SCI 발표논문

2012년 229편

1092012

제1저자 박효은 · 교신저자 최수연

, , , , , ,
The prevalence and distribution of coronary artery calcium in asymptomatic Korean population.
Int J Cardiovasc Imaging. 2012;28(5):1227-35.

Abstract
Coronary artery calcium score (CACS) is a strong predictor of coronary heart disease and provides incremental prognostic information beyond traditional risk factors. The difference in prevalence and distribution of CACS in different ethnic groups has been reported with conflicting results. We aimed to investigate the prevalence and distribution of CACS in asymptomatic Korean population. A total of 5,239 asymptomatic patients free of known coronary artery disease who had coronary artery calcium scoring computed tomography during comprehensive medical examinations were included in the analysis. Coronary calcium was present in 33.1% of overall population, 40.5% of males and 19.3% of females. In all age groups, CACS was higher in males. The pattern of increase in CACS appeared in different patterns, with earlier and gradual increase in males. In females, there was a time-lag, behind that observed in males by about 10 years. Multivariate analysis showed that male gender (OR 3.759, 95% CI 3.120-4.529, P < 0.001), older age (OR 1.095, 95% CI 1.085-1.106, P < 0.001), pulse pressure (OR 1.142, 95% CI 1.063-1.227, P < 0.001), HbA1C (OR 1.390, 95% CI 1.255-1.540, P < 0.001), and obesity defined by body mass index (BMI) ≥ 25 kg/m(2) (OR 1.042, 95% CI 1.011-1.073, P = 0.007) were related to the presence of coronary artery calcification (CACS > 0). This study provides a healthy reference value of coronary artery calcification in Korean subjects, based on sex and age percentiles. Similar age and gender associations and distributions of coronary artery calcification are found, compared to the previous studies in western populations, but median CACS tend to be lower in Koreans.
PubMed IF 1.5 순환기내과
1082012

제1저자 심은진 · 교신저자 박흥우

, , , , , , ,
The role of high-mobility group box-1 (HMGB1) in the pathogenesis of asthma.
Clin Exp Allergy. 2012;42(6):958-65.

Abstract
BACKGROUND High-mobility group box 1 protein (HMGB1) belonging to endogenous danger signals prolongs eosinophil survival and acts as a chemoattractant.
OBJECTIVE The authors evaluated the role of HMGB1 in the pathogenesis of asthma characterized by eosinophilic airway inflammation.
METHODS Firstly, HMGB1 expressions in induced sputum obtained from human asthmatics were determined. This was followed by an evaluation of the role of HMGB1 in a murine model of asthma using anti-HMGB1 antibodies. Then the effect of HMGB1 on the receptor of advanced glycation end products (RAGE) expressions on CD11b-CD11c(+) cells isolated from a murine model of asthma were measured to elucidate the mechanisms involved.
RESULTS Sputum HMGB1 expressions were markedly higher in asthmatics than in normal controls, and were positively correlated with sputum eosinophilia and sputum TNF-α, IL-5 and IL-13 expressions. In a murine model of asthma, HMGB1 expressions in lung tissue and HMGB1 levels in bronchoalveolar lavage fluid were significantly elevated and eosinophilic airway inflammation, non-specific airway hyperresponsiveness, and pathological changes were attenuated by blocking HMGB1 activity. Furthermore, we found that enhanced RAGE expressions on CD11b-CD11c(+) also significantly decreased when HMGB1 activity was blocked.
CONCLUSION AND CLINICAL RELEVANCE Our findings suggest that HMGB1 plays a key role in the pathogenesis of clinical and experimental asthma characterized by eosinophilic airway inflammation.
PubMed IF 5 알레르기내과
1072012

제1저자 김지원 · 교신저자 오도연

, , , , , , , , , , ,
A phase II trial of erlotinib in combination with gemcitabine and capecitabine in previously untreated metastatic/recurrent pancreatic cancer: combined analysis with translational research.
Invest New Drugs. 2012;30(3):1164-74.

Abstract
BACKGROUND To confirm the efficacy and toxicity of Erlotinib in combination with Gemcitabine and Capecitabine when used as a first-line therapy in metastatic/recurrent pancreatic cancer (PC).
METHODS Locally advanced PC was excluded. Erlotinib was given at a dose of 100 mg daily from D1 to D28. 1000 mg/m(2) of gemcitabine was given on D1,8,15 and 1660 mg/m(2)/day of capecitabine was given from D1 to 21, repeated every 4 weeks. Response was assessed every 8 weeks.
RESULTS A total of 47 patients were enrolled. Response rate and disease control rate was 32.6% (95% CI, 18.6-46.6%) and 83.7% (95% CI, 72.7-94.7%) respectively. The PFS was 6.5 months (95% CI, 3.4-9.7) and OS was 12.0 months (95% CI, 8.6-15.9). The Gr 3/4 toxicities were: neutropenia (6.8%), thrombocytopenia (3.2%), anemia (1.6%). nausea (1.6%), vomiting (1.6%), anorexia (5.3%), rash (2.4%). The EGFR expression was associated with shorter OS and ERCC2 expression was associated with longer PFS and OS. PFS and OS were not different according to K-RAS mutation or polymorphism of RRM1 and CDA.
CONCLUSIONS Erlotinib, gemcitabine and capecitabine combination showed promising efficacy and good tolerability in metastatic PC. This efficacy was observed irrespective of K-RAS mutation, and EGFR expression was poor prognostic factor for OS.
PubMed IF 3.4 혈액종양내과
1062012

제1저자 류한희 · 교신저자 송영욱

, , , , , , , , , , , ,
Hepatitis B virus reactivation in rheumatoid arthritis and ankylosing spondylitis patients treated with anti-TNFα agents: a retrospective analysis of 49 cases.
Clin Rheumatol. 2012;31(6):931-6.

