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.

쥐의 성주기에 따른 자궁 비만세포와 성호르몬의 변화

최영자,제갈승주,윤영승,김재만 木浦大學校 基礎科學硏究所 2001 基礎科學硏究誌 Vol.19 No.-

Mast cells reside in connective tissue and mucous tissue that encircle the internal environment of the body, where they mediate inflammatory response encountering foreign materials. Mast cells are also found in uterus tissue which is, in fact, exposed to external world. Because the cells are provoked by invading foreign cells to cause inflammatory response, their response in the uterus should be controled for success in fertilization and implantation, in that the foreign sperms and fertilized egg are willing to invade into the body. In order to confirm such assumption, we investigated the changes in mast cell numbers and their contents in the rat uterus during the estrus cycle and related these to the changes in sex-hormone concentration. The mean number of mast cell at the proestrus and estrus phase was 4.8±2.72 and 5.98±1.55. respectively. The number increased as much as 3 times more then previous phase at the metestrus phase and subsided to half at following the diestrus phase. Those mast cells were subdivided type. Connective tissue type was major at metestrus and diestrus phase. At the following proestrus, however, the muscous type was largely increased and major population was changed to muscous and intermediate type at estrus phase. In the immature uterus of young female, as few as 1.67±0.23 cells were detected and most of them were mucous and intermediate type. The concentration of circulating estradiol-17 β was lowest at the metestrus phase both in free and bound form. The results suggest that estrogen may be involved in inhibiting swarming of mast cells in the uterus and accumulating the contents of secretory vesicles.

Floristic characteristics of vascular plants and first distributional report of Pseudostellaria baekdusanensis M. Kim in Yongneup wetland protected area

Young-Chul Kim,Hyun-Hee Chae,Sang-Heock Oh,Seung-Ho Choi2,Moon-Pyo Hong3,Gi-Heum Nam,Jae-Yoon Choi,Hyun-Sook Choi,Kyu-Song Lee 한국환경생태학회 2015 한국환경생태학회지 Vol.29 No.2

Yongneup wetland protected area, the only high moor in Korea, is a core area to conserve biodiversity. Even though the Yongneup wetland protected area is relatively small, various plant species are distributed in the Yongneup wetland protected area because it includes various habitats showing different environmental gradients. Vascular plants distributed in the Yongneup wetland protected area were identified as a total of 376 taxa that is composed of 73 families, 217 genera, 322 species, 3 subspecies, 44 varieties and 7 forms. For endangered plants designated by the Ministry of Environment, 5 species including Trientalis europaea var. arctica, Lilium dauricum, Halenia corniculata, Lychnis wilfordii and Menyanthes trifoliata were found and 34 taxa were confirmed to be distributed only in the mountainous wetland habitats. Regarding naturalized plants, a total of 11 taxa were distributed, but most of them were distributed in the areas where artificial interference has occurred. And in areas inside the wetlands that are relatively well preserved, 2 species of Bidens frondosa and Erigeron annuus were observed. In this study, the occurrence and distribution of Pseudostellaria baekdusanensis M. Kim, which was recently found in Mt. Baekdu and reported as a new species, were identified in the Yongneup wetland protected area. A wetland is a very vulnerable area to drastic environmental changes and damages to its ecosystem could cause the extinction of rare plant species which are distributed only in the wetlands. Therefore, it is mandatory that current status of the Yongneup wetland protected area is evaluated and actions to prevent rapid environmental changes are taken. Fourteen separate investigations were conducted in 2013 and another four in 2014, to evaluate current status of the Yongneup wetland protected area. These investigations have provided us the basic information for future actions of conservation and restoration.

비만증 환자에서 한약제에 의한 체중 감소효과

Oh, Seung-Joon,Jeong, In-Kyung,Kim, Young-Seol,Choi, Young-Kil,Paeng, Jeong-Ryung,Bae, Jung-Hwan,Shin, Hyun-Dae 경희대학교 동서의학연구소 1999 INTERNATIONAL SYMPOSIUM ON EAST-WEST MEDICINE Vol.1999 No.1

