SCI 발표논문

2009년 146편

262009

제1저자 김혜진 · 교신저자 이근욱

, , , , , ,
Chemotherapy-induced transient CEA and CA19-9 surges in patients with metastatic or recurrent gastric cancer.
Acta Oncol. 2009;48(3):385-90.

Abstract
BACKGROUND Rising serum tumor markers after chemotherapy are generally considered to indicate tumor progression. However, we have observed a transient increase in carcinoembryonic antigen (CEA) or carbohydrate antigen 19-9 (CA19-9) levels despite clinical benefits from chemotherapy in patients with metastatic or recurrent gastric cancer (MRGC). Therefore, this study was performed to determine the incidence of CEA and CA19-9 surges and their implications on the clinical outcome in MRGC patients.
MATERIAL AND METHODS Fifty-one and 40 patients who had evaluable data for CEA or CA19-9 surges, respectively, were included. Both CEA and CA 19-9 surges were defined as a > 20% increase in these tumor markers from the baseline that was followed by a > 20% drop in subsequent levels compared to the baseline.
RESULTS Of 51 evaluable patients for CEA surges, nine patients (18%) had documented CEA surges. The median time to CEA peak and the duration of the CEA surge were 2.8 (1.7 approximately 7.0) and 9.1 weeks (7.6 approximately 21.0), respectively. Of 40 evaluable patients for CA19-9 surges, seven patients (18%) had CA19-9 surges. The median time to peak and the duration of the CA19-9 surge were 2.3 (1.9 approximately 6.0) and 7.1 weeks (4.3 approximately 16.1), respectively. All patients with CEA or CA19-9 surges had radiographic evidence of benefits from chemotherapy.
CONCLUSION CEA or CA19-9 surges can be observed in MRGC patients receiving chemotherapy. All patients with these surge phenomena had clinical benefits from chemotherapy. An initial rise in CEA or CA19-9 levels after initiation of chemotherapy should not be used as an indicator of progressive disease.
PubMed IF 2.7 혈액종양내과
252009

제1저자 임수 · 교신저자 이홍규

, , , , , , , ,
Fat in liver/muscle correlates more strongly with insulin sensitivity in rats than abdominal fat.
Obesity (Silver Spring). 2009;17(1):188-95.

Abstract
Intrahepatic or intramuscular lipid (IHL/IML) content has been reported to be correlated with insulin resistance. Visceral fat has also been shown to be associated with insulin resistance. Thus, we investigated whether IHL/IML or visceral fat content is more closely associated with insulin resistance. Twenty Sprague-Dawley rats were divided into two groups based on regular chow diet (RCD) or high-fat diet (HFD; 40% fat). The insulin-sensitivity index (ISI) was determined by euglycemic glucose clamp study, the amount of visceral fat by computed tomography (CT), and the IHL/IML content by magnetic resonance spectroscopy (MRS). Weight, food, and water intake, physical activity, energy expenditure, lipid profile, adiponectin, and high-sensitivity C-reactive protein (hsCRP) levels were measured. At the study end point, visceral fat, and the IHL/IML content were higher in the HFD group than in the RCD group. The IHL/IML content was more highly correlated with ISI than was visceral fat amount. Stronger correlations were also found between adiponectin or hsCRP level and IML/IHL content than visceral fat, especially in the HFD group. Furthermore, the IHL/IML content was significantly associated with the ISI in the multiple regression models but visceral fat was not. There was clear discrimination between RCD and HFD groups in scatter plots of IML/IHL against the ISI, but substantial overlap in that of visceral fat against the ISI. This result suggests that IHL/IML contents are closely related with insulin resistance or atherosclerosis and is a better metabolic index of insulin sensitivity than the visceral fat.
PubMed IF 4.9 내분비대사내과
242009

제1저자 김형일 · 교신저자 박경수

, , , , , , , , , ,
The effect of composite pig islet-human endothelial cell grafts on the instant blood-mediated inflammatory reaction.
Cell Transplant. 2009;18(1):31-7.

Abstract
Instant blood-mediated inflammatory reaction (IBMIR) causes rapid islet loss in portal vein islet transplantation. Endothelial cells are known to protect against complement-mediated lysis and activation of coagulation. We tested composite pig islet-human endothelial cell grafts as a strategy to overcome IBMIR. Porcine islets were cocultured with human endothelial cells in specially modified culture medium composed of M199 and M200 for 1-9 days. A positive control group, negative control group, and the endothelial cell-coated group were examined with an in vitro tubing loop assay using human blood. The endothelial cell-coated group was subdivided and analyzed by degree of surface coverage by endothelial cells (< or = 50% vs. > 50%) or coculture time (< 5 days vs. > or = 5 days). Platelet consumption and complement and coagulation activation were assessed by platelet count, C3a, and thrombin-antithrombin complex (TAT), respectively. After 60-min incubation in human blood, the endothelial cell-coated group showed platelet consumption inhibition and low C3a and TAT assay results compared to uncoated controls. When the endothelial cell-coated group was subdivided by degree of surface coverage, the < or = 50% coated group showed less platelet consumption and less activation of complement and coagulation compared with the positive control (uncoated) group. On analysis by coculture time, only the subgroup cocultured for < 5 days showed the same protective effect. Human endothelial cell-coated pig islets, especially the partially coated and short-term cocultured pig islet-human endothelial cell composites, reduced all components of IBMIR. If the optimal endothelial cell-islet coculture method could be identified, human endothelial cell coating of pig islets would offer new strategies to improve xenogenic islet transplantation outcomes.
PubMed IF 3.7 내분비대사내과
232009

제1저자 강은하 · 교신저자 송영욱

, , , , , ,
Renal expression of galectin-3 in systemic lupus erythematosus patients with nephritis.
Lupus. 2009;18(1):22-8.

