67 results on '"Hyun Hee Lee"'
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2. Low-dose aspirin was associated with an increased risk of cardiovascular events in patients with chronic kidney disease patients and low bodyweight: results from KNOW-CKD study
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Yun Jung Oh, Seung Hyeok Han, Han Ro, Yeong Hoon Kim, Hyun Hee Lee, Jae Hyun Chang, Young Youl Hyun, Joongyub Lee, Wookyung Chung, Kook Hwan Oh, Ae Jin Kim, Dong Wan Chae, Curie Ahn, and Ji Yong Jung
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medicine.medical_specialty ,Science ,Renal function ,030204 cardiovascular system & hematology ,Kidney Function Tests ,Risk Assessment ,Article ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,030212 general & internal medicine ,Renal Insufficiency, Chronic ,Proportional Hazards Models ,Aspirin ,Creatinine ,Multidisciplinary ,Kidney diseases ,business.industry ,Incidence (epidemiology) ,Body Weight ,medicine.disease ,Prognosis ,Quartile ,chemistry ,Cardiovascular Diseases ,Nephrology ,Propensity score matching ,Medicine ,business ,medicine.drug ,Cohort study ,Kidney disease ,Glomerular Filtration Rate - Abstract
The benefits and risks of aspirin therapy for patients with chronic kidney disease (CKD) who have a high burden of cardiovascular events (CVE) are controversial. To examine the effects of low-dose aspirin on major clinical outcomes in patients with CKD. As a prospective observational cohort study, using propensity score matching, 531 aspirin recipients and non-recipients were paired for analysis from 2070 patients and fulfilled the inclusion criteria among 2238 patients with CKD. The primary outcome was the first occurrence of major CVE. The secondary outcomes were kidney events defined as a > 50% reduction of estimated glomerular filtration rate from baseline, doubling of serum creatinine, or onset of kidney failure with replacement therapy, the all-cause mortality, and bleeding event. The incidence of CVE was significantly greater in low-dose aspirin users than in non-users (HR 1.798; P = 0.011). A significant association between aspirin use and an increased risk of CVE was observed only in the lowest quartile of body weight (HR 4.014; P = 0.019) (Q1
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- 2021
3. Concomitant Mitochondrial Diabetes and Myopathy Mistook for Complications of Immunosuppressants After Kidney Transplant
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Woo Kyung Chung, Ji Yong Jung, Hyun Hee Lee, Jae Hyun Chang, Han Ro, Yong Hoon Shin, and Ae Jin Kim
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Mitochondrial encephalomyopathy ,Transplantation ,Pediatrics ,medicine.medical_specialty ,business.industry ,Mitochondrial Diabetes ,medicine.disease ,Kidney transplant ,Diabetes mellitus ,Concomitant ,Lactic acidosis ,medicine ,Sensorineural hearing loss ,medicine.symptom ,business ,Myopathy - Abstract
Posttransplant diabetes mellitus, presenile deafness, and myopathy are not commonly accompanied symptoms after kidney transplant. We report the case of a 48-year-old woman with diabetes mellitus, sensorineural hearing loss, and severe myopathy without neuropathy after deceased donor kidney transplant. ShehadamitochondrialDNApointmutation at position 3243 (A>G), and mitochondrial diseases such as maternally inherited diabetes deafness or mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodeswere suspected.Diabetes andother symptoms following kidney transplant can often be overlooked as complications of immunosuppressants taken after kidney transplant. However, in patients without a known cause of their symptoms, appropriate examinations and consultation for other diseases, including genetic diseases, should be considered.
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- 2021
4. Association between acute kidney injury and serum procalcitonin levels and their diagnostic usefulness in critically ill patients
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Jae Hyun Chang, Ae Jin Kim, Ji Yong Jung, Han Ro, Hyun-Sook Kim, Kayeong Chun, Wookyung Chung, and Hyun Hee Lee
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0301 basic medicine ,Adult ,Male ,medicine.medical_specialty ,congenital, hereditary, and neonatal diseases and abnormalities ,Critical Illness ,Renal function ,lcsh:Medicine ,urologic and male genital diseases ,Procalcitonin ,Article ,law.invention ,Sepsis ,03 medical and health sciences ,0302 clinical medicine ,law ,Internal medicine ,parasitic diseases ,medicine ,Humans ,Risk factor ,lcsh:Science ,Aged ,Multidisciplinary ,business.industry ,lcsh:R ,Acute kidney injury ,Odds ratio ,Acute Kidney Injury ,Middle Aged ,medicine.disease ,bacterial infections and mycoses ,Intensive care unit ,Systemic inflammatory response syndrome ,030104 developmental biology ,Female ,lcsh:Q ,business ,030217 neurology & neurosurgery ,Biomarkers ,hormones, hormone substitutes, and hormone antagonists - Abstract
Procalcitonin (PCT) is a useful marker for the diagnosis of systemic inflammatory response syndrome. In addition, PCT is affected by renal function. However, few studies have investigated the relationship between PCT and the development of acute kidney injury (AKI). Hence, we investigated whether serum PCT levels at the time of admission were associated with the development of AKI and clinical outcomes. A total of 790 patients in whom PCT was measured on admission to the intensive care unit (ICU) were analyzed retrospectively. We attempted to investigate whether serum PCT levels measured at the time of admission could be used as a risk factor for the development of AKI in septic and nonseptic patients or as a risk factor for all-cause mortality, and diagnostic usefulness of PCT was further assessed. Serum PCT levels were significantly higher in patients with AKI than in those without AKI (P P = 0.035). However, PCT was not effective in predicting mortality. The cut-off value of PCT for the prediction of AKI incidence was calculated to be 0.315 ng/ml, with sensitivity and specificity of 60.9% and 56.9%, respectively. The odds ratios (ORs) from an equation adjusted for optimum thresholds of PCT levels for developing AKI with and without sepsis were 2.422 (1.222–4.802, P = 0.011) and 1.798 (1.101–2.937, P = 0.019), respectively. However, there were no absolute differences between the pre- and posttest probabilities after including the PCT value for AKI development. This study suggests that the PCT value was higher in AKI patients than in non-AKI patients, but PCT measurement at the time of admission did not improve the prediction model for AKI.
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- 2019
5. Soluble ST2 and Galectin-3 as Predictors of Chronic Kidney Disease Progression and Outcomes
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Jae Hyun Chang, Hyun-Sook Kim, Ae Jin Kim, Han Ro, Hyun Hee Lee, Ji Yong Jung, and Wookyung Chung
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Male ,medicine.medical_specialty ,Galectins ,Renal function ,chemistry.chemical_compound ,Risk Factors ,Internal medicine ,Diabetes mellitus ,medicine ,Humans ,Hypoalbuminemia ,Renal Insufficiency, Chronic ,Aged ,Proportional Hazards Models ,Heart Failure ,Creatinine ,business.industry ,Proportional hazards model ,Blood Proteins ,Middle Aged ,medicine.disease ,Interleukin-1 Receptor-Like 1 Protein ,Proteinuria ,chemistry ,Nephrology ,Cardiovascular Diseases ,Heart failure ,Cohort ,Disease Progression ,Female ,business ,Biomarkers ,Kidney disease ,Glomerular Filtration Rate - Abstract
Background: Soluble suppression of tumorigenicity-2 (sST2) and galectin-3, novel biomarkers of heart failure and cardiovascular stress, predict cardiovascular events (CVEs) and mortality. However, their relationship with kidney function and adverse outcomes in CKD are uncertain. The purpose of this study was to determine the association between sST2 and galectin-3 with CKD progression and adverse clinical outcomes. Methods: We measured baseline sST2 and galectin-3 levels in the CKD patient cohort at our institution between October 2013 and December 2014. The primary outcome was CKD progression (kidney failure with replacement therapy or ≥50% reduction in estimated glomerular filtration rate from the baseline). The secondary outcome was the composite of CVEs and death. We used a Cox proportional hazards model to evaluate the associations between sST2 and galectin-3 levels, with kidney and clinical outcomes. Results: In total, 352 patients were enrolled in this study. At baseline, log sST2 and galectin-3 were directly associated with the serum creatinine (Cr) and urine protein-to-Cr ratio. Cox regression analysis showed that the baseline log sST2 level independently predicted CKD progression and composite outcome after adjustment for age, sex, smoking, diabetes mellitus, hypertension, cardiovascular disease, renin-angiotensin system blocker, calcium channel blocker, β-blocker, diuretics, antiplatelet agents, anemia, and hypoalbuminemia. The baseline log galectin-3 level was independently associated with CKD progression, but not with the composite outcome after adjustment for confounding variables. Conclusions: Elevated levels of sST2 and galectin-3 are significantly associated with CKD progression, but only sST2 is associated with adverse clinical outcomes.
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- 2020
6. Reduction of Secreted Frizzled-Related Protein 5 Drives Vascular Calcification through Wnt3a-Mediated Rho/ROCK/JNK Signaling in Chronic Kidney Disease
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Ae Jin Kim, Jae Hyun Chang, Hyun Hee Lee, Yun Jung Oh, Ji Yong Jung, Hee-Sook Jun, Han Ro, Hyun-Sook Kim, and Wookyung Chung
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0301 basic medicine ,Male ,Vascular smooth muscle ,Core Binding Factor Alpha 1 Subunit ,030204 cardiovascular system & hematology ,Muscle, Smooth, Vascular ,Rats, Sprague-Dawley ,lcsh:Chemistry ,0302 clinical medicine ,Osteogenesis ,Wnt Signaling Pathway ,lcsh:QH301-705.5 ,Spectroscopy ,Cells, Cultured ,rho-Associated Kinases ,Chemistry ,Kinase ,Wnt signaling pathway ,General Medicine ,Computer Science Applications ,vascular calcification ,Signal transduction ,medicine.drug ,medicine.medical_specialty ,Calcitriol ,Catalysis ,Article ,Inorganic Chemistry ,03 medical and health sciences ,Adipokines ,Internal medicine ,Proto-Oncogene Proteins ,medicine ,Animals ,Humans ,Physical and Theoretical Chemistry ,Renal Insufficiency, Chronic ,Protein kinase A ,Wingless-related integration site ,Molecular Biology ,Adaptor Proteins, Signal Transducing ,Osteoblasts ,Adenine ,Gene Expression Profiling ,Organic Chemistry ,JNK Mitogen-Activated Protein Kinases ,Angiotensin II ,Rats ,secreted frizzled-related protein 5 ,Disease Models, Animal ,030104 developmental biology ,Endocrinology ,lcsh:Biology (General) ,lcsh:QD1-999 ,WNT3A ,chronic kidney disease - Abstract
Vascular calcification (VC) is commonly associated with bone loss in patients with chronic kidney disease (CKD). The Wingless-related integration site (Wnt) regulates osteoblast activation through canonical signaling pathways, but the common pathophysiology of these pathways during VC and bone loss has not been identified. A rat model of adenine-induced CKD with VC was used in this study. The rats were fed 0.75% adenine (2.5% protein, 0.92% phosphate) with or without intraperitoneal injection of calcitriol (0.08 µ, g/kg/day) for 4 weeks. Angiotensin II (3 µ, M)-induced VC was achieved in high phosphate medium (3 mM) through its effect on vascular smooth muscle cells (VSMCs). In an mRNA profiler polymerase chain reaction assay of the Wnt signaling pathway, secreted frizzled-related protein 5 (sFRP5) levels were significantly decreased in the CKD rat model compared with the control group. The repression of sFRP5 on VSMC trans-differentiation was mediated through Rho/Rho-associated coiled coil containing protein kinase (ROCK) and c-Jun N-terminal kinase (JNK) pathways activated by Wnt3a. In a proof of concept study conducted with patients with CKD, serum sFRP5 concentrations were significantly lower in subjects with VC than in those without VC. Our findings suggest that repression of sFRP5 is associated with VC in the CKD environment via activation of the noncanonical Wnt pathway, and thus that sFRP5 might be a novel therapeutic target for VC in CKD.
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- 2020
7. Outcomes of hepatitis B surface antigenaemia in patients with incident end-stage renal disease
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Byoungho Choi, Hyun Hee Lee, Jae Hyun Chang, Ae Jin Kim, Eul Sik Jung, Han Ro, Jin Hwan Lee, Wookyung Chung, Ji Yong Jung, and Kwang Pil Ko
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HBsAg ,medicine.medical_specialty ,medicine.medical_treatment ,Population ,030232 urology & nephrology ,medicine.disease_cause ,End stage renal disease ,Peritoneal dialysis ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,education ,Hepatitis B virus ,education.field_of_study ,business.industry ,virus diseases ,Retrospective cohort study ,General Medicine ,Hepatitis B ,medicine.disease ,digestive system diseases ,Nephrology ,030211 gastroenterology & hepatology ,Hemodialysis ,business - Abstract
AIM Hepatitis B virus (HBV) infection is an important risk factor for morbidity and mortality in the general population. However, limited data are available on the progression of HBV infection in patients with end-stage renal disease (ESRD), and available data are controversial. Therefore, we investigated the association between hepatitis B surface antigen (HBsAg) seropositivity and mortality in patients with incident ESRD. METHODS All adult patients (≥18 years of age) starting dialysis for ESRD from January 2000 to December 2011 were included. A total of 1090 patients with ESRD were analyzed. HBsAg-positive patients were paired 1:6 with HBsAg-negative patients using propensity score matching. RESULTS Eighty one (7.4%) patients were HBsAg positive. No differences in the survival rates of the HBsAg-positive and HBsAg-negative patients with ESRD were detected in either the entire cohort or the propensity score matched cohort. No differences in survival were detected between the groups of HBsAg-positive patients based on the hepatitis B envelope antigen, hepatitis B envelope antibody, HBV DNA status, or use of antiviral agents. No difference in mortality was found between the haemodialysis (HD) and peritoneal dialysis (PD) subgroups among HBsAg-positive patients. CONCLUSION Our results suggest that hepatitis B surface antigenaemia is not related to increased mortality in patients with incident ESRD. Survival of HBsAg-positive patients undergoing PD was comparable to that of patients undergoing HD.
