SCI 발표논문

2010년 155편

1552010

제1저자 이경훈 · 교신저자 방영주,임석아

, , , , , , , , , ,
RAD001 shows activity against gastric cancer cells and overcomes 5-FU resistance by downregulating thymidylate synthase.
Cancer Lett. 2010;299(1):22-8.

Abstract
We evaluated RAD001, an inhibitor of the mammalian target of rapamycin (mTOR) in human gastric cancer cell lines and determined the molecular mechanisms. RAD001 has marked growth inhibitory activity against the SNU-1 and SNU-216 cells. It inhibited phosphorylation of mTOR and S6K, and induced G1 cell cycle arrest. Synergistic growth-inhibitory effects in combination with 5-fluorouracil (5-FU) was identified. Furthermore, RAD001 conferred sensitivity to 5-FU-resistant cell lines by downregulating thymidylate synthase (TS). In conclusion, RAD001 showed growth inhibitory activity against gastric cancer cells and acted synergistically with cytotoxic agents such as 5-FU by downregulating TS.
PubMed IF 11.8 혈액종양내과
1542010

제1저자 김진욱 · 교신저자 김진욱

, , , , , , ,
Increased urinary lipocalin-2 reflects matrix metalloproteinase-9 activity in chronic hepatitis C with hepatic fibrosis.
Tohoku J Exp Med. 2010;222(4):319-27.

Abstract
Hepatic fibrosis is characterized by excessive accumulation of extracellular matrix. Matrix metalloproteinases (MMPs) play an important role in the remodeling of the extracellular matrix during hepatic fibrosis. Lipocalin-2 (LCN2) forms complexes with MMP-9 and can be detected in the urine of patients with several types of cancers. The objective of this study was to examine the relationship between urinary LCN2 levels and MMP-9 activity with respect to the stage of liver fibrosis in patients with chronic hepatitis C (CHC), and to assess the utility of urine LCN2 as a non-invasive marker of hepatic fibrosis. Fresh spot urine samples were prospectively collected from forty-two interferon-naive CHC patients who underwent liver biopsy. The stage of hepatic fibrosis was assessed according to the METAVIR fibrosis score; 18 patients had no or mild fibrosis (stages F0 and F1) and 24 patients showed significant fibrosis (stages F2-F4). Immunoblot analyses demonstrated co-migration of urine LCN2 and MMP-9. Gelatin zymography showed that urinary MMP-9/MMP-2 activity ratios were higher in patients with significant fibrosis (F2-F4) than in patients no or mild fibrosis (F0-F1). Urine LCN2 levels which were normalized to urine creatinine concentration (urine LCN2-to-creatinine ratio; ULCR) were higher in F2-F4 patients compared to F0-F1 patients. There was a positive correlation between ULCR and urine MMP-9/MMP-2 activity ratios (r = 0.735). ULCR and AST-to-platelet ratio index were independent predictors of significant fibrosis by multivariate analysis. The present study suggests that urinary LCN2 is a novel marker of hepatic fibrosis by reflecting urine MMP-9 activity in CHC.
PubMed IF 1.5 소화기내과
1532010

제1저자 푸얀얀 · 교신저자 진호준

, , , , , , ,
Hyperbilirubinemia reduces the streptozotocin-induced pancreatic damage through attenuating the oxidative stress in the Gunn rat.
Tohoku J Exp Med. 2010;222(4):265-73.

Abstract
Oxidative stress is an important pathogenic factor in diabetes. Bilirubin may serve a cytoprotective function as an anti-oxidant. The Gunn rat lacks the enzyme uridine-diphosphate glucuronosyltransferase that is responsible for conjugation of bilirubin, exhibiting elevation of plasma bilirubin. We examined the effect of hyperbilirubinemia on the pancreatic damage caused by streptozotocin (STZ) in the Gunn rat. Male Wistar rats and male Gunn rats were treated with STZ (WS and GS groups, respectively) or vehicle (WC and GC groups, respectively). All 5 rats in the WS group developed diabetes, defined as fasting blood glucose 300 mg/dL or more, at 3 days, whereas only 2 of the 5 GS rats became diabetic at 7 days after STZ injection. Without insulin supplement at 7 days after STZ injection, the WS group displayed higher levels of fasting blood glucose (510.3 ± 50.3 vs. 236.4 ± 42.5 mg/dL, p = 0.003) and HbA1c (5.0 ± 0.1 vs. 3.9 ± 0.1, p = 0.001), compared to those of GS group. In Wistar rats, STZ induced apoptosis of the pancreatic islet cells, accompanied with activation of NADPH oxidase and increased production of reactive oxygen species and nitric oxide, but not in Gunn rats. Moreover, in a rat insulinoma cell line (RIN-m5F), pre-treatment with bilirubin (0.1 mg/dL) decreased cell death and apoptosis caused by STZ, and also reduced H₂O₂ production. Considering the protective effect of hyperbilirubinemia against STZ-induced injury, we postulate that bilirubin could be a potential therapeutic modality for oxidative stress of pancreas islets.
PubMed IF 1.5 신장내과
1522010

제1저자 최정민 · 교신저자 김상균

, , , , ,
Is endoscopic ultrasonography indispensable in patients with early gastric cancer prior to endoscopic resection?
Surg Endosc. 2010;24(12):3177-85.

Abstract
BACKGROUND Endoscopic resection as curative treatment of early gastric cancer (EGC) requires accurate staging for depth of invasion (T) before therapy. This study aimed to compare T staging of EGC using a miniprobe with that of conventional endoscopy (CE).
METHODS A total of 388 patients with suspected of EGC by CE were prospectively enrolled in the study. After miniprobe staging by an experienced endosonographer, CE staging was performed by another endoscopist who was blinded to the miniprobe assessment. Patients underwent either endoscopic resection (n = 325) or surgery (=63) according to staging results. Results of each method were compared with the histology of the resected specimen. Clinicopathological factors affecting accuracy of each test were also evaluated.
RESULTS Overall accuracy of miniprobe and CE staging was 78.9% (306/388) and 81.4% (316/388), respectively (p = 0.052). Sensitivity for T1m was more than 95% (miniprobe 98.7%, CE 97.7%), whereas sensitivity for T1sm was lower at 6.6% for miniprobe and 23.7% for CE (p = 0.002). Among nine lesions identically considered submucosal invasion by both methods, three were T1sm cancer. Diagnostic accuracy of the miniprobe was lower than that of CE with respect to lesions located in the lower third of the stomach, differentiated histology, or massive submucosal invasion.
CONCLUSIONS Overall accuracy of the miniprobe and CE for T staging in EGC was approximately 80% with no significant difference. Accurate prediction of both techniques for submucosal invasion was poor, even by using a combination of the two methods. The use of the miniprobe may not increase the positive predictive value for T staging over the use of CE alone.
PubMed IF 3.3 소화기내과
1512010

제1저자 정지용 · 교신저자 오국환

, , , , , , , , , ,
Factors associated with aortic stiffness and its change over time in peritoneal dialysis patients.
Nephrol Dial Transplant. 2010;25(12):4041-8.

