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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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수록정보
수록범위 : 1권1호(1986)~34권4호(2019) |수록논문 수 : 2,183
The Korean Journal of Internal Medicine
34권4호(2019년) 수록논문
최근 권호 논문
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KCI등재 SCI

1Current status and therapeutic considerations of hypertension in the elderly

저자 : Ju-hee Lee , Kwang-il Kim , Myeong-chan Cho

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 34권 4호 발행 연도 : 2019 페이지 : pp. 687-695 (9 pages)

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As the prevalence of hypertension in the elderly population is increasing, information regarding the characteristics, optimal blood pressure targets, and special considerations for elderly hypertensive patients is needed to improve clinical outcomes. Various factors should be considered when managing hypertension in elderly patients, and there are many controversial issues and conflicting results related to the optimal treatment of hypertension in the elderly. In this review, we provide an overview of the epidemiology and characteristics of elderly hypertensive patients and discuss the optimal treatment of hypertension in elderly people.

KCI등재 SCI

2Current status of pulmonary arterial hypertension in Korea

저자 : Albert Youngwoo Jang , Wook-jin Chung

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 34권 4호 발행 연도 : 2019 페이지 : pp. 696-707 (12 pages)

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Pulmonary arterial hypertension (PAH) is characterized by remodeling of the distal pulmonary arteries resulting in high pulmonary vascular resistance and, eventually, right ventricular heart failure. Although current advances in PAH therapy have improved outcomes, poor survival remains a reality worldwide, including Korea. One of the most important issues in PAH is the late diagnosis, since screening or diagnostic efforts are often overlooked due to the rarity of disease. Data from Korean registries and observational cohorts show that delayed detection leads to increased morbidity. Additionally, low percentages of Korean patients are committed to intensive PAH-targeted therapy. Current Korean health insurance policies' lack of coverage for new PAH-targeted drugs and upfront combination therapy may also hamper the improvement of treatment outcomes. Understanding individual variability in response to therapeutics through deep phenotyping is a novel strategy that should be considered when treating PAH. Overall, early detection of PAH by proactive screening together with early, intensive, individualized PAH therapy using deep phenotyping is crucial for improving prognoses for PAH patients in Korea.

KCI등재 SCI

3Application of machine learning in rheumatic disease research

저자 : Ki-jo Kim , Ilias Tagkopoulos

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 34권 4호 발행 연도 : 2019 페이지 : pp. 708-722 (15 pages)

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Over the past decade, there has been a paradigm shift in how clinical data are collected, processed and utilized. Machine learning and artificial intelligence, fueled by breakthroughs in high-performance computing, data availability and algorithmic innovations, are paving the way to effective analyses of large, multi-dimensional collections of patient histories, laboratory results, treatments, and outcomes. In the new era of machine learning and predictive analytics, the impact on clinical decision-making in all clinical areas, including rheumatology, will be unprecedented. Here we provide a critical review of the machine-learning methods currently used in the analysis of clinical data, the advantages and limitations of these methods, and how they can be leveraged within the field of rheumatology.

KCI등재 SCI

42018 Guidelines for the management of dyslipidemia

저자 : Eun-jung Rhee , Hyeon Chang Kim , Jae Hyeon Kim , Eun Young Lee , Byung Jin Kim , Eun Mi Kim , Yoonju Song , Jeong Hyun Lim , Hae Jin Kim , Seonghoon Choi , Min Kyong Moon , Jin Oh Na , Kwang-yeol Park ,

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 34권 4호 발행 연도 : 2019 페이지 : pp. 723-771 (49 pages)

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KCI등재 SCI

5Using big data to see the forest and the trees: endoscopic submucosal dissection of early gastric cancer in Korea

저자 : Chang Seok Bang , Gwang Ho Baik

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 34권 4호 발행 연도 : 2019 페이지 : pp. 772-774 (3 pages)

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KCI등재 SCI

7Duodenal Niemann-Pick C1-like 1 expression was negatively correlated with liver X receptor expression in nonalcoholic fatty liver disease

저자 : Sang Bong Ahn , Dae Won Jun , Kiseok Jang , Byung Hoon Lee , Kye Jung Shin

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 34권 4호 발행 연도 : 2019 페이지 : pp. 777-784 (8 pages)

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Background/Aims: Intestinal cholesterol absorption includes intestinal Niemann-Pick C1-like 1 (NPC1L1) and is an important target pathway in nonalcoholic fatty liver disease (NAFLD). We investigated the expression of NPC1L1 and its correlation with liver X receptor (LXR) expression in peripheral mononuclear (PMN) cells in patients with NAFLD.
Methods: We evaluated intestinal expression of NPC1L1 in 25 NAFLD patients and 28 healthy controls. We calculated the mRNA expression levels of LXR and farnesoid X receptor (FXR), which are master players of cholesterol metabolism in PMN cells. The protein expression of ABCA1, ABCG5/8, NPC1L1, SREBP, LXR, FXR, and CD36 was measured on tissue samples from the duodenum and ileum.
Results: The expression of LXR (p = 0.01) and FXR (p = 0.03) in PMN cells was increased in the NAFLD group compared to the control group. Duodenal NPC1L1 decreased in the NAFLD group compared to the healthy controls (3.38 ± 1.4 vs. 2.42 ± 1.2, p = 0.05). NPC1L1 expression in the duodenum was negatively correlated with LXR expression in PMN cells. Expression of LXR and FXR in the ileum was also negatively correlated with the expression of LXR in PMN cells.
Conclusions: Duodenal NPC1L1 expression was decreased in NAFLD and was negatively correlated with LXR expression in PMN cells.

