http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
A novel prognostic factor for hepatocellular carcinoma: protein disulfide isomerase
Yu, Su Jong,Won, Jae-Kyung,Ryu, Han Suk,Choi, Won-Mook,Cho, Hyeki,Cho, Eun-Ju,Lee, Jeong-Hoon,Kim, Yoon Jun,Suh, Kyung-Suk,Jang, Ja-June,Kim, Chung Yong,Lee, Hyo-Suk,Yoon, Jung-Hwan,Cho, Kwang-Hyun The Korean Association of Internal Medicine 2014 The Korean Journal of Internal Medicine Vol.29 No.5
<P><B>Background/Aims</B></P><P>Protein disulfide isomerase (PDI) has been implicated in the survival and progression of some cancer cells, by compensating for endoplasmic reticulum stress by upregulating the protein-folding capacity. However, its prognostic role in patients with hepatocellular carcinoma (HCC) has not been investigated.</P><P><B>Methods</B></P><P>We collected HCC tissues from 83 HCC patients who underwent surgical resection for an immunohistochemical study of PDI. Overall survival (OS) was measured from the date of surgical resection until the date of death from any cause. Radiological progression was evaluated using the modified Response Evaluation Criteria in Solid Tumors in an independent radiological assessment.</P><P><B>Results</B></P><P>PDI expression was found to be increased in human HCC compared to adjacent nontumor tissues. Increased immunopositivity for PDI was associated with a high Edmondson-Steiner grade (<I>p</I> = 0.028). Univariate analysis of patients who had undergone surgical resection for HCC showed that tumor PDI upregulation is a significant risk factor for poor OS (<I>p</I> = 0.016; hazard ratio [HR], 1.980) and time to progression (TTP; <I>p</I> = 0.007; HR, 1.971). Multivariate analyses revealed that high PDI expression was an independent predictor of a shorter TTP (<I>p</I> = 0.015; HR, 1.865) and poor OS (<I>p</I> = 0.012; HR, 2.069).</P><P><B>Conclusions</B></P><P>Upregulated PDI expression is associated with aggressive clinicopathological features of HCC; thus, PDI might serve as an independent prognostic factor and a potential therapeutic target for HCC patients.</P>
Applications of systems approaches in the study of rheumatic diseases
Kim, Ki-Jo,Lee, Saseong,Kim, Wan-Uk The Korean Association of Internal Medicine 2015 The Korean Journal of Internal Medicine Vol.30 No.2
<P>The complex interaction of molecules within a biological system constitutes a functional module. These modules are then acted upon by both internal and external factors, such as genetic and environmental stresses, which under certain conditions can manifest as complex disease phenotypes. Recent advances in high-throughput biological analyses, in combination with improved computational methods for data enrichment, functional annotation, and network visualization, have enabled a much deeper understanding of the mechanisms underlying important biological processes by identifying functional modules that are temporally and spatially perturbed in the context of disease development. Systems biology approaches such as these have produced compelling observations that would be impossible to replicate using classical methodologies, with greater insights expected as both the technology and methods improve in the coming years. Here, we examine the use of systems biology and network analysis in the study of a wide range of rheumatic diseases to better understand the underlying molecular and clinical features.</P>
Park, Keun-Ho,Ahn, Youngkeun,Jeong, Myung Ho,Chae, Shung Chull,Hur, Seung Ho,Kim, Young Jo,Seong, In Whan,Chae, Jei Keon,Hong, Taek Jong,Cho, Myeong Chan,Bae, Jang Ho,Rha, Seung Woon,Jang, Yang Soo The Korean Association of Internal Medicine 2012 The Korean Journal of Internal Medicine Vol.27 No.2
<P><B>Background/Aims</B></P><P>The aim of this study was to evaluate the impact of diabetes mellitus (DM) on in-hospital and 1-year mortality in patients who suffered acute myocardial infarction (AMI) and underwent successful percutaneous coronary intervention (PCI).</P><P><B>Methods</B></P><P>Among 5,074 consecutive patients from the Korea AMI Registry with successful revascularization between November 2005 and June 2007, 1,412 patients had a history of DM.</P><P><B>Results</B></P><P>The DM group had a higher mean age prevalence of history of hypertension, dyslipidemia, ischemic heart disease, high Killip class, and diagnoses as non-ST elevation MI than the non-DM group. Left ventricular ejection fraction (LVEF) and creatinine clearance were lower in the DM group, which also had a significantly higher incidence of in-hospital and 1-year mortality of hospital survivors (4.6% vs. 2.8%, <I>p</I> = 0.002; 5.0% vs. 2.5%, <I>p</I> < 0.001). A multivariate analysis revealed that independent predictors of in-hospital mortality were Killip class IV or III at admission, use of angiotensin converting enzyme inhibitors or angiotensin-II receptor blockers, LVEF, creatinine clearance, and a diagnosis of ST-elevated MI but not DM. However, a multivariate Cox regression analysis showed that DM was an independent predictor of 1-year mortality (hazard ratio, 1.504; 95% confidence interval, 1.032 to 2.191).