Abstract
The aim of the study is to characterize the expression pattern of galectin-3 (Gal-3) in renal tissues of patients with systemic lupus erythematosus (SLE) nephritis and to determine whether tissue and serum Gal-3 are associated with SLE nephritis. Gal-3 expressions were examined with immunohistochemistry in renal biopsy specimens of 88 patients with SLE nephritis and in five normal specimens. Activity and chronicity indexes and glomerular Gal-3 expressions were analysed in each specimen. Serum Gal-3 levels were measured using enzyme-linked immunosorbent assays in 20 patients with SLE, including 11 with nephritis, and in 50 healthy controls. Glomerular Gal-3 expression was observed in 81.8% (72/88) of patients with SLE nephritis but not in 5 controls. Gal-3 staining was attributed mainly to its cellular expression rather than its deposition, and Gal-3 expression levels were correlated with histologic activity indexes, anti-dsDNA titers, and complement 3 and 4 levels. Serum Gal-3 levels were higher in patients with SLE, particularly in those with nephritis, than in healthy controls, and correlated with anti-dsDNA titers. In conclusion, glomerular Gal-3 expression in renal tissue and serum Gal-3 levels were elevated in patients with SLE nephritis versus healthy controls; moreover, they reflected disease activity. These findings suggest that Gal-3 might contribute to the inflammatory process in SLE.
PubMed IF 1.8 류마티스내과
222009

제1저자 김병수 · 교신저자 허대석

, , , , , , , , , ,
Effective second-line chemotherapy for extranodal NK/T-cell lymphoma consisting of etoposide, ifosfamide, methotrexate, and prednisolone.
Ann Oncol. 2009;20(1):121-8.

Abstract
BACKGROUND Many patients with extranodal natural killer/T-cell lymphoma (NTCL) fail to the front-line therapy and need an effective second-line chemotherapy.
PATIENTS AND METHODS This was single-institutional, phase II study. The primary end point was response rate and secondary end points were toxicity, time to treatment failure (TTF), and overall survival (OS). Patients with relapsed or refractory NTCL were eligible. They received the chemotherapy consisting of ifosfamide, methotrexate, etoposide, and prednisolone and it was repeated every 3 weeks.
RESULTS Thirty-two patients were enrolled and 15 patients had achieved partial remission (PR) or complete remission (CR) after the front-line chemotherapy. The International Prognostic Index scores were 0-1 in thirteen, 2 in five, 3 in five, and 4-5 in nine patients. Twelve and two patients achieved CR and PR, respectively. Median OS and TTF of all patients were 8.2 and 3.7 months, respectively. Non-hematologic toxic effects were well tolerated, but grade 3/4 leukopenia occurred in 11.7% of all cycles. Four patients developed febrile neutropenia and one patient died due to pneumonia.
CONCLUSIONS This chemotherapy regimen was moderately effective for relapsed/refractory extranodal NTCL, nasal type. Toxic effects were moderate, but caution should be exercised to prevent severe infection.
PubMed IF 80.4 혈액종양내과
212009

제1저자 김형관 · 교신저자 김용진

, , , , , ,
Impact of cardiac rhythm on mitral valve area calculated by the pressure half time method in patients with moderate or severe mitral stenosis.
J Am Soc Echocardiogr. 2009;22(1):42-7.

Abstract
BACKGROUND The pressure half-time (PHT) method has been widely used to estimate mitral valve area (MVA) in patients with mitral stenosis (MS), in the belief that this simple method provides reliable information on true MVA. However, its limitation has been repeatedly recognized under different circumstances. The aim of this study was to evaluate the effect of cardiac rhythm on PHT-derived MVA calculation in relation to net atrioventricular compliance (C(n)).
METHODS Patients (n = 41) with rheumatic pure moderate or severe MS were consecutively recruited. Eighteen patients with sinus rhythm were allocated to group 1 and the remaining patients with chronic atrial fibrillation to group 2. MVA was obtained using the PHT method and by planimetry (considered the gold standard in this study). C(n) was calculated with a previously validated equation.
RESULTS There were no differences between the 2 groups in terms of age, gender, left ventricular dimensions or ejection fraction, or transmitral pressure gradient. Left atrial volume index (134.6 +/- 106.7 vs 79.2 +/- 16.8 mL; P = .003) and C(n) (6.6 +/- 1.5 vs 4.7 +/- 1.2 mL/mm Hg; P < .001) were higher in group 2 than in group 1. Disagreement of MVA estimation by PHT compared with that by 2-dimensional planimetry was 8.0 +/- 19.2% for group 1 and -24.9 +/- 13.9% for group 2 (P = .002). In addition, the extent of disagreement of PHT-derived MVA compared with that by 2-dimensional planimetry was significantly correlated with C(n) (r(2) = 0.71, P < .001). MVA by the PHT method was estimated to be substantially higher in patients with C(n) values < 4 mL/mm Hg, most of whom were in sinus rhythm. Multivariate analysis confirmed the independent association of cardiac rhythm with discrepancy of PHT-derived MVA compared with that by planimetry.
CONCLUSION Changes in cardiac rhythm with associated modifications of C(n) can alter the accuracy of the PHT method for estimating MVA. Given the limitation described here, 2-dimensional planimetry, not the PHT method, should be used as a primary echocardiographic tool for MVA calculation.
PubMed IF 8.3 순환기내과
202009

제1저자 강경필 · 교신저자 김나영

, , , , , , , , ,
Role of intestinal metaplasia subtyping in the risk of gastric cancer in Korea.
J Gastroenterol Hepatol. 2009;24(1):140-8.