Abstract
BACKGROUND An increase in aortic stiffness, as reflected by an increase in pulse wave velocity (PWV), is an important predictor of cardiovascular mortality in dialysis patients. Decreased serum concentration of calcification inhibitor, such as fetuin-A, is inversely related to mortality in haemodialysis patients. Our aim is to investigate the factors associated with aortic stiffness and its change over time in peritoneal dialysis (PD) patients.
METHODS As a prospective observational study, we analysed 67 PD patients, aged 50 ± 14 years (mean ± SD) and with dialysis duration of 26 (5-58) months (median, interquartile range). At baseline, age, mean arterial pressure (MAP), left ventricular mass (LVM) index, diabetes, serum albumin, calcium (Ca), phosphorus (P) and intact parathyroid hormone (iPTH), uric acid, total bilirubin, high-sensitivity C-reactive protein (hsCRP), fetuin-A, and residual renal function were included in association analysis with aortic stiffness represented by heart-to-femoral PWV (hfPWV). We also evaluated simple vascular calcification score (SVCS) with plain radiograph of the pelvis and both hands. PWV was measured both at baseline and at 1 year. Change of aortic stiffness was determined by △PWV (difference between 1-year PWV and baseline PWV). Time-averaged concentrations were used to evaluate the relation between biologic markers and changes of aortic stiffness.
RESULTS hfPWV was 1022 ± 276 cm/s at baseline, and hfPWV determined at 1 year was 1069 ± 317 cm/s. Mean serum fetuin-A concentration was 0.34 ± 0.08 g/L. At baseline, aortic PWV positively correlated with age, smoking status, diabetes, MAP, total cholesterol and LDL cholesterol. On the other hand, aortic PWV inversely correlated with fetuin-A, log PTH, haemoglobin and albumin. In a multiple regression model, association of serum fetuin-A (β = -0.329, P = 0.003) with aortic PWV remained significant, along with age (β = 0.512, P < 0.001), MAP (β = 0.215, P = 0.047) and log PTH (β = -0.269, P = 0.025). At follow-up, △MAP (β = 0.500, P < 0.001) and time-averaged TG (aTG) (β = 0.259 P = 0.019) were determinants of △PWV.
CONCLUSIONS For our PD patients, serum fetuin-A was an independent determinant of aortic stiffness, as well as age, MAP and log PTH. Although 1 year is not sufficient to observe the change of aortic stiffness, some patients exhibited >15% increase of PWV during this period. △MAP and aTG were factors affecting the change of PWV. Follow-up over a longer period is necessary to elucidate factors that determine changes of aortic stiffness over time from PD patients.
PubMed IF 8.3 신장내과
1502010

제1저자 정은욱 · 교신저자 윤정환

, , , , , , , ,
Hypoxia and retinoic acid-inducible NDRG1 expression is responsible for doxorubicin and retinoic acid resistance in hepatocellular carcinoma cells.
Cancer Lett. 2010;298(1):9-15.

Abstract
Hypoxia may activate survival signals in cancer cells. Moreover, hypoxic cells are less sensitive than normoxic cells to doxorubicin cytotoxicity, a potent activator of the p53 tumor suppressor gene. N-myc downstream-regulated gene-1 (NDRG1) is a hypoxia- and retinoic acid-inducible protein, and has been previously implicated in carcinogenesis. As this protein is also a downstream target of p53 and hepatocellular carcinoma (HCC) cells frequently evidence resistance to retinoic acid (RA) cytotoxicity, we attempted to determine whether the suppression of NDRG1 expression may sensitize HCC cells to doxorubicin and/or RA cytotoxicity. HCC cells expressed NDRG1 protein, and the expression of this protein was hypoxia- and RA-inducible. Doxorubicin treatment induced HCC cell cytotoxicity via the activation of mitochondrial apoptotic signals, including caspase-9 activation. Hypoxic HCC cells are less sensitive to doxorubicin-induced apoptosis. The suppression of NDRG1 expression either by siRNA or flavopiridol sensitized hypoxic HCC cells to doxorubicin cytotoxicity, and this was attributed to more profound augmentation of JNK and caspase-9 activation. The suppression of NDRG1 expression also sensitized RA-resistant HCC cells to RA-induced apoptosis, and this sensitization was more apparent in hypoxic HCC cells than in normoxic cells. Glutaredoxin2 expression was down-regulated in NDRG1-suppressed HCC cells. These results show that hypoxia- and RA-inducible NDRG1 expression is responsible for doxorubicin and RA resistance in HCC cells. Thus, the selective interruption of NDRG1 signaling may prove to be therapeutically useful in HCCs, particularly in the advanced infiltrative type of tumors exposed to hypoxic environments.
PubMed IF 11.8 소화기내과
1492010

제1저자 임정윤 · 교신저자 김동희

, , , , , , ,
Sagittal abdominal diameter is a strong anthropometric measure of visceral adipose tissue in the Asian general population.
Diabetes Care. 2010;33(12):2665-70.

Abstract
OBJECTIVE Finding the anthropometric measure of visceral obesity is essential to clinical practice, because it predicts cardiovascular and metabolic risks. Sagittal abdominal diameter (SAD) has been proposed as an estimate of visceral adipose tissue (VAT). The aim of the present study was to evaluate the usefulness of SAD in predicting visceral obesity by comparing SAD to other anthropometric measures.
RESEARCH DESIGN AND METHODS Estimation of subcutaneous and visceral adipose tissue and measurement of SAD and transverse abdominal diameter using computed tomography at the umbilical level were obtained in 5,257 men and women who were enrolled in a health checkup program in Korea. To compare SAD to other anthropometric measures, linear regression analyses were used to determine correlations between anthropometrics and visceral obesity.
RESULTS SAD showed a stronger correlation to VAT than waist circumference, BMI, and transverse abdominal diameter in the both sexes (men: r = 0.804, women: r = 0.724). Waist circumference showed generally stronger associations to subcutaneous adipose tissue (SAT) than to VAT (men: r = 0.789 vs. 0.705, women: r = 0.820 vs. 0.636). Even after subdividing according to age or BMI in both sexes and analyzing multiple regressions, SAD showed the strongest correlation to VAT.
CONCLUSIONS SAD showed the strongest correlation to VAT irrespective of age, sex, and the degree of obesity compared with other anthropometric measures, whereas waist circumference may have a stronger correlation to SAT than to VAT. The clinical use of SAD has advantages over other anthropometric measures in predicting VAT.
PubMed IF 22.6 소화기내과
1482010

제1저자 김형관 · 교신저자 김형관

, , , , , , ,
Effects of the aging process on left ventricular systolic and diastolic synchronicity indexes: insights from 160 "completely" healthy volunteers.
Clin Cardiol. 2010;33(12):E24-31.

