SCI 발표논문

1. 4482009

   제1저자 김선문 · 교신저자 김성권

   Kim SM, Moon KC, Oh KH, Joo KW, Kim YS, Ahn C, Han JS, Kim S

   Clinicopathologic characteristics of IgA nephropathy with steroid-responsive nephrotic syndrome.

   J Korean Med Sci. 2009;24 Suppl(Suppl 1):S44-9.

   Abstract

   Nephrotic syndrome is an unusual manifestation of IgA Nephropathy (IgAN). Some cases respond to steroid treatment. Here we describe a case-series of IgAN patients with steroid-responsive nephrotic syndrome. Twelve patients with IgAN with steroid-responsive nephrotic syndrome were evaluated and followed up. All patients presented with generalized edema. Renal insufficiency was found in two patients. The renal biopsy of eight patients revealed wide foot process effacement in addition to the typical features of IgAN. They showed complete remission after steroid therapy. Seven relapses were reported in five patients; six of the relapsed cases responded to steroid therapy. Compared with steroid-non-responsive patients, the patients with steroid-responsive nephrotic syndrome had shorter symptom duration, more weight gain, more proteinuria, and lower histologic grade than did those that had steroid-non-responsive nephrotic syndrome at presentation. None of the responders progressed to end stage renal disease, whereas five (38%) non-responders required dialysis or renal transplantation. Patients with IgAN who have steroid-responsive nephrotic syndrome likely have both minimal change disease and IgAN. The clinical features of sudden onset of generalized edema, initial heavy proteinuria and initial severe hypoalbuminemia might help identify the subset of patients, especially in low grade IgAN.

   PubMed IF 3.2 신장내과
2. 4472009

   제1저자 한세원 · 교신저자 김태유

   Han SW, Oh DY, Im SA, Park SR, Lee KW, Song HS, Lee NS, Lee KH, Choi IS, Lee MH, Kim MA, Kim WH, Bang YJ, Kim TY

   Phase II study and biomarker analysis of cetuximab combined with modified FOLFOX6 in advanced gastric cancer.

   Br J Cancer. 2009;100(2):298-304.

   Abstract

   This prospective study was conducted with the Korean Cancer Study Group to evaluate the efficacy and safety of cetuximab combined with modified FOLFOX6 (mFOLFOX6) as first-line treatment in recurrent or metastatic gastric cancer and to identify potential predictive biomarkers. Patients received cetuximab 400 mg m(-2) at week 1 and 250 mg m(-2) weekly thereafter until disease progression. Oxaliplatin (100 mg m(-2)) and leucovorin (100 mg m(-2)) were administered as a 2-h infusion followed by a 46-h continuous infusion of 5-fluorouracil (2400 mg m(-2)) every 2 weeks for a maximum of 12 cycles. Biomarkers potentially associated with efficacy were analysed. Among 38 evaluable patients, confirmed response rate (RR) was 50.0% (95% CI 34.1-65.9). Median time-to-progression (TTP) was 5.5 months (95% CI 4.5-6.5) and overall survival (OS) 9.9 months. Eleven patients having tumour EGFR expression by immunohistochemistry with low serum EGF and TGF-alpha levels showed a 100% RR compared to 37.0% in the remaining 27 patients (P<0.001). Moreover, ligand level increased when disease progressed in seven out of eight patients with EGFR expression and low baseline ligand level. No patient exhibited EGFR amplification or K-ras mutations. Gastric cancer patients with EGFR expression and low ligand levels had better outcomes with cetuximab/mFOLFOX6 treatment.

   PubMed IF 7.8 혈액종양내과
3. 4462009

   제1저자 김재현 · 교신저자 박경수

   Kim JH, Park SG, Lee HN, Lee YY, Park HS, Kim HI, Yu JE, Kim SH, Park CG, Ha J, Kim SJ, Park KS

   ATP measurement predicts porcine islet transplantation outcome in nude mice.

   Transplantation. 2009;87(2):166-9.

   Abstract

   Current nude mice islet transplantation studies cannot be used prospectively. Therefore, to predict transplantation outcomes, reliable and rapid assays for islet quality assessment are warranted. This study evaluated the predictive power of the porcine islet ATP content on the outcomes of islet transplantation in nude mice. Here, we report that the ATP measurement using a small number of handpicked islets with a diameter of 100 to 150 mum is a good predictor of islet graft efficacy in nude mice. Using receiver-operator characteristic analysis, the area under the curve of the ATP content using a small number of handpicked islets was 0.867 (95% confidence interval 0.744-0.989, P<0.001). The sensitivity and the specificity measured were 83.3% and 73.3%, respectively. In conclusion, a simple and a rapid measurement of intraislet ATP content could be a promising substitute for current nude mice islet transplantation studies.

   PubMed IF 4.9 내분비대사내과
4. 4452009

   제1저자 박경우 · 교신저자 정우영

   Park KW, Cho YS, Chung JW, Yeon TJ, Chae IH, Choi DJ, Oh BH, Park YB, Chung WY

   One year clinical and six month angiographic results of drug eluting stents for ST elevation acute myocardial infarction: 'real world' comparison between sirolimus- and paclitaxel-eluting stents.

   Int J Cardiol. 2009;131(3):350-5.

   Abstract

   BACKGROUND Concerns about safety of drug eluting stents have stirred up controversy on their use in patients with acute STEMI. It is also unknown whether differences in efficacy and safety exist between sirolimus- (SES) and paclitaxel-eluting stents (PES).

   OBJECTIVE To investigate the difference in angiographic results and clinical outcome between SES and PES in the treatment of acute STEMI, we analyzed "real world" 6 months angiographic and 1 year clinical outcome of 244 patients, comparing the results between SES and PES.

   METHODS 244 consecutive acute STEMI patients were analyzed retrospectively (185 patients in SES group (Group S), 59 patients in PES group (Group P). Immediate post PCI and six month angiographic findings were analyzed by quantitative coronary angiography. Clinical events up to 1 year including cardiovascular death, myocardial infarction, and target lesion revascularization were also analyzed.

   RESULTS Baseline clinical and immediate post-procedure angiographic characteristics were similar in the two groups except for mean stent diameter and length which was slightly wider and shorter in group P compared with group S (Mean stent diameterxlength: 3.12+/-0.34x24.4+/-5.1 vs. 3.01+/-0.34x26.6+/-7.2 mm in group P vs. S, p=0.02, p=0.03). At six months, late loss was significantly greater in group P compared with group S (0.35+/-0.62 vs. 0.07+/-0.42, p<0.01), although the difference in binary restenosis was not statistically significant. Diameter stenosis, which was similar immediately after PCI, was significantly greater in group P (22.0+/-17.1 vs. 15.6+/-13.4%, p=0.02). At 1 year, the incidence of stent thrombosis was similar in both groups (5.1% vs. 3.8% for group P vs. C). There were no differences between the two groups up to 1 year with regard to cardiovascular death, nonfatal myocardial infarction, and TLR. The free from adverse event rate was not statistically different between the two groups (84.2% vs. 90.2%, p=0.20 for group P vs. C).

