SCI 발표논문

1. 2292012

   제1저자 김용철 · 교신저자 진호준

   Kim YC, Goo HS, Ahn SY, Oh SW, Kim SJ, Na KY, Chae DW, Kim SG, Chin HJ

   The low number of red blood cells is an important risk factor for all-cause mortality in the general population

   Tohoku J Exp Med. 2012;227:149-159.

   IF 1.358 신장내과
2. 2282012

   제1저자 윤지완, 강선미 · 교신저자 임수

   Yoon JW, Kang SM, Jason L Vassy, Shin H, Lee YH, Ahn HY, Choi SH, Park KS, Jang HC, Lim S

   Efficacy and safety of ginsam, a vinegar extract from Panax ginseng, in type 2 diabetic patients: Resuts of a double-blind, placebo-controlled study

   Journal of Diabetes Investigation. 2012;3:309-317.

   IF 1.861 내분비대사내과
3. 2272012

   제1저자 조유리 · 교신저자 이동호

   Cho Y, Lee DH, Oh HS, Seo JY, Lee DH, Kim N, Jeong SH, Kim JW, Hwang JH, Park YS, Lee SH, Shin CM, Jo HJ, Jung HC, Yoon YB, Song IS

   Erratum to: Higher Prevalence of Obesity in Gastric Cardia Adenocarcinoma Compared to Gastric Non-Cardia Adenocarioma

   Dig Dis Sci. 2012;30.

   IF 2.06 소화기내과
4. 2262012

   제1저자 최형진 · 교신저자 이성수

   Choi HJ, Shin CS, Ha YC, Jang S, Jang S, Park C, Yoon HK, Lee SS

   Burden of osteoporosis in adults in Korea: a national health insurance database study

   Journal of bone and mineral metabolism. 2012;30(1):59.

   IF 2.238 내분비대사내과
5. 2252012

   제1저자 김장언/황진혁 · 교신저자 이상협

   Kim JE, Hwang JH, Lee SH, Cha BH, Park YS, Kim JW, Jeong SH, Kim NY, Lee DH

   The clinical outcome of elderly patients with acute pancreatitis is not different in spite of the different etiologies and severity

   Arch Gerontol Geriatr. 2012;54(1):256-60.

   IF 1.438 순환기내과
6. 2242012

   제1저자 이병환 · 교신저자 김나영

   Lee BH, Kim N, Lee HS, Kang JM, Park HK, Jo HJ, Shin CM, Lee SH, Park YS, Hwang JH, Kim JW, Jeong SH, Lee DH, Jung HC, Song IS

   The Role of CDX2 in the Intestinal metaplasia Evaluated by Immunohistochemistry

   Gut and Liver. 2012;6(1):71-77.

   IF 0.219 소화기내과
7. 2232012

   제1저자 조영민 · 교신저자 조영민

   Cho YM, Kim JH, Kim M, Park SJ, Koh SH, Ahn HS, Kang GH, Lee JB, Park KS, Lee HK

   Mesenchymal Stem Cells Transfer Mitochondria to the Cells with Virtually No Mitochondrial Function but Not with Pathogenic mtDNA Mutations

   PLoS ONE. 2012;7(3):e32778.

   IF 4.351 내분비대사내과
8. 2222012

   제1저자 최종경/류지곤 · 교신저자 이상협

   Choi J, Ryu JK, Lee SH, Ahn DW, Hwang JH, Kim YT, Yoon YB, Han JK

   Biliary drainage for obstructive jaundice caused by unresectable hepatocellular carcinoma: the endoscopic versus percutaneous approach.

   Hepatobiliary Pancreat Dis Int. 2012;11(6):636-42.

   Abstract

   BACKGROUND For palliative treatment of the obstructive jaundice associated with unresectable hepatocellular carcinoma (HCC), percutaneous transhepatic biliary drainage (PTBD) or endoscopic retrograde biliary drainage (ERBD) has been performed. PTBD is preferred as an initial procedure. Little is known about the better option for patients with obstructive jaundice caused by unresectable HCC.

   METHODS Sixty patients who had received ERBD or PTBD for the palliative treatment of obstructive jaundice caused by unresectable HCC between January 2006 and May 2010 were included in this retrospective study. Successful drainage, drainage patency, and the overall survival of patients were evaluated.

   RESULTS Univariate analysis revealed that the overall frequency of successful drainage was higher in the ERBD group (22/29, 75.9%) than in the PTBD group (15/31, 48.4%) (P=0.029); but multivariate analysis showed marginal significance (P=0.057). The duration of drainage patency was longer in the ERBD group than in the PTBD group (82 vs 37 days, respectively, P=0.020). Regardless of what procedure was performed, the median survival time of patients who had a successful drainage was much longer than that of the patients who did not have a successful drainage (143 vs 38 days, respectively, P<0.001).

   CONCLUSION Besides PTBD, ERBD may be used as the initial treatment option to improve obstructive jaundice in patients with unresectable HCC if there is a longer duration of drainage patency after a successful drainage.

   PubMed IF 3.9 소화기내과
9. 2212012

   제1저자 서정원, 김치훈 · 교신저자 최동주

   Suh JW, Kim CH, Oh IY, Yoon CH, Kim KI, Cho YS, Youn TJ, Chae IH, Choi DJ

   Effect of tailored antiplatelet therapy on periprocedural myonecrosis in patients with diabetes mellitus (from the DM-Verify Now Trial).

   Am J Cardiol. 2012;110(12):1749-55.

