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.

[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.

A survey of knowledge and behavior regarding skin cancer.

( Young Bin Shin ),( Jeong Won Jo ),( Hae Bong Jeong ),( Yun Sun Moon ),( Do Seon Jeong ),( Chi Yeon Kim ),( Tae Jin Yoon ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.2

Background: The recognition of prevention and early detection of skin cancer has been increased more than before. Although skin cancer is not rare, most patients are little known about general awareness of skin cancer. Objectives: In this study, we survey the awareness and knowledge of skin cancer and sun protection behavior among South-Gyeongnam province. Methods: We reviewed a written questionnaire and patients’ self-checked records including patients’ basic medical information and knowledge of skin cancer protective modalities. Results: In total 284 subjects (94.7%(284/300), 67%(190/284) females, mean age 57.4 years) completed the survey. Most people (77.5%, 220/284) knew that the sun was most dangerous for their skin but relatively large portion of them (42.7%, 94/220) had no action to protective attitude like sun screen, large hat and gloves. Conclusion: The results show that many participants had known necessity of skin cancer prevention and importance of early detection, but didn’t have had any protective action. Therefore, a more effective skin cancer education and prevention program is needed. We suggest that the measurement of effects of a multimodal educational intervention on knowledge of sun protection practices and engagement in self sun-protection behaviors also need to be check.

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)

장간막 림프절염으로 발현된 Kikuchi-Fujimoto병 1예

최원섭,이승순,권진우,이영석,김선영,전선영,김민정,정두련 대한감염학회 2006 감염과 화학요법 Vol.38 No.5

Kikuchi-Fujimoto 병은 주로 경부 림프절을 침범하는 질환이지만, 드물게 회맹부 장간막 림프절을 침범하여, 발열을 동반한 우하복부 통증과 반발압통을 나타내는 장간막 림프절염을 일으킬 수 있다. 급성 충수돌기염과 유사한 양상의 급성 복증을 호소하는 젊은 성인의 경우, 장간막 림프절염 여부를 확인하여야하며, 그럴 경우 Kikuchi-Fujimoto 병을 감별 진단에 포함시켜야 한다. 저자 등이 경험한 장간막 림프절염으로 발현된 성인의 KikuchiFujimoto 병 1예는 국내에서는 최초로 발견된 것이기에 문헌 고찰과 함께 보고하는 바이다. Kikuchi-Fujimoto disease or histiocytic necrotizing lymphadenitis is a benign, rare, self limitimg disease presenting with mainly cervical lymphadenopathy and fever unresponsive to antibiotics or medical treatment. A 28-year old man presented with fever and right lower quadrant abdominal pain. Physical examination showed abdominal tenderness and rebound tenderness mimicking acute appendicitis. Imaging studies showed normal appendix and other abdominal organs except enlarged multiple mesenteric lymph nodes. Symptoms persisted despite antimicrobial therapy. Multiple tender lymph nodes were palpable on bilateral cervical area at the 7th hospital day. The biopsy of the neck node showed large areas of patchy, irregular necrosis with prominent nuclear debris surrounded by T lymphocytes, histiocytes without neutrophils and granuloma, so he was diagnosed as Kikuchi- Fujimoto disease. With conservative management, clinical improvement was observed. We suggest that Kikuchi-Fujimoto disease with mesenteric lymphadenitis should be added to the differential diagnosis of acute abdomen mimicking acute appendicitis in young adults.

흡연이 치과 외래 이용 및 치과 외래 의료비에 미치는 영향

정선락 ( Sun Rak Jeong ),김영희 ( Young Hee Kim ),장지언 ( Ji Eon Jang ),이원기 ( Won Kee Lee ) 대한예방치과·구강보건학회 2015 大韓口腔保健學會誌 Vol.39 No.4

Objectives: The objectives of this study were to evaluate the effect of smoking on utilization of and expenses in ambulatory dental care. Methods: The subjects of this study were 5,751 men aged over 20 years selected from the Korea Health Panel data collected during 2010-2012. Pack-years of smoking were calculated based on the survey data. Dental utilization was defined as dental outpatient clinic use least once in three years. The expenses in ambulatory dental care were summed to determine total dental health care spending for three years. To detect the effect of smoking, we used multiple logistic regression analysis for dental utilization and multiple linear regression for expenses in ambulatory dental care after changing log. Results: The pack-years had a significant effect on dental utilization and expenses in participants aged 40-59 years. After controlling for income level, bedtime brushing, and the presence of chronic disease, dental care utilization rates in the over 10 to less than 25 pack-year and the over 25 pack-year groups were about 1.4 (OR=1.37, (P =0.007)) and 1.6 times (OR=1.59, (P =0.001)) those in the 0 pack-year group. In comparison with the 0 pack-year group, the over 10 to less than 25 pack-year group spent 50,000 won more over dental expenses, while the corresponding number for the over 25 pack-year group was about 100,000 won. Thus, the ambulatory dental care expenses increased with the packyears of smoking. Conclusions: Smoking significantly influenced the utilization and expense in ambulatory dental care in men aged 40-59 years.