Abstract
BACKGROUND AND AIM Gastric cancer is believed to develop by a multistage process. Intestinal metaplasia (IM) is regarded as a premalignant condition; it is classified into subtypes I, II and III. The aim of this study was to evaluate whether the subtypes of IM were associated with progression to gastric cancer.
METHODS The study cohort consisted of 861 subjects, categorized as controls, gastric ulcers, dysplasia and cancer. The IM was scored histologically using the Sydney classification for the antrum and the body of the stomach. The biopsies were stained with high iron diamine and alcian blue (pH 2.5) (HID-AB2.5), and the IM was subtyped as I, II or III.
RESULTS The proportion of IM subtypes I, II and III were 14.5%, 47.2% and 38.3% in the antrum, and 28.1%, 57.8% and 14.1% in the body of the stomach, respectively. These distributions did not show significant differences depending on disease or Helicobacter pylori positivity. In cases that were H. pylori-positive, the prevalence of IM subtype II in the cancer and dysplasia groups was higher than in the control group in the body of the stomach (P < 0.05). The proportion of IM subtype III in the antrum increased in proportion with age (P = 0.036).
CONCLUSIONS IM subtyping was not found to play a major role in the prediction of gastric cancer development in Korea. IM subtype III was associated with aging, and IM subtype II appeared to be related to gastric carcinogenesis in the presence of H. pylori infection.
PubMed IF 3.5 소화기내과
192009

제1저자 우상명 · 교신저자 류지곤

, , , , , , , , ,
Feasibility of endoscopic papillectomy in early stage ampulla of Vater cancer.
J Gastroenterol Hepatol. 2009;24(1):120-4.

Abstract
BACKGROUND AND AIM Although endoscopic papillectomy has been attempted in early stage ampullary cancer (pTis, T1), its curative role and indications remain uncertain. The present study was designed to assess the factors that predict malignancy and lymph node metastasis and to suggest potential indications for endoscopic papillectomy by analyzing clinicopathological data.
METHODS We performed a retrospective analysis of clinical and histopathological data of 216 patients with ampullary cancer between 1991 and 2006.
RESULTS No tumor in pTis stage had metastasized to lymph nodes and only 9% of tumors in pT1 had metastasized. Tumor size (P = 0.018), depth of invasion (P = 0.021) and venous invasion (P = 0.014) were found to be significantly related to lymph node metastasis. Cases with early stage ampullary cancer of less than 2 cm with a well-differentiated histology and no angiolymphatic invasion (n = 13) showed no lymph node metastasis and no recurrence during a median follow up of 35.9 months.
CONCLUSION Endoscopic papillectomy can be adopted as a viable alternative to surgery in patients with early stage ampullary cancer of less than 2 cm in size and with a well-differentiated histology. When a resected specimen has a well-differentiated histology, and there is no resection margin involvement and no angiolymphatic invasion, our findings indicate that subsequent radical surgery is unnecessary.
PubMed IF 3.5 소화기내과
182009

제1저자 김진현 · 교신저자 송영욱

, , , , , , , ,
Serum levels of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) and pentraxin 3 (PTX3) as markers of infection in febrile patients with systemic lupus erythematosus.
Clin Exp Rheumatol. 2009;27(5):773-8.

Abstract
OBJECTIVE To investigate the role of sTREM-1 and PTX3 as markers of infection in febrile patients with SLE.
METHODS In febrile (body temperature > or =38 degrees C) patients with SLE, blood samples of day 0, 1, 2, and 14 after presentation were drawn and relevant clinical data were collected. The patients were allocated to an infection group (n=19) or disease flare group (n=14). Serum levels of sTREM-1 and PTX3 were measured by ELISA using the serum samples of SLE patients and age- and sex-matched healthy controls (n=31).
RESULTS A total of 33 febrile episodes occurred in 32 SLE patients (19 infections, 14 flares) were studied. sTREM-1 levels on day 0 were significantly higher in the infection group than in the flare group (109.9 pg/ml (median) vs. 48.0 pg/ml, p=0.002), but PTX3 levels were similar in these two groups. The difference of sTREM-1 levels between infection group and flare group was persistent on day 1 and 2 (day 1, p=0.007; day 2, p=0.034). The highest diagnostic value (sensitivity=1.0, specificity=0.664) of sTREM-1 was obtained at the threshold value of 53.2 pg/mL.
CONCLUSION Serum sTREM-1 levels were significantly higher in the infection group than in the flare group of febrile SLE patients. Our findings suggest that serum sTREM-1 levels could be used to determine whether SLE patients have contracted an infection.
PubMed IF 3.2 류마티스내과
172009

제1저자 김진현 · 교신저자 송영욱

, , , , , ,
Mannose-binding lectin gene-2 polymorphisms and serum mannose-binding lectin levels in Behçet's disease.
Clin Exp Rheumatol. 2009;27(2 Suppl 53):S13-7.

