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Park WY, Han S, Choi BS, Park CW, Yang CW, Kim YS, Kim JI, Moon IS, Chung BH. Progression of Osteoporosis After Kidney Transplantation in Patients With End-Stage Renal Disease. Transplant Proc 2018; 49:1033-1037. [PMID: 28583521 DOI: 10.1016/j.transproceed.2017.03.038] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND This study investigated the prevalence of osteoporosis and the risk factors for its progression in kidney transplant recipients (KTRs). METHODS Dual energy X-ray absorptiometry was used to prospectively measure changes in bone mineral density (BMD) before kidney transplantation (KT) and 1 year after transplantation in 207 individuals. We also analyzed the risk factors of osteoporosis progression during this period. RESULTS Prior to KT, the mean BMD score (T-score of the femur neck area) was -2.1 ± 1.2, and the prevalence of osteoporosis was 41.5% (86/207). At 1 year post-transplantation, the mean BMD score significantly decreased to -2.3 ± 1.1 (P < .001), and the prevalence of osteoporosis increased to 47.3% (98/207; P = .277). The BMD score worsened over the study period in 69.1% (143/207) of patients, improved in 24.1% (50/207), and showed no change in 6.8% (14/207). Minimal intact parathyroid hormone (iPTH) improvement after KT was found to be an independent risk factor of osteoporosis progression. CONCLUSIONS This study demonstrates progressive loss of BMD after KT and sustained secondary hyperparathyroidism might influence the progression of osteoporosis.
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Chen KL, Cho YT, Yang CW, Sheen YS, Liang CW, Lacouture ME, Chu CY. Olmutinib-induced palmoplantar keratoderma. Br J Dermatol 2017; 178:e129-e131. [PMID: 28869782 DOI: 10.1111/bjd.15935] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Huang GX, Wang CY, Yang CW, Guo PC, Yu HQ. Degradation of Bisphenol A by Peroxymonosulfate Catalytically Activated with Mn 1.8Fe 1.2O 4 Nanospheres: Synergism between Mn and Fe. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2017; 51:12611-12618. [PMID: 28985472 DOI: 10.1021/acs.est.7b03007] [Citation(s) in RCA: 302] [Impact Index Per Article: 43.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
A high-efficient, low-cost, and eco-friendly catalyst is highly desired to activate peroxides for environmental remediation. Due to the potential synergistic effect between bimetallic oxides' two different metal cations, these oxides exhibit superior performance in the catalytic activation of peroxymonosulfate (PMS). In this work, novel Mn1.8Fe1.2O4 nanospheres were synthesized and used to activate PMS for the degradation of bisphenol A (BPA), a typical refractory pollutant. The catalytic performance of the Mn1.8Fe1.2O4 nanospheres was substantially greater than that of the Mn/Fe monometallic oxides and remained efficient in a wide pH range from 4 to 10. More importantly, a synergistic effect between solid-state Mn and Fe was identified in control experiments with Mn3O4 and Fe3O4. Mn was inferred to be the primary active site in the surface of the Mn1.8Fe1.2O4 nanospheres, while Fe(III) was found to play a key role in the synergism with Mn by acting as the main adsorption site for the reaction substrates. Both sulfate and hydroxyl radicals were generated in the PMS activation process. The intermediates of BPA degradation were identified and the degradation pathways were proposed. This work is expected to help to elucidate the rational design and efficient synthesis of bimetallic materials for PMS activation.
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Jin J, Jin L, Luo K, Lim SW, Chung BH, Yang CW. Effect of Empagliflozin on Tacrolimus-Induced Pancreas Islet Dysfunction and Renal Injury. Am J Transplant 2017; 17:2601-2616. [PMID: 28422431 DOI: 10.1111/ajt.14316] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 03/10/2017] [Accepted: 04/01/2017] [Indexed: 01/25/2023]
Abstract
An inhibitor of sodium glucose co-transporter type 2 (SGLT-2) is recommended in type 2 diabetes mellitus (DM) but its use is still undetermined in tacrolimus (TAC)-induced DM. We evaluated the effect of empagliflozin (Em) on TAC-induced pancreatic islet dysfunction and renal injury in an experimental model of TAC-induced DM and in vitro. TAC induced a twofold increase in SGLT-2 expression, while Em decreased SGLT-2 expression and further increased urinary glucose excretion compared to the TAC group. Em reduced hyperglycemia and increased plasma insulin level, pancreatic islet size, and glucose-stimulated insulin secretion compared to the TAC group. In kidney, Em alleviated TAC-induced renal dysfunction and decreased albumin excretion and histological injury compared with the TAC group. Increased oxidative stress and apoptotic cell death by TAC was remarkably decreased with Em in serum and pancreatic and renal tissues. In in vitro study, TAC decreased cell viability and increased reactive oxygen species (ROS) production in both insulin-secreting beta-cell derived (INS-1) and human kidney-2 (HK-2) cell lines. Addition of Em increased cell viability and decreased ROS production in HK-2 but not in INS-1 cell lines. This suggests that Em is effective in controlling TAC-induced hyperglycemia and has direct protective effect on TAC-induced renal injury.