Abstract
Clinical guidelines regarding anti-viral prophylaxis for HBV surface antigen (HBsAg) carriers starting anti-TNFα agents are not yet fully established, even in endemic regions of HBV infection. We retrospectively collected the clinical data of 52 HBsAg carriers with rheumatoid arthritis (RA) or ankylosing spondylitis (AS) that had been administered anti-TNFα treatment at seven medical centers in South Korea. Periodic data of liver function tests and serum HBV DNA were both utilized to assess HBV reactivation. The YMDD motif mutation of HBV DNA polymerase was tested in lamivudine-treated patients with elevated HBV DNA. Three of the 52 patients were excluded from the analysis. Of the 49 analyzed patients, 20 patients received anti-viral prophylaxis (15 lamivudine, five entecavir) with anti-TNFα treatment. The remaining 29 patients were treated with anti-viral agents if needed at the discretion of the clinician and did not receive prophylaxis. Of the 29 patients who did not receive primary prophylaxis, two (6.9%) developed viral reactivation within a year of anti-TNFα treatment. In the prophylaxis group, one patient developed viral reactivation at week 64 of anti-TNFα therapy attributed to YMDD mutation caused by lamivudine. Patients with HBV reactivation all responded well to anti-viral therapy. In summary, anti-viral prophylaxis helped preventing HBV reactivation in HBsAg carriers with RA or AS starting anti-TNFα, yet mutation in the YMDD motif of HBV DNA polymerase could be detrimental to some patients under long-term lamivudine prophylaxis.
PubMed IF 2.7 류마티스내과
1052012

제1저자 김의석 · 교신저자 김효열

, , , , , , , , , , , , , , , ,
Prospective nationwide surveillance of surgical site infections after gastric surgery and risk factor analysis in the Korean Nosocomial Infections Surveillance System (KONIS).
Infect Control Hosp Epidemiol. 2012;33(6):572-80.

Abstract
OBJECTIVE To evaluate the risk factors for surgical site infection (SSI) after gastric surgery in patients in Korea.
DESIGN A nationwide prospective multicenter study.
SETTING Twenty university-affiliated hospitals in Korea.
METHODS The Korean Nosocomial Infections Surveillance System (KONIS), a Web-based system, was developed. Patients in 20 Korean hospitals from 2007 to 2009 were prospectively monitored for SSI for up to 30 days after gastric surgery. Demographic data, hospital characteristics, and potential perioperative risk factors were collected and analyzed, using multivariate logistic regression models.
RESULTS Of the 4,238 case patients monitored, 64.9% (2,752) were male, and mean age (± SD) was 58.8 (± 12.3) years. The SSI rates were 2.92, 6.45, and 10.87 per 100 operations for the National Nosocomial Infections Surveillance system risk index categories of 0, 1, and 2 or 3, respectively. The majority (69.4%) of the SSIs observed were organ or space SSIs. The most frequently isolated microorganisms were Staphylococcus aureus and Klebsiella pneumoniae. Male sex (odds ratio [OR], 1.67 [95% confidence interval (CI), 1.09-2.58]), increased operation time (1.20 [1.07-1.34] per 1-hour increase), reoperation (7.27 [3.68-14.38]), combined multiple procedures (1.79 [1.13-2.83]), prophylactic administration of the first antibiotic dose after skin incision (3.00 [1.09-8.23]), and prolonged duration (≥7 days) of surgical antibiotic prophylaxis (SAP; 2.70 [1.26-5.64]) were independently associated with increased risk of SSI.
CONCLUSIONS Male sex, inappropriate SAP, and operation-related variables are independent risk factors for SSI after gastric surgery.
PubMed IF 2.6 감염내과
1042012

제1저자 정고은 · 교신저자 윤정환

, , , , , , , , , ,
Prognostic implications of tumor vascularity and its relationship to cytokeratin 19 expression in patients with hepatocellular carcinoma.
Abdom Imaging. 2012;37(3):439-46.

Abstract
OBJECTIVE Although hepatocellular carcinoma (HCC) demonstrates characteristic hypervascularity, some HCCs have a hypovascular pattern on computed tomography (CT). Cytokeratin 19 (CK19) is a marker for the biliary phenotype reflecting a poor prognosis. We assessed the prognostic implications of tumor vascularity and its association with CK19 expression in HCC.
METHODS Patients that underwent surgical resection for HCC were included. Tumor vascularity was evaluated according to the arterial enhancement patterns on CT scans and CK19 expression was evaluated by using tissue microarray methods.
RESULTS One hundred and forty patients were included. Their median follow-up duration was 55.0 months, and 92 (65.7%) patients had tumor recurrence. Forty-five patients (30.6%) had hypovascular HCC at the time of diagnosis, and they showed a significantly higher CK19 expression rate (32.5% vs. 8.2%, P = 0.001) and earlier recurrence rate within 6 months (hazard ratio (HR), 2.301; P = 0.025) compared to the patients with hypervascular HCCs. Hypovascularity (HR, 1.694; P = 0.045) was an independent risk factor for short overall survival.
CONCLUSIONS Hypovascular HCCs were associated with early recurrence and short overall survival, and CK19 was more frequently expressed in hypovascular HCC than in hypervascular tumors. Therefore, tumor vascularity on CT images might be utilized in determining the prognosis of patients with HCCs.
PubMed IF 1.95 소화기내과
1032012

제1저자 서명기 · 교신저자 구본권

, , , , , , , , , ,
Comparison of hyperemic efficacy between central and peripheral venous adenosine infusion for fractional flow reserve measurement.
Circ Cardiovasc Interv. 2012;5(3):401-5.

Abstract
BACKGROUND Maximal hyperemia is a prerequisite for the accurate measurement of fractional flow reserve (FFR). Although continuous infusion of adenosine via the femoral vein is considered to be the gold standard, this requires an additional invasive procedure for femoral vein access and is difficult to use during transradial coronary catheterization. We performed this prospective study to evaluate the feasibility and efficacy of peripheral intravenous infusion of adenosine for FFR measurement.
METHODS AND RESULTS Seventy-one patients were prospectively enrolled, and FFR was measured using a 0.014-inch coronary pressure wire. Hyperemic efficacy of adenosine was compared among intracoronary bolus injection and continuous IV infusion (140 μg/min/kg) via the femoral and via the forearm vein. In 20 patients, hyperemic mean transit time and index of microcirculatory resistance were also measured. Mean FFR after bolus administration of adenosine was 0.81±0.10. As compared with femoral vein infusion (FFR: 0.80±0.10), hyperemic efficacy of forearm vein infusion of adenosine (FFR: 0.80±0.11) was not inferior (P for noninferiority=0.01). The number of functionally significant stenoses (FFR <0.75) was also not different between the 2 methods (femoral vein versus forearm vein; 17 (25.0%) versus 17 (25.0%), P=1.0). Both hyperemic mean transit time and index of microcirculatory resistance were not different between the 2 routes of adenosine infusion. Additional bolus injection of adenosine during IV infusion did not improve the hyperemic efficacy but increased the risk of atrioventricular block.
CONCLUSIONS This study suggests that continuous intravenous infusion of adenosine via the forearm vein is a convenient and effective way to induce steady-state hyperemia for invasive physiological measurements.
CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT01070420.
PubMed IF 7.2 순환기내과
1022012

제1저자 전재현 · 교신저자 김홍빈

, , , , , , , , , , , ,
Empirical use of ciprofloxacin for acute uncomplicated pyelonephritis caused by Escherichia coli in communities where the prevalence of fluoroquinolone resistance is high.
Antimicrob Agents Chemother. 2012;56(6):3043-6.

