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153. Concomitant renal insufficiency and diabetes mellitus as prognostic factors for acute myocardial infarction

Author

Kim Chang Seong, Choi Joon Seok, Park Jeong Woo, Bae Eun Hui, Ma Seong Kwon, Jeong Myung Ho, Kim Young Jo, Cho Myeong Chan, Kim Chong Jin, and Kim Soo Wan

Subjects
acute myocardial infarction, diabetes mellitus, major adverse cardiac events, renal insufficiency, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Abstract Background Diabetes mellitus and renal dysfunction are prognostic factors after acute myocardial infarction (AMI). However, few studies have assessed the effects of renal insufficiency in association with diabetes in the context of AMI. Here, we investigated the clinical outcomes according to the concomitance of renal dysfunction and diabetes mellitus in patients with AMI. Methods From November 2005 to August 2008, 9905 patients (63 ± 13 years; 70% men) with AMI were enrolled in a nationwide prospective Korea Acute Myocardial Infarction Registry (KAMIR) and were categorized into 4 groups: Group I (n = 5700) had neither diabetes nor renal insufficiency (glomerular filtration rate [GFR] ≥ 60 ml/min/1.73 m2), Group II (n = 1730) had diabetes but no renal insufficiency, Group III (n = 1431) had no diabetes but renal insufficiency, and Group IV (n = 1044) had both diabetes and renal insufficiency. The primary endpoints were major adverse cardiac events (MACE), including a composite of all cause-of-death, myocardial infarction, target lesion revascularization, and coronary artery bypass graft after 1-year clinical follow-up. Results Primary endpoints occurred in 1804 (18.2%) patients. There were significant differences in composite MACE among the 4 groups (Group I, 12.5%; Group II, 15.7%; Group III, 30.5%; Group IV, 36.5%; p < 0.001). In a Cox proportional hazards model, after adjusting for multiple covariates, the 1-year mortality increased stepwise from Group III to IV as compared with Group I (hazard ratio [HR], 1.96; 95% confidence interval [CI], 1.34-2.86; p = 0.001; and HR, 2.42; 95% CI, 1.62-3.62; p < 0.001, respectively). However, Kaplan-Meier analysis showed no significant difference in probability of death at 1 year between Group III and IV (p = 0.288). Conclusions Renal insufficiency, especially in association with diabetes, is associated with the occurrence of composite MACE and indicates poor prognosis in patients with AMI. Categorization of patients with diabetes and/or renal insufficiency provides valuable information for early-risk stratification of AMI patients.

Published
2011
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170. Eight-Year Clinical Follow-Up of Sinus Grafts with Micro-Macroporous Biphasic Calcium Phosphate Granules

Author

Kim Sung Cho, Claire Daculsi, Elodie Seris, Kim Chang Seong, and Daculsi Guy

Subjects
Synthetic bone graft material, Materials science, business.industry, Mechanical Engineering, Dentistry, Biphasic calcium phosphate, Height loss, Resorption, medicine.anatomical_structure, Mechanics of Materials, medicine, General Materials Science, Bone height, Bone regeneration, business, Sinus (anatomy), Dental alveolus, Biomedical engineering
Abstract

Restoring alveolar bone following tooth extraction or pathological diseases is important, and recent efforts have been made to overcome the use of autografts during dental implantation. Although micro-macroporous biphasic calcium phosphate (MBCPTM) has performed well in orthopedic procedures, few studies have investigated its use in dentistry. Here, we report a greater than eight-year clinical follow-up of bone regeneration using MBCPTM after sinus grafting. MBCPTM technology is a unique mixture of hydroxyapatite and β-tricalcium phosphate, which displays both macroporosity and microporosity. A total of 25 patients (33 implantation sites) were evaluated by X-rays, and their pre-operative and immediate post-operative bone heights were measured. After approximately six months, dental implantation was performed. Subsequently, X rays were performed each year, and bone height was measured. In all cases, radio-opacity of the implantation area decreased with time, indicating resorption and bone ingrowth at the expense of the MBCPTM material. After one year, the implantation area had the appearance of physiological bone and

Published
2013

185. Tamoxifen ameliorates obstructive nephropathy through Src and the PI3K/Akt/mTOR pathway.

Author

Kim, Chang Seong, Kim, In Jin, Choi, Joon Seok, Bae, Eun Hui, Ma, Seong Kwon, and Kim, Soo Wan

Subjects
*TAMOXIFEN, *CHRONIC kidney failure, *ESTROGEN receptors, *TRANSFORMING growth factors-beta, *PHOSPHOINOSITIDES
Abstract

