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대한내과학회> The Korean Journal of Internal Medicine

The Korean Journal of Internal Medicine update

  • : 대한내과학회
  • : 의약학분야  >  내과학
  • : KCI등재
  • : SCOPUS
  • : 연속간행물
  • : 격월
  • : 1226-3303
  • : 2005-6648
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수록정보
수록범위 : 1권1호(1986)~37권3호(2022) |수록논문 수 : 2,705
The Korean Journal of Internal Medicine
37권3호(2022년 05월) 수록논문
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KCI등재 SCOPUS

1Emotional and cognitive changes in chronic kidney disease

저자 : Duk-soo Kim , Seong-wook Kim , Hyo-wook Gil

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 37권 3호 발행 연도 : 2022 페이지 : pp. 489-501 (13 pages)

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Chronic kidney disease (CKD) leads to cognitive impairment and emotional changes. However, the precise mechanism underlying the crosstalk between the kidneys and the nervous system is not fully understood. Inflammation and cerebrovascular disease can influence the development of depression in CKD. CKD is one of the strongest risk factors for cognitive impairment. Moreover, cognitive impairment occurs in CKD as patients experience the dysregulation of several brain functional domains due to damage caused to multiple cortical regions and to subcortical modulatory neurons. The differences in structural brain changes between CKD and non-CKD dementia may be attributable to the different mechanisms that occur in CKD. The kidney and brain have similar anatomical vascular systems, which may be susceptible to traditional risk factors. Vascular factors are assumed to be involved in the development of cognitive impairment in patients with CKD. Vascular injury induces white matter lesions, silent infarction, and microbleeds. Uremic toxins may also be directly related to cognitive impairment in CKD. Many uremic toxins, such as indoxyl sulfate, are likely to have an impact on the central nervous system. Further studies are required to identify therapeutic targets to prevent changes in the brain in patients with CKD.

KCI등재 SCOPUS

2Glomerular filtration rate as a kidney outcome of diabetic kidney disease: a focus on new antidiabetic drugs

저자 : Hyo Jin Kim , Sang Soo Kim , Sang Heon Song

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 37권 3호 발행 연도 : 2022 페이지 : pp. 502-519 (18 pages)

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Diabetes has reached epidemic proportions, both in Korea and worldwide and is associated with an increased risk of chronic kidney disease and kidney failure (KF). The natural course of kidney function among people with diabetes (especially type 2 diabetes) may be complex in real-world situations. Strong evidence from observational data and clinical trials has demonstrated a consistent association between decreased estimated glomerular filtration rate (eGFR) and subsequent development of hard renal endpoints (such as KF or renal death). The disadvantage of hard renal endpoints is that they require a long follow-up duration. In addition, there are many patients with diabetes whose renal function declines without the appearance of albuminuria, measurement of the eGFR is emphasized. Many studies have used GFR-related parameters, such as its change, decline, or slope, as clinical endpoints for kidney disease progression. In this respect, understanding the trends in GFR changes could be crucial for developing clinical management strategies for the prevention of diabetic complications. This review focuses on the clinical implication of the eGFR-related parameters that have been used so far in diabetic kidney disease. We also discuss the use of recently developed new antidiabetic drugs for kidney protection, with a focus on the GFR as clinical endpoints.

KCI등재 SCOPUS

3Omics-based biomarkers for diagnosis and prediction of kidney allograft rejection

저자 : Jeong-hoon Lim , Byung Ha Chung , Sang-ho Lee , Hee-yeon Jung , Ji-young Choi , Jang-hee Cho , Sun-hee Park , Yong-lim Kim , Chan-duck Kim

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 37권 3호 발행 연도 : 2022 페이지 : pp. 520-533 (14 pages)

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Kidney transplantation is the preferred treatment for patients with end-stage kidney disease, because it prolongs survival and improves quality of life. Allograft biopsy is the gold standard for diagnosing allograft rejection. However, it is invasive and reactive, and continuous monitoring is unrealistic. Various biomarkers for diagnosing allograft rejection have been developed over the last two decades based on omics technologies to overcome these limitations. Omics technologies are based on a holistic view of the molecules that constitute an individual. They include genomics, transcriptomics, proteomics, and metabolomics. The omics approach has dramatically accelerated biomarker discovery and enhanced our understanding of multifactorial biological processes in the field of transplantation. However, clinical application of omics-based biomarkers is limited by several issues. First, no large-scale prospective randomized controlled trial has been conducted to compare omics-based biomarkers with traditional biomarkers for rejection. Second, given the variety and complexity of injuries that a kidney allograft may experience, it is likely that no single omics approach will suffice to predict rejection or outcome. Therefore, integrated methods using multiomics technologies are needed. Herein, we introduce omics technologies and review the latest literature on omics biomarkers predictive of allograft rejection in kidney transplant recipients.

