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.

동씨침을 시술한 안면경련의 치험 3례

김태우,김효은,조명제,강영화,이재동,Kim, Tae-woo,Kim, Hyo-eun,Cho, Myung-je,Kang, Young-hwa,Lee, Jae-dong 대한침구의학회 2003 대한침구의학회지 Vol.20 No.1

Objective : Hemifacial spasm is painless uncommon disorder characterized by involuntary paroxysmal movement of one side of face, In this study, the effect of Dong-Si acupuncture therapy for three patients with hemifacial spasm were evaluated. Methods : We have treated them with acupuncture treatment of Dong-Si acupuncture points(Cheuk-Samni and Cheuk-ha-Samni) and evaluated the effect by Scott's scale, For the first two weeks, it was dine once a day, and after two weeks, the other day. Results : Before therapy, the grades of spasm intensity classified by Scott's description in three cases were 3. And after Dong-Si acupuncture therapy, the grade of one case was 0, and two cases were 1. Conclusion : The Dong-Si acupuncture therapy for hemifacial spasm was effective and will be attempted to the patients with it.

NR과 SBR 가황물의 경도와 강성도에 대한 온도의 영향

진현호 ( Hyun Ho Jin ),홍창국 ( Chang Kook Hong ),조동련 ( Dong Lyun Cho ),강신영 ( Shin Young Kaang ) 한국고무학회 2007 엘라스토머 및 콤포지트 Vol.42 No.3

본 연구에서는 고무제품의 수치 안정성과 성능유지에 직접적으로 영향을 미치는 중요한 특성 중 하나인 온도변화에 따른 고무재료의 경도변화를 고찰하였다. 새롭게 제작된 International Rubber Hardness Degree(IRHD, Normal type) 경도측정 시험기를 사용하여 미충전된 NR과 SBR시편의 여러 온도에서 경도변화를 측정하였으며 Young`s modulus 값과 비교하였다. NR과 SBR 모두 유리전이온도 근처에서 경도와 Young`s modulus의 급격한 변화를 보였다. 온도가 증가함에 따라 경도와 Young`s modulus 값이 증가하는 경향을 보였으며 이는 분자의 운동성과 엔트로피 영향으로 해석할 수 있다. 카본블랙과 실리카가 충전된 NR과 SBR의 경우 충전제의 함량이 증가함에 따라 경도에 미치는 온도의 영향이 감소함을 관찰하였다. Hardness of rubbery materials, which is important for dimensional stability and product performance, was investigated upon temperature change in this study. A newly developed IRHD (International Rubber Hardness Degree) tester was used to measure the hardness changes of NR and SBR specimens at various temperatures and the hardness values were compared with the Young`s modulus. The hardness and Young`s modulus of NR and SBR showed an abrupt change near the glass transition temperatures. The hardness and Young`s modulus were increased by increasing temperature due to the increased random chain conformation of molecules. The effect of temperature on hardness and Young`s modulus of NR and SBR specimens filled with carbon black and silica was decreased by increasing filler content.

3T Multi Voxel Spectroscopy에서 SENSE와 NEX 변화에 따른 정상인 뇌 대사물질 변화 분석

성열훈,임재동,이재현,조성봉,우동철,최보영,Seong, Yeol-Hun,Rhim, Jae-Dong,Lee, Jae-Hyun,Cho, Sung-Bong,Woo, Dong-Chul,Choe, Bo-Young 한국의학물리학회 2008 의학물리 Vol.19 No.4

