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.

ApoB/ApoA-I ratio is independently associated with carotid atherosclerosis in type 2 diabetes mellitus with well-controlled LDL cholesterol levels

( Ji Eun Jun ),( Young Ju Choi ),( Yong-ho Lee ),( Dae Jung Kim ),( Seok Won Park ),( Byung Wook Huh ),( Eun Jig Lee ),( Sun-ha Jee ),( Kyu Yeon Hur ),( Sung Hee Choi ),( Kap Bum Huh ) 대한내과학회 2018 The Korean Journal of Internal Medicine Vol.33 No.1

Background/Aims: This study aimed to investigate whether the apolipoprotein (Apo) B/ApoA-I ratio is associated with carotid intima-media thickness (CIMT) in type 2 diabetes mellitus (T2DM) subjects with low density lipoprotein cholesterol (LDL-C) levels less than 100 mg/dL. Methods: This cross-sectional study included 845 subjects aged with T2DM 40 to 75 years who had visited Huh’s Diabetes Center in Seoul, Republic of Korea for CIMT measurement. Traditional fasting lipid profiles, ApoB and ApoA-I levels were examined. CIMT was measured at three points on the far wall of 1 cm long section of the common carotid artery in the proximity of the carotid bulb. The mean value of six measurements from right and left carotid arteries were used as the mean CIMT. In this study, carotid atherosclerosis was defined as having a focal plaque or diffuse thickening of the carotid wall (mean CIMT ≥ 1.0 mm) Results: The prevalence of carotid atherosclerosis increased with ApoB/ApoA-I ratio. The ApoB/ApoA-I ratio, expressed as both quartiles (odds ratio [OR], 2.14; 95% confidence interval [CI], 1.21 to 3.79; p for trend = 0.014) and continuous values (OR, 10.05; 95% CI, 3.26 to 30.97; p < 0.001), was significantly associated with a higher risk for carotid atherosclerosis, regardless of conventional cardiovascular disease risk factors. The optimal ApoB/ApoA-I ratio cutoff value for detecting carotid atherosclerosis was 0.57, based on receiver operating characteristic curve analysis with a sensitivity of 58.0% and a specificity of 55.1%. Conclusions: A high ApoB/ApoA-I ratio was significantly associated with carotid atherosclerosis in T2DM patients with LDL-C levels less than 100 mg/dL.

제2형 당뇨병환자에서 ApoB/ApoA-I Ratio와 대사증후군 및 대사증후군 각 요소와의 관계

김정은 ( Jung Eun Kim ),김화영 ( Wha Young Kim ),이윤정 ( Yoon Jung Lee ),박지은 ( Ji Eun Park ),최영주 ( Young Ju Choi ),허갑범 ( Kap Bum Huh ),황지윤 ( Ji Yun Hwang ) 대한당뇨병학회 2009 Diabetes and Metabolism Journal Vol.33 No.2

