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>

OB-63 : Positive effects of Teratogenic risk counseling in pregnant women inadvertently exposed to medications

( Hyo Yeon Gwak ),( Jung Eun Lee ),( Ju Young Choi ),( So Yeon Kim ),( Song Mi Park ),( June Seek Choi1,),( Hyun Kyong Ahn ),( Min Hyung Kim ),( Jin Hoon Chung ),( Moon Young Kim ),( Hyun Mee Ryu ),( 대한산부인과학회 2014 대한산부인과학회 학술대회 Vol.100 No.-

목적: To evaluate the positive effects of teratogenic risk counseling in pregnant women inadvertently exposed to medication in early pregnancy. 방법: In a prospective cohort study, 250 pregnant women exposed to medications in early pregnancy were recruited after teratogenic risk counseling at Korean MotherSafe Counsling Center, which has given information about teratogenic risk of medication to pregnant women. Positive effects are evaluated by visual analogue scale(VAS) for perception on teratogenic risk and percent prefering termination of pregnancy after medication exposures in pregnancy. 결과: Mean age of participants is 31.8±5.3years old. Mean gravidity is 2.4±2.1. Medications exposed in early pregnancy include antibiotics, analgesics, anti-inflammatory drugs, antacid and so on. Mean perceptive teratogen risk before and after the counseling is 33.9±1.6% and 15.8±1.6%, respectively. And mean percent prefering termination of pregnancy (≥5) before and after the counseling is 31.1±1.9% and 13.5±1.7%, respectively. 결론: Our data suggest that information on teratogenic risk for pregnant women inadvertently exposed to medication may have positive effects for reassuring pregnant women and preventing termination of pregnancy.

Associations between prospective symptom changes and slow-wave activity in patients with Internet gaming disorder : A resting-state EEG study

Kim, Yeon Jin,Lee, Jun-Young,Oh, Sohee,Park, Minkyung,Jung, Hee Yeon,Sohn, Bo Kyung,Choi, Sam-Wook,Kim, Dai Jin,Choi, Jung-Seok Wolters Kluwer Health 2017 Medicine Vol.96 No.8

<P><B>Abstract</B></P><P>The identification of the predictive factors and biological markers associated with treatment-related changes in the symptoms of Internet gaming disorder (IGD) may provide a better understanding of the pathophysiology underlying this condition. Thus, the present study aimed to identify neurophysiological markers associated with symptom changes in IGD patients and to identify factors that may predict symptom improvements following outpatient treatment with pharmacotherapy. The present study included 20 IGD patients (mean age: 22.71 ± 5.47 years) and 29 healthy control subjects (mean age: 23.97 ± 4.36 years); all IGD patients completed a 6-month outpatient management program that included pharmacotherapy with selective serotonin reuptake inhibitors. Resting-state electroencephalography scans were acquired prior to and after treatment, and the primary treatment outcome was changes in scores on Young's Internet Addiction Test (IAT) from pre- to posttreatment. IGD patients showed increased resting-state electroencephalography activity in the delta and theta bands at baseline, but the increased delta band activity was normalized after 6 months of treatment and was significantly correlated with improvements in IGD symptoms. Additionally, higher absolute theta activity at baseline predicted a greater possibility of improvement in addiction symptoms following treatment, even after adjusting for the effects of depressive or anxiety symptoms. The present findings demonstrated that increased slow-wave activity represented a state neurophysiological marker in IGD patients and suggested that increased theta activity at baseline may be a favorable prognostic marker for this population.</P>

Rat의 복강내에 투여한 5-fluorouracil-polyglycolic acid 제형이 장기에 미치는 영향에 관한 연구

강대영,송규상,최정목,노승무,정경수,오정연,김진향,양준묵,최선웅,이진호,조준식,민병무,김용백,김창식,박근성,김승영,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

