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.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

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.

일 대학병원에 입원한 노년기 양극성 장애 환자의 인구학적 및 임상적 특징

조숙현(Sook Hyun Cho),정한용(Han Yong Jung),권영준(Young Jun Kwon),이소영(So Young Lee),김양래(Yang Rae Kim),김윤정(Yun Jung Kim) 대한노인정신의학회 2006 노인정신의학 Vol.10 No.2

Objectives : As the elderly population is continuing to increase, psychiatric diseases of the elderly are becoming an important social issue. This study looks into the demographical and clinical features of the elderly patients diagnosed with bipolar disorder in a University hospital. Methods : The study subjects include patients admissioned in the closed wards of Soonchunhyang Seoul hospital and Cheonan hospital from March, 2000 to February, 2005 who met the DSM-IV-TR criteria for bipolar disorder at the time of discharge. A total of 146 patients (76 men, 70 women) medical records were studied retrospectively. Subjects older than the age of 50 at time of admission were grouped as the old age group, whereas those who were younger than 50 as the young age group. Also among the old age group, those who had the first onset of episode under the age of 50 were grouped as the early onset group, whereas those who had the first onset after the age 50 were grouped as the late onset group. Results : The number of bipolar disorder patients in the young age group and old age group were 73 and 73 respectively. The number of early onset group and late onset group were 46 and 23 respectively. The old age group had a relatively higher incidence of bipolar II disorder than the young age group. Also in the old age group there was a higher incidence of hypomanic or depressive episode rather than manic episode compared to the young age group. And in the old age group psychotic symptoms were less common and the mean admission length shorter than the young age group. Additionally in the old age group treatment with Lithium monotherapy or with no mood stabilizers at all were relatively common. Among the old age group, late onset group had a higher rate of bipolar II disorder than the early onset group. Conclusion : This study shows differences in the demographical and clinical features among different age groups. But additional research would be required to determine whether the bipolar disorders in the elderly or late onset group are actually a different type of disorder from those of the young.

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

18–30세 사이에 발생하는 뇌경색의 특징, 다기관 레지스트리 연구

장윤경,송태진,김용재,허지회,이경열,김영은,장민욱,조수진,강석윤 이화여자대학교 의과학연구소 2017 EMJ (Ewha medical journal) Vol.40 No.3

Objectives: Although there have been several reports that described characteristics for young age stroke, information regarding very young age (18–30 years old) has been limited. We aimed to analyze demographic factors, stroke subtype, and 3-month outcome in acute ischemic stroke patient who have relatively very young age in multicenter stroke registry. Methods: We evaluated all 122 (7.1%) consecutive acute ischemic stroke (within 7 days after symptom onset) patients aged 18 to 30 from 17,144 patients who registered in multicenter prospective stroke registry, 1997 to 2012. Etiology was classified by Trial of Org 10172 in Acute Stroke Treatment criteria. Stroke severity was defined as National Institutes of Health Stroke Scale (NIHSS) and stroke outcome was defined by modified Rankin scale (mRS) at 3 months after index stroke. Results: The mean age of all included patients was 25.1±3.7 years and 76 patients (62.2%) were male. The median NIHSS at admission was 4. Considering stroke subtype, 37 patients (30.3%) had stroke of other determined etiology (SOD), 37 (30.3%) had undetermined negative evaluation (UN) and 31 (25.4%) had cardioembolism (CE) were frequently noted. After adjusting age, sex and variables which had P<0.1 in univariable analysis (NIHSS and stroke subtype), CE stroke subtype (odds ratio, 4.68; 95% confidence interval, 1.42–15.48; P=0.011) were significantly associated with poor functional outcome (mRS≥3). Conclusion: In very young age ischemic stroke patients, SOD and UN stroke subtype were most common and CE stroke subtype was independently associated with poor discharge outcome.

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.

複合 韓藥劑 淸籬滋坎湯의 抗癌效果 및 作用機轉 糾明

Cho, Kyung-Sam,Kim, Si-Young,Park, Jai-Kyung,Choi, Seung-Hoon,Chung, Se-Young,Yoon, Hwi-Joong 경희대학교 동서의학연구소 1999 INTERNATIONAL SYMPOSIUM ON EAST-WEST MEDICINE Vol.1999 No.1