   CONCLUSION In this group of Korean acute STEMI patients, SES stent showed lower late loss compared to PES at 6 months angiographic follow up, but there was no difference in clinical outcome up to 1 year.

   PubMed IF 3.3 순환기내과
5. 4442009

   제1저자 황진혁 · 교신저자 김용태

   Hwang JH, Lee SH, Lee KH, Lee KY, Kim H, Ryu JK, Yoon YB, Kim YT

   Cathepsin B is a target of Hedgehog signaling in pancreatic cancer.

   Cancer Lett. 2009;273(2):266-72.

   Abstract

   This study investigated the influence of cathepsin B (CATB), a downstream target of Hedgehog (Hh) signaling, in pancreatic cancer. Cyclopamine (Hh signal inhibitor) suppressed expression of Shh, as well as Hh-induced transcription factor Gli1, and induced apoptosis in Shh-positive pancreatic cancer cell line (PANC-1). Microarray analysis revealed CATB as a gene downregulated by Hh. Cyclopamine reduced CATB protein and mRNA levels. Cyclopamine or CATB inhibitor reduced PANC-1 cell invasiveness (P<0.05). CATB expression in human pancreatic cancer tissues tended to correlate with Shh expression (P=0.053). Conclusively, Hh targets CATB and Hh signaling through CATB might influence pancreatic cancer cell invasiveness.

   PubMed IF 11.8 소화기내과
6. 4432008

   제1저자 강해연 · 교신저자 정현채

   Kang HY, Kang HW, Kim SG, Kim JS, Park KJ, Jung HC, Song IS

   Incidence and management of colonoscopic perforations in Korea.

   Digestion. 2008;78(4):218-23.

   Abstract

   BACKGROUND AND AIM Despite the low incidence of perforation after endoscopic procedures in the colon, the increasing use of these procedures is likely to cause a commensurate increase in such problems. This study was undertaken to determine the incidence of iatrogenic perforation of the colon, to define clinical characteristics, and to assess the management of these complications.

   METHODS A retrospective review of the medical records was performed for all patients with iatrogenic colon perforations after endoscopy between January 2000 and June 2007.

   RESULTS Over this 7-year study period, a total of 20,660 sigmoidoscopies, 17,102 colonoscopies, and 6,772 therapeutic procedures were performed, and 53 (0.12%) perforations were determined to be related to endoscopy. A diagnostic procedure was undertaken in 26 of these 53 perforation cases (perforation rate, 0.07%; 1 per 1,452 procedures), and a therapeutic procedure in the remaining 27 (perforation rate, 0.40%; 1 per 251 procedures). Nineteen patients (36%) were treated conservatively, and the remaining 34 (64%) required surgical management. Endoscopic clipping was performed in 9 patients, and conservative treatment was possible in 7 patients with successful closure. No procedure-related mortality occurred.

   CONCLUSIONS Endoscopic repair of iatrogenic colon perforations with clips could reduce immediate operative intervention rates.

   PubMed IF 3.4 소화기내과
7. 4422009

   제1저자 백우현 · 교신저자 황진혁

   Paik WH, Park YS, Hwang JH, Lee SH, Yoon CJ, Kang SG, Lee JK, Ryu JK, Kim YT, Yoon YB

   Palliative treatment with self-expandable metallic stents in patients with advanced type III or IV hilar cholangiocarcinoma: a percutaneous versus endoscopic approach.

   Gastrointest Endosc. 2009;69(1):55-62.

   Abstract

   BACKGROUND AND OBJECTIVE Endoscopic or percutaneous biliary drainage with self-expandable metallic stents (SEMS) is widely used for the palliation of cholestasis in patients with advanced hilar cholangiocarcinoma. However, little is known about which is the better option in patients with advanced hilar cholangiocarcinoma. We compared the clinical outcomes of these 2 methods of biliary decompression in these patients.

   DESIGN AND SETTING Multicenter retrospective study.

   PATIENTS A total of 85 patients with newly diagnosed advanced hilar cholangiocarcinoma (Bismuth III or Bismuth IV) and who did not receive an operation, chemotherapy, or radiotherapy were retrospectively reviewed. Forty-four of the 85 received endoscopic SEMS and 41 received percutaneous SEMS.

   INTERVENTIONS Endoscopic SEMS or percutaneous SEMS.

   MAIN OUTCOME MEASUREMENTS AND RESULTS Baseline characteristics were similar in the 2 groups, but the rate of successful biliary decompression was significantly higher in the percutaneous SEMS group than in the endoscopic SEMS group (92.7% vs 77.3%, respectively, P= .049). Overall rates of procedure-related complications were similar for the 2 groups, but 1 death (from biliary sepsis) occurred in the endoscopic SEMS group. Median survival of patients in whom biliary drainage was successful initially, regardless of which procedure was performed, was much longer than that of patients who had failed biliary drainage (8.7 months vs 1.8 months, respectively, P< .001). Once successful biliary decompression had been achieved, median survival and stent patency duration were similar in the 2 study groups.

   LIMITATION Retrospective study.

   CONCLUSIONS Percutaneous SEMS may be chosen for initial biliary drainage in patients with advanced type III or IV hilar cholangiocarcinoma, given higher initial success rate and low level of procedure-related cholangitis.

   PubMed IF 8 소화기내과
8. 4412009

   제1저자 김혜진 · 교신저자 이근욱

   Kim HJ, Lee KW, Kim YJ, Oh DY, Kim JH, Im SA, Lee JS

   Chemotherapy-induced transient CEA and CA19-9 surges in patients with metastatic or recurrent gastric cancer.

   Acta Oncol. 2009;48(3):385-90.

   Abstract

   BACKGROUND Rising serum tumor markers after chemotherapy are generally considered to indicate tumor progression. However, we have observed a transient increase in carcinoembryonic antigen (CEA) or carbohydrate antigen 19-9 (CA19-9) levels despite clinical benefits from chemotherapy in patients with metastatic or recurrent gastric cancer (MRGC). Therefore, this study was performed to determine the incidence of CEA and CA19-9 surges and their implications on the clinical outcome in MRGC patients.

   MATERIAL AND METHODS Fifty-one and 40 patients who had evaluable data for CEA or CA19-9 surges, respectively, were included. Both CEA and CA 19-9 surges were defined as a > 20% increase in these tumor markers from the baseline that was followed by a > 20% drop in subsequent levels compared to the baseline.

   RESULTS Of 51 evaluable patients for CEA surges, nine patients (18%) had documented CEA surges. The median time to CEA peak and the duration of the CEA surge were 2.8 (1.7 approximately 7.0) and 9.1 weeks (7.6 approximately 21.0), respectively. Of 40 evaluable patients for CA19-9 surges, seven patients (18%) had CA19-9 surges. The median time to peak and the duration of the CA19-9 surge were 2.3 (1.9 approximately 6.0) and 7.1 weeks (4.3 approximately 16.1), respectively. All patients with CEA or CA19-9 surges had radiographic evidence of benefits from chemotherapy.