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Kong FL, Chen SY, Ran JS, Yang CW, Jiang XS, Lan D, Hu YD, Liu YP. The Identification of SNPs in BCDO2 Gene for Skin Color in Chinese Indigenous Chicken. BRAZILIAN JOURNAL OF POULTRY SCIENCE 2017. [DOI: 10.1590/1806-9061-2016-0397] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Zhang X, Yang CW, Yu HQ, Sheng GP. Light-induced reduction of silver ions to silver nanoparticles in aquatic environments by microbial extracellular polymeric substances (EPS). WATER RESEARCH 2016; 106:242-248. [PMID: 27728818 DOI: 10.1016/j.watres.2016.10.004] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 09/30/2016] [Accepted: 10/01/2016] [Indexed: 06/06/2023]
Abstract
Microbial extracellular polymeric substances (EPS) widely exist in natural environments and affect the migration and transformation of pollutants in aquatic environments. Previous works report that EPS have some reducing functional groups and can reduce heavy metals. However, because of the weak reducing capability of EPS, the reduction of heavy metals by EPS without cells is extremely slow, and its effect on heavy metals species is insignificant. In this work, the accelerated reduction of silver ions (Ag+) by EPS from Shewanella oneidensis MR-1 under illumination was investigated. UV-visible spectroscopy, transmission electron microscopy (TEM) coupled with an energy dispersive spectrometer (EDS) and X-ray photoelectron spectroscopy (XPS) were used to confirm the formation of silver nanoparticles (AgNPs) via the reduction of Ag+ by EPS under light illumination. The Ag+ reduction by EPS follows pseudo-first-order kinetics under both visible and UV light, and the light irradiation can significantly accelerate AgNPs formation. On the one hand, visible light can excite AgNPs for their surface plasma resonance (SPR) and accelerate the electrons from the EPS to adjacent Ag+. On the other hand, EPS molecules may be excited by UV light to produce strong reducing species, which enhance Ag+ reduction. Moreover, pH, dissolved oxygen were found to affect the formation of AgNPs by EPS. This work proves the reducing capability of EPS on the reduction of Ag+, and this process can be accelerated under light illumination, which may affect the speciation and transformation of heavy metals in natural waters.
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Hwang HS, Kim SY, Hong YA, Cho WK, Chang YK, Shin SJ, Yang CW, Kim SY, Yoon HE. Clinical impact of coexisting retinopathy and vascular calcification on chronic kidney disease progression and cardiovascular events. Nutr Metab Cardiovasc Dis 2016; 26:590-596. [PMID: 27089976 DOI: 10.1016/j.numecd.2016.02.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 12/16/2015] [Accepted: 02/05/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND AND AIMS Retinopathy and vascular calcification (VC) are representative markers of microvascular and macrovascular dysfunction in patients with chronic kidney disease (CKD). However, their relationship and combined effects on clinical outcomes remain undetermined. METHODS AND RESULTS We included 523 patients with nondialysis-dependent CKD stage 3-5 who had been examined with fundus photography for diabetic or hypertensive retinopathy. Simple radiographs were analyzed for the presence of VC. The clinical significance of VC of the abdominal aorta and iliofemoral artery (apVC) and retinopathy was evaluated in terms of the rate of renal function decline and composite of any cardiovascular event or death. CKD patients with retinopathy showed higher prevalence of apVC than those without retinopathy (25.6% vs. 12.5%, P < 0.001).The presence of retinopathy was independently associated with apVC (OR 2.13, 95% CI 1.31, 3.49). In multivariate analysis, compared with subjects with neither apVC nor retinopathy, the coexistence of both apVC and retinopathy were independently associated with rapid renal function decline (β = -1.51; 95% CI -2.40, -0.61), whereas apVC or retinopathy alone were not. Compared with subjects with neither apVC nor retinopathy, the HRs for composite end points were 1.05 (95% CI 0.48, 2.27), 1.79 (95% CI 1.14, 2.80), and 2.07 (95% CI 1.17, 3.67) for patients with apVC only, those with retinopathy only, and those with both apVC and retinopathy, respectively. CONCLUSION The coexistence of VC and retinopathy was independently associated with CKD progression and cardiovascular events or deaths, and its combined effect was stronger than any separate condition.
