1.Major Adverse Cardiovascular Events in Korean Congenital Heart Disease Patients:A Nationwide Age- and Sex-Matched Case-Control Study
Jue Seong LEE ; Jin-Man JUNG ; Jongun CHOI ; Woo-Keun SEO ; Hong Ju SHIN
Yonsei Medical Journal 2022;63(12):1069-1077
Purpose:
Congenital heart disease (CHD) is a known risk factor for acquired cardiovascular and cerebrovascular diseases. However, available evidence on CHD is limited mostly to Western populations. This study aimed to evaluate the prevalence of vascular events and all-cause mortality in Korean patients with CHD and to further corroborate CHD as a predictor of vascular events and all-cause mortality.
Materials and Methods:
The claims data of the Korean National Health Insurance Service (NHIS) were retrospectively reviewed. Information regarding diagnostic codes, comorbidities, medical services, income level, and residential area was also collected. Outcomes of interest included stroke, myocardial infarction (MI), all-cause mortality, and major adverse cardiovascular events (MACE).
Results:
We included 232203 patients with CHD and 3024633 individuals without CHD as a control group through age- and sexmatched 1:10 random sampling. The prevalences of hypertension, congestive heart failure, ischemic heart disease, hyperlipidemia, and atrial fibrillation were significantly higher in the CHD group, which had a more than two-fold higher incidence of vascular events and all-cause mortality, than in the group without CHD. Multivariable models demonstrated that CHD was a significant risk factor for stroke, MI, all-cause mortality, and MACE.
Conclusion
In conclusion, this nationwide study demonstrates that Korean patients with CHD have a high incidence of comorbidities, vascular events, and mortality. CHD has been established as an important predictor of cardiovascular events. Further studies are warranted to identify high-risk patients with CHD and related factors to prevent vascular events.
2.Effects of Tempol on Blood Pressure and Tissue Oxidative Stress in DOCA-alt and L-AME-nduced Hypertension.
Young Wook CHO ; Jung Won CHO ; Eun Hee BAE ; Soo Wan KIM ; Seong Kwon MA ; Ki Chul CHOI ; JongUn LEE
Korean Journal of Nephrology 2006;25(4):525-531
BACKGROUND: Effects of oxidative stress on the development of deoxycorticosterone acetate (DOCA)-salt or N(G)-nitro-L-arginine (L-NAME) hypertension were examined. METHODS: Male Sprague-awley rats were treated with DOCA (200 mg/kg, subcutaneous)-salt or L-NAME (40 mg/L in daily drinking water) for 4 weeks. To reduce the oxidative stress, 4-hydroxyl-2,2,6,6-tetramethylpiperidine-1-oxyl (Tempol, 3 mM/L) was cotreated in drinking water. The expression of endothelial nitric oxide synthase (eNOS) and nitrotyrosine proteins was determined in the renal cortex and thoracic aorta. RESULTS: Tempol prevented the development of DOCA-salt hypertension, whereas it was without effect on L-NAME hypertension. In DOCA-salt hypertension, the eNOS expression in the renal cortex was increased, the degree of which was attenuated by Tempol. The renal expression of nitrotyrosine was decreased, which was further decreased by Tempol. In the aorta, the expression of both eNOS and nitrotyrosine was decreased, which was not further affected by Tempol. In L-NAME hypertension, the renal expression of eNOS was significantly increased, which was blocked by Tempol. The expression of eNOS in the aorta was slightly decreased, and was not further affected by Tempol. The renal expression of nitrotyrosine was not significantly altered. However, its expression was significantly decreased in the aorta, and was further reduced by Tempol. CONCLUSION: The blockade of oxidative stress may attenuate the development of hypertension and provide tissue protection in DOCA-salt hypertension. The blockade of oxidative stress may also contribute to a tissue protection in L-NAME hypertension.
Animals
;
Aorta
;
Aorta, Thoracic
;
Blood Pressure*
;
Desoxycorticosterone
;
Desoxycorticosterone Acetate
;
Drinking
;
Drinking Water
;
Humans
;
Hypertension*
;
Male
;
NG-Nitroarginine Methyl Ester
;
Nitric Oxide Synthase
;
Nitric Oxide Synthase Type III
;
Oxidative Stress*
;
Rats
3.Blockade of Nitric Oxide Synthesis Further Diminishes Aquaporin Water Channels in Rat Kidney Subjected to Ischemia/reperfusion Injury.
Seong Kwon MA ; Yoon Wha OH ; Choonsoon PARK ; Youn Kyoung LEE ; Soo Wan KIM ; Nam Ho KIM ; Ki Chul CHOI ; JongUn LEE
Korean Journal of Nephrology 2006;25(1):7-12
BACKGOUND: The present study examined whether a blockade of nitric oxide (NO) synthesis affects the regulation of aquaporin (AQP) water channels in rats subjected to renal ischemia/reperfusion (I/R). METHODS: Renal I/R was experimentally induced by clamping the left renal artery for 60 minutes in rats. The rats were kept for 7 days thereafter, during which they were supplied with tap water containing NG-nitro-L-arginine methyl ester (L-NAME, 100 mg/L). The expression of AQP1-3 was determined in the kidney by Western blot analysis. RESULTS: In renal I/R injury, the expression of AQP2 was significantly decreased. The treatment with L-NAME further diminished the expression of AQP2. Although the expression of either AQP1 or AQP3 was not significantly altered in the kidney subjected to I/R, it was also significantly decreased by the treatment with L-NAME. CONCLUSION: It is suggested that endogenous NO system should play a role in the regulation of AQP water channels in rat kidney subjected to I/R injury.