Seung-Joon Oh, In-Kyung Jeong, Young-Seol Kim, Young-Kil Choi, Jeong-Ryung Paeng¹, Jung-Hwan Bae and Hyun-Dae Shin²Department of internal Medicine, College Medicine, Endocrine Research Institute¹. Department of Rehabilitation, College of Oriental Medicine², Seoul, korea. Bady Fat Reduction Effects of Red Ginseng Compound Preparation on the Patients with Obesity. Proceedings of International Symposium on East-West Medicine, Seoul. 244-254, 1999.-Obesity can be defined as a metabolic disease due to an increased state of fat tissues caused by an imbalance of calorie intake and use. Recently, in Korea by improvement and westernization of food intake, along with decrease in exercise activities, the prevalence of obesity has increased greatly. Our objectives were to study stability and effects of decrease in body fat by administering red ginseng compound preparation (known to have body fat decreasing effects in laboratory animals) to obesity patients on low calorie diets. Changes in weight and body fat were measured while carrying out calorie-restricted diets on patients for 4 weeks, then administering red ginseng compound preparation for another 4 weeks. The patients were 20 people whose BMI were 25kg/㎡ or over and whose percent body fat was also 30% or over when tested by bioelectrical conductivity. 1. Changes in weight were from 70.04kg(base line) to 67.43kg(after taking red ginseng compound preparation). 2. In similar sense, BMI decreased from 27.12kg/㎡(base line) to 26.56kg/㎡(after dieting), and further to 26.01kg/㎡ (after taking red ginseng compound preparation). The BMI seemed to decrease significantly compared to the baseline after the use of red ginseng compound. 3. Waist hip ratio was changed from 0.8858(base line) to 0.8728, but it was statistically insignificant. 4. The percent body fat was 35,16%(base line), 33.87%(after dieting), and 31.68%(after taking red ginseng compound preparation). 5. Complete blood cell count and blood chemisrty remained unaffected by the administration. 6. In concern to endocrinologic studies, T3 decreased from 118.7 to 98.2ng/dL, and T4 increased from 8.8 to 9.2㎕/ dL. Epinephrine showed a tendency to decreased from 0.27 to 0.25 ng/mL, and norepinephrine increased from 0.39 to 0.44ng/mL. 7. Leptin was not changed. 8. Some patients complained adverse effects; constipation(5 patients, may be due to diet therapy), fatigue (2 patients), pruritus(2 patients), flushing(s patients), dizziness(3 patients) and epigastric discomfort(2 patients). However their symptoms were mild, so medication did not stopped. In conclusion, loss of weight without significant side effects was observed during low calorie diet and red ginseng compound preparation administration. This is thought to be in relation to sympathetic nerve system rather than adrenal gland. Also, further long0term studies should be required, since the observed results were based on short-term changes in weight.

진행성 위암과 동반된 후복막 섬유화증 7예의 임상적 고찰

장재영,천영국,최우봉,김진오,조주영,이준성,이문성,심찬섭 순천향의학연구소;Soonchunhyang Medical Research Institute 2000 Journal of Soonchunhyang Medical Science Vol.6 No.1

Background/Aims: Retroperitoneal fibrosis is a fibrosing disease process which frequently develops ureteral obstruction. Malignant retroperitoneal fibrosis has been reported that various types of cancer including cancer of the breast, stomach, prostate, lung, cervix, uteri, colon, pancreas, ovary, and even Hodgkin's disease. While the pathogenesis remains obscure, small foci of metastatic neoplasm in the retroperitoneal space can elicit a desmoplastic reaction in secondary form to malignancy. Methods: Recently we experienced 7 cases of retroperitoneal fibrosis with advanced gastric cancer. So, we report 7 cases of retroperitoneal fibrosis with clinical and radiologic characteristics. Results: The most common signs and symptoms were related irreversible renal dysfunction. The urologic finding noted medial deviation of the involved ureters and hydronephrosis Conclusions: Clinical manifestations are abdominal pain, back pain, hydronephrosis, and uremia. When sudden back pain and hydronephrosis develop in advanced malignancy, physicians should be considerd for retroperitoneal fibrosis.

