Neutrophil extracellular traps and heparin-induced antibodies contribute to vascular access thrombosis in hemodialysis patients

( Hoi Woul Lee ),( Jung Nam An ),( Hyung Seok Lee ),( Young Rim Song ),( Hyung Jik Kim ),( Sung Gyun Kim ),( Jwa-kyung Kim ) 대한신장학회 2021 Kidney Research and Clinical Practice Vol.40 No.4

Background: Anti-heparin/platelet factor 4 (PF4) antibodies may trigger severe thrombotic complications in hemodialysis (HD) patients. Tetrameric PF4 has a high affinity for extracellular DNA, which is a key component of neutrophil extracellular traps (NETs); therefore, the interactions between anti-heparin/PF4 antibodies and NETs can contribute to prothrombotic events. Methods: Anti-heparin/PF4 antibody levels were measured by enzyme-linked immunosorbent assay and an optical density > 1.8 was regarded as clinically significant. We additionally measured serum nucleosome levels as representative markers of NETs, and the contributions of anti-heparin/PF4 and increased serum nucleosome levels to the primary functional patency loss of vascular access was assessed. Results: The frequency of anti-heparin/PF4 antibodies was significantly higher in incident HD patients compared to prevalent HD patients (23.6% vs. 7.7%). Serum nucleosome levels, as well as the white blood cell counts, neutrophil counts, and high- sensitivity C-reactive protein levels, were significantly higher in anti-heparin/PF4 antibody-positive patients compared to the control. Platelet counts tended to be lower in the patients with anti-heparin/PF4 of >1.8 than in the controls. Relative risk calculations showed that the presence of anti-heparin/PF4 antibodies increased the risk of primary functional patency failure by 4.28-fold, and this risk increased further with higher nucleosome levels. Furthermore, in the anti-heparin/PF4 antibody-positive group, the time to first vascular intervention was much shorter, and the risk of repeated intervention was higher, compared to the controls. Conclusion: In incident HD patients, the presence of anti-heparin/PF4 antibodies was associated with increased NET formation; this could be a strong predictor of vascular access complications

OSTEOPETROSIS

Kim,Onn,Rim,Jae Suk,Kim,Sung Moon,Kim,Hoi Jong 大韓顎顔面成形再建外科學會 1989 Maxillofacial Plastic Reconstructive Surgery Vol.11 No.2

Osteopetrosis (Albers - Schonberg disease) is a rare disease characterized by generaized sclerosis of bones, hepatoslenomegaly, pancytopenia, multiple fracture, blindness. The disease shows characteristic radiographic feature and two rather well - defined pattern have been recognized. We experienced a case of osteopetrosis in a 31 year old man, who has had pus discharge and fetid odor after extraction of upper maxillary molar. We made a brief review of literature.

Directional single mode emission in a microcavity laser.

Kim, Myung-Woon,Yi, Chang-Hwan,Rim, Sunghwan,Kim, Chil-Min,Kim, Jong-Hoi,Oh, Kwang-Ryung Optical Society of America 2012 Optics express Vol.20 No.13

<P>We report directional single mode emission in an InGaAsP semiconductor microcavity laser, which is composed of a circle and an isosceles trapezoid. When exciting a whole cavity, the laser generates a single mode without hopping in two directions over a wide range of continuous injection currents. In the emission spectrum, it is confirmed from the equidistant mode spacing that a scar mode becomes a single lasing mode above the lasing threshold. A numerical analysis of the boundary element method shows that the far-field pattern of the resonance agrees well with that of the experiment.</P>

The relationship between autophagy, increased neutrophil extracellular traps formation and endothelial dysfunction in chronic kidney disease

Kim, Jwa-Kyung,Park, Mi Jin,Lee, Hoi Woul,Lee, Hyung Seok,Choi, Sun Ryoung,Song, Young Rim,Kim, Hyung Jik,Park, Hyeong-Cheon,Kim, Sung Gyun Elsevier 2018 Clinical immunology Vol.197 No.-