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- 2016
8. Hepatoprotective Effect of Kombucha Tea in Rodent Model of Nonalcoholic Fatty Liver Disease/Nonalcoholic Steatohepatitis
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Young-Su Seo, Youngmi Jung, Namgyu Kim, Chanbin Lee, Hyun-Hee Lee, Ji Eun Kim, Sumi Sung, and Sihyung Wang
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Male ,0301 basic medicine ,Palmitates ,Kombucha tea ,lcsh:Chemistry ,Mice ,0302 clinical medicine ,Non-alcoholic Fatty Liver Disease ,Lipid droplet ,Nonalcoholic fatty liver disease ,nonalcoholic steatohepatitis ,lcsh:QH301-705.5 ,Cells, Cultured ,Spectroscopy ,chemistry.chemical_classification ,Fatty liver ,food and beverages ,General Medicine ,lipotoxicity ,Immunohistochemistry ,Computer Science Applications ,Lipotoxicity ,Lipogenesis ,Toxicity ,030211 gastroenterology & hepatology ,medicine.medical_specialty ,hedgehog ,complex mixtures ,Article ,Catalysis ,Cell Line ,Inorganic Chemistry ,03 medical and health sciences ,Internal medicine ,medicine ,Animals ,Hedgehog Proteins ,Physical and Theoretical Chemistry ,Molecular Biology ,Cell Proliferation ,Organic Chemistry ,Fatty acid ,Lipid metabolism ,Lipid Metabolism ,medicine.disease ,Mice, Inbred C57BL ,Disease Models, Animal ,030104 developmental biology ,Endocrinology ,lcsh:Biology (General) ,lcsh:QD1-999 ,chemistry ,Hepatocytes - Abstract
Kombucha tea (KT) has emerged as a substance that protects the liver from damage, however, its mechanisms of action on the fatty liver remain unclear. Therefore, we investigated the potential role of KT and its underlying mechanisms on nonalcoholic fatty liver disease (NAFLD). db/db mice that were fed methionine/choline-deficient (MCD) diets for seven weeks were treated for vehicle (M + V) or KT (M + K) and fed with MCD for four additional weeks. Histomorphological injury and increased levels of liver enzymes and lipids were evident in the M + V group, whereas these symptoms were ameliorated in the M + K group. The M + K group had more proliferating and less apoptotic hepatocytic cells than the M + V group. Lipid uptake and lipogenesis significantly decreased, and free fatty acid (FFA) oxidation increased in the M + K, when compared with the M + V group. With the reduction of hedgehog signaling, inflammation and fibrosis also declined in the M + K group. Palmitate (PA) treatment increased the accumulation of lipid droplets and decreased the viability of primary hepatocytes, whereas KT suppressed PA-induced damage in these cells by enhancing intracellular lipid disposal. These results suggest that KT protects hepatocytes from lipid toxicity by influencing the lipid metabolism, and it attenuates inflammation and fibrosis, which contributes to liver restoration in mice with NAFLD.
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- 2019
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9. Liver cirrhosis leads to poorer survival in patients with end-stage renal disease
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Han Ro, Wookyung Chung, Hyun Hee Lee, Ji Yong Jung, Ae Jin Kim, Jae Hyun Chang, and Hye Jin Lim
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Adult ,Liver Cirrhosis ,Male ,medicine.medical_specialty ,Time Factors ,Cirrhosis ,medicine.medical_treatment ,Peritoneal dialysis ,030232 urology & nephrology ,Kaplan-Meier Estimate ,urologic and male genital diseases ,Gastroenterology ,End stage renal disease ,03 medical and health sciences ,0302 clinical medicine ,Renal Dialysis ,Risk Factors ,Internal medicine ,Republic of Korea ,Prevalence ,medicine ,Humans ,Mortality ,Intensive care medicine ,Survival rate ,Dialysis ,Aged ,Proportional Hazards Models ,Retrospective Studies ,business.industry ,Proportional hazards model ,Retrospective cohort study ,Middle Aged ,medicine.disease ,female genital diseases and pregnancy complications ,Survival Rate ,Treatment Outcome ,Nephrology ,Hemodialysis ,Kidney Failure, Chronic ,Female ,Original Article ,030211 gastroenterology & hepatology ,business - Abstract
Background/Aims: Liver cirrhosis (LC) is an important problem in patients withend-stage renal disease (ESRD). Few studies have investigated the inf luence ofLC on mortality in patients with ESRD. This study investigated the associationbetween LC and mortality among patients with ESRD and compare mortality betweentwo dialysis modalities. Methods: Adult patients (≥ 18 years of age) starting dialysis for ESRD were enrolledin the present study from 2000 to 2011. We analyzed 1,069 patients withESRD; of these, 742 patients were undergoing hemodialysis (HD) and 327 patientswere undergoing peritoneal dialysis (PD). Results: The prevalence of LC was 44 of 1,069 patients (4.1%). The cumulative 1-,3-, and 5-year survival rates of noncirrhotic patients were 93%, 83%, and 73%, respectively,whereas the equivalent survival rates of cirrhotic patients were 90%,68%, and 48%, respectively (p = 0.011). After adjustment, LC was an independentrisk factor for death in patients with ESRD. No difference in mortality associatedwith LC was found between the HD and PD subgroups. Conclusions: Of the patients with ESRD, cirrhotic patients had poorer survivalthan noncirrhotic patients. Among patients with ESRD and LC, survival of patientsundergoing PD may be comparable with that of patients undergoing HD.
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- 2016
10. Renin-Angiotensin-Aldosterone System Blockade in Critically Ill Patients Is Associated with Increased Risk for Acute Kidney Injury
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Ae Jin Kim, Han Ro, Hyun Hee Lee, Ji Yong Jung, Hyung Soo Kim, Hye Jin Lim, Jae Hyun Chang, and Wookyung Chung
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Male ,medicine.medical_specialty ,Critical Illness ,urologic and male genital diseases ,General Biochemistry, Genetics and Molecular Biology ,law.invention ,Renin-Angiotensin System ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,law ,Internal medicine ,medicine ,Humans ,030212 general & internal medicine ,Risk factor ,Intensive care medicine ,Survival rate ,business.industry ,Incidence (epidemiology) ,Confounding ,Acute kidney injury ,030208 emergency & critical care medicine ,General Medicine ,Odds ratio ,Acute Kidney Injury ,Middle Aged ,medicine.disease ,Intensive care unit ,Confidence interval ,Survival Rate ,Logistic Models ,Multivariate Analysis ,Female ,business - Abstract
Acute kidney injury (AKI) is a major clinical problem and a predictor of outcomes in critically ill patients who frequently required treatments in the intensive care unit (ICU). Renin-angiotensin-aldosterone system (RAAS) blockers are commonly used for treating hypertension but demands caution because of accompanying illnesses including AKI. The aim of this study was to evaluate whether the use of RAAS blockers affected the incidence of AKI in ICU patients. From a total of 26,287 patients who were admitted to the ICU from January 2003 to December 2013 were included in the final analyses. The primary outcome was the incidence of AKI based on the prescription of RAAS blockers. The secondary outcomes were all-cause mortality. RAAS blocker users were more likely to develop AKI (P < 0.001) and remained an independent risk factor for AKI (odds ratio [OR], 1.56; 95% confidence interval [CI], 1.37-1.79; P < 0.001) after adjusting confounding factors. There was no significant difference in the cumulative 90-day survival rate between the RAAS blocker users and non-users (P = 0.381). However, the adjusted mortality risk associated with AKI was 1.38 (95% CI, 1.22 to 1.56; P < 0.001) and increased as the severity of AKI stage increased from 1 to 3: 1.17 (1.02 to 1.36), 1.77 (1.45 to 2.16), and 1.93 (1.55 to 2.41; P < 0.01 for the trend). RAAS blockers may have a harmful influence to increase the incidence of AKI and temporary withholding of these medications may deserve careful consideration in ICU patients.
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- 2016
11. Mediation of the relationship between proteinuria and serum phosphate: Insight from the KNOW-CKD study
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Jae Hyun Chang, Kook Hwan Oh, Yeong Hoon Kim, Tae Hyun Yoo, Han Ro, Seung Hyeok Han, Kyu Beck Lee, Wookyung Chung, Hyun Hee Lee, Sue K. Park, Soo Wan Kim, Ae Jin Kim, Curie Ahn, Ji Yong Jung, and Dong Wan Chae
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Male ,Fibroblast Growth Factor ,Physiology ,030232 urology & nephrology ,Urine ,030204 cardiovascular system & hematology ,Pathology and Laboratory Medicine ,urologic and male genital diseases ,Cohort Studies ,Hyperphosphatemia ,Endocrinology ,0302 clinical medicine ,Chronic Kidney Disease ,Medicine and Health Sciences ,Klotho ,Glucuronidase ,Multidisciplinary ,Proteinuria ,Reabsorption ,Middle Aged ,female genital diseases and pregnancy complications ,Body Fluids ,Chemistry ,Kidney Tubules ,Treatment Outcome ,Nephrology ,Physical Sciences ,Medicine ,Regression Analysis ,Female ,Anatomy ,medicine.symptom ,Glomerular Filtration Rate ,Research Article ,medicine.medical_specialty ,Science ,Urinary system ,Excretion ,Renal function ,Phosphates ,03 medical and health sciences ,Signs and Symptoms ,Diagnostic Medicine ,Growth Factors ,Internal medicine ,Republic of Korea ,medicine ,Humans ,Renal Insufficiency, Chronic ,Klotho Proteins ,Renal Physiology ,Endocrine Physiology ,urogenital system ,business.industry ,Chemical Compounds ,Biology and Life Sciences ,Renal System ,medicine.disease ,Fibroblast Growth Factors ,Fibroblast Growth Factor-23 ,Physiological Processes ,business ,Kidney disease - Abstract
Proteinuria and hyperphosphatemia are risk factors for cardiovascular disease in patients with chronic kidney disease (CKD). Although the interaction between proteinuria and the serum phosphate level is well established, the mechanistic link between the two, particularly the extent to which this interaction is mediated by phosphate-regulating factors, remains poorly understood. In this study, we examined the association between proteinuria and the serum phosphate level, as well as potential mediators, including circulating fibroblast growth factor (FGF23)/klotho, the 24-h urinary phosphate excretion rate to glomerular filtration rate ratio (EP/GFR), and the 24-h tubular phosphate reabsorption rate to GFR ratio (TRP/GFR). The analyses were performed with data from 1793 patients in whom 24-h urine protein and phosphate, serum phosphate, FGF23, and klotho levels were measured simultaneously, obtained from the KoreaN cohort study for Outcome in patients With Chronic Kidney Disease (KNOW-CKD). Multivariable linear regression and mediation analyses were performed. Total, direct, and indirect effects were also estimated. Patients with high serum phosphate levels were found to be more likely to exhibit greater proteinuria, higher FGF23 levels, and lower klotho levels. The 24-h EP/GFR increased and the 24-h TRP/GFR decreased with increasing proteinuria and CKD progression. Simple mediation analyses showed that 15.4% and 67.9% of the relationship between proteinuria and the serum phosphate level were mediated by the FGF23/klotho ratio and 24-h EP/GFR, respectively. Together, these two factors accounted for 73.1% of the relationship between serum markers. These findings suggest that proteinuria increases the 24-h EP/GFR via the FGF23/klotho axis as a compensatory mechanism for the increased phosphate burden well before the reduction in renal function is first seen.
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- 2020
12. Glucose transport 1 deficiency presenting as infantile spasms with a mutation identified in exon 9 of SLC2A1
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Yun Jung Hur and Hyun Hee Lee
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0301 basic medicine ,medicine.medical_specialty ,Myoclonic Jerk ,Intractable epilepsy ,Case Report ,medicine.disease_cause ,Pediatrics ,03 medical and health sciences ,Exon ,0302 clinical medicine ,Cerebrospinal fluid ,Internal medicine ,medicine ,Missense mutation ,Mutation ,business.industry ,SLC2A1 protein ,Glucose transporter ,Infantile Spasm ,030104 developmental biology ,Endocrinology ,Pediatrics, Perinatology and Child Health ,GLUT-1 deficiency syndrome ,Infantile spasm ,business ,030217 neurology & neurosurgery - Abstract
Glucose transport 1 (GLUT-1) deficiency is a rare syndrome caused by mutations in the glucose transporter 1 gene (SLC2A1) and is characterized by early-onset intractable epilepsy, delayed development, and movement disorder. De novo mutations and several hot spots in N34, G91, R126, R153, and R333 of exons 2, 3, 4, and 8 of SLC2A1 are associated with this condition. Seizures, one of the main clinical features of GLUT-1 deficiency, usually develop during infancy. Most patients experience brief and subtle myoclonic jerk and focal seizures that evolve into a mixture of different types of seizures, such as generalized tonic-clonic, absence, myoclonic, and complex partial seizures. Here, we describe the case of a patient with GLUT-1 deficiency who developed infantile spasms and showed delayed development at 6 months of age. She had intractable epilepsy despite receiving aggressive antiepileptic drug therapy, and underwent a metabolic workup. Cerebrospinal fluid (CSF) examination showed CSF-glucose-to-blood-glucose ratio of 0.38, with a normal lactate level. Bidirectional sequencing of SLC2A1 identified a missense mutation (c.1198C>T) at codon 400 (p.Arg400Cys) of exon 9.
