SCI 발표논문

1. 402008

   제1저자 김유정 · 교신저자 방영주

   Kim YJ, Kim MA, Im SA, Kim TM, Kim DW, Yang HK, Heo DS, Lee KU, Choe KJ, Kim NK, Kim TY, Kim WH, Bang YJ

   Metastasis-associated protein S100A4 and p53 predict relapse in curatively resected stage III and IV (M0) gastric cancer.

   Cancer Invest. 2008;26(2):152-8.

   Abstract

   PURPOSE Pathologic stage is the most important predictive factor of relapse in gastric cancer after curative resection. However, patients with the same stage often have different risks of relapse. Here, we investigated whether the expressions of molecular markers can supplement the current staging system in terms of relapse prediction.

   PATIENTS AND METHODS One hundred and nine stage III or IV (M0) patients who had received curative gastrectomy followed by adjuvant 5-fluorouracil and cisplatin chemotherapy were included in this study. The expressions of molecular markers including p53, p27, COX-2, HER-2, EGFR, maspin, S100A4, E-cadherin, Sp1, and p97 were analyzed by immunohistochemistry in cancer and paired normal tissues.

   RESULTS The overall relapse rate was 58.7%, and pathologic stage was a significant predictive factor of relapse (42% in stage IIIA, 48% in IIIB, 76% in IV, p = 0.005). Of the 10 markers examined, p53 and S100A4 were expressed only in tumor tissues, and S100A4 expression was significantly associated with a higher relapse rate (85% vs. 53%, p = 0.008). In multivariate analysis including tumor stage, S100A4 and p53 expression were independent predictive factors of relapse (relative risk, 6.98; 95% confidence interval [CI], 1.608-30.342, 3.49; 95% CI, 1.328-9.186, respectively). On comparing patients who expressed S100A4 or p53 with those who expressed neither, relapse rates were 58% vs. 25% in stage III (p = 0.011) and 95% vs. 59% in stage IV (M0) (p = 0.003).

   CONCLUSION In addition to staging system, the expressions of S100A4 and p53 were significant predictive factors of relapse in gastric cancer after curative resection and adjuvant chemotherapy.

   PubMed IF 2.2 혈액종양내과
2. 392008

   제1저자 구본권 · 교신저자 김효수

   Koo BK, Park KW, Kang HJ, Cho YS, Chung WY, Youn TJ, Chae IH, Choi DJ, Tahk SJ, Oh BH, Park YB, Kim HS

   Physiological evaluation of the provisional side-branch intervention strategy for bifurcation lesions using fractional flow reserve.

   Eur Heart J. 2008;29(6):726-32.

   Abstract

   AIMS This study was performed to evaluate the functional outcomes of fractional flow reserve (FFR)-guided jailed side-branch (SB) intervention strategy.

   METHODS AND RESULTS One hundred and ten patients treated by provisional strategy were consecutively enrolled and SB FFR was measured in 91 patients. SB intervention was allowed when FFR was <0.75. FFR measurement was repeated after SB intervention and at 6-month follow-up angiography. In 26 of 28 SB lesions with FFR <0.75, balloon angioplasty (SB balloon/artery ratio = 0.84 +/- 0.14) was performed and FFR >or=0.75 was achieved in 92% of the lesions although the mean residual stenosis was 69 +/- 10%. During follow-up, there were no changes in SB FFR in lesions with (0.86 +/- 0.05 to 0.84 +/- 0.01, P = 0.4) and without SB angioplasty (0.87 +/- 0.06 to 0.89 +/- 0.07, P = 0.1). Functional restenosis (FFR <0.75) rate was only 8% (5/65). When clinical outcomes of these patients were compared with 110 patients with similar bifurcation lesions treated without FFR-guidance, there was no difference in 9-month cardiac event rates (4.6 vs. 3.7%, P = 0.7) between the two groups.

   CONCLUSION In conclusion, FFR-guided SB intervention strategy resulted in good functional outcomes.

   PubMed IF 45.3 순환기내과
3. 382008

   제1저자 조요한 · 교신저자 허대석

   Cho YH, Lee SH, Kim DW, Wu HG, Hah JH, Rhee CS, Sung MW, Kim KH, Heo DS

   Long-term survival of resectable subset after induction chemotherapy in patients with locally advanced head and neck cancer.

   Head Neck. 2008;30(3):346-50.

   Abstract

   BACKGROUND Although meta-analysis showed that survival improved with concurrent chemoradiation in locally advanced head and neck cancer, neoadjuvant chemotherapy is still unique, because it renders curative surgery feasible for marginally resectable head and neck cancer patients.

   METHODS We reviewed patients with locally advanced head and neck cancer, who had been treated with neoadjuvant chemotherapy between June 1984 and February 2001 at the Seoul National University Hospital.

   RESULTS A total of 167 patients were included. After 2 to 3 chemotherapy cycles, either surgery (38 patients) or radiation (104 patients) was conducted. Those who received surgery exhibited better survival than those who received radiation [median survival: not reached vs 33.6 months (95% CI: 22.6-44.7), p = .006]. The 5-year and 10-year survival rates of surgery group were 63.2% and 59.8%.

   CONCLUSION The potential benefit of neoadjuvant chemotherapy with surgery in patients with locally advanced head and neck cancers merits further evaluation in future clinical trials.

   PubMed IF 2.2 혈액종양내과
4. 372008

   제1저자 박완범 · 교신저자 최강원

   Park WB, Jang HC, Kim SH, Kim HB, Kim NJ, Oh MD, Choe KW

   Effect of highly active antiretroviral therapy on incidence of early syphilis in HIV-infected patients.

   Sex Transm Dis. 2008;35(3):304-6.

   Abstract

   OBJECTIVES To evaluate the incidence of early syphilis based on time from initiation of highly active antiretroviral therapy (HAART) in human immunodeficiency virus (HIV)-infected patients.

   STUDY DESIGN Five hundred thirty-nine HIV-positive patients undergoing HAART were followed up to 4 years to identify early (primary or secondary) syphilis. Incidence rate trends according to time from HAART initiation were evaluated by Poisson regression after adjustment for calendar year.

   RESULTS With median follow-up of 2.9 years, 56 (10.4%) patients experienced early syphilis, 17 (3.2%) with primary syphilis, and 39 (7.2%) with secondary syphilis. The overall incidence rate of early syphilis for 4 years after the start of HAART was 4.57 per 100 person-years (95% confidence interval, 3.45-5.93). The incidence rate of early syphilis significantly increased in proportion to the years after the start of HAART (3.4-6.1 per 100 person-year, P for trend <0.001).