   CONCLUSION CEA or CA19-9 surges can be observed in MRGC patients receiving chemotherapy. All patients with these surge phenomena had clinical benefits from chemotherapy. An initial rise in CEA or CA19-9 levels after initiation of chemotherapy should not be used as an indicator of progressive disease.

   PubMed IF 2.7 혈액종양내과
9. 4402009

   제1저자 임수 · 교신저자 이홍규

   Lim S, Son KR, Song IC, Park HS, Jin CJ, Jang HC, Park KS, Kim YB, Lee HK

   Fat in liver/muscle correlates more strongly with insulin sensitivity in rats than abdominal fat.

   Obesity (Silver Spring). 2009;17(1):188-95.

   Abstract

   Intrahepatic or intramuscular lipid (IHL/IML) content has been reported to be correlated with insulin resistance. Visceral fat has also been shown to be associated with insulin resistance. Thus, we investigated whether IHL/IML or visceral fat content is more closely associated with insulin resistance. Twenty Sprague-Dawley rats were divided into two groups based on regular chow diet (RCD) or high-fat diet (HFD; 40% fat). The insulin-sensitivity index (ISI) was determined by euglycemic glucose clamp study, the amount of visceral fat by computed tomography (CT), and the IHL/IML content by magnetic resonance spectroscopy (MRS). Weight, food, and water intake, physical activity, energy expenditure, lipid profile, adiponectin, and high-sensitivity C-reactive protein (hsCRP) levels were measured. At the study end point, visceral fat, and the IHL/IML content were higher in the HFD group than in the RCD group. The IHL/IML content was more highly correlated with ISI than was visceral fat amount. Stronger correlations were also found between adiponectin or hsCRP level and IML/IHL content than visceral fat, especially in the HFD group. Furthermore, the IHL/IML content was significantly associated with the ISI in the multiple regression models but visceral fat was not. There was clear discrimination between RCD and HFD groups in scatter plots of IML/IHL against the ISI, but substantial overlap in that of visceral fat against the ISI. This result suggests that IHL/IML contents are closely related with insulin resistance or atherosclerosis and is a better metabolic index of insulin sensitivity than the visceral fat.

   PubMed IF 4.9 내분비대사내과
10. 4392009

    제1저자 김형일 · 교신저자 박경수

    Kim HI, Yu JE, Lee SY, Sul AY, Jang MS, Rashid MA, Park SG, Kim SJ, Park CG, Kim JH, Park KS

    The effect of composite pig islet-human endothelial cell grafts on the instant blood-mediated inflammatory reaction.

    Cell Transplant. 2009;18(1):31-7.

    Abstract

    Instant blood-mediated inflammatory reaction (IBMIR) causes rapid islet loss in portal vein islet transplantation. Endothelial cells are known to protect against complement-mediated lysis and activation of coagulation. We tested composite pig islet-human endothelial cell grafts as a strategy to overcome IBMIR. Porcine islets were cocultured with human endothelial cells in specially modified culture medium composed of M199 and M200 for 1-9 days. A positive control group, negative control group, and the endothelial cell-coated group were examined with an in vitro tubing loop assay using human blood. The endothelial cell-coated group was subdivided and analyzed by degree of surface coverage by endothelial cells (< or = 50% vs. > 50%) or coculture time (< 5 days vs. > or = 5 days). Platelet consumption and complement and coagulation activation were assessed by platelet count, C3a, and thrombin-antithrombin complex (TAT), respectively. After 60-min incubation in human blood, the endothelial cell-coated group showed platelet consumption inhibition and low C3a and TAT assay results compared to uncoated controls. When the endothelial cell-coated group was subdivided by degree of surface coverage, the < or = 50% coated group showed less platelet consumption and less activation of complement and coagulation compared with the positive control (uncoated) group. On analysis by coculture time, only the subgroup cocultured for < 5 days showed the same protective effect. Human endothelial cell-coated pig islets, especially the partially coated and short-term cocultured pig islet-human endothelial cell composites, reduced all components of IBMIR. If the optimal endothelial cell-islet coculture method could be identified, human endothelial cell coating of pig islets would offer new strategies to improve xenogenic islet transplantation outcomes.

    PubMed IF 3.7 내분비대사내과
11. 4382009

    제1저자 강은하 · 교신저자 송영욱

    Kang EH, Moon KC, Lee EY, Lee YJ, Lee EB, Ahn C, Song YW

    Renal expression of galectin-3 in systemic lupus erythematosus patients with nephritis.

    Lupus. 2009;18(1):22-8.

    Abstract

    The aim of the study is to characterize the expression pattern of galectin-3 (Gal-3) in renal tissues of patients with systemic lupus erythematosus (SLE) nephritis and to determine whether tissue and serum Gal-3 are associated with SLE nephritis. Gal-3 expressions were examined with immunohistochemistry in renal biopsy specimens of 88 patients with SLE nephritis and in five normal specimens. Activity and chronicity indexes and glomerular Gal-3 expressions were analysed in each specimen. Serum Gal-3 levels were measured using enzyme-linked immunosorbent assays in 20 patients with SLE, including 11 with nephritis, and in 50 healthy controls. Glomerular Gal-3 expression was observed in 81.8% (72/88) of patients with SLE nephritis but not in 5 controls. Gal-3 staining was attributed mainly to its cellular expression rather than its deposition, and Gal-3 expression levels were correlated with histologic activity indexes, anti-dsDNA titers, and complement 3 and 4 levels. Serum Gal-3 levels were higher in patients with SLE, particularly in those with nephritis, than in healthy controls, and correlated with anti-dsDNA titers. In conclusion, glomerular Gal-3 expression in renal tissue and serum Gal-3 levels were elevated in patients with SLE nephritis versus healthy controls; moreover, they reflected disease activity. These findings suggest that Gal-3 might contribute to the inflammatory process in SLE.

    PubMed IF 1.8 류마티스내과
12. 4372009

    제1저자 김병수 · 교신저자 허대석

    Kim BS, Kim DW, Im SA, Kim CW, Kim TY, Yoon SS, Heo DS, Bang YJ, Park S, Kim BK, Kim NK

    Effective second-line chemotherapy for extranodal NK/T-cell lymphoma consisting of etoposide, ifosfamide, methotrexate, and prednisolone.

    Ann Oncol. 2009;20(1):121-8.

    Abstract

    BACKGROUND Many patients with extranodal natural killer/T-cell lymphoma (NTCL) fail to the front-line therapy and need an effective second-line chemotherapy.

    PATIENTS AND METHODS This was single-institutional, phase II study. The primary end point was response rate and secondary end points were toxicity, time to treatment failure (TTF), and overall survival (OS). Patients with relapsed or refractory NTCL were eligible. They received the chemotherapy consisting of ifosfamide, methotrexate, etoposide, and prednisolone and it was repeated every 3 weeks.