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- 2016
13. Occupational Burden of Asbestos-Related Diseases in Korea, 1998-2013: Asbestosis, Mesothelioma, Lung Cancer, Laryngeal Cancer, and Ovarian Cancer
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Dongmug Kang, Se-Yeong Kim, Young-Ki Kim, Jong-Eun Kim, and Hyun-Hee Lee
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Oncology ,Male ,Mesothelioma ,medicine.medical_specialty ,Lung Neoplasms ,Asbestosis ,Burden of Disease ,medicine.disease_cause ,Asbestos ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Occupational Exposure ,Republic of Korea ,medicine ,Humans ,030212 general & internal medicine ,Lung cancer ,Laryngeal Neoplasms ,Asbestos-related diseases ,Aged ,Ovarian Neoplasms ,Korea ,Asbestos-related Diseases ,business.industry ,Preventive Medicine, Occupation & Environmental Medicine ,Cancer ,General Medicine ,Middle Aged ,medicine.disease ,030210 environmental & occupational health ,Europe ,Occupational Diseases ,Years of potential life lost ,Female ,Original Article ,Ovarian cancer ,business ,Potential Years of Life Lost - Abstract
Background Asbestos exposure causes asbestos-related diseases (ARDs) including asbestosis, malignant mesothelioma, lung cancer, laryngeal cancer, and ovarian cancer. Although Korea used substantial amounts of asbestos in the past, no study has focused on its occupational burden of disease (OBD). Therefore, this study aimed to determine the OBDs of ARDs in Korea. Methods The CARcinogen Exposure (CAREX) database was used to determine the proportion of exposed population. Relative risks for lung cancer, laryngeal cancer, and ovarian cancer were used to determine the population-attributable fraction. Data for deaths caused by ARDs during 1998–2013 were obtained from the World Health Organization mortality database. The potential years of life lost (PYLL) and annual average PYLL (APYLL) indicated OBDs. Results In Korea, the number of ARD-attributable deaths and PYLL due to all ARDs during 1998–2013 were 4,492 and 71,763.7, respectively. The number of attributable deaths and PYLL due to asbestosis, malignant mesothelioma, lung cancer, laryngeal cancer, and ovarian cancer were 37 and 554.2, 808 and 15,877.0, 3,256 and 47,375.9, 120 and 1,605.5, and 271 and 6,331.1, respectively; additionally, the APYLL were 15.0, 19.7, 14.6, 13.4, and 23.4, respectively, and the average age at death was 70.4, 62.6, 69.1, 69.9, and 61.8, respectively. Our study showed that although the use of asbestos has ceased in Korea, the incidence of ARDs tends to increase. Conclusion Therefore, efforts to reduce future OBDs of ARDs, including early detection and proper management of ARDs, are needed in Korea., Graphical Abstract
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- 2017
14. Efficacy of Statin Treatment in Early-Stage Chronic Kidney Disease
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Jae Hyun Chang, Chana Myoung, Hong-suk Park, Ji Yong Jung, Han Ro, Ae Jin Kim, Eun Yeong Cho, Wookyung Chung, and Hyun Hee Lee
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Male ,lcsh:Medicine ,Cardiovascular Medicine ,030204 cardiovascular system & hematology ,Pathology and Laboratory Medicine ,urologic and male genital diseases ,Biochemistry ,Severity of Illness Index ,chemistry.chemical_compound ,0302 clinical medicine ,Chronic Kidney Disease ,Medicine and Health Sciences ,030212 general & internal medicine ,lcsh:Science ,Multidisciplinary ,Hazard ratio ,Age Factors ,Drugs ,Middle Aged ,Lipids ,Proteinuria ,Treatment Outcome ,Nephrology ,Cardiovascular Diseases ,Creatinine ,Cohort ,Female ,Research Article ,Glomerular Filtration Rate ,Adult ,medicine.medical_specialty ,Statin ,Death Rates ,medicine.drug_class ,Renal function ,03 medical and health sciences ,Signs and Symptoms ,Sex Factors ,Diagnostic Medicine ,Internal medicine ,Medical Dialysis ,medicine ,Humans ,Renal Insufficiency, Chronic ,Intensive care medicine ,Demography ,Aged ,Proportional Hazards Models ,Retrospective Studies ,Pharmacology ,business.industry ,lcsh:R ,Statins ,Case-control study ,Biology and Life Sciences ,Retrospective cohort study ,medicine.disease ,chemistry ,Case-Control Studies ,People and Places ,lcsh:Q ,Hydroxymethylglutaryl-CoA Reductase Inhibitors ,business ,Biomarkers ,Kidney disease - Abstract
Chronic kidney disease (CKD) represents a major medical challenge and frequently coexists with cardiovascular disease (CVD), which can be treated by statin trerapy. However, whether statin treatment affects renal progression and outcomes in CKD patients remains unclear. We retrospectively reviewed CKD patients at Gachon University Gil Medical Center from 2003-2013. From a total of 14,497 CKD patients, 858 statin users were paired with non-users and analyze with propensity score matching was performed. The outcomes of this study were creatinine doubling, renal death, all-cause mortality, and interactive factors for composite outcomes. Statins were prescribed to 13.5% of the study subjects. Hazard ratios (HRs) [95% confidence intervals (CIs)] for statin treatment for the doubling of serum creatinine levels were significant only in CKD patients with an estimated glomerular filtration rate (eGFR) ≥30 mL/min/1.73 m2, and were 0.744 (0.635-0.873) in the unmatched cohort and 0.767 (0.596-0.986) in the matched cohort. In analyses of secondary outcomes, the HRs (95% CIs) for all-cause mortality were 0.655 (0.502-0.855) in the unmatched cohort and 0.537 (0.297-0.973) in the matched cohort. The HRs (95% CIs) for statin therapy for composite outcomes among patients with and without an eGFR ≥30 mL/min/1.73 m2 were 0.764 (0.613-0.952) and 1.232 (0.894-1.697), respectively (P for interaction, 0.017). Thus, statin treatment may have beneficial effects on renal progression and all-cause mortality only for the patients with early- stage CKD.
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- 2017
15. PERITONEAL DIALYSIS 1
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Nada Dimkovic, Wei Mei Lim, Mercedes Moreiras-Plaza, Carmen A. Vlahu, Seok Hui Kang, Shadi Hassan, Kamal Hassan, Yuta Kogure, Magnus Braide, Elbis Ahbap, Isabel Silva, Şeref Yüksel, Yon-Su Kim, Mauro Pietribiasi, Sibel Gokcay Bek, Deirisa Lopes Barreto, Rosa M. Agostinelli, Saimir Seferi, Cuneyt Akgol, Flora Correia, Ploumis Passadakis, José Portolés, Taisuke Shimizu, Martin Wilkie, Gülay Ulusal Okyay, Raquel Blanco-García, Manuel Pestana, Mauro Marani, Daniel Baczyński, Young-Il Jo, Jan Poleszczuk, Alexander Shturman, Jae Hyun Chang, Abdulkadir Unsal, G Caparrós, André Luis Balbi, Theodora Gioka, G. Lenzora, María José Fernández-Reyes, Vassilis Vargemezis, Ahmet Ahsen, Carla Santos-Araújo, Ekrem Kara, Gloria del Peso, Ibrahim Saeed, Tuncay Sahutoglu, Adnan Batman, Grazia Maria Virzì, Darío Janeiro, Mustafa Sevinc, Merita Rroji, Ha-Young Na, Marijke de Graaff, S. Scofferi, Efthimia Mourvati, Nestor Thereska, Tetsuya Mitarai, Ines Castellano, Stefano Santarelli, Triantafillia Bounta, James Fotheringham, Jong Won Park, Irina Rubinchik, Tomonari Ogawa, Jacek Waniewski, Raweewan Witoon, Jose Barata, Matthias Zeiler, Rafael Selgas, Hyun Hee Lee, Fadi Hassan, Takatsugu Iwashita, Abdullah K Al-Hwiesh, Salih I·Nal, Liliana Simões Silva, Shaul Atar, Vanessa Banin, Tatjana Lazarevic, Touta Kiba, Massimo de Cal, Erkan Dervisoglu, Elias Thodis, Kyung Yoon Chang, Ricardo Vizinho, Nam Ho Kim, Antosiewicz S, Hajime Hasegawa, Wan Shaariah Mohd Yusuf, Marjorie Foo, Denise E. Sampimon, Ljubica Djukanovic, Marios Theodoridis, Lily Mushahar, Paolo Ancarani, Patricia Martinez Miguel, Francisco Fernández-Fleming, Yong Kyun Kim, Lorena Ferrando, Selman Ünverdi, Murat Duranay, Rui Poínhos, Marina Di Luca, Raymond T. Krediet, Pasqual Barretti, Jelena Marinkovic, Pelagia Kriki, Shinpei Okazaki, Athanasios Roumeliotis, Young Ok Kim, Maria João Sousa, Akihiko Matsuda, Laura Beato-Coo, D. Parodi, Necmi Eren, Shin Wook Kang, Tania Monteburini, Sudhaharan Sivathasan, Atila Altuntaş, Dirk G. Struijk, Sung Jin Moon, Jun Young Do, Zhenli Yu, Yousuke Tayama, Carlo Crepaldi, Mohamed Nasreldin, Rita Marinelli, O. Terrile, Konstadina Griva, Isabel Martin-Baez, Yong-Lim Kim, Kyung Woo Yoon, Michael J. Campbell, Young Baek Kim, Wookyung Chung, Ana Rita Martins, Dunia Hassan, Sabrina Milan Manani, Majster Zdenka, Genc Burazeri, Su-Hyun Kim, Ilaria Tantillo, Alessandra Brocca, Mayra Ortega, Fatma Ceyla Eraldemir, Jacqueline Costa Teixeira Caramori, Tamer Sakaci, Veysel Kidir, Hans Vink, Maite Rivera, Claudio Ronco, Ho Chul Song, Ji Yong Jung, Han Ro, Memnune Sena Ulu, Patrícia Branco, Kyu Hyang Cho, Steva Pljesa, Hyung Wook Kim, Margarida Sarmento-Dias, Chul Woo Yang, Paula López, Taner Basturk, Daniela Ponce, Yener Koc, Mehmet Tugrul Sezer, Minoru Hatano, Caterina Riello, Maria Augusta Gaspar, Zofia Wankowicz, Tricya Bueloni, and Ana M Tato
- Subjects
03 medical and health sciences ,Transplantation ,medicine.medical_specialty ,0302 clinical medicine ,Nephrology ,business.industry ,medicine.medical_treatment ,030232 urology & nephrology ,medicine ,Urology ,030204 cardiovascular system & hematology ,business ,Peritoneal dialysis - Published
- 2014
16. Residual Urinary Volume Is a Predictor of Overhydration in Patients on Peritoneal Dialysis
- Author
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Jae Hyun Chang, Hyun Hee Lee, Ji Yong Jung, Ae Jin Kim, Wookyung Chung, Eul Sik Jung, Han Ro, Ji Yoon Sung, and Song Yi Han
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Water-Electrolyte Imbalance ,Urology ,Urine ,General Biochemistry, Genetics and Molecular Biology ,Peritoneal dialysis ,Extracellular fluid ,medicine ,Intravascular volume status ,Humans ,Dialysis ,Demography ,Body fluid ,business.industry ,General Medicine ,Middle Aged ,Linear Models ,Female ,Anuria ,medicine.symptom ,business ,Peritoneal Dialysis ,Body mass index ,Bioelectrical impedance analysis - Abstract
Fluid overload is linked to hypertension and cardiovascular diseases in patients on peritoneal dialysis (PD). It is important to monitor the residual urinary volume in patients with end-stage renal disease (ESRD). In fact, fluid overload and residual urinary volume have been considered the risk factors of mortality in ESRD patients on PD. However, the relationship between residual urinary volume and fluid overload was still controversial. Therefore, the objective of this cross-sectional study was to evaluate the association between residual urinary volume and the volume status of PD patients. Body composition was measured using a portable multifrequency whole-body bioimpedance assessment. Relative overhydration was defined when the ratio of overhydration to extracellular water was > 0.15. We examined 75 patients, with a mean age of 50.7 years and mean body mass index of 23.5 kg/m(2). Dialysis vintage was 46.5 months. The patients were divided into the anuric group (n = 30; urine output ≤ 100 mL/day) and the group of urine output > 100 mL/day (n = 45). The anuric group showed higher degree of relative overhydration compared to the patients with the urine output of > 100 mL/day (p = 0.020). In a multivariable linear regression analysis, anuria, diabetes, and serum albumin level were independently associated with relative overhydration. In conclusion, volume status should be closely monitored in anuric patients, and the preservation of residual urinary volume is one of important goals to maintain volume status in PD patients.
- Published
- 2014
17. Environmental health centers for asbestos and their health impact surveys and activities
- Author
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Chang-Yeol Lee, Seong-Jae Moon, Dongmug Kang, Jong-Eun Kim, Yong-Jin Lee, Min-Sung Kang, and Hyun-Hee Lee
- Subjects
Mesothelioma ,medicine.medical_specialty ,Short Communication ,Health impact ,Voluntary participation ,medicine.disease_cause ,Asbestos ,Environmental ,03 medical and health sciences ,0302 clinical medicine ,Environmental health ,medicine ,030212 general & internal medicine ,Public awareness ,business.industry ,Public health ,Public Health, Environmental and Occupational Health ,Awareness ,030210 environmental & occupational health ,Act ,Impact ,Lung cancer ,business ,Relief ,Compensation - Abstract
In 2009, Korea banned the import, transport, and use of asbestos, and the Asbestos Injury Relief Act (AIRA) was promulgated in 2011. Two environmental health centers for asbestos (EHCA), including Pusan National University Yangsan Hospital (PNUYH) and SoonChunHyang University Cheonan Hospital (SCHUCH), were adapted to find environmental asbestos-related diseases (ARDs) and to support the purposes of AIRA. EHCA conducted a health impact survey (HIS) on persons who resided or reside near asbestos factories or mines. A total of 13,433 persons have taken screening examinations in PNUYH EHCA, and 623 persons (4.6%) have had secondary examinations. Of the 21,014 persons who had screening examinations in SCHUCH EHCA, 2490 persons (11.8%) had secondary examinations. Some of those who tested positive for ARDs through HISs filed applications for the asbestos victims’ medical pocketbook (AVMP). Approximately 116 and 612 persons received AVMPs as a result of PNUYH and SCHUCH examinees, respectively. EHCAs have conducted HISs, public relations, and education for asbestos victims, ordinary citizens, and physicians. As HISs are based on voluntary participation, they does not monitor high-risk groups. Active surveillance focusing on high-risk groups has been blocked by the personal information protection act. Although important work has been performed in finding environmental asbestos victims and increasing public awareness on asbestos, it is necessary to improve the current system and registration.
- Published
- 2016
18. Circulating levels of soluble receptor for advanced glycation end product are inversely associated with vascular calcification in patients on haemodialysis independent of S100A12 (EN-RAGE) levels
- Author
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Hyun Hee Lee, Ae Jin Kim, Jae Hyun Chang, Han Ro, Wookyung Chung, Ji Yong Jung, and Hyung Soo Kim
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medicine.medical_specialty ,Univariate analysis ,business.industry ,Confounding ,General Medicine ,Disease ,Systemic inflammation ,RAGE (receptor) ,chemistry.chemical_compound ,Endocrinology ,chemistry ,Nephrology ,Glycation ,Internal medicine ,medicine ,Advanced glycation end-product ,medicine.symptom ,business ,Receptor - Abstract
Aim The receptor for advanced glycation end products (RAGE) has emerged as a central regulator of vascular inflammation and atherosclerosis. Soluble RAGE (sRAGE) has an anti-inflammatory effect by quenching ligands for RAGE. On the other hand, extracellular RAGE-binding protein S100A12 (EN-RAGE) shows a pro-inflammatory effect in a way, but may play pleiotropic roles related to inflammatory process. Therefore, we determined the levels of sRAGE and S100A12 in haemodialysis (HD) patients and evaluated their relationship with vascular calcification. Methods We performed a cross-sectional study with 199 HD patients. Plain X-ray images of the lateral lumbar spine from all subjects were studied to calculate semiquantitative vascular calcification scores (VCS), as described by Kauppila. Commercially available enzyme linked immunosorbent assay (ELISA) kits were used to quantify the serum concentration of sRAGE and S100A12. Results The patients were 57.1 ± 13.7 years of age; 54.3% were male, 49.2% were diabetic, and 36.2% had a history of cardiovascular disease. In a univariate analysis, serum sRAGE was negatively associated with VCS (log sRAGE, r = –0.208, P = 0.003), whereas S100A12 showed a positive tendency (log S100A12, r = 0.235, P = 0.085). Even after adjustments for confounding risk factors, sRAGE was independently associated with VCS (β = –1.679, P = 0.002). Conclusion This study demonstrated that the circulating sRAGE level was inversely associated with VCS in HD patients independent of the S100A12 level and the severity of systemic inflammation.