정상인에서 베타3-아드레날린 수용체 유전자의 변이가 복부 비만도 및 지질대사에 미치는 영향

김영선,윤석기,김철희,서교일,김학선,김극배,변동원,유명희 순천향의학연구소 1998 Journal of Soonchunhyang Medical Science Vol.4 No.1

The β₃-adrenergic receptor is expressed in visceral adipose tissue in humans and is thought to contribute to the regulation of the resting metabolic rate and lipolysis. We studied the influence of a mutation in the β₃ -adrenergic receptor gene(Trp64Arg) on body fat distribution, central obesity, lipid metabolism in 65 healthy young male adults. One out of 65 subjects were homozygous (Arg/Arg) for the trp64Arg mutation, 17 subjects were heterozygous (Trp/Arg), and 47 lacked the mutation(Trp/Trp). The body weight, height, body mass index, waist-to-hip ratio were similar between the subjects with- and without the mutation. Total body fat, abdominal fat amount, body fat distribution, serum total- and HDL-cholesterol, triglyceride, glucose, and insulin concentrations were also not different according to the presence or absence of the mutation. These results suggested that Trp64Arg mutation in β₃-adrenergic receptor gene is not a major contributing factor for central obesity or change in lipid metabolism in Korean young adults.

젊은 성인에서 흡연에 의한 상완동맥 내피기능의 부전에 관한 연구

이상철,권영주,방덕원,이선해,이보영,김지욱,김영훈,온영근,현민수,김성구 순천향의학연구소 2002 Journal of Soonchunhyang Medical Science Vol.8 No.1

Background and Objectives : Cigarette smoking is a major factor and the most modifiable risk factor for atherosclerosis. Endothelial dysfunction is an early event in atherosclerosis, before the structural change of the systemic arteries. We hypothesized that endothelial dysfunction might be present in the systemic arteries of young adult smokers and that this might be dose-dependent phenomenon. Therefore, we try to certify that smoking is associated with endothelial dysfunction in healthy young adults without other risk factor of atherosclerosis. Subjects and Methods : we studied noninvasively 29 subjects aged 3 to 4 decades without other risk factor of atherosclerosis, they were composed of the two groups, current smokers(n=15) and nonsmokers(n=14). Smoking history varied from 3 to 20 pack years. Using high-resolution ultrasound, vessel diameter and mean flow rate were measured at rest, during reactive hyperemia(with flow-mediated endothelium-dependent dilation), and after sublingual nitroglycerin(NG-induced endothelium-independent vasodilation). Result : Flow mediated endothelium dependent dilation was observed in the control subjects (9.4±3.44%) but was impaired in the smokers(5.8±2.51%)(p=0.004). NG-induced endothelium independent dilation is no difference in all subjects. Conclusion : Cigarette smoking is associated with endothelial dysfunction in healthy young adults.

분자유전학 검사로 확진된 Hereditary Neuropathy with Liability to Pressure Palsy 환자 1 례

변재환,이원영,박성익,기창석,공선영,김종원,김선희 대한근전도전기진단의학회 2003 대한근전도 전기진단의학회지 Vol.5 No.1

Growth Inhibition of Colon Cancer through Inactivation of STAT3 Pathway by IL-10 and IL-1ra Released from Murine Macrophage

Jin Tae Hong, Dohee Won1, Mi Hee Park, Sun Mi Kown, Miran Jo, Sang-Yoon Nam, Beom Jun Lee, Young Won Yun, Ki-Wan Oh, Sang Bae Han 충북대학교 동물의학연구소 2011 Journal of Biomedical and Translational Research Vol.12 No.4

The objective of this study was to determine the effect of macrophages on growth of human colon cancer cells. The results showed that co-culture of colon cancer cells with macrophages inhibited the growth of colon cancer cells (HCT116 and SW620) depending on the number of macrophages, RAW 264.7 cells, and activated THP-1 cells accompanied by down regulation of pSTAT3 in cancer cells. We also found that expression and release of cancer cell growth inhibitory cytokines, IL-1 receptor antagonist (IL-1ra) and IL-10, was increased in macrophages. Blocking of the STAT3 pathway with specific inhibitor and siRNA of STAT3 abolished the growth of colon cancer cells and expression of IL-1ra and IL-10. In addition, neutralization of IL-1ra and IL-10 with antibodies resulted in reversal of macrophage-induced inhibition of cancer cell growth. These data showed that IL-1ra and IL-10 released from macrophages inhibit growth of colon cancer cells through inhibition of the STAT3 pathway