<P><B>Abstract</B></P> <P>In chronic kidney disease (CKD), the number of circulating neutrophils are increased, and this is usually accompanied by an increased basal activation state. However, the possible association between neutrophil extracellular traps (NETs) with vascular complications has not been evaluated. We assessed the relationship between NETs, autophagy and endothelial dysfunction in maintenance hemodialysis (MHD) patients. NET formation, neutrophil elastase (NE) activities, and serum nucleosome levels were measured in MHD (<I>n</I> = 60) and controls (<I>n</I> = 20). Basal NET formation were markedly increased in MHD patient compared to controls. After PMA stimulation, MHD neutrophils showed significantly increased NETs formation response than controls. The degree of NETs was strongly associated with lower flow-mediated dilatation(%) of brachial artery even after adjustment for cardiovascular risk factors and uremic toxins. Moreover, MHD neutrophils showed increased basal autophagy activity. Interestingly, the levels of NETs were markedly augmented after autophagy inhibition, suggesting a protective role of autophagy in excessive NET formation.</P> <P><B>Highlights</B></P> <P> <UL> <LI> In patients with CKD, NET formation is significantly increased, and it may directly contribute to endothelial dysfunction. </LI> <LI> Chronic uremia-associated increased autophagy activity could be an adaptive response. </LI> <LI> Blocking autophagy activities induced exaggerated NET release, suggesting a protective role of autophagy in CKD patients. </LI> </UL> </P>

골석화증에 대한 문헌고찰

임재석(Jae Suk Rim),김석문(Suk Moon Kim),김회종(Hoi Jong Kim),김온(Onn Kim) 대한악안면성형재건외과학회 1989 Maxillofacial Plastic Reconstructive Surgery Vol.11 No.2

Osteopetrosis는 드물게 볼 수 있는 질환으로 일명, Albers-Schonberg disease 혹은 Marble bone disease 라고도 하며 그 주요한 특징은 전반적인 골경화증, 임파선의 증대, 간비 증대, 범혈구 감소증, 다발성 골절과 실명 등이다. 이 질환은 X-선상에서 독특한 소견을 보이며 임상적으로 악성형과 양성형으로 나눌 수 있다. Dominant form은 양성형으로써 다양하게 표현되어 단독 X-선상에서 이상을 나타내는 것부터 골절과 뇌신경을 침범하기까지 다양하게 나타나며, Recessive form은 악성형으로 자궁내에서 진단되어지고 빈혈이 심하며 골수양화생이 있으며, 감염 특히 하악의 골수염으로 대개는 첫 1 년 이내에 사망 한다고 보고되어 있다. 이에 저자들은 개인치과에서 상악 좌측 제 2대구치 발거후 골수염이 발생한 31세 남자 골석화증 환자를 치험하였기에 문헌고찰과 함께 보고하는 바이다. Osteopetrosis (Albers-Schonberg disease) is a rare disease characterized by generaized sclerosis of bones, hepatoslenomegaly, pancytopenia, multiple fracture, blindness. The disease shows characteristic radiographic feature and two rather well - defined patterns have been recognized, We experienced a case of osteopetrosis in a 31 year old man, who has had pus discharge and fetid odor after extraction of upper maxillary molar. We made a brief review of literature.

50세 이상 고관절 주위골절 환자에서의 골다공증 치료

김태영 ( Tae Young Kim ),하용찬 ( Yong Chan Ha ),김연호 ( Yeun Ho Kim ),이성락 ( Sung Rak Lee ),김상림 ( Sang Rim Kim ),김장락 ( Jang Rak Kim ),김신윤 ( Shin Yoon Kim ),구경회 ( Kyung Hoi Koo ) 대한고관절학회 2007 Hip and Pelvis Vol.19 No.4

제주도 지역 고관절 주위골절에 대한 역학연구

하용찬(Yong-Chan Ha),김상림(Sang-Rim Kim),구경회(Kyung-Hoi Koo),윤택림(Taek-Rim Yoon),김신윤(Shin-Yoon Kim),이봉진(Bong-Jin Lee),현광철(Kwang-Chul Hyun),김연성(Yeon-Sung Kim),황선철(Sun-Chul Hwang),황인환(In-Hwan Hwang),임인(In Im) 대한정형외과학회 2004 대한정형외과학회지 Vol.39 No.2