   CONCLUSIONS Early syphilis incidence in HIV-infected patients increased in proportion to HAART duration. The finding suggests that screening for syphilis in HIV-infected patients who initiate HAART should be encouraged with attention to the time passed since HAART initiation.

   PubMed IF 1.9 감염내과
5. 362008

   제1저자 박완범 · 교신저자 오명돈

   Park WB, Lee JH, Jeon JH, Lee SJ, Kim SH, Kim NJ, Kim HB, Oh MD, Choe KW

   Effect of tumor necrosis factor-alpha on intracellular Staphylococcus aureus in vascular endothelial cells.

   FEMS Immunol Med Microbiol. 2008;52(2):247-52.

   Abstract

   Although tumor necrosis factor-alpha (TNF-alpha) is an important host factor against intracellular bacteria, little is known about the effect of TNF-alpha on the persistence of intracellular Staphylococcus aureus in vascular endothelial cells. It was investigated whether recombinant human TNF-alpha influences the survival of intracellular S. aureus (ATCC 29213) in human umbilical vein endothelial cells (HUVEC) under a condition with an antistaphylococcal agent, and its mechanism. The HUVECs were incubated with TNF-alpha, oxacillin, or both in 24-well plates for up to 48 h following internalization of S. aureus (10(6) CFU well(-1)) into HUVECs for 1 h. TNF-alpha (1 ng mL(-1)) significantly reduced the number of intracellular S. aureus in HUVECs, and TNF-alpha plus oxacillin eliminated more intracellular S. aureus in HUVEC than oxacillin alone. The LDH viability assay and quantification of apoptosis using photometric enzyme-immunoassay showed that TNF-alpha preferentially induced cell death and apoptosis of HUVECs infected with S. aureus compared with noninfected HUVECs. These results indicate that TNF-alpha helps antistaphylococcal antibiotics to eliminate intracellular S. aureus in vascular endothelial cells, partly because TNF-alpha preferentially induces apoptosis of endothelial cells infected by S. aureus.

   PubMed IF 2.281 감염내과
6. 352008

   제1저자 손성욱 · 교신저자 민경업

   Sohn SW, Lee HS, Park HW, Chang YS, Kim YK, Cho SH, Kim YY, Min KU

   Evaluation of cytokine mRNA in induced sputum from patients with allergic rhinitis: relationship to airway hyperresponsiveness.

   Allergy. 2008;63(3):268-73.

   Abstract

   BACKGROUND Although airway hyperresponsiveness (AHR) is a characteristic feature of asthma, it is also frequently present in allergic rhinitis (AR). However, the pathogenesis of AHR is unclear and the roles of cytokines in the airway have not been well established in AR. We sought to compare cytokine mRNA levels in the sputum of AR patients with or without AHR and those of asthma patients, and to evaluate whether differences in cytokine levels are associated with the development of an abnormal airway response and the absence of respiratory symptoms in AR patients with AHR.

   METHODS Airway cells were obtained by sputum induction from 18 AR patients with AHR, 58 AR patients without AHR, and 27 asthma patients. Airway cell cytokine levels, interleukin (IL) -4, IL-5, IL-13, vascular endothelial growth factor (VEGF), and interferon-gamma (IFN-gamma), were studied at the mRNA level by RT-PCR.

   RESULTS Vascular endothelial growth factor and IL-5 mRNA levels were significantly higher in AR patients with AHR than in AR patients without AHR, but these were lower than those of asthmatic patients. Eosinophils were significantly higher in AR patients with AHR and in asthmatic patients than in AR patients without AHR. Interleukin-4, IL-13, and IFN-gamma levels were not elevated in AR patients with or without AHR vs asthma patients.

   CONCLUSIONS These findings suggest that VEGF and IL-5 can be important determinants of the development of AHR in AR patients and that lower levels of other cytokines may be associated with the absence of asthmatic symptoms in AR patients with AHR.

   PubMed IF 11.3 알레르기내과
7. 342008

   제1저자 김황필 · 교신저자 김태유

   Kim HP, Han SW, Kim SH, Im SA, Oh DY, Bang YJ, Kim TY

   Combined lapatinib and cetuximab enhance cytotoxicity against gefitinib-resistant lung cancer cells.

   Mol Cancer Ther. 2008;7(3):607-15.

   Abstract

   Although non-small cell lung cancer (NSCLC) cells with somatic mutations in their epidermal growth factor receptors (EGFR) initially show a dramatic response to tyrosine kinase inhibitor (TKI), these cells eventually develop resistance to TKI. This resistance may be caused by a secondary T790M mutation in the EGFR tyrosine kinase, which leads to the substitution of methionine for threonine in 790. In this study, we show that a combination of lapatinib and cetuximab overcomes gefitinib resistance in NSCLC with the T790M mutation. We observed that T790M lung cancer cells were resistant to gefitinib, and Stat3 was persistently activated in the resistant cells. A reversible EGFR and HER2 TKI, lapatinib, decreased Stat3 activation by blocking heterodimerization of EGFR and HER2, which led to a modest increase in the inhibitory effect on gefitinib-resistant T790M cells. In addition to lapatinib, the anti-EGFR antibody, cetuximab, induced down-regulation of EGFR and apoptotic cell death in T790M cells. Finally, combined lapatinib and cetuximab treatment resulted in significantly enhanced cytotoxicity against gefitinib-resistant T790M cells in vitro and in vivo. Taken together, these data suggest that treatment with a combination of lapatinib and cetuximab, which induces dimeric dissociation and EGFR down-regulation, appears to be an effective strategy for treatment of patients with EGFR TKI-resistant NSCLC.

   PubMed IF 6.9 혈액종양내과
8. 332008

   제1저자 송은기 · 교신저자 허대석

   Song EK, Kim SY, Kim TM, Lee KW, Yun T, Na II, Shin H, Lee SH, Kim DW, Khwarg SI, Heo DS

   Efficacy of chemotherapy as a first-line treatment in ocular adnexal extranodal marginal zone B-cell lymphoma.

   Ann Oncol. 2008;19(2):242-6.

   Abstract

   BACKGROUND Radiotherapy is commonly used as a first-line treatment for localized ocular adnexal extranodal marginal zone B-cell lymphoma (EMZBL), despite its ophthalmologic complications. This study was undertaken to analyze the efficacy of first-line chemotherapy in treating EMZBL. Chemotherapy was followed by radiotherapy only in recurrent cases.