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Tang Q, Wang D, Yao DM, Yang CW, Sun YC. Highly efficient electro-generation of hydrogen peroxide using NCNT/NF/CNT air diffusion electrode for electro-Fenton degradation of p-nitrophenol. WATER SCIENCE AND TECHNOLOGY : A JOURNAL OF THE INTERNATIONAL ASSOCIATION ON WATER POLLUTION RESEARCH 2016; 73:1652-1658. [PMID: 27054737 DOI: 10.2166/wst.2015.647] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
To promote the in situ generation of hydrogen peroxide (H2O2) in electro-Fenton system, a new air diffusion electrode (ADE) was put forward in the present work using N-doped multi-walled carbon nanotubes (NCNT) as the catalyst layer, multi-walled carbon nanotubes (CNT) as the diffusion layer, and nickel foam (NF) as the supporting material, respectively. The catalyst layer in ADE was characterized by transmission electron microscopy and X-ray photoelectron spectroscopy. Then the performances of H2O2 accumulation and p-nitrophenol (p-NP) degradation with the electrode (NCNT/NF/CNT ADE) were investigated. The experimental results showed that H2O2 accumulation on the NCNT/NF/CNT ADE was greatly improved by the presence of N doping, and H2O2 accumulation concentration could reach 307 mg L(-1) after 120 min at the current intensity of 100 mA. Moreover, the NCNT/NF/CNT ADE presented more effective performance on p-NP degradation than the CNT/NF/CNT ADE or the NF ADE. p-NP of initial 50 mg L(-1) could be almost completely removed after 30 min, and the total organic carbon removal efficiency reached 62.61% after 120 min when 0.4 mM Fe(2+) was added into the system. The repeatability test suggested that the stability of the NCNT/NF/CNT ADE was very good.
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Yang CW. Effectiveness of Debriefing in Hybrid Simulation For Communication Skills Training in End-Of-Life Care. Intensive Care Med Exp 2015. [PMCID: PMC4798121 DOI: 10.1186/2197-425x-3-s1-a39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Yang CW, Lin HH, Hsieh TY, Chang WK. Palliative enteral feeding for patients with malignant esophageal obstruction: a retrospective study. BMC Palliat Care 2015; 14:58. [PMID: 26542798 PMCID: PMC4635529 DOI: 10.1186/s12904-015-0056-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 11/02/2015] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Malignant esophageal obstruction leads to dysphagia, deterioration in quality of life, and malnutrition. Traditional bedside nasogastric (NG) tube placement is very difficult under these circumstances. However, endoscopically assisted NG tube placement under fluoroscopic guidance could be an alternative option for establishing palliative enteral nutrition. This study aimed to compare the clinical outcomes of enteral tube feeding and esophageal stenting for patients with malignant esophageal obstruction and a short life expectancy. METHODS Thirty-one patients were divided into 3 groups according to their treatment modality: NG tube (n = 12), esophageal stent group (n = 10), and supportive care with nil per os (NPO) (n = 9). Enteral nutrition, clinical outcomes, length of hospital stay, and median survival were evaluated. RESULTS There were no significant baseline differences among the groups, except in age. The tube and stent groups had significantly higher enteral calorie intake (p = 0.01), higher serum albumin (p < 0.01), shorter hospital stay (p = 0.01), and longer median survival (p < 0.01) than the NPO group. The incidence of dislodgement in the tube group was significantly higher than in the stent group (58% vs. 20%, respectively; p = 0.01). However, stenting costs more than NG tube placement. CONCLUSIONS Palliative enteral feeding by NG tube is safe, inexpensive, and has a low complication rate. Endoscopically assisted NG tube placement under fluoroscopic guidance could be a feasible palliative option for malignant esophageal obstruction for patients who have a short life expectancy.