자기공명분광법(magnetic resonance spectroscopy: MRS)은 인체내 대사물질을 정량분석하여 병변의 조기진단 및 정밀진단에 도움을 주고 있으며, 최근 임상에 이용되고 있는 자기공명분광법은 single voxel spectroscopy (SVS) 기법과 multi voxel spectroscopy (MVS) 기법이 있다. 본 연구에서는 SENSE와 NEX를 변화시킨 multi voxel spectroscopy (MVS)의 데이터와 기존 single voxel spectroscopy (SVS)의 데이터를 비교 분석하여, 각각의 데이터의 유의성 차이를 평가하고자 하였다. 정상 성인 지원자 13명(남자: 5명, 여자: 8명, 평균 41세, 표준편차 11.65세)을 대상으로 chemical shift image (CSI)를 이용한 MVS검사를 시행하였다. 장비는 3.0T Achieva Release Version 2.1 (Philips Medical System, Netherland)을 이용하였고, 8 channel head coil을 사용하여 brain thalamus 부위에서 CSI spectrum을 1 slice 획득하였다. Scan parameter로는 FOV (field of view): $230{\times}184mm^2$, TR (time to repetition): 2000 msec, TE (time to echo): 288 msec, matrix: $15{\times}12$, VOI(view of interest): $110{\times}110mm^2$, voxel size: $15{\times}15{\times}15mm^3$로 하였다. SENSE factor (S)와 NEX (N)는 S1*N1, S2*N1, S2*N2, S3*N2로 변화하여 스펙트럼을 획득하였고, 각 scan time은 5분 54초, 3분 32초, 6분 20초, 4분 20초였다. 얻은 모든 MRS 데이터는 jMRUI 3.0 Version 프로그램에서 분석하였고, SENSE factor와 NEX를 변화시켜 얻은 MVS data 그룹들이 정상 성인 뇌 대사물질의 변화에 영향을 주는지 검증하기 위해 그룹 간에 ANOVA분석을 실행하여 P 값이 0.05보다 크게 나오면 그룹들 사이에 유의한 차이가 없다고 분석하였다. NAA/Cr과 Cho/Cr의 상대적 비율은 MV와 SVS사이에서는 유의한 차이가 없었다. 즉, SENSE factor와 NEX를 변화시켜 얻은 MVS data에서 정상 성인 뇌조직의 대사물질의 변화를 관찰한 결과, S1*N1의 NAA/Cr은 $1.45{\pm}0.03$, Cho/Cr은 $0.88{\pm}0.03$이고, S2*N1의 NAA/Cr은 $1.44{\pm}0.03$, Cho/Cr은 $0.87{\pm}0.05$, S2*N2의 NAA/Cr은 $1.43{\pm}0.02$, Cho/Cr은 $0.87{\pm}0.04$이며, S3*N2의 NAA/Cr은 $1.45{\pm}0.03$, Cho/Cr은 $0.87{\pm}0.03$으로 나타났다(F-value : 1.37, D.F : 3, P-value : 0.262). 그러나 데이터의 질을 측정하기 위한 MVS 데이터의 NAA Peak line-width는 SVS 데이터의 NAA Peak line-width 보다 약 3배 정도 넓었다. 본 연구에서는 MVS에서 SENSE factor와 NEX 값을 다양하게 변화시킨 MVS의 데이터와 SVS의 데이터가 큰 차이가 없음을 확인하였다. 즉, 어는 특정 부위의 뇌 조직의 대사물질은 MVS와 SVS 기법 모두 큰 차이가 없음을 확인할 수 있었다. 그러므로 MVS는 SVS보다 광범한 부위를 짧은 시간 안에 검사할 수 있으므로 매우 유용한 방법이라고 사료된다. To evaluate the metabolic changes in normal adult brains due to alterations SENSE and NEX (number of excitation) by multi voxel MR Spectroscopy at 3.0 Tesla. The study group was composed of normal volunteers (5 men and 8 women) with a mean ($\pm$ standard deviation) age of 41 (${\pm}11.65$). Their ages ranged from 28 to 61 years. MR Spectroscopy was performed with a 3.0T Achieva Release Version 2.0 (Philips Medical System-Netherlands). The 8 channel head coil was employed for MRS acquisition. The 13 volunteers underwent multi voxel spectroscopy (MVS) and single voxel spectroscopy (SVS) on the thalamus area with normally gray matter. Spectral parameters were as follows: 15 mm of thickness; 230 mm of FOV (field of view); 2000 msecs of repetition time (TR); 288 msecs of echo time (TE); $110{\times}110$ mm of VOI (view of interest); $15{\times}15{\times}15$ mm of voxel size. Multi voxel spectral parameters were made using specially in alteration of SENSE factor (1~3) and 1~2 of NEX. All MRS data were processed by the jMRUI 3.0 Version. There was no significant difference in NAA/Cr and Cho/Cr ratio between MVS and SVS likewise the previous results by Ross and coworkers in 1994. In addition, despite the alterations of SENSE factor and NEX in MVS, the metabolite ratios were not changed (F-value : 1.37, D.F : 3, P-value : 0.262). However, line-width of NAA peak in MVS was 3 times bigger than that in SVS. In the present study, we demonstrated that the alterations of SENSE factor and NEX were not critically affective to the result of metabolic ratios in the normal brain tissue.

