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.

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.

노화가 인체 중간엽 줄기세포로부터 조골세포로의 증식 및 분화에 미치는 영향

백기현,태현정,오기원,이원영,조정기,권순용,강무일,차봉연,이광우,손호영,강성구,김춘추 대한내분비학회 2003 Endocrinology and metabolism Vol.18 No.3

연구배경: 일반적으로 골다공증과 연관된 위험인자로는 연령, 폐경, 약물, 불충분한 칼슘섭취, 만성질환 및 운동부족 등이 있는데, 특히 노화가 진행할수록 골밀도가 감소하는 것은 잘 알려져 있다. 노화와 관련하여 진행되는 골소실은 조골세포 및 전구조골세포의 기능적 결핍에 의한 골형성의 감소가 주요한 요인으로 여겨지고 있다. 그 동안 연령이 조골모 세포의 양과 조골모 세포로부터 성숙조골세포로의 분화 및 증식에 미치는 영향에 대한 일부 보고들이 있었으나 아직 일치된 견해는 없는 형편이다. 방법: 다양한 연령의 사람으로부터 골수를 채취, 중간엽 줄기세포가 포함된 단핵세포를 분리한 후 조골세포로 분화하기 좋은 조건하에서 배양하였다. 대상군은다시 젊은군과 노령군으로 구분하여 다양한 변수를 비교 분석하였다. 일차배양에서는 CFU-F를 계수하여 골수내 중간엽 줄기세포의 수를 추산하였고, 칼슘측정을 통하여 기질의 무기화 정도를 비교하였다. 계대배양후 이차배양에서는 시기별로 알카리성 포스파타제 활성도를 측정하고 오스테오칼신 mRNA의 발현을 관찰하여 젊은군과 노령군 사이의 증식능 차이를 비교하였다. 또한 이차배양 시기별로 MTT 측정을 하여 양군간에 증식능 차이가 있는지 알아보았다. 결과: 1. 일차배양 15일째에 평균 CFU-F의 수는 젊은군에서 유의하게 많았다(젊은군 148.3±28.9, 노령군 54.3±9.1, p=0.02). CFU-F의 평균면적은 젊은군에서 넓은 경향을 보였으나 통계적으로 유의하지는 않았다. 2. 일차배양 17일 경과 후 양군간에 기질 칼슘 침착정도는 유의한 차이를 보이지 않았다(젊은군 103.6±50.6, 노령군: 114.0±56.5, p=NS). 3. 이차배양 10일째에 젊은군에서 알카리성 포스파타제 활성도가 고령군에 비해 유의하게 높았다(젊은군: 935.5±115.0 U/mg, 노령군: 578.4±115.7U/mg,p.0.05). 고령군에서는 시간 경과에 따른 변화가 미약했으며 전반적으로 알카리성 포스파타제의 활성도가 젊은군에 비해 낮았다. 4. 이차배양도중 오스테오칼신 mRNA의 발현은 배양시기별로 젊은군에 비해 고령군에서 더 낮은 경향을 관찰할 수 있었다. 5. 이차배양 10일과 15일에 젊은군에서 노령군보다세포증식이 유의하게 증가된 양상을 보였다(10앓 젊은군 0.73±0.05, 노령군 0.58±0.04, p=0.05, 15일; 젊은군 0.80±0.05, 노령군 0.70±0.03, p=0.05).결론: 이상의 연구에서 저자들은 노령군에서 젊은군보다 골수 내 중간엽줄기세포의 수가 적고, 노령군에서 유래한 전구조골세포의 성숙조골세포로의 증식 및 분화가 젊은군 보다 감소해 있는 것을 관찰할 수 있었다. Background: Osteoblasts originate from osteoprogenitor cells in bone marrow stroma, termed mesenchymal stem cells (MSCs) or bone marrow stromal cells. Each MSC forms colonies (colony forming units-fibroblasts [CFL-Fs]) when cultured ex vivo. There are some reports about the age-related changes of the number and osteogenic potential of osteoprogenitor cells, but any relationship has not been clearly established in humans. In this study, we counted MSCs using CFU-Fs count and examined the proliferative capacity and differentiation potential of osteoprogenitor cells. Finally, we analyzed how these parameters varied with donor age. Methods: Bone marrow was obtained from the iliac crest of young (n=6, 27.2±8.6 years old) and old (n= 10, 57.4k6.7 years old) healthy donors. Mononuclear cells, including MSCs, were isolated and cultured in osteogenic medium. In primary culture, we compared the colony-forming efficiency of MSCs between the two groups and determined the matrix calcification. When primary culture showed near confluence, the cells were subcultured. Alkaline phosphatase activity, osteocalcin expression by RT-PCR and proliferative potential by MTT assay were examined by the time course of secondary culture. Results: At the 15th day of primary culture, the mean number of CFU-Fs was significantly higher in the younger donors (young: 148.3±28.9, old: 54.3±9.1, p=0.02) and the mean size of CFL-Fs was also larger in the younger donors than the older donors. However, matrix calcification was not different between the two groups (young: 103.6±50.6, old: 114.0±56.5, p=NS). In secondary culture, alkaline phosphatase activities were significantly lower in the older donors. The younger donors showed peak alkaline phosphatase activity at day 10, while the older donors didn't showed a remarkable peak (young: 935.5±115.OU/mg, old: 578.4±115.7U/mg, p<0.05). Total cell number as a proliferative index increased progressively during the secondary culture and a significantly greater cell number was noted in the younger donors. Osteocalcin expression was generally upregulated in the younger donors, but this was not statistically significant. Conclusion: Our study shows that the number of osteoprogenitor cells is decreased during aging and that the proliferative capacity and differentiation potential of osteoprogenitor cells seem to be reduced during aging (J Kor SOC Endocrinol 18:296-305, 2003).