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Striker GE, Peten EP, Yang CW, Striker LJ. Glomerulosclerosis: studies of its pathogenesis in humans and animals. CONTRIBUTIONS TO NEPHROLOGY 2015; 107:124-31. [PMID: 8004958 DOI: 10.1159/000422970] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Chen XX, Yang CW, Huang LB, Niu QS, Jiang SZ, Chi F. Zearalenone Altered the Serum Hormones, Morphologic and Apoptotic Measurements of Genital Organs in Post-weaning Gilts. ASIAN-AUSTRALASIAN JOURNAL OF ANIMAL SCIENCES 2015; 28:171-9. [PMID: 25557812 PMCID: PMC4283161 DOI: 10.5713/ajas.14.0329] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 07/28/2014] [Accepted: 09/05/2014] [Indexed: 11/30/2022]
Abstract
The present study was aimed at investigating the adverse effects of dietary zearalenone (ZEA) (1.1 to 3.2 mg/kg diet) on serum hormones, morphologic and apoptotic measurements of genital organs in post-weaning gilts. A total of twenty gilts (Landrace×Yorkshire×Duroc) weaned at 21 d with an average body weight of 10.36±1.21 kg were used in the study. Gilts were fed a basal diet with an addition of 0, 1.1, 2.0, or 3.2 mg/kg purified ZEA for 18 d ad libitum. Results showed that 3.2 mg/kg ZEA challenged gilts decreased (p<0.05) the serum levels of luteinizing hormone, however, serum levels of prolactin in gilts fed the diet containing 2.0 mg/kg ZEA or more were increased (p<0.05) compared to those in the control. Linear effects on all tested serum hormones except progesterone were observed as dietary ZEA levels increased (p<0.05). Gilts fed ZEA-contaminated diet showed increase (p<0.05) in genital organs size, hyperplasia of submucosal smooth muscles in the corpus uteri in a dose-dependent manner. However, the decreased numbers of follicles in the cortex and apoptotic cells in the ovarian were observed in gilts treated with ZEA in a dose-dependent manner. Degeneration and structural abnormalities of genital organs tissues were also observed in the gilts fed diet containing 1.1 mg/kg ZEA or more. Results suggested that dietary ZEA at 1.1 to 3.2 mg/kg can induce endocrine disturbance and damage genital organs in post-weaning gilts.
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Lei DM, Piao SG, Jin YS, Jin H, Cui ZH, Jin HF, Jin JZ, Zheng HL, Li JJ, Jiang YJ, Yang CW, Li C. Expression of erythropoietin and its receptor in kidneys from normal and cyclosporine-treated rats. Transplant Proc 2014; 46:521-8. [PMID: 24656003 DOI: 10.1016/j.transproceed.2013.12.047] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Revised: 12/07/2013] [Accepted: 12/16/2013] [Indexed: 01/08/2023]
Abstract
Long-term treatment with cyclosporine A (CsA) is associated with various types of complications; however, CsA-induced anemia has not been reported. The present study examined the impact of CsA on hematopoietic parameters and intrarenal expression of erythropoietin (EPO) and the EPO receptor (EPOR) in a rat model of chronic CsA nephrotoxicity. Sprague-Dawley rats were fed a low-salt diet (0.05% sodium) and were treated daily for 4 weeks with vehicle (olive oil 1 mL/kg subcutaneously) or CsA (15 mg/kg subcutaneously). The expression of EPO and EPOR was evaluated by immunohistochemistry and immunoblotting, and hematopoietic parameters were assessed by measuring blood hemoglobin and hematocrit levels, and these variables were compared between treatment groups. Renal function, oxidative stress, histopathology (tubulointerstitial fibrosis), apoptotic cell death, and expression of transforming growth factor β-inducible gene-h3 (βig-h3) were also compared between treatment groups. In kidneys from vehicle-treated rats, endogenous EPO and EPOR protein were expressed constitutively in the outer stripe of the outer medulla and the cortex. EPO protein expression decreased significantly in kidneys from CsA-treated rats. By contrast, EPOR expression was higher in kidneys from CsA-treated rats than in vehicle-treated rats. These changes were accompanied by decreases in serum hemoglobin and hematocrit levels and correlated with the number of cells positive for terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (r = -0.769, P = .003) and βig-h3 protein expression (r = -0.910, P < .001). Long-term treatment with CsA suppresses renal endogenous EPO expression, resulting in anemia. Increases in apoptotic cell death and βig-h3 expression are closely associated with inhibition of EPO expression in chronic CsA nephrotoxicity.
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Yang KS, Kim JI, Moon IS, Choi BS, Park CW, Yang CW, Kim YS, Chung BH. The clinical outcome of end-stage renal disease patients who return to peritoneal dialysis after renal allograft failure. Transplant Proc 2014; 45:2949-52. [PMID: 24157010 DOI: 10.1016/j.transproceed.2013.08.080] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND With the increased numbers of kidney transplantations, more patients return to dialysis after graft loss (DAGL). The aim of this study was to investigate the safety and efficacy of peritoneal dialysis (PD) after graft loss compared with transplant-naive PD patients (TN-PD). METHOD This study was conducted on 715 patients who started PD between 1988 and 2009, including 47 who started PD after allograft loss (DAGL-PD) and 668 in the (TN-PD) group. RESULT The mean ages were 40.8 ± 10.7 in DAGL-PD group and 51.03 ± 14.20 in TN-PD group (P < .01). The most common cause of end-stage renal disease in DAGL was primary glomerulonephritis (76.6%), but it was diabetes mellitus (38.9%) in the TN-PD group (P < .05). Patient survival rates at 1, 5, and 10 years were not different: 100%, 86%, and 57% versus 91%, 70%, and 62%, respectively. PD survival rate at 1, 5, and 10 years did not show significant differences: 98%, 95%, and 88% versus 95%, 80%, and 66%, respectively. The most common causes of death in both groups were infection (DAGL, 26.7%; TN-PD, 24.5%) followed by cardiovascular disease (DAGL, 20.0%; TN-PD, 19.6%); the distribution of causes did not differ significantly (P > .05). CONCLUSION The clinical outcomes of PD in DAGL group were comparable with those of TN-PD patients. Therefore, PD could be considered as a dialysis modality for patients who experience allograft failure.