니세틸 정(아세틸 - 엘 - 카르니틴 500mg)에 대한 뉴로세틸 정의 생물학적 동등성

조혜영,오인준,이용복,임동구,문재동,심영순,김은아,정현철 한국약제학회 2001 Journal of Pharmaceutical Investigation Vol.31 No.1

Acetyl-L-carnitine (ALC), an endogenous component of the L-carnitine family, is naturally occurring molecule synthesized from L-carnitine (LC) by carnitine acetyl transferase. ALC has been shown to improve the cognitive performance of patients suffering from dementia of the Alzheimer's type and proposed for treating Alzheimer's disease in pharmacological doses. The purpose of the present study was to evaluate the bioequivalence of two ALC tablets, Nicetile^(TM) (Dong-A pharmaceutical Co., Ltd.) and Neurocetil^(TM) (Kyung-Dong Pharmaceutical Co., Ltd.), according to the guidelines of Korea Food and Drug Administration. Twenty six normal male volunteers, 22.80±2.76 year in age and 63.07±7.98 ㎏ in body weight, were divided into two groups and a randomized 2 × 2 cross-over study was employed. After one tablet containing 500 ㎎ of ALC was orally administered, blood was taken at predetermined time intervals and the concentrations of ALC in serum were determined using HPLC with fluorescence detector. Because of the presence of endogenous ALC, the calibration was performed using dialyzed serum. Pharmacokinetic parameters such as AUC_t, C_(max) and T_(max) were calculated and ANOVA was utilized for the statistical analysis of the parameters. The results showed that the differences in AUC_t, C_(max) and T_(max) between two tablets were 2.72%, -0.65% and -8.42%, respectively, when calculated against the Nicetile^(TM) tablet. The powers (1-β) for AUC_t and C_(max) were 94.87% and 87.17%, respectively. Minimum detectable differences (△) at α=0.05 and 1-β=0.8 were less than 20% (e.g., 15.58% and 19.16% AUC_t and C_(max), respectively). The 90% confidence intervals were within ±20% (e.g., -11.84∼6.41 and -10.57∼11.88 for AUC_t and C_(max), respectively). Two parameters met the criteria of KFDA for bioequivalence, indicating that Neurocetil^(TM) tablet is bioequivalent to Nicetile^(TM) tablet.