Abstract
OBJECTIVE Behçet's disease (BD) is an autoimmune disease with an unknown etiology and mannose-binding lectin (MBL) is a pattern recognition receptor in the innate immune system, which is associated with some autoimmune diseases. We investigated MBL2 gene polymorphisms and serum MBL levels in BD patients and controls.
METHODS MBL2 gene polymorphisms in exon 1 (MBL2 54 Gly/Asp, (A/B)), promoter (MBL2 H/L (G-550C), MBL2 Y/X (G-221C)), and 5' UTR region (MBL2 P/Q (C+4T)) were investigated using polymerase chain reaction and restriction fragment length polymorphism in 119 BD patients and 252 healthy controls. Serum MBL levels were measured by enzyme linked immunosorbent assay in 49 BD patients and 102 sex-/genotype-matched controls.
RESULTS No significant difference was found between BD patients and controls in terms of MBL2 polymorphisms and MBL serum levels. However, the presence of genital ulcer and neurologic involvement were found to be associated with MBL2 54 allele A (OR=2.415, OR=6.632, respectively). Eye involvement was found to be related to the presence of the MBL2 54 AA or AB genotypes (OR=12.46), MBL2-G-550C allele H (OR=1.829). High serum MBL level (> or =500 ng/ml) was associated with skin lesions (p=0.002).
CONCLUSION The frequencies of the four MBL2 genetic polymorphisms examined were not different in BD patients and healthy controls. However, the presence of genital ulcer, eye involvement, and neuro-Behcet's disease were found to be associated with MBL2 polymorphisms that are associated with the production of high levels of MBL or functional MBL.
PubMed IF 3.2 류마티스내과
162009

제1저자 임철현 · 교신저자 송영욱

, , , , , , , , , ,
Receptor activator of nuclear factor kappa B ligand-mediated osteoclastogenesis is elevated in ankylosing spondylitis.
Clin Exp Rheumatol. 2009;27(4):620-5.

Abstract
OBJECTIVE Ankylosing spondylitis (AS) is an inflammatory arthritis involving the axial skeleton. Decreased bone mineral density has also been reported in AS patients. This study sought to determine whether osteoclastogenesis and osteoclast activity are increased in AS.
METHODS Twenty patients with AS were evaluated using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and other clinical parameters. Mononuclear cells were separated out from peripheral blood samples taken from AS patients and normal healthy controls and cultured with monocyte colony stimulating factor and receptor activator of the nuclear factor kappa B ligand (RANKL). Multi-nucleated, tartrate-resistant acid phosphatase stain-positive osteoclasts were counted after 9 days, and the areas of calcium absorption on calcium-coated plates were determined.
RESULTS Osteoclastogenesis was significantly greater in AS patients than in normal controls (number of osteoclasts/1106 mononuclear cells, median, 518.0 vs. 362.5, p=0.036). No differences were observed between AS patients and controls in terms of calcium absorption areas or the serum concentrations of tumor necrosis factor and RANKL. Osteoclastogenesis was greater in AS patients with sacroiliac joint ankylosis than in those without. Osteoclastogenesis and the calcium absorption area were not found to be correlated with BASDAI nor with other clinical parameters including age, erythrocyte sedimentation rate, and C-reactive protein levels.
CONCLUSION Osteoclastogenesis is elevated in AS patients, especially in those with sacroiliac joint ankylosis. Increased osteoclastogenesis may be related to osteopenia in AS patients.
PubMed IF 3.2 류마티스내과
152009

제1저자 이정훈 · 교신저자 윤정환

, , , , , , , ,
Enterococcus: not an innocent bystander in cirrhotic patients with spontaneous bacterial peritonitis.
Eur J Clin Microbiol Infect Dis. 2009;28(1):21-6.

Abstract
Clinicians sometimes experience treatment failure in the initial empirical antibiotics treatment using cephalosporins in cirrhotic patients with spontaneous bacterial peritonitis (SBP). Enterococcus, which is intrinsically resistant to cephalosporins, may be one of the causes of treatment failure. The aim of this study was to evaluate the clinical importance and the clinical characteristics of spontaneous enterococcal peritonitis (SEP). This was a retrospective cohort study of 359 patients with SBP treated in a single tertiary care center in South Korea from January 2000 through December 2004. We evaluated the clinical manifestation and the treatment results of SBP patients with enterococci identified from ascites culture. During the observation period, 13 of 359 patients (3.6%) diagnosed with culture-positive SBP had enterococcal peritonitis. For the initial empirical treatment, third-generation cephalosporins were administered to the 13 patients, ten of whom (76.9%) did not improve in the first 48 h. An in vitro antibiotic sensitivity test showed that the identified enterococci were susceptible to ampicillin plus gentamycin in eight patients (61.5%) and there was no vancomycin-resistant enterococcus. Although antibiotics were changed to antienterococcal antibiotics in 11 patients, only five patients improved. As a result, eight of the 13 patients (61.5%) with enterococcal SBP died during the observation period, and the one-month mortality was significantly higher from enterococcal SBP than from nonenterococcal SBP (P = 0.038). We conclude that enterococcal SBP has poor prognosis and it is reasonable to use antienterococcal antibiotics when enterococcus is identified from ascites culture of patients with liver cirrhosis.
PubMed IF 3.2 소화기내과
142009

제1저자 황영환 · 교신저자 오국환

, , , , , , , ,
Effects of interleukin-6 T15A single nucleotide polymorphism on baseline peritoneal solute transport rate in incident peritoneal dialysis patients.
Perit Dial Int. 2009;29(1):81-8.