화이트보드를 이용한 원격교육시스템 구현

조영태,박기현 계명대학교 산업기술연구소 1998 産業技術硏究所 論文報告集 Vol.21 No.1

With the rapid development of internet and intranet, there have been big changes in remote education. The appearance of WWW makes it possible for remote education to povide higher education effects with low costs. With the development of internet technologies, teachers and students can communicate each other in open educational environments. Until now, however, e-mail and BBS have been used in order to obtain information and to exchange opinions in the internet/intranet. Therefore, it is impossible for teachers and students to communicate each other in real time. In this paper, the concept of white board is used in order to solve the problem, mentioned above, The white board is implemented in java, With the whiteboard, it is possible for teachers and students to ask and answer at the same time using chatting functions. Text books and teaching materials required for lectures can be made in HTML and CGI, thus they can be viewed by any Web Browsers.

해양 레저스포츠 관광상품화 개발을 위한 대학과 지방자치 단체간의 커뮤니케이션 모형개발(Ⅰ)

조재기,신영균,손명준 한국스포츠리서치 2003 한국 스포츠 리서치 Vol.14 No.6

This study utilized antecedent studies and statistics made by local governments and other public organizations in order to obtain objective data necessary for the development of marine-leisure tourism products, and adopted related literature research and descriptive analysis as its primary method of data analysis. Based on the primary research, case study by means of field study in advanced countries was adopted in the stage of the secondary research, which aimed to draw inductive reasoning necessary for understanding the circumstances of commercializing marine-leisure sports tourism. The tertiary analysis intended to understand policies related to marine-leisure tourism product development and to design a tourism product, which takes B! usan as its model. The research results are as follows: 1. It is necessary to construct sustainable and organized policies and systems after the public hearing led by the local government and supported by local universities throughout the whole process of developing a marine-leisure tourism product so that the concept of sustenance can be applied. 2. In order to judge and measure the potential for sustainable development of marine-leisure tourism, an index of sustainable tourism should be developed by academic institutes like universities. 3. An event to publicize investment opportunities in marine-leisure tourism should be held under the joint sponsorship of local governments and universities so that enterprises at home and abroad can take interest in investment and further move on to sign an MOU. 4. As past tourist attraction development caused damage to natural environment and ignorance of profitability, the direction of the future marine-leisure tourism development should be separated into the tourism product developmenmt and tourist attraction development. 5. An academy to train professionals in the field of marine-leisure tourism should be established by the joint supervision of the local government and universities. 6. Korean-style marine-leisure sports should take root in the social system and be standardized. 7. Marine-leisure sports should take root in the social system and be standardized. 8. Tourism products using large-scale cruisers should be developed. 9. Coastal cruise course should be developed.