Abstract
There is little information about the effectiveness of ciprofloxacin in regions where ciprofloxacin-resistant Escherichia coli is prevalent. This study was conducted to evaluate whether ciprofloxacin is effective as the initial empirical antibiotic for treatment of uncomplicated acute pyelonephritis (APN) due to ciprofloxacin-resistant E. coli. A total of 255 women with clinical diagnoses of uncomplicated APN due to E. coli were enrolled in the emergency department between March 2005 and December 2008. All enrolled patients were initially treated with ciprofloxacin. Patients were followed up 4 to 7 days after the start of therapy and 14 to 21 days after its completion. At the first follow-up visit, ciprofloxacin was changed to the appropriate antibiotic when necessary, depending on the antibiotic susceptibility results. Not only improvement of symptoms and signs but also microbiologic eradication was assessed at each visit. Fifteen percent (39/255) of the E. coli isolates were resistant to ciprofloxacin. There was no statistically significant difference between the clinical cure rates of the ciprofloxacin-susceptible group and the ciprofloxacin-resistant group at the first follow-up (87.0% versus 76.9%, P = 0.135) or the second follow-up (98.6% versus 94.9%, P = 0.177). However, there was a lower microbiologic cure rate in the ciprofloxacin-resistant group than in the ciprofloxacin-susceptible group (92.4% versus 41.7%, P = 0.000) at the first follow-up visit. No complications occurred in the ciprofloxacin-resistant group during the follow-up period. Our findings indicate that ciprofloxacin is an appropriate choice for empirical therapy of uncomplicated APN and has no serious adverse outcomes, if it is tailored appropriately, even for women infected with ciprofloxacin-resistant E. coli.
PubMed IF 4.2 감염내과
1012012

제1저자 김유선 · 교신저자 김주성

, , , , , , , , , , , ,
Cytomegalovirus infection in patients with new onset ulcerative colitis: a prospective study.
Hepatogastroenterology. 2012;59(116):1098-101.

Abstract
BACKGROUND/AIMS Immunosuppressive therapy in ulcerative colitis (UC) may induce cytomegalovirus (CMV) infection or reactivation in the colonic mucosa and in turn exacerbate UC. However, it is unclear whether colonic inflammation itself affects CMV infection in UC. This prospective study evaluated the prevalence and clinical outcome of CMV infection in patients with new onset UC who have not been exposed to UC medication.
METHODOLOGY A prospective, multi-center study was conducted in 65 patients with new onset UC. The presence of CMV was evaluated by a serology test and a histopathological examination including immunohistochemical staining. The assessment of clinical outcome was performed based on CMV positivity.
RESULTS Evidence of CMV infection was found in three (4.5%) patients with UC. Two patients with moderate disease activity improved with 5-aminosalicylate or steroid treatment. One patient with severe active colitis, however, required antiviral therapy.
CONCLUSIONS CMV infection is rare in new onset UC, which suggests that use of immunosuppressive medications is an important risk factor for CMV infection in UC. However, CMV evaluation is necessary for severe active UC, even with new onset of the disease.
PubMed IF 0.658 소화기내과
1002012

제1저자 황성욱 · 교신저자 김나영

, , , , , , , , , , , , ,
Probiotic suppression of the H. pylori-induced responses by conjugated linoleic acids in a gastric epithelial cell line.
Prostaglandins Leukot Essent Fatty Acids. 2012;86(6):225-31.

Abstract
Conjugated linoleic acids (CLA) produced by Lactobacillus acidophilus was reported to decrease the activation of nuclear factor-kappa B. CLA was suggested as one of the anti-inflammatory molecular mechanisms of probiotics. In the present study, the effects of CLA on H. pylori-induced multiple responses were evaluated. IL-8, TNF-α and iNOS were measured in mRNA and/or protein levels in AGS cells after pretreatment with CLA or CLA-containing conditioned medium (CM) produced by Lactobacillus acidophilus or Lactobacillus plantarum. The increased expressions of IL-8 mRNA/protein and TNF-α mRNA were significantly suppressed by pretreatment with CM or CLA. The levels of IL-8 protein and TNF-α mRNA were suppressed by CM pretreatment better than CLA. The expression of iNOS mRNA was also significantly inhibited by CM pretreatment. These results suggest that the suppression of multiple mediators by CLA-containing CM plays a key role in the anti-inflammatory and anti-carcinogenic effects of probiotics on H. pylori infection.
PubMed IF 2.4 소화기내과
992012

제1저자 박진현 · 교신저자 김유정

, , , , , , , ,
Clinical outcomes of leptomeningeal metastasis in patients with non-small cell lung cancer in the modern chemotherapy era.
Lung Cancer. 2012;76(3):387-92.

Abstract
BACKGROUND We analyzed the patterns of treatment and clinical outcomes of leptomeningeal metastasis (LM) in patients with non-small cell lung cancer (NSCLC) in the modern chemotherapy era.
METHODS We retrospectively reviewed the data of NSCLC patients who were diagnosed with LM between 2003 and 2009 at Seoul National University Bundang Hospital.
RESULTS Of the 50 patients with cytologically proven LM, 25 were male (50%), 14 (28%) had an ECOG performance status (PS) ≥ 3, and the median age was 62.5 years (range, 34-81 years). The patients were diagnosed with LM after a median of 10.4 months (range, 0-86.8 months) from the initial diagnosis of metastatic NSCLC. LM was present in 11 patients at the time of initial diagnosis. The median overall survival (OS) after the diagnosis of LM was 4.3 months (95% CI, 1.5-6.7 months). Forty-eight patients (96%) received intrathecal chemotherapy and the cytological response rate was 52%. The median survival was 5.5 months in cytological responders and 1.4 months in non-responders (p=0.075). The median OS in patients with an ECOG PS of 1-2 was longer than patients with an ECOG PS of 3-4 (5.5 vs. 0.7 months, p<0.001). Twenty-two patients (44%) received systemic cytotoxic chemotherapy or an EGFR tyrosine kinase inhibitor (TKI) after being diagnosed with LM. These patients had prolonged survival (11.5 vs. 1.4 months, p<0.001), and in 14 patients (28%) who received an EGFR TKI, the median OS was 19.2 months. In subgroup of patients with an ECOG PS of 1-2, those who received further systemic chemotherapy had improved survival compared to patients who did not receive further chemotherapy (11.5 vs. 2.1 months, p<0.001).
CONCLUSION NSCLC patients with LM exhibited diverse clinical outcomes rather than a uniformly poor prognosis. Systemic chemotherapy, especially EGFR TKIs in addition to intrathecal chemotherapy, might confer a survival benefit.
PubMed IF 5.3 혈액종양내과
982012