Abstract
OBJECTIVE To study the genetic effects of various inflammatory cytokines on peritoneal solute transport rate (PSTR) in incident Korean peritoneal dialysis (PD) patients.
DESIGN Case-control association study.
METHODS 132 patients with baseline peritoneal equilibration test within 1-3 months after starting PD were enrolled. We analyzed the influence of single nucleotide polymorphisms (SNPs) of interleukin-6 (IL-6; -572G/C, T15A), tumor necrosis factor-alpha (TNF-alpha; -1031C/T, -863C/A, -308G/A), and IL-10 (-1082A/G, -592A/C) on baseline PSTR. Clinical parameters such as age, gender, presence of diabetes mellitus, comorbidity, C-reactive protein, and residual renal function were also included as covariates.
RESULTS The T15A SNP of IL-6 (rs13306435) was associated with PSTR. Patients with TA genotype (n=18) had significantly lower D4/P creatinine (0.65+/-0.087 vs 0.73+/-0.110, p=0.0046) and higher D4/D0 glucose (0.39+/-0.174 vs 0.31+/-0.119, p=0.027) than patients with TT genotype (n=114). The log value of the dialysate appearance rate of IL-6 had a strong positive correlation with D4/P creatinine (r2=0.1294, p<0.0001) and was significantly lower in the TA genotype than the TT genotype (201.7+/-14.42 vs 116.8+/-88.91 pg/minute, p=0.0358). By multiple logistic regression, TA genotype was negatively associated with a higher PSTR (high or high average; odds ratio 0.18; 95% confidence interval 0.048-0.666).
CONCLUSIONS In incident Korean PD patients, T15A polymorphism of IL-6 is associated with dialysate IL-6 concentration and baseline PSTR.
PubMed IF 1.8 신장내과
132009

제1저자 정성수 · 교신저자 박경수

, , , , , , , , , ,
Glutathione peroxidase 3 mediates the antioxidant effect of peroxisome proliferator-activated receptor gamma in human skeletal muscle cells.
Mol Cell Biol. 2009;29(1):20-30.

Abstract
Oxidative stress plays an important role in the pathogenesis of insulin resistance and type 2 diabetes mellitus and in diabetic vascular complications. Thiazolidinediones (TZDs), a class of peroxisome proliferator-activated receptor gamma (PPARgamma) agonists, improve insulin sensitivity and are currently used for the treatment of type 2 diabetes mellitus. Here, we show that TZD prevents oxidative stress-induced insulin resistance in human skeletal muscle cells, as indicated by the increase in insulin-stimulated glucose uptake and insulin signaling. Importantly, TZD-mediated activation of PPARgamma induces gene expression of glutathione peroxidase 3 (GPx3), which reduces extracellular H(2)O(2) levels causing insulin resistance in skeletal muscle cells. Inhibition of GPx3 expression prevents the antioxidant effects of TZDs on insulin action in oxidative stress-induced insulin-resistant cells, suggesting that GPx3 is required for the regulation of PPARgamma-mediated antioxidant effects. Furthermore, reduced plasma GPx3 levels were found in patients with type 2 diabetes mellitus and in db/db/DIO mice. Collectively, these results suggest that the antioxidant effect of PPARgamma is exclusively mediated by GPx3 and further imply that GPx3 may be a therapeutic target for insulin resistance and diabetes mellitus.
PubMed IF 2.8 내분비대사내과
122009

제1저자 임철현 · 교신저자 송영욱

, , , , , , ,
Anti-cyclic citrullinated peptide antibody is associated with radiographic erosion in rheumatoid arthritis independently of shared epitope status.
Rheumatol Int. 2009;29(3):251-6.

Abstract
Shared epitope (SE) and anti-cyclic citrullinated peptide (CCP) antibody are known to be associated with rheumatoid arthritis (RA). The authors investigated their adjusted effects on RA from Korean population. Clinical features were evaluated in 226 RA patients; 164 healthy controls were enrolled. HLA-DRB1 typing for SE was done by polymerase chain reaction. Anti-CCP antibody levels were determined by enzyme linked immunosorbent assay. Logistic regression analysis method was used for adjusted effects. SE and anti-CCP antibody were associated with RA susceptibility. Anti-CCP antibody was associated with RA susceptibility independent of SE [odds ratio, OR 179.9 (95% confidence interval, CI 40.8-792.2), P < 0.001]. Anti-CCP antibody was associated with radiographic erosive changes independent of SE or rheumatoid factor [OR 3.9 (95% CI 1.1-13.3), P = 0.032]. Anti-CCP antibody was strongly associated with RA susceptibility and radiographic erosion of RA patients, independent of SE in Korean.
PubMed IF 3.5 류마티스내과
112009

제1저자 이재진 · 교신저자 허대석

, , , , , ,
Neoadjuvant chemotherapy followed by limited surgery in a mouse model of head and neck cancer.
Anticancer Res. 2009;29(1):255-9.

Abstract
BACKGROUND This study evaluated the effect of limited surgery following neoadjuvant chemotherapy compared to radical surgery in SCC VII (squamous cell cancer) tumor-bearing syngeneic C3H/HeJ mice.
MATERIALS AND METHODS Mice showing a tumor response to cisplatin and 5-fluorouracil therapy were divided into three groups: radical surgery, with a 5 mm margin from the original tumor, group (A); limited surgery of 5 mm margin from the residual tumor, group (B); and very limited surgery with no margin from the residual tumor, group (C). The number of mice was 13 (group A), 12 (group B) and 12 (group C).
RESULTS No recurrence developed except in one mouse in group C. Three mice died in group A, one in group B and one in group C from perioperative complications. By intent-to-treat analysis, the survival was not significantly different among the three groups (p = 0.64), or between group A and B (p = 0.33).
CONCLUSION The outcome of limited surgery was comparable to radical surgery after neoadjuvant chemotherapy in the mouse model of head and neck cancer.
PubMed IF 1.8 혈액종양내과
102009

제1저자 선종무 · 교신저자 이종석

, , , , , , ,
Efficacy and toxicity of pemetrexed as a third-line treatment for non-small cell lung cancer.
Jpn J Clin Oncol. 2009;39(1):27-32.

