SCI 발표논문

2007년 129편

992007

제1저자 신형두 · 교신저자 이효석

, , , , ,
SPP1 polymorphisms associated with HBV clearance and HCC occurrence.
Int J Epidemiol. 2007;36(5):1001-8.

Abstract
BACKGROUND Secreted phosphoprotein-1 (SPP1) is a secreted arginine-glycine-aspartate (RGD)-containing phosphoprotein. SPP1 is overexpressed in metastatic hepatocellular carcinoma (HCC), and therefore could act as both a diagnostic marker and a potential therapeutic target for metastatic HCC. We investigated the genetic polymorphisms in SPP1 to determine whether it is a potential candidate gene for a host genetic study of hepatitis B virus (HBV) clearance and HCC occurrence.
METHODS Five genetic variants in SPP1 were genotyped by TaqMan assay and the genetic association with HBV clearance and HCC occurrence was analysed.
RESULTS Genetic association analysis of SPP1 polymorphisms with an HBV cohort (n = 1,069) from the Korean population revealed that the most common haplotype (SPP1-ht2 [T-T-C-T-A]) was associated with HBV clearance. The frequency of the SPP1-ht2-bearing genotype in the chronic carrier (CC) group was higher than in the spontaneously recovered (SR) group (OR = 1.44 [95% CI 1.11-1.87], P = 0.006, P(corr) = 0.02). By Cox relative hazard analysis, both SPP1-ht2 and -1,800G > T were associated with age of HCC occurrence among chronic hepatitis patients, e.g. ht2/h2- and 1800T/T-bearing patients showed earlier progression to HCC than did others (RH = 1.85, P = 0.004, P(corr) = 0.01 and RH = 1.85, P = 0.003, P(corr) = 0.01, respectively).
CONCLUSION Our findings suggest that SPP1 polymorphisms might be among the genetic factors for HBV clearance and/or HCC occurrence.
PubMed IF 5.7 소화기내과
982007

제1저자 유병철 · 교신저자 이효석

, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,
Clevudine is highly efficacious in hepatitis B e antigen-negative chronic hepatitis B with durable off-therapy viral suppression.
Hepatology. 2007;46(4):1041-8.

Abstract
UNLABELLED Clevudine is a pyrimidine analog with potent and sustained antiviral activity against HBV. In the present study, we evaluated the safety and efficacy of clevudine 30 mg daily for 24 weeks and assessed the durability of antiviral response for 24 weeks after cessation of dosing in hepatitis B e antigen (HBeAg)-negative chronic hepatitis B (e-CHB). We randomized a total of 86 patients (3:1) to receive clevudine 30 mg (n = 63) or placebo (n = 23) daily for 24 weeks. We followed patients for an additional 24 weeks after withdrawal of treatment. The median changes in HBV DNA from baseline were -4.25 and -0.48 log(10) copies/mL at week 24 in the clevudine and placebo groups, respectively (P < 0.0001). Viral suppression in the clevudine group was sustained after withdrawal of therapy, with 3.11 log(10) reduction at week 48. At week 24 and week 48, 92.1% and 16.4% of patients in the clevudine group had undetectable serum HBV DNA levels by Amplicor PCR assay (<300 copies/mL). The proportion of patients who achieved ALT normalization was 74.6% and 33.3% in the clevudine and placebo groups at week 24, respectively (P = 0.0006). ALT normalization in the clevudine group was well-maintained during the post-treatment follow-up period. The incidence of adverse events was similar in the 2 groups. No resistance to clevudine was detected during treatment.
CONCLUSION A 24-week clevudine therapy was well-tolerated and showed potent and sustained antiviral effect without evidence of viral resistance in e-CHB patients. However, treatment for longer than 24 weeks would be needed to achieve durable remission.
PubMed IF 18 소화기내과
972007

제1저자 이상협 · 교신저자 김용태

, , , , , , ,
Outcomes of cystic lesions in the pancreas after extended follow-up.
Dig Dis Sci. 2007;52(10):2653-9.

Abstract
Incidental pancreatic cysts are frequently detected, but no appropriate management guidelines have been issued for their management because their natural history is relatively unknown. The aim of this study was to investigate their long-term clinical outcomes. Pancreatic cysts detected from 1998 to 2004 were retrospectively reviewed in patients followed up for more than 3 months. A total of 182 patients with incidental pancreatic cysts (initial mean size, 1.8+/-1.1 cm) underwent follow-up for an average of 35.4 months. An age>/=60 years was found to be associated with an increase in cyst size, with an odds ratio of 2.56. Two malignant cysts were found among 20 patients who underwent surgical resection during follow-up. Old age was also associated with the presence of a premalignant or malignant cyst (P<0.01). Although the majority of incidental pancreatic cysts show an indolent behavior, long-term, regular follow-up studies should be considered for all pancreatic cysts, especially in the elderly.
PubMed IF 2.8 소화기내과
962007

제1저자 박완범 · 교신저자 김홍빈

, , , , , , , , , ,
In vitro ability of Staphylococcus aureus isolates from bacteraemic patients with and without metastatic complications to invade vascular endothelial cells.
J Med Microbiol. 2007;56(Pt 10):1290-1295.

Abstract
Invasion of vascular endothelial cells is thought to be a critical step in the development of metastatic infections in patients with Staphylococcus aureus bacteraemia. This study was designed to evaluate the association between the ability to invade endothelial cells and metastatic infection by S. aureus. Patients with metastatic infection were identified among those with community-acquired S. aureus bacteraemia in a tertiary referral hospital. Patients with simple bacteraemia caused by S. aureus over the same period served as the control group. The ability of each clinical isolate to invade endothelial cells was evaluated by counting the number of intracellular organisms 1 h after inoculation onto human umbilical vein endothelial cells in vitro. The cytotoxic activity of intracellular S. aureus was determined 24 h after internalization, and expressed as the percentage of cells killed. The clinical isolates varied in invasiveness and cytotoxicity. The median invasiveness, relative to S. aureus reference strain ATCC 29213, was 145 % in the cases (n=10) [interquartile range (IQR) 103-160] and 153 % (IQR 111-173) in the controls (n=11; P=0.44). The median cytotoxicity was 59.4 % (IQR 47-68) in the cases and 65.2 % (IQR 50-74) in the controls (P=0.44). Differences in the ability of S. aureus to invade and destroy vascular endothelial cells in vitro were not associated with the development of metastatic complications in patients with S. aureus bacteraemia. This implies that the invasiveness and toxicity of S. aureus for endothelial cells may not be major determinants of metastatic infection.
PubMed IF 2.7 감염내과
952007

제1저자 배현미 · 교신저자 김동완

, , , , , , ,
Palliative chemotherapy for pulmonary pleomorphic carcinoma.
Lung Cancer. 2007;58(1):112-5.

