Hidden Acid Retention with Normal Serum Bicarbonate Level in Chronic Kidney Disease

( Eun Sil Koh ) 대한전해질학회 2023 Electrolytes & Blood Pressure Vol.21 No.1

Management of metabolic acidosis is crucial for preserving bone, muscle, and renal health, as evidenced by the results of several interventional studies conducted on patients with chronic kidney disease (CKD). Considering the continuity of CKD progression over time, it is reasonable to deduce that a subclinical form of metabolic acidosis may exist prior to the manifestation of overt metabolic acidosis. Covert H⁺ retention with normal serum bicarbonate level in patients with CKD may result in maladaptive responses that contribute to kidney function deterioration, even in the early stages of the disease. The loss of adaptive compensatory mechanisms of urinary acid excretion may be a key factor in this process. Early modulation of these responses could be an important therapeutic strategy in preventing CKD progression. However, to date, the optimal approach for alkali therapy in subclinical metabolic acidosis in CKD remains uncertain. There is a lack of established guidelines on when to initiate alkali therapy, potential side effects of alkali agents, and the optimal blood bicarbonate levels based on evidence-based practices. Therefore, further research is necessary to address these concerns and establish more robust guidelines for the use of alkali therapy in patients with CKD. Herein, we provide an overview of recent developments on this subject and examine the potential therapeutic approaches that interventional treatments may present for patients with hidden H⁺ retention, exhibiting normal serum bicarbonate levels - commonly described as subclinical or eubicarbonatemic metabolic acidosis in patients with CKD.

D-Pinitol alleviates cyclosporine A-induced renal tubulointerstitial fibrosis via activating Sirt1 and Nrf2 antioxidant pathways

Koh, Eun Sil,Kim, Soojeong,Kim, Minyoung,Hong, Yu Ah,Shin, Seok Joon,Park, Cheol Whee,Chang, Yoon Sik,Chung, Sungjin,Kim, Ho-Shik UNKNOWN 2018 INTERNATIONAL JOURNAL OF MOLECULAR MEDICINE Vol.41 No.4

<P>Although the mechanism of cyclosporine A (CsA)-induced renal injury remains to be fully elucidated, accumulating evidence suggests that oxidative stress is critical in producing CsA-induced structural and functional renal impairment. The present study investigated the effect of D-pinitol, a cyclitol present in soybean, on chronic CsA nephropathy. Male ICR mice were treated with vehicle, CsA (30 mg/kg/day), D-pinitol (50 mg/kg/day) or a combination of CsA and D-pinitol for 28 days. To assess which pathway responding to oxidative stress is augmented by D-pinitol, the expression levels of several antioxidant enzymes and their possible regulators were measured. Treatment with D-pinitol significantly suppressed the increase of serum creatinine and decrease of urine osmolality, compared with the CsA control group. Histological examination of Masson's trichrome- and α-smooth muscle actin-stained renal tissue demonstrated that the CsA-induced tubulointerstitial fibrosis and inflammation were attenuated by D-pinitol. Following the administration of D-pinitol, there were increased expression levels of heme oxygenase-1, NAD(P)H:quinone oxidoreductase 1, superoxide dismutase 1 and catalase in CsA-treated kidneys. In addition, D-pinitol increased the level of sirtuin 1 (Sirt1), and the total and nuclear expression levels of nuclear erythroid factor 2-related factor 2 (Nrf2), suggesting that activation of the Sirt1 and Nrf2 pathways may induce the cellular antioxi dant system against CsA-induced nephropathy. Collectively, these data suggested that D-pinitol may protect the kidney from CsA-induced fibrosis, and that this renoprotective effect of D-pinitol was due to the inhibition of oxidative stress through the activation of Sirt1 and Nrf2, and the subsequent enhancement of antioxidant enzymes.</P>

Weight change and microvascular outcomes in patients with new-onset diabetes: a nationwide cohort study

( Eun Sil Koh ),( Kyung Do Han ),( Mee Kyoung Kim ),( Eun Sook Kim ),( Min-kyung Lee ),( Ga Eun Nam ),( Hyuk-sang Kwon ) 대한내과학회 2021 The Korean Journal of Internal Medicine Vol.36 No.4

Background/Aims: Because weight control is important in treatment of type 2 diabetes, it is essential to understand the associations between weight change and the risk of microvascular complications among patients with type 2 diabetes. We examined whether weight changes early after new-onset diabetes have an impact on the clinical outcomes of diabetic nephropathy and retinopathy. Methods: Using the Korean National Health Insurance Service-National Health Screening Cohort database, 181,872 patients newly diagnosed with type 2 diabetes who were free of end-stage renal disease (ESRD) and proliferative diabetic retinopathy (PDR) during 2007 to 2012 were followed to the end of 2016. Weight change was defined as the difference in body weight from the time of diabetes diagnosis to 2 years later. Results: We identified 180 cases of ESRD and 780 cases of PDR followed up for a median of 5.5 years from the index year at 2 years after diagnosis. Those with 5% to 10% weight gain showed a significantly higher hazard ratio (HR) for ESRD, compared with those with ≤ 5% weight change after adjusting for several confounding factors, including the baseline estimated glomerular filtration rate (HR, 1.75; 95% confidence interval [CI], 1.14 to 2.70). Those with ≥ 10% weight loss showed the lowest HR for PDR (HR, 0.52; 95% CI, 0.33 to 0.83), whereas those with ≥ 10% weight gain showed the highest HR for PDR (HR, 3.20; 95% CI, 2.51 to 4.08). Conclusions: Weight gain after new-onset diabetes was associated with increased risk of ESRD and PDR whereas weight loss with decreased risk of PDR, but not ESRD.