Abstract
OBJECTIVE Pemetrexed has been approved for second-line treatment in non-small cell lung cancer (NSCLC). However, the role of third-line pemetrexed therapy in NSCLC has not yet been generally accepted. We attempted to validate third-line pemetrexed therapy and evaluate predictive factors for pemetrexed therapy for NSCLC.
METHODS Medical records of NSCLC patients who received pemetrexed therapy that progressed after systemic therapy were reviewed retrospectively. We stratified patients according to clinicopathologic characteristics to find predictive factors for pemetrexed therapy.
RESULTS A total of 100 patients were eligible for analysis, and overall progression-free survival (PFS) was 3.03 months. The objective response rate was 12%, and the toxicity profile was favorable. Pemetrexed was used as a second-line treatment in 30% of patients, and as third- or further-line treatment in 70%. Comparing the efficacy of pemetrexed in these two settings (second-line versus third- or further-line), there was no significant difference in terms of PFS (3.07 versus 2.83 months, P = 0.86). When we evaluated predictive factors by multivariate analysis, performance status significantly influenced PFS.
CONCLUSIONS Pemetrexed is a suitable third-line treatment option with good efficacy and tolerable toxicity profile for NSCLC.
PubMed IF 2.5 혈액종양내과
92009

제1저자 강정묵 · 교신저자 김나영

, , , , , , ,
The effects of genetic polymorphisms of IL-6, IL-8, and IL-10 on Helicobacter pylori-induced gastroduodenal diseases in Korea.
J Clin Gastroenterol. 2009;43(5):420-8.

Abstract
BACKGROUND The genes that encode proinflammatory and anti-inflammatory cytokines are good candidate markers of host susceptibility to gastroduodenal disease. The present study was performed to evaluate whether or not the genetic polymorphisms of IL-6, IL-8, and IL-10 are associated with gastroduodenal disease in the Korean population.
METHODS This study enrolled 1187 patients, including controls, those with gastric cancer (GC), benign gastric ulcer (BGU), and duodenal ulcer patients. Six polymorphisms were genotyped, 3 of IL-10 (at -592, -819, and -1082), 1 of IL-8 (at -251), and 2 of IL-6 (at -174 and -572), by polymerase chain reaction-restriction fragment length polymorphism analysis.
RESULTS The frequency of IL-10-1082 G carriers was higher in cases of a diffuse type GC [odds ratio (OR) 1.8, 95% confidence interval (CI): 1.0-3.1, P=0.041] or BGU (OR 1.6, 95% CI: 1.0-2.5, P=0.040), than in the control group regardless of Helicobacter pylori infection. The IL-8-251 A/A genotype was more common in H. pylori-positive patients with GC (OR 2.0, 95% CI: 1.2-3.6, P=0.013) or BGU (OR 2.7, 95% CI: 1.5-4.8, P=0.001) than in H. pylori-positive controls. In addition, the frequencies of IL-6-572 G/G (OR 0.3, 95% CI: 0.1-0.9, P=0.027) and of G carriers (OR 0.5, 95% CI: 0.4-0.8, P=0.003) were lower in H. pylori-positive duodenal ulcer patients than in H. pylori-positive controls. IL-10-592 C/C (OR 0.4, 95% CI: 0.2-0.9, P=0.028) was an independent factor associated with a decreased risk of the intestinal type of GC by multivariate analysis. Furthermore, a synergistic effect was observed between IL-10-592 A/A and IL-8-251 A/A with respect to the development of GC or BGU.
CONCLUSIONS These results suggest that the genetic polymorphisms of these 3 inflammation-related cytokines, IL-10, IL-8, and IL-6, are associated with the development of H. pylori-associated gastroduodenal disease.
PubMed IF 2.7 소화기내과
82009

제1저자 김혜련 · 교신저자 임재준

, , , , ,
Increased CA 19-9 level in patients without malignant disease.
Clin Chem Lab Med. 2009;47(6):750-4.

Abstract
BACKGROUND The measurement of carbohydrate antigen 19-9 (CA 19-9) is recommended for the diagnosis and follow-up of pancreatic cancer. However, increased CA 19-9 has also been reported in patients with various benign diseases of the lung. We aimed to elucidate the pulmonary radiographic abnormalities and laboratory results associated with increased concentrations of CA 19-9.
METHODS This study was performed using a case-controlled design. Cases included all participants in a cancer screening program who had an increased CA 19-9 concentration (>37 U/mL), but without a diagnosis of malignancy. Age- and sex-matched participants with normal CA 19-9 levels were enrolled as controls. Laboratory results and radiographic features were compared.
RESULTS In total, 119 participants with increased CA 19-9 concentrations and 476 controls were included. A higher erythrocyte sedimentation rate (ESR) [adjusted odd ratio (aOR), 1.03; 95% confidence interval (CI), 1.01-1.05], higher hemoglobin A(1c) (HbA(1c)) (aOR, 1.28; 95% CI, 1.05-1.56), bronchiectasis (aOR, 2.48; 95% CI, 1.22-5.02), bronchiolitis (aOR, 3.93; 95% CI, 1.88-8.22), emphysema (aOR, 2.67; 95% CI, 1.32-5.40), and interstitial fibrosis (aOR, 10.62; 95% CI, 2.03-55.44) were independent factors for increased CA 19-9.
CONCLUSIONS CA 19-9 concentrations, as well as increased ESR and HbA(1c), can be increased in patients with various lung abnormalities.
PubMed IF 4.4 호흡기내과
72009

제1저자 조영석 · 교신저자 임 청

, , , , , , ,
Should we consider the ethnic difference in selecting size of intraaortic balloon by commercial guideline?
ASAIO J. 2009;55(5):519-22.