Abstract
Pulmonary pleomorphic carcinoma is a rare tumor of the lung, which is believed to spread at an early stage and to have an aggressive clinical course. The efficacy of chemotherapy for advanced pulmonary pleomorphic carcinoma has not been defined. The objective of this study was to evaluate the efficacy of palliative chemotherapy for pulmonary pleomorphic carcinoma. Thirteen consecutive patients who received palliative chemotherapy for advanced pulmonary pleomorphic carcinoma were investigated. All 13 patients were treated using chemotherapy regimens known to be active for the treatment of advanced non-small cell lung cancer (NSCLC). Eleven patients (85%) had progressive disease and two (15%) had stable disease after first-line chemotherapy. No patient achieved an objective response (objective response rate, 0%; 95% confidence interval, 0-23%). Of the 13, eight were given second-line chemotherapy, and all had progressive disease after second-line chemotherapy (objective response rate, 0%; 95% CI, 0-32%). Median overall survival from the initiation of first-line palliative chemotherapy was only 5 months (range, 2-12) with a median follow-up of 16 months. Advanced pulmonary pleomorphic carcinoma showed poor response to chemotherapy regimens that provide active treatment for NSCLC. Novel treatment approaches are required for pulmonary pleomorphic carcinoma.
PubMed IF 5.3 혈액종양내과
942007

제1저자 정연주 · 교신저자 김태유

, , , , , , , ,
Potential advantages of DNA methyltransferase 1 (DNMT1)-targeted inhibition for cancer therapy.
J Mol Med (Berl). 2007;85(10):1137-48.

Abstract
The deoxyribonucleic acid (DNA) methyltransferase (DNMT) inhibitor 5-aza-2'-deoxycytidine (5-aza-dC) has been used as a drug in a part of cancer therapy. However, because of its incorporation into DNA during DNA synthesis, 5-aza-dC can cause DNA damage, mutagenesis, and cytotoxicity. In view of the adverse effects of 5-aza-dC, DNMT-targeted inhibition may be a more effective approach than treatment with 5-aza-dC. To address the possibility of DNMT-targeted cancer therapy, we compared the effects of treatment with small interfering ribonucleic acids (siRNAs) specific for DNMT1 or DNMT3b and treatment with 5-aza-dC on transcription, cell growth, and DNA damage in gastric cancer cells. We found that DNMT1-targeted inhibition induced the re-expression and reversed DNA methylation of five (CDKN2A, RASSF1A, HTLF, RUNX3, and AKAP12B) out of seven genes examined, and 5-aza-dC reactivated and demethylated all seven genes. In contrast, DNMT3b siRNAs did not show any effect. Furthermore, the double knockdown of DNMT1 and DNMT3b did not show a synergistic effect on gene re-expression and demethylation. In addition, DNMT1 siRNAs showed an inhibitory effect of cell proliferation in the cancer cells and the induction of cell death without evidence of DNA damage, whereas treatment with 5-aza-dC caused DNA damage as demonstrated by the comet assay. These results provide a rationale for the development of a DNMT1-targeted strategy as an effective epigenetic cancer therapy.
PubMed IF 5 혈액종양내과
932007

제1저자 양종인 · 교신저자 윤정환

, , , , , , , , ,
Bile acid-induced TGR5-dependent c-Jun-N terminal kinase activation leads to enhanced caspase 8 activation in hepatocytes.
Biochem Biophys Res Commun. 2007;361(1):156-61.

Abstract
TGR5 is a novel G protein-coupled cell-surface bile acid receptor. In cholestasis, bile acids induce hepatocyte apoptosis by primarily activating death receptor-mediated signaling. We examined if bile acid-induced TGR5 activation is participating in bile acid-induced hepatocyte apoptosis. TGR5 expression and its responsiveness to bile acid were confirmed in human hepatocytes. TGR5 inhibition attenuated bile acid-induced caspase 8 activation, which resulted from reduced bile acid-induced caspase 8 recruited to a death-inducing signaling complex (DISC). Bile acid-induced c-Jun-N terminal kinase (JNK) activation was dependent on bile acid activation of TGR5. JNK formed complexes with caspase 8, which were reduced following bile acid treatment, but this reduction was prevented when TGR5 or JNK was inhibited. In conclusion, bile acids activate TGR5, which leads to JNK activation and reduced complex formation of JNK with caspase 8, thus facilitating caspase 8 recruitment to DISC. These observations suggest therapeutic applications for TGR5 signaling blockage in cholestasis.
PubMed IF 2.5 소화기내과
922007

제1저자 진상만 · 교신저자 이상민

, , , , , ,
Small solid noncalcified pulmonary nodules detected by screening chest computed tomography.
Respir Med. 2007;101(9):1880-4.

Abstract
We aimed to determine the outcome of small (<10 mm) solid noncalcified pulmonary nodules detected by chest computed tomography (CT) scans. Reports of low-dose chest CT scans performed from October 2003 to April 2005 at the Seoul National University Hospital Healthcare System Gangnam Center were reviewed to identify patients with solid noncalcified pulmonary nodules smaller than 10 mm. Partly solid and nonsolid nodules or nodules without follow-up imaging within 1 year were excluded. Records were studied to determine if the initial nodules had changed in size. A total of 3478 chest CT examinations were performed, with 232 patients having small noncalcified nodules (6.7%). One hundred and thirty-eight patients met the criteria (104 men and 34 women) and 213 nodules were identified. The median age was 54 years (range 32-80) and at least 86 patients (62%) were at low to intermediate risk for developing lung cancer. The largest nodule was less than 5 mm in diameter in 87 patients (63%) and 5 mm or more in 51 patients (37%). None of the nodules grew and 29 (14%) decreased in size at follow-up CT scans performed within 12 months. When those individuals at low to intermediate risk for lung cancer were included, solid noncalcified subcentimeter nodules were less frequently found in low-dose CT screening and were nearly unchanged in size when a follow-up CT scan was done within 12 months.
PubMed IF 3.3 호흡기내과
912007

제1저자 엄상원 · 교신저자 이재호

, , , , , , ,
Low serum concentrations of anti-tuberculosis drugs and determinants of their serum levels.
Int J Tuberc Lung Dis. 2007;11(9):972-8.

