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Adenosine monophosphate-activated protein kinase in diabetic nephropathy

  • Kim, Yaeni;Park, Cheol Whee
    • Kidney Research and Clinical Practice
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    • v.35 no.2
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    • pp.69-77
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    • 2016
  • Diabetic nephropathy (DN) is the leading cause of end-stage renal disease, and its pathogenesis is complex and has not yet been fully elucidated. Abnormal glucose and lipid metabolism is key to understanding the pathogenesis of DN, which can develop in both type 1 and type 2 diabetes. A hallmark of this disease is the accumulation of glucose and lipids in renal cells, resulting in oxidative and endoplasmic reticulum stress, intracellular hypoxia, and inflammation, eventually leading to glomerulosclerosis and interstitial fibrosis. There is a growing body of evidence demonstrating that dysregulation of 50 adenosine monophosphate-activated protein kinase (AMPK), an enzyme that plays a principal role in cell growth and cellular energy homeostasis, in relevant tissues is a key component of the development of metabolic syndrome and type 2 diabetes mellitus; thus, targeting this enzyme may ameliorate some pathologic features of this disease. AMPK regulates the coordination of anabolic processes, with its activation proven to improve glucose and lipid homeostasis in insulin-resistant animal models, as well as demonstrating mitochondrial biogenesis and antitumor activity. In this review, we discuss new findings regarding the role of AMPK in the pathogenesis of DN and offer suggestions for feasible clinical use and future studies of the role of AMPK activators in this disorder.

Reninoma: a rare cause of curable hypertension

  • Kim, Ji Hye;Kim, Ji Hyun;Cho, Myung Hyun;Park, Eujin;Hyun, Hye Sun;Ahn, Yo Han;Kang, Hee Gyung;Moon, Kyung Chul;Ha, Il-Soo;Cheong, Hae Il
    • Clinical and Experimental Pediatrics
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    • v.62 no.4
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    • pp.144-147
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    • 2019
  • The most common type of refractory hypertension found in children is secondary hypertension, which is a potentially curable disease. Reninoma, a renin-secreting juxtaglomerular cell tumor, is a rare cause of severe hypertension that is usually diagnosed in adolescents and young adults. Surgical resection of the tumor completely cures the hypertension of patients with reninoma. The typical clinical presentation of reninoma includes hypokalemia, metabolic alkalosis, and features secondary to the increased activation of the renin-angiotensin system without renal artery stenosis. We report a case of reninoma in a female adolescent with a typical clinical presentation, in which surgical removal of the tumor completely cured hypertension. We discuss here the clinical features, imaging studies, and immunohistochemical examination of the tumor used to establish the diagnosis of reninoma and for the management of the condition.

Experiential treatment of ankylosing spondylitis using Ortho-Cellular Nutrition Therapy (OCNT)

  • Baek, Kyungsin
    • CELLMED
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    • v.12 no.3
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    • pp.14.1-14.2
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    • 2022
  • Currently, a 70-year-old woman started suffering from S.I joint pain from 1973 and had severe pain in the S.I joint, wrist, and elbow from 1975 to 1977, and was diagnosed with spinal tuberculosis at a general hospital. From 1978 to 1987, she suffered from chronic fatigue and insomnia, and since January 1, 1988, she was unable to get up while lying down, suffering from whole body joint, muscle pain, and fibromyalgia. In May 1989, she was also diagnosed with ankylosing spondylitis through genetic testing at the Catholic St. Mary's Hospital Rheumatology Department in Korea, and was treated with sulfasalazine, analgesic, and immunosuppressant, methotrexate, for 12 years until 1999, but none of the drugs eliminated the pain. She was hospitalized and discharged repeatedly, and continued to receive salt water poultice and exercise therapy at home, but was unable to move at all. In 2000, after biologic treatment with Remicade injection (Remsima®), she was able to walk and move, and after that, she was continuously prescribed biologics. From 2015 to 2019, Enbrel® (Etanercept) injection was prescribed once a week, but the symptoms such as severe pain (joint and muscle, fibromyalgia), scleroderma, Sjogren's syndrome (dryness of eyes, nose and mouth), difficulty swallowing, chronic fatigue, and stiff body appeared. Around January 2018, hepatic indicators were high and lymphocytes became enlarged. However, most serious injuries were highly improved after the OCNT combination therapy using active phytonutrients, anthocyanin-fucoidan nanocomplex. Therefore, for patients with such experiences, OCNT treatment is proposed as an alternative.

Why Should We Consider Potential Roles of Oral Bacteria in the Pathogenesis of Sjögren Syndrome?

