SCI 발표논문

1. 952010

   제1저자 고성준 · 교신저자 임재준

   Koh SJ, Song T, Kang YA, Choi JW, Chang KJ, Chu CS, Jeong JG, Lee JY, Song MK, Sung HY, Kang YH, Yim JJ

   An outbreak of skin and soft tissue infection caused by Mycobacterium abscessus following acupuncture.

   Clin Microbiol Infect. 2010;16(7):895-901.

   Abstract

   Although outbreaks of Mycobacterium abscessus infection have been reported, none of these reports has identified the potential sources of infection and modes of transmission. In April 2008, we identified and investigated an outbreak of M. abscessus skin and soft tissue infections following acupuncture among the patients who visited an oriental medical clinic. Active surveillance of patients who had visited the clinic was conducted to define the extent of the outbreak. Environmental cultures and a case-control study were performed to elucidate the source of infection and mode of transmission. From 1002 patients interviewed, 109 patients were identified as having suffered M. abscessus skin and soft tissue infections at acupuncture sites. A single strain of M. abscessus was isolated from the wounds of 31 patients and nine environmental samples, including a diluted glutaraldehyde solution. The case-control study revealed that a higher numbers of visits to the clinic for acupuncture (adjusted OR (aOR) 20.12; 95% CI 4.34-93.35) and the use of interferential current therapy or low-frequency therapy (aOR 36.12; 95% CI 5.54-235.44) were associated with the development of M. abscessus infection. The contaminated diluted glutaraldehyde solution that was used to disinfect the physical therapy devices may have been the source of the outbreak of M. abscessus infection in the 109 patients who underwent acupuncture.

   PubMed IF 8.7 호흡기내과
2. 942010

   제1저자 김윤준 · 교신저자 이효석

   Kim YJ, Kim HY, Kim JS, Lee JH, Yoon JH, Kim CY, Park BL, Cheong HS, Bae JS, Kim S, Shin HD, Lee HS

   Putative association of transforming growth factor-alpha polymorphisms with clearance of hepatitis B virus and occurrence of hepatocellular carcinoma in patients with chronic hepatitis B virus infection.

   J Viral Hepat. 2010;17(7):518-26.

   Abstract

   Previous studies showed that several genetic polymorphisms might influence the clinical outcome of chronic hepatitis B virus (HBV) infection, including HBV clearance or development of hepatocellular carcinoma (HCC). The aim of this study was to determine whether polymorphisms of the transforming growth factor-alpha (TGF-alpha) gene are associated with clinical outcome of HBV infection. A total of 1096 Korean subjects having either present or past evidence of HBV infection were prospectively enrolled between January 2001 and August 2003. Among 16 genetic variants in TGFA gene, nine variants were genotyped using TaqMan assay and the genetic association with HBV clearance and HCC occurrence was analysed. Statistical analyses revealed that TGFA+103461T>C, TGFA+106151C>G and TGFA-ht2 were marginally associated with clearance of HBV infection. However, only TGFA-ht2 retained significance after multiple correction (OR = 0.39, P(corr) = 0.007 in recessive model). Although no variants were significant after multiple correction, TGFA+88344G>A and TGFA+103461T>C were weakly associated in recessive model in the analysis of HCC occurrence. In addition, Cox relative hazards model also revealed that TGFA+88344G>A was associated with onset age of HCC occurrence in subjects (RH = 1.46, P(corr) = 0.04). TGF-alpha polymorphisms might be an important factor in immunity, progression of inflammatory process and carcinogenesis, which explains the variable outcome of HBV infection at least in part. Further biological evidence is warranted in the future to support these suggestive associations.

   PubMed IF 2.3 소화기내과
3. 932010

   제1저자 이태우 · 교신저자 진호준

   Lee T, Oh KH, Joo KW, Kim YS, Ahn C, Han JS, Kim S, Chin HJ

   Tacrolimus is an alternative therapeutic option for the treatment of refractory lupus nephritis.

   Lupus. 2010;19(8):974-80.

   Abstract

   We conducted an open-labeled, prospective study to determine the efficacy and safety of tacrolimus as an alternative therapeutic option for those patients with refractory lupus nephritis. The study population comprised one male and eight female patients with diffuse proliferative lupus nephritis. All patients had failed to respond to sufficient intravenous cyclophosphamide therapy with proteinuria of >or=1 g/day and active urinary sediments. Tacrolimus (0.1 mg/kg/day) was administered for 1 year with adjusting drug level (4-10 microg/l). The mean serum creatinine level and spot urine protein creatinine ratio (UPCR) at baseline were 1.39 mg/dl and 2.27, respectively. After the treatment, proteinuria reduced significantly from median UPCR value of 2.19 (range, 1.19-3.34) to 0.44 (range, 0.12-2.13) (p < 0.05). Seven (78%) of the nine patients showed a complete clinical response, which was defined as stabilization in the disease-activity markers and serum creatinine level with reduction of >or=50% in UPCR; two patients showed complete remission with UPCR <0.2. One patient showed treatment failure because of the disease progression. No serious adverse effects were observed during the study. This study demonstrates that tacrolimus can show a significant therapeutic response in cases that are refractory to the standard regimen for diffuse proliferative lupus nephritis.

   PubMed IF 1.8 신장내과
4. 922010

   제1저자 최평균 · 교신저자 김남중

   Choe PG, Park WB, Song JS, Song KH, Jeon JH, Park SW, Kim HB, Chang KH, Oh MD, Choe KW, Kim NJ

   Spectrum of intracranial parenchymal lesions in patients with human immunodeficiency virus infection in the Republic of Korea.

   J Korean Med Sci. 2010;25(7):1005-10.

   Abstract

   The incidence of specific intracranial parenchymal lesions of HIV-infected patients varies considerably between countries. In the Republic of Korea, the number of HIV-infected patients is increasing, but little is known regarding the spectrum of intracranial parenchymal lesions in these patients. The aim of the present study was to obtain this information. To identify HIV patients with intracranial parenchymal lesions, the electronic database of radiological reports for 1,167 HIV-infected patients, seen from 1999 to 2008 at the Seoul National University Hospital, were reviewed. Neuroradiologic studies were performed on 165 of these patients, and intracranial parenchymal lesions were detected in 40 (3.4%) of them. Thirty-seven were male, and median age was 41 yr (range, 26-61). At the time of the diagnosis of intracranial parenchymal lesions, median CD4(+) lymphocyte count was 40 cells/microL (range 5-560) and in 33 (82.5%) patients, it was less than 200 cells/microL. Progressive multifocal leukoencephalopathy (12 patients) is the most frequent intracranial parenchymal lesions, followed by intracranial tuberculoma (7 patients), primary central nervous system lymphoma (7 patients), intracranial cryptococcoma (4 patients), Toxoplasma encephalitis (4 patients), and disseminated non-tuberculous mycobacterial infection (3 patients).

   PubMed IF 3.2 감염내과
5. 912010

   제1저자 임수 · 교신저자 장학철

   Lim S, Kim JH, Yoon JW, Kang SM, Choi SH, Park YJ, Kim KW, Lim JY, Park KS, Jang HC

   Sarcopenic obesity: prevalence and association with metabolic syndrome in the Korean Longitudinal Study on Health and Aging (KLoSHA).