Abstract
BACKGROUND Growing attempt to use left ventricular (LV) systolic (LVSIsys) and diastolic (LVSIdia) synchronicity indexes in the process of selecting potential responders to cardiac resynchronization therapy has created a need for normative reference values.
HYPOTHESIS This study sought: (1) to determine normal reference ranges for LVSIsys and LVSIdia, and (2) to assess their relationships to age and conventional parameters reflecting LV systolic and diastolic functions.
METHODS We recruited 160 healthy volunteers (104 men) free of any systemic or cardiovascular disease. Maximal difference and standard deviation of time to peak systolic and peak early diastolic myocardial velocities for LVSIsys and LVSIdia were measured using 6 and 12 segment models.
RESULTS Normal ranges for LVSIsys and LVSIdia obtained in this study were slightly higher than previously reported. The normal aging process did not significantly change LVSIsys, whereas LVSIdia progressively and consistently increased with age. Significant correlations were observed between LVSIdia and parameters representing LV diastolic function, that is, early mitral inflow velocity and its deceleration time, and early mitral annulus velocity. A physiologic increase in LV mass/Ht²·⁷ showed a weak, but significant correlation with LVSIdia (r = 0.15-0.22), but not with LVSIsys. On multivariate analysis, an age-dependent increase in LVSIdia was confirmed.
CONCLUSIONS In this study, we propose age-specific reference ranges for LVSIsys and LVSIdia. LVSIsys remains stable throughout age groups, whereas LVSIdia progressively increases with age. We believe that the reference values provided here will be useful for defining abnormal LV synchronous contraction and relaxation.
PubMed IF 2.8 순환기내과
1472010

제1저자 오세일 · 교신저자 오세일

, , , ,
Complex fractionated electrograms and AF nests in vagally mediated atrial fibrillation.
Pacing Clin Electrophysiol. 2010;33(12):1497-503.

Abstract
BACKGROUND Catheter ablation targeting of complex fractionated atrial electrograms (CFAEs) is one of the techniques used for atrial fibrillation (AF) ablation. The ablation of sites showing a high-frequency spectral component (HFC) during sinus rhythm, known as AF nests, has been introduced as an adjunct to conventional ablation. Known locations of some AF nests are similar to CFAE sites. However, it has not been systematically evaluated whether these two targets represent the same foci. The purpose of this study was to compare the anatomical locations of these sites using an animal model of vagally mediated AF.
METHODS Five anesthetized open-chest dogs were evaluated. Atrial electrograms were obtained epicardially. AF was induced by burst atrial pacing with 20 Hz during vagal stimulation. A total of 15 sites (eight sites in right atrium and seven sites in left atrium) were evaluated in each animal. The CFAE was determined during AF according to the electrogram patterns. After sinus conversion, real-time spectrum analysis was used for AF nest assessment at the same location.
RESULTS The CFAE was observed at the high and mid sulcus terminalis areas, pulmonary vein antrum, and mid portion of the coronary sinus. Among them, only 60% of the CFAE sites showed HFC during sinus rhythm. In addition, some of the non-CFAE sites (22%) showed HFC during sinus rhythm.
CONCLUSION The CFAE sites were not the same as the AF nests in this animal model of vagally mediated AF. Therefore, these two types of ablation methods appear to target different substrates of AF.
PubMed IF 1.3 순환기내과
1462010

제1저자 윤원재 · 교신저자 류지곤

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Endoscopic management of occluded metal biliary stents: metal versus 10F plastic stents.
World J Gastroenterol. 2010;16(42):5347-52.

Abstract
AIM To compare the efficacy of self-expandable metal stents (SEMSs) with 10F plastic stents (PSs) in the endoscopic management of occluded SEMSs.
METHODS We retrospectively reviewed the medical records of 56 patients who underwent SEMS insertion for palliation of unresectable malignant biliary obstruction between 2000 and 2007 and subsequent endoscopic retrograde biliary drainage (ERBD) with SEMS or PS for initial SEMS occlusion between 2000 and 2008.
RESULTS Subsequent ERBD with SEMS was performed in 29 patients and with PS in 27. The median time to stent occlusion after subsequent ERBD was 186 d in the SEMS group and 101 d in the PS group (P = 0.118). Overall median stent patency was 79 d for the SEMS group and 66 d for the PS group (P = 0.379). The mean number of additional biliary drainage procedures after subsequent ERBD in patients that died (n = 50) during the study period was 2.54 ± 4.12 for the SEMS group and 1.85 ± 1.95 for the PS group (P = 0.457). The mean total cost of additional biliary drainage procedures after the occlusion of subsequent SEMS or PS was $410.04 ± 692.60 for the SEMS group and $630.16 ± 671.63 for the PS group (P = 0.260). Tumor ingrowth as the cause of initial SEMS occlusion was the only factor associated with a shorter time to subsequent stent occlusion (101 d for patients with tumor ingrowth vs 268 d for patients without tumor ingrowth, P = 0.008).
CONCLUSION Subsequent ERBD with PSs offered similar patency and number of additional biliary drainage procedures compared to SEMSs in the management of occluded SEMS.
PubMed IF 7.7 소화기내과
1452010

제1저자 양재성 · 교신저자 조영민

, , , , , , , ,
Changes in hepatic gene expression upon oral administration of taurine-conjugated ursodeoxycholic acid in ob/ob mice.
PLoS One. 2010;5(11):e13858.

Abstract
Nonalcoholic fatty liver disease (NAFLD) is highly prevalent and associated with considerable morbidities. Unfortunately, there is no currently available drug established to treat NAFLD. It was recently reported that intraperitoneal administration of taurine-conjugated ursodeoxycholic acid (TUDCA) improved hepatic steatosis in ob/ob mice. We hereby examined the effect of oral TUDCA treatment on hepatic steatosis and associated changes in hepatic gene expression in ob/ob mice. We administered TUDCA to ob/ob mice at a dose of 500 mg/kg twice a day by gastric gavage for 3 weeks. Body weight, glucose homeostasis, endoplasmic reticulum (ER) stress, and hepatic gene expression were examined in comparison with control ob/ob mice and normal littermate C57BL/6J mice. Compared to the control ob/ob mice, TUDCA treated ob/ob mice revealed markedly reduced liver fat stained by oil red O (44.2±5.8% vs. 21.1±10.4%, P<0.05), whereas there was no difference in body weight, oral glucose tolerance, insulin sensitivity, and ER stress. Microarray analysis of hepatic gene expression demonstrated that oral TUDCA treatment mainly decreased the expression of genes involved in de novo lipogenesis among the components of lipid homeostasis. At pathway levels, oral TUDCA altered the genes regulating amino acid, carbohydrate, and drug metabolism in addition to lipid metabolism. In summary, oral TUDCA treatment decreased hepatic steatosis in ob/ob mice by cooperative regulation of multiple metabolic pathways, particularly by reducing the expression of genes known to regulate de novo lipogenesis.
PubMed IF 2.8 내분비대사내과
1442010

제1저자 허은영 · 교신저자 김영환

, , , , ,
Impact of whole-body ¹⁸F-fluorodeoxyglucose positron emission tomography on therapeutic management of non-small cell lung cancer.
Respirology. 2010;15(8):1174-8.