   PATIENTS AND METHODS Twenty-one patients with histologically confirmed EMZBL were treated with combination of cyclophosphamide, vincristine, and prednisolone (CVP). Radiotherapy was given to CVP failure cases.

   RESULTS CVP alone resulted in overall response rate of 100% [complete remission (CR), 76.2%]. After a median follow-up of 58 months, 14 (66.7%) of 21 cases were disease free with CVP alone, while seven cases showed disease progression, including two extra-orbital and five local failures. Radiotherapy was delivered to five local failure cases, who subsequently achieved CR with late ophthalmologic complications. There were tolerable adverse events associated with CVP.

   CONCLUSIONS Front-line CVP, in conjunction with radiotherapy in recurrent cases, is effective and well tolerated in patients with localized ocular adnexal EMZBL.

   PubMed IF 80.4 혈액종양내과
9. 322008

   제1저자 박완범 · 교신저자 최강원

   Park WB, Kim JY, Kim SH, Kim HB, Kim NJ, Oh MD, Choe KW

   Self-reported reasons among HIV-infected patients for missing clinic appointments.

   Int J STD AIDS. 2008;19(2):125-6.

   Abstract

   Although adherence to clinic visits is important for successful clinical outcome in HIV treatment, little is known about the reasons patients with HIV miss appointments. We prospectively monitored the self-reported reasons for missed clinic appointments among HIV patients at a university hospital in South Korea from June through December 2006. Of the 1562 scheduled clinic visits, 131 (8%) of appointments were missed. Work schedule, forgetfulness and lack of motivation were the primary reasons given for missed appointments. Considering these factors when scheduling appointments may improve adherence to clinic attendance among HIV-infected patients.

   PubMed IF 1.6 감염내과
10. 312008

    제1저자 남수연 · 교신저자 김주성

    Nam SY, Kim JS, Kim JM, Lee JY, Kim N, Jung HC, Song IS

    DA-6034, a derivative of flavonoid, prevents and ameliorates dextran sulfate sodium-induced colitis and inhibits colon carcinogenesis.

    Exp Biol Med (Maywood). 2008;233(2):180-91.

    Abstract

    Previously, we have shown that DA-6034, a synthetic derivative of flavonoid eupatilin, inhibited NF-kappaB activation in colon epithelial cells and prevented trinitrobenzene sulfonic acid-induced rat colitis. The aim of this study was to investigate the preventive and therapeutic effect of DA-6034 on dextran sulfate sodium (DSS)-induced colitis and on inflammation-related cancer. C57BL/6 mice were given 4% DSS for 5 days with and without DA-6034 in the acute preventive model. In the acute therapeutic model, mice were given 4% DSS for 5 days followed by rectal administration of DA-6034. Colitis was quantified by body weight, disease activity index (DAI), colon length, and histology. In the inflammation-related cancer model, mice were given a single intraperitoneal injection of azoxymethane, then three cycles of 2% DSS for 5 days, then 2 weeks of free water consumption. Apoptosis was determined by in situ terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling assay, and the expression of Ki-67, phospho-kappaB kinase alpha (IKKalpha), and COX-2 were evaluated by immunohistochemistry. In both the acute preventive and acute therapeutic models, DA-6034 significantly attenuated DSS-induced weight loss, an increase in DAI, and a shortening of colon length. DA-6034-treated mice maintained crypt architecture and revealed a scanty infiltration of inflammatory cells in both the preventive and therapeutic models. In the inflammation-related cancer model, DA-6034 reduced the number of colon tumors and ameliorated weight loss and shortening of colon length. DA-6034 strongly enhanced apoptosis and inhibited the expression of COX-2 and phospho-IKKalpha in inflammation-related colon cancer models. Our results suggest that DA-6034 prevents acute murine colitis and inhibits inflammation-related colon carcinogenesis. DA-6034 could be a potential therapeutic agent for inflammatory bowel disease.

    PubMed IF 3.8 소화기내과
11. 302008

    제1저자 이해영 · 교신저자 김효수

    Lee HY, You HJ, Won JY, Youn SW, Cho HJ, Park KW, Park WY, Seo JS, Park YB, Walsh K, Oh BH, Kim HS

    Forkhead factor, FOXO3a, induces apoptosis of endothelial cells through activation of matrix metalloproteinases.

    Arterioscler Thromb Vasc Biol. 2008;28(2):302-8.

    Abstract

    BACKGROUND The forkhead factor, FOXO3a, is known to induce apoptosis in endothelial cells (ECs). However, its effects on extracellular matrices (ECM), which are important in EC survival, remained unknown. Here, we evaluated the role of FOXO3a on EC-ECM interaction.

    METHODS AND RESULTS Constitutively active FOXO3a was transduced to human umbilical vein endothelial cells by adenoviral vector (Ad-TM-FOXO3a). Ad-TM-FOXO3a transfection led to dehiscence of ECs from fibronectin-coated plates, resulting in anoikis, which was significantly reversed by matrix metalloproteinase (MMP) inhibitor, GM6001. FOXO3a increased the expression of MMP-3 (stromelysin-1) but decreased the expression of tissue inhibitors of metalloproteinases-1 (TIMP-1), which was associated with increased MMP enzymatic activity in zymography. Pathophysiologic conditions such as serum starvation or heat shock also induced activation of endogenous FOXO3a, leading to activation of MMP-3 and apoptosis, which was reversed by GM6001. Delivery of Ad-TM-FOXO3a to the intraluminal surface in vivo led to EC denudation, disrupted vascular integrity, and impaired endothelium-dependent vasorelaxation.

    CONCLUSIONS Activation of MMPs and possible ECM disruption represent novel mechanisms of FOXO3a-mediated apoptosis in ECs.

    PubMed IF 8.8 순환기내과
12. 292008

    제1저자 윤진선 · 교신저자 이영열,김병국

    Yoon JS, Kim JY, Park HK, Kim ES, Ahn KS, Yoon SS, Cho CG, Kim BK, Lee YY

    Antileukemic effect of a synthetic vitamin D3 analog, HY-11, with low potential to cause hypercalcemia.

    Int J Oncol. 2008;32(2):387-96.