KCI등재 SCI

8Current status of endoscopic submucosal dissection for early gastric cancer in Korea: role and benefits

저자 : Sang Gyun Kim , Da Hyun Lyu , Chan Mi Park , Na Rae Lee , Jiyoung Kim , Youngju Cha , Hwoon-yong Jung

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 34권 4호 발행 연도 : 2019 페이지 : pp. 785-793 (9 pages)

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Background/Aims: This study was aimed to investigate the current clinical status of endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) in Korea based on a National Health Insurance (NHI) database between 2011 and 2014.
Methods: The claims data of ESD for EGC in Korean NHI were reviewed using material codes of Health Insurance Review and Assessment Service between November 2011 and December 2014. The current clinical status was analyzed in terms of treatment pattern, in-hospital length of stay (LOS), total medical costs, and en bloc resection rate according to the hospital type.
Results: A total of 23,828 cases of ESD for EGC were evaluated. ESD was performed in 67.4% of cases in tertiary care hospitals, 31.8% in general hospitals, and 0.8% in hospitals, respectively. The median LOS was 5 days, and total median medical costs was approximately 1,300 US dollars. En bloc resection rate was 99%; 8.5% of cases underwent additional treatment within 90 days ESD, and 5.5% in 91 to 365 days after ESD. The clinical status was not significantly different according to the year and hospital type.
Conclusions: A majority of ESD for EGC were performed in tertiary care hospitals in Korea. The clinical status showed excellent clinical outcomes and did not differ by the year and between the types of hospitals in Korea.

KCI등재 SCI

9Daclatasvir and asunaprevir combination therapy for patients with chronic hepatitis C virus genotype 1b infection in real world

저자 : Jae Young Oh , Byung Seok Kim , Chang Hyeong Lee , Jeong Eun Song , Heon Ju Lee , Jung Gil Park , Jae Seok Hwang , Woo Jin Chung , Byoung Kuk Jang , Young Oh Kweon , Won Young Tak , Soo Young Park , Se Youn

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 34권 4호 발행 연도 : 2019 페이지 : pp. 794-801 (8 pages)

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Background/Aims: Previous studies have reported a high rate of sustained virologic response (SVR) and a low rate of serious adverse events with the use of daclatasvir (DCV) and asunaprevir (ASV) combination therapy. We evaluated the efficacy and safety of DCV and ASV combination therapy for patients with chronic hepatitis C virus (HCV) genotype 1b infection in real world.
Methods: We enrolled 278 patients (184 treatment-naïve patients) from five hospitals in Daegu and Gyeongsangbuk-do. We evaluated the rates of rapid virologic response (RVR), end-of-treatment response (ETR), and SVR at 12 weeks after completion of treatment (SVR12). Furthermore, we investigated the rate of adverse events and predictive factors of SVR12 failure.
Results: The mean age of patients was 59.5 ± 10.6 years, and 140 patients (50.2%) were men. Seventy-seven patients had cirrhosis. Baseline information regarding nonstructural protein 5A (NS5A) sequences was available in 268 patients. Six patients presented with pretreatment NS5A resistance-associated variants. The RVR and the ETR rates were 96.6% (258/267) and 95.2% (223/232), respectively. The overall SVR12 rate was 91.6% (197/215). Adverse events occurred in 17 patients (7.9%). Six patients discontinued treatment because of liver enzyme elevation (n = 4) and severe nausea (n = 2). Among these, four achieved SVR12. Other adverse events observed were fatigue, headache, diarrhea, dizziness, loss of appetite, skin rash, and dyspnea. Univariate analysis did not show significant predictive factors of SVR12 failure.
Conclusions: DCV and ASV combination therapy showed high rates of RVR, ETR, and SVR12 in chronic HCV genotype 1b-infected patients in real world and was well tolerated without serious adverse events.

KCI등재 SCI

10Efficacy of long-term tenofovir disoproxil fumarate therapy in chronic hepatitis B patients with partial virologic response in real practice

저자 : Jeong Eun Song , Chang Hyeong Lee , Byung Seok Kim

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 34권 4호 발행 연도 : 2019 페이지 : pp. 802-812 (11 pages)

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Background/Aims: The optimal management of chronic hepatitis B (CHB) patients with partial virologic response (PVR) to tenofovir disoproxil fumarate (TDF) remains unclear. We aimed to evaluate the long-term efficacy of prolonged TDF therapy in treatment-naïve CHB patients with PVR to TDF therapy in real practice.
Methods: We retrospectively investigated the efficacy of prolonged TDF therapy in treatment-naïve CHB patients with PVR to TDF. PVR was defined as a decrease in serum hepatitis B virus (HBV) DNA over 2 log10 IU/mL from baseline, with detectable HBV DNA by real-time polymerase chain reaction at week 48.
Results: We included 232 patients who underwent TDF therapy for over 48 weeks. Forty-two patients (18.1%) showed PVR. In multivariate analysis, hepatitis B e antigen (HBeAg) positivity, and high levels of serum HBV DNA at baseline and week 12 were independent predictive factors for PVR during TDF therapy. Out of 42 patients with PVR, 39 (92.9%) achieved virologic response (VR) during continuous TDF treatment; the cumulative VR rates at 24, 36, and 48 months were 79.8%, 88.2%, and 95.6%, respectively. With an additional 12 months of therapy, VR was achieved in 28/31 (90.3%) patients with HBV DNA < 100 IU/mL, compared to 5/11 (45.5%) patients with HBV DNA ≥ 100 IU/mL, at week 48.
Conclusions: The vast majority of patients achieved VR through prolonged TDF therapy, thus TDF treatment can be maintained in nucleos(t)ide-naïve patients with PVR at week 48, especially in those with low viremia.

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