목적: 2002년 한 해 동안 제주도에 거주하는 만 50세 이상 인구를 대상으로 고관절 주위 골절 발생률에 대한 전향적인 연구를 시행하였다. 대상 및 방법: 고관절 주위 골절로 제주도내의 정형외과 병 의원을 방문한 만 50세 이상의 환자를 대상으로 2002년 1월 1일부터 12월 31일까지 환자들의 의무기록지와 방사선사진을 대상으로 하여, 나이, 성별, 수상원인, 수상시기, 수상부위, 수상 후부터 병원 방문시기와 치료방법, 골다공증의 정도, 동반된 환자의 전신상태에 대하여 파악하였다. 대퇴 경부 및 전자간 골절을 연구대상으로 하였고, 전체 인구 구성 비율 및 제주도내의 인구분포와 사망률에 대한 자료는 통계청으로부터 지원을 받았다. 결과: 고관절 주위골절은 남자 36예(36명), 여자 115예(114명)으로 전체 151예(150명)에서 발생하였고, 50대 이상의 인구에서 고관절 주위골절 발생률은 12.8/10,000명(남 7.3/10,어0명, 여 16.8/10,000명)을 나타내었다. 1985년 50세 이상의 미국 백인 인구에 연령표준화를 하여 골절 발생률을 구한 결과 남자 119/100,000명, 여자 182/100,000명으로 나타났다. 계절별로 분석하면 가을이 50예로 가장 많았고, 봄 40예, 겨울 35예, 여름에 35예 순이었다. 수상 당한 원인은 미끄러짐이 131예로 가장 많았으며, 낙상이 13예, 가벼운 교통사고가 7예였다. 고관절 주위 골절을 당한 환자의 평균 나이는 77.1세 (범위 50-98세)였고, 남자는 68.7세(범위, 50-91세), 여자는 79.7세(범위, 50-98세)였다. 방사선학적인 분류에서 확정된 골다공증(Singh index, Grade Ⅰ-Ⅲ)은 126예, 골다공증이 의심되는(Singh index, Grade Ⅳ-Ⅴ) 예는 25예였다. 결론: 1991년 호남지방에서 50세 이상에서 보고한 10,000명당 3.4명의 고관절 주위 골절에 비해, 2002년에 시행한 저자들의 연구는 12.8/10,000의 발생률을 나타내어 3.8배가 증가하였다. 앞으로 노인인구의 골다공증성 골절의 정확한 유형과 발생률에 대한 파악을 위하여 장기 추시 연구가 필요할 것이라 생각된다. Purpose: This prospective study conducted to estimate incidence of hip fracture among persons over 50 years of age, in Jeju island, Korea during the year 2002. Materials and Methods: Patients over 50 years of age who lived in Jeju island and sustained a femoral neck or intertrochanteric fracture during the year 2002 (from January 1st 2002 to December 31th 2002) were investigated. The information collected from the hospital records for each patient included age, sex, the nature of injury, the day of injury, location, the method of treatment, and the degree of osteoporosis. The population figures were derived from the National Statistical Office. Results: There were 151 fractures of the neck or intertrochanteric region of the femur (36 in men, 115 in women) in population over 50 years of age. The incidence was 12.8/10,000 for total patients (7.3/10,000 for men, 16.8/10,000 for women). The standardized incidence rate against the 1985 U.S. population was 119/100,000 for men and 187/100,000 population for women. The incidence rate showed seasonal variations, being highest in fall. The mean age of patients was 77.1 years (range 50-98 years). The most common cause of injury was a simple fall (131/151, 86.8%). There were 92 (60.9%) fractures of the neck and 59 (39.1%) of the intertrochanteric fracture. One hundred twenty six patients (83.4%) showed definite osteoporosis (Singh index, Grade Ⅰ-Ⅲ). Conclusion: The incidence rate of hip fracture increased 3.8 times in 2002 data (12.8/10,000) in Jeju island when compared with 1991 data (3.4/10,000) in Honam area. To have more accurate trend and estimate of incidence rate of osteoporotic fractures in the elderly, further longitudinal study need to be conducted.