   Diabetes Care. 2010;33(7):1652-4.

   Abstract

   OBJECTIVE We investigated the prevalence of sarcopenic obesity (SO) and its relationship with metabolic syndrome in a community-based elderly cohort in Korea.

   RESEARCH DESIGN AND METHODS In this study, 287 men and 278 women aged 65 or older were recruited. Sarcopenia was defined as the appendicular skeletal muscle mass (ASM) divided by height squared (Ht(2)) (kg/m(2)) or by weight (Wt) (%) of <1 SD below the sex-specific mean for young adults. Obesity was defined as a visceral fat area >or=100 cm(2).

   RESULTS The prevalence of SO was 16.7% in men and 5.7% in women with sarcopenia defined by ASM/Ht(2); however, it was 35.1% in men and 48.1% in women by ASM/Wt. Using ASM/Wt, the homeostasis model assessment of insulin resistance of subjects with SO was higher and they were at higher risk for metabolic syndrome (odds ratio [OR] 8.28 [95% CI 4.45-15.40]) than the obese (5.51 [2.81-10.80]) or sarcopenic group (2.64 [1.08-6.44]).

   CONCLUSIONS SO defined by ASM/Wt was more closely associated with metabolic syndrome than either sarcopenia or obesity alone.

   PubMed IF 22.6 내분비대사내과
6. 902010

   제1저자 이정훈 · 교신저자 김동희

   Lee JH, Kim D, Kim HJ, Lee CH, Yang JI, Kim W, Kim YJ, Yoon JH, Cho SH, Sung MW, Lee HS

   Hepatic steatosis index: a simple screening tool reflecting nonalcoholic fatty liver disease.

   Dig Liver Dis. 2010;42(7):503-8.

   Abstract

   BACKGROUND/AIMS To optimize management of nonalcoholic fatty liver disease (NAFLD), a simple screening tool is necessary. In this study, we aimed to devise a simple index of NAFLD.

   STUDY A cross-sectional study with 10,724 health check-up subjects (5362 cases with NAFLD versus age- and sex-matched controls) was conducted. Study subjects were randomly assigned to a derivation cohort or a validation cohort.

   RESULTS Multivariate analysis indicated that high serum alanine aminotransferase (ALT) to serum aspartate aminotransferase (AST) ratio, high body mass index (BMI), and diabetes mellitus were independent risk factors of NAFLD (all P<0.001). Using these variables, a formula was derived by a logistic regression model: hepatic steatosis index (HSI)= 8 x(ALT/AST ratio)+BMI (+2, if female; +2, if diabetes mellitus). HSI had an area under receiver-operating curve of 0.812 (95% confidence interval, 0.801-0.824). At values of <30.0 or >36.0, HSI ruled out NAFLD with a sensitivity of 93.1%, or detected NAFLD with a specificity of 92.4%, respectively. Of 2692 subjects with HSI <30.0 or >36.0 in the derivation cohort, 2305 (85.6%) were correctly classified. HSI was validated in the subsequent validation cohort.

   CONCLUSION HSI is a simple, efficient screening tool for NAFLD that may be utilized for selecting individuals for liver ultrasonography and for determining the need for lifestyle modifications.

   PubMed IF 4.9 소화기내과
7. 892010

   제1저자 박완범 · 교신저자 오명돈

   Park WB, Choe PG, Song KH, Jeon JH, Park SW, Kim HB, Kim NJ, Oh MD, Choe KW

   Genetic factors influencing severe atazanavir-associated hyperbilirubinemia in a population with low UDP-glucuronosyltransferase 1A1*28 allele frequency.

   Clin Infect Dis. 2010;51(1):101-6.

   Abstract

   BACKGROUND High prevalence of severe atazanavir-associated hyperbilirubinemia in Asians with low prevalence of the UDP-glucuronosyltransferase (UGT)1A1*28 polymorphism suggests the importance of genetic factors other than UGT1A1*28 for atazanavir-associated hyperbilirubinemia in these populations.

   METHODS Serum bilirubin levels were measured in 129 Korean human immunodeficiency virus-infected patients 3 months after initiation of atazanavir (400 mg per day) with good adherence to medication. The multidrug resistance gene 1 (MDR1) C3435T and G2677T/A variations and UGT1A1*6 and *28 were examined by direct sequencing of DNA from peripheral whole blood samples. The associations between genetic polymorphisms and severe (grade 3-4) hyperbilirubinemia were evaluated using multivariate logistic regression analysis including demographic and clinical variables.

   RESULTS The median patient age was 39 years (interquartile range, 34-51 years), and 91% were men. At baseline, the median CD4 cell count was 261 cells/microL (interquartile range, 181-405 cells/microL). Severe hyperbilirubinemia was detected in 27 patients (21%). The independent risk factors for severe hyperbilirubinemia were low baseline CD4 cell count (adjusted odds ratio per 10 cells/microL increase, 0.97; 95% confidence interval, 0.94-0.99), UGT1A1*28 (adjusted odds ratio, 4.15; 95% confidence interval, 1.46-11.84), and MDR1 G2677T/A (adjusted odds ratio, 9.65; 95% confidence interval, 1.09-85.61). Of 19 patients with wild-type alleles for both MDR1 2677 and UGT1A1*28, none developed severe hyperbilirubinemia.

   CONCLUSION The MDR1 G2677T/A variation and UGT1A1*28 are independent risk factors for severe atazanavir-associated hyperbilirubinemia in Korean human immunodeficiency virus-infected patients.

   PubMed IF 8.3 감염내과
8. 882010

   제1저자 박태준 · 교신저자 김윤준

   Park TJ, Chun JY, Bae JS, Park BL, Cheong HS, Lee HS, Kim YJ, Shin HD

   CCND2 polymorphisms associated with clearance of HBV infection.

   J Hum Genet. 2010;55(7):416-20.

   Abstract

   Cyclin D2s (CCND2s) are members of the D-type cyclin family. They interact and construct complexes with cyclin-dependent kinase (CDK)4 or 6. The cyclin D2/CDK4 or CDK6 complexes have key roles in controlling the progression of cell cycle from the Gap 1 (G1) phase to the synthesis (S) phase. Overexpression of cyclin D2 is associated with the development of tumors. In this study, we identified 16 sequence variants of CCND2 polymorphisms through direct DNA sequencing in 24 individuals, and 5 common variants were selected for genotyping in larger-scale subjects (n=1100). Genetic associations of those polymorphisms with hepatitis B virus (HBV) clearance and hepatocellular carcinoma (HCC) outcome among patients with HBV were analyzed. Although no significant association was observed between the polymorphisms and HCC outcome among HBV patients, one common polymorphism in the 5'-untranslated region (that is, rs1049606) and the most common haplotype (CCND-ht1 [T-C-T-A-T]), however, were significantly associated with HBV clearance (odds ratio=0.69, P=0.0002, Pcorr=0.001 and odds ratio=1.37, P=0.0009, Pcorr=0.004, respectively). The minor allele frequency of rs1049606 among the spontaneously recovered (SR) group was significantly higher than that of the chronic carrier (CC) group (frequency=0.403 vs 0.336, P=0.0002). In contrast, the frequency of CCND-ht1 was higher among the CC group than among the SR group (frequency=0.429 vs 0.374, P=0.0009). The information identified in this study might provide valuable insights into generating strategies for control of HBV.