제1저자 임석아/박연희 · 교신저자 임영혁

, , , , , , , ,
Small node-negative (T1b-cN0) invasive hormone receptor-positive breast cancers: is there a subpopulation that might have benefit from adjuvant chemotherapy?
Breast Cancer Res Treat. 2012;133(1):247-55.

Abstract
The aims of the study were to identify a subpopulation more likely to be at greater risk of recurrence in small T1b-c node-negative hormone receptor (HR)-positive breast cancer, and which would benefit from adjuvant chemotherapy. Clinico-pathologic characteristics and clinical outcomes of 538 postoperative HR-positive T1b-cN0 breast cancer patients were retrospectively analyzed. High Ki67 index and a young age (< 35 years) were identified as independent risk factors for relapse (p < 0.0001 and 0.015, respectively). A nomogram based on Cox-regression model showed an area under the curve (AUC) of 0.73 in the training set. The validation set showed a good discrimination with an AUC of 0.65. In patients with high nomogram scores (≥ 100, n = 24, 4.5%) who had high Ki67 index with more than 75%, or young age (< 35 years) and a Ki67 index > 50%, the relapse-free survival curve of patients who had received anthracycline-containing adjuvant chemotherapy showed a better outcome than those who had not (p = 0.029). Ki67 index and age are valuable surrogate markers to predict recurrence and as indicators of tumors that could benefit from adjuvant chemotherapy in small T1b-c node-negative HR-positive breast cancer.
PubMed IF 3.3 혈액종양내과
972012

제1저자 오세원 · 교신저자 나기영

, , ,
Erythropoietin improves long-term outcomes in patients with acute kidney injury after coronary artery bypass grafting.
J Korean Med Sci. 2012;27(5):506-11.

Abstract
Previous studies reported the beneficial effect of erythropoietin (EPO) in acute injuries. We followed patients with and without acute kidney injury (AKI) after coronary artery bypass grafting (CABG) and evaluated the effect of EPO on long-term outcome. We also assessed the efficacy of urinary neutrophil gelatinase-associated lipocalin (uNGAL) as a predictive marker of AKI. Seventy-one patients scheduled for elective CABG were randomly given either 300 U/kg of EPO or saline before CABG. The primary outcome was AKI, and the secondary outcome was the all-cause-mortality and composite of all-cause-mortality and end stage renal disease (ESRD). Twenty-one patients had AKI, 14 (66.7%) in the placebo group and 7 (33.3%) in the EPO group (P = 0.05). Also, uNGAL was higher in the patients with AKI than in those without AKI at baseline, 2, 4, 24, and 72 hr after CABG (P = 0.011). Among patients with AKI, 2-week creatinine (Cr) was not different from baseline Cr in the EPO group, but 2-week Cr was significantly higher than baseline Cr in the placebo group (P = 0.009). All-cause-mortality (P = 0.022) and the composite of all-cause-mortality and ESRD (P = 0.003) were reduced by EPO. EPO reduces all-cause-mortality and ESRD in patients with AKI, largely due to the beneficial effect of EPO on recovery after AKI.
PubMed IF 3.2 신장내과
962012

제1저자 윤혁 · 교신저자 김나영

, , , , , , , ,
Effect of endoscopic screening at 1-year intervals on the clinicopathologic characteristics and treatment of gastric cancer in South Korea.
J Gastroenterol Hepatol. 2012;27(5):928-34.

Abstract
BACKGROUND AND AIM The recommended interval of endoscopic screening for gastric cancer (GC) in a general population is 2 years in Korea. However, it has not been determined whether endoscopic screening with a shorter interval is beneficial, especially for high-risk groups.
METHODS A total of 415 patients with GC were categorized according to whether they had (vigilant screening group) or not (non-vigilant screening group) undergone endoscopic screening within 1 year before being diagnosed with GC. Clinicopathologic GC characteristics of the two groups were compared. Next, the same analyses were conducted in subgroups of patients with high risk for GC including males, current smokers, first-degree relatives of GC; and patients with Helicobacter pylori infection, gastric atrophy, or intestinal metaplasia (IM).
RESULTS The proportion of vigilant screening patients was 36.1%. Early gastric cancer (EGC) was more frequently observed in the vigilant screening group than the non-vigilant screening group (62.7% vs 49.4%, P = 0.009). In the high-risk factor analyses, EGC was more frequently detected among patients with severe IM in the vigilant screening group than the non-vigilant screening group (66.7% vs 35.5%, P = 0.047). In addition, more patients in the vigilant screening group had undergone endoscopic submucosal dissection (ESD; 26.7% vs 0%, P = 0.008) and had stage I (84.6% vs 41.7%, P = 0.012) than in the non-vigilant screening group.
CONCLUSIONS Endoscopic screening for GC at 1-year intervals would be beneficial for patients with severe IM in South Korea; this method could detect EGC for which the curative modality would be ESD.
PubMed IF 3.5 소화기내과
952012

제1저자 홍유진 · 교신저자 송영욱

, , , , , , ,
Serum elastin-derived peptides and anti-elastin antibody in patients with systemic sclerosis.
J Korean Med Sci. 2012;27(5):484-8.

