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전립선 비대증 환자에서 항콜린성 약물다제투여 및 중추신경계 부작용 조사
홍우성,김홍섭,김형지,정홍,양상국,이준민,김동욱 대한배뇨장애요실금학회 2007 International Neurourology Journal Vol.11 No.1
Purpose: Elderly patients commonly receive multiple drugs compared to young patients because of high comorbidity. Some common illnesses in the elderly with underlying diseases are complicated or aggravated by treatment with anticholinergic agents. We evaluated the use of anticholinergic agents and their adverse effects in the men with benign prostate hyperplasia. Materials and Methods: One hundred-eighty four patients over 40 years-old who visited hospital for the treatment of benign prostate hyperplasia and prescribed more than one anticholinergic agent from January 2005 to June 2006 were enrolled. The patients who took anticholinergics during less than 2 months or suffered from psychiatric problems were excluded. One hundred-fifteen patients were included and all prescribed drugs were classified and counted. The number of anticholinomimetic agents and their 10 adverse effects were checked. Results: Mean age was 67.0±10.6 years and mean cormobidity diseases counted 1.1±1.1. Mean pill and mean anticholinergic agents counted 7.3±4.3 and 1.8±1.1, respectively. Prescribed anticholinergic agents count increased with patient's age (p=0.401). As the patients took more medications, they had higher possibility to take anticholinergic agents. And as the patients took more anticholinergic agents, they showed more anticholinergic adverse effects (p<0.001). Conclusion: Elderly patients mistakenly tend to attribute drug-induced changes in memory and cognitive function to aging or comorbid conditions. Therefore prescribers should consider an anticholinergic agent's receptor selectivity, ability to cross the blood-brain barrier, and pateint's medical history in elderly patients. Additionally physicians can actively perform Mini-Mental Status Examination for evaluation of the patient's cognitive functions under anticholinergic medication. (J. Korean Continence Society 2007;11:24-29)
면역억제제 Basiliximab이 신장이식 1년 이내 급성 거부반응의 빈도에 미치는 영향
홍우성(Woo Sung Hong),이병모(Byung Mo Lee),오창권(Chang-Kwon Oh),김세중(Se Joong Kim),김흥수(Heungsoo Kim),신규태(Gyu Tae Shin) 대한외과학회 2007 Annals of Surgical Treatment and Research(ASRT) Vol.73 No.6
Purpose: Basiliximab has become widely used in clinical practice for initial immunosuppression in renal transplantation cases, to reduce the incidence of acute rejection without adverse events. Herein, we report the early outcomes of renal transplantation using basiliximab at a single center. Methods: This retrospective study included 148 renal allograft recipients at a single center. All patients were followed for longer than 1 year after transplantation, and treated with a calcineurin inhibitor and steroids for maintenance immunosuppression. The use of basiliximab and mycophenolate mofetil (MMF) was optional. We compared the incidence of episodes of acute graft rejection in kidney recipients who were treated with basiliximab as an initial immunosuppressive therapy with those who were treated without basiliximab. Results: Basiliximab was used for initial immunosuppression in 58 patients. Patients maintained immunosuppression with triple (n=69) or double (n=79) regimens including a calcineurin inhibitor (cyclosporine A (n=111) or tacrolimus (n=37)) and methylprednisolone with or without MMF. Thirty-six (24.3%) patients had a rejection episode within 1 year after transplantation and twenty-six (17.6%) patients had an episode of infection. The patients who were treated with basiliximab had fewer rejection episodes (n=11, 18.9%) within the first year after transplantation than the patients who did not take basiliximab (n=25, 27.7%); this difference was not statistically significant. (P=0.245). However, basiliximab significantly affected the number of rejection episodes in the double regi men group (P=0.006), but not the number of rejections in the triple regimen group (P=0.432) and did not affect the number of infection episodes in both groups (P value of double, triple=0.291, 0.772) within one year after transplantation. Conclusion: The results of this study suggest that basiliximab might be more useful for graft recipients who are treated with double immunosuppression with a calcineurin inhibitor and steroid than for the recipients with triple immunosuppression including MMF.