    Abstract

    1alpha,25-dihydroxyvitamin D3 [1,25(OH)2D3] is capable of inhibiting the proliferation of acute myelogenous leukemia (AML). However, toxicity of hypercalcemia has limited the use of 1,25(OH)2D3 in clinical trials. We have evaluated 11 synthesized vitamin D3 analogs for their ability to inhibit clonal growth of HL-60 myeloid leukemic cells. Among the 11 vitamin D3 analogs, HY-11 (code name) showed the most potent antileukemic activity with 2.5x10(-6) M of IC50, however, it did not affect the cellular growth of normal peripheral blood mononuclear cells until 10(-6) M. Flow cytometric analysis indicated that HY-11 induced the G1 arrest in a dose-dependent manner, which was mediated via inactivation of CDK4 and CDK6 in association with up-regulation of CDKI (cyclin-dependent kinase inhibitor), p27 and Rb protein. Induction of apoptosis was mediated via caspase-3 pathway in HY-11-treated HL-60. In addition, HY-11 enhanced the expression of TGF-beta1, TGF-beta receptor type I and II and vitamin D3 receptor (VDR). VDR expression was increased by TGF-beta1, suggesting that TGF-beta1 might be involved in the antiproliferative effect of HY-11 on HL-60 cells by autocrine and paracrine regulation. Serum calcium levels were within normal limit when HY-11 was given intraperitoneally (i.p.) every other day for 5 weeks to BALB/c mice at the doses of 10(-7), 10(-6)and 10(-5) M. HY-11 inhibited the growth of WEHI-3BD+ mouse leukemic cells in vitro, and syngeneic BALB/c mice that received WEHI-3BD+ mouse leukemic cells and HY-11 had a significantly longer survival without producing hypercalcemia compared to control group. In summary, HY-11 is a vitamin D3 analog that inhibited the proliferation of human AML cell line, HL-60, through induction of cell cycle arrest, triggering apoptosis as well as modulation of TGF-beta1 and its receptors. In particular, HY-11 significantly increased the survival of mice that had myeloid leukemia without producing hypercalcemia.

    PubMed IF 7.3 혈액종양내과
13. 282008

    제1저자 조영민 · 교신저자 이홍규

    Cho YM, Lim JM, Yoo DH, Kim JH, Chung SS, Park SG, Kim TH, Oh SK, Choi YM, Moon SY, Park KS, Lee HK

    Betacellulin and nicotinamide sustain PDX1 expression and induce pancreatic beta-cell differentiation in human embryonic stem cells.

    Biochem Biophys Res Commun. 2008;366(1):129-34.

    Abstract

    The major obstacle in cell therapy of diabetes mellitus is the limited source of insulin-producing beta cells. Very recently, it was shown that a five-stage protocol recapitulating in vivo pancreatic organogenesis induced pancreatic beta cells in vitro; however, this protocol is specific to certain cell lines and shows much line-to-line variation in differentiation efficacy. Here, we modified the five-stage protocol for the human embryonic stem cell line SNUhES3 by the addition of betacellulin and nicotinamide. We reproduced in vivo pancreatic islet differentiation by directing the cells through stages that resembled in vivo pancreatic organogenesis. The addition of betacellulin and nicotinamide sustained PDX1 expression and induced beta-cell differentiation. C-peptide-a genuine marker of de novo insulin production-was identified in the differentiated cells, although the insulin mRNA content was very low. Further studies are necessary to develop more efficient and universal protocols for beta-cell differentiation.

    PubMed IF 2.5 내분비대사내과
14. 272008

    제1저자 박경우, 황경국 · 교신저자 김효수

    Park KW, Hwang KK, Cho HJ, Hur J, Yang HM, Yoon CH, Kang HJ, Oh BH, Park YB, Kim HS

    Simvastatin enhances endothelial differentiation of peripheral blood mononuclear cells in hypercholesterolemic patients and induces pro-angiogenic cytokine IL-8 secretion from monocytes.

    Clin Chim Acta. 2008;388(1-2):156-66.

    Abstract

    BACKGROUND Statins are known to have pleiotropic effects. We examined the effect and mechanism of simvastatin therapy on EPC differentiation and pro-angiogenic cytokines in patients with hypercholesterolemia.

    METHODS Twenty-two hypercholesterolemia patients without any other modifiable cardiovascular risk factors or history of previous lipid-lowering therapy were given simvastatin 20 mg/day for 4 weeks. Blood were drawn pre- and post-therapy. The in vitro effects of simvastatin were studied in a separate set of experiments.

    RESULTS Simvastatin treatment significantly increased the number of DiI-acLDL, UEA-1 lectin double-positive EPCs and facilitated its appearance. By FACS analysis of freshly isolated PBMNCs, KDR (+) cells increased after simvastatin treatment while there were no differences in CD34, AC133, and VE-cadherin. Also, serum concentration of IL-8 was markedly increased, while VEGF was only slightly increased. In vitro, PBMNCs co-cultured with simvastatin showed increased cluster formation at day 7, and simvastatin facilitated the appearance and networking of EPCs compared with vehicle. Simvastatin-co-cultured PBMNCs showed significantly increased KDR (+) cells, in contrast to CD34, CD31, and VE-Cadherin (+) cells. In response to simvastatin, IL-8 was mainly increased in monocyte culture supernatants while VEGF increased in smooth muscle cell culture supernatants. These cytokines were associated with increased EPC migratory function. The increase in IL-8 secretion from monocytes by statin treatment was associated with phosphorylation and inactivation of GSK3beta, which was reversed by constitutive activation of GSK-3beta.

    CONCLUSION Simvastatin enhances endothelial differentiation of peripheral blood mononuclear cells in patients with hypercholesterolemia and increases pro-angiogenic cytokine IL-8 secretion from monocytes. Our results may explain the pro-angiogenic effects associated with statin therapy and offer further evidence of statin pleiotropism.

    PubMed IF 4.1 순환기내과
15. 262008

    제1저자 손대원 · 교신저자 손대원

    Sohn DW, Kim HK, Park JS, Kim YJ, Zo JH, Oh BH, Park YB, Choi YS

    Pneumatic lower extremity compression during dobutamine stress echocardiography.

    Circ J. 2008;72(2):251-5.

    Abstract

    BACKGROUND Afterload is expected to increase with pneumatic compression of the lower extremities. There are left ventricular (LV) wall stress, which is the most important factor determining myocardial oxygen demand, will also increase, leading to an increase in the sensitivity of dobutamine stress echocardiography (DSE) or a shortened time to a positive response.

    METHODS AND RESULTS In 40 patients who underwent DSE and were anticipating undergoing coronary angiography (CAG), the imaging was repeated with pneumatic compression (100 mmHg) of the lower extremities (DSEcomp) prior to CAG. The sensitivity and specificity of DSE and DSEcomp were determined based on the CAG findings. All patients tolerated pneumatic compression of the lower extremities during the tests. LV end-systolic volume (p=0.042) and end-systolic wall stress (p=0.036) were significantly greater with DSEcomp than with DSE. In 3 patients with false-negative results for DSE, DSEcomp gave a positive response, demonstrating a significant increase in sensitivity from 75% to 94% (p=0.045). Only 1 patient with a true negative result for DSE was interpreted as showing a positive response for DSEcomp, resulting in a decrease in specificity from 88% to 83% (p=NS). In 10 of 12 patients with true positive results for both DSE and DSEcomp, positive responses were seen at least 1 stage earlier with DSEcomp than with DSE.