   Abstract

   We investigated whether additional platelet inhibition with a glycoprotein IIb/IIIa inhibitor would be beneficial in reducing the risk of periprocedural myocardial infarction (PMI) in diabetic patients with high residual platelet reactivity (HPR). Patients with diabetes mellitus were administered aspirin and clopidogrel at a 300-mg loading dose 1 day before the procedure, and the VerifyNow P2Y(12) assay was performed just before percutaneous coronary intervention. Patients with HPR, defined as a P2Y(12) reaction unit of ≥270 were randomly assigned to group A or control group C1. Patients without HPR were assigned to control group C2. Conventional anticoagulation with heparin was given to groups C1 and C2, and group A received additional abciximab treatment. Clinically relevant PMI was defined as any elevation in the biomarkers creatine kinase-MB isoenzyme and cardiac troponin I >3 times the upper normal limit measured 8, 16, or 24 hours after percutaneous coronary intervention. Of the patients, 47 and 51 were assigned to group A and C1; the clinical and procedural characteristics in the 2 groups were balanced. Of the 47 patients in group A and 51 patients in group C1, 9 (19%) and 9 (18%), respectively, experienced a PMI event according to the creatine kinase-MB cutoff (p = 1.00), and 27 in group A (57%) and 29 in group C1 (57%) experienced a PMI event according to the troponin I cutoff (p = 1.00). Five minor bleeding events, including small and localized hematomas, were observed immediately after the procedure (4 in group A and 1 in group C1). Only 1 major bleeding event, retroperitoneal hemorrhage, was observed in group A. The patients in group C2 had a PMI event rate (50% of 32 patients, p = 1.00) similar to that of group C1. In conclusion, additional platelet inhibition using a tailored approach and a point-of-care assay did not improve the periprocedural outcome in diabetic patients with HPR.

   PubMed IF 2.5 순환기내과
10. 2202012

    제1저자 김덕겸 · 교신저자 Edwin K. Silverman

    Kim DK, Cho MH, Hersh CP, Lomas DA, Miller BE, Kong X, Bakke P, Gulsvik A, Agustí A, Wouters E, Celli B, Coxson H, Vestbo J, MacNee W, Yates JC, Rennard S, Litonjua A, Qiu W, Beaty TH, Crapo JD, Riley JH, Tal-Singer R, Silverman EK, ECLIPSE, ICGN, and COPDGene Investigators

    Genome-wide association analysis of blood biomarkers in chronic obstructive pulmonary disease.

    Am J Respir Crit Care Med. 2012;186(12):1238-47.

    Abstract

    RATIONALE A genome-wide association study (GWAS) for circulating chronic obstructive pulmonary disease (COPD) biomarkers could identify genetic determinants of biomarker levels and COPD susceptibility.

    OBJECTIVES To identify genetic variants of circulating protein biomarkers and novel genetic determinants of COPD.

    METHODS GWAS was performed for two pneumoproteins, Clara cell secretory protein (CC16) and surfactant protein D (SP-D), and five systemic inflammatory markers (C-reactive protein, fibrinogen, IL-6, IL-8, and tumor necrosis factor-α) in 1,951 subjects with COPD. For genome-wide significant single nucleotide polymorphisms (SNPs) (P < 1 × 10(-8)), association with COPD susceptibility was tested in 2,939 cases with COPD and 1,380 smoking control subjects. The association of candidate SNPs with mRNA expression in induced sputum was also elucidated.

    MEASUREMENTS AND MAIN RESULTS Genome-wide significant susceptibility loci affecting biomarker levels were found only for the two pneumoproteins. Two discrete loci affecting CC16, one region near the CC16 coding gene (SCGB1A1) on chromosome 11 and another locus approximately 25 Mb away from SCGB1A1, were identified, whereas multiple SNPs on chromosomes 6 and 16, in addition to SNPs near SFTPD, had genome-wide significant associations with SP-D levels. Several SNPs affecting circulating CC16 levels were significantly associated with sputum mRNA expression of SCGB1A1 (P = 0.009-0.03). Several SNPs highly associated with CC16 or SP-D levels were nominally associated with COPD in a collaborative GWAS (P = 0.001-0.049), although these COPD associations were not replicated in two additional cohorts.

    CONCLUSIONS Distant genetic loci and biomarker-coding genes affect circulating levels of COPD-related pneumoproteins. A subset of these protein quantitative trait loci may influence their gene expression in the lung and/or COPD susceptibility. Clinical trial registered with www.clinicaltrials.gov (NCT 00292552).

    PubMed IF 21.7 호흡기내과
11. 2192012

    제1저자 오도연 · 교신저자 방영주

    Oh DY, Kim TW, Park YS, Shin SJ, Shin SH, Song EK, Lee HJ, Lee KW, Bang YJ

    Phase 2 study of everolimus monotherapy in patients with nonfunctioning neuroendocrine tumors or pheochromocytomas/paragangliomas.

    Cancer. 2012;118(24):6162-70.

    Abstract

    BACKGROUND The current study was conducted to evaluate the efficacy and safety of everolimus in the treatment of patients with nonfunctioning neuroendocrine tumors (NETs) or pheochromocytomas/paragangliomas.

    METHODS Patients with histologically confirmed nonfunctioning NETs or pheochromocytomas/paragangliomas and with documented disease progression before study enrollment were eligible for the current study. Everolimus was administered daily at a dose of 10 mg for 4 weeks. Response was assessed by Response Evaluation Criteria In Solid Tumors (RECIST; version 1.0) every 8 weeks. The primary endpoint was the 4-month progression-free survival rate (PFSR). The hypothesis of the current study was that the 4-month PFSR would increase from 50% to 65%. Safety was evaluated using the National Cancer Institute's Common Terminology Criteria for Adverse Events (version 3.0).

    RESULTS A total of 34 patients were enrolled. Of these, 27 patients had nonfunctioning NETs, 5 had pheochromocytomas, and 2 had paragangliomas. The 4-month PFSR was 78%. Partial response (PR) was observed in 3 patients. Twenty-eight patients had stable disease (SD) and 2 patients developed progressive disease (PD). The response rate (RR) and overall disease control rate (DCR) were 9.0% (95% confidence interval [95% CI], 0%-18.6%) and 93.9% (95% CI, 85.8%-100%), respectively. The PFS was 15.3 months (95% CI, 4.6 months-26.0 months). Of the patients with nonfunctioning NETs, 3 achieved a PR and 23 had SD (RR, 11.1%; DCR, 100%); the PFS was 17.1 months (95% CI, 11.1 months-23.0 months) and the 4-month PFSR was 90.0%. Twenty-one patients (80.8%) demonstrated tumor shrinkage. In 7 patients with pheochromocytomas/paragangliomas, 5 achieved SD, and 2 developed PD. The PFS was 3.8 months (95% CI, 0.5 months-7.0 months) and the 4-month PFSR was 42.9%. Four patients demonstrated tumor shrinkage. The major grade 3/4 adverse events were thrombocytopenia (14.7%), hyperglycemia (5.9%), stomatitis (5.9%), and anemia (5.9%).

