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.

혈우병 소견을 가진 뇌출혈 환자 치험(治驗) 1례(例)

정인태,서병관,이현종,하지영,강미경,홍장무,백용현,박동석,최도영,Jung, In-tae,Seo, Byung-kwan,Lee, Hyun-jong,Ha, Ji-young,Kang, Mi-kyeong,Hong, Jang-moo,Baek, Yong-hyeon,Park, Dong-suk,Choi, Do-young 대한침구의학회 2003 대한침구의학회지 Vol.20 No.4

Objective : Hemophilia, a genetically determined disorder, is characterized by abnormality of the coagulation mechanism due to functional deficiency of a specific factor, namely VIII or IX. In this study, the effect of Dong-Si acupuncture therapy on the cerebral hemorrhage patient with hemophilia was evaluated. Methods : We treated him with acupuncture by stimulating Dong-Si acupuncture point(Yuk Wan) and assessed the effect by using manual dynamic evaluation of MRC(Medical Research Council) and Modified Barthel Index. Results : After treatment, the bleeding tendency was grossly reduced and bleeding lesion was absorbed gradually. And manual dynamic evaluation of the upper extremity increased from 4 grade to 5 grade. Conclusions : This result suggest that Dong-Si acupuncture therapy on the cerebral hemorrhage patient with hemophilia was effective. And futher studies are required to concretely prove the effectiveness of Dong-Si acupuncture therapy for treating hemorrhagic diseases.

Brassica 種들의 花뢰크기에 의한 小胞子 發育段階 및 胚發生 比較

장영석(Young Seok Jang),민경수(Kyung Soo Min),오용비(Yong Bee Oh),정동희(Dong Hee Chung) 한국육종학회 1997 한국육종학회지 Vol.29 No.4

The purpose of this study is to search for the identifing method that could separate buds with embryogenic potential from collected buds for increasing the efficiency of embryogenesis by microspore culture in Brassica species. It was investigated developmental stage of microspore by bud-size and ratio of petal/anther length and compared to amount of embryogenesis through isolated microspore culture from the buds with late-uninucleate stage. In Brasica napus, Lisandra of spring type showed bud-size of 3.2~4.1mm which belongs to late-uninucleate stage as embryogenic microspores and their range of petal/ anther length ratio were 1/2~3/4. Hallayuchae of winter type rapeseed showed bud-size of 3.1~3.6mm which belongs to late-uninucleate stage as embryogenic microspores and their range of petal/anther length ratio were 1/3~1/2. Two genotypes of B juncea had the same petal/anther length ratio as range of 1/2~3/4 with embryogenic microspores but their bud-size were some difference as bud-size of Young-sanpohwanggyeja were 2.9~4.0mm and bud-size of Hwanggyeja were 2.9~4.1mm. Also, two genotypes of B. campestris had the same petal/anther length ratio as range of 2/3~3/4 with embryogenic microspores but bud-sizes were some difference as bud-size of Hyakusai were 2.9~3.4mm and bud-size of Sosongchae were 2.9~3.2mm. In B. oleracea, the petal/anther length ratio with embryogenic microspores according to bud-size were showed range of 1/2~2/3 in all of two genotypes and bud-size of Broccoli were 2.4~3.2mm and bud-size of Cauliflower were 2.9~3.7mm. In the embryo yield per 100,000 microspores by isolated microspore culture from the buds with embryogenic microspores, Young-sanpohwanggyeja of B. juncea were 47 embryos and Hwanggyeja of B. juncea were 23 embryos, B. campestris of Hyakusai were 367 and Sosongchae were 123, B. oleracea of Broccoli were 678 and Cauliflower were 562. However in B. napus was showed much differences by the growth habit, the spring type of Lisandra were producted 7,047 embryos of which higher about 9.2 times than those of winter type Hallayuchae.

