1.Fasting blood glucose and the risk of all-cause mortality in patients with diabetes mellitus undergoing hemodialysis
Soo-Young YOON ; Jin Sug KIM ; Gang Jee KO ; Yun Jin CHOI ; Ju Young MOON ; Kyunghwan JEONG ; Hyeon Seok HWANG
Kidney Research and Clinical Practice 2024;43(5):680-689
Glycemic control is particularly important in hemodialysis (HD) patients with diabetes mellitus (DM). Although fasting blood glucose (FBG) level is an important indicator of glycemic control, a clear target for reducing mortality in HD patients with DM is lacking. Methods: A total of 26,162 maintenance HD patients with DM were recruited from the National Health Insurance Database of Korea between 2002 and 2018. We analyzed the association of FBG levels at the baseline health examination with the risk of all-cause and cause-specific mortality. Results: Patients with FBG 80–100 mg/dL showed a higher survival rate compared with that of other FBG categories (p < 0.001). The risk of all-cause mortality increased with the increase in FBG levels, and adjusted hazard ratios (HRs) were 1.10 (95% confidence interval [CI], 1.04–1.17), 1.21 (95% CI, 1.13–1.29), 1.36 (95% CI, 1.26–1.46), and 1.61 (95% CI, 1.51–1.72) for patients with FBG 100–125, 125–150, 150–180, and ≥180 mg/dL, respectively. The HR for mortality was also significantly increased in patients with FBG <80 mg/dL (adjusted HR, 1.14; 95% CI, 1.05–1.23). The analysis of cause-specific mortality also revealed a J-shaped curve between FBG levels and the risk of cardiovascular deaths. However, the risk of infection or malignancy-related deaths was not linearly increased as FBG levels increased. Conclusion: A J-shaped association was observed between FBG levels and the risk of all-cause mortality, with the lowest risk at FBG 80–100 mg/dL in HD patients with DM.
2.Fasting blood glucose and the risk of all-cause mortality in patients with diabetes mellitus undergoing hemodialysis
Soo-Young YOON ; Jin Sug KIM ; Gang Jee KO ; Yun Jin CHOI ; Ju Young MOON ; Kyunghwan JEONG ; Hyeon Seok HWANG
Kidney Research and Clinical Practice 2024;43(5):680-689
Glycemic control is particularly important in hemodialysis (HD) patients with diabetes mellitus (DM). Although fasting blood glucose (FBG) level is an important indicator of glycemic control, a clear target for reducing mortality in HD patients with DM is lacking. Methods: A total of 26,162 maintenance HD patients with DM were recruited from the National Health Insurance Database of Korea between 2002 and 2018. We analyzed the association of FBG levels at the baseline health examination with the risk of all-cause and cause-specific mortality. Results: Patients with FBG 80–100 mg/dL showed a higher survival rate compared with that of other FBG categories (p < 0.001). The risk of all-cause mortality increased with the increase in FBG levels, and adjusted hazard ratios (HRs) were 1.10 (95% confidence interval [CI], 1.04–1.17), 1.21 (95% CI, 1.13–1.29), 1.36 (95% CI, 1.26–1.46), and 1.61 (95% CI, 1.51–1.72) for patients with FBG 100–125, 125–150, 150–180, and ≥180 mg/dL, respectively. The HR for mortality was also significantly increased in patients with FBG <80 mg/dL (adjusted HR, 1.14; 95% CI, 1.05–1.23). The analysis of cause-specific mortality also revealed a J-shaped curve between FBG levels and the risk of cardiovascular deaths. However, the risk of infection or malignancy-related deaths was not linearly increased as FBG levels increased. Conclusion: A J-shaped association was observed between FBG levels and the risk of all-cause mortality, with the lowest risk at FBG 80–100 mg/dL in HD patients with DM.