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Hwang JK, Chun HJ, Kim JM, Kwon KH, Kim YK, Kim SD, Park SC, Choi BS, Kim JI, Yang CW, Kim YS, Moon IS. Contrast-enhanced magnetic resonance angiography in the early period after kidney transplantation. Transplant Proc 2014; 45:2925-30. [PMID: 24157005 DOI: 10.1016/j.transproceed.2013.08.039] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Our objective was to evaluate the usefulness of three-dimensional (3-D) contrast-enhanced (CE) magnetic resonance angiography (MRA) to assess renal parenchyma, arterial inflow stenosis, and peritransplant fluid collections in the early period after kidney transplantation (KT). Between January 2010 and April 2011, we examined a consecutive series of 144 renal transplants using 3-D CE MRA at 14 days after KT. MRA showed parenchyma infarctions (n = 17, 11.8%), arterial inflow stenoses (n = 23, 16%), lymphoceles (n = 14, 9.7%), and hematomas (n = 6, 4.2%). The degree of renal transplant artery inflow stenosis was graded qualitatively based on diameter criterion; <50% = mild, 50% to 70% = moderate, and >70% = severe in 10 (6.9%), 5 (3.5%), and 8 (5.6%) subjects, respectively. The study recipients were divided into 3 groups according to the degree of renal artery inflow stenosis (group I: normal; group II: mild and moderate, <70%; group III: severe, >70%). Among group III patients who underwent digital subtraction angiography, 5 had percutaneous transluminal angioplasty or stenting performed after 1 month. Their mean resume creatinine levels at 1, 6, and 12 months after transplantation were not significantly different from those in the other groups (P = .391, .447, .110). The prevalence of graft loss (n = 2) was high in group III (P = .012), although the frequency of acute rejection episodes was not different among the groups (P = .890). The incidences of renal parenchyma infarction, peritransplant fluid collection and arterial inflow stenosis were unexpectedly high in the early period after KT. Thus, 3-D CE MRA provided a rapid global assessment of the renal parenchyma, transplant arterial system, and peritransplant fluid collection that can be helpful to detect or exclude many causes of renal transplant dysfunction.
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Xiang Y, Piao SG, Zou HB, Jin J, Fang MR, Lei DM, Gao BH, Yang CW, Li C. L-carnitine protects against cyclosporine-induced pancreatic and renal injury in rats. Transplant Proc 2014; 45:3127-34. [PMID: 24157049 DOI: 10.1016/j.transproceed.2013.08.041] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND L-carnitine has protective effects against various types of injury. This study was designed to evaluate the beneficial effects of L-carnitine on pancreatic and renal injuries caused by cyclosporine (CsA). METHODS Rats maintained on a low sodium diet were given vehicle (olive oil, 1 mL/kg/d), CsA (15 mg/kg/d), L-carnitine (50 or 200 mg/kg/d), or a combination of CsA and L-carnitine for 4 weeks. The impact of L-carnitine on pancreatic injury was assessed by blood glucose levels, plasma insulin concentrations, and hemoglobulin A1c (HbA1c). In addition, the protective effects of L-carnitine against CsA-induced kidney injury were evaluated in terms of renal function, histopathology (inflammatory cell influx and tubulointerstitial fibrosis), oxidative stress (8-hydroxy 2'-deoxyguanosine, 8-OHdG), transforming growth factor-betal (TGF-β1), apoptosis (caspase-3), and autophagy (LC3-II). RESULTS CsA treatment caused diabetes, renal dysfunction, tubulointerstitial inflammation (ED-1-positive cells), and fibrosis, which were accompanied by an increase in 8-OHdG production and upregulation of TGF-β1, caspase-3, and LC3-II. Concomitant administration of L-carnitine increased plasma insulin concentrations, decreasing plasma glucose and HbA1c levels. In the kidney, L-carnitine induced dose-dependent improvement of renal function, inflammation, and fibrosis in parallel with suppression of the expression of TGF-β1 and 8-OHdG. Furthermore, the administration of L-carnitine at a high dose inhibited the expression of caspase-3 and LC3-II. CONCLUSION These findings suggest that L-carnitine has a protective effect against CsA-induced pancreatic and renal injuries.