Abstract
To evaluate the appropriateness of commercial guideline in selecting the size of balloon for intraaortic counterpulsation in Asian patients, we analyzed the relationship between aortic dimensions measured from computed tomography and body indexes. There were 125 patients who underwent the computed tomography. They were divided into three height groups [<152 cm (I), 152-162 cm (II), and 163-183 cm (III)]. Aortic length and diameter were obtained from the origin of left subclavian artery to the orifice of renal artery. We compared those measurements with the balloon size according to the commercial guideline. Aortic lengths were measured as 250 +/- 15 (233-289), 262 +/-16 (227-298), and 285 +/- 19 (239-334) mm in each group, respectively. As the guideline, if we insert the balloon of 25 ml/191 mm, 34 ml/236 mm, and 40 ml/280 mm, there will be 29 of 66 patients (44%) in group III, who have shorter aortic length, with increased risk of obstructing renal artery. In addition, the younger the patient the higher is the risk (p = 0.038). We should pay attention to proper positioning of intraaortic balloon in younger Asian patients with 163-183 cm height, in applying the commercial guideline to prevent renal arterial obstruction.
PubMed IF 2.2 순환기내과
62009

제1저자 장은선 · 교신저자 이동호

, , , , , , , , , , ,
Age as a clinical predictor of relapse after induction therapy in ulcerative colitis.
Hepatogastroenterology. 2009;56(94-95):1304-9.

Abstract
BACKGROUND/AIMS Whether older patients with ulcerative colitis (UC) have a better clinical course than younger patients is unclear. We compared the clinical characteristics between older and younger age groups in South Korea to elucidate the impact of age on relapse in UC.
METHODOLOGY Patients between 18 and 85 years old who were diagnosed with UC at Seoul National University Bundang Hospital between 1 May 2003 and 31 Oct 2007 were enrolled. It was reviewed their symptoms, endoscopic and pathologic findings, and drugs used in induction treatment.
RESULTS Of the 73 patients with UC who achieved remission after induction treatment, 38 relapsed. The patients aged 18-44 and 45-85 years had similar clinical features, but the relapse rate was significantly higher in the younger group (69.2 vs. 32.4%; p = 0.002). In a multivariable analysis, age 45-85 years old was an independent protective factor against relapse (OR, 0.146; 95% CI, 0.035-0.508; p = 0.003) after adjusting for sex, frequency of diarrhea, hematochezia grade, disease extent, and systemic steroid used in induction treatment.
CONCLUSION An age of 45 years or older is an independent predictor of less relapse in UC.
PubMed IF 0.68 소화기내과
52009

제1저자 임수 · 교신저자 장학철

, , , , , , , , , ,
Effect of ginsam, a vinegar extract from Panax ginseng, on body weight and glucose homeostasis in an obese insulin-resistant rat model.
Metabolism. 2009;58(1):8-15.

Abstract
Extracts of ginseng species show antihyperglycemic activity. We evaluated the antihyperglycemic and antiobesity effects of ginsam, a component of Panax ginseng produced by vinegar extraction, which is enriched in the ginsenoside Rg3. Otsuka Long-Evans Tokushima Fatty rats, an obese insulin-resistant rat model, were assigned into 1 of 3 groups (n = 8 each): controls (isotonic sodium chloride solution, 5 mL/d), rats given 300 mg/(kg d) ginsam, and rats given 500 mg/(kg d) ginsam. An intraperitoneal 2-hour glucose tolerance test was performed at the end of the 6-week treatment. After 8 weeks, body and liver weights, visceral fat measured by computed tomography, and fasting glucose and insulin concentrations and lipid profiles were recorded. Insulin-resistant rats treated with ginsam had lower fasting and postprandial glucose concentrations compared with vehicle-treated rats. Importantly, overall glucose excursion during the intraperitoneal 2-hour glucose tolerance test decreased by 21.5% (P < .01) in the treated rats, indicating improved glucose tolerance. Plasma insulin concentration was significantly lower in ginsam-treated rats. These changes may be related to increased glucose transporter 4 expression in skeletal muscle. Interestingly, when the data from both ginsam-treated groups were combined, body weight was 60% lower in the ginsam-treated rats than in the controls (P < .01). Liver weight and serum alanine aminotransferase concentrations were also lower in the ginsam-treated rats. These effects were associated with increased peroxisome proliferator-activated receptor gamma expression and adenosine monophosphate-activated protein kinase phosphorylation in liver and muscle. Our data suggest that ginsam has distinct beneficial effects on glucose metabolism and body weight control in an obese animal model of insulin resistance by changing the expression of genes involved in glucose and fatty acid metabolism.
PubMed IF 16.7 내분비대사내과
42009

제1저자 김진택 · 교신저자 박경수

, , , , , , , , ,
Polymorphisms of ADIPOR1 and ADIPOR2 are associated with phenotypes of type 2 diabetes in Koreans.
Clin Endocrinol (Oxf). 2009;70(1):66-74.