Abstract
The elastin metabolism in systemic sclerosis (SSc) has been known to be abnormal. The authors investigated relationship between the clinical manifestations of systemic sclerosis (SSc) and serum levels of soluble elastin-derived peptide (S-EDP) and anti-elastin antibodies. Serum samples were obtained from 79 patients with SSc and 79 age- and sex-matched healthy controls. Concentrations of serum S-EDP and anti-elastin antibodies were measured by ELISA. The serum concentrations of S-EDP in SSc patients were significantly higher than in healthy controls (median, 144.44 ng/mL vs 79.59 ng/mL, P < 0.001). Serum EDP concentrations were found to be correlated with disease duration in SSc (P = 0.002) and particularly in diffuse cutaneous SSc (P = 0.005). Levels of anti-elastin antibodies were found to be more elevated in SSc patients than in healthy controls (median, 0.222 U vs 0.191 U, P = 0.049), more increased in diffuse cutaneous SSc than limited cutaneous SSc (median, 0.368 U vs 0.204 U, P = 0.031). In addition, levels of anti-elastin antibodies were also found to be negatively associated with presence of anti-centromere antibody (P = 0.023). The S-EDP levels were not found to be correlated with levels of anti-elastin antibodies. The increased S-EDP and anti-elastin antibody levels and association with clinical and laboratory characteristics may reflect the abnormal metabolism in SSc.
PubMed IF 3.2 류마티스내과
942012

제1저자 이동원 · 교신저자 오세일

, , , ,
A case of focal fibrosis near the fascicle as a possible cause of incessant ventricular tachycardia.
Pacing Clin Electrophysiol. 2012;35(5):e131-5.

Abstract
A 22-year-old woman presented with ventricular tachycardia and heart failure of acute onset, and rapid hemodynamic deterioration despite medical treatment. The heart failure required extracorporeal membrane oxygenation followed by cardiac transplantation. The histopathological mapping of the ventricular conduction system of the explanted heart revealed focal fibrosis of the myocardium in close proximity to the left posterior fascicle. There was no other evidence of myocardial infarction or myocarditis. Immunohistochemical staining did not demonstrate any cause of this lesion; however, atrophy of cardiac muscle fibers around the lesion was noted. The focal fibrosis was presumed to be the cause of the ventricular tachycardia.
PubMed IF 1.3 순환기내과
932012

제1저자 권재우 · 교신저자 박흥우

, , , , , , , , , ,
Genetic Variations in TXNRD1 as Potential Predictors of Drug-Induced Liver Injury.
Allergy Asthma Immunol Res. 2012;4(3):132-6.

Abstract
PURPOSE Drug-induced liver injury (DILI) is the most common adverse drug reaction; however, it is not easily predicted. We hypothesize that DILI has a common genetic basis. Based on the findings of previous animal studies on toxic hepatitis, we selected the thioredoxin reductase 1 gene (TXNRD1) as a candidate marker of DILI for this genetic association study.
METHODS Records from 118 patients with DILI were extracted from the database of the Adverse Drug Reaction Research Group in South Korea. Causative drugs included antituberculosis drugs (n=68, 57.6%), antibiotics (n=22, 18.6%), antiepileptic drugs (n=7, 5.9%), non-steroidal anti-inflammatory drugs (n=5, 4.2%), and others (n=16, 13.7%). Seven single nucleotide polymorphisms (SNPs) in TXNRD1 (rs10735393, rs4964287, rs4595619, rs10861201, rs11111997, rs4246270, and rs4246271) were scored in 118 DILI patients and in 120 drug-matched controls without liver injury.
RESULTS No differences were found between the frequencies of any of the 7 SNPs in the cases and controls; however, a significant association was found between a TTA haplotype composed of rs10735393, rs4964287, and rs4595619 and DILI using an allele model (odds ratio, 1.79; 95% confidence interval, 1.18-2.73; P=0.008; Bonferroni corrected P=0.024).
CONCLUSIONS These results suggest that genetic variations in TXNRD1 favor the development of DILI, although a larger confirmative study is needed.
PubMed IF 4.3 알레르기내과
922012

제1저자 김지원 · 교신저자 윤성수

, , , , , , , , , , ,
Mitoxantrone, etoposide, cytarabine, and melphalan (NEAM) followed by autologous stem cell transplantation for patients with chemosensitive aggressive non-Hodgkin lymphoma.
Am J Hematol. 2012;87(5):479-83.

Abstract
Patients with chemosensitive aggressive non-Hodgkin lymphoma (NHL) could benefit from high-dose chemotherapy (HDC) followed by autologous stem cell transplantation (auto-SCT). We report clinical outcomes of HDC using a novel regimen consisting of mitoxantrone, etoposide, cytarabine, and melphalan (NEAM) with auto-SCT. A total of 69 patients were consecutively enrolled. Median age was 42 years (range, 20-66 years). Median event-free survival (EFS) was 17.9 months. Median overall survival (OS) has not been reached yet and estimated 2-year OS was 64.2%. Among patients with measurable lesions, response rate was 79.5%. Median time to recovery of neutrophil (>500 mL) and platelet (gt;20,000 mL) was 12.5 and 13.5 days, respectively. Febrile neutropenia developed in 61 patients (88.4%). Grades 3 or 4 hepatic toxicity developed in 7 patients (10.1%), Grades 3 or 4 renal toxicity in 2 patients (2.9%), and Grade 3 or 4 cardiac toxicity in 2 patients (2.9%). Transplant-related mortality (TRM) developed in two patients (2.9%). Multiple prior treatments before transplantation, auxiliary bone marrow harvest for stem cell collection, and high serum lactate dehydrogenase level were related to unfavorable treatment outcomes. In conclusion, NEAM conditioning with auto-SCT demonstrated considerable efficacy with modest toxicity in patients with chemosensitive aggressive NHL.
PubMed IF 9.4 혈액종양내과
912012

제1저자 오세일 · 교신저자 오세일

Disease modification by autonomic nerve stimulation.
Heart Rhythm. 2012;9(5):810-1.

PubMed IF 7 순환기내과
902012

제1저자 이하정 · 교신저자 김동기

, , , , , , , , , , , ,
The association of moderate renal dysfunction with impaired preference-based health-related quality of life: third Korean national health and nutritional examination survey.
BMC Nephrol. 2012;13:19.