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Hong YA, Choi DE, Lim SW, Yang CW, Chang YK. Decreased parathyroid Klotho expression is associated with persistent hyperparathyroidism after kidney transplantation. Transplant Proc 2014; 45:2957-62. [PMID: 24157012 DOI: 10.1016/j.transproceed.2013.08.060] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Although successful kidney transplantation usually corrects hyperparathyroidism, the condition persists in some patients. The present study was designed to determine whether Klotho or fibroblast growth factor 23, the key regulator of parathyroid hormone, is involved in persistent hyperparathyroidism in kidney transplant recipients (KTRs). Nineteen hyperplastic parathyroid glands were obtained from end-stage renal disease (ESRD) patients and KTRs; 6 normal parathyroid glands were used as controls. We compared the expression of Klotho, fibroblast growth factor receptor 1 (FGFR1) and calcium-sensing receptor (CaSR) in the KTRs and ESRD patients. Expressions of Klotho, FGFR1, CaSR and vitamin D receptor, as evaluated by immunohistochemistry, were quantified as the number of positive cells per unit area. The Klotho, FGFR1 and CaSR expressions in parathyroid glands of the post-kidney transplantation (PSKT) and the ESRD groups were significantly decreased compared with normal controls. In the ESRD group, Klotho expression and number of proliferating cell nuclear antigen-positive cells in the parathyroid gland were significantly decreased in parathyroid adenomas as compared with parathyroid hyperplasia. The expression of FGFR1 and CaSR in the parathyroid glands was significantly increased in the PSKT compared with the ESRD group. There was no significant difference in Klotho expression between the PSKT and ESRD groups. Incomplete recovery of Klotho levels in the parathyroid gland may play a role in the pathogenesis of tertiary hyperparathyroidism after kidney transplantation.
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Yang CW, Wang D, Tang Q. Pretreatment of furfural industrial wastewater by Fenton, electro-Fenton and Fe(II)-activated peroxydisulfate processes: a comparative study. WATER SCIENCE AND TECHNOLOGY : A JOURNAL OF THE INTERNATIONAL ASSOCIATION ON WATER POLLUTION RESEARCH 2014; 70:414-421. [PMID: 25098869 DOI: 10.2166/wst.2014.242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The Fenton, electro-Fenton and Fe(II)-activated peroxydisulfate (PDS) processes have been applied for the treatment of actual furfural industrial wastewater in this paper. Through the comparative study of the three processes, a suitable pretreatment technology for actual furfural wastewater treatment was obtained, and the mechanism and dynamics process of this technology is discussed. The experimental results show that Fenton technology has a good and stable effect without adjusting pH of furfural wastewater. At optimal conditions, which were 40 mmol/L H₂O₂ initial concentration and 10 mmol/L Fe²⁺ initial concentration, the chemical oxygen demand (COD) removal rate can reach 81.2% after 90 min reaction at 80 °C temperature. The PDS process also has a good performance. The COD removal rate could attain 80.3% when Na₂S₂O₈ initial concentration was 4.2 mmol/L, Fe²⁺ initial concentration was 0.1 mol/L, the temperature remained at 70 °C, and pH value remained at 2.0. The electro-Fenton process was not competent to deal with the high-temperature furfural industrial wastewater and only 10.2% COD was degraded at 80 °C temperature in the optimal conditions (2.25 mA/cm² current density, 4 mg/L Na₂SO₄, 0.3 m³/h aeration rate). For the Fenton, electro-Fenton and PDS processes in pretreatment of furfural wastewater, their kinetic processes follow the pseudo first order kinetics law. The pretreatment pathways of furfural wastewater degradation are also investigated in this study. The results show that furfural and furan formic acid in furfural wastewater were preferentially degraded by Fenton technology. Furfural can be degraded into low-toxicity or nontoxic compounds by Fenton pretreatment technology, which could make furfural wastewater harmless and even reusable.