   PubMed IF 2.3 소화기내과
9. 872010

   제1저자 한승석 · 교신저자 진호준

   Han SS, Na KY, Chae DW, Kim YS, Kim S, Chin HJ

   Survival benefit of high serum bilirubin and low alkaline phosphatase in older adults.

   J Am Geriatr Soc. 2010;58(7):1413-5.

   PubMed IF 4.6 신장내과
10. 862010

    제1저자 이윤종 · 교신저자 송영욱

    Lee YJ, Kang SW, Baek HJ, Choi HJ, Bae YD, Kang EH, Lee EY, Lee EB, Song YW

    Association between matrix metalloproteinase 9 promoter polymorphisms and Behçet's disease.

    Hum Immunol. 2010;71(7):717-22.

    Abstract

    Matrix metalloproteinase (MMP)-9 expression is reported to be upregulated in several primary vasculitides. The -1562C>T and -91 [CA](n) repeat polymorphisms can affect MMP-9 promoter activity. We investigated the distributions of these functional polymorphisms in 122 patients with Behçet's disease (BD) and in 122 gender- and age-matched healthy controls. Plasma levels of MMP-9 were analyzed. The frequency of "L" alleles with [CA](n) <21 was significantly lower in all BD patients (vs controls, odds ratio (OR) = 0.371 [95% confidence interval 0.152-0.905]) and male patients (vs male controls, OR = 0.117 [0.019-0.737]). Furthermore, the frequency of "H/H" homozygote with [CA](n) > or = 21 was significantly higher in BD patients than controls (OR = 2.677 [1.065-6.729]). Moreover, the frequency of CL haplotype with lower promoter activity was significantly lower in BD patients (vs controls, OR = 0.374 [0.149-0.939]) and in BD patients with visceral involvement (OR = 0.202 [0.044-0.916]). Although plasma MMP-9 levels were not different between controls and BD patients, concentrations of this substance were significantly higher in male patients (vs male controls, p = 0.044) or patients with visceral involvements (vs patients without visceral involvement, p = 0.027). These results suggest that MMP-9 is a novel susceptibility gene and its promoter polymorphisms can affect the development of visceral involvement in BD.

    PubMed IF 2.1 류마티스내과
11. 852010

    제1저자 정수진 · 교신저자 김동희

    Chung SJ, Kim D, Song JH, Park MJ, Kim YS, Kim JS, Jung HC, Song IS

    Efficacy of computed virtual chromoendoscopy on colorectal cancer screening: a prospective, randomized, back-to-back trial of Fuji Intelligent Color Enhancement versus conventional colonoscopy to compare adenoma miss rates.

    Gastrointest Endosc. 2010;72(1):136-42.

    Abstract

    BACKGROUND Colonoscopy is the criterion standard for screening of colorectal neoplasms. Nonetheless, a substantial miss rate with conventional, white-light colonoscopy (WL) remains a challenge.

    OBJECTIVE To assess whether Fuji Intelligent Color Enhancement (FICE) can detect more adenomas than WL in screening colonoscopy.

    DESIGN Prospective, randomized trial of tandem colonoscopy adjusted for withdrawal time and lavage effect.

    SETTING Seoul National University Hospital Healthcare System Gangnam Center, Korea.

    PATIENTS This study involved 359 average-risk adults undergoing screening colonoscopy.

    INTERVENTION Patients were randomized to the first withdrawal with either FICE (FICE-WL group) or WL (WL-FICE group).

    MAIN OUTCOME MEASUREMENTS The primary end point measure was the difference in adenoma miss rates, and the secondary outcome measure was the adenoma detection rate.

    RESULTS We enrolled 359 patients (mean age 50.6 years, male 66.9%) and randomly assigned 181 to the WL-FICE group and 178 to the FICE-WL group. The number of adenomas detected by FICE and WL was 123 and 107, respectively. The adenoma miss rate with FICE showed no significant difference compared with that of WL (6.6% vs 8.3%, P = .59). Characteristics of lesions missed by use of FICE were similar to those missed by use of WL; 93% of overall missed polyps were < or =5 mm, and none were > or =1 cm. All missed adenomas were low grade and nonpedunculated. There was no significant difference between FICE and WL in adenoma detection rate (mean 0.64 vs 0.55 per patient, P = .65) nor percentage of patients with > or =1 adenoma (33.7% vs 30.4%, P = .74).

    LIMITATIONS Single-center study.

    CONCLUSION FICE at screening colonoscopy did not improve the adenoma miss rate or detection rate compared with WL.

    PubMed IF 8 소화기내과
12. 842010

    제1저자 김정목 · 교신저자 김주성

    Kim JM, Kang HW, Cha MY, Yoo D, Kim N, Kim IK, Ku J, Kim S, Ma SH, Jung HC, Song IS, Kim JS

    Novel guggulsterone derivative GG-52 inhibits NF-kappaB signaling in intestinal epithelial cells and attenuates acute murine colitis.

    Lab Invest. 2010;90(7):1004-15.

    Abstract

    We already showed that the plant sterol guggulsterone has been reported to inhibit nuclear factor-kappaB (NF-kappaB) signaling in intestinal epithelial cells (IECs) and to attenuate dextran sulfate sodium (DSS)-induced colitis. This study investigates the anti-inflammatory effects of novel guggulsterone derivatives on IEC and preventive and therapeutic murine models of DSS-induced colitis. Novel guggulsterone derivates with high lipophilicity were designed and four derivates, including GG-46, GG-50B, GG-52, and GG-53, were synthesized. Two guggulsterone derivatives, GG-50B and GG-52, significantly inhibited the activated NF-kappaB signals and the upregulated expression of interleukin-8 (IL-8) in COLO 205 cells stimulated with tumor necrosis factor-alpha (TNF-alpha). Pretreatment with GG-50B and GG-52 attenuated the increased IkappaB kinase (IKK) and IkappaBalpha phsophorylation induced by TNF-alpha. In preventive and therapeutic models of murine colitis, administration of GG-52 significantly reduced the severity of DSS-induced colitis, as assessed by disease activity index, colon length, and histology. In contrast, GG-50B did not show a significant reduction in the colitis severity. Moreover, the efficacy on attenuating colitis by GG-52 was comparable to that by sulfasalazine or prednisolone. These results indicate that the novel guggulsterone derivative GG-52 blocks NF-kappaB activation in IEC and ameliorates DSS-induced acute murine colitis, which suggests that GG-52 is a potential therapeutic agent for the treatment of inflammatory bowel diseases.

    PubMed IF 4.1 소화기내과
13. 832010

    제1저자 조구영 · 교신저자 조구영

    Cho GY, Kim HK, Kim YJ, Choi DJ, Sohn DW, Oh BH, Park YB

    Electrical and mechanical dyssynchrony for prediction of cardiac events in patients with systolic heart failure.

    Heart. 2010;96(13):1029-32.