- Published
- 2013
19. Hemodialysis Leads to Better Survival in Patients with Diabetes or High Comorbidity, Compared to Peritoneal Dialysis
- Author
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Jae Hyun Chang, Ji Yong Jung, Hyun Hee Lee, Sejoong Kim, Wookyung Chung, Han Ro, Ji Yoon Sung, Kwang Pil Ko, and Shin Young Ahn
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Comorbidity ,Kaplan-Meier Estimate ,General Biochemistry, Genetics and Molecular Biology ,Peritoneal dialysis ,End stage renal disease ,Renal Dialysis ,Diabetes mellitus ,Internal medicine ,Republic of Korea ,Diabetes Mellitus ,Humans ,Medicine ,Renal Insufficiency, Chronic ,Dialysis ,Proportional Hazards Models ,Retrospective Studies ,business.industry ,Retrospective cohort study ,General Medicine ,medicine.disease ,Surgery ,Cohort ,Hemodialysis ,business ,Peritoneal Dialysis - Abstract
Peritoneal dialysis (PD) has some advantages, such as hemodynamic stability and volume regulation, compared with hemodialysis (HD). However, the influence of the dialysis modality on survival is still controversial. This study assessed the mortality of incident patients undergoing HD versus PD using a propensity score approach. This study enrolled 873 subjects who began dialysis therapy at Gachon University Gil Hospital in Korea between January 2000 and June 2009. A propensity score comprising demographic, clinical, and laboratory variables was used to select a 1:1 matched cohort. The overall 1-, 2-, 3-, and 5-year survival rates for the HD patients (n = 212) were 95.1, 89.6, 82.5, and 65.3%, respectively, whereas the equivalent survival rates for the PD patients (n = 212) were 93.6, 83.1, 73.9, and 48.4%, respectively (P = 0.002 by log rank test). In patients without diabetes or patients with a low modified Charlson comorbidity index (MCCI), including hypertension, cardiovascular disease, liver disease, etc., there was no difference in mortality between PD and HD. However, PD was associated with a higher mortality for diabetic patients (HR, 2.86; 95% CI, 1.73-4.74) and for patients with a high MCCI (HR, 2.54; 95% CI 1.57-4.10). These data suggest that survival for PD may be comparable with that for HD in incident dialysis patients without diabetes or high MCCI and that HD could be more beneficial in patients with diabetes or high MCCI in this propensity score-matched cohort.
- Published
- 2013
20. Hyperuricemia Is an Independent Risk Factor for Mortality Only if Chronic Kidney Disease Is Present
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Han Ro, Hyun Hee Lee, Jae Hyun Chang, Ji Yong Jung, Ae Jin Kim, and Wookyung Chung
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Male ,musculoskeletal diseases ,medicine.medical_specialty ,MEDLINE ,Hyperuricemia ,Disease ,urologic and male genital diseases ,chemistry.chemical_compound ,Percutaneous Coronary Intervention ,Internal medicine ,Republic of Korea ,Humans ,Medicine ,Renal Insufficiency, Chronic ,Risk factor ,Aged ,Retrospective Studies ,business.industry ,nutritional and metabolic diseases ,Retrospective cohort study ,Middle Aged ,medicine.disease ,chemistry ,Nephrology ,Uric acid ,Female ,business ,Kidney disease - Abstract
Background/Aims: Hyperuricemia has been considered a risk factor for renal disease and cardiovascular disease. However, the potential contribution of hyperuricemia to mortality remains uncertain, and the results in the available literature vary according to kidney function. The aim of this study was to determine the association between hyperuricemia and mortality in patients undergoing percutaneous coronary intervention (PCI) across the interaction of kidney function. Method: We retrospectively reviewed patients who underwent PCI from 2003 to 2009. Propensity scores for hyperuricemia (>7 mg/dl for males and >6 mg/dl for females) were used to assemble a matched cohort of 693 pairs of patients with and without hyperuricemia for analysis from the 3,201 patients who fulfilled the inclusion criteria among the 4,842 patients who underwent PCI. Results: Of the 3,201 patients who underwent PCI and for whom data were available regarding their baseline serum uric acid level, 763 (23.8%) had hyperuricemia. The hyperuricemia-associated hazard ratios (HRs) [95% confidence intervals (CIs)] for all-cause mortality were 1.780 (1.270-2.495) in the unmatched cohort and 1.655 (1.109-2.468) in the matched cohort. The HRs (95% CI) for all-cause mortality among those with and without chronic kidney disease (CKD) were 2.080 (1.318-3.283) and 1.592 (0.778-3.256), respectively (p for interaction, 0.001). Conclusions: Hyperuricemia is an independent risk factor for all-cause mortality in those patients with CKD but not in those without CKD.
- Published
- 2013
21. Circulating S100A12 Levels Are Associated with Progression of Abdominal Aortic Calcification in Hemodialysis Patients
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Jae Hyun Chang, Byoungho Choi, Hyun Hee Lee, Ji Yong Jung, Han Ro, Eul Sik Jung, Ae Jin Kim, and Wookyung Chung
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Male ,Physiology ,medicine.medical_treatment ,Receptor for Advanced Glycation End Products ,030232 urology & nephrology ,lcsh:Medicine ,030204 cardiovascular system & hematology ,Cardiovascular Medicine ,Gastroenterology ,Biochemistry ,Ion Channels ,chemistry.chemical_compound ,0302 clinical medicine ,Endocrinology ,Risk Factors ,Medicine and Health Sciences ,Aorta, Abdominal ,Enzyme-Linked Immunoassays ,Post-Translational Modification ,lcsh:Science ,Glycation ,Multidisciplinary ,Physics ,Middle Aged ,Lipids ,Electrophysiology ,Cholesterol ,Cardiovascular Diseases ,Nephrology ,Physical Sciences ,Disease Progression ,Advanced glycation end-product ,Female ,Hemodialysis ,Research Article ,medicine.medical_specialty ,Endocrine Disorders ,Biophysics ,Neurophysiology ,Research and Analysis Methods ,Calcification ,03 medical and health sciences ,Renal Dialysis ,Internal medicine ,Diabetes mellitus ,medicine.artery ,Medical Dialysis ,medicine ,Diabetes Mellitus ,Humans ,Immunoassays ,Vascular Calcification ,Aorta ,business.industry ,lcsh:R ,S100A12 Protein ,Biology and Life Sciences ,Proteins ,Odds ratio ,medicine.disease ,Confidence interval ,Radiography ,chemistry ,Metabolic Disorders ,Immunologic Techniques ,lcsh:Q ,Calcium Channels ,business ,Physiological Processes ,Biomarkers ,Neuroscience - Abstract
Vascular calcification is an important factor associated with mortality in dialysis patients. Recently, soluble receptor for advanced glycation end product (sRAGE) and extracellular RAGE binding protein S100A12 (EN-RAGE) have been reported to be involved in the process of vascular calcification. Therefore, we investigated whether sRAGE and S100A12 are useful indicators of progression of abdominal aortic calcification in hemodialysis (HD) patients. We analyzed annual changes in vascular calcification score (VCS) for up to 4 years, compared to clinical and biological parameters in 149 HD patients. VCS was assessed annually using plain X-ray images of the lateral lumbar spine. The progression group was defined as patients with an increase in VCS more than 1 point each year on average during the observation period. Time-averaged concentrations were also evaluated to examine the association between biological parameters and changes in VCS. The patients had a mean age of 58.59 ± 12.93 years; 53.7% were male, and 45% were diabetic. The VCS increased in 55 patients; the mean increase was 1.60 ± 2.91 points. In a stepwise multivariate logistic analysis, we found that higher levels of S100A12 were significantly associated with progression of VCS (odds ratio [OR], 2.622; 95% confidence interval [CI], 1.371-5.016; P = 0.004). The relationship between sRAGE and VCS was not statistically significant (OR, 0.644; 95% CI, 0.302-1.374; P = 0.255). Our findings suggest that serum levels of S100A12 are associated with progression of abdominal aortic calcification in HD patients, independent of sRAGE level.
- Published
- 2016
22. Metastatic Sarcomatoid Carcinoma to Liver and Bone Marrow in Renal Transplant Recipient: Due to Exacerbation of Quiescent Renal Cancer? A Case Report
- Author
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H.N. Choi, Yeon Ho Park, Jae Hyun Chang, Hyun-Hee Lee, Ji Yong Jung, Yeun Sun Kim, and Wookyung Chung
- Subjects
Male ,medicine.medical_specialty ,Pathology ,Time Factors ,Biopsy ,Metastasis ,Fatal Outcome ,Carcinoma ,Humans ,Medicine ,Neoplasm Invasiveness ,Cyst ,Sarcomatoid carcinoma ,Carcinoma, Renal Cell ,Kidney transplantation ,Cell Proliferation ,Transplantation ,Kidney ,business.industry ,Liver Neoplasms ,Cancer ,Middle Aged ,medicine.disease ,Kidney Transplantation ,Kidney Neoplasms ,Treatment Outcome ,medicine.anatomical_structure ,Positron-Emission Tomography ,Kidney Failure, Chronic ,Surgery ,Radiology ,Bone Marrow Neoplasms ,Tomography, X-Ray Computed ,business ,Immunosuppressive Agents - Abstract
Sarcomatoid carcinoma is a rare tumor with rapid growth and a poor prognosis. A 60-year-old man underwent kidney transplantation. Three months after transplantation, multiple tumors were found in the liver and bone, and the patient died several days later. Pathological examination of liver and bone marrow biopsies revealed metastatic sarcomatoid carcinoma. Pretransplantation, the patient's workup was positive only for mild thrombocytopenia and a complicated cyst with peripheral rim calcification (Bosniak IIF) in the right kidney. Retrospectively, we found the abdominal computed tomography film, which had been examined at another hospital 6 years previously. The calcified complicated cyst was a 3-cm enhancing solid mass in the right kidney, suggesting renal cell cancer. It is possible that the cancer developed from the calcified complicated cyst. In this case, immunosuppressants may have altered malignant cell proliferation, invasion, and the form of metastasis.
- Published
- 2012
23. Role of Coronary Artery Calcification Score on the Decrease in GFR among Subjects with CT Coronary Angiography
- Author
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Sejoong Kim, Jae Hyun Chang, Young Hwan Hwang, Ji Yoon Sung, Wookyung Chung, Hyomi Jeong, Yon Mi Sung, Mi Young Jo, Hee Eun Nam, Hyun Hee Lee, and Ji Yong Jung
- Subjects
Male ,Coronary angiography ,medicine.medical_specialty ,Physiology ,Renal function ,Coronary Artery Disease ,Coronary Angiography ,urologic and male genital diseases ,Models, Biological ,Predictive Value of Tests ,Internal medicine ,Internal Medicine ,medicine ,Humans ,In patient ,Renal Insufficiency, Chronic ,Aged ,Retrospective Studies ,Proteinuria ,business.industry ,Disease progression ,Confounding ,Calcinosis ,General Medicine ,Middle Aged ,female genital diseases and pregnancy complications ,Increased risk ,Coronary artery calcification ,Multivariate Analysis ,Linear Models ,Cardiology ,Female ,medicine.symptom ,Tomography, X-Ray Computed ,business ,Glomerular Filtration Rate - Abstract
Higher levels of coronary artery calcification score (CACS) are associated not only with an increased risk for cardiovascular death, but also with lower glomerular filtration rates (GFRs). However, its role in renal disease progression in patients has not been elucidated.We evaluated the change of estimated GFR in 279 nondialytic outpatients, who had undergone computed tomographic coronary angiography and follow-up over a period of 3 months.The mean age of the participants was 57.7 ± 10.5 years, and the mean GFR was 88.2 ± 15.7 mL/min/1.73 m(2). Although there was no difference in baseline GFR between the CACS ≤ 200 AU group (n = 240) and the CACS200 AU group (n = 39), the latter group had a lower level of final GFR and higher annual reduction rate of GFR than the former group after an observation period of 13.1 ± 5.97 months. After adjusting for confounding variables, including age, gender, baseline GFR, albumin, and proteinuria, high levels of CACS showed an independent association with an annual reduction rate of GFR (r = -0.142, P = .048).The results suggest that CACS was related to an annual decrease in GFR and may predict the faster decline in GFR in patients with symptoms requiring computed tomographic coronary angiography.
- Published
- 2011
24. Association between Renal Dysfunction and the Mixed Plaque of Coronary Artery on Computed Tomographic Angiography
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Jae Hyun Chang, Wook-Jin Chung, Sejoong Kim, Sun Young Na, Wookyung Chung, Yon Mi Sung, Young Hwan Hwang, Hyun Hee Lee, Chan Il Moon, Ji Yong Jung, and Jiyoon Sung
- Subjects
medicine.medical_specialty ,Renal function ,Coronary Artery Disease ,Coronary Angiography ,General Biochemistry, Genetics and Molecular Biology ,Lesion ,Coronary artery disease ,Internal medicine ,Multidetector Computed Tomography ,Odds Ratio ,medicine ,Humans ,Multislice ,Analysis of Variance ,business.industry ,General Medicine ,Odds ratio ,medicine.disease ,Plaque, Atherosclerotic ,Confidence interval ,medicine.anatomical_structure ,Cardiology ,Kidney Failure, Chronic ,medicine.symptom ,business ,Glomerular Filtration Rate ,Artery ,Kidney disease - Abstract
Coronary artery plaque is related to development of coronary artery disease (CAD), and chronic kidney disease is associated with CAD. However, the association of renal dysfunction (RD) with coronary artery plaque characteristics has not been fully elucidated. We evaluated the association between RD and coronary artery plaque characteristics in patients with suspected CAD, who underwent multislice computed tomographic angiography (CTA). A total of 918 patients were classified into 4 groups: group with no plaque (NP) (48.9%), group with calcified plaque (CP) (16.0%), group with noncalcified plaque (NCP) (22.4%), and group with mixed plaque (MP) (12.7%). NCP is considered as rupture-prone soft plaque, and CP as more stable lesion. The mean of estimated glomerular filtration rate (eGFR) was 82.5 ± 15.4 mL/min/1.73m2, and the prevalence of RD (defined as eGFR < 60 mL/min/1.73m2) was 6.3%. The prevalence of RD was 3.3% in the NP group, 10.2% in the CP group, 5.3% in the NCP group, and 14.5% in the MP group (P < 0.001 by ANOVA tests). The adjusted odds ratio for RD was 3.38 (95% confidence interval, 1.27 - 9.04) for the MP group, compared with the NP group. The presence of RD showed an independent association with the MP counts (r = 0.155, P < 0.001); however, there was no association between RD and other plaque characteristics. In conclusion, RD is associated with MP rather than CP or NCP, compared with NP, which may reflect one of the developmental processes of CAD in patients with RD.