    CONCLUSIONS Everolimus was associated with high therapeutic efficacy and tolerability in patients with nonfunctioning NETs, and demonstrated modest efficacy in patients with pheochromocytomas/paragangliomas.

    PubMed IF 5.6 혈액종양내과
12. 2182012

    제1저자 조영진 · 교신저자 오세일

    Cho Y, Lee S, Choi EK, Park HE, Park KS, Oh S

    Posterior body surface potential mapping using capacitive-coupled electrodes and its application.

    J Korean Med Sci. 2012;27(12):1517-23.

    Abstract

    Using 49 capacitive-coupled electrodes, mattress-type harness was developed to obtain posterior body surface potential map (P-BSPM) in dressed individuals. The aim of this study was to investigate how valuable information P-BSPM could provide, especially in discrimination of old myocardial infarction (OMI). P-BSPM of 59 individuals were analyzed; 23 normal control, 11 right bundle branch block (RBBB), 3 left bundle branch block (LBBB) and 19 OMI patients. Principal component analysis and linear hyper-plane approach were used to evaluate diagnostic performance. The axes of P-BSPM vector potential corresponded well with 12-lead electrocardiogram. During QRS, the end point of P-BSPM vector potential demonstrated characteristic clockwise rotation in RBBB, and counterclockwise rotation in LBBB patients. In OMI, initial negativity on P-BSPM during QRS was more frequently located at lower half, and also stronger in patients with inferior myocardial infarction (MI). The area under the receiver-operating characteristic curve of P-BSPM during QRS in diagnosing overall OMI, anterior MI, and inferior MI was 0.83 (95% confidence interval, 0.70-0.97), 0.71 (0.47-0.94), and 0.98 (0.94-1.0), respectively (P = 0.022 for anterior vs inferior MI groups). In conclusion, the novel P-BSPM provides detailed information for cardiac electrical dynamics and is applicable to diagnosing OMI, especially inferior myocardial infarction.

    PubMed IF 3.2 순환기내과
13. 2172012

    제1저자 박진용 · 교신저자 박완범

    Park J, Kim TM, Hwang JH, Kim NH, Choe PG, Song KH, Kim ES, Park SW, Kim HB, Kim NJ, Park WB, Oh MD

    Risk factors for febrile neutropenia during chemotherapy for HIV-related lymphoma.

    J Korean Med Sci. 2012;27(12):1468-71.

    Abstract

    We evaluated risk factors for neutropenic fever and febrile prolonged neutropenia during vincristine-including chemotherapy to treat HIV-related lymphoma to investigate whether protease inhibitor (PI) treatment is associated with infectious complications due to drug interactions with chemotherapeutic agents. We included all HIV patients who received chemotherapy including vincristine for lymphoma at a single referral center in 1999-2010. Neutropenic fever was defined as absolute neutrophil count < 500 cells/µL with body temperature over 38℃; and prolonged neutropenia was defined if it persisted over 7 days. CODOX-M/IVAC and Stanford regimens were considered high-risk regimens for prolonged neutropenia. We analyzed 48 cycles of chemotherapy in 17 HIV patients with lymphoma. There were 22 neutropenic fever and 12 febrile prolonged neutropenia events. In multivariate analysis, neutropenic fever was associated with old age and low CD4 cell count, but not with PI use or ritonavir-boosted PI use. Low CD4 cell count and high-risk regimens were associated with febrile prolonged neutropenia. Neutropenic fever and febrile prolonged neutropenia is associated with old age, low CD4 cell count, and high-risk regimens, but not PI use, in HIV patients undergoing chemotherapy including vincristine for lymphoma.

    PubMed IF 3.2 감염내과
14. 2162012

    제1저자 윤연이 · 교신저자 Hajime Sakuma

    Yoon YE, Kitagawa K, Kato S, Ishida M, Nakajima H, Kurita T, Ito M, Sakuma H

    Prognostic value of coronary magnetic resonance angiography for prediction of cardiac events in patients with suspected coronary artery disease.

    J Am Coll Cardiol. 2012;60(22):2316-22.

    Abstract

    OBJECTIVES This study sought to determine whether whole-heart coronary magnetic resonance angiography (CMRA) can predict cardiac events in patients with suspected coronary artery disease.

    BACKGROUND Recent studies demonstrated that the presence of stenosis on coronary computed tomography angiography has a significant prognostic impact on the prediction of cardiac events. However, the prognostic value of whole-heart CMRA is unknown.

    METHODS We studied 207 patients with suspected coronary artery disease who underwent non-contrast-enhanced free-breathing whole-heart CMRA acquired with a 1.5-T MR system and 32-channel cardiac coils. The presence of significant coronary stenosis (≥50% diameter reduction) was visually determined on sliding thin- maximum intensity projection images. Follow-up information was obtained for occurrence of severe cardiac events (cardiac death, myocardial infarction, and unstable angina) and all cardiac events (additionally including revascularization>90 days after CMRA).

    RESULTS During a median follow-up of 25 months, 10 cardiac events, of which 5 were severe, were observed in 84 patients with significant stenosis. Whereas, in 123 patients without significant stenosis, only 1 cardiac event with no severe event was observed. Kaplan-Meier curves demonstrated a significant difference in event-free survival between the 2 groups for severe events (annual event rate, 3.9% and 0%, respectively; log-rank test, p = 0.003), as well as for all cardiac events (6.3% and 0.3%; p < 0.001). Cox regression analysis showed that presence of significant stenosis on CMRA was associated with a >20-fold hazard increase for all cardiac events (hazard ratio: 20.78; 95% confidence interval: 2.65 to 162.70; p = 0.001).

    CONCLUSIONS Whole-heart CMRA is useful for predicting the future risk for cardiac events in patients with suspected coronary artery disease.

    PubMed IF 22.3 순환기내과
15. 2152012

    제1저자 이하정 · 교신저자 진호준

    Lee H, Kim DK, Oh KH, Joo KW, Kim YS, Chae DW, Kim S, Chin HJ

    Mortality of IgA nephropathy patients: a single center experience over 30 years.

    PLoS One. 2012;7(12):e51225.

