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Management of chronic kidney disease-mineral and bone disorder: Korean working group recommendations
( Eunah Hwang ),( Bum Soon Choi ),( Kook-hwan Oh ),( Young Joo Kwon ),( Gheun-ho Kim ) 대한신장학회 2015 Kidney Research and Clinical Practice Vol.34 No.1
For Korean dialysis patients, chronic kidney disease-mineral bone disorder is a serious burden because of cardiovascular calci.cation and mortality. However, recent epidemiologic data have demonstrated that many patients undergoing maintenance hemodialysis are out of the target ranges of serum calcium, phosphorus, and intact parathyroid hormone. Thus, we felt the necessity for the development of practical recommendations to treat abnormal serum phosphorus, calcium, and iPTH in dialysis patients. In this paper, we brie.y comment on the measurement of serum calcium, phosphorus, iPTH, dialysate calcium concentration, dietary phosphorus restriction, use of phosphate binders, and medical and surgical options to correct secondary hyperparathyroidism. In particular, for the optimal management of secondary hyperparathyroidism, we suggest a simpli.ed medication adjustment according to certain ranges of serum phosphorus and calcium. Large-scale, well-designed clinical studies are required to support our strategies to control chronic kidney disease-mineral bone disorder in this country. Based on such data, our practice guidelines could be established and better long-term outcomes should be anticipated in our dialysis patients. Copyright & 2015. The Korean Society of Nephrology. Published by Elsevier. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
한은아 ( Eunah Han ),황현아 ( Hyuna Hwang ),유지나 ( Gina Yu ),고동률 ( Dong Ryul Ko ),공태영 ( Taeyoung Kong ),유제성 ( Je Sung You ),좌민홍 ( Minhong Choa ),정성필 ( Sung Phil Chung ) 대한임상독성학회 2021 대한임상독성학회지 Vol.19 No.1
Purpose: The purpose of this study was to conduct a systematic review to investigate the socio-economic benefits of the poison control center (PCC) and to assess whether telephone counseling at the poison control center affects the frequency of emergency room visits, hospitalization, and length of stay of patients with acute poisoning. Methods: The authors conducted a medical literature search of the PubMed, EMBASE, and Cochrane Library databases. Two reviewers evaluated the abstracts for eligibility, extracted the data, and assessed the study quality using a standardized tool. Key results such as the cost-benefit ratio, hospital stay days, unnecessary emergency room visits or hospitalizations, and reduced hospital charges were extracted from the studies. When meta-analysis was possible, it was performed using RevMan software (RevMan version 5.4). Results: Among 299 non-duplicated studies, 19 were relevant to the study questions. The cost-benefit ratios of PCC showed a wide range from 0.76 to 36 (average 6.8) according to the level of the medical expense of each country and whether the study included intentional poisoning. PCC reduced unnecessary visits to healthcare facilities. PCC consultation shortened the length of hospital stay by 1.82 (95% CI, 1.07-2.57) days. Conclusion: The systematic review and meta-analysis support the hypothesis that the PCC operation is cost-beneficial. However, when implementing the PCC concept in Korea in the future, it is necessary to prepare an institutional framework to ensure a cost-effective model.