관동맥질환에서 저밀도 지단백 입자 크기의 분포

임효영,김인숙,승기배,강동헌,전두수,장기육,박준철,이수영,홍순조,최규보 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.8

성인병에 대한 한방치료법(증치의학과 사상의학)에 관한 연구 : 고혈압에 대한 한방치료법(중치의학과 사상의학)에 관한 연구

박동일,김영균,안창범,이인선,김종원,권정남,장경전,이인선,이성근,장용우,신영민 동의대학교 한의학연구소 1999 동의한의연구 Vol.3 No.-

We had a result of the treatment as below when is devided Korean medicine Tx.. Western medical Tx., Cooperative Tx.. 1) At the improvement of BP control, an average in Korean medicine Tx. (from 170㎜Hg/100㎜Hg to 150㎜Hg/90㎜Hg), an average in Western medical Tr. (from 170㎜Hg/100㎜Hg to 130㎜Hg/80㎜Hg), an average in Cooperative Tx.(from 180㎜Hg/110㎜Hg to 130㎜Hg/90㎜Hg), generally all pars had improvements of BP control. But it is not significant of each case. 2) At the improvement of symptoms by the apologetics, Cooperative Tx. is profitable in cases of 'GanHwa',' DamEum', 'EumYangYangHer', 'EumHer'. Korean medicine Tx. is superior in case of 'GiChe'. 3) At the improvement of symptoms by a questionnaire, Korean medical Tx., Western medical Tx., Cooperative Tx. groups had improvements, but each practice group didn't have specific significance. Only it was somewhat profitable to Korean medical Tx. in the 210㎜Hg/110㎜Hg, Western medical Tx. in the 180㎜Hg/110㎜Hg, Cooperative Tx, in the 170㎜Hg/90㎜ Hg. 4) There are the apparent improvements in patients whose BP are over 200㎜Hg of Korean medical Tx. group, whose BP are over 190㎜Hg of Western medical Tx. group and whose BP are over 170㎜Mg of Cooperative Tx. group. There are the improvement of diastolic BP in 110㎜Mg(Korean medical Tx., Western medical Tx.) and 90㎜Hg(Cooperative Tx.). 5) At the improvement of Pulse pressure, generally Pulse pressure are decreased. There are similar improvements in all of Korean medical Tx., Western medical Tx., and Cooperative Tx.. 6) At the Symptomatic approvement according to ages, Korean medical Tx., Cooperative Tx. are somewhat good for his twentieth, and Western medical Tx. is somewhat good for his forties. 7) the correlation of Obesity-grade and BP, as Obesity-grade is higher as BP is higher, but there are no similarity in the improvement. 8) At the EAV improvements, as examination into correlation with the point of 1~3th, we could get results as below. There are high improvements of DRHTM, DRALM, DLLYM, DLLIM in Cooperative Tx. There are high improvements of DRPASI, DLLARI in the Korean medical Tx. group. There are high improvements of DRFADM in Western medical Tx. group.

ATM망에서 실시간 연결수락제어에 관한 연구

장혁,김영훈,김용수,김희철,나상동 조선대학교 동력자원연구소 1997 動力資源硏究所誌 Vol.19 No.1

본 논문은 이질적 버스트 트래픽을 갖는 ATM(Asynchronous Transfer Mode) 망에서 실시간 연결 수락 제어를 위한 유체 흐름 모델(fluid flow model)에 기반을 둔 실시간 알고리즘을 제안한다. 셀 손실 확률은 QOS(Quality of Service)의 기준이 되므로 제안된 실시간 알고리즘은 일정한 메모리 크기와 연결 요청의 수락 여부 즉, 연결 수락 여부의 결정을 위한 하나의 영역을 필요로 한다. 이러한 트래픽 소스 각 타입에 대한 셀 손실 확률은 트래픽 소스 타입 전체에 하나만 존재하더라도 요구를 충족 시킬 수 없으므로, 본 논문에서 제안된 실시간 알고리즘에 의해 산출되는 각각의 셀 손실확률에 충분한 상한선을 제공하는 전형적 트래픽 매개변수를 사용하여 성능을 분석한다.

