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Can Tissue Cilia Lengths and Urine Cilia Proteins Be Markers of Kidney Diseases?.

Chonnam Medical Journal.2018;54(2):83-89. doi:10.4068/cmj.2018.54.2.83

The primary cilium is an organelle which consists of a microtubule in the core and a surrounding cilia membrane, and has long been recognized as a “vestigial organelle”. However, new evidence demonstrates that the primary cilium has a notable effect on signal transduction in the cell and is associated with some genetic and non-genetic diseases. In the kidney, the primary cilium protrudes into the Bowman's space and the tubular lumen from the apical side of epithelial cells. The length of primary cilia is dynamically altered during the normal cell cycle, being shortened by retraction into the cell body at the entry of cell division and elongated at differentiation. Furthermore, the length of primary cilia is also dynamically changed in the cells, as a result and/or cause, during the progression of various kidney diseases including acute kidney injury and chronic kidney disease. Notably, recent data has demonstrated that the shortening of the primary cilium in the cell is associated with fragmentation, apart from retraction into the cell body, in the progression of diseases and that the fragmented primary cilia are released into the urine. This data reveals that the alteration of primary cilia length could be related to the progression of diseases. This review will consider if primary cilia length alteration is associated with the progression of kidney diseases and if the length of tissue primary cilia and the presence or increase of cilia proteins in the urine is indicative of kidney diseases.
Acute Kidney Injury ; Cell Body ; Cell Cycle ; Cell Division ; Cilia* ; Epithelial Cells ; Ischemia ; Kidney Diseases* ; Kidney* ; Membranes ; Microtubules ; Organelles ; Renal Insufficiency, Chronic ; Signal Transduction

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Congenital Absence of the Left Atrial Appendage: An Unexpected and Incidental Anomaly in a Patient with Multiple Cerebellar Infarctions.

Doohyuck LEE ; Dongmin KIM

Chonnam Medical Journal.2018;54(2):133-134. doi:10.4068/cmj.2018.54.2.133

No abstract available.
Atrial Appendage* ; Humans ; Infarction*

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Spontaneous Huge Subdural Spine Hematoma in a Patient Receiving Dual Anti-platelet Therapy after Drug-eluting Coronary Stent Implantation.

Xiongyi HAN ; Jumin WON ; Doo Sun SIM ; Min Chul KIM ; Yongcheol KIM ; Young Joon HONG ; Ju Han KIM ; Youngkeun AHN ; Myung Ho JEONG

Chonnam Medical Journal.2018;54(2):131-132. doi:10.4068/cmj.2018.54.2.131

No abstract available.
Hematoma* ; Humans ; Spine* ; Stents*

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Endogenous Bacterial Endopthalmitis from Long-term Use of a Tunneled Cuffed Hemodialysis Catheter Infection.

Young Rok HAM ; Ki Ryang NA

Chonnam Medical Journal.2018;54(2):129-130. doi:10.4068/cmj.2018.54.2.129

No abstract available.
Catheters* ; Renal Dialysis*

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Effects of Bisoprolol Are Comparable with Carvedilol in Secondary Prevention of Acute Myocardial Infarction in Patients Undergoing Percutaneous Coronary Intervention.

Seung Jin JUN ; Kyung Hwan KIM ; Myung Ho JEONG ; Min Chul KIM ; Doo Sun SIM ; Young Joon HONG ; Ju Han KIM ; Myeong Chan CHO ; Jei Keon CHAE ; Hun Sik PARK ; Jong Sun PARK ; Young Keun AHN

Chonnam Medical Journal.2018;54(2):121-128. doi:10.4068/cmj.2018.54.2.121

Although the benefits of carvedilol have been demonstrated in the era of percutaneous coronary intervention (PCI), very few studies have evaluated the efficacy of bisoprolol in the secondary prevention of acute myocardial infarction (MI) in patients treated with PCI. We hypothesized that the effect of bisoprolol would not be different from carvedilol in post-MI patients. A total of 13,813 patients who underwent PCI were treated either with carvedilol or bisoprolol at the time of discharge. They were enrolled from the Korean Acute MI Registry (KAMIR). After 1:2 propensity score matching, 1,806 patients were enrolled in the bisoprolol group and 3,612 patients in the carvedilol group. The primary end point was the composite of major adverse cardiac events (MACEs), which was defined as cardiac death, nonfatal MI, target vessel revascularization, and coronary artery bypass surgery. The secondary end point was defined as all-cause mortality, cardiac death, nonfatal MI, any revascularization, or target vessel revascularization. After adjustment for differences in baseline characteristics by propensity score matching, the MACE-free survival rate was not different between the groups (HR=0.815, 95% CI:0.614–1.081, p=0.156). In the subgroup analysis, the cumulative incidence of MACEs was lower in the bisoprolol group in patients having a Killip class of III or IV than in the carvedilol group (HR=0.512, 95% CI: 0.263–0.998, p=0.049). The incidence of secondary end points was similar between the two beta-blocker groups. In conclusion, the benefits of bisoprolol were comparable with those of carvedilol in the secondary prevention of acute MI.
Bisoprolol* ; Coronary Artery Bypass ; Death ; Humans ; Incidence ; Mortality ; Myocardial Infarction* ; Percutaneous Coronary Intervention* ; Propensity Score ; Secondary Prevention* ; Survival Rate