대퇴 골두 연골하 스트레스 골절

송원석(Won Seok Song),김종원(Jong Won Kim),유정준(Jeong Joon Yoo),구경회(Kyung-Hoi Koo),윤강섭(Kang Sup Yoon),김상림(Sang Rim Kim),김영민(Young-Min Kim),김희중(Hee Joong Kim) 대한정형외과학회 2004 대한정형외과학회지 Vol.39 No.7

목적: 대퇴 골두 연골하 스트레스 골절(subchondral stress fracture of the femoral head)은 드문 질환으로서 최근에 주로 부전 골절(insufficiency fracture)의 형태로 발생한 예들에 대해 보고되고 있다. 본 연구에서는 부전 골절 및 피로 골절(fatigue fracture) 형태로 발생한 스트레스 골절 환자의 임상적, 방사선학적 특정을 평가하였다. 대상 및 방법: 1998년 1월부터 2003년 4월 사이에 대퇴 골두 연골하 스트레스 골절로 진단 및 치료 받은 8명 10예를 대상으로, 이들의 임상적 방사선학적 소견에 대해 평균 33개월 추시 결과를 평가하였다. 결과: 피로 골절의 양상으로는 6명의 젊고 건강한 군인에게서 입대 후 5개월 이내에 발생하였고, 부전 골절의 양상으로는 1명의 노인과 1명의 골형성 부전증 환자에게 발생하였다. 1명을 제외한 모든 환자에서 대퇴 골두 무혈성 괴사의 위험 요소 및 뚜렷한 선행 외상의 과거력은 있지 않았다. 최초의 단순 방사선 사진상 6명 7예에서 이상 소견이 관찰되었다. 이 중 4예에서 대퇴 골두의 함몰 소견이 관찰되었다. 골 주사 검사상 대퇴 골두에 증가된 흡수 음영 소견이 관찰되었다. 자기 공명 촬영에서 대퇴 골두 연골하 이상 신호 선(MR crescent sign)과 전반적인 골수의 부종 소견이 관찰되었다. 결론: 대퇴 골두 연골하 스트레스 골절은 부전 골절 및 피로 골절의 양상으로 모두 나타날 수 있으며, 의심되는 환자의 경우 골 주사 검사 등을 통하여 조기 진단함으로써 대퇴 골두의 함몰을 방지할 수 있을 것이다. Purpose: Subchondral stress fracture of the femoral head is a rare condition that usually occurs as an insufficiency fracture in people with poor bone quality. This study evaluated the clinical and radiographic aspects of the subchondral stress fracture of the femoral head that occurred in the form of an insufficiency or a fatigue fracture. Materials and Methods: Between January 1998 and April 2003, 10 cases of the subchondral stress fracture of the femoral head in 8 patients were treated. The characteristics of this condition were determined by assessing the clinical course and findings of the radiographs, bone scintigram and MR images. Results: A fatigue fracture developed in 6 young healthy conscripts within 5 months after recruitment. An insufficiency fracture developed in one senile patient and in one known osteogenesis imperfecta patient. All patients except for one did not have any predisposing factors for osteonecrosis and antecedent trauma. On the initial radiographs, femoral head collapse was observed in 4 hips. Bone scintigraphs showed increased radionuclide uptake in the femoral head. The MR images demonstrated an subchondral abnormal signal intensity line (MR crescent sign) and a bone marrow edema pattern. Conclusion: A subchondral stress fracture of the femoral head can occur as a fatigue fracture as well as an insufficiency fracture. Bone scintigraphy is a valuable tool for screening patients suspected of having a subchondral stress fracture.

