬밤나방, 8월 두줄가지나방, 9월은 털뿔가지나방이 조사되었다. 월별 종다양도는 4월 2.95, 5월 3.37, 6월 4.63, 7월 4.62, 8월 4.23, 9월은 2.97이었으며, 평균 종다양도는 3.80으로 서대산 일대의 나비목 곤충상은 비교적 양호한 편으로 조사되었다. This study was carried out to investigate Lepidopterous insect fauna from Mt. Seodae in Geumsan-gun, Chungnam. The samples were collected from April to September in 2001. Total 1,936 individuals belonging to 344 species, 22 families of Lepidoptera were collected. The sum of individuals belonging to Noctuidae and Geometridae exceed 50% of the collected samples in that Noctuidae was consisted of 102 species 589 individuals and Geometridae was 67 species 440 individuals. The dominant species in surveyed area was Rikiosatoa grisea of Geometridae, the dominant species by month were Idiotephria amelia in April, Neptis pryeri in May, Paraona staudinger in June, Ercheia niveostrigata in July, Rikiosatoa grisea in August and Alcis angulifera in September respectively. Species diversity indices by month were 2.93 in April, 3.37 in May, 4.63 in June, 4.62 in July, 4.23 in August and 2.97 in September respectively. Mean species diversity index was 3.80.

인삼엽의 엽록체발달과 CO2 고정양상에 관한 연구

이순희,조영동,홍영남,권영명 ( Sun Hi Lee,Young Dong Cho,Young Nam Hong,Young Myung Kwon ) 생화학분자생물학회 1982 BMB Reports Vol.15 No.2

Development of chloroplast, ability of CO₂-fixation, photosynthetic early intermediates and activities of catalase and glycolate oxidase were observed during greening process. Such results were discussed with the formation of CP-complex. The phenomenon of chloroplast development was similar to other plants, but the rate of process was relatively slow, and ability of CO₂-fixation was slow accordingly. The increase in chlorophyll was observed after more than 12 hours illumination. Such results were paralleled with the formation of CP-complex in thylakoid membrane. Considering the low ability of CO₂-fixation compared with that of other sun-plants, different photosynthetic intermediates at early period, and activities of both glycolate oxidase and catalase, ginseng is more likely to be C₃-plant.