Abstract
BACKGROUND AND OBJECTIVE Accurate staging at the time of diagnosis is very important in deciding on the appropriate treatment for cancer patients. FDG PET indicates metabolic changes in cancer cells, enabling the early detection of lesions. This has the advantage of allowing more accurate staging than is possible with conventional staging tools, and has led to the incorporation of FDG PET in the initial work-up protocols for lung cancer patients. In this study, we evaluated the clinical impact of FDG PET as an initial staging tool, on the therapeutic management of patients with non-small cell lung cancer (NSCLC).
METHODS Patients diagnosed with NSCLC by histopathology were retrospectively identified and both chest CT and FDG PET were performed for initial staging. Information was collected regarding the results of conventional versus FDG PET staging, and any resulting modifications of treatment were evaluated.
RESULTS Among the 537 patients who were evaluated FDG PET resulted in upstaging of the tumour in 91 (17%) and downstaging of the tumour in 68 (13%). Consequently, therapeutic management was modified in 118 patients (22%). Furthermore, use of FDG PET resulted in the detection of a second primary cancer in six patients.
CONCLUSIONS This study confirms that FDG PET has a considerable impact on the initial staging and therapeutic management of patients with NSCLC.
PubMed IF 7.2 호흡기내과
1432010

제1저자 최수연 · 교신저자 오병희

, , , , , ,
General and abdominal obesity and abdominal visceral fat accumulation associated with coronary artery calcification in Korean men.
Atherosclerosis. 2010;213(1):273-8.

Abstract
OBJECTIVE It is unclear whether visceral adipose tissue (VAT) is responsible for an increased risk of coronary artery calcification (CAC). We evaluated the associations between body mass index (BMI), waist circumference (WC) and abdominal VAT area with the CAC in healthy Korean men.
METHODS This is a cross-sectional study of 1336 Korean men free of cardiovascular disease who underwent CAC score (CACS) by multislice computed tomography (CT) and abdominal CT as part of a routine medical examination. VAT area was measured at the level of the umbilicus using CT.
RESULTS Mean BMI, WC, total adipose tissue and VAT area were higher in subjects with moderate-to-severe CAC (CACS>100) compared to subjects with CACS ≤ 100. The subjects in the fourth quartile of VAT had significantly higher CACS and the greater prevalence of CAC presence and moderate-to-severe CAC than those in the first to third quartiles. The highest quartiles of BMI, WC and VAT area were significantly associated with moderate-to-severe CAC in the age- and CVD risk factor-adjusted model (OR [95% CI]=1.56 [1.11-2.19], 1.56 [1.12-2.18] and 1.42 [1.01-1.98] with p<0.05 for all, respectively).
CONCLUSION The higher levels of general and central measure of obesity and the amount of abdominal visceral fat were related to moderate-to-severe CAC in asymptomatic Korean men with relatively low risk.
PubMed IF 7.1 순환기내과
1422010

제1저자 양선영 · 교신저자 김영선

, , , , , , , , , , ,
Association between colorectal adenoma and coronary atherosclerosis detected by CT coronary angiography in Korean men; a cross-sectional study.
J Gastroenterol Hepatol. 2010;25(11):1795-9.

Abstract
BACKGROUND Colorectal adenoma and coronary artery disease (CAD) appear to share common risk factors, such as male gender, diabetes mellitus, smoking, and obesity. We investigated the relationship between colorectal adenoma and coronary atherosclerosis, as a risk factor for colorectal adenoma.
METHODS A cross-sectional study was conducted on Korean men who presented for a health check-up. The subjects were 488 men (217 colorectal adenoma and 271 normal colonoscopic findings) who underwent colonoscopy and coronary computed tomography angiography (CTA) on the same day as a screening examination. Advanced colonic lesion was defined as a presence of adenoma with villous component, high-grade dysplasia, and/or with size of ≥1 cm. CTA findings were classified as normal, mild (low-grade atherosclerosis or <50% stenosis), and significant CAD (≥50% stenosis). Abnormal CTA findings included mild and significant CAD.
RESULTS Patients with abnormal CTA findings were more likely to have colorectal adenoma compared with those with normal CTA findings (P < 0.005). Furthermore, presence of advanced adenoma was significantly associated with significant CAD (P < 0.01). On multivariate analyses, abnormal CTA findings (OR = 1.66, 95% CI: 1.14-2.41, P < 0.01) and significant CAD (OR = 1.96, 95% CI: 1.15-3.35, P < 0.05) were found to be independent risk factors for colorectal adenoma after adjusting for age, current smoking, and metabolic syndrome.
CONCLUSIONS In this study, in the population who underwent CTA and colonoscopy for health check-up, prevalence of colorectal adenoma was greater in subjects with low-grade coronary atherosclerosis or significant CAD. The presence of advanced adenoma was significantly associated with significant CAD.
PubMed IF 3.5 소화기내과
1412010

제1저자 강정묵 · 교신저자 김나영

, , , , , , , , , , , , , ,
Effect of aging on gastric mucosal defense mechanisms: ROS, apoptosis, angiogenesis, and sensory neurons.
Am J Physiol Gastrointest Liver Physiol. 2010;299(5):G1147-53.

Abstract
Aging changes in the stomach lead to a decreased capacity for tissue repair in response to gastric acid. The aim of this study was to determine the mechanism associated with the increased susceptibility to injury of aging mucosa including reactive oxygen species (5), apoptosis, angiogenesis, and sensory neuron activity. Fischer 344 rats at four different ages (6, 31, 74 wk, and 2 yr of age) were studied. The connective tissue indicators [salt-soluble collagen and sulfated glycosaminoglycan (sGAG)], lipid hydroperoxide (LPO), myeloperoxidase (MPO), and hexosamine were assessed. We also evaluated the expression of early growth response-1 (Egr-1), phosphatase and tension homologue deleted on chromosome 10 (PTEN), caspase-9 (index of apoptosis), VEGF (index of angiogenesis), calcitonin gene-related peptide (CGRP, index of sensory neurons), and neuronal nitric oxide synthase (nNOS). The histological connective tissue area in the lower part of rat gastric mucosa increased with aging, with increase of salt-soluble collagen and sGAG. LPO and MPO in old rats were significantly greater than in the young rats, whereas hexosamine was significantly reduced. The old gastric mucosa had increased expression of Egr-1, PTEN, and caspase-9, whereas the VEGF, CGRP, and nNOS expression were significantly reduced. These results indicate that the lower part of rat gastric mucosa was found to be replaced by connective tissue with accumulation of oxidative products with aging. In addition, impairment of apoptosis, angiogenesis, and sensory neuron activity via the activation of Egr-1 and PTEN might increase the susceptibility of gastric mucosa to injury during aging.
PubMed IF 3 소화기내과
1402010

제1저자 이세원 · 교신저자 임재준

, ,
Serial interferon-gamma release assays during treatment of active tuberculosis in young adults.
BMC Infect Dis. 2010;10:300.