For more effective intraperitoneal chemotherapy, the authers made 5-fluorouracil-polyglycolic acid composite disks(FU-PGA disks) with 5-fluorouracil and polyglycolic acid, a biodegradable polymer. We inserted the FU-PGA disk into the peritoneal cavites of Sprague-Dawley male rats, the control and three experimental groups; one FU-PGA disk insert group(300mg/kg), two FU-PGA disk insert group(600mg/kg), and three FU-PGA disk insert group(900mg/kg). The control group received a similar number of PGA disk inserts. A pharmacokinetic study was performed to measure the 5-fluorouracil concentration in the peritoneal fluid, blood, and tissues(liver, kidney and heart) at 24 hours, 72hours and 168 hours after insertion of the FU-PGA disk. Light and electron microscopic studies were done. The results were as follows: 1) The number of white blood cells and platelets decreased after FU-PGA insertion. The degree was proportional to the duration and amounts inserted. The change in the number of red blood cells varied slightly. 2) Light microscopically, slight changes were noted at 168 hours in the 3 disk insert group (900mg/kg). Mild fatty change and hepatocyte degeneration around the central veins of the liver were noted, with vacuolar degeneration in the proximal convoluted tubules of the kidney. 3) Electron microscopically,the liver showed focal increases of lipid droplets in the hepatocytes, and irregular nuclear membrane with focal nucleolar segregation of the fibrillar and granular elements. Also the double membranous structure of the hepatocytes and Kupffer cells was widened with bleb formation. The kidney showed wide separation of the nuclear double membrane in the proximal convoluted tubular cells and mesangial cells, with vacuolation and myelin figure formation in the mitochondria of the proximal convoluted tubular cells, at 72 hours and 168 hours in the 2 to 3 FU-PGA insert groups. The heart showed focal loss of cristae,vacuolation and myelin figure formation in the mitochondria of the 2 to 3 FU-PGA insert groups. In conclusion, despite the large amont of FU-PGA inserted, the histopathological changes in the liver, kidney and heart were slight, and consonant with the very low amount of 5-fluorouracil concentrations detected in the liver, kidney and heart. The above results suggest that the FU-PGA composite can serve as a new device for releasing drugs in a controlled manner and easily targeted to intraperitoneal organs. This device can improve the efficacy of intraperitoneal chemotherapy for gastric cancer.

시니어에어로빅스에 참여한 여성노인의 신체적 자기개념과 심리적 웰빙감에 관한 연구

최연정 ( Yeon-jung Choi ),조영희 ( Young-hee Cho ) 한국리듬운동학회 2019 한국리듬운동학회지 Vol.12 No.1

The purpose of study was to examine the physical self-conception and psychological well-being of elderly women participating in senior aerobics. The subjects of this study were 193 people in the elderly welfare center and seniors participating in senior aerobics in the northern part of Gyeongido (Uijeongbu, Yangju, Dongducheon, Pocheon). The survey tool used the physical self-concept scale developed by Kim Byung-Joon(2001) and the psychological well-being scale developed by Hwang Young-Joon(2009) as a questionnaire. The 5-point Likert scale was used. The collected data were analyzed by One-way ANOVA, correlation analysis, and multiple regression analysis. The results of this study were as follows ; First, there was no difference in age, physical self-concept and psychological well-being according to general characteristics(age, exercise duration, frequency, intensity). Second, the correlation between physical self-concept and psychological well-being was positively correlated. Third, physical self-concept is related to psychological well-being. Among the sub-factors of physical self-concept, appearance and overall physical factors influenced sub-factors of psychological well-being. The physical self-concept of elderly women who participated in senior aerobics partially affected psychological well-being.

백서의 복강내에 투여한 Mitomycin-C-Polyglycolic acid 제형이 장기에 미치는 영향에 관한 연구

송규상,강대영,최정목,노승무,정경수,오정연,김진향,양준목,최선웅,이진호,조준식,민병무,김용백,김창식,박근성,김승영,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

To evaluate the in-vivo effects of mitomycin-C-polyglycolic acid composite(MMC-PGA) the disk: shaped composite were implanted into the peritoneal cavity of the Sprague-Dawley rats. The pathologic changes were examined at various time points up to 12 weeks. Initially the soft tissue around the inserted disks showed capillary congestion at 3 days. Inflammatory infiltrates with foreign body giant cells appeared from the 2nd week and reached peak response at 6-8 weeks. These reaction diminished prominently at 12 weeks. No specific pathologic change was found in the liver, the kidneys, and the heart. The above results suggest that the MMC-PGA composite can serve as a new device for intraperitoneal chemotherapy of various types of cancers.