- Published
- 2011
25. Chronic Kidney Disease in Cancer Patients: An Independent Predictor of Cancer-Specific Mortality
- Author
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Yeon Ho Park, Sun Young Na, Jae Hyun Chang, Ji Yong Jung, Kook Hwan Oh, Ji Yoon Sung, Wookyung Chung, Sejoong Kim, and Hyun Hee Lee
- Subjects
Adult ,Male ,medicine.medical_specialty ,Time Factors ,Renal function ,Kidney ,Risk Factors ,Neoplasms ,Internal medicine ,Humans ,Medicine ,Cumulative incidence ,Risk factor ,Survival analysis ,Aged ,Proportional Hazards Models ,business.industry ,Proportional hazards model ,Hazard ratio ,Cancer ,Middle Aged ,medicine.disease ,Treatment Outcome ,Nephrology ,Kidney Failure, Chronic ,Female ,business ,Glomerular Filtration Rate ,Kidney disease - Abstract
Background/Aims: The effects of chronic kidney disease (CKD) on the risk of death for patients with malignant disease are uncertain. The aim of this study was to determine the association between the presence of CKD and mortality in cancer patients. Method: We retrospectively reviewed the cases of 8,223 cancer patients with one or more serum creatinine measurements from January 1, 2000 to December 31, 2004. The key outcome was cancer-specific mortality within the follow-up period. The cumulative incidence rate for death from cancer was estimated using methods of competing risks survival analysis. Cox proportional-hazards regression with the use of Fine and Gray’s proportional-hazards model were evaluated in multiple analyses. Results: CKD was associated with an increased risk of death in cancer patients. The adjusted hazard ratios were 1.12 for patients with an estimated glomerular filtration rate (eGFR) of 30–59 ml/min/1.73 m2 (95% confidence interval 1.01–1.26, p = 0.04) and 1.75 for patients with an eGFR 2 (95% confidence interval 1.32–2.32, p < 0.001). Conclusions: CKD should be considered a risk factor for survival among patients with cancer.
- Published
- 2011
26. Validity of interferon-γ-release assays for the diagnosis of latent tuberculosis in haemodialysis patients
- Author
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J. Y. Sung, Hyun-Hee Lee, S. J. Choi, Z. L. Zheng, Jaeseok Yang, Sejoong Kim, and Wookyung Chung
- Subjects
Adult ,Male ,Microbiology (medical) ,medicine.medical_specialty ,Tuberculosis ,Adolescent ,medicine.medical_treatment ,Tuberculin ,Immunocompromised Host ,Interferon-gamma ,Young Adult ,Predictive Value of Tests ,Renal Dialysis ,Risk Factors ,Internal medicine ,Immunopathology ,latent tuberculosis ,Humans ,Medicine ,BCG ,interferon-γ-release assays ,Renal Insufficiency ,Aged ,Aged, 80 and over ,Latent tuberculosis ,Tuberculin Test ,business.industry ,Reproducibility of Results ,General Medicine ,Middle Aged ,bacterial infections and mycoses ,medicine.disease ,haemodialysis ,Vaccination ,immunocompromised ,Infectious Diseases ,Predictive value of tests ,Immunology ,BCG Vaccine ,Female ,Reagent Kits, Diagnostic ,Hemodialysis ,business ,BCG vaccine - Abstract
Haemodialysis patients are at higher risk of developing active tuberculosis (TB) infection. However, tuberculin skin tests (TST) have limitations and the diagnostic usefulness of interferon-γ-release assays (IG-RAs) remains unclear in immunocompromised hosts including haemodialysis patients. Haemodialysis patients were enrolled from a dialysis centre in Korea, an intermediate TB-burden country with a high bacille Calmette–Guérin (BCG) vaccination rate. The QuantiFERON-Gold TB In tube test® (QFT) and the T-SPOT TB test® (T-SPOT) were performed, along with the TST. We stratified patients to low- and high-risk groups, according to the risk factors for latent TB. Association between each of the three diagnostic tests and the risk of latent TB was analysed. One hundred and sixty-seven patients were enrolled. The positive rates for the TST, the QFT and T-SPOT were 23.5, 45.9 and 60.4%, respectively. Previous BCG vaccination increased the TST-positive rate in the low-risk group (OR 4.438), whereas it affected neither QFT nor T-SPOT. The positive QFT rates were 41.2 and 62.5% in the low- and high-risk groups, respectively. The QFT was associated with the high-risk group (OR 2.578), whereas the TST was not. The positive T-SPOT rates were 58.9 and 65.7% in the low- and high-risk groups, respectively. The frequency of indeterminate results was higher for the QFT (12.6%) compared with the T-SPOT (4.8%). In conclusion, the IG-RAs can be useful for the diagnosis of latent TB infection in haemodialysis patients.
- Published
- 2010
27. FP381DIMINUTION OF SECRETED FRIZZLED-RELATED PROTEIN 5 CONFERS DEVELOPMENT OF VASCULAR CALCIFICATION IN CHRONIC KIDNEY DISEASE
- Author
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Jae Hyun Chang, Ji Yong Jung, Ae Jin Kim, Yun Jung Oh, Han Ro, Wookyung Chung, Chungsik Lee, Hyun-Sook Kim, and Hyun Hee Lee
- Subjects
Transplantation ,Pathology ,medicine.medical_specialty ,Nephrology ,Secreted Frizzled-Related Protein 5 ,business.industry ,medicine ,business ,medicine.disease ,Vascular calcification ,Kidney disease - Published
- 2018
28. Early Vascular Access Blood Flow as a Predictor of Long-term Vascular Access Patency in Incident Hemodialysis Patients
- Author
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Jae Hyun Chang, Jin-Woong Park, Wookyung Chung, Sejoong Kim, Yeon Ho Park, Hyun Hee Lee, Hyung Soo Kim, and Jaeseok Yang
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Renal function ,Indicator Dilution Techniques ,Kidney Function Tests ,Risk Assessment ,Sensitivity and Specificity ,Blood vessel prosthesis ,Renal Dialysis ,Risk Factors ,Prevalence ,Medicine ,Vascular Patency ,Humans ,Korea ,business.industry ,Hazard ratio ,Graft Survival ,Graft Occlusion, Vascular ,Reproducibility of Results ,General Medicine ,Middle Aged ,medicine.disease ,Prognosis ,Thrombosis ,Confidence interval ,Surgery ,Blood Vessel Prosthesis ,Stenosis ,Treatment Outcome ,Nephrology ,Original Article ,Female ,Hemodialysis ,business ,Blood Flow Velocity - Abstract
The long-term clinical benefits of vascular access blood flow (VABF) measurements in hemodialysis (HD) patients have been controversial. We evaluated whether early VABF may predict long-term vascular access (VA) patency in incident HD patients. We enrolled 57 patients, of whom 27 were starting HD with arteriovenous fistulas (AVFs) and 30 with arteriovenous grafts (AVGs). The patients' VABF was measured monthly with the ultrasound dilution technique over the course of the first six months after the VA operation. During the 20.4-month observational period, a total of 40 VA events in 23 patients were documented. The new VA events included 13 cases of stenosis and 10 thrombotic events. The lowest quartile of average early VABF was related to the new VA events. After adjusting for covariates such as gender, age, hypertension, diabetes, VA type, hemoglobin levels, body mass index, parathyroid hormone, and calcium-phosphorus product levels, the hazard ratio of VABF (defined as
- Published
- 2010
29. De Novo Hypokalemia in Incident Peritoneal Dialysis Patients: A 1-Year Observational Study
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Jae Hyun Chang, Wookyung Chung, Sejoong Kim, Hyun Hee Lee, and Ji Yong Jung
- Subjects
medicine.medical_specialty ,Hyperkalemia ,endocrine system diseases ,Physiology ,medicine.medical_treatment ,serum albumin ,Serum albumin ,Renal function ,urologic and male genital diseases ,Gastroenterology ,Peritoneal dialysis ,chemistry.chemical_compound ,Internal medicine ,Internal Medicine ,medicine ,hypokalemia ,Therapeutic strategy ,Original Investigation ,Creatinine ,biology ,business.industry ,Incidence (epidemiology) ,nutritional and metabolic diseases ,Hypokalemia ,Surgery ,nutrition ,chemistry ,peritoneal dialysis ,biology.protein ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business - Abstract
Hypokalemia occurs frequently in patients undergoing peritoneal dialysis (PD). However, the therapeutic strategy may differ from that of non-PD-related hypokalemia. We investigated clinical features and related factors of de novo hypokalemia in incident PD patients. We retrospectively enrolled 82 normokalemic patients starting PD at Gachon University Gil Hospital, Korea. The patients were divided into hypokalemia (K(+)
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- 2009
30. Tristetraprolin regulates expression of VEGF and tumorigenesis in human colon cancer
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Byung Ju Lee, Hee Jeong Cha, Wha Ja Cho, Young Woo Park, Young Joo Min, Young Joon Son, Seoung Wan Chae, Seok Won Jung, Hyun Hee Lee, Dae Hwa Choi, Won Hyeok Lee, Jeong Woo Park, Hye-Jeong Choi, Soon Eun Park, and Young Min Kim
- Subjects
Cancer Research ,medicine.medical_specialty ,Angiogenesis ,Colorectal cancer ,Tristetraprolin ,medicine.disease_cause ,chemistry.chemical_compound ,hemic and lymphatic diseases ,Internal medicine ,Gene expression ,medicine ,heterocyclic compounds ,Regulation of gene expression ,business.industry ,Cancer ,respiratory system ,medicine.disease ,digestive system diseases ,Vascular endothelial growth factor ,Endocrinology ,Oncology ,chemistry ,Cancer research ,Carcinogenesis ,business ,therapeutics - Abstract
Tristetraprolin (TTP) is an AU-rich element-binding protein that regulates mRNA stability. Here, we report that TTP suppress the growth of human colon cancer cells both in vivo and in vitro by regulating of the expression of vascular endothelial growth factor (VEGF). TTP protein expression in human colonic tissues was markedly decreased in colonic adenocarcinoma compared with in normal mucosa and adenoma. VEGF expression was higher in colonic adenocarcinoma than in normal mucosa and adenoma. Specific inhibition of TTP expression by RNA-interference increased the expression of VEGF in cultured human colon cancer cells, and TTP overexpression markedly decreased it. In addition, elevated expression of TTP decreased the expression level of luciferase linked to a 3' terminal AU-rich element (ARE) of VEGF mRNA. Colo320/TTP cells overexpressing TTP grew slowly in vitro and became tumors small in size when xenografted s.c into nude mice. These findings demonstrate that TTP acts as a negative regulator of VEGF gene expression in colon cancer cells, suggesting that it can be used as novel therapeutic agent to treat colon cancer.
- Published
- 2009
31. A Case of Childhood Sleep-Related Rhythmic Movement Disorder
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Hyun Hee Lee, Kon Hee Lee, Tae-Yeon Kim, and Sung Ku Kim
- Subjects
medicine.medical_specialty ,business.industry ,media_common.quotation_subject ,Repetitive movements ,medicine.disease ,Sleep in non-human animals ,Physical medicine and rehabilitation ,Rhythm ,Rhythmic movement disorder ,medicine ,Sleep related rhythmic movement disorder ,Circadian rhythm ,Girl ,business ,Slow-wave sleep ,media_common - Abstract
A Case of Childhood Sleep-Related Rhythmic Movement Disorder Tae Yeon Kim, M.D., Hyun Hee Lee, M.D., Sung Ku Kim, M.D., Kon Hee Lee, M.D. Department of Pediatrics, Kangnam Sacred Heart Hospital, School of Medicine Hallym University Sleep-related rhythmic movement disorder (SRMD) is defined by uniformed, repetitive movements, which occurs from onset of sleep to light sleep and sometimes during deep sleep. We experienced a 21 month-old girl complained of the rhythmic movements during sleep. After controlling her circadian rhythm for 45days, her symptoms dramatically improved; there was no more hitting her head or legs on the floor. We considered that rhythmic movement would be related to circadian rhythm without medication.
- Published
- 2009
32. IL-10 Diminishes CTLA-4 Expression on Islet-Resident T Cells and Sustains Their Activation Rather Than Tolerance
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J. Jeremiah Bell, Renu Jain, Hyun-Hee Lee, Randal K. Gregg, Scott J. Schoenleber, Rohit D. Divekar, and Habib Zaghouani
- Subjects
medicine.medical_specialty ,Insulin Antibodies ,medicine.medical_treatment ,T cell ,Molecular Sequence Data ,Immunology ,Antigen-Presenting Cells ,Down-Regulation ,Mice, SCID ,Biology ,Lymphocyte Activation ,T-Lymphocytes, Regulatory ,Islets of Langerhans ,Mice ,Antigen ,Antigens, CD ,Mice, Inbred NOD ,T-Lymphocyte Subsets ,Internal medicine ,Immune Tolerance ,medicine ,Animals ,Immunology and Allergy ,CTLA-4 Antigen ,Amino Acid Sequence ,NOD mice ,Mice, Knockout ,geography ,geography.geographical_feature_category ,Insulin ,Cell Differentiation ,Islet ,Antigens, Differentiation ,Interleukin-10 ,Interleukin 10 ,Diabetes Mellitus, Type 1 ,Endocrinology ,Cytokine ,medicine.anatomical_structure ,CTLA-4 ,Female ,Immunosuppressive Agents - Abstract
IL-10, a powerful anti-Th1 cytokine, has shown paradoxical effects against diabetes. The mechanism underlying such variable function remains largely undefined. An approach for controlled mobilization of endogenous IL-10 was applied to the NOD mouse and indicated that IL-10 encounter with diabetogenic T cells within the islets sustains activation, while encounter occurring peripheral to the islets induces tolerance. Insulin β-chain (INSβ) 9-23 peptide was expressed on an Ig, and the aggregated (agg) form of the resulting Ig-INSβ triggered IL-10 production by APCs, and expanded IL-10-producing T regulatory cells. Consequently, agg Ig-INSβ delayed diabetes effectively in young NOD mice whose pathogenic T cells remain peripheral to the islets. However, agg Ig-INSβ was unable to suppress the disease in 10-wk-old insulitis-positive animals whose diabetogenic T cells have populated the islets. This is not due to irreversibility of the disease because soluble Ig-INSβ did delay diabetes in these older mice. Evidence is provided indicating that upon migration to the islet, T cells were activated and up-regulated CTLA-4 expression. IL-10, however, reverses such up-regulation, abolishing CTLA-4-inhibitory functions and sustaining activation of the islet T lymphocytes. Therefore, IL-10 supports T cell tolerance in the periphery, but its interplay with CTLA-4 sustains activation within the islets. As a result, IL-10 displays opposite functions against diabetes in young vs older insulitis-positive mice.
