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Han S.,Seoul National University | Lee K.-M.,Seoul National University | Park S.K.,Seoul National University | Lee J.E.,DNA Link Inc. | And 10 more authors.
Leukemia Research | Year: 2010

We conducted a genome-wide association study of childhood acute lymphoblastic leukemia (ALL) in a case-control study conducted in Korea. Incident childhood ALL cases (n=50) and non-cancer controls (n=50) frequency-matched to cases by age and sex, recruited from three teaching hospitals in Seoul between 2003 and 2008, were genotyped using Affymetrix SNP Array 6.0 platform. ALL risks were estimated as odds ratios (ORs) and 95% confidence intervals (CIs) adjusted for age and birth weight. The false discovery rate (FDR) was used for adjusting multiple tests. Of these 1 million SNPs, six SNPs in 4 genes (HAO1 rs6140264, EPB41L2 rs9388856, rs9388857, rs1360756, C2orf3 12105972, MAN2A1 rs3776932) were strongly associated with childhood ALL risk (Pdominant≤0.0001 and Ptrend<0.006). These SNPs remained significant after FDR adjustment (FDR value <0.2). Our genome-wide association study in Korea children identified a few genetic variations as potential susceptibility markers for ALL, warranting further replication studies among various ethnic groups. © 2010 Elsevier Ltd.


Kim M.K.,CHA Medical University | Seong S.J.,CHA Medical University | Lee T.S.,Seoul Metropolitan Boramae Hospital | Kim J.W.,Seoul National University | And 3 more authors.
Japanese Journal of Clinical Oncology | Year: 2012

A prospective multicenter trial has been started in Korea to investigate the treatment efficacy of a levonorgestrel-releasing intrauterine system plus medroxyprogesterone acetate in young women with early-stage endometrial cancer. A number of studies have reported the effectiveness of hormonal therapy using systemic progestin in women clinically diagnosed with early endometrial adenocarcinoma at Stage IA, Grade 1, who want to maintain reproductive potential. In addition, several recent studies reported the use of a levonorgestrel-releasing intrauterine system to treat patients at a high risk of perioperative complications who cannot tolerate systemic progesterone because of its adverse effects. However, there has been no prospective multicenter trial that investigated the effectiveness of treatment with systemic progesterone in combination with intrauterine progesterone in young women with endometrial cancer. Young patients with histologically confirmed Grade 1 endometrioid adenocarcinoma that is presumably confined to the endometrium, who desired to preserve their fertility potential, undergo levonorgestrel-releasing intrauterine system insertion and are administered medroxyprogesterone acetate at a dosage of 500 mg/day concurrently. The follow-up and treatment response assessment were implemented at a 3-month interval with office endometrial aspiration biopsy with the levonorgestrel-releasing intrauterine system in place, and dilatation and curettage after removal of the levonorgestrel-releasing intrauterine system. The primary endpoint is the complete response rate. The secondary endpoint is to estimate the consistency of the results of the office endometrial aspiration biopsy with the levonorgestrel-releasing intrauterine system in the uterus and a dilatation and curettage after removal of the levonorgestrel-releasing intrauterine system. © The Author 2012. Published by Oxford University Press. All rights reserved.


Kim S.-H.,Seoul National University | Kim S.-H.,Seoul Metropolitan Boramae Hospital | Kim M.-K.,Seoul National University | Seo H.-S.,Korea University | And 5 more authors.
Clinical Therapeutics | Year: 2013

Background: Flexibility in the recommended dosing time for a statin may improve patient compliance. Objective: This study was designed to compare the efficacy and tolerability of morning and evening doses of controlled-release simvastatin in Korean adults with dyslipidemia. It was carried out as a requirement to obtain authorization from the Korean regulatory agency to market the product. Methods: In this prospective, randomized, double-blind, multicenter, placebo-controlled Phase III study, we randomly assigned 132 patients with hypercholesterolemia to a morning-dose group or an evening-dose group. Patients in the morning-dose group received 20 mg controlled-release simvastatin in the morning and a placebo in the evening, and those in the evening-dose group received a placebo in the morning and 20 mg controlled-release simvastatin in the evening. Results: After 8 weeks of the treatment, the difference in the mean change of LDL-C between the morning-dose and evening-dose groups was -2.78% (95% confidence interval, -7.65 to 2.10). The changes in total cholesterol, triglycerides, HDL-C, apolipoprotein A1, apolipoprotein B, and lipoprotein (a) after treatment did not differ between groups. Also, the achievement rates of the target LDL-C goal suggested by the dyslipidemia treatment guideline of the Korean Society of Lipidology and Atherosclerosis were not different. No serious adverse event was observed in either group. Mild and moderate adverse events were observed similarly in both groups. Conclusions: Although controlled-release simvastatin significantly reduces LDL-C levels with good tolerability in Korean adults with dyslipidemia, the time of administration does not affect its efficacy. © 2013 Elsevier HS Journals, Inc.


