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.

Clinical Significance of Classification of Graves` Disease According to the Characteristics of TSH receptor Antibodies

(Won Bae Kim),(Hyun Kyung Chung),(Young Joo Park),(Do Joon Park),(Hong Kyu Lee),(Bo Youn Cho) 대한내과학회 2001 The Korean Journal of Internal Medicine Vol.16 No.3

N/A Background:It has been widely accepted that the epitope (s) and/or functional characteristics of thyrotropin receptor antibodies (TSHRAb) from Graves` patients are heterogenous among patients. However, the clinical significance of such heterogeneity has not been systematically evaluatedyet. We were to elucidate and find the clinical significance of heterogeneity for TSH receptor antibodies in Graves` disease. Methods:We measured stimulating TSHRAb (TSAb) activities using CHO-hTSHR cells, FRTL-5 cells and chimeric receptor expressing cells (Mc1+2 and Mc2), specific blocking TSHRAb (TSBAb) activities using Mc2 cells and TBII activities using porcine thyroid membrane in 136 patients with untreated hyperthyroid Graves` disease. Results: Based on various TSHRAb activities from each patient, the patients could be categorized into 7 subgroups by cluster analysis; 1) Group 1 (n=41) was characterized by moderate TSAb activities bothin CHO-hTSHR cells and in FRTL-5 cells, typical TSAb epitope, rare blocking antibodies and high TBII activities. 2) Group 2 (n=16) was characterized by the presence of blocking TSHRAb in most patients, albeit the other characteristics were the same as those in Group 1. 3) Group 3 (n=19) patients had low TSAb activities bothin CHO-hTSHR cells and in FRTL-5 cells, seldom had blocking TSHRAb, but they had high TBII activities. 4) Group 4 (n=30) could be categorized as `mild disease` group, as they had low activities in all kinds of TSHRAb assay and had low antim icrosomal antibody activities. 5) Group 5 (n=14) was characterized by moderate TSAb activities with atypical epitope (s), rare blocking TSHRAb and moderate TBII activities. 6) Group 6 (n=10) patients had veryhigh TSAb activities with typical epitopes, seldom blocking TSHRAb and low TBII activities. 7) Group 7 (n=6) was characterized by very high TSAb activities with atypical epitopes and high TBII activities. Pretreatment serum thyroid hormone level was low only in group 4 patients compared to the other 6 groups (p<0.05). The size of goiter was significantly larger in those in group 1 and group 3 (p<0.05) compared to the other 5 groups. The prevalence of clinically significant ophthalmopathy was higher in group 2 patients than the other 6 groups (50%vs.27.5%,p=0.06). Among 6 kinds of TSHRAb activities, only the blocking TSHRAb activity was significantly associated with the presence of ophthalmopathy in multivariate analysis. Conclusion:These results suggest that the differences inepitopes for TSAb or the presence of blocking TSHRAb is not a major factor in determining the degree of thyrotoxicosis in Graves` disease. Although the pathogenic mechanism is not clearyet, we suggest that patients with ophthalmopathy have different TSHRAb repertoire from those without ophthalmopathy in Graves` disease.

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.

HIV 감염자에 대한 달팽이 엑기스의 혈액면역학적 효과

조영걸,이희정,오원일,강은숙,김은순,김영봉,조양자,조군제 大韓免疫學會 1996 大韓免疫學會誌 Vol.18 No.2

A unique sialic-acid-binding lectin from giant African snail Achatina fulica(AF) has a T cell mitogenicity. It was also noted that acetone extracts of AF have a anti-HIV effect in vitro. Thirty HIV-infected individuals(HIV+) were treated with AF extract(40% Chunho extract) for average 5. 5 months. Peripheral blood sampling and questionnaire were done every month after take. There was a significant decrease of WBC from 4 months after take. As a result, lymphocyte counts also decreased(P<0.01). However, there was a significant increase of CD4+T cell percentage from 1 month(P<0.01). The mean increase of CD4+T cell count was significant for first one month(39/pl)(P<0.05). Body weight also increased significantly(P<0.05). Over 90% HIV+ ex-pressed symptomatic improvement and wanted to be treated with AF extract continuously after the end of this study. In one HIV+ treated with AF for 19 months, the increases of CD4+T cell percentage and counts over 11 times after AF extract take were mean 67% and 85%, respectively, compared to baseline value. These data strongly suggest that aqueous AF extract has a immune enhancing effect on HN+.

