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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.
허규 ( Gyoo Huh ),이현주 ( Heun-joo Lee ),최영준 ( Young-jun Choi ),김원석 ( Won-serk Kim ),이가영 ( Ga-young Lee ) 대한피부과학회 2021 大韓皮膚科學會誌 Vol.59 No.10
Granuloma annulare (GA) is a common non-infectious granulomatous disease. Generalized GA is the second most common variant of GA. It is often associated with recalcitrant disease progression despite treatment. The lesion of generalized GA typically presents widespread papules that coalesce to form annular plaques over the whole body. We report a case of a patient with disseminated papules and coalescing annular plaques, primarily involving the intertriginous area and mimicking tinea corporis or cruris. Histopathological findings confirmed the lesion as GA. This case underscored the unusual clinical presentation of generalized GA. A case of GA localized to the intertriginous area has rarely been reported. Given the recalcitrant nature of the disease, dermatologists should consider generalized GA as a differential diagnosis in patients with an annular lesion involving the intertriginous area. Thus, we report this as an atypical case of generalized GA localized to the intertriginous area. (Korean J Dermatol 2021;59(10):797∼800)
가정보육시설과 기관보육시설의 질적 특성과 영아의 사회·정서 발달
최보가,문영경 대한가정학회 2004 Human Ecology Research(HER) Vol.42 No.1
The purposes of this study were to investigate the quality (structure and process) of home-based day care and center-based day care, and to examine socioemotional development among infants who were in both types of day care. The subjects of this study were 101 infants who were in home-based day care and 181 infants who were in center-based day care. The measurements were socio-emotional development scale and assessment scales for day care programs. Results indicated that, first, home-based day care did not significantly differ from center-based day care in terms of structure. Second, home-based day care were, to some degree, significantly different from center-based day care in the process: home-based day care had better play environment and play activities than did center-based day care. Lastly, there were significant differences in socio-emotional development among infants according to the type of day care: infants in home-based day care were more independent to their teacher and felt more secure in child care homes than was true for the infants in center-based day care.
( Ga Eun Kim ),( Ye Eun Choi ),( Su Seong Yang ),( Sun A Kim ),( Young Sook Bae ) 대한물리치료학회 2018 대한물리치료학회지 Vol.30 No.5
Purpose: This study compared the functional fitness and brake response of elderly and young drivers to confirm the correlation between the functional fitness and brake response. Methods: This study was a cross sectional observational design. Older drivers (>65age, n=21) and young adult drivers (20-40aged, n=20) were enrolled as subjects. The functional fitness of the subjects was measured using a senior fitness test consisting of a back scratch (BS), chair sit and reach (CSR), arm curl (AC), chair stand up (CSU), foot up and go (8-FUG), and 2-minute step (2-MS). The brake response used the virtual driving simulator to measure the brake reaction time (BRT) and braking distance (BD) according to the pedestrian protection and traffic signal compliance. Results: The older drivers had a lower BS (p<0.000), CSU (p=0.040), and 8-FUG (p=0.011) than the young adult drivers. BS and 8-FUG showed a significant positive correlation with the BRT and BD of pedestrian protection and traffic signal compliance. CSU showed a significant negative correlation with the BRT of pedestrian protection and traffic signal compliance. Conclusion: These findings suggest that the flexibility of the upper extremity, lower extremity strength, and agility are strongly correlated with the driving performance of elderly drivers.
( Young Mi Choi ),( Hyun Jong Park ),( Ji Yun Lee ),( Ga Won Yim ),( Maria Lee ),( San Hee Lee ),( Ji Heum Park ),( Eun Ji Nam ),( Sang Wun Kim ),( Young Tae Kim ) 대한산부인과학회 2010 Journal of Womens Medicine Vol.3 No.2
Chylous ascites is an infrequent postoperative complication of retroperitoneal surgery caused by unrecognized disruption of major retroperitoneal lymphatics and is associated with serious mechanical, nutritional, and immunologic consequences due to the constant loss of protein and lymphocytes. Recently, the robotic-assisted approach to surgical staging for gynecologic malignancy is increased, which allows for enabling the performance of complex procedures. As our experience, in patients with robotic-assisted lymphadenectomy for endometrial cancer, chylous ascites can be also developed despite the meticulous dissection. In our opinion, it is recommended to remove large amount of ascites through paracentesis as much as possible at a time and we should be observed at least 8 weeks before surgical intervention while maintaining nutritional supports.