Abstract
BACKGROUND Only a few large-scale studies have investigated the association between health-related quality of life (HRQOL) and renal function. Moreover, the HRQOL of patients with moderate renal dysfunction is frequently underestimated by healthcare providers. This study assessed the impact of renal function on preference-based HRQOL in Korean adult population.
METHODS We analyzed data for 5,555 adults from the 3(rd) Korean National Health and Nutritional Examination Survey 2005. The EuroQol-5D (EQ-5D) utility score was used to evaluate HRQOL. The study subjects were stratified into three groups based on their estimated glomerular filtration rates (eGFRs): ≥ 90.0, 60.0-89.9 and 30.0-59.9 mL/min/1.73 m(2). Individuals with advanced renal dysfunction were excluded from the analysis.
RESULTS The proportions of participants who reported problems in each of the five EQ-5D dimensions increased significantly with decreasing eGFR. However, a significant decrease in the EQ-5D utility score was observed among participants with an eGFR of 30.0-59.9 mL/min/1.73 m(2). Participants with an eGFR of 30.0-59.9 mL/min/1.73 m(2) had an almost 1.5-fold higher risk of impaired health utility (the lowest quartile of EQ-5D utility score) compared with those participants with eGFRs ≥ 90.0 mL/min/1.73 m(2), after adjustment for age, gender, health-related behaviors, socioeconomic and psychological variables, and other comorbidities. Among the five dimensions of the EQ-5D, an eGFR of 30.0-59.9 mL/min/1.73 m(2) was an independent determinant of self-reported problems in the mobility and pain/discomfort dimensions.
CONCLUSIONS Although age affects the association between renal dysfunction and the EQ-5D, moderate renal dysfunction seems to be an important determinant of impaired health utility in a general population and may affect the mobility and pain/discomfort dimensions of health utility.
PubMed IF 2.9 신장내과
892012

제1저자 이승표 · 교신저자 김효수

, , , , , , , , ,
Angiographic patterns of restenosis after percutaneous intervention of chronic total occlusive lesions with drug-eluting stents.
Int J Cardiol. 2012;156(2):180-5.

Abstract
BACKGROUND Although the success rate of percutaneous coronary intervention (PCI) of chronic total occlusive (CTO) lesions is rising recently, the nature and behavior of these revascularized lesions in the real-world practice are unknown.
METHODS Data was collected from a prospective cohort of patients with successfully revascularized CTO lesions using drug-eluting stent (DES). Among these, patients with angiographical in-stent restenosis (ISR) were analyzed.
RESULTS 58% (n=149) of the total patients (n=255) with successful PCI of CTO received 6-9 months' angiographical follow-up. Angiographic ISR was identified in 36 lesions from 36 patients. There was a strong tendency towards diffuse ISR (61% of total ISR lesions) in these lesions, as compared with ISR after implantation of DES for non-CTO lesion in previous literatures. Multivariate analysis showed that post-procedural minimal lumen diameter (MLD) and total stent length were the only reliable predictors of diffuse ISR (HR 0.527 per 0.5 mm increment of MLD, HR 1.262 per 10mm increment of stent length). Compared with the group with larger post-procedural MLD (> 1.9 mm) and shorter stent length (≤ 55 mm), the group with smaller post-procedural MLD (≤ 1.9 mm) and longer stent length (> 55 mm) carried a 9-fold higher risk of diffuse restenosis. In addition, diffuse ISR was more frequently associated with symptoms or signs of myocardial ischemia.
CONCLUSION Revascularized CTO lesions using DES may carry a high risk of diffuse ISR, which is associated with more frequent myocardial ischemia compared with focal ISR. Post-procedural MLD and total stent length are significant predictors of these types of ISR after successful CTO intervention.
PubMed IF 3.3 순환기내과
882012

제1저자 서평주 · 교신저자 김나영

, , , , , , , , , ,
Comparison of Indomethacin, Diclofenac and Aspirin-Induced Gastric Damage according to Age in Rats.
Gut Liver. 2012;6(2):210-7.

Abstract
BACKGROUND/AIMS Aging gastric mucosa is known to have decreased mucosal defenses and increased susceptibility to injury by nonsteroidal anti-inflammatory drugs. Depending on the type of nonsteroidal anti-inflammatory drug (NSAID), the underlying mechanisms and the extent of damage to the stomach or intestine may differ. This study was performed to evaluate the acute gastric damage caused by different doses of indomethacin, diclofenac and aspirin in rats of various ages.
METHODS For the acute models, indomethacin (10, 20 or 40 mg/kg), diclofenac (40 or 80 mg/kg) or aspirin (100 mg/kg) was given to 7- and 25-week-old and 1-year-old Sprague-Dawley rats by intragastric gavage. The gross ulcer index, damage area as assessed by imaging, histological index, myeloperoxidase (MPO) activity, and cytosolic phospholipase A(2) (cPLA(2)) levels were measured after 24 hours.
RESULTS The gross ulcer index and damage area increased with age in the presence of three NSAIDs (p<0.05). The increases in MPO levels induced by diclofenac and aspirin were significantly higher in 1-year-old than 7-week-old rats (p<0.05). cPLA(2) expression induced by indomethacin (10 and 40 mg/kg) was greater in the 1-year-old rats, compared with 7-week-old rats (p<0.05).
CONCLUSIONS NSAID-induced acute gastric damage increased in a dose- and age-dependent manner.
PubMed IF 4.1 소화기내과
872012

제1저자 임수 · 교신저자 박경수

, , , , , , , , , ,
Effect of a dipeptidyl peptidase-IV inhibitor, des-fluoro-sitagliptin, on neointimal formation after balloon injury in rats.
PLoS One. 2012;7(4):e35007.

Abstract
BACKGROUND Recently, it has been suggested that enhancement of incretin effect improves cardiac function. We investigated the effect of a DPP-IV inhibitor, des-fluoro-sitagliptin, in reducing occurrence of restenosis in carotid artery in response to balloon injury and the related mechanisms.
METHODS AND FINDINGS Otsuka Long-Evans Tokushima Fatty rats were grouped into four: control (normal saline) and sitagliptin 100, 250 and 500 mg/kg per day (n = 10 per group). Sitagliptin or normal saline were given orally from 1 week before to 2 weeks after carotid injury. After 3 weeks of treatment, sitagliptin treatment caused a significant and dose-dependent reduction in intima-media ratio (IMR) in obese diabetic rats. This effect was accompanied by improved glucose homeostasis, decreased circulating levels of high-sensitivity C-reactive protein (hsCRP) and increased adiponectin level. Moreover, decreased IMR was correlated significantly with reduced hsCRP, tumor necrosis factor-α and monocyte chemoattractant protein-1 levels and plasminogen activator inhibitor-1 activity. In vitro evidence with vascular smooth muscle cells (VSMCs) demonstrated that proliferation and migration were decreased significantly after sitagliptin treatment. In addition, sitagliptin increased caspase-3 activity and decreased monocyte adhesion and NFκB activation in VSMCs.
CONCLUSIONS Sitagliptin has protective properties against restenosis after carotid injury and therapeutic implications for treating macrovascular complications of diabetes.
PubMed IF 2.8 내분비대사내과
862012

제1저자 박효은 · 교신저자 최수연

, , , , ,
Epicardial fat reflects arterial stiffness: assessment using 256-slice multidetector coronary computed tomography and cardio-ankle vascular index.
J Atheroscler Thromb. 2012;19(6):570-6.