Abstract
SETTING Low serum concentrations of anti-tuberculosis drugs have occasionally been associated with treatment failure.
OBJECTIVE To determine the prevalence of low serum concentrations of anti-tuberculosis drugs and to identify the determinants of drug concentrations.
DESIGN Venous blood was obtained 2 h after drug ingestion, and serum levels of isoniazid (INH), rifampicin (RMP), ethambutol (EMB), pyrazinamide (PZA), acetyl INH and 25-desacetyl RMP were analysed using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Patients with human immunodeficiency virus co-infection and gastrointestinal disease or diarrhoea were excluded.
RESULTS Among 69 enrolled TB patients, the prevalence of a low 2 h serum concentration of at least one anti-tuberculosis drug was 46.4%. Prevalences of a low concentration of INH, RMP, EMB or PZA were 15.2%, 23.5%, 22.4% and 4.5%, respectively. By multivariate linear regression analysis, the serum concentrations of INH, RMP and PZA were positively associated with dose per kg of body weight (P < 0.05). Moreover, INH concentration was associated with acetyl INH/INH ratio (beta = -8.588, P < 0.001) and EMB concentration was associated with calculated creatinine clearance (beta = -0.025, P < 0.001).
CONCLUSION Low concentrations of anti-tuberculosis drugs are common, and although the clinical significance of low concentrations remains uncertain, it may be necessary to optimise drug doses by therapeutic drug monitoring, especially in patients with an inadequate clinical response to chemotherapy.
PubMed IF 3.6 호흡기내과
902007

제1저자 양승희 · 교신저자 김연수

, , , , , , , ,
Role of NKT cells in allogeneic islet graft survival.
Clin Immunol. 2007;124(3):258-66.

Abstract
Although NKT cells expressing CD1d-reactive TCR exerted protective role in autoimmune diseases, the regulatory function of CD1d-dependent NKT cells in alloimmune responses has not been investigated thoroughly. Here, we demonstrated the regulatory effects of NKT cells using a pancreas islet transplantation model. CD40/CD154 blocking induced long-term graft survival in most B6 recipients, but B6.CD1d(-/-) recipients showed co-stimulation blockade-resistant rejection. Adoptive transfer of NKT cells into B6.CD1d(-/-) restored tolerizing capacity of co-stimulatory blockade. Activation of NKT cells was effective for the prolongation of graft survival and up-regulated membrane-bound TGF-beta expression transiently on their cell surface. The activated CD1d-dependent NKT cells inhibited alloantigen-driven cell proliferation through cell contacts and the beneficial effect of CD154 blocking for allograft survival was related to TGF-beta pathway. Thus, we can conclude that NKT cells are essential for the stable allograft survival and the regulatory function is dependent on, at least in part, TGF-beta engagement.
PubMed IF 4.1 신장내과
892007

제1저자 강영애 · 교신저자 임재준

, , , , , ,
Usefulness of whole-blood interferon-gamma assay and interferon-gamma enzyme-linked immunospot assay in the diagnosis of active pulmonary tuberculosis.
Chest. 2007;132(3):959-65.

Abstract
PURPOSES The aim of this study was to evaluate the usefulness of the whole-blood interferon-gamma assay (enzyme-linked immunosorbent assay [ELISA]) and interferon-gamma enzyme-linked immunospot assay (ELISPOT) based on early secretory antigenic target 6 and culture filtrate protein 10 in the diagnosis of active pulmonary tuberculosis (TB) in routine clinical practice.
METHOD We conducted a prospective study enrolling 144 participants with suspected pulmonary TB in a tertiary referral hospital in Seoul, South Korea, to investigate the diagnostic sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of these tests. Clinical assessment, tuberculin skin test (TST), whole-blood interferon-gamma ELISA (QuantiFERON-TB Gold [QFT-G]; Cellestis Ltd; Victoria, Australia), and an ELISPOT assay (T SPOT.TB; Oxford Immunotec; Oxford, UK) were performed. Test results were compared with the final confirmed diagnoses.
RESULTS Active pulmonary TB was diagnosed in 67 of 144 participants (47%). Sensitivities of QFT-G and T SPOT.TB for active pulmonary TB were 89% (95% confidence interval [CI], 79 to 96%) and 92% (95% CI, 83 to 97%), respectively; and specificities were 49% (95% CI, 37 to 61%) and 47% (95% CI, 36 to 59%). NPVs of QFT-G (84%; 95% CI, 69 to 93%) and T SPOT.TB (87%; 95% CI, 73 to 96%) were higher than that of TST (64%; 95% CI, 51 to 76%) [p = 0.001 and p < 0.001, respectively].
CONCLUSION High NPVs of QFT-G and T SPOT.TB for the diagnosis of active TB suggest the supplementary role of these tests for the diagnostic exclusion of active TB, although the low PPV limits their usefulness in routine clinical practice in South Korea, where the prevalence of latent TB infection is considerable.
PubMed IF 9.8 호흡기내과
882007

제1저자 김용진 · 교신저자 Takahiro Shiota

, , , , , , ,
Evaluation of left ventricular contractile function using noninvasively determined single-beat end-systolic elastance in mitral regurgitation: experimental validation and clinical application.
J Am Soc Echocardiogr. 2007;20(9):1086-92.

Abstract
OBJECTIVE We performed this study to validate the single-beat estimation of end-systolic elastance (E(es)) in an animal model of chronic mitral regurgitation (MR) and to use E(es) to predict postoperative left ventricular (LV) systolic function with the noninvasively derived single-beat E(es) (E(es-s)) in patients with MR.
METHODS Eight sheep with MR were studied under 4 different loading conditions. E(es) was measured as the slope of the end-systolic pressure-volume relationship with a conductance catheter during inferior vena cava occlusion. E(es-s) was calculated using a bilinearly approximated time-varying elastance curve. We also studied 105 patients with MR who had undergone mitral valve repair. All measurements in these patients were performed before surgery and repeated at about 1 week after surgery.
RESULTS In the animals in a total of 23 different stages, E(es-s) showed a good correlation and agreement with invasively determined E(es) (y = 0.84 x + 0.38; r = 0.8; P < .01, mean difference = 0.1 +/- 0.6 mm Hg/mL). In the clinical study, preoperative E(es-s) (r = 0.77; P < .001) and end-systolic volume index correlated well with postoperative ejection fraction (r = -0.69; P < .001). Multivariate analyses revealed that only E(es-s) was an independent predictor of postoperative LV function. Preoperative E(es-s) less than or equal to 1.0 mm Hg/mL was most predictive for identifying patients with LV dysfunction after surgery (sensitivity 87%; specificity 76%).
CONCLUSIONS LV end-systolic elastance can be estimated noninvasively and is useful to detect latent LV dysfunction in patients with MR before surgery.
PubMed IF 8.3 순환기내과
872007

제1저자 이근욱 · 교신저자 김지현

, , , , , , , , , , , , , , ,
Phase II study of low-dose paclitaxel and cisplatin as a second-line therapy after 5-fluorouracil/platinum chemotherapy in gastric cancer.
J Korean Med Sci. 2007;22 Suppl(Suppl):S115-21.