    RESULTS Thirty-two patients were enrolled and 15 patients had achieved partial remission (PR) or complete remission (CR) after the front-line chemotherapy. The International Prognostic Index scores were 0-1 in thirteen, 2 in five, 3 in five, and 4-5 in nine patients. Twelve and two patients achieved CR and PR, respectively. Median OS and TTF of all patients were 8.2 and 3.7 months, respectively. Non-hematologic toxic effects were well tolerated, but grade 3/4 leukopenia occurred in 11.7% of all cycles. Four patients developed febrile neutropenia and one patient died due to pneumonia.

    CONCLUSIONS This chemotherapy regimen was moderately effective for relapsed/refractory extranodal NTCL, nasal type. Toxic effects were moderate, but caution should be exercised to prevent severe infection.

    PubMed IF 80.4 혈액종양내과
13. 4362009

    제1저자 김형관 · 교신저자 김용진

    Kim HK, Kim YJ, Chang SA, Kim DH, Sohn DW, Oh BH, Park YB

    Impact of cardiac rhythm on mitral valve area calculated by the pressure half time method in patients with moderate or severe mitral stenosis.

    J Am Soc Echocardiogr. 2009;22(1):42-7.

    Abstract

    BACKGROUND The pressure half-time (PHT) method has been widely used to estimate mitral valve area (MVA) in patients with mitral stenosis (MS), in the belief that this simple method provides reliable information on true MVA. However, its limitation has been repeatedly recognized under different circumstances. The aim of this study was to evaluate the effect of cardiac rhythm on PHT-derived MVA calculation in relation to net atrioventricular compliance (C(n)).

    METHODS Patients (n = 41) with rheumatic pure moderate or severe MS were consecutively recruited. Eighteen patients with sinus rhythm were allocated to group 1 and the remaining patients with chronic atrial fibrillation to group 2. MVA was obtained using the PHT method and by planimetry (considered the gold standard in this study). C(n) was calculated with a previously validated equation.

    RESULTS There were no differences between the 2 groups in terms of age, gender, left ventricular dimensions or ejection fraction, or transmitral pressure gradient. Left atrial volume index (134.6 +/- 106.7 vs 79.2 +/- 16.8 mL; P = .003) and C(n) (6.6 +/- 1.5 vs 4.7 +/- 1.2 mL/mm Hg; P < .001) were higher in group 2 than in group 1. Disagreement of MVA estimation by PHT compared with that by 2-dimensional planimetry was 8.0 +/- 19.2% for group 1 and -24.9 +/- 13.9% for group 2 (P = .002). In addition, the extent of disagreement of PHT-derived MVA compared with that by 2-dimensional planimetry was significantly correlated with C(n) (r(2) = 0.71, P < .001). MVA by the PHT method was estimated to be substantially higher in patients with C(n) values < 4 mL/mm Hg, most of whom were in sinus rhythm. Multivariate analysis confirmed the independent association of cardiac rhythm with discrepancy of PHT-derived MVA compared with that by planimetry.

    CONCLUSION Changes in cardiac rhythm with associated modifications of C(n) can alter the accuracy of the PHT method for estimating MVA. Given the limitation described here, 2-dimensional planimetry, not the PHT method, should be used as a primary echocardiographic tool for MVA calculation.

    PubMed IF 8.3 순환기내과
14. 4352009

    제1저자 강경필 · 교신저자 김나영

    Kang KP, Lee HS, Kim N, Kang HM, Park YS, Lee DH, Choe G, Kim JS, Jung HC, Song IS

    Role of intestinal metaplasia subtyping in the risk of gastric cancer in Korea.

    J Gastroenterol Hepatol. 2009;24(1):140-8.

    Abstract

    BACKGROUND AND AIM Gastric cancer is believed to develop by a multistage process. Intestinal metaplasia (IM) is regarded as a premalignant condition; it is classified into subtypes I, II and III. The aim of this study was to evaluate whether the subtypes of IM were associated with progression to gastric cancer.

    METHODS The study cohort consisted of 861 subjects, categorized as controls, gastric ulcers, dysplasia and cancer. The IM was scored histologically using the Sydney classification for the antrum and the body of the stomach. The biopsies were stained with high iron diamine and alcian blue (pH 2.5) (HID-AB2.5), and the IM was subtyped as I, II or III.

    RESULTS The proportion of IM subtypes I, II and III were 14.5%, 47.2% and 38.3% in the antrum, and 28.1%, 57.8% and 14.1% in the body of the stomach, respectively. These distributions did not show significant differences depending on disease or Helicobacter pylori positivity. In cases that were H. pylori-positive, the prevalence of IM subtype II in the cancer and dysplasia groups was higher than in the control group in the body of the stomach (P < 0.05). The proportion of IM subtype III in the antrum increased in proportion with age (P = 0.036).

    CONCLUSIONS IM subtyping was not found to play a major role in the prediction of gastric cancer development in Korea. IM subtype III was associated with aging, and IM subtype II appeared to be related to gastric carcinogenesis in the presence of H. pylori infection.

    PubMed IF 3.5 소화기내과
15. 4342009

    제1저자 우상명 · 교신저자 류지곤

    Woo SM, Ryu JK, Lee SH, Lee WJ, Hwang JH, Yoo JW, Park JK, Kang GH, Kim YT, Yoon YB

    Feasibility of endoscopic papillectomy in early stage ampulla of Vater cancer.

    J Gastroenterol Hepatol. 2009;24(1):120-4.

    Abstract

    BACKGROUND AND AIM Although endoscopic papillectomy has been attempted in early stage ampullary cancer (pTis, T1), its curative role and indications remain uncertain. The present study was designed to assess the factors that predict malignancy and lymph node metastasis and to suggest potential indications for endoscopic papillectomy by analyzing clinicopathological data.

    METHODS We performed a retrospective analysis of clinical and histopathological data of 216 patients with ampullary cancer between 1991 and 2006.

    RESULTS No tumor in pTis stage had metastasized to lymph nodes and only 9% of tumors in pT1 had metastasized. Tumor size (P = 0.018), depth of invasion (P = 0.021) and venous invasion (P = 0.014) were found to be significantly related to lymph node metastasis. Cases with early stage ampullary cancer of less than 2 cm with a well-differentiated histology and no angiolymphatic invasion (n = 13) showed no lymph node metastasis and no recurrence during a median follow up of 35.9 months.

    CONCLUSION Endoscopic papillectomy can be adopted as a viable alternative to surgery in patients with early stage ampullary cancer of less than 2 cm in size and with a well-differentiated histology. When a resected specimen has a well-differentiated histology, and there is no resection margin involvement and no angiolymphatic invasion, our findings indicate that subsequent radical surgery is unnecessary.