니세틸 정(아세틸-엘-카르니틴 500 mg)에 대한 뉴로세틸 정의 생물학적 동등성

조혜영,김은아,정현철,심영순,임동구,오인준,문재동,이용복 전남대학교 약품개발연구소 2001 약품개발연구지 Vol.10 No.-

Acetyl-L-carnitine (ALC), an endogenous component of the L-carnitine family, is naturally occurring molecule synthesized from L-carnitine (LC) by carnitine acetyl transferase. ALC has been shown to improve the cognitive performance of patients suffering from dementia of the Alzheimer's type and proposed for treating Alzheimer's disease in pharmacological doses. The purpose of the present study was to evaluate the bioequivalence of two ALC tablets, Nicetiler^TM (Dong-A pharmaceutical Co., Ltd.) and Neurocetil^TM (Kyung-Dong Pharmaceutical Co., Ltd.), according to the guidelines of Korea Food and Drug Administration. Twenty six normal male volunteers, 22.80±2.76 year in age and 63.07 7.98㎏ in body weight, were divided into two groups and a randomized 2×2 cross-over study was employed. After one tablet containing 500㎎ of ALC was orally administered, blood was taken at predetermined time intervals and the concentrations of ALC in serum were determined using HPLC with fluorescence detector. Because of the presence of endogenous ALC, the calibration was performed using dialyzed serum. Pharmacokinetic parameters such as AUC_t, C_max and T_max were calculated and ANOVA was utilized for the statistical analysis of the parameters. The results showed that the differences in AUC_t, C_max and T_max between two tablets were 2.72%, -0.65% and -8.42%, respectively, when calculated against the Nicetile^TM tablet. The powers (1-β) for AUC_t and C_max were 94.87% and 87.17%, respectively. Minimum detectable differences (Δ) at α=0.05 and 1-β=0.8 were less than 20% (e.g., 15.58% and 19.16% AUC_t and C_max, respectively). The 90% confidence intervals were within ±20% (e.g., -11.84∼6.41 and -10.57∼11.88 for AUC_t and C_max, respectively). Two parameters met the criteria of KFDA for bioequivalence, indicating that Neurocetil^TM tablet is bioequivalent to Nicetile^TM tablet.

유도초음파 분산 특성을 이용한 박판의 탄성계수 측정

이동진(Dong-Jin Lee),조윤호(Younho Cho),장강원(Kang-Won Jang),조승현(Seung-Hyun Cho),안봉영(Bong-Young Ahn) 한국비파괴검사학회 2012 한국비파괴검사학회지 Vol.32 No.1

MEMS/NEMS 구조체의 개발과 응용기술의 발달로 박판 및 박막의 기계적 물성 평가에 대한 요구가 점차 늘어나고 있다. 기계적 물성은 주로 인장시험이나 초음파의 속도 측정으로 평가되어 왔으나, 박판/박막 구조의 경우 기존의 기술로는 측정에 한계가 있어 나노압입시험법, 유도초음파법 등의 새로운 기술이 개발되고 있다. 본 연구에서는 박판 구조의 금속재료의 탄성계수를 평가하기 위하여 EMAT으로 송수신된 박판내에서의 유도초음파 진행 속도를 측정하였으며, 이론적으로 계산된 유도초음파 군속도와 실험적인 군속도의 최적화 과정을 통해 최종적으로 박판의 탄성계수를 평가하였다. 두께 50 μm의 니켈 박판에서 측정된 영률은 201.6 GPa이었으며, 나노압입시험법으로 측정된 207 GPa, 참고문헌의 203.7 GPa과 비교하면 약 3% 내에서 일치하는 결과이다. As the development of MEMS/NEMS structure and application technology the demand for an assessment of the mechanical properties have increased. The mechanical properties are mainly evaluated by using tensile test or ultrasonic wave measurement. However, the new technology have been developed such as nano-indentation, guided wave method because they have a limitation in case of a thin plate and thin film. In the study, the guided wave velocities are measured by electromagnetic-acoustic transducer(EMAT), the material properties of thin metallic foils are obtained using optimization process of the theoretical and experimental group velocity of guided wave. The Young"s modulus obtained by the optimization process(201.6 GPa), nano-indentation(207.0 GPa) and literature value(203.7 GPa) of a 50 μm thick nickel thin plate shows good agreement within 3%.