Park, Yeonah,Kang, Eunah,Kwon, Oh-Joon,Hwang, Taewon,Park, Hongkwan,Lee, Jung Min,Kim, Jung Hyun,Yun, Chae-Ok Elsevier 2010 Journal of controlled release Vol.148 No.1
<P><B>Abstract</B></P> <P>For effective cancer gene therapy, systemic administration of tumor-targeting adenoviral (Ad) complexes is critical for delivery to both primary and metastatic lesions. Electrospinning was used to generate nanocomplexes of Ad, chitosan, poly(ethylene glycol) (PEG), and folic acid (FA) for effective FA receptor-expressing tumor-specific transduction. The chemical structure of the Ad/chitosan–PEG–FA nanocomplexes was characterized by NMR and FT-IR, and the diameter and surface charge were analyzed by dynamic light scattering and zeta potentiometry, respectively. The average size of Ad/chitosan–PEG–FA nanocomplexes was approximately 140nm, and the surface charge was 2.1mV compared to −4.9mV for naked Ad. Electron microscopy showed well-dispersed, individual Ad nanocomplexes without aggregation or degradation. Ad/chitosan nanocomplexes retained biological activity without impairment of the transduction efficiency of naked Ad. The transduction efficiency of Ad/chitosan–PEG–FA was increased as a function of FA ratio in FA receptor-expressing KB cells, but not in FA receptor-negative U343 cells, demonstrating FA receptor-targeted viral transduction. In addition, the transduction efficiency of Ad/chitosan–PEG–FA was 57.2% higher than chitosan-encapsulated Ad (Ad/chitosan), showing the superiority of FA receptor-mediated endocytosis for viral transduction. The production of inflammatory cytokine, IL-6 from macrophages was significantly reduced by Ad/chitosan–PEG–FA nanocomplexes, implying the potential for use in systemic administration. These results clearly demonstrate that cancer cell-targeted viral transduction by Ad/chitosan–PEG–FA nanocomplexes can be used effectively for metastatic tumor treatment with reduced immune reaction against Ad.</P> <P><B>Graphical abstract</B></P> <P>Ad nanocomplexes composed with chitosan–PEG–FA and processed via electrospinning showed high transduction efficacy and low immune responses.</P> <P>[DISPLAY OMISSION]</P>
( Yae Rim Kim ),( Eunah Hwang ),( Sung Bae Park ) 대한신장학회 2014 Kidney Research and Clinical Practice Vol.33 No.4
Tumoral calcinosis is a rare complication in uremic patients. An in-depth review ofpublished literature suggests that most patients with uremic tumoral calcinosis donot respond to medical treatment. Here, we report the case of a patient on peritonealdialysis who presented with infected multifocal masses on both hip joints and wassuccessfully treated by medical intervention. The patient was diagnosed with uremictumoral calcinosis by physical examination and radiologic imaging, and treated withlow-calcium dialysis and a non-calcium phosphate binder, sevelamer, withoutincreasing the dose of dialysis. At the 36-month follow-up, the majority of masseshad disappeared and the patient was asymptomatic.
극단적 에너지절감형 초절전 미래 반도체소자 기술 개발 연구
조가람(Karam Cho),고은아(Eunah Ko),김소영(Soyeong Kim),박윤희(Yunhee Park),홍성은(Seongeun Hong),임지현(Jihyun Lim),이유진(Yujin Lee),황윤정(Yun Jeong Hwang),신창환(Changhwan Shin) 대한전자공학회 2016 대한전자공학회 학술대회 Vol.2016 No.11
A negative capacitor is fabricated using poly(vinylidene fluoride-trifluoroethylene) copolymer and connected in series to an a-IZO TFT (amorphous-InZnO thin film transistor). It is experimentally demonstrated that the negative capacitance of the negative capacitor can achieve super steep switching in the a-IZO TFT (i.e., a subthreshold slope from 342 mV/decade to 221 mV/decade (forward voltage sweep) and 209 mV/decade (reverse voltage sweep) at room-temperature.
HONG, WAN GI,CHO, JEONG HYUN,HWANG, SANG-GU,LEE, EUNAH,LEE, JAESEOK,KIM, JONG-IL,UM, HONG-DUCK,PARK, JONG KUK Lychnia 2016 International journal of oncology Vol.48 No.6