Serum β₂-Microglobulin Predicts Mortality in Peritoneal Dialysis Patients: A Prospective Cohort Study

Koh, Eun Sil,Lee, Kyungsoo,Kim, Su Hyun,Kim, Young Ok,Jin, Dong Chan,Song, Ho Chul,Choi, Euy Jin,Kim, Yong Lim,Kim, Yon Su,Kang, Shin Wook,Kim, Nam Ho,Yang, Chul Woo,Kim, Yong Kyun S. Karger AG 2015 American journal of nephrology Vol.42 No.2

<P>Abstract</P><P><B><I>Background/Aims:</I></B> β<SUB>2</SUB>-Microglobulin (β<SUB>2</SUB>-M) is a surrogate marker of middle-molecule uremic toxins and is associated with mortality in chronic hemodialysis patients. However, the impact of serum β<SUB>2</SUB>-M levels on mortality in peritoneal dialysis (PD) patients is uncertain. The purpose of this study was to examine the association of serum β<SUB>2</SUB>-M levels with all-cause mortality in PD patients. <B><I>Methods:</I></B> A total of 771 PD patients were selected from the Clinical Research Center registry for end-stage renal disease cohort in Korea. Patients were categorized into 3 groups by tertiles of serum β<SUB>2</SUB>-M levels. The primary outcome was all-cause mortality. <B><I>Results:</I></B> The median value of serum β<SUB>2</SUB>-M was 23.6 mg/l (interquartile range 14.8-33.4 mg/l), and the median follow-up period was 39 months. The Kaplan-Meier analysis showed that the all-cause mortality rate was significantly different according to tertiles of serum β<SUB>2</SUB>-M in PD patients (p = 0.03, log-rank). Multivariate Cox proportional analysis showed that the hazards ratio for all-cause mortality was 1.02 (95% CI 1.01-1.04, p = 0.006) per 1 mg/l increase in β<SUB>2</SUB>-M after adjustment for multiple confounding factors that relate to malnutrition and inflammation marker. However, serum β<SUB>2</SUB>-M was not associated with all-cause mortality after adjustment for residual renal clearance. <B><I>Conclusions:</I></B> These results are supportive of the potential role of the serum β<SUB>2</SUB>-M level as a predictor of mortality in PD patients.</P><P>© 2015 S. Karger AG, Basel</P>

Posterior nutcracker phenomenon with Down syndrome

( Eun Sil Koh ),( Min Young Kim ),( Yoon Sik Chang ),( Sung Jin Chung ) 대한신장학회 2015 Kidney Research and Clinical Practice Vol.34 No.4

Dysphagia Caused by Myasthenia Gravis Mimicking Brainstem Stroke in an Elderly Man

Eun Sil Koh 대한뇌졸중학회 2009 Journal of stroke Vol.11 No.2

Myasthenia gravis (MG) can present with dysphagia and mimic brainstem stroke in the elderly. The authors experienced an elderly man with dysphagia who was initially suspected to have suffered a brainstem stroke and was managed accordingly. However, a diagnostic work up eventually revealed myasthenia gravis with thymoma. Achieving an accurate diagnosis of stro-ke during the acute stage is becoming more important because thrombolysis is now considered early during stroke treatment. Therefore, clinicians should be aware of conditions that mimic stroke symptoms, including myasthenia gravis, to avoid the risks of unnecessary procedures and to facilitate optimal treatment. (Korean J Stroke 2009;11:100-101)

맥스팩터(Max Factor)의 업적 고찰을 통한 철학적 의미 연구

김은실 ( Eun Sil Kim ),조고미 ( Koh Mi Cho ) 한국미용학회 2015 한국미용학회지 Vol.21 No.3

The purpose of this study is to examine Max Factor, the founder of Max Factor company, who constructed the stepping stone in the hollywood make-up history and the media production. Max Factor company still has high reputation and value among the numerous make-up and media industries, and this study will re-examine the company`s footprint. The method of this study is designed from the domestic and overseas scholarly articles, which provide Max Factor`s biography, pictures, official web site, and news articles from all over the world. The time span for inspecting Max Factor company takes a place between 1914 and 2014, which is between immediately after Max`s death and the present in which P&G’s online marketing has been operated since P&G took over the ownership of Max Factor company. The result shows the challenge spirit and creativity of Max Factor company provided a huge success to the company. Newly invented make-up kits were not only thorough but also contained humanity, natural beauty, and futuristic features. As a result, Max Factor company became leading company in the industries, and no company could beat its popularity. For example, the air-spray body painting, optical illusion based animal make-up, innovative make-up research development, etc. are the proof of Max Factor`s characteristics which made him so special. Currently, there is Max Factor Museum established in Hollywood; therefore, it has been obvious that Mac Factor`s contribution in the art and make-up industry is very impressive. The history of Max Factor will remain forever among the people all over the world.

