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.

초등학생 입학 후 발생한 두통의 유병률과 임상적 특성

노영일,김은영,양은석,문경래,박상기,박영봉 朝鮮大學校 附設 醫學硏究所 2003 The Medical Journal of Chosun University Vol.28 No.2

Purpose : The purpose of the study was to determine prevalence and clinical features of the occurrence of childhood headache after the start of elementary school. Method : The survey was performed by a special questionnaire on 552 children in grade 1 (195 children) and grade 6 (357 children) at the three elementary schools from 1 to 31 August, 2002 in Gwangju city. We have analyzed the prevalence and the clinical features of headache of them. Result: The prevalence of headache in grade 6(49.0%) was statistically higher than grade 1(22.6%). The onset time of headache within 6 months in grade 1 (88.2%) was significantly higher than grade 6 (64.1 %). The frequency of headache is more often in grade 6. As for the timing of occurrence of headache, grade 1 student suffered from it after school (36.4%), grade 6 student suffered from it at school (30.9%). Children who suffered from severe headache can't live in the routine life were grade 1 20.5 % and grade 6 21.1 %, respectively. According to the duration of headache, there were within 1 hour grade 1 90.9%, grade 6 81.8%, respectively. Risk factors of headache were, in grade 1, fatigue (34.0%), stress (25.0%), weather change (18.2%), anxiety (11.4%), and others (11.4%). In grade 6, there were fatigue(44.3%), stress (34.0%), weather change(10.9%), others (5.7%) and anxiety (5.1%). Conclusion : Starting school represents a remarkable life event for children. Starting school results in significantly increasing prevalence of overall headache. 목적 : 입학 전에 비해 입학 후 두통의 증가률을 알아보고, 1학년의 두통의 임상적 특징을 알아보고자 하였다. 방법 : 2002년 8월 1일부터 31일까지 광주시내 3개 초등학교 1학년과 6학년 학생 612명에게 설문지 (두통 에 대한 주요 설문지 내용 :부록)를 배부하여 그 중 작성이 불량한 60명을 제외한 552명 (1학년 195명, 6학년 357명)을 대상으로 두통의 유병률을 알아보았으며, 임상적 특징은 두통이 있는 학생 219명 (1학년 44명, 6학년 175명)을 대상으로 분석하였다. 결과 : 두통의 빈도는 1학년 44명 (22.6%), 6학년 175명 (49.0%)로 6학년에서 의의 있게 높았다(0.001). 두통의 초발 시기가 6개월 이상인 경우 1학년 11.8%, 6학년 35.9%이였으며, 6개월 미만인 경우는 1학년 88.2%, 6학년 64.1%로 입학 전보다 입학 후에 더 높았으며 6개월 미만의 초발 두통이 1학년에서 의의 있게 높았다(p=o. 03). 두통의 발생빈도는 6학년에서 통계학적으로 의의 있게 높았다(P=0. 03). 두통이 가장 자주 발생하는 시기는 1학년에서 학교 수업 후 (36.4%)이었고, 6학년에서는 학교 수업 중(30.9%)이었다. 학교나 일상 생활을 하기 힘들 정도의 두통은 각각 1학년에서 20.5%, 6학년에서 21.1%이었다. 두통의 지속시간은 1시간 이내인 경우가 각각 1학년 90.9%,6학년 81.8%이었다. 두통의 유별인자는 1학년에서 피로, 수면 부족이 34.0%로 가장 많았으며, 스트레스, 기후 변화, 불안, 기타 순이었고, 6학년은 피로 수면 부족 44.3%로 가장 많았으며, 스트레스 34.0%, 기후 변화, 기타, 불안 순이었다.

남매에서 발생한 심한 용혈성 빈혈과 간경변증을 동반한 Wilson 병 2례

노영일,박동호,서우철,문경래,박상기,박영봉,이미숙,전호종 조선대학교 1995 The Medical Journal of Chosun University Vol.20 No.1

We experienced two case of Wilson's disease in female and male sibling. The first case was a 10 year-old female who showed jaundice. pancytopenia and cirrhotic change in liver biopsy. She died 10 days after diagnosis. The second case of 7 year-old male showed specific symptoms and revealed increased AST/ALT, low serun copper level and increased 24 hour urinary copper excretion level He is being treated with D-penicillamine and follow up examinations.