    Abstract

    Research on the prognosis of IgA nephropathy (IgAN) has focused on renal survival, with little information being available on patient survival. Hence, this investigation aimed to explore long-term patient outcome in IgAN patients. Clinical and pathological characteristics at the time of renal biopsy were reviewed in 1,364 IgAN patients from 1979 to 2008. The outcomes were patient death and end stage renal disease (ESRD) progression. Overall, 71 deaths (5.3%) and 277 cases of ESRD (20.6%) occurred during 13,916 person-years. Ten-, 20-, and 30-year patient survival rates were 96.3%, 91.8%, and 82.7%, respectively. More than 50% patient deaths occurred without ESRD progression. Overall mortality was elevated by 43% from an age/sex-matched general population (GP) (standardized mortality ratio [SMR], 1.43; 95% confidence interval [CI], 1.04-1.92). Men had comparable mortality to GP (SMR, 1.22; 95% CI, 0.82-1.75), but, in women, the mortality rate was double (SMR, 2.17; 95% CI, 1.21-3.57). Patients with renal risk factors such as initial renal dysfunction (estimated glomerular filgration rate <60 ml/min per 1.73 m(2); SMR, 1.70; 95% CI, 1.13-2.46), systolic blood pressure ≥ 140 mmHg (SMR, 1.88; 95% CI, 1.19-2.82) or proteinuria ≥ 1 g/day (SMR, 1.66; 95% CI, 1.16-2.29) had an elevated mortality rate. Patients with preserved renal function, normotension, and proteinuria <1 g/day, however, had a similar mortality rate to GP. When risk stratification was performed by counting the number of major risk factors present at diagnosis, low-risk IgAN patients had a mortality rate equal to that of GP, whereas high-risk patients had a mortality rate higher than that of GP. This investigation demonstrated that overall mortality in IgAN patients was higher than that of GP. Women and patients with renal risk factors had a higher mortality than that of GP, Therefore, strategies optimized to alleviate major renal risk factors are warranted to reduce patient mortality.

    PubMed IF 2.8 신장내과
16. 2142012

    제1저자 남현진 · 교신저자 오도연

    Nam HJ, Kim HP, Yoon YK, Song SH, Min AR, Han SW, Im SA, Kim TY, Oh DY, Bang YJ

    The irreversible pan-HER inhibitor PF00299804 alone or combined with gemcitabine has an antitumor effect in biliary tract cancer cell lines.

    Invest New Drugs. 2012;30(6):2148-60.

    Abstract

    Biliary tract cancer (BTC) is associated with poor survival and unresponsiveness to chemotherapy. Targeted therapies for BTC have been studied, and HER family members are promising therapeutic targets in BTC. In this study, we evaluated the efficacy of PF00299804, an irreversible pan-HER inhibitor, in eight BTC cell lines alone or combined with gemcitabine. PF00299804 potently inhibited the growth of two cell lines (SNU308 and SNU478) out of the eight BTC cell lines as a single agent. PF00299804 blocked HER family and downstream signaling pathways, inducing G1 arrest or apoptosis. Moreover, PF00299804 exerted synergistic effects with gemcitabine in seven of the eight BTC cell lines, possibly through the regulation of the genes involved in the response to gemcitabine, such as TS (thymidylate synthase), RRM1 (ribonucleotide reductase), and MAGEH1, which is negatively correlated with gemcitabine sensitivity. Our results support the need for further study of PF00299804 alone or combined with gemcitabine for the treatment of BTC.

    PubMed IF 3.4 혈액종양내과
17. 2132012

    제1저자 박종선 · 교신저자 임재준

    Park JS, Lee JS, Kim MY, Lee CH, Yoon HI, Lee SM, Yoo CG, Kim YW, Han SK, Yim JJ

    Monthly follow-ups of interferon-γ release assays among health-care workers in contact with patients with TB.

    Chest. 2012;142(6):1461-1468.

    Abstract

    BACKGROUND Interferon-γ (IFN-γ) release assays (IGRAs), which can overcome several limitations of the tuberculin skin test in detecting latent TB infection, were introduced recently in routine clinical practice. However, IGRAs are highly dynamic tests, and the T-cell responses tend to fluctuate over time. We wanted to evaluate the conversion and reversion rates of monthly IGRAs over 1 year among health-care workers (HCWs) in contact with patients with TB in South Korea, a country with an intermediate TB burden.

    METHODS Forty-nine HCWs in contact with patients with active pulmonary TB were prospectively enrolled. Interviews on exposure to patients with active TB, a physical examination, and a QuantiFERON TB Gold In-Tube assay (QFT-GIT) were carried out monthly for 1 year.

    RESULTS Among 48 participants, 25 (52%) showed inconsistent results in serial testing. When an increase from< 0.35 IU/mL to ≥ 0.70 IU/mL was applied as the definition of a conversion, inconsistent IGRA results were identified in 13 participants (27.0%). Consistency in QFT-GIT results was associated with age, length of service, and baseline IFN-γ levels, but not with the profession of the participant, degree of TB exposure, or wearing of an N95 mask. In five participants, fluctuations in IFN-γ levels showed levels > 0.70 IU/mL two or more times.

    CONCLUSIONS Fluctuation in IGRA findings was common when HCWs in contact with patients with TB were tested monthly. This could be a result of poor reproducibility of the assay, repeated infection and true reversion, or periodic secretion of antigens from Mycobacterium tuberculosis.

    TRIAL REGISTRY ClinicalTrials.gov; No.: NCT01121068; URL: www.clinicaltrials.gov

    PubMed IF 9.8 호흡기내과
18. 2122012

    제1저자 강현재, 김민경 · 교신저자 김효수

    Kang HJ, Kim MK, Lee HY, Park KW, Lee W, Cho YS, Koo BK, Choi DJ, Park YB, Kim HS

    Five-year results of intracoronary infusion of the mobilized peripheral blood stem cells by granulocyte colony-stimulating factor in patients with myocardial infarction.

    Eur Heart J. 2012;33(24):3062-9.

    Abstract

    AIM To evaluate the long-term effects of peripheral blood stem cell therapy in myocardial infarction (MI) patients.