Abstract
BACKGROUND The role of interferon-γ release assay (IGRA) in monitoring responses to anti-tuberculosis (TB) treatment is not clear. We evaluated the results of the QuantiFERON-TB Gold In-tube (QFT-GIT) assay over time during the anti-TB treatment of adults with no underlying disease.
METHODS We enrolled soldiers who were newly diagnosed with active TB and admitted to the central referral military hospital in South Korea between May 1, 2008 and September 30, 2009. For each participant, we preformed QFT-GIT assay before treatment (baseline) and at 1, 3, and 6 months after initiating anti-TB medication.
RESULTS Of 67 eligible patients, 59 (88.1%) completed the study protocol. All participants were males who were human immunodeficiency virus (HIV)-negative and had no chronic diseases. Their median age was 21 years (range, 20-48). Initially, 57 (96.6%) patients had positive QFT-GIT results, and 53 (89.8%), 42 (71.2%), and 39 (66.1%) had positive QFT-GIT results at 1, 3, and 6 months, respectively. The IFN-γ level at baseline was 5.31 ± 5.34 IU/ml, and the levels at 1, 3, and 6 months were 3.95 ± 4.30, 1.82 ± 2.14, and 1.50 ± 2.12 IU/ml, respectively. All patients had clinical and radiologic improvements after treatment and were cured. A lower IFN-γ level, C-reactive protein ≥ 3 mg/dl, and the presence of fever (≥ 38.3°C) at diagnosis were associated with negative reversion of the QFT-GIT assay.
CONCLUSION Although the IFN-γ level measured by QFT-GIT assay decreased after successful anti-TB treatment in most participants, less than half of them exhibited QFT-GIT reversion. Thus, the reversion to negativity of the QFT-GIT assay may not be a good surrogate for treatment response in otherwise healthy young patients with TB.
PubMed IF 3.2 호흡기내과
1392010

제1저자 권지현 · 교신저자 김지현

, , , , , , , , , , , , , ,
Triple negativity and young age as prognostic factors in lymph node-negative invasive ductal carcinoma of 1 cm or less.
BMC Cancer. 2010;10:557.

Abstract
BACKGROUND Whether a systemic adjuvant treatment is needed is an area of controversy in patients with node-negative early breast cancer with tumor size of ≤1 cm, including T1mic.
METHODS We performed a retrospective analysis of clinical and pathology data of all consecutive patients with node-negative T1mic, T1a, and T1b invasive ductal carcinoma who received surgery between Jan 2000 and Dec 2006. The recurrence free survival (RFS) and risk factors for recurrence were identified.
RESULTS Out of 3889 patients diagnosed with breast cancer, 375 patients were enrolled (T1mic:120, T1a:93, T1b:162). Median age at diagnosis was 49. After a median follow up of 60.8 months, 12 patients developed recurrences (T1mic:4 (3.3%), T1a:2 (2.2%), T1b:6 (3.7%)), with a five-year cumulative RFS rate of 97.2%. Distant recurrence was identified in three patients. Age younger than 35 years (HR 4.91; 95% CI 1.014-23.763, p = 0.048) and triple negative disease (HR 4.93; 95% CI 1.312-18.519, p = 0.018) were significantly associated with a higher rate of recurrence. HER2 overexpression, Ki-67, and p53 status did not affect RFS.
CONCLUSIONS Prognosis of node-negative breast cancer with T1mic, T1a and T1b is excellent, but patients under 35 years of age or with triple negative disease have a relatively high risk of recurrence.
PubMed IF 4.1 혈액종양내과
1382010

제1저자 김대희 · 교신저자 김용진

, , , , , , , ,
The protective effect of thalidomide on left ventricular function in a rat model of diabetic cardiomyopathy.
Eur J Heart Fail. 2010;12(10):1051-60.

Abstract
AIMS To evaluate the protective effect of thalidomide, a potent anti-inflammatory drug, on the development of diabetic cardiomyopathy (DMCMP).
METHODS AND RESULTS We induced type 1 diabetes using streptozocin in 8-week-old Sprague-Dawley rats, divided them into two groups-a thalidomide treatment group (DM-T, n = 15) and a non-treatment group (DM-N, n = 15)-and compared them with a normal control (n = 10). Ten weeks after diabetes induction, heart and lung mass indices were higher in the DM-N group compared with the control group. In the DM-T group, increases in heart and lung mass indices were attenuated compared with the DM-N group. On echocardiographic examination, systolic and diastolic mitral annulus velocities were impaired in the DM-N group, but they remained normal in the DM-T group. On haemodynamic analyses, left ventricular (LV) systolic function, represented by end-systolic elastance (0.35 ± 0.14 vs. 0.18 ± 0.07 mmHg/μl, P < 0.001) and preload-recruitable stroke work (90.5 ± 24.3 vs. 51.8 ± 22.0 mmHg, P < 0.001), was preserved in the DM-T group compared with the DM-N group. Likewise, deterioration of LV diastolic function was attenuated in the DM-T group. Increases in serum levels of TNF-α were attenuated in the DM-T group compared with the DM-N group. On histological analysis, thalidomide treatment lowered total myocardial collagen content and the expression of TNF-α, IL-1β, ICAM-1, and VCAM-1.
CONCLUSION In an animal model of DMCMP, deterioration of LV systolic and diastolic function was partially prevented by thalidomide treatment.
PubMed IF 10.3 순환기내과
1372010

제1저자 정혜승 · 교신저자 박경수

, , , , , , , , , ,
Analysis of hemodialysis-associated hypoglycemia in patients with type 2 diabetes using a continuous glucose monitoring system.
Diabetes Technol Ther. 2010;12(10):801-7.

Abstract
BACKGROUND Adequate glycemic control is important for patients with end-stage renal disease on maintenance hemodialysis (HD). Continuous glucose monitoring (CGM) systems are reported as a useful method for glucose monitoring in patients under maintenance HD. The object of this study was to describe glucose profiles and hypoglycemia associated with HD in diabetes patients using a CGM system.
METHODS We recruited nine medically stable patients with type 2 diabetes under maintenance HD. CGMS System Gold (Medtronic MiniMed, Northridge, CA) was applied to the subjects for 144 h. During the period, HD using glucose-containing dialysate was performed every other day. Various glucose profiles were calculated from the CGM readings and compared between the day on and the day off dialysis.
RESULTS Mean ± SD for age, duration of diabetes, and hemoglobin A1c were 67 ± 9 years, 24 ± 9 years, and 8.6 ± 1.2%, respectively. Hemoglobin A1c was correlated with mean glucose (ρ = 0.780, P < 0.05) and with area under the curve for glucose above 180 mg/dL (ρ = 0.797, P<0.05). Although there was no difference for mean amplitude of glycemic excursion between the day on and off HD, hypoglycemia occurred predominantly with day on HD. In the subjects who maintained antidiabetes agents with day on HD, glucose levels decreased with initiation of HD, causing significantly lower glucose levels compared to those during the equivalent time of the following day without HD.
CONCLUSIONS According to the CGM system, glucose variability was not affected by HD. However, in spite of glucose-containing dialysate, HD seemed to increase the risk of hypoglycemia.
PubMed IF 7.4 내분비대사내과
1362010

제1저자 박승정 · 교신저자 오세일

, , , , , , , , ,
Long-term prognosis of left ventricular lead.
J Korean Med Sci. 2010;25(10):1462-6.