당뇨병성 합병증을 가진 환자에서 혈중 Erythropoietin 농도

김동규,유기동,허광식,김상용,윤성호,조영신,권용은,김태원,김건영,정종훈,배학연 朝鮮大學校 附設 醫學硏究所 1998 The Medical Journal of Chosun University Vol.23 No.1

연구 배경 : 고혈당성에 의한 산화환원반응 이상(가저산소증)이 조절 되지않는 당뇨병의 특징으로 혈관과 신경 기능에 대한 진성 저산소증의 효과와 유사하며, 당뇨 합병증의 병태생리에 중요한 역할을 한다. 고혈당이 있는 인슐린 비의존형 당뇨병 환자에서 인슐린 수준이 정상이듯이, 빈혈이 있는 당뇨병 환자에서 EPO의 농도는 실제 혈색소 농도의 감소비율과 차이가 있을 것이라 추측된다. Friedman 등은 당뇨병성 합병증 원인 인자로 가저산소증(pseudohypoxia) 또는 저산소증(hypoxia)을 제기하였고 이런 인자들이 EPO의 상대적 또는 절대적 결핍에 의한 것임을 보고하였다. 방법 : EPO-Trac^(TM 125)I RIA kit을 이용하여 방사면역측정법으로 EPO 수준을 검사하였다. 전혈 3㎖을 5-10㎖ 시험관에 정맥 채혈하였으며, 용혈과 장기간의 보존을 위하여 원심분리를 즉시 시행하여 혈청을 영하 200C에서 냉동 보관 후 일괄적으로 검사 결과를 얻었다. 결과 : 1996년 9월부터 1997년 2월까지 조선대학교 부속병원 내과에 입원한 2형 당뇨병 환자 63례를 대상으로 하여 다음과 같은 결과를 얻었다. 1) 당뇨병성 합병증이 없는 군과 있는 군간의 혈색소, 혈중 EPO농도의 차이는 유의한 차이가 있었으며 혈색소의 감소율보다 혈중 EPO의 감소율이 더 높았다. 2) 당뇨병성 망막증의 유무에 따른 혈색소 농도의 차이는 유의한 차이가 없었으나 혈중 EPO농도는 유의한 차이가 있었다. 증식성군에서만 혈중 EPO의 감소비율이 혈색소에 비해 높았다. 3) 당뇨병성 신증의 유무에 따른 혈색소, 혈중 EPO농도는 유의한 차이가 있었고 혈색소 감소율에 비해 EPO농도의 감소율이 높았다. 신증의 중증도에 따른 혈색소, EPO의 차이는 미세알부민뇨군을 제외하고는 유의한 차이를 보였고 혈색소 감소율에 비해 EPO의 감소율이 더높았다. 4) 당뇨병성 신경병증의 유무에 따른 혈색소 농도의 차이는 유의한 차이가 없었으며 EPO농도는 유의한 차이를 보였다. 혈색소와 EPO의 감소비율은 비슷하였다. 신경병증의 중등도에 따른 혈색소와 EPO농도의 변화는 유의한 차이가 없었으나 stage 3에서는 혈색소감소율보다 EPO감소율이 더높았다. 결론 : 당뇨병성 합병증을 가진 환자에서 빈혈의 정도는 대부분 혈청 EPO치의 절대적 감소에 의함을 간접적으로 밝혀낼 수 있었으며 차후 더 많은 대상으로 비교 분석이 필요하리라 사료된다. Background: Hyperglycemic-induced redox(pseudohypoxia) imbalance is a characteristic feature of poorly controlled diabetes that mimics the effects of true hypoxia on vascular and neural functions and plays an important role on the pathogenesis of diabetic complications. As is true for apparently "normal" insulin levels typically found in NIDDM even in the presence of hyperglycemia, a "normal" erythropoietin level in an anemic diabetic subject may be disproportionally low for the actual red cell mass. Therefore, Friedman et al suggested that pseudohypoxia or hypoxia as an etiological factor of diabetic complications are due to absolute or relative erythropoietin deficiency Method: EPO-TracTM 125I RIA kit was used for the quantitative determination of erythropoietin(EPO) in serum by radioimmunoassay. An adequate sample of blood (3ml whole blood) was collected aseptically by venipuncture in a 5~10ml glass tube to yield a minimum of 400 L of serum per assay. The serum was promptly removed from the clot by centrifugation in order to avoid hemolysis. Then to increase its storage time it was frozen at -200C in a nonself defrosting freezer. Finally, tests were undertaken simultaneously Results We studied 63 cases with diabetes mellitus, who were admitted to Chosun University Hospital from September, 1996 to February, 1997 at the Department of Internal Medicine. We defined the control group, as diabetic patients who did not have anemia(<13mg/dl), diabetic complications(retinopathy, nephropathy, neuropathy) and the remainders were defined as the experimental group(we excluded anemic patients, who had secondary causes of anemia and diabetic patients with end stage renal disease)Data were as follow 1) The relationship of Hb and the 24hr urine protein between diabetic patients with and without complications significantly differed(p=0.02, < 0.001 respectively), but the Hb level was poorly related between diabetic patients with and without retinopathy(except in preproliferative, proliferative subgroups) and neuropathy. 2) Subgroups of patients with diabetic complications had higher 24hr urine protein than patients without diabetic complications, except stage I diabetic neuropathy 3) The EPO level was significantly different between diabetic patients with and without complications. 4) The correlation between EPO and Hb was significantly different, especially in diabetic patients with retinopathy and nephropathy according to severity of diabetic complications, compared with patients who did not have diabetic complications such as retinopathy and nephropathy. Conclusion: We know that anemia induced by diabetic complications is due to relative EPO deficiency than absolute EPO deficiency, and further evaluation and studies are needed on many cases in the future