Abstract
This study was performed to evaluate the efficacy and toxicity of low-dose paclitaxel/cisplatin chemotherapy in patients with metastatic or recurrent gastric cancer that had failed 5-fluorouracil/platinum-based chemotherapy. Thirty-two patients with documented progression on or within 6 months after discontinuing 5-fluorouracil/platinum-based chemotherapy were enrolled. As a second-line treatment, paclitaxel (145 mg/m(2)) and cisplatin (60 mg/m(2)) was administered on day 1 every 3 weeks. Among 32 patients enrolled, 8 (25%) responded partially to paclitaxel/cisplatin, 8 (25%) had stable disease, and 14 (44%) had progressive disease. Two patients (6%) were not evaluable. The median time to progression (TTP) and overall survival for all patients were 2.9 months and 9.1 months, respectively. The most common hematologic toxicity was anemia (47%). Grade 3 neutropenia developed in three patients (9%), but no other grade 3/4 hematologic toxicity occurred. The most common non-hematologic toxicities were emesis (31%) and peripheral neuropathy (38%). Three cases (9%) of grade 3/4 emesis and 2 cases (6%) of grade 3 peripheral neuropathy developed. In conclusion, low-dose paclitaxel and cisplatin chemotherapy showed moderate activity with favorable toxicity profiles. However, relatively short TTP of this regimen warrants the development of more effective paclitaxel-based regimens other than combination with cisplatin in these patients as second-line therapies.
PubMed IF 3.2 혈액종양내과
862007

제1저자 최의근 · 교신저자 김효수,구본권

, , , , , , , , , , ,
Prognostic significance of asymptomatic coronary artery disease in patients with diabetes and need for early revascularization therapy.
Diabet Med. 2007;24(9):1003-11.

Abstract
AIMS Information on the clinical outcome of patients with diabetes with silent myocardial ischaemia is limited. We compared the clinical and angiographic characteristics, and the clinical outcomes of diabetic patients with asymptomatic or symptomatic coronary artery disease (CAD).
METHODS Three hundred and ten consecutive diabetic patients with CAD were divided into two groups according to the presence of angina and followed for a mean of 5 years. Fifty-six asymptomatic patients with a positive stress test and CAD on coronary angiography were compared with 254 symptomatic patients, 167 with unstable angina and 87 with chronic stable angina.
RESULTS Although the severity of coronary atherosclerosis was similar in asymptomatic and symptomatic patients, revascularization therapy was performed less frequently in the asymptomatic than the symptomatic patients (26.8 vs. 62.0%; P < 0.001). Asymptomatic patients experienced a similar number of major adverse cardiac events (MACEs; death, non-fatal myocardial infarction, and revascularization; 32 vs. 28%; P = 0.57), but had higher cardiac mortality than symptomatic patients (26 vs. 9%; P < 0.001). However, patients who underwent revascularization therapy at the time of CAD diagnosis in these two groups showed similar MACE and cardiac mortality (20.0 vs. 22.5%, 6.7 vs. 5.3%, respectively; all P > 0.05).
CONCLUSIONS This study suggests that diabetic patients with asymptomatic CAD have a higher cardiac mortality risk than those with symptomatic CAD, and that lack of revascularization therapy may be responsible for the poorer survival.
PubMed IF 3.3 순환기내과
852007

제1저자 김상현 · 교신저자 김효수

, , , , , , , , , , , , , , ,
Results of a phase III, 8-week, multicenter, prospective, randomized, double-blind, parallel-group clinical trial to assess the effects of amlodipine camsylate versus amlodipine besylate in Korean adults with mild to moderate hypertension.
Clin Ther. 2007;29(9):1924-36.

Abstract
BACKGROUND Amlodipine besylate has been used in Korea for the treatment of hypertension for >17 years, with well-established efficacy and tolerability. Amlodipine camsylate is a newer formulation developed for generic use. It has been assessed in terms of physical stability and pharmacokinetic and pharmacodynamic properties and been found to be effective in lowering blood pressure in preclinical and Phase I and II trials. However, to date, no studies have compared the clinical effectiveness of amlodipine camsylate and amlodipine besylate in treating hypertension.
OBJECTIVE This study was designed to determine the effectiveness and tolerability of amlodipine camsylate compared with amlodipine besylate in Korean patients with mild to moderate hypertension.
METHODS This Phase III, 8-week, prospective, randomized, double-blind, parallel-group study was conducted in 13 cardiology centers across the Republic of Korea. Male and female Korean patients aged 18 to 75 years having uncomplicated, mild to moderate, essential hypertension (sitting diastolic blood pressure [SiDBP] 90-<110 mm Hg) and receiving no antihypertensives in the 2 weeks before randomization were eligible. Patients were randomly assigned to receive oral treatment with amlodipine camsylate or amlodipine besylate. For the first 4 weeks, patients received amlodipine 5 mg QD (morning). After 4 weeks, if either blood pressure was > or =140/ > or =90 mm Hg or SiDBP had not decreased by > or =10 mm Hg from baseline, the dose of amlodipine was increased to 10 mg QD for 4 weeks. Trough blood pressure and heart rate were measured in duplicate with the patient in the sitting position at each clinic visit (baseline [week 0] and weeks 4 and 8 of treatment); mean values were calculated and recorded. At weeks 4 and 8, tolerability was assessed using history taking and laboratory analysis, and compliance was assessed using pill counts. The primary end point was change from baseline in SiDBP at week 8. Secondary end points were change from baseline in sitting systolic blood pressure (SiSBP) at week 8 in the total population and in the subgroup of patients who had previously received antihypertensive treatment versus those who had not.
RESULTS A total of 189 patients were enrolled (mean age, 53 years; 105 women, 84 men; mean body weight, 65.8 kg). One patient in the amlodipine camsylate group dropped out of the study at week 0 of treatment (this patient did not use any study medication) and was excluded from the modified intent-to-treat (ITT) analysis. Thus, 188 patients were treated and included in the ITT analysis (94 patients per treatment group; ITT analysis); 161 patients were included in the perprotocol (PP) analysis (n = 80 for amlodipine camsylate, n = 81 for amlodipine besylate) (14 patients in the amlodipine camsylate group and 13 patients in the amlodipine besylate group were excluded from the PP analysis due to consistent withdrawal or protocol violation). Mean (SD) SiSBP and SiDBP were significantly decreased from baseline in both groups (amlodipine camsylate, from 146.7 [12.3]/96.6 [5.4] to 127.9 [14.8]/83.4 [7.7] mm Hg [both, P < 0.001]; amlodipine besylate, from 146.8 [12.8]/96.7 [5.1] to 128.0 [10.1]/83.8 [7.5] mm Hg [both, P < 0.001]). The differences in SiSBP/SiDBP between the 2 groups at week 8 were not significant. The SiDBP response rates in the subgroups that had and had not been previously treated with antihypertensives were statistically similar (56/69 [81.2%] and 83/92 [90.2%], respectively). The prevalences of clinical adverse events (AEs) were not significantly different between the 2 treatment groups (amlodipine camsylate, 27.3 %; amlodipine besylate, 28.7%). The most common AEs were dizziness and dyspnea (both in 3/94 [3.2%] and 1/94 [1.1%] patients who received amlodipine camsylate and amlodipine besylate, respectively).
CONCLUSION The effectiveness and tolerability of amlodipine camsylate were not significantly different from those of amlodipine besylate in these Korean adults with mild to moderate hypertension.
PubMed IF 3.7
842007