  • Sung-Ho Chang;Sung-Hwan Park;Mi-La Cho;Youngnim Choi
    • IMMUNE NETWORK
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    • v.22 no.4
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    • pp.32.1-32.20
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    • 2022
  • Sjögren syndrome (SS) is a chronic autoimmune disorder that primarily targets the salivary and lacrimal glands. The pathology of these exocrine glands is characterized by periductal focal lymphocytic infiltrates, and both T cell-mediated tissue injury and autoantibodies that interfere with the secretion process underlie glandular hypofunction. In addition to these adaptive mechanisms, multiple innate immune pathways are dysregulated, particularly in the salivary gland epithelium. Our understanding of the pathogenetic mechanisms of SS has substantially improved during the past decade. In contrast to viral infection, bacterial infection has never been considered in the pathogenesis of SS. In this review, oral dysbiosis associated with SS and evidence for bacterial infection of the salivary glands in SS were reviewed. In addition, the potential contributions of bacterial infection to innate activation of ductal epithelial cells, plasmacytoid dendritic cells, and B cells and to the breach of tolerance via bystander activation of autoreactive T cells and molecular mimicry were discussed. The added roles of bacteria may extend our understanding of the pathogenetic mechanisms and therapeutic approaches for this autoimmune exocrinopathy.

THE MORPHOLOGICAL OBSERVATION OF HUMAN PERIODONTAL LIGAMENT CELLS ATTACHMENT AND SPREADING ON THE SURFACE OF SLIDE GLASS (치주인대세포의 부착과 전개에 관한 형태학적 관찰)

  • Lee, Jin-Mi;Suh, Jo-Young;Park, Joon-Bong
    • Journal of Periodontal and Implant Science
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    • v.23 no.1
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    • pp.97-108
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    • 1993
  • One of the important initial events required for periodontal regeneration is the attachment and subsequent spreading of periodontal ligament cells on the root surface. The purposes of this study is to investigate the attachment and spreading pattern of human periodontal ligament cell on the surface of glass slides. After establishment of a cell line of the primary cell culture from the periodontal ligament of 1st premolar teeth which were extracted for the purpose of orthodontic treatment, author dispersed the cells at $5{\times}10^3\;cells/ml$ into the each 35mm culture petri-dish containing 2 glass slides. To observe the morphological changes of the cells which attached to the surfaces of glasses at every designed time schedule, author used the inverted phase contrast microscope and scanning electron microscope. During the whole experiment culture condition was at $37^{\circ}C$, 100% Humidity, 5% $CO_2$ gas incubator. The following results were obtained. Periodontal ligament cells showed spherical outline and started to attach to glass surface by basal sytoplasmic extension after 10min in culture. After 30min in culture, periodontal ligament cells were attached to glass surface by well - developed filopodia which protruded from the lamellipodia. The cell surface is covered with bubble-like structures and occasional microvillus can be seen with diffculty among these structures. After 1.5hr in culture, peridontal ligament cells shhowed radially well-spread cytoplasm and the nucleus was centered on its cytoplasm. Unspread central region of the cell was covered with numerous microvilli. The change of cell attachment and spreading pattern was manifest at 6hr in culture. At this time, periodontal ligament cell showed elongated outline and an oval-shaped nucleus. After 12hr in culture, periodontal ligament cells showed more stretched fibroblast-like appearance with polarity. Two long lamellipodia can be seen around the both terminal ends of cells. After 24hr in culture, periodontal ligament cells showed spindle shapes and an oval-shaped nucleus was slanted toward one side of the cell.

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Changes in midpalatal suture area and adjacent periodontal tissues of individual tooth following rapid palatal expansion in young adult dogs ; Histomorphologic and immunohistochemical study (유성견 급속 구개확장시 정중구개봉합부 및 치아주위 조직 변화에 관한 조직형태학적 및 면역조직화학적 연구)