연구배경: Apolipoprotein B/apolipoprotein A-I 비율(ApoB/ApoA-I)은 대사증후군의 중요한 임상적 지표이다. 하지만, 한국인 제2형 당뇨병환자들을 대상으로 ApoB/ApoA-I과 대사증후군의 관련성을 살펴본 연구는 미미하다. 따라서 본 연구에서는 ApoB/ApoA-I과 ApoB/ApoA-I 사분위에 따른 대사증후군 및 대사증후군 각 요소별 위험도를 보았다. 방법: 대상자는 서울의 당뇨병 전문 클리닉 허내과를 방문한 제2형 당뇨병환자 812명 (남자 424명, 여자 388명)이다. 이들을 성별로 ApoB/ApoA-I의 사분위에 따라 네 군으로 나누었다(가장 낮은 군:Q1-가장 높은 군:Q4). 체위, 혈액성상 및 식품섭취 빈도조사지를 통한 식이섭취량이 측정되었다. 결과: 대사증후군의 유병률은 남자 47.9%, 여자 66.5%였다. 대사증후군과 대사증후군의 각 위험요소에 대한 OR은 남녀 모두 ApoB/ApoA-I의 Q2에서 Q4로 갈수록 유의하게 증가했다(남자: OR=5.37; 95% CI=2.98-9.65 and OR=7.41; 95% CI=4.04-13.6; 여자: OR=2.57; 95% CI=1.28-5.15 and OR=8.49; 95% CI=4.28-16.8). 이러한 경향은 남녀 모두에서 연령, 당뇨 유병기간, 공복 혈당, 대량영양소를 보정한 후에도 변하지 않았다(남자: OR=5.24; 95% CI=2.80-9.24 and OR=7.98; 95% CI=4.09-15.6; 여자: OR=3.54; 95% CI=1.84-6.81, OR=4.41; 95% CI=2.26-8.61, and OR=8.29; 95% CI=3.85-17.8). 결론: 본 연구에서는 당뇨병환자에서 가장 중요한 인자 중 하나인 다량 영양소 섭취량을 포함한 대사증후군의 위험요인을 보정하기 전과 후 모두 ApoB/ApoA-I이 증가 할수록 대사증후군 및 대사증후군 각 요소의 위험도가 증가했다. 향후, ApoB/ApoA-I 증가와 대사증후군 및 대사증후군 각 요소의 위험도에 대한 정확한 평가를 위해 ApoB/ApoA-I과 관련한 식이위험요인에 대한 전향적인 연구가 필요할 것으로 사료된다. Background: The Apolipoprotein B/apolipoprotein A-I ratio (apoB/apoA-I) is a powerful clinical indicator of metabolic syndrome. However, few studies have searched for an association between ApoB/ApoA-I and metabolic syndrome in Korean patients with type 2 diabetes. We investigated the relation between ApoB/ApoA-I and the risk of metabolic syndrome and its components. Methods: Subjects were 812 (424 males and 388 females) Korean patients who were being treated for type 2 diabetes at Huh`s Diabetes Center in Seoul. The patients were classified into quartiles (lowest:Q1- highest:Q4) of ApoB/ApoA-I by gender. Anthropometric and hematological characteristics and dietary intake using a food frequency questionnaire were assessed. Results: The prevalence of metabolic syndrome in our sample was 47.9% in males and 66.5% in females. The odds ratios (OR) for metabolic syndrome and for having its components were significantly increased from Q2 to Q4 quartiles of ApoB/ApoA-I in males (OR = 5.37; 95% CI = 2.98-9.65 and OR = 7.41; 95% CI = 4.04-13.6) and females (OR = 2.57; 95% CI = 1.28-5.15 and OR = 8.49; 95% CI = 4.28-16.8). These trends withstood adjustment for age, duration of type 2 diabetes, fasting blood glucose levels, and macronutrient intake both in males (OR = 5.24; 95% CI = 2.80-9.24 and OR = 7.98; 95% CI = 4.09-15.6) and in females (OR=4.41; 95% CI = 2.26-8.61 and OR = 8.29; 95% CI = 3.85-17.8). Conclusion: ApoB/ApoA-I appeared to be independently associated with risk of having metabolic syndrome and its components in Korean patients with type 2 diabetes after adjustment for putative risk factors including macronutrient intake, a particularly important lifestyle factor for patients with type 2 diabetes. A follow-up study of this population should evaluate the mechanisms underlying the relation between ApoB/ApoA-I and metabolic syndrome and its components. (Korean Diabetes J 33:143-154, 2009)

화농성 중이염에 의한 경막하 고름집 1예

허소영,이지현,박지영 고신대학교 의과대학 2009 고신대학교 의과대학 학술지 Vol.24 No.1

Subdural empyema represents infection within the potential space that lies between the dura and arachnoid. Subdural empyema is a life-threatening and uncommon sequelae of suppurative otitis media. Treatment was invariably surgical with antibiotics. We present the case of a patient with a serious intracranial pyogenic infection due to otitis media, who was successfully treated only with antibiotics. The case shows a complication of subdural empyema, which reveals an importance of early diagnosis and suitable management.

Association between dietary flavanones intake and lipid profiles according to the presence of metabolic syndrome in Korean women with type 2 diabetes mellitus

Ji Soo Oh,Hyesook Kim,Aswathy Vijayakumar,Oran Kwon,Young Ju Choi,Kap Bum Huh,Namsoo Chang 한국영양학회 2016 Nutrition Research and Practice Vol.10 No.1

BACKGROUND/OBJECTIVES: This study was aimed at examining the association between dietary flavanones intake and lipid profiles according to the presence of metabolic syndrome (MetS) in Korean women with type 2 diabetes mellitus (T2DM). SUBJECTS/METHODS: A cross-sectional analysis was performed among 502 female T2DM patients (non-MetS group; n = 129, MetS group; n = 373) who were recruited from the Huh’s Diabetes Clinic in Seoul, Korea between 2005 and 2011. The dietary intake was assessed by a validated semi-quantitative food frequency questionnaire (FFQ) and the data was analyzed using the Computer Aided Nutritional Analysis program (CAN-Pro) version 4.0 software. The intake of flavanones was estimated on the basis of the flavonoid database. RESULTS: In the multiple linear regression analysis after adjustment for confounding factors, daily flavanones intake was negatively associated with CVD risk factors such as total cholesterol, LDL-cholesterol, and apoB and apoB/apoA1 ratio only in the MetS group but not in the non-MetS group. Multiple logistic regression analysis revealed that the odds ratio for a higher apoB/apoA1 ratio above the median (≥ 0.74) was significantly low in the 4th quartile compared to that in the 1st quartile of dietary flavanones intake [OR: 0.477, 95% CI: 0.255-0.894, P for trend = 0.0377] in the MetS group. CONCLUSIONS: Dietary flavanones intake was inversely associated with the apoB/apoA1 ratio, suggesting a potential protective effect of flavanones against CVD in T2DM women with MetS.