KCI등재 SCOPUS

4Role of T cells in ischemic acute kidney injury and repair

저자 : Kyungho Lee , Hye Ryoun Jang

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 37권 3호 발행 연도 : 2022 페이지 : pp. 534-550 (17 pages)

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Ischemic acute kidney injury (AKI) is a common medical problem with significant mortality and morbidity, affecting a large number of patients globally. Ischemic AKI is associated with intrarenal inflammation as well as systemic inflammation; thus, the innate and adaptive immune systems are implicated in the pathogenesis of ischemic AKI. Among various intrarenal immune cells, T cells play major roles in the injury process and in the repair mechanism affecting AKI to chronic kidney disease transition. Importantly, T cells also participate in distant organ crosstalk during AKI, which affects the overall outcomes. Therefore, targeting T cell-mediated pathways and T cell-based therapies have therapeutic promise for ischemic AKI. Here, we review the major populations of kidney T cells and their roles in ischemic AKI.

KCI등재 SCOPUS

5Changes in practice for mechanically ventilated patients: effect of the pain, agitation, and delirium guidelines

저자 : Jin Won Huh

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 37권 3호 발행 연도 : 2022 페이지 : pp. 553-554 (2 pages)

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KCI등재 SCOPUS

6Safety of direct oral anticoagulants compared to warfarin in cirrhotic patients with atrial fibrillation

저자 : Seo Yeon Yoo , Eunju Kim , Gi-byoung Nam , Danbi Lee , Ju Hyun Shim , Kang Mo Kim , Young-suk Lim , Han Chu Lee , Young-hwa Chung , Yung Sang Lee , Jonggi Choi

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 37권 3호 발행 연도 : 2022 페이지 : pp. 555-566 (12 pages)

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Background/Aims: The safety of direct oral anticoagulants (DOACs) compared with warfarin in patients with both nonvalvular atrial fibrillation (AF) and clinically confirmed liver cirrhosis (LC) has not been well studied. We compared the risk of a major bleeding event between DOAC and warfarin treatments in this patient population.
Methods: A total of 238 cirrhotic patients with AF were retrospectively analyzed. The major bleeding event risk was compared between DOAC- and warfarin-treated groups. The median follow-up duration was 5.6 years.
Results: Among the 238 study patients with LC and AF, 128 (53.8%) received DOACs and 110 (46.2%) received warfarin. The mean patient age was 68.8 years, and 78.2% were men. A major bleeding event occurred in 10 and 20 patients in the DOAC and warfarin groups, respectively, most commonly caused by gastrointestinal bleeding (70.0%). The cumulative risk of major bleeding did not differ between the groups by log-rank test (p = 0.12). This finding did not change when using 60 propensity score-matched pairs. A multivariable Cox regression model indicated that the concomitant use of antiplatelet agents (adjusted hazard ratio [aHR], 2.06; 95% confidence interval [CI], 1.00 to 4.30; p = 0.048) and presence of esophageal or gastric varices confirmed by endoscopic examination (aHR, 2.31; 95% CI, 1.03 to 5.17; p = 0.04) were associated with major bleeding in the entire cohort.
Conclusions: A major bleeding event risk is not increased by DOAC compared with warfarin treatment. Antiplatelet agent use and varices are independently associated with a higher risk of major bleeding during anticoagulation.

KCI등재 SCOPUS

7Radiology plus ileocolonoscopy versus radiology alone in Crohn's disease: prognosis prediction and mutual agreement

저자 : Hye Kyung Hyun , Jongwook Yu , Eun Ae Kang , Jihye Park , Soo Jung Park , Jae Jun Park , Tae Il Kim , Won Ho Kim , Jae Hee Cheon

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 37권 3호 발행 연도 : 2022 페이지 : pp. 567-579 (13 pages)

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Background/Aims: The optimal tools for monitoring Crohn's disease (CD) are controversial. We compared radiology plus ileocolonoscopy and radiology alone in terms of prognosis prediction and evaluated the agreement between radiologic and ileocolonoscopic findings in patients with CD.
Methods: Patients with CD who were followed up with computed tomography enterography (CTE) or magnetic resonance enterography (MRE) alone or CTE or MRE plus ileocolonoscopy were retrospectively recruited. Time to relapse was investigated to evaluate the difference in prognosis using the log-rank and Cox regression tests, and the agreement between radiologic and ileocolonoscopic findings was determined using a kappa value.
Results: A total of 501 patients with CD in clinical remission who underwent CTE or MRE and/or ileocolonoscopy were analyzed. Of these, 372 (74.3%) patients underwent CTE or MRE alone and 129 (25.7%) patients underwent CTE or MRE plus ileocolonoscopy. The cumulative maintenance rate of clinical remission between the two groups was not significantly different (p = 0.526, log-rank test). In multivariate analysis, age <40 years (hazard ratio [HR], 2.756; 95% confidence interval [CI], 1.263 to 6.013) and a history of steroid use (HR, 2.212; 95% CI, 1.258 to 3.577) were found to independently predict an increased risk for clinical relapse in patients with CD in clinical remission. Radiologic and ileocolonoscopic findings had a moderate degree of agreement (κ = 0.401, -0.094 to 0.142). The comparison of agreement between radiologic and ileocolonoscopic findings was the highest in the anastomotic site (κ = 0.749, -0.168 to 0.377).
Conclusions: Radiology plus ileocolonoscopy was not superior to radiology alone in predicting the prognosis of CD.