    Abstract

    BACKGROUND Recent clinical trials have challenged the clinical applicability of mechanical dyssynchrony in predicting cardiac resynchronisation therapy response.

    OBJECTIVE To evaluate whether mechanical dyssynchrony has an additional benefit over QRS duration in predicting cardiac events in patients with systolic heart failure.

    METHODS A total 167 patients admitted to hospital with heart failure (age 65+/-12, ejection fraction <35%) were followed up prospectively. Using tissue Doppler imaging (TDI), the time to peak systolic velocity during the ejection phase was measured in the basal septal and lateral segments. A temporal difference between the septal to lateral wall (Ts-l) of > or =65 ms was defined as a mechanical dyssynchrony.

    RESULTS After 33 months of follow-up, 70 patients (41.9%) had cardiac events, including 42 (25.1%) with cardiac death. The event-free survival time decreased as Ts-l or QRS duration increased. Patients with QRS > or =120 ms had increased risks of cardiac events by multivariate Cox proportional hazard analysis (HR=1.88, 95% CI 1.07 to 3.29, p = 0.028). The presence of mechanical dyssynchrony also predicted an increased risk of cardiac events (HR=2.37, 95% CI 1.39 to 4.04, p = 0.002). Those with both electrical and mechanical dyssynchrony had a HR of 3.98 (95% CI 2.02 to 7.86, p <0.001) when compared with those with normal QRS duration and absence of mechanical dyssynchrony. The addition of mechanical dyssynchrony significantly improved the prognostic power of a model containing echocardiographic parameters and QRS duration.

    CONCLUSIONS TDI-derived mechanical dyssynchrony is an important prognosticator and independently associated with QRS duration in predicting adverse events in patients with systolic heart failure.

    PubMed IF 4.4 순환기내과
14. 822010

    제1저자 김경희 · 교신저자 김용진

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

    Left atrial remodelling in patients with successful percutaneous mitral valvuloplasty: determinants and impact on long-term clinical outcome.

    Heart. 2010;96(13):1050-5.

    Abstract

    BACKGROUND Left atrial (LA) volume is an independent prognosticator in various cardiac diseases. The authors assessed the changes of LA volume after successful percutaneous mitral valvuloplasty (PMV) and the impact of LA enlargement on long-term clinical outcome after PMV.

    METHODS AND RESULTS From a prospective PMV registry started in 1988, 303 patients (242 women, age: 39.3+/-10.8 years) who had undergone successful PMV were followed for 4-20 years (median 11 years). Echocardiographic examination including LA volume measurement was performed before PMV and repeated after PMV. LA volume decreased from 92+/-50 to 69+/-42 ml (p < 0.001) immediately after PMV and remained stationary until 1 year after PMV. Since then, LA volume subsequently increased exceeding the pre-PMV level by 8 years after PMV. Multivariate analysis showed that LA volume increase at 10 years after PMV was independently related to the post-PMV mitral valve area, the echo score, the presence of atrial fibrillation and post-PMV LA volume. On multiple regression analysis, pre-PMV LA volume and percentage change of LA volume immediately after PMV emerged as independent predictors of event-free survival along with age, pre-PMV tricuspid regurgitation and post-PMV mitral valve area. Ten-year survival rate was 93% in patients with smaller LA before PMV (< or =72 ml/m(2)), whereas it was only 60% in those with larger LA (>72 ml/m(2)).

    CONCLUSIONS Progressive increase of LA volume was observed even after successful PMV. Larger pre-PMV LA volume was associated with poor prognosis.

    PubMed IF 4.4 순환기내과
15. 812010

    제1저자 최의근 · 교신저자 Chen P-S

    Choi EK, Shen MJ, Han S, Kim D, Hwang S, Sayfo S, Piccirillo G, Frick K, Fishbein MC, Hwang C, Lin SF, Chen PS

    Intrinsic cardiac nerve activity and paroxysmal atrial tachyarrhythmia in ambulatory dogs.

    Circulation. 2010;121(24):2615-23.

    Abstract

    BACKGROUND Little is known about the relationship between intrinsic cardiac nerve activity (ICNA) and spontaneous arrhythmias in ambulatory animals.

    METHODS AND RESULTS We implanted radiotransmitters to record extrinsic cardiac nerve activity (ECNA; including stellate ganglion nerve activity and vagal nerve activity) and ICNA (including superior left ganglionated plexi nerve activity and ligament of Marshall nerve activity) in 6 ambulatory dogs. Intermittent rapid left atrial pacing was performed to induce paroxysmal atrial fibrillation or atrial tachycardia. The vast majority (94%) of ligament of Marshall nerve activity were preceded by or coactivated with ECNA (stellate ganglion nerve activity or vagal nerve activity), whereas 6% of episodes were activated alone without concomitant stellate ganglion nerve activity or vagal nerve activity. Paroxysmal atrial fibrillation and atrial tachycardia were invariably (100%) preceded (<5 seconds) by ICNA. Most paroxysmal atrial tachycardia events (89%) were preceded by ICNA and sympathovagal coactivation, whereas 11% were preceded by ICNA and stellate ganglion nerve activity-only activation. Most paroxysmal atrial fibrillation events were preceded only by ICNA (72%); the remaining 28% were preceded by ECNA and ICNA together. Complex fractionated atrial electrograms were observed during ICNA discharges that preceded the onset of paroxysmal atrial tachycardia and atrial fibrillation. Immunostaining confirmed the presence of both adrenergic and cholinergic nerve at ICNA sites.

    CONCLUSIONS There is a significant temporal relationship between ECNA and ICNA. However, ICNA can also activate alone. All paroxysmal atrial tachycardia and atrial fibrillation episodes were invariably preceded by ICNA. These findings suggest that ICNA (either alone or in collaboration with ECNA) is an invariable trigger of paroxysmal atrial tachyarrhythmias. ICNA might contaminate local atrial electrograms, resulting in complex fractionated atrial electrogram-like activity.

    PubMed IF 41.3 순환기내과
16. 802010

    제1저자 임호영 · 교신저자 오도연

    Yhim HY, Han SW, Oh DY, Han W, Im SA, Kim TY, Kim YT, Noh DY, Chie EK, Ha SW, Park IA, Bang YJ

    Prognostic factors for recurrent breast cancer patients with an isolated, limited number of lung metastases and implications for pulmonary metastasectomy.

    Cancer. 2010;116(12):2890-901.

    Abstract

    BACKGROUND The aim of this study was to evaluate the clinical treatment outcomes of recurrent breast cancer with a limited number of isolated lung metastases, and to evaluate the role of pulmonary metastasectomy.

    METHODS The authors consecutively enrolled 140 recurrent breast cancer patients with isolated lung metastasis from 1997 to 2007 in Seoul National University Hospital and retrospectively analyzed 45 patients who had <4 metastatic lesions.