2급 응급구조사의 성인외상환자에 대한 처치의 적절성 평가

장문수,어은경,김상현,김창섭,송근정,박한규,유지영,최동섭 대한응급의학회 1995 대한응급의학회지 Vol.6 No.2

In Korea, EMT have two classified subgroup of first and second degree : EMT-P, and EMT. For the beginning, authorization of the first EMT was made in this year through the EMT educational program. There are 8 items which EMT can perform the treatment without the supervision by a physician. But there was no previous report of pertinent assesment of treatment performed by the EMT. There upon authors have conducted review of assessment done by the EMT in EC setting, and proposed the following treatment application can be used by EMT at the field of accident. The study materials include adult trauma patient older than 15 years, and sustained trauma within 48 hours before visiting Ewha University DongDaeMoon Hospital Emergency Deparment. The duration of study was from Apr. 1 1995 to Aug. 31 1995. the study was conducted by 5 certified EMT. The EMT's performance was evaluated by the attending Emergency Medicine physician. The result were as followings ; 1. Among the total 5532 ED visiting patients during the study period, 1267 were adult trauma patients who recieved treatment within 48 hours of injury. 2. Among 1222 out of 1267 patients have completed performed survey. 3. Male to female ratio was 2.6 : 1, age distribution was from 15 to 87 years old and mean age was 34.6 years old. 4. The MOI showed : MVA (33.1%), blunt trauma (29.9%), slip down (16.8%), penetrating injury(15.4%), and miscellaneous (5.7 %), burn (3.1%), falling down injury(2.9 %), bite injury(1.1%) in order. 5. There were 437 cases of survey completed by the EMT. For assessment of mental status of 3 different method : AVPU, 5 scale mental status and GCS, were correlated with EM physician with 99.1%, 98.6%, 97.7 %, respectively. 6. For 320 out of 437 cases of survey completed, 319 patients recieved treatment by the EMT within 30 minute and 1 patient between 30 to 60 minute of an ED arrival. 7. For those 437 cases of survey completed, 266 patient (60.9%) had adequate treatment and 54 patients (12.4%) had inadequate treatment. 67 patient (15.3%) did not received treatment but it was adequate inway, and 50 patients (11.9%) did not received treatment even though patient required treatment. In cases of adult trauma patients, EMT's mental status assessment was correlated with EM physician's assessment. But treatment done by EMT without the supervision of EM physician was adequate only in 76.2 %. Therefore, continuous education and assessment of treatment performed by EMT in needed to improve field treatment by EMT future.

Dong-Chun Lecture : Cell-based High Content Screening (HCS) for action modes of drug targets by using systematic deletion mutants of Schizosaccharomyces pombe

( Dong Uk Kim ),( Im Seon Woo ),( Mi Sun Won ),( Young Joo Jang ),( Kyung Sook Chung ),( Han Oh Park ),( Hyang Sook Yoo ),( Kwang Lae Hoe ),( Doo Sik Kim ) 한국생화학분자생물학회 (구 한국생화학회) 2005 생화학분자생물학회 춘계학술발표논문집 Vol.2005 No.-

Trichophyton verrucosum infection in Korea: Analysis on 224 patients from 1976 to 2015

( Dong Hyuk Eun ),( Jun Hong Park ),( Sun Young Moon ),( Yong Hyun Jang ),( Seok-jong Lee ),( Do Won Kim ),( Yong Jun Bang ),( Jae Bok Jun ),( Weon Ju Lee ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.2

Background: Trichophyton (T.) verrucosum is a dermatophyte causing ringworm in cattle, distributed worldwide. It can be responsible for various inflammatory lesions of skin and scalp. In Korea, kerion celsi caused by T. verrucosum was first reported at 1986 in the southeast province of Korea. Since then, many patients infected with T. verrucosum have been reported in Young-nam province. There are few long-term studies about epidemiological characteristics of T. verrucosum. Objectives: To investigate the clinical and epidemiological characteristics of T. verrucosum infections in Korea. Methods: A total of 224 patients were diagnosed as T. verrucosum infection by fungal culture from 1976 to 2015. The data were based on a retrospective survey of medical records. Results: The annual incidence of patients with T. verrucosum infection had been increasing since the report in 1986. The number of patients showed a peak in 1988. After 2000, the number of patients had been decreasing. Female to male ratio showed a 1.2-fold predominance of female infection. And more than 15-year-old group was 59.4% of total patients. T. verrucosum infection was most commonly seen in spring and was found predominantly in patients living in rural areas. Face was most frequently involved, followed by arms. Conclusion: These findings provide useful information for understanding of T. verrucosum infection and future dermatophytosis prospects.