다중 제어루프에 의한 자기부상용 DC-DC 전원장치에 관한 연구

조주현,조정민,전기영,이상집,이승환,오봉환,이훈구,한경희 明知大學校 産業技術硏究所 2004 産業技術硏究所論文集 Vol.23 No.-

The author present a modified multi-loop algorithm including feedforward for controlling a 55kW step down chopper in the power supply of Maglev. The control law for the duty cycle consists of three terms. The first is the feedforward term which compensates for variations in the input voltage. The second term consists of the difference between the slowly moving inductor current and output current. The third term consists of proportional and integral terms involving the perturbation in the output voltage. This perturvation is derived by subtracting the desired output voltage from the actual output voltage. The proportional and integral action stabilizes the system and minimizes output voltage error. In order to verify the validity of the proposed multi-loop controller, simulation study was tried using Matlab simulink.

유도선수의 경쟁불안이 경기력에 미치는 영향

조인철,김영훈,이병기 龍仁大學校 體育科學硏究所 2002 體育科學硏究論叢 Vol.12 No.1

The objective of this study consists in inquiring into how competition - related anxieties affect judo matches, and then providing based on the basis of the analytical results of the present study the data needed for effective training as well as for the enhancement of athletic power in judo. In order to analyse the aforementioned hypotheses, the present study took as demographic attributes some principal factors such as sexes, prize-winners, non-prize winners, and school career, on 194 male and female student subjects randomly sampled out from Y University, K University, H University, B High school, and K High School. The resultant findings were revealed, as follows : The results of having measured 27 variables out of three factors of cognitive anxieties, physical anxieties, and affective anxieties indicated that competition-related anxieties in all the three factors were found to influence athletic power. However, when viewed from a demographic characteristic perspective, the mean response to competition-related anxieties in all the three factors was identified not to have so power an effect upon athletic power by responding with 'a little bit'.

상아질에 대한 자가 산부식 접착제의 전단결합강도와 SEM 분석 비교

조영곤,노기선,김수미,이영곤,정진호,기영재 大韓齒科保存學會 2003 Restorative Dentistry & Endodontics Vol.28 No.3

The purpose of this study was to compare shear bond strength and interfacial pattern of composite bonded to dentin using self-etching adhesive systems. Sixty extracted human molars with exposed occlusal dentin were divided into four groups and bonded with four adhesives and composites: Single Bond/Filtek Z 250(SB), Tyrian SPE-One-Step Plus/Aelitefil(TY), Prompt L-Lpop/Filtek Z 250(LP), and one-Up Bond F/Palfique Toughwell(OU). The results of this study were as follows; 1. Shear bond strength for OU was significantly lowet than that of other groups(p<0.05). No significant difference was founded among SB, TY, and LP. 2. Failure modes to dentin showed adhesive and mixed for SB, TY, and LP, but them for OUT showed adhesive in all spceimens. 3. Dentin-resin interface showed close adaptation for SB, TY, and LP, but it showed gap for OU. 4. The hybrid layers for TY, LP, OU were thinner than that of SB. Adhesive layers were observed between composite and hybrid layer, which were 5 ㎛ thick for TY and 10 ㎛ thick for OU.

