1.Bisphosphonates as a Tacrolimus-Sparing Strategy in Kidney Transplantation: Insights from a Retrospective Analysis
Hee Byung KOH ; Hyo Jeong KIM ; Ga Young HEO ; Namki HONG ; Yaeji LEE ; Seung Hwan SONG ; Hoon Young CHOI ; Chan-Young JUNG ; Hyung Woo KIM ; Jaeseok YANG ; Kyu Ha HUH ; Chung Mo NAM ; Beom Seok KIM
Yonsei Medical Journal 2026;67(1):17-26
Purpose:
Due to chronic toxicity, tacrolimus-sparing is an important issue in kidney transplant recipients (KTRs). Several studies have shown that bisphosphonate use is associated with favorable graft outcomes in KTRs. We investigated whether the association between tacrolimus trough levels (TTLs) and graft outcomes differed according to bisphosphonate use in KTRs.
Materials and Methods:
We conducted a retrospective study encompassing 1441 KTRs who were administered tacrolimus-based immunosuppressants. The primary exposure was a time-dependent cross-product of TTLs (low TTLs vs. normal-high TTLs with a reference of 6 ng/mL) and bisphosphonate use. Two primary outcomes were evaluated: overall graft loss (death or conversion to kidney replacement) and an estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m 2 .
Results:
During the median follow-up of 6.1 (3.4–9.7) years, overall graft loss occurred in 157 (10.9%) patients. Cox regression revealed that normal-high TTLs without bisphosphonate use were associated with a reduced risk of overall graft loss [adjusted hazard ratio (aHR), 0.65; 95% confidence interval (CI), 0.45–0.95] compared to low TTLs without bisphosphonate use. The use of bisphosphonate in conjunction with normal-high TTLs correlated with an even lower risk of overall graft loss (aHR, 0.25; 95% CI, 0.08–0.80) compared with low TTLs without bisphosphonate use. In patients with low TTLs, bisphosphonate use was associated with a reduced risk of overall graft loss compared with non-use (aHR, 0.20; 95% CI, 0.09–0.43). Similar trends were observed in the eGFR outcome.
Conclusion
The use of bisphosphonate was associated with favorable graft outcomes, even with low TTLs. Incorporating bisphosphonate into a conventional immunosuppressant regimen may potentially reduce tacrolimus requirement.
2.Orthodontic Treatment Using Invisalign First® in Pediatric Patients with Mild Skeletal Malocclusion: Case Reports
Haesong KANG ; Seonmi KIM ; Namki CHOI
Journal of Korean Academy of Pediatric Dentistry 2025;52(1):102-116
This case report explores the orthodontic treatment of pediatric patients with mild skeletal malocclusion using Invisalign First®. Two cases are presented: (1) a patient with upper incisor protrusion, deep bite, and skeletal Class II malocclusion; and (2) a patient with dental crowding and skeletal Class III malocclusion. Their treatment demonstrated the efficacy of Invisalign First® in achieving arch expansion, tooth alignment, space creation for erupting teeth, and skeletal malocclusion correction. The overall results were satisfactory; however, limitations in rotational and intrusive movements, as well as skeletal improvements, were observed. Careful treatment planning, including overcorrection and patient selection, is essential for achieving optimal outcomes.
3.Orthodontic Treatment Using Invisalign First® in Pediatric Patients with Mild Skeletal Malocclusion: Case Reports
Haesong KANG ; Seonmi KIM ; Namki CHOI
Journal of Korean Academy of Pediatric Dentistry 2025;52(1):102-116
This case report explores the orthodontic treatment of pediatric patients with mild skeletal malocclusion using Invisalign First®. Two cases are presented: (1) a patient with upper incisor protrusion, deep bite, and skeletal Class II malocclusion; and (2) a patient with dental crowding and skeletal Class III malocclusion. Their treatment demonstrated the efficacy of Invisalign First® in achieving arch expansion, tooth alignment, space creation for erupting teeth, and skeletal malocclusion correction. The overall results were satisfactory; however, limitations in rotational and intrusive movements, as well as skeletal improvements, were observed. Careful treatment planning, including overcorrection and patient selection, is essential for achieving optimal outcomes.
4.Orthodontic Treatment Using Invisalign First® in Pediatric Patients with Mild Skeletal Malocclusion: Case Reports
Haesong KANG ; Seonmi KIM ; Namki CHOI
Journal of Korean Academy of Pediatric Dentistry 2025;52(1):102-116
This case report explores the orthodontic treatment of pediatric patients with mild skeletal malocclusion using Invisalign First®. Two cases are presented: (1) a patient with upper incisor protrusion, deep bite, and skeletal Class II malocclusion; and (2) a patient with dental crowding and skeletal Class III malocclusion. Their treatment demonstrated the efficacy of Invisalign First® in achieving arch expansion, tooth alignment, space creation for erupting teeth, and skeletal malocclusion correction. The overall results were satisfactory; however, limitations in rotational and intrusive movements, as well as skeletal improvements, were observed. Careful treatment planning, including overcorrection and patient selection, is essential for achieving optimal outcomes.