Song S.H.,Jeungpyung Health Center | Son H.,Seoul Metropolitan Boramae Hospital | Kim K.T.,Aerospace Medical Center | Kim S.W.,Catholic University of Korea | And 7 more authors.
Asian Journal of Andrology | Year: 2011

This study was undertaken to determine the impact on ejaculatory function of tamsulosin (0.2mg) given once daily (OD) for 12 weeks and to identify risk factors for ejaculatory dysfunction in patients undergoing this treatment. Males with an International Prostatic Symptom Score (IPSS) 8 were enrolled in this study. All participants completed questionnaires, including the IPSS and the Male Sexual Health Questionnaire (MSHQ), and serum prostate-specific antigen, transrectal ultrasound and uroflowmetry with post-void residual were measured. After initiating 0.2mg OD tamsulosin, patients were re-evaluated on the fourth and twelfth weeks of medication. The chi-squared test, the independent t-test and one-way ANOVA were used to compare means. Binary logistic regression analysis was used to calculate the odds ratio for all risk factors. A total of 177 men constituted the study cohort. No significant difference was observed between baseline and follow-up for the erectile function, ejaculatory function, satisfaction, sexual activity and desire domains (EFD, EjFD, SDA and ADD) or for erectile or ejaculatory bother mean scores. After 12 weeks, the overall incidence of ejaculatory dysfunction (EjD) was 13.4%. Incidences of the seven different types of EjD (decreased frequency, delay, dryness, decreased strength/force, decreased volume, decreased pleasure and pain at ejaculation) were 2.4%, 3.1%, 3.9%, 3.9%, 6.3%, 7.1% and 3.1%, respectively. Baseline EjFD scores were higher for IPSS responders than for non-responders (26.09 vs. 24.06, P<0.03). An EjFD score reduction was more frequent in IPSS responders. The incidence of EjD was small, but not negligible and was more frequent in patients with less lower urinary tract symptoms, a smaller prostate, higher baseline MSHQ totals and higher EjFD scores. © 2011 AJA, SIMM &SJTU. All rights reserved.


Lee T.S.,Seoul Metropolitan Boramae Hospital | Seong S.J.,CHA Medical University | Kim J.W.,Seoul National University | Ryu H.S.,Ajou University | And 2 more authors.
Japanese Journal of Clinical Oncology | Year: 2011

A prospective multicenter trial has been commenced in Korea to investigate the treatment efficacy of the levonorgestrel-releasing intrauterine system in patients with endometrial hyperpla-sia. The levonorgestrel-releasing intrauterine system is an alternative to oral progesterone without the disadvantages of oral progestogens. Therefore, we hypothesize that if the thera-peutic efficacy of the levonorgestrel-releasing intrauterine system is similar to or greater than that of oral progesterone, the levonorgestrel-releasing intrauterine system could become the standard treatment for endometrial hyperplasia patients who do not want a hysterectomy. The levonorgestrel-releasing intrauterine system is inserted into uteri of patients with histologically confirmed endometrial hyperplasia. An office endometrial aspiration biopsy and transvaginal ultrasound are conducted every 3 months at an outpatients clinic. The primary endpoint is the response rate. The secondary endpoint is to estimate the consistency of the results of the office endometrial aspiration biopsy during the levonorgestrel-releasing intrauterine system being placed in uterus and a dilatation and curettage procedure. © The Author (2011). Published by Oxford University Press. All rights reserved.