3.Fasting blood glucose and the risk of all-cause mortality in patients with diabetes mellitus undergoing hemodialysis
Soo-Young YOON ; Jin Sug KIM ; Gang Jee KO ; Yun Jin CHOI ; Ju Young MOON ; Kyunghwan JEONG ; Hyeon Seok HWANG
Kidney Research and Clinical Practice 2024;43(5):680-689
Glycemic control is particularly important in hemodialysis (HD) patients with diabetes mellitus (DM). Although fasting blood glucose (FBG) level is an important indicator of glycemic control, a clear target for reducing mortality in HD patients with DM is lacking. Methods: A total of 26,162 maintenance HD patients with DM were recruited from the National Health Insurance Database of Korea between 2002 and 2018. We analyzed the association of FBG levels at the baseline health examination with the risk of all-cause and cause-specific mortality. Results: Patients with FBG 80–100 mg/dL showed a higher survival rate compared with that of other FBG categories (p < 0.001). The risk of all-cause mortality increased with the increase in FBG levels, and adjusted hazard ratios (HRs) were 1.10 (95% confidence interval [CI], 1.04–1.17), 1.21 (95% CI, 1.13–1.29), 1.36 (95% CI, 1.26–1.46), and 1.61 (95% CI, 1.51–1.72) for patients with FBG 100–125, 125–150, 150–180, and ≥180 mg/dL, respectively. The HR for mortality was also significantly increased in patients with FBG <80 mg/dL (adjusted HR, 1.14; 95% CI, 1.05–1.23). The analysis of cause-specific mortality also revealed a J-shaped curve between FBG levels and the risk of cardiovascular deaths. However, the risk of infection or malignancy-related deaths was not linearly increased as FBG levels increased. Conclusion: A J-shaped association was observed between FBG levels and the risk of all-cause mortality, with the lowest risk at FBG 80–100 mg/dL in HD patients with DM.
4.Fasting blood glucose and the risk of all-cause mortality in patients with diabetes mellitus undergoing hemodialysis
Soo-Young YOON ; Jin Sug KIM ; Gang Jee KO ; Yun Jin CHOI ; Ju Young MOON ; Kyunghwan JEONG ; Hyeon Seok HWANG
Kidney Research and Clinical Practice 2024;43(5):680-689
Glycemic control is particularly important in hemodialysis (HD) patients with diabetes mellitus (DM). Although fasting blood glucose (FBG) level is an important indicator of glycemic control, a clear target for reducing mortality in HD patients with DM is lacking. Methods: A total of 26,162 maintenance HD patients with DM were recruited from the National Health Insurance Database of Korea between 2002 and 2018. We analyzed the association of FBG levels at the baseline health examination with the risk of all-cause and cause-specific mortality. Results: Patients with FBG 80–100 mg/dL showed a higher survival rate compared with that of other FBG categories (p < 0.001). The risk of all-cause mortality increased with the increase in FBG levels, and adjusted hazard ratios (HRs) were 1.10 (95% confidence interval [CI], 1.04–1.17), 1.21 (95% CI, 1.13–1.29), 1.36 (95% CI, 1.26–1.46), and 1.61 (95% CI, 1.51–1.72) for patients with FBG 100–125, 125–150, 150–180, and ≥180 mg/dL, respectively. The HR for mortality was also significantly increased in patients with FBG <80 mg/dL (adjusted HR, 1.14; 95% CI, 1.05–1.23). The analysis of cause-specific mortality also revealed a J-shaped curve between FBG levels and the risk of cardiovascular deaths. However, the risk of infection or malignancy-related deaths was not linearly increased as FBG levels increased. Conclusion: A J-shaped association was observed between FBG levels and the risk of all-cause mortality, with the lowest risk at FBG 80–100 mg/dL in HD patients with DM.
5.Circulatory endostatin level and risk of cardiovascular events in patients with end-stage renal disease on hemodialysis
Jin Sug KIM ; Miji KIM ; Kyung Hwan JEONG ; Ju-Young MOON ; Sang Ho LEE ; Gang Jee KO ; Dong-Young LEE ; So Young LEE ; Yang Gyun KIM ; Hyeon Seok HWANG
Kidney Research and Clinical Practice 2024;43(2):226-235
Endostatin is released during extracellular matrix remodeling and is involved in the development of vascular pathology and cardiovascular (CV) disease. However, the role of circulating endostatin as a biomarker of vascular calcification and CV events in patients undergoing hemodialysis (HD) remains unclear. Methods: A total of 372 patients undergoing HD were prospectively recruited. Plasma endostatin levels were measured at baseline, and their associations with circulating mineral bone disease (MBD) biomarkers and abdominal aortic vascular calcification scores were analyzed. The primary endpoint was defined as a composite of CV and cardiac events. Results: Plasma levels of patients in endostatin tertile 3 were significantly associated with low-density lipoprotein cholesterol levels and predialysis systolic blood pressure in multivariate analysis. However, endostatin levels did not correlate with circulating MBD biomarkers or vascular calcification scores. Patients in endostatin tertile 3 had a significantly higher cumulative event rate for the composite of CV events (p = 0.006). Endostatin tertile 3 was also associated with an increased cumulative rate of cardiac events (p = 0.04). In multivariate Cox regression analyses, endostatin tertile 3 was associated with a 4.37-fold risk for composite CV events and a 3.88-fold risk for cardiac events after adjusting for multiple variables. Conclusion: Higher circulating endostatin levels were independently associated with atherosclerotic risk factors but did not correlate with MBD markers or vascular calcification. Higher circulating endostatin levels were associated with a greater risk of composite CV events in patients undergoing HD, and endostatin is a biomarker that helps to determine the high risk of CV events.