녹동균 세포외막 단백질 백신 CFC-1-101의 안정성 및 면역원성 검토 : 임상 제 Ⅰ/Ⅱa상 시험

장인진,김익상,유경상,임동석,김형기,신상구,장우현,박완제,이나경,정상보,안동호,조양제,안보영,이윤하,김영지,남성우,김현수 대한감염학회 1998 감염 Vol.30 No.3

목적 : 제일제당에서는 녹농균의 세포외막 단밸질을 유효성분으로 하는 백신인 CFC-101을 개발하였으며, 동물시험에서 이 백신의 안전성과 유효성을 입증하였다. 본 연구에서는 이 녹농균 백신의 인체에 대한 안전성과 면역원성을 평가하는 동시에 인체 접종시의 최적 투여 용량을 결정하기 위하여 제 I/Ⅱa상 임상시험을 수행하였다. 방법 : 건강한 성인 남자를 피험자로 선별하여 각 용량군에 백신투여자 6명, 위약투여자 2명을 배정하였다. 백신 투여군은 0.25mg, 0.5mg 또는 1.0mg 용량의 녹농균 백신을 7일 간격으로 3회에 걸쳐 근육주사 하였으며, 위약 투여군에게는 세포외막 단백질을 제외한 동일한 성분을 투여하였다. 백신접종 후 국소적 또는 전신적인 반응의 발생여부를 관찰하고, 혈액시료를 체취하여 백신의 역가와 유효성을 검정하였다. 결과 : 녹농균 백신 CFC-101은 모든 접종자에서 양호한 내약성을 보였다. 또한 0.5mg 과 1.0mg 백신 투여군에서는 100%의 항체양전율을 나타내었다. 생성된 항체는 녹농균 세포외막단백질에 특이성을 보였고, 녹농균 감염에 대해 방어효능이 있었다. 결론 : 이와같은 결과로부터 이 녹농균 백신은 인체에 안전하게 투여할 수 있으며, 높은 항체 생성능으로 감염방어 효능을 보이고 0.5mg과 1.0mg이 최적용량인 것으로 판단되었다. Background : We developed a Pseudomonas aeruginosa outer membrane protein(OMP) vaccine CFC-101, and the prophylactic efficacy of which has been demonstrated in animal models. In order to evaluate the safety and immunogenicity of the P. aeruginosa vaccine, we carried out a phase I/Ⅱa clinical trial in healthy male volunteers. Methods : Groups of eight volunteers, including two placebo subjects, were vaccinated intramuscularly with three doses of 0.25, 0.5 or 1.0 mg of the vaccine at one week intervals. Sings of systemic and local reactions observed after vaccination were recorded for each vaccinee for 5 days. Physical examinations were performed on days 0, 1, 7, 8, 14, 15, 21, and 42, and clinical laboratory tests were done on days 0, 3, and 21. Blood samples for assay of serum antibody levels were obtained up to 42 days after the first vaccination. Results : The vaccine was generally well tolerated by all vaccinees, showing no significant side effects. In the three dosage groups, all vaccinees, except one receiving the 0.25 mg dose, showed significant elevation in serum IgG antibody titers against the vaccine proteins, indicating 100% seroconversion in 0.5 and 1.0 mg groups. The human antibodies induced by the vaccine were specific for P. aeruginosa OMPs, as confirmed by western blot analysis and immunoprecipitation assays. The capacity of the human antisera to enhance opsonophagocytic killing activity by polymorphonuclear leukocytes and to confer protection against P. aeruginosa infections indicates that the antibodies elicited by the vaccine have protective efficacy. Conclusion : We conclude that the P. aeruginosa OMP vaccine is safe and effective for human use and its optimal dose to be 0.5 or 1.0 mg.