노인정신장애 평가척도(Psychogeriatric Assessment Scale)의 한국판 표준화 연구

조맹제,박임순,신영민,김무진,정희연,정은기,최용성,조성진,서국희,함봉진 大韓神經精神醫學會 2000 신경정신의학 Vol.39 No.1

연구목적 : 본 연구는 치매와 우울증을 다차원적으로 평가할 수 있는 도구인 Psychogeriatric Assessment Scale(PAS)의 한국판(PAS-K)을 개발하기 위한 것이다. 방 법 : 번역, 역번역, 그리고 세차례의 예비조사를 통하여 PAS-K를 제작하였다. 60세 이상의 노인 291명(임상환자군 : 58명, 지역사회노인군 : 168명, 수용시설 거주자 : 67명)과 그들의 정보제공자들을 대상으로 PAS-K, Geriatric Depression Scale(GDS), Korean version of Mini-Mental State Examination(MMSE-K), Hamilton Rating Scale for Depression(HRSD), 그리고 Hachinski Ischemic Score 를 적용하고, Diagnostic Interview chedule(DIS-Ⅲ-R)을 사용하여 치매와 우울증을 진단하였다. PAS-K의 신뢰도와 타당도를 평가하고, 예민도와 특이도, Kappa값, 그리고 ROC커브 분석법을 이용하여 PAS-K의 6개의 소척도들(피검자면접 : 인지기능 장애척도, 우울척도, 뇌졸중척도, 정보제공자면접 : 인지기능 저하척도, 행동변화척도, 뇌졸중척도)의 최적 절단점을 구하였다. 결 과 : PAS-K는 높은 내적 일관성을 보였고, 검사자간 신뢰도도 만족할 만한 수준이었다. PAS-K의 소척도들을 다른 표준화된 검사도구들과 비교하였을 때 인지기능 장애척도와 인지기능 저하척도는 MMSE-K와, 우울척도는 GDS 및 HRSD와 유의한 상관관계를 보였으며, 뇌졸중척도는 Hachinski Ischemic Score와 통계적으로 의미있는 상관관계를 보였다. 최적절단점은 인지기능 장애척도 10점, 인지기능 저하척도 3점, 우울척도 5점, 피검자면접과 정보제공자 뇌졸중척도 모두 1점, 그리고 행동변화척도 2점으로 추정하였다. 결 론 : 본 연구를 통해 PAS-K의 신뢰도와 타당도가 검증되었고, 노인정신의학 역학연구나 보건분야에서 치매와 우울증의 임상경과관찰 및 일차 선별도구로서 유용하게 사용될 수 있게 되었다. Objectives : This study was designed to develop the Korean version of the Psychogeriatric Assessment Scale(PAS-K), a multidimensional screening tool for the dementia and depression. Methods : Through three times preliminary trials, the authors translated PAS into Korean. The PAS-K, Geriatric Depression Scale, Hamilton Depression Rating Scale, Hachinski Ischemic Scale and Mini-Mental State Examination-Korean version were administered to 291 subjects over the age of 60 and the same number of their informants(67 subjects were institutionalized, 168 subjects were in community, 58 subjects were psychiatric hospital patients). And the Diagnostic Interview Schedule(DSM-Ⅲ-R) was independently administered to exactly diagnose dementia and depression. The reliability and validity test, optimal cut-off point estimation for six each scale and ROC curve analyses were done to investigate the diagnostic validity of PAS-K. Results : Internal consistency and interrater reliability of the PAS-K were high. Concurrent validity of each scales of PAS-K was good in being measured with other standardized scales. The optimal cut-off points of each scale of the PAS-K were estimated as follows : 1) Stroke Scale of subject interview : 1, 2) Cognitive Impairment Scale of subject interview: 10, 3) Depression Scale of subject interview : 5, 4) Stroke Scale of informant interview : 1, 5) Cognitive Decline Scale of informant interview : 3, and 6) Behavioral Change Scale of informant : 2. conclusions : The PAS-K was valid and reliable screening tools for detecting dementia and depression. Therefore the PAS-K could be widely and extensively used in psychogeriatric epidemiological research or clinical setting of primary screening for dementia and depression.