PubMed | Seoul National University, Seoul Metropolitan Boramae Hospital, Asan Medical Center, Chungbuk National University and 2 more.
Type: Journal Article | Journal: Journal of clinical neurology (Seoul, Korea) | Year: 2015

The functional recovery after the lateral medullary infarction (LMI) is usually good. Little is known about the prognostic factors associated with poor outcome following acute LMI. The aim of this study was to identify the factors associated with poor long-term outcome after acute LMI, based on experiences at a single center over 11 years.A consecutive series of 157 patients with acute LMI who were admitted within 7 days after symptom onset was evaluated retrospectively. Clinical symptoms were assessed within 1 day after admission, and outcomes were evaluated over a 1-year period after the initial event. The lesions were classified into three vertical types (rostral, middle, and caudal), and the patients were divided into two groups according to the outcome at 1 year: favorable [modified Rankin Scale (mRS) score 1] and unfavorable (mRS score 2).Of the 157 patients, 93 (59.2%) had a favorable outcome. Older age, hypertension, dysphagia, requirement for intensive care, and pneumonia were significantly more prevalent in the unfavorable outcome group. The frequencies of intensive care (13%) and mortality (16.7%) were significantly higher in the rostral lesion (p=0.002 and p=0.002). Conditional logistic regression analysis revealed that older age and initial dysphagia were independently related to an unfavorable outcome at 1 year [odds ratio (OR)=1.04, 95% confidence interval (95% CI)=1.001-1.087, p=0.049; OR=2.46, 95% CI=1.04-5.84, p=0.041].These results suggest that older age and initial dysphagia in the acute phase are independent risk factors for poor long-term prognosis after acute LMI.


Lee T.S.,Seoul Metropolitan Boramae Hospital | Lee T.S.,Seoul National University | Kim J.W.,Seoul National University | Kim D.Y.,University of Ulsan | And 4 more authors.
Journal of Korean Medical Science | Year: 2010

To determine whether radical hysterectomy is necessary in the treatment of endometrial cancer patients with cervical involvement, we reviewed the medical records of women who underwent primary surgical treatment for endometrial carcinoma and selected patients with pathologically proven cervical invasion. Among 133 patients, 62 patients underwent extrafascial hysterectomy (EH) and 71 radical or modified radical hysterectomy (RH). The decision regarding EH or RH was made at the discretion of the attending surgeon. The sensitivity of pre-operative magnetic resonance imaging for cervical invasion was 44.7% (38/85). In RH patients, 10/71 (14.1%) patients had frankly histologic parametrial involvement (PMI). All were stage III or over. Eight of 10 patients had pelvic/paraaortic node metastasis and two showed extrauterine spread. In 74 patients with stage II cancer, RH was performed in 41 and PMI was not seen. Sixty-six (89.2%) patients had adjuvant radiation therapy and there were 3 patients who had developed recurrent disease in the RH group and none in the EH group (Mean follow-up: 51 months). Although these findings cannot conclusively refute or support the necessity of radical hysterectomy in patients with cervical extension, it is noteworthy that the risk of PMI seems to be minimal in patients with a tumor confined to the uterus without evidence of extrauterine spread. © 2010 The Korean Academy of Medical Sciences.


Kim H.,Seoul National University | Lee C.-K.,Seoul National University | Yeom J.S.,Seoul National University | Lee J.H.,Seoul Metropolitan Boramae Hospital | And 4 more authors.
European Spine Journal | Year: 2013

Purpose: This study was undertaken to assess the change of psoas and paravertebral muscles in patients with degenerative scoliosis. Methods: Eighty-five patients with degenerative scoliosis were evaluated with simple radiography for the location and direction of the apex of scoliosis, coronal Cobb's angle, rotational deformity and lumbar lordosis, and with magnetic resonance imaging scan at the apex level of each patient, the cross-sectional area (CSA) and the fatty infiltration rate (FI) of bilateral paravertebral and psoas muscles were measured and the values of convex and concave side were compared. Results: Fifty-three patients had apex of curves on the left side and thirty-two patients on the right. The mean Cobb's angle was 17.9. The difference index of CSA (CDI) of psoas and multifidus muscle at apex of curvature level was significantly larger in convex side rather than that in concave side (by 6.3 and 8.4 % with P = 0.019 and 0.000, respectively). FI of each muscle showed no significant difference. Conclusions: Hypertrophy of the muscles on the convex side is suggested as the explanation of this asymmetry rather than atrophy of the muscles on the concave side as muscle atrophy is known to be associated with increased fatty infiltration. © 2013 Springer-Verlag Berlin Heidelberg.


