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.

Comparison of trophic factors changes in the hippocampal CA1 region between the young and adult gerbil induced by transient cerebral ischemia.

Yan, Bing Chun,Park, Joon Ha,Kim, Sung Koo,Choi, Jung Hoon,Lee, Choong Hyun,Yoo, Ki-Yeon,Kwon, Young-Geun,Kim, Young-Myeong,Kim, Jong-Dai,Won, Moo-Ho Kluwer Academic/Plenum Publishers 2012 Cellular and molecular neurobiology Vol.32 No.8

<P>In the present study, we investigated neuronal death/damage in the gerbil hippocampal CA1 region (CA1) and compared changes in some trophic factors, such as brain-derived neurotrophic factor (BDNF), glial cell line-derived neurotrophic factor (GDNF) and vascular endothelial growth factor (VEGF), in the CA1 between the adult and young gerbils after 5 min of transient cerebral ischemia. Most of pyramidal neurons (89%) were damaged 4 days after ischemia-reperfusion (I-R) in the adult; however, in the young, about 59% of pyramidal neurons were damaged 7 days after I-R. The immunoreactivity and levels of BDNF and VEGF, not GDNF, in the CA1 of the normal young were lower than those in the normal adult. Four days after I-R in the adult group, the immunoreactivity and levels of BDNF and VEGF were distinctively decreased, and the immunoreactivity and level of GDNF were increased. However, in the young group, all of their immunoreactivities and levels were much higher than those in the normal young group. From 7 days after I-R, all the immunoreactivities and levels were apparently decreased compared to those of the normal adult and young. In brief, we confirmed our recent finding: more delayed and less neuronal death occurred in the young following I-R, and we newly found that the immunoreactivities of trophic factors, such as BDNF, GDNF, and VEGF, in the stratum pyramidale of the CA1 in the young gerbil were much higher than those in the adult gerbil 4 days after transient cerebral ischemia.</P>

영구형 항서맥 심박조율기 환자의 장기추적관찰

최현석,이무용,최영진,최성준,김효수,손대원,오병희,이명묵,박영배,최윤식,이영우,이명용 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.5

GG-38 : Minimal invasive surgery (LESS) for huge cystic adnexal tumors in whole abdomen

( In Young Choi ),( Ji Hye Lee ),( Mi Hyun Park ),( Ji Kwoun Park ),( Jeong Kyu Shin1 ),( Won Jun Choi1 ),( Soon Ae Lee ),( Jong Hak Lee ),( Won Young Paik ) 대한산부인과학회 2014 대한산부인과학회 학술대회 Vol.100 No.-

Laparoendoscopic single-site surgery (LESS) is helpful if not an evidence of suspicious malignancy in huge adnexa tumors. This approach might be reasonable alternative to conventional laparoscopic surgery. We report two cases with LESS for huge cystic adnexal tumors in whole abdomen. A 58 years old multigravida woman in menopause underwent removal of a huge cystic adnexal mass that occupied her entire abdomen by LESS.(ca.5200ml aspiration) A 15 years old single nulligravida woman had a huge cystic adnexal tumor in whole abdomen reaching to the level of the xyphoid process. A needle through the transumbilical single port was inserted directly under the mass. Subsequently, 8000 ml of cystic fluid was aspirated without spillage.

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.

소음인(少陰人) 태음병(太陰病) 심하비증(心下?證)의 병증약리(病證藥理) 고찰

서영광,이지원,이준희,최원철,이의주,고병희,Seo, Young-Kwang,Lee, Ji-Won,Lee, Jun-Hee,Choi, Won-Cheol,Lee, Eui-Ju,Kho, Byung-Hee 사상체질의학회 2010 사상체질의학회지 Vol.22 No.3

1. Objective: Gastric Stuffiness (心下?證) in the Soeumin Taeeum symptomatology (少陰人 太陰病) in Sasang Constitutional Medicine shows an interesting evolutionary process. Originally found in the texts of Sanghanlun (傷寒論), the perspectives regarding the symptoms of Gastric Stuffiness were expanded by many medical scholars and Lee Jema. To comprehend the Jema's concept of Taeeum symptomatology and utilize his prescription clinically, it deserves to study on the Gastric Stuffiness in Donguisuseowon (東醫壽世保元). 2. Methods: Many texts including Sanghanlun (傷寒論) and Dongeuibogam (東醫寶鑑) were reviewed in order to track the evolutionary process concerning the symptoms of Gastric Stuffiness. Also, Lee Jema's works including the different versions of Donguisuseowon (東醫壽世保元) were reviewed to examine the development of Lee's concepts regarding the Gastric Stuffiness in the Soeumin Taeeum symptomatology. 3. Results and Conclusions: 1) Most of the previous concepts on Gastric Stuffiness were generally similar to those found in Sanghanlun, especially in that they addressed Yang deficiency of the middle triple energizeer as the central pathogenic process. 2) Lee Jema's views on the epigastric discomfort in the Soeumin Taeeum symptomatology evoloved over time and culminated in the finalized pathology and therapeutics appearing in his last work, the Shinchuk version of Donguisuseowon (東醫壽世保元). 3) 4 kinds of prescription which invented by Lee Jema to treat the Gastric Stuffiness in the Soeumin Taeeum symptomatology can be matched to the prescription of Sanghanlun respectively. However through evolutionary process of Jema's prescriptions, the indication of them expanded: not only to treat Gastric Stuffiness but to diverse symptoms of Soeumin.