원예작물의 염류장애 원인과 대책을 위한 생리, 생화학적 연구 2. 토마토 뿌리조직 H+ 펌프 활성 및 Thapsigargin 저해효과

조광현,사공정,김영기 충북대학교 한국과학재단 지정 첨단원예기술개발 연구센터 1997 연구보고서 Vol.2 No.-

Thapsigargin은 동물조직 SR/ER-type Ca²+-ATPase에 특이성이 높은 선택적 저해제로서 토마토 뿌리조직으로부터 분리한 마이크로솜에 Ca²+-ATPase의 존재를 확인하기 위하여 사용되었다. 원형질막과 액포막에 위치하는 H+-ATPase들의 활성은 각각의 선택적 저해제인 vanadate와 NO₃를 이용하여 평가하였고, 이들의 활성은 각각 마이크로솜 ATPase 총활성의 ∼26%, ∼36%로 나타났다. 이들 두 가지 저해제 효과는 additive하게 나타났으며, 전체활성의 약 50∼70%를 저해함을 확인하였다. 마이크로솜 ATPase활성에 대한 thapsigargin의 저해효과에서 10 μM thapsigargin은 총활성의 30%를 저해하였으며, 저해효과는 농도 의존적으로 나타났다. Thapsigargin에 의한 활성저해 기작을 조사하기 위하여 H+-ATPase의 선택적 저해제들을 사용하였다. 액포막의 H+-ATPase 활성에 대한 thapsigargin의 효과를 조사하기 위한 NO₃의 dose-response 실험에서, thapsigargin은 NO₃에 의해 저해되는 ATPase활성을 경쟁적으로 감소시켰다. 반면, vanadate의 농도를 10 nM∼2mM로 증가시켜 원형질막의 H+-ATPase 활성을 저해시킨 조건에서는 thapsigargin에 의하여 저해되는 활성이 온전히 나타나 vanadate의 저해효과와는 무관한 결과를 얻었다. 이러한 결과는 액포막 H+-ATPase의 활성이 thapsigargin에 의해 저해된다는 것을 의미한다. 저자들은 액포막 H+-ATPase의 활성이 Ca²+에 의하여 저해됨을 이미 보고하였다 (Cho et al., 1998). Thapsigargin에 의하여 저해되는 마이크로솜 ATPase활성은 반응용액의 Ca²+농도가 증가할수록 감소하였으며, 이것은 thapsigargin이 액포막 H+-ATPase 활성을 저해한다는 가능성을 더욱 지지하였다. 이상의 결과는 토마토 뿌리조직의 마이크로솜 ATPase중 액포막의 H+-ATPase 활성이 thapsigargin에 의해서 저해되는 것을 보여주며, 액포막 H+-ATPase와 ER-type Ca²+-ATPase와의 구조적, 기능적 연관성이 있을 가능성을 제안한다. The effect of thapsigargin, a SR/ER-type Ca²+-ATPase inhibitor, was investigated to determine the presence of thapsigargin-sensitive Ca²+-ATPases in the microsomes of tomato roots. The activities of plasma membrane H+-APTase and vacuolar H+-ATPase were evaluated to ∼26% and ∼36% of total microsomal ATPase activity by using their specific inhibitors, vanadate and NO₃, respectively. The inhibitory effects of vanadate and NO₃- were additive and the simultaneous additions of these two inhibitors decreased the total activity up to 50∼70%. Thapsigargin (10μM) inhibited the microsomal ATPase activity by ∼30% and the thapsigargin-induced inhibition was appeared to be dose-dependent. In order to understand the molecular mechanism of thapsigargin-induced inhibition, the effects of specific H+-ATPase inhibitors were tested and compared to the effect of thapsigargin. The NO₃-induced inhibition was decreased by simultaneous treatment of thapsigargin. In dose-response experiments of vanadate and NO₃-, thapsigargin only blocked the NO₃-induced inhibition, while the effects of vanadate and thapsigargin were independent at the whole range of vanadate concentration (10 nM∼2 mM). Meanwhile, the thapsigargin-induced inhibition was decreased by increasing Ca²+ concentration. Since we have shown that Ca²+ blocks the activity of vacuolar H+-ATPase, these results together suggest that thapsigargin inhibits the NO₃-sensitive vacuolar H+-ATPase but not the vanadate-sensitive plasma membrane H+-ATPase. Our results also suggest that there is structural and functional relations between vacuolar H+-ATPase and SR/ER-type Ca²+-ATPase.