폐고속국도의 생태복원 방안 -영동선 192.4K(인천) 지점을 중심으로-

조동길 ( Dong Gil Cho ),최재용 ( Jae Yong Choi ),전용철 ( Young Chul Jeon ) 한국환경보건기술학회(구 한국환경복원녹화기술학회) 2010 한국환경복원기술학회지 Vol.13 No.5

Expressways are often upgraded by widening the lanes and/or by reshaping the roads to be more linear for faster travel time. However, during the process of improving the route of the expressways, the areas where the old expressways used to be are often unused and abandoned. When these neglected sites are left alone, they often become dump sites causing pollution and impacting the surrounding environment. Therefore, it is important to restore the abandoned expressway sites to its full natural beauty. In this study, the abandoned expressway at the Soksa interchange in Pyungchang county, located in Kangwon province was studied for establishing the model of ecological restoration project. Considering the characteristics of the site, the target flora species was chosen to be Quercus species and the target fauna species as amphibians. After the target species were carefully chosen, each species` habitat requirements were studied in order to figure out the appropriate methods toward habitat restoration specifically for these species. In addition, to determine the most efficient method toward restoration of abandoned expressways, the study utilized the planting hole techniques, the crack techniques, and the colonization techniques. In terms of the spatial organization, public education program is incorporated at the main entrance area and the programs for experimenting, and developing vegetation and habitat restoration techniques are placed in the vicinity. In the master plan-to provide natural ecosystem at the site-ASCON (asphalt concrete) was removed first, then plans for restoration including species` habitat restoration were established. Furthermore, the project included plans for improving water quality polluted through non-point source considering the surrounding nearby road and farm lands. Finally, the study established a planning process that will experimentally apply to the abandoned expressway restoration method. In the future, there will be a continuous monitoring of the methods applied to verify if the restoration methods are effective. Also, new restoration techniques should be available according to a variety of abandoned expressways` characteristics.

당뇨병성 합병증을 가진 환자에서 혈증 Erythropoietin 농도

김동규,유기동,허광식,김상용,윤성호,조영신,권용은,김태원,김건영,정종훈,배학연 조선의대 1998 The Medical Journal of Chosun University Vol.23 No.1