    PubMed IF 3.5 소화기내과
16. 4332009

    제1저자 김진현 · 교신저자 송영욱

    Kim J, Koh JK, Lee EY, Park JA, Kim HA, Lee EB, Garlanda C, Cotena A, Song YW

    Serum levels of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) and pentraxin 3 (PTX3) as markers of infection in febrile patients with systemic lupus erythematosus.

    Clin Exp Rheumatol. 2009;27(5):773-8.

    Abstract

    OBJECTIVE To investigate the role of sTREM-1 and PTX3 as markers of infection in febrile patients with SLE.

    METHODS In febrile (body temperature > or =38 degrees C) patients with SLE, blood samples of day 0, 1, 2, and 14 after presentation were drawn and relevant clinical data were collected. The patients were allocated to an infection group (n=19) or disease flare group (n=14). Serum levels of sTREM-1 and PTX3 were measured by ELISA using the serum samples of SLE patients and age- and sex-matched healthy controls (n=31).

    RESULTS A total of 33 febrile episodes occurred in 32 SLE patients (19 infections, 14 flares) were studied. sTREM-1 levels on day 0 were significantly higher in the infection group than in the flare group (109.9 pg/ml (median) vs. 48.0 pg/ml, p=0.002), but PTX3 levels were similar in these two groups. The difference of sTREM-1 levels between infection group and flare group was persistent on day 1 and 2 (day 1, p=0.007; day 2, p=0.034). The highest diagnostic value (sensitivity=1.0, specificity=0.664) of sTREM-1 was obtained at the threshold value of 53.2 pg/mL.

    CONCLUSION Serum sTREM-1 levels were significantly higher in the infection group than in the flare group of febrile SLE patients. Our findings suggest that serum sTREM-1 levels could be used to determine whether SLE patients have contracted an infection.

    PubMed IF 3.2 류마티스내과
17. 4322009

    제1저자 김진현 · 교신저자 송영욱

    Kim J, Im CH, Kang EH, Lee EY, Lee YJ, Park KS, Song YW

    Mannose-binding lectin gene-2 polymorphisms and serum mannose-binding lectin levels in Behçet's disease.

    Clin Exp Rheumatol. 2009;27(2 Suppl 53):S13-7.

    Abstract

    OBJECTIVE Behçet's disease (BD) is an autoimmune disease with an unknown etiology and mannose-binding lectin (MBL) is a pattern recognition receptor in the innate immune system, which is associated with some autoimmune diseases. We investigated MBL2 gene polymorphisms and serum MBL levels in BD patients and controls.

    METHODS MBL2 gene polymorphisms in exon 1 (MBL2 54 Gly/Asp, (A/B)), promoter (MBL2 H/L (G-550C), MBL2 Y/X (G-221C)), and 5' UTR region (MBL2 P/Q (C+4T)) were investigated using polymerase chain reaction and restriction fragment length polymorphism in 119 BD patients and 252 healthy controls. Serum MBL levels were measured by enzyme linked immunosorbent assay in 49 BD patients and 102 sex-/genotype-matched controls.

    RESULTS No significant difference was found between BD patients and controls in terms of MBL2 polymorphisms and MBL serum levels. However, the presence of genital ulcer and neurologic involvement were found to be associated with MBL2 54 allele A (OR=2.415, OR=6.632, respectively). Eye involvement was found to be related to the presence of the MBL2 54 AA or AB genotypes (OR=12.46), MBL2-G-550C allele H (OR=1.829). High serum MBL level (> or =500 ng/ml) was associated with skin lesions (p=0.002).

    CONCLUSION The frequencies of the four MBL2 genetic polymorphisms examined were not different in BD patients and healthy controls. However, the presence of genital ulcer, eye involvement, and neuro-Behcet's disease were found to be associated with MBL2 polymorphisms that are associated with the production of high levels of MBL or functional MBL.

    PubMed IF 3.2 류마티스내과
18. 4312009

    제1저자 임철현 · 교신저자 송영욱

    Im CH, Kang EH, Ki JY, Shin DW, Choi HJ, Chang EJ, Lee EY, Lee YJ, Lee EB, Kim HH, Song YW

    Receptor activator of nuclear factor kappa B ligand-mediated osteoclastogenesis is elevated in ankylosing spondylitis.

    Clin Exp Rheumatol. 2009;27(4):620-5.

    Abstract

    OBJECTIVE Ankylosing spondylitis (AS) is an inflammatory arthritis involving the axial skeleton. Decreased bone mineral density has also been reported in AS patients. This study sought to determine whether osteoclastogenesis and osteoclast activity are increased in AS.

    METHODS Twenty patients with AS were evaluated using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and other clinical parameters. Mononuclear cells were separated out from peripheral blood samples taken from AS patients and normal healthy controls and cultured with monocyte colony stimulating factor and receptor activator of the nuclear factor kappa B ligand (RANKL). Multi-nucleated, tartrate-resistant acid phosphatase stain-positive osteoclasts were counted after 9 days, and the areas of calcium absorption on calcium-coated plates were determined.

    RESULTS Osteoclastogenesis was significantly greater in AS patients than in normal controls (number of osteoclasts/1106 mononuclear cells, median, 518.0 vs. 362.5, p=0.036). No differences were observed between AS patients and controls in terms of calcium absorption areas or the serum concentrations of tumor necrosis factor and RANKL. Osteoclastogenesis was greater in AS patients with sacroiliac joint ankylosis than in those without. Osteoclastogenesis and the calcium absorption area were not found to be correlated with BASDAI nor with other clinical parameters including age, erythrocyte sedimentation rate, and C-reactive protein levels.

    CONCLUSION Osteoclastogenesis is elevated in AS patients, especially in those with sacroiliac joint ankylosis. Increased osteoclastogenesis may be related to osteopenia in AS patients.

    PubMed IF 3.2 류마티스내과
19. 4302009

    제1저자 이정훈 · 교신저자 윤정환

    Lee JH, Yoon JH, Kim BH, Chung GE, Myung SJ, Kim W, Kim YJ, Kim EC, Lee HS

    Enterococcus: not an innocent bystander in cirrhotic patients with spontaneous bacterial peritonitis.

    Eur J Clin Microbiol Infect Dis. 2009;28(1):21-6.

    Abstract

    Clinicians sometimes experience treatment failure in the initial empirical antibiotics treatment using cephalosporins in cirrhotic patients with spontaneous bacterial peritonitis (SBP). Enterococcus, which is intrinsically resistant to cephalosporins, may be one of the causes of treatment failure. The aim of this study was to evaluate the clinical importance and the clinical characteristics of spontaneous enterococcal peritonitis (SEP). This was a retrospective cohort study of 359 patients with SBP treated in a single tertiary care center in South Korea from January 2000 through December 2004. We evaluated the clinical manifestation and the treatment results of SBP patients with enterococci identified from ascites culture. During the observation period, 13 of 359 patients (3.6%) diagnosed with culture-positive SBP had enterococcal peritonitis. For the initial empirical treatment, third-generation cephalosporins were administered to the 13 patients, ten of whom (76.9%) did not improve in the first 48 h. An in vitro antibiotic sensitivity test showed that the identified enterococci were susceptible to ampicillin plus gentamycin in eight patients (61.5%) and there was no vancomycin-resistant enterococcus. Although antibiotics were changed to antienterococcal antibiotics in 11 patients, only five patients improved. As a result, eight of the 13 patients (61.5%) with enterococcal SBP died during the observation period, and the one-month mortality was significantly higher from enterococcal SBP than from nonenterococcal SBP (P = 0.038). We conclude that enterococcal SBP has poor prognosis and it is reasonable to use antienterococcal antibiotics when enterococcus is identified from ascites culture of patients with liver cirrhosis.