5.Analysis and Consideration of Factors for Predicting Cooperation Levels in Pediatric Dentistry
Soomin LIM ; Namki CHOI ; Seonmi KIM
Journal of Korean Academy of Pediatric Dentistry 2024;51(3):229-244
This study aimed to evaluate various factors related to cooperation levels in pediatric dentistry and determine their correlation with children’s cooperation during dental treatments. This study included one hundred children and their guardians who visited the dental hospital at the Chonnam National University. Children and their guardians completed surveys regarding dental fear, dental caries experience, dental treatment experience, temperament, and guardians’ dental anxiety, as well as the background characteristics of the children. Based on these data, factors associated with children’s cooperation during dental treatment were investigated. Dental fear, caries experience during the primary and mixed dentition stages, and temperament traits such as shyness and negative emotionality significantly impacted children’s cooperation during dental visits, with higher levels of these factors corresponding to lower cooperation. The extent of dental experience also modestly influenced children’ s cooperation, with higher levels of cooperation observed in children with greater dental experience. Additionally, children’s dental fear was strongly correlated with guardians’ dental anxiety, increasing as guardians’ anxiety levels increased. Twelve-year-old children exhibited significantly lower levels of dental fear compared to other age groups, and regardless of cooperation levels, injections (shots) were identified as the primary factor inducing dental fear among the children. To improve children’ s cooperation in pediatric dentistry, strategies should focus on alleviating their fears and adopting an individualized approach that consider their oral health status and temperamental traits.
6.Perception of Parents Regarding Specialized Pediatric Dentistry
Soomin LIM ; Kyunghi KIM ; Namki CHOI ; Seonmi KIM
Journal of Korean Academy of Pediatric Dentistry 2024;51(4):344-358
This study analyzed parents’ perceptions of pediatric dentistry and pediatric dental specialists, identified factors influencing their choice of dental practice for children, and compared perceptions between those with and without pediatric dentistry experience. A nationwide online survey (February 15 - 19, 2024) was conducted among 500 parents of children aged 15 years or younger: 170 from Seoul/Gyeonggi/ Incheon, 100 each from Chungcheong, Gyeongsang, Jeolla, and 30 from Gangwon. Data covered demographics, factors influencing dentist selection for children, awareness of pediatric dentists, and insights on whether parents had visited a pediatric dentist. 75.6% had visited a pediatric dental clinic, and 49.6% recognized pediatric dental specialists. Among visitors, 59.5% were aware of pediatric dental specialists, compared to 18.9% of non-visitors. Furthermore, 90.7% of parents aware of pediatric dental specialists had visited a clinic, versus 60.7% of those unaware. The highest visit rates were among parents with three children, especially aged 7 - 9. Awareness of pediatric dental specialists was highest among parents in their 20s, living in Gangwon, Seoul, Gyeonggi, and Incheon regions, with professional occupations and household monthly incomes of 7.5 - 8.5 million won. Parents with experience visiting pediatric dental clinics prioritized dentists’ expertise; those without experience prioritized short waiting times. Prior experience with pediatric dental clinics significantly increased the intention to revisit and reduced hesitation. Improving parents’ perceptions of pediatric dentists enhances decision-making and accessibility for children’s specialized dental care. Professional associations must raise awareness of pediatric dentistry. Pediatric dentists should prioritize expertise and advance their specializations in pediatric orthodontics.
7.Analysis and Consideration of Factors for Predicting Cooperation Levels in Pediatric Dentistry
Soomin LIM ; Namki CHOI ; Seonmi KIM
Journal of Korean Academy of Pediatric Dentistry 2024;51(3):229-244
This study aimed to evaluate various factors related to cooperation levels in pediatric dentistry and determine their correlation with children’s cooperation during dental treatments. This study included one hundred children and their guardians who visited the dental hospital at the Chonnam National University. Children and their guardians completed surveys regarding dental fear, dental caries experience, dental treatment experience, temperament, and guardians’ dental anxiety, as well as the background characteristics of the children. Based on these data, factors associated with children’s cooperation during dental treatment were investigated. Dental fear, caries experience during the primary and mixed dentition stages, and temperament traits such as shyness and negative emotionality significantly impacted children’s cooperation during dental visits, with higher levels of these factors corresponding to lower cooperation. The extent of dental experience also modestly influenced children’ s cooperation, with higher levels of cooperation observed in children with greater dental experience. Additionally, children’s dental fear was strongly correlated with guardians’ dental anxiety, increasing as guardians’ anxiety levels increased. Twelve-year-old children exhibited significantly lower levels of dental fear compared to other age groups, and regardless of cooperation levels, injections (shots) were identified as the primary factor inducing dental fear among the children. To improve children’ s cooperation in pediatric dentistry, strategies should focus on alleviating their fears and adopting an individualized approach that consider their oral health status and temperamental traits.