Abstract
AIM The cardio-ankle vascular index (CAVI) reflects overall arterial stiffness from the aorta to the ankle, independent of blood pressure. We aimed to investigate the association of fat burden assessed by visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT) and epicardial adipose tissue (EAT) with CAVI in an asymptomatic population.
METHODS A total of 260 asymptomatic Korean individuals who had CAVI, abdominal computed tomography (CT) and coronary CT were evaluated retrospectively. The VAT, SAT, EAT and SAT to VAT ratio (SVR) were measured and assessed for correlation with CAVI.
RESULTS Different fat compartments showed different correlations with arterial stiffness as assessed by CAVI. The amount of fat measured by VAT (r= 0.129, p= 0.037), EAT (r=0.193, p= 0.002) and SVR (r=-0.168, p= 0.007) showed a significant correlation with CAVI, whereas the amount of total abdominal fat and SAT did not (p= 0.261 and p= 0.434 respectively). From step-wise multivariate regression analysis including age, pulse pressure, fasting blood sugar level, VAT, SVR and EAT, EAT (p= 0.036) and age (p<0.001) showed significant associations with CAVI. When quartiles of CAVI were assessed, EAT showed serial increment, whereas SVR showed a stepwise decrease from the first quartile to fourth quartile of CAVI (p=0.041).
CONCLUSION VAT, EAT and SVR, which reflect metabolic risk, have shown significant correlations with arterial stiffness measured by CAVI. EAT showed an independent association with arterial stiffness after adjusting for covariables by multivariable correlation analysis. Among the different parameters reflecting fat burden, EAT showed the strongest correlation with CAVI.
PubMed IF 3.4 순환기내과
852012

제1저자 임석아 · 교신저자 노정실

, , , , , , , , , , , , , ,
Phase II trial of preoperative paclitaxel, gemcitabine, and trastuzumab combination therapy in HER2 positive stage II/III breast cancer: the Korean Cancer Study Group BR 07-01.
Breast Cancer Res Treat. 2012;132(2):589-600.

Abstract
An addition of trastuzumab preoperatively to chemotherapy for human epidermal growth factor receptor 2 (HER2) positive breast cancer improved relapse-free survival (RFS). This study was designed to evaluate the efficacy and safety of preoperative paclitaxel, gemcitabine, and trastuzumab (PGH) combination for HER2-positive breast caner. Pathologically, proven node positive stage II/III breast cancer patients with adequate organ function and no history of anti-cancer therapy were eligible. Patients received weekly trastuzumab with paclitaxel 80 mg/m(2) and gemcitabine 1,200 mg/m(2) on days 1 and 8, every 3 weeks for 6 cycles. Postoperatively, patients completed trastuzumab for 1 year and hormone therapy for 5 years if indicated. All patients received postoperative radiation therapy. Of 53 enrolled patients with a median tumor of 5.3 (range, 2.0 to >12) cm; 43.4%, T3/T4; 75.4%, N2/N3; and 45.3%, positive hormone receptors. The pathologic complete response (pCR) rate was 58.5% in both tumor and lymph nodes. Grade 3/4 adverse events were neutropenia (32%), febrile neutropenia (0.6%), and transient elevation of AST/ALT (1.6%) during a total of 318 cycles. All patients maintained normal cardiac function. With a median follow-up of 40 months, 3-year RFS rate was 84% with 91.7% distant metastasis-free survival rates. Remarkable pCR rate was obtained with non-anthracycline-based PGH therapy for HER2-positive stage II/III breast cancer. Adverse events were mild with few incidences of febrile neutropenia.
PubMed IF 3.3 혈액종양내과
842012

제1저자 강정묵 · 교신저자 김나영

, , , , , ,
Predictive factors for improvement of atrophic gastritis and intestinal metaplasia after Helicobacter pylori eradication: a three-year follow-up study in Korea.
Helicobacter. 2012;17(2):86-95.

Abstract
BACKGROUND AND AIMS To date, data on the effects of anti-Helicobacter therapy on the improvement of atrophic gastritis (AG) and intestinal metaplasia (IM) have been conflicting. This study was performed to investigate whether eradication of H. pylori could lead to the improvement of AG and IM, and the prognostic factors associated with the improvement of AG and IM.
METHODS Four hundred patients consisting of H. pylori-negative (n = 116) and H. pylori-positive (n = 284) groups were followed up 1 and 3 years after initial H. pylori tests. Serum levels of pepsinogen (PG), bacteria, environmental factors, and genetic polymorphisms were determined.
RESULTS The grade of corpus atrophy decreased at 1 and 3 years after successful eradication (p < .001 and p = .033, respectively). However, there was no significant change in the IM in the antrum and in the corpus. Prediction factors for the improvement of corpus AG by H. pylori eradication were baseline low PG I/II ratio (≤3), high salt intake, and corpus-predominant gastritis. IM improvement was also associated with spicy food intake and high baseline grade of IM, in addition to these factors. In addition, IL-1B-511 C/T and IL-6-572 C/G alleles were found to inhibit IM improvement. However, H. pylori-negative and noneradicated group did not show any significant change in AG or IM.
CONCLUSION Corpus AG was reversed by H. pylori eradication, and improvement of IM by H. pylori eradiation was more definite in patients with severe IM, low PG I/II ratio, and corpus-predominant gastritis, suggesting that H. pylori eradication is valuable even in severe cases.
PubMed IF 4.6 소화기내과
832012

제1저자 최윤진 · 교신저자 김나영

, , , , , , , , , , , ,
Accuracy of diagnostic tests for Helicobacter pylori in patients with peptic ulcer bleeding.
Helicobacter. 2012;17(2):77-85.