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Kim HG, Kim EY, Yu YJ, Kim GH, Jeong JW, Byeon JH, Chung BH, Yang CW. Comparison of clinical outcomes in hepatitis B virus-positive kidney transplant recipients with or without pretransplantation antiviral therapy. Transplant Proc 2013; 45:1374-8. [PMID: 23726576 DOI: 10.1016/j.transproceed.2013.01.088] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Accepted: 01/24/2013] [Indexed: 12/15/2022]
Abstract
BACKGROUND Antiviral agents have improved the outcomes of hepatitis B virus (HBV)-positive kidney transplant recipients (KTRs). Preemptive therapy has been the main approach to forestall HBV reactivation. We sought to compare prophylactic and preemptive approaches. METHODS We divided the 69 HBV-positive KTRs into treatment and historical control groups, according to the time of starting pretransplantation antiviral therapy. The treatment group was further divided into prophylactic and preemptive therapy groups. RESULTS The treatment group showed a significant improvement in 10-year graft (82% vs 34%) and patient (91% vs 57%) survivals. Among the historical control group, the main causes of graft failure were patient deaths (68%), which were mostly caused by liver diseases. In contrast, there was no liver-related death in the treatment group. In addition, there was no difference in graft or patient survival between the prophylactic and preemptive groups, but the incidence of HBV reactivation was lower in the prophylactic group. Antiviral therapy was an independent factor for the improved patient survival (P = .005). CONCLUSIONS Pretransplantation antiviral therapy is essential to improve clinical outcomes. Prophylactic may be better than preemptive antiviral therapy to decrease HBV reactivation.
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Yang CW, Yen HH. Reply to Matsushita. Endoscopy 2013; 45:230. [PMID: 23446672 DOI: 10.1055/s-0032-1326207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
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Chung BH, Yun JT, Ha SE, Kim JI, Moon IS, Choi BS, Park CW, Kim YS, Yang CW. Combined use of rituximab and plasmapheresis pre-transplant increases post-transplant infections in renal transplant recipients with basiliximab induction therapy. Transpl Infect Dis 2013; 15:559-68. [PMID: 24011062 DOI: 10.1111/tid.12135] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Revised: 02/21/2013] [Accepted: 03/24/2013] [Indexed: 12/22/2022]
Abstract
INTRODUCTION We investigated the effect of combined use of rituximab (RTX) and plasmapheresis (PP) pre-transplant on post-transplant infection. METHODS A total of 196 patients undergoing living-donor kidney transplantation at Seoul St. Mary's Hospital, all of whom underwent basiliximab induction therapy, were included in the study. They were divided into 3 groups: RTX/PP/intravenous immune globulin (IVIG) (the RPI group; n = 53), RTX monotherapy (the RTX group; n = 14), and control (the CONT group; n = 129). We compared the post-transplant infections in the 3 groups. RESULTS The overall prevalence of infection was significantly higher, and the infection-free survival rate was lower, in the RPI group compared with the RTX or CONT groups (P < 0.05). A trend toward more severe bacterial infections was seen in the RPI group compared with the other groups, and fungal infections developed only in the RPI group. After anti-rejection therapy, a significantly higher rate of infection developed in the RPI group than in the other groups (P < 0.05). In addition, the RPI group was an independent risk factor for the development of infection. CONCLUSION Our results show that in the setting of basiliximab induction, the use of combined RTX and PP therapy pre-transplant significantly increases the risk for post-transplant infection.
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Li YJ, Wu HH, Weng CH, Chen YC, Hung CC, Yang CW, Wang RYL, Sakamoto N, Tian YC. Cyclophilin A and nuclear factor of activated T cells are essential in cyclosporine-mediated suppression of polyomavirus BK replication. Am J Transplant 2012; 12:2348-62. [PMID: 22642569 DOI: 10.1111/j.1600-6143.2012.04116.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Immunosuppressants have impacts on the development of polyomavirus-associated nephropathy. We previously demonstrated that cyclosporin A (CsA) suppressed polyomavirus BK (BKV) replication. The role of cyclophilin A (CypA) and nuclear factor of activated T cells (NFAT) in CsA-imposed suppression of BKV replication was determined in this study. Results demonstrated that knockdown of CypA but not CypB significantly reduced BKV large T antigen (TAg) expression and BKV titer. Overexpression of CypA reversed CypA siRNA-induced inhibition in BKV TAg expression. In addition, CypA overexpression attenuated the suppressive effect of CsA on TAg expression, suggesting CypA implicated in CsA-mediated anti-BKV effect. Knockdown of NFATc3 abrogated TAg expression, while overexpression of NFATc3 promoted TAg expression and augmented BKV promoter activity. NFATc3 binding to the BKV promoter was verified by chromatin immunoprecipitation assay and electrophoretic mobility shift assay. Renal histology also displayed an increase in NFATc3 expression in tubulointerstitium of BKV-associated nephropathy. Furthermore, overexpression of NFATc3 rescued CsA-mediated inhibition of BKV load and TAg expression. A CsA analog, NIM811, which cannot block NFAT functionality, failed to suppress TAg expression. In conclusion, CypA and NFAT are indispensable in BKV replication. CsA inhibits BKV replication through CypA and NFAT, which may be potential targets of anti-BKV treatment.