2-D Synthesized Magnetic Field Focusing Technology With Loop Coils Distributed in a Rectangular Formation

Kim, Ji H.,Choi, Bo H.,Kim, Hoi R.,Rim, Chun T. Institute of Electrical and Electronics Engineers 2019 IEEE transactions on industrial electronics Vol.66 No.7

<P>In this paper, a novel loop coil structure for synthesized magnetic field focusing (SMF) technology and two current distribution calculating algorithms in the structure are proposed. The proposed structure enables field focusing in two-dimensional (2-D) space for the first time. The loop coil structure with a rectangular formation is adopted for a 2-D SMF system to minimize the volume and weight of the transmitting (Tx) coil array considering that conventional SMF systems inevitably have a volumetric design due to their dipole-based structure. Two algorithms to calculate the current distribution so as to focus the magnetic field at the target point are proposed. The first algorithm applies the Biot–Savart law to a loop-coil-based 2-D SMF system to calculate the distribution. The second algorithm utilizes a time-efficient synthesis method which reduces the matrix dimensions used in current distribution calculation. The second algorithm shows synthesis results with similar synthesis resolution compared with the first algorithm. Although the magnetic field distribution with the second algorithm has a little difference with that of first algorithm, its synthesis result focuses the magnetic field on the target point successfully, and it becomes more powerful as the number of coils increases. Synthesis results using two algorithms were compared with a finite-element method simulation with 100 Tx coils and 25 receiving (Rx) points. The synthesis resolution, as determined by –3 dB points, was enhanced by 4.45 times and 6.15 times for the first and the second algorithm, respectively, when compared to nonfocused case. An experimental prototype with 36 Tx coils and 9 Rx points with each coil 10 × 10 cm in size was built to demonstrate field focusing with current distributions calculated by the second algorithm at a frequency of 145 kHz. The experimental results were in good agreement with the simulated results, including a case in which the magnetic field was focused at Rx point other than center.</P>

Poster Session : PS 1306 ; Endocrinology : A Case of Kikuchi Disease with Concurrent Autoim-mune Thyroiditis and Sporadic Medullary Thyroid Canc-er

( Mi Rim Choi ),( Sung Sik Oh ),( Hyun Ju Yang ),( Myung Woo Choi ),( Jong Hwa Lee ),( Sun Kyung Song ),( Ji Hye Kim ),( Ki Hoi Kim ),( Cho Ok Baek ),( Seol Bong Yoo ) 대한내과학회 2014 대한내과학회 추계학술발표논문집 Vol.2014 No.1

Kikuchi disease (KD) is characterized by fever and lymphadenitis. Its pathogenesis is unclear, but two hypotheses have been reported: one, that it is caused by a viral infection, and the other, that it is an autoimmune origin. Patients with different types of autoimmune diseases have been reported to have had KD. A 32-year-old man presented painful cervical lymphadenopathy. The pathological examination from the LN excision showed necrotizing lymphadenitis. The patient was found to have had an anti-TPO antibody, and KD with concurrent autoimmune thyroiditis was confirmed. The thyroid sonogram revealed a thyroid nodule. The calcitonin level increased to 16.3 pg/ml, but histology was further required to come up with a treatment plan. Two-time aspiration cytology revealed severe atypia, which was needed for diagnostic confirmation of poorly differentiated carcinoma. After the surgery, the patient was confirmed with MTC. Based on the negative result of the RET mutation, sporadic type MTC was confirmed. The association of KD with SLE has often been reported. However, the association of KD with autoimmune thyroid diseases has seldom been reported. Based on the association of KD with autoimmune diseases, the pathogenesis of KD is also considered associated with autoimmune etiology. MTC is usually diagnosed based on the results of fine needle aspiration, but it is sometimes dif. cult to diagnose due to the extremely diverse microscopic findings. The level of calcitonin is important in diagnosing MTC. However, problems concerning false positive results, and low prevalence of MTC limit this approach. When the baseline serum calcitonin concentration level is 100 pg/ml or higher, MTC is strongly suspected. However, when the calcitonin concentration level is lower than 100 pg/ml and autoimmune thyroiditis are also found, additional tests may be required.