    RESULTS Fifteen patients had pulmonary metastasectomy followed by systemic treatment (pulmonary metastasectomy group), and 30 received systemic treatment alone (nonpulmonary metastasectomy group). The 3-year progression-free survival (PFS) and 4-year overall survival (OS) was significantly longer in the pulmonary metastasectomy group than in the nonpulmonary metastasectomy group (3-year PFS, 55.0% vs 4.5%, P < .001; 4-year OS, 82.1% vs 31.6%, P = .001). In multivariate analysis, a disease-free interval (DFI) of <24 months (hazard ratio [HR], 4.53; 95% CI, 1.72-11.90), no pulmonary metastasectomy (HR, 9.52; 95% CI, 3.34-27.18) and biologic subtypes such as human epithelial growth factor receptor-2 positive (HR, 3.00; 95% CI, 1.04-8.64) and triple negative (HR, 3.92; 95% CI, 1.32-11.59) were independent prognostic factors for shorter PFS.

    CONCLUSIONS The authors' results demonstrated that DFI and biologic subtypes of tumor are firm, independent, prognostic factors for survival, and pulmonary metastasectomy can be a reasonable treatment option in this population. Further prospective studies are warranted to evaluate the role of pulmonary metastasectomy.

    PubMed IF 5.6 혈액종양내과
17. 792010

    제1저자 권지현 · 교신저자 김인호

    Kwon JH, Kim I, Lee YG, Koh Y, Park HC, Song EY, Kim HK, Yoon SS, Lee DS, Park SS, Shin HY, Park S, Park MH, Ahn HS, Kim BK

    Clinical course of non-severe aplastic anemia in adults.

    Int J Hematol. 2010;91(5):770-5.

    Abstract

    The clinical course of non-severe aplastic anemia is variable, and risk factors related to disease progression are not well known. We reviewed clinical and laboratory data of the patients who were diagnosed with non-severe aplastic anemia from 1997 to 2007 at Seoul National University Hospital and analyzed the clinical course and outcomes in these patients. We defined non-severe aplastic anemia as hypocellular marrow with cytopenia in the peripheral blood, which does not meet the criteria for severe aplastic anemia (at least two of the following: ANC < 500/microl, platelet < 20,000/microl or reticulocyte < 20,000/microl). Among a total of 96 patients, 53 (55.2%) were male and the median age was 37.6 years old. As much as 41.7% (40) of the patients were initially asymptomatic. Sixty-two patients who were treated with oxymetholone, ATG/ALG, cyclosporin or other agents after initial diagnosis showed significantly lower levels of initial hemoglobin, red blood cell count and platelet count than those who did not receive any treatment. During the follow-up period, 18 patients progressed to severe aplastic anemia. Their median age was 29.9 years and the median progression time was 18 months. Initial white blood cell count and absolute neutrophil count in the evolution group tended to be lower than in the other group. The patients whose thrombocytopenia did not respond to treatment showed markedly higher frequency of progression to severe aplastic anemia. Treatment itself and responsiveness in reticulocyte and absolute neutrophil count were not correlated with their clinical courses. Sixteen patients showed overall improvement, whereas three patients developed secondary hematologic disease, acute myeloid leukemia, myelodysplastic syndrome and paroxysmal nocturnal hemoglobinuria. Non-severe aplastic anemia has a relatively indolent and mild clinical course. However, 18.8% of the study population progressed to severe disease. White blood cell and absolute neutrophil count at diagnosis and treatment responsiveness of thrombocytopenia were associated with disease progression. Careful monitoring and early management are needed for patients at risk.

    PubMed IF 1.9 혈액종양내과
18. 782010

    제1저자 신철민 · 교신저자 김나영

    Shin CM, Kim N, Jung Y, Park JH, Kang GH, Kim JS, Jung HC, Song IS

    Role of Helicobacter pylori infection in aberrant DNA methylation along multistep gastric carcinogenesis.

    Cancer Sci. 2010;101(6):1337-46.

    Abstract

    CpG island hypermethylation is frequently found during gastric carcinogenesis. We investigated methylation profiles of p16, LOX, HAND1, THBD, p41ARC, and APC along multistep gastric carcinogenesis and determined their association with Helicobacter pylori infection. Methylation levels in these six genes were evaluated in noncancerous gastric biopsy specimens using quantitative methylation-specific PCR in 459 patients with gastric cancer (GC), 137 with dysplasia, and 248 controls. Controls were divided into four subgroups sorted by current H. pylori infection status (active vs past or negative infection) and the presence of intestinal metaplasia (IM). In controls, active H. pylori infection significantly increased methylation levels in THBD, LOX, and HAND1 (all P < 0.001), and hypermethylation of THBD, HAND1, and APC was associated with IM. Aberrant DNA hypermethylation was correlated well with activity of H. pylori-associated gastritis. However, methylation levels in LOX, HAND1, THBD, and p41ARC remained increased in cases with past H. pylori infection compared to those that were H. pylori negative (all P < 0.05). Hypermethylation of THBD, and possibly p16, was significantly associated with GC, regardless of the status of current H. pylori infection (all P < 0.05). These results suggest that aberrant DNA hypermethylation caused by H. pylori-associated gastritis occurs in a gene-specific manner along gastric carcinogenesis, which can be persistent even after the disappearance of H. pylori. Aberrant methylation of THBD might provide a link between H. pylori infection and development of GC.

    PubMed IF 4.9 소화기내과
19. 772010

    제1저자 김세훈 · 교신저자 지영구

    Kim SH, Kim M, Lee KW, Kim SH, Kang HR, Park HW, Jee YK

    HLA-B*5901 is strongly associated with methazolamide-induced Stevens-Johnson syndrome/toxic epidermal necrolysis.

    Pharmacogenomics. 2010;11(6):879-84.

    Abstract

    AIMS The carbonic anhydrase inhibitor methazolamide infrequently causes Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). An association between these diseases and the HLA-B59 serotype has been suggested in case reports. This study examined the disease-associated B*59 allele and investigated the association of these diseases with other HLA class I alleles.

    METHODS We performed high-resolution HLA-A, -B and -C genotyping in five patients with methazolamide-induced SJS/TEN using a PCR-sequencing-based typing method and analyzed the association between HLA-class I alleles and occurrence of methazolamide-induced SJS/TEN.

    RESULTS B*5901 and Cw*0102 alleles were observed in all patients and A*2402 was observed in four patients. The B*5901 allele showed the strongest association with methazolamide-induced SJS/TEN (p < 0.001; odds ratio: 249.8; 95% CI: 13.4-4813.5), followed by Cw*0102 (p = 0.004; odds ratio: 22.1; 95% CI: 1.2-414.3), when compared with the general population as a control. The frequency of the patients carrying B*5901, Cw*0102 and A*2402 simultaneously was significantly higher than that in the general population (p < 0.001; odds ratio: 110.1; 95% CI: 11.7-1038.6).

    CONCLUSION A strong association was observed between HLA-B*5901 and methazolamide-induced SJS/TEN in Korean patients. HLA-B*5901 may be a useful screening marker for predicting methazolamide-induced SJS/TEN in patients of Korean and Japanese ancestry.

    PubMed IF 1.6 알레르기내과
20. 762010

    제1저자 한승석 · 교신저자 진호준

    Han SS, Na KY, Chae DW, Kim YS, Kim S, Chin HJ

    High serum bilirubin is associated with the reduced risk of diabetes mellitus and diabetic nephropathy.

    Tohoku J Exp Med. 2010;221(2):133-40.