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Role of Red Cell Distribution Width in the Relationship between Clinical Outcomes and Anticoagulation Response in Patients with Atrial Fibrillation.

Ki Hong LEE ; Jeong Gwan CHO ; Hyung Wook PARK ; Nam Sik YOON ; Hyung Ki JEONG ; Nuri LEE

Chonnam Medical Journal.2018;54(2):113-120. doi:10.4068/cmj.2018.54.2.113

Little is known as to why elevated red cell distribution width (RDW) is associated with adverse clinical outcomes in patients with atrial fibrillation (AF). We hypothesized that RDW value might predict the intensity of anticoagulation, resulting in higher adverse events in patients with AF taking warfarin. We analyzed 657 patients with non-valuvular AF who took warfarin. The intensity of anticoagulation was assessed as mean time in the therapeutic range (TTR) and defined TTR ≥60% as an optimal intensity. The primary end-point was the composite of stroke/systemic embolism and major bleeding. The secondary end-point was the composite of stroke/systemic embolism, major bleeding and death. The relationship between the baseline RDW with TTR and clinical outcomes was assessed using categorical variables as quartiles or dichotomous variables. The mean value of TTR decreased as an increment of the RDW (45.2% vs. 44.7% vs. 40.8% vs. 35.2%, p < 0.001). Primary and secondary end-points were significantly increased when TTR was less than 60% and RDW was more than 13.6%. Ratio of patients achieving optimal anticoagulation were significantly decreased as an increment of RDW. A RDW of ≥13.6% was a significant predictor for poor anticoagulation control (adjusted Odds ratio [OR] 0.43, 95% confidence interval [CI] 0.23–0.82), stroke (adjusted hazard ratio [HR] 3.86, 95% CI 1.11–13.40), primary (adjusted HR 1.88, 95% CI 1.12–3.16) and secondary end-point (adjusted HR 2.46, 95% CI 1.26–4.81). RDW was negatively associated with TTR in patients with AF. Therefore, RDW might be a useful marker for the prediction of anticoagulation response and clinical outcomes in patients with AF.
Anticoagulants ; Atrial Fibrillation* ; Embolism ; Erythrocyte Indices* ; Hemorrhage ; Humans ; Odds Ratio ; Prognosis ; Stroke ; Warfarin

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Addressing the Side Effects of Contemporary Antidepressant Drugs: A Comprehensive Review.

Sheng Min WANG ; Changsu HAN ; Won Myoung BAHK ; Soo Jung LEE ; Ashwin A PATKAR ; Prakash S MASAND ; Chi Un PAE

Chonnam Medical Journal.2018;54(2):101-112. doi:10.4068/cmj.2018.54.2.101

Randomized trials have shown that selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) have better safety profiles than classical tricyclic antidepressants (TCAs). However, an increasing number of studies, including meta-analyses, naturalistic studies, and longer-term studies suggested that SSRIs and SNRIs are no less safe than TCAs. We focused on comparing the common side effects of TCAs with those of newer generation antidepressants including SSRIs, SNRIs, mirtazapine, and bupropion. The main purpose was to investigate safety profile differences among drug classes rather than the individual antidepressants, so studies containing comparison data on drug groups were prioritized. In terms of safety after overdose, the common belief on newer generation antidepressants having fewer side effects than TCAs appears to be true. TCAs were also associated with higher drop-out rates, lower tolerability, and higher cardiac side-effects. However, evidence regarding side effects including dry mouth, gastrointestinal side effects, hepatotoxicity, seizure, and weight has been inconsistent, some studies demonstrated the superiority of SSRIs and SNRIs over TCAs, while others found the opposite. Some other side effects such as sexual dysfunction, bleeding, and hyponatremia were more prominent with either SSRIs or SNRIs.
Antidepressive Agents* ; Antidepressive Agents, Tricyclic ; Bupropion ; Depressive Disorder ; Drug-Related Side Effects and Adverse Reactions ; Hemorrhage ; Hyponatremia ; Mouth ; Seizures ; Serotonin and Noradrenaline Reuptake Inhibitors ; Serotonin Uptake Inhibitors

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Updates on Cancer Epidemiology in Korea, 2018.