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Kim SH, Hwang HS, Yoon HE, Kim YK, Choi BS, Moon IS, Kim JC, Hwang TK, Kim YS, Yang CW. Long-term risk of hypertension and chronic kidney disease in living kidney donors. Transplant Proc 2012; 44:632-4. [PMID: 22483456 DOI: 10.1016/j.transproceed.2011.12.066] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to assess the long-term risks of chronic kidney disease and arterial hypertension in living kidney donors. METHODS Donors who were followed for more than 1 year after nephrectomy were included. We assessed each donor's blood pressure, urine protein, and estimated glomerular filtration rate (eGFR). RESULTS The follow-up rate was 11% (154 out of 1,356 donors), only 19% of whom were followed by nephrologists. Blood pressure had increased from 113/75 to 116/77 mm Hg (P < .01), urinary protein excretion after donation did not increase, and renal function was well preserved after donor nephrectomy. However, 33 patients (21.4%) showed a decreased eGFR of <60 mL/min/1.73 m(2), and 3 donors developed end-stage renal disease that required renal replacement therapy. CONCLUSIONS The follow-up rate of living donors after donation was low, and we observed an increased risk of developing chronic kidney disease after donation.
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Sun IO, Hong YA, Kim HG, Park HS, Choi SR, Chung BH, Chun HJ, Choi BS, Park CW, Kim YS, Yang CW. Clinical usefulness of 3-dimensional computerized tomographic renal angiography to detect transplant renal artery stenosis. Transplant Proc 2012; 44:691-3. [PMID: 22483470 DOI: 10.1016/j.transproceed.2011.12.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate whether 3-dimensional computerized tomographic angiography (3D-CTA) is useful to detect transplant renal artery stenosis (TRAS). METHODS Fourteen patients with clinically suspected TRAS underwent color Doppler ultrasonography (CDU) and 3D-CTA before renal angiography. We compared 3D-CTA and CDU for accuracy based on the results of renal angiography. The safety of 3D-CTA was investigated by measuring the estimated glomerular filtration rate (eGFR) before and after the 3D-CTA examination. RESULTS The 10 men and 4 women who participated in this study showed a mean eGFR of 75 mL/min/1.73 m(2) (range 60-94). Of these, 9 patients were diagnosed with TRAS. 3D-CTA detected stenoses in all 9 patients, but CDU failed to detect it in 3, including, 2 with end-to-side arterial anastomoses, which may be more challenging to detect compared with end-to-end anastomoses. The stenotic area in 3D-CTA was similar to that detected by renal angiography (70 ± 12 vs 68 ± 11). The eGFR did not differ significantly before versus after the 3D-CTA examination; 72 ± 13 vs 69 ± 14 mL/min/1.73 m(2). CONCLUSIONS 3D-CTA was an effective safe method to detect renal artery stenosis among transplant recipients with an eGFR >60 mL/min/1.73 m(2).
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Hwang JK, Kim YK, Kim SD, Park SC, Choi BS, Kim JI, Yang CW, Kim YS, Moon IS. Does donor kidney to recipient body weight ratio influence long-term outcomes of living-donor kidney transplantation? Transplant Proc 2012; 44:276-80. [PMID: 22310632 DOI: 10.1016/j.transproceed.2011.12.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study evaluated the effect of the donor kidney to recipient body weight (Kw/Rw) ratio on long-term graft function and survival. We investigated retrospectively whether there was any association between Kw/Rw ratio and long-term graft survival and function after a follow-up of >10 years. We studied a consecutive series of 123 adult-to-adult living kidney transplants. According to the Kw/Rw ratio, patients were divided into 3 groups: "low" (Kw/Rw <2.85; n = 29), "medium" (2.85 ≤ Kw/Rw < 4.04; n = 63), and "high" (≥4.04; n = 31). Among the 3 groups, the mean serum creatinine levels at 1 and 6 months as well as 1 year after transplantation were significantly lower among patients with a high Kw/Rw ratio than in those with a medium or low ratio, but serum creatinine levels at 3 and 5 years did not differ significantly (P = .394 and 0.620, respectively). Graft survival rates at 5 and 10 years after transplantation were significantly lower in the "low" group. We observed a significant association between Kw/Rw ratio and graft survival (P = .018). The Kw/Rw ratio is an important factor for long-term graft survival and early graft function. However, it did not significantly affect subsequent renal function.
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