  • Lee, Ju-Young;Lee, Jin-Woo;Cha, Kyung-Suk
    • The korean journal of orthodontics
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    • v.30 no.3 s.80
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    • pp.317-333
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    • 2000
  • The purpose of this study was to determine the proliferative activity of the osteoblasts and fibroblasts in the midpalatal area and to investigate the adjacent periodontal tissues of individual tooth following rapid expansion of the palate. Ten young adult dogs, aged approximately ten months, were used in the experiment. The experimental design was consisted of 1 week expansion group(Group E1, 3 dogs), 2 week expansion group(Group E2, 3 dogs), 2 week expansion and 2 week retention group(Group E3, 3 dogs), and control group(Group C, 1 dog). For each group, expansion screw was activated one time per day(1/4 turn;$90^{\circ}$) following Hyrax-screw application. The experimental animals in each group were sacrificed at 1, 2 and 4 weeks following palatal expansion. Maxillary tissue blocks were obtained and prepared ior the histomorphologic and immunohistochemical studies. Light mcroscope, polarizing microscope, and soft X-ray apparatus were used in this study, and following results were obtained. 1. In polarizing microscopic study, the expansion groups(E1 & E2) showed blue color representing bone resorption and new bone formation in midpalatal suture area. E3 groups skewed less blue color compared to the E1 and E2 group. But yellow color increased by calcification in the E3 groups. 2. Immunohistochemical study revealed that positive responses of the osteoblasts to PCNA and undifferentiated fibroblasts to EGF in E1 group were somewhat increased. Positive response to PCNA and EGF were increased in fibroblasts and the osteoblasts forming new bone in E2 group. In E3 group, the positive response cell concentrated the periphery of edge of palatal process in both PCNA and EGF. 3. Throughout the expansion period(E1 & E2), light microscopic study showed the edges of the extensive resorption and new palatal processes, indicating bone remodeling within the suture. E3 group exhibited less remodeling of midpalatal suture area. E2 group and E3 group showed cementum formation and resorption at the apex of 3rd premolar and 1st molar E3 group exhibited extensive hyalinized zone on the cervical portion of buccal side of 1st molar. 4. Soft X-ray analysis of E1 group showed hypomineralized defect and microfractures in various parts of the suture areas when compared with control animals. There was no significant difference in the degree of mineralization in the midpalatal suture region between the C and E3 groups. Tooth axis showed tipping of 3rd premolar and 1st molar in the E2 group and E3 group. Based upon these experimental results, it is concluded that the undifferentiated mesenchymal cells always presented in midpalatal suture area following RPE. Differentiated osteoblasts and fibroblasts possess proliferating cellular activity until the 2 week retention period. The posterior teeth are tend to tip buccally as RPE force applied. Retention group exhibited irreversible response with severe hyalinized zone on the buccal surface of the first molar.

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The Effectiveness of Visual Field C10-2 in the Early Detection of Glaucoma with Parafoveal Scotoma (중심부 시야결손을 보이는 초기 녹내장 환자의 진단에서 자동시야계 C10-2의 유용성)

  • Hwang, Bo Een;Park, Hae-Young Lopilly;Park, Chan Kee
    • Journal of The Korean Ophthalmological Society
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    • v.58 no.3
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    • pp.321-326
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    • 2017
  • Purpose To identify the correspondence between the central sensitivity of several visual field (VF) tests and ganglion cell inner plexiform layer (GC-IPL) thickness in early glaucoma patients with parafoveal scotoma. Methods Fifty-seven eyes from 57 patients with glaucomatous optic neuropathy and parafoveal scotoma were analyzed using the standard automated perimetry (SAP) C10-2 test, the SAP C24-2 test, and the frequency doubling technology perimetry (FDT) C24-2 test. The correlation between the VF central sensitivity and the GC-IPL thickness from macular scans via optical coherence tomography was analyzed. Results The central sensitivity was $27.51{\pm}5.43dB$, $27.39{\pm}5.05dB$, and $22.09{\pm}5.08dB$ for SAP C24-2, SAP C10-2, and FDT C24-2, respectively. Mean GC-IPL thickness was $70.2{\pm}8.5{\mu}m$. Using regression analysis, the value of log $R^2$ between the logarithmic central sensitivity and GC-IPL thickness was 0.498, and the linear $R^2$ between the antilogarithmic central sensitivity and GC-IPL thickness in SAP C10-2 was 0.486, and both were statistically significant (p < 0.05). This relationship was stronger in early glaucoma patients compared to late glaucoma patients using SAP C10-2. Conclusions The structure-function relationship between GC-IPL thickness and central sensitivity was better with SAP C10-2, especially in early glaucoma patients, compared to other VF modalities.

AN EXPERIMENTAL STUDY OF THE IRRADIATION EFFECTS ON THE MICROVASCULATURE OF THE RAT SUBMANDIBULAR GLAND (방사선 조사가 백서 악하선 미세혈관계에 미치는 영향에 관한 실험적 연구)