Sun Seog KWEON

Chonnam Medical Journal.2018;54(2):90-100. doi:10.4068/cmj.2018.54.2.90

Cancer is a major cause of morbidity and the most common cause of death in Korea. There are currently approximately 200,000 incident cancer cases and 78,000 individuals die from cancer every year. The factors directly related to cancer incidence, including aging, smoking, obesity, and Westernized dietary habits, have been increasing during the past several decades. Since 1999, trends toward increased incidence have been observed for thyroid, breast (in women), colorectal, and prostate cancer. Currently, these trends have changed direction, and the incidence of stomach and liver cancer in both sexes, and cervical cancer in women have continually declined. Although the number of cancer deaths increased by a factor of 2.7 from 1983 to 2016, the age-standardized mortality associated with cancer has been decreasing by 3% every year. The 5-year relative survival rate (RSR) has also improved over the past several decades, especially for stomach, prostate, and breast cancer, which had 5-year RSRs greater than 90% in the most recent report.
Aging ; Breast ; Breast Neoplasms ; Cause of Death ; Epidemiology* ; Female ; Food Habits ; Humans ; Incidence ; Korea* ; Liver Neoplasms ; Mortality ; Obesity ; Prostate ; Prostatic Neoplasms ; Republic of Korea ; Smoke ; Smoking ; Stomach ; Survival Rate ; Thyroid Gland ; Uterine Cervical Neoplasms

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An Unusual Adult Complex Congenital Heart Disease.

Wei Chieh LEE ; Yi Wei LEE ; Sarah CHUA

Chonnam Medical Journal.2018;54(3):197-198. doi:10.4068/cmj.2018.54.3.197

No abstract available.
Adult* ; Heart Defects, Congenital* ; Humans

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Predictors of Clinical Outcome in Patients with Angiographically Intermediate Lesions with Minimum Lumen Area Less than 4 mm² Using Intravascular Ultrasound in Non-Proximal Epicardial Coronary Artery.

Jumin WON ; Young Joon HONG ; Dae Yong HYUN ; Hyung Ki JEONG ; Sung Sik OH ; Hyung Yoon KIM ; Yongcheol KIM ; Hyukjin PARK ; Min Chul KIM ; Jae Yeong CHO ; Ki Hong LEE ; Doo Sun SIM ; Nam Sik YOON ; Hyun Ju YOON ; Kye Hun KIM ; Hyung Wook PARK ; Ju Han KIM ; Youngkeun AHN ; Myung Ho JEONG ; Jeong Gwan CHO ; Jong Chun PARK

Chonnam Medical Journal.2018;54(3):190-196. doi:10.4068/cmj.2018.54.3.190

We investigated predictors of major adverse cardiac events (MACE) with two years after medical treatment for lesions with angiographically intermediate lesions with intravascular ultrasound (IVUS) minimum lumen area (MLA) <4 mm² in non-proximal epicardial coronary artery. We retrospectively enrolled 104 patients (57 males, 62±10 years) with angiographically intermediate lesions (diameter stenosis 30–70%) with IVUS MLA <4 mm² in the non-proximal epicardial coronary artery with a reference lumen diameter between 2.25 and 3.0 mm. We evaluated the incidences of major adverse cardiovascular events (MACE including death, myocardial infarction, target lesion and target vessel revascularizations, and cerebrovascular accident) two years after medical therapy. During the two-year follow-up, 15 MACEs (14.4%) (including 1 death, 2 myocardial infarctions, 10 target vessel revascularizations, and 2 cerebrovascular accidents) occurred. Diabetes mellitus was more prevalent (46.7% vs. 18.0%, p=0.013) and statins were used less frequently in patients with MACE compared with those without MACE (40.0% vs. 71.9%, p=0.015). Independent predictors of MACEs with two years included diabetes mellitus (odds ratio [OR]=3.41; 95% CI=1.43–8.39, p=0.020) and non-statin therapy (OR=3.11; 95% CI=1.14–6.50, p=0.027). Long-term event rates are relatively low with only medical therapy without any intervention, so the cut-off of IVUS MLA 4 mm² might be too large to be applied for defining significant stenosis. The predictors of long-term MACE were diabetes mellitus and statin therapy in patients with angiographically intermediate lesions in non-proximal epicardial coronary artery.
Constriction, Pathologic ; Coronary Artery Disease ; Coronary Vessels* ; Diabetes Mellitus ; Follow-Up Studies ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Incidence ; Male ; Myocardial Infarction ; Plaque, Atherosclerotic ; Retrospective Studies ; Ultrasonography* ; Ultrasonography, Interventional

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