Background information: Tubulointerstitial fibrosis is the end‐point of chronic kidney diseases. Tamoxifen, a selective oestrogen receptor (ER) modulator, attenuates renal fibrosis, by regulating the transforming growth factor (TGF)‐β/Smad signalling. Src and phosphoinositide 3‐kinase (PI3K)/Akt pathways play critical roles in the pathogenesis of renal fibrosis. However, the activation of the non‐canonical TGF‐β signalling in renal fibrosis after treatment with tamoxifen remains unclear. Renal fibrosis was induced by unilateral ureteral obstruction (UUO) in rats. Tamoxifen was orally administered after UUO. Additionally, HK‐2 cells were treated with tamoxifen in the presence or absence of TGF‐β1. The selective ER down‐regulator ICI and ER‐α silencing were used to confirm the involvement of ER‐α on the effect of tamoxifen on TGF‐β1‐stimulated fibrosis in HK‐2 cells. Results: Tamoxifen treatment ameliorated UUO‐induced renal fibrosis as shown by decreased expression of α‐smooth muscle actin (SMA), fibronectin and connective tissue growth factor (CTGF). The phosphorylation of Src, PI3K, Akt, mammalian target of rapamycin (mTOR) and p70S6K significantly decreased in UUO kidneys from tamoxifen‐treated animals. Tamoxifen dose‐dependently suppressed the TGF‐β1‐induced expression of α‐SMA and CTGF, and phosphorylation of Src, PI3K, Akt, mTOR and p70S6K in HK‐2 cells. These anti‐fibrotic effects were reversed by treatment with ICI and silencing of ER‐α. Moreover, inhibition of the PI3K/Akt and mTOR/p70S6K pathways was observed in HK‐2 cells co‐treated with PP1 (a Src kinase inhibitor) and tamoxifen. Conclusions: The anti‐fibrotic effects of tamoxifen are associated with the suppression of Src kinase function via ER‐α, followed by inhibition of the PI3K/Akt and mTOR/p70S6K signalling pathways. Significance: Our findings suggest that tamoxifen is a novel therapeutic option for the prevention and treatment of renal fibrosis. Research Article: Our results demonstrated that phosphorylation of Src kinase in the obstructive kidney medicates renal fibrosis by activation of PI3K/Akt and mTOR/p70S6K signalling pathway, and treatment of tamoxifen has anti‐fibrotic effect on renal fibrosis by suppressing these pathways. In addition, our in vitro results suggested that anti‐fibrotic effect and its downstream signalling pathway were attenuated by tamoxifen in an ER‐α‐dependent manner. However, at present, it remains difficult to determine whether tamoxifen acts as anti‐oestrogenic or oestrogenic effect in our study. [ABSTRACT FROM AUTHOR]

Published
2019
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199. Association between vitamin D deficiency and health-related quality of life in patients with chronic kidney disease from the KNOW-CKD study.

Author

Oh, Tae Ryom, Kim, Chang Seong, Bae, Eun Hui, Ma, Seong Kwon, Han, Seung Hyeok, Sung, Su-Ah, Lee, Kyubeck, Oh, Kook Hwan, Ahn, Curie, Kim, Soo Wan, and null, null

Subjects
*CHRONIC kidney failure, *VITAMIN D deficiency, *HEMODIALYSIS, *GLOMERULAR filtration rate, *QUALITY of life
Abstract

Vitamin D deficiency is a growing health problem in both the general population and in patients with chronic kidney disease (CKD). However, the relationship between serum 25-hydroxyvitamin D levels and health-related quality of life in CKD is not well established. This study examined the association between vitamin D deficiency and quality of life in pre-dialysis CKD patients. Serum 25-hydroxyvitamin D levels and the Korean version of the Kidney Disease Quality of Life short form were obtained for 1844 pre-dialysis CKD patients in the prospective KoreaN cohort Study for Outcomes in patients With Chronic Kidney Disease (KNOW-CKD). The baseline estimated glomerular filtration rate was 50.26 ± 0.71 mL/min/1.73 m2. We identified 1294 (70.2%) patients with vitamin D deficiency, defined as a 25-hydroxyvitamin D level < 20 ng/ml. The scores of the kidney disease component summary, physical component summary, and mental component summary in the vitamin D deficiency group were significantly lower compared to the scores of those without vitamin D deficiency. The serum 25-hydroxyvitamin D level was independently associated with the kidney disease component summary and mental component summary scores (β = 0.147, p = 0.003 and β = 0.151, p = 0.047). In conclusion, there was a significant association between serum 25-hydroxyvitamin D levels and kidney disease component summary and mental component summary scores in pre-dialysis CKD patients. [ABSTRACT FROM AUTHOR]

Published
2017
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