Kyung Sam Cho¹Si Young Kim¹, Jai Kyung Park²,Seung Hoon Choi³,Se Young Chung⁴, Hwi Joong Yoon¹¹College of Medicine, ²East-West Medical Research Institute, ³College of Oriental Medicine, ⁴College of Pharmacology, Kyung Hee University,Seoul, Korea. The Anti-cancer Effect of Oriental Medicine Chung-Ri-Ja-Gam-Tang in the Mouse with Metastatic Lung Cancer. Proceedings of International Symposium on East-West Medicine, Seoul. 231-243, 1999.-The oriental medicine Chung-Ri-Ja-Gam-Tang is an herbal medicine which has been used for pulmonary diseases and known as having immune stimulatory effects. It has been known effective in lung cancer. So we studied the effects and the mechanisms of this herbal medicine it the mouse with metastatic lung cancer. The metastatic lung cancer of the mouse was produced with melnoma cell line(B16BL/6).5×10□/mouse tumor cells were injected intravenously to the CDF1 mouse via tail vein. The mice were divided 4 groups. The first group was treated with 50mg/kg extract of Chung-Ri-Ja-Gam-Tang per oral for 10 days after cancer cell injection, second group treated with saline after cancer cell injection, the third group with medicine without cancer cell, and the last group with saline only. After 10 days treatments some of the mice were scarificed and the lung and spleen was removed. The survival duration, weight change, the number of metastatic cancer nodule of the lung, the NK cell activity, the capacity of cytokines(INF-γ,INF-α,IL-2) production and the proliferation activities of mouse lymphocytes were measured. The surival times of the group 1 mice were longer and the weight loss was less than the group 2 significantly. The number of the metastatic nodule of the lung were decresed in the group 1 than the group 2. The production of INF-γ,was increase in group 2 than group 3 and 4, IL-2 production was increased in group 1 than group 2,3,4 significantly. There was no difference in TNF- α production and proliferation activity of lymphocyte in each group. The NK cell activity was significantly increased in group 1 than group 2,3,4. We conclude that the Chung-Ri-Ja-Gam-Tang has the effect of increasing the NK cell activity of the CDF1 mouse with metastatic lung cancer(B16BL/6). And it is suggested that the increased production of the IL-2 is the mechanisms of enhanced NK cell activity.

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.

개질 아스팔트 혼합물의 변형강도 측정 연구

김광우,도영수,이기호,조문진,최선주 강원대학교 부설 석재복합신소재 제품연구센터 2004 석재연 논문집 Vol.9 No.-

본 논문은 아스팔트 혼합물의 소성변형 저항성과 상관성이 높은 특성치를 찾고자 Kim test를 개발하여 현재 적용성 연구결과를 다루고 있다. 이 논문은 새로운 강도특성치인 변형강도(S_(D))를 개발하는 Kim, test 연구의 4단계 연구 결과이다. 13 mm 골재(편마암, 화강암)와 입도(밀입도, 갭입도) 5가지 폴리머로 제조한 8가지 바인더로 두 가지 입도에서 소성변형 저항성이 다른 32가지 혼합물을 만들었다. 슬래브(305㎜×305㎜×62㎜)공시체를 제조하여 한쪽은 Kim, test를 수행하기 위하여 18 cm정도로 잘라서 코어를 3개 채취하고 다른 한쪽은 12cm크기로 하여 반복주행시험을 실시하였다. Kim, test는 하중봉 3(0.75), 4(1.0)을 사용하였다. W/T시험으로부터 최종 침하 깊이와 동적안정도의 두 가지 소성변형 계수를 각 혼합물별로 구했다. 각 하중봉과 골재별, 입도별로 S_(D)와 소성변형 계수간의 통계적 상관관계 분석을 수행한 결과 S_(D)와 소성변형 계수와의 결정계수가 매우 높게 (R²>0.95) 나타났다. 하중봉 4(1.0)이 3(0.75)보다 다소 높은 상관성을 보였다. 향후 Kim test실험에서 하중봉 4(1.0)을 사용하고 4단계 방법을 이용한다면 소성변형 특성치인 침하깊이(DR)와 동적안정도(DS)와의 상관성이 매우 큰 시험법이 될 것이다. 또한 변형강도의 파괴 메커니즘은 콘크리트의 펀칭파괴와 유사하여 콘크리트의 전단강도 추정식을 근거로 아스팔트 콘크리트의 재료 특성에 적합한 추정식 계수 ◁ 원문 수식 참조 ▷ 를 얻었다. 이 식을 이용한다면 아스팔트 콘크리트가 견딜 수 있는 임계하중을 변형강도에 근거하여 추정할 수 있을 것이다. This study shows predictability of rut parameters of modified and unmodified asphalt concretes based on the deformation strength (S_(D)) which is calculated from the maximum load, deformation and size variables of loading head under simple static loading. This paper is the result of latest studies, phase 4 which is a part of Kim, Test studies for developing a new strength property for asphalt concrete. Two aggregates, gneiss and granite, two gradations, dense-graded, gap-graded, with maximum, size of 13mm and eight binders using different contents of five polymers (RLDPE, RHDPE, LDPE, SBS, SBR) were used to produce 32 different mixtures. A slab (305㎜×305㎜×62㎜) was cut into two pieces(18cm and 12cm width) and three 10cm cores were taken for S_(D) test from the larger piece and wheel tracking test was performed on the smaller piece. Kim test was performed using loading head 4(1.0), 3(0.75). Two rut parameters, depth of rut and dynamic stability, from the rut depth-cycle curve from a WT test were obtained for each mixture. Statistical analysis were performed for each loading head, aggregate, and gradation to find out correlation between S_(D) values and each rut parameter. The analysis results showed that S_(D) had high R² (over 0.95) on the average with rut parameters. The loading head 4(1.0) showed R² better than 3(0.75). It is concluded that S_(D) is the property that has excellent predictability for rut parameter of asphalt concretes. An equation, ◁ 원문 수식 참조 ▷ was obtained based on the equation of concrete shear load creating punching failure and current test data, because the failure mechanism of S_(D) is similar to punching failure of concrete. In the equation, P is shearing force creating punching effect, b is length of perimeter of punching area and d is depth of specimen. If this formula is used, a critical load for deformation failure will be predicted based on the S_(D).