    PubMed IF 3.2 소화기내과
20. 4292009

    제1저자 황영환 · 교신저자 오국환

    Hwang YH, Son MJ, Yang J, Kim K, Chung W, Joo KW, Kim Y, Ahn C, Oh KH

    Effects of interleukin-6 T15A single nucleotide polymorphism on baseline peritoneal solute transport rate in incident peritoneal dialysis patients.

    Perit Dial Int. 2009;29(1):81-8.

    Abstract

    OBJECTIVE To study the genetic effects of various inflammatory cytokines on peritoneal solute transport rate (PSTR) in incident Korean peritoneal dialysis (PD) patients.

    DESIGN Case-control association study.

    METHODS 132 patients with baseline peritoneal equilibration test within 1-3 months after starting PD were enrolled. We analyzed the influence of single nucleotide polymorphisms (SNPs) of interleukin-6 (IL-6; -572G/C, T15A), tumor necrosis factor-alpha (TNF-alpha; -1031C/T, -863C/A, -308G/A), and IL-10 (-1082A/G, -592A/C) on baseline PSTR. Clinical parameters such as age, gender, presence of diabetes mellitus, comorbidity, C-reactive protein, and residual renal function were also included as covariates.

    RESULTS The T15A SNP of IL-6 (rs13306435) was associated with PSTR. Patients with TA genotype (n=18) had significantly lower D4/P creatinine (0.65+/-0.087 vs 0.73+/-0.110, p=0.0046) and higher D4/D0 glucose (0.39+/-0.174 vs 0.31+/-0.119, p=0.027) than patients with TT genotype (n=114). The log value of the dialysate appearance rate of IL-6 had a strong positive correlation with D4/P creatinine (r2=0.1294, p<0.0001) and was significantly lower in the TA genotype than the TT genotype (201.7+/-14.42 vs 116.8+/-88.91 pg/minute, p=0.0358). By multiple logistic regression, TA genotype was negatively associated with a higher PSTR (high or high average; odds ratio 0.18; 95% confidence interval 0.048-0.666).

    CONCLUSIONS In incident Korean PD patients, T15A polymorphism of IL-6 is associated with dialysate IL-6 concentration and baseline PSTR.

    PubMed IF 1.8 신장내과
21. 4282009

    제1저자 정성수 · 교신저자 박경수

    Chung SS, Kim M, Youn BS, Lee NS, Park JW, Lee IK, Lee YS, Kim JB, Cho YM, Lee HK, Park KS

    Glutathione peroxidase 3 mediates the antioxidant effect of peroxisome proliferator-activated receptor gamma in human skeletal muscle cells.

    Mol Cell Biol. 2009;29(1):20-30.

    Abstract

    Oxidative stress plays an important role in the pathogenesis of insulin resistance and type 2 diabetes mellitus and in diabetic vascular complications. Thiazolidinediones (TZDs), a class of peroxisome proliferator-activated receptor gamma (PPARgamma) agonists, improve insulin sensitivity and are currently used for the treatment of type 2 diabetes mellitus. Here, we show that TZD prevents oxidative stress-induced insulin resistance in human skeletal muscle cells, as indicated by the increase in insulin-stimulated glucose uptake and insulin signaling. Importantly, TZD-mediated activation of PPARgamma induces gene expression of glutathione peroxidase 3 (GPx3), which reduces extracellular H(2)O(2) levels causing insulin resistance in skeletal muscle cells. Inhibition of GPx3 expression prevents the antioxidant effects of TZDs on insulin action in oxidative stress-induced insulin-resistant cells, suggesting that GPx3 is required for the regulation of PPARgamma-mediated antioxidant effects. Furthermore, reduced plasma GPx3 levels were found in patients with type 2 diabetes mellitus and in db/db/DIO mice. Collectively, these results suggest that the antioxidant effect of PPARgamma is exclusively mediated by GPx3 and further imply that GPx3 may be a therapeutic target for insulin resistance and diabetes mellitus.

    PubMed IF 2.8 내분비대사내과
22. 4272009

    제1저자 임철현 · 교신저자 송영욱

    Im CH, Kang EH, Ryu HJ, Lee JH, Lee EY, Lee YJ, Lee EB, Song YW

    Anti-cyclic citrullinated peptide antibody is associated with radiographic erosion in rheumatoid arthritis independently of shared epitope status.

    Rheumatol Int. 2009;29(3):251-6.

    Abstract

    Shared epitope (SE) and anti-cyclic citrullinated peptide (CCP) antibody are known to be associated with rheumatoid arthritis (RA). The authors investigated their adjusted effects on RA from Korean population. Clinical features were evaluated in 226 RA patients; 164 healthy controls were enrolled. HLA-DRB1 typing for SE was done by polymerase chain reaction. Anti-CCP antibody levels were determined by enzyme linked immunosorbent assay. Logistic regression analysis method was used for adjusted effects. SE and anti-CCP antibody were associated with RA susceptibility. Anti-CCP antibody was associated with RA susceptibility independent of SE [odds ratio, OR 179.9 (95% confidence interval, CI 40.8-792.2), P < 0.001]. Anti-CCP antibody was associated with radiographic erosive changes independent of SE or rheumatoid factor [OR 3.9 (95% CI 1.1-13.3), P = 0.032]. Anti-CCP antibody was strongly associated with RA susceptibility and radiographic erosion of RA patients, independent of SE in Korean.

    PubMed IF 3.5 류마티스내과
23. 4262009

    제1저자 이재진 · 교신저자 허대석

    Lee JJ, Hah JH, Im SA, Kim SY, Sung MW, Kim KH, Heo DS

    Neoadjuvant chemotherapy followed by limited surgery in a mouse model of head and neck cancer.

    Anticancer Res. 2009;29(1):255-9.

    Abstract

    BACKGROUND This study evaluated the effect of limited surgery following neoadjuvant chemotherapy compared to radical surgery in SCC VII (squamous cell cancer) tumor-bearing syngeneic C3H/HeJ mice.

    MATERIALS AND METHODS Mice showing a tumor response to cisplatin and 5-fluorouracil therapy were divided into three groups: radical surgery, with a 5 mm margin from the original tumor, group (A); limited surgery of 5 mm margin from the residual tumor, group (B); and very limited surgery with no margin from the residual tumor, group (C). The number of mice was 13 (group A), 12 (group B) and 12 (group C).