    Abstract

    Several studies have suggested a potential effect of serum bilirubin as an antioxidant and cytoprotectant factor. For the results presented here, we evaluated the correlation between serum bilirubin and diabetes mellitus (DM) or chronic kidney disease originated from DM (DMCKD) in a Korean population. We used a cross-sectional, population-based design to examine 93,909 subjects (aged 18-96 years, 53.0% male). The trend of P values in the odds ratios for being DM and DMCKD was calculated using patients separated into five groups based on individual serum bilirubin concentrations. The prevalence of DM and DMCKD was 6.7% and 0.8%, respectively. Higher serum bilirubin levels were significantly associated with decreased prevalence of DM in both men (P trend < 0.001) and women (P trend = 0.014). The risk of DMCKD also decreased as bilirubin levels increased in women (P trend = 0.011), but not in men (P trend = 0.467). Serum bilirubin level was inversely related to insulin resistance using the homeostasis model assessment (HOMA-IR), serum insulin, and C-reactive protein (CRP) levels in multiple linear regression analyses. The regression coefficients (B) of log-HOMA-IR, log-insulin, and log-CRP were as follows: -0.09, -0.13, and -0.60 in men; -0.07, -0.09, and -0.50 in women, respectively. All the regressions were statistically significant (P < 0.001). These results indicate that serum bilirubin might have some protective function against DM and DMCKD, although the association between high serum bilirubin and decreased prevalence of DMCKD is observed only in women.

    PubMed IF 1.5 신장내과
21. 752010

    제1저자 최정민 · 교신저자 김상균

    Choi J, Kim SG, Kim JS, Jung HC, Song IS

    Comparison of endoscopic ultrasonography (EUS), positron emission tomography (PET), and computed tomography (CT) in the preoperative locoregional staging of resectable esophageal cancer.

    Surg Endosc. 2010;24(6):1380-6.

    Abstract

    BACKGROUND Endoscopic ultrasonography (EUS) has been a useful method for the accurate staging of esophageal cancer. This study aimed to compare the diagnostic performance of EUS, positron emission tomography (PET), and computed tomography (CT) in the locoregional staging of resectable esophageal cancer.

    METHODS A total of 109 patients with resectable esophageal cancer were prospectively enrolled and retrospectively reviewed for evaluation of preoperative EUS, PET, and CT. The sensitivity, specificity, and accuracy of tumor depth (T) staging and regional lymph nodal (N) staging for each test were compared with the postoperative histopathologic stage as the gold standard.

    RESULTS The overall accuracy of EUS for T staging was 72%, and it was the only method for delineating the layers of the esophageal wall. The sensitivities for N staging were 42% for EUS, 49% for PET, and 35% for CT, and their specificities were, respectively, 91, 87, and 93%. The accuracy for N staging was 66% for EUS, 68% for PET, and 63% for CT, and it did not differ significantly across the three tests.

    CONCLUSIONS Preoperative EUS for the locoregional staging of esophageal cancer provides excellent T staging accuracy and similar accuracy for N staging compared with PET and CT. Especially in T staging, EUS could play an important role in the choice of candidates for esophageal cancer surgery.

    PubMed IF 3.3 소화기내과
22. 742010

    제1저자 강정묵 · 교신저자 김나영

    Kang JM, Kim N, Kim B, Kim JH, Lee BY, Park JH, Lee MK, Lee HS, Kim JS, Jung HC, Song IS

    Enhancement of gastric ulcer healing and angiogenesis by cochinchina Momordica seed extract in rats.

    J Korean Med Sci. 2010;25(6):875-81.

    Abstract

    Cochinchina momordica seed is the dried ripe seed of Momordica cochinchinensis, a perennial vine. The antiulcer effect of an extract from cochinchina momordica seeds (SK-MS10) was evaluated in a rat model of acetic acid-induced gastric ulcers. Gastric ulcers were produced by subserosal injection of acetic acid. SK-MS10 (200 mg/kg) or vehicle was administered orally once per day for 14 days after the acetic acid injection. The stomach was removed and the ulcer size measured at day 7 and 14 of the treatment. Expression of vascular endothelial growth factor (VEGF) was assessed by real-time RT-PCR and Western blot analysis. In addition, the microvasculature density (MVD) adjacent to the ulcer margin was examined by immunohistochemistry. The treatment with SK-MS10 for 7 and 14 days significantly accelerated ulcer healing and increased the expression of mRNA (at day 7) as well as VEGF protein (at day 14) compared to the vehicle-treated rats. The MVD for factor VIII was also higher in the SK-MS10 treatment group compared to the vehicle-treated rats; however, these differences were not statistically significant. These results suggest that SK-MS10 treatment accelerates the healing of gastric ulcers via upregulation of VEGF and angiogenesis in an acetic acid rat model.

    PubMed IF 3.2 소화기내과
23. 732010

    제1저자 김형관 · 교신저자 김용진

    Kim HK, Kim YJ, Park EA, Bae JS, Lee W, Kim KH, Kim KB, Sohn DW, Ahn H, Park JH, Park YB

    Assessment of haemodynamic effects of surgical correction for severe functional tricuspid regurgitation: cardiac magnetic resonance imaging study.

    Eur Heart J. 2010;31(12):1520-8.

    Abstract

    AIMS There has been growing attention for the development of functional tricuspid regurgitation (TR) long after left-sided valve surgery. We attempted to determine the long-term haemodynamic effects of corrective surgery for severe functional TR in patients who had prior left-sided valve surgery using cardiac magnetic resonance imaging (CMR).

    METHODS AND RESULTS Thirty-one patients with severe functional TR (TR fraction of 46.0+/-16.2% by CMR) were analysed. CMR was performed within 1 month before and at a median 27.0 months after surgery. Long after TR surgery, 28 of the 31 patients had no or mild residual TR, two had mild-to-moderate TR, and one showed moderate TR. Remarkable reductions in the right ventricular (RV) end-diastolic volume index (RV-EDVI) (177.4+/-59.1 mL/m(2) vs. 118.2+/-31.2 mL/m(2), P<0.001) and end-systolic volume index (RV-ESVI) (88.5+/-30.1 mL/m(2) vs. 67.2+/-31.0 mL/m(2), P=0.002) were observed, whereas RV ejection fraction (RV-EF) showed no change (49.7+/-8.3% vs. 44.9+/-12.5%, P=0.09). Pre-operative RV-EDVI (R=-0.86, P<0.001) and RV-ESVI (R=-0.55, P=0.001) were significantly associated with their respective changes after corrective surgery. Post-surgery, a normal RV-EF was achieved in 14 patients (42.5%). Pre-operative RV-EDVI of 164 mL/m(2) effectively discriminated patients with normal RV-EF from those without post-surgery, with a sensitivity of 77% and a specificity of 72% (P=0.01). A significant rise in the left ventricular (LV) EDVI and cardiac index (CI) was found after surgery (from 92.9+/-24.4 to 123.2+/-31.6 mL/m(2) for LV-EDVI, P<0.001; from 3.8+/-1.3 to 4.2+/-0.8 L/min/m(2) for CI, P=0.03). Functional capacity as assessed by NYHA class showed a significant improvement from 2.7+/-0.6 before surgery to 2.0+/-0.6 long after surgery (P<0.001).