KCI등재 SCOPUS

8Is radiological healing alone enough? 'Can't take my eyes off' the mucosa

저자 : Su Hyun Park , Sang Hyoung Park

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 37권 3호 발행 연도 : 2022 페이지 : pp. 567-568 (2 pages)

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KCI등재 SCOPUS

9Long-term effect of the eradication of Helicobacter pylori on the hemoglobin A1c in type 2 diabetes or prediabetes patients

저자 : Won Seok Kim , Yonghoon Choi , Nayoung Kim , Seon Hee Lim , Gitark Noh , Ki Wook Kim , Jaehyung Park , Hyeongho Jo , Hyuk Yoon , Cheol Min Shin , Young Soo Park , Dong Ho Lee

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 37권 3호 발행 연도 : 2022 페이지 : pp. 579-596 (18 pages)

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Background/Aims: The long-term effect of Helicobacter pylori eradication on the metabolic syndrome or diabetes are unclear. The aim of this study was to evaluate the effect of H. pylori eradication on glycemic control in type 2 diabetes mellitus (T2DM) or prediabetes mellitus (preDM).
Methods: A total of 124 asymptomatic subjects with T2DM or preDM were divided into H. pylori-negative (n = 40), H. pylori-positive with non-eradicated (n = 34), and eradicated (n = 50) groups. We measured H. pylori status (culture, histology, and rapid urease test) and glycated hemoglobin A1c (A1C) levels and followed-up at the 1st year and the 5th year of follow-up.
Results: The A1C levels significantly decreased in the eradicated group compared to the negative group and the non-eradicated groups (at the 1st year, p = 0.024; at the 5th year, p = 0.009). The A1C levels decreased in male, and/or subjects < 65 years of age in subgroup analyses (in male subjects, p = 0.047 and p = 0.020 at the 1st and the 5th year; in subjects < 65 years of age, p = 0.028 and p = 0.006 at the 1st and the 5th year; in male subjects < 65 years of age, p = 0.039 and p = 0.032 at the 1st and the 5th year). The eradication of H. pylori was related to the decrease in A1C values throughout the follow-up period, compared to the non-eradicated group (p = 0.017).
Conclusions: H. pylori eradication was related to the decreasing of A1C levels in patients with T2DM or preDM over a long-term follow-up period, especially in male and subjects < 65 years of age.

KCI등재 SCOPUS

10Off-hour presentation and outcomes for percutaneous coronary intervention in acute myocardial infarction with Killip Ⅲ-Ⅳ

저자 : Seok Oh , Ju Han Kim , Kyung Hoon Cho , Min Chul Kim , Doo Sun Sim , Young Joon Hong , Youngkeun Ahn , Myung Ho Jeong

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 37권 3호 발행 연도 : 2022 페이지 : pp. 591-610 (20 pages)

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Background/Aims: Acute myocardial infarction (AMI) is conventionally recognized as an urgent medical condition requiring timely and effective reperfusion therapy. However, the results of studies on the clinical outcomes in AMI according to hospital visit timings are inconclusive. To explore the difference in long-term outcomes between off- and on-hour percutaneous coronary interventions (PCI) in patients with AMI of Killip functional classification III-IV (Killip III-IV AMI).
Methods: Data on the characteristics and clinical outcomes of 1,751 patients with Killip III-IV AMI between November 2011 and June 2015 from the Korea Acute Myocardial Infarction Registry-National Institutes of Health registry were analyzed. All participants were allocated into two groups: off-hour (weekdays from 6:00 PM to 8:00 AM, weekends, and legal holidays) and on-hour (weekdays from 8:00 AM to 6:00 PM) groups. The incidence of major adverse cardiac and cerebrovascular events, defined as a composite of all-cause mortality, nonfatal myocardial infarction, any revascularization, cerebrovascular accident, and stent thrombosis, was the primary endpoint.
Results: Among the 1,751 patients, 572 (39.1%) underwent PCI during on-hours and 892 (60.9%) during off-hours. At the 3-year follow-up, no significant difference was found in the clinical outcomes between the two groups in both the unadjusted and propensity-score weighing-adjusted analyses.
Conclusions: The outcomes of patients with Killip III-IV AMI admitted during off- and on-hours were similar.

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