Ga-Ram You,Seon-Young Park,Hye-Su You,Seung-Young Seo,Sung-Kyun Yim,Byung-Chul Jin,Jung-In Lee,Young-Dae Kim,Suck-Chei Choi,Chan-Guk Park,Wan-Sik Lee 대한상부위장관ㆍ헬리코박터학회 2023 Korean Journal of Helicobacter Upper Gastrointesti Vol.23 No.4
Objectives: Gastrointestinal cytomegalovirus (CMV) disease is a major contributor to mortality in immunocompromised patients. Few studies have discussed upper gastrointestinal CMV (UGICMV) disease in immunocompetent patients. We compared the clinical outcomes of UGI-CMV between immunocompromised and immunocompetent patients.Methods: This retrospective study included patients with UGI-CMV disease from five tertiary hospitals across Korea (2010– 2022). Patients’ clinical data and outcomes were recorded.Results: UGI-CMV was diagnosed in 54 patients; 27 (50.0%) had esophageal, 24 (44.4%) had gastric, and 3 patients (5.6%) had duodenal involvement. Patients’ median age was 64 years (interquartile range 53–75 years), and the most common comorbidities included hypertension (57.4%) and diabetes (38.9%). The predominant symptom was abdominal pain (46.3%), and the most common endoscopic finding was ulcers (70.4%). Antiviral treatment was administered to 31 patients, and 23 patients underwent observation without treatment. We investigated 32 immunocompromised (59.3%) and 22 immunocompetent (40.7%) patients and observed no intergroup differences in comorbidities and in laboratory and endoscopic findings. Immunocompromised patients had longer length of hospitalization (median 46.2 days vs. 20.0 days, <i>p</i>=0.001). However, treatment outcomes, including the need for intensive care unit admission and mortality did not significantly differ. The overall mortality rate was 13.0%; one patient from the immunocompromised group died of UGI-CMV disease. The treatment success rate was higher in immunocompromised patients who received antiviral therapy (<i>p</i>=0.011).Conclusions: UGI-CMV disease is not uncommon in immunocompetent patients, although symptoms are milder than those in immunocompromised patients. Our findings emphasize the importance of clinical vigilance for accurate diagnosis of CMV infection, particularly in susceptible symptomatic patients and highlight the need for active antiviral treatment for management of immunocompromised patients.
Case Reports : Multiple Unilateral Zosteriform Connective Tissue Nevi on the Trunk
( Young Jun Choi ),( Seung Jae Lee ),( Chong Won Choi ),( Won Serk Kim ),( Ga Young Lee ) 대한피부과학회 2011 Annals of Dermatology Vol.23 No.2s
Connective tissue nevus is not a true tumor, but rather a hamartoma involving various components of connective tissue. It presents as a slow-growing, painless, flesh-colored, or pink nodule or plaque that is evident from childhood. While any region of the body may be affected, there is a predilection for the trunk and extremities. A 20-month-old girl presented with three ipsilateral confluent popular plaques with zosteriform distribution that had formed over the previous 17 months on the left chest and abdomen. The patient remained asymptomatic. Unlike all previously reported cases demonstrating a single lesion, we report a connective tissue nevi in a child who presented with multiple unilateral zosteriform lesions, an unusual pattern of distribution without evidence of tuberous sclerosis complex. (Ann Dermatol 23(S2) S243~S246, 2011)
Choi, Ki Hong,Han, Seongwook,Lee, Ga Yeon,Choi, Jin-Oh,Jeon, Eun-Seok,Lee, Hae-Young,Lee, Sang Eun,Kim, Jae-Joong,Chae, Shung Chull,Baek, Sang Hong,Kang, Seok-Min,Choi, Dong-Ju,Yoo, Byung-Su,Kim, Kye The Korean Society of Cardiology 2018 Korean Circulation Journal Vol.48 No.11
<P><B>Background and Objectives</B></P><P>The prognostic impact of left axis deviation (LAD) on clinical outcomes in acute heart failure syndrome (AHFS) with left bundle branch block (LBBB) is unknown. The aim of this study was to determine the prognostic significance of axis deviation in acute heart failure patients with LBBB.</P><P><B>Methods</B></P><P>Between March 2011 and February 2014, 292 consecutive AHFS patients with LBBB were recruited from 10 tertiary university hospitals. They were divided into groups with no LAD (n=189) or with LAD (n=103) groups according to QRS axis <−30 degree. The primary outcome was all-cause mortality.</P><P><B>Results</B></P><P>The median follow-up duration was 24 months. On multivariate analysis, the rate of all-cause death did not significantly differ between the normal axis and LAD groups (39.7% vs. 46.6%, adjusted hazard ratio, 1.01; 95% confidence interval, 0.66, 1.53; p=0.97). However, on the multiple linear regression analysis to evaluate the predictors of the left ventricular ejection fraction (LVEF), presence of LAD significantly predicted a worse LVEF (adjusted beta, −3.25; 95% confidence interval, −5.82, −0.67; p=0.01). Right ventricle (RV) dilatation was defined as at least 2 of 3 electrocardiographic criteria (late R in lead aVR, low voltages in limb leads, and R/S ratio <1 in lead V<SUB>5</SUB>) and was more frequent in the LAD group than in the normal axis group (p<0.001).</P><P><B>Conclusions</B></P><P>Among the AHFS with LBBB patients, LAD did not predict mortality, but it could be used as a significant predictor of worse LVEF and RV dilatation (Trial registry at KorAHF registry, ClinicalTrial.gov, NCT01389843).</P>