양극성 정동장애와 혈청 Inositol-1-phosphatase 활성도 변화

조현주,김영철,우행원,연규월,조기승 대한생물치료정신의학회 1998 생물치료정신의학 Vol.4 No.2

Objects : Several lines of possibilites have been oroposed about the etiology of bipolar attective disorder in biological, genetic and psychosocial aspect. The purpose of this study is to inspect the etiology of bipolar affective disorder in biological aspect by measuring the changes of serum inositol-1-phosphatase activity and investing a causal relationship between clinical symptoms and serum inositol-1-phosphatase activities in patients with bipolar affective disorder. Methods : The subjects were 18 inpatients who met DSM-IV diagnostic criteria for bipolar I affective disorder, manic episode and 15 normal controls. Inositol-1-phosphatase activities were measured in serum by using spectrophotometer. Clinical symptoms of patients were assessed by YMRS at admission day and after 2 weeks lithium treatment. Results : 1) Inositol-1-phosphatase activities of the patients were increased to about 2 times as compared with those of normal controls. And the activity levels were decreased gradually to the normal at 14 days. 2) Young's Mania Rating Scale(YMRS) scores were decreased significantly by lithium treatment. 3) Statistical significance could not be found between the change of YMRS scores and the levels of inositol-1-phosphatase activity. Conclusion : In this study, statistical significance could not be found between clinical improvement and inositol-1-phosphatase activities, but the fact that lithium treatment improve the clinical manifestation shown by YMRS score changes, and reverse the increased inositol-1-phosphatase activities suggests the strong association between pathophysiology of bipolar affective disorders and inositide metabolism.

LC, Acute : O-061 ; Mode of cirrhosis related complication in Korean patients with liver cirrhosis -A prospective multicenter cohort study

( Hyun Young Woo ),( Jeong Won Jang ),( Sang Gyune Kim ),( Chang Hyeong Lee ),( Tae Yeob Kim ),( Won Young Tak ),( Sung Kyu Choi ),( Mong Cho1 ),( Jong Young Choi ) 대한간학회 2012 춘·추계 학술대회 (KASL) Vol.2012 No.-

Background: Cirrhosis-related complications are indications for transplantation. However, the mode of complication has not been evaluated so far. To better address this issue, we investigated the mode of cirrhosis related complication and impact of these complications on survival in prospective, multicenter, inception cohort study of subjects with liver cirrhosis presenting with the first onset of decompensated complication. Methods: In this observational study, 1515 patients with the confirmed onset time of the first decompensated complication were enrolled. The mortality risk of cirrhosis-related complications, including ascites, portal hypertensive gastrointestinal bleeding (PHGB), spontaneous bacterial peritonitis (SBP), hepatic encephalopathy (HE), hepatorenal syndrome (HRS), was analyzed in these cirrhotic patients. Result: As the first complication, ascites was the most frequent (53.8%), followed PHGB (36.2%), HE (7.6%), SBP (1.7%) and HRS (0.7%). During follow-up (mean 32±47 months), 484 (31.9%) experienced subsequent decompensations and the proportion of subsequent complication was consistently changed; the proportion of HE, SBP, HRS increased as time progressed. The interval between subsequent decompensative events was progressively shortened. The mortality rate according to the first complication was as follows; Ascites =PHGB> HE=SBP>HRS. The mortality rate of patients experienceing subsequent complication was significantly higher than those without subsequent complication. According to the kinds of subsequent complication, survival of HE was also higher than HRS but lower than ascites or PHGB and similar to that of SBP and this difference of survival disappeared after repeated complication. Conclusion: The mortality risk correlated with initial complication and the risk increases as the number of complication episodes is repeated. Patient`s mean age was 56±11.50 years and 72.1% was male. The cause of liver cirrhosis is hepatitis B virus (38.6%), alcohol (35.5%) and hepatitis C virus (8.9%).

석탄 가스화를 통한 전력 생산과 DME 병산 공정에 대한 기초 경제성 분석

유영돈 ( Young Don Yoo ),김수현 ( Su Hyun Kim ),조원준 ( Won Jun Cho ),모용기 ( Yong Gi Mo ),송용택 ( Tae Kyong Song ) 한국화학공학회 2014 Korean Chemical Engineering Research(HWAHAK KONGHA Vol.52 No.6