  • Choi Karp Shik;Choi Soon Chul;Park Tae won
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.22 no.1
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    • pp.43-53
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    • 1992
  • The purpose of this study was to investigate the effects of irradiation on the microvascular structure of the submandibular gland in rats. For this study, 110 male rats were singly irradiated with the dose of 10Gy or 20Gy to their neck region by 6MV X-irradiation and sacrificed on the 1st, 3rd, 7th, 14th and 28th day after irradiation. The author observed distribution and structural changes of the microvasculature in rat submandibular glands using a scanning electron microscope by forming vascular resin casting. The author observed ultrastructural changes of the endothelial cells using a transmission electron microscope, and also histologic changes using a light microscope at Hematoxylin and Eosin staining and PAS staining process. The results of the irradiation effects on the microvasculature in rat submandibular gland were as follows: By light microscopic examination, the dilation of small vessels were observed until the 7th day after irradiation. After then, the vascular constriction and decrease in number of small vessels were noticed. Changes were greater on 20Gy irradiated group than on lOGy irradiated group. The reaction to PAS staining at acinar cells was decreased just after irradiation, but gradually recovered with days. There was no specific difference between two irradiated groups. By scanning electron microscopic examination, general findings on the two irradiated groups were similar. The dilation of conduits and meandering were observed on the 3rd day after irradiation. Decrease of capillary density and blunt ended small vessels were appeared on the 7th day after irradiation. After that, findings of the tortuous and twisted vascular running and coarseness of capillary lumen were increased. Changes were greater on 20Gy irradiated group than on l0Gy irradiated group. By transmission electron microscopic examination, increase of the formation of cytoplasmic process was observed on the 3rd day after irradiation. After that, swelling of endothelial cell and bridge formation of cytoplasmic processes were also observed, but destruction of endothelial cell and loss of basement membrane were observed only on 20Gy irradiated group on the 28th day after irradiation.

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Optimal Ccontrol Strategy of Cooling System for Polymer Electrolyte Membrane Fuel Cell using Hardware-In-the-Loop Simulation (Hardware-In-the-Loop Simulation을 이용한 고분자 전해질 연료전지 냉각시스템 최적 제어기법 연구)

  • Choi, Eunyeong;Ji, Hyunjin
    • Journal of Energy Engineering
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    • v.25 no.1
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    • pp.113-121
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    • 2016
  • Polymer electrolyte membrane fuel cell(PEMFC) requires cooling system to maintain the proper operating temperature(about $65^{\circ}C{\sim}75^{\circ}C$) because the efficiency and power are affected by operating temperature. In order to retain the operating temperature of PEMFC, cooling system and coolant control logic are needed. Hardware-in-the-loop simulation(HILS) is one of effective methods to study and evaluate control algorithm. In this paper, the HILS system was designed to study the coolant control algorithm. The models of HILS system consisted of PEMFC, heat exchanger, and external environment associated with temperature. The hardwares in HILS system are 3-way valves, pumps, and a heat exchanger. The priority control and the control target temperature were investigated to improve the control performance using HILS. The 3-way valve in $1^{st}$ cooling circuit was selected as priority control target. The under limit value of $2^{nd}$ 3-way valve set as a function of PEMFC power and $2^{nd}$ circuit coolant temperature to correct temperature control performance. As a result, the temperature of PEMFC is stably controlled.

The Effect of a Video Exercise Program on Cancer-related Fatigue, Physical Function and Emotional Status in Patients with Cancer during Chemotherapy (동영상 운동프로그램이 항암 화학요법을 받는 암환자의 피로와 신체기능 및 정서상태에 미치는 효과)

  • Cho, Mee Young;Park, Ji Young;Lee, Chung Eun;Song, Su Kyung;Lee, Sun Hi;Byun, Eun Sung;Kim, Ji Youn;Park, Ok Sun;Kim, Soon Ho;Kang, Young Lynn;Han, Soo Young;Lee, Hyang Kyu;Choi, Hye Jin
    • Journal of Korean Clinical Nursing Research
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    • v.18 no.3
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    • pp.368-380
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    • 2012
  • Purpose: The purpose of this study was to evaluate the effects of a home-based video exercise program on cancer-related fatigue, physiological and psychological status in patients with colon and rectal cancers undergoing chemotherapy. Methods: The study design was a non-equivalent control group non-synchronized design. Data were collected from patients with colo-rectal cancers in Yonsei cancer center from July 5th to October 31st in 2011. There were 40 participants; 20 in the experimental group and 20 in the control group. The structured questionnaire was used to measure fatigue, physical function and emotional status. Data were analyzed using SPSS 18.0 and a chi-squre test, Fisher's exact test, Mann-Whitney U test and Wilcoxon signed- rank test were conducted to examine the homogeneity and the research hypotheses. Results: There was a statistically significant difference in White Blood Cell count in the experimental group compared with that of the control group. The exercise group showed a slight decrease of White Blood Cell count compared with that of the control group after 4 week program (z=-2.935, p=.003). However, there were no significant differences in fatigue, physiological and psychological status between the two groups. Conclusion: In this study, the developed video exercise program was effective in markedly slightly decreasing White Blood Cell count in patients with colo-rectal cancers undergoing chemotherapy. Therefore, utilizing the video exercise program can be an useful method to promote health among patients with cancer in clinical practice.