인터넷중독 청소년을 위한 해결중심 집단상담 프로그램 효과

문현실(Hyun Sil Mun),고영삼(Young Sam Koh),이은경(Eun Kyoung Lea) 한국청소년문화연구소 2011 청소년 문화포럼 Vol.- No.28

The purpose of this study was to develop a group counseling program for adolescents internet addiction and to find out counseling therapeutic effects. For this purpose, a counseling program based on the 5-step treatment model of De Shazer in the Brief Family Therapy Center was modified by the present investigators. Participants of this study were 46 middle school students selected high-level inernet use risky group by internet addiction inventory. 46 students were divided experimental group and control group by random. Measurements included a self-control scale, a self-competence Scale, a BDI(Beck Depression Inventory), and a family-related stress inventory. Results showed that the solution-focused group counseling program for adolescent internet addiction had significant effects on self-competence, depression and family-related stress of adoelescent internet addiction.

근육근막염으로 발현한 사르코이드증

도연실 ( Yeon Sil Do ),이진영 ( Jin Young Lee ),김형진 ( Hyung Jin Kim ),김응호 ( Eung Ho Kim ),채지영 ( Ji Young Chai ),전찬홍 ( Chan Hong Jeon ),차훈석 ( Hoon Suk Cha ),고은미 ( Eun Mi Koh ) 대한류마티스학회 2005 대한류마티스학회지 Vol.12 No.1

Sarcoidosis is a systemic granulomatous disorder of unknown cause. The isolated noduar type muscular sarcoidosis without other systemic involvement is very rare in Korea. We report a case of sarcoidosis presented with myofasciitis. A 46-year-old man visited hospital with painful nodular swelling on the right arm for 1 month. We performed a humerus MRI and it revealed irregular shaped subcutaneous mass infiltrating along the fascial plane. The biopsy of triceps mass showed non-caseating granuloma of muscle and fascia. To find out the cause of granuloma, we checked chest CT scan and found out some enlargement of mediastinal lymph nodes. The biopsy also demonstrated non-caseating granulomas. It had no cancerous component and culture for microorganisms were all negative. He was diagnosed as sarcoidosis and given NSAID. On follow up evaluation, the size of mass was decreased.

A Novel Non-agonist Peroxisome Proliferator-activated Receptor γ (PPARγ) Ligand UHC1 Blocks PPARγ Phosphorylation by Cyclin-dependent Kinase 5 (CDK5) and Improves Insulin Sensitivity

Choi, Sun-Sil,Kim, Eun Sun,Koh, Minseob,Lee, Soo-Jin,Lim, Donghyun,Yang, Yong Ryoul,Jang, Hyun-Jun,Seo, Kyung-ah,Min, Sang-Hyun,Lee, In Hee,Park, Seung Bum,Suh, Pann-Ghill,Choi, Jang Hyun American Society for Biochemistry and Molecular Bi 2014 The Journal of biological chemistry Vol.289 No.38

<P>Thiazolidinedione class of anti-diabetic drugs which are known as peroxisome proliferator-activated receptor gamma (PPAR gamma) ligands have been used to treat metabolic disorders, but thiazolidinediones can also cause several severe side effects, including congestive heart failure, fluid retention, and weight gain. In this study, we describe a novel synthetic PPAR gamma ligand LTNIST HYUNDAI Compound 1 (UH('1) that binds tightly to PPAR gamma without the classical agonism and which blocks cyclin-dependent kinase 5 (CDK5)-mediated PPAR gamma phosphorylation. We modified the non-agonist PPAR gamma ligand SR1664 chemically to improve its solubility and then developed a novel PPAR gamma ligand, UHC1. According to our docking simulation, UHC1 occupied the ligand-binding site of P PARy with a higher docking score than SR1664. In addition, UHC1 more potently blocked CDK5-mediated PPAR gamma phosphorylation at Ser273. Surprisingly, UHC1 treatment effectively ameliorated the inflammatory response both in vitro and in high-fat diet-fed mice. Furthermore, UHC1 treatment dramatically improved insulin sensitivity in high-flit diet-fed mice without causing fluid retention and weight gain. Taken together, compared with SR 1 664, UHC1 exhibited greater beneficial effects on glucose and lipid metabolism by blocking CD K5-mediated PPAR gamma phosphorylation, and these data indicate that UHC1 could be a novel therapeutic agent for use in type 2 diabetes and related metabolic disorders.</P>