제1저자 유지연 · 교신저자 김나영

, , , , , , , , , ,
Detection rate of Helicobacter pylori against a background of atrophic gastritis and/or intestinal metaplasia.
J Clin Gastroenterol. 2007;41(8):751-5.

Abstract
BACKGROUND To evaluate the detection rate of the CLOtest, Giemsa stain, and culture for the diagnosis of Helicobacter pylori organisms in patients with or without atrophic gastritis (AG) and/or intestinal metaplasia (IM).
METHODS We used either the CLOtest, Giemsa staining, or culture to determine the presence of H. pylori in 430 participants who were documented to be infected with H. pylori from September 2003 to June 2006. The detection rates of the methods were evaluated according to the presence of AG and IM in antrum and body, which were classified using the updated Sydney system classification.
RESULTS Positivity by the CLOtest markedly reduced depending on the degree of AG and IM in both antrum and body (P<0.05), and the positivity of Giemsa staining was markedly reduced as the degree of IM increased (P<0.01), but was not affected by the degree of AG (P=0.08) in antrum or body. When the results of these tests were evaluated in terms of combinations of AG and IM, the positivity of CLOtest was found to be lower in AG with IM than in AG without IM, (50.0% vs. 80.0% in antrum, 47.5% vs. 78.0% in body, respectively, P<0.01). In addition, the positivity of Giemsa stain was less frequent in AG with IM than in AG without IM in antrum (65.1% vs. 100%, respectively, P<0.01). However, the positivity of Giemsa stain in the body showed no statistical difference between AG without IM and AG with IM (97.6% vs. 91.7%, respectively).
CONCLUSIONS Invasive H. pylori tests, especially the CLOtest, had a lower detection rate for H. pylori in the presence of mucosal atrophy and IM, and this became more prominent in the presence of higher levels of IM and AG.
PubMed IF 2.7 소화기내과
832007

제1저자 김 원 · 교신저자 윤정환

, , , , , , ,
Apoptosis-inducing antitumor efficacy of hexokinase II inhibitor in hepatocellular carcinoma.
Mol Cancer Ther. 2007;6(9):2554-62.

Abstract
Hypoxia stimulates hepatocellular carcinoma (HCC) cell growth via hexokinase (HK) II induction, and alternatively, HK II inhibition induces apoptosis by activating mitochondrial signaling. This study was to investigate whether the induction of HK II by hypoxia is associated with enhanced mitochondrial stability and to confirm the apoptosis-inducing efficacy of HK II inhibitor in an in vivo model of HCC. Mitochondrial stability was examined by treating isolated mitochondria with deoxycholate, a permeability-enhancing agent. Alteration of permeability transition pore complex composition was analyzed by immunoprecipitation and immunoblotting. An in vivo model of HCC was established in C3H mice i.d. implanted with MH134 cells. The antitumor efficacy of i.p. given 3-bromopyruvate (3-BrPA), a HK II inhibitor, was evaluated by measuring tumor volumes and quantifying apoptosis using terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling staining and (99m)Tc-hydrazinonicotinamide-Annexin V scans. Hypoxia enhanced mitochondrial stability, and this was inhibited by 3-BrPA treatment. In particular, HK II levels in permeability transition pore complex immunoprecipitates were reduced after 3-BrPA treatment. In mice treated with 3-BrPA, mean tumor volumes and tumor volume growth were found to be significantly reduced. Moreover, percentages of terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling-positive cells were significantly increased in 3-BrPA-treated mice, and this apoptosis-inducing efficacy was reflected in vivo by (99m)Tc-hydrazinonicotinamide-Annexin V imaging. Our results show that hypoxia enhances mitochondrial stability via HK II induction and that HK II inhibitor treatment exhibits an in vivo antitumor effect by inducing apoptosis. Therefore, HK II inhibitors may be therapeutically useful for the treatment of advanced infiltrative hypovascular HCCs, which are growing in a hypoxic environment.
PubMed IF 6.9 소화기내과
822007

제1저자 이윤종 · 교신저자 송영욱

, , , , , , , , ,
Associations between interferon regulatory factor-1 polymorphisms and Behçet's disease.
Hum Immunol. 2007;68(9):770-8.

Abstract
Interferon regulatory factor-1 (IRF-1) is a transcription factor that regulates the functions of type I and II interferons and plays a role in host protection. Behçet's disease (BD) is an idiopathic systemic vasculitis that is often complicated with thrombotic features, and infectious agents have long been postulated to be a disease-triggering factor in its pathogenesis. The authors investigated the distributions of IRF-1 promoter -415 C/A, -410 A/G, and -300 A/G, and 3'-untranslated region (UTR) A/G polymorphisms in 105 BD patients (mean age 41.7 +/- SEM 1.1 years, 44 male and 61 female) and in 105 gender- and age-matched healthy controls. The frequencies of individual alleles and genotypes were not different between the control and BD groups. However, the frequency of AGGG haplotype was significantly higher (73.5% vs 60.2%, odds ratio [OR] = 1.842, 95% confidence interval [95% CI] = 1.219-2.783, p(c) = 0.036) and that of the CAAG haplotype was significantly lower (2.2% vs 9.5%, OR = 0.195, 95% CI = 0.068-0.559, p(c) = 0.02) in BD patients than in healthy controls. In addition, the frequency of the AGGG haplotype was significantly higher (80.3% vs 57.4%, OR = 3.033, 95% CI = 1.716-5.360, p(c) = 0.001) and that of the CAAG haplotype was significantly lower (0.8% vs 12.3%; OR = 0.059, 95% CI = 0.010-0.357, p(c) = 0.005) in female BD patients than female controls. By subgroup analyses, the CAAA haplotype tended to be more common in BD patients with moderate or severe disease than in those with mild disease (25.4% vs 13.6%, OR = 2.158, 95% CI = 1.046-4.440, p = 0.037 before Bonferroni correction). When BD patients were subclassified by a history of deep vein thrombosis (DVT), the CAAA haplotype was found to be significantly increased the risk of DVT (42.1% vs 15.7%, OR = 3.906, 95% CI = 1.836-8.324, p(c) = 0.0015) and the AGGG haplotype tended to reduce this risk (57.9% vs 77.3%, OR = 0.403, 95% CI = 0.195-0.834, p(c) = 0.0685). Furthermore, the frequency of the CAAA haplotype was significantly higher in BD patients that had experienced a thrombotic event than in those that had not (40.5% vs 15.5%, OR = 3.7147, 95% CI = 1.778-7.770, p(c) = 0.0015). These results suggest that IRF-1 is a novel susceptibility gene in BD, especially in women, and furthermore, that IRF-1 polymorphisms may be related to thrombosis in BD patients.
PubMed IF 2.1 류마티스내과
812007

