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대한내과학회> The Korean Journal of Internal Medicine

The Korean Journal of Internal Medicine update

  • : 대한내과학회
  • : 의약학분야  >  내과학
  • : KCI등재
  • : SCI
  • : 연속간행물
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  • : 1226-3303
  • : 2005-6648
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수록범위 : 1권1호(1986)~35권2호(2020) |수록논문 수 : 2,296
The Korean Journal of Internal Medicine
35권2호(2020년 03월) 수록논문
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KCI등재 SCI

1Recent advances in diagnostic technologies in lung cancer

저자 : Hye Jung Park , Sang Hoon Lee , Yoon Soo Chang

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 35권 2호 발행 연도 : 2020 페이지 : pp. 257-268 (12 pages)

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The increase in lung cancer incidence of Korea has been dampened since 2000; however, increased human lifespan, interest in health care and the widespread implementation of health examinations have resulted in a considerable rise in detection of small lesions that need to be differentiated from lung cancer. Detection of lung cancer at an early stage rather than at a symptomatic advanced stage is also increasing, suggesting that there are increasing diagnostic demands for small peripheral lung lesions. The development of new molecular diagnostics, including next generation sequencing, companion diagnostics that accompany development of new anti-cancer drugs, and re-biopsy for application of new therapeutic modality accelerate the development of lung cancer diagnostics. In this review, we extensively describe the current available diagnostic tools in lung cancer.

KCI등재 SCI

2Latent tuberculosis infection: recent progress and challenges in South Korea

저자 : Doosoo Jeon

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 35권 2호 발행 연도 : 2020 페이지 : pp. 269-275 (7 pages)

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Management of latent tuberculosis infection (LTBI) is a critical element in the elimination of tuberculosis (TB). However, the low positive predictive value of the current diagnostic tests and the low acceptance and completion rate of the isoniazid-based regimen are major barriers to the implementation and scale-up of programmatic management of LTBI. In the past decade, there has been some progress in the conception, diagnosis, and treatment of LTBI. LTBI is now understood as a dynamic spectrum rather than the traditional binary distinction between active and latent TB. New insight into LTBI has led to a renewed interest in incipient TB, which would be a potential target for developing new diagnostics and therapeutics of LTBI. Recent studies showed that host transcriptomic signatures could be a potential biomarker for incipient TB. The new shorter rifamycin-based regimens have shown comparable efficacy, but better completion rate and safety compared to the isoniazid-based regimen. In South Korea, LTBI management has been expanded and integrated into key elements of the National Tuberculosis Control Program. For the programmatic approach to LTBI management, the following challenges need to be addressed; target group selection, treatment-related interventions, monitoring and surveillance system, and extending the plan for vulnerable groups.

KCI등재 SCI

3Role of phosphodiesterase-4 inhibitors in chronic obstructive pulmonary disease

저자 : Chin Kook Rhee , Deog Kyeom Kim

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 35권 2호 발행 연도 : 2020 페이지 : pp. 276-283 (8 pages)

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Phosphodiesterase-4 inhibitors (PDE4Is) are potent anti-inf lammatory agents and roflumilast has been used to prevent acute exacerbation of chronic obstructive pulmonary disease (COPD). Roflumilast decreases neutrophil migration, restores cystic fibrosis transmembrane conductance regulator activity, and recovers glucocorticoid effects. A forced expiratory volume in 1 second of < 50%, a chronic bronchitis phenotype, high blood eosinophil levels, and a history of hospitalization are biomarkers for predicting responses to roflumilast. Adverse effects are common in clinical practice. An inhaled PDE4I has recently been developed and is under clinical trial. CHF6001 and RPL554 exhibit promise and may be future treatment options for COPD.

KCI등재 SCI

4Continuous renal replacement therapy in elderly with acute kidney injury

저자 : Kristianne Rachel P. Medina-liabres , Sejoong Kim

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 35권 2호 발행 연도 : 2020 페이지 : pp. 284-294 (11 pages)

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The objective of this article is to raise awareness among physicians of the increasing incidence of acute kidney injury in the elderly population and the utility of continuous renal replacement therapy (CRRT) in its management. While CRRT is frequently applied in younger patients, its use in elderly patients is less frequent, for various reasons, including resistance to such an aggressive intervention from the family and the healthcare team. However, predictors of prognosis have been identified and some studies have concluded that advanced age is not associated with poor outcomes. Decisions regarding management are more complex when dealing with the elderly but like very other patient, the approach should be patient-centered.