    RESULTS No recurrence developed except in one mouse in group C. Three mice died in group A, one in group B and one in group C from perioperative complications. By intent-to-treat analysis, the survival was not significantly different among the three groups (p = 0.64), or between group A and B (p = 0.33).

    CONCLUSION The outcome of limited surgery was comparable to radical surgery after neoadjuvant chemotherapy in the mouse model of head and neck cancer.

    PubMed IF 1.8 혈액종양내과
24. 4252009

    제1저자 선종무 · 교신저자 이종석

    Sun JM, Lee KW, Kim JH, Kim YJ, Yoon HI, Lee JH, Lee CT, Lee JS

    Efficacy and toxicity of pemetrexed as a third-line treatment for non-small cell lung cancer.

    Jpn J Clin Oncol. 2009;39(1):27-32.

    Abstract

    OBJECTIVE Pemetrexed has been approved for second-line treatment in non-small cell lung cancer (NSCLC). However, the role of third-line pemetrexed therapy in NSCLC has not yet been generally accepted. We attempted to validate third-line pemetrexed therapy and evaluate predictive factors for pemetrexed therapy for NSCLC.

    METHODS Medical records of NSCLC patients who received pemetrexed therapy that progressed after systemic therapy were reviewed retrospectively. We stratified patients according to clinicopathologic characteristics to find predictive factors for pemetrexed therapy.

    RESULTS A total of 100 patients were eligible for analysis, and overall progression-free survival (PFS) was 3.03 months. The objective response rate was 12%, and the toxicity profile was favorable. Pemetrexed was used as a second-line treatment in 30% of patients, and as third- or further-line treatment in 70%. Comparing the efficacy of pemetrexed in these two settings (second-line versus third- or further-line), there was no significant difference in terms of PFS (3.07 versus 2.83 months, P = 0.86). When we evaluated predictive factors by multivariate analysis, performance status significantly influenced PFS.

    CONCLUSIONS Pemetrexed is a suitable third-line treatment option with good efficacy and tolerable toxicity profile for NSCLC.

    PubMed IF 2.5 혈액종양내과
25. 4242009

    제1저자 강정묵 · 교신저자 김나영

    Kang JM, Kim N, Lee DH, Park JH, Lee MK, Kim JS, Jung HC, Song IS

    The effects of genetic polymorphisms of IL-6, IL-8, and IL-10 on Helicobacter pylori-induced gastroduodenal diseases in Korea.

    J Clin Gastroenterol. 2009;43(5):420-8.

    Abstract

    BACKGROUND The genes that encode proinflammatory and anti-inflammatory cytokines are good candidate markers of host susceptibility to gastroduodenal disease. The present study was performed to evaluate whether or not the genetic polymorphisms of IL-6, IL-8, and IL-10 are associated with gastroduodenal disease in the Korean population.

    METHODS This study enrolled 1187 patients, including controls, those with gastric cancer (GC), benign gastric ulcer (BGU), and duodenal ulcer patients. Six polymorphisms were genotyped, 3 of IL-10 (at -592, -819, and -1082), 1 of IL-8 (at -251), and 2 of IL-6 (at -174 and -572), by polymerase chain reaction-restriction fragment length polymorphism analysis.

    RESULTS The frequency of IL-10-1082 G carriers was higher in cases of a diffuse type GC [odds ratio (OR) 1.8, 95% confidence interval (CI): 1.0-3.1, P=0.041] or BGU (OR 1.6, 95% CI: 1.0-2.5, P=0.040), than in the control group regardless of Helicobacter pylori infection. The IL-8-251 A/A genotype was more common in H. pylori-positive patients with GC (OR 2.0, 95% CI: 1.2-3.6, P=0.013) or BGU (OR 2.7, 95% CI: 1.5-4.8, P=0.001) than in H. pylori-positive controls. In addition, the frequencies of IL-6-572 G/G (OR 0.3, 95% CI: 0.1-0.9, P=0.027) and of G carriers (OR 0.5, 95% CI: 0.4-0.8, P=0.003) were lower in H. pylori-positive duodenal ulcer patients than in H. pylori-positive controls. IL-10-592 C/C (OR 0.4, 95% CI: 0.2-0.9, P=0.028) was an independent factor associated with a decreased risk of the intestinal type of GC by multivariate analysis. Furthermore, a synergistic effect was observed between IL-10-592 A/A and IL-8-251 A/A with respect to the development of GC or BGU.

    CONCLUSIONS These results suggest that the genetic polymorphisms of these 3 inflammation-related cytokines, IL-10, IL-8, and IL-6, are associated with the development of H. pylori-associated gastroduodenal disease.

    PubMed IF 2.7 소화기내과
26. 4232009

    제1저자 김혜련 · 교신저자 임재준

    Kim HR, Lee CH, Kim YW, Han SK, Shim YS, Yim JJ

    Increased CA 19-9 level in patients without malignant disease.

    Clin Chem Lab Med. 2009;47(6):750-4.

    Abstract

    BACKGROUND The measurement of carbohydrate antigen 19-9 (CA 19-9) is recommended for the diagnosis and follow-up of pancreatic cancer. However, increased CA 19-9 has also been reported in patients with various benign diseases of the lung. We aimed to elucidate the pulmonary radiographic abnormalities and laboratory results associated with increased concentrations of CA 19-9.

    METHODS This study was performed using a case-controlled design. Cases included all participants in a cancer screening program who had an increased CA 19-9 concentration (>37 U/mL), but without a diagnosis of malignancy. Age- and sex-matched participants with normal CA 19-9 levels were enrolled as controls. Laboratory results and radiographic features were compared.

    RESULTS In total, 119 participants with increased CA 19-9 concentrations and 476 controls were included. A higher erythrocyte sedimentation rate (ESR) [adjusted odd ratio (aOR), 1.03; 95% confidence interval (CI), 1.01-1.05], higher hemoglobin A(1c) (HbA(1c)) (aOR, 1.28; 95% CI, 1.05-1.56), bronchiectasis (aOR, 2.48; 95% CI, 1.22-5.02), bronchiolitis (aOR, 3.93; 95% CI, 1.88-8.22), emphysema (aOR, 2.67; 95% CI, 1.32-5.40), and interstitial fibrosis (aOR, 10.62; 95% CI, 2.03-55.44) were independent factors for increased CA 19-9.

    CONCLUSIONS CA 19-9 concentrations, as well as increased ESR and HbA(1c), can be increased in patients with various lung abnormalities.

    PubMed IF 4.4 호흡기내과
27. 4222009

    제1저자 조영석 · 교신저자 임 청

    Cho YS, Lim C, Han MJ, Chun EJ, Choi SI, Park KH, Chae IH, Choi DJ

    Should we consider the ethnic difference in selecting size of intraaortic balloon by commercial guideline?

    ASAIO J. 2009;55(5):519-22.