Abstract
OBJECTIVE Adiponectin receptors 1 and 2 (ADIPOR1 and ADIPOR2) are considered as candidate genes for type 2 diabetes because they mediate the metabolic effects of adiponectin on target tissues. We investigated whether common polymorphisms of ADIPOR1 and ADIPOR2 are associated with type 2 diabetes or its related phenotypes in Koreans.
DESIGN AND PATIENTS By sequencing of the DNA samples from 24 unrelated Korean subjects, we selected seven single nucleotide polymorphisms (SNPs) from ADIPOR1 and four SNPs from ADIPOR2 for genotyping in 757 type 2 diabetic patients and 644 nondiabetic subjects.
RESULTS None of the SNPs were associated with the risk of type 2 diabetes. However, g.-7309A>G (rs75172865) in ADIPOR1 was associated with lower insulin resistance, measured by the homeostasis model assessment of insulin resistance (HOMA-IR). Thereafter, we transfected three different human cell lines with plasmids harbouring g.-7309A>G and found that this variant reduced the promoter activity of ADIPOR1. In ADIPOR2, g.-63442G (novel SNP) and g.33447T (rs1044471) were associated with smaller waist circumference.
CONCLUSIONS None of the SNPs in either ADIPOR1 or ADIPOR2 were associated with the risk of type 2 diabetes in Koreans. However, the altered activity of the ADIPOR1 promoter was associated with insulin resistance and SNPs of ADIPOR2 were associated with waist circumference.
PubMed IF 2.8 내분비대사내과
32009

제1저자 이은경 · 교신저자 조영민

, , , , , , , , ,
Derivation of a new equation for estimating creatinine clearance by using fat-free mass and serum creatinine concentration in Korean patients with type 2 diabetes mellitus.
Diabetes Res Clin Pract. 2009;83(1):44-9.

Abstract
AIMS Equations to predict creatinine clearance (Ccr) or glomerular filtration rate have limitations in applying to a wide range of ethnicities with different fat-free mass (FFM). We aimed to determine the serum creatinine (Scr) concentrations that indicate renal insufficiency and formulate a new equation to estimate Ccr by a function of FFM in Korean type 2 diabetic patients.
METHODS Ccr was measured in 283 type 2 diabetic patients by 24-h urine collection. Receiver operating characteristic (ROC) curve was used to determine the Scr concentration corresponding to a Ccr of 60 mL min(-1) x 1.73 m(-2). A new equation to predict Ccr was derived by using Scr and FFM.
RESULTS The Scr concentration corresponding to a Ccr of 60 mL min(-1) x 1.73 m(-2) was 1.15 mg/dL in men and 0.95 mg/dL in women. The regression equation estimating the Ccr was expressed as (1.72 x FFM-0.23 x age)/Scr, and it showed a good correlation with the measured Ccr (r=0.718, P<0.001).
CONCLUSIONS Scr concentrations indicating renal insufficiency in the Korean patients were considerably lower than those in Caucasians. The equation derived in this study would be more useful in Korean or other Asian type 2 diabetic patients.
PubMed IF 4.6 내분비대사내과
22009

제1저자 이승헌 · 교신저자 임재준

, , ,
Effect of matrix metalloproteinase-9 -1562C/T gene polymorphism on manifestations of pulmonary tuberculosis.
Tuberculosis (Edinb). 2009;89(1):68-70.

Abstract
Increased levels of matrix metalloproteinase-9 (MMP-9) in patients with tuberculous meningitis, tuberculous pleuritis, and advanced pulmonary tuberculosis (TB) suggest a pivotal role for MMP-9 in the development of pulmonary TB and its clinical manifestations. The present study was performed to evaluate the role of the -1562C/T single nucleotide polymorphism (SNP) in the promoter region of the human MMP-9 gene in development of pulmonary TB and its radiographic characteristics. A case-control study was performed with a study population of 205 patients with pulmonary TB and 223 healthy controls. Differences were explored in the allele and genotype distributions of the -1562C/T polymorphism between patients with pulmonary TB and healthy controls, between patients with single- and multi-lobe involvement, and between patients with and without cavities. The -1562C/C genotype was more common in patients with multi-lobe involvement than in those with single-lobe involvement (81.8 vs. 67.6%, P=0.03). However, there were no significant differences in the distribution between patients with pulmonary TB and healthy controls (P=0.40) or between patients with and without cavities (P=0.18). These results suggest that the -1562C/C genotype is associated with the intrapulmonary spread of TB rather than its development.
PubMed IF 2.9 호흡기내과
12009

제1저자 김태민 · 교신저자 윤성수

, , , , , , , , , , , , ,
Clinical predictors of recurrent venous thromboembolism: a single institute experience in Korea.
Thromb Res. 2009;123(3):436-43.

Abstract
INTRODUCTION Racial disparities in incidence rate as well as risk factors for venous thromboembolism (VTE) exist between Asian and Western populations. Moreover, predictors for recurrent VTE were not identified in Asians. Thus, this study was undertaken to investigate risk factors for recurrent VTE events in Korean people.
MATERIALS AND METHODS Three hundred-three patients newly diagnosed as VTE were enrolled from Seoul National University Hospital. Recurrence rate based on risk factors for VTE were investigated. Cumulative incidence of recurrent VTE was calculated by the Kaplan and Meier method. Independent predictors for VTE were determined using Cox proportional hazards model.
RESULTS After a median follow-up of 44 months, 24 (8%) of 303 patients relapsed for a total observation time of 1,217 patient-year. Cumulative incidences of recurrent VTE were 3% at 1 year, 10% at 5 years, and 18% at 8 years. Independent predictors for recurrent VTE were presence of residual thrombosis (hazard ratio [HR]=3.1, 95% confidence interval [CI] 1.0-9.3; p=0.044), antiphospholipid syndrome (APS) (HR=4.3, 95% CI 1.0-19.0; p=0.052), and age 50 years or younger (HR=2.5, 95% CI 1.0-6.6; p=0.053) by multivariate analysis. Residual thrombosis and APS remained predictive of recurrence by the anticoagulation-period stratified analysis.
CONCLUSIONS In contrast to Western populations, Korean patients with VTE had the lower recurrent rate. Extended anticoagulation is necessary for Korean patients with residual thrombosis or APS.
PubMed IF 3.4 혈액종양내과

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