Abstract
Transvenous left ventricular (LV) lead implantation is on the increase due to cardiac resynchronization therapy (CRT). However, there has been paucity of data on the prognosis of LV lead. Consecutive 32 patients with LV lead for CRT (n=22) or pacemaker (n=10) were subjected. Serial changes in pacing threshold and impedance along with lead-related complications were evaluated. Over 2 yr follow-up, there was no significant change in relative threshold voltage to the initial value (100%, 110%, 89.6%, and 79.6% at baseline, 1, 6, and 24 months respectively, P=0.62) as well as lead impedance (816±272, 650±178, 647±191, and 590±185 ohm at baseline, 1, 6, and 24 months respectively, P=0.80). The threshold change was not affected by lead position, lead polarity, and indication of lead implantation. The cumulative rates of lead revision were 6.3% (n=2) and 9.4% (n=3) in 6 month and 2 yr follow-up, respectively. One case of phrenic nerve capture at left lateral decubitus position was detected 1 month after the implantation. However, there were no serious complications over 2 yr period. In conclusion, transvenous LV lead implantation showed favorable long-term prognosis. Pacing parameters remained stable without significant changes over 2 yr follow-up.
PubMed IF 3.2 순환기내과
1352010

제1저자 최평균 · 교신저자 오명돈

, , , , , , , ,
Incidence of atazanavir-associated hyperbilirubinemia in Korean HIV patients: 30 months follow-up results in a population with low UDP-glucuronosyltransferase1A1*28 allele frequency.
J Korean Med Sci. 2010;25(10):1427-30.

Abstract
Hyperbilirubinemia is frequently observed in Caucasian HIV patients treated with atazanavir. UDP-glucuronosyltransferase 1A1 polymorphism, UGT1A1*28, which is associated with atazanavir-induced hyperbilirubinemia, is less common in Asians than in Caucasians. However, little is known about the incidence of atazanavir-associated hyperbilirubinemia in Asian populations. Our objective was to investigate the incidence of and tolerability of atazanavir-associated hyperbilirubinemia in Korean HIV patients. The prevalence and cumulative incidence of atazanavir-associated hyperbilirubinemia and UGT1A1*28 allele frequency was investigated in 190 Korean HIV-infected patients treated with atazanavir 400 mg per day. The UGT1A1*28 were examined by direct sequencing of DNA from peripheral whole blood. The UGT1A1*28 allele frequency was 11%. The cumulative incidence of any grade of hyperbilirubinemia was 77%, 89%, 98%, and 100%, at 3, 12, 24, and 30 months, respectively. The cumulative incidence of severe (grade 3-4) hyperbilirubinemia was 21%, 41%, 66%, and 75%, at 3, 12, 24, and 30 months, respectively. However, the point prevalence of severe hyperbilirubinemia did not increase with time and remained around 25%. Our data suggest that atazanavir-associated hyperbilirubinemia is common but transient in a population with low UGT1A1*28 allele frequency.
PubMed IF 3.2 감염내과
1342010

제1저자 김상현,박경일 · 교신저자 김효수

, , , , , , , , , ,
Efficacy and tolerability of a generic and a branded formulation of atorvastatin 20 mg/d in hypercholesterolemic Korean adults at high risk for cardiovascular disease: a multicenter, prospective, randomized, double-blind, double-dummy clinical trial.
Clin Ther. 2010;32(11):1896-905.

Abstract
BACKGROUND The reduction in plasma LDL-C concentrations with 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor (statin) therapy has been reported to reduce cardiovascular risk and mortality in individuals with or without preexisting coronary artery disease and elevated LDL-C concentrations. Atorvastatin is a statin used for lowering LDL-C concentrations. A generic formulation of atorvastatin is being developed in Korea. This study was undertaken for the purposes of marketing the generic formulation.
OBJECTIVE This study was designed to compare the efficacy and tolerability of a generic formulation of atorvastatin 20 mg/d versus a branded formulation at the same dosage in hypercholesterolemic Korean adults at high risk for cardiovascular events.
METHODS This 8-week, multicenter, randomized, double-blind, double-dummy study was conducted at 10 clinical centers in Korea between September 2008 and May 2009. Male and female patients aged 20 to 85 years at high risk for cardiovascular events (defined as an elevated LDL-C concentration [≥100 mg/dL]) were enrolled. Eligible patients were randomly assigned to receive generic or branded atorvastatin 20 mg once daily for 8 weeks. The primary end point was the percentage change from baseline to 8 weeks in LDL-C concentration. Secondary end points were the percentage changes from baseline in total cholesterol (TC), triglycerides (TG), HDL-C, apolipoprotein (apo) A1 and B, and high-sensitivity C-reactive protein concentrations; small, dense LDL (sdLDL) fraction; and tolerability. Tolerability was assessed using physical examination, laboratory testing, and by recording adverse events (AEs) at each visit. An additional secondary end point was the proportion of patients who achieved an LDL-C goal of <100 mg/dL.
RESULTS A total of 244 patients were randomized to treatment, and 33 patients were withdrawn from the study (9 patients did not receive the study medication, 11 patients due to AEs, and 13 patients due to withdrawal of consent). A total of 211 patients completed the study (50.7% male; 100% Asian; mean [SD] age, 61.7 [9.2] years) (106 patients in the group that received Accepted for publication October 5, 2010. the generic formulation and 105 patients in the group that received the branded formulation). LDL-C concentrations were reduced from the baseline by 44% and 46% after 8 weeks of treatment with the generic and branded formulations, respectively (P = NS). The percentage changes from baseline to study end in HDL-C, TC, TG, apo A1, apo B, and hsCRP concentrations and sdLDL fraction the proportions of patients who achieved the LDL-C goal between the 2 groups did not reach statistical significance. The most commonly reported events were hepatobiliary laboratory abnormality (1.7%), general somatic discomfort (1.7%), and epigastric pain (0.8%) in the group that received the generic formulation, and myalgia (1.7%), epigastric pain (0.9%), and elevation of creatinine phosphokinase (0.9%) in the group that received the branded formulation. No serious AEs were reported in either group.
CONCLUSIONS After 8 weeks of treatment, the differences in the LDL-C-lowering effects between the generic and branded formulations of atorvastatin 20 mg/d did not reach statistical significance in these Korean patients at high risk for cardiovascular events. Both formulations were generally well tolerated.
PubMed IF 3.7 순환기내과
1332010

제1저자 김충종 · 교신저자 김남중

, , , , , , , ,
A comparative study of pyogenic and tuberculous spondylodiscitis.
Spine (Phila Pa 1976). 2010;35(21):E1096-100.