    Abstract

    To evaluate the appropriateness of commercial guideline in selecting the size of balloon for intraaortic counterpulsation in Asian patients, we analyzed the relationship between aortic dimensions measured from computed tomography and body indexes. There were 125 patients who underwent the computed tomography. They were divided into three height groups [<152 cm (I), 152-162 cm (II), and 163-183 cm (III)]. Aortic length and diameter were obtained from the origin of left subclavian artery to the orifice of renal artery. We compared those measurements with the balloon size according to the commercial guideline. Aortic lengths were measured as 250 +/- 15 (233-289), 262 +/-16 (227-298), and 285 +/- 19 (239-334) mm in each group, respectively. As the guideline, if we insert the balloon of 25 ml/191 mm, 34 ml/236 mm, and 40 ml/280 mm, there will be 29 of 66 patients (44%) in group III, who have shorter aortic length, with increased risk of obstructing renal artery. In addition, the younger the patient the higher is the risk (p = 0.038). We should pay attention to proper positioning of intraaortic balloon in younger Asian patients with 163-183 cm height, in applying the commercial guideline to prevent renal arterial obstruction.

    PubMed IF 2.2 순환기내과
28. 4212009

    제1저자 장은선 · 교신저자 이동호

    Jang ES, Lee DH, Kim J, Yang HJ, Lee SH, Park YS, Hwang JH, Kim JW, Jeong SH, Kim N, Jung HC, Song IS

    Age as a clinical predictor of relapse after induction therapy in ulcerative colitis.

    Hepatogastroenterology. 2009;56(94-95):1304-9.

    Abstract

    BACKGROUND/AIMS Whether older patients with ulcerative colitis (UC) have a better clinical course than younger patients is unclear. We compared the clinical characteristics between older and younger age groups in South Korea to elucidate the impact of age on relapse in UC.

    METHODOLOGY Patients between 18 and 85 years old who were diagnosed with UC at Seoul National University Bundang Hospital between 1 May 2003 and 31 Oct 2007 were enrolled. It was reviewed their symptoms, endoscopic and pathologic findings, and drugs used in induction treatment.

    RESULTS Of the 73 patients with UC who achieved remission after induction treatment, 38 relapsed. The patients aged 18-44 and 45-85 years had similar clinical features, but the relapse rate was significantly higher in the younger group (69.2 vs. 32.4%; p = 0.002). In a multivariable analysis, age 45-85 years old was an independent protective factor against relapse (OR, 0.146; 95% CI, 0.035-0.508; p = 0.003) after adjusting for sex, frequency of diarrhea, hematochezia grade, disease extent, and systemic steroid used in induction treatment.

    CONCLUSION An age of 45 years or older is an independent predictor of less relapse in UC.

    PubMed IF 0.68 소화기내과
29. 4202009

    제1저자 임수 · 교신저자 장학철

    Lim S, Yoon JW, Choi SH, Cho BJ, Kim JT, Chang HS, Park HS, Park KS, Lee HK, Kim YB, Jang HC

    Effect of ginsam, a vinegar extract from Panax ginseng, on body weight and glucose homeostasis in an obese insulin-resistant rat model.

    Metabolism. 2009;58(1):8-15.

    Abstract

    Extracts of ginseng species show antihyperglycemic activity. We evaluated the antihyperglycemic and antiobesity effects of ginsam, a component of Panax ginseng produced by vinegar extraction, which is enriched in the ginsenoside Rg3. Otsuka Long-Evans Tokushima Fatty rats, an obese insulin-resistant rat model, were assigned into 1 of 3 groups (n = 8 each): controls (isotonic sodium chloride solution, 5 mL/d), rats given 300 mg/(kg d) ginsam, and rats given 500 mg/(kg d) ginsam. An intraperitoneal 2-hour glucose tolerance test was performed at the end of the 6-week treatment. After 8 weeks, body and liver weights, visceral fat measured by computed tomography, and fasting glucose and insulin concentrations and lipid profiles were recorded. Insulin-resistant rats treated with ginsam had lower fasting and postprandial glucose concentrations compared with vehicle-treated rats. Importantly, overall glucose excursion during the intraperitoneal 2-hour glucose tolerance test decreased by 21.5% (P < .01) in the treated rats, indicating improved glucose tolerance. Plasma insulin concentration was significantly lower in ginsam-treated rats. These changes may be related to increased glucose transporter 4 expression in skeletal muscle. Interestingly, when the data from both ginsam-treated groups were combined, body weight was 60% lower in the ginsam-treated rats than in the controls (P < .01). Liver weight and serum alanine aminotransferase concentrations were also lower in the ginsam-treated rats. These effects were associated with increased peroxisome proliferator-activated receptor gamma expression and adenosine monophosphate-activated protein kinase phosphorylation in liver and muscle. Our data suggest that ginsam has distinct beneficial effects on glucose metabolism and body weight control in an obese animal model of insulin resistance by changing the expression of genes involved in glucose and fatty acid metabolism.

    PubMed IF 16.7 내분비대사내과
30. 4192009

    제1저자 김진택 · 교신저자 박경수

    Kim JT, Kim Y, Cho YM, Koo BK, Lee EK, Shin HD, Jang HC, Choi JW, Oh B, Park KS

    Polymorphisms of ADIPOR1 and ADIPOR2 are associated with phenotypes of type 2 diabetes in Koreans.

    Clin Endocrinol (Oxf). 2009;70(1):66-74.

    Abstract

    OBJECTIVE Adiponectin receptors 1 and 2 (ADIPOR1 and ADIPOR2) are considered as candidate genes for type 2 diabetes because they mediate the metabolic effects of adiponectin on target tissues. We investigated whether common polymorphisms of ADIPOR1 and ADIPOR2 are associated with type 2 diabetes or its related phenotypes in Koreans.

    DESIGN AND PATIENTS By sequencing of the DNA samples from 24 unrelated Korean subjects, we selected seven single nucleotide polymorphisms (SNPs) from ADIPOR1 and four SNPs from ADIPOR2 for genotyping in 757 type 2 diabetic patients and 644 nondiabetic subjects.

    RESULTS None of the SNPs were associated with the risk of type 2 diabetes. However, g.-7309A>G (rs75172865) in ADIPOR1 was associated with lower insulin resistance, measured by the homeostasis model assessment of insulin resistance (HOMA-IR). Thereafter, we transfected three different human cell lines with plasmids harbouring g.-7309A>G and found that this variant reduced the promoter activity of ADIPOR1. In ADIPOR2, g.-63442G (novel SNP) and g.33447T (rs1044471) were associated with smaller waist circumference.

    CONCLUSIONS None of the SNPs in either ADIPOR1 or ADIPOR2 were associated with the risk of type 2 diabetes in Koreans. However, the altered activity of the ADIPOR1 promoter was associated with insulin resistance and SNPs of ADIPOR2 were associated with waist circumference.

    PubMed IF 2.8 내분비대사내과

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