- Published
- 2005
33. The Impact of Renin-Angiotensin System Blockade on Renal Outcomes and Mortality in Pre-Dialysis Patients with Advanced Chronic Kidney Disease
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Chungsik Lee, Ji Yong Jung, Jae Hyun Chang, Sun Moon Kim, Wookyung Chung, Ae Jin Kim, Byung Chul Shin, Hyun Hee Lee, Han Ro, Hyun Lee Kim, Yun Jung Oh, and Jong Hoon Chung
- Subjects
Male ,Nephrology ,Peptide Hormones ,lcsh:Medicine ,Blood Pressure ,Angiotensin-Converting Enzyme Inhibitors ,030204 cardiovascular system & hematology ,Pathology and Laboratory Medicine ,Kidney ,Biochemistry ,Vascular Medicine ,Renin-Angiotensin System ,Endocrinology ,0302 clinical medicine ,Chronic Kidney Disease ,Medicine and Health Sciences ,Medicine ,030212 general & internal medicine ,lcsh:Science ,Geriatric Nephrology ,Multidisciplinary ,Hazard ratio ,Middle Aged ,Prognosis ,Survival Rate ,Proteinuria ,Treatment Outcome ,Disease Progression ,Female ,Anatomy ,Research Article ,Adult ,medicine.medical_specialty ,Endocrine Disorders ,Angiotensin Receptor Antagonists ,03 medical and health sciences ,Signs and Symptoms ,Diagnostic Medicine ,Diabetes mellitus ,Internal medicine ,Diabetes Mellitus ,Humans ,Renal Insufficiency, Chronic ,Intensive care medicine ,Survival rate ,Aged ,Retrospective Studies ,business.industry ,lcsh:R ,Geriatric nephrology ,Biology and Life Sciences ,Retrospective cohort study ,Renal System ,medicine.disease ,Hormones ,Blockade ,Geriatrics ,Metabolic Disorders ,lcsh:Q ,business ,Kidney disease - Abstract
Renin-angiotensin-system (RAS) blockade is thought to slow renal progression in patients with chronic kidney disease (CKD). However, it remains uncertain if the habitual use of RAS inhibitors affects renal progression and outcomes in pre-dialysis patients with advanced CKD. In this multicenter retrospective cohort study, we identified 2,076 pre-dialysis patients with advanced CKD (stage 4 or 5) from a total of 33,722 CKD patients. RAS blockade users were paired with non-users for analyses using inverse probability of treatment-weighted (IPTW) and propensity score (PS) matching. The outcomes were renal death, all-cause mortality, hospitalization for hyperkalemia, and interactive factors as composite outcomes. RAS blockade users showed an increased risk of renal death in PS-matched analysis (hazard ratio [HR], 1.381; 95% CI, 1.071–1.781; P = 0.013), which was in agreement with the results of IPTW analysis (HR, 1.298; 95% CI, 1.123–1.500; P < 0.001). The risk of composite outcomes was higher in RAS blockade users in IPTW (HR, 1.154; 95% CI, 1.016–1.310; P = 0.027), but was marginal significance in PS matched analysis (HR, 1.243; 95% CI, 0.996–1.550; P = 0.054). The habitual use of RAS blockades in pre-dialysis patients with advanced CKD may have a detrimental effect on renal outcome without improving all-cause mortality. Further studies are warranted to determine whether withholding RAS blockade may lead to better outcomes in these patients.
- Published
- 2017
34. Associations between Soluble Receptor for Advanced Glycation End Products (sRAGE) and S100A12 (EN-RAGE) with Mortality in Long-term Hemodialysis Patients
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Ae Jin Kim, Han Ro, Eul Sik Jung, Jae Hyun Chang, Hyun Hee Lee, Wookyung Chung, and Ji Yong Jung
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Glycation End Products, Advanced ,Male ,medicine.medical_treatment ,030232 urology & nephrology ,030204 cardiovascular system & hematology ,Gastroenterology ,Cohort Studies ,0302 clinical medicine ,Risk Factors ,Prospective Studies ,Prospective cohort study ,Univariate analysis ,biology ,Hazard ratio ,General Medicine ,Middle Aged ,C-Reactive Protein ,Cardiovascular Diseases ,Nephrology ,Hemodialysis ,Female ,Original Article ,sRAGE ,Adult ,medicine.medical_specialty ,03 medical and health sciences ,Renal Dialysis ,Diabetes mellitus ,Internal medicine ,medicine ,Humans ,Renal Insufficiency, Chronic ,Mortality ,Serum Albumin ,Survival analysis ,Aged ,Proportional Hazards Models ,Proportional hazards model ,business.industry ,S100A12 Protein ,C-reactive protein ,medicine.disease ,Survival Analysis ,Endocrinology ,S100A12 ,Multivariate Analysis ,biology.protein ,business ,Biomarkers ,Follow-Up Studies - Abstract
Hemodialysis (HD) patients experience vascular calcification, ultimately leading to high mortality rates. Previously, we reported associations between soluble receptor for advanced glycation end products (sRAGEs) and extracellular newly identified RAGE-binding protein S100A12 (EN-RAGE) and vascular calcification. Here, we extended our observations, investigating whether these biomarkers may be useful for predicting cardiovascular morbidity and mortality in these subjects. Thus, we evaluated the relationship between sRAGE and S100A12 and mortality in long-term HD patients. This was a prospective observational cohort study in 199 HD patients from an extended analysis of our previous study. Plasma sRAGE, S100A12, comorbidities, and other traditional risk factors were investigated. The cumulative incidences for death using Cox proportional hazards regression were evaluated in multivariable analyses. The observation period was 44 months. During the observation period, 27 (13.6%) patients died. Univariate analysis demonstrated that S100A12 was correlated with diabetes (P = 0.040) and high-sensitivity C-reactive protein (hsCRP) (P = 0.006). In multivariable analyses, plasma sRAGE (hazard ratio [HR] = 1.155; 95% confidence interval [CI] = 0.612–2.183; P = 0.656) and S100A12 (HR = 0.960; 95% CI = 0.566–1.630; P = 0.881) were not associated with mortality in HD patients, although traditional predictors of mortality, including age, history of cardiovascular diseases (CVDs), and serum levels of albumin and hsCRP were related to mortality. Powerful predictors of mortality were age, CVD, and albumin levels. Plasma sRAGE and S100A12 may be weak surrogate markers for predicting all-cause mortality in patients undergoing HD, although S100A12 was partly related to diabetes and inflammation., Graphical Abstract
- Published
- 2017
35. In vitro induction of differentiation by ginsenosides in F9 teratocarcinoma cells
- Author
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Yujeong Lee, Hyun-Hee Lee, Kwang-Baek Kim, Se Ik Kim, Byung Chae Park, Hae Young Chung, and Seung Ki Lee
- Subjects
Teratocarcinoma ,Transcriptional Activation ,Cancer Research ,medicine.medical_specialty ,Embryonal Carcinoma Stem Cells ,Ginsenosides ,Cellular differentiation ,Immunoblotting ,Panax ,Biology ,Mice ,Ginseng ,Transactivation ,Receptors, Glucocorticoid ,Glucocorticoid receptor ,Internal medicine ,Tumor Cells, Cultured ,medicine ,Animals ,Electrophoretic mobility shift assay ,Luciferases ,Plants, Medicinal ,Cell Differentiation ,Saponins ,Molecular biology ,Gene Expression Regulation, Neoplastic ,Mifepristone ,Endocrinology ,Oncology ,Nuclear receptor ,Cell culture ,Neoplastic Stem Cells ,Stem cell - Abstract
The aim of this study was to determine the ability of the ginsenosides, extracts of Panax ginseng C.A. Meyer, to cause differentiation of F9 teratocarcinoma stem cells as a model system. F9 stem cells cultured in the presence of the ginsenosides together with dibutyryl cyclic AMP (dbcAMP) became parietal endoderm-like cells. Moreover, the expression of differentiation marker genes, such as laminin B1 and type IV collagen, was increased after treatment with the ginsenosides. Among the various purified ginsenosides, Rh1 and Rh2 were the most effective at causing differentiation of F9 cells. Since ginsenosides and glucocorticoid hormone have similar chemical structures, we examined the possibility of the involvement of a glucocorticoid receptor (GR) in the differentiation process induced by the ginsenosides. According to Southwestern blot analysis, a 94 kDa protein regarded as a GR was detected in F9 cells cultured in the medium containing the ginsenosides Rh1 or Rh2. In addition, F9 stem cells treated with the ginsenosides Rh1 or Rh2 and with RU486, a glucocorticoid antagonist with a high affinity for the GR, did not differentiate into endoderm cells morphologically, and the expression of laminin B1 gene was not induced in these cells. In a gel mobility shift assay, protein factors capable of binding to the glucocorticoid responsive element (GRE) specifically were detected in nuclear extracts of the ginsenoside-treated F9 cells. Moreover, overexpression of GR by cotransfection of GR expression vector and GRE-luciferase vector enhanced the transactivation activity of GRE promoter in the presence of ginsenosides Rh1 or Rh2 and was further augmented by dbcAMP. In addition, ginsenosides Rh1 and Rh2 bound to a GR assessed by whole-cell binding assay, even though the specific binding affinity was weaker compared to dexamethasone. Based on these data, we suggest that the ginsenosides Rh1 and Rh2 cause the differentiation of F9 cells and the effects of ginsenosides might be exerted via binding with a GR or its analogous nuclear receptor.
- Published
- 1996
36. Klotho and S100A8/A9 as Discriminative Markers between Pre-Renal and Intrinsic Acute Kidney Injury
- Author
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Jae Hyun Chang, Ae Jin Kim, Hyun-Sook Kim, Han Ro, Hyun Hee Lee, Wookyung Chung, and Ji Yong Jung
- Subjects
Male ,0301 basic medicine ,Physiology ,Neutrophils ,030232 urology & nephrology ,lcsh:Medicine ,Urine ,Lipocalin ,Kidney ,Pathology and Laboratory Medicine ,urologic and male genital diseases ,Biochemistry ,Rats, Sprague-Dawley ,White Blood Cells ,chemistry.chemical_compound ,0302 clinical medicine ,Animal Cells ,Intraperitoneal Injections ,Medicine and Health Sciences ,Medicine ,Enzyme-Linked Immunoassays ,lcsh:Science ,Immune Response ,Klotho ,Routes of Administration ,Glucuronidase ,Multidisciplinary ,Acute kidney injury ,Furosemide ,Acute Kidney Injury ,Middle Aged ,Lipocalins ,female genital diseases and pregnancy complications ,Body Fluids ,medicine.anatomical_structure ,Creatinine ,Female ,Anatomy ,Cellular Types ,Research Article ,medicine.drug ,medicine.medical_specialty ,Immune Cells ,Urinary system ,Immunology ,Urology ,Research and Analysis Methods ,03 medical and health sciences ,Signs and Symptoms ,Lipocalin-2 ,Proto-Oncogene Proteins ,Animals ,Calgranulin B ,Humans ,Calgranulin A ,Immunoassays ,Klotho Proteins ,Aged ,Inflammation ,Pharmacology ,Blood Cells ,business.industry ,lcsh:R ,Biology and Life Sciences ,Kidneys ,Renal System ,Cell Biology ,medicine.disease ,Rats ,Disease Models, Animal ,Cross-Sectional Studies ,Early Diagnosis ,030104 developmental biology ,chemistry ,Immunologic Techniques ,lcsh:Q ,business ,Biomarkers ,Acute-Phase Proteins - Abstract
Early detection and accurate differentiation of the cause of AKI may improve the prognosis of the patient. However, to date, there are few reliable biomarkers that can discriminate between pre-renal and intrinsic AKI. In this study, we determined whether AKI is associated with altered serum and urinary levels of Klotho, S100A8/A9 (an endogenous ligand of toll-like receptor 4), and neutrophil gelatinase-associated lipocalin (NGAL), which may allow differentiation between pre-renal and intrinsic AKI. A volume-depleted pre-renal AKI model was induced in male Sprague Dawley rats fed a low-salt diet (0.03%) without water 96 h before two intraperitoneal (IP) injections of furosemide (20 mg/kg) at a 24 h interval. In contrast, in the cisplatin-induced intrinsic AKI model, animals were given a single IP injection of cisplatin (5 mg/kg). All of the animals were euthanized 72 h after the first IP injection. Serum and urinary levels of Klotho, S100A8/A9, and NGAL were measured using an enzyme-linked immunosorbent assay. We also performed a proof-of-concept cross-sectional study to measure serum and urinary biomarkers in 61 hospitalized patients with established AKI. Compared to the intrinsic AKI group, the pre-renal AKI group showed a marked depression in urinary Klotho levels (13.21 ± 17.32 vs. 72.97 ± 17.96 pg/mL; P = 0.002). In addition, the intrinsic AKI group showed marked elevation of S100A8/A9 levels compared to the pre-renal AKI group (2629.97 ± 598.05 ng/mL vs. 685.09 ± 111.65 ng/mL; P = 0.002 in serum; 3361.11 ± 250.86 ng/mL vs. 741.72 ± 101.96 ng/mL; P = 0.003 in urine). There was no difference in serum and urinary NGAL levels between the pre-renal and intrinsic AKI groups. The proof-of-concept study with the hospitalized AKI patients also demonstrated decreased urinary Klotho in pre-renal AKI patients and increased urinary S100A8/A9 concentrations in intrinsic AKI patients. The attenuation of urinary Klotho and increase in urinary S100A8/A9 may allow differentiation between pre-renal and intrinsic AKI.