Rat의 복강에 삽입한 Fluorouracil-Polyglycolic acid 제형의 Fluorouracil 용출에 관한 연구

노승무,정경수,오정연,김진향,양준묵,강대영,송규상,최정목,최선웅,이진호,조준식,민병무,김용백,김창식,박근성,김승영,김학용,인현빈 忠南大學校 癌共同硏究所 1998 癌共同硏究所 硏究誌 Vol.2 No.1

A common form of relapse in adenocarcinoma of the stomach is intraperitoneal dissemination, in fact, among gastric adenocarcinoma patients who have undergone surgery intended to cure, approximately 50% of the patients develope initial recurrence in the peritoneal cavity regardless of the anatomic site of the primary tumor within the stomach. The efficacy of systemic postoperative chemotherapy to prevent peritoneal recurrence of gastrric adcnocarcinoma is not satisfactory. There is still a great need for improved therapeutic strategies on the disseminated microscopic disease and small miliary nodules remaining on the peritoneal surface or lymphatics after operation. The authers have made fluorouracil-polyglycolic acid composite disks(Fu-PGA disks) with fluorouracil and biodegradable polymer: polyglycolic acid for more effective intraperitoneal chemotherapy. We inserted the Fu-PGA disk(s) in the peritoneal cavity of rat and pharmacokinetic study was performed to measure fluorouracil concentration in the peritoneal fluid, plasma, liver, kidney and heart tissue at 24 hour, 72 hour and 168 hour after insertion of Fu-PGA disk(s). Myelosuppressive action of this composite also was determined following its administration. The data of this study suggested that Fu-PGA composite will be a new device releasing drugs in a controlled manner and having targetability to peritoneum, and this device will be improving the efficacy of intraperitoneal chemotherapy for gastric adenocarcinoma.

포도당과 이소프로테레놀에 의한 시상하부의 소마토스타틴 분비가 갑상선자극호르몬방출호르몬에 의한 갑상선자극호르몬에 미치는 효과

박철영,양인명,오승준,김덕윤,우정택,김성운,김진우,김영설,최영길 대한내분비학회 2000 Endocrinology and metabolism Vol.15 No.4·5

미치광이풀 모상근 배양에서 Tropane Alkaloid 생산성 증진을 위한 최적 생물학적 엘리시터 선발

정희영,강승미,강영민,김용덕,양재경,정영관,최명석 Plant molecular biology and biotechnology research 2003 Plant molecular biology and biotechnology research Vol.2003 No.-

Scopolamine and hyoscyamine which belong to tropane alkaloids are the pharmaceutically valuable anticholinergic drugs. In order to increase the productivities, the effects of elicitation were investigated during hairy root cultures of Scopolia parviflora. Biotic elicitors originated from 3 fungi and 1 yeast were prepared as homogenate and supernatant and added to 3-week-old cultures. Both of homogenate and supernatant of Candida albicans elicitors increased the scopolamine production. The production of hyoscyamine was enhanced by homogenate of Fusarium solani and supematant of C. albicans. Most of the other fungal elicitors were also improved on the tropane alkaloid production compared to non-treatment. Among the elicitors tested, C. albicans was proved the optimal biotic elicitor on tropane alkaloids production. These results will be served mass production of tropane alkaloids by large-scale production.

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.

Rat의 복강에 삽입한 Filorouracil-Polyglycolic acid제형의 Fluorouracil용출에 관한 연구

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

A common form of relapse in adenocarcinoma of the stomach is intraperitioneal dissemination, in fact, among gastric adenocarcinoma patients who have undergone surgery intended to cure, approximately 50% of the patients develope initial recurrence in the peritoneal cavity regardless of the anatomic site of the primary tumor within the stomach. The efficacy of systemic postoperative chemotherapy to prevent peritoneal recurrence of gastrric adenocarcinoma is not satisfactory. There is still a great need for improved therapeutic strategies on the disseminated microscopic disease and small miliary nodules remaining on the peritoneal surface or lymphatics after operation. The authers have made fluorouracil-polyglycolic acid composite disks(Fu-PGA disks) with fluorouracil and biodegradable polymer: polyglycolic acid for more effective intraperitoneal chemotherapy. We inserted the Fu-PGA disk(s) in the peritoneal cavity of rat and pharmacokinetic study was performed to measure fluorouracil concentration in the peritoneal fluid, plasma, liver, kidney and heart tissue at 24 hour, 72 hour and 168 hour after insertion of Fu-PGA disk(s). Myelosuppressive action of this composite also was determined following its administration. The data of this study suggested that Fu-PGA composite will be a new device releasing drugs in a controlled manner and having targetability to peritoneum, and this device will be improving the efficacy of intraperitoneal chemotherapy for gastric adenocarcinoma.