    CONCLUSION Successful TR surgery can remarkably reduce RV volumes and preserve RV systolic function. In addition, successful TR surgery led to a significant rise in LV preload and CI, which may significantly contribute to a significant amelioration in the functional capacity of the patients. It seems that RV volume measurement by CMR is helpful for determining optimal timing for TR surgery.

    PubMed IF 45.3 순환기내과
24. 722010

    제1저자 허남주 · 교신저자 진호준

    Heo NJ, Ahn JM, Lee TW, Chin HJ, Na KY, Chae DW, Kim S

    Very low-grade albuminuria reflects susceptibility to chronic kidney disease in combination with cardiovascular risk factors.

    Hypertens Res. 2010;33(6):573-8.

    Abstract

    Low-grade albuminuria has been proposed as a cardiovascular risk factor that is below the conventional cut-off point for microalbuminuria, which has been previously identified as a marker for cardiovascular disease and chronic kidney disease (CKD). Metabolic syndrome has also been shown to be related with microalbuminuria and CKD. We assessed the relationship among low-grade albuminuria, CKD and metabolic syndrome among 5998 non-diabetic subjects. The subjects were divided into six groups: subjects with urine albumin-to-creatinine ratio (UACR) <30 mg g(-1) were divided into five groups in accordance with their UACR values, and subjects with 30<or=UACR <300 mg g(-1) were allocated to the microalbuminuria group. The prevalence of CKD increased in parallel with increasing UACR values and greater numbers of metabolic syndrome characteristics, which were in turn associated with a reduced UACR cut-off point for an increased prevalence of CKD. Among the subjects with metabolic syndrome, UACR values above 10.2 mg g(-1) were related to increased CKD prevalence (odds ratio (OR): 2.63, 95% confidence interval (CI) 1.11-6.24), as were values of 30 mg g(-1) among those with 1 or 2 components of metabolic syndrome (OR: 2.98, 95% CI 1.83-4.83); elevated UACR was not observed to increase the risk of CKD in subjects who had no components of metabolic syndrome. The cut-off point varied in subjects with various cardiovascular risk profiles such as serum uric acid level, gender or hypertension. Very low levels of albuminuria were associated with increased CKD prevalence. The UACR cut-off point for increased CKD risk varied according to the risk profile, including the number of metabolic syndrome components.

    PubMed IF 5 신장내과
25. 712010

    제1저자 김희선 · 교신저자 김태유

    Kim H, Park J, Jung Y, Song SH, Han SW, Oh DY, Im SA, Bang YJ, Kim TY

    DNA methyltransferase 3-like affects promoter methylation of thymine DNA glycosylase independently of DNMT1 and DNMT3B in cancer cells.

    Int J Oncol. 2010;36(6):1563-72.

    Abstract

    DNA methyltransferase (DNMT) 1 and 3 are primarily responsible for abnormal methylation in cancer. Unlike these DNMTs, DNA methyltransferase 3-like (DNMT3L) harbors no conserved catalytic domain, and has been shown to function as a regulatory cofactor for DNA methylation. However, it is unclear whether DNMT3L directly regulates DNA methylation in cancer cells. To address this, we investigated the methylation targets of DNMT3L by conducting methylation microarray trials after the siRNA-induced knockdown. We determined that methylation of 242 out of 1,505 CpG sites was significantly altered by DNMT3L knockdown. Among these 242 CpG sites, 204, 12, and 11 CpG sites were identified as common targets of DNMT 1/3B/3L, 1/3L, and 3B/3L, respectively; this indicates that DNMT3L participates in DNA methylation via cooperation with other DNMTs. However, we also determined that the methylation of 15 CpG sites was significantly altered by DNMT3L knockdown only. As a validation, we confirmed that thymine DNA glycosylase (TDG), an enzyme involved in the base excision repair of mismatched-DNA, was up-regulated in DNMT3L knockdown cells, but neither in DNMT1 nor 3B knockdown cells. Methylation-specific PCR (MSP) also showed that promoter methylation of TDG was decreased in DNMT3L knockdown cells. Interestingly, 5-aza-2'-deoxycitidine (5-aza-dC) re-expressed DNMT3L, leading to down-regulation of TDG. This study is the first to show that DNMT3L exerts a major effect on the transcriptional regulation of a specific target gene, such as TDG, despite the absence of enzymatic activity.

    PubMed IF 7.3 혈액종양내과
26. 702010

    제1저자 김선문 · 교신저자 김연수

    Kim SM, Cha RH, Lee JP, Kim DK, Oh KH, Joo KW, Lim CS, Kim S, Kim YS

    Incidence and outcomes of contrast-induced nephropathy after computed tomography in patients with CKD: a quality improvement report.

    Am J Kidney Dis. 2010;55(6):1018-25.

    Abstract

    BACKGROUND Although there has been considerable investigation of the general characteristics of contrast-induced nephropathy (CIN), it has not been studied adequately in a computed tomography (CT) population. We assessed the incidence and outcomes of CIN after contrast-enhanced CT in patients with chronic kidney disease pretreated with saline and N-acetylcysteine (NAC).

    DESIGN Quality improvement report.

    SETTING & PARTICIPANTS 520 patients registered in a CIN prevention program.

    QUALITY IMPROVEMENT PLAN We initiated the CIN prevention program in January 2007. In this program, patients with chronic kidney disease undergoing contrast-enhanced CT in an outpatient setting were automatically referred to nephrologists, and patients received saline and NAC before and after CT. The development of CIN was assessed 48-96 hours after CT.

    OUTCOMES Incidence of CIN and time to renal replacement therapy.

    MEASUREMENTS Baseline serum creatinine, hemoglobin, and serum albumin levels; type and volume of contrast agents; and post-CT serum creatinine level.

    RESULTS Overall, CIN occurred in 13 (2.5%) patients. Incidences of CIN were 0.0%, 2.9%, and 12.1% in patients with an estimated glomerular filtration rate of 45-59, 30-44, and <30 mL/min/1.73 m(2), respectively. The risk of CIN was increased in patients with severely decreased kidney function and diabetes. The development of CIN consequently increased the risk of renal replacement therapy (P < 0.001 by log-rank), and the risk was significantly accentuated in patients with estimated glomerular filtration rate <30 mL/min/1.73 m(2).

    LIMITATIONS A single-center study and comparison with previous studies.

    CONCLUSIONS The incidence of CIN was relatively low in patients treated with saline and NAC. The development of CIN predisposed to poor kidney survival in the long term.

    PubMed IF 9.4 신장내과
27. 692010

    제1저자 선종무 · 교신저자 김동완

    Sun JM, Oh DY, Lee SH, Kim DW, Im SA, Kim TY, Lee JS, Kim YW, Heo DS, Bang YJ

    The relationship between response to previous systemic treatment and the efficacy of subsequent pemetrexed therapy in advanced non-small cell lung cancer.

    Lung Cancer. 2010;68(3):427-32.

    Abstract

    BACKGROUND We sought to identify the relationship between response to previous systemic treatment and the efficacy of subsequent pemetrexed therapy in advanced non-small cell lung cancer (NSCLC).