Kim S.-H.,Seoul National University | Kim S.-H.,Seoul Metropolitan Boramae Hospital | Kim M.-K.,Seoul National University | Lee H.-Y.,Seoul National University | And 3 more authors.
European Journal of Clinical Nutrition | Year: 2011

Background:This study was designed to evaluate the effects of omega-3 fatty acids supplements and simvastatin on lipoproteins and heart rate variability (HRV), a surrogate parameter of cardiac autonomic function, in patients with mixed dyslipidemia.Methods:This study was a prospective, randomized, open-label study. Among the 171 patients screened, 62 who met the inclusion criteria after 6 weeks on a strict diet therapy were randomized into two treatment groups. The inclusion criteria were mixed dyslipidemia with a high triglyceride level (200-499 mg per 100 ml) and a total cholesterol level 200 mg per 100 ml. After a run-in period of 6 weeks, the patients were randomized into two groups and given a combination treatment with 4 g of omega-3 fatty acids (four 1 g Omacor (eicosapentaenoic acid, 465 mg; docosahexaenoic acid, 375 mg; other omega-3 fatty acids, 60 mg; others 100 mg, Gun-il Pharmacy, Seoul, Korea)) and 20 mg of simvastatin daily or a monotherapy of 20 mg simvastatin for 6 weeks. In the combination therapy group, seven patients dropped out, and in the simvastatin alone therapy group, five patients dropped out during the study period.Results:After 6 weeks of drug treatment, triglyceride levels decreased by 41.0% in the combination treatment group and 13.9% in the simvastatin monotherapy group (from 309.2±95 mg per 100 ml to 177.7±66 versus 294.6±78 mg per 100 ml to 238.3±84 mg per 100 ml, respectively, P=0.0007). No significant changes in the HRV parameters were observed in either group.Conclusion:The combination of omega-3 fatty acids plus simvastatin, which achieved a significantly greater reduction of triglycerides without adverse reactions, should be considered as an optimal treatment option for patients with mixed dyslipidemia. © 2011 Macmillan Publishers Limited All rights reserved.


Jeong I.-K.,Seoul National University | Cho S.W.,Seoul National University | Kim S.W.,Seoul National University | Kim S.W.,Seoul Metropolitan Boramae Hospital | And 7 more authors.
Calcified Tissue International | Year: 2010

Although it has been hypothesized that an atherogenic lipid profile might be associated with lower bone mineral density (BMD), the previous results are controversial. We investigated the association between lipid profile and BMD in premenopausal and postmenopausal women in a large Korean population. This study considered 10,402 women who underwent measurements of lipid profile and BMD from October 2003 to October 2005 at Healthcare System Gangnam Center, Seoul National University Hospital. Participants with potential confounding factors affecting BMD (n = 3,128) were excluded. The associations between lipid profiles (total cholesterol [TC], low-density lipoprotein [LDL-C] and high-density lipoprotein [HDL-C] cholesterol, and triglyceride [TG]) and BMD at various skeletal sites (lumbar spine [L1-L4], proximal total hip, femoral neck, and trochanter) were explored by Pearson's correlation and partial correlation, adjusting for age, body mass index, and menarche age. Multiple linear regression analyses adjusting for all other covariates were also performed. Data on 4,613 premenopausal and 2,661 postmenopausal women aged 20-91 years were finally included in the analysis. In multivariate analyses, there was no significant relationship between lipid profiles and BMD, except that HDL-C was positively associated with BMD at only the lumbar spine in postmenopausal women and that the quartiles of TG were negatively associated with BMD at the total hip and trochanter in only premenopausal women. We conclude that although there were some weak associations between lipid profiles and BMD, the results of this study hardly support the hypothesis that an atherogenic lipid profile is associated with osteoporosis. © 2010 Springer Science+Business Media, LLC.

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