Abstract
BACKGROUND AND AIMS To assess the validity of biopsy-based tests (histology, culture, and urease test) and serology in detecting current H. pylori infection for the peptic ulcer patients who had gastric bleeding.
METHODS A total of 398 peptic ulcer patients were enrolled and divided into two groups, according to the presence or absence of bleeding. The diagnosis for current H. pylori infection was verified using the gold standard combining individual H. pylori tests. Sensitivity, specificity, and positive and negative predictive values of the culture, Campylobacter-like organism (CLO) test (urease test), histology, and serology were compared.
RESULTS Of the total study population (N = 398), 157 (39.4%) patients were categorized into the bleeding group. The sensitivities of the culture (40.0%) and CLO (85.0%) in the bleeding group were significantly lower than culture (58.1%) and CLO (96.4%) in the nonbleeding group (p = .012 and p < .001, respectively). In the bleeding group, the sensitivity of CLO (85.0%) was significantly lower than histology (92.5%) and serology (97.4%) (p = .013 and p = .002, respectively), which was not found in the nonbleeding group. The specificity of serology in the bleeding group (56.3%) was significantly lower than that of nonbleeding group (74.2%) (p = .038). Similarly, the specificity of serology was significantly lower than the other H. pylori tests in the bleeders.
CONCLUSIONS Bleeding decreased the sensitivity of H. pylori tests in patients with peptic ulcer, especially in urease test or culture. In contrast, histology was found to be a quite reliable test, regardless of the presence of bleeding.
PubMed IF 4.6 소화기내과
822012

제1저자 강은하 · 교신저자 송영욱

,
Behçet's disease and genes within the major histocompatibility complex region.
Mod Rheumatol. 2012;22(2):178-85.

Abstract
The role of genetic background in the development of Behçet's disease (BD) is best reflected by the strong association between HLA-B*51 and BD that has been demonstrated across various ethnic groups. The contributions made by other HLA or non-HLA genes to disease susceptibility have been suggested by the results of a number of gene association studies, although the true associations between the genes located within the major histocompatibility complex (MHC) region and BD have often been doubted due to the possibility of linkage disequilibrium of those genes with HLA-B*51. The presence of a true susceptibility gene in the vicinity of HLA-B*51 has also been extensively investigated because of the limited evidence that directly relates HLA-B*51 to the pathogenesis of BD. However, recent genome-wide association studies have confirmed that HLA-B*51 is primarily associated with BD and that there are multiple susceptibility loci other than HLA-B*51. In this review, we discuss BD-associated genes within the MHC region and their biological roles in the pathogenesis of BD.
PubMed IF 2.1 류마티스내과
812012

제1저자 박영주, 안화영 · 교신저자 조보연

, , , , ,
The long-term outcomes of the second generation of familial nonmedullary thyroid carcinoma are more aggressive than sporadic cases.
Thyroid. 2012;22(4):356-62.

Abstract
BACKGROUND Familial nonmedullary thyroid carcinoma (FNMTC) is frequently detected, but the prevalence or the aggressiveness of FNMTC is still unclear. We aimed to investigate the prevalence, clinical characteristics, and prognosis of FNMTC.
METHODS This study included 3056 nonmedullary thyroid carcinoma (NMTC) patients who were pathologically confirmed to exhibit differentiated thyroid carcinoma from January 1962 through March 2010. The duration of follow-up was 6.2±6.2 years.
RESULTS The prevalence of FNMTC was 9.6%; 37.9% of the FNMTC patients exhibited a parent-offspring relationship, and 62.1% exhibited a sibling relationship. FNMTC was smaller in tumor size (1.2±0.9 vs. 1.4±1.1 cm) and more multifocal (33.6% vs. 27.0%) than sporadic cases. FNMTC presented higher recurrence rates (29.5% vs. 19.8%) and shorter recurrence-free survival than sporadic NMTC (p=0.046). When we compared sporadic NMTC with parent-offspring or sibling FNMTC separately, parent-offspring FNMTC was more multifocal (39.3% vs. 27.0%), while sibling FNMTC was more prevalent in female patients (89.6% vs. 82.5%) and presented smaller tumors (1.2±0.8 vs. 1.4±1.1 cm) than sporadic NMTC. The recurrence rate was higher than that of sporadic NMTC in parent-offspring FNMTC (35.6% vs. 19.8%) but not in sibling FNMTC. Among the 123 parent-offspring FNMTC cases, the second generation exhibited an earlier age at the diagnosis (38±11 vs. 57±11 years), more extrathyroidal invasion (57.8% vs. 29.4%), a higher recurrence rate (50.0% vs. 19.0%), and shorter recurrence-free survival (p=0.015) than the first generation.
CONCLUSION FNMTC was found to have a very high prevalence in our population. Parent-offspring FNMTC demonstrated higher recurrence than sporadic NMTC; specifically, the second generation of parent-offspring FNMTC cases exhibited more aggressive clinical characteristics than the first generation.
PubMed IF 6.6 내분비대사내과
802012

제1저자 장혜정 · 교신저자 이근욱

, , , , , , ,
Adjuvant capecitabine chemotherapy using a tailored-dose strategy in elderly patients with colon cancer.
Ann Oncol. 2012;23(4):911-8.

Abstract
BACKGROUND This study was conducted to analyze the feasibility of adjuvant capecitabine therapy using a tailored-dose escalation strategy in elderly patients with colon cancer (CC).
METHODS CC patients (≥ 70 years of age) who received adjuvant capecitabine were enrolled. The starting dosage of capecitabine was 2000 mg/m(2)/day (days 1-14, every 3 weeks). On the second cycle, the dosage was escalated to 2500 mg/m(2)/day if the patient tolerated the first cycle. Dose intensity (DI), toxicity, and the change in quality of life (QoL) were evaluated.
RESULTS Of 82 patients enrolled, 67 completed eight cycles. Dose escalation to 2500 mg/m(2)/day was possible in 56 patients, and this dosage was maintained in 24 patients until the completion of chemotherapy (eight cycles). Forty-one patients completed therapy with a DI ≥ 1333 mg/m(2)/day [relative dose intensity (RDI) ≥ 80%]. Toxic effects were tolerable and the QoL was not compromised during treatment. Creatinine clearance < 50 ml/min and Charlson-Age comorbidity index ≥ 8 were related to a reduced capecitabine dosage (RDI < 80%).
CONCLUSIONS A tailored-dose escalation strategy was feasible in elderly CC patients receiving adjuvant capecitabine chemotherapy. Decreased renal function and an increased number of comorbidities were independently predictive of reduced administration of the capecitabine dose.
PubMed IF 80.4 혈액종양내과

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