</P><P><B>Conclusions</B></P><P>DM has a higher association with 1-year mortality than in-hospital mortality in patients with AMI who underwent successful PCI. Therefore, even when patients with AMI and DM undergo successful PCI, they may require further intensive treatment and continuous attention.</P>
Yoon, Jiyeol,Kwon, Seong-Ryul,Lim, Mie-Jin,Joo, Kowoon,Moon, Chang-Gi,Jang, Jihun,Park, Won The Korean Association of Internal Medicine 2010 The Korean Journal of Internal Medicine Vol.25 No.4
<P><B>Background/Aims</B></P><P>Osteoporotic fractures are an important comorbidity with rheumatoid arthritis (RA). We determined the overall fracture risk as assessed by the World Health Organization (WHO)'s FRAX® tool in Korean patients with seropositive RA. Additionally, we compared treatment eligibility according to the criteria of the Korean Health Insurance Review Agency (HIRA), FRAX, and the National Osteoporosis Foundation (NOF).</P><P><B>Methods</B></P><P>Postmenopausal women and men ≥ 50 years of age with seropositive RA were recruited from one rheumatism center in Korea. The FRAX score was estimated using the Japanese model. Patients were classified as eligible for treatment using the HIRA, NOF, and FRAX thresholds for intervention.</P><P><B>Results</B></P><P>The study of 234 patients included 40 men (17%). The mean age was 60 ± 9 years, and 121 (52%) patients had osteoporosis according to the WHO criteria. The overall median 10-year fracture risk was 13% for major osteoporotic fractures and 3.5% for hip fractures. HIRA guidelines identified 130 patients (56%) eligible for treatment, FRAX included 126 patients (54%), and 151 patients (65%) were included according to NOF guidelines. Older patients with a greater number of risk factors were included by FRAX compared to HIRA. The overall concordance between HIRA and FRAX, expressed as the kappa index, was 0.67, but was as low as 0.44 when limited to patients ≥ 60 years of age.</P><P><B>Conclusions</B></P><P>One-half of the patients had osteoporosis requiring treatment. RA patients have a high risk of fracture, and the adoption of a risk-scoring system should be considered.</P>
Sun, In O,Hong, Yu Ah,Park, Hoon Suk,Choi, Sun Ryoung,Chung, Byung Ha,Park, Cheol Whee,Yang, Chul Woo,Kim, Yong Soo,Choi, Bum Soon The Korean Association of Internal Medicine 2012 The Korean Journal of Internal Medicine Vol.27 No.4
<P><B>Background/Aims</B></P><P>Chronic hepatitis B infection is a common cause of secondary membranous nephropathy (MN) in endemic areas. Lamivudine treatment improves renal outcome in patients with hepatitis B virus-associated MN (HBV-MN), but prolonged use leads to the emergence of lamivudine-resistant variants. We describe our experience treating lamivudine-resistant and other strains of HBV-MN with new antiviral drugs.</P><P><B>Methods</B></P><P>Of the 89 patients biopsied and diagnosed with MN from 1996 to 2011, 10 positive for hepatitis B surface antigen were recruited for this study. We investigated the clinical courses, therapeutic responses, and prognoses of patients with HBV-MN.</P><P><B>Results</B></P><P>The incidence of HBV-MN among the original 89 patients was 11.2%. Of these patients, four were treated with supportive care and six with antiviral drugs. One of the four patients treated with supportive care had a spontaneous remission. Four of the six patients treated with antiviral drugs were given lamivudine, and the other two were given entecavir. Two of the four patients treated with lamivudine achieved complete remission with seroconversion (i.e., development of anti-hepatitis B e antigen antibodies), whereas the other two had lamivudine-resistant strains, which were detected at 22 and 23 months after lamivudine treatment, respectively. We added adefovir to the treatment regimen for one of these patients, and for the other patient we substituted clevudine for lamivudine. Both of these patients experienced complete remission, as did the two patients initially treated with entecavir, neither of whom showed resistance to the drug.</P><P><B>Conclusions</B></P><P>New nucleoside analogues, such as entecavir, adefovir, and clevudine, can be effective for treatment of HBV-MN, including lamivudine-resistant strains.</P>