    CONCLUSIONS Pneumatic compression of the lower extremities increases the sensitivity of DSE and shortens the time to a positive response.

    PubMed IF 5.8 순환기내과
16. 252008

    제1저자 김광일 · 교신저자 김철호

    Kim KI, Lee JH, Chang HJ, Cho YS, Youn TJ, Chung WY, Chae IH, Choi DJ, Park KU, Kim CH

    Association between blood pressure variability and inflammatory marker in hypertensive patients.

    Circ J. 2008;72(2):293-8.

    Abstract

    BACKGROUND Blood pressure (BP) variability has been reported to be associated with hypertensive target organ damage and cardiovascular events. However, the exact mechanism linking BP variability and organ damage is uncertain. This study was designed to investigate the association between BP variability and inflammatory marker in hypertensive patients.

    METHODS AND RESULTS Fifty-two hypertensive patients (28 men, 55.9+/-1.5 years) completed 24-h ambulatory BP monitoring. Inflammatory markers were evaluated by measuring plasma levels of interleukin (IL)-6, tumor necrosis factor (TNF)-alpha by enzyme-linked immunosorbent assay and high sensitive C-reactive protein (hs-CRP) by particle-enhanced light-scattering immunoassay. BP variability was obtained by calculating within-subject standard deviation (SD) and coefficient of variation of BP. Subjects were grouped into tertiles according to IL-6, TNF-alpha, and hs-CRP levels. A significant association between ambulatory BP and TNF-alpha level was identified (P for trend =0.011). In contrast, no association was observed between BP and IL-6 level; however, BP variability index was linked to IL-6 level (P for trend =0.046). The association between inflammatory marker and pattern of diurnal variation was investigated. The hs-CRP concentration was significantly higher in the riser group compared with the dipper group. However, IL-6 and TNF-alpha levels did not differ among the different diurnal variation groups. Correlation analysis showed varying associations between IL-6 and TNF-alpha. TNF-alpha level correlated with the BP index; however, IL-6 level correlated with the BP variability index. Multiple linear regression models revealed that the SD of daytime systolic BP (beta=0.065, p=0.001) and age (beta=0.024, p=0.016) were all positively and significantly related to IL-6. In contrast, only daytime diastolic BP (beta=0.029, p=0.002) was independently related to TNF-alpha.

    CONCLUSION Inflammatory markers are associated with BP variability in hypertensive patients. This finding implies that inflammation may be a mediator for the link between BP variability and target organ damage.

    PubMed IF 5.8 노인병내과
17. 242008

    제1저자 곽수헌 · 교신저자 박경수

    Kwak SH, Cho YM, Moon MK, Kim JH, Park BL, Cheong HS, Shin HD, Jang HC, Kim SY, Lee HK, Park KS

    Association of polymorphisms in the insulin-degrading enzyme gene with type 2 diabetes in the Korean population.

    Diabetes Res Clin Pract. 2008;79(2):284-90.

    Abstract

    Insulin-degrading enzyme (IDE) is a metalloproteinase which degrades insulin and terminates its action. Homologous deletion of IDE gene resulted in hyperinsulinemia and glucose intolerance in a rat model of type 2 diabetes mellitus. Several genetic association studies examined IDE as a susceptibility gene for type 2 diabetes in European descents. Here we investigated the genetic association of IDE polymorphisms with the risk of type 2 diabetes and its related phenotypes in the Korean population. Among six single nucleotide polymorphisms analyzed, g.-179T>C (OR=1.73, P=0.04), and g.IVS18+99G>A (OR=1.23, P=0.02) revealed borderline association with increased risk of type 2 diabetes. Combining our results with previous data obtained from the European population, g.-179T>C (OR=1.11, P=0.03), and g.IVS24-64A>T (OR=1.18, P=0.005) showed significant association with type 2 diabetes. Haplotype consisting of common alleles of the six polymorphisms was associated with decreased risk of type 2 diabetes (OR=0.82, P=0.02). However, none of the polymorphisms was significantly associated with metabolic phenotypes. We can conclude that variations in IDE might contribute to diabetes susceptibility in the Korean population.

    PubMed IF 4.6 내분비대사내과
18. 232008

    제1저자 이은영 · 교신저자 유빈

    Lee CK, Lee EY, Kim YG, Mun SH, Moon HB, Yoo B

    Alpha-lipoic acid inhibits TNF-alpha induced NF-kappa B activation through blocking of MEKK1-MKK4-IKK signaling cascades.

    Int Immunopharmacol. 2008;8(2):362-70.

    Abstract

    The therapeutic effects of alpha-lipoic acid (alpha-LA) via NF-kappa B down regulation were demonstrated on joint inflammation and erosion in an animal model. In this study, we investigated how alpha-LA inhibits the pathway of NF-kappa B activation by TNF-alpha via the mitogen-activated protein kinase (MAPK) pathway in rheumatoid arthritis (RA) fibroblast-like synovial cells (FLS). FLS were stimulated with TNF-alpha following pre-treatment with or without alpha-LA. Electrophoretic mobility shift assays (EMSA) revealed that TNF-alpha activates NF-kappa B in FLS. This was inhibited by alpha-LA at concentrations of 1 mM. TNF-alpha induced IKK mediated phosphorylation of GST-I kappa B and pre-treatment with alpha-LA inhibited this pathway. FLS constitutively express MEKK1, MEKK2, MEKK3, and TAK1 and that their levels are unaffected by TNF-alpha or alpha-LA. Immunoprecipitation using anti-MEKK1 antibody phosphorylated GST-I kappa B and pre-treating the cells with alpha-LA could abolish the reaction. FLS were immunoprecipitated using an antibody to MEKK1, and MKK4 was coprecipitated with MEKK1. In addition, immune complexes precipitated with anti-MKK4 antibody phosphorylated GST-I kappa B, and pre-treatment with alpha-LA inhibited the phosphorylation. Immunoprecipitation assay showed that MEKK1, MKK4, IKK-alpha, IKK-beta, I kappa B, and NF-kappa B comprised immunocomplex. It can be concluded that TNF-alpha activates NF-kappa B in FLS through MEKK1-MKK4-IKK signaling complex, and alpha-LA inhibits this signaling at the level of or upstream of IKK-alpha and IKK-beta.