8.Perception of Parents Regarding Specialized Pediatric Dentistry
Soomin LIM ; Kyunghi KIM ; Namki CHOI ; Seonmi KIM
Journal of Korean Academy of Pediatric Dentistry 2024;51(4):344-358
This study analyzed parents’ perceptions of pediatric dentistry and pediatric dental specialists, identified factors influencing their choice of dental practice for children, and compared perceptions between those with and without pediatric dentistry experience. A nationwide online survey (February 15 - 19, 2024) was conducted among 500 parents of children aged 15 years or younger: 170 from Seoul/Gyeonggi/ Incheon, 100 each from Chungcheong, Gyeongsang, Jeolla, and 30 from Gangwon. Data covered demographics, factors influencing dentist selection for children, awareness of pediatric dentists, and insights on whether parents had visited a pediatric dentist. 75.6% had visited a pediatric dental clinic, and 49.6% recognized pediatric dental specialists. Among visitors, 59.5% were aware of pediatric dental specialists, compared to 18.9% of non-visitors. Furthermore, 90.7% of parents aware of pediatric dental specialists had visited a clinic, versus 60.7% of those unaware. The highest visit rates were among parents with three children, especially aged 7 - 9. Awareness of pediatric dental specialists was highest among parents in their 20s, living in Gangwon, Seoul, Gyeonggi, and Incheon regions, with professional occupations and household monthly incomes of 7.5 - 8.5 million won. Parents with experience visiting pediatric dental clinics prioritized dentists’ expertise; those without experience prioritized short waiting times. Prior experience with pediatric dental clinics significantly increased the intention to revisit and reduced hesitation. Improving parents’ perceptions of pediatric dentists enhances decision-making and accessibility for children’s specialized dental care. Professional associations must raise awareness of pediatric dentistry. Pediatric dentists should prioritize expertise and advance their specializations in pediatric orthodontics.
9.Quinic Acid Alleviates Behavior Impairment by Reducing Neuroinflammation and MAPK Activation in LPS-Treated Mice
Yongun PARK ; Yunn Me Me PAING ; Namki CHO ; Changyoun KIM ; Jiho YOO ; Ji Woong CHOI ; Sung Hoon LEE
Biomolecules & Therapeutics 2024;32(3):309-318
Compared to other organs, the brain has limited antioxidant defenses. In particular, the hippocampus is the central region for learning and memory and is highly susceptible to oxidative stress. Glial cells are the most abundant cells in the brain, and sustained glial cell activation is critical to the neuroinflammation that aggravates neuropathology and neurotoxicity. Therefore, regulating glial cell activation is a promising neurotherapeutic treatment. Quinic acid (QA) and its derivatives possess anti-oxidant and anti-inflammatory properties. Although previous studies have evidenced QA’s benefit on the brain, in vivo and in vitro analyses of its anti-oxidant and anti-inflammatory properties in glial cells have yet to be established. This study investigated QA’s rescue effect in lipopolysaccharide (LPS)-induced behavior impairment. Orally administering QA restored social impairment and LPS-induced spatial and fear memory. In addition, QA inhibited proinflammatory mediator, oxidative stress marker, and mitogen-activated protein kinase (MAPK) activation in the LPS-injected hippocampus. QA inhibited nitrite release and extracellular signal-regulated kinase (ERK) phosphorylation in LPS-stimulated astrocytes. Collectively, QA restored impaired neuroinflammation-induced behavior by regulating proinflammatory mediator and ERK activation in astrocytes, demonstrating its potential as a therapeutic agent for neuroinflammation-induced brain disease treatments.
10.Bone Loss after Solid Organ Transplantation: A Review of Organ-Specific Considerations
Kyoung Jin KIM ; Jeonghoon HA ; Sang Wan KIM ; Jung-Eun KIM ; Sihoon LEE ; Han Seok CHOI ; Namki HONG ; Sung Hye KONG ; Seong Hee AHN ; So Young PARK ; Ki-Hyun BAEK ;
Endocrinology and Metabolism 2024;39(2):267-282
This review article investigates solid organ transplantation-induced osteoporosis, a critical yet often overlooked issue, emphasizing its significance in post-transplant care. The initial sections provide a comprehensive understanding of the prevalence and multifactorial pathogenesis of transplantation osteoporosis, including factors such as deteriorating post-transplantation health, hormonal changes, and the impact of immunosuppressive medications. Furthermore, the review is dedicated to organ-specific considerations in transplantation osteoporosis, with separate analyses for kidney, liver, heart, and lung transplantations. Each section elucidates the unique challenges and management strategies pertinent to transplantation osteoporosis in relation to each organ type, highlighting the necessity of an organ-specific approach to fully understand the diverse manifestations and implications of transplantation osteoporosis. This review underscores the importance of this topic in transplant medicine, aiming to enhance awareness and knowledge among clinicians and researchers. By comprehensively examining transplantation osteoporosis, this study contributes to the development of improved management and care strategies, ultimately leading to improved patient outcomes in this vulnerable group. This detailed review serves as an essential resource for those involved in the complex multidisciplinary care of transplant recipients.

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