Cho, Byung-Sik,Kim, Hee-Je,Eom, Ki-Sung,Lee, Jong-Wook,Min, Woo-Sung,Kim, Chun-Choo The Korean Association of Internal Medicine 2010 The Korean Journal of Internal Medicine Vol.25 No.1
<P>Secondary leukemia occurring after hematopoietic stem cell transplantation (HSCT) for acute myeloid leukemia (AML) is rare. Secondary AML usually follows autologous and not allogeneic transplants. When a new leukemia develops in a patient successfully treated with an allogeneic HSCT, the possibility of a de novo or secondary leukemia from either the donor or recipient should be considered. We present a case initially diagnosed as de novo AML without a cytogenetic abnormality. The patient was successfully treated with an HLA-matched sibling allogeneic HSCT. However, more than six years later, AML developed again and was associated with new complex cytogenetic abnormalities. After a second HSCT, the patient has been followed without serious complications. Considering the allogeneic setting, the newly developed cytogenetic abnormalities, a relatively long latent period, and the good clinical course after the second allogeneic HSCT, this case might represent a second de novo AML following successful treatment of the first AML.</P>
Neuron-specific enolase as a novel biomarker reflecting tuberculosis activity and treatment response
Nam, Sung-Jin,Jeong, Jee-Yeong,Jang, Tae-Won,Jung, Mann-Hong,Chun, Bong-Kwon,Cha, Hee-Jae,Oak, Chul-Ho The Korean Association of Internal Medicine 2016 The Korean Journal of Internal Medicine Vol.31 No.4
<P><B>Background/Aims:</B></P><P>It is not clear which tests are indicative of the activity and severity of tuberculosis (TB). This study aimed to investigate the predictive value of neuron-specific enolase (NSE) and to determine the origin of NSE in TB patients.</P><P><B>Methods:</B></P><P>A single-center retrospective analysis was conducted on newly diagnosed TB patients between January and December 2010. Patients were categorized into one of two disease groups (focal segmental or extensive) based on chest X-ray. Pre- and post-treatment NSE concentrations were evaluated. To determine the origin of serum NSE concentration, NSE staining was compared with macrophage-specific CD68 staining in lung tissues and with a tissue microarray using immunohistochemistry and immunofluorescence.</P><P><B>Results:</B></P><P>A total of 60 newly diagnosed TB patients were analyzed. In TB patients, NSE serum concentration was significantly increased and NSE level decreased after treatment (<I>p</I> < 0.001). In proportion to serum high-sensitivity C-reactive protein concentration, the mean serum concentration of NSE in the extensive group (25.12 ng/mL) was significantly higher than that in the focal segmental group (20.23 ng/mL, <I>p</I> = 0.04). Immunohistochemical staining revealed a large number of macrophages that stained positively for both NSE and CD68 in TB tissues. In addition, NSE signals mostly co-localized with CD68 signals in the tissue microarray of TB patients.</P><P><B>Conclusions:</B></P><P>Our results suggest that NSE may be a practical parameter that can be used to monitor TB activity and treatment response. Elevated serum NSE level originates, at least in part, from macrophages in granulomatous lesions.</P>
Lee, Chang Youl,Jeon, Jeong Hee,Kim, Hyung Jung,Shin, Dong Hwan,Roh, Tae Woong,Ahn, Chul Min,Chang, Yoon Soo The Korean Association of Internal Medicine 2008 The Korean Journal of Internal Medicine Vol.23 No.3
<P><B>Background/Aims</B></P><P>The insulin-like growth factor (IGF) system has been implicated in tumor growth, invasion, and metastasis. However, reports on the IGF-1 receptor (IGF-1R) based on radioimmunoassays are conflicting, and its prognostic implications in non-small-cell lung cancer (NSCLC) are still controversial.</P><P><B>Methods</B></P><P>Seventy-one paraffin-embedded tissue sections from stage I NSCLC patients were stained using a mouse monoclonal antibody against human IGF-1R.</P><P><B>Results</B></P><P>The intensity and frequency of IGF-1R expression on the membrane and cytoplasm of cancer cells was evaluated and scored using a semiquantitative system. IGF-1R expression was detected in nine of 71 (12.7%) cases. No significant relationship was found between clinical/histopathological parameters and IGF-1R expression. None of the patients whose tumor expressed IGF-1R had experienced distant metastasis or cancer-related death, although the difference did not reach statistical significance.</P><P><B>Conclusions</B></P><P>We conclude that IGF-1R expression may not be a major prognostic factor for stage I NSCLC.</P>