- Published
- 2016
37. Toxic megacolon and interstitial pneumonia caused by cytomegalovirus infection in a pediatric patient with acute lymphoblastic leukemia receiving chemotherapy
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Jeong A. Park, Yun-Jeong Lim, Hyun-Seop Kwon, Chung Ryul Paik, and Hyun Hee Lee
- Subjects
0301 basic medicine ,Ganciclovir ,Foscarnet ,medicine.medical_specialty ,Toxic megacolon ,medicine.medical_treatment ,030106 microbiology ,Congenital cytomegalovirus infection ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Immune system ,Internal medicine ,medicine ,Letter to the Editor ,Chemotherapy ,business.industry ,virus diseases ,Induction chemotherapy ,Hematology ,medicine.disease ,Transplantation ,030220 oncology & carcinogenesis ,Immunology ,business ,medicine.drug - Abstract
TO THE EDITOR: Cytomegalovirus (CMV) is a major cause of morbidity and mortality after transplantation. However, the risk of CMV infection increases with more intense treatment outside transplantation settings. We describe a case of fatal CMV disease in a pediatric patient with standard risk acute lymphoblastic leukemia (ALL). She developed life-threatening toxic megacolon and interstitial pneumonia, complicated with bacterial sepsis, during induction chemotherapy. With a diagnosis of ganciclovir (GCV)-resistant CMV disease, she was successfully treated with foscarnet and has remained in complete remission for >2 years. We discuss the association between CMV and immune suppression, the clinical utility of diagnostic tools, and CMV antiviral resistance.
- Published
- 2016
38. RESIDUAL RENAL VOLUME IS ASSOCIATED WITH VOLUME STATUS DETERMINED BY BODY COMPOSITION MONITORING IN PATIENTS WITH PERITONEAL DIALYSIS
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Hyun Hee Lee, Jae Hyun Chang, Ji Yong Jung, Han Ro, and Wookyung Chung
- Subjects
lcsh:Internal medicine ,medicine.medical_specialty ,lcsh:Specialties of internal medicine ,business.industry ,Urology ,medicine.medical_treatment ,Renal function ,medicine.disease ,Peritoneal dialysis ,Surgery ,lcsh:RC581-951 ,Nephrology ,Diabetes mellitus ,Extracellular fluid ,medicine ,Intravascular volume status ,Anuria ,medicine.symptom ,lcsh:RC31-1245 ,business ,Body mass index ,Dialysis - Abstract
Fluid overload has been linked to mortality in peritoneal dialysis (PD) patients. Residual renal function is important for patient survival. Therefore, the objective of this study was to analyze volume status in PD patients, and to identify associations between volume status and residual renal volume. We performed a cross-sectional, observational, single-center study. Body composition was measured using a portable multifrequency whole-body bioimpedance assessment, and residual renal volume was measured. We examined 75 patients (66.7% male), with a mean age of 50.7±13.0 years and mean body mass index of 23.5±3.5 kg/m2. Length of time on dialysis was 46.5±37.9 months. Anuria (≤100 mL/day) is associated with relative overhydration (ROH) (p=0.014) and extracellular water volume (p=0.014). In a multivariable linear regression analysis, anuria (coefficient β=0.217, p=0.025), diabetes (coefficient β=0.213, p=0.027), and serum albumin level (coefficient β=−0.533, p
- Published
- 2012
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39. Early start of dialysis has no survival benefit in end-stage renal disease patients
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Hyun Hee Lee, Sejoong Kim, Jae Hyun Chang, Ji Yong Jung, Wookyung Chung, Jiyoon Sung, Min Young Rim, Dong Ki Kim, and Kwang-Pil Ko
- Subjects
Adult ,Male ,medicine.medical_specialty ,Time Factors ,medicine.medical_treatment ,Urology ,Renal function ,Kaplan-Meier Estimate ,Peritoneal dialysis ,End stage renal disease ,Renal Dialysis ,Risk Factors ,Medicine ,Humans ,Mortality ,Propensity Score ,Dialysis ,Serum Albumin ,Aged ,Proportional Hazards Models ,business.industry ,Proportional hazards model ,Mortality rate ,Hazard ratio ,Age Factors ,General Medicine ,Middle Aged ,Surgery ,Log-rank test ,Nephrology ,Kidney Failure, Chronic ,Female ,Original Article ,End Stage Renal Disease ,business ,Peritoneal Dialysis ,Glomerular Filtration Rate - Abstract
The timing for dialysis initiationis still debated. The aim of this study was to compare mortality rates, using a propensity-score approach, in dialysis patients with early or late starts. From January 2000 to June 2009, incident adult patients (n = 836) starting dialysis for end-stage renal disease (ESRD) were enrolled. The patients were assigned to either an early- or late-start group depending on the initiation time of the dialysis. After propensity-score-basedmatching, 450 patients remained. At the initiation of dialysis, the mean estimated glomerular filtration rate (eGFR) was 11.1 mL/min/1.73 m(2) in the early-start group compared with 6.1 mL/min/1.73 m(2) in the late-start group. There were no significant differences in survival between the patients in the early- and late-start groups (Log rank tests P = 0.172). A higher overall mortality risk was observed in the early-start group than in the late-start group for the patients aged ≥ 70 yr (hazard ratio [HR]: 3.29; P = 0.048) and/or who had albumin levels ≥ 3.5 g/dL (HR: 2.53; P = 0.046). The survival of the ESRD patients was comparable between the patients in the early and late-start groups. The time to initiate dialysis should be determined based on clinical findings as well as the eGFR.
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- 2012
40. Donor-recipient age difference and graft survival in living donor kidney transplantation
- Author
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Yeon Ho Park, Hyun-Hee Lee, Young Jae Lee, Ji Yong Jung, H.N. Choi, Yeun Sun Kim, Wookyung Chung, and Jae Hyun Chang
- Subjects
Adult ,Graft Rejection ,Male ,medicine.medical_specialty ,Time Factors ,Kaplan-Meier Estimate ,Risk Assessment ,Donor Selection ,Young Adult ,Risk Factors ,Internal medicine ,Republic of Korea ,Living Donors ,Medicine ,Humans ,Young adult ,Kidney transplantation ,Proportional Hazards Models ,Retrospective Studies ,Transplantation ,Chi-Square Distribution ,Donor selection ,Proportional hazards model ,business.industry ,Graft Survival ,Age Factors ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Kidney Transplantation ,Treatment Outcome ,Donation ,Creatinine ,Cohort ,Multivariate Analysis ,Surgery ,Female ,business ,Chi-squared distribution ,Biomarkers - Abstract
In paired living kidney exchange donation from an old donor to a young recipient, it may be argued that elderly donors provide an inferior quality kidney. However, the impact of donors older than recipients on transplant outcomes remains unclear.We retrospectively reviewed the charts of primary living kidney transplantation patients who were divided into two groups based on the age difference between donor and recipient (recipient age subtracted from donor age, donor-recipient20 vs ≥ 20). The donor-recipient age difference20 group comprised 75 and donor-recipient age difference ≥ 20 group, 25 subjects. Outcome measures included serum creatinine, acute rejection episodes as well as graft and patient survivals at 1 and 5 years after transplantation.The mean donor age difference cohorts of20 and ≥ 20 years showed donor ages of 33 ± 8 and 54 ± 8 years, respectively. The mean recipient age in both groups averaged under 40 years. The acute rejection rate within the first year posttransplantation was greater among age difference ≥ 20 years. The mean serum creatinine values of the donor-recipient age difference20 group was lower than the ≥20 years group at 1 and 5 years posttransplant. The 1-year difference was associated with an increased creatinine value at 5 years. However, death-censored graft survival of the age difference of the ≥ 20 years group was not different (hazard ratio [HR] = 0.1, 95% confidence interval [CI] = 0.01-1.37, P = .08). Patient survival of the age difference ≥ 20 years group showed no difference compared with the age difference20 years group (HR = 0.25, 95% CI = 0.01-6.35, P = .4).Although the cohort of a donor-young recipient age difference ≥ 20 years showed a greater risk of an acute rejection episode early posttransplantation, it did not affect graft or patient survivals. When considering paired kidney donation, older age donors should not necessarily be limited.
- Published
- 2012
41. Prognostic implication of interdialytic fluid retention during the beginning period in incident hemodialysis patients
- Author
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Jae Hyun Chang, Jiyoon Sung, Han Ro, Ae Jin Kim, Dong Su Shin, Eul Sik Jung, Shung Han Choi, Hyun Hee Lee, Hyeonsu Park, Ji Yong Jung, and Wookyung Chung
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Population ,Nutritional Status ,Blood Pressure ,General Biochemistry, Genetics and Molecular Biology ,End stage renal disease ,Renal Dialysis ,Risk Factors ,Internal medicine ,Odds Ratio ,Medicine ,Humans ,education ,Dialysis ,Retrospective Studies ,education.field_of_study ,Analysis of Variance ,Blood Volume ,business.industry ,Body Weight ,Age Factors ,General Medicine ,Odds ratio ,Water-Electrolyte Balance ,medicine.disease ,Prognosis ,Confidence interval ,Surgery ,Blood pressure ,Cardiovascular Diseases ,Heart failure ,Kidney Failure, Chronic ,Hemodialysis ,business ,Blood Chemical Analysis - Abstract
Patient with end stage renal disease have characteristics in common with heart failure patients, and volume overload in heart failure is associated with poorer outcomes. Fluid removal during the hemodialysis (HD) is the cornerstone of volume management in this population. The objective of this study is to assess the long-term prognostic effect of interdialytic fluid retention (IDFR) and its relationship with cardiovascular (CV) events in incident HD patients who newly started dialysis. IDFR is defined as the difference between the predialysis weight and the weight at the end of the previous dialysis session, and it mainly reflects the consequence of salt and water intake between two consecutive dialysis sessions. We retrospectively reviewed the 172 patients who newly started and maintained HD over 6 months at Gachon University Gil Hospital between 1 January 2003 and 31 December 2008. The average data were collected for 3 months during the beginning period, including total IDFR and IDFR/dry weight (IDFR%), nutritional parameters, blood pressure, and other biochemical parameters. Patients were classified into 3 cohorts according to the tertile of IDFR%; low (T1; ≤ 3.21%), intermediate (T2; 3.21%-4.56%), and high (T3; ≥ 4.56%). The high IDFR% group showed higher prevalence of diabetes and better nutritional status. The adjusted odds ratio for CV events was 1.562 (95% confidence interval, 1.026-2.378) for high IDFR% group, compared with the low IDFR% group. In incident HD patients, greater IDFR% soon after HD initiation showed an independent association with higher risk for CV events.
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- 2012
42. The effect of renin-angiotensin-aldosterone system blockade on contrast-induced acute kidney injury: a propensity-matched study
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Hyun Hee Lee, Jae Hyun Chang, Min Young Rim, Ji Yong Jung, Ae Jin Kim, Han Ro, Wookyung Chung, Woong Chol Kang, and Hyeonsu Park
- Subjects
Male ,medicine.medical_specialty ,Angiotensin receptor ,medicine.medical_treatment ,Urology ,Contrast Media ,Angiotensin-Converting Enzyme Inhibitors ,urologic and male genital diseases ,Coronary Angiography ,law.invention ,Renin-Angiotensin System ,chemistry.chemical_compound ,Angiotensin Receptor Antagonists ,Percutaneous Coronary Intervention ,Randomized controlled trial ,law ,Medicine ,Humans ,Propensity Score ,Aged ,Retrospective Studies ,Creatinine ,business.industry ,Acute kidney injury ,Percutaneous coronary intervention ,Retrospective cohort study ,Acute Kidney Injury ,Middle Aged ,medicine.disease ,Survival Analysis ,female genital diseases and pregnancy complications ,Surgery ,chemistry ,Nephrology ,ACE inhibitor ,Propensity score matching ,Multivariate Analysis ,Female ,business ,medicine.drug - Abstract
The role of the angiotensin-converting enzyme (ACE) inhibitor and angiotensin receptor blocker (ARB) in the pathophysiology of contrast-induced acute kidney injury (AKI) is controversial, and the available literature is contradictory.A retrospective propensity score-matched study to analyze the effect of ACE-inhibitor/ARB therapy on the development of contrast-induced AKI.Using propensity score matching, 1,322 ACE-inhibitor/ARB recipients and nonrecipients were paired for analysis from 5,299 patients and fulfilled the inclusion criteria among 11,447 patients receiving coronary angiography (CAG) or percutaneous coronary intervention.ACE-inhibitor/ARB use based on prescription and risk factors for contrast-induced AKI.The incidence of contrast-induced AKI defined by AKI Network (AKIN) criteria: an absolute increase in serum creatinine levels ≥0.3 mg/dL or a relative increase ≥50% from baseline values within 48 hours after exposure to the contrast medium.Baseline serum creatinine, hemoglobin, and albumin levels; volume of contrast agents; preprocedural medication; and post-CAG serum creatinine levels.An ACE inhibitor/ARB was prescribed for 64.0% of patients receiving CAG. ACE-inhibitor/ARB users showed an increased incidence of contrast-induced AKI after propensity score matching (11.4% vs 6.3%; P0.001). In multivariable analysis, use of ACE inhibitors/ARBs remained an independent and significant predictor of contrast-induced AKI in an unmatched cohort (OR, 1.39; 95% CI, 1.10-1.76; P = 0.06). In the matched cohort, use of ACE inhibitors/ARBs also was associated with a higher adjusted OR of contrast-induced AKI (OR, 1.43; 95% CI, 1.06-1.94; P = 0.02).A retrospective study at a single center.Use of ACE inhibitors/ARBs during CAG has a possible influence to increase the incidence of contrast-induced AKI. Further randomized clinical trials are warranted to confirm the effect of ACE-inhibitor/ARB therapy on the development of contrast-induced AKI.