제1저자 구본권 · 교신저자 김효수

, , , , , , , , , , , , , , , , ,
Effect of celecoxib on restenosis after coronary angioplasty with a Taxus stent (COREA-TAXUS trial): an open-label randomised controlled study.
Lancet. 2007;370(9587):567-74.

Abstract
BACKGROUND In-vitro and animal experiments have shown that the cyclo-oxygenase 2 inhibitor celecoxib can reduce formation of neointima within stents. We aimed to test whether celecoxib has similar effects in a clinical setting.
METHODS In a randomised two-centre trial, we enrolled 274 patients who had angina pectoris or a positive stress test and who had native coronary artery lesions for which implantation of paclitaxel-eluting stents was feasible. All patients were given aspirin (100 mg daily) and clopidogrel (75 mg daily). 136 patients were randomly assigned to receive celecoxib (400 mg before the intervention, and 200 mg twice daily for 6 months after the procedure). The primary endpoint was late luminal loss on quantitative coronary angiography at 6 months after the intervention. Secondary endpoints were cardiac death, non-fatal myocardial infarction, and revascularisation of the target lesion. Analysis was done on a modified intention-to-treat basis. This study is registered with ClinicalTrials.gov, number NCT00292721.
FINDINGS At 6 months, mean in-stent late luminal loss was lower in the celecoxib group (0.49 mm, SD 0.47) than in the control group (0.75 mm, 0.60) (absolute difference 0.26 mm; 95% CI 0.12-0.40). Frequency of secondary outcomes at 6 months was also lower in the celecoxib group, mainly because of a reduced need for revascularisation of the target lesion.
INTERPRETATION These data suggest that the adjunctive use of celecoxib for 6 months after stent implantation in patients with coronary artery disease is safe and can reduce the need for revascularisation of the target lesion.
PubMed IF 109 순환기내과
802007

제1저자 김성한 · 교신저자 오명돈

, , , , , ,
Detailed kinetics of immune responses to a new cell culture-derived smallpox vaccine in vaccinia-naïve adults.
Vaccine. 2007;25(33):6287-91.

Abstract
The aim of the present study was to investigate the kinetics of humoral and cell-mediated immune responses to a new cell culture-derived smallpox vaccine (CJ-50300, CJ Corporation, South Korea) in 18 vaccinia-naïve volunteers. All subjects achieved positive humoral immune responses (plaque reduction neutralizing antibody assay) 28 days after vaccination, and cell-mediated immune responses (ELISPOT assay) 14 days after vaccination. Humoral immune responses increased up to 28 days after vaccination and were maintained up to 56 days after vaccination. In contrast, cell-mediated immune responses increased up to 14 days after vaccination and steadily decreased to 56 days after vaccination [Clinical Trial No. NCT 00336635].
PubMed IF 3.4 감염내과
792007

제1저자 임정윤 · 교신저자 김나영

, , , , , , , , , , ,
Seroprevalence of Helicobacter pylori in South Korea.
Helicobacter. 2007;12(4):333-40.

Abstract
BACKGROUND Helicobacter pylori-associated gastrointestinal diseases have been widely recognized. The aims of this study were to investigate the interval change of seropositivity of H. pylori between 1998 and 2005 in Korean adult population and to find the factors related to H. pylori infection.
METHODS Between January and December of 2005, a total of 15,916 health check-up subjects (aged > or = 16 years) from all parts of South Korea responded to the questionnaire, and the prevalence of H. pylori was investigated by measuring anti-H pylori IgG antibodies. The seropositivity in asymptomatic subjects (aged > or = 16 years) was compared with that of 1998, which was surveyed by the Korean H. pylori Study Group.
RESULTS The overall seropositivity rate (aged > or = 16 years) was 56.0%, and 13.9% of seropositive subjects were found to have a history of H. pylori eradication therapy. With the exclusion of subjects who had a history of H. pylori eradication and current gastrointestinal symptoms, the seropositivity rate of H. pylori became 59.6% in 8020 subjects. Seroprevalence of H. pylori was significantly higher in subjects aged 50-59 years, males, low income group, and subjects from provinces. The seroprevalence in 2005 (59.6%) significantly decreased compared with that of 1998 (66.9%), and the decrease was significant in subjects aged < 70 years, Seoul and Gyeonggi province (which is close to Seoul).
CONCLUSIONS The seroprevalence of H. pylori in asymptomatic health check-up adult subjects in 2005 decreased to 59.6% from 66.9% in 1998, probably as a result of the improvement of socioeconomic status and hygiene.
PubMed IF 4.6 소화기내과
782007

제1저자 이지원 · 교신저자 임재준

, , , , , , ,
Lack of association between matrix metalloproteinase 8 promoter polymorphism and bronchiectasis in Koreans.
J Korean Med Sci. 2007;22(4):667-71.