개 대뇌겉질에서 Platelet-Derived Growth Factor α-Receptor의 출생 후 발달에 관한 면역조직화학적 연구

윤영,안병수,김인정,양경철,박선홍,김기훈,박도영,김장만,문정석,장인엽,조하영 조선대학교 부설 의학연구소 2002 The Medical Journal of Chosun University Vol.27 No.1

Background and Objectives : The localization of platelet-derived growth factor-α receptor (PDGF-α R) was commonly restricted to oligodendrocyte progenitors during late embryonic and postnatal development. However, several studies recently demonstrated that mature neurons could also synthesize PDGF-α, Materials and Methods : In the present study, to analyze the distributional pattern of PDGF-αR during postnatal development of the canine cerebral cortex, we used immunohistochemistry on sections of canine brain tissue. Results : We found that neurons of various regions of cerebral cortex exhibited the immunoreactivity to PDGF-αR as early as postnatal day 0, and slightly decreased after postnatal day 14. Whereas neuronal PDGF-αR were maintained at all ages, the oligodendroglia-like expression of PDGF-αR could not be confirmed. Conclusion : The localization of PDGF-αR in immature and mature neurons supports the several roles of PDGF during development, protection and survival of neurons.

모체 Thyroxine 투여가 태아알코올효과를 가진 흰쥐 대뇌겉질 및 해마에서 NPY함유 신경세포의 생후 발달에 미치는 영향

김복,박상기,박영란,김종중,문정석,김주수,문영민,현영식,천관영,정윤영 朝鮮大學校 附設 醫學硏究所 2005 The Medical Journal of Chosun University Vol.30 No.2

Background and Objectives: Maternal alcohol abuse is considered to be one of the most prominent cause of neurobiological malformations in the postnatal and adult life of the offspring. In this study, we investigated the effects of maternal alcohol drinking on the postnatal development of NPY-containing neuron, and, the influence of thyroxine treatment on the cerebral cortex and hippocampus of pups of alcohol abused mother. Materials and Method: Time-pregnant rats were divided into three groups. Alcohol-fed group A received 35 calories of liquid alcohol diet daily from gestation day 6; control pair-fed group B was fed a liquid diet in dextrin replaced alcohol isocalorically: alcohol + T4 group C received 35 calories liquid alcohol diet and exogenous thyroxine subcutaneously. Results: Group C showed prominent NPY immunoreactivity in the cerebral cortex compared to group A and B at P7. In group C, NPY-containing neurons were widely distributed in the all layers of cerebral cortex after P14. Besides, numerical decrease of NPY-containing neuron as age increases was not found in group C. However, the decrease of NPY-containing neuron was clearly observed in group A compared to group C after P14. In hippocampus, group Band C were appeared similar patterns after P7. Additionally, in group C, NPY immunoreactivity was prominently appeared in CA2 and CA3 at P14 as compared to group B. Conclusions: The present results showed the increase of intensity and number of NPY-containing neurons in cerebral cortex and hippocampus of pups of exogenous T₄ supplemented alcohol-exposed dams as compared to control pair-fed and alcohol-exposed pups at P7. It presumably suggest that NPY-containing neurons might be regulated by the early postnatal growth stimulatory effect of the exogenously supplemented T₄. Therefore, the increase of NPY synthesis caused by maternal administration of exogenous thyroxine may ameliorate fetal alcohol effect, one of the ill effects as a result of the dysthyroid state following maternal alcohol abuse.

Variation of Bird community and Habitat use after Developing Hangang river Ecological Learning Center

Paik, In-Hwan,Jin, Seon-Deok,Jeon, Byung-Seon,Yu, Jae-Pyoung,Park, Chi-Young,Paek, Woon-Kee national science museum of korea 2010 Journal of Korean nature Vol.3 No.4

The Hangang (Han River) Ecological Learning Center is a river ecosystem park which was completed in December of 2002. The river ecosystem park was created based on the understanding of the problems of standard park-formed river which centers around convenient facilities instead of on the wish to accentuate the innate unique characteristics of a river. Therefore, the study was conducted in order to analyze the changes and habitation usage of the avifauna in the Hangang Ecological Learning Center to provide basic information for the improvement of bird species diversity in an ecosystem park. The study was conducted in July and October of both 2003 and 2005 to study the avian colonies of the same time period, and the habitat usage of four different areas were examined. Main dominant species includes species which preferred waterside and grassland, and 2005 showed higher levels of species, bird count and number of migratory birds. Furthermore, among the four regions used as habitats, the confluence region showed the highest level of increase, and this is predicted to have caused by the shallow depth of the confluence and the stability of the waterside plant colonies.

