SCI 발표논문

1. 52010

   제1저자 이준규 · 교신저자 이상협

   Lee JK, Lee SH, Kang BK, Kim JH, Koh MS, Yang CH, Lee JH

   Is it necessary to insert a nasobiliary drainage tube routinely after endoscopic clearance of the common bile duct in patients with choledocholithiasis-induced cholangitis? A prospective, randomized trial.

   Gastrointest Endosc. 2010;71(1):105-10.

   Abstract

   BACKGROUND Little is known about whether a routinely inserted endoscopic nasobiliary drainage (ENBD) tube improves the clinical course in patients with choledocholithiasis-induced acute cholangitis after clearance of choledocholithiasis.

   OBJECTIVE The aim of this study was to investigate the need for ENBD on the clinical outcomes of patients with acute cholangitis undergoing endoscopic clearance of common bile duct (CBD) stones.

   DESIGN Prospective, randomized study.

   SETTING Tertiary referral center.

   PATIENTS A total of 104 patients with choledocholithiasis-induced acute cholangitis who underwent primary endoscopic treatment were compared according to insertion of an ENBD tube (51 in the ENBD group and 53 in the no-ENBD group).

   INTERVENTION Insertion of an ENBD tube after clearance of CBD stones.

   MAIN OUTCOME MEASUREMENTS Recurrence of cholangitis and length of hospital stay after clearance of CBD stones.

   RESULTS Baseline clinical characteristics were similar between both groups. There were no significant differences in the recurrence rate of cholangitis at 24 weeks (3.9% for the ENBD group vs 3.8% for the no-ENBD group at 24 weeks; P = .99) and length of hospital stay (7.9 days [standard error = 1.2] for the ENBD group vs 7.9 days [standard error = 0.7] for the no-ENBD group; P = .98). However, procedure time was longer (26.2 [SE = 1.8] minutes vs 22.7 [SE = 1.0] minutes, respectively; P = .01) and the discomfort score was higher (4.9 [SE = 0.4] vs 2.8 [SE = 0.3], respectively; P = .02) in the ENBD group than in the no-ENBD group.

   LIMITATIONS Single-center study.

   CONCLUSIONS A routinely inserted ENBD tube did not improve the clinical course, despite patients having to endure increased procedure time and discomfort, and the insertion would therefore be unnecessary.

   PubMed IF 8 소화기내과
2. 42010

   제1저자 김대영

   Kim DY, Lee JH, Lee JH, Lee KH, Kim YK, Ahn JS, Kim HJ, Kim I, Yoon SS, Park S, Bae SH, Bang SM, Lee HG, Shin HJ, Lee JH, Min YH, Won JH, Mun YC, Oh D, Korean Society of Hematology AML/MDS Working Party

   Comparison of various criteria in predicting treatment response and prognosis of patients with myelodysplastic syndrome treated with azacitidine.

   Ann Hematol. 2010;89(1):15-23.

   Abstract

   This study was performed to identify whether cytogenetics, International Prognostic Scoring System (IPSS), or World Health Organization Classification-Based Prognostic Scoring System are predictive of the efficacy of azacitidine in patients with myelodysplastic syndrome (MDS). We retrospectively reviewed the clinical records of 113 patients with MDS treated with azacitidine. The "response alternating disease natural history," "cytogenetic response," and "hematologic improvement" were assessed by serial bone marrow biopsy, cytogenetic study, and hemogram analyses. The complete and partial remission rates were 17.6% and 3.9% in 51 evaluable patients. There were no significant differences in response rate in the different cytogenetic/IPSS/WPSS groups. The overall hematologic response (HR) rate was 49.6%, and the HR rate was significantly greater in patients classed as "very high" risk according to the WPSS compared with other patient groups. The 1-year overall survival (OS) rate was higher among patients with HR compared with those without HR (80.9% vs 63.3%, p = 0.046), and the 1-year OS rate among patients classed as being at high risk by each criteria was similar to that of patients classed as being at low risk. The hazard ratio of death among patients with HR compared with those without HR was 0.17 (95% CI 0.04-0.69) for high + very high risk group based on WPSS. Patients in the WPSS high-risk group had an increased HR rate compared with other patient groups, and the achievement of HR was associated with a significant increase in OS. Azacitidine showed similar efficacy in all patient groups, even in patients with poor cytogenetics and in high-risk groups.

   PubMed IF 2.3 혈액종양내과
3. 32010

   제1저자 장성아 · 교신저자 김형관

   Chang SA, Kim HK, Kim DH, Kim JC, Kim YJ, Kim HC, Sohn DW, Oh BH, Park YB

   Left ventricular twist mechanics in patients with apical hypertrophic cardiomyopathy: assessment with 2D speckle tracking echocardiography.