    METHODS AND RESULTS A total of 163 patients with MI who were successfully revascularized with drug-eluting stents were enrolled and randomly assigned to four groups: acute MI (AMI) cell infusion, AMI control, old MI (OMI) cell infusion, and OMI control. We compared 5 years' clinical outcomes between the cell infusion group (57 and 22 patients with AMI and OMI, respectively) and the control (60 and 24 patients with AMI and OMI, respectively). In the time-sequence comparison from baseline to 6 and 24 months follow-up after AMI, left ventricular ejection fraction (LVEF) by cardiac magnetic resonance imaging was significantly improved in the cell infusion group (n = 57), but not in the control group (n = 60). In the between-group comparison, the difference in improvement of LVEF for 2 years after AMI did not reach statistical significance between cell infusion and control groups. Intriguingly, the major adverse cardiac events for 5 years were significantly reduced in the cell infusion group (n = 79) compared with the control (n = 84; composite of cardiac death, non-fatal MI, hospitalization for heart failure and angina, and target vessel revascularization; 22.8 vs. 39.3%, P = 0.015).

    CONCLUSIONS Peripheral blood stem cell therapy has potential to improve long-term cardiovascular outcomes in MI patients.

    PubMed IF 45.3 순환기내과
19. 2112012

    제1저자 이주명 · 교신저자 김효수

    Lee JM, Choe W, Kim BK, Seo WW, Lim WH, Kang CK, Kyeong S, Eom KD, Cho HJ, Kim YC, Hur J, Yang HM, Cho HJ, Lee YS, Kim HS

    Comparison of endothelialization and neointimal formation with stents coated with antibodies against CD34 and vascular endothelial-cadherin.

    Biomaterials. 2012;33(35):8917-27.

    Abstract

    Vascular endothelial-cadherin (VE-cadherin) is exclusively expressed on the late endothelial progenitor cells (EPC). Therefore, VE-cadherin could be an ideal target surface molecule to capture circulating late EPC. In the present study, we evaluated whether anti-VE-cadherin antibody-coated stents (VE-cad stents) might accelerate endothelial recovery and reduce neointimal formation more than anti-CD34 antibody-coated stents (CD34 stents) through the superior ability to capture the late EPC. The stainless steel stents were coated with anti-human VE-cadherin antibodies or anti-human CD34 antibodies under the same condition. In vitro, VE-cad stents showed higher number of adhering EPC (823.6 ± 182.2 versus 379.2 ± 137.2 cells per HPF, p < 0.001). VE-cad stents also demonstrated better specific capturing of cells with endothelial lineage markers than CD34 stents did in flow cytometric analysis. VE-cad stents showed more effective re-endothelialization after 1 h, 24 h, and 3 days in vivo. At 42 days, VE-cad stents demonstrated significantly smaller neointima area (0.92 ± 0.38 versus 1.24 ± 0.41 mm(2), p = 0.002) and significantly lower PCNA positive cells in neointima (1684.8 ± 658.8/mm(2) versus 2681.7 ± 375.1/mm(2), p = 0.008), compared with CD34 stents. In conclusion, VE-cad stents captured EPC and endothelial cells more selectively in vitro, accelerated re-endothelialization over stents, and reduced neointimal formation in vivo, compared with CD34 stents.

    PubMed IF 13.6 순환기내과
20. 2102012

    제1저자 박효은 · 교신저자 김효수

    Park HE, Koo BK, Park KW, Paeng JC, Lee HY, Kang HJ, Kim HS

    Diagnostic value of myocardial SPECT to detect in-stent restenosis after drug-eluting stent implantation.

    Int J Cardiovasc Imaging. 2012;28(8):2125-34.

    Abstract

    Different angiographic patterns and restenosis rate may affect diagnostic value of single-photon emission computed tomography (SPECT) in the era of drug-eluting stents (DES). We aimed to determine the ability of myocardial SPECT to detect in-stent restenosis (ISR) in patients treated with DES compared to that of patients treated with bare metal stent (BMS). We evaluated 228 consecutive patients who underwent 6 months follow-up SPECT and coronary angiography (CAG) after stent implantation. In 228 patients, 354 vessels were treated with stent implantation (BMS, n = 105; DES, n = 249) and 65 (18.4%) vessels showed ISR (angiographic % diameter stenosis ≥ 50%) at the 6-month follow-up CAG. In patients with BMS-ISR (n = 37), restenosis was primarily diffuse (70.3%), whereas patients with DES-ISR (n = 28) exhibited more focal restenosis (53.6%, p = 0.028). The sensitivity and specificity of myocardial SPECT did not differ significantly between patients with BMS and those with DES (BMS vs. DES: sensitivity 56.8 vs. 39.3%, p = 0.163; specificity 72.1 vs. 76.5%, p = 0.460). Evaluation of 71 false positive and 33 false negative lesions showed that the most common cause of false-positive results in SPECT was the perfusion decrease which improved but not disappeared compared with the baseline (46 among 71 vascular territories). Despite different patterns of restenosis and ISR rates, the diagnostic value of SPECT did not differ between BMS and DES. Further study looking at ISR in larger number of patients and using other protocol such as Fleming-Harrington Redistribution Wash-in Washout may give additional information.

    PubMed IF 1.5 순환기내과
21. 2092012

    제1저자 이세원 · 교신저자 이춘택

    Lee SW, Kim DR, Kim TJ, Paik JH, Chung JH, Jheon S, Huh JW, Lee JH, Lee CT

    The association of down-regulated toll-like receptor 4 expression with airflow limitation and emphysema in smokers.

    Respir Res. 2012;13(1):106.

    Abstract

    BACKGROUND An association between innate immunity including Toll-like receptors (TLRs) and COPD is reported recently; TLR4 deficiency in lung can cause emphysema in animals, which is not evident in humans. We analyzed the association of TLR4 expression, airflow limitation and emphysema in smokers.

    METHODS We enrolled patients of ≥40years old with smoking histories of ≥10 pack-years and who had undergone lung resection. We measured TLR4 expression in lung lysates. The severity of emphysema was evaluated on computed tomography. TLR4 expression was also evaluated immunohistochemically.