Abstract
The observation that human matrix metalloproteinase (MMP)-8 is over-expressed in ectatic bronchi in patients with bronchiectasis suggests that polymorphisms altering the expression of MMP-8 may contribute to the susceptibility to development of bronchiectasis. We evaluated the association between the presence of bronchiectasis in a Korean population and two single nucleotide polymorphisms (SNPs) (-799C/ T and -381A/G) on the promoter region of the MMP-8 gene that are reported to alter the promoter activity and thereby the gene expression. Genotyping through polymerase chain reaction (PCR) and subsequent automatic sequencing was done in 167 patients with bronchiectasis and their age-, sex-matched healthy controls to reveal that only -799C/T is polymorphic among Koreans. In the patient group with bronchiectasis, the frequency of -799C/C, C/T, and T/T genotypes were 41.9%, 49.7%, and 8.4%, respectively. A similar distribution was observed in the control group: C/C (49.7%), C/T (43.1%), and T/T (7.2%) (p=0.36). In subgroup analysis, no significant difference was observed among the patients according to; the extent of disease (p=0.76), colonization of microorganisms (p=0.56), or association of mycobacteria (p=0.17). From these results, we conclude that -799C/T on the promoter region of MMP-8 lacks association with development of bronchiectasis in Koreans.
PubMed IF 3.2 호흡기내과
772007

제1저자 박영주 · 교신저자 박소연

, , , , , , , , ,
Diagnostic value of galectin-3, HBME-1, cytokeratin 19, high molecular weight cytokeratin, cyclin D1 and p27(kip1) in the differential diagnosis of thyroid nodules.
J Korean Med Sci. 2007;22(4):621-8.

Abstract
The distinction between benign and malignant thyroid tumors is critical for the management of patients with thyroid nodules. We applied immunohistochemical staining for galectin-3, HBME-1, cytokeratin 19 (CK19), high molecular weight cytokeratin (HMWCK), cyclin D1 and p27(kip1) in 295 thyroid lesions to determine their diagnostic accuracy. The expression of all markers was significantly associated with differentiated thyroid carcinoma (DTC). The sensitivity for the diagnosis of DTC was 94.7% with galectin-3, 91.3% with HBME-1, and 90.3% with CK19. The specificities of these markers were 95.5%, 69.7%, and 83.1%, respectively. Combining these markers, co-expression of galectin-3 and CK19 or galectin-3 and HBME-1 was seen in 93.2% of carcinomas but in none of the benign nodules. Comparing follicular variant of papillary carcinoma (FVPC) with follicular carcinoma (FC), the expression of galectin-3, CK19, and HMWCK was significantly higher in FVPC. When comparing FC with FA, the expression of galectin-3 and HBME-1 was significantly higher in FC. These results suggest that 1) galectin-3 is a useful marker in the distinction between benign and malignant thyroid tumors, 2) the combined use of HBME-1 and CK19 can increase the diagnostic accuracy, and 3) the use of CK19 and HMWCK can aid in the differential diagnosis between PC and FC.
PubMed IF 3.2 내분비대사내과
762007

제1저자 조수정 · 교신저자 이효석

, , ,
Do young hepatocellular carcinoma patients with relatively good liver function have poorer outcomes than elderly patients?
J Gastroenterol Hepatol. 2007;22(8):1226-31.

Abstract
BACKGROUND AND AIM The risk of hepatocellular carcinoma (HCC) is known to be age dependent; the influence of age on prognosis is, however, controversial. The aim of this study was to compare the tumor characteristics and survival rates of young and old HCC patients, with respect to tumor stage.
METHODS We reviewed the clinical data and survival times of 71 young HCC patients from 1987 to 2003 and compared these with those of their older counterparts (n = 239). Patients were categorized into three age groups: group A, age <30 years (n = 71); group B, age >/=30 to <61 years (n = 168); and group C, age >/=61 years (n = 81). Kaplan-Meier methods and Cox proportional hazards regression were used to analyze survival.
RESULTS The overall survival time of group A was shorter than groups B or C (P = 0.0071). Survival was not different in the three groups in subgroup analysis according to several tumor staging systems (e.g. Japan Integrated Staging score, Cancer of the Liver Italian Program scoring system and Barcelona Clinic Liver Cancer staging classification). The multivariate hazard ratio of group B was 0.840 (95% confidence interval [CI] 0.490-1.440) and that of group C was 0.770 (95% CI 0.410-1.446) in reference to group A.
CONCLUSIONS Young HCC patients showed a poorer prognosis than older HCC patients because they have a more advanced tumor stage at diagnosis. However, age was not an independent prognostic factor when stages were matched. Therefore, we suggest that periodic surveillance in young chronic hepatitis B virus carriers would improve outcomes.
PubMed IF 3.5 소화기내과
752007

제1저자 주권욱 · 교신저자 안규리

, , , , , , , , ,
MCP-1 and RANTES polymorphisms in Korean diabetic end-stage renal disease.
J Korean Med Sci. 2007;22(4):611-5.

Abstract
Macrophage infiltration has been observed in the renal biopsy specimens of diabetic nephropathy (DN), and hyperglycemic state stimulates the renal expression of RANTES (regulated upon activation, normal T-cell expressed and secreted) and MCP- 1 (monocyte chemoattractant protein-1). Upregulation of RANTES and MCP-1 with infiltrating macrophages may play a crucial role in the development and progression of DN. Genetic polymorphisms of RANTES and its receptors were reported to be independent risk factors for DN. We genotyped single nucleotide polymorphism (SNPs) in the MCP-1 G-2518A, CCR2 G46295A, RANTES C-28G and G-403A in 177 diabetic end-stage renal disease (ESRD) patients and 184 patients without renal involvement (controls) in order to investigate the effects of these SNPs on DN in Korean patients with type 2 DM. There were no differences in the frequencies of SNPs and the distribution of haplotypes of RANTES promoter SNPs between two groups. In conclusion, there were no associations of MCP-1, CCR2 and RANTES promoter SNPs with diabetic ESRD in Korean population. Prospective studies with clearly-defined, homogenous cohorts are needed to confirm the effect of these genetic polymorphisms on DN.
PubMed IF 3.2 신장내과
742007

제1저자 이상협 · 교신저자 류지곤

, , , , , ,
How to predict the outcome of endoscopic mechanical lithotripsy in patients with difficult bile duct stones?
Scand J Gastroenterol. 2007;42(8):1006-10.

Abstract
OBJECTIVE Endoscopic mechanical lithotripsy is frequently used to overcome the difficulties of removing large bile duct stones endoscopically. The aim of this study was to identify predictors of endoscopic mechanical lithotripsy failure.
MATERIAL AND METHODS One hundred and thirty-four patients who underwent mechanical lithotripsy for difficult choledocholithiasis were evaluated retrospectively. Predictive factors of outcome and procedure-related complications were analyzed. The clinical outcomes of subsequent management were also evaluated in cases of unsuccessful endoscopic mechanical lithotripsy.
RESULTS Endoscopic mechanical lithotripsy was successful in 102 patients (76.1%). Stone impaction, size (>or=30 mm), and the stone size to bile duct diameter ratio (>1.0) were significant predictors of endoscopic mechanical lithotripsy failure, with estimated odds ratios of 17.83, 4.32 and 5.47, respectively. There was no difference in complication rates between the successful and failed mechanical lithotripsy groups. When mechanical lithotripsy failed, all patients were successfully treated using various modalities, including surgery, without mortality.
CONCLUSIONS An impacted stone, stone size (>or=30 mm) and stone size to bile duct diameter ratio (>1.0) were predictors of failure of endoscopic mechanical lithotripsy for a difficult bile duct stone. Alternative approaches should be considered in patients with predictors of unsuccessful endoscopic mechanical lithotripsy in order to avoid wasting time and resources.
PubMed IF 1.8 소화기내과
732007

제1저자 최윤식 · 교신저자 오세일

, ,
Typical atrioventricular nodal reentrant tachycardia in a patient with fasciculoventricular pathway.
J Electrocardiol. 2007;40(6):535-8.