6.Proteomic identification of arginine-methylated proteins in colon cancer cells and comparison of messenger RNA expression between colorectal cancer and adjacent normal tissues
Yongchul LIM ; Da Young GANG ; Woo Yong LEE ; Seong Hyeon YUN ; Yong Beom CHO ; Jung Wook HUH ; Yoon Ah PARK ; Hee Cheol KIM
Annals of Coloproctology 2022;38(1):60-68
Purpose:
Identification of type I protein arginine methyltransferase (PRMT) substrates and their functional significance during tumorigenesis is becoming more important. The present study aimed to identify target substrates for type I PRMT using 2-dimensional (2D) gel electrophoresis (GE) and 2D Western blotting (WB).
Methods:
Using immunoblot analysis, we compared the expression of type I PRMTs and endogenous levels of arginine methylation between the primary colorectal cancer (CRC) and adjacent noncancerous tissues paired from the same patient. To identify arginine-methylated proteins in HCT116 cells, we carried out 2D-GE and 2D-WB with a type I PRMT product-specific antibody (anti-dimethyl-arginine antibody, asymmetric [ASYM24]). Arginine-methylated protein spots were identified by mass spectrometry, and messenger RNA (mRNA) levels corresponding to the identified proteins were analyzed using National Center for Biotechnology Information (NCBI) microarray datasets between the primary CRC and noncancerous tissues.
Results:
Type I PRMTs and methylarginine-containing proteins were highly maintained in CRC tissues compared to noncancerous tissues. We matched 142 spots using spot analysis software between a Coomassie blue (CBB)-stained 2D gel and 2D-WB, and we successfully identified 7 proteins that reacted with the ASYM24 antibody: CACYBP, GLOD4, MAPRE1, CCT7, TKT, CK8, and HSPA8. Among these proteins, the levels of 4 mRNAs including MAPRE1, CCT7, TKT, and HSPA8 in CRC tissues showed a statistically significant increase compared to noncancerous tissues from patients using the NCBI microarray datasets.
Conclusion
Our results indicate that the method shown here is useful in identifying arginine-methylated proteins, and significance of arginine modification in the proteins identified here should be further identified during CRC development.
7.Mitochondrial Effects on the Physiological Characteristics ofLentinula edodes
Minseek KIM ; Seong-Hyeok YANG ; Hui-Gang HAN ; Eunbi KIM ; Sinil KIM ; Youn-Lee OH ; Hyeon-Su RO
Mycobiology 2022;50(5):374-381
In the mating of filamentous basidiomycetes, dikaryotic mycelia are generated through the reciprocal movement of nuclei to a monokaryotic cytoplasm where a nucleus of compatible mating type resides, resulting in the establishment of two different dikaryotic strains having the same nuclei but different mitochondria. To better understand the role of mitochondria in mushrooms, we created four sets of dikaryotic strains of Lentinula edodes, including B2 × E13 (B2 side) and B2 × E13 (E13 side), B5 × E13 (B5 side) and B5 × E13 (E13 side), E8 × H3 (E8 side) and E8 × H3 (H3 side), and K3 × H3 (K3 side) and K3 × H3 (H3 side). The karyotypes and mitochondrial types of the dikaryotic strains were successfully identified by the A mating type markers and the mitochondrial variable length tandem repeat markers, respectively. Comparative analyses of the dikaryotic strains on the mycelial growth, substrate browning, fruiting characteristics, and mitochondrial gene expression revealed that certain mitochondria are more effective in the mycelial growth and the production of fruiting body, possibly through the activated energy metabolism. Our findings indicate that mitochondria affect the physiology of dikaryotic strains having the same nuclear information and therefore a selection strategy aimed at mitochondrial function is needed in the development of new mushroom strain.