Abstract
STUDY DESIGN We performed a retrospective review of 126 cases of infectious spondylodiscitis over a 4-year period.
OBJECTIVE Differentiation between pyogenic spondylodiscitis (PS) and tuberculous spondylodiscitis (TS) is essential for deciding on the appropriate therapeutic regimen. The aim of this study was to compare the characteristics of the 2 forms of spondylodiscitis.
SUMMARY OF BACKGROUND DATA There has been much effort to distinguish the radiologic findings in PS versus TS, but classification based on radiologic findings alone had limitations yet.
METHODS We compared the predisposing factors or associated illnesses, clinical, radiologic, and laboratory features of microbiologically confirmed cases of PS and TS in 2 university hospitals.
RESULTS Of 126 patients, 79 had PS and 47 TS. PS was more frequently associated with the followings: previous invasive spinal procedures (PS vs. TS: 32.9% vs. 8.5%), preceding bacteremia (13.9% vs. 0%), chronic renal failure (12.7% vs. 0%), liver cirrhosis (13.9% vs. 0%), fever (temperature >38°C) (48.1% vs. 17.0%), white blood cell counts over 10,000/mm (41.8% vs. 19.1%), fraction of neutrophils >75% (49.4% vs. 27.7%), C-reactive protein levels over 5 mg/dL (58.2% vs. 27.7%), erythrocyte sedimentation rate levels over 40 mm/h (84.4% vs. 66.0%), and ALP levels over 120 IU/L (45.6% vs. 17.0%). TS was frequently associated with active tuberculosis of other organs (0% vs. 31.9%), longer diagnostic delay (47.6 vs. 106.3 days), involvement of thoracic spines (21.5% vs. 38.3%), and involvement of ≥3 spinal levels (11.4% vs. 36.2%).
CONCLUSION Previous invasive spinal procedures, preceding bacteremia, fever, higher white blood cell counts, C-reactive protein, ALP, and higher fraction of neutrophils are suggestive of PS. Concurrent active tuberculosis, more indolent course and involvement of thoracic spines are suggestive of TS. When the causative organism is not identified despite all efforts at diagnosis, combination of the clinical, radiologic, and laboratory characteristics of the patient is helpful.
PubMed IF 3.7 감염내과
1322010

제1저자 박완범 · 교신저자 김원/이국래

, , , , , , , , , , ,
Antituberculosis drug-induced liver injury in chronic hepatitis and cirrhosis.
J Infect. 2010;61(4):323-9.

Abstract
OBJECTIVES To evaluate the incidence, risk factors and outcomes for anti-tuberculosis (TB) drug-induced liver injury (DILI) in patients with chronic liver disease including cirrhosis.
METHODS A total of 107 patients with chronic liver disease were assessed for anti-TB DILI. Anti-TB DILI was defined as elevation of alkaline phosphatase (ALP), aspartate transaminase, or alanine transaminase, or an increase in Child-Turcotte-Pugh score within 2 months of initiating anti-TB medication. The risk factors for anti-TB DILI were evaluated by multivariate logistic regression analysis.
RESULTS Fifty-eight (54%) patients had cirrhosis. Of 93 patients receiving one or more hepatotoxic anti-TB drugs, 18 (17%) experienced DILI: 11 (24%) among 46 patients with chronic hepatitis and 7 (15%) among 46 patients with compensated liver cirrhosis (P = 0.271). Independent risk factors for DILI were female sex, number of hepatotoxic anti-TB drugs administered and baseline ALP levels but not cirrhosis itself. Of the 18 patients with DILI, 13 (72%) successfully completed anti-TB treatment after switching to less hepatotoxic drug regimens.
CONCLUSIONS Hepatotoxic anti-TB drugs may be safely used in the patients with chronic liver disease including compensated cirrhosis if number of hepatotoxic drugs used is adjusted appropriately.
PubMed IF 10 감염내과
1312010

제1저자 박상원 · 교신저자 이창섭

, , , , , , ,
Antigenic drift of Orientia tsutsugamushi in South Korea as identified by the sequence analysis of a 56-kDa protein-encoding gene.
Am J Trop Med Hyg. 2010;83(4):930-5.

Abstract
This study was performed to determine the nationwide antigenic diversity of Orientia tsutsugamushi in South Korea. Sequence analysis was performed around variable domains I and II of a 56-kDa protein-encoding gene. We used eschar to overcome the disadvantages of conventional serotyping. The serological passive hemagglutination assay (PHA) was assessed based on the genotyping results. We analyzed 153 isolates from scrub typhus patients in major endemic areas and found that Boryong was the major strain (68.6%). New strains were also identified: Taguchi (19.6%), Kanda/Kawasaki (9.2%), and UAP7 (1.3%). PHA yielded significantly fewer positive results among Kawasaki strains (P < 0.001), which are not included in the PHA antigen panel. In South Korea, Boryong was still the predominant strain, but the sequence analysis identified new changes in minor strains (30.1%). This antigenic drift had a negative effect on the PHA results. Periodic surveillance of the contemporary strains using sequence analysis is needed.
PubMed IF 1.9 감염내과
1302010

제1저자 강은하 · 교신저자 송영욱

, , , , , ,
Myositis autoantibodies in Korean patients with inflammatory myositis: anti-140-kDa polypeptide antibody is primarily associated with rapidly progressive interstitial lung disease independent of clinically amyopathic dermatomyositis.
BMC Musculoskelet Disord. 2010;11:223.

Abstract
BACKGROUND To investigate the association between myositis autoantibodies and clinical subsets of inflammatory myositis in Korean patients.
METHODS Immunoprecipitation was performed using the sera of classic polymyositis (PM) (n = 11) and dermatomyositis (DM) (n = 38) patients who met the Bohan and Peter criteria for definite inflammatory myositis. A panel of defined myositis autoantibodies was surveyed to investigate the association between each autoantibody and clinical subsets of inflammatory myositis.
RESULTS Either MSAs, anti-p140, or anti-p155/140 antibodies were found in 63.3% (31/49) of the study subjects. Anti-140-kDa-polypeptide (anti-p140) (18.4%, 9/49) and anti-155/140-kDa polypeptide (anti-p155/140) (16.3%, 8/49) antibodies were the most common, followed by anti-Mi2 (14.3%, 7/49), anti-ARS (12.2%, 6/49) and anti-SRP (2.0%, 1/49) antibodies. All MSAs and anti-p140 and anti-p155/140 antibodies were mutually exclusive. Anti-p140 (23.7%, 9/38), anti-p155/140 (21.1%, 8/38), and anti-Mi2 (18.4%, 3/38) antibodies were found exclusively in DM patients. Anti-p140 antibody was associated with rapidly progressive interstitial lung disease (ILD) (p = 0.001), with a sensitivity of 100.0% (4/4) and a specificity of 85.3% (29/34) in DM patients. Anti-p155/140 antibody was associated with cancer-associated DM (p = 0.009), with a sensitivity of 55.6% (5/9) and a specificity of 89.7% (26/29). Cancer-associated survival was significantly worse when anti-p155/140 antibody was present (19.2 ± 7.6 vs. 65.0 ± 3.5 months, p = 0.032). Finally, anti-ARS antibodies were associated with stable or slowly progressive ILD in PM and DM patients (p = 0.005).
CONCLUSIONS Anti-p140 and anti-p155/140 antibodies were commonly found autoantibodies in Korean patients with inflammatory myositis. Despite the lack of clinically amyopathic DM patients in the study subjects, a strong association was observed between anti-p140 antibody and rapidly progressive ILD. Anti-p155/140 antibody was associated with cancer-associated myositis and poor survival.
PubMed IF 2.8 류마티스내과
1292010

제1저자 이정훈 · 교신저자 윤정환

, , , , , , , , , , ,
Retinoic acid and its binding protein modulate apoptotic signals in hypoxic hepatocellular carcinoma cells.
Cancer Lett. 2010;295(2):229-35.