    PATIENTS AND METHODS Two hundred and fifty clinical stage IIIB or IV NSCLC patients treated with pemetrexed as a second-line or further-line treatment between April 2007 and June 2008 were analyzed retrospectively. Prior therapies were divided into four types (gemcitabine-based [G], paclitaxel-based [P], docetaxel-based [D], and EGFR tyrosine kinase inhibitor [I]). Objective response rates (ORR) and progression-free survivals (PFS) for pemetrexed therapy were analyzed according to the response outcome with each previous treatment.

    RESULTS The ORR of pemetrexed therapy was higher for patients who had achieved partial response with previous [G] therapy than others (15.0% vs. 4.3%, p=0.02). In addition, median PFS for pemetrexed therapy was greater for responders to [G] than for nonresponders (3.0 months vs. 1.7 months, p=0.004). The longer PFS for responders to [G] was also shown in the analysis among patients with squamous cell carcinoma (3.2 months vs. 1.7 months, p=0.056). By univariate analyses, the variables of the responder to [G] therapy, female, adenocarcinoma, never smoking status, and ECOG performance status of 0-1 were good predictive factors for pemetrexed therapy in terms of PFS. Multivariate analysis revealed that only response to [G] had statistical significance (hazard ratio=0.62, p=0.006).

    CONCLUSION Response outcome to prior [G] therapy might predict the efficacy of subsequent pemetrexed therapy in advanced NSCLC.

    PubMed IF 5.3 혈액종양내과
28. 682010

    제1저자 박경우 · 교신저자 김효수

    Park KW, Kang SH, Chung WY, Lee HY, Park JS, Kang HJ, Cho YS, Youn TJ, Koo BK, Chae IH, Choi DJ, Hahn S, Park BJ, Kim HS

    'Real world' comparison of drug-eluting stents vs bare metal stents in the treatment of unselected patients with acute ST-segment elevation myocardial infarction.

    Circ J. 2010;74(6):1111-20.

    Abstract

    BACKGROUND Concerns exist regarding the long-term efficacy and safety of drug-eluting stents (DES) in patients with ST-segment elevation myocardial infarction (STEMI). The study aimed to compare the mid- to long-term outcomes of DES vs bare metal stents (BMS) in patients with STEMI in a real-world setting.

    METHODS AND RESULTS Six hundred and eighty four consecutive patients with STEMI who underwent percutaneous coronary intervention from January 2003 to December 2006 were analyzed; 539 patients (78.8%) with DES and 145 (21.2%) with BMS. Patients were followed for the occurrence of target vessel failure (TVF); a composite of cardiac death, non-fatal myocardial infarction, or target vessel revascularization (TVR). After a follow-up duration of 36 months, the TVF rate was significant lower in the DES group compared with the BMS group (17.8% vs 34.5%, P<0.01), which was mainly driven by a decrease in TVR (9.1% vs 22.8%, P<0.01). Diabetic patients, those with multivessel disease and those treated with smaller or longer stents benefited more from DES implantation. Propensity score matching concordantly indicated a benefit of DES with regard to TVF (13.5% vs 34.2%; P<0.01). The overall incidence of stent thrombosis (ST) in each group was comparable (3.9% vs 4.1%, P=0.47).

    CONCLUSIONS Compared to BMS, the mid- to long-term outcome was better in patients receiving DES for acute STEMI. This was driven mainly by a reduction in repeat revascularization.

    PubMed IF 5.8 순환기내과
29. 672010

    제1저자 정지용,황영환 · 교신저자 오국환

    Jung JY, Hwang YH, Lee H, Ro H, Lee H, Chung W, Chae DW, Joo KW, Ahn C, Oh KH

    Association of AHSG gene polymorphisms and aortic stiffness in peritoneal dialysis patients.

    Am J Nephrol. 2010;31(6):510-7.

    Abstract

    BACKGROUND/AIMS Fetuin-A is a negative acute-phase reactant and extraosseous calcification inhibitor. Decreased serum concentration of fetuin-A is independently related to all-cause and cardiovascular mortality in dialysis patients. Our aim is to investigate the association between the genetic polymorphism of alpha(2)-Heremans-Schmid-glycoprotein (AHSG) encoding fetuin-A and its serum concentration, vascular calcification, and aortic stiffness in peritoneal dialysis (PD) patients.

    METHOD A total of six single nucleotide polymorphisms (SNPs) in the AHSG gene were genotyped and evaluated for association with serum fetuin-A level, quantitative measures of vascular calcification and aortic stiffness represented by heart-to-femoral pulse wave velocity (hfPWV).

    RESULTS Five SNPs in the AHSG gene were nominally associated with the serum fetuin-A level in our PD patients. In haplotype analyses, there were haplotypes positively (H1; AGCA, H2; CC) and inversely (H1; TTCG, H2; TT) related with the serum fetuin-A level. The serum fetuin-A level inversely and independently correlated with hfPWV. Moreover, the serum fetuin-A concentration was a determinant for the simple vascular calcification score (SVCS), which subsequently was associated with hfPWV.

    CONCLUSIONS Our study showed an association between AHSG polymorphism and its serum concentration, and also revealed an association of the serum fetuin-A level with SVCS and aortic stiffness in PD patients.

    PubMed IF 3.8 신장내과
30. 662010

    제1저자 김태민 · 교신저자 허대석

    Kim TM, Kim KH, Lee MJ, Jeon YK, Lee SH, Kim DW, Kim CW, Kim IH, Khwarg SI, Heo DS

    First-line therapy with doxycycline in ocular adnexal mucosa-associated lymphoid tissue lymphoma: a retrospective analysis of clinical predictors.

    Cancer Sci. 2010;101(5):1199-203.

    Abstract

    This retrospective study was launched to evaluate the efficacy of doxycycline and to find independent predictors of a clinical response in patients with ocular adnexal lymphoma of mucosa-associated lymphoid tissue (OAML). Thirty-eight patients with newly diagnosed, localized OAML received doxycycline for 3 weeks (12 patients) or 6 weeks (26 patients). Clinical factors including absolute lymphocyte count (ALC) and neutrophil count (ANC) were compared between responders and non-responders. After a median follow-up of 26.4 months, doxycycline resulted in an overall response rate of 47% and a 3-year time-to-treatment failure (TTF) rate of 84%. Patients treated with doxycycline for 6 weeks versus 3 weeks tended to have a higher response rate (54%vs 33%). Absolute lymphocytosis (ALC > 3.01 x 10(9)/L) and absolute neutrophilia (ANC > 1.92 x 10(9)/L) were defined based on the median value of each count. Patients with (19 patients) versus without absolute lymphocytosis had significantly shorter 2-year TTF (70%vs 100%, P = 0.021) and a lower response rate (32%vs 63%, P = 0.051). Absolute lymphocytosis (odds ratio [OR] = 4.7; 95% confidence interval [CI], 1.1-20.8; P = 0.043) and non-conjunctival tumor (OR = 11.8; 95% CI, 1.1-122.5; P = 0.038) were negative predictors for response by multivariate analysis. Front-line doxycycline is effective particularly in localized OAML patients without absolute lymphocytosis but with conjunctival involvement.

    PubMed IF 4.9 혈액종양내과

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