    PubMed IF 5.6 류마티스내과
19. 222008

    제1저자 정연주 · 교신저자 김태유

    Jung Y, Park J, Bang YJ, Kim TY

    Gene silencing of TSPYL5 mediated by aberrant promoter methylation in gastric cancers.

    Lab Invest. 2008;88(2):153-60.

    Abstract

    DNA methylation is crucial for normal development, but gene expression altered by DNA hypermethylation is often associated with human diseases, especially cancers. The gene TSPYL5, encoding testis-specific Y-like protein, was previously identified in microarray screens for genes induced by the inhibition of DNA methylation and histone deacetylation in glioma cell lines. The TSPYL5 showed a high frequency of DNA methylation-mediated silencing in both glioma cell lines and primary glial tumors. We now report that TSPYL5 is also inactivated by DNA methylation and could be a putative epigenetic target gene in gastric cancers. We found that the expression of TSPYL5 mRNA was frequently downregulated and inversely correlated with DNA methylation in seven out of nine gastric cancer cell lines. TSPYL5 mRNA expression was also restored after treating with a DNA methyltransferase inhibitor. In primary gastric tumors, methylation-specific PCR results in 23 of the 36 (63.9%) cases revealed that the hypermethylation at CpG islands of the TSPYL5 was detectable at a high frequency. Furthermore, TSPYL5 suppressed the growth of gastric cancer cells as demonstrated by a colony formation assay. Thus, strong associations between TSPYL5 expression and hypermethylation were observed, and aberrant methylation at a CpG island of TSPYL5 may play an important role in development of gastric cancers.

    PubMed IF 4.1 혈액종양내과
20. 212008

    제1저자 오소연 · 교신저자 김지현

    Oh SY, Kim JH, Lee KW, Bang SM, Hwang JH, Oh D, Lee JS

    Venous thromboembolism in patients with pancreatic adenocarcinoma: lower incidence in Asian ethnicity.

    Thromb Res. 2008;122(4):485-90.

    Abstract

    BACKGROUND Pancreatic adenocarcinoma is one of the cancers most frequently associated with venous thromboembolism (VTE), with the varying incidences of 10%-20% reported in Western countries. Asians are known to have a lower risk for VTE than Caucasians, but few studies have been conducted regarding the incidence of VTE in Asian cancer patients.

    MATERIALS AND METHODS Incidence of radiologically confirmed VTE was assessed by review of medical records of all patients histologically diagnosed with advanced pancreatic adenocarcinoma, with follow-up conducted at a regional teaching hospital from Jun 2003 to Dec 2005.

    RESULTS Seventy five patients with advanced pancreatic adenocarcinoma were identified for evaluation (M:F=44:31, locally advanced:metastatic=25:50, median age:67 years). Four patients (5.3%) developed VTE during median follow-up period of 124 days. Three of four patients had metastatic disease and were receiving chemotherapy when VTE developed. The mean time from cancer diagnosis to the detection of VTE was 160 days. No episodes of peripheral arterial thrombosis were detected, but three multiple cerebral infarctions occurred, which proved fatal in all three. Median survival time was shorter in patients with VTE than those without, but the difference was not statistically significant (4.3 vs 6.6 months).

    CONCLUSION The incidence of VTE complications in Korean patients with advanced pancreatic cancer was 5.3%, which is lower than that observed in other ethnic groups. Our study warrants further prospective investigations on the incidence and mechanism of VTE and cerebral infarctions in cancer patients of different ethnic groups.

    PubMed IF 3.4 혈액종양내과
21. 202008

    제1저자 김형관 · 교신저자 손대원

    Kim HK, Kim YJ, Sohn DW

    Images in cardiovascular medicine. Impact of careful survey of pulmonary arteries during echocardiographic examination on diagnosis and treatment: an echocardiographic snapshot makes them different.

    Circulation. 2008;117(3):450-2.

    PubMed IF 41.3 순환기내과
22. 192008

    제1저자 이상협 · 교신저자 류지곤

    Lee SH, Ryu JK, Lee KY, Woo SM, Park JK, Yoo JW, Kim YT, Yoon YB

    Enhanced anti-tumor effect of combination therapy with gemcitabine and apigenin in pancreatic cancer.

    Cancer Lett. 2008;259(1):39-49.

    Abstract

    Apigenin is a dietary flavonoid possessing therapeutic potential against cancers. This study was designed to investigate whether combination therapy with gemcitabine and apigenin enhanced anti-tumor efficacy in pancreatic cancer. In vitro, the combination treatment resulted in more growth inhibition and apoptosis through the down-regulation of NF-kappa B activity with suppression of Akt activation in pancreatic cancer cell lines (MiaPaca-2, AsPC-1). In vivo, the combination therapy augmented tumor growth inhibition through the down-regulation of NF-kappa B activity with the suppression of Akt in tumor tissue. The combination of gemcitabine and apigenin enhanced anti-tumor efficacy through Akt and NF-kappa B activity suppression and apoptosis induction.

    PubMed IF 11.8 소화기내과
23. 182008

    제1저자 김나영 · 교신저자 정인식

    Kim N, Lee SW, Cho SI, Park CG, Yang CH, Kim HS, Rew JS, Moon JS, Kim S, Park SH, Jung HC, Chung IS, H. pylori and Gerd Study Group of Korean College of Helicobacter and Upper Gastrointestinal Research

    The prevalence of and risk factors for erosive oesophagitis and non-erosive reflux disease: a nationwide multicentre prospective study in Korea.

    Aliment Pharmacol Ther. 2008;27(2):173-85.

    Abstract

    BACKGROUND Prospective nationwide multicentre studies that have evaluated endoscopic findings and reflux symptoms using a well-designed questionnaire are very rare.

    AIM To compare the prevalence rates of and risk factors for erosive oesophagitis and non-erosive reflux disease (NERD) in the Korean population.

    METHODS A gastroscopic examination was performed on 25 536 subjects who visited 40 Healthcare Centers for a health check-up. A gastro-oesophageal reflux questionnaire and multivariate analysis were used to determine the risk factors for erosive oesophagitis and NERD.

    RESULTS 2019 (8%) and 996 subjects (4%) had erosive oesophagitis and non-erosive reflux disease, respectively; only 58% of subjects with erosive oesophagitis had reflux symptoms. Multivariate analysis showed that the risk factors for erosive oesophagitis and NERD differed, i.e. those of erosive oesophagitis were male, a Helicobacter pylori eradication history, alcohol, body mass index > or =25 and hiatal hernia. In contrast, the risk factors for NERD were female, age <40 and > or =60 vs. 40-59 years, body mass index <23 and a monthly income <$1000, glucose > or =126 mg/dL, smoking, a stooping posture at work and antibiotic usage.

