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.

심혈관계 질환으로 관상질환 집중치료실에 입원한 환자들의 혜후 측정을 위한 APACHEⅢ점수 체계의 임상적 유용성

이공섭,이창선,최현주,홍종서,강지향,김도형,이민영,오인균,김병엽,김상억,김학찬,한승혜,이재용,지영우,안경주 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.8

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.

지난 2년간의 학회지 "신경정신의학" 심사 평가보고

김찬형,김세주,김도관,김성곤,박원명,송동호,박용천,이영문,오강섭,정영철,이상열,김주한,이동영,이헌정,함병주,김율리,김문두,김정진,이강욱,천근아,김재진,홍진표,홍승철 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.6

Polypropylene Nanocomposites with Graphene Oxide Containing Flame Retardant Moieties

Seung Won Lee(이승원),Huiseob Shin(신휘섭),Yong Hun Lee(이용훈),Jong-Chan Lee(이종찬),Jae Young Jho(조재영) 한국고분자학회 2020 폴리머 Vol.44 No.5

폴리프로필렌(polypropylene, PP)/산화그래핀(graphene oxide, GO) 복합재료의 난연성과 기계적 성질을 향상시키기 위해 GO를 인계 난연제로 개질시켰다. 복합재료는 무수말레인산이 수식된 PP(maleic anhydride-grafted PP, MAPP)를 상용화제로 사용하여 용융 혼합 방식으로 제작되었다. 푸리에 적외선 분광학(Fourier transform infrared, FTIR), 광전자분광법(X-ray photoelectron spectroscopy, XPS)을 통해 난연제와 GO 사이에 공유 결합이 형성된 것을 확인할 수 있었다. GO의 기능화와 상용화제 사용이 PP/GO 복합재료의 형태학, 난연성, 기계적 성질에 미치는 영향을 평가하였다. 주사전자현미경(SEM)을 이용한 형태학 분석 결과, MAPP를 첨가함으로써 충전제와 기지재 사이의 계면 상호작용이 증가되어 GO의 박리 및 분산성이 향상되었다. PP/기능화된 GO 복합재료의 한계산소지수, 영 탄성률, 인장 강도가 PP/GO 복합재료에 비해 증가된 결과를 나타냈다. Graphene oxide (GO) was functionalized with phosphorus-containing groups to give the flame retardancy to the polypropylene (PP)/GO nanocomposites. The composites were prepared via melt mixing with maleic anhydride-grafted PP (MAPP) as a compatibilizer. Through the Fourier transform infrared (FTIR) spectroscopy, and X-ray photoelectron spectroscopy (XPS), covalently-bonded flame retardant moieties on GO were characterized. The effect of the functionalization of GO and the use of compatibilizer on the morphology, flame retardancy, and mechanical properties of the PP/GO composites were investigated. SEM observation of the composites showed that the addition of MAPP improved the exfoliation and dispersion state of the GO sheets by improving the interfacial interaction between the filler and the matrix. For PP/functionalized GO composites, the limiting oxygen index (LOI), Young’s modulus, and tensile strength were increased compared with PP/GO composites.

Poly(vinyl alcohol) nanocomposites containing reduced graphene oxide coated with tannic acid for humidity sensor

Lim, Min-Young,Shin, Huiseob,Shin, Dong Myung,Lee, Sang-Soo,Lee, Jong-Chan Elsevier 2016 Polymer Vol.84 No.-

<P><B>Abstract</B></P> <P>Poly(vinyl alcohol) (PVA) nanocomposites were prepared by a solution casting method using a reduced graphene oxide coated with tannic acid (rGO-TA) as a filler. The rGO-TA was simply prepared by mixing tannic acid (TA) with graphene oxide (GO). The simple mixing process was found to be effective to reduce GO and to produce covalently-grafted TA layers on the reduced GO. The mechanical properties of PVA were much improved by the addition of rGO-TA because the TA layers increased the compatibility of the reduced GO with PVA matrix. For example, Young's modulus and elongation at break values of PVA were increased by 34.0 and 56.9%, respectively, by adding 1.0 wt% of rGO-TA. In addition, the PVA nanocomposites showed excellent humidity sensing properties over the wide relative humidity range and the long-term stability due to the conductive property of the reduced GO and the enhanced mechanical strength by the effective incorporation of rGO-TA into the PVA matrix.</P> <P><B>Highlights</B></P> <P> <UL> <LI> The rGO-TA was prepared by a facile and green method using a low-cost tannic acid. </LI> <LI> The effect of rGO-TA on the properties of PVA nanocomposites has been studied. </LI> <LI> The rGO-TA improved the important properties for PVA-based humidity sensors. </LI> <LI> The PVA/rGO-TAs are promising materials for high-performance humidity sensors. </LI> </UL> </P> <P><B>Graphical abstract</B></P> <P>[DISPLAY OMISSION]</P>