Animals
;
Aquaporins*
;
Blotting, Western
;
Constriction
;
Ischemia
;
Kidney*
;
NG-Nitroarginine Methyl Ester
;
Nitric Oxide*
;
Rats*
;
Renal Artery
;
Reperfusion
4.Effects of BCG infection on Schultz-Dale reaction, allergen-specific IgE levels, and Th2 immune response in sensitized rats.
Young I KOH ; In Seon CHOI ; Won Young KIM ; Hyun Chul LEE ; Jongun LEE
The Korean Journal of Internal Medicine 2001;16(3):180-186
BACKGROUND: BCG, a potent inducer of Th1 immune response, has been suggested to suppress Th2 response which is known to mediate IgE-mediated allergic disorders, in particular allergic asthma. Schultz-Dale reaction is known to be a model of IgE-mediated hypersensitivity. This study was done to investigate whether BCG infection suppresses the Schultz-Dale reaction by inhibiting Th2 response and allergen-specific IgE production. METHODS: Twenty-four Sprague-Dawley rats were sensitized and provoked with ovalbumin (OVA). A pretreatment of 6 x 10(4) colony forming units of BCG or saline was done 7 days before sensitization. The Schultz-Dale reaction was represented as tracheal smooth muscle contractions to 50 micrograms/mL OVA challenge in vitro. Serum OVA-specific IgE levels and IFN-gamma and IL-4 concentrations in bronchoalveolar lavage fluid (BALF) were measured. RESULTS: The Schultz-Dale reaction and serum OVA-specific IgE levels were significantly decreased in BCG infected and OVA sensitized rats compared with only sensitized rats (p < 0.01 and p < 0.05, respectively). As compared with only sensitized rats, IL-4 concentration and a ratio of IFN-gamma:IL-4 in BCG infected and OVA sensitized rats were significantly decreased (p < 0.001) and increased (p < 0.05), respectively. The Schultz-Dale reaction was correlated with OVA-specific IgE levels (r = 0.50, p < 0.05), IL-4 concentration (r = 0.69, p < 0.001), and ratio of IFN-:IL-4 (r = -0.44, p < 0.05). OVA-specific IgE levels were correlated with IL-4 concentration (r = 0.61, p < 0.01) and ratio of IFN-gamma:IL-4 (r = -0.48, p < 0.05). CONCLUSION: These findings suggest that BCG infection prior to allergen sensitization may inhibit Schultz-Dale reaction developed in the sensitized rat tracheal smooth muscle via the suppressive effects of Th2 immune response and allergen-specific IgE production.
Animal
;
Bronchial Provocation Tests
;
Bronchoalveolar Lavage Fluid/*chemistry
;
Comparative Study
;
Cytokines/analysis
;
Disease Models, Animal
;
Hypersensitivity, Immediate/*immunology
;
Immunization
;
Immunoglobulin E/*analysis
;
Male
;
Mycobacterium bovis/*immunology
;
Probability
;
Rats
;
Rats, Sprague-Dawley
;
Reference Values
;
Sensitivity and Specificity
;
T-Lymphocytes/*immunology
;
Tuberculosis/*immunology/veterinary
5.Increased Phosphorylation of PI3K/Akt/mTOR in the Obstructed Kidney of Rats with Unilateral Ureteral Obstruction
Seong Kwon MA ; Soo Yeon JOO ; Chang Seong KIM ; Joon Seok CHOI ; Eun Hui BAE ; Jongun LEE ; Soo Wan KIM
Chonnam Medical Journal 2013;49(3):108-112
The present study aimed to investigate changes in the mammalian target of rapamycin (mTOR) signaling pathway in the obstructed kidney of rats with unilateral ureteral obstruction (UUO). Male Sprague-Dawley rats were unilaterally obstructed by ligation of the left proximal ureter for 7 days. Control rats were treated in the same way except that no ligature was made. The expression levels of phosphorylated phosphatidylinositol 3-kinase (PI3K), Akt, and mTOR were determined in the kidney by semiquantitative immunoblotting. The protein expression levels of transforming growth factor (TGF)-beta1, Bax, and Bcl-2 were also determined in the kidney. The phosphorylation of PI3K, Akt, and mTOR was increased in the kidney of ureteral obstruction rats compared with the control. In the obstructed kidney, the protein expression of TGF-beta1 and Bax was also increased, whereas Bcl-2 expression was decreased. In conclusion, the phosphorylation of PI3K/Akt/mTOR was increased in the obstructed kidney of rats with UUO.
Animals
;
Apoptosis
;
Fibrosis
;
Humans
;
Immunoblotting
;
Kidney
;
Ligation
;
Male
;
Phosphatidylinositol 3-Kinase
;
Phosphorylation
;
Rats
;
Rats, Sprague-Dawley
;
Sirolimus
;
Transforming Growth Factor beta1
;
Transforming Growth Factors
;
Ureter
;
Ureteral Obstruction