Increased 11β-hydroxysteroid dehydrogenase type 1 contributes to barrier dysfunction in aged skin

( Beom Jun Kim ),( Noo Ri Lee ),( Chung Hyeok Lee ),( Young Bin Lee ),( Solam Lee ),( Hyun Jee Hwang ),( Eunjung Kim ),( Eung Ho Choi ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.2

Background: 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) converts inactive cortisone into cortisol, an active form, and is expressed by several tissues including the skin. Excessive active glucocorticoid (GC) deteriorates skin barrier function. Objectives: To find out if 11β-HSD1 affects on the barrier function in aged skin. Methods: We have performed human and in vivo studies. We measured cortisol in stratum corneum (SC) and oral epithelium of the elderly and young. Hairless mice were used for 11β-HSD1 immunohistochemistry staining of skin and measuring skin barrier function and serum cytokines. 11β-HSD1 knock-out (KO) mice and its wild-type were used for measuring lipid synthesis related enzyme. Results: Cortisol levels were elevated in SC and oral epithelium of the elderly rather than young. The 11β -HSD1 expression was increased in immunohistochemistry stain of aged mice skin. Aged mice showed decreased transepidermal water loss (TEWL) and SC hydration, and increased SC integrity than young. Serum inflammatory cytokines including interleukin-1α, -4, -10, -31 and tumor necrosis factor-α were increased in aged mice than young. The expressions of lipid synthesis related enzymes in epidermis were elevated in KO mice and topical 11β -HSD1 inhibitor applied mice. Conclusion: 11β-HSD1 expression is elevated in aged skin. It increases active GC and then deteriorates skin barrier function.

브루셀라균에 노출된 미생물 검사실 직원들에 대한 예방적 항생제 요법과 혈청학적 추적검사

이창섭,이혜수,이재현,박진희,최영실,황규잠,이흥범 대한감염학회 2008 감염과 화학요법 Vol.40 No.2

The aerozolization is one of possible Brucella transmission mechanisms, particularly in air-borne exposed laboratory workers. In this study, seven laboratory workers were potentially exposed to B. abortus via aerosols. Two laboratory workers who sniffed an agar plate several times were considered to be at high risk for acquiring the disease, 5 workers who did not work directly with the strain were be considered at low risk of infection. Prophylactic antibiotics of doxycycline 200 mg/day and rifampin 600 mg/day were offered for 6 weeks in high risk workers and 3 weeks for low risk workers respectively. Enrolled workers were advised to check for serological testing of Brucella species every 3 weeks during a total period of 12 weeks. Compliance with taking medicine was 57.1% (4/7) and compliance for completing the serological tests was 85.7% (6/7). None of the laboratory workers developed clinical disease or tested positive serologically during 3 months of seroloaical testing and 1 year of clinical follow-up.

A Basic Study on Leaf and Stem Production of Angelica acutiloba

Choi,Seong-Kyu,Yun,Kyeong-won,Chon,Sang-Uk,Lee,Jong-Ill,Seo,Young-Nam,Seo,Kyoung-Sun,Choi,Kyeong-Ju 한국자원식물학회 2004 Plant Resources Vol.7 No.3

This study was conducted to develop effective production system in greenhouse for leaves and stems of Angelica acutiloba by using connect pots in 2003 and 2004. Seed germination rate and plant biomass of Angelica acutiloba collected in 2004 were higher than those harvested in 2003. Germination rate of Angelica acutiloba seeds collected in 2003 was 10%, while germination rate of seeds collected in 2004 was above 90%. Especially, plant growth and yield of Angelica acutiloba grown in connect pots sized with 4×4×5cm(length×width×height) were the highest. These results indicate that leaf and stem production of Angelica acutiloba can be improved by using connect pots and optimizing seed collecting time in greenhouse.

Pomeranian에서 발생한 치주 질환에 의한 비염 1례

이기자,최윤정,최형준,이용진,최호정,이영원,정성목 忠南大學校 獸醫科大學 動物醫科學硏究所 2005 動物醫科學硏究誌 Vol.13 No.-

A 10-year-old spayed female dog with history of persistent nasal discharge and halitosis was presented. In oral examination, there were severe dental calculi and gingivitis. The radiographic imaging showed lesions of left nasal cavity and periodontal membrane. In computed tomographic imaging, there are increased density of left nasal cavity, loss of nasal concha and partial defect of nasal septum. Many inflammatory cells were observed in nasal cytology. The result of culture from nasal smear was negative. All these findings result in rhinitis by dental calculi and gingivitis. The dog got improved after scaling, tooth extraction, and medical treatment.