Mayo imaging classification is a good predictor of rapid progress among Korean patients with autosomal dominant polycystic kidney disease: results from the KNOW-CKD study.

BACKGROUND: Mayo imaging classification (MIC) is a useful biomarker to predict disease progression in autosomal dominant polycystic kidney disease (ADPKD). This study was performed to validate MIC in the prediction of renal outcome in a prospective Korean ADPKD cohort and evaluate clinical parameters associated with rapid disease progression. METHODS: A total of 178 ADPKD patients were enrolled and prospectively observed for an average duration of 6.2 ± 1.9 years. Rapid progressor was defined as MIC 1C through 1E while slow progressor was defined as 1A through 1B. Renal composite outcome (doubling of serum creatinine, 50% decline of estimated glomerular filtration rate [eGFR], or initiation of renal replacement therapy) as well as the annual percent change of height-adjusted total kidney volume (mHTKV-α), and eGFR decline (mGFR-α) were compared between groups. RESULTS: A total of 110 patients (61.8%) were classified as rapid progressors. These patients were younger and showed a higher proportion of male patients. Rapid progressor was an independent predictor for renal outcome (hazard ratio, 4.09; 95% confidence interval, 1.23-13.54; p = 0.02). The mGFR-α was greater in rapid progressors (-3.58 mL/min per year in 1C, -3.7 in 1D, and -4.52 in 1E) compared with that in slow progressors (-1.54 in 1A and -2.06 in 1B). The mHTKV-α was faster in rapid progressors (5.3% per year in 1C, 9.4% in 1D, and 11.7% in 1E) compared with that in slow progressors (1.2% in 1A and 3.8% in 1B). CONCLUSION: MIC is a good predictive tool to define rapid progressors in Korean ADPKD patients.

Adjustable bipod flexures for mounting mirrors in a space telescope.

A new mirror mounting technique applicable to the primary mirror in a space telescope is presented. This mounting technique replaces conventional bipod flexures with flexures having mechanical shims so that adjustments can be made to counter the effects of gravitational distortion of the mirror surface while being tested in the horizontal position. Astigmatic aberration due to the gravitational changes is effectively reduced by adjusting the shim thickness, and the relation between the astigmatism and the shim thickness is investigated. We tested the mirror interferometrically at the center of curvature using a null lens. Then we repeated the test after rotating the mirror about its optical axis by 180° in the horizontal setup, and searched for the minimum system error. With the proposed flexure mount, the gravitational stress at the adhesive coupling between the mirror and the mount is reduced by half that of a conventional bipod flexure for better mechanical safety under launch loads. Analytical results using finite element methods are compared with experimental results from the optical interferometer. Vibration tests verified the mechanical safety and optical stability, and qualified their use in space applications.