    CONCLUSIONS The prevalence rates of erosive oesophagitis and NERD were 8% and 4%, respectively, in Korean health check-up subjects. The risk factors for erosive oesophagitis and NERD were found to differ, which indicates that their underlying pathogeneses are distinct.

    PubMed IF 6.8 소화기내과
24. 172008

    제1저자 양민석 · 교신저자 장윤석

    Yang MS, Lee SH, Kim TW, Kwon JW, Lee SM, Kim SH, Kwon HS, Park CH, Park HW, Kim SS, Cho SH, Min KU, Kim YY, Chang YS

    Epidemiologic and clinical features of anaphylaxis in Korea.

    Ann Allergy Asthma Immunol. 2008;100(1):31-6.

    Abstract

    BACKGROUND Little is known about the characteristics of anaphylaxis in Korea or even in Asia.

    OBJECTIVE To evaluate the incidence of anaphylaxis and the clinical features of patients with anaphylaxis in a Korean tertiary care hospital.

    METHODS We performed a retrospective review from January 1, 2000, through July 31, 2006, of 138 patients with anaphylaxis, including inpatients, outpatients, and emergency department visitors, in the Seoul National University Hospital.

    RESULTS Among 978,146 patients, 138 (0.014%) had anaphylaxis. Two cardiopulmonary resuscitations were performed and 1 death occurred. The total mortality rate of anaphylactic patients was 0.0001%. The causes of anaphylaxes were drug (35.3%), food (21.3%), food-dependent exercise-induced (13.2%), idiopathic (13.2%), insect stings (11.8%), exercise induced (2.9%), blood products (1.5%), and latex (0.7%). Radiocontrast media and buckwheat were the leading causes of drug and food anaphylaxis, respectively. The organs most frequently involved in the anaphylaxis were cutaneous (95.7%), cardiovascular (76.8%), and respiratory (74.6%). The most common manifestations were dyspnea (71.3%), urticaria (81.9%), and angioedema (69.4%). Three of 138 patients (2.2%) had biphasic reactions.

    CONCLUSIONS The incidence, mortality rate, and clinical features of Korean patients with anaphylaxis were similar to rates for patients from other countries, despite some differences in causative agents.

    PubMed IF 7.1 알레르기내과
25. 162008

    제1저자 엄상원 · 교신저자 김덕겸

    Um SW, Yoon YS, Lee SM, Yim JJ, Yoo CG, Chung HS, Kim YW, Han SK, Shim YS, Kim DK

    Predictors of persistent airway stenosis in patients with endobronchial tuberculosis.

    Int J Tuberc Lung Dis. 2008;12(1):57-62.

    Abstract

    SETTING The university and municipal hospitals in Seoul, Korea.

    OBJECTIVE To evaluate the predictors of persistent airway stenosis following anti-tuberculosis chemotherapy in patients with endobronchial tuberculosis (TB).

    DESIGN Diagnosis of TB was confirmed by microbiology or histopathology. Bronchoscopic examinations revealed that patients had endobronchial lesions compatible with endobronchial TB. Study subjects had at least one follow-up bronchoscopy to evaluate their treatment response. Treatment response was determined by changes in the degree or extent of airway stenosis between the first and last bronchoscopic examinations.

    RESULTS Sixty-seven subjects were recruited retrospectively from Seoul National University Hospital and Seoul National University Boramae Hospital. Persistent bronchostenosis occurred in 41.8% of the patients. In multivariate regression analysis, age >45 years (OR 3.65), pure or combined fibrostenotic subtype (OR 5.54) and duration from onset of chief complaint to the initiation of anti-tuberculosis chemotherapy >90 days (OR 5.98) were identified as independent predictors of persistent airway stenosis. Oral corticosteroids (prednisolone equivalent >or=30 mg/d) did not reduce the frequency of persistent airway stenosis.

    CONCLUSION Early diagnosis and early administration of anti-tuberculosis chemotherapy before involvement of the deeper airways is important to prevent the development of unwanted sequelae of bronchostenosis.

    PubMed IF 3.6 호흡기내과
26. 152008

    제1저자 강은하 · 교신저자 송영욱

    Kang EH, Shen GQ, Morris R, Metzger A, Lee EY, Lee YJ, Lee EB, Song YW

    Flow cytometric assessment of anti-neuronal antibodies in central nervous system involvement of systemic lupus erythematosus and other autoimmune diseases.

    Lupus. 2008;17(1):21-5.

    Abstract

    The objective of this study is to evaluate the association between anti-neuronal antibody (anti-NA) and central nervous system (CNS) manifestations of systemic lupus erythematosus (SLE) and other rheumatic diseases using a flow cytometric method. Anti-NA was measured by flow cytometry in serum and cerebrospinal fluid (CSF) samples from patients with SLE (n=44 for serum, n=17 for CSF), other rheumatic diseases (n=64 for serum, n=21 for CSF) and from healthy controls (n=65 for serum, n=18 for CSF). Serum anti-NA was more frequently observed in SLE (31.8%, 14/44) than in other rheumatic diseases (4.7%, 3/64, P<0.001) or in healthy controls (0%, 0/65, P<0.00001). In SLE patients, the frequency of serum anti-NA was significantly higher in CNS-SLE (76.5%, 13/17) than in non CNS-SLE (3.7%, 1/27, P<0.000001). CSF anti-NA was detected in 88.2% (15/17) of CNS-SLE and was more frequently detected in CNS-SLE (15/17, 88.2%) than in other rheumatic diseases with CNS involvement (1/21, 4.8%, P<0.000001) or in healthy controls (0/18, P<0.000001). In conclusion, serum anti-NA was more frequently found in CNS-SLE than in non CNS-SLE, other rheumatic diseases or in healthy controls. The frequency of CSF anti-NA in CNS-SLE was significantly higher than in other rheumatic diseases with CNS involvement or in healthy controls.

    PubMed IF 1.8 류마티스내과
27. 142008

    제1저자 김유정 · 교신저자 임석아

    Kim YJ, Im SA, Kim HG, Oh SY, Lee KW, Choi IS, Oh DY, Lee SH, Kim JH, Kim DW, Kim TY, Kim SW, Heo DS, Yoon YB, Bang YJ

    A phase II trial of S-1 and cisplatin in patients with metastatic or relapsed biliary tract cancer.