만성 호중구성 백혈병 1예

박기령,조성민,우가은,이기현,손혜영,임정윤,최진혁,이순남,정화순 梨花女子大學校 醫科大學 醫科學硏究所 1997 EMJ (Ewha medical journal) Vol.20 No.2

Chronic neutrophilic leukemia(CNL) is a very rare myeloproliferative disease, characterized by sustained mature neutrophilic leukocytosis with granulocytic bone marrow infiltration, high NAP(neutrophilic alkaline phosphatase) score and absence of philadelphia chromosome, It is frequently accompanied by hepatosplenomegaly, elevated serum vitamin B_12 and uric acid level. For the diagnosis of CNL, the leukemoid reaction, especially secondary to neoplasia, infection and autoimmune diseases, should be excluded. Since Tuohy's first description in 1920, more than 50 cases fullfilling the above criteria have been reported worldwide, and 4 cases in Korea. Several authors have demonstrated the defect of intracellualr killing in the mature neutrophil and this finding correlates well with the very high incidence of fatal infection, The hemorrhagic diasthesis in CNL is caused by functional abnormality of the platelet. This disease has tendency to transform to blastic crisis and acute leukemia as in other myeloproliferative disease, but characteristically shows frequent coexistence with multiple myeloma. Until now , the therapeutic trials in CNL have been disappointing. Hydroxyrea and busulfan can control hyperleukocytosis. On the basis of functional defect in neutrophil, alpha-2b-interferon has been tried and several reports have demonstrated the clinical and functional effect of interferon on CNL. CNL is very rate hematologic disease and there are few report about general aspect of disorder. We report here a typical CNL case presenting with splenomegaly and leukocytosis with a review of the literature.

양성 가속도(+Gz)가 마우스의 면역반응에 미치는 영향

박영민,이인기 공군본부 의무감실 1992 항공의학 Vol.40 No.1-2

제4형 가족성 고중성지방혈증 임산부에서 발생한 급성 췌장염 1례

박관응,윤채중,김영학,진영기,윤성호,권용은,김태원,박찬국,김만우 朝鮮大學校 附設 醫學硏究所 1997 The Medical Journal of Chosun University Vol.22 No.2

Plasma levels of cholesterol (TC) and triglyceride(TG) physiologically increase during pregnancy. The lipid increment is 23-53% above the pregravidic level for TC and 2- to 3-fold of the prepregnancy level for TG. If the TC and TG are higher than normal values in pregnancy, the patient must be carefully monitored. Acute pancreatitis is the main consequence of hyperlipidemia and occurs either during pregnancy, in the third trimester, or in the puerperium. Mortality is high both for the mother (21%) and the fetus (20%). We report a case of 28 year-old pregnant woman at 29 weeks gestation with hypercholesterolemia (TC = 357 ㎎/dl) and severe hypertriglyceridemia (TG = 1300 ㎎/dl). The patient was admitted to the hospital because of severe epigastric pain, nausea and vomiting. Total serum cholesterol was increased and trigyleride was markedly increased. The electroporesis pattern of serum lipoprotein showed increase in pre-beta lipoprotein fraction, suggesting IV hypertriglyceridemia pattern. According to a review of the literature, the incidence of pancreatitis during pregnancy is 1 in 1000 to 3000 pregnancies. Severe hypertriglyceridemia in pregnancy should be treated with a careful restriction of calories and fat: for preventing acute pancreatitis, hospitalization for intravenous fluid therapy and plasma exchange must be required.

사립체 DNA 뉴클레오타이드 3243 A→G 돌연변이 [MTTL1^*MELAS3243G]에 의한 MELAS 증후군

박기형,김승현,이영주,김희태,김주한,김명호,박성섭 대한신경과학회 1998 대한신경과학회지 Vol.16 No.4