KCI등재 SCI

5A different detection method reveals a new role of alanine aminotransferase as an indicator of liver fibrosis

저자 : Pil Soo Sung

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 35권 2호 발행 연도 : 2020 페이지 : pp. 295-297 (3 pages)

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KCI등재 SCI

6Successful transition to the QFT-PLUS assay, but more is needed for diagnosis of latent tuberculosis infection

저자 : Eun Hye Lee , Young Ae Kang

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 35권 2호 발행 연도 : 2020 페이지 : pp. 298-299 (2 pages)

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KCI등재 SCI

7Outcomes and clinical relevance of stool multiplex bacterial polymerase chain reaction in patients with acute diarrhea: single center experience

저자 : Won Gun Kwack , Yun Jeong Lim , Ki Hwan Kwon , Jae Woo Chung , Jin Young Oh

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 35권 2호 발행 연도 : 2020 페이지 : pp. 300-309 (10 pages)

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Background/Aims: Diagnostic stool multiplex polymerase chain reaction (PCR) testing has attracted considerable interest, because of its high sensitivity, short turnaround time, and ability to detect multiple organisms simultaneously. This study investigates the clinical usefulness of a stool multiplex bacterial PCR in patients with acute diarrhea.
Methods: We retrospectively evaluated the stool multiplex bacterial PCR results, clinical parameters, and clinical courses of patients hospitalized because of acute diarrhea between August 2014 and November 2016.
Results: A total of 725 patients (male, 372; mean age, 30.9 ± 29.3 years) underwent stool multiplex bacterial PCR. A total of 243 pathogens were detected in 226 patients. The detection rate of multiplex PCR testing was higher than that of stool culture (32.7% vs. 3.3%, p < 0.01). Severe symptoms of acute diarrhea (bloody diarrhea, frequent diarrhea) and prescribed empirical antibiotics were significantly more common in the positive multiplex PCR group (p = 0.02, p < 0.01, p < 0.01, respectively). However, mean durations of hospital stay were similar in the 2 groups according to the multiplex PCR results (p = 0.32). In addition, Campylobacter spp., which was the most commonly detected pathogen (97/243, 39.9%), was significantly associated with frequent diarrhea and prescribed empirical antibiotics (p < 0.01), but not with duration of hospital stay (p = 0.09).
Conclusions: We concluded that stool multiplex bacterial PCR might be a useful tool for identifying bacterial etiology in patients with acute diarrhea, especially in those with Campylobacter spp. infection.

KCI등재 SCI

817β-Estradiol reduces inflammation and modulates antioxidant enzymes in colonic epithelial cells

저자 : Hee Jin Son , Nayoung Kim , Chin-hee Song , Sun Min Lee , Ha-na Lee , Young-joon Surh

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 35권 2호 발행 연도 : 2020 페이지 : pp. 310-319 (10 pages)

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Background/Aims: Estrogen is known to have protective effect in colorectal cancer development. The aims of this study are to investigate whether estradiol treatment reduces inflammation in CCD841CoN, a female human colonic epithelial cell line and to uncover underlying mechanisms of estradiol effects.
Methods: 17β-Estradiol (E2) effect was measured by Western blot after inducing inf lammation of CCD841CoN by tumor necrosis factor α (TNF-α). Expression levels of estrogen receptor α (ERα) and β (ERβ), cyclooxygenase-2 (COX-2), nuclear factor-κB (NF-κB), heme oxygenase-1 (HO-1), and NAD(P)H-quinone oxidoreductase-1 (NQO-1) were also evaluated.
Results: E2 treatment induced expression of ERβ but did not increase that of ERα. E2 treatment for 48 hours significantly elevated the expression of anti-oxidant enzymes, HO-1 and NQO-1. TNF-α treatment significantly increased the level of activated NF-κB (p < 0.05), and this increase was significantly suppressed by treatment of 10 nM of E2 (p < 0.05). E2 treatment ameliorated TNF-α-induced COX-2 expression and decrease of HO-1 expression. 4-(2-phenyl-5,7-bis(trifluoromethyl) pyrazolo(1,5-a)pyrimidin-3-yl)phenol (PHTPP), antagonist of ERβ, removed the inhibitory effect of E2 in the TNF-α-induced COX-2 expression (p = 0.05).
Conclusions: Estrogen seems to inhibit inflammation in female human colonic epithelial cell lines, through down-regulation of NF-κB and COX-2 expression and induction of anti-oxidant enzymes such as HO-1 and NQO-1.