Abstract
We report a 34-year-old female patient with preexcitation electrocardiogram and recurrent paroxysmal palpitations. Standard 12-lead electrocardiogram showed minimal preexcitation with normal PR interval and normal frontal QRS axis. The electrophysiologic study showed normal AH intervals, short HV intervals, and no change in the degree of preexcitation by rapid atrial pacing. These findings were compatible with the fasciculoventricular pathway. Typical atrioventricular nodal reentrant tachycardia with narrow QRS complex and normal HV interval was induced reproducibly by programmed electrical stimulation. Slow pathway was ablated successfully with radiofrequency catheter ablation, and then the patient remained asymptomatic during a follow-up of 12 months. Although the fasciculoventricular pathway is rare and supraventricular tachycardia in a patient with fasciculoventricular pathway may mimic Wolff-Parkinson-White syndrome, possibility of typical atrioventricular nodal reentrant tachycardia with fasciculoventricular pathway should be considered as a mechanism of supraventricular tachycardia in a patient showing preexcitation electrocardiogram.
PubMed IF 1.5 순환기내과
722007

제1저자 김진욱 · 교신저자 Jian Wu

, , , ,
Short hairpin RNA causes the methylation of transforming growth factor-beta receptor II promoter and silencing of the target gene in rat hepatic stellate cells.
Biochem Biophys Res Commun. 2007;359(2):292-7.

Abstract
Small interfering RNA (siRNA) induces transcriptional gene silencing (TGS) in plant and animal cells. RNA dependent DNA methylation (RdDM) accounts for TGS in plants, but it is unclear whether siRNA induces RdDM in mammalian cells. To determine whether stable expression of short hairpin siRNA (shRNA) induces DNA methylation in mammalian cells, we transduced rat hepatic stellate SBC10 cells with lentiviral vectors which encode an U6 promoter-driven shRNA expression cassette homologous to the transforming growth factor-beta receptor (TGFbetaRII) promoter region. Sequencing analysis of bisulfite-modified genomic DNA showed the methylation of cytosine residues both in CpG dinucleotides and non-CpG sites around the target region of the TGFbetaRII promoter in SBC10 cells transduced with the promoter-targeting lentiviral vector. In these cells, real-time RT-PCR showed a decrease in TGFbetaRII mRNA levels which were reversed by treatment with 5-aza-2-deoxycytidine. Our results demonstrate that recombinant lentivirus-mediated shRNA delivery resulted in the methylation of the homologous promoter area in mammalian cells, and this approach may be used as a tool for transcriptional gene silencing by epigenetic modification of mammalian cell promoters.
PubMed IF 2.5 소화기내과
712007

제1저자 이관식 · 교신저자 이효석

, , , , , , , ,
Clevudine therapy for 24 weeks further reduced serum hepatitis B virus DNA levels and increased ALT normalization rates without emergence of viral breakthrough than 12 weeks of clevudine therapy.
Intervirology. 2007;50(4):296-302.

Abstract
OBJECTIVES The objectives of the study were to evaluate the safety and antiviral activity of 24-week treatment with clevudine 30 mg in HBeAg(+) chronic hepatitis B patients. Biochemical and serological responses were also assessed.
METHOD Twenty-one patients received clevudine 30 mg for 24 weeks and were followed up for another 24 weeks off therapy.
RESULTS Median decreases from baseline in HBV DNA were 4.65 and 1.96 log(10) copies/ml at week 24 (end of treatment) and week 48 (24 weeks off therapy), respectively. Analysis of individual data showed that HBV DNA levels were below the lower limit of detection (300 copies/ml) by Amplicor PCR assay in 19, 57, 19 and 0% at week 12, 24, 34 and 48, respectively. The proportion of patients with normal ALT were 67, 81 and 75% at week 24 (end of treatment), 34 and 48 (24 weeks off therapy), respectively. The rates of HBeAg loss were 24 and 20% at week 24 and 48, respectively. No viral breakthrough during treatment was observed.
CONCLUSION Clevudine 30 mg treatment for 24 weeks was well tolerated and exhibited more potent antiviral activity and a higher ALT normalization rate than 12-week treatment with durable efficacy at week 24 off therapy.
PubMed IF 1.8 소화기내과
702007

제1저자 이재호 · 교신저자 이춘택

, , , , , ,
Haemoptysis due to chronic tuberculosis vs. bronchiectasis: comparison of long-term outcome of arterial embolisation.
Int J Tuberc Lung Dis. 2007;11(7):781-7.

Abstract
OBJECTIVE To evaluate the factors that influence the outcome of bronchial arterial embolisation (BAE) in chronic tuberculosis (TB). In cases of chronic TB, non-bronchial systemic arteries (NBSA) provide a significant source of massive or recurrent haemoptysis.
DESIGN Medical records and radiological findings of 30 consecutive TB patients who underwent BAE were retrospectively analysed and compared with those of 19 bronchiectasis patients.
RESULTS Chronic TB patients had higher numbers of total feeding vessels (4.40 + or - 3.85 vs. 1.79 + or - 1.51, P = 0.007) and NBSA (1.57 + or - 1.63 vs. 0.42 + or - 0.61, P = 0.005) than the bronchiectasis patients. The number of embolisations required for obliterating feeding vessels (3.87 + or - 2.48 vs. 1.95 + or - 1.47, P = 0.004), and the incidence of incomplete embolisation (30% vs. 5.3%, P = 0.033) were also higher in the TB patients. Moreover, recurrence after BAE was more frequent in the TB patients (17/30, 56.7% vs. 5/19, 26.3%, P = 0.037). Male sex, past history of haemoptysis and incomplete embolisation during BAE were associated with higher recurrence of haemoptysis in chronic TB patients. The existence of a fungus ball or significant pleural thickening (> or =10 mm) was not found to influence the recurrence rate of haemoptysis.
CONCLUSION The haemoptysis recurrence rate was higher in chronic TB than in bronchiectasis; this was found to be related to incomplete feeding vessel embolisation.
PubMed IF 3.6 호흡기내과

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