    RESULTS In total, 53 patients were enrolled. Forced expiratory volume in one second per forced vital capacity (FEV1/FVC) increased (P=0.03) and emphysema score decreased (P=0.01) as TLR4 expression increased. These were still significant, in multiple regression analysis including sex, age, tuberculosis history, smoking history and inhaled corticosteroid (ICS) usage. We also classified patients as high, intermediate, and low expressers according to TLR4 expression. Although no differences in age, gender, tuberculosis, or smoking history were observed among the groups, emphysema severity increased significantly (P = 0.02) and FEV1/FVC decreased significantly (P = 0.006) in TLR4 low expresser. The difference in TLR4 expression based on immunohistochemistry was most prominent in bronchial and alveolar epithelial cells.

    CONCLUSION Down-regulated TLR4 expression in lung was associated with emphysema and airflow limitation in smokers.

    PubMed IF 5.7 호흡기내과
22. 2082012

    제1저자 정수진 · 교신저자 박민정

    Chung SJ, Park MJ, Kang SJ, Kang HY, Chung GE, Kim SG, Jung HC

    Effect of annual endoscopic screening on clinicopathologic characteristics and treatment modality of gastric cancer in a high-incidence region of Korea.

    Int J Cancer. 2012;131(10):2376-84.

    Abstract

    We investigated risk factors for gastric cancer (GC) and effect of annual endoscopic screening on detection and treatment modality of GC. Asymptomatic adults who underwent upper endoscopy during health checkups at Seoul National University Hospital Healthcare System Gangnam Center were enrolled. We compared clinicopathologic characteristics of GC according to screening interval (repeated vs. infrequent, annual vs. biennial). After age- and sex-matching, relative risk was computed by hazard ratio (HR) using Cox proportional regression with multivariate adjustment. Of the 58,849 subjects who received screening endoscopy, 277 (0.47%) were found to have GC. Intestinal type comprised 55.4% (102/184) followed by diffuse type (n = 65, 35.3%). Age ≥ 50 years, family history and smoking independently increased the risk of GC for both types, whereas male gender [HR = 4.81, 95% confidence interval (CI): 2.72-8.03] and intestinal metaplasia (IM) (HR = 10.87, 95% CI: 3.36-22.30) were significant predictors for intestinal type only. Proportion of early gastric cancer (EGC) was 98.6% (71/72) in annual screening group and 80.7% (46/57) in biennial screening group (p < 0.01). In the former, tumor size was smaller (1.7 ± 1.3 vs. 2.3 ± 1.8 cm; p < 0.01] and proportion of intramucosal cancer was larger (75.0 vs. 56.1%; p = 0.04). Endoscopic resection was performed more frequently in annual screening group (56.9 vs. 33.3%; p = 0.02). IM along with male gender and older age was a strong risk factor for intestinal type GC. Annual screening group improved detection of early-stage and endoscopically treatable GC suggesting that intensive screening and surveillance may be useful for high-risk subpopulations with epidemiologic risk factors or premalignant lesions such as IM.

    PubMed IF 4.9 소화기내과
23. 2072012

    제1저자 안정명 · 교신저자 나기영

    Ahn JM, You SJ, Lee YM, Oh SW, Ahn SY, Kim S, Chin HJ, Chae DW, Na KY

    Hypoxia-inducible factor activation protects the kidney from gentamicin-induced acute injury.

    PLoS One. 2012;7(11):e48952.

    Abstract

    Gentamicin nephrotoxicity is one of the most common causes of acute kidney injury (AKI). Hypoxia-inducible factor (HIF) is effective in protecting the kidney from ischemic and toxic injury. Increased expression of HIF-1α mRNA has been reported in rats with gentamicin-induced renal injury. We hypothesizd that we could study the role of HIF in gentamicin-induced AKI by modulating HIF activity. In this study, we investigated whether HIF activation had protective effects on gentamicin-induced renal tubule cell injury. Gentamicin-induced AKI was established in male Sprague-Dawley rats. Cobalt was continuously infused into the rats to activate HIF. HK-2 cells were pre-treated with cobalt or dimethyloxalylglycine (DMOG) to activate HIF and were then exposed to gentamicin. Cobalt or DMOG significantly increased HIF-1α expression in rat kidneys and HK-2 cells. In HK-2 cells, HIF inhibited gentamicin-induced reactive oxygen species (ROS) formation. HIF also protected these cells from apoptosis by reducing caspase-3 activity and the amount of cleaved caspase-3, and -9 proteins. Increased expression of HIF-1α reduced the number of gentamicin-induced apoptotic cells in rat kidneys and HK-2 cells. HIF activation improved the creatinine clearance and proteinuria in gentamicin-induced AKI. HIF activation also ameliorated the extent of histologic injury and reduced macrophage infiltration into the tubulointerstitium. In gentamicin-induced AKI, the activation of HIF by cobalt or DMOG attenuated renal dysfunction, proteinuria, and structural damage through a reduction of oxidative stress, inflammation, and apoptosis in renal tubular epithelial cells.

    PubMed IF 2.8 신장내과
24. 2062012

    제1저자 김선문 · 교신저자 임춘수

    Kim SM, Lee CH, Lee JP, Oh YK, Kim YS, Kim S, Lim CS

    The association between albumin to creatinine ratio and total protein to creatinine ratio in patients with chronic kidney disease.

    Clin Nephrol. 2012;78(5):346-52.

    Abstract

    AIMS Although albumin to creatinine ratio (ACR) and total protein to creatinine ratio (PCR) in random urine have been supposed as alternatives to 24-h urine measurements, there are few studies comparing these tests in CKD patients. Therefore, we investigated the relations between ACR and PCR in CKD patients and the factors that affect the relationship.

    METHODS We enrolled 808 patients with CKD prospectively and compared ACR, PCR and urine dipstick test in random urine.

    RESULTS Albuminuria was well correlated with proteinuria (β = 1.114, p < 0.001). The association between albuminuria and proteinuria was greater in patients with following characteristics: dipstick protein positive compared with negative (p < 0.001 for interaction), urine creatinine level ≥ 60 mg/dl compared with < 60 mg/dl (p = 0.024 for interaction) and estimated glomerular filtration rate < 60 ml/min/1.73 m2 compared with ≥ 60 ml/min/1.73 m2 (p = 0.040 for interaction). However, the association between albuminuria and proteinuria was not affected by sex, the presence of diabetes, or old age (≥ 60 years).