가축에서 분리된 Vancomycin 내성 장구균의 내성유전자 구조 분석을 통한 분자생물학적 역학 연구

허지영,이선민,이석호,이위교,용동은,이경원,신완식,이동건 대한임상미샐물학회 2003 Annals of clinical microbiology Vol.6 No.2

고추 탄저병 저항성 중간모본 ‘원예 100005호 ’,‘원예 100006호’ 육성

양은영,김수,채영,채수영,조명철,문지혜,박태성,이우문,곽정호 忠北大學校 農業科學硏究所 2015 農業科學硏究 Vol.31 No.2

Owing to frequent heavy rain due to abnormal weather, the occurrence of pepper anthracnose has recently increased, which affects the supply and demand of pepper. As a result, the price of red pepper powder in 2011, for example, increased three times compared to the average year. Although anthracnose of pepper plants has been controlled by fungicides until now, it is important to develop new resistant cultivars because of the reduction of the labor force in rural area and occurrence of new anthracnose strains resistant to fungicides. National Institute of Horticultural and Herbal Science developed two pepper lines, ‘Wonye 100005’ and ‘Wonye 100006’ that are resistant to pepper anthracnose. These lines were developed by continuous selection of progenies from a cross between ‘Wonye AR1’, which were developed from interspecific hybridization and ‘TF68’. The anthracnose resistance level of the two lines was higher than that of commercial cultivars and similar to check varieties showing highest level of anthracnose resistance.

Smoking Is Associated With Abdominal Obesity, Not Overall Obesity, in Men With Type 2 Diabetes

Yun, Ji-Eun,Kimm, Hee-Jin,Choi, Young-Ju,Jee, Sun-Ha,Huh, Kap-Bum The Korean Society for Preventive Medicine 2012 Journal of Preventive Medicine and Public Health Vol.45 No.5

Objectives: Abdominal obesity increases mortality and morbidity from cardiovascular disease and there is a possibility that smoking effects obesity. However, previous studies concerning the effects of smoking on obesity are inconsistent. The objective of this study was to examine whether smoking is positively related to abdominal obesity in men with type 2 diabetes. Methods: Subjects consisted of 2197 type 2 diabetic patients who visited Huh's Diabetes Center from 2003 to 2009. Indices of abdominal obesity were defined as visceral fat thickness (VFT) measured by ultrasonography and waist circumference (WC). Overall obesity was defined as body mass index (BMI). Results: Statistically significant differences in WC and VFT by smoking status were identified. However, there was no statistical difference in BMI according to smoking status. Means of WC and VFT were not significantly higher in heavy smokers and lower in mild smokers. Compared to nonsmokers, the BMI confounder adjusted odds ratio and 95% confidence interval for VFT in ex-smokers and current-smokers were 1.70 (1.21 to 2.39) and 1.86 (1.27 to 2.73), respectively. Conclusions: Smoking status was positively associated with abdominal obesity in type 2 diabetic patients.

사지 임파부종에 대한 임상적 분석

김동익,허세호,이병붕,김은숙,문지영,황지혜 대한혈관외과학회 2002 Vascular Specialist International Vol.18 No.1

Purpose: Given the increased frequency of operative therapy and radiation therapy on breast cancers and uterine cancers, there is very little information on lymphedema associated with these treatments in Korea. Thus, the authors conducted this study to describe and analyze the data which they had obtained from the patients. Method: A retrospective study was undertaken on 840 patients who registered to the Lymphedema Clinic of Samsung Seoul Hospital throughout the period of February 1995 to August 2001. Result: Out of 840 patients, 205 patients (24%) were confirmed as having primary lymphedema, while 635 patients (76%) had secondary lymphedema. The ratio of male to female for primary lymphedema was 1 :1.8(Male : Female), while secondary lymphedema demonstrated to be 1:21 (Male : Female), demonstrating a female preponderance. Secondary lymphedema mostly developed after undergoing treatment for uterine cancer (341 patients, 53.7%) and breast cancer (226 patients, 35.5%) The lesions of occurrence for both primary and secondary lymphedema were mainly in the lower extremities than the upper extremities. In regards to the degree of clinical edema, a large number of the patients, that is 633 patients (76%) had progressed to Stage Ⅱ~Ⅲ. Among the patients who developed edema after undergoing treatment for cancers, only 43 patients (7%) were provided information on the possibility of developing lymphedema, while the majority of the patients had no knowledge about this possibility. When the patients' subjective experiences were investigated on the degree of the edema, there was no significant increase in pain despite an increase in the degree of the edema (P<0.05), nevertheless, a significant increase was found in cosmetic problems (P>0.05). Conclusion: As a general rule, complete recovery from chronic lymphedema is not expected. However, early detection of lymphedema and timely appropriate treatment as well as aggressive patient education on lymphedema and its related complications can prevent its progression.

방광 크롬친화세포종과 동반된 배뇨후 벼락두통

하윤석,강성진,허소영,이지현,김민정,김종국,김광수 고신대학교 의과대학 2009 고신대학교 의과대학 학술지 Vol.24 No.1

Thunderclap headache is a hyperacute, severe headache that is so named because the pain strikes suddenly and severely, and is sometimes a sign of a medical emergency. We report a case of pheochromocytoma in the urinary bladder in a 48-year-old woman who presented with recurrent thunderclap headache after voiding and exercise. So we think thunderclap headache during or immediately after micturition may be an important diagnostic clue of bladder pheochromocytoma.