Abstract
Hypoxia induces survival signals in hepatocellular carcinoma (HCC). We attempted to find a hypoxia-induced signal that could be used for modulating HCC cell death. Cellular retinoic acid binding protein-II (CRABP-II) expression was significantly increased in hypoxic HCC cells. Treatment with retinoic acid (RA), a ligand for CRABP-II, induced HCC cell apoptosis more effectively in hypoxia than in normoxia, whereas hypoxia-induced CRABP-II expression attenuated RA-induced apoptosis. Inhibition of CRABP-II enhanced RA-induced apoptosis and sensitized RA-resistant HCC cells to RA cytotoxicity by attenuating p42/44 MAPK and Akt activation. Therefore, RA/CRABP-II signal modulation is therapeutically implicated in infiltrative HCCs exposed to hypoxia.
PubMed IF 11.8 소화기내과
1282010

제1저자 윤원재 · 교신저자 윤용범

, , , ,
Secondary appendiceal tumors: a review of 139 cases.
Gut Liver. 2010;4(3):351-6.

Abstract
BACKGROUND/AIMS This study evaluated the clinicopathologic characteristics of patients with secondary appendiceal tumors (SATs).
METHODS We performed a single-center, retrospective study of patients with pathologically confirmed SATs.
RESULTS Among 180 cases of appendiceal malignancies diagnosed between 2000 and 2007, 139 cases (77.2%, 46 male) were SATs. The median age at SAT diagnosis was 55 years. The most common primary origin was the ovary. The mode of appendiceal involvement was metastasis in 122 and invasion in 17 patients. Extra-appendiceal involvement was present in 134 patients. The only manifestation that could be attributed to the SAT itself was appendicitis (n=8). Serosal involvement was predominant. The median survival after diagnosis of SAT was 22.6 months. In the Cox regression analysis, chemotherapy included in the treatment was the only factor associated with prolonged survival (hazards ratio, 0.12; 95% confidence interval, 0.06-0.23; p<0.001). Complete resection of the SAT had no influence on survival.
CONCLUSIONS SATs accounted for 77.2% of all pathologically diagnosed appendiceal malignancies. The most common origin was the ovary. SATs were usually associated with widespread disease, and the median survival after SAT diagnosis was 22.6 months. Complete resection of the SAT had no influence on survival.
PubMed IF 4.1 소화기내과
1272010

제1저자 김진현 · 교신저자 이은봉

, , , , ,
Imbalance of Th17 to Th1 cells in Behçet's disease.
Clin Exp Rheumatol. 2010;28(4 Suppl 60):S16-9.

Abstract
OBJECTIVES Behçet's disease (BD) is a helper T cell-mediated autoimmune disease characterised by recurrent orogenital ulcers, uveitis and skin lesions. The helper T cells are divided into Th1, Th2 and Th17 cells according to the pattern of cytokine secretion. Th1 and Th17 cells can contribute to the development of the disease with their respective proinflammatory cytokines, IFN-γ and IL-17. In this study, we investigated the relative role of Th17, Th1 and Th2 cells in BD.
METHODS Peripheral blood mononuclear cells were isolated from 30 patients with BD, for whom the detailed clinical manifestations and medication history were investigated and recorded. Surface markers and intracellular levels of IL-17, IFN-γ and IL-4 in isolated CD4+ T cells were measured using flow-cytometry from these patients and from two control groups, 34 rheumatoid arthritis patients and 24 healthy blood donors to analyse the relationship of Th1, Th17 and Th2 cells in BD.
RESULTS The ratio of Th17/Th1 cells was significantly increased in BD compared to healthy controls (0.16±0.09 vs. 0.10±0.04, p=0.012), while there was no difference in the ratios of Th1/Th2 or Th17/Th2 cells. Th17/Th1 ratio was elevated in BD patients with uveitis or folliculitis compared to those without it (0.21±0.10 vs. 0.13±0.06, p=0.045 for uveitis; 0.18±0.10 vs. 0.12±0.05, p=0.036 for folliculitis).
CONCLUSIONS Our results confirm that TH17 cells are instrumental in Behçet's uveitis and folliculitis. Furthermore, our findings suggest that the role of Th17 cells should be interpreted in the context of their ratio to Th1 cells.
PubMed IF 3.2 류마티스내과
1262010

제1저자 정용진 · 교신저자 김윤준

, , , , , , , ,
Clinical features of acute renal failure associated with hepatitis A virus infection.
J Viral Hepat. 2010;17(9):611-7.

Abstract
Acute hepatitis A (AHA) is one of the most common infectious diseases; it is usually a self-limiting disease affecting the liver. Although extrahepatic manifestations are not common, some cases have been reported associated with acute renal failure. We reviewed the clinical features of patients with AHA complicated by acute renal failure (ARF group) and compared them with patients with noncomplicated AHA (non-ARF group). The medical records of 208 consecutive patients with AHA who were diagnosed between January 2003 and October 2008 were reviewed. We identified 15 patients (7.2%) with ARF associated with AHA. There were no differences between the ARF and non-ARF group with regard to gender and age. The peak value of alanine aminotransferase (ALT) (median: 6060 IU/L vs 1792 IU/L, P < 0.001), prothrombin time (PT) (International normalized ratio, median 1.72 vs 1.10, P < 0.001), and total bilirubin level (median: 9.6 mg/dL vs 6.3 mg/dL, P = 0.04) were significantly higher in the ARF than in the non-ARF group. Twelve patients (80%) recovered completely with haemodialysis (seven patients, 46.7%) or only conservative management (five patients, 33.3%), while one patient underwent liver transplantation because of fulminant hepatic failure, and two patients died because of fulminant hepatic failure. There were no deaths among patients with noncomplicated AHA in the non-ARF group. Five patients underwent kidney biopsy; two patients were diagnosed with acute tubular necrosis, two patients with acute interstitial nephritis with IgA nephropathy and one patient with acute tubulointerstitial nephritis. All patients in the ARF group had microscopic haematuria and proteinuria (100%vs 31.1%, P < 0.001). Urine sodium levels were more than 10 mEq/L in 10 patients. The findings of high urinary sodium concentrations, microscopic haematuria and proteinuria did not support the diagnosis of hepatorenal syndrome (HRS). Patients with AHA with ARF had higher ALT levels, more prolonged PTs, and higher total bilirubin levels. The prognosis for these patients was poorer than for those without ARF. However, the patients with ARF and nonfulminant AHA had recovered with proper treatment and should not be confused with patients that have HRS.
PubMed IF 2.3 소화기내과

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