전경대원에서 발생한 결핵의 임상 양상

문창기,박상준,조민구,김영중,김소연,김윤권,정준오,안석진,김은실,서승오,김지훈,최원제,이윤영,박형기,최규영,김현근 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

Background: The purpose of this study was to document the incidence and clinical characteristics of patients with tuberculosis (TB) in combat and auxiliary police, living in a group, in Korea where the incidence rate of active TB in a general population is higher than in Western countries. Materials and Methods:We retrospectively reviewed the medical records of all tuberculosis patients diagnosed at National Police Hospital from January 2002 through December 2004. Results:In 2002-2004, a total of 156 cases of tuberculosis were identified with the mean (Standard deviation) age of 20.6 (±1.0) years. Of these, 134 (85.9%) patients were registered as new cases, 11 (7.1%) as relapse, 2 (1.3%) as failure, 5 (3.1%) as treatment-after-default cases whereas 4 (2.6 %) patients were not included in any categories. Average annual new TB rate and smear-positive TB rate were 86.5/10^(5) and 17.4/10^(5) person-years, respectively. In 12 of 31 smear-positive cases, time from onset of symptoms to diagnosis was more than 30 days. Two multidrug-resistance TB cases were identified and two suspected outbreak episodes of TB had occurred during 3 years. Conclusion:There was no statistically significant difference in the incidence rate of new cases of TB between the general population aged 20 to 29 years and combat and auxiliary police in Korea. 배경 : 국내 결핵의 발생은 감소 추세에 있으나 여전히 후진국형 발생양상을 보이고 있다. 특히 집단생활을 하는 젊은이들에서 발생하는 결핵의 유행이 간헐적으로 알려지고 있어 우려를 낳고 있다. 이에 저자들은 최근 전경대원의 결핵 발병 양상에 대해 알아보고자 본 연구를 시행하였다. 재료 및 방법 : 2002년 1월부터 2004년 12월까지 3년간 경찰병원에서 결핵 진료를 받은 전경대원의 의무기록을 후향적으로 분석하여 연도별 결핵 신환발생률, 도말양성결핵 신환율, 진단 지연, 집단발병, 다제내성결핵을 조사하였다. 결과 : 연도별 결핵 신환자 수(10만명당 발생추정치)는 2002년 50명(83.6명), 2003년 42명(83.7명), 2004년 42명(93.5명)이었고 도말양성 폐결핵 신환자 수는 2002년 10명(16.7명), 2003년 11명(21.9명), 2004년 6명(13.4명)이었다. 3년간 도말양성 폐결핵 환자는 31명이 있었고 그 중 12명은 호흡기 증상 발생 30일이 지나서 진단을 받았다. 다제내성 결핵은 2명이 있었으며 결핵의 집단발병이 의심되는 사례는 2차례 있었다. 결론 : 전경대원과 20-29세 연령군 일반인의 결핵 신환발생률, 도말양성 폐결핵 발생률의 통계적으로 유의한 차이는 없었다.

Tardive Dyskinesia를 Calcium Blocker로 치료한 1례 보고

최원,임두원,정희연,권영준 大韓神經精神醫學會 1996 신경정신의학 Vol.35 No.1

Short duration(5 days) of antipsychotic medication induced tardive dyskinesia(TD) in a mood disorder patient with hyperthyroidism, giving us an experience that TD is more liable in a sensitive patient and is not always induced by high potency drugs. TD in a patient with mood disorder who also had hyperthyroidism improved within 14 days when treated with calcium blocker, diltiazem.

흰쥐 십이지장 점막의 Polyamine 대사, [^(14)C]Spermine 단백 결합능 및 [³H]Thymidine DNA 섭취에 대한 Calcitriol과 Prednisolone의 상호작용

최상현,이영재,정휘정,김형건,신경호,천연숙,전보권 고려대학교 의과대학 1997 고려대 의대 잡지 Vol.34 No.1

Calcitriol has been shown to induce the duodenal synthesis of the spermine-binding protein. and hydrocortisone was reported to increase the intestinal polyamine contents. This study examined whether prednisolone might enhance or reduce the calcitriol effects on the polyamine contents, [^(14)C]spermine-protein binding activity, and [^(3)H] thymidine DNA synthesis of the rat duodenum. The mucosal contents of putrescine. spermidine. and spermine were increased by 198.8%, 84.0%, and 78.3%, respectively, within 6 hours after calcitriol. 5 ㎍/kg (CT) and fell down to the control values at 12 hours. And prednisolone. 10 mg/kg (PD) also increased the polyamine contents in similar patterns. They did not counteract each other in the polyamine metabolism. CT increased the [^(14)C]spermine-binding activity of the cytosol protein fraction from the duodenal mucosa by 71.1%. But PD increased the binding activity by 28.0% and did not affect the CT-induced increase. CT increased the [^(3)H]thymidine DNA synthesis of the duodenal mucosa by 42.3%. but PD reduced it slightly. The CT-dependent increase of the synthesis was significantly inhibited by PD. These results suggested that the inhibitory effect of glucocorticoids on the vitamin D dependent increases of the duodenal calcium absorption and mucosal proliferation seems not to be associated with the metabolic changes of polyamines in the duodenal mucosa.