부신피질 자극호르몬 단독결핍 1례

박경식,이승현,최석영,박태규,이동화,이찬우,정성복,이인규 啓明大學校 醫科大學 1997 계명의대학술지 Vol.16 No.3

부신피질 자극호르몬 단독결핍은 국내에서 7례만이 보고된 희귀 질환이며 병인 및 경과 등 아직 불분명한 측면이 많다. 이는 질환지체의 희귀성도 있지만 치료후 자연경과에 대한 장기적인 추적검사가 이루어진 경우가 드물기 때문이기도 하다. 저자들은 비특이적인 전신증상을 주소로 내원한 폐경기후의 56세 여자 환자에서 자가면역질환의 증거없이 고프로릭틴혈증을 보인 부신피질 자극호르몬 단독결핍 1례를 경험하고 1년간의 부신피질호르몬 대치요법후 추적검사를 실시하였기에 문헌 고찰과 함께 보고하는 바이다. Isolated ACTH deficiency is a rare disorder which shows secondary adrenal insufficiency with normal states of other pituitary hormones. A 56-year-old postmenopausal woman complaining general weakness and intermittent mental confusion presented negligible serum cortisol and ACTH level with hyperprolactinemia and mild hyponatremia. Rapid ACTH stimulation test did not show significant increase of serum cortisol level. Combined pituitary stimulation test showed negligible response of cortisol and ACTH, and slightly decreased response of prolactin and gonadotropin. But the responses of TSH and GH were normal. There was no evidence of organic pituitary of hypothalamic lesion in brain MRI and antithyroid autoantibody was not detected in serum. After receiving 12 months of glucocorticoid replacement therapy, she skipped the medicine for 3 weeks and we performed follow-up endocrinologic tests. Serum ACTH and cortisol level was also negligible and prolonged ACTH simulation test showed normal response of serum cortisol. CRF stimulation test showed no response of serum ACTH. Basal prolactin level was decreased to near normal and combined pituitary stimulation test showed normal response of prolactin with slightly blunted response of TSH and GH. We concluded that the case was nonautoimmune origined isolated ACTH deficiency which was accompanied by hyperprolactinemia and resultant deficiency of gonadotropin, so we report this case with review of literatures.

비혈연간 동종골수이식에 의해 치료된 중증 재생불량성빈혈 1예

김현중,이홍기,이방훈,이창근,이종태,정현식,김원석,윤성수,강원기,박근칠,김대식,고영혜,박찬형 대한조혈모세포이식학회 1997 대한조혈모세포이식학회지 Vol.2 No.1

비혈연간 동종골수이식은 혈연간 동종골수이식이 불가능한 환자에서 기존의 면역역제요법으로 효과가 없었던 경우나 재발한 경우에 적응증이 될수 있다. 이식 거부와 이식편대숙주병의 발생이 골수 이식의 성공률을 감소시키므로, 보다 강력한 conditioning regimen의 사용과 T cell이 제거된 골수를 사용하는 것이 필요하다. 기존의 high dose corticosteroid나 cyclosporine에 대하여 불응성인 이식편대숙주병의 치료를 위해서 ATG와 Mycophenolate mofetil (Cellcept®) 의 사용이나 Tacrolimus, Methotrexate와 같은 다른 면역억제제치료를 고려해 볼 수 있다. It is known that allogenic bone marrow transplantation is the most effective treatment for aplastic anemia. However, this treatment is only applicable to a minority of patients because the proportion of patients who have HLA-matched siblings about 25% to 30% of all the aplastic anemia patients. In the case of the absence of HLA-matched donor, unrelated allogenic bone marrow transplantation is considered. However, (because of severe acute and chronic GVHD and graft failure) the success rate of this approach is only 20~30%. Recently, it was reported that increased immunosuppressive condition combined with T cell depletion of the marrow graft would result in greater success. There was no case of successfully treated aplastic anemia patient by unrelated allogenic bone marrow transplantation in Korea. Here, we report a case of severe aplastic anemia successfully treated with unrelated allogenic bone marrow transplantation.