    CONCLUSIONS Both ACR and PCR in random urine are correlated well and can be used for monitoring of protein excretion in CKD patients, alternatively. However, the correlation is not strong in patients with low amount of protein excretion or with low urinary creatinine concentration.

    PubMed IF 0.8 신장내과
25. 2052012

    제1저자 김재환 · 교신저자 이상협

    Kim J, Lee SH, Paik WH, Song BJ, Hwang JH, Ryu JK, Kim YT, Yoon YB

    Clinical outcomes of patients who experienced perforation associated with endoscopic retrograde cholangiopancreatography.

    Surg Endosc. 2012;26(11):3293-300.

    Abstract

    BACKGROUND Perforation after endoscopic retrograde cholangiopancreatography (ERCP) is a rare but severe complication. The purpose of this study was to assess the clinical outcomes with perforations after ERCP from a large number of cases.

    METHODS Among 11,048 patients who underwent ERCP during 10 years, medical records from 68 patients (0.62 %) who experienced post-ERCP perforation with radiologic, endoscopic, or surgical evidence were retrospectively reviewed. We assessed the clinical outcomes of patients and analyzed the factors associated with poor outcomes, which were defined as mortality, prolonged hospital stay due to complications, or loss of chance of cure in the case of cancer.

    RESULTS Twenty-nine patients were male, and the median age was 65.0 years. Therapeutic ERCP was performed in 52 cases (77 %). Common mechanisms of perforation were endoscopic sphincterotomy (37 %), catheter or guidewire (34 %), and endoscope (19 %). In contrast to 9 patients who underwent emergent operation, 59 patients (87 %) were conservatively treated. In 44 patients, perforation was detected during the procedure; however, detection after 24 h or permitted oral intake before detection occurred in 18 cases (27 %). Although 58 patients recovered without poor outcomes, 10 patients (15 %) experienced poor outcomes, which consisted of mortality (n = 4), loss of chance of cure (n = 2), and prolonged hospital stay without surgery more than 1 month due to complications (n = 4). By multiple logistic regression analysis, perforation by endoscope and rebound tenderness was statistically associated with poor outcomes (odds ratio: 13.7 and 7.3, respectively).

    CONCLUSIONS Most patients fully recovered from perforation; however, some patients experienced grave outcomes, including mortality. Perforation by endoscope and rebound tenderness was significantly associated with poor outcomes.

    PubMed IF 3.3 소화기내과
26. 2042012

    제1저자 김종엽 · 교신저자 정숙향

    Kim JY, Cho J, Hwang SH, Kil H, Bae SH, Kim YS, Lee HC, Jeong SH

    Behavioral and healthcare-associated risk factors for chronic hepatitis C virus infection in Korea.

    J Korean Med Sci. 2012;27(11):1371-7.

    Abstract

    The risk factors related to hepatitis C virus (HCV) infection showed geographic and temporal differences. We investigated HCV-related risk factors in Korea where intravenous drug use (IVDU) is uncommon. The HCV-related risk factors were investigated in a prospective, multicenter chronic HCV cohort (n = 711) using a standardized questionnaire in four university hospitals. The results were compared with those of 206 patients with chronic liver diseases not related to either of HCV or hepatitis B virus infection (comparison group). The IVDU was found in 3.9% and remote blood transfusion (≥ 20 yr ago) in 18.3% in HCV cohort group, while that in comparison group was in none and 5.3%, respectively. In a multivariate logistic analysis, transfusion in the remote past (odds ratio [OR], 2.99), needle stick injury (OR, 4.72), surgery (OR, 1.89), dental procedures (OR, 2.96), tattooing (OR, 2.07), and multiple sexual partners (2-3 persons; OR, 2.14, ≥ 4 persons; OR, 3.19), were independent risk factors for HCV infection. In conclusion, the major risk factors for HCV infection in Korea are mostly related to conventional or alterative healthcare procedures such as blood transfusion in the remote past, needle stick injury, surgery, dental procedure, and tattooing although multiple sex partners or IVDU plays a minor role.

    PubMed IF 3.2 소화기내과
27. 2032012

    제1저자 서명기 · 교신저자 김형관

    Seo MK, Park EA, Kim HK, Lee W, Kim YJ, Kim KH, Kim KB, Sohn DW, Ahn H, Park JH

    Electrocardiographic QRS duration reflects right ventricular remodeling in patients undergoing corrective surgery for isolated tricuspid regurgitation: a comparative study with cardiac magnetic resonance imaging.

    Clin Cardiol. 2012;35(11):692-9.

    Abstract

    BACKGROUND The role of electrocardiogram (ECG) is unclear for the longitudinal follow-up of patients who undergo corrective surgery for isolated severe tricuspid regurgitation (TR).

    HYPOTHESIS This study sought to investigate the usefulness of changes in QRS duration of ECG after TR surgery in predicting right ventricular (RV) reverse remodeling as determined by cardiac magnetic resonance imaging (CMR).

    METHODS We enrolled 30 consecutive TR patients (27 women, aged 57.8 ± 9.6 years) who had undergone prior left-sided valve surgery. A computer-assisted analysis was performed for objective calculation of QRS duration before and after surgery.

    RESULTS At a median CMR follow-up of 27.5 months postsurgery, QRS duration was cut by 14.6%, from 110.4 ± 14.6 msec to 96.9 ± 11.9 msec (P < 0.001), while CMR showed a decrease in RV end-diastolic volume index (RV-EDVI) from 179.5 ± 59.7 to 119.1 ± 30.4 mL/m(2) (P < 0.001). QRS duration correlated significantly with RV-EDVI and RV end-systolic volume index (r = 0.65, P < 0.001 and r = 0.53, P < 0.001, respectively), and a percent change in QRS duration was significantly correlated with a percent change in RV-EDVI (r = 0.40, P = 0.03). When significant RV reverse remodeling was defined as a reduction in RV-EDVI ≥20% following TR surgery, the sensitivity and specificity for significant RV reverse remodeling were 75% and 78%, respectively, with a 9% reduction in QRS duration (P = 0.01, area underneath the receiver operator curve [AUC] = 0.81).