<P>Podophyllotoxin acetate (PA) acts as a radiosensitizer against non-small cell lung cancer (NSCLC) <I>in vitro</I> and <I>in vivo</I>. In this study, we examined its potential role as a chemosensitizer in conjunction with the topoisomerase inhibitors etoposide (Eto) and camptothecin (Cpt). The effects of combinations of PA and Eto/Cpt were examined with CompuSyn software in two NSCLC cell lines, A549 and NCI-H1299. Combination index (CI) values indicated synergistic effects of PA and the topoisomerase inhibitors. The intracellular mechanism underlying synergism was further determined using propidium iodide uptake, immunoblotting and electrophoretic mobility shift assay (EMSA). Combination of PA with Eto/Cpt promoted disruption of the dynamics of actin filaments, leading to subsequent enhancement of apoptotic cell death via induction of caspase-3, -8, and -9, accompanied by increased phosphorylation of p38. Conversely, suppression of p38 phosphorylation blocked the apoptotic effect of the drug combinations. Notably, CREB-1, a transcription factor, was constitutively activated in both cell types, and synergistically inhibited upon combination treatment. Our results collectively indicate that PA functions as a chemosensitizer by enhancing apoptosis through activation of the p38/caspase axis and suppression of CREB-1.</P>
A Profile of Serum Mineral Parameters in Korean CKD Patients on Maintenance Hemodialysis
( Gheunho Kim ),( Bumsoon Choi ),( Daeryong Cha ),( Eunah Hwang ),( Hyungwuk Kim ),( Jaehyun Chang ),( Joohak Lee ),( Joongkyung Kim ),( Kwonwook Joo ),( Mikyung Kim ),( Sangchoel Lee ),( Sangwoong Ha 대한내과학회 2012 대한내과학회 추계학술대회 Vol.2012 No.1
( Gheun-Ho Kim ),( Bum Soon Choi ),( Dae Ryong Cha ),( Dong Hyun Chee ),( Eunah Hwang ),( Hyung Wook Kim ),( Jae Hyun Chang ),( Joong-Kyung Kim ),( Jung Woo Noh ),( Kwon Wook Joo ),( Sang Choel Lee ) 대한신장학회 2014 Kidney Research and Clinical Practice Vol.33 No.1
Background: In many countries, nephrologists follow clinical practice guidelines for mineral bone disorders to control secondary hyperparathyroidism (SHPT) associated with abnormal serum calcium (Ca) and phosphorus (P) levels in patients undergoing maintenance hemodialysis (MHD). The Kidney Disease Outcomes Quality Initiative (KDOQI) Guidelines have long been used in Korea, and this study was undertaken to investigate the current status of serum Ca and P control in MHD patients. Methods: Data were collected from a total of 1,018 patients undergoing MHD without intercurrent illness, in 17 hemodialysis centers throughout the country. Serum levels of Ca, P, and intact parathyroid hormone (iPTH) were measured over 1 year, and the average values were retrospectively analyzed. Results: Serum levels of Ca, P, and the Ca×P product were 9.1±0.7mg/dL, 5.3±1.4mg/dL, and 48.0±13.6mg2/dL2, respectively. However, the percentages of patients with Ca, P, and Ca × P product levels within the KDOQI guideline ranges were 58.7%, 51.0%, and 70.7%, respectively. Of the 1,018 patients, 270 (26.5%) had iPTH >300pg/mL (uncontrolled SHPT), whereas 435 patients (42.7%) showed iPTH <150pg/mL. Patients with uncontrolled SHPT had significantly higher values of serum Ca, P, and Ca×P product than those with iPTH ≤300pg/mL. Conclusion: Despite the current clinical practice guidelines, SHPT seems to be inadequately controlled in many MHD patients. Uncontrolled SHPT was associated with higher levels of serum Ca, P, and Ca × P product, suggestive of the importance of SHPT management.
Cho, Jeong Hyun,Hong, Wan Gi,Jung, Yu-Jin,Lee, Jaeseok,Lee, Eunah,Hwang, Sang-Gu,Um, Hong-Duck,Park, Jong Kuk Spring 2016 TUMOR BIOLOGY Vol.37 No.6
<P>Here, we report a new intracellular signaling pathway involved in gamma-ionizing radiation (IR)-induced migration/invasion and show that podophyllotoxin acetate (PA) inhibits the IR-induced invasion and migration of A549 cells (a non-small cell lung cancer (NSCLC) cell line). Our results revealed that IR increased the invasion/migration of A549 cells, and this effect was decreased by 10 nM PA treatment. PA also inhibited the expressions/activities of matrix metalloprotase (MMP) -2, MMP-9, and vimentin, suggesting that PA could block the IR-induced epithelial-mesenchymal transition (EMT). The IR-induced increases in invasion/migration were associated with the activation of EGFR-AKT, and PA inhibited this effect. P38 and p44/42 ERK were also involved in IR-induced invasion/migration, and combined treatments with PA plus inhibitors of each MAPK synergistically blocked this invasion/migration. In terms of transcription factors (TFs), IR-induced increases in cyclic AMP response element-binding protein-1 (CREB-1) and signal transducer and activator of transcription 3 (STAT3) increased invasion/migration and EMT. PA also inhibited these transcription factors and then blocked IR-induced invasion/migration. Collectively, these results indicate that IR induces cancer cell invasion/migration by activating the EGFR-p38/ERK-CREB-1/STAT3-EMT pathway and that PA blocks this pathway to inhibit IR-induced invasion/migration.</P>