동일한 환자에서 조혈모세포이식 전후의 호중구감소 기간 중 감염양상에 대한 비교연구 : 중심정맥관 관련 패혈증을 중심으로 Based on Central Venous Catheter Related Septicemia

류재호,노규태,이영석,이영호,권혁찬,김재석,김효진,이영민,박혜원,박근희 대한조혈모세포이식학회 2002 대한조혈모세포이식학회지 Vol.7 No.1

연구배경: 동일한 환자를 대상으로 조혈모세포이식 전 일반 병실에서의 관해유도 항암제치료 및 강화요법으로 인한 호중구감소 기간의 감염양상과 고용량 항암제치료 후 무균실에서의 조혈모세포이식 시 호중구감소 기간의 감염양상을 중심정맥관 관련 패혈증을 중심으로 비교 연구함으로써 효율적인 감염관리지침을 마련하고자 하였다. 대상 및 방법: 1999년 1월부터 2001년 7월까지 2년 7개월간 동아대학교병원 일반병실에서 악성혈액질환으로 항암제 치료를 받다가 조혈모세포이식을 시행받았던 22명을 대상으로 중심정맥관 관련 패혈증의 형태를 비교분석하였다. 결과: 대상 환자들의 일반병실과 무균실에서의 입원기간은 각각 32±13일, 33±19일, 호중구 감소기간은 15±12일, 17±18일, 호중구 감소기간의 발열 횟수는 14회, 14회로서 입원병실의 종류에 따른 차이는 없었다. 환자들의 중심정맥관 사용일수는 일반병실에서 29일(7~545일), 무균실에서 100.5일(25~606일)이었으며, 총 사용일수는 각각 1,515일, 3,250일로서 무균실에서의 중심정맥관 사용일수가 의미 있게 길었다(P=0.001). 중심정맥관 사용 일수에 대한 감염률은 각각 5.28/1,000일, 3.08/1,000일로서 일반병실에서 그 빈도가 높았으나 통계적 유의성은 보이지 않았다(P=0.141). 결론: 중심정맥관 삽입 후 일반병실에서 항암제 치료를 받던 환자가 조혈모세포이식을 위하여 무균실에 입원하는 경우, 중심정맥관을 교체하는 것이 감염관리를 위하여 바람직할 것으로 생각된다. Background: We compared the incidence of central venous catheter (CVC) related septicemia during neutropenic period in the same patient, which developed following chemotherapy for remission induction and consolidation, or hematopoietic stem cell transplantation (HSCT). Methods: We retrospectively reviewed the medical records and laboratory data of 22 patients with hematologic malignancies who received anticancer chemotherapy followed by HSCT at Dong-A University Hospital between January, 1999 and July, 2001. We investigated the duration of hospitalization, duration of neutropenic period, duration of catheterization, microbiologically documented organisms and incidence of CVC related septicemia. Results: The data in general ward (before HSCT) and laminar air flow room (after HSCT) were as follows: duration of hospitalization was 32±13 days and 33±19 days, duration of neutropenic period was 15±12 days and 17±18 days, median duration of catheterization was 29 days (7~545 days) and 100.5 days (25~606 days) (P=0.001), and incidence of CVC related septicemia was 5.28/1000 days and 3.08/1000 days, respectively. In the CVC related septicemia, the most common etiologic organism was coagulase negative staphylococcus. Conclusion: We suggest that the exchange of CVC before admission to laminar air flow room could decrease the incidence of CVC related septicemia in HSCT recipients.

수복재료와 내가동연결장치가 IMZ 임프란트 보철물의 충격흡수효과에 미치는 영향

이수정,정찬목,전영찬,Lee, Su-Jeong,Chung, Chan-Mo,Jeon, Young-Chan 대한치과보철학회 1997 대한치과보철학회지 Vol.35 No.1

The purpose of this study was to evaluate the shock absorbing effect of 4 restorative materials and intramobile connector. The damping effect of four restorative materials used to veneer test crown rigidly connected to IMZ implant and subjected to an impact force was measured. These materials included a gold alloy(stabilor G) : a noble metal ceramic alloy(Degudent H) : porcelain(Duceram) : composite resin(Dentacolor). In addition, this study compared damping effect of same restoretive materials after using polyoxymethylene intramobile connector(POM IMC). The result of this study suggest that : In case of using metal IMC 1. Veneered composite resin(group IV) reduced the impact force by 75%, when compared to an equivalent thickness of porcelain(group III). Group IV reduced the impact force by 87% and 89%, respectively, when compared to Stabilor G(group I) and Degudent H(group II). 2. The impact force recorded was higher for the alloy with the higher elastic modulus.(Stabilor G, group I, Young's modulus 107 Gpa, versus Degudent H, Group II, Young's modulus 95 Gpa) 3. It took the longest time for composite resin veneered group(IV) to reach to peak force when compared group I, II, III. In case of using POM IMC 4. The mean impact force recorded were reduced by 79%(group I), 78%(group II), 69%(group III), 84%(group IV), respectively, when compared to using metal IMC. 5. The time required to reach the peak force were increased by 78%(group I, II) 87%(group III), 34%(group IV), respectively, when compared to using metal IMC>.