    CONCLUSIONS The extent of changes in postoperative QRS duration can be used as a useful, inexpensive, and simple index reflecting the occurrence of significant RV reverse remodeling in patients undergoing corrective TR surgery.

    PubMed IF 2.8 순환기내과
28. 2022012

    제1저자 이진우 · 교신저자 이상민

    Lee J, Yim JJ, Yang SC, Yoo CG, Kim YW, Han SK, Lee EY, Lee EB, Song YW, Lee SM

    Outcome of patients with connective tissue disease requiring intensive care for respiratory failure.

    Rheumatol Int. 2012;32(11):3353-8.

    Abstract

    Occasionally acute respiratory failure (ARF) develops in patients with connective tissue disease (CTD), but the etiologies of ARF in these patients are not fully elucidated. The objective of this study is to find out the causes of ARF leading to intensive care unit (ICU) admission in these patients and to assess their clinical outcome. The medical records of 1,870 consecutive patients admitted to the ICU in Seoul National University Hospital since January 2005-September 2008 were reviewed. A total of 66 patients with CTD were analyzed. The median age was 58 years, and 45 patients were women. The median length of ICU stay was 16 days with a median duration of mechanical ventilation support of 15 days. The distribution of underlying CTD was 17 patients with systemic lupus erythematosus; 15 with rheumatoid arthritis; 14 with systemic vasculitis; and nine with polymyositis-dermatomyositis. Pneumonia was the leading cause of ARF in 24 patients (36%). We could not identify the cause of ARF in 14. Other causes of ARF were acute pulmonary edema for nine patients, diffuse alveolar hemorrhage for eight and Pneumocystis pneumonia for four. Forty-one patients (62%) died during admission, and the mortality rate was the lowest in those with acute pulmonary edema. Use of norepinephrine was statistically higher in nonsurvivors. We could identify the cause of ARF leading to ICU admission in at least 80% of patients with CTD. However, these patients still showed a high mortality rate regardless of etiology. Their survival might be influenced by hemodynamic status.

    PubMed IF 3.5 호흡기내과
29. 2012012

    제1저자 송경호 · 교신저자 김홍빈, 최희정

    Song KH, Kim ES, Kim YK, Jin HY, Jeong SY, Kwak YG, Cho YK, Sung J, Lee YS, Oh HB, Kim TK, Koo KH, Kim EC, Kim JM, Choi TY, Kim HY, Choi HJ, Kim HB

    Differences in the risk factors for surgical site infection between total hip arthroplasty and total knee arthroplasty in the Korean Nosocomial Infections Surveillance System (KONIS).

    Infect Control Hosp Epidemiol. 2012;33(11):1086-93.

    Abstract

    OBJECTIVE To compare the characteristics and risk factors for surgical site infections (SSIs) after total hip arthroplasty (THA) and total knee arthroplasty (TKA) in a nationwide survey, using shared case detection and recording systems.

    DESIGN Retrospective cohort study.

    SETTING Twenty-six hospitals participating in the Korean Nosocomial Infections Surveillance System (KONIS).

    PATIENTS From 2006 to 2009, all patients undergoing THA and TKA in KONIS were enrolled.

    RESULTS SSI occurred in 161 (2.35%) of 6,848 cases (3,422 THAs and 3,426 TKAs). Pooled mean SSI rates were 1.69% and 2.82% for THA and TKA, respectively. Of the cases we examined, 42 (26%) were superficial-incisional SSIs and 119 (74%) were "severe" SSIs; of the latter, 24 (15%) were deep-incisional SSIs and 95 (59%) were organ/space SSIs. In multivariate analysis, a duration of preoperative hospital stay of greater than 3 days was a risk factor for total SSI after both THA and TKA. Diabetes mellitus, revision surgery, prolonged duration of surgery (above the 75th percentile), and the need for surgery due to trauma were independent risk factors for total and severe SSI after THA, while male sex and an operating room without artificial ventilation were independent risk factors for total and severe SSI after TKA. A large volume of surgeries (more than 10 procedures per month) protected against total and severe SSI, but only in patients who underwent TKA.

    CONCLUSIONS Risk factors for SSI after arthroplasty differ according to the site of the arthroplasty. Therefore, clinicians should take into account the site of arthroplasty in the analysis of SSI and the development of strategies for reducing SSI.

    PubMed IF 2.6 감염내과
30. 2002012

    제1저자 고영일 · 교신저자 임석아

    Koh Y, Lee HE, Oh DY, Kim JH, Lee SH, Kim SH, Kim DW, Im SA, Kim TY, Heo DS, Kim WH, Bang YJ

    The lack of CD34 expression in gastrointestinal stromal tumors is related to cystic degeneration following imatinib use.

    Jpn J Clin Oncol. 2012;42(11):1020-7.

    Abstract

    OBJECTIVE We evaluated the characteristics of the gastrointestinal stromal tumors that showed discrepancies between their assessment using the Response Evaluation Criteria in Solid Tumor (RECIST) and Choi's criteria. We also investigated the clinical applicability of Choi's criteria to Korean gastrointestinal stromal tumor patients undergoing imatinib therapy.

    METHODS Patients with advanced gastrointestinal stromal tumors treated with frontline imatinib were analyzed. Computed tomography images of these patients were reviewed and genotyping for the KIT and PDGFRA genes was performed. Immunohistochemical staining of c-KIT, CD34, platelet derived growth factor receptor-alpha, platelet derived growth factor receptor-beta, AKT, P-ERK and vascular endothelial growth factor was followed.

    RESULTS Ninety-five patients were enrolled. When using Choi's criteria to evaluate the 61 patients who achieved at least partial response by Choi's criteria, 27 patients showed discrepancies in their response to treatment between these two sets of criteria. A lack of CD34 expression in tumors was found to be related to cystic degeneration after imatinib treatment (P=0.001). Patients who showed partial response by Choi's criteria but stable disease by RECIST criteria had a similar progression-free survival to cases who showed a partial response under both systems (P=0.951).

    CONCLUSIONS Gastrointestinal stromal tumors showing cystic degeneration after imatinib treatment lack CD34 expression. Choi's criteria have a clinical value in terms of the progression-free survival in Korean patients treated with imatinib.

    PubMed IF 2.5 혈액종양내과

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