KCI등재 SCI

9Immunological measurement of aspartate/alanine aminotransferase in predicting liver fibrosis and inflammation

저자 : Hyun Jeong Kim , Sang Yeol Kim , Suk Pyo Shin , Young Joo Yang , Chang Seok Bang , Gwang Ho Baik , Dong Joon Kim , Young Lim Ham , Eui Yul Choi , Ki Tae Suk

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 35권 2호 발행 연도 : 2020 페이지 : pp. 320-330 (11 pages)

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Background/Aims: Enzymatic analysis of aspartate/alanine aminotransferase (AST/ALT) does not exactly represent the progression of liver fibrosis or inflammation. Immunoassay for AST (cytoplasmic [c] AST/mitochondrial [m] AST) and ALT (ALT1/ALT2) has been suggested as one alternatives for enzymatic analysis. The objective of this study was to evaluate the efficacy of immunoassay in predicting liver fibrosis and inflammation.
Methods: A total of 219 patients with chronic hepatitis B (CHB) who underwent hepatic venous pressure gradient (HVPG) and liver biopsy before antiviral therapy were recruited. Serum samples were prepared from blood during HVPG. Results of biochemical parameters including enzymatic AST/ALT and immunological assays of cAST, mAST, ALT1, and ALT2 through sandwich enzyme-linked immunosorbent assay (ELISA) immunoassay with fluorescence labeled monoclonal antibodies were compared with the results of METAVIR stage of live fibrosis and the Knodell grade of inflammation.
Results: METAVIR fibrosis stages were as follows: F0, six (3%); F1, 52 (24%); F2, 88 (40%); F3, 45 (20%); and F4, 28 patients (13%). Mean levels of AST and ALT were 121 ± 157 and 210 ± 279 IU/L, respectively. Mean HVPG score of all patients was 4.7 ± 2.5 mmHg. According to the stage of liver fibrosis, HVPG score (p < 0.001, r = 0.439) and ALT1 level (p < 0.001, r = 0.283) were significantly increased in all samples from patients with CHB. ALT (p < 0.001, r = 0.310), ALT1 (p < 0.001, r = 0.369), and AST (p < 0.001, r = 0.374) levels were positively correlated with Knodell grade of inflammation.
Conclusions: ALT1 measurement by utilizing sandwich ELISA immunoassay can be useful method for predicting inf lammation grade and fibrosis stage in patients with CHB.

KCI등재 SCI

10Comparison of procedural sequence in same-day bidirectional endoscopy: a systematic review and meta-analysis

저자 : Geun Joo Choi , Hyoung-chul Oh , Hee-kyeong Seong , Jeong Wook Kim , Jin Soo Ko , Hyun Kang

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 35권 2호 발행 연도 : 2020 페이지 : pp. 331-342 (12 pages)

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Background/Aims: To compare the efficacy and safety of procedural sequence in same-day bidirectional endoscopy.
Methods: We searched OVID-MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Google Scholar to identify randomized controlled trials that compared the procedural sequences in same-day bidirectional endoscopy, including esophagogastroduodenoscopy (EGD) and colonoscopy. The sedative and analgesic doses required, discomfort and satisfaction scores, procedure time, recovery time, adenoma detection rate, and failed cecal intubation were evaluated. Adverse effects, including respiratory and cardiovascular complications, were also assessed.
Results: We included six studies, with 1,848 patients in total. The requirement for sedative treatment was significantly lesser in the EGD-colonoscopy sequence than in the colonoscopy-EGD sequence (standardized mean difference [SMD], -0.39; 95% confidence interval [CI], -0.54 to -0.24; p = 0.12; I2 = 49%). Discomfort, scored by patients during the EGD procedure, was significantly lesser in the EGD-colonoscopy sequence than in the colonoscopy-EGD sequence (SMD, -0.45; 95% CI, -0.80 to -0.09; p = 0.02; I2 = 73%), while it was comparable during colonoscopy between the two sequences. Recovery time was significantly shorter in the EGD-colonoscopy sequence than in the colonoscopy-EGD sequence (SMD, -0.47; 95% CI, -0.65 to -0.30; p = 0.28; I2 = 21%). Total procedure duration, EGD, colonoscopy, cecal intubation time and incidence, incidences of pathologic findings, and adenoma detection were comparable between the two sequences. There was no significant difference in the incidences of desaturation, hypotension, hypertension, bradycardia, and tachycardia between the two sequences.
Conclusions: When conducting same-day bidirectional endoscopy, EGD followed by colonoscopy is the most beneficial sequence to be used because patients require lower sedative doses, recover faster, and report lesser discomfort.

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