   Heart. 2010;96(1):49-55.

   Abstract

   OBJECTIVE Left ventricular (LV) apical rotation significantly contributes to LV twist, which has been reported to have a vital role in maintaining LV systolic and diastolic function. Apical hypertrophic cardiomyopathy (ApHCM) is a unique disease with pathological LV hypertrophy at the apex. We aimed (1) to evaluate LV twist mechanics in ApHCM and (2) to demonstrate the influence of predominantly local, pathological involvement of the apical myocardium on LV twist mechanics.

   METHODS 21 patients diagnosed with ApHCM were consecutively enrolled and compared with normal controls. After a standard echocardiographic examination, we scanned parasternal basal and apical short-axis planes to quantify LV rotations and LV twist using the speckle tracking technique. For better understanding of LV twist mechanics in ApHCM, LV radial and biplanar strains and LV twist-volume curve were also evaluated.

   RESULTS Compared with the normal controls, apical rotation was markedly decreased in ApHCM patients (p<0.001), but the decreases in basal rotation were not significant. As a consequence, LV twist was significantly lower in ApHCM patients (p = 0.007). Apical radial (p = 0.01) and biplanar (p<0.001) strains in ApHCM were also significantly decreased. Compared to normal controls, LV twist-volume and twist-radial displacement curves clearly showed a decrement in the slope of the linear systolic phase and a loss of an inflection point separating the early from late untwisting phase in ApHCM patients.

   CONCLUSION LV twist in ApHCM was significantly decreased due to a reduction in apical rotation, suggesting that regional myocardial changes in ApHCM can modify the global LV twist mechanics. Given the close interconnection between LV systolic and diastolic function, impairment of LV twist may lead to the loss of early diastolic suction and finally generate diastolic dysfunction in ApHCM.

   PubMed IF 4.4 순환기내과
4. 22010

   제1저자 한승석 · 교신저자 진호준

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

   Age- and gender-dependent correlations between body composition and chronic kidney disease.

   Am J Nephrol. 2010;31(1):83-9.

   Abstract

   BACKGROUND Body mass index (BMI) is a predictor of chronic kidney disease (CKD) in the general population. Here, we evaluated the association between BMI, body composition and CKD according to age and gender.

   METHODS We examined 75,127 adults between 2005 and 2008. Odds ratios for CKD were calculated between two age groups (a younger group, aged <65 years, and an elderly group, aged > or =65 years) using BMI, lean mass index (LMI, lean mass divided by the square of height), fat mass index (FMI, fat mass divided by the square of height), waist circumference and the lean mass-to-fat mass ratio (LFR).

   RESULTS The elderly group comprised 8.9% of the population, and 7.4% of all subjects had CKD. By multivariate analysis, BMI was positively correlated with CKD, but FMI was negatively correlated in the younger group. LMI was not associated with CKD in the younger group. In the elderly group, BMI, FMI and waist circumference were positively correlated with CKD. However, LMI and LFR were negative predictors of CKD. In female subjects, the correlation trends in the younger and the elderly group were opposite.

   CONCLUSIONS The associations between BMI, body composition and CKD differed according to age and gender stratifications.

   PubMed IF 3.8 신장내과
5. 12010

   제1저자 박영주 · 교신저자 김기웅

   Park YJ, Lee EJ, Lee YJ, Choi SH, Park JH, Lee SB, Lim S, Lee WW, Jang HC, Cho BY, Woo JI, Kim KW

   Subclinical hypothyroidism (SCH) is not associated with metabolic derangement, cognitive impairment, depression or poor quality of life (QoL) in elderly subjects.

   Arch Gerontol Geriatr. 2010;50(3):e68-73.

   Abstract

   The objective of this study was to examine the relationship between SCH and metabolic and neuropsychiatric derangements in Korean elderly subjects. Nine hundred and eighteen euthyroid and SCH subjects aged 65 years and older were enrolled in the present study. We compared anthropometric (age, sex, blood pressure, body mass index=BMI, body fat contents=BF, waist circumference=WC and hip circumference=HC), laboratory (glucose and lipid profile, renal and liver functions, and C-reactive protein=CRP levels), and neuropsychiatric (neuropsychological function, mood, and QoL) parameters of SCH subjects with those of euthyroid subjects. Associated metabolic disorders of the subjects were also compared between the euthyroid and SCH groups. We could not observe any differences between the SCH group and the euthyroid group with regards to metabolic parameters as well as neuropsychiatric parameters. These findings may suggest that SCH does not appear to be associated with metabolic and neuropsychiatric derangement in elderly subjects.

   PubMed IF 4.7 내분비대사내과

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