    Ann Oncol. 2008;19(1):99-103.

    Abstract

    BACKGROUND Optimal chemotherapy for advanced biliary tract cancer (BTC) is yet to be defined. We carried out this study to evaluate the efficacy and toxicity of combination chemotherapy with S-1 and cisplatin in metastatic or relapsed BTC.

    PATIENTS AND METHODS Patients with pathologically proven BTC were eligible. The chemotherapy regimen consisted of S-1 (40 mg/m(2) p.o. b.i.d. from D1-14) and cisplatin (60 mg/m(2) on D1), repeated every 3 weeks.

    RESULTS Fifty-one BTC patients (metastatic:relapsed = 37:14, Gall-bladder:intrahepatic bile ducts:extrahepatic bile ducts = 16:25:10) were enrolled from January 2005 to December 2006. Median age was 57 years (range, 31-71) and most patients had a good performance status. The overall response rate was 30% [95% confidence interval (CI), 17.3-42.7] and complete response was observed in two patients (4%), partial response in 13 (26%), stable disease in 21 (42%), and progressive disease in 9 (18%). With a median follow-up of 12.4 months, the median time to progression was 4.8 months (95% CI, 3.3-6.3) and median overall survival was 8.7 months (95% CI, 6.0-11.4). Major toxic effects were grade 3/4 neutropenia (8.9% of all cycles) and febrile neutropenia was observed in six cycles (2.7% of all cycles).

    CONCLUSION Combination chemotherapy with S-1 and cisplatin was a moderately effective outpatient-based regimen in BTC patients. Toxic effects were moderate but manageable.

    PubMed IF 80.4 혈액종양내과
28. 132008

    제1저자 임수 · 교신저자 박경수

    Lim S, Koo BK, Cho SW, Kihara S, Funahashi T, Cho YM, Kim SY, Lee HK, Shimomura I, Park KS

    Association of adiponectin and resistin with cardiovascular events in Korean patients with type 2 diabetes: the Korean atherosclerosis study (KAS): a 42-month prospective study.

    Atherosclerosis. 2008;196(1):398-404.

    Abstract

    Adiponectin and resistin are proteins that affect insulin resistance and atherosclerosis significantly. We investigated adiponectin and resistin concentrations as predictors of cardiovascular events in Korean patients with type 2 diabetes. The study in 2001 comprised 343 unrelated patients with type 2 diabetes (65+/-9.2 years old). They were followed up for 42 months. The baseline duration of diabetes, smoking status and history of cardiovascular diseases (CVD) were recorded. BMI, blood pressures, HbA1c, lipid profiles, ECG, creatinine and urine microalbumin were measured. Adiponectin and resistin were measured using enzyme-linked immunosorbent assays. The primary endpoint was defined as one of cardiovascular death, myocardial infarct, CABG, stroke, unstable angina or overt nephropathy. Thirty-eight patients (11.1%) experienced primary endpoint during the follow-up. After adjustment for age, sex, BMI, blood pressure and lipid status, participants in the lowest quartile of adiponectin levels compared with the highest had significantly increased risk of primary endpoint (relative risk=3.03; 95% CI 1.09-8.41; p=0.034). In contrast, resistin level had no influence on the risk of primary endpoint. A low level of adiponectin, not resistin, was a significant risk factor for the development of cardiovascular events in these Korean patients with type 2 diabetes.

    PubMed IF 7.1 내분비대사내과
29. 122008

    제1저자 예병덕 · 교신저자 김상균

    Ye BD, Kim SG, Lee JY, Kim JS, Yang HK, Kim WH, Jung HC, Lee KU, Song IS

    Predictive factors for lymph node metastasis and endoscopic treatment strategies for undifferentiated early gastric cancer.

    J Gastroenterol Hepatol. 2008;23(1):46-50.

    Abstract

    BACKGROUND AND AIM Although more than 80% of undifferentiated early gastric cancers (EGC) are not associated with lymph node metastasis, endoscopic mucosal resection is not generally accepted as a means of curative treatment because of an abundance of conflicting data concerning clinicopathological characteristics and prognoses. The aim of this study was to define a subgroup of undifferentiated EGC that could be cured by endoscopic treatment without the risk of lymph node metastasis.

    METHOD A total of 591 patients surgically resected for undifferentiated EGC between January 1999 and March 2005 were reviewed. Associations between various clinicopathological factors and the presence of lymph node metastasis were analyzed to identify the risk factors of lymph node metastasis.

    RESULTS Lymph node metastasis was found in 79 patients (13.4%). By multivariate logistic regression analysis, a tumor diameter 2.5 cm or larger, invasion into the middle third of the submucosal layer or deeper, and lymphatic involvement were identified as independent risk factors of lymph node metastasis (P < 0.001, respectively). Lymph node metastasis was not found in any patient with undifferentiated EGC smaller than 2.5 cm confined to the mucosa or upper third of the submucosal layer without lymphatic involvement.

    CONCLUSIONS Undifferentiated intramucosal EGC smaller than 2.5 cm without lymphatic involvement was not associated with lymph node metastasis. Thus, we propose in this circumstance that endoscopic mucosal resection could be considered a definitive treatment without compromising the possibility of cure.

    PubMed IF 3.5 소화기내과
30. 112008

    제1저자 방지환 · 교신저자 김남중

    Bang JI, Song KH, Kim SH, Cho JH, Park WB, Park SW, Kim HB, Kim NJ, Oh MD, Choe KW

    Prevalence of primary antiretroviral resistance: trends in Korea.

    AIDS Res Hum Retroviruses. 2008;24(1):83-5.

    Abstract

    Primary drug resistance is an emerging problem in HIV infections. We have investigated the current prevalence of primary resistance in Korea and compared it with previous data. Drug-naive HIV patients attending the outpatient clinic of Seoul National University Hospital between April and August 2006 were enrolled. A medical interview and a genotypic resistance test were performed for each patient. The International AIDS Society-USA Panel consensus statement issued in 2006 was used to define resistance mutations. Eighty-one drug-naive HIV patients were enrolled. Two (2.5%) were infected with primary drug-resistant virus: M41L and K103N, respectively. In our previous study, conducted between 1998 and 2002, three (6%) of 50 subjects harbored resistant viruses. Thus the frequency of primary resistance was lower in the present sample than in the earlier one, though the difference is not statistically significant (p = 0.37). In view of our findings, routine antiretroviral resistance tests for drug-naive HIV patients are not obligatory in Korea.

    PubMed IF 1 감염내과

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