- Published
- 2011
43. Study on the relationship between serum 25-hydroxyvitamin D levels and vascular calcification in hemodialysis patients with consideration of seasonal variation in vitamin D levels
- Author
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Sejoong Kim, Jae Hyun Chang, Hyun Hee Lee, Han Ro, Wookyung Chung, and Ji Yong Jung
- Subjects
Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Physiology ,Risk Assessment ,vitamin D deficiency ,Renal Dialysis ,Risk Factors ,Internal medicine ,Diabetes mellitus ,Republic of Korea ,medicine ,Vitamin D and neurology ,Prevalence ,Humans ,Prospective Studies ,Vitamin D ,Prospective cohort study ,Vascular Calcification ,Aged ,Univariate analysis ,Chi-Square Distribution ,business.industry ,Confounding ,Middle Aged ,medicine.disease ,Vitamin D Deficiency ,Radiography ,Endocrinology ,Blood pressure ,Logistic Models ,Multivariate Analysis ,Female ,Hemodialysis ,Seasons ,Cardiology and Cardiovascular Medicine ,business ,Biomarkers - Abstract
Background/aims The aim of this study was to determine the prevalence of vitamin D deficiency in hemodialysis (HD) patients and the relationship between seasonal variations in vitamin D levels and vascular calcification. Methods As a prospective observational study, we analyzed 289 HD patients. We have assessed serum 25-hydroxyvitamin D (25D) levels at the end of the summer (September) and winter (March) and analyzed the data to reveal the association of serum 25D level with vascular calcification scores (VCS) at the end of the summer, when vitamin D levels were found to peak. Plan X-ray images of lateral lumbar spine from all subjects were studied for calculation of semiquantitative VCS as described by Kauppila. Results The prevalence of 25D deficiency was 86.2% at the end of the summer and increased to 96.2% at the end of the winter. Female gender and diabetes were associated with vitamin D deficiency. According to univariate analysis, 25D levels were inversely related to vascular calcification. However, after correcting for confounding factors, this relationship lost statistical significance. Multivariate analysis showed that age, systolic blood pressure, and LDL-cholesterol levels were directly associated with a higher VCS. Conclusion Vitamin D deficiency was highly prevalent in HD patients with marked seasonal variation. However, low 25D levels could not be identified as an independent predictor of vascular calcification in these patients.
- Published
- 2011
44. Serum resistin as a novel marker of erythropoietin resistance in nondiabetic patients on hemodialysis
- Author
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Sejoong Kim, Ji Yong Jung, Jae Hyun Chang, Hyun Hee Lee, Kwon-Wook Joo, and Wookyung Chung
- Subjects
Male ,medicine.medical_specialty ,Heart disease ,Anemia ,medicine.medical_treatment ,Drug Resistance ,Adipokine ,General Biochemistry, Genetics and Molecular Biology ,Renal Dialysis ,Internal medicine ,Diabetes Mellitus ,Medicine ,Humans ,Resistin ,Erythropoietin ,Dialysis ,business.industry ,General Medicine ,Middle Aged ,medicine.disease ,Endocrinology ,Linear Models ,Female ,Hemoglobin ,Hemodialysis ,business ,Biomarkers ,medicine.drug - Abstract
The use of higher erythropoietin (EPO) doses is associated with an increased risk of an adverse outcome and increased mortality in patients with renal failure. Resistin is related to heart disease, and may contribute to an increased atherosclerotic risk. We hypothesized that a link between resistin and EPO responsiveness may exist. We therefore investigated the relationship between resistin and the EPO resistance index (ERI) in nondiabetic hemodialysis (HD) patients. Fifty-seven patients enrolled in the study underwent HD for ≥ 3 months and intravenous EPO therapy to maintain a target hemoglobin (Hb) level of 11.0 g/dl. The ERI was defined as the weekly EPO dose per unit Hb per body weight. The mean patient age was 52.6 ± 11.9 years and the mean time on dialysis was 4.9 ± 4.4 years. Serum Hb and ERI were 10.4 ± 0.7 g/dl, and 13.3 ± 7.0 (IU/kg/week/g/dl), respectively. Serum resistin levels were 23.6 ± 9.3 μg/L. EPO resistance is associated with low body mass index (BMI) (coefficient β =−0.393, p = 0.002) and with high serum resistin levels (coefficient β = 0.332, p = 0.018). According to a multiple regression analysis, the serum resistin level was a significant independent factor related to EPO resistance (p = 0.017). The results suggest that serum resistin levels reflect EPO responsiveness in nondiabetic HD patients. Resistin may therefore be considered as a new marker of EPO responsiveness in HD patients.
- Published
- 2011
45. Serial testing of interferon-gamma-release assays for the diagnosis of latent tuberculosis in hemodialysis patients
- Author
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Hyun Hee Lee, Jin Woong Park, Jaeseok Yang, Woo Kyung Chung, Ji Yong Jeong, Jae Hyun Chang, Hyun Joo Lee, Hyung Soo Kim, Sejoong Kim, and Zhen Long Zheng
- Subjects
Microbiology (medical) ,Adult ,Male ,medicine.medical_specialty ,Tuberculosis ,Adolescent ,medicine.medical_treatment ,Tuberculin ,Gastroenterology ,Interferon-gamma ,Young Adult ,Interferon γ ,Latent Tuberculosis ,Renal Dialysis ,Internal medicine ,medicine ,Humans ,Renal Insufficiency ,Aged ,Aged, 80 and over ,Immunoassay ,Bacteriological Techniques ,Latent tuberculosis ,business.industry ,Odds ratio ,Skin test ,Middle Aged ,bacterial infections and mycoses ,medicine.disease ,Confidence interval ,Infectious Diseases ,Immunology ,Female ,Hemodialysis ,business - Abstract
Summary Introduction The performance of serial interferon-γ-release assays (IGRAs) for the diagnosis of latent tuberculosis has not been studied in hemodialysis patients. Method The QuantiFERON-TB-Gold In-Tube test (QFT) and T-SPOT-TB test (TSPOT) were performed 1 year after initial testing at a hemodialysis center. Results Ninety-eight patients were included in the final analysis. Positive rates for the initial tuberculin skin test (TST), QFT and TSPOT were 26.5%, 43.9% and 58.2%, respectively. The follow-up QFT and TSPOT showed positive responses in 52.0% and 53.1%. Conversion rates of the QFT and TSPOT were 20.0% and 26.8%. Reversion rates of the QFT and TSPOT were 16.3% and 29.8%; however, they decreased to 0.0% and 4.8% in patients with a concordantly positive response at the initial TST. A group at high risk for latent tuberculosis increased the risk for the TSPOT conversion [odds ratio (95% confidence interval), 7.76 (1.27–47.40)] and showed a trend of increasing the risk for the QFT conversion [1.97 (0.45–8.71)]. Reversion of both the QFT [18.92 (2.01–178.65)] and TSPOT [6.16 (1.57–24.19)] occurred more frequently in the group at low risk. Conclusions Both conversion and reversion of the IGRAs were associated with the risk for latent tuberculosis in hemodialysis patients. However, serial IGRAs results should be interpreted cautiously due to their high variability.
- Published
- 2010
46. Genetic polymorphisms of hypoxia-inducible factor-1 alpha and cardiovascular disease in hemodialysis patients
- Author
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Min Jung Son, Kwon-Wook Joo, Jaeseok Yang, Woo Kyung Chung, Young Hwan Hwang, Sejoong Kim, Zhen Lon Zheng, Han Ro, Seong Kyun Kim, Hyun Hee Lee, and Su Ah Sung
- Subjects
Adult ,Male ,medicine.medical_specialty ,Linkage disequilibrium ,Adolescent ,Anemia ,medicine.medical_treatment ,Ischemia ,Single-nucleotide polymorphism ,Comorbidity ,Polymorphism, Single Nucleotide ,Risk Assessment ,Young Adult ,Renal Dialysis ,Risk Factors ,Internal medicine ,medicine ,Humans ,Genetic Predisposition to Disease ,Myocardial infarction ,Aged ,Aged, 80 and over ,Korea ,business.industry ,Incidence ,Haplotype ,General Medicine ,Odds ratio ,Middle Aged ,medicine.disease ,Hypoxia-Inducible Factor 1, alpha Subunit ,Surgery ,Nephrology ,Cardiovascular Diseases ,Kidney Failure, Chronic ,Female ,Hemodialysis ,business - Abstract
Background: Hemodialysis patients are prone to ischemic events potentially aggravated by hypoxia. The key player in adaptation to hypoxia is hypoxia-inducible factor-1 alpha (HIF-1α). Therefore, we investigated the association of HIF-1α polymorphisms with ischemia/hypoxia-related events in hemodialysis patients. Methods: Patients on maintenance hemodialysis were enrolled from 4 training hospitals in Korea. Seven single nucleotide polymorphisms (SNP) of HIF-1α were genotyped. The association of these SNP with hypoxia-related clinical outcomes (ischemic diseases and anemia) and cancer was analyzed. Results: A total of 376 patients participated in the study. No significant difference in genotype distribution was found between subjects with and without the hypoxia-related events. Three sets of linkage disequilibrium blocks were made for haplotype analyses (rs2783778 and rs7148720 in 5′ upstream region; rs7143164 and rs10873142; rs2301113, rs11549465 and rs2057482). Of these, the CT haplotype in the first set was associated with both acute myocardial infarction and frequent intradialytic hypotension (acute myocardial infarction: adjusted odds ratio = 0.15, 95% CI: 0.03–0.69; frequent intradialytic hypotension: adjusted odds ratio = 0.29, 95% CI: 0.12–0.72). Conclusion: Genetic polymorphisms of HIF-1α were associated with acute myocardial infarction and intradialytic hypotension in hemodialysis patients.
- Published
- 2008
47. SP730THE ASSOCIATION BETWEEN HEPATITIS B VIRUS INFECTION AND MORTALITY IN INCIDENT END-STAGE RENAL DISEASE PATIENTS
- Author
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Wookyung Chung, Han Ro, Hyun Hee Lee, Ae Jin Kim, Jae Hyun Chang, Ji Yong Jung, and Eul Sik Jung
- Subjects
Hepatitis B virus ,Transplantation ,medicine.medical_specialty ,Nephrology ,business.industry ,Internal medicine ,medicine ,business ,medicine.disease_cause ,Gastroenterology ,End stage renal disease - Published
- 2015
48. SP194PREVALENT USE OF RENIN-ANGIOTENSIN SYSTEM BLOCKADE IS ASSOCIATED WITH INCREASED RISK FOR ACUTE KIDNEY INJURY IN CRITICALLY ILL PATIENTS
- Author
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Chungsik Lee, Jae Hyun Chang, Ae Jin Kim, Ji Yong Jung, Eul Sik Jung, Han Ro, Wookyung Chung, and Hyun Hee Lee
- Subjects
Transplantation ,Renin angiotensin system blockade ,medicine.medical_specialty ,Increased risk ,Nephrology ,Critically ill ,business.industry ,Acute kidney injury ,medicine ,medicine.disease ,Intensive care medicine ,business - Published
- 2015
49. IgG4-Related Systemic Disease Can Be Easily Mistaken as a Uroepithelial Tumor
- Author
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Wookyung Chung, Song Yi Han, Ji Yong Jung, Jae Hyun Chang, Yeon Hee Lee, Hye Jin Lim, Hyun Hee Lee, Han Ro, Ae Jin Kim, and Seung ik Lee
- Subjects
Systemic disease ,Pathology ,medicine.medical_specialty ,Case Report ,Disease ,Kidney ,Immunoglobulin G ,parasitic diseases ,Biopsy ,medicine ,skin and connective tissue diseases ,Sclerosis ,integumentary system ,biology ,medicine.diagnostic_test ,business.industry ,fungi ,General Engineering ,medicine.disease ,medicine.anatomical_structure ,biology.protein ,Antibody ,Differential diagnosis ,business ,Infiltration (medical) - Abstract
Immunoglobulin G4-related disease (IgG4-RD) is a newly recognized systemic syndrome characterized by elevated serum IgG4 concentrations and tumefaction or tissue infiltration by IgG4-positive plasma cells. We experienced a case of IgG4-RD involving multiple organs in a 64-year-old female who was referred for a suspected uroepithelial tumor. A mass biopsy confirmed dense lymphoplasmacytic infiltration with an increased number of IgG4-positive plasma cells. We discuss this case and review the literature to bring IgG4-RD to the attention to clinicians because it responds dramatically well to steroid therapy and should be kept in mind as a differential diagnosis to avoid unnecessary surgery.
- Published
- 2015
50. A sudden decline in active membrane-bound TGF-beta impairs both T regulatory cell function and protection against autoimmune diabetes
- Author
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Rohit D. Divekar, Habib Zaghouani, Randal K. Gregg, Scott J. Schoenleber, Ping Yu, Renu Jain, J. Jeremiah Bell, and Hyun-Hee Lee
- Subjects
medicine.medical_specialty ,Aging ,Immunology ,Glutamate decarboxylase ,Molecular Sequence Data ,Down-Regulation ,Epitopes, T-Lymphocyte ,chemical and pharmacologic phenomena ,Nod ,Mice, SCID ,Biology ,medicine.disease_cause ,T-Lymphocytes, Regulatory ,Epitope ,Autoimmunity ,Mice ,Mice, Inbred NOD ,Transforming Growth Factor beta ,Internal medicine ,Diabetes mellitus ,medicine ,Immunology and Allergy ,Animals ,IL-2 receptor ,Amino Acid Sequence ,Mice, Knockout ,Glutamate Decarboxylase ,Peripheral tolerance ,Membrane Proteins ,hemic and immune systems ,Cell Differentiation ,medicine.disease ,Clone Cells ,Endocrinology ,Diabetes Mellitus, Type 1 ,Female ,Peptides ,Insulitis - Abstract
Autoimmunity presumably manifests as a consequence of a shortfall in the maintenance of peripheral tolerance by CD4+CD25+ T regulatory cells (Tregs). However, the mechanism underlying the functional impairment of Tregs remains largely undefined. In this study a glutamic acid decarboxylase (GAD) diabetogenic epitope was expressed on an Ig to enhance tolerogenic function, and the resulting Ig-GAD expanded Tregs in both young and older insulitis-positive, nonobese diabetic (NOD) mice, but delayed autoimmune diabetes only in the former. Interestingly, Tregs induced at 4 wk of age had significant active membrane-bound TGF-β (mTGF-β) and sustained protection against diabetes, whereas Tregs expanded during insulitis had minimal mTGF-β and could not protect against diabetes. The Tregs probably operate suppressive function through mTGF-β, because Ab blockade of mTGF-β nullifies protection against diabetes. Surprisingly, young Tregs that modulated pathogenic T cells maintained stable frequency over time in the protected animals, but decreased their mTGF-β at the age of 8 wk. More strikingly, these 8-wk-old mTGF-β-negative Tregs, which were previously protective, became unable to confer resistance against diabetes. Thus, a developmental decline in active mTGF-β nullifies Treg function, leading to a break in tolerance and the onset of diabetes.
- Published
- 2004
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