석탄가스화를 기반으로 한 발전(IGCC 발전) 및 화학원료 제조공정의 상업화 관건은 화석연료인 원유 또는 천연가스를 기반으로 생산되는 경우와 비교하여 경제성을 확보할 수 있는지 여부이다. 경제성 확보를 위한 가장 현실적인 방법으로는 석탄 가스화를 통해 얻어진 합성가스로부터 2개 이상의 생산물(예: 발전과 화학원료를 동시 생산)을 병산(coproduction또는 poly-generation)하는 것이다. 본 연구에서는 석탄 가스화를 기반으로 하여 발전과 수송용, 발전용 및 가정용 연료로 사용이 가능한 DME(dimethyl ether)를 병산하는 공정에 대한 경제성 분석을 실시하였다. 경제성 분석을 위한 병산 공정에서는 250 MW 전력생산 연간 30만 톤의 DMZ 생산을 기준으로 하였다. 병산 공정에서 DME 판매가격이 50만원/ton인 경우, 전기 생산원가는 34.8~58.4원/kWh으로 SMP(계통한계가격) 가중평균인 150.69원/kwh(2013년 1월~12월까지의 평균값)의 33~58% 수준으로 산정되었다. 따라서, DME 판매가격이 적정하게 유지될 경우 석탄IGCC+DME 병산공정은 IGCC 단독 발전과 비교하여 경제성을 확보할 수 있을 것으로 판단된다. 현재 중국에서 DME판매가격이 900,000원/톤 내외이므로, 전력과 DME를 병산할 경우, IGCC 단독으로 전력을 생산할 경우와 비교하여 전력 생산 원가를 월등하게 낮출 수 있음을 알 수 있다. 이와 같이 석탄 가스화를 기반으로 한 병산 공정을 통해 전력과 DME를 병산하는 시스템에서, 시장 여건에 따라 전력과 DME 생산비율 제어가 가능하고, 석탄 가스화기 및 정제 시스템을 공통 설비로 활용함으로써, 개별적으로 생산하는 것보다 생산 원가를 낮출 수 있다는 결과를 얻었다. The key for the commercial deployment of IGCC power plants or chemical (methanol, dimethyl ether, etc.) production plants based on coal gasification is their economic advantage over plants producing electricity or chemicals from crude oil or natural gas. The better economy of coal gasification based plants can be obtained by co-production of electricity and chemicals. In this study, we carried out the economic feasibility analysis on the process of co-producing electricity and DME (dimethyl ether) using coal gasification. The plant’s capacity was 250 MW electric and DME production of 300,000 ton per year. Assuming that the sales price of DME is 500,000 won/ton, the production cost of electricity is in the range of 33~58% of 150.69 won/kwh which is the average of SMP (system marginal price) in 2013, Korea. At present, the sales price of DME in China is approximately 900,000 won/ton. Therefore, there are more potential for lowering the price of co-produced electricity when comparing that from IGCC only. Since the co-production system can not only use the coal gasifier and the gas purification process as a common facility but also can control production rates of electricity and DME depending on the market demand, the production cost of electricity and DME can be significantly reduced compared to the process of producing electricity or DME separately.

Original Articles : Clinical significance of occult hepatitis B virus infection in chronic hepatitis C patients

( Jae Young Jang ),( Soung Won Jeong ),( Sung Ran Cheon1 ),( Sae Hwan Lee1 ),( Sang Gyune Kim ),( Young Koog Cheon ),( Young Seok Kim1 ),( Young Deok Cho1 ),( Hong Soo Kim ),( So Young Jin ),( Yun Soo 대한간학회 2011 Clinical and Molecular Hepatology(대한간학회지) Vol.17 No.3

Background/Aims: We investigated the frequency of occult hepatitis B virus (HBV) infection in anti-hepatitis C virus (HCV)-positive individuals and the effects of occult HBV infection on the severity of liver disease. Methods: Seventy-one hepatitis B virus surface-antigen (HBsAg)-negative patients were divided according to their HBV serological status into groups A (anti-HBc positive, anti-HBs negative; n=18), B (anti-HBc positive, anti-HBs positive; n=34), and C (anti-HBc negative, anti-HBs positive/negative; n=19), and by anti-HCV positivity (anti-HCV positive; n=32 vs. anti-HCV negative; n=39). Liver biopsy samples were taken, and HBV DNA was quantified by real-time PCR. Results: Intrahepatic HBV DNA was detected in 32.4% (23/71) of the entire cohort, and HBV DNA levels were invariably low in the different groups. Occult HBV infection was detected more frequently in the anti-HBc-positive patients. Intrahepatic HBV DNA was detected in 28.1% (9/32) of the anti-HCV-positive and 35.9% (14/39) of the anti-HCV-negative subjects. The HCV genotype did not affect the detection rate of intrahepatic HBV DNA. In anti-HCV-positive cases, occult HBV infection did not affect liver disease severity. Conclusions: Low levels of intrahepatic HBV DNA were detected frequently in both HBsAg-negative and anti-HCV-positive cases. However, the frequency of occult HBV infection was not affected by the presence of hepatitis C, and occult HBV infection did not have a significant effect on the disease severity of hepatitis C. (Korean J Hepatol 2011;17:206-212)

농장 사육되는 타조에서 나타난 다리 기형의 증례 보고

최종윤,손화영,전무형,조성환,김혜성,류시윤,박배근,이영원,윤원기 충남대학교 수의과대학 동물의과학연구소 2001 動物醫科學硏究誌 Vol.9 No.-

Two farmed young ostrich chicks were applied to pathology laboratory at Chungnam National University. Grossly, one ostrich showed rotated tibiotarsus, the other showed rolled toes. Case 1 ostrich was hypertrophy of fibualis longus and tibial cranialis tendon and gastrocnemius tendon in crus, inflammation of flexor digitorum longus. In histopathological views, myocytes of fiburalis longus were showed hypertrophy and hyperplasia. It is not found any specific feature in X-ray of the case 2 ostrich. Limb deformities were detected frequently in farmed ostrich chicks in 2- to 3 weeks old. Limb deformities were an important cause of mortality in farmed ostrich chicks during the first 10weeks after hatch. Cause of limb deformities were considered a nutrition problem.

조혈모세포이식술이 골수기질세포의 기원 및 조골세포로의 증식 및 분화에 미치는 효과

강무일,조성원,오은숙,백기현,이원영,오기원,김혜수,한제호,윤건호,차봉연,이광우,손호영,강성구,김춘추 대한내분비학회 2000 Endocrinology and metabolism Vol.15 No.4·5