8.Postoperative Complications of Esophageal Atresia and Role of Endoscopic Balloon Dilatation in Anastomotic Strictures
Jin Young CHO ; Mea-young CHANG ; Mi Hyeon GANG ; Yong Wook LEE ; Jun Beom PARK ; Jae Young KIM ; Hyun Jin KIM
Pediatric Gastroenterology, Hepatology & Nutrition 2022;25(6):453-460
Purpose:
Esophageal atresia (EA) with or without tracheoesophageal fistula (TEF) is a congenital anomaly that can cause frequent digestive and nutritional problems, even after repair. The most common complication is anastomotic stricture, for which reoperation or balloon dilatation is performed. This study aimed to evaluate the postoperative complications of EA and the role of endoscopic balloon dilatation (EBD) in cases of anastomotic stricture.
Methods:
We retrospectively analyzed patients diagnosed with EA with or without TEF between January 2000 and February 2021. Patients’ baseline characteristics, associated anomalies, and postoperative complications were reviewed.
Results:
Among 26 patients, 14 (53.8%) were male, 12 (46.2%) had coexisting anomalies, and the median follow-up was 6.1 years (range, 1.2–15.7 years). In univariate analysis, prematurity, low birth weight, and long-gap EA were associated with postoperative complications in 12 (46.2%) patients. Among the 10 (38.5%) patients with anastomotic stricture, nine (90.0%) required EBD. Regarding the first EBD, it was performed at a median of 3.3 months (range, 1.2–7.6 months) post-repair, while the average patient weight was 4.6 kg. The mean diameter ranged from 3.3 to 9.1 mm without major complications. In univariate analysis, long-gap EA alone was significantly associated with EBD.
Conclusion
Approximately half of the patients experienced complications after EA repair.In particular, patients with a long-gap EA had a significantly increased risk of complications, such as anastomotic strictures. EBD can be safely used, even in infants.
9.Reconstruction of Tracheal Defect by Sternocleidomastoid Muscle Flap Covered with Skin Graft: A Case Report
Soo Kyung JANG ; Gang Hyeon SEO ; Sun CHOI ; Seok Hyun PARK ; Jin Hwan KIM ; Dong Jin LEE
Korean Journal of Head and Neck Oncology 2021;37(1):63-66
Supracricoid partial laryngectomy (SCPL) with cricohyoidoepiglottopexy (CHEP) or cricohyoidopexy (CHP) involves the removal of the whole thyroid cartilage, both true and false vocal cords, the ventricles, and the paraglottic spaces, sparing the cricoid cartilage, hyoid bone, and at least one functional and mobile cricoarytenoid unit. Reconstruction is performed by suturing of the cricoid cartilage up tightly to the hyoid bone, so trachea-releasing procedures are needed to prevent leakage at anastomosis site. In case of advanced tranglottic cancer invading tracheal tracheal wall, we need to perform additional circumferentrial tracheal wall resection. However, when we perform SCPL, circumferential resection of tracheal wall is limited because SCPL procedure itself needs releasing of tracheal length. We report a case of advanced transglottic cancer involving tracheal wall treated with induction chemotherapy and SCPL including tracheal wall resection with reconstruction of tracheal defect by sternocleidomastoid muscle flap covered with skin graft.
10.Reconstruction of Tracheal Defect by Sternocleidomastoid Muscle Flap Covered with Skin Graft: A Case Report
Soo Kyung JANG ; Gang Hyeon SEO ; Sun CHOI ; Seok Hyun PARK ; Jin Hwan KIM ; Dong Jin LEE
Korean Journal of Head and Neck Oncology 2021;37(1):63-66
Supracricoid partial laryngectomy (SCPL) with cricohyoidoepiglottopexy (CHEP) or cricohyoidopexy (CHP) involves the removal of the whole thyroid cartilage, both true and false vocal cords, the ventricles, and the paraglottic spaces, sparing the cricoid cartilage, hyoid bone, and at least one functional and mobile cricoarytenoid unit. Reconstruction is performed by suturing of the cricoid cartilage up tightly to the hyoid bone, so trachea-releasing procedures are needed to prevent leakage at anastomosis site. In case of advanced tranglottic cancer invading tracheal tracheal wall, we need to perform additional circumferentrial tracheal wall resection. However, when we perform SCPL, circumferential resection of tracheal wall is limited because SCPL procedure itself needs releasing of tracheal length. We report a case of advanced transglottic cancer involving tracheal wall treated with induction chemotherapy and SCPL including tracheal wall resection with reconstruction of tracheal defect by sternocleidomastoid muscle flap covered with skin graft.

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